Chapter 5: Services

5.1 Assistive Technology Evaluations

(Revised 07/14)

5.1.1 Job Function

Assistive technology evaluations are conducted to determine the most effective assistive technology to meet the consumer's vocational or scholastic needs.

5.1.2 Qualifications

(Revised 04/09)

Education, Training, and Experience

(Revised 4/07)

Assistive technology evaluators must

Proficiency Tests

(Revised 03/12)

Assistive technology evaluators must pass proficiency tests administered by the Assistive Technology Unit (ATU) in Austin before they can be approved to evaluate a DBS consumer's ability to benefit from the purchase of assistive equipment in achieving a vocational or scholastic goal.

Phase I testing may be completed at the DBS ATU in Austin or online at the discretion of the DBS ATU staff. Phase II testing is completed at the DBS ATU in Austin.

Phase II testing can be scheduled two weeks after successful completion of Phase I.

Service providers are responsible for all travel costs related to Phase I and Phase II testing including transportation, food, and lodging. Costs will not be reimbursed.

Periodic performance checks are also conducted by the Employment Assistance Services (EAS) specialist or his or her designee.

In-Service Training Requirement for Service Providers

Contract service providers are encouraged to budget funds for each evaluator to attend a yearly conference or workshop relating to assistive technology. At a minimum, each evaluator must attend a technology vendor demonstration or Train the Trainer Workshop in Austin offered by DBS.

Provider Authorization

Services must not be provided to DBS consumers until DBS has issued written authorization and a purchase order (PO). No service by a provider's employee will be paid for if the service is provided before written authorization is given. For additional information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets of this manual.

Product Authorization

Each assistive technology evaluator must pass a product-specific proficiency test before evaluating DBS consumers on that specific product. DBS maintains a list of approved assistive technology evaluators and the products they are authorized to evaluate consumers on. To maintain DBS approval, the evaluator must obtain new models, upgrades, or versions of the equipment and software that he or she has been authorized for within 45 days of notice that the new product is available.

Staff-to-Consumer Ratio

Assistive technology evaluations must be conducted one-on-one with one staff member for each consumer.

On-Site Visits

DBS has the right to conduct initial and periodic on-site visits to verify that each contract service provider (or potential provider) meets DBS minimum requirements for assistive technology evaluators or that the provider has evaluators on staff who meet DBS minimum requirements.

On-site visits may include

5.1.3 Service Delivery

(Revised 04/09, 08/10, 03/12 12/12)

Scope of Services

Assistive technology evaluations determine the most effective assistive technology for the consumer's vocational or scholastic needs. Assistive technology evaluations give DBS consumers access to

When not conducted by DBS, assistive technology evaluations must be conducted at the provider’s facility.

Referral

DBS requires the consumer's DBS counselor or case manager to

The provider shares the responsibility of securing an EAS report or referral forms and PO before scheduling an assistive technology evaluation for a DBS consumer. Note: A PO must be obtained before any services are provided to DBS consumers.

An assistive technology evaluator may request a consumer’s

EAS Consultation Reports must be less than one year old. Typing tests are conducted if the consumer is being evaluated for computer-based assistive technologies.

Referral Requirement—Exception

The only exception to the requirement for an EAS Consultation Report applies to consumers who require evaluation for a stand-alone and/or portable video magnifier. A video magnifier uses a video camera's zoom lens to project magnified text and images to a monitor or screen. Stand-alone, portable, luggable, and hand-held video magnifiers do not connect to a computer system.

Minimum Assessment Requirements

DBS requires most consumers to have

These minimum assessment requirements are evaluated on a case-by-case basis. For example, these requirements may be waived for consumers who have secondary disabilities that limit the use of one or both hands and for consumers who have sustained a traumatic brain injury. The evaluator should discuss these circumstances with the consumer's counselor or case manager as appropriate.

Initial Assessment for Assistive Technology

If initial assessments indicate that the consumer does not meet the minimum requirements for typing or braille reading, the evaluator may substitute a demonstration for the evaluation. The evaluator should

Evaluation Period for Assistive Technology

The initial interview should generally require between 30 minutes and one hour. Other segments of the evaluation process generally require two and three hours to complete. However, the length of time required to complete an assistive technology evaluation is based on the consumer's individual circumstances. Therefore, there are no set requirements as to the amount of time each evaluation will require.

Conducting the Evaluation

The evaluator must

Evaluation Components

Assistive technology evaluations include three components.

  1. A private interview is conducted with the consumer to discuss the individual's background and to review information developed by DBS staff, including the consultation report, if applicable, provided by the EAS specialist.
  2. The consumer's ability (or potential ability) to use assistive technology equipment and to benefit from the contract service provider's recommendations is assessed and observed.
  3. A closing interview is conducted to summarize the results of the evaluation process and is documented in the evaluation report.

Interview Process—Overview

Interviews are conducted in a confidential manner. The purpose of the interview is to

Some consumers may experience anxiety related to the evaluation and the use of computers or assistive technology. Therefore, it is important for the evaluator to set a comfortable and relaxed atmosphere.

The evaluator may find it helpful to explain to the consumer exactly what will be done during the evaluation. It should be stressed that the evaluation process is not an evaluation of the consumer, but an opportunity for the consumer to evaluate the equipment.

The evaluator should refrain from saying "I will be teaching you" and instead emphasize that the consumer and evaluator will be working together during the evaluation process. The evaluator should stress to the consumer that he or she should be as specific as possible regarding which piece of equipment works best and why.

For additional information about the interview process, assistive technology evaluators are encouraged to contact the ATU at atu@dars.state.tx.us or (512) 377-0310.

Interview Process—All Evaluations

During the interview process for all evaluations, the evaluator should

Interview Process—CCTV Evaluations

The evaluator should address the following questions during closed circuit television (CCTV) evaluation interviews:

Interview Process—Scanner Evaluations

During scanner evaluation interviews, the evaluator should determine

Interview Process—Computer Applications

The following areas should be addressed during evaluation interviews for screen magnification devices, refreshable braille PC screen access devices, and screen review systems:

Post-Evaluation Discussion

When the interview and product evaluation(s) have been completed, the assistive technology evaluator should

The contract service provider also must remind the consumer that the evaluation process is for the sole purpose of making recommendations and that the decision to purchase (or not to purchase) assistive technology equipment can only be made by the consumer's counselor.

Documenting Assistive Technology Evaluations

Evaluation reports must be submitted in the standard format required by DBS using a DARS2867, Assistive Technology Evaluation Report. Confidentiality issues must be adhered to at all times.

Information gathered during the interview and evaluation process does not need to be included in the evaluation report unless it is different from the information noted in the referral packet and/or the EAS consultation report.

Submitting Evaluation Reports

Evaluation reports must be completed within seven working days from the date of the evaluation and may be submitted by email to

The evaluation report, DARS2867, identifies consumers using only (a) the consumer's first name and last initial and (b) the DBS caseload number. The consumer's Social Security number (SSN) must not be used when contract evaluation reports are submitted by email.

Consumer Statistics Worksheet

The DBS consumer statistics worksheet (available by request) summarizes the services provided to individual consumers. Contract service providers must complete the worksheet on a quarterly basis by the following deadlines:

5.1.4 Product Inventory

(Revised 04/09, 08/10, 03/12, 12/12, 02/14)

On-Site Visits

DBS may conduct initial and periodic on-site visits to verify that each facility-based contract service provider (or potential provider) meets the following requirements:

Approved Products

DBS consumers are evaluated only on products and equipment included on the DBS-approved product list. To obtain a list of approved products, vendors can call (512) 424-4558.

Questions about the approved product lists may be addressed to the ATU at atu@dars.state.tx.us or (512) 377-0310.

Product categories on the approved product lists include

Before completing an evaluation on any product that is not included on the DBS list of approved products, the assistive technology evaluator must get approval from the ATU at atu@dars.state.tx.us. The request should be made in writing.

Vendors must submit an up-to-date inventory list within 30 calendar days of each contract award.

Minimum Inventory Requirements

Service providers must conduct assistive technology evaluations using at least two competing products. There may be times when there is only one of a "type" of product available, especially when a product is new to the market. In these circumstances, providers are required to obtain written approval from the regional program support specialist. They can contact Consumer Procurement and Client Services Contracting (CPCSC) at (512) 424-4702 to begin the approval process.

Video Magnifier Products

All products used in evaluations must be on the DBS-approved product list. Stand-alone video magnifiers must be available in

Provider must have two competing products from each of the following video magnifier categories:

Computer-Based Assistive Technology

The provider must have at least two computer-based assistive technology programs in each of the categories listed below, as defined in the provider's contract and from the most current DBS-approved products list. The products in the following categories must be compatible with the most current version of Microsoft Windows or the agency standard operating system for DBS-issued computer systems for consumers:

Special Technologies

The provider must have a product from the approved products list for

The provider must also have a Mac computer with the current Mac operating system and the newest version of MS Office installed.

Synthesizers—External

A minimum of two external synthesizers from the most recently updated DBS list of approved products is required.

Synthesizers—Internal

No internal synthesizers are required. Since software synthesizers are included as an integral component of the screen review software package with which the synthesizer will be used, there is no requirement to maintain internal synthesizers separately.

5.1.5 Performance Measures

(Revised 04/09, 01/12)

DBS considers the following questions in measuring provider performance:

5.2 Assistive Technology Training

(Revised 04/09, 01/11, 07/14)

In addition to the standards outlined below, contractors that provide assistive technology training services must also comply with requirements outlined in the Assistive Technology Trainer Guidelines and Procedures.

5.2.1 Job Function

(Revised 10/09)

Assistive technology training is provided to prepare a consumer to use assistive technology effectively in employment and postsecondary educational settings. Training may be provided at a facility, on-site at a consumer's home or workplace, in a DARS office, or in a community resource center. Group training can be provided by facility-based trainers or on-site trainers.

5.2.2 Qualifications

(Revised 12/08)

Education, Training, and Experience

Assistive technology trainers must

Proficiency Tests

Assistive technology trainers must pass proficiency tests administered by DBS before providing services to DBS consumers.

Assistive technology trainers must pass periodic proficiency tests administered and conducted by DBS, as well as periodic performance monitoring conducted by the EAS specialist, regional program support specialist (RPSS) or designated representative.

In-Service Training

Contract service providers are encouraged to budget funds for each evaluator to attend a yearly conference or workshop relating to assistive technology. At a minimum, each evaluator must attend a technology vendor demonstration or Train the Trainer Workshop in Austin offered by DBS.

Provider Authorization

Services must not by provided to DBS consumers until DBS has issued written authorization and a PO.

No service by a provider's employee will be paid for if the service is provided before DBS written authorization is given.

For additional information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

Product Authorization

Assistive technology trainers must meet DBS testing and approval requirements on specific products before providing services to DBS consumers.

DBS proficiency tests are product-specific (separate tests are required for each product). Assistive technology trainers must pass the required tests for each product in order to provide training on each specific product.

