SOCIAL AND HEALTH SERVICES
(Health and Rehabilitative Services Administration)
Preproposal statement of inquiry was filed as WSR 02-01-130.
Title of Rule: The Division of Vocational Rehabilitation (DVR) is proposing new chapter 388-892 WAC, Purchase of services -- Selection criteria -- DVR Vocational rehabilitation service contractors.
Purpose: Repealing WAC 490-500-520 Purchase of services -- Selection criteria -- Community rehabilitation programs; and establishing new rules regarding DVR's contract purchase of vocational rehabilitation (VR) services from independent community-based VR service providers.
Statutory Authority for Adoption: RCW 74.29.020(8).
Statute Being Implemented: Chapter 74.29 RCW, RCW 74.29.020, 34 C.F.R., Part 361.51.
Summary: The proposed rules define the process by which DVR may purchase client vocational rehabilitation (VR) services through contracts with community-based providers of VR services. Outcomes include a quality assurance component for contract VR service providers and increased effectiveness and efficiencies in the expenditure of DVR case services dollars.
Reasons Supporting Proposal: Current rules have not been updated for more than fifteen years. Many do not meet current nationally recognized professional standards for community-based providers of VR services nor do they reflect current quality expectations of individuals, and their supporting family members, who receive DVR services.
The new rules will conform to state statutes requiring criminal background checks for providers of human services to vulnerable adults. Federal regulations require DVR to provide individuals receiving DVR services with information about the effectiveness, efficiency and customer satisfaction results of community-based service providers whom they may choose to receive services from. The new rules will enable individuals receiving DVR services to make more informed decisions regarding their service delivery options.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Connee Bush, Ph.D., DVR Headquarters, 612 Woodland Square Loop S.E., Lacey, WA 98503, (360) 438-8013.
Name of Proponent: Department of Social and Health Services (DSHS), governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: See Purpose, Summary, and Reasons Supporting Proposal above.
Proposal Changes the Following Existing Rules: Repeals WAC 490-500-520 and replaces it with new chapter 388-892 WAC, Purchase of services -- Selection criteria -- DVR Vocational rehabilitation service contractors. See Purpose, Summary, and Reasons Supporting Proposal above.
A small business economic impact statement has been prepared under chapter 19.85 RCW.
DVR does not license VR service contractors. VR service contractors operate as independent businesses to offer direct client rehabilitation services for potential purchase by various private and public customers - including DVR. However, as DVR clients are defined as the state's most vulnerable persons, DVR's proposed WAC determines DVR's quality assurance process and expectations of VR service contractors so that DVR may, if needed, purchase direct client services from VR service contractors.
DVR's quality assurance process and expectations for VR service contractors has not been enhanced for many years. Doing so now is critical to meet the increased quality expectations by DVR clients, their supporting family members, the governor, the state legislature and various public groups advocating for improved quality of services for persons with the most significant disabilities.
DVR's proposed WAC continues DVR's current VR service contractor quality assurance expectations. The main changes involve background checks for VR service contractor personnel and the accreditation organization that DVR has chosen to recognize for accreditation of DVR VR services.
Small Business Economic Impact Statement (SBEIS): Chapter 19.85 RCW requires the economic impact of proposed rules be analyzed in relation to small businesses. An SBEIS is required when a proposed rule may impose more than minor costs that are disproportionate to small businesses as compared to 10% of large businesses affected by the rule.
By definition, small businesses employ fifty or fewer people, are independently owned and established for the purpose of making a profit. Large businesses employ more than fifty people and are also organized to make a profit.
DVR has analyzed potential impacts of its proposed rule on small businesses as defined. The potential impact will be no more than a minor increase in the overall cost of doing business with DVR and will not be disproportionate to small businesses. Regardless, DVR has chosen to complete an SBEIS.
Industry Analysis: DVR maintains a data base of some one hundred fifty-nine VR service contractors that DVR purchases direct client services from. Approximately seventy-five meet the "small business" definition.
Involvement of Small Businesses: Throughout calendar year 2002 and 2003, DVR held twenty-seven public meetings and trainings to provide VR service contractors, including those defined as "small businesses," with information and an opportunity to provide input regarding DVR's proposed rule changes. The meetings included explanations of the potential financial impacts of the proposed rule changes on small businesses. Multiple mailings of the proposed rule changes, and an invitation to provide input regarding the proposed changes and their potential costs, were also sent to all VR service contractors - including "small businesses." The meetings and trainings were well attended. Many responses were positive and suggestions were incorporated into the proposed changes.
