Agency for Workforce Innovation August 2007 Medical Limitations and Incapacity.
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Transcript of Agency for Workforce Innovation August 2007 Medical Limitations and Incapacity.
Agency for Workforce Agency for Workforce InnovationInnovation
August 2007August 2007
Medical Limitations and Medical Limitations and IncapacityIncapacity
What is a Deferral?
Background
Federal law requires all work-eligible recipients to
Complete an initial assessment
Develop a plan towards self-sufficiency
Participate in work activities to achieve goals
However, not everyone can participate in work activities
Some individuals will have temporary good cause reasons for not participating in work or other activities
Some individuals will have ongoing good cause for not participating in work activities due to medical reasons
What is a Deferral?
Individuals with an inability to complete work activity requirements or cannot participate full-time in work activities should have a deferral entered on their case in the One-Stop Service Tracking (OSST) system
A deferral is simply a flag on a case that shows a participant may have limitations to work
What is a Deferral?
There are several deferral types in the OSST system Lack of childcare
Lack of transportation
Medical
Alcohol, drug and mental health
Domestic violence
Caring for a family member that is disabled and living in the home full time
Caring for a school age child that is disabled and living in the home
What is a Deferral?
What is a Deferral?
These “flags” may be entered on a case if the participant is not able to comply as a result of Not having reliable or adequate childcare
within a reasonable distance of home, work or school based on mode of transportation
Not having reliable transportation, including public transportation
Dealing with the effects of or past effects of domestic violence
Etc.
What is a Deferral?
The RWB should have a local operating procedure that outlines when a deferral should be entered in the system and what actions a staff member should take to help the participant overcome the barrier to participation
The local operating procedure should also include the type of documentation required to confirm certain deferral types
Example
A participant reports that (s)he does not have transportation to complete work activities The RWB requires the staff member to
review with the participant options for transportation
Review public transportation options
Review bus routes
Review places to go to school and work within walking or biking distance
The RWB requires the staff member to discuss a plan to overcome the barrier
Medical Deferral-Documentation Requirements
Medical deferrals have specific requirements prior to entry in the OSST system
Medical deferrals
Alcohol, drug, and mental health deferrals
Medical Deferral-Documentation Requirements
Before a medical or alcohol, drug and mental health deferral can be entered in the OSST system, the program participant must provide proof of a limitation signed by a licensed physician, 414.065 (F.S.)
The physician must be licensed under Florida Statutes chapter 458 or 459
In addition to a note documenting that the participant has a medical limitation or need for treatment, the Florida Administrative Code 65A-4.206 requires the RWB to collect specific information
Documentation must specify
The nature of the disability
The duration of incapacity
The number of hours per week the individual can participate in activities
The percentage of the individual’s disability
Other limitations on participation
Medical Deferral-Documentation Requirements
Medical Deferral-SSI/SSDI Applicants
Individuals applying for Social Security Income (SSI) or Social Security Disability Income (SSDI) payments may also be deferred from participation in work activities if they meet all requirements
Florida Statutes section 445.024 requires the participant to document current application for SSI/SSDI
The participant must document medical limitations through a statement signed by a licensed physician
Medical Deferral-SSI/SSDI Applicants
Participants that have applied for SSI/SSDI must still participate in program and work requirements
According to 414.105 (8), F.S.
Participants that have applied for SSI/SSDI must meet program requirements based on medical ability to comply until a final determination is made
Medical Deferral-SSI/SSDI Applicants
Question
What happens if a participant provides you with a doctor’s note stating simply, “the participant cannot do any work?”
Answer Get more information
If the initial note simply states that the participant cannot work, cannot go to school or has limitations
Establish steps with the participant to secure more information
Remember Florida Administrative Code requires the RWB to obtain certain information to engage the participant appropriately and develop a plan
Answer Enter the receipt of the document in
the OSST system
There are a lot of options regarding data entry Enter the appropriate medical deferral
(less than 30 days) with a “Begin Date” and enter a follow-up date to review any new information
Enter a medical deferral with a “Referral Date”
Enter an “other” deferral until you secure more detailed information
Develop a clear plan Have the participant bring in more
information
If the participant has a permanent disability, discuss applying for SSI/SSDI
Have the participant attend assessments
Ensure that treatment elements are included in the plan-e.g., counseling, treatment, etc.
