Arkansas Administrative Code
Agency 172 - Department of Career Education
Rule 172.00.18-004 - ARS Field Services Policy Manual

Prior to the determination that an individual with a significant disability is incapable of benefiting from VR services in terms of an employment outcome due to the severity of the disability, the Agency will provide the opportunity for Trial Work Experience/Extended Evaluation to demonstrate whether or not there is clear and convincing evidence to support the determination.

Assessments for determining eligibility and priority for Order of Selection are exempt from economic needs assessment.

PROCEDURES - ASSESSMENT

* The counselor will gather information (i.e., medical, psychological, psychiatric, educational or vocational reports) documenting diagnosis, i.e., with limitations of functional capacities. Priority must be given to existing information.

* The counselor should secure a signature from the applicant or their representative on the agency Request for Release of Information form in order for reports to be obtained from specific sources. Examples of medical information that should be requested include specialist reports, medical and psychological reports, high school transcripts, and ACT scores.

* If existing reports do not describe the current functioning of the individual, the counselor may purchase copies of additional medical records, request consultation with the RIDAC consultant, authorize diagnostic services, or refer and applicant for diagnostic services through the Agency support until (RIDAC) exercising informed choice. (See Appendix B Access and Accommodations)

* If the case is to be closed at any time during the assessment process, refer to Closed Not Rehabilitated Before/During Evaluation. (Section VIII)

INFORMED CHOICE -ASSESSMENT

ARS will assure that applicants and eligible individuals or, if appropriate, their representatives are provided information and support services to assist them in exercising informed choice throughout the rehabilitation process. The counselor will inform each applicant and eligible individual through appropriate modes of communication about the availability of and opportunities to exercise informed choice, including the availability of support services for individuals with cognitive or other disabilities who require assistance in exercising informed choice in decisions related to the assessment process. Applicants will be given information, or assistance in acquiring the information, to make an informed choice of vendors who provide assessment services needed to establish eligibility for VR services.

Counselor judgment and experience must be used to provide the appropriate information, or assistance in acquiring the information, to enable the individual to make a responsible decision regarding the assessment process and the program of services. A responsible decision is one that is realistic, considering the unique strengths, resources, priorities, concerns, abilities, capabilities, and interest of the individual and that must lead to an employment outcome. 34 C.F.R. § 361.52

PROCEDURES - INFORMED CHOICE - ASSESSMENT

* The counselor will maintain a local, regional and statewide list of vendors who provide assessment services needed to establish eligibility for VR services.

* To the extent available, the counselor will provide, or assist the applicant in acquiring consumer satisfaction surveys and reports regarding the service providers.

* The counselor will provide, or assist the applicant in acquiring accreditation, certification, or other information relating to the qualification of the providers.

* The counselor will describe the consequences of assessment outcomes and the effect on the potential eligibility for services for the individual.

* The counselor will make referrals to other consumer, local consumer groups, or disability advisory councils who have relevant information regarding the appropriate assessment.

* The counselor will document in the case note the specific action taken in the above procedures to assure that informed choice was provided.

TRIAL WORK EXPERIENCE (STATUS 06)

The purpose of the trial work experience is to enable the counselor to make a decision when the counselor questions whether the applicant can or cannot work due to the severity of disability. The trial work experience is only used in this instance. The decision is based on a determination of the work potential of the individual through realistic work settings. The counselor must conduct an exploration of the individual's abilities, capabilities, and capacity to perform in realistic work situations.

The exploration during the trial work experience makes the determination that either:

Each individual who meets the eligibility requirements is presumed to be able to benefit from VR services in terms of an employment outcome, unless determined, based on clear and convincing evidence, that the applicant is incapable of benefiting in terms of an employment outcome due to the severity of the disability. Clear and convincing evidence requires a high degree of certainty in order to conclude the individual is incapable of benefiting from services in terms of an employment outcome. The term clear means unequivocal. Given this standard, the use of a standard intelligence test only, would not constitute clear and convincing evidence. A functional assessment of the individual's abilities, capabilities and capacity to perform work situations through the use of trial work experience with appropriate supports and training would assist in defining clear and convincing evidence.

Correct medical documentation to support eligibility determination MUST BE IN THE FILE before COE.

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, the client must provide appropriate evidence, i.e. award letter, benefit check, verification from 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 will be attached to ECF, i.e. award letter, benefit check, verification from Social Security Administration.

* Exception: The counselor must document in the case record the justification for completing a Certificate of Eligibility/lneligibility before verification is obtained. (See procedures on page III-3)

* Complete the Certificate of Eligibility/lneligibility for VR or Trial Work Experience, (See Appendix E). The certification statement for the Certificate of Eligibility/lneligibility is "This individual meets the presumptive eligibility requirement." Three areas of functional limitations should be included on the Certificate of Eligibility.

* 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 functional limitations if this information is needed in the development of the IPE.

COMPLETION OF PRELIMINARY DIAGNOSTIC STUDY

The counselor completes the preliminary diagnostic study when enough information is obtained to write the Certificate of Eligibility/lneligibility.

CERTIFICATION OF ELIGIBILITY/INELIGIBILITY

ELIGIBILITY

The counselor must include a certification statement signed and dated in each individual's record of services indicating eligibility for VR, Trial Work.

The Certificate of Eligibility/lneligibility must be completed simultaneously with an individual's acceptance for VR services or Trial Work. At a minimum, the Certificate of Eligibility/lneligibility will contain the client's name, date of eligibility, and a statement of primary or secondary disability with resulting limitations.

PROCEDURES - ELIGIBILITY

* To determine functional limitations, priority should be given to existing information.

* Complete the Certificate of Eligibility/lneligibility for VR or Trial Work Experience services signed and dated by the counselor. (See Appendix E)

* The Certificate of Eligibility/lneligibility will be generated by the case management system. (See Section X)

* The case management system will generate the status move after required data is keyed for Status 10 (VR) or Status 06. (Trial Work Experience)

Note: Under presumptive eligibility, the Certificate of Eligibility/lneligibility will be completed with documented verification that the consumer is a recipient of SSI/SSDI benefits.

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 Certificate of Eligibility/lneligibility in the individual's record of services. This Certificate of Eligibility/lneligibility 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.

PROCEDURES - INELIGIBILITY - See Closure Section VIM, Closed Not Rehabilitated

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. § 361.43(c)

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 if requested by the individual or, if appropriate, by the individual's representative. This review need not be conducted if the individual refuses to participate, 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)

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.

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 applicants to determine eligibility and category placement.

The Order of Selection status is changed by the Commissioner notifying the Rehabilitation Services Administration (RSA). Notification of this change to ARS staff is made available through a directive from the Chief of Field Services.

DESCRIPTION OF PRIORITY SELECTION

The Order of Selection priority categories, justification for each, outcome and service goals are listed below:

When applicable, 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 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:

PRIORITY OF CATEGORIES RECEIVING VR SERVICES UNDER THE ORDER

When ARS is under an Order of Selection, this section will be utilized.

When applicable, 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:

The IPE may be developed jointly between the counselor and the individual, or the individual may develop all or part of the plan independently, or with the technical assistance from another source. The completed plan must be approved and signed by the counselor and the individual, or if appropriate, the individual's representative, within the framework of a counseling and guidance relationship. Assistance in completing the IPE form, if requested by the consumer will be provided.

The IPE must be designed to achieve the specific employment outcome, which is chosen by the individual consistent with the individual's unique strengths, resources, priorities, concerns, abilities, capabilities, career interest, and informed choice. The documentation should show that there is adequate labor market demand to support the employment outcome. If relocation would be required, the individual must agree to relocate to an area with sufficient labor market demand for the chosen employment outcome prior to the signature and initiation of the IPE. The individual should acknowledge that they are familiar with the entry-level wages that are common in the chosen vocation.

For supported employment services, an employment outcome should include a description of the extended services needed and the source of extended services. If it is not possible to identify the source of extended services at the time the IPE is developed, a statement must be included explaining the reasonable expectation that extended services will become available prior to closure.

The IPE for each eligible individual should be developed as soon as possible, but no later than 90 days following determination of eligibility, unless the VR counselor and the individual agree to a specific extension of time.

The 90-day time period for IPE development begins once the counselor has deemed the client eligible for services and completed the certificate of eligibility.

Note: If circumstances preclude developing an IPE that addresses the mandatory components within 90 days, the counselor and individual must agree to a specific extension of time 34 C.F.R. § 361.45. In this instance the counselor should complete a case note labeled "IPE Extension." The case note should reflect the dates (timeframe) of the Extension and the specific reasons for the need for an extension.

The IPE is amended each time a substantial change or annual/periodic review is made in the individual's rehabilitation program. A substantial change could include:

In determining an individual's financial resources, the counselor will identify all resources available to the individual and/or spouse, prior to developing the IPE. If the individual is a dependent, the resources of the parents will be determined. If the individual is 23 years of age or under and unmarried, the parent(s) assets must be verified with a copy of the parent(s) income tax forms. If the parent(s) do not support the individual, the individual must provide documentation of non-support. If the client's family states the client will not be claimed on next year's income tax, the client will no longer be considered a dependent. The client will be required to verify their source(s) of income to cover their expenses.

EXCEPTION: SSDI and SSI recipients are exempt from financial need; however, the financial resources form should be completed to assess comparable benefits and gather information for federal reporting.

Provision of services conditioned on financial need entails:

A need standard in the form of a Normal Living Requirement (NLR) has been established for different family groups and single individuals living alone. The NLR includes amounts for food, shelter, clothing, household maintenance, routine medical care, personal care, recreation, insurance, and personal taxes.

NORMAL LIVING REQUIREMENT

($750.00 for each additional family member)

Special circumstances include anything that has changed from one year to the next and anything that distinguishes the family from the typical family.

Examples of special circumstances include:

* Tuition expenses at an elementary or secondary school

* Medical or dental expenses not covered by insurance

* Unusually high child care or dependent care including elder care costs

* A parent or another sibling enrolled in a training program

NOTE: When using a special condition, proof of payments being made monthly must be provided to the counselor. These payments must have been made prior to applying for ARS services.

Ascertaining an individual's financial resources is an important step in determining ability or inability to pay for rehabilitation services. A resource is considered available only if it is at the individual's disposal when needed. Careful study of the individual's resources is necessary to determine availability.

The provision of certain services to the individual is dependent upon financial need, but the counselor should use discretion upon applying financial need. Stripping the individual of all resources may impair the individual's rehabilitation.

The comparable benefits provision provides VR agencies with an organized method for assessing an individual's eligibility for benefits under other programs. Any benefit available to individuals under any other program to meet, in whole or in part, the cost of any VR service will be utilized. This benefit will be considered only to the extent that it is available and timely.

A "comparable benefit" is not the same as "determination of economic need." In determination of economic need, the objective is to set the conditions for equitably determining the amount, if any, an individual is expected to participate in the cost of the rehabilitation. In the area of comparable benefits, the objective is to give full consideration to alternative funding sources prior to spending VR funds to purchase consumer services.

If the individual refuses to apply for services for which the individual may be eligible or if the individual refuses to accept services from another Agency as a comparable benefit when receipt of such services do not interfere with achieving the rehabilitation objective, ARS cannot provide the services using VR funds.

Federal VR funds cannot be used to pay training costs in institutions of higher education unless every effort has been made to secure financial assistance, in whole or in part, from other funding sources. In all training cases, the record of services must include evidence that applications were made and the individual will or will not receive assistance.

Evidence of approval of receipt of financial assistance may be documented through a financial aid award letter. This letter originates at the training institution and lists the type/amount received by semester (quarter). Federal law requires students to accept/reject awards by signing on this letter. Repayable loans should not be considered as a comparable benefit or resource.

Note: Comparable benefits do not include awards and scholarships based on merit.

PROCEDURES - UTILIZING FINANCIAL NEED

* Exempt SSDI/SSI recipients from financial need assessment/requirements.

* The individual must apply for comparable benefits and documentation of benefits must be placed in the ECF, i.e., award letter/Student Financial Aid Grant.

* The RS-16 Financial Resources form must be completed by the time the IPE is developed.

* For those individuals or the parents of individuals under the age of 23 not exempt as recipients of SSI/SSDI, the counselor will verify income by requesting Income Tax returns, copies of earnings statements, Student Financial Aid grant summary or the individual may be required to request their earnings history from the Social Security Administration.

* Any available benefits will be utilized and must be considered in the provision of services.

* Other than diagnostic services, no authorizations will be issued until financial need is verified.

* In all instances where the Student Financial Aid is utilized, the counselor will utilize the basic cost of education reported from the school that the individual will attend. The applicable Student Financial Aid categories are dependent, on campus, dependent off campus, and independent. The basic costs may include tuition, books, fees, room and board, supplies, and transportation.

* Financial need should be re-assessed and a RS-16 Financial Resource form completed at Annual Review or at any time the individual's financial situation changes.

Vocational diagnostic or assessment services may include referral to the Arkansas Career Training Institute (ACTI) for assessment.

The above listed services may be provided an individual at any time, but normally will be completed during the case investigation process. They may be provided by ARS personnel, obtained elsewhere at no cost to ARS, or purchased by ARS.

RESTORATION (PHYSICAL/MENTAL) SERVICES

Restoration services mean those medical and medically related services that are necessary to correct or substantially modify within a reasonable period of time, a stable or slowly progressive physical or mental condition. These include surgery, therapy, treatment, and hospitalization.

Prosthetic appliances/devices provided to improve or maintain an individual's ability to work are coded as Rehabilitation Technology Devices.

If an individual has a physical or mental disability with resulting limitations constituting an impediment to employment which, in the opinion of competent medical personnel, can be removed by restoration services without injury to the individual, the individual is not eligible for any ARS services except counseling, guidance and placement if the individual refuses to accept the appropriate restoration services.

PHYSICAL RESTORATION SERVICES PURCHASED IN-STATE

ARS will pay for all physical restoration services that are properly authorized. Payment will be made according to the vendors' stated fee, up to but not to exceed, the maximum amount determined by the established ARS Fee Schedules. The fee paid by ARS must be accepted as payment in full by the vendor. The fee paid to physicians for surgical treatment includes 15 days of routine post-operative care.

PROCEDURES - PHYSICAL/MENTAL RESTORATION SERVICES

* Documentation of the action to be taken will be made in the case note.

* Medical reports and recommendations will be obtained from the attending physician and attached to the ECF.

* Medical Consultant's review is required and attached to the ECF, if needed. (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 attached to the ECF. Does not apply to IL/SDHH cases. (See Appendix E)

* Refer to ARS Fee Schedule. (See Appendix I)

* The case management system will generate the status move after required data is keyed for Status 18 if needed.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

PHYSICAL RESTORATION 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 note.

* Medical reports and recommendation will be obtained from the attending physician and attached to the ECF.

* Medical Consultant's review is required and attached to the ECF, if needed. (See Appendix E)

* Refer to ARS Vendor List or secure W-9 from new vendor.

* Refer to ARS Fee Schedule. (See Appendix I)

* The case management system will generate the status move after required data is keyed for Status 18 if needed.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

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 and attached to the ECF.

