172.00.10 Ark. Code R. 002
ARS has the sole responsibility for determining eligibility for VR Services. The ARS Commissioner has delegated the responsibility of determination of eligibility to the Counselor.
For all individuals applying for services, ARS will conduct an assessment to determine eligibility and priority for services if the state is operating under an Order of Selection. 34 C.F.R. § 361.42 (a.)(2.)
Eligibility requirements will be applied in compliance with Titles VI and VII of the Civil Rights Act, The Americans with Disabilities Act and without regard to age, religion, disability, sex, race, color or national origin. The eligibility requirements are applicable without regard to the particular service need or anticipated cost of services required by an applicant or the income level of an applicant or applicant's family. Eligibility determination will be made within 60 days of the application date. Exceptional and unforeseen circumstances beyond the control of ARS that prevent the Agency from making an eligibility determination within 60 days will require ARS and the individual to agree on a specific extension of time. 34 C.F.R. § 361.42 (b.)(1-4)
Basic eligibility requirements are:
Each individual who meets the eligibility requirements is presumed to be able to benefit from VR services in terms of an employment outcome, unless determined, based on clear and convincing evidence, that the applicant is incapable of benefiting in terms of an employment outcome due to the severity of the disability. Clear and convincing evidence requires a high degree of certainty in order to conclude the individual is incapable of benefiting from services in terms of an employment outcome. The term clear means unequivocal. Given this standard, the use of a standard intelligence test only, would not constitute clear and convincing evidence. A functional assessment of the individual's abilities, capabilities and capacity to perform work situations through the use of trail work experience with appropriate supports and training would assist in defining clear and convincing evidence.
PRESUMPTIVE ELIGIBILITY SSDI/SSI RECIPIENTS
Social Security Disability Income (SSDI) beneficiaries and Supplemental Security Income (SSI) recipients are considered to be individuals with a significant disability (Category II) and presumed eligible for VR services, if the intent of the individual is to achieve an employment outcome. The employment outcome must be consistent with the unique strengths, resources, priorities, concerns, abilities, capabilities, interests and informed choice of the individual. The Agency is responsible for informing individuals through the application process that the individual must intend to achieve an employment outcome in order to receive VR services. No additional tests or procedures may be used to assess disability in order to determine eligibility.
Note: The individual who is presumed eligible as a recipient of SSI/SSDI and who intends to achieve an employment outcome is eligible unless clear and convincing evidence demonstrate that the individual is incapable of benefiting from vocational services in terms of achieving an employment outcome due to the severity of the disability.
Although an SSDI/SSI recipient is considered an individual with a significant disability, presumptive eligibility for VR services does not entitle the individual to priority for services over other individuals with significant disabilities or most significant disabilities if the state is operating under an Order of Selection.
If an applicant for VR services asserts that he or she is eligible for Social Security benefits, but is unable to provide appropriate evidence, such as an award letter, to support that assertion, ARS must verify the applicant's eligibility by contacting the Social Security Administration. This verification must be made within a reasonable period of time that enables ARS to determine the applicant's eligibility for VR services within 60 days of the individual submitting an application for services. 34 C.F.R. § 361.42 (a.)(3.)
Note: Information in this section should not be construed to create entitlement to any vocational rehabilitation service.
PROCEDURES - SSDI/SSI ELIGIBILITY
* The counselor will obtain verification of SSI/SSDI benefits and a copy will be placed in the individual's file i.e. awards letter, benefit's check, verification from Social Security Administration, or a verified/valid Ticket.
* Exception: The counselor must document in the case record the justification for completing a Certificate of Eligibility before verification is obtained, (See procedures on page III-3.)
* Complete the Certificate of Eligibility for VR, Trial Work Experience, or Extended Evaluation (EE) services. {Form RS-600-B (1) in Appendix E) The certification statement for the Certificate of Eligibility is "This individual meets the presumptive eligibility requirement." The area for limitations does not need to be completed.
* The counselor must be aware of the Ticket to Work Program. If the Applicant is eligible under "presumptive eligibility", the counselor must follow guidelines outlined in Ticket to Work in Appendix B (Special Programs).
* The applicant can be scheduled for additional testing, or medical, psychological, or psychiatric evaluation based on informed choice to determine limitations if this information is needed in the development of the IPE.
* Also, the special program code 401 (SSDI), 600 (SSI) or 601(both) Must be utilized for all individuals receiving Social Security benefits.
CERTIFICATION OF ELIGIBILITY
The counselor must include a formal certification statement signed and dated by the ARS counselor in each individual's record of services indicating eligibility for VR, Trial Work or EE services.
The Certificate of Eligibility must be completed simultaneously with an individual's acceptance for VR services, Trial Work or EE. As a minimum, the Certificate of Eligibility will contain the client's name, client's social security number, date of eligibility, and a statement of mental or physical impairment with resulting limitations.
COMPLETION OF PRELIMINARY DIAGNOSTIC STUDY
The counselor completes the preliminary diagnostic study when enough information is obtained to write the Certificate of Eligibility or Ineligibility.
PROCEDURES - CERTIFICATE OF ELIGIBILITY
* To determine functional limitations, priority should be given to existing information.
* Complete the Certificate of Eligibility for VR, Trial Work Experience, or Extended Evaluation services signed and dated by the counselor. {Form RS-600-B (1)} (See Appendix E)
* The Certificate of Eligibility must be placed in the individual's file. (See Section X)
* Case narratives should be made to reflect Status 10 (VR) or Status 06 (Trial Work Experience or Extended Evaluation). (See Appendix E)
* Key data for Status 10 (VR) or Status 06 (Trial Work Experience or Extended Evaluation). (See the case management system.)
Note: Under presumptive eligibility, the Certificate of Eligibility will be completed with documented verification that the consumer is a recipient of SSI/SSDI benefits.
CERTIFICATION OF INELIGIBILITY
When clear and convincing evidence establishes that an applicant does not meet the VR eligibility conditions or intervening reasons prevent eligibility determination (i.e. applicant does not follow through with assessment, individual physical, educational, or medical records unavailable, applicant does not appear for scheduled appointments, for plan development, etc.) the counselor must include a formal Certificate of Ineligibility in the individual's record of services. This Certificate of Ineligibility will be dated and signed by the counselor. The counselor will notify the applicant in writing of the action taken, or by other appropriate modes of communication consistent with the informed choice of the individual, including the reasons for the ineligibility determination. When appropriate, referral will be made to other agencies and programs that are part of the One-Stop service delivery system under the Workforce Investment Act. Note: For procedures see Closure Section VIII.
APPEAL/INELIGIBILITY DETERMINATION
The individual may appeal the ineligibility determination. The counselor will provide the individual with information on the means, by which an appeal can occur, including informal and formal due process procedures, such as administrative review, mediation and review by an impartial hearing officer. The counselor will also provide the individual with information regarding services available from the Client Assistance Program and how to contact the Client Assistance Program. (See Due Process Section XIV) 34 C.F.R. § 361.41
Note: An Annual Review is required on a case that has been closed as incapable of achieving an employment outcome due to the severity of disability. This review need not be conducted if the individual refuses to participate, no longer resides in the state, or the whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal. 34 C.F.R. § 361.43(e)
ORDER OF SELECTION
Under the Vocational Rehabilitation Act (Title IV of the Workforce Investment Act of 1998) certain state Vocational Rehabilitation agencies are required to have an order of selection. An order of selection requires that a priority be given to individuals with the most significant disabilities in the provision of vocational rehabilitation services. The order of selection is required in the event that the state is unable to provide the full range of vocational rehabilitation services to all eligible individuals or, in the event that vocational rehabilitation services cannot be provided to all eligible individuals in the State who apply for the services. ARS has determined that there are insufficient funds to provide services to all eligible individuals within the State.
The ARS Order of Selection assures the highest priority in service provision is reserved for eligible individuals with the most significant disabilities. Services and expenditures are closely monitored to enable the ARS Commissioner to close or open priority categories as deemed appropriate. This will assure services are continued for cases determined eligible and receiving services under an Individualized Plan for Employment. Adequate funds will be reserved to provide diagnostic services for all applicants to determine eligibility and category placement.
DESCRIPTION OF PRIORITY SELECTION
The Order of Selection priority categories, justification for each, outcome and service goals are listed below:
ARS will provide services based on an Order of Selection on a statewide basis. The ARS Order of Selection assures clients in Priority I and II will have first priority for the provision of services. If funds become available, individuals in Priority III may receive services.
Rehabilitation clients who have an Individualized Plan for Employment (IPE) for vocational rehabilitation (VR) services or extended evaluation (EE) services in place prior to the implementation of the Order of Selection policy will receive services as recorded in their IPE.
Priority Category I - Most Significantly Disabled
An eligible individual with a most significant disability is defined as one who has a significant physical or mental impairment which:
Priority Category II - Significantly Disabled
An eligible individual with a significant disability is defined as one who has a significant physical or mental impairment which:
Priority Category III - Non-Significantly Disabled
An eligible individual with a non-significant disability is defined as one who has a significant physical or mental impairment which:
Definitions:
* Two (2) or more major VR services, i.e. counseling and guidance, assistive technology, physical or mental restoration, training, and placement.
** 90 days or more from the date services are initiated.
*** One or more physical or mental disabilities resulting from: amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end- stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.
PRIORITY OF CATEGORIES TO RECEIVE VR SERVICES UNDER THE ORDER
ARS will provide services based on an Order of Selection on a statewide basis. The ARS Order of Selection assures clients in Priority I and II will have first priority for the provision of services. If funds become available, individuals in Priority III may receive services. Rehabilitation clients who have an Individualized Plan for Employment (IPE) for vocational rehabilitation (VR) services or extended evaluation (EE) services in place prior to the implementation of the Order of Selection policy will receive services as recorded in their IPE.
PROCEDURES - ORDER OF SELECTION
* Eligibility (Status 10) must be established prior to applying the Order of Selection.
* Complete the Assessment for Determining Priority Category for Services. (See Appendix E)
* The consumer will be notified in writing of the priority category using the required form letter. The original will be mailed to the individual and a copy will be placed in the case file. (See Appendix E)
* Document the Category placement in the case narrative by using the Order of Selection heading.
* If the individual does not meet the level of the priority category necessary to receive services, the individual may choose to be placed in a waiting (list) Status 04, or be referred to other Workforce partners or agencies, or closed in Status 30:
If the individual chooses to be referred to other Workforce partners or agencies:
- Referral will be made to the appropriate Workforce partner.
- Documentation of the referral will be placed in the case file.
- The case will be closed in Status 30 by completing RS600-C.
- Key data for Status 30.
If the individual chooses to be placed on a deferred services list (Status 04):
- Documentation of the action taken will be made in the case narrative.
- Complete the Certificate of Eligibility. (See Appendix E)
- Key data for Status 04.
- If funding becomes available, an IPE will be completed and the case moved to Status 12 and services will be provided without further delay.
- If funding is not available, any cases remaining in Status 04 at the end of the fiscal year will be closed in Status 38.
An individual's economic need is not used to determine eligibility for VR services. An economic needs assessment is used only to determine if the individual can pay any costs of VR services and if so, how much. In all cases, no economic needs evaluation will be applied as a condition for furnishing the following VR services:
In determining an individual's financial resources, the counselor will identify all resources available to the individual and/or spouse. If the individual is a dependent, the resources of the parents will be determined. If the individual is 23 years of age or under and unmarried, the parent(s) assets must be verified with a copy of the parent(s) income tax forms. If the parent(s) do not support the individual, the individual must provide documentation of non-support. If the client's family states the client will not be claimed on next year's income tax, the client will no longer be considered a dependent. The client will be required to verify their source(s) of income to cover their expenses.
EXCEPTION: SSDI and SSI recipients are exempt from financial need; however, the financial resources form should be completed to assess comparable benefits and gather information for federal reporting.
Provision of services conditioned on financial need entails:
A need standard in the form of a Normal Living Requirement (NLR) has been established for different family groups and single individuals living alone. The NLR includes amounts for food, shelter, clothing, household maintenance, routine medical care, personal care, recreation, insurance, and personal taxes.
NORMAL LIVING REQUIREMENT
Number of Persons | Monthly Amount |
1 | $3,200.00 |
2 | $3,600.00 |
3 | $4,000.00 |
($400.00 for each additional family member)
Special Circumstances (conditions) of other expenditures/debts that impose unusual burdens on the client or family's income can be added to the normal living requirement. (Example: medication or medical payments for client or other family members, child support, education expenses, etc.)
Ascertaining an individual's financial resources is an important step in determining ability or inability to pay for rehabilitation services. A resource is considered available only if it is at the individual's disposal when needed. Careful study of the individual's resources is necessary to determine availability.
The provision of certain services to the individual is dependent upon financial need, but the counselor should use discretion upon applying financial need. Stripping the individual of all resources may impair the individual's rehabilitation.
The comparable benefits provision provides VR agencies with an organized method for assessing an individual's eligibility for benefits under other programs. Any benefit available to individuals under any other program to meet, in whole or in part, the cost of any VR service will be utilized. This benefit will be considered only to the extent that it is available and timely.
A "comparable benefit" is not the same as "determination of economic need." In determination of economic need, the objective is to set the conditions for equitably determining the amount, if any, an individual is expected to participate in the cost of the rehabilitation. In the area of comparable benefits, the objective is to give full consideration to alternative funding sources prior to spending VR funds to purchase consumer services.
If the individual refuses to apply for services for which the individual may be eligible or if the individual refuses to accept services from another Agency as a comparable benefit when receipt of such services do not interfere with achieving the rehabilitation objective, ARS cannot provide the services using VR funds.
Federal VR funds cannot be used to pay training costs in institutions of higher education unless every effort has been made to secure financial assistance, in whole or in part, from other funding sources. In all training cases, the record of services must include evidence that applications were made and the individual will or will not receive assistance.
Evidence of approval of receipt of financial assistance may be documented through a financial aid award letter. This letter originates at the training institution and lists the type/amount received by semester (quarter). Federal law requires students to accept/reject awards by signing on this letter.
Repayable loans should not be considered as a comparable benefit or resource.
Note: Comparable benefits do not include awards and scholarships based on merit.
PROCEDURES - UTILIZING FINANCIAL NEED
* Exempt SSDI/SSI recipients from financial need assessment/requirements.
* The individual must apply for comparable benefits and documentation of benefits must be placed in the case file, i.e., award letter/Student Financial Aid Grant
* The financial resources form (RS-16) must be completed by the time the IPE is developed.
* For those individuals or the parents of individuals under the age of 23 not exempt as recipients of SSI/SSDI, the counselor will verify income by requesting Income Tax returns, copies of earnings statements, Student Financial Aid grant summary or the individual may be required to request their earnings history from the Social Security Administration.
* Any available benefits will be utilized and must be considered in the provision of services.
* Other than diagnostic services, no authorizations will be issued until financial need is verified.
* In all instances where the Student Financial Aid is utilized, the counselor will utilize the basic cost of education reported from the school that the individual will attend. The applicable Student Financial Aid categories are dependent, on campus, dependent off campus, and independent. The basic costs may include tuition, books, fees, room and board, supplies, and transportation.
* Financial need should be re-assessed and a RS-16 completed at Annual Review or at any time the individual's financial situation changes.
Arkansas Rehabilitation Services highest priority is to provide individualized services to eligible individuals so they can work in full-time competitive employment.
Services will be provided in compliance with Title VI and VII of the Civil Rights Act, The Americans with Disabilities Act and without regard to age, religion, disability, sex, race color or national origin.
SUBSTANTIALITY OF SERVICES
Substantial vocational rehabilitation services are those services, which, provided in the context of the counseling relationship, collectively and significantly contribute to the achievement of an employment outcome consistent with the informed choice of the individual.
In order for the counselor to show substantial services in a case, the counselor must document the relationships of the provision of services, the criteria for evaluation of the intermediate objectives or steps needed to reach the vocational goal, and the counseling necessary for successful closure of a case. Documentation of substantiality of services in the case file is an ongoing process. This documentation must be found in the case narrative entries; therefore, the case narrative must tell the story of the case and subsequently show the individual's participation and the services provided enabled the individual to become employed.
THREE CONTACTS A YEAR
There must be three contacts a year, which will include the annual review. The case narrative should be direct face-to-face contact, e-mail conversation, phone conversation with the client, or a letter from the client. If contact with the client is not possible, use a letter to document the counselor's attempts to contact the client leading to closure of the case due to loss of contact. Be sure to document counseling after services have been initiated at least once a year.
VOCATIONAL REHABILITATION SERVICES
As appropriate to the vocational rehabilitation needs of each individual and consistent with each individual's informed choice, the following vocational rehabilitation services are available:
PROVISION AND AUTHORIZATION OF SERVICES
ARS currently requires District Manager approval on all new counselors (Section XIII, Policy and Procedure Manual). District Manager and/or Administrative approval is also required for several specified purchases and services (Section VI, Policy and Procedure Manual).
The Authorization/Payment justification should consist of a copy of an invoice/receipt and a notation in the case narrative explaining why the services were necessary.
Written authorization must be made, simultaneously with, or prior to, the provision of the service or goods. A verbal authorization may be given in an emergency followed immediately by a written authorization. The written authorization must contain the date of the verbal authorization. An IPE must be written before any services or goods, other than diagnostic or to support diagnostic assessment, can be provided. It is the counselor's responsibility to document case progress throughout provision of services.
NOTE: A "comparable" benefit will be considered only to the extent that it is available and timely to meet the cost of the particular VR services.
NOTE: The counselor will not approve payment requests until documentation that the service has been provided and has been received. Documentation may include medical reports, training progress reports, attendance forms, receipts and/or invoices.
PROCEDURES - PROVISION AND AUTHORIZATION OF SERVICES
* Before an authorization is issued the counselor must consider the following issues:
- Is this service allowable under ARS Policy?
- What, if any, limitation exists to providing this service?
- Are there any comparable benefits available to provide the service?
- Has the counselor verified financial need?
- What other required references need to be accessed (i.e., fee schedule vendor list)?
- Does the counselor have sufficient funds in the allotment to procure/provide the service and if not, whom does the counselor contact?
- What documentation is needed to procure/provide the service? (i.e., Licensed Medical Consultant (LMC), prior approval, case narrative.)
- Document method of calculating cost of services (i.e.: estimates, quotes, recommendations, fee schedule, etc.) and explain why the current service is needed.
- How is the paperwork routed?
- Determine if the vendor is in the case management system vendor list. Complete a W-9 if needed.
- Create the authorization in the case management system.
- The original authorization goes to the vendor, a copy is placed in the case file, and the individual may be provided a copy.
- When service is received, along with the billing statement, verify the individual received service, then process for payment
VOCATIONAL REHABILITATION COUNSELING AND GUIDANCE
The counselor will write a program for a "vocational rehabilitation counseling, guidance, placement, and follow-up" case. The program will outline in the criteria for evaluation of progress toward the employment outcome the counseling process and anticipated results. Documentation of counseling progress will be placed in the record of services. Vocational rehabilitation counseling and guidance services must be provided and documented in all VR cases closed rehabilitated.
PROCEDURE - VOCATIONAL REHABILITATION COUNSELING AND GUIDANCE
* The counselor will document in the case narratives the specific progress the individual is making toward the employment outcome.
* The individual's progress will be reviewed three times a year.
* Counseling and guidance must be documented in each successful closure.
EMPLOYMENT SERVICES (JOB FINDING/REFERRAL)
A job-finding service is provided when enough information has been given to permit the individual to arrange for a job interview with an employer. A job-finding service is also rendered when ARS directly refers or arranges for the direct referral of the individual to a prospective employer.
PROCEDURES - EMPLOYMENT SERVICES (JOB FINDING/REFERRAL)
* The individual may be referred to either an ARS Employment Services Representative or other vendors for employment services in status 12 or 18. The ARS Employment Services Representative can assist the counselor at this stage in the planning process, but significant involvement of the ARS Employment Services Representative may occur when the individual has completed services and is ready for employment.
* The counselor and ARS Employment Services Representative will assist the individual, singly or in groups, in developing job-seeking skills which would include instructions on how to read the want ads, prepare job resumes, write cover letters and prepare for job interviews.
* The counselor may refer the individual for services from other resources providing job-seeking skills, if appropriate.
* The counselor will document in the case narrative the specific progress the individual is making toward the employment outcome.
PLACEMENT SERVICES
Placement services are organized and identifiable attempts to establish or improve the linkage of an individual and a work situation. While employment placement is the VR program goal and usually occurs toward the end of the rehabilitation process, employment planning should be an ongoing process throughout the case services program. Placement is provided when the individual is referred to and is hired by an employer. The State VR Agency, the State employment service, One-Stop Arkansas Workforce Centers, or any other job-finding source may provide this service. A key feature of this service is that the individual became competitively employed as a result of the job referral.
PROCEDURES - PLACEMENT SERVICES
* The counselor will assist the individual with employment planning throughout the rehabilitation program.
* The counselor and the ARS Employment Services Representative will document in the case narrative the specific progress the individual is making toward the employment outcome.
FOLLOW-UP
The counselor will provide follow-up services to each individual placed in employment to determine if all planned for services have been provided and the VR objective achieved. Follow-up services will include contacts and reports from the individual, employer, and others that provide reports to help the counselor determine if the employment situation is suitable to the individual's needs. The individual must be provided follow up services within a minimum of 90 days and the counselor will have assurance other ARS criteria have been met prior to case closure.
PROCEDURES - FOLLOW-UP
* The counselor or the rehabilitation assistant will maintain contact with the individual and employer to determine if the employment is suitable for the individual.
* The counselor or the rehabilitation assistant will provide supportive services as necessary for maintaining employment.
* The counselor or the rehabilitation assistant will document in the case the specific progress the individual is making toward the employment outcome.
ASSESSMENT SERVICES
Case Service Code for Status 02 - 1110
Case Service Code for Status 04 - 1310
Case Service Code for Status 06 - 1210
Case Service Code for Status 10-22 - 1310
Case Service Code for Status 32 - 1410
Assessment services are those services required to determine an applicant's eligibility for rehabilitation services, priority for services, and to determine the services needed to achieve an employment outcome.
Medical diagnostic services may include:
Vocational diagnostic or assessment services may include:
The above listed services may be provided an individual at any time, but normally will be completed during the case investigation process. They may be provided by ARS personnel, obtained elsewhere at no cost to ARS, or purchased by ARS.
RESTORATION (PHYSICAL/MENTAL) SERVICES
Restoration services mean those medical and medically related services that are necessary to correct or substantially modify within a reasonable period of time, a stable or slowly progressive physical or mental condition. These include surgery, therapy, treatment, and hospitalization.
Prosthetic appliances/devices provided to improve or maintain an individual's ability to work are coded as Rehabilitation Technology Devices.
If an individual has a physical or mental disability with resulting limitations constituting an impediment to employment which, in the opinion of competent medical personnel, can be removed by restoration services without injury to the individual, the individual is not eligible for any ARS services except counseling, guidance and placement if the individual refuses to accept the appropriate restoration services.
PHYSICAL RESTORATION SERVICES PURCHASED IN-STATE
ARS will pay for all physical restoration services that are properly authorized. Payment will be made according to the vendors' stated fee, up to but not to exceed, the maximum amount determined by the established ARS Fee Schedules. The fee paid by ARS must be accepted as payment in full by the vendor. The fee paid to physicians for surgical treatment includes 15 days routine post-operative care.
PROCEDURES- PHYSICAL/MENTAL RESTORATION SERVICES
* Documentation of the action to be taken will be made in the case narrative.
* Medical reports and recommendations will be obtained from the attending physician and the reports placed in the case file
* Medical Consultant review is required. (Form RS3-g) (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* If wheelchairs or other durable medical equipment is purchased, a title of retention will be completed and placed in the case file. (See Appendix E).
* Refer to ARS Fee Schedule. (See Appendix I. for additional fee information.)
* Key data for Status 18 if needed. (Refer to the case management system.)
* Select appropriate ARS Procedure code.
* Key authorization. (Refer to the case management system.)
* When billing statement is received, along with a medical report, key payment in the case management system. NOTE: The vendor must agree to accept ARS fees for services.
PHYSICAL RESORTATION SERVICES PURCHASED OUT-OF-STATE
If ARS purchases physical restoration services out-of-state (in this instance Texarkana, TX is considered in the State), the rate paid will not exceed fees paid by the local rehabilitation Agency. ARS will use physicians and facilities that are used by the local state Agency. If fee information is not available, the counselor will contact the nearest out-of-state VR office to determine fees paid for needed services.
