An authorization for vocational rehabilitation services reflects DVR’s commitment to pay for specific goods and services rendered in accordance with the terms and conditions of the authorization. Any service paid for in part or in whole by DVR shall be authorized by the DVR counseling team prior to its initiation, with written supervisory approval when necessary. When prior written authorization is not possible, or a prior authorization does not get completed due to error, the individual’s service record shall document this and a supervisor will review to determine whether it is appropriate for DVR to pay for the good/service.
Once an IPE, Business Exploration Agreement (BEA), or Trial Work Experience (TWE) Plan has been developed and signed by the individual and DVR Counselor, no service or good may be authorized unless it is identified in the applicable plan while the plan is in effect; or if it falls into one of the exceptions to prior authorization. The counselor shall document in the service record all services/goods provided without prior authorization and the circumstances of the exceptions.
The DVR Counselor and individual shall work collaboratively to identify a comprehensive set of necessary services to be included in the individual’s plan for the achievement of an employment outcome. However, DVR is restricted from purchasing, or reimbursing others for the purchase of, the following goods and services under any circumstances:
● Firearms
● Ammunition
● Vehicles licensed to operate on public thoroughfares
● Land or buildings
● Marijuana or psilocybin in any form, or related equipment
● Payments directly made to an employer in the marijuana or psilocybin industry
In the event that DVR is restricted from purchasing and/or reimbursing for a good/service, the DVR Counselor shall assist the individual in finding other avenues to obtain the good/service when it is considered necessary and appropriate to reach the employment objective.
Payment for a vocational rehabilitation service provided before it was authorized may only be made in the following circumstances:
● To meet an urgent vocational rehabilitation need.
Vocational rehabilitation services authorized and paid for to address an emergency situation shall be limited only to those services and goods that are necessary to meet the immediate need that cannot be authorized under DVR’s normal procedures.
● To pay for unanticipated medical procedures.
When medical diagnostic or treatment procedures have been pre-authorized and, during the course of medical examination or treatment, an additional procedure(s) and/or vendor was needed to accomplish the pre-authorized medical service, payment may be made for the additional procedure(s) and/or vendor without preauthorization. Such circumstances are limited to those where the initial medical practitioner is unable to determine the exact scope of examination or treatment until medical services begin and the additional procedure(s)/vendor is necessary for the completion of the examination/treatment procedure(s) that has already been preauthorized.
● Following premature cancellation of an existing authorization.
When vocational rehabilitation services have been preauthorized and the authorization balance has been prematurely canceled before all covered services or goods have been completely provided, payment for the remaining vocational rehabilitation services may be paid for under a new authorization, even though the service or good was rendered before the new authorization was prepared.
● To pay for medical records.
When DVR requests medical records, it may be unclear whether the entity providing the records will require payment. If payment is requested, an authorization shall be completed as soon as possible following receipt of the invoice and medical records.
Payments for DVR goods and services rendered before the beginning date of service on a corresponding draft authorization shall be approved in writing by a supervisor, following the agency approved authorization exception process. The DVR counseling team shall provide the District Supervisor with all necessary documentation to support payment requests, including:
● The draft authorization for the vocational rehabilitation service for which payment approval is being requested.
● The vendor’s bill for the provision of goods and services.
● An explanation about why a prior authorization was not prepared.
Payment for services and goods by DVR shall only be made to providers who are registered in accordance with purchasing requirements and meet required standards.
Payments to individuals shall only be approved when no alternatives exist. All direct payments to individuals receiving services shall be authorized, including authorization amendments, in accordance with the established supervisory approval process. Authorizations to individuals shall not circumvent state purchasing rules or DVR purchase procedures and shall not be broken down into several small amounts to avoid the supervisory approval process. All requests, approvals, and supporting documentation shall be fully documented in the individual’s service record. Examples of supporting documentation may include:
● Why a vendor is not available.
● Research completed for maintenance/rent.
● Why the individual cannot use public transportation.
Regardless of the amount, DVR staff shall ensure all receipts/invoices are attached to the corresponding authorization for direct payments to individuals receiving services. DVR staff shall maintain copies of all warrants and attach these, with the remittance advice, to the corresponding authorization in the service record. DVR staff shall also ensure the individual signs the approved form to acknowledge they received the warrant. All corresponding documentation shall be placed with the authorization in the service record. Similarly, when the direct payment to an individual involves goods, the individual shall sign the agency approved form, documenting receipt of the goods.
In rare cases when an individual does not have available funds for a purchase and a direct payment to the individual is necessary so the individual may purchase the good or service, a final receipt(s) shall be provided by the individual within seven business days unless otherwise specified on the agency approved form.