Miss. Admin. Code Title 32 — Rehabilitation and Disabilities

MISSISSIPPI INDUSTRIES FOR THE BLIND MISSISSIPPI INDUSTRIES FOR THE BLIND

Part 101 Mississippi Industries for the Blind

Chapter 1 Names, Purpose and Duties

32 Miss. Admin. Code Pt. 101, R. 1.1 Name

Pursuant to Miss. Code Ann. 43-3-103 this body shall be known as the Board of Directors (Board) for Mississippi Industries for the Blind (MIB), an agency of the state of Mississippi created by Miss. Code Ann. 43-3-101 et seq.

History

• Source: Miss. Code Ann. § 43-3-103 (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 1.2 Purpose

The purpose of the Board, which is set out in Miss. Code Ann. 43-3-103 is to govern MIB in conformity with Federal rules and regulations and the laws of the state of Mississippi and the United States of America.

History

• Source: Miss. Code Ann. § 43-3-103 (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 1.3 Duties of the Board

A. To serve as the governing body for MIB by establishing and implementing a mission statement for MIB B. To employ an Executive Director who shall serve as the executive and administrative head of MIB and to set said Executive Director’s salary C. To make and publish policies, rules and regulations as may be necessary for the effective administration and operation of MIB not inconsistent with the terms of Miss. Code Ann. 43-3-103 et seq. and the Federal rules and regulations and the laws of the state of Mississippi and the United States of America D. To adopt and publish rules and regulations, in it’s discretion, to establish a policy of sick leave with pay and personal leave with pay for MIB employees and to require that MIB offices be open and staffed on legal holidays as determined necessary by the Board of Directors E. To meet quarterly F. To annually elect officers G. To act as advocate for MIB H. To annually review all physical facilities of MIB I. To annually review the financial status of MIB including all contracts and the profits therefrom J. To annually review the personnel manual of MIB

History

• Source: Miss. Code Ann. § 43-3-103 (Rev. 2009)

Chapter 2 Membership

32 Miss. Admin. Code Pt. 101, R. 2.1 Composition of Board

The membership of the Board is established by Miss. Code Ann. 43-3-103

History

• Source: Miss. Code Ann. § 43-3-103 (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 2.2 Appointment and Approval

Miss. Code Ann. 43-3-103 sets out who shall appoint the various members of the Board. All Board members must be approved by the Mississippi State Senate.

History

• Source: Miss. Code Ann. § 43-3-103 (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 2.3 Vacancies

A. The Chair shall sign a letter addressed to the Governor and Lt. Governor by November 1 of each year reminding them of the Board member positions for which they will need to nominate someone for the upcoming year, such letters will be prepared by the Executive Director. B. If a vacancy occurs through resignation or dismissal for failure to attend meetings, and then the Chair will notify the appointing authority within thirty (30) days of said resignation or dismissal of the necessity to nominate another person to fill that position.

History

• Source: Miss. Code Ann. § 43-3-103 (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 2.4 Compensation of Board Members

Compensation for the Board will include travel and per diem for Board meetings and for any other expenses pre-approved by a vote of the Board or the Chair and the Executive Director.

History

• Source: Miss. Code Ann. § 25-3-41 (Rev. 2010); § 25-3-69 (Rev. 2010)

Chapter 3 Meetings of the Board

32 Miss. Admin. Code Pt. 101, R. 3.1 Overview

A. Meetings will conform to the Mississippi Open Meetings Act at Miss. Code Ann. 25-41-1 et seq. B. Meetings will be conducted pursuant to the latest version of Roberts Rules of Order revised.

History

• Source: Miss. Code Ann. § 25-41-1 (Rev. 2010)

32 Miss. Admin. Code Pt. 101, R. 3.2 Regularly Scheduled Meetings

A. The Board will hold four (4) regular meetings annually with the dates of these meetings being set for the next fiscal year at the first meeting held after July 1 of each year. B. The secretary to the Board will be required to post notice of regular meetings at all MIB facilities at least fifteen (15) calendar days prior to the meeting date and to distribute the same notice to other agencies and organizations as designated by the Board. C. The date of a regularly scheduled meeting can only be changed by agreement of a majority of Board members and must be published in the same manner with the new time, date, and place of the next regularly scheduled meeting at least five (5) working days prior to said meeting.

History

• Source: Miss. Code Ann. § 43-3-103 (4) (b) (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 3.3 Called Meetings

Notice for any called special meetings shall be posted in a prominent place available to examination and inspection by the general public in the building in which MIB normally meets within one (1) hour after such meeting is called. A copy of the notice shall be made part of the minutes.

History

• Source: Miss. Code Ann. § 25-41-13 (Rev. 2010)

32 Miss. Admin. Code Pt. 101, R. 3.4 Quorum

A quorum is a minimum of four (4) Board members.

History

• Source: Miss. Code Ann. § 43-3-103 (4) (b) (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 3.5 Attendance

A. If unable to attend meeting, a Board member must notify the Chair or the Executive Director as soon as possible. B. If anyone misses more than two (2) consecutive regularly scheduled meetings a majority of the Board may call for his or her resignation. If a majority of the Board votes to do so, the person responsible for appointing the absentee member shall be notified in writing of the member’s failure to attend and the appointing authority shall be requested by the Executive Director to fill the vacancy. C. A quorum (majority) must be in attendance to conduct business.

History

• Source: Miss. Code Ann. § 43-3-103 (4) (b) (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 3.6 Public Access to the Board

A. Members of the public are welcome to attend all meetings of the Board except for executive sessions B. Members of the public who would like to address the Board must submit their agenda item in writing to the Executive Director at least ten (10) working days before the Board meeting. Unless otherwise granted by the Board, the public will have five (5) minutes to address the Board. Personnel matters are considered confidential and will be brought before the Board in executive session in compliance with Section 25-41-7 (4) (a), Miss. Code Ann. as amended. C. Individuals who wish to be included on the Board’s agenda must submit a written request to the Board on the Agenda Request Form provided by the Board’s administrative assistant. The Secretary to the Board must receive this request at least ten (10) working days prior to the regularly scheduled Board meeting. Only the individual signing the Agenda Request Form will be recognized by the Board to speak for the five (5) minute period, unless otherwise granted by the Board.

History

• Source: Miss. Code Ann. § 43-3-103 (4) (b) (Rev. 2009); §25-41-1, et. seq. (Rev. 2010)

32 Miss. Admin. Code Pt. 101, R. 3.7 Teleconference Meeting

A. Section 25-41-5, Miss. Code Ann. (1972) as amended provides that a public body may conduct a meeting through teleconference or video means. A quorum of a public body as

prescribed by law may be at different locations for the purpose of conducting a meeting through teleconference or video means provided participation is available to the general public. Notice of any teleconference or video meetings shall be provided at least five (5) days in advance of the date scheduled for the meeting. The notice shall include the date, time, place and purpose for the meeting and shall identify the locations for the meeting. All locations shall be made accessible to the public. All persons attending the meeting at any of the meeting locations shall be afforded the same opportunity to address the public body as persons attending the primary or central location. Any interruption in the teleconference or video broadcast of the meeting shall result in the suspension of action at the meeting until repairs are made and public access restored. B. Votes taken during teleconference or video means shall be recorded be name in roll-call fashion and included in the minutes. Minutes of all meetings held by teleconference or video means shall be recorded as required by Section 25-41-11, Miss. Code Ann. (1972) as amended. Personnel matters are considered confidential and will be brought before the Board in executive session in compliance with Section 25-41-7 (4) (a), Miss. Code Ann. (1972) as amended. C. The public body shall make an audio recording of the meeting, if a teleconference medium is used, or an audio/visual recording, if the meeting is held by video means. The recording shall be preserved by the public body for a period of three (3) years following the date of the meeting and shall be available to the public. D. An agenda and materials that will be distributed to members of the public body and that have been made available to the staff of the public body in sufficient time for duplication and forwarding to all locations where public access will be provided shall be made available to the public at the time of the meeting.

History

• Source: Miss. Code Ann. § 25-41-5 (Rev. 2010)

32 Miss. Admin. Code Pt. 101, R. 3.8 Order of Business

The order of business for each regular and special meeting shall generally be recommended by the Executive Director and at the pleasure of the Chair. Board members wishing a particular item on the agenda must notify the Executive Director at least ten (10) working days prior to the meeting. The agenda will be available in alternate formats, i.e. Braille/large print upon request.

History

• Source: Miss. Code Ann. § 43-3-103 (4) (b) (Rev. 2009)

Chapter 4 Officers and Duties

32 Miss. Admin. Code Pt. 101, R. 4.1 Officers

The Board shall elect a Chair and a Vice Chair.

History

• Source: Miss. Code Ann. § 43-3-103 (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 4.2 Election and Terms A

Officers shall be elected at the first meeting after July 1 of each year or at the next regularly scheduled meeting after a vacancy occurs. B. Chair and Vice Chair are elected in terms of one (1) year. Each officer may not serve more than two (2) consecutive terms.

History

• Source: Miss. Code Ann. § 43-3-103 (4) (b) (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 4.3 Duties

A. The Chair shall: a) Preside at all Board meetings b) Sign the approved minutes of all meetings chaired c) Consult with the Executive Director and other Board members to set the agenda for said meeting d) Ensure that dates, times, places of meetings shall be posted pursuant to the Open Meetings Act B. The Vice Chair shall: a) Conduct all meetings when the Chairperson is absent b) Sign the approved minutes of all meetings chaired C. The Administrative Secretary to the Board shall: a) Insure that all approved minutes of Board meetings are submitted to the Executive Director b) Sign the approved minutes of all meetings

History

• Source: Miss. Code Ann. § 43-3-103 (4) (b) (Rev. 2009)

Chapter 5 Record Keeping

32 Miss. Admin. Code Pt. 101, R. 5.1 Minutes

A. It is required that minutes be kept of all business conducted at Board meetings, except for discussion held during executive sessions in accordance with Miss. Code Ann. 25-41-7 B. All written reports submitted at a Board meeting shall be attached to that meeting’s minutes. Such reports will be available in alternate formats upon request. C. Minutes shall reflect all who attended that meeting, all Board members who are absent, and all business conducted at that meeting except for discussions held during executive session in accordance with Miss. Code Ann. 25-41-7. D. Minutes of a Board meeting must be approved by the Board within the next two (2) consecutive regularly scheduled Board meetings. E. Minutes of the Board which have been approved will be signed by the person chairing said meeting and the Secretary to the Board who shall be responsible for maintaining and storing said minutes. F. Corrections approved by the Board will be the responsibility of the Board’s Administrative Assistant who acts as the Board’s secretary. Such corrected minutes will be distributed prior to the next regularly scheduled Board meeting.

History

• Source: Miss. Code Ann. § 25-41-11 (Rev. 2010)

32 Miss. Admin. Code Pt. 101, R. 5.2 Procedures for Inspecting and Copying Public Records of the Board

The following is intended for the purpose of providing reasonable written procedures concerning the cost, time, place and method of access, under the provisions of the MS Public Records Act (Open Records Act) [Section 25-61-5, et seq.]

A. Board minutes, the annual audit and other Board documents and/or reports may be inspected in the Office of the Executive Director but shall not be removed from his/her control and custody. B. All requests to inspect Board documents and/or records must be submitted to the Executive Director in writing specifically setting out the documents and/or records to be inspected. C. The Executive Director, upon receipt of any such request, shall review same and determine whether the records sought are exempt under the Mississippi Public Records Act, and shall either produce records or access to records or deny access to or production of the records sought within seven (7) working days from the date of the receipt of the request for the production of the record. If MIB is unable to produce a public record by the seventh working day after the request is made, MIB must provide a written explanation to the person making the request stating the record requested will be produced within the seven-day period unless there is a mutual agreement of the parties, but in no event shall the date for MIB’s production of the requested record be any later than fourteen (14) working days from the receipt by MIB of the original request. D. The cost of copying and mailing said documents and/or records shall be paid by the requesting party prior to the receipt of the copies. E. Cost of mechanical reproduction of documents and/or records will be calculated on the basis of actual cost. F. The mode of transmission will be designated by the requesting party who shall pay the actual cost of same. G. The Executive Director may waive any or all of the forgoing requirements related to written notice, time and method of access, prepayment of expenses whenever the determination is made that such waiver would be in the public’s best interest. H. There shall be no charge for inspection of the current Board records maintained by the Secretary to the Board. Costs of obtaining records from any storage facilities and the search for it shall be charged based on actual costs. I. Mailing costs shall be calculated at the applicable rate for each such mailing. If the request involves a notice to be given to a third party, the cost of mailing such notice via certified mail return receipt requested shall be charged to the person requesting such public records. J. There shall be a charge of $0.50 per page for each copy. Copies printed on both sides (front and back) shall be considered as two pages for copy charge purposes.

History

• Source: Miss. Code Ann. § 25-61-5 (Rev. 2010)

Chapter 6 Rules and Procedures

32 Miss. Admin. Code Pt. 101, R. 6.1 Approval

A. Rules and procedures will be available in alternate formats, i.e. Braille/large print. B. Rules and procedures must be approved by a majority of the Board.

History

• Source: Miss. Code Ann. § 43-3-103 (c) (D) (Rev. 2009)

32 Miss. Admin. Code Pt. 101, R. 6.2 Amendments

A. Proposed amendments to these rules and procedures must be submitted in writing to the Board at least thirty (30) calendar days prior to a regularly scheduled meeting. B. All amendments will require a majority of the Board for approval. C. All amendments to rules will comply with Administrative Procedures Act, Section 25-43- 1. 101, et seq. D. All amendments to the Board’s rules and procedures will be available in alternate formats, i.e. Braille/large print and will comply with Administrative Procedures Act, Section 25-43-1. 101, et seq.

History

• Source: Miss. Code Ann. § 43-103 (4) (b) (Rev. 2009); § 25-43-1.101, et. seq. (Rev.2010)

32 Miss. Admin. Code Pt. 101, R. 6.3 Administrative Rules (as required by Mississippi Administrative Procedures Law)

A. Oral Proceedings on Proposed Rules (suggested by 25-43-3. 104 (2) (d) not mandatory) a. Scope. This rule applies to all oral proceedings held for the purposes of providing the public with an opportunity to make oral presentations on proposed new rules and amendments to rules before Mississippi Industries for the Blind pursuant to 25-43-3.

b. When Oral Proceedings will be scheduled on Proposed Rules. Mississippi Industries for the Blind will conduct an oral proceeding on a proposed rule or amendment if requested by a political subdivision, an agency or ten (10) persons in writing within twenty (20) days after the filing of the notice of the proposed rule. c. Request Format. Each request must be printed or typewritten, or must be in legible handwriting. Each request must be submitted on standard business letter-size paper (8 ½ inches by 11 inches). Requests may be in the form of a letter addressed to Mississippi Industries for the Blind. d. Notice of Oral Proceeding. The date, time and place of all oral proceedings will be scheduled no earlier than twenty (20) days from the filing of this information with Secretary of State. e. Presiding Officer. The Executive Director or his/her designee, who is familiar with the substance of the proposed rule, shall preside at the oral proceeding on a proposed rule f. Public Presentation and Participation. a) At an oral proceeding on a proposed rule, persons may make oral statements and make documentary and physical submissions, which may include data, views, comments or arguments concerning the proposed rule b) Persons wishing to make oral presentations at such a proceeding shall notify Mississippi Industries for the Blind at least one (1) business day prior to the proceeding and indicate the general subject of their presentations. The presiding officer in his or her discretion may allow individuals to participate that have not previously contacted Mississippi Industries for the Blind. c) At the proceeding, those who participate shall indicate their names and addresses, identifying any persons or organizations they may represent, and provide any other information relating to their participation deemed appropriate by the presiding officer.

d) The presiding officer may place time limitations on individual oral presentations when necessary to assure the orderly and expeditious conduct of the oral proceeding. To encourage joint oral presentations and to avoid repetition, additional time may be provided for persons whose presentations represent the views of other individuals as well as their own views. e) Persons making oral presentations are encouraged to avoid restating matters that have already been submitted in writing. f) There shall be no interruption of a participate who has been given the floor by the presiding officer, except that the presiding officer may in his or her discretion interrupt or end the partisans time when the orderly conduct of the proceeding so requires. g. Conduct of Oral Proceeding. a) Presiding Officer. The presiding officer shall have authority to conduct the proceeding in his or her discretion for the orderly conduct of the proceeding. The presiding officer shall; (i) call proceeding to order; (ii) give a brief synopsis of the proposed rule, a statement of the statutory authority for the proposed rule, and the reasons provided by Mississippi Industries for the Blind for the proposed rule; (iii) call on individuals who have contacted Mississippi Industries for the Blind about speaking on or against the proposed rule; (iv) allow for rebuttal statements following all participant’s comments; (v) adjourn the proceeding. b) Questions. The presiding officer where time permits and to facilitate the exchange of information, may open the floor to questions or general discussion. The presiding office may question participants and permit the questioning of participants by other participants about any matter relating to that rule-making proceeding, including any prior written submissions made by those participants in that proceeding; but no participant shall be required to answer any question. c) Physical and Documentary Submissions. Submissions presented by participants in an oral proceeding shall be submitted to the presiding officer. Such submissions become the property of Mississippi Industries for the Blind and subject to Mississippi Industries for the Blind’s public records request procedure. d) Recording. Mississippi Industries for the Blind may record oral proceedings by stenographic or electronic means.

History

• Source: Miss. Code Ann. § 25-43-3.104 (Rev. 2010)

32 Miss. Admin. Code Pt. 101, R. 6.4 Declaratory Opinions [required by 25-43-2.103 (2)]

A. Scope. These rules set forth the Mississippi Industries for the Blind’s (hereinafter MIB). “MIB’s rules governing the form and content of requests for declaratory opinions and MIB’s procedures regarding the requests, as required by Mississippi Code 25-43-2.103. These rules are intended to supplement and be read in conjunction with the provisions of the Mississippi Administrative Procedures Law, which may contain additional information regarding the issuance of declaratory opinions. In the event of any conflict between these rules and the Mississippi Administrative Procedures Law, the latter shall govern.

B. Persons Who May Request Declaratory Opinions. Any person with a substantial interest in the subject matter may request a declaratory opinion from MIB by following the specified procedures. “Substantial interest in the subject matter” means; an individual, business, group or other entity that is directly affected by MIB’s administration of the laws within constitutional or statutory grant of authority in the subject matter at issue. C. Subjects Which May Be Addressed In Declaratory Opinions. MIB will issue declaratory opinions regarding the applicability to specified facts of: (1) a statue administered or enforceable by MIB or (2) a rule promulgated by MIB. MIB will not issue a declaratory opinion regarding a statue or rule which is outside the primary jurisdiction of the agency. D. Circumstances in Which Declaratory Opinions Will Not Be Issued. MIB may, for good cause, refuse to issue a declaratory opinion. The circumstances in which declaratory opinions will not be issued include, but at not necessarily limited to: a) Lack of clarity concerning the question presented b) There is pending or anticipated litigation, administrative action, or other adjudication which may either answer the question presented by the request or otherwise make an answer unnecessary c) The statue or rule on which a declaratory opinion is sought is clear and not in need of interpretation to answer the question presented by the request d) The facts presented in the request are not sufficient to answer the question presented e) The request fails to contain information required by these rules or the requestor failed to follow the procedure set for the in these rules f) The request seeks to resolve issues which have become moot, or are abstract or hypothetical such that the requestor is not substantially affected by the statute or rule on which a declaratory opinion is sought g) No controversy exists concerning the issue as the requestor is not faced with existing facts or those certain to arise which raise a question concerning the application of the statute or rule h) The question presented by the request concerns the legal validity of a statue or rule i) The request is not based upon facts calculated to aid in the planning of future conduct but is, instead, based on past conduct in an effort to establish the effect of that conduct j) No clear answer is determinable k) The question presented by the request involves the application of a criminal statute or a sets of facts which may constitute a crime l) The answer to the question presented would require the disclosure of information which is privileged or otherwise protected by law from disclosure m) The question is currently the subject of an Attorney General’s opinion request or has been answered by Attorney General’s opinion n) A similar request is pending before this agency or any other agency or a proceeding is pending on the same subject matter before any agency, administrative or judicial tribunal, or where such a opinion would constitute the unauthorized practice of law

o) Where issuance of a declaratory opinion may adversely affect the interests of the State, MIB or any of their officers or employees in any litigation which is pending or may reasonably be expected to arise p) The question involves eligibility for a license, permit, certificate or other approval by MIB or some other agency, and there is a statutory or regulatory application process by which eligibility for said license, permit, certificate or other approval would be determined E. Written Request Required. Each request must be printed or typewritten, or must be in legible handwriting. Each request must be submitted on standard business letter-size paper (8 ½ inches by 11 inches). Requests may be in the form of a letter addressed to MIB F. Where to Send Requests. All requests must be mailed, delivered or transmitted via facsimile to MIB. The request shall clearly state that it is a request for a declaratory opinion. No oral, telephone requests or email requests will be accepted for official opinions. G. Name, Address and Signature of Requestor. Each request must include the full name, telephone number and mailing address of the requestor. All requests shall be signed by the person filing the request, who shall attest that the request complies with the requirements set for the in these rules, including but not limited to a full, complete, and accurate statement of relevant facts and that there are no related proceedings pending before any other administrative or judicial tribunal. H. Question Presented. Each request shall contain the following: a) A clear and concise statement of all the facts on which the opinion is requested b) A citation to the statute or rule at issue c) The question (s) sought to be answered in the opinion, stated clearly d) A suggested proposed opinion from the requestor, stating the answers desired by petitioner and a summary of the reasons in support of those answers e) The identity of all other known persons involved in or impacted by the described factual situation, including their relationship to the facts, name, mailing address and telephone number; and f) A statement to show that the persons seeking the opinion has a substantial interest in the subject matter I. Time for MIB Response. Within forty-five (450 days after the receipt of a request for a declaratory opinion which complies with the requirements of these rules, MIB shall, in writing: a) Issue a declaratory opinion regarding the specified statute or rule as applied to the specified circumstances b) Decline to issue a declaratory opinion, stating the reasons for its actions; or c) Agree to issue a declaratory opinion by a specified time but not later than ninety (90) days after receipt of the written request The forty-five (45) day period shall begin running on the first State of Mississippi business day on or after the request is received by MIB, whichever is sooner. J. Opinion Not Final for Sixty Days. A declaratory opinion shall not become final until the expiration of sixty (60) days after the issuance of the opinion. Prior to the expiration of sixty (60) days, MIB may, in its discretion, withdraw or amend the declaratory opinion for any reason which is arbitrary or capricious. Reasons for withdrawing or amending an

opinion include, but are not limited to a determination that the request failed to meet the requirements of these rules or that the opinion issued contains a legal or factual error. K. Notice by MIB to Third Parties. The MIB may give notice to any person, agency or entity that a declaratory opinion has been requested and may receive and consider data, facts, arguments and opinions from other persons, agencies or other entities other than the requestor. L. Public Availability of Requests and Declaratory Opinions. Declaratory opinions and requests for declaratory opinions shall be available for public inspection and copying in accordance with the Public Records Act and MIB’s public records request procedure. All declaratory opinions and requests shall be indexed by name and subject. Declaratory opinions and requests which contain information which is confidential or exempt from disclosure under the Mississippi Public Records Act or other laws shall be exempt from this requirement and shall remain confidential. M. Effects of a Declaratory Opinion. MIB will not pursue any civil, criminal or administrative action against a person who is issued a declaratory opinion from MIB and who, in good faith, follows the direction of the opinion and acts in accordance therewith unless a court of competent jurisdiction holds that the opinion is manifestly wrong. Any declaratory opinion rendered by MIB shall be binding only on MIB and the person to whom the opinion is issued. No declaratory opinion will be used as precedent for any other transaction or occurrence beyond that set forth by the requesting person.

History

• Source: Miss. Code Ann. § 25-43-2.103 (Rev. 2010)

REHABILITATION SERVICES REHABILITATION SERVICES

Part 1 Part 1 Office of Special Disability Programs Manual (OSDP)

32 Miss. Admin. Code Pt. 1, R. 10.0 Personal Care Services

11. Respite Services

32 Miss. Admin. Code Pt. 1, R. 11.0 Respite Services

12. Electronic Visit Verification (EVV)

32 Miss. Admin. Code Pt. 1, R. 12.0 EVV

13. Transition Assistance Services

32 Miss. Admin. Code Pt. 1, R. 13.0 Transition Assistance Services

14. Case Service Record

32 Miss. Admin. Code Pt. 1, R. 14.0 Case Service Record

15. Case Record Closures

32 Miss. Admin. Code Pt. 1, R. 15.0 Case Record Closures

16. Assistive Technology

32 Miss. Admin. Code Pt. 1, R. 16.0 Assistive Technology

17. Authorization of Services

32 Miss. Admin. Code Pt. 1, R. 17.0 Authorization of Services

18. DME/SMS and Supplies

32 Miss. Admin. Code Pt. 1, R. 18.0 DME/SMS and Supplies

19. Prosthetic and Orthotic & Appliances

32 Miss. Admin. Code Pt. 1, R. 19.0 Prosthetic and Orthotic & Appliances

Mission Statement

It is the mission of the Mississippi Department of Rehabilitation Services to provide appropriate and comprehensive services to Mississippians with disabilities in a timely and effective manner. Programs and services assist individuals with disabilities to live independently in their home and community.

Service Limitations Waiver

The OSDP Policy and Procedure Manual establishes guidelines in terms of case service procedures and expenditures. In instances where limitations have been written into policies, OSDP leadership reserves the right to waive any such limitations in order to meet the specific needs of the individual. Any policies other than those set forth by federal and/or state law or regulations are not absolute and may be considered for exceptions or waiver.

SECTION 1: GENERAL POLICIES

1.0 Non-Discrimination

No individual or group of individuals is excluded from or found ineligible of services on the basis of age, color, religion, gender, gender identity, national origin, type of disability, marital status, sexual orientation or military status.

Individuals eligible for services in the State will not be discriminated against based on their geographic residence in Mississippi.

1.1 Confidential Nature of Medical Information (HIPAA) The Health Insurance Portability and Accountability Act of 1996 (PL 104- 191), also known as HIPAA is a federal law that sets additional standards to protect the confidentiality of individually identifiable health information. Individually identifiable health information is information that identifies or could be used to identify an individual that relates to the:

o Past, present, or future physical mental health or condition of the individual; o Provision of health care to the individual; or o Past, present, or future payment for the provision of health care to the individual. HIPAA also includes provisions for the privacy and security of health information, specifies electronic standards for the transmission of health information and requires unique identifiers for providers.

1.2 Member Authorized or Legal Representative

Members have the right to appoint a designated authorized representative. The authorized

representative is the only person that can permit the use or disclosure or obtain information on behalf of the member.

1.3 Client Assistance Information MDRS will advise and inform applicants and individuals eligible for services and benefits available under the Rehabilitation Act of 1973 (Rehabilitation Act), as amended by the Workforce Innovation and Opportunity Act (WIOA), and title I of the Americans with Disabilities Act of 1990 (ADA), including students with disabilities under section 113 and individuals with disabilities employed at subminimum wage under section 511 of the Rehabilitation Act. In addition, applicants and eligible individuals may be provided advocacy and representation to ensure their rights in their relationship with projects, programs, and services to protect their rights provided under the Rehabilitation Act.

1.4 Abuse, Neglect, Exploitation of a Vulnerable Adult

It is the policy of MDRS that the persons we serve be treated with dignity and respect at all times. This includes the right to be free from psychological and/or physical abuse, neglect, and/or exploitation. Incidents of abuse, neglect, exploitation will be reported to the appropriate entities.

1.5 Accessibility of Individual Identifiable Health Information to the Member

Except as provided elsewhere in this section, if requested in writing by an applicant or eligible individual or representative, MDRS makes all requested information in an individual’s record of services accessible to the individual and will release the information to the individual or the individual’s representative in a timely manner.

MDRS has established reasonable fees to cover costs of duplicating records or making extensive searches and has established policies and procedures governing access to records.

If duplication of records is requested, by a member or a member’s representative, for that member’s own use, no fees for reproducing those records shall be charged, unless the volume of such requested information is so extensive as to exceed 20 pages. Should a request for information exceed 20 pages, the Agency employee processing the request shall institute common procedure for such requests by persons authorized to have access to this information by contacting the Office of Finance for the Agency and requesting a “fund number” for receipt of money collected to defray the cost of duplicating the requested records. The employee may then charge the requesting party a fee of $.25 (twenty-five cents) for each page in excess of 20 pages for the information. Payment should be requested in the form of check or money order, payable to the “Mississippi Department of Rehabilitation Services.” When funds are collected, a receipt will be issued to the purchaser. A duplicate receipt will be forwarded to the State along with the check or money order. There will be no charge to State or Federal agencies associated in providing services directed toward the member’s rehabilitation program, or any other agencies that have an exchange of information agreement with this Agency.

1.6 Releasing Individual Identifiable Health Information That May Be Harmful to the Member

Medical, psychological, or other information that MDRS determines may be harmful to the individual may not be released directly to the individual, but must be provided to an individual, which may include, among others, an advocate, a family member, or a qualified medical or mental health professional, unless a representative has been appointed by a court to represent the individual, in which case the information must be released to the court- appointed representative.

1.7 Releasing Individual Identifiable Health Information Obtained From Other Sources

If personal information has been obtained from another agency or organization, it may be released only by, or under the conditions established by, the other agency or organization.

1.8 Inaccurate or Misleading Individual Identifiable Health Information

An applicant or eligible individual who believes that information in the individual’s record of services is inaccurate or misleading may request that the designated Agency amend the information. If the information is not amended, the request for an amendment will be documented in the record of services.

1.9 Release of Information for Audit, Evaluation, and Research

Personal information may be released to an organization, agency, or individual engaged in audit, evaluation, or research only for purposes directly connected with the administration of the rehabilitation program or for the purposes that would significantly improve the quality of life for applicants and eligible individuals and only if the organization, agency, or individual assures that:

▪ The information will be used only for the purpose for which it is being provided. ▪ The information will be released only to persons officially connected with the audit, evaluation, or research. ▪ The information will not be released to the involved individual. ▪ The information will be managed in a manner to safeguard confidentiality; and ▪ The final product will not reveal any personal identifying information without the informed written consent of the involved individual or the individual’s representative.

1.10 Releasing Individual Identifiable Health Information for Legal Investigations

MDRS must release personal information in response to investigations in connection with the law enforcement, fraud, or abuse, unless expressly prohibited by Federal or State laws or regulations, and in response to an order issued by a judge, magistrate, or other authorized judicial officer.

MDRS also may release personal information in order to protect the individual or others if the individual poses a threat to his or her safety or to the safety of others.

Notice

When the Agency makes a disclosure to any person or entity other than the client, the following or similar statement shall accompany the disclosure:

NOTICE

THIS IS CONFIDENTIAL INFORMATION FROM THE RECORDS OF THE MISSISSIPPI DEPARTMENT OF REHABILITATION SERVICES. STATE AND FEDERAL LAWS AND REGULATIONS PROHIBIT YOU FROM MAKING ANY FUTHER DISCLOSURE OF THIS INFORMATION WITHOUT THE INFORMED WRITTEN CONSENT OF THE CLIENT FOR WHOM THIS INFORMATION PERTAINS. ANY SUCH FURTHER DISCLOSURE COULD RESULT IN CIVIL OR CRIMINAL LIABILITY.

1.11 Release of Information Regarding Deceased Member

If information is requested concerning a deceased member, the Agency shall release such information only to the executor of a probate will or the administrator of the estate upon written proof of such status by the court. No other heirs or family members shall be given any information without a court order.

1.12 Disposal of Case Records

When disposing of records, care must be taken to prevent inappropriate disclosure of confidential information contained in Agency files. Such files must be shredded, burned, or otherwise destroyed to prevent the unwarranted use of this information.

Case records can be shredded six (6) years after the date of case closure.

1.13 Notice of Action (Home and Community Based Waiver Services)

The applicant/member will be informed in writing of a decision that will result in the following:

• Being determined ineligible for services; • The amount (quantity) of the service the member will receive; • The request for particular services being denied; • Being determined ineligible for continued services.

The Notice of Action shall contain the following information:

• A description of the action the provider has taken or intends to take; • An explanation for the action;

• Notification that the member/representative has the right to file an appeal; • Procedures for filing an appeal; • Notification of member/representative’s right to request a Fair Hearing; • Notice that the member/representative has the right to have benefits continued pending the resolution of an appeal; and • The specific regulations or the change in Federal or State Law that supports or requires the action. (Authority: Title 42, CFR 431, Subpart E)

1.14 Advance Notice (Home and Community Based Waiver Services)

Notice of decisions must be given in advance to ensure members have the right to appeal. Timelines are set for the use of appropriate interventions and opportunities for conflict resolution through mediation or other techniques before initiating actions to suspend, deny or terminate services. These timelines are as follows:

Advance Notice – The member must receive a notice at least 10 (ten) calendar days before the effective date of an action.

Advance Notice Less Than 10 (ten) days – The member may be given a notice less than 10 (ten) days before the action will occur if the following occurs:

o There is factual information confirming the death of the member; o The member has been admitted to a nursing home; o The member has been admitted to a hospital/institution for more than 30 days; o Member gives information that requires termination or reduction of services and indicates that he/she understands that this must be the result of supplying that information (i.e. states he/she no longer wants services); o Whereabouts of the member are unknown and the post office returns agency mail directed to him indicating no forwarding address; o Member has been accepted for Medicaid services in another state; o Loss of Medicaid eligibility. The effective date of the action must match the effective date of the termination of Medicaid eligibility.

Advance Notice In Cases of Probable Fraud – A notice may be given to the member five (5) days before an action if there are facts that have been verified, if possible, through reliable sources, that there is probable fraud by the member.

1.15 Hearings and Appeals (Home and Community Based Services)

Decisions that result in services being denied, terminated, or reduced may be appealed. The member/legal representative has thirty (30) days from the date on the notice to appeal the decision. All appeals must be in writing.

The member/legal representative is entitled to an initial appeal at the local level with the MDRS/OSDP Counselor and the immediate supervisor. The action will be explained at that time. The local hearing will be documented and become a permanent part of the member file.

If the member/legal representative does not agree with the decision made following the local hearing, he/she may appeal that decision by requesting a State-level hearing within 15 days of the notice of the local hearing decision. The member/legal representative must submit this request in writing to the Division of Medicaid. Upon receiving the notification from the Division of Medicaid that the member has requested a State level hearing, the OSDP Case Manager/District Manger assigned will prepare a copy of the pertinent case file documentation used to reach the decision and send the copy to OSDP in the State Office. The copy of the documentation must be forwarded to the Division of Medicaid no later than five (5) days after MDRS has been notified that the member has requested a State level hearing.

The Division of Medicaid will assign a hearing officer. The member/legal representative will be given advance notice of the hearing date, time, and place. The hearing may be conducted with all parties involved present, or it may be conducted as a conference call (telephone) hearing. The hearing will be recorded.

The hearing officer will make a recommendation, based on all evidence presented at the hearing, to the Executive Director of the Division of Medicaid. The Executive Director will make the final determination of the case, and the member/legal representative will receive written notification of the decision. The final administrative action, including state or local, will be made within ninety (90) days of the date of the initial request for a hearing. OSDP will be notified by the Division of Medicaid to either initiate/continue or terminate/reduce services.

During the appeals process, contested services that were already in place must remain in place, unless the decision is one of immediate termination due to possible danger or racial or sexual harassment of the service providers. The OSDP Case Manager/registered nurse is responsible for ensuring that the member receives all services that were in place prior to their receipt of the notice that informed them that an action will occur regarding services.

1.16 The False Claims Act (Deficit Reduction Act of 2005)

The Department of Rehabilitation Services has a strong and continuing commitment to ensure that its services are conducted in accordance with applicable laws relating to all professional practices, third party reimbursement, and contractual and legal obligations. Knowledge of applicable laws that could affect the Department is essential for employees. One such law is the False Claims Act.

The False Claims Act is aimed at the following conduct:

(1) knowingly presenting or causing to be presented a false or fraudulent claim for payment to the government

(2) knowingly using a false record or statement to obtain payment on a false or fraudulent claim paid by the government; or

(3) engaging in a conspiracy to defraud the government by getting a false or

fraudulent claim allowed or paid.

For purposes of the False Claims Act, the terms “knowing” and “knowingly” mean that a person, with respect to information:

(1) has actual knowledge of the information

(2) acts in deliberate ignorance of the truth or falsity of the information; or

(3) acts in reckless disregard of the truth or falsity of the information, and no proof of specific intent to defraud is required.

Under the False Claims Act, those who knowingly submit, or cause another person or entity to submit, false claims for payment of government funds are liable for three times the government’s damages plus civil penalties of $5,000 to $10,000 per false claim. Examples of fraud include, but are not limited to:

• billing for services not rendered; • requesting, offering, or receiving a kickback, bribe, or rebate; • using an incorrect or inappropriate provider number in order to be paid; • selling or sharing patients’ Medicare/Medicaid numbers so false claims can be filed; • falsifying information on applications, medical records, billing statements, and/or cost reports or on any statement filed with the government; • submitting time and task (services) which were not provided; • filing a false time entry/authorization/claim; • submitting false invoice; • billing for equipment/supplies never ordered; • billing Medicaid/Medicare for new equipment but providing the member used equipment; • billing Medicaid/Medicare for expensive equipment but providing the member cheap equipment; and • charging more than once for the same service.

For more detailed language of the Statute see Appendix 1.

Furthermore, to encourage citizens to report violations, certain protections are in place to shield an individual from retaliation for bringing suit against his or her employer. Any such individual is protected under the “whistleblower” section of the False Claims Act.

1.17 Appeal Process for Non-Waiver Clients

MDRS provides an opportunity to request a Fair Hearing to individuals:

1. Who are not given the choice of home and community-based services as an alternative to the institutional care, 2. Who are denied the service(s) of their choice or the provider(s) of their choice, or 3. Whose services are denied, suspended, reduced, or terminated.

MDRS must provide the individual with a Notice of Action (NOA) via certified mail as required in 42 CFR §431.210. The NOA must include:

• A description of the action the provider has taken or intends to take, • An explanation for the action, • Notification that the participant has the right to file an appeal, • Procedures for filing an appeal, • Notification of participant’s right to request a Fair Hearing, • Notice the participant has the right to have benefits continued pending the resolution of the appeal, and • The specific regulations or the change in Federal or State law that supports or requires the action.

The participant or his/her representative may request to present an appeal through a local- level hearing, a state-level hearing, or both. The request for a local or state hearing must be made in writing by the participant or his/her legal representative.

The participant may be represented by anyone he/she designates. If the participant elects to be represented by someone other than a legal representative, he/she must designate the person in writing.

The participant has thirty (30) days from the date the appropriate notice is mailed to request either a local or state hearing. This thirty (30) day filing period is extended if the participant can show good cause for not filing within (30) days.

A hearing cannot be scheduled until a written request is received by MDRS or the State (MDRS) office. If the written request is not received within the thirty (30) days of the NOA, services will be discontinued.

At the local hearing level, MDRS issues a determination within thirty (30) days of the date of the initial request for a hearing.

If a local appeal is received within the 30 days of receipt of the Notice of Action, the District Manager has five (5) days to meet with the participant to address their appeal. If the District Manager concurs with the initial discharge NOA, he/she will send a written notice to the client within five (5) business days. The letter will include information on

how to request a State (MDRS) hearing. A State (MDRS) hearing request must be made within fifteen (15) days of the mailing date of the local hearing decision.

At the State office hearing level, MDRS issues a determination within ninety (90) days of the date of the initial request for a hearing. The participant or his representative has the following rights in connection with a local or state hearing:

1. The right to examine at a reasonable time before the date of the hearing and during the hearing the contents of the applicant or recipient’s case record. 2. The right to have legal representation at the hearing and to bring witnesses. 3. The right to produce documentary evidence and establish all pertinent facts and circumstances concerning eligibility. 4. The right to present an argument without undue interference and to question or refute testimony or evidence, including an opportunity to confront and cross- examine adverse witnesses.

Services must remain in place during any appeal process, except when there is a threat of harm of the participant or the service provider.

1.18 Whistleblower

A whistleblower is an individual who makes an initial report to the appropriate government entity or law enforcement that a false claim has occurred or may have occurred.

Additionally, a whistleblower is one who participates in investigations, testimony, or assistance in an action filed or to be filed under the False Claims Act.

Whistleblower Protection

The False Claims Act provides protection to individuals whose employer retaliates against him/her because of the employee's participation in an action taken under the False Claims Act. The protection is available to any employee who is terminated, demoted, threatened, harassed or otherwise discriminated against by his or her employer because the employee investigates, files or participates in an action under the False Claims Act. This "whistleblower" protection includes reinstatement and damages of double the amount of lost wages if the employee is terminated, and any other damages sustained if the employee is otherwise discriminated against. What Protections Are Afforded to Whistleblowers? 1. An employer may not make, adopt, or enforce any rule, regulation, or policy preventing an employee from being a whistleblower. 2. An employer may not retaliate against an employee who is a whistleblower. 3. An employer may not retaliate against an employee for refusing to participate in an

activity that would result in a violation of a state or federal statue, or a violation or non-compliance with a state or federal rule or regulation. 4. An employer may not retaliate against an employee for having exercised his or her rights as a whistleblower in any former employment.

1.19 Fraud/Abuse

MDRS/OSDP endorses the concept that people who provide services are essentially honest and are entitled to the same protection under the law as all other individuals. However, when there is an indication of potential fraud, the allegations must be investigated.

MDRS/OSDP is responsible for identifying, investigating, and referring cases of suspected fraud or abuse of Medicare or Medicaid.

To help carry out this responsibility, OSDP must be prepared to exclude paying for services when any provider defrauds or abuses the Medicare or Medicaid program.

To determine the existence of fraud and/or abuse, the following must be established:

• intentional misstatement or concealment by direct care worker or vendor created a false impression; • MDRS/OSDP paid the direct care worker or vendor based on the false impression, when the payment would not have been made if the truth had been known; or • practices are inconsistent with sound fiscal, business practices, and these inconsistent practices result in unnecessary cost to the program and payment for services that were not provided.

Examples of fraud include, but are not limited to:

• billing for services not rendered; • requesting, offering, or receiving a kickback, bribe, or rebate; • using an incorrect or inappropriate provider number in order to be paid; • selling or sharing patients’ Medicare/Medicaid numbers so false claims can be filed; • falsifying information on applications, medical records, billing statements, and/or cost reports or on any statement filed with the government; • submitting time and task (services) which were not provided; • filing a false time log/authorization/claim; • submitting a false invoice; • billing for equipment/supplies never ordered; • billing Medicaid/Medicare for new equipment but providing the member used equipment; • billing Medicaid/Medicare for expensive equipment but providing the member cheap equipment; and • charging more than once for the same service.

Pursuant to United States Code § 3729. False claims (a) LIABILITY FOR CERTAIN ACTS.— (1) IN GENERAL, any person who— (A) knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval; (B) knowingly makes, uses, or causes to be made or used, a false record or statement material to a false or fraudulent claim; (C) conspires to commit a violation of sub1paragraph (A), (B), (D), (E), (F), or (G); is liable to the United States Government for a civil penalty of not less than $5,000 and not more than $10,000, as adjusted by the Federal Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note; Public Law 104–410 1), plus 3 times the amount of damages which the Government sustains because of the act of that person.

The current FCA penalty, as of February 12, 2024, is “Min $13,946, Max $27,894” plus treble damages (three times the amount that the government is defrauded).

In addition, if MDRS receives an overpayment from Medicaid, MDRS shall:

• report and return the overpayment to the Mississippi Division of Medicaid; • notify the Mississippi Division of Medicaid in writing of the reason for the overpayment; • must be reported and returned by the later of; a) the date which is 60 days after the date on which the overpayment was identified; or b) the date any corresponding cost report is due, if applicable.

How To Report Fraud or Abuse

You can report fraud or abuse multiple ways as listed below, including by phone, postal mail, fax and online forms. It is advised that you do not email forms or submit online forms with protected health information or personally identifiable information, to protect confidentiality in accordance with the Health Insurance Portability and Accountability Act of 1996.

MS Department of Rehabilitation Services:

• Phone: 601-853-5233 • FAX: 601-853-5218 • Mailing Address: ATTN: Office of Program Integrity 1281 Hwy. 51 North Madison, MS 39110

MS Division of Medicaid Contact Information:

• Toll-free: 800-880-5920 • Phone: 601-576-4162 • FAX: 601-576-4161 • Mailing Address: ATTN: Office of Program Integrity 550 High Street, Suite 1000 Jackson, MS 39201

Office of Inspector General (OIG) Hotline Contact Information:

• Online form • Toll-free: 800-447-8477 • FAX: 800-223-8164 • Mailing Address: U.S. Department of Health & Human Services Office of Inspector General ATTN: OIG Hotline Operations P.O. Box 23489 Washington, D.C. 20026

1.20 Fingerprint and Criminal Background Checks

As of July, 1, 2010, in accordance with Section 37-33-157 of the Mississippi Code Annotated of 1972, the Mississippi Department of Rehabilitation Services (also referred to herein as “MDRS” and “department”) is authorized to fingerprint and perform state and federal background checks on persons performing services for or on behalf of the department. This includes a current state and federal criminal history record check, child abuse registry check, sex offender registry check, and vulnerable person abuse or neglect check.

MDRS is authorized to use the results of the fingerprinting and background checks for the purposes of employment decisions and/or actions and service provision to consumers of the department's services.

Specifically, any person who has been convicted of a felony in this state or any other jurisdiction is not eligible to be employed as a direct care worker (DCW) with MDRS.

Any person subject to registration as a sex offender in this state or any other jurisdiction is not eligible to be employed as a DCW by MDRS. Likewise, any person subject to registration in a child abuse registry, or convicted of a criminal offense related to the abuse or neglect of a vulnerable person or a child in this state or any other jurisdiction, is not eligible to be employed as a direct care worker (DCW) with MDRS.

Any person who has been charged with or convicted of certain misdemeanor crimes that could adversely affect the health, safety or welfare of the participants of MDRS is precluded from employment as a DCW. Such misdemeanors include, but are not limited to:

(a) Neglect or abuse of a vulnerable adult, (b) Theft, (c) Indecent exposure, (d) Shoplifting, (e) Forgery, (f) Assault, (g) Misconduct involving weapons, firearms, or explosives (h) Unlawful drug possession, use, or sale, (i) Domestic violence, (j) Arson, (k) Endangerment, (l) Identity theft, (m) Fraudulent use of a credit card

MDRS reserves the right to review and consider other misdemeanor charges and convictions on a case-by-case basis.

The aforementioned background and registry checks will be performed prior to a DCW’s employment with the department, every two (2) years thereafter, and as deemed necessary by MDRS. If performed prior to the two years, the HR department must be consulted first. In the event that an adverse finding or findings are identified within the criminal background and registry checks, the person will be disqualified from being employed as a DCW if such findings are discovered prior to employment with MDRS, and the person will be terminated immediately if discovered subsequent to the person’s employment with MDRS. However, the person can be found eligible for employment or re-employment in the event that he or she can prove that they were not found guilty of the offense for which they were denied employment or for which they were terminated. Acceptable proof of a not guilty verdict for a criminal offense shall be in the form of a certified court copy of a not guilty verdict judgment, or a certified copy of a court abstract evincing a not guilty verdict. In the case of a disqualifying misdemeanor criminal charge, a certified court copy of a release, dismissal or nolle prosequi of such charge or charges shall be considered as proof of such a disposition by the court in which the charges were brought. If the DCW refuses to have an updated background check, they will be terminated.

MDRS and its agents, officers, employees, attorneys and representatives shall be exempt from liability for any findings, recommendations or actions taken through the use of the results of the fingerprinting and background checks; and for related purposes.

1.21 Direct Care Worker (DCW) Social Media Policy

It is considered to be protected expression for Direct Care Workers (DCWs) to engage in social media activity concerning issues of public concern, while on personal time and in a personal capacity. DCWs maintain their First Amendment rights, but any speech or expression, even in a personal capacity, causing disruption or that undermines the effectiveness and/or operation of AbilityWorks, Inc., and MS Department of Rehabilitation Services (MDRS) is prohibited.

Any of the following social media activity, comments, expression or posts by a DCW in his or her professional or personal capacity are also prohibited:

a) Content that is discriminatory, harassing, or physically threatening; b) Disclosure of personal information that is confidential or proprietary; c) Content that demonstrates unlawful conduct.

DCWs who violate this policy are subject to termination.

1.22 DCW Electronic Visit Verification (EVV) and Smart Device Requirements Policy

In December 2016, Congress enacted the 21st Century Cures Act, which requires all states to implement Electronic Visit Verification (EVV) for all Medicaid financed Personal Care Attendants (PCAs). EVV is a process that uses technology to verify provider visits for personal care services in the home. It gives PCAs, Case Managers and the Division of Medicaid access to service delivery information in real time. The HHAeXchange smart device application will be the tool used to provide this information.

Effective August 1, 2023, all PCAs are required to have access to a smart device (i.e. smart phone, iPad, tablet, etc.). The smart device needs to be compatible with downloading the HHAeXchange EVV application where services are rendered. WiFi and internet connections must be accessed routinely for the functionality of this application.

The HHAeXchange application will electronically document time in and time out features and tasks that are performed in the home of the participant on a shift by shift basis. The mobile application is GPS-enabled, so it will log the address where the PCA is clocking in and out to ensure they are at the proper location during their shift.

PCAs will be paid based on the data received through this smart device application. The PCA may only work hours approved on the participants’ Plan of Services and Support (PSS). PCAs who knowingly work over the approved hours, without prior approval, will be subject to termination. In addition, any PCA who allows the participant, another PCA or any other individual to falsely clock in on their behalf will be terminated immediately.

1.23 Conflict of Interest and Improper Use of Office

Miss. Code Ann. § 25-4-101. Legislative Declaration of Public Policy

The legislature declares that elective and public office and employment is a public trust and any effort to realize personal gain through official conduct, other than as provided by law, or as a natural consequence of the employment or position, is a violation of that trust. Therefore, public servants shall endeavor to pursue a course of conduct which will not raise suspicion among the public that they are likely to be engaged in acts that are in violation of this trust and which will not reflect unfavorably upon the state and local governments.

Miss. Code. Ann. § 25-4-105. Contract Restrictions and Other Prohibited Conduct; Penalties

(1) No public servant shall use his official position to obtain, or attempt to obtain, pecuniary benefit for himself, other than that compensation provided for by law, or to obtain, or attempt to obtain, pecuniary benefit for any relative or any business with which he is associated.

(2) No public servant shall be interested, directly or indirectly, during the term for which he shall have been chosen, or within one (1) year after the expiration of such term, in any contract with the state, or any district, county, city or town thereof, authorized by any law passed or order made by any board of which he may be or may have been a member.

(3) No public servant shall:

(a) Be a contractor, subcontractor or vendor with the governmental entity of which he is a member, officer, employee or agent, other than in his contract of employment, or have a material financial interest in any business which is a contractor, subcontractor or vendor with the governmental entity of which he is a member, officer, employee or agent.

(b) Be a purchaser, direct or indirect, at any sale made by him in his official capacity or by the governmental entity of which he is an officer or employee, except in respect of the sale of goods or services when provided as public utilities or offered to the general public on a uniform price schedule.

(c) Perform any service for any compensation for any person or business after termination of his office or employment in relation to any case, decision, proceeding or application with respect to which he was directly concerned or in which he personally participated during the period of his service or employment.

(4) Notwithstanding the provisions of subsection three (3) of this section, a public servant or his relative:

(a) May be a contractor or vendor with any authority of the governmental entity other than the authority of the governmental entity of which he is a member, officer, employee or agent or have a material financial interest in a business which is a contractor or vendor with any authority of the governmental entity other than the authority of the governmental entity of which he is a member, officer, employee or agent where such contract is let to the lowest and best bidder after competitive bidding and three (3) or more legitimate bids are received or where the goods, services or property involved are reasonably available from two (2) or fewer commercial sources, provided such transactions comply with the public purchases laws.

(b) May be a subcontractor with any authority of the governmental entity other than the authority of the governmental entity of which he is a member, officer, employee or agent or have a material financial interest in a business which is a subcontractor with any authority of the governmental entity other than the authority of the governmental entity of which he is a member, officer, employee

or agent where the primary contract is let to the lowest and best bidder after competitive bidding or where such goods or services involved are reasonably available from two (2) or fewer commercial sources, provided such transactions comply with the public purchases laws.

(c) May be a contractor, subcontractor or vendor with any authority of the governmental entity of which he is a member, officer, employee or agent or have a material financial interest in a business which is a contractor, subcontractor or vendor with any authority of the governmental entity of which he is a member, officer, employee or agent: (i) where such goods or services involved are reasonably available from two (2) or fewer commercial sources, provided such transactions comply with the public purchases laws; or (ii) where the contractual relationship involves the further research, development, testing, promotion or merchandising of an intellectual property created by the public servant.

(5) No person may intentionally use or disclose information gained in the course of or by reason of his official position or employment as a public servant in any way that could result in pecuniary benefit for himself, any relative, or any other person, if the information has not been communicated to the public or is not public information.

(6) Any contract made in violation of this section may be declared void by the governing body of the contracting or selling authority of the governmental subdivision or a court of competent jurisdiction and the contractor or subcontractor shall retain or receive only the reasonable value, with no increment for profit or commission, of the property or the services furnished prior to the date of receiving notice that the contract has been voided.

SECTION 2: OSDP PROGRAM OVERVIEW

2.0 Independent Living (IL) Waiver

The statutory basis for this program is §1915 c (7) (B) of the Social Security Act. The Independent Living (IL) Waiver is a Medicaid Home and Community-Based Services (HCBS) program operated by MDRS and administered by the Mississippi Division of Medicaid. The IL Waiver allows Mississippi to provide services that are not available under the regular Medicaid State Plan program. Waiver applicants/members receive services through the IL Waiver and through other non-waiver service providers that are necessary to provide a safe alternative to nursing facility (NF) placement.

Requirements of the program include:

1. Must be 16 years of age or over; 2) Exhibit severe orthopedic and/or neurological impairment that renders the person dependent on others, assistive devices, other types of assistance, or a combination of the three to accomplish the activities of daily living; 3) Be able to express ideas and wants either verbally or nonverbally with caregivers, personal care attendants, case managers, or others involved in their care;

2. Be medically stable as certified by a physician or nurse practitioner. Medical stability is defined as the absence of any of the following: (a) an active, life threatening condition (sepsis, respiratory, or other conditions requiring systematic therapeutic measures); (b) intravenous infusions to control or support blood pressure; (c) intracranial pressure or arterial monitoring.

For additional information, refer to: Application for 1915(c) HCBS Waiver: MS.0255.R07.00 at https://medicaid.ms.gov/providers/waivers

Authority: 42 CFR 430.25 Waivers of State Plan Requirements

2.1 Traumatic Brain Injury/Spinal Cord Injury Waiver (TBI/SCI)

The statutory basis for this program is § 1915 (c) (7) (B) of the Social Security Act. The TBI/SCI Waiver is a Medicaid Home and Community-Based Services (HCBS) program operated by MDRS and administered by the Division of Medicaid.

The Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver provides cost-effective in-home support services to Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) members who would require institutionalization in a Nursing Facility (NF).

Persons served on this waiver must:

1. Have a traumatic brain injury or spinal cord injury as defined below. Traumatic brain injury is defined as an insult to the skull, brain, or its covering resulting from external trauma, which produces an altered state of consciousness or anatomic, motor, sensory, or cognitive/behavioral deficits. Spinal cord injury defined as a traumatic injury to the spinal cord or cauda equina with evidence of motor deficit, sensory deficit, and/or bowel and bladder dysfunction. The lesions must have significant involvement with two of the above three. The extent of injury must be certified by their physician or nurse practitioner. Brain or spinal cord injury that is due to a degenerative or congenital condition, or that results (intentionally or unintentionally) from medical intervention, is excluded.

2. Be medically stable as certified by a physician or nurse practitioner. Medical stability is defined as the absence of the following: (a) an active, life-threatening condition (e.g., sepsis, respiratory, or other condition requiring systematic therapeutic measures) (b) intravenous drip to control or support blood pressure (c) intracranial pressure or arterial monitoring.

There is no maximum age limit for this waiver. This waiver is limited to individuals who are able to direct their own care or have a legal representative who they have chosen to direct their care.

For additional information, refer to: Application for 1915(c) HCBS Waiver: MS.0255.R05.00 at https://medicaid.ms.gov/providers/waivers

2.2 Hospice and IL or TBI/SCI Waiver Concurrent Services

Hospice and IL or TBI/SCI Waiver concurrent services are authorized by Mississippi Administrative Code Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule 1.1: General.

Applicants/members may receive non-duplicative IL or TBI/SCI waiver services in coordination with in-home hospice services. Since the programs offer similar services, it is imperative that the hospice provider and OSDP staff work together with the applicant/member and/or designated representative to assure the applicant/member’s needs are met without duplicating services.

SECTION 3: REFERRALS

3.0 Information and Referrals

The Mississippi Department of Rehabilitation Services’ (MDRS) Office of Special Disability Programs (OSDP) has an information referral system in place. This system provides:

• Individuals with disabilities information about services; • The opportunity to be referred to other appropriate services and programs; • The opportunity to be placed on the referral list for OSDP programs.

Referrals for OSDP Programs are placed on the Referral List based on the date of their request for services. All referrals must be placed in the AACE Referral Database within three (3) days of request.

Within Appendix B of the IL and TBI/SCI Waivers, MDRS agrees to reserve capacity for each waiver year for individuals transitioning from nursing facilities (NF) and other home and community-based services (HCBS) waivers. Nursing home transition members must have been in the nursing facility for over thirty (30) days.

Due to the reserve capacity, individuals transitioning from a nursing facility (NF) and other HCBS waivers are placed at the top of the list for HCBS Waiver Referrals (IL Waiver and TBI/SCI Waiver) and are expedited in the transition to the home and community.

The State reserves capacity within the waiver for individuals transitioning from institutional long term care settings to a home and community-based service (HCBS) setting. Individuals must have resided in the institutional setting for a minimum of thirty (30) days with at least one of those days being covered in full by Mississippi Medicaid. If the reserved capacity is not utilized within three (3) months of the end of the waiver year, the State reserves the right to reassign the reserve capacity for others awaiting services.

DOM evaluated the number of service referrals along with the waiver limits and determined that the reserve capacity will be twenty-five (25) IL waiver slots and fifteen (15) TBI/SCI waiver slots for the calendar year.

Legal Basis

Under the authority of §1915(c) of the Social Security Act.

SECTION 4: PROGRAM OVERVIEW OF NON-WAIVER SERVICES

4.0 Non-Waiver Program Services

MDRS provides non-waiver programs to individuals who are not eligible under the Independent Living Waiver or the Traumatic Brain Injury/Spinal Cord Injury Waiver. The non-waiver programs include the State Attendant Care program, TBI/SCI Trust Fund and the IL Grant program.

4.1 State Attendant Care Program (SAC Program)

In 1985, the Mississippi Legislature created the State Attendant Care (SAC) Fund. This state funded program provides personal care services to individuals who have severe disabilities and are not eligible to receive these services through other sources. Requirements of the program include:

1. Must have a severe physical or mental impairment which limits his/her ability to obtain, maintain or advance employment. 2) Cannot be eligible to receive duplicate services under any other program. 3) No age restrictions.

4.2 Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Trust Fund Services

As established by the Mississippi Code of 1972 amended, § 37-33-251, 253, 257, 259, and 261, the TBI/SCI Trust Fund was enacted.

Effective from and after July 1, 1997, the TBI/SCI Trust Fund enables individuals who have sustained a traumatic brain injury/spinal cord injury to resume the activities of daily living and reintegrate into the community with as much dignity and independence by providing services, regardless if they qualify for waiver services and as soon as possible.

Requirements of the program include:

1. Must have sustained a traumatic brain or traumatic spinal cord injury which is as a result of external trauma and is verified by a physician; 2) Must be medically stable; and 3) Any Mississippi resident, regardless of age.

4.3 Federal Independent Living Grant (IL Grant) Services

MDRS receives a federal grant from the Administration for Community Living (ACL) in

the U.S. Department of Health and Human Services (HHS), in accordance with the Workforce Innovation and Opportunity Act.

Through a federal grant from the ACL, the Office of Special Disability Programs provides funding for solutions that help individuals with disabilities maintain independence in their environments.

Requirements of the program include:

1. Must have a severe physical or mental impairment which limits his/her ability to obtain, maintain or advance employment. 2) No age restrictions. 3) Services provided must not duplicate services allowable under any other federal mandate.

For additional information, please refer to: (WIOA, (Public Law 113-128).

4.4 Financial Needs Analysis

While there is no federal requirement to consider the financial need of individuals when providing services, OSDP does consider the financial need of individuals for purposes of determining the extent of their participation in the cost of OSDP services. Proof of income is required to determine the amount a client must contribute, if any, to the cost of services. A Financial Needs Analysis form must be completed during the application process for any Non-Waiver client requesting services who does not currently receive Medicaid or Social Security benefits. The individual is responsible for informing OSDP of any changes in financial circumstances and providing appropriate documentation within 30 days of the date of such changes. Failure to do so may result in the termination of paid Independent Living services.

A client whose net income exceeds the Financial Needs Analysis is not required to help pay for services if:

1. The client is eligible for Medicaid or Social Security benefits (SSI or SSDI) 2) The OSDP Regional Manager grants and exception because the client’s financial participation would prevent the client from receiving the necessary service (i.e., a TBI client that has a high medical bill and would be unable to afford the cost of services).

SECTION 5: APPLICATION

5.0 Application for OSDP Services

Any individual with a disability can apply for services with the Office of Special Disability Programs (OSDP). The Case Manager is responsible for completing and reviewing the content of the application with the individual and assuring his/her understanding of the application. If the individual is under the age of 18 or someone who in the best judgment

of the Case Manager, cannot understand the content of the application, then it should be discussed with a parent or legal guardian. A copy of the application should be given to the applicant.

5.1 Request for OSDP Services

The application process begins with the Request for OSDP Services intake form which is completed at the initial home visit. All relevant personal and financial information in addition to the person’s disability, family support, etc. is gathered at this time. This process is completed for waivered and non-waivered services through OSDP and is one component to assist the case manager in determining eligibility.

5.2 Statement of Understanding

All applicants whether applying for waivered services, State Attendant Care, IL Grant or TBI/SCI Trust Fund are required to read and sign the Statement of Understanding. The purpose of this form is ensure that the applicant has:

a) The presence of a significant mental or physical disability;

b) The presence of a severe limitation in ability to function independently in the family or community; and

c) A reasonable expectation that OSDP services will significantly assist in the ability to function more independently in the home or community or to engage or continue in employment.

5.3 Health Information Portability and Accountability Act (HIPAA)

MDRS is required by law to maintain the privacy of a person’s health information and to provide a notice of its legal duties and privacy practices with respect to an applicant/persons protected health information. This applies to all applicants whether applying for waivered or non-waivered services through MDRS.

5.4 Authorization for the Use/Disclosure of Protected Health Information

The purpose of the Authorization for the disclosure form is to give MDRS the legal authority to access an applicant’s protected health information to determine eligibility. Case Managers are required to obtain a completed form with signatures prior to attempting to access the applicant’s protected health information.

5.5 Opportunity to Register to Vote

The National Voter Registration Act of 1993 requires that MDRS assist individuals applying for public assistance and applicants in registering to vote. The intent of the Act was to enhance voting opportunities for every American and increase representation in the electorate.

5.6 Estate Recovery

Federal and State law requires that the Division of Medicaid have an Estate Recovery plan in place. Under this program, the Division of Medicaid becomes a creditor against the estate of a deceased Medicaid recipient under certain conditions. During the initial application process the Counselor must inform the client about Estate Recovery.

Estate Recovery provisions apply to individuals enrolled in Home and Community Based Services beginning July 1, 2001.

5.7 Application Completion

In order to complete the application, the Case Manager must enter an AACE case note documenting the initial home visit within three (3) business days. The applicant’s case file must be created within five (5) business days of the home visit and will contain the original signed application forms and the case note. It is essential that the case file be stored in a secure location.

SECTION 6: WAIVER ELIGIBILITY

6.0 IL Waiver Eligibility

The basic eligibility criteria for IL waiver enrollment include:

• age - 16 years of age or older; • financial eligibility – the member must be eligible for Medicaid as described in the waiver; • medical necessity – the member must meet the level of care criteria for nursing facility (NF) care.

The waiver specific criteria the member must meet is based on his/her choice of services and service planning. They must:

• have a severe orthopedic and/or neurological impairment; that renders the member dependent on others, assistive devices, other types of assistance, or a combination of the three to accomplish the activities of daily living; • choose home and community-based services in lieu of nursing facility care/informed choice; • have an on-going need for waiver services; • need assistance with one or more of the activities of daily living such as dressing, bathing, eating, toileting, transferring; • Be medically stable as certified by a physician or nurse practitioner. Medical stability is defined as the absence of any of the following: (a) an active, life- threatening condition (sepsis, respiratory, or other conditions requiring systematic therapeutic measures); (b) intravenous infusions to control or support blood pressure; (c) intracranial pressure or arterial monitoring;

• be able to communicate effectively with caregivers, Direct Care Workers (DCW), Case Managers, and others involved in their care; and • be at risk of nursing facility placement if services were not available.

6.1 TBI/SCI Waiver Eligibility

The basic eligibility criteria for TBI/SCI waiver enrollment include:

1. Must have a certified traumatic brain or spinal cord injury. See Spinal Cord/Traumatic Brain Injury Verification form.

• Traumatic brain injury is defined as an insult to the skull, brain or its covering resulting from external trauma, which produces an altered state of consciousness or anatomic motor, sensory, or cognitive/behavioral deficit.

• Spinal cord injury is defined as a traumatic injury to the spinal cord or the cauda equina with evidence of motor deficit, sensory deficit, and/or bowel and bladder dysfunction. The lesions must have significant involvement with two of the above three.

2. Must be certified as medically stable by the primary care physician.

Medical stability is defined as the absence of the following:

a. An active, life-threatening condition (e.g. sepsis, respiratory, or other condition requiring systematic therapeutic measures); b. IV drip to control or support blood pressure; c. Intracranial pressure or arterial monitoring

3. Certified as meeting nursing home level of care by their primary care physician.

4. Be at risk of nursing home placement in the absence of waiver services;

5. Meet the special income and assets limits (up to 300% of the Supplemental Security Income federal benefit rate) SSI.

SECTION 7: WAIVER ASSESSMENT

7.0 InterRAI Assessment

All members applying for Medicaid long-term care must complete an interRAI assessment for clinical eligibility determination.

Members enrolled in Medicaid long term care must be recertified annually. Members desiring continued waiver services must be recertified by submission of a new interRAI assessment at least ten (10) days, but no more than ninety (90) days, prior to the expiration

of the current assessment.

An initial interRAI assessment must be completed by a certified OSDP Case Manager and Registered Nurse. Both the Case Manager and the RN must pass a certification course prior to performing interRAI assessments.

SECTION 8: PLAN OF SERVICES AND SUPPORTS (PSS)

8.0 Plan of Services and Supports (PSS)

The Plan of Services and Supports (PSS) is a fundamental tool used to ensure the health and welfare of the members served under the waiver programs. The OSDP Case Manager/RN, together with the potential member, will develop a PSS based on assessment results. The PSS is used to address services needed and activities/tasks necessary for the individual to maintain and independent lifestyle in their home and community. This includes necessary change requests made to the PSS for increase/decrease in services or the addition of new services based upon the individual’s health and safety.

SECTION 9: CASE MANAGEMENT

9.0 Case Management

Case management services are defined as services assisting members in accessing needed waiver and non-waiver services, as well as needed medical, social, educational and other services regardless of the funding source for these services. Case management services are provided by MDRS Case Managers and Registered Nurses (RN) who meet minimum qualifications listed in the waiver. Case Managers and RNs are responsible for initial assessments, whereas the Case Manager continues to follow the services through monthly contacts, quarterly reviews and annual recertifications.

SECTION 10: PERSONAL CARE SERVICES

32 Miss. Admin. Code Pt. 1, R. 10.0 Personal Care Services

Personal care services are provided to waiver members by direct care workers (DCWs). DCWs provide non-medical support services to eligible members by assisting with their activities of daily living in order to keep them independent in their home and communities.

SECTION 11: RESPITE SERVICES

32 Miss. Admin. Code Pt. 1, R. 11.0 Respite Services

Respite services are services offered to assist members who are unable to care for themselves or because of the absence of, or the need to provide relief to the primary

caregiver on a short-term basis. The level of such assistance provided to the member will be determined by their assignment to one of the four “tiers” by their primary physician.

a) Services must be provided in the member’s home, foster home, group home or in a Medicaid certified hospital, nursing facility or licensed respite care facility. b) All respite providers must be certified by the MS Dept. of Rehabilitation Services (MDRS).

SECTION 12: ELECTRONIC VISIT VERIFICATION (EVV)

32 Miss. Admin. Code Pt. 1, R. 12.0 EVV

EVV technology is used to document direct care worker (DCW) time worked for members in their homes. HHA eXchange provides the platform for DCWs to clock in and clock out on their mobile device at the member’s GPS-enabled location. Personal care services are also indicated as tasks performed on the HHA eXchange app.

DCWs are authorized to work the daily approved hours on the member’s plan of services and supports (PSS). Data is captured for each shift worked and stored in HHA Exchange, in order to provide time and attendance reporting for payroll purposes.

SECTION 13: TRANSITION ASSISTANCE SERVICES

32 Miss. Admin. Code Pt. 1, R. 13.0 Transition Assistance Services

Transition Assistance Services are services provided to a Mississippi Medicaid eligible nursing facility resident to assist in transitioning them from the nursing facility into one of the MDRS waiver programs (IL waiver or TBI/SCI waiver). Transition assistance is a one- time initial expense required for setting up a household. Services may include security deposits, essential furnishings, utility set up fees or health and safety measures.

Transition assistance services are capped at $800.00 one-time initial expense per lifetime. The expenses must be included on the approved PSS.

SECTION 14: CASE SERVICE RECORD

32 Miss. Admin. Code Pt. 1, R. 14.0 Case Service Record

Case Managers will maintain an active case file folder for each OSDP member. Each folder contains up-to-date information pertaining to the member’s health, services received, requests for services and DCW tasks/activities. All records will be entered into the electronic database (AACE) as well as printed and filed in the member’s file folder.

SECTION 15: CASE RECORD CLOSURES

32 Miss. Admin. Code Pt. 1, R. 15.0 Case Record Closures

A member’s case shall be closed when it is determined that planned services are completed or that additional services are unnecessary. There must be adequate documentation in the case record showing that all requests are completed and/or unnecessary. The member must be notified of the pending closure and in agreement prior to the case being closed.

SECTION 16: ASSISTIVE TECHNOLOGY

32 Miss. Admin. Code Pt. 1, R. 16.0 Assistive Technology

Assistive Technology (AT) is defined as the application of technology to alleviate barriers that interfere with the lives of individuals with disabilities and is intended to help the participant maintain or enhance his or her ability to function personally, socially, and/or vocationally.

MDRS Rehabilitation Engineers and Rehabilitation Technologists are available to provide consultation on all AT referrals as well as perform initial evaluations and assessments, and set-up AT equipment, provide follow-up evaluations, design and fabricate original items, and provide specifications and final inspections for AT services. When necessary, referrals will be made to outside sources.

All Assistive Technology (AT) needs and/or requests are first evaluated by the OSDP Case Manager or DOM staff (if applicable) to determine if the person could benefit from a referral to MDRS AT staff for evaluation and recommendation. If a Durable Medical Equipment (DME) item is needed and covered by a 3 rd party (such as insurance), the Case Manager will coordinate the purchase directly through the person’s vendor of choice and provide monthly progress on such equipment. If the AT need is a non-covered DME item, a vehicle modification, or an Environmental Accessibility Adaptation (EAA), the Case Manager will refer the person to MDRS AT staff for evaluation and recommendation.

SECTION 17: AUTHORIZATION OF SERVICES

32 Miss. Admin. Code Pt. 1, R. 17.0 Authorization of Services

All services purchased for an OSDP member will be authorized either simultaneously with, or prior to, such purchase. Authorizations and purchases should be pre-planned and approved by the Case Manager or another member of the OSDP staff, unless in case of emergency. Authorizations must include all required documentation and invoice information to be paid and processed.

SECTION 18: DME/SMS AND SUPPLIES

32 Miss. Admin. Code Pt. 1, R. 18.0 DME/SMS and Supplies

Durable Medical Equipment (DME) and Specialized Medical Supplies (SMS) are provided based on the medical needs of each member. DME and SMS are only available through waiver funds after all comparable benefits/third party providers the member is eligible for, including insurances, have been used to meet the member’s needs.

SECTION 19: PROSTHETIC AND ORTHOTIC APPLIANCES

32 Miss. Admin. Code Pt. 1, R. 19.0 Prosthetic and Orthotic & Appliances

The provision of prosthetic and orthotic devices and appliances is an appropriate OSDP Service. These services are provided to improve a member's ability to function more independently in their home and community. All services purchased through OSDP will be pre-authorized by the Case Manager or another member of the OSDP staff before the purchase of the item.

32 Miss. Admin. Code Pt. 1, R. 10.0 Rule 10.0

Personal Care Attendant/Attendant Care Services 10.1 Choosing a Personal Care Attendant/Direct Care Worker (PCA/DCW) 10.2 Individual Requirements to be Considered for Employment/Certification as a Personal Care Attendant (PCA)/Direct Care Worker (DCW) 10.3 Situation in Which a New PCA/DCW Certification Process May Not be Required 10.4 Personal Care Attendant (PCA)/Direct Care Worker (DCW) Training Responsibilities of the OSDP Case Manager 10.5 Flexibility to Change PCA/DCW Tasks Assigned 10.6 Approving EVV Entries (Waiver Programs) 10.7 Approval of Timesheets (Non-Waiver Programs)

11. Respite Care Services

32 Miss. Admin. Code Pt. 1, R. 11.0 Rule 11.0

Respite Care Services 11.1 Certifications Required for Respite Providers

12. Direct Care Worker (DCW) Payroll/Time and Attendance

32 Miss. Admin. Code Pt. 1, R. 12.0 Direct Care Worker (DCW) Payroll/Time and Attendance Report

13. Transition Assistance Services

32 Miss. Admin. Code Pt. 1, R. 13.0 Rule 13.0

Transition Assistance Services 13.1 Description of Transition Assistance Services 13.2 Services and Items Not Included in Transition Assistance Services 13.3 Preparing the Home for Transition 13.4 Transitioning Assistance Services Form - Estimated Cost of Items and Services 13.5 Changes to the Transitional Assistance Services 13.6 Five Day Monitoring Required by Case Manager After Transition 13.7 Failure to Transition from the Nursing Facility

14. Eligibility For SAC and TBI/SCI Trust Fund Programs

32 Miss. Admin. Code Pt. 1, R. 14.0 State Attendant Care (SAC) Eligibility

32 Miss. Admin. Code Pt. 1, R. 14.1 Rule 14.1

Eligibility Criteria for the Traumatic Brain Injury/Spinal Cord Injury Trust Fund Program

15. Application for State Attendant Care and TBI/SCI Trust Fund Services

32 Miss. Admin. Code Pt. 1, R. 15.0 Rule 15.0

Application for SAC and TBI/SCI Trust Fund Services 15.1 Request for SAC and TBI/SCI Trust Fund Services 15.2 SAC Statement of Understanding 15.3 TBI/SCI Trust Fund Statement of Understanding 15.4 Health Information and Portability and Accountability Act (HIPAA) 15.5 Authorization for the Use/Disclosure of Protected Health Information 15.6 Opportunity to Register to Vote 15.7 Application Completion

16. Functional Assessment for State Attendant Care (SAC)

32 Miss. Admin. Code Pt. 1, R. 16.0 Functional Assessment for SAC Services

17. Functional Assessment for TBI/SCI Trust Fund Services

32 Miss. Admin. Code Pt. 1, R. 17.0 Functional Assessment for TBI/SCI Trust Fund Services

18. Eligibility for IL Grant Services

32 Miss. Admin. Code Pt. 1, R. 18.0 Rule 18.0

Determining the Applicant’s Disability 18.1 Medical Information to Establish Eligibility and for the Provision of Services 18.2 Documenting Eligibility for Services 18.3 Eligibility Determination Extension

19. Application for IL Grant Services

32 Miss. Admin. Code Pt. 1, R. 19.0 Rule 19.0

Application for IL Grant Services 19.1 Request for OSDP Services/Initial Intake for IL Grant Services 19.2 Statement of Understanding 19.3 Health Information Portability and Accountability Act (HIPAA) 19.4 Authorization for Use/Disclosure of Protected Health Information 19.5 Opportunity to Register to Vote 19.6 Application Completion

20. Financial Needs Analysis for Non-Waiver Services

32 Miss. Admin. Code Pt. 1, R. 20.0 Rule 20.0

Participation of the Individual in Cost of Services 20.1 Determining Financial Need 20.2 PSS Requirements 20.3 Circumstances When Financial Participation Does Not Apply 20.4 Determination and Application of Financial Participation 20.5 Completion and Use of Financial Participation Assessment 20.6 Financial Needs Exemptions

32 Miss. Admin. Code Pt. 1, R. 20.7 Informing the Individual about Financial Needs Policy

21. Functional Assessment for IL Grant Services

32 Miss. Admin. Code Pt. 1, R. 21.0 Functional Assessment for IL Grant Services

22. Case Service Record

32 Miss. Admin. Code Pt. 1, R. 22.0 Rule 22.0

Case File Folder 22.1 Case Notes 22.2 Case Service Record Organization - IL & TBI Waiver 22.3 Case Service Record Organization - State Attendant Care & TBI/SCI Trust Fund 22.4 Case Service Record Organization - IL Grant Only

23. Case Record Closures

32 Miss. Admin. Code Pt. 1, R. 23.0 Rule 23.0

Case Record Closures for Independent Living Services 23.1 Closure - Goals Met 23.2 Case File Documentation for Closure - Goals Met 23.3 Closures - Goals Not Met 23.4 Closure Reasons other than Eligibility Criteria Not Met (Intervening Reasons)

24. Assistive Technology

32 Miss. Admin. Code Pt. 1, R. 24.0 Rule 24.0

General 24.1 Referrals for AT Services 24.2 Purchasing Assistive Technology Services/Devices 24.3 Maintenance and Repair Costs 24.4 Home Modifications (Environmental Accessible Adaptation) 24.5 Environmental Accessible Adaptations (EAA)/Home Modifications Process 24.6 Job Site Accommodation 24.7 Seating and Mobility 24.8 Vehicle Accommodation 24.9 Project START (Success Through Assistive/Rehabilitative Technology)

25. Authorization of Services

32 Miss. Admin. Code Pt. 1, R. 25.0 Rule 25.0

Authorization of Services 25.1 Time Limit for Filing Claims 25.2 MDRS/OSDP Filing Claims to Medicaid

26. Durable Medical/Specialized Medical Equipment and Supplies

32 Miss. Admin. Code Pt. 1, R. 26.0 Rule 26.0

Durable Medical/Specialized Medical Equipment and Supplies 26.1 Specialized Medical Equipment and Adaptive Aids 26.2 Medical Equipment/Adaptive Aids Covered 26.3 Making Requests for Non-Covered Items 26.4 Requesting Items that are Not on the List of Covered Medical Equipment/Adaptive Aids

32 Miss. Admin. Code Pt. 1, R. 26.5 Rule 26.5

Utilizing Comparable Benefits, Third Party Providers, Before Purchasing Adaptive Aid/Medical Equipment 26.6 Requesting Adaptive Aid/Medical Equipment that the Case Manager Thinks May Not be Paid 26.7 Documentation Required Justifying the Cost-Effective Purchase of Adaptive Aid/Medical Equipment 26.8 Durable Medical Equipment Prior to Transition 26.9 Specialized Medical Supplies Fee Schedule/Cost Neutrality

27. Prosthetic and Orthotic Appliances

32 Miss. Admin. Code Pt. 1, R. 27.0 Rule 27.0

Prosthetic and Orthotic Appliances 27.1 Determining Eligibility for Individuals with Hearing Impairments 27.2 Degrees of Hearing Loss 27.3 Completing your ENT Report Form 27.4 Authorizing for ENT Evaluation 27.5 Authorizations for Hearing Aids and Options 27.6 Four (4) Reasons for Replacing Hearing Aids 27.7 Member Participation 27.8 Two (2) Week Follow Ups/Thirty Day Follow Up

28. Abbreviations, Acronyms, and Definitions

32 Miss. Admin. Code Pt. 1, R. 28.0 Rule 28.0

Abbreviations, Acronyms, and Definitions 28.1 PAS Definitions, New Terms, and Functionality 28.2 Definitions for Authorized Representative 28.3 Definitions Vulnerable Adults and Children 28.4 Definitions - Notice of Action/Hearings

SECTION 1: GENERAL PROCEDURES

1.0 Non-Discrimination

MDRS staff will adhere to the practice of not excluding any individual or group of individuals from ineligibility of services based on age, color, religion, gender, gender identity, national origin, type of disability, marital status, sexual orientation or military status when carrying out OSDP operations.

Individuals eligible for services in the State will not be discriminated by OSDP staff based on their geographic residence in Mississippi when applying for services.

1.1 Confidential Nature of Member Information Health Information Portability and Accountability Act The Office of Special Disability Programs (OSDP) will abide by HIPAA guidelines. All information that the Mississippi Department of Rehabilitation Services (MDRS) and OSDP obtains, collects and in possession of MDRS/OSDP to determine eligibility, continue eligibility, or directly connected with the administration of programs, is confidential.

MDRS/OSDP may disclose general information about policies, procedures, or other methods of determining eligibility, and any other information that is not about or does not specifically identify a member.

All information that MDRS acquires in reference to a member or any individual on the member’s case file is confidential. Confidential information includes, but is not limited to, individually identifiable health information.

Before discussing or releasing information about a member or any individual on the case file, steps should be taken to reasonably be sure the individual receiving the information is either a member or an individual authorized to receive confidential information (i.e., personal representative).

Telephone identity outside of a face-to-face contact can be established by an individual who identifies himself as a member using his knowledge of the following:

o Date of birth o Medicaid number o Social Security Number o Other identifying information Telephone identity outside of a face-to-face contact can be established by an authorized representative by using their knowledge of the member’s:

o Date of Birth

o Medicaid number o Social Security number o Other identifying information o The knowledge of the same information about the consumer’s representative

Identity of attorneys or legal representatives is established by a completed and signed Authorization for the Use/Disclosure of Protected Health Information form or a document containing all of the following information:

o The applicant’s full name (including middle initial)and one of the following:

• Date of Birth • Medicaid Number • Social Security number

o A description of the information to be released,

o A statement specifically authorizing MDRS to release this information,

o The purpose of the release,

o An expiration date of the release and the purpose of the release,

o A statement about whether refusal to sign the release affects eligibility for delivery of services,

o A statement describing the applicant’s or member’s right to revoke the authorization to release information,

o The date the document is signed, and

o The signature of the applicant/member.

1.2 Appointment of a Designated Representative

The member or a legally authorized representative (LAR) for the member has the option of designating or changing a designated representative (DR) to assist with the responsibilities to assist the member in directing their services/care.

• The OSDP Case Manager must document the decision on the Appointment of a Designated Representative Form.

• Documentation of this should also be maintained in the member’s case file only.

• For waiver members only, electronic documentation will be entered in LTSS under the Person Profile box, Profile Overview and then Representative.

1.3 Measures for Detecting and Preventing Waste, Fraud and Abuse

A. The following procedures are used to detect and prevent waste, fraud and abuse. The Case Management Verification Report is used to verify that monthly contacts, quarterly review visits and recertification visits are completed each month. The Case Manager also verifies that the direct care workers (DCWs) are working the hours that are approved on the Plan of Services and Supports (PSS).

B. The Case Management team and the OSDP Billing staff ensure that services billed and paid under the State’s plan are:

1. Provided to an eligible beneficiary, 2. Medically necessary, 3. Provided at the appropriate level of care, 4. Appropriately documented, specifically including the assignment of diagnosis and procedure codes submitted by providers and that may be used by the Division of Medicaid to calculate payment and reimbursement.

C. For members who are eligible for Medicare or Medicaid and have any other third- party resources, the OSDP Case Manager must explore all available benefits. The Case Manager must document any available benefits in the case file. All comparable benefits and third-party resources are explored and utilized prior to authorizing for member services;

D. The MDRS Program Evaluation Division conducts case file audits; and,

E. The Assistive Technology delivery receipt is signed by the member to verify recommended equipment is received as ordered. The original form is maintained in the case file.

SECTION 2: OVERVIEW OF PROGRAMS

2.0 Independent Living Waiver (IL)

The Independent Living Waiver (IL) program provides home and community-based services to waiver applicants/members who:

1. Are 16 or older who exhibit severe orthopedic and/or neurological impairment that render the member dependent on others, assistive devices, other types of assistance, or a combination of the three to accomplish the activities of daily living.

2. Must be able to express ideas and wants either verbally or nonverbally with caregivers, direct care workers, case managers or others involved in their care.

3. Must be medically stable. Medical stability is defined as the absence of any of the following: (a) An active, life threatening condition (sepsis, respiratory, or other

conditions requiring systematic therapeutic measures); (b) IV drip to control or support blood pressure; (c) intracranial pressure or arterial monitoring.

In addition, the goal of the Independent Living Waiver program is to provide waiver applicants/members with a meaningful choice regarding long-term care services. This goal is accomplished by facilitating the development and utilization of services that allow waiver applicants/members to avoid premature nursing facility (NF) placement and provide current NF residents an opportunity to return to the home and community. It is accomplished through the utilization of a comprehensive Long Term Support Services (LTSS) assessment process and is designed to fill two primary functions: 1) determine eligibility for Medicaid Long Term Care across both institutional and HCBS settings; and 2) facilitate informed choices by persons applying for services.

Waiver applicants/members receive services though the IL Waiver and through other non- waiver service providers that are necessary to provide a safe alternative to nursing facility (NF) placement. The Independent Living Waiver allows Mississippi to provide services that are not available under the regular Medicaid State Plan program.

2.1 Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver

The Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver provides cost-effective in-home support services to Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) members who:

1. Have sustained a traumatic brain or traumatic spinal cord injury which is verified by a physician, and 2) Are medically stable.

There are no age restrictions for this program.

Traumatic Brain Injury” means an insult to the skull, brain, or its covering, resulting from external trauma which produces an altered state of consciousness or anatomic, motor, sensory or cognitive/behavioral deficits.

“Spinal Cord Injury” means an acute traumatic insult to the spinal cord, not of a degenerative or congenital nature, but caused by an external trauma resulting in any degree of motor or sensory deficit.

Members who have brain or spinal cord injury at birth do not qualify for this program.

The goal of the TBI/SCI Waiver program is to provide members seeking Long Term Care assistance, meaningful choices to allow residency in their own homes and communities. This goal is accomplished through the utilization of a comprehensive Long Term Support Services (LTSS) assessment process and is designed to fill two primary functions: 1) determine eligibility for Medicaid Long Term Care across both institutional and HCBS settings; and 2) facilitate informed choices by persons applying for services.

The program offers an array of home and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutionalization in a Nursing Facility (NF). Waiver services complement and/or supplement the services that are available to members through the Medicaid State plan and other federal, state and local public programs as well as the supports that families and communities provide.

2.2 Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Trust Fund

The Traumatic Brain Injury/Spinal Cory Injury Trust Fund program provides services to injured members as soon as possible after the injury, regardless if they are Medicaid recipients or qualify for waiver services.

Requirements of the program include:

1. Must have sustained a traumatic brain or traumatic spinal cord injury which is verified by a physician and 2) Must be medically stable and 3) Any Mississippi resident, regardless of age 4) Must not be eligible to receive duplicate services under any other program.

“Traumatic Brain Injury” means an insult to the skull, brain, or its covering, resulting from external trauma which produces an altered state of consciousness or anatomic, motor, sensory or cognitive/behavioral deficits.

“Spinal Cord Injury” means an acute traumatic insult to the spinal cord, not of a degenerative or congenital nature, but caused by an external trauma resulting in any degree of motor or sensory deficit.

The goal of this program is to enable members who have sustained a traumatic brain injury/spinal cord injury to resume the activities of daily living and reintegrate into the community with as much dignity and independence as possible. For those persons who cannot achieve complete independence, supportive services are needed in order for them to live as normally as possible.

The TBI/SCI Trust Fund program awards sub-grants to organizations throughout the state to support programs that focus on the awareness and prevention of these conditions.

The Mississippi Department of Rehabilitation Services is required by the TBI/SCI Trust Fund to conduct an annual survey of nursing homes in the state to determine the number of members fifty-five (55) years of age and under who reside in such homes due to a spinal cord injury or traumatic brain injury. All members identified in such a survey shall be evaluated by the OSDP Case manager and any member who may benefit from rehabilitation services shall be given an opportunity to participate in an appropriate rehabilitation program for which he may be eligible.

Also, a requirement of the TBI/SCI Trust Fund is the Advisory Council on Spinal Cord Injuries and Traumatic Brain Injuries created within the MS Department of Rehabilitation

Services. The Advisory Council must be composed of a physician with expertise in areas related to the care and rehabilitation of members with spinal cord injuries or traumatic brain injuries or the prevention of spinal cord and traumatic brain injuries, a professional in a clinical rehabilitation setting, a representative designated by the Mississippi Head Injury Association, a representative designated by the Mississippi Paralysis Association, three (3) members with spinal cord injuries or traumatic brain injuries, and three (3) family members of members with spinal cord or traumatic brain injuries.

The TBI/SCI Trust Fund is to provide the cost of care for spinal cord and traumatic brain injury as a payer of last resort, therefore, a member must seek assistance from all available resources prior to receiving Trust Fund assistance.

Fees and surcharges on moving traffic violations are collected under subsections (1) and (2) of §99-19-73, Mississippi Code of 1972 and are deposited into a special fund that is created in the State Treasury and designated to the Spinal Cord and Head Injury Trust Fund.

2.3 Federal Independent Living (IL) Grant

Through a federal grant from the Administration for Community Living (ACL), the Office of Special Disability Programs provides IL Grant funding for solutions that help members with disabilities maintain independence in their environments. Requirements of the program include:

1. Must have a severe physical or mental impairment which limits his/her ability to obtain, maintain or advance employment. 2) No age restrictions. 3) Services provided must not duplicate services allowable under any other federal mandate.

This program provides necessary services including but not limited to home modifications (environmental accessibility adaptations), vehicle modifications, orthotics and prosthetics, durable medical equipment (DME), specialized medical supplies (SMS) and assistive technology aids (hearing aids and other communication devices).

2.4 State Attendant Care (SAC) Program

This state funded program provides personal care services to members who have severe disabilities and are not eligible to receive these services through other sources. Members cannot be eligible to receive duplicate services under any other program. By receiving these services, a member is able to live at home instead of a nursing facility. Requirements of the program include:

1. Must have a severe physical or mental impairment which limits his/her ability to obtain, maintain or advance employment. 2) No age restrictions. 3) Must not be eligible to receive duplicate services under any other programs. The only services provided under the SAC Program are personal care services and case

management.

SECTION 3: REFERRAL INTAKE

3.0 Information and Referral

The Mississippi Department of Rehabilitation Services, Office of Special Disability Programs has an information and referral system in place.

This system provides:

• Individuals with disabilities information about services; • The opportunity to be referred to other appropriate services and programs; • The opportunity to be placed on the referral list for OSDP programs.

3.1 Receiving and Screening Individuals Receiving Services

A. The initial request for services may be made by:

• Self referral • Relative • Hospital • Nursing facility staff • Physician • Friend, etc.

B. The OSDP staff must determine if the referral is appropriate.

The OSDP staff must review the referral for key information necessary for appropriate screening, such as:

1. Does the individual need assistance with a service provided by OSDP?

2. Does the individual meet the technical/medical criteria for OSDP programs? (Age, Impairment, Medical Stability)

3. If a waiver referral, does the individual have Medicaid? (Check Envision to determine)

4. If not, does the individual appear to meet the financial eligibility criteria for Medicaid, if applying through the waiver?

5. Does the individual have other comparable benefits that would provide the requested service?

6. If referred by another party, does the individual or his/her designated/legal

representative actually wish to be placed on the referral list?

7. Is the individual able to direct his/her own care and control of his/her personal resources, finances, etc.?

3.2 Screening Referrals for Specific OSDP Programs

A. The staff member accepting the initial referral must determine which of the following programs should be reflected on the referral based on the information received:

• Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Trust Fund; • Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver; • Independent Living (IL) Waiver; • State Attendant Care (SAC) Program; • Independent Living (IL) Grant.

B. Individuals should be informed of the services available through all programs and the current availability of specific programs including referral list procedures, if applicable.

C. If an individual requests to be placed on the HCBS Referral List after being informed of eligibility criteria, whether or not he/she appears eligible, the individual must be placed on the Referral List.

D. If an individual is requesting services that only a specific program can address such as Direct Care Worker (DCW) services, the program that provides that service must be checked on the referral so that the individual will be placed on that Referral List.

E. All referrals received are:

• Entered into the AACE Referral Module as soon as all the information is gathered in order to place the individual in the referral module.

• Do not enter partial information in the Referral Module. Only enter a referral in AACE, if you have all of the necessary and required information needed to determine an appropriate referral.

F. All referrals are organized by:

• The date of referral with the oldest date at the top of the list and the most recent date at the bottom of the list.

G. Individuals may be placed on more than one referral wait list, if they are eligible.

H. If a current referral wants additional services for a different program type, a new referral will be taken and entered for the new requested program.

I. If a current referral wants additional services for the same program type, the Case Manager will update the referral with the new requested services and enter a referral note.

3.3 Information to be Discussed When Contacting a Referral

When the initial contact is made with the referral, the OSDP Case Manager or Case Manager Assistant will complete/discuss the following:

• Explain basic program eligibility requirements;

• Explain services/options available;

• Confirm their desire to continue with the application process;

• Review and discuss their rights and responsibilities;

• Review and discuss eligibility criteria and responsibilities;

• Get information about financial eligibility;

• Obtain third-party resources (comparable benefits) including if they are receiving Home Health through Medicare and other formal and informal support systems;

• Present and review information about Medicaid Estate Recovery Program and document that this was presented and discussed (for Home and Community Based Services (HCBS) waiver applicants only).

3.4 Releasing Referrals from the Referral List

A. Referrals for OSDP Programs are placed on the Referral List in AACE based on the date (oldest to most recent) of their request for services.

B. MDRS/OSDP will maintain separate Referral Lists for individuals requesting services from the following programs:

• IL Waiver • TBI/SCI Waiver • TBI/SCI Trust Fund • SAC Program • IL Grant

C. As allocation allows, referral names will be released from the Referral List for individuals requesting services via the IL Waiver, TBI/SCI Waiver, SAC Program, TBI/SCI Trust Fund, and IL Grant.

D. On the date the referral is released, all referrals released will be assigned to an OSDP Case Manager for the area in which the individual will be served.

E. All referrals must be contacted, scheduled for a home visit and/or closed within fourteen (14) days of being assigned to the OSDP Case Manager.

F. Any referral can apply for services when:

• Their name comes to the top of the list; • MDRS/OSDP has funding available to support the slots that have been federally approved; • Funding is available to support the requested services, including the waivers.

G. All referrals will remain in the AACE Referral Module until funds become available for appropriate services or a request to be closed by the potential client.

3.5 Referrals for Individuals Temporarily Out of Their County of Residence

A referral that is in a hospital or long-term care facility that is not located in their native county, will have his or her application processed by a Case Manager assigned to the county he or she is temporarily residing in. Once the participant is approved for services, the initial Case Manager will transfer the case to a Case Manager in the participant’s permanent county of residence.

The OSDP District Managers in both districts will collaborate and coordinate with their OSDP Case Managers to complete the waiver application and transfer.

The Case Manager in the county where the individual temporarily resides will provide the following case management services:

• Interview the member along with the responsible party (if applicable); • Arrange for and conduct the initial assessment; • Assist the member along with the responsible party (if applicable) with completing the application process; • Obtain medical documentation such as Physician Certification, medical documents that indicate diagnosis, TBI/SCI Verification of the document (if applicable), etc. • Discuss with Social Workers, etc. the services that the applicant will need and then the possible need for his or her assistance with obtaining required documents; • Forward current information obtained by the OSDP Case Manager that will receive the case and any additional information that comes after the case file has been transferred; and • Perform additional services that the two Case Managers have agreed upon due to the location of the needed request.

The OSDP Case Manager for the county in which the individual will reside is responsible for determining whether the applicant is eligible for services. This includes but is not limited to scheduling a visit to the member’s permanent residence to ensure that the home

is safe for the member to reside. In addition, the Case Manager will be initiating services following the development of the PSS and/or certification for waiver services.

3.6 Referrals or Applicants Who Want to Request or Apply for the IL or TBI/SCI Waiver While Residing in a Nursing Facility

A. Any individual who is residing in a nursing facility (NF), whose NF services are being paid by Medicaid and wants to transition from the NF to the home and community may request and apply for services through the IL Waiver or TBI/SCI Waiver.

B. Within the IL Waiver - Appendix B, MDRS agrees to reserve capacity for each waiver year for individuals transitioning from nursing facilities (NF) and other home and community-based services (HCBS) waivers.

C. Due to the reserve capacity, individuals transitioning from a nursing facility (NF) and other HCBS waivers are placed at the top of the list for HCBS Waiver Referrals (IL Waiver and TBI/SCI Waiver) and are expedited in the transition to the home and community.

• Individuals need to have been in the NF for 30 days to be considered for expedited transition. • Transition services must be provided within 90 days of the nursing home discharge.

D. The nursing home resident that is eligible to transition from the NF to one of the HCBS Waivers due to the reserve capacity will:

1. Have their name placed on the IL Waiver or TBI/SCI Waiver Referral List and the referral will be released immediately.

2. The release of the referral is contingent on:

• A waiver slot is available and; • MDRS/OSDP has funding available to support the slots that are federally approved. • Must have a home to transition to.

3. Must reside in the nursing facility (NF) until they receive notification of certification for home and community-based services. If the individual leaves the nursing facility (NF) prior to notification of certification by MDRS, their name will be put on the IL Waiver or TBI/SCI Waiver Referral List based on the date of referral. Waiver services will not begin until a certification date is received.

E. If the reserve capacity is not utilized within three (3) months of the end of the waiver year, MDRS reserves the right to reassign the reserve capacity for others awaiting

services.

F. Persons whose NF stay is temporary or rehabilitative or whose services are covered by Medicare or other insurance, wholly or partially, are not eligible for this expedited transition service.

3.7 Transitioning from a Nursing Facility to the Waiver Program

OSDP Case Managers must strongly stress to referrals that are transitioning from a nursing facility (NF) on a waiver program the importance of remaining in the (NF) until they receive notification of certification from the OSDP Case Manager for home and community-based services.

• If the individual leaves the (NF) prior to notification of certification by MDRS, their name will be put on the IL Waiver or TBI/SCI Waiver Referral List based on the date of referral.

• If they are currently, an applicant for waiver services and leave the nursing facility prior to notification of certification for home and community – based services, services will not begin until a certification date is received.

SECTION 4: SERVICES

4.0 Services Available to Applicants/Members

The services available to members are dependent on the needs of the person as well as the specific services available through the member’s approved waiver or program. Services complement and/or supplement the services that are available to members through the Medicaid State plan, private insurance and other federal, state, and local public programs as well as the supports that families and communities provide.

The following table specifies the services available for each program type:

IL Waiver

TBI/SCI Waiver TBI/SCI Trust Fund State Attendant Care Fund

IL Grant Case Management X X X X X Direct care worker services X X X Respite X X Specialized Medical Equipment & Supplies X X X X Transition Assistance X X Environmental Accessibility Adaptations X X X X Vehicle Modifications X X Emergency Services X Transitional Attendant Care Services X

Hospice Concurrent Services X X

The Case Management Team (OSDP Case Manager and Registered Nurse, if applicable) strive to identify the needs of the applicant/member to provide cost-effective services as identified on the plan of services and supports (PSS). OSDP Case Managers are responsible for ongoing monitoring of the provision of services included on the member’s plan of services and supports (PSS). Services are furnished by MDRS/OSDP, providers/un-paid resources/vendors for MDRS/OSDP and Division of Medicaid.

4.1 IL & TBI Waiver Services

Applicants/members who are interested in receiving services through the IL or TBI/SCI waiver must meet nursing home level of care. The purpose of these services and supports is to keep the individual independent in their home and communities. Service descriptions are detailed below:

1. Case Management – Activities that assist the waiver applicant/member in gaining access to needed waiver services and other State plan services, as well as needed medical, social, educational, and other services regardless of the funding source for the services to which access is gained, and also to needed non-waiver services from other resources or other OSDP Programs;

2. Direct Care Worker (DCW) Services – Assistance provided to a waiver applicant/member to meet daily living needs to ensure adequate support for optimal functioning at home or in the community, but only in non-institutional settings. Direct care worker services may include the following: bathing, personal grooming, dressing, personal hygiene, toileting, transferring, assisting with ambulation, assistance with housekeeping, food shopping, meal preparation, assistance with eating, and community participation. Prior approval must be obtained from the Case Manager when the member is unable to go with the DCW into the community.

3. Respite Services (TBI/SCI Waiver & Trust Fund only) – Respite services are provided to individuals unable to care for themselves; furnished on a short-term basis because of the absence or need for relief of those persons normally providing the care. Room and board will not be reimbursed in any private residence including the individual’s place of residence or the private residence of the respite provider. Respite hours allowed are as follows:

a. In-home Companion Respite - 288 hours per year allowed

b. In-home Nursing Respite – 288 hours per year allowed

4. Specialized Medical Equipment and Supplies: Devices, controls, appliances or medically necessary supplies which enable the member to increase their ability to perform his/her activities of daily living; perceive, control, or communicate with the environment in which they live;

5. Transition Assistance Services: A one-time initial expense required for setting up a household that is provided to a Mississippi Medicaid eligible nursing facility resident to assist in transitioning from a nursing facility to a waiver or program.

6. Environmental Accessibility Adaptations: Physical adaptations to the home, required by the member’s plan of services and supports, which are necessary to ensure the health, welfare, and safety of the member, or which enable the member to function with greater independence in the home, and without which, the member would require institutionalization. Such adaptations may include the following: ramps, grab-bars, widening of doorways, and bathroom modifications.

7. Hospice and HCBS Waiver Concurrent Services: Applicants/members enrolled in the IL Waiver who elect to receive hospice care may not receive waiver services, which are duplicative of services rendered through hospice. Applicants/members may receive non-duplicative waiver services in coordination with hospice services. Since the programs offer similar services, it is imperative that the hospice provider and the OSDP Case Manager work together with the applicant/member and/or designated representative to assure the applicant/member’s needs are met without duplicating services.

4.2 TBI/SCI Trust Fund Services

The TBI/SCI Trust Fund has services available to individuals with traumatic spinal cord or brain injuries. The Trust Fund is the payor of last resort, therefore an individual must seek assistance from all available resources prior to receiving Trust Fund assistance. Monies deposited in the fund shall be expended and authorized by the Department of Rehabilitation Services as authorized and appropriated by the Legislature. Trust Fund services include:

1. Case Management – Activities that assist the applicant/member in gaining access to needed medical, social, educational, and other services regardless of the funding source for the services to which access is gained.

2. Respite Services (TBI/SCI Waiver & Trust Fund only) – Respite services are provided to individuals unable to care for themselves; furnished on a short-term basis because of the absence or need for relief of those persons normally providing the care. Room and board will not be reimbursed in any private residence including the individual’s place of residence or the private residence of the respite provider. Respite hours allowed are as follows:

a. In-home Companion Respite - 288 hours per year allowed b. In-home Nursing Respite – 288 hours per year allowed

3. Specialized Medical Equipment and Supplies – Devices, controls, appliances or medically necessary supplies which enable the member to increase their ability to perform his/her activities of daily living; perceive, control, or communicate with the environment in which they live;

4. Home Modifications (Environmental Accessibility Adaptations [EAA]) - Physical adaptations to the home, required by the member’s plan of services and supports, which are necessary to ensure the health, welfare, and safety of the member, or which enable the member to function with greater independence in the home, and without which, the member would require institutionalization. Such adaptations may include the following: ramps, grab-bars, widening of doorways, and bathroom modifications.

5. Vehicle Modifications - Modifications to the member’s vehicle to make it accessible for them, either as a driver or passenger. For additional guidelines, refer to Section 13, Assistive Technology Services.

Note: Lifetime CAP for Specialized Medical Equipment, Home Modifications, and Vehicle Modifications combined is $50,000 per individual lifetime.

6. Emergency Services – Emergency services are services provided to individuals that are of a short-term, urgent, time sensitive nature and are considered critical for the individual’s survival, general health, and welfare. There is a $1,000 lifetime cap limitation per individual.

Note: Any requests for emergency services must be submitted to the TBI/SCI Trust Fund Coordinator for approval.

7. Transitional Attendant Care Services - An individual of the member’s choosing to assist them with their activities of daily living for up to twelve (12) months. During this twelve-month lifetime period, the member and the OSDP Case Manager should make every effort to explore other attendant care options.

4.3 State Attendant Care (SAC) Services

Services offered through the State Attendant Care program assist individuals with severe disabilities that are not eligible to receive services through other resources or programs. Available services include: 1. Case Management – Activities that assist the applicant/member in gaining access to needed medical, social, educational, and other services regardless of the funding source for the services to which access is gained.

2. Direct Care Worker (DCW) Services – Assistance. provided to an applicant/member to meet daily living needs to ensure adequate support for optimal functioning at home or in the community, but only in non-institutional settings. Direct care worker services may include the following: bathing, personal grooming, dressing, personal hygiene, toileting, transferring, assisting with ambulation, assistance with housekeeping, food shopping, meal preparation, assistance with eating, and community participation. Prior approval must be obtained from the Case Manager when the member is unable to go with the DCW into the community.

4.4 Independent Living Grant Services

A) Advocacy/Legal Services – Assistance and /or representation in obtaining access to benefits, services, and programs to which an individual may be entitled.

B) Assistive Technology – Any assistive technology device, that is, any item, piece of equipment or product system that is used to increase, maintain or improve functional capabilities of individuals with disabilities and any assistive technology service that assists an individual with a disability in the selection, acquisition or use of an assistive technology device.

C) Children’s Services – The provision of specific IL services designed to serve individuals with significant disabilities under the age of 14. (Not provided by OSDP)

D) Communication Services – Services directed to enable individuals to better communicate, such as interpreter services, training in communication equipment use, Braille instruction, and reading services. (Not provided by OSDP)

E) Counseling and Related Services – These include information sharing, psychological services of a non-psychiatric, non-therapeutic nature, parent-to-parent services, and related services.

F) Family Services – Services provided to the family members of an individual with a significant disability when necessary for improving the individual’s ability to live and function more independently, or ability to engage or continue in employment. Such services may include respite care. Record the service in the consumer’s CSR on behalf of whom services were provided to the family.

G) Housing, Home Modifications, and Shelter Services – These services are related to securing housing or shelter, adaptive housing services (including appropriate accommodations to and modifications of any space used to serve or occupied by individuals with significant disabilities).

H) IL Skills Training and Life Skill Training Services – These may include instruction to develop independent living skills in areas such as personal care, coping, financial management, social skills, and household management. This may also include education and training necessary for living in the community and participating in community activities.

I) Information and Referral Services – Identify all individuals who requested this type of assistance. This is the only service (other than services to family members) that may be provided to all individuals, whether or not the individual has a disability. Some entities record this service using strokes on an answering pad without opening a CSR, others create a CSR or other such file for future contact and outreach.

J) Mental Restoration Services – Psychiatric restoration services including maintenance

on psychotropic medication, psychological services, and treatment management for substance abuse. (Not provided by OSDP)

K) Mobility Training Services – A variety of services involving assisting individuals to get around their homes and communities.

L) Peer Counseling Services – Counseling, teaching, information sharing, and similar kinds of contact provided to individuals by other people with disabilities. (Not provided by OSDP)

M) Personal Assistance Services – These include, but are not limited to, assistance with personal bodily functions; communicative, household, mobility, work, emotional, cognitive, personal, and financial affairs; community participation; parenting; leisure; and other related needs.

N) Physical Restoration Services – Restoration services including medical services, health maintenance, eyeglasses, and visual services. (Not provided by OSDP)

O) Preventive Services – Services intended to prevent additional disabilities, or to prevent an increase in the severity of an existing disability.

P) Prostheses, Orthotics, and Other Appliances – Provision of, or assistance in obtaining through other sources, an adaptive device or appliance to substitute for one or more parts of the human body.

Q) Recreational Services – Provision or identification of opportunities for the involvement of consumers in meaningful leisure time activities. These may include such things as participation in community affairs and other recreation activities that may be competitive, active, or quiet. (Not provided by OSDP)

R) Rehabilitation Technology Services – Any service that assists an individual with a disability in the selection, acquisition or use of applied technologies, engineering methodologies or scientific principles to meet the needs of the individual and address the barriers confronted by individuals with significant disabilities with respect to education, rehabilitation, employment, transportation, IL and/or recreation.

S) Therapeutic Treatment – Services provided by registered occupational, physical, recreational, hearing, language, or speech therapists. (Not provided by OSDP)

T) Transportation Services – Provision of, or arrangements for, transportation. (Not provided by OSDP)

U) Youth/Transition Services – Any service that develops skills specifically designed for youth with significant disabilities between the ages 14 and 24 to promote self- awareness and esteem, develop advocacy and self- empowerment skills and career exploration, including the transition from school to post school activities such as postsecondary education, vocational training, employment, continuing and adult

education, adult services, independent living or community participation. (Not provided by OSDP)

V) Vocational Services – Any services designed to achieve or maintain employment. (Not provided by OSDP)

W) Other Services – Any IL services not listed above in A-V. (Not provided by OSDP)

4.5 Hospice and IL or TBI/SCI Waiver Concurrent Services

Communication and Coordination

• DOM requires Hospice and the OSDP Case Manager to work collaboratively when providing services to the same applicant/member.

• The Hospice Case Manager and the OSDP Case Manager are required to have regular communication with one another.

• If the applicant/member is enrolled in the IL or TBI/SCI waiver program, they may also elect to receive hospice services. As soon as the OSDP Case Manager is notified that the applicant/member has elected hospice services, the OSDP Case Manager must contact the hospice provider so that services are coordinated.

• The Hospice provider and the OSDP Case Manager must have a person-centered planning conference regarding the joint hospice plan of care and plan of services and supports (PSS) before concurrent services can start.

• The conference must include participation of the applicant/member and/or designated representative.

• The joint hospice plan of care and waiver plan of services and supports (PSS) must be retained in the applicant/member’s record by both the hospice and the OSDP Case Manager.

• The hospice and OSDP Case Manager must work for a common goal and not provide duplicate services.

• Ongoing communication and coordination must occur regularly between Hospice and the OSDP Case Manager during the time they are providing services to the same applicant/member.

• Written documentation of this ongoing communication and coordination must be retained in the applicant/member’s case file.

4.6 Potential Duplicative Services

Services considered to be potentially duplicative in nature must be coordinated in the joint

hospice plan of care and waiver plan of services and supports (PSS) to avoid duplicative services and include, but are not limited to:

1. Hospice Aide/Homemaker and IL or TBI/SCI waiver direct care worker services;

2. Hospice in-patient respite and IL or TBI/SCI waiver institutional respite;

3. Hospice medical appliances and supplies and IL or TBI/SCI waiver specialized medical equipment and supplies;

4. Hospice physical therapy, speech-language pathology and occupational therapy, and IL or TBI/SCI waiver physical therapy, speech therapy and occupational therapy;

5. Hospice nursing care and IL or TBI/SCI waiver home health skilled nurse visits.

Care planning requirements

• The hospice provider is the primary provider and manages the joint hospice plan of care and IL or TBI/SCI waiver plan of services and support, when a person is receiving both hospice and waiver services;

• The joint hospice plan of care and IL or TBI/SCI waiver plan of services and support must be retained in the applicant/member’s record by both hospice and the OSDP Case Manager;

• The joint hospice plan of care and IL or TBI/SCI waiver plan of services and support (PSS) must clearly identify the services the applicant/member receives, which entity is responsible for providing the services, and the frequency of the services to be provided; For example, the joint plan of care and IL or TBI/SCI waiver plan of services and support related to homemaker/aide/direct care worker services should be task oriented with a designation of which task would be provided by the hospice provider and which task would be provided by the IL or TBI/SCI waiver DCW;

• Each IL or TBI/SCI waiver service included in the joint hospice plan of care and IL or TBI/SCI waiver plan of services and support must be accompanied by documentation stating why the service is not covered under hospice;

• The frequency of hospice and IL or TBI/SCI waiver services must be coordinated in the joint hospice plan of care and IL or TBI/SCI waiver plan of services and support to avoid duplicative visits;

• The hospice provider and OSDP Case Manager must have a conference regarding the joint hospice plan of care and plan of services and support before concurrent services can start;

• The conference must include participation of the applicant/member and/or designated representative.

Service Utilization

• Hospice benefits must be fully utilized prior to waiver service utilization in instances of potential duplication.

• DOM will conduct retrospective reviews of waiver and hospice services.

• If duplication of services is found, DOM may seek recovery of Medicaid funds paid for those services.

IL/TBI/SCI Waiver Eligibility Requirements

• All certification/recertification requirements under 42 CFR, Part 418 must be met. Refer to Miss. Admin. Code Title 23, Part 205, Ch. 1, Rule 1.3. Continued Medicaid eligibility is determined by the regional office and waiver service changes must be communicated to the hospice provider.

• An applicant/member that is receiving in-home hospice and home and community-based service (IL or TBI/SCI) waiver services, but then chooses in-patient hospice care, must be discharged immediately from waiver services.

• IL or TBI/SCI waiver services will be suspended for applicants/ members receiving in-patient hospice respite services. If the applicant/member does not receive waiver services for more than thirty (30) days, the applicant/member must be discharged from the IL or TBI/SCI waiver.

SECTION 5: APPLICATION

5.0 Application For OSDP Services

The Case Manager must complete the official documentation for applicants who wish to apply for services under the Office of Special Disability Programs. This application process takes place at the initial home visit and includes completing the Request for OSDP Services intake form, the Statement of Understanding, Consent to Disclose, HIPPA, Statement to Permit Medicaid Payment form, Voter Registration and the Assessment forms. These documents/forms can be found on the T: drive. All completed forms are then placed in a new case file when the Case Manager returns to the office.

Additionally, Estate Recovery must be discussed at this time with waiver applicants.

5.1 Request for OSDP Services

The application process begins with the Request for OSDP Services Intake form which is

completed at the initial home visit. The purpose of this form is to gather all relevant personal and financial information in addition to the person’s disability, family support, etc.

The Request for OSDP Services Intake Form is completed for waivered and non-waivered services through OSDP and is one component to assist the Case Manager in determining eligibility. This form needs to be filed in the applicant’s case file when the Case Manager returns to the office.

The Application Documentation

The Application Documentation Page that is a part of the Request for OSDP Services intake form is very important to the overall case process. This information lays the foundation of the entire casework process.

Documentation

Reasons for seeking services:

In this section, the Case Manager should record information that they received during the initial application process regarding the individual’s disability and their medical history to help the Case Manager determine what medical or other information should be requested from third parties. The history of the individual’s adjustment or lack of adjustment to their impairment is very important, as well as their family support system.

5.2 Statement of Understanding

During the initial home visit for waivered, IL Grant, State Attendant Care and TBI/SCI Trust fund, the Case Manager will present the Statement of Understanding to the applicant. It is the Case Manager’s responsibility to ensure the applicant comprehends the entirety of the form, which includes the following:

a) The presence of a significant mental or physical disability;

b) The presence of a severe limitation in ability to function independently in the family or community; and

c) A reasonable expectation that independent living rehabilitation services will significantly assist in the ability to function more independently in the family or community or to engage or continue in employment.

MDRS may obtain personal information from the applicant, their representative, services providers, and cooperating agencies for eligibility purposes with assurances that this information may not be divulged except:

d) To the applicant or their representative, when requested in writing, unless MDRS believes it harmful to do so;

e) For audit, evaluation, or research purposes;

f) To other programs for the applicants’ benefit (e.g., DDS, Mental Health, DHS) or as required by federal law.

All services will be available to applicants regardless of race, gender, color, religion, marital status or national origin.

Once an applicant is determined eligible, the Case Manager will involve them in planning for their services and will review the plan annually. Services are dependent upon the availability of funds, and if there is any delay in the provision of services at any time, the person will be promptly advised. Persons will need to understand that they may also have to contribute toward program costs.

The person is advised during this time to keep scheduled appointments with their Case Manager and service providers. In the event that the person is not satisfied with decisions made by their Case Manager, they can appeal his/her decision in writing to the District Manager.

Additionally, persons may contact the statewide Client Assistance Project (CAP) with questions or concerns about services provided by OSDP. The CAP staff will work with each party to assist in resolving the problem.

Once the person acknowledges and signs the Statement of Understanding, the form will be filed in the applicant’s case file when the Case Manager returns to the office.

TBI/SCI Trust Fund Statement of Understanding

TBI/SCI Trust Fund applicants sign an additional Trust Fund Statement of Understanding which notifies applicants that attendant care services provided through the Trust Fund are available only for a short term and will not exceed a maximum of twelve (12) months from the date of initiation of services.

During this twelve-month period, efforts will be made to enroll applicants in the TBI/SCI Home and Community-Based Waiver Services Program based on eligibility criteria established by Medicaid, availability of openings, and adequate funding.

In the event that enrollment in the Home and Community-Based Program is not possible, the person or their legal representative is responsible for seeking other resources that would address the attendant care services beyond the initial twelve-month service period. The form will be filed in the applicant’s case file when the Case Manager returns to the office.

5.3 Health Information Portability and Accountability Act (HIPAA)

At the initial home visit, applicants are given the Notice of Privacy document. The Case Manager will review this document with the applicant to ensure that they understand their

health information protections. At this time, the applicant will sign the receipt of notice form which is then filed in the case file when the Case Manager returns to the office.

The Health Insurance Portability and Accountability Act of 1996, allows individuals to set boundaries on who has access to their protected health information. It is MDRS legal duty to maintain the privacy of a person’s health information and to provide notice to an applicant. The Case Manager must verify the applicant comprehends their rights.

5.4 Authorization for the Use/Disclosure of Protected Health Information

The applicant signs this form to authorize the Case Manager to request and receive medical records on their behalf. The content of this form specifies:

a) For one time use and/or disclosure

b) One year from the effective date of signature/or upon revocation

c) Release to an attorney throughout the course of representation at his/her request.

Persons are under no obligation to sign this authorization. However, the Department of Rehabilitation may condition eligibility for benefits on the signing of this authorization if the information is necessary to determine a person’s eligibility or enrollment in MDRS services, however not for the use or disclosure of psychotherapy notes.

Information disclosed pursuant to this authorization may be re-disclosed, by the recipient, to additional parties and may no longer be protected. If this authorization is signed by a personal representative, supporting documents must be attached to confirm the representative’s right to make this request.

The specified information is necessary and related to the program of services and its confidentiality and privacy is to be respected by the recipient in accordance with all applicable federal and/or state laws and regulation on confidentiality. Use of copies, including electronic copies are also authorized.

The form will be filed in the applicant’s case file when the Case Manager returns to the office.

5.5 Opportunity to Register to Vote

The following are instances in which a Case Manager should give applicants/members an opportunity to complete the mail-in Voter Registration Application at their home:

1. At the time of application,

2. At annual re-certifications,

3. Change of address, or

4. When requested.

Applicants/members must be given the opportunity to:

1. Complete the mail-in Voter Registration application at home and mail it in, or

2. Leave the completed form with MDRS staff.

3. Complete the portable Voter Registration form online.

If the member wishes to complete the form during the interview, the OSDP Case Manager should:

1. Review the form for completeness in the presence of the member.

2. If it does not contain all the required information and/or the required signature, return it to the member for completion.

Voter Registration forms must be transmitted to the appropriate county voter registrar within five (5) days of receipt from applicant/member. If the applicant or member is not of voter registration age, do not complete the voter registration form.

The Case Manager must document, in the case file, any action when the member asks to register to vote. Any questions regarding voter registration process, can be directed to www.MSVoterID.ms.gov or by calling (844) 678-6837.

5.6 Informing Applicants of Estate Recovery

All persons applying for IL Waiver or TBI/SCI Waiver services must be informed about Medicaid Estate Recovery. During the initial application process, the Case Manager must inform the person about Estate Recovery and document in the case file that this information was provided to them. In addition, all waiver recipients must be given the DOM’s contact person and phone number to refer for more estate recovery information. At application, the fact that the person was informed of Estate Recovery has to be documented in the initial home visit case note.

In order for Estate Recovery to apply, the applicant/person must be eligible for Medicaid and be:

• age 55 and older, and, • in a nursing facility or enrolled in a home and community-based services waiver program at the time of death. • enrolled in hospice at the time of death.

The Estate Recovery law does not apply if, at the time of death, the applicant/person has:

• A surviving husband or wife, or • A surviving dependent child or children under 21 years of age, or • A surviving dependent child or children of any age who are blind or disabled, or • An undue hardship condition that causes Estate Recovery not to apply.

Estate property is made up of real and personal property that the applicant/person owns at the time of death:

• Real property such as home, family business, farm or ranch; • Cash reserves, stocks, bonds, automobiles, recreational vehicles, mobile home; • Or any property with value owned by the beneficiary in full or in part

5.7 Application Completion

At the conclusion of the application process in which the applicant has signed the Request for OSDP Services, Statement of Understanding, Consent to Disclose, HIPAA, Statement to Permit Medicaid Payment form and Voter Registration forms, the Case Manager will ask the applicant if they have any questions or need any clarification. If the applicant agrees to move forward, the Case Manager will conduct the interRAI assessment with a registered nurse. The Case Manager will return to the office and enter a case note in AACE. The case note will contain a summary of the home visit and all relevant information gathered during the initial home visit. All forms will be filed in the applicant’s case file and stored in a secure location.

SECTION 6: ELIGIBILITY FOR IL AND TBI/SCI WAIVER SERVICES

6.0 Independent Living (IL) Waiver Eligibility

The Independent Living (IL) waiver provides services to persons who, but for the provision of such services, would require the level of care found in a nursing facility. The IL Waiver is a Medicaid home and community-based waiver operated jointly with the Division of Medicaid.

Eligibility is limited to individuals age sixteen (16) or older who have severe orthopedic and/or neurological impairments and possess maximum medical improvement potential. Maximum medical improvement potential, as defined by DOM, has been achieved when the following criteria are met:

• Person/applicant is able to communicate effectively (verbally or non-verbally) with caregiver, Direct Care Workers (DCW), Case Managers and others;

• Person/applicant is medically stable as certified by their primary physician. Medical stability is defined as the absence of the following:

o an active, life-threatening condition (e.g. sepsis, respiratory, or other condition requiring systematic therapeutic measures);

o intravenous drip to control or support blood pressure;

o inter-cranial pressure or arterial monitoring; and

o a diagnosis of dementia, Alzheimer’s, mental illness, mental retardation or any related condition of such severity that renders the individual unable to direct his/her own care.

Clinical eligibility for the IL waiver will be determined through the utilization of a comprehensive assessment which encompasses the following areas: activities of daily living, instrumental activities of daily living, sensory deficits, cognitive deficits, client behaviors, medical conditions, and medical services.

Persons/applicants must be Medicaid eligible either as an SSI recipient or meet the 300% of the Supplemental Security Income Federal benefit rate.

Note: All services are provided pursuant to an individualized plan of services and supports (PSS) approved by the Division of Medicaid.

Additional Eligibility for IL Enrollment:

The basic eligibility criteria include:

• age - 16 years of age or older;

Note: Elderly and Disabled (E & D) Waiver serves individuals 21 years of age and older. IDD Waiver serves children under age 21.

• financial eligibility – the person must be eligible for Medicaid as described in the waiver;

• medical necessity – the person must meet the level of care criteria for nursing facility (NF) care.

The waiver specific criteria the person must meet is based on his/her choice of services and service planning. They must:

• have a severe orthopedic and/or neurological impairment that renders the person dependent on others, assistive devices or other types of assistance, or a combination of the three to accomplish the activities of daily living.

• choose home and community-based services in lieu of nursing facility care/informed choice;

• have an on-going need for waiver services;

• need assistance with one or more of the activities of daily living such as dressing, bathing, eating, toileting, transferring;

• Be medically stable as certified by a physician or nurse practitioner. Medical stability is defined as the absence of any of the following: (a) an active, life- threatening condition (sepsis, respiratory, or other conditions requiring systematic therapeutic measures); (b) intravenous infusions to control or support blood pressure; (c) intracranial pressure or arterial monitoring.

• be able to communicate effectively (verbally or non-verbally) with caregivers, DCWs, Case Managers, and others involved in their care, and

• be at risk of nursing facility placement if services were not available.

Enrollment in the Independent Living Waiver is limited to:

• the number of persons approved by the Centers for Medicare and Medicaid Services (CMS) or the availability of state funding

• persons are enrolled from the Independent Living Waiver Referral List on a “first come, first served” basis

• MDRS suspends enrollment into the waiver program when it is determined that the existing caseloads exceed funds within the current budget year.

6.1 Traumatic Brain Injury (TBI)/Spinal Cord Injury (SCI) Waiver

The Traumatic Brain Injury (TBI)/Spinal Cord Injury (SCI) waiver provides services to persons who, but for the provision of such services, would require the level of care found in a nursing facility. The TBI/SCI Waiver is a Medicaid home and community-based waiver operated jointly with the Division of Medicaid.

Eligibility Criteria:

1. Must have a certified traumatic brain or spinal cord injury. See Spinal Cord/Traumatic Brain Injury Verification Form.

• Traumatic brain injury is defined as an insult to the skull, brain or its covering resulting from external trauma, which produces an altered state of consciousness or anatomic motor, sensory, or cognitive/behavioral deficit.

• Spinal cord injury is defined as a traumatic injury to the spinal cord or the cauda equina with evidence of motor deficit, sensory deficit, and/or bowel and bladder dysfunction. The lesions must have significant involvement with two of the above three.

2. The extent of the injury must be certified by their physician or nurse practitioner.

3. Be medically stable as defined by the absence of the following:

a. an active, life-threatening condition (e.g. sepsis, respiratory, or other condition requiring systematic therapeutic measures); b. intravenous drip (IV) to control or support blood pressure; c. intracranial pressure or arterial monitoring

4. Certified as meeting nursing home level of care by their primary care physician or nurse practitioner;

5. At risk of nursing home placement in the absence of waiver services;

6. Meet the special income and assets limits (up to 300% of the Supplemental Security Income federal benefit rate) SSI.

This waiver is limited to individuals who are able to direct their own care or have a legal representative who they have chosen to direct their care.

Additional Eligibility for TBI Enrollment

The basic eligibility criteria include:

• age - no age limit;

• financial eligibility – the person must be eligible for Medicaid as described in the waiver;

• medical necessity – the individual must meet the level of care criteria for nursing facility (NF) care.

The waiver specific criteria the person must meet is based on his/her choice of services and service planning. They must:

• choose home and community-based services in lieu of nursing facility care/informed choice;

• have a severe traumatic brain and/or spinal cord injury verified by a physician or nurse practitioner;

• have an on-going need for waiver services;

• needs assistance with one or more of the activities of daily living such as dressing, bathing, eating, toileting, transferring;

• be at risk of nursing facility placement if services were not available.

Enrollment in the TBI/SCI Waiver is limited to:

• the number of persons approved by the Centers for Medicare and Medicaid Services (CMS) or the availability of state funding

• persons are enrolled from the Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver referral list on a “first come, first served” basis.

• MDRS suspends enrollment into the waiver program when it is determined that the existing case loads exceed funds within the current budget year.

Note: All services are provided pursuant to an individualized plan of services and supports (PSS) approved by the Division of Medicaid.

6.2 Traumatic Brain Injury (TBI)/Spinal Cord Injury (SCI) Physician Verification

The Traumatic Brain Injury/Spinal Cord Injury Physician Verification form must be completed by the physician certifying that the person’s injury was due to trauma and that their condition is medically stable.

The original copy of the TBI/SCI Verification form should be kept in the case file and a copy submitted to the DOM with the assessment.

It is necessary to use the verification form that is in the actual TBI/SCI Waiver.

(See Resource Guide for a copy of the TBI/SCI Verification form)

6.3 Pre-Admission Screening Appeals

Applicants/persons have the right to appeal long term care eligibility denials. If a person files an appeal and the case has not already been subject to the secondary review process, it will be handled in the manner described in Section 10.4. If the secondary review has already occurred, the case will be reviewed again by a supervisory level clinician who has not previously reviewed the case. Appeals will be processed in accordance with existing state policies.

6.4 Secondary Clinical Reviews

Secondary clinical reviews will be performed in the following circumstances:

• Individual scores below the clinical eligibility numerical threshold but falls into a DOM defined “automatic secondary review” range (score of 45-49) • Individual is under the age of twelve (12) on the date of the screening • Individual appeals the denial in accordance with Medicaid’s appeal procedures

Secondary reviews will be performed by DOM Registered Nurses, Nurse Practitioners, Licensed Social Workers and/or physicians as deemed by DOM to be clinically appropriate. DOM reviewers may request additional supporting documentation from the OSDP Case Manager before making a determination. The OSDP Case Manager also may submit additional supporting documentation, in a format specified by DOM, for consideration during the secondary review.

In conducting the secondary review, the reviewer may consider all available information from the assessment as well as any additional documentation provided by the OSDP Case Manager or applicant/person. The reviewer also may consult with the OSDP Case Manager and/or the certifying physician.

Once the secondary review is completed DOM will notify the applicant/person and MDRS of its determination. If the secondary review upholds the finding of clinical ineligibility, the applicant/person retains the right to appeal.