PROCEDURES - PHYSICAL/MENTAL SERVICES - OUT-OF-STATE
* Documentation of the action to be taken will be made in the case narrative.
* Medical reports and recommendation will be obtained from the attending physician and the reports placed in the case file.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Refer to ARS Fee Schedule. (See Appendix I. for additional fee information.)
* Key data for Status 18 if needed. (Refer to the case management system.)
* Select appropriate ARS Procedure code.
* Key authorization (Refer to the case management system.)
* When billing statement is received, along with a medical report, key payment in case management system.
* The medical report will be placed in the case file.
MEDICAL CONSULTANT
In all cases involving medical and surgical treatment, hospitalization, drugs (except for acute medical care), and all medically directed therapies, a written consultation must be obtained from the Medical Consultant.
PROCEDURES - MEDICAL CONSULTANT
* The medical consultant will review medical/psychiatric reports and make recommendations.
* The medical consultant will complete the Medical Consultant form RS3-G.
* The form will be placed in the case file.
MEDICAL, SURGICAL, PSYCHIATRIC, AND MEDICALLY DIRECTED TREATMENT
Case Service Code for Status 06 - 1221
Case Service Code for Status 18 -22 - 1321
Case Service Code for Status 32 - 1421
Medical Treatment: After the initial diagnostic medical evaluation, payments may be made to a physician (general practitioner or specialist), clinic, dispensary, or hospital for services provided to the individual. Examples include drugs, biological, or other medical supplies incidental to treatment.
Psychiatric Treatment: After the initial psychiatric diagnostic evaluation, payments may be made to a specialist in neuropsychiatry, a psychiatric clinic or hospital for psychiatric treatment.
Surgical Treatment: Payments may be made for surgical operations and fees for pre-operative care. Payments will be made according to the established ARS Fee Schedule. (See Appendix I. for additional fee information.)
Anesthesia: Payments may be made to anesthetists and anesthesiologists not included in hospitalization.
University of Arkansas Medical Sciences:Payments for professional services including surgical treatment, anesthesia, pathology, and others provided at the UAMS are to be authorized to the "Medical College Physicians Group."
Physical and Occupational Therapy (PT/OT): ARS will pay for PT/OT services when prescribed and provided by competent medical personnel and when necessary to a VR program. If the expected duration of treatment is more than 30 days, then equivalent services at ACTI should be considered.
Podiatrist or Chiropractor: ARS will pay for the services of a Podiatrist or Chiropractor only with Medical Consultant approval.
Dental: ARS may purchase dental services including oral surgery when necessary for an individual to participate in or complete a VR program. Available services do not include routine preventive dental care. Services will be purchased consistent with the ARS fee schedule. (See Appendix I. for additional fee information.)
EXCEPTION: Insurance benefits must be used first in paying for surgical and medical services. The amount allowed by the ARS Fee Schedule will be authorized followed by the statement "Rehabilitation Services will pay only that part of the authorized amount not covered by the insurance policy up to the maximum amount allowed by the ARS Fee Schedule". (See Appendix I. for additional fee information.)
PROCEDURES - MEDICAL, SURGICAL, PSYCHIATRIC, AND MEDICALLY DIRECTED TREATMENTS
* Documentation of the action to be taken will be made in the case narrative.
* Medical reports and recommendations will be obtained from the attending physician and the reports placed in the case file.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Refer to ARS Fee Schedule. (See Appendix I. for additional fee information.)
* Select appropriate ARS Procedure code..
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When billing statement is received, along with a report, key payment in case management system.
* The medical report will be placed in the case file.
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
DIRECTED THERAPY FOR WEIGHT LOSS
ARS may provide services for structured weight loss programs such as Weight Watchers, TOPS, etc. or other medical directed programs. The counselor should make every effort to seek out programs in the community that provide supportive/mental health counseling and address significant lifestyle changes including diet, exercise, and behavior modification. The counselor will consult with the District Manager for approval of the treatment program and negotiated costs.
PROCEDURES - DIRECTED THERAPY FOR WEIGHT LOSS
* Medical reports and recommendations will be obtained from the attending physician and the reports placed in the case file.
* Medical Consultant review is required. (See Appendix E).
* Counselor will negotiate reasonable fees with the vendor.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Select appropriate ARS Procedure code.
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
TREATMENT FOR MORBID OBESITY (GASTRIC RESTRICTIVE, LAP BAND OR BYPASS SURGERY)
Individuals requesting assistance from ARS for gastric restrictive, lap band or bypass surgery as a method of treatment for morbid obesity are to be informed the procedure is a major operation with the potential of both short-and long-term complications.
Any decision to use surgery as a treatment for morbid obesity requires assessing the risk-benefit by an experienced physician(s). Candidates for the procedure should be judged as having a low probability of success using non-surgical measures as demonstrated by failure in an established weight control program(s). Such programs might include in various combinations behavior modification, exercise, low- or very low-calorie diets, and drug therapy.
A diagnosis of morbid obesity alone does not indicate an individual is an appropriate candidate for this procedure. High-risk conditions such as significant diabetes mellitus, obstructive sleep apnea, obesity-related cardiomyopathy and joint disease would increase the likelihood an individual would be an appropriate candidate for gastric restrictive, lap band or bypass surgery.
Individuals with a diagnosis of morbid obesity may be eligible for restoration services if all the following criteria are met:
SUPPORTED COUNSELING RELATED TO WEIGHT
After 3 months in a weight loss program, at the counselor's discretion and based on little or no success, the client program needs to be modified.
PROCEDURES - GASTRIC BYPASS SURGERY
* Obtain a general medical assessment or current medical information that documents the individual's diagnosis of morbid obesity and any other high-risk co-morbid conditions.
* Obtain a Mental Health Assessment that indicates the individual does not have a mental health condition that might preclude this restoration service.
* Obtain documentation from a treating physician of the individual's failure in a structured weight loss program for at least 1 year (this documentation must be within the last 2 years.) and the presence of morbid obesity for at least 5 years.
* Documentation of co-morbid conditions by an appropriate physician with a statement of recommendation for weight loss surgery.
* Obtain medical reports that document the need for referral to a surgeon for an assessment to determine the appropriateness of gastric restrictive, lap band, or bypass surgery.
* Obtain an examination from a surgeon proficient in gastric restrictive, lap band, and bypass procedures that documents the individual is an appropriate candidate for this procedure.
* Assess the individual regarding motivation for the procedure and understanding of the associated risks.
* The Counselor will submit received reports and documentation for review and approval by the Medical Consultant.
* The Counselor will submit a memorandum to the District Manager with the reports and all required documentation requesting approval for the procedure. As a part of the memorandum the counselor will provide the District Manager the counseling issues to be addressed during the restoration and recovery process.
* If the District Manager agrees that all the required documentation is present and the individual meets ARS eligibility and Order of Selection requirements, the individual is an appropriate candidate for the procedure, and agrees with the identified counseling issues, the District Manager will provide the Counselor a memorandum of approval.
* If the District Manager does not agree the individual meets eligibility and Order of Selection criteria, is not an appropriate candidate for the requested gastric restrictive or bypass procedure, or is of the opinion that the identified counseling issues are inadequate or inappropriate, a memorandum of denial will be sent to the counselor notifying the counselor of the decision.
* If the District Manager approves, the Counselor will proceed as with any other physical restoration case.
* During the recovery process the Counselor will be required to document a minimum of 3 counseling sessions prior to case closure.
* It is recommended that the case be placed in post-employment status so that necessary counseling and follow-up can take place to ensure optimum benefits from the procedure.
NOTE: If the referred case has serious medical problems that pose serious consequences due to delay of case processing, an administrative exception may be requested.
COCHLEAR IMPLANTS
Requirements:
* Complete psychological exam to determine emotional and mental stability of the individual.
* Document evidence from the individual or employer that the procedure would remove any significant vocational impediment.
* Document counseling with medical personnel and a peer in regard to after effects and adjustment to the procedure.
* Document post-operative aural rehabilitation plan.
* Refer required documentation to District Manager, Deputy Director of Field Operations and Chief of Field Services for approval.
SURGICAL AND HOSPITAL INSURANCE
Insurance benefits must be used first in paying for surgical and medical services. The amount allowed by the ARS Fee Schedule will be authorized followed by the statement.
"Rehabilitation Services will pay only that part of the authorized amount not covered by the insurance policy up to the maximum amount allowed by the ARS Fee Schedule". Authorization will be based on the ARS Fee Schedule. (See Appendix I. for additional fee information.)
CONSULTATION
For diagnostic purposes, the attending physician may consult with another specialist. The counselor must have a recommendation for consultation and prior authorization is required.
POST-OPERATIVE REPORTS
It is the counselor's responsibility to obtain a post-operative report or narrative letter prior to processing the final payment.
MINOR SURGERY BY GENERAL PRACTITIONERS
ARS may pay general practicing physicians for minor surgery, such as the opening of a superficial abscess or removal of a superficial tumor or cyst.
MEDICATION
Case Service Code for Status 02 - 1110
Case Service Code for Status 06 - 1221
Case Service Code for Status 18 - 22 - 1321
Case Service Code for Status 32 - 1421
Medication can be provided throughout the program and 30 days following placement.
The counselor must document the ongoing medication need either through the Medical Consultant, or the individual's personal care physician. The counselor must actively negotiate for the most economical medication prices.
PROCEDURES - MEDICATION
* Documentation of the action to be taken will be made in the case narrative.
* Medical reports and recommendations including prescription will be obtained from the attending physician and the reports placed in the case file.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Select appropriate ARS Procedure code.
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
SPEECH AND HEARING THERAPEUTIC SERVICES
Case Service Code for Status 06 - 1221
Case Service Code for Status 18 - 22 - 1321
Case Service Code for Status 32 - 1421
Individuals with organic or inorganic speech and hearing disorders may be scheduled for evaluation and therapy by an approved therapist. The counselor will furnish the therapist with information needed to provide services.
PROCEDURES - SPEECH AND HEARING THERAPEUTIC SERVICES
* Documentation of the action to be taken will be made in the case narrative.
* Medical reports and recommendations will be obtained from the attending physician and the reports placed in the case file.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Refer to ARS Fee Schedule. (See Appendix I. for additional fee information.)
* Select appropriate ARS Procedure code.
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
HOSPITALIZATION, CONVALESCENT CARE AND NURSING SERVICES
Case Service Code for Status 06 - 1222
Case Service Code for Status 18 - 22 - 1322
Case Service Code for Status 32 - 1422
ARS will pay for inpatient or outpatient hospitalization, including blood, in Arkansas hospitals according to current Medicaid fees or other fees established.
ARS will pay for the day an individual enters the hospital, but not the day on which the individual is discharged.
PROCEDURE - HOSPITALIZATION, CONVALESCENT CARE AND NURSING SERVICES
* Documentation of the action to be taken will be made in the case narrative.
* Medical reports and recommendations will be obtained from the attending physician and the reports placed in the case file.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Refer to ARS Fee Schedule. (See Appendix I. for additional fee information.)
* Select appropriate ARS Procedure code.
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
CONVALESCENT OR NURSING HOME CARE
Case Service Code for Status 06 - 1222
Case Service Code for Status 18 - 22 - 1322
Case Service Code for Status 32 - 1422
If care in a convalescent or nursing home is medically recommended after a period of hospitalization, the arrangements will be noted in the IPE. There will be a re-evaluation of rehabilitation potential within 30 days.
PROCEDURES - CONVALESCENT OR NURSING HOME CARE
* A recommendation from the attending physician must be secured before authorizing for convalescent or nursing home care.
* Documentation of the action to be taken will be made in the case narrative.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Refer to ARS Fee Schedule. (See Appendix I. for additional fee information.)
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
HOSPITALIZATION THROUGH COOPERATING AGENCIES
ARS will use hospitalization available through cooperating agencies when feasible. It is the counselor's responsibility to determine if these services are available through the cooperating agencies before obligating ARS for these services.
RADIOLOGY/ PATHOLOGY
Case Service Code for Status 06 - 1221
Case Service Code for Status 18 -22 - 1321
Case Service Code for Status 32 - 1421
ARS may pay for radiology/pathology services according to the ARS Fee Schedule.
PROCEDURE - RADIOLOGY/PATHOLOGY
* Documentation of the action to be taken will be made in the case narrative.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Refer to ARS Fee Schedule for fees. (See Appendix I. for additional fee information.)
* Select appropriate ARS Procedure code.
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
NOTE: If radiology and pathology are provided in conjunction with surgery, the medical consultant review is not necessary for these services since the consultant has already reviewed the recommendation for surgery.
SPECIAL NURSES
Case Service Code for Status 06 - 1223
Case Service Code for Status 18 - 22 - 1323
Case Service Code for Status 32 - 1423
ARS may provide nursing service by a registered nurse only if ordered by the attending physician. Practical nurses will be used only when a registered nurse cannot be obtained or if, in the opinion of the attending physician, the services of a registered nurse are not required. ARS may pay the standard rate for this service in the community.
PROCEDURES - SPECIAL NURSES
* Documentation of the action to be taken will be made in the case narrative.
* Medical Consultant review is required. (See Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Refer to ARS Fee Schedule. (See Appendix I. for additional fee information.)
* Select appropriate ARS Procedure code.
* Key data for Status 18 if needed. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
CHILDREN'S MEDICAL SERVICES
Any individual who may be eligible for Children's Medical Services and who might need physical restoration will be referred to CMS to determine eligibility. If the individual is eligible for services through CMS, ARS will not provide the services.
TRAINING
Training services are those services needed to prepare an eligible individual for work. These services are individualized and are jointly developed by the individual and counselor through the process of informed choice.
Vocational training includes the following broad categories:
It is the policy of ARS to provide "individual-appropriate" training services needed to achieve employment. Individual-appropriate services reflect the unique strengths, priorities, concerns, abilities, capabilities, and career interests of each eligible individual. These individual-appropriate services may be based upon a review, to the extent needed, of the following:
ARS recognizes that the transition from high school to post-secondary training is a crucial time and is a period of change and stress. Training options beyond the vocational-technical level must have documentation based on the assessment of rehabilitation needs that the individual can be successful in the selected training area.
An individual is eligible for training:
FINANCIAL AID
The counselor will provide general information regarding various alternative-financing sources; however, the individual is responsible for securing financial aid. Documentation must be presented to the counselor prior to the school's established payment deadline. This documentation can include: college award letter, Student Financial Aid grant response letter, on-line Student Financial Aid grant printouts, or copies of Student Financial Aid grant application forms.
The counselor will utilize the basic cost of education reported from the school that the individual attends. The applicable Student Financial Aid categories are dependent, on campus, dependent off campus, and independent. The basic cost may include tuition books, fees, room and board, supplies and transportation.
The individual will indicate choice of school and course of study in accordance with informed choice by signing the IPE.
NOTE: ARS will not be bound to any agreement or contract the individual entered into prior to signing the IPE.
A threshold of $5000 has been established per twelve month period beginning with initiation date of the IPE for tuition, required textbooks, academic fees, maintenance, and transportation. For an exception refer to Appendix G. (Exception: Medical, dental, veterinary schools and those individuals with special needs may be funded at a higher level.)
COLLEGES AND UNIVERSITIES
Case Service Code - Tuition - for Status 06 - 1231
Case Service Code - Tuition - for Status 18 - 22 - 1331
Case Service Code - Tuition - for Status 32 - 1431
ARS will assist individuals in pursuing two and four-year College and university training programs in only those colleges and universities accredited by the appropriate accrediting Agency and whose courses will be given full recognition by other accredited colleges and universities. It is the counselor's duty to determine if the selected institution is approved by the State Department of Education or by another qualified accrediting Agency of the state in which it is located.
Preference will be given to institutions in Arkansas. If training is not available within the State, or if there are other circumstances, which the counselor feels justifies out-of-state training, such training will be permitted.
If training is available within the State and the client attends an out-of-state institution, the maximum amount payable will be the same as that paid if the individual would be attending an institution within the State as a full-time student. The cost of tuition, fees, textbooks, maintenance, and transportation will not exceed the institution's established education costs.
The cost of private school training will not exceed the cost of State supported institutions. For training at a private Arkansas institution, ARS may supplement the individual's resources and pay up to, but not more than, training fees at State supported institutions for a full-time student. If training is not available within the State, ARS may pay the fees charged by the particular out-of-state university or college for a full-time student.
A threshold of $5000 has been established per twelve month period beginning with initiation date of the IPE for tuition, required textbooks, academic fees, maintenance, and transportation. For an exception refer to Appendix G.
ADVANCED DEGREE
It is ARS policy to assist individuals in obtaining an advanced degree only when this degree is a minimum requirement for the vocational objective. The decision to obtain an advanced degree must be determined at the time of initial plan development. For example: A client whose vocational objective is teaching may not change the objective to superintendent or principal in order to receive further ARS financial assistance.
ARS may assist clients beyond the Bachelor level in occupations that require advanced training for entry level, such as medicine, dentistry, law, etc. and must be determined at the time of initial plan development.
FULL-TIME STUDENT
A full-time student receiving financial support from ARS is one who completes 12 per semester hours or 6 semester hours for per summer term at the college level.
At the counselor's discretion, exceptions may be made when the record of services reveals that, because of the severity of the disability or for other obvious reasons such as schedule difficulties, the need for part-time work or upon the recommendation from the client's physician, school officials, etc., the client cannot be expected to carry 12 hours of course work. Documentation of the exception must be made in the case file.
REMEDIAL COURSES
ARS will only pay for a total of 6 semester hours of remedial work. These remedial hours must be completed during the first academic year. The following statement will be placed on authorizations for college tuition "ARS will only pay for 6 hours of remedial work."
SATISFACTORY PERFORMANCE - COLLEGE AND UNIVERSITIES
Any full-time college student who does not complete 12 hours of course work during the regular semester or 6 hours during summer semester with a "C" average (2.0) may be placed on probation for the following semester at the counselor's discretion. If the client is placed on probation and fails to make a "C" average (2.0), college training will be terminated. Failure to do acceptable college course work will result in a re-evaluation of the client's program and the selection of a more realistic vocational objective.
GRADES - COLLEGES AND UNIVERSITIES
The counselor is responsible for obtaining grades. This responsibility should be delegated to the individual. Grades (GPA) will be used as the measure of satisfactory progress and must be provided to the counselor in a timely manner in order to approve the next semester. Responsibilities of College Students Form must be signed by the individual and counselor and placed in the individual's record of services prior to the initial semester and each following fall semester.
Accredited universities/colleges are beginning to offer classes via Internet and other distance education options. These classes can provide college training to individuals with most significant disabilities whose accessibility or environmental needs made traditional campus-based training difficult.
This type of training, however, may be impractical for students who require the reinforcement and motivation of time-scheduled classes and social participation. Because of the many non-accredited correspondence courses offered by businesses or companies, the counselor should evaluate this option carefully.
PROCEDURE - COLLEGE AND UNIVERSITY TRAINING
* Documentation of the action to be taken will be made in the case narrative.
* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid grant response letter, on-line Student Financial Aid printouts, or copies of Student Financial Aid grant application forms.
* Complete Annual Review documenting any changes to the IPE by completing the Amendment (RS600-C.)
* Update the Financial Resources Form (RS16) at Annual Review, if appropriate.
* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* If specialized equipment, i.e. computers, software, etc., is purchased a title of retention will need to be completed. (See Appendix E.)
* Refer to the K Drive for the College and University folder for fees.
* Key data for Status 18. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
* Refer to Out of State Policy limitations, if necessary.
COLLEGE TEXTBOOKS
Case Service Code for Status 06 - 1230
Case Service Code for Status 18 - 22 -1330
Case Service Code for Status 32 - 1430
ARS may purchase required textbooks for full-time students who are making satisfactory progress. Authorizations for textbooks must be submitted to the bookstore in a timely manner, usually prior to the beginning of classes. The request for payment from the bookstore must be accompanied by a list of books purchased, individual book price, and the individual's signature.
PROCEDURES - COLLEGE TEXTBOOKS
* Documentation of the action to be taken will be made in the case narrative.
* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid grant response letter, online Student Financial Aid printouts or copies of Student Financial Aid grant application forms.
* Complete Annual Review documenting any changes to the IPE by completing the Amendment (RS600-C.)
* Update the Financial Resources Form (RS16) at Annual Review.
* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for Status 18. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment.
* Refer to Out of State Policy limitations, if necessary.
BUSINESS/COMPUTER SCHOOLS OR COLLEGES
Case Service Code for Status 06 - 1233
Case Service Code for Status 18 - 22 -1333
Case Service Code for Status 32 - 1433
ARS may purchase training for qualified clients in any business school or college capable of providing the training necessary for the client to attain the vocational objective.
Satisfactory performance will be documented by a progress report indicating satisfactory progress in the training program.
PROCEDURES - BUSINESS SCHOOLS OR COLLEGES
* Documentation of the action to be taken will be made in the case narrative.
* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid grant response letter, online Student Financial Aid printouts or copies of Student Financial Aid grant application forms
* Complete Annual Review documenting any changes to the IPE by completing the Amendment (RS600-C.)
* Update the Financial Resources Form (RS16) at Annual Review.
* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* If specialized equipment, i.e. computers, software, etc., is purchased a title of retention will need to be completed. (See Appendix E.)
* Key data for Status 18. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment.
* Refer to Out of State Policy limitations, if necessary.
VOCATIONAL SCHOOL
Case Service Code for Status 06 - 1234
Case Service Code for Status 18 - 22 -1334
Case Service Code for Status 32 - 1434
ARS may purchase training for qualified individuals in any vocational, trade, or technical school capable of providing the training necessary for the individual to attain the vocational objective. If training is available within the State and the individual attends an out-of-state school, the maximum amount payable will be the same as that paid if the individual would be attending an institution within the State as a full-time student. Satisfactory performance in a non-academic program will be documented by a progress report indicating satisfactory progress in the training program.
PROCEDURES - VOCATIONAL SCHOOL
* Documentation of the action to be taken will be made in the case narrative.
* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid grant response letter, online Student Financial Aid printouts or copies of Student Financial Aid grant application forms.
* Complete Annual Review documenting any changes to the IPE by completing the Amendment (RS600-C.)
* Update the Financial Resources Form (RS16) at Annual Review.
* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for Status 18. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment.
* Refer to Out of State Policy limitations, if necessary.
COSMETOLOGY/BARBER SCHOOL
Case Service Code for Status 06 -1234
Case Service Code for Status 18-22 - 1335
Case Service Code for Status 32 - 1434
ARS may purchase training for qualified individuals in cosmetology/barber schools capable of providing training necessary for the individual to attain the vocational objective. ARS requires a copy of the schools program costs and Student Financial Aid grant eligibility or ineligibility be placed in the individual's case file by the time of plan development. Tuition will be authorized and paid at an hourly rate. Billing will be processed only with receipt of a monthly progress report verifying the number of hours the individual attended.
The District Manager's approval is required if extenuating circumstances occur such as changes or expenses beyond the agreed rate, or additional training time to meet the required 1500 hours.
Satisfactory performance in a non-academic program will be documented by a progress report indicating satisfactory progress in the training program.
PROCEDURES - COSMETOLOGY/BARBER SCHOOL
* Key data for Status 18 (Refer to the case management system.)
* Documentation of the action to be taken will be made in the case narrative.
* A copy of the school's program costs will be placed in the case file by the time of plan development.
* The case record must document the school's Student Financial Aid eligibility or ineligibility.
* The award/denial letter/Student Financial Aid will be obtained and placed in the case file
* Complete Annual Review documenting any changes to the IPE by completing the Amendment (RS600-C.)
* Update the Financial Resources Form (RS16) at Annual Review.
* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for Status 18. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment.
* Refer to Out of State Policy limitations, if necessary.
ON-THE-JOB TRAINING
Case Service Code for Status 06 - 1235
Case Service Code for Status 18 - 22 - 1335
Case Service Code for Status 32 - 1435
Vendors used for on-the-job training must be reputable, established firms that can supply the individual training in the selected job. The counselor must choose only those training sites that have:
The counselor will consider:
Arkansas Rehabilitation Services will pay an On-the-Job training fee to the vendor for providing instruction to the individual to help them reach a skilled proficiency level in the work area selected. ARS does not pay the individual's salary or wages. ARS pays a training fee to the vendor or employer for on-the-job training services.
The vendor must put the individual on the payroll and pay the same starting wage that is paid to other new employees. The training fee should be equal or above the current minimum wage amount. The individual must be offered the same benefits as other employees. The trainee has the same responsibilities as all other employees.
