Chapter 9: Comprehensive Rehabilitation Services (CRS)

9.1 Purpose

The comprehensive rehabilitation services (CRS) program helps consumers who have traumatic brain injury (TBI) and traumatic spinal cord injury (SCI) improve their ability to function independently in the home and the community, with a focus on mobility, self-care, and communication. The program sponsors three core services to address functional ability:

Traumatic brain injury (TBI) is an insult to the brain that is

Traumatic spinal cord injury (SCI) is an acute, traumatic lesion of neural elements in the spinal canal, resulting in any degree of temporary or permanent

The spinal cord is the part of the central nervous system that extends from the foramen magnum to the cauda equina. All nerve roots within the spinal canal are included.

9.2 Overview

Unless stated otherwise, policies and procedures in other chapters of this manual apply to the CRS program.

However, neither of the following two VR policies and procedures applies to the CRS program:

When you consider policies in other chapters, substitute the term "independent living," which applies to the CRS program, for terms such as "vocational rehabilitation," "vocational," and "employment."

The CRS Individualized Written Rehabilitation Plan (IWRP) is the same as the VR IPE, except for the goals and intermediate objectives on the CRS IWRP.

Fiscal policies for the CRS program are the same as those for the VR Program, except the four fiscal policies listed under 9.16 CRS Procurement.

*CRS core services have maximum limits, and they are not subject to exception by the area manager.*

*40 TAC Section 107.1209

In this chapter, "you" refers to the CRS counselor.

9.3 Funding

Authorized by the 72nd Legislature, 1991, the CRS program is funded with court cost surcharges on state felony and misdemeanor convictions.

9.4 Initial Contact

The initial contact date for CRS is the date the consumer who has TBI and/or SCI (or the consumer's representative) first

Use the initial contact date to determine whether DRS may sponsor the following two CRS core services; DRS may sponsor:

9.4.1 Designated CRS Counselors

Only counselors designated to work in the CRS program are assigned to CRS cases. A non-CRS counselor making initial contact with a CRS consumer must

9.4.2 Procedure

(Revised 02/11)

Document in the electronic case management system the initial call or visit to DRS. Complete the initial contact record and personal information screen regardless of the consumer's current level of functioning. The electronic case management system adds the consumer to the CRS Interest and Waiting List.

When a CRS consumer with a case previously closed ineligible or unsuccessful reapplies for services for

As soon as you determine that a case is not warranted, close the initial contact case as ineligible. This action removes the consumer's name from the CRS Interest and Waiting List. In the CRS program, initial contact information is not automatically removed from the electronic case management system when no profile is completed.

9.5 The CRS Interest and Waiting List

Because the need for services is usually greater than the amount of available funds, CRS has an Interest and Waiting List for consumers. Consumers are served in the order in which their original CRS IWRP is written and signed.

A consumer is considered to be "waiting" for CRS funds when the IWRP is signed in the consumer case management system.

All other consumers are considered “interested.”

The Interest and Waiting List

Refer to the operations director for programs any inquiries about a consumer's status on the Interest and Waiting List from persons other than the consumer or the consumer's representative.

9.5.1 Procedure

While the consumer is on the Interest and Waiting List

9.5.2 Purchases Allowed While the Consumer Is on the CRS Interest and Waiting List

(Revised 02/11, 09/11)

Only items and services listed in this section may be purchased while a consumer is on the Interest and Waiting List.

You may purchase medical records and assessments for all consumers on the Interest and Waiting List.

You may purchase the services below for consumers who have been determined eligible and experience the listed conditions:

You may purchase case management services for consumers on the CRS Waiting List who have an IWRP. Generate a purchase order in anticipation of case management services soon after the IWRP is signed requiring direct communication between the CRS counselor and the MSC.

When funds become available and a consumer can be removed from the CRS Waiting List, Central Office programs staff or a designee must allocate funds for any services other than those itemized in this section.

