Opportunities for Ohioans with Disabilities



Slide 1VR Fee Schedule UpdateVR Fee Schedule Process September 2019Slide 2VR Fee Schedule Update: AgendaListening FirstJob Related ServicesBreakCommunity Based AssessmentsSummer Youth ServicesPre-Employment Transition ServicesContracted ServiceSlide 3Listening FirstJay BurnsSupervisor, Provider & Contract Management UnitSlide 4Listening to providersStarting in October 2018, OOD met with the provider community around the state regarding current services, the VR fee schedule, rates, and improving participant successes. 1 – Central Office5 Regional26 in attendance at Columbus (Central)33 in attendance at Findlay (NW)40 in attendance at Akon (NE)40 in attendance at Canton (EC)25 in attendance at Cincinnati (SW)27 in attendance at Whitehall (SE)191 Total ParticipantsSlide 5Why are changes happening?Increased rates to facilitate successful outcomes and rapid engagementAcknowledge inflation/cost of living increases, and to allow providers to hire and maintain qualified staffOOD is always assessing and considering ways to enhance services to our individualsAdditional incentives for outcomes and efficienciesWe received tremendous input and considerations from our provider partnersSlide 6Updating VR fee schedule How does the process work? OOD collects feedback from stakeholders and considers areas of improvementMultiple proposed changes are considered and communicated out for feedbackFee schedule proposed changes first go to Common Sense Initiative (CSI)Fee schedule proposal then goes to Joint Committee on Agency Rule Review (JCARR)Implementation date: October 1, 2019Slide 7Approved!JCARR has approved the VR fee schedule update, and it will be effective on October 1, 2019Slide 8Changes to VR fee schedule6.5% minimum increase for VR fee schedule servicesRate increases: 8% increase for performance based job development (tier package) and supported employment job development (tier package)Job related services – reorganized tiers, reduced riskCommunity based assessment & work adjustment servicesSummer youth servicesPre-employment transition services Contracted (BSVI) services moving to the fee schedule with increased ratesSlide 9Field input: Fee Schedule Think TankOOD Area Managers, Supervisors, Counselors, and AE2s met together on December 19, 2018 to consider the proposed Fee Schedule changes and to offer input. The Supported Employment & Training Unit joined the Think Tank to discuss the direction of Summer Youth going forward.Thank you to all Think Tank members: Patricia Boogher, Michelle McDougall, Mark Fay, Lenore Commisso, Shannon Fletcher, Kelly Rodriguez, Traci Conkling, Helen McNamara, Beth Knack, Jerica Kruse, Paetra Flaspohler, Curt Morman, Jeremy Gildow, Jennifer Pollard, Greg Dormer, Marc Manheim, Lynn Hartman, Ashley Gardella, and Mia MurphySlide 10Job Related ServicesJim GearsRehabilitation Program SpecialistSlide 11Job related servicesRates increased 6.5% for job seeking skills, job development – uos, and on-the-job supportsRates increased 8% for performance based and supported employment job developmentChanged rate structure of tiersWeighted more towards Tier I instead of Tier IIITier II may be paid again for appropriate subsequent placementsTier III split into three thirty (30) day increments (30 days, 60 days, & 90 days)Clarified requirements for supported employment job developmentOn-the-job supports shift differential for off-peak hoursNOTES: Split into 30, 60, & 90 Day increment to address fall-out of Participants who lose their job prior to successfully completing 90 Days of workSlide 12Job Seeking Skills TrainingPurpose: To teach Individuals how to conduct their own job search, e.g. how to develop a résumé, how to find job leads, how to answer interview questions, etc.Current fee scheduleRésumé or mock applicationCounselor/coordinator must approve the résuméHave five (5) business days to approveUpdateRésumé with option for VR staff to also request a mock application, in which both would be requiredCounselor/coordinator must approve the résuméClarification on editable résuméInclusion of OOD’s résumé standardsNOTES:Job Seeking Skills Training outside of Tier I“Teach a person to fish” methodologyIndividuals will likely not be referred for Job Development; however if a person is unable to locate a position Job Development can be authorizedJob Seeking Skills should not be authorized prior to Performance Based or Supported Employment Job DevelopmentCounselors have five (5) business days to approve the résumé, if not Provider may assume it is approved. If concerns are raised after the five (5) days Counselor and Provider should work to resolve it.Editable résumé must be submitted with the invoice and report, even if a copy was previously provided to CounselorRésumé Standards set benchmarks not specifics, e.g. free from spelling errors, accurate information, specific details, etc.Philosophy is that the résumé is a living document that can expand as the person works, develops more skills, and put them into a better ;position to get a job in the futureSlide 13Job developmentPurpose: To assist an Individual to find a position based on their identified employment goal or other specific situations, e.g. non-permanent Job Development and academic Internships.Current Fee ScheduleTier I Includes job seeking skills trainingMay be used for non-permanent placements for transition youth (uos only)Specific “subsequent placement” feeSingle Tier III payment with single outcomeUpdateTier I Includes job seeking skills trainingExpanded non-permanent placements to include academic internships for youth and/or adults (uos only)Subsequent placement fee increased to same