DBS maintains a list of approved assistive technology trainers and authorized products for each trainer.

Performance

Assistive technology trainers must provide training only on the specific products for which they have met DBS testing and approval requirements.

DBS approval is granted for individual trainers only. DBS approval applies to the individual and not the position held by the individual.

Staff-to-Consumer Ratio

(Revised 01/11)

For the purpose of conducting assistive technology training, the staff-to-consumer ratio for group training may not exceed one staff member to three consumers (1:3).

On-Site Visits

DBS may conduct initial and periodic on-site visits to verify that each contract service provider (or potential provider) meets DBS minimum requirements for assistive technology trainers or that the provider has trainers on staff who meet DBS minimum requirements.

5.2.3 Service Delivery

(Revised 08/10)

Scope of Services

Assistive technology trainers provide the following services:

Required Curriculum

Assistive technology trainers must use the DBS-established training curriculum. The required curriculum is detailed in the DBS Assistive Technology Trainer Guidelines and Procedures Manual.

Predefined Curriculum Modules

(Revised 04/12)

Assistive technology trainers must receive predefined curriculum modules for various levels of program skills and/or specific skills. Each module will include appropriate time frames. The required modules are detailed in the DBS Assistive Technology Trainer Guidelines and Procedures Manual, but reasonable flexibility to vary the training curriculum will be authorized in order to accommodate the specific needs of individual consumers.

Baseline Assessment

(Revised 01/11, 04/12)

The assistive technology trainer or EAS specialist administers a basic-skills test to each consumer who is referred for assistive technology training. The baseline assessment is used to determine the level of training each consumer requires. The assistive technology trainer requests a copy of the baseline assessment before beginning services. If the baseline assessment has not been completed by the EAS specialist or designated staff member, the assistive technology trainer may complete the baseline assessment and document the results on a DARS2902, Assistive Technology Training: Baseline Assessments. The baseline assessment is included as a separate line item in the PO.

Post-Training Assessment

(Revised 04/12, 02/14)

Post-training assessments are used to determine training effectiveness and assess whether the consumer requires additional training. The post-training assessment is conducted by the EAS specialist, vocational rehabilitation counselor (VRC), or assistive technology trainer once training is complete. On average, each assessment takes two to four hours. The EAS specialist, VRC, or designee may observe the post-training assessment. The post-training assessment is documented on form DARS2902 and is listed as a separate line item on the PO. The initial baseline can be used to document if the training met the consumer’s training needs and objectives, if the training was effective, and to justify additional training hours. If training services were job- or task-specific, assistive technology trainers must list objectives on the training report and whether the objectives were met. Assistive technology trainers may consult with the EAS specialist or VRC if other objectives are needed that are not listed in the DBS Assistive Technology Trainer Guidelines and Procedures Manual.

Authorization for Additional Training

(Revised 04/12, 12/12)

If the post-training assessment indicates the need for additional training that exceeds the maximum number of hours for that module in the assistive technology trainer guidelines, the consumer's counselor or case manager may approve up to 10 additional hours of training.

If additional training is still required, the local DBS regional director may approve up to 10 hours of training in addition to the 10 hours previously approved by the consumer's counselor or case manager.

Training beyond the above limits, if any, must be approved through the supervisory chain of management to the appropriate director of field services, after consultation with the ATU and/or technical support specialists.

Changes to Configuration Files

(Revised 04/12)

At the end of the last training session, the trainer must provide the consumer with electronic media containing copies of any changes or additions to the consumer's batch, keyboard, script, set, or other configuration files. Trainers must also document changes to configuration files in the technology training report.

Consumer Equipment Problems

(Revised 01/11, 04/12)

If a problem is discovered with a consumer's equipment or hardware, the trainer must contact the consumer's counselor or case manager and/or the EAS specialist who conducted the consumer's consultation report before leaving the consumer’s home. The trainer documents all equipment problems and resulting contacts with DBS staff members in the final training report.

Service Limitations

(Revised 01/11)

Assistive technology trainers must not

Assistive technology trainers must document compliance with the above requirements in the narrative portion of the final training report.

Interim Training Reports

(Revised 01/11, 04/12)

If consumer training continues beyond one 30-calendar-day period, the trainer must submit an interim training report for each 30-calendar-day period within 10 working days of the close of each 30-calendar-day period.

Training reports for DBS consumers are submitted to the consumers’ counselors.

Final Training Reports

(Revised 01/11, 04/12)

Final training reports must be submitted within 10 working days from the date training is completed. For more information, see Chapter 3: Rates, 3.5.2 Submitting Service Reports.

Final training reports for DBS consumers are submitted to

Documenting Assistive Technology Training

(Revised 01/11, 04/12)

All training reports must be submitted in the standard format required by DBS using a DARS2868, Assistive Technology Training Report. Confidentiality issues must be adhered to at all times.

Information gathered during the training process does not need to be included in the interim or final report unless it is different from the information noted in the referral packet.

Submitting Training Reports

(Revised 04/12)

Email is the preferred method for submitting assistive technology training reports.

Training reports submitted by email should identify consumers using only (a) the consumer's first name and last initial and (b) the DBS caseload number. The consumer's SSN should never be used when training reports are submitted by email.

Training reports submitted in writing should identify consumers by first name, last initial, and caseload number.

Never use the consumer’s full name in the DARS2868, Assistive Technology Training Report.

The DARS2868, Assistive Technology Training Report is used only for documenting training services and information related to the consumer and must not be used to market services to DBS staff members. Forms and reports submitted to DBS are public records. DBS does not provide marketing services for any service provider.

5.2.4 Performance Measures

(Revised 05/09, 01/12, 04/12)

DBS considers the following questions in measuring provider performance:

5.3 Independent Living Services (Individualized Skills Training Only)

(Revised 04/09)

5.3.1 Job Function

Independent living (IL) services are designed to accommodate for the consumer's vision loss in daily living activities.

5.3.2 Qualifications

Education, Training, and Experience

(Revised 4/07)

All independent living trainers must

Provider Authorization

Services must not begin until DBS has issued a purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service will be paid if the service is provided before DBS written authorization is received.

For additional information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes of this manual and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

5.3.3 Service Delivery

(Revised 12/12, 02/13, 11/13)

Scope of Services

Independent living skills vendors provide the following services in the consumer's residence or local community. The independent living skills vendor may provide one or more of the following services as authorized by the DBS IL worker (ILW):

Note: Information and referral (I&R) services help the consumer identify and use alternative resources, such as Meals on Wheels, the Texas State Library, and the How To Guide, to meet his or her individual needs. These services can be provided at any point in the independent living process.

Designation of Independent Living Worker

The ILW, who is designated by the DBS field director, provides case coordination, direction to the IL skills vendor on service provision, as well as the following services:

Case Management

The case manager is responsible for:

IL Skills Vendor Responsibilities

The IL skills vendor

Initial Contact

The IL skills vendor must make the initial contact with a DBS consumer who is referred for independent living skills training within 15 working days of the referral.

Initial Contact and Application Assessment

All initial contacts and application assessments must be conducted individually and documented using the following forms:

Comprehensive Assessment

The IL skills vendor must contact a DBS consumer who is referred for a comprehensive assessment within 30 calendar days of the referral.

The vendor must document the comprehensive assessment on the DARS2954, Comprehensive Assessment for IL Services. The recommendations section of the form must contain a summary of IL skills training and services that the vendor has identified for inclusion on the Independent Living Plan (ILP).

Independent Living Skills Training

After the ILW has developed the ILP, the IL skills vendor provides monthly training services as authorized by the ILW. The services are documented monthly using the DARS2891, Independent Living Services Progress Report. The monthly report must

5.3.4 Performance Measures

(Revised 12/12)

DBS considers the following questions in measuring vendor performance:

5.4 Vocational Evaluations

5.4.1 Job Function

The vocational evaluation process is designed to determine the consumer's present and future vocational potential including evaluating the consumer's employment-related strengths and limitations.

5.4.2 Qualifications

Education, Training, and Experience

Vocational evaluators must have one of the following

Certification Requirements

Each person who administers vocational tests, batteries, and/or related instruments that require certification must be certified by the appropriate entity. Examples of these tests or batteries include the Comprehensive Vocational Evaluation System (CVES), the McCarron Dial System (MDS), psychological tests, etc.

Provider Authorization

Services must not begin until DBS has issued a purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Documenting Staff Changes in section 1.6.4 of this manual and Staff Information Sheets in section 4.2 of this manual.

Performance

Vocational evaluations must be performed by a vocational evaluator who meets the criteria described in this manual or a psychologist who is licensed and certified in the state of Texas.

Staff-to-Consumer Ratio

For the purpose of conducting vocational evaluations, the staff-to-consumer ratio must not exceed one staff member to three consumers (1:3). If the number of DBS consumers receiving vocational evaluation services at the same time is more than three but less than seven—in other words, a maximum of six consumers—a competent aide (technician) under the supervision of the vocational evaluator may be used to ensure the staff-to-consumer ratio does not exceed one to three (1:3).

5.4.3 Service Delivery

Scope of Services

Vocational evaluators provide the following services:

Referral Form

Prior to each vocational evaluation, DBS will provide the vocational evaluator with a Referral for Vocational Evaluation form (or equivalent). The referral form will:

Developing the Consumer's Case History

Information about the consumer's case history shall be gathered through a review of available records and consumer self-reports and a summary of this information included in the vocational evaluation report. The consumer's case history should encompass:

Information To Be Assessed

The evaluation process must address the consumer's employment assets and liabilities, potential for training, and overall work adjustment.

In the majority of instances at least two different techniques should be utilized to provide a more thorough evaluation. Vocational evaluators have the discretionary authority to determine which techniques should be used—in each case, however, the governing factor in selecting the most appropriate techniques must be the individual needs of the consumer.

The following areas shall be assessed.

  1. Cognitive abilities
    • learning ability including attention, concentration, comprehension, memory/ retention, creativity, and conceptualization;
    • communication skills and interaction with others;
    • ability to follow oral or written instructions;
    • work organization and planning; and
    • spatial concepts.
  2. Academic achievements (grade level) in reading, writing, spelling and mathematics.
  3. Physical abilities
    • fine motor abilities including bimanual dexterity, speed, coordination, and strength;
    • gross motor abilities including strength, balance, and coordination; and
    • stamina/physical tolerances and endurance.
  4. Sensory abilities (identify preferred learning style: visual, auditory, or tactile)
    • use of residual vision,
    • auditory processing and sound localization, and
    • tactile perception.
  5. Aptitudes and vocational interests/exploration
    • specific equipment and technical skills and
    • preferred vocational interests compared to abilities.
  6. Behavioral observations and work habits
    • general behaviors and work related behaviors;
    • self-image (pertaining to self and work);
    • appearance (grooming, hygiene, appropriate clothing for the work setting, etc.);
    • motivation and attitude toward work;
    • attendance and punctuality;
    • orientation to the work setting and travel within the work setting;
    • work stability (including attention to work despite environmental distractions);
    • work quality;
    • work productivity;
    • acceptance of supervision (accepting and responding to suggestions and corrections);
    • responsibility for materials and work;
    • adherence to workplace standards (employee policies, rules, schedules, etc.);
    • safety standards (understanding and adhering to safety standards);
    • impulse control (predictable behavior, adequate self-control, etc.);
    • stress tolerance;
    • flexibility;
    • persistence (following through on the work task to completion);
    • initiative (working independently);
    • job seeking skills; and
    • the consumer's potential to benefit from vocational rehabilitation services.

