From Mark Peterson, Virginia Department for Aging and Rehabilitative Services:

Virginia VR is in the process of operationalizing CE throughout the State. CE is occurring in certain areas, but we are interested in creating teams made up of VR and Partners to have available for our most severe consumers.

From Kellie Scott, KY-OVR:

We incorporated customized employment into our Supported Employment Service Fee memo last year. Although we are a general agency the blind agency is able to use our Service Fees. I will send that attachment.

Attachments: 1

From Mike Hermanson, Montana VR:

Montana for the most part pays for CRP services on an hourly basis and any customized employment services are paid on the regular hourly basis.

March 29, 2016 admin Comments Off on — (03/29/2016) Are any states incorporating Customized Employment as a paid service into their job placement contracts? Any information will give NYSCB a better sense of how to help our consumers & agencies obtain work opportunities.

From James Gears, Opportunities for Ohioans with Disabilities:

No, Ohio VR only accepts Cost Reimbursement cases. We have in the past taken Tickets as an Employment Network (EN) but found that there was a significant risk and loss of revenue due to cases being mis-labelled or Consumers going on to work above SGA after initially reporting an interest in part time work.

From Shanti Aaron, Georgia Vocational Rehabilitation Agency (GVRA):

No, Georgia does not have a PP agreement that involves milestone payments.

From Linda Lingen, Organization: MN State Services for the Blind:

We do not at this time use any milestone payments – only cost reimbursement payments.

From Nelva Sneed, DARS-Division for Rehabilitation Services (Texas):

The Department of Assistive and Rehabilitative Services-Division for Rehabilitation Services uses the cost reimbursement system only.

From Richard Clark, Iowa Vocational Rehabilitation Services:

Iowa used to do the milestones but went away from it a couple of years ago.  We now just do the cost reimbursement.

From Gina Haupt, Division of Vocational Rehabilitation:

Wisconsin is Cost Reimbursement only. We have one agreement that we use and we currently have an agreement with 8 different EN’s. We are hoping to expand and get more agreements. All Partnership Plus agreements are with vendors of VR so we know they are quality providers.

From Veronica A. De Leon-Dowd, NM DVR:

NM does not do this.

From David Leon, DARS (VA):

I am the ticket to work coordinator for the Virginia Department for Aging and rehabilitative services. The nature of Partnership Plus implies that the VR agency has chosen cost reimbursement for that case. As a state VR agency that at times also acts as an Employment Network, we occasionally choose to assign a clients ticket rather than place it in use SVR. In these cases, we do have a revenue sharing agreement in place for the ticket revenue, but in Virginia, we view this as an administrative EN agreement, not Partnership Plus.

July 28, 2014 admin Comments Off on — (07/28/2014) Are any states using a milestones payment system for PARTNERSHIP PLUS instead of cost reimbursement? Partnership Plus is an agreement between VR agencies and Employment Networks to provide ongoing job support services for Ticket-to-Work customers. After a VR customer’s case is successfully closed, a designated EN is able to provide various job retention and support services directly to customers. The various allowable services directly assist the customer in maintaining employment and increasing earnings.

From Douglas Morton, from the Illinois Division of Rehabilitation Services:

Illinois VR has used a milestone payment system with CRP agencies for the last six years. We pay providers 25% of the total amount when an individual achieves 15 days of employment, another 25% at 45 days of employment, and the final 50% when the individual achieves employment stability after 90 days of employment. Milestone contracts account for about a third of our CRP contracts. We also continue to have contracts that pay a lump sum payment when an individual achieves employment stability after 90 days of employment. These types of performance-based contracts have reduced our spending on unsuccessful closures, compared to service-based contracts used in the past. While there was some initial resistance the milestone contracts have proven to be popular with providers. We believe that the interests of the VR agency, the customer and the provider are aligned in this system.

From LuAnn Summers, from WVDRS:

WVDRS implemented Milestone payments in 2008 when we closed our Rehabilitation Center and worked on moving CRP services back into the communities that clients reside. Below is feedback regarding benefits, potential issues and concerns. If you have additional questions please feel free to contact me.