Satisfactory performance in a non-academic program will be documented by a progress report indicating satisfactory progress in the training program.
PROCEDURES ON-THE-JOB
* The counselor will negotiate with the vendor the training fee and the length of On-the-Job program. The fee and time period should be kept to a minimum.
* Documentation of the action to be taken will be made in the case narrative.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for Status 18 (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
* The training vendor will provide a progress report to the counselor with appropriate billing forms. The counselor will not process payment for On-the-Job training without proper progress reports.
ADJUSTMENT TRAINING
Case Service Code for Status 06 - 1236
Case Service Code for Status 18 - 22 -1336
Case Service Code for Status 32 - 1436
This is training which will help the individual adjust to a particular situation hindering his/her ability to work. Included would be work conditioning, developing work tolerance, mobility training, remedial training, literacy training, lip reading, Braille, etc.
PROCEDURES - ADJUSTMENT TRAINING
* Documentation of the action to be taken will be made in the case narrative.
* Complete applicable vendor referral form.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for Status 18 (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* The training vendor will provide a progress report to the counselor with appropriate billing forms. The counselor will not process payment for the adjustment training without proper progress reports.
NOTE: Training in the use of Rehabilitation Technology Devices would be coded Rehabilitation Technology Services.
MISCELLANEOUS TRAINING
Case Service Code for Status 06 - 1237
Case Service Code for Status 18 - 22 -1337
Case Service Code for Status 32 - 1437
This category includes academic training on secondary education level or lower, as well as, specialized academic schools for persons who are blind or deaf. It also includes training not listed in the above categories, such as correspondence study. Only a few individuals are able to satisfactorily pursue a correspondence study course; therefore, ARS personnel regard this method as impractical in most cases. There may be exceptions if justified by specific conditions.
The correspondence method may be used if:
The following criteria will be used for those individuals considered for correspondence training:
For college correspondence training, fees will be determined by the number of "credit hours" and the institution's rate. The published fees of the selected college will be the maximum paid by ARS. Fees will be paid when the college submits a bill.
In paying for correspondence courses other than college, the total cost of the training will be divided by the number of lessons. ARS payment will be made as lessons are completed. Counselors are responsible for negotiating with correspondence study vendors to ensure agreement with this payment plan.
If correspondence training is selected, the counselor must obtain the District Manager's approval.
PROCEDURES - MISCELLANEOUS TRAINING
* Documentation of the action to be taken will be made in the case narrative.
* Complete Annual Review documenting any changes to the IPE by completing the Amendment (RS600-C.)
* Update the Financial Resources Form (RS16) at Annual Review.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for Status 18 (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* Refer to Out of State Policy limitations, if necessary.
* The training vendor will provide a progress report to the counselor with appropriate billing forms. The counselor will not process payment for the training without proper progress reports.
* When the billing statement is received, key the payment into the case management system.
BOOKS AND TRAINING MATERIALS
Books and training materials will be limited to required textbooks, including required math calculators. ARS will not furnish office supplies such as paper, pencils, pens, glue and file folders.
TRANSPORTATION
Case Service Code for Status 02 - 1191
Case Service Code for Status 06 - 1291
Case Service Code for Status 18 - 22 -1391
Case Service Code for Status 32 - 1491
Transportation costs for VR services may be paid at the usual rates not to exceed the State allowed rate. Transportation costs can only be paid as an auxiliary service to core VR services. Transportation is not a stand-alone service.
If public transportation is not available or the individual, because of disability, cannot travel by public transportation, the counselor should make every effort to negotiate an estimated cost of gas only if it is the least expensive travel cost.
This does not apply to taxicab fares within a city, which will be paid at the prevailing rates when necessary and authorized.
NOTE: Transportation for diagnostic services will be coded as diagnostic.
The case record will document justification for the need for the service and include the method of calculating the cost of the service. Receipts or other documentation showing the individual received the service is required before the payment is processed.
TRANSPORTATION FOR PHYSICAL RESTORATION SERVICES
Case Service Code for Status 06 - 1291
Case Service Code for Status 18 - 22 -1391
Case Service Code for Status 32 - 1491
Transportation for physical restoration services may be paid. Transportation may be paid for checkup visits to a doctor or hospital only when the counselor has prior notice of the necessity of the visit and has authorized each trip.
TRANSPORTATION FOR TRAINING SERVICES INCLUDING COLLEGE
Case Service Code for Status 06 - 1291
Case Service Code for Status 18 - 22 - 1391
Case Service Code for Status 32 - 1491
If the training location is where the individual cannot live at home, transportation costs may be paid for a direct, one-way trip at the beginning of the training session. At the session's conclusion, transportation from the training location to the job site may be paid. ARS may pay bus fare, or if justified by the individual's physical condition, may pay taxi fare to and from the boarding house and training site. Transportation may be paid if the individual lives at home and daily transportation is required. Note: Receipts are required for reimbursement if transportation costs are to be provided directly to the client.
TRANSPORTATION FOR PLACEMENT
Case Service Code for Status 20 - 22 -1391
Case Service Code for Status 32 - 1491
Transportation may be paid for placement or self-employment when necessary for up to 30 days.
AMBULANCE
Case Service Code for Status 06 - 1291
Case Service Code for Status 18 - 22 -1391
Case Service Code for Status 32 - 1491
ARS will pay for ambulance service only when the attending physician or other health authorities certify the individual cannot safely travel by other public or private transportation or if ambulance service can be secured as cheaply as other transportation.
TRANSPORTATION FOR DIAGNOSIS INCLUDING SUBSISTENCE WHILE IN TRANSIT
Case Service Code for Status 02 - 1110
Case Service Code for Status 06 - 1210
Case Service Code for Status 10 - 22 -1310
Case Service Code for Status 32 - 1410
Transportation and meals may be paid for transit when required for out of town diagnosis. Transportation and meal reimbursement based on the State VR Agency's prevailing rate.
PROCEDURES - TRANSPORTATION
* Documentation of the action to be taken with justification for the service will be made in the case narrative.
* Documentation of the method used to calculate the cost of the service will be made in the case narrative.
* Receipts or other documentation verifying the individual received the service will be made in the case narrative.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Case must be in a service status before the authorization can be written. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
MAINTENANCE
Case Service Code for Status 06 - 1240
Case Service Code for Status 18 - 22 -1340
Case Service Code for Status 32 - 1440
Maintenance includes payment to cover the individual's basic living expenses such as food, shelter, clothing, health maintenance, and other subsistence expenses essential to determine the individual's rehabilitation needs or to achieve the VR objective.
Maintenance may be provided at any time while the case is in a Trial Work Experience or Extended Evaluation program or an IPE is in effect.
After job placement, maintenance will only be paid until the individual receives their first paycheck. If the individual is self-employed, maintenance is limited to 30 days. For an exception refer to Appendix G.
Maintenance payments for training will be reimbursed at the end of a stated period (two weeks, four weeks, one month, or other). Authorization will be made in accordance with the IPE and may be paid to the client's boarding house, landlord, school, etc.
Note: Maintenance for diagnostic services will be coded as diagnostic.
The case record will document justification for the need for the service and include the method of calculating the cost of the service. Receipts or other documentation showing the individual received the service is required before the payment is processed.
PROCEDURES - MAINTENANCE
* Documentation of the action to be taken with justification for the service will be made in the case narrative.
* Documentation of the method used to calculate the cost of the service will be made in the case narrative.
* Receipts or other documentation verifying the individual received the service will be made in the case narrative.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Case must be in a service status before the authorization can be written. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
MAINTENANCE DURING PHYSICAL RESTORATION SERVICES
Case Service Code for Status 06 - 1240
Case Service Code for Status 18 - 22 - 1340
Case Service Code for Status 32 - 1440
An individual receiving physical restoration services may be eligible for maintenance while away from home.
MAINTENANCE FOR VOCATIONAL PROGRAMS
COLLEGE TRAINING
Case Service Code for Status 06 - 1240
Case Service Code for Status 18 - 22 - 1340
Case Service Code for Status 32 - 1440
Note: An outside substantial source of support must be documented prior to beginning a college program.
ARS may pay college maintenance costs to those individuals eligible under order of selection, provided:
Maintenance services are available at the Arkansas Career Training Institute (ACTI.)
FULL-TIME VOCATIONAL TRAINING
Case Service Code for Status 06 - 1240
Case Service Code for Status 18 - 22 -1340
Case Service Code for Status 32 - 1440
Maintenance may be paid for an individual in business, trade, technical, or other schools, on - the - job training, and apprenticeship training.
REHABILITATION CENTERS AND FACILITIES
Case Service Code for Status 06 - 1240
Case Service Code for Status 18-22 -1340
Case Service Code for Status 32 - 1440
Maintenance will be paid based on the State VR Agency's prevailing rate.
PLACEMENT
Case Service Code for Status 20-22 -1340
Case Service Code for Status 32 - 1440
After job placement, maintenance may be paid until the individual receives the first paycheck. Maintenance will not continue for more than 30 days after placement unless approved by the District Manager. For an exception refer to Appendix G.
PROCEDURES - MAINTENANCE FOR VOCATIONAL PROGRAMS
* Documentation of the action to be taken with justification for the service will be made in the case narrative.
* Documentation of the method used to calculate the cost of the service will be made in the case narrative
* Receipts or other documentation verifying the individual received the service will be made in the narrative.
* Complete Annual Review documenting any changes to the IPE by completing the Amendment (RS600-C.)
* Update the Financial Resources Form (RS16) at Annual Review.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Case must be in a service status before the authorization can be written. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
OTHER SERVICES
Case Service Code for Status 06 - 1290
Case Service Code for Status 18 -22 -1390
Case Service Code for Status 32 - 1490
Other goods and services include tools, equipment, and initial stock and supplies for vending stands, business and occupation licenses.
PROCEDURES - OTHER SERVICES
* Documentation of the action to be taken will be made in the case narrative.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Case must be in a service status before the authorization can be written. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
SUPPORTED EMPLOYMENT SERVICES (SES)
For a detailed discussion of all aspects of Supported Employment and transitional employment for persons who have long-term mental illness (LTMI), counselors are directed to the Arkansas Guide to Supported Employment Services.
ARS will provide supported employment services to any individual who is certified as having a most significant disability and for whom competitive employment has not traditionally occurred or has been interrupted or intermittent as a result of that disability; has been determined eligible under Title I; and has been determined by an assessment of rehabilitation needs to have:
Supported Employment involves full or part-time employment averaging at least 15 hours per week for each pay period. It may be less than 15 hours with District Manager's approval.
The individual is placed in an integrated work setting with no more than eight persons with disabilities. Ongoing support services are provided at least twice monthly at the work site (except for LTMI) after ARS case closure throughout the term of employment.
The 18-month limitation on the provision of supported employment services has been amended to permit extension of this service on a case-by-case basis as determined and documented on the IPE.
Primary job coach components of supported services are:
Choosing the Supported Employment Service Model: Supported employment services can be provided through individual (individual placement, job coach) models or group (enclave, mobile crew) models. For an extensive discussion of these models, counselors are directed to the Arkansas Guide to Supported Employment Services.
Supported Employment consumers may not be considered for post-employment services.
When a job is lost, the counselor should take a new referral. The counselor can re-initiate supported employment services for a former consumer in instances of job destabilization or potential upgrade.
All ARS requirements related to the provision of services will apply in the provision of supported employment services.
ARS funding will cease when an individual meets the supported employment service objectives on the IPE and is stable in employment.
Job stability measures in the Individual Competitive Employment Model are:
Job stability measures for the Group Models are:
PROCEDURES - SUPPORTED EMPLOYMENT SERVICES (SES)
* Complete the Certificate of Eligibility. (See Appendix E)
* Complete the IPE utilizing informed choice. The counselor will indicate the extended service provider on the IPE at plan development.
* ARS will purchase services on a fee-for-service basis as directed in current Arkansas Guide to Supported Employment:
- Milestone #1 - Referral/Job Development: to be paid at time of referral by counselor to the provider Agency.
- Milestone #2 - Job Match: upon job placement as agreed by the counselor, individual and provider.
- Milestone #3 - Stabilization: at point of stabilization Status 22 (stabilization is to be determined by job coach intervention faded to 20 percent).
In addition, the individual and the employer must be satisfied with the job placement performance.
- Milestone #4 - Closure: after remaining in Status 22 for 90 days and eligible for a successful Status 26 closure.
SUPPORTED EMPLOYMENT SERVICES (SES)-TRANSITIONAL EMPLOYMENT SERVICES (TES)
Transitional Employment Services are for persons with LTMI and provide paid work in a job slot in competitive industry. This service may result in independent competitive employment. ARS sponsored transitional employment must involve an average of 15 hours of work per pay period with the District Manager's approval. Authorizations for Transitional Employment Services will not exceed 125 days over a 12- month period.
PROCEDURES - SES TRANSITIONAL EMPLOYMENT SERVICES
* Complete the Certificate of Eligibility. (See Appendix E.)
* Complete the IPE utilizing informed choice.
* ARS will purchase services on a fee-for-service basis as outlined in procedures above.
Primary Agency Fund Codes and their appropriate use for authorizing SE and TES are as follows:
PROVISION, IMPACT AND SCOPE OF SERVICES TO FAMILY MEMBERS
Services may be provided to an individual's family when necessary for the individual to attain the vocational objective. These services must substantially contribute to the individual's rehabilitation. The necessity of service provision to an individual's family should be based on a study of the individual's needs. This includes problems faced by the family in support of the individual's rehabilitation. Substantial impact services are those that allow or increase the opportunity for an individual's use of VR services. Without these services, the individual would be unable to begin or continue the IPE, which may result in delayed employment or unachievable employment. The individual and their family member(s) must be jointly involved in deciding if services to a family member can contribute to the individual's rehabilitation program. In developing the IPE, it is important that both the individual and family members understand the basis for provision of family services, i.e., such services must be necessary to the individual's adjustment or vocational rehabilitation.
While the counselor often sees family members during the preliminary or thorough diagnostic study, these interviews and any incidental advice provided during such sessions are not considered a service to a family member. Rather, such interviews and counseling are part of the process of determining the individual's eligibility for VR or the scope of services to be provided.
Services may include childcare, training, transportation, relocation of the family to an area where work is available for the individual, and any other necessary support services for the individual. These services may include any VR services and may be provided without age restriction of the family members. Services to family members must be included on the IPE.
Educating the family on the importance of using personal resources, family support, and other available community resources is essential to the successful completion of the rehabilitation program. Appropriate and available resources should be fully utilized in the provision of services to a individual's family when necessary to the individual's adjustment or rehabilitation. Any contribution by family members to the cost of these services is regarded as participation by the individual.
Although these services are intended for the individual's benefit, the family member(s) will also benefit. A family member with a disability that might qualify the individual for VR services should be considered a prospective ARS consumer.
PROCEDURES - SERVICES TO FAMILY MEMBERS
* The counselor must document in the case narrative why services are needed, which family member needs services, what services are needed, how the services will contribute to the individual's adjustment or rehabilitation, and how services will be secured in accordance with informed choice.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
TERMINATING SERVICES TO FAMILY MEMBERS
Services to family members can be an integral part of the individual's VR, Trial Work Experience or EE program, service termination should be considered when the service no longer substantially contributes to the individual's program or when the individual is rehabilitated.
When the individual has been placed in employment and the case is ready for closure, but services to the family members have not been completed and are still expected to substantially contribute to the individual's rehabilitation program, the case should not be closed until services to family members are completed or terminated.
POST- EMPLOYMENT SERVICES TO FAMILY MEMBERS
Post-employment services to family members may be provided after the individual is rehabilitated if services are necessary to help the individual maintain employment. Post-employment services to family members must be included on an IPE.
POST- EMPLOYMENT SERVICES
Post-employment services may be provided after the individual has been closed as Rehabilitated (Status 26) and needs services to maintain, regain or advance employment. Post-employment services may only be provided to individuals in Status 32. Cases that are closed in Status 26 can only be placed in Status 32.
These services are available to meet rehabilitation needs that do not require a complex and comprehensive provision of services and, thus, should be limited in scope and duration. If more comprehensive services are required, then a new rehabilitation effort should be considered. Post-employment services are to be provided under an amended individualized plan for employment; thus, a redetermination is not required.
NOTE: Procedures to develop a Status 32 closure are covered in the Closure Section VIII.
NOTE: Post-employment services will not exceed 18 months; however an extension of time can be requested from the District Manager, Deputy Director of Field Services, and Chief of Field Services.
PROCEDURES - POST- EMPLOYMENT
* Case must be in Status 32 to provide post-employment services.
* The counselor must maintain contact with the individual, employer, and vendors who may be involved in the provision of services.
* Document in the case narrative the justification for post-employment services and the individual's progress in maintaining employment.
* Refer to ARS Vendor List or secure W-9 from new vendor, if needed.
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
TOOLS, EQUIPMENT, INITIAL STOCK, AND CONSTRUCTION
Case Service Code for Status 06 - 1290
Case Service Code for Status 18 - 22 -1390
Case Service Code for Status 32 - 1490
Tools, equipment, initial stock and occupational licenses may be provided for an individual if:
These articles must be for the individual's own use in work performance and must remain in the individual's possession and control as long as the individual remains in the job or occupation. However, the individual may dispose of initial stock in the ordinary course of business.
A threshold of $5000 has been established for the purchasing of Tools, Equipment, Initial Stock, and Construction related services. For an exception refer to Appendix G.
PURCHASING (State Purchasing Guidelines)
When the purchase exceeds $5,000.01 but is less than $10,000 (tax excluded) District Manager approval is required. The counselor will obtain at least three written quotes, complete the RS-357 with a Memo, and submit this information to the District Manager. If less than three quotes are obtained, a statement of explanation will accompany the purchase request. Quote specification details will be consistent to all vendors. The RS-357 will be submitted to the Chief of Field Services for approval. An approved copy of the RS-357 will be returned to the counselor. Upon receipt, the counselor may issue an authorization.
Exception: If the Central Office provides the counselor with a copy of the State Purchasing Agency's purchase order (contract), a copy of the authorization will not be sent to the vendor.
Exemption: Surgery, treatment, hospitalization; prosthetic devices; professional, technical, and other personal services; room and board; transportation charges; books, manuals; periodicals; and copyrighted educational aids.
PROCEDURES - PURCHASING (State Purchasing Guidelines)
* If the cost of one item or the total cost of like items amount to:
- $5,000.01 or more but less than $10,000 (tax excluded) will require the approval of the District Manager. The counselor will obtain at least three written quotes, complete the RS-357 with a Memo, and submit this information to the District Manager. If less than three quotes are obtained, a statement of explanation will accompany the purchase request. Quote specification details will be consistent to all vendors. The RS-357 will be submitted to the Chief of Field Services for approval. An approved copy of the RS-357 will be returned to the counselor. Upon receipt, the counselor may issue an authorization.
- $10,000.01 or more but less than $25,000 (tax excluded) will require the approval of the Chief of Field Services through the District Manager. The counselor will obtain at least three or more verbal or written quotations and submit this information to the District Manager. If unable to obtain three quotes, a statement of explanation must accompany the purchase request. Quote specification details will be consistent to all vendors.
- $25,000.01 or more, the request will be forwarded to the Chief of Field Services. The Central Office will arrange for the purchase. The counselor will determine whether the total cost exceeds $25,001.00 and, if so, will obtain complete specifications and submit these to the Central Office Quote specification details will be consistent to all vendors. Brand names may be used as a means of identification and as the basis of specifications only.
Note: The Vendor selected must provide proof of liability insurance, license, and worker's compensation coverage or exemption to comply with State Building Services regulations.
TITLE RETENTION/RELEASE/REPOSSESSION
The individual who is provided durable medical equipment, equipment for training, occupational tools and/or equipment by ARS will sign a Title Agreement listing the items provided and specifying that ARS will retain the title. The individual may not sell, mortgage, give away, or dispose of tools and/or equipment provided during the time that ARS retains title. The individual upon receipt of the authorized goods will sign a Title Agreement form in duplicate with a list of all articles. It is the counselor's responsibility to secure the Title Agreement.
PROCEDURES - TITLE RETENTION
* Complete the Receipt for Occupational Tools and/or Equipment and Title Agreement form. (See Forms Appendix E).
* A copy of the Title Agreement with signature will be placed in the case file and a copy given to the individual.
TITLE RELEASE
The counselor may release the title of durable medical equipment, equipment for training, occupational tools and/or equipment when the case is closed rehabilitated. However, in the counselor's judgment, if it is in the best interest of the individual or ARS, the title may be retained indefinitely. When the title is relinquished, the counselor will submit the original Release of Title Form to the individual. A copy of this form will also be placed in the record of services.
PROCEDURES - TITLE RELEASE
* Complete the Release of Title for Tools and/or Equipment
* The original will be placed in the file and copy will be given to the individual.
REPOSSESSION
The Counselor must repossess all durable medical equipment, equipment for training, occupational tools and/or equipment purchased for an individual if the case does not result in a rehabilitated closure.
PROCEDURES - REPOSSESSION
* The counselor will arrange to reclaim the tools or equipment listed on the Title Retention form.
* The case narrative should reflect the action taken.
* The counselor will be responsible for storage of the equipment.
RETURNED OR DONATED ITEMS
Returned or donated equipment will be made available for counselors across the state to use for other cases.
REHABILITATION TECHNOLOGY SERVICES
Assistive technology services must be considered for each individual and if appropriate, referred for the Assistive Technology Program AT @ Work evaluation/assessment.
Rehabilitation Technology Services is the systematic application of technologies, engineering methodologies or scientific principles to meet the needs of and address the barriers confronted by individuals with disabilities in areas which include education, rehabilitation, employment, transportation, independent living and recreation. The term includes Rehabilitation Engineering, Assistive Technology Devices, and Assistive Technology Services.
REHABILITATION ENGINEERING
Case Service Code for Status 02 - 1197
Case Service Code for Status 06 - 1297
Case Service Code for Status 18 - 22 - 1397
Case Service Code for Status 32 - 1497
Rehabilitation engineering is the systematic application of engineering sciences to design, develop, adapt, test, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities in the functional areas, such as mobility, communications, hearing, vision, and cognition, and in activities associated with employment, independent living, education, and integration into the community.
PROCEDURES - REHABILITATION ENGINEERING
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Counselor will meet with individual to discuss findings of assistive technology evaluation in accordance with informed choice and with similar benefits.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
* Refer to Out of State Policy limitations, if necessary.
ASSISTIVE TECHNOLOGY SERVICES
Case Service Code for Status 02 - 1199
Case Service Code for Status 06 - 1299
Case Service Code for Status 18 - 22 - 1399
Case Service Code for Status 32 - 1499
Assistive Technology Services are services that directly assist an individual in the selection, acquisition, or use of an assistive technology device. Services included are:
PROCEDURES - ASSISTIVE TECHNOLOGY SERVICES
* Check for appropriate status in the case management system.
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Counselor will meet with individual to discuss findings of assistive technology evaluation in accordance with informed choice and with similar benefits.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
* Refer to Out of State Policy limitations, if necessary
ASSISTIVE TECHNOLOGY DEVICES
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
These are devices that enable the individual to participate in a rehabilitation program, to complete necessary assessments, or make it possible for the person to work or become more productive. These devices include any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.
PROCEDURES - TECHNOLOGY DEVICES
* Check for appropriate status in the case management system
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Counselor will meet with individual to discuss findings of assistive technology evaluation in accordance with informed choice and with similar benefits.
* Medical Consultant review if required. (See Form Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* If assistive technology devices are purchased, a title of retention will be completed and placed in the case file. (See Appendix E)
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
* Refer to Out of State Policy limitations, if necessary.
PROSTHETIC AND ORTHOTIC DEVICES
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
Prosthesis means an artificial appliance used for functional or corrective reasons, or both. Orthotics means an orthopedic appliance or apparatus used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body. For an original or first device, the purchase must be based on the recommendation of a specialist in the appropriate field.
In cases of replacement and repair of devices, for individuals with a history of satisfactory device use, and in which the basic examination report indicated no pathological change, this report may be sufficient medical basis for rendering the service.
All new or initial wearers and individuals who have had difficulty wearing a limb may be referred to the ACTI Amputee Clinic for evaluation. (See Appendix C)
ARS will purchase prosthetic and orthotic devices from certified professionals in the area of expertise by the American Board of Certification on Orthotics and Prosthetics in accordance with informed choice. Artificial arms, legs, and components must be purchased through prosthetics certified by the American Board of Certification on Orthotics and Prosthetics. A list of approved vendors will be maintained. Payments will be made according to the established ARS Fee Schedule.
