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The Oregon Administrative Rules contain OARs filed through June 15, 2014
 
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DEPARTMENT OF HUMAN SERVICES,
VOCATIONAL REHABILITATION SERVICES

 

DIVISION 70

STANDARDS FOR PROVISION OF SERVICES AND RATES OF PAYMENT

582-070-0010

General Policy

NOTE: For community rehabilitation programs and medical or related services refer also to OAR 582-010, 582-075 and 582-080.

It is the policy of the OVRS to reimburse vendors who provide previously-authorized services and/or supplies to persons who qualify for such services.

(1) Vendors shall be paid in accordance with the lesser of:

(a) The vendor’s usual charge for such service, i.e., that fee for service which the vendor under ordinary circumstances charges to the general public for such services; or

(b) A pre-determined charge that has been negotiated between the vendor and an agency person authorized to consummate agreements between this agency and the vendor.

(2) In addition to any such general contracts or agreements, actual services to individuals must be specifically prior authorized and are not considered approved or billable until the vendor receives a completed Agency Authorization for Purchase (AFP) form or its equivalent, listing specific prior authorized services and estimated billable amounts, signed by the appropriate agency representative(s):

(a) Only in extreme emergencies may services be prior authorized verbally and any such verbal authorization must be documented promptly and followed with a written AFP within 72 hours;

(b) Apparent fraud, misrepresentation or substantial discrepancies between services rendered and billed amounts shall be investigated and, as appropriate, legal steps taken to prevent or recover overpayments.

(3) Except as specified in OAR 582-070-0010(4), Rehabilitation Services funds will not be expended before OVRS determines that “comparable benefits and services” are not available to meet, in whole or in part, the cost of such services, unless such a determination would interrupt or delay:

(a) The progress of the individual toward achieving the employment outcome identified in the Individualized Plan for Employment;

(b) An immediate job placement; or

(c) The provision of vocational rehabilitation services to any individual who is determined to be at extreme medical risk, based on medical evidence provided by appropriate qualified medical personnel.

(4) The following vocational rehabilitation services are exempt from a determination of the availability of comparable services and benefits:

(a) Assessment for determining eligibility and vocational rehabilitation needs;

(b) Counseling and guidance, including information and support services to assist an individual in exercising informed choice;

(c) Referral and other services to secure needed services from other agencies, including other components of the statewide workforce investment system, if those services are not available from OVRS;

(d) Job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services;

(e) Rehabilitation Technology, including telecommunications, and other technological aids and devices.

(f) Post-employment services consisting of any of the services in OAR 582-070-0010(4)(a)–(e); and

(5) Purchases shall be of the most reasonable and satisfactory quality at the lowest available cost, subject to supervisory and/or administrative review and/or approval prior to authorization; accordingly, OVRS reserves the right to establish upper limits on the utilization of existing services, subject to an exception process.

(6) Preliminary diagnostic assessment is limited to a review of existing data and such additional data as is necessary to determine eligibility or, for Rehabilitation Services, to assign priority for order of selection for service (when appropriate). Comprehensive assessment and/or extended evaluation services may be provided only until eligibility/ineligibility or nature and scope of needed Rehabilitation Services can be determined. Additionally, other services are available (including the use of Rehabilitation Technology services, as appropriate) to determine the nature, scope and types of services needed to attain a specific vocational rehabilitation objective of the eligible individual. Continued eligibility is contingent upon reasonable progress by the individual toward attainment of measurable intermediate objectives within time-lines arrived at and agreed to through joint counselor/individual development of the plan and any amendments thereto.

Stat. Auth.: ORS 344.530
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 1-1978, f. 3-14-78, ef. 3-15-78; VRD 2-1992, f. & cert. ef. 4-20-92; VRD 4-1993, f. & cert. ef. 11-1-93; VRS 2-2004, f. & cert. ef. 3-9-04; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2009(Temp), f. & cert. ef. 2-11-09 thru 8-9-09; Administrative correction 8-21-09; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0020

Specific Policies

Specific rules pertain to the provision of the following services:

(1) On-the-Job Training:

(a) Payment to on-the-job trainers/employers for training services shall be negotiated at the lowest reasonable level and shall always be considered as reimbursement for actual expenses and/or trainer time; the trainer/employer cannot expect to make a profit from such payments;

(b) Offset against an individual's wages shall be negotiated with the trainer/employer on a mutual sharing basis at the lowest reason able level to adequately pay the individual for his/her productive work efforts with the trainer/employer ultimately paying the entire wage. Total length of the training program and length of OVRS involvement in payments shall be negotiated on the basis of the complexity of the training and the amount of relevant skill and knowledge the individual possesses prior to entering training.

(2) Training: Educational and training services, except on-the-job training, must be purchased from public educational organizations in Oregon. Exceptions are authorized only when:

(a) No publicly-supported school provides the courses necessary for the individual’s needs in order to reach the vocational objective; or

(b) The individual cannot utilize publicly-supported schools because of his or her disability; or

(c) OVRS’s financial participation in the plan is no greater than if the individual had enrolled at the nearest appropriate publicly-supported school; or

(d) The net cost to Oregon governmental agencies is significantly less; or

(e) The training services for the individual will be significantly delayed.

