RULE 172.00.13-007 - Rehabilitation Services Policy and Procedure Manual

RULE 172.00.13-007. Rehabilitation Services Policy and Procedure Manual

I. INTRODUCTION

LEGISLATION

This manual is based on:

* State and Federal statutes

* Federal and State regulations

* State Plan for Vocational Rehabilitation Services

HISTORY AND CURRENT LEGISLATION

Arkansas Code Annotated § 25-30-201, Rehabilitation Act of Arkansas

Arkansas Code Annotated § 20-79-207, Arkansas Rehabilitation Services

Rehabilitation Act Amendments of 1998 - 29 U.S.C. § 701 et. seq.

State Vocational Rehabilitation Services Program - 34 C.F.R. Part 361

Workforce Investment Act of 1998 - 20 U.S.C. § 9201 et. seq.

Individuals with Disabilities Education Act - 20 U.S.C. § 1400 et. seq.

Americans with Disabilities Act - 42 U.S.C. § 12101 et. seq.

Civil Rights Act of 1964 - 42 U.S.C. § 2000d et. seq.

Arkansas Workforce Investment Act of 1998 - Arkansas Code Annotated § 15-4-2201

Other Federal and State laws

PURPOSE

Arkansas Rehabilitation Services (ARS) receives a federal grant from the Rehabilitation Services Administration (Office of Special Education and Rehabilitation Services, Department of Education) to operate a comprehensive, coordinated, effective, efficient and accountable program designed to assess, plan, develop, and provide vocational rehabilitation services for individuals with disabilities, consistent with their strengths, resources, priorities, concerns, abilities, capabilities, and informed choice, in order to prepare for and engage in gainful employment. 34 C.F.R. § 361.1

PUBLIC ACCESS TO ADMINISTRATIVE POLICY

State Plan - This multi-year plan contains a description of Arkansas Rehabilitation Services (ARS) vocational rehabilitation services program, the policies to carry out the program and other information as requested by Rehabilitation Services Administration. This multi-year plan seeks input from the public and others designated by the Rehabilitation Act. 34 C.F.R. § 361.10 (a.), 34 C.F.R. § 361.10 (d.), 34 C.F.R. § 361.20 (a.) and 34 C.F.R. § 361.21

Rehabilitation Council - The Council partners with ARS on a regular and on-going basis by providing advice on the development, implementation and amendments to the State plan, policies and procedures pertaining to vocational rehabilitation services. The Council is Governor appointed consisting of individuals with disabilities, family members, advocates, vocational rehabilitation counselor, and representatives from parent training center, Client Assistance Program, business industry and labor. The Commissioner serves as a non-voting member. 34 C.F.R. § 361.17

Policy Promulgation Process - Arkansas Administrative Procedures Act requires ARS to receive public input on policies and procedures.

Arkansas Independent Living Council (AILC) - ARS works jointly with the AILC in the development and implementation of a statewide Independent Living State Plan.

II. REFERRAL, APPLICATION AND ASSESSMENT

REFERRAL (STATUS 00)

Arkansas Rehabilitation Services (ARS) will receive all referrals from any source.

Eligibility requirements will be applied without regard to the person's sex, race, age, creed, color, or national origin. No group of individuals will be excluded or found ineligible solely on the basis of type of disability.

ARS will provide outreach to underrepresented and under-served individuals in seeking referrals from non-profit and for profit agencies serving minorities, owned or controlled by minorities, and medical professionals who serve the minority community. ARS does not impose a residence duration requirement. 29 U.S.C. § 19 (b.)

LEGAL AND ILLEGAL IMMIGRANTS

Illegal Immigrants (individuals in the U.S. without legal status) are not eligible for VR services.

Legal Immigrants are individuals admitted to this country for the purpose of permanent residence. Immigrant aliens must possess a valid Registration Card issued by the United States Immigration and Naturalization Service (USINS) before they can be determined eligible for VR services

Non-immigrant aliens are individuals admitted to this country for a particular purpose and time period, and is expected to return to their home country upon completion of the specified purpose or time period. This group includes:

* Visitors for business or pleasure;

* Crew of vessels or aircraft;

* Representatives of international organizations;

* Ambassadors, public ministers, and career diplomatic or consular officers; and

* Students pursuing a course of study (most common visas: "FI" and "JI" ;no work authorized except work related to the applicants academic program).

The immigrant applicant must be available to complete the IPE, which includes suitable employment in the United States. When completion cannot be expected, the applicant is not eligible for rehabilitation services.

To determine whether services can be provided, request alien status evidence (usually a temporary Registration Card I-94). Note whether work is permitted under the visa.

Immigrants who are part of the Amnesty Program receive a letter stating that they are not eligible for Federal Financial Assistance. ARS programs are not considered Federal Financial Assistance, so services may be provided if the individual is otherwise eligible.

Status 00 is used when an individual has been referred to VR and the minimum information has been obtained. The individual has not actually requested services in this status. No money may be spent in this status.

PROCEDURES - REFERRAL (STATUS 00)

* Referral sources will be cultivated and considered partners in our communities.

* A referral will be keyed into the case management system using the demographics and referral specifics forms, which moves a client into a program of Status 00.

* The counselor will create a Status 00 ECF that includes all information received, the case management system printout, and case note of action taken.

* The counselor will attach into the system all information received at referral which is deemed pertinent to initiating a case. The counselor will create a case note of action taken within the case management system.

* Within five (5) working days, the individual will be contacted and provided directions and information to prepare the individual to consider making an application.

* To expedite the application process the individual will be provided a client handbook, and will be instructed to gather current information (medical, psychological, educational, vocational, and SSI & SSDI verification).

* Verification of alien status. (See legal and Illegal Alien above.)

* The individual will be given an appointment and a contact person, or information to contact the Agency for an appointment.

* If the individual does not wish to receive VR services but needs work related services, the counselor will provide information and referral services using an appropriate means of communication.

* Document in the case note the specific action taken.

Note: If an individual with a primary disability of blindness or visual impairment is referred for services, the individual will be referred to Services for the Blind. ARS may serve individuals with blindness or visual impairment as a secondary disability.

Note: Cases reported/referred by the State Office/Governor's Office/ Legislators. The counselor will immediately (or no more than 3 working days) report findings and opinions to the Chief of Field Services. This response will be in writing.

APPLICATION (STATUS 02)

An individual is considered an applicant and placed in Status 02 when sufficient information to initiate an assessment is received, through written application or other method, and the individual is available to complete the assessment process. If the individual definitely requests to make application or requests services, the individual is placed in Status 02 regardless of method of request, (including in-person, written, telephone, e-mail or internet.)

Note: Referrals on Application forms from One-Stop Arkansas Workforce Centers will be accepted as an application for Rehabilitation Services and placed in Status 02.

ARS will make application forms widely available throughout the state including the One-Stop Arkansas Workforce Centers.

An application will be accepted on any individual who claims to have a disability and requests to apply for services. If the individual is under age 18, parent/guardian consent is required.

Status 02 is used for the purpose of preliminary assessment, that is, determination of the individual's eligibility for VR services. Only assessment services can be provided in this status.

The 60-day time period for determining eligibility begins once the individual:

1. Has either completed and signed an Agency application form or has otherwise requested services.

2. Has provided information necessary for the Agency to initiate the assessment.

3. Is available to complete the assessment process.

Note: If unforeseen circumstances beyond the control of the counselor and individual preclude making an eligibility determination within 60 days, the counselor and individual must agree to a specific extension of time. 34 C.F.R. § 361.41. 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.

The applicant's completion of the application process for vocational rehabilitation services is sufficient evidence of the individual's intent to achieve an employment outcome, and no additional demonstration on the part of the applicant is required. 34 C.F.R. § 361.42(i)(ii)

PROCEDURES - APPLICATION

* Referrals on one- stop applications will be placed in Status 02.

* The counselor or rehabilitation assistant will complete the ARS application. (See Appendix E)

* The counselor or rehabilitation assistant will secure a copy of the Social Security Card and driver's license or picture identification. If applicable, a copy of the alien registration.

* Informed Consent if under age 18.

* Complete voter registration form or declination form, if applicable.

* The individual will be provided the ARS Client Handbook.

* The counselor will discuss the agency's Substance Free Policy with the applicant and give the applicant a copy of the Policy. (See Appendix F.)

* The applicant will acknowledge receipt of the Policy by signing the ARS Substance Free Policy form. The form will be placed in the individual's file. (See Appendix F.)

(See Section X)

* For each source where information is needed, the counselor will complete the Authorization for Release of Information Form and secure client's signature. (See Appendix E-24).

* Begin collecting existing data (medical, psychological, psychiatric, educational, or vocational reports and, if appropriate, SSI/SSDI verification.) Appropriate information will be attached into the case management system as it is received.

INFORMED CHOICE - APPLICATION

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 application process. Applicants will be given information, or assistance in acquiring the information, to assist in making an informed choice concerning vendors who provide 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 applicant to make a responsible decision regarding the application process and program of services. A responsible decision is one that is realistic considering the unique strengths, resources, priorities, concerns, abilities, capabilities, and interests of the applicant and that must lead to an employment outcome. 34 C.F.R. § 361.42

PROCEDURES - INFORMED CHOICE -APPLICATION

* The counselor will maintain a local, regional and statewide list of vendors who provide 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 qualifications of the providers.

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

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

* The counselor must be aware of the Ticket to Work Program. If the individual is an SSI/SSDI recipient, the counselor must follow guidelines outlined in Ticket to Work in Appendix B.

Complete initial case note.

* Document the need for an extension of time to determine eligibility must be made in the case notes. The counselor must document the specific period of time for the extension. 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.

CONFLICT OF INTEREST

Counselors should make every effort to avoid dual relationships that could impair their professional judgment or appear as a conflict of interest. Examples of dual relationships include close friends and relatives as consumers or prospective vendors in the community. If an applicant by virtue of address or day of application or by alphabet, etc., is routinely assigned to a counselor with whom the individual already has a close relationship, the counselor should advise the District Manager of the relationship. The District Manager will review the circumstances and determine if another counselor within the office should serve the case or if referral to another office should be made. ARS policy requires disclosure of any possible conflict of interest or the appearance of a conflict of interest and documentation of the action taken by the District Manager should be placed in the ECF.

PROCEDURES - CONFLICT OF INTEREST

* Document any potential conflict of interest.

* Complete the form "Disclosure of Possible Conflict of Interest". (Refer to Appendix E).

* Document action taken in the case note.

ASSESSMENT

Preliminary Diagnostic Study

ARS will conduct an assessment to determine eligibility and, if an Order of Selection is in effect the individual's priority for services. Assistive technology services will be provided if required to complete the assessment. This assessment will be conducted in the most integrated setting possible, consistent with the individual's needs and based on the individual's informed choice. 34 C.F.R. § 361.42

The counselor will review existing data, before determining if an assessment is needed to determine eligibility and, if so, what type. Based upon counselor judgment, additional assessment may be necessary if the existing data is unavailable, insufficient or inappropriate in describing the current functioning of the individual. Trial work experiences, assistive technology devices and services, personal assistance services and other appropriate support services necessary to determine whether an individual is eligible for services will be provided.

PRESUMPTIVE ELIGIBILITY FOR SSDI/SSI RECIPIENTS

Any applicant who has been determined eligible for Social Security benefits under Title II or Title XVI of the Social Security Act is presumed eligible in accordance with the provisions under ARS Policy and Procedure Manual, Section III, SSDI/SSI Eligibility. No further assessment is necessary for eligibility. 34 C.F.R. § 361.42

Assessments for Eligibility are completed to determine the following:

1) The applicant has a physical or mental impairment.

2) The impairment results in a substantial impediment to employment.

3) A presumption that the applicant can benefit from receiving VR services in terms of an employment outcome.

4) The applicant requires VR services to prepare for, enter into, engage in, or retain gainful employment consistent with the applicant's strengths, resources, priorities, concerns, abilities, capabilities, and informed choice. 34 C.F.R. § 361.42 (a.)

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 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 an applicant for diagnostic services through the Agency support unit (RIDAC) exercising informed choice. (See Appendix B Special Programs)

* 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 program of services. A responsible decision is one that is realistic considering the unique strengths, resources, priorities, concerns, abilities, capabilities, and interests 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:

(1) There is sufficient evidence to conclude that the individual can benefit from the provision of vocational rehabilitation services in terms of an employment outcome; or

(2) There is clear and convincing evidence* that the individual is incapable of benefiting from vocational rehabilitation services in terms of an employment outcome due to the severity of the individual's disability.

Trial work experiences include supported employment, on-the-job training, and other experiences using realistic work settings. The counselor must develop a written plan to assess periodically the individual's capacity to perform in work situations, which must be provided in the most integrated setting possible, consistent with the informed choice and rehabilitation needs of the individual.

*Note: Clear and convincing evidencemeans a high degree of certainty before concluding that an individual is incapable of benefiting from services in terms of an employment outcome. The "clear and convincing" standard constitutes the highest standard used in our civil system of law and is to be individually applied on a case -by-case basis. The term clear means unequivocal. For example, the use of an intelligence test result alone would not constitute clear and convincing evidence. Clear and convincing evidence might include a description of assessments, including situational assessments and supported employment assessments, from service providers who have concluded that they would be unable to meet the individual's needs due to the severity of the individual's disability. The demonstration of "clear and convincing evidence" must include, if appropriate, a functional assessment of skill development activities, with any necessary supports, including assistive technology, in real life settings. 34 C.F.R. § 361.42

If Trial Work Experience is not available or if a determination cannot be made in Trial Work Experience that an individual can benefit from VR services in terms of an employment outcome, the individual will have the opportunity to be placed in Extended Evaluation. An applicant may chose closure rather than enter or continue in either Trial Work Experience or Extended Evaluation. ARS must provide assistive technology devices and services, personal assistance services, and other appropriate support services that are necessary to determine whether an individual is eligible.

Termination of Trial Work Experience services must occur at any point if a determination is made that:

1) Sufficient evidence concludes the individual can benefit from VR services in terms of an employment outcome.

2) Clear and convincing evidence concludes the individual is incapable of benefiting from VR services in terms of an employment outcome due to the severity of the disability. 34 C.F.R. § 361.42 (d.)

Clear and convincing evidence is also in Appendix D. Definitions.

The Trial Work Experience Individualized Plan for Employment will include only those services necessary to determine an employment outcome. Services must be provided in the most integrated setting possible and be consistent with informed choice.

The individual's progress will be assessed at least once every 90 days.

PROCEDURES - TRIAL WORK EXPERIENCE

* Complete a Certificate of Eligibility/Ineligibility for Trial Work Experience.

* 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.

* Write an IPE consistent with Informed Choice.

* The case management system will generate the case note and status move after required data is keyed for Status 06.

* The IPE for trial work/extended evaluation (status 06) is to be reviewed every 90 days. The counselor and the individual must complete a periodic review of the rehabilitation plan every 90 days to assess the individual's progress. The Amendment to the IPE will be completed to document the periodic review.

* When a decision of work feasibility or non-feasibility is made, the appropriate action of case closure or case acceptance is taken in accordance with informed choice. (Refer to Closure Section VIII or Eligibility Section III)

* The case management system will only allow 18 months for the case to remain in Trial Work Experience. The Federal Regulations allow for an adequate period of time to make an eligibility determination in Status 06.

EXTENDED EVALUATION (STATUS 06)

The extended evaluation is used to make the above determination, under limited circumstances, only in two instances.

(1) If an individual cannot take advantage of trial work experiences.

(2) If options for trial work experiences have been exhausted before the counselor is able to make the determination.

The counselor must develop a written plan for providing the vocational rehabilitation services that are necessary to make the determination. The vocational rehabilitation services must be provided in the most integrated setting possible, consistent with the informed choice and rehabilitation needs of the individual. Only those services are provided that are necessary to make the determination described above and are terminated when the counselor is able to make the determination. When the determination indicates that an employment outcome is feasible, an IPE must be written to achieve the appropriate outcome.

If a determination cannot be made that an individual can benefit from VR services in terms of an employment outcome due to the severity of the disability, the individual will have an opportunity to be placed in Extended Evaluation. The Extended Evaluation must explore the individual's abilities, capabilities, and capacity to perform in real work situations with appropriate supports and training provided by the Agency, except in limited circumstances when the individual cannot take advantage of such experiences. Extended Evaluation can include only services needed to determine eligibility for services. Extended Evaluation must be of sufficient variety and over a sufficient period of time to make a determination that:

1) Sufficient evidence concludes that the individual can benefit from VR services in terms of an employment outcome, or

2) Clear and convincing evidence concludes the individual is incapable of benefiting from VR services in terms of an employment outcome

If Trial Work Experience is not available or if a determination cannot be made in Trial Work Experience that an individual can benefit from VR services in terms of an employment outcome, the individual will have the opportunity to be placed in Extended Evaluation. An applicant may chose closure rather than enter or continue in Extended Evaluation. ARS must provide assistive technology devices and services, personal assistance services, and other appropriate support services that are necessary to determine whether an individual is eligible.

Termination of Extended Evaluation services must occur at any point if a determination is made that:

1) Sufficient evidence concludes the individual can benefit from VR services in terms of an employment outcome.

2) Clear and convincing evidence concludes the individual is incapable of benefiting from VR services in terms of an employment outcome due to the severity of the disability. 34 C.F.R. § 361.42 (d.)

Clear and convincing evidence is defined in Appendix D. Definitions

Extended Evaluation Plan will include only those services necessary to determine an employment outcome. Services must be provided in the most integrated setting possible and be consistent with informed choice.

The individual's progress will be assessed at least once every 90 days.

PROCEDURES -EXTENDED EVALUATION

* Complete a Certificate of Eligibility/Ineligibility for Extended Evaluation.

* 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.

* Write an IPE consistent with Informed Choice.

* The case management system will generate the case note and status move after required data is keyed for Status 06.

* The IPE for trial work/extended evaluation (status 06) is to be reviewed every 90 days. The counselor and the individual must complete a periodic review of the rehabilitation plan every 90 days to assess the individual's progress. The Amendment to the IPE will be completed to document the periodic review.

* When a decision of work feasibility or non-feasibility is made, the appropriate action of case closure or case acceptance is taken in accordance with informed choice. (Refer to Closure Section VIII or Eligibility Section III)

* The case management system will only allow 18 months for the case to remain in Extended Evaluation. The Federal Regulations allow for an adequate period of time to make an eligibility determination in Status 06.

INFORMED CHOICE -EXTENDED EVALUATION

ARS will assure that applicants and eligible individuals or 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 support services for individuals with cognitive or other disabilities who require assistance in exercising informed choice in decisions related to Extended Evaluation. Applicants will be given information, or assistance in acquiring the information, to make informed choice of vendors who provide assessment services by means of an Extended Evaluation. 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 program of services through an Extended Evaluation. A responsible decision is one that is realistic considering the unique strengths, resources, priorities, concerns, abilities, capabilities, and interests of the individual and that must lead to an employment outcome. 34 C.F.R. § 361.52

PROCEDURES - INFORMED CHOICE -EXTENDED EVALUATION

* The counselor will maintain a local, regional and statewide list of vendors/employers who may provide Extended Evaluation services needed to establish feasibility for employment.

* 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 the outcomes and the effect on the potential eligibility for services for the individual.

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

III. ELIGIBILITY OR INELIGIBILITY DETERMINATION

ARS has the sole responsibility for determining eligibility for VR Services. The ARS Commissioner has delegated the responsibility of determination of eligibility to the counselor.

For all individuals applying for services, ARS will conduct an assessment to determine eligibility and priority for services if the state is operating under an Order of Selection. 34 C.F.R. § 361.42 (a.)(2.)

Eligibility requirements will be applied in compliance with Titles VI and VII of the Civil Rights Act, The Americans with Disabilities Act and without regard to age, religion, disability, sex, race, color or national origin. The eligibility requirements are applicable without regard to the particular service need or anticipated cost of services required by an applicant or the income level of an applicant or applicant's family. Eligibility determination will be made within 60 days of the application date. Exceptional and unforeseen circumstances beyond the control of ARS that prevent the Agency from making an eligibility determination within 60 days will require ARS and the individual to agree on a specific extension of time. 34 C.F.R. § 361.41(b-1) (i)

Basic eligibility requirements are:

1. A determination that the individual has a physical or mental impairment defined as an injury, disease or other condition that results in persistent functional limitations: resulting from amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

2. A determination that the individual's physical or mental impairment constitutes or results in a substantial impediment to employment for the individual. A substantial impediment to employment exists when the impairment and the resultant limitation: Prevent the individual from obtaining a job consistent with their abilities; significantly interfere with preparing for employment consistent with their abilities, need for special accommodations or technology to perform essential job duties or barriers to job retention; for example loss of job due to impairment or unable to perform essential job duties.

3. A presumption that the individual can benefit in terms of an employment outcome from the provision of VR services. An individual is presumed capable of achieving an employment outcome, unless documented with clear and convincing evidence is obtained documenting for example: the severity of the diagnosis would preclude not obtainable that employment cannot be obtained due to the severity of the individual's disability.

4. A determination that the individual requires VR services to prepare for entrance into, engage in, or retain gainful employment consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities and informed choice. 34 C.F.R. § 361.42 (i.-iv.) An individual is expected to require multiple VR services that will have a substantial impact on the individual's disability and resultant functional limitations or reduce the impediment to employment to allow the applicant to prepare for, obtain, retain or regain employment consistent with the individual's capabilities and abilities and the individual services cannot access these services without VR intervention.

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.

PRESUMPTIVE ELIGIBILITY SSDI/SSI RECIPIENTS

Social Security Disability Income (SSDI) beneficiaries and Supplemental Security Income (SSI) recipients are considered to be individuals with a significant disability (Category II) and presumed eligible for VR services, if the intent of the individual is to achieve an employment outcome. The employment outcome must be consistent with the unique strengths, resources, priorities, concerns, abilities, capabilities, interests and informed choice of the individual. The Agency is responsible for informing individuals through the application process that the individual must intend to achieve an employment outcome in order to receive VR services. No additional tests or procedures may be used to assess disability in order to determine eligibility.

Note: The individual who is presumed eligible as a recipient of SSI/SSDI and who intends to achieve an employment outcome is eligible unless clear and convincing evidence demonstrate that the individual is incapable of benefiting from vocational services in terms of achieving an employment outcome due to the severity of the disability.

Although an SSDI/SSI recipient is considered an individual with a significant disability, presumptive eligibility for VR services does not entitle the individual to priority for services over other individuals with significant disabilities or most significant disabilities if the state is operating under an Order of Selection.

If an applicant for VR services asserts that he or she is eligible for Social Security benefits, but is unable to provide appropriate evidence, such as an award letter, to support that assertion, ARS must verify the applicant's eligibility by contacting the Social Security Administration. This verification must be made within a reasonable period of time that enables ARS to determine the applicant's eligibility for VR services within 60 days of the individual submitting an application for services. 34 C.F.R. § 361.42 (a.)(3.)

Note: Information in this section should not be construed to create entitlement to any vocational rehabilitation service.

PROCEDURES - SSDI/SSI ELIGIBILITY

* The counselor will obtain verification of SSI/SSDI benefits and will be attached to ECF, i.e. awards letter, benefit's check, verification from Social Security Administration.

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

* Complete the Certificate of Eligibility/Ineligibility for VR, Trial Work Experience, or Extended Evaluation (EE) services (See Appendix E) The certification statement for the Certificate of Eligibility/Ineligibility is "This individual meets the presumptive eligibility requirement." The area for limitations does not need to be completed.

* The counselor must be aware of the Ticket to Work Program. If the Applicant is eligible under "presumptive eligibility", the counselor must follow guidelines outlined in Ticket to Work in Appendix B (Special Programs).

* The applicant can be scheduled for additional testing, or medical, psychological, or psychiatric evaluation based on informed choice to determine 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/Ineligibility.

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 or EE services.

The Certificate of Eligibility/Ineligibility must be completed simultaneously with an individual's acceptance for VR services, Trial Work or EE. As a minimum, the Certificate of Eligibility/Ineligibility 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/Ineligibility for VR, Trial Work Experience, or Extended Evaluation services signed and dated by the counselor. (See Appendix E)

* The Certificate of Eligibility/Ineligibility 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 or Extended Evaluation).

Note: Under presumptive eligibility, the Certificate of Eligibility/Ineligibility 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/Ineligibility in the individual's record of services. This Certificate of Eligibility/Ineligibility will be dated and signed by the counselor. The counselor will notify the applicant in writing of the action taken, or by other appropriate modes of communication consistent with the informed choice of the individual, including the reasons for the ineligibility determination. When appropriate, referral will be made to other agencies and programs that are part of the One-Stop service delivery system under the Workforce Investment Act.

PROCEDURES - INELIGIBILITY - See Closure Section VIII. 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. This review need not be conducted if the individual refuses to participate, no longer resides in the state, or the whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal. 34 C.F.R. § 361.43(e)

ORDER OF SELECTION

When ARS is under an order of selection, this section will be utilized.

Under the Vocational Rehabilitation Act (Title IV of the Workforce Investment Act of 1998) certain state Vocational Rehabilitation agencies are required to have an order of selection. An order of selection requires that a priority be given to individuals with the most significant disabilities in the provision of vocational rehabilitation services. The order of selection is required in the event that the state is unable to provide the full range of vocational rehabilitation services to all eligible individuals or, in the event that vocational rehabilitation services cannot be provided to all eligible individuals in the State who apply for the services

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. The notification of change of Order of Selection to ARS staff is placed permanently in Appendix J for reference.

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 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:

1) Seriously limits at least three functional capabilities (mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of employment outcome;

2) Whose vocational rehabilitation can be expected to require multiple VR services* over an extended period of time**; and

3) Who has one or more physical or mental disabilities as defined below***.

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:

1) Seriously limits two functional capacity area (mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of employment outcome;

2) Whose vocational rehabilitation can be expected to require multiple VR services* over an extended period of time**; and

3) Who has one or more physical or mental disabilities as defined below***:

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:

1) Seriously limits one functional capacity area (mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of employment outcome;

2) Whose vocational rehabilitation can be expected to require multiple VR services* over an extended period of time**; and

3) Who has one or more physical or mental disabilities as defined below***:

Definitions:

* Two (2) or more major VR services, i.e. counseling and guidance, assistive technology, physical or mental restoration, training, and placement.

** 90 days or more from the date services are initiated.

*** One or more physical or mental disabilities resulting from: amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

PRIORITY OF CATEGORIES TO RECEIVE VR SERVICES UNDER THE ORDER

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.

PROCEDURES - ORDER OF SELECTION

When applicable ARS Order of Selection follows the procedures outlined.

* Eligibility (Status 10) must be established prior to applying the Order of Selection.

* Complete the Assessment for Determining Priority Category for Services. (See Appendix E)

* The consumer will be notified in writing of the priority category using the required form letter. The original will be mailed to the individual and a copy will be placed in the ECF. (See Appendix E)

* If under Order of Selection, document the Category in the case note. If the individual does not meet the level of the priority category necessary to receive services, the individual may choose to be placed in a waiting (list) Status 04, or be referred to other Workforce partners or agencies, or closed in Status 30.

If the individual chooses to be referred to other Workforce partners or agencies:

- Referral will be made to the appropriate Workforce partner.

- Documentation of the referral will be placed in the ECF.

- The case will be closed in Status 30.

- The case management system will generate the status move after required data is keyed for Status 30.

If the individual chooses to be placed on a deferred services list (Status 04):

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

- Complete the Certificate of Eligibility/Ineligibility. (See Appendix E)

- The case management system will generate the status move after required data is keyed for Status 04.

- If funding becomes available, an IPE will be completed and the case moved to Status 12 and services will be provided without further delay.

- If funding is not available, any cases remaining in Status 04 at the end of the fiscal year will be closed in Status 38.

IV. INDIVIDUALIZED PLAN FOR EMPLOYMENT (IPE)

ARS will conduct a thorough assessment for determining VR needs for each eligible individual. The purpose of this assessment is to determine the specific employment outcome, the criteria for evaluation of progress toward an employment outcome, and the nature and scope of VR services to be included in the Individualized Plan for Employment (IPE.) The term employment outcome means with respect to the individual, (A) entering or retaining full-time, or if appropriate, part-time competitive employment in the integrated labor market, (B) satisfying the vocational outcome that is determined appropriate, including self-employment, telecommuting, or business ownership.

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 is developed after a Certificate of Eligibility/Ineligibility for VR Services or a Certificate of Eligibility/Ineligibility for Trial Work Experience or EE Services has been completed. A copy of the IPE will be provided to the individual.

The IPE is amended each time a substantial change or annual (12 months)/periodic review (Status 06, every 90 days) are made in the individual's rehabilitation program. A substantial change could include:

1) a vocational goal change which may require a change in the evaluation criteria (intermediate objective)

2) deletion or addition of services

3) the cost of services

4) termination of the cost

5) periodic or annual review of the case, and

6) extension of an expired IPE. A copy of all Amendments will be provided to the individual.

Note: A new IPE must be completed when an individual is moved from Trial Work Experience or EE services to an accepted status for VR Services.

Counselor's Role:

_ provide information, tools, and resources to encourage decision making skills,

_ facilitate the decision making process,

_ support decision implementation, and

_ provide the consumer with information about the parameters, which may affect the range of available career goals or service options.

The mandatory components that the IPE must contain are based on 34 C.F.R. § 361.45 and 34 C.F.R. § 361.46, please see Procedures-Individualized Plan for Employment (IPE).

The services, service providers, and all activities selected by the individual must be necessary to meet the employment outcome goal.

The individual or representative must sign and date the IPE. The individual or representative must be given a copy of the IPE.

The counselor is the approving authority; therefore, the counselor's signature indicates approval of the individual's IPE.

The IPE for trial work/extended evaluation (status 06) is to be reviewed every 90 days. The counselor and the individual must complete a periodic review of the rehabilitation plan every 90 days to assess the individual's progress. The Amendment to the IPE will be completed to document the periodic review. (See Appendix E: IPE)

Annually, the counselor and the individual must review the rehabilitation plan to assess the individual's progress toward an employment outcome. The IPE Amendment is completed as appropriate to document the annual review in the ECF.

The IPE can be amended at any time utilizing informed choice. IPE Amendment does not take effect until agreed to and signed by the counselor and individual or representative.

PROCEDURES - INDIVIDUALIZED PLAN FOR EMPLOYMENT (IPE)

* The counselor will inform the individual of the options for developing the IPE.

* The counselor will inform the individual of the required components of the IPE if the individual chooses to develop the IPE:

_ The mandatory components that the IPE must contain:

_ A specific employment outcome consistent with informed choice,

_ criteria for evaluation of progress toward employment outcome,

_ specific rehabilitation services, (See Appendix E: IPE.)

_ projected timelines for initiation and duration of services,

_ schedule for periodic reviews and evaluations

_ entity to provide services and methods for procurement,

_ responsibilities of the individual,

_ need for post-employment services, and

_ need for supported employment services.

34 C.F.R. § 361.45 and 34 C.F.R. § 361.46

* The counselor will inform the individual that the IPE must be completed and assistance in completing the forms is available upon request.

* Complete IPE (See Forms Appendix E).

* The case management system will generate the status move after required data is keyed for Status 12.

*The counselor will document in the case note the counseling provided at IPE development.

* Cost Estimate - Cost estimates cannot be for more than one year.

* Annual Review must be completed.

INFORMED CHOICE - IPE DEVELOPMENT

ARS will assure that eligible individuals or their representatives are provided information and support services to assist them in exercising informed choice throughout the rehabilitation process. The counselor will inform each 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 development of an Individualized Plan for Employment (IPE). Eligible individuals will be given information, or assistance in acquiring the information, to make an informed choice with respect to the selection of the employment outcome, specific vocational rehabilitation services needed to achieve the employment outcome, the vendors that can provide the services, employment setting and the settings in which the services will be provided, and the methods available for procuring the 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 reasonable decision regarding the development of the IPE and program of services. A reasonable decision is one that is realistic considering the unique strengths, resources, priorities, concerns, abilities, capabilities, and interests of the individual and that must lead to an employment outcome.

To ensure that the availability and scope of informed choice is consistent, the information must include, at a minimum, information relating to the following:

1) Cost, accessibility, and duration of potential services.

2) To the extent available, consumer satisfaction with those services.

3) Qualifications of potential service providers.

4) Types of services offered by the potential providers.

5) The degree to which services are provided in integrated settings.

6) To the extent available, outcomes achieved by individuals working with service providers. 34 C.F.R. § 361.52

PROCEDURES - INFORMED CHOICE - IPE DEVELOPMENT

* The counselor will maintain a regional and statewide list of vendors that provide services that lead to an employment outcome.

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

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

* When appropriate, the counselor will make referrals to other consumers, local consumer groups, or disability advisory councils qualified to discuss the services or service providers.

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

V. ECONOMIC NEEDS/COMPARABLE BENEFITS

An individual's economic need is not used to determine eligibility for VR services.

An economic needs assessment is used only to determine if the individual can pay any costs of VR services and if so, how much. In all cases, no economic needs evaluation will be applied as a condition for furnishing the following VR services:

1) Assessment of rehabilitation needs, including rehabilitation technology, except for those services other than of a diagnostic nature which are provided under extended evaluation;

2) Counseling, guidance, and referral services, and

3) Placement.

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:

1) Determination of the individual's financial ability or inability to obtain services, either through individual or other resources;

2) Determination of the extent ARS will provide these services to the individual lacking sufficient resources.

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

NORMAL LIVING REQUIREMENT

Number of Persons

Monthly Amount

1

$3,200.00

2

$3,600.00

3

$4,000.00

($400.00 for each additional family member)

Special Circumstances (conditions) of other expenditures/debts that impose unusual burdens on the client or family's income can be added to the normal living requirement. (Example: medication or medical payments for client or other family members, child support, education expenses, etc.)

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

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

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

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

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

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

Evidence of approval of receipt of financial assistance may be documented through a financial aid award letter. This letter originates at the training institution and lists the type/amount received by semester (quarter). Federal law requires students to accept/reject awards by signing on this letter.

Repayable loans should not be considered as a comparable benefit or resource.

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

PROCEDURES - UTILIZING FINANCIAL NEED

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

* The individual must apply for comparable benefits and documentation of benefits must be placed in the 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.

VI. SERVICES

Arkansas Rehabilitation Services highest priority is to provide individualized services to eligible individuals so they can work in full-time competitive employment.

Services will be provided in compliance with Title VI and VII of the Civil Rights Act, The Americans with Disabilities Act and without regard to age, religion, disability, sex, race color or national origin.

SUBSTANTIALITY OF SERVICES

Substantial vocational rehabilitation services are those services, which, provided in the context of the counseling relationship, collectively and significantly contribute to the achievement of an employment outcome consistent with the informed choice of the individual.

In order for the counselor to show substantial services in a case, the counselor must document the relationships of the provision of services, the criteria for evaluation of the intermediate objectives or steps needed to reach the vocational goal, and the counseling necessary for successful closure of a case. Documentation of substantiality of services in the ECF is an ongoing process. This documentation must be found in case note entries; therefore, the case note must tell the story of the case and subsequently show the individual's participation and the services provided enabled the individual to become employed.

THREE CONTACTS A YEAR

There must be three contacts a year, which will include the annual review. The case note should reflect direct face-to-face contact, e-mail conversation, phone conversation with the client, or a letter from the client. If contact with the client is not possible, use a letter to document the counselor's attempts to contact the client leading to closure of the case due to loss of contact. Be sure to document counseling after services have been initiated at least once a year.

VOCATIONAL REHABILITATION SERVICES

As appropriate to the vocational rehabilitation needs of each individual and consistent with each individual's informed choice, the following vocational rehabilitation services are available:

1) Assessment for determining eligibility and priority for services;

2) Assessment for determining vocational rehabilitation needs;

3) Vocational Rehabilitation counseling and guidance, including personal adjustment counseling, to maintain a counseling relationship throughout the program of services for an individual with a disability; and the referral necessary to help the individual with a disability secure needed services from other agencies when such services are not available and to advise those individuals about Client Assistance Programs;

4) Physical and mental restoration services necessary to correct or substantially modify a physical or mental condition which is stable or slowly progressive;

5) Vocational and other training services, including personal and vocational adjustment, books, tools, and other training materials, provided that no training or training services in institutions of higher education (universities, colleges, community/junior colleges, vocational schools, technical institutes, or hospital schools of nursing), may not be paid for with funds under this part unless maximum efforts have been made to secure grant assistance in whole or in part from other sources;

6) Maintenance, not to exceed the estimated cost of subsistence, provided in connection with VR services at any time from the date of initiation of services through the provision of post-employment services. Maintenance covers that individual's basic living expenses, such as food, shelter, clothing, and other subsistence expenses that are necessary to support and derive the full benefit of other VR services being provided.

7) Transportation, including cost of travel and subsistence during travel (or per diem payments in lieu of subsistence) in connection with transporting individuals with disabilities and their attendants/escorts for the purpose of deriving the full benefit of other VR services being provided. Transportation may include relocation and moving expenses necessary for achieving a VR objective;

8) Services to a client's family when necessary to the adjustment or rehabilitation of the client.

