Contract Subject: Orientation and Mobility
The contractor and contractor staff that provide services described in this chapter also must comply with Chapters 1–3 of the VR Standards for Providers manual.
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Orientation and Mobility (O&M) services prepare blind and visually impaired customers to travel independently with competence and confidence.
O&M specialists offer complex, interrelated services designed to develop independent travel skills in individuals who are blind or visually impaired. O&M services begin with an assessment and can include training held in environments frequently visited by customers.
Orientation is the process of using the available senses to establish one's position and relationship within the environment.
Mobility is the ability to travel in the environment with the help of an established tool (including white canes, dog guides, and electronic travel aids).
O&M assessments and training can be provided in locations within the customer's home or community. O&M assessments and training are provided in person and cannot be provided remotely.
Examples of training locations include:
Any request to change a Service Definition, Process and Procedure, or Outcomes Required for Payment must be documented and approved by the VR director, using the VR3472, Contracted Service Modification Request for Blind and Visually Impaired Services, before the change is implemented. The approved VR3472 must be maintained in the provider’s customer case file. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.
For information on acceptable signatures refer to VR-SFP sections 3.2.14 Documentation and 3.2.16 Signatures.
Before services are provided, the service provider director must:
The O&M specialist must meet one of the following criteria:
In addition to meeting the requirements for education, training, and experience described in 5.2.1 Orientation and Mobility Specialist, all prospective O&M providers must successfully complete the Orientation and Mobility Texas Confidence Builders training before becoming providers.
Texas Confidence Builders training is a two- to three-day training program offered in Austin. While the training is provided free of cost, providers must pay all costs associated with attending the training program. Contact the state office O&M program specialist to schedule the training.
To ensure that O&M specialists remain competent in their skills, VR recommends that each O&M trainer complete a minimum of 20 hours of blindfold travel per fiscal year, so that the O&M trainer:
Examples of recommended activities for blindfold travel include:
VR also recommends that O&M specialists:
O&M service providers are ultimately responsible for the monitoring, supervision, and follow-up of the O&M intern during the internship.
O&M service providers using interns to work with vocational rehabilitation (VR) customers must:
The O&M intern must:
Note: VR does not pay for any expenses incurred by the intern during the internship.
The assessment includes an evaluation of the customer's O&M skills in multiple situations in person and cannot be conducted remotely.
Assessments may be conducted using the customer's functional vision. Functional vision refers to the way in which an individual uses whatever vision he or she has in a given travel situation. Assessments provide an opportunity for customers to recognize that their vision might not meet all their travel needs.
Locations for assessments include a combination of:
For Independent Living Services for Older Individuals Who Are Blind (OIB) customers, the OIB worker authorizes a maximum of three hours for the initial assessment to be completed.
The O&M specialist must include in the initial assessment observations of and recommendations on white cane skills. The recommended number of hours allowed for training must include the customer's travel needs, regardless of the mobility tool (dog or white cane). Training with a guide dog must not exceed more than four hours and must be preapproved in writing by the VR counselor or OIB worker.
Recommendations for training must be:
Following the assessment, it is recommended that the O&M specialist reviews the results with the customer and answers any questions that the customer might have about the recommended training.
Any request to change a Service Definition, Process and Procedure, or Outcomes Required for Payment must be documented and approved by the VR director, using the VR3472, Contracted Service Modification Request for Blind and Visually Impaired Services, before the change is implemented. The approved VR3472 must be maintained in the provider’s customer case file. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.
For information on acceptable signatures, refer to VR-SFP sections 3.2.14 Documentation and 3.2.16 Signatures.
The VR counselor or OIB worker completes the VR2897, Orientation and Mobility Referral, leaving no blanks and putting NA (not applicable) as needed. After completion of the form, the VR counselor or OIB worker sends it to the provider that has been chosen by the customer. Included with the referral is information that helps the O&M specialist assess and recommend training for the customer.
The VR counselor or OIB worker is responsible for authorizing an O&M assessment and approving services, including approving the documentation for payment when invoiced.
Based on the results of the O&M assessment, the VR counselor or OIB worker determines the training goal and hours to be funded by VR or OIB. No assessments or training sessions are completed before a service authorization is issued.
After submitting VR2894, Orientation and Mobility Assessment, the O&M specialist must contact the customer's VR counselor or OIB worker to discuss the initial assessment. This discussion must be documented and filed in the O&M provider's customer file.