(3) Vocational training: Referrals for vocational training may be made only to the following schools or programs:

(a) A school that has accreditation recognized by the United States Department of Education;

(b) A school has been approved by the Oregon Student Assistance Commission through the Office of Degree Authorization to offer and confer degrees in Oregon;

(c) A community college;

(d) A state institution of higher education within the Oregon University System;

(e) The Oregon Health and Science University.

(f) A career school licensed under ORS 345.010 to 345.450

(g) An apprenticeship program that is registered with the State Apprenticeship and Training Council

(4) Maintenance: OVRS shall only pay or provide for maintenance expenses consistent with the definition of this term at OAR 582-001-0010(25) and 34 CFR 361.5(b) (35).

(5) Clothing Purchases: Clothing purchases may be authorized if the need is a result of participation by the individual in a rehabilitation program and the individual does not possess sufficient financial resources to provide for these expenses. These must be appropriate in type and in a price range, comparable to clothing items normally used by persons engaged in similar rehabilitation, training or employment settings.

(6) Transportation Services:

(a) OVRS may provide transportation services if the services are necessary to enable the applicant or eligible individual to participate in required rehabilitation services.

(b) Selection of transportations services shall:

(A) Give preference to the most inexpensive alternative as determined by OVRS; and

(B) Take into consideration the circumstances and special needs of the individual.

(d) Moving and relocation expenses. OVRS may authorize moving and relocation expenses when the office has determined that it is less costly than having the individual commute for employment or training.

(e) Routine vehicle maintenance. It is the owner's responsibility to maintain a private vehicle. OVRS does not pay for routine costs associated with maintenance of a vehicle. OVRS may make an exception if OVRS determines circumstances justify vehicle maintenance.

(f) Travel and related expenses for personal assistance. OVRS may provide travel and related expenses for personal assistance services if such services are necessary to enable the individual to travel to participate in a vocational rehabilitation assessment or service.

(7) Vehicle Insurance: OVRS does not generally pay for vehicle insurance. Oregon law requires insurance to operate a vehicle and it is an ongoing maintenance expense.

(a) OVRS does not pay for vehicle insurance unless exceptional circumstances necessitate assistance to reduce a transportation barrier. OVRS may authorize full or partial payment only if the office determines auto liability insurance is necessary for participation in vocational rehabilitation services and supports the least expensive transportation option.

(b) The individual shall be responsible for insurance for a vehicle purchased or modified by OVRS and for insurance on vehicular adaptive equipment

(c) If the insurance premium increases, or will increase, OVRS may pay for an increase in the premium for minimum vehicle liability insurance coverage required under Oregon law.

(d) OVRS may pay for the full premium amount for minimum vehicle liability insurance coverage required under Oregon state law if the office determines that payment is appropriate. OVRS may pay the full premium amount for up to 60 days from the start of employment.

(e) Authorization of full or partial payment for vehicle insurance requires that:

(A) Payment for vehicle insurance supports the least expensive transportation alternative for the individual;

(B) The individual owns the insured vehicle. If the individual is a minor the individual’s parents or legal guardians shall own the insured vehicle; and

(C) The individual, or minor individual’s parents or guardians, has a current valid Oregon driver’s license.

(8) Travel: When an individual’s travel requires lodging and meals, payment for lodging and meals shall be based on the definition of maintenance under 582-001-0010(25) and shall not exceed the current federal GSA domestic per diem rates for the state in which the lodging occurred.

(a) The per diem rate used shall be based on the rate for the city in which the individual lodges, or the rate for the city closest to where the individual lodges.

(b) Unless the individual uses a personal vehicle for the needed transportation, reservations shall be made through the state travel agency.

(c) If the individual utilizes a service animal; OVRS may provide payment for the lodging of the service animal.

(d) In those instances in which the federal per diem rate is insufficient to cover the cost of lodging, or the individual has a legitimate need for more costly lodging, payment may exceed the federal per diem rate.

(9) Community Rehabilitation Programs’ (CRP) Services.

NOTE: Refer also to OAR 582-010.

(a) State-wide rates are intended to pay only the anticipated cost of standard rehabilitation services. This fee schedule may be adjusted for a specific CRP to reflect non-standard types or levels of service, or statewide for standard service, if a significant increase or decrease in the actual cost of serving individuals occurs;

(b) For a CRP operated under private auspices, fees may be negotiated taking into consideration costs such as buildings, staffing and equipment. For a publicly owned and operated CRP (e.g., state or county owned or operated) fees, if any, must be based upon and not exceed actual costs.

(10) Extended Evaluation: OVRS shall provide only those services authorized under OAR 582-050-0005.

(11) Personal Care Assistance (PCA). A personal care assistant is provided only when necessary to allow an individual to benefit from other rehabilitation services, including assessment, and when the individual is not entitled to PCA services from another source:

(a) Participant as Employer: The participant, in most cases, as the employer of the personal care assistant may be reimbursed for necessary PCA services required to participate in rehabilitation services;

(b) Third Party Vendor: Direct payment to the PCA vendor by OVRS requires prior approval in addition to the requirements of Oregon Administrative Rules Chapter 582, Office 10;

(c) Written Contract: In most instances the individual is to be the employer of his/her own personal care assistant. OVRS may assist the individual to establish an appropriate written contract with the provider.

