Chapter VII - D

Financial Measures

Financial Determination Guideline
The Department for the Blind and Vision Impaired (DBVI) has elected to consider an individual’s ability to participate in the cost of some services.  In some instances individuals may be required to pay in whole or in part for the cost of vocational rehabilitation services they may receive.  Financial need determination is permitted by Federal Regulations and must be administered in an equitable manner. Federal Regulations exclude SSI and/or SSDI recipients from financial consideration for vocational rehabilitation services, if they intend to enter or return to work (CFR 361.54). SSI and/or SSDI recipients are only required to report the monthly amount of SSI and/or SSDI on the Financial Determination/Redetermination Form, which may be required to be utilized as a comparable benefit.

1. It is the policy of DBVI that the financial Determination/Redetermination Statement will be reviewed and updated annually for all individual receiving vocational rehabilitation services.

Definitions of Family Unit, Emancipated Adult, and Economic Need

1. Family Unit
   The basic family unit consists of one or more adults and children, if any, related by blood, marriage, or adoption, and living in the same household. The family unit includes family members, temporarily absent from the household, for whom the family claims financial responsibility for tax purposes.
2. Emancipated Adult
   An emancipated adult is an individual who has obtained his/her 21st birthday unless that person is married or maintains a household. An individual 21 years of age or over who lives with his/her family and is not claimed for income tax purposes may also be considered emancipated. The definition for an undergraduate college student is different (see Chapter 9A.5, Section E).
3. Economic Need
   An Economic Need determination has been established by DBVI because of its limited resources. The provision of VR services, based on economic need, requires a thorough examination of the customer's ability to participate in the cost of services and other comparable benefits. When the customer is dependent on the family income, this income is to be considered.

General Discussion

Diagnostic services are required to determine the nature and scope of rehabilitation services needed by a customer. These services do not require consideration of financial need, and the majority of these services are provided as a part of the preliminary and thorough diagnostic studies. Rehabilitation services are services which increase the employability of a customer and require consideration of the individual’s participation in the cost of services.

Rehabilitation services provided in Extended Evaluation (Application X) which can be considered diagnostic in nature do not require consideration of financial means (see Chapter II).

The following information is a listing of specific services to be provided when considering the financial participation of a customer:

1. VR Services

   Vocational rehabilitation services in active status that require consideration of an individual’s participation in the cost of services:

   1. Physical restoration;
   2. Maintenance during training;
   3. Tuition or training fees;
   4. Books and supplies;
   5. Equipment (except for adaptive equipment);
   6. Transportation (except incidental to diagnostic services);
   7. Personal incidentals during training; and
   8. Post-employment services.

   Vocational rehabilitation services which do not require the consideration of financial needs:

   1. Diagnostic and evaluation services;
   2. Counseling, guidance, and referral;
   3. Prevocational training (within DBVI);
   4. Job placement and follow-up;
   5. Orientation and mobility services;
   6. Reader services;
   7. Interpreter services for individuals who are deafblind;
   8. Rehabilitation technology services including adaptive equipment;
   9. All evaluation and training programs at VRCBVI;
   10. Work Evaluation (30 days);
   11. Community Evaluation Training Program with Rehabilitation Teaching;
   12. Summer Work Program (two months);
   13. Work Experience for Adults (three months);
   14. Work Adjustment Training (three months);
   15. On-the-Job Training (30 days);
   16. Supported Employment Services; and
   17. Personal Assistance Services.

2. Allowable Deductions

   The only deductions to be considered are medical and current in-school tuition for customers and other family members.

   1. Medical
      Examples of medical conditions which need continuous treatment are diabetes and epilepsy. Other instances of allowed medical expenses are for acute medical conditions or traumas in which an additional burden is placed upon the family income and resources. Expenses for a catastrophic illness would also be an allowable medical expense. Unusual dental expenses, such as oral surgery or the fitting and maintenance of dental braces, retainers, etc., are also allowable expenses. Routine co-payments or hospitalization insurance premiums are not an allowable medical expense.

   2. Educational
      The only other expenses allowable are for the cost of tuition and/or related expenses for customers or family members currently in school or a training facility. These expenses could range from tuition in a private school to a special training center for an individual with a disability member of the family. Ancillary costs, such as transportation, which relate to training or special supplies, are also allowable, as long as the costs pertain to the family member.

3. Real Property
   Real property will not be a consideration for financial need. Income level from real property, however, such as rental fees or income from crops raised, etc., will be included as earned income on the Financial Determination/Redetermination Statement.

4. Normal Living Requirements
   The Normal Living Requirements will be used with the Financial Determination/Redetermination Statement to determine the customer's participation in cost of services and, if not, how much the customer is required to contribute toward the cost of his/her Vocational Rehabilitation program. Normal Living Requirements are based on median income for a four-person family provided by the Bureau of the Census as published in the Federal Register for the Low income Home Energy Assistance Program (LIHEAP). The median income for a four-person family is multiplied by percentages to adjust for family size.