rate as Tier IITier III has specific outcomes for each of the thirty (30) day paymentsNOTES:Tier is preferred placement protocols, UOS may be done on a case by case basis but recommended that Counselor staff with Supervisor for reason. Requirements for Performance Based and UOS Job Development are the sameNon-permanent placements are not the positions that OOD intends to close an IndividualPerformance Based authorizations shall not be used for non-permanent jobsTier payments are for specific outcomes as identified in the VR Fee ScheduleTier I authorization initiates Performance Based Job Development until the next outcomeSee slide on Job Development authorizationsTier I is designed to get the person “job search” ready, e.g. interview skills (how to address employment gaps, criminal histories, etc.), develop resume, etc.Tier II is paid upon successful completion of the second day of paid workTier III is paid in three thirty (30) day outcomes. Specific Provider requirements for each outcomeSlide 14Performance Based Job Development Current fee schedule“Kick Off” meeting was included in policy/procedureJobs now notification requirementsUpdateIncluded “kick off” meeting in VR fee schedule requirements“Kick Off” must take place during Tier I(or as soon after résumé is ready for uos)Résumé’s should be turned in one week prior to kick off for review so approval can be given at kick offJobs now notification requirementsNOTES: Providers will notify Talent Sourcing Coordinators once an Individual applies or is interviewed with a Job Now employer. TSC will follow up with prospective employer to facilitate placement activities.Slide 15Job Development – Facilitated (UOS)Used when individual is receiving performance based or supported employment job development from one provider but a second provider is authorized job development to pursue a specific employment opportunity.NOTEIf Individual is placed through Facilitated Job Development the original Provider will receive Tier II and the secondary Provider, the one with the specific lead, will be authorized UOSSlide 16Supported Employment Job Development (SJED)Purpose: To assist an Individual to find a position based on their identified employment goal. Requirements for Individuals and Providers.Current Fee ScheduleFee weighted towards final outcome payment (Tier III)Provider staff must contact individual twice per weekTeam meetings bi-monthlyUpdateFee weighted towards initial outcome payment (tier I)Provider staff must contact individual twice per weekClarified that team meetings must occur every 60 daysNOTEDesigned for individuals who need more intensive services, e.g. more frequent contacts, job carving, and people who will need long term supports, e.g. will always need OJTS, etc.Fee Schedule does not specify the type of contact but it should be interactive and meaningful to the IndividualsSlide 17Supported Employment Job Development (SJED)Provider & provider staff credentials defined in proceduresParticipants must be MSD, coded se in aware, need and have long term supports availableProvider staff had to be CESP certified for Tier III activitiesClarified provider & provider staff credential requirements for Tier I& Tier IIProvider must be DODD certified in career planning (JD) and individual employment supports (OTJS) plus staff must be CESP or CRCMust be IPS approved by ODMHAS; no CESP requiredProvider staff do not need to be CESP or CRC for Tier III, but must complete employment first partnership trainingRequirements at Ohio employment first website, under resources section ()NOTEBoth CESP and CRC have online look ups on their respective websites to help determine if Staff meet credential requirementsProvider Addendums will also be updated with names of trained staffProviders must send in changes of trained staff to crpvendor@ood. to update their listSlide 18PBJD & SJED: TIER IIICurrent Fee ScheduleSingle payment at the end of the outcome (90 days)No specifics on frequency of contactUpdateThree payments for each thirty (30) days with specific outcomes30 days60 days90 days90 days rapid90 days – SGA90 days – rapid & SGA“Interactive” contacts required every to weeksNOTES:Used to be paid once ninety (90) days of employment and specific contact between days 83 and 90. New model specifies weekly interactive contacts with Employer and/or Individual once every two weeks, or more often if required based on Participant’s needs.Issue was in the past Provider documented no contacts except between days 83 – 90Contact must be “interactive” e.g. not “I sent an email” or “I left a message”Providers need to make a “good faith” effort to make contacts.If Provider is having trouble connecting with Individual should notify Counselor immediately.Slide 19Service AuthorizationsCurrent Fee ScheduleTier I authorization with “referral to community rehabilitation program”Tier II upon approval of the positionTier III upon “job stabilization”Subsequent placement after Tier II but before Tier III paid, lower rate for subsequent placementUpdateTier I authorization with “referral to community rehabilitation program”Tier II upon approval of the positionTier III upon “job stabilization”Three (3) authorizationsService category for each thirty (30) day periodPremiums included on final authorizationSubsequent placement after Tier II but before Tier III paid, same rate as Tier IINOTECounselors need to be specific in referrals and include job goal as identified on Individual Plan for Employment (IPE), wages, hours, etc.Counselors need to review the position description (or a summary of job task) and approve the position, wages, hours, etc., at which time Counselors will issue the Tier II authorization