Test Instruments

All test instruments must be appropriate for use with the DBS target population including appropriate norms, adaptations, and accommodations.

Prior to the initiation of each contract, the vocational evaluator must provide DBS with a written list that:

The emphasis of the vocational evaluation is based on the outcome. Because the scope of each evaluation is governed by the consumer's individual need(s), there are no fixed guidelines regarding the number of days or hours per day required to complete an evaluation. Generally, an evaluation would be expected to take three to five days to gather all of the work characteristics outlined above.

The techniques used to establish and measure consumer work characteristics can generally be categorized as follows.

Standardized Tests

Standardized tests include tests that measure the consumer's academic achievement, cognitive abilities, aptitude, personality, vocational interests, sensory/motor skills, and independent living skills and compare the individual's performance with the performance of an appropriate sample population.

Psychological Tests

Psychological tests include any battery of tests or psychometric instruments that are administered and interpreted by a licensed psychologist or psychological associate to assess intelligence, aptitude, academic achievement, interests, personality, and level of adjustment.

Work Samples

Work samples provide a close simulation of an actual industrial task, business operation, or component of an occupational area.

Situational Assessments

A situational assessment is done at multiple work sites within a usual business or industry setting in the community. These community-based assessments provide an opportunity for the consumer to explore their ability to perform a variety of job tasks and help the consumer make informed choices about the type of work environment and job tasks they prefer. The evaluator's observations and the consumer's experiences are then used to determine the kind of job and needed supports that most closely match the consumer's preferences.

Vocational Evaluation Reports

(Revised 4/07)

Vocational evaluation reports must be submitted in the standard format required by DBS using a DARS2869, Vocational Evaluation Report.

Vocational evaluation reports are due within 15 working days after the evaluation is completed.

Each report must summarize

  1. the cumulative findings of the vocational evaluation; and
  2. the evaluator's outcome-oriented recommendations relating to the consumer's
    • vocational potential,
    • vocational rehabilitation needs, and
    • objective.

The direct service provider (i.e., vocational evaluator or psychologist) must sign the evaluation report.

The provider is not required to submit the DARS2869 if the provider performs a psychological evaluation in conjunction with the vocational evaluation. Reporting for this combination must be submitted using the traditional psychological evaluation format.

Cumulative Findings

The evaluator's written report must include:

  1. consumer demographic information,
  2. the reason for referral,
  3. background information (including visual impairment; other medical conditions; psychological, academic and work history; and social/emotional information),
  4. a complete list of all tests administered,
  5. interpretations of all test results (including a summary of strengths and limitations),
  6. the consumer's vocational interests,
  7. behavioral observations, and
  8. the evaluator's recommendations.

Outcome-Oriented Recommendations

Each report must include the evaluator's recommendations and must address the following.

  1. A response to each specific referral question.
  2. The consumer's optimal level of employment potential and job readiness.
  3. Specific occupations for the consumer to consider/explore.
  4. Job-related accommodations or adaptations, if needed.
  5. Any additional training or education needed for employment.
  6. Any additional evaluation needs such as medical or psychological evaluations, rehabilitation technology evaluations, etc.
  7. Consideration for supported employment services, if appropriate.
  8. Independent living needs, accommodations, and/or adaptations.
  9. Other vocational rehabilitation needs.

Pre-Staffing, Interim Staffing, and Post-Staffing

After the vocational evaluation has been completed, a post-staffing is required for each consumer receiving services. The meeting must include the evaluator, the consumer (and/or their representative if applicable), and the consumer's counselor or case manager.

If needed, pre-staffings and interim staffings may be held.

All staffings must be documented and placed in the consumer's file.

5.4.4 Performance Measures

(Revised 01/12)

DBS considers the following questions in measuring provider performance:

5.5 Vocational Adjustment

5.5.1 Job Function

Vocational adjustment training provides formal classroom training designed to increase a consumer's interpersonal skills relating to basic traits and attitudes. The focus of vocational adjustment training is work-related skills and successful employment.

5.5.2 Qualifications

Education, Training, and Experience

(Revised 04/09)

Vocational adjustment trainers must have one of the following:

Provider Authorization

Services must not begin until DBS has issued a purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Documenting Staff Changes in section 1.6.4 of this manual and Staff Information Sheets in section 4.2 of this manual.

Performance

Reasonable flexibility to vary vocational adjustment services will be authorized in order to accommodate the specific needs of individual consumers.

Staff-to-Consumer Ratio

For the purpose of conducting vocational adjustment training, the staff-to-consumer ratio must not exceed one staff member to six consumers (1:6). In a group setting (a maximum of ten consumers per group), a competent aide under the supervision of the vocational adjustment trainer may be used if the number of DBS consumers receiving vocational adjustment training at the same time is more than six but not more than ten consumers.

5.5.3 Service Delivery

Scope of Services

Vocational adjustment training may be provided one-on-one or in a group setting, as determined by the trainer. Training is provided in a formal classroom environment and includes job-related skills such as:

Outcome—Social Skills

The consumer will demonstrate appropriate social behavior in selected settings on a routine basis.

Outcome—Daily Living Skills

The consumer will demonstrate the daily living skills (food preparation, homemaking, etc.) necessary to function independently.

Outcome—Effective Communication Skills

The consumer will demonstrate clear and open communication in multiple settings including authority figures, co-workers, and peers. Skill areas will include appropriate phone etiquette, face-to-face communication, and cooperative communication with an interactive group.

Outcome—Grooming and Hygiene

The consumer will demonstrate appropriate personal grooming and hygiene for a work environment.

Outcome—Problem Solving

The consumer will demonstrate appropriate solutions to pre-identified work-related barriers.

Outcome—Goal Setting

The consumer will demonstrate an understanding of realistic goals and objectives.

Outcome—Time Management

The consumer will demonstrate effective time scheduling including but not limited to: understanding the importance of punctuality, following attendance guidelines, meeting deadlines, and scheduling appointments appropriately.

Outcome—Financial Management

The consumer will demonstrate an understanding of basic budgeting, banking services, and the responsible use of credit.

Outcome—Disability Awareness

The consumer will demonstrate proficiency in explaining their disability and offering solutions to disability-related problems.

Outcome—Self-Concept

The consumer will demonstrate a clear understanding of their personal assets, skills, and abilities.

Outcome—Self-Motivation

The consumer will demonstrate a clear understanding of the concept, influence, and benefits of self-motivation.

Outcome—Work Traits and Work Ethics

The consumer will demonstrate appropriate work-related behaviors including acceptable attendance and tardiness records during vocational adjustment training, developing and maintaining productive interpersonal relationships with both co-workers and supervisors, recognition of "quality" work, and the ability to compete appropriately for work assignments, supervisory recognition, promotions, etc.

Outcome—Conflict Resolution

The consumer will demonstrate the ability to cope with and resolve work-related problems or conflicts in an appropriate manner.

Vocational Adjustment Training Reports

Vocational adjustment training reports must be submitted in the standard format required by DBS using a DARS2870, Vocational Adjustment Progress Report form.

Vocational adjustment training reports are due within 35 calendar days from the date training is completed.

5.5.4 Performance Measures

(Revised 01/12)

DBS considers the following questions in measuring provider performance:

5.6 Work Adjustment

5.6.1 Job Function

Work adjustment trainers provide formal hands-on training for DBS consumers within the context of "real" work (training on work-related behaviors is provided in a work setting where the work performed by the consumer produces compensation for both the community rehabilitation program facility and the consumer).

5.6.2 Qualifications

Education, Training, and Experience

(Revised 04/09)

Work adjustment trainers must have one of the following:

Provider Authorization

Services must not begin until DBS has issued a purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Documenting Staff Changes in section 1.6.4 of this manual and Staff Information Sheets in section 4.2 of this manual.

Performance

Reasonable flexibility to vary work adjustment services will be authorized in order to accommodate the specific needs of individual consumers.

Staff-to-Consumer Ratio

For the purpose of conducting work adjustment training, the staff-to-consumer ratio must not exceed one staff member to six consumers (1:6). A competent aide under the supervision of the work adjustment trainer may be used if the number of DBS consumers receiving work adjustment training at the same time is more than six but not more than ten consumers.

5.6.3 Service Delivery

Scope of Services

Work adjustment services are designed to assist consumers in the following areas.

  1. Address the consumer's work behaviors.
  2. Motivate the consumer to:
    • perform productive work,
    • be self-reliant,
    • accept supervision, and
    • interact appropriately with co-workers.
  3. Help the consumer develop:
    • work tolerance,
    • good work practices (including safety and speed), and
    • job-readiness skills based on community standards.

Work adjustment services may also include training in other job-related skills such as:

Documenting Work Adjustment Training

DARS2955, Consumer Services Report: Work Adjustment Progress Report for individual consumers must be signed by the work adjustment trainer who conducted the training and submitted to the consumer's counselor or case manager upon completion of training.

5.6.4 Performance Measures

(Revised 01/12)

DBS considers the following questions in measuring provider performance:

5.7 Job Readiness Training

5.7.1 Job Function

Job readiness trainers provide complex, interrelated services designed primarily to help prepare individual consumers for job searches.

5.7.2 Qualifications

Education, Training, and Experience

Job readiness trainers must have:

Provider Authorization

Services must not begin until DBS has issued a purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Documenting Staff Changes in section 1.6.4 of this manual and Staff Information Sheets in section 4.2 of this manual.

5.7.3 Service Delivery

Scope of Services

Job readiness services may include:

Job Readiness Training Period

The extent of services required for individual consumers to complete job readiness training is based on each consumer's specific needs. It is anticipated that most DBS consumers will complete job readiness training in 20 hours or less.

Personal/Socialization Skills Training

Purpose—Personal/socialization skills services reinforce the proper socialization skills needed in the workplace.

Outcome—The consumer will understand the importance of:

Résumé Development

Purpose—Résumé development services are designed to assist the consumer in developing and completing an effective résumé.

Outcome—The consumer will understand the importance of and how to develop a résumé, vita, cover letter, and/or portfolio. The consumer will demonstrate the ability to:

Note: A copy of the consumer's completed résumé, vita, cover letter, and/or portfolio must be submitted to the consumer's counselor at the post-staffing.

Job Application Training

Purpose—Job application services are provided to assist and/or train the consumer in the skills needed to accurately complete a job application.

Outcome—The consumer will demonstrate the ability to:

Note: No less than three applications must be completed. A copy of each completed application must be submitted to the consumer's counselor at the post-staffing.

