revised 4-02
CONSUMER CHOICE
AUTHORITY
The Rehabilitation Act of 1973 as amended
Federal Regulation: Section 361.52
For the purpose of this manual, use of the terms must or shall
reflect requirements of Federal law or regulation or state law or administrative
regulation and must be adhered to strictly.
PHILOSOPHY AND HISTORY OF INFORMED CHOICE
Vocational rehabilitation is all about choice. Working with a consumer to
assist her or him in understanding options, possibilities, and choices is not
just a part of the rehabilitation counseling profession, it is the heart of the
profession and the job that rehabilitation counselors do every day.
Vocational Rehabilitation has always been about choice. As early as the 1920’s,
rehabilitation professionals worked with many individuals with disabilities who
chose to work. Choice was exercised even at that early time. Consequently, as
the program has grown and expanded over eighty years and as consumers have
advocated for changes and continuous improvement in the public vocational
rehabilitation program, discussions and concerns about informed choice have been
more prominent
Rehabilitation professionals employed by the Department, feel strongly that
all persons with disabilities, like all persons in general, should have choices
and options. The Department’s published values support this belief. Staff of
the Department are keenly aware that choices and options have been severely
limited for years and have worked as diligent advocates to create avenues,
alternatives, options, and yes, choices, for people with disabilities.
Consumers have advocated for more power and control over their individual
destinies and for more choice in decisions, service delivery and selection of
career goals. With this new self-advocacy, combined with the advocacy of
rehabilitation professionals and others, the more recent amendments to the
Rehabilitation Act of 1973 contain substantial language emphasizing consumer
choice. Choice is mentioned 32 times in the 1998 Amendments to the
Rehabilitation Act and 46 times in the Federal Regulations governing the Act.
Department staff are better able to assist individuals with the most
significant disabilities when the individual has the desire to make decisions
about his or her personal future. To that end, the Department has developed
guidelines and best practices to insure that consumers make informed choices
about their personal, individualized rehabilitation program.
GUIDELINES FOR PROVIDING INFORMED CHOICE
Be aware of decision points.
Informed Choice /Checklist (ICC)
Any disagreement regarding choices will be thoroughly discussed and
resolved as quickly as possible so as not to impede the consumer’s
rehabilitation program. Consumer choices will
be given preference unless there are overriding considerations of cost
or appropriateness. Choices will be reviewed periodically, especially during
scheduled and unscheduled reviews of vocational rehabilitation goals and
objectives.
Suggested Procedures
Throughout the vocational rehabilitation process, follow the procedures
outlined below for best assurance that consumer choice is offered, explained and
adhered to, as appropriate.
Identify where and when you may be making choices for the consumer that the
consumer could make or be a partner in making.
Let the consumer know that choice needs to be made periodically and at
discrete points and that she or he should make the choice or be a partner in
making the choice.
Give the consumer all available information. If not available, a choice may
need to be made about who should gather the needed information and how the
information should be collected. The counselor could be the gatherer of
information, the consumer could be the gatherer of information or both the
consumer and counselor could collect information.
Help clarify issues and options. This is where professional skills can be of
greatest value. Frequently the consumer may not see options that we may be able
to readily identify. They may also not see implications about this decision
versus that decision.
Obtain consultation when needed. No one person has all the information needed
to make every choice possible. Get help from colleagues, supervisors, support
staff, friends, relatives, etc. Get assistance wherever it can be found.
Accept and be open to challenge. Recognize the fact that people are not
always going to be in agreement. The intent of informed choice is to give more
choice to consumers. It’s that simple. As counselors attempt to meet this
mandate many are going to be moved out of their comfort zone. Too much
discomfort and the counselor probably should examine his or her own agenda.
Staff may or may not need help in working through issues. Counselors should not
burden consumers with their own "stuff."
Recognize when a consumer CANNOT make a choice. CANNOT is different from
refusing to or reluctance to make a choice. Professional expertise is absolutely
essential in identifying when a consumer CANNOT make a choice and may need
assistance from the counselor or others. Knowing the difference among refusal,
reluctance or inability to make a choice is a significant test of
professional expertise. Consumers, like all people, may be able to make choices
on some days and unable to make choices on other days. Timing comes into play,
also. Perhaps, taking a couple of days to reflect on issues and information will
enable the consumer to make a choice that he or she was unable to decide
earlier.