9) Interpreter services and note-taking services for the deaf, including tactile interpreting for deaf-blind individuals;

10) Reader services, rehabilitation teaching services, note-taking services and orientation and mobility services;

11) Recruitment and training services to provide new employment opportunities in the fields of rehabilitation, health, welfare, public safety, law enforcement and other appropriate public service employment;

12) Job search, placement assistance and job retention services;

13) Supported employment;

14) Personal assistance services;

15) Post-employment services necessary to maintain employment;

16) Occupational licenses (including 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 a small business, tools, equipment, initial stocks and supplies;

17) Rehabilitation technology services including vehicular modification, telecommunication, sensory, and other assistive technological aids, devices and services;

18) Transition Services in accordance with the definition of the term;

19) Technical assistance and other consultation services to individuals who are pursuing self-employment, telecommuting or establishing a small business operation as an employment outcome; and,

20) Other goods and services determined necessary for the individual with a disability to achieve an employment outcome. 34 C.F.R. § 361.48

PROVISION AND AUTHORIZATION OF SERVICES

Payment request will not be approved until documentation that the service has been received. Documentation may include medical reports, training progress reports, attendance forms, receipts and/or invoices. Payment will not be processed without an attached bill from the vendor.

ARS currently requires District Manager approval on all new counselors (Section XIII, Policy and Procedure Manual). District Manager and/or Administrative approval is also required for several specified purchases and services (Section VI, Policy and Procedure Manual).

The Authorization/Payment justification should consist in the case note explaining why the services were necessary.

Electronic authorization must be made for the provision of services or goods. A verbal approval may be given in an emergency followed immediately by a written authorization. An IPE must be completed before any services or goods, other than diagnostic or to support diagnostic assessment, can be provided. It is the counselor's responsibility to document case progress throughout provision of services.

NOTE: A "comparable" benefit will be considered only to the extent that it is available and timely to meet the cost of the particular VR services.

SEGREGATION OF DUTIES

ARS require segregation of duties to assure effective internal control in regards to authorizing services. The implementation of the new Case Management System (CMS), System 7, enables staff to perform key functions required by their role. The authorization process is as follows:

* Support staff creates the authorization from the invoice.

* The counselor approves and dates the authorization.

* The support staff submits payment to accounts payable.

ACCOUNTS PAYABLE

* Verify proper invoice with authorization/payment.

* Verify dollar amounts, vendor and client name.

* Reject authorizations/payments that contain errors.

* Approve authorization for final payment.

ADDITIONAL PROVISIONS

* All authorizations must have a copy of the invoice attached.

* All new counselors' authorizations must have the Manager approval.

* Authorization for $5,000.01 or more but less than $10,000 (tax excluded) will require the approval of the District Manager.

CHIEF OF FIELD SERVICES

Authorization for $10,000.01 or more but less than $25,000 (tax excluded) will require the approval of the Chief of Field Services through the District Manager.

PROCEDURES - PROVISION AND AUTHORIZATION OF SERVICES

* Before an authorization is issued the counselor must consider the following issues:

- Is this service allowable under ARS Policy?

- What, if any, limitation exists to providing this service?

- Are there any comparable benefits available to provide the service?

- Has the counselor verified financial need?

- What other required references need to be accessed (i.e., fee schedule vendor list)?

- Does the counselor have sufficient funds in the allotment to procure/provide the service and if not, whom does the counselor contact?

- What documentation is needed to procure/provide the service? (i.e., Licensed Medical Consultant (LMC), prior approval, case note.)

- Document method of calculating cost of services (i.e.: estimates, quotes, recommendations, fee schedule, etc.) and explain why the current service is needed.

- How is the paperwork routed?

- Determine if the vendor is in the case management system vendor list.

* Complete a W-9 if needed.

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

* The authorization goes to the vendor. It can be emailed, copied, faxed or mailed and the copy is automatically generated in the ECF. The individual may be provided a copy.

* 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.

VOCATIONAL REHABILITATION COUNSELING AND GUIDANCE

The counselor will include on an IPE services of "vocational rehabilitation counseling, guidance, placement, and follow-up." The program will outline in the criteria for evaluation of progress toward the employment outcome the counseling process and anticipated results. Documentation of counseling progress will be placed in the record of services. Vocational rehabilitation counseling and guidance services must be provided and documented in all VR cases closed rehabilitated.

PROCEDURE - VOCATIONAL REHABILITATION COUNSELING AND GUIDANCE

* The counselor will document in the case note the specific progress the individual is making toward the employment outcome.

* The individual's progress will be reviewed three times a year.

* Counseling and guidance must be documented in each successful closure.

EMPLOYMENT SERVICES (JOB FINDING/REFERRAL)

A job-finding service is provided when enough information has been given to permit the individual to arrange for a job interview with an employer. A job-finding service is also rendered when ARS directly refers or arranges for the direct referral of the individual to a prospective employer.

PROCEDURES - EMPLOYMENT SERVICES (JOB FINDING/REFERRAL)

* The individual may be referred to either an ARS Business Relations Representative (BRR) or other vendors for employment services in status 12 or 18. The ARS BRR can assist the counselor at this stage in the planning process, but significant involvement of the ARS BRR may occur when the individual has completed services and is ready for employment.

* The counselor and ARS BRR will assist the individual, singly or in groups, in developing job-seeking skills which would include instructions on how to read the want ads, prepare job resumes, write cover letters and prepare for job interviews.

* The counselor may refer the individual for services from other resources providing job-seeking skills, if appropriate.

* The counselor will document in the case note the specific progress the individual is making toward the employment outcome. With agreement from the counselor, the Business Relations Representative (BRR) will have access to the ECF (via worker assignment) for the purpose of documenting specific progress the individual is making toward employment

PLACEMENT SERVICES

Placement services are organized and identifiable attempts to establish or improve the linkage of an individual and a work situation. While employment placement is the VR program goal and usually occurs toward the end of the rehabilitation process, employment planning should be an ongoing process throughout the case services program. Placement is provided when the individual is referred to and is hired by an employer. The State VR Agency, the State employment service, One-Stop Arkansas Workforce Centers, or any other job-finding source may provide this service. A key feature of this service is that the individual became competitively employed as a result of the job referral.

PROCEDURES - PLACEMENT SERVICES

* The counselor will assist the individual with employment planning throughout the rehabilitation program.

* The counselor and the ARS Employment Services Representative will document in the case note the specific progress the individual is making toward the employment outcome.

FOLLOW-UP

The counselor and/or BRR will provide follow-up services to each individual placed in employment to determine if all planned for services have been provided and the VR objective achieved. Follow-up services will include contacts and reports from the individual, employer, and others that provide reports to help the counselor determine if the employment situation is suitable to the individual's needs. The individual must be provided follow up services within a minimum of 90 days and the counselor will have assurance other ARS criteria have been met prior to case closure.

PROCEDURES - FOLLOW-UP

* The counselor or the rehabilitation assistant and/or the BRR will maintain contact with the individual and employer to determine if the employment is suitable for the individual.

* The counselor or the rehabilitation assistant will provide supportive services as necessary for maintaining employment.

* The counselor or the rehabilitation assistant and/or the BRR will document in the case the specific progress the individual is making toward the employment outcome.

ASSESSMENT SERVICES

Assessment services are those services required to determine an applicant's eligibility for rehabilitation services, priority for services, and to determine the services needed to achieve an employment outcome.

Medical diagnostic services may include:

1) medical and surgical examinations;

2) dental examinations;

3) consultations with and examinations by specialists in all medical specialty fields;

4) inpatient hospitalization for study or exploration, not to exceed three days or five days with local medical consultant recommendation;

5) clinical laboratory, tests;

6) diagnostic x-ray procedures;

7) trial treatment for differential diagnosis, stabilization of drug therapy, or determination of feasibility in the case of emotional disturbance;

8) maintenance; and

9) other medically recognized diagnostic services.

Vocational diagnostic or assessment services may include:

1) Referral to a Community Rehabilitation Program for assessment.

2) Referral to the 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 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 Consultants 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 attach to the ECF. (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 Purchased 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 Consultants 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 Purchased 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.

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, PSYCHIATRIC, AND MEDICALLY DIRECTED 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.

Psychiatric Treatment: After the initial psychiatric diagnostic evaluation, payments may be made to a specialist in neuropsychiatry, a psychiatric clinic or hospital for psychiatric treatment.

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

Anesthesia: Payments may be made to anesthetists and anesthesiologists not included in hospitalization.

University of Arkansas Medical Sciences: Payments for professional services including surgical treatment, anesthesia, pathology, and others provided at the UAMS are to be authorized to the "Medical College Physicians Group."

Physical and Occupational Therapy (PT/OT): ARS will pay for PT/OT services when prescribed and provided by competent medical personnel and when necessary to a VR program. If the expected duration of treatment is more than 30 days, then equivalent services at ACTI should be considered.

Podiatrist or Chiropractor: ARS will pay for the services of a Podiatrist or Chiropractor only with Medical Consultant approval.

Dental: ARS may purchase dental services including oral surgery when necessary for an individual to participate in or complete a VR program. Available services do not include routine preventive dental care. Services will be purchased consistent with the ARS fee schedule. (See Appendix I.)

EXCEPTION: Insurance benefits must be used first in paying for surgical and medical services. The amount allowed by the ARS Fee Schedule will be authorized followed by the statement "Rehabilitation Services will pay only that part of the authorized amount not covered by the insurance policy up to the maximum amount allowed by the ARS Fee Schedule". (See Appendix I.)

PROCEDURES - MEDICAL, SURGICAL, PSYCHIATRIC, AND MEDICALLY DIRECTED TREATMENTS

* 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 Consultants 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 Purchased 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.

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 such as Weight Watchers, TOPS, etc. or other medical directed programs. The counselor should make every effort to seek out programs in the community that provide supportive/mental health counseling and address significant lifestyle changes including diet, exercise, and behavior modification. The counselor will consult with the District Manager for approval of the treatment program and negotiated costs.

PROCEDURES - DIRECTED THERAPY FOR WEIGHT LOSS

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

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

* Counselor will negotiate reasonable fees with the vendor.

* 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 Purchased 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.

TREATMENT FOR MORBID OBESITY (GASTRIC RESTRICTIVE, LAP BAND OR BYPASS SURGERY)

Individuals requesting assistance from ARS for gastric restrictive, lap band or bypass surgery as a method of treatment for morbid obesity are to be informed the procedure is a major operation with the potential of both short-and long-term complications.

Any decision to use surgery as a treatment for morbid obesity requires assessing the risk-benefit by an experienced physician(s). Candidates for the procedure should be judged as having a low probability of success using non-surgical measures as demonstrated by failure in an established weight control program(s). Such programs might include in various combinations behavior modification, exercise, low- or very low-calorie diets, and drug therapy.

A diagnosis of morbid obesity alone does not indicate an individual is an appropriate candidate for this procedure. High-risk conditions such as significant diabetes mellitus, obstructive sleep apnea, obesity-related cardiomyopathy and joint disease would increase the likelihood an individual would be an appropriate candidate for gastric restrictive, lap band or bypass surgery.

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

1) Have a Body Mass Index (BMI) of at least 55 (BMI is an individual's weight in kilograms divided by his/her height in meters squared),

2) Have an associated high-risk co-morbid condition(s);

3) Have documentation the morbid obesity has been present for a minimum of 5 years;

4) Have documentation from a treating physician of failure by the individual in a structured weight loss program while under that physician's care for a minimum of 1 year; and this documentation must be within the last 2 years.

5) Counselor's impression that the individual is well motivated and understands the risks associated with the surgical procedure and the restricted eating habits which will follow.

6) If the individual has demonstrated success in a structured weight loss program in the past, the Counselor will be required to assess the appropriateness of the gastric restrictive, lap band or bypass procedure Re-enrollment in a structured weight loss program should be explored.

SUPPORTED COUNSELING RELATED TO WEIGHT

After 3 months in a weight loss program, at the counselor's discretion and based on little or no success, the client program needs to be modified.

PROCEDURES - GASTRIC BYPASS SURGERY

* Obtain a general medical assessment or current medical information that documents the individual's diagnosis of morbid obesity and any other high-risk co-morbid conditions.

* Obtain a Mental Health Assessment that indicates the individual does not have a mental health condition that might preclude this restoration service.

* Obtain documentation from a treating physician of the individual's failure in a structured weight loss program for at least 1 year (this documentation must be within the last 2 years.) and the presence of morbid obesity for at least 5 years.

* Documentation of co-morbid conditions by an appropriate physician with a statement of recommendation for weight loss surgery.

* Obtain medical reports that document the need for referral to a surgeon for an assessment to determine the appropriateness of gastric restrictive, lap band, or bypass surgery.

* Obtain an examination from a surgeon proficient in gastric restrictive, lap band, and bypass procedures that documents the individual is an appropriate candidate for this procedure.

* Assess the individual regarding motivation for the procedure and understanding of the associated risks.

* The Counselor will submit received reports and documentation for review and approval by the Medical Consultant.

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

* If the District Manager agrees that all the required documentation is present and the individual meets ARS eligibility and Order of Selection requirements, the individual is an appropriate candidate for the procedure, and agrees with the identified counseling issues, the District Manager will provide the Counselor a memorandum of approval.

If the District Manager does not agree the individual meets eligibility and Order of Selection criteria, is not an appropriate candidate for the requested gastric restrictive or bypass procedure, or is of the opinion that the identified counseling issues are inadequate or inappropriate, a memorandum of denial will be sent to the counselor notifying the counselor of the decision.

* If the District Manager approves, the Counselor will proceed as with any other physical restoration case.

* During the recovery process the Counselor will be required to document a minimum of 3 counseling sessions prior to case closure.

* It is recommended that the case be placed in post-employment status so that necessary counseling and follow-up can take place to ensure optimum benefits from the procedure.

* 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.

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

* Document counseling with medical personnel and a peer in regard to after effects and adjustment to the procedure.

* Document post-operative aural rehabilitation plan.

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

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

SURGICAL AND HOSPITAL INSURANCE

Insurance benefits must be used first in paying for surgical and medical services. The amount allowed by the ARS Fee Schedule will be authorized followed by the statement.

"Rehabilitation Services will pay only that part of the authorized amount not covered by the insurance policy up to the maximum amount allowed by the ARS Fee Schedule". Authorization will be based on the ARS Fee Schedule. (See Appendix I.)

CONSULTATION

For diagnostic purposes, the attending physician may consult with another specialist. The counselor must have a recommendation for consultation and prior authorization is required.

POST-OPERATIVE REPORTS

It is the counselor's responsibility to obtain a post-operative report or letter prior to processing the final payment.

MINOR SURGERY BY GENERAL PRACTITIONERS

ARS may pay general practicing physicians for minor surgery, such as the opening of a superficial abscess or removal of a superficial tumor or cyst.

MEDICATION

Medication can be provided throughout the program and 30 days following placement.

The counselor must document the ongoing medication need either through the Medical Consultant, or the individual's personal care physician. The counselor must actively negotiate for the most economical medication prices.

PROCEDURES - MEDICATION

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

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

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

* 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 Purchased 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.

SPEECH AND HEARING THERAPEUTIC SERVICES

Individuals with organic or inorganic speech and hearing disorders may be scheduled for evaluation and therapy by an approved therapist. The counselor will furnish the therapist with information needed to provide services.

PROCEDURES - SPEECH AND HEARING THERAPEUTIC SERVICES

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

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

* Medical Consultants review is required and attached to the ECF. (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 Purchased 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.

HOSPITALIZATION, CONVALESCENT CARE AND NURSING SERVICES

ARS will pay for inpatient or outpatient hospitalization, including blood, in Arkansas hospitals according to current Medicaid fees or other fees established.

ARS will pay for the day an individual enters the hospital, but not the day on which the individual is discharged.

PROCEDURE - HOSPITALIZATION, CONVALESCENT CARE AND NURSING SERVICES

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

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

* Medical Consultants review is required and attached to the ECF. (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 Purchased 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.

CONVALESCENT OR NURSING HOME CARE

If care in a convalescent or nursing home is medically recommended after a period of hospitalization, the arrangements will be noted in the IPE. There will be a re-evaluation of rehabilitation potential within 30 days.

PROCEDURES - CONVALESCENT OR NURSING HOME CARE

* A recommendation from the attending physician must be secured before authorizing for convalescent or nursing home care and attached to the ECF.

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

* Medical Consultants review is required attached to the ECF.(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 Purchased 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.

HOSPITALIZATION THROUGH COOPERATING AGENCIES

ARS will use hospitalization available through cooperating agencies when feasible. It is the counselor's responsibility to determine if these services are available through the cooperating agencies before obligating ARS for these services.

RADIOLOGY/PATHOLOGY

ARS may pay for radiology/pathology services according to the ARS Fee Schedule.

PROCEDURE - RADIOLOGY/PATHOLOGY

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

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

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

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

* 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 Purchased 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.

NOTE: If radiology and pathology are provided in conjunction with surgery, the medical consultant review is not necessary for these services since the consultant has already reviewed the recommendation for surgery.

SPECIAL NURSES

ARS may provide nursing service by a registered nurse only if ordered by the attending physician. Practical nurses will be used only when a registered nurse cannot be obtained or if, in the opinion of the attending physician, the services of a registered nurse are not required. ARS may pay the standard rate for this service in the community.

PROCEDURES - SPECIAL NURSES

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

* Medical Consultants review is required and attached to the ECF (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 Purchased 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.

CHILDREN'S MEDICAL SERVICES

Any individual who may be eligible for Children's Medical Services and who might need physical restoration will be referred to CMS to determine eligibility. If the individual is eligible for services through CMS, ARS will not provide the services.

TRAINING

Training services are those services needed to prepare an eligible individual for work. These services are individualized and are jointly developed by the individual and counselor through the process of informed choice.

Vocational training includes the following broad categories:

1) On-the-job Training

2) Short-term Specialized Training

3) Vocational/Technical

4) Community College

5) College/University

It is the policy of ARS to provide "individual-appropriate" training services needed to achieve employment. Individual-appropriate services reflect the unique strengths, priorities, concerns, abilities, capabilities, and career interests of each eligible individual. These individual-appropriate services may be based upon a review, to the extent needed, of the following:

1) An analysis of pertinent medical, psychiatric, psychological, neuro-psychological, and other pertinent vocational, education, cultural, social, recreational, and

2) Environmental factors, and related functional limitations, that affect the employment and rehabilitation needs of the individual;

3) An analysis of the individual's personality, career interests, interpersonal skills, intelligence and related functional capacities, educational achievements, work experience, vocational aptitudes, personal and social adjustments, and employment opportunities;

4) An appraisal of the individual's patterns of work behavior and services needed to acquire occupational skills and to develop work attitudes, work habits, work tolerance, and social and behavior patterns suitable for successful job performance; and

5) An assessment, through provision of rehabilitation technology services, of the individual's capacities to perform in a work environment, including in an integrated setting, to the maximum extent feasible and consistent with the individual's informed choice.

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

An individual is eligible for training:

1. if the individual meets basic eligibility requirements;

2. if the individual is mentally, physically, and temperamentally capable of completing the training and performing the resulting job;

3. if the individual has no skill which, within the limitations of the disability, can be used for satisfactory employment;

4. if there is every indication employment can be found in the trade or occupation for which the individual is to be trained; and

5. after every effort has been made to utilize comparable benefits and other resources.

FINANCIAL AID

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

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

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

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

A threshold of $5000 has been established per twelve month period beginning with initiation date of the IPE for tuition, required textbooks, academic fees, maintenance, and transportation. For an exception form refer to Appendix G. (Exception: Medical, dental, veterinary schools and those individuals with special needs may be funded at a higher level.)

COLLEGES AND UNIVERSITIES

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

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

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

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

A threshold of $5000 has been established per twelve month period beginning with initiation date of the IPE for tuition, required textbooks, academic fees, maintenance, and transportation. For an exception form refer to Appendix G.

ADVANCED DEGREE

It is ARS policy to assist individuals in obtaining an advanced degree only when this degree is a minimum requirement for the vocational objective. The decision to obtain an advanced degree must be determined at the time of initial plan development. For example: A client whose vocational objective is teaching may not change the objective to superintendent or principal in order to receive further ARS financial assistance.

ARS may assist clients beyond the Bachelor level in occupations that require advanced training for entry level, such as medicine, dentistry, law, etc. and this need must be determined at the time of initial plan development.

FULL-TIME STUDENT

A full-time student receiving financial support from ARS is one who completes 12 per semester hours or 6 semester hours for per summer term at the college level.

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

REMEDIAL COURSES

ARS will pay for a total of 9 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 6 hours during summer semester with a "C" average (2.0) may be placed on probation for the following semester at the counselor's discretion. If the client is placed on probation and fails to make a "C" average (2.0), college training will be terminated. Failure to do acceptable college course work will result in a re-evaluation of the client's program and the selection of a more realistic vocational objective.

GRADES - COLLEGES AND UNIVERSITIES

The counselor is responsible for obtaining grades 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 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 Purchased 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. 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 Status18.

* Key required information into the case management system for ARS Purchased 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/COMPUTER 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 Purchased 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 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 Purchased 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. ARS requires a copy of the schools 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 District Manager's approval is required if extenuating circumstances occur such as changes or expenses beyond the agreed rate, or additional training time to meet the required 1500 hours. 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.

* 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 Purchased 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:

1) proper equipment,

2) sufficient work to ensure adequate practice for the individual to reach proficiency,

3) the trainer must possess the knowledge, skill, and ability to train the individual,

4) daily training period long enough for the individual to acquire the necessary skills.

The counselor will consider:

1) the personality and skill of the trainer,

2) attitude toward the individual,

3) past success in training individuals, and

4) willingness of the employer to hire the individual when trained.

Arkansas Rehabilitation Services will pay an On-the-Job training fee to the vendor for providing instruction to the individual to help them reach a skilled proficiency level in the work area selected. ARS does not pay the individual's salary or wages. ARS pays a training fee to the vendor or employer for on-the-job training services.

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

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

PROCEDURES ON-THE-JOB

* The counselor will negotiate with the vendor the training fee and the length of On-the-Job program. The fee and time period should be kept to a minimum.

* Documentation of the action to be taken will be made in the case 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 Purchased 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 Purchased 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 (including Correspondence/Online)

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:

1) training cannot be arranged by any other method;

2) the individual needs preliminary training, which may be obtained more practically and efficiently by correspondence, prior to entering another training method; or

3) living arrangements cannot be made to secure training by any other method.

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

1) an intense interest in the chosen work field,

2) standardized tests or past academic performance indicate the individual may complete the training,

3) some previous knowledge of, or experience in, the chosen field,

4) adequate time to devote to course study, and

5) the labor market reflects employment possibilities upon completion of the 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 District 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 Purchased 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.

TRANSPORTATION

Transportation costs for VR services may be paid at the usual rates not to exceed the State allowed rate. Transportation costs can only be paid as an auxiliary service to core VR services. Transportation is not a stand-alone service.

If public transportation is not available or the individual, because of disability, cannot travel by public transportation, the counselor should make every effort to negotiate an estimated cost of gas only if it is the least expensive travel cost.

This does not apply to taxicab fares within a city, which will be paid at the prevailing rates when necessary and authorized.

The case note will document justification for the need of the service and include the method of calculating the cost of the service. Receipts or other documentation showing the individual received the service is required before the payment is processed.

TRANSPORTATION FOR PHYSICAL RESTORATION SERVICES

Transportation for physical restoration services may be paid. Transportation may be paid for checkup visits to a doctor or hospital only when the counselor has prior notice of the necessity of the visit and has authorized each trip.

TRANSPORTATION FOR TRAINING SERVICES INCLUDING COLLEGE

If the training location is where the individual cannot live at home, transportation costs may be paid for a direct, one-way trip at the beginning of the training session. At the session's conclusion, transportation from the training location to the job site may be paid or a return trip to where the individual resides. Transportation may be paid to and from the individual's place of residence to the training site. Note: Receipts are required for reimbursement if transportation costs are to be provided directly to the client.

TRANSPORTATION FOR PLACEMENT

Transportation may be paid for placement or self-employment when necessary for up to 30 days.

TRANSPORTATION FOR DIAGNOSIS INCLUDING SUBSISTENCE WHILE IN TRANSIT

Transportation and meals may be paid when required for out of town diagnosis.

Transportation and meal reimbursement based on the State VR Agency's prevailing rate.

PROCEDURES - TRANSPORTATION

* Documentation of the action to be taken with justification for the service will be made in the case 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 Purchased 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 includes payment to cover the individual's basic living expenses such as food, shelter, clothing, health maintenance, and other subsistence expenses essential to determine the individual's rehabilitation needs or to achieve the VR objective.

Maintenance may be provided at any time while the case is in a Trial Work Experience or Extended Evaluation program or an IPE is in effect.

After job placement, maintenance will only be paid until the individual receives their first paycheck. If the individual is self-employed, maintenance is authorized for 30 days, unless additional days are approved by the District Manager. For an exception form refer to Appendix G.

Maintenance payments for training will be reimbursed at the end of a stated period (two weeks, four weeks, one month, or other). Authorization will be made in accordance with the IPE and may be paid to the client's boarding house, landlord, school, etc.

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 Purchased 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 DURING PHYSICAL RESTORATION SERVICES

An individual receiving physical restoration services may be eligible for maintenance while away from home.

MAINTENANCE FOR VOCATIONAL PROGRAMS

COLLEGE TRAINING

Note: An outside substantial source of support must be documented prior to beginning a college program.

ARS may pay college maintenance costs to those individuals eligible provided:

1) the assessment for vocational needs indicates that college training is the most feasible training option, and,

2) a comprehensive search of similar benefits and alternative funding sources has been completed.

Maintenance services are available at the Arkansas Career Training Institute (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.

REHABILITATION CENTERS AND FACILITIES

Maintenance will be paid based on the State VR Agency's prevailing rate.

PLACEMENT

After job placement, maintenance may be paid until the individual receives the first paycheck. Maintenance will not continue for more than 30 days after placement unless approved by the District Manager. For an exception form refer to Appendix G.

PROCEDURES - MAINTENANCE FOR VOCATIONAL PROGRAMS

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

OTHER SERVICES

Other goods and services include tools, equipment, initial stock and supplies for vending stands, business and occupation licenses.

PROCEDURES - OTHER SERVICES

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

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

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

SUPPORTED EMPLOYMENT SERVICES (SES)

See Appendix C for detailed definitions and the SE process.

ARS will provide supported employment services to any individual who is determined eligible for services who has a most significant disability and for whom competitive employment has not traditionally occurred or has been interrupted or intermittent as a result of their disability.

1) the ability to engage in a training program with supports leading to supported employment;

2) a need for on-going support services in order to perform competitive work; and

3) the ability to be employed in an integrated settings in which individuals are working toward competitive employment.

Supported Employment involves full or part-time employment averaging at least 15 hours per week for each pay period. It may be less than 15 hours with District Manager's approval. For an exception form refer to Appendix G.

Ongoing support services are provided at least twice monthly at the worksite (except for ongoing behavioral health issues) by the Supported Employment Vendor. Under special circumstances at the request of the individual and documented in the IPE, the vendor may provide off-site monitoring with twice monthly meetings. Ongoing support is provided after ARS case closure throughout the term of employment.

The 18-month limitation on the provision of supported employment services may be amended to permit extension of this service on a case-by-case basis as determined by the counselor and documented on the IPE. Document justification for the additional service in the case note.

When a job is lost, the counselor should take a new referral. The counselor can reinitiate supported employment services for a former consumer in instances of job destabilization or potential upgrade.

All ARS requirements related to the provision of services will apply in the provision of supported employment services.

PROCEDURES - SUPPORTED EMPLOYMENT SERVICES (SES)

* Complete the Certificate of Eligibility. (See Appendix E)

* Complete the IPE utilizing informed choice. The counselor will indicate the extended service provider on the IPE at plan development.

* ARS will purchase services on a fee-for-service basis.

* Attach monthly progress reports to the ECF.

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

* When Milestone 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.

- Milestone #1 - Referral/Job Development (Status 18): completed at time of the provider referral acceptance letter/email is obtained by counselor.

- Milestone #2 - Job Match/Placement (Status 20): completed at the time job placement occurs and is agreed upon by the counselor, individual and provider.

- Milestone #3 - Stabilization (Status 22): is completed when the individual remains on the job 30 days or more at 15 hours a week or more, and job coach/employment specialist support fades to less than 20 percent).

- Milestone #4 - Closure (Status 22): is completed when the individual has been employed for an additional 90 days after the 30 day stabilization period. The individual and their employer must be satisfied with the employment outcome, the individual is eligible for a successful Status 26 closure

SUPPORTED EMPLOYMENT SERVICES (SES)-TRANSITIONAL EMPLOYMENT SERVICES (TES)

Transitional Employment Services are for persons with ongoing behavioral health issues due to a mental illness and provides paid work in a job slot in competitive industry. This service may result in independent competitive employment. Supported Employment involves full or part-time employment averaging at least 15 hours per week for each pay period. It may be less than 15 hours with District Manager's approval. For an exception form refer to Appendix G.

PROCEDURES - SES TRANSITIONAL EMPLOYMENT SERVICES

* Complete the Certificate of Eligibility. (See Appendix E.)

* Complete the IPE utilizing informed choice.

* ARS will purchase services on a fee-for-service basis.

* Attach monthly progress reports to the ECF.

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

* When Milestone 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.

PROVISION, IMPACT AND SCOPE OF SERVICES TO FAMILY MEMBERS

Services may be provided to an individual's family when necessary for the individual to attain the vocational objective. These services must substantially contribute to the individual's rehabilitation. The necessity of service provision to an individual's family should be based on a study of the individual's needs. This includes problems faced by the family in support of the individual's rehabilitation. Substantial impact services are those that allow or increase the opportunity for an individual's use of VR services. Without these services, the individual would be unable to begin or continue the IPE, which may result in delayed employment or unachievable employment. The individual and their family member(s) must be jointly involved in deciding if services to a family member can contribute to the individual's rehabilitation program. In developing the IPE, it is important that both the individual and family members understand the basis for provision of family services, i.e., such services must be necessary to the individual's adjustment or vocational rehabilitation.

While the counselor often sees family members during the preliminary or thorough diagnostic study, these interviews and any incidental advice provided during such sessions are not considered a service to a family member. Rather, such interviews and counseling are part of the process of determining the individual's eligibility for VR or the scope of services to be provided.

Services may include childcare, training, transportation, relocation of the family to an area where work is available for the individual, and any other necessary support services for the individual. These services may include any VR services and may be provided without age restriction of the family members. Services to family members must be included on the IPE.

Educating the family on the importance of using personal resources, family support, and other available community resources is essential to the successful completion of the rehabilitation program. Appropriate and available resources should be fully utilized in the provision of services to an individual's family when necessary to the individual's adjustment or rehabilitation. Any contribution by family members to the cost of these services is regarded as participation by the individual.

Although these services are intended for the individual's benefit, the family member(s) will also benefit. A family member with a disability that might qualify the individual for VR services should be considered a prospective ARS consumer.

PROCEDURES - SERVICES TO FAMILY MEMBERS

* The counselor must document in the case note why services are needed, which family member needs services, what services are needed, how the services will contribute to the individual's adjustment or rehabilitation, and how services will be secured in accordance with informed choice.

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

* 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 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.

TERMINATING SERVICES TO FAMILY MEMBERS

Services to family members can be an integral part of the individual's VR, Trial Work Experience or EE program, service termination should be considered when the service no longer substantially contributes to the individual's program or when the individual is rehabilitated.

When the individual has been placed in employment and the case is ready for closure, but services to the family members have not been completed and are still expected to substantially contribute to the individual's rehabilitation program, the case should not be closed until services to family members are completed or terminated.

POST- EMPLOYMENT SERVICES TO FAMILY MEMBERS

Post-employment services to family members may be provided after the individual is rehabilitated if services are necessary to help the individual maintain employment. Post-employment services to family members must be included on an IPE.

POST- EMPLOYMENT SERVICES

Post-employment services may be provided after the individual has been closed as Rehabilitated (Status 26) and needs services to maintain, regain or advance employment. Post-employment services may only be provided to individuals in Status 32. Cases that are closed in Status 26 can only be placed in Status 32.

These services are available to meet rehabilitation needs that do not require a complex and comprehensive provision of services and, thus, should be limited in scope and duration. If more comprehensive services are required, then a new rehabilitation effort should be considered. Post-employment services are to be provided under an amended individualized plan for employment; thus, a redetermination is not required.

NOTE: Procedures to develop a Status 32 closure are covered in the Closure Section VIII.

NOTE: Post-employment services will not exceed 18 months; however an extension of time can be requested from the District Manager, Deputy Chief of Field Services, and Chief of Field Services.

PROCEDURES - POST- EMPLOYMENT

* Case must be in Status 32 to provide post-employment services.

* The counselor must maintain contact with the individual, employer, and vendors who may be involved in the provision of services.

* Document in the case note the justification for post-employment services and the individual's progress in maintaining employment.

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

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

TOOLS, EQUIPMENT, INITIAL STOCK, AND CONSTRUCTION

Tools, equipment, initial stock and occupational licenses may be provided for an individual if:

1) They are necessary for placing the individual in a job or occupation best suited to that individual's abilities and skills;

2) the employer does not ordinarily furnish these articles;

3) they are for the individual's exclusive use; and

4) if the individual is self-employed, self-employment is the most suitable method of placing the individual in a remunerative occupation.

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 District Manager. If less than three quotes are obtained, a statement of explanation will accompany the purchase request. Quote specification details will be consistent to all vendors. The RS-357 will be submitted to the Chief of Field Services for approval. An approved copy of the RS-357 will be returned to the counselor. Upon receipt, the counselor may issue an authorization.

Exception: If the Central Office provides the counselor with a copy of the State Purchasing Agency's purchase order (contract), a copy of the authorization will not be sent to the vendor.

Exemption: Surgery, treatment, hospitalization; prosthetic devices; professional, technical, and other personal services; room and board; transportation charges; books, manuals; periodicals; and copyrighted educational aids.

PROCEDURES - PURCHASING (State Purchasing Guidelines)

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

- $5,000.01 or more but less than $10,000 (tax excluded) will require the approval of the District Manager. The counselor will obtain at least three written quotes, complete the RS-357 with a Memo, and submit this information to the District Manager. If less than three quotes are obtained, a statement of explanation will accompany the purchase request. Quote specification details will be consistent to all vendors. The RS-357 will be submitted to the Chief of Field Services for approval. An approved copy of the RS-357 will be returned to the counselor. Upon receipt, the counselor may issue an authorization.

- $10,000.01 or more but less than $25,000 (tax excluded) will require the approval of the Chief of Field Services through the District Manager. The counselor will obtain at least three or more verbal or written quotations and submit this information to the District Manager. If unable to obtain three quotes, a statement of explanation must accompany the purchase request. Quote specification details will be consistent to all vendors.

- $25,000.01or more, the request will be forwarded to the Chief of Field Services. The Central Office will arrange for the purchase. The counselor will determine whether the total cost exceeds $25,001.00 and, if so, will obtain complete specifications and submit these to the Central Office. Quote specification details will be consistent to all vendors. Brand names may be used as a means of identification and as the basis of specifications only.

Note: The Vendor selected must provide proof of liability insurance, license, and worker's compensation coverage or exemption to comply with State Building Services regulations.

TITLE RETENTION/RELEASE/REPOSSESSION

The individual who is provided durable medical equipment, equipment for training, occupational tools and/or equipment by ARS will sign a Title Agreement listing the items provided and specifying that ARS will retain the title. The individual may not sell, mortgage, give away, or dispose of tools and/or equipment provided during the time that ARS retains title. The individual upon receipt of the authorized goods will sign a Title Agreement form 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.

REHABILITATION TECHNOLOGY SERVICES

Assistive technology services must be considered for each individual and if appropriate, referred for the Assistive Technology Program AT @ Work evaluation/assessment.

Rehabilitation Technology Services is the systematic application of technologies, engineering methodologies or scientific principles to meet the needs of and address the barriers confronted by individuals with disabilities in areas which include education, rehabilitation, employment, transportation, independent living and recreation. The term includes Rehabilitation Engineering, Assistive Technology Devices, and Assistive Technology Services.

REHABILITATION ENGINEERING

Rehabilitation engineering is the systematic application of engineering sciences to design, develop, adapt, test, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities in the functional areas, such as mobility, communications, hearing, vision, and cognition, and in activities associated with employment, independent living, education, and integration into the community.

PROCEDURES - REHABILITATION ENGINEERING

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

* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

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

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

* Key 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. 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.

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

ASSISTIVE TECHNOLOGY SERVICES

Assistive Technology Services are services that directly assist an individual in the selection, acquisition, or use of an assistive technology device. Services included are:

1) Evaluation of the needs of individuals including a functional evaluation in his/her customary environment;

2) Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices;

3) Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing of assistive technology devices;

4) Coordinating and using other therapies or interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;

5) Training or technical assistance for the individual or, where appropriate, the individual's family.

6) Training or technical assistance for professionals (including individuals providing education and rehabilitation services), employers, or others who provide services to, employ, or are otherwise substantially involved in the major life functions of individuals with disabilities, to the extent that training or technical assistance is necessary to the achievement of an employment outcome by an individual with a disability.