Job Seeking Skills Training

Purpose—Job seeking skills services are designed to assist the consumer in developing the skills needed to conduct an effective job search.

Outcome—The consumer will demonstrate the ability to:

Note: A copy of the consumer's resource list must be submitted to the consumer's counselor at the post-staffing.

Interviewing Skills Training

Purpose—Interviewing skills services reinforce essential skills and/or instruct the consumer in new skills necessary to help the consumer complete a successful interview.

Outcome—The consumer will demonstrate the skills needed to conduct a successful interview including the ability to:

Note: At the post-staffing, the trainer must provide the consumer's counselor or case manager with a written evaluation (critique) of three video/audio taped mock interviews and documentation of face-to-face discussions with the consumer regarding each of the three interviews. Discussion of each interview should include areas such as appearance, attentiveness, confidence, motivation, and communication skills. The trainer should make a video/audio copy of the three mock interviews available to the consumer upon request. The tapes may be destroyed after the consumer has been successfully placed in employment or upon counselor authorization.

Job Retention Skills Training

Purpose—Job retention skills help the consumer develop the skills and techniques necessary to maintain successful employment.

Outcome—The consumer will demonstrate the skills needed to maintain successful employment including the ability to:

Initial and Interim Staffings

An initial staffing must be completed before services may be initiated.

The consumer (and/or their representative if applicable), the consumer's counselor or case manager, and the provider will conduct an initial staffing before training is initiated to ensure a complete understanding of the consumer's vocational goal.

During the initial staffing, a DARS2877, Initial Staffing Recommendations, form will be completed to detail the job readiness training needed by the individual consumer. The form shall be signed by the consumer, the consumer's counselor or case manager, and the provider.

If needed, interim staffings may be held.

All initial and interim staffings must be documented using a DARS2877 form and placed in the consumer's file.

Authorization for Training

Based on the results of the initial staffing, the consumer's counselor or case manager may approve from one to 20 hours of job readiness training.

Authorization for Additional Training

If the consumer requires more than 20 hours of training, an interim staffing must be completed to determine the consumer's progress and to document the status of their job readiness training.

If it is determined that additional training is appropriate, the consumer's counselor or case manager may request approval for up to ten additional hours of training through the regional director.

All requests for additional training must be approved by the regional director. Training beyond the first 25 hours, if any, must be approved through the supervisory chain of management to the DBS director of field services.

Post-Staffing

After job readiness training has been completed, a post-staffing is required for each consumer receiving services. The meeting must include the consumer (and/or their representative if applicable), the consumer's counselor or case manager, and the provider.

At the time of the post-staffing,

The post-staffing process determines:

  1. Is the consumer job ready?
  2. What is the anticipated number of hours the consumer will work per week?
  3. Will the provider accept the referral of the consumer for job placement services?

If the provider accepts the job placement referral, a DARS2876, Job Placement Referral Acceptance, form must be completed and signed before the post-staffing process is concluded (for additional information, please see 5.8 Job Placement in this manual).

All staffings must be documented and placed in the consumer's file.

Documenting Services

Completion of job readiness training services requires the following documentation:

5.7.4 Performance Measures

(Revised 01/12)

DBS considers the following questions in measuring provider performance:

5.8 Job Placement

(Revised 04/09)

5.8.1 Job Function

Job placement service providers assist consumers with employment-related services necessary for the consumer to secure and maintain acceptable employment.

5.8.2 Qualifications

Education, Training, and Experience

Job placement service providers must have:

Provider Authorization

Services must not begin until DBS has issued a purchase order.

A purchase order must be completed at placement for the first payment and the second payment. Then, when all progress reports and payments are due, DBS will adjust dollar amounts as needed based on the check stub at the final billing.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service provided by a provider's employee will be paid if the service is provided before DBS written authorization is received.

For more information, see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes of this manual and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

5.8.3 Service Delivery

(Revised 01/10)

Scope of Services

Job placement services include, but are not limited to, the following.

  1. Account building, employer contacts, and job analysis.
  2. Matching individual DBS consumers with appropriate employment opportunities.
  3. Job placement services for individual consumers including pre-employment orientation, support of newly-hired consumers for at least 90 days of employment, and; follow-up with the consumer and/or employer as appropriate.

Acceptable Employment

Acceptable employment is a position in an integrated employment setting at or above current minimum wage. Integrated employment is defined in federal regulations as:

"a setting typically found in the community in which applicants or eligible individuals interact with non-disabled individuals other than non-disabled individuals who are providing services to those applicants or eligible individuals."

Acceptable Job Placement

Acceptable job placement means acceptable employment of a DBS consumer in a meaningful job commensurate with the individual consumer's stated vocational goals in an integrated employment setting at a wage equal to or above current minimum wage for at least 90 days.

Acceptable job placement is limited to job placement in an integrated setting within an organization or business that is not owned, operated, controlled, or otherwise governed by the contract service provider.

Outcome—Job Placement

Job placement services are completed when the consumer:

Referral Process

An initial staffing must be completed before job placement services may be initiated. The purpose of the initial staffing is to allow the consumer, the counselor, and the job placement provider an opportunity to meet and discuss the consumer's employment goals including:

All initial staffings must be documented using a DARS2876, Job Placement Referral Acceptance, form (see immediately below) and placed in the consumer's file.

Referral Acceptance

Following completion of the initial staffing, the job placement provider shall complete a DARS2876, Job Placement Referral Acceptance form.

The DARS2876 form documents the job placement provider's acceptance (or non-acceptance) of the referral for job placement services.

The DARS2876 form must be signed by both the counselor and the job placement provider.

Notification of Job Placement

The job placement provider is required to notify the consumer's counselor or case manager when the consumer is scheduled for an employment interview.

The job placement provider is required to submit a DARS2873, Initial Placement Report, form to the consumer's counselor or case manager when the consumer accepts a job offer.

Follow-Up Reports

On the 30th and 60th day of employment, the job placement provider must submit a written report to the consumer's counselor or case manager.

All post-employment follow up reports must be submitted in the standard format required by DBS using a DARS2875, Post-Employment Follow Up Report form.

The written report must include a brief narrative of the consumer's performance including:

The narrative should include any actions taken to resolve problems/issues and expected outcomes as a result of the actions. These actions may include but are not limited to:

Documenting Job Placement

After the consumer has been successfully employed for at least 90 calendar days, the job placement provider is required to submit a fully completed and signed DARS2872, Job Placement Final Billing, form to the consumer's counselor or case manager verifying that the consumer has been employed for at least 90 days in a job that is consistent with the consumer's vocational goal.

The job placement provider's signature on the DARS2872 form is the provider's verification of the following minimum employment conditions:

Note: A copy of the consumer's most recent paycheck or check stub must be attached to the provider's DARS2872, Job Placement Final Billing form. If the job placement provider is unable to obtain a copy of the consumer's most recent paycheck or check stub, a fee estimated to be the equivalent of one-week salary will be paid if the consumer's counselor or case manager documents verification of employment in the consumer's case file.

Verification of Employment

Upon receipt of the job placement provider's written statements, DBS will verify completion of job placement services by

Social Security Administration/Vocational Rehabilitation (SSA/VR) Employment Network

For providers who are also employment networks as defined by the Social Security Administration, see 5.13 SSA/VR Ticket to Work Partnership Plus—EN Employment Advancement Payments.

5.8.4 Performance Measures

(Revised 01/12)

DBS considers the following questions in measuring provider performance:

5.9 Diabetes Self-Management Education Services

(Revised 4/07, 04/09, 03/12)

5.9.1 Job Function

The purposes of diabetes self-management education services are to

The comprehensive program covers a full range of issues from nutrition to stress management. A diabetes educator instructs and counsels the consumer and family through individual and group training.

5.9.2 Qualifications

(Revised 01/10, 03/12)

Education, Training, and Experience

A diabetes educator is a health professional, licensed or registered, as required by his or her profession, who has completed basic academic requirements for his or her field. Through academic preparation, continuing education, or on-the-job training, the diabetes educator or provider will have developed

Diabetes self-management education services for DBS consumers are provided by a registered nurse (RN), registered dietician (RD), or certified diabetes educator (CDE). For RNs and RDs, a copy of the provider's current license must be on file. For a CDE, a copy of the provider's current certification from the National Certification Board for Diabetes Education (NCBDE) or the American Association of Diabetes Educators (AADE) must be on file.

The diabetes educator or provider (CDE, RN, or RD) must have at least one year of paid experience working with people who have diabetes and must have experience working in group settings. RNs and RDs must have completed 15 hours of CEUs on diabetes from an accredited agency within the last 12 months. A CDE must have completed ten CEUs on diabetes from an accredited agency within the last 12 months. The CEUs must be from an agency approved by the provider’s licensing or certifying body.

The provider must send a copy documenting the CEUs to the diabetes field specialist (DFS), who maintains a copy in the DFS file and forwards a copy to the RPSS.

Technical Skills Requirement

(Revised 03/12)

The diabetes educator or instructor must have

A skills test and an interview with the diabetes field specialist may be conducted during the initial contracting process to gather information about a potential provider’s diabetes and behavioral change expertise.

Required Training

(Revised 03/12)

Before providing services to DBS consumers, the diabetes educator or provider must attend a Texas Confidence Builders training session conducted by the DBS diabetes field specialist or an approved minitraining session and the next available Texas Confidence Builders training. Veteran diabetes educators must attend Texas Confidence Builders training at least every two years.

The Texas Conference Builder training is a 14-hour training led by the diabetes field specialist, which includes a two-hour blindfold experience. The diabetes educator or provider is expected to attend the entire training. Exceptions must be approved by the DFS in writing before the training begins.

At the discretion of the DBS diabetes field specialist, diabetes self-management education service providers may also be required to attend additional periodic training seminars.

If travel is necessary in order to attend required training, the service provider is responsible for all travel costs including transportation, food, and lodging.

Provider Authorization

(Revised 03/12)

Services must not begin until DBS has issued a purchase order. It is the provider’s responsibility to check the accuracy of the PO before scheduling the visit. If the provider is unable to schedule the visit within a few weeks, the provider should notify the consumer’s VRC or ILW.

Providers must have written authorization from DBS before the provider or provider's employee provides services to DBS consumers. No service will be paid if the service is provided before DBS written authorization is received.

For additional information, please see Chapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes of this manual and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

Group Training

(Revised 03/12)

Diabetes service providers are encouraged to coordinate group training (two or more consumers at a time). Group trainings are cost efficient and should be used when they will benefit the instruction process and better meet the needs of the consumer. Approval must be obtained from the referring case manager before training begins. The initial assessment and posttraining assessment should be done individually so that health information and concerns may be addressed privately.

Diabetes education providers are reimbursed only for time spent teaching consumers about diabetes and not for travel time, planning time, office interaction time, or time spent completing and submitting the required paperwork.

