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HomeMy WebLinkAbout20030157.tiff RESOLUTION RE: APPROVE PROVIDER AGREEMENT FOR DIVISION OF VOCATIONAL REHABILITATION IMMUNIZATION PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Provider Agreement for an Immunization Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Human Services, Division of Vocational Rehabilitation, with terms and conditions being as stated in said agreement, and WHEREAS, after review, the Board deems it advisable to approve said agreement, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Provider Agreement for an Immunization Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Human Services, Division of Vocational Rehabilitation, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 13th day of January, A.D., 2003. BO D OF COUNTY COMMISSIONERS W COU TY, COLORA O ATTEST: getki �� �' Ells.� ��% D id c. Long, Chgaic Weld County Clerk to thti8: ' �a��� \ki\\ IN2 / , W n '," �� Robert D , asden, Pro-Tem BY: :_.I/,L_ • 7�a Deputy Clerk to the Boa: j� ,//L' Fag, M. J. Geile Al ED AS TO EXCUSED �'" William H. Jer e County Attorney A(/v Glenn Vaad'� Date of signature: //"4/ 2003-0157 ' /L(7(1 .' / (aa-tt7) HL0030 Department of Human Services DIVISION OF VOCATIONAL REHABILITATION PROVIDER AGREEMENT dC1 ocy Page 1 to be completed by the g p Provider AGREEMENT made: (Date) a1 4-1(. 3 ,between the State of Colorado ("State")for the use and benefit of Department of Human Services ("CDHS"), Division of Vocational Rehabilitation ("DVR"), 2211 W. Evans,Building B,Denver,CO 80223,and (Full legal name of provider) The County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment ("Provider") GOODS AND SERVICES GOVERNED BY THIS AGREEMENT: (Service codes to be entered by DVR staff) Service Service Service/Product code(s) Service/Product code(s) Immunizations .7C Tai Office visits S[0O Add additional page if necessary PROFESSIONAL LICENSES,CERTIFICATIONS,AND CREDENTIALS: Enter those which apply to the services identified above Date Expiration Type of credential Issued Date License#(if applicable) All physician, nurses, and nurse practitioner licenses are currently up to date. Add additional page if necessary • TYPE OF PROVIDER: Check the box which applies 4" Unit of local,state,or federal government o Private entity THE PARTIES AGREE TO THE TERMS AND CONDITIONS SET FORTH BELOW: PROVIDER QUALIFICATIONS. The Provider shall • Maintain professional licenses, certifications, and/or credentials required by DVR for the types of goods and services to be provided to DVR consumers. • Be licensed or registered to do business in the State of Colorado or the state in which goods and services will be delivered to DVR consumers to the full extent required by the state's law. • Carry minimum liability insurances below, as applicable to the service(s) being rendered, and provide DVR with proof of insurance coverage upon request. If the insurance is on a daims made basis, the policy shall'include coverage which extends two years beyond the performance period defined under the Authorization for Service, and the State shall be named as an additional insured on all liability policies other than professional liability insurance. (i) Standard worker's compensation and employer liability insurance as required by State statute; a003- OI57 (ii) General, personal injury, automobile liability (including bodily injury,personal injury,and property damage), and/or professional liability insurance with a minimum coverage of$600,000 combined single limit if written on an occurrence basis,aggregate limit not less than$1,000,000. SERVICE AUTHORIZATION- TASK ORDERS. • Services and goods will be defined and ordered, as needed, by DVR based on the then current DHS Division of Vocational Rehabilitation Fee Schedules, such task orders hereinafter referred to as "Authorization for Service". Amendments to terms and conditions or other provisions of this Agreement other than an individual Authorization for Service as specified in this paragraph shall be by formal amendment,processed and executed in compliance with State Fiscal Rules and signed by the Executive Director, Department of Human Services, or designee. • Authorization for Services processed in accordance with this paragraph to authorize work shall occur as follows: A. If DVR has need of services or goods from the Provider, the Authorization for Service form attached as Appendix A and incorporated herein shall be prepared and signed by DVR and given to the Provider. The Provider's beginning of performance under the Authorization for Service shall be considered as Provider's acceptance of the requirements of the Authorization for Service. B. Performance of the authorized work, and payment for that work, shall be governed by the standards, procedures, and terms set forth in the Authorization for Service and this Agreement. Upon acceptance of the Authorization for Service, the Provider warrants that performance will be successfully completed within the time,rate,and cost ceiling identified in the Authorization for Service. BILLING FOR SERVICES. The Provider shall: • Bill DVR only for the goods and services identified in this Agreement when provided to DVR consumers. • Bill DVR only for those goods and services provided to DVR consumers when authorized by a DVR counselor prior to rendering the service. • Bill DVR for goods and services provided to DVR consumers for only those amounts authorized in accordance with DVR's fee schedules effective at the time of service authorization. • Bill DVR only for goods and services rendered to DVR consumers. • Furnish DVR with invoices,signed or otherwise meeting normal commercial practices, and