PROCEDURES - ASSISTIVE TECHNOLOGY SERVICES

* Check for appropriate status in the case management system.

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

* Complete referral procedures for the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

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

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

* Key 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. Document in the 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.

* Refer to Out of State Policy limitations, if necessary

ASSISTIVE TECHNOLOGY DEVICES

These are devices enable the individual to participate in a rehabilitation program, to complete necessary assessments, or make it possible for the person to work or become more productive. These devices include any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.

PROCEDURES - ASSISTIVE TECHNOLOGY DEVICES

* 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 the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

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

* Medical Consultants review if required and attach to the ECF. (See Form Appendix E)

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

* If assistive technology devices are purchased, a title of retention will be completed and attached to the ECF. (See Appendix E)

* 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. Document in the 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.

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

PROSTHETIC AND ORTHOTIC DEVICES

Prosthesis means an artificial appliance used for functional or corrective reasons, or both. Orthotics means an orthopedic appliance or apparatus used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body. For an original or first device, the purchase must be based on the recommendation of a specialist in the appropriate field.

In cases of replacement and repair of devices, for individuals with a history of satisfactory device use, and in which the basic examination report indicated no pathological change, this report may be sufficient medical basis for rendering the service.

All new or initial wearers and individuals who have had difficulty wearing a limb may be referred to the ACTI Amputee Clinic for evaluation. (See Appendix C.)

ARS will purchase prosthetic and orthotic devices from certified professionals in the area of expertise by the American Board of Certification on Orthotics and Prosthetics in accordance with informed choice. Artificial arms, legs, and components must be purchased through prosthetics certified by the American Board of Certification on Orthotics and Prosthetics. A list of approved vendors will be maintained. Payments will be made according to the established ARS Fee Schedule..

In selecting the vendor, the counselor will consider:

1) the individual's informed choice,

2) the proximity of the vendor to the individual (the vendor should be accessible to the individual for measurements, fittings, adjustments, maintenance and repair) and

3) the referral source, if the source is an appropriate vendor.

PROCEDURES - PROSTHETIC AND ORTHOTIC DEVICES

* Check for appropriate status in the current case management system.

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

* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

* Counselor will meet with individual to discuss findings of the Assistive Technology Program AT @ Work / Arkansas Career Training Institute evaluation in accordance with informed choice and with similar benefits.

* Medical Consultants review is required and in the ECF. (See Forms Appendix E)

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

* 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. Document in the 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.

* UAMS requires special payment.

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

PROVISION OF HEARING AID SERVICES

ARS may provide hearing aids as part of an individual's Employment Plan when the individual requires amplification to manage the required communication on the job. The technology involved with hearing aids changes rapidly, and it is important that ARS understand the employment related communication requirements, and the available options, when providing amplification.

The counselor will utilize existing medical reports within the past three (3) months by a licensed otologist or otolaryngologist (ENT) or Physician/Specialist knowledgeable in disease of the inner ear. In addition, an Audiological and hearing aid evaluation performed within the past three (3) months by a State Licensed Audiologist. If not available, ARS will purchase this service.

The hearing aid evaluation report is expected to document significant improvement in speech reception and discrimination with the new aid(s), or improvement in awareness to required environmental sounds on the job. The audiologist's hearing aid evaluation report must specify the type of hearing aid, the specific brand name, and model. Hearing aid adjustments will be included as part of the ARS purchase. The individual must indicate vendor choice in accordance with informed choice by signing the application, or IPE.

A hearing loss of 41db or greater (unaided) as measured by the Speech Reception Threshold (SRT) or Pure Tone Average (PTA) or,

Degree Hearing Loss

Hearing loss range (dB HL)

Normal

-10 to 15

Slight

16 to 25

Mild

26 to 40

Moderately

41 to 55

Moderately severe

56 to 70

Severe

71 to 90

Profound

91+

PROCEDURES - HEARING AIDS

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

* Counselor will utilize existing medical reports within the past three (3) months by a licensed otologist or otolaryngologist (ENT.) or Physician/Specialist knowledgeable in disease of the inner ear. In addition, an Audiological and hearing aid evaluation performed within the past three (3) months by a State Licensed Audiologist.

* If medical reports are not available, the counselor refers to the appropriate specialist.

* Counselor will meet with individual to discuss audiologist recommendations in accordance with informed choice and with similar benefits

* Medical Consultants review is required and attached to the ECF. (See Forms Appendix E.)

* Verification of medical insurance coverage - ARS will authorize purchase of the appropriate hearing aids after the individual has provided verification of the amount of coverage, or denial of coverage, by their medical insurance carrier in writing. Any insurance benefit will be used as the required comparable benefit.

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

* Select appropriate ARS CPT code.

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

* 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. Document in the 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.

HEARING AIDS REPLACEMENT CONSIDERATION

If an individual who is already a hearing aid user comes to ARS to request replacement of aid(s), they must bring a report from an audiologist explaining why a replacement is required.

* The individual's hearing aids are no longer working up to specifications and repairs will not restore them to that condition

* The individual's hearing loss has changed significantly requiring different amplification, or

* The communication needs on the job have changed notably, requiring different amplification.

Any case where the counselor believes that there may be other reasons for replacement of hearing aids must be reviewed by the ARS District Manager.

WHEELCHAIRS

ARS may purchase electric and manual wheelchairs and necessary repairs for the individual to proceed through the rehabilitation process. Wheelchairs will be purchased as prescribe by the treating physician. Purchases of specific wheelchairs will be consistent with the recommendation of the therapist and/or wheelchair specialist involved. All requests for power wheelchairs will be referred to the ACTI Physical Therapy Department.

PROCEDURES - WHEELCHAIRS

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

* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

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

* Medical Consultants review is required and in the ECF. (See Forms Appendix E)

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

* If wheelchairs or other durable medical equipment is purchased, a title of retention will be completed and attached to the ECF. (See Appendix E)

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

* When device/service is received, verify the individual received device/service and can use device. Document in the ECF.

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

REPAIR OF WHEELCHAIRS

Repairs of wheelchairs present numerous problems and it will not be possible to provide detailed procedures to cover every possibility. In general, all repairs should first be addressed through the vendor where the wheelchair was purchased. If this is not possible, arrangements should be made to repair the chair at ACTI. The counselor and individual will make the decision based on resources and immediacy of the situation in accordance with informed choice.

PROCEDURES - REPAIR OF WHEELCHAIRS

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

* Check with the Assistive Technology Program AT @ Work to check for parts in inventory for repair. If not, refer to Durable Medical Equipment Vendor for repairs.

* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

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

* 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. Document in the 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.

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

* UAMS requires special payment.

BRACES

Braces will be purchased in accordance with informed choice, upon the recommendation of the specific specialist in charge, i.e., an orthopedist in orthopedic cases; a neurologist in neurological cases. Shoes are standard accessories for all leg braces, if the braces attach to the shoes.

These shoes must be included in the brace purchase. Repairs may be authorized for any eligible applicant upon a basic examination only, unless the basic examination indicates other consultations are necessary.

PROCEDURES - BRACES

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

* Complete referral procedures for the Assistive Technology Program AT @ Work for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

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

* Medical Consultants review is required and attached to the ECF. (See Forms Appendix E)

* 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. Document in the 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.

GLASSES AND ARTIFICIAL EYES

NOTE: Individuals with blindness as a primary disabling condition must be referred to Division of Services for the Blind.

Glasses, artificial eyes and other visual services may be purchased if recommended by a current eye examination performed by an Ophthalmologist or Optometrist, in accordance with informed choice. Glasses may be purchased only when necessary for the individual to complete evaluation, enter, or complete a rehabilitation service planned training program, or to enter employment. Glasses, ornamental and/or expensive frames will not be purchased for cosmetic reasons.

Prosthetic eyes may be purchased for either cosmetic effect or functional use. Plastic eyes should be purchased unless there are justifiable reasons for another type.

PROCEDURES - GLASSES/ARTIFICIAL EYES

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

* Refer individual to an ophthalmologist from ARS Vendor list for an eye examination.

* Counselor will meet with individual to discuss findings of examination in accordance with informed choice and with similar benefits

* Medical Consultants review is required and attached to the ECF. (See Forms Appendix E)

* 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. Document in the 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.

PERSONAL ASSISTANCE SERVICES

Personal Assistance Services is a range of services provided by one or more persons, designed to assist an individual with disabilities to perform daily living activities on or off the job that the individual would typically perform if the individual did not have a disability.

These services may be provided to an individual at any time during the rehabilitation process and may include:

1) Attendant

2) Interpreter

3) Reader

ATTENDANT

ARS will purchase attendant services in accordance with informed choice provided by one or more persons, designed to assist an individual with disabilities to perform daily living activities on or off the job that the individual would typically perform if the individual did not have a disability. These services may be provided to an individual at any time during the rehabilitation process when prescribed by an attending physician.

PROCEDURES - ATTENDANT

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

* Medical Consultants review is required and attached to the ECF. (See Forms Appendix E)

* 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 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.

INTERPRETER SERVICES

ARS may purchase interpreter services for deaf or hearing-impaired individuals involved in a rehabilitation program in accordance with informed choice.

PROCEDURES - INTERPRETER SERVICES

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

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

READER

ARS may purchase reader services for deaf or hearing - impaired individuals and visually impaired individuals involved in a rehabilitation program in accordance with informed choice.

PROCEDURES - READER

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

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

MOTOR VEHICLES

ARS policy is not to purchase motor vehicles for an individual or groups of individuals.

SPECIAL EQUIPMENT AND 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 an immediate family member or a designated attendant to provide the individual transportation if:

1) The individual or vehicle operator has a current operator license, proof that insurance will cover equipment and proof of vehicle ownership.

2) Equipment is purchased from an approved vendor.

3) Equipment purchase and/or vehicle modification is made to enable a individual to participate in an approved full-time VR training program or employment. Needed equipment must be established as a criterion for evaluation of progress toward the employment outcome or covered in an IPE amendment.

4) A vehicle more than five (5) years old and/or a vehicle with more than 50,000 miles has been determined mechanically sound. This requirement does not apply to vehicles less than five (5) years old or with less than 50,000 miles.

5) An Assistive Technology evaluation from the Assistive Technology Program AT @ Work has been completed upon a counselor's request. The evaluation must include an equipment description or specification.

6) The individual has been instructed in safe operation and/or use of equipment through a training course.

7) A threshold of $5,000 has been established for van modifications, including lift. For an exception form refer to Appendix G.

The counselor will follow the State Purchasing guidelines.

In certain situations, the counselor should consider referral of the individual for a driving evaluation to determine their ability to drive and the necessary vehicle modifications required to operate a vehicle. This evaluation should be completed before the vehicle modifications are approved by the Counselor. Driver's training is available at ACTI or ARS may purchase driver training from an approved instructor or Agency.

PROCEDURES-SPECIAL EQUIPMENT AND MODIFICATION FOR MOTOR VEHICLES

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

* Complete referral procedures for the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

* Secure the Assistive Technology Program AT @ Work evaluation/assessment recommendation.

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

* The counselor will follow the State Purchasing guidelines. (See VI. Services Table of Contents)

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

* 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. Document in the 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.

NOTE: THIS SERVICE CANNOT BE PLANNED ON THE IPE OR AMENDMENT UNTIL THE ASSISTIVE TECHNOLOGY EVALUATION HAS BEEN PERFORMED.

HOME MODIFICATIONS

ARS will only provide assistance when modifying an individual's place of residence if the individual owns, is buying, or is a long-term renter or in an extended lease of the property. Modifications to the structure of the home will be consistent with American with Disabilities Act (ADA) recommendations. In situations where the person is not the owner or buyer the individual will be responsible for providing in writing landlord approval to make modifications. Modifications to rental property will be restricted to a ramp for the purpose of access/egress. Modifications to an individual's place of residence will be limited to a one time occurrence, whether IL or VR, regardless of the times an individual's case is reopened.

Except for ramps to assist with access/egress, any changes (remodeling) to the home will only occur inside the structure's footprint. Additions to the home are excluded. If the individual, a family member, or caregiver is insistent on an addition to the existing structure it will be the individual's responsibility to provide payment for the addition including all plumbing and electrical costs. ARS can provide technical assistance regarding how to make the addition accessible. If the Counselor is in agreement, ARS can provide support in the purchase of fixtures and related items to assist with toileting, bathing, and related Activities of Daily Living.

Modifications to modular/mobile homes will be limited to construction of wheelchair ramps to assist with access/egress. No construction will be approved inside a mobile home as it may compromise structural integrity.

The individual and or family member will be asked to be part of the solicitation of bids for ARS approved home modifications.

PROCEDURES - HOME MODIFICATIONS

* Check for appropriate status in the case management system.

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

* Complete referral procedures for the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

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

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

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

* When the home modification is completed the Counselor will verify the need of individual has been met. Document in the 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.

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

VII. INDEPENDENT LIVING REHABILITATION SERVICES

DEFINITION AND INFORMATION

Independent Living Rehabilitation Services (ILRS) are any appropriate vocational rehabilitation services (as defined under Title I of the Rehabilitation Act) that will enhance the ability of an individual with a significant disability to live more independently and function within his/her family or community and, if appropriate, secure and maintain appropriate employment.

Services may be provided under this title to any individual whose ability to engage or continue in employment, or whose ability to function independently in the family or community is so limited by the severity of the disability that vocational or comprehensive rehabilitation services are required to significantly improve either the ability to engage in employment or to function independently in the family or community. Priority of services under this part shall be given to individuals not served by other provisions of the Rehabilitation Act.

The term "comprehensive services for independent living" means any appropriate vocational rehabilitation service (as defined under Title I of the Rehabilitation Act) and any other available service that will enhance the ability of an individual with disabilities to live independently and function within the family and community and, if appropriate, secure and maintain appropriate employment. Such service may include any of the following: counseling services, including psychological, psychotherapeutic, and related services; housing incidental to the purpose of this section (including appropriate accommodations to and modification of any space to serve individuals with disabilities; appropriate job placement services; transportation; attendant care; physical rehabilitation; therapeutic treatment; needed prostheses and other appliances and devices; health maintenance; recreational services; services for children of preschool age including physical therapy, development of language and communication skills and child development services; and appropriate preventive services to decrease the needs of individuals assisted under the program for similar services in the future.

If/when an individual is in an institution at the time of referral or enters an institution after they have applied for services, their presence in an institution may affect their eligibility for services. A person's eligibility for ILRS services is based in part on the expectation that the individual will be present and able to participate in services. When a person is in an institution, the counselor may conclude that the person will not be available to take part in a rehabilitation program. The presence of an individual in an institution affects that person's ability to meet the reasonable expectation that ILRS may significantly assist the individual to improve his/her ability to function independently in family or community or to engage or continue in employment and maintain independent functioning. One of the main concerns as a counselor is the projected length of the person's stay in the institution. For example, if a person is very ill and must enter a hospital for a lengthy stay, is it reasonable to expect they cannot benefit from services. Examples of institutions in which residents may spend a long period of time are group home placements, human development centers, prisons, nursing homes, and psychiatric hospitals.

ILRS CASE STATUS CLASSIFICATIONS

70 Referral/Applicant Status

71 Closure from Referral/Applicant Status

72 Active Status

73 Closure from Active Status (Services Not Completed)

74 Closure from Active Status (Services Completed)

ELIGIBILITY

Eligibility requirements will be applied without regard to sex, race, age, creed, color, national origin, or type of disability of the individual applying for services. No group of individuals will be excluded or found ineligible solely on the basis of type of disability. A person who meets basic eligibility requirements cannot be determined ineligible because of their age.

Residence requirements are the same as for VR services.

RESPONSIBILITY FOR DETERMINING ELIGIBILITY

ARS has the sole responsibility for determining the eligibility of individuals for ILR services. This responsibility remains within the Agency and will not be delegated to any other Agency or individual. The Commissioner has delegated the primary duty for this determination to the counselor. The counselor is required to establish documentary evidence to support the decision and must execute a Certificate of Eligibility/Ineligibility for ILR Services. In every case, the Certificate of Eligibility/Ineligibility for ILR Services must be completed prior to authorization of case service funds except for diagnosis.

BASIC ELIGIBILITY REQUIREMENTS FOR ILR SERVICES

The counselor is required to show the following conditions exist for each individual determined eligible for ILR services:

1) The individual has a significant physical or mental disability with resulting functional limitations in activities.

2) These significant limitations constitute a substantial impediment to function independently in family or community or to engage or continue in employment.

3) There is a reasonable expectation that ILR services may significantly assist the individual to improve his/her ability to function independently in family or community or to engage or continue in employment and maintain independent functioning.

The following paragraphs define the basic criteria:

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

Substantial Impediment to Function Independently means an individual's ability to live an independent life is significantly restricted, there is a loss of independence, or an individual needs special help to be independent and that services provided will reduce or correct the resulting functional limitations of the disability, overcome the obstacles to independence and/or will significantly assist the individual to improve his/her ability to function independently in family or community or to engage or continue in employment and maintain independent functioning. Consideration should be given to such factors as medical diagnosis, age, education, appearance, personality, attitude, interest, resources, environment, expressed desires, work history, and work opportunities.

ECONOMIC NEED AND COMPARABLE BENEFITS

Services are based on financial need and comparable benefits will be utilized. Services are intended to be comprehensive and one-time services to enable individuals to live and function independently in the home, family, or community and/or to maintain employment. Note: Hearing Aides and related services: Title XX SSBG must be considered as the priority funding source if available.

In all cases, comparable benefits must be considered. If assistive technology is needed, referral to the Assistive Technology AT @ Work program is required for consideration of comparable benefits. (Refer to Appendix B-20).

CERTIFICATION OF ELIGIBILITY/INELIGIBILITY

ELIGIBILITY

The counselor is required to complete the ILRS Certificate of Eligibility/Ineligibility 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.

INELIGIBILITY

When it has been determined that an individual is ineligible for ILR services, the counselor is required to initiate a Certificate of Eligibility/Ineligibility 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:

1) The diagnostic evaluation fails to establish a significant disability.

2) There is no functional limitation to independent living.

3) There is no potential for independent living because the prognosis is unfavorable, services were refused or unavailable, the individual is uncooperative, institutionalized, dies, or cannot be located.

4) The counselor should be sure the individual understands the purpose of the program and the services that are available.

ILRS INDIVIDUALIZED PLAN

The counselor must complete a plan for services.

The components that the ILRS plan must contain:

1) A specific Independent Living Services goal consistent with informed choice,

2) Criteria for evaluation of progress toward the ILRS goal,

3) Specific ILRS services,

4) Projected timelines for initiation and duration of services,

5) Entity to provide services and methods for procurement,

6) Responsibilities of the individual.

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.

* (See Forms Appendix E)

* 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:

1) The individual does not follow through with the planned program or is uncooperative or

2) The individual dies, becomes institutionalized, leaves the state, or becomes too ill to continue the program.

The decision to close the case should be made only with the full participation of the individual, or, as appropriate, the parents, guardian, or other representative, unless the individual is no longer in the State, or his/her whereabouts are unknown. The individual or representative's participation in the decision shall be recorded in the 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 or engaging or continuing in employment. The date of annual review will also be recorded on the Amendment.

RE-OPENING A CASE

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

REVIEW OF INELIGIBILITY DECISION

When a case is closed as ineligible, because there is no reasonable expectation ILR services will significantly improve the individual's ability to function independently, an annual review will take place no later than twelve (12) months from the date of ineligibility determination. This review will be conducted so the individual, their parent, guardian or representative is given full opportunity for consultation in the reconsideration of the decision of ineligibility.

SERVICES

1) Counseling services including psychological and psychotherapy, counseling, advocacy services and related services;

2) Housing incidental to the provision of any independent living rehabilitation service, including appropriate accommodations to and modifications of any space utilized to serve individuals with significant disabilities;

3) Physical and mental restoration services including the services identified in the definition of comprehensive services for independent living;

4) Transportation;

5) Interpreter services for individuals who are deaf, including tactile interpretation to individuals who are deaf/blind;

6) Services to family members of an individual with a significant disability, if necessary, for improving the individual's ability to live and function more independently, or the individual's ability to engage or continue in employment;

7) Vocational and other training services including personal and vocational adjustment, when necessary, for improving the ability of an individual with significant disabilities to live and function more independently, or engage or continue in employment;

8) Referral services;

9) Telecommunications, sensory and other technological aids and devices;

10) Services for children of preschool age including physical therapy, development of language and communication skills, and child development services;

11) Any other vocational rehabilitation services available under the State Plan for VR services under Title I of the Act, which are appropriate to the independent living rehabilitation needs of an individual with significant disabilities.

MOTOR VEHICLE MODIFICATION POLICY

Administrative exception must be obtained to provide vehicle modification or van lifts for ILRS cases. For an exception refer to Appendix G.

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

MODIFICATION FOR MOTOR VEHICLES

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

1) The individual or vehicle operator has a current operator license, proof that insurance will cover equipment and proof of vehicle ownership.

2) Equipment is purchased from an approved vendor.

3) Equipment purchase and/or vehicle modification is made to enable an individual to participate in an approved full-time VR training program or employment. Needed equipment must be established as a criterion for evaluation of progress toward the employment outcome or covered in an amendment.

4) A vehicle more than five (5) years old and/or a vehicle with more than 50,000 miles has been determined mechanically sound. This requirement does not apply to vehicles less than five (5) years old or with less than 50,000 miles.

5) An Assistive Technology evaluation from the AT @ Work program has been completed upon a counselor's request. The evaluation must include an equipment description or specification.

6) The individual has been instructed in safe operation and/or use of equipment through a training course.

7) A threshold of $5,000 has been established for van modifications, including lift. For an exception refer to Appendix G.

The counselor will follow the State Purchasing guidelines.

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

PROCEDURES-MODIFICATION FOR MOTOR VEHICLES

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

* Complete referral procedures to the Assistive Technology Program AT @ Work program for an evaluation/assessment. (See Forms Appendix E and Special Programs Appendix B.)

* Secure the Assistive Technology Program AT @ Work evaluation/assessment recommendation.

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

* The counselor will follow the State Purchasing guidelines. (See VI. Services Table of Contents)

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

* 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. 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.

NOTE: THIS SERVICE CANNOT BE PLANNED ON THE ILRS Plan OR AMENDMENT UNTIL THE ASSISTIVE TECHNOLOGY EVALUATION HAS BEEN PERFORMED.

VIII. CLOSURE

CASES CLOSED FROM STATUS 00/02 - CLOSED NOT REHABILITATED BEFORE/DURING EVALUATION (Status 08)

ARS will not close the case record of a referral or applicant prior to making an eligibility determination unless the applicant declines to participate, or is unavailable to complete an assessment for determining eligibility and priority for services. ARS will make a reasonable number of attempts to contact the applicant (at least one in writing) or the applicant's representative to encourage the applicant's participation. 34 C.F.R. § 361.44

PROCEDURES - CLOSED NOT REHABILITATED BEFORE/DURING EVALUATION

* Complete Certificate of Eligibility/Ineligibility. (See Forms Appendix E)

* The case management system will generate the status move after required data is keyed for Status 08.

Note: An Annual Review is required on a case that has been closed as incapable of achieving an employment outcome due to the severity of disability. This review need not be conducted in situations, in which the individual has refused, no longer resides in the state, the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal. 34 C.F.R. § 361.43(e)

CLOSED NOT REHABILITATED DURING/ AFTER EVALUATION (Status 08)

An individual's record of services is closed from application or Trial Work Experience/Extended Evaluation when the VR eligibility conditions are not met or intervening reasons prevent eligibility determination. The ineligibility determination must be made based on clear and convincing evidence that the individual cannot benefit from services in terms of an employment outcome due to severity of disability. The counselor must include a formal certification statement indicating ineligibility for VR services in the individual's record of services.

A Certificate of Eligibility/Ineligibility will be dated and signed by the counselor. Ineligibility determination will be made only after full participation and an opportunity for consultation with the individual or, if appropriate, the individual's representative. In such cases, the counselor will notify the applicant in writing of the action taken, or by other appropriate modes of communication consistent with the informed choice of the individual, including the reasons for the ineligibility determination. When appropriate, referral will be made to other agencies and programs that are part of the One-Stop service delivery system under the Workforce Investment Act.

The individual may appeal the ineligibility determination. The counselor will provide the individual with information on the means by which an appeal can occur, including informal and formal due process procedures, such as administrative review, mediation and review by an impartial hearing officer. The counselor will also provide the individual with information regarding services available from the Client Assistance Program and how to contact the Client Assistance Program. 34 C.F.R. § 361.41

PROCEDURES - CLOSED NOT REHABILITATED DURING/AFTER EVALUATION

* Cancel or pay any outstanding encumbrance.

* Complete Certificate of Eligibility/Ineligibility if closed Status 08 from Status 02. (See Forms Appendix E)

* When appropriate, referral will be made to other agencies and programs that are part of the One-Stop service delivery system under the Workforce Investment Act.

* The case management system will generate the status move after required data is keyed for Status 08 Closure.

Note: An Annual Review is required on a case that has been closed as incapable of achieving an employment outcome due to the severity of disability. This review need not be conducted in situations, in which the individual has refused it, no longer resides in the state, or the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal. 34 C.F.R. § 361.43(e)

CLOSED REHABILITATED (Status 26)

An individual's record of service will be closed as successfully rehabilitated when the individual has achieved an employment objective consistent with informed choice, substantiality of services has been documented in the case notes, and the following requirements have been met:

1) The individual has achieved the employment outcome described in the IPE.

2) The employment outcome is consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

3) The employment outcome is in the most integrated setting possible, consistent with the individual's informed choice.

4) The individual has maintained the employment outcome for a period of at least 90 days.

5) The individual and the VR counselor consider the employment outcome to be satisfactory.

6) The individual is informed through appropriate modes of communication of the availability of post-employment services. 34 C.F.R. § 361.56

Additional information is required and must be included in the closure document:

1) Name and address of the employer

2) Type of work performed. (Occupation)

3) Gross weekly earning and hours worked per week

4) Medical insurance coverage at closure

5) Public assistance at closure

6) The individual is compensated at or above minimum wage.

7) The wage and level of benefits are not less than that customarily paid by the employer for the same or similar work performed by non-disabled individuals.

8) How did the services provided contribute substantially to the individual's achievement of the employment outcome consistent with informed choice.

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, WIA 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 WIA 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:

1) satisfactory resolution of the problem requiring post-employment services;

2) the individual's attainment of sufficient independence to function without continuing post-employment services, or a counselor's professional judgment to discontinue services;

3) employment appears secure as determined by suitable work performance, job satisfaction, and acceptance in the employment setting with respect to employee benefits, and opportunities for job development and advancement;

4) employment continues at a suitable level in relation to the individual's potential and the locality and labor market, or potential can be realized by the individual's initiative.

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

* 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.

IX. CASELOAD MANAGEMENT

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/Extended Evaluation Status

06 Evaluation Status

Closures from Referral (00)/Applicant (02)

08 Closed before, during, or after Evaluation

Closures from Trial Work Experience or Extended Evaluation (06)

08 Closed after Evaluation

ACTIVE STATUSES

Pre-Service Statuses

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 or Extended Evaluation services. An individual can only remain in Status 02 for 60 days unless the counselor and applicant agree to a specific extension of time. 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.

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/Ineligibility. 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/EXTENDED EVALUATION

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

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

STATUS 08 - CLOSED FROM EVALUATION

Status 08 identifies all individuals not accepted for VR services whether closed from referral Status (00) applicant Status (02) or Trial Work Experience or Extended Evaluation Status (06).

STATUS 10 - CERTIFICATION OF ELIGIBILITY/INELIGIBILITY

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

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:

1) On-the-job Training

2) Short-term Specialized Training

3) Vocational/Technical

4) Community College

5) College/University

STATUS 20 - READY FOR EMPLOYMENT

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

STATUS 22 - EMPLOYED

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

STATUS 24 - SERVICES INTERRUPTED

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

STATUS 26 - CLOSED REHABILITATED

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

STATUS 28 - CLOSED NOT REHABILITATED AFTER IPE INITIATED

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

STATUS 30 - CLOSED NOT REHABILITATED BEFORE IPE INITIATED

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

STATUS 32 - POST-EMPLOYMENT SERVICE

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

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

STATUS 34 - CLOSED FROM POST-EMPLOYMENT

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

STATUS 36 - CLOSED FROM POST-EMPLOYMENT TO BE REOPENED

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

STATUS 38 -CLOSED FROM SERVICE DELAYED/ORDER OF SELECTION

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

STATUS 39 - CLOSED FROM POST-EMPLOYMENT/OTHER REASONS

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

TRANSFER OF CASES - Cases Transferred will retain their status and the date of the transfer.

CASES TRANSFERRED OUT

PROCEDURES - CASES TRANSFERRED OUT

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

* The 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 District Managers; to ensure that case information is current and prepared for transfer. Both counselors, District 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.

CASES TRANSFERRED IN

PROCEDURES- CASES TRANSFERRED IN

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

* Document in 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 District Manager requesting the closure to be voided. The Chief of Field Services will notify the counselor through the District Manager that the closure has been voided so the necessary services can be provided.

ANNUAL REVIEW OF CLOSED CASES - INELIGIBLE

Refer to Closure VIII.

X. CASE RECORD DEVELOPMENT, MAINTENANCE AND DESTRUCTION

RECORD OF SERVICE (ECF)

In accordance with Federal and State regulation, ARS will maintain case record documentation on each applicant or eligible individual. 34 C.F.R. § 361.47

A record of services (ECF) will be established for each individual placed in Status 00 or 02 and maintained until the designated time when it may be destroyed. For each record of services, certain ARS forms, in addition to correspondence, reports, etc., are required at certain statuses to assure adequate casework during the rehabilitation process.

RECORD OF SERVICE (ECF) DOCUMENTATION

The primary purpose of documentation is to facilitate the counseling relationship by bringing into focus all the pertinent data about the individual. This enables the counselor to understand the individual, to counsel and help plan future adjustment, to help secure necessary medical, educational, and other rehabilitation services, and to assist in locating suitable employment.

It provides the information needed to establish a professional relationship with the individual. During early contacts with the individual, the documentation should emphasize history, present adjustment and environmental situation, and the objective measures of, or reports on, physical and mental capacities. This provides an informational basis for the counseling relationship and provides substantiation for planned programs of services.

Document information that is clear and objective. Limit documentation to vocational information that is significant and pertinent to the individual's vocational rehabilitation needs. Also document information that leads to a plan of action, this includes but not limited to evaluation summaries, work history, medical/behavior assessments and other relevant resources.

The processing of work in accordance with existing policies and procedures is the counselor's responsibility. Case processing, filing, reporting, and recording must be performed with extreme care. Case documentation includes Agency forms, medical information, case narratives, post-operative reports, training reports, and other pertinent information related to the individual's rehabilitation program.

ELECTRONIC CASE FILE (ECF)

The individual's file is the official record of service. The ECF will contain all relevant correspondence, reports, forms, financial records and documentation of the individual's rehabilitation program. The ECF will be maintained uniformly across the State.

The case management system will file chronologically by the most recent date:

Intake

Assessment

Eligibility

IPE

Progress Report

Authorizations

Correspondence

Closure

Case Reviews

ECF PROCEDURES - INDIVIDUAL RECORD OF SERVICES

INTAKE

* SS Card

* Driver's License/ID

* Application for Services

* Informed Consent (if under age 18)

* Release of Information Form

* Conflict of Interest Form

* Copy of Voter Registration Form or Declination Form

* Substance Abuse Policy Signature Form

ASSESSMENT

* Copies of existing medical or psychological information

* Medical Records/Reports (ARS/ACTI)

* RIDAC referral form

* RIDAC/ARS/ACTI medical and psychological reports

* RIDAC Medical consultation form

* RIDAC Psychological consultation form

* Local Medical Consultant Form

* Memo from ACTI Staff Physician

* Neuropsychological Reports

* Consultations

* 60 day assessment

* Copies of school transcripts

* IEP information

* Copies of medical reports

* Assistive Technology Reports

* Recommendations for Special Accommodations or Equipment

ELIGIBILITY

* VR Certificate of Eligibility/Ineligibility

* ILRS Certificate of Eligibility/Ineligibility

* Assessment for Determining Priority Category (Scope of Case Study)

* Order of Selection Notification Letter, if applicable

* Income Verification

* Financial Resource Form

* Award Letter or verification (if SSI/SSDI recipient)

IPE

* Individualized Plan for Employment IPE

* Individualized Written Client Plan (ACTI)

* Amendments

* Annual reviews completed

* Exception to Service Provision Policy

AUTHORIZATIONS

* Authorizations (ARS/ACTI)

* Attached billing statements/invoices

* CRP Statements of Account and CPD Verification Payment Forms

CORRESPONDENCE

* Referrals, internal and external

* ACTI, CRP, SE, Employment Services/Job Placement, and Job Services-VR only referral forms

* Copies of letters, e-mails

* Transition referral forms

* Letters to clients/Client Follow-up Information Form

* Referrals from Social Security

* Medical Release request forms and letters

* Copies of forms mailed to client

a. Due Process Forms

b. Receipt/Release of Tools and Equipment

c. Consumer Satisfaction Surveys

* 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/Ineligibility

* 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.

DESTRUCTION OF RECORDS

Individual's record of services (ECF) will be destroyed in accordance with Federal and State regulations.

The District Manager or his/her designee must witness or be responsible for the destruction of the record of services (ECF). All closed cases (Statuses 08, 26, 28, 30, 34, 36, 38 and 39) are to be maintained currently for five (5) fiscal years.

NOTE: Status 00 cases that have reached the 180 days maximum and have been closed or dropped from the case management system may be destroyed.

XI. RELEASE OF INFORMATION

SAFEGUARDING INDIVIDUAL'S RECORD AND INFORMATION

Employees are responsible for complying with the legal requirement to protect the confidential nature of information in individual ECF, including all individual's identifying information contained in reports, lists, and other paper or electronic documents, and for prohibiting unauthorized access.

All personnel are to maintain a professional respect for the confidential nature of the data on individuals. Refrain from indiscreet and/or casual conversation that might reveal to unauthorized persons information concerning individuals receiving services from ARS.

In accordance with federal and state regulation, the state will safeguard the confidentiality of all personal information. 34 C.F.R. § 361.38

RELEASING INDIVIDUAL'S INFORMATION

Individual's information is released in only four situations:

1) when authorized by the individual,

2) in response to a valid subpoena, court order, or other legal process,

3) when directly connected with the individual's rehabilitation, or

4) in certain emergency and investigative circumstances which poses an immediate threat to the safety of the individual or others.

RELEASE TO THE INDIVIDUAL OR A REPRESENTATIVE

When information is released to the individual or the individual's representative, personal information in the file obtained from another Agency or organization can be released only by, or under the conditions established by the other (external) Agency or organization. ARS must refer the individual to the source to obtain the information.

The counselor must make appropriate Agency information in the individual's ECF accessible and or release to the individual, or representative, in a timely manner, when requested in writing by the individual or authorized representative.

A relative of the individual may not receive records without written authorization by the individual:

1) if the individual is a minor, the parent may be considered the authorized representative;

2) if a court-appointed representative or legal guardian has been appointed by the court, information must be released to the representative or guardian.

HARMFUL INFORMATION

Medical, psychological, or other information the counselor believes may be harmful to the individual must not be released directly to the individual. Such information must be released through a representative designated in writing by the individual, who may include, among others, an advocate, a family member, or qualified medical or mental health professional.

RELEASE TO A COURT OR ADMINISTRATIVE BODY

ARS may release the individual's information in response to an order, subpoena, or summons issued by a court or other judicial body under state or federal rules of civil or criminal procedure. The document may be signed by the judge, magistrate, administrative law judge or hearings officer, clerk of court, or by any official who is authorized by law to issue subpoenas.

RELEASE FOR A PURPOSE DIRECTLY CONNECTED WITH THE ADMINISTRATION OF THE INDIVIDUAL'S VR PROGRAM

Provisions of the individual's IPE determine the scope of the individual's rehabilitation.

Releasing the individual's information for a purpose directly connected with the individual's rehabilitation usually poses no problem. This release does not legally require express or written consent from the individual.

When it is difficult to ascertain whether the purpose of the release is "directly connected with the individual's rehabilitation program," obtain a written authorization from the individual to provide information to an organization or individual.

RELEASE FOR RESEARCH OR EVALUATION

Written authorization must be obtained from the individual to release information to the organization or person engaged in audit, evaluation, or research for a purpose that could significantly improve the quality of life for persons with a disability.

XII. REFUNDS/CONTRIBUTIONS

CURRENT YEAR REFUNDS

The vendor should make the refund check payable to the Arkansas Rehabilitation Services. The check should carry the name of the individual. The refund and memorandum giving full information about the refund will be sent to the Chief of Field Services. A cancellation for the refunded amount will be keyed in the case management system. The amount will automatically be added into the counselor's allotment.

PRIOR YEAR REFUNDS

The vendor should make the check payable to Arkansas Rehabilitation Services. The check should carry the name of the individual. All refunds will be sent to the Chief of Field Services or his/her designee. The refund and a memorandum giving full information about the refund will be sent to the Chief of Field Services or his/her designee. All prior year refunds are placed into the Arkansas Kidney Disease Commission allotment as required by state law. Prior year refunds do not require cancellations.

