Vocational Rehabilitation Services Manual C-200: Technology Services

Texas Workforce Commission–Vocational Rehabilitation Services (TWC-VR) sponsors:

• rehabilitation engineering;
• assistive technology devices; and
• assistive technology services.

VR counselors may use rehabilitation technology services at any time during the case, as necessary, to:

• conduct assessments;
• achieve the customer's planned goal and objectives; or
• provide authorized services to the customer's family members. See C-1400: Supplemental Services.

Consultation is available from the following:

• Designated regional program specialist (RPS)
• Program specialist for assistive and rehabilitation technology (PSART) in state office
• Assistive technology subject matter expert (AT SME)
• Assistive technology unit subject matter expert (ATU SME)
• Employment assistance specialist (EAS)
• Assistive technology professional specialist (ATP)
• Vehicle modification evaluation subject matter expert (VME SME)
• Vocational rehabilitation teacher (VRT)
• Assistive Technology Specialist (ATS) in each unit

For information services specific to customers who work on farms or ranches, see Texas AgrAbility.

If a counselor has determined that an exception will facilitate a customer’s progress and there is not an approval exception listed in policy, counselors are encouraged to staff the request through their chain of management to the Deputy Division Director for Field Services for consideration. VRSM clearly states when no exceptions are allowed.

The mission of the Assistive Technology Unit (ATU) is to work in partnership with TWC-VR customers who have a primary disability of vision loss and staff to provide AT evaluations to help VR customers identify which AT products will best meet their educational and vocational goals.

In addition to providing AT evaluations, ATU tests and trains the contracted AT services training and evaluation providers, reviews new AT products, and maintains the information resources that AT services providers use to deliver services to VR customers.

C-202-1: Referral to the Assistive Technology Unit

VR counselors must contact the EAS for an initial consultation before referring a customer for an ATU AT evaluation. Once the EAS consultation report or basic consultation report is entered into ReHabWorks, the VR counselor sends a service record to ATU for an AT evaluation.

C-202-2: Services

Evaluation

And ATU evaluator shows a customer products listed in specific categories based on the recommendations in the EAS or basic consultation report to help the customer determine which technology most effectively meets his or her vocational and educational needs. An AT evaluation usually last two to three hours.

C-202-3: Prerequisites for Evaluation

An EAS consultation report or basic consultation report is required for all referrals to ATU except for referrals to evaluate stand-alone and portable video magnifiers.

C-202-4: Follow-Up

The ATU evaluator enters a case note titled Report—Equipment Recommendation, which contains specific AT recommendations with proper justification, as appropriate.

An AT Evaluation Report may include recommendations for specific AT training for products that the customer selects in the AT evaluation. VR purchases AT services, including evaluation and training from contracted AT services providers.

For information on AT evaluation and training available from providers to help customers succeed at work, school, and/or in vocational training, refer to the VR Standards for Providers Chapter 9: Assistive Technology for Sight-Related Disabilities.

Vehicle modification services help Vocational Rehabilitation (VR) customers achieve competitive integrated employment outcomes. Through use of a personal vehicle, these services provide equitable transportation opportunities for individuals with disabilities. The goal of vehicle modification is to promote greater independence and access to communities, educational institutions, and other supports necessary to locate jobs, sustain work and living arrangements, and enable career advancement and related travel. The vehicle modification process includes five phases, as follows:

1. Criteria for assistance review and approval
2. Evaluation and training
3. Vehicle selection and Texas A&M Transportation Institute (TTI) review
4. Installation and other considerations
5. Vehicle delivery and final configuration

Vehicle modification needs can arise at any time during the VR process and must be addressed as soon as possible. Services are considered substantial even though the customer might not be the driver of the modified vehicle (for example, passenger-only lowered-floor vehicle conversions). All vehicle modifications must be included on the customer's individualized plan for employment (IPE) before proceeding with related services. This section of the Vocational Rehabilitation Services Manual provides information about vehicle modification, organized by phase.

Effective Communication

Effective communication is essential to successfully navigate all five phases of the vehicle modification process. Customers and VR counselors must regularly discuss progress and needs. Tracking tools and other resources must be used to promote accountability and transparency. The assistive technology specialist (ATS) assigned to oversee vehicle modifications must engage in effective communication with the customer regularly, usually on a weekly basis (but at least once every 30 days).

Contacting the customer does not necessarily qualify as effective communication. Instead, effective communication must include discussion of progress, needs, questions, and planning next steps in the vehicle modification process. To avoid misunderstandings and delays, all parties involved in vehicle modification must be included in communications about process status and expectations. Everyone has important roles and responsibilities to ensure success.