6.5 Applicants without Medicaid Eligibility

The completed assessment will be adjudicated through application of an eligibility algorithm that generates a numerical score. The numerical score will be compared to a DOM defined threshold score of fifty (50) or greater. If a person’s score is equal to or greater than the threshold of fifty (50), the applicant/person will be determined clinically eligible for Medicaid long term care.

Persons seeking applicable HCBS waiver programs that meet the threshold of fifty (50) or greater, or approved based on a secondary review will be referred to the requested HCBS waiver program. Each request will be considered individually and the applicant/person shall be admitted to the waiver as soon as possible. DOM/LTC will submit the required documentation for eligibility prior to admission as required for each HCBS waiver program. Financial eligibility requirements must be met at that time.

6.6 Appeal and Hiring Procedures for the Waiver

Decisions that result in services being denied, terminated, or reduced may be appealed. The person/legal representative has thirty (30) days from the date on the notice to appeal the decision. The person/legal representative can elect either a local or state hearing. All appeals must be in writing.

The consumer/legal representative is entitled to an initial appeal at the local level with the MDRS/OSDP Counselor and the immediate supervisor. The action will be explained at that time. The local hearing will be documented and become a permanent part of the consumer file.

If the consumer/legal representative does not agree with the decision made following the local hearing, he/she may appeal that decision by requesting a State level hearing within 15 days of the notice of the local hearing decision. The consumer/legal representative must submit this request in writing to the Division of Medicaid. Upon receiving the notification

from the Division of Medicaid that the consumer has requested a State level hearing, the OSDP Counselor/District Manager assigned will prepare a copy of the pertinent case file documentation used to reach the decision and send the copy to OSDP in the State Office. The copy of the documentation must be forwarded to the Division of Medicaid no later than five (5) days after MDRS has been notified that the consumer has requested a State level hearing.

The Division of Medicaid will assign a hearing officer. The consumer/legal representative will be given advance notice of the hearing date, time, and place. The hearing may be conducted with all parties involved present, or it may be conducted as a conference call (telephone) hearing. The hearing will be recorded.

The hearing officer will make a recommendation, based on all evidence presented at the hearing, to the Executive Director of the Division of Medicaid. The Executive Director will make the final determination of the case, and the consumer/legal representative will receive written notification of the decision. The final administrative action including state or local will be made within ninety (90) days of the date of the initial request for a hearing. OSDP will be notified by the Division of Medicaid to either initiate/continue or terminate/reduce services.

During the appeals process, contested services that were already in place must remain in place unless the decision is one of immediate termination due to possible danger or racial or sexual harassment of the service providers. The OSDP Counselor/registered nurse is responsible for ensuring that the consumer receives all services that were in place prior to their receipt of the notice that informed them that an action will occur regarding services.

NOTE: Refer to Resource Guide for appropriate notice of action forms.

6.7 Continuation of Services

(42 CFR 431.231)

If the person requests a hearing within 10 days of the date on the notice and prior to services being terminated, the services that the consumer is currently receiving may continue during the hearing process until a decision is made. Services must also continue if:

• Action is taken without giving the consumer advance notice of action when required;

• MDRS/OSDP determines that the action resulted from reasons not supported by Federal and State law or MDRS/DOM policy;

• If the person is unable to be located, services that were terminated must be reinstated if the person is located and requests that services be reinstated. Reinstatement occurs only if they are still certified for the waiver (same certification year).

6.8 Termination of Services if the Person Does Not Appeal

If a person does not request an appeal or request that services continue, IL or TBI/SCI Waiver services will end on the termination date that is on the notice they received.

If the certification ends before the 10-day notification period expires, the Case Manager will continue services through the 10-day notification period.

SECTION 7: INITIAL ASSESSMENT

7.0 interRAI Assessment Determination Requirements The new interRAI assessment process became effective on September 1, 2017. All applicants/persons applying for Medicaid long-term care on September 1, 2017 and beyond must complete an interRAI assessment for clinical eligibility determination. The interRAI assessment needs to be submitted to DOM within thirty (30) days of the Level of Care date.

Persons enrolled in Medicaid long term care must be recertified annually. Persons desiring continued waiver services must be recertified by submission of a new interRAI assessment at least ten (10) days, but no more than ninety (90) days, prior to the expiration of the current assessment. Failure to submit timely may result in a lapse in certification.

7.1 interRAI Assessment Requirements An initial interRAI assessment must be completed by a certified OSDP Case Manager and Registered Nurse. In addition, the Registered Nurse must have a current, active, and unencumbered registered nurse license to practice in the state of Mississippi, or be working in Mississippi on a privilege with a valid compact RN license, and at least one year of experience with the aged and/or individuals with disabilities. The nurse must not have a history of a criminal offense which precludes him/her from working with the vulnerable population. The RN’s name must not appear on the Mississippi Nurse Aide Abuse Registry or the Office of Inspector General’s (OIG) exclusion list.

The requirements for completing the interRAI assessment are as follows:

• Conduct a face-to-face interview with the applicant/person to the extent feasible, given the person’s physical and cognitive status; • Obtain information from caregiver(s) and/or designated representative, to the extent practicable; • Review medical records and other relevant medical documentation to verify medical conditions and services, to the extent practicable; • Provide information to the applicant/person and their responsible party/designated representative about available Medicaid program placement options, to facilitate informed decision making; • Provide information about alternative services/resources for persons who may not be eligible for Medicaid long term care; and • Provide information about the secondary review process and appeal rights for persons who may not be eligible for Medicaid long term care.

7.2 Documentation of Informed Choice

When a person is determined likely to require a home and community-based waiver service, the person and/or the person’s legal representative will be:

• Informed of any feasible alternatives under the waiver; and • Given the choice of either institutional or home and community-based services.

The person and/or the person's legal representative will sign the acknowledgment form where long term services and supports options were presented and explained. They also will acknowledge participation in selecting the desired waiver and of being informed of the Medicaid Program’s financial eligibility requirements.

The OSDP Case Manager must also sign the Informed Choice to acknowledge that the person and/or the person's legal representative was informed of the available long-term care options.

(See Resource Guide for the interRAI Informed Choice form).

The consumer cannot receive services from:

• More than one Medicaid Waiver program at a time, including waivers that are administered by the Department of Rehabilitation Services. This includes but is not limited to the Elderly and Disabled (E & D) Waiver and the Assisted Living (AL) Waiver.

• A Medicaid institutional program such as a nursing home facility.

7.3 Person’s Choice and Comparable Benefits

Non – Waiver Services

The Case Management Team must document any available benefits and services the person is receiving before waiver funds are used to meet the person’s needs. Example: If the person is eligible for Medicare and needs medical supplies/equipment. These services must be provided using Medicare resources before utilizing IL Waiver or TBI/SCI waiver funds.

The OSDP Case Manager is responsible for assisting the person in applying for and using all available non-waiver services.

The OSDP Case Manager must consider all third party resources including services provided by family members and other informal supports to reduce waiver expenditures. Non-waiver services must be considered in the development of the Plan of Services and Supports (PSS) and must not duplicate IL Waiver or TBI/SCI Waiver services.

7.4 Applicants Without Medicaid Eligibility

If the applicants’ individual income exceeds the Supplemental Security Income federal benefit rate (FBR) per month, the applicant can apply for Medicaid through the Special Handicapped Coverage Group, 300% of SSI federal benefit rate which is the institutional income limit for persons entering a nursing facility. The special income level permits Medicaid to cover persons who would be eligible for Medicaid as if they were in a nursing facility. The Special Income Criteria allows eligibility for persons with gross income at or below 300 percent of current SSI.

The special handicapped coverage group only applies to persons who have been determined to meet the medical eligibility criteria for the waiver by DOM.

The Special Income Criteria:

• Allows eligibility for persons with gross income at or below 300 percent of current SSI.

• Allows states to provide home and community based waiver services to children without regard to their parents’ income or assets and to married individuals without regard to their spouse’s income.

• Requires states to impose a post-eligibility cost-sharing burden.

• When the 300 percent rule is a state’s only option for providing Medicaid to higher income persons, it allows persons to achieve eligibility by diverting excess income into a Miller Trust (income trust account).

7.4.1 Applicants with Medicaid Eligibility Coverage

At the time of the initial intake, information on the applicant’s Medicaid and/or financial status will be obtained. OSDP staff handling the initial intake must determine if the applicant is currently on Medicaid and should check LTSS to confirm the applicant’s current status.

Applicant’s who receive Supplemental Security Income (SSI) are already eligible for Medicaid and will not need to have a Medicaid eligibility decision.

It is the OSDP Case Manager’s responsibility to assist the person in applying for Medicaid benefits.

7.5 Application Process for Medicaid Eligibility Determination

If the person does not have Medicaid coverage, their case record will be reviewed by the Division of Medicaid/Long Term Care (DOM/LTC) to determine if they meet the medical criteria for the waiver. If approved, the DOM will forward notification to the Medicaid regional office that the applicant has met medical certification for participation and would like to apply for coverage under the Home and Community based services Special Income

Category (300% of SSI).

DOM/LTC will approve the Level of Care (LOC) in LTSS. This will notify the OSDP Case Manager that the person’s application for waiver services has been determined to meet the medical criteria for the waiver and will be certified pending approval for Medicaid coverage.

The OSDP Case Manager will inform the person in writing or by phone that he/she will need to go to their Medicaid Regional Office within 10 days to apply for Medicaid eligibility through the Special Handicapped Coverage Group.

The HCBS Division will maintain a case record in a pending status for 60 days from the date it was processed. If the applicant and/or their representative does not initiate appropriate action to obtain eligibility, failure to comply will result in closure of their case.

After the applicant completes the application at the Regional Office, they have 45 days to provide all requested information to complete the eligibility process. Failure to comply will result in closure of their case. Medicaid will inform the OSDP Case Manager that he/she has been approved.

Examples:

Case record is approved 5/01/16, the applicant takes no action toward obtaining Medicaid eligibility by 07/01/16, case record will be disapproved and returned to the Case Manager.

Case record approved 5/01/16, applicant waits until 06/29/16 to fill out application at the Regional Office, the “clock” restarts time -allows applicant 45 days to complete the eligibility process.

No services can be initiated under the waiver program until eligibility has been established. The DOM will submit an approved Overall Decision in LTSS. The effective date is now the Level of Care date.

7.6 Family Members and Informal Supports

As part of the initial assessment, the Case Manager determines the need for personal care services and the estimated hours necessary to meet those needs. The need for a particular task is determined based on a person’s functional limitations to complete that task and if that task will be completed by other sources including unpaid caregivers, such as family members or other informal supports. Personal care hours cannot be authorized if there is not a need for these services.

The Plan of Services and Supports (PSS) should be developed considering the needs of the person and the stated intentions and willingness of the caregiver and other informal supports to provide unpaid care. The PSS will reflect hours of those needed tasks that will not be provided by another source or the caregiver as unpaid care. The caregiver should

be asked in all cases which services/tasks he or she will provide without payment.

A legally responsible person, such as a spouse or parent of a minor, may not be employed to be paid as a Personal Care Attendant.

Additionally, there must be adequate justification for the relative to function as the PCA, e.g., lack of other qualified PCAs in remote areas. PCA services may be furnished by family members provided they are not the parent (or stepparent) of a minor child, or their spouse. Only qualified family members who are not legally responsible for the person may be employed as the personal care attendant. Family members must meet all provider standards, and must be certified competent to perform the required tasks by the person and the case manager/registered nurse.

7.7 Informal Support Providing Assistance With Activities of Daily Living

Activities of daily living necessary for daily functioning include eating, toileting, transferring, dressing, bathing, personal hygiene, ambulation and meal preparation as identified in the interRAI assessment. The activities of daily living are those tasks that do impact the person’s health and safety.

7.8 Ensuring Health and Safety

The OSDP Case Manager and a Registered Nurse have the responsibility to ensure the person’s health and safety and develop a Plan of Services and Supports (PSS) that includes all necessary elements to adequately meet the person’s needs. Use of informal supports, third party resources and other community resources are an integral part of the overall development of the PSS. The use of third party resources ensures the most cost-effective and efficient use of funds to meet the person’s needs.

The Case Manager must inform the family member or other non-paid supports of the importance of their contribution toward the Plan of Services and Supports.

7.9 Informing Applicant/Persons of Estate Recovery

All persons applying for IL Waiver or TBI/SCI Waiver services must be informed about Medicaid Estate Recovery. During the initial application process or quarterly home visits, the Case Manager must inform the person about Estate Recovery and document in the case file that this information was provided to them. In addition, all waiver recipients must be given the DOM’s contact person and phone number to refer for more estate recovery information. At application, the fact that the person was informed of Estate Recovery should be documented in the initial home visit case note.

7.10 What is Estate Recovery?

In order for Estate Recovery to apply, the applicant/person must be eligible for Medicaid and be:

• age 55 and older, and, • in a nursing facility or enrolled in a home and community based services waiver program at the time of death. • enrolled in hospice at the time of death.

The Estate Recovery law does not apply if, at the time of death, the applicant/person has:

• A surviving husband or wife, or • A surviving dependent child or children under 21 years of age, or • A surviving dependent child or children of any age who are blind or disabled, or • An undue hardship condition that causes Estate Recovery not to apply.

Estate property is made up of real and personal property that the applicant/person owns at the time of death:

• Real property such as home, family business, farm or ranch; • Cash reserves, stocks, bonds, automobiles, recreational vehicles, mobile home; • Or any property with value owned by the beneficiary in full or in part

7.11 interRAI Instrument Components

The interRAI consist of nineteen (19) sections, some of which have two (2) or more subsections. The table below lists the sections:

Section A. Identification Information B. Intake and Initial History C. Cognition D. Communication and Vision E. Mood and Behavior F. Psychosocial Well-being G. Functional Status H. Continence I. Disease Diagnoses J. Health Information K. Oral and Nutritional Status L. Skin Condition M. Medications N. Treatments and Procedures O. Responsibility P. Social Supports Q. Environmental Assessment R. Discharge Potential & Overall Status T. Assessment Information

7.12 interRAI Certification Periods Clinical eligibility will be granted for a period of one year. HCBS waiver persons desiring continued waiver services must be recertified by submission of a new interRAI assessment at least ten (10) days (but no more than ninety (90) days) prior to date of expiration of the current interRAI assessment. Failure to submit the assessment to the DOM timely will result in a lapse in certification. If there is a lapse in certification, all services must stop for the person until DOM has approved the recertification application packet.

7.13 interRAI Re-Certification

A re-assessment of a person’s functional limitations and functional capacities as they relate to activities of daily living and their impairment must be completed annually for persons enrolled in the waiver. The re-certification re-assess’ their need for services that will be developed on the PSS to maintain them in his/her own home.

It is the responsibility of the OSDP Case Manager to complete the annual re-certification. It is performed in the home and again gives the Case Manager the opportunity to visually re-assess if the person continues to meet the medical criteria for the waiver program.

In order to assure that the PSS is reassessed annually as required by the waiver requirements, the Case Manager must:

1. Begin the re-certification process no sooner than 90 days prior to the certification end date/expiration of the current LOC date; 2. Complete the development of the re-certification PSS and verify all aspects of eligibility and; 3. Complete all necessary procedures no sooner than 90 days prior to the expiration of the current PSS and submit all information to OSDP Nurse Administration no later than 60 days prior to the expiration of the current LOC date. 4. Enter information in the OSDP program certification page to reflect the date of reassessment.

In addition to the above, the Case Manager must run their tickler file from AACE which will ensure timely recertifications.

Note: Case Managers must ensure that the person understands that all services provided through the HCBS Waiver programs are subject to the approval of the Division of Medicaid.

SECTION 8: PLAN OF SERVICES AND SUPPORTS (PSS)

8.0 Home and Community-Based Services – Plan of Services and Supports (PSS)

The Plan of Services and Supports (PSS) is the fundamental tool by which the health and

welfare of the member served under the waiver is assured. It is the link between the assessment and delivery of services.

The OSDP Case Manager/Registered Nurse must, together with the potential member, develop a PSS based upon assessment results.

The Plan of Services and Supports is developed at an in-person meeting with the member/consumer by the OSDP Case Manager and RN.

The member’s deficits identified on the interRAI assessment are addressed by the OSDP Case Manager and Registered Nurse to develop a written plan of services and supports. The PSS is used to address those services and activities to overcome or enrich the effect of the deficits in accomplishing the activities of daily living and maintaining an independent lifestyle in the community.

The medical and physical limitations are considered simultaneously with the independent living potential of the member to avoid institutionalization.

Applicable non-waivered services, services provided by other funding sources, are included in the PSS and subsequently monitored as non-waivered services.

The need for any services on the PSS must be addressed in one or more of the assessment areas (ex. Home Modification and Specialized Medical Supplies).

Note: There are no pre-determined or fixed limits on the number of services or the number of units of any particular service.

The Plan of Services and Supports is subject to periodic reviews and updates. The purpose of these reviews is to determine the appropriateness and adequacy of the services provided and to ensure that the services furnished are consistent with the nature and severity of the member’s disability.

Plan of Services and Supports must be submitted for the initial certification and annually for each re-certification. Added services must be approved by DOM. Sufficient documentation must be submitted to justify the added service request.

8.1 The Case Management Team at the Service Planning Meeting

The OSDP Case Manager leads the Case Management Team. Those included in the Case Management Team are the Case Manager, member or their designated representative and the Registered Nurse.

The Case Management Team is involved and is responsible for planning through the assessment of the member’s needs during the development of the Plan of Services and Supports. The Case Management Team is responsible for:

• Considering all available assessment information

• Estimating costs for the types and amounts of services identified as necessary to meet the member’s needs • Determining that the member can be served safely in the community • Identifying the waiver and non-waiver services to be used to meet members’ needs • Documenting the PSS and other supporting documentation • Determining that the services identified on the PSS are necessary as an alternative to institutional care and appropriate to meet the needs of the consumer.

The Case Management Team must make all the determinations listed above for the initial and each subsequent PSS.

If the OSDP Case Manager/RN has doubts about the adequacy or appropriateness of the PSS to meet the needs of the applicant in the community, these concerns should be expressed and documented during the assessment/re-assessment process.

The OSDP Case Manager may involve other members such as the District Manager or other OSDP Administrative staff in the process.

Refusal of a member to sign the PSS should be documented in the case file notes for the assessment meeting.

8.2 Revising the Plan of Services and Supports (PSS) – Increasing/Decreasing Services – Requesting Approval

Within the certification year, it may be necessary to revise the PSS due to changes in the needs of the member. The Case Manager should request a service change in the PSS, such as hours, days or SMS services, when there is significant improvement or decline in the member’s condition and the PSS does not reflect their current needs.

The OSDP Case Manager must obtain appropriate documentation to support the need to change services. The request must be submitted for review and approval to their District Manager prior to any changes made to the PSS.

The Case Manager must:

• Review DCW Task Assignment Sheet and HHA Exchange to determine tasks the DCW is currently performing • Determine the reason(s) for the request to change services and review specific information from the member indicating that the member’s condition requires a change in services (Example: If care was being provided as unpaid care by a family member, determine why this person is now unable to provide the care; OR determine if the member has had a significant change in their medical condition.) • Obtain the member’s consent to request current medical information, if additional documentation is needed, to support the change in their medical condition. Include this information, if obtained, prior to submitting the request for approval • Submit all supporting documentation, case notes, and a copy of the PSS for review

and approval to the District Manager. NOTE: The District Manager, at their discretion, has the option of submitting the request to the OSDP Administrative RN for additional review of medical documentation.

Once the District Manager has reviewed the request, determined if funds are available, he/she will notify the Case Manager in writing of the approval/disapproval

If the disapproval is based on documentation submitted, a request will be made to the Case Manager to submit or clarify documentation prior to final decision.

If the request has been approved, the District Manager will instruct the Case Manager to submit a change request for the current PSS to reflect the change(s) in services.

The DCW cannot work the additional hours until the above procedure has been completed.

The Case Manager will send a MDRS Notice of Action to the member informing he/she of the changes in services.

8.3 Revising the Plan of Services and Supports (PSS) – Adding New Services – Requesting Approval

The Case Manager may request approval for added service(s) that were not included on the Plan of Services and Supports after it has been determined that the member has an unmet need for these items. The request must be submitted for review and approval to the District Manager prior to any changes being made to the PSS. When an added service is requested, the Case Manager must proceed as follows:

• Evaluate the necessity of the added service and obtain appropriate documentation to support the request for additional services to the PSS

• Obtain a doctor’s prescription for the service item needed

• AT Referral needed if driving evaluation, home/vehicle modifications or DME is not covered under insurance

• Investigate all comparable benefits (Medicaid, Medicare, Home Health, any other third-party resources)

• Upon receipt of necessary documents (AT report, specs, quotes, prescriptions), submit to District Manager by entering program certification page information to request funding and attach all necessary documents in AACE.

• Complete and submit the following to your District Manager for approval and review of documentation to verify appropriate need for additional service item(s):

o Case note justification o Approved Adaptive Aid form

o Copy of the Prescription(s) o Copy of Quotes o AT Specification Report (if applicable)

The District Manger will review the request and enter the approval date on the program certification page in AACE. If there are questions regarding the documentation, a request will be made to the Case Manager to submit or clarify documentation prior to a final decision.

• The District Manager will instruct the Case Manager to complete a Change Request to add the new service to the current PSS. The OSDP RN will review requests and submit them to DOM.

• After approval is received from DOM, OSDP state office will notify the Case Manager and District Manager via a Notice of Determination that the service has been approved.

• The Case Manager will send a Notice of Action to the member to inform them of the change to the PSS.

• Funds will then be distributed to the Case Manager to plan and authorize for the added service.

8.4 Time Frame for Authorizing for Approved Supplies/Equipment

Within five (5) working days of receiving approval to purchase services, the services must be planned on the PSS, authorized and purchased. If supplies/equipment cannot be authorized due to unusual circumstances such as special supply needs or the availability of a supply, the member must be notified and given the reason. Case notes must be documented to reflect the delay in services.

8.5 Re-Authorizing for Supplies Currently Planned and Approved on the PSS

If the member has existing supplies when it is time to re-authorize for the supplies, the Case Manager must document that the member has existing supplies on hand, and they do not require delivery at this time. The vendor must be contacted so that they will not deliver surplus supplies.

Stock piling of medical supplies should not occur. Supplies needed on an on-going basis should be delivered so that there is not more than the one-month supply in the member’s home at a time. The delivery date of the supplies must be documented.

8.6 Emergency Service Changes to the PSS

If the member experiences an emergency or crisis that the OSDP Case Manager/RN in their judgment feels requires additional DCW hours, the Case Manager must provide the additional care to meet the member’s needs. The Case Manager must then verbally notify

the District Manager by the next workday of the change. The Case Manager must then, within (7) seven workdays, submit to OSDP Program Administration via the District Manager:

• The Case note or rationale for the service change or any other reports/documentation; the service and amount of additional services needed; the anticipated begin and end date for the service. It must be signed by the OSDP Case Manager • Documentation of medical necessity/prescription, AT evaluation, Adaptive Aid, Medical Supply forms • A copy of the PSS identifying the change

The OSDP Case Manager may procure adaptive aids and medical supplies not currently authorized on the PSS in emergencies that are defined as only situations that place the consumer’s health and/or safety at risk. If procuring emergency adaptive aids and medical supplies, the Case Manager must:

• Submit a copy of the PSS identifying the change and the consumer’s signature or verbal consent, indicating that the change was an emergency • Verbally inform the Regional Manager by the next workday after purchasing the necessary item • Submit the following documentation to OSDP Administration via the Regional Manager:

o the revised PSS showing the change and the member’s signature showing that the purchase was needed; o Case note/rationale explaining why the emergency purchase was necessary; and o Physician prescription or medical necessity indicating that the supply is an emergency.

SECTION 9: CASE MANAGEMENT

9.0 Case File Documentation of Monitoring Services

A. Required documentation of Case Management monitoring activities, include, but not limited to:

1. All initial and re-certification Plan of Services and Supports (PSS) must include all the services (both waivered and non-waivered) that the member is receiving that are adequate to meet their needs.

2. Case notes/records in which the OSDP Case Manager documents the appropriateness and adequacy of the services the member is receiving should be included in the member’s case file.

3. Information regarding the member’s complaints regarding services being provided.

4. Documentation of any actions taken in a crisis.

5. Monthly contacts should include, but are not limited to:

a) OSDP Case Manager’s evaluation of health, welfare and safety of members, b) Correspondence received from Medicaid or SSI, c) Contact with member/caregiver, d) List at least three (3) activities the DCW is performing; e) Satisfaction of services being provided; f) List all waivered and non-waivered services the member is receiving. g) If a specific problem was identified, was a follow-up conducted or resolution obtained?

6. Quarterly Reviews are assessed to see if they were done every three (3) months and the following documentation is required at a QR visit:

a) Describe the progress towards achieving the goal identified on the PSS. b) Describe, in detail, the member’s appearance safety and home environment. c) List all waivered and non-waivered services the member is receiving. d) List the services that were identified during the visit with the member and satisfaction of services being provided (include the status of all pending service requests). e) Describe any medical changes in the member’s condition, hospitalizations, or emergency room visits etc.). f) Information regarding any letters or correspondence from Medicaid/Medicare the member received. g) List anyone present during the visit. h) List DCW(s), hours worked, ADL’s performed by DCW and if the member is satisfied with their services. i) Information regarding the use of unauthorized restraints or seclusion observed or reported by the member. If so, explain. j) Information regarding any dissatisfaction expressed by the member pertaining to the services he/she has received. If member did express any dissatisfaction of services, provide how they will be addressed and resolved. k) Summarize the visit.

B. If problems are identified, the OSDP Case Manager is responsible for taking appropriate steps, including, but not limited to:

1. Making a determination if the PSS requires a change to address new needs,

2. Referring any suspected case of abuse, neglect, or exploitation to the Department of Human Services, the Attorney General’s Office, and the MDRS/OSDP State Office,

3. Referring any potential fraud to the Attorney General’s Office,

4. Encouraging the member to comply with the PSS in those situations in which the member is unwilling to allow the DCW or other providers to deliver services as identified in the PSS or otherwise is refusing to comply with his/her PSS.

9.1 Registered Nurses

Qualifications of the Registered Nurse:

1. Must have a valid license to practice as a Registered Nurse in the State of Mississippi,

2. Must have at least one year of experience with the aged and/or individuals with disabilities,

3. Must not have a history of a criminal offense which precludes him/her from working with a vulnerable person,

4. Must not appear on the Mississippi Nurse Aide Abuse Registry or the Office of Inspector General exclusion list,

5. Must complete the application for employment by Ability Works.

Proof of R.N. licensure can be validated by:

1. Checking the Mississippi Board of Nursing website at www.ms.gov/msbn.

2. Go to the Nurse Inquiry link,

3. Enter either the License Number and Last Name or,

4. Enter the last 4 digits of the SSN and the Last Name,

5. Print out the Nurse Details and keep it in your file.

6. Frequency of verification is ongoing and annually.

9.2 Case Manager/RN Roles

The case management team consists of the OSDP Case Manager and a Registered Nurse (RN).

A. Case Management activities that require a Registered Nurse:

1. Initial/Readmission assessment for IL and TBI/SCI Waiver.

2. Quarterly home visits and Direct Care Worker (DCW) certifications, as deemed appropriate by the OSDP Case Manager; (Case managers are allowed to conduct quarterly reviews, DCW certifications, and annual re-certifications without the RN component, if appropriate.)

3. Assist Case Manager in monitoring services delivered to participants at quarterly home visits.

4. Assist in evaluating/monitoring services delivered.

B. The Case Manager and the RN responsibilities include, but are not limited to:

1. Initial Evaluation is conducted by the Case Management Team using a Long Term Services & Supports (LTSS) assessment to ensure the needs of the participant are fully captured. The level of care is certified by a physician.

2. Long-term care options are explained by the Case Manager prior to enrollment and the participants indicate their choice of waiver services or institutional services by evidence of their signature and initials placed by their service choice. Participant signs and attests to their choice of placement on an Informed Choice form.

3. Train DCWs and have them demonstrate competency to perform each activity of daily living task to the participant, Case Manager, and RN (if applicable) prior to rendering any waivered services.

4. Must see the DCW demonstrate the ability to comprehend and comply with basic written and verbal instructions at a level determined by the participant and case management team to be adequate in fulfilling the responsibilities of personal care.

5. Must certify and verify competency of the DCW to perform the required tasks for the participant.

6. The initial Plan of Services and Supports (PSS) is developed at the time of the completion of the LTSS assessment with the case management team.

C. Case Managers review and approval of RN time logs include the following procedures:

1. OSDP contract nurse (RN) time logs must be reviewed and verified by the Case Manager, as they are responsible for ensuring that their RN is complying with all established policies and procedures.

2. The RN time log must accurately reflect the name of each IL or TBI/SCI waiver participant in the time order of the home visit completed that day. An intentional misrepresentation of hours worked constitutes fraud in accordance with MDRS policy.

3. Time in and time out of visit on each date must be documented by the RN.

4. At no time will pre-signed time logs be submitted for payment. All time logs must be signed in blue ink by the RN and Case Manager at the end of each day worked.

5. Case Managers will review, approve and sign the original time log in blue ink for each day worked and submit in accordance with the payroll schedule. It is the Case Manager’s responsibility to ensure that all participants listed on the RN time log are correct and in the order of when the home visits were completed.

6. RNs are paid hourly for in-home visits. They are paid per visit if completing virtual assessments/visits.

7. All OSDP RN time logs are subject to review. All RN time logs are to be filed in a 3-ring binder by fiscal year for each case manager.

SECTION 10: PERSONAL CARE SERVICES

32 Miss. Admin. Code Pt. 1, R. 10.0 Personal Care Attendant/Attendant Care Services

Personal Care Attendant services are service components of the following programs/funds:

1. State Attendant Care (SAC);

2. Independent Living (IL) Waiver;

3. Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver;

4. Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Trust Fund - 12 month Transitional Program.

Personal Care Attendant services are provided to meet daily living needs to ensure adequate support for optimal functioning at home or in the community, but only in non-institutional settings.

Personal care services may include, but are not limited to, Activities of Daily Living (ADLs) such as:

1. Assistance with bathing (sponge, tub) personal grooming, dressing, personal hygiene, toileting, transferring, and ambulation.

2. Assistance with housekeeping that is directly related to the person’s disability and which is necessary for the health and well-being of the person (not family) such as, but not limited to, changing bed linens, straightening area used by person, doing the personal laundry of the person, preparation of meals for the person, and cleaning the person’s equipment such as wheelchairs or walkers.

3. Food shopping, meal preparation and assistance with eating, but does not include the cost of the meals themselves;

4. Support for community participation by accompanying and assisting the person as necessary to access community resources; participate in community activities, including appointments, shopping, and community recreation/leisure resources, and socialization opportunities, but does not include the price of the activities themselves.

Personal care services are non-medical, hands-on care of both a supportive and health related nature. The provision of personal care services is recorded on the PSS and is not purely diversional in nature.

Personal care attendant services may be furnished by family members provided they are:

1. NOT the parent (NOR step-parent) of a minor child NOR their spouse.

2. NOT the executor of the person’s estate NOR the person with durable/medical power of attorney.

3. Qualified family members who are NOT legally responsible for the member.

4. Certified competent to perform the required tasks by the member and the OSDP Case Manager/Registered Nurse (if applicable).

5. Adequately justified to function as the attendant, e.g., lack of other qualified attendants in remote areas.

There must be adequate justification for the relative to function as the DCW, e.g., lack of other qualified DCWs in remote areas. DCW services may be furnished by family members provided they are not the parent (or step-parent) of a minor child, or their spouse, or reside in the home with the person. Only qualified family members who are not legally responsible for the person may be employed as the personal care attendant. Family members must meet all provider standards, and must be certified competent to perform the required tasks by the person and the case manager/registered nurse.

MDRS verifies the competency for all direct care workers (DCW).

Skilled services that may be performed only by a health professional, such as a nurse, are not considered personal care services. Examples of such skilled services include, but are not limited to, catheter care, wound care, ventilator care, etc.

Payment will NOT be made for services furnished to a person by anyone legally responsible for the person. Services are often supplemented by informal, unpaid care provided by other family members and friends. This practice is commendable and often necessary to reduce costs and assure quality and continuity of care.

32 Miss. Admin. Code Pt. 1, R. 10.1 Choosing a Personal Care Attendant/Direct Care Worker (PCA/DCW)

The person’s choice of attendants is not limited unless:

• The Case Manager has specified that a particular attendant should not be employed; or • The Case Manager or RN has determined that the attendant is not providing adequate care.

If an attendant is hired and later identified as being inappropriate or undesirable, they must meet with OSDP staff to discuss the issues and try to resolve the problem. If the problems cannot be resolved through discussion, the Case Manager will document the discussion in AACE case notes and take appropriate action.

A current DCW should not continue employment if:

• There is evidence to indicate that the DCW has abused, neglected, or exploited the person whom they are caring for and/or others; • The DCW has been providing inadequate care and the issues have not been able to be resolved; or • It is discovered that the DCW is the spouse or the individual legally responsible for the person. • The DCW’s name shows up on the OIG or the Nurse Abuse Registry.

32 Miss. Admin. Code Pt. 1, R. 10.2 Rule 10.2

Individual Requirements to be Considered for Employment and Certification as a Personal Care Attendant (PCA)/Direct Care Worker (DCW)

1. Must be at least 18 years of age.

2. Must be a high school graduate, have a GED, or demonstrate the ability to read and write adequately to complete any required forms and reports of visits.

3. Must be able to follow verbal and written instructions.

4. Have the ability to communicate effectively and carry out directions.

5. No known physical/mental limitations that prevent lifting, transferring or providing any other assistance to the person.

6. Must be certified as meeting the training and competence requirement by the person and the Case Manager/RN.

7. Completed training/instruction in the areas of the Vulnerable Person’s Act, caregiver boundaries, and dealing with difficult patients upon hire and annually thereafter.

8. Must demonstrate the ability to comprehend and comply with basic verbal/written instructions at a level determined by the Case Manager and RN in fulfilling the responsibilities of the attendant.

9. A DCW may be certified by the Case Manager and the RN at the time of the initial assessment. However, the DCW cannot begin providing services to the person until MDRS has received an approved Overall Decision from the Division of Medicaid and the DCW has been certified. If another funding source will be paying for the services, such as TBI/SCI Trust fund, the DCW can begin providing services after certification.

10. DCW cannot begin working with the member until the entire application for employment has been processed by State Office. Upon completion of the interview and a contingent job offer, a background check will be conducted for all potential new hires recommended for employment. The background check will be processed through the federal and state bureaus of investigation and must be clear of any felony convictions or certain misdemeanors which include, but are not limited to, possession and/or sale of drugs, murder, manslaughter, armed robbery, rape, sexual battery, any sex offense, child abuse, arson, grand larceny, burglary, gratification of lust, aggravated assault, or felonious abuse and/or battery of a vulnerable adult, or that any such conviction or plea was reversed on appeal or a pardon was granted for the conviction or plea.

32 Miss. Admin. Code Pt. 1, R. 10.3 Situation in Which a New DCW Certification May Not be Required

1. If a DCW has previously been certified to provide services for a particular person and their employment ended, but within twelve (12) months of the last day they were employed for the person, the person desires to re-employ that same DCW, they do not have to be re-certified unless the person’s condition has changed since the last day that they worked for them. However, the Case Manager must work with the person and the DCW to complete a new Task Assignment Sheet so that there will be a clear understanding of the tasks the person is needing and requesting assistance with. The Case Manager must also ensure the DCW understands how to utilize Electronic Visit Verification (EVV) in the HHA Exchange mobile application. This mobile app allows clocking in and out at the appropriate member location, indicates which tasks were performed and signing off on the shift that was worked. In addition, the HHA Exchange mobile application is the tool that is used for payroll processing. The case file must document this.

If it has been more than 12 months since the DCW was employed to work for a member, they must be re-certified.

2. If a DCW was certified to provide services for a member and another person wishes to employ them as their DCW, the DCW must be certified to work for each individual person. A copy of all DCW certification information must be in the person’s case file that the DCW is providing services to and attached in AACE.

3. If a DCW was certified to provide services for a member but is no longer working for them, and a different person has requested to employ this particular DCW, even if within 12 months of the last day of employment as a DCW, they must be certified to work for the new member.

32 Miss. Admin. Code Pt. 1, R. 10.4 Rule 10.4

Personal Care Attendant (PCA)/Direct Care Worker (DCW) Training Responsibilities of the OSDP Case Manager

Training shall be conducted by the person receiving services (or caregiver), the OSDP Case Manager and Registered Nurse (if applicable). Training shall include the purpose and philosophy of self-directed services by person with disabilities, disability awareness, employee-employer relationships, and the need for respect for the person’s privacy and property.

The Case Manager must provide orientation regarding the training program, which must be completed prior to being certified. The Case Manager/RN (if applicable) should provide orientation to the functional requirements for a DCW in the person’s home, on or before the service initiation date for DCW Services, in order to:

• Provide them necessary training to deliver the personal care tasks and document that the orientation/training was provided or initiated;

• Determine if the individual is competent to deliver the authorized personal care tasks and document competency on the Provider Competency Form.

The Case Manager/RN (if applicable) will provide information to the DCW on the following:

• Information about the person’s condition and how it may affect the performance of tasks;

• Tasks to be performed, work schedule, safety and procedures;

• Changes in the person’s condition in which they should contact the Case Manager to report the problem.

If more than one attendant is needed to provide the service, the individuals identified as attendants should be certified at the same time.

The Case Manager will provide information to the DCW on the following:

• The maximum number of DCW hours per day and the number of days per calendar week the person is certified/approved to receive DCW services.

• A calendar week begins on Sunday and ends on the following Saturday.

• In order to protect the health, safety and well-being of the DCW and the person, the DCW is not to provide services for the person over forty (40) hours per calendar week without prior approval from the Case Manager. The DCW may contact the District Manager for prior approval if the Case Manager is unavailable. Failure to do so may result in termination. • In the event of an emergency which requires services to be provided to the person

beyond 40 hours in a calendar week, and before the DCW continues to provide services for the person beyond the 40 hour limit, the DCW and the person shall make every effort to secure care for the person by contacting the person’s backup DCW or a member of the person’s support system (i.e., family member or friend).

If neither a backup DCW, nor a person within the person’s support system are available to provide services during a time of emergency and the DCW must work beyond the calendar week limit of 40 hours over the weekend, the DCW is required to contact the Case Manager no later than 10:00 a.m. the following Monday. Failure to do so may result in termination.

• Discuss with the DCW how to access the HHA Exchange mobile application for electronic visit verification (EVV) to be performed for each shift.

• Inform the DCW of the pay periods and the amount to be paid.

• Inform the DCW that services cannot be rendered while the person is in the hospital.

The DCW will be instructed to provide information to the Case Manager on the following:

• To provide at least a 5 day notice if they decide to no longer work for the person.

• If the condition of the person changes (improves or declines).

• Any suspicion or instances of abuse, neglect, or exploitation of the person.

32 Miss. Admin. Code Pt. 1, R. 10.5 Flexibility to Change PCA/DCW Tasks Assigned

The person and the Case Manager can modify the initial schedule and change the personal assistance tasks assigned that are included on the DCW Task Assignment Sheet to a mutually agreeable schedule that will meet the person’s needs. This does not change the number of hours that have been approved as needed. Only DCW tasks that are allowed on the IL Waiver or TBI/SCI Waiver can be provided and paid for. If additional hours are needed, the procedures outlined in Section 12.2 must be utilized. The schedule modification can be ongoing; for example, the person’s scheduled tub bath daily can be changed to 4 times per week; or tasks assigned Monday, Wednesday and Friday can be changed to Monday, Tuesday and Wednesday. Flexibility allows the person’s tasks to meet the particular needs of the person, considering changes in their condition and wants. Hours are based solely on hours assumed to be provided within the home environment. Flexibility is not intended to be for convenience or to be applied to justify the absence of an attendant or break in services.

OSDP has a backup system to assure the provision of all DCW services on the schedule agreed and approved without service break; even if there are unexpected changes in

personnel.

If the member notifies the Case Manager that the DCW has not provided services as mutually agreed, the Case Manager must contact the DCW to find out the problem of which endangered the health and safety of the member.

32 Miss. Admin. Code Pt. 1, R. 10.6 Approval of EVV Entries (Waiver Programs)

The DCW is responsible for completing their time entries for each shift in the HHA Exchange mobile application for waiver members. The Case Manager/Assistant will monitor this EVV system daily to check for completed shifts, tasks performed, GPS locations and appropriate signatures. Insufficient EVV data or pre-billing errors will be confirmed through the member and/or the DCW and corrected by the Case Manager/Assistant in HHA Exchange.

EVV data that passes the system’s compliance is sent to AbilityWorks payroll department for payment of the confirmed shifts within the established time frame for each DCW.

DCW will utilize a DCW missed EVV Service Note only in circumstances in which the DCW was unable to clock in/out or if the mobile application fails. DCW missed EVV Service Notes must be utilized whenever a manual change in the HHA Exchange system takes place by the Case Manager or the Case Manager Assistant. The member, DCW and Case Manager must sign and date each DCW missed EVV Service Note.

32 Miss. Admin. Code Pt. 1, R. 10.7 Approval of Timesheets (Non-Waiver Program)

Timesheets are still required to be submitted for members on the State Attendant Care and TBI/SCI Trustfund programs. These non-waiver programs do not utilize EVV entries. Paper timesheets are received by the Case Manager and processed for payment and billing.

SECTION 11: RESPITE CARE SERVICES

32 Miss. Admin. Code Pt. 1, R. 11.0 Respite Care Services

Respite Care Services are a service component of the TBI/SCI Trust fund and the TBI/SCI Waiver. Respite care services gives short-term, temporary relief to the usual caregiver because of the absence or need for relief of the caregiver. Respite provides all the necessary care that the usual caregiver would provide during that time period to the member. Respite care enables the member to remain in their current living situations and provides services to the family member. Respite care services and DCW services are not the same.

Goals of Respite:

• Reduce stress and help maintain family relations

• Assist and strengthen the family as a unit

• Contribute to good physical and emotional health

• Provide the caregiver time to rest, relax, and re-create

Respite care may be provided in the individual’s home or place of residence, foster home or institution – Medicaid certified Hospital, Medicaid certified Nursing Facility, Group Home and Licensed respite care facility.

A DCW, Nurse Aide/Certified Nursing Assistant (CNA), Licensed Practical Nurse (LPN) or Registered Nurse (RN) may provide respite care services. The primary care physician determines the level of respite care that the member requires. This is documented by his/her physician by completion of the Respite Tier-Determination Form (see OSDP Insight – Respite Tiers).

Tier 1 – DCW Tier 2 – CNA Tier 3 – LPN Tier 4 – RN

All respite care providers must be certified as meeting the skill level determined to be required by the physician, by the OSDP Case Manager and the Registered Nurse (Case Management).

When respite care is provided, payment for other duplicative services is precluded.

The Tier determination level should also be reflected on the authorization for services so that the appropriate pay level (tier) is verified.

Limitation: A member is allowed a maximum of 288 respite hours per year which is scheduled at the discretion of the member and regular caregiver. Institutional Respite is only for TBI/SCI waiver members (720 hours or 30 days in a facility per year). However, the OSDP Case Manager must be notified when it becomes necessary for the individual to use respite services that have been planned on the PSS for waiver cases and ILP for all IL cases.

32 Miss. Admin. Code Pt. 1, R. 11.1 Certifications Required for Respite Providers

1. In Home Companion (DCW)

• Must be at least 18 years of age.

• Must be a high school graduate, have GED, and/or demonstrate ability to read and write adequately to complete required forms and reports of visits and follow verbal and written instructors.

• Must have no known physical/mental limitations that interfere with their ability to lift, transfer or provide any other assistance to the member. If the individual indicates any physical/mental limitations, statement must be received form their primary care physician treating that condition indicating their ability to perform the duties of a respite provider.

• Must demonstrate their ability to perform each task of assistance with the activities of daily living to the recipient, IL Case Manager and Registered Nurse prior to rendering any services under the waiver.

• An individual that has satisfactorily provided in-home companion respite services for four (4) weeks prior to coverage under the waiver program, with such service certified by and verified by the member, the IL Case Manager and the Registered Nurse.

2. Certified Nursing Assistant (CNA)/Aide

• Must be at least 18 years of age.

• Must have satisfactorily completed a nurse aide training program for a hospital, nursing facility or in home health agency (copy of certification) or

• Was continuously employed for twelve months during the last three (3) years as a nurse aide, orderly, nursing assistant or an equivalent position by one of the above medical facilities.

• Must have no known physical/mental limitations that interfere with their ability to lift, transfer or provide any other assistance to the member. If the individual indicates any physical/mental limitations, statement must be received from their primary care physician treating that condition indicating their ability to perform the duties of a respite provider.

3. Licensed Practical Nurse (LPN)

• Must be at least 18 years of age.

• Must have satisfactorily completed a Licensed Practical Nurse Program (Copy of Certification in the State of Mississippi).

• Must have no known physical/mental limitations that interfere with their ability to lift, transfer or provide any other assistance to the member. If the individual indicates any physical mental limitations, statement must be received from their primary care physician treating that condition indicating their ability to perform the duties of a respite provider.

4. Registered Nurse (RN)

• Must be at least 18 years of age.

• Must have RN License in the State of Mississippi.

• Must have no known physical/mental limitations that interfere with their ability to lift, transfer or provide any other assistance to the member. If the individual indicates any physical/mental limitations, statement must be received from their primary care physician treating that condition indicating their ability to perform the duties of a respite provider.

SECTION 12: DIRECT CARE WORKER (DCW) PAYROLL/TIME AND ATTENDANCE

32 Miss. Admin. Code Pt. 1, R. 12.0 Direct Care Worker (DCW) Payroll/Time and Attendance Report

In order for Payroll to process time entry data for DCWs, the Case Manager must rectify any issues on the HHA Exchange’s Call Dashboard. After all entries have been validated and cleared of error, the AbilityWorks payroll staff will send each Case Manager a Time and Attendance Report. This report shows total hours that the DCW worked on each day in that pay period. The Case Manager should review the report, sign/date if all the entered data is correct and send it back to Payroll. Once a Time and Attendance report has been verified and signed off on by a Case Manager, no changes can be made in HHA Exchange for that pay period. Each DCW is paid based on the verified Time and Attendance Report data.

SECTION 13: TRANSITION ASSISTANCE SERVICES

32 Miss. Admin. Code Pt. 1, R. 13.0 Transition Assistance Services

Transition Assistance Services are services which assist Mississippi Medicaid eligible nursing facility residents who are being discharged from the facility onto a waiver program. This assistance is a one-time initial expense required for setting up a household. The expenses must be included on the approved PSS. Transition Assistance Services are capped at a one-time initial expense per lifetime.

Transition Assistance Services include:

• Security deposits that are required to obtain a lease on an apartment or home. • Essential furnishings and moving expenses required to occupy and use a community domicile. • Set up fees or deposits for utility or service access (e.g. telephone, electricity, heating). • Health and safety assurances, such as pest eradication, allergen control, or one-time cleaning prior to occupancy.

Essential items for an individual to establish his/her basic living arrangement includes such items as a bed, table, chairs, window blinds, eating utensils, and food preparation items. Diversional or recreational items such as televisions, cable TV access, etc. are not considered furnishings.

Need for the service: All items/services covered must be essential to:

• Ensure that the individual can transition from the current nursing facility. • Remove an identified barrier or risk to the success of the transition to a more independent living situation.

Eligibility:

Individual must be a current nursing facility resident whose services are being paid by Medicaid and want to transition on the Independent Living or Traumatic Brain Injury/Spinal Cord Injury waiver programs.

In order to provide sufficient time to coordinate and plan appropriate transition services, the transition service must occur within 90 days of discharge but must be completed by the day the individual relocates from the institution. Person whose nursing facility stay is temporary or rehabilitative, or whose services are covered by Medicare or other insurance, wholly or partially, are not eligible for this service. Transition services will be considered provided once the individual has transitioned from the nursing facility to the waiver.

Exclusions: Transition Assistance is not available to residents whose stay in a nursing facility is ninety (90) days or less.

32 Miss. Admin. Code Pt. 1, R. 13.1 Description of Transition Assistance Services

Deposits:

Deposits can include security deposits for rental and utilities including basic telephone service. Security deposits or utility deposits must be in the applicant’s name.

Security deposits may be paid if the payment is specifically called a security deposit and not rent, the payment is for a one-time expense, and the amount of the payment is no more than the equivalent of two months rent. Transition assistance services cannot pay for rent.

Transition assistance services can be used to pay for arrears on previous utilities if the account is in the member’s name and the member will not be able to get the utilities unless the previous balance is paid. Transition assistance services cannot pay the first month’s payment on utilities.

Transition assistance services can be used to pay for a telephone since it is a basic need but minutes or services on the telephone cannot be paid.

Transition assistance services cannot pay for any charges for upgraded services beyond the basic service.

Transition assistance services funds can be used to pay for initial setup or reconnection fees to propane or butane service including the minimal supply of fuel if the utility company has a policy that requires a minimal supply of fuel to be delivered during the initial or reconnection service call. Transition assistance services funds cannot be used to top off a tank with fuel when the individual’s home is connected and has a supply of butane or propane.

Transition assistance services can pay for pet deposits only if the pet is a service animal essential to the member.

Household Needs:

Household needs include basic furniture/appliances. This includes bedroom furniture, living room furniture, kitchen furniture, refrigerator, stove, washer, dryer, etc.

An applicant may request a specific brand or type of appliance, furniture or other transition assistance services item as long as the applicant’s needs are met within the cost limit.

Transition assistance services items may be placed in someone’s home other than the applicant only when furnishings are not available and are necessary for the applicant to transition to the community. Transition assistance services cannot pay for items that would only be used by the other person.

If existing items are not usable and the lack of a usable basic/essential item creates a barrier keeping the individual from transitioning to the home and community, the item is considered a need.

House wares:

House wares can include pots, pans, dishes, silverware, cooking utensils, linens, towels, clocks and other small items required for the household.

Small Appliances:

Small appliances can include a microwave oven, electric can opener, coffee pot, toaster, etc.

Cleaning Supplies:

Cleaning supplies can include a mop, broom, vacuum, brushes, soaps and cleaning agents.

32 Miss. Admin. Code Pt. 1, R. 13.2 Services/Items Not Included in Transition Assistance Services

Transition assistance services does not include any items or services that will be included

under waiver services such as adaptive aids, minor home modifications and medical supplies/equipment.

Transition assistance services does not include any recreational items including television, games, computers, cable TV, exercise equipment, vehicles or other modes of transportation.

Transition assistance services will not cover the cost of repairs on the member’s dwelling.

Transition assistance services funds cannot be used for food. The OSDP Case Manager may refer the member to the Department of Human Services for food stamp assistance and any local food pantry resources.

32 Miss. Admin. Code Pt. 1, R. 13.3 Preparing the Home for Transition

Preparing the home for transition can include the following services:

• Moving expenses which include the cost of moving the applicant’s items from another location or delivery charges on large purchased items. • Pest eradication, if the applicant’s place of residence has been unattended and some type of extermination is needed. • Allergen control, if the applicant’s place of residence has been unattended or the applicant is moving into a place that poses a respiratory health problem or • One time cleaning, if the applicant’s place of residence has been unattended or the applicant is moving into a private home or apartment where pre-move-in cleaning should not be expected, e.g., a family friend has an empty house available but cannot provide the cleaning.

32 Miss. Admin. Code Pt. 1, R. 13.4 Rule 13.4

Transitioning Assistance Services Form – Estimated Cost of Items and Services

The OSDP Case Manager may use the Transition Assistance Services form to assist with planning and determining the services needed and estimated cost. The amounts must be reasonable estimates of the cost of basic items and services. The list may be used to assist the applicant in identifying specific needs, but the Case Manager will enter a description and amount only for the items and services identified by the applicant.

All services provided will be authorized in advance of such purchases. Only the Case Manager or another member of the OSDP/IL staff will authorize the purchase of services. Services can only be authorized after the purchases have been staffed with and approved by the District Manager. When making payments in AACE, enter all corresponding invoice numbers on the AACE payment page. A copy of the invoice and the AACE payment page must accompany the authorization when being sent to the State Office for payment to the vendor. A copy of the authorization, AACE payment page, and invoice will be filed in the member's file folder.

32 Miss. Admin. Code Pt. 1, R. 13.5 Changes to the Transitional Assistance Services

Supervisory approval is required to authorize delivery of transition assistance services after the nursing facility discharge.

32 Miss. Admin. Code Pt. 1, R. 13.6 Five Day Monitoring Required by Case Manager After Transition

The Case Manager must monitor the members within (5) five workdays of the discharge date to be sure that all services and items authorized were received and the member has transitioned successfully. If the member reports that any items have not been provided, the Case Manager must follow-up to resolve the issue.

Once the Case Manager confirms that all items/services have been delivered, the Case Manager pays the Authorization in AACE and submits the authorization and all documentation to OSDP Madison for reimbursement.

32 Miss. Admin. Code Pt. 1, R. 13.7 Failure to Transition from the Nursing Facility

While the Case Manager makes every effort to confirm that the member has definite plans to leave the nursing facility, there may be situations in which the member changes his mind or has a change in his health making it impossible for him to relocate to the community as planned. In this situation, the Case Manager must contact any vendor that has provided a service and stop the delivery of the services. No additional service should be provided/purchased.

MDRS via the Case Manager must attempt to return any item(s) purchased on behalf of the individual and collect a refund for the amount of the purchase. MDRS must also attempt to recoup security, utility and other deposits paid on behalf of the individual.

• If the Case Manager is unsuccessful in returning the item(s) for the amount or the deposits paid on behalf of the individual cannot be recouped, MDRS is responsible for paying for the item(s) or deposits paid. The Case Manager must attach to the authorization when submitting to State Office, case note documentation stating that the item(s) could not be returned, or the deposits could not be recouped. Any items obtained from the member may be used to serve individuals whose needs are similar to those of the individual for whom the items were purchased or must be dedicated to assisting other individuals to establish a home.

• If the Case Manager is able to return the item(s) or receives the deposits back, the refund for money must be made payable to: Mississippi Department of Rehabilitation Services. A claim will not be billed to Division of Medicaid.

• If the individual is only in the home for a few days and returns to the nursing facility, the individual can keep the item(s) purchased or donate them to other individuals to help establish a home. The Case Manager must work with the member to determine what item(s) they should keep and what items should be used for other members.

The Case Manager must explain the purpose and limitations of transition assistance

services to the individual when determining their need for the service(s).

The applicant may appeal a decision regarding a needed item or service, but transition services should not be delayed due to the appeal.

SECTION 14: ELIGIBILITY FOR SAC AND TBI/SCI TRUST FUND PROGRAMS

32 Miss. Admin. Code Pt. 1, R. 14.0 State Attendant Care Eligibility

The State Attendant Care Program is a special program created by the Mississippi Legislature in 1985 to provide personal care services to persons who have severe disabilities. The intent of the State Attendant Care Program is to provide a means for securing attendants for those not able to access personal care services under other programs.

Eligibility Criteria:

In order for an individual to be served under the State Attendant Care Program, the following eligibility criteria must be met:

• The presence of a significant mental or physical disability

• The presence of a severe limitation in ability to function independently in the family or community, and

• A reasonable expectation that independent living rehabilitation services will significantly assist in their ability to function more independently in the home or community.

32 Miss. Admin. Code Pt. 1, R. 14.1 Eligibility Criteria for the TBI/SCI Trust Fund Program

In order for an individual to be served under the TBI/SCI Trust Fund program, the following eligibility criteria must be met:

1. Must have a certified traumatic brain or spinal cord injury. See Spinal Cord/Traumatic Brain Injury Verification Form.

• Traumatic brain injury is defined as an insult to the skull, brain or its covering after birth, resulting from external trauma which produces an altered state of consciousness or anatomic motor, sensory, or cognitive/behavioral deficits. (This excludes any birth trauma.)

Note: Birth trauma is defined as a physical injury sustained by an infant during birth; and birth is defined as the entire separation of the infant from the maternal body (after cutting of the umbilical cord).

• Spinal cord injury is defined as a traumatic injury to the spinal cord or the cauda equina with evidence of motor deficit, sensory deficit, and/or bowel and bladder dysfunction. The lesions must have significant involvement with two of the above three.

Note: This excludes brain injury and spinal cord injury trauma that results intentionally or unintentionally from medical intervention.

2. Must be certified as medically stable by the primary care physician. Medical stability is defined as the absence of the following:

A. An active, life threatening condition (e.g. sepsis, respiratory, or other condition requiring systematic therapeutic measures);

B. IV drip to control or support blood pressure;

C. Intracranial pressure or arterial monitoring

SECTION 15: APPLICATION FOR STATE ATTENDANT CARE AND TBI/SCI TRUST FUND

32 Miss. Admin. Code Pt. 1, R. 15.0 Rule 15.0

Application for State Attendant Care (SAC) and TBI/SCI Trust Fund Services

The Case Manager must complete the official documentation for applicants who wish to apply for services under the OSDP SAC/Trust Fund Services. This application process takes place at the initial home visit and includes completing the request for OSDP Services intake form, the Statement of Understanding, Consent to Disclose, HIPAA, Voter Registration, and Functional Assessment Forms. All completed forms are then placed in a new case file when the Case Manager returns to the office.

32 Miss. Admin. Code Pt. 1, R. 15.1 Request for State Attendant Care (SAC) and TBI/SCI Trust Fund Services

The application process begins with the Request for OSDP Services intake form which is completed at the initial home visit. The purpose of this form is to gather all relevant personal and financial information in addition to the person’s disability, family support, etc.

The Request for OSDP Services form is completed for waivered and non-waivered services through OSDP and is one component to assist the case manager in determining eligibility. This form needs to be filed in the applicant’s case file when the Case Manager returns to the office.

The Application Documentation

The Application Documentation Page that is a part of the Request for OSDP Services intake form is very important to the overall case process. This information lays the

foundation of the entire casework process. The Case Manager should also inform the individual that they will not be eligible for services through another program.

Reasons for Seeking Services:

In this section, the Case Manager should record information that they received during the initial application process regarding the individual’s disability and their medical history to help the Case Manager determine what medical or other information should be requested from third parties. The history of the individual’s adjustment or lack of adjustment to their impairment is very important, as well as their family support system.

32 Miss. Admin. Code Pt. 1, R. 15.2 SAC Statement of Understanding

During the initial home visit for State Attendant Care, the Case Manager will present the Statement of Understanding to the applicant. It is the Case Manager’s responsibility to ensure the applicant comprehends the entirety of the form, which includes the following:

a) The presence of a significant mental or physical disability

b) The presence of a severe limitation in ability to function independently in the family or community; and

c) A reasonable expectation that independent living rehabilitation services will significantly assist in the ability to function more independently in the family or community or to engage or continue in employment.

MDRS may obtain personal information from the applicant, their representative, services providers, and cooperating agencies for eligibility purposes with assurances that this information may not be divulged except:

d) To the applicant or their representative, when requested in writing, unless MDRS believes it harmful to do so

e) For audit, evaluation, or research purposes

f) To other programs for the applicants’ benefit (e.g., DDS, Mental Health, DHS) or as required by federal law.

All services will be available to applicants regardless of race, gender, color, religion, marital status or national origin.

Once an applicant is determined eligible, the Case Manager will involve them in planning for their services and will review the plan annually. Services are dependent upon the availability of funds, and if there is any delay in the provision of services at any time, the person will be promptly advised. Persons will need to understand that they may also have to contribute toward program costs.

The person is advised during this time to keep scheduled appointments with their Case Manager and service providers. In the event, that the person is not satisfied with decisions made by their Case Manager, they can appeal his/her decision in writing to the District Manager.

Additionally, persons may contact the statewide Client Assistance Project (CAP) with questions or concerns about services provided by OSDP. The CAP staff will work with each party to assist in resolving the problem.

Once the person acknowledges and signs the Statement of Understanding, the form will be filed in the applicant’s case file when the Case Manager returns to the office.

32 Miss. Admin. Code Pt. 1, R. 15.3 TBI/SCI Trust Fund Statement of Understanding

TBI/SCI Trust Fund applicants sign an additional Trust Fund Statement of Understanding which notifies applicants that attendant care services provided through the Trust Fund are available only for a short term and will not exceed a maximum of twelve (12) months from the date of initiation of services.

During this twelve-month period, efforts will be made to enroll applicants in the TBI/SCI Home and Community-Based Waiver Services Program based on eligibility criteria established by Medicaid, availability of openings, and adequate funding.

In the event that enrollment in the Home and Community-Based Program is not possible, the person or their legal representative is responsible for seeking other resources that would address the attendant care services beyond the initial twelve-month service period. The form will be filed in the applicant’s case file when the Case Manager returns to the office.

32 Miss. Admin. Code Pt. 1, R. 15.4 Health Information Portability and Accountability Act (HIPAA)

At the initial home visit, applicants are given the Notice of Privacy document. The Case Manager will review this document with the applicant to ensure that they understand their health information protections. At this time, the applicant will sign the receipt of notice form which is then filed in the case file when the Case Manager returns to the office.

The Health Information Portability and Accountability Act of 1996, allows individuals to set boundaries on who has access to their protected health information. It is MDRS legal duty to maintain the privacy of a person’s health information and to provide notice to an applicant. The Case Manager must verify the applicant comprehends their rights.

32 Miss. Admin. Code Pt. 1, R. 15.5 Authorization for the Use/Disclosure of Protected Health Information

The applicant signs this form to authorize the Case Manager to request and receive medical records on their behalf. The content of this form specifies:

a) For one time use and/or disclosure

b) One year from the effective date of signature/or upon revocation

c) Release to an attorney throughout the course of representation at his/her request.

Person are under no obligation to sign this authorization. However, MDRS may condition eligibility for benefits on the signing of this authorization if the information is necessary to determine a person’s eligibility or enrollment in MDRS services, however not for the use or disclosure of psychotherapy notes.

Information disclosed pursuant to this authorization may be re-disclosed, by the recipient, to additional parties and may no longer be protected. If this authorization is signed by a personal representative, supporting documents must be attached to confirm the representative’s right to make this request.

The specified information is necessary and related to the program of services and its confidentiality and privacy is to be respected by the recipient in accordance with all applicable federal and/or state laws and regulation on confidentiality. Use of copies, including electronic copies are also authorized.

The form will be filed in the applicant’s case file when the Case Manager returns to the office.

32 Miss. Admin. Code Pt. 1, R. 15.6 Opportunity to Register to Vote

The following are instances in which a Case Manager should give applicants/members an opportunity to complete the mail-in Voter Registration Application at their home:

1. At the time of application,

2. At annual re-certifications,

3. Change of address, or

4. When requested.

Applicants/members must be given the opportunity to:

1. Complete the mail-in Voter Registration Application at home and mail it in, or

2. Leave the completed form with MDRS staff.

3. Complete the portable Voter Registration Form online.

If the person wishes to complete the form during the interview, the OSDP Case Manager should:

1. Review the form for completeness in the presence of the member.

2. If it does not contain all the required information and/or the required signature,

return it to the member for completion.

Voter Registration forms must be transmitted to the appropriate county voter registrar within five (5) days of receipt from applicant/person. If the applicant or member is not of voter registration age, do not complete the voter registration form.

The Case Manager must document, in the case file, any action when the member asks to register to vote. Any questions regarding voter registration process, can be directed to www.MSVoterID.ms.gov or by calling (844) 678-6837.

32 Miss. Admin. Code Pt. 1, R. 15.7 Application Completion

At the conclusion of the application process in which the applicant has signed the Request for OSDP Services, Statement of Understanding, Consent to Disclose, HIPAA and Voter Registration forms, the Case Manager will ask the applicant if they have any questions or need any clarification. If the applicant agrees to move forward, the Case Manager will conduct the Functional Assessment. The Case Manager will return to the office and enter a case note in AACE. The case note will contain a summary of the home visit and all relevant information gathered during the initial home visit. All forms will be filed in the applicant’s case file and stored in a secure location.

SECTION 16: FUNCTIONAL ASSESSMENT FOR STATE ATTENDANT CARE (SAC) SERVICES

32 Miss. Admin. Code Pt. 1, R. 16.0 Functional Assessment for SAC

A. Functional Assessment

If the member is requesting attendant care services through the State Attendant Care Program, a functional assessment must be completed.

As part of the Functional Assessment

• The Functional Assessment may be completed by the OSDP Case Manager and does not require the RN to be present

• The OSDP Case Manager determines the attendant care services the member needs

• The OSDP Case Manager determines the estimated hours necessary to meet those needs

• The need for the particular task is determined based on the member’s functional impairment to complete the task and if that task will be completed by other sources including unpaid caregivers, such as family members or other informal supports.

• Attendant care hours should not be planned if there is not a need for these services.

B. Plan of Services and Supports

The non-waivered plan of services and supports should be developed and updated annually considering:

• The needs of the member

• The stated intentions and willingness of the caregiver to provide unpaid care.

C. Attendant Care Workers

• Family members, except spouses and those legally responsible, may be employed as the attendant under the SAC Program.

D. Upon Completion of the Functional Assessment

• Update the OSDP program certification page by entering the functional assessment date

• Enter the start and end date

• Enter the number of PCA hours authorized.

E. Monthly Contacts are Required

• The OSDP Case Manager is required to make monthly contacts with members receiving State Attendant Care services.

• The OSDP Case Manager is required to make a face-to-face visit annually each June. During this home visit, the Case Manager will complete a new Functional Assessment and review the PSS to ensure if it still meets the individual’s needs.

F. The OSDP Case Manager must make attempts to assist the member in accessing other resources for this service (i.e., Medicaid waiver programs) for those requiring long term care.

G. Approval of Additional Attendant Care Hours

• Although the number of hours needed is determined during the functional assessment process, the number of hours an individual receives via the SAC program may be affected by the availability of state funds.

• Any additional hours given above what has been approved must be prior approved by the OSDP Office Director.

H. Process to Follow When Requesting an Increase in Attendant Care Hours

• The Case Manager is to staff the case with their District Manager and include a justification for the request to increase hours.

• Upon approval, the OSDP District Manager should email the request up to their Regional Manager with the justification for an increase.

• Upon approval, the Regional Manager should email the request to the OSDP Director.

• Upon approval by the Office Director, funds will be distributed appropriately.

I. Include the Following Information in the Email When Requesting Approval for the Service Increase:

• Name of member

• Age of member

• Disability

• Case note justification

• Current approved attendant hours/day

• Amount of money needed in order to amend the authorization

• Dates of service that the increase will cover

SECTION 17: FUNCTIONAL ASSESSMENT FOR TBI/SCI TRUST FUND SERVICES

32 Miss. Admin. Code Pt. 1, R. 17.0 Functional Assessment for TBI/SCI Trust Fund Services

A. Functional Assessment

If the member is requesting transitional attendant care services through the TBI/SCI Trust Fund program, a functional assessment must be completed.

As Part of the functional Assessment:

• The OSDP Case Manager determines the attendant care services the member needs

• The OSDP Case Manager determines the estimated hours necessary to meet those needs

• The need for the particular task is determined based on the member’s functional impairment to complete the task and if that task will be completed by other sources including unpaid caregivers, such as family members or other informal supports.

• Transitional attendant care hours should not be planned if there is not a need for these services.

B. Plan of Services and Supports

The non-waivered plan of services and supports should be developed and updated annually considering:

• The needs of the member

• The stated intentions and willingness of the caregiver to provide unpaid care.

C. Attendant Care Workers

• Family members, except spouses and those legally responsible, may be employed as the attendant under the TBI/SCI Trust Fund Program.

D. Upon Completaion of the Functional Assessment:

• Update the OSDP program certification page by entering the functional assessment date

• Enter the start and end date

• Enter the number of PCA hours authorized.

E. Monthly Contacts are Required

• The OSDP Case Manager is required to make monthly contacts with members receiving transitional attendant care. If services continue past the twelve-month mark, a new face-to-face visit, including a functional assessment would need to be completed.

F. The OSDP Case Manager must make attempts to assist the member in accessing other resources for this service (i.e. Medicaid waiver programs) for those requiring long term care.

G. Time Limit on Transitional Attendant Care Services

• There is a twelve-month time limit on transitional attendant care services.

• During this time, the member or family members will be assisted with seeking other attendant care options.

H. TBI/SCI Verification Form

• The TBI/SCI Verification form must be completed by the treating physician.

I. Process to Follow When Requesting an Increase in Transitional Attendant Care Hours:

• The Case Manager is to staff the case with their District Manager and include a justification for the request to increase hours.

• Upon approval, the OSDP District Manager should email the request up to their Regional Manager with the justification for an increase.

• Upon approval, the Regional Manager should email the request to the OSDP Director.

• Upon approval by the Office Director, funds will be distributed appropriately.

J. Include the Following Information in the Email When Requesting Approval for the Service Increase:

• Name of member

• Age of member

• Disability

• Case note justification

• Current approved PCA Hours/Days

• Amount of money needed in order to amend the authorization

• Dates of service that the increase will cover

SECTION 18: ELIGIBILITY FOR IL GRANT SERVICES

32 Miss. Admin. Code Pt. 1, R. 18.0 Determining the Applicant’s Disability

Determining the member’s disability is the first major step in the process. This process begins with the Counselor’s recording of medical history obtained from the consumer during the application process. Information regarding their impairment and illnesses including dates and types of treatments or services provided should be recorded. The names and addresses of physicians who have treated them, as well as hospitals and clinics where they may have been a patient are important so that the Case Manager may request, if needed, pertinent medical records. As much as possible, the Case Manager should try to determine the member’s primary care physician for the impairment they are reporting.

32 Miss. Admin. Code Pt. 1, R. 18.1 Rule 18.1

Medical Information to Establish Eligibility for the Provision of Services

When an individual is in Application status, medical reports/examination, etc., are necessary to make an eligibility determination. When medical information is used as a basis to establish eligibility, the following guidelines shall be followed:

1.If a disability is reported and may be documented by medical records but does not cause substantial functional limitations to activities of daily living or the condition is stable, this impairment does not have to be recorded on the Certificate of Eligibility. The Case Manager’s knowledge of this impairment and its stability, and the fact that it is not a factor to the rehabilitation process should be documented in Case notes or in the other section of the Certificate of Eligibility.

2.Medical information does not have to be signed if the diagnostician, medical groups, or clinic is clearly identified in the information. DDS reports, hospital/VA records data on letterhead stationery, faxes to Case Managers, copies of letter to other physicians, and letters to Case Managers are acceptable.

3.Medical data not readily identifiable, handwritten notes, office/clinic notes, or pages from charts would all require a signature if the physician or office is not identified.

4.Members’ name must be on all medical data to ensure that there is no question concerning the identification of the consumer/member.

5.Medical information, if used to help determine eligibility, must contain an actual diagnosis.

6. Medical documentation must be in the file and dated on or before the date of the certificate of eligibility.

7. Medical reports completed by a Family Nurse Practitioner (FNP) or Physicians Assistant must be co-signed by a physician to be acceptable.

8.Medical reports completed/signed by the physician’s office staff (i.e., secretary, nurse, etc.) are never acceptable.

A disability will generally be considered stable if the answer is “no” to all the following questions:

1. Has the member’s condition changed in the past year?

2. Has the member been hospitalized during the past year as a result of his/her condition?

3. Has the member’s medication or therapy been changed in the past year?

32 Miss. Admin. Code Pt. 1, R. 18.2 Documenting Eligibility for Services

At a minimum, the case file for each individual determined eligible for services must include the following information supporting the determination of eligibility:

• The medical, psychological, and other information supporting the presence of a most significant or significant physical disability.

• The Certificate of Eligibility that records the impairment, justification analysis of a severe (serious) limitation in their ability in to function, continue functioning or move towards functioning independently in the family or community or to continue in employment.

The existence of a DISABILITY must be based upon medical, psychiatric, and/or psychological reports.

The IL Case Manager may utilize other staff members (case reviews) in making eligibility decision. The final eligibility decision must be made and certified by the IL Case Manager the case is assigned to.

32 Miss. Admin. Code Pt. 1, R. 18.3 Eligibility Determination Extension

A determination of eligibility shall be made within 60 days from the date of application.

The 60-day period is consecutive calendar days and is counted in this manner. The 60-day period begins on the date the consumer or his/her representative signs the application for services.

A delay in determining eligibility for services may be extended if exceptional or unforeseen circumstances beyond the control of the Agency preclude making the eligibility determination within 60 days, and the Agency and the individual agree to a specified extension of time.

This agreement and extension must be documented as an eligibility determination extension. The extension must reflect the reason for the extension, the date in which the eligibility determination will be made, and that the individual agrees with the extension. Extensions cannot be more than 60 additional calendar days.

Under unusual circumstances, the Case Manager Assistant can complete and sign the extension. The reason must be documented.

It is the sole responsibility of the Office of Special Disability Programs, Mississippi Department of Rehabilitation Services to determine if an individual is eligible for services and to determine the nature and scope of the services to be provided.

SECTION 19: APPLICATION FOR IL GRANT SERVICES

32 Miss. Admin. Code Pt. 1, R. 19.0 Application for IL Grant Services

The Case Manager must complete the official documentation for applicants who wish to apply for services through IL Grant Services. This application process takes place at the initial home visit and includes completing the Request for OSDP Services Initial Intake form, the Statement of Understanding, Consent to Disclose, HIPPA, Voter Registration and the Functional Assessment. These completed are then placed in a new case file when the Case Manager returns to the office.

32 Miss. Admin. Code Pt. 1, R. 19.1 Request for OSDP Services/Initial Intake for IL Grant Services

The application process begins with the Request for OSDP Services/Initial Intake form which is completed at the initial home visit. The purpose of this form is to gather all relevant personal and financial information in addition to the person’s disability, family support, etc.

The Request for OSDP Services/Initial Intake form is one component to assist the Case Manager in determining eligibility. This form needs to be filed in the applicant’s case file when the Case Manager returns to the office.

Documentation:

Reasons for seeking services:

In this section, the Case Manager should record information that they received during the initial application process regarding the individual’s disability and their medical history to help the Case Manager determine what medical or other information should be requested from third parties. The Case Manager should also note that the services being requested by the individual are not provided through the individual’s insurance or another program.

32 Miss. Admin. Code Pt. 1, R. 19.2 Statement of Understanding

During the initial home visit for IL Grant services, the Case Manager will present the Statement of Understanding to the applicant. It is the Case Manager’s responsibility to ensure the applicant comprehends the entirety of the form, which includes the following:

a) The presence of a significant mental or physical disability

b) The presence of a severe limitation in ability to function independently within the family or community and

c) A reasonable expectation that independent living rehabilitation services will significantly assist in the ability to function more independently within the family or community or to engage or continue in employment.

MDRS may obtain personal information from the applicant, their representative, services providers, and cooperating agencies for eligibility purposes with assurances that this information may not be divulged except:

a) To the applicant or their representative, when requested in writing, unless MDRS believes it harmful to do so

b) For audit, evaluation, or research purposes

c) To other programs for the applicants’ benefit (e.g., DDS, Mental Health, DHS) or as required by federal law.

All services will be available to applicants regardless of race, gender, color, religion, marital status or national origin.

Once an applicant is determined eligible, the Case Manager will involve the applicant in planning for their services. Services are dependent upon the availability of funds. If there is any delay in the provision of services at any time, the individual will be promptly advised. Individuals will need to understand that they may also have to contribute toward program costs.

The individual is advised during this time to keep scheduled appointments with their Case Manager and service providers. In the event, that the person is not satisfied with decisions made by their Case Manager, they can appeal his/her decision in writing to the District Manager.

Additionally, persons may contact the statewide Client Assistance Project (CAP) with questions or concerns about services provided by OSDP. The CAP staff will work with each party to assist in resolving the problem.

Once the person acknowledges and signs the Statement of Understanding, the form will be filed in the applicant’s case file when the Case Manager returns to the office.

Health Information Portability and Accountability Act (HIPAA)

At the initial home visit, applicants are given the Notice of Privacy document. The Case Manager will review this document with the applicant to ensure that they understand their health information protections. At this time, the applicant will sign the receipt of notice form which is then filed in the case file when the Case Manager returns to the office.

The Health Insurance Portability and Accountability Act of 1996, allows individuals to set boundaries on who has access to their protected health information. It is MDRS’s legal duty to maintain the privacy of a person’s health information and to provide notice to an applicant. The Case Manager must verify the applicant comprehends their rights.

32 Miss. Admin. Code Pt. 1, R. 19.3 Health Information Portability and Accountability Act (HIPPA)

At the initial home visit, applicants are given the Notice of Privacy document. The Case Manager will review this document with the applicant to ensure that they understand their health information protections. At this time, the applicant will sign the receipt of notice form which is then filed in the case file when the Case Manager returns to the office.

The Health Insurance Portability and Accountability Act of 1996, allows individuals to set boundaries on who has access to their protected health information. It is MDRS’s legal duty to maintain the privacy of a person’s health information and to provide notice to an applicant. The Case Manager must verify the applicant comprehends their rights.

32 Miss. Admin. Code Pt. 1, R. 19.4 Authorization for the Use/Disclosure of Protected Health Information

The applicant signs this form to authorize the Case Manager to request and receive medical records on their behalf. The content of this form specifies:

a) For one time use and/or disclosure

b) One year from the effective date of signature/or upon revocation

c) Release to an attorney throughout the course of representation at his/her request.

Persons are under no obligation to sign this authorization. However, MDRS may condition eligibility for benefits on the signing of this authorization if the information is necessary to determine a person’s eligibility or enrollment in MDRS services, however not for the use or disclosure of psychotherapy notes.

Information disclosed pursuant to this authorization may be re-disclosed, by the recipient, to additional parties and may no longer be protected. If this authorization is signed by a personal representative, supporting documents must be attached to confirm the representative’s right to make this request.

The specified information is necessary and related to the program of services and its confidentiality and privacy is to be respected by the recipient in accordance with all applicable federal and/or state laws and regulation on confidentiality. Use of copies, including electronic copies are also authorized.

The form will be filed in the applicant’s case file when the Case Manager returns to the office.

32 Miss. Admin. Code Pt. 1, R. 19.5 Opportunity to Register to Vote

The following are instances in which a Case Manager should give applicants/members an opportunity to complete the mail-in Voter Registration Application at their home:

• At the time of application, • At annual re-certifications, • Change of address, or • When requested.

Applicants/members must be given the opportunity to:

• Complete the mail-in Voter Registration Application at home and mail it in, or • Leave the completed form with MDRS staff or • Complete the portable Voter Registration form online.

If the individual wishes to complete the form during the interview, the OSDP Case Manager should:

1. Review the form for completeness in the presence of the member.

2. If it does not contain all the required information and/or the required signature, return it to the member for completion.

Voter Registration forms must be transmitted to the appropriate county voter registrar within five (5) days of receipt from applicant/person. If the applicant or member is not of voter registration age, do not complete the voter registration form.

The Case Manager must document, in the case file, any action when the member asks to register to vote. Any questions regarding the voter registration process, can be directed to www.MSVoterID.ms.gov or by calling (844)678-6837.

32 Miss. Admin. Code Pt. 1, R. 19.6 Application Completion

At the conclusion of the application process in which the applicant has signed the Request for OSDP Services, Statement of Understanding, Consent to Disclose, HIPPA and Voter Registration forms, the Case Manager will ask the applicant if they have any questions or need any clarification. If the applicant agrees to move forward, the Case Manager will conduct the Functional Assessment. The Case Manager will return to the office and enter a case note in AACE. The case note will contain a summary of the home visit and all relevant information gathered during the initial home visit. All forms will be filed in the applicant’s case file and stored in a secure location.

SECTION 20: FINANCIAL NEEDS ANALYSIS FOR NON-WAIVER SERVICES

32 Miss. Admin. Code Pt. 1, R. 20.0 Participation of the Individual in Cost of Services

While there is no Federal requirement to consider the financial need of individuals when providing services, OSDP does consider the financial need of individuals for purposes of determining the extent of their participation in the cost of OSDP services. Proof of income is required to determine the amount a client must contribute, if any, to the cost of services. A Financial Needs Analysis form must be completed during the application process for any Non-Waiver client requesting services that does not currently receive Medicaid or Social Security benefits. The individual is responsible for informing OSDP of any changes in financial circumstances and providing the appropriate documentation within 30 days of the date of such changes. Failure to do so may result in the termination of paid independent living services.

1. Comparable Services and Benefits: OSDP must not expend funds on specific services unless the OSDP Case Manager and the client have made a good faith effort to secure comparable services and benefits from other sources to pay for the services.

2. Recipients of Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), or Medicaid Benefits: including those receiving Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), or Medicaid benefits are exempt from the cost-sharing requirement for OSDP services due to their disability, regardless of income.

3. Exceptions to Policy: When necessary to address a participant/client’s specific independent living needs, OSDP staff may request exceptions to established policies and procedures by submitting a request through the appropriate management chain to the OSDP Office Director or their designee. However, exceptions cannot be granted for policies and procedures that are governed by Federal or State law, statutes, or regulations.

32 Miss. Admin. Code Pt. 1, R. 20.1 Determining Financial Need

Documentation is required for the client’s income and expenses. A client who is eligible for Social Security Disability Benefits (SSI and SSDI) shall provide proof of Social Security eligibility. A client receiving Medicaid benefits shall provide a copy of their Medicaid Card and/or Medicaid number. If a client refuses to provide the necessary documentation to complete the Financial Needs Analysis (FNA) Form, OSDP will presume that the client’s income exceeds the established financial participation threshold. As a result, the client will be required to pay the full cost of any goods and/or services for which financial participation is required, provided that the FNA policy is in effect. For all other clients, documentation regarding the following must be received:

1. Income: Adjusted gross income indicated on the client’s most recent income tax return (Form 1040, line 11) • Documentation Required: most recent income tax return. If unavailable: check

stub, bank statement, earnings statement, award letter, or a court order may be utilized.

2. Optional Additions: Monthly home mortgage or rental payments, prescribed diet and medications used by the client, debts imposed by court order, medical costs, and disability related expenses of the client. This information should be included in “Section II: Client/Family Income” under “4. Optional” of the Financial Needs Analysis Form. • Documentation Required: Statement, canceled check, money order stub, contract, lease, itemized receipts, or a court order

32 Miss. Admin. Code Pt. 1, R. 20.2 PSS Requirements

If the client’s PSS needs to be developed before proof of income and expenses are received, the OSDP Case Manager shall not include services that require the client’s participation in the cost. When proof of income and expenses are received, the OSDP Case Manager amends that PSS as needed.

32 Miss. Admin. Code Pt. 1, R. 20.3 Circumstances When Financial Participation Does Not Apply

A client whose net income exceeds the FNA is not required to help pay for services if:

1. The client is eligible for Medicaid or Social Security Disability Benefits (SSI or SSDI) 2. The OSDP Regional Manager grants an exception (if approved through the MDRS State Office) because the client’s participation would prevent the client from receiving the necessary service

Example: A participant/client with a significant disability has a new Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI). The FNA indicates that the client must pay part of the service fee; however, due to ongoing medical expenses related to their disability, they are unable to afford the required contribution. The OSDP Regional Manager grants an exception, allowing OSDP to cover the full cost of the service so the participant/client can receive services identified in their Plan of Services and Support (PSS).

32 Miss. Admin. Code Pt. 1, R. 20.4 Determination and Application of Financial Participation

A. Categorization of Individuals

Each non-exempt individual shall be classified into one of the following categories for purposes of determining financial participation:

1. Independent: The individual is unmarried and was not claimed as a dependent on another person’s US tax return for the prior year or has received a dependency override from a financial aid administrator under 20 U.S.C. § 1087 vv.

2. Dependent: The individual is unmarried and was claimed as a dependent on another person’s US tax return for the prior year. 3. Married: The individual is legally married.

B. Determination of Available Income

Based on the individual’s category, the following income sources shall be considered available resources:

1. Independent: Only the individual’s income 2. Dependent: The income of the individual and the person(s) who claimed the individual as a dependent 3. Married: The income of the individual and their spouse (may include additional dependents)

C. Financial Needs Assessment (FNA) and Participation Threshold

1. The OSDP Case Manager shall determine the amount a client must contribute to the cost of services based on the client’s net monthly income and family size, as related to the US Federal Poverty Guidelines for the current fiscal year. 2. The client’s financial participation threshold shall be calculated annually by OSDP and set at 285 percent of the poverty guidelines published in the Federal Register by the US Department of Health and Human Services, as specified in Section 673(2) of the Omnibus Budget Reconciliation Act of 1981. 3. When the client’s income exceeds the financial needs analysis (FNA) level, including optional additions, the client shall contribute to the cost of applicable goods and services. The client’s contribution shall not exceed the actual cost of the service or goods.

32 Miss. Admin. Code Pt. 1, R. 20.5 Completion and Use of Financial Participation Assessment

The Financial Needs Analysis Form shall be completed during the initial home visit/application process by the Case Manager. If the individual/guardian refuses to provide the required financial information or to accept their assessed contribution, OSDP shall not authorize non-exempt services. OSDP Case Managers should inform individuals that failure to provide complete and accurate financial information may result in the denial or delay of services subject to client contribution.

A. Payment Responsibilities and Limits

1. An individual shall pay their assessed percentage directly to the service vendor for each non-exempt service. 2. The participant/client’s total contribution shall not exceed the amount determined on the Financial Needs Analysis Form. 3. Once the full contribution amount has been met, no further payments shall be required for subsequent non-exempt services within the service period. B. Exceptions to Financial Participation

Exceptions may be granted for the following reasons:

1. Substantial change in financial circumstances, verified with current documentation 2. Urgent medical need, supported by documentation 3. The required participation exceeds the individual’s calculated available income

If a request is being made for an exception, the Case Manager shall submit a written request to the Regional Manager to be reviewed by the State Office that includes:

1. Description and cost of the requested service 2. Current Financial Needs Analysis Form 3. Supporting documentation provided by the client/participant

Any approved exception shall apply ONLY to the specific service for which it is granted. All of participation requirements remain in effect.

32 Miss. Admin. Code Pt. 1, R. 20.6 Financial Needs Exemptions

Some services are exempt from the FNA (minus SSI/SSDI and Medicaid recipients) and client financial participation in the cost of services, as shown in the table below:

32 Miss. Admin. Code Pt. 1, R. 20.7 Informing the Individual About Financial Needs Policy

The individual and/or their representative will be informed of OSDP policies and procedures related to determining financial need and participating in the cost of services during the initial interview/home visit by the Case Manager. The individual will be informed that OSDP will not pay for any service that is not pre-approved and authorized in writing by an OSDP official. The individual will also be informed that OSDP bases its rate of financial assistance on the provision of the lowest cost services that meet the needs OSDP Service FNA Applies Assessment of Determining Eligibility and OSDP Needs No OSDP Case Management No Home Modifications (actual service) Yes Personal Care Attendant Services No Assistive Technology Devices and Services, including Hearing Aids (comparable benefits are not required but should be used if readily available to meet best value requirements) Yes Services for SSI/SSDI Recipients No Vehicle Modifications Yes

of the individuals, with consideration of the individual’s informed choice.

SECTION 21: FUNCTIONAL ASSESSMENT FOR IL GRANT SERVICES

32 Miss. Admin. Code Pt. 1, R. 21.0 Functional Assessment for IL Grant Services

If the member is requesting IL Grant Services through MDRS, a Functional Assessment must be completed during the initial home visit.

As Part of the Functional Assessment:

• The OSDP Case Manager determines the services the member needs

• The OSDP Case Manager determines the functional limits of the member as well as the current services being provided through other sources including family and friends.

The Functional Assessment will be printed and filed in the member’s case file upon return to office.

The OSDP Case Manager is required to make phone contact with the member every 30 days and provide an update on the member’s requested service.

The OSDP Case Manager must make attempts to assist the member in accessing other resources for the requested services.

SECTION 22: CASE SERVICE RECORD

32 Miss. Admin. Code Pt. 1, R. 22.0 File Folder

Each member’s folder will have a label affixed to the tab on the folder. The label will include: the person’s name, address, phone number, county, and program type.

32 Miss. Admin. Code Pt. 1, R. 22.1 Case Notes

Entries made are to include a record of all Case Manager contacts with and/or on behalf of the person. Case notes should include at a minimum the monthly contacts, quarterly reviews, telephone conversations, letters and reports of progress. All case notes must be entered into the electronic case file (AACE), printed, and placed in the hard copy case file. All entries will be dated and the type of contact recorded. The nature of the case notes will be recorded in the Summary Section. AACE records the author of the case notes as the person logged in the system. If another staff is entering the case note on the Case Manager’s behalf, the case notes will be signed by the Case Manager. Record the first initial and last name.

All documents in the person’s file are considered medical records, including DCW certifications.

When corrections or late entries need to be added to documents, always write legibly and make every effort to enter documentation in a timely manner. Never use corrective tape, corrective liquid or other obliteration supplies to change or erase any part of the medical record.

For entry corrections:

• Draw a single line through the error making certain that the error entry, though crossed out, is still legible. • Place date, time and initials as to when the entry was marked out. • Enter correct information in a new entry on the next available line.

For late entries:

• Identify the new entry as a “late entry” in the medical record. • Enter the current date and time when the entry is actually being made in the medical record, but also remember to document in the body of the entry when the event originally occurred.

32 Miss. Admin. Code Pt. 1, R. 22.2 Case Service Record Organization – IL & TBI Waivers

The case record should be organized in such a way as to allow for easy access of information. All materials should be filed in reverse chronological order (most recent on top) based on the date information was received.

The case file is deficient and out of compliance if it does not contain the following

information, at a minimum:

▪ Running Record – Case notes

• Documentation of Quarterly Reviews (QR) - Recertification Notes - Monthly Contacts

*Some people correspond with their Case Manager via e-mail. If this occurs the e- mail shall become a part of case notes and filed accordingly.

SECTION 1 - Application

• Referral Form - Application for Services - Statement of Understanding - Consent to Disclose Form - HIPPA - Medical Records - Voter Registration Form - Certificate of Eligibility - LTSS PSS ▪ Added Services ▪ Increasing and Decreasing Services

SECTION 2 - Case Notes

• Case Notes (including Monthly Contacts, QRs, AACE generated letters, NOAs, etc.) - Yearly Waiver Approval Letter

SECTION 3 - Physician’s Form

• Physician Certification of Medical Stability & Nursing Level of Care form - TBI/SCI Verification form (if applicable) - Respite Tier form (if applicable) - Medical Necessity form (if applicable)

SECTION 4 – Direct Care Worker (DCW) Certification

• DCW Certification Packet (not application) - DCW Change of Address forms - DCW Task Assignment Sheets (as updated) - DCW Annual Training forms/Certificate of Completion

SECTION 5 – Service Notes

• DCW Service Notes

SECTION 6 - Financial Documents

• Authorizations & AACE Payment Sheets - EOBs - All AT Referrals, forms and reports - Quotes/Bids - AT Related Prescriptions

32 Miss. Admin. Code Pt. 1, R. 22.3 Rule 22.3

Case Service Record Organization – State Attendant Care & TBI/SCI Trust Fun

The case record should be organized in such a way as to allow for easy access of information. All materials should be filed in reverse chronological order (most recent on top) based on the date information was received.

The case file maintained by the OSDP Case Manager should contain all assessment and eligibility information.

The case file is considered to be deficient and out of compliance if it does not contain the following information, at a minimum:

▪ Running Record – Case notes

• Documentation of Quarterly Reviews - Monthly Contacts

*Some people correspond with their Case Manager via e-mail. If this occurs the e- mail shall become a part of case notes and filed accordingly.

SECTION 1 - Application

• Referral Form - Application for Services - Statement of Understanding & Trust Fund Statement of Understanding (if applicable) - Consent to Disclose Form - HIPAA - Medical Records - Voter Registration Form - Emergency Preparedness Form - Certificate of Eligibility - Hardcopy PSS

SECTION 2 - Case Notes

• Case Notes (including Monthly Contacts, QRs, AACE generated letters, NOAs, etc.)

SECTION 3 - Physician’s Form

• Functional Assessment - TBI/SCI Verification Form (Trustfund only) - Respite Tier Form (Trustfund only, if applicable) - Medical Necessity form (if applicable)

SECTION 4 – Direct Care Worker (DCW) Certification

• DCW Certification Packet (not application) - DCW Change of Address forms - DCW Task Assignment Sheets (as updated) - DCW Annual Training forms/Certificate of Completion

SECTION 5 - Financial Documents

• Authorizations, AACE Payment Sheets and applicable timesheet - EOBs - All AT Referrals, forms and reports - Quotes/Bids - AT Related Prescriptions - Respite Time Logs (Trustfund only)

32 Miss. Admin. Code Pt. 1, R. 22.4 Case Service Record Organization – IL Grant ONLY

The case record should be organized in such a way as to allow for easy access of information. All materials should be filed in reverse chronological order (most recent on top) based on the date information was received.

The case file maintained by the OSDP Case Manager should contain all assessment and eligibility information.

The case file is considered to be deficient and out of compliance if it does not contain the following information, at a minimum:

▪ Running Record – Case notes

*Some people correspond with their Case Manager via e-mail. If this occurs the e- mail shall become a part of case notes and filed accordingly.

SECTION 1 - Application

• Referral Form - Application for Services - Statement of Understanding & Trust Fund Statement of Understanding (if applicable)

• Consent to Disclose form - HIPAA - Medical Records - Voter Registration form - Emergency Preparedness form - Certificate of Eligibility - Hard Copy PSS

SECTION 2 - Case Notes

• Case Notes (including Monthly Contacts, AACE generated letters, NOAs, etc.)

SECTION 3 - Physician’s Form

• Medical Necessity Form (if applicable) - Functional Assessment

SECTION 4 - Financial Documents

• Authorizations & AACE Payment Sheets - EOBs - All AT Referrals, forms and reports - Quotes/Bids - AT Related Prescriptions

SECTION 23: CASE RECORD CLOSURES

32 Miss. Admin. Code Pt. 1, R. 23.0 Case Record Closures for Independent Living Services

A member’s case shall be closed when it has been determined by the Case Manager that planned services are completed, as appropriate, or that additional services are either unnecessary or inappropriate.

Cases may be closed at different stages in the rehabilitation process:

▪ From Applicant Status ▪ After eligibility from Pre-Service Listing ▪ After eligibility but prior to ILP development ▪ After ILP development but prior to ILP services being initiated ▪ After initiation of ILP services

There are two types of closure statuses:

▪ Closed Goals Met ▪ Closed Other Than Rehabilitated – Goals Not Met

There must be adequate documentation in the case record regarding the case closure. Documentation may be on AACE forms and case notes.

Required documentation generated from AACE includes the following:

▪ AACE Closure Report ▪ Closing Statement for Goals Met ▪ AACE Case Summary Report at closure ▪ AACE Case History Report

All documentation regarding case closure must be clearly stated and written in a manner that presents a thorough explanation of the reasons or situations regarding the closure. All closure documentation must be based on the contents of the case record.

Case records can be shredded, six (6) years after the date of the case closure.

32 Miss. Admin. Code Pt. 1, R. 23.1 Closure – Goals Met

Cases closed, as goals are met must meet the minimum criteria listed below:

• The individual has been determined eligible. • The individual was provided an assessment for services. • The individual was provided case management as an essential IL service.

There must be documented evidence that the Case Manager personally addressed the following issues with the individual or, as appropriate, the individual’s representative:

• The member’s ability to function independently in the home or community or continue in employment has improved. • Individual’s indication of agreement/disagreement with the decision to close their case.

The closing summary must be entered in AACE on the Case Closure page and must include:

• Indication that the individual agreed/disagreed with the decision. • Indication that the provision of services contributed significantly to improving their ability to function or continuing functioning in the home and community. • Information regarding benefits/insurance.

32 Miss. Admin. Code Pt. 1, R. 23.2 Case File Documentation for Closure – Goals Met

• Documentation throughout the case file must show that the services planned and provided did in fact contribute significantly to the member’s ability to functioning more independently in the home or community.

• The case file should document the reason(s) any planned service(s) were not

provided or services closed not met.

• If counseling and guidance were planned, there must be documentation to indicate that this service was provided at appropriate intervals. Any delays or interruptions of services should be documented.

• There must always be documentation of essential counseling and guidance before a case can be closed as rehabilitated, Goals Met.

• Appropriate contact by agency staff should be documented as required (at least every 30 days and more often if warranted by member’s disability or services being provided, ex. waiver services). Any reason for extended periods of time without contact should be documented.

• Documentation at case closure must show that the Case Manager personally contacted the consumer at the time of closure and that case closure was discussed.

• All documentation must indicate that the appropriate mode of communication was used.

32 Miss. Admin. Code Pt. 1, R. 23.3 Closures – Goals Not Met

There are two reasons for closures – goals not met:

1. Because eligibility requirements are not met and 2. For reasons other than eligibility criteria not met (often referred to as intervening reasons)

Ineligibility determination must be based on one of the following:

▪ No disabling condition

To close cases as “no disabling condition” medical documentation must indicate that the applicant does not have a severe physical or mental impairment.

▪ No serious limitations in their ability to function independently in the family or community or continue in employment

To close case as “no serious limitation in their ability to function”, case documentation must show that the applicant’s physical or mental condition does not cause serious limitations in their ability to function independently in the family or community.

▪ The delivery of IL Services will not significantly assist the individual to improve his or her ability to function, continue functioning or move towards functioning in the family or community.

▪ Disability is too severe/unable to benefit from IL services.

To close a case as “disability too severe” requires clear and convincing evidence of the severity of the disability. “Clear and convincing evidence” means that MDRS shall have a higher degree of certainty before it can conclude that an individual is incapable of benefiting from services in terms of improving their ability to function independently in the home and community. The clear and convincing standard constitutes the highest standard used in our civil system of law and is to be individually applied on the case-by- case basis. It would require evidence from more than one source. Also, a demonstration of clear and convincing evidence requires the exploration of the applicant’s abilities, capabilities, and capacity to perform in the home and community with any necessary supports in real life settings. Medical documentation is required if an applicant has a severe physical/mental condition.

Closures because eligibility requirements are not met, require full consultation with the applicant. This consultation must be recorded.

Written notification must include:

• The reason for the ineligibility determination • Appeal rights • Availability of the Client Assistance Program (CAP) • Referral to other agencies and facilities

32 Miss. Admin. Code Pt. 1, R. 23.4 Closure Reasons Other Than Eligibility Criteria Not Met

Unable to locate or moved: This reason is used when the individual has moved without a forwarding address or is otherwise unavailable. Also, use this reason for persons who have left the state and show no intentions of continuing in their IL program or returning to the state in the foreseeable future.

The case file should indicate that a minimum of two (2) letters and two (2) telephone call attempts were made prior to closure. A telephone call with no answer is not considered an attempt. A home visit is also required before closure to be sure that they are not at the residence.

Does not want further services: This reason is used when the individual declines to accept, participate in, or use independent living services. Prior to closing a case for refused services, the documentation must indicate that the individual or his representative has communicated verbally or in writing that he/she does not want services.

Death: This reason requires case file documentation. Documentation may include copy of the obituary, case note indicating notification by family member, etc.

Unable to participate: This reason is used when an individual has entered an institution and will be unavailable to participate in an IL program for an indefinite or considerable period of time. An institution includes a hospital, a nursing home, a prison or jail, a treatment center, etc. Documentation may include a case note indicating notification by

member, family member, etc.

Does not require IL Services: This reason is used when an individual needs services that are more appropriately obtained elsewhere. Appropriate referral information is forwarded to the other agency so that agency may provide services more effectively.

Failure to cooperate: Using this closure reason indicates individual actions or non-actions that make it impossible to begin or continue an IL program. Failure to cooperate includes repeated failures to keep appointments for assessment or other services (Ex. medical appointments). Efforts by the Case Manager to overcome these actions or non-actions are required and must be documented in the case file. The case file must indicate that a minimum of three (3) legitimate (by letter and/or telephone call) attempts were made prior to closure for this reason. At least one of these attempts must be by the Case Manager. A telephone call with no answer is not considered an attempt.

SECTION 25: AUTHORIZATION OF SERVICES

32 Miss. Admin. Code Pt. 1, R. 25.0 Authorization of Services

All services purchased for OSDP/IL members will be authorized in AACE either simultaneously with, or prior to, such purchases. Only a Case Manager or other member of the OSDP/IL staff will authorize the purchase of services. Authorizations will be issued only after a case has been placed in Application Status. Authorizations are to be signed by the Case Manager in the top and bottom sections where indicated.

Any authorization with missing documentation will be sent back to the Case Manager for correction. (Authorizations will not be held at the State Office due to missing or incorrect information.)

All authorizations for SMS will be reviewed by the Case Manager, and then forwarded to the vendor, on the first day of each month.

Authorizations for SMS should not be printed for more than one month at a time for the following reasons:

a) The member’s needs may change; therefore, the authorization will need to be amended.

b) Change in Case Managers. If transferred, a Case Manager cannot amend another Case Manager’s authorization.

c) Overstock in supplies. If a member has too many supplies, the authorization should not be submitted for the following month; thus saving money.

The file copy will be placed in an outstanding authorization holding file until the original copy is received back from the vendor, paid in AACE or the authorization is cancelled.

All SMS payments must be paid in AACE then forwarded to State Office by the 15 th of each month.

When making payments in AACE, enter all corresponding invoice numbers on the AACE payment page.

All authorizations for SMS or DME must include member’s Medicaid, Medicare and private insurance information directly on the authorization. Also include the qualifying diagnosis and the ICD-10 code. Remember:

a) Medicare will not pay for adult diapers or blue pads, so an Explanation of Benefits (EOB) is not needed. b) State Medicaid will provide adult diapers or pull ups and blue pads.

Check the dates of services rendered to the authorization date. If the date of service is prior to the authorization date, verify that a draft authorization was done, and note on the statement of account that a draft is in the file.

If for some reason the authorization was not issued in the electronic case file prior to or simultaneously with provision of services, the following should occur:

a) An authorization must be initiated and placed in DRAFT status.

b) The DRAFT authorization should then be forwarded to the District Manager with an explanation as to why the authorization that was verbally authorized was not issued simultaneously in the electronic file, AACE. This explanation can be entered in the comments section of the authorization.

c) The District Manager then must review the authorization and explanation and either approve or disapprove the issuance of the authorization.

d) If the District Manager approves the authorization, the authorization can then be issued in AACE and mailed to the vendor.

e) When the Authorization/Statement of Account is signed and returned to the Case Manager prior to submitting to Finance, DRAFT in file must be entered/written on the authorization. The dates of services should be recorded as the actual date the service was provided which in most case is prior to the authorization begin dates.

When checking the status of a vendor payment, the Case Manager must:

a) Check with his/her District Manager on the status of a vendor’s payment

b) Managers will check to see if the authorization was received by the State Office

c) Managers can check with Finance after the above has been checked.

32 Miss. Admin. Code Pt. 1, R. 25.1 Time Limit for Filing Claims

Claims for covered services will be paid by DOM only when received within twelve (12) months of the dates of service.

The following are the only reasons allowed consideration for overriding the timely filing:

• Claims filed within twelve (12) months from the date of service but denied can be resubmitted with the internal control number (ICN) from the original denied claim recorded on the face of the resubmitted claim.

• Claims over twelve (12) months can be processed if the member’s Medicaid eligibility has been approved retroactively by the Division of Medicaid. Proof of retroactive determination should accompany the claim and be filed within twelve (12) months from the date of the retroactive letter.

Claims submitted two (2) years from the date of service are not reimbursable unless the member’s Medicaid eligibility is retroactive.

32 Miss. Admin. Code Pt. 1, R. 25.2 MDRS/OSDP Filing Claims to Medicaid

After receiving payment or denial from all third-party sources, MDRS is required to file a claim with DOM. The amount of the third-party payment must be indicated in the appropriate claim field. The claim is processed, and Medicaid either pays the balance due on the claim (the total Medicaid payment amount less the third-party payment amount) or makes no additional payment if the third-party payment is equal to or greater than the total amount due to Medicaid. In either situation, the member’s history of services is updated.

SECTION 26: DURABLE MEDICAL EQUIPMENT (DME) AND SPECIALIZED MEDICAL SUPPLIES (SMS)

32 Miss. Admin. Code Pt. 1, R. 26.0 Durable Medical Equipment (DME) and Specialized Medical Supplies (SMS)

Specialized medical equipment and supplies are devices, controls, or appliances that enable individuals to increase their abilities to perform ADL’s, or to perceive, control, or communicate with the environment in which they live. These services also include items necessary to the proper functioning of such items and durable and non-durable medical equipment not available under the Medicaid State Plan.

Specialized medical supplies are supplies that are medically necessary to meet the needs of the consumer. The Case Manager must document the necessity of the requested medical supply based on:

• Individual’s disability or medical condition; and • Evaluation of the medical supply to adequately support the member living in the most integrated setting possible in the community.

• Medical supplies are only covered after the member has exhausted any insurance, including Medicaid and Medicare, the consumer is eligible to receive.

Covered medical supplies include:

• Briefs • Blue pads • Underpads • Catheters • Gloves • Drainage Bags • Leg Bags • Skin Barrier Products (medically prescribed) • Ostomy Supplies (medically prescribed)

32 Miss. Admin. Code Pt. 1, R. 26.1 Specialized Medical Equipment and Adaptive Aids

Specialized medical equipment/adaptive aids are devices, controls, or appliances that increase a consumer’s ability to:

• Perform Activities of Daily Living (ADLs) • Perceive, control, or communicate with the environment in which they live • Ensure safety, security, and accessibility.

Medical equipment/adaptive aids may:

• Assist with mobility and communication • Compensate for conditions resulting in disability or loss of function • Medical equipment/adaptive aids are only covered after the member has exhausted any insurance, including Medicaid and Medicare, the consumer is eligible to receive.

32 Miss. Admin. Code Pt. 1, R. 26.2 Medical Equipment/Adaptive Aids Covered

Medical equipment/adaptive aids consist of the following services:

Lifts:

• Wheelchair lifts • Porch lifts • Hydraulic, manual, or other electronic lifts • Bathtub seat lifts • Transfer bench

Mobility Aids:

• Manual/electric wheelchairs and necessary accessories

• Scooters • Braces, crutches, walkers, canes • Prescribed prosthetic devices • Prescribed orthotic devices, orthopedic shoes and other prescribed footwear • Portable ramps and • Batteries and chargers

Positioning Devices:

• Customized seating systems • Electric or manual hospital beds, tilt-frame bed, and necessary accessories • Trapeze bars • Egg crate mattresses, sheepskin, and other medically related padding

Communication Aids (including repair, maintenance and batteries):

• Augmentative communication devices • Speech amplifies, aids and assistive devices • Hearing aids

Control Switches/Pneumatic Switches and Devices:

• Sip and puff controls and • Adaptive switches/devices

Environmental Control Units:

• Locks • Electronic devices • Voice activated, light-activated, oral motion-activated devices

Adaptive equipment for activities of daily living:

• Assistive devices:

• Reachers • Holders • Shower chairs • Overbed tray tables

• Medically Necessary Durable Medical Equipment not covered in the State plan for the Mississippi Medicaid Program.

• Temporary rental of medically necessary durable medical equipment to allow for repair, purchase, replacement of essential equipment, or temporary usage of the equipment.

32 Miss. Admin. Code Pt. 1, R. 26.3 Making Requests for Non-Covered Items

The request must include:

• The cost estimate/price quote • Assistive Technology Report (if applicable) and • Medical Prescription (if applicable) • Justification case note explaining why member needs this item

32 Miss. Admin. Code Pt. 1, R. 26.4 Rule 26.4

Requesting Items that are Not on the List of Covered Mecical Equipment/Adaptive Aids

The Case Manager must submit a request to the District Manager for approval of an adaptive aid or medical equipment that is not on the current list. The Case Manager must forward the request to the District Manager. The District Manager will staff the case with the Registered Nurse and Program Director based on:

• How the request is related to the consumer’s disability, and

• If the Medical equipment is:

o Medically necessary o Cost effective and o Necessary to prevent institutionalization

32 Miss. Admin. Code Pt. 1, R. 26.5 Rule 26.5

Utilizing Comparable Benefits, Third-Party Providers Before Purchasing Adaptive Aid/Medical Equipment

All comparable benefits/third party providers the consumer is eligible for must be accessed before using the waiver or any other funding program to pay for adaptive aids or medical equipment. The Case Manager must work with the vendor to ensure that, if the consumer is eligible for Medicare, Medicaid, Home Health Services, or any other comparable benefit, the resources are used to meet the consumer’s need for services. If the Case Manager determines the consumer qualifies for services provided by another resource, they must obtain documentation to support their eligibility for the resource.

32 Miss. Admin. Code Pt. 1, R. 26.6 Rule 26.6

Requesting Adaptive Aid/Medical Equipment that the Case Manager Thinks May Not Be Paid

The Case Manager must submit a request with supporting documentation to the District Manager for a decision. It is outside of the Case Manager’s role to make decisions about the adaptive aids for which will or will not be covered. Decisions regarding such requests must be made by the Case Manager and must be made under OSDP procedures to ensure the member’s due process rights are observed.

32 Miss. Admin. Code Pt. 1, R. 26.7 Rule 26.7

Documentation Required Justifying Cost-Effective Purchase of Adaptive Aid/Medical

Equipment

A price quote from at a minimum of two (2) vendors is required to purchase medical equipment/adaptive aid.

The quote must contain:

• Name of the adaptive aid/medical equipment • A price quote • Date of the quote • Name of agency

DME exempt from obtaining two (2) quotes are:

• Prosthesis • Orthotics • Wheelchairs and accessories • Hospital Beds and accessories • Motorized Scooters • Patient Lifts and • Other medically prescribed, medically necessary DME

Regardless of whether the vendor is also the manufacturer, or the vendor is purchasing from a manufacturer or from a distributor/supplier, it is the responsibility of the vendor to clearly note whether a charge is the MSRP or cost. Vendors are entirely responsible for submitting correct documentation for DME at MSRP or cost. Vendors should be able to produce documentation to show the charges can be substantiated if audited. The Case Manager will provide information on vendors of specialized medical equipment and supplies so that the consumer can make an informed choice regarding vendor for services.

Quotes are not acceptable as an invoice.

32 Miss. Admin. Code Pt. 1, R. 26.8 Durable Medical Equipment Prior to Transition

Recommended/medically prescribed Durable Medical Equipment can be purchased within 60 days of a scheduled transition date if the item is an approved waiver service.

SECTION 27: PROSTHETIC AND ORTHOTIC APPLIANCES

32 Miss. Admin. Code Pt. 1, R. 27.0 Prosthetic and Orthotic Appliances

The provision of Prosthetic and Orthotic devices in an appropriate Independent Living Service.

OSDP staff will follow the same guidelines and procedures set forth in the OVR/OVRB Resource Guide and the Fee Schedule Amputee Clinic Section and fees for Orthotic

Procedures L0000-L4999, that specify guidelines regarding Prescriptions, Authorizations, Physical Therapy, Checkout Sessions, Appointments and Fees.

The IL Case Manager should provide the member receiving a prosthetic or orthotic device with sufficient information so the member can make informed choices regarding the provision of this service. In some instances, a physician or prosthetist may refer the member. A member who was originally referred to OSDP by a prosthetist should have the new appliance purchased from that company unless there are documented reasons to the contrary (Ex. The member chooses to use another prosthetic company).

If the individual has experienced recent physical problems or changes, a current evaluation and medical records should be obtained from the primary treating physician that documents their current condition.

Any member with amputations resulting from diabetes should be evaluated prior to a prosthetic fitting by an internist or their primary treating physician, to determine that there have been no exacerbations of the physical condition that would affect the successful fitting of a new appliance. The Case Manager may obtain current medical information from their primary treating physician that may reflect that there have been no exacerbations of their physical condition.

When determining if a prosthetic or orthotic appliance will benefit an individual in terms of improving their ability to function more independently in the family or community, the following should be considered:

1. Is the person medically ready to wear a prosthesis? 2. Will a prosthetic or orthotic fitting be beneficial in terms of functioning more independently in the home and community? 3. Prescription for the prosthetic or orthotic device 4. Recommendations for appropriate training in the use of the prosthesis or orthotic device.

(See L code fee schedule when purchasing orthotic and/or prosthetics.)

32 Miss. Admin. Code Pt. 1, R. 27.1 Determining Eligibility for Individuals with Hearing Impairments

To determine eligibility, the Case Manager must obtain a valid ENT report signed by a licensed Otolaryngologist. This report can be furnished by the member, or the Case Manager can authorize for a comprehensive ENT examination.

A. If the hearing loss is between 40-50 dB in the better ear and the speech discrimination scores are between 75% and 85%, this case would normally be served by the cross- over Case Manager.

B. If the hearing loss is 55dB or greater in the better ear and speech discrimination score is between 50% and 75%, this case would normally be served by the RCD.

32 Miss. Admin. Code Pt. 1, R. 27.2 Degrees of Hearing Loss

0 dB to 25 dB Normal limits 26 dB to 40 dB Mild loss 41 dB to 55 dB Moderate loss 56 dB to 70 dB Moderately severe loss 71 dB to 90 dB Severe loss 91+ Profound loss

Difficulty in Speech Discrimination

32 Miss. Admin. Code Pt. 1, R. 90 Rule 90

to 100% Normal limits 75 to 90% Slight difficulty, comparable to listening over a telephone 60 to 75% Moderate difficulty 50 to 60% Poor discrimination, marked by difficulty in following conversation Below 50% Unable to follow running a speech

32 Miss. Admin. Code Pt. 1, R. 27.3 Completing Your ENT Report Form

1. Page one - Background information (should be completed by the Case Manager prior to the examination). 2. Page two - Audiogram and pure tones scores.

(O): represents right ear (X): represents left ear [ ]: represents bone conduction (sound introduced in the temporal lobe).

MDRS uses the pure tone scores at [500hz, 1000hz, 2000 hz], which are referred to as the Speech Range, to determine if the member’s loss causes serious limitation in their ability to function or move toward functioning on the home or community.

Pure Tone Averages are determined by adding the scores of these ranges and dividing by three. This is called a three-frequency average. If there is a presence of loss in at least one of the frequencies in the speech range that drops sharply at 4000 hrtz, the Case Manager should do a four-frequency average.

Several terms are used in the section:

• Air refers to the result of the test for air conduction using pure one averages.

• Bone refers to the results of the test for bone conduction.

3. Page three

1. Additional test results – this is not a part of most routine ENT evaluations. If the physician recommends additional testing, the recommended procedure would be authorized in advance on a separate authorization.

2. Hearing aid specifications – This section is also not needed as part of the ENT

evaluation. If the ENT group will be the “informed choice” vender, the recommended fitting should be listed in this section. If the ENT group is not the “informed choice” vendor, this section will not be completed.

3. Hearing for speech – This section is where the audiologist will score the speech discrimination test. SD scores are stated as percentages (%). The signature of the Audiologist is required at the bottom of this page.

4. Page four - Prognosis and recommendation by the diagnosis Otolaryngologist.

Terms used in this section:

• Conduction refers to the outer and middle ear. • Nerve refers to the inner ear. • Mixed refers to both the conduction and nerve areas. • Stable means that the loss has stabilized and might be improved with surgery. • Progressive means that the loss can be expected to become worse unless corrected by surgery. • Permanent means that the loss has stabilized, but surgery will not benefit it. • Diagnosis refers to the physician’s medical opinion as to cause of hearing loss. • Prognosis refers to the physician’s medical opinion as to expected outcome of recovery.

If the ENT Physician recommends surgery or hearing aids, the Case Manager must still establish eligibility based on hearing loss in the better ear, OSDP is not bound by the ENT physician’s recommendation if:

1. The member is not eligible for services. 2) The member does not elect to follow the recommended procedure.

32 Miss. Admin. Code Pt. 1, R. 27.4 Authorizing for ENT Evaluation

ENT Evaluations: Which CPT Codes to Use

For comprehensive Otological and Audiological visit for a new patient * to the same office, authorize:

• 99203 Otological evaluation • 92557 Audiological evaluations • 92507 Speech Therapy sessions • 92508 Auditory Training

If the Otolaryngologist and the Audiologist are in different offices, the Case Manager would authorize for the CPT procedures on separate authorizations.

If the member is returning to the same Otolaryngologist, they are now considered to be an established patient, authorized:

• 99213 (office visit/outpatient visit/typically 15 mins).

*The fees listed in the fee schedule should always be used unless the vendor’s usual and customary fee is less than that listed in the fee schedule.

32 Miss. Admin. Code Pt. 1, R. 27.5 Authorizations for Hearing Aids and Options

MDRS prices for recommended hearing aids should be established according to the following guidelines: Markup

Monaural Fitting – Vendor’s invoice cost from manufacturer plus...................$375.00 Binaural Fitting – Vendor’s invoice cost from manufacturer.............................$575.00 Additional for Digital Aids..................................................................$200.00

The MDRS markup includes cost of impressions, postage, insurance, batteries, and a one- year warranty.

In keeping with the established policy for purchasing hearing aids and options, MDRS will pay the vendor’s invoice cost for the hearing aid and options which are recommended and agreed upon by the Case Manager plus the appropriate markup for monaural or binaural aide.

Case Managers should obtain the factory cost (invoice) from the hearing aid dealer and authorize for the aid/aids.

The following statement should be on the authorization:

“INVOICE TO ACCOMPANY STATEMENT OF ACCOUNT”

Case Managers should receive an actual copy of the invoice with the Statement of Account from the hearing aid dealer and attach it to the Statement of Account when submitting for payment. A copy of the invoice should also be placed in the case file.

The following is a partial list of other optional and assistive devices with prices:

Ear-mold (when authorized separately) $40.00 Telephone switch (when authorized separately) $25.00 Bi-Cros (invoice price plus monaural markup) Hearing aid repairs (factory invoice cost plus) $30.00

*Note: Ear-mold(s) would not be authorized for in-the-ear aids.

If an option is listed as being more than these prices, the actual manufacturer’s invoice cost for the option may be paid.

All Authorizations for hearing aids MUST include the make and model of the aid, monaural

or binaural markup, and cost of the aid. Example authorizations are given below:

Siemens BTE analog aid $380.00 Monaural markup $375.00 TOTAL $755.00

Resound digital aid (x2) $1,380.00 Binaural markup $ 575.00 Additional markup $ 200.00 TOTAL $2,155.00

Digital/Programmable Hearing Aids

Digital/programmable hearing aids may be more appropriate for some types of hearing loss configurations; however, they are not required for the majority of members with hearing loss. These aids are more expensive and require much more time to adjust properly after the initial fitting. For these reasons, an additional markup of $200 has been allowed to compensate the vendor for up to 4 additional office visits to cover services rendered after the initial fitting.

Any Digital/programmable hearing aids in excess of $2,300.00, including markups must be staffed with the State Coordinator of Deaf Services (SCD) before an authorization is issued.

32 Miss. Admin. Code Pt. 1, R. 27.6 Reasons for Replacing Hearing Aids

a. If the aid is at least four years old b. If the aid has been repaired at least once at the cost of the user* c. If the aid now being worn is no longer appropriate for the member’s hearing loss d. If technology has improved to the point that a new aid is significantly better.

*If the member purchases an extended warranty, his/her out-of-pocket expenses are automatically considered to meet the requirements “for part b”.

32 Miss. Admin. Code Pt. 1, R. 27.7 Member Participation

Member participation can be an appropriate way to utilize case service funds if the member can afford to participate in the payment of his/her hearing aids. If you do receive some amount of member participation by the member, MDRS is still ultimately responsible for the hearing aid payment.

32 Miss. Admin. Code Pt. 1, R. 27.8 Two (2) Week Follow-Ups/Thirty Day Follow-Up

The purpose of the two-week follow-up is to show that the vendor has successfully fitted the member with the prescribed hearing aid and has met with the member within two weeks to confirm his/her satisfaction with the fitting. The form should be included along with the initial authorization and sent directly to the vendor. Two weeks after the fitting, the form should be completed by the member in the hearing aid dealer’s office, not sent to the member in the mail. Again, the two-week follow-up form is your confirmation that the member has received the proper services for which you are paying. If the member is not satisfied with

his hearing aid or the services of the vendor, the two-week follow- up serves as the member’s mechanism to express his feelings in writing.

The thirty-day follow-up is conducted by the Case Manager with the member, thirty days after the initial fitting, to confirm that the member is still satisfied after thirty days. Most often, during a thirty-day follow-up session, the member will have questions and concerns about his new aids that only the Case Manager is qualified to answer.

SECTION 28: ABBREVIATIONS, ACRONYMS AND DEFINITIONS

32 Miss. Admin. Code Pt. 1, R. 28.0 Abbreviations, Acronyms and Definitions

AACE Accessible Automated Case Environment ACB American Council of the Blind ACT The Rehabilitation Act of 1973, as amended ADA Americans with Disabilities Act ADHD Attention Deficit Hyperactivity Disorder ADL Activities of Daily Living AW Ability Works AFDC Aid to Families with Dependent Children AGI Adjusted Gross Income ALF Assisted Living Facility AMRC Addie McBryde Rehabilitation Center for the Blind ARC Association for the Rights of Citizens with Developmental Disabilities AT Assistive Technology AL Assisted Living BEP Business Enterprise Program BIA Brain Injury Association BSC Basic Service Grant CAP Client Assistance Program C/E Certificate of Eligibility CEC Comprehensive Evaluation Center CEU Continuing Education Unit CIL Center for Independent Living CF Count Fingers

Core Services – IL services defined in Section 7 (17) of the Act means: information and referral services; IL Skills Training; peer counseling (including cross-disability peer counseling); and, individual and systems advocacy.

CSR – Member Service Record maintained for an eligible member receiving IL services and meeting the requirements of 34 CRF 364.53

CMI Chronic Mental Illness CMN Certificate of Medical Necessity CPM Certified Public Manager

CRP Community Rehabilitation Program CRC Certified Rehabilitation Counselor CRS Case Review Schedule CSAVR Council of State Administrators for Vocational Rehabilitation CSLR Counselor CCWAVES Commission of Certification of Work Adjustment and Vocational Evaluation Specialists CD Member Directed COLA Cost of Living Adjustment CVE Certified Vocational Evaluator DB Decibel D/B Deaf-Blind DCW Direct Care Worker DD Developmental Disability DDS Disability Determination Services DFA Mississippi Department of Finance and Administration DHS Mississippi Department of Human Services DM District Manager DMH Mississippi Department of Mental Health DOM Division of Medicaid DSU Designated State Unit E & D Elderly & Disabled EPSDT Early and Periodic Screening, Diagnosis, and Treatment EVV Electronic Visit Verification FFP Federal Financial Participation FFY Federal Fiscal Year FHA Federal Housing Administration FOB Fixed Object Device FTE The equivalent of one person working full-time for one year HCBS Home and Community-Based Services HMO Health Maintenance Organization HIPPA Health Insurance Portability and Accountability Act HUD Department of Housing and Urban Development IADL Instrumental Activities of Daily Living ICF Intermediate Care Facility ICF/MR Intermediate Care Facility for persons with Mental Retardation ID/DD Intellectually Delayed/Developmentally Disabled IDEA Individuals with Disabilities Education Act IPE Individualized Plan for Employment IL Independent Living ILP Individualized Independent Living Plan ILRC Independent Living Rehabilitation Counselor LIFE Living Independence for Everyone LPC Licensed Professional Counselor LOC Level of Care LSW Licensed Social Worker LTC Long Term Care MDRS Mississippi Department of Rehabilitation Services

MRC Methodist Rehabilitation Center

Minority – Alaskan Natives, American Indians, Asian Americans, Black (African Groups) Americans, Hispanic or Latino Americans, Native Hawaiians, and Pacific Islanders.

MP&A Mississippi Protection & Advocacy Systems MPA Mississippi Paralysis Association NF Nursing Facility NOA Notice of Action NOD Notice of Determination NFB National Federation of the Blind NLP No Light Perception OBRA Omnibus Budget Reconciliation Act OSDP Office of Special Disability Programs OVR Office of Vocational Rehabilitation OVRB Office of Vocational Rehabilitation for the Blind OS Left Eye OD Right Eye OU Both Eyes PA Prior Authorization PCMS Physician Certification of Medical Stability PERS Personal Emergency Response System PERS Public Employees’ Retirement System PCA Personal Care Attendant PSS Plan of Services and Supports PRTF Psychiatric Residential Treatment Facility RAM Rehabilitation Association of Mississippi RAMP Rehabilitation Administration & Management Programs RCD Rehabilitation Counselor for the Deaf RCF Residential Care Facility RID Registry of Interpreters for the Deaf REACH Realizing that Empowerment through Accomplishment and Confidence building, it is Honorable to be Blind.

Reporting Year – The most recently completed Federal fiscal project year staring October 1 and ending September 30.

RM Regional Manager RN Registered Nurse RSA Rehabilitation Services Administration OSERS Office of Special Education and Rehabilitative Services SGA Substantial Gainful Activity SCI Spinal Cord Injury SE Supported Employment SFY State Fiscal Year SILC Statewide Independent Living Council established in each State as required by Section 704 and 705 of the Act.

SILS A State Independent Living services program funded under Part B, Chapter 1 of the Title VII of the ACT SLD Specific Learning Disability SMI Serious Mental Illness SNF Skilled Nursing Facility SOICC State Occupational Information Coordinating Committee SPB State Personnel Board SPIL State Plan for Independent Living SRC State Rehabilitation Council SRT Speech Reception Threshold SSA Social Security Administration SSDI Social Security Disability Insurance SSI Supplemental Security Income START Success through Assistive Rehabilitation Technology SWIB State Workforce Investment Board TANF Temporary Assistance for Needy Families TBI Traumatic Brain Injury TCM Targeted Case Management TDD Telecommunication Device for the Deaf TTY Teletypewriter for the Deaf TWE Trail Work Experience UCL Uncomfortable listening level VA U.S. Department of Veteran’s Affairs VE Vocational Evaluation VEWAA Vocational Evaluation & Work Adjustment Association VR Vocational Rehabilitation VSMS Vineland Social Maturity Scale VTI Vocational Training Instructor WAIS Wechsler Adult Intelligence Scale WC Workers’ Compensation WEP Work Experience Program

WIA Workforce Investment Act WIIA Work Incentives Improvement Act WIOA Workforce Innovation and Opportunity Act WISC Wechsler Intelligence Scale for Children WMS Wechsler Memory Scale WRAT Wide Range Achievement Test

32 Miss. Admin. Code Pt. 1, R. 28.1 Definitions for Authorized Representative

If the applicant/member is an adult, their representative is a person who has the authority to make decisions about the member and includes a:

• Person the member has appointed under a medical power of attorney, a durable power of attorney with the authority to make health care decisions, or a power of attorney

with the authority to make health care decisions, • Court – appointed guardian for the member, or • Person designated by law to make health care decisions when the member is in an institution and is incapacitated or mentally or physically incapable of communication.

Legal Representative is any person who has been vested by law with the power to act on behalf of another individual. The term includes a guardian appointed by a court of competent jurisdiction in the case of an incompetent individual or minor; or a parent in the case of a minor; or a person acting under a valid power of attorney. Categories of legal representatives include:

• Conservator - an individual or corporation appointed by a court to manage the estate, property, and/or other business affairs of an individual whom the court has determined is unable to do so for him/herself.

• Power of Attorney - a document which authorizes a person (agent) to act on behalf of another person (the principal). The principal delegates this authority, establishes its parameters, and may terminate it. Its authority is also terminated by death, disability, or incompetence of the principal, unless it is “durable.”

• Durable Power of Attorney - a power of attorney document which specifically states it is to (1) remain in effect despite the principal’s subsequent incapacity or (2) take effect upon the principal’s incapacity.

• Guardian - an individual or corporation appointed by a court to see to the needs of a person proven to be incapacitated or in need or continuing care or supervision. A guardianship may be “limited’”, addressing only some types of need, an arrangement which is less restrictive than a full guardianship.

32 Miss. Admin. Code Pt. 1, R. 28.2 Definitions Vulnerable Adults and Children

Definitions under MISS. CODE ANN. 43-47-5:

“Vulnerable adult” shall mean a person eighteen (18) years of age or older or any minor not covered by the Youth Court Act who is present in the State and who, regardless of residence, is unable to protect his or her own rights, interests, and/or vital concerns and who cannot seek help without assistance because of physical, mental, or emotional impairment.

“Abuse” shall mean the willful infliction of physical pain, injury or mental anguish on a vulnerable adult, the unreasonable confinement of a vulnerable adult, or the willful deprivation by a caretaker of services which are necessary to maintain the mental and physical health of a vulnerable adult. Abuse shall not mean conduct which is a part of the treatment and care of, and in furtherance of the health and safety of a patient or resident of a care facility.

“Neglect” shall mean either the inability of a vulnerable adult who is living alone to provide

for him/herself the food, clothing, shelter, health care, or other services which are necessary to maintain his/her mental and physical health, or failure of a caretaker to supply the vulnerable adult with the food, clothing, shelter, health care, supervision, or other services which are necessary to maintain his/her mental and physical health.

“Exploitation” shall mean the illegal or improper use of vulnerable adult or his/her resources for another’s profit or advantage.

Definitions under MISS. CODE ANN, 43-21-105:

“Child” and “Youth” are synonymous, and each means a person who has not reached his/her eighteenth (18) birthday. A child who has not reached his/her eighteenth (18) birthday who is on active duty for a branch of the armed services and is married is not considered a child or youth for the purposes of this section.

“Abused child” means a child whose parent, guardian, custodian, or any person for his/her care or support, whether legally obligated to do so or not, has caused or allowed to be caused upon said child sexual abuse, sexual exploitation, emotional abuse, mental injury, non- accidental physical injury, or other maltreatment.

“Neglected child” means a child:

a) Whose parent, guardian, custodian, or any person responsible for his/her care or support, neglects or refuses, when able to do so, to provide for him/her proper and necessary care or support, or education as required by law, or medical, surgical, or other care necessary for his well-being; provided, however, a parent who withholds medical treatment from any child who in good faith is under treatment by spiritual means alone through prayer in accordance with the tenets and practices of a recognized church or religious denomination by a duly accredited practioner thereof shall not, for that reason alone, be considered to be neglectful under any provision of this section; or b) Who is otherwise without proper care, custody, supervision, or support; or c) Who for any reason, lacks the special care made necessary for him by reason of his mental condition, whether said mental condition be mentally retarded or mentally ill; or d) Who, for any reason, lacks the care necessary for his health, morals, or well-being.