Benefits:

• Ability to pay the CRP throughout the rehabilitation process

• Ensures follow up of services from the CRP

• Provides regular on-going updates to the counselor as the CRP must send in required paperwork with the invoice during the process

• Reimburses the CRP for services provided and does not punish them if through no fault of theirs if the client is not successful

• Better promotes the counselor being a part of the rehabilitation process making decisions along the way

Potential issues:

• During implementation there was initial confusion regarding making payments for services provided if the client was not successful

• Must ensure that time lines are reasonable for the CRP and the client to ensure that follow up is being done in a timely manner for the client and enables the CRP to provide the services within reasonable time frame

• Having the ability to train all new and existing staff prior to implementation/utilization of services and update on regular basis

• This milestone system does require the counselor to be on top of the case to be a part of the decision making throughout the rehabilitation process

Concerns:

We really did not have any major concerns. We researched how other states were implementing services along with fees for those services and utilized those aspects that would work well in WV. After implementation we reviewed utilization reports and met with each district to discuss utilization and determine why certain services were utilized more than other and made some tweaking along the way. We had one service, community based assessment, that we had made milestone that just did not seem to work well for milestone payment so we did go back and change it to an hourly rate. You will have to follow the process after implementation to ensure it is providing your clients and counselors with the type of outcomes you are hoping to obtain.

Attachments: 1

From Tim Gravier, Missouri VR:

The benefit is that it’s “outcome based” and as an agency, you can define the outcome parameters. The issue faced is a third party verification of the outcome or a very reliable source of verification.

From Don Kay, WA-DVR:

WA-DVR has used an outcome-based CRP contract for a number of years. Here is a link to the current contract that is on our website:

http://www.dshs.wa.gov/pdf/HRSA/dvr/CRP/CRP_Sample_Contract.pdf

Let me know if youhave any questions.

From David Higginbotham, Louisiana Rehab Services:

For each Milestone: 1) Clearly define the parameters (e.g. related activities, time frame); 2) Specify the quality indicators for each Milestone (e.g. standards for service delivery, doucmentation of services; and 3) Specify the standard(s) that must be met for the CRP to recieve payment for services.

May 27, 2014 admin Comments Off on — (05/27/2014) IDVR is evaluating a Milestones(outcome-based) payment system for CRPs. I would like feedback from other VR programs who use or have evaluated a Milestones payment system in order to better understand potential issues, concerns, and benefits. The purpose of evaluating and possibly changing our payment system is to improve service delivery, job placement, and retention of VR clients.

From Jennifer Beilke, MN State Services for the Blind:

MN Services for the Blind (SSB) has a vendor monitoring system that monitors CRPs a minimum of every three years. Additionally, SSB conducts customer satisfaction surveys specific to CRPs providing adjustment to blindness training services.

May 13, 2014 admin Comments Off on — (05/13/2014) What practices do states use for quality assurance of CRP services? I am particularly interested in examples of consumer satisfaction surveys specifically related to CRP services. This information will help to provide information for assessing the strengthens and weaknesses of the CRPs providing services. In particular, it will assist in getting the consumer perspective on CRP services.

From Karon Grandon, Arizona RSA:

Yes, we contract with CRPs for many services for both VR and IL.

From Janet Cool, Opportunities for Ohioans with Disabilities:

Ohio established Fee Schedule for VR services as part of our administrative code: OAC 3304-2-52 (Appendix) that outline rates and service delivery requirements. Please find attached the portion of our VR Manual that addresses these areas. We are also attaching a copy of our current Provider Agreement form. We are currently in the process of reviewing this administrative rule and making changes. OOD does not purchase Supported Employment as a separate service, however, any VR service can be provided to weave a fabric of services to ensure the Consumer’s needs are met.

Attachment: 1, 2

From Michael Shoemaker, Utah State Office of Rehabilitation:

Utah’s Vocational Rehabilitation program uses a milestone program to pay CRPs for providing supported employment. As this inquiry lends itself to wanting to view policy I am attaching chapter 22 of our case service manual for the details in how we work with clients that receive supported employment.

Attachment: 1

October 15, 2013 admin Comments Off on — (10/01/2013) We’re interested in finding out how other states are handling contracts for services with Community Rehab Providers (CRPs). This includes contracting with vendors to provide services for programs such as VR and IL. We’d like to see some models, policies, procedures and contract templates if possible. And, if states are not contracting out but providing these services through in-house staff, that would be helpful to know as well. We’re also interested in learning if there’s anyone contracting on a fee for service basis for supported employment services. If so, it would be great if they were willing to share the model, policies, procedures on that. Additionally, if someone has a particularly successful Supported Employment program we’d love to see their model (fee for service or otherwise). Information will be used to formulate policy that will our agency increase the efficiency and effectiveness of services provided through Community Rehabilitation Programs. Thank you!