PURPOSE: This rule establishes the standards for physical and mental restoration services provided by the Division of Vocational Rehabilitation, Department of Elementary and Secondary Education for individuals with disabilities pursuant to the Rehabilitation Act of 1973 as amended and the Code of Federal Regulations.

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 individ-

uals from an out-of-state hospital may be paid according to the rates and methods approved by the vocational rehabilitation agency in the state where the hospital is located;

1. (B) Surgical services for eligible individuals may be provided upon approval by the Division of Vocational Rehabilitation’s

1. (DVR) Medical Review Committee and 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;

   1. (C) Hearing aids may only be provided from a Missouri licensed hearing aid dealer and fitter upon the recommendation of a Missouri physician specializing in diseases of the ear or a Missouri certified audiologist. The recommendation must include the recommended type of aid and specifications or prescriptions. All licenses or certifications must be valid, unencumbered, unrestricted, and undisciplined.

      1. 1. Prior to purchase authorization, DVR

will—

1. A. Consult with the physician or audi-

ologist to determine feasibility of any repair or reconditioning of an existing aid;

1. B. Obtain estimates including the

itemized cost of the aid, batteries, service and warranty from more than one (1) licensed dealer when practical;

1. C. Request agency discounts;
2. D. Allow for the eligible individual’s

preference of vendor whenever possible; and

1. E. Ensure that the quality of aid,

accessories, service, warranty and cost effectiveness are evaluated; and/or

1. (D) Individuals with mental illness may be referred to the Missouri Department of Mental 5 CSR 20-500

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 DVR’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.

AUTHORITY: sections 161.092, 178.600, 178.610 and 178.620, RSMo 1994.* 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.

*Original authority: 161.092, RSMo 1963, amended 1973; 178.600, RSMo 1963; 178.610, RSMo 1963; and 178.620, RSMo 1963.