A New Paradigm for Vehicle Modification Services

Please note that before March 1, 2021, most responsibilities for facilitating vehicle modification services were delegated to the VR counselor. This is no longer the case. After the decision is made to pursue vehicle modification services, the ATS now exercises a leadership role and has a responsibility to move the vehicle modification process from start to finish.

The Vehicle Modification Team's Roles and Responsibilities

Vehicle modification requires coordination and team effort. Members of the vehicle modification team (VM team) include the customer, VR counselor, ATS, service providers, and the state office.

The customer's roles and responsibilities in vehicle modification are to:

• become fully informed about vehicle modification rules and schedules;
• proactively obtain and complete all necessary documentation;
• practice effective communication about their needs; and
• seek advice from the VM team to arrive at informed choices.

The VR counselor's roles and responsibilities in vehicle modification are to:

• provide counseling and guidance to the customer regarding transportation opportunities and responsibilities;
• identify criteria for vehicle modification assistance in communication with the customer;
• coordinate with the VM team to ensure quality, timely services; and
• assist the customer in making informed choices.

The ATS's roles and responsibilities in vehicle modification are to:

• provide leadership and expertise to advance the vehicle modification process;
• educate the customer about processes, opportunities, and responsibilities;
• coordinate all VM team members and services;
• enter progress documentation case notes in ReHabWorks (RHW);
• maintain effective communication among all VM team members to support roles; and
• set up and generate all service records and authorizations as indicated in the IPE.

The service providers' roles and responsibilities in vehicle modification are to:

• abide by requirements in the VR Standards for Providers (VR-SFP) manual;
• educate the customer about TWC-VR state approved equipment and options;
• provide accurate and timely documentation as requested; and
• proactively pursue effective communication with the customer and the ATS.

The state office's roles and responsibilities in vehicle modification are to:

• ensure timely advancement of vehicle modifications and delivery of services;
• coordinate with Texas A&M Transportation Institute for compliance;
• practice effective stewardship over the assistive technology budget; and
• moderate disagreements and facilitate conflict resolution.

C-204-1: Phase 1—Criteria for Assistance Review and Approval

Phase in Brief

• Criteria for Assistance Review
• Justification and Approval
• VM Request to State Office

During the first phase of vehicle modification, needs are identified and core members of the VM team are assembled. The VR counselor and customer must carefully approach this task in a timely manner to ensure the success of subsequent phases. It is important to set reasonable expectations while discussing criteria for assistance and plan for logistical and scheduling challenges that may arise.

Criteria for Assistance Review

Before seeking any service approvals, the VR counselor and customer must determine whether vehicle modification is the best option to provide equitable transportation opportunities. Vehicle modification is an example of rehabilitation technology and, therefore, is not subject to consideration of comparable benefits. However, basic living requirements (BLR) still apply for determining customer cost contributions (if any).

Consider vehicle modification when the following criteria for assistance are met:

• Because of the customer's disability, the customer could benefit from a modified vehicle for greater independence and access to communities, educational institutions, or other supports necessary to locate jobs, sustain work and living arrangements, or enable career advancement and related travel.
• The customer has enough income or other resources or achieving the planned employment goal will result in enough income or other resources to cover future payments, insurance premiums, gasoline, and routine maintenance costs for the vehicle.

Note: When considering a vehicle modification for a student with a disability, additional specific stipulations must be met. Staff must forward relevant case information to the state office transition team for review via the Pre-ETS mailbox before including any vehicle modification services on the IPE. More information can be found in VRSM C-1305-6: Providing Pre-Employment Transition Services.

Justification and Approval

Once the VRC has determined a vehicle modification is needed, VR Supervisor approval is required for vehicle modification services to include all associated costs. Refer to E-200: Summary Table of Approval, Notifications, and Consultations. The justification and approval must be documented in RHW, and the customer's IPE must be amended accordingly. Furthermore, the customer must continue to meet the aforementioned criteria for assistance throughout the vehicle modification process.

VM Request to State Office

Following approval, VR staff emails a request for vehicle modification to the PSART@twc.texas.gov mailbox using the specified Vehicle Modification Request cover sheet. The state office logs the request, and a program specialist for assistive and rehabilitative technology (PSART) assigns it to an ATS. Notification is then sent via email to the VR counselor and to the assigned ATS with instructions about coordination, communication, and standards.