32 Miss. Admin. Code Pt. 1, R. 28.3 Definitions – Notice of Actions/Hearings

Independent Living Waiver & Traumatic Brain/Spinal Cord Injury Waiver

For the purpose of this section (42 CFR 431.201)

Notice means a written statement explaining what action is being taken.

Action means a termination, suspension, or reduction of Medicaid eligibility or covered services.

Date of action means the intended date on which termination, suspension, reduction, transfer or discharge becomes effective.

Request for hearing means a clear expression by the applicant/member or his/her authorized representative that they want the opportunity to present his/her case to a reviewing authority.

The applicant/member must be informed in writing of a decision that will result in the following:

• Being determined ineligible for services • The amount (quantity) of the service the client will receive • The request for services being denied • Being determined ineligible for continued services

32 Miss. Admin. Code Pt. 1, R. 28.4 Independent Living Member Achievements, Goals and/or Objectives

Self-Advocacy/Self-Empowerment – Goals involving either improvement in a member’s ability to represent himself/herself with public and/or private entities or ability to make key decisions involving himself/herself.

Communication – Goals involving either improvement in a member’s ability to understand communication by others (receptive skills) and/or improvements in a member’s ability to share communication with others (expressive skills).

Mobility/Transportation – Goals to improve a member’s access to his/her life space, environment, and community. This may occur by himself/herself or the use of public transportation.

Community Services – Goals that provide for a change in living situations with increased autonomy for the member. This may involve a member’s goal related to obtaining/modifying of an apartment or house.

Educational – Goals of an academic or training nature that are expected to improve the member’s basic knowledge or increase his/her ability to perform certain skills deemed to increase his/her independence consistent with IL philosophy.

Vocational – IL goals related to obtaining, maintaining, or advancing in employment.

Self-Care – Goals to improve/maintain a member’s autonomy with respect to activities of daily living such as grooming and cleaning, toileting, meal preparation, shopping, eating, etc.

Information Access/Technology – Goals related to a member obtaining and/or using a computer or other assistive technology, devices, or equipment, also a member’s goal of developing skills in using information technology, e.g. emerging computer screen-reading software.

Personal Resource Management – Goals related to a member learning to establish and maintain a personal/family budget, managing a checkbook, and/or obtaining knowledge of available direct and indirect resources related to income, housing, food, medical, and/or other benefits.

Other – IL goals not included in the above categories.

Part 3 Vocational Rehabilitation for the Blind

Chapter 1 Addie McBryde Rehabilitation Center Manual

32 Miss. Admin. Code Pt. 3, R. 13.05 Rule 13.05

Retention of Referral Information ............................................................................ 32 13.06 Disclosure of Confidential Client Information ......................................................... 32 13.07 Single Case Record ................................................................................................... 32 13.08 Organization of Material in Case Record ................................................................. 32 13.09 Case Record Requirements ....................................................................................... 33 13.10 Case Recording ......................................................................................................... 34 13.11 Signature Policy ........................................................................................................ 34 13.12 Case Review (Quality Assurance) ............................................................................ 34

SECTION 14 (1N) Performance Improvements ...................................................................... 35

SECTION 15 (1O) Client Services ............................................................................................ 36 15.00 GENERAL SERVICE INFORMATION ................................................................. 36 A. Referrals ........................................................................................................................ 36 B. Re-referrals ................................................................................................................... 36 C. Order of Acceptance Policy .......................................................................................... 37 D. Reentry Policy ............................................................................................................... 37 E. Reorientation Policy...................................................................................................... 37 F. Ineligible Individuals .................................................................................................... 37 G. Orientation Policy for Clients ....................................................................................... 37 H. Client Handbook ........................................................................................................... 37 I. Intake Interview ............................................................................................................ 38 J. Individual Program Planning Policy ............................................................................. 38 K. Program Manager.......................................................................................................... 39 L. Assistive Technology .................................................................................................... 39 M. Behavior Management Policy and Procedures ............................................................. 39 N. Referrals for Additional Services.................................................................................. 40 O. Termination Procedures ................................................................................................ 40 P. Follow-Up ..................................................................................................................... 41 15.01 Personal Adjustment Training (PAT) Services......................................................... 41 A. PAT Admission Criteria ............................................................................................... 41 B. PAT Services ................................................................................................................ 41 C. PAT Techniques............................................................................................................ 42 D. Individualized Personal Adjustment Training Plan (IAP) ............................................ 42 E. PAT Progress Staffings and Reports............................................................................. 42 F. PAT Final Staffing ........................................................................................................ 43 G. PAT Exit Criteria .......................................................................................................... 43 15.02 Comprehensive Vocational Evaluation Services ...................................................... 43 A. Vocational Evaluation Admission Criteria ................................................................... 43 B. Vocational Evaluation Services .................................................................................... 43 C. Vocational Evaluation Techniques ............................................................................... 44 D. Individualized Vocational Evaluation Plan (IVEP) ...................................................... 44 E. Vocational Evaluator Participation in Monthly Client Staffing ................................... 44 F. Vocational Evaluation Summary .................................................................................. 45 G. Vocational Evaluation Report ....................................................................................... 45 H. Vocational Evaluation Exit Criteria .............................................................................. 45

ADDIE McBRYDE CENTER MANUAL TABLE of CONTENTS

32 Miss. Admin. Code Pt. 3, R. 15.03 Rule 15.03

Low Vision Services ................................................................................................. 45 A. Low Vision Admission Criteria .................................................................................... 45 B. Low Vision Services and Techniques ........................................................................... 46 C. Low Vision Reports ...................................................................................................... 46 D. Low Vision Exit Criteria ............................................................................................... 46 15.04 Additional “Special” Services ................................................................................... 46

APPENDIX A .............................................................................................................................. 47 Supplemental Documentation / Resources ............................................................................ 48

APPENDIX B .............................................................................................................................. 49 Code of Ethics ........................................................................................................................ 49

INDEX ........................................................................................................................................... A

ADDIE McBRYDE CENTER MANUAL Leadership Section 1

SECTION 1 (1A) Leadership 1.00 MDRS Mission Statement It is the mission of the Mississippi Department of Rehabilitation Services (MDRS / the Department) to provide appropriate and comprehensive services to Mississippians with disabilities in a timely and effective manner. Programs and services assist individuals with disabilities to gain employment, retain employment and/or to live more independently. 1.01 AMRC Mission Statement In keeping with its mission, MDRS operates a non-profit community rehabilitation program (CRP), The Addie McBryde Rehabilitation Center (the Center). The mission of the Center is to provide options which promote the personal, social and economic independence of persons living with vision loss. 1.02 Scope of Services Located in Jackson, Mississippi, on the University of Mississippi Medical Center campus, the Center provides the following: Personal Adjustment Training in Orientation and Mobility, Personal Management, Techniques of Daily Living, Leisure Education, Recreation, Arts & Crafts, Communications, Typewriting/Keyboarding and Advanced Communications are also a part of the curriculum designed to meet the needs of those served. The Center also provides individualized vocational evaluations, diabetic counseling and low-vision assessments.

The Center is committed to providing service delivery that will empower individuals served to reach the highest and most appropriate functional level. This is accomplished through the designation of entrance and exit criteria for each service area. 1.03 Assurances/Principles 1. The Center’s leadership is philosophically, as well as legally, committed to ensuring that the human rights, dignity, health and safety of all its clients are fully protected. 2. The Center’s leadership is committed to soliciting and utilizing input from those served throughout all states of the service delivery process. 3. The Center’s leadership is committed to providing services designed to assist those served in reaching their maximum independence. The primary goal for each person is to develop the skills necessary to achieve this goal. A second goal is to coordinate services that will lead to an employment outcome. 4. The Center’s leadership is committed to providing services that are individualized, coordinated, and reflects the informed choices of the persons served. 1.04 Code of Ethics and Ethical Violations The Center has established a code of ethics and seeks to adhere in all its activities and services to the highest ethical and moral standards. Accepting and/or exchange of any gratuities, money, or gifts is prohibited. At any time that a presumed violation of either the Addie McBryde Code of Ethics or the Mississippi Department of Rehabilitation Services Code of Ethics is noted, it should be reported in writing to the Center director or his/her designee. The Center director is responsible

ADDIE McBRYDE CENTER MANUAL Leadership Section 1

for reporting such violations to appropriate MDRS administration. (Reference: “Code of Ethics and Our Mission Statement” Book 1.) 1.05 The Governance Authority As set by state statute and through management by the Mississippi Department of Rehabilitation Services, the Governing Authority provides effective and ethical leadership and stability for the Center so that it can achieve its stated mission. Together they have responsibility for establishing policy and maintaining high standards of operation. The Governing Authority meets formally on a quarterly basis, at a minimum, and informally as needed.

ADDIE McBRYDE CENTER MANUAL Governance Section 2

SECTION 2 (1B) Governance 2.00 Governing Authority The Governing Authority of the Addie McBryde Rehabilitation Center for the Blind is a three-member body set by State legislative statute. The Governing Authority has the responsibility for approving the appointment of the Director of the Addie McBryde Center. In addition, it is responsible for reviewing major policy issues presented by the Director of the Office of Vocational Rehabilitation for the Blind and the McBryde Center Director, for maintaining high standards of operation, and for the continuing development of the Center. Members of the Governing Authority, as set by legislative mandate, are the Vice Chancellor of the University of Mississippi Medical Center, the University of Mississippi Medical Center's Assistant Vice- Chancellor for Administrative Services and the Director of the MDRS Office of Vocational Rehabilitation for the Blind. The Governing Authority meets at least quarterly, and minutes are kept of all meetings.

Orientation procedures for a new governing authority member include the Center Director arranging a tour of the Center, providing an overview of the Center's operations and its history and copies of governing authority minutes for the previous three years. Policies to guard against the development of a conflict of interest are established by the Department and by the University of Mississippi Medical Center. Any suggestion of the possibility of a conflict of interest between an individual member and the Center is referred to the attorney assigned to the Department by the Mississippi Attorney General's Office for an opinion which shall be binding upon the member in question. (Reference: "Governing Authority" Book 1.) 2.01 Administrative Agency The administrative agency of the Addie McBryde Center is the Mississippi Department of Rehabilitation Services. With the exception of the appointment of the Center Director as noted above, all decisions regarding staff, finances, policies, procedures, and the like, are under the purview of MDRS. The responsibility of administering and supervising the Center's programs, including expansion, changes, or modification of the Center lies with the Department.

MDRS, as the administrative agency, manages the general business, property and affairs of the Center. The Center is located organizationally within the Office of Vocational Rehabilitation for the Blind. OVRB Administrative staff, of which the McBryde Center Director is a member, meets periodically at the initiation of the OVRB Director. 2.02 Organizational Structure The Center is structured and administered to meet the established goals of the Department and the Center. The Director of OVRB recommends the designation of the Center Director and all other Center personnel. However, the ultimate approval for employment rests with the MDRS Executive Director. For the purposes of CARF, the Center Director is the chief executive officer of the Addie McBryde Center. The Department vests authority to the Center Director for the direct oversight of the day-to-day management of the Center in accordance with the policies and procedures of the Department and sound management principles. Support personnel or technical

ADDIE McBRYDE CENTER MANUAL Governance Section 2

assistants are supervised and function within the organizational structure for the Center as set by the Department.

A review and approval process in critical management areas is carried out through a chain of command. This begins with the Center Director, proceeds to the OVRB Director, the Deputy Director of Vocational Services and on to the MDRS Executive Director. The Center Director reports directly to the OVRB Director who is next in line above this staff position in responsibility and accountability for the management and operation of the Center. In the absence of the Center Director, the Assistant Center Director is in charge of the management of the Center.

The Center Director, with the approval of the OVRB Director, initiates decisions that affect the Center such as the establishment of Center goals and objectives, budgeting, employee selection, staff utilization, space allocation, travel, in-service training, use of consultants, public information, and program development.

The Center Director is responsible for meeting with the staff to ensure that input in these areas is secured and documented. The Center Director provides input on behalf of the entire Center to her supervisor, the OVRB Director. 2.03 Organizational Chart MDRS has an organizational chart that sets forth lines of authority, responsibility, and communication in accordance with Department policies and procedures and with approval of applicable state regulatory agencies. This organizational structure is reviewed and amended as necessary by the MDRS Executive Director. In addition, the Center's organizational chart delineates the lines of authority, responsibility and communication within the Center. (Reference: "Human Resources" Book 4.)

ADDIE McBRYDE CENTER MANUAL Strategic Integrated Planning Section 3

SECTION 3 (1C) Strategic Integrated Planning 3.00 Reports Various management records and reports generated by the Center are used to guide the operation, support the assessment and improvement in quality of services, measure and communicate performance, and reflect the current status of the Center.

The Center Director assists in the OVRB Director's formulation of policy by presenting and interpreting operating reports, including those reflecting the efficiency and effectiveness of the Center. These reports include, but are not limited to, the following: Monthly Reports, Annual Outcomes Management Report, Outcome Measurement System Results, Financial Statements, Strategic Management Plans, Personnel Reports, and the results of Program Quality Assessment activities. These results are supplied to the McBryde Governing Authority and to the OVRB Director who presents them to the MDRS Executive Director. These presentations provide an opportunity for policy and operational review, analysis, and action.

The Center Director analyzes management reports and compares performance against budgetary, administrative, and professional standards. In addition, the Center Director analyzes the extent to which the Center's goals and objectives are being attained. The results of these activities are used by the Center Director to upgrade operations by the initiation of appropriate preventive, pro-active, or corrective measures.

The Center Director provides, interprets, and presents data to the OVRB Director and the Governing Authority in order to identify local needs and achievements, ensures that staff is operating in an efficient and effective manner, and initiates statewide management direction and actions to accomplish the goals and objectives of the Center. The OVRB Director initiates ongoing efforts to ensure that a management information system exists to provide regular, timely flow of information.

The MDRS reviews the total effectiveness of the Center in relation to the stated purposes of the Center and the Department. If reviews indicate significant deviations from goals or expectations, then a determination of probable causes and needed changes in either service delivery or expectations are taken into consideration. 3.01 Strategic Management Plan The Center maintains a Strategic Management Plan through the Office of Vocational Rehabilitation for the Blind with goals and objectives based upon a periodic, systematic needs assessment of current and potential consumers. The Center, in accomplishing the planning process, solicits cooperative interagency coordination for those persons who need long-term assistance and/or supplementary supportive services. Center personnel participate in local community planning activities related to the persons served and the mission of the organization. (Reference: “Strategic Management Plans", "Clients Referred for Ancillary Concurrent Services", and "Community Involvement Book 1, Book 7, Book 6.)

ADDIE McBRYDE CENTER MANUAL Strategic Integrated Planning Section 3

3.02 Additional Planning Tools The Center's target service area is statewide. Its services are intended for people who are blind or visually impaired and who are eligible clients of one of the programs administered by the Office of Vocational Rehabilitation for the Blind.

The Center describes changes and trends that may affect planning and have an impact on the future. These may include such items as changes in the community, government, economy, labor market, consumer needs, service area, and services. In addition to the Strategic Management Plan, the Center uses the following to document planning for future needs:

1. Accessibility Plan 2. Staff Development and Training Plan 3. Outreach Plan 4. Short-Long Range Goals

ADDIE McBRYDE CENTER MANUAL Input from Persons Served and Other Stakeholders Section 4

SECTION 4 (1D) Input from Persons Served and Other Stakeholders 4.0 Input from Stakeholders

The Addie McBryde Rehabilitation Center for the Blind is committed to creating an environment that is responsive to the needs and expectations of the people served, and that is relevant to their maximum participation in society. The involvement of the people receiving the services, or their personal representatives is an integral part of the total environment of the Addie McBryde Rehabilitation Center for the Blind. By providing opportunities for consumers themselves to have input about the system, the Addie McBryde Center benefits from their unique perspectives, and demonstrates a belief in the value of self-determination and informed choice.

The Center is committed to obtaining and utilizing input from those served throughout every aspect of the service delivery process. The Center has established written procedures which describe each of the major systems used to obtain input from persons served and other stakeholders. 4.01 Case/Program Managers In addition to formal methods for receiving input, the Center is committed to maximizing opportunities for clients to contribute in more informal ways to the development and implementation of their program of services. The Center Director maintains an "open door" policy and meets with each new client shortly after arrival. All clients entering the Center are assigned to a Program Manager who is responsible for developing, implementing, monitoring and modifying as necessary the clients' program of services. Program Managers meet regularly with each client on their caseload, acting as a liaison with the client's MDRS district counselor and with other service providers.

Input received from these procedures is reviewed and used to make decisions about program improvement, change, or modification to insure that the needs of the persons served are being met. When appropriate, input is used to change practices and/or policies of the Addie McBryde Rehabilitation Center for the Blind. 4.02 Consumer Based Planning The Center maintains its programs based upon the needs of prospective and current consumers. Consumers include persons served and referral sources. It is critical that communication between the Center and its consumers be maintained to ensure the Center's programs and services are effectively utilized. 4.03 Mechanisms Used to Obtain Input The methods include but are not limited to the following: 1. Suggestion Box - In order to promote input from those served, a suggestion box is located in the client lounge on the second floor. 2. Client Advisory Committee – A group of three clients is chosen at random and serves voluntarily to gather input from their peers. This input is shared with staff at the Psychosocial Committee meetings. Oral and written input from individual

ADDIE McBRYDE CENTER MANUAL Input from Persons Served and Other Stakeholders Section 4

clients is solicited from those served through each phase of the service delivery process (from intake to program planning and service implementation, to progress reviews, exit and follow-up). The Center's Program Managers are charged with maintaining regular and ongoing contact with clients assigned to their caseloads. Program Managers document all significant communication with or about clients on their respective caseloads in the client file's case notes. Program Managers also maintain regular contact with referring district counselors of each client, informing them immediately, either orally or in writing, of any significant issue that may arise. 3. Public Meetings - Input from those served and the general public is solicited and secured annually at regional meetings for the public review of the Mississippi OVR/VRB State Plan. Meeting locations and schedules are advertised, and other informal means are used to encourage participation from advocacy groups, consumers, and the general public. The Mississippi OVR/VRB State Plan is available for review by persons with disabilities and/or other interested parties during regular office hours at the Department's central administrative office and certain district locations and available on the MDRS website. The State Plan is provided in alternate media for access by people who are blind or visually impaired. 4. Facilities Advisory Committee - Input is solicited from the representatives of the service community and blind consumers through the quarterly meeting of the Facilities Advisory Committee. (Reference: "Facilities Advisory Committee" Book 1)

The Center develops and maintains an annual comprehensive, written consumer-based management plan. This plan is the result of the Center's investigations and its mission in the community. As a minimum, this plan includes:

1. A prioritized set of objectives 2. An action plan to accomplish the objectives 3. Identification of responsibilities for accomplishment of the planning objectives to include who will be responsible for what and the time frames that are projected for their accomplishment 4. An evaluation of performance toward objectives (minimum of annually) (Reference: "Outcomes Measurement System” and "Strategic Management Plans" Book 1.) 4.04 Facility Advisory Committee The Center maintains continual participation in a Facilities Advisory Committee (the Committee). The Committee provides a mechanism to promote community input. It also solicits and secures community involvement in support of the Center. The Committee serves strictly in an advisory capacity and has neither legal responsibility nor authority over the operation of the Center. The Committee is composed of members who are blind consumers or who are representatives from the various agencies and organizations for people who are blind or visually impaired.

The purpose of the Committee is to gather and provide diverse, energetic, and creative community input. Functions of the Committee are to promote accessibility (physical,

ADDIE McBRYDE CENTER MANUAL Input from Persons Served and Other Stakeholders Section 4

programmatic, economic/employment) for persons with disabilities and interagency service coordination. The Committee meets at least quarterly with minutes taken at all meetings. (Reference: "Facility Advisory Committee" Book 1.) 4.05 Public Relations and Outreach Information Addie McBryde Rehabilitation Center for the Blind maintains an active, ongoing public information (PI) program that serves to promote understanding and support of the Center while preserving and respecting the dignity and rights of the persons served. The Center plans, initiates, and documents PI activities. Open houses, involvement in local interagency councils or boards, press releases, and presentations to civic organizations represent examples of PI activities. PI is the key to community support and serves to enhance the viability of the Center. The Center Director is directly involved in PI activities and other related duties but is provided support and technical assistance from specialized Center staff. (Reference: "Public Information and Outreach" Book 6.)

The purposes of the Center are clearly stated in various publications which are distributed to staff, those served, referral sources, and other interested individuals or groups. All Center brochures and other appropriate publications contain descriptions of the services available and are designed to enhance the value of the persons served. All PI activities are conducted in accordance with MDRS Policy Manual, 1.10 Public Information Guidelines, page 1-28. 4.06 Staff meetings Staff meetings of management and professional staff in the Center are held at least monthly. Minutes of all staff meetings are taken and distributed to personnel. Through these meetings Center staff are provided opportunity to make suggestions, offer observations, as well as receive information from the Center Director about progress toward reaching management goals. (Reference: "Staff Meeting Minutes" Book 5.)

ADDIE McBRYDE CENTER MANUAL Legal Requirements and Legal Issues Section 5

SECTION 5 (1E) Legal Requirements and Legal Issues 5.00 Legal Conformance It is the intent of the Addie McBryde Rehabilitation Center for the Blind to demonstrate conformance with all applicable legal requirements and regulations of the governmental authorities and legally authorized agencies under whose authority it operates. In support of this intent, the Center maintains all legally required licenses and certificates that relate to its conformance with such requirements including, but not limited to, accessibility, affirmative action, equal employment, health and safety, licensure and fair labor practices. (Reference: SPB Personnel Handbook; Executive Director's Memoranda; "Human Resources" file.) Applicable legal requirements are checked periodically with the attorney assigned to the Mississippi Department of Rehabilitation Services from the State Attorney General's Office.

The State of Mississippi does not require licensure for community rehabilitation programs. Should the Center plan to engage in any activity regulated or licensed by the State or the United States Government or any other legally authorized agencies under whose authority it operates, then the appropriate licensure or certification will be secured prior to the initiation of the activity. 5.01 Search Warrants and Legal Proceedings Involving Staff The policy for personnel responding to search warrants, investigations, inquiries from attorneys relating to current or former clients or other legal actions are as follows:

1. Contact the immediate supervisor for assistance. 2. If a staff member receives a subpoena, he/she will follow guidelines in the OVR/VRB Policy Manual: Section 3.5. 3. All legal inquiries concerning clients must be directed to the Center Director or his/her designee. 4. The MDRS staff attorney will be consulted on any issue needing legal guidance.

ADDIE McBRYDE CENTER MANUAL Financial Planning and Management Section 6

SECTION 6 (1F) Financial Planning and Management 6.00 Financial Policy The Addie McBryde Rehabilitation Center for the Blind is accountable for efficient and effective financial management to ensure the viability of its programs. Fiscal affairs are managed in a manner that is consistent with the purposes of the Center and in accordance with sound practices and legal requirements as promulgated by the MDRS Office of Finance and the State of Mississippi Department of Finance and Administration. All financial matters are reviewed by multiple levels of administrative personnel. 6.01 Fiscal Management All the fiscal affairs of the Center are conducted in a prudent manner consistent with sound business practices as well as State and Federal requirements. Efficient and effective recording, reporting, and controlling of expenses, assets, and liabilities are accomplished through written policies and procedures established by the Department and maintained at the MDRS Central Office. 6.02 Funding The Department funds the Center. (Reference: "Budget" file.) Limited revenue is generated by donations from civic groups and individuals. All such donations are deposited in the Lions Sight Foundation Addie McBryde Resource Center account with the Lions of Mississippi. 6.03 Fee Splitting Policy The Department prohibits the splitting of fees with third party sponsors as consideration for referral of the person to be served. 6.04 Donations Policy The Center documents the receipt of all donations and provides a letter of acknowledgement to donors listing the current tax-exempt status of the CRP. Receipt of donations is verified in writing by at least two staff members, and the fair market value of the donation is documented. (Reference: “Donations” Book 2) 6.05 Insurance Through the Department, the Center maintains a comprehensive risk protection program which includes general liability, workers compensation, bonding, automotive liability, and damage to the property of others. This program is reviewed on an annual basis. The Department does not provide malpractice liability or errors and omission coverage. However, the Mississippi Tort Reform Act provides limited coverage to state employees who are acting within the scope of their employment. 6.06 Financial Records Fiscal records covering all aspects of the financial operation of the Center are maintained by the Department. (Reference: “Budget” Book 2.)

ADDIE McBRYDE CENTER MANUAL Financial Planning and Management Section 6

6.07 Release of Financial Information Under no circumstances is financial information released to any parties other than OVRB personnel unless so authorized by the OVRB Director or his/her designee. General financial information is contained in the MDRS Annual Fiscal Report which is distributed to the general public. (Reference: "Outcomes Measurement System” Book 2.) 6.08 Cash Management Policy 1. Working capital needs for the Center are provided for in the operation of the MDRS Central Fund. 2. Cash control procedures for the AMC Petty Cash Fund include adherence to State and Federal guidelines and accepted accounting principles. The AMC Petty Cash Fund is a non-interest-bearing fund. 3. Procedures are in place to account for the holding and expending of money belonging to persons served. Monies being held for persons served do not generate interest. (Reference: "Cash Management Policies” Book 2.) 6.09 Budget The Center prepares and submits an annual budget. Fiscal reports are generated monthly by the MDRS Finance Office. The Center's budget reflects the needs and resources for realizing its goals and includes input from professional and/or administrative staff concerning equipment, modification of physical facilities, and staffing requirements. The budget is approved by the MDRS Executive Director in consultation with the OVRB Director prior to the initiation of the fiscal year. The budget is used as a management tool to assess accomplishment of financial goals. Budget line items are compared with actual performance on a monthly basis. (Reference: “Budget” Book 2.) 6.10 External Audit The Center is audited as a part of the standard procedures under which the Department is audited. Results of any audit are reviewed, responded to, and as needed corrective action is taken in regard to the recommendations. 6.11 Annual Fiscal Report An annual fiscal report of the Center's activities is prepared and communicated to the public as a part of the MDRS reporting procedures.

ADDIE McBRYDE CENTER MANUAL Risk Management Section 7

SECTION 7 (1G) Risk Management 7.00 Risk Management Policy Addie McBryde engages in activities designed to control threats to its customers, property, goodwill, and ability to accomplish goals. Through a documented security plan pro-active measures mitigate risks. 7.01 Security Plan The Center maintains a written security plan which details security provisions and procedures in order to provide maximum protection of the assets of the Center. In addition to the efforts put forth by the Center, back-up protection is provided by the University of Mississippi Medical Center's Department of Campus Police.

7.02 Physical Plant The Center Director and/or his/her designee are responsible for insuring that all doors are locked, and all areas secured.

7.03 Keys The Center exercises reasonable efforts to disseminate and collect keys to the physical plant. Staff members are only given keys to gain access to their respective work areas. Keys to the clients' files and safe/vault room are restricted to the Center Director, the Assistant Center Director and the designated staff member responsible for this area. In dispensing keys to staff members, the CRP maintains documentation with signatory acknowledgement that the staff member has been provided such keys, agrees not to make copies of the keys, and will return the keys upon their termination of employment with the Department or upon their relocation to another physical plant. Vehicle keys are secured in the Front Office area. Spare keys for the vehicles are locked in a secure location. 7.04 Vehicles on-site are disseminated and collected on a daily basis. Center vehicles are parked in a secure area on the premises. Vehicles are locked and secured at night. In no instance may a Center vehicle be parked at a personal residence unless approved in advance by the Center Director. 7.05 Financial Documents & Equipment General ledgers, journals, and other critical accounting information are kept within the Center Director administrative assistant’s office and the administrative assistant in the Front Office. Petty cash and other funds are kept within the Center safe. Only the Center Director, Assistant Director, and administrative assistant(s) have access to the safe. The postage machine is located in the Center workroom area which is accessible by codes only. Each department (AMC, BEP, ILS, OVRB District Counselors) has a separate code that enable them access to the postage machine.

Fuelman Cards Vehicle gas cards (Fuelman) are kept in each vehicle and are accessible by employee driver PIN numbers. Designated staff are assigned employee driver PIN numbers for which they

ADDIE McBRYDE CENTER MANUAL Risk Management Section 7

are responsible. 7.06 Insurance Through the Department, the Center maintains a comprehensive risk protection program which includes general liability, workers compensation, bonding, automotive liability, and damage to the property of others. This program is reviewed on an annual basis. The Department does not provide malpractice liability or errors and omission coverage. However, the Mississippi Tort Reform Act provides limited coverage to state employees who are acting within the scope of their employment.

ADDIE McBRYDE CENTER MANUAL Health & Safety Section 8

SECTION 8 (1H) Health & Safety 8.00 Safety and Health Policy The Addie McBryde Center is committed to the maintenance and monitoring of the safety conditions of its physical plant. The welfare of the clients and staff is a matter of priority. The Center is committed to maintaining optimal safety practices, instructional environments, and equipment operation to ensure the welfare of both clients and staff is protected. The Center maintains an active, ongoing, comprehensive health and safety plan. The Center’s daily procedures ensure a safe, healthy environment. 8.01 Program Restrictions The client's health and any other special considerations are taken into account when deciding appropriate program assignments. Any restrictions are provided in written form to the Center Director and the individual who is responsible for assigning class schedules. Documentation of such restrictions is maintained in the case file. 8.02 External Safety Inspections Types of Inspections Comprehensive, externally conducted inspections of the premises and operations are conducted in the areas of health and safety. Documentation of these inspections, areas covered, and recommendations are obtained. (Reference: "External Inspections" Book 3.)

These inspections where applicable cover the following: 1. Emergency warning devices, means of egress, and emergency plans. 2. Operations involving hazardous materials and processes including safe and effective management of bio-hazardous materials. 3. Walking and working surfaces. 4. Health and sanitation provisions in food preparation, eating areas, rest rooms, etc. 5. Working environment including ventilation, illumination, noise, and air contaminants. 6. Fire protection in accordance with applicable provisions of the National Fire Protection Association Fire Code. 7. Electrical system hazards.

Qualifications of Inspectors Surveys and inspections must be conducted by competent authorities. These include combinations of the following: 1. A licensed or registered safety engineer, where applicable. 2. A representative of a state agency providing an inspection on consultative basis 3. A private safety consultant or on who represents the Departments’ fire or Worker’s Compensation carrier. 4. A local fire control authority such as personnel from the University of Mississippi Medical Center or the City of Jackson. 5. A State or Federal technical assistance consultant in safety and health.

ADDIE McBRYDE CENTER MANUAL Health & Safety Section 8

Frequency of Inspections Comprehensive, externally conducted fire inspections of the Center are accomplished at a minimum of every three years. Comprehensive, externally conducted safety inspections of the Center are accomplished at a minimum of every three years. New or supplemental inspections are conducted upon occupancy of new quarters or the installation of new processes or major items of equipment.

Response to Inspections A written response is developed which documents the results of the review and corrective action taken with respect to reports and recommendations received from such inspections. 8.03 Internal Health & Safety Program The Center maintains an organized, comprehensive health and safety program. (Reference "Safety Policies and Procedures" Book 3.) This program provides for: 1. Designation of person(s) responsible for the health and safety program. This may be the chairperson of the Safety Committee or the entire committee if so designated. 2. Emergency Plans and Procedures a. The Center maintains written emergency plans which are posted in appropriate locations in the Center and communicated to staff and supervisory personnel. The emergency plans include provisions for dealing with bomb threats, fire, medical emergencies, power failures, and natural disasters. Records document that all staff are knowledgeable of fire and emergency plans. The plans include provisions for temporary shelter and handling of evacuees. b. Tests of emergency situations are conducted at least once a month. All emergency provisions of the safety plan are tested at least once per year. These provisions may include but are not limited to fire, tornado, earthquake, gas leak, power failure, bomb threat, medical emergency, chemical spill, terrorist attack, etc. c. Each drill or test of emergency provisions is documented to analyze the conduct and effectiveness of the drill. Such reports are submitted to the Center Director. (Reference: “Drills” and "Safety Policies and Procedures" Book 3.) d. The Safety Committee meets quarterly. The committee reviews all reports of incidents, illnesses, injuries, safety inspections, drills, etc. This committee is responsible for conducting documented self-inspections of the facility at least quarterly. The committee reviews the entire safety plan and program and, as appropriate, makes recommendations in writing to the Center Director. (Reference: "Safety Policies and Procedures" Book 3.) e. All evacuation exits are properly marked in a manner appropriate to the needs of clients and staff. f. The Center maintains a written medical emergency plan that is posted in the first aid room and at other appropriate locations. The purpose of the plan is to outline procedures for the procurement of medical care that is beyond the scope of basic first aid. (Reference: "Safety Policies and Procedures" Book 3.) 8.04 Emergency/Crisis Procedures The comprehensive, detailed Center's Safety/Crisis Plan covers all crisis, disaster and

ADDIE McBRYDE CENTER MANUAL Health & Safety Section 8

emergency situations including procedures for dealing with disruptive or violent behaviors, the presence of unauthorized, threatening persons in the Center, and emergency situations related to weather, fire, bomb threats, accidents involving hazardous materials and the like. The Plan contains procedures for notification of proper authorities, evacuation, accounting for and relocation of staff and clients. All staff receive regular and ongoing training involving the Safety/Crisis Plan and the procedures to follow in the case of crisis or emergencies. (Reference: "Safety Policies and Procedures" and "Staff Development and Training" Book 3.) 8.05 Critical Incident Reporting Procedures The Center maintains written procedures that specify actions for the reporting and investigation of all incidents, injuries, and illnesses regardless of the need for medical treatment. (Reference: "Incident/Accident Reports" Book 3.) This plan provides for the following: 1. Prompt recording of the incident to the appropriate persons within the organization and prompt emergency care. 2. Recording of the essential facts surrounding the incident. 3. Review of the incident reports by the Safety Committee to formulate recommendations for improving the safety program and handling of incidents and injuries. 4. Documentation of corrective action taken, as appropriate, to implement recommendations. 8.06 Health & Safety Training Training is provided by external authorities, videotapes, and internal personnel with the required competencies. (Reference: "Staff Development and Training" Book 3.)

The Center provides training to the appropriate staff, volunteers, interns/trainees and clients by the following safety methods: 1. Safety meetings to resolve safety issues or problems 2. Posted safety rules and practices 3. Training in techniques for fire suppression (annually) 4. Annual training of staff to deal with persons with violent, aggressive, or other unsafe behaviors (threats of homicide, suicide, or cases of abuse, etc.) 5. Training in adult CPR and basic First Aid Techniques to ensure a sufficient number of personnel is able to provide basic first aid and cardiopulmonary resuscitation (CPR) in each work or office area at all times during the routine hours of operation. 6. Training in Defensive Driving (annually) 7. Prevention and control of infectious diseases, including the Blood Borne Pathogens Exposure and Control Plan (annually). 8.07 Smoking Products Policy The use of tobacco products was prohibited on the UMC Campus as of November 1, 2005. Center clients are allowed to smoke only on balconies of the 2 nd (dorm) floor. (Reference: “Rights of Persons Served” Book 5 and Client Handbook.) 8.08 Infection Control Policy The Center maintains an ongoing, organized written program for the education and training of clients, staff, volunteers, and interns/trainees in the prevention and control of infectious diseases

ADDIE McBRYDE CENTER MANUAL Health & Safety Section 8

including, but not limited to the following: Human Immunodeficiency Virus (HIV), Staph infections, Hepatitis, Rubella, Tuberculosis, and Cytomegalovirus (CMV). Training in infectious disease prevention and/or management is conducted at least annually for staff and periodically for clients. Every client receives information and signs the “Universal Precautions” form at intake. (Reference: “Health Policies and Procedures” and “Rights of Persons Served” Book 5.) 8.09 Emergency Medical Information The Center keeps medical information on all current staff and clients which contains the basic information that would be needed in an emergency situation. This medical information is in a notebook, which is easily accessible so that it can be removed in case of building evacuation. 8.10 Medication Monitoring Policy When necessary, the Center is responsible for the monitoring, handling, storage, and disposal of oral and injectable medications. Written procedures are in place for the storage and dispensing of medications. (Reference: "Health Policies and Procedures" file.) The Center Nurse supervises all activities related to the client administering and monitoring of medication. Trained staff may also utilize basic first aid supplies (i.e., burn cream, ointments, eye wash, etc.). 8.11 First Aid Room The Center maintains a suitable first aid room that has adequate medical supplies and equipment to provide basic first aid. 8.12 Ergonomics Policy The Center is committed to providing a safe working environment for clients and staff. A Risk Management Site Survey identifies problem areas which might cause injury and makes suggestions for improvement. The Center utilizes this information to plan improvements to the work environments: physical facility, equipment, furniture, work method, etc. (Reference: "Safety Policies and Procedures" Book 3.) 8.13 Emergency Lighting The Center has an acceptable form of emergency lighting to ensure safe egress from the building in the event of a power failure. Safety authorities have approved the alternate emergency lighting. 8.14 Equipment Safety Equipment used in the instructional areas by clients or staff is calibrated and maintained in accordance with the manufacturer's recommendations. 8.15 Emergency/Fire Alarm System The Center maintains acceptable equipment for fire detection, warning, and suppression. This equipment appropriately meets the needs of the clients and staff. The emergency alarm system is inspected and approved by a fire control authority. The emergency alarm system provides for both auditory and visual alert. The emergency alarm system has an alternate or back-up power source and there is an alternate alarm system that operates in the absence of power.

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8.16 Transportation 1. The department maintains a preventative maintenance and inspection programto ensure the safe operation of vehicles and to promote the long-term life of the vehicle. (Reference: "Safety Policies and Procedures” Book 3) Vehicle bodies and interiors are maintained in a manner that promotes the positive image of the MDRS transportation system. They provide an attractive, comfortable, safe, and efficient means of transportation. Vehicles are serviced and cleaned on a routine basis. Methods used to minimize breakdowns and expensive repairs and to identify when maintenance is needed include: a. Weekly Vehicle Inspection b. Vehicle Service History c. Routine Maintenance Schedule 2. Vehicles and related auxiliary equipment meet all applicable legal requirements and are maintained in a safe and efficient condition. 3. Seat belts are used in all vehicles transporting people. 4. Each vehicle has adequate first aid supplies, and DOT approved triangle reflectors. These items are secured in a manner which prevents them from posing safety hazards to passengers. 5. The Center maintains and updates a list of all authorized drivers. Included on this list is the following information: driver's name, job title, license number, date of birth, and types of vehicles authorized to drive. 6. MDRS verifies proper licensure of drivers upon employment as part of the background check by procuring a motor vehicle report (MVR) of the driver. At least annually, the Center updates information to verify the credentials of all authorized drivers. 7. All drivers for the Center have photo identification or other type of visible identification to identify them as an authorized representative of the Center. 8. The Center provides all drivers with annual, specialized training regarding the safe operation and use of the vehicle driven. This training includes, as applicable, the movement of people and/or materials as well as the safe transportation of persons with disabilities. 9. At least annually, all vehicle operators are provided training in the handling of accidents and road emergencies. All vehicles have supplies and/or equipment to aid in the response to a road emergency. Written procedures for handling road emergencies and/or accidents are placed in accessible locations in the vehicle. 10. In the event that evidence is provided on an authorized driver regarding moving violations or hazardous driving, the Center Director determines if the driver shall continue to operate Center vehicles or if disciplinary action is to be carried out. SPB policies are applied to State employees in these circumstances. In no event is a driver who demonstrates reckless or dangerous performance allowed to drive a Center vehicle. 11. In the event that an accident occurs with a Center vehicle, the Center Director or his/her designee conducts a thorough investigation of the accident. 8.17 Alcohol and Drug Testing Policy AMRC has a drug and alcohol testing policy which is designed to provide early detection and to reduce significantly or eradicate use, possession, and influence of alcohol, prohibited drugs,

ADDIE McBRYDE CENTER MANUAL Health & Safety Section 8

and/or other chemicals within the AMRC environment. In pursuit of such purpose, AMRC declares that the use or possession of drugs and/or alcohol or intoxication and physical influence thereof at the Center or at Center-related or sponsored activities, events, or functions is inherently detrimental to the attainment of a maximized vocational rehabilitation experience and, therefore, will not be tolerated. (Reference: “Rights of Persons Served” Book 5.)

ADDIE McBRYDE CENTER MANUAL Human Resources Section 9

SECTION 9 (1I) Human Resources 9.00 Staffing Pattern and Back-up Plan The staffing pattern at the Addie McBryde Rehabilitation Center is established to meet the fluctuating service demands of clients throughout the year, except for designated holidays/closings. This necessitates flexibility of faculty who often assist in more than one area of the Center. When faculty expects to be unavailable to teach their classes, they must submit a plan for the continuation of services to clients assigned to their instructional units. Such plans can include substitution of other Center staff, use of volunteers or guest speakers, or special activities. The Center Director or appropriate supervisor reviews these plans prior to approval of the Request for Leave. For unexpected absences, the Center Director or the Program Manager temporarily assigns other qualified instructors to provide scheduled training or substitute appropriate activities so that services are not interrupted. 9.01 Staff Qualifications The Department strives to employ the most qualified, competent personnel to provide rehabilitation services essential to the achievement of its stated goals. Standards for the establishment of qualifications for personnel are set from the Department by the Mississippi State Personnel Board (SPB) with comparison to appropriate qualification requirements for similar jobs in state government. All persons in a supervisory capacity are required to hold the qualifications, experience, and skill to provide sound supervision of employees. 9.02 Background/Credentials Verification Policy The credentials and qualifications of persons hired for state service positions are verified by the SPB. The department’s HRD also does an investigative background check on certain other information, such as driving records. Credentials and qualifications of persons employed directly by the Center may be further verified by the Center Director. Verification activities include review of official transcripts, school records, contacts with previous employers and character references or other information as needed. The Center Director or his/her designee conducts a verification of the background/credentials on any volunteer, intern and/or consultant utilized by the Center. 9.03 Nondiscrimination Policy The Department maintains a policy and has procedures in place to ensure nondiscrimination in regard to employment, promotion, pay, or place of work regardless of race, creed, national origin, sex, disability, or age. (Reference: MDRS Policy and Procedures Manual) 9.04 Interns/Trainees All interns/trainees serving at the McBryde Center meet appropriate legal requirements for the work performed as well as have a basic professional understanding of the area in which they serve. Interns/trainees are held to the same professional standards and code of conduct required for full-time employees. The Department has an ongoing, collaborative relationship with various universities and colleges to provide rehabilitation interns/trainee positions (also called "practicum" experiences) to students. Interns/trainees are coordinated through the MDRS Office of Human Resource Development (HRD).

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9.05 Volunteers Any volunteer used by the Center is supervised. Volunteers are held to the same professional standards and code of conduct required for their assignment as any full-time employee. (Reference: "Volunteer/Intern Program" Book 5.) 9.06 Outside Consultants The Department procures the services of outside medical, psychiatric, and other experts in accordance with the fee schedule established by MDRS. These services are obtained from appropriate certified and licensed authorities or those who meet standards as established by the Department. 9.07 Job Descriptions Each staff and volunteer position has a job description that sets forth qualifications, the reporting supervisor, positions supervised, and duties, including essential job functions for the position. Job descriptions are dated, for appropriateness, and provided to the individual involved. (Reference: Center's Personnel Files and "Volunteer/Intern Program" and “Human Resources” Book 4, Book 5.) 9.08 Orientation Policy (Employees/Interns/Trainees/Volunteers) MDRS maintains a written policy of timely orientation of new staff members, staff moving to new positions, consultants, volunteers and interns/trainees. (Reference: OVR/OVRB Policy and Procedures Manual; "Volunteer/Intern Program," "Human Resources" Book 4, Book 5.) Organized documentation is maintained on orientation of staff, volunteers and interns/trainees. Any personal risk, liability, and insurance coverage are communicated to the volunteers and interns/trainees. A Checklist is used to ensure that all important information has been communicated to the individual. (Reference: Blank Forms Book.) 9.09 Personnel Policies for Employees of Addie McBryde MDRS has established personnel policies and procedures. (Reference: SPB Employee Handbook, MDRS Policy and Procedures Manual.) Each employee is given in-depth instruction in personnel policies and procedures and signs a statement verifying these procedures has been explained and are understood. All personnel are provided a copy of personnel policies/procedures. Policies are reviewed annually.

Personnel policies and procedures have been developed and implemented to clarify what the Department expects of personnel and what personnel can expect from the Department. MDRS Personnel Policies/Procedures include but are not limited to the following:

1. Employment procedures a. Authority for hiring and firing b. Administrative requirements c. Job descriptions for each position which are provided to the employee

2. Operating policies a. Probationary period b. Performance appraisal

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c. Conduct and general regulations d. Hours of work, holidays, vacations, leave of absences e. Promotion policy f. Grievance procedures g. Disciplinary actions

3. Wages/Benefits a. Method of payment b. Fringe benefits c. The Mississippi Tort Reform Act provides limited liability coverage to state service personnel acting within the scope of their duties.

The MDRS does not provide general malpractice liability insurance. 9.10 Performance Development System The staff of the Addie McBryde Center receives a performance appraisal at least annually with a semi-annual review and feedback session in accordance with MDRS policies and procedures. The performance appraisal is conducted by the immediate supervisor. The results of performance appraisals are provided in written form and reviewed with the respective employee. Management and supervisory personnel are responsible and accountable for employee scheduling, job performance, and performance appraisal of employees.

The immediate supervisor is responsible for conducting performance appraisals on all subordinates. These results are documented, reviewed with the staff, and included in the individual's personnel file. The performance appraisal is based upon an assessment of job performance in relation to quantity and quality of work. The performance appraisal includes establishing objectives for the next rating period. (Reference: Center's Personnel Book 7.) 9.11 Staff Input Opportunities for Staff to have input on personnel policy is provided through staff meetings, suggestion solicitation, and submittal of proposals to the appropriate administrative authority. State employee personnel policies are subject to the control of the SPB with the Center's personnel policies directly under the authority of the MDRS Executive Director. 9.12 Staff Development and Training The Center Director conducts periodic assessment of the training needs of personnel and maintains a planned, scheduled in-service training program. 1. The CRP, as well as MDRS, maintains a library of relevant professional material. (Reference: "Resource Material: Professional/ Educational" file.) 2. Supplemental, continuing, or advanced education is provided, as appropriate to the needs of MDRS, contingent upon availability of funds. 3. The Department, with its own Program Evaluation Unit as well as other external entities and as opportunities are available, engages in appropriate rehabilitation research. 4. In-service training budgets and time allocations are established at the Department level for all personnel.

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5. The Center engages in an active and ongoing process of staff development related to pertinent issues and concerns and in response to identified needs. (Reference: "Staff Development Training" Book 4.) 9.13 Community Involvement The Center Director and staff show evidence of involvement in local, state, and national professional and/or civic and community organizations. A listing of staff involvement has been developed and is updated annually. (Reference: "Employment and Community Services" Book 7.) 9.14 Staff-Client Fraternization In order for staff to carry out their assigned duties of training and guidance without contributing to feelings of dependence or favoritism, the staff is prohibited from fraternizing with clients on an individual or selective basis. However, staff are encouraged to participate in group activities during or after class hours.

ADDIE McBRYDE CENTER MANUAL Technology Section 10

SECTION 10 (1J) Technology 10.00 MDRS Management Information System (MIS) The Department provides overall technology solutions and support for the Center. This includes hardware, software, assistive technology, security, virus protection, backup and disaster recovery plan and repairs and maintenance. 10.01 Case Management Software AACE (Accessible Automated Case Environment) provides communication, data collection, documentation and performance information via the agency network. Service requests from district counselors within the network are completed on-line. 10.02 Confidentiality of Records The Addie McBryde Center takes all necessary actions to safeguard the use of information technology and confidential information stored and accessed on the Center’s computers and the MDRS agency network. (Reference: “Information Technology and Computers” Book 5.) 10.03 Use of Computers All staff are required to sign a statement regarding appropriate and ethical use of computer equipment and agency information at the time of employment.

ADDIE McBRYDE CENTER MANUAL Rights Section 11

SECTION 11 (1K) Rights 11.00 Assurance of Commitment to Rights of Persons Served The Addie McBryde Rehabilitation Center for the Blind is philosophically, as well as legally, committed to insuring that the rights of all its clients are fully protected. These policies and procedures are communicated to persons served, Center faculty and staff, consultants, interns/trainees, and volunteers through the Center Manual and the Client Handbook. These rights include but are not limited to the following: 1. The right to personal privacy unless the safety and welfare of the person served or others is threatened or there is a violation of state or federal law 2. The right to be treated with dignity and respect at all times 3. The right to be free from psychological and/or physical abuse in any form 4. The right to be given all appropriate information concerning service delivery and consideration for placement in the highest and most appropriate program level 5. The right to have maximum input into the delivery of services whenever possible. 6. The right to be free from financial exploitation 7. The right to have access to information in sufficient time to facilitate decision making 8. The right to access or be referred to legal entities’ self -help, and or advocacy support services 9. The right to have input in composition of the service delivery team 11.01 Violations and/or Complaints The Center uses the complaint/suggestions procedure to allow for client allegations of possible infringements of his/her rights. Whenever there is a suspected case of client abuse, neglect or exploitation, the Center staff follows procedures contained in the MDRS Policy Manual. Any staff member who is found to have violated the rights of any person served will be appropriately disciplined under the provisions and overview of the SPB. Any violation of the rights of those served is promptly reported to the most appropriate level supervisor who is not directly involved in the violation. Failure to report a violation is a serious offense, as this implies collusion with the violation. Upon the report of a violation, a thorough investigation is undertaken within a thirty-day period. Disciplinary action, if determined appropriate, is initiated under the guidelines of the SPB. 11.02 Informed Consent Signed informed consent is obtained from the person served prior to the implementation of any procedures that restrict or limit the rights of the person served (e.g.: removal of phone privileges, short-term suspensions, terminations). (Reference: Blank Forms Book.) Positive behavior modification is tried prior to the use of any restrictive procedures. 11.03 Physical/Psychological Abuse Abuse of any individual served by a staff member is considered a serious offense. Abuse includes any type of physical abuse (including corporal punishment) and/or any psychological abuse (including humiliating, degrading, or exploiting). The party involved is subject to dismissal. In addition, any employee who has knowledge of such abuse and fails to report the abuse is subject

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to disciplinary action. Any client who abuses another is subject to immediate dismissal or other disciplinary action dependent upon the circumstances. 11.04 Sexual Harassment Policy The Department maintains a strict policy regarding the prohibition of sexual harassment in any form. Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when submission to or rejection of this conduct explicitly or implicitly affects an individual's employment, work performance, or creates an intimidating, hostile or offensive work environment. Any report of sexual harassment is promptly investigated, and appropriate disciplinary measures taken. (Reference: SPB State Employee Handbook and MDRS Policy Manual, "Sexual Harassment" Book 5.) 11.05 Release of Persons Served The Center does not release a client, who is underage, legally adjudicated as not competent or whose mental and/or intellectual condition prevents the ability to adequately represent his/her own interests, to any party other than the person's parent, spouse or legal guardian unless such parties provide written authorization to release the client to another designated individual, agency, or institutional representative. 11.06 Grievance/ Complaint Procedures The grievance procedures for clients of the Addie McBryde Rehabilitation Center are adapted from the Hearing Policy in the Mississippi Department of Rehabilitation Services Vocational Rehabilitation/Vocational Rehabilitation for the Blind Policy Manual. This information is in the Client Handbook and is explained to all clients at the beginning of the services.

ADDIE McBRYDE CENTER MANUAL Accessibility Section 12

SECTION 12 (1L) Accessibility 12.00 Location of Facility The Center is geographically located in the central part of the state and in an area in the community that is readily accessible to clients, staff, and visitors. The facility is designed to provide adequate parking, dining areas, and other common services. Areas in the physical plant are designated for counseling, testing, instruction, training, residential and administrative services. 12.01 Accessibility Plan The Center has a written plan for addressing barriers Identified in the following areas: 1. Attitudes - The Addie McBryde Center is committed to the removal of all attitudinal barriers to service access. Center staff, OVRB personnel, and clients are assessed regarding attitudes, including perceptions that may be in conflict with full integration of people with disabilities into the programs and services of the organization. This assessment is conducted informally throughout a client's program of services and accomplished formally via the Staffing Checklist, Exit Interview, staff meetings, and the Center's Annual Survey. 2. Architectural - At a minimum of every three (3) years, an external inspection by a competent authority (i.e., rehabilitation engineer or technology specialist) is conducted based on Americans with Disabilities Act (ADA) standards with a written report of findings. The Assistant Director for Facility Management documents through a written corrective action plan all efforts to address deficit findings. The Center Director provides a written report of actions taken to enhance architectural accessibility resulting from client input and/or general operating activities in the annual outcomes management report. 3. Transportation - The client's need for transportation services to and from the Center to enable participation in programs and services is evaluated. Transportation to the Center at the beginning of a client's program of services and to his/her home at the end of the program is arranged by the OVRB referring counselor if needed. The Center provides resources to allow clients to return home one weekend each month during their stay at the Center, and enable them to participate in necessary programs and activities. Staff communicates with the client and the district counselor to determine transportation needs. 4. Communication - The need for interpreter services and alternate media by clients, staff and other stakeholders is addressed. The Center uses testing and training materials which are readily understandable by the client. The Center has the capability to produce audio tape, Braille, and large print media as needed. If appropriate, the Center, through its referring counselors, accesses needed communication services through the MDRS Office of Assistive Technology, MDRS interpreters for the deaf, other MDRS communication specialists, and as appropriate and necessary, by the purchase of services from private sector providers and/or other governmental agencies. (Reference: "Interagency Agreements/ Collaboration" file.) 5. Environmental - Changing needs of the community, stakeholders, clients and staff

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are considered in planning for budget and utilization of financial resources. 6. Financial - Donations and other additional community resources are used to meet identified barriers of individual clients. 7. Employment - Staff training and client services address the employment barriers of persons with disabilities both locally and nationally. 12.02 Measuring Accessibility Resources for assessing accessibility include, but are not limited to: 1. MDRS Assistive Technology Staff 2. AMRC Client Management Staffings 3. AMRC Client Exit Interviews 4. AMRC Client Follow-up Survey 5. AMRC Annual Survey 6. Director/Clients Meetings

ADDIE McBRYDE CENTER MANUAL Information Measurement and Management Section 13

SECTION 13 (1M) Information Measurement and Management 13.00 Outcomes Measurement System The Center has an Outcomes Measurement System, which meets the following criteria: 1. Measures results of programs and services 2. Includes all programs 3. Includes all persons served 4. Measures regularly the progress of those being served in relation to program goals 5. Evaluates information after completion of services

The Center's Outcomes System includes the following: 1. Each program of services provided by the CRP—Personal Adjustment Training and Vocational Evaluation—has an individual Outcomes component to determine the degree to which persons served meet the goals of their individual program plans and their satisfaction with the service delivery system. (Reference: “Outcomes Measurement System” Book 1.) 2. The Outcomes Measurement System has in written form for both Personal Adjustment Training services and Vocational Evaluation services entrance criteria, a listing of services, measurable objectives, specification of the time each measure is applied, measures of effectiveness and efficiency, and measures of satisfaction of persons served with the program. (Reference: Center Manual and “Outcomes Measurement System" Book 1.)

The System tracks at least the following: 1. Caseload characteristics (diagnoses and incidence of secondary disabilities) 2. Services received 3. Dates of services (entrance and exit) 4. Outcomes of services provided by each program

Outcomes management reports include the following: 1. Measures of effectiveness 2. Measures of efficiency 3. Measures of satisfaction of persons served with the programs 4. Characteristics of the persons served 5. Interpretation of the results through a narrative report 6. Actions taken or planned to improve performance.

Information generated by the Outcomes System is made available to appropriate levels of management. Information is analyzed, interpreted, and used to provide the basis for the development of an annual, comprehensive report that assesses all programs operated by the Center. Such information is used by management to maintain, modify, or improve individual programs. The Outcomes System structure includes the following: 1. A mechanism to identify performances less than acceptable 2. When performance is less than acceptable, reasons are noted and identified 3. Management action taken to improve performance to an acceptable level 4. Follow-up and monitoring of corrective action that takes place at specific times with

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results documented

There is evidence that Outcomes information is utilized at every level of the Center to continually improve services.

Incorporated into the Annual Management Report is a review of the Outcomes System by the Center to analyze the nature of the caseload. This review includes the following: 1. The consideration of the appropriateness of the caseload for the intensity and type of services provided 2. The determination as to whether changes in characteristics of the persons served indicate a need for program modification or expansion.

Following the reporting period, Outcomes information is disseminated in an understandable fashion to the Department administrative staff, the Governing Authority, Center staff, and the Center's public including persons served, contributors, supporters, referring counselors, and others.

The Center portrays itself in a manner, which is accurate and valid. The information is consistent with results shown in the Center's Outcomes System.

An ongoing review of the effectiveness of the Center is undertaken by the Center Director through the Outcomes Measurement System.

The Center provides for a continuous review of the Outcomes Measurement System and its adequacy. (Reference: “Outcomes Management System” Book 1.) This review ensures that: 1. Formal reviews take place on an annual basis 2. Center staff and the persons served have an opportunity to recommend or make modifications 3. A determination of the efficiency of the Outcomes System is documented 13.01 Confidential Records Examples of confidential records include, but are not limited to, client files, performance appraisal information on individual employees, employee reprimands/commendations, personnel and training records, I-9 information, and accounting and budget information. 13.02 Records Protection Policy The Addie McBryde Center takes precautions to protect all confidential administrative and case records by the following steps: 1. Access to confidential records is limited to the Center Director, the Assistant Center Director, the Program Manager designated to monitor the client's progress, and the office administrative assistant assigned to maintain client files. 2. The Addie McBryde Center maintains a policy for persons being served to access his/her record. Anyone desiring part or all of his or her record needs to inform the Center Program Manager of this. The Program Manager will review the record, and, in the normal course of events, will inform the Center Director of this fact and release the records. Under federal law, certain rare circumstances may trigger a medical

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professional or legal review. If this is the case, the person being served or their representative will be informed of this, and the review will take place as quickly as possible. 3. A generally accepted filing system for such records is maintained at all times. 4. A check in/check out system for all files and records is maintained when files are removed from the area where files are kept. A staff person in the area where such records are kept is designated as responsible for control and accounting for such records. 5. During the workday, all records are kept in the Center Admin office in metal files or storage cabinets with reasonable protection against fire, water damage, and other hazards taken. 6. MDRS network back up on the server and hard copies are retained for all electronic records to ensure protection of such records against loss. 13.03 Records Retention/Disposal Policy All confidential administrative and case records are kept for a minimum of three years with the exception of certain accounting records which are retained indefinitely. (Reference: OVR/OVRB Policy and Procedures Manual.) 13.04 Personnel File Contents Each Center employee has a permanent personnel file to retain the employment application, job description (may include a Job Content Questionnaire), verification of credentials, performance appraisals, payroll deductions, salary, and position changes, etc. The official records for State Service Personnel are maintained at the MDRS central office. A supplemental personnel file is maintained at the Center and includes copies of annual performance appraisals and feedback, attendance/leave information, flex time forms and job description. 13.05 Retention of Referral Information If a client does not report on the scheduled admission date, the referring counselor is notified in writing immediately. If the client is not rescheduled for entry, the Center retains the referral information in a "No Show" file. 13.06 Disclosure of Confidential Client Information See the OVR/OVRB Policy and Procedures Manual. 13.07 Single Case Record Each client has a hard copy individual case file. During their stay at the Center, the Center Nurse maintains a separate medical file. Upon completion of the program of services, the medical file is combined with the case file. Records are clear, complete and current. Reports are objective and distinguish fact from opinion. Records confirm in writing that all recommended and planned services have been carried out or there is documentation as to reason not completed. 13.08 Organization of Material in Case Record The client record is divided into four sections. After the initial referral information, all subsequent information is filed in inverse chronological order based on date of receipt. Section One contains the original referral documents, including: initial referral material

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and the client data sheet. Section Two contains general information originated at intake and while the client is in the Center, including the following forms: Initial Intake, Orientation Checklist, Fire Exit, Picture Release, Permission to Leave the Center (if applicable), IAP and/or IVEP, Counselor Correspondence, Cane/Noir, Informed Consent, Alcohol and Drug Testing, Service Notes, and all correspondence concerning the client including any received from the district counselor. Section Three covers information obtained at exit as well as certain supplemental services provided by the Center. This information includes Exit Interview, and, if applicable, Psychiatric Case Notes, Medical Consent Form and medical records. Section Four contains all Center generated reports and includes: Psychological Reports, Vocational Evaluation Report, Instructors' Reports, and Staffing Checklist.

When a client has exited from the Center, Sections One and Two are placed together on the left side of the file with a colored section divider between the two sections. Sections Three and Four are placed together on the right side of the file with a colored section divider between each section. 13.09 Case Record Requirements A case file should include the following: 1. Case identification data 2. Name and address of client's guardian, if appropriate 3. Pertinent history, diagnosis of disability, limitations, special needs (e.g., communication), and desired outcomes/expectations 4. Prescribed medications, the name of the prescribing physician and other relevant medical information 5. Reports of initial and ongoing assessments 6. Reports from referring sources 7. Reports from outside consultants 8. Designation of program manager 9. Evidence of the direct involvement of the person served in the decision making process related to his/her program. 10. Reports of staff conferences and, if held, family conferences 11. Client's individual PAT objectives for each instructional area 12. Progress reports from each service area (signed and dated) 13. Pertinent correspondence 14. Release forms 15. Exit interview 16. Follow-up reports

In addition to the above, for clients who receive Vocational Evaluation services, case records will include the following: 1. Potential employment goals 2. IVEP (Individualized Vocational Evaluation Plan) 3. Documentation of evaluation results that pertain to work tolerance (physical/mental tolerance, persistence in work/physical activity).

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32 Miss. Admin. Code Pt. 3, R. 13.10 Rule 13.10

Case Recording All files are kept current. Information is recorded within 48 hours of the event and exit reports within ten working days following termination/completion of program. Individual instructional areas may maintain work sheets pertinent to that area to record information. However this does not replace the main case record. These work sheets are secured to protect the confidentiality of the information. 13.11 Signature Policy Entries in the Service Notes are signed with the person's first initial and last name. All formal reports and official outgoing correspondence include full signature. 13.12 Case Review (Quality Assurance) The Center provides a bi-annual internal quality assurance and record keeping review of client files. The Center Director performs the quality assurance analysis and provides a written report. A representative sampling is reviewed. This sampling is taken from cases that were active and/or closed during the period being reviewed. Results of findings are shared with members of the psychosocial committee. The Center Director is responsible for the case reviews and provides reports of the findings with recommendations for improvement. Upon approval any corrective action(s) will be initiated as indicated by the report. The review of case quality assesses the following: 1. Each service began at the appropriate time 2. Appropriate services were provided for an adequate duration 3. Appropriate goals were stated for each service 4. Services produced the desired results in terms of program goals and the needs and preferences of the individual 5. The person served participated in program planning 6. All required and appropriate documents are contained in the file

ADDIE McBRYDE CENTER MANUAL Performance Improvements Section 14

SECTION 14 (1N) Performance Improvements

Various management records and reports generated by the Center are used to guide the operation, support the assessment and improvement in quality of services, measure and communicate performance, and reflect the current status of the Center.

The Center Director presents and interprets operating reports, including those reflecting the efficiency and effectiveness of the Center. These reports include, but are not limited to, the following: 1. Annual Outcomes Management Report 2. Outcome Measurement System Results 3. Financial Statements 4. Strategic Management Plan Reports 5. Personnel Reports 6. Program Quality Assessment 7. Monthly Reports

These results are supplied to the McBryde Governing Authority and to the OVRB Director who presents them to the MDRS Executive Director. These presentations provide an opportunity for policy and operational review, analysis, and action.

The Center Director analyzes management reports and compares performance against budgetary, administrative, and professional standards. In addition, the Center Director analyzes the extent to which the Center's goals and objectives are being attained. The results of these activities are used by the Center Director to initiate appropriate preventive, pro-active, or corrective measures.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

SECTION 15 (1O) Client Services 15.00 GENERAL SERVICE INFORMATION The information in the following section contains procedures that are common to each of the primary service areas of the Center – Personal Adjustment Training, Vocational Evaluation, and Low Vision. A. Referrals Service requests are submitted to the Center via AACE (the Automated Accessible Case Environment) electronic local area network of MDRS. Some outside third-party sources continue to utilize the AMRC-01 paper form. The Center Director sets the entry date. The VRB/IL counselor or third-party sponsor provides copies of the following information when making a service request from the Center: 1. Medical information including an eye report, general medical, psychiatric, and/or psychological reports pertinent to the individual client. In some cases the Center may require more recent and/or detailed information than the counselor has required to establish eligibility. This information may be needed to determine a client’s ability to benefit and participate in a residential program and ensures that the client and others are not jeopardized by being placed in an inappropriate assessment or class assignment. 2. School records, including IEP for all Transition Students, if available. 3. Previous vocational evaluation and/or work adjustment reports if available. B. Re-referrals If a counselor refers a former client to the Center for additional services, the counselor submits a NEW service request stating the services the client currently needs and explaining why the counselor feels the client should return, including any changes which might affect the plan for services.

The counselor's request is staffed, and the previous case file will be the case of record for the Center's filing purposes.

Prior to setting entry date, all referral information is reviewed to see if it is adequate to determine appropriate services for the client. The Center Director, the Center Nurse, Medical and Psychiatric consultants and others, as necessary, may all be involved in the decision when questions arise. The responsibility for determining appropriateness of referrals lies with the Center Director. Records of the pre-entry procedures are maintained in the client's file and include the following: 1. Date of service request and review of materials 2. Entry date of client if accepted or, if not accepted, the reason 3. Designation of a Center Program Manager

The counselor is notified of the scheduled entrance date, services planned and the client's Center Program Manager by way of the "Counselor Correspondence Form." (Reference: Blank Forms Book.) If, considering the client's disabilities the Center needs more

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

information than provided, a meeting with the client prior to a decision on entrance may be suggested. C. Order of Acceptance Policy For MDRS clients the acceptance policy of the Addie McBryde Rehabilitation Center for the Blind is first referred, first accepted. This policy also applies in times when a waiting list is in use. Administrative staff of the Center reserves the right to exercise judgment regarding acceptance based on special circumstances and client's need. In the event of a backlog, clients will be scheduled in the order received. D. Reentry Policy Terminated clients seeking re-entry to the Center are considered as a standard referral. E. Reorientation Policy It is the policy of the Addie McBryde Center that any client participating in our program for more than twelve (12) months will be reoriented and his/her rights will be discussed. F. Ineligible Individuals If a person is determined ineligible for services at the time of referral or any other point during his/her stay at the Center, the client and/or the referring counselor is informed of the reason. If possible, appropriate recommendation for referral is made to other community services. Records are kept on these individuals indicating the following: 1. Reason for ineligibility 2. Action taken 3. Contact person 4. Outcome of recommendation

At least annually, an analysis of trends in ineligible cases is conducted with resulting information incorporated into the Center's planning activities. (Reference: "Ineligible Individuals" file.) G. Orientation Policy for Clients All information provided to the client is communicated in terms he/she can understand, using modes of communication that are appropriate to the individual client. On the first day at the Center, clients are given an orientation to the Center services, and what to expect during his/her stay. The Client Handbook is explained in detail to the client by the Program Manager who also ensures that the client has a personal copy of this handbook. (This handbook is available in regular print, large print, Braille and audio-cassette). The client is also given a tour of the Center to familiarize him/her with the staff and the physical layout of the facility. Clients are not placed in class assignments until the orientation has been completed. An audiocassette containing the Client Handbook and a brief orientation to the Center is available from the Dormitory Supervisor on duty or the Techniques of Daily Living instructor. It is made available to day students, as needed, to review the layout of classrooms and other student areas within the Center. H. Client Handbook The Center distributes—in appropriate alternate format—and explains the Client

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Handbook to all clients. Information in the Client Handbook includes: 1. The responsibilities of the Center and the client 2. Rules and regulations 3. Nondiscrimination provisions 4. Grievance and appeal provisions 5. Human Rights provisions 6. Services provided at the Center 7. Policies regarding re-entry into the program I. Intake Interview The client participates in an intake interview conducted by the Program Manager. The intake interview includes a discussion of: 1. The mission, programs, and services of the Center 2. The process for the development of program goals and the active participation of the persons served in goal setting and individual planning 3. A list of the rights and responsibilities of the persons served, corresponding grievance and appeal procedures, and any restrictive procedures that may be used 4. The identification of the individual responsible for coordinating services and a description of the role of this individual (the Center Program Manager). 5. Clients of MDRS are informed that they have no financial obligation for services provided by the CRP.

The client signs the statement of understanding at the end of the Client Initial Intake Form. (Reference: Blank Forms Book.) The referring counselor is notified that the client has entered as scheduled.

Whenever possible the client's family or client representative is invited to participate in the orientation/rehabilitation process. The referring counselor ascertains if the client wishes this participation. J. Individual Program Planning Policy After entry into the Center, staff reviews all the referral and intake information and makes recommendations regarding the individual's program needs. The client and his/her Program Manager work together to develop an individual program focusing on the client's expectations and desired outcomes.

When appropriate, the client's family or significant others are involved. The focus of the program is on integrating the individual into the community through increased independence and skills. Both the Program Manager and client sign the program. Personal Adjustment Training Instructors and others who have responsibility for implementing parts of the program sign off indicating awareness of their responsibilities. The individualized program is reviewed at least monthly and modified as needed.

The person served is actively involved in the individual planning process and has a major role in determining the direction of his/her individual plan.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

All services provided are related to the individual's goals. Each plan is based on the client's specific and unique needs. This plan contains the following: 1. Individual client preferences and choices 2. Services to be provided 3. Specific service goals and objectives 4. Time intervals at which service outcomes will be reviewed 5. Anticipated time frames for the accomplishment of the individual's goals 6. Measures and procedures to assess outcomes (Individual Functional Assessment) 7. Person responsible for implementation of the plan (Center Program Manager) 8. Special needs (e.g., assistive technology, sign/foreign language interpreter, Alcoholics Anonymous participation, Mental Health counseling, etc.) K. Program Manager Each client is assigned to a single Program Manager who is a member of the Psychosocial Team. The Program Manager is responsible for the client during the implementation of his/her plan. The Program Manager ensures the individual is adequately oriented to, and actively participates in, discussions of plans, goals, and status of his/her program on an on-going basis. Program Managers ensure that the client's program proceeds in an effective manner toward the goals and that all planned services are provided. The Program Manager promotes the program's responsiveness to the strengths, abilities, needs and preferences of the client and attends conferences about the client to ensure proper decisions are made regarding program continuation, termination, follow-up, etc. The Program Manager serves as the primary liaison with referring counselors, family members and significant others. L. Assistive Technology In order to maximize the client's performance, adaptive measures are used whenever possible with individuals having sensory, physical, communication, or other functional limitations which might otherwise present barriers. The client's assistive technology/reasonable accommodation needs are considered from the time the referral information is received throughout the client's entire program (Vocational Evaluation and/or Personal Adjustment Training). Equipment modifications and other techniques are used to provide reasonable accommodations to assist in maximizing the productive capacity of the client. The Center's assistive technology resources through the Low Vision Evaluation and the MDRS Office of Assistive Technology are utilized to address these areas as appropriate to the needs of the client and Center. (Reference: Section 8.03 of the Center Manual.) M. Behavior Management Policy and Procedures It is the policy of the Center to use positive interventions prior to the use of restrictive procedures. In the event that unacceptable behavior (including but not limited to engaging in sexual intercourse and/or sexual penetration as defined in Miss. Code Ann. § 97-3-97(a)) is displayed by a client, an analysis, either formal or informal, is completed by Center staff to determine if any environmental factors may have caused or reinforced such behavior. If environmental factors are determined to be involved, the staff implements appropriate positive measures to modify or restructure the environmental influences in order to reduce or eliminate the behavior. 1. In the event the unacceptable behavior continues after efforts are made to restructure

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

or change the environment, the next step is to implement positive counseling and/or other positive behavioral modification techniques including positive reinforcement to alter, reduce, or eliminate the undesirable behavior. These behavioral techniques and efforts become a component of the individual program plan. 2. Only after extensive counseling and/or behavioral management techniques fail to produce a change of the behavior, will the staff employ appropriate restrictive procedures. 3. Allowable restrictive procedures may include time-out (not to exceed a 30-minute period) and suspension (not to exceed 3 days). The area chosen for timeout (usually a client's dorm room) is well lit, ventilated, and does not present an environment of total seclusion from visual or auditory feedback. During time-out procedures, a staff member checks on or monitors the status of the person served every fifteen (15) minutes. If at any point the client is deemed to need counseling, time-out is terminated and counseling is provided. If time-out procedures do not effectively alter, reduce or eliminate undesirable behavior then suspension from the program is implemented. 4. In all cases where restrictive procedures are under consideration, the staff only implements such actions after clearly explaining the procedures to the client and/or, as applicable, his/her representative. The person served is requested to sign an Informed Consent Form to acknowledge that he/she understands the restrictive procedures that are being put in place. This Form is then attached to the individualized program plan. 5. Failure to change the behavior is reason for termination from the program. The termination occurs only after extensive and graduated steps of environmental change or counseling procedures are found to be ineffective in stopping the behavior. N. Referrals for Additional Services Outside services are obtained that meet the individual needs of the client. These are coordinated with the Center's program of services. (Reference: "Clients Referred for Concurrent Ancillary Services" file.) Records of persons referred are kept and contain at least the following information: 1. Place referred 2. Date 3. Reason for referral 4. Contact person O. Termination Procedures Termination planning begins early in the program and involves the person served, all professional staff, and resource personnel contributing to the person's program. All parties involved receive ample notice concerning the termination decision. The client is provided an exit conference and completes an Exit Interview Form. (Reference: Blank Forms Book.) This form includes the following information: 1. Reason for termination 2. Any recommended referral action 3. Date of termination 4. Satisfaction with services provided while at the Center

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

P. Follow-Up A follow-up is done on all clients to determine to what degree the person's program was successful, whether the services provided were optimal, and if further services are required. Documentation of measurable satisfaction of the person served is obtained through the follow-up process. This information is incorporated into the Outcomes Measurement System. Contact is made regarding every client within ninety working days after his/her closure date. This contact may be by telephone, letter, or in person. The client is contacted directly by the Center or the referring counselor or an OVRB Itinerant Teacher may assist in obtaining the follow-up information. The follow-up information is maintained in the Assistant Center Director’s office. 15.01 Personal Adjustment Training (PAT) Services Personal Adjustment Training is an array of services provided directly at the Addie McBryde Center and through linkage with other resources in the community which takes into consideration the needs of the individual served and that person’s family, the informed choices of the individual, and the unique socioeconomic and cultural needs of those served. PAT services result in increased inclusion in community activities, increased or maintained ability to perform activities of daily living, and increased self-direction, self-determination, self-reliance, and self- esteem. A. PAT Admission Criteria The requirements for entrance to personal adjustment training services are as follows: 1. Has VR/VRB or other 3rd party sponsorship 2. Is at least 16 years of age 3. Has prior medical and/or psychological evaluation appropriate to disabling condition(s) 4. Is not dangerous to self and/or others 5. Is free of any acute medical and or psychological conditions 6. Is able to care for his/her own personal needs 7. Has specifically identified functional limitations to independence and/or employment that requires PAT services B. PAT Services PAT makes provision for but is not limited to the following: 1. Instruction in Techniques of Daily Living 2. Instruction in Personal Management (planning, shopping, preparing meals) 3. Communication Activities including skills such as time, telephone and money management 4. Functional literacy skills, including Braille 5. Education and Training Activities 6. Access to governmental and community services (including SSI/SSDI and other benefits) 7. Development of work attitudes and vocational pursuits 8. Adjustment to blindness, including building self-esteem. 9. Orientation, Mobility, and transportation skills 10. Assistive technology, including computer training 11. Keyboarding skills

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

12. Leisure or Recreation 13. Health and wellness promotion 14. Specialized communication services for individuals with dual sensory impairments

It is not required that every person served receives all the services available. Each individual receives those services that will help meet his/her goals. The time spent in adjustment services is based on the time necessary to accomplish the individual's goals. The progress of each client is monitored by the Program Manager to ensure timely progress. C. PAT Techniques The provision of PAT services is based on the individual client's needs and choices. They are documented in such a way that uniform application is ensured. This includes a curriculum guide and specific instructional methods. (Reference: PAT Curricula Book.) Examples of adjustment techniques include, but are not limited to, the following: 1. Classroom Instructional Activities 2. One-on-one contacts with program manager and other staff 3. Individual/Group activities, including community outings 4. Guest Speakers D. Individualized Personal Adjustment Training Plan (IAP) Each client participates in the development of his/her individual adjustment plan. The plan is based on consideration of the individual’s goals, strengths, capabilities, and preferences and is relevant to maximum participation in environments of their choice. The IAP includes the following: 1. Objectives (stated in observable, measurable terms) which are considered necessary to attain the person's vocational objectives 2. Statements of expected outcomes 3. Time intervals for achieving outcomes 4. Assignments or specific instructional techniques and methods consistent with the adjustment goals 5. Identification of specialized needs and/or services 6. Specific persons to be involved in the plan and evidence that these individuals are aware of their role in the plan (their signature or initials suffice for documentation) 7. Reviews to be conducted at least monthly with modifications made as necessary E. PAT Progress Staffings and Reports Staffings are held at least monthly. Attendance at this staffing includes the person served, those instructors involved in the person's program of services, the person's Program Manager and the Vocational Evaluator, if appropriate. These staffings address the client's progress toward his/her program objectives, point out any amendments necessary, and justify recommendations regarding continuation of his/her program. A separate memo is not required to document staffings, but staffing information is included in the progress report to the referring counselor. (Reference: Blank Forms Book.) This report is to be completed and disseminated to the appropriate parties within 10 working days following a staffing.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

F. PAT Final Staffing A staffing is held prior to the completion of PAT services. This staffing addresses the results of PAT services and provides recommendations for the future (i.e., information about other agencies or services and specific information about equipment that may be beneficial for the individual). If the referring counselor is not present, a copy of the original Counselor Correspondence Form is sent to the referring counselor notifying date of termination. G. PAT Exit Criteria A client may exit PAT services for any one of the following reasons: 1. Completion of all the goals on the IAP 2. Entrance into employment 3. Entrance into training (College or Skills training) 4. Client exits the program of his/her own accord prior to completion of the IAP 5. Client fails to carry out his/her assigned responsibilities in the IAP 6. Client develops an acute medical and/or psychological condition 7. Client develops behaviors that pose a danger to self or others 15.02 Comprehensive Vocational Evaluation Services Vocational Evaluation is a comprehensive process that systematically utilizes formal testing instruments for assessment and vocational exploration. The purpose is to assist the person with vocational development leading to employment options. Vocational Evaluation incorporates medical, psychological, social, vocational, cultural, assistive technology, and economic data into the process of evaluation. A. Vocational Evaluation Admission Criteria The requirements for Vocational Evaluation are as follows: 1. Client has VR/VRB or 3rd party sponsorship 2. Is at least 16 years of age 3. Has prior medical evaluation appropriate to disabling condition(s) 4. Is free of any acute medical and/or psychological conditions 5. Is not dangerous to self and/or others 6. Is able to care for personal needs 7. Vocational potential is uncertain 8. Adjustment service needs have not been determined B. Vocational Evaluation Services Services are comprehensive and assess information about the following: 1. Physical and psychomotor capacities and limitations 2. Cognitive functioning 3. Social, personal, and work-related behaviors 4. Interests, attitudes, career aspirations, and knowledge of occupational information 5. Personal, social, and work histories 6. Aptitudes 7. Achievements (e.g., educational and vocational) 8. Job seeking and retention skills 9. Identification of work and non-work related needs

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

10. Possible employment objectives 11. Ability to learn about self as a result of the information obtained from evaluation 12. Learning style (including ability to understand, recall, and respond to various types of instruction) 13. Transferable skills 14. Environmental conditions 15. Assistive technology and reasonable accommodations 16. Community and employment supports 17. Independent living skills 18. Mode of communication

The program has the capacity to assess all of the above but does not assess every person's functioning in each of these areas. The needs of the person served dictate the areas in which assessment is done. C. Vocational Evaluation Techniques A variety of tasks are utilized to ensure the evaluation needs of the client are met. Vocational evaluation services draw on one or more of the following techniques based on the specific abilities and needs of the persons served: 1. Psychometrics 2. Work samples 3. Situational assessment (if needed)

The area set aside for Vocational Evaluation is designed with sufficient space for these activities. The use of specific instruments is based on the individual client's needs, interests, and capacities. All diagnostic and technical data are supplemented with personal interviews and behavioral observations. Time frames for the evaluation of a client are determined by the individual needs of the client. D. Individualized Vocational Evaluation Plan (IVEP) Each client shall participate in the development of his/her Individualized Evaluation Plan (IVEP). For clients who are also receiving Personal Adjustment Training services, the IVEP is considered an addendum to the Individualized Adjustment Plan (IAP). Any assessment plan is based on the referral information, intake interview, questions asked by the referral source, stated purpose of the evaluation, and the individual's interests and capabilities. The plan: 1. Identifies specific questions to be answered in evaluation 2. Specifies what accommodations are utilized including assistive technology 3. Specifies the individuals to be involved in carrying out the plan with evidence of their participation (signatures will suffice for this) 4. Is modified if necessary E. Vocational Evaluator Participation in Monthly Client Staffing For clients in PAT, the vocational evaluator attends the initial or evaluation staffing to provide recommendations and information to instructors. The evaluator also meets with instructors separately on an as need basis to assist in planning for individualized approaches which take into consideration learning styles and special needs of the client.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

F. Vocational Evaluation Summary A meeting is held with the client prior to the completion of evaluation. The meeting is attended by the Vocational Evaluator and person served if the individual has received only Vocational Evaluation. This meeting addresses the preliminary results of the evaluation and any recommendations for further services. G. Vocational Evaluation Report The Evaluation Report is completed, disseminated and properly interpreted to the client/district counselor in a reasonable amount of time (20 working days) following the completion of the evaluation. A cover letter is sent to the referring counselor stating the date the meeting was held, persons present, barriers to employment, recommendations (including vocational goal, if appropriate), and starting dates of any new services. The evaluator has 20 working days from the client's exit date in which to complete and disseminate the report.

Any possible vocational goals are expressed in terms of D.O.T. job titles / families when vocational goals are not found, non-vocational goals are specified and related to resources available in the community. H. Vocational Evaluation Exit Criteria A client exits the evaluation services unit for any of the following reasons: 1. All the questions contained in the IVEP are completely addressed or answered 2. Vocational potential and direction is determined 3. Lack of vocational potential is determined 4. Client exits program of his/her own accord prior to termination and/or completion of the IVEP 5. Client fails to carry out his/her assigned responsibilities in the IVEP 6. Client develops an acute medical and/or psychological condition 7. Client develops behaviors that pose a danger to self or others 15.03 Low Vision Services The Low Vision Program at the Addie McBryde Center was developed to allow persons with significant visual loss to be evaluated to determine if aids, appliances, devices, or equipment exists that will enhance their ability to confidently and independently pursue their careers and private lives.

Technology is available in many forms, ranging from various types of magnifiers, lamps, to high-tech items and closed-circuit television reading systems and specially modified computer systems. When it is determined that a client will need computer equipment, the program manager contacts the district counselor for referral to MDRS Office of Assistive Technology. A. Low Vision Admission Criteria To receive Low-Vision services, a client must: 1. Have VR/VRB or 3rd party sponsorship 2. Be at least 16 years of age 3. Have specific request for low vision services by the referral source

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

B. Low Vision Services and Techniques Evaluation/Assessment: This service includes an assessment of the person's ability to use and benefit from equipment by hands-on demonstrations and try-outs of a broad array of devices such as magnifiers, and closed-circuit television devices.

Limited training is provided in the use of assistive devices. If it is determined that a client could benefit from in-depth training in the use of a computer, such recommendation will be made to the referring counselor, who, at his/her discretion, will make arrangements for an assistive technology evaluation through the MDRS Office of Assistive Technology. Center staff also provides demonstrations to various MDRS personnel and other service providers as requested. C. Low Vision Reports Reports generated by the Low Vision specialist to referring counselors include equipment recommendations, justification, prices, vendors, etc. Reports are completed within 10 working days after completion of an evaluation. When appropriate, recommendations of low vision evaluations are incorporated into the individualized programs of services for Center clients. D. Low Vision Exit Criteria A client may exit from the Low Vision services unit for any of the following reasons: 1. All the questions contained in the original referral and request for evaluation are addressed or answered 2. Equipment or device needs are determined 3. Client exits program of his/her own accord prior to completion of the evaluation; client refuses to participate or is unable to keep scheduled evaluation appointment 15.04 Additional “Special” Services The Center offers the following additional “special” services on an adjusted per diem when space and schedule permits to clients of the MDRS Independent Living Program for the Older Blind and third-party payers: 1. On-site orientation and mobility at the individual’s workplace. 2. Computer training in specific skill areas such as E-mail, Internet use, etc.

ADDIE McBRYDE CENTER MANUAL CARF Documentation Appendix A

APPENDIX A Accessibility Reports Action Taken From Stakeholders Input Annual Survey Budget Cash Management Policies Client Group Meeting/Training/Activities Client/Director Meetings Clients Referred for Concurrent Ancillary Services Code of Ethics / Our Mission Statement Community Involvement (Clients) Consultants / Referral Resources Daily Maintenance on Building Dietary Procedures Donations / Contributions Lions Club/Other Dorm Supervisors Drills Employee Handbook and Standards of Conduct External Inspection Facility Advisory Committee Fee for Service Schedule Governing Authority Guidelines on Legal Issues Health Policies and Procedures Human Resources Incident / Accident Reports Ineligible Individuals Interagency Agreement / Collaboration Letters of Acknowledgement to Referral Sources Letters of Appreciation Clients and Staff MDRS—Board Members Monthly Reports Outcomes Measurement System Psychosocial Meeting Minutes and Staffing Schedule Public Information and Outreach Public Meetings for State Plans Quality Assurance Resource Material: Professional / Education Rights of Persons Served Safety Policies and Procedures Staff Development/Training Staff Meeting Minutes Staff Outreach Strategic Management Plans

ADDIE McBRYDE CENTER MANUAL CARF Documentation Appendix A

Technology and Computers Volunteer / Intern Program

Supplemental Documentation / Resources Addie McBryde Center Manual Addie McBryde Center Personnel Files Executive Memoranda File MDRS / HRD Policies Notebook OVR / OVRB Policy and Procedures Manual State Personnel Board (SPB) Employee Handbook

ADDIE McBRYDE CENTER MANUAL Code of Ethics Appendix B

APPENDIX B Code of Ethics

1. MORAL AND ETHICAL STANDARDS

The employees of Addie McBryde Rehabilitation Center and the members of the Addie McBryde Rehabilitation Center governance authority shall behave in a moral and ethical manner in the conduct of their specific roles.

2. BUSINESS / FINANCIAL STANDARDS

The Addie McBryde Center shall conduct its business/financial practices in an ethical manner, in keeping with generally accepted business/financial principles.

3. MARKETING STANDARDS

The Addie McBryde Center shall conduct its marketing activities in a moral and ethical manner. Public information and outreach activities shall be honest, accurate, and positive in the depiction of individuals with disabilities.

4. TREATMENT OF THE PERSONS SERVED AND OTHER COMMUNITY MEMBERS

The employees of Addie McBryde Center shall respect the dignity and worth of all individuals with whom they work. The primary ethical obligation of Addie McBryde Center employees is to their consumers; or those persons who are directly receiving their services. Addie McBryde employees will endeavor at all times to protect each consumer’s welfare and to place this interest above their own.

5. PROFESSIONAL RELATIONSHIPS

Interpersonal cooperative relationships shall be seen as vital in achieving optimum benefits for consumers. Professionals shall respect the value and roles of professionals and staff in other disciplines and act with integrity in their relationships with professional colleagues, organizations, agencies, referral sources and related disciplines.

6. CONFIDENTIALITY

The employees of Addie McBryde Center shall respect the confidentiality of information obtained from consumers in the course of their work.

7. WITNESSING OF DOCUMENTS

The employees of Addie McBryde Center are prohibited from serving as a witness on legal documents for clients. This should be completed by family or the client’s representative.

ADDIE McBRYDE CENTER MANUAL Code of Ethics Appendix B

8. NO REPRISAL FOR WHISTLEBLOWING

There will be no adverse consequences to employees for reporting alleged violations to the code of ethics.

INDEX Accessibility, 28 Additional “Special” Services, 54 Administrative Agency, 3 Alcohol and Drug Testing Policy, 19 AMRC Mission Statement, 1 Annual Fiscal Report, 12 APPENDIX A, 47 APPENDIX B, 49 Assistive Technology, 39 Assurances/Principles, 1 Background/Credentials Verification Policy, 21 Behavior Management Policy and Procedures, 39 Budget, 12 Case Record Requirements, 33 Case Recording, 34 Case Review (Quality Assurance), 34 Cash Management Policy, 12 Client Handbook, 37 Code of Ethics, 49 Code of Ethics and Ethical Violations, 1 Community Involvement, 24 Comprehensive Vocational Evaluation Services, 43 Confidential Records, 31 Consumer Based Planning, 7 Critical Incident Reporting Procedures, 17 Disclosure of Confidential Client Information, 32 Donations Policy, 11 Emergency Lighting, 18 Emergency Medical Information, 18 Emergency/Crisis Procedures, 16 Emergency/Fire Alarm System, 18 Equipment Safety, 18 Ergonomics Policy, 18 External Audit, 12 External Safety Inspections, 15 Facility Advisory Committee, 8 Fee Splitting Policy, 11 Financial Planning and Management, 11 Financial Records, 11 First Aid Room, 18 Fiscal Management, 11 Follow-Up, 41 Funding, 11

General Service Information, 36 Governing Authority, 3 Health & Safety Training, 17 Individual Program Planning Policy, 38 Individualized Personal Adjustment Training Plan (IAP), 42 Individualized Vocational Evaluation Plan (IVEP), 44 Ineligible Individuals, 38 Infection Control Policy, 17 Input from Persons Served, 7 Insurance, 11, 14 Intake Interview, 38 Internal Health & Safety Program, 16 Interns/Trainees, 21 Job Descriptions, 22 Leadership, 1 Legal Requirements and Legal Issues, 10 Low Vision Admission Criteria, 45 Low Vision Exit Criteria, 46 Low Vision Reports, 46 Low Vision Services, 45 Low Vision Services and Techniques, 46 Management Information System, 25 MDRS Mission Statement, 1 Medication Monitoring Policy, 18 Nondiscrimination Policy, 21 Order of Acceptance Policy, 37 Organization of Material in Case Record, 32 Organizational Chart, 4 Organizational Structure, 3 Orientation Policy (Employees/Interns/Trainees/Volunteers), 22 Orientation Policy for Clients, 37 Outcomes Measurement System, 41 Outside Consultants, 22 PAT Admission Criteria, 41 PAT Exit Criteria, 43 PAT Final Staffing, 43 PAT Progress Staffings and Reports, 42 PAT Services, 41 PAT Techniques, 42 Performance Development System, 23 Personal Adjustment Training (PAT) Services, 41 Personnel File Contents, 32 Personnel Policies for Employees of Addie McBryde Center, 22 Physical/Psychological Abuse, 26 Program Manager, 7, 39 Program Restrictions, 15 Public Relations and Outreach Information, 9

Records Protection Policy, 31 Records Retention/Disposal Policy, 32 Reentry Policy, 37 Referrals, 36 Referrals for Additional Services, 40 Release of Financial Information, 12 Release of Persons Served, 27 Re-referrals, 36 Reorientation Policy 37 Retention of Referral Information, 32 Risk Management, 13 Sexual Harassment Policy, 27 Signature Policy, 34 Single Case Record, 32 Smoking Products Policy, 17 Staff Development and Training, 23 Staff Input, 23 Staff Meetings, 9 Staff Qualifications, 21 Staffing Pattern and Back-up Plan, 21 Supplemental Documentation/Resources, 48 Termination Procedures, 40 Transportation, 19 Vocational Evaluation Admission Criteria, 43 Vocational Evaluation Exit Criteria, 45 Vocational Evaluation Report, 45 Vocational Evaluation Services, 43 Vocational Evaluation Summary, 45 Vocational Evaluation Techniques, 44 Vocational Evaluator Participation in Monthly Client Staffing, 44 Volunteers, 22

Chapter 1 Policy Manual

32 Miss. Admin. Code Pt. 3, R. 10.1 Rule 10.1

Bidding Process 10.2 Selection Process 10.3 Temporary Assignments 10.4 Emergency Assignments or Temporary Assignments Due to Unique Circumstances 10.5 Lateral Transfers

SECTION 11 BEM OPERATING AGREEMENT

32 Miss. Admin. Code Pt. 3, R. 11.1 Rule 11.1

General 11.2 Contents of Operating Agreement 11.3 Duration of Operating Agreement 11.4 Distribution of Signed Vendor’s Agreement

SECTION 12 SANCTIONING OF A BLIND VENDOR’S LICENSE

Emerge Center Student Handbook 52 Effective Date: 10/20/2024

32 Miss. Admin. Code Pt. 3, R. 12.1 Rule 12.1

Grounds for Sanctioning 12.2 Notice of Probation 12.3 Right to Bid 12.4 Repeated Probations 12.5 License Revocation Not Requiring a Probationary Status 12.6 Distribution of Probation Letters 12.7 Complying with the Terms of Probationary Status

SECTION 13 EMERGENCY REMOVAL OF A VENDOR

32 Miss. Admin. Code Pt. 3, R. 13.1 Removing the Blind Vendor 13.2 The Agency’s Responsibilities

SECTION 14 USE OF TEAMING PARTNERS

32 Miss. Admin. Code Pt. 3, R. 14.1 Rule 14.1

When Teaming Partners are Permissible 14.2 Criteria for a Military Dining Teaming Partner 14.3 Full-Service Vending 14.4 Branded Concepts 14.5 Failure to Be Engaged

SECTION 15 CONTINUING EDUCATION / UPWARD MOBILITY

32 Miss. Admin. Code Pt. 3, R. 15.1 General

SECTION 16 GUIDELINES FOR LOCATIONS OF VENDING FACILITIES

32 Miss. Admin. Code Pt. 3, R. 16.1 Employers Contact Report (BEM-1) 16.2 Location Criteria Guidelines

SECTION 17 ESTABLISHING A NEW VENDING FACILITY

32 Miss. Admin. Code Pt. 3, R. 17.1 Rule 17.1

Initial Start-Up of New Vending Facilities 17.2 Vendor Secured Locations

SECTION 18 POLICY FOR CLOSING VENDING FACILITIES

32 Miss. Admin. Code Pt. 3, R. 18.1 Consideration for Closure

SECTION 19 RENOVATION OF VENDING FACILITIES

SECTION 20 MERCHANDISE

32 Miss. Admin. Code Pt. 3, R. 20.1 Rule 20.1

Quality Control 20.2 Display of Merchandise 20.3 Typical Variety of Merchandise

Emerge Center Student Handbook 53 Effective Date: 10/20/2024

32 Miss. Admin. Code Pt. 3, R. 20.4 Selling Prices 20.5 Initial Stock 20.6 Inventory of Merchandise

SECTION 21 VENDING FACILITY EQUIPMENT

32 Miss. Admin. Code Pt. 3, R. 21.1 Rule 21.1

Purchase of Equipment 21.2 Transfer of Equipment 21.3 Storage of Equipment 21.4 Salvage of Equipment Parts 21.5 Transmittal of Procedure for Disposal 21.6 Telecommunication Equipment 21.7 Repair of Equipment

SECTION 22 REPORTS

32 Miss. Admin. Code Pt. 3, R. 22.1 Reports by Vendor to BEM 22.2 BEM Reports to Vendors

SECTION 23 FACILITY OBSERVATION AND QUARTERLY SITE VISIT REPORT

32 Miss. Admin. Code Pt. 3, R. 23.1 Facility Observation Report 23.2 Quarterly Site Visit Report

SECTION 24 DUE PROCESS PROCEDURES

32 Miss. Admin. Code Pt. 3, R. 24.1 Rule 24.1

Administrative Review Procedure 24.2 Full Evidentiary Hearing 24.3 Arbitration

SECTION 25 CONFIDENTIALITY

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SECTION 1 DEFINITIONS

The definition of terms contained in this Policy Manual are the same as outlined in Section 1.2 of the Business Enterprises of Mississippi (BEM) Rules and those found at 34 C.F.R. 395.1.

SECTION 2 HISTORY OF BUSINESS ENTERPRISES IN MISSISSIPPI

In 1936, Congress passed and President Franklin Roosevelt signed into law, the Randolph- Sheppard Act, authorizing the blind to operate vending facilities in federal buildings. The Act was strengthened by amendments enacted in 1954 and 1974. The program authorized by that legislation made possible in the years to follow a means of employment through entrepreneurship for blind people in Mississippi and throughout the country.

The year after the Randolph-Sheppard Act was signed into law, Mississippi Vocational Rehabilitation for the Blind applied for designation to be the state licensing agency on March 9, 1937. The Agency then began opening vending facilities in 1938 with an appropriation from the legislature of $l,000.00. Subsequent appropriations of $l,000.00 were received during the legislative sessions of 1939, 1940 and 1942.

The first vending facility was established in October 1938 in the Vicksburg Post Office. Mr. David Dicks became the Vendor of this vending facility and managed it continuously until his retirement in April 1972. A second vending facility was opened in the Jackson Post Office shortly after the Vicksburg facility was opened. Mrs. Hazel Dunn and her husband managed it until July 1971 when they both retired. Both of these vending facilities had continuous operation by the same person for more than thirty years.

Two additional vending facilities were opened in Greenwood and Picayune. The Greenwood vending facilities closed when the Vendor recovered their sight, and the Picayune vending facility was closed when the Vendor retired.

In 1944, Mississippi Vocational Rehabilitation for the Blind formally established the Business Enterprises of Mississippi. The four facilities referenced above became part of the BEM. The establishment of the program was made possible with the expansion of the Vocational Rehabilitation Act in 1943 which created the availability of federal VR funds that could be spent in a state Business Enterprises Program. Presently, there are numerous vending facilities operating in all three regions of the state.

In order to establish better communication and closer involvement between the Blind Vendors and the administrative staff, the Business Enterprises Committee of Blind Vendors was organized in 1972 which was a full two years before Congress amended the Randolph-Sheppard Act requiring the establishment of such a Committee. The Committee has been active in program and policy decisions since that time. The Business Enterprises of Mississippi still presents an excellent opportunity to legally blind clients who want to go into business.

SECTION 3 LEGAL AUTHORITY

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The Mississippi Department of Rehabilitation Services (MDRS) has the authority, as the State Licensing Agency, to operate a Business Enterprises Program (the “Program”) under both state and federal laws.

3.1 State Laws

The State Licensing Agency's legal authority to perform the functions necessary for the administration of the program, including its authority to issue regulations having the force and effect of law within the State is contained in the following State Laws:

▪ Laws 1989, Chapter 434, Section 1, Mississippi Vocational Rehabilitation for the Blind Law. Effective July 1, 1989 ▪ Laws 1985, Section 43-3-93, Mississippi Code of 1972, effective July 1, 1985 3.2 Federal Laws

Authority is also given to MDRS as a State Licensing Agency for the Business Enterprises of Mississippi from the following federal laws:

▪ The Rehabilitation Act as amended through P.L. 114-95, and, ▪ 20 U.S. Code, 107-107F as amended, 1974 commonly referred to as the Randolph- Sheppard Act and the implementing regulations found at 34 C.F.R. 395, and any Technical Assistance Circulars issued by the U.S. Rehabilitation Services Administration which can be found at https://rsa.ed.gov/about/programs/randolph-sheppard-vending-facility- program.

3.3 Business Enterprises Regulations

MDRS, with the active participation of the Committee of Blind Vendors, has developed program rules and regulations which have been promulgated in accordance with State of Mississippi requirements. These regulations lay out the framework for how the Business Enterprises of Mississippi is to be administered. The rules and regulations are binding upon both the Agency and Blind Licensees.

3.4 Business Enterprises Policies and Procedures Manual

Policies and procedures implementing the program rules and regulations specific to Business Enterprises of Mississippi are contained within this Policy and Procedures Manual (sometimes referred to as “Policy Manual”). The policies contained herein are binding upon both the SLA and Blind Licensees. When implemented, this Manual replaces the previous Policy Manual and any other policies in place at the time. SECTION 4 PURPOSE AND ORGANIZATIONAL STRUCTURE

4.1 Purpose

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The purpose of the Business Enterprises of Mississippi is to provide blind persons with remunerative employment, enlarge the economic opportunities for the blind, and stimulate the blind to greater efforts to make themselves self-supporting. 4.2 Responsibilities of the State Licensing Agency

It is the responsibility of the BEM to provide necessary management services to ensure, to the extent practicable, the success of the Program and of individual Blind Vendors. As such, the responsibilities of the State Licensing Agency (SLA) include: A. The SLA will recruit, train, and license blind persons to operate vending facilities in Mississippi, and take such action as necessary to terminate licenses for reasons outlined in Section 2.5 of the BEM rules. B. The SLA shall provide all management services as required by 34 C.F.R. 395.3(11)(ii); C. At all times, the SLA shall comply with the Randolph-Sheppard Act, its implementing regulations, the BEM rules, and the provisions of this Policy Manual. D. In administering all aspects of the program, the SLA will not discriminate on the basis of sex, age, physical or mental impairment, creed, race, color, national origin, or political affiliation and will comply with all applicable federal and state laws related to discrimination. E. The SLA will provide an accessible copy of the Rules and the Business Enterprises of Mississippi Policy Manual to each Vendor and will take steps to ensure the Vendor understands the requirements contained therein. F. The SLA will ensure that the Rules and Business Enterprises of Mississippi Policy Manual are implemented fairly and uniformly. G. The SLA will ensure that all documents are provided to the Vendors in an accessible format of the Vendor’s choice. H. With the exception of soft drink machines made available to the Vendor through the bottlers at no cost, all necessary equipment, including vending machines, and any other items deemed appropriate by the SLA for the successful operation of the Vending Facility, will be provided by the Agency for the use and benefit of the Vendor. I. To the fullest extent feasible, the SLA shall ensure that all customers of vending facilities have the ability to make purchases using credit or debit cards, and will provide the necessary equipment to facilitate this. An exception may be granted if the SLA and Vendor jointly determine that credit / debit card readers do not represent a sound business decision. In this context, a sound business decision shall be defined as an economic opportunity that offers significant value to the business. J. Except for routine maintenance (i.e., changing of light bulbs, price changes, and routine cleaning), all maintenance of vending facility equipment, including preventive maintenance, shall be performed by the Agency. Equipment will be maintained in good repair by the Agency. If repairing certain equipment is not cost effective, the item or items will be replaced by the Agency. K. The Agency shall provide all merchandise, supplies, and additional allowable support necessary to begin operation of the Vending Facility during the first six-month establishment period after a Blind Vendor is inventoried into a vending facility. These

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support services during the establishment period may be provided as a Vocational Rehabilitation service if the individual has an open case or by the Program. L. The Agency shall assign a Business Consultant and shall provide management services to ensure adequate oversight and supervision to all vending facilities pursuant to 34 C.F.R. 395.3(11)(ii). M. The Business Consultant having responsibility for the assigned Vending Facility shall be available if needed to assist in resolving problems and assuring that all appropriate and necessary support services are provided for the efficient and effective operation of the Vending facility. N. If problems arise concerning the operation of a Vending Facility, all correspondence or complaints are to be forwarded to the SLA. Minor issues can be resolved by the Blind Vendor, and if necessary, with the assistance of their Business Consultant. Serious issues that jeopardize the existence of the facility or require the sanctioning of a Vendor’s license, shall be addressed by the SLA, and shall be brought to the attention of the Chair and Vice Chair of the Committee for input. It is the responsibility of the Blind Vendor to refer any and all building management issues to the SLA to ensure compliance with all laws and policies governing the Randolph-Sheppard Program. Permit negotiations, relocation of facilities and/or vending machines, requests for additional equipment and/or services, and unresolved complaints, shall be the sole responsibility of the Agency. O. The Agency shall make continuing education / upward mobility training available to the Vendor to afford an opportunity to enhance skills and to improve earning potential. P. The Agency, with active participation of the Committee of Blind Vendors, shall conduct surveys of potential vending facilities and make every effort to create new opportunities for Blind Vendors within the scope of the priority given under the state and federal laws as well as private sector locations not governed by any priority. Criteria for establishing and closing vending facilities shall be contained in the Business Enterprise Program Manual. Q. The Agency shall work collaboratively with the Committee of Blind Vendors and ensure its active participation in all major administrative decisions affecting the overall operation of the program pursuant to 34 C.F.R. 395.14. R. If funds are available and approved by a majority vote of all Vendors, the SLA shall share federal unassigned income on a quarterly basis in accordance with 34 C.F.R. 395.8. S. At all times the Agency shall be committed to the highest standards of ethical conduct in the performance of their obligations to Blind Vendors, suppliers, property management officials, SLA colleagues, and others with whom they have contact.

4.3 Organizational Structure

The Business Enterprises of Mississippi is organizationally located in the Mississippi Department of Rehabilitation Services (MDRS). The Executive Director of MDRS has ultimate responsibility for the BEM. The Director of the Office of Vocational Rehabilitation for the Blind (OVRB) reports to the Executive Director and supervises the Director of the Business Enterprises of Mississippi. If the Director of the OVRB position is vacant, the Executive Director shall designate someone to perform the duties specifically assigned to that position in this Manual. Likewise, if the Director of BEM position is vacant, the Director of OVRB or their designee shall perform the duties of the BEM Director.

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Other BEM positions include:

A. Business Enterprises of Mississippi Regional Manager; B. Business Enterprise Consultants; C. Business Enterprises Trainer D. Maintenance Technician; E. Warehouse Officer / Technician; and, F. Administrative Assistant. This list is provided as a general guide as to the BEM positions funded at the time this Policy Manual was promulgated. There is no obligation to staff at this level and additional positions may be added if determined necessary after allowing the Committee of Blind Vendors the opportunity to actively participate in such decision. The goal of these staff members is to create and expand opportunities for Blind Vendors trained and licensed by MDRS, to provide support that is necessary to ensure the highest quality of service to customers, as well as a financial return to all Vendors that will allow them to be self-sufficient. 4.4 Responsibilities of the Business Enterprises Director

The Director of the Business Enterprises of Mississippi has oversight responsibilities for the Business Enterprises of Mississippi and will have direct communication with all BEM staff and the Committee of Blind Vendors to ensure an effective and efficient operation that meets the program purpose as spelled out in Section 4.1. The Director shall ensure that the State Licensing Agency provides supervision and management services as required by 34 C.F.R. 395.3(a)(11)(ii).

The BEM Director reports to the Director of OVRB and is responsible for planning, directing, and supervising all aspects of the BEM. The Director shall:

A. Provide oversight and direction to ensure the BEM fulfills the stated goal of enlarging economic opportunities for the Blind; B. Provide supervision to staff assigned and perform personnel duties associated with said supervision; C. Interpret State and Federal laws and regulations and ensure compliance; D. Develop policy and manual changes as needed and administer the BEM in accordance with said Policy Manual; E. Strategically plan for the future including having a plan for growth of the BEM; F. Oversee the process for licensing including ensuring a strong training program for new candidates; G. Negotiate and process agreements, contracts, and permits; H. Ensure an effective in-service training program and provide administrative / technical support to all BEM staff;

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I. Approve purchases requested by BEM Consultants; J. Process contracts or agreements for third-party vending, ensure compliance by the Vendor, and monitor payments of commissions and ensure the accuracy thereof; K. Provide assistance and consultation on difficult problems; L. Monitor prompt payment of all facility accounts; M. Schedule installation, repairs, replacement of equipment, and removal of vending facility equipment; N. Prepare specifications and solicit bids for major equipment purchases; O. Develop annual budget for BEM with the OVRB Director and Committee of Blind Vendors; P. Solicit input from the OVRB Director when opening or closing a vending facility, when selecting a Blind Vendor for a vacant vending facility, when placing a Vendor’s license in probationary status, and when removing a Vendor from a vending facility or the Program; Q. May recommend to the OVRB Director termination of a Blind Vendor’s license; R. Oversee collection and disbursement of set aside funds (if applicable) and preparation of summary documents that report Vendor operations and delinquent accounts; S. Coordinate provision of direct support and management services to Vendors and review or approve all support expenditures and monitor all case documentation; T. Oversee and coordinate all facets of the transfer and promotion system including preparation of bid announcements; U. Prepare Federal, State and Agency reports as assigned; V. Maintain a comprehensive inventory of all equipment purchased; W. Ensure the active participation of the State Committee of Blind Vendors in all major administrative and policy decisions affecting the overall operation of the program in accordance with Technical Assistance Circular TAC 21-01 dated December 15, 2020; X. Work collaboratively and ensure effective communication with the Chair and Co-Chair of the Committee of Blind Vendors while ensuring that decisions requiring active participation are presented to the full Committee; Y. Participate in all meetings of the State Committee of Blind Vendors; Z. Provide necessary support to the State Committee of Blind Vendors so it can sponsor the annual meeting as required by federal law; AA. Perform public relations and marketing duties as necessary; and,

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BB. Stay abreast of industry trends and best practices and communicate knowledge gained to staff and Vendors as appropriate.

4.5 Responsibilities of the Regional Manager

The Business Enterprises of Mississippi Regional Manager reports to the BEM Director and will have direct communication with all BEM staff when needs arise in any area. The Regional Manager shall:

A. Provide oversight and direction to ensure the BEM fulfills the stated goal of enlarging economic opportunities for the Blind; B. Provide supervision to BEM Consultants and maintenance personnel and perform personnel duties associated with said supervision; C. Provide for training and administrative / technical support to BEM Consultants; D. Approve submissions by BEM Consultants’ and facility file records; E. Provide assistance and consultation on difficult problems; F. Schedule installation, repairs, replacement of equipment, and removal of vending facility equipment; G. Provide input to the BEM Director on the annual budget for BEM; H. Coordinate provision of direct support services to Vendors and review and monitor all case documentation; I. Provide input on preparation of Federal, State and Agency reports; J. Maintain comprehensive inventory of all equipment purchased; K. Actively participate in the State Committee of Blind Vendors meetings and the annual meeting; L. Develop and coordinate with other staff members training for agency BEM personnel and Blind Vendors; M. Provide counseling on best business practices to the Vendors; N. May recommend to the BEM Director disciplinary action against a Blind Vendor’s license; O. Participate in the evaluation and recommendation of new facility locations; P. Be responsible for survey(s) of new vending facility locations; Q. Search out new vending facility locations, negotiate permits or contracts, help develop the facility design, and help purchase initial stock and equipment; R. Ensure that new trainees are provided on-the-job training; S. Check on repair work and instigate preventive maintenance training; T. Investigate consistent low earnings and/or sales loss in vending facility and initiate remedial training of the Vendor if appropriate;

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U. Be responsible for ensuring the temporary operation or closure of the vending facility in the absence of a Vendor V. Recommend closure of vending facilities to the Business Enterprises Program Director when appropriate; W. Be responsible for visiting and supervising the vending facilities and performing other duties of the Consultants when necessary; X. Perform public relations and marketing duties as necessary; and, Y. Stay abreast of industry trends and best practices and communicate knowledge gained to staff and Vendors as appropriate.

4.6 Responsibilities of the Business Enterprises Trainer

A. Develop the curriculum for entry-level training with the active participation of the Committee; B. If a third party is being utilized to provide this training, provides input to the Director on the selection of that third party and coordinates training with the contractor; C. Schedule classes and provides training to all candidates for licensure; D. Work with the Regional Manager to schedule and arrange for on-the-job training (OJT) for candidates who have completed the formal training; E. Visit individuals during their OJT training to assess progress; F. Visit those individuals who have been placed into their first assignment for their 6-month establishment period and provides support and training as necessary; G. If an individual applies for a waiver from the entry-level training, review the documentation supporting the waiver request and provides input to the Director of the Office of Vocational Rehabilitation for the Blind; H. Make upward mobility training available to Blind Vendors either internally or externally; I. Design customized training for Blind Vendors who have identified performance issues; J. Plan and coordinate, with the active participation of the Committee, the annual Blind Vendor training conference; K. Oversee training of new BEM staff and develop ongoing staff training; L. Participate in all meetings of the State Committee of Blind Vendors; M. Perform public relations and marketing duties as necessary; N. Stay abreast of industry trends and best practices and communicate knowledge gained to staff and Vendors as appropriate; and O. Serve as a resource to the BEM Director.

4.7 Responsibilities of the Business Consultants

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The Business Consultant reports to the Regional Manager. The Consultant is responsible for working directly with the Vendors in an effort to fulfill the purposes as outlined in Section 4.1. The Consultant shall: A. Provide consultation to the Blind Vendors on best business practices and ways to enhance their business opportunities in order to maximize profits while ensuring high quality customer service; B. Ensure that adequate merchandise and other allowable supports are provided to the Blind Vendor during the 6-month establishment period after the Vendor is inventoried into a facility. C. Ensure that all vending facilities assigned to the Consultant are operated in accordance with this Policy Manual and all applicable State and Federal laws/regulations; D. Conduct site surveys on potential new vending facilities and participate in the evaluation and recommendation of new facility locations; E. Search out new vending facility locations, assist in negotiating contracts / permits, help develop the facility design, and make recommendations regarding the initial stock and equipment; F. Provide consultation to Vocational Rehabilitation for the Blind Counselors in the establishment of vending facilities and businesses in areas other than the Business Enterprises Program; G. Provide on-the-job training to the Vendors; H. May recommend to the BEM Regional Manager disciplinary action against a Blind Vendor’s license; I. Check on repair work and instigate preventive maintenance training; J. Investigate consistent low earning facilities or net losses in vending facility sales / profits and initiate a corrective action plan to enhance profitability; K. Follow up on complaints about a vending facility, and if problems are substantiated, create a corrective action plan; L. Ensure the temporary operation or closure of the vending facility in the absence of a Vendor; M. Help train the Vendors on accounting procedures to ensure accuracy of reporting; N. Recommend closure of vending facilities to the Business Enterprises Program Regional Manager; O. Serve as liaison between host facility and the Vendor; P. Be responsible for visiting and supervising the vending facilities assigned to the Consultant;

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Q. Arrange with the Vendor and visit vending facilities on at least a monthly basis; observe and prepare a Monthly Observation Report after each; and provide said report electronically in an accessible format to the Vendor; R. Arrange with the Vendor and conduct a quarterly site visit and detailed inspection, prepare a Facility Quarterly Report, and provide said report electronically in an accessible format to the Vendor; S. Send a copy of the Monthly Observation Report and Facility Quarterly Report to the BEM State Office. For active rehabilitation cases, a copy of the Contact Report will be sent to the client's Casework Counselor; T. Maintain files on vending facilities assigned to the Consultant. These files should include Monthly Observation Reports and monthly financial reports submitted by the Vendor; U. Notify Vendors of delinquent accounts and secure payment and/or submission of reports; V. Be responsible for equipment and inventory duties related to assigned vending facilities. A monthly list of transferred equipment will be sent to the BEM Consultant from the BEM State Office; W. Keep abreast of all information that has an effect on the operation of the Business Enterprise Program; X. Assist the Vendor in developing sanitation and safety procedure; Y. Assist the Vendor with purchasing, pricing, customer relations, and inventory; Z. Assist the Vendor with ascertaining prices in the general area to ensure the Vendor’s prices are competitive and they are able to meet performance standards; AA. Abide by all program rules and this Policy Manual, as well as State and Federal laws/regulations; BB. Stay abreast of industry trends and best practices and communicate knowledge gained to staff and Vendors as appropriate; and, CC. Perform public relation and marketing duties as appropriate.

4.8 Responsibilities of the Maintenance Technicians

The Maintenance Technicians report to the Regional Manager. The Maintenance Technician shall:

A. Make equipment repairs and maintain all state-owned BEM equipment used in the vending facility; B. Be responsible for the installation of vending machines and equipment; C. Train Vendors in the care and use of the vending equipment;

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D. Make recommendations on machine and equipment purchases; E. Advise on electrical needs; F. Advise on prevention of equipment breakdowns; G. Move equipment from one location to another; H. Complete property salvage reports; and, I. Be responsible for inventory report on transfer.

4.9 Responsibilities of the Warehouse Officer / Technician

The Warehouse Officer / Technician reports to the Regional Manager. The Warehouse Officer / Technician shall: A. Make equipment repairs and maintain all state-owned BEM equipment used in the vending facility; B. Strategically manage the equipment warehouse to ensure the maximization of utilization of assets; C. Oversee receiving, warehousing, distribution, and maintenance operations; D. Set up the layout of, and ensure efficient warehouse space utilization; E. Maintain standards of health and safety guidelines; and, F. Control inventory levels by conducting physical counts and reconciling with the inventory database.

4.10 Conduct of BEM Employees

Staff shall be committed at all times to the highest standards of ethical conduct in the performance of their obligations to Blind Vendors, suppliers, property management officials, SLA colleagues, and others with whom they have contact.

It is the policy of the Agency that BEM employees shall neither solicit nor accept from any Blind Vendor any form of gratuity, donation, gift or merchandise which could be interpreted as creating a conflict of interest. BEM employees shall pay for any item in the above categories. Violation of this policy could be interpreted as conflicting with the administration of this program and could constitute cause for dismissal under certain conditions.

4.11 Policy of Nondiscrimination

As the State Licensing Agency, MDRS ensures that every aspect of the Business Enterprises of Mississippi shall be administered without reference to sex, age, religion, race, color, creed, national origin, political affiliation, or disability and shall ensure compliance with all federal and state laws related to discrimination. SECTION 5 RESPONSIBILITIES OF THE BLIND VENDOR

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5.1 Requirements of All Blind Vendors

The Blind Vendor is an independent businessperson who is responsible for all aspects of the vending facility business. The Blind Vendor’s responsibilities are as follows:

A. Shall ensure that the vending facility is operated in accordance with BEM rules, this Policy Manual including the Business Code of Conduct, the terms of the permit, the terms of the operating agreement, and all other applicable State and Federal laws and regulations; B. Shall be responsible for the day-to-day management and operation of the vending facility including hiring adequate staff, training staff, establishing menus, purchasing product, pricing products, cleaning the facility, ensuring quality customer service, resolving problems, and other duties associated with owning and operating a business. It is understood that some contracts such as military dining eliminate some of these requirements such as menu planning and purchasing product. All Vendors are required to be on-site at their facilities at least twice per month. C. Responsible for having the vending facility open for business on the days and during the hours specified in the permit. D. Shall maintain at all times adequate stock to meet the demands of the business. E. Ensure that products are competitively priced as compared to other businesses in the general area. F. Will be accountable to the SLA for the proceeds of the business of the vending facility and will handle the proceeds, including payments to suppliers, in accordance with instructions from the SLA. G. Will meet or exceed all standards of performance developed jointly by the SLA and State Committee of Blind Vendors. H. Will carry on the business of the vending facility in compliance with applicable health laws and regulations and ensure proper sanitization while maintaining the facility in an attractive condition. I. Will maintain a neat businesslike appearance and will conduct the facility in an orderly, businesslike manner. J. Will take proper care of the equipment of the vending facility, and will make alterations or changes therein only with written approval of the SLA. K. Will notify the SLA a reasonable time in advance of any voluntary extended absences from the vending facility, and as soon as possible with respect to any involuntary extended absences.

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L. Will ensure the continuous operation of the vending facility as may be necessitated due to the Vendor's absence because of illness, vacation or otherwise. M. Will keep such records and make such reports as the SLA shall require with the assurance that all required reports are in an accessible format. N. Provide liability insurance in amounts required by the Agency; O. Agrees to enter the facility at their own risk. The responsibility for any injury received and all related expenses will be assumed by the Vendor P. Will strive at all times to maintain a positive working relationship with management and customers of the location wherein their business resides. Q. Shall not discriminate against any individual based upon sex, age, religion, race, color, creed, national origin, political affiliation, or disability and shall comply with all federal and state anti-discrimination laws. R. Shall be committed at all times to the highest standards of ethical conduct in the performance of their obligations to customers, suppliers, property management, the SLA, and others with whom they have contact (See Attachment B).

5.2 Performance Standards

A. Net profit percentage is a key indicator of a Blind Vendor’s success since it directly reflects the earnings of the Blind Vendor. The Agency must ensure that the Vendor is maximizing the opportunity afforded to them.

Minimum net profit standards for Blind Vendors have been established as follows:

1. All Counter - 25% 2. All Vending - 30% 3. Counter/Vending - 25% 4. On-Site Food Prep (Cafeteria / Snack Bar) - 15% 5. On-Site Food Prep and Vending – 17% 6. Micromarkets – 25%

Performance shall be measured annually to account for variations that may occur during the year.

B. In the event a Blind Vendor fails to meet the above standards, the Business Enterprises Consultant and Blind Vendor will jointly develop a plan of action to help the Vendor achieve the minimum standards.

C. Failure to meet the above standards shall not result in sanctioning of a Vendor’s license pursuant to Section 12 of this Manual unless a Vendor refuses to abide by the plan of

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action and deliberately does not implement agreed upon action steps that would better enable them to meet the standard.

5.3 County or City License Fees

The Vendor of each vending facility is subject to the provisions of any ordinance of the county or city in which the vending facility is located. If a license or permit for the conduct of such business is required, any such license or permit may be issued free of charge to a qualified blind individual licensed by Vocational Rehabilitation for the Blind pursuant to Section 43-3-93 Mississippi Code of 1972, as amended. A. Such county or city licenses (in some cases, both require a license) are valid for one year at which time the license must be renewed by the Blind Vendor. B. The BEM Consultant shall make inquiry as to the local need for said license five (5) days before actual vending operation begins. All paperwork for the original license is completed by the Business Enterprise Consultant. C. The BEM Consultant shall notify the official at the time of application that the license is for a Blind Vendor, at which time it will be at the discretion of the official as to whether there will be a fee for the license. D. The county or city license is applicable to the vending facility location, not to the Vendor per se; therefore, if the Vendor vacates a vending facility, the license is still valid until its date of expiration.

SECTION 6 THE STATE COMMITTEE OF BLIND VENDORS

6.1 General

The State Committee of Blind Vendors is a group of Vendors who are elected by their peers to represent the interests of all Blind Licensees in the state. There shall be an annual statewide meeting, which all Licensees are invited to attend. It is at this meeting that members of the Committee of Blind Vendors are elected biennially by a majority vote of those in attendance. The Committee's members are chosen as far as practicable on the basis of geography and vending facility type, (i.e., federal or other property). All Blind Licensees are eligible to vote in any election regardless of any outstanding debt. Only a Blind Vendor actively assigned to a vending facility may serve on the Committee. 6.2 Committee Bylaws

The actions of the Committee shall be controlled by a set of bylaws which shall be developed by the Committee. The bylaws shall encompass such things as elections, duties of officers, meetings, etc. The bylaws must be approved by a majority of Blind Licensees attending an annual meeting. At its discretion, the Committee may choose to mail out proposed bylaw changes in an accessible format and let Blind Licensees vote by mail or some other means.

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6.3 Functions of the State Committee of Blind Vendors

The State Committee for Blind Vendors shall: A. Actively participate with the State Licensing Agency in any major administrative decisions and policy program development decisions affecting the overall administration of the State's vending facility program; B. Receive and transmit to the State Licensing Agency grievances at the request of blind licensees and serve as advocates for such Licensees in connection with such grievances; C. Actively participate with the State Licensing Agency in the development and administration of a state system for the transfer and promotion of Blind Vendors; D. Actively participate with the State Licensing Agency in the development of training and retraining programs for the Blind Vendors; and E. Sponsor, with the assistance of the State Licensing Agency, meetings and instructional conferences for Blind Vendors within the state. 6.4 Active Participation The intent of the active participation requirement is to ensure that the Committee is able to influence major decisions affecting the overall operation of the Program. This means the Committee will play a meaningful and deliberate role and share in all major decisions. In order for the Committee to be effective in this role, the Agency must share information so that the Committee can make informed decisions. It is understood that MDRS has final authority for the administration of the Program including ensuring active participation by the Committee. MDRS will only exercise final authority over the Committee when the two sides are deadlocked and, in the opinion of the Agency, further negotiations would be fruitless.

SECTION 7 FUNDING

The BEM operates using a combination of State, Federal, Set Aside, and Unassigned Funds. 7.1 Set-Aside Funds A. Method for Determining Set Aside Rate 1. The State Licensing Agency and the State Committee of Blind Vendors determine the total amount of set-aside funds that will be needed to operate the program for one year. These figures are compiled from previous experience and are developed at the beginning of each fiscal year. 2. The BEM Director then reviews the figures and in conjunction with the State Committee of Blind Vendors agrees to a total amount of set-aside funds for the ensuing year and the percentage of net proceeds of each vending facility required to achieve that level of funding.

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3. The fee schedule is then submitted to the U.S. Department of Education for approval prior to implementation. In subsequent years, the set aside schedule only has to be submitted for this federal approval if there is a change in the schedule. 4. Each Vendor is assessed the derived percentage rate of their own net proceeds. 5. Quarterly and annual financial reports are made to the Vendors so that they can stay abreast of the total BEM income and expenditures. 6. At the end of each fiscal year, any unexpended set aside funds may be carried over into the next fiscal year. 7. The Agency and Committee may agree to suspend Set Aside for a given period of time after considering the budgetary needs of the Program, including the need for a reasonable reserve.

B. Determining Net Proceeds

In determining net proceeds, the Blind Vendor is allowed to deduct allowable expenses from gross sales to arrive at the figure. The SLA cannot deny a Vendor the ability to deduct legitimate business expenses when determining net proceeds. This does not mean a Vendor can expense the same things allowed by the Internal Revenue Service. IRS deductions are intended to arrive at one’s personal taxable income; whereas, deductions for purposes of this section are intended to determine the income or net proceeds of the vending facility. An example might be the IRS will allow travel to a training conference as an expense, but such training is not a direct expense to the vending facility and is not deductible for the purposes of determining set aside. Expenses that are deducted from gross sales in determining net proceeds include:

1. Product cost including supplies; 2. Employee expenses including wages, benefits, taxes, uniforms, and related expenses; 3. Credit card, micromarket, franchise, and bank fees; 4. Accounting/bookkeeping expenses; 5. Pest control; 6. Janitorial services; 7. Vehicle mileage for Vendors who operate a vehicle in conjunction with their vending facility business provided that such mileage is substantiated by a travel log (allowable rate will be the same as allowed by state travel regulations) provided further that travel expenses from home to the vending facility and back are not allowable deductions; 8. Internet if required in the facility, telephone, pagers, and other communication expenses; 9. Liability insurance;

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10. Supplies that do not qualify for purchase by the Agency by virtue of the threshold for capitalizing state equipment; 11. Lease payments, rent, or commissions; and, 12. Any other business expenses related directly to the operation of the vending facility provided the Agency has given prior approval. *Set aside payments are not an allowable expense to be deducted.

C. Use of Set Aside Funds.

Set aside funds may be used for only the following purposes:

1. In accordance with any guidance provided by the U.S. Department of Education, the purchase of new equipment, including delivery and installation charges; 2. The maintenance and replacement of equipment; 3. Management services; 4. Assuring a fair minimum return; and/or, 5. Pension funds, health insurance contributions, and the provision of vacation and/or sick pay provided a majority of the Vendors have voted to do so.

D. Vendor Late Payment Fee

A $50.00 late fee will be assessed if a Vendor fails to timely file a monthly report or has an unpaid Set Aside balance of more than $50.00 that is not paid by the due date established by this Policy Manual. Failure to pay any part of the vending facility bill, including any duly assessed late payment fee, may result in sanctioning of the Vendor’s license pursuant to Section 12 of this Policy Manual and shall jeopardize the Vendor’s continued operation of the Vending Facility. Late fees are not an allowable deduction for the purpose of determining net proceeds of the vending facility. Late payment fees shall cease to be calculated and added to the outstanding balance for late payments at the end of the third complete month after a Blind Vendor leaves the Business Enterprises Program. All late payment fees received by the SLA shall be placed in the set-aside account. Vendors must mail monthly reports and payments with a postmark no later than the

th day of the month following the month that business was transacted. Should the due date fall on Saturday or Sunday, payment must be postmarked on the following Monday; or, in the event that Monday happens to be a holiday, payment will be expected on Tuesday. The Agency and Committee may agree to utilize technology that will allow or perhaps require Vendors to file reports and possibly pay set-aside fees electronically. This may include traditional email and/or an on-line management information system. If such technology is available, the due date remains the same. If an on-line management

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information system is utilized, the Agency shall ensure the system is accessible to blind users. 7.2 Federal Unassigned Funds In the event the Agency receives income pursuant to 34 C.F.R. 395.32 from vending machines on federal property which may or may not be in direct competition with a licensed Blind Vendor, the Agency will be guided by 34 C.F.R. § 395.8 in distributing any such funds to a Licensed Blind Vendor. Any funds not distributed to a Licensed Blind Vendor shall be used by the Agency for the establishment and maintenance of retirement or pension plans, for health insurance contributions, and for the provision of paid sick leave and vacation time for Blind Vendors if it is so determined by a majority vote of Blind Vendors licensed in Mississippi after the Agency has provided to each such Vendor information on all matters relevant to such purposes. Any vending machine income not necessary for such purposes shall be used by the State Licensing Agency for the maintenance and replacement of equipment, the purchase of new equipment, management services, and ensuring a fair minimum return to Vendors. Any set aside assessment charged to Blind Vendors by the State Licensing Agency shall be reduced pro rata in an amount equal to the total of such remaining vending machine income.

The Agency will comply at all times with Technical Assistance Circular 21-02 which was issued by the U.S. Department of Education and forbids the Agency from entering into agreements with third parties for the purpose of generating unassigned income to be spent for the benefit of Business Enterprises of Mississippi.

