Ariz. Admin. Code § R6-4-206 - Provision of Vr Services

A. Scope and general considerations.

1. Rehabilitation Services Bureau provides all those services included under scope of services outlined in R6-4-201(A) and for which federal government provides financial participation.

2. No VR services shall be provided to VR personnel or their families without prior review and approval of District VR Program Manager and the Chief of Rehabilitation Services Bureau. All such actions shall also be reviewed by Department of Economic Security administration.

3. Cases and case facts, including the Individualized Written Rehabilitation program, shall be subject to review by VR administrative and consultative personnel.

B. Restoration services.

1. Physical or mental restorative services shall be provided only by individuals specially qualified to provide such services. The agency has established provider standards which are on file with Rehabilitation Services Bureau and available for review to the public on request.

2. Any IWRP, Program of Services, which proposes to provide physical or mental restorative services in excess of $5,000 shall be submitted for review and approval by the District VR Program Manager and consultants, as appropriate.

3. Restorative procedures that might be considered investigative, controversial or of high risk to the client shall be subject to approval by Rehabilitation Services Bureau administration.

4. A course of physical or mental restoration shall not extend beyond three months without an assessment of documented progress made towards stated goals. Authorization for additional physical or mental restoration shall be predicated upon acceptable progress to date, and the setting of treatment goals for any subsequent course of therapy.

5. Authorization for inpatient care at any hospital, rehabilitation center, skilled nursing facility or any other institutions whose primary function it is to provide medical or allied services shall be for a specified period of time. A comprehensive assessment of progress to date and a statement of justification by the treating physician will be required for any extension exceeding 30 days.

6. Chronic conditions; e.g., diabetes, epilepsy, which were diagnosed and placed on an effective medical regime before an individual becomes a client shall not become the responsibility of VR. The counselor shall not pay for his ongoing health maintenance costs.

C. Training services.

1. Training services shall be provided to prepare an eligible individual with the necessary skills for employment consistent with the rehabilitation goal.

2. All training, including OJT's, purchased from private schools or individuals shall be provided under a contract signed by the VR counselor and the trainer or representative of the training institution.

3. Training services will be provided to prepare a client for placement at entry level requirements. In the case of higher education, VR will normally conclude sponsorship of training with completion of a bachelor's degree. Consideration will be given to the special needs of a severely disabled individual who may require post-graduate training due to an inability to work at entry level.

4. The VR client shall be given his choice of properly licensed private, technical, business and vocational training schools. The counselor, however, shall also consider:

a. Relative costs of training;

b. Transportation;

c. Living arrangements;

d. Other factors bearing on the particular client situation.

5. VR shall not pay non-resident fees to out-of-state schools if the same training programs are available within the state.

6. VR may pay non-resident fees to a local school if required and necessary to carry out an IWRP, Program of Services.

7. Training at private, business, technical and vocational schools shall be paid for on a month-to-month basis after the service has been provided. Encumbrances shall be written prior to the provision of training. If a client withdraws from training prior to completion, VR shall pay only for that portion of the training utilized by the client on a prorated basis.

8. On-the-job training shall be that training purchased under contract from an employer who provides the individual training on the job site. Such arrangements may result in an employer/employee relationship subject to wage and hour laws under the Fair Labor Standards Act.

9. OJT contracts shall be written only in those instances where the client does not meet the entry and/or production requirements for that job without a period of on-the-job training or unless a period of on-the-job training is necessary to provide an employment opportunity for the individual.

10. OJT contracts shall be written only for those occupations in which the client, upon successful completion of the on-the-job training, can reasonably be expected to become employed. OJT contracts shall not be written for:

a. Occupations in which commissions provide more than 50% of client's salary;

b. Intermittent seasonal occupations;

c. Occupations which require licenses such as therapists, teachers, barbers, cosmetologists, nurses, etc.

11. Workmen's Compensation Insurance shall be provided by VR for the duration of an OJT contract unless such coverage is provided by the employer.

12. Wages to be paid the client upon successful completion of an OJT contract shall be comparable to wages of other employees engaged in similar work and at the same production level.

13. An employer may not have more than 25% of his labor force under OJT contracts. If an employer has fewer than four employees, he may be given one OJT contract if he demonstrates the capability of providing the necessary training.

14. Payment to the employer under an OJT contract shall never be in excess of 50% of client's wages averaged over the length of the contract.

15. All training and adjustment services shall be provided under established standards (see R6-4-302(A) and (B)).

D. Maintenance.

1. Maintenance means payments, not exceeding the estimated cost of subsistence and provided at any time from the date of initiation of vocational rehabilitation services through the provision of post-employment services, to cover a handicapped individual's basic living expenses, such as food, shelter, clothing and other subsistence expenses. Maintenance is provided only in order to enable a handicapped individual to derive the benefit of other vocational rehabilitation services being provided.