The medical consultant's role is to assess medical information for the provision of guidance on the medical aspects of the client's disability to include; symptoms, functional limitations, treatment and diagnostic tests, standards of care, and to provide clarification of medical reports.

Medical consults may be provided by ARS personnel, obtained elsewhere at no cost to ARS or purchased by ARS. This will be contingent on the availability of ARS personnel.

PROCEDURES - MEDICAL CONSULTANT

* The medical consultant will review medical/psychiatric reports and make recommendations.

* The medical consultant will complete the Medical Consultant form.

* The form will be attached to ECF.

MEDICAL, SURGICAL, AND PSYCHIATRIC TREATMENT

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 up to 90 days (three (3) months). If additional treatment is needed, a new medical evaluation/prescription is required.

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. Treatment is initially approved for up to 12 visits. If additional is needed, this should be suggested by the specialist.

Surgical Treatment: Payments may be made for surgical operations and fees for preoperative care. Payments will be made according to the established ARS Fee Schedule. (See Appendix I)

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, Occupational, or Speech Therapy (PT/OT/ST): ARS will pay for PT/OT/ST 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 12 visits a new evaluation/prescription should be done.

Podiatrist or Chiropractor: ARS will pay for the services of a Podiatrist or Chiropractor only with Medical Consultant approval up to 12 visits. If greater time is needed, a new evaluation and prescription must be obtained.

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 or cosmetic dental procedures. Provided dental services must be directly connected to disabling conditions documented during eligibility process. Recommendation by the dental consultant will be required. A specific treatment plan and estimated cost must be obtained. An LMC is required and approval by the Chief of Field Services is needed. Services will be purchased consistent with the ARS fee schedule. (See Appendix I)

EXCEPTION: Insurance benefits must be used first in paying for surgical/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)

PROCEDURES - MEDICAL, SURGICAL, PSYCHIATRIC TREATMENT

* Documentation of the action to be taken will be made in the case note.

* Medical reports and recommendations will be obtained from the attending physician and attached to the ECF.

* Medical Consultant's review is required and attached to the ECF if needed. (See Appendix E)

* Refer to ARS Vendor List or secure W-9 from new vendor.

* Refer to ARS Fee Schedule. (See Appendix I)

* The case management system will generate the status move after required data is keyed for Status 18 if needed.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Refer to Out-of-State Policy limitations, if necessary.

* UAMS requires special payment.

* Dental Services require recommendation by the Dental Consultant.

BREAST REDUCTION INFORMATION/GUIDELINES

Listed below are guidelines for breast reduction surgery for ARS:

* There must be verification of back/neck pain for at least six months by a medical physician (not just the cosmetic surgeon), which has not responded to conservative treatment.

* There should be no other etiology of back pain other than enlarged breast - such as scoliosis, morbid obesity (BMI 40 or above), degenerative disc disease, etc.

* There should be no family history of breast cancer in first degree maternal relatives. If this is present, a mammogram shall be performed prior to breast reduction.

* Liposuction is considered cosmetic surgery and is not covered by ARS.

DIRECTED THERAPY FOR WEIGHT LOSS

ARS may provide services for structured weight loss programs for 12 months such as Weight Watchers, TOPS, etc. or other medically directed programs. The counselor will maintain monthly contact with the client to ensure proper follow-up. The counselor should make every effort to seek out programs in the community that provide behavior modification counseling and address significant lifestyle changes including diet, exercise and behavior modification. Prior to service provision, the client must compare at least three programs and discuss with counselor. If program does not offer behavior modification counseling, there must be documentation of participation with another provider. Behavior modification counseling must occur throughout the entirety of the client's case. Program must provide reports outlining expected progress within a designated amount of time.

The counselor will consult with the 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 attached to the ECF.

* Medical Consultant's review is required and attached to the ECF. (See Appendix E)

* Counselor will negotiate reasonable fees with the vendor.

* The counselor will make monthly contact with client.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for Status 18 if needed.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Refer to Out-of-State Policy limitations, if necessary.

* UAMS requires special payment.

* If non-compliance is documented, directed therapy may be discontinued.

SUPPORTED COUNSELING RELATED TO WEIGHT

Progress should be monitored monthly. After three months in a weight loss program, at the counselor's discretion and based on little or no success, the client's program needs to be modified.

TREATMENT FOR MORBID OBESITY (MORBID OBESITY SURGERY)

Individuals requesting assistance from ARS for a surgical procedure 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 morbid obesity surgery.

Individuals with a diagnosis of morbid obesity may be eligible for restoration services if all the following criteria are met:

PROCEDURES - MORBID OBESITY 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 one year (this documentation must be within the last two years.) and the presence of morbid obesity for at least five 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 the specific morbid obesity surgical procedure being requested.

* Obtain an examination from a surgeon proficient in the specific morbid obesity surgical procedure 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 recommendation by the Medical Consultant.

* The Counselor will submit a request to the Manager with the reports and all required documentation requesting approval for the procedure. As a part of the request the counselor will provide the Manager the counseling issues to be addressed during the restoration and recovery process.

* If the 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 Manager will note approval in the ECF.

* If the Manager does not agree the individual meets eligibility and Order of Selection criteria, is not an appropriate candidate for the requested morbid obesity surgical 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 and noted in the ECF.

* If the 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 three 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.

* Reports and recommendations will be obtained from the attending physician and attached to the ECF.

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

Individuals requesting assistance from ARS for cochlear implant surgery as a method of treatment to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing must meet the following:

* Complete psychological exam to determine emotional and mental stability of the individual.

* Documented evidence from the individual or employer that the procedure would remove any significant vocational impediment.

* Documented evidence from medical personnel in regard to the type and severity of the hearing loss.

* Documented counseling with medical personnel in regard to after effects and adjustment to the procedure.

* Documented post-operative aural rehabilitation plan.

* Refer required documentation to Manager, Deputy Chief of Field Services and Chief of Field Services for approval.

Reports and recommendations will be obtained from the attending Physician, Audiologist, and other required healthcare team members and attached to the ECF. Follow general ARS guidelines for bill payment processes such as using Health Care Common Procedures Coding System (HCPCS) codes. ARS is the payer of last resort.

PROCEDURES - COCHLEAR IMPLANTS

PROCEDURES - BAAI

An individual is eligible for training:

ARS recognizes that the transition from high school to post-secondary training is a crucial time and is a period of change and stress. Training options beyond the vocational-technical level must have documentation based on the assessment of rehabilitation needs that the individual can be successful in the selected training area.

FINANCIAL AID

The role of ARS is not to act as the primary funding source for training programs. All clients pursuing training programs are required to explore, and when appropriate, apply for funding from sources other than ARS. Federal VR funds cannot be used to pay training costs in institutions of higher education unless every effort has been made to secure financial assistance, in whole or in part, from other funding sources. In all training cases, the record of services must include evidence that applications were made and the individual will or will not receive assistance. Evidence of approval of receipt of financial assistance may be documented through a financial aid award letter. This letter originates at the training institution and lists the type/amount received by semester (quarter). Federal law requires students to accept/reject awards by signing this letter.

The counselor will provide general information regarding various alternative financing sources; however, the individual is responsible for securing financial aid. Documentation must be presented to the counselor prior to the school's established payment deadline. This documentation can include: college award letter, Student Financial Aid grant response letter, on-line Student Financial Aid grant printouts, or copies of Student Financial Aid grant application forms.

If the student has defaulted on a Guaranteed Student Loan, the student will be denied a Pell Grant and other forms of financial aid. Before spending ARS funds for training, the consumer must arrange to repay the defaulted loan, and provide supporting documentation of progress throughout the plan year.

The counselor will utilize the basic cost of education reported from the school that the individual attends. The applicable Student Financial Aid categories are dependent, on campus, dependent off campus, and independent. The basic cost may include tuition books, fees, room and board (maintenance), supplies and transportation.

Please see the policy guidance on maintenance and transportation for information on the application of these separate policies to training cases. Maintenance may only be considered for those expenses incurred that are directly related to attending college and are in excess of normal living expenses. Expenses such as housing may be considered at a rate of 70% of the lowest double occupancy dorm room cost per term.

ARS will finance Arkansas state tuition costs as an Arkansas resident for all training programs found within the State of Arkansas. This includes programs that have the same exit degree, diploma, or certificate awarded. The individual will be responsible for all fees in excess of the cost of the in-state fees.

ARS will only sponsor individuals at institutions that are fully accredited by the appropriate accrediting authority.

Every effort will be made to secure training nearest where the individual's primary residence is located. Individuals who choose to attend a school outside of the commuting distance (50-mile radius) will incur the additional costs associated with that choice.

The individual will indicate choice of school and course of study in accordance with informed choice by signing the IPE.

Note: ARS will not be bound to any agreement or contract the individual entered into prior to signing the IPE.

A threshold of $5000 has been established per twelve-month period beginning with initiation date of the IPE for tuition, required textbooks, academic fees, maintenance and transportation.

COLLEGES AND UNIVERSITIES

ARS will assist individuals in pursuing two- and four-year college and university training programs in only those colleges and universities accredited by the appropriate accrediting agency and whose courses will be given full recognition by other accredited colleges and universities. It is the counselor's duty to determine if the selected institution is approved by the State Department of Education or by another qualified accrediting agency of the state in which it is located.

ARS will only sponsor an individual to the bachelor's degree level unless sufficient justification is provided in writing that demonstrates that the individual is unable to reach the desired employment goal without additional training and education. This information should be obtained from an employer or other credentialed professional in the field for which the individual is seeking an advanced degree.

The individual will provide a yearly degree audit signed by an academic advisor or program supervisor. This degree audit will be used to ensure that the required course work is being taken for consideration of continued ARS funding. The yearly audit will also ensure that the classes are being taken that lead to the degree and employment goal listed on the IPE.

Preference will be given to institutions in Arkansas. If training is not available within the State, or if there are other circumstances, which the counselor feels justifies out-of-state training, such training will be permitted on a case-by-case basis.

If training is available within the State of Arkansas and the client attends an out-of-state institution, the maximum amount payable will be the same as that paid if the individual would be attending an institution within the State as a full-time student. The individual must attend on a full-time basis. The cost of tuition, fees, textbooks, will not exceed the institution's established education costs.

The application of maintenance and/or transportation costs will be applied according to the maintenance and transportation policies. Maintenance may only be considered for those expenses incurred that are directly related to attending college and are in excess of normal living expenses. Expenses such as housing may be considered at a rate of 70% of the lowest double occupancy dorm room cost per term.

The cost of private school training will not exceed the cost of State of Arkansas supported institutions. For training at a private Arkansas institution, ARS may supplement the individual's resources and pay up to, but not more than, training fees at State supported institutions for a full-time student. If training is not available within the State, ARS may pay the fees charged by the particular out-of-state university or college for a full-time student.

A threshold of $5,000 has been established per twelve-month period beginning with initiation date of the IPE for tuition, required textbooks, academic fees, maintenance and transportation. For an exception form refer to Appendix G.

Required Time Frames for Completion of Academic Training

ARS sponsorship of academic training is limited to the following time frames:

* An associate's degree must be completed within three years.

* A bachelor's degree must be completed within a total of six years (including time at a junior college or community college).

* A master's degree must be completed within three years (this does not include time to complete the bachelor's degree before beginning the master's degree program).

When a consumer has spent time in a college or university before ARS sponsorship, prorate the time frames according to the remaining hours needed to complete the degree. This information can usually be found on the student's individualized degree plan from the college or university. Document the justification for the prorated and agreed upon time frame in the ECF.

ADVANCED DEGREE

It is ARS policy to assist individuals in obtaining an advanced degree only when this degree is a minimum requirement for the vocational objective. The decision to obtain an advanced degree must be determined at the time of initial plan development.

ARS may assist clients beyond the Bachelor level in occupations that require advanced training for entry level, such as medicine, dentistry, law, science, technology, engineering and mathematics, and this need must be determined at the time of plan development. ARS will sponsor advanced degrees beyond the bachelor's level with sufficient justification provided in writing that demonstrates that the individual is unable to reach the desired employment goal without additional training and education. This information should be obtained from an employer or other credentialed professional in the field for which the individual is seeking an advanced degree.

FULL-TIME STUDENT

Undergraduate

A full-time student receiving financial support from ARS is one who completes 12 per semester hours or six (6) semester hours per summer term at the college level. ARS will follow the same timeline for completion of an undergraduate program as established by Federal Student Aid. Individuals will have no more than six (6) years or 12 semesters to complete an undergraduate degree.

At the counselor's discretion, exceptions may be made when the record of services reveals that, because of the severity of the disability or for other obvious reasons such as schedule difficulties, the need for part-time work or upon the recommendation from the client's physician, school officials, etc., the client cannot be expected to carry 12 hours of course work. Documentation of the exception must be made in the ECF.

Graduate Level

An individual taking nine (9) semester hours or six (6) quarter hours is considered a full-time graduate student. Individuals seeking a master's level program must be enrolled on a full-time basis. The individual has no more than three (3) years to complete the graduate level program.

Doctorate Level

Doctorate programs differ in programming and requirements. A yearly audit of the coursework and progress towards the doctoral level program is required. An individual has seven (7) years to complete an approved and accredited doctorate program.

Summer Courses

At the counselor's discretion, ARS will pay for summer courses for students classified as a junior or higher.

Remedial Courses

ARS will pay for a total of six (6) semester hours of remedial courses to fulfill academic requirements within the first year of college. The counselor will review the above policy with the client and document in a case note using the "description": ARS Policy on Remedial Course.

SATISFACTORY PERFORMANCE - COLLEGE AND UNIVERSITIES

Any full-time college student who does not complete 12 hours of course work during the regular semester or six (6) hours during summer semester with a "C" average (2.0) may be placed on probation for the following semester at the counselor's discretion. If the client is placed on probation and fails to make a "C" average (2.0), college training will be terminated. More than one probationary period during the student's entire training program will require the Manager's approval. Failure to do acceptable college course work will result in a re-evaluation of the client's program and the selection of a more realistic vocational objective.

GRADES - COLLEGES AND UNIVERSITIES

The counselor is responsible for obtaining grades from student to document satisfactory progress. This responsibility should be delegated to the student. The Grades (GPA) will be used as the measure of satisfactory progress and must be provided to the counselor in a timely manner in order to approve payment for tuition for the next semester. The Responsibilities of College Students Form must be signed by the individual and counselor and placed in the individual's record of services prior to the initial semester and each following fall semester.

Accredited universities/colleges are beginning to offer classes via Internet and other distance education options. These classes can provide college training to individuals with most significant disabilities whose accessibility or environmental needs made traditional campus-based training difficult.

This type of training, however, may be impractical for students who require the reinforcement and motivation of time-scheduled classes and social participation. Because of the many non-accredited correspondence courses offered by businesses or companies, the counselor should evaluate this option carefully.

PROCEDURE - COLLEGE AND UNIVERSITY TRAINING

* Documentation of the action to be taken will be made in the case note.

* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid grant response letter, on-line Student Financial Aid printouts, or copies of Student Financial Aid grant application forms. Attach documents to the ECF.

* The individual will provide a copy of an official degree plan at IPE to the counselor. Attach documents to the ECF.

* The individual will provide yearly a degree audit signed by an academic advisor or program supervisor, and will be used to ensure that the required course work is considered for ARS funding and that good progress is made toward the training outcome.

* The counselor will review the grade report each period.

* The counselor will review all planned courses the consumer will take during the next period to ensure that they are a part of the consumer's required coursework.

* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* If specialized equipment, i.e., computers, software, etc., is purchased a title of retention will need to be completed. (See Appendix E)

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Refer to Out-of-State Policy limitations, if necessary.

* Complete Annual Review documenting any changes to the IPE.

* Update the RS16 Financial Resources Form at Annual Review, if appropriate.

COLLEGE TEXTBOOKS

ARS may purchase required textbooks for full-time students who are making satisfactory progress. Authorizations for textbooks must be submitted to the bookstore in a timely manner, usually prior to the beginning of classes. Payments for textbooks must fall within the $5,000 threshold unless an exception is approved. The request for payment from the bookstore must be accompanied by a list of books purchased, individual book price, and the individual's signature.

PROCEDURES - COLLEGE TEXTBOOKS

* Documentation of the action to be taken will be made in the case note.

* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid grant response letter, online Student Financial Aid printouts or copies of Student Financial Aid grant application forms. Attach documents to the ECF.

* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Refer to Out-of-State Policy limitations, if necessary.

* Complete Annual Review documenting any changes to the IPE.

* Update the RS16 Financial Resources Form at Annual Review, if appropriate

BUSINESS SCHOOLS OR COLLEGES

ARS may purchase training for qualified clients in any business school or college capable of providing the training necessary for the client to attain the vocational objective.

Satisfactory performance will be documented by a progress report.

PROCEDURES - BUSINESS SCHOOLS OR COLLEGES

* Documentation of the action to be taken will be made in the case note.

* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid grant response letter, online Student Financial Aid printouts or copies of Student Financial Aid grant application forms. Attach documents to the ECF.

* The counselor and the individual will complete the College Student's Responsibilities Form prior to the first semester and then each fall semester.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* If specialized equipment, i.e., computers, software, etc., is purchased a title of retention will need to be completed and attach the documents to the ECF. (See Appendix E)

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Refer to Out-of-State Policy limitations, if necessary.

* Complete Annual Review documenting any changes to the IPE

* Update the RS16 Financial Resources Form at Annual Review.

VOCATIONAL SCHOOL

ARS may purchase training for qualified individuals in any vocational, trade, or technical school capable of providing the training necessary for the individual to attain the vocational objective. If training is available within the State and the individual attends an out-of-state school, the maximum amount payable will be the same as that paid if the individual would be attending an institution within the State as a full-time student. Satisfactory performance in a non-academic program will be documented by a progress report indicating satisfactory progress in the training program.

PROCEDURES - VOCATIONAL SCHOOL

* Documentation of the action to be taken will be made in the case note.

* The individual will provide the counselor with documentation of any financial aid awards and scholarships. This documentation can include: college award letter, Student Financial Aid-grant response letter, online Student Financial Aid printouts or copies of Student Financial Aid grant application forms. Attach documents to the ECF.

* The counselor and the individual will complete Responsibility of Vocational Training Students prior to the first semester and then each fall semester.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Refer to Out-of-State Policy limitations, if necessary.

* Complete Annual Review documenting any changes to the IPE.

* Update the RS16 Financial Resources Form at Annual Review

COSMETOLOGY/BARBER SCHOOL

ARS may purchase training for qualified individuals in cosmetology/barber schools capable of providing training necessary for the individual to attain the vocational objective. Cosmetology/Barber Schools must have the ability to accept federal financial aid as a comparable benefit. ARS requires a copy of the school's program costs and Student Financial Aid grant eligibility or ineligibility be placed in the individual's ECF by the time of plan development. Tuition will be authorized and paid at an hourly rate. Billing will be processed only with receipt of a monthly progress report verifying the number of hours the individual attended.

The Manager's approval is required if extenuating circumstances occur such as changes or expenses beyond the agreed rate, or additional training time to meet the required 1500 hours. For an exception form refer to Appendix G.

Satisfactory performance in a non-academic program will be documented by a progress report.

PROCEDURES - COSMETOLOGY/BARBER SCHOOL

* Documentation of the action to be taken will be made in the case note.

* A copy of the school's program costs will be attached to the ECF by the time of plan development. Tuition will be paid at an hourly rate.

* The case record must document the school's Student Financial Aid eligibility or ineligibility.

* The award/denial letter/Student Financial Aid will be obtained and attached to the ECF.

Responsibility of Vocational Training Students

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Refer to Out-of-State Policy limitations, if necessary.

* Complete Annual Review documenting any changes to the IPE.

* Update the RS16 Financial Resources Form at Annual Review.

ON THE JOB TRAINING

Vendors used for on-the-job training must be reputable, established firms that can supply the individual training in the selected job. The counselor must choose only those training sites that have:

The counselor will consider:

Arkansas Rehabilitation Services will pay an On-the-Job training fee to the vendor for providing instruction to the individual to help them reach a skilled proficiency level in the work area selected. ARS can pay the individual's salary or wages at a negotiated rate.

The vendor must put the individual on the payroll and pay the same starting wage that is paid to other new employees. The training fee should be equal or above the current minimum wage amount. The individual must be offered the same benefits as other employees. The trainee has the same responsibilities as all other employees.

Satisfactory performance in a non-academic program will be documented by a progress report indicating satisfactory progress in the training program.

PROCEDURES - ON THE JOB TRAINING

* The counselor will utilize the ARS approved On-the-Job (OJT) contract.

* 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 note.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* The training vendor will provide a monthly 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

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 note.

* Complete applicable vendor referral form.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* The training vendor will provide a monthly progress report to the counselor with appropriate billing forms. The counselor will not process payment for the adjustment training without proper progress reports. Attach documents to ECF.

MISCELLANEOUS TRAINING

This category includes academic and other specialized training that will prepare an individual with a disability to be employed. This training may include correspondence and online study.

The correspondence/online method may be used if:

The following criteria will be used for those individuals considered for correspondence/online training:

For college correspondence training, fees will be determined by the number of "credit hours" and the institution's rate. The published fees of the selected college will be the maximum paid by ARS. Fees will be paid when the college submits a bill.

In paying for correspondence/online courses other than college, the total cost of the training will be divided by the number of lessons or the parameters set out by the course work. Counselors are responsible for negotiating with the vendors to ensure agreement with this payment plan. If correspondence training is selected, the counselor must obtain the Manager's approval.

PROCEDURES - MISCELLANEOUS TRAINING

* Documentation of the action to be taken will be made in the case note.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for Status 18.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* 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.

* Complete Annual Review documenting any changes to the IPE.

* Update the RS16 Financial Resources Form at Annual Review.

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. ARS will not furnish computers as training materials. Computers purchased for training needs will be considered only when the computer is required as an accommodation based on the nature of the individual's disability and will be utilized as assistive technology. An AT evaluation, assessment, and recommendation will be documented and placed in the ECF.

TRANSPORTATION

Transportation costs may be reimbursed to the client at the state allowed rate. Transportation costs may be paid to an approved vendor at the rate set forth in the Vendor Transportation Service Agreement. The vendor shall agree to the fees by signing the Vendor Transportation Service Agreement prior to providing services. The terms are listed below.

ARS shall provide the Vendor, at least 24 hours in advance and no more than 30 days in advance, with the time and location of pickups and discharges as well as the names, telephone numbers and special needs (e.g. vans with wheelchair lift) of the clients to be served.

ARS shall provide the Vendor with adequate notice of cancellation of prescheduled transportation. "Adequate Notice" is defined as two hours. ARS will be charged $15.00 for each cancellation when less than two hours' notice is provided.

ARS shall reimburse the vendor using the following rates: pick up fee of $8.00, $1.05 per mile ambulatory rate and wheelchair rate at $1.60 per mile. Transportation is reimbursed from the point of pick-up to the destination and back. In the event that the client is brought to a training program and a return trip is not scheduled in the same day, the return trip for the Vendor will be reimbursed at a flat rate of $15.00 for trips exceeding a 30-mile radius from the drop off location. This is based on an average cost of transportation vendor rates across the State.

Transportation is not to exceed 300 miles in one trip without an approved exception from the Manager.

ARS shall reimburse the Vendor for transportation services within thirty (30) days from the date of the monthly statement is submitted to ARS.

The case note will document justification for the need of the service, an estimate will be provided to counselor prior to transport. An invoice and receipt showing the individual received the service is required before the payment is processed.

PROCEDURES - TRANSPORTATION

* Documentation of the action to be taken with justification for the service will be made in the case note.

* The Vendor Transportation Service Agreement Form will be completed and signed prior to providing the service.

* A copy of the estimate will be provided prior to transport. Estimates are requested per client and can be for one trip or multiple trips, depending on what is required as per the Individualized Plan for Employment of the individual.

* Receipts and invoices verifying the individual received the service will be attached in the case management system, a case note will be entered. Invoices will be provided upon completion of the service. The invoice will outline the following:

* Name of the Client

* Date and Times of pick-up and return

* Invoice date

* From and to destination

* Total number of miles billed, which must be based on mileage as indicated by Google Maps

* Refer to ARS Vendor List or secure W-9 from new vendor.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

MAINTENANCE

Maintenance is a supportive vocational rehabilitation service in the form of cash payments which should be made first to a vendor, maintenance payments written directly to clients for basic living expenses such as food, shelter, clothing, or other incidental needs so a consumer may participate in a specific service. In all cases the most cost effective solution as well as comparable services must be applied.

Maintenance is a support which is provided, if necessary, so that the consumer can derive full benefit of vocational rehabilitation services, accomplish the vocational goal, and achieve a successful employment outcome. Progress towards the employment goal must be maintained in order to continue maintenance as a supportive service.

The counselor must first exhaust the assistance available through consumer resources and any other comparable services or benefits programs before funding maintenance support.

Maintenance for Training

To participate in vocational, prevocational, or college training, the consumer may need maintenance assistance for supplies, room and board in excess of normal living expenses. ARS will provide maintenance assistance in the event the client is moved outside of a 50-mile radius of his/her existing domicile to participate in an approved training program. Training programs nearest the client's primary residence will first be considered for cost effectiveness. Maintenance is to cover the additional costs incurred in excess of normal living expenses. Maintenance assistance is temporary and is not meant to cover the cost of the client's primary living situation.

Guidelines

A consumer living in their own residence (house or apartment), will not receive maintenance for living expenses they would normally incur if they were not involved in a rehabilitation program.

Consumers are to provide the counselor with a copy of the most current rental or lease agreement in order for maintenance payments for the purpose of rent to be authorized.

The Counselor must first utilize comparable services/similar benefits such as community resources and consumer resources before any ARS funds can be committed for rental assistance payments. Individuals who receive SSI or SSDI benefits are expected to use those funds for their normal living expenses, but not for payment of VR services. If an individual receiving SSI or SSDI benefits is authorized by ARS to receive maintenance support, the individual will not be required to contribute the SSI/SSDI benefits toward the maintenance support.

All maintenance payments will not exceed the cost of subsistence, provided in connection with VR services at any time from the date of initiation of services. After job placement, maintenance may be paid at subsistence level for job retention.

Maintenance payments for rent, mortgage, and room and board will be paid based on Fair Market Rent documentation system by Housing and Urban Development (HUD). Maintenance will be made in accordance with the IPE with a maximum of three (3) months of payment per plan year.

College Training

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 provided:

Maintenance services are available at the ACTI.

Full-Time Vocational Training

Maintenance may be paid for an individual in business, trade, technical, or other schools, on-the-job training and apprenticeship training.

Placement

After job placement, maintenance may be paid at subsistence level at the counselor discretion.

PROCEDURES - MAINTENANCE

* Documentation of the action to be taken with justification for the service will be made in the case note.

* Documentation of the method used to calculate the cost of the service will be made in the case note.

* Receipts or other documentation verifying the individual received the service will be made in the case note.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* Key required information into the case management system for ARS Purchase Authorization.

* When billing statement is received, verify the individual received the service. Document in the ECF.

* Key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

* Complete Annual Review documenting any changes to the IPE.

* Update the RS16 Financial Resources Form at Annual Review.

SUPPORTED EMPLOYMENT SERVICES

Supported Employment means competitive integrated employment, including customized employment, or employment in an integrated work setting in which an individual with a most significant disability, including a youth with a most significant disability, is working on a short-term basis toward competitive integrated employment that is individualized and customized, consistent with the unique strengths, abilities, interests, and informed choice of the individual.

These articles must be for the individual's own use in work performance and must remain in the individual's possession and control as long as the individual remains in the job or occupation. However, the individual may dispose of initial stock in the ordinary course of business.

A threshold of $5000 has been established for the purchasing of Tools, Equipment, Initial Stock, and Construction related services. For an exception form refer to Appendix G.

PURCHASING (STATE PURCHASING GUIDELINES)

When the purchase exceeds $5,000.01 but is less than $10,000 (tax excluded) District Manager approval is required. The counselor will obtain at least three written quotes, complete the RS-357 with a Memo, and submit this information to the 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. If the Central Office provides the counselor with a copy of the State Purchasing Agency's purchase order, a copy of the authorization will not be sent to the vendor.

Exceptions: 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

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 Manager. The counselor will obtain at least three written quotes, complete the RS-357 with a Memo, and submit this information to the 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 Manager. The counselor will obtain at least three or more verbal or written quotations and submit this information to the 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 $25,000.01 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.

TITLE RETENTION/RELEASE/REPOSSESSION

An 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 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 attached to the ECF 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 be attached to the ECF.

PROCEDURES - TITLE RELEASE

* Complete the Release of Title for Tools and/or Equipment

* The original will be attached to the ECF 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 note 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.

ASSISTIVE TECHNOLOGY SERVICES AND ENGINEERING

Assistive technology services (including hearing services, aids and assistive listening devices such as telecoils) may be considered for each individual in terms of his or her Employment Plan. Assistive technology services are defined as the systematic application engineering methodologies and scientific principles to meet the needs of, and address the barriers confronted by, individuals with disabilities. Assistive technology services may be useful in areas including education, rehabilitation, employment, transportation, independent living, and recreation. Likewise, 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.

If the individual's VR counselor deems assistive technology or rehabilitation engineering services appropriate, the counselor may refer the individual for evaluation and assessment by Access and Accommodations section. In order to refer Access and Accommodations section, the counselor will follow the procedures for evaluation and assessment found in Appendix B (Special Programs Access and Accommodations) and Appendix E (Forms Access and Accommodations).

PROCEDURES - ASSISTIVE TECHNOLOGY SERVICES/ REHABILITATION ENGINEERING

* Check for appropriate status in the case management system.

* Documentation of the action to be taken will be made in the case note.