an acceptance of the jobNeed to approve position based on current facts. Don’t approve a position based on the possibility that hours may increase.Do not wait till the person has started working to issue Tier IIEmployment verifications may be signed first day of paid work, including orientation if paidMultiple authorization subcategories for Tier III (30 Days, 60 Days, 90 Days, 90 Days - Rapid, 90 Days - SGA, 90 Days – Rapid & SGA.Slide 20On-The-Job SupportsPurpose: To assist an Individual to learn job tasks, adjust to the work environment, and maintain employment.Current fee scheduleCurrently requiring “fade plans” as part of reports; not consistently receiving themNo guidance on requesting addition service timeUpdateClarified support (“fade”) plans should be submitted within five (5) days of serviceidentifies what areas individual needs to learnestimated duration and frequency of supportbenchmarks to determine progressProviders submit a request for additional service units by the 20 and must include brief explanationSlide 21On-The-Job SupportsCurrent Fee ScheduleNot specific about supported employment requirementsNo “shift differential” for off-peak hoursUpdateClarified the staff providing OTJS services on supported employment cases through the developmentally disabled (DD) model must complete the employment first training if they do not hold a CESP or CRC. Does not apply to approved IPS providers through ODMHASIncreased rate for services which occur during off-peak hours, after 9:00 pm and before 5:30 amBased on start time of serviceTiers: Authorization & Billingjob AidTo print the job aid:Go to the slideSelect file and printUnder “settings” change “print all slides” to “print current slide”Change “full page slides” to “notes page”Slide 23Fee schedule transition planAuthorizations can be issued by ae2s after attending fee schedule update trainingUnder no circumstances can an authorization cross from September into OctoberTier III is moving from one payment at day 90 to three payments, one at day 30, 60, & 90Services are paid based on the current VR fee schedule when the outcome is achievedIf provider is in first 30 days, OOD will issue the day 30 authorization on 10/01If provider is in the 31 – 60 day cycle, OOD will issue authorizations for both the day 30 & day 60 on 10/01/19If a provider is in the 61 – 90 cycle OOD will issue authorizations for 30, 60, & appropriate (e.g. Regular, rapid, SGA, or r & s) 90 day on 10/01/19Providers may invoice any Tier III payments that are completedReminder: tiers are now “front loaded,” with the higher payment in tier ISlide 24Job AideSlide 25Case example 1Individual is involved in performance based job development and is hired by company. Job offer was September 3, 2019. Job developer sends placement information to counselor. Counselor approves placement on September 5th and issues Tier II. Person starts job on September 9th and signs employment verification (EV). Job developer submits Tier II on September 10th, second day of work. Slide 26Case example 2Individual gets job offer but it is not at the number of hours or wages individual identified when the IPE was developed. Discussion between the individual and counselor to determine if job offer is appropriate prior to approving placement. If participant and counselor agree job is appropriate can authorize Tier II. Moves into OTJS or Tier III. No additional job development to be authorized.Case example 3OTJS shift starts at 9:30 pm and ends at 11:30 pm. Shift differential should be paid.OTJS shift starts at 8:30 pm and ends at 11:30 pm. No shift differential.Slide 28Questions? Slide 29Community Based AssessmentsRonna WoodsRehabilitation Program SpecialistSlide 30Community based assessment Faster service completionIncentive for providersCompensation for job placements that result from a CBA or WASlide 31Community Based AssessmentsCurrent fee schedule Is an individualized service (i.e. One provider staff for one participant 1:1)Site development only allowed for new sites, not for sites with current employer relationshipsNo fees for placements facilitated by providers arising out of CBAs UpdateProvider staff may assess up to 2 participants at the same time as part of the service with VR counselor/contractor approval (2:1)The full rate will be authorized for each participantReports will continue to be individualized, and capture the individual’s experienceSite coordination: used to facilitate a CBA at a business that a provider has an existing relationship withCBA rapid engagement premium (CRE)Community based assessment placement premium (CPP)NOTESMention provider will have to get approval from VR staff for 2:1 ratio for CBAAdd that Site Development will still be a service, site coordination is a new added serviceSite Coordination includes all contacts with the participant, potential business, VR counselor/coordinator, may include interview, site tours with potential business and/or staff to discuss potential site and job dutiesMore familiar components will remain on fee schedule such as Full Day/Half day, and VTSMENTION RAPID ENGAGEMENT BEFORE PLACEMENT PREMIUM! (CRE/CPP *new*) Site Coordination: $140 Flat FeeRapid engagement premium rate $400 flat fee CBA placement premium $1251 flat fee Slide 32Community based assessmentsCBA-rapid engagement premium (CRE) Providers who complete the CBA and submit invoice/report within 30 days from the date of the referral (authorization issue date) shall receive a rapid engagement premium Premium shall be calculated based on the date the referral was issued to the date that the report/invoice for the CBA is received by OODCBA-placement premium (CPP)CBAs shall not be marketed