APPENDIX I

ARS MEDICAL FEES

The applicable cost of procedures, devices, and other medical services may be found in the fee schedules maintained by Medicare or the Arkansas Workers' Compensation Commission. Links to these schedules are located on the ARS network. Before applying the fee schedules, ARS counselors must first determine if comparable benefits are available, including all health insurance plan coverages.

34 § 361.5 (b)(10) Comparable services and benefits means—(i) Services and benefits that are—

1. (A) Provided or paid for, in whole or in part, by other Federal, State, or local public agencies, by health insurance, or by employee benefits;
2. (B) Available to the individual at the time needed to ensure the progress of the individual toward achieving the employment outcome in the individual's individualized plan for employment in accordance with § 361.53; and
3. (C) Commensurate to the services that the individual would otherwise receive from the designated State vocational rehabilitation agency. (ii) For the purposes of this definition, comparable benefits do not include awards and scholarships based on merit. (Authority: Sections 12(c) and 101(a)(8) of the Act; 29 U.S.C. 709(c) and 721(a)(8))

EXTERNAL EMPLOYMENT VENDOR SERVICES FEES

ARS EMPLOYMENT FIRST CAREER PATHWAYS

(E1st Services Total $7750)

Benchmark 1. Total Discovery/Career Planning - Discovery Staging Record (1- 5)

Benchmark 2. Employment Path

Benchmark 3. Job Development/Placement - Discovery Staging Record (6-7)

Benchmark 4. Employment Closure (90 Days)

ARS Employment First (E1st) Career Pathways	Fee	System 7
Benchmark 1. Discovery/Career Planning Discovery Staging Record (1 - 5)	$1750	Assessment - Discovery (E1st)
Benchmark 2. Employment Path	$2000	Job Readiness- Employment Path
Benchmark 3. Job Development/Placement Discovery Staging Record (6 - 7)	$1000	Job Placement (E1st)

Benchmark 4. Employment Closure (90 Days)	$3000	E1st 26 Closure

SUPPORTED EMPLOYMENT MILESTONE FEES (Total $8000)

Milestone 1. Supported Employment (SE-1)

Milestone 2. Supported Employment (SE-2)

Milestone 3. Supported Employment (SE-3)

Milestone 4. Supported Employment (SE-4)

Supported Employment Services	Fee	System 7
Milestone 1. Referral (SE-1)	$1,000	Referral (SE)
Milestone 2. Job Match/Placement (SE-2)	$3,000	Job Placement (SE)
Milestone 3. Stabilization (SE-3)	$1,000	Stabilization (SE)
Milestone 4. Closure (SE-4)	$3,000	Closure (SE)

INDIVIDUAL JOB COACHING SERVICE/YOUTH EXTENDED SERVICES

Individual Job Coaching $26 an hour (System 7 Job Coaching).

JOB SERVICES-VR ONLY PER DIEM FEES

Job Referral (JP-1) - VR Only - $250

Job Placement (JP-2) - VR Only - $500

Job Closure (JP-3) – VR Only (90-Days) - $1500

Training/Evaluation Area	Hours	Weeks	Months	Training Costs/Hour	Room and Meals/Month	Comprehensive Client Services/Month	Student Issue	Tuition Fees	Total
Auto Collision Repair	2400	80	18.48	$25	$1,100	$1,100	$547	$60,000	$101,203
Auto Maintenance Tech	720	24	5.54	$25	$1,100	$1,100		$18,000	$30,188
Business Ed. Account Clerk	720	24	5.54	$25	$1,100	$1,100	$332	$18,000	$30,520
Business Ed. Med. Office Tech.	1080	36	8.31	$25	$1,100	$1,100	$256	$27,000	$45,538
Business Ed. Office Assistant	1080	36	8.31	$25	$1,100	$1,100	$268	$27,000	$45,550
Business Ed. Billing and Coding	480	16	3.7	$25	$1,100	$1,100		$12,000	$20,140
Business Ed. Computer Applications	480	16	3.7	$25	$1,100	$1,100	$186	$12,000	$20,326
Business Ed. QuickBooks	360	12	2.77	$25	$1,100	$1,100	$166	$9,000	$15,260
Certified Nursing Assistant	450	20	4.62	$25	$1,100	$1,100	$143	$11,250	$21,557
Construction Technology	1680	56	14	$25	$1,100	$1,100	$155	$42,000	$72,955
Cosmetology	1500	50	11.55	$25	$1,100	$1,100	$161	$37,500	$63,071
Cosmetology Instructor	600	20	4.62	$25	$1,100	$1,100	$357	$15,000	$25,521
Cosmetology Nail Tech	600	20	4.62	$25	$1,100	$1,100	$427	$15,000	$25,591
Food Service Cafeteria	570	19	4.39	$25	$1,100	$1,100	$150	$14,250	$24,058
Food Service Baking	460	15	3.46	$25	$1,100	$1,100	$310	$11,500	$19,422
Food Service Cooking	615	21	4.85	$25	$1,100	$1,100		$15,375	$26,045
Food Service Salad Making	150	5	1.15	$25	$1,100	$1,100		$3,750	$6,280
Welding	1680	46	14	$25	$1,100	$1,100		$42,000	$72,800
Printing and Bindery	960	32	7.39	$25	$1,100	$1,100	$90	$24,000	$40,348
Printing /Offset Press	1440	48	11.09	$25	$1,100	$1,100	$90	$36,000	$60,488
Printing/Graphic Communication	1440	48	11.09	$25	$1,100	$1,100	$70	$36,000	$60,468
Printing/Screen Printing	600	20	4.62	$25	$1,100	$1,100	$90	$15,000	$25,254
Sales and Marketing	720	24	5.54	$25	$1,100	$1,100	$75	$18,000	$30,263
Outdoor Power Equipment Tech.	1200	40	9.24	$25	$1,100	$1,100	$752	$30,000	$51,080
Career Readiness Certificate	120	4	1	$25	$1,100	$1,100		$3,000	$5,200
10-Day Vocational Assessment	60	2	0.5	$25	$1,100	$1,100		$1,500	$2,600
OSHA Training	40	1	0.25	$25	$1,100	$1,100		$1,000	$1,550
Vocational Evaluation	120	4	1	$25	$1,100	$1,100		$3,000	$5,200
Driver's Education	33	4	1	$40	$1,100	$1,100		$1,320	$3,520
Vocational Prep	120	4	1	$25	$1,100	$1,100		$3,000	$5,200
Job Club	30	1	0.25	$25	$1,100	$1,100		$750	$1,300

