1. (a) The initial interview narrative builds the foundation and sets the platform for the documentation of the case service record.
2. (b) It gives the reader a snapshot view of the consumer’s history, perceptions, and living and work situations at intake.

3. (c) The following outline should be followed when completing the initial narrative:

   1. (1)

      1. (A) Opening paragraph.
      2. (B) Include:

4. (i) The referral, initial contact, orientation meeting, and application dates;

   1. (ii) Who referred the individual; and

      1. (iii) Where you met with the consumer.
      2. (C) Indicate the date the application was signed;

   2. (2)

      1. (A) Consumer’s statement of disability.

      2. (B) State the consumer’s perception of:

         1. (i) The problem, including their disability;
         2. (ii) Barriers to employment;
         3. (iii) Any proposed solutions; and
         4. (iv) Any future goals;

   3. (3)

      1. (A) Family arrangements and income.

      2. (B) List:

         1. (i) The consumer’s type of residence (private home, institution, halfway house, etc.);
         2. (ii) Other who live in the home;
         3. (iii) The household income; and
         4. (iv) The source of income;

   4. (4)

      1. (A) Education.
      2. (B) List the individual’s highest level of education at application;

   5. (5)

      1. (A) Work history.
      2. (B) State the individual’s work history for the past ten (10) years, if possible;

   6. (6)

      1. (A) Similar benefits.
      2. (B) List all benefits the consumer has at the time of application.

      3. (C) This may include, but is not limited to:

         1. (i) Medical insurance;
         2. (ii) United States Veterans Administration benefits;
         3. (iii) Pell Grants;
         4. (iv) Scholarships;
         5. (v) Workers’ compensation;
         6. (vi) Supplemental Security Income/Social Security Disability Insurance; and
         7. (vii) Transitional Employment Assistance;

   7. (7)

      1. (A) Presumed eligibility.
      2. (B) If the individual receives Supplemental Security Income or Social Security Disability Insurance due to visual problems, and meets Criterion II (requires VR services to prepare for, enter, engage in, or retain gainful employment), the counselor may presume the applicant eligible for VR services and immediately proceed with the case.
      3. (C) An applicant’s history and counselor observation that the person is obviously totally blind and has received previous services from the Division of State Services for the Blind, or the person has bilateral ocular prosthesis also give the counselor reason to presume eligibility;

   8. (8)

      1. (A) Informed choice.
      2. (B) State how informed choice was explained to the applicant.
      3. (C) See 25 CAR § 2-201 et seq.; and

   9. (9)

      1. (A) Explanation of services.

      2. (B) Document that the following items were discussed and explained to the applicant:

         1. (i) Services available through the division;
         2. (ii) What the division can and cannot do;
         3. (iii) Confidentiality of information;
         4. (iv) Eligibility guidelines;
         5. (v) Consumer’s rights and responsibilities;
         6. (vi)
5. (a) (a) The appeal process and how to contact the supervisor and CAP personnel if needed.

6. (b) (b) State that the applicant signed the CAP form and was given a copy;

   1. (vii) Arkansas Information Reading Services for the Blind;

      1. (viii) NFB Newsline;

         1. (ix) Talking books;
         2. (x) Voter registration; and
         3. (xi) Consumer organizations.

Codification Notes: “CAP” means Client Assistance Program. "NFB" means National Federation of the Blind. "VR" means vocational rehabilitation.