Narrative: j. 1. A.

MVR and the State Rehabilitation Council (SRC) jointly conduct a comprehensive, statewide assessment of the rehabilitation needs of Missourians with disabilities, over a three-year period. The last assessment was completed in 2021 and covered PY 2018 through PY 2020. The next assessment will be completed in 2024 and cover PY 2021 through PY 2023. MVR submits the results of the needs assessment to the Rehabilitation Services Administration during the four-year combined state plan cycle, two-year modification cycle or anytime circumstances require a modification in accordance with 20 CFR § 676.145. This section pertains to the statewide assessment period completed in 2021 and illustrates all areas of need. The conclusions and recommendations of these assessments are incorporated into MVR’s goals and priorities for the purpose of improving services to individuals with disabilities.

MVR uses a mixed methods approach to collect, in aggregate, qualitative and quantitative information on the rehabilitation needs of Missouri individuals with disabilities. Information resources include:

a. Consumer Satisfaction Surveys

MVR routinely surveys a random sample of clients throughout various stages of open cases and case closures to obtain feedback on MVR services and to determine how to better serve the needs of individuals with disabilities.

b. Public Hearings

Annually, MVR conducts public hearings throughout the state to obtain input on the state plan, its key goals and priorities, plan changes and any other topic related to MVR services. In 2021, MVR and the SRC jointly held virtual public hearings statewide.

c. Input from the State Rehabilitation Council

During quarterly and ad hoc committee meetings, the SRC provides input to MVR on the rehabilitation needs of individuals with disabilities.

d. Strategic Teams

MVR utilizes both ad hoc and on-going teams, such as the CRP-MVR Steering Committee Team, Transition Team, and Cultural Diversity Team, to gather data from its partners, school districts and underserved individuals with disabilities.

e. Analysis of Performance Measures and Program Data

On a quarterly basis, MVR management reviews data to ensure the program is meeting its goals. The SRC annually reviews and analyzes this information with MVR and receives quarterly program updates.

f. In 2021, MVR used an online questionnaire to survey its staff on the rehabilitation needs of Missourians with disabilities, including students and youth with disabilities. The MVR Diversity Team reviews the results of the survey in order to make recommendations to administration on how to best utilize the feedback. MVR also reviews information from its annual training needs assessment to determine unmet needs of individuals with disabilities.

g. In 2019, MVR leadership visited all VR district offices and Centers for Independent Living to gather input on the needs of clients and individuals with disabilities.

Additional resources include:

• quality assurance case reviews
• quarterly reviews of case management data
• census data annually or as data is available
• data from the American Community Survey and U.S. Census Bureau
• data from other state and federal agencies
• data from state and community boards and commissions
• information obtained during WIOA partner team meetings
• due process hearings and mediations--annually MVR analyzes feedback from hearings
• literature reviews

Feedback from the public hearings cited that a lack of transportation was a barrier to services. MVR continually reviews this issue for possible resolutions. Offices work with local transportation providers such as OATS and Centers for Independent Living. One of the MVR district offices has a special arrangement with its local public transit agency where the office can order bus passes and provide them directly to clients. Housing, homelessness and affordable childcare were also mentioned.

Considered in this assessment period was the effects that the COVID-19 pandemic had on the rehabilitation needs of individuals with disabilities. MVR expanded its services by adding remote and virtual service options. Staff realized the importance of maintaining client engagement when in-person meetings were not advisable. They quickly adapted to virtual service delivery ensuring the continuation of quality services. MVR worked with its CRP providers to address COVID challenges. MVR temporarily raised its fees for service to offset the providers’ additional costs incurred. CRPs were given flexible service delivery options so clients’ needs could be met. At the onset of the pandemic, MVR met virtually each week with core and combined state plan partners to share updates on service delivery and keep abreast of partners’ COVID-related service initiatives.

The following is a summary of the comprehensive statewide assessment results in response to the rehabilitation needs of individuals with disabilities in Missouri, particularly the VR service needs of:

(A) individuals with the most significant disabilities (MSD) including their need for supported employment (SE) services

Based on MVR data from the last three years, the projected number of eligible individuals with MSD who will receive MVR services during the state plan period will be approximately 15,000 to 15,300. Of that estimate, approximately 4,500 to 4,550 individuals will need SE services.

From the comprehensive statewide assessment, MVR identified the following services as necessary to meet the key needs of the MSD:

• SE Services -- The nature of the service itself requires an individualized approach based on the needs of an eligible individual. SE services are ongoing support services, including customized employment, and other appropriate services needed to support an individual with a most significant disability to achieve and maintain competitive integrated employment. SE services include customized employment and IPS. Services are provided by CRPs. MVR can provide up to 24 months of community-based job training.
• Assistive Technology and Rehabilitation Engineering Services -- Services include assessment and recommendations for accommodations, assistive devices and rehabilitation technology necessary to improve the quality of work and/or increase work productivity. Services are usually provided over a four-week period by accredited CRPs and qualified rehabilitation engineers.

• Self-Employment Services -- Individuals with MSD will need assistance in setting up approved business plans for self-employment. These services may include required business equipment, various supplies, rental fees or start-up costs for the plan. Services will be provided by MVR counselors and business consultants as needed.