VR-SFP Chapter 4: Employment Assessments

Employment assessments are tools that evaluate a customer's work and training background, general functional capacities, and social behavior. Employment assessments are designed to determine a customer's present and future vocational potential and to evaluate the customer's employment-related strengths and limitations.

This chapter includes information on the following employment-related assessment services:

• Vocational Evaluation
• Situational Assessments and Work Samples
• Environmental Work Assessment (EWA)
• Career Planning Assessment (CPA)

Premium payments may be available for some employment assessment services. Premium payments are paid after all deliverables for the service have been achieved. For more information about premiums, refer to Chapter 20: Premiums.

Any request to change a Service Definition, Process and Procedure, or Outcomes Required for Payment must be documented and approved by the VR director, using the VR3472, Contracted Service Modification Request for Vocational Assessments form, before the change is implemented. The approved VR3472 must be maintained in the provider’s customer case file. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.

4.3.1 Vocational Evaluation Service Description

Vocational evaluation is an assessment of an individual's work and training background, general functional capacities, and social and/or behavioral characteristics. The vocational evaluation must contain a detailed description of the customer's behaviors and must describe any implications for the workplace. The evaluation must be designed to determine the customer's present and future vocational potential. The evaluation also must include an assessment of the customer's employment-related strengths and limitations. Vocational evaluations cannot be conducted remotely.

Any request to change a Service Definition, Process and Procedure, or Outcomes Required for Payment must be documented and approved by the VR director, using the VR3472, Contracted Service Modification Request for Vocational Evaluation, before the change is implemented. The approved VR3472 must be maintained in the provider’s customer case file. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.

The evaluation must:

• be conducted by the vocational evaluator;
• document up to six hours of assessment per day; and
• result in a vocational objective or alternative vocational objectives being identified by the vocational evaluator.

The following techniques are generally used to establish and measure a customer's work characteristics.

4.3.1.1 Standardized Tests

Standardized tests include tests that:

• measure the customer's academic achievement, cognitive abilities, aptitude, personality, vocational interests, sensory and/or motor skills, and independent living skills; and
• compare the individual's performance with the performance of an appropriate sample population.

All test instruments must be appropriate for use with the target population, including appropriate norms, adaptations, and accommodations.

4.3.1.2 Work Samples

Work samples provide a close simulation of an actual industrial task, business operation, or component of an occupational area. Work samples might not be necessary for all vocational evaluations. However, when deemed necessary by the vocational evaluator or when requested on the referral form or service authorization, work samples must be completed.

The activities involved in conducting a vocational evaluation and preparing a report include developing a case history, assessing information, performing standardized tests, and providing work samples, when appropriate.

The customer's case history must include:

• contact information;
• educational background;
• employment history;
• medical history;
• social history;
• psychological and/or emotional history and current stability;
• daily living activities; and
• independent living skills.

The following areas must be evaluated during the vocational evaluation:

1. Cognitive abilities, such as:
   • learning ability, including attention, concentration, comprehension, memory and/or retention, creativity, and conceptualization;
   • communication skills and interaction with others;
   • ability to follow oral and written instructions;
   • work organization and planning; and
   • spatial concepts
2. Academic achievements (grade level) in reading, writing, spelling, and mathematics
3. Physical abilities, such as:
   • fine motor abilities, including bimanual dexterity, speed, coordination, and strength;
   • gross motor abilities, including strength, balance, and coordination; and
   • stamina and/or physical tolerance and endurance
4. Sensory abilities (identifying preferred learning style—visual, auditory, or tactile), such as the use of:
   • residual vision;
   • auditory processing and sound localization; and
   • tactile perception
5. Aptitudes and vocational interests and/or exploration, such as:
   • specific equipment and technical skills; and
   • preferred vocational interests compared to abilities
6. Behavioral observations and work habits, such as:
   • general and work-related behaviors;
   • self-image (pertaining to self and work);
   • appearance (for example, grooming, hygiene, appropriate clothing for the work setting);
   • motivation and attitude toward work;
   • attendance and punctuality;
   • travel to and from the work setting (for example, access to dependable transportation, understanding how to use transportation);
   • orientation within the work setting (for example, showing the customer where the work area is, restrooms, break rooms, supervisor's location);
   • work stability (including attention to work despite environmental distractions or changes);
   • work productivity and quality;
   • acceptance of supervision (accepting and responding to suggestions, corrections, and general feedback);
   • responsibility for materials and work;
   • adherence to workplace standards (for example, employee policies, rules, and schedules);
   • safety standards (understanding and adhering to specific workplace safety standards);
   • impulse control (for example, predictable behavior and adequate self-control);
   • stress tolerance;
   • cognitive flexibility;
   • persistence (following through on a work task to completion);
   • initiative (working independently);
   • job-seeking skills; and
   • the customer's potential to benefit from VR services.