9.5.3 Removal from the CRS Interest and Waiting List

(Revised 02/11)

The electronic case management system removes a person's name from the interest and waiting list when

When you determine that a case is unwarranted, close the initial contact case as ineligible.

9.6 Personal Information

(Revised 12/09, 03/10, 02/11)

The "Texas Residence" option in the electronic case management system is active for CRS cases. Select "Yes" or "No" to indicate whether the six-month Texas residency requirement has been established at application (see 9.7.1 Eligibility Requirements).

If you select "No," you may not determine that the consumer is eligible until he or she meets the residency requirement, at which time you must update the screen.

Forms are signed to permit the exchange of information needed during the rehabilitation process. These forms are the same as those used for the VR program. See Chapter 2: Initial Contact and Application, 2.4.7 Forms to Be Signed at Application.

9.7 CRS Eligibility Criteria

Determine eligibility for services without regard to sex, race, religion, color, and national origin.

The 60-day limit for determining eligibility does not apply to CRS. See CRS Determining Eligibility.

9.7.1 Eligibility Requirements

The consumer must

*40 TAC Section 107.1203

Exception: A consumer who meets the eligibility requirements for the DBS independent living services (ILS) program and the DRS CRS program may receive services from both programs concurrently.

You must reasonably expect that having received CRS program core services, the consumer will be able to function more independently in the home and the community.

9.7.2 Providing Information about Community-Based Services

When you help a consumer make an informed choice about residing in an institution, including a nursing home, you must inform the person about any community support that may help him or her function in the most independent setting possible.

You must

For more information, see Chapter 4: Assessing and Planning, 4.7 Providing Community-Based Service Information.

9.7.3 A Consumer Requiring Ongoing Services

A consumer who requires ongoing services (for example, personal attendant services, medications, medical supplies) is not eligible for CRS if

9.7.4 A Consumer Reapplying for CRS

When a consumer has a second TBI and/or SCI, the consumer may

9.7.5 Evaluation and Assessments to Determine CRS Eligibility

(Revised 03/09, 02/11)

When documentation from the consumer's treatment providers is not conclusive, begin assessments necessary to help determine eligibility. You may spend funds for assessment activities without removing the consumer from the interest and waiting list.

The eligibility evaluation must include

See Chapter 3: Eligibility, 3.8 Required Assessments and Policies for Selected Disabilities, Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI).

9.7.6 CRS Eligibility Procedure

Eligibility Evaluation and Assessments

To determine whether a consumer is eligible,

  1. evaluate the consumer to the degree necessary to determine eligibility and to plan services; and
  2. obtain existing medical and psychological records (when records are unavailable or inadequate, purchase assessments as necessary).

Do not use CRS funds to pay for assessments that require inpatient hospitalization.

To determine eligibility or plan services for another DRS program, pay for assessments with funds from that program (see example).

When you can presume that a consumer is capable of achieving an employment outcome, close the CRS case and open a VR case.

Eligibility Statement

(Revised 02/11)

If the consumer meets CRS eligibility criteria, complete DARS5107, Comprehensive Rehabilitation Services Eligibility Statement.

Ineligibility Letter

(Revised 02/11)

If the consumer does not meet CRS eligibility criteria,

9.8 The Individualized Written Rehabilitation Plan (IWRP)

Except for CRS IWRP goals and intermediate objectives, the IWRP is the same as the VR IPE (see Chapter 4: Assessing and Planning, 4.4 Developing the IPE).

9.8.1 Goals and Intermediate Objectives

Select one or more of the following independent living goals:

Services listed on the IWRP must clearly support the achievement of consumer goals.

Document the consumer's informed choice in a case note (see example).