The VR counselor then contacts the customer and the assigned ATS to expedite an introductory planning meeting (remote or in person) to review the vehicle modification process and plan next steps. During this planning meeting, the ATS becomes familiar with the customer's individualized needs and facilitates services accordingly.

C-204-2: Phase 2—Evaluation and Training

Phase in Brief

• Driver's Evaluation
• Driver's Training

Not every vehicle modification request necessitates a driver's evaluation and training. Drivers whose disabilities have not significantly changed and are nonprogressive may move immediately to phase three of the vehicle modification process. However, a driver's evaluation and training are needed in most cases.

Driver's Evaluation

The customer must complete a driver's evaluation with appropriate equipment if:

• the customer has never driven;
• the customer has never driven with adaptive equipment;
• the customer's adaptive equipment may change; or
• the customer's condition or disability has significantly changed or is progressive.

If a driver's evaluation is needed, the VRC will enter a service justification case note for this evaluation, if the case is not in employment phase in RHW.  If the case is in employment phase in RHW an IPE amendment is required.  During the introductory meeting, the customer consults with the ATS and makes an informed choice regarding the evaluation provider. The completed driver's evaluation must be submitted as soon as possible, but always before six months after the date of completion, to be included in VR3408, Vehicle Modification Evaluation. The ATS must support and assist the customer in a timely manner with completing and gathering all required documents for the chosen provider. Whenever possible, the services of a certified driving rehabilitation specialist (CDRS) are preferred.

A driver's evaluation always requires a license (or learner's permit) and a prescription. Items specific to the provider may include referral forms, medical records requests, and other safety forms, waivers, and paperwork. Once all required documents are obtained, the ATS issues a service authorization for the provider.

The report from the driver's evaluation is sent to the ATS to discuss with the customer. At this point, the customer may be determined ready to drive, in which case the VM team proceeds to phase three. Otherwise, the customer may need training or may be determined not ready to drive even with appropriate adaptive equipment.

Driver's Training

Driver's Training is considered a substantial service that must be included on the customer's IPE. If the driver's evaluation provider recommends further training, the ATS consults with the PSART regarding the recommendation to reach an agreement with the provider. Once training hours are determined, the VR counselor amends the customer's IPE accordingly. At the conclusion of approved training, the ATS reviews progress reports and consults with the PSART regarding additional training. After all training is complete, the customer receives a recommendation from the driver evaluator. Regardless of whether the customer will be a driver or passenger only, the vehicle modification process then advances to phase three.

C-204-3: Phase 3—Vehicle Selection and TTI Review

Phase in Brief

• Vendor and Vehicle Selection
• TTI Review and VR3408
• Purchasing Considerations

During phase three, the customer works with the VM team to make an informed decision about selecting service providers (also called vendors), vehicles, and modifications. The comprehensive list of TWC-approved lowered-floor conversions and modification equipment can be found on the TTI-TWC website. The present subsection is intended to provide only an overview of the selection process.

Vendor and Vehicle Selection

The ATS has a responsibility to work with the customer to review a list of approved vendors near the customer's area of residence. If needed, the ATS consults with the PSART for a complete list of vendors to support the customer's informed choice. The ATS sends a copy of the driver's evaluation recommendations, if applicable, to the selected vendor for completion of the vendor's portion of the VR3408, Vehicle Modification Evaluation. At no cost to the VR program, the vendor then prepares a proposal for the modification using VR3408, Vehicle Modification Evaluation. Before completing and submitting this proposal, the vendor must first meet with the customer. During this meeting, the vendor collects information about mobility needs and relevant measurements, including the customer's weight and height inclusive of any applicable mobility device. The vendor also discusses available options for vehicles, modifications, and equipment.

Approved vehicle modifications may include anything from a minor installation of hand controls, to a wheelchair securement system in a passenger vehicle, to a lowered-floor conversion. Vehicles for modification may be used or new, but VR may pay only for new modification equipment. Salvaged vehicles are not acceptable for any type of modifications. Additionally, VR may not sponsor modifications or purchase equipment for:

• a vehicle not owned by the customer or an immediate family member (for example, a spouse or parent);
• a vehicle without a current state registration and license plates; or
• appearance rather than function.

The purpose of vehicle modification is to ensure that the functionality and safety of the vehicle meet the customer's needs. Changes that only modify interior and exterior appearance, or that are only cosmetic in nature and do not improve the function of the vehicle, may not be included in requests for modifications and equipment.

Please contact the PSART when in doubt about vehicles, modifications, or equipment.