In selecting the vendor, the counselor will consider:
PROCEDURES - PROSTHETIC AND ORTHOTIC DEVICES
* Check for appropriate status in the current case management system.
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Counselor will meet with individual to discuss findings of the Assistive Technology Program AT @ Work / Arkansas Career Training Institute evaluation in accordance with informed choice and with similar benefits.
* Medical Consultant review is required. (See Forms Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
* UAMS requires special payment.
* Refer to Out of State Policy limitations, if necessary
HEARING AIDS
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
ARS will purchase hearing aids for individuals from licensed dealers or physicians skilled in diseases of the ear after a hearing evaluation by a physician and a hearing aid evaluation by an audiologist. The audiologist's hearing aid evaluation report must specify the type of hearing aid, the specific brand name, and model. Hearing aid adjustments will be included as part of the ARS purchase. The individual must indicate vendor choice in accordance with informed choice by signing the application, or IPE.
PROCEDURES - HEARING AIDS
* Documentation of the action to be taken will be made in the case narrative.
* Refer individual to audiologist from ARS Vendor list for hearing aid evaluation.
* Counselor will meet with individual to discuss audiologist recommendations in accordance with informed choice and with similar benefits
* Medical Consultant review is required. (See Forms Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Select appropriate ARS Procedure code.
* Key data for Status 18, if appropriate. (Refer to the case management system.
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
WHEELCHAIRS
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
ARS may purchase electric and manual wheelchairs and necessary repairs for the individual to proceed through the rehabilitation process. Wheelchairs will be purchased as prescribe by the treating physician. Purchases of specific wheelchairs will be consistent with the recommendation of the therapist and/or wheelchair specialist involved. All requests for power wheelchairs will be referred to the ACTI Physical Therapy Department.
PROCEDURES - WHEELCHAIRS
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Counselor will meet with individual to discuss findings of the assistive technology evaluation in accordance with informed choice and with similar benefits
* Medical Consultant review is required. (See Forms Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* If wheelchairs or other durable medical equipment is purchased, a title of retention will be completed and placed in the case file. (See Appendix E)
* Key data for appropriate Status. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* Key authorization (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
REPAIR OF WHEELCHAIRS
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
Repairs of wheelchairs present numerous problems and it will not be possible to provide detailed procedures to cover every possibility. In general, all repairs should first be addressed through the vendor where the wheelchair was purchased. If this is not possible, arrangements should be made to repair the chair at ACTI. The counselor and individual will make the decision based on resources and immediacy of the situation in accordance with informed choice.
PROCEDURES - REPAIR OF WHEELCHAIRS
* Documentation of the action to be taken will be made in the case narrative.
* Check with the Assistive Technology Program AT @ Work to check for parts in inventory for repair. If not refer to Durable Medical Equipment Vendor for repairs.
* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for Status 18, if appropriate. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
* Refer to Out of State Policy limitations, if necessary.
* UAMS requires special payment.
BRACES
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
Braces will be purchased in accordance with informed choice, upon the recommendation of the specific specialist in charge, i.e., an orthopedist in orthopedic cases; a neurologist in neurological cases. Shoes are standard accessories for all leg braces, if the braces attach to the shoes.
These shoes must be included in the brace purchase. Repairs may be authorized for any eligible applicant upon a basic examination only, unless the basic examination indicates other consultations are necessary.
HSRC Hospital Cases - Braces for individuals who plan to enter the Center will not be provided until the individual is enrolled in the Center and as recommended by the HSRCH Medical Staff. HSRCH Medical Staff will recommend repairs and new braces for Center consumers.
PROCEDURES - BRACES
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Counselor will meet with individual to discuss findings of the assistive technology evaluation in accordance with informed choice and with similar benefits.
* Medical Consultant review is required. (See Forms Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
GLASSES AND ARTIFICIAL EYES
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
Glasses, artificial eyes and other visual services may be purchased if recommended by a current eye examination performed by an Ophthalmologist or Optometrist, in accordance with informed choice. Glasses may be purchased only when necessary for the individual to complete evaluation, enter, or complete a rehabilitation service planned training program, or to enter employment. Glasses, ornamental and/or expensive frames will not be purchased for cosmetic reasons.
Prosthetic eyes may be purchased for either cosmetic effect or functional use. Plastic eyes should be purchased unless there are justifiable reasons for another type.
PROCEDURES - GLASSES/ARTIFICIAL EYES
* Documentation of the action to be taken will be made in the case narrative.
* Refer individual to an ophthalmologist from ARS Vendor list for an eye examination.
* Counselor will meet with individual to discuss findings of examination in accordance with informed choice and with similar benefits
* Medical Consultant review is required. (See Forms Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
PERSONAL ASSISTANCE SERVICES
Personal Assistance Services is a range of services provided by one or more persons, designed to assist an individual with disabilities to perform daily living activities on or off the job that the individual would typically perform if the individual did not have a disability.
These services may be provided to an individual at any time during the rehabilitation process and may include:
ATTENDANT
Case Code for Status 02 - 1170
Case Code for Status 06 - 1270
Case Code for Status 10 - 24 - 1370
Case Code for Status 32 - 1470
ARS will purchase attendant services in accordance with informed choice provided by one or more persons, designed to assist an individual with disabilities to perform daily living activities on or off the job that the individual would typically perform if the individual did not have a disability. These services may be provided to an individual at any time during the rehabilitation process when prescribed by an attending physician.
PROCEDURES - ATTENDANT
* Documentation of the action to be taken will be made in the case narrative.
* Medical Consultant review is required. (See Forms Appendix E)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
INTERPRETER SERVICES
Case Code for Status 02 - 1171
Case Code for Status 06 - 1271
Case Code for Status 10 - 24 - 1371
Case Code for Status 32 - 1471
ARS may purchase interpreter services for deaf or hearing-impaired individuals involved in a rehabilitation program in accordance with informed choice.
PROCEDURES - INTERPRETER SERVICES
* Documentation of the action to be taken will be made in the case narrative.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
READER
Case Code for Status 02 - 1172
Case Code for Status 06 - 1272
Case Code for Status 10 - 24 - 1372
Case Code for Status 32 - 1472
ARS may purchase reader services for deaf or hearing - impaired individuals and visually impaired individuals involved in a rehabilitation program in accordance with informed choice.
PROCEDURES - READER
* Documentation of the action to be taken will be made in the case narrative.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* Key authorization. (Refer to the case management system.)
* When the billing statement is received, key the payment into the case management system.
MOTOR VEHICLES
It is ARS policy not to purchase motor vehicles for an individual or groups of individuals.
SPECIAL EQUIPMENT AND MODIFICATION FOR MOTOR VEHICLES
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
Purchase and installation of special equipment and/or vehicle modification may be provided to enable the individual to drive their vehicle or an immediate family member or a designated attendant to provide the individual transportation if:
The counselor will follow the State Purchasing guidelines.
ARS will purchase one van lift and/or van modification per individual regardless of the times a case is reopened. ARS retains title to special equipment until the case is closed. It is the individual and/or family's responsibility to repair the lift and other adaptive equipment after warranty expiration.
In certain situations, the counselor should consider referral of the individual for a driving evaluation to determine their ability to drive and the necessary vehicle modifications required to operate a vehicle. This evaluation should be completed before the vehicle modifications are approved by the Counselor. Driver's training is available at ACTI or ARS may purchase driver training from an approved instructor or Agency.
PROCEDURES-SPECIAL EQUIPMENT AND MODIFICATION FOR MOTOR VEHICLES
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Secure an the Assistive Technology Program AT @ Work evaluation/assessment recommendation.
* Counselor will meet with individual to discuss findings of assistive technology evaluation in accordance with informed choice and with similar benefits.
* The counselor will follow the State Purchasing guidelines. (See VI. Services Table of Contents)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
NOTE: THIS SERVICE CANNOT BE PLANNED ON THE IPE OR AMENDMENT UNTIL THE ASSISTIVE TECHNOLOGY EVALUATION HAS BEEN PERFORMED.
HOME MODIFICATIONS
ARS will only provide assistance when modifying an individual's place of residence if the individual owns, is buying, or is a long-term renter or in an extended lease of the property. Modifications to the structure of the home will be consistent with American with Disabilities Act (ADA) recommendations. In situations where the person is not the owner or buyer the individual will be responsible for providing in writing landlord approval to make modifications. Modifications to rental property will be restricted to a ramp for the purpose of access/egress. Modifications to an individual's place of residence will be limited to a one time occurrence, whether IL or VR, regardless of the times an individual's case is reopened.
Except for ramps to assist with access/egress, any changes (remodeling) to the home will only occur inside the structure's footprint. Additions to the home are excluded. If the individual, a family member, or caregiver is insistent on an addition to the existing structure it will be the individual's responsibility to provide payment for the addition including all plumbing and electrical costs. ARS can provide technical assistance regarding how to make the addition accessible. If the Counselor is in agreement, ARS can provide support in the purchase of fixtures and related items to assist with toileting, bathing, and related Activities of Daily Living.
Modifications to modular/mobile homes will be limited to construction of wheelchair ramps to assist with access/egress. No construction will be approved inside a mobile home as it may compromise structural integrity.
The individual and or family member will be asked to be part of the solicitation of bids for ARS approved home modifications.
PROCEDURES - HOME MODIFICATIONS
* Check for appropriate status in the case management system.
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures for the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Counselor will meet with individual to discuss findings of assistive technology evaluation in accordance with informed choice and with similar benefits.
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key authorization. (Refer to the case management system.)
* When the home modification is completed the Counselor will verify the need of individual has been met. Document in case narrative.
* When the billing statement is received, key the payment into the case management system.
* Refer to Out of State Policy limitations, if necessary
Independent Living Rehabilitation Services (ILRS) are any appropriate vocational rehabilitation services (as defined under Title I of the Rehabilitation Act) that will enhance the ability of an individual with a significant disability to live more independently and function within his/her family or community and, if appropriate, secure and maintain appropriate employment.
Services may be provided under this title to any individual whose ability to engage or continue in employment, or whose ability to function independently in the family or community is so limited by the severity of the disability that vocational or comprehensive rehabilitation services are required to significantly improve either the ability to engage in employment or to function independently in the family or community. Priority of services under this part shall be given to individuals not served by other provisions of the Rehabilitation Act.
The term "comprehensive services for independent living" means any appropriate vocational rehabilitation service (as defined under Title I of the Rehabilitation Act) and any other available service that will enhance the ability of an individual with disabilities to live independently and function within the family and community and, if appropriate, secure and maintain appropriate employment. Such service may include any of the following: counseling services, including psychological, psychotherapeutic, and related services; housing incidental to the purpose of this section (including appropriate accommodations to and modification of any space to serve individuals with disabilities; appropriate job placement services; transportation; attendant care; physical rehabilitation; therapeutic treatment; needed prostheses and other appliances and devices; health maintenance; recreational services; services for children of preschool age including physical therapy, development of language and communication skills and child development services; and appropriate preventive services to decrease the needs of individuals assisted under the program for similar services in the future.
If/when an individual is in an institution at the time of referral or enters an institution after they have applied for services, their presence in an institution may affect their eligibility for services. A person's eligibility for ILRS services is based in part on the expectation that the individual will be present and able to participate in services. When a person is in an institution, the counselor may conclude that the person will not be available to take part in a rehabilitation program. The presence of an individual in an institution affects that person's ability to meet the reasonable expectation that ILRS may significantly assist the individual to improve his/her ability to function independently in family or community or to engage or continue in employment and maintain independent functioning. One of the main concerns as an ILRS counselor is the projected length of the person's stay in the institution. For example, if a person is very ill and must enter a hospital for a lengthy stay, is it reasonable to expect they can benefit from services. Examples of institutions in which residents may spend a long period of time are group home placements, human development centers, prisons, nursing homes, and psychiatric hospitals.
ILRS CASE STATUS CLASSIFICATIONS
ELIGIBILITY
Eligibility requirements will be applied without regard to sex, race, age, creed, color, national origin, or type of disability of the individual applying for services. No group of individuals will be excluded or found ineligible solely on the basis of type of disability. A person who meets basic eligibility requirements cannot be determined ineligible because of their age.
Residence requirements are the same as for VR services.
RESPONSIBILITY FOR DETERMINING ELIGIBILITY
ARS has the sole responsibility for determining the eligibility of individuals for ILR services. This responsibility remains within the Agency and will not be delegated to any other Agency or individual. The Commissioner has delegated the primary duty for this determination to the rehabilitation counselor. The counselor is required to establish documentary evidence to support the decision and must execute a Certificate of Eligibility for ILR Services (RS-600-B-1). In every case, the Certificate of Eligibility for ILR Services must be completed prior to authorization of case service funds except for diagnosis.
BASIC ELIGIBILITY REQUIREMENTS FOR ILR SERVICES
The counselor is required to show the following conditions exist for each individual determined eligible for ILR services:
The following paragraphs define the basic criteria:
Significant Physical or Mental Impairment means a physical or mental condition that seriously limits one or more functional capacities (mobility, communication, self-care, self direction, interpersonal skills, work tolerance or work skills) in terms of ability to function independently in family or community or to engage or continue in employment.
Substantial Impediment to Function Independently means an individual's ability to live an independent life is significantly restricted, there is a loss of independence, or an individual needs special help to be independent and that services provided will reduce or correct the resulting functional limitations of the disability, overcome the obstacles to independence and/or will significantly assist the individual to improve his/her ability to function independently in family or community or to engage or continue in employment and maintain independent functioning. Consideration should be given to such factors as medical diagnosis, age, education, appearance, personality, attitude, interest, resources, environment, expressed desires, work history, and work opportunities.
ECONOMIC NEED AND COMPARABLE BENEFITS
Services are based on financial need and comparable benefits will be utilized. Services are intended to be comprehensive and one-time services to enable individuals to live and function independently in the home, family, or community and to maintain employment.
In all cases, comparable benefits must be considered. If assistive technology is needed, referral to the Assistive Technology AT @ Work program is required for consideration of comparable benefits. (Refer to Appendix B-20).
CERTIFICATE OF ELIGIBILITY
The counselor is required to include a formal statement of certification indicating eligibility for ILR services in the record of services for each individual. This Certificate of Eligibility statement assures the individual has met the requirements. As a minimum, the certificate shall contain the individual's name, date of eligibility and a narrative statement explaining how the counselor arrived at the basic conditions of eligibility. It must be dated and signed by the counselor. The certificate must be completed simultaneously with, an individual's acceptance for services.
CERTIFICATE OF INELIGIBILITY
When it has been determined that an individual is ineligible for ILR services, the counselor is required to initiate a Certificate of Ineligibility to close the record of services. Ineligibility certification will be made only after full participation with the individual or, as appropriate, parent, guardian or representative after an opportunity for consultation. This certificate will be dated and signed by the counselor and the individual, their parent/guardian or their representative, then placed in the record of services. In such cases, the counselor will notify the individual in writing of the action taken. When appropriate, referral will be made to other agencies and facilities. The individual may appeal the ineligibility determination. ARS will provide the individual with information on the means by which the an appeal can occur, including informal and formal due process procedures, such as administrative review, mediation and review by an impartial hearing officer. The counselor will also provide the individual with information regarding services available from the Client Assistance Program and how to contact the Client Assistance Program.
The basic reasons for ineligible determinations are:
ILRS INDIVIDUALIZED PLAN
The counselor must complete a plan for services.
The components that the ILRS plan must contain:
The services, service providers, and all activities selected by the individual must be necessary to meet the ILRS goal.
The individual or representative must sign and date the ILRS plan. the individual or representative must be given a copy of the ILRS individualized plan.
The ARS counselor is the approving authority; therefore, the counselor's signature indicates approval of the ILRS individualized plan.
PROCEDURES - ILRS INDIVIDUALIZED PLAN
* The ARS counselor will inform the individual of the options available for development of an Individualized Living Rehabilitation Services Plan on Form RS600-A.
* The ARS counselor will inform the individual of the required components of the ILRS Plan.
* Complete RS600-A. (See Forms Appendix E)
* Key data for status 72.
* Document the counseling provided at ILRS Plan development in the case narrative. (See Forms Appendix E)
TERMINATION OF SERVICES UNDER AN IPE
When it has been determined that an individual cannot meet the projected goals, the counselor is required to initiate an Amendment to the IPE. The reasons for initiating an IPE amendment are:
The decision to close the case should be made only with the full participation of the individual, or, as appropriate, the parents, guardian, or other representative, unless the individual is no longer in the State, or his/her whereabouts are unknown. The individual or representative's participation in the decision shall be recorded in the IPE. The rationale will be recorded on an Amendment to the IPE (600-C) certifying that the provision of ILR services has demonstrated that the individual is not capable of functioning more independently in family or community or engaging or continuing in employment. The date of annual review will also be recorded on the Amendment.
RE-OPENING A CASE
A person with a significant disability may re-apply for ILR services at any time after 30 days of closure. In such a situation, the counselor must process the case in a manner similar to an individual applying for the first time. Every effort should be made to review and arrive at a decision on the basis of the present rather than previous conditions.
REVIEW OF INELIGIBILITY DECISION
When a record of services is closed as ineligible, because there is no reasonable expectation ILR services will significantly improve the individual's ability to function independently, an annual review will take place no later than twelve (12) months from the date of ineligibility determination. This review will be conducted so the individual, their parent, guardian or representative is given full opportunity for consultation in the reconsideration of the decision of ineligibility.
SERVICES
MOTOR VEHICLE MODIFICATION POLICY
Administrative exception must be obtained to provide vehicle modification or van lifts for ILRS cases. For an exception refer to Appendix G.
NOTE: If an Administrative Exception is granted the following procedures are to be used:
MODIFICATION FOR MOTOR VEHICLES
Case Service Code for Status 72 - 1398
Purchase and installation of special equipment and/or vehicle modification may be provided to enable the individual to drive their vehicle or an immediate family member or a designated attendant to provide the individual transportation if:
The counselor will follow the State Purchasing guidelines.
ARS will purchase one van lift and/or van modification per individual regardless of the times a case is reopened. ARS retains title to special equipment until the case is closed. It is the individual and/or family's responsibility to repair the lift and other adaptive equipment after warranty expiration. Driver's training is available at ACTI or ARS may purchase driver training from an approved instructor or Agency.
PROCEDURES-MODIFICATION FOR MOTOR VEHICLES
* Documentation of the action to be taken will be made in the case narrative.
* Complete referral procedures to the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)
* Secure an Assistive Technology Program AT @ Work evaluation/assessment recommendation.
* Counselor will meet with individual to discuss findings of assistive technology evaluation in accordance with informed choice and with similar benefits.
* The counselor will follow the State Purchasing guidelines. (See VI. Services Table of Contents)
* Refer to ARS Vendor List or secure W-9 from new vendor.
* Key data for appropriate Status. (Refer to the case management system.)
* When device/service is received, verify the individual received device/service and can use device. Document in case file.
* When the billing statement is received, key the payment into the case management system.
NOTE: THIS SERVICE CANNOT BE PLANNED ON THE IPE OR AMENDMENT UNTIL THE ASSISTIVE TECHNOLOGY EVALUATION HAS BEEN PERFORMED.
CASES CLOSED FROM STATUS 00
Status 00 cases will be dropped automatically by the Case Management System after 180 days if the case is not advanced to Status 02.
CLOSED NOT REHABILITATED BEFORE/DURING EVALUATION (Status 08)
ARS will not close the case record of a referral or applicant prior to making an eligibility determination unless the applicant declines to participate, or is unavailable to complete an assessment for determining eligibility and priority for services. ARS will make a reasonable number of attempts to contact the applicant (at least one in writing) or the applicant's representative to encourage the applicant's participation. 34 C.F.R. § 361.44
PROCEDURES - CLOSED NOT REHABILITATED BEFORE/DURING EVALUATION
* Complete Certificate of Ineligibility. (RS-4C) (See Forms Appendix E)
* Key data for Status 08.
Note: An Annual Review is required on a case that has been closed as incapable of achieving an employment outcome due to the severity of disability. This review need not be conducted in situations, in which the individual has refused, no longer resides in the state, the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal.34 C.F.R. § 361.43(e)
CLOSED NOT REHABILITATED DURING/ AFTER EVALUATION (Status 08)
An individual's record of services is closed from application or Trial Work Experience/Extended Evaluation when the VR eligibility conditions are not met or intervening reasons prevent eligibility determination. The ineligibility determination must be made based on clear and convincing evidence that the individual cannot benefit from services in terms of an employment outcome due to severity of disability. The counselor must include a formal certification statement indicating ineligibility for VR services in the individual's record of services.
A Certificate of Ineligibility will be dated and signed by the counselor. Ineligibility determination will be made only after full participation and an opportunity for consultation with the individual or, if appropriate, the individual's representative. In such cases, the counselor will notify the applicant in writing of the action taken, or by other appropriate modes of communication consistent with the informed choice of the individual, including the reasons for the ineligibility determination. When appropriate, referral will be made to other agencies and programs that are part of the One-Stop service delivery system under the Workforce Investment Act.
The individual may appeal the ineligibility determination. The counselor will provide the individual with information on the means by which an appeal can occur, including informal and formal due process procedures, such as administrative review, mediation and review by an impartial hearing officer. The counselor will also provide the individual with information regarding services available from the Client Assistance Program and how to contact the Client Assistance Program. 34 C.F.R. § 361.41
PROCEDURES - CLOSED NOT REHABILITATED DURING/AFTER EVALUATION
* Cancel or pay any outstanding encumbrance.
* Complete Certificate of Ineligibility if closed Status 08 from Status 02. (See Forms Appendix E)
* Complete RS600-C if closed Status 08 from Status 06. (See Forms Appendix E))
* When appropriate, referral will be made to other agencies and programs that are part of the One-Stop service delivery system under the Workforce Investment Act.
* Key data for Status 08 Closure.
Note: An Annual Review is required on a case that has been closed as incapable of achieving an employment outcome due to the severity of disability. This review need not be conducted in situations, in which the individual has refused it, no longer resides in the state, or the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal. 34 C.F.R. § 361.43(e)
CLOSED REHABILITATED (Status 26)
An individual's record of service will be closed as successfully rehabilitated when the individual has achieved an employment objective consistent with informed choice, substantiality of services has been documented in the case notes, and the following requirements have been met:
Additional information is required and must be included in the closure document:
Note: An individual will not be closed "Rehabilitated" more than once in any fiscal year.
PROCEDURES - CLOSED REHABILITATED - STATUS 26
* Pay or cancel any outstanding encumbrance.
* The counselor must demonstrate through documentation in a summary case note that substantial services provided under the individual's IPE contributed to the achievement of the employment outcome.
* If there is a need for an IPE goal change, an amendment must be completed 90 days prior to closure.
* Case must be in Status 22 for 90 days.
* If the counselor has information concerning employment of the individual, but cannot obtain the individual's signature that is required on the closure amendment, the counselor may close the case by using the method described in the next bullet.
* A minimum of three written attempts (2 letters and one registered letter) must be made to contact the individual is required. (See forms section)
* The receipt verification (card) signed by the client must be placed in the case file. (If the card is not signed by the client, the case cannot be closed "26.")
* Complete the RS600-C. (See Forms Appendix E)
* The original RS600-C will be placed in the case file and a copy of the RS600-C will be given to the individual.
* If the individual received services at HSRC, a copy of the RS600-C will be sent to the Center Counselor.
* Key data for Status 26.
* The individual will complete the Consumer Satisfaction Survey form. This form can be given to the individual, mailed or accessed online.
CLOSED NOT REHABILITATED (STATUS 28)
Cases closed not rehabilitated in Status 28 can only be closed from Statuses 18 - 24. An individual's record of services will be closed as not rehabilitated when it is determined that suitable employment cannot be achieved or that employment resulted without benefit derived from VR services. The counselor will also provide the individual with information regarding services available from the Client Assistance Program and how to contact the Client Assistance Program.
PROCEDURES - CLOSED NOT REHABILITATED - (STATUS 28)
* Pay or cancel any outstanding encumbrance.
* The counselor must document in the case notes the reason for closure.
* Complete the RS600-C. (See Forms Appendix E)
* The original RS600-C will be placed in the case file and a copy of the RS600-C will be given to the individual.
* If appropriate, the individual will be referred to other agencies, programs, WIA One Stop Partners.
* Key data for Status 28.