4.3.2 Process and Procedure

An employment service provider receives a VR5000, Referral for Provider Services, and a service authorization.

The VR5000, Referral for Provider Services, includes any documentation that will:

• prepare the provider to better work with the customer;
• indicate the reasons for referral; and
• include specific questions to be addressed during the evaluation.

The scope of each evaluation is determined based on the customer's individual needs. There are no fixed guidelines regarding the number of days required to complete an evaluation. Generally, an evaluation is expected to take one to eight days. The VR counselor determines the appropriate length of the evaluation based on the assessment of the customer's individual needs and circumstances.

The vocational evaluator's job responsibilities during the evaluation are to:

• remain on-site to supervise all services, including the evaluation;
• supervise qualified vocational evaluator aides and maintain the following ratios:
  • One evaluator to no more than six customers without an aide
  • One evaluator and one aide to no more than 10 customers
  • One evaluator to no more than three customers with blindness and/or visual impairment
  • One evaluator and one aide to no more than six customers with blindness and/or visual impairment
• provide written proof, through attendance records made available on request, that the correct ratio of customers to vocational evaluators and vocational evaluator aides is maintained;
• identify appropriate and inappropriate behaviors using existing records, personal observations, and conversations with the VR counselor, the customer, family members, and others;
• prepare a typed VR1837, Report for Vocational Evaluation, or a typed report with all required elements; and
• review the customer's vocational interests, strengths, challenges, and recommendations with the customer, the customer's representation, if any, and the VR counselor, when requested on the VR5000, Referral for Provider Services, or on the service authorization.

4.3.3 Outcomes Required for Payment

Vocational evaluation reports must be submitted using a VR1837, Report for Vocational Evaluation, or a typed report containing all required elements outlined in the service description and noted in the VR1837. The cumulative findings of a vocational evaluation must be submitted no later than 10 working days from the last day of the evaluation.

The report must describe the customer's behavior and must stress the vocational implications of the following factors:

• results of the evaluator's findings and observations specified in the service description;
• potential for competitive integrated employment, or the reasons that competitive integrated employment is not appropriate, when applicable;
• job recommendations related to the current job market using the Standard Occupational Classification (SOC) codes for the customer's geographic area;
• specific training options that match the customer's capabilities; and
• specific job modifications and/or accommodations necessary to achieve the employment goal

The VR1837, Report for Vocational Evaluation, or the typed report must contain the signature of the vocational evaluator who conducted the evaluation. For more information, refer to VR-SFP sections 3.2.14 Documentation and 3.2.16 Signatures.

When requested on VR5000, Referral for Provider Services, or on the service authorization, the vocational evaluator must complete a feedback session with the customer, the customer's representative, if any, and the VR counselor, to review the evaluator's recommendations and the customer's vocational interests, strengths, and challenges.

To request partial payment for work that has not been completed in its entirety, a VR3472, Contracted Service Modification Request, can be submitted. Justification for why the vocational evaluation cannot be completed in its entirety must be included on VR3472, Contracted Service Modification Request.

A partial work product, such as a report and documentation of the time spent completing the deliverables, must be submitted with the VR3472, Contracted Service Modification Request, and must be approved by the TWC-VR director before any partial work is invoiced. The achievement of required deliverables and the hours spent is evaluated on a case-by-case basis. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.

4.3.4 Fees

For more information, refer to 4.7 Employment Assessments Fee Schedule.

4.5.1 Environmental Work Assessment Service Description

An EWA is a diagnostic tool that assesses how the customer responds to variables in a work environment. The EWA is an accurate assessment of the correlations between a customer's performance and environmental variables and is critical to the customer's ability to find and maintain employment. Results of the assessment identify the variables in a work environment that affect the customer's ability to function at his or her full potential. The EWA is provided in person and cannot be conducted remotely.

Any request to change a service definition, process and procedure, or outcomes required for payment must be documented and approved by the VR director, using VR3472, Contracted Service Modification Request for Vocational Assessments, before the change is implemented. The approved VR3472 must be maintained in the provider’s customer case file. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.

The EWA is most appropriate for a customer who:

• has a neurodevelopmental disorder that significantly affects him or her;
• has a history of behavior that varies depending on the environment; and
• may benefit from an evaluation that assesses how his or her neurodevelopmental disorder may manifest in a work setting.

The EWA evaluator assesses the customer's skills in at least three work environments that align with his or her interests and the employment goal in the customer's individualized plan for employment (IPE), when known. Each environment is assessed for a minimum of two hours.