2. General considerations.

a. Vocational Rehabilitation is not legally obligated to meet the total costs of living for its clients nor does the budget provide funds to do so. Because of these limitations, maintenance payments are provided only to assist the client with expenses essential to services listed in the client's individualized written rehabilitation program and approved in advance by the Vocational Rehabilitation in an IWRP, Program of Services, except for those maintenance payments necessary to complete diagnostic services.

b. Maintenance may not be paid out of SSI/SSDI special funds unless it is to defray extra costs of client living away from home because of participation in a rehabilitation program. If a counselor decides to pay regular maintenance for a client eligible for special funds, but not eligible for maintenance under those funds, maintenance must be paid for out of regular funds and are subject to all regulations set forth in this subsection.

c. Maintenance checks may be paid directly to the client, to the training agent or to parents or guardian or other representative.

d. The counselor must monthly review, adjust, as appropriate, and authorize the disbursement of maintenance checks.

e. The combined total of maintenance plus the client's income will never exceed client's actual client monthly obligations.

f. Maintenance for a client who must live on campus, in a rehabilitation facility, halfway house, or boarding home may be paid to the college, school or facility directly either for only that portion of maintenance to include room and board or for distribution of total maintenance.

g. Maintenance may not be provided for clients pursuing academic college level training as a part-time student, as defined by the school, except in the case of an extended evaluation to determine rehabilitation potential and then only after prior supervisory review.

h. Maintenance may never be provided for the sole purpose of meeting total costs of subsistence for clients or to supplement other resource (AD, SSDI, etc.) deficiencies.

i. Unusual client circumstances may call for an administrative adjustment by the District VR Program Manager in the rates set on a case-by-case basis.

3. Provision of maintenance.

a. No economic need criteria apply to maintenance provided while client is receiving diagnostic services regardless of status. Maintenance in this case is only that money necessary to defray costs to client during a period away from the home. The amount of maintenance may never exceed the actual costs incurred by the client as a result of participating in the diagnostic study.

b. Maintenance as ongoing payments during an IWRP will never, together with client income, exceed established client monthly obligations.

i. All liquid assets must be used first.

ii. Once liquid assets have been used, the following procedure is used:

(1) If client does not meet the economic need criteria, no maintenance may be provided. When the client does meet the economic need criteria, the counselor must complete the Financial Disclosure Statement and compare client's total income to client's monthly obligations;

(2) The counselor may provide maintenance payments necessary to assist client with expenses essential to accomplishing the services listed in the client's IWRP up to documented need; i.e., monthly obligations, but never to exceed the maximum allowed.

c. Maintenance payments above the basic rate may be approved by the supervisor when they are provided to meet special client needs which are ongoing but not normally considered as usual subsistence requirements. Such special needs may include special diet, ongoing repair and maintenance of assistive devices, ongoing need for medical supplies such as stump socks, catheters, etc. These needs must be documented and explained on the client's IWRP.

4. A counselor may pay for a client's attendant care only as necessary while client is engaged in a program of services. Financial need criteria as well as the need to explore and use similar benefits, if available, apply. Vocational Rehabilitation does not accept responsibility for total costs of attendant care. Vocational Rehabilitation will pay for such care within the following guidelines:

a. The client must have a doctor's statement regarding the need for and extent of attendant care required.

b. For the purpose of computing the amount of Vocational Rehabilitation's contribution, a distinction is made between:

i. Training or training-related costs, such as preparation for school, transportation to and from school, assistance while in school.

ii. Attendant care not directly related to a specific rehabilitation activity but necessary for health maintenance. Such care can and is often provided by family or friends and should not be paid for by Vocational Rehabilitation unless absolutely necessary, and unless it is a direct cost item to the client.

c. Hourly minimum wage shall be paid to attendants; however, Rehabilitation Services Bureau will not contribute more than $150 monthly for each type of attendant care.

E. Transportation. In providing transportation monies to the VR client, the following rules shall be applied:

1. Client may only be reimbursed for actual costs for transportation and per diem.

2. The counselor shall determine the most economical, yet adequate, mode of transportation available to client.

3. The maximum allowed per diem shall never be more than $30 a day.

F. Other services.

1. The VR counselor shall not purchase for a client automobiles, trucks or any other self-powered vehicles which require licensing by the state. Included in this prohibition is purchasing or contributing to the cost of those accessories or optional equipment normally available by or through automobile manufacturers or dealers in the purchase of a new vehicle.

2. The VR counselor may purchase assistive devices and modifications designed to allow a handicapped individual to use or operate a vehicle either for a new or used vehicle.

3. The VR counselor may purchase or contribute to the purchase, accessories or optional equipment as well as assistive devices and modifications to used or previously purchased vehicles when such are medically prescribed.

Notes

Ariz. Admin. Code § R6-4-206

Adopted effective June 14, 1977 (Supp. 77-3).