any other information requested by the authorizing DVR counselor regarding goods and services rendered within the time or in accordance with the schedule established by him or her. • Accept amounts paid by DVR for goods and services rendered to DVR consumers as payment in full except for those amounts designated by the counselor to be paid by the recipient of service or a third party. Total payment cannot exceed DVR's established allowable fee. • In the event that a third party is paying for part of a good or service, apply the other party's payment first, and make DVR the payor of last resort. OTHER RESPONSIBILITIES. The Provider shall: • Maintain documents, papers, statements, and other records which are pertinent to the rendering of goods and services to DVR consumers for each service authorization for a minimum of three years after final payment by DVR thereof. • • • For the purpose of audit, examination, and obtaining excerpts and transcriptions, make available to DVR, CDHS, the U.S. Department of Education, or any duly authorized representatives, any documents, papers and records which are pertinent to the rendering of goods and services to DVR. • Comply with all applicable accessibility requirements of the Americans with Disabilities Act(Public Law 101-336), Title VI of the Civil Rights Act of 1964 (Public Law 88.352) which prohibits discrimination on the grounds of race, color or national origin, and Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794) which prohibits discrimination on the basis of disability during the furnishing of goods and services to DVR consumers. • Abide by applicable federal and state statutes, rules and regulations governing the confidentiality of information about DVR consumers. This provision shall not be construed as limiting DVR's or CDHS's right of access to records or other information relating to the rendering of goods and services to DVR consumers. • Comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957, as amended, and other applicable law respecting discrimination and unfair employment practices (CRS 24-34 102), and as required by Executive Order,Equal Opportunity and Affirmative Action,dated April 16,1975. • Strictly adhere to all other applicable federal and state laws, rules, and regulations which have been or may hereafter be established. • Accept responsibility for compensation of its personnel and subcontractors. • THE PROVIDER SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE. NEITHER THE PROVIDER NOR ANY AGENT OR EMPLOYEE OF THE PROVIDER SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. THE PROVIDER SHALL PAY,WHEN DUE,ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX WITHHOLDING,INCLUDING ALL FEDERAL AND STATE INCOME TAX AND LOCAL HEAD TAX,ON ANY MONIES PAID PURSUANT TO THIS AGREEMENT. THE PROVIDER ACKNOWLEDGES THAT THE PROVIDER AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE PROVIDER OR A THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. THE PROVIDER SHALL HAVE NO AUTHORIZATION,EXPRESS OR IMPLIED,TO BIND THE STATE TO ANY AGREEMENTS,LIABILITY,OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. THE PROVIDER SHALL PROVIDE AND KEEP IN FORCE WORKER'S COMPENSATION(AND SHOW PROOF OF SUCH INSURANCE)AND UNEMPLOYMENT COMPENSATION INSURANCE IN THE AMOUNTS REQUIRED BY LAW,AND SHALL BE SOLELY RESPONSBILE FOR THE ACTS OF THE PROVIDER,ITS EMPLOYEES AND AGENTS. • Accept sole responsibility and full liability for the performance and actions of all of its personnel,contractors, and agents providing goods and services to DVR consumers under this Agreement. • Fully disclose any relationship(s) it has with a third party where such relationship is in opposition or conflict to its relationship with DVR as a potential purchaser of goods or services. • Notify DVR immediately in the event of a change in name or other vendor identification information; any significant changes affecting ownership or control; changes in provider qualification provisions, including professional certification, licensure or credentials; or, changes in ability to provide the goods and services identified in this Agreement. 7 • File a revised vendor Agreement form to reflect necessary changes within one calendar month of the effective date of the change. GENERAL PROVISIONS. • This Agreement shall not be deemed valid until it shall have been approved by the Controller of the State of Colorado or such assistant as he may designate. • Filing of this Agreement does not obligate the vendor to provide goods and services to DVR consumers or DVR to purchase goods and services from the vendor. • Financial obligations of DVR payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted,and otherwise made available. • The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,and enforcement of this Agreement. • All amendments to this Agreement must be made in writing and signed by both parties. • This Agreement is effective on the date signed by the State Official and,unless otherwise indicated below,remains in effect as long as all of its requirements, provisions, and conditions are being met and at least one service is purchased in a three-year period. • This Agreement may be terminated by either party upon 30 days prior written notice, but the parties shall not be released from the duty to perform their obligations under any outstanding service authorization up to the date of termination. • To the extent authorized by law, the provider shall indemnify, save, and hold harmless the State of Colorado, its employees and agents, against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees incurred as a result of any act or omission by the provider, or its employees, agents, subcontractors,or