Last update: May 2016
TABLE OF CONTENTS
- 1.0 - OUTREACH
- 2.0 - INTAKE / NEEDS ASSESSMENT
- 3.0 - ELIGIBILITY DETERMINATION
- 4.0 - PLAN DEVELOPMENT
- 5.0 - SERVICE PROVISION
- 6.0 - INVOICING
- 7.0 - PROGRESS / SERVICE DOCUMENTATION
- 8.0 - CLOSURE
This manual is designed to provide Rehabilitation Specialists with guidelines and procedures for case management of the Children’s (CP) Program. The following case management responsibilities are addressed in this guide:
- Intake / Needs Assessment
- Eligibility Determination
- Plan Development
- Service Provision
- Invoicing (For Contracts, Authorizations, Etc.)
- Progress / Service Documentation
- Additional Requirements (QA, Surveys, Monitoring)
The focus of the Children’s Program (CP) is to provide Information and Referral services, Parent Education, and Preparation for Referral to the Transition Program. Children’s Program Rehabilitation Specialists serve eligible children who are blind or visually impaired so that their families can be informed advocates for their child. Successful outcomes enable the children to participate in the Division of Blind Services Transition Program or other appropriate community programs.
The Children’s Program supplements services offered by the public school system to foster the child’s learning and ability to function as independently as possible. The student’s caregivers are critical team members to prepare their child for the greatest degree of independence as an adult.
Outcome goals for the Children’s Program may include:
- Functional and household management skills integrated into daily routines
- Self-advocacy skills
- Promoting developmentally and/or age-appropriate recreation and leisure skills
- Promoting developmentally and/or age-appropriate awareness, participation in work and work-related activities, and career exploration
- Transition to Division of Blind Services Vocational Rehabilitation Transition Program, appropriate school programs, and/or other community programs
1.0 - OUTREACH
Outreach activities are to inform and educate community organizations and the public in order to obtain referrals for individuals who may be eligible for DBS program services. Activities include staying in touch with key community organizations that are able to identify and refer potential clients. Outreach follow-up activities can include personal contacts, phone communication, news releases, mail-outs, special events, Public Service Announcements (PSAs), etc.
2.0 - INTAKE / NEEDS ASSESSMENT
2.1 - Referrals
An individual may be referred to Division of Blind Services by letter, telephone, in person, or by other means. Referrals may be directed to either a designated support staff member in the local office or directly to the Rehabilitation Specialist as determined by the District Administrator. The Rehabilitation Specialist will be responsible for contacting or attempting to contact the parent/guardian within ten working days of receipt of the referral. All contact attempts should be documented in the electronic case management system, AWARE. The DBS Referral and Application for Services is completed at this time (Appendix 1, DBS-001).
2.2 - Applicants
The Rehabilitation Specialist will talk with the family to describe the services available through the Children’s Program. If the child’s parent/guardian makes the referral or contact is made to confirm interest in services, the case is then in Applicant status. Intake information will be entered in the Participant Module of AWARE. The initial interview may be scheduled at this time.
2.2.1 - Initial Interview
The purpose of the initial interview is to gather information about the child, family and to determine the need for specific DBS services. The face-to-face initial interview is preferred and should occur within 30 days of receipt of the signed application or from the applicant status date. If a face-to-face initial interview is not possible, a phone interview is acceptable.
The initial interview documentation may be a narrative or completion of the initial interview form in the AWARE Letters section. The choice is the Children’s Specialist’s decision. This documentation will include the family and child’s current priorities and concerns. Background information important to the family or critical in planning for school/social success should be included. Plans for services and issues the Rehabilitation Specialist determines are priorities should also be included. Three optional Initial Interview forms are included in the Appendix to assist the Specialist in covering information needed from the parent/guardian or child (Appendix 2A, 2B and 2C). The following items will be included in the documentation for the Initial Interview (II) or in other sections of AWARE:
- Date and location of meeting and those present
- Child’s living arrangements, parent/guardian’s names, and legal status
- Emergency contact information
- Insurance Information, as needed
- Caregivers or guardian’s contact information
- School information - List school name and Vision Teacher, if known
- Tentative services to include in the client’s plan
- ENA Application, if requesting services based on income (Appendix 3)
- Signed Consent for Release of Information for eye medical and other (Appendix 4)
- Documentation that Client Rights were provided (Appendix 5)
- Signed Referral and Application for Services (Appendix 1)
3.0 - ELIGIBILITY DETERMINATION
3.1 - Eligibility Criteria
The following criteria are required for an applicant to be eligible for the Division of Blind Services Children’s program:
- The presence of a bilateral visual impairment which, with best correction for that individual, constitutes or results in a substantial impediment to the child’s ability to learn, function independently, and
- A reasonable expectation that services may benefit the child and family in terms of education, independence, and transition.
