PURPOSE: This rule establishes the standards for physical and mental restoration services provided by Vocational Rehabilitation, Office of Adult Learning and Rehabilitation Services, Department of Elementary and Secondary Education for individuals with disabilities pursuant to the Rehabilitation Act of 1973 as amended and 34 CFR sections 361.5(c)(39) and 361.48(b)(5).

PUBLISHER’S NOTE: The secretary of state has determined that publication of the entire text of the material that is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.

1. (1) The following physical and/or mental restoration services as defined in the federal act and/or applicable regulations may be provided to applicants or eligible individuals based upon financial need:

   1. (A) Hospital services for eligible individuals shall be provided from an instate hospital accredited by the Joint Commission on Accreditation of Hospitals (JCAH) or by the American Osteopathic Association and licensed by the Missouri Department of Health. Preference will be given to hospitals having fifty (50) or more beds and well-developed surgical and specialty services.

      1. 1. Hospital services for eligible individuals from an out-of-

state hospital may be paid according to Missouri Vocational Rehabilitation (VR) established rates;

1. (B) Surgical services for eligible individuals may be provided upon approval by VR when necessary to correct or substantially modify a physical or mental impairment, which is stable or slowly progressive and constitutes a substantial impediment to employment. The condition must be of such a nature that correction or modification may be reasonably expected to eliminate or substantially reduce the impediment to employment within a reasonable length of time;

2. (C) Hearing aids may only be provided from a Missouri licensed hearing aid dealer upon the recommendation of a Missouri physician specializing in diseases of the ear or a Missouri certified audiologist. The specific make and model of hearing aids must be included in the recommendation. All licenses or certifications must be valid, unencumbered, unrestricted, and undisciplined.

   1. 1. Prior to purchase authorization, VR will—

      1. A. Consult with the physician or audiologist to determine

feasibility of any repair or reconditioning of an existing aid;

1. B. Allow for the eligible individual’s preference of

vendor whenever possible; and

1. C. Ensure that the quality of aid, accessories, service,

basic warranty, and cost effectiveness are evaluated; and/or

1. (D) Individuals with mental illness may be referred to the Missouri Department of Mental Health or other mental health providers as a comparable service. Psychotherapy services may be authorized when required for the eligible individual to begin or continue a rehabilitation plan under the following conditions:

   1. 1. The need for psychotherapy is clearly related to the

expected employment outcome and recommended by a Missouri licensed psychiatrist or psychologist;

1. 2. An Individualized Plan for Employment (IPE) must have

been developed or be in the process of development to provide services leading to the attainment of the vocational goal;

1. 3. The eligible individual meets VR’s financial need

guidelines;

1. 4. The provider must be a Missouri licensed psychiatrist,

psychologist, clinical social worker, or professional counselor. The provider must possess a valid, unencumbered, unrestricted, and undisciplined Missouri license; and

1. 5. Psychotherapy may be authorized for a period up to

three (3) months. An additional three (3) months of therapy may be approved if the therapist feels that the consumer is making satisfactory progress that will lead to the attainment of the vocational goal specified on the IPE.

1. (2) 34 CFR sections 361.5(c)(39) and 361.48(b)(5) is hereby incorporated by reference and made part of this rule as published by the U.S. Government Publishing Office, 732 North Capitol Street NW, Washington, DC 20401-0001, in June 2023. Copies of this regulation can also be obtained from the Department of Elementary and Secondary Education, Office of Adult Learning and Rehabilitation Services, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese. mo.gov/governmental-affairs/dese-administrative-rules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

AUTHORITY: sections 161.092, 178.600, 178.610, and 178.620, RSMo 2016.* This rule previously filed as 5 CSR 90-5.430. Original rule filed Dec. 17, 1999, effective Aug. 30, 2000. Moved to 5 CSR 20-500.240, effective Aug. 16, 2011. Amended: Filed June 15, 2023, effective Jan. 30, 2024. *Original authority: 161.092, RSMo 1963, amended 1973, 2002, 2003, 2013, 2014; 178.600, RSMo 1963; 178.610, RSMo 1963; and 178.620, RSMo 1963.