assignees pursuant to the terms of this Agreement. • Pursuant to CRS 24-30-202.4 (as amended), the State controller may withhold debts owed to Colorado State agencies under the vendor offset intercept system for: (a) unpaid child support debt or child support arrearages; (b) unpaid balance of tax, accrued interest, or other charges specified in Article 22,Title 39, CRS; (c) unpaid loans due to the student loan division of the department of higher education; (d) owed amounts required to be paid to the unemployment compensation fund; and (e) other unpaid debts owing to the State or any agency thereof, the amount of which is found to be owing as a result of final agency determination or reduced to judgment as certified by the controller. • All parties to the Agreement certify that they are familiar with CRS 18-8-301, et. seq., (Bribery and Corrupt Influences) and CRS 18-8-401,et.seq.,(Abuse of Public Office),and that no violation of such provisions is present. • All parties to the Agreement certify that to their knowledge, no State employee has any personal or beneficial interest whatsoever in the service or property described herein: SIGNATURES PROVIDER I agree to all of the terms and conditions contained in this Agreement I certify that all of the information provided by me in this Agreement and my W true,complete, and accurate. .-.‘ r f".. 1, `�X - Attest: !ii :... i�� L� - fr'i ,' Authorized Signature Clerk to the :.a.: ' / ``,/ i David E. Long - By: /' Print Name Deputy Clerk to th• $a p _\ � •\. U Chair (01/13/2003) Title Weld County Board of Commissioners Name of business(if other than above) 01/13/2003 Date W-9: The applicable block below must be checked. o W-9 is attached. o W-9 has already been submitted to the Division of Vocational Rehabilitation under separate cover. State of Colorado Department of Human Services DIVISION OF VOCATIONAL O REHABILITATION Signatur"�M Office Supervisor I 7/34/0) Date WELD COUNTY DEPARTMENT OF D �,tii✓��ti PU IC HEALTH Afy ENVIRONMENT Signature of Author' d State Official VGC',J") For the Executive Director BY: Mark I Wallace, M , MPH-Director y -7/-03( Date Approved Termination Date,if applicable APPROVAL: STATE CONTROLLER ART '-c .B A ' BY . .1rl - '/ /ilaS rin�name (Si tore 0 /23 Da g State of Colorado Department of Human Services Division of Vocational Rehabilitation a PURCHASE OF CONSUMER SERVICES SERVICE DEFINITIONS • • Established October I, 1998 Effective January I, 1999 Revised and Reprinted January 1,2000 • .1 . . DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS TABLE OF CONTENTS Introduction Diagnostic Services Medical Evaluations 2 Psychological and Psychiatric Evaluations Non-Medical Assessments 2 Vocational Evaluation Situational Assessment 2 Supplemental Evaluation 2 Personal Adjustment Evaluation 3 Rehabilitation Technology Evaluation 3 Physical&Mental Restoration Services 4 Medical and Dental Care 4 Counseling and Therapy 4 Prosthetic and Orthotic Services 4 Medical Equipment 4 Training Services 5 Adjustment Training 5 Academic Training 5 Vocational Training 5 Training Support Services 6 Other Training 6 On-the-job Training 6 Job Coaching 6 Job Seeking Skills Training • 6 Trial Work Experiences 6 Supportive Services 7 Transportation.... 7 Maintenance 7 Personal Assistance Services 7 Services to Family Members 7 Interpreter, Reader and Notetaking Services 7 DIVISION'OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS ii TABLE OF CONTENTS. (Continued) Rehabilitation Technology Services 8 Vehicle, Residential and Job Site Modification 8 Assistive Technology Device and Services 8 Rehabilitation Engineering 8 Self-Employment Services 9 Job Search and Placement Services 9 Appendix A INDEX DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page I INTRODUCTION The Division of Vocational Rehabilitation (DVR)purchases a wide variety of services on behalf of individuals with disabilities in order to determine their eligibility and vocational rehabilitation needs and to assist them in obtaining a job in the employment field of their choice. Vendors typically develop their own names for services and service components which they offer, and these may or may not be consistent with the names used by other vendors offering the same services. Thus, in order to assure meaningful and informed business transactions between DVR and interested community service providers,a set of definitions have been developed to govern the procurement of consumer services by DVR. SERVICE: A service provided by DVR is a planned intervention designed to assess an individual's eligibility and vocational rehabilitation needs, to accommodate barriers to employment, and to assist the individual in attaining an employment outcome. In accordance with the Rehabilitation Act of 1973, as amended, planned interventions can include the provision of physical merchandise and durable goods to individuals with disabilities. Appendix A`contains a list of alt of the goods and services which can be purchased by DVR for persons with disabilities. Goods contained on the list are identified by an arrow,and purchases of these items are not governed by a Provider Agreement. SERVICE PROVIDER. Any individual and/or organization which renders a good or service to a DVR consumer is considered a service provider. Services provider include, but are not limited to, vocational rehabilitation counselors, mobility instructors,rehabilitation teachers,or placement specialists,trainers,and other individuals; public, private and non-profit business entities; community rehabilitation programs; and,training facilities. SERVICE SETTINGS. Services are frequently described, in part,by the settings in which