POLICY GOVERNING THE RATES OF PAYMENT FOR PURCHASED VR SERVICES

1. VOCATIONAL REHABILITATION SERVICES

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

2. REQUIREMENTS FOR REHABILITATION SERVICE PROVISION

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

3. RATES OF PAYMENT

When determining rates of payment to third party vendors, ARS first requires that the vendors be properly licensed or accredited. For example, medical providers must be in good standing with the applicable State of Arkansas licensing board or agency. If properly licensed, medical providers will be paid using the fee schedules established by (1) Medicare, or (2) the Arkansas Workers' Compensation Commission. For services covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the medical provider. For hospitals or clinics with which ARS has a contract establishing an all-inclusive amount for services, ARS will pay the contract amount without regard to Medicare or Workers' Compensation-based fee schedules.

4. ARS PURCHASING REQUIREMENTS

PROCEDURES – PURCHASING

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

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

4.01 Tier 1

$5,000.01 or more but less than $10,000 (tax excluded) will require the approval of the District Manager. Within 30 calendar days, the counselor will obtain at least three written quotes, complete the Request for Purchase form (RS-357) with a Memo explaining the need for purchase, and submit this information to the District Manager. The District Manager will approve the lowest bid in accordance with the State of Arkansas procurement laws, rules, and regulations. If less than three quotes are obtained, a statement of explanation will accompany the purchase request. Quote specification details will be consistent to all vendors. If the District Manager approves the lowest vendor, a copy of the RS-357 will be returned to the counselor. Upon receipt, the counselor may issue an authorization.

4.02 Tier 2

$10,000.01 or more but less than $25,000 (tax excluded) will require the approval of the Chief of Field Services and the District Manager. Within 30 calendar days, the counselor will obtain at least three written quotes, complete the Request for Purchase form (RS-357) with a Memo explaining the need for purchase, and submit this information to the District Manager. The District Manager will approve the lowest bid in accordance with the State of Arkansas procurement laws, rules, and regulations. If less than three quotes are obtained, a statement of explanation will accompany the purchase request. Quote specification details will be consistent to all vendors. The RS-357 will be submitted to the Chief of Field Services for final approval. If approved by the Chief of Field Services and the District Manager, a copy of the RS-357 will be returned to the counselor. Upon receipt, the counselor may issue an authorization.

4.03 Tier 3

$25,000.01 or more requires the approval of the Chief of Field Services and the Commissioner. Within 30 calendar days, the counselor will obtain at least three or more verbal or written quotes, and submit this information to the District Manager. If the counselor is unable to obtain three quotes, a statement of explanation must accompany the purchase request. Quote specification details will be consistent to all vendors. The counselor/District Manager must be satisfied the price is fair and reasonable based on the following:

1. Evaluation of the work to be performed
2. Bids including consolidated price summary of material (list items) quantities
3. Labor hours/rate of pay
4. Reflect fair market value – price a buyer would ordinarily pay.

The counselor completes the Request for Purchase form (RS-357) with a Memo explaining the need for purchase, and submits to the District Manager. If the District Manager approves the need for purchase, he or she will forward the Request for Purchase to Central Office to arrange for the purchase in accordance with the State of Arkansas procurement laws, rules, and regulations. The bid process ensures costs are reasonable, and the segregation of duties ensures internal control. The Central Office will complete the purchase and notify the counselor, who will note the justification in the IPE.