* The individual will complete the Consumer Satisfaction Survey form. This form can be given to the individual, mailed or accessed online.
CLOSED NOT REHABILITATED (STATUS 30)
Cases closed not rehabilitated in Status 30 can only be closed from Status 10 or 12. An individual's record of services will be closed as not rehabilitated when it is determined that the vocational objective is not feasible, the counselor and individual cannot agree on a rehabilitation plan, progress toward rehabilitation cannot be made for one reason or another, the individual has moved to another state, or is no longer available for services. The counselor will also provide the individual with information regarding services available from the Client Assistance Program and how to contact the Client Assistance Program.
PROCEDURES - CLOSED NOT REHABILITATED - (STATUS 30)
* Pay or cancel any outstanding encumbrance.
* The counselor must document in the case notes the reason for closure.
* Complete the RS600-C. (See Forms Appendix E)
* The original RS600-C will be placed in the case file and a copy of the RS600-C will be given to the individual.
* The individual will be referred to other agencies, programs, or WIA One Stop Partners.
* Key data for Status 30.
POST-EMPLOYMENT - (STATUS 32)
Status 32 is used when the need for post-employment services has been identified. Post-employment services may be provided after the individual has been closed as Rehabilitated (26) and needs services to maintain employment. The case must be in active status for post-employment (32) before any services may be provided. Cases can only be placed in Status 32 after being closed in Status 26.
The counselor and individual must agree on the services planned to maintain the individual in employment. The purpose of this status is to avoid the necessity of reopening a case in order to provide a minor service that can be provided quickly, expeditiously, at a minimum cost and with little counselor effort.
For example, these may include minor repair to prosthesis or a small amount of retraining in the use of prosthesis, weekly or biweekly counseling and guidance or a spinal cord injured individual who suffers from an acute kidney infection and needs immediate medical treatment.
If the counselor is aware of the need for Post-Employment services at the time of the 26 Closure, all planned and anticipated services should be documented and must be included on the closure (amendment) document (RS600-C). If a need for post-employment services is determined several weeks after the 26 Closure, an amendment (RS600-C) must be completed.
Post-employment services are expected to be a minor, one-time service and not provided in excess of 18 months. 34 C.F.R. § 361.5(b)(42)
PROCEDURES - POST-EMPLOYMENT (STATUS 32)
* The counselor must document in the case notes the need for Post-Employment.
* If Post-Employment services are identified at the time of 26 Closure, the counselor can complete the RS600-C to document all planned or anticipated services on the closure amendment. (See Forms Appendix E) Close the case in Status 26 in the case management system and immediately reopen the case in the case management system in Status 32 by keying in the Social Security Number.
* If Post-Employment services are identified after the 26 Closure, the counselor must complete an RS600-C to document all planned services. (See Forms Appendix E) Reopen the case directly into Status 32 by keying in the Social Security Number. The original RS600-C will be placed in the case file and a copy of the RS 600-C will be given to the individual.
* A case narrative entry must document progress.
CLOSED FROM POST-EMPLOYMENT (STATUS 34)
Decisions to terminate post-employment services should be made in consultation with the individual and documented in the amended IPE (RS600-C). The counselor will work with the individual to achieve a satisfactory level where post-employment support is no longer necessary. It also requires the counselor's professional judgment as to the individual's employment stability.
In making these decisions, the following factors should be considered:
PROCEDURES - CLOSED FROM POST-EMPLOYMENT (STATUS 34)
* Pay or cancel any outstanding encumbrances.
* The counselor must document in the case notes the reason for closure and result of post-employment services.
* Complete RS600-C.
* The original RS600-C will be placed in the case file and a copy of the RS600-C will be given to the individual.
* Key data for Status 34.
CLOSED FROM POST-EMPLOYMENT TO BE REOPENED (STATUS 36)
The counselor will close an individual's case in Status 36 when the counselor determines to reopen the individual's record of services (place in 02) to provide necessary VR services.
PROCEDURES - CLOSED FROM POST-EMPLOYMENT TO BE REOPENED (STATUS 36)
* Pay or cancel any outstanding encumbrances.
* The counselor must document in the case notes the reason for closure.
* Complete RS600-C.
* The original RS600-C will be placed in the case file and a copy of the RS600-C will be given to the individual.
* Key data for Status 36.
* Initiate a new Application (RS-4) and follow procedures for a new referral.
CLOSED FROM SERVICE DELAYED/ORDER OF SELECTION (STATUS 38)
This status is used to identify individuals eligible for VR who will not advance to Status 12 and whose names are being removed from the Service Delayed/Order of Selection list (Status 04).
PROCEDURES CLOSED FROM SERVICE DELAYED/ORDER OF SELECTION
* Pay or cancel any outstanding encumbrances.
* The counselor must document in the case notes the reason for closure.
* Complete RS600-C.
* The original RS600-C will be placed in the case file and a copy of the RS600-C will be given to the individual.
* Key data for Status 38.
CLOSED FROM POST-EMPLOYMENT (STATUS 39)
An individual will be closed from post-employment when the individual cannot maintain employment.
PROCEDURES - CLOSED FROM POST-EMPLOYMENT (STATUS 39)
* Pay or cancel any outstanding encumbrances.
* The counselor must document in the case narrative the reason for closure.
* Complete RS600-C.
* The original RS600-C will be placed in the case file and a copy of the RS600-C will be given to the individual.
* Key data for Status 39.
The counselor accounts for case movement by using statuses. The counselor must make the initial entry from the Client Referral and Survey Information Document (RS-4). Thereafter, the counselor must update the case management system each time there is a status change.
CASE STATUS CLASSIFICATIONS
Referral Status
Application Status
Trial Work Experience/Extended Evaluation Status
Closures from Applicant (02)
Closures from Trial Work Experience or Extended Evaluation (06)
ACTIVE STATUSES
Pre-Service Statuses
Service Statuses
Counseling and Guidance
Physical Restoration
CLOSURES FROM ACTIVE STATUS
CLOSURES FROM POST-EMPLOYMENT SERVICES
RSA designed the VR Caseload Status System to aid the tracking of individuals as they progress through the service system. Because RSA uses a closed-case reporting system, only those status codes specifying the point in the VR process where the counselor closed an individual's case would apply (closure codes 08, 26, 28, 30 and 38).
STATUS 00 - REFERRAL
Status 00 represents an individual who has been referred to VR with minimum information provided to the counselor. The individual has not made a request for services, but the counselor must place the individual in Status 00 if sufficient demographic information is available. Sufficient demographic information is name, SSN, address, and referral source.
STATUS 02 - APPLICANT
Status 02 represents an individual's entrance into the VR process. When an individual signs a document requesting VR services, the counselor must place the individual into Status 02. At that point, the individual is considered an applicant after completing an Agency application form RS-4. However, the counselor may place an individual into Status 02 if the individual requests services with a signed letter and minimum basic referral information.
The counselor must place every case in Status 02 before authorizing diagnostic service(s). While the individual is in Status 02, the counselor investigates and secures sufficient information to determine eligibility for VR services or a decision to use Trial Work Experience or Extended Evaluation services. An individual can only remain in Status 02 for 60 days unless the counselor and applicant agree to a specific extension of time.
STATUS 04 - SERVICE DELAYED/ORDER OF SELECTION
The counselor moves an applicant into Status 04 when the Preliminary Assessment justifies writing a Certificate of Eligibility. However, the individual cannot receive services because the individual does not meet the Order of Selection priorities. The individual's name is placed on a waiting list for services until such time as the Agency has sufficient funds available to provide services. Placement of the individual's name on the waiting list for services indicates there will be a delay in the initiation of services for which the individual is otherwise entitled to receive.
An individual leaving this status will be moved to Status 12 to signify that services will be provided without further delay or will be closed status 38 at end of fiscal year.
STATUS 06 - TRIAL WORK EXPERIENCE/EXTENDED EVALUATION
When the individual's eligibility for VR services cannot be readily certified, the counselor moves the individual into Status 06. The counselor may provide services to the individual to determine there is clear and convincing evidence that the individual can benefit from the provision of vocational rehabilitation services in terms of an employment outcome or there is clear and convincing evidence that the individual is incapable of benefiting from vocational rehabilitation services due to the severity of disability.
The case management system will only allow 18 months in Status 06.
STATUS 08 - CLOSED FROM EVALUATION
Status 08 identifies all individuals not accepted for VR services whether closed from applicant Status (02) or Trial Work Experience or Extended Evaluation Status (06).
STATUS 10 - CERTIFICATION OF ELIGIBILITY
The counselor moves an applicant into Status 10 when the Preliminary Assessment justifies writing a Certificate of Eligibility.
STATUS 12 - INDIVIDUALIZED PLAN FOR EMPLOYMENT
After the counselor completes the comprehensive assessment and the counselor and individual or representative agree on an IPE, the individual is moved into Status 12.
STATUS 18-RECEIVING SERVICE STATUS
Status 18 is used when the individual begins receiving services.
COUNSELING AND GUIDANCE
The counselor moves an individual in status 18 after completing an IPE, which outlines counseling and guidance services are necessary to prepare the individual for employment.
The service is necessary to prepare the individual for employment, or a breakdown has occurred in the progress of the case after other services have been initiated and the counselor has determined that substantial counseling and guidance are essential to successful rehabilitation.
PHYSICAL AND/OR MENTAL RESTORATION
The counselor moves an individual into Status 18 when the individual receives physical and/or mental restoration services as the primary service. Restoration services include medical, surgical, psychiatric, or therapeutic treatment, the fitting of prosthetic appliances, hospitalization, convalescent care or nursing services.
STATUS 20 - READY FOR EMPLOYMENT
Status 20 is used when VR services have prepared the individual for gainful employment and the individual is ready to begin placement activities or the individual has been placed but has not yet begun employment.
STATUS 22 - EMPLOYED
Status 22 is used when the individual begins employment. To ensure adequacy of employment in accordance with the individual's unique strengths, resources, priorities, concerns, abilities, capabilities, interest, and informed choice, the individual must remain employed in Status 22 for a minimum of 90 days before the counselor can close the individual's case as achieving an employment outcome. (Status 26)
STATUS 24 - SERVICES INTERRUPTED
Status 24 is used when VR services are interrupted while in Status 18, 20, or 22. The individual will remain in Status 24 until the individual is able to return to one of the above-mentioned statuses or the individual's case is closed in Status 28.
STATUS 26 - CLOSED REHABILITATED
Status 26 is used when the individual has achieved a suitable employment outcome described in the individual's IPE and has been maintained for a minimum of 90 days in Status 22. An individual will not be closed in Status 26 more than once in any Federal fiscal year.
STATUS 28 - CLOSED NOT REHABILITATED AFTER IPE INITIATED
Status 28 is used to close an individual's case from Statuses 18 through 24 when it has been determined the individual does not meet the criteria for Status 26 closure.
STATUS 30 - CLOSED NOT REHABILITATED BEFORE IPE INITIATED
Status 30 is used to close a case from either Status 10 or 12.
STATUS 32 - POST-EMPLOYMENT SERVICE
Status 32 is used when the need for post-employment services has been identified and planned to maintain the individual in employment. The purpose of this status is to avoid the necessity of reopening a case in order to provide a relatively minor service.
Post-employment services are expected to be of a one-time nature and not provided in excess of 18 months. Cases in Status 32 cannot be transferred.
STATUS 34 - CLOSED FROM POST-EMPLOYMENT
Status 34 is used to close an individual's case when the individual maintains employment through the completion of planned services provided in Status 32.
STATUS 36 - CLOSED FROM POST-EMPLOYMENT TO BE REOPENED
Status 36 is used to close an individual's case from post-employment when the counselor determines the need to reopen the individual's case to provide necessary VR services. The case will be reopened in Status 02.
STATUS 38 -CLOSED FROM SERVICE DELAYED/ORDER OF SELECTION
Status 38 is used to identify individuals eligible for VR who will not advance to the Statuses (12 to 24) and whose names are being removed from the Service Delayed/Order of Selection list (Status 04).
STATUS 39 - CLOSED FROM POST-EMPLOYMENT/OTHER REASONS
Status 39 is used to close an individual for any other reason for termination from post-employment services.
TRANSFER OF CASES - Cases Transferred will retain their status and the date of the transfer.
CASES TRANSFERRED OUT
PROCEDURES - CASES TRANSFERRED OUT
* A transfer will be made when an individual on a counselor's caseload either permanently moves or request another counselor's within or out of that counselor's district.
* The transferring counselor will discuss the case with the receiving counselor as well as notifying the District Manager. Both counselors should be in agreement before the case is transferred.
* Status 22 cases will be transferred ONLY if the counselor believes this would be in the individual's best interest.
* Transfers will not be made during the same month the case is accepted and/or the IPE is completed and/or services are initiated.
* Key data in case management system.
* Document in case narrative under "TRANSFER OUT", reason for transfer.
CASES TRANSFERRED IN PROCEDURES- CASES TRANSFERRED IN
* After the case has been transferred in the case management system, the receiving counselor will meet with the individual.
* Document in case narrative under "TRANSFER IN", reason for transfer,
CASES TRANSFERRED IN FROM OTHER STATE REHABILITATION AGENCIES
Cases cannot be transferred from other State Rehabilitation Agencies. Individuals moving from another state and requesting services from ARS will be treated the same as a new referral.
OPENING CLOSED CASES
If an individual, whose case has been previously closed, requests services the counselor will follow the same procedures for new applicants (02).
Counselors cannot reopen cases in the same month in which they were closed.
Exception: When necessary to reopen a case in the same month in which it was closed, the counselor will submit a memorandum to the Chief of Field Services through the District Manager requesting the closure to be voided. The Chief of Field Services will notify the Counselor through the District Manager that the closure has been voided so the necessary services can be provided.
ANNUAL REVIEW OF CLOSED CASES - INELIGIBLE
Refer to Closure VIII.
CURRENT YEAR REFUNDS
The vendor should make the refund check payable to the Arkansas Rehabilitation Services. The check should carry the name of the individual. The refund and memorandum giving full information about the refund will be sent to the Chief of Field Services. A cancellation for the refunded amount will be keyed in the case management system. The amount will automatically be added into the counselor's allotment.
PRIOR YEAR REFUNDS
The vendor should make the check payable to Arkansas Rehabilitation Services. The check should carry the name of the individual. All refunds will be sent to the Chief of Field Services or his/her designee. The refund and a memorandum giving full information about the refund will be sent to the Chief of Field Services or his/her designee. All prior year refunds are placed into the Arkansas Kidney Disease Commission allotment as required by state law. Prior year refunds do not require cancellations.
INDIVIDUAL'S CONTRIBUTION
Individual contributions are to be paid to the vendor. If an individual contributes to ARS toward the cost of any services or goods, an ARS authorization will be written for the remaining amount. The contribution amount will be recorded in the IPE (RS-600 A).
PRIOR APPROVAL POLICY
Prior approval is defined as "the rehabilitation program and other record of services materials are reviewed and approved by a District Manager or his/her designee before the services planned for are initiated." The District Manager or his/her designee will review all cases requiring prior approval. When the case is approved, the District Manager or his/her designee stamps or writes "Approved", dates and initials the upper right hand corner on all copies of the IPE and the authorization/billing form.
The State Office, a District Manager, or a counselor may request prior approval on a particular case, on types of cases, or on all cases.
PRIOR APPROVAL - NEW COUNSELORS
A District Manager's or his/her designee prior approval is required on all cases during a new counselor's 12-month probationary period. Approval will be indicated on all:
PRIOR APPROVAL - STATE OFFICE
The State Office, a District Manager, or a counselor may request prior approval on a particular case, on types of cases, or on all cases. The District Manager, after a detailed study of the case, will prepare a memorandum justifying the recommendation for an administrative review and approval. This, with the record of services, will be submitted to the Chief of Field Services or his/her designee.
TICKET TO WORK
Clients that receive Supplemental Security Income (SSI) or Social Security Disability Income (SSDI) as a disabled adult are eligible for the Ticket. A minor child of a disabled worker or a disabled adult child is not eligible for Ticket.
*Benefits Counseling
REHABILITATION INITIAL DIAGNOSIS AND ASSESSMENT FOR CLIENTS (RIDAC)
Rehabilitation Initial Diagnosis and Assessment for Clients (RIDAC) is a support unit for the Field Program. Its goal is to provide diagnostic services to counselors working with individuals during the initial stages of case development and planning. Services are provided at the RIDAC Office, local field offices, or a setting arranged by the counselors and/or District Managers. Services include general medical examinations, mental health assessments, psychological and vocational evaluations, educational assessments, ability assessments, conditions determinations, case consultation, and technical assistance. To expedite the evaluation process, the counselor should make every effort to secure existing information. To the extent that existing data does not describe the current functioning of the individual, is insufficient, or inappropriate to make an eligibility determination, additional assessment may be requested. 34 C.F.R. § 361.42
To insure competent, consistent professional quality, RIDAC diagnostic evaluation services are completed by individuals who are Arkansas licensed physicians, psychologists, or psychological examiners. If RIDAC were to expand evaluation service, employed individuals will be licensed to perform the type of service provided by the appropriate Arkansas Licensing Board.
PROCEDURES - RIDAC REFERRAL
* Complete the RIDAC Service Authorization. It is very important the referring counselor indicate any assessment problems or questions to be addressed. In addition, necessary accommodations related to mobility, vision, hearing, etc. should be identified. During the course of the evaluation RIDAC staff will address identified problems or questions. If other evaluation concerns are discovered, they will be evaluated to determine if the identified concern could have an impact on the success of the rehabilitation program. If a general medical examination is requested, complete the top portion of the general medical form and attach it to the RIDAC Service Authorization.
* When individuals have not reached the age of majority or have been determined incompetent, an informed consent for the RIDAC assessment is signed by the appropriate parent/guardian, with a copy attached to the RIDAC Service Authorization Form. Referring rehabilitation counselors are to insure that all individuals referred to RIDAC assessment consent to the evaluation process.
* When existing medical, psychological, employment, history, or disability information is available, a consultation with the appropriate RIDAC staff can be obtained to review the existing data. The RIDAC staff person will complete a written report or consultation form.
* Contact the individual responsible for scheduling in the local office to obtain an appointment. Once the appointment has been obtained, the RIDAC Service Authorization and, if appropriate, the general medical form should be given to the individual responsible for scheduling RIDAC appointments in the local office. When available, existing psychological testing records, mental health reports, medical records, etc., shall be made available for review by the RIDAC evaluation team.
* The referring counselor is responsible for notifying the individual of the RIDAC appointment and providing directions to the evaluation site as well as other pertinent information. If the individual fails to report as scheduled, the RIDAC Service Authorization will be returned to the referring counselor documenting the individual's failure to report. To reschedule, follow procedures as outlined above.
The RIDAC program has a goal of returning evaluations completed within 10 work days or less from the time the individual is seen. However, when specialized evaluations are completed that require individualized evaluation, for instance neuropsychological limitations, the report time will likely be extended. RIDAC assessment forms will be maintained for a period of three months. Original evaluation reports shall be forwarded to the client file maintained by the referring field counselor. However, electronic records of the report will be transferred to the secured RIDAC folder and later transferred for permanence to be maintained in a secured location.
SMALL BUSINESS ENTERPRISE PROGRAM
A self-employment situation is sometimes the best rehabilitation program that can be developed with an eligible individual. Assistance with the purchase of occupational tools, equipment and initial stocks may enable an individual to reach a self-employment outcome rather than working for a wage or salary in a competitive situation. A threshold of $5000 has been established. For exception refer to Appendix G.
PROCEDURES - SMALL BUSINESS ENTERPRISE PROGRAM
Eligibility is determined and the case is placed in Status 10.
* Counselor will consult with the District Manager(DM) as soon as a case is determined to need Small Business Enterprise services.
* The Small Business Enterprise (SBE) Consultant is used to facilitate a SBE case and will be given a copy of the RS-4 and a memo summarizing the case, including medical and psychological information.
* The SBE Consultant will provide technical information concerning the development of the small business plan, information about contacting the Small Business Administration and how to access information and training in the local area, and the availability of other resources.
* The consultant will prepare a small business assessment of the project, which will be presented to the counselor and district manager.
* If the counselor and client agree, the Small Business Plan will be presented to the District Manager for approval.
* The DM must approve the SBE plan before services can be authorized.
* The DM will review all Small Business Programs and may require an onsite inspection.
* The DM must approve expenses beyond the threshold of $5,000. For exception refer to Appendix G.
* The counselor will develop the IPE with the individual.
* The counselor will follow all agency guidelines, purchasing policy, and procedures.
* The counselor is responsible for the supervision of the case and provision of services.
* The counselor must assure all local ordinances and regulations are followed.
Learning & Evaluation Center
The Learning and Evaluation Center (LEC) provides direct service to ARS clients through individual psychological/neuropsychological evaluations, after referral from the Counselor and also generally after a RIDAC screening evaluation. LEC evaluations generally require one to two days, are conducted by licensed psychology professionals, followed by a detailed written report and individual feedback session involving the counselor, the consumer, and other family members if indicated. All evaluations are conducted in Little Rock with feedback sessions typically conducted at an ARS office near the consumer's home.
The purpose of the evaluation is to assist in the diagnosis of disabilities that may be affecting the consumer's educational progress, to identify strengths that may be used to mitigate disabilities, and to suggest accommodations when those may be helpful. Evaluations may also be focused on identifying strengths and weaknesses in areas more related to abilities to perform in the workplace, when a RIDAC screening evaluation has not been able to answer those questions. Neuropsychological evaluations for consumers who may have suffered from some form of traumatic brain injury are conducted to help determine the consumer's recovery process and readiness for job training, job placement, or further education.
The LEC also offers the services of an educator with considerable experience in deafness providing sign language classes and related training to agency staff, other professionals, and the public at large. In addition LEC provides college preparatory activities and training to individuals preciously evaluated by the LEC.
CLIENT ASSISTANCE PROGRAM
The Client Assistance Program (CAP) is operated by an agency designated by the Governor and is independent of any agency that provides treatment, services, or rehabilitation to individuals under the Rehabilitation Act.
The purpose of the Client Assistance Program is to:
CAP can advise the ARS of identified problems, problem areas in the delivery of VR services to persons with disabilities and suggest methods and means of improving the delivery of services.
INCREASING CAPABILITIES ACCESS NETWORK
Increasing Capabilities Access Network (ICAN) is Arkansas's statewide assistive technology program. ICAN is federally mandated to provide training, device loans, demonstrations and donations in the area of assistive technology to persons with disabilities - all ages, all disabilities, family members, caregivers, therapist, educators, employers, professionals and other interested parties. Assistive technology (AT) is any kind of device or tool that helps people learn, work, communicate and live more independently. AT can be very simple and inexpensive, like a modified knife and fork, or it can be very sophisticated and costly, like a computerized speech device.
SERVICES:
Loan: A wide range of AT devices are available for loan to try-out before buying, use while another is being repaired or borrow for use in a temporary time of need.
Donation: Used AT in good condition can be donated to ICAN. These donations are repaired and sterilized then made available at no cost to individuals and agencies. Equipment, such as wheelchairs, standers and walkers require a doctor's prescription.
Demonstration: If you are considering what type of device might work best for you, one of your clients, family member or friend ICAN offers AT device demonstrations to assist in making an informed decision.
Equipment Exchange: The public can list and find used devices for sale, trade or donation through our website.
Training Opportunities/Exhibits: ICAN works with therapist, vendors and professionals to develop AT trainings and/or exhibits in areas such as workplace accessibility, computer access, low vision, hearing impairment, switch access and learning software.
ICAN is a statewide resource for information in all areas of assistive technology, such as funding resources, accessibility at work, school and/or home, and much more. Visitors to our technology center can see numerous devices in simulated office, school and home situations as well as hands-on experiences.
For more information visit our website (www.ar-ican.org) or contact us at:
ICAN
Phone: 501-666-8868
Fax: 501-666-5319
Toll Free/TTY: 800-828-2799
Assistive Technology Program AT @ Work
REFERRAL AND ASSESSMENT PROCESS
The AT @ Work program (Assistive Technology at Work) is designed to assist the ARS consumer and the referring Counselor in selecting and obtaining the appropriate assistive technology. The program is a collaborative effort involving Little Rock based staff as well as ACTI therapy staff. Services offered include evaluation/assessment, assistive technology device training, device modification/adaptation, and technical assistance as it relates to work, school, home, and transportation. ARS Counselors are required to determine the need for assistive technology at time of application, plan development, and placement.