they are rendered. Two types of settings apply to the services purchased by DVR,as follows: FACILITY-BASED SERVICES--Services provided in structures designed specifically to provide services to persons with disabilities and other special populations, such as community rehabilitation program facilities, clubhouses, independent living centers and residential facilities,extended employment facilities,etc. COMMUNITY-BASED SERVICES--Services provided in real life settings appropriate to the type of service, such as real work settings, transitional employment program sites, home or community environments, training facilities serving the general public,etc. Definitions of specific services purchased by DVR appear on the following pages: I DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 2 DIAGNOSTIC SERVICES MEDICAL EVALUATIONS The definitions associated with the provision of medical assessments are consistent with information contained in St. Anthony's"Relative Values for Physicians"and the"Physician's Current Procedural Terminology:. PSYCHOLOGICAL AND PSYCHIATRIC EVALUATIONS The definitions associated with the provision of psychological/psychiatric assessments are consistent with information contained in St.Anthony's Relative Values for Physicians" and the "Physician's Current Procedural Terminology. • NON-MEDICAL ASSESSMENTS VOCATIONAL EVALUATION - An individualized and systematic process in which an individual, in partnership with the evaluator, learns to identify his or her strengths, resources, abilities, capabilities, interests andviable employment options in order to develop employment goals and objectives. A-variety of testing and assessment strategies may be used, including a standardized vocational assessment, situational assessments, community-based job tryouts,job shadowing,work experiences,etc. • Standardized Vocational Evaluation —Type of vocational evaluation utilizing formalized testing tools and standard protocols. Standardized vocational evaluations typically involve the use of formalized nonmed work samples,such as the Valpar,McCarron-Dial, written tests, etc. A standardized vocational evaluation must be conducted by an individual who is qualified to administer the standardized assessment tools. • • Situational Assessment — A type of vocational evaluation conducted to assess work behaviors, interpersonal skills, and job-related skill levels for purposes of establishing eligibility or developing the Employment Plan. Situational assessments may take place in community-based settings, including real life work settings and transitional employment settings, or in facility-based settings, such as community rehabilitation program facilities. o Work experience —A community-based situational assessment provided in real life work settings for the limited purposes of exposing individuals to the world of work and what is required to maintain successful employment. Work experience is not intended to result in permanent employment in the job setting. o Job shadowine - A community-based situational assessment provided in a real work setting where the individual observes and possibly assists in the performance of a specific job so that the individual has a sufficient understanding of job requirements when making a choice among potential employment goals. o Job site evaluation - A limited situational assessment (up to three hours) which consists of observing an individual on a specific job to determine if the particular job and/or work setting is appropriate for the individual and what accommodations may be needed. • Supplemental Evaluation - A type of vocational evaluation provided for an individual receiving supported employment services subsequent to the development of the Employment Plan when necessary to reassess the particular on-going support services needed and/or the.suitability of the particular placement. Supplemental evaluations typically take the form of situational assessments when-additional information is necessary to determine an appropriate change or modification in the supported employment placement. Established October I, 1998 Effective January I, 1999 DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 3 DIAGNOSTIC SERVICES (CONTINUED) NON-MEDICAL ASSESSMENTS(CONTINUED) PERSONAL ADJUSTMENT EVALUATION — An individualized and systematic process to evaluate an individual's skills, behaviors and needs in the areas of independent living, communications, homemaking, mobility and community travel,and personal functioning. • Rehabilitation Teaching Evaluation —Personal adjustment evaluation for a person who is blind or visually impaired to identify his or her skills and needs in the areas of communication, home and personal management,adjustment to blindness, independent decision making,and independent mobility • Orientation and Mobility Evaluation — Personal adjustment evaluation for a person who is blind to determine his or her independent travel skills and needs. REHABILITATION TECHNOLOGY EVALUATION — An assessment to identify the assistive technology deices, assistive technology services and/or rehabilitation engineering services which-are necessary for the individual to participate in his or her vocational rehabilitation evaluations and Employment Plan program. • Assistive Technology Evaluation — A rehabilitation technology evaluation to identify the assistive technology device(s) which is necessary for the individual to participate in his or her vocational rehabilitation evaluations and Employment Plan program. S DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 4 • PHYSICAL AND MENTAL RESTORATION SERVICES MEDICAL AND DENTAL CARE The definitions associated with the provision of medical