(12) Interpreter Service: OVRS provides interpreter service only when necessary to assist the individual to derive full benefit from other rehabilitation services:

(a) Limitation: To be provided by OVRS only when "comparable benefits" are not available;

(b) For the Deaf and Hearing Impaired: OVRS gives preference to using interpreters certified by the National Registry of Interpreters for the Deaf and/or one who is on the approved vendor list of the State Association of the Deaf. When deemed mutually acceptable by the individual and the counselor, another interpreter may be utilized;

(c) Regional Resources: Oregon Deaf and Hard of Hearing Services (ODHHS) may be used as a resource to both individuals and staff for securing interpreters.

(13) Other Support Services Providers: May be selected for specific skills needed. Where provider licenses, insurance, certificates and state or local codes are indicated OVRS reasonably attempts to assure that appropriate levels are met before authorizing services from the provider. (See OAR 582-080 for additional rules on vendor selection.)

(14) Vendor Insurance: Providers of services shall obtain and maintain insurance as required by law for that provider; additionally, where OVRS is providing for services, appropriate levels of personal, automobile, professional and general liability insurance may be required, depending on the type of service.

(15) Private vehicle maintenance is primarily the responsibility of the owner. The office does not pay for insurance or associated expenses such as registration costs. In exceptional circumstances, as determined by OVRS, the office may make an exception.

(16) Occupational Licenses, Tools and Equipment for Training and/or Employment:

(a) May be provided when required for either extended evaluation or when an individual is in plan status, including post employment. OVRS accepts no responsibility for individual lease/rental agreements or the leased/rented items other than to reimburse the individual for such prior authorized expenditures;

(b) Repossessed items shall be used whenever appropriate and available;

(c) Except for personally prescribed items, title/ownership of an OVRS purchased (or jointly purchased) item is held by OVRS (or jointly with OVRS) until case closure when ownership may be transferred to the individual for non-expendable items deemed by OVRS to be needed for continued success in the individual’s program.

(17) Land and/or Stationary Buildings: Are never purchased by OVRS as a service to an individual. Existing buildings may be modified when necessary to enable an eligible individual to attain a vocational plan goal. No permanent additions or weight bearing partitions are to be erected as services to individuals.

(18) Rehabilitation Technology Services: May be applied at any time during rehabilitation services to address barriers to the individual’s participation in evaluation, training, and employment:

(a) OVRS shall ensure that rehabilitation technology service providers are qualified in the areas of engineering skills and/or technology required for a given service. Selected Community Rehabilitation Programs’ Approvals may include rehabilitation technology services, when State Standards for Approvals are met for rehabilitation technology services;

(b) Rehabilitation technology services are exempt from a determination of the availability of comparable benefits. All reasonably available comparable services shall be used before authorizing expenditure by OVRS. Personal services contracts for rehabilitation technology services require field services manager approval prior to implementation.

Stat. Auth.: ORS 344.530
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 1-1978, f. 3-14-78, ef. 3-15-78; VRD 2-1992, f. & cert. ef. 4-20-92; VRD 4-1993, f. & cert. ef. 11-1-93; VRD 1-1996(Temp), f. 2-26-96, cert. ef. 3-1-96; VRS 1-2003, f. & cert. ef. 9-23-03; VRS 2-2003, f. & cert. ef. 12-31-03; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2008, f. & cert. ef. 2-4-08; VRS 2-2008, f. & cert. ef. 3-3-08; VRS 3-2008, f. & cert. ef. 4-10-08; VRS 1-2009(Temp), f. & cert. ef. 2-11-09 thru 8-9-09; Administrative correction 8-21-09; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0025

Vehicle Purchase/Vehicle Modification

(1) The following definitions apply to this rule:

(a) “Approved Vendor” means a dealer recognized by OVRS as an approved retailer or installer of specified devices;

(b) "Qualified Mechanic" means; American Standard Automotive or American Standard Engineering certified;

(c) "Qualified Vehicle Modification Evaluation" means an evaluation performed by a licensed occupational therapist;

(d) “Reasonable transportation alternatives” include but are not limited to:

(A) Car repairs to a vehicle already owned;

(B) Use of mass transit or community transportation;

(C) Moving the individual to a new area;

(D) Assistance from family members, volunteers, paid drivers or attendants;

(E) Car pools; or

(F) Accommodations made by individual’s employer.

(e) “Vehicle modifications” are services involving the purchase and installation of adaptations or devices intended to meet the employment-related transportation needs of individuals.

(2) OVRS does not provide funds for individuals to lease or purchase motor vehicles that require a license to operate. The OVRS administrator may grant an exception if no reasonable transportation alternatives are available and the office has made the following determinations:

(a) The exception is not prohibited by state or federal statute, rule or regulation;

(b) The individual is eligible for vocational rehabilitation services and is in plan or post-employment status;

(c) Assessments, evaluations and tests demonstrate the purchase is necessary to remove a transportation related barrier;

(d) The purchase is in support of a specific vocational goal (identified in the individual's IPE);

(e) At closure the individual will have sufficient income and resources to meet daily living expenses and cost of vehicle operation and replacement;

(f) The individual possesses or can obtain a valid driver's license; and

(g) The individual can safely operate the vehicle.