Cost of Conformance: DVR's rules have historically required DVR's quality assurance expectations to be met in order for a VR service contractor's services to be considered for potential purchase, if needed, by DVR. The main changes are background checks for VR service contractor personnel, and the accrediting organization that DVR now recognizes for VR services requiring accredited status.
Background Checks: By law, DVR must perform background checks of service provider personnel providing direct services for DVR clients who are considered vulnerable due to their significant physical and/or mental disabilities.
Many VR service contractors already complete personnel background checks because their other public agency customers require this to be done as a condition of purchasing their services. These VR service contractors will be deemed as meeting DVR's quality assurance expectations on this matter.
VR service contractors that do not currently perform personnel background checks and want their services to be considered for potential purchase by DVR will need to meet this DVR quality assurance expectation.
DVR will pay the DSHS Background Check Unit to perform background checks for VR service contractors that do not already do so. Therefore, there will be no additional cost to CRPs in meeting this DVR quality assurance expectation.
Accreditation: DVR's rules have always required accreditation by an "accreditation body as the division shall deem appropriate" if a VR service contractor, irrespective of "size" or tax status, wants their direct client services to be considered for potential purchase by DVR.
Following the authority of its current WAC, DVR now recognizes CARF - the Rehabilitation Accreditation Commission as its chosen accreditation body. Accreditation is a VR service contractor's principal cost in meeting DVR's quality assurance expectations. Some VR service contractors may realize a minor increase (approximately $37 to $277 per year) in accreditation fees as charged by CARF. Others may realize a savings of approximately $123 to $983 per year.
Disproportionate Economic Impact Analysis: DVR purchases direct client services from approximately seventy-five VR service contractors that meet the definition of a "small business" - employing fifty or fewer people and organized for profit. Conversely, large businesses are those that employ more than fifty people and organize for profit.
DVR looked at the possible disproportionate financial impact of its proposed rules on small businesses as compared to 10% of large businesses affected by the rule. There are no VR service contractors that meet the definition of a large business, as defined, so such a comparison was not possible.
Mitigating CARF Accreditation Fees: As mentioned previously, accreditation has always been a rule for VR service contractors and is not a new cost. Some VR service contractors will, however, realize a savings and other a minor increase in the accreditation fee charged by CARF.
Regardless of the minor size of the increase and to be fair to all VR service contractors, irrespective of "size" or tax status, DVR will implement the following mitigation measures to offset any potential increases in accreditation fees:
|•||DVR recognizes that accreditation fees are a legitimate cost for a VR service contractor to do business with DVR. DVR has historically supported VR service contractors in recovering their accreditation fees by actively encouraging them to factor these costs into the fees they in turn charge DVR for potential purchase of their services.|
|&lhlsqbul;||DVR will continue to assure that its fees for purchase of VR services are sufficient to fairly allow a VR service contractor to recover their direct and indirect costs of conforming to DVR's VR service contractor quality assurance standards (including CARF accreditation) and delivery of DVR client services.|
|•||DVR will require CARF accreditation only for those VR services which require accredited status.|
|•||CARF accreditation will not be required for services that are unique to VR service contractor's other customers, i.e. DSHS Division of Developmental Disabilities.|
|•||DVR will provide all VR service contractors with a minimum of two years to obtain CARF accreditation. During this two-year period:|
|&lhlsqbul;||VR service contractors that are not presently accredited by CARF will be free to continue their typical sales transactions with DVR without change or penalty in any form.|
|&lhlsqbul;||DVR will pay for, provide and maintain all VR service contractors with current CARF Standards Manuals and CARF Survey Preparation Guides until they have gained CARF accreditation.|
|&lhlsqbul;||DVR will pay for and host CARF accreditation training for all VR service contractors. The curriculum will be repeated on multiple dates and held at different sites throughout the state to maximize scheduling and travel efficiencies for VR service contractors.|
|Training will be conducted by CARF staff members or peer CARF surveyors. VR service contractors may send as many staff members as they please to any or all of these trainings.|
|&lhlsqbul;||Upon request, DVR will provide VR service contractors with direct technical assistance regarding interpretation and implementation of the CARF standards. Additional coaching may include preparation for a contractor's first CARF survey - including a "mock" survey.|
|Technical assistance will be provided by consultants having current professional knowledge and experience in all aspects regarding interpretation and implementation of the CARF accreditation standards and CARF quality survey process.|
A copy of the statement may be obtained by writing to Connee Bush, Ph.D., DVR Chief of Operations, DSHS/DVR, P.O. Box 45340, Olympia, WA 98504-5340.