Blood Glucose Meter

(Revised 03/12)

For the purpose of evaluating and training DBS consumers, diabetes self-management education service providers may use the nontalking and talking blood glucose meter currently recommended by DBS. If another talking meter is recommended, the diabetes field specialist must approve it before training.

If the talking blood glucose meter recommended by DBS is changed, the provider has 90 days following DBS notification of change to obtain a new talking blood glucose meter.

5.9.3 Service Delivery

Scope of Services

(Revised 03/12)

Up to 15 hours can be approved for individual and group diabetes self-management education. Additional hours must be approved by the field director and discussed with the DFS.

Self-management of diabetes is an important component of a treatment plan. The management plan should be customized for each consumer considering age, schedule, physical activity, eating patterns, cultural factors, personality, and any presence of complications of diabetes or other medical conditions (ADA, 2003e).

Diabetes self-management education services include

Individual diabetes self-management training should be broken into reasonable segments (ideally two-hour blocks) to control travel costs and ensure that the consumer maintains the physical and intellectual stamina to benefit from the training.

Note: Services may take more or less than the recommended amount of time (for instance, an assessment may take more than two hours). But the provider must document any exceptions to the recommended amount of time and include the documentation in the report before DBS will consider payment.

Required documentation must be submitted within 35 days of the training. Providers are strongly encouraged to call or email the consumer’s VRC or ILW immediately when situations arise that affect the consumer’s health or ability to participate in training.

Assessment

The initial assessment for each DBS consumer must include

Documentation of Assessment

(Revised 03/12)

The service provider's assessment for each DBS consumer is documented using

If a talking blood pressure monitor is recommended, the service provider must provide the consumer a DARS2305, Certificate of Medical Necessity: Physician Order for Blood Pressure Monitor. The consumer is responsible for completing the form, including obtaining the physician’s signature, and returning it to his or her VRC or ILW.

For consumers who have third-party payors, the diabetes educator and referring staff member work together to identify local resources to get equipment and supplies for the consumer using his or her benefits (see Similar Benefit Reimbursement below for additional information).

The VRC or ILW is responsible for approving the purchase of the recommended equipment or supplies.

Diabetes Self-Management Education Program Content

(Revised 03/12)

Diabetes self-management skills training can be provided to a consumer in a group consisting of two or more DBS consumers, or to a consumer in a combination of one-on-one and group meetings not to exceed 15 hours. Individual self-management skills training may be authorized if group training cannot be scheduled in a timely manner.

The initial assessment and subsequent teaching are usually done in the consumer's home. However, if the training is provided in a group and meets outside the consumer's home, the training and payment are different. Contact DBS for more information.

The number of individual training hours should be based on the assessment and cover topics related to the consumer’s vocational and independent living goals. Training should include behavioral change goals and participation in healthy lifestyle changes.

The service provider ensures that the individualized training plan, instructional methods, and teaching materials are appropriate for each DBS consumer based on the consumer's age, type and duration of diabetes, cultural influences, and learning abilities. A copy of the current DARS diabetes education materials should be provided to the consumer in his or her preferred medium (large print, CD, etc.). Other resources and referrals are documented on the required forms.

The primary goal of diabetes education is to provide knowledge and skills training and help the consumer identify barriers, solve problems, and develop coping skills to achieve effective self-care and behavior change. The assessment and subsequent training should be based on the American Association of Diabetes Educators seven (AADE7) self-care behaviors. The AADE7 self-care behaviors are

Self-management skills training may include the following content areas:

Documenting Diabetes Self-Management Education Services

(Revised 03/12)

Service providers must document each session with each consumer using a DARS2884, Diabetes Self-Management Educator Notes.

If services for the DBS consumer include receipt of equipment, the service provider's responsibilities include

Posttraining Services

(Revised 03/12)

Posttraining (follow-up) services are provided beginning one month (30 days) after diabetes self-management skills training and are reported using

Return demonstrations may be required. The posttraining assessment should review the training that has been provided and reinforce the behavioral changes. If posttraining services are provided before one month (30 days), the provider must secure approval from the DBS referring case manager.

Similar Benefit Reimbursement

(Revised 03/12)

If the consumer meets economic criteria, DBS may help access his or her similar benefit (Medicare) by helping him or her pay the deductible and co-pay amounts. Payment cannot exceed what DBS would have paid under MAPS, and it cannot exceed Medicare's allowed amount. The provider cannot accept any payment or combination of payments that exceeds Medicare's allowed rate. The provider bills either the Standards Manual rate or Medicare, but cannot bill both for the same service.

Some consumers have comparable benefits from Medicare, Medicaid, or private insurance. For those consumers who receive diabetes education from a hospital, clinic, or other community resource, but need adaptive equipment diabetes education, the provider completes DARS2888, Diabetes Self-Management Education Assessment and includes information about the consumer attending the adaptive equipment training. The focus of the education should be on adaptations and using the equipment, and not on other self-care behaviors that will be covered in the community diabetes education program.

If the appropriate equipment is available at the time of this assessment visit, additional time may be necessary since the visit would include teaching the equipment, such as a talking meter or a medication aid like the count-a-dose. A DAR2889, Diabetes Self-Management Education Services - Adaptive Diabetes Equipment Receipt should be completed and submitted if the provider delivers the equipment to the consumer.

If the provider’s visit is to identify what adaptive equipment would most benefit this consumer, the provider makes recommendations to the VRC or ILW, and an additional visit would be needed to instruct the consumer on the adaptive equipment.

Any additional visits between the initial assessment and the posttraining assessment must be approved by the consumer’s VRC or ILW and DARS2884, Diabetes Self-Management Educator Notes is submitted for each approved visit.

A one-hour posttraining assessment visit is provided beginning 30 days after the consumer attends the community-based education and DARS2900, Diabetes Self-Management Education Posttraining Assessment is completed at that visit. The focus of this visit is to find out what the consumer has learned and what barriers his or her blindness imposes in achieving self-care behaviors.

5.9.4 Performance Measures

(Revised 01/12, 03/12)

DBS considers the following questions in measuring provider performance:

5.10 Aides and Drivers

5.10.1 Aides

  1. Aides (such as vocational evaluation aides, work adjustment aides, etc.) must be qualified and must work under the direct supervision of an authorized service provider.
  2. Aides are required to have one year of actual work experience in vocational areas directly related to vocational evaluation, personal-social adjustment, and/or work adjustment. At the discretion of the Department of Assistive and Rehabilitative Services-Division for Blind Services (DBS), post-secondary education in a related field may be substituted for actual work experience.
  3. Aides must be able to follow instructions and establish rapport with DBS consumers.
  4. Aides are not authorized to sign reports.

5.10.2 Drivers

Any person who transports DBS consumers must have a valid Class B or Class C driver's license, appropriate liability insurance, and a good driving record.

5.11 Orientation and Mobility Training

(Revised 04/09)

5.11.1 Job Function of O&M Providers

(Revised 11/10)

Orientation and Mobility (O&M) providers offer complex, interrelated services designed to promote independent travel skills for people who are blind or visually impaired.

O&M training prepares DBS consumers to travel independently with competence and confidence. Orientation is the process of using the available senses to establish one's position and relationship within the environment. Mobility is the ability to travel in the environment with the help of an established tool (including white canes, dog guides, and electronic travel aids).

5.11.2 Qualifications and Requirements of O&M Providers

(Revised 01/10, 11/10, 03/11, 07/11)

Education, Training, and Experience

(Revised 03/12)

The O&M contractor must ensure that each person approved to provide O&M services to DBS consumers under its contract meets one of the following requirements.

  1. The provider is certified by either the Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) or the National Blindness Professional Certification Board (NBPCB).
  2. The provider is not certified at the start of the contract, but he or she
    • has a degree in O&M from an accredited college or university with an established O&M training curriculum and will be certified within one year of the contract date by ACVREP or NBPCB; or
    • has at least two years' full-time work experience teaching O&M skills for an entity DBS recognizes, such as a rehabilitation center, VA hospital, or educational system; and also
      • has three professional references indicating the person's ability to teach O&M skills to blind or visually impaired people, and
      • will be certified within one year of the contract date by ACVREP or NBPCB.

To continue contracting services with DBS, all O&M service providers under the contract must maintain ACVREP or NBPCB certification.

Required Texas Confidence Builders Training

(Revised 4/07, 11/10)

In addition to meeting the education, training, and experience requirements described above, all prospective O&M providers must successfully complete the DBS Texas Confidence Builders Training before becoming providers. Texas Confidence Builders Training is offered quarterly in Austin and is a two- or three-day training program. Each provider is responsible for all costs related to training attendance.

Additional training may be provided by the DBS O&M consultant if necessary or requested by the O&M provider.

Recommended Blindfold Travel Activities

(Revised 11/10)

O&M providers are encouraged to complete a minimum of 20 hours of blindfold travel per fiscal year and submit a detailed statement describing each travel activity completed and the number of hours achieved per activity. This ensures that an O&M provider

Examples of acceptable blindfold travel activities include traveling around a city block, sidewalk travel on an L-shaped sidewalk route, traveling to the grocery store, and exploring a new neighborhood.

DBS recommends that the O&M providers create a report like the sample O&M Provider's Independent Travel Activity Report. Each O&M provider sends a copy of the provider's blindfold travel activity statement to

Internship Requirements

(Added 11/10)

O&M providers using interns to work with DBS consumers must

O&M interns must

Provider Authorization

Providers must not provide services without a purchase order. DBS does not reimburse for costs or pay for services provided before the date on the purchase order.

5.11.3 Service Delivery

(Revised 11/10, 07/11, 02/14)

Scope of Services

O&M services include the following:

Provider Objectivity

The O&M provider must remain impartial and objective.

Referral Information

Before contacting the consumer, the O&M provider receives referral information from the consumer's DBS counselor or case manager. The DBS counselor or case manager should fill out known information on DARS2897, O&M Referral. The O&M Referral form will help the O&M provider prepare and plan before contacting the consumer.

Initial Assessment

Assessments may be conducted using the consumers' functional vision, which is an opportunity for consumers to recognize that their vision may not meet all their travel needs.

The initial assessment includes an evaluation of the consumer's orientation and mobility skills in multiple situations, which may include the following:

Postassessment Discussion

Following the initial assessment, the O&M provider reviews the results with the consumer and answers any questions that he or she may have about the recommended training. A meeting with the consumer, counselor or case manager, and O&M provider is strongly recommended so that all parties can agree on the overall O&M training plan.

Documenting the Initial Assessment

Initial assessment reports must be submitted using a DARS2894, Consumer Services Report: O&M Assessment.

The assessment report includes

Training Authorization

After submitting the DARS2894, Consumer Services Report: O&M Assessment, the O&M provider must contact the consumer's counselor or case manager to discuss the initial assessment and get authorization to provide training services.

The discussion includes the following:

Monthly Progress Reports

After receiving authorization to provide training services, the O&M provider must document each consumer's monthly training progress using a DARS2896, Consumer Services Report: O&M Training.

Monthly progress reports must be submitted within 30 days of the end of each calendar month until the consumer's O&M services are completed or services are no longer recommended by the consumer's counselor or case manager.