to participants or businesses as an incentive to hire a participant, however, in a circumstance where an employer is interested in hiring a participant following a CBA, the provider may charge a placement premium Note: referral should be sent with intake and CBA authorization, to allow provider to rapidly engage the participantNOTEStress to counselors to refer for intake and CBA at the same time, the clock will start for rapid engagement upon authorization issue; when doing the referral, authorization needs to be sent ASAPMake sure to address rapid engagement premium is authorized by the VR counselor or contractor after the requirements have been fulfilled; provider can prompt counselor; counselor verifies timeframeMake sure to address that the participant must be hired within 4 weeks from the date of finishing CBAPerformance based Job development and Supported Employment TIERS shall not be authorized, if already authorized, providers may bill according to service definitions (not eligible for CPP)Providers would receive EITHER Tiered JD (if already began) OR CPPIf additional support is needed after hire, on the job supports may be authorized Slide 33Work adjustmentPurpose: To assist an Individual in their job readiness, based on their individual needs. This service is not authorized for additional work experience, to develop specific work skills, or to build a resume.Current fee scheduleSite development only allowed for new sites, not for sites with current employer relationshipsNo fees for placements facilitated by providers arising out of wasUpdate Site coordination: used to facilitate a WA at a business the provider has an existing relationship withWork adjustment placement premium (WAPP)Components of the WAPP are the same as for the CBA placement premium (CPP)NOTEMention site development will still be an optionFull/Half day rates will remain on fee scheduleMention work adjustment placement premium works in the same way CBA placement premium does-not to be marketed as a business incentive, if a participant is hired the hiring must take place within 4 weeks from the date of finishing the WA, job development/supported employment tiers are not eligible, if additional support is needed on the job coaching may be authorized -for WA placement facilitation, position must be in line with the job goal and IPE (if completed) and be appropriate, VR staff will still need to approve placement WA placement premium $1251 flat fee Slide 34Site Development vs. Site Coordination ReviewSite DevelopmentSite development may be authorized to secure a new business location for community based assessments and work adjustmentSite CoordinationUsed by providers to coordinate a community based assessment or work adjustment at an established site or at a business that a provider has an existing relationshipMay include scheduling, interview, site tour with potential business, and/or staffing to discuss potential site and job duties Slide 35Why is a placement premium being proposed?This fee is for the coordination and facilitation of the participant being hired by the employer following this service (within 28 days). OOD recognizes providers can help facilitate a participant being hired following a service, when it is appropriate and matches the ipe employment goal.Reminder: community based assessments and work adjustments are not “job trials” or “testing out employees,” and must not be marketed as such to individuals or employers.Slide 36Case Scenario VRC meets with participant on October 18, 2019 for a follow up planning meeting after eligibility/order of selection was determined, during this meeting it was determined participant would complete a community based assessment (CBA) in a janitorial or cleaning settingOn October 21, 2019, VRC was informed by participant that the participant was interested in doing the CBA at provider g.o.t., VRC completes the referral on October 22, 2019 and provider g.o.t. receives the authorization and referral on October 25, 2019OOD receives the report/invoice for the CBA on November 19, 2019Is provider g.o.t. eligible for CRE (rapid engagement premium)?NOTEAnswer Yes-provider is eligible for CRE (rapid engagement premium) Mention VR counselor/contractor would then authorize for the rapid engagement premium because the provider met all the requirements and invoice/report is received within the 30 day period Mention staffing would not count?Also mention that the CRE would count for established sites and in house/provider sites if the VRC wants the CBA to take place thereSlide 37Case ScenarioParticipant completed a work adjustment with provider ABC, the WA took place at a local grocery store where the participant was stocking shelves and bagging groceries, the WA began on December 2, 2019 and ended on December 13, 2019Participant began Tier I JSST services with provider ABC on January 7, 2020.On January 22, 2020, provider ABC received a call from the local grocery store where the participant completed the WA, the employer stated that three employees quit after the holiday and that the employer was in desperate need of quality workers, because the participant did such an excellent job during their time at the grocery store, the employer would like to offer a position to the participant at the grocery store (participant accepted)Is provider ABC eligible for a WA placement premium? NOTEAnswer No-the job offer from the employer came over 5 weeks after the end date of the WA, employment must begin within 4 weeks (28 days) after service completionIf the case had already moved into Tier I of PBJD, it would continue to move through to Tier II and Tier III; WPP is not “stackable” on top of the TiersAnswer