RESNA 27th International Annual Confence
Vocational Rehabilitation, Rehabilitation Engineering, and the Client Service Delivery - Two Vehicle Modification Case Studies
The Division of Vocational Rehabilitation (VR) and the USF Rehabilitation Engineering and Technology Services Program operate under the Counselor Policy Manual. Two vehicle modification case studies and two sections of the policy manual will be presented examining the relationship between Vocational Rehabilitation, Rehabilitation Engineering, and the client. One case study examines the policy of the client turning over their insurance settlement for the original vehicle modification to VR when the vehicle was involved in an accident, which is applied to the cost of modifying their new vehicle. The second case study examines the policy of the client being responsible for purchasing a suitable vehicle requiring the most economical modifications. Specifically, the responsibility of purchase of the van interior will be examined based on the type of modification i.e. raised roof and/or door vs. dropped floor.
Vocational Rehabilitation, Rehabilitation Engineering, Service Delivery, Policy Manual, Vehicle Modifications
The Division of Vocational Rehabilitation's Policy Team is comprised of six Area Directors and the Chief of Field Services who are responsible for writing and revising the policy manual. Rehabilitation Engineering is responsible for writing and revising Chapter 14 entitled Rehabilitation Services: Rehabilitation Technology, which is approved by the previously mentioned groups. The Division also receives input from the Florida Rehabilitation Council and Client Assistance Program. Clients returning for their second vehicle modification will be examined. The VR Counselor Policy Manual states:
The client is a 43 year old male, C 5-6 incomplete quadriplegic.
VR previously installed an Aztec driving system. The vehicle was in an accident and declared a total loss. Now VR is installing an EMC AEVIT driving system in a minivan. The client received a traffic citation and his license was suspended as a result of the accident but it was reinstated after he paid his traffic fines.
The VR Counselor Policy Manual states:
The client's first vehicle modification initially cost $25,978.50 in 1998 but due to the "bugs" in the Aztec system an additional amount of $7,050.20 was paid between August 1998 and March 1999 bringing the total cost of the vehicle modification to =$33,028.70. The client's second vehicle modification cost $41,548.20 in May 2003. Of that amount, VR paid $22,262.20 and the client 's insurance paid $19,286.00. T he client expected and planned to use his entire insurance settlement to purchase his new vehicle but complied with the policy when it was shown and explained to him.
The client is a 32 year old male, partially paralyzed as a result of meningitis and he also suffers from spinal atrophy . VR previously modified this client 's 1995 E-150 full size van mod in November 1995 and he's returning for his second vehicle modification. He requires a raised roof but not raised doors, power door openers, lift, power seat base, brake hand control only and gas pedal enlargement, and a cam lock for his wheelchair.
The VR Counselor Policy Manual states:
The pertinent sections of the VR Counselor Policy Manual w ere explained to the client by his VR counselor, the Rehab. Tech , and the Engineer but he violated the policy and purchased a van before the quotes for the modifications and the recommendations were completed by the Rehab. Engineer. He purchased a 2002 F ord E-150 van with 109 miles on it. The van was previously used as a delivery vehicle and was equipped with industrial shelving and a barrier between the driver and the rear of the van. The van d id n't have an interior, flooring, side and rear windows, power windows or door locks, and cruise control, which VR require s . VR paid $ 12,902.66 for the modifications and the client was required to pay $5,191.85 to cover the cost of the required items and for the removal of the industrial shelving . T he policy changed since the client's previous vehicle modification when VR paid for the items, which the client is now required to pay, and the client ap p ealed the policy change. The case went to Administrative Review attended by the client , the VR counselor, and the Area Director . The client lost his appeal so he requested mediation, which involved the client , the VR counselor, Bureau Chief of Field Services, and a qualified mediator where he also lost. He then requested a F air Hearing, which involved client , the VR counselor, the Rehab. Engineer, the VR lawyer , and an Administrative Law Judge from the Florida Division of Administrative Hearings where he lost his appeal again. He was then free to request a Civil Court hearing and then appeal to the District Court of Appeals but he decided to pay the $ 5,191.85
While the policy in the first case study is clear, the policy in the second case study is not. VR prevailed in the second case study based on a detailed email to the client from the Rehabilitation Engineer, which stated not to purchase the vehicle until the quotes for the modifications and the recommendations were completed to which the client responded that he understood and agreed not to purchase the vehicle. The policy isn't clear regarding the most economical modification and the additional costs for which the individual is responsible . An unwritten policy is followed here in that the client pays for the interior of the vehicle if they have a raised roof and/or raised door modification , and VR pays for the interior of the vehicle if the vehicle requires a dropped floor modification . These types of modifications , raised roof and/or door vs. dropped floor, are based on the Rehabilitation Engineer and/or the Certified Driver Rehabilitation Specialist' s recommendations.
What are your other state's policies concerning clients who return to have a second state sponsored vehicle modification after their vehicle has been involved in an accident ? . Does the state require them have their car insurance settlement broken down into a settlement for the vehicle and a settlement for the modifications? Is the client required to use their modification settlement to pay for the new vehicle modification? What are other state's policies concerning vehicle purchases and required vehicle options i.e. interiors, flooring, side and rear windows, power windows or door locks, and cruise control? What are your state's policies concerning clients who have dropped floor full size van or raised roof vehicle modifications? Does the client pay for the interior of the vehicle?
Thank you to Linda Parnell, Bureau Chief of Field Services, for providing information on the Division of Vocational Rehabilitation's Counselor Policy Manual and the client appeals process .
AUTHOR CONTACT INFORMATION:
Patti Barrett, ATP, Rehabilitation Engineer,
The University
of South Florida Rehabilitation Engineering & Technology
Program,
2002 Old St. Augustine Road, Bldg. B, Suite B-18
Tallahassee FL 32301,
Telephone #: 850-921-0244,
Fax #:
850-245-3436,
email: pbarret2@eng.usf.edu
Stephanie McGhee, Engineering Technician,
The University
of South Florida Rehabilitation Engineering & Technology
Program,
2050 Art Museum Drive, Suite 101,
Jacksonville,
FL 32207,
Telephone #: 904-348-2770 x110,
Fax #: 904-348-2636
email: smcghee @eng.usf.edu