and dental restoration services are consistent with information contained in St. Anthony's Relative Values for Physicians.'and the "Physician's Current Procedural Terminology. COUNSELING AND THERAPY The definitions associated with the provision of counseling, psychotherapy,physical therapy, speech, therapy, and occupational therapy services are consistent with information contained in St. Anthony's Relative Values for Physicians"and the"Physician's Current Procedural Terminology. PROSTHETIC/ORTHOTIC SERVICES WHEELCHAIRS - Definitions associated with the provision of wheelchairs are consistent with the HCPCS codes developed by the Health Care Financing Administration. PROSTHESIS, ORTHOTICS, BRACES, AND SUPPORTS (, ) - Definitions associated with the provision of prosthetic and orthotic devices are consistent with information contained in "The Illustrated Guide to Orthotics and Prosthetics",published by the American Orthotic and Prosthetic Association. HEARING AIDS -The definitions associated with the provision of hearing aids are consistent with the HCPCS codes developed by the Health Care Financing Administration. EYEGLASSES,CONTACT LENSES,AND OCULAR PROSTHESES<,)-The definitions associated with the provision of glasses, contacts, and ocular prostheses are consistent with the HCPCS codes developed by the Health Care Financing Administration. MEDICAL EQUIPMENT -The definitions associated with the provision of medical equipment are consistent with the HCPCS codes developed by the Health Care Financing Administration. • Established October 1, 1998 Effective January I, 1999 • DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 5 TRAINING SERVICES ADJUSTMENT TRAINING WORK ADJUSTMENT TRAINING —Training provided to help individuals adjust behavior and/or develop compensatory skills in vocational areas, such as peer work relationships, supervisory work relationships, general work behaviors and expectations, and work habits. Work adjustment training may take place in facility settings or in community-based settings, and it includes training to improve an individual's interpersonal skills to the degree necessary to engage in employment. PERSONAL ADJUSTMENT TRAINING —Training provided to help individuals develop compensatory skills and/onto adjust behavior in the areas of independent living, communications, homemaking, personal mobility and ability to travel in the community,and personal functioning. • Rehabilitation Teaching — Personal adjustment training provided to persons who are blind or visually impaired to identify and/or overcome or circumvent the barriers to communication, home and personal lnanagement, and may include independent mobility. Rehabilitation teaching may include counseling and guidance to enhance an individual's adjustment to his or her blindness, self-reliance, and independent decision making. • •- :Orientation and Mobility Training — Personal adjustment training provided to persons who are blind to • teach independent travel skills. • Drivers Training —Formalized instruction in the safe operation of a motor vehicle which does not involve the use of adaptive equipment. COMMUNICATION SKILLS TRAINING — Training in specialized visual, auditory or sign language communication techniques needed by an individual with a disability to communicate with others. COGNITIVE/LEARNING DISABILITIES TRAINING — Training in the development of cognitive skills to improve attention,memory and problem-solving. ACADEMIC TRAINING. Training.provided to develop verbal, numerical, and abstract reasoning abilities as well as to develop skills for a specific occupation or profession, including remedial reading programs, GED preparation courses, and other training programs which grant degrees at the Associate's level or higher. • • GED Preparation - Educational services provided on a one-to-one basis or through a specialized adult learning program to help an individual prepare for obtaining their GED in lieu ofa high school diploma. VOCATIONAL TRAINING Training typically provided through community colleges, vocational schools, technical institutes, and other certification programs to enable individuals to develop the skills necessary to perform the tasks of a specific job or family of jobs. • Skill Training--Other— Instruction provided by a community rehabilitation program, individual, or another entity other than one of the above as part of an organized, formal training program which equips an individual with skills necessary to perform the tasks of a specific job or a family of jobs. DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 6 • TRAINING SERVICES (CONTINUED) TRAINING SUPPORT SERVICES TRAINING BOOKS, SUPPLIES & MATERIALS —Non-adaptive materials required for the individual's participation in adjustment training programs,vocational training programs, and/or academic training programs, including books,manuals,normal supplies,special training materials,and training clothing. TUTORIAL SERVICES — One-to-one specialized instructional services provided most often in educational settings to help individual gain knowledge and skills in a specific subject area. Tutorial services may be provided to supplement a course of formalized academic or vocational training or to remediate an individual's knowledge or skill deficit in a particular area. OTHER TRAINING SERVICES • ON-THE-JOB TRAINING — Job skill training provided by the employer in an employment setting after placement has been secured with the clear expectation that employment in the same or a similar job for the employer will continue if training is successful. JOB COACHING — Training services provided by an individual other than the employer (unless under a program