(3) OVRS may deny purchase of vehicle modification services if:

(a) The individual fails to cooperate with required evaluations, assessments or tests; or

(b) It is determined the individual is unable to drive safely. OVRS may permit an exception when a qualified driver other than the individual will be operating the vehicle.

(4) When OVRS authorizes payment toward a purchase, the primary lien holder must be the office.

(5) OVRS shall transfer ownership only when required for employment and successful file closure. OVRS must repossess, reassign or otherwise dispose of the vehicle when it has determined transfer to the individual is not justified. Disposal must occur according to department or office property disposition guidelines.

(6) Scope of Vehicle Modifications: OVRS shall only authorize a vehicle modification when the office determines modification is the most cost effective and appropriate means of providing necessary employment-related transportation for the individual. Purchase of a vehicle modification shall be the least costly necessary to accomplish the goal of enabling the individual to enter, maintain or regain employment.

(a) As Rehabilitation Technology, defined as necessary to address vocational barriers confronted by individuals with disabilities in the area of transportation, OVRS may not purchase the following:

(A) Modifications to a van if it would be possible to modify a sedan style automobile to meet the individual's need for transportation;

(B) Modifications to a vehicle if the individual owns or has use of another vehicle that would meet the individual's transportation needs; or

(C) Modifications to a vehicle if a qualified vehicle modification evaluation indicates that the individual is not capable of driving due to the individual’s disability. OVRS may permit an exception when a qualified driver other than the individual will be operating the vehicle.

(b) OVRS may provide vehicle modifications if:

(A) The exception is not prohibited by state or federal statute, rule or regulation;

(B) The individual does not own another vehicle which meets the individual’s employment-related transportation needs;

(C) The individual is capable of safely operating a motor vehicle; and

(D) The individual requires the proposed modification, as documented and recommended in by a qualified vehicle modification evaluation.

(7) Vehicle requirements for OVRS participation in the cost of modifications are as follows:

(a) the vehicle to be modified has been judged safe and is in reasonably good condition, as determined by a qualified mechanic;

(b) All proposed modifications are consistent with applicable vehicle safety laws;

(c) OVRS shall preauthorize any payment for a modification in a new or used vehicle acquired by the individual. The individual shall be responsible for the costs of any modification not recommended by a qualified vehicle modification evaluation. The individual is responsible for the costs of any modification-equipment not covered by the office;

(d) Preinstalled modifications in used vehicles. OVRS shall preauthorize any payment for preinstalled modifications in a used vehicle acquired by the individual. The individual shall be responsible for all payment for any modification equipment not recommended by the qualified vehicle modification evaluation and/or any modification equipment costs not covered by the office;

(e) Unmet modification requirements. Where new or used pre-existing vehicle modification equipment is insufficient to meet the individual’s needs, as documented by the qualified vehicle modification evaluation, the office shall direct negotiate or bid out the unmet minimum necessary modification requirements;

(f) OVRS shall not provide such optional equipment as may generally be purchased through an automobile dealer at the time the vehicle is purchased unless such equipment is required as a result of the individual’s disability and is categorized in the Occupational Therapists driver's evaluation as necessary to the modification of the vehicle;.

(8) OVRS conditions for vendor selection are as follows:

(a) Vehicle modifications shall be purchased from vendors or dealers who are listed and on file with OVRS as an approved vendor of the devices;

(b) Such purchases must be made in accordance with State procurement regulations and OVRS purchase policy and procedures.

(9) OVRS is not obligated to purchase any service negotiated or contracted by the individual or individual's family. The office shall authorize all vehicle modification services through the standard State and OVRS procurement and purchasing process.

(10) Maintaining a private vehicle is the responsibility of the owner.

(11) OVRS assumes no warranty responsibility.

(12) Second or subsequent modifications are limited to those needed to accommodate changes in the individual's medical condition.

(13) The individual shall be the primary driver of the modified vehicle. The office may make an exception permitting a qualified driver other than the individual to operate the modified vehicle;

(14) The individual must register or co-register the modified vehicle in the individual's own name. A minor individual must register the modified vehicle in the name of the individual’s parents or guardian. The office may authorize an exception to register the modified vehicle in a name other than the name of the individual and/or individual’s parent or guardian.

Stat. Auth.: ORS 344.530
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 2-1996, f. & cert. ef. 8-28-96; VRS 1-2003, f. & cert. ef. 9-23-03; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2008, f. & cert. ef. 2-4-08; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0030

Limitations of Payments

NOTE: For medical and related services refer also to OAR 582-075 and 582-080; and, for providers of community rehabilitation services refer also to OAR 582-010.

(1) Payment in Full: Vendors providing any services authorized by OVRS shall not make any charge to or accept any payment from the individual or his/her family for such services unless the amount of the service charge or payment to be borne by the individual is previously agreed to by the individual or his/her family, known to and, where applicable, approved by OVRS.