The following process is recommended in those situations when the Counselor identifies the potential need for assistive technology:
The counselor will also be responsible for obtaining the consumer's signature on the retention of title for necessary equipment.
TELECOMMUNICATIONS ACCESS PROGRAM (TAP)
The Telecommunications Access Program (TAP) was established by Act 501 in 1995 and amended by Act 530 of 2001. It is a statewide equipment distribution loan program for Arkansans with disabilities or impairments to receive equipment necessary to be able to communicate on the telephone. Any individual who has a disability that impairs their ability to effectively access the telecommunication network may apply for the program. Eligibility is based on Arkansas residency, personal telecommunication service, certification of disability by an approved certifier, and income eligibility. Approved individuals may be eligible for up to two adaptive equipment systems to provide access to telecommunication service.
Interested individuals must complete the TAP application form and submit any additional information the program deems necessary to determine an applicant's eligibility. This information is also used to determine the adaptive equipment which best meets each eligible individual's needs. Individuals determined eligible must sign an agreement to follow TAP rules.
All information is maintained confidential and TAP follows the ARS appeals process. Additional information and application forms may be obtained from TAP, by calling (501) 686-9693 V/TTY or 1-800-981 -4463 V/TTY.
ARKANSAS TRANSITION PROGRAM
TRANSITION SERVICES
The term transition services means a coordinated set of activities for a student, designed within an outcome-oriented process, that promotes movement from school to post-school activities, including post-secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adults services, independent living, or community participation. The coordinated set of activities shall be based upon the individuals student's needs, taking into account the student's preferences and interest, and shall include instruction, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation. 34 CFR § 361.22(a)(2) provides that, if the student is determined eligible for VR services, the student's IPE should be developed as early as possible during the transition process but no later than when the student exits the school setting.
PROCEDURES FOR TRANSITION SERVICES
Age 14 or before:
Arkansas Rehabilitation Services will provide informational services and brochures regarding ARS services to any student, parent or guardian, special education teacher or other school official.
Age 16 or before:
The ARS counselor will meet with the special education teachers on a yearly basis to discuss potential referrals for ARS services. A meeting will be scheduled to discuss students in the 11th grade to determine recommendations for referral to ARS before the end of the junior year.
Before Graduation:
The ARS counselor will receive referral from the special education teacher no later that October of the senior year. All referrals will be accepted using the Arkansas Transition Referral Form 410. In addition to the referral form, the teacher will submit copies of school records, psychological evaluations and the ARS Informed Consent signed by the parent or guardian (if the referral is under the age of 18). The school will submit any additional information that is pertinent and useful in assisting the ARS counselor to determine eligibility and assist the student and the counselor in identifying, selecting and pursuing appropriate career objectives.
The ARS counselor will complete an application at the earliest date possible upon receipt of the transition referral form and supporting documents. The ARS counselor must determine eligibility for services and ensure the development and approval of the Individualized Plan for Employment (IPE) by the time the student leaves the school setting. 34 CFR § 361.22 and 361.45
If the ARS counselor is unable to complete the vocational assessment to determine eligibility within 60 days of application, (due to missed appointments) the counselor must notify the special education teacher or other official as soon as possible to enable the special education teacher to resume the IEP planning process.
The ARS counselor will follow established procedures for referral, application, eligibility determination and IPE development consistent with informed choice.
RESPONSE LETTERS FOR TRANSITION REFERRALS
In order to have a reasonably predictable statewide response to Transition Referrals and to make the process as easy as possible, it is suggested that each office adopt the following format for use as cover letters for the ARS Transition Information Packet (Template Sample Letter 1) and for Rehabilitation Services (Template Sample Letter 2).
The complete packet should include:
SAMPLE LETTER 1 Date
Student Name
Address
City, State, Zip Code
Dear Student's name:
Thank you for asking about vocational rehabilitation services. Throughout Arkansas, we help eligible persons, become employed and independent in their daily lives.
Agency customers may be offered a wide variety of services that can prepare them for employment. To help you understand more about what vocational rehabilitation services means, we are sending data explaining many rehabilitation services and programs in Arkansas Please talk with your parents and teachers about your plans. We want you to be familiar with vocational rehabilitation services so you can make better decisions about the next few years.
Once again, thank you for contacting our agency. I hope the enclosed data will be helpful to you. We look forward to possibly working with you later, as you prepare for adult life.
Sincerely,
Counselor
Order of Selection Information for Transition Services
CATEGORIES:
WHAT IS ORDER OF SELECTION? If ARS is unable to provide rehabilitation services to all eligible individuals, the agency will operate under an order of selection. Individuals with the most significant disabilities have first priority when it comes to services that require the expenditure of money
WHAT ARE SOME OF THESE SERVICES? Counseling, guidance, career exploration, physical restoration, college of vocational training, supported employment, job placement, and follow up services.
WHAT IS A SIGNIFICANT DISABILITY? One that seriously limits a person's ability to move, communicate, take care of themselves or relate well with other people. Must impact employability.
WHY HAVE THIS POLICY? When ARS doesn't have enough money to serve all eligible people with disabilities who apply, the law says we have to give first priority to people with the most significant disabilities.
WHO DECIDES IF I'M SIGNIFICANTLY DISABLED? The ARS Counselor makes this decision.
WILL I AUTOMATICALLY QUALIFY FOR PAID-FOR SERVICES IF MY DISABILITY IS LISTED UNDER THE DEFINITION OF SIGNIFICANTLY DISABLED? No Significance of disability is only one factor used to determine eligibility for paid-for services. All applicants must be evaluated and must meet several criteria before eligibility is determined.
WHAT IF I DON'T HAVE A SIGNIFICANT DISABILITY, YET STILL WANT PAID-FOR SERVICES? Contact your local ARS office, talk to a counselor and complete all paperwork. This way eligibility will already be determined if money does become available.
WHAT IF I DISAGREE WITH THE DECISION? You may appeal the decision.
SAMPLE LETTER 2
Date
Student Name
Address
City, State, Zip Code
Dear Student's Name:
We recently received a Transition Referral Form from the Individual Education Plan (IEP) Team at your High School showing that you may be interested in learning about how vocational rehabilitation services might be helpful to you.
The purpose of Arkansas Rehabilitation Services is to assist persons who are eligible for our services to become employed and independent in their daily lives. Eligible persons may be offered a wide variety of services that can prepare them for employment.
In order to find out more about how vocational rehabilitation services can personally help you, call me at ( _________) within the next two weeks. I will be happy to set up a personal appointment so we can discuss your future and how Arkansas Rehabilitation Services may be able to help you.
Sincerely,
Counselor
DISABILITY MANAGEMENT PROGRAM
ARS' Disability Management Program is intended to achieve a win-win situation that addresses the reciprocal, economic, and humanistic needs of the true stakeholders in disability management-employers and employees.
Common interests that can be achieved through an effective program include important outcomes such as preventing and reducing the risks of injury and illness, mitigating the damages associated with injury and illness, retaining productivity, effectively using human resources and health care services, improving financial security, avoiding adversarial relationships, and achieving the goals of disability legislation.
ARS' Disability Management Program focuses on workplace prevention and remediation strategies that seek to prevent disability from occurring or, lacking that, to intervene early following the onset of disability, using coordinated, cost-conscious, quality rehabilitation services that reflect an organizational commitment that encourages return to work for employees with disabilities.
One of the most effective strategies utilized within disability management is the implementation of an early Return-to-Work Program. A Return-to-Work Program is an employer-sponsored program designed to assist an employee who is recovering from injury or illness in the individual's return to work as soon as it is safe and medically feasible. By utilizing transitional employment an employee whose condition is stable enough to endure some work activity can return to the work place and perform those work tasks the individual is capable of completing. An employee is assigned specific work tasks the individual can perform taking into account physical and/or emotional restriction. Accommodations that can be offered during the transitional work period include reduced work hours, modified work tasks, or entirely different jobs. The objective of a Return-to-Work Program is to provide a safe and gradual return of the employee to full, regular employment. Upon request, ARS disability management staff will assist an employer in the development of Return-to-Work Program policy and procedures, program implementation, and follow-up.
Referrals to the ARS Disability Management/Return-to-Work Program should be directed to the Program Administrator. Referral information should include the following:
* The name/phone number/address of the referral (employer and/or employee)
* Employer contact person (if available), and the Employee's disability (if indicated)
ARKANSAS KIDNEY DISEASE COMMISSION
HISTORY AND LEGISLATIVE AUTHORITY
The Arkansas Kidney Disease Commission (AKDC) was established by the General Assembly of the State of Arkansas through Act 450 of 1971 to establish a program for the care and treatment of persons with chronic renal disease. The legislation charged the AKDC to "provide financial assistance for persons suffering from chronic renal disease who require life-saving care and treatment to the extent as determined by the Commission." The ten-member, Governor appointed, AKDC Board provides general over-site to the program with the ARS Commissioner serving on the Board as Secretary/Chief Disbursing Officer.
SERVICES AND PROGRAMS
Services available to individuals determined eligible for the AKDC are dependent on treatment status as well as eligibility for benefits related to other programs such as Medicare, Medicaid, Veterans, or private health insurance. The program has an annual limit of funding provided per client with that limit subject to change based on the availability of funds. The AKDC may provide financial assistance to eligible individuals for payment of prescription drugs, pre-transplant dental services, transportation services, and in certain instances, medical services. In addition, the AKDC is dedicated to providing support to educational activities related to preventative measures and healthy living with End Stage Renal Disease (ESRD).
PRESCRIPTION DRUGS
The AKDC may pay for a limited number of ESRD related and post-kidney transplant prescriptions. With certain medications prior-approval is required. There are patient co-payments for all allowable medications. Program clients are required to utilize available drug benefits before requesting the AKDC to provide prescription coverage as the program is identified as a payer of last resort.
DENTAL SERVICES
The AKDC may assist with payment of infectious free dental care for program clients awaiting kidney transplantation. Payments for services rendered will require prior approval of such treatments and follow the established AKDC dental fee schedule. As the AKDC is a payer of last resort, clients with dental coverage are required to utilize the benefit. The program can assist with co-payment.
MEDICAL SERVICES
The AKDC may assist in paying for some ESRD related medical treatment costs during the Medicare three-month waiting period or when other coverage does not exist. Documentation of lack of coverage and prior approval is required. The availability of this service is dependent on funding.
TRANSPORTATION SERVICES
The AKDC may assist with some transportation costs specifically associated with ESRD treatment. The intent of this service is to provide assistance with travel to/from dialysis treatments. Requests for other ESRD related treatment, including doctor's office visits, will be reviewed on a case-by-case basis. The availability of this service is dependent on funding and requires prior approval. Reimbursement for the service will be based on a mileage per-diem rate established by the AKDC board.
PATIENT EDUCATION
The AKDC is dedicated to educating program clients and the public at large in improving health behavior of patients with ESRD as well as preventative education to sustain healthy kidneys. The purpose of this service is to maintain and hopefully improve the health of program clients and also if not prevent then slow down the loss of kidney function. This is met through conveying the importance of patient compliance when taking medication, nutritional needs, life-style changes, as well as, resources that are provided for the success of preventing ESRD or at least surviving the disease should it occur.
SUPPORTED HOUSING OFFICE
The Supported Housing Office (SHO) augments ARS' mission of providing opportunities for Arkansans with disabilities to lead productive and independent lives by focusing on a wide range of affordable housing issues. Supported Housing is defined as 'normal' housing such as an apartment, a single-family or multi-family home available for rent or purchase, coupled with individualized support services to maximize independent living.
The SHO assists Arkansans with disabilities to navigate the maze of local, state, and federal affordable housing programs, to identify solutions for the issue at hand. Common housing problems run the gamut from requests for shelters for homeless persons with disabilities, to sources of rental assistance, information on home repair and modification programs, foreclosure issues, and home-ownership opportunities. In addition, the Office provides targeted research, predevelopment consultations, and technical assistance on universal design and affordable housing development to the non-profit and the private sectors.
The SHO also staffs the Arkansas Governor's Task Force on Supported Housing (GTFSH) which is charged with increasing the supply of affordable, universal design housing for persons with disabilities as mandated by the U.S. Supreme Court in the Olmstead Decision. The centerpiece of the GTFSH Plan is the Arkansas Universal Design Project (AUDP) which produced single and multi-family universal design housing standards that are currently being implemented by Arkansas Development Finance Authority (ADFA), the State Housing Agency. Currently ADFA is leader in the production of single and multi-family universal design housing throughout the State. More information on the AUDP Standards and related research is available on-line at www.studioaid.org.
Arkansans experiencing housing problems are encouraged to contact Jeanette Davies via e-mail at jeanette.davies@arkansas.gov or by phone at 501.701.6378.
ARKANSAS CAREER TRAINING INSTITUTE (ACTI)
MISSION
To assist individuals with disabilities to become employed through the provision of comprehensive rehabilitation services.
SELECTION OF CLIENTS
Residents of Arkansas who make inquiry to ACTI will be reported to a Field Counselor. The Field Counselor will give these reported cases first priority for investigation, as well as all others reported for ACTI services by other sources. This investigation must be sufficient to determine whether the reported case is eligible or ineligible for services.
ACTI will provide services to individuals with disabilities whom it is believed can benefit from ACTI Services directed towards rehabilitation goals.
ADMISSION GUIDELINES
Applications for admission to ACTI will be reviewed in accordance with these guidelines. The responsibility for the administration of these guidelines rests with the ACTI Admissions Coordinator in consultation with various other staff representing the service delivery units of the facility.
GENERAL REFERRAL CONSIDERATIONS
Each request for admission will be evaluated using the following criteria:
BEHAVIOR CONSIDERATIONS FOR GROUP LIVING
Given the wide variety of disabilities served at ACTI, it is essential to create and maintain an effective and productive rehabilitation environment in which needs of persons with significant disabilities may be addressed.
Therefore, admission of any individual having the following anti-social patterns of behavior as judged to be disruptive to the good order of the student body will be rejected:
GUIDELINES FOR SPECIFIC DISABILITIES
These guidelines relate to specific disabling conditions and/or individual's problems meriting careful consideration by all ARS staff, both in the field and at the ACTI, in the process of selecting individuals for ACTI services. Each of these areas must have reasonable assurance that enrollment will result in employment:
ARKANSAS CAREER TRAINING INSTITUTE DRUG POLICY
Students enrolling at Arkansas Career Training Institute (ACTI) must sign the Arkansas Rehabilitation Services Substance Free Policy with a Field Counselor. All students enrolled at Arkansas Career Training Institute will be tested for prohibited substances during the first week of enrollment. If a student tests positive for drugs, the student will be suspended for 45 calendar days. The student will be required to provide ACTI with a clean drug screen and sign a behavioral agreement prior to their return. The student will be retested within 30 days of their return to ACTI. If the student tests positive for drugs at that time, the student will be discharged from ACTI.
Readmission is subject to the criteria outlined in the ACTI Alcoholism, Drug Dependence, Abuse, or Addiction policy. The student must demonstrate 1) successful participation in a primary treatment program and/or 2) the individual has not engaged in alcohol or drug abuse for a period of six months and has a good, medically documented prognosis and 3) participate in NA/AA programs as recommended by ARS/ACTI staff and 4) submit to drug screens (ARS Policy Procedure Manual, Appendix C.)
ACTI students are subject to random drug testing.
ADMISSION PROCEDURES FOR REHABILITATION CONSUMERS
Everyone, regardless of sponsorship, must be scheduled for admission by request from an ARS Field Counselor. The Admissions Coordinator makes this schedule after review. A VR consumer can be admitted to HSRCH (Hot Springs Rehabilitation Center Hospital) for a short-term admission by a direct hospital transfer, and/or admitted for any ACTI service, per request from ARS Field Counselor.
To schedule a client for admission to ACTI, the Field Counselor will provide the Admissions Coordinator the following information.
ACTI REQUEST FOR SERVICES FORM (SEE APPENDIX E)
This referral document will be submitted for entry into ACTI for an evaluation not to exceed 60 calendar days in EE (Status 06) or VR services (Status 10 - 22). The Request for Services form will interpret the Field Counselor's impressions and opinions of the individual's abilities, personality, background, social and behavior assets and limitations, giving particular attention to describing the rehabilitation problem. The Field Counselor will identify any specific problem areas, including the need for special diet and medication with copies of the physician's prescriptions. The Request for Services form is the primary means for the Field Counselor to provide substantial and meaningful knowledge to ACTI personnel and should also include such information as the consumer's choice of limb maker, program identification for SSI/SSDI cases and any current insurance information (Medicare, Medicaid, private) that may provide funding for services. For referral of alcoholics, a statement should be included that the individual has been dry for a 6-month period and/or has successfully completed treatment in a recognized treatment facility. A similar statement is required for individuals with a known history of substance abuse. If the individual has previously been an ACTI student, include the name(s) used at each enrollment if known.
A completed copy of the Survey Interview/Application, the general medical reports provided by other agencies or facilities that substantially cover content of the General Medical Form may be accepted in lieu of the Agency General Medical Form, Specialists' Reports, and the ACTI Medical Supplement Form (PHS-2) will be submitted. In addition, available case narratives, ARS-75, test results, profile sheets and school records will be provided the Admissions Coordinator. A copy of the Test Record Form (complete form) of the Wechsler Adult Intelligence Scale (WAIS) results will be included if these tests have been administered. A copy of RIDAC completed within the last 6 months is required for admissions.
For Status 06 referrals
A completed IPE for EE Services (RS-600-A) will be submitted prior to the individual's admission for EE services. The RS-600-A will serve as the authorizing document in lieu of an authorization for services to be provided by ACTI. Services provided include those planned at entry as well as those that normally might be anticipated at a later date, i.e. brace repairs, new braces, wheelchairs, etc.
For Status 12 and above referrals
A completed IPE for VR Services (RS-600-A) will be submitted prior to the individual's admission for VR services. The RS-600-A will serve as the authorizing document in lieu of the authorization for services to be provided by ACTI. Services to be provided are to include those planned at entry as well as those, which normally might be anticipated at a later date, i.e. brace repairs, new braces, wheelchairs, etc.
CHECKLIST FOR CASES SUBMITTED TO ACTI ADMISSIONS COORDINATOR
The following documents must be completed with necessary signature before the Admissions Coordinator can review a case:
Student will bring a 1-week supply of medications to ACTI.
SHORT-TERM ADMISSION FOR HSRCH MEDICAL SERVICES
Short-term admissions (normally from one to ten working days) for initial wheelchair prescription, revision, repair, adjustment, replacement of prosthetic or orthotic appliances, neuropsychological evaluations and driver rehabilitation assessments/physical functional abilities assessment can be accomplished by submitting the following forms and information: If incidental expenses, clothing, transportation, and/or meals other than the noon meal for non-residents are to be provided, this must be planned for and recorded in the Services Section of IPE and specified on RS 344 Request for ACTI Services.
PROSTHETIC/ORTHOTICS AT ACTI
Case Service Code for Status 02 - 1198
Case Service Code for Status 06 - 1298
Case Service Code for Status 18 - 22 - 1398
Case Service Code for Status 32 - 1498
All new or initial wearers and individuals who have had difficulty wearing a limb may attend the HSRCH Amputee Clinic for evaluation. ACTI Admissions Coordinator will schedule the individual for admission to the Amputee Clinic. The individual's Field Counselor will submit the same materials, including recommendations from a physician that the residual limb is ready for fitting; the signed Application for Services; and the completed Request for ACTI Services.
When possible, the vocational objective or tentative objective should be indicated since this type of information is extremely helpful to the clinic team in their total evaluation. Although the amputees' initial evaluation normally lasts five days, the length of time for ACTI services may vary from case to case. The Admissions Coordinator will advise the prosthetist and the counselor when the individual must report to the ACTI. The Field Counselor will notify the individual. The individual should expect to return home when the initial evaluation is completed.
The appropriate prosthetist is required to attend the Clinic for the initial prescription or evaluation of the prosthesis. All replacement prostheses recommended through this clinic will be evaluated as outlined below. The prosthetists may be required to attend other clinics to help resolve prosthetic problems.
The appropriate ACTI Counselor will immediately notify the Field Counselor of the evaluation results. If the Clinic recommends prosthesis, the Field Counselor may provide the limb in accordance with the recommendations. Actual construction of the new prosthesis (upper or lower extremity) should not begin before verbal or written authorization is received from the Field Counselor.
The details of measurement and fitting will be arranged by agreement between the Field Counselor, the individual, and the vendor. If the individual cannot travel to the limb company for the measurement and/or initial fitting, the prosthetist should contact the Field Counselor. A copy of the IPE will be submitted to the Admissions Coordinator prior to the individual's returning to HSRCH for the final fitting.
A prosthesis should be made and returned to HSRCH for initial evaluation within two (2) weeks of initial measurement. The prosthesis will not be delivered to the individual's home unless it is a replacement prosthesis recommended outside the HSRCH Amputee Clinic.
The Field Counselor will notify the ACTI Counselor when the individual is ready to return to ACTI for the first fitting of the prosthesis.
The final fitting will be performed at the HSRCH Amputee Clinic. The individual will remain at HSRCH for training in the use of the limb. The prosthetist will notify the Field Counselor in writing with a copy of the notification to the individual and the Admissions Committee at least one week prior to the time the individual will be ready for final fitting. The individual will re-enter HSRCH the day prior to the scheduled date.
DIRECT REFERRAL FROM ACUTE CARE HOSPITALS TO ACTI REHABILITATION HOSPITAL
The HSRCH accepts direct referrals from acute care hospitals throughout the State. Following is the procedure to accomplish a direct transfer
ARKANSAS REHABILITATION SERVICES CLIENTS
ADMISSIONS CRITERIA
Persons being considered for direct referral should satisfy the following medical criteria:
CASE PROCESSING
Prior to the individual's entry into ACTI in Status 12 or above, the results of the diagnostic study and a supporting IPE are to be provided. Even when this study is completed, the individual may be sent to ACTI for additional diagnostic/evaluation services. Request for evaluation at ACTI will be addressed regardless of rehabilitation status.
Each consumer is assigned to an ACTI Counselor upon arrival. The ACTI Counselor becomes the extension of the Field Counselor in the case management and case processing while the individual remains at ACTI. All communication regarding a student's program is communicated through the ACTI Counselor. The ACTI Counselor is ACTI's liaison with the Field Counselor and service provider. The ACTI Counselor and Field Counselor will negotiate authorizations for necessary services provided outside ACTI. The ACTI Counselor who prepares the authorization and any additional documents such as Amendments to the IPE will be responsible for proper disposition of copies. The ACTI Counselor may authorize any services essential for the completion of the VR program.
All Statements of Account and related documents resulting from these authorizations will be sent to the Central Office after the ACTI r Counselor has verified that services have been rendered. The Central Office will notify the ACTI Counselor when payment is made.
CLOTHING PRIOR TO ENROLLMENT
It is essential each individual arrive at ACTI with a 5-day supply of clothes that would be considered appropriate on the job to maintain a clean and neat appearance. A suggested list of minimum clothing has been established and such clothing is to be purchased or otherwise provided prior to arriving at ACTI. In planning with the individual, seasonal changes and the type of training must be considered.
CLOTHING AFTER ENROLLMENT
Requests for normal personal clothing after enrollment will be directed to the Field Counselor. The Field Counselor, after investigating the family resources, will determine what clothing ARS will provide and advise the ACTI Counselor. The ACTI Counselor will write the necessary Amendments and authorizations to provide the clothing. Designation of funds and preparation of authorization will be determined by the Field Counselor and ACTI Counselor.
TRANSPORTATION TO ACTI
When ARS provides transportation, planning should include the need for a round-trip. The Field Counselor should remind clients of the date to report to ACTI approximately two weeks prior to the scheduled reporting date. Recommended time to arrive at ACTI is on Sunday between 8:00 a.m. and 4:00 p.m. unless otherwise specified in the admissions letter. This allows the student an opportunity to begin the orientation program on a timely basis. The difference, if any, between the estimated date for ACTI enrollment listed in Section I of RS-600-A under Objectives and the actual date given by the Admissions Coordinator should be explained to the individual to prevent individuals from arriving on the wrong date. If any changes are necessary, ACTI should be notified. The Field Counselor should instruct the client to report to the Reception Office at ACTI immediately upon arrival.
TRANSPORTATION WHILE ENROLLED
The ACTI Counselor will write the amendment for transportation provided by an outside vendor if needed. Authorizations will not be written when such transportation is provided with ACTI vehicles and personnel. ACTI Counselor will authorize transportation only when the individual has no resources and only at times when ACTI is initiating individual's leaving such as Christmas closing, time of discharge, or when client has an extreme emergency situation that necessitates leaving. The ACTI Counselor will not provide transportation for home visits or other non-emergency conditions.