* Complete referral procedures for Access and Accommodations for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B)

* Counselor meets with individual to discuss findings of assistive technology/ rehabilitation engineering evaluation in accordance with informed choice and with similar benefits.

* Refer to ARS Vendor List or secure W-9 from new vendor.

* Key required information into the case management system for ARS Purchase Authorization.

* Verify that the individual received the device/service and is able to use the device/service. Document in ECF.

* Invoices for assistive technology/rehabilitation engineering services must be itemized. Each line item must correspond to the device or service authorized for the individual in his or her Access and Accommodations evaluation. Non-itemized or bundled invoices will be rejected and returned to the vendor.

* Each line item on the invoice must correspond to an appropriate billing code from the HCPCS. ARS may request further documentation to support a given billing code, and reserves the right to refuse payment if the vendor cannot provide the documentation requested.

* ARS will issue payment for assistive technology/rehabilitation engineering services according to the price indicated in the Blue Cross Blue Shield fee schedule (current as of the date of the invoice) for a given HCPCS line item. ARS will pay 80% of the price indicated in the Blue Cross Blue Shield fee schedule for a given HCPCS line item.

* For individuals with insurance coverage for assistive technology/rehabilitation engineering services, ARS will issue payment after that coverage has been applied. In no event will ARS pay an amount greater than 80% of the price indicated in the Blue Cross Blue Shield fee schedule for a given HCPCS line item.

* Refer to Out of State Policy limitations, if necessary.

PROSTHETICS AND ORTHOTIC DEVICES

Prosthetics are artificial appliances 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 of 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 which the basic examination report indicated no pathological change, this report may be sufficient medical basis for rendering their service.

All new or initial wearers and individuals who have had difficulty wearing a limb may be referred to the Access and Accommodations 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:

The following paragraphs define the basic criteria:

Significant Physical or Mental Impairment means a physical or mental condition that seriously limits one or more functional capacities (mobility, communication, self-care, self-direction, interpersonal skills, work tolerance or work skills) in terms of ability to function independently in family or community or to engage or continue in employment.

Substantial Impediment to Function Independently means an individual's ability to live an independent life is significantly restricted, there is a loss of independence, or an individual needs special help to be independent and that services provided will reduce or correct the resulting functional limitations of the disability, overcome the obstacles to independence and/or will significantly assist the individual to improve his/her ability to function independently in family or community or to engage or continue in employment and maintain independent functioning.

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. In all cases, comparable benefits must be considered. If assistive technology is needed, referral to Access and Accommodations is required for consideration of comparable benefits. (Refer to Appendix B). Note for hearing aids and related services: Title XX SSBG must be considered as the priority funding source if available.

CERTIFICATION OF ELIGIBILITY/INELIGIBILITY

The counselor is required to complete the ILRS Certificate of Eligibility/lneligibility for services in the individuals ECF. The certificate shall contain the individual's name; eligibility date, and signature of the counselor. The counselor shall complete a case note. The certificate must be completed simultaneously with, an individual's acceptance for services. (See Forms Appendix E)

INELIGIBILITY

When it has been determined that an individual is ineligible for ILR services, the counselor is required to initiate a Certificate of Eligibility/lneligibility to close the ECF. 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. 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 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 ILRS plan must contain:

The services, service providers, and all activities selected by the individual must be necessary to meet the ILRS goal. The individual or representative must sign and date the ILRS plan. The individual or representative must be given a copy of the ILRS individualized plan. The counselor is the approving authority; therefore, the counselor's signature indicates approval of the ILRS individualized plan.

PROCEDURES - ILRS INDIVIDUALIZED PLAN

* The counselor will inform the individual of the options available for development of an Individualized Living Rehabilitation Services Plan.

* The counselor will inform the individual of the required components of the ILRS Plan.

* The case management system will generate the status move after required data is keyed for status 72(ILS).

* Document the counseling provided at ILRS Plan development in the case note.

TERMINATION OF SERVICES UNDER AN ILRS INDIVIDUALIZED PLAN

When it has been determined that an individual cannot meet the projected goals, the counselor is required to initiate an Amendment to the ILRS Plan. The reasons for initiating an amendment are:

The decision to close the case should be made only with the full participation of the individual, or, as appropriate, the parents, guardian, or other representative, unless the individual is no longer in the State, his/her whereabouts are unknown, or deceased. The individual or representative's participation in the decision shall be recorded in the ILRS Plan. The rationale will be recorded on an Amendment to the ILRS Plan certifying that the provision of ILR services has demonstrated that the individual is not capable of functioning more independently in family or community. The date of annual review will also be recorded on the Amendment.

RE-OPENING A CASE

A person with a significant disability may re-apply for ILR services at any time after 30 days of closure. In such a situation, the counselor must process the case in a manner similar to an individual applying for the first time. Every effort should be made to review and arrive at a decision on the basis of the present rather than previous conditions.

REVIEW OF INELIGIBILITY DECISION

Review within 12 months and annually thereafter if requested by the individual or, if appropriate, by the individual's representative any ineligibility determination that is based on a finding that the individual is incapable of achieving an employment outcome. This review need not be conducted in situations in which the individual has refused it, the individual is no longer present in the State, the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal.

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. If an Administrative Exception is granted the following procedures are to be used.

MODIFICATION FOR MOTOR VEHICLES

Purchase and installation of special equipment and/or vehicle modification may be provided to enable the individual to drive their vehicle, or to enable an immediate family member or a designated attendant to provide the individual transportation, if:

The counselor will follow the State Purchasing guidelines. ARS will purchase one van lift and/or van modification per individual regardless of the times a case is reopened. ARS retains title to special equipment until the case is closed. It is the individual and/or family's responsibility to repair the lift and other adaptive equipment after warranty expiration. Driver's training is available at ACTI or ARS may purchase driver training from an approved instructor or agency.

PROCEDURES - MODIFICATION FOR MOTOR VEHICLES

* This service cannot be planned on the ILRS plan or Amendment until an assistive technology evaluation has been performed.

* Documentation of the action to be taken will be made in the case note.

* Complete referral procedures to the Access and Accommodation program for an evaluation/assessment.

* Secure the Access and Accommodation evaluation/assessment recommendation.

* Counselor will meet with individual to discuss findings of assistive technology evaluation in accordance with informed choice and with similar benefits.

* The counselor will follow the State Purchasing guidelines. (See Section VI, Services)

* Refer to ARS Vendor List or secure W-9 from new vendor.

* The case management system will generate the status move after required data is keyed for appropriate Status.

* Key required information into the case management system for ARS Purchased Authorization.

* When device/service is received, verify the individual received device/service and can use device. Individual will sign the Receipt/Release for Equipment and Title Agreement Instructions (See Appendix E-81). Document in ECF.

* When billing statement is received, key required information into the case management system for payment. Support staff will be responsible for making payments. Payment will not be processed without an attached bill from the vendor.

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 attached to the ECF. If the card is not signed by the client, the case cannot be closed "26."

* Complete VR Case and Closure/Amendment Information Form (See Forms Appendix E).

* The VR Case and Closure/Amendment Information Form will be generated in the case file and a copy will be given to the individual.

* If the individual received services at ACTI, the VR Case and Closure/Amendment Information Form will be available through the case management system for the Center Counselor's review.

* The case management system will generate the status move after required data is keyed for Status 26.

* The individual will complete the Consumer Satisfaction Survey form. This form can be given to the individual, mailed emailed 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 VR Case and Closure/Amendment Information Form (See Forms Appendix E).

* The VR Case and Closure/Amendment Information Form will be generated in the case file and a copy will be given to the individual.

* If appropriate, the individual will be referred to other agencies, programs, WIOA One Stop Partners.

* The case management system will generate the status move after required data is keyed for Status 28.

* The individual will complete the Consumer Satisfaction Survey form. This form can be given to the individual, mailed, emailed 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 VR Case and Closure/Amendment Information Form (See Forms Appendix E).

* The VR Case and Closure/Amendment Information Form will be generated in the case file and a copy will be given to the individual.

* The individual will be referred to other agencies, programs, or WIOA One Stop Partners.

* The case management system will generate the status move after required data is keyed 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 must be documented in the ECF. If a need for post-employment services is determined several weeks after the 26 Closure, an IPE amendment 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 to be identified after the 26 Closure, and documented in the ECF (See Forms Appendix E). Reopen the case directly into Status 32 by keying in the Social Security Number.

* The VR Case and Closure/Amendment Information Form will be generated in the case file and a copy will be given to the individual.

* A case note 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. The counselor will work with the individual to achieve a satisfactory level where post-employment support is no longer necessary. It also requires the counselor's professional judgment as to the individual's employment stability.

In making these decisions, the following factors should be considered:

PROCEDURES - CLOSED FROM POST-EMPLOYMENT (Status 34)

* Pay or cancel any outstanding encumbrances.

* The counselor must document in the case notes the reason for closure and result of post-employment services.

* The case management system will generate the status move after required data is keyed for Status 34.

CLOSED FROM POST-EMPLOYMENT TO BE REOPENED (Status 36)

The counselor will close an individual's case in Status 36 when the counselor determines to reopen the individual's record of services to provide necessary VR services.

PROCEDURES - CLOSED FROM POST-EMPLOYMENT TO BE REOPENED (Status 36)

* Pay or cancel any outstanding encumbrances.

* The counselor must document in the case notes the reason for closure.

* The case management system will generate the status move after required data is keyed for Status 36.

* Initiate a new Application (RS-4) and follow procedures for a new referral.

CLOSED FROM SERVICE DELAYED/ORDER OF SELECTION (Status 38)

This status is used to identify individuals eligible for VR who will not advance to Status 12 and whose names are being removed from the Service Delayed/Order of Selection list (Status 04).

PROCEDURES - CLOSED FROM SERVICE DELAYED/ORDER OF SELECTION (Status 38)

* Pay or cancel any outstanding encumbrances.

* The counselor must document in the case notes the reason for closure.

* The case management system will generate the status move after required data is keyed for Status 38.

CLOSED FROM POST-EMPLOYMENT (Status 39)

An individual will be closed from post-employment when the individual cannot maintain employment.

PROCEDURES - CLOSED FROM POST-EMPLOYMENT (Status 39)

* Pay or cancel any outstanding encumbrances.

* The counselor must document in the case narrative the reason for closure.

* The case management system will generate the status move after required data is keyed for Status 39.

CASELOAD MANAGEMENT

Thereafter, the counselor is accountable for the case management system each time there is a status change.

CASE STATUS CLASSIFICATIONS

Referral Status

00 Referral

Application Status

02 Applicant

Trial Work Experience

06 Evaluation Status

Closures from Referral (00)/Applicant (02)

08 Closed before, during, or after Evaluation

Closures from Trial Work Experience

08 Closed after Evaluation

ACTIVE STATUSES

Pre-Service Statuses

04 Service Delayed/Order of Selection

10 Certificate of Eligibility/lneligibility Completed

12 IPE Completed

Service Statuses

18 Receiving Service Status

Counseling and Guidance

Physical Restoration

Training, etc.

20 Ready for Employment

22 In Employment

24 Service Interrupted

Closures from Active Status

26 Closed Rehabilitated (After 90 days in Status 22)

28 Closed Not Rehabilitated AFTER IPE initiated (Status 18 through 24)

30 Closed Not Rehabilitated BEFORE IPE initiated (Status 10 through 12)

32 Post-Employment

38 Closed from Service Delayed /Order of Selection (closed from 04)

CLOSURES FROM POST-EMPLOYMENT SERVICES

34 Employment Maintained

36 Placed back in 02

39 Other

RSA designed the VR Caseload Status System to aid the tracking of individuals as they progress through the service system. Because RSA uses a closed-case reporting system, only those status codes specifying the point in the VR process where the counselor closed an individual's case would apply (closure codes 08, 26, 28, 30 and 38).

STATUS 00 - REFERRAL

Status 00 represents an individual who has been referred to VR with minimum information provided to the counselor. The individual has not made a request for services, but the counselor must place the individual in Status 00 if sufficient demographic information is available. Sufficient demographic information is name, SSN, address, and referral source.

STATUS 02 - APPLICANT

Status 02 represents an individual's entrance into the VR process. When an individual signs a document requesting VR services, the counselor must place the individual into Status 02. At that point, the individual is considered an applicant after completing an Agency application form. However, the counselor may place an individual into Status 02 if the individual requests services with a signed letter and minimum basic referral information.

The counselor must place every case in Status 02 before authorizing diagnostic service(s). While the individual is in Status 02, the counselor investigates and secures sufficient information to determine eligibility for VR services or a decision to use Trial Work Experience. An individual can only remain in Status 02 for 60 days unless the counselor and applicant agree to a specific extension of time. If needed, under the Heading of 60-Day Extension in the case note, record the dates of the Extension and the specific reasons for the need for an extension of time to determine eligibility.

Example (60-Day Extension): This client will be placed in status 02 for an additional 30 days April 1-30 due to the fact that more testing and medical records re needed in order to determine eligibility.

STATUS 04 - SERVICE DELAYED/ORDER OF SELECTION

If under, the Order of Selection the counselor moves an applicant into Status 04 when the Preliminary Assessment justifies writing a Certificate of Eligibility/lneligibility. However, the individual cannot receive services because the individual does not meet the Order of Selection priorities. Status 04 identifies the individuals who are on a waiting list for services until such time as the Agency has sufficient funds available to provide services. Placement of the individual's name on the waiting list for services indicates there will be a delay in the initiation of services for which the individual is otherwise entitled to receive. An individual leaving this status will be moved to Status 12 to signify that services will be provided without further delay or will be closed status 38 at end of fiscal year.

STATUS 06 - TRIAL WORK EXPERIENCE

When the individual's eligibility for VR services cannot be readily certified, the counselor moves the individual into Status 06. The counselor may provide services to the individual to determine there is clear and convincing evidence that the individual can benefit from the provision of vocational rehabilitation services in terms of an employment outcome or there is clear and convincing evidence that the individual is incapable of benefiting from vocational rehabilitation services due to the severity of disability.

The case management system will only allow 18 months in Status 06.

STATUS 08 - CLOSED FROM EVALUATION

Status 08 identifies all individuals not accepted for VR services whether closed from referral Status (00) applicant Status (02) or Trial Work Experience.

STATUS 10 - CERTIFICATION OF ELIGIBILITY/INELIGIBILITY

The counselor moves an applicant into Status 10 when the Preliminary Assessment justifies writing a Certificate of Eligibility/lneligibility.

STATUS 12 - INDIVIDUALIZED PLAN FOR EMPLOYMENT

After the counselor completes the comprehensive assessment and the counselor and individual or representative agree on an IPE, the individual is moved into Status 12.

STATUS 18 - RECEIVING SERVICE STATUS

Status 18 is used when the individual begins receiving services.

Counseling and Guidance

The counselor moves an individual in status 18 after completing an IPE, which outlines counseling and guidance services are necessary to prepare the individual for employment.

The service is necessary to prepare the individual for employment, or a breakdown has occurred in the progress of the case after other services have been initiated and the counselor has determined that substantial counseling and guidance are essential to successful rehabilitation.

