Arkansas Administrative Code
Agency 172 - Department of Career Education
Rule 172.00.10-002 - Policy and Procedure Manual Revision

III. ELIGIBILITY OR INELIGIBILITY DETERMINATION

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:

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:

V. ECONOMIC NEEDS/COMPARABLE BENEFITS

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:

VI. SERVICES

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:

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:

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:

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:

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:

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:

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:

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:

VII. INDEPENDENT LIVING REHABILITATION SERVICES DEFINITION AND INFORMATION

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:

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:

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:

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:

VIII. CLOSURE

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:

IX. CASELOAD MANAGEMENT

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

ACTIVE STATUSES

Pre-Service Statuses

CLOSURES FROM ACTIVE STATUS

CLOSURES FROM POST-EMPLOYMENT SERVICES

XII. REFUNDS/CONTRIBUTIONS

XIII. PRIOR APPROVAL

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:

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.

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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

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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.

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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.

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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:

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:

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.

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.

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.

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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.

CERTIFICATE OF ELIGIBILITY INSTRUCTIONS (RS-600-B-1)

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CERTIFICATE OF ILRS ELIGIBILITY INSTRUCTIONS (RS-600-B-1)

ORDER OF SELECTION - PRIORITY CATEGORY INSTRUCTIONS

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.

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ORDER OF SELECTION NOTIFICATION LETTER INSTRUCTIONS

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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

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.

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INDIVIDUALIZED PLAN FOR EMPLOYMENTS (RS-600-A)

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.

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.

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REQUEST FOR ACTI/HSRCH SERVICES INSTRUCTIONS (RS-344)

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:

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.