9.8.2 Procedure to Develop the IWRP

Use the following procedure to develop the IWRP:

  1. before beginning services, complete a DARS5164, Comprehensive Rehabilitation Services, Individualized Written Rehabilitation Plan (IWRP) with the consumer (and/or consumer's representative);
  2. review the IWRP with the consumer (and/or the consumer's representative) at least annually, near the anniversary date;
  3. as necessary, amend the IWRP with the consumer (and/or the consumer's representative) using the DARS5160, Comprehensive Rehabilitation Services, Individualized Written Rehabilitation Plan (IWRP) Amendment; and
  4. give a copy of the IWRP, along with other referral information, to the identified provider of post-acute brain injury rehabilitation to help coordinate services between the consumer, provider, and DRS.

9.9 Service Records

After you complete the IWRP, you or the MSC develop service records to help you

Service records can be

Handle CRS service records the same way as VR service records. See Chapter 7: Purchasing, 7.5.4 Service Records for more information.

9.10 Comparable Services and Benefits

Before using CRS funds, use comparable services and benefits.

Do not delay services while an application for comparable services and benefits is pending.

9.11 Preservice Criterion for Consumers with Traumatic Brain Injury (TBI)

After a plan has been initiated, and before you provide any purchased services to a consumer who has a TBI, *the consumer must be functioning at or above Level IV of the Rancho Los Amigos Levels of Cognitive Functioning Scale, or equivalent.*

*40 TAC Section 107.1209(8)

When medical services providers do not clearly indicate the Rancho Level, you may

9.12 Inpatient Comprehensive Medical Rehabilitation Services

Inpatient comprehensive medical rehabilitation services

*40 TAC Section 107.1209(1)(A) and (1)(D)

An interdisciplinary team of professionals closely coordinates services to achieve team treatment goals in order to

The 90-day limit on inpatient comprehensive rehabilitation services is measured from the first day of services sponsored by DRS. When a facility divides its program into phases and discharges the consumer for a period before bringing the consumer back to complete the program,

When necessary, and within the 90-day time limit, a comprehensive hospital day-treatment program may be used.

Inpatient comprehensive medical rehabilitation services

9.13 Outpatient Therapy Services

Outpatient therapies

*40 TAC Section 107.1209(2)(A) and (2)(B)

Therapy (any combination) includes

When necessary, provide physician follow-up visits, not included in the 120-hour limit of services.

Outpatient therapy services

9.14 Post-Acute Brain Injury Rehabilitation Services

(Revised 12/08)

Post-acute brain injury (PABI) rehabilitation services (residential or nonresidential)

*40 TAC Section 107.1209(3)

When necessary to achieve a consumer's independent-living goals, and as indicated in the IWRP, DRS may sponsor

While the consumer is receiving PABI rehabilitation services, individual therapies

The six-month limit on PABI rehabilitation services is measured from the first day of services sponsored by DRS. When a PABI rehabilitation facility divides its program into two phases and releases the consumer for a period before bringing the consumer back to complete the program, DRS may sponsor both periods of PABI services up to a cumulative total of six months.

When a consumer is receiving PABI rehabilitation services

Give a copy of the IWRP, along with other referral information, to the PABI rehabilitation services providers to help coordinate services between the consumer, providers, and DRS.

9.14.1 Procedure

(Revised 02/11)

Use only DRS-approved providers of PABI rehabilitation services. To find a provider,

9.15 Additional Comprehensive Rehabilitation Services

9.15.1 Counseling and Guidance

Provide counseling and guidance to the consumer and family throughout the program to help the consumer achieve independent-living goals. Counseling and guidance includes providing information and helping the consumer and family

9.15.2 Other CRS, as Needed

(Revised 12/08)

Plan the following goods and services on the IWRP in support of a CRS core service. You may provide these services as needed to the consumer during participation in a core service:

9.15.3 Drugs, Rehabilitation Technology, and Medical Equipment and Supplies

(Revised 12/08)

After using available comparable benefits, provide drugs, rehabilitation technology, and medical equipment and supplies while the consumer participates in rehabilitation services. At discharge from the facility, when necessary, provide, *but do not exceed, a 30-day supply of drugs and medical supplies.*

*40 TAC Section 107.1209(4)

9.15.4 Medical Procedures

The CRS program sponsors rehabilitation medical procedures that are expected to help increase the consumer's functional ability.