INDIVIDUAL'S CONTRIBUTION

Individual contributions are to be paid to the vendor. If an individual contributes to ARS toward the cost of any services or goods, an ARS authorization will be written for the remaining amount. The contribution amount will be recorded in the IPE.

XIII. PRIOR APPROVAL

PRIOR APPROVAL POLICY

Prior approval is defined as "the rehabilitation program and other record of services materials are reviewed and approved by a District Manager or his/her designee before the services planned for are initiated." The District Manager or his/her designee will review all cases requiring prior approval.

The State Office, a District Manager, or a counselor may request prior approval on a particular case, on types of cases, or on all cases.

PRIOR APPROVAL - NEW COUNSELORS

A District Manager's or his/her designee prior approval is required on all cases during a new counselor's 12-month probationary period. Approval will be indicated on all:

1) Authorizations for diagnostic services exceeding $200.00

2) Authorizations for other services

3) Certificate of Eligibility

4) Order of Selection

5) IPE and any Amendments

6) 08 closures from Status 02 and Status 06

7) 26 and 32 closures

8) 28 closures

9) 30 closures

10) 38 closures

PRIOR APPROVAL - STATE OFFICE

The State Office, a District Manager, or a counselor may request prior approval on a particular case, on types of cases, or on all cases. The District Manager, after a detailed study of the case, will prepare a memorandum justifying the recommendation for an administrative review and approval. This, with the record of services, will be submitted to the Chief of Field Services or his/her designee.

XIV. DUE PROCESS

Due Process begins once an applicant/client makes a request verbally or in writing. The request starts the 60-day clock to complete steps 1-5 below. Due Process will normally progress in the following sequence:

STEPS

PROCEDURES

1

Applicant/client will discuss the issue(s) with the counselor and ask for a decision in writing. The counselor will advise the applicant/client of the Client Assistance Program (CAP.)

2

If dissatisfied with the decision, applicant/client can ask for an administrative review from a District Manager.

3 Optional

Mediation process is available.

4

If dissatisfied with the decision, applicant/client can ask for an impartial hearing.

5

If dissatisfied with the decision, applicant/client can file civil action in court.

IMPACT ON PROVISION OF SERVICES

Unless an applicant/client or their representative so requests, ARS shall not institute a suspension, reduction, or termination of services being provided for the individual (including evaluation and assessment services and plan development) while a decision through due process is pending. Such services can be suspended, reduced or terminated if obtained through misrepresentation, fraud, collusion, or criminal conduct on the part of the individual, or the individual's representative.

NOTIFICATION OF RIGHTS

NOTE: The applicant/client is notified of their rights at each step in the due process procedure.

The right to be represented by an attorney, Client Assistance Program, parent or guardian, friend, relative, or any other representative of his/her choice.

(NOTE: ARS cannot provide reimbursement for attorney's fee.)

The rights to present evidence and witnesses and to cross examine all witnesses and other relevant sources of information and evidence.

The right to prohibit the introduction of evidence not discussed at least five days prior to hearing.

The right to have reasonable accommodations: i.e. an interpreter/reader, if notice is given to ARS at least three (3) working days prior to the impartial hearing should be given in scheduling an interpreter.

The right to a written report of the findings of fact and conclusions shall be provided to all parties within thirty (30) days of the hearing.

STEP 1 - DECISION OF COUNSELOR

If an ARS staff member has any indication an applicant or client has a concern with ARS, they must inform their District Manager immediately. ARS staff may receive a verbal, e-mail or written request from an applicant, client or their representative, to appeal an ARS decision. If a verbal request is received, ARS staff will assure the correct form is completed. This may require the ARS staff to assist the applicant or client to fill out the appropriate form. The form must include the day of the verbal request. The counselor will advise the applicant/client of the Client Assistance Program (CAP.) All forms completed for appeal will immediately be given to the District Manager.

STEP 2 -ADMINISTRATIVE REVIEW

The District Manager will schedule the Administrative Review to be conducted within ten (10) days of initial date of request:

At a date, time and place convenient to the applicant/client (usually during business hours at the local ARS office), and conducted by a supervisory staff member who has no previous knowledge of the details involved in the matters that are related to the decision being reviewed, can conduct the administrative review in an unbiased way, and has a broad working knowledge of the ARS policies and procedures and the State Plan for VR services.

The applicant/client will receive a decision in writing from the supervisory staff member conducting the Administrative Review within five (5) days following the review.

STEP 3 - MEDIATION POLICY (OPTIONAL)

Mediation ensures that policy and procedures are established to allow that all ARS applicants/clients have the opportunity to resolve disputes through a mediation process. Mediation shall be available before a 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 in federal and state law or ARS Policy.

Mediation is an informal, non-adversarial process whose objective is the encouragement and facilitation of a mutually acceptable agreement based on the parties self-determined needs, interest and values. All parties may present whatever evidence they wish in support of their position in a neutral setting. The process relies on the good faith efforts of the participants communicating together to reach their own agreement as to how the dispute should be resolved.

MEDIATION PURPOSE

This process allows an opportunity for, applicants or clients and/or their representative and Arkansas Rehabilitation Services (ARS), to resolve disputes involving the determinations that affect the provisions of vocational rehabilitation services.

Mediation is an informal, non-adversarial process whose objective is the encouragement and facilitation of a mutually acceptable agreement based on the parties self-determined needs, interest and values. All parties may present whatever evidence they wish in support of their position in a neutral setting. The process relies on the good faith efforts of the participants communicating together to reach their own agreement as to how the dispute should be resolved.

MEDIATION PROCEDURES

INFORMING APPLICANTS AND CLIENTS

ARS is required, at the minimum, to inform in writing applicants, clients, or their representatives of mediation when:

1. An individual applies for vocational rehabilitation services.

2. Order of Selection is utilized.

3. An individualized plan for employment is developed.

4. The individual is determined ineligible, or when services are reduced, suspended or terminated.

VOLUNTARY

Mediation, in the Rehabilitation Act, is voluntary for both parties. At any time during the mediation process, either party or the mediator may elect to terminate the mediation. (See Due Process: PPD&E Cancellation of an Appeal form) In the event that the mediation is terminated, either party may pursue a resolution through an impartial hearing.

IMPORTANT NOTE - Once a request is made for any type of review, which may include mediation, the appeal process through an impartial hearing must be completed within 60 calendar days.

Mediation does not involve findings of facts or the strict weighing of evidence as a formal review process requires. Although mediation does not lead to fact finding, Mediation participants should be prepared to describe the factual background behind the dispute and to discuss the desired outcome.

ARS participants must be prepared to describe the legal policy context around which the dispute arose, as well as factual details of the situation. All parties should be prepared to discuss and consider each other's viewpoints and be willing to cooperate in seeking a resolution acceptable to both parties. The focus of mediation is on resolution, not which party is right or wrong.

REQUEST FOR MEDIATION

The form "Request for Mediation" is completed. Provide the consumer with the handout "Consumer Information on Mediation". The form on Request for Mediation is to be submitted from the District Manager to Chief of Field Services. If Chief of Field Services is unavailable, the form must be submitted to the Deputy Chief of Field Services or designated staff. The ARS Chief of Field Services and/or the Deputy Chief of Field Services or designated staff will review the complete file of the individual requesting mediation within five (5) working days and determine whether the agency wishes to resolve the dispute through the mediation process. If the issue cannot be resolved through the mediation process, a certified letter will be sent to the applicant/client within five (5) working days, informing them of their right to request an impartial hearing.

After reviewing the Electronic Case File (ECF), the Request for Mediation form is sent to Program Planning Development & Evaluation (PPD&E) Section to coordinate the mediation session. PPD&E staff assures the Due Process requirements are met and the applicant/client is informed of their rights. The applicant or client has the right to be represented at the mediation session, although the mediator will encourage the individual to speak for themselves as much as possible to re-establish a relationship between the ARS staff and the individual. The PPD&E Section is responsible for all Mediation forms after a request is received.

PPD&E staff communicates with the applicant/client, ARS staff, and mediator to establish a date, place, time, and who will participate in the session. These meetings will be set up as expeditiously as possible. The PPD&E staff completes the form "Mediation Scheduling." The required ARS staff needed for mediation may have to reschedule their appointments to be available on the day established.

AGREEMENT TO MEDIATE

PPD&E staff is responsible for the completion of form "Agreement to Mediate" with signature by all parties.

MEDIATION WITHDRAWAL

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

MEDIATOR

A pool of mediators is established and agreed upon by the Commissioner and the Rehabilitation Council. The PPD&E Section keeps a list of mediators for review by the applicant or client, so they can chose a mediator. PPD&E staff will present no more than five names of mediators and their qualifications to an applicant/client for their choice. If an applicant or client does not have a preference, the mediator will be randomly selected from the available list. The mediator will be an independent qualified neutral third party facilitator.

MEDIATOR'S ROLE

In mediation, decision-making authority rests with the parties agreeing to mediate. The mediator will set the stage that promotes a reasonable coming together in disclosure, understanding, trust, acceptance and cooperation as necessary for the parties to defend making decisions for settlement purposes. 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 settlement terms, but is not to recommend, judge, or impose settlement terms on the parties.

MEDIATION DAY

What the parties can expect to happen:

1. Introduction of the parties involved and the mediator.

2. The mediator discusses their neutrality in the session and confidentiality for all parties involved.

3. The mediator discloses potential conflict of interest.

The mediator will set the ground rules for the session.

1. Open statements - Both parties will be afforded the opportunity to explaining their positions on why this session is being held.

2. The mediator will provide an opportunity for witnesses and/or evidence to be presented.

3. At any time during the process, the mediator may ask questions for clarification or to obtain more information. The mediator may allow the parties to ask clarifying questions of each other.

4. The mediator will provide a summary or feedback to the parties.

5. The mediator will facilitate the parties' communication to develop options or compromises for a settlement agreement, which may require the mediator to hold private caucusing meetings with the separate parties.

6. The mediator will produce a written formal agreement with the assistance of the Parties' involve.

When reaching an agreement, 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 written mediation agreement (Final Mediation Agreement Form) before leaving the mediation session. The agreement will be implemented as soon as possible. After the agreement is initiated the PPD&E section will send the "ARS Mediation Feedback Survey" form to the applicant/client, their representative, ARS staff involved and the mediator. The written mediation agreement will be attached to the ECF.

NO AGREEMENT REACHED

The applicant or client has the right to request an Impartial Hearing by completing the form "Request for an Impartial Hearing". This form must be sent to the PPD&E Section immediately due to the requirement to complete all appeals within 60-day time frame of the initial request.

For more information on these Procedures contact the PPD&E Section at Central Office 501.296.1600.

STEP 4 - IMPARTIAL HEARING POLICY

Each applicant/client has the right for 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) days from the date of initial request made verbally or in writing.

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 IHO will not be an employee of a public agency or a member of the State Rehabilitation Council. The IHO shall be selected on a random basis from a pool of qualified persons identified jointly by ARS Commissioner and the Rehabilitation Council.

IMPARTIAL HEARING PROCEDURE

When an applicant/client or his/her representative wishes to request an impartial hearing, he/she may do so by submitting a request in writing to the ARS Commissioner, the form "Request for Impartial Hearing" is completed. The request must be made no later than five (5) days of the administrative review decision.

When the ARS Commissioner receives a request for an impartial hearing, the Program Planning, Development and Evaluation Section will request information from the clients' ECF from the District Manager. If the request for a hearing has not been requested within the five-day timeframe, the District Manager should electronically notify the Program Planning, Development and Evaluation Section. The Impartial Hearing will be completed no later than sixty (60) days from the date of initial request whether verbal or written.

The counselors' 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 counselors' memorandum will be sent to the applicant/client, and a copy to the appropriate ARS Staff member, and a copy to the Program Planning, Development and Evaluation Section.

The applicant/client and/or their representative have the right to review the client's ECF at the local ARS field office. The counselor shall be advised to inform the applicant/client of this fact in writing and a copy sent to the Program Planning, Development and Evaluation Section.

IMPARTIAL HEARING WITHDRAWAL

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

REQUEST FOR WITNESSES

The applicant/client and/or their representative will be advised in a certified letter with a return receipt requested, that he/she has ten (10) days to request witnesses in writing by mail, fax or email from the date of signature on the ARS certified mail receipt.

The District Manager must advise the ARS Commissioner of any witnesses he/she wishes to appear in order to document the action or to support an administrative decision.

SCHEDULING THE HEARING

The Program Planning, Development and Evaluation Section will communicate with the applicant/client, ARS staff and the Impartial Hearing Officer to coordinate a date, time and place of the hearing. The scheduling letter advises the applicant/client of the time, date, place of hearing, and the name of the IHO who will conduct the hearing.

PLACE OF 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.

NON-ATTENDANCE AT HEARING

A request for rescheduling by either ARS staff or the applicant/client prior to the date of the hearing is submitted to the ARS Commissioner to determine if good cause exists for such a request. A hearing can be rescheduled for good cause and if mutually agreed upon. If the applicant/client fails to appear for the hearing, and does not provide notice prior to the date of the hearing, the appeal may be dismissed at the discretion of the IHO. If an emergency arises, the applicant/client must justify in writing his/her reasons for non-appearance.

ARS RESPONSIBILITIES

It is the responsibility of the Program Planning, Development and Evaluation Section to communicate with the District Manager to arrange for an office to conduct the hearing.

The appropriate ARS staff will be responsible for presenting ARS' case and answering any questions regarding the issue. The staff usually includes the counselor and/or the District Manager. The applicant/client and/or representative have the right to cross-examine the ARS representatives.

ARS may request legal assistance in preparing for the hearing by contacting the Arkansas Attorney General.

CONFIDENTIALITY REQUIREMENTS

Arkansas Code 20-79-216 states that it is unlawful, except for purposes directly connected with the administration of ARS programs, to disclose the names or refer to the names of persons applying to receive services.

To ensure the confidentiality of a closed hearing, the IHO shall inquire if there is anyone present with whom the applicant/client is not familiar. Should an applicant/client indicate in the affirmative, the party in question will come forward, identify himself/herself and state the reason for his/her presence.

Should there be objection on the part of the applicant/client to the relevance of this person's attendance at the hearing, the IHO will have the responsibility to rule on the individual's presence.

CONDUCT OF 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 hearing shall provide both parties with 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. An applicant/client may have his interpreter or personal care attendant present. The applicant/client or representative and ARS representative will be given the opportunity to present witnesses, offer evidence, and to cross-examine any witness or information introduce. 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 all facts are to be heard by both parties to assure impartiality. The IHO should provide for reasonable recesses in lengthy hearings.

IHO OPENING STATEMENT

An IHO opening statement will include:

1. IHO self-introduction and statement of impartiality,

2. function, role and authority,

3. confidentiality,

4. reason for hearing, and ;

5. citing of applicant/client request.

OPENING STATEMENT ON BEHALF OF BOTH PARTIES

Both parties will state their name, whom they represent, and their address. Only one person shall make an opening statement on behalf of a party.

The ARS opening statement will be a summary of the applicant/clients rehabilitation case and the reason for any decisions made.

The applicant/clients opening statement will be a summary of his/her reasons for requesting a hearing and the issues related to this decision.

QUESTIONS FOR THE RECORD (ARS)

1. If records, reports, and files were requested, were they made available?

2. Are copies available for the record?

3. Are all appropriate personnel in attendance?

4. Was applicant/client informed in writing that he/she has the right:

a. to bring counsel, or a representative;

b. to provide witnesses;

c. to examine all ARS records upon which the Agency based its decisions;

d. to request certain ARS personnel be present at the hearing and of their right to cross examine the Agency witnesses; and

e. The role of the IHO includes:

f. hearing both sides;

g. limiting evidence presented at the hearing to relevant information;

h. making a decision based on evidence presented; and

i. engage in fact finding.

QUESTIONS FOR THE RECORD (APPLICANT/CLIENT)

1. Have you had an opportunity to examine your VR Record of Services, reports and files regarding your rehabilitation status?

2. Have you had an opportunity for an informal administrative review by the District Manager?

3. Have you had an opportunity to call witnesses?

4. Have ARS assured you that your rehabilitation status would not change until all proceedings were completed?

IHO DECISION

The IHO will prepare the decision based on a comprehensive review of the information presented at the hearing. The format will consist of an Introduction, Findings of Fact, Conclusion of Law, and a Decision. The decision will be based on the provisions of the approved State Plan and the Rehabilitation Act. The decision of the IHO must be provided to the applicant/client within thirty (30) days from the date the hearing was conducted. A decision made through an impartial hearing shall be final.

STEP 5 - CIVIL ACTION

An applicant/client who is not satisfied by the final decision from an impartial hearing may bring a civil action for review of such decision. The action may be brought in any State court of competent jurisdiction or in a district court of the United States of competent jurisdiction, without regard to the amount in controversy.

ARKANSAS REHABILITATION SERVICES

REQUEST FOR ADMINISTRATIVE REVIEW

ARKANSAS REHABILITATION SERVICES

REQUEST FOR MEDIATION

ARKANSAS REHABILITATION SERVICES

REQUEST FOR AN IMPARTIAL HEARING

ARKANSAS REHABILITATION SERVICES

AGREEMENT TO MEDIATE

ARKANSAS REHABILITATION SERVICES

CANCELLATION OF AN APPEAL

FINAL MEDIATION AGREEMENT FORM

MEDIATION SCHEDULING

This PPD&E form will be provided to any consumer who requests Mediation.

CONSUMER INFORMATION ON MEDIATION

Q. What is mediation? Mediation is an optional and voluntary process offered to clients of Arkansas Rehabilitation Services (ARS). It is a way to resolve concerns or disagreements about services and related issues. An impartial third party called a "mediator" helps you and your counselor to develop solutions to the concerns and to reach an agreement.

Q. Do I have to do it? No and not every concern or disagreement should go to mediation. The law offers it as an option before going into an impartial hearing. You and your counselor must both agree to go to mediation. ARS sees it as a tool to solve concerns or disagreements that might not need to go to a hearing. It is a proven way to resolve concerns or disagreements and improve the working relationships between individuals. It allows you to have serious input into the options to settle the concern or disagreement.

Q. Who pays for it? Arkansas Rehabilitation Services

Q. Where does it happen? You get to choose the location.

Q. What happens if I need accommodations for my disability to participate? You must inform ARS of your need. If the need is a disability accommodation ARS will assist you in locating the services and for paying for it. For example, if you need a sign language interpreter ARS can provide that need and/or pay for it.

Q. Who can I bring? You can bring someone to support you, a guardian, representative, advocate and witnesses. The advocate might be the Client Assistance Program (CAP) staff, a case manager, or a representative from a program you believe can help you to participate in the process. You have the right to bring witnesses. You have a right to have legal counsel at your own expense.

Q. How does it work? You request mediation from your counselor or their supervisor. You must complete and sign a form for mediation. Both you and your counselor or ARS must agree to mediation. Once everyone agrees to mediate, you are given a list of mediators to choose from. If for some reason you do not want to choose, a mediator is randomly selected from the list. Once the mediator is selected, ARS will contact you and set up the day, time and location of the mediation session that will convenient for everyone involved.

Q. What do mediators actually do? Mediators are trained to encourage open communication in a confidential setting. The mediator assists the individuals with concerns or disagreements to a solution through different ways. Since there is no one method available to solve these concerns or disagreements, the mediator will be flexible in their approach to explore options and to respect the different individual personalities involved in the session.

Q. Is mediation confidential? In most instances, yes. There are situations, which may not be covered by confidentiality, but the mediator will explain those to you.

Q. What do I get out of mediation? If successful, a written agreement that states the solution to your concern or disagreement. This agreement may be used in the development of your Individualized Plan for Employment (IPE) or require a change in your present IPE.

MEDIATION DAY - WHAT THE PARTIES CAN EXPECT

1. Introduction of the parties involved and the mediator.

2. The mediator discusses their neutrality in the session and confidentiality for all parties involved.

3. The mediator discloses potential conflict of interest.

4. The mediator will set the ground rules for the session.

5. Open statements - Both parties will be afforded the opportunity to explain their position on why this session is being held.

6. The mediator will provide an opportunity for witnesses and/or evidence to be presented.

7. At any time during the process, the mediator may ask questions for clarification or to get more information. The mediator may allow the parties to ask clarifying questions of each other.

8. The mediator will provide a summary or feedback to the parties.

9. The mediator will facilitate the parties communication to develop a wish list, options and or compromises for settlement agreement, which may require the Mediator to hold private caucusing meetings with the separate parties.

10. The mediator will produce a written formal agreement with the assistance of the parties involved.

For more information contact the Arkansas Rehabilitation Services Program Planning, Development and Evaluation Section at 501.296.1600.

MEDIATOR GUIDELINES

A mediator adheres to the Arkansas Alternative Dispute Resolution Commissions Requirements for the Conduct of Mediation and Mediators and the ADR Guidelines for Mediators Skills and Qualifications.

A mediator should not render a decision on the issues in dispute. The primary responsibility for the resolution of a dispute rests with the parties. A mediator may make suggestions, but all settlement decisions are to be made voluntarily by the parties themselves.

1. Mediator Conduct -A mediator should protect the integrity and confidentiality of the mediation process. The duty to protect the integrity and confidentiality of the mediation process commences with the first communication of the mediator, is continuous in nature, and does not terminate upon the conclusion of the mediation.

2. Disclosure of Possible Conflicts -Prior to commencing the mediation, the mediator should make full disclosure of any known relationships with the parties or their counsel that may affect or give the appearance of affecting the mediator's neutrality. A mediator should not serve in the matter if a party makes an objection to the mediator based upon a conflict or perceived conflict. If after commencement of the mediation the mediator discovers that such a relationship exists, the mediator should make full disclosure as soon as practicable.

3. Neutrality/Impartiality - A mediator should be neutrality/impartial toward all parties. If a mediator or the parties find that the mediator's neutrality/impartiality has been compromised, the mediator should offer to withdraw from the mediation process. Neutrality/Impartiality means freedom from favoritism or bias in word, action, and appearance; it implies a commitment to aid all parties in reaching a settlement.

4. Mediator Qualifications - Upon request, a mediator's qualifications and experience constitute the foundation upon which the mediation process depends; therefore, if there is any objection to the mediator's qualifications to mediate the dispute, the mediator should withdraw from the mediation. Likewise, the mediator should decline to serve if the mediator feels unqualified to do so.

5. The Mediation Process -A mediator should inform and discuss with the participants the rules and procedures pertaining to the mediation process. A mediator should inform the parties about the mediation process no later than the opening session.

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

1. the mediation is private (Unless otherwise agreed by the participants, only the mediator, the parties and their representatives are allowed to attend.);

2. the mediation is informal (There are no court reporters present, no record is made of the proceedings, no subpoena or other service of process is allowed, and no rulings are made on the issues or the merits of the case.); and the mediation is confidential to the extent provided by law.

6. Convening the Mediation - Unless the parties agree otherwise, the mediator should not convene a mediation session unless all parties represented to the mediator possess the adequate authority to negotiate a settlement, and an adequate amount of time has been reserved by all to allow the mediation process to be productive. A mediator should not convene the mediation if the mediator has reason to believe that a pro se party fails to understand that the mediator is not providing legal representation for the pro se party.

7. Confidentiality - A mediator should not reveal information made available in the mediation process, which information is privileged and confidential, unless the affected parties agree otherwise or as may be required by law. A mediator should not permit recordings or transcripts to be made of mediation proceedings. A mediator should maintain confidentiality in the storage and disposal of records and should render anonymous all identifying information when materials are used for federal reporting, research, and educational or other informational purposes. Unless authorized by the disclosing party, a mediator should not disclose to the other parties information given in confidence by the disclosing party and should maintain confidentiality with respect to communications relating to the subject matter of the dispute. The mediator should report to ARS whether or not the mediation occurred, and that the mediation either resulted in a settlement or an impasse, or that the mediation was either recessed or rescheduled. In certain instances, applicable law may require disclosure of information revealed in the mediation process, such as: if a person is harmful to themselves or others. If confidential information is disclosed, the mediator should advise the parties that disclosure is required and will be made.

8. Professional Advice - A mediator should not give legal or other professional advice to the parties. In appropriate circumstances, a mediator should encourage the parties to seek assistance from a disability advocate, legal, or other professional advice before, during, or after the mediation process. A mediator should explain generally to pro se parties that there may be risks in proceeding without independent counsel or other professional advisors.

9. Disclosure and Exchange of Information - A mediator should encourage the disclosure of information and should assist the parties in considering the benefits, risks, and the alternatives available to them.

10. Termination of Mediation Session - A mediator should postpone, recess, or terminate the mediation process. This termination would exist if it is apparent to the mediator that the case is inappropriate for mediation or one or more of the parties is unwilling or unable to participate meaningfully in the mediation process or if the mediation process is being used to further illegal conduct.

11. Agreements in Writing - A mediator will assist the parties to reduce all settlement agreements to writing.

PPD&E Form

ARS MEDIATION FEEDBACK SURVEY

APPENDIX A

FISCAL AND STATISTICAL CODES

Codes are automatically generated in the case management system for reporting purposes only.

CASE SERVICE CODES

SERVICES FOR INDIVIDUALS, STATUS 02 & 04

  

Assessment (Diagnostic) ................................................................................

1110

Maintenance ...................................................................................................

1140

Personal Assistance Services

  

Attendant Care .....................................................................................

1170

Interpreter ............................................................................................

1171

Reader .................................................................................................

1172

Other Services ................................................................................................

1190

Transportation ................................................................................................

1191

Rehabilitation Technology

  

Engineering ..........................................................................................

1197

Assistive Devices .................................................................................

1198

Assistive Services ................................................................................

1199

SERVICES FOR INDIVIDUALS, STATUS 06

  

Assessment (Diagnostic) ................................................................................

1210

Restoration Services (Physical or Mental)

  

Surgery and Treatment ........................................................................

1221

Hospitalization and Convalescent Care ...............................................

1222

Other Restoration Services ..................................................................

1223

Training

  

College Textbooks ...............................................................................

1230

College or University Tuition ................................................................

1231

Other Academic (Elementary or High School) .....................................

1232

Business School or College .................................................................

1233

Vocational School ................................................................................

1234

On-the-Job Training .............................................................................

1235

Adjustment ...........................................................................................

1236

Miscellaneous ......................................................................................

1237

Maintenance ...................................................................................................

1240

Family Members

  

Child Care Services .............................................................................

1251

Training and Related ...........................................................................

1252

Transportation ......................................................................................

1253

Relocation ............................................................................................

1254

Other ....................................................................................................

1255

Personal Assistance Services

  

Attendant Care .....................................................................................

1270

Interpreter ............................................................................................

1271

Reader .................................................................................................

1272

Other Goods and Services .............................................................................

1290

Transportation ................................................................................................

1291

Rehabilitation Technology

  

Engineering ..........................................................................................

1297

Assistive Devices .................................................................................

1298

Assistive Services ................................................................................

1299

SERVICES FOR INDIVIDUALS, STATUS, 10-24

  

Assessment (Diagnostic) ................................................................................

1310

Restoration Services (Physical or Mental)

  

Surgery and Treatment ........................................................................

1321

Hospitalization and Convalescent Care ...............................................

1322

Other Restoration Services ..................................................................

1323

Training

  

College Textbooks ...............................................................................

1330

College or University Tuition ................................................................

1331

Other Academic (Elementary or High School) .....................................

1332

Business School or College .................................................................

1333

Vocational School ................................................................................

1334

On-the-Job Training .............................................................................

1335

Adjustment ...........................................................................................

1336

Miscellaneous ......................................................................................

1337

Supported Employment Services .........................................................

1338

Maintenance ...................................................................................................

1340

Family Members

  

Child Care Services .............................................................................

1351

Training and Related ...........................................................................

1352

Transportation ......................................................................................

1353

Relocation ............................................................................................

1354

Other ....................................................................................................

1355

Personal Assistance Services

  

Attendant Care .....................................................................................

1370

Interpreter ............................................................................................

1371

Reader .................................................................................................

1372

Other Goods and Services .............................................................................

1390

Transportation ................................................................................................

1391

Rehabilitation Technology

  

Engineering ..........................................................................................

1397

Assistive Devices .................................................................................

1398

Assistive Services ................................................................................

1399

POST-EMPLOYMENT SERVICES, STATUS 32

  

Assessment (Diagnostic) ................................................................................

1410

Restoration Services (Physical or Mental)

  

Surgery and Treatment ........................................................................

1421

Hospitalization and Convalescent Care ...............................................

1422

Other Restoration Services ..................................................................

1423

Training

  

College Textbooks ..............................................................................

1430

College or University Tuition ...............................................................

1431

Other Academic (Elementary or High School) ....................................

1432

Business School or College ................................................................

1433

Vocational School ...............................................................................

1434

On-the-Job Training ............................................................................

1435

Adjustment ..........................................................................................

1436

Miscellaneous .....................................................................................

1437

Maintenance ..................................................................................................

1440

Family Members

  

Child Care Services ............................................................................

1451

Training and Related ..........................................................................

1452

Transportation .....................................................................................

1453

Relocation ...........................................................................................

1454

Other ...................................................................................................

1455

Personal Assistance Services

  

Attendant Care ....................................................................................

1470

Interpreter ...........................................................................................

1471

Reader ................................................................................................

1472

Other Services ...............................................................................................

1490

Transportation ...............................................................................................

1491

Rehabilitation Technology

  

Engineering .........................................................................................

1497

Assistive Devices ................................................................................

1498

Assistive Services ...............................................................................

1499

SPECIAL PROGRAM CODES

None ............................................................................................................................ 000

Social Security Disability Beneficiary/Trust Fund (SSDI) ............................................. 001

Veteran ........................................................................................................................ 002

Annual Review/Ineligibility Determination .................................................................... 004

Migratory Agricultural Worker ...................................................................................... 010

Project with Industry Program ..................................................................................... 020

Brain Injured ................................................................................................................ 040

Deaf/Blind .................................................................................................................... 100

Supplemental Security Income (SSI)........................................................................... 200

Significantly Disabled .................................................................................................. 400

PROGRAM CODES

Independent Living/ODHI - Case service expenditures for applicants/individuals who meet Title XX- financial eligibility requirements ............................................................. 20

Supported Employment Program .............................................................................. 34

Independent Living Rehabilitation Services ............................................................. 77

Community Rehabilitation Program- Cost of services, work assessment, extended services, work adjustment training, etc. provided by a sheltered workshop that has been certified by ARS ............................................................................................................ 97

General VR Services (All Services Not Identified Above) - All other Case Service expenditures will be coded 99 ....................................................................................... 99

FISCAL CODES

General Agency VR Services ........................................................................................ 02

ODHI Independent Living Title XX ............................................................................... 20

Supported Employment Services .................................................................................. 34

Independent Living Rehabilitation Services ................................................................... 77

CLASSIFICATION OF DISABLING CONDITIONS AND CAUSES

The General Agency cannot serve blind or visually impaired cases as a primary disability.

CODES FOR IMPAIRMENTS

00 No impairment

SENSORY/COMMUNICATIVE IMPAIRMENTS:

01 Blindness

02 Other Visual Impairments

03 Deafness, Primary Communication Visual

04 Deafness, Primary Communication Auditory

05 Hearing Loss, Primary Communication Visual

06 Hearing Loss, Primary Communication Auditory

07 Other Hearing Impairments (Tinnitus, Meniere's Disease, hyperacusis, etc.)

08 Deaf-Blindness

09 Communicative Impairments (expressive/receptive)

PHYSICAL IMPAIRMENTS:

10 Mobility Orthopedic/Neurological Impairments

11 Manipulation/Dexterity Orthopedic/Neurological Impairments

12 Both mobility and Manipulation/Dexterity Orthopedic/Neurological Impairments

13 Other Orthopedic Impairment (e.g., limited range of motion)

14 Respiratory Impairments

15 General Physical Debilitation (fatigue, weakness, pain, etc.)

16 Other Physical Impairments (not listed above)

MENTAL IMPAIRMENTS

17 Cognitive Impairments (impairments involving learning, thinking, processing information and concentration)

18 Psychosocial Impairments (interpersonal and behavioral impairments, difficulty coping)

19 Other Mental Impairments

CODES FOR CAUSES/SOURCES OF IMPAIRMENTS

00 Cause unknown

01 Accident/Injury (other than TBI or SCI)

02 Alcohol Abuse or Dependence

03 Amputations

04 Anxiety Disorders

05 Arthritis and Rheumatism

06 Asthma and other Allergies

07 Attention-Deficit Hyperactivity Disorder (ADHD)

08 Autism

09 Blood Disorders

10 Cancer

11 Cardiac and other Conditions of the Circulatory System

12 Cerebral Palsy

13 Congenital Condition or Birth Injury

14 Cystic Fibrosis

15 Depressive and other Mood Disorders

16 Diabetes Mellitus

17 Digestive

18 Drug Abuse or Dependence (other than alcohol)

19 Eating Disorders (e.g., anorexia, bulimia, or compulsive overeating)

20 End-Stage Renal Disease and other Genitourinary System Disorders

21 Epilepsy

22 HIV and AIDS

23 Immune Deficiencies excluding HIV/AIDS

24 Mental Illness (not listed elsewhere)

25 Mental Retardation

26 Multiple Sclerosis

27 Muscular Dystrophy

28 Parkinson's Disease and other Neurological Disorders

29 Personality Disorders

30 Physical Disorders/Conditions (not listed elsewhere)

31 Polio

32 Respiratory Disorders other than Cystic Fibrosis or Asthma

33 Schizophrenia and other Psychotic Disorders

34 Specific Learning Disabilities

35 Spinal Cord Injury (SCI)

36 Stroke

37 Traumatic Brain Injury (TBI)

COUNTY CODE LIST

Arkansas ............................................ 01

Ashley ................................................ 02

Baxter ................................................. 03

Benton ................................................ 04

Boone . ................................................ 05

Bradley ............................................... 06

Calhoun .............................................. 07

Carroll ................................................. 08

Chicot ................................................. 09

Clark . .................................................. 10

Clay . ................................................... 11

Cleburne ............................................. 12

Cleveland ........................................... 13

Columbia ............................................ 14

Conway .............................................. 15

Craighead ........................................... 16

Crawford ............................................. 17

Crittenden ........................................... 18

Cross . ................................................. 19

Dallas ................................................. 20

Desha . ................................................ 21

Drew . .................................................. 22

Faulkner ............................................. 23

Franklin .............................................. 24

Fulton ................................................. 25

Garland .............................................. 26

Grant . ................................................. 27

Greene ............................................... 28

Hempstead ......................................... 29

Hot Spring .......................................... 30

Howard ............................................... 31

Independence .................................... 32

Izard . .................................................. 33

Jackson .............................................. 34

Jefferson ............................................ 35

Johnson .............................................. 36

Lafayette ............................................ 37

Lawrence ............................................ 38

Lee . .................................................... 39

Lincoln ................................................ 40

Little River .......................................... 41

Logan . ................................................ 42

Lonoke ............................................... 43

Madison .............................................. 44

Marion ................................................ 45

Miller ................................................... 46

Mississippi .......................................... 47

Monroe ............................................... 48

Montgomery ....................................... 49

Nevada ............................................... 50

Newton ............................................... 51

Ouachita ............................................. 52

Perry . .................................................. 53

Phillips ................................................ 54

Pike . ................................................... 55

Poinsett .............................................. 56

Polk . ................................................... 57

Pope . .................................................. 58

Prairie ................................................. 59

Pulaski ................................................ 60

Randolph ............................................ 61

Saline ................................................. 62

Scott . .................................................. 63

Searcy ................................................ 64

Sebastian ........................................... 65

Sevier ................................................. 66

Sharp . ................................................. 67

St. Francis .......................................... 68

Stone . ................................................. 69

Union . ................................................. 70

Van Buren .......................................... 71

Washington ........................................ 72

White . ................................................. 73

Woodruff ............................................. 74

Yell . .................................................... 75

MASTER LIST OF CASES

ARS accounts for all cases of a counselor by using the Master List. The Master List records the service status and closure status of each case.

INSTRUCTIONS

The counselor can print a master list from the case management system.

APPENDIX B

SPECIAL PROGRAMS

TICKET TO WORK

Clients between 18 and 64 who receive Supplemental Security Income (SSI) or Social Security Disability Income (SSDI) as a disabled adult are eligible for the Ticket. A minor child of a disabled worker or a disabled adult child is not eligible for a Ticket.

1. Verification of Ticket Assignability from SSA.

a. Counselors should verify Ticket assignability through SSA's Interactive Voice Response (IVR) System by calling 1-866-949 -3687.

b. Counselors must provide the Agency DUNS, Agency PIN, and the client's SSN.

c. The IVR System provides the following information:

i. Ticket is assignable - ticket will be assigned to ARS when the IPE is completed.

ii. Ticket is not in the database - ticket is not in the SSA database and client should contact the beneficiary helpline.

iii. Ticket is not assignable - ticket may have been terminated and client should contact the beneficiary helpline for more information.

iv. Ticket is assigned - ticket is assigned to another VR agency or an Employment Network. Client can be encouraged to contact MAXIMUS to have ticket unassigned so it is eligible for assignment to ARS. Counselors can complete the Ticket Un-assignment form and fax to Maximus. If client refuses to un-assign the Ticket, the counselor should request a copy of the client's Individual Work Plan (IWP) from their EN to check for duplication of services

v. Ticket is in "In-use SVR" - ticket is assigned to another VR agency and is receiving Cost Reimbursement. Contact the ARS Ticket Coordinator for assistance.