For purposes of this section, interstate rest areas are not federal property and any revenue generated from third party vendors will be treated as non-federal unassigned income as outlined in Section 7.3 below.

7.3 Non-Federal Unassigned Funds Any monies that accrue to the Agency from vending machines on non-federal property shall be used for the same purposes as set-aside dollars. Additionally, these dollars can be used to purchase stock, items that do not meet RSA’s definition of equipment due to the purchasing threshold, and other items not eligible for federal participation that benefit the Program and its Blind Vendors. 7.4 Expenses Paid by the Blind Vendor Program funds, including vending machine income from non-federal properties, will not be used to pay for day-to-day operating costs associated with an individual vending facility except during the first 6 months after a Blind Vendor has been inventoried into a vending facility. The Blind Vendor shall be responsible for paying for day-to-day operational costs other than purchasing and/or repairing/maintaining of vending facility equipment, which are the responsibility of the SLA. The Blind Vendor shall be solely responsible for preparing their payroll documents and/or preparing state and/or federal tax documents.

This does not preclude the Agency from using Vocational Rehabilitation funds to pay for operating expenses during the first six (6) months of assigning a Vendor to a Vending Facility.

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This may include, but is not limited to, paying for permit and licensing fees, credit card and kiosk fees, franchising fees, janitorial services, employee uniforms, rent/utilities, and personnel costs. The Vocational Rehabilitation Counselor or BEM may help pay for such operational expenses consistent with 34 C.F.R. 361.49(a)(5)(iii), or they may be provided by BEM as management services with the assurance that regardless of which avenue is utilized, such support shall not extend beyond the initial 6-month establishment period.

SECTION 8 REFERRAL AND TRAINING

8.1 Cooperation Between Business Enterprise Consultant and Rehabilitation Counselor The Vocational Rehabilitation (VR) Counselor will be the primary referral source for potential BEM candidates. When the VR Counselor has a client who would be suitable for this type of self- employment, the VR District Manager shall be provided written information as to the client's visual condition, education, experience and other pertinent factors. If the client, VR Counselor, and the District Manager agree on the client’s potential as a Blind Vendor, the Counselor may proceed with plans for a more comprehensive evaluation. The VR Counselor will maintain responsibility for a client, who has been placed as a Blind Vendor, and whose case is still open. The Counselor will plan and authorize case service expenditures that may be reasonable, necessary, and allowable before closure. VR funds may be used to assist the Blind Vendor for up to six (6) months after being placed into their facility as a self-employed Vendor. This may include but is not limited to inventory and supplies, cash for vending machines or cash register, equipment, licensing and permit fees, banking and related fees, employee uniforms, payroll expenses, rent, etc. Such expenditures must be reasonable, necessary, allowable, and comply with any federal requirements related to the expenditure of Vocational Rehabilitation dollars. The Counselor will continue regular counseling contacts and shall exchange information with the Business Enterprise Consultant regarding the progress or problems with the case 8.2 Evaluation

A. Clients must successfully meet evaluation criteria contained in this Policy Manual prior to being accepted for training. As a minimum, the evaluation covers the following areas:

1. Basic and business math; 2. Orientation and mobility; 3. Personal and home management; 4. Communication skills; 5. Computer skills; and, 6. Social skills.

The evaluation must determine the client:

1. Is legally blind which is supported by appropriate documentation in the case file; 2. Is a U.S. citizen;

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3. Possesses a high school degree or GED; 4. Passed the BEM math test documenting proficiency at the 8 th grade level in addition, subtraction, multiplication, division, fractions, decimals, and percentages; 5. Be able to arrange public transportation when necessary and demonstrate travel skills that will enable the client to travel independently to and from the vending facility as well as inside the facility; 6. Possesses a form of written communication such as print, braille, or digital; 7. Demonstrates keyboarding and computer skills that enable the individual to effectively use Word, Excel, email, and use the web independently;

If the evaluation indicates any deficiencies, the VR Counselor shall arrange for remedial training if the client still wishes to pursue BEM as a vocational outcome and there is reason to believe that such remediation will enable the candidate to achieve the minimum criteria.

8.3 Entry Level Training

If the evaluation indicates that the individual possesses the attributes needed to become a licensed Blind Vendor, they may be accepted for training. A comprehensive training curriculum is the basis for preparing potential Vendors. The training consists of two parts. The first is a classroom component. The Agency and Committee may jointly determine to allow this portion of the training to be completed through a nationally recognized on-line provider. Any on-line training must be fully accessible to blind individuals. The second phase of training is an on-the-job experience which places the client with an experienced Blind Vendor in an existing vending facility. A. Entry Level Curriculum

The Agency, with the active participation of the State Committee of Blind Vendors, shall develop a training program for potential Blind Vendors. Training may be provided by the Agency in a classroom setting or through an on-line entity. The curriculum shall include:

1. The Randolph-Sheppard Act 2. Vending Management 3. Café / Snack Bar Operations 4. Micromarket Management 5. Business Management Systems 6. Accounting 7. Sales Techniques 8. Human Resource Management 9. Financial Analysis of a Business 10. Customer Service 11. Business Practices 12. Health and Sanitation (ServeSafe)

A trainee must pass all modules and a comprehensive final exam in order to successfully complete the training.

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B. On-the-Job Training

Pursuant to 34 C.F.R.395.11, the entry-level training shall include an on-the-job training component. The Training Director shall work with the Regional Manager to arrange for the on-the-job training at an existing vending facility operated by a blind vendor. If for whatever reason a qualified Blind Vendor is not available to provide the on-the-job training experience, the Training Director may arrange the training with a privately owned food service business. If the training is to be provided by a private entity rather than a blind licensee, the Committee shall actively participate in the decision as to the selection of the training provider.

C. Waiver

After consulting with the BEM Director and Training Director, the OVRB Director may waive some training requirements to be certified for placement into a vending facility. Such a waiver may only be granted to individuals who meet any of the following criteria:

1. Previously licensed in Mississippi and left in good standing either voluntarily or for medical reasons; 2. Previously successfully managed a vending facility in another state and left that state in good standing; 3. Have experience of five years or more in food service management in either the private or public sector and meet all other prerequisites for entry into the Program; 4. Have extensive business experience of at least five years in a related field; and/or, 5. Have completed a nationally recognized food service training program or possess a college degree in hospitality management or a related field.

In order to be considered to be in “good standing”, the individual must have not left the previous assignment owing the Program any money, and must not have been on any corrective action plan or had their license in disciplinary status at the time of departure. It will be the responsibility of the Director of the Business Enterprises of Mississippi to document the Vendor’s good standing before they will be allowed into training or considered for a waiver. The Director of OVRB may make an exception and allow an individual who was either not in good standing in their prior state, or that state fails to verify the Vendor’s status. An exception will only be granted if there is evidence to suggest the individual has the necessary skills to succeed as a Vendor in Mississippi. Any individual seeking such a waiver, must submit documentation of the above which will be considered by the Training Director who shall make a recommendation to the OVRB Director.

Individuals who meet the above criteria may be certified without going through the Vocational Rehabilitation Program. The Training Director shall arrange for training

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on Mississippi requirements (i.e., reporting, health codes, tax laws, etc.). Based upon the individual experience of a candidate, the Director may choose to require additional training in specific areas (e.g. vending machine operations, café management, micromarkets, etc.) and may require on-the-job training.

Prior to granting a waiver, the OVRB Director shall consult with the Chair of the Committee to solicit their input.

D. Post-Employment Training

Pursuant to 34 C.F.R. 395.11, the Agency shall make post-employment services available to the individual. Once placed into a vending facility, additional Vocational Rehabilitation services may be required prior to the VR case being closed. The Vocational Rehabilitation Counselor, after collaborating with the BEM Consultant, will make such services available to maximize the chances of the individual succeeding. If additional VR services are required after the case is closed, the individual may reapply for VR services.

8.4 Delinquent BEM Account Qualifications

A Vendor or former Vendor must have all accounts paid in full with any Business Enterprises Program in any state, the Mississippi State Tax Commission or any other state tax commission, state and federal employment tax agencies, or any like programs or any related state or federal agencies.

SECTION 9 LICENSING OF VENDORS

Upon completion of all training requirements, the blind individual is eligible to begin the licensing process.

9.1 Certified for Placement List

Upon completion of all training requirements, an individual’s name will be placed on the Certified for Placement List. Being placed on the Certified for Placement List allows for the individual to be assigned to manage and operate a vacant vending facility in accordance with Section 10 of this policy manual.

9.2 Initial Assignment

Individuals on the Certified for Placement List must compete for their initial permanent vending facility assignment pursuant to Section 10, This requirement does not preclude the Agency from assigning a vending facility on a temporary basis pursuant to Section 10.4. Individuals who have had their training waived pursuant to Section 8.3(C) will be placed on the Certified for Placement List.

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9.3 Licensing of Blind Vendors

A. Eligibility

The Agency shall issue licenses to individuals who meet the following criteria:

1. Legally blind; 2. A citizen of the United States; and, 3. Determined by the Agency to be qualified to manage a vending facility operation as evidenced by:

a. Successful completion of all training requirements and a six-month trial period managing a vending facility; or, b. If training is waived, deemed qualified based on prior education and work experience as well as a six-month trial period.

9.4 Trial Period

In determining that an individual is qualified to manage a vending facility, the Agency shall require that each individual placed into their initial assignment off of the Certified for Placement List has successfully completed a six-month trial period. They may meet this requirement either as a permanently or temporarily assigned Vendor. If they are successful in managing this first assignment for six months, the Agency may issue a license. The Training Director, at their discretion, may extend the trial period beyond six months if not satisfied that the individual has demonstrated the requisite skills to be successful and there is reason to believe that with additional time the individual will prove to be successful. The reason(s) for extending the trial period must be documented in the file. During this initial six-month assignment, the Agency shall closely monitor the operation and provide management services to increase the likelihood of success. Individuals who are on their initial assignments will not be allowed to bid on vacant facilities until they successfully complete the trial period and receive a license.

9.5 Issuance of License

The Agency shall issue a license for an indefinite period of time subject to termination for cause after first affording the Vendor an opportunity for an evidentiary hearing.

9.6 Termination of License

A. Disciplinary Termination

The Agency shall issue licenses for an indefinite period of time, but subject to termination if, after affording the Blind Vendor an opportunity for a full evidentiary hearing, the Agency finds that the vending facility is not being operated in accordance with:

1. The BEM rules;

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2. This Policy Manual; 3. The terms and conditions of the permit or contract; 4. The Operating Agreement; 5. State, federal, or local law, the violation of which is, or reasonably may, result in financial or physical harm to the customers of the facility or other persons, the Agency, or the Vendor; or 6. Regulations of other agencies of the State of Mississippi or local governments which have regulatory authority directly related to the operation of a vending facility (i.e., Tax Commission, Department of Health, etc.).

The Agency will give thirty (30) days written notice in an accessible format in advance of terminating a Vendor’s license, and such advance notice shall be given only after the expiration of a thirty (30) day probationary period, except as provided in Sections 9.7, 12.5, and/or 15.1 of this Policy Manual.

Only the Director of OVRB may terminate a license.

9.7 Non-Disciplinary Termination

A. The Agency must revoke the Vendor’s license if:

1. The Vendor resigns or retires from the Program; 2. The Vendor has an extended illness that extends beyond twelve (12) months with a medically documented diagnosis of the Vendor’s incapacity to operate a facility. At the end of the twelve (12) month period, the Agency shall request that the Vendor provide medical documentation from their physician stating that they are able to return to work; 3. The Vendor fails to meet the definition of blindness as set forth at 34 C.F.R. § 395.1(c). At its discretion, the Agency may require the Vendor to undergo an ophthalmologic examination to verify blindness. If an examination is required, the Agency will select the doctor and will pay for the office visit.

Termination of license for a non-disciplinary reason will not require a thirty (30) day probation prior to termination.

SECTION 10 ASSIGNMENT OF VENDING FACILITIES

This section will outline the process whereby the State Licensing Agency shall make assignments to vacant vending facilities. If an existing facility is vacant and it does not meet the requirements of Section 16.2(B) of this Policy Manual which establishes an income target for new facilities, the Agency shall consult with the Committee to determine if it should still be bid out as a stand-alone facility or perhaps added to another vending facility.

32 Miss. Admin. Code Pt. 3, R. 10.1 Bidding Process

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A. Eligibility to Bid

When new vending facilities are established and/or existing facilities become vacant, all current Licensed Blind Vendors and those individuals on the Certified for Placement List are eligible to compete for those assignments through a bidding process. Individuals can submit a bid provided they:

1. Do not have their license in probationary status on the date of the bid announcement; 2. Are not delinquent on the date of the bid announcement in the filing of financial reports required by the SLA or the State Tax Commission, or any other agency of the State of Mississippi; and, 3. Are not delinquent on the date of the bid announcement in the payment of any financial obligation owed to the SLA or the Department of Revenue.

B. Notice

All Licensed Blind Vendors and individuals on the Certified for Placement List shall be notified of any vacant vending facilities. The announcement shall be in an accessible format and include: 1. The location of the vending facility; 2. Description of the vending facility; 3. A notation as to whether the vending facility is available as a permanent or temporary assignment; 4. Estimated number of prospective patrons; 5. Operating hours of the facility; 6. A general idea of the items to be sold; 7. Projected net sales for the facility; 8. Date of site visit for candidates to see the facility if they choose; 9. Any special circumstances that may exist; 10. Specific training that must have been completed or certifications possessed; 11. The bid closing date; and, 12. Tentative interview date. In regard to #10 above, the Agency and Committee may jointly decide to require candidates for certain types of facilities to complete specialized training in order to be eligible to bid. Examples might include bidding on a military dining contract, food prep location requiring ServeSafe certification, micromarket, or inmate commissary. It is the responsibility of the Agency to ensure that Vendors have access to the required training prior to including it as a condition for bidding on a vacant vending facility. This required training may be provided by the Agency or an outside entity.

The bid announcement shall include a space for the Blind Vendor to sign indicating their interest in being considered as well as a statement whereby the Vendor agrees to the release of pertinent information about their past performance to the interview panel.

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If technology permits, the bid process may be administered electronically and submission of a digital bid will serve as permission for the release of information. C. Submitting a Bid If a Blind Licensee or individual on the Certified for Placement List wishes to bid on the vending facility, they will sign the bid announcement, attach a resume, and return it to the Director on or before the closing date. Bids may be returned using surface mail, email, or hand-delivery. As each bid is received it will be dated and time of receipt noted. Any bids received after the closing date will not be considered. Bids will remain open for ten (10) working days. Following the closing of bids, the Director will make a list of all bids received on or before the closing date. The list will indicate the date and time the bid was received and will be kept on file in the Director's office. If technology permits, bids may be submitted on-line in lieu of the above-described process. 10.1 The Selection Process

A. After the candidates have been determined eligible to bid, a selection panel shall interview each candidate. The panel shall consist of:

1. The Director of the Business Enterprises of Mississippi or their designee;

2. The Chairperson of the Committee of Blind Vendors or their designee who may or may not be a member of the Committee; and,

3. An independent person jointly determined by the Director and Committee Chairperson or their designee.

No Vendor shall serve on the interview panel if they are a candidate for the vacancy. If the Chair is a candidate for a vacancy or chooses not to serve and fails to designate a panel member, the Vice Chair or their designee shall serve on the panel. If both the Chair and Vice Chair are candidates for the vacancy or fail to designate a panel member, the remaining Committee member with the most seniority as a Licensed Vendor will serve. If they are also a candidate or choose not to serve, the next most senior member will serve. If all Committee members are candidates or choose not to serve, the Director of OVRB will select a Vendor to participate.

The independent panel member may be an independent businessperson, a property management official, or another person familiar with the Business Enterprises of Mississippi, but not an employee of the BEM, and they and/or their family do not stand to benefit personally or financially in the decision. If the two panel members cannot agree on a third panel member, the Director of OVRB shall select the third panel member.

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Barring unique circumstances, interviews shall be conducted within ten (10) working days after the bid closing date.

C. If only one individual bids on a vacant facility, that person shall be awarded the facility without an interview provided they are otherwise eligible to be assigned to the facility.

D. Rating Each Candidate

The panel shall rate each candidate based upon their record of performance for the preceding twelve (12) months, responses received to questions during the interview, a review of the Vendor’s resume, and the business plan submitted by the Vendor. Each panel member shall rate each candidate according to the following:

First Choice......................10 Points Second Choice..................8 Points Third Choice.....................6 Points Fourth Choice...................4 points Fifth Choice......................2 points

For purposes of this section, record of performance shall include:

1. Gross profit, net profit, and labor percentages; 2. Number of times late filing reports; 3. Number of times late paying set aside assessments; 4. Number of documented complaints; and, 5. Other areas as jointly agreed to by the Director and Committee.

The rating shall be done by ballot. The rater’s name will not be on the ballot. The ballots will be maintained in the vending facility file. The Agency shall ensure that the process is fully accessible so any blind panel members can participate fully. The Chairperson of the panel, who shall be the Agency representative, shall collect the ballots and tabulate the ratings, which shall be verified by the other panel members. The individual with the highest score shall be awarded the vending facility. In the event there is a tie, the individual with the highest score and greatest amount of seniority shall be awarded the facility. The successful candidate shall be immediately offered the award upon the completion of interviews. The chosen candidate shall have twenty-four (24) hours to accept or reject the award. If the award is refused, the individual with the next highest rating shall be offered the opportunity. If the candidate is scheduled for more than one interview as a result of their bids on a number of facilities contained in a single bid package, then the Vendor may wait until the conclusion of the last interview in which the Vendor participates to accept or reject the award of a facility.

E. It is understood that property management may impose additional selection criteria for Vendors on their properties. This may include, but is not limited to, such things as security clearance, special training, and random drug testing if such additional

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conditions are also required of other property management contractors. If a Vendor who is awarded a facility fails to meet the additional selection criteria, the Vendor with the next highest score who meets the additional selection criteria will be awarded the facility.

F. It is incumbent on the Agency provide training to all members of the Committee on all aspects of interviewing so they know what is appropriate and allowable in interviews and what is not.

32 Miss. Admin. Code Pt. 3, R. 10.3 Temporary Assignments

A. In considering temporary assignments, preference shall be granted in the following order:

1. Persons on the Certified for Placement List;

2. A Blind Vendor who is currently managing another vending facility and can take on the additional workload;

3. An individual or private vending / foodservice company.

If more than one person is available on the Certified for Placement List to be potentially assigned temporarily, the selection process outlined in Section 10.2 above shall be utilized to select the individual. Likewise, if there is no one on the Certified for Placement List but more than one current Blind Vendor desiring the assignment, Section 10.2 shall be utilized to select the Vendor.

B. In the event that no other Blind Vendor or individual on the Certified for Placement List bids on a vacant vending facility opportunity or declines the assignment after bidding, the Agency may offer the assignment to a person who is not blind on a temporary basis for a period of time not to exceed twelve (12) months. At the conclusion of that twelve (12) - month period, the vending facility shall be announced for bid to all Blind Vendors and individuals on the Certified for Placement List. If no blind person is interested, the facility may be reassigned for an additional twelve (12) months. In order to comply with Technical Assistance Circular 21-02, federal sites may only be assigned temporarily for two consecutive 12-month periods. At the conclusion of the second 12-months, the Agency shall assign the site to a Vendor either temporarily or permanently who may utilize a third party if necessary to provide the service.

32 Miss. Admin. Code Pt. 3, R. 10.4 Rule 10.4

Emergency Assignment or Temporary Assignments Due to Unique Circumstances

A. Unique circumstances may dictate that the Agency make an emergency assignment without announcing the facility for bid. This may occur when:

1. A Vendor resigns without notice;

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2. The Agency is forced to remove the current Vendor on an emergency basis; 3. The current Vendor passes away; or, 4. There are other unique circumstances.

In such instances, the Agency, in consultation with the Committee, may make a temporary assignment. Such temporary assignments shall be made in the same priority order as outlined in Section 10.3 above unless the SLA and Committee agree that circumstances dictate that an experienced Vendor be assigned to better address issues at the facility. Such an emergency assignment shall not exceed twelve (12) months.

B. In the event of the establishment of a new vending facility, there may not be historical sales figures available upon which a bid could be based. Under such circumstances, the facility may be awarded on a temporary basis until such time as sales can be established provided it is not longer than twelve (12) months.

32 Miss. Admin. Code Pt. 3, R. 10.5 Lateral Transfers

A. Blind Vendors who face displacement not attributable to their conduct or lack of performance shall be afforded the opportunity to be assigned to a comparable facility without having to compete through the standard bid process. A transfer shall not result in a substantial financial advantage or disadvantage to the Vendor. In order to ensure the effectiveness of this provision, the Blind Vendor’s sales for the preceding twelve (12) months shall be calculated and compared to the projected sales on the bid announcement. The greater of these two numbers shall be used to determine the range of transfer eligibility. If a vacant facility for which the Vendor is qualified and which produces sales comparable to those calculated for the displaced Vendor, meaning that sales may be fifteen percent (15%) above or fifteen percent (15%) below those calculated, then the Vendor may be considered.

B. Transfer eligibility may be established if:

1. A determination is made to close the vending facility; 2. The nature of the Vendor’s facility changes, and the Vendor does not possess the necessary skills to be successful in the new facility; 3. A permanent loss of customers occurs equal to thirty-three percent (33%) of the population figures reflected on the bid announcement; or 4. The Vendor is on medically documented sick leave and requests to be placed on transfer status.

C. Transfer eligibility is valid for a period of two (2) years, during which seniority will be frozen and eligibility is not maintained for all benefits. Transfer eligibility is lost if the Vendor bids on and receives the award of a facility which produces sales within or which exceed the Vendor’s transfer range, or the Vendor declines an award based on their transfer eligibility.

SECTION 11 BEM OPERATING AGREEMENT

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32 Miss. Admin. Code Pt. 3, R. 11.1 General

At the time the Blind Vendor or individual on the Certified for Placement List is assigned to a vending facility either permanently or temporarily, the Agency and Vendor shall enter into an Operating Agreement which shall be provided to the Vendor in an accessible format. This Operating Agreement shall outline the terms and conditions under which the vending facility is to be operated. The Operating Agreement is signed by the Blind Vendor and the BEM Consultant and witnessed if practical. Before getting the Vendor’s signature, the Consultant shall read the Agreement to the Blind Vendor if requested. A copy of the Operating Agreement is attached as Appendix A to this Policy Manual.

32 Miss. Admin. Code Pt. 3, R. 11.2 Contents of Operating Agreement

The various responsibilities of both the State Licensing Agency and the Vendor are outlined in detail in the Operating Agreement. The Agreement will include the location of the facility, type of enterprise, and hours of operation.

32 Miss. Admin. Code Pt. 3, R. 11.3 Duration of Operating Agreement

An Operating Agreement is issued for an indefinite period of time. A new Agreement must be signed each time a Vendor is transferred or promoted to a new vending facility. The agreement is valid from the time a Blind Vendor takes over the operation of a vending facility until the Vendor is removed from the facility or is inventoried out of the facility. The Agreement can be cancelled by the Vendor by giving thirty (30) days written notice. The Agency may terminate the Agreement for cause by providing thirty (30) days written notice provided such termination occurs only after giving the Vendor an opportunity to correct any deficiencies if the revocation is performance related. All notices of termination to the Vendor must be provided in an accessible format.

32 Miss. Admin. Code Pt. 3, R. 11.4 Distribution of Copies of Vendor's Agreement

After the Agreement has been signed, a copy shall be given to the Blind Vendor and a copy shall be retained at the Business Enterprises office. The Consultant shall keep a copy for the local file.

SECTION 12 SANCTIONING OF A VENDOR’S LICENSE

32 Miss. Admin. Code Pt. 3, R. 12.1 Grounds for Sanctioning

A Vendor’s license may be placed into probationary status when the Agency determines that the vending facility is not being operated in accordance with:

A. The Business Enterprises of Mississippi rules;

B. Policies contained in this Policy Manual including the Business Code of Conduct;

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C. The terms and conditions of the permit / contract;

D. The terms and conditions of the Operating Agreement;

E. State, federal, or local law, the violation of which is, or reasonably may, result in financial or physical harm to the customers of the facility, other persons, the Agency, or the Vendor; or

F. Regulations of other agencies of the State or local governments which have regulatory authority directly related to the operation of a vending facility including but not limited to the Department of Revenue, Department of Health, and Employment Security Commission.

32 Miss. Admin. Code Pt. 3, R. 12.2 Notice of Probationary Status

Notice of the license being placed into probationary status shall be sent in an accessible format to the Blind Vendor by email, certified mail (return receipt requested), or notices may be hand- delivered by the Agency or a process server. The inception of probation shall be the date upon which the notice is received by the Vendor as indicated on the signed receipt. If a Vendor declines to accept or sign for a notice or does not accept delivery, a copy of such notice shall be posted in the mail. In such instances, the inception of the probation shall be the date the Agency certifies it posted the letter in the U.S. Mail. If the notice is sent via email, a copy shall be sent by regular U.S. Mail on the same day and the inception of probationary status shall be the date of the email. The notice of disciplinary probation shall contain the reason(s) for probation, steps to be taken, if any, to avoid termination of the license, the Vendor’s right to appeal the Agency’s action, and information about contacting a member of the Committee to serve as an advocate. The probationary period shall be for a mandatory thirty (30) days. If at the conclusion of the thirty (30) days the identified issues have not been adequately corrected, the Agency may extend the probation for an additional thirty (30) days or initiate additional disciplinary action. Only the OVRB Director may place a Vendor’s license in probationary status.

32 Miss. Admin. Code Pt. 3, R. 12.3 Right to Bid

Vendors whose licenses have been placed in probationary status pursuant to this Part will not be permitted to bid on vacant vending facilities.

32 Miss. Admin. Code Pt. 3, R. 12.4 Repeated Probations

If a Blind Vendor’s license is placed in probationary status for the same offense for a third time during a twelve (12) month period, notice of termination of the Vendor’s license will be sent at the conclusion of the third probation.

32 Miss. Admin. Code Pt. 3, R. 12.5 Rule 12.5

Revocation (Termination) of Licenses Not Requiring a Probationary Status

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If the violation results in the emergency removal of the Vendor pursuant to Section 13 of this Policy Manual, a probationary period is not required before a Vendor’s license is terminated. However, the Agency must still afford the Vendor an opportunity for an evidentiary hearing prior to terminating the license. Likewise, if a Vendor knowingly falsifies the monthly financial report, the Agency may proceed directly to revoking the license without a probationary status. 12.6 Distribution of Probation and Termination Letters

Notices of the license being placed in probationary status or being terminated shall be distributed as follows:

• Original to the Blind Vendor • Copy for BEM Consultant's file • Copy for the BEM Director • Copy to the Director of OVRB.

32 Miss. Admin. Code Pt. 3, R. 12.7 Rule 12.7

Complying with Terms of Probationary Status The Vendor is expected to comply with the terms of the probation. If the Vendor does not correct the problem, further steps to ensure compliance will be initiated by the Agency staff. These steps may include, among other things, extension of the probationary period or termination of the license and removal from the vending facility.

SECTION 13 EMERGENCY REMOVAL OF A BLIND VENDOR

32 Miss. Admin. Code Pt. 3, R. 13.1 Rule 13.1

Removing the Blind Vendor The Agency shall remove a Blind Vendor from a vending facility if a situation develops that prevents a Vendor from fulfilling their obligations or if there is reasonable evidence of a hazardous situation involving the Vendor which poses an immediate threat to the safety of the Vendor or others. This removal may be immediate if the circumstances require. Prior to or within twenty- four (24) hours of the removal, the Agency shall contact the Chairperson of the Committee and inform them of the action. In providing such notice, no confidential information (as described in Section 25 herein) will be shared. 13.2 Agency’s Responsibilities In the event of a Vendor’s removal under Section 13.1, the Agency must, within fifteen (15) working days, do one of the following: 1. Return the Vendor to the facility if it is determined no wrongdoing on the part of the Blind Vendor occurred and no hazardous situation exists;

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2. Mandate re-training if it is determined that the Vendor’s lack of knowledge and/or skills contributed to problems and there is a likelihood that training will afford the Blind Vendor a better opportunity to succeed; 3. Terminate the Operating Agreement but allow the Vendor to have their name placed on the Certified for Placement List and bid on any vacant vending facilities if it is determined that the problems were unique to that vending facility and there is no reason to expect the Blind Vendor could not be successful at another vending facility location; or 4. Initiate disciplinary action which might include placing the license in probationary status or termination of the license if it is determined that the Blind Vendor was at fault and violated the rules, policy manual, permit, operating agreement and/or other state or federal laws or regulations.

SECTION 14 USE OF TEAMING PARTNERS

32 Miss. Admin. Code Pt. 3, R. 14.1 When Teaming Partners Are Permissible

Some vending facility operations are very complex and require large capital investments, cash flow, and/or expertise that most Vendors do not enjoy. Cafeterias are the best example, especially military troop dining contracts. Other examples may be utilizing a branded concept such as Subway or placing some vending machines on full-service. The Agency may require the use of a teaming partner or allow a Vendor to utilize a teaming partner upon request. The Vendor shall be allowed to select a teaming partner with the approval of the Agency unless the teaming arrangement is already in place when the Vendor is assigned to the facility.

If a teaming partner is required for a cafeteria operation or full-service vending, the Agency shall provide the Vendor with a list of potential teaming partners it has approved. If a branded concept is contemplated, the Agency and Vendor will work collaboratively to select a franchisee.

32 Miss. Admin. Code Pt. 3, R. 14.2 Criteria for a Military Dining Teaming Partner

A. The Teaming Agreement

In approving a teaming partner, the Agency must ensure that the following criteria are met:

1. The teaming partner has experience in successfully managing the type of services to be operated with the Vendor. 2. The teaming partner has demonstrated that they have the financial resources to support the operation including cash flow to pay employees while waiting on payment from the government. 3. The agreement between the Vendor and teaming partner shall be based on profit sharing with the Vendor receiving a minimum of 51% of the profit from the operation. A guaranteed draw is permissible as long as it can be documented that the guarantee represents at least 51% of the profit.

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4. The agreement between the Vendor and teaming partner must show the training that will be provided to the Vendor by the teaming partner. The Vendor is required to be trained in all aspects of the operation.

B. Engagement of the Vendor

The Vendor must be engaged in the day-to-day operations of the business and an active participant in all major decisions. Such engagement necessitates that the Blind Vendor be on-site a minimum of twice per month and more if the demands and/or complexity of the contract require it. Being engaged includes but is not limited to:

1. Participate in the hiring of all management personnel. 2. Attend regular meetings with the military including monthly and quarterly meetings. 3. Track all inspection and deficiency reports and assure they are remedied. 4. Track financials including all expenditures, especially labor.

However, even when working remotely, the Blind Vendor must remain engaged in the day-to-day management of the contract. This includes decisions on hiring and firing key personnel

C. Approval

The Agency must approve the teaming partner agreement based upon the above criteria. In approving a teaming agreement, the Agency may agree that a teaming partner may remain, even if the current Blind Vendor leaves the facility, until the current contract is up. The Agency will not approve a teaming agreement that makes commitments beyond the current contract with the government. If a new Blind Vendor assumes responsibility for a military dining contract, they shall remain with the current teaming partner under the terms of the existing teaming agreement. However, the Blind Vendor may make a change at the time the contract renews provided the selection of the new teaming partner is done in accordance with these policies.

In the event a teaming partner fails to provide a satisfactory level of support, the Blind Vendor may change teaming partners with the approval of the Agency provided they do so in accordance with the teaming agreement.

32 Miss. Admin. Code Pt. 3, R. 14.3 Full-Service Vending

A. When Allowable

As noted earlier, another type of teaming arrangement is a full-service vending agreement. In these types of arrangements, the teaming partner provides the vending equipment as well as the merchandise inventory and pays a commission to the Blind Vendor. Generally, the vending teaming partner is only responsible for a portion of the

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vending facility operation. An example might be a Vendor who is managing a cafeteria may choose to utilize a teaming partner to service the vending machines. Another example might be a Vendor who services their own vending machines at their anchor facility but chooses to use a full-service company for a satellite facility several miles away. A third example might be a Vendor who contracts with one of the major drink bottlers to service drink machines while the Vendor services all other vending machines.

B. Engagement of the Vendor

In this type of teaming arrangement, the Blind Vendor is engaged in the day-to-day oversight of the vending machines and is still responsible for ensuring a quality service. Being engaged includes but is not limited to:

1. Determine products to be sold. 2. Establish pricing of all products. 3. Inspect machines to ensure they are adequately filled with products and pricing as agreed to by the Vendor. 4. Ensure that stickers are affixed to machines identifying the Vendor as the contact for complaints and/or machine malfunctions. 5. Make regular contact with property management to ascertain satisfaction with service. 6. Track financials, including sales, to ensure appropriate commissions are being paid.

In order to ensure such engagement, the Blind Vendor must visit each site at least twice per month to confirm the level and quality of service is satisfactory. The Blind Vendor shall communicate with property management to ensure their satisfaction with the service. The Vendor earns a percentage of the sales in the way of a commission. Any such full-service arrangements may be approved by the Director if it is a good business decision for both the Agency and the Vendor and the teaming partner can provide quality service. In determining that full-service is a good business decision, the commissions generated for the Blind Vendor must be comparable (not necessarily equal) to profits generated by machines filled by Blind Vendors and/or their employees. In determining whether income is comparable, the commission rate should be at least equal to the standards established in Section 5.2. The Agency may grant an exception if it has been documented that the maximum profit that can be generated by a vending facility is less than the standard established in Section 5.2. Still, the commission must be comparable to what a Vendor could make filling the machines themselves. In approving such arrangements, the Director shall ensure that the Vendor is engaged in the business as defined herein. Under no circumstances will a Vendor be allowed to place an entire vending facility on full-service and simply draw a check.

C. Any Vendor with all of their machines on full-service at the time these rules are implemented shall be grandfathered in and may continue with full-service. However,

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the grandfathering provision does not negate the responsibilities of the Vendor to be engaged in the day-to-day operations as outlined above in this section.

D. The Agreement

The Agency must approve the teaming partner agreement for full-service vending. In doing so, the Agency shall ensure that: 1. The teaming partner has experience in successfully managing vending accounts of the type to be operated with the Vendor. 2. The teaming partner has demonstrated that they have the financial resources to support the operation. 3. The agreement between the Vendor and teaming partner ensures that the Blind Vendor receives a competitive commission based upon net sales and that such commission is comparable to what a Vendor would earn if they serviced the machines. In making this determination, the Agency shall consider the performance standards outlined in Section 5.2 of this Manual. 4. The agreement must ensure that the Vendor is engaged in the day-to-day operations of the business and an active participant in all major decisions. Such engagement necessitates that the Blind Vendor be on-site a minimum of twice per month and more if the demands and/or complexity of the contract require it. When on-site, the Blind Vendor shall inspect all vending machines to ensure the machines are adequately stocked and quality products are being vended. The agreement shall specify that the Blind Vendor is responsible for pricing of products. However, even when working remotely, the Blind Vendor must remain engaged in the day-to-day management of the contract. The agreement shall clearly describe the duties of the Blind Vendor

32 Miss. Admin. Code Pt. 3, R. 14.4 Branded Concepts

In those facilities where a Vendor utilizes a teaming partner to offer a branded concept such as Subway®, the Vendor must provide oversight to the branded operation to ensure compliance with Program requirements. It is not the intent of this section to establish a branded operation that constitutes the Vendor’s entire vending facility. The Vendor is still expected to service a portion of their facility such as the vending machines or over-the-counter operation. The Vendor and SLA will jointly make decisions on allowing a branded franchise to operate as part of the vending facility and negotiate a competitive commission. There may be situations where a Vendor bids into a facility with a branded concept already there. In such instances, the Vendor is obligated to continue to work with that partner for the remainder of any contract period.

There may be an opportunity for a Blind Vendor to actually operate a franchise. The Agency will review any request for a franchise and will consider its feasibility as it would with any vending

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facility opportunity. If accepted, the Agency shall provide the same types of supports as it would for any facility.

32 Miss. Admin. Code Pt. 3, R. 14.5 Failure to Be Engaged

As has been noted, it is the expectation that the Blind Vendor is in charge and involved in the day- to-day decision-making at their facilities even when utilizing a teaming partner. Although the Blind Vendor relies on the support of a teaming partner, it is the Blind Vendor who owns the business and it is the Blind Vendor who will be held accountable to the Agency for poor performance. This is why it is critically important for the Blind Vendor to be engaged in the day- to-day management of the contract. The Agency may ask the Blind Vendor to document site visits and will provide the format for such documentation.

A teaming partner arrangement is not a way to effectively semi retire while maintaining a source of income. Under no circumstances will a Blind Vendor be allowed to sit at home and simply draw a check. Doing so reflects negatively on the Program and blind people in general. If a Blind Vendor is unable to perform the essential functions of the job and be on-site and be involved in the day-to-day management of the contract, the Blind Vendor must relinquish the facility. No individual will be discriminated against based upon mental or physical disabilities and this section has no application to utilizing alternative techniques to perform the essential functions of the job.

SECTION 15 CONTINUING EDUCATION / UPWARD MOBILITY

32 Miss. Admin. Code Pt. 3, R. 15.1 General

Licensed Blind Vendors already participating in Business Enterprises of Mississippi and operating facilities or are on the Certified for Placement List will be required to obtain additional training for the purpose of maintaining their licenses and eligibility to bid on vacant vending facilities. The intent is to set the expectation for Licensees to update skills, to gain new skills to assist them in qualifying for higher level facilities, and to improve and refresh their current knowledge and skills.

Each Licensee will be required to accrue twelve (12) training credits over a two-year period. For purposes here, a year is a calendar year. This requirement is effective the calendar year following the implementation of the new rules and Policy Manual.

Training credits may be obtained in the following ways:

i. Mississippi BEM annual training conference = 4 Points ii. Special training offered by the Agency on topics of importance = 2 Points iii. National conferences sponsored by blind Randolph-Sheppard consumer groups (i.e., BLAST which is sponsored by the National Association of Blind Merchants) = 4 Points iv. National conferences sponsored by national trade organizations (i.e., National Automated Merchandising Association, National Restaurant Association, etc.) = 4 Points v. Lighthouse for the Blind on-line training modules approved by the Director = 2 Points vi. Other on-line training courses approved by the Director = 2 Points

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vii. Director approved on-line webinars = 1 Point viii. Business related college courses = 8 Points ix. Serve Safe or other nationally recognized training for certification or recertification = 2 Points x. Food shows sponsored by suppliers = 2 Points xi. Leadership training sponsored by a vending / food service organization or national blind consumer group = 4 Points xii. Other training as approved by the Agency after active participation by the Committee of Blind Vendors – Point Value to be Determined

If a Blind Licensee or individual on the Certified for Placement List fails to achieve the required points over the two-year period, the Director shall notify the individual in December and so advise them. In the case of a Licensed Blind Vendor, their license shall be placed in probationary status. The letter, which shall be provided in an accessible format, will afford the Licensed Blind Vendor or individual on the Certified for Placement List an extra three months (March 31 st ) in order to meet the requirements. If a Blind Licensee or individual on the Certified for Placement List fails to meet the minimum training requirements, the license for a Licensed Blind Vendor to manage a vending facility will be terminated. For individuals on the Certified for Placement List, their names will be removed from the list, and they will no longer be eligible to compete for vending facility assignments.

It is incumbent upon the Agency to offer sufficient training or provide financial assistance that will enable the Vendor to fulfill these requirements to stay abreast of the vending and food industry. The Blind Vendor must provide documentation to their Business Enterprise Consultant of any outside training.

The Director may grant an exception to the training requirement if a Vendor experiences a documented extended illness of six (6) months or longer that prevents them from participating in training.

The Director may also grant an exception to the training requirement if a Vendor, who has requested Agency-sponsored travel and accommodations to attend a national conference (see v. and vi., above), is denied their request for Agency sponsorship due to Agency budgetary constraints or other limitations placed on the Agency. To be eligible for this exception, the Vendor must make a written request for Agency-sponsorship to attend the national convention in question at least sixty (60) days prior to the conference’s commencement date, and said request must be denied by the Agency. This exception may be granted only one time per vendor, per two (2) year period, and shall only except up to four (4) training credits per two (2) year period. For example, a Vendor who has obtained 8 training credits during a 2-year time frame and is granted this exception shall be in compliance with the training credit requirements. Conversely, a Vendor who has obtained 4 training credits during a 2-year time frame and is granted this exception is still short 4 training credits and shall be subject to the consequences as outlined above. An exception will only be made if the Vendor has received four (4) training credits for attending at least one BEM annual vendor training conference during the 2-year period.

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SECTION 16 GUIDELINES FOR LOCATION OF A VENDING FACILITY

It is imperative that new vending facilities be established in order to maintain an adequate number of opportunities for blind individuals. One of the duties of the BEM Consultant is to secure new vending facilities with the support of the Director and Regional Manager.

32 Miss. Admin. Code Pt. 3, R. 16.1 Marketing / Facility Survey and Employers Contact Report

The primary method of securing new facilities is to make contact with private sector businesses and governmental agencies. Data from these contacts is recorded on the Employer Contact Report, BEM-1. The emphasis on employer contacts is quality, not quantity. The Agency, with the active participation of the Committee, may establish expectations for the number of contacts by the Consultants.

The Consultant should keep in mind the location criteria guidelines (See Section 16.2) when selecting a contact. If a contact suggests interest in allowing the Agency to establish a vending facility, the BEM Consultant is expected to make follow-up contacts with the prospective host facility. The BEM Consultant should follow-up leads for new vending facilities as quickly as possible even though the required number of contacts may already have been made for the month. All Employer Contact Reports (Form BEM-1) are completed with an original and one (1) copy. The original will be sent to the Director, and one copy will be retained by BEM Consultant. Results of these contacts shall be shared with the Committee at a regularly scheduled meeting. 16.2 Location Criteria Guidelines

A. Each proposed vending facility location will be subjected to a comprehensive survey to determine that a vending facility established would meet the requirements for economic success to a Vendor and thus will contribute to the maximum development of economic opportunities for the blind and will provide for the most productive utilization of program assets. The selection of a vending facility will be made upon the basis of an evaluation of the criteria listed below which have been disclosed and recorded as a result of a comprehensive survey of that particular location. The results of the survey will be recorded on Marketing Facility Survey Form (BEM-2). B. If the results of the survey suggest a new vending facility has the potential to generate a net profit to the Vendor of at least the average per capita income for Mississippi, its establishment as a stand-alone facility is encouraged in most instances. The Agency may make exceptions to this requirement if agreed to by the Committee of Blind Vendors.

C. When establishing a vending facility in a commercial development or business area in the community, traffic count must be evaluated in order to determine the viability of the business opportunity. This location should be considered based on similar competitive enterprises.

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D. In order that a reasonable return on the investment of a new vending facility is obtained, the availability of the location must be ensured, through a lease, permit or agreement.

E. Whenever possible, the location for a new vending facility should be obtained at no cost to the Vendor; however, it is understood that a commission may be required when establishing certain facilities especially in the private sector. Where it is necessary to pay a commission, such commission may be a flat rate or percentage of gross sales (minus sales tax). Commissions or rent payments should not be so high as to make the facility unprofitable. Any commission or rent made a part of a concessionaire agreement or permit is a cost of doing business and will have to be paid by the Blind Vendor operating the facility. On federal locations, no rent is required, but there may be a utility charge.

F. In the event the criteria of A-E above are not met, it does not preclude the Agency from establishing a facility and adding it to another Vendor’s vending facility either temporarily or permanently.

SECTION 17 ESTABLISHING A NEW VENDING FACILITY

Planning and coordination are essential to the establishment of a new vending facility. Communication between the BEM Director and the BEM Consultant will ensure the successful preparation of the vending facility. It is recommended that a timetable of implementation be drawn up by the BEM Consultant, and that the BEM Director and BEM Consultant monitor installation to ensure timely services to future Vendors. 17.1 Initial Start-up of New Vending Facilities

The BEM Director and Regional Manager will be available to consult in all areas of establishment. In order to establish a new vending facility, the following must be accomplished, although not necessarily in this order:

1. Consultant conducts a survey to ascertain potential sales based upon the population and any historical data available; 2. The Consultant documents the results of the survey on Marketing Facility Survey Form (BEM- 2); 3. If the survey results look promising, the Director will project a budget for the project and submit to the OVRB Director for approval; 4. If approved, the Consultant and Director or Regional Manager shall negotiate a permit/agreement with property management and submit to the Director of OVRB for approval; 5. The Director will design the vending facility or have it designed, including the layout of all equipment and placement of electrical outlets and plumbing; 6. The Consultant shall obtain all necessary licenses and/or permits;

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7. The Director shall solicit bids as required by state purchasing requirements for necessary equipment with assistance from the Regional Manager of Business Enterprises of Mississippi or other staff, if necessary; 8. The Consultant shall set up equipment and make arrangements for plumbing and electrical connections to accommodate the new equipment; 9. The Agency shall assign a Vendor in accordance with the policies contained in this Manual; 10. The Consultant shall arrange for sufficient quantity of initial stock and supplies and other allowable supports to ensure the vending facility can operate as a viable, ongoing concern. Such supports can only be provided for the first 6 months after the individual assumes operation of a facility. If the chosen Vendor is a VR client, they will coordinate with the Vocational Rehabilitation Counselor (VRC) to pay or submit a request to use BEM funds as permissible; 11. If the Vendor is a VR client, the Consultant shall work with the VRC on any other services that may be available and that would benefit the Vendor in their business provided that such services do not extend beyond the first 6 months of operation; 12. The Agency shall ensure that the vending facility complies with state and local fire and health codes; and, 13. Orient the Vendor to the new vending facility and assist them with any problems which may arise.

32 Miss. Admin. Code Pt. 3, R. 17.2 Vendor Secured Locations

It is the intent of Business Enterprises of Mississippi to support Blind Vendors who want to expand their businesses and have the initiative to do the legwork to secure sites in the private sector. This policy is predicated upon the belief that the best salespeople for the Business Enterprises are the Blind Vendors themselves. It is also based upon a commitment to enable blind individuals to maximize their vocational potential.

A. Market Research

The Blind Vendor who wishes to expand their business enterprises may research potential sites where BEM may place equipment. The Blind Vendor shall make the initial contact with the potential building host and present the idea of allowing the SLA to provide the vending / foodservice in the building. It is the responsibility of the Blind Vendor to be professional at all times when promoting the opportunity for BEM. No commitments can be made by the Blind Vendor on behalf of BEM.

B. Business Plan

If a potential customer expresses a strong interest or willingness to allow the SLA to establish a vending facility on the property, the Blind Vendor shall immediately contact their Business Consultant to advise them of the potential opportunity. The Blind

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Vendor shall then submit a business plan to the Business Consultant that includes estimated cost of equipment, projected sales and profits, and a brief operational plan.

C. Agreement

After consulting with the Regional Manager, if the business plan is approved, arrangements will be made for the Consultant to make an on-site visit to meet with the property contact. The Consultant will prepare and present a permit agreement to the property contact. After an agreement has been reached, the permit agreement shall be fully executed and the SLA will do its due diligence to secure the needed equipment for the site and have it delivered in accordance with any timeline that has been established. Section 17.1 above applies to such establishments.

D. Equipment and Inventory

It will be the responsibility of the Agency to provide the needed equipment and sufficient stock so that the Vendor can commence with the business.

E. Commissions

It is understood that in order to compete for business within the private sector, the Vendor may be required to pay a commission to the property. Such commission payment shall be deducted as a cost of doing business on the financial reports filed by the Blind Vendor with the SLA.

F. Attachment

The newly acquired site shall be added on to the Blind Vendor’s current vending facility. It will remain attached to that facility even if the Vendor leaves unless it is agreed to by the Agency and Committee. If a Vendor retires or is removed from the Business Enterprise Program for whatever reason, the Director, with the active participation of the Committee of Blind Vendors, shall determine what to do with the facility. They may determine to leave it with the vending facility and bid it out or they may elect to attach it to another vending facility.

The Vendor shall be required to report all sales and profits and pay set aside if applicable.

G. Performance

If the Blind Vendor fails to provide satisfactory service, the property contact may request to have the Vendor removed. If the Agency receives such a request, the Blind Vendor may be removed if the Agency’s investigation determines the Blind Vendor’s performance was in fact unsatisfactory or property management advises BEM that it intends to terminate the agreement unless a change is made.

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H. Reporting

It is the responsibility of the Blind Vendor to report all sales, expenses, etc. the same as for any vending facility. For purposes of the sales report which must be filed with the SLA, figures for the newly acquired satellite site may be reported with sales from the main facility; however, the Vendor is required to keep separate records for inspection by the Business Consultant at any time.

I. Limitations on Applicability

This policy is applicable only to properties not covered by any state or federal priority enjoyed by the SLA.

J. Businesses Outside of Business Enterprises of Mississippi

Nothing in this Policy Manual shall be construed to limit a Blind Vendor’s ability to secure businesses outside of BEM. If a Blind Vendor chooses to expand their business into the private sector and is willing and able to purchase the needed equipment, there is no obligation to bring the new opportunity to the SLA. However, the Vendor must ensure that no outside business ventures interfere with, or in any way affect, their responsibilities to manage the BEM vending facility. The Blind Vendor shall keep separate records and not intermingle monies, product, etc. from the BEM facility and the outside business.

SECTION 18 POLICY FOR CLOSING VENDING FACILITIES

The Agency, with the active participation of the Committee, may choose to close a vending facility under certain circumstances. Examples of reasons for closure of a vending facility may include but are not limited to the following: 1. Failure of the vending facility to provide economic success to a Vendor; 2. The building that houses the vending facility closes; 3. There is a significant reduction in the number of tenants in a building making the business no longer profitable; 4. A building manager on private property requests the closure and terminates the agreement, etc.

32 Miss. Admin. Code Pt. 3, R. 18.1 Consideration for Closure

A. After the establishment of the vending facility, the Agency will continue to assess the operation to determine if it meets the criteria for economic success to the Vendor. If sales and other reports show that the operation is failing to meet the requirements, the Business Consultant, with assistance from the Director and/or Regional Manager, may recommend to the Director of OVRB to close the vending facility or attach it to another

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vending facility. The Director of OVRB shall make the final decision after allowing the active participation of the Committee. Under no circumstances will a Vendor be displaced in order to achieve the purpose of this section unless they are in agreement. B. Vendors whose vending facilities are closed are eligible to be placed on transfer status pursuant to Section 10.5(A) and have their name placed on the Certified for Placement List. The displaced Vendor may also reapply for vocational rehabilitation services. The Business Consultant should inform the Vendor of this right. The Consultant is encouraged to inform the District Counselor of the Vendor's situation if the Vendor so chooses. C. When a Vendor retires, is transferred, or leaves a particular operation for any other reason, the State Licensing Agency will purchase any increase above the stock originally provided pursuant to the conditions outlined in Section 20.6 of this Manual.

SECTION 19 RENOVATION OF VENDING FACILITIES

The Business Enterprises of Mississippi will maintain the vending facility in good repair and attractive condition and replace worn out or obsolete equipment as necessary. A renovation of a vending facility may be necessary if the facility is worn-out, there are safety issues, or the nature of the facility changes (e.g., converting a café to a micromarket). The extent to which set aside and/or federal dollars can be used to pay for the costs of such renovations will be guided by Technical Assistance Circular 24-06. If there is a requirement for an exhaust fan and hood, the Agency may provide the fan and hood if it is a state asset and can be removed if BEM vacates the premises, but the installation of all ductwork and roof cuts should be provided by the host facility. The Agency will only use BEM resources to renovate vending facilities to the extent that such renovations are necessary to prepare the space for new equipment. Renovations and equipment costs will be evaluated for cost effectiveness and the availability of funds.

SECTION 20 MERCHANDISE

It is the policy of the Business Enterprises of Mississippi to sell only such products as can be sold profitably on a competitive basis. 20.1 Quality Control

Such products which are sold must be of a quality equal to that of similar products on the market. All food must be fresh. The Blind Vendor should order only a quantity which can be sold before the merchandise becomes stale or spoiled. The quality of consumable merchandise must meet health codes and any applicable regulations within that particular locale. The Vendor is required to rotate stock and dispose of outdated merchandise. Spoilage may be accounted for at wholesale prices in the miscellaneous expense column of the Record of Sales and Expenditures Form. Note: A Vendor may not expense spoiled items for which they receive credit from wholesalers or which they use for their personal benefit.

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32 Miss. Admin. Code Pt. 3, R. 20.2 Display of Merchandise

Products which are for sale should be displayed in an attractive manner. Merchandise which is out-of-date should be removed from display and replaced. The display of articles for sale should be orderly.

32 Miss. Admin. Code Pt. 3, R. 20.3 Typical Variety of Merchandise

The products to be sold are generally outlined in the permit and also specified in the bid announcements. A typical inventory for vending or a market might include soft drinks, milk, bottled waters, juices, coffee, energy drinks, chips, candies, nuts, crackers, gum, sandwiches, fruit, snack foods, ice cream, snack and meal replacement bars, magazines, newspapers, etc. Additionally, in some facilities, over-the-counter medications such as Aspirin, cough drops, and stomach aids may be offered for sale as well as tissues, postal accessories, etc. Snack bars and cafeterias may sell the items listed above but will also offer hot foods and salads. This list is provided for illustration purposes only and is not intended to limit the products to be sold in a vending facility.

The variety of products will differ from vending facility to vending facility as each Vendor will cater to the demands of their customers. Likewise, the size of the vending facility will also determine the variety and quantity of the products.

32 Miss. Admin. Code Pt. 3, R. 20.4 Selling Prices

Pricing for products is the responsibility of the Blind Vendor. However, pricing for merchandise in the vending facility should be comparable to prices for similar merchandise in similar or competing businesses. Pricing that is out of line, either too high or too low, can have an adverse impact on their business’ bottom line. If it is brought to the attention of the Business Consultant that a price may be out of line, the Consultant and Vendor will conduct a market basket analysis comparing the Vendor’s prices to those at 2 convenience stores in close proximity. The Vendor’s prices should not be more than 10% higher than the average as determined by the market basket analysis. Likewise, if prices are less than 90% of the average as compared to the market basket analysis, the Consultant shall discuss with the Blind Vendor and the two will jointly decide the appropriate selling price.

32 Miss. Admin. Code Pt. 3, R. 20.5 Initial Stock

The SLA will assume full responsibility for providing each Blind Vendor with suitable equipment and adequate initial stock and supplies. This policy is congruent with federal regulations found at 34 C.F.R. 395.3(a)(5).

Initial inventory is purchased by the SLA in an amount determined by the SLA to be sufficient to give the Blind Vendor a good start in business. In general, this amount shall be equal to up to 3 weeks of projected sales. For example, if a vending facility is projected to generate sales of

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approximately $3,000 per week, the facility will be eligible for $9,000 in inventory. Extenuating circumstances may require more or less merchandise. Additional inventory may be added if necessary during the initial 6-month establishment period. The Vendor is responsible for this amount as long as they remain in the Program and is expected to carry this amount with them to future assignments. The initial inventory will be purchased by the Vocational Rehabilitation Counselor if the Vendor has an open VR case. The VR Counselor can assist with other start-up costs for the first six months of operation as reasonable, necessary, and allowable. The VR Counselor shall provide Blind Vendors with sufficient stock to begin operation so that no blind individual is denied the opportunity of entering the Randolph-Sheppard Program or getting a new assignment because they lack resources to purchase initial stock.

If a Vendor does not have an open VR case, the Business Consultant shall ensure stock is provided at the above levels.

The right, title to, and interest in the stock-in-trade provided by the VR Counselor is vested in the Vendor. The right, title to, and interest in the stock-in-trade of any inventory provided by the SLA over and above the amount provided by the VR Counselor is vested with the SLA. Upon assuming the operation of a vending facility, the Blind Vendor is given the use of the initial stock of inventory and is given an accounting of the fair wholesale value of this stock.

32 Miss. Admin. Code Pt. 3, R. 20.6 Inventory of Merchandise

Upon termination of the Vendor's agreement, the SLA conducts an inventory of the stock in trade and compares it with the initial inventory provided the Blind Vendor by the VR Counselor and/or BEM. If the fair wholesale value of the merchandise exceeds the initial cost, the surplus will be paid by the SLA to the Vendor if so desired by the Vendor. The Blind Vendor may take stock with them to their next vending facility assignment or sell it to the Agency to be assigned to the incoming Vendor or under some circumstances sell it directly to the incoming Vendor. In determining the fair wholesale value of the closing inventory, the BEM Consultant shall utilize receipts provided by the outgoing Vendor. If the outgoing Vendor cannot or does not provide receipts within 5 days of the inventory, the Consultant will utilize pricing provided by suppliers of the SLA’s choosing.

As a practical matter, the process is as follows:

• Vendor A is given $9,000 in initial inventory for their initial assignment by their VR Counselor. • They stay at a facility for 3 years and get promoted into another facility. The Vendor is expected to take the $9,000 with them to their new assignment. • If the new assignment requires $12,000, the Agency shall provide the additional $3,000 and the Vendor will be expected to take the full $12,000 to their next assignment. • If a Vendor resigns or retires, the Vendor is expected to have on hand $12,000 in inventory but has $14,000. The Agency will pay them for the amount of the inventory on hand, minus any amounts provided by BEM which in this example was $3,000. Therefore, in this scenario, the Agency would pay the outgoing Vendor $11,000 ($14,000 on hand minus $3,000 in stock provided by BEM). In other words, the Vendor is responsible to the Agency

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for any of the assigned amount over and above the original amount provided by the VR Counselor.

If the initial inventory was not provided by a VR Counselor, the Vendor will be expected to have on hand an amount equal to the initial inventory assigned to them.

The SLA determines what constitutes the stock-in-trade of a vending facility (i.e., the quality, quantity and type of merchandise that is to be considered and inventoried as the stock in trade of a particular vending facility). This is done to ensure that the SLA does not purchase stock that is damaged, out-of-date, or is inappropriate for sale in the facility. Under no circumstances will an incoming Vendor be asked to accept product that cannot reasonably be expected to sell. The extent to which merchandise is appropriate shall be determined by the SLA.

The Consultant shall complete the extension of the pricing of the merchandise and submit the completed inventory sheets to the Regional Manager within thirty (30) calendar days of taking the inventory. State Office staff shall complete calculations and the inventory letter to both the outgoing and incoming Blind Vendors involved no later than sixty (60) calendar days after taking the physical inventory. If, because of extenuating circumstances, the inventory cannot be completed and sent to the Vendors within sixty (60) days, both Vendors should be notified of the delay.

The final profit and loss statement will be adjusted for overages and shortages of inventory in order to comply with generally accepted accounting principles.

SECTION 21 VENDING FACILITY EQUIPMENT

Ownership of all equipment in the Business Enterprises Program will be vested in the State of Mississippi. Any equipment purchased or leased by the Vendor requires prior approval by the Consultant before placing it in the vending facility. When a Vendor leaves a vending facility, the SLA will have the first right of refusal to buy at fair market value any equipment purchased for use in the facility.

32 Miss. Admin. Code Pt. 3, R. 21.1 Purchase of Equipment

All purchases must be justified by the Consultant in writing.

A. Bid Requirements for Purchases

Items that are not covered by any state contract may be purchased on the open market in accordance with state purchasing regulations. See Miss. Code Ann. § 31-7-13.

1. Purchases Not in Excess of $5,000.

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An agency may purchase items costing less than $5,000 without receiving any written quotes: however, it is suggested that the Agency contact at least two companies to get verbal quotes.

2. Purchases of More Than $5,000 but Not More Than $75,000.

The Agency is required to solicit and obtain at least two competitive written quotes. The quotes should be dated and must be signed by a company official.

3. Purchases Over $75,000

The Agency is required to advertise for two weeks and shall solicit written competitive bids.

B. Contract Purchases

1. Negotiated (Multiple Source) Contracts

These are contracts that are established on the basis of negotiation as opposed to competitive bidding. The term "multiple source" refers to the fact that such contracts are in effect with more than one Vendor, offering a similar commodity line. These contracts may be established on the basis of Department of Finance & Administration (DFA) pricing and for a period that coincides with the DFA contract period. These contracts do not specify any volume and none is either guaranteed, written or implied. This type of agreement is sometimes referred to as a brand name contract.

2. Competitive Contracts

These are contracts that are established on the basis of written specifications and sealed competitive bids. These contracts may or may not specify a quantity. However, these are sole source contracts either statewide or by locality and state agencies must purchase that commodity from that supplier at the specified price unless exempt by special provisions. Such contracts may either be a state contract established by the Office of Purchasing and Travel or a contract established by individual state agencies and approved by the Office of Purchasing and Travel.

C. Purchases Not Requiring Competitive Bids

State law does not require bids for the following:

1. Contracts for professional service where no purchases of commodities are involved, utilities, freight or transportation of goods, commodities for resale, equipment repair. Note: Electrical, paint, construction and plumbing work, if it is over $75,000 and contains commodities as well as labor, requires bids.

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2. When the commodity or service costing over $5,000.00 is available from only one source, and competitive quotations or comparative prices cannot be obtained, the Director should explain this in writing when submitting a requisition for a purchase order.

3. When an emergency exists and a purchase needs to be made quickly, the Business Consultant should immediately call to request that the purchase be affected. They shall contact the BEM State Office with a sufficiently detailed description of the emergency so the purchasing agent of MDRS Finance can determine if the described situation meets the legal definition of an emergency. A requisition will have to be submitted for the emergency purchase.

D. Purchase of Replacement Equipment When contemplating purchasing replacement equipment, the following factors shall be used by the SLA staff to determine the disposition of equipment: 1. The number of previous repairs to this particular piece of equipment; 2. Age of the item; 3. The item’s life expectancy; 4. The estimated salvage value, if any; 5. Repair cost vs. replacement cost; and,

32 Miss. Admin. Code Pt. 3, R. 21.2 Transfer of Equipment

The transfer of equipment will be handled on a statewide basis with the process being initiated by the Vendor, Business Consultant, or Maintenance Tech. A written notice of the transfer of equipment will be provided by the Warehouse Tech for the Consultant’s files. 21.3 Storage of Equipment

Surplus equipment shall be stored in the BEM Warehouse. The Agency may utilize storage units as an extension of the BEM Warehouse. The equipment inventory compiled by BEM shall reflect the location of the equipment as the BEM Warehouse. Unused equipment will not be stored in existing vending facilities. Equipment in a vending facility will be kept on the current inventory of the location where it is located.

32 Miss. Admin. Code Pt. 3, R. 21.4 Salvage of Equipment Parts

In some instances, equipment may be salvageable for parts. This is especially true of vending machines. Vending machines may have component parts such as coin changers, motors, etc., which are still in good condition and can be used to repair other equipment. After the useful parts

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are taken off the equipment, the remainder may be discarded only after the equipment is taken off inventory.

32 Miss. Admin. Code Pt. 3, R. 21.5 Transmittal Procedure for Disposal

In order to dispose of a piece of equipment by discarding it or donating it to another state agency, it is essential that the item be removed from the agency inventory. The following steps must be taken:

1. Form PSR-961, Property Salvage Report, listing all equipment to be taken off inventory, is completed by the MDRS staff. 2. The form is then reviewed and signed by the appropriate state agency officials. 3. Once the appropriate forms have been signed, the equipment shall be removed from inventory, and the BEM staff may dispose of the item in any manner it sees fit, as long as the equipment is not sold. 21.6 Telecommunication Equipment Telecommunication equipment includes such items as reading and writing systems, talking calculators, computers, etc. When contemplating such purchases, the Agency shall ensure that a Vendor undergoes an assistive technology evaluation. This evaluation may be waived if the equipment is not of a technical nature such as a talking calculator and the Vendor has proven their ability to operate the equipment. The equipment should be returned to the SLA in the event the facility closes and/or the Vendor leaves the program. 21.7 Repair of Equipment

When there is a need for repairs in a vending facility, the Vendor calls the Business Enterprises Office directly to expedite the process. Except for refrigeration, repairs will be performed by the BEM Repair Tech(s) or arranged through a private repair service. All refrigeration repairs will be outsourced to experts in that field.

32 Miss. Admin. Code Pt. 3, R. 21.8 Transmittal Procedure for Repairs

A. When a request for repair is made, the BEM State Office or Consultant will authorize the repair, if appropriate. B. The repair will be assigned to a Maintenance Tech who shall perform the necessary repairs and complete the BEM Repair Form. Copies of the BEM Repair Form shall be sent to the Business Consultant. When the Consultant receives the Repair Form for repair work, they will initial the invoice, copy, and make notes of any information concerning the repair that they feel needs to be brought to the attention of the Vendor or State Office. C. The Consultant will then forward a copy of the BEM Repair Form to the State Office.

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D. Copies of BEM Repair Forms shall be retained by the Consultant. E. From time to time, it may be necessary to outsource a repair. An example would be refrigeration equipment. The BEM State Office will determine the appropriate company to perform such repairs.

SECTION 22 REPORTS

In addition to BEM reports, there are numerous reports required of Vendors by the federal and state government. The Vendor is responsible for filing these government reports and the SLA shall ensure that all Vendors are trained on the requirements concerning these reports. In order for the Business Enterprise Program to function properly, communication through the following reports by and to Vendors is essential.

32 Miss. Admin. Code Pt. 3, R. 22.1 Reports by the Vendor to BEM

A. Record of Sales and Expenditures In order to accurately assess the income from sales and to accurately prepare required U.S. Department of Education reporting, it is necessary to track financial activity of all vending facilities. The Vendor is required to report such financial activity monthly to the Agency in the format required. The report shall include all sales, purchases and expenses so that the net proceeds of each facility can be determined. This report shall include a record of gross sales, other income not taxable (newspapers, etc.), taxes collected and paid, cost of goods sold, all costs associated with personnel, miscellaneous expenses (each expense must be itemized e.g., spoilage, etc.). Each report should be complete and should always contain the Vendor's name, facility name, and the dates to indicate the month in question. Copies of all purchase invoices, invoices for all expense items (e.g., pest control, contract cleaning invoices, etc.), and payroll documentation must be maintained by the Vendor and made available to the Agency for inspection so that the accuracy of the reports can be verified. In order to accomplish this, the Business Enterprises Consultant shall conduct a semi-annual review and randomly review documentation for one month. If no issues are identified, the review is complete. If discrepancies are noted, additional months may be reviewed. The Blind Vendor will be required to file amended reports if errors are noted. B. For each person employed, the Vendor must include Social Security number, name, gross wages, FICA tax withheld, Federal tax withheld, state tax withheld and net wages. This information is on the lower portion of the Monthly Sales and Expenditure report D. Wages paid to spouses and other family members are permissible provided: 1. The Vendor does all withholdings and treats the family member as any other employee; and,

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2. The wages paid are commensurate with what other employees in the same type of job would earn.

32 Miss. Admin. Code Pt. 3, R. 22.2 BEM Reports to Vendors

A. After the close of each month's business, a work sheet entitled "Monthly Summary of Facility Operations" is sent to each Vendor. This worksheet details all income and expenses affecting business and summarizes the amount the Vendor owes the Business Enterprise Program. B. Every Vendor is provided a monthly Profit and Loss Sheet to assist the Vendor in controlling various factors affecting the profitability of their vending facility. The Profit and Loss Sheet also has a "Year to Date" column which gives the Vendor a management tool to use when evaluating the performance of various aspects of their business. C. On a quarterly basis, a statement of expenses and revenues is sent out to all the Vendors. This report contains all the financial data relating to the Business Enterprise Program for the period involving the three (3) preceding months. The amount of total expenses and the actual cash balance plus other important data are contained in this report. All questions or requests for assistance in interpretations of this report should be directed to the SLA.

SECTION 23 FACILITY OBSERVATION REPORT & QUARTERLY SITE REPORT

The Consultant is responsible for providing management services to all vending facilities. In so doing, they must, establish written documentation of all important factors affecting vending facilities under their supervision. The Consultant uses the BEM Observation Report and Quarterly Site Report as tools to ensure that quality services are being provided to customers and that profits to the Vendor are being maximized to the extent practicable. Additional narrative reports may be generated as needed. To the extent practicable, the Consultant should schedule in advance facility visits with the Blind Vendor and provide at least forty-eight (48) hours notice. If a Blind Vendor fails to show at the agreed upon time, the Consultant may continue with the site visit and note the absence of the Blind Vendor and reason on the report.

32 Miss. Admin. Code Pt. 3, R. 23.1 Observation Report

A. Purpose of Visit

The Consultant should have a definite purpose in mind when planning the visit and should be thoroughly acquainted with all of the pertinent facts and information prior to the contact. B. Timing

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An important factor to consider in visiting Vendors is timing. Visits should be scheduled at times that will not interfere with rush hours and ample time should be allowed in order to hold a worthwhile meeting.

C. Report Observations

The BEM Facility Observation Report contains a checklist for evaluation by the BEM Consultant of on-going areas of concern if there are any. The BEM Consultant will explain in the remarks section in sufficient detail the nature of the problems and the proposed solution of all areas evaluated as “poor”. The remarks section may be used to record anything the BEM Consultant feels should be recorded. The Vendor is not required to sign the Observation Report; however, a copy shall be sent to the Vendor in an accessible format and the Vendor will have an opportunity to respond and that response will be added to the form.

D. Frequency of Report

The BEM Observation Report is expected be completed each month for each vending facility. If no visit was made during the month, the report should still be made indicating that no visit was made and the reason(s). One Observation Report form may be used to record multiple visits during the month.

32 Miss. Admin. Code Pt. 3, R. 23.2 Quarterly Site Visit Report

A. Purpose of Visit

The purpose of the quarterly site visit report is to conduct a more formal inspection of the vending facility and to do a more in-depth analysis of the business operation.

B. Timing

The intent is that the Consultant will complete 2 monthly Observation Reports and complete a Quarterly Site Report in the third month of the quarter. Like with Observation Reports, visits should be scheduled at times that will not interfere with the business. However, this does not preclude the Consultant from being at the facility during rush hours to observe the business operation. Ample time should be allowed for the Consultant and Vendor to discuss any findings.

C. Quarterly Site Report

This report will incorporate results of a physical inspection, a financial analysis of the business, and feedback from property management if any. It shall also include any unresolved deficiencies noted on the Observation Reports for that reporting period. The report shall be given to the Vendor in an accessible format and the Vendor will be required to sign it. Signing does not necessarily indicate agreement with the report.

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The Vendor may add their comments to the report and those comments will be included on the report.

D. Frequency of Report

The Quarterly Site Visit Report is expected to be completed once during each quarter of a calendar year. If no visit was made during the quarter, the report should still be made indicating that no visit was made and the reason(s). One Observation Report form may be used to record multiple visits during the month.

E. Areas for Periodic Consideration

When a vending facility is underperforming, the following are areas which the BEM Consultant may want to consider when evaluating the situation. These areas by no means constitute all areas which need evaluation and the Consultant must be mindful that each vending facility and Vendor are unique. What pertains to one location may not be applicable to another.

The following questions may be addressed in the remarks section of the Observation Report on those facilities with consistent problems.

1. Are there factors related to the customer base such as employees being moved out of the building and/or downsizing that are potentially affecting sales? 2. Is the type of service (i.e., snack bar, vending, micromarket, etc.) still appropriate for this particular location? 3. Does the facility have the necessary equipment that will enable the Vendor to be successful? 4. Is pricing consistent with the general area or are they too low, which is keeping sales figures low and lowering gross profit percentages? 5. Is the staffing level appropriate to maximize profits while still ensuring an efficient operation? 6. Is the quality of the food meeting the needs of the customers? 7. Is the facility being maintained in a clean and attractive condition so as to entice customers? 8. Is Vendor interaction with customers impacting sales and/or profits? 9. Is there training that may better enable the Vendor to be more successful? 10. What can be done to improve the efficiency of the operation?

SECTION 24 DUE PROCESS PROCEDURES

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Any Blind Licensee dissatisfied with any agency action arising from the operation or administration of the vending facility program shall be provided the right to due process. There are 3 levels of due process available to Blind Licensees in Mississippi - administrative review, full evidentiary hearing, and federal arbitration. A Blind Licensee must submit their request for due process in writing no later than fifteen (15) business days from the occurrence of the Agency action with which they are dissatisfied or being advised of such action. A Licensee may require additional information prior to filing a due process request. The Licensee may preserve their right to due process prior to filing a request by notifying the Agency of the need for more information, provided that such notice is given within fifteen (15) business days of the occurrence of the Agency action. Under such circumstances, the Licensee must file a formal request for due process within thirty (30) days of the original notice or within fifteen (15) days of being provided the additional information requested from the Agency, whichever is longer.

32 Miss. Admin. Code Pt. 3, R. 24.1 Administrative Review Procedure

A. The purpose of an administrative review is to provide an informal procedure through which the Agency provides a Blind Licensee or their representative an opportunity to express and seek remedy for their dissatisfactions with any agency action arising from the operation or administration of the vending facility program. Such efforts should not, however, discourage or interfere with Licensees exercising their rights to pursue the formal full evidentiary hearing process. The administrative review is an optional step and is at the discretion of the Blind Licensee. B. The Blind Licensee or their designee (who may or may not be a member of the State Committee of Blind Vendors) may request in writing, within fifteen (15) business days of the occurrence of the Agency action, an administrative review of the action arising out of the operation or administration of the vending facility program. A Blind Licensee may require additional information prior to filing an administrative review request. The Licensee may preserve their right to due process prior to filing an administrative review request by notifying the Agency of the need for more information, provided that such notice is given within fifteen (15) business days of the occurrence of the Agency action. Under such circumstances, the Licensee must file a formal request for an administrative review within thirty (30) days of the original notice or within fifteen (15) days of being provided the additional information requested from the Agency, whichever is longer. The review will be conducted only by a member or members of the MDRS staff who has not in any way participated in the Agency action in question. C. The administrative review shall be held at a time and place convenient to the Blind Licensee requesting such review. The administrative review shall be held during regular Agency working hours, at a district or local office location. It is expected that an administrative review will be conducted within fifteen (15) business days of receipt by the Agency of such written request. D. The Blind Licensee will be reimbursed for any travel expenses associated with an administrative review in accordance with State of Mississippi travel regulations.

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Reader or other communication services, if needed, shall be arranged for the Blind Licensee by the State Licensing Agency. E. Documentation of written requests for administrative review and actions and decisions resulting therefrom shall be maintained as part of the official record of the administrative review process. F. When an informal administrative review does not resolve a dispute to the satisfaction of a Blind Licensee, such Blind Licensee may request a full evidentiary hearing. 24.2 Full Evidentiary Hearings

A. When a Blind Licensee is dissatisfied with any State Licensing Agency action arising from the operation or administration of the vending facility program, such Blind Licensee may request a full evidentiary hearing. The request must be in writing and be within fifteen (15) days of the decision in an administrative review, or within fifteen (15) days of the occurrence of any Agency action with which the Blind Licensee is dissatisfied if they choose to bypass the administrative review. A Blind Licensee may require additional information prior to filing a full evidentiary hearing request. The Licensee may preserve their right to due process prior to filing a full evidentiary hearing request by notifying the Agency of the need for more information, provided that such notice is given within fifteen (15) business days of the occurrence of the Agency action. Under such circumstances, the Licensee must file a formal request for a full evidentiary hearing within thirty (30) days of the original notice or within fifteen (15) days of being provided the additional information requested from the Agency, whichever is longer. Such request for a full evidentiary hearing shall identify one or more disputed issues to be resolved in an evidentiary hearing.

B. Blind Licensees shall be informed in writing of their right to and the procedures to be followed in obtaining a full evidentiary hearing at the time they are licensed. C. A Blind Licensee must request a full evidentiary hearing in writing. This request must be transmitted to the Executive Director of MDRS. It may be transmitted personally, by certified mail, return receipt requested, or email. This request may be transmitted through the State Committee of Blind Vendors. D. A Blind Licensee is entitled to legal counsel or other representation that does not have to be an attorney in a full evidentiary hearing. The Licensee shall be responsible for paying for their own representation. E. Reader service or other communication services required by the Blind Licensee shall be arranged for and paid by the SLA, should the Licensee so request. Transportation costs and per diem shall be provided also to the Blind Licensee during the pendency of the evidentiary hearing, if the location of the hearing is in a city other than the legal residence of the Blind Vendor.

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F. The hearing shall be held at a time and place convenient and accessible to the Blind Licensee. A hearing shall be held during the regular Agency working hours at a time and place convenient to the Blind Licensee. The hearing shall be scheduled by the State Licensing Agency within fifteen (15) working days of its receipt of such a request, unless the State Licensing Agency and Blind Licensee mutually agree, in writing, to some other period of time. The Blind Licensee shall be notified in writing of the time and place fixed for the hearing and of their right to be represented by legal or other counsel. The Blind Licensee shall be provided a copy of the hearing procedures and other relevant information necessary to enable them to prepare their case for the hearing. G. The presiding officer at the hearing shall be an impartial and qualified official who has no involvement either with the Agency action which is at issue in the hearing or with the administration or operation of the Randolph-Sheppard Vending Facility Program. They may be a staff member, official of another state agency, a state agency hearing officer, or an outside person qualified to act as a hearing officer. H. The presiding officer shall conduct a full evidentiary hearing, avoid delay, maintain order and make sufficient record of the proceedings for a full and true disclosure of the facts and issues. To accomplish these ends, the presiding officer shall have all powers authorized by law and make all procedural and evidentiary rulings necessary for the conduct of the hearing. The hearing shall be open to the public unless the presiding officer, for good cause shown, otherwise determines. I. Both the Blind Licensee and the State Licensing Agency are entitled to discovery and to present their case by oral or documentary evidence, to submit rebuttal evidence, and to conduct such examination and cross-examination of witnesses as may be required for a full and true disclosure of all facts bearing on the issues. J. All papers and documents introduced into evidence at the hearing shall be filed with the presiding officer and provided to the other party. All such documents and other evidence submitted shall be open to examination by the parties and opportunities shall be given to refute facts and arguments advanced on either side of the issues. K. A transcript shall be made of the oral evidence and shall be made available to the parties. The State Licensing Agency shall pay all transcript costs and shall provide the Blind Vendor with at least one copy of the transcript in an accessible format. L. The transcript of testimony, exhibits, and all papers and documents filed in the hearing shall constitute the exclusive record for decision. M. The decision of the presiding officer shall set forth the principal issues and relevant facts adduced at the hearing, and the applicable provisions in law, regulation, and Agency policy. It shall contain findings of fact and conclusions with respect to each of the issues, and the reasons and basis therefore. The decision shall also set forth any remedial action necessary to resolve the issues in dispute. The decision shall be made within fifteen (15) working days after the receipt of the official transcript. The decision

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shall be mailed promptly to the Blind Vendor and the State Licensing Agency. The SLA shall promptly forward a copy of any such decision to the Committee of Blind Vendors. 24.3 Federal Arbitration Pursuant to 34 C.F.R. 395.13(a), any Blind Vendor dissatisfied with any action or decision arising out or decision rendered in an evidentiary hearing may file a complaint with the Secretary of Education. Pursuant to 34 C.F.R. 395.13(c), the Secretary shall convene an ad hoc panel to conduct a hearing and render a decision which shall be final and binding on the parties except that such decisions are subject to appeal and review as a final agency action.

SECTION 25 CONFIDENTIALITY

The Business Enterprises of Mississippi shares business and logistical information only as it is operationally required. As an eligibility program, it is considered common knowledge and is openly shared that participants are legally blind, along with meeting all other eligibility requirements. The Agency may also share the name and location of facilities managed by a Vendor as well as the Vendor’s business contact information. Any personal information, including earnings, will be treated as confidential information and not released.

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Attachment A AGREEMENT FOR OPERATION OF A VENDING FACILITY UNDER RANDOLPH- SHEPPARD ACT BETWEEN THE OFFICE OF VOCATIONAL REHABILITATION FOR THE BLIND DEPARTMENT OF REHABILITATION SERVICES BUSINESS ENTERPRISES of MISSISSIPPI, STATE LICENSING AGENCY AND __________________________ A BLIND ENTREPRENEUR THIS AGREEMENT entered into this ___ day of ____________, ______, by and between the MISSISSIPPI VOCATIONAL REHABILITATION FOR THE BLIND, State Licensing Agency (hereinafter SLA), and __________________, a Blind Entrepreneur or Trainee under the Randolph-Sheppard Program, (hereinafter, Entrepreneur), WITNESSETH: WHEREAS, the SLA has been granted a permit or contract by ___________________________________, for the operation of a vending facility by a licensed blind entrepreneur under the Randolph-Sheppard Program on the ___ Federal Property or ___ Non-Federal Property located at ______________________________, a copy of which permit or contract is attached hereto and made a part hereof; and, WHEREAS, the SLA has offered the Entrepreneur the opportunity to operate the vending facility under the terms and conditions hereinafter set forth as a ____ Temporary ____ Permanent Assignment; and, WHEREAS, __________________ is qualified by law to be an Entrepreneur by virtue of having been declared legally blind as a result of information reported by a licensed practitioner of eye care, and having completed other eligibility requirements for participation in the Program; and, WHEREAS, the Entrepreneur has agreed to undertake the operation of the vending facility under the terms and conditions hereinafter set forth; and, WHEREAS, the parties do not intend to derogate in any way from responsibilities and rights imposed and granted by applicable federal, state, or local laws or regulations by this agreement.

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NOW, THEREFORE, in consideration of the premises, it is mutually agreed as follows: 1. The SLA will: 1. Equip the vending facility for carrying out the business authorized by the permit or contract as necessary. 2. Furnish initial stocks of merchandise sufficient to enable the entrepreneur to commence operating the business authorized by the permit or contract. The SLA will also furnish the Entrepreneur with a complete listing of all equipment and initial stocks. 3. Maintain the equipment at the vending facility in good repair, and will replace obsolete and worn out equipment as necessary. 4. Assign a Business Consultant and shall provide management services to ensure adequate oversight and supervision to all vending facilities pursuant to 34 C.F.R. 395.3(11)(ii). 5. Afford the Entrepreneur with an opportunity for upward mobility / continuing education training. 6. Comply at all times with the Randolph-Sheppard Act, its implementing regulations, the Business Enterprises of Mississippi Rules, and Policy Manual. 7. Ensure that the Rules and Business Enterprises of Mississippi Policy Manual are implemented fairly and uniformly. 8. Provide written materials to the Entrepreneur in an accessible format. 9. Afford any blind Licensee who is dissatisfied with any Agency action arising from the operation and administration of the vending facility program with an opportunity for an evidentiary hearing. 2. The ENTREPRENEUR will: 1. Be engaged in and responsible for the day-to-day business of the vending facility and shall not enter into a teaming arrangement or subcontract without written approval of the SLA; 2. Abide by all requirements of the Business Enterprises of Mississippi Rules and Regulations and Policy Manual; 3. Carry on the business of the vending facility in compliance with the terms and conditions of the permit or contract; 4. Comply with applicable health laws / regulations and laws / regulations of other governmental entities with jurisdiction over the operation of this business; 5. Be responsible for having the vending facility open for business on the days and during the hours specified in the permit or contract; 6. Be accountable to the SLA for the proceeds of the business of the vending facility, and handle the proceeds, including payments to suppliers and deposits of funds, in accordance with instructions from the SLA. 7. Maintain a neat business-like appearance while working at the vending facility, and manage the facility in an orderly, business-like manner. 8. Take proper care of the equipment of the vending facility, and make alterations or changes therein only with written approval of the SLA. 9. Notify the SLA a reasonable time in advance of taking any voluntary leave from the vending facility, and as soon as possible with respect to any involuntary leave.

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10. Ensure there is sufficient staff to maintain the efficient operation of the vending facility if the Entrepreneur is absent due to illness, vacation, or otherwise. The salary of any additional staff required, or that of other emergency help, shall be paid by the Entrepreneur and reported as a business expense on the monthly report. 11. Keep such records and make such reports as the SLA shall require. 12. Agree to enter their vending facility at their own risk. The responsibility for injury they may receive and all related expenses will be assumed by the Entrepreneur. C. GENERAL 1. The SLA and Entrepreneur will not discriminate on the basis of sex, age, physical or mental impairment, creed, race, color, national origin, or political affiliation and will comply with all applicable federal and state laws related to discrimination. 2. The Entrepreneur is self-employed and nothing in this Agreement shall be construed as to constitute an employer / employee relationship nor is the Entrepreneur forbidden from securing other vending business that is outside the scope of the Business Enterprises of Mississippi and this Agreement; 3. The SLA and Entrepreneur will at all times abide by the BEM Code of Conduct. 4. The business to be carried on at the vending facility will be limited to that specified and authorized in the permit or contract. 5. The right, title, and interest in and to the equipment of the vending facility, the stock in trade, and funds on hand are vested in the SLA, and will be left at the vending facility or turned over to the SLA on the termination of this Agreement for any reason by either of the parties. In such an event, the SLA will conduct an inventory to determine the wholesale value of stock in trade, cash on hand, and presence of the equipment. This will be compared with the inventory done at the time the entrepreneur took the facility. If the fair wholesale value of merchandise exceeds the initial cost, the surplus will be paid to the Entrepreneur, their heirs, or assignees. Should it be less, the deficit will be due and payable to the SLA at the completion of the inventory. 6. The monthly income of the Entrepreneur shall be the net profits of the business of the vending facility for the period in question, less the funds, which must be set aside. 7. The business and premises of the vending facility shall be covered by public liability insurance, Workers Compensation Insurance and any such other insurance required by permit or law. The cost of such insurance shall be a cost of operating the business of the vending facility and taken into account as such in determining the net proceeds of the business. 8. This Agreement may be terminated at any time by the Entrepreneur by providing thirty (30) days written notice. It shall be automatically terminated upon the revocation or termination of the permit or contract. Additionally, the Agreement may be terminated by the SLA if the business of the vending facility is not conducted in accordance with this Agreement, or with applicable federal, state, or local laws and regulations or the BEM Policy Manual. The Agency shall provide thirty (30) days advance notice of terminating this Agreement for cause and shall first afford the Vendor an opportunity for an evidentiary hearing.

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I certify that the foregoing document has been read to me and that I understand and agree with its contents. I also understand the provisions of the permit or contract, the SLA rules and regulations, and the BEM Policy Manual. I understand that I have the right to an administrative review of any state agency action with which I am dissatisfied. If such review does not resolve the matter to my satisfaction or I elect to forgo an administrative review, I can request a full evidentiary hearing. Any such requests on the Entrepreneur's part shall be made in writing addressed to the SLA, within fifteen (15) days of notice of the Agency action.

____________________________________________ ___________________ Business Enterprise of Mississippi Blind Entrepreneur Date

____________________________________________ ___________________ Business Enterprise of Mississippi Consultant Date

____________________________________________ ___________________ Witness Date

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Attachment B

Business Enterprises of Mississippi Business Code of Conduct

As a Licensed Blind Vendor, Trainee, or SLA staff member, I understand my obligation to conduct all aspects of my responsibilities with honesty and integrity and to always present a positive image of the Business Enterprises of Mississippi and to promote the abilities of blind people in general. Signing this Business Code of Conduct is my commitment to conduct myself in a manner that reflects positively on me as a person and on BEM as a Program.

I AGREE TO:

 Deal honestly with all customers, employees, suppliers, property management officials, SLA staff, and anyone else with whom I have contact in my capacity with Business Enterprises of Mississippi;

 Treat with dignity, fairness, and respect customers, employees, suppliers, property management officials, SLA staff, and others with whom I have contact in my capacity with BEM;

 Create a safe workplace free of sexual harassment or any manner of sexual misconduct;

 Create an environment that is not considered by employees or others to be a hostile environment and is free of bullying and harassment of any kind;

 Acknowledge and embrace historical, cultural, and social diversity and promote full participation while refraining from demeaning, derogatory, or discriminatory language;

 Do not discriminate in any facet of the BEM based upon sex, age, religion, race, color, creed, national origin, political affiliation, or disability and ensure compliance with all federal and state laws related to discrimination.

 Respect the privacy and confidentiality of others as required by law, regulation, and/or Agency policy;

 Take no action to bring the reputation or image of the Business Enterprises of Mississippi, its staff, or Blind Vendors into disrepute;

 Act responsibly when posting on social media and refrain from using profanity and posting pictures or other content not suitable for children or that may be considered to be offensive by others;

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 Comply with all federal, state, and local laws as well as governmental rules and regulations that have application to BEM, including all requirements contained in this Policy Manual;

 Do my part in my capacity with BEM to ensure a focus on providing quality products and/or excellent customer service;

 When applicable, maintain accurate records and documentation, use sound accounting and bookkeeping practices, and report accurately operational activities and pay all fees as required in a timely manner.

_______________________________ PRINT NAME

_______________________________ _________________________ SIGNATURE DATE

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Chapter 2 Program Rules

32 Miss. Admin. Code Pt. 3, R. 10.1 General Responsibilities

The responsibilities of the Blind Vendor are generally as follows:

1. Shall ensure that the vending facility is operated in accordance with BEM rules, Business Enterprises Policy Manual, the terms of the permit or contract, the terms of the operating agreement, and all other applicable state and federal laws and regulations; 2. Shall be responsible for the day-to-day management of the vending facility including hiring adequate staff, training staff, establishing menus, purchasing product, pricing products, cleaning the facility, ensuring quality customer service, resolving problems, and other duties associated with owning and operating a business. It is understood that some contracts such as military dining eliminate some of these requirements such as menu planning and purchasing product. All Vendors are required to be on-site at their facilities at least twice per month. 3. Responsible for having the Vending Facility open for business on the days and during the hours specified in the permit. 4. Shall maintain at all times adequate stock to meet the demands of the business. 5. Ensure that products are competitively priced as compared to other businesses in the general area. 6. Will be accountable to the SLA for the proceeds of the business of the vending facility and will handle the proceeds, including payments to suppliers, in accordance with instructions from the SLA. 7. Will meet or exceed all standards of performance developed jointly by the SLA and State Committee of Blind Vendors and contained in the Business Enterprises Policy Manual. 8. Will achieve at least the minimal number of continuing education credits as required by the Business Enterprises Policy Manual. 9. Will carry on the business of the vending facility in compliance with applicable health laws and regulations and ensure proper sanitization while maintaining the facility in an attractive condition. 10. Will maintain a neat businesslike appearance and will conduct the facility in an orderly, businesslike manner. 11. Will take proper care of the equipment of the vending facility, and will make alterations or changes therein only with written approval of the SLA. 12. Will notify the SLA a reasonable time in advance of any voluntary extended absences from the vending facility, and as soon as possible with respect to any involuntary extended absences. 13. Will ensure the continuous operation of the vending facility as may be necessitated due to the Vendor's absence because of illness, vacation or otherwise. 14. Will keep such records and make such reports as the SLA shall require with the assurance that all required reports are in an accessible format. 15. If a set aside fee is being assessed, the Blind Vendor shall remit the amount due within timeframes outlined in the Business Enterprises Policy Manual.

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16. Agrees to enter the facility at their own risk. The responsibility for any injury received and all related expenses will be assumed by the Vendor 17. Will strive at all times to maintain a positive working relationship with management and customers of the location wherein their business resides. 18. Shall not discriminate against any individual based upon sex, age, religion, race, color, creed, national origin, political affiliation, or disability and shall comply with all federal and state anti-discrimination laws. 19. Shall be committed at all times to the highest standards of ethical conduct in the performance of their obligations to customers, suppliers, property management, the SLA, and others with whom they have contact.

32 Miss. Admin. Code Pt. 3, R. 10.2 Detail on Responsibilities of the Blind Vendor

More detail on the responsibilities of the Vendor may be included in the Business Enterprises Policy Manual.

Section 11. USE OF TEAMING PARTNERS

Some vending facilities may require the use of a third-party teaming partner in order to meet the obligations of a permit/contract. The criteria that potential teaming partners must meet and the role of the Blind Vendor shall be outlined in the Business Enterprises Policy Manual.

Section 12. UNASSIGNED INCOME

32 Miss. Admin. Code Pt. 3, R. 12.1 Federal Unassigned Income

Federal unassigned income which accrues to the SLA pursuant to 34 C.F.R. 395.32 shall be used in accordance with 34 C.F.R. 395.8.

32 Miss. Admin. Code Pt. 3, R. 12.2 Non-Federal Unassigned Income

In the event funds accrue to the SLA from unassigned vending machines on non-federal property, such income is to be placed into an account to be used for the benefit of the Vendors by the Business Enterprises of Mississippi. Funds collected shall be treated the same as set aside funds unless the U.S. Department of Education provides guidance to the contrary. The Committee shall receive quarterly reports which state the amount of the vending machine income accrued over the time period covered by the report.

Section 13. COMMITTEE OF BLIND VENDORS

32 Miss. Admin. Code Pt. 3, R. 13.1 Rule 13.1

General The State Committee of Blind Vendors is a body of Blind Vendors who are elected by their peers

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to represent the interests of all Blind Licensees in the State. The Agency shall provide for a biennial election of the Committee of Blind Vendors. The Committee's members are chosen as far as practicable on the basis of geography and vending facility type (i.e., federal or other property). All blind licensees are eligible to vote in any election. Only a Blind Vendor actively assigned to a vending facility may serve on the Committee. The Committee shall develop a set of by-laws which will govern the activities of the group. Said by-laws must be approved by a majority vote of all Blind Licensees. 13.2 Functions of the State Committee of Blind Vendors

Pursuant to 34 C.F.R. 395.14, the State Committee of Blind Vendors shall:

F. Actively participate with the State Licensing Agency in any major administrative decisions and policy program development decisions affecting the overall administration of the State's vending facility program; G. Receive and transmit to the State Licensing Agency grievances at the request of blind licensees and serve as advocates for such Vendors in connection with such grievances; H. Actively participate with the State Licensing Agency in the development and administration of a state system for the transfer and promotion of Blind Vendors; I. Actively participate with the State Licensing Agency in the development of training and retraining programs for the Blind Vendors; and J. Sponsor, with the assistance of the State Licensing Agency, meetings and instructional conferences for Blind Vendors within the state.

Section 14. DUE PROCESS

32 Miss. Admin. Code Pt. 3, R. 14.1 Right to Appeal

Any Blind Licensee dissatisfied with any Agency action arising from the operation or administration of the vending facility program shall be provided the right to due process. A Blind Licensee must submit their request for due process in writing, no later than fifteen (15) business days from the occurrence of the action with which they are dissatisfied or the date they were advised of such action. A Licensee may require additional information prior to filing a due process request. The Licensee may preserve their right to due process prior to filing a request by notifying the Agency of the need for more information, provided that such notice is given within fifteen (15) business days of the occurrence of the Agency action. Under such circumstances, the Licensee must file a formal request for due process within thirty (30) days of the original notice or within fifteen (15) days of being provided the additional information requested from the Agency, whichever is longer.

A Licensee may have an attorney or another individual represent them during due process proceedings. Details on the process for such appeals shall be outlined in the Business Enterprises Policy Manual.

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There are three (3) levels of due process available to Blind Licensees in Mississippi.

32 Miss. Admin. Code Pt. 3, R. 14.2 Administrative Review

An administrative review provides an optional, informal mechanism through which the Agency provides a Blind Licensee or their representative an opportunity to express and seek remedy for their dissatisfactions with any Agency action arising from the operation or administration of the vending facility program. The review will be conducted by a member or members of the MDRS staff who have not in any way participated in the Agency action in question. A Blind Licensee may forgo an Administrative Review and go directly to a Full Evidentiary Hearing.

32 Miss. Admin. Code Pt. 3, R. 14.3 Full Evidentiary Hearing

Any Blind Licensee dissatisfied with any Agency action arising from the operation or administration of the vending facility program shall be provided the right to an Evidentiary Hearing. This is a more formal process for resolving grievances. The presiding officer at the hearing shall be an impartial and qualified official who has no involvement either with the State Agency action which is at issue in the hearing or with the administration or operation of the Randolph-Sheppard Vending Facility Program. They may be a staff member or official of another state agency, a state agency hearing officer, or private individual qualified by virtue of their education or experience and training to conduct such hearings. 14.4 Federal Arbitration

Pursuant to 34 C.F.R. 395.13(a), any Blind Vendor dissatisfied with any action or decision rendered in an evidentiary hearing, may file a complaint with the Secretary of Education. Pursuant to 34 C.F.R. 395.13(c), the Secretary shall convene an ad hoc panel to conduct a hearing and render a decision which shall be final and binding on the parties except that such decisions are subject to appeal and review as a final agency action.

Section 15. CONFIDENTIALITY

32 Miss. Admin. Code Pt. 3, R. 15.1 Vendor Personal and Financial Information

The Business Enterprises of Mississippi shares business and logistical information only as it is operationally required. As an eligibility program, it is considered common knowledge and is openly shared that participants are legally blind, along with meeting all other eligibility requirements. The Agency may also share the name and location of facilities managed by a Vendor as well as the Vendor’s business contact information. Any personal information, including earnings, will be treated as confidential information and not released.

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Part 4 AbilityWorks

32 Miss. Admin. Code Pt. 4 AbilityWorks

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Title 32: Rehabilitation Services Part 4: AbilityWorks Subpart 2: Client Handbook

Client Handbook

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MISSION STATEMENT

It is the mission of AbilityWorks, Inc. of Mississippi to provide an appropriate and timely program of comprehensive rehabilitation services for people with disabilities that will result in improved quality of life and employment opportunities.

AbilityWorks, Inc. is just one of many special programs operated under the Office of Vocational Rehabilitation, a division of Mississippi Department of Rehabilitation Services, to meet the needs of eligible individuals with disabilities. AbilityWorks is a work training program for individuals with disabilities and is NOT A JOB!

GOAL OF ABILITYWORKS

AbilityWorks, Inc. is a special program to help people with disabilities/problems. Here are the kinds of help that are available:

• Assessment (vocational evaluation) – the purpose of assessment is to find out if you can work, and if so, what kind of jobs you like and can do. It will also help determine what you need to go to work and how to maintain employment. This is accomplished by providing counseling, testing, and observation of you while on a job(s). • Work Adjustment – the purpose of work adjustment is to focus on what areas that you need to perform better in to maintain employment. Some areas of focus are usually work speed, dress, work quality, attendance, etc. This is accomplished by providing counseling, group/individual class participation, and real work scenarios on or off site. • Job Placement – the purpose of job placement is to help you locate an area business that offers jobs that interest you and that you can also perform and how to apply. This is accomplished by teaching you how to properly fill out a job application, how to interview for a job as well as how to keep a job.

During the Assessment and Work Adjustment phases, your Evaluator will help you determine what your needs are, what kind of services should be provided, and will write out a service plan to assist you in meeting your individual needs. You will need to work hard to accomplish the goals that have been set.

The service plan will explain which services are needed, how much time is anticipated to accomplish the goal(s), as well as who is responsible for providing those services.

AbilityWorks, Inc. contracts with local industries and small businesses to produce goods/services. By doing this, we can provide you with real work to complete. All services provided by AbilityWorks are time limited and the type of service provided is based upon your individual needs.

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STAFF QUALIFICATIONS

All AbilityWorks, Inc. staff members meet the job requirements of AbilityWorks, Inc., the Human Resources Department of the Mississippi Department of Rehabilitation Services, and the Mississippi State Personnel Board.

Staff members receive additional training in the following areas:

• Working with individuals with disabilities • Cultural diversity • Sexual harassment • Managing individuals with violent and aggressive behaviors • CPR (including defibrillator operation) • First Aid • Blood Borne Pathogens/Infectious Diseases • Fire Suppression • Defensive Driving • Proper Lifting Techniques • Forklift Driving/Safety

NON-DISCRIMINATION

AbilityWorks, Inc. and Vocational Rehabilitation does not discriminate based on race, color, age, sex, religion, disability or national origin in providing services.

MISSISSIPPI CLIENT ASSISTANCE PROGRAM

This is a program within the Mississippi Coalition for Citizens with Disabilities to help clients of Vocational Rehabilitation if they have problems getting services for which they are eligible. Any person needing help of this kind may contact the Mississippi Client Assistance Program (MS CAP), 2 Old River Place, Suite M, Jackson, MS 39202-3435, or telephone 601-969-0601, or toll free at 1-800-721-7255.

DRUG FREE WORK-PLACE POLICY

It is AbilityWorks, Inc. and the Office of Vocational Rehabilitation policy to provide a drug-free work environment for our clients as mandated by the Drug-Free Workplace Act of 1988. You must agree not to unlawfully make, possess, use, hand out, buy, sell, or be under the influence of illegal drugs or controlled substances. The unlawful presence of illegal drugs or controlled substance in the workplace jeopardizes your health and safety, as well as the health and safety of

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other employees, our customers and/or members of the public. Clients in violation of this policy will be removed and/or terminated from program participation.

FRATERNIZATION AND SEXUAL HARASSMENT

All AbilityWorks, Inc. clients, non-clients, and state employees expect a workplace free from fraternization and sexual harassment. Fraternization consists of romantic relationships between peers and/or supervisors which are discouraged to maintain professional behavior while on premises. Sexual harassment may consist of requests for sexual favors, unwelcome sexual advances, threats, actual bodily contact, or other deliberate verbal or physical conduct of a sexual nature. This behavior is also unacceptable at AbilityWorks, Inc.

Reporting any incidents of fraternization and/or sexual harassment should be directed to your immediate supervisor or to the AbilityWorks Facility Manager.

Charges of sexual harassment against you will result in your case being terminated from AbilityWorks, Inc. and you may face legal prosecution. Should you file a charge of sexual harassment you will not face any financial, other exploitation, or any retaliation.

VISITOR POLICY

You may have a visitor during breaks and lunchtime on occasion. Visitors are not allowed in the workshop. They are to report to the front office of AbilityWorks, Inc. and you will be notified to come to the front lobby.

CELL PHONE POLICY

You are not allowed to leave your workstation to make or receive phone calls during working hours. If you receive an emergency call, the staff will notify you. Cell phones are to remain off and kept in your pocket or purse during work hours. You may use your cell phone during breaks and lunch periods only. AbilityWorks is not responsible for lost, stolen or damaged cell phones.

SAFETY

It is our intent to provide a safe and healthy work environment for our clients. A few basic common-sense rules of safety on the job are:

1. Observe safety procedures, particularly those regarding operating equipment.
2. Know how to do your assigned tasks properly and safely. Do not try to do work you are not qualified to do. If you have any questions or need more training, ask for assistance before proceeding.

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3. Always pay attention to your work and do not allow yourself to be distracted. Accidents can happen quickly when you are not concentrating on your task(s).
4. Never operate equipment or perform tasks other than those assigned.
5. Watch for unsafe conditions. Please report defective equipment, hazardous chemicals, wet floors, and other unsafe conditions to your instructor.
6. If you are injured, notify your instructor immediately.
7. Always wear the personal protective equipment that is required to do your tasks safely.

AbilityWorks has an active safety program that includes emergency drills. Drills are held to prepare you and staff members on what to do in an emergency. Please do what your instructor tells you during all drills. The staff at AbilityWorks have been trained in first aid. You should report all accidents/injuries to your instructor as soon as it happens. If you are injured, first aid will be given and if needed, you will be sent to a local hospital for further treatment. You must follow all safety rules in using equipment and in performing work.

Safety rules will be posted in the work areas.

PAYROLL PRACTICES

As part of your program, you will perform real work on subcontracts provided by local industries. Your pay will be based on productivity and calculated on the prevailing wage paid by local industry for similar types of work along with a guarantee of earning the federal minimum wage per hour, at least.

Standard deductions are made from your check for Federal and State taxes based on completed tax forms. Child support, garnishments, and/or court order deductions will be made from your payroll check if those orders are received.

The payroll period for AbilityWorks is for two weeks. The payroll period begins at 12:01 a.m. on Wednesday and ends two weeks later at midnight on Tuesday. Payroll checks are issued every two weeks on Friday at the end of the day. If you work over forty (40) hours in the workweek you will receive overtime pay calculated at one and one-half times the federal minimum wage.

FRINGE BENEFITS

AbilityWorks provides Workers’ Compensation on all clients. If you are hurt while at AbilityWorks, you should tell your instructor as soon as it happens so that you can be provided with medical help and Workers’ Compensation reports can be completed and submitted. The federal government sets fringe benefits for clients working on federal contracts.

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UNEMPLOYMENT COMPENSATION

Clients of AbilityWorks are NOT eligible for unemployment compensation coverage under Mississippi Law.

GENERAL RULES

All clients of the facility are expected to observe the following rules:

1. Daily attendance (Monday-Friday). If you cannot be present, call the main office telephone number provided before 8:00 a.m. and advise staff of the reason for your absence. A statement from your doctor is required for the absences due to sickness.

• When you are absent due to illness for three consecutive workdays, you must have your physician complete a release form with any limitations and forward it to the workshop before returning.

• You are to notify your instructor and your evaluator of any appointments you may have (medical, housing, school, assistance, etc.) at least a day ahead of time. Documentation of the appointment could be required.

DAILY SCHEDULE*: (Monday – Friday)

__________________ Start of workday - Punch your timecard and report to instructor for job assignment. __________________ 15-minute morning break __________________ 30-minute lunch break __________________ Clean work area and prepare to leave __________________ Punch your timecard and depart from facility

• Each AW location independently sets its work hours, typically between the hours of 8:00 AM to 5:00 PM

2. Return to your workstation promptly after all breaks.

3. Food and drinks are allowed only in the break areas during break periods.

4. Use of tobacco products (cigarettes, vapes, etc.) is only permitted in the designated areas.

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5. No artificial noisemakers are allowed in the workshop (i.e. radios, headsets, I-pods, Bluetooth devices, etc.) We strongly discourage these from being brought to the facility and will not be responsible if lost or stolen.

6. Personal phone calls are not allowed except during break times. Cell phones must be off when on the work floor.

7. Cleanliness is a MUST. Clients are to bathe and wear clean clothes each day they report to the facility. Remember: appearance on the job is important.

8. AbilityWorks does not store or give out medicine of any kind. You are responsible for keeping up with and taking your medicine in the right way.

9. Clients should wear clothing appropriate for a work setting.

• No baggy pants or loose-fitting clothing • No pants that hang below the waistline exposing underwear or causing significant sagging. Pants must be worn at the proper level with a belt if necessary • Clothing displaying underwear or clothing that could be considered too revealing will not be tolerated • No tank top/muscle shirts/or halter tops • No open toe shoes or house shoes • No hair rollers or bonnets • No excessive long jewelry or necklaces • No tops revealing your abdomen • No miniskirts or short shorts (shorts should come to top of knees or below)

If you report for work wearing any of the above listed clothing items, you will be sent home

10. No horseplay or abusive language is allowed in the facility or in facility vehicles.

11. Clients should not leave their assigned workstations without staff approval. See your instructor in this event.

12. Do not operate machines unless instructed. Report to your instructor immediately upon completion of assigned tasks to get your next assignment.

You may be dismissed from the facility if the following rules are not obeyed:

1. No weapons, alcoholic beverages, or illegal drugs will be tolerated.
2. Obey all instructions and safety rules and operate machinery exactly as instructed by staff (use safety glasses, earplugs, etc. as needed.)
3. No violence or threat of violence directed at the staff or other clients will be tolerated.
4. No falsification of production information in any way.

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5. Theft or damage to the property of others.
6. If you ride the van to AbilityWorks, you must ride the van home and not with someone else, unless permission has been granted.
7. No client is permitted to leave facility property on foot.

DISCIPLINARY PROCEDURE

If you are given a warning for not following any of the general workshop rules, and no improvements are observed, the following disciplinary measures will be taken for subsequent offenses:

• First Offense – Counseling and Guidance (to include a 30-minute time out if necessary) • Second Offense - Written Contract • Third Offense - Suspension for up to three (3) working days. • Fourth Offense – Termination

Restrictive measures (e.g., suspension) are used only when counseling and other remedial measures have failed. The only restrictive procedure allowed prior to termination is suspension not to exceed three (3) working days for severe behavioral issues. A suspension will only be done with your knowledge and as part of your plan of services.

TRANSPORTATION

AbilityWorks, Inc. provides transportation to and from the workshop each day. It is very important that you are at your designated stop on time each day. If you are not reporting for work, you must call in by 8:00 AM. You must adhere to the van driver’s rules and seat belts must be worn at all times.

POLICY REGARDING HUMAN RIGHTS

It is the intent of AbilityWorks, Inc. to relate to everyone served in a manner that will preserve the dignity and personal safety of those served.

The Department of Rehabilitation Services provides all services on a non-discriminatory basis. No individual or group of individuals is excluded from MDRS services or found ineligible for services based on sex, age, race, creed, religion, national origin, or disability. Some of your rights include:

1. Personal privacy except where your safety or that of others is in danger or where illegal acts take place.
2. Treatment with respect and dignity.
3. Input into all the help given by AbilityWorks.

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4. Freedom from physical and/or mental abuse, retaliation, humiliation, neglect, financial or other exploitation.
5. The right to be provided with the highest level of service for which you are ready.
6. Physical and/or mental abuse in any form is not allowed. If you feel your rights have been violated or you have been abused in any way, you may tell your Instructor, Evaluator, Facility Manager or Regional Manager.

CLIENT INPUT

AbilityWorks staff values your opinions and ideas. There are several ways to express those.

1. Suggestion Box – Write your suggestions/complaints and place them in the box.
2. Human Rights Committee – meets quarterly to review complaints (in case of emergency, committee may meet in three days.) The committee is made up of at least 3 clients and a staff member who is the advisor. They can make suggestions and/or give complaints to the Facility Manager for action.
3. Client Management Meetings – The Facility Manager and/or Evaluator meet every other month with all clients to give them information and hear suggestions and complaints.

GRIEVANCE AND APPEAL PROCESS

Any client who is not satisfied with a decision to provide services or denial of services may file an appeal. If a client files an appeal, there will be no exploitation or retaliation, barriers to service, or any abuse against the client by the staff of AbilityWorks, Inc. The first step is to try to work it out with the Facility Manager and your Vocational Rehabilitation Counselor. If the client cannot reach a resolution with MDRS and AbilityWorks staff, they may appeal in writing to the Director of Vocational Rehabilitation at P.O. Box 1698, Jackson, MS 39215-1698 or via email at vrhearing@mdrs.ms.gov, and request either the informal dispute resolution process, a mediation, or impartial due process hearing. MDRS’s Hearing and Mediation Procedures shall be furnished to the aggrieved client upon request.

PROCEDURES FOR INDIVIDUAL PERSONAL COMPLAINTS

1. Talk with your Instructor. If you are not satisfied, discuss the problem with the Evaluator.
2. The Human Rights Committee will meet quarterly and make recommendations to the Facility Manager.
3. The Facility Manager will give you the final decision.

RE-ENTRY POLICY

Any client who is placed into employment or another program and who loses the job/program slot within 60 days after entrance or employment, due to circumstance beyond their control, shall be

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guaranteed priority for reentrance based upon the first available opening. All clients seeking reentrance into the program should contact your Vocational Rehabilitation Counselor.

RE-ORIENTATION POLICY

Any client who remains in the program beyond a year or if they return, will be required to attend another reorientation where the Evaluator discusses the client rights, rules, regulations, safety procedures, use of time clock, an overview of our services, and what to expect during his/her program stay. Tax forms should be reviewed as well to verify if any changes need to be made.

Acknowledgment Receipt of Client Handbook

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I have been orientated to the information in the client handbook and a copy has been provided to me. I understand my rights, input, rules/regulations, restrictive procedures, discharge procedures, grievance procedures and confidentiality.

---

Client Signature Date

---

Evaluator Date

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Title 32: Rehabilitation Services Part 4: AbilityWorks Subpart 3: Non-Client Handbook

Non-Client Handbook

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Our Mission

ABILITYWORKS, INC. MISSION STATEMENT:

It is the mission of AbilityWorks, Inc. of Mississippi to provide an appropriate and timely program of comprehensive rehabilitation services for people with disabilities that will result in improved quality of life and employment opportunities.

AbilityWorks is one of many special programs operated by Vocational Rehabilitation to meet the needs of eligible individuals with disabilities. AbilityWorks is a work training program for individuals with disabilities.

Equal Employment Opportunity

Equal employment opportunity for all individuals regardless of race, color, creed, sex, religion, national origin, age, physical handicap, disability, or political affiliation is the policy of AbilityWorks, Inc. To ensure non-discriminatory personnel administration, AbilityWorks, Inc. promotes non-discriminatory practices and procedures in all phases of personnel administration. AbilityWorks’ equal employment opportunity policy, therefore, prohibits any form of unlawful discrimination based on the forgoing and other considerations made unlawful by federal or state laws.

Non-Client Qualifications

All Non-Client employees must meet the job requirements that are listed in the AbilityWorks job descriptions.

Section 1: AbilityWorks, Inc. Employment

I. Training Period/Orientation

Every non-client employee upon entry into AbilityWorks’ employment shall serve a training period based on his/her job assignment. The training period provides an effective means for the employee to learn the job responsibilities. Through supervision, AbilityWorks determines if the individual is progressing toward successful performance of the major duties of the job.

The immediate supervisor will be responsible for making any orientation arrangements for the new employee. After the initial introduction to the workplace and to fellow staff members, the supervisor will take the new employee to the designated staff person who will have him/her to complete all the required payroll forms including the Employment Eligibility Verification (I-9) form.

The immediate supervisor shall be responsible for any production or general AbilityWorks orientation. The supervisor will explain the time reporting process and the Performance

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Appraisal system and provide the new employee with a complete set of duty statements or job description. Non-client employees whose positions are covered by the U.S. Department of Transportation’s drug testing requirements will receive formal training in this area and a copy of AbilityWorks’ drug testing policy.

AbilityWorks employees will receive training in the following areas:

• Cultural Diversity • Sexual Harassment, • Managing individuals with violent & aggressive behaviors • CPR (including defibrillator operation) • First Aid • Bloodborne Pathogens/Infectious Diseases • Fire Suppression, • Defensive Driving • Proper lifting techniques • Forklift Driving/Safety

II. Work Schedules/Performance

All AbilityWorks, Inc. employees shall be provided with a copy of their work schedule and hours by their immediate supervisor. Full-time AbilityWorks non-client employees will normally work a total of forty (40) hours per week.

The work schedules of non-client employees are subject to reduction or change with or without formal notice to meet or respond to increasing or decreasing contract demands of AbilityWorks customers/contracting office. At any point AbilityWorks does not have adequate work to address the needs of clients, a reduction in force for non-clients will be implemented based upon the respective contract work area, work skills, credentials, and work performance, and conduct record of the employee.

Non-client employees are expected to perform assigned duties during the full schedule for which compensation is being received.

Non-client employees are expected to meet established performance standards. Any conditions or circumstances in the work environment which prevent the employee from performing effectively are to be reported immediately to the supervisor.

III. Attendance

Non-client employees are expected to report to and leave work at the time designated by either the Facility Manager or Production Manager. Planned lost time is to be arranged, in advance, with the employee’s immediate supervisor. Unexpected lost time is to be reported promptly to the supervisor prior to the beginning of the employee’s work period.

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IV. Performance Appraisals

Performance Appraisals are designed to reward employees for successful job performance, to promote understanding between employees and supervisors, to correct inadequate performance, and to identify training needs.

Performance Appraisals are to be administered in a fair manner. Only job-related and performance-related factors are to be considered. The performance goals/expectations for the non-client employee should be established in writing between the employee and his/her immediate supervisor within fourteen (14) days of the hire date.

Performance Appraisals are to be conducted annually, at a minimum, by the non-client employee’s immediate supervisor.

V. Promotions

Promotions may be given as merited by the non-client employee’s job performance and in accordance with the personnel needs of AbilityWorks.

VI. Resignations

A non-client employee who desires to terminate employment with AbilityWorks should submit a written resignation to either the Facility Manager or Production Manager at least ten (10) working days before his/her final workday.

VII. Termination at Will

A non-client employee may be dismissed with or without cause or notice, at any time during employment at AbilityWorks and for any reason other than for discriminatory purposes.

VIII. Grievance/Appeal Procedure

Non-Clients do not have the right to appeal their employment status. Any other grievances can be taken to their immediate supervisor. If an employee is not satisfied with the result, it can be appealed to the facility manager. The facility manager will make the final decision.

Employees have three days to file any grievance with their supervisor. If employees want to appeal to the facility manager, they have five days to appeal.

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Section 2: AbilityWorks, Inc. Work Environment

I. Drug Free Workplace Policy

It is AbilityWorks, Inc. policy to provide a drug-free work environment for our clients and our employees as mandated by the Drug-Free Workplace Act of 1988. You must agree not to unlawfully make, possess, use, hand out, buy, sell, or be under the influence of illegal drugs or controlled substances. You must also agree to provide notice to any criminal conviction for a drug-related offense. Your notice must be provided within five (5) days after the conviction. If you are working on a SourceAmerica contract, the contracting officer at that location will be notified within ten (10) days of your conviction.

Because the unlawful presence of illegal drugs or controlled substances in the workplace jeopardizes your health and safety, as well as the health and safety of other employees, our customer and/or members of the public, the employee in violation of this policy will be removed and/or terminated from employment.

II. Drug Screening

It is the policy of AbilityWorks, Inc. to follow the guideline set forth in the AbilityWorks, Inc. of Mississippi Drug and Alcohol Testing Policy and Procedures. In the event of reasonable suspicion as provided in the policy, you will agree to submit to drug and/or alcohol testing and fully understand that the presence of detectable traces of any drugs and/or alcohol as defined in the policy may result in disciplinary action or termination from employment. You understand that failure to submit to testing or submit a specimen for testing will constitute grounds for termination of your employment with AbilityWorks, Inc.

If you need help with a substance abuse problem, contact one of the organizations listed below:

*your local health department *hospital *mental health center *social service agency *National Cocaine Hotline 1-800-COCAINE *National Institute on Drug Abuse Hotline 1-800-662-HELP

III. Weapons Policy

It is the policy of AbilityWorks, Inc. that weapons of any kind, concealed or not, are prohibited on our premises. Individuals who intentionally, knowingly or unknowingly carry a weapon on the premises are subject to immediate termination from employment with AbilityWorks, Inc. Weapons include, but not limited to: pocketknife, hand guns, razors, pistols, etc.

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IV. Workplace Violence Policy

It is the policy of AbilityWorks that threats, threatening behaviors or acts of violence against staff, co-workers, customers, visitors, guests, or other individuals while on our premises are not tolerated. Those who violate this policy will be terminated and may be subject to prosecution.

V. Sexual Harassment

All AbilityWorks, Inc. clients, non-clients, and state employees expect a workplace free from sexual harassment. Sexual harassment may consist of requests for sexual favors, unwelcome sexual advances, threats, actual bodily contact, or other deliberate verbal or physical conduct of a sexual nature. Such behavior is unacceptable within the scope of employment at AbilityWorks, Inc.

Reporting any incidents of sexual harassment should be directed to your immediate supervisor or to the AbilityWorks Facility Manager.

Charges of sexual harassment against you will result in your employment being terminated from AbilityWorks and you may face legal prosecution. Should you file a charge of sexual harassment you will not face any financial, other exploitation, or any retaliation.

VI. Prohibition on Retaliation (Whistle Blower Actions)

It is the duty of each non-client employee to ensure the efficient and effective performance of the AbilityWorks system. Therefore, any non-client employee reporting any wrongdoing, such as, but not limited to excess waste, abuse, fraud, and illegal activities will be protected from retaliation from supervisors and/or AbilityWorks’ management.

VII. Confidentiality/Building Access Policy

Participation in the community rehabilitation program at AbilityWorks, Inc. is confidential. No disclosure of client participation shall ever be made without the express permission of the clients themselves. At no time should anyone other than MDRS employees, AbilityWorks, Inc. employees, or current clients be on the production floor of AbilityWorks, Inc.

Only visitors authorized by either the Facility Manager or Production Manager are allowed on the work floor, such as repair persons, etc. All visitors must come to the front lobby of AbilityWorks, not the back of the work floor. Former clients are not allowed to go onto the work floor to visit.

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At any time, you witness someone on the work floor who is not authorized to be there, please escort them to the front lobby of AbilityWorks, Inc.

VIII. Visitor Policy

If you have a visitor at AbilityWorks, they are to report to the front office of AbilityWorks and you will be paged to come to the front lobby. Visitors should not enter through the doors on the work floor.

IX. Cell Phone Policy

You may make calls on your cell phone during your lunch break outside in the break area. Do not make or receive calls in the building as it is distracting to the learning process for our clients. If you need to make an emergency call, you may use a phone belonging to AbilityWorks with the permission of your supervisor. If your family needs to contact you in the event of a family emergency, they may call the office. The phones at AbilityWorks are for business purposes only, therefore personal calls are allowed only with the permission of your supervisor.

X. Safety

It is our intent to provide a safe and healthy work environment for our clients, our staff, and our customers. A few basic common-sense rules of safety on the job are:

(1) Observe safety procedures, particularly those regarding operating equipment. (2) Know how to do your job properly and safely. Do not try to do work you are not qualified to do. If you have any questions or need more training, ask for assistance before proceeding. (3) Always pay attention to your work and do not allow yourself to be distracted. Accidents can happen quickly when you are not concentrating on your job. (4) Never operate equipment or perform tasks other than those assigned. (5) Watch for unsafe conditions. Please report defective equipment, hazardous chemicals, wet floors, and other unsafe conditions to your immediate supervisor. (6) If you are injured on a job, notify your supervisor immediately. (7) Always wear the personal protective equipment that is required to do your job safely.

AbilityWorks has an active safety program that includes emergency drills. Drills are held to prepare clients and staff for what to do in emergency situations. Please do what your supervisor tells you during all drills. The staff at AbilityWorks have been trained in first aid. You should report all accidents/injuries to your supervisor as soon as it happens. If you are injured, first aid will be given and if needed, you will be sent to a local hospital for further treatment. You must follow all safety rules in using equipment and in doing work.

Safety rules will be posted in the work area.

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Section 3: AbilityWorks, Inc. Payroll Practices

I. Pay Period

The pay period begins at 12:01 a.m. on Wednesday and ends two weeks later at midnight on Tuesday.

II. Overtime Wages

In the event an employee works more than forty (40) hours during the established workweek, he/she will be paid for any excess hours at a rate equal to one and one-half times his/her regular pay for these hours. All overtime hours must be approved by either the Facility Manager or Production Manager.

III. Paycheck Stub

Attached to each non-client employee’s paycheck is a stub that provides useful information for personal records. The paycheck stub may consist of the following:

1. Date – the actual day the payroll check is issued.
2. Net Amount – the amount of any pay remaining after all mandatory deductions have been subtracted.
3. Federal Tax – the amount of federal income tax withheld from the gross earnings; depends upon the salary and how many dependents are claimed each year by the employee.
4. Social Security Tax (FICA) – the social security tax is deducted from each employee’s paycheck at a fixed rate set by federal law.
5. State Tax – the amount of state tax withheld from the gross earnings; depends on the salary and how many dependents are claimed each year by the employee.
6. Fringe Benefits – the amount designated by federal contract for the employee to use to purchase his/her own health insurance (only applies to those non-clients working on SourceAmerica contracts).
7. Gross Pay – total pay before deductions.
8. Hours Worked – includes regular hours worked during the pay period and overtime hours.
9. Insurance – for employees with insurance benefits through AbilityWorks, Inc.

Standard deductions are made from your check for Federal and State taxes and Social Security. Child Support, garnishments, and/or court order deductions can be made from your payroll check.

IV. Pay Days

Pay Days are every other Friday.

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Section 4: AbilityWorks, Inc. Employee Benefits

I. Unemployment Compensation

If a non-client employee loses his/her job at AbilityWorks, that individual may be eligible for unemployment compensation.

II. Worker’s Compensation

A non-client employee who is injured on the job may be entitled to worker’s compensation benefits. If an employee is injured, no matter how minor the injury, the employee should report this to the supervisor immediately.

III. Health and Welfare Benefits

Employees who work on federal contracts are provided health and welfare benefit payments in accordance with federal contract requirements.

IV. Holidays

Employees of AbilityWorks shall receive regular pay for five (5) holidays. These paid holidays are:

New Year’s Day..............January 1 st

Independence Day....... ....July 4 th

Labor Day.....................1 st Monday in September Thanksgiving Day............4 th Thursday in November Christmas Day.................December 25 th

If any paid holiday falls on a Saturday or Sunday, the following Monday may be observed as a paid holiday. Extra days may be given at the discretion and approval of the AbilityWorks Corporate Board.

Employees who work on federal contracts are provided holidays in accordance with the federal contract requirements. These paid holidays are:

New Year’s Day.........................January 1 st

Martin Luther King Jr. Day............3 rd Monday in January President’s Day..........................3 rd Monday in February Memorial Day............................4 th Monday in May Juneteenth.................................June 19 th

Independence Day........................July 4 th

Labor Day.................................1 st Monday in September Columbus Day............................2 nd Monday in October Veteran’s Day.............................2 nd Monday in November Thanksgiving Day........................4 th Thursday in November

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Christmas Day.............................December 25 th

When it is essential for a non-client employee to work on an official holiday, either the employee shall earn his/her regular hourly rate for the time worked or be given the option of taking time earned off during the established workweek.

V. Military Leave

Non-client employees shall not be reimbursed for time lost due to military duty, but may request personal/sick leave for this purpose.

VI. Leave of Absence

Requests for leave of absence should be submitted to the non-client employee’s immediate supervisor and shall be considered on an individual basis, and may or may not be granted, due to the circumstance(s).

VII. Leave Benefits

Non-client employees, full and part-time, shall be granted personal/sick leave and are covered under the Family Medical Leave Act (FMLA).

A. Personal/Sick Leave

Non-client employees are eligible for ten (10) days total personal/sick leave commencing one (1) year from the first day of employment. These ten (10) days can be used for vacation and/or sick leave. AbilityWorks non-client employees hired prior to the effective date of this handbook will maintain any personal/sick leave days previously agreed upon.

Personal/sick leave shall be taken during the state fiscal year it is awarded and will not accumulate. AbilityWorks non-client employees will be paid at the end of each state fiscal year (June 30) for any unused leave time. When foreseeable, leave should be requested prior to being taken and approved by the immediate supervisor. When circumstances prevent prior notice, the employee should notify his/her immediate supervisor prior to the beginning of his/her assigned work period.

If an employee is absent due to an illness or injury for more than three (3) consecutive workdays, the employee is required to provide certification from his/her health care provider prior to returning to duty stating he/she is able to resume work.

Part-time employees will be given pro-rated leave benefits based on the number of hours worked.

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B. Family Medical Leave Act (FMLA) Leave

An employee shall be considered for FMLA leave when he/she has been absent from work for a serious health condition (as defined later in this section) for more that three (3) consecutive workdays. This includes absences for a serious health condition for the employee as well as an immediate family member(s) (i.e.; parent, spouse, son or daughter). A medical certification is required from a health care provider to support FMLA leave requests. Attendance records should designate FMLA leave, when applicable, and an employee’s failure to follow FMLA policy will be subject to disciplinary action.

A serious health condition is defined as follows:

An illness, injury (including on-the-job injuries), impairment, or physical or mental condition that requires in-patient care in a hospital, hospice, or residential medical care facility; or continuing treatment by a health care provider for a chronic or long-term health condition that is incurable or so serious that if not treated would likely result in a period of incapacity of more than three (3) consecutive workdays or for prenatal care; or any period of incapacity requiring absence from work of more that three (3) consecutive workdays, that also involves continuing treatment by (or under the supervision of) a health care provider.

• Qualifications

The Family Medical Leave Act entitles eligible non-client employees to take up to twelve (12) weeks of unpaid, job-protected leave during any twelve (12) month period for the following family and medical reasons:

A. for the birth or placement of a child for adoption or foster care;

B. to care for an immediate family member with a serious health condition;

C. to take medical leave when the employee is unable to perform the functions of the employee’s position because of a serious health condition.

The FMLA leave period for all AbilityWorks non-client employees shall coincide with the state fiscal year (July-June).

• Eligibility

An eligible non-client employee is one who has been employed by AbilityWorks for at least twelve (12) months and has worked for at least 1250 hours over the prior twelve (12) months.

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• Notice to AbilityWorks

When the necessity for leave is foreseeable based on an expected birth or placement, the employee shall provide AbilityWorks with no less than thirty (30) days notice before the date the leave is to begin and of the employee’s intention to take leave under FMLA. The exception being when the date of birth or placement requires to begin in less than thirty (30) days, the employee shall provide such notice as is practicable.

When the necessity for leave is foreseeable based on planned medical treatment, the employee:

A. shall make a reasonable effort to schedule the treatment so as not to unduly disrupt the operations of AbilityWorks subject to the approval of the health care provider of the son, daughter, spouse, or parent of the employee, as appropriate; and

B. shall provide AbilityWorks with no less than thirty (30) days’ notice before the date the leave is to begin and of the employee’s intention to take leave, under FMLA. The exception being when treatment is to begin in less than thirty (30) days, the employee is to provide such notice as is practicable.

If the employee fails to give thirty (30) days’ notice for foreseeable leave with no reasonable excuse for the delay, AbilityWorks may deny taking FMLA leave until at least thirty (30) days after the date the employee provides notice to AbilityWorks of the need for FMLA leave.

AbilityWorks may require periodic reports from an employee on FMLA leave regarding the employee’s status and intent to return to work. If the employee provides a statement of intent to return to work, and the statement is qualified, he/she is entitled to leave and maintenance of health/wellness benefits (provided to those non-client employees working on SourceAmerica contracts). However, if the employee gives a notice of intent not to return to work, AbilityWorks’ obligations to provide health benefits (where applicable) and to restore the employee ends at this point.

• Intermittent Leave or Leave on a Reduced Leave Schedule

Family leave for childbirth, adoption, or foster care may not be taken intermittently or on a reduced leave schedule. Leave to care for a seriously ill family member or due to the employee’s own serious health condition may be taken intermittently or on a reduced schedule whenever medically necessary.

If an employee requests intermittent leave, or leave on a reduced leave schedule, that is foreseeable based on planned medical treatment, AbilityWorks may require

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the employee to transfer temporarily to an available alternative position for which the employee is qualified with equivalent pay and benefits that better accommodate recurring periods of leave that the employee’s regular employment position.

Only the time taken as FMLA leave may be charged against the employee’s leave entitlement when leave is taken intermittently or on a reduced schedule. For part- time employees and those who work variable hours, the FMLA leave entitlement is calculated on a pro-rated basis by comparing the new schedule with the employee’s normal schedule.