(2) Client Financial Participation and the Financial Needs Test: Except as expressly exempted, services funded by OVRS are subject to Client Financial Participation. Individuals shall be allowed or required to contribute financially as set forth in OAR 582-070-0030. The contribution requirements apply starting July 1, 2004 for individuals submitting applications for services, requests for post-employment services, and for annual IPE reviews.

(a) The purpose of individual participation in service costs is to encourage the commitment of the individual to their vocational rehabilitation goal, create a cooperative relationship with the individual, and conserve limited OVRS resources.

(b) Except as provided in OAR 582-070-0030(2) (j) and (k), the following individuals are exempted from the Financial Needs Test and Client Financial Participation:

(A) Any individual who has been determined eligible for and is currently the recipient/beneficiary of Social Security Benefits under Title II (Social Security Disability Insurance, SSDI) or Title XVI (Supplemental Security Income, SSI) of the Social Security Act;

(B) Recipients of qualifying needs-based public assistance programs, including Self Sufficiency Cash Benefits, Oregon Health Plan, Temporary Assistance for Needy Families, and Food Stamps, and excluding financial aid for post-secondary education;

(C) Homeless or transient individuals.

(c) Except as provided in OAR 582-070-0030(2)(j) and (k), the following services are exempt from Client Financial Participation:

(A) Assessment for determining eligibility, vocational rehabilitation needs, or priority for services, including assessment by personnel skilled in rehabilitation technology;

(B) Vocational rehabilitation counseling and guidance, including information and support services to assist an individual in exercising informed choice;

(C) 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;

(D) Job related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services;

(E) Personal assistance 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;

(F) Auxiliary aids or services required to participate in the vocational rehabilitation program, such as interpreter services including sign language and oral interpreter services for individuals who are deaf or hard of hearing; or tactile interpreting services for individuals who are deaf-blind.

(d) Under the Financial Needs Test, individuals with annual family income of less than either 250 percent of the federal poverty guidelines or $60,000 are not subject to Client Financial Participation and are exempt from the guidelines set out in OAR 582-070-0030(2)(e).

(e) Client Financial Participation shall be determined on an annual basis, not to exceed the annual cost of non-exempt services to OVRS, applying the following contribution schedule:

(A) Individuals with family income between $60,000 and $69,999 are subject to a mandatory financial contribution of $700.

(B) Individuals with family income between $70,000 and $79,999 are subject to a mandatory financial contribution of $900.

(C) Individuals with family income between $80,000 and $89,999 are subject to a mandatory financial contribution of $1300.

(D) Individuals with family income between $90,000 and $99,999 are subject to a mandatory financial contribution of $1700.

(E) Individuals with family income between $100,000 and $109,999 are subject to a mandatory financial contribution of $2100.

(F) Individuals with family income between $110,000 and $119,999 are subject to a mandatory financial contribution of $2900.

(G) Individuals with family income between $120,000 and $129,999 are subject to a mandatory financial contribution of $3700.

(H) Individuals with family income at $130,000 or higher are subject to a mandatory financial contribution of $3700 plus ten percent of their family income in excess of $130,000.

(f) OVRS shall use the following definitions to calculate Client Financial Participation:

(A) "Income" is determined by the adjusted gross income from the most recent federal tax return, unless unusual circumstances merit other documentation.

(B) "Family income" consists of income from the individual, the spouse of the individual if residing with the individual, and includes parents if the individual is under 18 and living with parents, or the parents claim the individual as a dependent on federal taxes, or the individual maintains dependent status for financial aid reasons.

(C) "Federal poverty guidelines" are the current poverty guidelines of the United States Department of Health and Human Services.

(D) "Size of the family unit" for purposes of selecting the appropriate federal poverty guideline includes those family members residing with the individual or claimed on federal taxes as dependents; but if the individual is under 18 and living with parents, or the parents claim the individual as a dependent on federal taxes, or the individual maintains dependent status for financial aid reasons, the family unit may include those family members residing with the parents or claimed on the federal taxes of the parents as dependents

(g) If the individual or their family choose not to share information about their income as part of the calculation of the financial needs test, an annual, mandatory individual contribution of $3700 shall be established, not to exceed the annual cost of non-exempt services to OVRS, unless OVRS concludes that the annual family income of a individual may exceed $130,000 in which case the individual contribution shall be established at 100 percent for items and services subject to Client Financial Participation.

(h) Subsequent Financial Needs Tests shall be conducted with the annual review of the Individualized Plan for Employment, and may also be conducted if there is a change in the financial situation of either the individual or the family unit.

(i) "Extenuating Circumstances" shall be considered when the counselor identifies other information related to the individual's financial situation that negatively affects the individual's ability to participate in the cost of the rehabilitation program or if requiring the expected financial contribution will result in undue delay in the rehabilitation program. In determining whether to make an adjustment for extenuating circumstances, OVRS may consider the individual's current income and the reasons for the request. If there are extenuating circumstances that justify an exception, OVRS may delay or waive all or part of the individual's financial contribution. In such cases the counselor shall:

(A) Obtain written approval of their supervisor;

(B) Provide documentation of the reasons for the exception;

(C) Maintain both the signed exception and the documentation of circumstances in the client individual file record.