TTI Review and VR3408

Once a potential vehicle has been identified, the ATS must request a review of the vendor's vehicle modification proposal using the TTI-TWC website. The ATS first ensures the make, model, year, and mileage of the vehicle that the customer plans to purchase are in the completed VR3408 and are permitted by policy. The ATS also checks the quote against the TWC Accepted Products/Pricing List to ensure that all products are on the list and priced appropriately. Any pricing or product discrepancies that the ATS is not able to resolve are referred to the PSART for further guidance. VM reviews under $1,500 are at no cost.

TTI reviews verify whether the:

• vendor's quoted cost of the modification equipment is correct;
• CDRS's prescription appears to meet the customer's needs; and
• specifications for equipment meet TWC-VR standards.

TTI immediately acknowledges via email review requests that are submitted electronically through the TTI-TWC website. The review process can take up to 10 business days after receipt of all required documents. TTI emails the review letter to the ATS. The ATS, with guidance from the PSART if needed, addresses any findings by TTI with vendors and sends a courtesy copy of the corrected VR3408 to TTI.

The ATS works with the VM team to complete the following forms:

• VR3410, Vehicle Modification Agreement, which the customer signs to acknowledge essential roles in the vehicle modification process and individual responsibilities to maintain modification equipment by adhering to periodic maintenance or adjustments needed on a periodic basis (typically every six months) for the life span of the vehicle and equipment (usually seven to 10 years). The customer's signature is required for the vehicle modification process to continue.
• VR3411, Vehicle Modification Notice to Lien Holder, which explains ownership of the equipment being installed (The signed form is submitted to the lien holder.)

The VR counselor amends the customer's IPE to include modifications after the ATS has verified that the vehicle purchased is the same vehicle described in the submitted packet. After the IPE has been updated, a service authorization must be issued before the vendor begins the vehicle modification process and before any customer or vendor purchases of vehicles or equipment occur.

Purchasing Considerations

Subsequent to completion of VR3408, VR3410, and VR3411, the ATS completes a service record for the vehicle modification equipment using the appropriate state office budget. The ATS sends a request to the PSART mailbox to review and release the funds. Once the funds have been released, the ATS generates applicable service authorizations and delivers them to the vendor.

New vehicles are often preferred for lowered-floor conversions. However, the ATS and the customer may consider the purchase of a reliable used or pre-owned vehicle. The VM team must verify all applicable items, such as the vehicle's reliability and serviceability, age, mileage, and insurance coverage. All vehicles with more than 30,000 miles or that are more than four years old need a mechanic evaluation by a certified mechanic using VR3494, Mechanic's Evaluation—Used Vehicle. The ATS requests a CarFax from TTI at no cost. VR may pay for the cost of the evaluation (see VR3494).

Lowered-floor conversions, whether used or new, require special consideration. Not all vehicles are suitable for lowered-floor conversions. As mentioned at the beginning of this subsection, the complete list of approved vehicles for lowered-floor conversions are on the TTI-TWC website. Mobility providers are located around the state and specialize in this type of vehicle. The ATS must contact the PSART to identify provider locations. For a used vehicle to be considered for a lowered-floor conversion, it must have fewer than 30,000 miles, pass the requisite mechanic inspection, and have no evidence of ever having been in a wreck.

C-204-4: Phase 4—Installation and Other Considerations

Phase in Brief

• Installation and Equipment Setup
• Payment Procedures
• Modification Repairs and Reclamations

During phase four, to help avoid delays, the VM team must work to ensure that all modifications have been accurately requested, documented, installed, and fitted. It is essential to maintain effective communication with all service providers.

Installation and Equipment Setup

During phase four, all mobility providers must follow the requirements outlined in VR Standards for Providers, Chapter 22: Vehicle Modifications. Once all modifications have been installed, the local vendor schedules the final fitting with the customer and makes any needed adjustments before proceeding to phase five.

Payment Procedures

VR may help with the base cost or chassis (before modifications) of the vehicle. Vehicle purchasing assistance helps defray initial costs that the customer must pay to take possession of the vehicle to be modified, such as down payment, registration fees, and initial insurance. However, VR does not purchase vehicles outright for customers. TWC limits vehicle purchasing assistance to a maximum of $4,000 down payment, based on demonstrated financial need, and this requires VR Supervisor approval before the VR counselor may include it on the customer's IPE. All payments related to vehicle modification are made directly to the customer in the form of a warrant mailed directly to the customer via USPS mail using the following process:

1. Create the service authorization.
2. Once the payment is authorized, email rtm.revenue.accounting@twc.texas.gov and request the Special Handling Form F-29 (695).
3. Complete the form and return it to rtm.revenue.accounting@twc.texas.gov. This step must be completed before the warrant number is issued.
4. Send the warrant to the customer via USPS mail and verify receipt.
5. Verify that the vendor receives down payment assistance in the amount issued on the warrant and document this with a case note.