5. MEDICAL REHABILITATION SERVICES

The rate of payment for physician services, dental treatment, glasses, optical aids, and artificial eyes, hearing aids, hospitalization, nursing services, orthotic devices, physical and occupational therapy, prosthetic devices, psychotherapy, speech and hearing therapy, and surgical implants/appliances are based on the fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission. For services covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

5.01 Physician Services

Rates of payment for medical services provided by physicians are based on the fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission, updated annually. Services are identified by CPT code where possible. For services covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

5.02 Dental Treatment

Rates of payment for dental services are based on the fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission, updated annually. Services are identified by CPT code where possible. For services covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

Insurance benefits must be used first in paying for surgical and medical services. The amount authorized by ARS will be followed by the statement 'Rehabilitation Services will pay only that part of the authorized amount not covered by the insurance policy up to the maximum amount allowed by the ARS Fee Schedule.' (See Appendix I-1.)

The file must document the rational use in price decision: previously proposed prices, contracted prices, market research for the same items.

5.03 Glasses, Optical Aids, and Artificial Eyes

Rates of payment are based on fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission for prescription glasses, optical aids, and artificial eyes. For devices covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

Rates of payment are set at the published list price for a non-prescription item, e.g., closed circuit television, magnifiers, etc. The ARS assistive technology team, here and after referred to as Access and Accommodations, reviews purchases to ensure the price is reasonable in the market. If no qualified vendor agrees to accept the published rate of payment, the counselor may, with the written permission of the district manager that is entered into the client case file, negotiate a reasonable fee based on the lowest of three competitive estimates from vendors in the local area.

5.04 Hearing Aids

Invoices for hearing aids must be itemized. Each line item must correspond to the recommendations for the individual in the audiology/hearing aid evaluation.

Line items for devices not recommended for the individual in the audiology/hearing aid evaluation may be rejected if inconsistent with the individual's Employment Plan. Non-itemized or bundled invoices will be rejected and returned to the vendor.

Each line item for a hearing aid or related device must include the appropriate billing code from the 'L' or 'V' sections of the Health Care Common Procedures Coding System (HCPCS). ARS may request further documentation to support a given L or V code, and may refuse payment if the vendor cannot provide the documentation requested.

Used devices, if provided, must be disclosed on the invoice as 'refurbished,' 'used,' or 'rebuilt.' Failure to disclose a refurbished device or to follow the FDA procedures may result in removal of the vendor from the ARS Approved Vendor List.

Counselor will verify that the individual received the device and is able to use it. Document in the ECF. Counselor will key required information into the case management system for ARS Purchase

Authorization.

ARS will issue payment for new hearing aids and related devices according to the price indicated for the appropriate L or V code in the fee schedule established by the Arkansas Workers' Compensation Commission. For used hearing aids and related devices, ARS will pay 70% of the price indicated for the appropriate L or V code, using the Arkansas Workers' Compensation Fee Schedule.

For hearing aids and related devices (new or used) not covered by Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

~~For individuals with insurance coverage for hearing aids and related devices, ARS will issue payment after that coverage has been applied. In no event will ARS pay an amount greater than 80% of the price indicated in the Blue Cross Blue Shield fee schedule for a given HCPCS line item.~~

5.05 Hospitalization

Rates of payment for the first day of inpatient hospital services are based on the fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission. For first- day hospital services covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

For hospital services beyond one day, ARS will pay up to 50% of the total amount billed by the provider.

For hospitals with which ARS has a contract establishing an all-inclusive amount for services, ARS will pay the contract amount.

5.06 Nursing Services

Rates of payment for nursing services are based on the fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission. For nursing services covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider. For hospitals or outpatient clinics with which ARS has a contract establishing an all-inclusive amount for services, ARS will pay the contract amount.

5.07 Orthotic Devices

Rates of payment for orthotic devices are based on fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission. For orthotics covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

5.08 Physical and Occupational Therapy

Rates of payment for physical and occupational therapy services are based on fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission. For physical and occupational therapies covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

5.09 Prescription Drugs

Rates of payment for prescription drugs are based on the average wholesale price plus a dispensing fee of $5.00 or the usual and customary list price, whichever is less. ARS has a preference for generic over brand unless the prescribing medical professional indicates otherwise.

The file must document the invoice includes vendor name, address, invoice date, the name of the prescribed medication, quantity, and the agreed/previously priced for the same or similar prescription drugs. The price is reasonable considering the charge/cost is the same for all customers, and reflects fair market price value for comparable goods or services in the local area.