of natural supports in a supported employment placement)to an individual with a disability after he or she has been placed in an employment situation. Job coaching includes job skill training,job site orientation, monitoring of the individual at the job site to assess employment stability, and coordination or provision of specific services at or away from the work site to maintain employment stability. JOB SEEKING SKILLS TRAINING — Training to teach individuals how to conduct job searches, how to prepare resumes and complete applications,and how to interview effectively. TRIAL WORK EXPERIENCES An individualized program of assistance and/or on-the-job supports provided to an applicant or eligible individual in real work settings to enable the individual to demonstrate and/or develop his or her abilities, capabilities, and capacity to perform in work situations. Such services are only provided to individuals whose eligibility or continuing eligibility is questioned due to the severity of his or her disability. (effective 7/1/1999) • Established October I, 1998 Effective January I. 1999 DIVISION.OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 7 SUPPORTIVE SERVICES TRANSPORTATION Necessary travel and related expenses in connection with transporting applicants or eligible individuals and their attendants or escorts to enable applicants or eligible individuals to participate in other vocational services being provided. Transportation services include the transporting of individuals from place to place, automobile repair, parking fees, etc. Transportation may also include subsistence during travel (or per diem payments in lieu of subsistence)during the preliminary and comprehensive assessments. • Relocation Costs—Support to cover those expenses of an individual with a disability when it is necessary to relocate the individual in order for him or her to participate in a rehabilitation program MAINTENANCE Monetary support to cover those expenses of an individual with a disability, such as food,shelter, and clothing, in excess of his or her normal expenses which are incurred as a result of participation in the rehabilitation program under an Employment Plan or an Extended Evaluation Plan. - PERSONAL ASSISTANCE SERVICES Assistance provided to an applicant or eligible individual in the performance and management of daily living activities on or away from the job site,which the individual would typically perform without assistance if he or she did not have impairment. SERVICES TO MEMBERS OF AN APPLICANT'S OR ELIGIBLE INDIVIDUAL'S FAMILY Supportive services provided to family members only when necessary to the vocational rehabilitation of the individual with a disability. Such services may include child care and elder care when the individual is responsible for the daily living needs of children or parents, family relocation costs when necessary for the employment of the individual, family therapy,and transportation for family members. • Relocation Costs —Support to-cover those expenses of moving the family of an individual with a disability when it is necessary to relocate the family in order for the individual to obtain a job. INTERPRETING, READER, NOTETAKING SERVICES INTERPRETER SERVICES Translation of expressive and receptive language through oral,manual or written communication techniques. READER SERVICES Verbal communication of printed text for an individual unable to read or comprehend typical written or printed materials. NOTETA KING SERVICES Services which accurately record the content of verbal material presented by an instructor, evaluator, or employer for an individual unable to hear or comprehend verbal communications. cn,nt.l:nL A n.....L.._ I Intro DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 8 REHABILITATION TECHNOLOGY SERVICES REHABILITATION TECHNOLOGY SERVICES Assistive technology devices, assistive technology services, and rehabilitation engineering services which are necessary to meet the needs of and address the barriers encountered by an applicant or eligible individual in order to facilitate participation in his or her assessments and Employment Plan program. Rehabilitation technology services may be provided to enhance individual functioning or to increase access and successful performance for individuals with disabilities through environmental adaptations or alterations to homes, training sites,and employment settings. • Vehicle Modification - Structural modifications or adaptations to a motorized vehicle to enable an individual with a disability access to and operation of the vehicle when necessary for the individual to obtain his or her employment goal. • Residential Modification - Structural modifications or adaptations to an individual's residence to enable access to and independent function in the residence to the degree necessary for work. • • Job Site Modification - Modifications or adaptations to a workstation and/or job site to enable the individual access to necessary tools, equipment, and materials for the performance of job tasks and to improve his or her ability to perform required job tasks. • Assistive Technology Device -A non-medical item,piece of equipment,or product system—acquired commercially off the shelf,modified,or customized--which is used to increase,maintain,or improve the functional capabilities of an individual with a disability. • Assistive Technology Service -Any service which directly assists individuals with disabilities in the selection, acquisition, or use of assistive technology devices, including assistive technology evaluations; designing, fitting, customizing, adapting, maintaining, or repairing, assistive technology devices; training or technical