2. The Ticket becomes active with ARS when the IPE is completed and the case enters status 12.

a. Each month a list of SSI/SSDI clients who enter status 12 is forwarded to Maximus by the Central Office.

b. The client then enters an "In-use SVR" status and receives Social Security Continuing Medical Disability Review protection as long as the Ticket is assigned to ARS and the client is meeting the IPE goals.

c. The Ticket also provides other work incentives and benefits such as maintaining health insurance (Medicare and Medicaid) when benefit checks stop due to wages and expedited reinstatement of benefits. Counselors should refer clients to Project AWIN for benefits counseling. Contact Project AWIN at 1-866-283 -7900 or email at wipa@arsources.org.

d. Ticket assignment allows ARS to collect reimbursement for services when the client works nine (9) months with wages over Substantial Gainful Activity (SGA). ARS is reimbursed for both actual expenses and administrative, counseling, and placement and tracking costs as long as comparable services and benefits were considered and the costs have not been paid by or will be paid by another source.

e. Each month a list of closed SSI/SSDI cases are forwarded to Maximus by Central Office.

f. Ticket protection from Continuing Medical Disability Review is terminated after 90 days if the client's ticket is not reassigned.

3. When ARS closes a client's case, the client is offered a Referral to a private Employment Network (EN).

a. Ticket protection is extended if the client assigns his/her Ticket within 90 days of case closure.

b. ENs can provide follow-along services to the client to support employment outcomes, which can help the client reach and maintain wages over the SGA level.

c. ARS has entered into Partnership Plus agreements with a number of ENs operating in the state of Arkansas.

d. The Partnership Plus agreement outlines how ARS and the EN will coordinate services for Ticket clients.

4. Ticket clients are subject to Timely Progress Review (TPR) every 12 months whether their tickets are assigned to VR or to an EN.

a. TPRs are SSA's way of verifying Ticket clients are making progress toward self-sufficiency. SSA contracts with MAXIMUS to conduct the TPRs.

b. TPRs are generally conducted every 12 months in the month the Ticket was first assigned. For example, if a client assigns his/her Ticket for the first time in June, the TPRs will be scheduled in June each year thereafter. It is important to note, SSA does not always conduct a TPR at the first 12-month point. Many clients do not receive a TPR until their Tickets have been assigned for 36 months. However, SSA will always be looking at the client's last 12-month period and the milestones he/she should have completed during that last 12-month period.

c. SSA requires that certain milestones be met in order to successfully pass a TPR. These milestones are based upon how long the Ticket has been assigned, and will change each 12-month period a Ticket is in use. Therefore, if SSA doesn't conduct a TPR until month 36, the client must have completed the required milestones for months 25 through 36. A breakdown of these requirements can be found at www.yourtickettowork.com.

d. MAXIMUS sends the client a TPR form, which must be completed and returned to MAXIMUS. If the client brings the TPR to the field office, the counselor can complete information and return the form to MAXIMUS.

e. If the TPR form is not completed and returned to MAXIMUS. PPD&E will be contacted.

f. If Ticket clients do not meet the TPR milestones for any reason including failure to respond, they will be subject to a Continuing Disability Review.

Glossary of Terms

IWP- Individual Work Plan developed for beneficiaries by an Employment Network

Ticket to Work Program - The purpose of the Ticket to Work Program is to expand the employment opportunities for most individuals receiving Social Security Disability (SSDI) or Supplemental Security Income (SSI) benefits and reduce their dependency on SSA benefits.

Ticket Assignment - SSDI/SSI beneficiaries eligible for a Ticket have the choice of placing their Ticket In-Use with ARS or assigning their Ticket to an Employment Network (EN). The beneficiary may decide to come directly to ARS for services or may be referred to ARS by another agency or EN. When the beneficiary signs the IPE, the beneficiary has placed his/her ticket "In-use SVR." A beneficiary cannot use both ARS and an EN at the same time.

Ticket Reassignment - Beneficiaries may choose initially to assign their Tickets to either ARS or an EN and then decide later to change the assignment.

REHABILITATION INITIAL DIAGNOSIS AND ASSESSMENT FOR CLIENTS (RIDAC)

Rehabilitation Initial Diagnosis and Assessment for Clients (RIDAC) is a support unit for the Field Program. Its goal is to provide diagnostic services to counselors working with individuals during the initial stages of case development and planning. Services are provided at the RIDAC Office, local field offices, or a setting arranged by the counselors and/or District Managers. Services include general medical examinations, mental health assessments, psychological and vocational evaluations, educational assessments, ability assessments, conditions, case consultation, and technical assistance. To expedite the evaluation process, the counselor should make every effort to secure existing information. To the extent that existing data does not describe the current functioning of the individual, is insufficient, or inappropriate to make an eligibility determination, additional assessment may be requested. 34 C.F.R. § 361.42

To insure competent, consistent professional quality, RIDAC diagnostic evaluation services are completed by individuals who are Arkansas licensed physicians, psychologists, or psychological examiners. If RIDAC were to expand evaluation service, employed individuals will be licensed to perform the type of service provided by the appropriate Arkansas Licensing Board.

PROCEDURES - RIDAC REFERRAL

* Complete the RIDAC Service Authorization. It is very important the referring counselor indicate any assessment problems or questions to be addressed. In addition, necessary accommodations related to mobility, vision, hearing, etc. should be identified. During the course of the evaluation RIDAC staff will address identified problems or questions. If other evaluation concerns are discovered, they will be evaluated to determine if the identified concern could have an impact on the success of the rehabilitation program. If a general medical examination is requested, complete the top portion of the general medical form and attach it to the RIDAC Service Authorization.

* When individuals have not reached the age of majority or have been determined incompetent, an informed consent for the RIDAC assessment is signed by the appropriate parent/guardian, with a copy attached to the RIDAC Service Authorization Form. Referring rehabilitation counselors are to insure that all individuals referred to RIDAC assessment consent to the evaluation process.

* When existing medical, psychological, employment, history, or disability information is available, a consultation with the appropriate RIDAC staff can be obtained to review the existing data. The RIDAC staff person will complete a written report or consultation form.

* Contact the individual responsible for scheduling in the local office to obtain an appointment. Once the appointment has been obtained, the RIDAC Service Authorization and, if appropriate, the general medical form should be given to the individual responsible for scheduling RIDAC appointments in the local office. When available, existing psychological testing records, mental health reports, medical records, etc., shall be made available for review by the RIDAC evaluation team.

* The referring counselor is responsible for notifying the individual of the RIDAC appointment and providing directions to the evaluation site as well as other pertinent information. If the individual fails to report as scheduled, the RIDAC Service Authorization will be returned to the referring counselor documenting the individual's failure to report. To reschedule, follow procedures as outlined above.

The RIDAC program has a goal of returning evaluations completed within 10 work days or less from the time the individual is seen. However, when specialized evaluations are completed that require individualized evaluation, for instance neuropsychological limitations, the report time will likely be extended. RIDAC assessment forms will be maintained for a period of three months. Original evaluation reports shall be forwarded to the client file maintained by the referring field counselor. However, electronic records of the report will be transferred to the secured RIDAC folder and later transferred for permanence to be maintained in a secured location.

Learning & Evaluation Center

The Learning and Evaluation Center (LEC) provides direct service to ARS clients through individual psychological/neuropsychological evaluations, after referral from the Counselor and also generally after a RIDAC screening evaluation. LEC evaluations generally require one to two days, are conducted by licensed psychology professionals, followed by a detailed written report and individual feedback session involving the counselor, the consumer, and other family members if indicated. All evaluations are conducted in Little Rock with feedback sessions typically conducted at an ARS office near the consumer's home.

The purpose of the evaluation is to assist in the diagnosis of disabilities that may be affecting the consumer's educational progress, to identify strengths that may be used to mitigate disabilities, and to suggest accommodations when those may be helpful. Evaluations may also be focused on identifying strengths and weaknesses in areas more related to abilities to perform in the workplace, when a RIDAC screening evaluation has not been able to answer those questions. Neuropsychological evaluations for consumers who may have suffered from some form of traumatic brain injury are conducted to help determine the consumer's recovery process and readiness for job training, job placement, or further education.

The LEC regularly works in collaboration with the AT @ Work program regarding the need of assistive technology accommodations for clients with physical, sensory, or learning disabilities.

CLIENT ASSISTANCE PROGRAM

The Client Assistance Program (CAP) is operated by an agency designated by the Governor and is independent of any agency that provides treatment, services, or rehabilitation to individuals under the Rehabilitation Act.

The purpose of the Client Assistance Program is to:

1) Provide an information and referral service to rehabilitation clients and applicants.

2) Assist clients and applicants in relationships with projects, programs, and facilities providing VR services.

3) Assist, upon request from the client or applicant, in pursuing legal, administrative, and other remedies available to ensure the protection of their rights under the Rehabilitation Act.

CAP can advise the ARS of identified problems, problem areas in the delivery of VR services to persons with disabilities and suggest methods and means of improving the delivery of services.

INCREASING CAPABILITIES ACCESS NETWORK

Increasing Capabilities Access Network (ICAN) is Arkansas's statewide assistive technology program. ICAN is federally mandated to provide training, device loans, demonstrations and donations in the area of assistive technology to persons with disabilities - all ages, all disabilities, family members, caregivers, therapist, educators, employers, professionals and other interested parties. Assistive technology (AT) is any kind of device or tool that helps people learn, work, communicate and live more independently. AT can be very simple and inexpensive, like a modified knife and fork, or it can be very sophisticated and costly, like a computerized speech device.

SERVICES

Loan: A wide range of AT devices are available for loan to try-out before buying, use while another is being repaired or borrow for use in a temporary time of need. Wheelchairs, standers and walkers require a doctor's or therapist prescription. ICAN requires a Speech and language therapist or an occupational therapist to check out any AAC (Augmentative and Alternative Communication device) over $3000. ICAN requires State ID to receive the equipment.

Donation: Used AT in good condition can be donated to ICAN. These donations are repaired (ICAN can only do minor repairs) and sterilized then made available at no cost to individuals and agencies. Equipment, such as wheelchairs, standers and walkers require a doctor's prescription.

Demonstration: If you are considering what type of device might work best for you, one of your clients, family member or friend ICAN offers AT device demonstrations to assist in making an informed decision.

Equipment Exchange: The public can list and find used devices for sale, trade or donation through our website.

Training Opportunities/Exhibits: ICAN works with therapist, vendors and professionals to develop AT trainings and/or exhibits in areas such as workplace accessibility, computer access, low vision, hearing impairment, switch access and learning software.

ICAN is a statewide resource for information in all areas of assistive technology, such as funding resources, accessibility at work, school and/or home, and much more. Visitors to our technology center can see numerous devices in simulated office, school and home situations as well as hands-on experiences.

For more information visit our website (www.ar-ican.org) or contact us at:

ICAN

Phone: 501-666-8868

Fax: 501-666-5319 or Toll Free/TTY: 800-828-2799

Assistive Technology at Work (AT @ Work)

Counselors are required to determine a consumer's need for assistive technology (AT) at time of application, plan development, and placement. The AT @ Work program is designed to assist the counselor when determining if AT would be beneficial for a consumer including the selection and acquisition of the appropriate equipment. Services offered include evaluation/assessment, AT device training, device modification/adaptation, and technical assistance.

To make a referral a consumer for AT @ Work services, the counselor is to complete the AT @ Work Referral Form in full and forward to the program's Administrative Specialist.

The counselor is responsible for the purchase of agreed upon AT equipment as identified in the AT @ Work evaluator's report. The counselor will inform the AT @ Work staff person when equipment is ordered and received. The counselor will contact AT @ Work when installation and/or training is required.

TELECOMMUNICATIONS ACCESS PROGRAM (TAP)

The Telecommunications Access Program (TAP) was established by Act 501 in 1995 and amended by Act 530 of 2001. It is a statewide equipment distribution loan program for Arkansans with disabilities or impairments to receive equipment necessary to be able to communicate on the telephone. Any individual who has a disability that impairs their ability to effectively access the telecommunication network may apply for the program. Eligibility is based on Arkansas residency, personal telecommunication service, certification of disability by an approved certifier, and income eligibility. Approved individuals may be eligible for up to two adaptive equipment systems to provide access to telecommunication service.

Interested individuals must complete the TAP application form and submit any additional information the program deems necessary to determine an applicant's eligibility. This information is also used to determine the adaptive equipment which best meets each eligible individual's needs. Individuals determined eligible must sign an agreement to follow TAP rules.

All information is maintained confidential and TAP follows the ARS appeals process. Additional information and application forms may be obtained from TAP, by calling (501) 686-9693 V/TTY or 1-800-981 -4463 V/TTY.

ARKANSAS TRANSITION PROGRAM

TRANSITION SERVICES

The term transition services means a coordinated set of activities for a student, designed within an outcome-oriented process, promoting movement from school to post-school activities, including post-secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adults services, independent living, or community participation. The coordinated set of activities shall be based upon the individuals student's needs, taking into account the student's preferences and interest, and shall include instruction, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation. 34 CFR § 361.22(a)(2) provides that, if the student is determined eligible for VR services, the student's IPE should be developed as early as possible during the transition process but no later than when the student exits the school setting.

PROCEDURES FOR TRANSITION SERVICES

Age 14 or before:

Arkansas Rehabilitation Services will provide informational services and brochures regarding ARS services to any student, parent or guardian, special education teacher or other school official.

Age 16 or before:

The counselor will meet with the special education teachers on a yearly basis to discuss potential referrals for ARS services. A meeting will be scheduled to discuss students in the 11th grade to determine recommendations for referral to ARS before the end of the junior year.

Before Graduation:

The counselor will receive referrals from the special education teacher no later that October of the senior year. All referrals will be accepted using the Arkansas Transition Referral Form 410. In addition to the referral form, the teacher will submit copies of school records, psychological evaluations and the ARS Informed Consent signed by the parent or guardian (if the referral is under the age of 18). The school will submit any additional information that is pertinent and useful in assisting the counselor to determine eligibility and assist the student and the counselor in identifying, selecting and pursuing appropriate career objectives.

The counselor will complete an application at the earliest date possible upon receipt of the transition referral form and supporting documents. The counselor must determine eligibility for services and ensure the development and approval of the Individualized Plan for Employment (IPE) by the time the student leaves the school setting. 34 CFR § 361.22 and 361.45

If the counselor is unable to complete the vocational assessment to determine eligibility within 60 days of application, (due to missed appointments) the counselor must notify the special education teacher or other official as soon as possible to enable the special education teacher to resume the IEP planning process.

The counselor will follow established procedures for referral, application, eligibility determination and IPE development consistent with informed choice.

RESPONSE LETTERS FOR TRANSITION REFERRALS

1) ARS Transition Information Packet

2) Rehabilitation Services

In order to have a reasonably predictable statewide response to Transition Referrals and to make the process as easy as possible, it is suggested that each office adopt the following format for use as cover letters for the ARS Transition Information Packet (Template Sample Letter 1) and for Rehabilitation Services (Template Sample Letter 2).

The complete packet should include:

1) A cover letter (Sample Letter 1)

2) One copy of the ARS Procedure on Referrals for Students in Transition

3) One copy of the ARS "TRANSITIONS" Information on Vocational Rehabilitation Programs sheet

4) When applicable, ARS Order of Selection Information for Transition Services sheet

5) An ARS Agency Brochure and Handbook

6) Other requested information, i.e. ACTI, SDHH, etc.

7) A Counselor's Business Card

SAMPLE LETTER 1

Date

Student Name

Address

City, State, Zip Code

Dear Student's name:

Thank you for asking about vocational rehabilitation services. Throughout Arkansas, we help eligible persons, become employed and independent in their daily lives.

Agency customers may be offered a wide variety of services that can prepare them for employment. To help you understand more about what vocational rehabilitation services means, we are sending data explaining many rehabilitation services and programs in Arkansas Please talk with your parents and teachers about your plans. We want you to be familiar with vocational rehabilitation services so you can make better decisions about the next few years.

Once again, thank you for contacting our agency. I hope the enclosed data will be helpful to you. We look forward to possibly working with you later, as you prepare for adult life.

Sincerely,

Counselor

Order of Selection Information for Transition Services

CATEGORIES:

1) Individuals with the Most Significant Disabilities

2) Individuals with Significant Disabilities

3) Individuals with Non-Significant Disabilities

WHAT IS ORDER OF SELECTION? If ARS is unable to provide rehabilitation services to all eligible individuals, the agency will operate under an order of selection. Individuals with the most significant disabilities have first priority when it comes to services that require the expenditure of money

WHAT ARE SOME OF THESE SERVICES? Counseling, guidance, career exploration, physical restoration, college of vocational training, supported employment, job placement, and follow up services.

WHAT IS A SIGNIFICANT DISABILITY? One that seriously limits a person's ability to move, communicate, take care of themselves or relate well with other people and must impact the individual's employability.

WHY HAVE THIS POLICY? When ARS doesn't have enough money to serve all eligible people with disabilities who apply, the law says we have to give first priority to people with the most significant disabilities.

WHO DECIDES IF I'M SIGNIFICANTLY DISABLED? The Counselor makes this decision.

WILL I AUTOMATICALLY QUALIFY FOR PAID-FOR SERVICES IF MY DISABILITY IS LISTED UNDER THE DEFINITION OF SIGNIFICANTLY DISABLED? No Significance of disability is only one factor used to determine eligibility for paid-for services. All applicants must be evaluated and must meet several criteria before eligibility is determined.

WHAT IF I DON'T HAVE A SIGNIFICANT DISABILITY, YET STILL WANT PAID-FOR SERVICES? Contact your local ARS office, talk to a counselor and complete all paperwork. This way eligibility will already be determined if money does become available.

WHAT IF I DISAGREE WITH THE DECISION? You may appeal the decision.

SAMPLE LETTER 2

Date

Student Name

Address

City, State, Zip Code

Dear Student's Name:

We recently received a Transition Referral Form from the Individual Education Plan (IEP) Team at your High School showing that you may be interested in learning about how vocational rehabilitation services might be helpful to you.

The purpose of Arkansas Rehabilitation Services is to assist persons who are eligible for our services to become employed and independent in their daily lives. Eligible persons may be offered a wide variety of services that can prepare them for employment.

In order to find out more about how vocational rehabilitation services can personally help you, call me at (_________) within the next two weeks. I will be happy to set up a personal appointment so we can discuss your future and how Arkansas Rehabilitation Services may be able to help you.

Sincerely,

Counselor

ARKANSAS KIDNEY DISEASE COMMISSION

HISTORY AND LEGISLATIVE AUTHORITY

The Arkansas Kidney Disease Commission (AKDC) was established by the General Assembly of the State of Arkansas through Act 450 of 1971 to establish a program for the care and treatment of persons with chronic renal disease. The legislation charged the AKDC to "provide financial assistance for persons suffering from chronic renal disease who require life-saving care and treatment to the extent as determined by the Commission." The ten-member, Governor appointed, AKDC Board provides general over-site to the program with the ARS Commissioner serving on the Board as Secretary/Chief Disbursing Officer.

SERVICES AND PROGRAMS

Services available to individuals determined eligible for the AKDC are dependent on treatment status as well as eligibility for benefits related to other programs such as Medicare, Medicaid, Veterans, or private health insurance. The program has an annual limit of funding provided per client with that limit subject to change based on the availability of funds. The AKDC may provide financial assistance to eligible individuals for payment of prescription drugs, pre-transplant dental services, transportation services, and in certain instances, medical services. In addition, the AKDC is dedicated to providing support to educational activities related to preventative measures and healthy living with End Stage Renal Disease (ESRD).

PRESCRIPTION DRUGS

The AKDC may pay for a limited number of ESRD related and post-kidney transplant prescriptions. With certain medications prior-approval is required. There are patient co-payments for all allowable medications. Clients are required to utilize available drug benefits before requesting the AKDC to provide prescription coverage as the program is identified as a payer of last resort.

DENTAL SERVICES

The AKDC may assist with payment of infectious free dental care for program clients awaiting kidney transplantation. Payments for services rendered will require prior approval of such treatments and follow the established AKDC dental fee schedule. As the AKDC is a payer of last resort, clients with dental coverage are required to utilize the benefit. The program can assist with co-payment.

MEDICAL SERVICES

The AKDC may assist in paying for some ESRD related medical treatment costs during the Medicare three-month waiting period or when other coverage does not exist. Documentation of lack of coverage and prior approval is required. The availability of this service is dependent on funding.

TRANSPORTATION SERVICES

The AKDC may assist with some transportation costs specifically associated with ESRD treatment. The intent of this service is to provide assistance with travel to/from dialysis treatments. Requests for other ESRD related treatment, including doctor's office visits, will be reviewed on a case-by-case basis. The availability of this service is dependent on funding and requires prior approval. Reimbursement for the service will be based on a mileage per-diem rate established by the AKDC board.

PATIENT EDUCATION

The AKDC is dedicated to educating program clients and the public at large in improving health behavior of patients with ESRD as well as preventative education to sustain healthy kidneys. The purpose of this service is to maintain and hopefully improve the health of program clients and also if not prevent then slow down the loss of kidney function. This is met through conveying the importance of patient compliance when taking medication, nutritional needs, life-style changes, as well as, resources that are provided for the success of preventing ESRD or at least surviving the disease should it occur.

SUPPORTED HOUSING OFFICE

The Supported Housing Office (SHO) augments ARS' mission of providing opportunities for Arkansans with disabilities to lead productive and independent lives by focusing on a wide range of affordable housing issues. Supported Housing is defined as 'normal' housing such as an apartment, a single-family or multi-family home available for rent or purchase, coupled with individualized support services to maximize independent living.

The SHO assists Arkansans with disabilities to navigate the maze of local, state, and federal affordable housing programs, to identify solutions for the issue at hand. Common housing problems run the gamut from requests for shelters for homeless persons with disabilities, to sources of rental assistance, information on home repair and modification programs, foreclosure issues, and home-ownership opportunities. In addition, the Office provides targeted research, predevelopment consultations, and technical assistance on universal design and affordable housing development to the non-profit and the private sectors.

The SHO also staffs the Arkansas Governor's Task Force on Supported Housing (GTFSH) which is charged with increasing the supply of affordable, universal design housing for persons with disabilities as mandated by the U.S. Supreme Court in the Olmstead Decision. The centerpiece of the GTFSH Plan is the Arkansas Universal Design Project (AUDP) which produced single and multi-family universal design housing standards that are currently being implemented by Arkansas Development Finance Authority (ADFA), the State Housing Agency. Currently ADFA is leader in the production of single and multi-family universal design housing throughout the State. More information on the AUDP Standards and related research is available on-line at www.studioaid.org.

Arkansans experiencing housing problems are encouraged to contact Jeanette Davies via e-mail at jeanette.davies@arkansas.gov or by phone at 501.701.6378.

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 disability(ies), 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 or 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 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 an employment outcome. This referral will occur prior to the 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:

1. Recommendation of training and technical assistance from appropriate organizations consisting of subjects such as exploring entrepreneurship, small business development, business plan development, small business management, accounting for business, and business financing.

2. Referral of the client to an appropriate resource as it relates to the development of a business plan defining the concept of the business and the business market and competition analysis.

3. Assist in identifying resources for the capitalization of the business.

4. The Consultant will develop a Report upon completion of these activities. The report will summarize the findings and provide recommendations as it relates to the operation of a new or existing business.

Definitions

1. Self-employment - refers to an employment outcome in which a client works in a business that s/he owns, operates, and manages with the intention of being profitable and becoming self-sufficient.

2. Form of Organization - refers to the way the client legally organizes the business.

a. Sole Proprietorship - one person who owns the business alone, but may have employees. S/he will have unlimited liability for all debts of the business, and the income or loss from the business will be reported on his or her personal income tax return along with all other income and expense s/he normally reports (although it will be on a separate schedule)

b. Corporation - requires a legal filing with the Internal Revenue Service for corporate status. Corporate organization provides limited liability for the investors. Shareholders in a corporation are obligated for the debts of the corporation; creditors can look only to the corporation's assets for payment. The corporation files its own tax return and pays taxes on its income.

* Clients who legally organize their businesses as a corporation, and are employed by their corporation may be eligible while in the start-up phase of operations.

c. General and Limited Partnerships - two or more individuals, one of which is a client of ARS with the controlling share.

d. Limited Liability Company - limited liability for all of its members (business partners), with the ARS client as the controlling member.

Eligibility Requirements

Participation in self-employment or small business operation as a vocational goal requires that:

1. The business venture is, at a minimum, 51% owned, controlled and managed by the client.

* Businesses organized as Sole Proprietorships, Corporations, General and

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

2. The business venture must be considered legal in Arkansas.

3. The business venture is accurately reported to appropriate government agencies including the Internal Revenue Service, the Arkansas Department of Finance and Administration, and the Arkansas Secretary of State, local City, or County Business licenses.

4. The business venture is organized as a for-profit entity.

Role of Counselor:

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

* 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.

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.

* Parti cipating in the assessment process.

* 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.

* 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 start up as noted in the Individualized Plan of Employment (IPE).

Process

The case record will reflect the following process:

1. The counselor determines that the individual is eligible for VR services and meets the Order of Selection, if the agency is under an Order of Selection.

2. Development of a vocational goal is under consideration by the client and their counselor.

3. When self-employment or small business operation is a viable possibility for vocational goal, the client is referred to the Self-Employment/Small Business Consultant (Consultant).

4. The Consultant assists the client to complete the process of assessment and approval.

5. Assessment of client's readiness for considering self-employment includes:

a. Evaluation of the client's interests, skills, aptitudes and personal qualities as they relate to self-employment or small business operation. This may include:

i. use of data gathering instruments, and

ii. vocational assessment to the degree necessary to ensure the client has the basic skills necessary to operate and manage a small business.

b. The client has attended appropriate training session/s, as recommended by the Consultant, through the Arkansas Small Business and Technology Development Center or other appropriate provider to affirm advantages and disadvantages of business ownership, explore preparedness from a personal perspective, and assess skills related to the business venture.

.

c. Examination of the client's financial goals related to self-employment should include consideration of issues such as terminating government benefits, supplementing family income versus primary source of support, and earning sufficient funds to maintain competitive employment standards.

d. The client's expectations relative to the financial support s/he anticipates/expects from ARS should be discussed at the onset. It is important that the client understands that ARS will not be the sole source of start-up capitalization and that any funding allocated to an existing business or to the start up of a business will be consistent with ARS policy related to financial participation.

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

Ensure the viability of self-employment as it relates to the client's disability. The counselor will have the appropriate documentation to determine the client's disability. Additional consultation with medical and/or psychological service providers that have been treating the client may be required. If clear information is not available reflecting the client's ability to handle the physical, mental/emotional, and cognitive aspects of the business venture, additional assessments, such as an assessment of physical limitations, an assessment of cognitive skills and abilities, mental status evaluations, and work site analysis, should be acquired as appropriate.

7. Assess the Feasibility of the Business:

a. Clients may be referred to outside resources for assistance in examining the concept, market and financial feasibility of the business. Examples of resources may include: the Arkansas Small Business Development Centers, and other local/regional microenterprise organizations and community economic development programs. If the business idea is deemed feasible, the information developed at this stage will provide some of the basic data that will be used in completing the Business Plan to be written later.

b. Testing the feasibility of the business idea must be formalized through a written business plan or feasibility Assessment documenting the following:

* Concept Feasibility: Clear description of the business idea; client's background related to the business concept including education, training, direct experience and transferable skill sets; a summary statement identifying issues of concern regarding the feasibility of the concept; and a recommendation as to whether the business concept if feasible.

* Market Feasibility: Geographic description of market area; description of competitors working in or marketing to potential customers in geographic area; definition of target markets including size and scope of each market; zoning issues/requirements for establishing a business at intended location.

* Financial Feasibility: Capitalization requirements (start up funding may not exceed 6 months) consistent with the client's business concept; identification of resources for startup funding and ongoing capitalization. Twelve months of projected sales/expenses may be included, when appropriate. A monthly update will be required upon authorization.

8. Individual Training and Technical Assistance:

a. All clients may be expected to attend training, and participate in technical assistance services related to self-employment or business operation as recommended by the Consultant. This includes options such as training and technical assistance from: the Arkansas Small Business and Technology Development Centers, local/regional microenterprise development service providers, or community economic development programs consisting of subjects such as exploring entrepreneurship, small business development, business plan development, small business management, accounting for business, and business financing.

b. Clients may require business specific skill training to eliminate skill gaps or prepare for the operation of the business. This could include coursework such as accounting/bookkeeping, using computers in business, human resources in business, etc. Skill-building courses should be noted in the IPE as necessary.

c. Upon approval of the Consultant a client may substitute training or technical assistance previously completed for this requirement if sufficient documentation is provided.

9. Business Plan Development:

The Business Plan is viewed as an essential element in any business venture and will be the document used by ARS, banks, micro lenders and other funding organizations to determine whether or not to participate in capitalizing the business venture.

a. A business plan approved by the Consultant is required.

b. A comprehensive Business Plan will be required for all clients as they request financial assistance for a business venture. The content for a comprehensive Business Plan is defined in the Client Business Plan Checklist (see Attachment 1). Clients should use the Client Business Plan Check List as a guide for preparing the business plan to ensure that all the critical areas are addressed.

c. The client will prepare the Business Plan with the Consultant and appropriate external technical assistance from a service provider experienced in business plan development.

d. Benefits counseling may be provided with a focus on the projected impact of revenues and expenses as noted in the Business Plan.

10. Explore and Apply for Resources Available From Other Sources:

All clients pursuing self-employment are required to explore, and when appropriate, apply for funding from sources other than ARS. These may include microloans, commercial and consumer loans, loans from family, forgivable loans, equity grants, and work incentives for Social Security recipients including Plans to Achieve Self Support (PASS) and personal property (inventory and equipment) essential to the operation of the business (PESS).

11. 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.

a. The Consultant will review the plan for completeness.

b. When the client's vocational goal is self-employment and his/her request does not exceed $2,500, the counselor, with the recommendation of the Consultant, can approve the Business Plan for financial assistance.

c. When the request for financial assistance exceeds $10,000, Business Plan review and approval by the Self-Employment Panel (Panel) is required. The Self-Employment Panel will make recommendation to Commissioner for final decision.

d. In cases where feasibility of the plan is in question as it relates to the funding request, ARS may have the Business Plan reviewed by an outside resource with expertise in small business, micro enterprise development and/or business finance.

Note: The recommendation of the outside resource will contribute to, but not define, the agency's final determination as to business feasibility.

1. Total startup costs.

2. Feasibility of the Business Plan in all aspects.

3. Potential for other financial resources, and

4. Availability of agency funds.

e. Process for Review by Self-Employment Panel:

* The Consultant will review the Business Plan, and complete the Business Plan Checklist.

* A Release of Information will be obtained from the client and will be submitted as part of the Business Plan review package.

* The Consultant will distribute the Business Plan review package to the Self-Employment Panel and schedule the review.

* The Self-Employment Panel will convene and conduct its review at a scheduled meeting after receiving the Business Plan review package.

* The Self-Employment Panel will provide an opportunity for the client, or a designated representative, to present information about the Business Plan.

* The Panel will review the Business Plan in terms of its feasibility, offer suggestions for improvement if necessary, and make recommendations for approval or disapproval.

* The review Panel will provide a written response with recommendations to the client within ten (10) working days of their review.

12. The decision of the Panel is forwarded to the appropriate approval parties i.e. Counselor, District Manager, Chief of Field Services, and/or Commissioner -please see Financial Participation Requirements.

13. If the client does not agree with the decision regarding the proposed Business Plan, the ARS appeal process is available to the client.

14. If approved the counselor completes the IPE or Amendment with the client with the vocational goal of self-employment or small business operation with the appropriate services.

15. The case is followed by the counselor and Consultant through post start-up and business stabilization.

16. The case is closed by the counselor with the agreement of the Client and with the recommendation of the Consultant. The business has been operating for a period of time long enough to adequately assess the stability of the business. A minimum of six months and a maximum of one year are recommended.

Individual Plan for Employment

The IPE or IPE Amendment will be developed after the comprehensive assessment is completed. The Business Plan and other required activities must be completed and approved by the Consultant and the Self-Employment Panel before the IPE is completed or amended with the vocational goal of self-employment or small business operation.

a. As part of the comprehensive assessment, training and technical assistance activities will occur such as training workshops and/or seminars focused on self-employment issues, feasibility assessment development, and other exploratory or preparatory activities that contribute to determining business feasibility.

* Business Plan must be completed and approved prior to IPE completion.

* The IPE or IPE Amendment would include the specific services to be provided for Business Planning.

* The IPE must include the approved financial assistance.

* The IPE must include a technical assistance plan for monitoring the business post start-up. This includes Benchmarks for case closure.

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.

a. In consideration of the business start-up capitalization noted in the Business Plan, financial participation by ARS and client is required as follows:

Business Capitalization

ARS Assistance

Client Participation

Approval

Up to $7,000

90%

10%

Consultant

$7,001

90%

10%

Consultant/Chief of Field Service/ Commissioner or or Designee

b. Client participation towards the business capitalization requirements can include equipment or inventory provided or purchased in an existing business or current business before the approval of the current business plan. The Consultant/Panel will determine the value of the items and have final approval of the items proposed to be included in the client participation in business capitalization in the current business plan.

Limitations and Restrictions

Financial assistance for business start-up capitalization does not include:

Limitations and Restrictions

Financial assistance for business start-up capitalization does not include:

1. Funding for speculative real estate development.

2. Utility deposits that are refundable to the client or business.

3. Cash.

4. Salary or benefits for the client, partners in ownership, or employees of the business that are members of the client's immediate family.

5. Purchase of real estate.

6. Erection of buildings.

7. Inventory or business supplies that include tobacco, firearms or alcoholic beverages.

8. Refinancing of existing debt - business or personal.

9. ARS is not responsible for any self-employment or business expenses incurred by the client prior to approval or denial of the business plan.

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 or the Commissioner, as outlined in Financial Participation Requirements above, after positive recommendation of the Self-Employment Panel.

Case Closure and Follow-up

1. Benchmarks leading to consideration for case closure in self-employment include:

a. The business shows signs of stability as reflected in the business' financial records.

c. The business has been operating for a period of time long enough to adequately assess the stability of the business. A minimum of 90 days and a maximum of one year are recommended.

d. All necessary services in the IPE have been provided.

e. The Client agrees with the counselor's recommendation to close the case.

2. 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.

a. Equipment necessary for the self-employment or business operation as outlined in the approved Business Plan will be listed by the client.

b. All purchases of equipment with ARS funds will be subject to State purchasing requirements.

c. All bids for equipment as required by State purchasing guidelines will be obtained by the client.

d. Equipment cannot be sold, consigned, or otherwise disposed of without the written consent of the District Manager.

e. Clients are legally responsible for damaged, lost or stolen equipment.

f. Clients are required to carry adequate insurance to cover all property involved in the self-employment or business operation.

g. Clients are required to carry adequate liability insurance appropriate to the self-employment or business operation.

h. In the event that the business is unsuccessful or that equipment is no longer useful or appropriate for the business, ARS may pick-up or dispose of the equipment according to the decision of ARS.

Attachment #1 Small Business

Client Checklist for Self-Employment

The Client Checklist should accompany a completed business plan and be submitted to the ARS Consultant for consideration of financial assistance.

___ Description/dates of training and technical assistance for feasibility & business planning

___ Copy of Feasibility Assessment

___ Completed Business Plan that includes:

Executive Summary: One to two page review of the business summarizing the most important points of the plan:

* Business description

* Business objectives

* Form of organization

* Product description

* Summary of business owner's qualifications

Industry/Business Analysis: Analysis of the current status of the industry in which the business operates:

* Definition (description of the economic sector that the industry occupies)

* Industry size and growth rate

* Key growth factors

* Analysis of industry in the geographic area where you will operate

Competition Analysis: Review of three to five direct competitors with a comparative analysis to your business

* Image

* Location

* Products & Services

* Pricing

* Advertising methods

Marketing Plan: Detail how business will identify, attract, and retain customers

* Customer profile: Comprehensive description of primary and secondary customer groups including the number of customers in market area

* Description of product attributes and why customers will want to purchase it

* Plan for distributing product (if applicable)

* Promotional schemes for initial 12 months of business

* Low cost and no cost advertising

* Buying advertising: Media type, frequency, intensity

Management: Description of the management of the organization including position responsibilities, salary/wages

* Management organization chart

* Personnel

Financial Plan: Total business capitalization request with supporting documentation

* Source and use of all funds for business development

* Total dollars needed to adequately capitalize business

* Identify all resources (banks, micro lenders, ARS, etc.) and confirm participation including personal financial participation

* Details of how all capital will be used (what it will buy)

* Specify use of "operating capital"

* Cash flow projection for 24 months

* Income/Expense projection for 2 years

* Profit/loss statement for 2 years

* Break-even analysis

* Personal financial statement for business owner

* Personal financial statement(s) for all business principals 20% or above

Supporting Documents: Documents that will strengthen the business plan

For example:

* Survey results

* Letters of commitment from funding sources

* Contracts

* Leases

* Letters of intent

* Sales agreements

* Resumes

* Personnel policies

* Job descriptions

* Credit report

____________________________

Client Signature Date

Attachment #2 Small Business

Consultant Checklist for Self-Employment

___Case Summary Feasibility Statement by the counselor: Detail the participant's ability to pursue the proposed plan based on academic and personality assessments (if applicable) and client readiness for considering self-employment.