• Outside Work

A non-client employee may not work on another job while on FMLA leave.

• Medical Certification

AbilityWorks requires a medical certification from a health care provider to support FMLA leave requests either to care for an employee’s seriously ill family member, or for leave due to a serious health condition that makes the employee unable to perform the functions of his/her job. The employee must provide such certification within fifteen (15) calendar days, unless it is not practicable to do so under the circumstances. The certification provided will be sufficient if it states:

1. the date the serious health condition commenced;

2. the probable duration of the condition;

3. the appropriate medical facts within the knowledge of the health care provider regarding the condition;

4. for purposes of leave to care for an immediate family member who is seriously ill . . .a statement that the employee is needed to care for the son, daughter, spouse, or parent, and an estimate of the amount of time that such employee is needed to care for such son, daughter, spouse, or parent;

5. in the case of an employee’s serious health condition: a statement that the employee is unable to perform the functions of his/her position;

6. in the case of certification for intermittent leave or leave on a reduced leave schedule for planned medical treatment, the dates on which such treatment is expected to be given and the duration of such treatment.

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If AbilityWorks has reason to doubt the validity of the certification, it may require at its own expense, the employee to obtain the opinion of a second health care provider (not regularly employed by the state) designated or approved by AbilityWorks.

If the second opinion differs from the original certification, AbilityWorks may require, at its own expense, an opinion from a third health care provider approved jointly by AbilityWorks and the employee. The opinion of the third health care provider concerning the information previously certified shall be considered final and shall be binding on AbilityWorks and the employee.

AbilityWorks may require, at its own expense, that the employee obtain subsequent recertification on a reasonable basis.

• Restoration

Non-client employees are entitled to be restored to their positions after returning to work:

1. The employee will be entitled to be restored by AbilityWorks to the position held by the employee when the leave commenced, OR the employee will be entitled to be restored to an equivalent position with equivalent benefits, pay status, and other terms and conditions of employment.

2. The employee will not lose any employment benefits accrued prior to the date on which leave commenced.

3. The employee will not accrue any employment benefits during a period of leave without pay.

4. The employee will not be entitled to any rights, benefits, or position of employment other than any which the employee would have been entitled to had the leave not been taken.

• Substitution of Paid Leave

AbilityWorks requires the employees to use all paid personal/sick leave concurrently with FMLA leave. Personal/sick leave shall be utilized until exhausted. At that time, the employee will be on FMLA leave without pay status. Worker’s Compensation leave may also run concurrently with FMLA leave.

• Maintenance of Benefits

At the end of an employee’s FMLA leave, benefits must be resumed in the same manner and at the same levels as provided when the leave began and subject to

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any changes in benefit levels that may have taken place during the period of FMLA leave affecting all AbilityWorks non-client employees. Upon returning from FMLA leave, an employee cannot be required to requalify for any benefits the employee enjoyed before FMLA leave began.

An employee is not entitled to accrue any additional benefits or seniority during unpaid FMLA leave. Benefits accrued at the time FMLA leave began must be available to an employee upon return from leave.

• Return to Duty from FMLA Leave

As a condition to return to duty, the employee is required to provide certification from his/her health care provider stating the employee is able to resume work.

• Record Keeping Procedures

Non-client employees are to be informed every 6 months of the amount of personal/sick leave that has been currently used. An employee may, however, request at any time a report of his/her leave balance. FMLA leave records will be maintained for a minimum of three (3) years.

Section 5: AbilityWorks, Inc. Work Rules/Employee Expectations

All non-client employees of AbilityWorks, Inc. are expected to observe the following:

• Daily attendance (Monday-Friday). If you cannot report to work, you are to call the main office number or your supervisor’s cell phone before your scheduled work time and advise your supervisor of the reason for your absence.

o When you are absent due to illness for four(4) consecutive workdays, you must have your physician complete a release form with any limitations and give it to your immediate supervisor before returning to work.

AbilityWorks’ Work Schedule*: (Monday-Friday) • 8:00 AM- 3:30 PM..............................Regular Work Hours *hours subject to change • 10:00 AM to 10:15 AM........................Morning Break

• 12:00 PM to 12:30 PM.........................Lunch

• 2:00 PM to 2:15 PM.............................Afternoon Break

• Each AW location independently sets its work hours, typically between 8:00 AM and 5:00 PM.

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• Eating and drinking are allowed only in the break areas during break periods. • Use of tobacco products is not permitted in the facility. • SMOKING: The designated area for smoking is outside. Smoking is not allowed in the building. • MEDICATION: AbilityWorks does not store or give out medicine of any kind. You are responsible for keeping up with and taking your medicine. • NO iPods, MP3 players, headphones, bluetooth devices, and/or any other type of music device will be allowed in the work areas. AbilityWorks, Inc. strongly discourages these items from being brought to the facility and will not be responsible if lost or stolen. • No horseplay or abusive language is allowed in the facility or in facility vehicles.

**NOTE: The Dress Code below may be modified at the AbilityWorks’ location when necessary due to the type of contract work at each location.

The following dress code should be followed: All Non-Client employees are to wear clothing appropriate for the work setting. Cleanliness/neatness is an expectation of all employees at AbilityWorks, Inc.

DRESS CODE • No baggy pants or loose-fitting clothing • No pants that hang below the waistline exposing underwear or causing significant sagging. Pants must be worn at the proper level with a belt if necessary. • Clothing displaying underwear and/or clothing that could be considered too revealing will not be tolerated • No tank top/muscle shirts/halter or tank tops • No open toe shoes or house shoes • No do-rags, hair-rollers, or bonnets • No excessive long jewelry or necklaces • No miniskirts or short shorts (shorts should come to top of knees or below) • No halter-tops/tank tops

The following includes but is not limited to the minimum expectations that AbilityWorks, Inc. has for all non-client employees:

1.Non-client employees should report to AbilityWorks at their scheduled work time. Employees should not enter the work area or punch the time clock no earlier than five (5) minutes prior to their scheduled start time.

2.Non-client employees should report to AbilityWorks on all scheduled workdays unless otherwise instructed or notified.

• If you cannot attend, you should call the AbilityWorks Facility Manager or Production Manager prior to start time.

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• Absence from work for vacation time or other personal time must be requested on a leave request form and approved by the AbilityWorks Production Manager and Facility Manager.

3.Non-clients should not make any personal calls during their work time. All personal phone calls should be made during breaks and lunch time frames.

4.Failure to notify the AbilityWorks Production Manager prior to absence from work unless a clear and/or severe medical situation exists will be considered a disciplinary offense.

• If an employee is absent for one day without notice this will result in a reprimand. • Failure to report to work or call your immediate supervisor for three consecutive days of absences will result in employment termination.

5.Non-client employees should promptly follow all instructions from their immediate supervisor and/or all other AbilityWorks staff.

6.Non-clients will be assigned to tasks or work areas as needed and required to meet the production or work schedules of AbilityWorks, Inc. Work assignments may and will be changed with or without formal notice.

7.Non-clients should not bring weapons, alcoholic beverages, or illegal drugs of any kind on the premises of AbilityWorks, Inc. Non-clients should not threaten or in any way cause harm to other co-workers, AbilityWorks staff, or clients. Any discrepancy in this area will result in immediate employment termination.

8.Non-clients will operate equipment in accordance with established procedures to avoid damages to products or equipment and most importantly, not to cause an accident. Non- clients are responsible for the care of equipment/product given to them for their work. Abuse of equipment or product or theft of product will result in disciplinary action or termination of employment.

9.Abuse of work time by non-clients will not be permitted. Non-clients should report to their immediate supervisor once an assigned task is completed. Non-clients should always be working productively.

10. Non-clients should report back to their workstations promptly following breaks and their scheduled lunch period.

11. AbilityWorks non-clients may not ride or drive AbilityWorks’ vehicles for personal use.

12. Some contracts of AbilityWorks, Inc. locations require security clearance for the Non- client employees. Where this is required, Non-clients must have and maintain a criminal free record, which includes absence of misdemeanors/felonies in order to meet

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federal security requirements. Non-clients must report to either the Facility Manager or Production Manager within 48 hours any arrests which would affect their security status. The Security office of the contract has final authority on security clearance.

13. Non-clients must maintain strict confidentiality of all client information in their possession. Non-clients must treat clients with respect and professional courtesy. Non- client employees are expected to treat anyone (i.e.: customers, vendors, co-workers, counselors, repairmen, etc.) they encounter with respect while on duty.

14. No fraternization with clients AND no selling/buying any items from/to clients on the property.

15. Non-clients who serve as authorized drivers must have and must maintain a safe driving record/proper licensure in compliance with the AbilityWorks, Inc. Fleet Policy. Non- clients who serve as authorized drivers must ensure that all clients adhere to the AbilityWorks’ van rider policy.

16. Theft of or damage to the property of AbilityWorks, Inc.’s personnel, contractors, or visitors may result in immediate employment termination.

17. Falsification of work documents, employment documents or records of AbilityWorks, Inc., or records related to any AbilityWorks’ contract may lead to immediate employment termination. (ex: time card, production record, etc).

18. Non-client employees must complete all required documents accurately and on time.

19. Unauthorized access, use or abuse of computer/hardware programs and/or phone equipment and phone service may lead to immediate employment termination.

NON-CLIENT FAILURE TO MEET ABILITYWORKS’ EXPECTATIONS/WORK RULES

The failure to meet any of the above-listed expectations or work rules will result in a disciplinary reprimand. Three (3) reprimands from the above listed expectations or work rules within a calendar year will result in employment termination.

Page 30 of 30

AbilityWorks, Inc. Non-Client Employee Certification Statement

By my signature below, I certify receipt of the AbilityWorks, Inc. Non-Client Handbook.

Also, I certify that I understand the importance of reading and becoming familiar with the contents of the handbook, and that this certification will be filed in my personnel file permanently.

Also, I certify that I have read and understand the AbilityWorks, Inc. Work Rules, Employee Expectations and Confidentiality of Information. I understand that I must meet all the work rules/employee expectations or be subjected to disciplinary action and/or termination.

---

Non-Client Employee name (Print)

---

Non-client employee signature Date

---

AbilityWorks Staff Member Date

Part 10 MDRS Vocational Rehabilitation Program Policy Manual

32 Miss. Admin. Code Pt. 10, R. 10.1 Rule 10.1

FINANCIAL NEEDS ANALYSIS OVR/OVRB calculates an individual’s financial participation rate by conducting a Financial Needs Analysis (FNA). MDRS sets the annual cost of living allowance (COLA), used in the FNA calculations, at three (3) times the federal poverty

guidelines. These guidelines are established by the Department of Health and Human Services (HHS) and published annually in the Federal Register. MDRS chooses to consider the financial need of applicants who are receiving services through Trial Work Experiences (TWE) for purposes of determining the extent of their participation in the costs of VR services.

Other VR services that require a financial needs test are:

• Tuition, housing, and meals for academic training at a university, college or community college; • All computers and software purchased for basic education or college training; • Hearing aids; • Home Modifications; • Vehicle Modifications; • Services to family members, and/or • Post-employment services in the six (6) aforementioned service areas. MDRS does not apply a financial needs test or require the financial participation of the individual as a condition for providing the following VR services:

• Assessments for determining eligibility, priority for services, and VR needs; • VR counseling and guidance; • Referral and other services; • Any auxiliary aid or services (e.g. interpreter or reader services); • Job-related services; • Personal assistance services; or • As a condition for providing any VR service for individuals who have been determined eligible for Social Security benefits under Title II or Title XVI of the Social Security Act.

32 Miss. Admin. Code Pt. 10, R. 10.2 Rule 10.2

COMPARABLE SERVICES AND BENEFITS Comparable services and benefits means services and benefits, including accommodations and auxiliary aids and services, that are:

• Provided or paid for, in whole or in part, by other Federal, State, or local public agencies, by health insurance, or by employee benefits; • Available to the individual at the time needed to ensure progress toward achieving the employment outcome in the individual’s IPE; and • Comparable to the services the individual would otherwise receive from MDRS. NOTE: Comparable services and benefits do not include awards and scholarships based on merit.

VR services will be provided after a determination that comparable services and benefits are not available under any other program, unless such a determination would interrupt or delay:

• The progress of the individual toward achieving the employment outcome stated in his/her IPE; • An immediate job placement; or, • The provision of VR services to any individual at extreme medical risk, based on medical evidence provided by an appropriate, qualified medical professional. The following services are exempt from the determination of comparable services and benefits:

1. Assessment for determining eligibility and VR needs by qualified personnel, 2. Counseling and guidance, including information and support services to assist an individual in exercising informed choice; 3. Referral and other services to secure needed services from other agencies including components of the statewide workforce development system, if such services are not available through this agency; 4. Job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services; 5. Rehabilitation technology, including telecommunication, sensory, and other technological aids and devices; and, 6. Post-employment services consisting of the aforementioned services ... (in items 1- 5 in this list.)

32 Miss. Admin. Code Pt. 10, R. 10.3 Rule 10.3

OUT-OF-STATE SERVICES If out-of-state services are requested when there are comparable services available in the state, the services must meet the same criteria in terms of comparable benefits, financial need, and determination of cost as in-state services.

32 Miss. Admin. Code Pt. 10, R. 10.4 Rule 10.4

FEE SCHEDULE Federal cost principles require that costs for purchased VR services be allowable, reasonable, allocable to the program, and be relative to the benefit received. In keeping with these principles, OVR/OVRB has an established Fee Schedule to ensure the most cost effective use of federal

funding and a statewide consistency of client service purchases. The Fee Schedule represents the "maximum allowable fee" for medical services, equipment, supplies, and the like. Rates of payment for services provided in agency-operated facilities shall be determined by MDRS’s facility cost reporting system.

32 Miss. Admin. Code Pt. 10, R. 10.5 Rule 10.5

STATE VENDOR CONTRACTS AND PURCHASING REGULATIONS The State of Mississippi enters into contracts with vendors for certain goods and services on an annual basis. When state contracts are in effect, these items must be obtained from the vendor indicated on the contract. No bids are required.

Items not covered by the Fee Schedule or a state contract are subject to the Mississippi Public Purchases law.

32 Miss. Admin. Code Pt. 10, R. 10.6 Rule 10.6

AUTHORIZATIONS Authorizations and expenditures for services will be made in accordance with all applicable: • OVR/OVRB fee schedules; • Operating agreements and contracts; • State contract rates; • Vendor's usual and customary charges; and • State/federal laws, regulations, policies, and procedures. NOTE: OVR/OVRB cannot supplement payments from any other source(s) ......... .in excess of the prevailing fee for services being purchased. Authorizations will be issued only after a case has been placed in application status. A written authorization for services shall be made either before or at the same time as the purchase of the services. However, for individuals who have been determined eligible, in rare situations that might cause extreme medical risk or loss of placement, or like circumstances, an authorization may be made verbally. In such instances, there must be prompt documentation and the authorization must be confirmed in writing and forwarded immediately to the provider of the services. Payment of a valid obligation may be approved when the eligible individual or authorized agency personnel have received the authorized goods or services and the vendor has signed, returned the authorization, and

supplied an invoice when required. State purchasing law requires payment within forty-five (45) days of receipt of authorized goods and services. Documentation supporting the decision to obligate funds, change amounts obligated, and recommend payment must be present in the service record.

SECTION 11: EMPLOYMENT 11.0 PURPOSE The goals of the VR program are to help individuals with disabilities achieve equality of opportunity, full inclusion, and integration into the labor market to ensure an employment outcome, thereby creating opportunities for independence. The VR program intends to accomplish these goals by increasing employment opportunities and employment outcomes for individuals with disabilities through encouraging meaningful input from employers on successful and prospective employment and placement strategies.

32 Miss. Admin. Code Pt. 10, R. 11.1 DEFINITIONS Competitive Integrated Employment (CIE) means work that:

1. Is performed on a full-time or part-time basis (including self-employment) for which an individual is compensated at a rate that: • Is not less than the rate required under the current minimum wage law;

• Is not less than the customary rate paid by the employer for the same or similar work performed by other employees who have similar training, experience, and skills and who are not individuals with disabilities; and

• In the case of an individual who is self-employed; yields an income that is comparable to the income received by other individuals who are not individuals with disabilities and who are self-employed in similar occupations. 2. Is eligible for the level of benefits provided to other employees; and is in a location where: • General working conditions demonstrate integration with other workers rather than separation or segregation;

• The job is available to the general public;

• The individual is employed under the same working conditions as others in similar positions (e.g. work hours, rest room facilities, lunch or other break arrangements, entrances/exits; and

• The individual has ongoing interaction on the job site, as part of their work responsibilities, with other workers without disabilities, supervisors, and the public to the same degree as workers without disabilities in the same or comparable occupations. 3. Presents, as appropriate, opportunities for advancement that are similar for other employees who are not individuals with disabilities and who have similar positions. Customized Employment means CIE, for an individual with a significant disability, that is:

1. Based on an individualized determination of the unique strengths, needs, and interests of the individual; 2. Designed to meet the specific abilities of the individual and the business needs of the employer; and 3. Carried out through flexible strategies, such as: • Job exploration by the individual;

• Working with an employer to facilitate placement;

• Customizing a job description based on current employer needs or on previously unidentified and unmet employer needs;

• Developing a set of job duties, a work schedule, specifics of supervision (including performance evaluation and review), and determining a job location;

• Using a professional representative chosen by the individual, or if elected self-representation, to work with an employer to facilitate placement; and

• Providing services and supports at the job location. Supported Employment means CIE, including customized employment, or employment in an integrated work setting in which an individual with a most significant disability, is working on a short-term basis toward CIE that is individualized and consistent with the unique strengths, abilities, interests, and informed choice of the individual.

Individuals in supported employment receive ongoing support services from their counselor, from the time of job placement, until they can be transitioned to extended services. Extended Services are provided to assist individuals in maintaining their employment outcome after they have transitioned from the support of their counselor.

Employment Outcome means, entering, advancing in, or retaining full-time or part-time CIE (including customized employment, self-employment, telecommuting, or business ownership), or supported employment that is consistent with an individual's unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

Extended Employment means work in a non-integrated or sheltered setting for a public or private nonprofit agency or organization that provides subminimum wage compensation in accordance with section 14(c) the Fair Labor Standards Act.

32 Miss. Admin. Code Pt. 10, R. 11.2 Rule 11.2

USE OF SUBMINIMUM WAGE Under Section 511 of the Rehabilitation Act of 1973, as amended, OVR/OVRB is obligated to provide Career Counseling and Information and Referral (CCIR) services to all individuals working in the state in subminimum wage employment. The purpose of the mandate is to ensure that individuals with disabilities have access to information and services that will enable them to achieve CIE.

Section 511 establishes two (2) requirements that must be met in order for a worker with a disability to be paid a subminimum wage, and they are: 1. Individuals with disabilities age 24 and younger (youth) must be provided with various services designed to improve their access to competitive integrated employment (CIE) before they are employed at a subminimum wage; and 2. All workers, including youth, must be regularly provided with career counseling and information as a condition of continued employment at a subminimum wage. Youth and Subminimum Wage

Before a youth with disabilities can begin employment in a subminimum wage position, OVR/OVRB must provide him/her with documentation verifying the completion of three (3) requirements, which are:

1. Receipt of Pre-Employment Transition Services (Pre-ETS) under the VR program or Transition Services provided under the Individuals with Disabilities Education Act (IDEA); 2. Proof the youth applied for VR services and was found ineligible or documentation showing the youth applied for VR services, was found eligible, had an approved IPE, worked toward a suitable employment outcome for a reasonable period of time without success, and the VR service record was closed as non-rehabilitated; and 3. Receipt of Career Counseling and Information and Referral Services (CCIR). Individuals (regardless of age) and Subminimum Wage

Employers may not continue to employ an individual with a disability, regardless of age, at subminimum wage unless the individual receives CCIR at the appropriate intervals as established in Section 511. CCIR, provided by OVR/OVRB, must be delivered in a manner that facilitates independent decision-making and informed choice, and shall be carried out once every six (6) months for the first year of the individual’s employment at a subminimum wage, and annually thereafter for the duration of such employment. It is the responsibility of the employers, who pay subminimum wages, to ensure their workers are referred to OVR/OVRB and receive CCIR as needed. NOTE: Employers with less than fifteen (15) employees must also refer individuals with disabilities to OVR/OVRB to receive information on self-advocacy, self- determination, and available peer-mentoring training opportunities before continuing to pay subminimum wages.

32 Miss. Admin. Code Pt. 10, R. 11.3 Rule 11.3

SERVICES TO EMPLOYERS MDRS’ Office of Business Development (OBD) strives to set the stage for sustainable success for both individuals with disabilities and employers. To accomplish this, OBD focuses on developing ongoing relationships with, and providing a variety of services to, both public and private sector employers in an effort to increase employment opportunities for individuals with disabilities. OBD assists individuals with disabilities and employers by:

• Providing disability awareness training and education to promote inclusion in the workplace, as well as assist with the employment and retention of individuals with disabilities;

• Increasing opportunities for recruitment of skilled, qualified individuals with disabilities through work-based learning experiences (including job shadowing, internships, apprenticeships, and on-the- job training);

• Providing consultation, technical assistance, and support on the use of accommodations and assistive technology in the workplace to aid in the recruiting, hiring, and retaining of individuals with disabilities; and by

• Aiding in the utilization of incentives and other financial support, such as tax credits, that are available for the hiring or accommodating of individuals with disabilities.

SECTION 12: CLOSURES 12.0 CLOSURES Closure of an individual’s service record occurs when the individual achieves: an employment outcome in a competitive integrated setting; declines services or refuses to participate; is not available to participate or is determined ineligible for services; does not meet the current order of selection priority and does not wish to remain on a waiting list; received services but did not achieve an employment outcome; or has completed post-employment services.

32 Miss. Admin. Code Pt. 10, R. 12.1 CRITERIA FOR CLOSING SERVICE RECORDS AS REHABILITATED

The record of services of an individual who has achieved a competitive integrated employment (CIE) outcome may be closed as rehabilitated only if all of the following requirements are met: 1. The individual received VR counseling and guidance throughout the life of record. 2. The individual has achieved the employment outcome that is described in the individual's IPE and is consistent with the individual's unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. 3. The individual has maintained the employment outcome for an appropriate period of time (a minimum of 90 days) to ensure stability, and it has been determined the individual no longer needs VR services.

4. At the end of the appropriate period of time, the individual and the qualified rehabilitation counselor employed by MDRS consider the employment outcome to be satisfactory and agree that the individual is performing well on the job. 5. The service record contains documentation that the services provided under the .... individual’s IPE, whether provided directly by OVR/OVRB/OBD or through ......service providers, contributed to the achievement of the employment outcome. 6. The individual is informed through appropriate modes of communication of the availability of post-employment services. 7. Additional Supported Employment provisions related to closure are: • The individual received supported employment services, as indicated in his/her IPE, prior to closure; and • The individual has transitioned to extended services that are not paid for with agency funds, but are provided through a comparable benefit or service.

NOTE: There must be supporting documentation in the service record to document the individual’s hourly wage at exit from the VR program. This information is required to verify the individual is compensated at a rate that meets the definition of CIE.

32 Miss. Admin. Code Pt. 10, R. 12.2 CLOSURE WITHOUT ELIGIBILITY DETERMINATION

A counselor may not close an individual’s record of services prior to making an eligibility determination unless: • The individual declines to participate in, or is unavailable to complete, an assessment for determining eligibility and priority for services, and

• The counselor has made a reasonable number of attempts to contact the individual or, if appropriate, the applicant's representative to encourage the individual's participation.

32 Miss. Admin. Code Pt. 10, R. 12.3 CLOSURE DUE TO INELIGIBILITY

If a counselor determines that an applicant is ineligible for VR services or determines that an individual receiving services under an IPE is no longer eligible, the counselor must: • Make the determination only after providing an opportunity for full consultation with the individual or, as appropriate, with the individual's representative;

• Inform the individual in writing, supplemented as necessary by other appropriate modes of communication, of the ineligibility determination, including the reasons for that determination, and the means by which the individual may express and seek remedy for any dissatisfaction;

• Provide the individual with a description of services available from the Client Assistance Program (CAP) and information on how to contact the program;

• Refer the individual to other programs in the statewide workforce development system, or other federal, state or local programs and/or service providers best suited to meet his/her rehabilitation needs; and

• Review, within 12 months and annually thereafter if requested by the individual or his/her representative, any ineligibility determination that is based on a finding that the individual is incapable of achieving an employment outcome. This review need not be conducted in situations in which the individual has refused it, the individual is no longer present in the State, the individual's whereabouts are unknown, or the individual's medical condition is rapidly progressive or terminal.

32 Miss. Admin. Code Pt. 10, R. 12.4 CLOSURE IN EXTENDED EMPLOYMENT

Some individuals are placed in extended [sheltered] employment earning less than minimum wage under a sub-minimum wage certificate issued by the U.S. Department of Labor. This is legal and appropriate for some individuals, but this type of employment outcome is not considered CIE. Criteria: 1. Before an individual’s service record is closed in extended employment, the counselor must include documentation that the individual is unable to achieve CIE or that the individual made an informed choice to remain in extended employment. 2. A semi-annual review and reevaluation of the status of the individual must occur for two years after the individual's record of services is closed (and annually thereafter) to determine the interests, priorities, and needs of the individual with respect to achieving or training for CIE. 3. The counselor must enable the individual or, if appropriate, the individual's representative to provide input into the review and reevaluation and must document that input in the record of services. Documentation must also include:

• The individual's or, as appropriate, the individual's representative's signed acknowledgment that the review and reevaluation have been conducted; and • A description of the efforts to identify and provide VR services, reasonable accommodations, and other necessary support services, to assist the individual in engaging in CIE.

32 Miss. Admin. Code Pt. 10, R. 12.5 Rule 12.5

CLOSURE AS NON-REHABILITATED If, for intervening reasons, an applicant does not reach a CIE outcome and no further services can be justified or are appropriate, the individual’s service record is closed as non-rehabilitated.

32 Miss. Admin. Code Pt. 10, R. 12.6 Rule 12.6

CLOSURE FROM DELAYED STATUS Closures in this category are for individuals who were determined eligible for VR services but did not meet the current Order of Selection criteria, and the service record never advanced to service status.

REFERENCES

Rehabilitation Act of 1973, as amended Sec.101(a)(21)(A)(ii)(II)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42(c)

Section 121(b)(1)(A)(i) of the Workforce Innovation and Opportunity Act (WIOA)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.41(b)(2)

Section 101 (a)(13) and Section 121 of the Rehabilitation Act of 1973, as amended

Section 101 (a)(11) of the Rehabilitation Act of 1973, as amended

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.37(a)

Section 101(a)(17) the Rehabilitation Act of 1973, as amended

Section 103(b)(2) and Section 104 of the Rehabilitation Act of 1973, as amended

Section 102(b)(3)(B) of the Rehabilitation Act of 1973, as amended

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.52(c)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.47(a) & (b)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.47

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.43

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.44

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42(e)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.46

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5(c)(9)(i)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(15); 361.47 (a)(10) & 361.55

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.38(c)(4)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.37

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.56

WIOA section 116(d)(5)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.38 (b)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.38 (c)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.38 (d)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.38 (e)

Authority: Sections 12(c) and 101(a)(6)(A) of the Rehabilitation Act of 1973, as amended; 29 U.S.C. 709(c) and 721(a)(6)(A)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (a) and (b)(1)(2)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (b)(5)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (c)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (e)(1)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (d)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (b)(3)(ii)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (b)(3)(i)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(43)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (e)(1)

State Rehabilitation Council

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (f)(1) and (2)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (b)(3)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (e)(i)(ii)

Rehabilitation Act of 1973, as amended

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (e)(2)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (c)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(24)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (b)(4)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.57 (e)(4) and (i)(1)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.41 (b)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42 (a)(2)

Rehabilitation Act of 1973, as amended

Section 7(21)(A) of the Act

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42 (a)(3)(B)(ii)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42 (d)(1)(i)

Section 7(2) of the Act and 34 CFR 361.5 (c)(5)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42 (e)(2)(B)(iv)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.42 (e)(2)(iii)(A) and (B)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.43

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.36 (d)(2)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(27) & (28)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(30)(iii)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(30)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(27)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.36 (e)(1)(2)(3)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.36 (a)(3)(iv)(B)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.36 (a)(3)(v)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.36 (e)(3)(i)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.45 (c)(1)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.45 (d)(3)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.45 (e)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.45 (c)(2)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.22 (a)(2) and 361.45 (d)(9)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.46 (b)(1,2,3)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.45 (d)(6)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.45 (d)(7)

34CFR 361.45 (d)(5)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.48 (b)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(55)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(51)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(58)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.48 (a) & (a)(1)

Section 110 (d) of the Rehabilitation Act of 1973, as amended

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.65

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.48 (a)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.48 (a)(2)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.48 (a)(3)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.48 (a)(4)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 363.22

Section 603(d) of the Rehabilitation Act of 1973, as amended

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.54 (b)(2)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.54 (b)(1)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.54 (b)(2)(i)(B)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.54 (b)(3)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(8)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.53 (a)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.53 (b)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(9)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(11)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(53)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(19)(iv)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(15)

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.5 (c)(18)

Section 511 (a)(2), Rehabilitation Act of 1973, as amended

Section 511 (c)(1), Rehabilitation Act of 1973, as amended

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.32

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.56

32 Miss. Admin. Code Pt. 10, R. 34 CFR 363.55

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.44

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.43

32 Miss. Admin. Code Pt. 10, R. 34 CFR 361.55

Part 11 MDRS Compilation Part 11 Vocational Rehabilitation Federal Regulations

32 Miss. Admin. Code Pt. 11 MDRS Compilation Part 11 Vocational Rehabilitation Federal Regulations

1

Title 32: Rehabilitation Services Part 11: Vocational Rehabilitation Regulations REPEALED. Effective 02/07/2025

Part 21 MDRS Compilation Part 21: VR Policy and Resource Guide

32 Miss. Admin. Code Pt. 21 MDRS Compilation Part 21: VR Policy and Resource Guide

1

Title 32 Rehabilitation and Disabilities

Part 21 Vocational Rehabilitation Policy and Resource Guide

Source: Miss Code § 37-33-54

Chapters

1 Mission and Assurances

1.0 MDRS Mission 1.1 General Policies 1.1.1 Nondiscrimination 1.1.2 Case File Documentation 1.1.3 Timely Processing of Referrals, Applications and Services 1.1.4 Agreements with Other Agencies and Organizations including the Mississippi Workforce Investment System 1.1.5 Cost Effective Service Provision 1.1.6 Data Collection 1.1.7 Outreach Activities 1.1.8 Services to American Indians Who are Disabled 1.1.9 Utilization of Community Rehabilitation Programs 1.1.10 Utilization of Profit-Making Organizations 1.1.11 Establishment and Construction Authority 1.2 Vocational Rehabilitation Services for Employees of MDRS 1.3 Client Assistance Information

2 Case Record 2.0 Case Record Policy Statement 2.1 Purpose 2.2 Scope 2.3 Required Documentation 2.3.1 Request for Amendment of Case Information 2.4 Case Folder as an Official Document 2.5 Case Record Organization 2.6 Case Record Retention 2.7 Case Record Disposal

3 Confidentiality 3.0 Confidentiality 3.1 Ownership of Records 3.1.1 Maintaining Client File Records 3.1.2 Improper Removal 3.1.3 Notice 3.2 Statement of Consent for Disclosure 3.2.1 Case Record Memorandum

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3.3 Release of Confidential Information with the Consent of the Client 3.4 Release of Confidential Information without the Consent of the Client 3.5 Subpoenas 3.6 Social Security Administration Case Record 3.7 Release of Information Regarding Deceased Client 3.8 Policies Concerning Provision of Confidential Information to Applicants, Clients and Other Interested Persons Including Those Who are Unable to Communicate in English or Who Rely on Special Modes of Communication

4 Hearing Procedures 4.0 Hearing Policy Statement 4.1 Informal Review 4.1.1 Informal Review Procedures 4.2 Mediation 4.2.1 Definition of a Qualified Mediator 4.3 Impartial Due Process Hearing 4.3.1 Definition of Impartial Hearing Officer 4.3.2 Conduct of the Hearing 4.4 Review of the Impartial Hearing Officer’s Decision 4.4.1 Finality of Review 4.5 Suspension, Reduction or Termination of Services

5 Eligibility 5.0 Eligibility 5.1 Policy Statement 5.2 Implementation 5.3 Definitions 5.3.1 Applicant 5.3.2 Assessment for Determining Eligibility and Vocational Rehabilitation Needs 5.3.3 Presumption 5.3.4 Physical or Mental Impairment 5.3.5 Substantial Impediment to Employment 5.3.6 Functional Limitations 5.3.7 Individual with a Disability 5.3.8 Individual with a Significant Disability 5.3.9 Individual with a Most Significant Disability 5.3.10 Employment Outcomes 5.4 Determination of Eligibility 5.4.1 Determining if the Applicant is an Individual with a Disability 5.4.2 Determining Whether an Individual Will Require Vocational Rehabilitation Services to Prepare For, Secure, Retain, or Regain Employment 5.5 Comprehensive Assessment 5.5.1 Trail Work Experience 5.6 Determination of Ineligibility

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5.6.1 Certificate of Eligibility 5.7 Client Order of Selection

6 Individualized Plan for Employment 6.0 Individualized Plan for Employment (IPE) 6.1 IPE Policy Statement 6.2 Scope of the IPE 6.3 Initiation of the IPE 6.4 Development of the IPE

6.5 Informed Choice 6.6 Individualized Plan for Employment Form Completion (IPE, revised 03-99) 6.7 Basic IPE Contents 6.8 Conclusion

7 Services 7.0 Services

8 Financial Accountability 8.0 Financial Accountability Policy Statement 8.1 Comparable Services and Benefits 8.2 Fee Schedule 8.3 State Vendor Contracts 8.4 State Purchasing Regulations 8.5 Purchase of Computer /Telecommunication Equipment and/or Services 8.6 Purchase of Drugs 8.7 Authorization 8.8 Statement of Accounts

9 Closures 9.0 Closures 9.1 Criteria Requirements for Closing Case Records as Rehabilitated 9.1.1 Criteria 9.1.2 Requirements for Closing Case Records as Rehabilitated 9.2 Criteria and Requirements for Closure of Case Records in a Non-Rehabilitated Status Subsequent to Initiation of IPE-Closed, Not Rehabilitated 9.2.1 Criteria 9.2.2 Requirements for Closing Case Records, Not Rehabilitated 9.2.2.1 Closure for Reasons other than Eligibility Criteria Not Met (Intervening Reasons) 9.2.2.2 Closure Because Eligibility Requirement are No Longer Met

9.3 Criteria and Requirements for Closure of Case Records 9.3.1 Criteria 9.3.2 Requirements for Closing Case Records 9.3.2.1 Closure for Reason Other than Eligibility Criteria Not Met

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9.3.2.2 Closure Because Eligibility Requirements are No Longer Met

9.4 Criteria and Requirements for the Closure of Case Records From Referral and Applicant Status 9.4.1 Criteria 9.4.2 Requirements for Closing Case Records from Application Status 9.4.2.1 Closure for Reason Other Than Eligibility Criteria Not Met 9.4.2.2 Closure Because Eligibility Requirements are Not Met 9.5 Closure from Pre-Service Listing 9.5.1 Criteria 9.5.2 Requirements for Closing Case Records 9.5.2.1Closure for Reasons Other Than Eligibility Criteria Not Met (Intervening reasons)

9.6 Post Closure Services 9.6.1 Criteria for Provision of Post-Employment Services 9.6.2 Requirements for Provision of Post-Employment Services 9.6.3 Closure from Post-Employment Service Status 9.6.3.1 Closure from Post-Employment Services-Case Reopened 9.6.3.2 Closure from Post-Employment Services – Successful 9.6.3.3 Closure from Post-Employment Services – Unsuccessful

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OVR/OVRB POLICY AND PROCDURE GUIDE

MISSIONS AND ASSURANCES

1.0 MDRS Mission

It is the mission of the Mississippi Department of Rehabilitation Services to provide appropriate and comprehensive services to Mississippians with disabilities in a timely and effective manner.

All policy statements expressed within this Office of Vocational Rehabilitation/Office of Vocational Rehabilitation for the Blind Policy and Procedure Manual reflect a commitment to the mission of the Agency as being the guiding principle with respect to all activities of the Department.

1.1 General Policies

(Pertinent sections of The Rehabilitation Act of 1973 As Amended by The Rehabilitation Act Amendments of 1998 are found in parentheses following some sections. MDRS is committed to achieving satisfactory performance outcomes through complying with, monitoring, and reporting the Evaluation Standards and Performance Indicators, as listed at 34 CFR Part 361.80, Subpart E)

All policies in this manual were reviewed by the State Rehabilitation Council in accordance with the Rehabilitation Act of 1973, as amended in the 1998 Workforce Investment Act, and with applicable federal regulations.

1.1.1 Nondiscrimination

No individual or group of individuals is excluded or found ineligible on the basis of sex, age, race, creed, color, religion, or, national origin, type of disability, duration of residence in Mississippi, public assistance status, citizenship, type of expected employment outcome, source of referral, particular service needs or anticipated costs of services required, or income level of an applicant or applicant’s family. This applies to all locations in which rehabilitation services are provided by this agency, including one-stop centers.

1.1.2 Informed Choice

MDRS provides applicants and clients with opportunities to exercise informed choice throughout the VR process, including making decisions about the employment goal, VR services, service providers, settings for employment and service provision, and methods for procuring services.

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To enable an individual to make such decisions, MDRS provides information, support and assistance needed by the individual. MDRS has implemented policies, procedures, and practices and developed resources that enable applicants and clients to exercise informed choice throughout the entire VR process; these policies, procedures, and practices are consistent with Federal statutory and regulatory requirements.

Specifically, MDRS ensures that the individual, or if appropriate, the individual through his or her representative:

 makes decisions related to the assessment process and to selection of the employment outcome and the settings in which employment occurs, vocational rehabilitation services, service providers, the settings for service provision, and the methods for procuring services;

 has a range of options from which to make these decisions or, to the extent possible, the opportunity to create new options that will meet the individual’s specific rehabilitation needs;

 has access to sufficient information about the consequences of various options;

 has skills for evaluating the information and for making decisions, or, to the extent possible, the opportunity to develop such skills or support and assistance in carrying out these functions;

 makes decisions in ways that reflect the individuals strengths, resources, priorities, concerns, abilities, capabilities, and career interests; and

 takes personal responsibility, to the extent possible, for implementing the chosen options.

For individual Areas of Responsibility, see the OVR/OVRB Resource Guide.

1.1.3. Timely Processing of Referrals, Applications and Services

The staff of MDRS shall process referrals and applications, determine eligibility or ineligibility for services, and provide services in a timely prompt and appropriate equitable manner. Vocational Rehabilitation staff should contact referred individuals within 14 days by telephone, letter, or personal visit. Good faith effort to inform individuals of application requirements, including the requirement that individuals who receive services under the program must intend to achieve an employment outcome, shall be made and a specific time and place to meet should be scheduled. Application forms are available statewide, including at One-Stop Centers established under Section 121 of the Workforce Investment Act of 1998. Evaluation and services are to be provided in the most integrated setting possible, consistent with the individual’s needs and informed choice, without undue delay.

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For purposes of determining eligibility within the 60 day federal requirement, an individual is considered to have submitted an application when the individual or their representative, as appropriate, (a) has completed and signed an agency application form or common intake form at a one-stop center or other outside source or has otherwise requested services from MDRS, (b) has provided to MDRS information necessary to initiate an assessment to determine eligibility and priority for services, and (c) is available to complete the application process.

The individual with disabilities shall be determined to be eligible or ineligible within a reasonable period of time, not to exceed 60 days after the individual has submitted an application to receive services unless:

1. the Agency notifies the individual that exceptional and unforeseen circumstances beyond the control of the Agency preclude the Agency from completing the determination within the prescribed time and the individual agrees that a specific extension of time is warranted; or,

2. unless the individual and the Agency agree to Trial Work Experiences.

As outlined in the Rehabilitation Act Amendments of 1998, to the maximum extent appropriate and consistent with the requirements under the Act, existing information available From other programs, particularly information used by educational officials and the Social Security Administration, and information provided by the individual with a disability or the individual's family, will be used in determining eligibility for vocational rehabilitation services, identifying rehabilitation needs, and developing Individualized Plan for Employment (IPE) goals, and services.

The Rehabilitation Act Amendments of 1998 established presumptive eligibility for disabled individuals who are recipients of Supplemental Security Income (SSI) or beneficiaries of Social Security Disability Insurance (SSDI) payments and who intend to achieve a specific employment outcome, (Section 102(a)(3) of the 1998 Rehabilitation Act Amendments) unless the Agency can prove by clear and convincing evidence documented in the case file that the applicant could not benefit from vocational rehabilitation services due to the severity of his or her disability.

1.1.4 Case File Documentation

A case file must be maintained for each applicant/client containing all required forms and case records. The counselor will record all decisions to provide, deny or modify services.

1.1.5. Data Collection

Counselors shall insure the provision of client and financial data necessary for the operation of the MDRS Management Information System.

1.1.6 Cost Effective Service Provision

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Services shall be provided in a cost-effective manner. Vocational rehabilitation services will be provided after a determination that comparable services and benefits are not available under any other program, except in three instances.

Such a determination of comparable services and benefits shall not be required prior to the provision of services planned on an IPE

1. If the determination would delay the provision of such services to any individual at extreme medical risk;

2. if an immediate job placement would be lost due to a delay in the provision of such comparable benefits; or,

3. if the search would delay or interrupt the progress of the individual toward achieving the specific employment outcome identified in the IPE. (Section 101(a)(8) of the 1998 Rehabilitation Act Amendments)

1.1.7 Outreach Activities

MDRS shall ensure issues of traditionally underserved populations are addressed. These issues include, but are not limited to, the following:

 the rapid changing racial profile of America,

 the disproportionately high rate of disability in ethnic and racial minorities,

 the historic inequitable treatment of minorities in the vocational rehabilitation process, and,

 the need to recruit larger numbers of minorities into the rehabilitation profession.

MDRS addresses strategies regarding minority outreach through the ten geographical case service districts. The following strategies for district outreach activities are designed to ensure that the philosophy of MDRS is implemented at all levels of the organization.

1. District Managers shall be familiar with the ethnic minorities (American Indian, African- Americans, Asian-Americans, and Latinos) located in their service areas.

2. Staff persons shall be designated in all districts to coordinate outreach activities related to minorities and other traditionally unserved or underserved individuals.

3. Each service area shall maintain an outreach program by establishing contact with community centers, churches, clubs, and social organizations where ethnic minorities participate actively and maintain their identity.

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4. Service delivery patterns shall be analyzed throughout the district to develop strategies to eradicate current deficiencies in service provision to minority individuals and thereby increase employment outcomes among those groups.

5. Each district shall provide in-service training periodically to increase awareness, sensitivity, and attitudinal shift or change on multi-cultural issues for counselors and support staff.

6. MDRS shall recruit qualified staff of various ethnic origins to fill professional staff vacancies.

1.1.8 Services to American Indians Who Are Disabled

MDRS will provide vocational rehabilitation services to American Indians with disabilities residing in the State to the same extent as the State provides such services to other significant segments of the population of individuals with disabilities residing in the State. Vocational rehabilitation services will continue to be provided, including as appropriate, services traditionally used by Indian tribes, to American Indians with disabilities on reservations eligible for services by special tribal programs under other sections of the Rehabilitation Act. (Section 101(a) (13) and 130 of the 1998 Rehabilitation Act Amendments)

1.1.9 Agreements with Other Agencies and Organizations, including the Mississippi Workforce Investment System

Counselors shall comply with the provisions of agreements between MDRS and other agencies and organizations; including those in the Mississippi Workforce Investment System. These agreements provide for interagency cooperation which may include establishing interagency working groups; coordinating policies, practices, and procedures; identifying available resources; setting up a comprehensive information and referral system; and defining the financial responsibility of each agency for paying for necessary services and resolving disputes. (Section 101(a)(11) of the 1998 Rehabilitation Act Amendments)

The Mississippi Department of Rehabilitation Services will make available an information and referral system adequate to ensure that individuals with disabilities, including eligible individuals who do not meet the Agency's order of selection criteria for receiving vocational rehabilitation services if the Agency is operating on an order of selection, are provided accurate vocational rehabilitation information and guidance (which may include counseling and referral for job placement) using appropriate modes of communication to assist them in preparing for, securing, retaining, or regaining employment; and will refer individuals with disabilities to other appropriate Federal and State programs, including other components of the statewide workforce investment system. In making these referrals, MDRS will refer the individual to Federal or State programs, including programs carried out by other components of the statewide workforce investment system, best

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suited to address the specific employment needs of an individual with a disability, and provide the individual who is being referred—

1. A notice of the referral by MDRS to the agency carrying out the program;

2. Information identifying a specific point of contact within the agency to which the individual is being referred; and

3. Information and advice regarding the most suitable services to assist the individual to prepare for, secure, retain, or regain employment.

In providing the information and referral services under this section to eligible individuals who are not in the priority category or categories to receive vocational rehabilitation services under an order of selection, if one is in effect, MDRS will maintain and report data on the number of eligible individuals who did not meet the Agency's order of selection criteria for receiving vocational rehabilitation services and did receive information and referral services.

4. MDRS shall maintain a list of interpreters fluent in languages spoken by the targeted populations.

5. District Managers shall maintain formal relationships with historically Black Colleges and Universities in their service area by assigning a liaison person(s) to encourage referrals, job placement, training, outreach, and recruitment.

MDRS has an agency-wide Cultural Diversity Committee that is responsible for the following:

1. developing strategies for outreach in the district offices to be implemented by the staff designated outreach workers;

2. establishing reporting formats for each district office to summarize outreach activities, which occurred during the quarter;

3. reviewing the quarterly outreach reports and submitting a summary to the MDRS Executive Director; and,

4. making recommendations to the MDRS Executive Director for additional outreach activities designed to increase contact with culturally diverse populations.

1.1.10 Utilization of Community Rehabilitation Programs

MDRS will, when in the best interest of the consumer, utilize community rehabilitation programs to meet the identified needs of those persons served by the Agency. In order to ensure quality of services provided by community rehabilitation programs, MDRS will institute a mechanism for review and maintenance of community rehabilitation program utilization statistics. Individuals

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with disabilities are active and full partners in their rehabilitation programming through the exercise of informed choices with respect to selection of services and service providers.

1.1.11 Utilization of Profit-Making Organizations

Mississippi Code, Section 37-33-157, gives MDRS direct purchasing authority for the purchase of services from a profit-making organization for the purpose of providing on-the-job training and related programs. Profit-making organizations may be utilized when they are better qualified than not-for-profit agencies and organizations to provide needed services. This can be determined based on past performance, quality of service, client satisfaction, and similar factors.

1.1.12 Establishment and Construction Authority

MDRS through its Office of Vocational Rehabilitation and Office of Vocational Rehabilitation for the Blind officially exercises the option of Establishment or Construction Authority as provided for in the 1998 Amendments to the Rehabilitation Act. In utilizing such special authority, MDRS will adhere to all applicable rules and regulations as set forth by the State of Mississippi, the Rehabilitation Services Administration, and the U.S. Department of Education.

MDRS will use this authority for the establishment, development, or improvements of community rehabilitation programs, including, under special circumstances, the construction of a facility and the provision of other services (including services offered at community rehabilitation programs) which promise to contribute substantially to the rehabilitation of a group of individuals but which are not related directly to the individualized rehabilitation program of any one individual with a disability. Such programs will be used to provide services that promote integration and competitive employment. (Section 103(b)(2) and Section 104 of the 1998 Rehabilitation Act Amendments)

1.2 Vocational Rehabilitation Services for Employees of MDRS

The practice for providing services to MDRS employees who have disabilities are exactly the same as those for providing vocational rehabilitation services to any person with a disability. Every case being considered for vocational rehabilitation services must be subjected to the eligibility criteria established in Section 102(a), Title I of the 1998 Rehabilitation Act Amendments. These criteria are equally applicable to employees of MDRS who may apply for vocational rehabilitation services. An employee of MDRS who is seeking vocational rehabilitation services should never confuse these services with having reasonable accommodations on the job. The concept of reasonable accommodations on the job applies to the accommodations needed at the job site in order to function on the job. The use of comparable benefits must be evident in all rehabilitation programs.

1.3 Client Assistance Information

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In accordance with requirements of the Rehabilitation Act Amendments of 1998, MDRS will advise all individuals with disabilities seeking or receiving services through the Department, or their authorized representatives, of the availability and purpose of the Client Assistance Program (CAP), including the means to seek CAP assistance. (Section 20 of the 1998 Rehabilitation Act Amendments

1.4 PUBLIC HEARING PROCEEDINGS ON PROPOSED POLICY CHANGES THAT SUBSTANTIALLY IMPACT SERVICES TO CLIENTS

1. Scope. - The following policy and procedures apply to all public hearings held for the purpose of providing the public with an opportunity to make oral presentations on proposed new policies and amendments to existing policies before the Department (MDRS) that substantially impact services to clients.

2. When Public Hearing Proceedings will be Scheduled on Proposed Policies. The Department will conduct a public hearing proceeding within thirty (30) days after the first notice of public hearing is run in certain regional and statewide newspapers on proposed policy or amendment to existing policies that substantially impact services to clients.

3. Requested Format. Each request to comment must be printed or typewritten, or must be in legible handwriting. Each request to comment must be submitted on standard business letter-size paper (8-1/2 inches by 11 inches). Requests to comment may be in the form of a letter addressed to the MDRS Executive Director and signed by the requestor(s).

4. Notification of Public Hearing Proceedings. The date, time and place of all public hearing proceedings will be announced via notice in certain regional and statewide newspapers, public service announcements via Mississippi Public Radio, notice on the MDRS website, and press releases to numerous consumer organizations who represent or serve people with disabilities. The public hearing proceeding will be scheduled within thirty (30) days after the first notice of public hearing is run in certain regional and statewide newspapers.

5. Presiding Officer. The Executive Director, or his/her designee, who is familiar with the substance of the proposed policy, shall preside at the public hearing proceeding on a proposed policy.

6. Public Presentations and Participation.

a. At a public hearing proceeding on a proposed policy, persons may make oral statements and make documentary and physical submissions, which may include data, views, comments or arguments concerning the proposed policy. b. Persons wishing to make oral presentations at such a proceeding shall notify the Department at least one business day prior to the proceeding and indicate the general subject of their presentations. The presiding officer at his or her discretion may allow individuals to participate that have not previously contacted the Department.

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c. At the proceeding, those who participate shall indicate their names and addresses, identify any persons or organizations they may represent, and provide any other information relating to their participation deemed appropriate by the presiding officer. d. The presiding officer may place time limitations on individual oral presentations when necessary to assure the orderly and expeditious conduct of the public hearing proceeding. To encourage joint oral presentations and to avoid repetition, additional time may be provided for persons whose presentations represent the views of other individuals as well as their own views. e. Persons making oral presentations are encouraged to avoid restating matters that have already been submitted in writing. f. There shall be no interruption of a participant who has been given the floor by the presiding officer, except that the presiding officer may in his or her discretion interrupt or end the participant’s time where the orderly conduct of the proceeding so requires.

7. Conduct of Oral Proceeding.

a. Presiding officer. The presiding officer shall have authority to conduct the proceeding at his or her discretion for the orderly conduct of the proceeding. The presiding officer shall (i) call proceeding to order; (ii) give a brief synopsis of the proposed policy, a statement of the statutory authority for the proposed policy; (iii) call on those individuals who have contacted the Department about speaking on or against the proposed policy; (iv) allow for rebuttal statements following all participant’s comments; (v) adjourn the proceeding. b. Questions. The presiding officer, where time permits and to facilitate the exchange of information, may open the floor to questions or general discussion. The presiding officer may question participants and permit the questioning of participants by other participants about any matter relating to that policy-making proceeding, including any prior written submissions made by those participants in that proceeding; but no participant shall be required to answer any question. c. Physical and Documentary Submissions. Submissions presented by participants in a public hearing proceeding shall be submitted to the presiding officer. Such submissions become the property of the Department and are subject to the Department’s public records request procedure. d. Recording. The Department may record oral proceedings by stenographic or electronic means.

CASE RECORD

2.0 Case Record Policy Statement

The Mississippi Department of Rehabilitation Services, with input from the State Rehabilitation Council, will establish and maintain a case record for each applicant and/or recipient of vocational rehabilitation services. This record will contain all information relevant and necessary to provide the individual with rehabilitation services.

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2.1 Purpose

The primary purpose of a case record is to facilitate the client-study process. Case records are indispensable as a device by which the Agency maintains and improves the quality of its operations and tests the effectiveness of the services it provides. Good case records are essential for supervision. They can provide information for making an evaluation of the program. Program administrators rely on case records to ensure the acceptance of cases, the provision of counseling and planning services, and that service provision meets the criteria that are established by law and regulations.

2.2 Scope

During early contact with the client, the case recording should emphasize history, present adjustment and environmental situations, and the objective measures of, or reports on, his/her physical and mental capacities.

Good documentation provides continuity with respect to all general information, evaluations, and services provided. The recorded information about a client should be accurate and reliable. If there are any contradictory reports, they are to be fully explained or reconciled in the case record. Reported observations or generalizations about a client should be recorded in such a way that the reliability of the reports can be determined. The source of all recorded data about the client should be clearly indicated.

The case record should indicate the nature and extent of professional contribution to the progress of the case. It should include any problems the counselor encountered in working with the client or helping secure services from other community agencies. The case documentation should reflect the effectiveness of the services. There should be enough information in the record to indicate whether or not treatment was successful, the client developed the vocational skills that were planned, and the personal counseling and social adjustments resulted in an improvement in the client's situation. All case records are subject to legal subpoena and may be used as evidence in fair hearings or court proceedings. Therefore, opinion-based (non-factual) observations should not be entered into the record.

2.3 Required Documentation

There can be no specific rules regarding the amount of information that will actually be included in the case record. In instances where a form is completed to document a particular event in a case file, a corresponding case note is not required. However, to the degree applicable, each case record will contain documentation:

1. sufficient to determine eligibility for vocational rehabilitation services, or supported employment;

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2. for presumptive eligibility in regards to recipients of SSI and/or SSDI appropriate evidence, such as an award letter, is sufficient for eligibility, although medical documentation of disability would be necessary before planning of services on the IPE;

3. for ineligibility specifying the reason for ineligibility determination and an annual review of the ineligibility determination;

4. of significance of disability(ies) and impediment(s) to employment;

5. of periodic assessment (not to exceed 30 days) of the applicant during Trial Work Experiences to determine vocational rehabilitation;

6. of an Individualized Plan for Employment (IPE) and any amendments to the plan;

7. supporting the determination that the clinical status of the applicant is stable or slowly progressive, in the event that physical and mental restoration services are provided, unless he/she is involved in Trial Work Experiences to assess rehabilitation potential;

8. supporting any decision to provide services to family members;

9. relating to the participation in the cost of any vocational rehabilitation service;

10. relating to the eligibility of the applicant or client for any available comparable benefits;

11. that the applicant or client has been advised of the confidentiality of all information pertaining to his/her case, and documentation that information about the applicant or client will not be released without his/her written consent;

12. as to the reason for closing a client's case including their employment status and, if determined to be rehabilitated, the basis on which the employment was determined to be suitable;

13. concerning any action and decision involving the request by the applicant or client for review of the rehabilitation counselor's determination;

14. of appropriate reviews of a client's status who has been provided vocational rehabilitation services under an IPE then determined to be no longer capable of achieving a specific employment outcome in an integrated setting;

15. of the source of the ongoing support services at the time of IPE for supported employment services;

16. of the progress of clients assisted under supported employment to determine whether services should be continued, modified, or discontinued;

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17. if necessary, documentation as to the reason eligibility determination required more than 60 days including the applicant's response; and

18. how informed choice was provided throughout the rehabilitation process.

2.3.1 Request for Amendment of Case Information

An applicant or client who believes that information in the case record is inaccurate or misleading may request that the Agency amend the information. If the information is not amended, the request for an amendment must be documented in the case record.

2.4 Case Folder As An Official Document

The case folder in the local district office is considered to be the legal record of the case and should be treated as such by all vocational rehabilitation personnel.

All materials must be legible and written in ink or typed. Documentation presented in the case record must be initialed or signed by the individual responsible. Any form that is initiated or completed by any Agency personnel must be signed and dated. All bills are to be initialed by the counselor. Case materials should be fastened in the folder in an orderly manner.

Information is not to be given out indiscriminately, but must follow guidelines as set forth in the Confidentiality section of this manual (Section 3.0).

Records are to be secured where any unauthorized parties may not gain access to or abstract information from them. If the counselor needs to take the case record out of the office, it should be signed out so anyone needing access to information from the file will know where it is.

2.5 Case Record Organization

The case record should be organized in such a way as to allow for easy access of information. All materials should be filed in reverse chronological order (most recent on top) based on the date the information was received. The left side of the file should contain all financial information. Case notes should be in front of the financial documents. The right side of the file will contain all other documents. The IPE and all amendments will be filed on the top of the right hand side of the file, with the Certificate of Eligibility filed directly beneath the IPE on the right side.

2.6 Case Record Retention

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Federal and State regulations require the retention of closed client files for a period of three years, beginning with the date of the submission of the final expenditure report for the year during which the case was closed.

If any litigation, claim, negotiation, audit, or other action has been initiated before the expiration of the three-year period, the records will be retained until the completion of the action and resolution of all issues which arise, or until the end of the regular three-year period, whichever is later.

All offices will be notified when the records of a particular year will be retained for the purpose of resolving any action initiated prior to the expiration of the three-year period.

The following situations may also require records to be retained longer than three years from closure:

1. Applicants closed from application status - Records must be maintained for at least three years after the last annual review.

2. Clients closed from service status - Records must be maintained for at least three years after the last annual review.

3. Clients closed in non-competitive, extended employment in a community rehabilitation program - Records must be maintained for at least three years after the last review and reevaluation takes place.

4. Clients who received post-employment services - Records must be maintained for at least three years after the case has been closed from post-employment.

5. Applicants or clients who received a fair hearing - Records must be maintained for at least three years after a final determination is made.

2.7 Case Record Disposal

When disposing of records, care must be taken to prevent inappropriate disclosure of confidential information contained in Agency files. Such files must be shredded, burned, or otherwise destroyed to prevent the unwarranted use of this information.

CONFIDENTIALITY

3.0 Confidentiality

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MDRS hereby expresses written policies and procedures to safeguard the confidentiality of all personal information, including photographs and lists of names. These policies and procedures ensure that—

1. Specific safeguards are established to protect current and stored personal information;

2. All applicants and eligible individuals and, as appropriate, those individuals' representatives, service providers, cooperating agencies, and interested persons are informed through appropriate modes of communication of the confidentiality of personal information and the conditions for accessing and releasing this information;

3. All applicants or their representatives are informed about MDRS' need to collect personal information and the policies governing its use, including—

a. Identification of the authority under which information is collected;

b. Explanation of the principal purposes for which MDRS intends to use or release the information;

c. Explanation of whether providing requested information to MDRS is mandatory or voluntary and the effects of not providing requested information;

d. Identification of those situations in which MDRS requires or does not require informed written consent of the individual before information may be released; and

e. Identification of other agencies to which information is routinely released;

4. An explanation of State policies and procedures affecting personal information will be provided to each individual in that individual's native language or through the appropriate mode of communication; and

5. These policies and procedures provide no fewer protections for individuals than State laws and regulations.

State Program Use

All personal information in the possession of MDRS is used only for the purposes directly connected with the administration of the vocational rehabilitation program. Information containing identifiable personal information is not shared with advisory or other bodies that do not have official responsibility for administration of the program. In the administration of the program, MDRS may obtain personal information from service providers and cooperating agencies under assurances that the information may not be further divulged, except as provided elsewhere in this section.

Release to Applicants and Eligible Individuals

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1. Except as provided elsewhere in this section, if requested in writing by an applicant or eligible individual, MDRS makes all requested information in that individual's record of services accessible to and will release the information to the individual or the individual's representative in a timely manner.

2. Medical, psychological, or other information that MDRS determines may be harmful to the individual may not be released directly to the individual, but must be provided to the individual through a third party chosen by the individual, which may include, among others, an advocate, a family member, or a qualified medical or mental health professional, unless a representative has been appointed by a court to represent the individual, in which case the information must be released to the court-appointed representative.

3. If personal information has been obtained from another agency or organization, it may be released only by, or under the conditions established by, the other agency or organization.

4. An applicant or eligible individual who believes that information in the individual's record of services is inaccurate or misleading may request that the designated Agency amend the information. If the information is not amended, the request for an amendment will be documented in the record of services.

Release for Audit, Evaluation, and Research

Personal information may be released to an organization, agency, or individual engaged in audit, evaluation, or research only for purposes directly connected with the administration of the vocational rehabilitation program or for purposes that would significantly improve the quality of life for applicants and eligible individuals and only if the organization, agency, or individual assures that—

1. The information will be used only for the purposes for which it is being provided;

2. The information will be released only to persons officially connected with the audit, evaluation, or research;

3. The information will not be released to the involved individual;

4. The information will be managed in a manner to safeguard confidentiality; and

5. The final product will not reveal any personal identifying information without the informed written consent of the involved individual or the individual's representative.

Release to Other Programs or Authorities

1. Upon receiving the informed written consent of the individual or, if appropriate, the individual's representative, MDRS may release personal information to another agency or organization for its program purposes only to the extent that the information may be released

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to the involved individual or the individual's representative and only to the extent that the other agency or organization demonstrates that the information requested is necessary for its program.

2. Medical or psychological information that MDRS determines may be harmful to the individual may be released if the other agency or organization assures MDRS that the information will be used only for the purpose for which it is being provided and will not be further released to the individual.

3. MDRS must release personal information if required by Federal law or regulations.

4. MDRS must release personal information in response to investigations in connection with law enforcement, fraud, or abuse, unless expressly prohibited by Federal or State laws or regulations, and in response to an order issued by a judge, magistrate, or other authorized judicial officer.

5. MDRS also may release personal information in order to protect the individual or others if the individual poses a threat to his or her safety or to the safety of others.

(Authority: Sections 12(c) and 101(a)(6)(A) of the Act; 29 U.S.C. 709(c) and 721(a)(6)(A))

MDRS has established reasonable fees to cover extraordinary costs of duplicating records or making extensive searches and has established policies and procedures governing access to records.

If duplication of records is requested, by a client or a client's personal representative, for that client's own use, no fees for reproducing those records shall be charged, unless the volume of such requested information is so extensive as to exceed 20 pages. Should a request for information exceed twenty pages, the Agency employee processing the request shall institute common procedure for such requests by persons authorized to have access to this information by contacting the Office of Finance for the Agency and requesting a "fund number" for receipt of money collected to defray the cost of duplicating the requested records. The employee may then charge the requesting party a fee of $1.00 (one dollar) for each page in excess of 20 pages for the information. Payment should be requested in the form of check or money order, payable to the "Mississippi Department of Rehabilitation Services." When funds are collected, a receipt will be issued to the purchaser. A duplicate receipt will be forwarded to the State Office along with the check or money order. There will be no charge to State or Federal agencies associated in providing services directed toward the client's rehabilitation program, or any other agencies that have an exchange of information agreement with this Agency.

3.1 Ownership of Records

All confidential information acquired by the Agency is the property of the Agency and shall remain so.

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3.1.1 Maintaining Client File Records

The Agency shall maintain in its records only such information about a client as is relevant and necessary to accomplish any purpose of the Agency required by State or Federal law, regulation or policy. These client file records should be maintained in an orderly, formal manner. Any information relating to the Agency's evaluation of factual information should be labeled as such. Any such information should be stated as objectively as possible.

3.1.2 Improper Removal

No information in the case record shall be removed, destroyed, or altered for purposes of avoiding compliance with these regulations.

3.1.3 Notice

When the Agency makes a disclosure to any person or entity other than the client, the following or similar statement shall accompany the disclosure:

NOTICE

THIS IS CONFIDENTIAL INFORMATION FROM THE RECORDS OF THE MISSISSIPPI DEPARTMENT OF REHABILITATION SERVICES. STATE AND FEDERAL LAW AND REGULATIONS PROHIBIT YOU FROM MAKING ANY FURTHER DISCLOSURE OF THIS INFORMATION WITHOUT THE INFORMED WRITTEN CONSENT OF THE CLIENT TO WHOM THIS INFORMATION PERTAINS. ANY SUCH FURTHER DISCLOSURE COULD RESULT IN CIVIL OR CRIMINAL LIABILITY.

3.2 Statement of Consent for Disclosure

All applicants, clients, or client representatives are to be informed of the confidentiality of records. Release of such information must be by written consent of the client or authorized representative and must include:

1. name and Social Security number of the client;

2. designation of the parties to whom the information may be released;

3. nature of the information to be released;

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4. specific purposes for which the released information may be used;

5. designation of the Agency person authorized to disclose the information;

6. dates of initiation and termination of consent; and,

7. signature of the client and/or client representative.

3.2.1 Case Record Memorandum

When confidential information is released, Form VR-19 ―Client Consent to Disclose Information‖ must be completed and placed in the case file.

3.3 Release of Confidential Information Without the Consent of the Client

In the direct course of providing vocational rehabilitation services an employee may disclose confidential information to other Agency employees, who have a legitimate need for the information, without the prior consent of the client. Also, the Agency may share confidential information on a need-to-know basis with its trainees, interns, and volunteers, who shall be bound by Agency rules concerning confidentiality, in the same manner as employees. Additional instances in which confidential information may be released without consent of the client are discussed earlier in this section.

3.5 Subpoenas

If an employee of the Agency is subpoenaed for appearance in court, by law the employee must appear at the time and place indicated in the subpoena. Unless specific records are subpoenaed, no files or records should be taken into the courtroom. When a client is involved in litigation or in an administrative proceeding and a subpoena for the production of only the client's records is received by the Agency, the employee receiving it shall do as follows:

1. Contact their immediate supervisor for assistance; and,

2. The subpoenaed employee shall do the following:

a. If the subpoena is from the client's attorney, contact that attorney immediately and request written confirmation of his/her status as the client's attorney.

b. If the subpoena is from an attorney other than the client's, contact the client's attorney, if known, or the client, and request written consent to release the information, and release the information only after such consent is received.

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c. If the subpoena is received and the consent has not been received by the due date of the subpoena, the employee shall appear before the court or administrative body and inform them of the requirements by law and regulations concerning confidentiality. The employee shall testify only upon order, or if the client consents, at the hearing.

d. If an employee receives a subpoena to testify in court or in an administrative hearing, the employee shall appear according to the terms of the subpoena, and shall testify if the client consents to such testimony. If no consent is given, the employee shall testify only under order and after informing the court or administrative body of the requirements of the law and regulations concerning confidentiality.

e. This section applies only to client records. The employee may testify without client consent about general information concerning the Agency, such as services available and eligibility criteria.

If an employee of the Agency is required to give sworn testimony, the employee should limit his/her remarks to professional aspects of the case with which the employee is familiar, and avoid unsubstantiated personal opinions. If travel expense is required in order to present testimony, travel costs are usually paid by the court or by one of the parties in the litigation. If no other reimbursement is provided, the employee may claim official reimbursement in keeping with Agency regulations.

3.6 Social Security Administration Case Record

Information in case records received from, or developed for, the Social Security Administration shall be controlled by the regulations governing confidentiality established by the Social Security Administration. Such information may be contained in the Agency's records as the result of a referral from the Office of Disability Determination Services in connection with the delivery of services to the client. However, should such information be sought by any client for any other reason, the client shall be directed to contact the Office of Disability Determination Services. Please note, under Federal law, a Member of Congress has a right to receive this information upon request. Congressional inquiries shall be forwarded to the Office of the Executive Director.

3.7 Release of Information Regarding Deceased Client

If information is requested concerning a deceased client, the Agency shall release such information only to the executor of a probated will or the administrator of the estate upon written proof of such status by the court. No other heirs or family members shall be given any information without a court order.

HEARING PROCEDURES

4.0 Hearing Policy Statement

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Throughout the rehabilitation process the counselor shall advise applicants or clients, or, if appropriate, their representative, of their right to request a timely review when they are dissatisfied with any determination made by MDRS personnel that affects the provision of vocational rehabilitation services and the procedures available for such review. This review may include mediation. The applicant or client or their representative shall be informed in writing regarding the right to obtain a review of agency determinations that affect the provision of vocational rehabilitation services through mediation or impartial due process hearings at the time of application for services; assignment to a category in the Agency’s order of selection; at the time the IPE is developed; and, whenever vocational rehabilitation services for an individual are reduced, suspended, or terminated. The applicant or client or, if appropriate, their representative shall be provided with the names and addresses of the individuals with whom requests for mediation or due process hearings may be filed, the manner in which a mediator or impartial hearing officer may be selected, and, the availability of the Client Assistance Program (CAP) to assist the applicant or client during mediation sessions or impartial due process hearings. The information provided to the applicant or client or their representative regarding the review of the counselor’s decision(s) shall be made available in a mode of communication that is accessible (understandable) to the applicant or client.

Applicants who are found ineligible for vocational rehabilitation services and previously eligible individuals who are determined to be no longer eligible for vocational rehabilitation services are permitted to challenge the determinations or ineligibility under the procedures described in this section.

4.1 Informal Review

The Mississippi Department of Rehabilitation Services has the authority to implement the informal review process when it is likely to result in a timely resolution of the issue(s) in disagreement. MDRS does not have the authority to require the applicant or client to use the informal review process or mediation prior to or instead of the provision of a formal review by an Impartial Hearing Officer. The Mississippi Department of Rehabilitation Services will not use the informal review process or mediation as a means to delay a formal review unless the parties jointly agree to the delay.

The timing of the informal review and/or mediation must take into account the fact that should the informal process not result in a resolution of the dispute, the informal and formal process must be concluded within 60 days of the date the individual requests a review of the rehabilitation counselor’s decision or determination, unless both parties agree to a specific extension of the time period.

4.1.1 Informal Review Procedures

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The entire informal review process, including mediation, shall be completed within a maximum of 15 days from the date of the receipt of the original request for an informal review to the date of the decision letter from the Director of the Office of Vocational Rehabilitation. The requestor may stop this informal process, including mediation, at any point (or bypass it entirely) and request the dispute be sent to an Impartial Hearing Officer for a formal review.

1. Within a maximum of 3 days from receipt of the original verbal/written request for an informal review, the District Manager having line supervision over the requestor’s counselor shall:

a. contact the requestor to set up appointment (time, date, place) for the informal review--this review date should be no later than 5 days from the receipt of the original verbal/written request for an informal review;

b. advise the requestor of the availability and function of the Mississippi Client Assistance Program;

c. advise the requestor that he/she may attend the review in person and, if he/she desires, be accompanied by a family member or an advocate from the Client Assistance Program; or any individual selected by the client to represent him/her,

d. contact the requestor if additional information is needed prior to the review; and,

e. offer mediation as a means of settling the dispute.

2. The requestor is to be notified immediately of the District Manager’s decision. The District Manager may notify the requestor verbally of his/her decision. However, this is to be followed up with notification to the requestor via Certified Mail, return receipt requested, with a copy to the case file. The letter shall:

a. state the matter(s) in dispute,

b. include the rationale for the decision, and,

c. advise the requestor to notify the Director of the Office of Vocational Rehabilitation (verbally or in writing), no later than five days from the receipt of the letter, if he/she is dissatisfied and wishes to have the Office Director review the decision, wishes to have the dispute mediated, or proceed with the formal review.

3. If the requestor seeks a review from the Director of the Office of Vocational Rehabilitation, this review must be conducted within a maximum of 15 days from the original request for an informal review. The review by the Office Director is to document review and does not necessitate the presence of the applicant or client. Should mediation be requested, the process must be completed no later than 15 days from the original request for an informal review.

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4. The requestor is to be notified immediately of the Office Director’s decision. The Office Director may notify the requestor verbally of his/her decision. However, this is to be followed up with notification to the requestor via Certified Mail, return receipt requested, with a copy to the case file. The letter shall:

a. state the matter(s) in dispute;

b. include the rationale for the decision;

c. advise the requestor to notify the Office Director (verbally or in writing), no later than five days from the receipt of the letter, if he/she is dissatisfied and wishes to proceed with the formal review by an Impartial Hearing Officer;

d. advise the requestor that an Impartial Hearing Officer will be selected at random from a list of qualified Impartial Hearing Officers; and,

e. advise the requestor that mediators are available should he/she choose mediation as a means to settle the dispute.

4.2 Mediation

Should the Informal Review process fail to resolve disputes involving Agency determinations that affect the provision of vocational rehabilitation services, accessible mediation may be used if both parties agree to this procedure. Participation in the mediation process is voluntary on the part of the applicant or client, as appropriate, and on the part of the Agency. The Mississippi Department of Rehabilitation Services shall maintain a list of qualified and impartial mediators from which one may be selected on a random basis to mediate the dispute. This process shall be at no cost to the client.

1. Each mediator on the list shall have knowledge of effective mediation techniques.

2. Mediation sessions shall be scheduled and conducted in a timely manner and shall be held in a location that is convenient to the parties in the dispute. Use of the mediation process is not used to deny or delay that applicant’s or client’s right to pursue resolution of the dispute through an impartial hearing held within the required time period or any other rights provided under this policy.

3. All agreements reached by the mediation process shall be set forth in a written mediation agreement developed by the parties with the assistance of the qualified and impartial mediator and signed by both parties. Copies of the agreement will be sent to both parties.

4. Discussions that occur during the mediation process shall be confidential and may not be used as evidence in any subsequent due process hearing or civil proceeding.

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5. The parties to the mediation process shall sign a confidentiality pledge prior to the commencement of the mediation process.

6. At any point during the mediation process, either party or the mediator may elect to terminate the mediation. In the event mediation is terminated, either party may pursue resolution through an impartial hearing.

7. The use of mediation to resolve a dispute does not remove the Agency from the responsibility to conclude the hearing process within 60 days.

8. The client, as a party to the dispute, has full discretion to choose an attorney, a guardian, a family member, a friend, or other person to serve as his or her advocate during mediation or a hearing.

9. The Agency will provide the applicant or client or, as appropriate, his or her representative, an opportunity to submit during mediation sessions information that supports his or her position.

10. MDRS shall bear the cost of the mediation process except for any costs related to the representation of an applicant or client.

4.2.1 Definition of a Qualified and Impartial Mediator

Qualified and Impartial Mediator is defined in the OVR/OVRB Resource Guide.

4.3 Impartial Due Process Hearing

The impartial due process hearing is to be conducted and completed by an Impartial Hearing Officer within 60 days from the day the applicant or client makes the original request for a review of a determination made by Agency personnel that affects the provision of vocational rehabilitation services to the applicant or client unless informal resolution or a mediation agreement is achieved prior to the 60th day or both parties agree to a specific extension of time. This includes any days utilized as part of the informal review.

1. The applicant or client, or if appropriate, a parent, guardian, or other representative shall be furnished an opportunity to present additional witnesses, evidence and information to the Impartial Hearing Officer. The applicant or client or his/her representative will also be given the opportunity to be represented by counsel or other appropriate advocate and examine all witnesses and other relevant sources of information and evidence.

2.The Impartial Hearing Officer is responsible for making a decision based on provisions of the approved State plan, the Rehabilitation Act as amended, Federal vocational rehabilitation regulations, and State regulations and policies that are consistent with Federal regulations.

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The decision shall be based on the provisions of the Mississippi Department of Rehabilitation Services approved State Plan and the Rehabilitation Act. A full written report of the findings and grounds for the decision will be completed within 30 days of the completion of the impartial due process hearing and provided to the requestor, or, if appropriate, the applicant or client’s parent, guardian, or other representative and to the Executive Director of the Mississippi Department of Rehabilitation Services.

4.3.1 Definition of Impartial Hearing Officer

Impartial Hearing Officer is defined in the OVR/OVRB Resource Guide.

4.3.2 Conduct of the Hearing

1. Duties of the Impartial Hearing Officer:

Once selected, at random from a list of qualified impartial hearing officers maintained by the Agency and identified by the Agency and State Rehabilitation Council, the Impartial Hearing Officer shall have the authority and responsibility to:

a. establish a date, time, and place for the hearing and give proper notice of the hearing to the parties;

b. review the case file prior to the hearing;

c. maintain order;

d. make a record of the proceedings;

e. establish reasonable time limits for the conduct of the proceedings, to include extending time limits for good cause;

f. rule on the admissibility of evidence;

g. hold a pre-hearing conference, if necessary, to clarify the matter(s) in dispute; establish the order of presentation; allow and establish time limits for the exchange of exhibits and names of witnesses; and,

h. enter an order on any other matter that will facilitate the conduct of the review.

1. The Requestor Shall be Afforded the Opportunity to:

a. receive timely and adequate notice of all events and/or proceedings related to and including the hearing; and,

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b. be heard, present evidence, call witnesses, cross-examine witnesses, be represented by counsel at his/her own expense (if he/she so chooses), and receive a written decision based on the evidence.

3. Notice of an Impartial Due Process Hearing

Once the Impartial Hearing Officer has established the date, place, and time of the hearing, written notice (in language understandable to the requestor) shall be provided to the requestor via Certified Mail, return receipt requested, and to the Executive Director of the Mississippi Department of Rehabilitation Services. Such notice shall contain:

a. the name and address of the requestor and the requestor’s file number;

b. the name and address (including the District) of the requestor’s counselor;

c. a brief statement of the matter(s) in conflict; and,

d. a brief statement of the date, place, and time of the hearing.

e. the right of the applicant or client or, as appropriate, his or her representative, to submit during impartial due process hearings information that supports his or her position.

4. Informal Dispositions

Issues in dispute may be resolved informally at any point in the process by stipulation, agreed settlement, consent order, default, or by another method agreed upon by the parties. An informal disposition shall be reduced to writing, signed by the parties, and made a part of the record of the proceedings.

5. Record of Proceedings

1. The record of a formal review shall include:
2. the notice of a formal review;

ii. a copy of the request for the review, specifying the matter(s) in dispute;

iii. the informal review decision(s), if any;

iv. all evidence received during the review (informal and formal);

v. a statement of all matters officially noticed;

vi. all questions, offers of proof, objections, and rulings thereon,

vii. a transcript of the hearing proceedings; and,

viii. written decision of the Impartial Hearing Officer.

b. The hearing shall be recorded by a certified court reporter. A copy of the transcript may be requested by either party (in addition to the official copy) with the expense of transcribing and reproducing the copy being charged to that party. The record of the proceedings shall be confidential and maintained by MDRS.

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6. Rules of Evidence

a. The technical rules of evidence shall be relaxed to the degree specified by the Hearing Officer.

b. All witnesses shall be sworn in by the court reporter, testify under oath, and be subject to cross-examination.

c. The Impartial Hearing Officer shall have the authority and discretion to admit into the record any and all evidence that has a reasonable degree of relevance to the dispute. The Impartial Hearing Officer shall have broad discretion to exclude evidence that is irrelevant, immaterial, or unduly cumulative to the matter(s) in dispute. Questions of admissibility should be decided in favor of admissibility even if only remotely relevant.

d. The Impartial Hearing Officer shall cause documents that are offered for admission into evidence to be marked and attached to the record of the proceedings.

7. Order of Proceedings

a. The requestor shall be the first to present his or her principle case. The case may be presented by direct examination of witnesses with an opportunity for cross-examination, redirect examination, and introduction of documentary evidence.

b. At the close of the requestor’s presentation, the Department shall present its principle case. The Department shall be afforded the same opportunity for direct, cross and redirect examination of witnesses, and introduction of documentary evidence.

8. Impartial Hearing Officer’s Decision

a. Upon completion of the impartial due process hearing, the Impartial Hearing Officer shall render a decision based on an application of State and Federal law and regulations, to the facts as presented in the hearing. The decision shall consist of a statement of facts found by the Impartial Hearing Officer and a recitation of the application of State and Federal statutes, regulations, policies, and procedures, to those facts. The full written report of the findings and grounds for the decision and the record shall be submitted to the Agency, within 30 days of the completion of the hearing.

b. The full written report of the findings and grounds for the decision shall also be mailed to the requestor, or, if appropriate, his or her representatives, via certified mail, return receipt requested, within 30 days of the completion of the hearing.

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c. If the Client Assistance Program was involved, a copy of the decision should be mailed to CAP.

4.4 Suspension, Reduction or Termination of Services

At no time in which an informal review, mediation, or impartial due process hearing is pending or during the conduct of any informal review, mediation or formal dispute resolution process, shall vocational rehabilitation services being provided to an applicant or client, including evaluation or assessment services and IPE development, be suspended, reduced or terminated; unless, (a) the applicant or client or his or her representative requests a suspension, reduction, or termination of services; or (b) the Agency has evidence that services have been obtained as a result of fraud, collusion, or criminal conduct on the part of the applicant or client or his or her representative. If a party brings a civil action to challenge the final decision of a hearing officer, the final decision of the hearing officer must be implemented pending review by the court.

MDRS, as an indirect provider, frequently provides services through other agencies or organizations that have their own eligibility rules. When such a service provider modifies or terminates a service, MDRS shall be obligated to assess the circumstances and in concert with the client make an appropriate and expedited amendment to the IPE.

4.5 Civil Action

Any party who disagrees with the findings and decision of an impartial hearing officer has a right to bring a civil action with respect to the matter in dispute. The action may be brought in any State court of competent jurisdiction or in a district court of the United States of competent jurisdiction without regard to the amount in controversy.

In any such action, the court—

(a) Receives the records related to the impartial due process hearing;

(b) Hears additional evidence at the request of a party; and

(c) Basing its decision on the preponderance of the evidence, grants the relief that the court determines to be appropriate.

ELIGIBILITY

5.1 Policy Statement

The Agency shall determine whether an individual is eligible for vocational rehabilitation services within a reasonable period of time, not to exceed 60 days after the individual has submitted an application for services. The eligibility determination period may be extended if:

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(a) exceptional and unforeseen circumstances beyond the control of the Agency preclude the making of the eligibility determination within 60 days and the Agency and the individual agree to a specific extension of time, or (b) if the Agency is exploring an individual's abilities, capabilities, and capacity to perform in work situations through the use of Trial Work Experiences.

5.2 Implementation

It is the sole responsibility of the Office of Vocational Rehabilitation, Mississippi Department of Rehabilitation Services to determine if an individual is eligible for vocational rehabilitation services and to determine the nature and scope of said services. The 1998 Amendments to the Rehabilitation Act made several significant changes in the area of eligibility to streamline the process for making determinations. The most significant of these changes is the creation of several presumptions by which an individual may be presumed to meet one or more of the criteria for eligibility; however, the ultimate decision of whether an individual is or is not eligible for vocational rehabilitation services shall be made by a qualified rehabilitation counselor (as defined by Sections 361.42(2)(i) and 361.45(c)(i)(A) of the 1998 Rehabilitation Act Amendments).

5. 3 Assessment for Determining Eligibility and Vocational Rehabilitation Needs

Assessment for Determining Eligibility and Vocational Rehabilitation Needs means, as appropriate in each case:

i. a review of existing data to:

1. to determine eligibility, and,
2. to assign priority for an order of selection;

2. to the extent necessary, the provision of appropriate assessment activities to obtain necessary additional data to make such determination and assignment;

2.to the extent additional data are necessary to make a determination of the employment outcomes, and the objectives, nature, and scope of vocational rehabilitation services, to be included in the individualized plan for employment of an eligible individual, a comprehensive assessment determines the unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice, including the need for supported employment, of the eligible individual;

4. Rehabilitation Technology assessment: referral for the provision of rehabilitation technology services to the individual, to assess and develop the capacities of the individual to perform in a work environment; and,

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5. Trial Work Experiences assessment: an exploration of the individuals abilities, capabilities, and capacity to perform in work situations which shall be assessed periodically, including experiences in which the individual is provided appropriate supports and training.

5.4 Determination of Eligibility

An applicant for vocational rehabilitation services is eligible for those services if the applicant can be shown to be:

1. an individual with a disability (Section 7(20)(A of the 1998 Rehabilitation Act Amendments)), who

2. requires vocational rehabilitation services to prepare for, secure, retain, or regain employment consistent with his or her unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice.

5.4.1 Determining If the Applicant Is an Individual With a Disability

To be an individual with a disability, an applicant must be:

1. an individual who has a physical or mental impairment which for that individual constitutes or results in a substantial impediment to employment; and,

2. who requires, in terms of an employment outcome, specific vocational rehabilitation services.

The 1998 Amendments have created two presumptions to facilitate the process of determining whether an applicant is an individual with a disability. Section 102(a)(3)(A) of the 1998 Rehabilitation Act Amendments states that an individual who has been determined to have a disability, or to be statutorily blind pursuant to either Title II or Title XVI of the Social Security Act shall be considered:

1. to be an individual with a significant disability under Section 7(21)(A) of the 1998 Rehabilitation Act Amendments; and,

2. presumed to be eligible for vocational rehabilitation services under this title (provided that the individual intends to achieve a specific employment outcome consistent with the unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice of the individual) unless the Agency involved can demonstrate by clear and convincing evidence documented in the case file that such individual is incapable of benefiting in terms of an employment outcome from specific vocational rehabilitation services due to the severity of the disability of the individual.

Thus, valid documentation from the Office of Disability Determination Services or the Social Security Administration is sufficient to show that an applicant meets the first part of the definition of an individual with a disability. No additional tests or procedures are used to

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assess ―intent‖ of applicants who are allowed SSDI beneficiaries and SSI recipients that would hinder speedy access to vocational rehabilitation services.

Section 102(a)(4) of the 1998 Rehabilitation Act Amendments creates a presumption that determinations of the existence of a disability, made by officials of other agencies, may be presumed to satisfy one or more factors leading to the determination that an individual is an individual with a disability or an individual with a significant disability as defined in the 1998 Amendments. "Other agencies" include but are not limited to:

 State Department of Education - determinations of special  education status i.e., learning disabilities, and the like;

 State Department of Mental Health - mental illness or  retardation;

 Workmen's Compensation Commission - findings of disability;

 Medicare/Medicaid - findings of disability;

 personal physicians - medical histories;

 advocates and advocacy groups;

 referring agencies; and,

 documentation from any entity that includes findings of disability as part of its services.

A determination of the existence of a disability by another agency may be sufficient evidence to show that an applicant is an individual with a disability, or such a determination may provide a starting point from which a preliminary assessment can be conducted to obtain any additional information necessary to show that an applicant is an individual with a disability.

Regardless of the results of the assessments and/or presumptions above to determine if an applicant has a disability which constitutes a substantial impediment to employment, a qualified rehabilitation counselor must still determine if the applicant intends to achieve an employment outcome in an integrated setting and requires specific vocational rehabilitation services in terms of an employment outcome.

Substantial Impediment to Employment means that a physical or mental impairment (in light of medical, psychological, vocational, educational, or other related factors) inhibits an individual's occupational performance by impeding the individual's ability to prepare for, secure, retain, or regain employment consistent with his or her unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice. A substantial impediment to employment exists when the physical or mental impairment results in a functional limitation or limitations that:

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1. require the individual to modify or change his or her regular occupation;

2. make it difficult for the individual to prepare for, secure, retain, or regain employment;

3. cause the refusal or reluctance of the former employer to re-employ the individual because of the impairment;

4. necessitate additional preparation in order to perform the occupation;

5. result in the deterioration of skills or of performance in the occupation;

6. could result in termination of employment as the impairment progresses;

7. reflect a direct relationship between the impairment and the individual's employability; or,

8. continue to exist when an individual is employed, but prevent that individual from functioning at an occupational level consistent with his/her unique strengths, resources, priorities, concerns, abilities, capacities, career interests, and informed choice

Functional Limitations - To be an impediment to employment, a physical or mental impairment must be assessed in terms of the limitations that impairment presents to an individual's ability to function vocationally - i.e., to prepare for, secure, retain, or regain competitive employment.

Such assessment may include, to the degree needed to make such a determination, an assessment of the personality, interests, career choices, interpersonal skills, intelligence and related functional capacities, educational achievements, work experience, vocational aptitudes, personal and social adjustments, and employment opportunities of the individual, and the medical, psychiatric, psychological, and other pertinent vocational, educational, cultural, social, recreational, and environmental factors, that affect the employment and rehabilitation needs of the individual;

Such assessment may also include, to the degree needed, an appraisal of the patterns of work behavior of the individual and services needed for the individual to acquire occupational skills and to develop work attitudes, habits, tolerance, and social and behavior patterns necessary for successful job performance, including the utilization of work in real job situations to assess and develop the capacities of the individual to perform adequately in a work environment.

5.4.2 Determining Whether an Individual Will Require Specific Vocational Rehabilitation Services to Prepare For, Secure, Retain, or Regain Employment

Section 102(a)(4)(A) of the 1998 Rehabilitation Act Amendments states that an individual shall be presumed to be an individual with a disability who will benefit, in terms of an employment outcome, from vocational rehabilitation services, unless the Agency can establish, by clear and

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convincing evidence documented in the case file, that such individual will not benefit, in terms of an employment outcome, from specific vocational rehabilitation services.

This means that an applicant who can be shown to be an individual with a disability will be presumed to be able to benefit from specific vocational rehabilitation services (and is, therefore, eligible) unless the applicant can be shown, to a high degree of certainty, to be unable, due to the severity of the disability, to prepare for, secure, retain, or regain employment.

In order to collect sufficient data to either, 1) determine eligibility and define the scope of necessary rehabilitation services, or 2) determine ineligibility, an applicant must undergo an "assessment for determining eligibility and vocational rehabilitation needs" (Section 7(2) of the 1998 Rehabilitation Act Amendments).

5.5 Comprehensive Assessment

A comprehensive assessment shall be performed, to the extent necessary, in the most integrated setting possible consistent with the individual’s needs and informed choice, to determine eligibility for and the scope of, vocational rehabilitation and supported employment services. The assessment shall be sufficient to determine, and the case record shall document, whether an individual has a physical or mental impairment that for the individual constitutes or results in a substantial impediment to employment. The assessment will include an appraisal of the individual based, to the extent possible, on available medical information, and, as appropriate, evaluation by qualified personnel of the potential to benefit from rehabilitation services.

To the extent additional data is necessary to make a determination of the employment outcomes, and the objectives, nature, and scope of vocational rehabilitation services, to be included in the individualized plan for employment of an eligible individual, a comprehensive assessment will be conducted.

The comprehensive assessment may include:

1. Diagnostic testing;

2. The provision of rehabilitation technology services;

3. The assessment of an assortment of work-related factors in "real job" situations where possible and/or appropriate to determine the unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice, including the need for supported employment of the eligible individual.

4. To the degree needed, an assessment of the personality, interests, career choices, interpersonal skills, intelligence and related functional capacities, educational achievements, work experience, vocational aptitudes, personal and social adjustments, and employment opportunities of the individual, and the medical, psychiatric, psychological, and other

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pertinent vocational, educational, cultural, social, recreational, and environmental factors, that affect the employment and rehabilitation needs of the individual;

5. To the degree needed, an appraisal of the patterns of work behavior of the individual and services needed for the individual to acquire occupational skills, and to develop work attitudes, work habits, work tolerance, and social behavior patterns necessary for successful job performance, including the utilization of work in real job situations to assess and develop the capacities of the individual to perform adequately in the work environment.

6. An exploration of the individual's abilities, capabilities, and capacity to perform in work situations, which shall be assessed periodically during Trial Work Experiences, including experiences in which the individual is provided appropriate supports and training.

In all cases of mental or emotional disorders an examination will be provided by a physician skilled in the diagnosis and treatment of such disorders, or by a psychologist licensed or certified in accordance with state laws and regulations. Any assessment to determine eligibility for supported employment must be supplementary to an assessment to determine eligibility for vocational rehabilitation services. Whether performed to ascertain the scope of rehabilitation services or to determine eligibility, a comprehensive assessment is limited to information necessary to identify the rehabilitation needs of and develop the Individualized Plan for Employment.

5.5.1 Trial Work Experiences

A case closed as ineligible due to the severity of the applicant’s disability must have been provided Trial Work Experiences in order to produce clear and convincing evidence documented in the case file supporting that judgment. Trial Work Experiences are not required in those limited circumstances when the applicant cannot take advantage of such experience. Trial Work Experiences are explorations of an individual’s abilities, capabilities, and capacity to perform in work situations, through the use of Trial Work Experiences provided in the most integrated setting possible consistent with the informed choice and rehabilitation needs of the individual, including experiences in which an individual is provided appropriate supports and training. Staff will explore an individual’s ability to perform in real work situations through Trial Work Experiences including supported employment, on-the-job training, or other experiences using realistic work settings.

Such experiences shall be of sufficient variety and over a sufficient length of time to determine the eligibility of the individual or to determine the existence of clear and convincing evidence that the individual is incapable of benefiting in terms of an employment outcome from vocational rehabilitation services due to the severity of the disability of the individual. Clear and convincing evidence must be determined on a case-by-case basis, constitutes the highest standard used in our civil system of law, and requires that staff have a high degree of certainty before concluding that an individual is incapable of benefiting from services in terms of an employment outcome. Thus, the review of existing information still would not provide clear and convincing evidence, meaning that, for example, the use of an intelligence test result alone would not constitute clear and convincing evidence. On the other hand, clear and convincing evidence

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could include a description of assessments, including situational assessments and supported employment assessments, from service providers who have concluded that they would be unable to meet the individual's needs due to the severity of the individual's disability. Also, a demonstration of clear and convincing evidence requires that the Agency explore the applicant's abilities, capabilities, and capacity to perform in work situations and provide appropriate supports.

The counselor will initiate a Trial Work Experiences Plan that must be agreed upon and signed by the counselor and the client or, as appropriate, the client's representative. The individual’s progress during the Trial Work Experiences will be assessed no less often than every 30 days during the trial work period.

An individual may not be determined to be ineligible for vocational rehabilitation services due to the unavailability of trial work settings since an inability to find suitable trial work would not constitute clear and convincing evidence that the individual cannot benefit from VR services in terms of an employment outcome.

Under limited circumstances if an individual cannot take advantage of Trial Work Experiences or if options for Trial Work Experiences have been exhausted before the Agency is able to make determinations of whether an individual may benefit from rehabilitation services, MDRS must conduct an Extended Evaluation to make these determinations. During the Extended Evaluation period, vocational rehabilitation services must be provided in the most integrated setting possible, consistent with the informed choice and rehabilitation needs of the individual. During the Extended Evaluation period, the Agency must develop a written plan for providing services necessary to make the determination. During the Extended Evaluation period, the Agency provides only those services that are necessary to make the determinations and terminates Extended Evaluation services when the Agency is able to make the determinations.

5.6 Certification of Eligibility, Determination of Ineligibility

The previously referenced 60 day period for determining eligibility is initiated according to the following guidelines: An individual is considered to have submitted an application when the individual or the individual’s representative, as appropriate, (a) has completed and signed an agency application form or common intake form at a one-stop center or other outside source or has otherwise requested services from MDRS, (b) has provided to MDRS information necessary to initiate an assessment to determine eligibility and priority for services, and (c) is available to complete the assessment process.

The currency of existing data is not a function of when the data were produced but whether the data describe the current functioning of the individual. Assessments to gather additional data should be authorized only when the existing data are either not current, unavailable, insufficient, or inappropriate to make a determination with respect to the eligibility of the applicant.

Once an assessment for determining eligibility has been completed, the counselor may either:

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1. certify the applicant as eligible for vocational rehabilitation services, or;
2. if an individual who applies for services is determined, based on the review of existing data and, to the extent necessary, the assessment activities described in Section 7(2)(A)(ii) of the 1998 Rehabilitation Act Amendments, not to be eligible for the services, or if an eligible individual receiving services under an Individualized Plan for Employment (IPE) is determined to be no longer eligible for the services:

a. the ineligibility determination involved shall be made only after providing an opportunity for full consultation with the individual or, as appropriate, the individual's representative;

b. the individual or, as appropriate, the individual's representative, shall be informed in writing (supplemented as necessary by other appropriate modes of communication consistent with the informed choice of the individual) of the ineligibility determination, including:

i. the reasons for the determination; and,

ii. a description of the means by which the individual may express, and seek a remedy for, any dissatisfaction with the determination, including the procedures for mediation and a review by an impartial hearing officer, consistent with the agency’s due process procedures.

The individual shall also be provided with a description of services available from the client assistance program and information on how to contact that program; and any ineligibility determination that is based on a finding that the individual is incapable of benefiting in terms of an employment outcome shall be reviewed, 1) within 12 months; and, 2) thereafter, if such a review is requested by the individual or, if appropriate, by the individual's representative. The review need not be conducted if the individual has refused it, the individual is no longer present in the state, the individual’s whereabouts are unknown, or the individual’s medical condition is rapidly progressive or terminal.

5.6.1 Certificate of Eligibility

A Certificate of Eligibility for each applicant who is determined to be eligible for vocational rehabilitation services shall be dated and signed by the counselor and shall show that the individual:

1. has a disability that is a substantial impediment to employment;

2. can benefit from specific vocational rehabilitation services; and,

3. will require specific vocational rehabilitation services to prepare for, secure, retain, or regain employment.

5.7 Client Order of Selection

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It is the intent of the Mississippi Department of Rehabilitation Services to provide comprehensive vocational rehabilitation services to all eligible individuals who apply for services. In the event that vocational rehabilitation services cannot be provided to all eligible applicants due to financial limitations, the Agency has adopted an Order of Selection that establishes a system for prioritizing individuals with the most significant disabilities to receive services.

Should a funding shortfall occur, the agency will continue to serve those individuals on an existing Individualized Plan for Employment, including the provision of post-employment services. If at any time, services cannot be provided to all of those individuals who can reasonably be expected to be determined eligible during the coming year, the Executive Director of the Department may declare the implementation of the Order of Selection.

An IPE cannot be developed for individuals in a closed priority category. However, the Order of Selection system does not preclude delivery of non-purchased services (i.e., counseling, guidance, placement, referral services, coordination of comparable benefits and services paid by a third party) for these individuals. The Order of Selection system will in no way restrict the provision of diagnostic and evaluation services. The Executive Director will notify staff by Executive Director Memorandum when the Order of Selection is to be implemented or withdrawn.

Allowed SSDI beneficiaries or SSI recipients are not afforded any special consideration in establishing the priority categories of the order, notwithstanding the automatic classification of such an individual as an ―individual with a significant disability.‖

An Order of Selection should be designed to ensure that individuals with the most significant disabilities as described in the OVR/OVRB Resource Guide above, will receive services in preference to less significantly disabled individuals, as described in the OVR/OVRB Resource Guide, in the event of a shortfall in funding.

ORDER OF SELECTION

1. Priority 1.

Individual With A Most Significant Disability: An individual who meets the criteria for "significantly disabled‖ (Section 7(21) of the 1998 Rehabilitation Act Amendments) and:

(i) whose physical or mental impairments seriously limit two or more functions in terms of employment outcomes, and,

(ii) who will require vocational rehabilitation services in order to prepare for, secure, retain, or regain employment that is consistent with that individual's unique strengths, resources, priorities, concerns, abilities, capacities, interests, and informed choice

(Authority: Sections 7(21)(E)(i) and 101(a)(5)(C) of the Act; 29 U.S.C. 705(21)(E)(i) and 721(a)(5)(C))

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2. Priority 2.

Individual With A Significant Disability: An individual with a disability—

(i) who has a severe physical or mental impairment that seriously limits one or more functional capacities (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of an employment outcome;

(ii) whose vocational rehabilitation can be expected to require multiple vocational rehabilitation services over an extended period of time; and

(iii) who has one or more physical or mental disabilities. or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

(Authority: Section 7(21)(A) of the Act; 29 U.S.C. 705(21)(A))

3. Priority 3.

Individuals with disabilities who do not meet the definitions of either "individuals with the most significant disabilities" or "individuals with significant disabilities", but will require specific vocational rehabilitation services to prepare for, secure, retain, or regain employment.

Individuals having an active plan under the former Order Of Selection will continue to receive services uninterrupted. Persons meeting eligibility requirements but in a closed category have access to a comprehensive information and referral system (see the OVR/OVRB Resource Guide). Specific details about referral to another agency are to be documented in the case record. Individualized Plan for Employment

6.0 Individualized Plan for Employment (IPE)

6.1 IPE Policy Statement

The Mississippi Department of Rehabilitation Services is required to initiate an Individualized Plan for Employment, periodically update it, and conduct an annual IPE review for each eligible individual being provided services. Vocational rehabilitation services must be provided in accordance with the IPE. The IPE sets forth the specific employment outcome, services to be provided, time frames, service providers, evaluation criteria, and dates of review. The client will have informed choice throughout the vocational rehabilitation process including selecting a specific employment outcome, specific vocational rehabilitation services, and the provider and methods by which these services will be provided.

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6.2 Scope of the IPE

The intended purpose of the IPE is to document and describe the required rehabilitation services necessary for the client to prepare for, secure, retain, or regain employment. It shall be presumed that an individual can benefit in terms of a specific employment outcome through specific vocational rehabilitation services provided under the IPE, unless the Agency can demonstrate by clear and convincing evidence documented in the case file that the individual is incapable of benefiting from services in terms of a specific employment outcome due to the severity of the disability of the individual.

Each IPE shall be designed to achieve the specific employment objective chosen by the individual, consistent with his/her unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice. Clients will be active and full partners in the vocational rehabilitation process, making meaningful and informed choices during assessments for vocational rehabilitation needs and in the selection of specific employment outcomes, services needed to achieve the outcomes, entities providing such services, and the methods used to secure such services. Eligible individuals will be informed about their options for developing an IPE, including the option for the individual to develop an IPE on agency forms without assistance from anyone.

6.3 Initiation of the IPE

The IPE must be initiated after eligibility determination by a qualified rehabilitation counselor has occurred. The Agency shall determine whether an individual is eligible for vocational rehabilitation services within a reasonable period of time, not to exceed 60 days after the individual has submitted an application for services. The eligibility determination period may be extended if: (a) exceptional and unforeseen circumstances beyond the control of the Agency preclude the making of the eligibility determination within 60 days and the Agency and the individual agree to a specific extension of time, or (b) if the Agency is exploring an individual's abilities, capabilities, and capacity to perform in work situations through the use of Trial Work Experiences. Such experiences should be of sufficient variety and over a sufficient period of time to determine the eligibility of an individual.

6.4 Development of the IPE

When an individual is determined to be eligible for vocational rehabilitation services, the IPE shall be completed. An IPE shall be a written document prepared on current forms provided by the Agency as outlined in Section 361.45(b)(2) of the 1998 Rehabilitation Act Amendments regarding general requirements.

The eligible individual or his/her representative will be provided information, in writing and in an appropriate mode of communication, regarding the individual’s options for developing an IPE including:

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1. information on the availability of assistance, to the extent determined to be appropriate by the eligible individual, from a qualified vocational rehabilitation counselor in developing all or part of the IPE for the individual, and the availability of technical assistance in developing all or part of the IPE for the individual;

2. a description of the full range of components as defined in Section 361.48 that shall be included in an IPE; and,

3. as appropriate--

a. an explanation of Agency guidelines and criteria associated with financial commitments concerning an Individualized Plan for Employment;

b. additional information the eligible individual requests or the Agency determines to be necessary;

c. information on the availability of assistance in completing designated Agency forms required in developing an IPE; and,

d. a description of the rights and remedies available to such an individual including, if appropriate, a description of the availability of a Client Assistance Program and information about how to contact the CAP.

An IPE for a student with a disability receiving special education services is developed--

a. In consideration of the student's IEP; and

b. In accordance with the plans, policies, procedures, and terms of the interagency agreement between MDRS and the local school district.

In planning transition services for students, the IPE for a student determined to be eligible for vocational rehabilitation services must be developed and approved (i.e., agreed to and signed by the individual and the counselor) before the student leaves the school setting and as early as possible during the transition planning process.

6.5 Informed Choice

An IPE shall be developed and implemented in a manner that affords eligible individuals the opportunity to exercise informed choice in selecting a specific employment outcome, the specific vocational rehabilitation services to be provided under the plan, the entity that will provide the vocational rehabilitation services, and the methods used to procure the services. Informed Choice implies that the specific employment outcome be both realistic and achievable for the individual.

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The specific employment outcome should be based upon an objective assessment of specific vocational rehabilitation needs and reflecting the individual's unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice. The IPE should reflect specific vocational rehabilitation services necessary to achieve the individual's chosen employment outcome and the case file should reflect how the client was informed about and involved in choosing among alternative services. All available comparable benefits should be applied toward each service.

Information regarding available vendors, certified/licensed vendors, cost and duration of all planned services, and like information, shall be provided to the client in the appropriate accessible mode of communication. Accessibility of the vendor's location will be discussed with the client. All rehabilitation services will be provided in the least restricted and most integrated setting compatible with the client’s interest and abilities.

6.6 Individualized Plan for Employment Form Completion

The IPE is organized into the following sections--

Part 1 General Information

This section includes the plan number, general plan type (i.e. training, physical restoration), the client’s specific employment outcome/objective, and the anticipated date for achievement of the employment outcome.

Part 2 Planned Services

This section describes services needed, dates of initiation, provider(s) of choice, and the estimated costs for each service and the total plan (including comparable benefits).

Part 3 Participant Responsibilities

This section will include a list of the client’s responsibilities toward completion of the plan; including any financial responsibilities.

Part 4 Plan Documentation

This section must contain the agreed-upon criteria for evaluating progress toward the goal.

Part 5 Terms and Conditions

This section contains post-employment services and the identification of the extended services provider for Supported Employment cases only.

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Part 6 Statements of Mutual Understanding

The counselor will complete the information under Review Process and Client Assistance Program. The counselor will review all information in this section in detail with each client and/or his/her representative.

Part 7 Plan Certification

The IPE is finalized and signed by the client or his/her representative and the counselor prior to service(s) being initiated.

6.7 Basic IPE Contents

Regardless of the approach selected by an eligible individual to develop an Individualized Plan for Employment, an IPE shall, at a minimum, contain mandatory components consisting of--

1. a description of the specific employment outcome that is chosen by the eligible individual, and, to the maximum extent appropriate, results in employment in an integrated setting and for which the individual is compensated at, or above, the minimum wage;

2. a description of the specific vocational rehabilitation services that are-

a. needed to achieve a specific employment outcome, including, as appropriate, provision of assistive technology devices and services, and personal assistance services, including training in the management of such services;

b. provided in the most integrated setting that is appropriate for the service involved and is consistent with the informed choice of the eligible individual; and,

c. time lines for the achievement of the employment outcome and for the initiation of the services;

3. a description of the entity chosen by the eligible individual or, as appropriate, the individual's representative, that will provide the vocational rehabilitation services, and the methods used to procure such services;

4. a description of criteria to evaluate progress toward achievement of the employment outcome;

5. the terms and conditions of the IPE, including, as appropriate, information describing;

a. the responsibilities of the Agency;

b. the responsibilities of the eligible individual, including--

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i. the responsibilities the eligible individual will assume in relation to the employment outcome of the individual; ii. if applicable, the participation of the eligible individual in paying for the costs of the plan; iii. the responsibility of the eligible individual with regard to applying for and securing comparable benefits; and, the responsibilities of other entities as the result of arrangements made pursuant to comparable services or benefit requirement;

6. for an eligible individual with the most significant disabilities for whom an employment outcome in a supported employment setting has been determined to be appropriate, information identifying--

a.the extended services needed by the eligible individual; and,

b.the source of extended services or, to the extent that the source of the extended services cannot be identified at the time of the development of the IPE, a description of the basis for concluding that there is a reasonable expectation that such source will become available; and,

7. as determined to be necessary, a statement of projected need for post-employment services.

6.7.1 Amendments to the IPE.

The IPE is amended, as necessary, by the applicant or client or, as appropriate, his or her representative, in collaboration with a representative of MDRS or a qualified vocational rehabilitation counselor (to the extent determined to be appropriate by the individual), if there are substantive changes in the employment outcome, the vocational rehabilitation services to be provided, or the providers of the vocational rehabilitation services.

Amendments to the IPE do not take effect until agreed to and signed by the applicant or client or, as appropriate, his or her representative and by a qualified vocational rehabilitation counselor employed by MDRS.

6.8 Conclusion

The Individualized Plan for Employment should include the appropriate outcomes and services necessary to achieve the individual's specific chosen employment outcome. Outcomes and services should be consistent with the client's unique strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice. No service(s) that is a part of the client’s IPE should be initiated until the plan has been finalized and signed by the client and counselor.

Each IPE should include time frames for employment outcome completion and service initiation. Additionally, the IPE should include use of all available comparable benefits. Even with careful

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evaluation and planning, circumstances may occur which precipitate a need for additional outcomes, evaluation criteria, or services. In such cases, a plan amendment should be considered.

A qualified rehabilitation counselor shall furnish a copy of the IPE and plan amendments to the individual with a disability or, as appropriate, a parent, other family member, guardian, advocate, or other authorized representative of the individual.

The counselor and client or, as appropriate, the client's representative shall review the IPE at least annually.

7.0 Services

Substantiality of Services Policy:

The definition of substantiality of services includes all the needs that should be met in the IPE, its amendments, and otherwise in the case record. These needs should include both those pertaining to the vocational abilities of the individual and those relating to the barriers to employment posed by the disability or disabilities. Substantial services are those services that address an individual’s major needs as identified in the assessment process or later in the case record that the counselor and the client agree have to be met in order for the individual to achieve an employment outcome consistent with that individual’s unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. The services required to meet the needs of an individual should be planned on the IPE and/or its amendments, regardless of the source of payment or service provider. The source of payment and service provider must be listed on the IPE for each service.

Specific Vocational Rehabilitation Services are any services described in an Individualized Plan for Employment (IPE) necessary to assist an individual in preparing for, securing, retaining, or regaining an employment outcome that is consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individual, including:

1. assessment for determining eligibility and priority for services by qualified personnel, including, if appropriate, an assessment by personnel skilled in rehabilitation technology.

2. an assessment for determining vocational rehabilitation needs by qualified personnel, including, if appropriate, an assessment by personnel skilled in rehabilitation technology;

3. vocational rehabilitation counseling and guidance, including information and support services to assist an individual in exercising informed choice as defined in the OVR/OVRB Resource Guide, Section 4.4 page 21;

4. referral and other services necessary to assist applicants and eligible individuals to secure needed services from other agencies, including other components of the statewide workforce investment system and to advise those individuals about Client Assistance Programs

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(OVR/OVRB Policy Manual Section 1.1.9; OVR/OVRB Resource Guide Section 4.4 page 28 & Form MDRS-VR-02, Information and Referral, following Section 2.7.3 of the Resource Guide);

5. Physical and mental restoration services, to the extent that financial support is not readily available from a source other than the Agency (such as through health insurance or a comparable service or benefit.

6. vocational and other training services, including the provision of personal and vocational adjustment, books, tools, and other training material, except that no training services provided at an institution of higher learning shall be paid with funds under this title unless maximum efforts have been made by the counselor and the individual to secure grant assistance, in whole or in part, from other sources to pay for such training;

7. maintenance for additional costs incurred while participating in an assessment for determining eligibility and rehabilitation needs or while under an IPE as defined in the OVR/OVRB Resource Guide, Section 4.4, page 28;

8. transportation, including adequate training in the use of public transportation vehicles and systems, that is provided in connection with the provision of any other service described in this section and needed by the individual to achieve an employment outcome as defined in the OVR/OVRB Resource Guide, Section 4.4, page 36;

9. vocational rehabilitation services to family members of an applicant or eligible individual if necessary to enable the applicant or eligible individual to achieve an employment outcome;

10. interpreter services, including sign language and oral interpreter services, for individuals who are deaf or hard of hearing and tactile interpreting services for individuals who are deaf-blind provided by qualified personnel;

11. reader services, rehabilitation teaching services and orientation and mobility services for individuals who are blind;

12. job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services as defined in the OVR/OVRB Resource Guide, Section 3.11;

13. supported employment services in accordance with the definition in the OVR/OVRB Resource Guide, Section 4.4, pages 34 – 35;

14. personal assistance services in accordance with the definition in the OVR/OVRB Resource Guide, Section 4.4, page 31;

15. post-employment services in accordance with the definition in the OVR/OVRB Resource Guide, Section 4.4, page 32 - 33;

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16. occupational licenses, tools, equipment, and initial stock and supplies;

17. rehabilitation technology services including vehicular modifications, telecommunications, sensory and other technological aids and devices in accordance with the definition in the OVR/OVRB Resource Guide, Section 4.4, page 33 & Section 3.2;

18. transition services in accordance with the definition in the OVR/OVRB Resource Guide, Section 4.4, page 35 - 36 & Section 3.17;

19. technical assistance and other consultation services to conduct market analysis, develop business plans, and otherwise provide resources, to the extent such resources are authorized to be provided through the statewide workforce investment system, to eligible individuals who are pursuing self-employment or telecommuting or establishing a small business operation as an employment outcome;

20. Other goods and services determined necessary for the individual with a disability to achieve an employment outcome.

(Authority: Section 103(a) of the Act; 29 U.S.C. 723(a)

FINANCIAL ACCOUNTABILITY

8.0 Financial Accountability Policy Statement

The Mississippi Department of Rehabilitation Services is committed to ensuring all funds are handled using sound financial management and proper accounting practices. These practices should facilitate the goals and objectives of the program. Only those funds necessary for diagnostic, evaluation and other services, which lead to the attainment of a vocational goal, should be expended.

Authorizations and expenditures for services will be made in accordance with all applicable Agency fee schedules; Agency operating agreements and contracts; State contract rates; vendor's usual and customary charges; and state/federal laws, regulations, policies, and procedures. Rates of payment for services provided in agency-operated facilities shall be determined by the Agency's facility cost reporting system.

Documentation supporting the decision to obligate funds, change amounts obligated, and recommended payment must be present in the case file.

8.1 Financial Needs Tests / Comparable Services and Benefits

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MDRS chooses to consider the financial need of clients or applicants who are receiving services through Trial Work Experiences or during an Extended Evaluation for purposes of determining the extent of their participation in the costs of vocational rehabilitation services, other than those services identified below. The OVR/OVRB Resource Guide explains the method for determining the financial need of an eligible individual; and specifies the types of vocational rehabilitation services for which MDRS has established a financial needs test;

Policies are applied uniformly to all individuals in similar circumstances. Policies do not require different levels of need for different geographic regions in the State, and policies ensure that the level of an individual's participation in the cost of vocational rehabilitation services is:

1. reasonable;

2. based on the individual's financial need, including consideration of any disability-related expenses paid by the individual; and,

3. not so high as to effectively deny the individual a necessary service.

MDRS does not apply a financial needs test, or require the financial participation of the individual as a condition for furnishing the following vocational rehabilitation services:

1. assessment for determining eligibility and priority for services, except those non-assessment services that are provided to an individual with a significant disability during either an exploration of the individual's abilities, capabilities, and capacity to perform in work situations through the use of Trial Work Experiences or an Extended Evaluation;

a. assessment for determining vocational rehabilitation needs;

b. vocational rehabilitation counseling and guidance;

c. referral and other services;

d. interpreter services;

e. reader services;

f. job-related services;

g. personal assistance services; or

2. as a condition for furnishing any vocational rehabilitation service if the individual in need of the service has been determined eligible for Social Security benefits under Title II or Title XVI of the Social Security Act.

Comparable Services and Benefits are defined in the OVR/OVRB Resource Guide.

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In all cases full consideration will be given to any comparable services and benefits available under any other program including those of other workforce agencies. This includes maximum utilization of public or other vocational/ technical training facilities to meet, in whole or part, the cost of any vocational rehabilitation service(s) provided to the individual. MDRS cannot supplement payments from any other source(s) in excess of the prevailing fee for services being purchased.

Appropriate comparable benefits must be used when purchasing services, as long as the determination of whether comparable services and benefits are available under any other program would interrupt or delay:

1. the progress of the individual toward achieving the employment outcome in the individualized plan for employment of the individual;

2. an immediate job placement; or,

3. the provision of such service to any individual at extreme medical risk.

Exceptions are as follows:

1. assessment for determining eligibility and vocational rehabilitation needs by qualified personnel, including, if appropriate, an assessment by personnel skilled in rehabilitation technology;

2. counseling and guidance, including information and support services to assist an individual in exercising informed choice;

3 referral and other services to secure needed services from other agencies including other workforce agencies through cooperative agreements, if such services are not available through this agency;

4. job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services;

5. rehabilitation technology, including telecommunication, sensory, and other technological aids and devices; and,

6. post-employment services consisting of the aforementioned services (in items 1– 5 in this list.)

8.2 Fee Schedule

The Agency has established a Fee Schedule that represents the Department's "maximum allowable fee" for medical services, equipment, supplies, and the like. The Fee Schedule Manual offers guidelines on authorizing for these types of services and must be adhered to when the Agency is providing these services.

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8.3 State Vendor Contracts

The State of Mississippi enters into contracts with vendors for certain goods and services on an annual basis. When State contracts are in effect, these items must be obtained from the vendor indicated on the contract. No bids are required.

8.4 State Purchasing Regulations

Items not covered by the Agency Fee Schedule or a State Contract are subject to the Mississippi Public Purchases law. This law requires the following for all client service purchases authorized by the counselor:

1.Purchases of $5,000.00 or under, exclusive of freight or shipping charges, may be authorized to any vendor with no bids or approval required (except for Computer /telecommunication related purchases).

2. Purchases over $5,000.00, but not in excess of $25,000.00, exclusive of freight or shipping charges, require at least two written quotes or certification that the vendor is a single source*. The Request for Purchase form (DRS-FIN 1) or client authorization and quotes or certification are to be submitted to the District Manager. Purchases will be made from the lowest and best overall quote that meets the specifications. DO NOT ISSUE AUTHORIZATIONS UNTIL NOTIFIED OF APPROVAL. After receiving written approval, the Authorization and Statement of Account may be issued. A copy of the approval document and quotes must be attached to the Statement of Account when submitted to the Finance Office for payment.

*Single source vendor considerations - Do other companies make similar commodities that will do the same job or meet the same goals? If so, why is this commodity unique from all others? What can it do that the others can't? Is there a copyright or patent on this commodity? Will the company write a letter certifying this to be true? Are there distributors outside of Mississippi or will the manufacturer give you a quote?

3. For purchases over $25,000.00, exclusive of freight and shipping charges, you must send the specifications for the items being purchased or construction projects being proposed to the District Manager, who will then submit the request to the Finance Office. (See Section 6.2.7 of the OVR/OVRB Resource Guide for requirements for AT related purchases). IT IS UNLAWFUL TO SPLIT A PURCHASE TO CIRCUMVENT THE REQUIREMENTS FOR ADVERTISING. The Finance Office will arrange for the advertising in the newspaper, provide guidance in obtaining the bids, and obtain approval from the Bureau of Purchasing (P-1). Purchases will be made from the lowest and best overall bidder that meets the specifications. AUTHORIZATIONS SHOULD NOT BE ISSUED UNTIL NOTIFICATION IS RECEIVED.

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8.5 Purchase of Computer/Telecommunication Equipment and/or Services

The Mississippi Department of Information Technology Services (ITS) governs the acquisition of any computer/telecommunications equipment, word processing equipment, computer software, or computer/telecommunications services. Requests for purchase of any of the above for clients, regardless of cost, must be sent to the District Manager, prior to submission to the Agency’s Office of Management Information Services (MIS). Approval from MIS must be secured before further action is taken.

8.6 Purchase of Drugs

Drugs and medication may be authorized when necessary for the treatment of a condition that affects the rehabilitation program. They may also be provided as part of a broader physical rehabilitation program.

The Agency will approve drugs that comply with rates established by the State Division of Medicaid. If a prescription is not on the Medicaid Formulary, the authorization will be based on the pharmacist's usual and customary charge. Similar benefits must be considered before the Agency can pay for this type of service.

8.7 Authorizations

Authorizations will be issued only after a case has been placed in application status. A written authorization for services shall be made either before or at the same time as the purchase of the services. After eligibility has been determined, in emergency situations that might cause extreme medical risk or loss of placement, or like circumstances, an authorization may be made orally. In such instances there must be prompt documentation and the authorization must be confirmed in writing and forwarded immediately to the provider of the services.

8.8 Statement of Accounts

Payment of a valid obligation may be approved when the authorized goods or services have been received by the client or authorized agency personnel and the vendor has signed, returned our Statement of Account and supplied an invoice when required. State purchasing law requires payment within 45 days of receipt of authorized good

CLOSURES

9.0 Closures

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A client’s case shall be closed when it has been determined by the counselor that planned services are completed, as appropriate, or that additional vocational rehabilitation services are either unnecessary or inappropriate.

9.1 Criteria and Requirements for Closing Case Records as Rehabilitated

9.1.1 Criteria

The minimum criteria, which must be met for an individual to be determined, rehabilitated are the following:

1. The individual has been determined to be eligible.

2. The individual was provided an evaluation of vocational rehabilitation potential, and counseling and guidance as essential vocational rehabilitation services.

3. The provision of services under the IPE has contributed significantly to the achievement of specific employment outcome that is consistent with the client’s strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice.

4. The employment outcome is in the most integrated setting possible, consistent with the client’s informed choice, and the client has maintained the employment outcome for a period of at least 90 days. At the end of the 90-day period, the individual and the counselor consider the employment to be satisfactory and agree that the individual is performing well on the job.

5. Additional Supported Employment provisions in relation to employment are--

a. employment must be competitive work and for the maximum number of hours possible based on the individual’s abilities and capability; and,

c. the client received on-going support services prior to closure and continues to need on-going support.

9.1.2 Requirements for Closing Case Records as Rehabilitated

Upon the determination that the client has achieved an employment outcome in accordance with the above criteria, the client’s case may be closed as rehabilitated.

1. Procedural requirements--

a. Prior to closure, the counselor must personally address the following issues with the client or, as appropriate, the client’s representative:

i. the need for post-employment services must be reviewed and reassessed through appropriate modes of communication; and,

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ii. the employment outcome must be determined to have been satisfactory and the client performing well on the job. The client must indicate whether he/she agrees or disagrees with this decision.

b. The client must be informed in writing of the case closure decision. This ―Closing Statement‖ must be dated and signed by the counselor and contain statements concerning-

i. the basis on which the client was determined to have achieved a specific employment outcome;

ii. the expected need for post-employment services and, if needed, terms and conditions for provision of services; and,

iii. if appropriate, a statement as to how post-employment services will be provided through cooperative agreements with other service providers.

2. Case record documentation requirements--

a. The results of the contact with the client in which case closure was discussed must be documented in the case file.

b. If the IPE provides for job placement in a non-integrated setting, there must be a justification for that non-integrated setting. Clients choosing extended employment as an employment outcome will not be considered rehabilitated.

There must be verification that the client is compensated at or above minimum wage and that the wage and level of benefits are not less than that customarily paid by the employer for the same or similar work by non-disabled clients. (Note: Some rehabilitants are placed in extended [sheltered] employment earning less than minimum wage under a sub-minimum wage certificate issued by the U.S. Department of Labor. This is legal and appropriate for certain clients but would not be considered a competitive employment outcome in terms of MDRS receiving credit for these types of closures.)

The case record must reflect the fact that the counselor annually reviews and reevaluates the status of each individual with a disability served under the vocational rehabilitation program who has achieved an employment outcome either in an extended employment setting in a community rehabilitation program or in any other employment setting in which the individual is compensated in accordance with section 14(c) of the Fair Labor Standards Act for two years after the individual achieves the employment outcome (and thereafter if requested by the individual or, if appropriate, the individual's representative) to determine the interests, priorities, and needs of the individual with respect to competitive employment or training for competitive employment.

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The record must also show that the counselor enabled the individual or, if appropriate, the individual's representative to provide input into the review and reevaluation and documents that input in the record of services with the individual's or, as appropriate, the individual's representative's signed acknowledgment that the review and reevaluation have been conducted.

The record must also reflect that the counselor has made maximum efforts, including identifying and providing vocational rehabilitation services, reasonable accommodations, and other necessary support services, to assist individuals placed in extended employment to engage in competitive employment. As noted, clients choosing extended employment as an employment outcome will not be considered rehabilitated.

9.2 Criteria and Requirements for Closure of Case Records in a Non-Rehabilitated Status Subsequent to Initiation of IPE -- Closed, Not Rehabilitated

9.2.1 Criteria

In order to close the case record of a client as closed, not rehabilitated, the client must have been provided at least one service under the IPE. In addition, one or more of the following must be determined as NOT met:

1. The client was provided counseling and guidance;

2. The client was provided appropriate and substantial vocational rehabilitation services in accordance with IPE requirements;

3. The client achieved and maintained a suitable employment goal of at least 90 days; or,

4. The client continues to meet eligibility criteria.

9.2.2 Requirements for Closing Case Records Not Rehabilitated

9.2.2.1 Closure for Reasons Other Than Eligibility Criteria Not Met (Intervening Reasons)

The case record may be closed subsequent to the initiation of the IPE if the client:

1. becomes unable to locate or contact or has moved;

2. refuses services or further services;

3. dies;

4. is institutionalized;

5. transfers to another agency;

6. fails to cooperate;

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7. has no transportation available to participate in rehabilitation services; or;

8. other reasons not encompassed above.

Case record documentation requirement--

The case record must indicate the reason for closure including the employment status if known.

9.2.2.2 Closure Because Eligibility Requirements Are No Longer Met

If it is determined that a client receiving services under an IPE is no longer capable of benefiting from services in terms of an employment outcome because of the severity of his/her disability, the case record may be closed.

1. Procedural requirements --

a. The determination shall be made only after providing an opportunity for full consultation with the client or, as appropriate, with the client’s representative.

b. A (closing) amendment to the IPE must be developed jointly and signed by a qualified rehabilitation counselor and client or, as appropriate, the client’s representative. The client must indicate whether he/she agrees or disagrees with the closure decision. The amendment must include the decision, the reason(s) on which the decision was based, and a copy must be provided to the client.

c. The client must be informed in writing, supplemented as necessary by other appropriate modes of communication consistent with the informed choice of the client, of the ineligibility determination, including the reason(s) for the determination, appeal rights, and availability of the Client Assistance Program.

d. The client must be referred to other agencies and facilities including, as appropriate, the State’s Independent Living Program and to other training or employment-related programs that are part of the One-Stop service delivery system under the Workforce Investment Act.

e. There must be a review of the ineligibility decision within 12 months and annually thereafter if requested by the client or, if appropriate, by the client’s representative. This review need not be conducted in situations in which the client has refused it, the client is no longer present in the State, the client’s whereabouts are unknown, or the client’s medical condition is rapidly progressive or terminal.

2. Case record documentation requirements--

a. The determination that a client is not capable of achieving an employment outcome and is no longer eligible to receive services under an IPE, must be recorded on a Certification of Ineligibility which is signed and dated by a qualified rehabilitation counselor. The

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determination must also be recorded on an IPE Closing Amendment that must be dated and signed by the counselor and client or, as appropriate, the client’s representative.

b. The case file must contain evidence of written notification to the client of the ineligibility decision including the reason(s) for the determination, appeal rights, availability of the Client Assistance Program, and review of decision.

c. The closure consultation between the client and counselor must be recorded in the case file.

9.3 Criteria and Requirements for Closure of Case Records Subsequent to Eligibility Certification But Prior to Rendering IPE Services

9.3.1 Criteria

These closures occur when the client has been determined eligible, but IPE services were not initiated.

9.3.2 Requirements for Closing Case Records

9.3.2.1 Closure for Reasons Other Than Eligibility Criteria Not Met (Intervening Reasons)

The case record may be closed subsequent to the eligibility determination but prior to rendering IPE services if the client:

1. becomes unable to locate or contact or has moved;

2. refuses services or further services;

3. dies;

4. is institutionalized;

5. transfers to another agency;

6. fails to cooperate;

7. has no transportation available to participate in rehabilitation services; or,

8. other reasons not encompassed above.

Case record documentation requirement--

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The case record must indicate the reason for closure including the employment status if known.

9.3.2.2 Closure Because Eligibility Requirements Are No Longer Met

If it is determined that a client is no longer capable of benefiting from services in terms of an employment outcome because of the severity of his/her disability, the case record may be closed.

1. Procedural requirements --

a. the determination shall be made only after providing an opportunity for full consultation with the client or, as appropriate, with the client’s representative.

b. If an IPE has been developed and signed (closure from Status 12), a closing amendment to the IPE must be developed jointly and signed by a qualified rehabilitation counselor and client or, as appropriate, the client’s representative. The client must indicate whether he/she agrees or disagrees with the closure decision. The amendment must include the decision, the reason(s) on which the decision was based, and a copy must be provided to the client.

c. the client must be informed in writing, supplemented as necessary by other appropriate modes of communication consistent with the informed choice of the client, of the ineligibility determination, including the reasons for the determination, appeal rights, and availability of the Client Assistance Program.

d. the client must be referred to other agencies and facilities including, as appropriate, the State’s Independent Living Program and to other training or employment-related programs that are part of the One-Stop service delivery system under the Workforce Investment Act.

e. There must be a review of the ineligibility decision within 12 months and annually thereafter if requested by the client or, if appropriate, by the client’s representative. This review need not be conducted in situations in which the client has refused it, the client is no longer present in the State, the client’s whereabouts are unknown, or the client’s medical condition is rapidly progressive or terminal.

2. Case record documentation requirements--

a. The determination that a client is not capable of achieving an employment outcome and is no longer eligible to receive services must be recorded in a case note which is dated and initialed by a qualified rehabilitation counselor.

b. The case file must contain evidence of written notification to the client of the ineligibility decision including the reason(s) for the determination, appeal rights, availability of the Client Assistance Program, and review of decision.

c. The closure consultation between the client and counselor must be recorded in the case file.

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9.4 Criteria and Requirements for Closure of Case Records From Referral and Applicant Status

9.4.1 Criteria

This closure status is used to identify an applicant who was not accepted for vocational rehabilitation services, either because the client did not meet the eligibility criteria or due to reasons other than the eligibility criteria not being met. A case closed in this status as ineligible due to the severity of the applicant’s disability must have been provided Trial Work Experiences, with appropriate supports, to explore the client’s abilities, capabilities, and capacity to perform in work situations to support the determination that the client is incapable of benefiting from specific vocational rehabilitation services in terms of an employment outcome. Trial Work Experiences are not required in those limited circumstances when the client cannot take advantage of such experience.