No-the job offer from the employer came over 5 weeks after the end date of the WA, employment must begin within 4 weeks (28 days) after service completionIf the case had already moved into Tier I of PBJD, it would continue to move through to Tier II and Tier III; WPP is not “stackable” on top of the TiersSlide 38Questions?Slide 39Summer Youth ServicesMelanie SecklerRehabilitation Program SpecialistSlide 40Summer youthHow can summer youth be improved to reduce fall out and increase real world work experiences?Can group rates be increased to allow for the increased supervision and reporting for groups of students?NOTES:OOD asked our stakeholders, “How can Summer Youth be improved to reduce fall-out and increase real world work experience?”The focus fell on the Education Week. Some providers indicated a preference to continue the Education Week because it helps them to better understand students before moving to the work site. Other providers indicated a preference to remove the requirement because the education component led to service fall out and the general nature of the curriculum is sometimes not appropriate for different student groups. Two main ideas came from this discussion: The program structure and student compensation. In return, OOD Stakeholders asked: “Can group rates be increased to allow for the increased supervision and reporting for groups of students?”The short answer: YES!Slide 41What is changing?Current fee scheduleFirst week is a mandatory education weekParticipants are not paid for week oneWeekly rate of SYWE is $1,138Weekly rate of SYCX is $853.50Group rates for both SYCX and SYWE are:2 in a group: 50% 3 in a group: 37.1% 4 in a group: 31.4% UpdateFirst day is a mandatory orientation dayParticipants earn wages the entire five weeksWeekly rate of SYWE is $1,212 (+$74)Weekly rate of SYCX is $909 (+$55.50)Group rates for both SYCX and SYWE will be increased to:2 in a group: 54% 3 in a group: 41% 4 in a group: 33%NOTES:So what do these two answers mean for the Summer Youth services? How will Summer Youth services change with the new Fee Schedule?Current practice:The first week is a mandatory Education week using Skills to Pay the Bills. Participants are required to attend each day of the first week in order to be permitted to continue to the four weeks of paid employment. Participants are not paid for this first week since it is more of a classroom experience and not actual work.The weekly rate for Summer Youth Work Experience is $1,138 and the weekly rate for Summer Youth Career Exploration is $853.50. *Group rates are structured as such: For two students in a group, the weekly rate is paid at 50 percent per student. For three in a group, it is paid at 37.1 percent and for four in a group it is paid at 31.4 percent.Based on your feedback, the following are the proposed changes to the Fee Schedule:The first day will be a mandatory Orientation Day. The students will earn wages for the entire five week service as they will have one orientation day and then go directly to work for the remainder of the five weeks. The weekly rate for Summer Youth Work Experience is $1,212; this is an increase of $74 and the weekly rate for Summer Youth Career Exploration is $909 which is an increase of $55.50. Group rates are structured as such: For two students in a group, the weekly rate is paid at 54 percent per student. For three in a group, it is paid at 41 percent and for four in a group it is paid at 33 percent.Slide 42OrientationFirst day of summer youth work experienceThis is a required first day. If participant misses day one, counselors may approve continuing in SYWE for special circumstancesOnboarding similar to the first day on a job where employees meet key staff, review safety information, call-off procedures, breaks, discuss work tasks, etc.Can take place at the work site (if available), at the provider office, or another convenient space in the communityNOTESLet’s talk a little more about what Orientation will look like:Again, it will be the first full day of the Summer Youth Work Experience– whether that first full day is a four hour day or a five hour day--- it is however the Provider chooses to structure the 20 hour weeks. That being said, the first day should not be 2 hours long and 18 hours are crammed into the rest of the first week. The schedule each week should look the same.This is a REQUIRED first day. If the Student misses day one, the VR Counselor may approve the student to continue in the Summer Youth Work Experience for special circumstances.Orientation will be an onboarding-type experience similar to the first day on a job where an employee would meet key staff, review safety information, call-off procedures, breaks, learn work tasks, etc. Similar to the Education week, Orientation can take place at the work site (if available), at the provider office, or another convenient space in the community. Keep in mind this is not a camp, so it should not take place in an unstructured environment such as a community park picnic table.Slide 43OrientationCan use material from “skills to pay the bills” or other OOD approved curriculumMay include an ice breaker or team building activity with the day’s scheduled servicesParticipants will receive vocational training stipend (VTS)NOTESYou may be thinking that a traditional orientation may not take very long, especially if it cannot take place at the actual work site. So how do you fill the four or five hours? Material from Skills to Pay the Bills or other OOD approved curriculum can be used. There are great topics and activities that cover Communication, Teamwork, and Professionalism– all topics from which the students can benefit.Ice