Include: evaluation of client's interest, skills, aptitude and personal qualities related to self-employment; examination of client's financial goals related to self-employment; review of client's expectations to anticipated financial support from ARS; assessment of client's disability as it relates to the potential self-employment goal.

$___Business Start Up/Expansion Capitalization (total as presented in business plan)

$___ Financial Request to ARS

Self-Employment Panel Review Needed: ____Yes ____No

___Copy of Feasibility Assessment

___ Completed Business Plan that includes:

Executive Summary: One to two page review of the business summarizing the most important points of the plan

* Business description

* Business objectives

* Form of organization

* Product description

* Summary client' qualifications

*

Industry/Business Analysis: Analysis of the current status of the industry in which the business operates

* Definition (description of the economic sector that the industry occupies)

* Industry size and growth rate

* Key growth factors

* Analysis of industry in the geographic area where you will operate

Competition Analysis: Review of three to five direct competitors with a comparative analysis to your business

* Image

* Location

* Products & Services

* Pricing

* Advertising methods

Marketing Plan: Detail how business will identify, attract, and retain customers

* Customer profile: Comprehensive description of primary and secondary customer groups including the number of customers in market area

* Description of product attributes and why customers will want to purchase it

* Plan for distributing product (if applicable)

* Promotional schemes for initial 12 months of business

* Low cost and no cost advertising

* Buying advertising: Media type, frequency, intensity

Management: Description of the management of the organization including position responsibilities, salary/wages

* Management organization chart

* Personnel

Financial Plan: Total business capitalization request with supporting documentation

* Source and use of all funds for business development

* Total dollars needed to adequately capitalize business

* Identify all resources (banks, micro lenders, ARS, etc) and confirm participation including personal financial participation

* Details of how all capital will be used (what it will buy)

* Specify use of "operating capital"

* Cash flow projection for 24 months

* Income/Expense projection for 2 years

* Projected business balance sheet for 2 years

* Break-even analysis

* Personal financial statement for business owner

* Personal financial statement(s) for all business principals

Supporting Documents: Documents that will strengthen the business plan.

For example

* Survey results

* Letters of commitment from funding sources

* Contracts

* Leases

* Letters of intent

* Sales agreements

* Resumes

* Personnel policies

* Job descriptions

* Credit report

__________________________________

Consultant Signature Date

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:

1) The reported needs of the individual.

2) The stability of the disabling condition and prognosis.

3) Capability of existing staff and facilities to meet the individual's service needs.

4) The ability of the individual to adapt to a group living experience.

5) Reasonable assurance that enrollment will not be harmful to the individual nor to other students.

6) Medically Stable.

7) No pending legal issues.

8) Individual will commit to an employment outcome.

9) Status as a registered sex offender (note: if registered at a level higher than two the individual is not eligible for services at ACTI.)

BEHAVIOR CONSIDERATIONS FOR GROUP LIVING

Given the wide variety of disabilities served at ACTI, it is essential to create and maintain an effective and productive rehabilitation environment in which needs of persons with significant disabilities may be addressed.

Therefore, admission of any individual having the following anti-social patterns is not eligible for services at ACTI.

A. Physical Aggression

B. Deliberate use of abusive and provocative language.

C. Willful destruction of property.

D. Overt sexual behavior.

GUIDELINES FOR SPECIFIC DISABILITIES

These guidelines relate to specific disabling conditions and/or individual's problems meriting careful consideration by all ARS staff, both in the field and at the ACTI, in the process of selecting individuals for ACTI services. Each of these areas must have reasonable assurance that enrollment will result in employment:

1) Epilepsy - Persons with seizures who are candidates for vocational programs must be stabilized on medication and possess a level of seizure control consistent with participation in a six hour per day learning environment. Persons interested in vocational programs such as Auto Technology, Auto Collision, Construction Technology, Outdoor Power Equipment Technology and Welding that require the use of dangerous equipment must be seizure free for one year.

2) Psychiatric Disabilities - Psychological and psychiatric services at ACTI are not equipped to provide primary mental health care. The psychiatric and psychological services available are designed to support and maintain those individuals who enter an ACTI program. For admission, individuals must meet the following criteria:

A. A current psychological or psychiatric assessment and report of mental disability and prognosis. There must be full disclosure of mental and/or psychiatric illness. (Completed within the last 6 months.)

B. The report of clear documented series of primary psychiatric or psychological treatment.

C. Stabilized on medication or otherwise determined stable by attending psychiatrist/psychologist. The reasonable assurance that enrollment will not be harmful to client or others.

3) Cognitive Disabilities - ACTI does not provide close 24-hour supervision, nor are students confined to the facility environment. Students requiring close supervision and monitoring are not candidates for ACTI services. For admission, individuals must meet the following criteria:

A. Have demonstrated a capacity to function independently and appropriately in-group living situations.

B. Follow a prescribed schedule.

C. Appropriately respond to direction.

D. Manage free time, both within a structured environment and in the community.

4) Alcoholism, Drug Dependence, Abuse or Addiction - ACTI is not a primary treatment program for alcoholism, drug dependence, abuse or addiction. Its mission is to continue the vocational rehabilitation of these individuals after the primary condition is well controlled. For admission, individuals must meet the following criteria:

A. A medical diagnosis of the condition is present and on record.

B. The individual has successfully participated in a primary treatment program and/or the individual has not engaged in alcohol or drug abuse for a period of six (6) months and has a good, medically documented prognosis.

C. Participate in NA/AA Programs as recommended by ARS/ACTI Staff and submit to drug screens.

5) Medication Management - Students will be capable of self-administering their own medication or capable of learning this skill.

ARKANSAS CAREER TRAINING INSTITUTE DRUG POLICY

Students enrolling at Arkansas Career Training Institute (ACTI) must sign the Arkansas Rehabilitation Services Substance Free Policy with their Field Counselor. All students enrolled at Arkansas Career Training Institute will be tested for prohibited substances during the first week of enrollment. If a student tests positive for drugs, the student will be suspended for 45 calendar days. The student will be required to provide ACTI with a clean drug screen and sign a behavioral agreement prior to their return. The student will be retested within 30 days of their return to ACTI. If the student tests positive for drugs at that time, the student will be discharged from ACTI.

Readmission is subject to the criteria outlined in the ACTI Alcoholism, Drug Dependence, Abuse, or Addiction policy. The student must demonstrate 1) successful participation in a primary treatment program and/or 2) the individual has not engaged in alcohol or drug abuse for a period of six months and has a good, medically documented prognosis and 3) participate in NA/AA programs as recommended by ARS/ACTI staff and 4) submit to drug screens (ARS Policy Procedure Manual, Appendix C.)

ACTI students are subject to random drug testing.

ADMISSION PROCEDURES FOR ARKANSAS REHABILITATION SERVICES CLIENTS

To schedule a client for admission to ACTI, the Field Counselor will provide the Admissions Coordinator the following information.

ACTI REQUEST FOR SERVICES FORM (SEE APPENDIX E)

This referral document will be submitted for entry into ACTI for an evaluation not to exceed 60 calendar days in Extended Evaluation (Status 06) or Vocational Rehabilitation, services (Status 10 - 22). The Request for Services form will interpret the Field Counselor's impressions and opinions of the individual's abilities, personality, background, social and behavior assets and limitations, giving particular attention to describing the rehabilitation problem. The Field Counselor will identify any specific problem areas, including the need for special diet and medication with copies of the physician's prescriptions. The Request for Services form is the primary means for the Field Counselor to provide substantial and meaningful knowledge to ACTI personnel and should also include such information as the consumer's choice of limb maker, program identification for SSI/SSDI cases and any current insurance information (Medicare, Medicaid, private) that may provide funding for services. For referral of individuals who are alcohol dependent, a statement should be included that the individual has not consumed alcohol for a 6-month period and/or has successfully completed treatment in a recognized treatment facility. A similar statement is required for individuals with a known history of substance abuse. If the individual has previously been an ACTI student, include the name(s) used at each enrollment if known.

A completed copy of the Survey Interview/Application, the general medical reports provided by other agencies or facilities that substantially cover content of the General Medical Form may be accepted in lieu of the Agency General Medical Form, Specialists' Reports, and the ACTI Medical Supplement Form (PHS-2) will be submitted. In addition, available case narratives, ARS-75, test results, profile sheets and school records will be provided the Admissions Coordinator. A copy of the Test Record Form (complete form) of the Wechsler Adult Intelligence Scale (WAIS) results will be included if these tests have been administered. A copy of Rehabilitation Initial Diagnosis and Assessment for Clients (RIDAC) completed within the last six months is required for admissions.

For Status 06 referrals

If referred to ACTI in 06 Status (Extended Evaluation) cases must be moved to Status 19 when the student is enrolled in Vocational Training or other training related Support Services. A completed Individualized Plan for Employment (IPE) for Extended Services will be submitted prior to the individual's admission for evaluation services as an authorizing document.

For Status 12 and above referrals

A completed Individual Plan for Employment (IPE) will be submitted prior to the individual's admission for Vocational Rehabilitation Services as an authorizing document. The case MUST be in status 18 at the time of admission or moved into status 18 prior to enrollment into Vocational Training or Other Training Related Support Services.

CHECKLIST FOR CASES SUBMITTED TO ACTI ADMISSIONS COORDINATOR

The following documents must be completed with necessary signature before the Admissions Coordinator can review a case:

1) RS-344 Request for ACTI Service

2) General Medical Examination Record, if appropriate

3) Client Referral and Survey Information

4) PHS-3 Living at ACTI

5) PHS-2 Medical Supplement (those cases with limited mobility and/or limited activities of daily living capabilities)

6) IPE, plus Amendments for VR services other than EE

7) Specialists Reports (medical, psychological, psychiatric)

8) Case Note (demographic info)

9) Test Results (including WAIS profile sheet results and RIDAC.)

10) School Records

11) Background and Social Information

12) Medication taken to include prescriptions (if applicable)*

13) Consumer's preference of limb maker (limb cases only)

14) Demographic Referral Form

15) Immunization Record Must be forwarded to Admissions with referral materials

16) Social Security Card (copy)

17) Insurance Cards

18) University of Rhode Island Change assessment and ACTI screening questionnaire.

19) A referral from the clients' primary care physician for medical services if they receive Medicaid benefits.

20) Provide a list of accommodations.

Student will bring a 1-week supply of medications to ACTI.

SHORT-TERM ADMISSION FOR ACTI MEDICAL SERVICES

Short-term admissions (normally from one to ten working days) for initial wheelchair prescription, revision, repair, adjustment, replacement of prosthetic or orthotic appliances, neuropsychological evaluations and driver rehabilitation assessments/physical functional abilities assessment can be accomplished by submitting the following forms and information:

1) RS-344 Request for ACTI Services

2) Demographic Referral Information

3) PHS-2 Medical Supplement

4) RS-600 IPE or Amendment in Status 06 or above status 12.

5) All medical information substantiating need for requested service including doctor's prescriptions

6) The purpose of this assessment is to assure employment outcome.

If incidental expenses, clothing, transportation, and/or meals other than the noon meal for non-residents are to be provided, this must be planned for and recorded in the Services Section of IPE and specified on RS-344 Request for ACTI Services.

PROSTHETIC/ORTHOTICS AT ACTI

All new or initial wearers and individuals who have had difficulty wearing a limb may attend the ACTI Amputee Clinic for evaluation. ACTI Admissions Coordinator will schedule the individual for admission to the Amputee Clinic. The individual's Field Counselor will submit the same materials, including recommendations from a physician that the residual limb is ready for fitting; the signed Application for Services; and the completed Request for ACTI Services.

When possible, the vocational objective or tentative objective should be indicated since this type of information is extremely helpful to the clinic team in their total evaluation. Although the amputees' initial evaluation normally lasts five days, the length of time for ACTI services may vary from case to case. The Admissions Coordinator will advise the prosthetist and the counselor when the individual must report to the ACTI. The Field Counselor will notify the individual. The individual should expect to return home when the initial evaluation is completed.

The appropriate prosthetist is required to attend the Clinic for the initial prescription or evaluation of the prosthesis. All replacement prostheses recommended through this clinic will be evaluated as outlined below. The prosthetists may be required to attend other clinics to help resolve prosthetic problems.

The appropriate ACTI Counselor will immediately notify the Field Counselor of the evaluation results. If the Clinic recommends prosthesis, the Field Counselor may provide the limb in accordance with the recommendations. Actual construction of the new prosthesis (upper or lower extremity) should not begin before verbal or written authorization is received from the Field Counselor.

The details of measurement and fitting will be arranged by agreement between the Field Counselor, the individual, and the vendor. If the individual cannot travel to the limb company for the measurement and/or initial fitting, the prosthetists should contact the Field Counselor. A copy of the IPE will be submitted to the Admissions Coordinator prior to the individual's returning to ACTI for the final fitting.

A prosthesis should be made and returned to ACTI for initial evaluation within two (2) weeks of initial measurement. The prosthesis will not be delivered to the individual's home unless it is a replacement prosthesis recommended outside the ACTI Amputee Clinic.

The Field Counselor will notify the ACTI Counselor when the individual is ready to return to ACTI for the first fitting of the prosthesis.

The final fitting will be performed at the ACTI Amputee Clinic. The individual will remain at ACTI for training in the use of the limb. The prosthetist will notify the Field Counselor in writing with a copy of the notification to the individual and the Admissions Committee at least one week prior to the time the individual will be ready for final fitting. The individual will re-enter ACTI the day prior to the scheduled date.

CASE PROCESSING

Prior to the individual's entry into ACTI in Status 12 or above, the results of the diagnostic study and a supporting IPE are to be provided. Even when this study is completed, the individual may be sent to ACTI for additional diagnostic/evaluation services. Request for evaluation at ACTI will be addressed regardless of rehabilitation status.

Each consumer is assigned to an ACTI Counselor upon arrival. The ACTI Counselor becomes the extension of the Field Counselor in the case management and case processing while the individual remains at ACTI. All communication regarding a student's program is communicated through the ACTI Counselor. The ACTI Counselor is ACTI's liaison with the Field Counselor and service provider. The ACTI Counselor and Field Counselor will negotiate authorizations for necessary services provided outside ACTI. The ACTI Counselor who prepares the authorization and any additional documents such as Amendments to the IPE will be responsible for proper disposition of copies. The ACTI Counselor may authorize any services essential for the completion of the VR program.

All Statements of Account and related documents will be attached to the authorization in the case management system and payment entered for checks to be issued after the ACTI Counselor has verified that services have been rendered. The ACTI Counselor will be responsible for following up to verify that payment has been completed.

CLOTHING PRIOR TO ENROLLMENT

It is essential each individual arrive at ACTI with a 5-day supply of clothes that would be considered appropriate on the job to maintain a clean and neat appearance. A suggested list of minimum clothing has been established and such clothing is to be purchased or otherwise provided prior to arriving at ACTI. In planning with the individual, seasonal changes and the type of training must be considered. Students should have at least two pairs of shoes to wear in the training areas.

CLOTHING AFTER ENROLLMENT

Requests for personal clothing after enrollment will be directed to the Field Counselor. The Field Counselor, after investigating the family resources, will determine what clothing ARS will provide and advise the ACTI Counselor. The ACTI Counselor will write the necessary Amendments and authorizations to provide the clothing. Designation of funds and preparation of authorization will be determined by the Field Counselor and ACTI Counselor.

TRANSPORTATION TO ACTI

When ARS provides transportation, planning should include the need for a round-trip. The Field Counselor should remind clients of the date to report to ACTI approximately two weeks prior to the scheduled reporting date. Recommended time to arrive at ACTI is on Sunday between 10AM and 3PM. unless otherwise specified in the admissions letter. This allows the student an opportunity to begin the orientation program on a timely basis. Students must be at ACTI in this time frame as orientation begins in the afternoon. Parents, guardians, or other family members should plan to stay for the 5:30 PM Orientation class. If any changes are necessary, ACTI should be notified. The Field Counselor should instruct the client to report to the Reception Office at ACTI immediately upon arrival.

TRANSPORTATION WHILE ENROLLED

The ACTI Counselor will write the amendment for transportation provided by an outside vendor if needed. Authorizations will not be written when such transportation is provided with ACTI vehicles and personnel. ACTI Counselor will authorize transportation only when the individual has no resources and only at times when ACTI is initiating individual's leaving such as Christmas closing, time of discharge, or when client has an extreme emergency situation that necessitates leaving. The ACTI Counselor will not provide transportation for home visits or other non-emergency conditions.

INCREASED PER DIEM COSTS

Authorizations and Amendments will not be written to provide for increased per diem costs due to the client's receiving short stay hospital or evaluation services. The ACTI Counselor will inform the Field Counselor of such changes in the original planning.

MEDICAL TREATMENT OUTSIDE OF ACTI

The ACTI Counselor, upon recommendation by the ACTI physician, will authorize emergency medical treatment and non-emergency medical diagnosis. If the ACTI Counselor has current information that indicates medical services are necessary and recommended by a physician outside ACTI, the Field Counselor must be notified by telephone followed or email followed by a case note in the case management system explaining the situation. The ACTI Counselor and the Field Counselor will confer and a determination will be made based on the circumstances, of which the Field Counselor will be responsible for payment and completing the need IPE Amendment and authorization.

Exception: When there is evidence either from the individual or the ACTI Counselor, the family or individual can purchase or make a substantial contribution to the purchase of the necessary prosthesis, appliance, etc., and/or treatment. The ACTI Counselor will submit the recommendation to the Field Counselor. The Field Counselor, after further investigation, may write the amendments and authorizations to the vendor, or request the ACTI Counselor complete them.

In the event outside medical treatment is needed due to actions purposely or deliberately caused by the student (example: breaking a window in anger) the student may be responsible for all medical expenses resulting from the injury.

INCIDENTAL EXPENSES

This service will not be authorized unless the ACTI and Field Counselor agree the service is needed. It is to be used for minor emergency needs only.

UTILIZING ABILITIES UNLIMITED

Effective July 1, 2006, ACTI no longer refers students directly to Abilities Unlimited in Hot Springs. All authorizations to Abilities Unlimited for students enrolled in the ACTI must be issued by the Field Counselor.

FINANCIAL PARTICIPATION

The Field Counselor, in accordance with ARS Policy and Procedure Manual, will determine financial participation. Refer to Appendix I. Fees for the ACTI Fees and Training Hours.

LEAVE POLICY FOR ACTI STUDENTS

Students enrolled in ACTI are expected to remain until services outlined in the IPE are completed or otherwise terminated. However, leave may be granted to students when the ACTI Counselor and/or Field Counselor deem it necessary. Leave may be granted to a student due to illness, personal or family problems, positive drug screen, suspension or the need to return home to plan with the Field Counselor.

If a student does not return at the end of his/her designated leave, contact will be made with the Field Counselor by the ACTI Counselor and a decision will be made to either extend the leave up to an additional 30 days or discharge the student.

Students on leave will be discharged at the end of 30 days unless an extension of leave time has been requested and agreed upon by the Field and ACTI Counselor, and approved by ACTI Counseling Supervisor. After a student has been discharged, an application must be submitted to the Admissions Coordinator before consideration for re-enrollment.

NON-RESIDENTS AT ACTI

ACTI is a residential facility. Exceptions may be for non-resident enrollment under certain conditions and upon specific request by the Field Counselor. These conditions are:

1) Students residing in Garland County and immediate area may be admitted for services as a non-resident student of the Field Counselor.

2) ACTI has no family facility or living quarters for students with family or dependents. In the event two students become married to each other; they will be required to become non-residents as soon as arrangements can be made.

Non-residents are authorized to eat a noon meal in the ACTI's cafeteria on Monday through Friday as part of the usual ACTI services. After analyzing the individual's financial needs, the Field Counselor may request the individual be provided additional meals per day on maintenance services. The request for additional meals per day must be specified and authorized in the IPE and requested on the RS-344. These guidelines should be reviewed with and understood by students prior to admission.

Non-resident students will be provided normal/routine health care services from 7: 00 a.m. to 3 p.m. Monday through Friday. Non-resident students will be required to arrange for their own emergency care other than these specified hours, unless special arrangements are made on an individual basis with appropriate ACTI staff.

COMMUNITY REHABILITATION PROGRAMS

Community Rehabilitation Programs provide community and facility based comprehensive vocational rehabilitation services, supported employment services and employment oriented services (assessment, work adjustment, job coaching, on-the job training, and job placement) as one of its major functions to individuals with disabilities. The primary purpose for utilizing the CRP's services is to assist individuals with disabilities to be successful at work and live independently the community.

GOAL OF THE COMMUNITY PROGRAM DEVELOPMENT SECTION

The primary goal of the ARS Community Program Development Section is to identify the service needs which can be met through the purchase of services from non-profit or public CRP's. Once these service needs are defined, the Community Program Development Section, in coordination with the ARS General Agency, establishes Purchased Services Agreements with CRP's. The ARS Community Program Development Section requires annual comprehensive certification process and recertification, which establishes guidelines that must be followed by all parties to assure the timely provision of quality rehabilitative services to eligible individuals'. ARS works with CRP's to develop new initiatives and to update their facility to assure ARS consumers are moving towards competitive integrated employment outcome.

The Community Program Development Section provides verification approval forms to the ARS counselor for monthly payments to CRP's, provides continuous fiscal and programmatic oversight of contract guidelines, and provides technical assistance.

COUNSELOR LIAISONS

ARS District Manager will assign a vocational rehabilitation counselor to act as the liaison to each CRP. The counselor liaison's role is to establish and foster relationship, which encourage collaboration, increase referrals to the CRP and job placements opportunities for referred individuals. The counselor liaisons are required to visit the assigned CRP once a month and will provide a monthly report to the assigned CPD Rehabilitation Program Specialist by the first Friday of each month. This report addresses activities at the CRP, the relationship between the ARS and the CRP, bridging any existing gaps, and addressing any concerns. In addition, the counselor liaison may request periodic conferences with ARS staff, CPDS staff, and the CRP staff to discuss Certification/Contract issues and scheduled programmatic/fiscal reviews.

CRP SERVICES PROCEDURES

Service hours for CRP, other than ACTI, consist of a full day at more than five hours of services (excluding transportation) constitutes one unit, and partial day at three to five hours of service (excluding transportation) constitutes one unit.

REFERRAL

1) The counselor will send a cover letter authorizing a ten (10) day for assessment.

The letter will contain the following:

A. The questions to be addressed during assessment;

B. The counselor's impression of the individual's aptitudes, interests, attitudes, and suggestions as to work tryout areas;

C. If available, a summary of medical, psychological, social, educational, and vocational assessment/evaluation results and an interpretation of how these results may influence CRP services; and

D. A statement informing the CRP personnel that if more complete information is needed, it is available for review from the file in the local rehabilitation office.

E. Copies of medical/psychological reports, verifying the individual's disability.

When the CRP accepts the individual into the program for the 10-day assessment, an Admission Cover Letter Voucher will be sent to the Community Program Development Section by the CRP.

The CRP case manager will complete an assessment plan. The CRP case manager will provide a report to the counselor of the findings of the initial assessment. If Work Adjustment is recommended, the CRP case manager will submit a plan for the counselor's review/approval. It is necessary for the ARS counselor to maintain contact with the CRP staff in order to provide input, and to be assured the authorized services are being provided.

The CRP 10 day assessment may lead to the individual being referred to additional work adjustment services, Supported Employment Services or Job Services - VR Only (placement.)

WORK ADJUSTMENT

The counselor may authorize up to 60 days of attendance for Work Adjustment by completing the Authorization for Adjustment Services form (RS-315). Copies of the RS-315 will be maintained in the ECF and a copy sent to the Community Program Development Section by the CRP. The CRP completes a Work Adjustment Plan and provides a copy to the counselor for review/approval.

Individuals may exit the Work Adjustment Program prior to completing the 60 days if the individual has achieved the rehabilitation goal of employment. If an individual drops out of the Work Adjustment Program, they may be readmitted as long as there are eligible days remaining. If the individual is officially discharged by the CRP, the individual may be readmitted by the counselor completing a new RS-315. A final Work Adjustment report will be obtained from the CRP.

See CRP BILLING PROCESS page 15.

EXTENDED SERVICES

Based on the Work Adjustment Report, the CRP may recommend extended services days. The counselor may authorize the number of days of attendance set out in the CRP/ARS agreement for Extended Services by completing the Authorization for Adjustment Services (RS-315). Copies of the RS-315 will be maintained in the ECF and a copy sent to the Community Program Development Section by the CRP.

The CRP completes an Extended Services Plan and provides a copy to the counselor for review/approval.

Individuals may exit the Extended Services Program prior to completing the days available if the individual has achieved a rehabilitation goal of employment. If an individual drops out of the Extended Services Program, they may be readmitted as long as there are eligible days remaining. If the CRP officially discharges an individual, the individual may be readmitted by the Counselor completing a new RS-315. A final report will be obtained from the CRP.

CRP PLAN FOR WORK ADJUSTMENT OR EXTENDED SERVICES

The plan contains:

1) Documentation showing the individual was involved in plan development, which reflects the client's choice of occupation.

2) Program goals stated in terms of how competitive employment will be achieved;

3) Measurable objectives leading toward achievement of each program goal;

4) Target dates for completion of goals and objectives;

5) Name of the CRP case manager who coordinates the rehabilitative process, submits reports, and amends the plan when necessary.

See CRP BILLING PROCESS page 15.

SSBG 26 CLOSURE (JOB PLACEMENT)

During the time an individual attends a CRP Community or Facility Based (Sheltered Workshop), the CRP staff will assist the individual to seek employment. Based on the CRP recommendation for job placement services, the counselor may authorize this service by completing the Authorization for Adjustment Services (RS-315). Copies of the RS-315 will be maintained in the ECF and a copy sent to the Community Program Development Section by the CRP.

Once the individual obtains employment, the CRP must assure the following criteria is met before billing ARS.

* Makes at least minimum wage

* Works 20 hours or more per week

* Employed at least 90 days consistently

* Integrated Setting

See CRP BILLING PROCESS page 15.

CLOSURE INFORMATION OTHER THAN EMPLOYMENT

When an individual exits a CRP, a Discharge Report will be completed and sent to the Community Program Development Section. The CRP should retain a copy for its record and send a copy to the counselor. A final report will be obtained from the CRP summarizing the time the client participated and the achievements, results and recommendations. Attach reports to the ECF.

WAGE AND HOUR REGULATIONS IN CRP'S

ARS prefers an individual be employed at minimum wage; however, some clients in a CRP may be covered by a Department of Labor (DOL), Wage and Hour Certificate. The DOL Wage and Hour Certificate will authorize the CRP to reimburse the individual at a rate below the current minimum wage if appropriate. The Department of Labor Wage and Hour Certificate is required by the ARS Community Program Development Section as part of the Certification process if individuals are compensated on a piecework rate.

Exception: A CRP may request exemption from the DOL, Section 14C, Wage and Hour Certificate requirements if individuals with disabilities receive pay standards at minimum wage or above.

CERTIFICATION POLICY

ARS certification of a CRP's program of Assessment, Work Adjustment, and Extended Services and SSBG Closure (Job Placement) is required for ARS to purchase services.

Certification is contingent upon:

1) Confirmation by the ARS District Manager of the need for a CRP (New CRP's only) within the community;

2) The CRP submits the required application for certification and mandatory documents, along with justification of the capability to provide the established services.

3) The Community Program Development Section recommends certification to the ARS Commissioner upon review of the application and compliance documents with the following prerequisites:

A. There is an organization with responsibility for providing building, equipment, staff, and leadership directed toward fulfilling the stated function of the CRP;

B. There is a written description of the program of services to be offered;

C. There is staff qualified to provide the services offered.

D. Sufficient training or workstations are identified and evidence that work is available in sufficient quantity and type to meet program needs.

E. An annual budget is projected for the CRP's operation, which sets forth estimated costs, and how these costs will be met.

F. There is an accessible building(s) or training programs of sufficient size and adequate construction to meet program needs.

The Community Program Development Section will continually monitor each program through onsite monitoring and surveys. If any of the prerequisites governing certification are not met, the Community Program Development Section will recommend corrective action to be taken. The CRP is given a period of 60 days from the date of notification of recommendation to correct the deficiency. At the end of the 60 days, if corrections are not made, a suspension of certification will occur. The certificate may be reinstated when the Community Program Development Section has documentation that corrective action has been completed.

CRP BILLING PROCESS (See Appendix I. Fees for daily per diem amounts.)

* The counselor and Community Program Development (CPD) Section Rehabilitation Program Specialist receive the billing documentation from the CRP. The Statements of Accounts list the individual's name, service program, number of days in each program, and the amount to be paid by ARS.

* The counselor verifies the Statement of Accounts. If there are errors, the counselor shall discuss the errors with the CRP for correction and/or seek technical assistance from the CPD Rehabilitation Program Specialist.

* The CRP submits required electronic data from the Community Billing database to the ARS Community Program Development Section by the 10th of the month. CPD reviews the Statements of Accounts and verifies the electronic data match before a Verification Payment Form (VPF) is processed.

* CPD will send a Verification Payment Form (VPF) to the counselor and support staff. The VPF is required for payments to be paid through the ARS Finance Section.

* The counselor will attach the Statement of Accounts and the CPD Verification Payment Form into the ECF.

* When billing documentation is received, key required information into the case management system for payment authorization. Support staff will be responsible for making payments.

CRP ESTABLISHMENT POLICY

Establishment Defined

Establishment, development, or improvement of a public or nonprofit community rehabilitation program means:

The establishment of a facility for a public or non-profit community rehabilitation program (as defined in 34 CFR 361.5(b)(18) to provide vocational rehabilitation (VR) services to applicants or eligible individuals. 34 CFR 361.5(b)(17)(i).

Establishment Authority

Section 103 (b)(2)(A) of the Rehabilitation Act of 1973, as amended and 34 CFR 361.49(a)(1) authorize the use of VR funds to support "The establishment, development, or improvement of community rehabilitation programs (CRP), including, under special circumstances, the construction of a facility. Such programs shall be used to provide services that promote integration and competitive employment." The authority is used to provide financial support to community rehabilitation programs to establish or develop service programs, or improve them and to increase their effectiveness in providing VR services to applicants or eligible individuals.

In serving groups of individuals with disabilities, ARS is authorized to establish, develop, or improve a public or private CRP, pursuant to section 103(b)(2)(A) of the Rehabilitation Act and 34 CFR 361.49(a)(1). ARS is permitted under the VR program to alter or remodel a CRP and install fixed or movable equipment, as necessary, to establish, develop, or improve the facility for a CRP (34 CFR 361.5(b)(18)(ii) and (v)).

Community Rehabilitation Program

Section 7 (5) of the Rehabilitation Act of 1973, as amended and 34 CFR 361.5(b)(9) defines CRP as a program that provides directly or facilitates the provision of one or more VR services to individuals with disabilities to enable those individuals to maximize their opportunities for employment, including career advancement.

Vocational Rehabilitation Services

Vocational rehabilitation (VR) services are those services provided to an individual pursuant to an Individualized Plan for Employment in accordance with 34 CFR 361.48 or to groups of individuals with disabilities in accordance with 34 CFR 361.49 (section 103 of the Rehabilitation Act of 1973, as amended and 34 CFR 361.5(b)(58)). Section 111(a)(1) of the Rehabilitation Act of 1973, as amended and 34 CFR 361.3 require that VR funds be used solely for the provision of VR services or for the administration of the VR program.

Establishment Activities

The need for establishment, development or improvement of a CRP must be determined through the ARS Comprehensive Statewide Needs Assessment (CSNA).

Plans to establish, develop and improve CRPs through establishment activities must be included in the ARS State Plan in the following attachments, if applicable:

* CSNA (Attachment 4.11(a))

* State Goals and Priorities (Attachment 4.11(c)(1))

* State's Strategies (Attachment 4.11(d))

* Cooperative Agreements with Private Nonprofit Organizations (Attachment 4.8(b)(3))

* Arrangements and Cooperative Agreements for the Provision of Supported Employment Services (Attachment 4.8(b)(4))

* Evaluation and Report of Progress (as the project moves forward) (Attachment 4.11(e)(2))

Comprehensive Statewide Needs Assessment

ARS and the State Rehabilitation Council conduct the Comprehensive Statewide Needs Assessment (CSNA) every three (3) years, or update the CSNA as needed. ARS and the rehabilitation council conduct the CSNA for the purpose of describing the rehabilitation service needs of individuals with disabilities residing within the state. The CSNA must include an assessment of the need to establish, develop, or improve community rehabilitation programs (CRPs) within the state (34 CFR 361.29(a)(1)(ii)). Any update to the CSNA is required to be reported to the Rehabilitation Services Administration (34 CFR 361.29(ii)(2).

The CSNA particularly focuses on the vocational rehabilitation services needs of:

* Individuals with the most significant disabilities, including their need for supported employment services;

* Individuals with disabilities who are minorities;

* Individuals with disabilities who have been unserved or underserved by the vocational rehabilitation program; and

* Individuals with disabilities served through other components of the statewide workforce investment system.

Expenditures

Other expenditures are permitted if related to establishment, development, or improvement of a CRP that are necessary to: Make the program functional or increase its effectiveness in providing VR services to applicants or eligible individuals, but are not ongoing operating expenses of the program. 34 CFR 361.5(b)(17)(iii).

The acquisition of an existing building and, if necessary, the land in connection with the acquisition is permitted, if the building has been completed in all aspects for a least one (1) year prior to the date of the acquisition and the Federal share of the cost of acquisition is not more than $300,000. 34 CFR 361.5(b)(18)(i).

The remodeling or alteration of an existing building is permitted, provided the estimated cost of remodeling or alteration does not exceed the appraised value of the existing building. 34 CFR 361.5(b)(18)(i)

The expansion of an existing building is permitted provided that:

* The existing building is complete in all respects;

* The total size in square footage of the expanded building, notwithstanding the number of expansions, is not greater than twice the size of the existing building;

* The expansion is joined structurally to the existing building and does not constitute a separate building; and

* The costs of the expansion do not exceed the appraised value of the existing building. 34 CFR 361.5(b)(18)(iii)

Other expenditures allowed:

* Architect's fees, site survey, and soil investigation, if necessary in connection with the acquisition, remodeling, alteration, or expansion of an existing building; and

* The acquisition of fixed or movable equipment, including the cost of installation of the equipment, if necessary to establish, develop, or improve a community rehabilitation program. 34 CFR 361.5(b)(18)(iv) and (v)

Financial Impact

* The non-federal share of an establishment project is 21.3 percent. 34 CFR 361.60(a)(1)

* The match may be made, in whole or in part, by the state VR agency or contributions by private entities (private organizations, agencies, individuals). 34 CFR 361.60(b)(3)(i)

* Contributions from private entities used to meet the non-federal share of an establishment project must be deposited in the account of the state agency in accordance with state law. 34 CFR 361.60(b)(3)

Allowable Costs

* The federal share of the cost of acquiring a building that is to be used for community rehabilitation program purposes cannot exceed $300,000.

* Acquisition includes land and is subject to the $300,000 Federal Fund Participation limitation.

* Remodeling or alteration costs of an existing building provided that the estimated cost does not exceed the appraised value of the building.

* The expansion of an existing building, provided thatthe existing building is complete in all respects; and the total square footage of the expanded building is not greater than twice the size of the existing building.

* The expansion of an existing building, provided that the expansion is joined structurally to the existing building; and the costs of expansion do not exceed appraised value of the existing building.

* Architect's fees, site survey, soil investigation. (If necessary in conjunction with the acquisition, remodeling, alteration, or expansion of an existing building)

* Fixed or moveable equipment, including the cost of installation of the equipment. (If necessary to establish, develop, or improve a community rehabilitation program) 34 CFR 361.5(b)(18)(i) - (iii)

Staffing

* Federal financial participation is limited to a total of 48 months.

* The total percentage of costs in which the federal government will participate is reduced each year during the 4-year period.

* Staffing limit is imposed to preserve the amount of funds available to ARS for providing services to eligible individuals, while preserving ARS's authority to expend VR funds to support necessary development or expansion of community rehabilitation facilities.

* If necessary to establish, develop or improve a CRP to serve applicants or eligible individuals, funding for staffing is permitted for a period of four (4) years, with financial participation available at the applicable matching rate for the following levels of staffing costs. 34 CFR 361.5(b)(17)(ii)

Staffing Costs

Year 1

100%

Year 2

75%

Year 3

60%

Year 4

45%

State Purchasing Requirements

ARS must comply with all State of Arkansas purchasing requirements including solicitation of bids, if applicable, in the provision of establishment activities.