(j) If an individual prefers an upgrade, enhancement, optional feature, or more expensive vendor of essentially the same service, equipment or item available from a less expensive vendor, and this preference is not required to satisfy the vocational rehabilitation goals that justify the expenditure, OVRS and the individual may agree that the individual shall pay the difference in cost between the service or item purchased and the service or item available that would have satisfied the vocational rehabilitation goals that justify the expenditure. In this situation, payment is required regardless of whether the financial needs test authorizes payments by the individual; and any payments by the individual in this situation do not count toward the individual's mandated financial contribution.

(k) An Individualized Plan for Employment (IPE) may include voluntary client contributions. An agreement in an IPE to make a voluntary contribution is not enforceable.

(3) Student Financial Aid: OVRS assures that "maximum" effort is made by OVRS and the individual to secure student financial aid for any approved training in institutions of higher education. "Maximum" effort includes making timely application for such grant assistance on a consistent basis and utilizing such benefits as are available in lieu of Vocational Rehabilitation funding:

(a) Coverage: All individuals, including graduate students, must apply for all financial aid benefits each academic year. All need based grants, including Pell Grants and Student Employment Opportunity Grants, must be used to pay for educational costs, including tuition and books, before an individual may utilize VR funds for this purpose. This requirement does not apply to merit based grants, including scholarships or loans. However, individuals may voluntarily elect to use these funds, as well as work study and loans for this purpose.

(b) Other Comparable Benefits or Services: If a third party (e.g., employer, insurance company, WCD) is required to or agrees to pay or reimburse to OVRS all of the case service rehabilitation costs of the individual, the financial aid grant offer need not be applied against the plan costs nor treated as a "comparable benefit;"

(c) Late Applications: Pending determination of student aid by the financial aid officer, OVRS funds can be expended for education-related expenses between the date of application for financial aid and determination of the individual's eligibility for federal student aid provided that such expenditures are reduced by any amounts of comparable benefits subsequently received, excepting student loans;

(d) Duplicate Payments: When student financial aid is approved, arrangements must be made promptly to reduce projected OVRS payments and/or recover duplicate payments;

(e) Parent Non-Participation: With the Field Services Manager's approval, the counselor may fund the parental contribution portion of the student's budget (as prepared by the college or university FAO) if the parents refuse or are unable to contribute.

(4) For Industrially-Injured Workers: OVRS shall provide only for the cost of those rehabilitation services which are not the responsibility of the employer, insurer or the Oregon Worker's Compensation Office.

(5) Increased Cost Maintenance: OVRS shall not provide maintenance except for additional costs incurred while participating in authorized services, such as when the individual must maintain a second residence away from the regular household in order to achieve a rehabilitation goal. Such maintenance shall be provided according to the provisions under OAR 582-070-0020(4), 582-001-0010(25), and 34 CFR 361.5(b) (35).

(6) Physical and Mental Restoration Services: Are provided only to ameliorate a diagnosed physical or mental condition that presents a substantial impediment to employment for the eligible individual. The services must be essential for the individual's achievement of a vocational goal:

(a) Drugs:

(A) When a physician (MD or OD) or dentist recommends prescription medication, if practical, the lowest price (e.g., generic) shall be obtained prior to issuing an authorization;

(B) Controlled substances require a prescription; an attending physician's statement under ORS 475.309(2)(a) does not qualify as a prescription.

(b) Dental Services: Dental care may be provided by OVRS when the condition of teeth or gums imposes a major impediment to employment (e.g., endangers health, emergency needs, or serious cosmetic needs). Dentures may be purchased from licensed dentists or certified denturists;

(c) Eye Glasses: Eye glasses may be purchased when determined essential for evaluation of eligibility or the achievement of the vocational goal, limited to basic frames and lenses unless other features are medically required (e.g., sun glasses, tints, contact lenses);

(d) Wheelchairs: OVRS may purchase a wheelchair when the equipment is required to reduce or eliminate a disability related functional limitation that is a substantial impediment to employment. Wheelchairs must be prescribed by a qualified medical specialist;

(e) Hearing Aids. OVRS may provide hearing aides only when:

(A) Essential to complete an evaluation;

(B) Necessary to reduce or eliminate a barrier to employment; or

(C) The participant requires the hearing aids to retain employment. OVRS shall document the need for a hearing aid. All hearing services must be performed by licensed audiologists.

(f) Other Prosthetic Devices: Prosthetic devices may be purchased only upon the authorization of the counselor and with a written prescription by a qualified professional;

(g) Psychotherapy: Group or individual psychotherapy may be provided in those instances when required for a person to reach a vocational goal and when an immediate and positive goal related impact is anticipated. A specific number of sessions or a specified time limit is required. OVRS may limit these services to those recommended by an OVRS psychological or psychiatric consultant;

(h) Physical or mental restoration services shall not be provided by OVRS for the treatment of an acute or chronic medical complication or emergency unless these are associated with or arise out of the provision of physical or mental restoration services in the IPE, or are inherent in the condition under treatment as described in the IPE.

(i) Corrective surgery or therapeutic treatment shall not be provided or funded by OVRS if it is not 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.