RCW 34.05.328 applies to this rule adoption. A cost-benefit analysis of the proposed rules has been prepared, and a copy may be obtained by writing to Connee Bush, Ph.D., DVR Chief of Operations, DSHS/DVR, P.O. Box 45340, Olympia, WA 98504-5340.
Hearing Location: Blake Office Park (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on August 26, 2003, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by August 22, 2003, phone (360) 664-6094, TTY (360) 664-6178, e-mail firstname.lastname@example.org.
Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, mail to P.O. Box 45850, Olympia, WA 98504-5850, deliver to 4500 10th Avenue S.E., Lacey, WA, fax (360) 664-6185, e-mail email@example.com by 5:00 p.m., August 26, 2003.
Date of Intended Adoption: No earlier than August 27, 2003.
June 30, 2003
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit3245.5
PURCHASE OF SERVICES -- SELECTION CRITERIA -- DVR VOCATIONAL REHABILITATION SERVICE CONTRACTS
(1) Vocational evaluation services,
(2) Job placement/retention services,
(3) Transitional employment services.
(1) "Brief" vocational assessment services are:
(a) Paper and pencil tests, such as psychometric testing, personality testing, preference and interest inventories that identify an individual's work interests and abilities; and
(b) Typically completed in one day or less.
(2) Comprehensive vocational evaluation services:
(a) Consist of tests and/or assessment methods designed to measure and document an individual's interests, values, work related-behaviors, aptitudes, skills, physical capacities, learning styles and training needs;
(b) Are performed using a variety of techniques, i.e., assessment of functional/occupational performance in real or simulated environments, work samples, psychometric testing, preference and interest inventories, personality testing, personal interviews and analysis of prior work experience and transferable skills;
(c) Identify at least three employment options that the individual could successfully perform either with or without training and long-term employment supports; and
(d) Are completed in three days or less.
(3) Situational assessment services are:
(a) Experiences in which individuals perform work in an actual paid employment setting or other realistic work setting to identify an individual's unique work interests and abilities;
(b) Conducted over a negotiated period of time depending on the individual's needs.
(2) There are two types of job placement/retention services -- "general" and "specialized."
(a) General job placement/retention services are provided for individuals who need job placement assistance without additional on-the-job supports.
Individuals requiring general job placement/retention services may include, but are not limited to, those who meet one or more of the following conditions:
(i) Graduated from high school or attained a GED;
(ii) Successfully completed some post high school training, such as vocational/technical school or college academic program;
(iii) Have a recent and/or stable work history;
(iv) Were employed at the time of application for DVR services; or
(v) Have a high level of gross motor skills and/or cognitive functioning.
(b) Specialized job placement/retention services are provided for individuals who, as determined by DVR, require a high level of support prior to or during the initial phases of job placement and/or additional supports after job placement to achieve satisfactory job performance and retain the job.
Individuals requiring specialized job placement/retention services may include, but not limited to, those who meet one or more of the following conditions:
(i) Have received SSI/SSDI or other types of public assistance;
(ii) Have received special education services;
(iii) Did not graduate from high school or attain a GED;
(iv) Have little or no work history;
(v) Have not worked in the previous two years;
(vi) Experience significant cognitive or sensory impairments; or
(vii) Have a criminal history and/or are subject to a community protection order.
(1) Level 1 services are provided for individuals who, as determined by DVR, may require a high level of support prior to or during the initial phases of job placement but do not require ongoing supported employment services to maintain their job after DVR closes the case.
(2) Level 2 services are provided for individuals who, as determined by DVR, require ongoing supported employment services to maintain their job after DVR closes the case.
(1) Meet the vocational rehabilitation needs of individuals with severe and persistent mental illness.
(2) Assess and build an individual's skills and abilities in a real work setting.
(3) Utilize the clubhouse programs model/international center for club house development (ICCD).
DVR VOCATIONAL REHABILITATION SERVICE CONTRACT PROCUREMENT
(2) A qualified provider is one that meets all DVR qualifications for a VR service contract as outlined in the RFQ.
(2) DVR may advertise the RFQ in a variety of ways, including but not limited to the DVR website, newspapers, and notices sent to potentially interested contractors.