3.2 - Certificate of Eligibility
The Division of Blind Services provides services for children and their families when the child is diagnosed with a bilateral visual impairment which will affect the child’s ability to learn through visual medium, or to function independently in the home or school.
Eligibility must be established within 60 days after application status for Children’s Program participants. Any cause for delay in eligibility must be documented in AWARE. A Certificate of Eligibility must be developed and should contain:
- A description of the bilateral visual impairment and its effect on the child’s learning.
- A description of any other special needs should also be included, if present.
- A description of how the services will benefit the child/family.
A hard copy of the Certificate of Eligibility must be printed and signed by the Children’s Program Rehabilitation Specialist or supervisor managing the caseload. The signed Certificate of Eligibility should be placed in the first section of the participant’s paper file.
Information from other sources may be used to support visual eligibility. Children applying for services who are already served by the public school vision programs have an eye report within the last three years on which school eligibility was based. This eye report may be used to determine eligibility. Social Security referrals include an eye medical report which may be used to determine eligibility. The eye medical information should be entered into the AWARE file to support eligibility determination. Eye medical documentation should be placed into Section 3 of the client’s paper case file.
A licensed ophthalmologist or optometrist’s report is required to make an eligibility determination. Requirements for the Ophthalmology reports are included in Policy 2.31 (Appendix 5). If no eye medical is available, and no other means of determining eligibility exists, the Rehabilitation Specialist should attempt to secure eye medical documentation utilizing comparable benefits (e.g., insurance such as Medicaid). When no comparable benefits are available to fund the examination, the Rehabilitation Specialist may request the District Administrator’s approval for DBS to sponsor a diagnostic eye examination. Written documentation of no comparable benefits available and a signed Economic Need Application (Appendix 3 and 3A) must be in place prior to DBS sponsorship of any diagnostic eye medical. The eye medical information should be updated every 3 years on each Children’s Program participant. The Rehabilitation Specialist should be aware that the public school vision program requires an updated eye exam every three (3) years to maintain placement (Appendix 7A and 7B. This report could be utilized as the update required in AWARE. Exceptions in updating the eye medical report will be allowed when documentation of No Light Perception in a Case Note titled Exemption from Eye Medical Update.
3.3 - Ineligibility
An Ineligibility determination will not be made before entering the client into application status in AWARE, even if the referral is accompanied by an eye report that clearly describes the client as not eligible. Therefore, do not determine any client ineligible without first entering the referral into the application status in AWARE. Once entered as an applicant, then the Certificate of Ineligibility signed by the Children’s Rehabilitation Specialist must be completed.
If ineligibility is established, then an Ineligibility letter is mailed to the parent/guardian with a copy of the Client Rights enclosed. The Certificate of Ineligibility will have to remain in Draft status in the Aware case management system, as entry of a date will change the case status to Eligible. A copy of the signed Certificate of Ineligibility and a copy of the letter to the guardian should be placed in the paper file.
A Certificate of Ineligibility is required when closing a case from Application status unless the parent/guardian decides at that time, that they are not interested in proceeding with the process. If this occurs then the parent’s decision should be documented in a case note outlined in the closure section (6.2) and closure report.
4.0 - PLAN DEVELOPMENT
After an Applicant has been determined eligible, the Rehabilitation Specialist is ready to develop the Plan of services. The Rehabilitation Specialist has determined, along with family input, which services are desired by the family and can be provided by the Children’s Program. The Initial Interview or subsequent contacts should justify the need for the services. Once the plan is approved, the case moves to Service status. The Rehabilitation Specialist should print two (2) copies of the plan. The two (2) Plans should be sent to the caregiver/guardian for their review and signature. A copy of the Client Rights should be sent with the initial and each new Plan. One copy of the Plan is included for the caregiver/guardian to sign and return to the Rehabilitation Specialist. The second copy is for the parent/guardian to keep for their records. The cover letter for the plan should be entered in a Case Note in Aware. An additional case note is required when the signed plan is received by the Rehabilitation Specialist. The Rehabilitation Specialist is responsible for ensuring the signed signature page is returned. The plan is not complete without the parent/guardian’s written agreement.
A DBS plan for services must be developed within 60 days of establishing eligibility. The Rehabilitation Specialist must document any reason for delay in a case note.
Plan amendments will take place as new service needs arise or when the previous plan expires. All subsequent plans must be signed by the parent or guardian. A copy of the Client Rights will be sent with each plan developed for the client.
4.1 - Duration of Services
Plans in the Children’s Program will have a start date determined by the Rehabilitation Specialist. The beginning date is usually the date the plan is written. The end date will be the day the participant turns 14 years of age. AWARE will automatically enter the month and day the client turns 14 years old in the Expected Plan End Date. The exact beginning and ending dates of services must be entered by the Rehabilitation Specialist. The plan can be amended or extended through age 21, as needed. If the participant is older than 14, the Rehabilitation Specialist will have to enter the Expected Plan End Date.