5.10 Prosthetic Devices

Rates of payment for prosthetics are based on the fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission. All prosthetic requests are reviewed by the Access and Accommodations physical therapist to ensure the prosthesis and its components are consistent with the client's expressed vocational goal. As part of the report, the physical therapist will document the allowable rate for the device. For prosthetics covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider.

ARS will purchase prosthetic and orthotic devices from certified professionals in the area of expertise by the American Board of Certification on Orthotics and Prosthetics in accordance with informed choice. Artificial arms, legs, and components must be purchased through prosthetics certified by the American Board of Certification on Orthotics and Prosthetics. A list of approved vendors will be maintained (Policy Manual Section IV: Services, Prosthetic and Orthotic device, page VI-40.)

5.11 Psychotherapy

Rates of payment for psychotherapy services are set using the most cost-effective means available considering the needs of the individual. Community mental health providers are utilized, as appropriate, and the rate of payment will be consistent with the facility's sliding schedule.

If services are not available or feasible from a community health provider, psychotherapy must be provided from a psychiatrist, licensed psychologist, psychological examiner, licensed clinical social worker, or licensed clinical professional counselor. Counselors preauthorize all services to ensure rate of payment matches the established Medicaid rate for the State of Arkansas as approved by the General Assembly (the Medicaid rate), which is set as of July 1st of each year, updated annually. Services are identified and reimbursed by CPT code. Invoices are validated by the counselor to match the CPT code.

5.12 Speech and Hearing Therapy

Rates of payment for speech and hearing therapy are at the Medicaid rate as of July 1st of each year, updated annually.

5.13 Surgical Implants/Appliances

Rates of payment for surgical implants/appliances are based on the fee schedules established by (1) Medicare or (2) the Arkansas Workers' Compensation Commission. For implants or appliances covered by neither Medicare nor Arkansas Workers' Compensation, ARS will pay up to 50% of the total amount billed by the provider. For hospitals or outpatient clinics with which ARS has a contract establishing an all-inclusive amount for services, ARS will pay the contract amount.

5.14 Wheelchairs

ARS will purchase wheelchairs consistent with a physician's prescription and upon review and recommendation by Access and Accommodations. A minimum of three bids from recognized vendors is required with the award going to the lowest bidder.

6. SERVICES RELATED PRIMARILY TO SENSORY AND COGNITIVE DISABILITIES

6.01 Assistive Aids and Devices

Rates of payment for assistive technological aids and appliances are set at the published list price. The Access and Accommodations assessment team reviews purchases to ensure that the price is reasonable in the market.

6.02 Auxiliary Aids

Agency interpreters will be utilized when available. Payment rates for non-agency interpreter services are set at the common and customary rate of pay used in colleges or universities. Payment rates for reader services and note taking services are set at the standard rates of the college, university, or institution the client is attending.

6.03 Auxiliary Aids/Reasonable Accommodations in Institutions of Higher Education

Reasonable accommodations will be provided by the agency, as appropriate, for out-of-class use in support of the educational program, such as reader services needed to complete homework assignments in a dormitory or at home. Rates of payment for the particular service are set at the standard rates of the college, university, or institution the client is attending.

7. RESIDENTIAL ARCHITECTURAL MODIFICATIONS

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

8. COMPUTERS

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

9. VEHICLE MODIFICATION SERVICES

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

10. VEHICLE REPAIR

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

1. Get a written estimate and work order
2. Receive a clear copy of the invoice
3. Invoice includes the shop's name and address, client's name, and car's license number and mileage. It includes the labor charge, the name, number, and price of each part replaced, and whether parts are new or rebuilt.
4. The shop's warranty should be printed on the bill.

11. JOB PLACEMENT SERVICES

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

12. SELF-EMPLOYMENT SERVICES AND HOME-BASED EMPLOYMENT SERVICES

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

13. SUPPORTED EMPLOYMENT SERVICES

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

Supported Employment Milestone (SE-1) Referral/Job Development - \$1,000 Supported Employment Milestone (SE-2) Job Match/Placement - \$3,000 Supported Employment Milestone (SE-3) Job Stabilization - \$1,000 Supported Employment Milestone (SE-4) Closure - \$3,000

14. VOCATIONAL COUNSELING AND GUIDANCE

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

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

15. VOCATIONAL TRAINING SERVICES

15.01 Personal Vocational Adjustment

Rates of payment are based on the published fee schedule of the provider. The counselor reviews and compares cost for the particular services in the local market to ensure the price is reasonable.

15.02 Vocational Training

Rates of payment for vocational training are set based on the type of vocational training services rendered. For Institutions of Higher Education and Community Colleges for Associate Degrees please refer to 15.08 below. Rates of payment for vocational training for non-degree programs are set at the fee schedule of the institution or entity providing the training. Out-of-state training fees will not exceed the rate paid for in-state training fees for the same degree, certification, or course of study available at an institution within the state.