breakers and team building activities can be used. This will be the day that the students get to meet their coaches and co-workers so make the most use of the time to build familiarity and comfort.The students will receive the Vocational Training Stipend for this day. So that means the students will be paid minimum wage for the time they participate in Orientation, just as if they were starting their first day of work at regular employment.Slide 44What if my participant isn’t ready for summer youth work experience?We would like to provide other services to participants in preparation for the summer youth work experience which would supplant the education week. Summer youth career explorationPRE-ETS servicesWe also hope that the schools will work with participants on the issues identified at IEP meetings.With regard to participants becoming familiar and comfortable with the job coach and co-workers, this should be addressed as much as possible on orientation day.Slide 45Group ratesSummer youth career explorationFlat weekly rate of $909Two participants: $490.86 (54%) 490.86 x 2= $981.72 two vs. Single $981.72 – $909= $72.72 Three participants: $372.69 (41%) 372.69 x 3= $1,118.07 three vs. Single $1,118.07 – $909= $209.07Four participants: $299.97 (33%) 299.97 x 4= $1,199.88 four vs. Single $1,199.88 – $909= $290.88NOTESThe proposed Group Rates will be quite different based upon Provider feedback. The current rates compensate Providers the same regardless of whether the Provider is working with one participant or two. The feedback we received is that there is more supervision and reporting required as the number of participants increase…makes sense, right? Therefore, with the proposed changes, not only has the base rate of the service increased but the rates for group size have also increased.Slide 46Group ratesSummer youth work experienceFlat weekly rate of $1,212Two participants: $654.48 (54%) 654.48 x 2= $1,308.96 two vs. Single $1,308.96 – $1,212= $96.96Three participants: $496.92 (41%) 496.92 x 3= $1,490.76 three vs. Single $1,490.76 – $1,212= $278.76Four participants: $399.96 (33%) 399.96 x 4= $1,599.84 four vs. Single $1,599.84 – $1,212= $387.84Slide 47Food For ThoughtSummer youth will always be an important core service for students. The students are typically available during this time of year and these developmental experiences provide a strong foundation for future employability. OOD would like to expand the idea of “summer” to year-round services for students whom are available, such as through PRE-ETS and other services individualized to their needs.Slide 48Case ScenarioMason is a high school student who successfully completed a summer youth career exploration. He is now more excited than anxious about work since he had the opportunity to job shadow during this service. The following school year, he received soft skills training in his high school classes. Mason stated a desire to work and both his parent and teacher agree he is ready for a real world work experience. His vocational rehabilitation counselor believes he is a great candidate for an experiential program. Summer youth work experience is authorized and mason is all set to start the five week service.NOTEWe recognize there are many paths and services that can help our participants reach their employment goal. Not everyone is going to have the same progression. The following are two case scenarios to demonstrate this. In this example, Mason had Career Exploration, some additional training in school, and he’s ready to work in the community.Slide 49Case ScenarioMary completed summer youth career exploration and it was found that she needs assistance with social and independent living skills. During the following school year, Mary’s VR counselor referred her for PRE-ETS services in workplace readiness training. Mary’s teacher pointed out to the PRE-ETS provider that Mary has been talking more about attending college. Mary could potentially be the first her in family to attend college. Provider brings this to the VRC’s attention and so Mary is also referred for PRE-ETS counseling on post-secondary opportunities.Mary now has a clearer post-secondary path in mind. She states a desire to obtain work experience and to put her newly acquired skills to practice. VR counselor refers her to summer youth work experience.NOTETo summarize, in this example, Mary had Career Exploration, additional needs were identified and she was referred for Pre-ETS, then she was ready for a work experience and she was referred to Summer Youth.Slide 50QuestionsSlide 5Pre-Employment Transition ServicesMike KinneyRehabilitation Program SpecialistSlide 52What will change?Currently45 providers, from the first group of providers, to more recent providers brought on through RFPsIndividual rates for each providerGeographical areas limited to contract termsFee Schedule UpdateCurrent approved providers with one year of experience providing services to students with disabilities may attend training and submit curriculumStandard rates for all providersNo contracts required for providersSlide 53Service RatesPRE-ETS often provided in group settingsIndividual rates existExampleInstruction in self-advocacy: individual rate per unit= $6.20 @ 6 minute unit---$6.20Group of 2= $3.35 per person @ 6 minute unit--$6.70Group of 3= $2.54 per person @ 6 minute unit--$7.62Group of 4= $2.05 per person @ 6 minute unit--$8.20Slide 54What Are Pre-Employment Transition Services?Job exploration counseling (introduction to work: discuss career options/interest inventories/Ohio Means Jobs/occupational and resume videos)Work-based learning (information on work settings, duties, expectations of