9.4.2 Requirements for Closing Case Records from Application Status

9.4.2.1 Closure for Reasons Other Than Eligibility Criteria Not Met

An applicant’s case record may not be closed prior to making an eligibility determination unless the applicant declines to participate in or is unavailable to complete an assessment for determining eligibility and priority for services.

1. Procedural requirement --

The agency must make a reasonable number of attempts to contact the applicant or, if appropriate, the applicant’s representative, to encourage the applicant’s participation.

2. Case record documentation requirements--

The attempts to contact the applicant must be documented in the case record. The reason for closure including the employment status, if known, must also be indicated.

9.4.2.2 Closure Because Eligibility Requirements are Not Met

1 .An ineligibility determination must be based on one of the following requirements:

a. The applicant does not have a physical or mental impairment;

b. The applicant’s physical or mental impairment does not constitute or result in a substantial impediment to employment;

c. The applicant does not require vocational rehabilitation services to prepare for, secure, retain, or regain employment; or,

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d. The applicant is not capable of benefiting from services in terms of an employment outcome due to the severity of his/her disability. This determination shall be made only after the agency has provided the applicant Trial Work Experiences with appropriate support to determine whether or not there is clear and convincing evidence documented in the case file to support the determination. Exceptions may be made in limited circumstances when the applicant cannot take advantage of such experiences.

2. Procedural requirements --

a. The determination shall be made only after providing an opportunity for full consultation with the applicant or, as appropriate, with the applicant’s representative.

b. The applicant must be informed in writing, supplemented as necessary by other appropriate modes of communication consistent with the informed choice of the applicant, of the ineligibility determination, including the reason(s) for the determination, appeal rights, and a description of services available from the Client Assistance Program.

c. The applicant must be referred to other agencies and facilities including, as appropriate, the State’s Independent Living Program and to other training or employment-related programs that are part of the One-Stop service delivery system under the Workforce Investment Act.

d. A review of the ineligibility decision must be conducted within 12 months and annually thereafter if requested by the applicant or, if appropriate, by the client’s representative. This review need not be conducted in situations in which the applicant has refused it, the client is no longer present in the State, the client’s whereabouts are unknown, or the applicant’s medical condition is rapidly progressive or terminal.

3. Case record documentation requirements--

a. The determination that an applicant is not eligible to receive services must be recorded in the case notes that are dated and initialed by the counselor. The case notes must include the basis for the decision.

b. The case file must contain evidence of written notification to the client of the ineligibility decision including the reasons for the determination, appeal rights, availability of the Client Assistance Program, and review of decision.

c. The closure consultation between the applicant and counselor must be recorded in the case file.

9.5 Closure from Pre-Service Listing

9.5.1 Criteria

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This status is used for an applicant who was certified eligible for vocational rehabilitation services but did not meet the Order of Selection criteria, and the case file never advanced to service status.

9.5.2 Requirements for Closing Case Records

9.5.2.1 Closure for Reasons Other Than Eligibility Criteria Not Met (Intervening Reasons)

The case record may be closed subsequent to the eligibility determination but prior to rendering IPE services if the individual:

1. becomes unable to locate or contact or has moved;

2. refuses services or further services;

3. dies;

4. is institutionalized;

5. transfers to another agency;

6. fails to cooperate;

7. has no transportation available to participate in rehabilitation services; or,

8. other reasons not encompassed above.

Case record documentation requirement--

The case record must indicate the reason for closure including the employment status if known.

9.5.2.2 Closure Because Eligibility Requirements Are No Longer Met

If it is determined that a client is no longer capable of benefiting from services in terms of an employment outcome because of the severity of his/her disability, the case record may be closed.

1. Procedural requirements --

a. The determination shall be made only after providing an opportunity for full consultation with the client or, as appropriate, with the client’s representative.

b. The client must be informed in writing, supplemented as necessary by other appropriate modes of communication consistent with the informed choice of the client, of the ineligibility determination, including the reasons for the determination, appeal rights, and availability of the Client Assistance Program.

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c. The client must be referred to other agencies and facilities including, as appropriate, the State’s Independent Living Program and to other training or employment-related programs that are part of the One-Stop service delivery system under the Workforce Investment Act.

d. There must be a review of the ineligibility decision within 12 months and annually thereafter if requested by the client or, if appropriate, by the client’s representative. This review need not be conducted in situations in which the client has refused it, the client is no longer present in the State, the client’s whereabouts are unknown, or the client’s medical condition is rapidly progressive or terminal.

2. Case record documentation requirements--

a. The determination that a client is not capable of achieving an employment outcome and is no longer eligible to receive services must be recorded on a case note which is dated and initialed by a qualified counselor.

b. The case file must contain evidence of written notification to the client of the ineligibility decision including the reasons for the determination, appeal rights, availability of the Client Assistance Program, and review of decision.

c. The closure consultation between the client and counselor must be recorded in the case file.

9.6 Post-Employment Services

9.6.1 Criteria for Provision of Post-Employment Services

Post-employment services may be one or more services that are provided subsequent to the achievement of an employment outcome and are necessary for a client to maintain, regain, or advance in employment, consistent with the client’s strengths, resources, priorities, concerns, abilities, capabilities, career interests, and informed choice. These services are available to meet rehabilitation needs that do not require a complex and comprehensive provision of services and, thus, should be limited in scope and duration. Post-employment service(s) must be related to the original IPE.

9.6.2 Requirements for Provision of Post-Employment Services

Procedural requirements -- Post-employment services are provided under an amended IPE which must be developed jointly, agreed to, and signed by a qualified rehabilitation counselor and client or, as appropriate, the client’s representative. A copy must be provided to the client. A re-determination of eligibility is not required.

9.6.3 Closure from Post-Employment Service Status

9.6.3.1 Closure from Post-Employment Services-Case Reopened

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If, after the closure of the case from post-employment, the counselor determines more comprehensive services are required, a new rehabilitation effort should be considered.

Case record documentation requirement--

The case record must indicate the basis for the decision.

9.6.3.2 Closure from Post Employment Services-Successful

A client is placed in this status after the provision of post-employment services result in the client maintaining, regaining, or advancing in employment that is consistent with his/her strengths, resources, priorities, concerns, abilities, capabilities, and career interests.

1. Procedural requirements--

a. Prior to closure, the counselor must personally address with the client or, as appropriate, the client’s representative whether the employment is satisfactory and if the client is performing well on the job. The client must indicate whether he/she agrees or disagrees with this decision.

b. The client must be informed in writing of the case closure. This ―Closing Statement‖ must be dated and signed by the counselor and contain statements concerning the basis on which the client has been determined to have achieved an employment outcome, whether he/she agrees or disagrees with the closure decision, appeal rights, and availability of Client Assistance Program.

2. Case record documentation requires the results of the client contact in which case closure was discussed must be documented in the case file.

9.6.3.3 Closure from Post-Employment Services - Unsuccessful

A client is placed in this status when post-employment services do not result in the client maintaining employment and additional rehabilitation services are not considered appropriate.

Case record documentation requirement--

The case record must indicate the reason for closure.

Part 22 MDRS Compilation Part 22: VRB Resource Guide

32 Miss. Admin. Code Pt. 22, R. 1309 Rule 1309

VR AbilityWorks Harrison Co. 1310 VR AbilityWorks Jackson 1311 VR AbilityWorks Kosciusko 1314 VR AbilityWorks Meridian 1315 VR AbilityWorks Oxford 1316 VR AbilityWorks Olive Branch 1317 VR AbilityWorks Philadelphia 1318 VR AbilityWorks Starkville 1319 VR AbilityWorks Tupelo 1321 VR Reach Center for the Blind 1325 VR AbilityWorks Hattiesburg 1331 VR AbilityWorks Laurel 1500 VR In Service Training 1510 VR/VRB Section 110 Training 1700 Independent Living 1705 VRB IL Older Blind 1730 VR/VRB IL Client Services 1750 VR IL Attendant Care 1800 START 2500 VR PCA Waiver 3000 VR Supported Employment Section 110 Funds 3050 VR/VRB Supported Employment Title VI Funds 3332 SCI/TBI Trust Fund 6500 VRB BEP Equipment 6501 VRB BEP Replacement Equipment 6502 VRB BEP Refurbishing Facilities 6503 VRB BEP Mgmt Services 6504 VRB BEP Initial Stock 6505 VRB BEP MTCE 6701 VRB Addie McBryde Center 8000 VR Deaf and Hard of Hearing Office

1.4 REAL PROPERTY LEASES

The Office of Administrative Security and Support is responsible for administering all real property leases including negotiations and required official notifications. The Director of the Office of Administrative Security and Support may delegate various tasks in assembling the required documentation for new leases and renewals to the appropriate District Manager depending on the location or to other MDRS personnel in consultation with the District Manager.

The Director of the Office of Administrative Security and Support shall be notified as soon as possible if a lease is not to be renewed or if a lease should be terminated prior to the expiration

date. The Director of the Office of Administrative Security and Support will make required official notifications. Questions regarding real property leases should be directed to the Office of Administrative Security and Support.

1.5 TRAVEL

1.5.1 Guidelines for Travel

Voucher for Reimbursement of Expenses - Incident to Official Travel (13.20.10) form must be completed, signed, and sent for approval through your supervisor before being submitted to the finance office for reimbursement. The voucher must indicate your program code in the space labeled ―Program" and your organization code should be written in the space indicated as ―Org‖.

The actual dates of travel must be completed and the purpose and points of travel must be filled out for each day. All excessive mileage should include specific points of travel or an attached detailed itinerary. All literature pertaining to the trip(s), such as original itemized hotel receipts, literature indicating conference/meeting hotel rates, flight itineraries, etc., should be attached as well. The original travel voucher will be signed in any color ink except black.

The supervisor approving travel should sign on line reading "Approved for Payment"; the line reading "Verified By" is for finance use only.

The original and one copy will be sent to finance. The original and the copy should be stapled. The original receipts will be stapled to the back of the original voucher in the top left-hand corner and the copy should be an exact duplicate.

See the Travel Policy Section, of the MDRS Administrative Policy Manual for travel guidelines and policy.

1.5.2 Use of Agency Vehicles

Oversight responsibility for the legal, efficient and most cost effective operation of the agency's fleet of vehicles resides with the agency vehicle manager and the AbilityWorks Facility Managers.

Unsafe, careless, reckless or drunken driving will not be tolerated. All persons in supervisory roles are to investigate all instances of observed or reported unsafe driving and determine appropriate disciplinary action.

The use of seat belts by drivers and front seat passengers of all state-owned vehicles is mandated by Section XI of the MDRS Motor Vehicle Use Policy. Vehicle use will be documented by means of a travel log form. Information contained in that log will include odometer reading (beginning and ending), dates and destinations, purpose of each trip, fuel/oil purchases and driver's name.

All vehicle accidents should be investigated by the appropriate supervisor and documented on

MDRS Accident Report (AI-1) form within 5 days of the accident. Copies of the report should be sent to the immediate supervisor and the agency vehicle manager.

2.0 CASE MANAGEMENT

It is the Agency's belief that efficient case management leads to the provision of more appropriate, quality, and timely services for the individuals it serves. Guidelines and additional resource information are provided in this section to assist the counselor in managing his/her caseload and meeting the needs of the Agency and its clients.

Case File Folder: A label is affixed to the tab of each client's printed case file folder. The label will include the client's name, address, county, and district number. The following will be stamped on the outside of the file folder and the appropriate information recorded beside the headings:

 Client's Social Security Number  Client's Telephone Number  SSI/SSDI Status  Disability Priority  Case Status Dates (update as status changes are made)

Statistics: The statistical system of the Agency is computerized. Information is correlated in many different ways for use on local, state, and federal levels. When efforts are made to get funds to operate the Agency, this data is presented to the state and federal officials.

The counselor, District Manager, and administrative staff have access to various reports in AACE that they may generate and use as management tools. (See AACE User‘s Manual for details.)

Cases will display in the Activity Due List when they meet the notification parameters set by the Agency. They will remain on this list until action is taken. Below is a listing of timelines for the various statuses.

Application Status 60 days Eligible Status 75 days Service Status Employed Status 90 days PES Status 90 days

Time Lines/Frames for Service Initiation/Provision:

The Agency is committed to the initiation and delivery of planned services in a timely manner without undue delays or interruptions to its clients. The Agency has established the following standards for time lines/frames for service initiation/provision:

Service Initiation/Provision Timelines/Frames Referral to Application Contact as soon as possible, not to exceed 14 days – Application is to be taken as soon as possible, not to exceed 30 days from referral

Application to Eligibility No more than 60 days w/o extension

Eligibility to IPE development 90 days (general standard), if exceeds 90 days, rationale for exception is to be documented in the case record. If exceeds 6 months, District Manager is to review case and approve any extension

Client Contact Maximum of 90 days, more often if warranted by client‘s disability or services being provided

Services Provided as appropriate & indicated on IPE

Annual Plan Review From date of last plan/amendment, not to exceed 1 year

Employment to Closure ―Rehabilitated‖ Must remain in Employed Status a minimum of 90 days from date of employment

Annual Review (cases closed: due to severity of disability and cases closed with an employment outcome of extended employment) No more than12 months from closure date and in keeping with the policies in the Closure section of the OVR/OVRB Policy & Procedure Manual

2.1 FILE DOCUMENTATION

The following documents, as appropriate to each case, are to be included in the client's printed case file folder (Details regarding related policy are in the OVR/OVRB Policy and Procedure Manual.):

 Application for Vocational Rehabilitation Services & Explanation of Client‘s Rights (MDRS-VR-01) form or a letter from applicant requesting services

Requires applicant's (or applicant's parent/guardian) signature.

 Information and Referral (MDRS-VR-02) form, if referral is made to an outside agency/organization for assisting the individual in preparing for, securing, retaining, or regaining employment.

Requires MDRS representative’s signature

 AACE Personal Information, Application Documentation reports. Participant Initial Interview (MDRS-VR-04) form may be used as the working copy, particularly when the counselor is on itinerary, but the information must be entered into the electronic file.

Requires MDRS representative’s signature

 Medical/Psychological Reports documenting the disability

Disability must be substantiated by a person qualified to diagnose the specific disability.

 Eligibility Extension

Requires counselor's signature

 Certificate of Eligibility/Ineligibility

Requires counselor's signature - If the client is determined to be ineligible after IPE has been developed; the client (or client’s parent/guardian) must also sign the Certificate of Ineligibility/IPE Closing Amendment.

 All Trial Work Experience Plans, Individualized Plans for Employment (IPE), PES Plans, Revisions, and Amendments

All, except revisions, require client (or client's parent/guardian*) and counselor's signatures. Revisions for minor changes should be attached to the original plan.

 Participant Initial Interview Form (MDRS-VR-04) - must be completed on all applicants. The VR Counselor or other staff member that completes this form is responsible for its accuracy since this information will be entered into AACE creating the official case file. This information is also used for program planning, evaluation and reporting.

The purpose of this form is to accumulate data for the completion of the RSA-911 Case Service Report which is an annual report of demographic and caseload information such as social security number, disability characteristics, services, training, health insurance, and financial information related to all individuals exiting the VR program during each fiscal year. Information for the completion of the Participant Initial Interview Form is usually obtained during the initial interview with the consumer. This form is also designed to provide prompts to assist in considering all information and resources systematically according to AACE. Any additional information that is obtained during the initial interview that is not specifically listed should be detailed in the additional information section of this form. It is important to be thorough when completing this form because much of the information is required to place an individual into Application Status.

Requires MDRS representative’s signature

 Financial Needs Analysis (FNA-01) form

Requires client (or client's parent/guardian) and counselor's signatures.

 Case Notes – are to be entered in the electronic file.

The author of an electronic case note is recorded by AACE as the individual who is logged in the system. When a counselor assistant enters a case note in AACE for a counselor, the case note should begin with this statement: This case note is being entered for (counselor’s name). The counselor assistant should print the completed case note for the counselor’s signature. The counselor is to sign the case note (first initial and last name). Then the case note should be placed in the client’s file.

 Authorizations

Requires counselor's signature to issue and approve for payment. Vendor must sign indicating service provision. The client is only required to sign those authorizations issued directly to the client as a vendor.

 IPE Reviews

Requires counselor's signature

 AACE Employment Reports on each job the client obtains

 AACE Closure Report

 Notification of Closure Letter

Requires counselor's signature - If the client is determined to be ineligible after IPE has been developed; the client (or client’s parent/guardian*) must also sign the certificate of ineligibility/IPE closing amendment.

 AACE Case Summary Report at case closure

 AACE Federal Follow-up Reports (6 month and 12 month)

 All Formal Correspondence

Requires counselor's signature - If the applicant/client is under the age of 18, or is not otherwise legally adjudicated, the parent/guardian’s signature is required.

2.2 DISABILITY CODES

From the disabling conditions, it will be possible to obtain data on multiple impairments such as the amputee who is hard of hearing and how these conditions contributed to the individual's employment impediment.

All disabling condition information should be taken from the most recent document(s) prepared by physicians based upon the examination of the individual and/or medical records of a hospital or clinic where the individual was examined. The disabilities described and coded will be based upon the complete and final diagnostic information used in determining eligibility for vocational rehabilitation services.

The diagnosis for visual and aural cases should always be recorded to include the degree of functional loss, stated in terms of Snellen's notations for the visual cases and in terms of decibels for the aural cases. Visual disabilities will always be described in terms of best correction. The description for mentally retarded individuals will include the Intelligence Quotient and the tests or scales used.

Primary Disability

Enter the four-digit code that best describes the individual's primary physical or mental impairment that causes or results in a substantial impediment to employment. The number reported is a combination of the impairment code and cause/source code. The first two digits designate the impairment (sensory, physical or mental), and the last two digits indicate the cause or source of the impairment.

If the person is found not to have a disability, this item should be coded 0000. Use Code **** if the information is not available for Closure Code 1.

Secondary Disability

Enter the four-digit code that best describes the secondary disability. This is the physical or mental impairment that contributes to, but is not the primary basis of, the impediment to employment. The number reported is a combination of the impairment code and cause/source code. Enter Code 0000 to indicate that the individual does not have a secondary disability. Use Code **** if the information is not available for Closure Code 1.

RSA Codes for Impairments

0 No impairment

Sensory/Communicative Impairments:

1 Blindness 2 Other Visual Impairments 3 Deafness, Primary Communication Visual 4 Deafness, Primary Communication Auditory 5 Hearing Loss, Primary Communication Visual 6 Hearing Loss, Primary Communication Auditory 7 Other Hearing Impairments (Tinnitus, Meniere's disease, hyperacusis, etc.)

8 Deaf-Blindness 9 Communicative Impairments (expressive/receptive)

Physical Impairments:

32 Miss. Admin. Code Pt. 22, R. 10 Rule 10

Mobility Orthopedic/Neurological Impairments 11 Manipulation/ Dexterity Orthopedic/ Neurological Impairments 12 Both mobility and Manipulation/ Dexterity Orthopedic/ Neurological Impairments 13 Other Orthopedic Impairments (e.g., limited range of motion) 14 Respiratory Impairments 15 General Physical Debilitation (fatigue, weakness, pain, etc.) 16 Other Physical Impairments (not listed above)

Mental Impairments:

32 Miss. Admin. Code Pt. 22, R. 17 Rule 17

Cognitive Impairments (impairments involving learning, thinking, processing information and concentration) 18 Psychosocial Impairments (interpersonal and behavioral impairments, difficulty coping) 19 Other Mental Impairments

RSA Codes For Causes/Sources Of Impairments

32 Miss. Admin. Code Pt. 22, R. 00 Rule 00

Cause unknown 01 Accident/Injury (other than TBI or SCI) 02 Alcohol Abuse or Dependence 03 Amputations 04 Anxiety Disorders 05 Arthritis and Rheumatism 06 Asthma and other Allergies 07 Attention-Deficit Hyperactivity Disorder (ADHD) 08 Autism 09 Blood Disorders 10 Cancer 11 Cardiac and other Conditions of the Circulatory System 12 Cerebral Palsy 13 Congenital Condition or Birth Injury 14 Cystic Fibrosis 15 Depressive and other Mood Disorders 16 Diabetes Mellitus 17 Digestive

32 Miss. Admin. Code Pt. 22, R. 18 Rule 18

Drug Abuse or Dependence (other than alcohol) 19 Eating Disorders (e.g., anorexia, bulimia, or compulsive overeating) 20 End-Stage Renal Disease and other Genitourinary System Disorders 21 Epilepsy 22 HIV and AIDS 23 Immune Deficiencies excluding HIV/AIDS 24 Mental Illness (not listed elsewhere) 25 Mental Retardation 26 Multiple Sclerosis 27 Muscular Dystrophy 28 Parkinson's Disease and other Neurological Disorders 29 Personality Disorders 30 Physical Disorders/Conditions (not listed elsewhere) 31 Polio 32 Respiratory Disorders other than Cystic Fibrosis or Asthma 33 Schizophrenia and other Psychotic Disorders 34 Specific Learning Disabilities 35 Spinal Cord Injury (SCI) 36 Stroke 37 Traumatic Brain Injury (TBI)

2.3 Case Statuses

A referral is defined as any individual who has applied or been referred to VR by letter, telephone, direct contact, or any other means, and for whom the following minimum information has been provided:

 Social Security Number  Name and Address  Disability (as reported, medical/psychological documentation substantiating is not required until the point of eligibility)  Age and Sex  Date of Referral  Source of Referral

The case status system in VR is designed to facilitate the tracking of individuals as they progress through the service system. There are 5 active statuses and 2 closed statuses.

Active Case Statuses:

 Application Status (old statuses 00, 02, and 06)

As soon as the referred individual signs a document requesting vocational rehabilitation services, he/she is designated an "applicant". Generally, the document will be an Agency

form, but a letter signed by an individual that includes the minimum basic referral information and requests services will be considered sufficient for placing the individual in Application Status. This is important since the applicant must be notified in writing if the request for VR services has been denied and the only certain basis for determining that the individual has knowledge of having been referred is by the existence of a document signed by the individual.

While the individual is in Applicant Status sufficient information is gathered to make a determination of eligibility or ineligibility for vocational rehabilitation services or a decision is made to provide the individual with a period of Trial Work Experiences prior to making such a determination.

 Eligible Status (old status 10)

An individual who has been certified as meeting the basic eligibility requirements is accepted for vocational rehabilitation services, designated as an active case, and placed into Eligible Status. While a client is in this status case study and diagnosis are completed to provide a basis for the formulation of the Individualized Plan for Employment (IPE). A comprehensive case study is basic to determining the nature and scope of services necessary to achieve the employment objective of the individual. The individual remains in this status until the IPE is written and approved.

Priority Category Closed (old status 04) - There is a separate caseload (PCC_ _) set up in each district to track these individuals and record information and referral services they are provided. This caseload will be used only when an Order of Selection has been implemented. A client will be placed in this status when the counselor has certified him/her eligible but he/she does not meet Order of Selection criteria. No services can be authorized while the client is in this priority category.

 Service Status (old statuses 14, 16, 18, and 20) A client enters Service Status when the IPE has been developed and signed by the counselor and client (client‘s parent or guardian, if appropriate).

Plan Type - Counseling and Guidance Only (old status 14) - It is intended that this plan type be used only for those individuals having an approved IPE which outlines counseling, guidance and placement as the only services required to prepare the client for employment. It is not to be used to reflect the counseling and guidance which takes place during the course of program development or is provided by the counselor during the provision of training or physical/mental restoration. Ancillary services (e.g.: diagnostic medical services, medication, transportation) can be authorized that facilitates/allows client's participation in this status.

When there is a breakdown in the progress of the case after other services have been provided, the counselor may determine that substantial counseling and guidance are essential to the successful placement and rehabilitation of the individual. The client may

then be entered in this plan type if an IPE amendment has been written and approved after consultation with the client, and this is the only additional service required to prepare the client for employment.

Plan Type - Physical and Mental Restoration (old status 16) - A client is placed in this plan type if he/she is receiving any physical or mental restoration service such as medical, surgical, psychiatric or therapeutic treatment, or is being fitted with an appliance. A case remains in this plan type until physical and mental restoration services are completed or terminated.

Plan Type – Training (old status 18) - A client is placed in this plan type if he/she is actually receiving academic, business, vocational, or personal and vocational adjustment training from any source, such as a public or private school, a commercial or individual establishment, a rehabilitation or other facility, an individual teacher or instructor, or correspondence course. Clients remain in this plan type until the training is either completed or terminated.

Job Ready (old status 20) - This data page is completed when a client has completed preparation for employment (counseling, guidance, treatment, fitting of an appliance, training, etc.) and is ready to accept a job but has not yet begun employment.

 Employed Status (old status 22) A client is placed in this status when he/she has been prepared for, been placed in and begun employment. The client must be observed in this employment for a minimum of 90 days before being closed rehabilitated to ensure adequacy of employment in accordance with the needs and limitations of the individual. Homemakers and unpaid family workers should be included in this status and the observation criteria will be applied to them.

 Post-Employment Service Status (old status 32) client is placed in this status if he/she has previously been closed rehabilitated and requires additional services to maintain or regain other suitable employment and prevent the recurrence of the disabling condition. The purpose of this status is, to avoid the necessity of reopening a case in order to provide a relatively minor service.

Post-employment services must be planned and may include any service or combination of services necessary to assist the individual in maintaining employment so long as the service(s) are related to the original IPE.

Closure Statuses

See the OVR/OVRB Policy and Procedure Manual for details regarding the case closure process. There are two types of closure statuses:

 Closed Rehabilitated Status (old statuses 26 and 36)  Closed Other Than Rehabilitated (old statuses 08, 28, 30, 34, 38, and 40)

RSA Closure Codes and Reasons:

Code Reason

1 Unable to locate, contact, or moved: This code is used when the individual has moved without leaving a forwarding address or has otherwise disappeared. It is also used when the individual leaves the state and gives little evidence of returning in the foreseeable future. A reasonable effort to contact the consumer must be made and documented in the case file before closing a case as unable to locate. Reasonable efforts include a minimum of 2 letters and 2 telephone call attempts. If a letter has been returned after it was sent by mail, check the envelope to ascertain whether it identifies a forwarding address; verify that the letter was correctly addressed; and attempt to reach the consumer by telephone. (A telephone call with no answer would not be counted as an attempt to locate.) An answering machine message would count as an attempt to contact if the counselor recognizes this as the consumer‘s residence and leaves an appropriate message. If these efforts are unsuccessful, efforts should be made to reach the consumer through contact with family members or friends. If these efforts are unsuccessful, the case may be closed as unable to locate.

2 Disability too significant to benefit from VR Services: This code is used to identify an individual whose mental or physical disability is so significant that the individual cannot benefit from VR services in terms of employment. Also, include individuals with disorders that are expected to progress to such a severely limiting degree in a short period of time that rehabilitation services will be of little or no help. Prior to closure for this reason, the case file should contain clear and convincing evidence of this through a period of Trial Work Experiences (TWE) or medical documentation that the client is unable to participate in TWE.

3 Refused services or further services: This code is used when the individual declines to accept, participate in, or use vocational rehabilitation services. Prior to case closure for this reason, the case file should indicate that the client (or client‘s parent/guardian) has communicated verbally, or in writing, that he/she does not want services. Does not require a closure letter.

4 Death: This code requires case file documentation. Documentation may include a copy of the obituary, case note indicating notification by a family member, etc. Does not require a closure letter.

5 Institutionalized: This code is used when an individual has entered an institution and will be unavailable to receive rehabilitation services for an indefinite or considerable length of time and continuance of an open case would not be beneficial to the person. For this item, an institution can include hospitals, nursing homes, prisons and jails, treatment centers, etc. Documentation may include a case note indicating notification by client, a family member, etc. Does not require a closure letter.

6 Transferred to another agency: This code is used when services needed by the individual are more appropriately provided elsewhere. Transfer to the other agency should be accompanied by referral information that can assist the other agency to accept the individual. Does not require a closure letter.

7 Failure to Cooperate: This code is used when the individual's actions (or non- actions) convince the counselor that it is not possible to begin or continue appropriate rehabilitation services. Non-cooperation would include promises not kept by the individual such as not showing up for counseling, interviews, school attendance or medical/psychological appointments made for diagnosis/treatment or other services. Efforts by the counselor to overcome these actions or non-actions are required and should be documented in the case file. The case file should indicate that a minimum of 3 legitimate (by letter and/or telephone call) attempts were made prior to closure for this reason. A telephone call with no answer is not considered an attempt. Does not require a closure letter.

8 No disabling condition: This code applies only to individuals not accepted for rehabilitation services (closures from Application Status). The use of this code means that no physical or mental impairment exists. Use this code when only an acute (as opposed to chronic) condition is observed (i.e. a broken bone that heals). This code may also be used in instances when a chronic condition appears to have no or very inconsequential effects in a medical sense.

9 No Impediment to Employment: This code applies only to individuals not accepted for rehabilitation services (closures from Application Status). The use of this code means that a physical or mental impairment is present but does not constitute a substantial impediment to employment.

32 Miss. Admin. Code Pt. 22, R. 10 Rule 10

Transportation not feasible or available: This code is used to indicate that acceptance of employment was either not feasible because transportation is too costly or not available. Does not require a closure letter.

32 Miss. Admin. Code Pt. 22, R. 11 Rule 11

Does not require VR services: Use this code for applicants who do not require VR services to prepare for, enter into, engage in, or retain gainful employment consistent with their strengths, resources, priorities, concerns, abilities capabilities, and informed choice.

32 Miss. Admin. Code Pt. 22, R. 12 Rule 12

Extended services not available: Use this code for individuals who would have benefited from the provision of supported employment services but for whom no source of extended services was available.

32 Miss. Admin. Code Pt. 22, R. 13 Rule 13

Extended employment: Use this code for individuals who received services and were placed in a non-integrated setting for a public or non-profit organization. This does require an employment record.

32 Miss. Admin. Code Pt. 22, R. 14 Rule 14

All Other Reasons: This code is used to cover reasons not encompassed by Codes 1 through 13. Does not require a closure letter.

CASE RECORD REQUIREMENTS BASED ON CLOSURE REASONS

Status Closure Reason Case Record Requirements Closed Rehabilitated - incl. Post Employment Service (PES) cases - Old Statuses 26, 36 Successfully Rehabilitated Closing Statement and Notification of Closure letter. Case note recording closure details. PES cases do not require reassessment of the need for post-employment services. Closed Other From Applicant Status - Old Status 08 No impairment; no impediment to employment; cannot benefit from VR services; disability too severe or unfavorable medical prognosis; and reasons not related to eligibility Certificate of Ineligibility - Notification of Closure letter. Case note recording consultation with client regarding determination. Case note recording closure details.

Closed Other From Eligible Status - Old Statuses 30, 38 Cannot benefit from VR services; disability too severe or unfavorable medical prognosis. Old Statuses 30, 38 (incl. PCC cases) Certificate of Ineligibility and Notification of Closure letter. Case note recording consultation with client regarding determination. Case note recording closure details

Closed Other From Service Status - Old Status 28 Can no longer benefit from VR services – Disability too severe or unfavorable medical prognosis; Reasons not related to eligibility - including transfer to other agency (e.g., extended employment providers) Certificate of Ineligibility/IPE Closing Amendment and Notification of Closure letter. Case note recording consultation with client regarding determination. Case note recording closure details

Closed Other From PES Status - Old Status 34, 40 Can no longer benefit from VR services – Disability too severe or unfavorable medical prognosis. Reasons not related to eligibility VR case reopened Certificate of Ineligibility/IPE Closing Amendment and Notification of Closure letter. Case note recording consultation with client regarding determination. Case note recording closure details

2.4 CASE TRANSFER

The counselor transferring an open case is to notify the receiving counselor of this intent (by mail or e-mail; with copy to the District Manager) prior to the transfer. A transfer summary will be completed in AACE case notes. This summary will include the following: brief summary of plans and the intent of case services.

The transferring counselor will mail the printed case file folder to the receiving counselor. The transferring counselor's District Manager/District Administrative Assistant will complete the electronic case transfer process in AACE. If the receiving counselor has not received either the electronic or printed case file within 5 working days from notification, he/she should contact the transferring counselor.

Printed case file folders will not be transferred for closed cases. The electronic file may be transferred at the receiving counselor's request. Copies of closed case file material will be forwarded if requested.

2.5 CASE REVIEW

The following information must be recorded when the Program Evaluation Unit pulls a case for review:

 Date  Client Name and Number  Receiver/Reviewer

(User will insert current copy of the Program Evaluation Case Review Manual/Instrument; available through the District Manager.)

2.6 FEDERAL REPORTS

Our federal funding source and reporting agency, the U. S. Department of Education, Office of Special Education and Rehabilitative Services, Rehabilitation Services Administration (RSA) requires the Agency to provide information regarding client service provision, expenditures, and outcome of services through the reports listed below. (The federal reports are based on regular casework information input by the field staff in AACE on a day-to-day basis. All RSA reporting and other casework requirements are identified in the AACE User's Manual. These reports will be generated at the State Office through the AACE system.)

Cumulative Caseload Report (RSA - 113) - Due to RSA 30 days after the end of the quarter

This quarterly report compiles aggregate information on all persons with disabilities in their rehabilitation process. This data is used to track trends of persons applying for VR services, determinations of eligibility by VR agencies, identification of persons with severe disabilities, employment planning, service implementation, employment outcomes. These trends provide a general assessment of the State-Federal VR program and its accomplishments. It is further used to identify technical assistance needs of the State agencies and develop RSA's budget requests. It is an integral part of RSA's Annual Report to the President and to the Congress on Federal Activities Related to the Rehabilitation Act of 1973, as Amended.

Case Service Report (RSA - 911) - Due November 30

This cumulative annual report collects data on an individual client basis for all cases closed from State agency caseloads in a given fiscal year. Examples of data elements collected in this report includes client demographic information (disability, gender, date of birth, etc.); work status and earnings at application and closure; amount of public support client received, dates of application, eligibility, and closure; services provided; costs of services; etc.

Vocational Rehabilitation Program Cost Report (RSA - 2) - Due January 30

This cumulative annual report must reflect all federal and state expenditures recorded for the 12- month federal fiscal year ending September 30. It must include those expenditures made this fiscal year but charged to either the Section 110 or Title VI-B federal funds that were carried over from the previous fiscal year. It also details the funds expended for specific services provided, certified public funds expended as a result of a cooperative agreement with another state or public agency, actual vocational rehabilitation jobs (staff) filled during the period, and any other expenditures not reported elsewhere.

Supported Employment Caseload Report (RSA - 636) - Due October 30

This annual report provides broad-based monitoring information on the flow of supported employment cases into and out of the caseloads of state vocational rehabilitation agencies. The Agency is required to separate data collected by the titles which these cases may be served (Title I and VI-B). Client information has been established in the RSA - 911. However, the RSA - 911

system is a closed case system and does not provide current caseload information. The RSA - 636 is designed to fill this gap and permit the tabulation of data on supported employment efforts in state agencies more quickly.

2.7 INFORMED CHOICE RESPONSIBILITIES

The Rehabilitation Act requires that MDRS ensure that applicants and clients, or their representatives, are provided information and support services to assist them in exercising informed choice throughout the VR process. Counseling and guidance services provided by MDRS staff include information and support services to assist an individual in exercising informed choice, reinforcing the facilitative and supportive role of the VR counselor in assisting individuals with disabilities to exercise informed choice.

Minimum information that must be provided by MDRS staff to applicants and client during the development of the IPE include: the cost, accessibility, and duration of services; the types of services; the degree to which service settings are integrated; the qualifications of service providers; and, to the extent possible, information about consumer satisfaction with these services.

The opportunity for the individual to exercise informed choice requires special emphasis during the development of the IPE. Individuals are provided a choice of options for developing the IPE, including: (a) the individual developing all or part of the IPE; or (b) the individual using technical assistance in developing all or part of the IPE, including the assistance of the MDRS VR counselor. Areas of informed choice include selection of an employment outcome, VR services, service providers, and methods for procuring services.

The employment outcome must be chosen by the individual and must be consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individual. The respective responsibilities of the individual and MDRS in working towards achievement of the employment outcome must be described in an IPE.

The cost, duration, or extent of vocational rehabilitation services that a client may need to achieve a particular employment goal will not be considered in identifying the goal.

2.7.1 MDRS

The role of MDRS is to administer the VR program in a manner that supports the joint efforts of the individual and the VR counselor. MDRS provides such support by implementing policies and procedures that provide the maximum opportunity for individuals to exercise informed choice, for the VR counselor to support individuals in that effort, and for the development of employment and service options that meet a wide range of individual needs. Commitment to informed choice by the leadership of MDRS is critical to these efforts.

MDRS is responsible for facilitating the development of information resources, tools, and support services needed by individuals and counselors to fully implement informed choice. MDRS provides information in accessible formats or modes of communications that individuals

can understand. MDRS also makes available a variety of resources to assist individuals in planning, problem solving, and building decision-making skills.

Working with State procurement staff and other relevant agencies, MDRS seeks maximum flexibility in procurement procedures for both the VR program and its participants. MDRS assures that its policies and procedures support an individual‘s ability to exercise informed choice so that MDRS‘ policies and procedures do not result in the pre-selection of employment outcomes, services, and service providers for MDRS applicants and clients.

Beyond fulfilling program requirements, MDRS uses its resources and influence to promote and improve the implementation of informed choice. The capacity for resource development is used to increase the employment and training options that are available for clients and to support the development of service providers willing to negotiate with VR clients about individualized services. Providing training about implementation of informed choice to VR counselors and other service providers who interact with participants helps to assure consistent practices and to disseminate information about innovations. MDRS fosters the development of creative approaches for implementing informed choice by identifying, supporting, and replication promising practices.

2.7.2 Vocational Rehabilitation Counselor

The Vocational Rehabilitation Counselor facilitates the informed choice process with knowledge of rehabilitation and the VR process, an understanding of informed choice, information regarding rehabilitation resources and current labor market trends, and the experience of assisting other individuals through the VR process.

It is generally the responsibility of the VR counselor to inform the individual about available options for developing the IPE and for exercising informed choice and to assure that the individual understands the options. MDRS has developed specific brochures and handouts to aid in this process. The counselor assists the individual during the assessment process to discover the individual‘s strengths, abilities, capabilities, and interests. If appropriate, the counselor encourages the participation of family members and others in the VR process.

The VR counselor also assists the individual in exercising informed choice, informs the individual of services that support the individual in exercising informed choice, and helps the individual link with any necessary support services. The counselor facilitates the development of the individual‘s ability to gather information and supports the individual in making decisions to the best of the individual‘s ability. The counselor works with the individual to build relationships and to align resources that will enable the individual to exercise informed choice and to work toward the employment outcome.

2.7.3 Applicant or Client

The individual must make decisions about the options for developing the IPE, the extent of technical assistance needed for exercising the various options, and the extent to which family members and others are to be involved in the IPE planning process.

Exercising informed choice and taking more responsibility in the VR process makes demands on individuals with disabilities, and may also make demands on other people in their lives. To be fully engaged in the VR process, including development of the IPE, the individual must gather and use information to the extent possible, participate in planning and problem solving, make and implement decisions, and seek or identify needed resources. The individual engages in these activities to make decisions about the selection of the employment outcome, VR services, service providers, service and employment settings, and methods for procuring services. Once the IPE has been signed both by the individual and the VR counselor employed by the State VR agency, the individual assumes the responsibilities identified in the IPE for implementing the decisions and achieving the employment outcome.

(Sections 2(c)(1), 100(a)(3)(C), 101(a)(6)(C), (8)(A), (9)(B), and (19); 102(b)(1)(A), (2)(B) and (C), (3)(A) and (3)(E)(i) and (ii); 102(d); and 103(a) and (a)(2) of the Rehabilitation Act of 1973, as amended.)

3.0 Special Services & Programs

Any question a counselor may have regarding a particular service or program area should be submitted in writing to the District Manager. If the District Manager is unable to answer the question, it should be forwarded to the State Office staff person assigned as coordinator for that area. The District Manager should forward all complaints regarding client services being provided by a particular vendor/service provider to the State Coordinator for that area. The list below identifies the Agency staff responsible for various services and programs.

Alcohol and Drug Services Joyce White Assistive Technology Program Vacant Business & Agricultural Projects Joyce White CARF/ Vocational Evaluation/Adjustment Services Mike Ward Community Rehabilitation Programs Joyce White Comparable Services and Benefits Joyce White CRP Training Issues/DOL Issues/AbilityWorks Manual Anna Thornton Deaf Services Program Denee Smith Dental Services Dwight Gregory Durable Medical Equipment Vacant Grant Development Dr. Michael Gandy Hospital Rehabilitation Centers Dwight Gregory Independent Living Services for the Blind Linda Hall Independent Living Services Shella Head Job Development/Placement Program Bob McDonald Out-of-State Services Dwight Gregory Post-Secondary Education Services Joyce White Program Evaluation System Chris Shackleford Project START Dorothy Young

Psychometric/Psychological Services Program Dr. J. Rowzee/D. Gregory Secondary Education/Transition Services Program Patty Horton/Donny Fraizer Selected Social Security Services/M-PIC Vicki Thornton Supported Employment Program Patty Horton Traumatic Brain & Spinal Cord Injury Trust Fund Allison Lowther Visual Impairment – Special Services Dr. Michael Gandy Weight Management Services Dwight Gregory WIA Youth Employment Skills Training (EST) Program Bob McDonald Workers' Compensation Referral Program Joyce White Workforce Development - WIN Job Centers Bob McDonald

3.1 ALCOHOL AND DRUG SERVICES

Diagnosis for alcohol and/or drug addiction is to be provided by a medical doctor skilled in the diagnosis and treatment of such disorders (i.e., addictionologist or medical doctor employed by a state licensed/certified substance abuse treatment program), psychiatrist, licensed psychologist, or psychologist in the employ of a local, state, or federal governmental agency. Documentation of the disability must be current (within the 12 months prior to the date of application).

The counselor must determine if the individual's functional limitations are severe enough to constitute a substantial impediment to employment. The counselor must determine how alcohol and/or drug abuse impedes the individual's occupational performance by assessing how the individual is prevented from securing, retaining, or regaining employment in accordance with their abilities. The counselor must describe the specific impact these functional limitations have had on the individual's vocational functioning within the last 12 months.

In general, the diagnosis of substance abuse/dependence does not constitute a substantial impediment to employment if the individual has been "in remission" according to the American Psychiatric Association‘s Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) criteria for one year or longer. If employment problems are still evident, it is suggested that other disabilities be explored. According to DSM-IV, individuals cannot be considered "in remission" while on prescribed medication for substance abuse (e.g., anabuse, methadone) or in a controlled environment (e.g., treatment facility, halfway house, prison).

Substance abuse/dependence can be a major disabling condition according to RSA disability codes. However, it is not automatically considered a severe disability. The counselor is to use the OVR/OVRB Policy and Procedures Manual and Resource Guide as reference when determining severity of disability.

The Agency does not provide assistance for primary alcohol and/or drug abuse treatment. These services are available through private treatment centers; public mental health-affiliated centers, and the two state hospitals. The public mental health-affiliated programs are mandated by law to serve all individuals who live within their region and need services regardless of ability to pay. There is no charge for the treatment at the two state hospitals.

On a case-by-case basis, clients who are eligible for vocational rehabilitation (VR) services may be assisted with the cost of residential secondary (three-quarter way) alcohol and/or drug treatment provided by those centers that have a written agreement on file with the Agency. The Agency contracts with both private and public, mental health affiliated programs. The counselor may only authorize for treatment to programs that are listed in the Agency Fee Schedule.

The Agency recognizes that for some individuals, detoxification* is the first step in the treatment process toward recovery from drug(s) of dependence. However, individuals who do not continue with primary treatment do not receive the benefit of education in the disease process; no teaching on the psycho/social affects of addiction; nor has the individual dealt with emotional and behavioral obstacles associated with life free from alcohol and/or drug abuse. Therefore, the Agency will not sponsor any client in three-quarter way treatment until that person has successfully completed a minimum of 28 days in a primary treatment program. Referral for residential secondary (three-quarter way) treatment should be made while the individual is in the latter stage of primary treatment. The client's file must contain a report from the treatment center that primary treatment has been successfully completed and three-quarter way treatment is recommended.

Individuals who are participating in primary alcohol/drug treatment and are being considered for VR sponsorship in secondary treatment need to be staffed by the counselor taking the application with the counselor to whom they plan to transfer the case. This should occur prior to the counselor accepting the case to ensure adequate funds are available in the district to which the case is being transferred.

It should not be the responsibility of the treatment center or individual to call the secondary treatment liaison counselor about this. It should be an internal VR process.

The Agency may pay for three-quarter way treatment a maximum of three times. After the third time the Agency has served (in an active status) an individual who has the disability of alcohol and/or drug dependence, service provision will be limited to counseling, guidance, placement, and follow-up ("no cost" services). To help track these clients there is a printout, which includes both alcohol, and drug cases served and closed from October 1987 through August 1995. Counselors may access this information through the appropriate District Manager's office. The counselor may access information from October 1993 through the present in the automated case management system. Any exception to these guidelines requires the approval of the District Manager.

For referrals received on individuals who have only completed detoxification and are already in secondary treatment, the Agency will not pay for secondary treatment. However, the Agency will provide other services, if the individual completes a minimum of 30 days of secondary treatment.

If an individual has completed primary treatment and declines the recommended secondary treatment, the counselor will decide whether to provide additional services. The counselor is to consider the individuals reason for not attending secondary treatment, the individual‘s plan for

ongoing treatment, and the individual‘s past history of treatment (history of relapse indicates extended treatment is needed).

If an individual requests services for another disabling condition, the counselor may request the individual take a drug test under the following conditions:

 Medical evidence or other objective and factual evidence shows that the individual is using drugs or  The individual‘s behavior suggests drug use

If the results of the drug test are positive, the individual will be given the option of submitting to primary treatment at his/her own expense. If the individual refuses treatment, the individual will not be served.

The Agency provides counseling, guidance, vocational evaluation, vocational adjustment, job placement, referral to Alcoholics or Narcotics Anonymous, and other VR services, as appropriate for the individual client. Alcoholics Anonymous and Narcotics Anonymous are recognized as valuable programs contributing to an individual's lifelong maintenance of sobriety and abstinence. The counselor should strongly encourage the client to participate in programs offered by these organizations.

*The Agency used the Department of Mental Health‘s definition of detoxification, which states that detoxification is the process through which a person who is physically and/or psychologically dependent on alcohol, illegal drugs, prescription medications, or a combination of these drugs is withdrawn from the drug(s) of dependence. Methods of detoxification include medical detoxification (detoxification in a hospital setting) and social detoxification (detoxification in a non-hospital supportive environment.)

Role of the VR Alcohol & Drug Treatment Center liaison counselor:

There is an Agency liaison counselor designated for secondary alcohol and drug treatment programs throughout the state. A list of these counselors may be found in the Agency Fee Schedule. Although the Agency does not sponsor individuals in primary treatment programs, a good working relationship must be maintained with these programs, as they will be making referrals to the Agency for other services. Each District Manager should assign a liaison counselor for each primary treatment program located in his/her district.

Examples of the liaison counselor's responsibilities include, but are not limited to, the following:

VR Liaison Counselor to the Primary Treatment Center

 Serve as the initial contact point for the treatment center on issues such as the Agency policies, services, funding matters, referrals, criteria for eligibility, paperwork required, etc.  Contact the counselor who serves the three-quarter way facility where the referred individual will be entering.

 Develop, with the referral, the IPE so that all parties involved (client, primary treatment staff, and three-quarter way administration) will know for sure before admission that VR will be sponsoring and authorizing the per diem.  Transfer the case file to the counselor who serves the three-quarter way facility so that he/she can authorize prior to admission.

VR Liaison Counselor to the Secondary Treatment Center

 Be an active participant in the client's treatment program.  Authorize for three-quarter way treatment prior to admission into the center.  Serve as an intermediary between the treatment center and the local counselor for any client who is from another area of the state.  Attend regularly scheduled staff meetings at the treatment center to share information, help plan, and coordinate appropriate client services.  If the client has a job to go to directly upon completion of three-quarter way services, the counselor should retain the case file for closure regardless of where the client is working. If the client does not have a job upon completion of three-quarter way services, and will need additional planned services, the case file should be transferred to the counselor serving his/her place of residence. The counselor who can best meet the VR needs of the client at the time should manage the case of any client whose circumstances fall outside those described above.

3.2 ASSISTIVE TECHNOLOGY

3.2.1 General

Assistive Technology (AT) is defined as the application of technology to alleviate barriers that interfere with the lives of individuals with disabilities and is intended to help the individual maintain or enhance his or her ability to function personally, socially, and/or vocationally.

Agency rehabilitation engineers and rehabilitation technologists are available to provide consultation on all AT referrals as well as perform initial evaluations and assessments, and set-up AT equipment, provide follow-up evaluations, design and fabricate original items, and provide specifications and final inspections for AT services. When necessary, referrals will be made to outside sources. Some AT services are provided by the counselor without assistance from the AT program.

Definitions:

Agriculture Accommodation – This service refers to those services provided for MDRS clients that would like to be able to work or to continue to work in the agriculture field that also includes turf, forestry, logging, row crop production, timber processing, and custom machinery and lawn care services, also anyone working in a support industry such as processing facility, machinery dealership, farm supply business, pest management business, agricultural consulting services, etc.

Auditory Accommodation – This service assists with the enhancement of communication through AT in the environment and relationships of a person who is hearing impaired.

Augmentative/Alternative Communication – This service refers to the provision of a device to supplement or to replace natural speech and/or writing.

Computer Access – This service refers to the provision of computer hardware and/or software.

Durable Medical Equipment (Activities of Daily Living Devices) – This service refers to devices that help a client perform daily living activities.

Environmental Control Unit – This service refers to the provision of a specific kind of assistive technology that gives a client control over items in their environment.

Home Modification – This service refers to modifications to a client‘s home.

Job Site Accommodation – This service refers to the process of modifying or rearranging job tasks (parts of a job) to allow a person with a disability to continue to work.

Seating and Mobility – This service refers to devices that assist a client with personal mobility such as a wheelchair, scooter, or wheelchair seating components.

Vehicle Accommodation – Vehicle Accommodations are broken into three specific services to assist a client with driving a vehicle:

Driver Evaluation - This service refers to determining whether a client is able to safely drive a vehicle.

Vehicle Consultation – This service refers to recommendations as to what type of vehicle would meet the client‘s needs. This service would be provided for a client who does not currently own a vehicle.

Vehicle Assessment – This service refers to determining if a client‘s vehicle meets the MDRS policy for modifications and determining what modifications a client would need for a vehicle that he/she currently owns.

Vision Aids (Non-Computer Related) – This service refers to the provision of devices used by an individual who is blind or has low vision that does not include a computer. For additional information on this service see the OVR/OVRB Resource Guide -Section 3.21.1.

The counselor should evaluate the client's need for AT services throughout the rehabilitation process. Examples of MDRS cases which may benefit from AT services include persons with mobility impairments, spinal cord injuries, traumatic brain injuries, visual impairments, speech impairments, respiratory impairments, cardiac impairments, learning disabilities, hearing impairments, and other limitations which result in a severe disability.

3.2.2 Referrals For At Services

VR/VRB, OSDP, and ILB field staff will refer their clients to the Agency‘s Assistive Technology program by creating a Service Authorization in AACE.

NOTE: It is imperative that the counselor verify that the information in the referral is accurate and up-to-date.

The referral will be assigned to the appropriate AT professional. The counselor will be advised via e-mail the name of his/her contact. Complete medical packets should be forwarded (mailed/eCopied/faxed) to the appropriate professional handling the case.

The following information must be included in the referral packet:

a) Medical reports, as indicated by the client‘s disability(ies). b) Specialist reports, as appropriate to the individual‘s disability(ies) for the services being requested (i.e., psychological evaluation, educational diagnostic testing, orthopedic reports, ophthalmology reports, occupational therapy reports, physical therapy reports, and pertinent reports from rehabilitation centers) c) An in-depth description of the client's limitations and how they impact him/her.

Once the service authorization and medical packet have been reviewed by the AT professional, he/she will notify the client and the referring counselor of the date and time of the initial evaluation. The counselor must identify the client‘s vendor of choice prior to any vendor accompanying an AT professional or counselor during an evaluation for durable medical equipment. Additionally, having vendors present during an evaluation should be limited and only with approval of the district manager. The counselor is encouraged to maintain contact with the client and notify the AT professional of any changes in the client's status or condition. After performing an initial evaluation for the requested AT service, the AT professional will send a report with all recommendations and cost estimates to the counselor. The counselor will request, in writing, the specifications, drawings, and/or other information necessary for the provision of the AT service.

NOTE: AT recommendations are valid for one year from date of evaluation, with the exception of computer access evaluations which are valid for six months. If action is taken on a report that is over this limit, the AT program should be consulted to determine if any changes should be made to the recommendation. Also, should there be any significant changes in the client's physical and/or cognitive abilities, the AT program should be consulted to determine if any changes should be made to the original recommendation.

3.2.3 Purchasing Assistive Technology Services/Devices

It is necessary to follow the Mississippi Public Purchasing Law when purchasing items not covered by contract, medical exemption, or comparable benefits. All items covered by any State contract must be authorized according to the State contract price (quotes/bids are not required).

For additional criteria for customized services, please see specific sections relating to:

 Computer Purchases – refer to Section 3.2.5.1  Vehicle Accommodations – refer to Section 3.2.5.5  Durable Medical Equipment (DME) – refer to Section 3.2.6

Purchases of $5,000 or under:

Purchases of $5,000 or under (exclusive of freight and/or shipping charges) do not require quotes or additional supervisory approval. These items should be purchased from a vendor chosen by the client. To be an eligible DME vendor, the vendor must give MDRS a minimum discount of 20% off manufacturer's suggested retail price (MSRP). (For Computer purchases, refer to Section 3.2.5)

Purchases over $5,000 but not over $25,000:

Purchases over $5,000 but not in excess of $25,000 (exclusive of freight and/or shipping charges) require at least two written quotes or certification that the vendor is a single source. (Single source means that no comparative or competitive quotations can be obtained and no other item would be suitable or acceptable to meet the need; consequently, very rarely will there ever be a single source.)

Once the counselor receives the AT recommendation, (except for items covered by contract, medical exemption, or comparable benefits) the client should be given the choice of eligible vendors from which to receive the AT services/device(s). The counselor will solicit quotes from at least two of these chosen vendors. Each quote must discount the MSRP by a minimum of 20% to be considered. The lowest and best competitive quote shall be selected. If the lowest quote is not selected, a justification must be written stating why the lowest quote was not chosen. NOTE: This does not include DME exemptions, home modifications, computers, or vehicle modifications.

Quotes (or if the vendor is certified as a single source, the single source certification) must be sent to the district manager for approval if the amount is over $15,000. After approval by the district manager, an authorization may be issued.

Purchases Over $25,000:

For purchases over $25,000 (exclusive of freight and/or shipping charges) the counselor must send the specifications for the items to the district manager for approval. Once approved, the district manager will then forward the material to the finance office. The finance office will arrange for advertising in the newspaper, and provide guidance in obtaining bids. Purchases over $25,000 require approval by the district manager. Furthermore, purchases over $45,000 require approval by the district manager and the director of client/field services. If the lowest bid price is not selected, a justification must be written stating why the lowest bid price was not chosen.

When purchasing AT equipment (including computers, telecommunication equipment, computer

software, etc.), the appropriate AT professional should be contacted for any required assistance.

NOTE: For computer based equipment refer to Section 3.2.5.1 For vehicle accommodations, you must refer to Section 3.2.5.5

Third Party Responsibility

In the event the client has Medicare, Medicaid, or private insurance, the counselor should verify the benefits available to the client before authorizing to the client-chosen vendor. If the client has Medicare, the vendor chosen by the client must be willing to accept assignment of the Medicare benefits/payment. The vendor shall not require the client to sign any forms obligating the client or MDRS for amounts over and above the Medicare approved rate.

3.2.4 Maintenance and Repair Costs

An AT professional will assist the client in securing satisfactory adjustments when problems occur that are under warranty or are reasonably expected to be remedied by a vendor at no cost to MDRS. It is the client's responsibility to provide ongoing upkeep and maintenance cost. The Agency is not responsible for upkeep, repairs, or replacement of vehicle modifications, wheelchairs/scooters, computers, or other AT equipment.

3.2.5 Customized Services

3.2.5.1 Computer Based AT Equipment/Computer Access

This area of computer access is very broad and encompasses any accommodations related to computer hardware or software that a client may need to accomplish his/her goal. It is imperative that the client and the counselor have a clearly defined goal, and this goal should be noted in the service authorization. Computer Literacy

A client must possess basic computer literacy to be eligible for an AT evaluation. MDRS AT Program does not provide computer literacy training for clients. Basic computer literacy may be obtained through community colleges, the Addie McBryde Center, the REACH Center, or other sources outside of MDRS. In addition, the AT program only provides limited training (approximately four hours) on computer technology that is purchased for a client. If the AT professional determines that a client needs additional training, that information will be included in the AT report.

When additional computer training and/or technical support is needed for the client to achieve a vocational or independent living goal, the counselor should contact the assigned AT professional, Addie McBryde, REACH, TK Martin, client‘s employer and/or the vendor to determine whether they can provide the training. If these providers are not able to provide the training, the counselor may purchase the service from a vendor chosen by the client and approved by the AT department. Requests for purchase of computer training and/or technical support exceeding 10

hours must be approved by the OVR district manager/OVRB regional manager.

Purchasing Computer Based AT Equipment

The need for computer equipment and related software should be carefully evaluated by an AT professional prior to preparation of equipment specifications to be certain of equipment compatibility. Companion equipment/software should be thoroughly tested to make this determination.

After securing the recommendation for computer systems from the AT professional, counselors should send a copy of the recommendation to the district manager for approval. Once the district manager approves the request, the counselor should send the recommendation to Management Information Systems (MIS). MIS staff will obtain a list of approved vendors and price quotes and send it to the counselor. The counselor should not write the Individualized Plan for Employment (IPE) or the Independent Living Plan (ILP) until this information is returned to the counselor. The counselor should secure the signature of the client on the MDRS-AT-02 before the authorization is issued. A signed copy should be given to the client and the original must be retained in the case file.

The counselor should request that the vendor ship the computer equipment to the AT professional handling the case. The counselor should send a copy of the authorization to the AT professional and MIS. When delivering the computer or computer systems to the client, the AT professional shall secure the signature of the client on the MDRS-AT-03. A signed copy should be given to the client and the original must be retained in the case file.

Computers for College Students - It is up to the counselor and the client to determine when and/or if it is necessary for MDRS to purchase a computer for college training. If a client is a college student and a referral is made for computer access, the AT program will assume that the counselor has made the decision to provide a personal computer for the client. The AT program cannot make a determination if a client should be provided a computer for college training. The AT program can only make recommendations as to what hardware and/or software would allow a client to reach his/her vocational goal.

Computer Repair - MDRS does not provide routine maintenance or computer repair. Referrals for AT service should not be made for routine maintenance or repair. The client should contact a local computer service provider or the manufacturer directly.

3.2.5.2 Home Modification

Home modification is the application of assistive technology to the residence of a client to remove barriers that prevent the client from reaching his/her specified goal. The desired goal(s) should be clearly stated on the referral for AT evaluation and consistent with the client‘s vocational or independence goal.

MDRS will not provide home modifications to a residence that is structurally unsound or in such

disrepair that to not have repairs prior to providing the modification would compromise the safety and effectiveness of the modification.

Title to Property - Prior to referring an individual to the AT program for a home modification evaluation, the counselor must determine property ownership of the residence to be modified. Rental or mortgaged property and/or property owned by someone other than the client may be considered for modification by MDRS for non-permanent modifications that can be moved to another location should the client move. It is necessary to secure written permission from the titleholder prior to modifying any property. This includes property:

 Owned by other parties  Mortgaged  Rented  Otherwise encumbered that could impede client's use  Owned by the client or the client and others

NOTE: Counselors should make a determination that the cost of any home modification is commensurate with the value of the home.

Home Additions - At no time will MDRS pay for modifications that add to the total square footage of the home. Total square footage refers to that area that is originally heated and cooled. MDRS may, however, pay for accessibility modifications to home additions that have been paid for by the client that are a component part of the original roofline.

MDRS DOES NOT PARTICIPATE IN THE CONSTRUCTION OF NEW HOMES OTHER THAN IN AN ADVISORY CAPACITY.

Home Repair/Maintenance - MDRS does not pay for home repairs or general maintenance of homes. Changes to Specifications - If it is necessary to make changes to the specifications, these changes must be made in writing with the approval of the AT professional who formulated the specifications. The AT professional, the client, the counselor, and the contractor must then sign these changes before they will be accepted. The counselor is not responsible for payment of additions to the specifications unless this procedure has been followed. The counselor should notify the client and the contractor that MDRS is not responsible for payment of additions to the specifications unless this procedure has been followed.

3.2.5.3 Job Site Accommodation

Job site accommodation is the process of modifying or rearranging job tasks (parts of a job) to allow a person with a disability to continue to work. Often a person with a disability can complete most of the job tasks required for a job, however, there may be specific job tasks that the client cannot complete without modification due to the limitations imposed by the disability.

The service authorization should identify the specific functional limitation that needs to be addressed. It is essential that the counselor work with the employer to achieve the required services. Counselors are reminded of ADA and 504 responsibilities; however, the success of the client‘s rehabilitation takes precedence.

For in-house job site accommodations – refer to Chapter 1.02 of the MDRS Policy Manual.

3.2.5.4 Seating and Mobility

Evaluation of the client in his/her home or other appropriate setting will be conducted in order to evaluate the client for a proper seating and/or mobility system. The AT professional will determine if there are any physical deformities and/or limitations such as pelvic obliquities, scoliosis, contractures, fixations, etc. that need to be addressed by an occupational therapist or physical therapist. NOTE: Medicare and some private insurance companies require seating and mobility systems to be evaluated/recommended by a licensed occupational or physical therapist.

The counselor should secure the signature of the client on the Client/Owner Agreement of Understanding (MDRS-AT-02) before the authorization is issued. A signed copy should be given to the client and the original retained in the case file. During the delivery of the seating and mobility system, the Agency AT professional should secure the signature of the client on the Assistive Technology Equipment Delivery Receipt (MDRS-AT-03). A signed copy should be given to the client and the original must be retained in the case file. Repairs. MDRS does not provide routine maintenance or repair. Referrals for AT service should not be made for routine maintenance or repair. The client should contact a local vendor for repair service or the manufacturer directly.

3.2.5.5 Vehicle Accommodation

Motor vehicle modifications may be provided, when necessary, to enable clients to prepare for, secure, retain, or regain employment or achieve independent living goals. Motor vehicle modification services can be provided when a specific employment goal has been identified on the IPE and subsequent rehabilitation services are required and will result in gainful employment or when identified as an approved/appropriate goal as part of an individual‘s ILP. MDRS will only participate financially in the purchase of AT devices, adaptive equipment, and vehicle modifications. MDRS will not purchase or lease a vehicle.

Driver Evaluation

If a client will be driving a vehicle modified by MDRS, and MDRS will be providing adaptive driving equipment, that client must have a driving evaluation performed to determine if the client has acceptable physical and cognitive abilities to drive.

NOTE: If the client has been a consistent driver for an extended period of time and is updating his vehicle with comparable adaptations to those used previously, an evaluation may not be required.

If the client has had a driving assessment in the last five years, an exception can be made. In order for the client to forego a driving assessment, the counselor must have:

 a copy of the previous driving assessment, and  a letter from the client‘s doctor stating there have been no changes in the last five years that would negatively affect this client‘s ability to drive a vehicle

A copy of these documents should be included with the medical information sent with the AT referral.

NOTE: The client must hold a valid driver‘s license or a valid learner‘s permit to receive a driving assessment.

Vehicle Consultation - When a client is considering purchasing a new or used vehicle, it is beneficial for the client and MDRS if they are referred to AT prior to that purchase. The consultation will assist the client in acquiring a vehicle that meets his or her needs.

Vehicle Assessment Vehicle Standards for Agency Approval - MDRS has established policies for the age and mileage of a vehicle that the Agency will modify. The requirements are different depending on the type of modifications that the client will need. The age/mileage requirements are necessary because adaptive equipment is often expensive. Older vehicles are subject to more frequent malfunctions and have a shorter operating life than newer vehicles.

It is recognized there are some vehicles that, because of excellent care and condition, may warrant consideration even though they exceed the age and mileage restriction and/or there may be hardship situations. So, even if the client‘s vehicle does not explicitly meet the above requirements, a referral can be made for vehicle modifications.

All vehicles must be in good working order. Used vehicles must have a vehicle inspection and mechanic‘s inspection in addition to meeting these requirements.

Modification Level Vehicle Age / Mileage Requirements

Level I None Mechanical gas/break (hand controls), unoccupied wheelchair/scooter loader/carrier, trailer hitch, steering devices, portable ramps, power and manual wheelchair tie-downs, simple non-driver devices, left foot accelerator, pedal extensions, secondary driving aids (non electrical), upgraded suspension. Level II < 7 years old or have < 140,000 miles Occupied wheelchair/scooter lift, power transfer seat, manual transfer seat, automatic door openers, low and zero effort steering systems, low and zero effort breaking systems, power seat bases, electronic secondary controls.

Level III < 3 years old or have < 60,000 miles Modifications to the structure of the vehicle (raised doors, raised roof), power pan, electronic driving equipment, electronic secondary controls, lowered floor for a full size van. Level IV < 30,000 miles Lowered floor minivan conversions.

NOTE: This listing is not exclusive. Any item that is not on this list should be approved by an AT professional to determine what level of modification that item would fall into.

Vehicle modifications are provided under State contract rates. The client will be informed of vendors who are under contract to provide modifications, repairs, and installation of adaptive equipment to vehicles (See Vehicle Modification Fee Schedule).

MDRS will not provide vehicle modifications without proof of ownership and insurance coverage for both the vehicle and the installed equipment. The intended driver must possess a valid driver‘s license.

Repairs and Maintenance - The Agency will neither repair nor replace motor vehicle modifications damaged by accident, vandalism, or fire.

The client should sign the new MDRS-AT-02 before the authorization is issued and the MDRS- AT-03 when the vehicle is delivered and before the statement of account is paid. Agency AT professionals are available for assistance with all aspects of this process.

The vehicle modifications will be inspected for quality assurance. For all vehicle modifications, the counselor should notify the AT professional upon completion of the modifications so the AT professional can make arrangements for final inspection before acceptance. The AT professional should secure the signature of the client on the MDRS-AT-03. A signed copy should be given to the client and the original must be retained in the case file.

If a modified vehicle is sold, the client is responsible for seeing that the adaptive equipment is transferred to the replacement vehicle, if practical. The Agency's AT professionals are available to assure that the transfer and refitting of the adaptive equipment is performed correctly and is deemed safe for normal operation.

3.2.6 Durable Medical Equipment (DME)

Federal regulations implementing the 1992 Amendments to the Rehabilitation Act were issued by the Rehabilitation Services Administration in March 1997. One of the most significant changes involved the increase of informed choice in client selection of service providers. Examples of durable medical equipment would be prosthetic and orthotic devices, wheelchairs and accessories, motorized scooters, patient lifts, and other medically prescribed items.

Effective October 1, 1997, DME that is medically prescribed has been placed on the exempt from quote or bid list in order to accommodate the federal mandates on informed choice for clients.

The OVR/OVRB counselor will buy DME and associated supplies, as exemptions, only when medically prescribed by a physician as medically necessary. Counselors must continue to ensure the Agency does not pay excessive prices or prices that exceed the lowest manufacturer's suggested retail price customary within the locality involved, less 20 percent. For non-medically prescribed DME, see non-exempt medical purchases in this section.

Federal regulations and State purchasing laws require a fee schedule be established for all purchases. For further guidance, please refer to the OVR/OVRB Fee Schedule.

Procedure for DME purchase

Medically Prescribed DME Purchase (Exempt)  Obtain prescription from medical professional  Discuss vendor choice with client, ensuring informed choice  Pursue and verify available comparable benefits  Contact DME vendor to obtain price (To be an eligible DME vendor, they must provide a copy of the lowest manufacturer's suggested retail price, less a 20 percent discount to the Agency.)  Purchase should be planned on the IPE  Authorization for DME should be issued

Non-Exempt Durable Medical Equipment Purchase

Should the need arise to acquire an item of DME that is not medically prescribed, OVR must purchase according the Agency purchasing rules and State purchasing laws. Please refer to purchasing guidelines in OVR/OVRB Resource Guide Section 3.2.3. DME and AT purchases/modifications, while similar are different. It is important to clarify which category the item for purchase belongs.

3.2.6.1 Orthotic/Prosthetic Services & Appliances

The VR counselor should provide the VR client with sufficient information for the client to make informed choice regarding the provision of the orthotic / prosthetic (O & P) service.

 Prescriptions: The provision of all orthotic or prosthetic devices, or the modification of such items, must be prescribed by an orthopedist, surgeon or M.D., licensed in the State to prescribe it.

 Authorizations: Authorizations for orthotic or prosthetic device/services must be issued only to a facility/location where the fitting, fabrication, modification or repair of same is performed by or under the direction of a certified prosthetist and orthotist, a certified orthotist in the case of an orthotic device, or a certified prosthetist in the case of a prosthesis. Please see the fee schedule for detailed information for authorizations.

 Physical Therapy: When a new prosthetic device is prescribed for a person with an

amputation, he or she should receive an initial physical therapy (PT) treatment/ training in a rehabilitation hospital, community hospital, or medical clinic setting if possible. The amount of time, care and services provided in the home by a home health physical therapist may not be uniform, and the length of physical therapy (prosthetic/gait training, etc.) time spent during the home visit may not be as comprehensive as conducted in a hospital or clinic setting.

 Checkout Sessions: Clients receiving upper and lower extremity prostheses should participate in the following checkout (office visit) sessions with at least the physical therapist and the orthotic & prosthetic company representative. When feasible, the team approach in the checkout sessions, which would include the client, the orthopedist, the physical therapist, the O & P company representative, and the VR counselor, is better for everyone.

These checkout sessions are to discuss and review the client's physical condition, and to review how the orthotic/prosthetic device is fitting and/or functioning, and like factors. In addition, these sessions allow upper and lower extremity wearers to demonstrate the individual is receiving maximum utilization of the preparatory (temporary) or the definitive (permanent) device.

At the completion of the initial physical therapy evaluation/training, the counselor should initially authorize, as needed, a minimum of ten physical therapy sessions and prosthetic/gait training sessions to insure maximum utilization of the prosthetic device. At the end of two months (60 days), the check-out session will be held to demonstrate the definitive (permanent) limb, how it fits, to check for shrinkage, swelling, skin irritation, etc.

3.2.7 Project START (Success through Assistive/Rehabilitative Technology)

Project START is made possible through a federal grant under the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (P.L. 100-407), as amended in 1994 (continued funding made available by the Assistive Technology Act of 1998) to improve the awareness of and access to assistive technology. Project START is the State Assistive Technology Act program that works to improve the provision of assistive technology to individuals with disabilities of all ages through a comprehensive statewide program of technology-related assistance. Additionally, the program supports activities designed to maximize the ability of individuals with disabilities and their family members, guardians, and advocates to access and obtain assistive technology devices and services.

Project START‘S Mission: Empowering Mississippians with disabilities through awareness, education, and access to assistive technology

Key Activities of Project START

 Device Loan Program  Device Reutilization  Device Demonstration Program

 Training and Technical Assistance  Public Awareness  Coordination and Collaboration  Transition Services

Without awareness and access to available assistive technology, Mississippians are unable to lead productive, rewarding and independent lives that are possible with assistive technology. Project START offers an on-line catalog www.msprojectstart.org that covers a broad range of devices and equipment.

The following categories are included in the on-line catalog:  Adapted Toys for Children  Adaptive Computer Equipment  Augmentative & Alternative Communication  Capability Switches  Communication  Computer  Durable Medical  Hearing Impairment  Low Vision  Mobility

Project START‘s services are provided on a statewide basis and are available to individuals of all ages and disabilities as well as to service providers. Services are available at no cost to consumers in Mississippi. To access these services through MDRS an AT referral in AACE is completed. A consumer may call Project START or the consumer may fill out the request for services on-line at www.msprojectstart.org

Device Loan Program

Project START‘s device loan program, Try AT before You Buy AT, enables people with disabilities to borrow and try out different types of AT devices for a limited time period (30 days for professional organizations and 90 days for consumers). Project START has developed an extensive device loan program containing state-of-the-art devices that cover a variety of needs. Equipment is used for demonstration, training, evaluation, and loan purposes. Equipment can be borrowed for the purpose of evaluation, for trial to determine its effectiveness and appropriateness, for use while a device is being repaired, or until a device is received from the manufacturer. The on-line catalog contains all the available equipment for loan or to be given away at no charge to consumers. Project START continually upgrades and adds to the device loan program to ensure appropriate devices are available.

Device Reutilization Program

Project START operates and/or supports device reuse through device exchange, repairing and recycling activities. Device exchange involves connecting an individual with a used device and an individual who needs a device. They often take the form of "want ads" or are similar to "e-

bay" ads. In a device exchange, the current owner of the device and the prospective recipient of the device negotiate the terms of exchanging the device directly. For this service, consumers can access Project START Equipment Exchange Program at www.msprojectstart.org, click on the Equipment Exchange Link.

Project START‘s recycling program involves the intake of used devices (usually through donation) by consumers or different organizations in Mississippi. Project START is responsible for device storage and redistribution. The recycling program differs from refurbishment in that devices are generally redistributed "as is" or with only minor work such as cleaning. This program takes donations of all available assistive technology, cleans it, and gives it away to Mississippians who can‘t afford and have no other access to the assistive technology.

Examples of donations are:  Walkers  Shower Chairs  Manual Wheelchairs  Hoyer Lifts  CCTV  Low Vision Aids  FM Systems  Voice Amplification  Hospital Beds

Device Refurbishment: Computer and Mobility

Project START‘s device refurbishment program involves the intake and repair or customization of used devices for computers and mobility equipment. Project START is responsible for device storage, repair, and redistribution of computers and wheelchairs to consumers in the state who can‘t afford or who have no other access to the assistive technology.

Device Demonstration

Project START provides consumers and others the opportunity to see the latest technology, get information, and learn what might be the most appropriate device for them through demonstrating all types of devices and equipment on a daily basis.

Training and Technical Assistance

Staff of Project START develop and disseminate training materials, conduct training, and provide technical assistance on a numerous topics statewide, including state and local educational agencies, other state and local agencies, early intervention programs, adult service programs, hospitals and other health care facilities, institutions of higher education, and businesses.

Public Awareness

The staff of Project START conduct public awareness activities, including statewide information and referral systems, designed to provide information that relates to the availability, benefits, appropriateness, and costs of AT. Project START provides exhibits and displays supplying information about assistive devices and services that relate to a cross-section of disabilities. Project START maintains a video and book library of assistive technology materials and information.

Consumers can request information from Project START. The request will be sent by mail within five working days of receiving the request or can be faxed or given over the phone when necessary. Typical information provided by Project START includes the following:

 Information concerning availability of assistive devices to meet specific needs  Where and how to obtain evaluations for assistive devices  Names of companies that manufacture the device  Referral to assistive technology services providers  Training opportunities for service providers, consumers, and other support groups

Coordination and Collaboration

Project START works to improve access to assistive technology, by partnering with many public and private entities responsible for policies, procedures, or funding for the provision of assistive technology devices and services to individuals with disabilities, service providers, and others.

Transition Services

Project START develops and disseminates training materials, conducts trainings, facilitates access to AT, and provides technical assistance to assist eligible secondary school students with disabilities transitioning from secondary to post-secondary school training or work and adults with disabilities who are maintaining or transitioning to community living.

Information and Referral Services

Project START maintains a clearinghouse for assistive technology information which includes articles, newsletters, catalogs, and data from various manufacturers and retailers for assistive devices from numerous resources. In addition, Project START has access to the Internet which allows Project START to maintain the latest and most up-to-date information about assistive technology issues and devices from the national level.

Training

Project START sponsors conferences and monthly trainings with consumer groups and other service provider systems to increase awareness of and access to assistive technology on a comprehensive basis. Partnerships include but not limited to: T.K. Martin Center, Magnolia Speech School, Hudspeth Mental Health Center, Technology Assistive Device (TAD) Center, Technology Learning Center, and Jackson State University.

Project START can arrange for consultants and experts to provide training in areas such as:

 Application of assistive technology in specific areas (i.e. Special education, with specific disabilities, in specific environments, etc.)  Use of specific assistive devices  Evaluation procedures for assistive technology  Assistance in accessing various service provider systems in the state  Information on funding options  Advocacy issues

3.3 BUSINESS PROJECTS

Self-employment, telecommuting, and establishing a small business are employment outcomes available in assisting individuals with disabilities to obtain employment opportunities consistent with their strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. To achieve a self-employment goal the counselor must determine if the client is capable of performing the duties required. A vocational assessment to measure intellectual functioning, as well as basic math and reading skill levels may be necessary. Additionally, the counselor should document that the client understands that he/she will be required to contribute to the costs of starting self-employment or a small business enterprise. For the client this will mean using his/her savings, resources, or income.

The Rehabilitation Act of 1973, as amended in 1998, allows for the provision of the following business project-related services to eligible individuals who are pursuing self-employment, telecommuting, or establishment of a small business operation as an employment outcome:

 Occupational licenses, tools, equipment, and initial stock.  Technical assistance and other consultation services to conduct market analyses, develop business plans, and otherwise provide resources; to the extent such resources are provided through the statewide workforce investment system.

The following guidelines will assist the counselor and the client in the provision of these services and in exploring the feasibility of a business venture.

Agency Participation:

Upon determination that the client is eligible for services and self-employment has been selected as an employment goal, the counselor shall accompany the client on a visit to an appropriate professional setting such as a small business development center, the office of a business consultant/planner, or a Certified Public Accountant‘s office. The purpose of this visit shall be to obtain guidance and assistance to be used in the development of a viable business proposal.

The counselor should ascertain the client is knowledgeable of the business venture guidelines (Entrepreneur‘s Tool Kit) compiled by the Mississippi Development Authority.

The client is to submit a completed Form VR-007 or a formal business plan so that the counselor

will have sufficient information to analyze the probability of success of any business project for which Agency financial participation is being sought. The counselor should consider the following factors and document in a case note prior to obligating Agency funds:

 Client‘s ability to perform the duties of the particular business  Previous work experience and/or training

 Knowledge of operating requirements of the particular business  Age, physical ability and psychological stability, medical information, and psychological reports should be obtained relating to the client‘s ability, physically, emotionally, and intellectually to handle the demands of a business.

Additional related Agency policies and guidelines (e.g., purchasing, comparable benefits, informed choice, and assistive technology services/devices) must be adhered to prior to obligating Agency funds.

After completion of the initial proposal for a self-employment business project (Form VR-007), the counselor shall assemble a self-employment team consisting of the counselor, client, district manager, state office business projects coordinator, Small Business Administration representative and/or small business consultant associated with chosen field of operation, or other professional such as certified public accountant to review the business proposal. (If the Small Business Administration representative assisted in writing the business proposal or any other individual who assisted in the development of the business proposal, this individual shall not serve on the team.) The duty of the team is to provide a recommendation for approval or disapproval of the business proposal. If the business proposal is disapproved, a written recommendation and suggestion for the conditions of approval should be given to the client. The client then has the option to re-submit the business proposal to the team, fund self-employment through means other than VR, abandon the business proposal, or appeals the decision (fair hearing process).

After approval of the business proposal by the self-employment team, the counselor may approve business projects that do not exceed five thousand dollars ($5,000). The District Manager may approve all business projects between five thousand dollars ($5,000) and ten thousand dollars, ($10,000). All business projects exceeding ten thousand dollars ($10,000) must be reviewed by the District Manager and forwarded to the state office for staffing/review. No definite commitment will be given to the client until the proposal is approved by the District Manager and/or, if appropriate, the Executive Director or designee.

Limitations of Agency Participation

Agency expenditures are allowed only for initial costs of starting the business project, and may include the following business related expenses:

 Initial stock, merchandise, and operating supplies that may not exceed an amount equal to a two-month inventory.  Rent, utilities, business telephone, etc., and necessary deposits can be paid only for a period

to cover the first two months of the operation.  Insurance payments (e.g., Workers‘ Compensation, liability, premises, equipment, etc.) may cover only the first two months of the business operation.  Advertisement (e.g., classified, telephone directory, portable business signs, etc.) may be purchased to cover a period not exceeding two months for the opening of the business.  VR may financially assist the client, as necessary, in securing the required business licenses permitting the sale of soft drinks, tobacco, foods, etc.

For any of the above business related expenses, which require a twelve-month payment, lease, and/or deposit, VR will only be responsible for a pro-rata share (two months or 1/6th) of the expenses.

VR will fund no more than 90% on amounts up to $5,000.00; 70% on amounts above $5,000.00 up to $10,000.00; and 50% on amounts above $10,000.

VR funds cannot be utilized for the purchase of: land, permanent building(s), or motorized vehicles including motorized farm equipment used for transportation. VR funds cannot be utilized for the rental of motorized vehicle(s) or motorized farm equipment. VR funds cannot be utilized for insurance coverage for motorized vehicle(s) or motorized farm equipment, purchased or rented.

Shelter (Portable):

Portable shelter for agricultural enterprises, road-side stands and other types of agricultural objectives will be covered by this policy which, in general, requires that the shelter be one which is portable and can be easily dismantled, moved along public roads by truck and reassembled, when necessary, at a new location. In order for shelter of this type to be considered as placement equipment, it must be different from shelter customarily furnished by a landlord as a part of a lease agreement. Portable shelter provided a client will be considered as any other equipment purchase.

Wells and Water Systems:

Of particular significance in rural or agricultural projects is the provision of sinking and curbing water wells as ―Other Services.‖ The provision of an adequate water supply may be necessary services in connection with establishing a client in a business or for the maintenance of livestock, for the maintenance, protection, and sanitary operation of a dairy or other related farm projects, or for the irrigation of crops, which are the sources of income from the farm. In providing this service, the counselor must take into consideration the following factors:

 The amount to be invested in the well should be reasonably related to the financial return anticipated from the agricultural project for which the well is necessary.

 No expenditure may be made for the general maintenance of such a well since this would normally be considered an operating expense rather than an expense involved in the initiation of the enterprise.

 The provision of well pumps and distribution systems is considered as ―equipment‖ and should be planned as such.

Business project expenses that are not herein discussed should be discussed with and reviewed by the District Manager before being planned for the business project.

ANY BUSINESS PROJECT TOTAL EXPENDITURE IN EXCESS OF TEN THOUSAND DOLLARS, ($10,000), MUST BE REVIEWED BY THE EXECUTIVE DIRECTOR OR DESIGNEE.

Client Cooperation: The client will be required to cooperate in all aspects of the business project by maintaining daily records of the business. The records shall be available for review, including daily sales, purchase invoices, business bank transaction documents validating all expenses such as pest control, machine repair, wages, etc., as well as records of any merchandise removed from the business for personal use. Any other records determined by the counselor to be necessary shall also be maintained.

Follow-Up: Close follow-up to ensure immediate problem identification and possible resolution is essential to the success of a client in a business project. The counselor should meet with the client at least every thirty days to ascertain any problem(s), which have been identified, are being adequately resolved.

Requirements for Case Closure (Rehabilitated):

The following, in addition to the requirements for successful closure listed in the OVR/OVRB Policy and Procedures Manual, apply to the business/agriculture project and is required prior to the successful case closure as rehabilitated:

A pre-closure conference must be held with the client, the counselor, and the District Manager. If other business professionals were consulted during the planning of the business project, they should be included in the conference, when feasible. This conference should determine if the business is profitable, if the client has additional needs now, or will need post-employment services in the future. If profits are determined to be adequate and if no immediate problems are foreseen, the case may be closed as rehabilitated.

3.4 COMMUNITY REHABILITATION PROGRAMS

Community Rehabilitation Programs (CRP) are programs that provide or facilitate the provision of vocational rehabilitation services to individuals with disabilities. These programs are used to provide services that promote integration into competitive employment.

3.4.1 Public

Through the Office of Vocational Rehabilitation for the Blind, MDRS owns and operates two (2) public Community Rehabilitation Programs. They are:

 Addie McBryde Rehabilitation Center for the Blind (AMRC) – Jackson  REACH (Realizing that Empowerment through Accomplishment and Confidence) – Tupelo

MDRS leads the nation by offering two techniques of instruction for individuals with blind and visual impairments at Addie McBryde and REACH.

Through the Office of Vocational Rehabilitation, MDRS owns and operates seventeen (17) public community rehabilitation programs known as AbilityWorks. They are located in the following areas:

 Region I – AbilityWorks of Corinth, Olive Branch, Oxford and Tupelo  Region II – AbilityWorks of Columbus, Greenwood, Monroe County, Starkville, and Washington County  Region III – AbilityWorks of Jackson, Kosciusko, Meridian, and Philadelphia  Region IV – AbilityWorks of Brookhaven, Hattiesburg, Laurel, and Harrison County

3.4.1.1 Addie McBryde Rehabilitation Center for the Blind

The Addie McBryde Rehabilitation Center for the Blind (AMRC), located in Jackson, provides comprehensive rehabilitation services to adults who are blind or have severe visual impairments. The Addie McBryde Center focuses on the Traditional Method of instruction which utilizes remaining sight as a key tool in instruction. Services include:

 Evaluation  Training in low vision  Center-based and itinerant orientation  Mobility Training  Communication Skills  Personal Management  Techniques of daily living  Recreation and Physical Conditioning  Psychological Evaluation  Vocational Evaluation  Personal Adjustment Counseling

3.4.1.2 REACH Center for the Blind

The REACH Center, located in Tupelo, is a residential personal adjustment facility for individuals with blind or visual impairments living in Mississippi.

The REACH Center operates as an immersion center following the Structured Discovery Method of instruction, a non-visual technique of instruction that helps build self-confidence and teaches important life skills and problem solving.

Using blindfolds, referred to as ―sleep shades‖, REACH students are taught to believe in and rely on their other senses for information. They learn to do simple, everyday tasks as a blind person in a highly supportive environment.

The majority of classes are in two-hour blocks. This allows the student plenty of time to problem-solve. Classes offered initially include: GED Preparation  Health Education  Leisure Activities/Community Involvement  Vocational Evaluation

The REACH Center services consist of a mandatory six to nine month core curriculum that include:  Cane Travel  Home Economics  Industrial Arts  Braille  Computer/Technology  Techniques of Daily Living

As students near the completion of the core curriculum, they have the opportunity to participate in a variety of additional classes. These classes include, but are not limited to:

 Career exploration/job seeking skills  Resume preparation and practice interviews

Students who complete the six to nine month program at REACH receive a certificate of completion and leave the center as more confident, independent individuals.

Referral Process for Addie McBryde and REACH

When the counselor determines that the client is in need of services offered by AMRC or REACH, the referring counselor will complete a service authorization in AACE listing the service/s they are requesting. The counselor must plan all anticipated services. The medical records and other referral material are to be sent by mail as soon as possible. Once all referral materials are received, the Addie McBryde Center staff will approve the authorization and issue it in AACE. If additional services are needed, the counselor will modify the original service request and add the additional services needed. Once services are completed, the authorization will be closed in AACE by the Addie McBryde or REACH Center staff. Any information regarding the client can be accessed through AACE.

3.4.1.3 AbilityWorks, Inc.

The Agency operates AbilityWorks, Inc., a statewide system of 17 transitional, community rehabilitation programs through the Office of Vocational Rehabilitation. Each AbilityWorks contracts with local businesses and industries to create a realistic work setting which provide

rehabilitation services to VR clients. All services are individualized to meet the needs of the client and prepare him/her for employment in the community. Some of the services offered through AbilityWorks are:

 Comprehensive Vocational Evaluation Services  Vocational Evaluation  Community Based Vocational Evaluation (LINCS)

 Job Readiness Services (Employee Development Services)  Community Based Job Readiness Services (LINCS)  Work Experience  Job Readiness Classes  Community Based Job Tryout (LINCS)  Interviewing Skills  Resume Development

There are also a variety of other available opportunities at some AbilityWorks location such as:  Forklift Training  GED Preparatory Training  Driver‘s License Preparatory Training  Specialized Skills Training  Counseling and Guidance

Many other individualized classes are available that are designed to give clients needed skills to obtain gainful employment.

3.4.1.3.1 AbilityWorks Referral Process

The VR counselor will make a referral to an AbilityWorks branch by creating a service authorization and selecting the specific services requested of the AbilityWorks staff. If the VR Counselor chooses to do so, he/she may authorize for vocational assessment and job readiness services at the same time on one service authorization. The VR counselor should add specific client issues to be addressed such as concentration, work tolerance, ability to accept supervision, etc.

An AbilityWorks designee will check for new service authorizations in AACE on a daily basis. The draft authorization (referral form) is printed and the case manager is assigned in AACE. Following the initial set up of the electronic case file and client file, the case manager reviews the referral information from the counselor. The records that cannot be printed from AACE must be forwarded as a hard copy to AbilityWorks. This includes the following:

 Relevant medical history, medical reports, psychiatric, and/or psychological reports  Legible copies of documents suitable for employment identification (Government issued photo identification and Social Security card)  School records for all Transition Students  Copy of the client‘s application for VR Services

 Other available information such as relevant social information or information on previous direct services and supports

If all pertinent records are present, the case manager notifies the counselor within seven (7) calendar days by generating a referral receipt letter. If all pertinent information is not provided, the case manager uses the referral receipt letter to notify the counselor of the missing information. When all required information is received from the referring counselor, it is reviewed for adequacy and the admission date is scheduled for the participant. The counselor should be provided a copy of the admission letter.

Under most conditions, a client cannot be admitted to any AbilityWorks for job readiness services unless an appropriate vocational assessment has been attained on the client. The purpose of the assessment is to provide documentation of disability required by the Department of Labor in order for AbilityWorks to pay sub-minimum wages. (The exception would be clients that do not require facility involvement and would not receive remunerative wages such as clients only receiving classroom training, job development and placement services, etc.). An acceptable vocational assessment may be based on past work experience and/or previous rehabilitation center evaluation results. It should include the client‘s functional limitations, abilities, interests, aptitudes, and achievement levels. If, considering the client's disability, AbilityWorks needs more information than provided, AbilityWorks will bring the client in for further evaluation services prior to providing job readiness services. AbilityWorks will notify the counselor of any changes that will need to be made to the authorization.

If a client does not report on the scheduled admission date, the counselor will be notified to check the service management module for an Entry/Non-Entry form. If the counselor does not want to reschedule the client for entry, AbilityWorks will then destroy the referral information and ask the counselor to cancel the authorization. Otherwise, AbilityWorks will destroy the referral information 90 days after the original admission date, provided that at least two attempts are made to reschedule the client.

After admission, AbilityWorks staff will take all referral and intake information into consideration in developing an individual evaluation, and job readiness plan with the client. The plan will meet both the counselor's requests and any other needs of the client that can be addressed by AbilityWorks. The client will be assigned to an individual case manager (vocational evaluator) who will be responsible for ensuring the client receives the services he/she wants and needs.

A service review (staffing) will be held at least monthly to discuss the client's progress toward completing evaluation or meeting the goals on his/her job readiness plan. Counselors must participate in the service review (staffing) of their clients. The counselor is encouraged to attend the service review (staffing) in person; however, attending via telephone is recommended when travel is extreme or difficult to schedule. The case manager is to document progress in an AACE Service Note within seven (7) calendar days after the service review (staffing). Case managers at AbilityWorks are not required to submit a copy to the counselor but should notify them when the report is ready to be viewed. If the case is being closed from AbilityWorks, the case manager is to submit to the referring party a closing summary within fourteen (14) calendar days of the

client's discharge date.

3.4.1.3.2 Comprehensive Vocational Evaluation Services

Vocational evaluation is a comprehensive process that systematically utilizes work, either paid or simulated, as the focal point for evaluation and vocational exploration to assist the person with vocational development.

Vocational evaluation services are designed to assess the client's physical and mental capacities, job interests, work behaviors, need for accommodations, general work knowledge, etc. The vocational evaluation process serves the purpose of providing the client and VR counselor with the information needed to make an informed choice regarding his/her employment objective and vocational goal.

Vocational evaluation should have the capacity to assess all of the areas below; however, the need to assess every client‘s functioning in the following areas is determined on an individual basis:  Physical and psychomotor capacities and limitations  Intellectual capacities  Social, personal, and work related behaviors  Interests, attitudes, career aspirations, and knowledge of occupational information  Personal, social and work histories  Aptitudes  Achievements (e.g. educational and vocational)  Work skills and tolerance  Job Seeking and Job Retention skills  Identification of work and non-work related needs  Possible employment objectives  Ability to learn about themselves  Learning style (ability to understand, recall, and respond to various types of instruction)  Need for tool and/or job site modifications or adaptive equipment  Transferable skills  Environmental conditions  Assistive technology and reasonable accommodations  Community and employment supports  Independent living  Loss of access to the labor market or earning capacity  Mode of communication

3.4.1.3.3 Evaluation Techniques

A variety of work settings and tasks are utilized to ensure all the evaluation needs of the client are met. Vocational evaluation services should draw on one or more of the following techniques based on the specific abilities and needs of the persons served:

1. Work samples – When work samples are used, written instructions specify materials

used, equipment used, layout, methods for administration, and interpretation of scoring. 2. Situational assessment – When situational assessments are used, they are evaluated as to the following: adequacy of supervision, safety, appropriateness of work behaviors, potential job accommodations, accessibility issues, expectations for quality and quantity of work, physical demands of the job, tasks and demands related to the goals of the situation assessment, and other issues as appropriate to the persons seeking employment.

3.4.1.3.4 Individual Evaluation Plan (IEP)

Each client shall participate in the development of his/her Individual Evaluation Plan. Any evaluation plan is based on the referral information, intake interview, questions asked by the referral source, stated purpose of the evaluation, opportunities available in the local labor market, and the individual‘s interests and capabilities.

Most services rendered by AbilityWorks can be obtained either inside the facility or outside the facility through LINCS (see section 3 –page 29). Even vocational testing can be arranged to be completed at an off site location, if this is the appropriate option for all parties concerned.

3.4.1.3.5 Evaluation Service Review (Staffing) Reports

Service reviews (staffing) are held monthly and should include input from the client, client‘s evaluator, referring counselor, and other parties involved in the client‘s plan. Service review (staffing) should address the client‘s progress toward the questions outlined in his/her IEP, be relevant to desired employment outcome, and justify recommendations regarding the continuation of his/her program. A service review (staffing) will be held prior to the completion of the evaluation. It will address the results of the evaluation and justify recommendations, if necessary.

3.4.1.3.6 Evaluation Summary or Evaluation Closing Summary

For clients moving from evaluation to job readiness, the evaluation summary will be completed within seven (7) calendar days, disseminated to the appropriate individuals (client, referring counselor), and properly interpreted to the client. If services ended after evaluation, the evaluator will then have fourteen (14) calendar days from the client‘s discharge date in which to complete, sign, and disseminate the report.

3.4.1.3.7 Job Readiness Services

Job readiness is a transitional, time-limited, systematic training program that assists individuals move toward their optimal level of vocational development. Job readiness utilizes real or simulated work. The intent of the program is to assist persons to understand the meaning, value, and demands of work; to learn or reestablish skills, attitudes, personal characteristics, and work behaviors, and to develop functional capacities. Job readiness services may require environmental accommodations. Services should be consistent with the person‘s employment objectives and relevant to the current geographical labor market.

Admission Criteria

The requirements for entrance to the job readiness services unit are as follows:

1. Has VR referral 2. Is at least 16 years of age 3. Has prior medical and/or psychological assessment appropriate to disabling conditions 4. Is non-dangerous to self and/or others 5. Is free of any acute medical and/or psychological conditions 6. Is able to care for his/her own personal needs 7. Has vocational potential determined 8. Has specific job goal determined 9. Has specifically identified problems to employment that need improvement

Services Job readiness services should be comprehensive enough to address or obtain information concerning the following areas; however, the need to address every client‘s functioning in the following areas is determined on an individual basis:

1. Awareness of requirements for attendance, punctuality, and grooming 2. Job seeking skills 3. On-the-job performance skills (e.g.; quality and quantity of work) 4. Work-related community skills (e.g.; time, mobility, and money management) 5. Functional literacy skills (e.g.; want ads, personnel handbooks, and safety signs) 6. Knowledge of work practices (e.g.; payroll deductions, unions, benefits, retirement, insurance, and safety) 7. Work-related academic skills 8. Work-related communication skills 9. Access to governmental and community service agencies 10. Community living arrangements and coordination 11. Knowledge of legal affairs/tax matters 12. Mobility and transportation skills 13. Need for assistive technology and reasonable accommodations 14. Other barriers to employment

Individual Job Readiness Plan (IJRP) Each client should participate in the development of his/her individual job readiness plan. This plan should be based on previous diagnostic findings. The plan should include the following:

1. A vocational goal (AACE retrieves the goal off the Individualized Plan for Employment that the VR Counselor developed with the client and places it on the IJRP.) 2. Behaviors and barriers (stated in observable, measurable terms) which are considered to impede the attainment of the person's vocational objectives 3. Statements of expected outcomes 4. Time intervals for outcomes to be achieved 5. Work assignments consistent with the job readiness goals

2. Specific treatment techniques and methods 7. Specify persons to be involved in the plan and give evidence that these individuals are aware of their role in the plan (their signature or initials will suffice for this) 8. Reviews to be conducted at least monthly (modifications should be made as necessary)

Job Readiness Service Review (Staffing) A service review (staffing) for each active client will be held monthly and will include input from the client, client's evaluator, referring counselor and other parties involved in the client's plan.

Job Readiness Closing Summary The job readiness closing summary will be completed and disseminated to the referring counselor. The summary is due to the counselor within fourteen (14) calendar days of the client‘s discharge date.

3.4.1.3.8 AbilityWorks LINCS – Linking Innovative Networks of Community Services

 LINCS - Vocational Evaluation  LINCS - Job Readiness  LINCS - Job Tryout

In situations when AbilityWorks is not able to provide vocational evaluation or job readiness in the CRP environment for a specific job in which a client has interest, LINCS can be provided.

The local AbilityWorks can secure a cooperative agreement with a local business to provide the evaluation, job readiness training or job tryout.

The evaluator should be the primary CRP staff member coordinating the evaluation, job readiness or job tryout between the local business and the CRP. The facility manager must approve all LINCS agreements. Other CRP staff may assist in the process of the LINCS as needed.

Procedures to follow when utilizing LINCS:

1. The number in hours of evaluation, job readiness or job tryout should be predetermined and should be sufficient to allow the client and evaluator to obtain specific results to indicate if the client is capable of performing that particular job or obtain his/her specific vocational goal.

2. AbilityWorks will pay the client minimum wage for the work activity during the vocational evaluation, job readiness training or job tryout.

3. The LINCS experience should be a useful tool to aid in determining a feasible vocational goal. It will also help determine the client‘s vocational strengths and weakness.

4. The business AbilityWorks partners with must report the client‘s progress verbally or in

writing to the evaluator or designee as agreed.

5. The business will be required to verify the number of hours worked by each client on a weekly basis, in writing.

When LINCS is utilized, the evaluator should evaluate the job site in regard to its appropriateness in the following areas:

1. Adequate supervision 2. Safety 3. Physical accessibility/worksite accommodations 4. Transportation accessibility 5. Competitiveness of work tasks and demands/expectations for quality and quantity of work

For clients that need additional job readiness training beyond the scope of the LINCS being provided, the facility manager, VR district manager and VR regional manager should be consulted to ensure adequate funding is available before additional training is offered.

3.4.1.3.9 Mississippi Industries for the Blind

Mississippi Industries for the Blind (MIB) is a separate state entity. Services provided at MIB are directed primarily to OVRB clients who are referred for employment. These services are designed to bridge the gap between the non-working individual and a productive worker. Services include, but are not limited to; counseling & guidance, vocational adjustment training, competitive job placement, work experience and evaluation of need for services from other programs.

The counselor will forward to MIB a vendor authorization listing the service to be purchased and all appropriate referral material. Vendor authorizations should be issued for the maximum amount (i.e., according to the IPE). Vendor authorizations must be received in a timely manner. The MIB Program Coordinator for Rehabilitation Services will complete the vendor authorization and return it to the counselor, along with an individual client progress report. The referring counselor will approve the vendor authorization for payment (in part or total) in AACE and send the signed authorization to finance for payment of the bill.

The referral package should include the following information:  IPE (Include job readiness and the length of time service is to be provided)  Reports from the Addie McBryde Center or other CRP; if available  Eye examination reports  Educational background  Any previous work experience  Physical/Medical reports  Transportation needs

Proper planning and communication with MIB will allow the counselor to authorize for support

services, such as transportation and medical needs, in accordance with the MDRS Fee Schedule.

Counselors must participate in the staffing of their client receiving job readiness training. The counselor is encouraged to attend staffing. Staffing by telephone is recommended when travel is extreme or difficult to schedule. A rehabilitation counselor for the blind has been assigned as a liaison counselor to MIB. This liaison counselor attends all staffing and meets individually with clients. Monthly reports on specific issues are provided to the referring counselor and specified Agency staff.

For more information contact: Rehabilitation Program Coordinator, Mississippi Industries for the Blind, Post Office Box 4417, Jackson, MS 39296-4417.

3.4.2 PRIVATE

These community rehabilitation programs (CRP) are owned and operated by private entities that contract with the Agency to provide services to Agency clients for an established fee.

3.4.2.1 Goodwill Industries

Goodwill Industries of America, Inc. is a private, non-profit organization. The Agency has contractual agreements with two Goodwill centers (Goodwill Industries of Jackson, Inc. and Goodwill Industries of South Mississippi, Inc.). The services provided are vocational evaluation, job readiness, and limited vocational training programs.

The counselor will forward to Goodwill a vendor authorization listing the service to be provided and all appropriate referral material. The counselor is to plan all anticipated services, but issue vendor authorizations as the client is referred for each service. Vendor authorizations should be issued for the maximum amount (i.e., according to the IPE). Vendor authorizations must be received in a timely manner. Goodwill will submit a signed statement detailing the number of days of service the client received in a given month to the referring counselor, as well as an individual client progress report. The referring counselor will approve the vendor authorization for payment in AACE and send the signed vendor authorization to finance for payment of the bill. Goodwill may submit the statement at the end of the month or at any time during the month for those who change service area or are closed from the program before the end of the month.

Counselors must participate in the staffing of the client receiving job readiness training. Staffing by telephone is recommended when travel is extreme or difficult to schedule.

For more information contact: Goodwill Industries of Jackson, 863 Centre Street, Ridgeland, MS 39157 or Goodwill Industries of South Mississippi, 2407 31st Street, Gulfport, MS 39501

3.4.2.2 MIDD-West Industries

MIDD-West Industries is a private, non-profit organization operated by the Warren County ARC. The Agency has a contractual agreement with MIDD-West to provide vocational evaluation and job readiness services.

The counselor will forward to MIDD-West a vendor authorization listing the service to be provided and all appropriate referral material. The counselor is to plan all anticipated services, but issue vendor authorizations as the client is referred for each service. Vendor authorizations should be issued for the maximum amount (i.e., according to the IPE). Vendor authorizations must be received in a timely manner. MIDD-West will submit a signed statement detailing the number of days of service the client received in a given month to the referring counselor, as well as, an individual client progress report. The referring counselor will approve the vendor authorization for payment and send the signed vendor authorization to finance for payment of the bill.

Counselors must participate in the staffing of their client receiving vocational evaluation and job readiness training. Staffing by telephone is recommended when travel is extreme or difficult to schedule.

For more information contact: MIDD-West Industries, 100 Smokey Lane, Vicksburg, MS 39180

3.4.3 CRP Referral Package Documentation

Referral packets will be submitted to the CRP for review prior to the setting of an admission date. The counselor will provide copies of the following information in the referral packet:

 Medical, psychiatric, and/or psychological reports; as indicated by the client's disability; include Consent to Disclose Information signed by client

 In some cases the program may require more recent and/or detailed information than the counselor needs to establish eligibility. This is needed to enable the program to better assess the client's abilities and ensure the program does not endanger the client or others by placing him/her on an inappropriate assessment or job assignment.

 McCarron-Dial evaluations require IQ test results. The Wechsler with its scaled scores is the preferred instrument. However, the McCarron-Dial system will accept Verbal, Performance, and Full Scale scores from any standardized IQ test which has a mean of 100 and a standard deviation of 15. The computer program will not generate as detailed an analysis of the intellectual factor without the scaled scores from its sub- tests; but it is still a valid report. If test results are not available at the time of referral, the client's evaluation should not be delayed. The assessment may be completed and the CRP may request a psychological assessment. Data from the psychological would be incorporated into the evaluation results when received.

 School records, IEP for all Transition Students; include Consent to Disclose Information signed by client and/or parent/guardian

If the student is placed on payroll (not testing only) these records must include the portion of the Individualized Education Plan or Individualized Transition Plan (IEP/ITP) which relates to the

vocational aspects of the student's education along with the signature page. This portion of the IEP/ITP should include VR/AbilityWorks.

 Previous vocational evaluation and/or job readiness reports; if available

 Application For Admission (CRP-01) form

This application should be very detailed and specific. It should include the counselor's summary of the disability, limitations, medications the client is taking, previous work history, and the information the counselor is requesting from the CRP. It should also indicate if the client possesses or has applied for the proper I-9 documents. Refer to the Employment Identity and Eligibility Information part of this section for further guidance. (T.K. Martin Center has its own referral form.)

 AACE Personal Information & Application - completed by the counselor

 Authorization for Services

If a counselor refers a former client to the CRP for additional services, that counselor must submit a new authorization for services and a new application for admission stating the services the client currently needs and explaining why the counselor feels the client should return (including any changes which indicate the client will be more successful this time).

If the client's case was closed from the CRP in the current state fiscal year, the counselor will only need to submit the new authorization and application plus documentation of any changes in the client's medical or psychological condition. The counselor's request will be staffed as a readmission and the previous case file will be the case of record for the center's filing purposes.

If the case was closed in a previous state fiscal year, an entire new referral packet is required. In most cases, the client will not need to be re-evaluated. This is required only if the client's mental or physical condition has changed to such an extent that the evaluator feels the previous evaluation results no longer reflect the client's current abilities.

3.4.4 Employment Identity & Eligibility (I-9) Information

The Immigration Act requires anyone applying for employment to provide documented proof of employment identity and eligibility. Proper I-9 documents are required for all clients for whom paid work is part of their CRP program. Before the client can be placed on the CRP's payroll, at least one current document from each category must be presented to the center staff for verification.

Category I - Employment Identity

 Driver's license or identification card issued by a state or outlying possession of the United States containing a photograph or information such as name, date of birth, sex, height, eye color, and address

 Identification card issued by a federal, state, or local governmental agency or entity containing a photograph or information such as name, date of birth, sex, height, eye color, and address

 School identification card with a photograph

 Voter's registration card

 U.S. Military card or draft record

 Military dependent's identification card

 U.S. Coast Guard Merchant Mariner card

 Native American tribal document

Category II - Employment Eligibility

 U.S. Social Security card (original)

 Original or certified copy of a birth certificate issued by a state, county, municipal authority or outlying possession of the United States bearing an official seal.

3.5 COMPARABLE SERVICES & BENEFITS

The major purpose of the Comparable Services and Benefits provision is to provide vocational rehabilitation agencies with an organized method for assessing an individual's eligibility for benefits under other programs and drawing upon these programs to provide rehabilitation services. This is not the same as the determination of economic need.

During the initial interview, the counselor will thoroughly investigate any comparable services and benefits to which the client may be entitled. This is to be documented in the client‘s case file. Determination of benefits will be made in all areas prior to the authorization of VR funds (exceptions are listed in the OVR/OVRB Policy and Procedures Manual).

During the time the IPE is being developed, the counselor will follow up on all appropriate comparable services and benefits. The counselor must list on the IPE any comparable services and benefits available to offset, in whole or part, the cost of each planned service. If there is any possibility a comparable benefit will pay for a service, it must be listed in the ―Comparable Benefits‖ section of the IPE under the applicable planned service. If ―Other‖ is selected from the AACE list, the comparable benefit must be identified in the ―Other Comments‖ section.

If the counselor has determined the comparable benefit will not pay on a service, ―None‖ should be listed under Comparable Benefits. In the ―Other Comments‖ section, the counselor must enter ―Insurance, Medicaid, etc. will not pay......‖ The counselor must also document how

verification was obtained that the comparable benefit will not pay. Documentation may be included on the IPE (as documented by the counselor‘s review of the insurance policy; counselor‘s contact with Mr. Smith at the Medicaid office; counselor‘s talking with Mr. Smith, the benefit specialist for XXX Insurance Company, etc.) or documentation may be in a case note (as documented in the case notes).

If a comparable benefit obviously does not pay for a planned service, ―None‖ may be entered in the ―Comparable Benefits‖ section with no further explanation. Examples: Medicaid or other insurance would obviously not pay for AbilityWorks services, job placement, or counseling and guidance by MDRS staff.

3.5.1 Types

Examples of comparable services and benefits include, but are not limited to:

I. Grants/Scholarships (non-merit), which do not have to be repaid (See the Post-secondary Education Services section of this Resource Guide for further information.)

Medicaid - Medicaid is a Federal-State supported program which helps pay for medical services for low-income families. This is NOT an insurance program. It is supported by special appropriations made by the United States Congress and the State Legislature from general revenue Federal and State tax funds. The program varies from state to state.

If a doctor or medical facility refuses to accept Medicaid or Medicare, the counselor is required to direct the client to another physician or facility that will accept these third- party payers.

This is a very comprehensive, technical, medical assistance service program. Benefits change often (almost constantly for certain benefits) depending upon the availability of appropriated funds and current needs demand.

Eligibility is primarily based upon economic need although age, disability, and dependency (Temporary Assistance for Needy Families - TANF) are also factors to be considered. All SSI beneficiaries are eligible for Medicaid. All eligibility factors and benefit allowances are subject to change or termination at any time.

Some services currently provided are prescription drugs, clinic visits, lab tests, physician office visits, dental care, ambulance transportation, surgery, hospitalization, home health care, and family planning.

Medicaid does have some limitations such as deductibles, co-payments, per diems with limitations on number of days, and upper limit fees for all medically approved service procedures. For example, a recipient may be provided 30 in-patient hospital days in one calendar year. VR does not pay for deductible, co-payments, etc.

The recipient CANNOT be charged more than the established co-payment and/or

deductible. The vendor must accept the established upper limit payment less the co- payment and/or deductible as payment in full for services rendered.

Under the HealthMACS program, the individual may choose a particular doctor or health care facility from a list of HealthMACS providers to be his/her primary health care provider. Medicaid benefits stay the same under the HealthMACS program.

The Agency may not supplement any Medicaid covered service but may purchase other uncovered, services, which are deemed vocationally necessary. When a client has both, Medicaid may be used to supplement Medicare. The VR counselor must always determine a client's current Medicaid status. To do this, write the Mississippi Medicaid Commission at Sillers Building, 550 High Street Suite 1000, Jackson, MS 39201-1399 or telephone: 601-359-6050 or toll free: 1-800-421-2408.

III. Medicaid - Disabled Child Living at Home - A child with a disability(ies) age 18 or under who lives at home may qualify for Medicaid if the following conditions are met:

A. The child requires the level of care provided in a hospital or nursing facility.

B. It is appropriate to provide this care outside a nursing facility.

C. The cost of care at home is no more expensive than the Medicaid cost of nursing facility care.

Eligibility for Medicaid begins the month the child is eligible on all factors, which may be up to three months prior to the month of Medicaid application. Medicaid has 90 days to process the claim for a disabled child.

IV. Medicaid - Early and Periodic Screening, Diagnosis and Treatment (EPSDT) - Individuals under age 21 who are on Medicaid are eligible for EPSDT services. Medicaid will provide a comprehensive physical assessment, vision and hearing tests, immunizations (as needed), blood and urine tests, nutritional and developmental assessments, and health and developmental history.

The Medicaid Commission also provides, on an as needed basis, referral to a doctor for health problems; visual examination and glasses; hearing examinations and hearing aids; adolescent counseling and case management; and all other medical services for which a Medicaid recipient is eligible. It also provides, based on medical need, in-patient hospital services and rehabilitation hospital services.

V. Medicare - Medicare is administered by the Social Security Administration. It is a Federal government health insurance program for people 65 and older qualifying for Social Security payment benefits. Individuals with disabilities under age 65 drawing SSDI payments are eligible for Medicare benefits after receiving disability benefits for two years; chronic end- stage renal dialysis patients are eligible after three months after the month dialysis begins or the month of kidney transplant surgery.

Medicare has two parts:

32 Miss. Admin. Code Pt. 22, R. 26 - 40 Mild Hearing Loss Difficulty with faint speech

32 Miss. Admin. Code Pt. 22, R. 41 - 55 Moderate Hearing Loss Frequent difficulty with normal speech

32 Miss. Admin. Code Pt. 22, R. 56 Rule 56

• 70 Moderately Severe Hearing Loss Frequent difficulty with loud speech

32 Miss. Admin. Code Pt. 22, R. 71 Rule 71

• 90 Severe Hearing Loss Can understand only shouted or amplified speech

91+ Profound Hearing Loss Usually cannot understand even amplified speech without visual cues

3.6.3 Referrals

Deaf and hard of hearing clients are served by specially trained rehabilitation counselors for the deaf (RCDs) and crossover counselors. RCDs normally serve hearing impaired clients who are coded severely disabled and crossover counselors normally serve non-severely disabled hearing- impaired clients.

Clients may be referred to RCDs and crossover counselors located within each of the ten vocational rehabilitation districts. Clients whose communication requires American Sign Language to communicate should be referred to the RCD. Clients whose communication is less difficult should be referred to the crossover counselor. After the RCD or crossover counselor obtains an audiogram, or is otherwise reasonably sure of the severity of the loss, the case will be retained and served or transferred as is appropriate. Referrals of Individuals with Multiple Disabilities

When a client has two or more disabling conditions, one of which is deafness and his /her primary means of communication is manual the client would be served by the RCD and deafness will be considered the primary disabling condition.

When a client has two or more disabling conditions, one of that is hard of hearing, the case normally will be staffed with the RCD to determine which disability will be listed as the primary disability. This staffing can be in person or via telephone, according to the situation. The counselor assigned to handle that disabling condition would then serve the case. If it is determined that the case should remain on the general VR counselor's caseload, periodic staffing with the RCD at the general counselor's discretion is recommended. The RCD's expertise in audiometric, ENT medicine and hearing aid recommendations will ensure consistency of service provision.

Referrals of Individuals Who Are Deaf-Blind

Individuals who should be referred for these services are those who would meet the above Agency definition for deaf-blind or have a progressive loss having a prognosis leading to deaf-

blindness as described in this Resource Guide. Referrals of deaf-blind clients can be made directly to each district's RCD, rehabilitation counselor for the blind (RCB), or District Manager's office. In order to insure that client needs are met, a district team--composed of the RCD, RCB, staff interpreter, and Supported Employment counselor--will staff the case to determine the appropriate counselor to receive the referral. Individuals who are deaf-blind and communicate manually will be served by each district's RCD.

3.6.4 Services

The type of hearing loss indicates the nature and extent of rehabilitation services that may be necessary.

I. Conductive losses often suggest two alternatives:

A. Make the original sound louder with amplification, or B. Correct the conductive disorder by medical treatment or otological surgery.

II. Sensorineural deficits can usually be helped by amplification, if evaluated properly.

III. A mixed loss will involve both conductive and sensorineural and speech and language intervention as may be indicated.

3.6.5 Initial Interview

Consumers who are deaf and hard of hearing and are referred to vocational rehabilitation will have a variety of communication abilities. Communication levels that may be encountered include:  Understandable speech and some speech skills (adventitiously deaf or hard of hearing)  Limited expressive or receptive communication skills, relying on expressions and visual cues  Limited manual skills without speech  Fair to good expressive manual skills with or without understanding speech.

Due to the different levels of communication skills of clients, the following should be considered when interviewing a client:

 Arrange seats facing each other  Ensure proper light in room  Avoid distractions and interruptions (i.e., telephone calls and smoking)  Keep language simple to ensure understanding  Use gestures, pantomimes, and expressions freely  Use written language or pictures  Be patient

If your manual communication skills are inadequate, utilize the services of a qualified interpreter.

3.6.6 Interpreters

Interpreters should be utilized as needed in any phase of the rehabilitation process. A list of freelance interpreters is maintained in the State Coordinator for Deaf Services (SCD) office. It is distributed to RCDs, District Managers and is available to others upon request. Persons needing interpreters are encouraged to secure interpreter services to ensure clients who are deaf have equal access to all aspects of the OVR program.

In order to assure effective communication in each RCD office statewide, interpreters will be available to each VR District under the supervision of the District Manager. Any Agency Community Rehabilitation Center or staff person needing the services of an interpreter can call the District Manager‘s office to request assistance from the staff interpreter. If staff interpreters are unavailable, assistance in securing a freelance interpreter will be provided by the local RCD's office or the State Coordinator of Deaf Services' office. (See the OVR/OVRB Fee Schedule for rates of pay.)

The Registry of Interpreters for the Deaf, Inc., 814 Thayer Avenue, Silver Spring, Maryland 20901-4589, and the Mississippi Registry of Interpreters for the Deaf (MSRID) have established a certification system for sign language interpreters on a national level and a state quality assurance screening on the state level.

This evaluation ensures the consumer (both the consumer who is hard of hearing and the consumer who is deaf) that the interpreter has gained a certain level of competence. This competence relates to a "qualified interpreter".

The following is a description of the different certificates issued by the Registry of Interpreters for the Deaf (RID).

I. CI - Certificate of Interpretation: a high level of skill in being able to expressively interpret in American Sign Language and has demonstrated skill, at a lower standard than the formerly standard Comprehensive Skills Certificate (CSC), in the ability to reverse interpret American Sign Language.

II. CT - Certificate of Transliteration: a high level of skill in being able to expressively transliterate in a manual code for English and has demonstrated, at a lower standard than the CSC, in the ability to reverse interpret a manual code for English.

III. RSC - Reverse Skills Certificate: a high level of skill in being able to reverse (Sign to Voice) interprets or transliterate.

IV. SC: L - Specialist Certificate: an interpreter who has a CSC plus demonstrated specialized skill in being able to interpret in legal settings.

V. OIC: C - Oral Interpreter Certificate: Comprehensive: the highest comprehensive level of interpreting skill in oral situations with oral adult deaf individuals. The interpreter is

skilled in being able to paraphrase or transliterate a spoken message with or without voice and reverse interpret for an oral adult individual who is deaf.

VI. OIC: S/V - Oral Interpreter Certificate: skill in interpreting for oral adults who are deaf; both in being able to paraphrase or transliterate a spoken message with or without voice and reverse interpret for an oral adult who is deaf, but at a lower standard of competence than the comprehensive certificate.

VII. OIC: V/S - Oral Interpreter Certificate: Visible to Spoken: able to understand the speech and/or mouth movements of an oral person who is deaf and repeat it for a third person. This is a reverse certificate for oral interpreting. It is generally awarded to oral adults who are deaf. However, a hearing interpreter may have this certificate if they have demonstrated skill in this area.

VIII. NIC – National Interpreter Certification: Individuals achieving certification at the NIC, NIC Advanced or NIC Master level are all professionally certified interpreters. The national Interpreter Certification exam tests interpreting skills and knowledge in three critical domains:

 General knowledge of the field of interpreting through the NIC written exam.  Ethical decision making through the interview portion of the NIC performance test.  Interpreting and transliterating skills through the performance portion of the test.

The Quality Assurance Panel facilitates Quality Assurance Screening of interpreters to assess their functioning level, provides guidance for professional growth, and recommends candidates whose skills warrant participation in RID evaluation.

The State Quality Assurance Screening Team issues the following three levels:

Level I – Basic level for the candidate who interprets 60 percent of the material. This may be appropriate for one-to-one situations on a non-technical subject with opportunities to stop for clarification.

Level II – Intermediate level for the candidate who interprets at least 80 percent of the material. This may be appropriate for job interviews, orientation and tutoring sessions, and non-technical medical exams.

Level III – Advanced level for the candidate who interprets 90 percent of the material. This candidate would be recommended to take the RID evaluation.

3.6.7 Psychological/Vocational Testing

Deaf clients needing psychological testing should be referred to the appropriate psychometrist. Specially trained psychometrist provides special and appropriate testing as needed. When a

manually communicating client is referred for either psychological or vocational testing, an interpreter should always be provided to enhance communication.

The procedure for evaluating the vocational and psychological characteristics for the Deaf and hearing impaired are comparable to any other disability with the following exceptions:

The psychologist's interpretation of the personality tests is based on the understanding of the client and his/her language level.

 Aptitude Testing

Aptitude testing is very important in determining the manual dexterity, mechanical aptitudes and spatial relation of individuals who are deaf.

 Interest Testing

Since interest tests are generally highly verbal, a close evaluation of their results should be made.

 Communication Skills

Before making recommendations from psychological and vocational results, a careful review of the client's communication skills should be made, keeping in mind that communication ability does not indicate the intelligence of a client.

3.7 DENTAL SERVICES/CONSULTATION

For cases involving dental care, oral surgery, or orthodontic services, the counselor must adhere to the following instructions:

A dental consultation (Dental Form-1) form is used to ensure programmatic accountability in the provision of planned dental services. This form will be completed for all VR clients for whom employment is the anticipated outcome and it appears the desired vocational goal cannot be achieved without essential dental services.

Transmittal Procedure:

Section 1 When there is a need for planned dental services, the VR counselor will complete Section 1 of the dental consultation form. The dental consultation form, a legible copy of the general dental examination form, which includes a proposed treatment plan, and supporting information (radiographic X-rays, cost estimate, etc.) should be sent to the district manager for review.

Section 2 Once approved by the district manager, the form and attachments (radiographic X- rays, dental cost, dental treatment plan, etc.) should be submitted to the state program coordinator for dental services for review; the state program coordinator will present

the request to the state dental consultant for review.

Section 3 After the state dental consultant has reviewed and taken appropriate action on the request, the information will be returned to the state program coordinator for dental services. The program coordinator will forward the information back to the counselor.

Dental services for a primary or secondary disability must not be promised, planned, or provided prior to review by the district manager and treatment recommendations obtained from the state dental consultant. If dental services are being requested even as a secondary condition, do not complete a certificate of eligibility prior to the completion of the review process.

Questions regarding this process should be discussed with the district manager.

3.10 HOSPITAL REHABILITATION CENTERS & OTHER HOSPITAL SERVICES

3.10.1 Hospital Rehabilitation Centers

The Hospital Rehabilitation Centers (HRC) Program provides inpatient and outpatient rehabilitation services to VR clients. A client may choose one of five centers in the state; however, special funds are only available for services provided at MRC on an inpatient basis. Services provided through one of the other centers or outpatient services at MRC are to be authorized from the local counselor‘s budget. Factors affecting where the client will be served include:

 The center's services meet the client's rehabilitation needs.  The client's physician recommends the client go to the center.  The client chooses to go to that center.  VR funds are available.

The client and counselor may choose from the following five centers:

Baptist Memorial Hospital-DeSoto 7601 Southcrest Parkway Southhaven, MS 38671 (Liaison counselor 1ML) Telephone: (662) 342-4000 Serves: Stroke, Brain Injury, Neurological Disorders, and Rheumatoid Arthritis

Forrest General Hospital 6051 U.S. Highway 49 P.O. Box 16389 Hattiesburg, MS 39404-6389 (Liaison counselor - 9GC) Telephone: (601) 582-4072 Serves: Stroke, Neurological Disorders, Arthritis, Multiple Trauma, and Orthopedics

Methodist Rehabilitation Center (MRC)

32 Miss. Admin. Code Pt. 22, R. 1350 Rule 1350

East Woodrow Wilson Jackson, MS 39216 (Liaison counselor - 5RL) Telephone: (601) 898-7079 Serves: Spinal Cord Injury, Head Injury, Stroke, Arthritis, Orthopedics, and Neurological Disorders

NOTE: All mail to VR Staff housed at MRC should be mailed to 3895 Beasley Road Jackson, MS 39213

North Mississippi Medical Center 830 South Gloster Street Tupelo, MS 38801 (Liaison counselor - 2GF) Telephone: (662) 840-9952 Serves: Spinal Cord Injury, Head Injury, Stroke, Neurological Disorders, Orthopedics, and Arthritis

River Region Health System 111 North Frontage Rd. Vicksburg, MS 39182 (Liaison counselor – 5GI) Telephone: (601) 638-1621 Serves: Stroke and Problem Fractures

3.10.1.1 HRC Screening Committee

The District Screening Committee reviews referrals to the hospital rehabilitation centers, using the Inpatient Referral Assessment form, to determine the appropriateness of the referral for services at one of the five centers.

Upon approval by the District Screening Committee, the referral will be forwarded to the State Screening Committee for review and processing. Referrals to the committee should be directed to the attention of CHAIRPERSON, HOSPITAL REHABILITATION CENTERS SCREENING COMMITTEE, P. O. BOX 1698, JACKSON, MS 39215-1698. Referrals should be received by Friday afternoon prior to Monday morning review. Referral information should include the following:

 Referral Assessment Form  Referral (MDRS-VR-24) form  AACE Personal Information/Application reports  Medical Records  A narrative that will address the following items:

a. primary purpose or need in referring the case to the rehabilitation center b. medical stabilization c. projected functional limitations d. psychological status e. circumstances of injury, i.e., evidence of substance abuse

f. high school grades if the referral is a minor or young adult g. client's attitude and motivation h. indicate stability of work history i. recency of work j. possibility of returning to previous employment ("Letter of Intent" from employer, if appropriate) k. list of current job skills l. client's potential for retraining m. educational level n. transferable skills to other employment o. Labor market in local area p. client's ability to relocate q. family support status r. client's resources and comparable benefits

Once the screening committee has approved a client for services at a center, the client does not have to be referred to the committee for any subsequent admissions.

3.10.1.2 HRC Inpatient Procedure

The screening committee approval report will be sent to the referring counselor and the appropriate liaison counselor. The referring counselor will be advised by the liaison counselor as to when the case is to be transferred. All cases must be in Service Status at the time of transfer. The liaison counselor will authorize all inpatient services from HRC funds. Upon completion of inpatient services, the liaison counselor will transfer the case electronically, effective the day of discharge. The paper file will be mailed to the referring counselor within seven working days after discharge.

3.10.1.3 HRC Outpatient Procedure

It is not necessary for the counselor to refer clients needing outpatient services to the screening committees. The counselor may schedule appointments directly through the appropriate liaison counselor or secure the service through other outpatient clinics as long as the client has a prescription for the required treatment or service.

An appointment will be scheduled soon after the referral information is received. Instructions relative to the scheduled appointment for the appropriate outpatient clinic and physician will be mailed to the referring counselor who will use the following guidelines to authorize and pay for services:

 All Authorizations and Statements of Account for VR outpatient clinic visits will be prepared by the referring counselor using their district code with the appropriate fund code.

 All services (including appropriate codes and costs) identified on the appointment memo from the liaison counselor at the hospital will be used to complete the Authorization of Services (MDRS-VR-6) form.

 The referring counselor will send the Authorization and Statement of Account to the hospital's Business Office and to the physician (not to liaison VR staff). A copy of the authorization should be sent to the liaison counselor. When the services are completed, the Business Office will return these forms. The liaison counselor will assist in obtaining medical reports. This is to be done on all clinic visits.

A VR liaison counselor or coordinator will contact the referring counselor prior to making decisions on all proposed outpatient services to be rendered by the hospital's clinical staff and will verbally authorize services if approved by the referring counselor. Authorizations will then be issued, using his/her district code and fund code, using the same procedure as for clinic visits.

Recommendations for such items as wheelchairs, hydraulic lifts, home fixtures, braces, wheelchair cushions, artificial limbs, or other major items will be verbally authorized, and a prescription will be sent to the referring counselor, who will issue a written authorization for items over $35. All such items will be charged to the referring counselor's district code and fund code. Individual items costing under $35 are covered in the outpatient per diem paid by the Agency.

The referring counselor will be notified of scheduled follow-up appointments by telephone and he/she will be responsible for arranging the client's transportation and preparing Authorizations and Statements of Account just as he/she did for the initial clinic visit. If an appointment cannot be kept, the liaison counselor must be notified immediately so that the client can be rescheduled. This information should be communicated as quickly as it becomes known.

Individual instructions will be given to the referring counselor for purchasing consultations at the center and for purchasing consultations outside the center. These authorizations will be charged to his/her district code, using the appropriate fund code, and will be authorized by the referring counselor to the appropriate physician providing the consultation.

It is imperative that complete and accurate insurance information be included on MDRS-VR-24 referral form. Clients must bring private insurance card, Medicaid and/or Medicare cards with them to all center outpatient clinic visits.

3.10.1.4 HRC Medical Information Requests

To obtain medical records from one of the Hospital Rehabilitation Centers (HRC), send to the liaison counselor Consent to Disclose Information (MDRS-VR-19) form, which will contain the following:

 Client's medical record number  Full name  Address

 Date of birth  Social Security number  Date(s) of the medical report(s) being requested

UNDER NO CIRCUMSTANCES SHOULD CLIENT CONSENT TO DISCLOSE FORM BE SENT DIRECTLY TO THE HRC. SEND ONLY TO THE LIAISON COUNSELOR.

3.10.2 Hospital/Other Medical Records

Medical information from the records of a hospital, clinic, or a physician should be obtained when it:

 will assist the counselor in establishing eligibility  is needed/helpful in assessing the client's medical history, current status, and/or prognosis for employment

When requesting medical records, the counselor should contact the vendor to determine whether an independent copying service is involved. (This would be particularly true for larger hospitals.)