The discussion includes:
The O&M provider documents in descriptive terms the information required on the VR2894, Orientation and Mobility Assessment, including:
O&M training prepares an individual who is blind or visually impaired to travel independently with competence and confidence.
Based on the results of the evaluation, the VR counselor or OIB worker determines the training goal and hours to be funded by VR or OIB. No training is provided before a service authorization is issued. Training is provided in person and cannot be conducted remotely.
All O&M training services for VR customers are conducted using:
All O&M training services for OIB customers are conducted using:
Any request to change a Service Definition, Process and Procedure, or Outcomes Required for Payment must be documented and approved by the VR director, using the VR3472, Contracted Service Modification Request for Blind and Visually Impaired Services, before the change is implemented. The approved VR3472 must be maintained in the provider’s customer case file.
The O&M specialist must discuss the benefits of nonvisual and visual training with each customer. Role modeling and peer support for nonvisual training are encouraged.
The O&M specialist cannot conduct more than six hours or fewer than two hours of O&M instruction per day. The O&M specialist cannot conduct more than six hours of training in a day, even if multiple customers are served during that day. Billing for O&M services must not exceed six hours per day. Lessons are at least two hours long unless approved by an obtained VR3472, Contracted Service Modification Request.
For Independent Living Services for Older Individuals Who Are Blind (ILS-OIB) customers, the OIB worker allows no more than five hours of training per month. If additional training time is needed because of unexpected circumstances, the O&M provider sends a written request to the OIB worker.
The VR counselor or OIB worker is responsible for authorizing O&M training for the customer and approving services, including approving the documentation for payment when invoiced.
The provider must not bill for any services other than Orientation and Mobility training, or Orientation and Mobility group training.
Based on the results of the assessment, the VR counselor or OIB worker determines the training goals and hours to be funded by VR or OIB. No training is provided before a service authorization is issued.
O&M training must not exceed the total number of training hours and type of training authorized by the customer's VR counselor or OIB worker on the service authorization.
Consistent and frequent scheduling is recommended to maximize learning. One two-hour lesson a week is the minimum training allowable. Daily O&M training is considered best practice.
Time spent transporting customers does not count toward training time. O&M specialists are not reimbursed for time spent in the car, even when a customer is present.
The O&M specialist must notify the customer's VR counselor or OIB worker within 24 hours about all:
If services are interrupted and training cannot be completed as planned, or if services are postponed indefinitely because of unexpected circumstances, the O&M provider must notify the customer's VR counselor or OIB worker within 24 hours.
The O&M specialist must submit required forms and complete the required training under the specifications of the referral and the service authorization.
VR and OIB encourages O&M specialists to coordinate group training sessions (that is, sessions of up to three customers) when it will benefit the instruction process and better meet the needs of the customers.
The O&M specialist must get approval in writing from each customer's VR counselor or OIB worker before providing group training.
An O&M specialist:
Active training—Any customer who is receiving an O&M assessment or is enrolled in O&M training is in active training.
The VR counselor or OIB worker purchases one rigid, long white cane with a metal tip and sleep shade (blindfold) for each customer who is approved to receive an O&M training.
The O&M specialist gives each customer information about how to purchase a white cane. Customers are responsible for replacing white canes and cane tips, buying backup white canes, and making similar purchases.
VR or OIB does not reimburse the O&M service provider for any items provided to a customer by the specialist.
The O&M specialist may recommend additional travel aids or other items to the customer's VR counselor or OIB worker, but the decision to purchase additional items rests solely with the VR counselor or OIB worker.
If a customer uses a guide dog, the customer is assessed by the O&M specialist to determine whether the customer also has proficient white cane skills. Once assessed, the customer may attend O&M training with either a white cane or a guide dog.
If customers need further assessment of and direct training for a guide dog, they must contact the school from which they obtained the dog.
The O&M specialist documents in descriptive terms each customer's monthly training progress and must include:
Monthly progress reports, along with the invoice and any other required supporting documentation, must be submitted within 30 days from the end of each calendar month until the customer's O&M services are completed or services are no longer authorized by the customer's VR counselor or OIB worker.
O&M Services |
Unit Rate |
Comment |
---|---|---|
O&M Assessment |
$75.00 per hour |
Limited to three hours per customer |
O&M Training–Individualized |
$75.00 per hour |
Note: OIB customers are limited to five hours of training per month |
O&M Training–Group |
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