Physical And/Or Mental Restoration

The counselor moves an individual into Status 18 when the individual receives physical and/or mental restoration services as the primary service. Restoration services include medical, surgical, psychiatric, or therapeutic treatment, the fitting of prosthetic appliances, hospitalization, convalescent care or nursing services.

Training

The counselor moves an individual into Status 18 when training services are 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:

STATUS 20 - READY FOR EMPLOYMENT

Status 20 is used when VR services have prepared the individual for gainful employment and the individual is ready to begin placement activities or the individual has been placed but has not yet begun employment.

STATUS 22 - EMPLOYED

Status 22 is used when the individual begins employment. To ensure adequacy of employment in accordance with the individual's unique strengths, resources, priorities, concerns, abilities, capabilities, interest, and informed choice, the individual must remain employed in Status 22 for a minimum of 90 days before the counselor can close the individual's case as achieving an employment outcome. (Status 26)

STATUS 24 - SERVICES INTERRUPTED

Status 24 is used when VR services are interrupted while in Status 18, 20, or 22. The individual will remain in Status 24 until the individual is able to return to one of the above-mentioned statuses or the individual's case is closed in Status 28.

STATUS 26 - CLOSED REHABILITATED

Status 26 is used when the individual has achieved a suitable employment outcome described in the individual's IPE and has been maintained for a minimum of 90 days in Status 22. An individual will not be closed in Status 26 more than once in any Federal fiscal year.

STATUS 28 - CLOSED NOT REHABILITATED AFTER IPE INITIATED

Status 28 is used to close an individual's case from Statuses 18 through 24 when it has been determined the individual does not meet the criteria for Status 26 closure.

STATUS 30 - CLOSED NOT REHABILITATED BEFORE IPE INITIATED

Status 30 is used to close a case from either Status 10 or 12.

STATUS 32 - POST-EMPLOYMENT SERVICE

Status 32 is used when the need for post-employment services has been identified and planned to maintain the individual in employment. The purpose of this status is to avoid the necessity of reopening a case in order to provide a relatively minor service.

Post-employment services are expected to be of a one-time nature and not provided in excess of 18 months. Cases in Status 32 cannot be transferred.

STATUS 34 - CLOSED FROM POST-EMPLOYMENT

Status 34 is used to close an individual's case when the individual maintains employment through the completion of planned services provided in Status 32.

STATUS 36 - CLOSED FROM POST-EMPLOYMENT TO BE REOPENED

Status 36 is used to close an individual's case from post-employment when the counselor determines the need to reopen the individual's case to provide necessary VR services. The case will be reopened in Status 02.

STATUS 38 - CLOSED FROM SERVICE DELAYED/ORDER OF SELECTION

Status 38 is used to identify individuals eligible for VR who will not advance to the Statuses (12 to 24) and whose names are being removed from the Service Delayed/Order of Selection list (Status 04).

STATUS 39 - CLOSED FROM POST-EMPLOYMENT/OTHER REASONS

Status 39 is used to close an individual for any other reason for termination from post-employment services.

TRANSFER OF CASES

Cases Transferred will retain their status and the date of the transfer.

PROCEDURES - CASES TRANSFERRED OUT

* A transfer will be made when an individual on a counselor's caseload either permanently moves or request another counselor's within or out of that_counselor's district.

* The client should contact the current counselor to initiate the case transfer.

* The transferring counselor prior to the transfer will discuss the case with the receiving counselor as well as notifying the Managers; to ensure that case information is current and prepared for transfer. Both counselors, Managers and client should be in agreement before the case is transferred.

* Discuss the transfer with the client, providing in writing the receiving counselor's name, field office's address and phone number.

* Status 22 cases will be transferred ONLY if the counselor believes this would be in the individual's best interest.

* Transfers will not be made during the same month the case is accepted and/or the IPE is completed and/or services are initiated.

* Contact the appropriate case management administrator to transfer ECF in the case management system.

* Document in case note under "TRANSFER OUT", a case summary for transfer.

PROCEDURES - CASES TRANSFERRED IN

* After the case has been transferred in the case management system, the receiving counselor will meet with the individual.

* Document in the case note, under "TRANSFER IN," a case summary for transfer.

CASES TRANSFERRED IN FROM OTHER STATE REHABILITATION AGENCIES

Cases cannot be transferred from other State Rehabilitation Agencies. Individuals moving from another state and requesting services from ARS will be treated the same as a new referral.

OPENING CLOSED CASES

If an individual, whose case has been closed, requests services the counselor will follow the same procedures for new applicants (02). Counselors cannot reopen cases for 30 days after closure.

Exception: When necessary to reopen a case before the 30 days from the closure date the counselor will submit a memorandum to the Chief of Field Services through the Manager requesting the closure to be voided. The Chief of Field Services will notify the counselor through the District Manager that the closure has been voided so the necessary services can be provided.

ANNUAL REVIEW OF CLOSED CASES - INELIGIBLE

Refer to Closure, Section VIII.

* Internal memos and policy requests

* Small Business referral information

* Employment Services/Job Placement referral forms

Progress Reports

* ACTI vocational training monthly report forms

* Training progress reports

* Letters from Trainee forms

* Counseling reports

* PT, OT, ST Reports (ARS/ACTI)

* Social Services Reports

* Supported Employment monthly progress reports forms

* Employment Services/Job Placement closure forms

* CRP monthly progress reports for Work Adjustment and Extended Services

* Responsibilities of College Students

* Documentation of Job Development and Placement Activities

* Job Services-VR Only monthly progress reports forms

Closure

* Certificate of Eligibility/lneligibility

* VR Case and Closure/Amendment Information Form

* Documentation of Registered Letter to Client prior to closure

Case Review

* Case Reviews

* Peer Reviews

* Statewide Case Reviews

* RSA Reviews

* Periodic Onsite Quality Assurance Team Reviews

Items listed under Case Review may not be included in every case. This is not a comprehensive list.

RECORD RETENTION

With the exception of certain files in Status 00, ARS will retain all records of services for a period of seven (7) years. See 34 C.F.R. § 80.42; Ark. Code Ann. § 25-18-601 and current Arkansas Record Retention Schedule. The seven-year retention period will commence upon case closure, defined as files assigned Statuses 08, 26, 28, 30,34, 36, 38 39, 73, and 74. Files associated with closed cases will be destroyed after the seven-year period. Files in Status 00 (new referrals) may be destroyed if the case does not progress beyond the referral stage by the end of 180 days from the time the file was opened.

RELEASE TO THE CLIENT OR THE CLIENT'S REPRESENTATIVE

If requested in writing by a client or a client's representative, ARS will generally make all personal information in that client's record of services directly accessible to the client or the client's representative. Medical, psychological, or other information that ARS determines may be harmful to the client must be provided to a third party of the client's choosing, unless the client has a court-appointed representative, in which case ARS will release the potentially harmful information only to the court-appointed representative. If ARS obtains personal information from another agency or organization, release of that information will be governed by conditions for release that the other agency or organization has established.

RELEASE FOR PURPOSES OF AUDIT, EVALUATION, OR RESEARCH

ARS may release personal information to an organization, agency, or individual engaged in audit, evaluation, or research, but only for purposes directly connected with administration of ARS's vocational rehabilitation program, or in order to significantly improve quality of life for ARS clients. Before release of personal information under this section, the organization, agency, or individual must:

* Sign a written confidentiality agreement;

* Assure ARS that the information will be used only for the purposes for which it is provided;

* Assure ARS that the information will be released only to persons officially connected with the audit, evaluation, or research;

* Assure ARS that the information will not be released to the involved client;

* Assure ARS that the information will be managed in a manner to safeguard confidentiality; and

* Assure ARS that the final product will not reveal any personal identifying information without the informed written consent of the involved individual or the individual's representative.

RELEASE TO OTHER PROGRAMS OR AUTHORITIES

If requested in writing by the client or the client's representative, and supported by a written agreement between ARS and the third party agency, ARS may release personal information to another agency or organization. Information released to a third party agency must be used for that agency's program purposes and necessary for those purposes, and may only be released to the extent the information could have been disclosed to the client or the client's representative. Medical or psychological information that ARS determines may be harmful to the client may be released if the other agency or organization provides assurances that the information will be used only for the purpose for which it is being provided, and will not be further released to the individual. However, ARS must release personal information if required by federal law or regulations. ARS may also release personal information to a third party agency in order to protect the client or others, if the client poses a threat to his or her safety or to the safety of others.

STEP 1 - DETERMINATION OF COUNSELOR

Whenever a determination is made by ARS that affects the provision of vocational rehabilitation services, the applicant/client can request a review of that determination. See generally 34 C.F.R. § 361.57; Ark. Code Ann. § 20-79-215. The applicant/client can make this request verbally or in writing, but must do so within thirty (30) days of the determination to initiate Due Process. It is the responsibility of ARS staff to immediately notify the appropriate District Manager if staff have a reasonable belief that an applicant/client seeks review of a determination. If a verbal request is received, ARS staff will ensure the correct form is completed, which may require assisting the applicant or client with the form. However it is completed, the form ("Request for Administrative Review") must include both the date of the determination in question, and the date of the request for review.

The counselor will advise the applicant/client of the Client Assistance Program. All forms documenting a request for review will immediately be given to the District Manager. If the issue cannot be resolved between the client/applicant and the counselor, the District Manager will follow the procedures in Step 2.

STEP 2 - ADMINISTRATIVE REVIEW

The District Manager/ACTI Director will hold an Administrative Review within ten (10) calendar days of the applicant/client's request for review of the counselor's determination. Subject to the ten-day limitation, the Administrative Review will be scheduled at a date, time and place convenient to the applicant/client, during business hours at the local ARS field office. If possible, the date and time will be agreed upon by the applicant/client and the ARS supervisory staff member conducting the review. The supervisory staff conducting the review must have no previous knowledge of the details of the determination in question; must conduct the administrative review in an unbiased way; and must have a broad working knowledge of ARS policies and procedures and the State Plan for VR services. If the applicant/client fails to appear for the Administrative Review or is more than 30 minutes late, the matter may be dismissed at the discretion of the supervisory staff. An Administrative Review may be rescheduled if the applicant/client notifies ARS staff that they are no longer available. Rescheduling an Administrative Review in this manner does not extend the sixty (60) day time-period for completion of an Impartial Hearing, unless the parties agree otherwise.

The applicant/client will receive a written decision from the supervisory staff member within five (5) business days following completion of the Administrative Review.

STEP 3 - MEDIATION (OPTIONAL)

Mediation is available to the applicant/client before an impartial hearing is requested. Mediation is not used to deny or delay the right of an individual to a hearing, or to deny any other right afforded by law or ARS Policy.

Mediation is a voluntary process that allows the parties to resolve disputes regarding the provision of vocational rehabilitation services. Mediation is informal, non-adversarial, and the parties may present whatever evidence they wish in support of their position, in a neutral setting. The mediation process relies on the good faith-efforts of the participants to reach their own agreement as to how the dispute should be resolved.

Although mediation does not involve fact-finding or the strict weighing of evidence, mediation participants should be prepared to describe the factual background behind the dispute and to discuss their desired outcome. Discussions that occur during the mediation process are confidential, and may not be used as evidence in any subsequent hearing or civil proceedings. The parties will be required to sign a confidentiality statement prior to commencement of the mediation.

MEDIATION PROCEDURES

ARS will notify applicants, clients, or their representatives in writing of the opportunity for mediation when:

Mediation is voluntary for both parties. At any time during the mediation process, either party or the mediator may elect to terminate the mediation. If mediation is terminated, either party may continue to an impartial hearing. However, terminating a mediation does not extend the sixty (60) day time-period for completion of an Impartial Hearing, unless the parties agree otherwise.

REQUEST FOR MEDIATION

The supervisory staff member who conducted the Administrative Review will provide the applicant/client with an "Information on Mediation" handout when the staff member renders the written, administrative decision. If interested in mediation, the applicant/client will complete and submit the "Request for Mediation" form to the District Manager. The District Manager will submit the Request for Mediation to the Chief of Field Services or designated deputy. The Chief of Field Services or designated deputy will review the relevant documentation and determine, within five (5) business days of receiving the Request for Mediation, whether ARS consents to mediation. If ARS does not consent to mediation, a certified letter will be sent to the applicant/client informing them of their right to request an impartial hearing.

If ARS consents to mediation, the agency's Program Planning Development & Evaluation (PPD&E) Section will coordinate the mediation session and inform the applicant/client of their Due Process rights. The PPD&E Section is responsible for all Mediation forms after a request is received. As expeditiously as possible (and keeping in mind the 60-day deadline to complete any impartial hearing) PPD&E staff will communicate with the applicant/client, ARS staff, and mediator to establish the date, place, time, and participants for the mediation. The PPD&E staff completes the "Mediation Scheduling" and "Agreement to Mediate" forms.

MEDIATION WITHDRAWAL

An applicant/client may withdraw from the mediation process at any time by completing the "Cancellation of an Appeal" form.

SELECTION AND ROLE OF MEDIATOR

The mediation will be conducted by a qualified and impartial mediator, as defined in 34 C.F.R. § 361.5(b)(43). The mediator will be selected from a list of qualified and impartial mediators maintained by the State of Arkansas. Selection will be by agreement between ARS and the applicant/client, or their representative; on a random basis; or by a procedure established by the State of Arkansas for assigning qualified, impartial mediators.

PPD&E staff will present no more than five names of mediators and their qualifications to the applicant/client. The applicant/client, or their representative, may choose the mediator from those names. If the applicant or client does not have a preference, the mediator will be randomly selected from the entire list of qualified and impartial mediators. In mediation, decision-making authority rests with the parties agreeing to mediate. The role of the mediator includes but is not limited to: assisting the parties to identifying issues, facilitating communication, focusing the parties on their interests, maximizing the exploration of alternatives, and helping the parties reach voluntary agreements. The mediator may offer options for the parties to consider as to settlement terms, but will not impose settlement terms on the parties.

MEDIATION DAY - REACHING AN AGREEMENT

The mediator will introduce him or herself and the parties involved; discuss the mediator's neutrality in the process; and confirm the confidentiality of the proceedings. Generally, the mediation will proceed as follows:

All parties must have a clear understanding of what each will do in carrying out the agreement. The mediator will compose the agreement and ask the parties to sign a "Final Mediation Agreement Form" before leaving the mediation. The agreement will be implemented as soon as possible, and copies will be provided to all parties. Although information exchanged at the mediation is confidential, ARS staff may enter the mediation agreement and supporting documents in the applicant/client's case file, which is itself subject to confidentiality protections. After the agreement is reached, PPD&E will send the "ARS Mediation Feedback Survey" form to the applicant/client, their representative, ARS staff involved, and the mediator. The parties' signed Final Mediation Agreement Form ends the Due Process steps and resolves the determination under review.