employers completed through job site tours, job shadowing, info interviews, field trips)Workplace readiness training (addresses need for professional skills: teamwork, customer service, safety, time management, online behavior, ADLs)Counseling on post-secondary options (info on degrees offered by colleges, application process, disability services, resources)Instruction in self-advocacy (info on individual rights and responsibilities, how to request accommodations, practice in using s-a skills)Non-individualized vs. Not focused on the individualSlide 55How to become a PRE-ETS providerProviders required to have one year of experience working with students with disabilities.Providers begin by attending required training from OOD (services, requirements, and best practices, working with local schools). Submit curriculum for each service.Submit request to add PRE-ETS services to PMP.Do not schedule or market PRE-ETS before being approved.Subscribe to Granicus provider e-mail distribution list to receive updates. Slide 56Subscribing to GranicusOOD internetStay connected boxSubscription type (e-mail)E-mail addressSubscription topics (VR providers/others)Slide 57Where to find more informationOOD website: OOD.OOD internetStudents 14+Pre-employment transition services (fact sheet and other resources)NOTESExplain that if one wants to find additional information about OOD’s PRE-ETS services one may go to OOD’s website, then look on the left hand column and click on the tab that is titled “OOD Internet” which then takes one to a page where at the top it will have a listing of Students 14+, that leads to a drop down box where one can then find resources for PRE-ETSSlide 58What’s Next?For OOD Staff: PRE-ETS Refresher TrainingHeld on MONDAY SEPT. 9@ Monthly VR Go-ToFor New PRE-ETS Providers: In-Person Training Coming up TUESDAY SEPT. 24 @OOD CENTRAL OFFICE 9 AM-NOON; MUST REGISTERSlide 59Contracted ServicesJane WorthRehabilitation Program SpecialistSlide 60Contracted servicesWhat are the proposed fee schedule updates?Contracted services returning to fee scheduleRate increasesCredentialed vs. Non-credentialed ratesAdditional credentials are being accepted to provide low vision servicesChanges in services Slide 62Specific Services Returning To Fee ScheduleActivities of daily livingOrientation and mobility trainingRehabilitation technologyLow vision servicesSlide 62Benefits to participantsMaintaining a provider pool to help individuals get the services they need to obtain employmentBenefit individuals with disabilities by establishing rates/requirements that promote consistent and quality servicesSlide 63Benefits To ProvidersCompetitive, Cost Informed Rates23 providers offered data regarding their staffing, billable hours, report writing, wages and moreMileage was included in the calculation of the ratesImproved ability to attract skilled workersEasier on-boarding for new providersSlide 64What is changing?Current fee scheduleServices were provided based on a contractual agreement between OOD and the providers of certain servicesAuthorizations were based on an agreed upon rate between OOD and the providersUpdateContracted services will return to the fee scheduleProviders will no longer need to go through the contract process each yearADLs clarified as an individual serviceCredentialed and non-credentialed ratesSlide 65Rate changesThere will be two rates for rehabilitation technology and activities of daily living services: credentialed and non-credentialedThere are additional credentials that will be able to provide ADL trainingThese rates were based on cost informed analysis with an additional incentive for credentialed providersCost informed analysis is based on the cost of doing business: building, utilities, pay roll, benefits, etc.Activities of daily living trainingSlide 66Activities of Daily Living TrainingAll providers must be approved in the PMP and will be listed in the provider search as “non-credentialed” or “credentialed”After a provider selection is made, look up the provider using the provider searchIf an individual has vision loss, the provider will always get the credentialed rate; ensure that provider has an appropriate credentialNOTES:For Activities of Daily Living Training, the non-credentialed rate per unit of service will be $10.40. Currently, the Ohio Administrative Code requires provider certification by the Academy for Certification of Vision Rehabilitation and Education Professionals (or ACVREP) or the Association of Education and Rehabilitation of the Blind and Visually Impaired (AER). Under the new fee schedule, the credentials can also include Occupational Therapists with graduate certification in vision rehabilitation or low vision as well as licensed Teachers for the Visually Impaired. Providers with these expanded credentials will be eligible to be compensated at the increased rate of $11.40 per unit of service. This increased rate only applies to providers providing ADL training to individuals with vision loss. In other words, the increased rate is based on the disability and on the credential.Slide 67Authorization Process For ADL ServicesVocational planning: ADL training has been deemed necessary to prepare an individual for employmentInformed choice procedures are utilized to select a provider and documented on the IPEDetermine rate: VRC will utilize the provider search to see if the selected provider is credentialed or non-credentialed Slide 68Combined Rehabilitation Technology And Low Vision Services RatesLow vision services are still considered a sub-category of rehabilitation technology. In an effort to streamline the definition and eliminate duplication, the new fee schedule will