Affect of Costs on Maintenance of Effort

Non-Federal expenditures incurred for the establishment, development, or improvement of a facility for a CRP are exempt from the calculation of the State's maintenance of effort requirement pursuant to 34 CFR 361.62(b).

Pursuant to section 111(a)(2)(B) of the Rehabilitation Act and 34 CFR 361.62, a State must ensure that non-Federal expenditures under the VR State plan for any given fiscal year must equal or exceed the non-Federal expenditures from two years prior to that year. For example, non-Federal expenditures incurred in FY 2013 would have to equal or exceed the agency's non-Federal expenditures incurred in FY 2011. Costs classified as administrative costs count towards the maintenance of effort requirement; however, costs classified as the establishment, development, or improvement of a facility for a CRP do not count towards the maintenance of effort requirement.

Required Pre-Planning Activities

* The need for the establishment activities must be identified in the approved Comprehensive Statewide Needs Assessment jointly developed and agreed to by ARS and the State Rehabilitation Council and approved by the ARS Commissioner. 34 CFR 361.29(a)(1)34 CFR 361.13

* The development of goals and strategies related to the establishment activities must be included and discussed in the ARS State Plan. 34 CFR 361.29(c)(1) and (d)(3)

* The establishment, development, or improvement of a public or other nonprofit community rehabilitation program that is used to provide vocational rehabilitation services must promote integration and competitive employment. 34 CFR 361.49

* ARS must ensure that it satisfies all pre-planning requirements before engaging in these activities.

* ARS also must ensure that it monitors all establishment expenditures to ensure compliance with Federal requirements pursuant to 34 CFR 80.40(a).

* ARS will only consider requests to use establishment activities to develop a CRP if the needs for particular VR services are identified in the Comprehensive Statewide Needs Assessment (CSNA) and unavailable through other programs including the Arkansas Career Training Institute (ACTI). If the need for a VR service is identified, ARS will first determine if ACTI programs can be adapted to provide the service. If a VR need is identified in the CSNA and unavailable through other programs or ACTI or ACTI programs cannot be adapted to provide the services, then ARS will advertise for Request for Proposals. Unsolicited proposals will not be considered for establishment activities to provide the establishment, development, or improvement of a public or other nonprofit community rehabilitation program.

Arkansas Rehabilitation Services (ARS) Community Program Development Section (CPDS) and Community Rehabilitation Program (CRP) Review Process and Resolution Protocol

CRP Review Procedures and Resolution Protocol

This resolution protocol is established to allow for communication by either ARS staff or CRP staff, who may have an issue causing a barrier to services in assisting individuals with disabilities to receive vocationally oriented services toward quality, competitive employment outcomes in integrated settings.

STEP ONE: ARS field staff or the CRP staff discusses the issue(s) with the ARS counselor liaison. The ARS counselor liaison will contact the CPDS Rehabilitation Program Specialist for technical assistance.

STEP TWO: The ARS counselor liaison will discuss the issue with the ARS District Manager. The ARS District Manager contacts the CPDS Manager for technical assistance or if a resolution cannot be reached.

STEP THREE: The CPDS Manager will communicate with both parties to seek a resolution, which may require a meeting to develop a corrective action plan with time frames.

STEP FOUR: If the issue cannot be resolved by the above steps, the ARS- CPDS with approval in writing (official memo) from the ARS Chief of Field Services can recommend to the ARS Commissioner the termination of the CRP's certification.

STEP FIVE: ARS Commissioner will review documents provided by memo requesting this review from the ARS Chief of Field Services and the CPDS Manager documenting the process taken to seek a resolution. The final decision determined by the ARS Commissioner will be provided to the CRP within thirty (30) days from the date the ARS Chief of Field Services provides a memo requesting this review.

STEP SIX: If dissatisfied with the ARS final decision, the CRP has the right to a hearing as set out in the Arkansas Administrative Procedure Act, § 25-15-208 to 213 Administrative Adjudication.

CRP DEFINITIONS

Community Rehabilitation Program (CRP) - A program that provides one or more of VR services to individuals with disabilities and to enable those individuals to maximize their opportunities for employment, including career advancement.

TYPES OF CRP'S

CRP Facility (Sheltered) Based - a work-oriented habilitation or rehabilitation program with a controlled working environment and individual vocational goals, which utilizes planned goal-directed work experience and related services for assisting an individual with a disability to progress toward independent living and a productive vocational status.

CRP Community Based - a non-sheltered program providing services in the community by situational assessment trainings, on the job training, and other available local resources, including but not limited to community programs, public places like the public library, and local employers,

CRP SERVICES

Assessment - an investigative goal-directed process identifying and measuring the individual's work related behaviors, including but not limited to, job readiness, transferable skills, social skills and vocational interest, in order to determine the need for placement or additional rehabilitation services.

Work Adjustment - a system of goal-directed services or groups of services directed toward enhancement of the individual's job seeking and job-keeping skills that facilitate movement toward a satisfactory vocational placement.

Facility Based (Sheltered) Extended Services - a continued goal directed service to increase the skills, abilities, job keeping skills, and opportunities for employment for individuals that facilitate movement toward a satisfactory vocational placement, which may be provided in the community.

Competitive Employment - refers to work in the competitive labor market that is performed full or part time in an integrated* setting, and for which an individual is compensated at or above the minimum wage. Work performed must be compensated with the same benefits and wages as other workers in similar jobs receive. This includes sick leave, vacation time, health benefits, bonuses, training opportunities, and other benefits. *Integrated Setting" definition on page 27.

Sheltered Employment (cannot be a 26 closure) - refers to the long-term employment of an individual with a disability within a Facility Based (sheltered) CRP. This individual is considered to be an employee of the CRP and cannot be closed vocationally as a Status 26 closure, unless the majority of their employment time is in an integrated setting where individuals with disabilities do not congregate for services, for example the CRP campus/property. Sheltered employees in CRP's are typically paid at less than minimum wage depending on their productivity, and in accordance with special Department of Labor, Wage and Hour Division guidelines.

SUPPORTED EMPLOYMENT SERVICES (SES) AND DEFINITIONS

Supported Employment means competitive work in integrated work settings for individuals with the most significant disabilities (i.e. intellectual or developmental disabilities, learning disabilities, traumatic brain injury, and behavioral health issues) for whom competitive employment has not traditionally occurred, and who, because of the nature and severity of their disability, need ongoing support services in order to perform their job.

Individuals employed through Supported Employment services must:

1. Be engaged in employment paid at or above minimum wage;

2. Work performed must be compensated with the same benefits and wages as other workers in similar jobs receive. This includes sick leave, vacation time, health benefits, bonuses, training opportunities, and other benefits.

3. Need and be provided ongoing, support services in order to maintain employment, which may include natural supports provided by the employers; and

4. Be employed in an integrated setting.

NOTE: Supported Employment Services shall be provided for a period of time not to exceed 18 months, unless under special circumstances the eligible individual and the rehabilitation counselor jointly agree to extend the time to achieve the employment outcome identified in the individualized plan for employment. The counselor will provide a justification memo stating why the individual's disability requires an extended period of time to the District Managers for approval.

Transitional Employment means competitive employment in an integrated work setting for individuals with a significant disability due to mental illness who may need support services (but not necessarily job skill training services) provided either at the work site or away from the work site to perform the work. The job placement may not necessarily be permanent employment for the individual.

Transitional Employment Services consist of a series of temporary sequential job placements until job permanency is achieved. The job could be temporary or seasonal and the on-going "job skill training" requirement of "at least twice monthly" is waived unless the individual needs these services.

TYPES OF SUPPORTED EMPLOYMENT PLACEMENT

Individual Model - A person with a disability is placed in a job in a community business which best suits his/her abilities and preferences. Training is provided on the job site in job skills and work related behaviors, including social skills, by a job coach. As the employee gains skills and confidence, the job coach gradually spends less time at the worksite. Support is never completely removed. The private or public agency furnishing the job coach is always available to the employer for retraining for new assignments, assisting in dealing with challenging behaviors, supplying periodic consultations with co-workers and employer, giving orientation and training for co-workers. (Self-employment is encouraged and supported within this model.)

Enclaves Model - Enclaves typically consist of a small group of individuals with disabilities (generally 5-8) working together as a team under the supervision of a provider employee in a community business or industry. There is a contractual relationship between the business and the provider, and the provider pays the workers with disabilities either by a piece rate, a straight subminimum wage, or by pay commensurate with production. Another variation of the enclave approach is called the "dispersed enclave." This model is used in service industries (e.g., universities, restaurants, and hotels). Each person works on a separate job, and the group is dispersed throughout the company.

Mobile Job Crews Model - Job crews (up to 6) are provider sponsored groups of individuals with disabilities who travel together to perform work. The crew works as a distinct unit and operates as a self-contained business that generates employment for their crew members by selling a service. The crew works at several locations within the community, under the supervision of a job coach/Supported Employment vendor Supervisor. The type of work usually includes janitorial or grounds keeping. Individuals with disabilities work with others who do not have disabilities in a variety of settings, such as offices and apartment buildings.

Small Business/Entrepreneur Model - Establishes a small business, which employs both individuals with significant disabilities, but not more than the number of employees without disabilities. The small business operates like any business, generating work and paying employees from revenues received. The small business is located within the community

SUPPORTED EMPLOYMENT SERVICES PROCEDURES AND MILESTONES

REFERRAL/JOB DEVELOPMENT (SE): ARS makes a referral to a provider requesting assistance for the individual to receive services in the development, creation, or identification of paid integrated work in a community business or self-employment setting that meets individual's interests, abilities, and needs.

REFERRAL/JOB DEVELOPMENT (SE) PROCESS - Status 18:

* After eligibility, the counselor and individual will meet to develop their SE plan and choose an SE Provider. (The Rehab Act and the counselor's ethical code require the counselor provide informed choice of available SE Providers.)

* The counselor sends a Referral Letter to the chosen Provider after the IPE meeting.

* The Provider sends ARS an acceptance or denial letter explaining why the individual's needs cannot be met. If denied, the counselor will assist them to select another Provider.

* The Provider is required to meet with the individual at least twice monthly during the job development period. (Transitional Employment Services has an exception, see the definition above.)

* The Provider will submit REFERRAL/JOB DEVELOPMENT MONTHLY PROGRESS REPORT (SE-1) and the Supported Employment Billing Form (SE -5.) Reports shall have the signature of the individual receiving services. Attach reports to the ECF.

* When Supported Employment Billing Form (SE-5) is received, key required information into the case management system for payment authorization. Attach the bill to the ECF. Support staff will be responsible for making payments.

JOB MATCH/PLACEMENT (SE) - Status 20: The individual is placed in a competitive integrated employment setting with supports for a period of time and is being compensated commensurate with others in their position at the federal minimum wage or above.

JOB MATCH/PLACEMENT (SE) PROCESS:

* Once placed on the job, the Provider provides a job coach for the number of hours needed for the individual to learn the job.

* The Provider is required to meet with the individual at least twice monthly during the job match/placement period. (Transitional Employment Services has an exception, see the definition above.)

* The Provider will submit JOB MATCH /PLACEMENT MONTHLY PROGRESS REPORT (SE-2) the Supported Employment Billing Form (SE -5.) Reports shall have the signature of the individual receiving services. Attach reports to the ECF.

* When Supported Employment Billing Form (SE-5) is received, key required information into the case management system for payment authorization. Attach the bill to the ECF. Support staff will be responsible for making payments.

JOB STABILIZATION (SE) Status 22: This time frame of this service assures the individual has learned their job with supports to the meet the demands of the integrated work environment in assurance of long-term job success. The individual works successfully for the minimum required *15 hours a week identified in the IPE. The individual must remain on the job 30 days or more to be considered stable. The Job Coach reduces support to *less than 20 percent of the individual's working hours.

* Exception: The counselor will provide a justification memo stating why the individuals' disability requires less than 15 hours a week and/or more than 20% of a job coach to the District Managers for approval.

JOB STABILIZATION (SE) PROCESS:

* The Provider is required to meet with the individual at least twice monthly during the stabilization period. (Transitional Employment Services has an exception, see the definition above.)

* The Provider will submit JOB STABILIZATION MONTHLY PROGRESS REPORT (SE-3) the Supported Employment Billing Form (SE -5.) Reports shall have the signature of the individual receiving services. Attach reports to the ECF.

* When Supported Employment Billing Form (SE-5) is received, key required information into the case management system for payment authorization. Attach the bill to the ECF. Support staff will be responsible for making payments.

CLOSURE (SE): The individual has remained employed a minimum of 90 days after the 30 day stabilization period. When the individual and the employer are satisfied with the employment outcome, the Provider and ARS are ready for a successful case closure.

CLOSURE (SE) PROCESS - Status 26:

* The Provider is required to meet with the individual at least twice monthly during the 90 days leading to closure. (Transitional Employment Services has an exception, see the definition above.)

* The Provider will submit CLOSURE REPORT (SE-4) and the Supported Employment Billing Form (SE-5) Attach reports to the ECF.

* When Supported Employment Billing Form (SE-5) is received, key required information into the case management system for payment authorization. Attach the bill to the ECF. Support staff will be responsible for making payments.

* After the bills are paid, the counselor assures the client has Extended Services (Follow Along) support from the provider and completes the required 26 Closure documents.

SUPPORTED EMPLOYMENT (SE) EXTENDED SERVICES (FOLLOW ALONG): The SE Provider is required to support the individual for the length of the job. Providers are required to obtain funding to provide this support to keep the individual stabilized in employment on a long term basis or assist the individual to be stabilized with supports, if needed. The Provider is required to contact the individual and employer, at a minimum, at least once a month for the first year and then at a minimum of quarterly for the length of the job.

JOB SERVICES - VR ONLY PROCEDURES

This is a standalone service. See Vendor requirement form at the end of this section. A job-finding service is provided by a vendor, when the employment seeking individual is job ready. These services may be provided by a Community Rehabilitation Program, a public or private vendor. Vendors are approved through the Community Program Development Section application process.

JOB REFERRAL- VR ONLY: The Vendor receives a referral from ARS. Prior to the ARS counselors' referral, a determination has been made the individual is job ready and has been provided informed choice of Vendors. Note: Informed choice is mandated by federal law, even if the Vendor refers an individual to ARS for services.

JOB REFERRAL- VR ONLY PROCESS:

* ARS sends the Referral Entry Form to an approved Vendor for employment services. The Vendor accepts the referral. If denied by the Vendor, the counselor will assist them to select another Provider.

* When Job Services-VR Only Vendor billing form is received for Job Referral, key required information into the case management system for payment authorization. Attach the bill to the ECF. Support staff will be responsible for making payments.

* The Vendor submits Job Services-VR Only Monthly Progress Reports by the 10th of the month until the individual is successfully employed for 90 days. Attach the reports to the ECF.

JOB PLACEMENT- VR ONLY: The Vendor assist an individual to obtain a job in an competitive integrated setting based on their interests, abilities, needs, and informed choice to be successful employed long-term.

JOB PLACEMENT- VR ONLY PROCESS

* When Job Services-VR Only Vendor billing form is received for Job Placement, key required information into the case management system for payment authorization. Attach the bill to the ECF. Support staff will be responsible for making payments.

* The Vendor submits Job Services-VR Only Monthly Progress Reports by the 10th of the month until the individual is successfully employed for 90 days. Attach the reports to the ECF.

JOB CLOSURE - VR ONLY (90 DAYS): The individual is being compensated commensurate with others in their position and working preferably 20 hours a week at the federal minimum wage for consecutive 90 days.

JOB CLOSURE - VR ONLY (90 DAYS) PROCESS:

* When Job Services-VR Only Vendor billing form is received for Job Closure, key required information into the case management system for payment authorization. Attach the bill to the ECF. Support staff will be responsible for making payments.

* The Vendor submits Job Services-VR Only Monthly Progress Reports by the 10th of the month until the individual is successfully employed for 90 days. Attach the reports to the ECF.

INTEGRATED SETTING by United States Department of Education, Office of Special Education and Rehabilitative Services, Rehabilitation Services Administration issued a 2005 Technical Assistance Circular with the following comments:

* ". . . the term "integrated setting," as referenced throughout the statute, 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.

* We want to point 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."

ARS SUPPORTED EMPLOYMENT

REFERRAL/JOB DEVELOPMENT

MONTHLY PROGRESS REPORT

ARS SUPPORTED EMPLOYMENT

JOB MATCH/PLACEMENT

MONTHLY PROGRESS REPORT

ARS SUPPORTED EMPLOYMENT STABILIZATION MONTHLY PROGRESS REPORT

ARS SUPPORTED EMPLOYMENT CLOSURE REPORT

ARKANSAS REHABILITATION SERVICES SUPPORTED EMPLOYMENT SERVICES VENDOR BILLING

ARKANSAS REHABILITATION SERVICES JOB SERVICES - VR ONLY REFERRAL ENTRY FORM

ARKANSAS REHABILITATION SERVICES JOB SERVICES-VR ONLY MONTHLY PROGRESS REPORTS

Provide to vendor.

ARKANSAS REHABILITATION SERVICES JOB SERVICES - VR ONLY VENDOR REQUIREMENTS

ARKANSAS REHABILITATION SERVICES JOB SERVICES - VR ONLY VENDOR REQUIREMENTS

Vendors can make referrals of individuals with disabilities to Arkansas Rehabilitation Services (ARS.) This referral does not guarantee the individual will be eligible for ARS services.

Important Information: The Dept of Ed., OSERS, Rehabilitation Services Administration has a required definition of individuals with the most significant disabilities. See attachment.

Before ARS can refer a client to an outside vendor for placement, the individual with a disability must meet the eligibility criteria for vocational rehabilitation services and be ready to seek employment. ARS is mandated by federal law, even if the Vendor refers an individual to ARS for services, to inform the client of a choice of vendors who provide the service.

JOB REFERRAL- VR ONLY PROCESS:

* The vendor receives the form titled ARKANSAS REHABILITATION SERVICES JOB SERVICES - VR ONLY REFERRAL ENTRY form.

* The Vendor accepts or denies the referral by informing the counselor in writing (preferably email.)

* During the initial visit with the individual, the Vendor completes the bottom portion of the

ARKANSAS REHABILITATION SERVICES JOB SERVICES - VR ONLY REFERRAL ENTRY form and submits long with the ARKANSAS REHABILITATION SERVICES JOB SERVICES-VR ONLY VENDOR BILLING form checking the box for payment of "ARS referral received and accepted."

* The Vendor submits ARKANSASREHABILITATIONSERVICESJOBSERVICES-VR ONLY MONTHLY PROGRESS REPORTS by the 10th of the month until the individual is successfully employed for 90 days.

JOB PLACEMENT- VR ONLY PROCESS: The client has obtain a job in an competitive integrated setting based on their interests, abilities, needs, and informed choice to be successful employed long-term.

* The vendor submits the ARKANSASREHABILITATIONSERVICESJOBSERVICES-VR ONLY VENDOR BILLING form checking the box for payment of Job Placement "Client placed on the job." The individual must have sustained employment for five days or more.

* The Vendor submits ARKANSASREHABILITATIONSERVICESJOBSERVICES-VR ONLY MONTHLY PROGRESS REPORTS by the 10th of the month until the individual is successfully employed for 90 days.

JOB CLOSURE - VR ONLY (90 DAYS) PROCESS: Once the client has been on the job for a consecutive 90 days, being paid at the same wage as others in their position, working preferably 20 hours a week at the federal minimum wage or higher

* The vendor submits the ARKANSASREHABILITATIONSERVICESJOBSERVICES-VR ONLY VENDOR BILLING form checking the box for payment of Job Closure "Client successfully completed 90 days on the job."

* The Vendor submits ARKANSASREHABILITATIONSERVICESJOBSERVICES-VR ONLY MONTHLY PROGRESS REPORTS by the 10th of the month until the individual is successfully employed for 90 days. Attach the reports to the ECF.

INTEGRATED SETTING by United States Department of Education, Office of Special Education and Rehabilitative Services, Rehabilitation Services Administration issued a 2005 Technical Assistance Circular with the following comments:

* ". . . the term "integrated setting," as referenced throughout the statute, 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.

* We want to point 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."

Technical Assistance - Information on the Federal Rehabilitation Services Administration definition of individual with the a significant disability or disability

1. Individual has a physical or mental disability defined as an injury, disease or other condition that results in persistent functional limitations: resulting from amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

2. The individual's physical or mental disability results in a substantial impediment to employment. A substantial impediment to employment exists when the individual's disability prevents them from obtaining a job consistent with their abilities; significantly interferes with preparing for employment consistent with their abilities, there is a need for special accommodations or technology to perform essential job duties or barriers to job retention; for example job lost due to limitations or unable to perform essential job duties.

3. The individual can benefit in terms of an employment outcome from the provision of VR services.

4. The individual requires VR services to prepare for entrance into, engage in, or retain gainful employment consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities and informed choice. 34 C.F.R. § 361.42 (i.-iv.) An individual is expected to require multiple VR services over an extended period of time. These services will have a substantial impact on the individual's disability reduces their functional limitations or the impediment to employment, so the applicant can prepare for, obtain, retain or regain employment consistent with the individual's capabilities and abilities and the individual services cannot access these services without VR intervention.

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:

A. To determine if an individual is eligible for VR services.

B. To assign priority for an order of selection if ARS is under an order of selection.

C. To the extent necessary, the provision of appropriate assessment activities to obtain necessary additional data to make the eligibility determination and assignment.

D. To the extent additional data are necessary to make a determination of the employment outcome and the nature and scope of VR services to be included in the IPE plan for employment of an eligible individual.

Assistive technology device - means any item, piece of equipment, or product system that is used to increase, maintain, or improve the functional capabilities of an individual with a disability.

Assistive technology service - means any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.

Blind - an individual who has: Not more than 20/200 central visual acuity in the better eye or an equal disabling loss of the visual field, i.e., a limitation in the field of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees.

Case Note/Narrative - Case notes document the VR process from the initial contact of an individual through the eventual closure of a case. They are written, in such a manner, to allow a clear understanding as to the individual's interest, informed choice, rationale for decision making, and critical steps in advancing the rehabilitation process.

Clear and convincing evidence means a high degree of certainty before concluding that an individual is incapable of benefiting from services in terms of an employment outcome. The "clear and convincing" standard constitutes the highest standard used in our civil system of law. The term "clear" means unequivocal. For example, the use of an intelligence test result alone would not constitute clear and convincing evidence. Clear and convincing evidence might include a description of assessments, including situational assessments and supported employment assessments, from service providers who have concluded that they would be unable to meet the individual's needs due to the severity of the individual's disability. The demonstration of "clear and convincing evidence" must include, if appropriate, a functional assessment of skill development activities, with any necessary supports, including assistive technology, in real life settings. § 361.42

Congenital disorder, or congenital disease, is a condition existing at birth and often before birth, or that develops during the first month of life (neonatal disease), regardless of causation.

Competitive employment - work that is performed on a full-time or part- time basis in an integrated setting and for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals who are not disabled.

Criminal Act - means any crime, including an act, omission or possession under the laws of the United States or a state of general government that poses a substantial threat of personal injury, notwithstanding that by reason of age, insanity, intoxication, or otherwise, the person engaging in the act, omission or possession was legally incapable of committing a crime.

Deafness - A hearing impairment of such severity that the individual must depend primarily upon visual communication such as writing, lip-reading, manual communication, and gestures.

Deaf/Blind

A. who has a central visual acuity of 20/200 or less in the better eye with corrective lenses, or a field defect such that the peripheral diameter of visual field subtends an angular distance no greater than 20 degrees, or a progressive visual loss having a prognosis leading to one or both of these conditions; (2) who has a chronic hearing impairment so severe that most speech cannot be understood with optimum amplification, or a progressive hearing loss having a prognosis leading to this condition; and (3) for whom the combination of impairments described in items 1 and 2 cause extreme difficulty in attaining independence in daily life activities, achieving psychosocial adjustment or obtaining a vocation;

B. who despite the inability to be measured accurately for hearing and vision loss due to cognitive or behavioral constraints, or both, can be determined through functional and performance assessment to have severe hearing and visual disabilities that cause extreme difficulty in attaining independence in daily life activities, achieving psychosocial adjustment or obtaining vocational objectives.

Degenerative disease is a disease in which the function or structure of the affected tissues or organs will progressively deteriorate over time, whether due to normal bodily wear or lifestyle choices such as exercise or eating habits.

Disability - Is defined in the Vocational Rehabilitation Regulations, an individual: who has one or more physical or mental disabilities condition resulting from amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

Eligible individual - means an applicant for VR services who meets the eligibility requirements;

A. A determination that the individual has a physical or mental impairment.

B. A determination the individual's physical or mental impairment constitutes or results in a substantial impediment to employment for the individual.

C. A presumption that the individual can benefit in terms of an employment outcome from the provision of VR services.

D. A determination that the individual requires VR services to prepare for entrance into, engage in, or retain gainful employment consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities and informed choice.

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:

A. Corrective surgery or therapeutic treatment that is likely, within a reasonable period of time, to correct or modify substantially a stable or slowly progressive physical or mental impairment that constitutes a substantial impediment to employment;

B. Diagnosis of and treatment for mental or emotional disorders by qualified personnel in accordance with state licensure laws.

Post-employment services - means one or more services that are provided subsequent to the achievement of an employment outcome and that are necessary for an individual to maintain, regain, or advance in employment, consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

Qualified and impartial mediator - means an individual who:

A. Is not an employee of a public agency (other than an administrative law judge, hearing examiner, employee of a State office of mediators, or employee of an institution of higher education);

B. Is not a member of the State Rehabilitation Council for the designated State unit;

C. Has not been involved previously in the vocational rehabilitation of the applicant or eligible individual;

D. Is knowledgeable of the vocational rehabilitation program and the applicable Federal and State laws, regulations, and policies governing the provision of vocational rehabilitation services;

E. Has been trained in effective mediation techniques consistent with any State-approved or-recognized certification, licensing, registration, or other requirements; and

F. Has no personal, professional, or financial interest that would be in conflict with the objectivity of the individual during the mediation proceedings.

An individual serving as a mediator is not considered to be an employee of the designated State unit for the purposes of this definition solely because the individual is paid by the designated State unit to serve as a mediator.

Rehabilitation engineering - 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 functional areas, such as mobility, communications, hearing, vision, and cognition, and in activities associated with employment, independent living, education, and integration into the community.

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:

A. Who has a significant physical or mental impairment that seriously limits one or more functional capacities (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of as employment outcome;

B. Whose vocational rehabilitation can be expected to require multiple vocational rehabilitation services over an extended period of time; and

C. Who has one or more physical or mental disabilities resulting from amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders including stroke and epilepsy, spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

Substantial impediment to employment - a physical or mental impairment (in light of attendant medical, physical, psychological, vocational, educational, communication, and other related factors) hinders an individual from preparing for, entering into, engaging in, or retaining employment consistent with the individual's abilities and capabilities.

Supported employment - See Appendix C.

Transition Services means a coordinated set of activities for a child with a disability that is designed to be within a results-oriented process, that is focused on improving the academic and functional achievement of the child with a disability to facilitate the child's movement from school to post-school activities, including postsecondary education; vocational education; integrated employment (including supported employment); continuing and adult education; adults services; independent living, or community participation. The coordinated set of activities shall be based upon the individual child's needs, taking into account the child's preferences and interest, and shall include instruction, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation. 34 CFR § 361.22(a)(2) provides that, if the child is determined eligible for VR services, the child's IPE should be developed as early as possible during the transition process but no later than when the child exits the school setting.

Transportation - means necessary travel and related expenses in connection with transporting individuals with disabilities and their attendants or escorts for the purpose of providing VR services under the State Plan and may include relocation and moving expenses necessary for the achievement of a VR objective.

APPENDIX E

FORMS AND INSTRUCTIONS

STATE OF ARKANSAS VOTER'S AGENCY-BASED DECLARATION STATEMENT

VOTER REGISTRATION (3 FORMS) INSTRUCTIONS

AGENCY BASED VOTER DECLARATION STATEMENT

See the Secretary of State Website for current forms.

VOTER REGISTRATION APPLICATION

VOTER REGISTRATION MONTHLY REPORTING FORM

State regulations require that ARS offer voter registration onsite to individuals who may not be currently registered to vote.

The counselor will complete the Agency-based Declaration Statement and have the individual sign.

If the individual desires to register to vote, the counselor will assist the individual in completing the Arkansas Voter Registration Application and will mail the completed form to the Secretary of State Office.

A designated person in each office will keep a record of all applications, declinations, and report to the Secretary of State Office monthly.

ARKANSAS REHABILITATION SERVICES INFORMED CONSENT

CONFLICT OF INTEREST DISCLOSURE FORM

CASE NOTE/NARRATIVE

Pg 2 Authorization for Disclosure Information

**

Alcohol and/or Drug Treatment Records: This information has been disclosed to you from records protected by the Federal confidentiality rule (42 CFR Part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise, permitted by 42 CFR Part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse patient.

*** HIV Related Information: This information has been disclosed to you from records whose confidentiality protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by the state law. A general authorization for the release of medical or other information in NOT sufficient for this purpose.

THIS INFORMATION IS AVAILABLE IN ALERNATE FORMATS. PHONE (800) 842-4524

GENERAL MEDICAL ASSESSMENT AND (NEXT TWO FORMS)

MEDICAL CONSULTANT WORKSHEET

PHYSICIAN CONSULTANT WORKSHEET INSTRUCTIONS

The counselor will complete the top section of the form. The Physician completes the form.

GASTRIC BYPASS STATEMENT OF UNDERSTANDING

I understand that weight reduction surgery is a complicated medical procedure and there are risks involved. As part of my rehabilitation program, I agree to adhere to the recommendations of the surgeon and any other treating physicians or medical professionals at the time of surgery and during my recovery process. I understand that weight reduction surgery is not a "magic cure" but only an initial step in my effort to lose weight due to morbid obesity. I understand I must commit to a change in my lifestyle in order to lost weight and maintain a weight that does not pose a threat to my health. I agree to adhere to medically recommended diet and exercise programs and understand that if I do not adhere to such programs, I can regain a significant portion of any weight I may have lost as a result of the surgery. I have been informed of the research that indicates 5 years post-surgery 70% of individuals who have weight reduction surgery regain 50% of weight initially lost. I have been informed that due to the above-mentioned research it is the practice of Arkansas Rehabilitation Services to pay for the weight reduction surgery one time.

I understand this service is provided to help me to gain or maintain employment.

______________________________________________________________________

Client Signature Date

GASTRIC BYPASS SURGERY CHECKLIST

Required information for submission to the District Manager

Arkansas Department of Career Education

Arkansas Rehabilitation Services

525 W. Capitol

Little Rock, AR 7220 1

Phone/TTY (501) 683-0719 or Toll Free/TTY 800-828-2799 or fax (501) 666-5319

ASSISTIVE TECHNOLOGY @ WORK INSTRUCTIONS

REFERRAL AND ASSESSMENT PROCESS

The AT @ Work program (Assistive Technology at Work) is designed to assist the ARS consumer and the referring Counselor in selecting and obtaining the appropriate assistive technology. The program is a collaborative effort involving Little Rock based staff as well as ACTI therapy staff. Services offered include evaluation/assessment, assistive technology device training, device modification/adaptation, and technical assistance as it relates to work, school, home, and transportation. ARS Counselors are required to determine the need for assistive technology at the time of application, plan development, and placement.

The following process is recommended in those situations when the Counselor identifies the potential need for assistive technology:

1) Counselor determines need for an assistive technology assessment or consultation.

2) Counselor completes the AT @ Work Referral Form in full and forwards to the AT @ Work Program Manager via e-mail or fax.

3) Program Manager receives Referral Form, reviews and assigns to the appropriate AT @ Work evaluator. (If referral requests a wheelchair or orthotic/prosthetic assessment referral is forwarded to the physical therapy department at ACTI. The physical therapist will contact the referring Counselor to discuss the need for the consumer referred to visit the ACTI.)

4) Evaluator reviews the referral. Prior to scheduling the assessment, the Evaluator contacts the referring Counselor to ascertain the Counselor's perception of the individual's specific needs and requests other information.

5) Evaluator and Counselor will discuss the availability of IL or VR funds and determine the need to proceed with the evaluation.

6) Evaluator and Counselor will determine responsibility of scheduling the assessment in a timely manner based on the availability of the consumer, Counselor and evaluator.

7) Evaluator will complete a functional assessment addressing the referred individual's specific need of assistive technology based on the Counselor's request.

8) Evaluator will complete a report summarizing findings with recommendations for any needed technology prioritized.

9) Evaluator and Counselor will determine responsibility for procurement of recommended and agreed upon assistive technology. The Evaluator will provide vendor information, along with the quoted cost of the technology.

10) Evaluator will determine training needs regarding recommended technology prior to purchase.

11) Evaluator and Counselor will jointly agree as to responsibility for follow-up services including final approval of modifications/adaptations.

12) The Counselor will be responsible for processing payment of authorized and purchased technology.

CERTIFICATE OF ELIGIBILITY INSTRUCTIONS

1. The Certificate of Eligibility is generated by the case management system after Status 10 is keyed.

2. The Certificate of Eligibility form is displayed with the individual's name, Social Security Number, and counselor's name.

3. The physical or mental disability, the limitations, and the date of certification are to be keyed.

4. Check appropriate box for Trial Work Experience, Extended Evaluation, or VR services.

5. The Certificate of Eligibility for Trial Work Experience, EE, or VR services is not valid if not signed by the counselor and the Date of Certification entered.

6. The Certificate of Eligibility is attached to the ECF.

CERTIFICATE OF INELIGIBILITY INSTRUCTIONS

1. The Certificate of Ineligibility will be completed when the case is closed "08" from Status 02.

2. The Certificate of Ineligibility generated by the case management system after Status 08 is keyed.

3. The Certificate of Ineligibility form is displayed with the individual's name, Social Security Number, and counselor's name.

4. In the space provided, explain the reason the individual is ineligible for services.

5. Describe in the space provided the client's participation in the decision reached.

6. Record the date scheduled for the annual review for all individuals closed from Status 02 found ineligible because the individual indicates the severity of disability prevents participation in a rehabilitation program.

7. The electronic date and signatures of the individual and counselor indicate understanding of, and agreement.

8. When an individual is closed in Status "08" from Status 02, a Certificate is completed, provide a copy to the applicant and a copy is attached to the ECF.

CERTIFICATE OF ILRS ELIGIBILITY/INELIGIBILTY INSTRUCTIONS

1. The Certificate of Eligibility for ILRS is generated by the case management system after Status 72 is keyed. The Certificate of Ineligibility for ILRS is generated by the case management system after appropriate Status is keyed.

2. The Certificate of Eligibility form for ILRS is displayed with the individual's name, Social Security Number, and counselor's name.

3. The Certificate of Eligibility is not valid if not signed by the counselor and the Date of Certification entered.

4. The Certificate of Eligibility must be attached to the ECF.

5. The physical or mental disability, the limitations, and the date of certification are to be keyed.

6. The electronic date and signatures of the individual and counselor indicate understanding of, and agreement.

ARKANSAS REHABILITATION SERVICES ASSESSMENT FOR DETERMINING PRIORITY CATEGORY FOR SERVICES

ORDER OF SELECTION-PRIORITY CATEGORY INSTRUCTIONS

When applicable ARS Order of Selection follows the procedures outlined.

1. Eligibility (Status 10) must be established prior to applying the Order of Selection.

2. Complete the Assessment for Determining Priority Category for Services. (See Appendix E)

3. The consumer will be notified in writing of the priority category using the required form letter. The original will be mailed to the individual and a copy will be placed in the ECF case file. (See Appendix E)

4. If under Order of Selection, Document the Category placement in the case note narrative by using the Order of Selection heading.

5. If the individual does not meet the level of the priority category necessary to receive services, the individual may choose to be placed in a waiting (list) Status 04, or be referred to other Workforce partners or agencies, or closed in Status 30.

System 7 form

RS-16 Financial Resources

RS -16 FINANCIAL RESOURCES INSTRUCTIONS

The RS-16 is used to document financial resources and comparable benefits of the individual. The RS-16 must be included in the ECF of each individual prior to the provision of any services. Individuals receiving SSI/SSDI are exempt from financial need assessment, but the comparable benefit section of the form should be completed to assess other available funding sources. The IPE and IPE Amendments are used to summarize and compute the amount of supplementation. Instructions for completion of the RS-16 are to be followed to assure compliance with State policies and regulations.

If the individual is 23 years of age or under and unmarried, the parent(s) assets must be verified with a copy of the parent(s) income tax forms. If the parent(s) do not support the individual, the individual must provide documentation of non-support.

Complete all sections of the financial resources in the electronic case management system.

Exception: If the client's family states the client will not be claimed on next year's income tax, the client will no longer be considered a dependent. The client will be required to verify their source(s) of income to cover their expenses.

* Record the individual's name, date, and the total number in household.