15.03 Books, Uniforms, and Supplies for Vocational Training

Rates of payment for books, uniforms, and supplies for vocational training are set at the fee schedule of the institution or entity providing the training.

15.04 Occupational Tools for Training

Rates of payment for occupational tools are set at the fee schedule of the institution or entity providing the training.

15.05 General Education Diploma (GED)

GED training and testing are provided through the Arkansas Department of Career Education, Adult Education programs in each county set at the fee rate of the Adult Education program.

15.06 Tutorial Services

The majority of universities in the state of Arkansas provide tutoring services for free as part of the disability support services on each campus. The agency encourages clients to utilize this benefit. If tutoring services are not available, rates will be determined in accordance with the level of course requirements and based on teaching credentials or qualifications of the tutorial services provider.

15.07 On-The-Job Training

On-the-job training (OJT) offers the opportunity for individuals to learn a job directly at the job site with the business owner or an assigned co-worker providing training specific to that position. Rates of payment for OJT are set at the entry level rate in the local market.

15.08 Training in Institutions of Higher Education and Community Colleges

Rates of payment for educational expenses are set on the tuition fee schedule of the institution or community college. Out-of-state tuition will not exceed the rate paid for in-state tuition for the same degree, certification, or course of study available at a public institution within the state.

16. OCCUPATIONAL TOOLS FOR EMPLOYMENT

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

17. SUPPORT SERVICES

17.01 Interpreter Services

Agency interpreters will be utilized when available. Payment rates for non-agency interpreter services are set at the common and customary rate of pay used in colleges or universities.

17.02 Personal Assistance Services

Personal Assistance Services, also referred to as attendant care, refers to a range of services provided by one or more persons designed to assist an individual with a disability to perform daily living activities on or off the job the individual would typically perform without assistance if the individual did not have a disability.

Payment for personal assistance services are determined on the basis of what activities are necessary and reasonable to meet the needs of the consumer. Rates of payment are based on the level of care prescribed by the attending physician. Personal assistance services must be reviewed and approved by the ARS Local Medical Consultant. Amounts of service and rates will be established on a case-by-case basis not to exceed Medicaid rates. Personal assistance services are not subject to financial means testing.

17.03 Maintenance

Rates of payment for maintenance are determined by ARS on a case-by-case basis of what is necessary and reasonable to meet the needs of the consumer.

17.04 Services to Family Members

Rates of payment for services to family members are determined by ARS on a case-by-case basis of what is necessary and reasonable to meet the needs of the family.

17.05 Transportation

The amount and type of funding for transportation is determined with the individual with consideration given to actual expense anticipated using the most cost-effective means of transportation consistent with the individual's needs. Rates of payment for private transportation assistance may include provision of gas money/mileage allowance not to exceed the current state reimbursement rate per mile. Public transportation will be utilized when possible.

17.06 Exception to Service Provision Policy

As stated in the ARS Policy Manual, Appendix G, Exceptions to Service Provision Policy, Page 1: The provision of VR services is based on the rehabilitation needs of the individual, as those needs are identified in the IPE and consistent with the individual's informed choice. Although it is not the intent of ARS to limit services to any individual, thresholds (maximum allowable amounts) have been established for some services. ARS recognizes some individuals with disabilities have unique needs, which may need to be considered as an exception to the normal policy. These individuals are informed and provided an opportunity to request an exception to service provision policies due to extenuating circumstances.

Please refer to the ARS Policy Manual, Appendix G, Pages 1-2 for the procedure to request an exception to a service provision policy.

PRE-EMPLOYMENT TRANSITION FEE SCHEDULE

ARS External Vendor for Pre-Employment Transition Service Fees

School programming based on 36 weeks	Measures/ Service	Fee
1. Job Exploration 2. Workplace readiness training to develop social skills and independent living 3. Counseling on opportunities for enrollment in comprehensive transition or post-secondary training opportunities 4. Self-advocacy	Training to develop Social and independent living skills; Career awareness; informational interviews; Career Speakers; Job clubs; Job shadowing; Career student organizations; Volunteering; Workplace simulations; Workplace tours/field trips; Labor Market studies to determine in-demand occupations Assessing vocational interest should be a component of job exploration. Minimum 3 inventories plus pre & post career readiness test. Interest inventories should assist in determining a student's work skill level, career interest, and career pathways Information on course offerings; Occupational training needed to succeed in the workplace; Provide information on postsecondary opportunities needed to succeed in the workplace & opportunities associated with career fields or pathways; Advising students on academic curricula; Assist with College application and admissions processes; Providing resources that may be used to support student success in education and training; Provide information disability support services; Document academic accommodations; Advocate for needed accommodations & services; Identify interest, abilities, talents, needs, learning styles, preferences and goals; promote use of executive functioning skills; Id admissions test accommodations; College fairs and tours; Assist with College and career exploration	$19.50 per hour COMBINED TOTAL: 7 hours per week
Work based learning/paid work experiences	Utilizes the workplace or real work to provide students with the knowledge and skills that will help them connect school experiences to real-life work activities and future career opportunities. It is essential that direct employer or community involvement be a component of the WBL to ensure in-depth student engagement (Max 360 hours or 10 hours per week)	$28.00 per hour total reimbursement fee for student wages; out of the total reimbursement the vendor must pay student for work experiences no less than minimum wage rolled into the total fee For purposes of ARS vendor programming, work-based learning applies to student work experiences only.