(7) Services Not Provided: OVRS shall not authorize or provide funding for the following services:

(a) Any individual-incurred debt;

(b) Any services obtained by the individual prior to the date of application;

(c) Purchase of land or stationary buildings;

(d) Fines or penalties, such as traffic violations, parking tickets, library fines, etc;

(e) Breakage fees and other refundable deposits;

(f) Contributions and donations;

(g) Entertainment costs;

(h) Payments to credit card companies;

(i) Authorization to supermarkets or grocery stores for food items;

(j) Basic Maintenance;

(k) Gender reassignment surgery;

(l) Except for eye glasses or hearing aids essential to completing diagnostic/evaluation services (to determine Rehabilitation Services eligibility) in applicant status, or occupational tools or licenses essential to Extended Evaluation Services, the following may never be authorized for an individual who has applied but has not yet been found eligible for rehabilitation services:

(A) Prosthetic devices;

(B) Occupational tools and licenses;

(C) Placement services.

(8) OVRS shall not contract with individuals receiving OVRS services, except in the following circumstances:

(a) The individual is a current OVRS vendor and is receiving services from or through OVRS; or,

(b) The individual's Individualized Plan for Employment provides for the development of a business where there is no known competition in the region of the state in which the business will be or is located. In addition, the individual's case has been reviewed by a branch manager who concurs there is no known competition to the business or proposed business.

Stat. Auth.: ORS 344.530
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 1-1978, f. 3-14-78, ef. 3-15-78; VRD 2-1981, f. & ef. 12-1-81; VRD 2-1992, f. & cert. ef. 4-20-92; VRD 4-1993, f. & cert. ef. 11-1-93; VRS 2-2004, f. & cert. ef. 3-9-04; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2008, f. & cert. ef. 2-4-08; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0040

Repossession/Disposition of Non-Expendable Property

(1) For tools, supplies, equipment, vehicles, etc., funded by OVRS and needed by the individual for employment at time of closure as employed (from Individualized Plan for Employment or post-employment services), ownership or title is transferred to the individual.

(2) If an individual is closed as 'other than rehabilitated', or if tools, supplies, equipment, vehicles, etc., are not needed while the individual is receiving plan services or not needed by the individual employed at the time of a successful closure, where practical and appropriate, such property shall be repossessed and reassigned or otherwise disposed of by OVRS if this property was funded by OVRS and has a current aggregate value of $1000 or more:

(a) For such property with a current aggregate value under $1000, the counselor may agree to transfer the property to the ownership of the individual. Such agreements are only valid if the agreement is written. If there is no such agreement, the counselor shall make a reasonable effort to repossess the property through voluntary cooperation by the involved individual, individual's family or other individual who may be in current possession of said property, including small claims court; and

(b) For property with current values estimated to be $1000 or more in the aggregate, OVRS may pursue, if necessary, other available legal means to regaining such property, or its equivalent value, including obtaining advice or assistance from the office of the attorney general.

(3) Any property funded by OVRS that has been purchased via prescription (such as glasses, hearing aids, wheelchairs) may be retained by the individual, with justification at closure documented in the individual’s record.

Stat. Auth.: ORS 344.530
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 2-1992, f. & cert. ef. 4-20-92; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2005, f. & cert. ef. 1-11-05; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0041

Self Employment Including Micro-Enterprises

Self-employment is an employment option that offers people with disabilities an opportunity to enter the labor market and contributes to self-sufficiency and independence. Self-employment, including micro-enterprises, should be consistent with the individual’s strengths, resources, priorities, concerns, abilities, capabilities and interests, providing the individual full opportunity to exercise informed choice in the selection of their employment outcome.

Stat. Auth: ORS 344.530(2)
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 1-2000, f. & cert. ef. 7-24-00; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0042

Definitions

The following definitions apply to Rules 582-070-0041 through 582-070-0044:

(1) "Business plan" means a document that describes the organization and operation of the proposed business. It is prepared by the individual, with assistance, as needed, from the counselor and/or Small Business Development Center at a local community college, a micro-enterprise organization, private business consultant, consultant from the Service Corps of Retired Executives (SCORE) or other similar source(s). The business plan shall be used by the counselor and the individual, in consultation with a qualified expert, to evaluate the viability of the business, as well as provide the individual with a blue print for the business. The business plan shall outline the financial projections of the business, the business marketing plan, and the method and schedule of ongoing record keeping and analysis that shall be used to evaluate the progress of the business. If the plan is viable, it can also be used to apply for any needed funding.

(2) "Self-employment" means working for oneself, in a business that sells goods or services. Self-employment may be a sole proprietorship, partnership, or corporation. If the business plan includes a partnership or corporation, and OVRS funding is requested, the individual must be the owner, controlling partner or controlling shareholder of the corporation.

(3) "Start-up costs" mean those costs as described in the business plan required in order for a business to begin operation. Start up costs that are considered reasonable and necessary shall only be considered for funding by OVRS after all comparable services and benefits have been applied. Reasonable and necessary start-up costs required to establish the business may be provided by the OVRS in accordance with applicable purchasing rules and regulations.