NO AGREEMENT REACHED

If mediation does not result in a final agreement between the parties, the applicant or client may request an Impartial Hearing by submitting a "Request for an Impartial Hearing" form within five (5) calendar days of the completion of the mediation

STEP 4 - IMPARTIAL HEARING

Each applicant/client has the right to a review, through an impartial hearing, of determinations made by ARS personnel that affect the provision of vocational rehabilitation services to applicants/clients. The Impartial Hearing will be completed no later than sixty (60) calendar days from the date of initial request for review, unless the parties agree to an extension of time.

The Impartial Hearing will be conducted by an Impartial Hearing Officer (IHO). The PPD&E Section will maintain a list of qualified impartial hearing officers, who are knowledgeable in laws and regulations relating to the provision of vocational rehabilitation services. The individuals on this list will be identified jointly by the ARS Commissioner and the State Rehabilitation Council. The individuals will not be employees of a public agency or members of the State Rehabilitation Council. The IHO will be selected on a random basis from the list of qualified impartial hearing officers.

IMPARTIAL HEARING PROCEDURES

An applicant/client or their representative may request the impartial hearing by submitting a "Request for Impartial Hearing" form. The form must be submitted to the PPD&E Section no later than five calendar (5) days after the administrative review decision is issued or the mediation is completed. The applicant/client may seek an extension of time to submit the Request for Impartial Hearing, by notifying ARS of the reason for the extension within five (5) calendar days of the administrative review decision/completion of mediation. The ARS Commissioner will determine whether to grant the request.

When the ARS Commissioner receives a request for an impartial hearing, the PPD&E Section will gather information from the applicant/client's ECF.

The ECF will contain a memorandum summarizing the basis for the administrative review decision. It will also contain a statement of issues and a summary of all facts supporting the administrative review decision. The memorandum will be sent to the applicant/client, to the appropriate ARS Staff member, and to the PPD&E Section.

The counselor shall notify applicants/clients in writing that they or their representatives have the right to review the client's ECF at the local ARS field office.

IMPARTIAL HEARING WITHDRAWAL

An applicant/client may withdraw from the Hearing Process at any time by completing a "Cancellation of an Appeal" Form.

REQUEST FOR WITNESSES

The applicant/client and/or their representative will be advised via certified mail, return receipt requested, that he/she has ten (10) days from the date of signature on the certified return receipt to request witnesses from ARS, or to notify ARS of the witnesses the applicant/client will call. The request or notice must be given in writing. Also within ten (10) days of the signature on the certified return receipt, ARS must notify the applicant/client, in writing, of any witnesses ARS will call at the hearing.

SCHEDULING THE HEARING

The PPD&E Section will coordinate with the applicant/client, ARS staff and the Impartial Hearing Officer to schedule of the hearing. PPD&E shall issue a letter advising the applicant/client of the time, date, place of hearing, and the name of the IHO who will conduct the hearing.

The hearing will normally be held in the local ARS field office. It may be held in another location if requested by either party and approved by the Commissioner.

RESCHEDULING AND NON-ATTENDANCE

A request for rescheduling by either ARS staff or the applicant/client prior to the date of the hearing must submitted to the ARS Commissioner, who will determine if good cause exists to grant such a request. A hearing may also be rescheduled (and the 60-day deadline for completing the hearing extended) by mutual agreement. If the applicant/client fails to appear for the hearing, and does not provide notice prior to the date of the hearing, the matter may be dismissed at the discretion of the IHO. If an emergency arises, the applicant/client must justify in writing his/her reasons for nonappearance. The IHO will review the emergency justification and decide whether to dismiss the matter or reschedule the hearing.

ARS RESPONSIBILITIES

The appropriate ARS staff will present the agency's case. This staff usually includes the counselor, the District Manager, and legal counsel representing the agency. ARS may request representation by the Arkansas Attorney General's Office. ARS may offer witnesses and documentary evidence. The applicant/client and their representative will be given an opportunity to object and cross-examine as needed, subject to the rulings of the IHO. ARS likewise will have the opportunity, subject to the rulings of the IHO, to object and cross-examine.

CONFIDENTIALITY REQUIREMENTS

In light of laws protecting the disclosure of information related to vocational rehabilitation applicants/clients, the Impartial Hearing will be closed. See 34 C.F.R. § 361.38; Ark. Code Ann. § 20-79-216. To ensure the confidentiality of the hearing, before taking testimony or evidence the IHO will inquire if there is anyone present with whom the applicant/client is not familiar. Should the applicant/client answer in the affirmative, the person in question will identify him or herself and state the reason for attending the hearing.

Should the applicant/client object to the person's attendance at the hearing, the IHO will decide whether the person may remain. A ruling that the person may remain at the hearing will not prejudice a later objection, by either party, as to the relevance of the person's testimony.

CONDUCT OF THE HEARING

The hearing will be conducted by the IHO. The IHO's responsibility is to maintain a professional atmosphere and to ensure the proceedings are conducted in a fair and impartial manner. The IHO will explain hearing procedures and swear in witnesses. The IHO shall allow both parties the opportunity to be heard and to present their evidence and testimony. The applicant/client may have an attorney or representative present testimony on their behalf. The applicant/client may have an interpreter or personal-care attendant present, subject to the three-business-day notice requirement discussed in the "Notification of Rights" section, above.

The IHO will make an opening statement at the outset of the hearing. The opening statement will include an introduction of the IHO; assurances of impartiality and confidentiality; a brief description of the IHO's role and authority with respect to the hearing; and a summary of the determination under review. The IHO can pose questions at any time during the proceedings. Questioning of all parties will be confined to the issue(s) involved. The IHO is to ensure only relevant information is permitted at the hearing. Arkansas Rules of Evidence will serve as general guidance as to the admissibility of evidence. The IHO shall not fraternize with either party prior to or during the hearing. The IHO is restricted from communicating with either party-privately. The IHO may need to explain that all facts are to be heard by both parties to assure impartiality. The IHO should provide for reasonable recesses in lengthy hearings.

PARTIES' OPENING STATEMENTS

Both parties will state their names, whom they represent, and their addresses. The applicant/client's opening statement will be a summary of his/her reasons for requesting a hearing and the issues related to the underlying determination. The ARS opening statement will be a summary of the applicant/clients rehabilitation case and the reasons for the determination under review.

QUESTIONS THAT MIGHT BE DIRECTED TO ARS

IHO'S DECISION

The IHO will prepare a report and decision based on a comprehensive review of the information presented at the hearing, as well as provisions of the approved State plan; the Rehabilitation Act and federal vocational rehabilitation regulations; and State regulations and policies that are consistent with Federal requirements. The report will consist of an Introduction, Findings of Fact, Conclusions of Law, and Decision. The IHO's written report must be provided to the applicant/client and ARS within thirty (30) calendar days of the completion of the hearing. The decision stated in the IHO's report will be final, except that any party to the hearing may bring a civil action as described under Step 5, below.

STEP 5 - AVAILABILITY OF CIVIL ACTION

Any party who disagrees with the findings and decision of the IHO has a right to bring a civil action with respect to the determination under review. The action may be brought in any district court of the United States without regard to the amount in controversy, or in any State court of competent jurisdiction.

APPENDIX A

SELF-EMPLOYMENT/SMALL BUSINESS PROGRAM

The ARS Self-Employment/Small Business Program is designed to assist clients to achieve an employment outcome through self-employment or small business operation.

Purpose

The role of ARS is to provide technical assistance and other consultation services to review market analysis, assist in developing business plans and otherwise provide resources that are authorized to be provided through the statewide workforce centers and their partners. ARS will assist the client in making informed decisions, to reduce or eliminate barriers created by disabilities with training in self-employment/small business development and operations and to identify possible funding sources that may assist the business. The role of ARS is not to act as the primary funding source for self-employment or small business endeavors. ARS may participate in partially funding small business start-up fees or assistance for retention of an existing business as approved by ARS.

ARS values self-employment as a viable vocational outcome. Self-employment is available within the repertoire of vocational options and may be considered by clients and their VR counselors as they work toward the development of an appropriate vocational goal. There may be a need for VR services prior to a commitment from ARS on a self-employment plan. If appropriate, ARS can assist the client by providing services, such as training needed for certain skills, or business knowledge before the decision is made by the client and their counselor to pursue the development of a business plan. Through initial exploration of personal and business feasibility assessment, the client and their counselor will be equipped to make an informed decision about self-employment as a vocational goal.

Individuals that are successful in becoming self-employed or operating a small business demonstrate a wide array of skills and abilities including, but not limited to, business organization, financial management, business marketing and/or other talents, as well as, knowledge and expertise regarding the goods or services being produced or provided. Such individuals are well aware of the potential risks involved when being self-employed or operating a small business and attempt to minimize such risks to the greatest extent possible.

The Self-Employment/Small Business Consultant

The counselor will refer the client to the Consultant in those situations where self-employment or small business operation is being considered by the client and their counselor as a possible employment outcome. This referral will occur prior to the approved development of the vocational goal or an amendment of the IPE to include self-employment as a service. The Consultant will be responsible for completing a report as it relates to being self-employed or operating a small business and an evaluation of the feasibility of the business endeavor.

The role of the Consultant includes but is not limited to providing assistance to the client as follows:

* Businesses organized as Sole Proprietorships, Corporations, General and

* Limited Partnerships, and Limited Liability Companies, as noted in Definitions-Forms of Organization.

Role of Counselor:

When working with clients expressing an interest in self-employment, the role of the counselor is to:

* The client has been found eligible as a client of ARS and received a positive assessment from RIDAC as capable of running a small business (see Small Business workflow).

* Provide relevant information regarding the availability of services supported by the agency.

* Assess the client's disability as it relates to the vocational goal.

* Review of the client's skills and abilities regarding self-employment or small business operation.

* Reduce or eliminate barriers to self-employment created by the disability.

* Authorize for the provision of external technical assistance including, but not limited to, business feasibility, training, business planning, market analysis and post start-up monitoring.

* Coordinate training and technical assistance services.

* Provide technical assistance as deemed appropriate at post start-up of the business.

* Monitor business development at post start-up.

* Regular follow up with Small Business Consultant to follow timelines prior to development of IPE (see Small Business plan workflow)

Role of the Client:

Exercising informed choice in the rehabilitation process has attendant responsibilities for the client. These responsibilities include, but are not limited to:

* Determining the concept of the business.

* The client will be notified that he/she has found eligible as a client of ARS. Client will need to participate in the assessment process and receive a positive assessment from RIDAC as capable of running a small business (see Small Business workflow).

* Assisting in the identification of existing and potential barriers created by the disability.

* Exploring the feasibility of the business venture by conducting research and gathering information, in collaboration with the technical assistance provider, including:

* develop business plan

* the business concept,

* market feasibility, and

* Financial feasibility

* Client will need to follow timelines for completing business plan before approval/denial

* Researching the availability of financial resources.

* Making application for financial assistance.

* Developing skills and abilities necessary to operate and sustain the business venture.

* Business implementation and management.

* Contributing financially to the capitalization of the business venture by utilizing all available financial resources including personal investment, microloans, commercial and consumer loans, loans from family, forgivable loans, equity grants, and personal property (inventory and equipment) essential to the operation of the business. Providing regular financial and other necessary documentation to the agency for post start-up monitoring.

* Fulfilling participation in the business plan assistance as noted in the Individualized Plan of Employment (IPE).

Training:

Additional Information on Small Business Plan:

Review of Business Plans for Funding Consideration:

The client's goal toward self-sufficiency and the level of the agency's financial participation in the start-up capitalization of the business will determine the level of review and approval required.

Financial Participation Requirements

For those clients pursuing self-sufficiency through self-employment, they will be required to participate in the start-up capitalization of the business through documented investment of funds from personal investment, microloans; commercial and consumer loans; loans from family; forgivable loans; equity grants; equipment; or inventory critical to the business operation.

Exceptions

If the Consultant/Panel determines that there are circumstances in a client's case that warrant consideration for an exception to financial participation policy, a full explanation with justification should be presented to the District Manager for review and decision by the Chief of Field Services and/or ARS Commissioner.

Approval

Final approval will be determined by the Chief of Field Services and/or the ARS Commissioner, as outlined in Financial Participation Requirements above, after positive recommendation of the Self-Employment Panel.

Property Agreements

Plans that include non-real property purchased by the agency must designate that such property will be released to the client at closure.

STAY-AT-WORK/RETURN-TO-WORK(SAW/RTW)

Program Description

SAW/RTW is designed to provide support to employers and employees when an employee experiences an injury or illness that results in disability, inhibiting the employee from remaining at work or returning to work as soon as it is safe and medically feasible. Program staff has the expertise to assist in the areas of: Vocational counseling to assist an employee in the process of adjusting to a disability and the importance of remaining positive as it relates to stay and work/return to work efforts; Specialized vocational assessments that help identify and employee's vocational strengths and weaknesses as it relates to successful job performance; Job site assessment to determine how an employee's presenting disability interferes with task performance with identification of potential modifications to the work environment; Job analysis to identify the specific functions of a job and the mental and/or physical requirements needed for successful job performance; Individualized employee training regarding the correct use of any new technology or equipment introduced to assist in work performance; Staff can also provide general ergonomic assessments and training targeted toward employees in jobs that may present the likelihood of occurrence of injury or illness that leads to disability.

Development of a stay at work/return to work plan that, if required, addresses the need for accommodation in the workplace; with employer assistance, an investigation to determine potential assignments for transitional employment.

Referral and Assessment Process

AGCPD provided scholarships

The AGCPD scholarship program is an activity the commission has elected to undertake. The AGCPD provides educational scholarships specifically for people with disabilities. The amount and number of the scholarships provided are approved by the commission members. These scholarships are funded by private donation, and through fines associated with accessible parking law. Scholarship applications are made available at the beginning of December each year, are due by the end of February, and are awarded every summer. These scholarships are a one-time award and are awarded per the recommendation of the scholarship sub-committee.

Phone: (501) 682-5317| Fax: (501) 296-1883.

ASSISTIVE TECHNOLOGY ALTERNATIVE FINANCING PROGRAM

The Arkansas Assistive Technology Alternative Financing Program (AFP) provides Arkansans with disabilities access to extended-term, below market interest rate loans for the purchase of assistive technology. The AFP is a loan program (not a grant program) provided in partnership by Arkansas Rehabilitation Services (ARS) and the Governor appointed Technology Equipment Revolving Loan Fund (RLF) Committee. The AFP is funded by a one-time federal grant through the US Department of Education's National Institute on Disability and Rehabilitation Research.

To be eligible for the AFP an individual must be an Arkansas resident with a disability and in need of assistive technology. For program purposes, a disability is defined as a physical or mental impairment that substantially limits one or more major life activities. Assistive technology is devices or services that assist people with disabilities to live more independently and productively and to improve quality of life at work, in school, at home, or in recreation or leisure activities.

ARS is the lead agency for the AFP and has the primary responsibilities of policy/procedure and program guidelines development and implementation; marketing; and the initial application review process. ARS has assumed all responsibilities related to review of applications, developing closing documents, closing for loans approved, and servicing loans made. The Governor appointed RLF Committee had and continues the responsibilities of providing program oversight and approving/denying all applications for loans.