5.0 - SERVICE PROVISION
5.1 - Contact Requirements
Primary services provided in the Children's Program include information and referral, advocacy services, and parent education. The Children's Program Specialist may attend IEP meetings, doctor appointments or meet with parents as his/her schedule permits. Parents and guardians will have primary responsibility to contact the Children's Specialist with requests or concerns. The Children's Specialist should be familiar with community resources and requirements to enable appropriate referrals to be made to area programs. Provisions of any services should be documented as a Case Note in AWARE.
The Rehabilitation Specialist will contact families once per year. The Specialist may have more contact as his/her schedule permits. The contact may be face to face with the parent or child, by phone contact with parent, or by letter. The current contact information should be confirmed. If the parent reports problems or challenges, the Specialist should assist with problem solving discussion and/or planning. The client's current school placement, grade, and Teacher of the Visually Impaired (TVI) name can be useful information if problems arise. This will provide the Specialist with a direction to address the issues concerning the parent if they concern school issues. The parent should be encouraged to contact their TVI should the problem concern the school. Facilitating communication between home and school can solve issues before they become problems. If the parent is having a problem with the TVI, the Specialist should use his/her judgment on the best course of action. The Specialist should notify/remind the parent/guardian that they will be responsible for contacting the Specialist should problems arise outside of annual contact.
5.2 - Transition
Beginning at age 12, the Rehabilitation Specialist will begin to familiarize the client and family with the eligibility criteria, goals, and services available through the Division of Blind Services Transition Program.
Families will be told a new eligibility determination will be required due to different eligibility criteria.
When a client will reach 14 years of age during the Transition contract year, the Children’s Program case should be staffed with the Transition Counselor at the beginning of that contract year. This staffing must, at minimum, include the Children’s Program Rehabilitation Specialist and Vocational Rehabilitation Transition Senior Specialist. If the client is determined appropriate for the Transition Program, the Rehabilitation Specialist will obtain parental/guardian agreement and close the Children’s Program case. The Children’s Program Specialist will make a referral to the Transition Program. Should it be determined the participant is not appropriate for Transition services, the case may remain in the Children’s Program through the participant’s 21st year. (For those participants of transition age remaining in the Children’s Program, it is required that the Children’s Specialist place a quarterly update into the AWARE file justifying why the participants are remaining in the Children’s Program.) The Transition staffing results must be documented in the client’s AWARE case file in a Case Note. If the case is to be closed, the Specialist should follow the closure procedures in 8.1 of this manual.
5.3 - Purchase of Goods and Services (Based on the availability of funds)
When goods or services are needed by Children’s Program participants, the Rehabilitation Specialist must justify the need and determine if there are comparable benefits that can sponsor the cost. If no comparable benefits are available and the Specialist feels DBS funds would be used appropriately, an AWARE case note should be entered justifying the need for the service and outlining other resources investigated and found to be unavailable. If use of DBS funds is being considered, an Economic Need Application must be completed (Appendix 3 and 3A, DBS-007). Then a new Plan of Service must be amended to include the service, approved by the District Administrator, and signed by the guardian. The Rehabilitation Specialist may then submit an authorization request with its justification for review by the District Administrator. If the Plan and the authorization are approved, the authorization may be issued. If equipment is purchased, the participant’s file must include the Client Equipment Receipt & Inventory Record (Appendix 9, DBS-108) signed by the participant’s guardian. The Rehabilitation Specialist is often asked to purchase low vision devices. The Policy on Low Vision Assistance (Policy 8.17) is in Appendix 8. The Florida State University Low Vision Initiative is most often used. A program description is in Appendix 10.
NOTE: DBS will obtain receipts from client’s when we give them direct maintenance checks so we can verify the money we gave them was spent. Receipts should be scanned into Attachments with the summary line stating:
“Receipt Auth#____”. If the client does not provide a receipt, counselor will document a counseling session indicating this is a requirement and that client may not directly receive maintenance in the future if this continues. If client does not provide a receipt the second time, counselor and supervisor will counsel with client and indicate that additional maintenance must be made directly to the vendor. Part of the VR program is to teach responsibility and that this is a team effort. Expecting a client to provide a receipt is a very reasonable expectation given the program they are involved in.
- Transportation: Try to pay the cab company directly. If not instruct client to obtain for cost of trip from the driver. If client uses a friend/family and pays gas, the friend/family needs to get gas receipts for client to turn in. No gas receipts no maintenance to reimburse friend.