Acute medical care may be sponsored only for an inter-current illness

When a consumer needs emergency care or treatment for a medical condition that requires extensive or ongoing care, use the consumer's other resources including

9.15.5 Orthotics and Prosthetics

Provide devices, including mobility and self-help aids, when these devices are essential to achieving the consumer's IWRP goals.

9.15.6 Personal Attendant Services

Provide personal attendant services only when necessary to enable the consumer to participate in CRS core rehabilitation services.

9.15.7 Psychological Services

Provide psychological services within the guidelines of Chapter 5: Services, 5.3.6 Mental Restoration Services, as part of the 120 hours of outpatient therapy.

9.15.8 Transportation

Limit transportation to helping

9.16 CRS Procurement

(Revised 02/11)

Before using CRS funds, use comparable services and benefits.

The priority for using CRS funds is

  1. consumers now receiving CRS,
  2. assessments for consumers on the interest and waiting list, and
  3. all other consumers on the interest and waiting list who are ready for services.

With the exception of the following four items, fiscal policies for the CRS program are the same as the VR program:

  1. Designated CRS counselors, RSTs, MSTs, and MSCs may issue purchase orders for CRS expenses.
  2. For a consumer on the CRS Interest and Waiting List who becomes ready for services, only Central Office programs staff or designee may allocate funds for services other than medical records or assessments.
  3. Because state funds are used for this program, services may be authorized only until August 31 of the state fiscal year in which the funds are obtained. Purchase order end dates may not extend beyond August 31 of the fiscal year in which the service is authorized.
  4. Obtain CRS funds by consulting with MSCs. Funds are allocated, case by case, using “Case Funds” actions assigned to the designated Central Office CRS program specialist or administrative technician.

9.16.1 Post-Closure Comprehensive Rehabilitation Services

Post-closure services, when combined with services previously provided, must not exceed the following time limits.

Services Time Limit

*Inpatient comprehensive medical rehabilitation*

*90 days*

*Outpatient comprehensive rehabilitation*

*120 hours*

*Post-acute brain injury rehabilitation*

*6 months*

*40 TAC Section 107.1209

To provide time-limited post-closure services, one of the following criteria must be met:

9.16.2 Procedure

(Revised 02/11)

When the IWRP does not list post-closure services, complete an IWRP amendment.

Notify the consumer of case closure with a DARS5210, CRS Successful Closure letter.

9.17 Comprehensive Rehabilitation Services Not Provided

The CRS program does not provide

9.18 Evaluating the CRS Consumer's Progress

You must ensure that the consumer is benefiting from treatment. You are a member of an interdisciplinary treatment team and should, whenever possible, participate in treatment team meetings to follow the consumer's progress. If you cannot be present, consider teleconferencing.

When a rehabilitation treatment is not leading to increased independence, you should work with the treatment team to consider changes that make the treatment more beneficial. When this is not possible, you should discontinue sponsorship of the treatment.

When complex issues evolve and treatment providers are distant from your office, you may request that the DRS liaison counselor to the facility or a medical services coordinator be present at a particular meeting.

Contact the consumer (and/or consumer's representative) at least every 30 days throughout the life of the case.

During service provision when a consumer becomes eligible for the VR program,

9.19 Transferring a Case

When necessary to help provide services (for example, when the consumer has moved, the consumer is changing from VR to CRS),

9.20 Requirements for CRS Case Closure

Regardless of the type, case files must substantiate the closure, documenting

An annual review of closed cases is not required.

9.20.1 Closing a CRS Case as Successful

Close a case as successful when

Notify the consumer by personal contact, telephone, and/or in writing that the case is closed.