Summer programming maximum 8 weeks minimum 4 weeks	Measures/Service	Fee
1. Job Exploration Counseling 2. work place readiness training to develop social skills and independent living 3. Counseling on opportunities for enrollment in comprehensive transition or post-secondary training opportunities 4. Self-advocacy	Assess Vocational interest Minimum 3 inventories plus pre & post career readiness test. Interest inventories should assist in determining a student's work skill level, career interest, and career pathways Training to develop Social and independent living skills; Career awareness; informational interviews; Career Speakers; Job clubs; Job shadowing; Career student organizations; Volunteering; Workplace simulations; Workplace tours/field trips; Labor Market studies to determine in-demand occupations Information on course offerings; Occupational training needed to succeed in the workplace; Provide information on postsecondary opportunities needed to succeed in the workplace & opportunities associated with career fields or pathways; Advising students on academic curricula; Assist with College application and admissions processes; Providing resources that may be used to support student success in education and training; Provide information disability support services; Document academic accommodations; Advocate for needed accommodations & services; Identify interest, abilities, talents, needs, learning styles, preferences and goals; promote use of executive functioning skills; Id admissions test accommodations; College fairs and tours; Assist with College and career exploration	$19.50 per hour COMBINED TOTAL: 7 hours per week
Work based learning/ paid work experiences	Paid work experiences: Utilizes the workplace or real work to provide students with the knowledge and skills that will help them connect school experiences to real-life work activities and future career opportunities. It is essential that direct employer or community involvement be a component of the WBL to ensure in-depth student engagement (Maximum 20 hours per week)	$28.00 per hour total reimbursement fee for student wages; out of the total reimbursement the vendor must pay student for work experiences no less than minimum wage rolled into the total fee. For purposes of ARS vendor programming, work-based learning applies to student work experiences only.

Pre-Employment Transition Services (Pre-ETS) Programming information

1. Once a student has completed Job Exploration counseling through vocational assessments the Pre-ETS provider may submit the completed assessments to the transition counselor at the local ARS office and receive reimbursement for services at $19.50 per hour not to exceed 10 hours per student per Pre-ETS program
2. Job exploration is a billable service designed to assist a student in developing an understanding of the job market through career exploration; job shadowing; worksite tours and fieldtrips, mock interviews, and career speakers.
3. Job Coaching is not a Pre-Employment Transition Service funded through this fee schedule. If a student needs 1:1 supports in a work experiences the provider will need to contact the transition counselor at the local ARS office and discuss the need for 1:1 supports.
4. Transportation is not a Service funded through the Pre-ETS fee schedule. Transportation is the responsibility of the Pre-Employment Service provider
5. Pre-ETS providers will receive a (1) time work experience development fee paid per student upon placement in students first integrated work experience.
6. Pre-ETS providers will be responsible for submitting documentation of student's placement in a work experience to the transition counselor at the local ARS office indicating the students' worksite, job duties (or title), and projected number of work experience hours student will receive per week
7. Pre-ETS providers will be responsible for paying student wages in the work experience at minimum wage or higher for a maximum reimbursement of $10.00 per hour (this fee includes administrative cost and benefits)

WIOA Common Performance Measures – Appendix J

Section 116 of Workforce Investment and Opportunity Act (WIOA) requires Arkansas Rehabilitation Services to assess how well the Vocational Rehabilitation program performs each quarter, and annually, based on the following 6 indicators:

Employment Rate - 2nd Quarter After Exit

The percentage of participants who are working in the community during the second quarter after exit from the program. A VR client must work 90 days before their case can be closed. Once the 90- day timeframe is complete and the case is closed, the client has “exited” the program. The client’s work record will be validated 6 months (2 quarters) after they exit the program. In order to verify that the client is employed at that time, ARS staff will obtain supporting documents such as: - Direct Unemployment Insurance (UI) wage match - I Wage (applies to status 26 and status 28 closures) - Federal or military employment records - Paystub - W2 or tax record - Verification from the client in writing using an agency form or a letter from the client, signed and dated from the client and counselor - Verification using an agency out-of-state wage form - Verification from the Employer on letterhead with employment start date and justification - Verification Form for Self-Employment Income and Expenses The “employment rate” for this indicator is essentially the number of clients who are employed 2 quarters after exiting the program, divided by the total number of clients who exited during the same reporting period. Participants counted for this indicator include clients whose record of services is closed successfully after development of an IPE, and clients whose record is closed unsuccessfully after development of an IPE.