- Accommodations for activities such as Family Café, etc: Hotel receipt must be provided to DBS as soon as client and family return from event
If the client does not spend all the money provided, they will be required to reimburse us the difference via a money order. Also please remember that every first effort should be made to pay vendors directly, rather than via maintenance checks.
5.4 - Economic Need Guidelines
The Economic Need Application (DBS-007) is only required when services based on income are being requested. Clients being provided services that require economic need eligibility must complete the first page of the Economic Need Application (Appendix 3 and 3A, DBS-007). Once the family income is determined, the Rehabilitation Specialist will update any appropriate screens in AWARE and enter the results in a Case Note. Children who receive Social Security or Medicaid benefits automatically meet the criteria for services based on income.
Assistive Technology is infrequently provided due to budget constraints. The Rehabilitation Specialist can discuss specifics with their Supervisor. Public schools may proceed with assessments and devices (Appendix 11).
All services in the Children’s Program are based on economic need eligibility and as DBS funds are available. Exceptions to this may be approved by the District Administrator as justified and as funds are available.
6.0 - INVOICING (If funds available to purchase goods/services)
(Policy 6.1 addresses who has authorization to draft, issue and invoice authorizations.)
- Rehabilitation Specialist determines that a particular service is necessary and directs appropriate staff to develop an authorization.
- If the service is already on the plan, then a case note will be created by the counselor regarding the justification for the authorization.
- If the service is not on the plan, then a case note will be created explaining the need to amend the current plan.
- Once the plan has been amended and approved, then the plan must be signed by the client before services can proceed.
- Once the plan has been signed, a case note is created regarding justification for the authorization.
- Assigned staff will create the authorization
- Once the authorization has been approved, the authorization will be sent/faxed to the vendor with a request that the authorization be signed and returned to the issuing Division of Blind Services office by the vendor along with an invoice.
- Once the service has been rendered, the authorization will be signed by the counselor (appropriate staff if counselor is unavailable, Policy 6.1) and the payment process. . .
- The authorization with invoice will be sent to Tallahassee for payment. Each copy of the authorization with its invoice should be stapled at the top left-hand corner.
- A copy of the authorization and invoice (and the DBS 108, Client Equipment Receipt and Inventory Record, which can be found in the “O” Drive/FORMS/Client Services Forms, if appropriate) are stapled together and placed in Section 4 of the client’s paper file.
- All vendor invoices must be signed in the lower right-hand corner by the assigned staff member or Supervisor.
- Reports that correspond to the invoice (doctor’s report, evaluations, etc. will be placed in the case notes section of the electronic file and/or in Section 3 of the paper file).
7.0 - PROGRESS / SERVICE DOCUMENTATION
As a significant portion of the services in the Children's Program are provision of training and information, documentation is critical. Contact with families, teachers, or other programs on a participant's behalf should be followed with a case note entered into the AWARE case management system. Letters or emails should either be copied or summarized in a case note in AWARE. Case files (including electronic and paper) will be reviewed periodically by the District Administrator (Appendix 12). A paper file is maintained by the Rehabilitation Specialist which will have the following items included:
- Signed Referral and Application for Services (DBS-001)
- Completed/Signed Economic Need Application, if required (DBS-007)
- Signed Authorization for Release of Medical Information (DBS-017)
- Eye Medical documentation supporting client’s eligibility
- Signed Equipment Receipt and Inventory Record, if needed (DBS-108)
- School information such as IEPs, etc., Low Vision Evaluations, etc.
- Other as required by the District Administrator
8.0 - CLOSURE
Upon completion of planned services, the case is ready to be assessed for closure. All Children’s Program Closures should have a closure justification entered as a Case Note. The AWARE Closure page completion is also required. A letter to the parent or guardian outlining the reason(s) for closure, including the Client Rights, is required for all closures.
8.1 - Closure – Goals Met
The Rehabilitation Specialist and the caregiver/guardian must concur that the objectives of the plan have been met and no further Children’s Program services are required. If substantial services have been provided and contact with the family is not possible, the case may be closed as Goals Met. Case documentation will then be completed to fulfill the requirements of the successful habilitation of the case. The Closure justification will outline a summary of the following information pertaining to the case:
- Eye and other conditions effecting the child’s education, as appropriate
- Summary of services provided
- All equipment purchased by DBS
- Training for any equipment given to the client
- What will happen to the equipment after closure
- Recommendations to Transition Counselor if Transition referral will follow
8.2 - Closure - Not Habilitated
When planned services have been interrupted prior to substantial delivery and/or the expiration of the plan, case documentation will be completed that documents the reason(s) for closure. A closure letter sent to the family along with the Client Rights (Appendix H, Rights Provided under the Children and Families Program) will then be sent to the last known address prior to closure of the case. A closure report must be completed in AWARE in a case note titled Closure-Goals Not Met and will outline the reasons for the closure.