9.20.2 Closing a Counseling-Only CRS Case

Before you close a CRS counseling-only case as successful, the consumer must have received treatment, as a comparable benefit or an arranged service, from

If counseling is the only CRS service provided, explicitly document in the case file that

9.20.3 Closing a CRS Case as Unsuccessful

(Revised 02/11, 09/11)

End services and close the case in the appropriate unsuccessful status when you determine that the consumer cannot

Make this decision only after

When, for any reason, you close a case as "unsuccessful" or "ineligible," and later the consumer comes back for CRS for the same injury,

Identify the reason the case was closed and procedure for closing. 

Reason Closed

Procedure

Severity of the Disability

You determine that the severity of the disability prevents CRS from helping the person function more independently in the home and the community.

Notify the consumer that the case is closed.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision and, if appropriate, refer him or her to another agency.

Other

Services may be denied or ended for reasons other than those described in this list.

Describe the reason for closure in a case note.

Notify the consumer that the case is closed.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision and, if appropriate, refer him or her to another agency

Unable to Locate or Moved out of State

Document

  • repeated attempts by telephone and mail, over a reasonable period, to contact the consumer, family, or references; and/or
  • that the person moved out of state and the reason you believe there is no evidence that the person is going to return.

Consumer Is Not Functioning More Independently

(valid after eligibility) You cannot verify that the consumer is functioning more independently in the home and community.

Notify the consumer that the case is closed.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision and, if appropriate, refer him or her to another agency.

CRS Not Required

The consumer

  • does not need CRS to function more independently in the home and community;
  • already is receiving needed services, or services are readily available, without DRS arranging, coordinating, paying for, and/or providing the services; or
  • does not need DRS counseling and guidance.

Notify the consumer that the case is closed.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision and, if appropriate, refer him or her to another agency.

Refused Services

The consumer clearly does not intend to follow through with the program.

Be certain that the consumer

  • knows about available services, and
  • persistently refuses services.

Notify the consumer that the case is closed.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision and, if appropriate, refer him or her to another agency.

Failure to Cooperate

The consumer fails to follow through with the program.

Document examples of failure to cooperate. Notify the consumer of

  • your intent to close case, and
  • his or her right to appeal.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision and, if appropriate, refer him or her to another agency.

Institutionalized

The consumer

  • entered an institution (for example, hospital, nursing home, treatment center);
  • will not be available for services for an indefinite or considerable time; and
  • certainly will not benefit from keeping the case open.

Provide information about community-based services, and document the action in a case note, as appropriate.

For more information, see Chapter 4: Assessing and Planning, 4.7 Providing Community-Based Service Information.

Notify the consumer that the case is closed.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision. Describe the circumstances in the case notes.

Death

No notification is necessary. You are required to contact the family only if DRS can reclaim equipment that was purchased. Be sensitive and minimize disruption to the family caused by reclaiming the equipment.

Consult with the Central Office program specialist for rehabilitation technology about which items to reclaim.

Transferred to Another Agency or DRS Program

When it is apparent that services from another DRS program or another agency are more appropriate than CRS,

  • discuss the transfer with the consumer;
  • discuss the case with the other DRS program's counselor; or
  • if appropriate, set up an appointment for the consumer with the other agency; and
  • provide the other agency with any appropriate information requested.

Notify the consumer that the case is closed.

Use the DARS5214, CRS Unsuccessful Closure letter to advise the consumer in writing of the decision. Describe the reasons for transfer in case notes.

 

9.21 Rancho Los Amigos Levels of Cognitive Functioning Scale

9.21.1 Levels and Description

Level I: Generalized

Patient appears to be in a deep sleep and is completely unresponsive to any stimuli.

Level II: Generalized Response

Level III: Localized Response

Level IV: Confused-Agitated

Level V: Confused, Inappropriate Non-Agitated

Level VI: Confused-Appropriate

Level VII: Automatic-Appropriate

Level VIII: Purposeful and Appropriate