Employment Rate - 4th Quarter After Exit

The percentage of participants who are working in the community during the fourth quarter after exit from the program. A VR client must work 90 days before their case can be closed. Once the 90- day timeframe is complete and the case is closed, the client has “exited” the program.

The client's work record will be validated 12 months (4 quarters) after they exit the program. In order to verify that the client is employed at that time, ARS staff will obtain supporting documents such as: - Direct Unemployment Insurance (UI) wage match - I Wage (applies to status 26 and status 28 closures) - Federal or military employment records - Paystub - W2 or tax record - Verification from the client in writing using an agency form or a letter from the client, signed and dated from the client and counselor - Verification using an agency out-of-state wage form - Verification from the Employer on letterhead with employment start date and justification - Verification Form for Self-Employment Income and Expenses The 'employment rate' for this indicator is essentially the number of clients who are employed 4 quarters after exiting the program, divided by the total number of clients who exited during the same the reporting period. Participants counted for this indicator include clients whose record of services is closed successfully after development of an IPE, and clients whose record is closed unsuccessfully after development of an IPE.

Median Earnings 2nd Quarter After Exit

The median quarterly earnings for participants who are working in the community 6 months after they exit the program, as validated through direct UI wage match, federal or military employment records, or supplemental wage information like the Verification Form for Self-Employment Income and Expenses. The median wage is determined by listing participants' quarterly wages from the lowest to the highest value. The wage in the middle of the list is the median quarterly wage. If there are an even number of participants in the list, the median is the average of the middle two wages. Generally, participants counted for this indicator include clients whose record of services is closed successfully after development of an IPE, and clients whose record is closed unsuccessfully after development of an IPE.

	However, the following clients are not included: - Clients who have exited but are not employed in the 2nd quarter after exit. - Clients who have exited and are employed, but for whom earnings are not yet available. - Clients who have exited and are working, but have no income (e.g., unpaid family workers) - Clients who have exited but are in subsidized employment. - Clients who have exited, but one or more of the “Exclusions” apply. See section on Exclusions, below. Note that there is a two-quarter lag in reporting wages. If a participant’s wages are not available after two quarters, the wage must be reported as $0, and the person is not considered employed for purposes of Median Earnings – 2nd Quarter. A median wage reported as $0 will negatively impacts Employment Rate – 2nd Quarter.
Credential Attainment	The percentage of program participants enrolled in an education or training program (excluding on-the-job training and customized training) who attain a recognized postsecondary credential or a secondary school diploma, or its recognized equivalent, during participation in, or within one year after exit from, the program. A high-school school diploma or GED can count for purposes of credential attainment, but only if the client becomes employed within one year after exit, or enrolls in an education or training program leading to a recognized postsecondary credential within one year after exit. Participants counted for this indicator include clients whose record of services is closed successfully after development of an IPE, and clients whose record is closed unsuccessfully after development of an IPE.
Measurable Skill Gains	The percentage of program participants who, during a program year, are enrolled in an education or training program that leads to a recognized postsecondary credential or employment and gain a skill that counts as “documented progress” towards the credential or employment. Progress can be academic, technical, occupational, or other, depending on the type of education or training program:

1. Documented achievement of at least one educational functioning level of a participant who is receiving instruction below the postsecondary education level; 2. Documented attainment of a secondary school diploma or its recognized equivalent; 3. Secondary: Transcript or report card showing passing grades for 1 semester; 4. Postsecondary, full-time (12 or more hours): Transcript showing passing grades for 1 semester. Postsecondary, part time (less than 12 hours): Transcript must show passing grades for a total of 12 hours, over 2 consecutive semesters; 1. Satisfactory or better progress report towards established milestones, such as completion of OJT or completion of one year of an apprenticeship program or similar milestones, from an employer or training provider; or 2. Successful passage of an exam that is required for a particular occupation or progress in attaining technical or occupational skills as evidenced by trade-related benchmarks such as knowledge-based exams. - Measurable Skill Gains are reported on a yearly basis and are not an exit-based measure. - Clients are generally given credit for 1 Measurable Skill Gain per year, even if they earn more than 1 during a program year. - Record all Measurable Skill Gains in the case management system—the reporting system will count them appropriately. Participants counted for this indicator include clients whose record of services is closed successfully after development of an IPE, and clients whose record is closed unsuccessfully after development of an IPE.

Effectiveness in Serving Employers

There are three approaches to measuring this indicator. The core partners are required to report on two of the three following measures. The core programs for the Combined State Plan in Arkansas, including VR, are in the pilot phase of choosing a common approach: • Approach 1 - Retention with the same employer - addresses the programs' efforts to provide employers with skilled workers; • Approach 2 - Repeat Business Customers - addresses the programs' efforts to provide quality engagement and services to employers and sectors and establish productive relationships with employers and sectors over extended periods of time; and • Approach 3 - Employer Penetration Rate - addresses the programs' efforts to provide quality engagement and services to all employers and sectors within a State and local economy.