VR may also help make the customer's vehicle payments on modified vehicles, up to the full monthly payment, for up to six consecutive months. This assistance requires VR Supervisor approval before the VR counselor may include it on the customer's IPE and may be authorized only when:

• the customer's financial circumstances create a temporary inability to make the payments;
• the customer's current modified vehicle is being replaced with another vehicle;
• the customer cannot pay for both vehicles at the same time; or
• the customer cannot sell the current vehicle until modifications on the replacement vehicle are completed.

All payments are made directly to the customer via the process detailed above.

Modification Repairs and Reclamations

In certain circumstances, VR may sponsor repairs to adaptive equipment and vehicle modifications. For additional information on vehicle repairs, see C-1402: Transportation Services. The ATS obtains a price quote and submits a repair pricing review electronically to TTI (see the TTI-TWC website). Once the TTI report has been received and reviewed by the ATS, the IPE is amended by the VRC and a service authorization is issued. In some cases, it may be best to replace equipment instead of repairing it. The PSART should be consulted as needed.

VR does not reclaim equipment that is broken, outdated, or no longer under warranty (see VR-SFP). If VR participated in paying for the cost of the vehicle modifications and a customer's vehicle is involved in a collision, or in the event of a customer's death, the VR counselor contacts the PSART in the state office.

If in doubt, the VR counselor contacts the PSART. For additional information about repairing a vehicle, see C-1402-9: Vehicle Repair.

C-204-5: Phase 5—Vehicle Delivery and Final Configuration

Phase in Brief

• Verification of Insurance
• Delivery and Inspection
• Post-Modification Training

During phase five, the vendor notifies the VM team that all modifications have been installed with necessary fittings and adjustments. The ATS coordinates verification of insurance, delivery and inspection, and any needed post-modification training.

Verification of Insurance

The customer must obtain, at the customer's own expense, insurance that covers the replacement cost of all sponsored modifications. The customer is required to carry full comprehensive coverage on the vehicle and adaptive equipment. Before releasing the vehicle, the ATS must obtain and file a copy of the paid insurance policy in the case file.

Delivery and Inspection

For vehicle modifications that cost less than $9,000, the ATS must inspect the vehicle and equipment after the work has been completed but before the vehicle is released to the customer. The ATS must coordinate the inspection with the VM team.

Note: Passenger-only lowered-floor conversions do not require TTI inspection but do require the ATS to inspect the vehicle before it may be released to the customer. However, TTI must inspect all other vehicle modifications that cost more than $9,000. TTI may also inspect a modification that costs less than $9,000 at the request of the ATS or PSART. The ATS also needs to attend the inspection.

For inspections costing more than $9,000, the ATS completes a service record for $3,000 to:

Texas A&M Transportation Institute
Texas A&M University System
College Station, Texas 77843-3135
Service Provider ID No. 3-727727727-5-999

The ATS emails a request to PSART@twc.texas.gov  to review and release the funds.  Once the funds have been released, the ATS generates applicable service authorizations. The ATS submits a vehicle inspection request through the TTI portal.

Once the inspection has been completed, the ATS places a copy of VR3474, Vehicle Modification Acceptance, the vendor invoice, warranty information, and other paperwork obtained at the inspection in the case file and gives a copy to the customer.

Post-modification Training

The purpose of post-modification training is to verify that all adaptive equipment and vehicle modifications comply with the driver's evaluation prescription. Post-modification training also ensures that modifications are fitted in a way that best meets the customer's needs. Additionally, post-modification training helps the customer learn to proficiently operate the modified vehicle.

If needed, the ATS completes a service record for the recommended post-modification training using the appropriate state office budget. The ATS emails a request to PSART@twc.texas.gov to review and release the funds. Once the funds have been released, the ATS generates applicable service authorizations and delivers them to the vendor. If there is a scheduling conflict and the post-modification training cannot be coordinated to take place on the same day as the inspection, the PSART must be contacted for guidance.

The vehicle modification process is complete once all recommended post-modification training (if applicable) is finished.

For information on customer participation in the cost of services and comparable benefits, see A-306-4: Participation in the Cost of Services Based on Financial Need; D 203-3: Use of Comparable Services and Benefits; and D-203-4: Customer Participation in the Cost of Services.