If hospital, clinic, or physician has charges for summaries or copies of records, an authorization form may be issued for the amount established by the Agency Fee Schedule. In most instances, you should enclose Consent to Disclose Information Form.

3.11 BUSINESS DEVELOPMENT SERVICES

The Agency is dedicated to the achievement of a quality employment outcome for every client consistent with his/her unique strengths, resources, priorities, interests, needs, concerns, abilities, capabilities, and informed choice.

The Agency specializes in seeking employment opportunities for individuals with disabilities. As such, every staff member is expected to be involved in the business development process. Statewide Business Development Services staff focuses on employer development and work with Agency VR counselors to establish the relationships necessary to facilitate placement of clients.

Although the VR counselor has the primary responsibility for placement of the client, the Agency has several avenues to assist the counselor in this effort.

 Statewide Business Development Services  Community Based Job Tryout (LINCS)  On-the-Job Training  Work Opportunity Tax Credit  Employability Skills Training for Youth  Workforce Investment Act Youth Disability Coordinator  Workforce Investment Network (WIN) Job Centers

3.11.1 Statewide Business Development Services

The Statewide Business Development Services (BDS) staff‘s goal is to identify opportunities and to make available a broad range of occupational choices for VR clients. The BDS staff works closely with the VR counselor and the client to identify employment prospects that represent for the client entry or re-entry into a meaningful career. The BDS staff canvases the constantly changing Mississippi job market through individual and group business contacts to identify potential linkage of client qualifications and employer needs.

Another focus of the business development efforts of the BDS staff is providing services to employers. The BDS staff educates employers about the capabilities of persons with disabilities to be successful in employment with or without supports.

The BDS staff is comprised of a state director who supervises the work of two regional employment managers. The regional employment managers or REMs are responsible for a variety of workforce development activities including but not limited to corporate level employer development and coordination of business development initiatives in their respective regions. REMs also provide leadership and training to staff; manage and implement contracted Workforce Investment Act (WIA) youth services; and, supervise the BDS Employment Coordinators.

A BDS Employment Coordinator (EC) is assigned to each of the MDRS districts. The function of the EC is to call on businesses in their respective districts and develop relationships with them. Once a relationship is developed, the EC establishes the business as an employer account and continues to call on the business to provide services and conduct business development and follow-up. The EC develops specific job leads from businesses and a variety of other sources resulting in placement of clients. The EC also serves as a consultant to businesses for on-the-job accommodations, community-based job tryout (through AbilityWorks LINCS), on-the-job training, Work Opportunity Tax Credit (WOTC) and any other incentives that may be available to employers who hire VR clients.

3.11.2 Community Based Job Tryout (LINCS Through AbilityWorks)

A job tryout may be used as part of the client‘s evaluation or as a placement tool. The purpose of a job tryout is to determine the client‘s readiness for a specific employment goal, or employment in general. It also provides the employer with an incentive to try out an individual with a disability while AbilityWorks pays the client‘s salary, worker‘s compensation, and other fringe benefits. For detailed instructions on a job tryout refer to Section 3.4.1.3.8 AbilityWorks LINCS–Linking Innovative Networks of Community Services.

3.11.3 On-The-Job Training

On-the-job training (OJT) can provide an excellent opportunity for VR clients to display their capabilities to a prospective employer. The training program should be designed to meet both the client's as well as the employer‘s needs. The employer should provide reasonable assurance

that the client will be employed at the successful termination of the OJT program.

When completing an OJT Program for a client, an On-the-Job Training Agreement Form (MDRS-VR-26) must be completed, a copy of the completed form placed in the client's file and a copy given to the employer before beginning the training.

An adequate supply of the Training Progress Report Form (MDRS-VR-28) for the OJT period covered by an authorization for services should be sent to the employer. A letter should be included requesting that the MDRS-VR-28 be completed monthly (or at more frequent intervals, if desired) and forwarded to the VR office for case file documentation.

Suitable records of attendance, performance, and progress of the client should be maintained by the employer and made available to the VR counselor when requested. Verbal reports should be documented in a case note and placed in the client's case file.

3.11.4 Work Opportunity Tax Credit

The Work Opportunity Tax Credit (WOTC) Program was created by the Small Business Job Protection Act of 1996 (PL 104-188). On May 26, 2007, Congress extended the WOTC Program through August 31, 2011. The WOTC is available to employers hiring individuals from one or more of eight target groups including VR referrals. The tax credit available to employers who hire an individual from one of the target groups is as follows:

 For eligible individuals who work for an employer at least 120 hours, but less than 400 hours, the tax credit available to the employer is 25% of the first $6,000.00 of wages paid.  For eligible individuals who work for an employer at least 400 hours or more, the tax credit available to the employer is 40% of the first $6,000.00 of wages paid.

Certification of Eligibility

In accordance with a Cooperative Agreement with the Mississippi Department of Employment Security (MDES), vocational rehabilitation (VR) counselors are allowed to issue Conditional Work Opportunity Tax Credits (Form ETA 9062) only to clients found eligible for vocational rehabilitation services. Form ETA 9062 replaces Form ETA 9061 and the letter of eligibility formerly submitted by VR Counselors to identify eligible target group members. The new Form ETA 9062 can be obtained either from the district BDS staff or from the MDRS State Office in care of the BDS Director.

Instructions for filling out Form ETA 9062 (Conditional Certification)

Instructions for each line item are listed on the back of the Form ETA 9062; however, specific information relative to MDRS for certain items are as follows:

Item #1: Initiating Agency Code. Each VR District will have its own code as listed below:

District I 2001 District II 2002 District III 2003 District IV 2004 District V 2005 District VI 2006 District VII 2007 District VIII 2008 District IX 2009 District X 2010

Item #2: Control No. (Leave blank. Check only Participating Agency.)

Item #3: Type of Conditional Certification. (Check Original)

Item #5: State Employment Security Agency‘s Name and Address. (This is the name and address of the VR Counselor, not the WIN Job Center.)

Item #6: Signature. (The VR Counselor must sign here. No other MDRS employee signature is acceptable.)

Item #11: Target Group Code. (The Code for VR eligible clients is E.)

Item #12: Group. (This item is to be left blank for all VR clients.)

Item #14: (This item is to be left blank for all VR clients.)

The Form ETA 9062 should be shown to the prospective employer prior to the job offer by the applicant (VR client). In the event the VR client is hired, the employer should be given the original of the Form ETA 9062. The form is due to the Mississippi Department of Employment Security within 21 days of the date the client is hired.

APPLICATION for WOTC

Application for the WOTC by the employer who hires a VR client is facilitated by the submission of the IRS Form 8850. This form may also be obtained from the District BDS staff or from the MDRS State Office in care of the BDS Director.

The job applicant (VR client) and the employer must sign and date IRS Form 8850 on or before the day the job offer is made. The employer must submit the IRS Form 8850 along with the Form ETA 9062 to MDES no later than the 21 st day after the job applicant begins work for the employer.

The BDS is the lead VR program for the facilitation of the WOTC and implementation of the Cooperative Agreement with MDES. Questions regarding any aspect of WOTC procedures may

be directed to the District BDS staff.

3.11.5 Workforce Investment Act (WIA)

The Federal Workforce Investment Act (WIA) of 1998 created a nationwide one-stop delivery system of employment services, known as the Workforce Investment Network (WIN) in Mississippi. MDRS is a mandated partner in WIA, or WIN in Mississippi, and plays an active role at the State and local levels. The MDRS partnership within the system is formalized through Memorandums of Understanding with the State, each of the four Local Workforce Investment areas, and through cost-sharing agreements with operators of the centers where Agency staff is located. MDRS is represented on the State Workforce Investment Board and each of the Local Workforce Investment Boards that govern the WIN system. MDRS has vocational rehabilitation counselors and other program staff located in some WIN Job Centers on a full-time basis. At WIN Job Center sites where a counselor is not co-located, information and referral services pertaining to MDRS is available. A WIA Director, with assistance from a One- Stop Coordinator, coordinates WIA activities for MDRS.

3.11.6 WIA Employability Skills Training Program

The Employability Skills Training (EST) Program is a service designed to assist VR counselors in placing clients in competitive employment. This program is funded by grants from the WIA. The purpose of the WIA funded program is to prepare youth for entry into the labor force. An individual may be eligible for the program if he/she is economically disadvantaged and a youth between the ages of 16 and 22 years.

Referral Process

To receive services from the EST program, an individual must be determined eligible for VR services must meet WIA eligibility criteria, and must demonstrate potential for entry into a competitive work situation. Counselors should refer any individual to the program who meets the age requirements and is a high school dropout, an individual who has completed high school, or any individual not currently receiving educational services that needs assistance with preparing for entry into employment. A referral should be initiated by case staffing between the EST counselor and the referring VR counselor. Required documentation for eligibility will be discussed at the time of referral. {A list of specific documents required for referral will be provided to counselors when the WIA provides instructions regarding documentation of eligibility.}

Services Provided

Eligible youth who are assessed as needing any one or all of the following required program elements may be provided those services by the MDRS EST Program or suitable arrangements may be made with other service providers to ensure that the participant obtains them:

 Tutoring, study skills training, and instruction leading to completion of secondary school, including dropout prevention strategies

 Alternative secondary school services, as appropriate  Summer employment opportunities that are directly linked to academic and occupational learning  Internships and job shadowing  Occupational skill training, as appropriate  Leadership development opportunities, which may include community service and peer- centered activities encouraging personal responsibility and other positive social behaviors during non-school hours, as appropriate  Supportive services  Adult mentoring for the period of participation and a subsequent period, for a total of not less than 12 months  Follow-up services for not less than 12 months after the completion of participation, as appropriate  Comprehensive guidance and counseling, which may include drug and alcohol abuse counseling and referral, as appropriate

3.11.7 Workforce Investment Act Youth Disability Coordinator

Recognizing the unique challenges faced in providing appropriate services to youth with disabilities to overcome barriers to employment, MDRS and the Mississippi Partnership Workforce Area and the Delta Workforce Investment Area work as partners to provide consultation and guidance to providers of services for youth. This partnership is led by a youth disability coordinator who functions as trainer for the Local Workforce Investment Area and who identifies services for youth with disabilities that are available from a variety of sources in the community including vocational rehabilitation.

Services provided by the Workforce Investment Act Youth Disability Coordinator include the following:  Coordination and referral for services among current youth providers and other social services providers depending on the particular needs of the individual  Training to youth providers on disability issues such as disability awareness, etiquette, terminology, and communication  Technical assistance regarding disability specific issues both on and off the job and while in training  Assistance with job placement.  3.12 OFFICE OF SPECIAL DISABILITY PROGRAMS

The Office of Special Disability Programs provides services statewide to individuals with the most severe disabilities. Counselors located in each of the MDRS district offices coordinate services targeted to individuals with severe disabilities who do not demonstrate immediate potential for competitive employment.

3.12.1 Who Is Eligible

The eligibility requirements are three fold:

1. An individual must have a severe disability(ies), 2. Which constitutes multiple barriers (handicaps) to the individual‘s capacity to live independently, and 3. There is a strong likelihood that the individual will be able to live significantly more independent in the family or community or be maintained in employment.

If the individual is to be served through the Traumatic Brain Injury/Spinal Cord Injury Trust Fund, he/she must have verification that they have sustained a traumatic brain or spinal cord injury.

3.12.2 Services

The services provided include a broad range of assistance designed to help individuals to function more independently in their families and communities. Because funds are limited, all possible resources for services are utilized, including Medicare, Medicaid, insurance, client involvement, state and federal funding, etc.

The following assistance can be provided and/or coordinated by the Independent Living Counselor: Assistive Technology Purchase of artificial limbs, hearing aids, communication equipment, environmental control units, magnifiers, low vision aids, etc.;

Home and Vehicle Modifications Residential accessibility of homes, including provision of ramps, widening doorways, lifts for vans, etc.;

Durable Medical Equipment Purchase of wheelchairs, walkers, hospital beds, lift equipment, etc.;

Daily Living Skills Instruction in cooking, cleaning, accident prevention, money management, self-advocacy, etc.;

Mobility Orientation Assistance in the use and maintenance of assistive equipment, utilization of transportation system, etc.;

Peer Counseling Guidance provided by persons who are disabled to assist individuals in problem-solving skills, adjustment to disability, and social integration;

Personal Care Attendant Services Assistance with daily living needs (e.g. bathing, dressing, ambulation);

Physical/Mental Evaluations General medical, psychological exams, special diagnostic reports and assessments, etc.

3.12.3 Independent Living Services

This program is a component of the State's Independent Living Rehabilitation Services Program and is funded with 100 percent State appropriations. The following eligibility criterion further clarifies the categories of persons with disabilities and the priorities given to the specific groups within these categories of clients that may be served through this program. The primary emphasis of this program is to provide opportunities for these individuals to become employable, to seek employment, maintain employment, and/or to avoid unnecessary institutionalization while being productive, independent members of society.

3.12.3.1 Eligibility Requirements

The individual must be of working age (generally between 18 and 62); have a diagnosis that involves a severe physical disability (functional loss of lower and upper extremities); be mentally capable of living independently and managing his/her own affairs; and not be eligible for Personal Care Attendant (PCA) services through other resources.

Priority Groups:

 Eligible persons who are ready for employment but cannot realistically seek employment without the availability of attendant care services;

 Eligible persons who are employed and require assistance with the cost of attendant care services in order to maintain employment;

 Eligible persons who require attendant care services to live independently; avoid undesirable and inappropriate nursing home placement; or to move from an institution (i.e., nursing home).

3.12.3.2 Referral Procedures

The Independent Living Rehabilitation counselors accept referrals from public and private agencies and/or self-referrals from individuals needing assistance with attendant care services. This counselor must complete the application process by signing and dating the application for attendant care services. The existing medical and/or psychological records necessary for determining eligibility will be obtained with the applicant's permission.

If the existing records are not adequate or current, applicants may be asked to undergo a medical and/or psychological examination. The Agency will incur the cost of any examinations that are required to determine eligibility. The eligibility determination will be made after a thorough review of the records and will be based on the counselor's assessment.

Once a person has been determined eligible for attendant care services, the counselor and the client will develop an IPE or IWILP which identifies the type(s) of attendant care services to be provided, the duration of services, and the degree of responsibility for the cost of services each party agrees to accept. This agreement shall be clearly stated with signed documentation in the client's file. The agreement may be renegotiated at any time; however, clear documentation of any change must be present in the client's file.

The purpose of this program is to assist the client with the cost of attendant care services while he/she works toward achieving the objectives outlined in his/her plan. Therefore, the client is expected to take responsibility for active participation in the planned services.

For referral of a client to the appropriate Independent Living rehabilitation counselor, refer to the chart below:

District I ILS Counselor District IV ILS Counselor District VII ILS Counselor 51 County Road 166 1003 College Drive 1400-A Harrison Drive P. O. Box 1415 P. O. Box 4339 P. O. Box 1408 Oxford, MS 38655 Meridian, MS 39304 McComb, MS 39649 (662) 234-6086 (601) 483-5394 (601) 249-4646

District II ILS Counselor District V ILS Counselor District VIII ILS Counselor 1244½ West Main 18 John Merle Tatum Road 300 Capers Avenue Tupelo, MS Hattiesburg, MS 39404 Jackson, MS 39203 (662) 840-9947 (601) 544-4860 or (601) 351-1490 or (601) 545-4405 (601) 351-1472

District III ILS Counselor District VI ILS Counselor District IX ILS Counselor 207 Industrial Park Road 625 Courthouse Road 706 Highway 49-82 Bypass P.O. Box 824 Suite 113 P. O. Box 543 Starkville, MS 39760 P.O. Drawer 6889 Greenwood, MS 38935 (662) 324-9646 Gulfport, MS 39506 (662) 455-2706 (228) 897-7612

3.12.4 Traumatic Brain & Spinal Cord Injury Trust Fund

The 1996 Mississippi Legislature created the Spinal Cord Injury and Traumatic Brain Injury (SCI/TBI) Trust Fund to provide services for eligible Mississippi residents who sustain a traumatic spinal cord injury or traumatic brain injury. The purpose of the program is to help individuals reintegrate into their home and community with as much independence as possible. The program is administered by the Agency‘s Office of Special Disability Programs.

3.14.4.1 Eligibility

Any resident of Mississippi, regardless of age, who has a severe disability as a result of a traumatic brain or spinal cord injury as defined below:

Traumatic Brain Injury - an insult to the skull, brain, or its covering, resulting from external trauma which produces an altered state of consciousness or anatomic, motor, sensory, cognitive, or behavioral deficits

Traumatic Spinal Cord Injury - Acute insults to the spinal cord, not of a degenerative or congenital nature, but caused by an external trauma resulting in any degree of motor or sensory

deficit

An individual must seek assistance from all available resources, including VR, prior to the Trust Fund's participation in a service. If an individual is not eligible for VR or a specific service is not covered by VR (e.g., respite care or attendant care), the individual should be referred to the Trust Fund. In some cases, VR and the Trust Fund may provide services simultaneously.

3.12.4.2 Services

The SCI/TBI Trust Fund program provides:

 Equipment/Modifications - durable medical equipment, assistive technology services and equipment, home and vehicle modifications.

 Emergency Services - assistance of a short-term, urgent nature that is considered critical for the individual's survival, general health or welfare, or the maintenance/ enhancement of their independent living capacity.

 Respite Services - the employment of a temporary, short-term caregiver to provide a respite to the family member or other caregiver who regularly assists the survivor of a spinal cord or brain injury.

 Transitional Personal Care Attendant Services - attendant care services to assist an individual with physical activities of daily living, such as bathing and grooming, or cognitive activities, such as planning daily schedules or participating in community reintegration activities.

To obtain information about the program, or to make referral, contact the TBI/SCI Trust Fund Coordinator.

3.13 OUT-OF-STATE SERVICES

It is the policy of the Agency to secure all necessary rehabilitation services within the state when they are available and appropriate.

The following are exceptions to the purchase/provision of in-state rehabilitation services:

 When the counselor and client determine that the in-state service is not adequate or poses an undue hardship on the client, service out-of-state may be considered. The counselor will document the case file as to the reason(s) the determination to use an out-of-state service provider/vendor is being considered. The District Manager MUST review cases in this category;

 When the necessary vocational rehabilitation service is not available within the state, and an out-of-state vendor is recommended to provide the service, the counselor MUST staff the case with the District Manager and the appropriate VR state office staff person

responsible for the service area (i.e.; Post-secondary Education, Assistive Technology, etc.) to obtain additional recommendations/guidance;

 When a physical restoration service is recommended to be provided by an out-of-state vendor because it is not available within the state, the counselor MUST obtain, in writing, the recommendations of the local District Medical Consultant and the appropriate State Consultant (e.g., State Dental Consultant, State Medical Consultant, and State Ophthalmological Consultant). After receiving the appropriate State Consultant's recommendations, the counselor MUST staff the case with the District Manager before planning the service or issuing an authorization for the recommended out-of-state service.

If a decision is made to use an out-of-state service for any of the above reasons, the counselor will need to contact the out-of-state vendor to determine if the vendor will consider/accept:

 The Mississippi VR Fee Schedule or;

 If the Mississippi fee is not acceptable, the fee schedule of the VR Agency of the state in which the service is being obtained.

NOTE: Only after the above two options have been discussed and are not acceptable by the vendor, will the usual and customary fee being charged by the out-of-state vendor be considered. The counselor should obtain in writing the vendor's fees and the case file should document the vendor and person contacted (telephone number, etc.) with whom the service/fee arrangements are finalized. The counselor will staff this information with the District Manager prior to planning the service or issuing an authorization for the recommended out-of-state service.

When the client chooses/prefers (Informed Choice) to go out-of-state for a recommended rehabilitation service which is available in-state and would meet the individual's rehabilitation needs, the Agency is not responsible for the cost in excess of the cost of the in-state service. The counselor should analyze the extensiveness of the rehabilitation case (i.e.; the cost of professional fees, hospitalization, lodging, transportation, tuition, vocational training, etc.). Should it be determined that the service is available within the state and it is more cost effective for the service to be rendered within the state, the Agency can only authorize the amount which would normally be authorized for the service in-state based on the VR fee schedule. This should be thoroughly explained to the client, the client's family or representative, and the out-of-state vendor as appropriate.

When it appears the client prefers an out-of-state vendor this Out-of-State Services Policy should be explained in detail as early in the rehabilitation process as possible to avoid undue, unforeseen conflicts or hardships among the involved parties. It is the intent of the Agency to provide all services on a timely basis and in a cost-effective manner.

3.14 POST-SECONDARY EDUCATION SERVICES

Post-secondary education (PSED) includes various training programs in which the Agency clients may choose to participate after completion of their secondary (high school) education. The training should be required for the person to achieve his/her employment objective. This objective should reflect the individual's interests and "informed choice" to the extent these factors are consistent with his/her strengths, resources, priorities, concerns, abilities, and capabilities.

When the employment objective has been determined, the counselor and client should investigate job market projections in the occupational area being considered and the various training resources available. It is important to train persons for occupations where there is a reasonable demand projected. The client's willingness to relocate should be explored if job opportunities are more readily available away from the home area. The case file should be documented to reflect this.

The length of the individual training program should not exceed that necessary to prepare the client for entering his/her chosen employment objective. The need for extensions must be substantiated and documented in the case record.

Types of post-secondary education programs:

Academic - Successful completion of course work leads to an Associate in Arts (A.A.), Baccalaureate, or higher degree.

Business - Successful completion of course work leads to a certificate in a particular business skill area (e.g., dictation, tax preparation, typing, shorthand, software application, etc.). It usually provides specific short-term job-related instruction but does not include broad-based academic courses. Courses such as these are not usually accepted for credit by academic degree programs. Business training that leads to an academic or technical degree should be classified as such.

Technical - Successful completion of combined academic and technical course work leads to an Associate in Applied Science (A.A.S.) or Associate in Advanced Technology (A.A.T.) degree.

Vocational - Successful completion of course work leads to a license or certificate in a specific job skill (e.g., auto mechanics, barber - cosmetology - hair design, computer repair, truck driving, TV repair, welding, etc.) but does not include broad-based academic courses. Courses such as these are not accepted for credit by academic degree programs.

There are short term, highly concentrated training programs for occupations such as auctioneer, gunsmith, taxidermist, etc. that are not offered in state-supported schools. The District Manager should review these programs on an individual basis.

3.14.1 Post-Secondary Training Sponsorship Guidelines

Post-secondary training may be appropriate for some carefully selected individuals whose disabilities result in substantial impediments to employment. In addition to the VR eligibility criteria, the following guidelines are to be used when identifying a client who may reasonably be expected to benefit from the training in terms of an employment outcome.

 The client has completed or terminated his/her secondary education (high school diploma/GED).

 The training is required for the client to enter into or engage in his/her chosen employment objective.

 Documentation must show that the client can be expected to succeed in the training program. This documentation may include psychological testing, college transcripts, high school grades, scores on college entrance examination(s) or any other information which, in the counselor's professional judgment, has a direct bearing on the individual's ability to succeed in the training program.

 Cases being considered for an academic degree program must be staffed with the District Manager and peer counselors before developing a plan for post-secondary education. (District Managers, at their discretion, may exempt senior counselors from this requirement. This does not exclude them from participating if they feel it is helpful in making a decision on a particular case.)

 Only one semester should be planned initially for students beginning college (community/senior) for the first time. Further plans may be made after the successful completion of this trial semester. The mid-semester grades should be used to project this since the final grades will not be available in time to plan for the next semester.

Graduate School

If the client's chosen employment objective requires an advanced degree for the entry level of his/her employment objective, the Agency may assist him/her in a graduate program. This should be planned for on the IPE when the employment objective is agreed upon between the client and counselor. Again, this employment objective should reflect the individual's interests and informed choice to the extent these factors are consistent with his/her strengths, resources, priorities, concerns, abilities, and capabilities.

3.14.2 Accreditation Standards

The Agency will not authorize funds to an institution (school) that is not accredited, licensed, or approved by the appropriate accrediting or licensing authority. Schools with provisional accreditation may be used. However, the counselor is to use caution when a client selects to attend one of these schools. If a school loses its accreditation during the school year, the counselor is to notify the client immediately and the Agency funds will cease at the end of that semester. Before sponsoring a client at any institution (including private and/or out-of state institutions, short term training programs, and correspondence courses) that does not appear on

the listing provided by the Mississippi Institutions of Higher Learning (located at the end of this sub-section), the counselor should contact the State Coordinator for Post-secondary Education Services for further investigation of the school's accreditation status.

The Mississippi Institutions of Higher Education has provided the Agency with the following list of schools that are approved by the Mississippi Commission on College Accreditation, and fully accredited members of the Commission on Colleges of the Southern Association of Colleges and Schools for the current school year:

INSTITUTION LOCATION CONTROL TYPE 1. Alcorn State University Lorman State Senior 2. Belhaven College Jackson Presbyterian Senior 3. Blue Mountain College Blue Mountain Southern Baptist Senior 4. Coahoma Community College Clarksdale Public Community 5. Copiah-Lincoln Community College Wesson Public Community 6. Delta State University Cleveland State Senior 7. East Central Community College Decatur Public Community 8. East MS Community College Scooba Public Community 9. Hinds Community College Raymond Public Community 10. Holmes Community College Goodman Public Community 11. Itawamba Community College Fulton Public Community 12. Jackson State University Jackson State Senior 13. Jones County Junior College Ellisville Public Junior 14. Magnolia Bible College Kosciusko Church of Christ Senior 15. Meridian Community College Meridian Public Community 16. Millsaps College Jackson Methodist Senior 17. Mississippi College Clinton Southern Baptist Senior 18. MS Delta Community College Moorhead Public Community 19. MS Gulf Coast Community College Perkinston Public Community 20. Mississippi State University MS State State Senior 21. Mississippi University for Women Columbus State Senior 22. Mississippi Valley State University Itta Bena State Senior 23. Northeast MS Community College Booneville Public Community 24. Northwest MS Community College Senatobia Public Community 25. Pearl River Community College Poplarville Public Community 26. Reformed Theological Seminary Jackson Independent Graduate

27. Rust College Holly Springs Methodist Senior 28. Southwest MS Community College Summit Public Community 29. Tougaloo College Tougaloo A.M.A. Senior 30. University of Mississippi University State Senior 31. University of MS Medical Center Jackson State Senior 32. University of Southern MS Hattiesburg State Senior 33. William Carey University Hattiesburg Southern Baptist Senior

The following institutions hold full accreditation with the Mississippi Commission on College Accreditation and full accreditation with the Association of Biblical Higher Education:

34. Southeastern Baptist College Laurel Baptist Missionary Senior

The following institutions hold full accreditation with the Mississippi Commission on College Accreditation for the current school year, based upon its full accreditation with the Commission on Accrediting of the Association of Theological Schools:

35. Reformed Theological Seminary Jackson Interdenominational Graduate 36. Wesley Biblical Seminary Jackson Interdenominational Graduate

The following institutions hold full accreditation with the Mississippi Commission on College Accreditation and full accreditation with the Southern Association of Colleges and Schools- Commission on Colleges that offer limited courses/programs at a specific site in Mississippi.

37. Crichton College Olive Branch, Southaven Private (TN) Senior Horn Lake 38. Embry-Riddle Aeronautical University Biloxi Private (FL) Senior 39. Faulkner University Corinth Private (AL) Senior 40. Loyola University - Institute of Ministry Biloxi Diocese Catholic (LA) Graduate 41. Loyola University - Institute of Ministry Jackson Diocese/ Catholic (LA) Graduate St Mary's Parish, Natchez 42. Saint Leo University Columbus AFB Private (FL) Senior 43. Tulane School of Continuing Studies Biloxi Independent (LA Senior

The following institution hold provisional accreditation with the Mississippi Commission on College Accreditation and full accreditation with the Southern Association of Colleges and

Schools-Commission on Colleges to offer limited courses/programs at a specific site in Mississippi.

44. Tulane School of Continuing Studies Madison Private (LA) Senior

The following institution holds full accreditation with the Mississippi Commission on College Accreditation and full accreditation with the North Central Association of Colleges and Schools that offer limited courses/programs at a specific site in Mississippi.

45. University of Phoenix Ridgeland Private Graduate

The following institution holds full accreditation with the Mississippi Commission on College Accreditation and full accreditation with the Middle States Commission on Higher Education to offer limited courses/programs at a specific site in Mississippi.

46. Strayer University Jackson Private Graduate

3.14.3 Client's Responsibility

At the time a plan for post-secondary education is written, the client is to be provided a copy of the Standards for the Agency Sponsorship in Post-Secondary Education (PSED-01) form explaining what is expected of him/her during the training period. The counselor should explain the information listed on the form and ensure the client thoroughly understands his/her responsibilities and that any exceptions must be approved by the counselor before registration. The client is to sign the form acknowledging his/her agreement. The original form is to be kept in the case file and the client provided a copy.

Individual exceptions for disability accommodations and special circumstances may be considered on a semester by semester basis. Any exceptions made to the standards require a written justification by the counselor and must be reviewed by the District Manager.

3.14.4 Liaison Counselors/Case Transfer

Mississippi State University (MSU), the University of Mississippi (UM), and the University of Southern Mississippi (USM) have designated liaison counselors. A rehabilitation counselor for the deaf (RCD) is assigned to serve as liaison for deaf and hard of hearing clients attending Hinds Community College (HCC). A client's case is to be transferred to the liaison counselor only if he/she needs ongoing (other than academic) vocational rehabilitation services while attending school. Otherwise, the client's case is to be kept by the counselor serving his/her hometown area.

Exceptions: Case files on all OVRB clients attending MSU and all deaf and hard of hearing clients attending HCC are to be transferred to the appropriate liaison counselor. Additionally, OVR clients outside the local district who are attending MSU and receiving support services through our contract with MSU's Student Support Services Office are to be transferred to the OVR liaison counselor.

Cases being transferred to a post-secondary liaison counselor are to be peer staffed, the IPE developed, and the client explained his/her responsibilities before the transfer. The case is to be sent to the liaison counselor at least one month prior to the start of school to allow time for him/her to issue all required authorizations.

3.14.5 Support Services

Support Services may be defined as any service or device that assists the individual in overcoming deficiencies caused by his/her disability. In the post-secondary education setting, these services should facilitate the student's ability to learn and affect his/her understanding of the course work he/she is taking.

Although the school has primary responsibility for ensuring the student is allowed full participation in the class, the counselor should work closely with Student Support Services at the school to be certain the client receives the assistance he/she needs to be successful. Typically the school would be responsible for anything which would make the class accessible (i.e., textbooks, handouts, alternate testing methods, etc.). However, exceptions may be made for services such as interpreters. Specific support services to be provided should be included on the client's Individualized Plan for Employment. Long range planning is critical in ensuring sufficient time is allowed so that materials (text books in Braille, on computer, on tape, etc.) or other special services the client needs are ready and available at the beginning of each semester.

Documentation for payment of support services should be submitted monthly on a Support Service Log (PSED-02) form along with a copy of the Authorization/Statement of Account. It should show the numbers of hours per day services were provided, the specific course for which assistance was being provided, and be signed by both the student and provider of the services. In cases where service provision is arranged by the school, an official representative of the school should also sign the form. The hourly rate paid to the provider of the services is outlined in the Agency Fee Schedule. The PSED-02 (which includes the client's signature) is to be attached to the Statement of Account when sent to Finance for payment.

Individual exceptions for disability accommodations and special circumstances may be considered on a semester by semester basis. Any exceptions made to the guidelines provided in this subsection require a written justification for case documentation by the counselor and must be reviewed by the District Manager.

Examples of PSED Support Services:

Assistive Technology Service - Assistive Technology is defined as the application of technology to alleviate barriers that interfere with the lives of persons with disabilities and open doors to employment. Assistive technology assessment should be considered for any student with obstacles identified that will require a specific support service(s) in order to successfully complete his/her course of study. This will enable the client and counselor to consider the most effective and cost-efficient method to assist the student. In some cases, it may be more

effective and less costly in the long run to purchase a piece of adaptive equipment to assist the client than to pay for individual services (i.e., readers).

When purchasing adaptive equipment, the general policy of the Agency is to assist with those necessary devices that are personal in nature and would be kept by the student. Items that make the classroom accessible are considered the school's responsibility.

Tutorial Services - Agency sponsored tutorial services are considered to be the provision of any tutorial hours above those provided at no cost by the institution to all students. The need for these additional hours should be well justified. Agency sponsored tutorial services will consist of an individual working one-on-one with the client to explain specific portions of the course work which the client is having difficulty understanding. It should not constitute re-teaching the entire class. Tutoring is to be provided by a person who is taking or has completed the course, demonstrates a knowledge of the material, is able to communicate this knowledge effectively, and is approved (either verbally or in writing) by an official representative of the institution. A total up to 20 hours of tutorial services per month may be authorized as needed to be determined by the individual client's disability and the nature and content of the courses being taken.

Reader Services - Reader services mean a literate, intelligible (plain-speaking) individual reading to the visually impaired printed material which is not available in an accessible format (Braille, large print, tape recording, computer disk, etc.). A total up to 40 hours of reader service per month may be authorized as needed. Individual needs and differences, including the nature and content of the course work, should be considered in planning reader services. The school will locate, hire, and pay the reader. VR will reimburse at the rate established in the VR Fee Schedule for classroom activities or other hours directly associated with academic studies.

Note Taker Services - Class notes may be obtained through various methods: provision of copies by the professor, use of augmentative devices (i.e., tape recorders), or accessing copies (carbon or photo) from a classmate. If these methods are not available, the Agency could assist in paying for note taker services up to the actual number of hours in the classroom.

Interpreter Services (Sign or Native Language) - Interpreter services are limited to the actual number of hours in the classroom or in planned tutorial sessions and are to be provided by a qualified Interpreter. A qualified Interpreter is an individual who is proficient enough in the client's primary language and knowledgeable enough in the course terminology to communicate the presented information effectively (in an understandable manner) to the client. Proficiency may be demonstrated by the Q.A. or certification level of the Interpreter and the student's acknowledgment that he/she understands the Interpreter. The school will locate, hire, and pay the interpreter. VR will reimburse at the rate established in the VR Fee Schedule for classroom activities or other hours directly associated with academic studies.

Other Technical Assistance Services - These services consist of any other special assistance needed to help the client successfully complete the course of study (e.g., locating library research materials for individuals who are blind and/or transcribing technical data into Braille, large print, computer format, etc.). A total up to ten hours of other technical assistance services per month may be authorized as needed.

Contract with Mississippi State University Student Support Services:

The Agency contracts with MSU to recruit, select, train, and compensate personal care attendants, readers, tutors, etc. for those clients in need of such support services. Services are provided, as needed by the client, approved by the Agency counselor, and in accordance with the contract between the Agency and MSU. The PSED-02 form is not needed for services covered under this contract.

3.14.6 Guidelines for Payment

3.14.6.1 Comparable Benefits for PSED

All post-secondary education expenses must be itemized on the IPE and appropriate comparable benefits applied to these costs. These benefits include PELL or other grants and non-merit scholarships. Any other funds the student receives for the cost of training, which do not have to be repaid, are to be counted. Loans, merit awards/scholarships, and work-study income are not to be considered as comparable benefits. (Further information may be found in the Comparable Benefits section of this Resource Guide.)

Every client seeking support for training in a post-secondary education program must apply for all grants available, including the PELL Grant. The counselor must be provided documented proof of grant application prior to agreeing to sponsor a client in training. The counselor should advise clients in high school, who plan to enter a post-secondary education program, to apply for financial aid early in their senior year. Even if a client has applied for and been denied a grant previously, the client must reapply each year.

There have been instances when the institution's Financial Aid Office only considered the PELL Grant because the Agency was paying the balance. Denying the client access to other financial aid for which they may be eligible is a violation of the Rehabilitation Act. The individual being an Agency client has no bearing on the amount of assistance for which he/she is entitled. In order to prevent this from happening and to determine all available comparable benefits the following procedures are to be followed:

 The counselor is to submit to the Financial Aid Office the Financial Aid Transmittal Document (VR-35) form with Part I completed and signed by the client.

 Part II of the VR-35 is to be completed by the Financial Aid Officer and returned to the counselor.

 The counselor is to complete Part III of the VR-35, send the original copy to the Financial Aid Office, and keep a copy in the client‘s case file.

 The counselor is to consult with the Financial Aid Officer regarding any other available grants that the client may be entitled.

The colleges and universities have different grant application deadlines. The counselor is responsible for contacting the individual school for and advising the client of the appropriate grant application deadline.

The counselor should not supplement grants, scholarships, and/or other comparable benefits in excess of the actual costs for tuition, room, and books. If the amount of the client's financial aid exceeds these costs, the excess is to be applied toward remaining training expenses.

The counselor is to authorize to the institution for payment of tuition, dorm, books, and other expenses identified in the IPE well in advance of the registration date. If the enrollment deadline requires authorization prior to the client receiving notification of grant award, the counselor may do so as long as the client's file contains evidence of grant application. Once the grant(s) is received, the school/client must reimburse the Agency for any costs covered by the grant award or cancel the authorization, if appropriate. Expenses for the following semester will not be authorized until this reimbursement has been made.

If a client is in default of a Title IV loan and denied a PELL Grant, then they are not able to access a comparable benefit. Clients who are in default should be advised to proceed to clear their default status by making arrangements to repay the loan. The client is required to provide the counselor documentation of his/her efforts to remove the default status. A determination to provide the Agency assistance can only be made on an individual basis after careful examination of all the circumstances involving the default status and the individual's financial situation. Default status can be cleared if the holder of the loan certifies, for the purpose of reinstating Title IV eligibility, the borrower has made satisfactory arrangements to repay the defaulted loan, or the loan is discharged in bankruptcy. (This is in accordance with RSA Policy Directive 92- 02.)

3.14.6.2 In-State Public PSED Institutions/Schools

 Academic, Business, Technical, or Vocational Training (Approved fees, provided by the Institutions of Higher Learning and Community College Board, will be transmitted in memorandum form annually.) The Agency will pay the actual costs allowed for tuition, dorm, and books less comparable benefits/client participation.

 Housing - Off Campus If the client relocates to attend the institution and chooses to live off campus, the Agency will pay the housing cost less comparable benefits. The Agency payments for the combined total of housing and transportation are not to exceed the dormitory fee allowed at that particular institution. Individual exceptions for disability accommodations and special circumstances may be considered on a semester by semester basis. Any exceptions made to these guidelines for payment require a written justification by the counselor for case file documentation and must be reviewed by the District Manager.

Housing costs not paid directly to the school should be authorized under the service area - Maintenance: Room/Board/Personal Items-Housing/Lodging. Only housing costs paid to

the institution should be charged to the service area - Maintenance: Training-Related - Dormitory.

 Transportation - Day Students Agency may authorize the cost of transportation up to the current state authorized rate per mile less comparable benefits. The Agency payments for the combined total of housing and transportation are not to exceed the dormitory fee allowed at that particular institution. Individual exceptions for disability accommodations and special circumstances may be considered on a semester by semester basis. Any exceptions made to these guidelines for payment require a written justification by the counselor for case file documentation and must be reviewed by the District Manager.

 Other Training Related Expenses Course-required books, training materials (audio cassettes, video cassettes, and special software), tools, and fees may be provided at the actual cost less comparable benefits/client participation. Documentation verifying the need for these items is required from the school.

3.14.6.3 Private or Out-of-State PSED Institutions/Schools

 Academic ,Business, Technical, or Vocational Training - Agency will pay the institution‘s fees up to the maximum that would be allowed for that individual for tuition, dorm and/or books if taking a comparable program at a Mississippi public institution, less comparable benefits. The client is responsible for any balance.

Examples:

1. 3000 1200 500 700 Institution‘s Tuition Max In-State Tuition Comparable Benefits Agency Pays

2. 400 500 100 300 Institution‘s Dorm Max In-State Dorm Comparable Benefits Agency Pays

 Gallaudet University and the National Technical Institute for the Deaf (NTID) - These are the only national, fully accessible post-secondary institutions for the deaf. They are funded by federal legislative appropriations for this purpose. Gallaudet is a liberal arts college located in Washington, D. C. NTID is a technical school located at the Rochester Institute of Technology in Rochester, NY. There are no comparable institutions in the State. The Agency will treat them as it does an in-state university. The Agency will pay the actual costs of tuition, dorm, and books less comparable benefits/client participation.

 The guidelines listed under In-State Public Institutions are to be applied to all other fees.

NOTE: The Mississippi Institutions for Higher Learning may provide financial assistance to individuals attending out-of-state programs if that particular curriculum is not available in Mississippi.

3.14.6.4 Non-Semester Programs

All in-state, public institutions operate on a semester schedule. In order to determine the allowable costs for programs that operate on a different schedule (quarter, trimester, etc.), the following procedure should be followed:

a. Divide the maximum allowable in-state fee by 16 (number of weeks in a semester) to get a weekly rate. b. Multiply this weekly rate by the number of weeks in the private or out-of-state program to get the amount allowed for the quarter, trimester, etc.

3.14.6.5 Summer Sessions

Unless State Office advises otherwise by May 1 each year, summer sessions will be allowed. The same guidelines are to be applied to summer sessions that are required for a regular semester.

3.14.6.6 Correspondence Courses

A client may be sponsored in a correspondence course(s) if it is approved by the Department of Education within the state out of which it operates. (The State Coordinator for Post-secondary Education Services will assist in determining the course's approval status.) If the course is offered at an in-state public institution, the counselor is to staff the case on an individual basis with the District Manager. Approved in-state fees for a comparable program (community or senior college) should not be exceeded.

3.15 PROGRAM EVALUATION SYSTEM

Program evaluation is a systematic method of analyzing the degree to which the Mississippi Department of Rehabilitation Services (MDRS) is complying with its approved State Plan to carry out the provisions of the Rehabilitation Act of 1973 as amended by the Rehabilitation Act Amendments of 1998. In carrying out these federally mandated requirements for monitoring and review, the following activities and/or reviews are indicated.

 Compile quarterly and annual statewide assessments of the rehabilitation needs of individuals with significant disabilities

 Conduct statewide case reviews for compliance with state and federal regulations

 Evaluation of state policy/procedures relevant to MDRS

 Quarterly review of the strategic management plan for program evaluation

 Participation in the development of the state plan and attachments

 Review of special programs and other projects/case evaluations as requested by MDRS Administration

 Caseload management and follow-up reviews for implementation of corrective actions

 Conduct OVR/OVRB Quarterly and Annual Evaluation Report

 Conduct ILS-OVRB Quarterly and Annual Evaluation Report

 Analyze caseload data

 Evaluate compliance with standards and performance indicators

 Participate in annual casework training for new OVR and OVRB counselors

 Participate in other casework training sessions for various MDRS programs as requested by administration

 Conduct annual OSDP Consumer Satisfaction Survey

3.16 PSYCHOLOGICAL SERVICES

To refer a client for a psychological evaluation, the counselor should complete a Psychological Evaluation Referral (VR-12) form, and send it to the psychometrist assigned to his/her district (each district has its an assigned psychometrist who works under the guidance of VR Psychological Services Director). It is very important that all previous psychological, psychiatric, relevant medical, educational, and relevant social information be included with the referral. The psychometrist will respond to the counselor with a Psychological Referral Response Report (VR-12a) form, a memo, or phone call, stating the date, time, and location that the client can be evaluated. The psychometrist will contact the client by letter and inform him/her where and when to report for the evaluation. When the counselor discusses the scheduled evaluation with the client, it is generally best not to mention "tests", "psychometrist", or "psychologist," since these terms can be disconcerting to some people. A better phrase to use is "...evaluation of your strengths and weaknesses".

Once the evaluation is complete, the psychometrist will score, interpret, and write a report explaining the test findings. This report is then sent to the psychologist in the Agency State Office for review and signature. If needed, an addendum is written by the psychologist and sent to the counselor as a part of the report. This information is confidential and should only be shared with other agencies or individuals in accordance with Agency policy.

Psychological evaluations are usually helpful or necessary in determining problem areas such as mental retardation, specific learning disabilities, psychoses, neuroses, character disorders, personality disorders, alcohol abuse or dependence, drug abuse or dependence, poly-substance abuse or dependence, perceptual-motor problems, memory problems, or clients' vocational interests.

Questions regarding psychological services should be directed to the appropriate local psychometrist, or if this person cannot be reached, the Psychologist in the VR State Office.

3.16.1 Report Retention

Psychological reports generated by vocational rehabilitation psychometrists or the Agency psychologist may be destroyed once the reports are three years old, provided the psychometrist or psychologist has not been notified that the report(s) is in litigation or under review. Work papers such as test answer sheets or work sheets may be destroyed after they are one year old provided the report(s) is not in litigation or under review.

3.16.2 Guidelines for Retesting

Vocational rehabilitation clients with appropriate psychological on file only need to be retested when an area in which they were tested earlier may have changed. For example, a client previously tested who has since had a head injury, stroke, etc., would need to be retested with the intelligence test (Wechsler), as well as with the achievement test (Wide Range Achievement Test), the Adaptive Behavior Test (ABAS), and the Bender Gestalt Test to see if there has been a decrease in functioning in any of these areas. If academic achievement level is a pertinent factor in the case, a client who has had additional education or academic training since the last psychological would also need to be retested with the achievement and adaptive behavior tests to see if functioning in these two areas has changed.

Regarding secondary students in special education who are referred to VR or are VR clients, VR will rely on the schools for test results for eligibility purposes. The school psychological/psychometric report as well as a current certification or re-certification form should be included in the client‘s case file. Former special education students (no longer in school) who are self-referred to VR or are referred from a source other than school, should be retested if test results are not available or are out-of-date (the client has had at least one year of additional schooling since the last evaluation). Clients who have had personality measures should be retested as the various conditions dictate. The large number of psychological disorders requires that each case be handled individually. Generally, the counselor may request the client be retested with the psychological measure if he/she feels the client's condition has changed.

Theoretically, one's Intelligence Quotient (IQ) remains relatively unchanged throughout life. An IQ Score obtained from the WISC-R or WISC-III (given ages 6 through 16) is just as accurate as an IQ score obtained from the WAIS-R or WAIS-III (given ages 16 through 74). Counselors may use Stanford-Binet IQ scores. However, clients who are to be evaluated by VR evaluators may require retesting, upon request, by a VR psychometrist so the evaluator will have the Wechsler Subtest Scaled scores necessary to run the McCarron-Dial computer program.

3.16.3 Classification & Coding Of Mental Retardation

The American Association on Mental Deficiency developed the definition of mental retardation

used by RSA in 1961. This reads as follows:

Mental retardation refers to sub-average intellectual functioning which originates during the development period and is associated with impairment in adaptive behavior. This may be reflected in:

A. Maturation: rate of sequential development of self-help skills of infancy and early childhood

B. Learning: the facility with which knowledge is acquired as a function of experience

C. Social Adjustment: the degree to which the individual is able to maintain himself or herself independently in the community and in gainful employment as well as by his or her ability to meet and conform to other personal and social responsibilities and standards set by the community.

As so defined, sub-average general intellectual functioning refers to performance on an individual test of intelligence which is more than one standard deviation below the mean or an IQ Score of 84 on the Wechsler and 83 on the Stanford-Binet. (The standard deviation on the Wechsler is 15 while the Stanford-Binet is 16). It is, however, important to note that a measured intelligence quotient in and of itself is insufficient diagnostic evidence of the existence of mental retardation and that the presence of maladaptive behavior associated with subnormal intellectual functioning must also be established. It is this factor of maladaptive behavior which is particularly important in determining whether an individual who achieves an IQ in the 70-84 range may or may not be classified as mentally retarded since many people in this borderline area may neither experience any particular problems or adjustment nor demonstrate any evidence of maladaptive behavior.

It is the behavioral component of mental retardation rather than the measured intelligence quotient which is meaningful in determining the individual's need for vocational rehabilitation services as well as his or her ultimate employment potential on the completion of such services. At the same time, it must be realized that the IQ can be of great importance to the counselor, especially in evaluating the client's readiness for academic training. The IQ should be obtained on the basis of an appropriate individual intelligence test administered by a qualified psychologist or psychometrist in all cases where the existence of mental retardation is suspected.

As an indicator of severity of retardation, impairment in adaptive behavior is used as the basic criterion for classifying mental retardates into three (3) levels of functioning: Mild, Moderate, and Severe. Those sometimes termed profoundly retarded are generally found in institutions where they must receive continuing care and supervision, are incapable of gainful employment and, thus, not suitable candidates for vocational rehabilitation.

For coding purposes, the three levels may be described as follows:

Mild: Persons who, with the provision of appropriate rehabilitation services, can become capable of independent living in the community and engage in

competitive employment. Generally, they will require supervision and guidance only under conditions of particular social and economic stress. Code as 530

Moderate: Persons capable of maintaining themselves in the community and performing adequately in low-demand competitive employment, but who will require continuing supervision and assistance in the management of personal affairs. Code as 532

Severe: Persons capable of productive work but only under sheltered, non-competitive conditions in a protective environment. Code as 534

There are problems inherent in the practical application of any classification system based on adaptive behavior. There are no objective scales that will determine with reasonable objectivity the functioning level of adaptive behavior to which a person should be assigned. It will be necessary for the counselor, with assistance from the psychologist, to use judgment to properly classify MR clients. The following sources of information may be considered to help make such decisions: personal client observations, review of all available case history, results of medical/psychosocial/vocational evaluation, reports from schools, and other sources who have provided services to the individuals.

3.16.4 Eligibility Guidelines (ADHD & SLD)

Attention Deficit Hyperactivity Disorder (ADHD):

The following guidelines shall be considered when determining eligibility for VR services for individuals diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD).

I. The diagnosis must be made and the accommodations prescribed by a professional trained in the diagnosis and treatment of ADHD (i.e., school psychologist, certified or licensed psychologist, psychiatrist, pediatrician, or psychologist employed by a state agency).

II. The ADHD must pose a substantial impediment to employment (i.e.; without accommodations person was unable to maintain a "C" average in school).

III. There must be a documented history of the person receiving the necessary, prescribed treatment/accommodations and, with such, being able to succeed (maintain a "C" average) in high school for at least one year prior to application for VR services.

Specific Learning Disorder (SLD):

The following should be considered when determining eligibility for VR services for someone who is diagnosed as SLD:

I. Generally, SLD is identified when the achievement test score(s) is fifteen (15) points or more below the Full Scale IQ score.

II. The area of the SLD poses a substantial impediment to employment. Reading is an example of the most common and vocationally limiting learning disability. Other examples of areas of SLD that may be served are Reading Comprehension or Written Expression. A client with an SLD in arithmetic may be served on rare occasions. A client with an SLD in spelling will rarely, if ever, be considered to have a substantial impediment to employment.

III. The SLD is significant enough to justify the Agency‘s help. The achievement standard score in the area of the SLD is no higher than 84 on individual achievement tests such as the Wide Range Achievement Test - III (WRAT-III) or at least one standard deviation below the mean on individual achievement tests with standard deviations other than 15.

3.17 TRANSITION PROGRAM (Secondary Education)

MDRS has been actively involved in working with eligible secondary school students with disabilities since 1962. The Agency has a commitment to provide a comprehensive program of services that will enable students with disabilities to make a seamless transition from school to work. In order to effectively meet the needs of these students, the Agency maintains a Memorandum of Understanding (MOU) with the Mississippi Department of Education (MDE). The Agency assigns VR Counselors to work with specific high schools to provide transition services in accordance with the following federal laws:

 Rehabilitation Act of 1973, as amended;

 The Carl D. Perkins Vocational and Applied Technology Act, as amended; and,

 The Individuals with Disabilities Education Act, as amended.

3.17.1 Agreement of Cooperation

In addition to the MOU with MDE, the Agency maintains individualized agreements between the local school districts and vocational rehabilitation offices. These agreements define referral procedures and the roles of the school and VR staff in the provision of transition services that are specific and tailored to the unique situation of each school and VR district.

Each VR Transition Counselor is responsible for developing and maintaining an agreement between the Agency and local school district. A copy of the form to be used for this agreement may be obtained from the State Coordinator for Transition Services. The form includes instructions and has been designed to assist in the development of the agreements locally.

Pages 1 and 2 of the form are generic (standard contract language). The VR Counselor will photocopy these pages and use them exactly as they are written with the name of the school district typed on the blank line.

Page 3 should begin with item number 10 (the Agency and (school district) further agree to the following procedures. The VR Transition Counselor and local school district personnel should jointly develop this section. The form includes examples which are provided as guidelines only to assist in the preparation of the individualized local agreement. The agreement should specify which agency is responsible for various activities; it can be as specific as needed. For example, the names of individuals who will be responsible for various tasks may be named, or they may be referred to by job titles instead. In individualizing these agreements, it will become apparent that there are several ways to handle referrals, etc. The form should be individualized according to the procedures that are established between the VR Transition Counselor and local school district personnel. If services are being provided at one of the Agency‘s CRP‘s the Facility Manager should be involved in developing and sign off on the school agreement. It is desirable to have a representative from the school accompany students to the CRP to assist with supervision, discipline, and instruction when possible. It is required that schools provide transportation to the CRP for students. This should be kept in mind when negotiating the Transition Agreements between the Agency and local schools. Item 10 may contain as many pages as needed, however, please number subsequent pages.

The signature page may be photocopied and filled in (include the page number at the top in the sequence in which it occurs).

The agreement may be developed with either an individual school or a school district that may include more than one school. However, MDE has requested that the Superintendent of the local school district sign the agreement. A copy of the agreement may be given to the local schools if appropriate.

The VR District Manager should approve and sign the original agreement. The VR District Office should keep the original agreement and provide copies to the School or School District and MDRS State Office (mail to the attention of the State Coordinator for Transition Services).

The agreement should be reviewed annually and updated if needed.

3.17.2 Identification of Secondary Students

At the time a student is placed on roll, the information is entered into AACE, MDRS‘ caseload computer system, to allow students to be tracked throughout the rehabilitation process. In order for these students to be tracked successfully, it is critical that counselors complete the fields on the ―Special Programs‖ and ―Personal Information‖ pages in AACE, which will indicate this is a transition case. When students leave the school system they continue to be enrolled in the VR system until such time that the individual is successfully rehabilitated or until their case is closed for reasons other than successfully rehabilitated.

3.17.3 Transition Planning

Transition planning activities may include: (a) IEP development, (b) vocational/career counseling and guidance, (c) sharing information about the availability of VR services to individuals or groups, (d) receiving referral information, (e) meeting with students and their

parents and/or representatives for the purpose of initiating intake procedures and explaining services, (f) evaluation and assessment, (g) career exploration services, (h) job search skills, (i) consultation and technical assistance, and (j) any other appropriate activities to assist the school or the student in preparing students for transition from secondary to post-secondary school training or work.

Counselors can accept applications on students while they are in the first semester of the junior year, as appropriate, to ensure completion of all intake and evaluation procedures and implement plan prior to graduation.

MDRS may provide services to eligible students with disabilities who are juniors, age 17 or older as outlined in the local school agreements. Counselors should be aware of and utilize all comparable benefits and what the local school can and is providing so not to duplicate services. In planning transition services for students, the IPE for a student determined to be eligible for vocational rehabilitation services must be developed and approved (i.e., agreed to and signed by the individual/representative and the counselor) before the student leaves the school setting and as early as possible during the transition planning process. The vocational component of the student's IEP should be monitored by the counselor to ensure collaboration with the school district on his/her IPE with respect to vocational goals and objectives. A copy of the student's IEP should be placed in the VR client file for that student.

Once the student leaves the school system, it becomes the full responsibility of the VR Transition Counselor to continue to provide services necessary to further prepare the individual for work and/or provide job development and placement in permanent employment that satisfies the goals and objectives of the IPE.

3.17.4 School-Based Transition Services

Career Exploration and Employability Skills Program

The VR Transition Counselor should work with the classroom teacher to implement a career exploration curriculum for students with disabilities including students who are participating in an occupational diploma course of study. Any student with a disability may participate in the career exploration program including those who are not VR clients. Each student should sign the roster when participating in the Career Exploration and Employability Skills Program. The column listed, ̳‘other students’’, should be signed by participants that are not VR clients.

The VR Transition Counselor is prepared to teach the curriculum and will do so as agreed upon with school personnel. In addition to being prepared to teach the curriculum, the counselor will provide the classroom teacher with information, technical assistance, and/or Career Exploration and Employability Skills Program curriculum materials as needed.

The VR Transition Counselor should document the student‘s progress in AACE case notes. Case notes should show progress in various areas of performance as described on the student's IPE. The VR Transition Counselor should provide the classroom teacher a report of the student‘s

participation and progress in the Career Exploration and Employability Skills Program on a regular basis.

Transition Specialist Program

MDRS and the local school district may enter into a Cooperative Agreement to jointly fund a Transition Specialist position to ensure a smoother transition of services between the school and VR. The Transition Specialist will provide services to selected secondary students with disabilities who are (a) in their exiting year of school, (b) in transition from school to work and community and, (c) eligible for vocational rehabilitation services. The addition of school-based transition services is intended to add a component to the overall school and rehabilitation service continuum, not supplant any existing employment-related or other services which are potentially appropriate for a particular student (any service the school is already responsible for providing). The Transition Specialist will not serve students who with or without modifications can benefit from existing school programs (career/technical and educational training programs, vocational education, etc.). The intended target student populations for receipt of services from the Transition Specialist are students who are (1) in their exiting year of school, (2) clients of vocational rehabilitation, and (3) require services that are more intensive.

The Transition Specialist will develop permanent jobs for students within the community and will provide temporary job-related support activities that are necessary to obtain and maintain employment. The Transition Specialist will coordinate all activities with, and provide monthly reports to the VR Transition Counselor as well as school personnel. The VR Counselor will provide program coordination and technical assistance as needed by the Transition Specialist, as well as providing oversight of the agreement for the position with the school.

3.17.5 Evaluation and Training

Regular Vocational-Technical Training

Some students with disabilities will participate in regular Vocational Technical Programs (Vo- Tech) such as welding, auto mechanics, auto body repair and etc. Students who are participating in a regular Vo-Tech program for part of the day and have academic classes the remainder of the day should not be offered services at a CRP as an option. For students who are in a regular Vo- Tech program the entire day and are allowed by the school to attend a CRP may do so when appropriately planned with the CRP facility manager.

Vocational Assessment

A vocational assessment helps to determine a student‘s abilities, limitations, interests and potential for training or towards a vocational goal. Students should proceed with having a vocational assessment to aid in development of the IPE. The VR counselor or other designated Agency personnel should be able to conduct an assessment of a student through vocational testing, work observation or generalized counseling and guidance. An appropriate assessment should be obtained prior to a student receiving Agency sponsored training. The counselor should seek any preexisting data which may include school records, information from the individual, the

family or representative of the individual, prior evaluations and other documents that address questions regarding eligibility and the vocational rehabilitation needs of the individual.

The VR counselor may choose to utilize a CRP to obtain the vocational assessment. Vocational assessments provided through a CRP, such as AbilityWorks, Inc, should be provided at the most optimum and convenient location – the assessment may be conducted at the facility, the local school, an MDRS office or other community locations.

Work Evaluation/Job Readiness Training

Counselors should inform school personnel that the CRP may provide up to a 6 week work evaluation which may begin during the junior school year. After the work evaluation is completed, recommendations can help determine the services the student needs. Job Readiness training may be planned and provided for each student individually as needed and appropriate and based on the availability of openings at the CRP.

The U.S. Department of Labor (DOL) mandates that an individual be disabled for work performed at a CRP in order to be paid subminimum wage. An appropriate assessment is required prior to the student receiving paid work experience and should show how the disability impairs the student‘s productivity on work assignments at the CRP.

The counselor will provide to the CRP records from school and/or other pertinent sources (medical physician, pediatrician, psychologist, psychiatrist and etc.), documentation of a disability and how it interferes with the student‘s employment potential. The CRP must determine if the student is able to perform work at the CRP based on the documentation of the disability. Should the prior assessment not specifically address this issue, a new vocational assessment will need to be obtained prior to entrance into Work Evaluation/Job Readiness Training. Everyone being served at an AbilityWorks is covered by Workers' Compensation during the time they are on payroll.

NOTE: The VR Transition Counselor should communicate regularly with the AbilityWorks Facility Manager to keep him/her informed of the number of potential referrals and be advised of the availability of work. Counselors should not make promises of any CRP services to students without reasonable assurances that the CRP will be accessible. (Accessible means access to transportation by the school, presence of sufficient CRP staff to provide adequate supervision, and availability of adequate amount and appropriate types of contract work.)

On-The-Job Training (OJT)

OJT may be developed occasionally with a student who is in the last few weeks or months of their school program. (Refer to Section 3.11.4) There is always an employee/employer relationship in an OJT program. The VR Transition Counselor and the employer (trainer) agree upon a fee that the Agency will pay for the training (usually on an hourly basis). It is the employer's responsibility to pay wages, taxes, Workers' Compensation, etc. on the client the same as with any other employee.

Other Work/Training Activities

There may be other types of work/training activities in which students have opportunities to participate such as internships, apprenticeships or volunteer activities. The counselor should encourage students to participate in all such experiences available to them during their school program. As with all other training programs provided to students, once they leave the school system, it becomes the full responsibility of the VR Transition Counselor to provide services necessary to prepare the individual for work and/or provide job development and placement in permanent employment that satisfies the goals and objectives of the IPE.

3.17.6 Occupational Diploma

In accordance with Senate Bill No. 2578 of the Mississippi Legislative Session of 2001, MDE developed criteria for an occupational diploma for students with disabilities. This diploma option expands the opportunities available for special education students to the following:

 Academic course of study aimed at obtaining a regular high school diploma,  Occupational course of study aimed at obtaining an occupational diploma,  Graduation Certificate as specified by Mississippi Code 37-16-11, or  General Education Equivalency Certificate (GED)

Students choosing to participate in the occupational course of study must have 20 course credits, career/technical requirements, and an approved portfolio containing a collection of evidence of the student‘s knowledge, skills, and abilities related to the occupational core curriculum. The primary postgraduate goal for these students is competitive employment.

The career/technical requirements consist of 540 hours of successful, paid employment OR successful completion of a two (2) year career/technical (Vocational) program. This requirement, which will consist of work experience, job shadowing, pre-vocational experiences, etc., will be completed within the realm of the educational system. If there are other services (such as vocational counseling and guidance, Career Exploration and Employability Skills Program and jointly sponsored Transition Specialist services) needed to assist a student on this diploma track, the VR Transition Counselor may provide appropriate services in order to serve the student.

Students on track for an occupational diploma may also attend a CRP. The counselor should consult with the AbilityWorks facility manager about the availability of work and how many hours are intended for community based work training and/or hours needed for completion of the occupational diploma. Services should be planned on an individualized basis for all students. The counselor should work closely with the special education teacher to see how many hours the school can provide to each student on track for an occupation diploma. After the special education teacher has reported the number of hours the school will provide, the counselor should work with the CRP staff regarding the remaining hours and the availability of work before the student receives services at the CRP. Hours of work performed at a CRP (including off-site contracts) may count towards the requirements of the occupational diploma, which may include 1) the 30 hours needed for community based work training and 2) the 540 hours needed towards

the requirements of the occupational diploma.

3.18 SELECTED SOCIAL SECURITY SERVICES

The Social Security Administration (SSA) and the Agency cooperate in providing vocational rehabilitation services to Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) beneficiaries with disabilities. The Selected Social Security Services Division administers the following programs:

1. Ticket to Work and Self-Sufficiency Program 2. Social Security Administration/Vocational Rehabilitation Reimbursement Program 3. Mississippi Partners for Informed Choice (M-PIC)/Work Incentive Planning and Assistance (WIPA) Program 4. Mississippi Model Youth Transition Innovation (MYTI) Project 5. Individual Development Account (IDA) Grant

3.18.1 Ticket to Work Program

The Ticket to Work and Self-Sufficiency Program (the Ticket to Work program) is the centerpiece of legislation signed into law under the Ticket to Work and Work Incentives Improvement Act of 1999 (Public Law 106-170). The Ticket to Work program allows SSDI and SSI disability beneficiaries to seek employment services, VR services and other support needed to obtain, retain, or maintain employment and reduce dependence on cash benefits. The law‘s purpose is to expand the universe of service providers available to SSDI and SSI disability beneficiaries and provide them with a Ticket they may use to obtain VR services, employment services, and other support services from an Employment Network (EN) of their choice. The original final regulations to implement the Ticket to Work program were published in the Federal Register on December 28, 2001 and became effective on January 28, 2002. After full implementation of the Ticket to Work Program, SSA published a request for comments, first in September 2005 and again in August 2007. Taking into account the comments received and the recommendations of the Ticket to Work Advisory Panel, significant changes were made to the Ticket to Work program with final rules effective July 21, 2008. The ultimate goal of the Ticket to Work program is to reduce reliance on Social Security disability benefits and to promote increased self-sufficiency for beneficiaries with disabilities through work.

Overview of Ticket to Work

A. Ticket Selection and Mailing Process

The SSA will review the records of beneficiaries who receive benefits under its two disability programs to determine who is eligible to receive a Ticket under the Ticket to Work program. SSA will send a Ticket mailer package to those found eligible for Tickets. This package includes a cover letter, the beneficiary‘s Ticket, and a brochure with basic information about the Ticket to Work program.

To be eligible for a Ticket, a beneficiary who is entitled to benefits under the SSDI or

SSI program must:  be at least 18 but not yet age 65;  be entitled on SSA‘s disability standard for adults; and  be receiving a Federal cash disability benefit.

Initially, SSA mailed Tickets to eligible beneficiaries in stages, and thereafter on a flow basis. New Tickets under the new regulations will not be sent routinely to beneficiaries who previously received a Ticket. New Tickets will be mailed to beneficiaries who previously had not received a Ticket due to medical improvement expected (MIE) provisions. Tickets will also be sent to all new disability beneficiaries, ages 18 through 64, as they are determined eligible for benefits on a flow basis.

A beneficiary who is eligible for a Ticket does not need to have a paper Ticket before contacting providers about possible services. SSA‘s Program Manager for the Ticket to Work program, MAXIMUS, Inc., is the beneficiary‘s contact source for Ticket questions and issues (e.g., MAXIMUS can answer questions about whether a beneficiary is eligible for a Ticket; MAXIMUS can issue replacements for lost Tickets).

B. Beneficiary Participation Is Voluntary

A beneficiary‘s participation in the Ticket to Work program is voluntary.

 The beneficiary is free to choose when and where to use the Ticket to obtain the assistance needed to return to work or to go to work for the first time.  At any time, a beneficiary can retrieve the Ticket from an EN and reassign it to another EN that is willing to take the Ticket assignment, provided the Ticket is assignable.  A beneficiary‘s non-use of a Ticket will not affect entitlement to disability-based benefits.

The benefit for a beneficiary who assigns his/her Ticket to an EN or works with a State VR agency is that SSA will not initiate a medical Continuing Disability Review (CDR) of the beneficiary‘s case provided the beneficiary is actively following an approved employment plan and making timely progress toward work or educational goals. SSA periodically conducts these reviews to determine whether a beneficiary‘s condition continues to meet SSA‘s definition of disability.

C. Linking Up With a Provider Via MAXIMUS

A beneficiary may not assign his/her Ticket to more than one provider of services at a time. Under the new regulations, a beneficiary may not work with MDRS or any State VR agency and an EN simultaneously. However, a beneficiary may discuss employment plans and goals with MDRS and as many ENs as the beneficiary chooses. The beneficiary can obtain a list of the State VR agency and approved ENs for a particular geographic area by:

 Calling MAXIMUS at 1-866-968-7842 or 1-866-833-2967 (TDD), or  Accessing MAXIMUS‘ website at www.yourTickettowork.com

A beneficiary may now chose to receive services from MDRS and then receive follow along services after the VR case is closed by assigning his/her Ticket to an approved EN.

D. ―In-Use SVR‖ Status Code

In developing the new Ticket regulations, SSA decided that an individual with a disability may move toward self-sufficiency incrementally requiring a longer period of support which might include educational goals. Therefore, a Ticket holder may receive VR services to meet his/her intensive up front service needs and, after the VR case is closed with the beneficiary in employment, the beneficiary may assign his/her Ticket to an EN and receive job retention or other support services.

To make VR participation less burdensome under the new Ticket to Work rules, SSA substituted an electronic process for the Form SSA-1365 when the Cost Reimbursement option is selected. SSA created the ―In-Use SVR‖ status code to be able to track SSDI and SSI beneficiaries who are working with a State VR agency (SVR). The ―In-Use SVR‖ status will provide the beneficiary the same protection from a medical CDR that a Ticket assignment does as long as the beneficiary is making timely progress towards self-supporting employment.

Therefore, under the new regulations, State VR agencies choosing Cost Reimbursement are not required to submit the Form SSA-1365. The MDRS Ticket Unit will coordinate electronic submission of the required elements to MAXIMUS with the MDRS MIS Office. While a beneficiary is working with MDRS, his/her Ticket will be coded as ―In- Use SVR‖ and will not be available to an EN.

E. MDRS Ticket Assignments

MDRS may choose selected cases where an EN payment option may be more obtainable than Cost Reimbursement. This will be handled in the Ticket Unit. When a case is selected for an EN payment option, MDRS will have to submit Form SSA-1365 and secure the beneficiary‘s Ticket assignment. The Ticket Unit will contact the counselor assigned to the case to obtain the required paperwork.

F. Counselor Responsibilities:

 As of March 1, 2009, no longer required to contact MAXIMUS to verify if a consumer‘s Ticket is assignable  As of March 1, 2009, no longer required to complete Ticket pages in AACE  For EN payment option, cooperate with the Ticket Unit and provide the required paperwork for selected cases (Form SSA-1365 signed by both the counselor and the consumer along with the first and last pages of the signed IPE) to the Ticket Unit for Ticket assignment under the Outcome-Milestone EN payment option.

3.18.2 Social Securtiy Reimbursement Program

I. Overview

Under the Social Security Administration/Vocational Rehabilitation Reimbursement Program, the Agency has a formal agreement with SSA that allows the Agency to receive incentive payments from SSA on all SSDI/SSI clients (receiving benefits based on disability) who receive services resulting in the client working at least nine months out of 12 continuous months at the Substantial Gainful Activity (SGA) level. The 2011 SGA amount is $1000 per month for all disabilities except blindness and $1640 for individuals who are blind. Because the Agency is entitled to incentive payments from SSA based on the period a client receives SSDI/SSI during the rehabilitation process, care should be taken in properly coding and updating cases. In addition, care should be taken to properly code disability-based SSDI/SSI cases since the Agency is not entitled to incentive payments on those cases receiving retirement, childhood, widows, and other non-disability-based benefits.

Claims for reimbursement must be filed within 12 months after the month in which the client completes nine months of SGA. For example, if the individual completed a period of 9 months of SGA in April 2008, the claim must be filed for reimbursement before May 2009. Therefore, all rehabilitated cases considered for reimbursement are pulled by the Ticket Unit approximately one year after closure since cases are normally closed 90 days following the date the client is successfully employed. However, should there be a situation where a client reaches the SGA threshold amount during the time the case is in open status, the Ticket Unit should be notified at 601-853-5351 so that a reimbursement claim can be filed within the allotted 12-month period.

II. Reimbursement Process

The Ticket Unit verifies receipt of SSDI/SSI benefits during the VR service period by means of SSA queries. Wage verification documentation is secured by the Ticket Unit on cases receiving VR services while in SSDI/SSI benefit status through an agreement with the Mississippi Department of Employment Security. The Ticket Unit searches for nine months of SGA within a continuous twelve-month period.

When wage verification is not available through this process, the Ticket Unit will explore AACE seeking documentation of employment at SGA. If qualifying criteria is identified, the Ticket Unit will forward a Wage Verification Letter to the counselor who closed the case. The counselor will contact the previously served client in an effort to obtain written verification of wages. The signed Wage Verification Letter or an explanation of inability to secure cooperation from the previously served client will be forwarded back to the Ticket Unit.

Good Provider Claims, Form SSA-199, are then submitted to the SSA Claims Processing Unit for consideration of reimbursement for direct costs, administrative costs, and tracking

costs. Required documentation to accompany the SSA-199 is usually pulled from AACE.

Requests for all signed authorizations for direct costs for services provided prior to implementation of the AACE System in October 1999 will be forwarded to the counselors from the Ticket Unit. Counselors will make copies of the signed authorizations and return to the Ticket Unit.

Upon receiving the SSA-199 with attachments, SSA can also request Payment Validation Reviews (PVRs) on a sample of cases for which they may request all signed authorizations and a copy of the IPE. These requests will be forwarded to the counselors who will copy the requested documents and return to the Ticket Unit. After reviewing submitted claims, SSA will forward notice of approval or denial to the Ticket Unit.

3.18.3 Case Coding

Because the Agency is entitled to incentive payments from SSA based on the period an individual receives SSDI/SSI during the rehabilitation process, care should be taken in properly coding and updating cases. In questioning a client regarding the type of benefit check (SSDI or SSI) that he/she receives, it may be helpful to ask the color of the envelope in which the check arrives. SSDI checks are mailed in draft (tan or brown) envelopes while SSI checks are mailed in blue envelopes. All SSI checks are issued on the first of each month while SSDI checks are staggered throughout the month based on the client‘s date of birth. There are occasions when an individual goes from an eligible category to an ineligible category and vice versa. In these cases, the cost of VR services beyond the conversion is not eligible for an incentive payment. For example, an individual drawing childhood benefits on a parent‘s social security number (ineligible) at age 18 is determined to have a disability, and then begins drawing benefits on that disability. At that time, he/she enters an eligible category. An individual is receiving disability benefits (eligible) and, upon reaching age 62 (or current required retirement age) is converted to retirement benefits then becomes ineligible. Reapplying for Benefits (Childhood Disability Cases): Childhood auxiliary benefits drawn off a parent‘s record will not continue beyond an individual's eighteenth birthday unless the individual or his/her parents reapply to SSA for continuation of benefits based solely on the individual's own disability. Some individuals may be determined ineligible for continuation of benefits because of stricter guidelines for adult disability. If the client has qualified for SSI benefits based on his/her own disability prior to age eighteen, the Disability Determination Services (DDS) will review the claim when the client attains age 18 to determine if the condition is disabling under adult criteria.

"301" Cases (Medically Improved Recipient Cases Reviewed by DDS):

When the disability status of a current VR client receiving SSDI/SSI payments is reviewed by DDS to determine if the individual has medically improved, a VR counselor may receive

a SSA-4290 Form to complete. The SSA-4290 Form is used by SSA to determine if the SSDI/SSI client who has medically improved is in a legitimate VR program.

Even if an individual has medically improved, disability benefits can be continued until the completion of that person's rehabilitation program (typically one year)--provided SSA determines that the person is participating in a legitimate VR program. If SSA determines that the individual has medically improved and is not participating in a legitimate VR program, disability payments will be terminated. Therefore, care should be taken to accurately answer all items on the SSA-4290 Form. All completed SSA-4290 Forms will be routed back to the DDS Examiner to attach to the Medical CDR Denial decision which is forwarded back to the local SSA Claims Representative at the Field Office.

Documentation of SSA Status during the VR Process:

A client's SSDI/SSI status should be documented in the computer system when referral information is entered. If known, enter SSA information at this time or at any time before closure. At the time of closure, the SSDI/SSI status must be entered or updated in the computer system.

On all cases that could potentially draw SSA benefits, counselors should check the individual's record with the local Social Security Office or the Ticket Unit. This includes all individuals whose disabling condition places them in the "severely disabled" classification or where other factors indicate that they are eligible for or are drawing disability benefits. Benefits verification can be obtained from the Ticket Unit, via email, written request, or by calling 601-853-5351.

All cases found drawing SSDI/SSI benefits based on personal disability must have written verification of the benefits in the file.

3.18.4 Service Provision

Service provision aspects of any SSDI/SSI case will follow the general guidelines of VR policies and procedures. This will be the same as or similar to service provision to individuals not receiving any type of payments due to a disabling condition.

Before beginning any work activity, the client is to notify the pertinent SSA District or Branch Office of his/her status. Although the counselor may wish to accompany the client to the SSA Office to notify them of the client's work activity, the counselor will not contact SSA for an individual.

VR counselors will maintain close contact with pertinent staff of the Mississippi Partners for Informed Choice (M-PIC) who can provide work incentives planning and assistance (WIPA) services to demonstrate the effect of wages on the recipient‘s disability benefits and dispel any unjustified fears of benefit loss due to work. A listing of the M-PIC staff is provided on pages following this section.

Social Security work incentives are designed to encourage individuals with disabilities to return to work by protecting their benefit or recipient status and thus protecting their Medicare/Medicaid coverage until they can earn sufficient income to maintain a reasonable standard of living and purchase their own health insurance.

In the last several years, a number of new work incentive provisions have been instituted. These work incentives are discussed in a publication entitled "Red Book On Employment Support - A Summary Guide To Employment Support Available To People With Disabilities Under The Social Security Disability Insurance And Supplemental Security Income Programs‖ (the Red Book). Each district office should have a copy of this publication and a computer diskette explaining SSA Work Incentives. Counselors are urged to utilize these tools.

These items may also be obtained by contacting the Division of Selected Social Security Services. The Red Book may be accessed on the Internet at the following website:

http://www.socialsecurity.gov/redbook/

Clients receiving SSDI and/or SSI are often afraid of trying a work experience because they think that if they work themselves off benefits and their medical condition worsens, they will have to begin the lengthy disability determination process again. The Ticket to Work and Work Incentives Improvement Act of 1999 included a new work incentive called Expedited Reinstatement of Benefits or EXR which says that within 60 months from the month of termination of benefits due to earnings from work, if the individual is unable to work because of the same medical condition, they can file a request for reinstatement of benefits without a new application. While Social Security is making a new determination, the individual may receive up to six months of provisional benefits, including Medicare and Medicaid, as appropriate, which will not have to be repaid even if the re-determination is not favorable.

SSDI and/or SSI recipients will be encouraged to report to their local Social Security office any payment made directly to him/her by VR, including income received while at AbilityWorks. Any payment made to a SSDI and/or SSI recipient may affect the amount of the benefit check.

One method of protecting the individual's SSI check when a client will be directly reimbursed for expenses incurred in a vocational training program at a school, college, or university is the development of a Plan for Achieving Self-Support (PASS). A PASS, which is developed and approved by appropriate Social Security offices, will classify all expenses related to an SSI recipient attaining a vocational goal as exempt from consideration as any form of income. This will prevent reduction of the client's SSI check. The "Red Book" contains a discussion of the PASS.

3.18.5 Work Incentives Planning and Assistance (WIPA) Program

Community Work Incentive Coordinators (CWICs) with the Mississippi Partners for Informed

Choice (M-PIC) Program within the Division of Selected Social Security Services administer the SSA Work Incentives Planning and Assistance (WIPA) program in Mississippi. CWICs were trained on the use of existing SSA work incentives as well as new ones created in the Ticket to Work and Work Incentives Improvement Act of 1999. The goal of the M-PIC/WIPA program is to better enable SSDI/SSI beneficiaries with disabilities to make informed choices about work. M-PIC/WIPA CWICs:  Examine the impact of work and earnings on disability benefits;  Provide work incentives planning and assistance to assist SSA beneficiaries with disabilities in their employment efforts;  Conduct outreach efforts to SSDI/SSI beneficiaries with disabilities (and their families), who are potentially eligible to participate in Federal or State work incentives programs;  Work in cooperation with Federal, State, and private agencies and nonprofit organizations that serve SSDI/SSI beneficiaries with disabilities;  Explain Ticket to Work along with screening and referring beneficiaries to appropriate Employment Networks; and  Provide information on the availability of protection and advocacy services including how to access such services.

For further clarification of any aspect of the Ticket to Work Program as it affects VR clients or for additional assistance in the development of a PASS, contact the M-PIC Program at (601) 853-5315.

3.19 Supported Employment Program

Supported Employment (SE) is a specialized placement and training program for the most significantly disabled individual...the individual for whom competitive employment has not traditionally occurred due to the severity of his/her disability.

The program is a cooperative effort between the Agency, community programs, agencies, and individuals called "third parties" with which the Agency has signed agreements for referrals and the provision of extended services.

If it is determined that the individual's disability is such that he/she needs on-going support services in order to maintain employment, consideration should be given to the Supported Employment program. Supported employment clients are eligible for any of the traditional vocational rehabilitation services available to other Agency clients.

3.19.1 SE Terminology

Competitive Employment means work--- (i) In the competitive labor market that is performed on a full-time or part-time basis in an integrated setting; and (ii) For which an individual is compensated at or above the minimum wage, but not less

than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals who are not disabled.

Supported employment requires no more than eight individuals with disabilities be clustered in an employment setting.

Extended Employment means --- work in a non-integrated or sheltered setting for a public or private nonprofit agency or organization that provides compensation in accordance with the Fair Labor Standards Act. Extended employment may also be used as a support service to enable an individual to continue to train or prepare for competitive employment, unless the individual through informed choice chooses to remain in extended employment.

Extended Services are on-going supports which are provided to an individual who is successfully rehabilitated into employment. These services are provided by third-party entities, and they are needed in order to support and maintain an individual with a most significant disability in supported employment.

Integrated Work Setting means job sites where most co-workers are not disabled and individuals with disabilities are not part of a work group of other individuals with disabilities. Supported employment services will include placement in an integrated work setting for the maximum number of hours possible based on the unique strengths, resources, priorities, concerns, abilities, capabilities, interests and informed choice of individuals with the most significant disabilities.

Job Trainers provide one-on-one intensive job skills training and support, both on and off the job, for individuals with mental retardation, severe learning disabilities, cerebral palsy and other developmental disabilities and mental illness. This training includes social skills, along with other training that would be essential to a person with a most significant disability obtaining and maintaining a job. Job trainers are hired on a part-time, temporary, as needed basis.

Natural Supports are those formal and informal mechanisms existing in a work environment that can be drawn upon to increase and sustain an employee's performance through the use of active assistance and/or approval or sanctioning of a worker's achievements.

Person Centered Planning (PCP) is a process of profiling and planning with an individual in order to increase self-management opportunities, community involvement and life satisfaction for the individual. A plan of action is adopted in order to determine and achieve goals by addressing the needs, strengths and experiences of the individual.

Successful Rehabilitation occurs when the individual maintains a supported employment placement for 90 days after making the transition to permanent employment.

Support means any appropriate service such as job site training, short-term transportation assistance, family support, or any other service necessary for job success, throughout the "term of employment".

Supported Employment means competitive work in an integrated work setting for individuals

with the most significant disabilities.

Transitional Employment is a series of temporary job placements in competitive work, in integrated work settings with on-going supports until job permanency is achieved for individuals with Serious Mental Illness.

Vocational Training Instructors (VTI) are responsible, in coordination with the supported employment counselor, for job development and placement for supported employment eligible clients. Although the supported employment counselor has the primary responsibility of securing a trainer, VTIs primarily handle the hiring of trainers and day-to-day management of the placement and trainer.

3.19.2 Services

Supported Employment services mean on-going support and other appropriate services needed to support and maintain an individual with the most significant disability in employment.

Person-centered planning should be considered for every Supported Employment client as a possible means for providing both the client and the counselor with additional information. This information can be utilized for a number of purposes, e.g., as a means of gathering additional information for eligibility determination, for development of a plan for employment, for determining support needs that will require referral to other agencies or organizations, and to map out future career options, etc..

Supported Employment services are generally provided for a period not to exceed 18 months, unless due to special circumstances a longer period is necessary to achieve job stabilization. This must be jointly agreed to by the individual and the rehabilitation counselor and established in the Individualized Plan for Employment (IPE) before an individual with the most significant disabilities makes the transition to extended services. Counselors should carefully document the cases when joint agreement arrangements are finalized to go beyond the 18-month period of time. If a longer period of time is warranted, the following should be given consideration: only when the client has made substantial progress toward meeting the hours-per-week work goal provided for in the IPE, the client is stabilized on the job, and extended services are available and can be provided without a break in services.

The use of a Job Trainer at the work site is an integral part of supported employment services. This individual is responsible for learning the job prior to the client coming to work, then teaching the job to the client. The trainer not only teaches the work skills needed at the job site but will help the client become adjusted to the new work environment. The trainer will help the client develop relationships with co-workers and supervisory staff. The trainer will also identify and promote the utilization of natural supports in the work environment. If the client cannot meet production standards, the trainer is there to ensure the employer that the work will be done to the business' quality and quantity standards. As the client becomes more independent at the work site and is able to perform most of the job tasks with minimum intervention by the trainer, the trainer will fade assistance until the case can be closed.

Personal assistance services (PAS) enable the employee to perform the daily living activities on or off the job that the individual would typically perform without assistance if the individual did not have a disability. Examples of these services are job functions such as activities of daily living aid, business travel companion, office services specialist or meeting assistant. The services must be necessary to the achievement of an employment outcome and may be provided only while the individual is receiving other vocational rehabilitation services. They are not to be construed to be supports that are considered a reasonable accommodation and therefore paid for by the employer or supports considered personal in nature and funded by Medicare or other funding sources. PAS are to be authorized for in the same manner as that a job trainer. In some instances, it may be possible for the job trainer to also perform the duties of the personal assistant. The same fee schedule used in paying job trainers will be utilized in paying for the PAS. In developing the IPE, an agreement will be made addressing each of the following issues:

 The name of the extended service provider -- specifically addressing the provision of Personal Assistant Services to be provided following VR case closure (If no extended service provider has been identified at the time of the development of the IPE, refer to the Flow Chart for SE Services - I.B.4.and III.B.5);

 The specific Personal Assistant Services that will be provided;

 The duration of the provision of Personal Assistant Services by VR

3.19.3 Flow-Chart For Se Services

I. Referral

A. Referral received from Third-Party Agency.

1. Schedule appointment for application. 2. Conduct interview, advise client of services available and discussion of client‘s informed choice in these services; get client release form to obtain records from other sources, (mental health center, state hospital, physician/ hospital, etc.). 3. Conduct evaluation for VR services, authorizing for services or information not available through other agencies.

B. Referral received from General VR program, Deaf Services, Deaf/Blind or Transition counselor.

1. General VR or Specialty counselor staffs the case with the SE counselor. 2. SE counselor assesses the case for eligibility for SE services. If the two counselors agree that SE should serve the case, the case will be transferred to the SE counselor using the established case transfer procedures. Cases transferred from any specialty area, for example, Deaf /Blind program, if determined eligible for SE services should be retained by the SE counselor. The Specialty counselor and the SE counselor should work closely on the case and the Specialty counselor should provide technical assistance to the SE counselor to ensure the client

receives appropriate services. 3. If any questions arise about the eligibility of the client for SE services, the two counselors will refer the case to their respective supervisors who will, together, determine the feasibility of the client for SE, the adequacy of the evaluation process, need for additional evaluating information, etc., and decide how the case will be handled. 4. In those cases when a client needs Supported Employment services but is not being served by a third-party, the SE counselor will explain the SE Program, services and options to the client as soon as possible after the referral has been made to the SE Program. The SE counselor will also, advise the client about the availability of third-party resources in that area. The counselor will assist the client with obtaining a third-party sponsor for extended services and must include on the IPE the source and description of the on-going support needed by the client to maintain the employment. Third-party agreements will be initiated by the SE counselor and negotiated at the local level regardless of whether there is a Cooperative Agreement with the Parent State Agency. Third-party agreements will be finalized by State Office staff. If no third-party can be located who is willing to provide needed services, the case may be closed as Unsuccessfully Rehabilitated after staffing with the District Manager. The SE counselor will document the attempts to assist the client in this way in the closure letter.

C. Referral received from VRB counselor:

Generally, it is appropriate for all SE eligible individual‘s cases to be handled by the SE counselor. In specialty areas, such as deaf, deaf/blind and blind, the case is handled with consultation from the appropriate specialty disability counselor on specific issues related to the individual‘s needs. However, in those instances where it is advisable, and is the client‘s choice, for their case to be retained by the VRB counselor for the receipt of supported employment services, the SE counselor will work closely with the VRB counselor to advise and consult on matters related to the use of SE funds for the hiring, managing and paying for job trainers and any other procedural matters related to SE services. The decision to transfer the SE case to the VRB counselor should be made after staffing with the District Manager. Upon transfer of the SE case to the VRB counselor, the State Coordinator for Supported Employment will be notified by the District Manager, and an allotment of SE funds will be made to the VRB counselor who will handle the case.

NOTE: After any referral to supported employment, the counselor should check the appropriate place on the Special Programs page in AACE indicating this is now a supported employment case. (In the instance of a transferred case, where the IPE has already been developed, the IPE should be amended with the client to reflect appropriate SE services; the counselor should record this as an SE case on the IPE and also on the Special Programs page in AACE.)

II. Eligibility

Individuals with severe disabilities who are appropriate to receive supported employment services must meet the eligibility requirements established for the VR program and meet the Order of Selection, Category I –

A. Be an individual who has never been competitively employed; and/or B. traditional competitive employment has been interrupted or intermittent as a result of a severe disability; and C. who, because of the nature and severity of the disability, needs intensive on-going support services that may include job trainer services, in order to obtain and maintain competitive employment, and D. who, because of the nature and severity of the disability needs extended services that continue after VR services ends, in order to maintain successful employment

III. IPE DEVELOPMENT

A. IPE Meeting - At the time of the IPE development the SE counselor should meet either individually or jointly with the following entities:

1. Client and, if necessary, client's parents or guardian, advocate or representative. 2. If possible, a representative from the source who will be providing and/or funding the extended services. 3. Representative(s) from the Mental Health Center who will be providing Transitional Employment/Supported Employment services.

B. Writing of the IPE.

1. The SE counselors need to utilize the information from assessments, including information gathered from Person Center Planning, and input from the client in establishing a vocational goal. The IPE should include a brief rationale as to the reason that the particular vocational goal was selected. The SE counselor, along with the client, will estimate an anticipated time during which the client is expected to reach the goal.

2. Each service that will be provided will be listed. These services should include all the supports needed by the supported employment client in order to reach the stated goal and should include at a minimum, two of the following: a. Placement Services b. Training: Supportive Services (inc. Job Coach) c. Counseling and Guidance d. Extended Employment e. Extended Services (this service may be listed under ―Other Goods and Services‖ and then customize the service by specifying Extended Services. f. Other appropriate services

Every Supported/Transitional Employment IPE should include Extended Services and Rehabilitation Counseling.

3. The source of funding for each service, the estimated cost of the service(s) or the utilization of comparable benefits must be listed. 4. Information should be included which indicates any understandings and responsibilities between the client and the SE counselor or any other individual or entity deemed critical to the success of the vocational program. 5. Extended Services, which are on-going services, should be indicated as such on the IPE. A Memorandum of Understanding-Extended Services Agreement should be developed for each Supported/Transitional Employment client and a copy should be kept in the client‘s file. These agreements should be coordinated through the State Office. Extended Services can be provided by more than one source. Sources for Extended Service provision may include: a. state agencies, b. private non-profit organizations, c. employers, co-workers, families or friends, d. Any other appropriate resource not funded by the Agency.

Counselors have the primary responsibility for negotiating these agreements; however, they must be formalized and signed by the Director of the Agency. Telephone or write the State Coordinator for Supported Employment to obtain copies of the agreements and to obtain details on putting these agreements in place. The beginning date for extended services should coincide with the date of movement of the case into employed status. Generally it is best to have these agreements in place at the time of the IPE development, or before, however they are required before closure of a successfully rehabilitated case and a copy of said signed Extended Service Agreement should be placed in client‘s file upon closure as successfully rehabilitated. If it is not possible to identify the source of the extended service provider at the time the IPE is developed, a statement describing the basis for concluding that there is a reasonable expectation that such sources will become available, should be addressed in the IPE.

IV. Placement

The responsibility for placement of SE clients lies primarily with the SE counselor with assistance by the Vocational Training Instructors (VTIs). The decision to place a client into a TEP versus a permanent employment situation will be done after careful consideration of the client's condition and with input from the third party representative. The decision to place a client in a particular job must be based on an assessment and documented in the case file.

V. Training

A. Securing Job Trainer, as well as overseeing work performance of the trainer regarding the actual knowledge and implementation of training, will be the primary responsibility of the SE counselor. However, the VTI will need to be responsive to the day-to-day management of the placement, contacting the SE counselor assistance when needed.

B. The SE counselor, with assistance of the VTI, will be responsible for ensuring that all trainers are adequately educated in how to provide appropriate training.

VI. Authorizations for Trainer Services

A. The vendor for all job trainer authorizations will be AbilityWorks - Jackson- Reimbursement

B. The following forms should be completed and mailed to MDRS Finance Department, Post Office Box 1698, Jackson, MS 39215-1698 - upon appointment of a Job Trainer to work with a client:

1. Application for Employment 2. I-9 form, with copies of driver‘s license and social security card. (The Counselor should sign the I-9 Form under Section 2 ―Signature of Employer or Authorized Representative). 3. W-4 Federal Withholding Form 4. State Withholding Tax Form 5. Drug-Free Workplace Form

These forms may be sent either in advance of, or along with the initial Authorization for Services for a Job Trainer. It should be noted that a copy of the Workers‘ Compensation Notice of Coverage should be furnished to the Job Trainer when hired.

a. After authorizing for a planned service indicate the Job Trainer's name in the General Comments – Section 3 of the Authorization.

b. A 13.57 percent processing fee to AbilityWorks - Jackson-Reimbursement should be added to the unit cost (per hour rate) for job trainers and added to the total estimated cost for job trainer services. The processing fee should be calculated in the following manner:

(per hour rate) x 13.57% = (processing fee) + (per hour rate) = (hourly service fee) x (no. of hours) = (total service cost)

C. The procedures for processing payments through AbilityWorks - Jackson-Reimbursement are as follows:

Step 1: Upon completion of a work period (2 weeks in most instances) the SE counselor will obtain signatures of the Job Trainer and the client on the Job Trainer Time Sheet. The Time Sheet should also be verified for accuracy and signed by a VR/SE staff member. After checking the Job Trainer Time Sheet for accuracy, a Statement of Account (SOA) should be prepared that matches the amount of the Job Trainer Time Sheet. If the original Authorization does not match the amount to be paid indicated on the Job Trainer Time Sheet, the Authorization should be modified to agree with the amount on the Job Trainer Time Sheet.

Step 2: The SOA should be completed indicating the type, the amount and dates of

service. Then the SOA should be approved for payment in AACE, signed by the approving SE counselor, attached to the Job Trainer Time Sheet and mailed as previously instructed (mail only one Authorization/SOA, and one original Time Sheet per client).

Step 3: Finance will write the check to the Job Trainer based on the information they receive after checking it for accuracy, (if errors are found by Finance they will mail the documents back to the counselor for corrections, delaying payment to the Job Trainer).

Finance will process payments to job trainers on Thursday of each week. All Authorizations/SOAs received by 10:30 a.m. on Thursday will be processed and mailed by 5:00 P.M. that day. Authorizations/SOAs received after noon on Thursday will be held over to the next Thursday for processing.

VII. Status Movement

Supported Employment cases should be moved through the VR case statuses as indicated below:

A. After eligibility determination is completed place the case in eligibility status.

B. After the IPE is planned, developed, and signed, the case will be moved to service status.

C. The case is moved to employment status when the client meets the criteria for movement into extended services and the Job Trainer has faded completely. This occurs when the client has demonstrated that he/she can perform the job to the employer's expectations. Also, there should be a concurrent agreement between client, counselor, VTI, job trainer and extended service provider that the client can perform the essential functions of his job with the provisions of extended services. This agreement should be the outcome of a meeting between the above parties and any other appropriate parties. Also, at this time, if the Extended Service Agreement has not been previously executed, it can be executed by the appropriate parties and placed in the file. In every instance, a copy of the Extended Service Agreement should be placed in the client‘s file upon being determined successfully rehabilitated.

D. The case is closed rehabilitated when the client has been in employed status for at least 90 days and continues to perform the job with minimal assistance from the extended service provider and is considered successful by the employer.

VIII. Supported Employment Closures

The following Supported Employment special outcome criteria must be met in order to close a case rehabilitated in Supported Employment:

 working in the competitive labor market;  working in an integrated work setting; and  receiving extended services at the time of closure

It is an integral part of the closure process that the SE counselor ensures that the client is transitioned to the appropriate third party for on-going support services. The case file will be well documented showing this effort.

NOTE: When supported employment cases are closed in AACE, the counselor needs to be sure the SE outcome is completed correctly on the closure page.

3.19.4 SE Clients in Community Rehabilitation Programs (CRP)

VR clients who are determined to be eligible for supported employment while receiving services of a CRP should be referred to the appropriate SE counselor (The SE counselor should be involved in routine staffing at AbilityWorks when informed by the vocational evaluator that supported employment is being considered as a service option for a client). When the supported employment counselor determines that the client is eligible, the case should be transferred to a supported employment caseload. The client should be fully informed about the supported employment program before the case transfer is made. The client should be informed whether continued evaluation at the CRP is needed. If the placement is not appropriate the client should be terminated from the CRP before or simultaneously with transfer to the SE caseload.

Generally, placement at a CRP is not appropriate for a SE client because it is not consistent with the place/train model, however in some instances placement of a SE client at a CRP may be appropriate for a particular assessment to, for example, observe behaviors, work habits, build rapport with the client, etc., or in rare instances remediate functional limitations. This may be done while the case is in eligibility status for the purpose of gathering information for IPE development, or in service status to provide specific training for remediation of functional limitations discovered after a client has been in a regular supported employment job and it has been determined that the CRP is the only suitable environment in which this remediation can take place.

The decision to refer a client to a CRP should be made in consultation with the district manager. An assessment or remediation plan should be developed that is specific to address the needs of the client and should coincide with the time limitations which apply to all CRP referrals. The client should be fully informed of the reason for the referral and that the placement is not a permanent job. Since the client is SE eligible a job trainer will be provided while in the CRP to assist the client and the CRP staff in the assessment. It is expected that referrals of SE clients to CRPs will be limited and should be made only when placement in a competitive, community based job is not a timely and feasible option.

To refer a client to a CRP follow the procedures outlined in the CRP section of this manual that describes the referral process. Referral of a SE client to a CRP requires District Manager review.

3.19.5 Transitional Employment

Under the definition of supported employment, transitional employment is an allowable service option for individuals with serious mental illness. Transitional employment is a series of

temporary placements in competitive work, in integrated work settings, with on-going support services. In transitional employment, the provision of on-going support services must include continuing sequential job placements until job permanency is achieved.

Transitional employment may be the best service option for an individual with chronic mental illness whom:

 is uncertain about choosing an appropriate vocational goal,  is fearful or tentative about his/her abilities to maintain employment, and/or,  is an individual for whom traditional work adjustment services would have been considered the best pre-employment preparation service

If a permanent job is not procured before the end of the 18-month period of VR time limited services, the extended services provider is responsible for procuring and maintaining the permanent job placement. There are few vocational services for individuals with mental illness (outside of the services offered through the Agency) that can fund job development or placement activities. Consequently, counselors should encourage permanent placement for most individuals prior to case closure, to ensure that the individual has access to funding for permanent job placement.

Generally, individuals who are motivated to work and have clear ideas regarding the type of work they would like to do should be treated as regular supported employment placements.

3.20 TANF REFERRAL PROGRAM

Mississippi Department of Rehabilitation Services (MDRS) has entered a cooperative agreement with Mississippi Department of Human Services (MDHS) whereby Temporary Assistance to Needy Families (TANF) recipients who are diagnosed as having a physical and/or mental disability are referred to MDRS for possible provision of vocational rehabilitation services.

3.20.1 Referrals

MDHS will select and refer TANF applicants/recipients to VR on the basis of medical documentation and provide or make available medical and/or psychological information on all referred TANF applicants/recipients. MDHS will contact the VR counselor and schedule intake interview appointments for TANF applicants/recipients. MDHS will notify TANF applicants/recipients of where, when and to whom to report for the initial appointment with the assigned VR counselor.

The VR counselor will cooperate with MDHS case management to schedule initial interview appointments within ten (10) working days of the referral date and notify MDHS case management of the appointment results within three (3) working days.

The VR counselor will follow Agency guidelines for completing an application for VR Services (MDRS-VR-1) and determine eligibility for those TANF applicants/recipients who are shown to be individuals with a disability which constitutes or results in a substantial impediment to

employment and who require, in terms of an employment outcome, specific vocational rehabilitation services.

The VR counselor will provide a copy of the IPE to MDHS to document services planned.

The case should be coded as TANF when entering data in AACE Referral Module and/or when entering data on the AACE Application Page.

The VR counselor is to notify MDHS immediately if the TANF client refuses to cooperate.

3.20.2 TANF Clients in Community Rehabilitation Programs

The Community Rehabilitation Program (CRP) will ensure daily supervision and tracking of TANF clients who choose to attend and are accepted into a CRP. This includes offering a minimum of 30 hours per week to TANF clients participating in a CRP based on the availability of work assignments.

The VR counselor will provide MDHS with a copy of the TANF client‘s monthly CRP progress reports which shall include, but are not limited to details of the individual‘s progress, level of participation, report on work or other activities, goals to be accomplished and goals completed.

3.20.3 TANF Clients in Other VR Programs

MDHS will provide quarterly progress report forms (Form T015-VR) to the VR counselor for TANF clients receiving services other than at a CRP. The VR counselor will complete the form and return it to MDHS.

3.20.4 Case Closure

The VR counselor will provide a copy of Notification of Closure Letter to MDHS case management whenever a TANF applicant/recipient‘s case is closed.

3.20.5 Exchange of Information

There will be a free and open exchange of information between the Agency and MDHS (MDRS- VR-19 Consent to Disclose Information is not needed).

All information will be deemed confidential by both parties and cannot be shared with third parties.

3.21 VISUAL IMPAIRMENT SERVICES

3.21.1 Aids and Appliances

When it is determined that adaptive aids and appliances are appropriate for visually impaired clients, the needed items can be provided. This service includes, but is not limited to, the

provision of items such as; Braille and talking watches, homemaking and cooking aids, low vision aids, canes, Braille writing devices, adaptive tape recorders, talking calculators, adaptive writing aids, etc. These and other aids and appliances are available at the Addie McBryde Center.

3.21.2 Bioptic Driving

The 1998 Mississippi Legislature passed into law a bill that allows a visually impaired person using a bioptic telescopic lens to be eligible for a Mississippi driver‘s license, if said individual can pass the standard driving test and is otherwise qualified as required by law. (Mississippi Code of 1972, as Amended, §63-1-11) ―Bioptic driving,‖ means operating an automobile with the assistance of specialized, telescopic/bioptic eyewear.

Services that vocational rehabilitation for the blind (VRB) eligible clients may receive related to bioptic lens driving include, but are not limited to: optometric services for the evaluation, prescribing and fitting of the lens; training by an optometric low-vision specialist in using the lens; and instruction in driving an automobile while using the lens. (NOTE: All vocational rehabilitation / vocational rehabilitation for the blind services must be required in order to achieve a specific employment outcome.)

The process to reach licensure with bioptics requires several steps designed to insure safe driving. A candidate for bioptic lens driving should be provided with the Bioptic/Telescopic Lens Application Form, available from the Mississippi Department of Public Safety, Highway Patrol Driver Services Bureau. The form comes with a packet of information that delineates the process and requirements a person must undertake to be able to obtain a driver‘s license using a bioptic lens. Application packets may be obtained by contacting the Driver Services Bureau at (601) 987-1200 or (601) 987- 1206.

The process consists of the following steps.

1. A candidate for bioptic driving must first be evaluated by a qualified optometric low- vision specialist who can determine if the individual meets the vision guidelines established by the Mississippi Department of Public Safety. An individual meeting these guidelines would then be evaluated and fitted with the lens by the low vision specialist. For information on the nearest optometric specialist who is qualified to prescribe the bioptic lens, contact the Mississippi Optometric Association at 601-956- 7412.

2. Subsequent to the fitting of the lens, the individual must participate in training in the use of the lens. The low vision specialist will provide this training. 3. Once an individual has proven proficient in the use of the bioptic/telescopic lens (as determined by the low vision specialist), the individual must obtain a driving permit from the Mississippi Highway Patrol, Driver Services Bureau. 4. Once a driving permit has been obtained, the individual must undergo training in driving an automobile while using the lens. Driving instruction may only be provided by an entity approved by the Mississippi Highway Patrol, Driver Services Bureau. For

a list of approved driver‘s training resources, contact the Driver Services Bureau at the number listed above. 5. When the driving training instructor judges that the client has the necessary and adequate driving skills with the bioptic lens, the individual is referred to the Highway Patrol‘s Driver Services Bureau headquarters in Jackson, Mississippi. The Bureau will review the applicant‘s information and determine if he/she has met the requirements necessary to take the driving test. If so, the person will be scheduled to take the test at a place and time to be determined by the Highway Patrol Office.

The codes necessary to authorize for the above services can be found in the MDRS Fee Schedule. Typical services include evaluation for the lens, fitting of the lens, the lens itself, and training in the use of the lens. Payment for driving instruction will be charged to Training: Adjustment, Personal/Vocational at the usual and customary fee charged by the vendor.

3.21.3 Business Enterprise Program (BEP)

The Business Enterprise Program (BEP) establishes and then provides ongoing support to businesses located throughout Mississippi which are operated by self-employed persons who are legally blind. Concentrating primarily on food service businesses ranging from small snack bars to full service cafeterias that serve thousands of customers daily, BEP provides blind vendors licensed under this program with the equipment, initial stock of merchandise and the management services needed to help insure their success. An associated Business Enterprise Training Program, located on the Addie McBryde Center, provides assessment, evaluation, and training for those individuals being considered for a career in the Business Enterprise Program. Clients who are participating in this program may utilize the McBryde dormitory facilities. The VR counselor will need to authorize to McBryde for the service - Maintenance, Training Related - Dormitory. These clients may also be provided meals, authorized to McBryde for the service - Maintenance, Training Related - Meals. The counselor will coordinate transportation for this program. For more information contact the Business Enterprise Program Director at Post Office Box 9727, Jackson, Mississippi, 39286-9727 or 1-800-443-1000 extension 5280.

3.21.4 Independent Living Services

These services are funded through a Title VII, Chapter 2 Grant (55 and older, legally blind individuals) and the Part B Independent Living Grant (legally blind with a secondary disability). Services provided include, but are not limited to; orientation and mobility training, personal adjustment training and counseling, physical restoration, provision of aids and appliances, referrals for other services, peer group interaction, and low vision services on an itinerant basis when appropriate. For more information, contact the VRB ILS Coordinator, Post Office Box 1698, Jackson, MS 39215-1698.

3.21.5 Itinerant Rehabilitation Teaching Services

These services are provided to eligible Office of Vocational Rehabilitation for the Blind (OVRB) clients who are unable to or who do not wish to participate in a center based training program. Itinerant services include, but are not limited to; orientation and mobility, low vision

services, development of job readiness skills, pre and post facility services, recommending and teaching the use of aids and appliances, as well as recommending and referring to other service providers. For more information, contact the VRB Itinerant Teacher Program Coordinator, Post Office Box 1698, Jackson, MS 39215-1698.

3.21.6 Prostheses

Prostheses for persons who are visually impaired may be provided when there is documentation that the absence of an appropriate prosthesis has interfered with securing, retaining, or performing work for which the client is otherwise prepared to do, or for which training is proposed. This service will be provided when there is a report from a specialist certifying the existence of a disability and recommending the provision of an appropriate prosthesis.

Prostheses most commonly provided for visually impaired clients include artificial eyes, contact lenses, glasses and low vision aids. Costs of repairs to prostheses are also allowed and should be considered when the device is appropriate and the repair is warranted.

3.21.7 Reader Assistance

Reader Assistance can be provided for eligible OVRB clients who are in training. Reader assistance means literate, plain speaking individuals reading to the visually impaired printed material which is not available in an accessible format (Braille, large print, tape recording, computer disk, etc.). The average student will need approximately forty (40) hours of reader service per month; however, this may be inadequate in some cases and may be exceeded when justified. See the Post-secondary Education Services subsection of this manual regarding support services for special guidelines related to college and other post-secondary education cases.

Documentation for payment of reader assistance should be submitted monthly, should show the number of hours read per day by date and should be signed by both the reader and student/client. The hourly rate paid to readers is determined by the prevailing student employment rate at the institution the client is attending. Individual needs and differences, including the nature and content of the course work, should be considered in planning reader services.

3.21.8 Corrective Surgery

The only surgical procedures to correct visual acuity (i.e. Lasik) to be provided are those required for an individual to perform the duties of a specific employment outcome as specified which cannot be accomplished through other traditional methods. All cases must be staffed and approved by supervisor prior to eligibility being determined. No services will be provided for cosmetic reasons.

3.22 WEIGHT MANAGEMENT SERVICES

In order for weight management services to be considered, the following must be taken into account and documented:

 The individual's weight must be causing functional limitations that prevent the securing, retaining, or regaining employment (In other words, what essential job functions can the individual not perform due to the weight?) and

 The individual's attending physician must recommend weight loss. The physician must document other medical problems that are exacerbated by the individual's weight and clearly impact employment and

 The individual must have a Body Mass Index (BMI) of 40 or more. Occasionally, lesser obesity may be considered as a secondary disability when in combination with serious life-threatening illnesses. This should be evaluated on a case-by-case basis.

Weight Loss/Management Programs

The Agency will only participate in weight loss/management programs that offer nutrition education involving registered dieticians or licensed nutritionists and provide long-term strategies to deal with weight problems the individual may have in the future. Weight loss/management programs must not be provided, planned, or promised before review with the District Manager and review by the District Medical Consultant. If recommended, services may only be authorized for an initial period of 8 - 12 weeks. Each additional period of 8 - 12 weeks of assistance may be offered only if the person has achieved an average weight loss of at least 1 - 2 pounds per week. The counselor is to review the person's progress at the end of each period and determine if Agency assistance will continue.

The Agency will not pay for surgical approaches to controlling obesity, exercise/weight loss equipment, foods including special pre-packaged foods, liquid diets, weight loss drugs, or special vitamins and other nutritional supplements.

3.23 WORKERS' COMPENSATION REFERRAL PROGRAM

The Mississippi Workers' Compensation Commission (MWCC) has a cooperative agreement with VR whereby selected individuals injured on the job are referred to VR for possible provision of vocational rehabilitation services.

3.22.1 Referrals

The MWCC Rehabilitation Director will route all Workers‘ Compensation (WC) referrals to VR counselors through the State Coordinator for the Workers' Compensation Referral Program‘s The WC referral (R-2) form is used for reporting to MWCC and for follow-up purposes. The VR counselor will be responsible for determining, through contact with the claimant, whether the individual could benefit from VR services. Absence of need for medical expense assistance will not be the sole reason for not serving a WC claimant.

MWCC requires a report of the action taken on each claimant within thirty (30) working days from the date of referral. Reports of action are documented on the R-2 by listing the attempts and/or methods of contact with the client and his/her employer, indicating the disposition of the referral by marking the appropriate response (i.e.; Will evaluate for rehabilitation service, No rehabilitation services needed - case closed, or Will accept case and develop program), and documenting rationale for decision. Upon completion of the R-2, a copy will be mailed directly to MWCC. The original will be retained in the case file in the district office. A copy will be forwarded to the State Coordinator for the Workers‘ Compensation Referral Program for his/her records. MWCC‘s address is:

Mississippi Workers' Compensation Commission Attention: Rehabilitation Director Post Office Box 5300 Jackson, MS 39296-5300

3.22.2 Exchange of Information

There will be a free and open exchange of information between the Agency and MWCC. However, when a VR counselor is requesting information from MWCC, the WC claim number must be provided. In cases that were referred by MWCC, this number can be found on the R-2 form.

3.22.3 Services

If an individualized plan for employment (IPE) is developed in a case involving workers compensation, the VR counselor must provide a copy of IPE or amendment to the MWCC Rehabilitation Director. If the IPE includes services that entail use of insurance carrier funds, both the insurance carrier (as identified on the R-2 form) and MWCC must give prior approval.

4.0 ABBREVIATIONS & ACRONYMS

Abbreviation/Acronym Formal Name AACE Accessible Automated Case Environment ABAS Adaptive Behavior Assessment System ACB American Council of the Blind ADA Americans with Disabilities Act ADHD Attention Deficit Hyperactivity Disorder AFB American Foundation for the Blind AMRC Addie McBryde Rehabilitation Center for the Blind ARC Association for the Rights of Citizens with Developmental Disabilities AT Assistive Technology AW AbilityWorks BDS Business Development Services

BEP Business Enterprise Program BIA Brain Injury Association BSG Basic Service Grant C/E Certificate of Eligibility CANAR Consortia of Administrators for Native American Rehabilitation CAP Client Assistance Program CCWAVES Commission on Certification of Work Adjustment and Vocational Evaluation Specialists CDBG Community Development Block Grant CEU Continuing Education Unit CLEO Chief Local Elected Official CMI Chronic Mental Illness CPM Certified Public Manager CRC Certified Rehabilitation Counselor CRP Community Rehabilitation Program CRS Case Review Schedule CSAVR Council of State Administrators for Vocational Rehabilitation CSLR Counselor CVE Certified Vocational Evaluator CWIC Community Work Incentives Coordinator D/B Deaf-Blind dB Decibel DD Developmental Disability DDS Disability Determination Services DFA Mississippi Department of Finance and Administration DHS Mississippi Department of Human Services DM District Manager DMH Mississippi Department of Mental Health DOL U. S. Department of Labor DOT Dictionary of Occupational Titles or U. S. Department of Transportation DSM-IV Diagnostic & Statistical Manual - IV DSU Designated State Unit EC Employment Coordinator EIN Employer Identification Number EN Employment Network FFY Federal Fiscal Year FM Facility Manager HRD Human Resource Development

ID Intellectual Disability IDEA Individuals with Disabilities Education Act IEP Individualized Education Plan IHL Institutions of Higher Learning ILS Independent Living Services INS U.S. Department of Immigration & Naturalization Services IPE Individualized Plan for Employment JDPS Job Development and Placement Services JR Job Readiness JWOD Javits-Wagner-O‘Day Act LBO Legislative Budget Office LEO Local Elected Official LIFE Living Independence for Everyone LINCS Linking Innovative Networks of Community Services LPC Licensed Professional Counselor LWIA Local Workforce Investment Area LWIB Local Workforce Investment Board MAD Mississippi Association of the Deaf MADE Mississippi Association of Disability Examiners MAER Mississippi Association for Education & Rehabilitation of the Blind & Visually Impaired MAIL Mississippi Association for Independent Living MARSS Mississippi Association of Rehabilitation Support Staff MCL Maximum Comfort Level MDES Mississippi Department of Employment Security MDOC Mississippi Department of Corrections MDOT Mississippi Department of Transportation MDRS Mississippi Department of Rehabilitation Services MHIA Mississippi Head Injury Association MIB Mississippi Industries for the Blind MIID Mississippi Industries for Individuals with Disabilities MMA Mississippi Manufacturers Association MMPI Minnesota Multiphasic Personality Inventory M-PIC Mississippi Partners for Informed Choice MPWA Mississippi Partnership Workforce Area MRAA Mississippi Rehabilitation Administration Association MRC Methodist Rehabilitation Center MRCA Mississippi Rehabilitation Counseling Association MRID Mississippi Registry of Interpreters for the Deaf MWCC Mississippi Workers‘ Compensation Commission

MYTI Mississippi Model Youth Transition Innovation Project NAIL National Association of Independent Living NAMRC National Association of Multicultural Rehabilitation Concerns NARL National Association of Rehabilitation Leadership NARSS National Association of Rehabilitation Support Staff NFB National Federation of the Blind NIDRR National Institute of Disability & Rehabilitation Research NISH National Institute for the Severely Handicapped NRA National Rehabilitation Association OD Right Eye OJT On-the-job Training OS Left Eye OSC One-Stop Center OSDP Office of Special Disability Programs OSERS U. S. Office of Special Education & Rehabilitative Services OSHA Occupational Safety & Health Association OU Both Eyes OVR Office of Vocational Rehabilitation OVRB Office of Vocational Rehabilitation for the Blind PAS Personal Assistance Services PASS Plan for Achieving Self-Support PES Post-employment Services PIC Private Industry Council PPVT Peabody Picture Vocabulary Test PSED Post-Secondary Education RAM Rehabilitation Association of Mississippi RCD Rehabilitation Counselor for the Deaf RCEA Rehabilitation Counselors and Educators Association REACH Realizing that Empowerment through Accomplishment and Confidence Building it is Honorable to be Blind REM Regional Employment Manager RID Registry of Interpreters for the Deaf RM Regional Manager RSA Rehabilitation Services Administration SAAS State Automated Accounting System SCI Spinal Cord Injury SDA Service Delivery Area SE Supported Employment

SFY State Fiscal Year SILC State Independent Living Council SLD Specific Learning Disability SMI Serious Mental Illness SOICC State Occupational Information Coordinating Committee SPB State Personnel Board SRC State Rehabilitation Council SRT Speech Reception Threshold SSA Social Security Administration SSDI Social Security Disability Insurance SSI Supplemental Security Income START Success through Assistive Rehabilitation Technology SWIB State Workforce Investment Board TBI Traumatic Brain Injury TDD Telecommunication Device for the Deaf TTY Tele-typewriter for the Deaf TWE Trial Work Experience UCL Uncomfortable listening level VA U. S. Department of Veterans‘ Affairs VE Vocational Evaluation VEWAA Vocational Evaluation & Work Adjustment Association VR Vocational Rehabilitation VSMS Vineland Social Maturity Scale VTI Vocational Training Instructor WAIS Wechsler Adult Intelligence Scale WC Workers‘ Compensation WEP Work Experience Program WIA Workforce Investment Act WIIA Work Incentives Improvement Act WIPA Work Incentives Planning and Assistance WISC Wechsler Intelligence Scale for Children WMS Wechsler Memory Scale WOTC Work Opportunity Tax Credit WRAT Wide Range Achievement Test

4.1 EMERGENCY ASSISTANCE PLAN

The purpose of the Agency‘s Emergency Assistance Plan (EAP) is to provide for the service delivery to disabled individuals during a natural disaster. The intent of the EAP is to develop a service delivery system that will enable VR clients in the event of a natural disaster to continue to receive services without a significant disruption in their programs.

Services provided by other community agencies/organizations will be coordinated by VR to assist in meeting the needs of clients if such services are typically not provided by VR. Agencies such as the American Red Cross, Salvation Army, and Goodwill Industries would be examples of assistance service agencies. In some instances, the designated disaster shelter in the community may not be accessible. A list of disaster shelters is attached to this plan. In some communities (such as Claiborne County), agreements and/or arrangements have been made with hospitals, nursing homes and other care providers to utilize their facilities, which are accessible in the event of an emergency.

The Mississippi Emergency Management Agency has incorporated into their State Plan of Emergency Services the following information:

The counties contained in each of the nine VR service delivery areas, the names, addresses and telephone number of each District Manger and VR counselor.

This information will be incorporated into each county emergency plan. This will enable community and local city governments to be aware of whom to contact in the event they identify or receive a request for assistance from an individual with a disability. In most instances, it is apparent that VR staff that lives within the area affected by the natural disaster will themselves be unable to immediately respond to requests from clients in an effective manner.

It will be the administrative responsibility of the Director of VR and the Director of Client Services to designate appropriate VR staff not affected by the disaster to assist clients in the affected area(s). Appropriate VR staff may consist of a counselor, secretary, assistive technology specialist, rehabilitation teacher for the blind, and a staff member with communication skills for the deaf. The designated staff will utilize existing VR office space and equipment in the affected area, if available. In the event such space/equipment has been destroyed, other office space will be secured within the area. If available, office space may be arranged at the county courthouse, mental health center, AbilityWorks, community college, fire station, hospital, disaster shelter, or church.

It may be necessary to select different office sites in the affected area to enable the counselor to have easy access to clients. This might also expedite the delivery of needed services. In the event, the counselor does not have sufficient case service funds to meet the needs of their clients during a disaster; they should request additional funds from their District Manager and/or the Director of Client Services.

The District Manager and/or the Madison State Office will duplicate client records, as needed and supplied to assigned VR staff. Case service records, which will be duplicated for use by designated staff, will consist of the following:

 Copy of Application for Services  Copy of IPE, Certificate of Eligibility  Copy of the case notes  Copy of testing and/or psychological reports

 Other information as needed for continuation of services

Every effort will be made to provide transportation (as needed), repair and/or replacement of assistive technology devices to clients when available and as needed. Assigned VR staff will be responsible for coordination of the various resources within the community to assist in meeting the client's needs. As a component of this plan, counselors will begin to educate their clients as to the community resources available to them in the event of a natural disaster. Such education and information will include the various locations of disaster shelters in their area, which are accessible; how to contact the Emergency Operation's Center in their county; as well as the toll free "hot line" telephone number for MDRS. The services of VR assistive technology specialists will be utilized to assess repairs to damaged equipment, home modifications, ramps, and other technology applications, which may be needed.

Each AbilityWorks unit has its own individual emergency plan, which is required by CARF. Periodic testing of this plan is required and conducted on a scheduled basis. A copy of the plan is posted on the bulletin board of each Community Rehabilitation Program (AbilityWorks). VR administrative staff conducts routine reviews/audits of those plans to be certain that each plan is being tested on a routine basis.

Assigned VR staff may need to give priority to selected cases of the most severely disabled due to individuals who have special needs and/or may be taking medications for disabilities that would be life threatening if not available to the client. These individuals might require assistance in obtaining insulin, for example, for a diabetic condition. Other individuals may require special medication for epileptic seizures, spinal cord, heart conditions, or anti-depressant drugs. Individuals with cognitive impairments (lack of ability to reason) may need assistance to determine a course of action during a disaster or emergency. Counselors should maintain a list of disabled individuals on their caseloads that they consider would require some type of assistance during a natural disaster. This list should be reviewed on a periodic basis, updated, and maintained for quick reference purposes.

Procedures to be followed in the event of a disaster:

 District Manager, Director of Client Services, and OVR Director become aware of disaster and inter-communication begins.

District Manager assesses situation and reports to Director of Client Services and/or OVR Director his/her recommendations.

 Director of Client Services evaluates the availability/adequacy of case service funds for utilization during this period.

 Appropriate VR staff is identified by the Director of Client Services and/or OVR Director

 As necessary, client records are duplicated by MIS.

 Assign VR staff to locate/occupy available office space. Office space in several areas

within specified territory may be necessary.

 High-risk clients are identified and efforts to contact begin.

 VR staff provides appropriate services within the mission of the VR program and arrange/coordinate other services provided by community programs/organizations.

 Identify any equipment item needs and determine if any surplus equipment is available for loan purposes.

 Finalize arrangements to deliver equipment items identified to clients to expedite services.

It may be necessary to arrange for interpreter services for the deaf and/or mobility or reader services for the blind. It should be understood that during this period that MIS would consider request for client data a high priority.

4.2 HANDICAPPED PARKING - LICENSE PLATES & PLACARDS

Based on Section 27-19-56 Mississippi Code of 1972 as amended, any legal resident of the State of Mississippi who is physically handicapped may obtain a special license plate bearing the International Symbol of Access for not more than one vehicle that is registered in the applicant's name. The initial application shall be accompanied by the certification of a licensed physician that the applicant meets the definition of persons with disabilities, which limit or impair the ability to walk.

An applicant for a special license plate bearing the International Symbol of Access shall not be required to pay any fee or charge for the issuance of such license plate separate from or in addition to road and bridge privilege taxes, ad valorem taxes and registration fees otherwise required by law to be paid for the issuance of a regular license plate for such vehicle.

Also available is a removable placard bearing the International Symbol of Access, which allows the vehicle to park in areas set aside for the disabled when the person who is disabled is the driver or occupant of the vehicle. A temporary placard may be issued based upon a period determined by a physician that the applicant will have the disability, not to exceed six months. Placards for permanent conditions are printed as white on a blue shield. Temporary placards are white on a red shield and include a date of expiration. Both placards identify the individual for which it was issued.

Special license plates and placards may be obtained through the office of the Tax Collector in the applicant‘s residence county. Forms requiring a physician to certify the presence of a disability are also available through the Tax Collector's office.

4.3 PERSONNEL RECLASSIFICATION CRITERIA

Criteria has been developed for reclassification for VR/VRB Counselor I, II, III, Senior; Evaluator I, II, III, Senior; Job Placement Counselor I, II, III, Senior; Facility Manager I, II, III; Production Manager I, II, III; and Work Adjustment Instructor I, II, III. These criteria should be used in addition to those set forth in the MDRS Policy Manual.

Promotions are not based solely on the time a person is in a particular position. That is the minimum requirement to be eligible for consideration to be reclassified. The individual‘s immediate supervisor must provide documented evidence (examples) illustrating how the employee meets the following criteria.

Additionally, the Agency must have the funds and spend authority available from the State Legislature in the salary category to pay for any salary increases. The State Personnel Board now sets annual budgetary limits for agencies, this may delay increases from being made at the time they are requested.

VR/VRB Counselor:

In addition to the criteria required in the MDRS policy manual, OVR requires the following:

1. Evidence that the individual has met successful closure goals on previous performance appraisal and YTD on a prorated basis.

2. A statement concerning the employee‘s performance and progress at the current level to include:

a. Ability to perform job duties independently, and

b. Case management statistics reflect overall attentiveness to caseload, including time in status and timely client contacts and severely disabled and unsuccessful closure rates as deemed appropriate by supervisor.

3. Examples of the employee‘s willingness to accept supervision, dependability, effectiveness as a team player, to include willingness to accept additional assignments.

4. Appropriate participation in agency sponsored and outside training sessions.

Evaluators:

In addition to the criteria required in the MDRS policy manual, OVR requires the following:

1. Evidence that the individual has met goals on ―Report Timeliness‖ and ―Service Planning‖ on previous performance appraisal and YTD on a prorated basis.

2. A statement concerning the employee‘s performance and progress at the current level to include:

a. Ability to perform job duties independently, and

b. Indication of an overall attentiveness to caseload, including minimization of time and service area and coordination of services with the referring counselor and others involved with services to individual clients.

3. Examples of the employee‘s willingness to accept supervision, dependability, effectiveness as a team player, to include willingness to accept additional assignments, going out of the way to assist clients and increase placement efforts, and innovation in service provision.

4. Appropriate participation in agency sponsored and outside training sessions.

Facility Manager

In addition to the criteria required in the MDRS policy manual, OVR requires the following:

1. Evidence that the individual has met goals on ―Financial Transactions,‖ ―Financial Status‖ and ―Employment Status‖ on the previous performance appraisal and YTD on a prorated basis. 2. A statement concerning the employee‘s performance and progress at the current level to include: a. Ability to perform job duties independently, and b. How the AbilityWorks Outcome Measurement Report demonstrates CRP activities on a level warranting promotion. 3. Examples of the employee‘s willingness to accept supervision, dependability, effectiveness as a team leader and maintenance of adequate number and diversity of contracts. 4. Appropriate participation in agency sponsored and outside training sessions.

Job Placement Counselor:

In addition to the criteria required in the MDRS policy manual, OVR requires the following:

1. Evidence that the individual has met goals of ―Enrolled,‖ ―Placed‖ and ―Employee at Follow-up‖ on previous performance appraisal and YTD on a prorated basis. 2. A statement concerning the employee‘s performance and progress at the current level to include: a. Ability to perform job duties independently, and b. Ability to communicate and to develop and maintain quality relationships with employers. 3. Examples of the employee‘s willingness to accept supervision, dependability, effectiveness as a team player, to include willingness to accept additional assignments. 4. Appropriate participation in agency sponsored and outside training sessions.

Production Manager:

In addition to the criteria required in the MDRS policy manual, OVR requires the following:

1. Evidence that the individual has met goals on ―Production Schedules‖ and ―Safety‖ on the previous performance appraisal and YTD on a prorated basis. 2. Describe and provide examples of the employee‘s performance and progress at the current level to include: a. Ability to perform job duties independently, and b. Provide activities within the workshop reflect overall attention to production needs. 3. Examples of the employee‘s willingness to accept supervision, dependability, effectiveness as a team player, to include willingness to accept additional assignments. 4. Appropriate participation in agency sponsored and outside training sessions.

Work Adjustment Instructor:

In addition to the criteria required in the MDRS policy manual, OVR requires the following: 1. Evidence that the individual has met goals on ―Completion of Reports to Interact within established procedures and prescribed time frames‖ on previous performance appraisal and YTD on a prorated basis.

2. Examples of the employee‘s performance and progress at the current level to include: a. Ability to perform job duties independently. b. Provide workshop clients with instruction and training regarding manufacturing duties. 3. Examples of the employee‘s willingness to accept supervision, dependability, effectiveness as a team player, to include willingness to accept additional assignments. 4. Appropriate participation in agency sponsored and outside training sessions.

4.4 REHABILITATION DEFINITIONS

Applicant means any person who signs or who, by and through his/her representative, i.e. parent, a family member, legal guardian, an advocate, or an authorized representative, causes to be signed, a dated application or letter requesting vocational rehabilitation services from the Mississippi Department of Rehabilitation Services.

(Authority: Section 12(c) of the Act; 29 U.S.C. 709(c))

Assistive Technology Device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of an individual with a disability.

(Authority: Section 7(3) of the Act; 29 U.S.C. 705(3))

Assistive Technology Service means any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device, including---

 The evaluation of the needs of an individual with a disability, including a functional evaluation of the individual in his or her customary environment;  Purchasing, leasing, or otherwise providing for the acquisition by an individual with a disability of an assistive technology device;  Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;  Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;  Training or technical assistance for an individual with a disability or, if appropriate, the family members, guardians, advocates, or authorized representatives of the individual; and  Training or technical assistance for professionals (including individuals providing education and rehabilitation services), employers, or others who provide services to, employ, or are otherwise substantially involved in the major life functions of individuals with disabilities, to the extent that training or technical assistance is necessary to the achievement of an employment outcome by an individual with a disability.