combine the rates and definition of low vision services with rehabilitation technology in the fee scheduleThe change will not change the way that these two services are authorized or deliveredSlide 69Proposed ratesPicture: Table with current and proposed rates and % change. (NOTE: Rates are included in V Fee Schedule)Slide 70Credentialed RatesProviders must submit proof of credentials (copy of certificate) through the PMP before this service can be billed at the higher (credentialed) rate (ADLs & Rehabilitation Technology)On September 20th, the updated PMP system will include these services to select credentialed services Please submit any credentialed documentation through PMP by September 30th to allow time to update the PMPSlide 71Changes To Rates And Expectations For ADL And O&M TrainingGroup rates removed from Fee ScheduleIndividualized instruction onlySlide 72Changes To Service DefinitionsActivities of Daily LivingOrientation & MobilityRehabilitation TechnologySlide 73Important Points To Remember About Activities Of Daily Services provided to individuals with vision loss must have specific accreditation or certification. These providers shall be compensated at the credentialed rate. These licenses/certifications may include:ACVREP - Academy for Certification of Vision Rehabilitation & Education Professionals - Certified Low Vision TherapistOccupational Therapists with additional post graduate low vision certification Teacher for the Visually Impaired (TVI) as licensed by the Ohio Department of EducationOptometrist/OpticianNOTES:Services provided to individuals with vision loss must have specific accreditation or certification as required by the Ohio Administrative Code. These providers shall be compensated at the certified rate. These accreditations or certifications include:ACVREPOccupational Therapists with additional post graduate low vision certification Examples of additional certification include Low Vision Rehabilitation, Specialty Certification in Low VisionTeacher for the Visually Impaired (TVI) as licensed by the Ohio Department of EducationSlide 74Orientation And Mobility Site DevelopmentChange in definition will allow providers the ability to complete an environmental assessment for safety and route planning in order to identify appropriate training environments without the individual being presentThe service will allow a provider to be better prepared when initially meeting with an individual, potentially reduce training time, and result in improved quality of serviceSlide 75Rehabilitation technologyAllows billable time for researching potential modifications or technology solutions Moves JAWS Scripting from a Fee Schedule service to an addendum request; if you would like to offer this service, submit an addendum through PMPSeparate authorizations for computer access, low vision services, etc.Credentialed providers who hold certain licensure/certification will be eligible for an increased rateThe authorization process will be the same as for ADL - the provider search will indicate if a provider is credentialed or notNOTES:Clarification to the definition allows billable time for researching potential modifications or technology solutions. This is case specific, and does not apply for general research or for training. For example, a provider cannot bill for reading a professional journal, or attending a workshop.Proposing to remove JAWS Scripting. This will be listed as an addendum service, in the same manner as if a provider offers the service of miscellaneous training, tutoring, or bioptic driving. BSVI is in the process of reaching out to providers so they can submit addendums for consideration and approval.Language in the definition discusses all technology, and still have separate authorizations for computer access, low vision services, etc.Proposing credentialed providers who hold RESNA - ATP, ACVREP - CLVT and CATIS, Licensed Professional Engineer, Board of Certification in Professional Ergonomics (CPE, CHFP, AEP, and AFHP), Optometrist, and Optician would be eligible for an increased rate. The authorization process will be the same as for ADL-the provider search will indicate if a provider is credentialed.Slide 76Acronyms for rehabilitation technology certification/licensureRESNA- Rehabilitation Engineering and Assistive Technology Society of North AmericaATP- Assistive Technology ProfessionalBoard of Certification in Professional ErgonomicsCPE- ErgonomicsCHFP- Human FactorsAEP- Associate Ergonomics ProfessionalAFHP- Affiliate Human Factors ProfessionalCertified Industrial ErgonomistSLIDE 77Acronyms for Vision Services Certifications/LicensureACVREP - CLVT - Academy for Certification of Vision Rehabilitation & Education Professionals - Certified Low Vision Therapist?AER - Association for the Education and Rehabilitation of the Blind and Visually Impaired ?CARF - Commission on Accreditation of Rehabilitation Facilities Accreditation in Vision Rehabilitation Services?CATIS - Certified Assistive Technology Instructional Specialist for People with Visual ImpairmentsSlide 78Questions?Slide 79Next stepsSlide 80Please continue to send all questions to crpvendor@ood.Please allow up to 3 business days for a response Supervisors will be providing guidance and accepting feedback at Quarterly Provider MeetingsFollow up meeting in December for Providers (Date TBD)Slide 81Continue to work with your local supervisor for identified issuesRoute concerns to regional PCMU RPSProvider Manual will be updatedDecember 3 Training (GoTo) for follow up discussionSpring GoTo Training post-implementation discussionSlide 82Questions? ................
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