5. Participation in the cost of services versus Comparable Benefit
   It is important that the vocational rehabilitation counselor remember that an individual’s participation in the cost of services and usage of comparable benefits are related, but not synonymous, although they comprise the concept of economic need. Individuals for whom DBVI provided financial sponsorship of all services are still required to utilize any comparable benefit which is available to him/her to meet the costs of Vocational Rehabilitation services. Refer to the Comparable Benefit section of this chapter for a more comprehensive discussion.

6. When to Request Verification of Income
   In assessing financial needs, the vocational rehabilitation counselor can and should request verification of income, liquid assets, and allowable debts when it appears there is a discrepancy by the customer in reporting such information.

   Financial Tables- Revised March 2008

   Normal Living Requirements:Based on 100% of Annual Median Income

   Number of Persons Depending on Income	Monthly Amounts	Annual Amounts
   1	$3,353.00	$40,264.00
   2	$4,388.00	$52,652.00
   3	$5,420.00	$65,041.00
   4	$6,452.00	$77,430.00
   5	$7,485.00	$89,819.00
   6	$8,517.00	$102,208.00
   7	$8,711.00	$104,531.00
   8	$8,904.00	$106,853.00

   The median Virginia income of $77,430 for a family of four is multiplied by the following percentages to adjust for family sizes over eight: family of 9, 141%; 10, 144%; 11, 147%; 12, 150%. For each additional family member over 12 add 3%. For example, for a family of 13 multiply $77,430 by 153% (150% + 3%).
   (Note: The monthly income amounts listed in the table above multiplied by 12 do not exactly equal the annual median income. These minor differences are due to rounding.)

   Exemptions for Liquid Assets- Revised March 2008

   The allowable liquid assets are based on 50 percent of annual median income.

   Number in Family	Amount
   1	$20,132.00
   2	$26,326.00
   3	$32,521.00
   4	$38,715.00
   5	$44,910.00
   6	$51,104.00
   7	$52,266.00
   8	$53,427.00

Instructions for Completion of DBVI-70-006
Financial Determination/Redetermination Statement
The individual program responsibilities for the initial Determination/Redetermination statement form are as follows:

1. Initial Determination
   1. New:
      The program worker who completes the Financial Determination/Redetermination Statement (DBVI-70-006) is responsible for completing the following sections for his/her program:
      1. IL: ---
      2. ES: Sections A, B, and F
      3. RT: ---
      4. VR: Sections A, B, C, D, E, F, and G
   2. Re-referral:
      The program worker who completes the Financial Determination/Redetermination Statement (DBVI-70-006) is responsible for completing the following sections:
      IL, RT, VR: Sections A, B, C, D, E, F, and G
   3. Redetermination
      The program worker who completes the Financial Determination/Redetermination Statement (DBVI-70-006) for a redetermination update is responsible for completing the following sections:
      1. IL, RT, VR: Sections A, B, C, D, E, F, and G;
      2. ES: Sections A, B, and F; and
      3. This form does not need to be typed.

DEMOGRAPHIC:
Name: Enter the first, middle initial, and last name. Do not use "nicknames."
Address: Enter complete current address.
Customer AWARE Participant Number: Enter the regional office assigned number

SECTION A. MEMBERS OF FAMILY UNIT:

1. Enter all members of the family unit living in the home, listing the customer's name first. Include age, relationship to customer, and gross monthly income of each family member. List only that portion of the gross income which is actively contributed in support of the family unit.
2. State the source(s) of the monthly income under "Source Gross Monthly Income." Sources to be included are: 1) Wages, 2) Social Security Disability Income (SSDI), 3) Supplemental Security Income (SSI), 4) Old Age Survivors Insurance (OASI), and 5) Other. "Other" includes, but is not limited to, net income from business or farm, railroad retirement, unemployment compensation, pensions, annuities, interest, dividends, net rental income, Workers' Compensation, alimony, child support, and veteran's disability.
3. 3. Column Six in the "Source Gross Monthly Income" should include the sum of columns one through five for each family member listed.

SECTION B. TOTAL SUM OF ALL GROSS MONTHLY INCOME:

Enter the amounts recorded in column six in Section A.

SECTION C. HOSPITALIZATION:

1. Enter the name of the company and the policy number of all medical insurance policies from which the customer may receive benefits
2. If the customer is eligible for Medicare or Medicaid, check the appropriate insurance program and enter the insurance number. If the customer is also eligible for Medicare, Part B, check the block
3. List in the "Other Comparable Benefits" section other benefits that the customer may be receiving, i.e., Pell Grant, CHAMPUS benefits, and Veteran's benefits other than income maintenance. Refer to the Virginia Department of Rehabilitative Services' Similar Benefits Directory for a full explanation of benefits, criteria, recipients, and points of contact. (See Chapter 7B.)