(3) The scope of work, fee to be paid, and contractor qualifications are defined in a separate RFQ and contract for each specific type of VR service:
(a) Brief vocational assessment,
(b) Comprehensive vocational evaluation,
(c) Situational assessment,
(d) General job placement/retention,
(e) Specialized job placement/retention Level 1,
(f) Specialized job placement/retention Level 2, and
(g) Transitional employment.
(4) Service providers, that are interested in obtaining a VR service contract as outlined in the RFQ, are instructed to submit their qualifications.
(5) First time respondents that demonstrate full conformance to the uniform VR service contract qualifications, as outlined in this chapter, may be granted an initial VR service contract.
(6) DVR may limit the number of VR service contracts it issues in a service delivery area as a result of an RFQ.
INITIAL DVR VOCATIONAL REHABILITATION SERVICE CONTRACTS
(1) Federal, state and local laws and DSHS regulations and policies;
(3) Safety and health;
(4) Liability insurance coverage;
(5) Having a system in place to report the effectiveness and efficiency of the provider's DVR services;
(6) Having a system in place to gather and report DVR customer satisfaction;
(7) DVR code of ethics and standards of practice;
(8) Having a complaint and dispute resolution process in place for DVR customers;
(9) Having current background checks in place for personnel serving DVR customers.
SUBSEQUENT DVR VOCATIONAL REHABILITATION SERVICE CONTRACTS
(a) Continue to meet all uniform VR service contract qualifications;
(b) Have met DVR's performance standards established in the prior VR service contract; and
(c) Meet the additional qualifications for each VR service to be offered.
(2) Contractors that have been granted an initial VR service contract between RFQs have two years from the effective date of their initial VR service contract to meet the additional qualifications outlined in this chapter. If the contractor fails to provide documentation of conformance to the additional qualifications within two years from the effective date of the initial contract, DVR may terminate the existing VR service contract with ten days notice to the contractor.
(2) A separate RFQ is published for each specific type of VR service contract that outlines the additional contractor qualifications that are pertinent to that service.
(a) Qualified as a certified vocational evaluator (CVE) by the Commission on Certification of Work Adjustment and Vocational Evaluation Specialists (CCWAVES); or
(b) Accredited in Comprehensive Vocational Evaluation Services by CARF - The Rehabilitation Accreditation Commission.
(2) Individuals or organizations providing situational assessment services must maintain conformance to all uniform VR service contract qualifications, and be:
(a) Qualified as a Certified Vocational Evaluator (CVE) by the Commission on Certification of Work Adjustment and Vocational Evaluation Specialists (CCWAVES); or
(b) Accredited in employment planning services by CARF - The Rehabilitation Accreditation Commission; or
(c) Licensed in employment services by the department of social and health services (DSHS)/mental health division (MHD); or
(d) Certified by the International Center for Clubhouse Development (ICCD).
(2) There are no additional qualifications for organizations that provide general job placement/retention services.
(3) Organizations that provide Levels 1 or 2 specialized job placement/retention services must also be:
(a) Accredited in community employment services by CARF - The Rehabilitation Accreditation Commission; or
(b) Licensed in employment services by the department of social and health services (DSHS)/mental health division (MHD); or
(c) Certified by the International Center for Clubhouse Development (ICCD).
(1) Maintain conformance to all uniform VR service contract qualifications; and
(2) Be certified by the International Center for Clubhouse Development (ICCD).
DVR VOCATIONAL REHABILITATION SERVICE CONTRACTS -- GENERAL OPERATIONS
(1) DVR identifies geographic VR service delivery areas based on economic cost of living data.
(2) Every two years or on an interval as announced in the contract RFQ, with input received from the service providers, DVR will establish and publish a scheduled of fixed payment fee for each contracted VR service.
(3) All VR service contractors, within each geographic VR service delivery area, are paid the fixed payment fee for each contracted VR service.
(2) VR service contracts may be terminated for cause or convenience at any time by DVR or the contractor in accordance with the terms of the contract. The contractor's administrative remedies shall be limited to those specified in the contract.
(3) Additionally, DVR may terminate all DVR individual case service delivery plans that are open with the contractor at the time their VR service contract is terminated. Termination provisions are outlined in the VR service contracts.
The following section of the Washington Administrative Code is repealed:
|WAC 490-500-520||Purchase of services -- Selection criteria -- Community rehabilitation programs.|