assistance.to the individual in the use of the device; and, training or technical assistance for professionals when necessary to the achievement of an employment outcome by an individual with a disability. o Drivers Training — Instruction and hands-on training in the use of specialized adaptive equipment as necessary for an individual to safely operate a motorized vehicle. o Assistive Technology Assessment-See Rehabilitation Technology Evaluation. • • Rehabilitation Engineering - Original design and fabrication of technological devices and solutions to problems confronted by individuals with disabilities in preparing for, entering, and/or maintaining employment. Established-October I, 1998 Effective January I. 1999 • DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS Page 9 SELF-EMPLOYMENT SERVICES MISC SELF-EMPLOYMENT SERVICES Services other than initial inventory, occupational tools and occupational equipment provided to assist an individual in assessing the suitability and desirability of a self-employment outcome, to improve the potential for success of self-employment programs, and to enable the individual to successfully run his or her own business. JOB SEARCH AND PLACEMENT SERVICES JOB CLUB A structured group setting which provides assistance and support for job search activities, emphasizing self- directed job search techniques. - JOB PLACEMENT Services to help an individual procure a suitable, stable and satisfactory employment situation in an integrated setting that is consistent with the individual's strengths, resources, priorities, interests, concerns, abilities, capabilities and informed choice. Job placement services include job development services, assistance in completing work applications and arranging for interviews, on-site job analysis, on-site consultation with the employer, recommendations for work-site job modifications, and/or orientation to the work place, as appropriate to the individual's specific needs. • Employment Stipend -Payment to an employer for part or all of an individual's salary for up to one month when necessary to procure a job placement. Employment stipends may not continue beyond one month,at which time the employer agrees to provide the individual commensurate wages and benefits as provided to other individuals performing the same or similar work. APPENDIX A CONSUMER SERVICES AND GOODS Goods are preceded by an "S" DIAGNOSTIC SERVICES PHYSICAL& MENTAL RESTORATION SERVICES MEDICAL EVALUATIONS • General medical evaluation MEDICAL/DENTAL CARE • Specialist evaluation • Professional medical care • Dental evaluation • Dental/orthodontic services • Lab/x-ray(medical/dental) • Prescription drugs —* Medical/dental report from file y Medical supplies--product purchase • Medical/Dental Consultation • Lab/x-ray • Occupational/physical therapy evaluation • Hospital--outpatient • Speech/language evaluation • Hospital--inpatient • Hearing assessment • Extended care facility(nursing home,hospice • Hearing aid evaluation care,etc.) • Optometric examination--general • Home health services • Lotrvision evaluation • • Learning/reading evaluation COUNSELING& THERAPY Substance abuse evaluation • Individual counseling&psychotherapy • • Group counseling/psychotherapy PSYCHOLOGICAL&PSYCHIATRIC • Other therapy(speech,physical,occupational, EYALUATIONS etc.) • Neuropsychological evaluation • Psychological evaluation (intelligence,adaptive PROSTHETIC/ORTHOTICSERVICES -4 Wheelchair--purchase or product,parts,and behavior,personality, LD,etc.) —) Psychological/psychiatric report from file accessories • Psychiatric evaluation • Wheelchair--rental.&repair Psychiatric consultation • Prosthesis--upper/lower extremity • Braces/supports/orthotics NON-MEDICAL ASSESSMENTS • Hearing aid--fining,purchase&repair • Standardized vocational evaluation —> Hearing aid—purchase of parts • Situational assessment--facility based • Eyeglasses/contact lenses--purchase/repair • Situational assessment--community based • Ocular prosthesis --> Community employment worksite fee • Personal adjustment evaluation for persons who MEDICAL EQUIPMENT are not blind Medical equipment-:product purchase • Personal adjustment evaluation for the blind • • Medical equipment--rental&repair • Rehabilitation technology evaluation —� Fees for testing, exams,transcripts,etc. TRAINING SERVICES ADJUSTMENT TRAINING • Work adjustment training--facility based • Work adjustment training--community based • Personal adjustment training for persons who are not blind(travel training, independent living training,driver's training, personal management training,etc.) • Personal adjustment training for the blind (rehabilitation teaching, mobility,braille, adjustment to blindness,etc.) • Communication skills training(visual, auditory, sign language,etc.) Established October I, I 99S APPENDIX A • Cognitive/LD training TRAINING SERVICES (CONTD) Trial work experience employment site fee ACADEMIC TRAINING • State college/university--degree program • Private/out-of-state college/university--degree program • GED preparation VOCATIONAL TRAINING • Trade/business/vocational school training • State college/university--vocational,non-degree program • Private/out-of-state college/university-- vocational, non-degree program •• Correspondence school training • Skill training--other provider TRAINING SUPPORT SERVICES --* Books,supplies,& materials--product purchase • --> Training equipment--non adaptive product purchase • Training equipment--rental,repair of non- adaptive equipment • Tutorial services OTHER TRAINING SERVICES • On-the-job training • Job coaching • Job seeking skills training . SUPPORTWE SERVICES TRANSPORTATION • Transportation(includes auto