CAPITAL ASSETS

1. Liquid Assets: Liquid assets of the individual and spouse are cash on hand, saving and checking accounts, bonds, securities, and other negotiable papers that can readily be turned into cash. Deduct the first $6,000 for persons (without dependent children), or 12,000 for persons with dependent children and enter the remainder of liquid assets on the blank line. If none, enter 0. If the individual is 23 years of age or under and unmarried, the parent(s) assets must be included. A copy of the parent(s) income tax forms must be provided for this purpose. If the parent(s) do not support the individual, the individual must provide documentation of non-support.

2. Other: Enter any other capital assets.

3. Total: Enter the sum of the amounts in Lines 1-2. If none, enter 0.

MONTHLY INCOME

Reported income must be verified. (See manual Section V)

If the individual or parent(s) reports zero income or did not file income tax forms, the individual must sign a written statement of verification. If the individual is 23 years of age or under and unmarried, the parent(s) income must be included. A copy of the parent(s) income tax forms must be provided for this purpose. If the parent(s) do not support the individual, the individual must provide documentation of non-support.

4. Net Salary: Deduct 25% of the gross income from the most recent paycheck computed on a monthly basis for a regular full-time employee.

Deduct 25% of the adjusted gross income computed on a monthly basis if the information is obtained from income tax returns or the PELL grant summary.

For farmers, teachers, or part-time employees, the amount entered will be the monthly average for the past 12 months. If income has ceased at the time of application or will not be continuing, enter 0 in the amount column.

5. Retirement/Pension: Enter the amount.

6. VA Disability (Client Only): Enter the amount.

7. SSDI (Client Only): Enter the amount.

8. SSI (Client Only): Enter the amount.

9. Annuities (Client Only): Enter the amount.

10. Private Insurance (Client Only): Enter the amount.

11. TANF (Client Only): Enter the amount.

12. Other (Client Only) Enter the source and the amount of any other income such as contributions, rent, board, etc. received. Enter the family income from parent(s) or spouse. If the individual is 23 years of age or under and unmarried, parent(s) income must be included.

13. Total (Lines 4 - 12) Enter the sum of amounts in Lines 4-12. If none, enter 0.

NORMAL LIVING REQUIREMENTS (NLR)

DO NOT COMPLETE FOR SSI/SSDI RECIPIENTS.

14. Family Group: Enter from the Normal Living Requirements Table the amount in accordance with the household group and any modification. NLR includes shelter, food, clothing, general health maintenance, utilities, and basic standard living requirements.

Number of Persons

Monthly Amount

1

$3,200.00

2

$3,600.00

3

$4,000.00

($400.00 for each additional family member)

15 & 16. Special Conditions: Special Circumstances (conditions) of other expenditures/debts that impose unusual burdens on the client or family's income can be added to the normal living requirement. (Example: medication or medical payments for client or other family members, child support, education expenses, etc.) List and identify each special condition.

17. Total: Enter the sum of Lines 14 through 16.

CLIENT'S AVAILABLE RESOURCES - DO NOT COMPLETE FOR SSI/SSDI RECIPIENTS.

Each individual is expected to use all resources available for the rehabilitation program.

18. Monthly Income Available Line 17 minus Line 13. (If line 17 is greater than line 13 enter 0.)

19. Income Available (Line 18 times Number of Months): This amount represents continuing income available to the client. In all instances, any amount exceeding the NLR will be entered and used.

20. Capital Assets: Enter the amount from Line 3. If none, enter 0.

21. Total: Enter the sum of Lines 19 and 20.

COMPARABLE BENEFITS - ESTIMATE IF EXACT AMOUNT IS NOT AVAILABLE.

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.

22. Medicaid: Check yes or no and enter the amount. If "no", enter 0.

23. Medicare: Check yes or no and enter the amount. If "no", enter 0.

24. Pell Grant: Check yes or no and enter the amount of grant as determined by the Financial Aid Administrator in the institution. If "no", enter 0.

25. Insurance: Check yes or no and enter the amount of insurance benefits available as determined by client statement or review of policy. The name of the company and policy number will be entered, if known. If "no", enter 0.

26. Veteran's Administration (Educ/Trng Only): Check yes or no. Enter the amount. If "no", enter 0.

27. Workers' Compensation: Check yes or no. Enter the amount. If "no", enter 0.

28. Other: Specify any other comparable benefits. Enter the amount. If none, enter 0.

29. Total: Enter the sum of Lines 22 through 28. If none, enter 0.

Comments: Additional information or explanation may be included in this section.

Individual and Counselor Signature: The electronic date and signatures of the individual and the counselor indicate understanding of, and agreement.

INDIVIDUALIZED PLAN FOR EMPLOYMENT (IPE) INSTRUCTIONS

Complete all sections of the IPE in the electronic case management system.

1. The individuals' name, SSN and the date of birth is automatically in the plan.

2. Employment Goal - Select from the dropdown box based on tthe individuals desired goal, skills and abilities

3. Plan begins on enter the dates 00/00/0000 and the estimated end on 00/00/0000. Enter the dates. Enter the Annual Review Date.

4. Projected Job Demand Select from the dropdown box the.

5. "All the Planned Services have been Completely Provided on:" complete when the IPE services have been completed.

6. Intermediate Objectives - List in the order of anticipated completion.

7. Evaluation Criteria - List the measuring tools to determine the progress of the IPE services toward an employment outcome.

8. Service: Select from the dropdown box the service to be provided. (Note: For each planned service follow #8-15.)

9. Provider: Select from the dropdown box what entity/agency is responsible to provide the service. NOTE: If the provider is not in the case management system communicate with the help desk for instructions to add them or an additional service.

10. Enter the Cost of Planned Services: No. of Unit, type of unit and unit price complete and the case management system will total the cost. (The units reflect the cost of planned services.)

Consumer Contribution:

Cost Estimate - Reference the RS-16 to determine if the individual has available resources or comparable benefits (i.e. Pell Grant) to contribute toward each service.

If resources are available, the counselor will negotiate with the individual the amount of their contribution and the agency supplementation. These amounts are entered under "Funded By."

11. Funded By: - Select from the dropdown box who will pay for each service. If a contribution is to be made choose the appropriate payer and in the cost box place the amount. For example:

Consumer $100

Pell Grant $100

Our Agency $1000

12. Service dates - type in dates 00/00/0000

13. Method of Procuring - select from dropdown.

Explanation:

Purchased - ARS will pay for the services.

Provided - ARS will provide the service.

Arranged - Service will be provided by another source

14. Outcome - select from dropdown.

15. Outcome Date- Once the outcome is completed, type in date 00/00/0000.

16. Total, Individual's Contribution, Total Agency Supplementation: The case management automatically calculates these boxes based on information previous entered.

17. Benefits Counseling or ACTI assignment - If appropriate, select from the dropdown list and enter the dates. Click Resend Assignment.

18. INDIVIDUAL UNDERSTANDINGS, RESPONSIBILITIES, RIGHTS, REMEDIES, AND INFORMED CHOICE - Provide to the individual to read, sign and date.

Electronic signature, approved "Y" and date REQUIRED by the Vocational Rehabilitation Counselor, appropriate approval staff and the individual.

The electronic date and signatures of the individual and counselor indicate understanding of, and agreement to the plan.

19. Provide a copy to the individual.

INDIVIDUALIZED PLAN FOR EMPLOYMENT AMENDMENTS INSTRUCTIONS

The original IPE form is used for amending the individual's plan whenever a change in the rehabilitation program is needed and to record the progress of the individual's rehabilitation program annually. A justification notation should be made in the case note to explain the need for an amendment or annual review consistent with informed choice. The counselor will complete only the items needed to accomplish the amendment or annual review. An amendment to the IPE may include a vocational objective change, deletion or addition of services, costs of services, termination of the case, extension of an expired IPE, etc. and the required annual review.

1. INDIVIDUAL UNDERSTANDINGS, RESPONSIBILITIES, RIGHTS, REMEDIES, AND INFORMED CHOICE - Provide to the individual to read, sign and date.

Electronic signature, approved "Y" and date REQUIRED by the Vocational Rehabilitation Counselor, appropriate approval staff and the individual.

The electronic date and signatures of the individual and counselor indicate understanding of, and agreement to the plan amendment.

2. Provide a copy to the individual.

System 7 form

Request for HSRC/ACTI Services

REQUEST FOR ACTI/HSRCH SERVICES INSTRUCTIONS

1. Name: Individual's last name, first name, and middle initial.

2. Social Security Number: Record client's social security number. Verify the number by checking the client's Social Security card.

3. Referring Counselor: Record last name only.

4. Counselor Number: Record field counselor's number.

5. Primary and Secondary Disabilities: List primary and all secondary disabilities with codes for each.

6. Describe Status of Disability: Complete if applicable. Example: Seizure disorder controlled by medication.

7. Prior ACTI/HSRCH Services: Dates of previous admissions and services received if known.

8. Contribution/Amount/Payment Source: Include the amount of contribution, frequency of contribution and name and address of the contributor to be billed if other than client.

9. Plan for Payment of Comparable Benefits: List all funding sources including name, address, and payment plan. Example: Worker's Compensation, Aetna Insurance Company, Medicaid (attach copy of current card with number), etc. and billing address.

10. Planning Information:

* Explanation of Rehabilitation Problem: This section should adequately identify and describe the rehabilitation problem in reference to the client's functional capacities and limitations and their implications in relation to his/her work potential. The rehabilitation problem is not the diagnosis or disability.

Rehabilitation problems are behaviors or conditions exhibited behavior or for conditions exhibited by individuals and/or presented by their environment which need to be eliminated or improved in order for the individuals to fulfill their vocational potential or maximize their work functioning.

Description of the rehabilitation problem should provide specific information related to the following questions:

1. Why is the individual not working?

2. What is preventing the individual's obtaining, retaining, or preparing for employment?

3. What are the specific functional limitations and restrictions imposed by the disability and how do these limitations and restrictions affect vocational functions and activities?

* Statement of How ACTI Services are Expected to Improve Individual's Employment/Placement Potential: The statement or information provided in this section should be linked to the explanation of the rehabilitation problem; i.e. what is the expected outcome of ACTI services in reducing, eliminating, or modifying the identified rehabilitation problem(s). Expectations should be stated in terms of improved or modified functional capacities related to the disability, not a change in the disabling condition itself. The expected, or desired, outcomes should be stated for each service requested.

* Services Requested: Place a number in boxes to identify services requested and probable sequence of services.

* Information Attached: Check appropriate box for documents attached to the Request for ACTI/HSRCH Services Form. These documents will be utilized for admissions information and program planning.

* Residential Information: Check appropriate boxes.

* Counselor Signature and Date: Counselor will sign and record the date the form is completed.

ARKANSAS REHABILITATION SERVICES AUTHORIZATION FOR ADJUSTMENT/EXTENDED SERVICES DAYS/90-DAY CLOSURE INSTRUCTIONS

The Authorization for Adjustment Services/Extended Services Days/90-Day Closure will be completed by the Counselor to authorize an individual to receive up to sixty (60) days of Work Adjustment in a CRP or additional training days through Extended Services Days or 90-Day Closure (Job Placement) Service.

Based on the need of the client as reported provided by the CRP, the counselor will complete the RS-315 for either Work Adjustment, Extended Services Days or 90-Day (Job Placement) Closure Service as appropriate Service time frames and fees are set out in a contract with a Community Rehabilitation Program and funded under Title XX SSBG.

TRAINING PROGRESS REPORT INSTRUCTIONS

(Next three forms.)

RESPONSIBILITY OF COLLEGE STUDENTS

This form is to be completed by all individuals participating in a college program. The report is signed by the individual and the counselor and attached to the ECF and a copy is provided to the individual.

LETTERS FOR STUDENTS FOR TRAINING - The counselor will mail the letter during the Spring Semester.

TRAINING PROGRESS REPORT - This form is to be completed by the instructor.

LETTER FOR STUDENTS IN TRAINING

Dear :

This is a reminder that in order for us to meet Federal and State Guidelines for you to receive assistance from our Agency, you must comply with the following:

1. Apply for the Student Financial Aid on an annual basis and send a copy of the award or denial letter for your file.

2. Final grades from the last semester in school or a copy of your transcript showing your final grades must be forwarded to me for your file.

3. Maintain a 2.0 grade point average per semester while enrolled as a full-time student.

4. Arrange to meet with me once following the Spring Semester and at least one month prior to the Fall Semester to accomplish an annual review.

Failure to comply with these guidelines will result in denial of tuition assistance to you.

Sincerely,

, Rehabilitation Counselor

Arkansas Rehabilitation Services

ARKANSAS REHABILITATION SERVICES MONTHLY TRAINEE LETTER

ARKANSAS REHABILITATION SERVICES TRAINING PROGRESS REPORT

NOTE-THIS REPORT MUST ACCOMPANY ANY CLAIM FOR PAYMENT OF TUITION OR OTHER CHARGES

ARKANSAS REHABILITATION SERVICES STUDENT HEALTH SURVEY

RECEIPT/RELEASE FOR OCCUPATIONAL TOOLS AND/OR EQUIPMENT AND TITLE AGREEMENT INSTRUCTIONS

RECEIPT/RELEASE FOR OCCUPATIONAL TOOLS AND/OR EQUIPMENT AND TITLE AGREEMENT INSTRUCTIONS

This form will be attached to the ECF and a copy provided to the individual.

Complete all sections in the electronic case management system.

1. Record the month, day, and year.

2. List in detail, the items purchased for the individual and describe each item, showing serial numbers, if applicable.

3. The electronic date and signatures of the individual (the same name in the ECF.) and counselor indicate understanding of, and agreement to the title of the tools/equipment.

EMPLOYMENT SERVICES REFERRAL

EMPLOYMENT SERVICES REFERRAL FORM INSTRUCTIONS

This form is used for all job placement referrals to the ARS Business Relations Representative (BRR.)

1. The counselor will complete the top half of the form.

2. The bottom half will be complete by Business Relations Representative.

Distribution (Field Office)

* Copy of the referral form is attached to the ECF.

* A copy of the referral form remains in the file of the Business Relations Representative.

* After the client interviews for possible employment, the Business Relations Representative completes the form and a copy of this form is attached to the ECF.

Distribution (ACTI)

* Copy of the referral form is in the ACTI client file at referral

* A copy of the referral form remains in the file of the Business Relations Representative.

* After the clients interview for possible employment, Business Relations Representative completes the form and a copy of this form is retained in the ACTI counselor's file and the field counselor's file.

VR Case and Closure/Amendment Information

REGI STERED LETTER - CLOSURE OF CASE RECORD OF SERVICES

Dear

This Registered Letter is to inform you that your ARS file is being closed since you are employed. A minimum of three written attempts (2 letters with one registered letter) has been made to contact you about closure of your case. The Code of Federal Regulations (Part 361.34, Section 361.56) states the case record of services of an individual who has achieved an employment outcome may be closed if the following requirements have been met:

(A) Employment outcome achieved. The individual has achieved the employment outcome that is described in the Individual's Individualized Plan for Employment that is

(1) Consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice; and

(2) In the most integrated setting possible, consistent with the individual's informed choice.

(B) Employment outcome maintained. The individual has maintained the employment outcome for an appropriate period of time, but not less than 90 days, necessary to ensure the stability of the employment outcome, and the individual no longer needs vocational rehabilitation services.

(C) Satisfactory outcome. At the end of the appropriate period under paragraph (B) of this section, the individual and vocational rehabilitation counselor considers the employment outcome to be satisfactory and agree that the individual is performing well in the employment.

(D) Post-employment services. The individual is informed of the availability of post-employment services.

If notice to the contrary is not received from you within five working days from the date of the receipt of this letter, I will consider the requirements met and your case will be closed. If you have any questions or concerns, please contact me.

Sincerely,

Counselor

Arkansas Rehabilitation Services

CONSUMER SATISFACTION SURVEY INSTRUCTIONS

This form is to be mailed to the individual at the time of closure (Status 26 and 28) or accessed online. The original form is postage paid so copies cannot be used.

APPENDIX 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 assure ARS customers with disabilities 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. The potential for violence in the school or workplace is very real. This is exacerbated by the prevalence of illegal substances among our customers. It is our obligation to employees and other customers 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

Unlawful manufacturing, distributing, dispensing, possession of, or the use of a controlled substance, illegal use of substances (drugs, alcohol, inhalants and steroids) while on any statewide agency premises or actively participating in an ARS program is prohibited. Any ARS customer violating this policy will be subject to disciplinary action.

The specifics of this policy are:

Transfer, sale, manufacture or use of a controlled substance, illegal use of substances and/or alcohol to minors by an ARS customer can be grounds for disciplinary action.

Use of prescription drugs other than prescribed by a licensed health care professional is not permitted, and abuse of prescribed drugs other than the prescribed amount.

Abuse of other substances, such as abuse of inhalants and steroids is not permitted.

The use of alcohol is not permitted on state premises or during the delivery of services away from state premises.

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 test, alcohol test or reasonable-suspicion testing.

* ARS customers refusing to submit to testing may be subject to disciplinary action.

* ARS customers with alcohol breath test confirmation of breath alcohol content .08 percent or more will be subject to disciplinary 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 (5) days after a conviction related to substance use, where the violation occurred on the statewide agency premises or while in a program being funded by ARS. A conviction means a pleading or finding of guilt (including a plea of nolo contendere) or a sentence 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 or 12-Step Recovery Program. ARS may, with agreement between the customer and counselor, provide assistance with such a program.

* ARS customers entering a training/internship/apprenticeship or employment related program, requiring drug or alcohol screening as part of the process that do not pass the screening are subject to disciplinary action.

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

SCREENINGS

ARS designated staff will be required to assure these tests are performed by a certified laboratory and reviewed by an official health professional for interpretation. ARS will provide payment for the required testing procedures under the arrangement of the counselor. For students at Arkansas Career Training Institute (ACTI), samples will be collected by the ACTI Hospital Laboratory during working hours or by a certified laboratory after hours and the testing will be completed by a non-agency laboratory.

TYPES OF TESTS

* Drug Test(s) includes urine and/or blood specimen*

* Alcohol Test(s) includes breath analysis, urine and/or blood specimen*

* Confirmation Test

* Reasonable - suspicion testing

*Specimens will be collected in conformance with Hospital Licensing Regulations.

DISCIPLINARY ACTION

An ARS customer who violates this policy may be disciplined in one or more of the following ways:

* 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 USC § 705 Sec. 102 (c) (7) 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 policy regarding the Substance Free Policy. (This has been provided in the appropriate format.) I understand that unlawful manufacturing, distributing, dispensing, possession of, or the use of a controlled substance, illegal use of substances while on any statewide agency premises or actively participating in an ARS program is prohibited. I understand a violation of this policy will subject me to disciplinary action.

The policy has been explained to me clearly, I understand my responsibilities, and I agree to abide by the terms of this policy. 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 and illegal use of drugs as described by the Rehabilitation Act as amended:

(A) Drug --The term "drug" means a controlled substance, as defined in Schedules I through V of section 202 of the Controlled Substances Act (21 U.S.C. 812).

(B) Illegal use of drugs --The term "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. (29 USC § 705 Sec. 6. (10))

Right and advocacy provisions as described by the Rehabilitation Act as amended:

In general exclusion of individuals engaging in drug use. - For purposes of title V of this chapter, the term individual with disability does not include an individual who is currently engaging in the illegal use of drugs, when a covered entity acts on the basis of such use. Exception for individuals no longer engaging in drug use.

Nothing in clause:

(I) shall be construed to exclude as an individual with a disability, an individual whom has successfully completed a supervised drug rehabilitation program and is no longer engaging in the illegal use of drugs, or has otherwise been rehabilitated successfully and is no longer engaging in such use;

(II) is participating in a supervised rehabilitation program and is no longer engaging in such use; or

(III) is erroneously regarded as engaging in such use, but is not engaging in such use; except that it shall not be a violation of this Act for a covered entity to adopt or administer reasonable policies or procedures, including but not limited to drug testing, designed to ensure that an individual described in sub clause (I) or (II) is no longer engaging in the illegal use of drugs.

EXCLUSION FOR CERTAIN SERVICES

Notwithstanding clause (I), for purposes of programs and activities providing health services and services provided under titles I, II, and III, an individual shall not be excluded from the benefits of such programs or activities on the basis of his or her current illegal use of drugs if he or she is otherwise entitled to such services.

Disciplinary action. For purposes of programs and activities providing educational services, local educational agencies may take disciplinary action pertaining to the use or possession of illegal drugs or alcohol against any student who is an individual with a disability and who currently is engaging in the illegal use of drugs or in the use of alcohol to the same extent that such disciplinary action is taken against students who are not individuals with disabilities Furthermore, the due process procedures at section 104.36 of title 34, Code of Federal Regulations (or any corresponding similar regulation or ruling) shall not apply to such disciplinary actions.

Employment; exclusion of alcoholics. For purposes of sections 503 and 504 as such sections relate to employment, the term individual with a disability does not include any individual who is an alcoholic whose current use of prevents such individual from the duties of the job in question or whose employment, by reason of such current alcohol abuse, would constitute a direct threat to property or the safety of others. (29 USC § 705 Sec. 6 (20) (C))

Drug Test means any chemical, biological or physical instrument analysis administered by a laboratory authorized to do so pursuant to this policy 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 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)

Confirmation Test- In drug testing, a second analytical procedure to identify the presence of a specific drug or metabolite. This test is independent of the previous screening test and uses a different technique and chemical principle from that of the screening test in order to ensure reliability and accuracy.

Gas chromatography/mass spectrometry (GC/MS) is the only authorized confirmation method for cocaine, marijuana, opiates, amphetamines, and phencyclidine.) In alcohol testing, a second test, following a screening test with a result of 0.02 or greater that provides quantitative data of alcohol concentration. (49 C.F.R. 40 Part 40.3)

Prescribed medication means medication prescribed by licensed health care professional.

Reasonable-suspicion testing means drugs, alcohol or other substance testing. This testing is based on 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.

Other Designated Staff refers to ARS staff approved by the Commissioner, who is responsible to assure a Substance Free ARS environment. These staff will be responsible for maintaining control and accountability from the initial collection of information to the final disposition of the situation. Also, accountable for each stage of handling, testing and storing specimens and reporting test result.

Other Substances means inhalants and steroids.

Inhalants means a product that

1. may be a legal, commonly available product; and

2. has a useful purpose but can be abused, such as spray paint, glue, gasoline, correction fluid, furniture polish, a felt tip marker, pressurized whipped cream, an air freshener, butane, or cooking spray.

Legal Steroids, which may be misused, are:

Anabolic steroid is the familiar name for synthetic substances related to the male sex hormones (androgens). They promote the growth of skeletal muscle (anabolic effects) and the development of male sexual characteristics (androgenic effects), and also have some other effects.

Steroid Supplements, such as dehydroepian-drosterone (DHEA) and androstenedione (street name Andro) can be purchased legally without a prescription through many commercial sources including health food stores. They are often referred to as dietary supplements, although they are not food products.

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 District 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 District 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 District 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 District Manager):

The District 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 District Manager will send a copy to the Chief of Field Services.

District Manager Signature _________________________ Date _____________

APPENDIX H

ARKANSAS TRANSITION PROJECT

TRANSITION SERVICES

The term transition services (as outlined in IDEA) means a coordinated set of activities for a student, designed within an outcome-oriented process, that promotes movement from school to post-school activities, including post-secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation. The coordinated set of activities shall be based upon the individual student's needs, taking into account the student's preferences and interest, and shall include instruction, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation. 34 CFR § 361.22(a)(2) provides that, if the student is determined eligible for Vocational Rehabilitation (VR) services, the student's IPE should be developed as early as possible during the transition process but no later than when the student exits the school setting.

MEMORANDUM OF UNDERSTANDING

A formal Memorandum of Understanding (MOU) is entered into by interested high schools and ATP prior to services being rendered. MOUs are reviewed annually and updated/revised as needed.

PURPOSE

Arkansas Transition Project (ATP) was established to address an identified gap in VR services for high school youth/young adults with disabilities. Transition Counselors assist youth/young adults who receive 504 accommodations or receive IEP services and are 10th grade or at least 16 years of age transitioning from high school to the career field of their choice. The intent is to connect the activities of high school students, higher education, and rehabilitation services to provide a continuum of year round supports which meet the needs of eligible youth/young adults with disabilities.

The integrated 8 continuum of services will:

A. Assure that eligible youth/young adults as defined by the Individuals with Disabilities Education Act (IDEA), the Rehabilitation Act of 1973 as amended, and the Americans with Disabilities Act, have a clear, direct, and primary voice in their individualized planning processes;

B. Assure that eligible youth/young adults receive appropriate and necessary supports to help achieve long-range goals;

C. Coordinate services to eligible youth/young adults to maximize their post-school outcomes and provide for a successful transition to appropriate work-based learning, internships, employment, independent living, and postsecondary education or training;

D. Formalize referral procedures with appropriate agency (ies) to ensure eligible youth/young adults are provided opportunities for year round services;

E. Ensure joint appropriate planning for each youth/young adult eligible for Arkansas Rehabilitation Services (ARS).

F. Ensure coordination of service delivery and follow-up/follow-along with education/employment/social/rehabilitation/habilitation/independent living services continuum as identified in IEPs and IPEs.

G. Ensure joint training between cooperating agencies for staff development and other activities.

FUNCTIONS AND RESPONSIBILITIES

As outlined in the MOU ATP/High School agree to cooperate in providing appropriate transition services to youth/young adults with identified disabilities, in order to assure the youth/young adult's entry into suitable employment, postsecondary education or training, and independent living. It is mutually agreed that the following steps and procedures will be utilized to accomplish this goal:

A. At the beginning of each academic year, Transition Counselor will meet with appropriate school personnel (i.e., counselors, department heads, principals, transition coordinators) to provide an overview of the comprehensive transition services available through this agreement, including eligibility requirements and services offered.

B. Following the meeting between Transition Counselor and the participating high school, special education teachers will identify youth/young adults, beginning no later than grade 10 or age 16, with identified disabilities for likely referral to the ATP or other service providers if appropriate. If the youth/young adult and/or parent/guardian are interested, communication will take place to determine the general appropriateness of each referral, leading to obtaining a completed release of information form from the school (or other sponsor agency) prior to the referral. Periodic updates will be provided for school personnel and others that have a stake in the youth/young adult's life.

C. Transition Counselor will provide consultative services in the areas of vocational and career planning, postsecondary education/training support strategies, internship possibilities, and employment preparation to school personnel, as requested, to facilitate preparing youth/young adult for transition to "adult service agencies". Consultation may occur at any time during the youth/young adult's secondary training, as appropriate to the needs of the individual youth/young adult.

D. Transition Counselor agrees to commit to attend and participate in all appropriate IEP, Transition Team, and Advisory Board meetings.

REFERRAL AND ASSESSMENT SERVICES

Youth/young adults generally will be referred by school staff in the service area. Youth/young adults must meet eligibility requirements. Parent/guardian must sign consents for inclusion in the program if the youth/young adult is under 18. The school will submit any additional information that is pertinent and useful in assisting the ATP

Transition Counselor to determine eligibility and assist the youth/young adult and the counselor in identifying, selecting and pursuing appropriate career objectives.

Referral Procedures:

Initial referrals will be made within the first two months of each school year. Referrals will then be ongoing as appropriate throughout the school year. The high school will provide an individual list of high school youth/young adults who may qualify for ATP services to the designated ATP staff. This list will include youth/young adult's name, grade, age, ID number, school, disability, and recommended supports or accommodations and will be accompanied by a release of information form signed by youth/young adult and parent/guardian if referral is under 18. Each person on the list will be encouraged to make contact with ATP to explore services, rather than waiting for ATP personnel to contact them.

ELIGIBILITY

At age 14 or before, ATP will provide informational services and brochures regarding ATP services to any youth/young adult, parent or guardian, special education teacher or other school official who requests or as time allows outreach.

Youth/young adults must:

* Be 10th grade or 16 years of age or older

* Have a Section 504 plan which addresses transition service needs or have a current IEP which includes a transition plan

* Have a disability which constitutes a substantial barrier to employment.

Appropriate Releases of Information are required prior to individual services being rendered.

ROLES AND RESPONSIBILITIES OF THE TRANSITION COUNSELOR

1. Support empowerment and the exercise of informed choice by the youth/young adult with a disability.

* Convey a high expectation of youth/young adults with disabilities.

* Inform youth/young adult about the array of available community options.

* Assist youth/young adults in understanding information and options throughout the decision-making process.

* Connect youth/young adults with peer mentors.

* Advocate for youth/young adults' rights.

2. Build partnerships

* Provide leadership in the transition community to build a shared vision.

* Assist in the leadership of Local Transition Coordinating Councils (LTCCs) to develop solutions and strategies.

* Link to consumer groups and peer support. Develop mentoring opportunities.

* Partner with community rehabilitation providers, training facilities, and institutions of higher education.

* Involve employers in transition planning activities.

3. Provide technical assistance and consultation services (to groups of youth/young adults, parents, educators, and/or other transition partners). Topics may include:

* Career exploration;

* Job readiness training;

* Soft skill development;

* Self-advocacy skills;

* Information about VR legislation, programs, available services, and comparable benefits;

* Career fairs;

* Transition planning; and

* Disability awareness.

4. Transition Planning

* Establish and maintain a process for receiving referrals of youth/young adults who receive special education and Section 504 services.

* Develop comprehensive assessment.

* Determine eligibility for Transition Services.

* Engage in the on-going development of the Individualized Education Program (IEP).

* Provide vocational counseling and guidance.

* Provide and coordinate VR and other services.

* Coordinate comparable benefits.

* Develop accommodation strategies for employment.

* Provide assistive technology programs and services for employment.

* Provide placement services.

Before Graduation:

The Transition Counselor will receive referrals from the special education teacher no later than October of the senior year. All referrals will be accepted using the Arkansas Transition Referral Form 410. In addition to the referral form, the teacher will submit copies of school records, psychological evaluations and the Informed Consent signed by the parent or guardian (if the referral is under the age of 18). The school will submit any additional information that is pertinent and useful in assisting the counselor to determine eligibility and assist the student and the counselor in identifying, selecting and pursuing appropriate career objectives.

The Transition Counselor will complete an application at the earliest date possible upon receipt of the transition referral form and supporting documents. The Transition counselor must determine eligibility for services and ensure the development and approval of the Individualized Plan for Employment (IPE) by the time the student leaves the school setting. (34 CFR § 361.22 and 361.45) If the Transition-counselor is unable to complete the vocational assessment to determine eligibility within 60 days of application, (due to missed appointments) the counselor must notify the special education teacher or other official as soon as possible to enable the special education teacher to resume the IEP planning process.

The Transition Counselor will follow established procedures for referral, application, eligibility determination and IPE development consistent with informed choice.

APPENDIX I.

FEES

ARS MEDICAL FEES

ARS Fee Schedule referenced in Section VI. Services is the annual Blue Cross/Blue Medical Coding (CPT) Fee Schedule to determine the agencies cost for Physical/Mental Restoration or related services. This Fee Schedule can be located on the ARS network. ARS counselor are first to determine if Comparable Benefits are available.

34 § 361.5 (b)(10) Comparable services and benefits means-(i) Services and benefits that are-

(A) Provided or paid for, in whole or in part, by other Federal, State, or local public agencies, by health insurance, or by employee benefits;

(B) Available to the individual at the time needed to ensure the progress of the individual toward achieving the employment outcome in the individual's individualized plan for employment in accordance with § 361.53; and

(C) Commensurate to the services that the individual would otherwise receive from the designated State vocational rehabilitation agency. (ii) For the purposes of this definition, comparable benefits do not include awards and scholarships based on merit. . (Authority: Sections 12(c) and 101(a)(8) of the Act; 29 U.S.C. 709(c) and 721(a)(8))

SUPPORTED EMPLOYMENT MILESTONE FEES

Supported Employment Milestone (SE-1)

Referral/Job Development - $1000

Supported Employment Milestone (SE-2)

Job Match/Placement - $3000

Supported Employment Milestone (SE-3)

Job Stabilization - $1000

Supported Employment Milestone (SE-4)

Closure - $ 3000

COMMUNITY REHABILITATION PROGRAM PER DIEM FEES

Assessment Services (10 days) - $45 per day

Work Adjustment Services (60 days) - $45 per day

Extended Services Days (75% of $32) - $24 per day

SSBG 26 Closure - $1000

JOB SERVICES-VR ONLY PER DIEM FEES

Job Referral - VR Only - $250

Job Placement - VR Only - $500

Job Closure - VR only (90-Days) - $1000

Arkansas Career Training Institute Fees

Training/Evaluation Area

Hours

Weeks

Months

Training Costs/Hour

Room and Meals/Month

Comprehensive

Client Services/Month

Student Issue

Tuition Fees

Total

Auto Collision Repair

2400

80

18.48

$25

$1,100

$1,100

$547

$60,000

$101,203

Auto Maintenance Tech

720

24

5.54

$25

$1,100

$1,100

  

$18,000

$30,188

Business Ed. Account Clerk

720

24

5.54

$25

$1,100

$1,100

$332

$18,000

$30,520

Business Ed. Med. Office Tech.

1080

36

8.31

$25

$1,100

$1,100

$256

$27,000

$45,538

Business Ed. Office Assistant

1080

36

8.31

$25

$1,100

$1,100

$268

$27,000

$45,550

Business Ed. Billing and Coding

480

16

3.7

$25

$1,100

$1,100

  

$12,000

$20,140

Business Ed. Computer Applications

480

16

3.7

$25

$1,100

$1,100

$186

$12,000

$20,326

Business Ed. QuickBooks

360

12

2.77

$25

$1,100

$1,100

$166

$9,000

$15,260

Certified Nursing Assistant

450

20

4.62

$25

$1,100

$1,100

$143

$11,250

$21,557

Construction Technology

1680

56

14

$25

$1,100

$1,100

$155

$42,000

$72,955

Cosmetology

1500

50

11.55

$25

$1,100

$1,100

$161

$37,500

$63,071

Cosmetology Instructor

600

20

4.62

$25

$1,100

$1,100

$357

$15,000

$25,521

Cosmetology Nail Tech

600

20

4.62

$25

$1,100

$1,100

$427

$15,000

$25,591

Food Service Cafeteria

570

19

4.39

$25

$1,100

$1,100

$150

$14,250

$24,058

Food Service Baking

460

15

3.46

$25

$1,100

$1,100

$310

$11,500

$19,422

Food Service Cooking

615

21

4.85

$25

$1,100

$1,100

  

$15,375

$26,045

Food Service Salad Making

150

5

1.15

$25

$1,100

$1,100

  

$3,750

$6,280

Welding

1680

46

14

$25

$1,100

$1,100

  

$42,000

$72,800

Printing and Bindery

960

32

7.39

$25

$1,100

$1,100

$90

$24,000

$40,348

Printing /Offset Press

1440

48

11.09

$25

$1,100

$1,100

$90

$36,000

$60,488

Printing/Graphic Communication

1440

48

11.09

$25

$1,100

$1,100

$70

$36,000

$60,468

Printing/Screen Printing

600

20

4.62

$25

$1,100

$1,100

$90

$15,000

$25,254

Sales and Marketing

720

24

5.54

$25

$1,100

$1,100

$75

$18,000

$30,263

Outdoor Power Equipment Tech.

1200

40

9.24

$25

$1,100

$1,100

$752

$30,000

$51,080

Career Readiness Certificate

120

4

1

$25

$1,100

$1,100

  

$3,000

$5,200

10-Day Vocational Assessment

60

2

0.5

$25

$1,100

$1,100

  

$1,500

$2,600

OSHA Training

40

1

0.25

$25

$1,100

$1,100

  

$1,000

$1,550

Vocational Evaluation

120

4

1

$25

$1,100

$1,100

  

$3,000

$5,200

Driver's Education

33

4

1

$40

$1,100

$1,100

  

$1,320

$3,520

Vocational Prep

120

4

1

$25

$1,100

$1,100

  

$3,000

$5,200

Job Club

30

1

0.25

$25

$1,100

$1,100

  

$750

$1,300

Non-traditional Programs (monthly fees)

N/A

N/A

1

N/A

$1,100

$1,100

        

Note: Comprehensive Client Services include the following: Vocational Rehabilitation Counseling, Non-Acute Medical Care, Physical Therapy, Occupational Therapy, Speech Therapy, Psychological Services, Dental Care, Social Services, Pharmacy and Recreational Activities.

APPENDIX J

AGENCY DIRECTIVES

Order of Selection

Under the Vocational Rehabilitation Act (Title IV of the Workforce Investment Act of 1998) certain state Vocational Rehabilitation agencies are required to have an order of selection. An order of selection requires that a priority be given to individuals with the most significant disabilities in the provision of vocational rehabilitation services. The order of selection is required in the event that the state is unable to provide the full range of vocational rehabilitation services to all eligible individuals or, in the event that vocational rehabilitation services cannot be provided to all eligible individuals in the State who apply for the services.

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. The notification of change of Order of Selection to ARS staff is placed permanently in Appendix J for reference. (P&PM, Section III Pages 6-9.)

Note:(OOS effective 8/01/91) History: Non-Significant cases were served from 6/11/03-6/30/03 & 2/26/04-9/30/04 and 05/04/05 -12/19/05. Order of Selection suspended effective 10/01/2011.

(12/19/2013)

The following state regulations pages link to this page.