Each consumer's monthly progress report must include

Expectations of Training

(Revised 03/11)

All O&M training services for DBS consumers must be conducted using nonvisual (blindfold) techniques and a rigid (nonfolding) cane. Any exceptions must be discussed with the consumer's counselor or case manager before training services are begun, and must be fully documented in the provider's required reports. Approval must be fully documented by the case manager in the case notes.

O&M providers should discuss the benefits of nonvisual training with each consumer. Role modeling and peer support for nonvisual training are encouraged.

With prior authorization from the consumer's counselor or case manager, visual training may be provided after nonvisual training is completed to transfer skills.

Note: The provider must get written authorization (by email or handwritten note) before providing visual training of any kind. DBS does not reimburse visual training without prior written authorization.

Group Training

DBS encourages O&M providers to coordinate group trainings (of up to 3 consumers) when it will benefit the instruction process and better meet the needs of the consumers. However, the O&M provider must get approval from each consumer's counselor or case manager before providing group training.

Travel Aids

The counselor or case manager provides one rigid, long, white cane for each consumer for O&M assessment and training, which the O&M provider might distribute to the consumer.

In addition, O&M providers give cane-purchasing information to each consumer. Consumers are responsible for acquiring all replacement canes, cane tips, back-up canes, etc.

O&M providers may recommend additional travel aids or other items to the consumer's counselor or case manager; but the decision to purchase additional items rests solely with the counselor or case manager.

DBS does not reimburse O&M providers for any items provided to a DBS consumer.

Providing Services

(Revised 11/11)

Orientation and mobility training may not exceed the extent of services (type of training and total number of training hours) authorized by the consumer's counselor or case manager.

An O&M provider cannot have more than 25 DBS consumers in active training at any time, and must keep counselors and case managers informed of the total number of consumers in active training. Any consumer who has been provided services, from assessment through completion, is considered to be in active training. The capacity for 25 consumers in active training was determined to allow for group lessons. Priority for training is determined on a case-by-case basis in consultation with each consumer's counselor or case manager.

O&M providers cannot provide more than eight hours of training on any given day. Lessons should be approximately two hours long. An individual consumer should not receive more than four hours of O&M instruction on any given day, and the eight-hour limit remains even if various consumers are served in one day.

Consistent and frequent scheduling is recommended to maximize consumer learning. For VR consumers one 2-hour lesson a week is the minimum in service and not a best practice.

For IL consumers, the IL worker authorizes two to three hours for the initial assessment. If training is recommended, the IL worker should allow five hours of training per month. If additional training time is needed (because of safety-related concerns, secondary disability, or a specific consumer request), the O&M provider sends a written request to the IL worker including the number of additional hours requested and the reason more hours are needed. If approved, the IL worker allows additional training hours. Requests for additional training should be made as a part of the initial assessment when possible.

Transporting consumers does not count towards training time. O&M providers are not reimbursed for time spent in the car even when a consumer is present.

The O&M provider must notify the consumer's counselor or case manager within 24 hours of any

O&M providers must get written approval from the counselor or case manager before deviating from any of these standards during training (even when based on an individual consumer's needs).

If Services Are Interrupted

If training cannot be completed as planned or if services are postponed indefinitely because of unexpected circumstances, the O&M service provider must notify the consumer's counselor or case manager within 24 hours.

5.11.4 Performance Measures

(Revised 11/10, 01/12)

DBS considers the following questions when measuring an O&M provider's performance:

5.12 Standards for Supported Employment Services

(Revised 10/08, 07/09, 04/11, 12/14)

5.12.1 Supported Employment (SE) Services Overview

Supported Employment (SE) is a "place then train" model, which is a two-part process:

  1. place a consumer with the most significant disabilities in a competitive job, and then
  2. provide training and support directly related to the job.

Unlike the traditional VR model, which provides job readiness and other training activities to prepare a consumer for employment, this model is more appropriate for consumers with the most significant disabilities. Problems transferring knowledge from an artificial training situation to a real job are eliminated, because the focus is on finding the best job match and providing training for that particular job.

For consumers to be eligible for SE services, they must meet the DARS definition of most significant disability as determined by the VRC. Consumers must

Consumers with the most significant disabilities who have any of the following challenges or needs are appropriate for SE services:

SE services enable consumers with the most significant disabilities to enter competitive employment by providing

SE services are for consumers who have been unable to find or maintain employment through traditional VR approaches and training programs.

Consumers in SE need assistance to

Often, these consumers have been

An SE service provider seeks the best possible match between a consumer's skills, interests, abilities, and support needs and the employer's unmet business needs. In many cases, these jobs need to be carved out or created for a good job match to be made. The employment specialist or job skills trainer addresses any barriers to employment the consumer might have and may provide short-term support, while natural supports (such as peers or co-workers) are being arranged to meet the consumer's long-term needs. An employer who hires a consumer in SE should provide training for the consumer just as he or she would for other new employees, with help and support from the DARS counselor and the employment specialist. The SE specialist should ensure that adequate support is provided to the consumer by the job skills trainer on a routine basis. The SE specialist works in coordination with the VRC throughout the SE process to ensure the best possible employment outcome for the consumer.

5.12.2 Supported Employment (SE) Definitions

(Revised 01/10, 12/14)

Benchmarks

Benchmarks are specific employment outcomes for which payments are made to the provider during the course of the SE process. 

These include

Competitive Employment

Competitive employment is work in the competitive labor market

Discovery Process

The discovery process entails collecting information about the consumer through interviews and observations of his or her abilities in multiple settings on multiple occasions. Research indicates that the discovery process may take as many as 20 to 30 hours per consumer (The Job Developer's Handbook, Griffin, Hammis, Geary).

Extended Services and Supports

Extended Services and supports may be needed to maintain the employment outcome after a consumer's VR case has been closed. Extended Services and supports involve either on-or off-site monitoring (as requested by the consumer or legal representative) for as long as needed to ensure the consumer's job stability. These services are provided and funded by sources other than DARS and may include the employer. Both natural supports and paid supports, including Long-Term Supports and Services provided by other state and federal programs, can be used to facilitate Extended Services.

Long-Term Supports and Services (LTSS) are Extended Services and supports available through the Texas Department of Aging and Disability Services (DADS) or Texas Deoartment of State Health Services (DSHS). The counselor should get a copy of the individual service plan from the LTSS case manager or service coordinator. The service "Supported Employment," detailing the provider and the amount of units authorized, should be included on the plan when LTSS are used to provide any of the Extended Services and supports a consumer may need to maintain employment before the counselor closes the case. For assistance in coordinating with DADS, contact the program specialist for benefits and DADS.

Integrated Work Setting

An integrated work setting provides an environment where consumers with disabilities regularly interact with nondisabled employees and/or the general public.

Most Significant Disability

Most Significant Disability is a term used to describe a consumer who

Natural Supports

Natural supports are supports that exist naturally in a workplace and the community. These are supports provided to an employee from supervisors and co-workers, such as mentoring, friendship, socializing at breaks or after work, providing feedback on job performance, or learning a new skill together. Friends, family, or volunteers who support the consumer's success with maintaining employment can also provide natural supports outside of the worksite. Examples of supports provided away from the worksite could include providing transportation, reporting of earned income to the Social Security Administration (SSA), providing feedback on attire and hygiene, or assisting with medication management. When natural support resources are not available, paid supports not funded by DARS can be used to ensure that a consumer maintains long-term employment.

Negotiable Employment Conditions

Negotiable Employment Conditions are preferences for working conditions and the things that a consumer would like the placement provider to consider when looking for suitable employment.

Non-negotiable Employment Conditions

Non-negotiable Employment Conditions are those conditions that a consumer and counselor have indicated must or must not be present in an employment placement. The placement provider must always assure these conditions are met when looking for an employment placement for the consumer.

Examples of non-negotiable conditions include, but are not limited to:

  • The job needs to be on a particular bus route.
  • The consumer must earn a certain dollar amount per hour.
  • The consumer must work at least 15 but no more than 20 hours per week.
  • The job must not require duties the consumer is unwilling to perform.
  • The worksite must allow for an onsite job coach.

Person-Centered Planning

In person-centered planning, the process and the products are owned and controlled by the person (consumer). The process creates a comprehensive portrait of who the person is and what the person wants to do with his or her life. It brings together all the people who are important to the person, including family members, friends, neighbors, support workers, and other professionals. This team identifies the skills and abilities that can help the person achieve his or her goals for competitive employment, independent living, continuing education, and full inclusion in the community. The team also identifies areas in which the person may need assistance and support and decides how it can best meet those needs.

Quality Criteria

Quality Criteria are points of reference used by DARS counselors and VR staff when they review provider documentation and services rendered to determine whether certain conditions and outcomes were achieved by the consumer and/or the provider. Quality Criteria, which must be effectively documented on the appropriate DARS reporting forms, must be met before the DARS counselor may authorize payment to the provider.

Significant Disability

Significant Disability is a term used to describe a consumer who

Social Security Administration/Vocational Rehabilitation (SSA/VR) Employment Network

For providers who are also employment networks as defined by the SSA, see 5.13 SSA/VR Ticket to Work Partnership Plus—EN Employment Advancement Payments.

Supported Employment

Supported Employment (SE) is competitive employment in an integrated work setting, consistent with the consumer's

SE services are appropriate for the consumer with the most significant disabilities who meets all the following criteria:

This definition includes transitional employment for people with the most significant disabilities caused by chronic mental illness.

Transitional Employment for Consumers with Chronic Mental Illness

Transitional employment is a series of temporary job placements in competitive employment in integrated work settings for consumers who need support services on or off the worksite. In transitional employment, the SE services must include continuing job placements until a suitable employment outcome is achieved.

5.12.3 Staff Qualifications

Before services are provided to DARS consumers, the staff person overseeing the provider's SE services (director, program manager, supervisor, etc.) must complete the Provider Orientation and Training, which is provided by the DARS contract manager and the regional program support specialist for DBS. The training focuses on the SE outcome-based standards, forms, contract compliance, and Quality Criteria. After being trained, this person must provide similar training to the staff members who will provide direct services to DARS consumers, as well as document the training in the personnel files.

Employment Specialist

An employment specialist must meet the education and experience qualifications in one of the following three options:

Option 1

Option 2

Option 3

UNT Certification Required of Employment Specialists

(Revised 08/12, 12/14)

In addition to the Provider Orientation and Training described above, employment specialists must have the UNT Certification for SE specialists. Completion of certification must be documented in the contract files.

All employment specialists are encouraged to attend at least one continuing education class per year to increase their skills in placing consumers in the job market.

Job Skills Trainer

A job skills trainer must have

In addition to the Provider Orientation and Training described above, job skills trainers must complete the UNT Certification for job skills trainer. Completion of training must be documented in the contract files. It is a best practice for the job skills trainer to work under the direction of the SE specialist.