Answer
Answer
Develop a clear plan
Remember to
Discuss with the participant what (s)he wants to do
Discuss with the participant what (s)he can do
Question
But, will we get credit for participants that cannot participate in activities for the required number of hours due to a medical incapacity, including a permanent disability?
Any participant included in the participation rate denominator and not completing the required number of hours to be included in the numerator will impact the participation rate
Answer
Is It Numbers VS People?
Answer
It is not numbers versus people
We engage all participants
The participation rate simply shows the percentage of those that we engage who participate in the minimum number of hours required in a countable work activity
If a participant cannot complete the minimum number of hours in a countable work activity today due to a medical limitation, the RWB may not get credit in the participation rate (this month)
However, the participant may be able to comply in countable work activities in the future if we work with them today
The participant may be able to secure a job in the future if we work with them today
Answer
Answer
Florida’s All-Family Participation Rate is 50 percent
Florida’s Two-Parent Participation Rate is 90 percent If a parent has a medical incapacity coded as
lasting greater than 30 days in OSST, the family will be removed from the Two-Parent Participation Rate and included only in the All-Family Participation Rate
Answer
We all have dreams
We all have goals
We all deserve a chance to reach our full potential
All participants join our program deserving that chance
Answer We are empowering
people to
Make a plan towards self-sufficiency
Stick with the plan
Achieve their goals
This includes participants with barriers
This includes participants with limited abilities
Medical Deferrals-Participation
Participants with limitations
Participants must be engaged to the extent possible as identified by a licensed physician in work activities
We may need to make accommodations
May need to work with employers to make accommodations
We can work with community partners to offer tools, work stations and other accommodations for participants that have special needs
Participants with limitations must be engaged in alternative activities like counseling, treatment, therapy, etc. to move towards being able to be engaged in work activities and self-sufficiency
What is the Career Specialist’s Responsibility?
Treat all participants equally
We treat everyone regardless of inclusion in the numerator in the participation rate
Engage the participant
Develop a plan with the participant that includes treatment, therapy, counseling, etc.
Hold the participant accountable for successes and failures
What is the Career Specialist’s
Responsibility?
Review medical information provided by the participant
Set up assessments
Provide information about Vocational Rehabilitation and The Center for Independent Living
What is the Career Specialist’s
Responsibility? Assign participants to APPROPRIATE
activities based on ability to comply, medical information, assessment results, and goals
List steps that will assist participants with health issues as well as help them achieve self-sufficiency
Medical Deferral We want all participants
working to resolve or manage their barriers so they can
Begin full-time participation as soon as possible
Work towards self-sufficiency
What Are Other Ways We Can Engage Our Medically Deferred Population?
Answer Empower the participant
Encourage or assist the participant with writing a list of issues (s)he wants to discuss with the doctor
Have the participant write a list of things (s)he wants (home, car, a high paying job, feeling better, respect, medical insurance)
Discuss what type of activities (s)he can engage in to work towards those goals
Make sure (s)he is ready to ask the physician what (s)he can do
Medical Deferral
Please remember:
We treat all of our participants equally
Compliance with federal laws
The Age Discrimination Act of 1975
Section 504 of the Rehabilitation Act of 1973
The Americans with Disabilities Act of 1990
Title VI of the Civil Rights Act of 1964.
If you have any questions, If you have any questions, comments, or concerns, please comments, or concerns, please
contact contact
the Welfare Transition Team the Welfare Transition Team
through the Agency for Workforce through the Agency for Workforce Innovation’s Call Center at Innovation’s Call Center at
1-866-352-23451-866-352-2345
An equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. All voice telephone numbers on this document may be reached by persons using TTY/TDD equipment via the Florida Relay Service at 711.