repair,auto insurance,parking,relocation costs) MAINTENANCE • Maintenance PERSONAL ASSISTANCE SERVICES • Attendant care(medical& non-medical personal care services) • Homemaking assistance SERVICES TO FAMILY MEMBERS • Transportation for family members(includes relocation costs) • • Individual/group counseling for family • Child/elder care • Established October 1, 1998 Effective January I, 1999 APPENDIX A INTERPRETER,READER, NOTETA KING SERVICES • Interpreter services(sign language,foreign language,etc.) • • Reader services • Notetaking services REHABILITATION TECHNOLOGY SERVICES • Rehabilitation technology evaluation • Vehicle/van modification • Residence modification • Job site modification —> Assistive technology(AT)device--product puriliase • AT devices--rental& repair • Professional services(fees for design,adaptation and customization, fabrication,consultation, training,and technical assistance ) SELF-EMPLOYMENT SERVICES —> Occupational tools/equipment--product purchase • Occupational tools/equipment--rental, repair —. Initial stock/inventory--product purchase • Miscellaneous self-employment services OCCUPATIONAL LICENSES,TOOLS, & EQUIPMENT Occupational tools/equipment--non-adaptive product purchase • Occupational tools/equipment--rental, repair —i Occupational license/fees • JOB SEARCH& PLACEMENT SERVICES • Job seeking skills training • Placement supplies--(resumes, business cards, etc.) • Placement clothing--purchase • Placement grooming • Job club • Job placement —> Employment stipend Fcrahlichvri(lrtnhnr I IOQR ._. rcc i I ,nnn DIVISION OF VOCATIONAL REHABILITATION . SERVICE DEFINITIONS a INDEX Academic training 5 Adjustment training Cognitive/learning disabilities training 5 Communication skills training 5 Personal adjustment training 5 Work adjustment training 5 Assistive Technology Assessment See Rehabilitation Technology Evaluation Assistive Technology Device 8 Assistive Technology Evaluation 3 Assistive Technology Service 8 Cognitive/Learning Disabilities Training 5 Communication Skills Training 5 Community-based Services 5 • Counseling And Therapy 4 Diagnostic Services 2 Eyeglasses,Contact Lenses.And Ocular Prostheses 4 Facility-based.Services I GED Preparation 5 Hearing Aids 4 Interpreter Services 7 • • Job Club 9 Job Coaching 6 Job Placement • J9 Job Seeking Skills Training 9 Job Shadowing 2 Job Site Evaluation • 2 Job Site Modification g Maintenance 7 Medical AndDental Care 4 Medical Equipment 4 Medical Evaluations 2 Non-Medical Assessments 2.3 Noteraking Services 7 Eslablished.October I, 1998 Effective January I. 1999 Revised Ianimry L 2000 • DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS b INDEX On-The-Job Training Orientation and Mobility Evaluation 6 Orientation and Mobility Training 53 5 Personal Adjustment Evaluation Personal Adjustment Training 3 Personal Assistance Services Physical And Mental Restoration Services 7 Prosihetic/Orthotic Services 4 Eyeglasses.Contact Lenses,and Ocular Prostheses Hearing Aids 4 Prosthesis,orthotics,braces,and supports 4 Wheelchairs 4 Psychological And Psychiatric Evaluations 4 2 Reader Tervices Rehabilitation Engineering 7 Rehabilitation Teaching • R8 Rehabilitation Technology Evaluation 5 Rehabilitation Technology Services - 3 Assistive Technology Device Assistive Technology Service 8 Job Site Modification 8 Rehabilitation Engineering 8 Residential Modification 8 Vehicle Modification 8 Residential Modification 8 8 Self-Employment Services Service 9 Service Provider Service Settings Community-based Facility-based Services To Members Of An Applicant's Or Eligible Individual's Family I Situational Assessment 7 Job Shadowing Job Site Evaluation 2 Work Experience 2 Skill Training--Other - 2 Standardized Vocational Evaluation 5 Supplemental Evaluation 2 Supportive Services 2 Maintenance 7 Personal Assistance Services - 7 Services To Family Members 7 Transportation 7 7 Established Ortnher I I99R __ k • • DIVISION OF VOCATIONAL REHABILITATION SERVICE DEFINITIONS c • INDEX Training Services Academic Training \ .n 5 Adjustment Training - Other Training Services 6 Training Support Services 6 Vocational Training 5 Training Supplies 6 • Training Support Services 6 Transportation 7 Trial Work Experiences • , 6 Tutorial Services 6 Vehicle Modification \. 8 Vocational Evaluation - 2 Vocational Training a • Wheelchairs - • 4 Work Adjustment Training Work Experience 2 • • • Established October 1, 1998 Effective January I, 1999 eitt Memorandum - F•t r lfl Inge TO: David E. Long, Chair Board of County CommisEoners COLORADO FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and /' Environment /}/<� o)V �� DATE: January 8, 2003 "� SUBJECT: Division of Vocational Rehabilitation Provider Agreement Enclosed for Board review and approval is a provider agreement between the State of Colorado, Division of Vocational Rehabilitation (DVR) and Weld County. The Division of Vocational Rehabilitation has requested Weld County Department of Public Health and Environment provide immunizations and office visits related to these immunizations to DVR clients. This provider agreement outlines the terms and conditions under which WCDPHE will provide the services. Fees charged to the DVR will be according to current Health Department fee schedules as approved by the Board of County Commissioners. If approved, the agreement will be effective on the date signed by the State Official and it will remain in effect as long as all of its requirements, provisions and conditions are being met and at least one service is purchased in a three-year period. I recommend your approval of this provider agreement with the State of Colorado, Department of Vocational Rehabilitation. Enclosure 2003-0157 Hello