SECTION D. LIQUID ASSETS AND ALLOWANCE:
List the total amount of liquid assets and allowances for the family unit shown in Section A. IRAs and other deferred annuities are not considered liquid assets for economic need. Funds held for minors in trust funds by social service agencies or guardians are not to be considered liquid assets until released to the customer upon attainment of majority.

1. Cash: Enter the total amount of all cash (including checking accounts).
2. Bank Deposits: Enter the total amount of savings accounts and certificates of deposit (CDs).
3. Stocks/Bonds: Enter the total amount of estimated cash value of all stocks and bonds.
4. Other: Enter the total amount of gifts, inheritance, or escrow accounts.
5. Total Liquid Assets: Enter the sum of D.1 through D.4.

SECTION D.6 AND D.7 ARE NOT APPLICABLE TO INTAKE WORKERS. HOWEVER, THEY MUST BE COMPLETED BY THE APPROPRIATE PROGRAM WORKER.

1. Standard Allowance: Enter the amount of allowed exemption for liquid assets based on the total number of members in the family unit.
2. Surplus: Subtract line D.6 from D.5 and enter the difference. If D.7 is zero or less, the customer meets income eligibility standards for liquid assets. If D.7 is greater than zero, further determination is necessary in Section G, Eligibility Determination.

SECTION E. MONTHLY INCOME AND ALLOWANCE:
SECTION E. IS NOT APPLICABLE TO INTAKE WORKERS. HOWEVER, IT MUST BE COMPLETED BY THE APPROPRIATE PROGRAM WORKER AS FOLLOWS:

1. Monthly Income from Section B: Enter the total amount from Section B.
2. Standard Allowance: Enter the amount of the Normal Living Requirements allowance for the total family unit.
3. Exceptional Allowance: These allowances are more fully explained in the Financial Determination Guide section
   1. Medical Debts: Unusual customer or family expenses
   2. Educational/Customer: Current educational expenses
   3. Educational/Family: Current educational expenses for a family member
4. Total of E.2 thru E.3c: Enter the sum of the Standard Allowance and Exceptional Allowance.
5. Surplus/Difference: Subtract E.4 from E.1 and enter the surplus or difference in E.5

SECTION F. FINANCIAL VERIFICATION:
If the applicant, parent, or guardian renders requested financial information and signs the form, put a check mark in the first block. However, if the applicant, parent, or guardian chooses not to disclose financial information, put a check in the second block.

1. Date: Enter the date the customer signs SECTION F, FINANCIAL VERIFICATION. The redetermination is to be done one year from this date.
2. Applicant Signature: The applicant is to sign on the applicant signature line. The parent or guardian must sign for a minor child.
3. If the required signature is not given, the worker collecting the information is to write a statement to this effect on the applicant signature line.
4. Worker Signature: The worker collecting the financial information is to sign on the worker signature line.

SECTION G. CLIENT’S PARTICIPATION IN THE COST OF SERVICES
The program staff completes Section G to determine the customer's participation in the cost of services after all relevant financial information has been obtained. The worker is to date and sign the form when he/she completes Section G. Instructions follow:

1. Yes: If the customer is not required to participate in the cost of services, check G.1 Yes. The worker is to enter the date and sign in the first worker signature space at the bottom of the form.

No: If the customer is responsible to participate in whole or in part in the cost, check G.1 No. The worker is to enter the date, have the customer sign in the customer signature space, and the worker will sign in the first worker signature space at the bottom of the form.

If G.1 "yes" or G.1 "no" not checked, complete G.2 through G.7.

1. In completing G.2, use one (1) month in determining monthly contribution per occurrence for physical restoration and equipment. Use up to twelve (12) months for all other services.
2. Liquid Assets and Allowance: If D.7 is greater than zero, divide that amount by G.2 to determine G.3 monthly contribution to rehabilitation plan.
3. Monthly Income and Allowance: Enter the total from the E.5 monthly contribution line (G.4).
4. Liquid Assets and Allowance AND Monthly Income and Allowance Exceed Zero: Enter the total from G.3 in the first space and enter G.4 in the second space. Put the total of G.3 plus G.4 in the third space (G.5).
5. Liquid Assets and Allowance Exceeds Zero AND Monthly Income and Allowance Zero Or Less: Enter the total from G.3 in the first space and enter the total for G.4 in the second space. Subtract G.4 from G.3. If the difference is a surplus, check monthly contribution and enter the surplus. If the difference is a minus, check financially eligible.
6. After all computations are done, the customer will be in one of the following situations: "Individual is required to participate in the cost of services" or "Individual is not required to participate in the cost of services." Check the appropriate box.
7. Signature lines: Customer signatures are explained on the form. The program worker signs and dates the form when the eligibility determination has been completed.