INCREASED PER DIEM COSTS
Authorizations and Amendments will not be written to provide for increased per diem costs due to the client's receiving short stay hospital or evaluation services. The ACTI Counselor will inform the Field Counselor of such changes in the original planning.
MEDICAL TREATMENT OUTSIDE OF ACTI
The ACTI Counselor, upon recommendation by the ACTI physician, will authorize emergency medical treatment and non-emergency medical diagnosis. If the ACTI Counselor has current information that indicates medical services are necessary and recommended by a physician outside ACTI, the Field Counselor must be notified by telephone followed by a written memorandum explaining the situation. The Field Counselor will determine whether or not the services are to be provided and complete the Amendment and authorization or request they be completed by the ACTI Counselor if the individual is expected to return to ACTI following the needed medical treatment.
Exception: When there is evidence either from the individual or the ACTI Counselor, the family or individual can purchase or make a substantial contribution to the purchase of the necessary prosthesis, appliance, etc., and/or treatment. The ACTI Counselor will submit the recommendation to the Field Counselor. The Field Counselor, after further investigation, may write the amendments and authorizations to the vendor, or request the ACTI Counselor complete them.
In the event outside medical treatment is needed due to actions purposely or deliberately caused by the student (example: breaking a window in anger) the student may be responsible for all medical expenses resulting from the injury.
INCIDENTAL EXPENSES
This service will not be authorized unless the ACTI and Field Counselor agree the service is needed. It is to be used for minor emergency needs only.
UTILIZING ABILITIES UNLIMITED
Effective July 1, 2006, ACTI no longer refers students directly to Abilities Unlimited in Hot Springs. All authorizations to Abilities Unlimited for students enrolled in the ACTI must be issued by the Field Counselor.
FINANCIAL PARTICIPATION
The Field Counselor, in accordance with ARS Policy and Procedure Manual, will determine financial participation. Refer to Appendix I. Fees for the ACTI Fees and Training Hours.
LEAVE POLICY FOR ACTI STUDENTS
Students enrolled in ACTI are expected to remain until services outlined in the rehabilitation program are completed or otherwise terminated. However, leave may be granted to students when the ACTI Counselor and/or Field Counselor deem it necessary. Leave may be granted to a student because of illness, personal or family problems, or the need to return home to plan with the Field Counselor after evaluation services have been completed.
Students on leave will be discharged at the end of 30 days unless an extension of leave time has been requested and agreed upon by the Field and ACTI Counselor, and approved by ACTI Counseling Supervisor. After a student has been discharged, an application must be submitted to the Admissions Coordinator before consideration for re-enrollment.
NON-RESIDENTS AT ACTI ACTI is a residential facility. Exceptions may be for non-resident enrollment under certain conditions and upon specific request by the Field Counselor. These conditions are:
Non-residents are authorized to eat a noon meal in the ACTI's cafeteria on Monday through Friday as part of the usual ACTI services. After analyzing the individual's financial needs, the Field Counselor may request the individual be provided additional meals per day on maintenance services. The request for additional meals per day must be specified and authorized in the IPE and requested on the RS-344. These guidelines should be reviewed with and understood by students prior to admission.
Non-resident students will be provided normal/routine health care services from 7:30 a.m. to 4:30 p.m. Monday through Friday. Non-resident students will be required to arrange for their own emergency care other than these specified hours, unless special arrangements are made on an individual basis with appropriate ACTI staff.
COMMUNITY REHABILITATION PROGRAMS
Community Rehabilitation Programs (CRP's) are one resource available to Arkansas Rehabilitation Services (ARS) as it develops services to meet identified and anticipated individual's needs. Planning for the Agency's use of CRP's is integrated with the Agency's general planning about how to use its financial resources and must be coordinated with Vocational Rehabilitation case service planning.
GOAL OF THE COMMUNITY PROGRAM DEVELOPMENT SECTION
The goal of the ARS Community Program Development Section is to identify the individual service needs which can most appropriately be met through the purchase of services from non-profit CRP's. Once these needs are defined the Community Program Development Section, in coordination with the ARS General Agency, contracts with CRP's The ARS Community Program Development Section requires annual comprehensive certification (Arkansas Standards for Community Rehabilitation Program Certification.) which establishes benchmark standards and guidelines that must be followed by all contracting parties to assure the timely provision of quality rehabilitative services to eligible consumers. ARS works with CRP's to develop new initiatives and to update their facility to assure ARS consumers are moving towards competitive employment outcome
In keeping with the provisions of the Arkansas Standards for Community Rehabilitation Program Certification, the Community Program Development Section completes numerous on-site visits to assure on-going program compliance with established certification standards. The primary goal of ARS Community Program Development Section in contracting with CRP's is to secure time-bound, community based; vocationally oriented services leading to competitive employment within integrated work environments. The Community Program Development Section negotiates, and approves annual Purchased Services Contracts between ARS and CRP's. The Community Program Development Section staff authorizes monthly compensation payments to CRP's, provides continuous fiscal and programmatic oversight of contract guidelines, and provides technical assistance as indicated to contracting CRP's.
ARS Field will have a vocational rehabilitation counselor liaison to each funded CRP to assure communication is convenient and to assure the CRP and ARS are mutually in agreement to the service provisions seeking competitive employment.
The following definitions apply to consumer services in community rehabilitation programs:
Community Rehabilitation Program (CRP) - a work-oriented habilitation or rehabilitation program with a controlled working environment and individual vocational goals, which utilizes planned goal-directed work experience and related services for assisting an individual with a disability to progress toward independent living and a productive vocational status.
Assessment - an investigative goal-directed process towards identifying and measuring the clients work related behaviors in order to determine the need for placement or additional rehabilitation services.
Work Adjustment - a system of goal-directed services or groups of services directed toward enhancement of the client's job seeking and job-keeping skills that facilitate movement toward a satisfactory vocational placement.
Extended Services - training provided over an extended period of time for individuals who appear employable and are in need of continued adjustment services. Individualized plans utilize social casework and adjustment services which are goal-directed and which maximize the individual's vocational, educational, personal, and social functioning.
Competitive Employment - refers to work in the competitive labor market that is performed full or part time in an integrated setting, and for which an individual is compensated at or above the minimum wage, or at a higher prevailing wage for the same or similar work in the local community performed by individuals who are not disabled.
Sheltered Employment - refers to the long-term employment of an individual with a disability within a CRP. This individual is non-agency sponsored, and is considered to be an employee of the CRP and cannot be closed vocationally as a Status 26 closure, unless the majority of their employment time is in an integrated setting. Sheltered employees in CRP's are typically paid at less than minimum wage depending on their productivity, and in accordance with special Department of Labor, Wage and Hour Division guidelines.
Supported Employment - means paid work in a variety of integrated settings, particularly regular work sites, especially designed for individuals with significant disabilities, irrespective of age or vocational potential (a) for whom competitive employment at or above the minimum wage has not traditionally occurred, and (b) who, because of their disability, need intensive ongoing post-employment support.
Specifically, significantly disabled employees in a supported employment setting must:
Some types of supported employment are:
Job Coach - The trained job coach develops the job in industry, matches the individual to the job, trains the individual on the job until performance criteria are met and provides follow-up support to the individual as long as necessary.
Enclave - A group of significantly disabled persons (eight or less) perform work within a company. Work performed is the same amount and types as other employees are guaranteed. Pay is commensurate.
Mobile Work Crew - A small group (five or less) and a supervisor work in regular industry. Typically, service occupations lend themselves to the crew approach.
Entrepreneur - Establishes a small business, which employs both persons with significant disabilities and persons without disabilities.
Bench Work - Specific to electronics assembly. Small, single purpose, not-for-profit corporation provides employment and related services for up to 15 individuals.
ADMISSION PROCEDURES
Prior to admission, the following information will be submitted:
If the CRP accepts the individual into their program for the 10-day assessment, an Admission Cover Letter Voucher (RS-347) will be sent to the Community Program Development Section.
The CRP case manager is required to complete an assessment plan to facilitate the client's orientation into the program and to specify how the questions formulated by the VR Field Counselor will be answered. The CRP case manager will provide the VR Field Counselor a written report of the findings of the initial assessment. The report will contain the answers to the questions addressed and the case manager's recommendations concerning further services needed by the individual. If Work Adjustment is recommended, the CRP case manager will submit a written work adjustment plan for the VR Field Counselor's review/approval. It will be necessary for the VR Field Counselor to maintain contact with the CRP staff in order to provide input and to be assured the authorized services are being provided.
WORK ADJUSTMENT
After assessment is completed a client may enter Work Adjustment and the VR Field Counselor reviews/approves a work adjustment plan which contains the following:
The VR Field Counselor will authorize up to 60 days of attendance for Work Adjustment by completing the Authorization for Adjustment Services (RS-315). Copies of the RS-315 will be maintained in the individual's file and a copy sent to the Community Program Development Section.
Consumers may exit the Work Adjustment Program prior to completing the 60 days if the client achieves his/her rehabilitation goal. If an individual drops out of the Work Adjustment Program, he/she may be readmitted as long as they have eligible days remaining in the Work Adjustment Program. If the individual is officially discharged by the CRP, the individual may be readmitted by the VR Field Counselor completing a new RS-315. Five or more hours of services (excluding transportation) constitutes one unit of full day services and three to five hours of service (excluding transportation) constitutes one unit of partial day service.
The VR Field Counselor may participate in scheduled staffing and will receive reports showing the plan is being implemented with reasonable progress being made toward achieving the overall goal, the program goals, and objectives. A written report will be completed by the CRP When Extended Services are recommended, the report will contain an estimate of the number of months needed to complete an extended services program for the individual.
EXTENDED SERVICES
The Extended Services Program is designed to meet the needs of persons with significant disabilities who would benefit from an extended Work Adjustment Program. The Field VR may authorize up to 9 calendar months of attendance for Extended Services by completing the RS-315. Movement into the Extended Services Program can be initiated only when the 60-day Work Adjustment Program has been fully utilized.
Individuals may exit the Extended Services Program prior to completing the 9-month period if the individual has achieved a rehabilitation goal. If a consumer drops out of the Program, the consumer may be readmitted as long as there are months remaining on the consumer's Extended Services Program. If the CRP officially discharges an individual, the individual may be readmitted by the VR Field Counselor completing a new RS-315. A consumer may enter Extended Services when the VR Field Counselor reviews/approves an Extended Services plan containing the following:
Documentation showing the client was involved in plan development;
Five or more hours of service (excluding transportation) constitutes one unit of full day service and three to five hours of client service (excluding transportation) constitutes one unit of partial day service.
The VR Field Counselor may participate in scheduled staffing and will obtain reports showing the plan is being implemented with reasonable progress being made toward achieving the overall goal, program goals, and objectives. A written report will be obtained from the CRP when the consumer completes this phase of training.
CLOSURE INFORMATION
When an individual exits a CRP, a Discharge Report (RS-348) will be completed and sent to the Community Program Development Section. The CRP should retain one copy for its record and send a copy to the VR Field Counselor.
WAGE AND HOUR REGULATIONS IN CRP'S
Most ARS clients in a CRP must be covered by a Department of Labor (DOL), Wage and Hour Certificate. The CRP DOL Wage and Hour Certificate will cover an individual during enrollment in the CRP and will authorize the CRP to reimburse the individual at a rate below the current minimum wage if appropriate. Clients in CRP's will be paid on a piecework rate commensurate with the prevailing rate for the same type work being performed.
The Department of Labor Wage and Hour Certificate is required by the ARS Community Program Development Section as part of the Certification process.
Exception: If a CRP agrees to have ARS client's paid minimum wage or above the will be exempt from DOL Certification.
CERTIFICATION POLICY
Certification of a CRP's program of Assessment, Work Adjustment, and Extended Services is necessary to purchase services for eligible individual.
Certification is contingent upon:
The Community Program Development Section will continually monitor each program through site surveys to determine its capability to provide authorized services. If it is noted that any of the six principles governing certification are not met, the Community Program Development Section will recommend corrective action to be taken. The program will be given a period of 30 to 60 days from the date of notification of recommendation to correct the deficiency. At the end of the specified time, if correction is not made, suspension of certification will occur. The certificate may be reinstated when the Community Program Development Section has documentation, which assures the program's capability to provide the authorized services has been restored.
PROCESSING STATEMENTS OF ACCOUNT
(See Appendix I. Fees for daily per diem amounts.)
At the end of each month, the CRP will direct to the appropriate VR Field Counselor a Statement of Account. This statement will list the consumers, program, number of days each was in the program, and the amount charged to each. The per diem charged to each consumer reflects the cost of the provision of service for the month. The VR Field Counselor will review the statement. If the Statement of Account contains errors or lists unauthorized services, it will be returned to the CRP for correction.
The CRP is responsible to submit required information electronically from the Community Billing database to the ARS Community Program Development Section.
The VR Field Counselor will process all signed Statements of Account, including the Extended Services Statements, and forward a copy of the Statement of Accounts, the authorization forms, and required documents for payment to the Community Program Development Section. The Community Program Development Section will confirm the electronic data has been verified, consolidate the Statements of Account and attached necessary documents for payment processing to the appropriate ARS Finance staff.
Arkansas Rehabilitation Services (ARS) Community Program Development Section (CPDS) and Community Rehabilitation Program (CRP) Review Process and Resolution Protocol
CRP Review Procedures
Arkansas Rehabilitation Services (ARS) CPDS will provide programmatic and fiscal oversight to the CRP through scheduled visits by ARS Facility Specialists. Site visits are completed quarterly. Two of these visits are onsite, which includes the Annual Certification Review. The other visit may be via contacting the CRP as a follow up visit. The CPDS staff communicates on a regular basis with the CRP staff.
ARS has counselor liaisons assigned to their local CRP's. The ARS counselor liaison is to assure communication on a monthly basis at the local level for the establishment of good working relationships. In addition, the counselor liaison may request periodic conferences with ARS staff, CPDS staff, and the CRP staff to discuss Certification/Contract issues and scheduled programmatic/fiscal reviews.
The CPDS staff recertifies CRP's annually as per the Arkansas Rehabilitation Services Standards for Community Rehabilitation Program Certification. Before this process begins, CPDS staff will contact the counselor liaison to assure the local office supports recertification of the CRP and to provide technical assistance as needed.
Resolution Protocol
This resolution protocol is established to allow for communication by either ARS Field Staff or CRP staff, who may have an issue causing a barrier to services in assisting individuals with disabilities to receive vocationally oriented services toward quality, competitive employment outcomes in integrated settings
STEP ONE: ARS field services staff or the CRP staff discusses the issue(s) with the ARS counselor liaison. The ARS counselor liaison will contact the CSPD Facility Specialist for technical assistance.
STEP TWO: The ARS counselor liaison will discuss the issue with the ARS District Manager. The ARS District Manager contacts the CPDS Director for technical assistance or if a resolution is not reached.
STEP THREE: The CPDS Director will communicate with both parties to seek a resolution, which may require a meeting to develop a corrective action plan with time frames.
STEP FOUR: If the issue cannot be resolved by the above steps, the ARS CPDS with approval from the ARS Chief of Field Services may recommend termination of the CRP's certification to the ARS Commissioner.
STEP FIVE: ARS Commissioner will review documents provided by memo from the ARS Chief of Field Services and the CPDS Director reflecting what process has taken place to seek a resolution. The final decision determined by the ARS Commissioner will be provided to the CRP within thirty (30) days from the date the ARS Chief of Field Services provides a memo requesting this review. A decision made through the ARS Commissioner shall be the ARS final decision.
STEP SIX: If dissatisfied with the ARS final decision, the CRP has the right to a hearing as set out in the Arkansas Administrative Procedure Act, § 25-15-208 to 213 Administrative Adjudication.
CHECKLIST INSTRUCTIONS
The checklist is a tool for the counselor to use in assuring that all required forms and documentation have been completed. The counselor will check each item as they are completed. The checklist will be filed on the right side of the case folder on the top of the case narrative..
Form completion is self-explanatory.
STATE OF ARKANSAS VOTER'S AGENCY-BASED DECLARATION STATEMENT
VOTER REGISTRATION (3 FORMS) INSTRUCTIONS
AGENCY BASED VOTER DECLARATION STATEMENT
VOTER REGISTRATION APPLICATION
VOTER REGISTRATION MONTHLY REPORTING FORM
State regulations require that ARS offer voter registration onsite to individuals who may not be currently registered to vote.
The counselor will complete the Agency-based Declaration Statement and have the individual sign.
If the individual desires to register to vote, the counselor will assist the individual in completing the Arkansas Voter Registration Application and will mail the completed form to the Secretary of State Office that the same day.
A designated person in each office will keep a record of all applications, declinations, and report to the secretary of state office monthly.
INFORMED CONSENT INSTRUCTIONS (RS-375)
This form is to be completed if the individual applying for services is less than 18 years of age.
CONFLICT OF INTEREST DISCLOSURE FORM INSTRUCTIONS
Form completion is self-explanatory.
CLIENT REFERRAL AND SURVEY INFORMATION INSTRUCTIONS (RS-4)
The RS-4 is a basic document for obtaining common data on all individuals served by ARS and in many instances, may be the most significant form found in the individual case record. This form must contain the basic information from which vital decisions affecting the rehabilitation program of the individual will be made. This form is intended to be a working document to be used by the counselor and individual in the development of a rehabilitation program. It will be completed during the initial interview with the individual. All items are to be completed. For the most part, the completion of the form is self explanatory, but to insure everyone has a common understanding, the following information should be studied.
All information should reflect the situation at the time of referral.
SOCIAL SECURITY NUMBER: Record the individual's social security number. COUNSELOR: Record your 3-digit counselor identification number.
AGENCY CODE: Enter the Agency Code from the following:
Code | Definition |
10 | General Agency |
30 | ODHI - VR Caseload |
32 | ODHI - Independent Living, Deaf |
80 | General Agency - ILRS |
APPLICANT NAME: Enter applicant's last name, first name and middle initial. Do not use punctuation or symbols.
STATUS: Enter Status 02.
EFFECTIVE DATE: Record the year, month, and day. This date should be entered in two digits; i.e., January 4, 2002, should be entered as 020104.
SSDI/SSI STATUS HISTORY: Enter the appropriate 1-digit code for the SSDI/SSI statuses at referral from the following list of codes:
Code | Definition |
0 | Not an Applicant |
1 | Applicant allowed benefits or currently a beneficiary or recipient |
2 | Applicant denied benefits |
3 | Applicant - status of application pending |
4 | Not known if an applicant |
5 | Benefits discontinued or terminated |
STREET ADDRESS - BOX OR ROUTE: Record the address by street and number, or rural route and box number, or whatever is necessary so the individual can be located easily.
CITY: Enter the name of the town or city of the individual's mailing address.
COUNTY CODE: Enter the 2-digit county code for the county of residence for the applicant. For institutionalized individuals, record the county of legal residence. Refer to Code Section of Manual.
ZIP CODE: Enter the zip code.
TELEPHONE NUMBER: enter the applicant's telephone number or the number at which the applicant may be reached.
TELEPHONE TYPE: Record voice, Video phone or TDD.
FEDERAL SPECIAL PROGRAM CODE: Enter the appropriate code from the list of codes below. Add the numbers assigned to each category and enter this sum as the Special Program Code.
Code Definition
Examples
COMPARABLE BENEFITS: Enter the applicable current comparable benefits 3 - digit code. (Refer to Part 6 on the RS-4 for appropriate code)
DATE OF BIRTH: Enter Year, Month and Day
GENDER: Check appropriate box.
RACE - ETHNICITY: Check appropriate box.
PREFERRED RACE - ETHNICITY: Record preferred race/ethnicity.
REFERRAL SOURCE AND CODE - Record the referral source and enter the 2-digit referral code from the list below. Wherever possible and appropriate, record an agency, organization or institution rather than an individual as the source of referral. For example, if a state employment service employee refers a person to the VR Agency, the proper referral source would be the State Employment Service (Code 53) and not an individual. An effort should be made to ascertain whether the coding for an applicant appearing to be self-referred might more properly be assigned to an agency, organization or institution.
Educational Institutions (Public and Private)
Hospitals and Sanatoriums (Public and Private)
Health Organizations and Agencies
Welfare Agencies
Public Organizations and Agencies (Not Specifically Educational, Health, or Welfare)
Private Organizations and Agencies (Not Specifically Educational, Health, or Welfare)
Individuals
MEDICAL INSURANCE COVERAGE AT APPLICATION - Check appropriate box.
DIRECTIONS TO RESIDENCE: Record if applicable.
PRIMARY DISABILITY: Record primary disability
DISABILITY CODES: Enter the 4 -digit code that best describes the individual's primary physical or mental impairment that causes or results in a substantial impediment to employment. The number reported is a combination of the impairment code and cause/source code. The first two digits designate the impairment (sensory, physical or mental), and the last two digits indicate the cause or source of the impairment.
If the person is found not to have a disability, this item should be coded 0000.
CODES FOR IMPAIRMENTS
SENSORY/COMMUNICATIVE IMPAIRMENTS:
PHYSICAL IMPAIRMENTS:
MENTAL IMPAIRMENTS
CODES FOR CAUSES or SOURCES OF IMPAIRMENTS
AGE AT ONSET: Record age at onset of disability.
CAUSE: Record cause of primary disability.
LAST TREATMENT OR EXAMINATION: Record the information requested.
SECONDARY DISABILITY: Record secondary disability.
SECONDARY DISABILITY CODE: Record the 4-digit disability code.
AGE AT ONSET: Record age at onset of disability.
CAUSE: Record cause of secondary disability.
LAST TREATMENT OR EXAMINATION: Record the information requested.
PROSTHESIS USED: Record the information requested.
PRIMARY PHYSICIAN: Record the primary physician.
MARITAL STATUS: Check appropriate box
HOUSEHOLD MEMBERS-NAME: Record persons living in the household.
Date Of Birth - Relationship - Employment: Record the information as requested.
LIVING ARRANGEMENT AT APPLICATION: Indicate the living arrangements of the individual, either temporary or permanent, on the date of application to the State VR Agency. Enter the 2-digit code from the following:
FAMILY MONTHLY INCOME: Record family monthly income amount.
PRIMARY SOURCE OF SUPPORT AT APPLICATION: The individual's primary source of support is simply the individual's largest single source of public support at application although it may account for less than 50 percent of the total support. The general rule is that the support should be attributed to a particular source only when it is related directly to the individual or the individual is directly involved.
A common source of error in coding source of support involves assigning earnings of, or payment to, source to record. For example, a female client who is supported through the current earnings of her husband or by his unemployment insurance checks should be recorded for primary source of support as "family and friends" and not as "current earnings" or "unemployment insurance." In determining the largest single source, combinations of public assistance payments should be considered as one single source in making the determination. For example, a person receives public assistance payments because of his/her disability and additional public assistance as aid to his/her dependent children. The total amount of public assistance, including both Federal and non-Federal, should be considered as one single source. Code 04 will be used only when the public assistance is General Assistance entirely and is the largest single source of support.
Institutionalized clients will be recorded as "Public institution-tax supported" if they are supported in the institution by public institution funds. However, if the person is being maintained in the institution by other financial sources such as the family, or hospitalization insurance, or other funds, the appropriate source of the funds will be recorded
Enter the 1-digit code from the following list of codes:
Code | Definition |
1 | Personal Income (earnings, interest, dividends, rent) |
2 | Family and Friends |
3 | Public Support (SSI, SSDI, TANF, etc.) |
4 | All other sources (e.g. private disability insurance and private charities) |
PUBLIC ASSISTANCE AT APPLICATION: Enter 0 if not receiving. Enter 1 if receiving and enter the monthly amount.
PERSONS THROUGH WHOM INDIVIDUAL MAY BE CONTACTED: Record the requested information.
NAME - ADDRESS - TELEPHONE NUMBER - RELATIONSHIP: Record the requested information.
Note: It is very important this part be thoroughly completed. Ask for persons who will maintain close contact with the applicant and whose residence is permanent or stable.
HIGHEST GRADE COMPLETED IN HIGH SCHOOL - YEAR - NAME AND LOCATION OF INSTITUTION: Record requested information.
IEP: Record yes or no if the individual had an IEP in high school.
OTHER TRAINING OR COURSE - YEAR - NAME AND LOCATION OF SCHOOL OR INSTITUTION: Record requested information.