(Authority: Sections 7(4) and 12(c) of the Act; 29 U.S.C. 705(4) and 709(c)) Community Rehabilitation Program means a program that provides directly or facilitates the provision of one or more of the following vocational rehabilitation services to individuals with disabilities to enable those individuals to maximize their opportunities for employment, including career advancement:

 Medical, psychiatric, psychological, social, and vocational services that are provided under one management;  Testing, fitting, or training in the use of prosthetic and orthotic devices;  Recreational therapy;  Physical and occupational therapy;  Speech, language, and hearing therapy;  Psychiatric, psychological, and social services, including positive behavior management;  Assessment for determining eligibility and vocational rehabilitation needs;  Rehabilitation technology;  Job development, placement, and retention services;  Evaluation or control of specific disabilities;  Orientation and mobility services for individuals who are blind;  Extended employment;  Psychosocial rehabilitation services;  Supported employment services and extended services;  Services to family members if necessary to enable the applicant or eligible individual to achieve an employment outcome;  Personal assistance services; and  Services similar to the services described above in this definition.

For the purposes of this definition, the word program means an agency, organization, or institution, or unit of an agency, organization, or institution, that provides directly or facilitates the provision of vocational rehabilitation services as one of its major functions.

Comparable Services and Benefits means—

I. Services and benefits that are—

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; 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 Sec. 361.53; and 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))

Competitive Employment means work---

I. In the competitive labor market that is performed on a full-time or part-time basis in an integrated setting; and

II. For which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals who are not disabled.

(Authority: Sections 7(11) and 12(c) of the Act; 29 U.S.C. 705(11) and 709(c))

Counseling and Guidance means to give advice, recommend, consult, and assist the consumer in dealing with issues related to adjustment to a disability. It can be --

I. Essential Counseling and Guidance - the mildest form of ―advice giving‖ based on the counselor‘s experience and training. The counselor primarily attempts to make the consumer aware of specific issues concerning services or reminds him/her of things/activities that need to be done regarding not only the services but also various issues surrounding those services. Essential counseling and guidance include subjects relating to the services that a counselor discusses with all consumers.

Example 1: For surgery, it may include a discussion with the consumer concerning following doctor‘s orders, when to return to work, taking medication properly, and what to

expect in the hospital.

Example 2: For visual problems, it may include subjects such as eye protection, regular follow-ups for eye care, and general concerns about possibility of further eye loss.

Example 3: For hearing aids, it may include protecting hearing, keeping ear canals clean, caring for aids, and battery requirements.

Example 4: For prosthesis wearers, it may include keeping the stump clean and dry, changing stump socks, and skin protection.

II. Planned Counseling and Guidance - results from the identification of a consumer problem(s) that requires the counselor and consumer to get together at regular intervals to discuss the problems(s) and work on its resolution or progress toward the goals established to resolve the problem. The issues related to adjustment to a disability such as problems with frustration/depression due to loss of functional capacities and changes in lifestyle are most likely the reason used to justify the counseling and guidance along with other problems that could possibly arise as the case progresses. There must be documentation to show that issues discussed, progress and future plans outlined to deal with the issues.

Eligible Individual means an applicant for vocational rehabilitation services who meets the following eligibility requirements:

I. Basic Requirements. The Agency's determination of an applicant's eligibility for vocational rehabilitation services must be based only on the following requirements:

A. A determination by qualified personnel that the applicant has a physical or mental impairment B. A determination by qualified personnel that the applicant's physical or mental impairment constitutes or results in a substantial impediment to employment for the applicant C. A determination by a qualified vocational rehabilitation counselor employed by the Agency that the applicant requires vocational rehabilitation services to prepare for, secure, retain, or regain employment consistent with the applicant's unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. D. A presumption, in accordance with paragraph (II) of this definition that the applicant can benefit in terms of an employment outcome from the provision of vocational rehabilitation services.

II. Presumption of Benefit. The Agency must presume that an applicant who meets the eligibility requirements in paragraphs (A) and (B) of the Basic requirements above can benefit in terms of an employment outcome unless it demonstrates, based on clear and convincing evidence, that the applicant is incapable of benefiting in terms of an

employment outcome from vocational rehabilitation services due to the severity of the applicant's disability.

III. Presumption of Eligibility for Social Security Recipients and Beneficiaries

A. Any applicant who has been determined eligible for Social Security benefits under Title II or Title XVI of the Social Security Act is ---

1. Presumed eligible for vocational rehabilitation services under paragraphs (I) and (II) of this definition; and 2. Considered an individual with a significant disability as defined

B. If an applicant for vocational rehabilitation services asserts that he or she is eligible for Social Security benefits under Title II or Title XVI of the Social Security Act (and, therefore, is presumed eligible for vocational rehabilitation services under paragraph (III)(A)(1) of this definition), but is unable to provide appropriate evidence, such as an award letter, to support that assertion, the Agency must verify the applicant's eligibility under Title II or Title XVI of the Social Security Act by contacting the Social Security Administration. This verification must be made within a reasonable period of time that enables the Agency to determine the applicant's eligibility for vocational rehabilitation services within 60 days of the individual submitting an application for services.

IV. Achievement of an Employment Outcome. Any eligible individual, including an individual whose eligibility for vocational rehabilitation services is based on the individual being eligible for Social Security benefits under Title II or Title XVI of the Social Security Act, must intend to achieve an employment outcome that is consistent with the applicant's unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

A. The Agency is responsible for informing individuals, through its application process for vocational rehabilitation services that individuals who receive services under the program must intend to achieve an employment outcome.

B. The applicant's completion of the application process for vocational rehabilitation services is sufficient evidence of the individual's intent to achieve an employment outcome, and no additional demonstration on the part of the applicant is required for purposes of satisfying paragraph (IV) of this definition.

V. Interpretation. Nothing in this definition is to be construed to create an entitlement to any vocational rehabilitation service.

(Authority: Sections 7(20) (A) and 102(a) (1) of the Act; 29 U.S.C. 705(20) (A) and 722(a) (1))

Employment Outcome means, with respect to an individual, entering or retaining full-time or, if appropriate, part-time competitive employment in the integrated labor market to the greatest

extent practicable; supported employment; or any other type of employment, including self- employment, telecommuting, or business ownership, that is consistent with an individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

(Authority: Sections 7(11), 12(c), 100(a) (2), and 102(b)(3)(A) of the Act; 29 U.S.C. 705(11), 709(c), 720(a)(2), and 722(b)(3)(A))

Extended employment means work in a non-integrated or sheltered setting for a public or private nonprofit agency or organization that provides compensation in accordance with the Fair Labor Standards Act.

(Authority: Section 12(c) of the Act; 29 U.S.C. 709(c))

Extended Services means ongoing support services and other appropriate services that are needed to support and maintain an individual with a most significant disability in supported employment and that are provided by a State agency, a private nonprofit organization, employer, or any other appropriate resource, from funds other than funds received under Title I (vocational rehabilitation) or Title VI, part B (supported employment), of the Rehabilitation Act as amended after an individual with a most significant disability has made the transition from support provided by the Agency.

(Authority: Sections 7(13) and 623 of the Act; 29 U.S.C. 705(13) and 795i)

Extreme Medical Risk means a probability of substantially increasing functional impairment or death if medical services, including mental health services, are not provided expeditiously.

(Authority: Sections 12(c) and 101(a)(8)(A)(i)(III) of the Act; 29 U.S.C. 709(c) and 721(a)(8)(A)(i)(III))

Family Member for purposes of receiving vocational rehabilitation services in accordance with Sec. 361.48(i), means an individual---

I. Who either—

A. Is a relative or guardian of an applicant or eligible individual; or

B. Lives in the same household as an applicant or eligible individual;

II. Who has a substantial interest in the well-being of that individual; and

III. Whose receipt of vocational rehabilitation services is necessary to enable the applicant or eligible individual to achieve an employment outcome.

(Authority: Sections 12(c) and 103(a)(17) of the Act; 29 U.S.C. 709(c) and 723(a)(17))

Impartial Hearing Officer means an individual who ---

I. Is not an employee of a public agency (other than an administrative law judge, hearing examiner, or employee of an institution of higher education)

II. Is not a member of the MDRS State Rehabilitation Council

III. Has not been involved previously in the vocational rehabilitation of the applicant or eligible individual

IV. Has knowledge of the delivery of vocational rehabilitation services, the State plan, and the Federal and State regulations governing the provision of services

V. Has received training with respect to the performance of official duties; and

VI. Has no personal, professional, or financial interest that would be in conflict with the objectivity of the individual.

An individual is not considered to be an employee of a public agency for the purposes of this definition solely because the individual is paid by the agency to serve as a hearing officer.

(Authority: Section 7(16) of the Act; 29 U.S.C. 705(16))

Individual Who is Blind means a person who is blind within the meaning of applicable State law.

(Authority: Section 12(c) of the Act; 29 U.S.C. 709(c))

Individual With A Disability for Vocational Rehabilitation and Supported Employment means an individual ---

I. Who has a physical or mental impairment;

II. Whose impairment constitutes or results in a substantial impediment to employment; and

III. Who can benefit in terms of an employment outcome from the provision of vocational rehabilitation services.

(Authority: Section 7(20)(A) of the Act; 29 U.S.C. 705(20)(A))

Individual with a Disability for Purposes of Special Disability Programs including independent living means an individual ---

I. Who has a physical or mental impairment that substantially limits one or more major life activities;

II. Who has a record of such an impairment; or

III. Who is regarded as having such impairment.

(Authority: Section 7(20)(B) of the Act; 29 U.S.C. 705(20)(B))

Individual with A Most Significant Disability: an individual who meets the criteria for "significantly disabled‖ (Section 7(21) of the 1998 Rehabilitation Act Amendments) and:

I. Whose physical or mental impairments seriously limit two or more functions in terms of employment outcomes, and,

II. Who will require vocational rehabilitation services in order to prepare for, secure, retain, or regain employment that is consistent with that individual's unique strengths, resources, priorities, concerns, abilities, capacities, interests, and informed choice

(Authority: Sections 7(21) (E) (i) and 101(a) (5) (C) of the Act; 29 U.S.C. 705(21) (E) (i) and 721(a) (5) (C))

Individual With A Significant Disability an individual with a disability ---

I. Who has a severe physical or mental impairment that seriously limits one or more functional capacities (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of an employment outcome;

II. Whose vocational rehabilitation can be expected to require multiple vocational rehabilitation services over an extended period of time; and

III. Who has one or more physical or mental disabilities or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

(Authority: Section 7(21) (A) of the Act; 29 U.S.C. 705(21) (A))

Individual’s Representative means any representative chosen by an applicant or eligible individual, as appropriate, including a parent, guardian, other family member, or advocate, unless a representative has been appointed by a court to represent the individual, in which case the court-appointed representative is the individual's representative.

(Authority: Sections 7(22) and 12(c) of the Act; 29 U.S.C. 705(22) and 709(c))

Information and Referral Services means referral and other services necessary to assist individuals with disabilities, including eligible individuals who do not meet the agency's order of

selection criteria for receiving vocational rehabilitation services when the agency is operating on an order of selection, to secure needed services from other agencies and to advise those individuals about client assistance programs. This includes other components of the statewide workforce investment system.

Integrated Setting means ---

I. With respect to the provision of services, a setting typically found in the community in which applicants or eligible individuals interact with non-disabled individuals other than non- disabled individuals who are providing services to those applicants or eligible individuals;

II. With respect to an employment outcome, a setting typically found in the community in which applicants or eligible individuals interact with non-disabled individuals, other than non- disabled individuals who are providing services to those applicants or eligible individuals, to the same extent that non-disabled individuals in comparable positions interact with other persons.

(Authority: Section 12(c) of the Act; 29 U.S.C. 709(c))

Maintenance means monetary support provided to an individual for expenses, such as food, shelter, and clothing, that are in excess of the normal expenses of the individual and that are necessitated by the individual's participation in an assessment for determining eligibility and vocational rehabilitation needs or the individual's receipt of vocational rehabilitation services under an individualized plan for employment.

Examples: The following are examples of expenses that would meet the definition of maintenance. The examples are illustrative, do not address all possible circumstances, and are not intended to substitute for individual counselor judgment.

▪ Example 1: The cost of a uniform or other suitable clothing that is required for an individual's job placement or job-seeking activities.

▪ Example 2: The cost of short-term shelter that is required in order for an individual to participate in assessment activities or vocational training at a site that is not within commuting distance of an individual's home.

▪ Example 3: The initial one-time costs, such as a security deposit or charges for the initiation of utilities that are required in order for an individual to relocate for a job placement.

▪ Example 4: The costs of an individual's participation in enrichment activities related to that individual's training program.

(Authority: Sections 12(c) and 103(a) (7) of the Act; 29 U.S.C. 709(c) and 723(a) (7))

Mediation means the act or process of using an independent third party to act as a mediator, intermediary, or conciliator to assist persons or parties in settling differences or disputes prior to pursuing formal administrative or other legal remedies.

(Authority: Section 12(c) of the Act; 29 U.S.C. 709(c))

Mediator (Qualified And Impartial) means an individual who ---

I. Is not an employee of a public agency (other than an administrative law judge, hearing examiner, employee of a State office of mediators, or employee of an institution of higher education);

II. Is not a member of the MDRS State Rehabilitation Council;

III. Has not been involved previously in the vocational rehabilitation of the applicant or eligible individual;

IV. Is knowledgeable of the vocational rehabilitation program and the applicable Federal and State laws, regulations, and policies governing the provision of vocational rehabilitation services;

V. Has been trained in effective mediation techniques consistent with any State-approved or -recognized certification, licensing, registration, or other requirements; and

VI. Has no personal, professional, or financial interest that would be in conflict with the objectivity of the individual during the mediation proceedings.

An individual serving as a mediator is not considered to be an employee of the Agency for the purposes of this definition solely because the individual is paid by the Agency to serve as a mediator.

(Authority: Sections 12(c) and 102(c) (4) of the Act; 29 U.S.C. 709(c) and 722(c) (4))

Ongoing Support Services as used in the definition of ``Supported employment''

I. Means services that are --

A. Needed to support and maintain an individual with a most significant disability in supported employment;

B. Identified based on a determination by the Agency of the individual's need as specified in an individualized plan for employment; and

C. Furnished by the Agency from the time of job placement until transition to extended services, unless post-employment services are provided following transition, and thereafter by one or more extended services providers throughout the individual's

term of employment in a particular job placement or multiple placements if those placements are being provided under a program of transitional employment;

II. Must include an assessment of employment stability and provision of specific services or the coordination of services at or away from the worksite that are needed to maintain stability based on ---

A. At a minimum, twice-monthly monitoring at the worksite of each individual in supported employment; or

B. If under specific circumstances, especially at the request of the individual, the individualized plan for employment provides for off-site monitoring, twice monthly meetings with the individual;

II. Consist of ---  Any particularized assessment supplementary to the comprehensive assessment of rehabilitation needs;  The provision of skilled job trainers who accompany the individual for intensive job skill training at the work site;  Job development and training;  Social skills training;  Regular observation or supervision of the individual;  Follow-up services including regular contact with the employers, the individuals, the parents, family members, guardians, advocates or authorized representatives of the individuals, and other suitable professional and informed advisors, in order to reinforce and stabilize the job placement;  Facilitation of natural supports at the worksite;  Any other service identified in the scope of vocational rehabilitation services for individuals, described in Sec. 361.48; or  Any service similar to the foregoing services.

(Authority: Sections 7(27) and 12(c) of the Act; 29 U.S.C. 705(27) and 709(c)) Personal Assistance Services means 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 that the individual would typically perform without assistance if the individual did not have a disability. The services must be designed to increase the individual's control in life and ability to perform everyday activities on or off the job. The services must be necessary to the achievement of an employment outcome and may be provided only while the individual is receiving other vocational rehabilitation services. The services may include training in managing, supervising, and directing personal assistance services.

(Authority: Sections 7(28), 102(b)(3)(B)(i)(I), and 103(a)(9) of the Act; 29 U.S.C. 05(28), 722(b)(3)(B)(i)(I), and 723(a)(9))

Physical and Mental Restoration Services means ---

 Corrective surgery or therapeutic treatment that is likely, within a reasonable period of time, to correct or modify substantially a stable or slowly progressive physical or mental impairment that constitutes a substantial impediment to employment;  Diagnosis of and treatment for mental or emotional disorders by qualified personnel in accordance with State licensure laws;  Dentistry;  Nursing services;  Necessary hospitalization (either inpatient or outpatient care) in connection with surgery or treatment and clinic services;  Drugs and supplies;  Prosthetic and orthotic devices;  Eyeglasses and visual services, including visual training, and the examination and services necessary for the prescription and provision of eyeglasses, contact lenses, microscopic lenses, telescopic lenses, and other special visual aids prescribed by personnel that are qualified in accordance with State licensure laws;  Podiatry;  Physical therapy;  Occupational therapy;  Speech or hearing therapy;  Mental health services;  Treatment of either acute or chronic medical complications and emergencies that are associated with or arise out of the provision of physical and mental restoration services, or that are inherent in the condition under treatment;  Special services for the treatment of individuals with end-stage renal disease, including transplantation, dialysis, artificial kidneys, and supplies; and

 Other medical or medically related rehabilitation services.

(Authority: Sections 12(c) and 103(a)(6) of the Act; 29 U.S.C. 709(c) and 723(a)(6))

Physical or Mental Impairment means ---

I. Any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, hemic and lymphatic, skin, and endocrine; or

II. Any mental or psychological disorder such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.

(Authority: Sections 7(20) (A) and 12(c) of the Act; 29 U.S.C. 705(20) (A) and 709(c))

Post-Employment Services means --- one or more of the services identified in Sec. 361.48 that are provided subsequent to the achievement of an employment outcome and that are necessary

for an individual to maintain, regain, or advance in employment, consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

Note: Post-employment services are intended to ensure that the employment outcome remains consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. These services are available to meet rehabilitation needs that do not require a complex and comprehensive provision of services and, thus, should be limited in scope and duration. If services that are more comprehensive are required, then a new rehabilitation effort should be considered. Post- employment services are to be provided under an amended individualized plan for employment; thus, a re-determination of eligibility is not required. The provision of post- employment services is subject to the same requirements in this part as the provision of any other vocational rehabilitation service. Post-employment services are available to assist an individual to maintain employment, e.g., the individual's employment is jeopardized because of conflicts with supervisors or co-workers, and the individual needs mental health services and counseling to maintain the employment; to regain employment, e.g., the individual's job is eliminated through reorganization and new placement services are needed; and to advance in employment, e.g., the employment is no longer consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

(Authority: Sections 12(c) and 103(a) (18) of the Act; 29 U.S.C. 709(c)) and 723(a) (18))

Presumption is an assumption of fact that the law requires to be made from another group of facts already established. The 1998 Amendments to the Rehabilitation Act have created several presumptions to streamline the process of determining eligibility.

Rehabilitation Engineering means the systematic application of engineering sciences to design, develop, adapt, test, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities in functional areas, such as mobility, communications, hearing, vision, and cognition, and in activities associated with employment, independent living, education, and integration into the community.

(Authority: Section 7(12) (c) of the Act; 29 U.S.C. 709(c))

Rehabilitation Technology means the systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers confronted by, individuals with disabilities in areas that include education, rehabilitation, employment, transportation, independent living, and recreation. The term includes rehabilitation engineering, assistive technology devices, and assistive technology services.

(Authority: Section 7(30) of the Act; 29 U.S.C. 705(30))

Substantial Impediment To Employment means that a physical or mental impairment (in light of attendant medical, psychological, vocational, educational, communication, and other related factors)

hinders an individual from preparing for, entering into, engaging in, or retaining employment in an integrated setting that is consistent with the individual's abilities, capabilities, career interests, and informed choice. A substantial impediment to employment exists when the physical or mental impairment results in a functional limitation or limitations that:

1. Require the individual to modify or change his or her regular occupation;

2. Make it difficult for the individual to prepare for, secure, retain, or regain employment;

3. Cause the refusal or reluctance of the former employer to re-employ the individual because of the impairment;

4. Necessitate additional preparation in order to perform the occupation;

5. Result in the deterioration of skills or of performance in the occupation;

6. Could result in termination of employment as the impairment progresses;

7. Reflect a direct relationship between the impairment and the individual's employability; or,

8. Continue to exist when an individual is employed, but prevent that individual from functioning at an occupational level consistent with his/her unique strengths, resources, priorities, concerns, abilities, capacities, interests, and informed choice.

(Authority: Sections 7(20) (A) and 12(c) of the Act; 29 U.S.C. 705(20) (A) and 709(c))

Supported Employment means ---

I. Competitive employment in an integrated setting, or employment in integrated work settings in which individuals are working toward competitive employment, consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individuals with ongoing support services for individuals with the most significant disabilities ---

A. For whom competitive employment has not traditionally occurred or for whom competitive employment has been interrupted or intermittent as a result of a significant disability; and

B. Who, because of the nature and severity of their disabilities, need intensive supported employment services from the Agency and extended services after transition as described to perform this work; or

II. Transitional employment, as defined, for individuals with the most significant disabilities due to mental illness.

(Authority: Section 7(35) of the Act; 29 U.S.C. 705(35))

Supported Employment Services means ongoing support services and other appropriate services needed to support and maintain an individual with a most significant disability in supported employment that are provided by the Agency ---

I. For a period of time not to exceed 18 months, unless under special circumstances the eligible individual and the rehabilitation counselor or coordinator jointly agree to extend the time to achieve the employment outcome identified in the individualized plan for employment; and

II. Following transition, as post-employment services that are unavailable from an extended services provider and that are necessary to maintain or regain the job placement or advance in employment.

(Authority: Sections 7(36) and 12(c) of the Act; 29 U.S.C. 705(36) and 709(c))

Transition Services means a coordinated set of activities for a student designed within an outcome-oriented process that promotes movement from school to post-school activities, including postsecondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation. The coordinated set of activities must be based upon the individual student's needs, taking into account the student's preferences and interests, and must include instruction, community experiences, the development of employment and other post-school adult living objectives, and, if appropriate, acquisition of daily living skills and functional vocational evaluation. Transition services must promote or facilitate the achievement of the employment outcome identified in the student's individualized plan for employment.

(Authority: Section 7(37) and 103(a) (15) of the Act; 29 U.S.C. 705(37) and 723(a) (15))

Transitional Employment as used in the definition of ―Supported employment‖ means a series of temporary job placements in competitive work in integrated settings with ongoing support services for individuals with the most significant disabilities due to mental illness. In transitional employment, the provision of ongoing support services must include continuing sequential job placements until job permanency is achieved.

(Authority: Sections 7(35) (B) and 12(c) of the Act; 29 U.S.C. 705(35) (B) and 709(c)

Transportation means travel and related expenses that are necessary to enable an applicant or eligible individual to participate in a vocational rehabilitation service, including expenses for training in the use of public transportation vehicles and systems.

Examples: The following are examples of expenses that would meet the definition of transportation. The examples are purely illustrative, do not address all possible circumstances, and are not intended to substitute for individual counselor judgment.

Example 1: Travel and related expenses for a personal care attendant or aide if the services of that person are necessary to enable the applicant or eligible individual to travel to participate in any vocational rehabilitation service.

Example 2: Relocation expenses incurred by an eligible individual in connection with a job placement that is a significant distance from the eligible individual's current residence.

(Authority: 103(a) (8) of the Act; 29 U.S.C. 723(a) (8))

Vocational Rehabilitation Services as appropriate to the vocational rehabilitation needs of each individual and consistent with each individual's informed choice, the Agency assures that the following vocational rehabilitation services are available to assist the individual with a disability in preparing for, securing, retaining, or regaining an employment outcome in an integrated setting that is consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice:

 Assessment for determining eligibility and priority for services by qualified personnel, including, if appropriate, an assessment by personnel skilled in rehabilitation technology;  Assessment for determining vocational rehabilitation needs by qualified personnel, including, if appropriate, an assessment by personnel skilled in rehabilitation technology;  Vocational rehabilitation counseling and guidance, including information and support services to assist an individual in exercising informed choice;  Referral and other services necessary to assist applicants and eligible individuals to secure needed services from other agencies, including other components of the statewide workforce investment system and to advise those individuals about client assistance program;  Physical and mental restoration services, to the extent that financial support is not readily available from a source other than the Agency (such as through health insurance or a comparable service or benefit);  Vocational and other training services, including personal and vocational adjustment training, books, tools, and other training materials, except that no training or training services in an institution of higher education (universities, colleges, community or junior colleges, vocational schools, technical institutes, or hospital schools of nursing) may be paid for with funds under this part unless maximum efforts have been made by the Agency and the individual to secure grant assistance in whole or in part from other sources to pay for that training;  Maintenance, as previously defined;  Transportation in connection with the rendering of any vocational rehabilitation service and in accordance with the previous definition of that term;  Vocational rehabilitation services to family members of an applicant or eligible individual if necessary to enable the applicant or eligible individual to achieve an employment outcome;

 Interpreter services, including sign language and oral interpreter services, for individuals who are deaf or hard of hearing and tactile interpreting services for individuals who are deaf-blind provided by qualified personnel;  Reader services, rehabilitation teaching services, and orientation and mobility services for individuals who are blind;  Job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services;  Supported employment services in accordance with the previous definition;  Personal assistance services in accordance with the previous definition;  Post-employment services in accordance with the previous definition;  Occupational licenses, tools, equipment, initial stocks, and supplies;  Rehabilitation technology in accordance with the previous definition, including vehicular modification, telecommunications, sensory, and other technological aids and devices;  Transition services in accordance with the previous definition;  Technical assistance and other consultation services to conduct market analyses, develop business plans, and otherwise provide resources, to the extent those resources are authorized to be provided through the statewide workforce investment system, to eligible individuals who are pursuing self-employment or telecommuting or establishing a small business operation as an employment outcome; and  Other goods and services determined necessary for the individual with a disability to achieve an employment outcome.

(Authority: Section 103(a) of the Act; 29 U.S.C. 723(a))

4.5 REGISTRATION OF INTERPRETERS FOR THE DEAF

The purpose of these regulations is to promote public health, safety, and welfare by ensuring that deaf and hearing persons needing to communicate through an interpreter service have some measure of determining the basic qualifications of the person who presents himself or herself as an interpreter/translator of Sign Language to English and English to Sign Language. Further, in order to encourage those engaged in the business of interpreting for deaf persons to continue to improve their skill and perform in a professional manner, it is the purpose of these regulations to provide and impose sanctions against those individuals who do not meet or adhere to the procedures, qualifications and standards set out in these regulations.

Legal Authority: The Office of Deaf and Hard of Hearing (ODHH) within the Mississippi Department of Rehabilitation Services (MDRS) shall discharge, as additional duties and responsibilities, the provisions of this chapter in the recording of documentation, registering and regulation of persons who interpret/translate to provide communication between deaf and hearing persons for pay or remuneration, as established and empowered by 2005 Mississippi Laws, Chapter 402.

Definitions: The following definitions apply as used in these regulations, unless the context otherwise requires:

Certification means the level of credentials that has been granted by the National Association of

the Deaf (NAD) or the Registry of Interpreters for the Deaf (RID), and the documentation that supports the certification level the interpreter has achieved.

Deaf or Hard of Hearing Person means a person who has either no hearing or who has significant hearing loss so as to need the services of an interpreter to communicate. For the purposes of these regulations the term ―deaf‖ will be used to denote persons who are deaf or hard of hearing who need interpreting services.

Deaf-Blind Person means a person who has either the dual loss of hearing and sight or who has significant hearing and vision losses so as to need the services of an interpreter to communicate. For the purposes of these regulations the term ―deaf‖ will be used to denote persons who are deaf-blind who need interpreting services.

Department means the Mississippi Department of Rehabilitation Services.

Interpreter Training Program (ITP) means a postsecondary degree program of at least two (2) years in duration that is accredited by the Mississippi State Board for Community and Junior Colleges, the Mississippi Institutions of Higher Learning or, in the case of a nonresident, a comparable agency in another state.

Interpreter means an individual certified by the National Association of the Deaf, the Registry of Interpreters for the Deaf or an individual who holds a valid Mississippi Quality Assurance (QA) screening level or holds the equivalent or higher credentials from another state.

Interpreting means the process of providing accessible communication between and among consumers who are deaf or hard of hearing and those who are hearing. This process includes, but is not limited to, communication between persons who use American Sign Language, English, cued speech and oral communication. It may also involve various other modalities that involve visual, gestural, and tactile methods.

Quality Assurance Level means the level granted through the Mississippi Quality Assurance screening committee, and the documentation that supports the Quality Assurance (QA) level the interpreter has achieved.

Register means the process whereby the certification and QA level of qualified interpreters are documented and maintained so as to permit those individuals to act as an interpreter for pay in the State of Mississippi.

Registering Authority is the Mississippi Department of Rehabilitation Services, Office on Deaf and Hard of Hearing.

The Council means the three-person Advisory Council to ODHH for the Mississippi Interpreter Registration Law.

The Act means the Mississippi Interpreter Registration Law.

Undue Hardship means when an agency or school is left without an interpreter and/or it would be unreasonable to acquire a replacement interpreter where one is required by law or regulations.

Publication: ODHH shall maintain a list of the names and addresses of all persons registered under the Interpreting Registering Law and a list of all persons whose registration has been denied initially or for renewal, pursuant to the sections in these regulations.

4.5.1 The Registering Authority

The Registering Authority, with the advice of the Council and approval of the Executive Director of MDRS shall:

A. Promulgate and implement rules and procedures to carry out the provisions of the Act B. Record, supervise and maintain the documentation of credentials of those applying for registration under the provisions of the Act C. Register persons who apply to the Registering Authority and meet requirements for registration as stated in Section IV and VI of these regulations and D. Establish registering and renewal of registration criteria for applicants

4.5.2 The Advisory Council

Council Structure and Purpose:

1. The Council shall consist of three (3) members; a deaf consumer, a registered interpreter who is actively engaged in the interpreting business and an at-large member. This council shall serve under the jurisdiction of ODHH and MDRS.

2. Council members shall be appointed by the Executive Director of MDRS.

3. Council members shall serve one (1) three-year (3) term, except for the initial members whose terms are set forth below.

4. The Council shall serve in an advisory capacity to the Department in matters relating to the administration and interpretation of the Act, including, but not limited to, writing rules and setting fees. It shall also serve as the appeals body for administration of the Act.

5. Terms of office for the initial council shall be as follows:

a. The deaf consumer member shall be selected for a three-year term. b. The interpreter member shall be selected for a two-year term. c. The at-large member shall be selected for a one-year term.

Meetings: Meetings will be held at the discretion of the Registering Authority, as deemed necessary. Meetings may be called by giving 10 days written notice.

4.5.3 Registration

Regular Registration Requirements: An applicant for regular registration shall submit to the Registering Authority written evidence in form and content satisfactory to the Registering Authority the following documentation:

1. Application for registration

2. Copy of Picture ID or Drivers‘ License with current address and one of the following:

a. copy of current RID certified membership card or

b. copy of current NAD Interpreter Certificate or membership card denoting applicant possesses NAD Interpreter Certificate or

c. copy of current QA Card indicating level achieved

3. Check or money order for required nonrefundable fees.

Student Registration: An applicant for student registration shall submit to the Registering Authority written evidence in form and content satisfactory to the Registering Authority the following documentation:

1. Application for student registration, signed by the applicant stating that he/she is a full-time student in an approved Interpreter Training Program as defined by the Act or has satisfactorily completed the ITP training not more than two years before. 2. Written permission to verify his/her status as a student. 3. A letter signed by his/her instructor verifying his/her current status as a student and indicating that the instructor is registered under the provisions of this act.

Student registration is for the purpose of permitting students to do occasional interpreting under the supervision of their teacher, or another skilled registered interpreter designated by their teacher. The student registration is not intended to permit students to hold full-time or regular part-time jobs as a professional interpreter while a current student. Student interpreters capable of functioning as a paid interpreter should be able to qualify for regular registration.

Persons registered under the student registration may continue to register under this classification for up to two years following the satisfactory completion of their Interpreter Training course of study. During this post-graduation time, they may work as a full-time or part-time paid interpreter.

Provisional registration may be granted to an applicant when one of the following occurs: A. Deaf consumer would be left without any interpreting service or B. Undue hardship would be put upon the school or agency because of the loss of interpreter services.

Length of Provisional Registration: 1. Provisional registration is for one year. 2. A person applying for renewal of a provisional registration must document activities to improve their skills toward the goal of meeting requirements for regular registration. 3. Only under extreme need that is documented in writing by the interpreter and others responsible for their work, plus a personal interview with the Council shall the provisional registration be renewed.

4. Out-of-State Registration: A person who resides in another state, but does interpret in the State of Mississippi for more than fifteen (15) calendar days, must register according to the Act in order to interpret in the state.

To apply for out-of-state registration, the applicant must provide the following documentation:

1. Application for registration 2. Copy of Picture ID or Drivers‘ License with current address and a copy of one of the following: a. Current RID certified membership card or b. Current NAD Interpreter Certificate or membership card denoting applicant possesses NAD Interpreter Certificate or c. Current QA Card indicating level achieved or d. State licensure/certification card or other credential that is equal or higher than what is required by the Act, and 3. Check or money order for required nonrefundable fees.

The Registering Authority will verify any out-of-state credentials to ensure they meet or exceed Mississippi standards. Out-of-state applicants may not register using a student or provisional registration.

4.5.4 Renewal of Registration

General Provisions: The Registering Authority shall register interpreters and renew them biennially, except for provisional registrations. The registering period shall begin on July 1 of each year.

Procedure for Renewal of Registration: The Registering Authority shall mail notices, at least thirty (30) days prior to the renewal date, to the last address registered with the Authority, to the person to whom the registration was issued or renewed during the preceding registration period. This mailing is done as a courtesy and is not incumbent on the Registering Authority. It is the registrant‘s responsibility to renew. The registrant shall: 1. Complete the renewal form 2. Submit documentation of credentials in accordance with Section IV 3. Enclose the renewal fee 4. File the above with the Registering Authority prior to the end of the renewal period.

Failure to Renew: A grace period extending for thirty penalties. A registrant who does not file, with the Registering Authority, his renewal application on or before the thirty (30) days will be deemed to have allowed his registration to lapse. A lapsed registration shall result in a fee of $10.00 to be reinstated. In the event the registration is not renewed and/or reinstated, he/she shall be considered unregistered from the date of expiration (30) days shall be allowed after the expiration of a registration, during which a registration may be renewed with no.

4.5.5 Fees

In accordance with the Act, the following nonrefundable fees, where applicable, are payable to the Registering Authority by check or money order:

1. Application and Regular Registration Fee $ 25.00 2. Application & Provisional Registration Fee $ 20.00 3. Regular Registration Renewal Fee $ 25.00 4. Provisional Registration Renewal Fee $ 20.00 5. Out of State Registration Fee $ 35.00 6. ID Card Replacement Fee $ 10.00 7. Late Registration Fee $ 10.00 8. Returned Check Fee $ 30.00

4.5.6 Professional Identification

Anyone working as an interpreter between a deaf and hearing person for pay shall register according to the requirements of the Act.

When interpreting, anyone registered under this Act shall have their current, valid registration card available for review on request from consumers to demonstrate their compliance with the Act.

4.5.6 Exceptions and Exemptions

The Act and the regulations promulgated thereto: A. Is not intended to prevent any person from providing interpreting service for meetings that are considered religious in nature and B. Shall not apply to anyone providing interpreting services for which they are not paid, reimbursed or compensated.

4.5.7 Criminal Offenses and Punishment

Offenses: It is a misdemeanor for any person not registered under the provisions of the Act to:

1. Interpret for pay, other than the exceptions in Section 4.5.6 2. Engage in the practice of, or offer to engage in the practice of, interpreting for a fee 3. Use the title of interpreter in connection with the person's name

2. Assume the identity of an interpreter, 5. Use the title of interpreter in advertisements or descriptions, and/or 6. Perform the function of or convey the impression that the person is an interpreter.

Punishment: Violation of any provision of this Chapter is a misdemeanor punishable upon conviction by a fine of not less than Two Hundred Dollars ($200.00) or more than One Thousand Dollars ($1000.00), or by imprisonment for not more than six (6) months in the county jail, or by both.

4.5.7 Administrative Grievance Procedure

All persons aggrieved by a decision regarding the initial application for registration, or the renewal of registration, shall have the right of appeal and hearing process which will be reviewed by the Council.

Written notice will be provided to all applicants regarding denial of an initial or renewal of registration. Such notice shall contain the reason thereof and shall offer the applicant thirty (30) days to appeal the decision or to submit additional information pertinent to their application for a review by the Council.

If requested in writing within the specified time frame, a hearing will be provided in which the aggrieved party may show cause why the registration should be granted or renewed. The hearing shall be presided over by the chairperson of the Council, who is a voting member, or his/her designee.

After the conclusion of the hearing, the Council shall make findings of facts and conclusions, and shall issue a decision, separately stated, as to whether the initial registration shall be issued, or whether the renewal of registration shall be granted.

4.5.8 Complaints

The Registering Authority shall assist in referring complaints regarding interpreting services to the appropriate professional organization and/or authorities.

Part 23 MDRS Compilation Part 23: Addie McBryde Manual

32 Miss. Admin. Code Pt. 23, R. 13.02 Rule 13.02

Records Protection Policy ......................................................................................... 36 13.03 Records Retention/Disposal Policy ........................................................................... 36 13.04 Personnel File Contents ............................................................................................ 36 13.05 Retention of Referral Information ............................................................................. 37 13.06 Disclosure of Confidential Client Information ......................................................... 37 13.07 Single Case Record ................................................................................................... 37 13.08 Organization of Material in Case Record ................................................................. 37

32 Miss. Admin. Code Pt. 23, R. 13.09 Rule 13.09

Case Record Requirements ....................................................................................... 38 13.10 Case Recording ......................................................................................................... 38 13.11 Signature Policy ........................................................................................................ 39 13.12 Case Review (Quality Assurance) ............................................................................ 39

CHAPTER 14 (1N) Performance Improvements ..................................................................... 40

CHAPTER 15 (1O) Client Services ........................................................................................... 41 15.00 GENERAL SERVICE INFORMATION .................................................................. 41 A. Referrals ........................................................................................................................ 41 B. Re-referrals.................................................................................................................... 41 C. Order of Acceptance Policy .......................................................................................... 42 D. Reentry Policy ............................................................................................................... 42 E. Reorientation Policy ...................................................................................................... 42 F. Ineligible Individuals .................................................................................................... 42 G. Orientation Policy for Clients ....................................................................................... 43 H. Client Handbook ........................................................................................................... 43 I. Intake Interview ............................................................................................................ 43 J. Individual Program Planning Policy ............................................................................. 44 K. Program Manager .......................................................................................................... 44 L. Assistive Technology .................................................................................................... 45 M. Behavior Management Policy and Procedures ............................................................. 45 N. Referrals for Additional Services. ................................................................................. 46 O. Termination Procedures ................................................................................................ 46 P. Follow-Up ..................................................................................................................... 47 15.01 Personal Adjustment Training (PAT) Services ......................................................... 47 A. PAT Admission Criteria ............................................................................................... 47 B. PAT Services ................................................................................................................ 47 C. PAT Techniques ............................................................................................................ 48 D. Individualized Personal Adjustment Training Plan (IAP) ............................................ 48 E. PAT Progress Staffings and Reports ............................................................................. 49 F. PAT Final Staffing ........................................................................................................ 49 G. PAT Exit Criteria .......................................................................................................... 49

ADDIE McBRYDE CENTER MANUAL TABLE of CONTENTS

32 Miss. Admin. Code Pt. 23, R. 15.02 Rule 15.02

Comprehensive Vocational Evaluation Services ...................................................... 50 A. Vocational Evaluation Admission Criteria ................................................................... 50 B. Vocational Evaluation Services .................................................................................... 50 C. Vocational Evaluation Techniques ............................................................................... 51 D. Individualized Vocational Evaluation Plan (IVEP) ...................................................... 51 E. Vocational Evaluator Participation in Monthly Client Staffing .................................... 51 F. Vocational Evaluation Summary .................................................................................. 52 G. Vocational Evaluation Report ....................................................................................... 52

H. Vocational Evaluation Exit Criteria .............................................................................. 52 15.03 Low Vision Services ................................................................................................. 52 A. Low Vision Admission Criteria .................................................................................... 53 B. Low Vision Services and Techniques ........................................................................... 53 C. Low Vision Reports ...................................................................................................... 53 D. Low Vision Exit Criteria ............................................................................................... 53 15.04 Additional “Special” Services ................................................................................... 53

APPENDIX A .............................................................................................................................. 55 Supplemental Documentation / Resources ............................................................................ 56

APPENDIX B .............................................................................................................................. 57 Code of Ethics ........................................................................................................................ 57

INDEX ............................................................................................................................................ 1

ADDIE McBRYDE CENTER MANUAL Leadership Section 1

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CHAPTER 1 (1A) Leadership 1.00 MDRS Mission Statement It is the mission of the Mississippi Department of Rehabilitation Services (MDRS / the Department) to provide appropriate and comprehensive services to Mississippians with disabilities in a timely and effective manner. Programs and services assist individuals with disabilities to gain employment, retain employment and/or to live more independently.

1.01 AMRC Mission Statement In keeping with its mission, MDRS operates a non-profit community rehabilitation program (CRP), The Addie McBryde Rehabilitation Center (the Center). The mission of the Center is to provide options which promote the personal, social and economic independence of persons living with vision loss.

1.02 Scope of Services Located in Jackson, Mississippi, on the University of Mississippi Medical Center campus, the Center provides the following: Personal Adjustment Training in Orientation and Mobility, Personal Management, Techniques of Daily Living, Leisure Education, Recreation, Arts & Crafts, Communications, Typewriting/Keyboarding and Advanced Communications, GED classes and Vocational Training are also a part of the curriculum designed to meet the needs of those served. The Center also provides individualized vocational evaluations and low-vision assessments. The Center is committed to providing service delivery that will empower individuals served to reach the highest and most appropriate functional level. This is accomplished through the designation of entrance and exit criteria for each service area.

1.03 Assurances/Principles 1. The Center’s leadership is philosophically, as well as legally, committed to ensuring that the human rights, dignity, health, and safety of all its clients are fully protected. 2. The Center’s leadership is committed to soliciting and utilizing input from those served throughout all stages of the service delivery process. 3. The Center’s leadership is committed to providing services designed to assist those served in reaching their maximum independence. The primary goal for each person is to develop the skills necessary to achieve this goal. A second

ADDIE McBRYDE CENTER MANUAL Leadership Section 1

Effective July 2008 Page 2 goal is to coordinate services that will lead to an employment outcome. 4. The Center’s leadership is committed to providing services that are individualized, coordinated, and reflects the informed choices of the persons served.

1.04 Code of Ethics and Ethical Violations The Center has established a code of ethics and seeks to adhere in all its activities and services to the highest ethical and moral standards. At any time that a presumed violation of either the Addie McBryde Code of Ethics or the Mississippi Department of Rehabilitation Services Code of Ethics is noted, it should be reported in writing to the Center director or his/her designee. The Center director is responsible for reporting such violations to appropriate MDRS administration. (Reference: “Code of Ethics and Our Mission Statement” file.)

1.05 The Governance Authority As set by state statute and through management by the Mississippi Department of Rehabilitation Services, the Governing Authority provides effective and ethical leadership and stability for the Center so that it can achieve its stated mission. Together they have responsibility for establishing policy and maintaining high standards of operation. The Governing Authority meets formally on a quarterly basis, at a minimum, and informally as needed.

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CHAPTER 2 (1B) Governance 2.00 Governing Authority The Governing Authority of the Addie McBryde Rehabilitation Center for the Blind is a three-member body set by State legislative statute. The Governing Authority has the responsibility for approving the appointment of the Director of the Addie McBryde Center. In addition, it is responsible for reviewing major policy issues presented by the Director of the Office of Vocational Rehabilitation for the Blind and the McBryde Center Director, for maintaining high standards of operation, and for the continuing development of the Center. Members of the Governing Authority, as set by legislative mandate, are the Vice Chancellor of the University of Mississippi Medical Center, the University of Mississippi Medical Center's Assistant Vice-Chancellor for Administrative Services and the Director of the MDRS Office of Vocational Rehabilitation for the Blind. The Governing Authority meets at least quarterly and minutes are kept of all meetings. Orientation procedures for a new governing authority member include the Center Director arranging a tour of the Center, providing an overview of the Center's operations and its history and copies of governing authority minutes for the previous three years. Policies to guard against the development of a conflict of interest are established by the Department and by the University of Mississippi Medical Center. Any suggestion of the possibility of a conflict of interest between an individual member and the Center is referred to the attorney assigned to the Department by the Mississippi Attorney General's Office for an opinion which shall be binding upon the member in question. (Reference: "Governing Authority" file.)

2.01 Administrative Agency The administrative agency of the Addie McBryde Center is the Mississippi Department of Rehabilitation Services. With the exception of the appointment of the Center Director as noted above, all decisions regarding staff, finances, policies, procedures, and the like, are under the purview of MDRS. The responsibility of administering and supervising the Center's programs, including expansion, changes, or modification of the Center lies with the Department. MDRS, as the administrative agency, manages the general business, property and affairs of the Center. The Center is located organizationally within the Office of Vocational Rehabilitation for the Blind. OVRB Administrative staff, of which the McBryde Center Director is a member, meets periodically at the initiation of the OVRB Director.

ADDIE McBRYDE CENTER MANUAL Governance Section 2

Effective July 2008 Page 4 2.02 Organizational Structure The Center is structured and administered to meet the established goals of the Department and the Center. The Director of OVRB recommends the designation of the Center Director and all other Center personnel. However, the ultimate approval for employment rests with the MDRS Executive Director. For the purposes of CARF, the Center Director is the chief executive officer of the Addie McBryde Center. The Depart - ment vests authority to the Center Director for the direct oversight of the day-to-day management of the Center in accordance with the policies and procedures of the Department and sound management principles. Support personnel or technical assistants are supervised and function within the organizational structure for the Center as set by the Department. A review and approval process in critical management areas is carried out through a chain of command. This begins with the Center Director, proceeds to the OVRB Director, the Deputy Director of Vocational Services and on to the MDRS Executive Director. The Center Director reports directly to the OVRB Director who is next in line above this staff position in responsibility and accountability for the management and operation of the Center. In the absence of the Center Director, one of two Assistant Center Directors is in charge of the management of the Center. The Center Director, with the approval of the OVRB Director, initiates decisions that affect the Center such as the establishment of Center goals and objectives, budgeting, employee selection, staff utilization, space allocation, travel, in-service training, use of consultants, public information, and program development. The Center Director is responsible for meeting with the staff to ensure that input in these areas is secured and documented. The Center Director provides input on behalf of the entire Center to her supervisor, the OVRB Director.

2.03 Organizational Chart MDRS has an organizational chart that sets forth lines of authority, responsibility, and communication in accordance with Department policies and procedures and with approval of applicable state regulatory agencies. This organizational structure is reviewed and amended as necessary by the MDRS Executive Director. In addition, the Center's organizational chart delineates the lines of authority, responsibility and communication within the Center. (Reference: "Human Resources" file.)

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CHAPTER 3 (1C) Strategic Integrated Planning 3.00 Reports Various management records and reports generated by the Center are used to guide the operation, support the assessment and improvement in quality of services, measure and communicate performance, and reflect the current status of the Center. The Center Director assists in the OVRB Director's formulation of policy by presenting and interpreting operating reports, including those reflecting the efficiency and effectiveness of the Center. These reports include, but are not limited to, the following: Monthly Reports, Annual Outcomes Management Report, Outcome Measurement System Results, Financial Statements, Strategic Management Plans, Personnel Reports, and the results of Program Quality Assessment activities. These results are supplied to the McBryde Governing Authority and to the OVRB Director who presents them to the MDRS Executive Director. These presentations provide an opportunity for policy and operational review, analysis, and action. The Center Director analyzes management reports and compares performance against budgetary, administrative, and professional standards. In addition, the Center Director analyzes the extent to which the Center's goals and objectives are being attained. The results of these activities are used by the Center Director to upgrade operations by the initiation of appropriate preventive, pro-active, or corrective measures. The Center Director provides, interprets, and presents data to the OVRB Director and the Governing Authority in order to identify local needs and achievements, ensures that staff is operating in an efficient and effective manner, and initiates statewide management direction and actions to accomplish the goals and objectives of the Center. The OVRB Director initiates ongoing efforts to ensure that a management information system exists to provide regular, timely flow of information. The MDRS reviews the total effectiveness of the Center in relation to the stated purposes of the Center and the Department. If reviews indicate significant deviations from goals or expectations, then a determination of probable causes and needed changes in either service delivery or expectations are taken under consideration. 3.01 Strategic Management Plan The Center maintains a Strategic Management Plan through the Office of Vocational Rehabilitation for the Blind with goals and objectives based upon a periodic, systematic needs assessment of current and potential consumers. The Center, in accomplishing the planning process, solicits cooperative interagency coordination for those persons who need long-term assistance and/or supplementary supportive services. Center personnel participate in local community planning activities related to the persons served and the mission of the organization. (Reference: “Strategic Management Plans", "Clients

ADDIE McBRYDE CENTER MANUAL Strategic Integrated Planning Section 3

Effective July 2008 Page 6 Referred for Ancillary Concurrent Services", and "Community Involvement files.)

3.02 Additional Planning Tools The Center's target service area is statewide. Its services are intended for people who are blind or visually impaired and who are eligible clients of one of the programs administered by the Office of Vocational Rehabilitation for the Blind. The Center describes changes and trends that may affect planning and have an impact on the future. These may include such items as changes in the community, government, economy, labor market, consumer needs, service area, and services. In addition to the Strategic Management Plan, the center uses the following to document planning for future needs: 1. Accessibility Plan 2. Staff Development and Training Plan 3. Outreach Plan 4. Short-Long Range Goals

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Effective July 2008 Page 7

CHAPTER 4 (1D) Input from Persons Served and Other Stakeholders

4.00 Input from Stakeholders The Addie McBryde Rehabilitation Center for the Blind is committed to creating an environment that is responsive to the needs and expectations of the people served, and that is relevant to their maximum participation in society. The involvement of the people receiving the services or their personal representatives is an integral part of the total environment of the Addie McBryde Rehabilitation Center for the Blind. By providing opportunities for consumers themselves to have input about the system, the Addie McBryde Center benefits from their unique perspectives, and demonstrates a belief in the value of self-determination and informed choice. The Center is committed to obtaining and utilizing input from those served throughout every aspect of the service delivery process. The center has established written procedures which describe each of the major systems used to obtain input from persons served and other stakeholders.

4.01 Case/Program Managers In addition to formal methods for receiving input, the Center is committed to maximizing opportunities for clients to contribute in more informal ways to the development and implementation of their program of services. The Center Director maintains an "open door" policy and meets with each new client shortly after arrival. All clients entering the Center are assigned to a Program Manager who is responsible for developing, implementing, monitoring and modifying as necessary the clients' program of services. Program Managers meet regularly with each client on their caseload, acting as a liaison with the client's MDRS district counselor and with other service providers. Input received from these procedures is reviewed and used to make decisions about program improvement, change, or modification to insure that the needs of the persons served are being met. When appropriate, input is used to change practices and/or policies of the Addie McBryde Rehabilitation Center for the Blind.

4.02 Consumer Based Planning The Center maintains its programs based upon the needs of prospective and current consumers. Consumers include persons served and referral sources. It is critical that communication between the Center and its consumers be maintained to ensure the

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Effective July 2008 Page 8 Center's programs and services are effectively utilized.

4.03 Mechanisms Used to Obtain Input The methods include but are not limited to the following: 1. Client/Director Meetings - The Center Director or designee meets with the persons served periodically. The purpose of this meeting is for the persons served to have direct access to the top management at the Center in order to pose questions, state concerns, and provide input into the operation of the Center. Although information is disseminated to them during these meetings, the main purpose is to solicit feedback and questions from those served in a group setting. (Reference: "Client / Director Meetings" file.) 2. Human Rights Committee - The committee meets quarterly or on an "as needed‖ basis. It is composed of three members, one of whom will be an OVRB field staff (non-Center employee) and at least one former Center client. The purpose of this committee is to provide a mechanism for complaints and/or concerns to be identified and presented, as appropriate, for management response or action. This is to ensure that the persons served have input into service delivery and Center management as it pertains to their rights. The committee examines and evaluates any restrictions and practices that may affect the human rights of a single client or the entire client population. The Assistant Director of Client Services is designated to serve as an advisor to this committee. (Reference: “Rights of Persons Served" file.) 3. Suggestion Box - In order to promote input from those served, a suggestion box is located in the client lounge on the second floor. Suggestions are discussed during Client/Director Meetings, Center Staff Meetings, and/or Human Rights Committee Meetings as appropriate. 4. Client Advisory Committee – A group of three clients is chosen at random and serves voluntarily to gather input from their peers. This input is shared with staff at the Psychosocial Committee meetings. Oral and written input from individual clients is solicited from those served through each phase of the service delivery process (from intake to program planning and service implementation, to progress reviews, exit and follow-up). The Center's Program Managers are charged with maintaining regular and ongoing contact with clients assigned to their caseloads. Program Managers document all significant communication with or about clients on their respective caseloads in the client file's case notes. Program Managers also maintain regular contact with referring district counselors of each client, informing them immediately, either orally or in writing, of any significant issue that may arise.

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Effective July 2008 Page 9 5. Public Meetings - Input from those served and the general public is solicited and secured annually at regional meetings for the public review of the Mississippi OVR/VRB State Plan. Meeting locations and schedules are advertised and other informal means are used to encourage participation from advocacy groups, consumers, and the general public. The Mississippi OVR/VRB State Plan is available for review by persons with disabilities and/or other interested parties during regular office hours at the Department's central administrative office and certain district locations, including the Addie McBryde Center. The State Plan is provided in alternate media for access by people who are blind or visually impaired. 6. Facilities Advisory Committee - Input is solicited from the representatives of the service community and blind consumers through the quarterly meeting of the Facilities Advisory Committee. (Reference: "Facilities Advisory Committee" file.) The Center develops and maintains an annual comprehensive, written consumer- based management plan. This plan is the result of the Center's investigations and its mission in the community. As a minimum, this plan includes: 1. A prioritized set of objectives 2. An action plan to accomplish the objectives 3. Identification of responsibilities for accomplishment of the planning objectives to include who will be responsible for what and the time frames that are projected for their accomplishment 4. An evaluation of performance toward objectives (minimum of annually) (Reference: "Outcomes Measurement System” and "Strategic Management Plans" files.)

4.04 Facility Advisory Committee The Center maintains continual participation in a Facilities Advisory Committee (the Committee). The Committee provides a mechanism to promote community input. It also solicits and secures community involvement in support of the Center. The Committee serves strictly in an advisory capacity and has neither legal responsibility nor authority over the operation of the Center. The Committee is composed of members who are blind consumers or who are representatives from the various agencies and organizations for people who are blind or visually impaired. The purpose of the Committee is to gather and provide diverse, energetic, and creative community input. Functions of the Committee are to promote accessibility (physical, programmatic, economic/employment) for persons with disabilities and interagency service coordination. The Committee meets at least quarterly with minutes taken at all meetings. (Reference: "Facility Advisory Committee" file.)

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Effective July 2008 Page 10 4.05 Public Relations and Outreach Information Addie McBryde Rehabilitation Center for the Blind maintains an active, ongoing public information (PI) program that serves to promote understanding and support of the Center while preserving and respecting the dignity and rights of the persons served. The Center plans, initiates, and documents PI activities. Open houses, involvement in local interagency councils or boards, press releases, and presentations to civic organizations represent examples of PI activities. PI is the key to community support and serves to enhance the viability of the Center. The Center Director is directly involved in PI activities and other related duties but is provided support and technical assistance from specialized Center staff. (Reference: "Public Information and Outreach" file.) The purposes of the Center are clearly stated in various publications which are distributed to staff, those served, referral sources, and other interested individuals or groups. All Center brochures and other appropriate publications contain descriptions of the services available and are designed to enhance the value of the persons served. All PI activities are conducted in accordance with MDRS Policy Manual, 1.10 Public Information Guidelines, page 1-28.

4.06 Staff meetings Staff meetings of management and professional staff in the Center are held at least monthly. Minutes of all staff meetings are taken and distributed to personnel. Through these meetings Center staff are provided opportunity to make suggestions, offer observations, as well as receive information from the Center Director about progress toward reaching management goals. (Reference: "Staff Meeting Minutes" file.)

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CHAPTER 5 (1E) Legal Requirements and Legal Issues

5.00 Legal Conformance It is the intent of the Addie McBryde Rehabilitation Center for the Blind to demonstrate conformance with all applicable legal requirements and regulations of the governmental authorities and legally authorized agencies under whose authority it operates. In support of this intent, the Center maintains all legally required licenses and certificates that relate to its conformance with such requirements including, but not limited to, accessibility, affirmative action, equal employment, health and safety, licensure and fair labor practices. (Reference: SPB Personnel Handbook; Executive Director's Memoranda; "Human Resources" file.) Applicable legal requirements are checked periodically with the attorney assigned to the Mississippi Department of Rehabilitation Services from the State Attorney General's Office. The State of Mississippi does not require licensure of community rehabilitation programs. Should the Center plan to engage in any activity regulated or licensed by the State or the United States Government or any other legally authorized agencies under whose authority it operates, then the appropriate licensure or certification will be secured prior to the initiation of the activity.

5.01 Search Warrants and Legal Proceedings Involving Staff The policy for personnel responding to search warrants, investigations, inquiries from attorneys relating to current or former clients or other legal actions are as follows: 1. Contact the immediate supervisor for assistance. 2. If a staff member receives a subpoena, he/she will follow guidelines in the OVR/OVRB Policy Manual: Section 3.5. 3. All legal inquiries concerning clients must be directed to the center director or his/her designee. 4. The MDRS staff attorney will be consulted on any issue needing legal guidance.

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CHAPTER 6 (1F) Financial Planning and Management 6.00 Financial Policy The Addie McBryde Rehabilitation Center for the Blind is accountable for efficient and effective financial management to ensure the viability of its programs. Fiscal affairs are managed in a manner that is consistent with the purposes of the Center and in accordance with sound practices and legal requirements as promulgated by the MDRS Office of Finance and the State of Mississippi Department of Finance and Administration. All financial matters are reviewed by multiple levels of administrative personnel.

6.01 Fiscal Management All the fiscal affairs of the Center are conducted in a prudent manner consistent with sound business practices as well as State and Federal requirements. Efficient and effective recording, reporting, and controlling of expenses, assets, and liabilities are accomplished through written policies and procedures established by the Department and maintained at the MDRS Central Office.

6.02 Funding The Department funds the Center. (Reference: "Budget" file.) Limited revenue is generated by donations from civic groups and individuals. All such donations are deposited in the Lions Sight Foundation Addie McBryde Resource Center account with the Lions of Mississippi.

6.03 Fee Splitting Policy The Department prohibits the splitting of fees with third party sponsors as consideration for referral of the person to be served.

6.04 Donations Policy The Center documents the receipt of all donations and provides a letter of acknowledgement to donors listing the current tax-exempt status of the CRP. Receipt of donations is verified in writing by at least two staff members, and the fair market value of the donation is documented. (Reference: Blank Form Book and

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Effective July 2008 Page 13 Donations) 6.05 Insurance Through the Department, the Center maintains a comprehensive risk protection program which includes general liability, workers compensation, bonding, automotive liability, and damage to the property of others. This program is reviewed on an annual basis. The Department does not provide malpractice liability or errors and omission coverage. However, the Mississippi Tort Reform Act provides limited coverage to state employees who are acting within the scope of their employment. 6.06 Financial Records Fiscal records covering all aspects of the financial operation of the Center are maintained by the Department. (Reference: “Budget” file.)

6.07 Release of Financial Information Under no circumstances is financial information released to any parties other than OVRB personnel unless so authorized by the OVRB Director or his/her designee. General financial information is contained in the MDRS Annual Fiscal Report which is distributed to the general public. (Reference: "Outcomes Measurement System” file.)

6.08 Cash Management Policy 1. Working capital needs for the Center are provided for in the operation of the MDRS Central Fund. 2. Cash control procedures for the AMC Petty Cash Fund include adherence to State and Federal guidelines and accepted accounting principles. The AMC Petty Cash Fund is a non-interest bearing fund. 3. Procedures are in place to account for the holding and expending of money belonging to persons served. Monies being held for persons served do not generate interest. (Reference: "Cash Management Policies" file.)

6.09 Budget The Center prepares and submits an annual budget. Fiscal reports are generated monthly by the MDRS Finance Office. The Center's budget reflects the needs and resources for realizing its goals and includes input from professional and/or administrative staff concerning equipment, modification of physical facilities, and staffing 40

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requirements. The budget is approved by the MDRS Executive Director in consultation with the OVRB Director prior to the initiation of the fiscal year. The budget is used as a management tool to assess accomplishment of financial goals. Budget line items are compared with actual performance on a monthly basis. (Reference: “Budget” file.)

6.10 External Audit The Center is audited as a part of the standard procedures under which the Department is audited. Results of any audit are reviewed, responded to, and as needed corrective action is taken in regard to the recommendations.

6.11 Annual Fiscal Report An annual fiscal report of the Center's activities is prepared and communicated to the public as a part of the MDRS reporting procedures.

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CHAPTER 7 (1G) Risk Management 7.00 Risk Management Policy Addie McBryde engages in activities designed to control threats to its customers, property, goodwill, and ability to accomplish goals. Through a documented security plan pro-active measures mitigate risks.

7.01 Security Plan The Center maintains a written security plan which details security provisions and procedures in order to provide maximum protection of the assets of the Center. In addition to the efforts put forth by the Center, back-up protection is provided by the University of Mississippi Medical Center's Department of Campus Police.

7.02 Physical Plant The Center Director and/or his/her designee are responsible for insuring that all doors are locked and all areas secured.

7.03 Keys The Center exercises reasonable efforts to disseminate and collect keys to the physical plant. Staff members are only given keys to gain access to their respective work areas. Keys to the clients' files and safe/vault room are restricted to the Center Director, the Assistant Center Directors and the designated staff member responsible for this area. In dispensing keys to staff members, the CRP maintains documentation with signatory acknowledgement that the staff member has been provided such keys, agrees not to make copies of the keys, and will return the keys upon their termination of employment with the Department or upon their relocation to another physical plant. Appropriately located, locked key box (es) shall contain spare keys to each door in the facility. Vehicle keys are secured in the Front Office area. Keys for vehicles located

7.04 Vehicles on-site are disseminated and collected on a daily basis. Center vehicles are parked in a secure area on the premises. Vehicles are locked and secured at night. In no instance may a Center vehicle be parked at a personal residence unless approved in advance by the Center Director.

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Effective July 2008 Page 16 7.05 Financial Documents & Equipment General ledgers, journals, and other critical accounting information are kept within the Center Director administrative assistant’s office. Petty cash and other funds are kept within the Center safe. Only the Center Director, Assistant Directors, and administrative assistant(s) have access to the safe. The postage machine is located in the Center workroom area which is accessible by codes only. Each department (AMC, AT, BEP, ILS Project START) has a separate code that enable them access to the postage machine. Fuelman Cards Designated staff is assigned employee driver PIN numbers for which they are responsible. Vehicle gas cards are kept in each vehicle and must have an employee PIN number to be activated.

7.06 Insurance Through the Department, the Center maintains a comprehensive risk protection program which includes general liability, workers compensation, bonding, automotive liability, and damage to the property of others. This program is reviewed on an annual basis. The Department does not provide malpractice liability or errors and omission coverage. However, the Mississippi Tort Reform Act provides limited coverage to state employees who are acting within the scope of their employment.

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CHAPTER 8 (1H) Health & Safety 8.00 Safety and Health Policy The Addie McBryde Center is committed to the maintenance and monitoring of the safety conditions of its physical plant. The welfare of the clients and staff is a matter of priority. The Center is committed to maintaining optimal safety practices, instructional environments, and equipment operation to ensure the welfare of both clients and staff is protected. The Center maintains an active, ongoing, comprehensive health and safety plan. The Center’s daily procedures ensure a safe, healthy environment.

8.01 Program Restrictions The client's health and any other special considerations are taken into account when deciding appropriate program assignments. Any restrictions are provided in written form to the Assistant Director of Client Services who is responsible for assigning class schedules. Documentation of such restrictions is maintained in the case file.

8.02 External Safety Inspections Types of Inspections Comprehensive, externally conducted inspections of the premises and operations are conducted in the areas of health and safety. Documentation of these inspections, areas covered, and recommendations are obtained. (Reference: "External Inspections" file.) These inspections where applicable cover the following: 1. Emergency warning devices, means of egress, and emergency plans. 2. Operations involving hazardous materials and processes including safe and effective management of bio-hazardous materials. 3. Walking and working surfaces. 4. Health and sanitation provisions in food preparation, eating areas, rest rooms, etc. 5. Working environment including ventilation, illumination, noise, and air contaminants. 6. Fire protection in accordance with applicable provisions of the National Fire Protection Association Fire Code. 7. Electrical system hazards. Qualifications of Inspectors Surveys and inspections must be made by competent authorities. These include combinations of the following:

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Effective July 2008 Page 18 1. A licensed or registered safety engineer, where applicable. 2. A representative of a state agency providing an inspection on a consultative basis. 3. A private safety consultant or one who represents the Department's fire or Worker's Compensation carrier. 4. A local fire control authority such as personnel from the University of Mississippi Medical Center or the City of Jackson 5. A State or Federal technical assistance consultant in safety and health Frequency of Inspections Comprehensive, externally conducted fire inspections of the Center are accomplished at a minimum of every three years. Comprehensive, externally conducted safety inspections of the Center are accomplished at a minimum of every three years. New or supplemental inspections are conducted upon occupancy of new quarters or the installation of new processes or major items of equipment. Response to Inspections A written response is developed which documents results of the review and corrective action taken with respect to reports and recommendations received from such inspections.

8.03 Internal Health & Safety Program The Center maintains an organized, comprehensive health and safety program. (Reference "Safety Policies and Procedures" file.) This program provides for: 1. Designation of person(s) responsible for the health and safety program. This may be the chairperson of the Safety Committee or the entire committee if so designated. 2. Emergency Plans and Procedures a. The Center maintains written emergency plans which are posted in appropriate locations in the Center and communicated to staff and supervisory personnel. The emergency plans include provisions for dealing with bomb threats, fire, medical emergencies, power failures, and natural disasters. Records document that all staff are knowledgeable of the fire and emergency plans. The plans include provisions for temporary shelter and handling of evacuees. b. Tests of emergency situations are conducted at least once a month. All emergency provisions of the safety plan are tested at least once per year. These provisions may include but are not limited to fire, tornado, earthquake, gas leak, power failure, bomb threat, medical emergency, chemical spill, terrorist attack, etc. c. Each drill or test of emergency provisions is documented to analyze the conduct and effectiveness of the drill. Such reports are submitted to

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Effective July 2008 Page 19 the Center Director. (Reference: “Drills” and "Safety Policies and Procedures" files.) d. The Safety Committee meets quarterly. The committee reviews all reports of incidents, illnesses, injuries, safety inspections, drills, etc. This committee is responsible for conducting documented self- inspections of the facility at least quarterly. The committee reviews the entire safety plan and program and, as appropriate, makes recommendations in writing to the Center Director. (Reference: "Safety Policies and Procedures" file.) e. All evacuation exits are properly marked in a manner appropriate to the needs of clients and staff. f. The Center maintains a written medical emergency plan that is posted in the first aid room and at other appropriate locations. The purpose of the plan is to outline procedures for the procurement of medical care that is beyond the scope of basic first aid. (Reference: "Safety Policies and Procedures" file.)

8.04 Emergency/Crisis Procedures The comprehensive, detailed Center's Safety/Crisis Plan covers all crisis, disaster and emergency situations including procedures for dealing with disruptive or violent behaviors, the presence of unauthorized, threatening persons in the Center, and emergency situations related to weather, fire, bomb threats, accidents involving hazardous materials and the like. The Plan contains procedures for notification of proper authorities, evacuation, accounting for and relocation of staff and clients. All staff receives regular and ongoing training involving the Safety/Crisis Plan and the procedures to follow in the case of crisis or emergencies. (Reference: "Safety Policies and Procedures" and "Staff Development and Training" files.)

8.05 Critical Incident Reporting Procedures The Center maintains written procedures that specify actions for the reporting and investigation of all incidents, injuries, and illnesses regardless of the need for medical treatment. (Reference: "Incident/Accident Reports" file.) This plan provides for the following: 1. Prompt recording of the incident to the appropriate persons within the organization and prompt emergency care 2. Recording of the essential facts surrounding the incident 3. Review of the incident reports by the Safety Committee to formulate recommendations for improving the safety program and handling of

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Effective July 2008 Page 20 incidents and injuries 4. Documentation of corrective action taken, as appropriate, to implement recommendations

8.06 Health & Safety Training Training is provided by external authorities, videotapes, and internal personnel with the required competencies. (Reference: "Staff Development and Training" file.) The Center provides training to the appropriate staff, volunteers, interns/trainees and clients by the following safety methods: 1. Safety meetings to resolve safety issues or problems 2. Posted safety rules and practices 3. Training in techniques for fire suppression (annually) 4. Annual training of staff to deal with persons with violent, aggressive, or other unsafe behaviors (threats of homicide, suicide, or cases of abuse, etc.) 5. Training in adult CPR and basic First Aid Techniques to ensure a sufficient number of personnel is able to provide basic first aid and cardiopulmonary resuscitation (CPR) in each work or office area at all times during the routine hours of operation. 6. Training in Defensive Driving (annually) 7. Prevention and control of infectious diseases, including the Blood Borne Pathogens Exposure and Control Plan (annually).

8.07 Smoking Products Policy The use of tobacco products was prohibited on the UMC Campus as of November 1, 2005. Center clients are allowed to smoke only on balconies of the 2 nd (dorm) floor. (Reference: “Rights of Persons Served” file and Client Handbook.)

8.08 Infection Control Policy The Center maintains an ongoing, organized written program for the education and training of clients, staff, volunteers, and interns/trainees in the prevention and control of infectious diseases including, but not limited to the following: Human Immunodeficiency Virus (HIV), Staph infections, Hepatitis, Rubella, Tuberculosis, and Cytomegalovirus (CMV). Training in infectious disease prevention and/or management is conducted at least annually for staff and periodically for clients. Every client receives information and signs the ―Universal Precautions‖ form at intake. (Reference: “Health Policies and Procedures” and “Rights of Persons Served” files.)

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Effective July 2008 Page 21 8.09 Emergency Medical Information The Center keeps medical information on all current staff and clients which contains the basic information that would be needed in an emergency situation. This medical information is in a notebook, which is easily accessible so that it can be removed in case of building evacuation.

8.10 Medication Monitoring Policy When necessary, the Center is responsible for the administration, handling, storage, and disposal of oral and injectable medications. Written procedures are in place for the storage and dispensing of medications. (Reference: "Health Policies and Procedures" file.) The Center Nurse supervises all activities related to the administering and monitoring of medication. Trained staff may also utilize basic first aid supplies (i.e., burn cream, ointments, eye wash, etc.).

8.11 First Aid Room The Center maintains a suitable first aid room that has adequate medical supplies and equipment to provide basic first aid.

8.12 Ergonomics Policy The Center is committed to providing a safe working environment for clients and staff. A Risk Management Site Survey identifies problem areas which might cause injury and makes suggestions for improvement. The Center utilizes this information to plan improvements to the work environments: physical facility, equipment, furniture, work method, etc. (Reference: "Safety Policies and Procedures" file.)

8.13 Emergency Lighting The Center has an acceptable form of emergency lighting to ensure safe egress from the building in the event of a power failure. Safety authorities have approved the alternate emergency lighting.

8.14 Equipment Safety Equipment used in the instructional areas by clients or staff is calibrated and maintained in accordance with the manufacturer's recommendations.

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Effective July 2008 Page 22 8.15 Emergency/Fire Alarm System The Center maintains acceptable equipment for fire detection, warning, and suppression. This equipment appropriately meets the needs of the clients and staff. The emergency alarm system is inspected and approved by a fire control authority. The emergency alarm system provides for both auditory and visual alert. The emergency alarm system has an alternate or back-up power source and there is an alternate alarm system that operates in the absence of power.

8.16 Transportation 1. The department maintains a preventative maintenance and inspection program to ensure the safe operation of vehicles and to promote the long-term life of the vehicle. (Reference: "Safety Policies and Procedures” file.) Vehicle bodies and interiors are maintained in a manner that promotes the positive image of the MDRS transportation system. They provide an attractive, comfortable, safe, and efficient means of transportation. Vehicles are serviced and cleaned on a routine basis. Methods used to minimize breakdowns and expensive repairs and to identify when maintenance is needed include: a. Weekly Vehicle Inspection b. Vehicle Service History c. Routine Maintenance Schedule 2. Vehicles and related auxiliary equipment meet all applicable legal requirements and are maintained in a safe and efficient condition. 3. Seat belts are used in all vehicles transporting people. 4. Each vehicle has adequate first aid supplies, fire suppression equipment, and DOT approved triangle reflectors. These items are secured in a manner which prevents them from posing safety hazards to passengers. 5. The Center maintains and updates a list of all authorized drivers. Included on this list is the following information: driver's name, job title, license number, date of birth, and types of vehicles authorized to drive. 6. MDRS verifies proper licensure of drivers upon employment as part of the background check by procuring a motor vehicle report (MVR) of the driver. At least annually, the Center updates information to verify the credentials of all authorized drivers. 7. All drivers for the Center have photo identification or other type of visible identification to identify them as an authorized representative of the Center. 8. The Center provides all drivers with annual, specialized training regarding the safe operation and use of the vehicle driven. This training includes, as applicable, the movement of people and/or materials as well as the safe transportation of persons with disabilities. 9. At least annually, all vehicle operators are provided training in the handling of

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Effective July 2008 Page 23 accidents and road emergencies. All vehicles have supplies and/or equipment to aid in the response to a road emergency. Written procedures for handling road emergencies and/or accidents are placed in accessible locations in the vehicle. 10. In the event that evidence is provided on an authorized driver regarding moving violations or hazardous driving, the Center Director determines if the driver shall continue to operate Center vehicles or if disciplinary action is to be carried out. SPB policies are applied to State employees in these circumstances. In no event is a driver who demonstrates reckless or dangerous performance allowed o drive a Center vehicle. 11. In the event that an accident occurs with a Center vehicle, the Center Director or his/her designee conducts a thorough investigation of the accident.

8.17 Alcohol and Drug Testing Policy AMRC has a drug and alcohol testing policy which is designed to provide early detection and to reduce significantly or eradicate use, possession, and influence of alcohol, prohibited drugs, and/or other chemicals within the AMRC environment. In pursuit of such purpose, AMRC declares that the use or possession of drugs and/or alcohol or intoxication and physical influence thereof at the Center or at Center-related or sponsored activities, events, or functions is inherently detrimental to the attainment of a maximized vocational rehabilitation experience and, therefore, will not be tolerated. (Reference: “Rights of Persons Served” file.)

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CHAPTER 9 (1I) Human Resources 9.00 Staffing Pattern and Back-up Plan The staffing pattern at the Addie McBryde Rehabilitation Center is established to meet the fluctuating service demands of clients throughout the year, except for designated holidays/closings. This necessitates flexibility of faculty who often assist in more than one area of the Center. When faculty expects to be unavailable to teach their classes, they must submit a plan for the continuation of services to clients assigned to their instructional units. Such plans can include substitution of other Center staff, use of volunteers or guest speakers, or special activities. The Assistant Director for Client Services reviews these plans prior to approval of the Request for Leave. For unexpected absences, the Assistant Director for Client Services or the Program Manager temporarily assigns other qualified instructors to provide scheduled training or substitute appropriate activities so that services are not interrupted.

9.01 Staff Qualifications The Department strives to employ the most qualified, competent personnel to provide rehabilitation services essential to the achievement of its stated goals. Standards for the establishment of qualifications for personnel are set from the Department by the Mississippi State Personnel Board (SPB) with comparison to appropriate qualification requirements for similar jobs in state government. All persons in a supervisory capacity are required to hold the qualifications, experience, and skill to provide sound supervision of employees.

9.02 Background/Credentials Verification Policy The credentials and qualifications of persons hired for state service positions are verified by the SPB. The department’s HRD also does an investigative background check on certain other information, such as driving records. Credentials and qualifications of persons employed directly by the Center may be further verified by the Center Director. Verification activities include review of official transcripts, school records, contacts with previous employers and character references or other information as needed. The Center Director or his/her designee conducts a verification of the background/credentials on any volunteer, intern and/or consultant utilized by the Center.

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Effective July 2008 Page 25 9.03 Nondiscrimination Policy The Department maintains a policy and has procedures in place to ensure nondiscrimination in regard to employment, promotion, pay, or place of work regardless of race, creed, national origin, sex, disability, or age. (Reference: SPB Employee Handbook, SPB Basic Supervisory Course Handbook and Executive Director's Memoranda.)

9.04 Interns/Trainees All interns/trainees serving at the McBryde Center meet appropriate legal requirements for the work performed as well as have a basic professional understanding of the area in which they serve. Interns/trainees are held to the same professional standards and code of conduct required for full-time employees. The Department has an ongoing, collaborative relationship with various universities and colleges to provide rehabilitation interns/trainee positions (also called "practicum" experiences) to students. Interns/trainees are coordinated through the MDRS Office of Human Resource Development (HRD).

9.05 Volunteers Any volunteer used by the Center is supervised. Volunteers are held to the same professional standards and code of conduct required for their assignment as any full-time employee. (Reference: "Volunteer/Intern Program" file.)

9.06 Outside Consultants The Department procures the services of outside medical, psychiatric, and other experts in accordance with the fee schedule established by MDRS. These services are obtained from appropriate certified and licensed authorities or those who meet standards as established by the Department.

9.07 Job Descriptions Each staff and volunteer position has a job description that sets forth qualifications, the reporting supervisor, positions supervised, and duties, including essential job functions for the position. Job descriptions are dated, for appropriateness, and provided to the individual involved. (Reference: Center's Personnel Files and "Volunteer/Intern Program" and “Human Resources” files.)

9.08 Orientation Policy (Employees/Interns/Trainees/Volunteers) MDRS maintains a written policy of timely orientation of new staff members, staff

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Effective July 2008 Page 26 moving to new positions, consultants, volunteers and interns/trainees. (Reference: OVR/OVRB Policy and Procedures Manual; "Volunteer/Intern Program," "Human Resources" files.) Organized documentation is maintained on orientation of staff, volunteers and interns/trainees. Any personal risk, liability, and insurance coverage are communicated to the volunteers and interns/trainees. A Checklist is used to ensure that all important information has been communicated to the individual. (Reference: Blank Forms Book.)

9.09 Personnel Policies for Employees of Addie McBryde MDRS has established personnel policies and procedures. (Reference: SPB Employee Handbook, SPB Basic Supervisory Course Handbook, HRD Policy Memoranda, and Executive Director's Memoranda.) Each employee is given in-depth instruction in personnel policies and procedures and signs a statement verifying these procedures has been explained and are understood. All personnel are provided a copy of personnel policies/procedures. Policies are reviewed annually. Personnel policies and procedures have been developed and implemented to clarify what the Department expects of personnel and what personnel can expect from the Department. MDRS Personnel Policies/Procedures include but are not limited to the following: 1. Employment procedures a. Authority for hiring and firing b. Administrative requirements c. Job descriptions for each position which are provided to the employee 2. Operating policies a. Probationary period b. Performance appraisal c. Conduct and general regulations d. Hours of work, holidays, vacations, leave of absences e. Promotion policy f. Grievance procedures g. Disciplinary actions 3. Wages/Benefits a. Method of payment b. Fringe benefits c. The Mississippi Tort Reform Act provides limited liability coverage to state service personnel acting within the scope of their duties. The MDRS does not provide general malpractice liability insurance. The MDRS encourages all personnel to purchase malpractice insurance on a private basis.

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9.10 Performance Appraisals The staff of the Addie McBryde Center receives a performance appraisal at least annually with a semi-annual review and feedback session in accordance with MDRS policies and procedures. The performance appraisal is conducted by the immediate supervisor. The results of performance appraisals are provided in written form and reviewed with the respective employee. Management and supervisory personnel are responsible and accountable for employee scheduling, job performance, and performance appraisal of employees. The immediate supervisor is responsible for conducting performance appraisals on all subordinates. These results are documented, reviewed with the staff, and included in the individual's personnel file. The performance appraisal is based upon an assessment of job performance in relation to quantity and quality of work. The performance appraisal includes establishing objectives for the next rating period. (Reference: Center's Personnel Files.)

9.11 Staff Input Opportunities for Staff to have input on personnel policy is provided through staff meetings, suggestion solicitation, and submittal of proposals to the appropriate administrative authority. State employee personnel policies are subject to the control of the SPB with the Center's personnel policies directly under the authority of the MDRS Executive Director.

9.12 Staff Development and Training The Center Director conducts periodic assessment of the training needs of personnel and maintains a planned, scheduled in-service training program. 1. The CRP, as well as MDRS, maintains a library of relevant professional material. (Reference: "Resource Material: Professional/ Educational" file.) 2. Supplemental, continuing, or advanced education is provided, as appropriate to the needs of MDRS, contingent upon availability of funds. 3. The Department, with its own Program Evaluation Unit as well as other external entities and as opportunities are available, engages in appropriate rehabilitation research. 4. In-service training budgets and time allocations are established at the Department level for all personnel. 5. The Center engages in an active and ongoing process of staff development related to pertinent issues and concerns and in response to identified needs. (Reference: "Staff Development Training" file.)

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Effective July 2008 Page 28 9.13 Community Involvement The Center Director and staff show evidence of involvement in local, state, and national professional and/or civic and community organizations. A listing of staff involvement has been developed and is updated annually. (Reference: "Human Resources" file.)

9.14 Staff-Client Fraternization In order for staff to carry out their assigned duties of training and guidance without contributing to feelings of dependence or favoritism, the staff is prohibited from fraternizing with students on an individual or selective basis. However, staff is encouraged to participate in group activities during or after class hours.

ADDIE McBRYDE CENTER MANUAL Technology Section 10

Effective July 2008 Page 29 CHAPTER 10 (1J) Technology 10.00 MDRS Management Information System (MIS) The Department provides overall technology solutions and support for the Center. This includes hardware, software, assistive technology, security, virus protection, backup and disaster recovery plan and repairs and maintenance.

32 Miss. Admin. Code Pt. 23, R. 10.01 Rule 10.01

Case Management Software AACE (Accessible Automated Case Environment) provides communication, data collection, documentation and performance information via the agency network. Service requests from district counselors within the network are completed on-line.

32 Miss. Admin. Code Pt. 23, R. 10.02 Rule 10.02

Confidentiality of Records The Addie McBryde Center takes all necessary actions to safeguard the use of information technology and confidential information stored and accessed on the Center’s computers and the MDRS agency network. (Reference: “Information Technology and Computers” file.)

32 Miss. Admin. Code Pt. 23, R. 10.03 Rule 10.03

Use of Computers All staff are required to sign a statement regarding appropriate and ethical use of computer equipment and agency information at the time of employment.

ADDIE McBRYDE CENTER MANUAL Rights Section 11

Effective July 2008 Page 30

CHAPTER 11 (1K) Rights 11.00 Assurance of Commitment to Rights of Persons Served The Addie McBryde Rehabilitation Center for the Blind is philosophically, as well as legally, committed to insuring that the rights of all its clients are fully protected. These policies and procedures are communicated to persons served, Center faculty and staff, consultants, interns/trainees, and volunteers through the Center Manual and the Client Handbook. These rights include but are not limited to the following: 1. The right to personal privacy unless the safety and welfare of the person served or others is threatened or there is a violation of state or federal law 2. The right to be treated with dignity and respect at all times 3. The right to be free from psychological and/or physical abuse in any form 4. The right to be given all appropriate information concerning service delivery and consideration for placement in the highest and most appropriate program level 5. The right to have maximum input into the delivery of services whenever possible.

32 Miss. Admin. Code Pt. 23, R. 11.01 Rule 11.01

Violations and/or Complaints The Center uses the complaint/suggestions procedure to allow for client allegations of possible infringements of his/her rights. Whenever there is a suspected case of client abuse, neglect or exploitation, the Center staff follows procedures contained in the MDRS Policy Manual. Any staff member who is found to have violated the rights of any person served will be appropriately disciplined under the provisions and overview of the SPB. Any violation of the rights of those served is promptly reported to the most appropriate level supervisor who is not directly involved in the violation. Failure to report a violation is a serious offense, as this implies collusion with the violation. Upon the report of a violation, a thorough investigation is undertaken within a thirty-day period. Disciplinary action, if determined appropriate, is initiated under the guidelines of the SPB.

32 Miss. Admin. Code Pt. 23, R. 11.02 Rule 11.02

Informed Consent Signed informed consent is obtained from the person served prior to the implementation of any procedures that restrict or limit the rights of the person served (e.g.: removal of phone privileges, short-term suspensions, terminations). (Reference: Blank Forms Book.) Positive behavior modification is tried prior to the use of any restrictive procedures.

ADDIE McBRYDE CENTER MANUAL Rights Section 11

Effective July 2008 Page 31

32 Miss. Admin. Code Pt. 23, R. 11.03 Rule 11.03

Physical/Psychological Abuse Abuse of any individual served by a staff member is considered a serious offense. Abuse includes any type of physical abuse (including corporal punishment) and/or any psychological abuse (including humiliating, degrading, or exploiting). The party involved is subject to dismissal. In addition, any employee who has knowledge of such abuse and fails to report the abuse is subject to disciplinary action. Any client who abuses another is subject to immediate dismissal or other disciplinary action dependent upon the circumstances.

32 Miss. Admin. Code Pt. 23, R. 11.04 Rule 11.04

Sexual Harassment Policy The Department maintains a strict policy regarding the prohibition of sexual harassment in any form. Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when submission to or rejection of this conduct explicitly or implicitly affects an individual's employment, work performance, or creates an intimidating, hostile or offensive work environment. Any report of sexual harassment is promptly investigated and appropriate disciplinary measures taken. (Reference: SPB State Employee Handbook and MDRS Policy Manual, "Sexual Harassment".)

32 Miss. Admin. Code Pt. 23, R. 11.05 Rule 11.05

Release of Persons Served The Center does not release a client, who is under age, legally adjudicated as not competent or whose mental and/or intellectual condition prevents the ability to adequately represent his/her own interests, to any party other than the person's parent, spouse or legal guardian unless such parties provide written authorization to release the client to another designated individual, agency, or institutional representative.

32 Miss. Admin. Code Pt. 23, R. 11.06 Rule 11.06

Grievance/ Complaint Procedures The grievance procedures for clients of the Addie McBryde Rehabilitation Center are adapted from the Hearing Policy in the Mississippi Department of Rehabilitation Services Vocational Rehabilitation/Vocational Rehabilitation for the Blind Policy Manual. This information is in the Client Handbook and is explained to all clients at the beginning of the services.

ADDIE McBRYDE CENTER MANUAL Accessibility Section 12

Effective July 2008 Page 32

CHAPTER 12 (1L) Accessibility 12.00 Location of Facility The Center is geographically located in the central part of the state and in an area in the community that is readily accessible to clients, staff, and visitors. The facility is designed to provide adequate parking, dining areas, and other common services. Areas in the physical plant are designated for counseling, testing, instruction, training, residential and administrative services.

32 Miss. Admin. Code Pt. 23, R. 12.01 Rule 12.01

Accessibility Plan The Center has a written plan for addressing barriers Identified in the following areas: 1. Attitudes - The Addie McBryde Center is committed to the removal of all attitudinal barriers to service access. Center staff, OVRB personnel, and clients are assessed regarding attitudes, including perceptions that may be in conflict with full integration of people with disabilities into the programs and services of the organization. This assessment is conducted informally throughout a client's program of services and accomplished formally via the Staffing Checklist, Exit Interview, staff meetings, and the Center's Annual Survey. 2. Architectural - At a minimum of every three (3) years, an external inspection by a competent authority (i.e., rehabilitation engineer or technology specialist) is conducted based on Americans with Disabilities Act (ADA) standards with a written report of findings. The Assistant Director for Facility Management documents through a written corrective action plan all efforts to address deficit findings. The Center Director provides a written report of actions taken to enhance architectural accessibility resulting from client input and/or general operating activities in the annual outcomes management report. 3. Transportation - The client's need for transportation services to and from the Center to enable participation in programs and services is evaluated. Transportation to the Center at the beginning of a client's program of services and to his/her home at the end of the program is arranged by the OVRB referring counselor if needed. The Center provides resources to allow clients to return home one weekend each month during their stay at the Center, and enable them to participate in necessary programs and activities. Staff communicates with the client and the district counselor to

ADDIE McBRYDE CENTER MANUAL Accessibility Section 12

Effective July 2008 Page 33 determine transportation needs. 4. Communication - The need for interpreter services and alternate media by clients, staff and other stakeholders is addressed. The Center uses testing and training materials which are readily understandable by the client. The Center has the capability to produce audio tape, Braille, and large print media as needed. If appropriate, the Center, through its referring counselors, accesses needed communication services through the MDRS Office of Assistive Technology, MDRS interpreters for the deaf, other MDRS communication specialists, and as appropriate and necessary, by the purchase of services from private sector providers and/or other governmental agencies. The Center has an agreement with the University of Mississippi Medical Center for the provision of interpreter services for a wide array of foreign languages, should the need arise. (Reference: "Interagency Agreements/Collaboration" file.) 5. Environmental - Changing needs of the community, stakeholders, clients and staff are considered in planning for budget and utilization of financial resources. 6. Financial - Donations and other additional community resources are used to meet identified barriers of individual clients. 7. Employment - Staff training and client services address the employment barriers of persons with disabilities both locally and nationally.

32 Miss. Admin. Code Pt. 23, R. 12.02 Rule 12.02

Measuring Accessibility Resources for assessing accessibility include, but are not limited to: 1. MDRS Assistive Technology Staff 2. AMRC Client Management Staffings 3. AMRC Client Exit Interviews 4. AMRC Client Follow-up Survey 5. AMRC Annual Survey 6. Director/Clients Meetings

ADDIE McBRYDE CENTER MANUAL Information Measurement and Management Section 13

Effective July 2008 Page 34

CHAPTER 13 (1M) Information Measurement and Management

32 Miss. Admin. Code Pt. 23, R. 13.00 Rule 13.00

Outcomes Measurement System The Center has an Outcomes Measurement System, which meets the following criteria: 1. Measures results of programs and services 2. Includes all programs 3. Includes all persons served 4. Measures regularly the progress of those being served in relation to program goals 5. Evaluates information after completion of services The Center's Outcomes System includes the following: 1. Each program of services provided by the CRP—Personal Adjustment Training and Vocational Evaluation—has an individual Outcomes component to determine the degree to which persons served meet the goals of their individual program plans and their satisfaction with the service delivery system. (Reference: “Outcomes Measurement System” file.) 2. The Outcomes Measurement System has in written form for both Personal Adjustment Training services and Vocational Evaluation services entrance criteria, a listing of services, measurable objectives, specification of the time each measure is applied, measures of effectiveness and efficiency, and measures of satisfaction of persons served with the program. (Reference: Center Manual and “Outcomes Measurement System" file.) The System tracks at least the following: 1. Caseload characteristics (diagnoses and incidence of secondary disabilities) 2. Services received 3. Dates of services (entrance and exit) 4. Outcomes of services provided by each program Outcomes management reports include the following: 1. Measures of effectiveness 2. Measures of efficiency 3. Measures of satisfaction of persons served with the programs 4. Characteristics of the persons served 5. Interpretation of the results through a narrative report 6. Actions taken or planned to improve performance. Information generated by the Outcomes System is made available to appropriate

ADDIE McBRYDE CENTER MANUAL Information Measurement and Management Section 13

Effective July 2008 Page 35 levels of management. Information is analyzed, interpreted, and used to provide the basis for the development of an annual, comprehensive report that assesses all programs operated by the Center. Such information is used by management to maintain, modify, or improve individual programs. The Outcomes System structure includes the following: 1. A mechanism to identify performances less than acceptable 2. When performance is less than acceptable, reasons are noted and identified 3. Management action taken to improve performance to an acceptable level 4. Follow-up and monitoring of corrective action that takes place at specific times with results documented There is evidence that Outcomes information is utilized at every level of the Center to continually improve services. Incorporated into the Annual Management Report is a review of the Outcomes System by the Center to analyze the nature of the caseload. This review includes the following: 1. The consideration of the appropriateness of the caseload for the intensity and type of services provided 2. The determination as to whether changes in characteristics of the persons served indicate a need for program modification or expansion. Following the reporting period, Outcomes information is disseminated in an understandable fashion to the Department administrative staff, the Governing Authority, Center staff, and the Center's public including persons served, contributors, supporters, referring counselors, and others. The Center portrays itself in a manner, which is accurate and valid. The information is consistent with results shown in the Center's Outcomes System. An ongoing review of the effectiveness of the Center is undertaken by the Center Director through the Outcomes Measurement System. The Center provides for a continuous review of the Outcomes Measurement System and its adequacy. (Reference: “Outcomes Management System” file.) This review ensures that: 1. Formal reviews take place on an annual basis 2. Center staff and the persons served have an opportunity to recommend or make modifications 3. A determination of the efficiency of the Outcomes System is documented

32 Miss. Admin. Code Pt. 23, R. 13.01 Rule 13.01

Confidential Records Examples of confidential records include, but are not limited to, client files, performance appraisal information on individual employees, employee reprimands/commendations, personnel and training records, I-9 information, and accounting and budget information.

ADDIE McBRYDE CENTER MANUAL Information Measurement and Management Section 13

Effective July 2008 Page 36 13.02 Records Protection Policy The Addie McBryde Center takes precautions to protect all confidential administrative and case records by the following steps: 1. Access to confidential records is limited to the Center Director, the Assistant Center Director, the Program Manager designated to monitor the client's progress, and the office administrative assistant assigned to maintain client files. 2. The Addie McBryde Center maintains a policy for persons being served to access his/her record. Anyone desiring part or all of his or her record needs to inform the Center Program Manager of this. The Program Manager will review the record, and, in the normal course of events, will inform the Center Director of this fact and release the records. Under federal law, certain rare circumstances may trigger a medical professional or legal review. If this is the case, the person being served or their representative will be informed of this, and the review will take place as quickly as possible. 3. A generally accepted filing system for such records is maintained at all times. 4. A check in/check out system for all files and records is maintained when files are removed from the area where files are kept. A staff person in the area where such records are kept is designated as responsible for control and accounting for such records. 5. During the workday, all records are kept in a supervised office in metal files or storage cabinets with reasonable protection against fire, water damage, and other hazards taken. The file area is locked and secured after working hours. 6. MDRS network back up on the server and hard copies are retained for all electronic records to ensure protection of such records against loss.

32 Miss. Admin. Code Pt. 23, R. 13.03 Rule 13.03

Records Retention/Disposal Policy All confidential administrative and case records are kept for a minimum of three years with the exception of certain accounting records which are retained indefinitely. (Reference: OVR/OVRB Policy and Procedures Manual.)

32 Miss. Admin. Code Pt. 23, R. 13.04 Rule 13.04

Personnel File Contents Each Center employee has a permanent personnel file to retain the employment application, job description (may include a Job Content Questionnaire), verification of credentials, performance appraisals, payroll deductions, salary, and position changes, etc. The official records for State Service Personnel are maintained at the MDRS central office.

ADDIE McBRYDE CENTER MANUAL Information Measurement and Management Section 13

Effective July 2008 Page 37 A supplemental personnel file is maintained at the Center and includes copies of annual performance appraisals and feedback, attendance/leave information, flex time forms and job description.

32 Miss. Admin. Code Pt. 23, R. 13.05 Rule 13.05

Retention of Referral Information If a client does not report on the scheduled admission date, the referring counselor is notified in writing immediately. If the client is not rescheduled for entry, the Center retains the referral information in a "No Show" file.

32 Miss. Admin. Code Pt. 23, R. 13.06 Rule 13.06

Disclosure of Confidential Client Information See the OVR/OVRB Policy and Procedures Manual.

32 Miss. Admin. Code Pt. 23, R. 13.07 Rule 13.07

Single Case Record Each client has a hard copy individual case file. During their stay at the Center, the Center Nurse maintains a separate medical file. Upon completion of the program of services, the medical file is combined with the case file. Records are clear, complete and current. Reports are objective and distinguish fact from opinion. Records confirm in writing that all recommended and planned services have been carried out or there is documentation as to reason not completed.

32 Miss. Admin. Code Pt. 23, R. 13.08 Rule 13.08

Organization of Material in Case Record The client record is divided into four sections. After the initial referral information, all subsequent information is filed in inverse chronological order based on date of receipt. Section One contains the original referral documents, including: initial referral material and the client data sheet,. Section Two contains general information originated at intake and while the client is in the Center, including the following forms: Initial Intake, Orientation Checklist, Fire Exit,

Picture Release, Permission to Leave the Center (if applicable), IAP and/or IVEP, Counselor Correspondence, Cane/Noir, Informed Consent, Alcohol and Drug Testing, Case Notes, and all correspondence concerning the client including any received from the district counselor. Section Three covers information obtained at exit as well as certain supplemental services provided by the Center. This information includes: Exit Interview, Follow-up Questionnaire and, if applicable, Psychiatric Case Notes, Medical Consent Form and medical records. Section Four contains all Center generated reports and includes: Psychological

ADDIE McBRYDE CENTER MANUAL Information Measurement and Management Section 13

Effective July 2008 Page 38 Reports, Vocational Evaluation Report, Instructors' Reports, and Staffing Checklist. When a client has exited from the Center, Sections One and Two are placed together on the left side of the file with a colored section divider between the two sections. Sections Three and Four are placed together on the right side of the file with a colored section divider between each section.

32 Miss. Admin. Code Pt. 23, R. 13.09 Rule 13.09

Case Record Requirements A case file should include the following: 1. Case identification data 2. Name and address of client's guardian, if appropriate 3. Pertinent history, diagnosis of disability, limitations, special needs (e.g., communication), and desired outcomes/expectations 4. Prescribed medications, the name of the prescribing physician and other relevant medical information 5. Reports of initial and ongoing assessments 6. Reports from referring sources 7. Reports from outside consultants 8. Designation of program manager 9. Evidence of the direct involvement of the person served in the decision making process related to his/her program. 10. Reports of staff conferences and, if held, family conferences 11. Client's individual PAT objectives for each instructional area 12. Progress reports from each service area (signed and dated) 13. Pertinent correspondence 14. Release forms 15. Exit interview 16. Follow-up reports In addition to the above, for clients who receive Vocational Evaluation services, case records will include the following: 1. Potential employment goals 2. IVEP (Individualized Vocational Evaluation Plan) 3. Documentation of evaluation results that pertain to work tolerance (physical/mental tolerance, persistence in work/physical activity).

32 Miss. Admin. Code Pt. 23, R. 13.10 Rule 13.10

Case Recording All files are kept current. Information is recorded within 48 hours of the event and exit reports within ten working days following termination/completion of program. Individual instructional areas may maintain work sheets pertinent to that area to record information. However this does not replace the main case record. These work sheets are secured to

ADDIE McBRYDE CENTER MANUAL Information Measurement and Management Section 13

Effective July 2008 Page 39 protect the confidentiality of the information.

32 Miss. Admin. Code Pt. 23, R. 13.11 Rule 13.11

Signature Policy Entries in the Case Notes are signed with the person's first initial and last name. All formal reports and official outgoing correspondence include full signature.

32 Miss. Admin. Code Pt. 23, R. 13.12 Rule 13.12

Case Review (Quality Assurance) The Center provides a bi-annual internal quality assurance and record keeping review of client files. The Assistant Director for Client Services performs the quality assurance analysis and provides a written report to the Center Director. A representative sampling is reviewed. This sampling is taken from cases that were active and/or closed during the period being reviewed. Results of findings are shared with members of the psychosocial committee. The Assistant Director for Client Services is responsible for the case reviews and provides the Center Director reports of the findings with recommendations for improvement. Upon approval by the Center Director, the Assistant Director for Client Services will initiate any corrective action indicated by the report. The review of case quality assesses the following: 1. Each service began at the appropriate time 2. Appropriate services were provided for an adequate duration 3. Appropriate goals were stated for each service 4. Services produced the desired results in terms of program goals and the needs and preferences of the individual 5. The person served participated in program planning 6. All required and appropriate documents are contained in the file

ADDIE McBRYDE CENTER MANUAL Performance Improvements Section 14

Effective July 2008 Page 40

CHAPTER 14 (1N) Performance Improvements

Various management records and reports generated by the Center are used to guide the operation, support the assessment and improvement in quality of services, measure and communicate performance, and reflect the current status of the Center. The Center Director presents and interprets operating reports, including those reflecting the efficiency and effectiveness of the Center. These reports include, but are not limited to, the following: 1. Annual Outcomes Management Report 2. Outcome Measurement System Results 3. Financial Statements 4. Strategic Management Plan Reports 5. Personnel Reports 6. Program Quality Assessment 7. Monthly Reports These results are supplied to the McBryde Governing Authority and to the OVRB Director who presents them to the MDRS Executive Director. These presentations provide an opportunity for policy and operational review, analysis, and action. The Center Director analyzes management reports and compares performance against budgetary, administrative, and professional standards. In addition, the Center Director analyzes the extent to which the Center's goals and objectives are being attained. The results of these activities are used by the Center Director to initiate appropriate preventive, pro-active, or corrective measures.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 41

CHAPTER 15 (1O) Client Services 15.00 GENERAL SERVICE INFORMATION The information in the following section contains procedures that are common to each of the primary service areas of the Center – Personal Adjustment Training, Vocational Evaluation, and Low Vision. A. Referrals Service requests are submitted to the Center via AACE (the Automated Accessible Case Environment) electronic local area network of MDRS. Some outside third party sources continue to utilize the AMRC-01 paper form. The Assistant Director for Client Services sets the entry date. The VRB/IL counselor or third-party sponsor provides copies of the following information when making a service request from the Center: 1. Medical information including an eye report, general medical, psychiatric, and/or psychological reports pertinent to the individual client. In some cases the Center may require more recent and/or detailed information than the counselor has required to establish eligibility. This information may be needed to determine a client’s ability to benefit and participate in a residential program and ensures that the client and others are not jeopardized by being placed in an inappropriate assessment or class assignment.

2. School records, including IEP for all Transition Students, if available. 3. Previous vocational evaluation and/or work adjustment reports if available. B. Re-referrals If a counselor refers a former client to the Center for additional services, the counselor submits a NEW service request stating the services the client currently needs and explaining why the counselor feels the client should return, including any changes which might affect the plan for services. The counselor's request is staffed and the previous case file will be the case of record for the Center's filing purposes. Prior to setting entry date, all referral information is reviewed to see if it is adequate to determine appropriate services for the client. The Assistant Directors, the Center Nurse, Medical and Psychiatric consultants and others, as necessary, may all be involved in the decision when questions arise. The responsibility for determining appropriateness of referrals lies with the Center Director. Records of

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 42 the pre-entry procedures are maintained in the client's file and include the following: 1. Date of service request and review of materials 2. Entry date of client if accepted or, if not accepted, the reason 3. Designation of a Center Program Manager The counselor is notified of the scheduled entrance date, services planned and the client's Center Program Manager by way of the "Counselor Correspondence Form." (Reference: Blank Forms Book.) If, considering the client's disabilities the Center needs more information than provided, a meeting with the client prior to a decision on entrance may be suggested. C. Order of Acceptance Policy For MDRS clients the acceptance policy of the Addie McBryde Rehabilitation Center for the Blind is first referred, first accepted. This policy also applies in times when a waiting list is in use. Administrative staff of the Center reserves the right to exercise judgment regarding acceptance based on special circumstances and client's need. In the event of a backlog, client will be scheduled in the order received. D. Reentry Policy Terminated clients seeking re-entry to the Center are considered as a standard referral. E. Reorientation Policy It is the policy of the Addie McBryde Center that any client participating in our program for more than 12 (twelve) months will be reoriented and his/her rights will be discussed. F. Ineligible Individuals If a person is determined ineligible for services at the time of referral or any other point during his/her stay at the Center, the client and/or the referring counselor is informed of the reason. If possible, appropriate recommendation for referral is made to other community services. Records are kept on these individuals indicating the following: 1. Reason for ineligibility 2. Action taken 3. Contact person 4. Outcome of recommendation At least annually, an analysis of trends in ineligible cases is conducted with resulting information incorporated into the Center's planning activities. (Reference: "Ineligible Individuals" file.)

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 43 G. Orientation Policy for Clients All information provided to the client is communicated in terms he/she can understand, using modes of communication that are appropriate to the individual client. On the first day at the Center, clients are given an orientation to the Center services, and what to expect during his/her stay. The Client Handbook is explained in detail to the client by the Program Manager who also ensures that the client has a personal copy of this handbook. (This handbook is available in regular print, large print, Braille and audio-cassette). The client is also given a tour of the Center to familiarize him/her with the staff and the physical layout of the facility. Clients are not placed in class assignments until the orientation has been completed. An audio cassette containing the Client Handbook and a brief orientation to the Center is in each client’s dormitory room. It is made available to day students, as needed, to review the layout of classrooms and other student areas within the Center. H. Client Handbook The Center distributes—in appropriate alternate format—and explains the Client Handbook to all clients. Information in the Client Handbook includes: 1. The responsibilities of the Center and the client 2. Rules and regulations 3. Nondiscrimination provisions 4. Grievance and appeal provisions 5. Human Rights provisions 6. Services provided at the Center 7. Policies regarding re-entry into the program I. Intake Interview The client participates in an intake interview conducted by the Program Manager. The intake interview includes a discussion of: 1. The mission, programs, and services of the Center 2. The process for the development of program goals and the active participation of the persons served in goal setting and individual planning 3. A list of the rights and responsibilities of the persons served, corresponding grievance and appeal procedures, and any restrictive procedures that may be used 4. The identification of the individual responsible for coordinating services and a description of the role of this individual (the Center Program Manager). 5. Clients of MDRS are informed that they have no financial obligation for services provided by the CRP. The client signs the statement of understanding at the end of the Client Initial Intake Form. (Reference: Blank Forms Book.) The referring counselor is notified

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 44 that the client has entered as scheduled. Whenever possible the client's family or client representative is invited to participate in the orientation/rehabilitation process. The referring counselor ascertains if the client wishes this participation. J. Individual Program Planning Policy After entry into the Center, staff reviews all the referral and intake information and makes recommendations regarding the individual's program needs. The client and his/her Program Manager work together to develop an individual program focusing on the client's expectations and desired outcomes. When appropriate, the client's family or significant others are involved. The focus of the program is on integrating the individual into the community through increased independence and skills. Both the Program Manager and client sign the program. Personal Adjustment Training Instructors and others who have responsibility for implementing parts of the program sign off indicating awareness of their responsibilities. The individualized program is reviewed at least monthly and modified as needed. The person served is actively involved in the individual planning process and has a major role in determining the direction of his/her individual plan. All services provided are related to the individual's goals. Each plan is based on the client's specific and unique needs. This plan contains the following: 1. Individual client preferences and choices 2. Services to be provided 3. Specific service goals and objectives 4. Time intervals at which service outcomes will be reviewed 5. Anticipated time frames for the accomplishment of the individual's goals 6. Measures and procedures to assess outcomes (Individual Functional Assessment) 7. Person responsible for implementation of the plan (Center Program Manager) 8. Special needs (e.g., assistive technology, sign/foreign language interpreter, Alcoholics Anonymous participation, Mental Health counseling, etc.) K. Program Manager Each client is assigned to a single Program Manager who is a member of the Psychosocial Team. The Program Manager is responsible for the client during the implementation of his/her plan. The Program Manager ensures the individual is adequately oriented to, and actively participates in, discussions of plans, goals, and status of his/her program on an on-going basis. Program Managers ensure that the client's program proceeds in an effective manner toward the goals and that all

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 45 planned services are provided. The Program Manager promotes the program's responsiveness to the strengths, abilities, needs and preferences of the client and attends conferences about the client to ensure proper decisions are made regarding program continuation, termination, follow-up, etc. The Program Manager serves as the primary liaison with referring counselors, family members and significant others. L. Assistive Technology In order to maximize the client's performance, adaptive measures are used whenever possible with individuals having sensory, physical, communication, or other functional limitations which might otherwise present barriers. The client's assistive technology/reasonable accommodation needs are considered from the time the referral information is received throughout the client's entire program (Vocational Evaluation and/or Personal Adjustment Training). Equipment modifications and other techniques are used to provide reasonable accommodations to assist in maximizing the productive capacity of the client. The Center's assistive technology resources through the Low Vision Evaluation and the MDRS Office of Assistive Technology are utilized to address these areas as appropriate to the needs of the client and Center. (Reference: CHAPTER 8.03 of the Center Manual.) M. Behavior Management Policy and Procedures It is the policy of the Center to use positive interventions prior to the use of restrictive procedures. In the event that unacceptable behavior is displayed by a client, an analysis, either formal or informal, is completed by Center staff to determine if any environmental factors may have caused or reinforced such behavior. If environmental factors are determined to be involved, the staff implements appropriate positive measures to modify or restructure the environmental influences in order to reduce or eliminate the behavior. 1. In the event the unacceptable behavior continues after efforts are made to restructure or change the environment, the next step is to implement positive counseling and/or other positive behavioral modification techniques including positive reinforcement to alter, reduce, or eliminate the undesirable behavior. These behavioral techniques and efforts become a component of the individual program plan. 2. Only after extensive counseling and/or behavioral management techniques fail to produce a change of the behavior, will the staff employ appropriate restrictive procedures. 3. Allowable restrictive procedures may include time-out (not to exceed a 30 minute period) and suspension (not to exceed 3 days). The area chosen for timeout (usually a client's dorm room) is well lit, ventilated, and does not present an environment of total seclusion from visual or auditory feedback.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 46 During time-out procedures, a staff member checks on or monitors the status of the person served every fifteen (15) minutes. If at any point the client is deemed to need counseling, time-out is terminated and counseling is provided. If time-out procedures do not effectively alter, reduce or eliminate undesirable behavior then suspension from the program is implemented. 4. In all cases where restrictive procedures are under consideration, the staff only implements such actions after clearly explaining the procedures to the client and/or, as applicable, his/her representative. The person served is requested to sign an Informed Consent Form to acknowledge that he/she understands the restrictive procedures that are being put in place. This Form is then attached to the individualized program plan. 5. Failure to change the behavior is reason for termination from the program. The termination occurs only after extensive and graduated steps of environmental change or counseling procedures are found to be ineffective in stopping the behavior. N. Referrals for Additional Services. Outside services are obtained that meet the individual needs of the client. These are coordinated with the Center's program of services. (Reference: "Clients Referred for Concurrent Ancillary Services" file.) Records of persons referred are kept and contain at least the following information: 1. Place referred 2. Date 3. Reason for referral 4. Contact person O. Termination Procedures Termination planning begins early in the program and involves the person served, all professional staff, and resource personnel contributing to the person's program. All parties involved receive ample notice concerning the termination decision. The client is provided an exit conference and completes an Exit Interview Form. (Reference: Blank Forms Book.) This form includes the following information: 1. Reason for termination 2. Any recommended referral action 3. Date of termination 4. Satisfaction with services provided while at the Center

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 47 P. Follow-Up A follow-up is done on all clients to determine to what degree the person's program was successful, whether the services provided were optimal, and if further services are required. Documentation of measurable satisfaction of the person served is obtained through the follow-up process. This information is incorporated into the Outcomes Measurement System. Contact is made regarding every client within ninety working days after his/her closure date. This contact may be by telephone, letter, or in person. The client is contacted directly by the Center or the referring counselor or an OVRB Itinerant Teacher may assist in obtaining the follow-up information. The follow-up information is maintained in the client's permanent file. 15.01 Personal Adjustment Training (PAT) Services Personal Adjustment Training is an array of services provided directly at the Addie McBryde Center and through linkage with other resources in the community which takes into consideration the needs of the individual served and that person’s family, the informed choices of the individual, and the unique socioeconomic, and cultural needs of those served. PAT services result in increased inclusion in community activities, increased or maintained ability to perform activities of daily living, and increased self-direction, self- determination, self-reliance, and self-esteem. A. PAT Admission Criteria requirements for entrance to personal adjustment training services are as follows: 1. Has VR/VRB or other 3rd party sponsorship 2. Is at least 16 years of age 3. Has prior medical and/or psychological evaluation appropriate to disabling condition(s) 4. Is not dangerous to self and/or others 5. Is free of any acute medical and or psychological conditions 6. Is able to care for his/her own personal needs 7. Has specifically identified functional limitations to independence and/or employment that require PAT services B. PAT Services PAT makes provision for but is not limited to the following: 1. Instruction in Techniques of Daily Living 2. Instruction in Personal Management (planning, shopping, preparing

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 48 meals) 3. Communication Activities including skills such as time, telephone and money management 4. Functional literacy skills, including Braille 5. Education and Training Activities, including GED preparation classes 6. Access to governmental and community services (including SSI/SSDI and other benefits) 7. Development of work attitudes and vocational pursuits 8. Adjustment to blindness, including building self-esteem. 9. Orientation, Mobility and transportation skills 10. Assistive technology, including computer training 11. Keyboarding skills 12. Leisure or Recreation 13. Health and wellness promotion 14. Specialized communication services for individuals with dual sensory impairments It is not required that every person served receives all the services available. Each individual receives those services that will help meet his/her goals. The time spent in adjustment services is based on the time necessary to accomplish the individual's goals. The progress of each client is monitored by the Program Manager to ensure timely progress. C. PAT Techniques The provision of PAT services is based on the individual client's needs and choices. They are documented in such a way that uniform application is ensured. This includes a curriculum guide and specific instructional methods. (Reference: PAT Curricula Book.) Examples of adjustment techniques include, but are not limited to, the following: 1. Classroom Instructional Activities 2. One-on-one contacts with program manager and other staff 3. Individual/Group activities, including community outings 4. Guest Speakers D. Individualized Personal Adjustment Training Plan (IAP) Each client participates in the development of his/her individual adjustment plan. The plan is based on consideration of the individual’s goals, strengths, capabilities, and preferences and is relevant to maximum participation in environments of their choice. The IAP includes the following: 1. Objectives (stated in observable, measurable terms) which are considered necessary to attain the person's vocational objectives 2. Statements of expected outcomes

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 49 3. Time intervals for achieving outcomes

4. Assignments or specific instructional techniques and methods consistent with the adjustment goals 5. Identification of specialized needs and/or services 6. Specific persons to be involved in the plan and evidence that these individuals are aware of their role in the plan (their signature or initials suffice for documentation) 7. Reviews to be conducted at least monthly with modifications made as necessary E. PAT Progress Staffings and Reports Staffings are held at least monthly. Attendance at this staffing includes the person served, those instructors involved in the person's program of services, the person's Program Manager and the Vocational Evaluator, if appropriate. These staffings address the client's progress toward his/her program objectives, point out any amendments necessary, and justify recommendations regarding continuation of his/her program. A separate memo is not required to document staffings, but staffing information is included in the progress report to the referring counselor. (Reference: Blank Forms Book.) This report is to be completed and disseminated to the appropriate parties within 10 working days following a staffing. F. PAT Final Staffing A staffing is held prior to the completion of PAT services. This staffing addresses the results of PAT services and provides recommendations for the future (i.e., information about other agencies or services and specific information about equipment that may be beneficial for the individual. If the referring counselor is not present, a copy of the original Counselor Correspondence Form is sent to the referring counselor notifying date of termination. G. PAT Exit Criteria A client may exit PAT services for any one of the following reasons: 1. Completion of all the goals on the IAP 2. Entrance into employment 3. Entrance into training (College or Skills training) 4. Client exits the program of his/her own accord prior to completion of the IAP 5. Client fails to carry out his/her assigned responsibilities in the IAP 6. Client develops an acute medical and/or psychological condition 7. Client develops behaviors that pose a danger to self or others

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 50 15.02 Comprehensive Vocational Evaluation Services Vocational Evaluation is a comprehensive process that systematically utilizes formal testing instruments for assessment and vocational exploration. The purpose is to assist the person with vocational development leading to employment options. Vocational Evaluation incorporates medical, psychological, social, vocational, cultural, assistive technology, and economic data into the process of evaluation. A. Vocational Evaluation Admission Criteria The requirements for Vocational Evaluation are as follows: 1. Client has VR/VRB or 3rd party sponsorship 2. Is at least 16 years of age 3. Has prior medical evaluation appropriate to disabling condition(s) 4. Is free of any acute medical and/or psychological conditions 5. Is not dangerous to self and/or others 6. Is able to care for personal needs 7. Vocational potential is uncertain 8. Adjustment service needs have not been determined B. Vocational Evaluation Services Services are comprehensive and assess information about the following: 1. Physical and psychomotor capacities and limitations 2. Cognitive functioning 3. Social, personal, and work related behaviors 4. Interests, attitudes, career aspirations, and knowledge of occupational information 5. Personal, social and work histories 6. Aptitudes 7. Achievements (e.g., educational and vocational) 8. Job seeking and retention skills 9. Identification of work and non-work related needs 10. Possible employment objectives 11. Ability to learn about self as a result of the information obtained from evaluation 12. Learning style (including ability to understand, recall, and respond to various types of instruction) 13. Transferable skills 14. Environmental conditions 15. Assistive technology and reasonable accommodations 16. Community and employment supports 17. Independent living skills

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 51 18. Mode of communication The program has the capacity to assess all of the above, but does not assess every person's functioning in each of these areas. The needs of the person served dictate the areas in which assessment is done. C. Vocational Evaluation Techniques A variety of tasks are utilized to ensure the evaluation needs of the client are met. Vocational evaluation services draw on one or more of the following techniques based on the specific abilities and needs of the persons served: 1. Psychometrics 2. Work samples 3. Situational assessment (if needed) The area set aside for Vocational Evaluation is designed with sufficient space for these activities. The use of specific instruments is based on the individual client's needs, interests, and capacities. All diagnostic and technical data are supplemented with personal interviews and behavioral observations. Time frames for the evaluation of a client are determined by the individual needs of the client. D. Individualized Vocational Evaluation Plan (IVEP) Each client shall participate in the development of his/her Individualized Evaluation Plan (IVEP). For clients who are also receiving Personal Adjustment Training services, the IVEP is considered an addendum to the Individualized Adjustment Plan (IAP). Any assessment plan is based on the referral information, intake interview, questions asked by the referral source, stated purpose of the evaluation, and the individual's interests and capabilities. The plan: 1. Identifies specific questions to be answered in evaluation 2. Specifies what accommodations are utilized including assistive technology 3. Specifies the individuals to be involved in carrying out the plan with evidence of their participation (signatures will suffice for this) 4. Is modified if necessary E. Vocational Evaluator Participation in Monthly Client Staffing For clients in PAT, the vocational evaluator attends the initial or evaluation staffing to provide recommendations and information to instructors. The evaluator also meets with instructors separately on an as need basis to assist in planning for individualized approaches which take into consideration learning styles and special needs of the client.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 52 F. Vocational Evaluation Summary A meeting is held with the client prior to the completion of evaluation. The meeting is attended by the Vocational Evaluator and person served if the individual has received only Vocational Evaluation. This meeting addresses the preliminary results of the evaluation and any recommendations for further services. G. Vocational Evaluation Report The Evaluation Report is completed, disseminated and properly interpreted to the client/district counselor in a reasonable amount of time (20 working days) following the completion of the evaluation. A cover letter is sent to the referring counselor stating the date the meeting was held, persons present, barriers to employment, recommendations (including vocational goal, if appropriate), and starting dates of any new services. The evaluator has 20 working days from the client's exit date in which to complete and disseminate the report. Any possible vocational goals are expressed in terms of D.O.T. job titles/families when vocational goals are not found, non-vocational goals are specified and related to resources available in the community. H. Vocational Evaluation Exit Criteria A client exits the evaluation services unit for any of the following reasons: 1. All the questions contained in the IVEP are completely addressed or answered 2. Vocational potential and direction is determined 3. Lack of vocational potential is determined 4. Client exits program of his/her own accord prior to termination and/or completion of the IVEP 5. Client fails to carry out his/her assigned responsibilities in the IVEP 6. Client develops an acute medical and/or psychological condition 7. Client develops behaviors that pose a danger to self or others 15.03 Low Vision Services The Low Vision Program at the Addie McBryde Center was developed to allow persons with significant visual loss to be evaluated to determine if aids, appliances, devices, or equipment exists that will enhance their ability to confidently and independently pursue their careers and private lives. Technology is available in many forms, ranging from various types of magnifiers, lamps, to high-tech items and closed circuit television reading systems and specially modified computer systems. When it is determined that a client will need computer equipment, the program manager contacts the district counselor for referral to MDRS Office of Assistive Technology.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 53 A. Low Vision Admission Criteria To receive Low-Vision services, a client must: 1. Have VR/VRB or 3rd party sponsorship 2. Be at least 16 years of age 3. Have specific request for low vision services by the referral source B. Low Vision Services and Techniques Evaluation/Assessment: This service includes an assessment of the person's ability to use and benefit from equipment by hands-on demonstrations and try-outs of a broad array of devices such as magnifiers, and closed circuit television devices. Limited training is provided in the use of assistive devices. If it is determined that a client could benefit from in-depth training in the use of a computer, such recommendation will be made to the referring counselor, who, at his/her discretion, will make arrangements for an assistive technology evaluation through the MDRS Office of Assistive Technology. Center staff also provides demonstrations to various MDRS personnel and other service providers as requested. C. Low Vision Reports Reports generated by the Low Vision specialist to referring counselors include equipment recommendations, justification, prices, vendors, etc. Reports are completed within 10 working days after completion of an evaluation. When appropriate, recommendations of low vision evaluations are incorporated into the individualized programs of services for Center clients. D. Low Vision Exit Criteria A client may exit from the Low Vision services unit for any of the following reasons: 1. All the questions contained in the original referral and request for evaluation are addressed or answered 2. Equipment or device needs are determined 3. Client exits program of his/her own accord prior to completion of the evaluation; client refuses to participate or is unable to keep scheduled evaluation appointment

32 Miss. Admin. Code Pt. 23, R. 15.04 Rule 15.04

Additional “Special” Services The center offers the following additional ―special‖ services on an adjusted per diem when space and schedule permits to clients of the MDRS Independent Living Program for the Older Blind and third party payers: 1. On-site orientation and mobility at the individual’s work place.

ADDIE McBRYDE CENTER MANUAL Client Services Section 15

Effective July 2008 Page 54 2. Computer training in specific skill areas such as E-mail, Internet use, etc.

ADDIE McBRYDE CENTER MANUAL CARF Documentation Appendix A

Effective July 2008 Page 55

APPENDIX A Accessibility Reports Action Taken From Stakeholders Input Annual Survey Budget Cash Management Policies Client Group Meeting/Training/Activities Client/Director Meetings Clients Referred for Concurrent Ancillary Services Code of Ethics / Our Mission Statement Community Involvement (Clients) Consultants / Referral Resources Daily Maintenance on Building Dietary Procedures Donations / Contributions Lions Club/Other Dorm Supervisors Drills Employee Handbook and Standards of Conduct External Inspection Facility Advisory Committee Fee for Service Schedule Governing Authority Guidelines on Legal Issues Health Policies and Procedures Human Resources Incident / Accident Reports Ineligible Individuals Interagency Agreement / Collaboration Letters of Acknowledgement to Referral Sources Letters of Appreciation Clients and Staff MDRS—Board Members Monthly Reports Outcomes Measurement System (3 folders) Psychosocial Meeting Minutes and Staffing Schedule Public Information and Outreach Public Meetings for State Plans Quality Assurance Resource Material: Professional / Education Rights of Persons Served

ADDIE McBRYDE CENTER MANUAL CARF Documentation Appendix A

Effective July 2008 Page 56

Safety Policies and Procedures Staff Development/Training Staff Meeting Minutes Staff Outreach Strategic Management Plans Technology and Computers Volunteer / Intern Program

Supplemental Documentation / Resources Addie McBryde Center Manual Addie McBryde Center Personnel Files Blank Forms Book Executive Memoranda File MDRS / HRD Policies Notebook OVR / OVRB Policy and Procedures Manual State Personnel Board (SPB) Employee Handbook

ADDIE McBRYDE CENTER MANUAL Code of Ethics Appendix B

Effective July 2008 Page 57

APPENDIX B Code of Ethics

1. MORAL AND ETHICAL STANDARDS

The employees of Addie McBryde Rehabilitation Center and the members of the Addie McBryde Rehabilitation Center governance authority shall behave in a moral and ethical manner in the conduct of their specific roles.

2. BUSINESS / FINANCIAL STANDARDS

The Addie McBryde Center shall conduct its business/financial practices in the ethical manner, in keeping with generally accepted business/financial principles.

3. MARKETING STANDARDS

The Addie McBryde Center shall conduct its marketing activities in a moral and ethical manner. Public information and outreach activities shall be honest, accurate, and positive in the depiction of individuals with disabilities.

4. TREATMENT OF THE PERSONS SERVED AND OTHER COMMUNITY MEMBERS

The employees of Addie McBryde Center shall respect the dignity and worth of all individuals with whom they work. The primary ethical obligation of Addie McBryde Center employees is to their consumers; or those persons who are directly receiving their services. Addie McBryde employees will endeavor at all times to protect each consumer’s welfare and to place this interest above their own.

5. PROFESSIONAL RELATIONSHIPS

Interpersonal cooperative relationships shall be seen as vital in achieving optimum benefits for consumers. Professionals shall respect the value and roles of professionals and staff in other disciplines and act with integrity in their relationships with professional colleagues, organizations, agencies, referral sources and related disciplines.

ADDIE McBRYDE CENTER MANUAL Code of Ethics Appendix B

Effective July 2008 Page 58

6. CONFIDENTIALITY

The employee of Addie McBryde Center shall respect the confidentiality of information obtained from consumers in the course of their work.

ADDIE McBRYDE CENTER MANUAL INDEX

Effective July 2008 Page 1

INDEX Accessibility, 32 Additional ―Special‖ Services, 53 Administrative Agency, 3 Alcohol and Drug Testing Policy, 23 AMRC Mission Statement, 1 Annual Fiscal Report, 14 APPENDIX A, 55-56 APPENDIX B, 57-58 Assistive Technology, 45 Assurances/Principles, 1 Background/Credentials Verification Policy, 24 Behavior Management Policy and Procedures, 45 Budget, 13 Case Record Requirements, 68 Case Recording, 38 Case Review (Quality Assurance), 39 Cash Management Policy, 13 Client Handbook, 43 Code of Ethics, 57 Code of Ethics and Ethical Violations, 2 Community Involvement, 28 Comprehensive Vocational Evaluation Services, 50 Confidential Records, 29,35 Consumer Based Planning, 7 Critical Incident Reporting Procedures, 18 Disclosure of Confidential Client Information, 37 Donations Policy, 12 Emergency Lighting, 21 Emergency Medical Information, 19 Emergency/Crisis Procedures, 18 Emergency/Fire Alarm System, 22 Equipment Safety, 21 Ergonomics Policy, 21 External Audit, 14 External Safety Inspections, 17 Facility Advisory Committee, 9 Fee Splitting Policy, 12 Financial Planning and Management, 12

ADDIE McBRYDE CENTER MANUAL INDEX

Effective July 2008 Page 2

Financial Records, 13 First Aid Room, 21 Fiscal Management, 12 Follow-Up, 47 Funding, 12 General Service Information, 41 Governing Authority, 2-3 Health & Safety Training, 19 Individual Program Planning Policy, 44 Individualized Personal Adjustment Training Plan (IAP), 48 Individualized Vocational Evaluation Plan (IVEP), 51 Ineligible Individuals, 42 Infection Control Policy, 20 Input from Persons Served, 7 Insurance, 13,16 Intake Interview, 43 Internal Health & Safety Program, 18 Interns/Trainees, 25 Job Descriptions, 25 Leadership, 1 Legal Requirements and Legal Issues, 11 Low Vision Admission Criteria, 53 Low Vision Exit Criteria, 53 Low Vision Reports, 53 Low Vision Services, 52 Low Vision Services and Techniques, 53 Management Information System, 34 MDRS Mission Statement, 1 Medication Monitoring Policy, 19 Nondiscrimination Policy, 25 Order of Acceptance Policy, 42 Organization of Material in Case Record, 37 Organizational Chart, 4 Organizational Structure, 4 Orientation Policy (Employees/Interns/Trainees/Volunteers), 25 Orientation Policy for Clients, 43 Outcomes Measurement System, 34-35 Outside Consultants, 25 PAT Admission Criteria, 47 PAT Exit Criteria, 49 PAT Final Staffing, 49

ADDIE McBRYDE CENTER MANUAL INDEX

Effective July 2008 Page 3

PAT Progress Staffings and Reports, 49 PAT Services, 47 PAT Techniques, 48 Performance Appraisals, 27 Personal Adjustment Training (PAT) Services, 47 Personnel File Contents, 36 Personnel Policies for Employees of Addie McBryde Center, 26 Physical/Psychological Abuse, 31 Program Manager, 44 Program Restrictions, 17 Public Relations and Outreach Information, 10 Records Protection Policy, 36 Records Retention/Disposal Policy, 36 Reentry Policy, 42 Referrals, 41 Referrals for Additional Services, 46 Release of Financial Information, 13 Release of Persons Served, 31 Re-referrals, 41 Reorientation Policy 42 Retention of Referral Information, 37 Risk Management, 15 Sexual Harassment Policy, 31 Signature Policy, 39 Single Case Record, 37 Smoking Products Policy, 20 Staff Development and Training, 27 Staff Input, 27 Staff Meetings, 10 Staff Qualifications, 24 Staffing Pattern and Back-up Plan, 24 Supplemental Documentation/Resources, 56 Termination Procedures, 46 Transportation, 22 Vocational Evaluation Admission Criteria, 50 Vocational Evaluation Exit Criteria, 52 Vocational Evaluation Report, 52 Vocational Evaluation Services, 50 Vocational Evaluation Summary, 52 Vocational Evaluation Techniques, 51 Vocational Evaluator Participation in Monthly Client Staffing, 51

ADDIE McBRYDE CENTER MANUAL INDEX

Effective July 2008 Page 4

Volunteers, 25

Part 24 Part 24: REACH Manual

32 Miss. Admin. Code Pt. 24 Part 24: REACH Manual

1

Title 32: Rehabilitation Services Part 24: Reach Manual REPEALED. Effective 02/07/2025