Phone: (501) 296-1663| Fax: (501) 296-1655.

APPENDIX C

COMMUNITY REHABILITATION PROGRAMS

ARKANSAS CAREER TRAINING INSTITUTE (ACTI)

MISSION

To assist individuals with disabilities to become employed through the provision of comprehensive rehabilitation services.

SELECTION OF CLIENTS

Residents of Arkansas who make inquiry to ACTI will be referred to a Field Counselor. The Field Counselor will give these referred cases first priority for investigation, as well as all others referred for ACTI services by other sources. This investigation must be sufficient to determine whether the referred case is eligible or ineligible for services.

ACTI will provide services to individuals with disabilities whom it is believed can benefit from ACTI Services directed towards rehabilitation goals.

ADMISSION GUIDELINES

Applications for admission to ACTI will be reviewed in accordance with these guidelines. The responsibility for the administration of these guidelines rests with the ACTI Admissions Coordinator in consultation with various other staff representing the service delivery units of the facility.

GENERAL REFERRAL CONSIDERATIONS

Each request for admission will be evaluated using the following criteria:

In addition, individuals with disabilities regardless of their age who are employed by a 14(c) must be provided career counseling and information by ARS. These individuals also must be provided, by ARS or the CRP, information about self-advocacy, self-determination, and peer mentoring training opportunities available in the individual's geographic area every six months for the first year they are employed, and annually thereafter.

APPENDIX D

DEFINITIONS

Applicant- an individual who submits an application for VR services; has signed an agency application form; or has completed a common intake application form in a One Stop center requesting VR services; or has other wise requested services from VR.

Assessment for determining eligibility and VR needs- as appropriate in each case means:

A review of existing data:

Employment outcome- entering or retaining full-time or, if appropriate, part-time competitive employment in the integrated labor market to the greatest extent practicable: supported employment, or any other type of employment, including self- employment, telecommuting, or business ownership, that is consistent with an individual's strengths, resources, priorities, concerns, abilities, capabilities, interest, and informed choice.

Extended Period of Time- as defined for ARS purposes means 90 days.

Extreme Medical Risk- Means a Probability of Substantially Increasing Functional impairment or death if medical services, including mental health services, are not provided expeditiously.

Family Member- means an individual who is a relative or guardian of an applicant or eligible individual; or lives in the same household as an applicant or eligible individual; who has a substantial interest in the well-being of that individual; and whose receipt of vocational rehabilitation services is necessary to enable the applicant or eligible individual to achieve an employment outcome.

Hard of hearing- A hearing impairment resulting in a functional loss, but not to the extent that the individual must depend primarily upon visual communication.

Pre-lingual hearing impairment- An impairment that is known or is assumed to have occurred prior to the third birthday.

Pre-vocational hearing impairment- An impairment that is known or is assumed to have occurred on or after the third birthday, but prior to the 19th birthday.

Post-vocational hearing impairment- An impairment that is known or is assumed to have occurred on or after the 19th birthday.

Individual's representative - any representative chosen by an applicant, or eligible individual, as appropriate, including a parent, guarding, other family member, or advocate, unless a representative has been appointed by a court to represent the individual, in which case the court-appointed representative is the individual's representative.

Informed Choice - the dissemination of appropriate information to the individual that will allow the individual to make decisions.

Integrated Setting - as referenced by RSA, "integrated setting" is intended to mean a work setting in a typical labor market site where people with disabilities engage in typical daily work patterns with co-workers who do not have disabilities; and where workers with disabilities are not congregated.

Further clarification on the definition of Integrated Setting: RSA points out that entities that are set up specifically for the purpose of providing employment to individuals with disabilities will likely not satisfy the definition of "integrated setting." The high percentage of individuals with disabilities employed with these entities most likely would result in little to no opportunities for interaction between individuals with disabilities and non-disabled individuals. These entities, therefore, would be considered sheltered or non-integrated employment sites."

Multiple services over an extended period of time - means two or more services and two of the services must last 90 days or longer.

Maintenance - means monetary support provided to an individual for expenses, such as food, shelter, and clothing, that are in excess of the normal expenses of the individual and that are necessitated by the individual's participation in an assessment for determining eligibility and vocational rehabilitation needs or the individual's receipt of VR services under an individualized plan for employment.

Mediation - means the act or process of using an independent third party to act as a mediator, intermediary, or conciliator to assist persons or parties in settling differences or disputes prior to pursuing formal administrative or other legal remedies.

Medical Directed Therapy - means any type of medical treatment that a physician recommends.

Occupational License - means any license, permit or other written authority required by a state, city or other governmental unit to be obtained in order to enter an occupation or enter a small business.

Outcome and Service Goals - objectives established by the State Agency, which are measurable in terms of expansion or program improvement in specified program areas and which the State Agency plans to achieve during a specified period of time.

Personal assistance services - means a range of services provided by one or more persons designed to assist as individual with a disability to perform daily living activities on or off the job that the individual would typically perform without assistance if the individual did not have a disability.

Physical or mental impairment - means any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more body systems or any mental or psychological disorder such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.

Physical and mental restoration services means:

Qualified and impartial mediator- means an individual who:

Rehabilitation technology - 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 the areas that include education, rehabilitation, employment, transportation, independent living, and recreation. The term includes rehabilitation engineering, assistive technology devices, and assistive technology services.

Service status - means, a status post IPE in which the individual is receiving VR services (status 18, 20, 22, 24).

Significant disability - means an individual with a disability:

At a minimum the mediator should inform the parties of the following:

PPD&E Form

ARS MEDIATION FEEDBACK SURVEY

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APPENDIX F

SUBSTANCE FREE POLICY

PURPOSE

ARS desires to create an environment that protects the public health and safety of ARS customers and staff as it relates to substance use. The purpose of this policy is to ensure that ARS customers have available vocational rehabilitation services to assist them in becoming employed without the risk of being affected by others utilizing drugs, alcohol or other substances. It is our obligation to customers as well as employees that the ARS experience is provided in the safest and most positive settings possible.

SCOPE

This policy is applicable to all customers seeking, applying for, or receiving assistance from ARS.

POLICY

Unlawfully manufacturing, distributing, dispensing, possessing, or using a controlled or illegal substance while an ARS customer is participating in vocational-rehabilitation services is prohibited. Use of prescription drugs other than those prescribed to an ARS customer by a licensed health care professional is likewise prohibited. Any ARS customer violating this policy will be subject to remedial action.

ARS CUSTOMER RESPONSIBILITY

ARS customers seeking, applying for, or receiving vocational rehabilitation services or pre-employment related services may receive a request from ARS to submit to a drug or alcohol test. ARS customers refusing to submit to testing may be subject to remedial action.

ARS customers residing at ACTI may be required to return to their field counselor for assistance with counseling and/or treatment.

ARS customers who reside at ACTI may randomly have their premises searched by a drug dog or designated personnel as deemed necessary by the ACTI Administrator. The customer will be asked to be present at the time of the search.

ARS customers are required to inform the agency within five (5) business days after a conviction related to substance use. A conviction means a pleading or finding of guilt (including a plea of nolo contendere) by a court of competent jurisdiction.

ARS customers may be required, as part of resuming services under their Individual Plan of Employment, to successfully finish a substance abuse rehabilitation program, sponsored by an approved private or governmental institution. ARS may, on a case-by-case basis and through agreement between the customer and counselor, provide financial assistance with such a program.

ARS customers entering a training, internship, apprenticeship or employment-related program that requires drug or alcohol screening as part of the process will be subject to remedial action if they fail the drug or alcohol screening.

ARS customers who are high school students are subject t * both their school policies and this policy while actively participating in an ARS program.

DRUG OR ALCOHOL SCREENINGS

Drug or alcohol screening may be conducted pursuant to the Substance Free Policy based on (1) the customer's self-disclosure that he or she is currently using illegal drugs, or (2) the reasonable suspicion of ARS staff, including the customer's counselor, that the customer is currently using illegal drugs. ARS staff will ensure that any drug or alcohol screens are performed by a certified laboratory and interpreted, if deemed necessary by the counselor, by a licensed health-care professional. ARS will cover the costs of required drug or alcohol screens. Such screens may involve urine, saliva, or blood samples, and breath analysis when screening for alcohol. Students at ACTI will have samples collected by the ACTI Hospital Laboratory during working hours, or by a certified laboratory after hours, with screening completed by a third-party, certified laboratory.

REMEDIAL ACTIONS

ARS customers found to have violated this policy may be subject to one or more of the following remedial actions:

* a behavioral contract

* referral for substance abuse counseling

* referral to a substance abuse rehabilitation program

* referral to a 12-Step Program of Recovery

* suspension or termination of services, in accordance with 29 U.S.C § 705(20)(c) (Impact on Provision of Services).

ARKANSAS REHABILITATION SERVICES SUBSTANCE FREE POLICY

As a customer of Arkansas Rehabilitation Services (ARS), I hereby certify, from my signature below, that I have received a copy of the agency's Substance Free Policy. I understand that the unlawful manufacturing, distributing, dispensing, possession of, or the use of a controlled substance, and the illegal use of substances like prescription drugs and alcohol, while actively participating in an ARS program is prohibited. I understand a violation of this policy will subject me to remedial action.

The policy has been explained to me clearly, I understand my responsibilities, and I agree to abide by its terms. I confirm that my guardian(s) or I have been provided a copy.

Customer's Signature: _____________________________

Parent/Guardian __________________________________________________

Customer's Printed Name: _____________________________________________

SSN: ________________________

Date: _______________________

SUBSTANCE FREE POLICY DEFINITIONS

ARS refers to Arkansas Rehabilitation Services.

Customers refer to ARS customers with disabilities, which include referrals, applicants and those receiving VR services.

Drug means a controlled substance, as defined in Schedules I through V of section 202 of the Controlled Substances Act. See 29 U.S.C. § 705(10)(A).

Illegal use of drugs means - the use of drugs, the possession or distribution of which is unlawful under the Controlled Substances Act. Such term does not include the use of a drug taken under supervision by a licensed health care professional, or other uses authorized by the Controlled Substances Act or other provisions of Federal law. See 29 USC § 705(10)(B).

Drug Screen or Test means any chemical, biological or physical instrument analysis administered by a laboratory authorized to do so for the purpose of determining the presence or absence of a drug or its metabolites pursuant to regulations governing drug testing adopted by the Department of Transportation or such other recognized authority approved by rule by the Commissioner.

Alcohol Screen or Test means an analysis of breath, urine or blood or any other analysis, which determines level or absence of alcohol as authorized by the Department of Transportation in it rules and guidelines concerning alcohol and drug testing. A breath test will consist of using an Evidential Breath Test Device approved by the National Highway Traffic Safety (NHTSA) for evidential testing of breath of alcohol content. ( 49 C.F.R. 40 Part 40.3)

Reasonable suspicion means a belief that an ARS customer is using or has used drugs, alcohol or other substances in violation of the covered policy drawn from specific objective, articulable facts, and reasonable inferences drawn from those facts in light of experience. Among other things, such facts and inferences may be based upon:

Observable phenomena while on ARS premises such as observation of drug, alcohol or other substance use or of the physical symptoms or manifestation of being intoxicated as defined in ACA § 5-2-207

Abnormal conduct or erratic behavior while on ARS premises or a significant deterioration in performance as it relates to ARS services or causes a critical incident;

A report of drug, alcohol or other substance use provided by a reliable and credible source;

Evidence that an ARS customer tampered with a drug test, alcohol test or other substance test;

Information that the ARS customer has used, possessed, sold solicited, or transferred drugs, alcohol or other substances while being on ARS premises or while operating ARS vehicles, machinery or equipment.

Specimen means tissue, fluid, or a human product of the human body capable of revealing the presence of substance used or their metabolite levels.

Substance Abuse Rehabilitation Program means a service provider that provides confidential, timely and expert identification, assessment, and resolution to the ARS customer's substance abuse. This program will be an approved private or governmental institution for the treatment of substance abuse.

APPENDIX G

EXCEPTIONS TO SERVICE PROVISION POLICY

The provision of VR services is based on the rehabilitation needs of the individual, as those needs are identified in the IPE and consistent with the individual's informed choice. Although it is not the intent of ARS to limit services to any individual, thresholds (maximum allowable amounts) have been established for some services. ARS recognizes that some individuals with disabilities have unique needs, which may need to be considered as an exception to the normal policy. These individuals are informed and provided an opportunity to request an exception to service provision policies due to extenuating circumstances.

Special approval by the District Manager is necessary for an exception. The Manager may approve an exception to the threshold (maximum allowable amount) for a specific service.

The individual is informed of the policy of exceptions to service provision policy and the procedure to request an exception by the Agency. This information is available on the application for services and in the Client Handbook that is provided to each applicant.

PROCEDURES - EXCEPTIONS

* When the counselor becomes aware of the client's extenuating circumstances, the counselor will inform the individual of the procedure to request an exception to a service provision policy.

* The counselor will complete Part 1 of the Request for Exception to Service Provision Policy form to inform the Manager of the extenuating circumstances that might justify an exception to the service provision policy. (See Request for Exception to Service Provision Policy form)

* After a review of the request for the exception, the Manager will respond to the Counselor with the decision by completing Part 2 of the Request for Exception to Service Provision Policy form. The District Manager will provide a copy to the Chief of Field Services.

* The counselor will contact the client by telephone, letter or email to arrange an appointment to discuss the District Manager's decision.

* The counselor will document in the case notes the action taken.

* The individual will be informed of the right to appeal the outcome of the decision if not in agreement

Request for Exception to Service Provision Policy

Part 1 (To be completed by the Counselor):

Client Name_____________________________SSN____________________

The above named individual is requesting an exception to the service provision policy due to the following extenuating circumstances:

Counselor Signature_____________________________ Date

Part 2 (To be completed by the Manager):

The Manager will record his/her decision below stating the reason (s) for the decision and will sign and date. This original will be returned to the Counselor. The Manager will send a copy to the Chief of Field Services.

Manager Signature___________________________Date

APPENDIX H

Pre-Employment Transition Services

Pre-Employment Transition Services (Pre-ETS) are the earliest set of vocational rehabilitation services that a student can receive. The student must at a minimum meet the potentially eligible guidelines set forth in 361.48 (a)(1) meaning all students with disabilities regardless of whether they have applied or been determined eligible for vocational rehabilitation services is provided to individuals meeting the student with a disability definition. The term potentially eligible is applicable ONLY when implementing the requirements governing Pre-ETS. WIOA requires the following five categories be provided to students in Pre-Employment transition:

Job exploration and assessments designed to determine career direction are intended to foster motivation, consideration of opportunities and informed decision-making. Real-world activities ensure that students recognize the relevance of high school and post-school education to their futures, both in college and/or the workplace. Career exploration must be done utilizing industry recognized assessments that will assist the student to choose a career path based on interests, skills, and strengths.