CURRENTLY EMPLOYED: Check appropriate box.
HOURS PER WEEK - PRESENT OR LAST EMPLOYER NAME - TYPE OF WORK PERFORMED - WEEKLY EARNINGS - MONTHS EMPLOYED - DATE LAST EMPLOYED: Record requested information.
EMPLOYMENT INTERRUPTED: Check appropriate box. If yes, state reason.
PREVIOUS EMPLOYMENT: Beginning with most recent employment, list employers, type of work performed, and length of employment.
COMPARABLE BENEFITS: Record the requested information and check the appropriate box or boxes.
COMPARABLE BENEFITS CODE: To arrive at the comparable benefit code, add the numbers assigned to each of the benefits checked. Record the total comparable benefits code.
MIGRANT AND SEASONAL FARM WORKERS: Check appropriate box.
List the services and vendors requested by the applicant.
APPLICANT'S SIGNATURE AND DATE: Secure the applicant or representative's signature. Record the date of application.
RS-307
ARKANSAS REHABILITATION SERVICES CASE NARRATIVE
Last Name:
First:
Middle:
SSN:
Date & Status
Headings
Forms and Instructions
E-22
Effective 10-1-10
CASE NARRATIVE INSTRUCTIONS
Specific documentation in the case record is required during the rehabilitation process. The case narrative form is used for the documentation. This form is self-explanatory. Examples of the case narrative formats, statuses, and headings for referral and acceptance/plan development are included.
AUTHORIZATION FOR RELEASE OF INFORMATION INSTRUCTIONS (M-6)
This form is to be used when requesting the release of information or exchange of information from another agency or vendor.
RIDAC SERVICE AUTHORIZATION FORM INSTRUCTIONS
This authorization for RIDAC services is to be completed and signed by the counselor prior to scheduling an individual for RIDAC services. The form is self-explanatory. The counselor will identify needed assessment services.
ASSISTIVE TECHNOLOGY @ WORK INSTRUCTIONS
REFERRAL AND ASSESSMENT PROCESS
The AT @ Work program (Assistive Technology at Work) is designed to assist the ARS consumer and the referring Counselor in selecting and obtaining the appropriate assistive technology. The program is a collaborative effort involving Little Rock based staff as well as ACTI therapy staff. Services offered include evaluation/assessment, assistive technology device training, device modification/adaptation, and technical assistance as it relates to work, school, home, and transportation. ARS Counselors are required to determine the need for assistive technology at the time of application, plan development, and placement.
The following process is recommended in those situations when the Counselor identifies the potential need for assistive technology:
The counselor will also be responsible for obtaining the consumer's signature on the retention of title for necessary equipment.
GENERAL MEDICAL EXAMINATION RECORD INSTRUCTIONS
The counselor will complete and sign the top section of the form.
GASTRIC BYPASS STATEMENT OF UNDERSTANDING
I understand that weight reduction surgery is a complicated medical procedure and there are risks involved. As part of my rehabilitation program, I agree to adhere to the recommendations of the surgeon and any other treating physicians or medical professionals at the time of surgery and during my recovery process. I understand that weight reduction surgery is not a "magic cure" but only an initial step in my effort to lose weight due to morbid obesity. I understand I must commit to a change in my lifestyle in order to lost weight and maintain a weight that does not pose a threat to my health. I agree to adhere to medically recommended diet and exercise programs and understand that if I do not adhere to such programs, I can regain a significant portion of any weight I may have lost as a result of the surgery. I have been informed of the research that indicates 5 years post surgery 70% of individuals who have weight reduction surgery regain 50% of weight initially lost. I have been informed that due to the above-mentioned research it is the practice of Arkansas Rehabilitation Services to pay for the weight reduction surgery one time.
I understand this service is provided to help me to gain or maintain employment.
______________________________________________________________________
Client Signature Date
GASTRIC BYPASS STATEMENT OF UNDERSTANDING INSTRUCTIONS
This form is to be completed on all gastric bypass cases and is to be signed by the individual and placed in the record of service.
GASTRIC BYPASS CHECKLIST INSTRUCTIONS
Form completion is self-explanatory.
MEDICAL CONSULTANT WORKSHEET (RS-3G) INSTRUCTIONS
Self-explanatory.
CERTIFICATE OF INELIGIBILITY INSTRUCTIONS (RS-4C)
CERTIFICATE OF ELIGIBILITY INSTRUCTIONS (RS-600-B-1)
CERTIFICATE OF ILRS ELIGIBILITY INSTRUCTIONS (RS-600-B-1)
ORDER OF SELECTION - PRIORITY CATEGORY INSTRUCTIONS
ORDER OF SELECTION
Under the Vocational Rehabilitation Act (Title IV of the Workforce Investment Act of 1998) certain state Vocational Rehabilitation agencies are required to have an order of selection. An order of selection requires that a priority be given to individuals with the most significant disabilities in the provision of vocational rehabilitation services. The order of selection is required in the event that the state is unable to provide the full range of vocational rehabilitation services to all eligible individuals or, in the event that vocational rehabilitation services cannot be provided to all eligible individuals in the State who apply for the services. ARS has determined that there are insufficient funds to provide services to all eligible individuals within the State.
The ARS Order of Selection assures the highest priority in service provision is reserved for eligible individuals with the most significant disabilities. Services and expenditures are closely monitored to enable the ARS Commissioner to close or open priority categories as deemed appropriate. This will assure services are continued for cases determined eligible and receiving services under an Individualized Plan for Employment. Adequate funds will be reserved to provide diagnostic services for all applicants to determine eligibility and category placement.
DESCRIPTION OF PRIORITY SELECTION
The Order of Selection priority categories, justification for each, outcome and service goals are listed below:
ARS will provide services based on an Order of Selection on a statewide basis. The ARS Order of Selection assures clients in Priority I and II will have first priority for the provision of services. If funds become available, individuals in Priority III may receive services.
Rehabilitation clients who have an Individualized Plan for Employment (IPE) for vocational rehabilitation (VR) services or extended evaluation (EE) services in place prior to the implementation of the Order of Selection policy will receive services as recorded in their IPE.
Priority Category I - Most Significantly Disabled
An eligible individual with a most significant disability is defined as one who has a significant physical or mental impairment which:
Priority Category II - Significantly Disabled
An eligible individual with a significant disability is defined as one who has a significant physical or mental impairment which:
Priority Category III - Non-Significantly Disabled
An eligible individual with a non-significant disability is defined as one who has a significant physical or mental impairment which:
Definitions:
* Two (2) or more major VR services, i.e. counseling, guidance, assistive technology,
physical or mental restoration, training, and placement.
** 90 days or more from the date services are initiated.
*** One or more physical or mental disabilities resulting from: amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.
PRIORITY OF CATEGORIES TO RECEIVE VR SERVICES UNDER THE ORDER OF SELECTION
ARS will provide services based on an Order of Selection on a statewide basis. The ARS Order of Selection assures clients in Priority I and II will have first priority for the provision of services. If funds become available, individuals in Priority III may receive services. Rehabilitation clients who have an Individualized Plan for Employment (IPE) for vocational rehabilitation (VR) services or extended evaluation (EE) services in place prior to the implementation of the Order of Selection policy will receive services as recorded in their IPE.
ORDER OF SELECTION NOTIFICATION LETTER INSTRUCTIONS
FINANCIAL RESOURCES INSTRUCTIONS (RS -16)
A properly executed RS-16 must be included in the case record of each individual prior to the provision of any services based on financial need. Individuals receiving SSI/SSDI are exempt from financial need assessment, but the form should be completed to assess comparable benefits. The RS-16 is used to document financial resources and comparable benefits of the individual. (The RS-600-A and RS-600-C are used to summarize and compute the amount of supplementation necessary.) Instructions for completion of the RS-16 are to be followed to assure compliance with State policies and regulations.
If the individual is 23 years of age or under and unmarried, the parent(s) assets must be verified with a copy of the parent(s) income tax forms. If the parent(s) do not support the individual, the individual must provide documentation of non-support.
Exception: If the client's family states the client will not be claimed on next year's income tax, the client will no longer be considered a dependent. The client will be required to verify their source(s) of income to cover their expenses.
* Record the individual's name, date, and the total number in household.
CAPITAL ASSETS
MONTHLY INCOME
Reported income must be verified. (See manual Section V)
If the individual or parent(s) reports zero income or did not file income tax forms, the individual must sign a written statement of verification. If the individual is 23 years of age or under and unmarried, the parent(s) income must be included. A copy of the parent(s) income tax forms must be provided for this purpose. If the parent(s) do not support the individual, the individual must provide documentation of non-support.
Deduct 25% of the adjusted gross income computed on a monthly basis if the information is obtained from income tax returns or the PELL grant summary.
For farmers, teachers, or part-time employees, the amount entered will be the monthly average for the past 12 months. If income has ceased at the time of application or will not be continuing, enter 0 in the amount column.
NORMAL LIVING REQUIREMENTS (NLR) DO NOT COMPLETE FOR SSI/SSDI RECIPIENTS.
Number of Persons | Monthly Amount |
1 | $3,200.00 |
2 | $3,600.00 |
3 | $4,000.00 |
($400.00 for each additional family member) | |
CLIENT'S AVAILABLE RESOURCES - DO NOT COMPLETE FOR SSI/SSDI RECIPIENTS.
Each individual is expected to use all resources available for the rehabilitation program.
COMPARABLE BENEFITS - ESTIMATE IF EXACT AMOUNT IS NOT AVAILABLE.
The essential purpose of providing the Comparable Benefits Section is to establish a way to document that a search for comparable benefits has been made. It should also be a tool in helping deal with financial planning. This list will provide a checklist of some of the well-known financial resources counselors will use as comparable benefits. The counselor must advise the individual where to go and who to call for each source of comparable benefits and monitor the search.
Comments: Additional information or explanation may be included in this section.
Individual and Counselor Signature: The individual and counselor will manually sign in the appropriate space.
INDIVIDUALIZED PLAN FOR EMPLOYMENTS (RS-600-A)
Explanation:
Purchased - ARS will pay for the services.
Provided - ARS will provide the service.
Arranged - Service will be provided by another source.
Cost Estimate - (a) Enter cost of planned services. (b) Enter comparable benefits such as Student Financial Aid. (c) Enter total cost of services column (d) Enter all of comparable benefits column. (e) The difference of services column minus comparable benefits will be entered in "unmet needs." (f) At this point the counselor will negotiate with the individual the amount of individual's contribution, the agency supplementation and enter the amounts. (Cost estimates cannot be for more than one year.)
IPE AMENDMENT (RS-600-A) INSTRUCTIONS
The RS600-C is a multipurpose form for use in amending the initial IPE whenever a change in the rehabilitation program is needed and to record the progress of the individual's rehabilitation program annually. A notation should be made in the case narrative. to explain the need for an amendment or annual review consistent with informed choice. The justification for the amendment or annual review should be made on the RS600-C. The counselor will complete only the items needed to accomplish the amendment or annual review. An amendment to the IPE may include a vocational objective change, deletion or addition of services, costs of services, termination of the case, extension of an expired IPE, etc, and the required annual review. The counselor and individual must sign and date the RS600-C and the individual must be provided a copy.
The counselor will complete only the appropriate item(s) needed to amend the IPE.
Explanation:
Purchased - ARS will pay for the services.
Provided - ARS will provide service.
Arranged -Service will be provided by another source.
Cost Estimate (a) Enter cost of planned services. (b) Enter comparable benefits such as Pell Grant (c) Enter total cost of services column (d) Enter all of comparable benefits column. (e) The difference of services column minus comparable benefits will be entered in "unmet needs." (f) At this point the counselor will negotiate with the individual the amount of individual's contribution, the agency supplementation and enter the amounts. . (Cost estimates cannot be for more than one year.)
RECEIPT/RELEASE FOR OCCUPATIONAL TOOLS AND/OR EQUIPMENT AND TITLE AGREEMENT INSTRUCTIONS (M-33)
This form will be prepared in duplicate; the original will be placed in the case record and the copy to the individual.
EMPLOYMENT SERVICES REFERRAL FORM INSTRUCTIONS
This form is used for all job placement referrals to the ARS Employment Services Representative.
Distribution (Field Office)
* Copy of the referral form is retained by counselor at referral.
* A copy of the referral form remains in the file of the Employment Services Representative.
* After the clients interview for possible employment, the Employment Services Representative completes the form and a copy of this form is retained in the counselors file.
Distribution (ACTI)
* Copy of the referral form is in the ACTI client file at referral
* A copy of the referral form remains in the file of the Employment Services Representative.
* After the clients interview for possible employment, the Employment Services Representative completes the form and a copy of this form is retained in the ACTI counselors file and the field counselor's file.
REQUEST FOR ACTI/HSRCH SERVICES INSTRUCTIONS (RS-344)
* Explanation of Rehabilitation Problem: This section should adequately identify and describe the rehabilitation problem in reference to the client's functional capacities and limitations and their implications in relation to his/her work potential. The rehabilitation problem is not the diagnosis or disability.
Rehabilitation problems are behaviors or conditions exhibited behavior or for conditions exhibited by individuals and/or presented by their environment which need to be eliminated or improved in order for the individuals to fulfill their vocational potential or maximize their work functioning.
Description of the rehabilitation problem should provide specific information related to the following questions:
* Statement of How ACTI Services are Expected to Improve Individual's Employment/Placement Potential: The statement or information provided in this section should be linked to the explanation of the rehabilitation problem; i.e. what is the expected outcome of ACTI services in reducing, eliminating, or modifying the identified rehabilitation problem(s). Expectations should be stated in terms of improved or modified functional capacities related to the disability, not a change in the disabling condition itself. The expected, or desired, outcomes should be stated for each service requested.
* Services Requested: Place a number in boxes to identify services requested and probable sequence of services.
* Information Attached: Check appropriate box for documents attached to the Request for ACTI/HSRCH Services Form. These documents will be utilized for admissions information and program planning.
* Residential Information: Check appropriate boxes.
* Counselor Signature and Date: Counselor will manually sign and record the date the form is completed.
AUTHORIZATION FOR ADJUSTMENT SERVICES INSTRUCTIONS (RS-315)
The Authorization for Adjustment Services will be completed by the Counselor to authorize an individual to receive up to sixty (60) days of Work Adjustment in a "block funded" CRP and for an individual to receive additional work adjustment in Extended Services under Title XX funding for up to 9 months. The counselor will decide upon the need for the individual to receive services in each instance and complete the RS -315 for either Work Adjustment or Extended Services as appropriate (if extended services, specify number of months).
TRAINING PROGRESS REPORT INSTRUCTIONS
This form is to be completed by all individuals participating in a college program. The original is to be filed in the case folder and a copy provided to the individual.
* Self-explanatory
* The counselor and individual will sign and date the form.
* The original is filed in the case folder and a copy provided to the individual.
LETTER FOR STUDENTS IN TRAINING
Dear :
This is a reminder that in order for us to meet Federal and State Guidelines for you to receive assistance from our Agency, you must comply with the following:
Failure to comply with these guidelines will result in denial of tuition assistance to you.
Sincerely,
Rehabilitation Counselor
Arkansas Rehabilitation Services
LETTER FOR STUDENTS IN TRAINING INSTRUCTIONS
This letter is to be mailed to the individual during the Spring Semester.
* Self-explanatory
* The content of the letter will remain the same.
* It will be necessary for the counselor to create the letter on local office letterhead.
MONTHLY TRAINEE LETTER FORM INSTRUCTIONS
Self- explanatory.
TRAINING PROGRESS REPORT INSTRUCTIONS
This progress report is to be submitted by the officer, or instructor in charge as prearranged by the counselor. The counselor and vendor determine time frame.
STUDENT HEALTH SURVEY INSTRUCTIONS
This form is to be used by the counselor to survey high school students.
CLIENT FOLLOWUP INSTRUCTIONS (M-17)
This form is used to assist the counselor to secure follow up information from the individual.
REGISTERED LETTER - CLOSURE OF CASE RECORD OF SERVICES
Dear
This Registered Letter is to inform you that your ARS file is being closed since you are employed. A minimum of three written attempts (2 letters with one registered letter) has been made to contact you about closure of your case. The Code of Federal Regulations (Part 361.34, Section 361.56) states the case record of services of an individual who has achieved an employment outcome may be closed if the following requirements have been met:
If notice to the contrary is not received from you within five working days from the date of the receipt of this letter, I will consider the requirements met and your case will be closed. If you have any questions or concerns, please contact me.
Sincerely,
Counselor
Arkansas Rehabilitation Services
REGI STERED LETTER - CLOSURE OF CASE RECORD OF SERVICES INSTRUCTIONS
Letterhead stationery will be used for this letter.
CONSUMER SATISFACTION SURVEY INSTRUCTIONS
This form is to be mailed to the individual at the time of closure (Status 26 and 28) or accessed online. The original form is postage paid so copies cannot be used.
APPENDIX H
ARKANSAS TRANSITION PILOT PROJECT
ARKANSAS TRANSITION PILOT PROJECT
TRANSITION SERVICES
The term transition services (as outlined in IDEA) means a coordinated set of activities for a student, designed within an outcome-oriented process, that promotes movement from school to post-school activities, including post-secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation. The coordinated set of activities shall be based upon the individual student's needs, taking into account the student's preferences and interest, and shall include instruction, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation. 34 CFR § 361.22(a)(2) provides that, if the student is determined eligible for Vocational Rehabilitation (VR) services, the student's IPE should be developed as early as possible during the transition process but no later than when the student exits the school setting.
PURPOSE
Arkansas Transition Pilot Project (ATPP) was established to address an identified gap in VR services for high school youth/young adults with disabilities. ATPP counselors assist youth/young adults who receive 504 accommodations or receive IEP services and are 10th grade or at least 16 years of age transition from high school to the career field of their choice. The intent is to connect the activities of high school students, higher education, and rehabilitation services to provide a continuum of year round supports which meet the needs of all eligible youth/young adults with disabilities.
The integrated 8 continuum of services will:
REFERRAL AND ASSESSMENT SERVICES
Youth/young adults generally will be referred by school staff in the service area. Youth/young adults must meet eligibility requirements. Parent/guardian must sign consents for inclusion in the program if the youth/young adult is under 18. The school will submit any additional information that is pertinent and useful in assisting the ARS/ATPP counselor to determine eligibility and assist the youth/young adult and the counselor in identifying, selecting and pursuing appropriate career objectives.
Referral Procedures:
Initial referrals will be made within the first two months of each school year. Referrals will then be ongoing as appropriate throughout the school year. The high school will provide an individual list of high school youth/young adults who may qualify for ATPP services to the designated ATPP staff. This list will include youth/young adult's name, grade, age, ID number, school, disability, and recommended supports or accommodations and will be accompanied by a release of information form signed by youth/young adult and parent/guardian if referral is under 18. Each person on the list will be encouraged to make contact with ATPP to explore services, rather than waiting for ATPP personnel to contact them.
ELIGIBILITY
At age 14 or before, ATPP will provide informational services and brochures regarding ARS/ATPP services to any youth/young adult, parent or guardian, special education teacher or other school official who requests or as time allows outreach.
Youth/young adults must:
* Be 10th grade or 16 years of age or older
* Have a Section 504 plan which addresses transition service needs or have a current IEP which includes a transition plan
* Have a disability which constitutes a substantial barrier to employment.
Appropriate Releases of Information are required prior to individual services being rendered.
CLOSURE
Transition cases are closed when students are deemed VR eligible and begin receiving services through ARS VR Counselor.
CASELOAD MANAGEMENT
ATPP Counselors may carry up to 125 active cases. Those students who graduate but are not deemed VR eligible will be followed along for 5 years by the ARS Transition Counselor.
DEVELOPMENT, MAINTENANCE AND DESTRUCTION OF THE CASE RECORD
In accordance with Federal and State regulation, ATPP will maintain case record documentation on each applicant or eligible individual. A record of services will be established for each individual placed in 01 status and maintained until transferred to VR or follow along is complete and the designated time when it may be destroyed.
MEMORANDUM OF UNDERSTANDING
A formal Memorandum of Understanding (MOU) is entered into by interested high schools and ATPP prior to services being rendered. MOUs are reviewed annually and updated/revised as needed.
FUNCTIONS AND RESPONSIBILITIES
As outlined in the MOU ATPP/High School agree to cooperate in providing appropriate transition services to youth/young adults with identified disabilities, in order to assure the youth/young adult's entry into suitable employment, postsecondary education or training, and independent living. It is mutually agreed that the following steps and procedures will be utilized to accomplish this goal:
ROLES AND RESPONSIBILITIES OF THE ARS TRANSITION COUNSELOR
* Convey a high expectation of youth/young adults with disabilities.
* Inform youth/young adult about the array of available community options.
* Assist youth/young adults in understanding information and options throughout the decision-making process.
* Connect youth/young adults with peer mentors.
* Advocate for youth/young adults' rights.
* Provide leadership in the transition community to build a shared vision.
* Assist in the leadership of Local Transition Coordinating Councils (LTCCs) to develop solutions and strategies.
* Link to consumer groups and peer support. Develop mentoring opportunities.
* Partner with community rehabilitation providers, training facilities, and institutions of higher education.
* Involve employers in transition planning activities.
* Career exploration;
* Job readiness training;
* Soft skill development;
* Information about VR legislation, programs, available services, and comparable benefits;
* Career fairs;
* Transition planning; and
* Disability awareness.
* Establish and maintain a process for receiving referrals of youth/young adults who receive special education and Section 504 services.
* Develop comprehensive assessment.
* Determine eligibility for Transition Services.
* Engage in the on-going development of the Individualized Education Program (IEP).
* Provide vocational counseling and guidance.
* Provide and coordinate VR and other services.
* Coordinate comparable benefits.
* Develop accommodation strategies for employment.
* Provide assistive technology programs and services for employment.
* Provide placement services.
COMPETENCIES
The role of the VR counselor is instrumental in transition planning for youth/young adults who are eligible for services from the State VR agency. This role can take many forms and must incorporate philosophical and ethical considerations.
According to the Commission on Certified Rehabilitation Counseling Association (CRCC), the scope of practice for the VR counselor includes the following:
Rehabilitation counseling is a systematic process which assists persons with physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal, career, and independent living goals in the most integrated setting possible though the application of the counseling process. The counseling process involves communication, goal setting, and beneficial growth or change through self-advocacy, psychological, vocational, social, and behavioral interventions. The specific techniques and modalities utilized within the rehabilitation counseling process may include, but are not limited to:
* assessment and appraisal;
* diagnosis and treatment planning;
* career (vocational) counseling;
* individual and group counseling treatment interventions focused on facilitating adjustments to the medical and psychosocial impact of disability;
* case management, referral, and service coordination;
* program evaluation and research;
* interventions to remove environmental, employment, and attitudinal barriers;
* consultation services among multiple parties and regulatory;
* job analysis, job development, and job placement services including assistance with employment and job accommodations; and
* the provision of consultation about and access to rehabilitation technology (CRCC, 2003, pp 4-5)
SAMPLE IDEAS OF ACTIVITIES
Transition counselors are able to work outside the box when planning activities for youth/young adults they serve. Possible activities include: relationship building with schools and youth/young adults; community mapping of resources; life skills classes/seminars; individual meetings with youth/young adults; career fairs; establish new mentoring program and/or utilize existing program; public relations for ATPP and ARS in the community; establish volunteer and paid work opportunities using community resources and networking; play an active role in IEPs of eligible youth/young adults.
APPENDIX I. FEES
ARS PHYSICAL AND MENTAL RESTORATION FEES
ARS Fee Schedule referenced in Section VI. Services is the annual Blue Cross/Blue Medical Coding (CPT) Fee Schedule to determine the agencies cost for Physical/Mental Restoration or related services. This Fee Schedule can be located on the ARS network. ARS counselor are first to determine if Comparable Benefits are available.
SUPPORTED EMPLOYMENT MI LESTONE FEE
Supported Employment Milestone (SE-1) Referral/Job Development - $1000
Supported Employment Milestone (SE-2) Job Placement/Match - $2000
Supported Employment Milestone (SE-3) Job Stabilization - $1000
Supported Employment Milestone (SE-4) Closure - $2000
COMMUNITY REHABILITATION PROGRAM PER DIEM FEES
Assessment Services (10 days) - $45 per day
Work Adjustment Services (60 days) - $45 per day
Extended Services (up to 9 months) - $24 per day
172.00.10 Ark. Code R. 002