Exceptions

The following exceptions are allowed when conducting an EWA:

• Conducting an EWA in another environment—Environments that accurately mimic the intended work environment are acceptable, when an intended work environment is not available or when another environment is in the best interest of the customer. For example, if the intended work environment is loud, busy, and bright, then the alternate environment in which the assessment is conducted must mimic those same variables in order for the assessment to be valid.
• Assessing three environments during an EWA—One environment can be used twice, if changing the day or time would significantly alter the environmental variables. For example, the environment in a grocery store on a Saturday at 1:00 p.m. is significantly different from the environment at the same grocery store on a Sunday at 11:00 p.m. The assessment must be conducted in an environment that accurately mimics the intended work environment.
• Spending at least two hours per environment—If appropriate, assessments in the same location can occur over time. For example, a customer can go to an environment for one hour on one day and go to the same environment for the second hour on another day.
• Reviewing the results of the EWA with the customer in person—If an in-person meeting with the customer is not possible, the VR counselor may approve a teleconference to review the EWA results. The written approval must be kept in the evaluator's and the customer's case files.

The EWA may be conducted during any phase of the VR process, but it is typically conducted during the development of the IPE. The EWA is not a Vocational Evaluation or a Career Planning Assessment.

For more information on fees for the EWA, refer to the fee chart.

4.5.2 Process and Procedure

An EWA evaluator must have a current bilateral contract for conducting EWAs before providing the service.

The VR counselor sends VR1879, Referral Form for Services for Neurodevelopmental Disorders, and a service authorization to the provider. The provider may request additional documentation from the VR counselor, such as case notes on psychological, vocational, or medical evaluations, that will prepare the provider to better work with the customer.

Billable time spent with the customer includes time spent on a combination of the following:

• Gathering information with the VR counselor and other pertinent professionals related to the customer (conducted by email, phone, or in person)
• Reviewing records
• Visiting the customer's home
• Observing the customer
• Planning for assessments at each work site
• Assessing the customer at each site
• Completing the report and recording the scores
• Meeting with the customer to review the assessment results, provide feedback, and plan next steps

After the EWA is completed, all results must be documented on the

• VR1877A, Environmental Work Assessment Report Part A;
• VR1877B, Environmental Work Assessment Report Part B (when printing the results of the EWA Part B, use the print option "print entire workbook.");
• VR1877C, Environment Work Assessment Signature Page Part C; and
• VR1878, Environmental Work Assessment Time Log.

The EWA evaluator must review the results of the EWA with the customer in person. The results must be presented to the customer in color; for example, printed with colored ink or viewed on a monitor that displays color.

4.5.3 Outcomes Required for Payment

The EWA evaluator documents in descriptive terms all the information required in the service description on VR1877, Environmental Work Assessment, parts A, B, and C, and VR1878, Environmental Work Assessment Time Log, demonstrating evidence that the customer's:

• interests, assets, and abilities in work and nonwork areas were explored, identified, and summarized;
• personal, social, school, and medical histories were collected;
• self-assessment includes the customer's score of the 40 basic skills;
• skills were assessed in three environments related to the following four domains, after the environmental demands were identified and rated:
  • Basic and social communication
  • Problem solving and executive functioning
  • Advanced social and communication
  • Self-regulation and emotional intelligence

The EWA evaluator documents in descriptive terms all the information required in the service description on the VR1878, Environmental Work Assessment (EWA) Time Log, recording:

• each session held with the customer;
• locations at which the sessions were held; and
• whether the time spent was direct or indirect, as well as whether:
  • no more than eight hours were spent on indirect services; and
  • no fewer than 12 hours were spent on direct services.

Payment is authorized when the EWA evaluator submits a complete, accurate, signed, and dated:

• VR1877A, Environmental Work Assessment (EWA) Report, Part A (Summary);
• VR1877B, Environmental Work Assessment (EWA) Report, Part B (Results);
• VR1877C, Environmental Work Assessment (EWA) Report, Part C (Signature Page);
• VR1878, Environmental Work Assessment (EWA) Time Log; and
• invoice.

This is an outcome-based service; therefore, VR will not pay unless all topics in the service description and service authorization are addressed. For more information, refer to VR-SFP sections 3.2.14 Documentation and 3.2.16 Signatures.

4.5.4 Fees

For more information, refer to 4.7 Employment Assessments Fee Schedule.

A provider may not collect money from a VR customer or the customer's family in excess of VR service fees for any service charged. If VR services and another resource are used to paying for a service for a customer, the total payment must not exceed the fee specified in the VR Standards for Providers manual.

Each employment assessment below must only be purchased one time per customer.

Premium payments may be available for some employment assessment services. Premiums payments are paid after all deliverables for the service have been achieved. For more information, refer to Chapter 20: Premiums.