This may include in-school or after school opportunities, or experience outside the traditional school setting (including internships), that is provided in an integrated environment in the community to the maximum extent possible. Work Based Learning will be done in an integrated setting utilizing work experiences where the student works and earns a wage at or above minimum wage. It is expected that supervision will be provided on job sites. Supervision of multiple students on a worksite is allowable so long as the students have individualized work. The number of student work experiences hours shall not exceed 20 hours per week per school year and/or the number of hours per work experience, as set forth by the department of labor. If additional time is required, the counselor will send a justification to the District Manager for approval. For an exception form refer to Appendix G. Students may receive a stipend through Arkansas Rehabilitation Services for time worked during a work experience; however, all stipends must be paid at minimum wage and adhere to Pre-ETS procedures.

Training to inform about career options, and the types of academic and occupational training needed to obtain the careers identified in the job exploration assessments. Training to learn about, prepare for, and/or apply for opportunities outside of high school that will lead to employment. This may include test preparations and testing for entry into post-secondary training.

Workplace readiness will focus on teaching soft skills needed in the work environment, communicating at work, and learning independent living skills. Curriculums, strategies, and activities will be documented monthly on the ARS monthly progress report form, indicating what skills were taught and how the students apply the skills they have acquired.

Self-advocacy can include how to communicate, convey, negotiate or asserting interests and/or desires. Additionally, curriculums can include disability understanding, disability disclosure, decision making, goal setting, evaluate options, identifying accommodations, requesting & utilizing accommodations, providing the knowledge of how to request & accept help, assisting the students in developing intrinsic motivation, developing problem solving skills, assisting with developing positive self-talk.

DEFINITIONS

Individualized Education Program

The school's written plan to meet educational goals and objectives for a student with a disability is called an Individualized Education Program (IEP). The IEP must include a statement of the student's present levels of academic achievement and functional performance. It must also include how the student's disability affects his or her involvement and progress in the general education curriculum, that is, the same curriculum as for students without disabilities. 34 CFR Section 300.320.

Student with a Disability

Student with a disability is an individual with a disability in a secondary, postsecondary, or other recognized education program who:

PRE-ETS REFERRAL

Students with disabilities will generally will be referred by school staff in the service area utilizing the pre-employment transition services referral document. Students with disabilities regardless of whether they have applied or been determined eligible for vocational rehabilitation services are eligible to receive Pre-employment transition services. Students must meet the definition of a student with a disability. Transition students who receive Pre-ETS services must have the following documentation uploaded into the clients ECF: Informed consent, copy of the SS Card and/or documentation verifying social security number, photo ID (Driver's License, State issued ID, and/or school ID), A copy of the students IEP, 504, or documentation to support disability.

Once the Transition counselor receives a Pre-ETS referral and all documentation to initiate services has been received; the counselors will provide verification (via email) to the referral source when the student is ready to begin Pre-Employment transition services.

If a student needs a service outside of the five core areas of Pre-ETS the transition counselor will need to initiate the process to develop an Individualized Plan for Employment (IPE).

If it has been determined a student needs a service outside of the five core areas of Pre-Employment Transition Services the transition counselor will need to initiate the process to develop an Individualized Plan for Employment (IPE)

Two contacts a year

There must be two contacts a year, evaluating and monitoring a student's progress in pre-employment transition services. The case note should reflect direct face-to-face contact, email conversation, phone conversation with the client, or a letter from the client. The case note should be labeled "guidance and counseling" and reflect which of the 5 core services the guidance and counseling is targeting in the body of the case note. If contact with the client is not possible, use a letter to document the counselor's attempts to contact the client.

Allowable PRE-ETS Services

Allowable expenditures are those incurred in carrying out any of the 5 core Pre-ETS services. Allowable expenditures must fit within the scope of itemized Pre-ETS activities. "Allowability" is dependent on the facts of each situation. Any service outside of the allowable Pre-ETS services will require that the student move from potentially eligible to eligible for vocational rehabilitation services status and an Individualized Plan for Employment must be developed.

Procedures for authorizing Pre-Employment Transition Services

Students who are enrolled in a Pre-ETS program and are receiving any of the 5 core Pre-ETS services the following is necessary for authorizing Pre-Employment transition services:

GENERAL VR AND TRANSITION SERVICES

Transition services are activities designed for a student to promote movement from school to post-school activities. These activities must be coordinated, goal-oriented, and based on the student's needs and interests. The services include post-secondary education, vocational training, integrated employment (including supported employment and job coaching), continuing and adult education, adult services, independent living, and/or community participation. Transition services must promote or facilitate the achievement of the employment outcome.

Any service that fall outside the scope of the five core Pre-employment transition services will require development of an individualized plan for employment (IPE). Transition services may be provided to a broader population-both students and youth with disabilities; transition services are a continuum and represent the next set of vocational rehabilitation services available to students and youth with disabilities.

Transition student may receive concurrent services which includes VR services and pre-employment transition services. If a transition student has moved through the VR process, and has been determined eligible for VR/transition services, the transition Counselor will:

If a student is participating in a work experience through Pre-ETS and needs additional supports such as job coaching that will require the student to move from potentially eligible to eligible for vocational rehabilitation services adhering to policy and procedures for determining eligibility and development on an individualized plan for employment.

Individual Job Coaching Services and Transition

Individual job coaching may be provided to students with a disability and individuals who, because of their disabilities, need intensive job coach supports to obtain and maintain a job in competitive or customized employment, trial work experiences, and/or Pre-ETS work experiences. Individual job coaching is not a Pre-ETS services and will require a student to move from potentially eligible to eligible for VR services. Job Coaching is available for up to 200 hours (unless an exception from the district manager is provided).

For a student to receive job coaching Substantial documentation is required. Substantial documentation can include but is not limited to: Individualized education plan, transition plan and/or other school records which substantiate the need for job coaching.

See Appendix I for the job coaching fee schedule. If additional time is required, the counselor will send a justification to the Manager's for approval. For an exception form refer to Appendix G.

MEMORANDA OF AGREEMENT

The purpose of the Memorandum of Agreement is to define the allowable activities and procedures for receiving payment for services rendered through vendors. The agreements define what services, curriculums and activities a vendor is approved to provide through fee-for-service arrangements with Arkansas Rehabilitation Services. It also lists the roles and responsibilities of the vendor and ARS in service delivery and receipt of payment for services rendered.

MEMORANDA OF UNDERSTANDING WITH LEA'S

The purpose of the MOU is to set the parameters for providing pre-employment transition core services in the school. The goal of the MOU is to establish access times, number of students to be served, and the required documentation and/or records needed to operate in the school system.

Should the high school be providing any of the 5 core services listed above as part of the school's transition program under IDEA, those services will be listed in the high school's responsibility section and be carried out by the school.

Students will be served who meet IEP, 504 criteria or who have a documented disability. The school will determine what course code to apply to the services, if any and determine how credits will be applied to the services, as appropriate. The school will also ensure that students enrolled in the program will meet graduation credit requirements.

Once all parties have signed the MOU with the school, it is distributed to all parties to begin service provisions following the steps outlined in the MOA and the Letter of Engagement (found on the ARS data drive).

The Counselor will signal to the service provider when all documentation and case management processes have been received and completed to initiate services. The counselor will receive the monthly report forms and timesheets for payment processing.

511 SUBMINIMUM WAGE FUNCTIONS AND RESPONSIBILITIES

ARS has developed a subminimum wage flow process and forms located on the ARS shared drive. If a youth with a disability is seeking subminimum wage and has completed secondary education and is 24 years old or younger, he/she cannot start working for less than minimum wage until he/she has had the opportunity to:

The ARS forms are provided in an accessible format when needed/requested to the youth no later than 45 calendar days after the determination or completion of the required activity or service. It can be as much as 90 calendar days, if additional time is necessary due to extenuating circumstances.

Extenuating circumstances should be interpreted narrowly to include circumstances such as the unexpected lengthy absence of the educational or designated State unit personnel necessary for the production of the documentation or the transmittal of that documentation due to illness or family emergency, or a natural disaster.

Forms when a youth has refused to participate are provided to the youth within 10 calendar days of the youth's refusal to participate.

The Pre-Employment Vendor Performance Rubric and the School Contracted Services Performance Rubric can both be found in the Pre-ETS procedures section of the ARS shared information drive.

Vendors are monitored on a yearly basis unless a compliance form is completed (ARS VC Form 1). The list of complaints and corrective action plans are maintained on the Transition Sharepoint Site at http://acesp.arkansas.gov/agdiv/ars/transition/default.aspx.

Implementation of Corrective Action or Termination

If ARS finds that corrective action is required, ARS will provide written notice to the vendor identifying of the requirement requiring corrective action. The vendor will have sixty (60) days from the date of notice to institute policy/procedural changes to rectify the corrective action and present a report to ARS on the corrective action that was taken. Additional time, as is reasonable due to the nature of the issue, and agreed upon by all parties will be negotiated on a situational basis.

At the end of the sixty day period, or such additional time as is reasonable due to the nature of the issue and agreed upon by the parties, in the event that Arkansas Rehabilitation Services determines that appropriate corrective action has not been applied, the Agreement will be brought forward for an administrative review to the Chief of Field Services.

Final disposition on the administrative review will be provided in writing no later than thirty (30) days from the date of the review. Final disposition may include continuation of the service agreement with corrective action or termination of the agreement.

APPENDIX I

RATES OF PAYMENT FOR PURCHASED VR SERVICES

ARS MEDICAL FEES

ARS Fee Schedule is referenced in Section VI. Descriptions of procedures, devices, and other related medical services along with the associated fees are found in the Arkansas Health Information Network's annual Blue Cross/Blue Shield Physician Fee Schedule, Hospital Fee Schedule and Outpatient Fee Schedule to determine the agency's cost for Physical/Mental Restoration or other medical services. This Fee Schedule can be located on the ARS network. ARS counselors are first to determine if Comparable Benefits are available, including all health insurance plan coverage.

§ 34.361.5 (b)(10) Comparable services and benefits means-

Vocational rehabilitation services are any services described in CFR 361.48, and necessary to assist an individual with a disability in preparing for, securing, retaining, or regaining an employment outcome consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individual.

See ARS Policy Manual Section 6 for Service Provision Guidelines and Excluded Services for Purchased VR Services.

When determining model rates for provider reimbursement, ARS utilizes approved standards of compensation that are recognized authorities or accrediting bodies in the applicable field and establishes that rate for its certified vendors providing goods or services. For example, licensure by the state is recognized by ARS as a criterion for approval of all health care providers. Rates of payment for licensed physician or other authorized health care professionals are set at 80% of the Arkansas Blue Cross Blue Shield rate of pay. Similarly, ARS recognizes national accreditation for the approval of colleges and universities as providers.

PROCEDURES - PURCHASING

The Arkansas Office of State Procurement requires competitive bids for commodities or services that cost over $20,000 (State of Arkansas Procurement Manual 6/1/2018. In order to ensure that the cost is reasonable ARS further requires competitive bids for purchases over $5,000. Rates of payment for goods or services under $5,000 are based on fee schedules or compared in the local market in order to ensure a reasonable price.

If the cost of one item or the total cost of like items amount to:

The rate of payment for physician services, dental treatment, glasses, optical aids, and artificial eyes, hearing aids, hospitalization, nursing services, orthotic devices, physical and occupational therapy, prosthetic devices, psychotherapy, speech and hearing therapy, and surgical implants/appliances are based at 80% of the Arkansas Blue Cross and Blue Shield fee schedule. Arkansas Blue Cross and Blue Shield uses the Resource Based Relative Value System (RBRVS) as a guide for establishing fees. The RBRVS was developed with input from thousands of providers, and has become industry standard for establishing physician payments. ARS utilizes health care professionals and facilities that have agreed to accept the Arkansas Blue Cross and Blue Shield fee schedule as their maximum payment, and cannot collect amounts greater than the schedule for covered services to those insured by Arkansas Blue Cross and Blue Shield.

With hospitals, Arkansas Blue Cross and Blue Shield determines hospital payment rates using the Diagnosis Related Groups (DRGs) classification system which groups hospital patients according to similar diagnostic criteria and other characteristics.

Rates of payment for approved architectural modifications to a consumer's residence will be consistent with recommendations of an Access and Accommodations assessment. Finding contractors familiar with construction with ADA requirements can be difficult in rural areas, especially for low cost projects. Counselors will work with Access and Accommodations staff and the client to find licensed contractors to provide quotes on the cost of construction to ensure reasonable cost on projects under $5,000.

Computers that are necessary for an accommodation for a disability will be consistent with recommendations of an Access and Accommodations assessment. Rates of payment for computers are set at the published list price. The Access and Accommodations assessment team reviews purchases to ensure the price is reasonable in the market.

Rates of payment for vehicle modifications will be consistent with the recommendation of an Access and Accommodations assessment and set at the vendor's published list price. The Access and Accommodations assessment team will review purchases to ensure that the price is reasonable in the market. As part of the review the Access and Accommodations evaluator may contact other vendors to determine if the quoted cost is reasonable. If the cost of vehicle modifications exceeds $5,000, counselors must adhere to the procedures outlined in Section 4. It will be the practice of ARS to utilize National Mobility Equipment Dealers Association (NMEDA) certified dealers whenever possible.

Rates of payment for vehicle repair are set at the published list price for the needed repair. The counselor obtains three price quotes and compares prices in the local market to ensure the price is reasonable. The following research price comparison in the local area is used to document the rational used in the price decision:

* Get a written estimate and work order

* Receive a clear copy of the invoice

* Invoice includes the shop's name and address, client's name, and car's license number and mileage. It includes the labor charge, the name, number, and price of each part replaced, and whether parts are new or rebuilt.

* The shop's warranty should be printed on the bill.

Rates of payment for job placement services by private vendors are negotiated by agency representatives and vendors. The approved standard rate is utilized throughout the state for all placement services: Job Referral - VR Only - $250; Job Placement - VR Only - $500; and Job Closure - VR Only (90 Days) - $1,000.

The role of ARS is not to act as the primary funding source for self-employment or small business endeavors. (Refer to ARS Policy Manual Appendix B on the Small Business Program.) Refer to specific VR services addressed in this policy for rates of payment for services required for self-employment and home-based employment.

Supported employment services include job development, job placement, job coaching, job stabilization, and successful closure. SE services include subsequent extended services funded by another entity than ARS. Rates of payment for Supported Employment Service were established by the agency with input from the vendors that provide these services. There was a determination made that ARS needed to put an emphasis on placement and closure based on recommendation from RSA. The approved standard rate is utilized throughout the state for all CRP invoices.

Supported Employment Milestone (SE-1) Referral/Job Development - $1,000

Supported Employment Milestone (SE-2) Job Match/Placement - $3,000

Supported Employment Milestone (SE-3) Job Stabilization - $1,000

Supported Employment Milestone (SE-4) Closure - $3,000

The counselor will provide discrete, substantial counseling services that are vocational in nature and are specifically designed to assist the individual to reach an employment outcome.

Vocational counseling and guidance is provided directly by agency staff at no cost to the consumer.

Rates of payment for occupational tools for employment are set at the published list price. The counselor reviews purchases and compares prices in the local market to ensure the price is reasonable.