5.12.4 Provider Responsibilities

All provider staff members must

DARS staff members are responsible for overseeing services provided to consumers. If the above general standards are not being met, the DARS Community Rehabilitation Provider (CRP) specialist or the DBS regional program support specialist reviews staff concerns and may require that the provider develop an action plan to address them. Continued failure to meet standards could result in adverse action against the provider.

5.12.5 Supported Employment (SE) Process

The following general rules apply to the SE process:

5.12.6 Benchmark 1A: Discovery, Supported Employment Assessment (SEA), the Review Meeting, and Supported Employment Services Plan (SESP) Part 1

Service Description

Benchmark 1A: Discovery, Supported Employment Assessment (SEA), and the Review Meeting

Discovery

If a consumer has an SE goal, discovery is conducted by the employment specialist. While there is no set standard for how much time a provider spends with a consumer during discovery, research suggests that providers should spend as many as 20 to 30 hours on the discovery process to observe the consumer' abilities, challenges, and resources, as well as to collect information from professional and nonprofessional supports in the consumer's life. The process includes exploring options related to wages, employment outcomes, and self-employment outcomes; including interests, capabilities, preferences, ongoing support needs, and Extended Services and supports required at and away from the job site that are necessary for employment success.

Discovery activities include

Supported Employment Assessment (SEA)

The discovery process enables the provider to gather information necessary to answer all the questions on the DARS1612, Career and Community Support Analysis, available until January 31,2015. The report must describe the consumer so that someone reading the report has a "clear picture" of who the consumer is and the consumer's employment goals. DARS recommends that the person-centered planning process be used when collecting information for the SEA.

The SEA must focus on the consumer's

The SEA must be submitted to the DARS counselor at least one week before the SEA review meeting. The DARS counselor reviews the SEA in accordance with the Quality Criteria. If the Quality Criteria are not achieved, the SEA is returned to the provider so the needed information can be added before the SEA review meeting.

SEA Review Meeting

The SEA review meeting is a meeting with the DARS counselor, consumer, and employment specialist following the completion of the discovery process and SEA. This meeting may happen in conjunction with Benchmark 1B. The SEA review meeting includes a discussion of SE, determines what employment outcome, if any, will be pursued, and identifies the type of documentation needed next. SEA information and recommendations are used to develop the DARS1614, Supported Employment Services Plan—Part 2.

Required Documentation

The SEA (DARS1612old, Career and Community Support Analysis available until January 31, 2015, and DARS1612, Supported Employment Assessment) is required documentation and must

See Quality Criteria for the SEA.

Outcome

Benchmark 1A is complete when the following documentation has been completed by the employment specialist and approved by the DARS counselor: DARS1612old, Career and Community Support Analysis,available until January 31, 2015, and DARS1612, Supported Employment Assessment.

Payment

Payment for Benchmark 1A (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves

Benchmark 1B: Supported Employment Services Plan (SESP) Part 1

Supported Employment Services Plan (SESP) Part 1

Benchmark

The SESP Part 1 is completed after the SEA and the SEA review meeting.

SESP Part 1 (DARS1613, Supported Employment Services Plan—Part 1) is a tool that is team-developed and -implemented with the consumer leading or assisted by team members. It identifies interests, preferences, and skills related to setting the long-term placement goal. Both the DARS counselor and SE provider ensure that group discussions include recommendations and strategies outlined in the SEA. The SESP Part 1 meeting typically is one to two hours long and is facilitated by the SE provider. The SESP meetings are planning meetings with the consumer, counselor, and provider and should be held in person to allow all parties to actively participate in the discussion. The provider should not bring a DARS1613 completed to the meeting or complete the DARS1613 after the conclusion of the meeting. The completed DARS1613 should be signed by all parties at the conclusion of the meeting.

The SESP Part 1 identifies

Team Members

Members of the consumer's SESP team must include, at a minimum

The team may include other significant people whom the consumer wants to invite and who may potentially help achieve a successful employment for the consumer or be a long-term support for the consumer. Significant people may include

The team maintains ongoing communication throughout the process to ensure that SE outcomes are achieved.

Team members can help

Preferences and Interests

Preferences and interests are specific types of work or activities in which the person would like to engage, for example,

Preferences and interests can also be stated in negative terms (for example, "no fast food restaurant employment"). Information must be consistent with the SEA. Although the listed preferences and interests are not all required to be present in the final job placement, they should be prioritized during the meeting.

Assets and Abilities

Assets and abilities are the skills and traits the consumer offers a potential employer.

These may include

Information must be consistent with the SEA.

Employment Conditions

Employment conditions are characteristics of any job that are important to the consumer and relevant to his or her support needs.

Conditions include

SESP information must be consistent with information provided in the SEA.

The SESP Part 1 identifies which employment conditions are "negotiable" and "non-negotiable" as identified by the consumer and others. Employment conditions should be written in measureable terms so that each person has a clear understanding of the needs to be addressed. The placement must meet all non-negotiable employment conditions and the majority (50 percent or more) of the negotiable employment conditions listed in the SESP Part l.

Potential Extended Services and Support Needs of the Consumer

Extended Services and supports (sometimes referred to as long-term supports or services) may involve either on-site or off-site monitoring or delivery of services necessary for the consumer to maintain employment after DARS case closure. The Extended Services and supports are provided for as long as the consumer needs them and as long as the consumer or legal representative requests them.

Extended Services and supports identified must be consistent with the SEA and are updated throughout the consumer's employment.

Some examples of extended services and supports include

Frequency of Extended Services and supports can be daily, weekly, monthly, or as identified.

Extended Services and supports are rendered and funded by sources other than DARS. Sources may include Social Security Employment Networks, Social Security Plan for Acheiving Self Support (PASS), property essential to self-support (PESS), or Impairment Related Work Expense (IRWE), Medicaid Waiver, parents, family, friends, churches, and nonprofits.

Possible resources for Extended Services and supports must be identified as part of the SESP Part 1 and updated throughout the process. When all other resources to pay for Extended Services and supports have been exhausted, a provider may offer to provide the supports on a fee-for-service basis. Such supports may be funded through a PASS or IRWE, or may be paid by the consumer or family. The cost of these supports must be disclosed to the consumer, the consumer must agree to that fee as part of the SESP Part 1 process, and the fee must be added to the consumer's IEP. The CRP provider will not attempt to collect any fees from the consumer or his or her family for services provided before DARS case closure.

Targeted Job Tasks

Targeted job tasks identified by the team are tasks the consumer can currently or potentially perform.

Information must be consistent with the

Job tasks are not the same as job titles. Job titles are titles given to a group of duties (for example, administrative assistant), and job tasks describe specific activities (for example, filing, greeting customers, stocking shelves). Vague descriptions such as "kitchen helper" are not acceptable.

Potential Employers

Potential employers are specific employers or industries, in the consumer's preferred or desired geographical boundaries where the identified job tasks might be performed. The list should be prioritized. If a member of the SESP Part 1 team has a potential job lead or contact, that information should be included.

Required Documentation

The DARS1613, Supported Employment Services Plan—Part 1 is required and must include

See Quality Criteria for SESP Part 1.

Outcome

Benchmark 1B is complete when the DARS1613, Supported Employment Services Plan—Part 1 has been completed by the employment specialist, signed by the appropriate parties, and approved by the DARS counselor.

Payment

Payment for Benchmark 1B is made when the DARS counselor receives and approves

5.12.7 Benchmark 2: Job Placement and SESP Part 2

Service Description

Job Placement

Job placement is complete when the consumer has begun work (completed at least one workday) in a job consistent with job matches identified in the SESP Part 1.

The job does not have to be an exact match from the employer list or job task list. However, the job match must meet identified non-negotiable conditions to be considered an acceptable job.

Activities related to obtaining a job placement may include

SESP Part 2

The SESP Part 2 (DARS1614, Supported Employment Support Plan—Part 2) is a written report that acts as a "blueprint" of the placement and short- and long-term training and/or supports needs of the consumer. It includes the following job details:

Required Documentation

The SESP Part 2 (DARS1614, Supported Employment Services Plan—Part 2) is required. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the job duties the consumer will be performing, the work culture, and any short- or long-term employment. The form must include the signatures of the consumer (or legally authorized representative) and the direct SE services provider.

See Quality Criteria for SESP Part 2.

Outcome

Benchmark 2 is complete when the following has been completed by the provider and approved by the DARS counselor:

Payment

Payment for Benchmark 2 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves the

5.12.8 Benchmark 3: Four-Week Job Maintenance

Service Description

Intensive on- and off-job site supports are provided to help the consumer adjust to the demands of the integrated work environment. 

Activities may include

Required Documentation

The DARS1615, Supported Employment Support Summary is required and should be written in positive, clear, descriptive English. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

To be considered complete, the DARS1615, Supported Employment Support Summary must

The form must include signatures of the consumer (or consumer's legally authorized representative) and the direct SE provider.

See Quality Criteria for Four-Week Job Maintenance.

Outcome

Benchmark 3 is complete when the consumer has

If transitional employment for consumers with chronic mental illness is specified in the SESP Part 1, the benchmark is four weeks (28 days) cumulatively of employment, but not necessarily at the same job. Additionally the SE provider responds to any support-need changes identified by the consumer and/or the employer.

Payment

Payment for Benchmark 3 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves

5.12.9 Benchmark 4: Eight-Week Job Maintenance

Service Description

On- and off-job site supports are provided to help the consumer adjust to integrated work environment demands. 

Services may include

Required Documentation

The DARS1615, Supported Employment Support Summary is required and should be written in positive, clear, descriptive English. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

To be considered complete, the DARS1615, Supported Employment Support Summary must

The form must include signatures of the consumer, consumer's representative (if any), and the direct SE provider.

See Quality Criteria for Eight-Week Job Maintenance.

Outcome

Benchmark 4 is complete when the consumer has

If transitional employment is specified in the SESP for a consumer with chronic mental illness, the benchmark is 8 weeks (56 days) of employment, but not necessarily at the same job. Additionally, the SE provider is responsive to any support-need changes identified by the consumer and/or the employer.

Payment

Payment for Benchmark 4 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves

5.12.10 Benchmark 5: Job Stability

Service Definition

The SE provider monitors the supports set up during Benchmark 3 and Benchmark 4 as outlined in the SESP Part 2 to ensure that the consumer is able to maintain successful long-term employment. The employme[nt specialist and/or job skills trainer should have a minimum of two contacts per month with the consumer and/or the employer or person providing natural supports. The employment specialist and/or job skills trainer should not be providing any direct service to the consumer during the 60-day period between job stability and service closure. If at any time, the employment specialist or job skills trainer must provide direct services to the consumer, stability has not been achieved, and the 60-day period starts over.

Note: If the consumer changes jobs between Benchmarks 4 and 5, a minimum of 30 cumulative calendars days of employment in the new job is required before job stability can be established.

Required Documentation

The DARS1616, Job Stability or Service Closure Justification Summary is required. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

To be considered complete, the DARS1616, Job Stability or Service Justification Summary must verify that

The form must be signed by the consumer (or legally authorized representative) and the direct SE provider.

