Fee Schedule Update FAQ & Transition Guidance

2019 VR Provider

Hello Vocational Rehabilitation Providers, 

              Thank you for joining us in the field for our in person trainings on the VR Fee Schedule updates.  The Provider Manual update will be out soon as well.  We will also be sending out the full PowerPoint presentation from the Fee Schedule Update training in an accessible format.

              In the meantime, please find attached the 2020 VR Fee Schedule.  Please find below the FAQs and guidance on transitioning between fiscal years and fee schedules.  This includes questions received from providers, as well as from VR staff.  While some of these may apply more directly to VR staff's work, we wanted providers to understand the guidance being given internally as well.


Do Tier authorizations for this FY need to be cancelled and reissued for FY2020?

Yes, Tier I authorizations which will not be completed/billed during FY2019 will need to be reissued for the FY2020 (as occurs between every fiscal year). 

No authorizations can cross Fiscal years (e.g. a CBA running from the last week of September through the first week of October must be on two separate authorizations).


Under the updated Fee Schedule, how long should Tier I authorizations be issued for?

Tier I can be authorized from within the same FY until the end of that FY (because it is not known when the individual will complete the Tier I package).


When is Tier II authorized?  Does the VR staff need to have the completed employment verification in hand to authorize Tier II?  How long should Tier II be authorized for?

Tier II is authorized upon VR staff approving the position (i.e. matches IPE goal, congruent with abilities/strengths/limitations, individual is in agreement, etc.).   The counselor does not have to have the employment verification in hand, but can make this determination based on the information received (e.g. phone call, staffing discussing opportunity, e-mail outlining details).  The counselor should only authorize for Tier II when they have full confidence that this is an appropriate position.

Tier II does not need to be authorized through the end of the FY.  Authorizing this for 30 days is adequate in most cases.  If an authorization needs to be issued for longer than 30 days for a start date more than a month away, this is allowable. 


Tier III: When should the 30, 60, and 90 day authorizations be issued?

As we cross into FY 2020, the 30 and 60 day authorizations may be issued to “catch up” for any of these benchmarks which have occurred to date. 

Counselors/coordinators are responsible for tracking dates of employment, and communicating authorization requests to their AE2.  For example, the 30 day authorization may be requested for a position which is stable on October 15th for 10/15 – 11/14 for the first month.

Monthly Tier III authorizations shall be issued sequentially, and not all together in a batch. 

The prior month’s Tier III does not have to be received or paid before the next month’s authorization is issued.


With the redistribution of the Tier payments to be more frontloaded, will Tier III payments in FY2020 be lower?

Yes.  The PBJD and SEJD packages are all raised by 8%, with a higher payment up front in Tier I.  Providers may notice the Tier III is slightly lower as we move into FY 2020.


Would the CBA/WA Placement Facilitation services be issued in conjunction with Performance Based Job Development (tiers)?

The Fee Schedule service description clarifies the provider would receive either the Placement Facilitation OR the tiered job development authorizations. While the goal of CBAs and WAs is not an employment outcome, if this were to occur, it would likely be before PBJD had been authorized.   In cases when PBJD has been authorized, we would honor that service trajectory and continue moving through the tiers.

The PBJD/SEJD would not be issued on top of the Placement Facilitation service. 


In cases where an individual is hired after a CBA or WA, would they receive Tier III for retention services?

No.  If the individual was not in PBJD or SEJD and the individual is hired following a CBA or WA, On-The-Job-Supports would be authorized for retention purposes.


If an individual is hired before Tier I activities are completed, are the requirements for Tier I still in place?

Yes.  OOD wants individuals participating in PBJD or SEJD to leave with a resume, interview skills, and the ability to conduct a job search to the best of their capacity.  If an individual is hired into a position which the counselor/coordinator approves before a resume is completed, all items on the Job Development Plan would still need to be completed before billing for Tier I. 


What is the process to schedule a timely kick-off meeting or staffing with the VRC?

Provider should contact VRC at the earliest opportunity to schedule a kick-off meeting or staffing.  Once some available dates and times are identified, the Provider should schedule the meeting with the Individual and then confirm the date and time with the VRC.  While it is preferable to meet in person, these meetings can be held virtually (over the phone, through Skype, GoTo, etc.) if that can facilitate the scheduling.  If there is any difficulty in reaching the VRC (multiple attempts/more than a week has passed), please contact the VRS for further assistance.


How do I determine when to authorize Site Development vs. Site Coordination?

VR staff should have an understanding of provider established sites based upon updates provided at the quarterly CRP meetings, through local relationships, and from provider materials.  If an individual selects a provider with a known, already established site, the counselor/coordinator should authorize Site Coordination.  If VR staff has an idea of an appropriate site but is unsure of whether or not the site is established, VRC should contact Provider to discuss and determine together if a Site Development authorization should be issued.  VR Staff may contact a provider ahead of a referral to clarify if a provider has a needed site, or if a site would need to be developed.


A provider had an individual quit mid-service and is having trouble getting a signature on the VTS. Can the provider send the service report now and submit the VTS later?

The service report (CBA, WA, SYWE) and VTS should be billed at the same time.  Please reach out to the VRC in the unusual situation where the individual is unavailable to sign the VTS.


What services can site coordination be used in conjunction with?

 Site Coordination can only be used for Community Based Assessments and Work Adjustments.


Do any services include mileage or is mileage billed separately?

The cost of mileage is built into the fee for each service.  Mileage should not be authorized separately.


For CBA Rapid Engagement Premium, when does the “clock” on the 30 days officially begin?

 The date the authorization was issued. 


For Summer Youth Work Experience, how many hours is required for the orientation day?

The first day of Summer Youth (Orientation Day) should match the schedule for the rest of the service. Therefore, if the service is scheduled four hours a day for five days a week, the first day will be four hours.  If the schedule is five hours a day for four days a week, the first day should also be five hours.


What constitutes one year of required work experience in order to provide Pre-ETS services?

The one year of experience working with students with disabilities can be in any service area; it does not have to be specific to Pre-Employment Services.


What is the difference between “employed stable” and “job stable”?

“Employed Stable” is a status in the AWARE case management system. An individual is put into Employed Stable status at the same time retention services start.  “Job Stable” is a term that means an individual is receiving the same level of supports that would be required post-case closure.  Job Stable and Employed Stable can be used interchangeably.


What services are eligible for the shift differential?

On-The-Job-Supports (OTJS) is the only service that is eligible for the shift differential.


How should staff authorize for Pre-ETS services?

VR staff should authorize for Pre-ETS services at the individual rate.  When the reports are received, the AE2s will adjust the billings based on the actual group size.


              We look forward to sending out the Provider Manual and training presentation soon.  Thank you for all of your hard work as you transition to the new fee schedule and fiscal year!

- Provider & Contract Management Unit