Clients Counted in the Performance Measures

A “participant” for VR purposes is someone who is eligible for services, has an individualized plan for employment, and is receiving services. These policies apply to all cases in the case- management system involving clients who meet the definition of participant.

Exit Wage Calculations

All earnings are reported before deductions of Federal, State and local income taxes and Social Security payroll tax. The entire amount received for the quarter is reported. Wages for salespersons, consultants, self-employed individuals, and other similar occupations are based on their adjusted gross income. Estimates of in-kind payments, such as meals and lodging, cannot be reported.

Exclusions

Things may happen in clients' lives that exclude them from certain performance measures. These exclusions occur due to:

1. • Incarceration in a correctional institution, or becoming a resident of an institution or facility providing 24-hour support (such as hospital or treatment center) for 90 days or longer, which is considered enough time to prevent the client from participation in a workforce program;
2. • Medical treatment where the treatment is expected to last longer than 90 days and precludes entry into unsubsidized employment or continued participation;
3. • Death; or
4. • Membership in the National Guard or other reserve military unit of the armed forces, and being called to active duty for at least 90 days.

Data Validation Generally

Under WIOA section 116(d), the U.S. Departments of Education and Labor have established data-validation guidelines in order to ensure that information included in program reports is valid and reliable. For ARS, this means the data supporting our performance indicators (and reported to RSA) must first meet internal, quality-assurance standards. Ultimately, data validation will improve ARS's performance accountability and help achieve better outcomes for our clients. ARS complies with all State and Federal laws applicable to performance-measure collection and reporting.

Quality-Assurance Standards for Data Validation

1) Data Collection for Effective and Efficient Operations. ARS counselors will be provided a monitoring tool, based on the 911 report and technical assistance from RSA, in order to review case data and supporting documentation. Using the monitoring tool, counselors will enter information into the electronic case management system the appropriate clients. The monitoring tool may also be used by managers each quarter to review cases for accuracy.

ARS staff responsible for monitoring will provide counselors and managers a written report of errors and missing data, with a request for corrections. Monitoring staff will also provide ongoing training and technical assistance. By the quarter prior to the due date for the next 911 report, counselors will provide a written response to their managers, showing that the errors identified by monitoring staff have been corrected. This statement will be forwarded to the monitoring staff, with a copy to the Chief of Field Services.

After receiving the statement from counselors, ARS monitoring staff will screen the electronic case files again for errors. At this time, any corrections still needed will be made by the monitoring staff or manager prior to the report's due date. Remedial training will be provided to counselors with recurring error corrections, as needed.

2) Retention. The ARS case management system maintains clients' full record of services, including assessments, evaluations, reports, financial records, and supporting documents. These records are kept electronically for the life of the case on the counselor's caseload. With the exception of certain files in Status 00, ARS will continue to keep all records of services for a period of seven (7) years. See 34 C.F.R. § 361.47; ARS Policy & Procedure Manual, sec. X; Ark. Code Ann. § 25-18-604; and current Arkansas Record Retention Schedule.

3) Timely Reporting to RSA. On a quarterly basis within each program year, the ARS Data Analyst will compile performance-indicator data to prepare 911 Reports, which are submitted to RSA as required by the Rehabilitation Act. The 911 Report collects case-service data, with a focus on performance indicators. As the 911 Reports are prepared, the Data Analyst will make note of errors and missing data from the counselors' caseloads. The Data Analyst will distribute summaries of the errors and omissions, along with a correction guide, to each counselor prior to the close of the quarter. Any errors will be addressed using the correction guide. This is intended to supplement the written report/correction/screening process involving ARS monitoring staff, described above.

The Data Analyst's summaries and correction guides will be distributed on the following timeline:

1. Q1: July 1 to September 30
2. Q2: October 1 to December 31
3. Q3: January 1 to March 31
4. Q4: Reporting Period: April 1-June 30

4) Reliability of Performance Indicators. Generally speaking, any information entered into the case management system must be verified using the supporting documents identified in TAC 19- 01 (RSA) and TEGL 7-18 (U.S. Departments of Labor and Education). Allowable supporting

documentation is listed for each performance indicator in the table following Attachment I of the TEGL, Source Documentation for WIOA Core Programs.

Continuous Performance Improvement Plan

When internal monitoring for accuracy in data validation reveals consistent best practices, or innovative practices, the counselors and managers responsible will be recognized by ARS administration. Their best practices will be shared with all ARS staff to improve performance and further the agency's mission.

Likewise, internal monitoring may lead to recommendations for corrective action when errors in supporting documentation are noted, or when a case file lacks supporting documentation. Recommendations for corrective action will reference the law, regulation, or policy that was not being followed, along with remedial steps that are proportional to the level and frequency of the errors.