See Quality Criteria for Job Stability.

Outcome

Benchmark 5 is complete when

During the 60-day transition period between job stability and service closure, the DARS counselor may purchase only VR services that

Examples of services that could be purchased include

Payment

Payment for Benchmark 5 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves the

5.12.11 Benchmark 6: Service Closure

Service Description

The SE provider has successfully placed the consumer in a job consistent with jobs and employment conditions identified in the SESP Part 1, and the consumer has worked at least 90 days. Supports have been established as outlined in the SESP Part 2 to ensure successful placement, and monitoring of supports is the only service that the SE provider has performed for at least 60 days.

Required Documentation

The DARS1616, Job Stability or Service Closure Justification Summary is required. Details in the report should describe the consumer so that someone reading the report has a "clear picture" of the consumer's support needs, abilities, and challenges related to the placement.

The DARS1616 must verify that the

The form must include signatures of the consumer (or legally authorized representative) and the direct SE services provider.

See Quality Criteria for Service Closure.

Outcome

Benchmark 6 is complete when

Payment

Payment for Benchmark 6 (see Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves the DARS1616, Job Stability or Service Closure Justification Summary.

5.12.12 Employment Premium Services

(Added 12/14)

Service Overview:

A DARS counselor may purchase an optional Employment Premium Service(s) for a consumer. The consumer must meet the requirements to be eligible for the Employment Premium Service, and the provider must receive a PO that authorizes the Employment Premium Service. An Employment Premium Service payment is paid only once, and it is paid when the consumer achieves the required criteria. For Bundled Services such as Job Placement and SE, all benchmarks must have been completed prior to payment of any invoice for an Employment Premium Service. The form(s) and invoice will be returned to the provider if incomplete. When returned, notification of issues related to the incomplete form(s) and/or invoice will be provided and the provider must resubmit for payment.

Service Descriptions/Scopes:

Criminal Background Premium- For a consumer’s case to be eligible for the Criminal Background Premium, DARS must have a Criminal Background Check (CBC) on file that indicates the consumer has

  • a felony criminal conviction, or
  • a guilty plea with deferred adjudication for a felony criminal offense, or
  • a no contest plea with deferred adjudication for a felony criminal offense.

The employment services provider is eligible for the Criminal Background Premium when the consumer gains employment that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Service Plan—Part 1, including the Criminal Background Premium. The Criminal Background Premium must also be authorized by a PO.

The premium payment is made only once at the conclusion of the achievement of the Wage Employment Service. See fees chart.

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report is submitted confirming the consumer has otherwise achieved the requirements for Basic or Enhanced Job Placement Service Benchmark C or Benchmark 6 in SE services.

Deaf Services Premium- The employment services provider is eligible for the Deaf Services Premium when a consumer communicates using manual sign and the job placement specialist or SE specialist providing services to consumers is proficient with sign language skills. The job placement specialist or SE specialist must prove proficiency in sign language by evidence of either holding a Board of Interpreters for the Deaf (BEI) certification, a Registry of Interpreters for the Deaf (RID) certification, or a Speech Language Pathologist (SLP) rating of intermediate plus. The employment services provider is eligible for the DEAF Service Premium when the consumer gains employment that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Service Plan—Part 1 including the Deaf Services Premium. The Deaf Services Premium must also be authorized by a PO. The premium payment is made only once at the conclusion of the achievement of the Wage Employment Service. See fees chart.

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833 or DARS1613 is submitted confirming the consumer

Livable Wage Premium- The employment services provider is eligible for the Livable Wage Premium when a consumer gains employment in a job that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report or DARS1613 Supported Employment Service Plan—Part 1 and the consumer earns a gross hourly wage of $16 per hour for more than 20 hours per week. The employment services provider is eligible for Livable Wage Premium when indicated on the DARS1833 or DARS 1613 and the Livable Wage Premium is authorized by a PO. Proof of the consumer’s earnings and average hours worked per week must be submitted such as an itemized pay stub with the invoice. The premium payment is made only once at the conclusion of the achievement of the employment service. 

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833 or DARS1613 is submitted confirming the consumer

Professional Placement Premium- The employment services provider is eligible for the Professional Placement Premium when a consumer gains employment in a job that meets all the criteria outlined in the DARS1833, Bundled Job Placement Service Plan and Benchmark Status Report and the position requires the completion of at least a bachelor's degree. This requirement must be stated in the employee's job description or job posting. The Professional Placement Premium must be indicated on the DARS1833 and the Professional Placement Premium must be authorized by a PO. The premium payment is made only once at the conclusion of the achievement of the Wage Employment Service. See fees chart.

Outcomes Required for Payment:
DARS is authorized to pay the provider when an accurate and complete invoice and DARS1833 is submitted confirming that the consumer

5.13 Social Security Administration/Vocational Rehabilitation (SSA/VR) Ticket to Work Partnership Plus—EN Employment Advancement Payments

(Added 01/10)

5.13.1 Overview

Under the Social Security Administration's Ticket to Work Partnership Plus Program, DARS and Employment Networks (ENs), as defined by the Social Security Administration (SSA), partner to provide a seamless system of service delivery that supports a consumer who receives either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) payments in his or her efforts toward achieving and maintaining self-supporting employment. DARS provides vocational rehabilitation services, including Job Placement or Supported Employment, if appropriate, and, after VR case closure, an EN provides ongoing job supports and services to ensure that the consumer maintains and has opportunities to advance in employment.

In order for an EN to partner with DARS under the Ticket to Work Partnership Plus option, the consumer's Ticket cannot be assigned to an EN while VR services are being provided.

DARS offers incentive payments called EN Employment Advancement Payments to DARS community rehabilitation program (CRP) providers under the following circumstances:

Note: DARS EN Employment Advancement Payments are not available to the CRP-EN when the consumer decides to assign the Ticket to an EN other than the CRP-EN. In keeping with informed choice, DARS will provide the consumer with a list of all available ENs at VR case closure.

If a CRP-EN is the holder of the consumer's Ticket assignment, the Ticket must be unassigned from CRP-EN and placed in use with DARS before the CRP-EN can partner with DARS and be eligible for EN Employment Advancement payments.

5.13.2 Definitions

CRP-EN
A provider of job placement and/or supported employment services under contract with DARS in accordance with these standards, and who is also under contract with the Social Security Administration (SSA) as an Employment Network.
EN Employment Advancement Payments
Payments to those DARS CRPs who are also under contract with the SSA as an Employment Network and who partner with DARS in an effort to ensure that VR consumers participating in the SSA's Ticket to Work Program receive job retention services and other types of services that advance employment or increase earnings after the consumer's VR case is closed.
Employment Networks (ENs)
Public or private entities that enter into an agreement with the Social Security Administration to provide employment, vocational, or other support services and help Ticket holders (consumers) obtain and maintain employment.
MAXIMUS
A private organization that contracts with the SSA to help manage the Ticket to Work Program.
Substantial Gainful Activity (SGA)
A level of consumer work activity and earnings defined by the SSA that includes the following concepts:
Substantial Work
Doing significant physical or mental activities, or a combination of both (full- or part-time).
Gainful Work
Work performed for pay or profit.

SGA is increased every January 1. Go to http://www.ssa.gov/OACT/COLA/sga.html to view the current amount.

105 percent of SGA
Amount calculated by identifying the SGA from the link above and then multiplying that amount by 1.05.
Tier Level (1 or 2)
A payment level assigned by a DARS counselor to a consumer receiving job placement or supported employment services and that is used as a basis for determining the amount of an EN Employment Advancement Payment.
Ticket
A paper document that is SSA's agreement to pay an EN the agreed-upon payments under the Ticket to Work Program.

5.13.3 EN Employment Advancement Payments

DARS offers a total of two EN Employment Advancement Payments to CRP-ENs who provide ongoing support services or job retention services that advance employment or increase earnings after a consumer's VR case is closed. Services provided by the CRP-EN must help the consumer meet the following outcomes:

  1. Consumer achieves one month of gross monthly pay that meets or exceeds SGA for the year in which the income was earned. This payment is available only during the first 12 months after VR case closure; and  
  2. Consumer achieves eight of twelve consecutive months of gross monthly pay that meets or exceeds 105 percent of SGA for the year in which the pay was earned. This payment is available only during the first 18 months after the first payment.

EN Employment Advancement Payment 1

Service Description

The CRP-EN provides services necessary for the consumer to retain and advance in employment to the point that the consumer can achieve one month of gross monthly pay that meets or exceeds SGA for the year in which the income was earned. This payment is available only during the first 12 months after VR case closure. For SE only, the CRP must be identified on the DARS1616, Job Stability or Service Closure Justification Summary as one of the primary providers helping the consumer achieve an identified long-term support need outlined in the DARS1616.  

The CRP-EN must notify the VR counselor, in writing, at least 30 days before the CRP-EN anticipates that the consumer will achieve the required income level, so that appropriate purchase orders may be issued.

Required Documentation

The DARS1050, Ticket to Work Partnership Plus, Employment Advancement Payment is required. The form must be signed by the job placement services or supported employment provider. Written documentation (such as a Ticket Assignment confirmation letter from MAXIMUS or SSA Form 1365 completed and signed by the consumer and CRP-EN within 30 days of the invoice) must also be provided as proof that the consumer's Ticket is currently assigned to the CRP-EN.

One of the following must be attached to the DARS1050, Ticket to Work Partnership Plus, Employment Advancement Payment to provide evidence of consumer gross earnings:

Outcome

The first EN Employment Advancement outcome is achieved when

Payment

The first EN Employment Advancement Payment can be made no more than 12 months after VR case closure.

Payment (see the Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves

EN Employment Advancement Payment 2

Service Description

The CRP-EN provides services necessary for the consumer to retain and advance in employment to the point that the consumer is able to achieve 8 of 12 consecutive months of gross monthly pay that meets or exceeds 105 percent of SGA for the year in which the income was earned. This payment is available only during the first 18 months after the first EN Employment Advancement Payment.

The CRP-EN must notify the VR counselor, in writing, at least 30 days before the CRP-EN anticipates that the consumer will achieve the required income level, so that appropriate purchase orders may be issued.

Required Documentation

The DARS1050, Ticket to Work Partnership Plus, Employment Advancement Payment is required. The form must be signed by the JP or SE provider. Written documentation (such as a Ticket Assignment confirmation letter from MAXIMUS) must also be provided as proof that consumer's Ticket is currently assigned to the CRP-EN. 

One of the following must be attached to DARS1050, Ticket to Work Partnership Plus, Employment Advancement Payment to provide evidence of consumer gross earnings for 8 of 12 consecutive months:

Outcome

The second EN Employment Advancement outcome is achieved when

Payment

The second EN Employment Advancement payment can be made no more than 18 months after the first payment.

Payment for the second EN Employment Advancement (see the Chapter 3: Rates, 3.2 Service Rates) is made when the DARS counselor receives and approves