(4) "Viable" when used with "business plan" means a business plan that has a reasonable chance of success leading to self sufficiency, based upon a market feasibility study; financial review of projected revenue, expenditures and assets; and the demonstrated technical and business management skills and abilities of the individual. An analysis of the ongoing costs required for the operation of the business and the resources that will cover those expenses will also be necessary to determine whether the projected resources will be sufficient to cover ongoing operational costs of the business. In order to be "viable" the individual’s technical skills must be commensurate with those required of the self-employment venture. A business plan, to be viable, has been reviewed, in consultation with the individual and the OVRS counselor, by an individual or organization with a credible background in business planning. Although OVRS does not require that an individual utilize loan funds as a comparable benefit, a business plan may require loan funding or additional funding sources other than OVRS (e.g., family, friends) in order to be considered viable.

Stat. Auth: ORS 344.530(2)
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 1-2000, f. & cert. ef. 7-24-00; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0043

Nature and Scope of OVRS Services/Role of the Vocational Rehabilitation Counselor and the Individualized Plan for Employment

(1) The primary role of the Vocational Rehabilitation Counselor when assisting the individual in obtaining self-employment is to address the individual’s disability-related barriers to employment. The Vocational Rehabilitation Counselor shall ensure the individual's business plan and the Individualized Plan for Employment (IPE) incorporates the strengths, resources, priorities, concerns, abilities, capabilities, and interests identified in a comprehensive assessment. In order to ensure the individual is provided full opportunity to exercise informed choice, OVRS may:

(a) Help the individual evaluate his or her abilities, and interest in managing a business, including both formal evaluation, as well as observation and assessment of the individual's planning skills, ability to formulate a marketing and business plan, aptitudes to perform skills intrinsic in the operation of the business, initiative, commitment, and follow-through on tasks;

(b) Help the individual develop a viable business plan;

(c) Help the individual research and obtain the resources necessary for the business plan;

(d) Identify, in full consultation with the individual, the measurements that shall be used to determine progress toward the planned outcome.

(e) Work with the individual to understand the risks and responsibilities of owning and operating a business, especially when funds are borrowed to capitalize and support ongoing business needs; and

(f) Assist with reasonable and necessary start-up costs of viable business plans when appropriate.

(2) If the individual's formal business plan is determined to be viable, the counselor and the individual shall complete the individual's Individualized Plan for Employment (IPE). The IPE must:

(a) Specify needed services and costs, including training in specific skill areas in starting and owning a business, if the individual lacks skills necessary for successful business management;

(b) Identify Assistive Technology and any other accommodations required;

(c) Identify all resources available to fund the business plan, as described in OAR 582-070-0044(2).

(d) Include a plan to monitor and evaluate the success of the business through scheduled reviews with the individual, and individual provided financial and marketing activity reports, as defined in the business plan.

Stat. Auth: ORS 344.530(2)
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 1-2000, f. & cert. ef. 7-24-00; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

582-070-0044

Funding Requirements for a Viable Business Plan

(1) Under most circumstances, OVRS should not be considered a primary resource for the capital required for a self-employment venture. When no comparable benefits and services are available, OVRS may fund reasonable and necessary start up costs for a business as part of a individual's Individualized Plan for Employment. In order for a plan to be viable, other funding sources may be necessary to cover costs identified in the business plan that would not be covered by OVRS.

(2) Funding for the business plan may include, but is not limited to, the individual's own resources; comparable services and benefits; loans from banks, finance companies or venture capitalists; grants; foundations; loans or loan guarantees from the Small Business Administration; local and state economic development funds; help from family or friends; a Social Security Plan for Achieving Self Support (PASS); or other such resources.

(3) The individual is not required to accept a loan or utilize a PASS plan to fund the business plan. However, to be viable, a business plan may require additional funding such as that in a subsection (2) to cover the cost of the business venture.

(4) Except for reasonable and necessary initial start-up costs, OVRS shall not pay for ongoing functions intrinsic to the operations of the business. Any request for initial start-up costs must include:

(a) The determination that OVRS and the individual have explored all reasonable self-employment funding options, as identified in subsection (2); and

(b) The determination that available financial resources, as identified in subsection (2), will not meet the reasonable and necessary start-up costs for the business.

(c) Verification from the qualified expert approving the business plan that the requested start up costs are reasonable, necessary, and representative of what would be required for a start up business to begin operations.

(5) OVRS shall assume no financial liability for debts, including existing debt. Any loss shall not be reimbursed by OVRS.

(6) If additional funding such as that in subsection (2) is required to cover the cost of the business venture, the individual shall decide, based upon informed choice about the funding options available, whether to proceed with the business plan. This may include deciding to accept a loan for capitalization and ongoing business expenses.

Stat. Auth: ORS 344.530(2)
Stats. Implemented: ORS 344.511 - 344.690 & 344.710 - 344.730
Hist.: VRD 1-2000, f. & cert. ef. 7-24-00; VRS 5-2004, f. & cert. ef. 8-5-04; VRS 1-2011(Temp), f. 2-15-11, cert. ef. 3-1-11 thru 8-28-11; VRS 2-2011, f. 8-12-11, cert. ef. 9-1-11

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