VR-SFP Chapter 20: Premiums

Premiums are payments made to contractors in addition to the base rate paid for services.

Premiums are paid to providers when the provider:

• has met the outcomes required for payment for the authorized premium in SFP 20; and
• has obtained the credentials necessary to work with individuals who have disabilities, such as autism or deafness.

Premium payments compensate providers for their additional efforts, such as taking required training that ultimately benefits customers but can increase the costs of providing services. Vocational Rehabilitation (VR) encourages all staff of contracted providers to obtain specialty endorsements. The specialty endorsement identifies the individuals working for contractors who possess the necessary knowledge for competent practice related to disability populations and complex employment barriers.

Whether a contractor receives a premium payment depends on a customer's specific vocational needs and barriers to employment. Multiple premiums may be associated with a base rate when vocationally justified. VR counselors are not required to provide premium payments when a direct service provider qualifies for the premium, if the VR counselor determines that extra effort made by the provider, such as taking required training, is not necessary for the specific customer's success. If a customer does not have a vocationally justified need for the service, it will not be approved by the VR counselor. Premiums are paid only when all outcomes for the service have been achieved and the criteria for the premium have been met.

Premium payments must be approved through a service authorization. Premium payments are invoiced as identified in the 20.12 Premium Fee Schedule below. No partial payments are made.

Disability Related Premiums

For outcome-based services such as Supported Employment and Job Placement benchmarks, Vocational Adjustment Training courses and the Career Planning Assessment (CPA), the service authorization will be issued before service delivery and invoiced after the outcome for the base service has been achieved.

For hourly based services, such as Job Skills Training, Work Experience Training, Personal Social Adjustment Training, and Work Adjustment Training, the service authorization will be issued before the service begins and will be invoiced when the services are completed.

Non-Disability Premiums related to Work Experience Placement, Bundled Job Placement and Supported Employment

Will be paid at the conclusion of the service as specified below.

 

20.3.1 Service Description

A service provider is eligible for the Autism Premium when:

• the customer has been diagnosed with one or more of the following, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5):
  • Autism spectrum disorder
  • Social communication disorder;
• the counselor determines that the customer requires intervention to remove barriers to employment that are directly related to the diagnosis of autism spectrum disorder or social communication disorder in any of the following categories:
  • Level of independence
  • Social skill deficits
  • Communication deficits
  • Obsessive thoughts and/or interests, resistance to change
  • Sensory integration issues (such as but not limited to, seeking deep pressure or having sensitivity to lights or noise)
  • Level of anxiety
  • Comorbidities (such as but not limited to, attention deficit hyperactivity disorder, depression, and obsessive compulsive disorder); and
• the direct service provider has a University of North Texas Workplace Inclusion and Sustainable Employment (UNTWISE) Autism Specialization Endorsement.

The Autism Premium may be available for the services covered in:

• Chapter 4: Employment Assessments
• Chapter 13: Work Readiness Services;
• Chapter 17: Basic Employment Services; and
• Chapter 18: Supported Employment

20.3.2 Process and Procedures

A contracted provider's staff member who provides a direct service to the customer must:

• meet the staff qualifications identified for the base service; and
• maintain a current UNTWISE Autism Endorsement.

The contracted provider receives authorization for both the base service and the Autism Premium through a service authorization.

The referral and/or service authorization identifies the categories in which the customer may need intervention to remove barriers related to the customer's diagnosis of autism spectrum disorder or social communication disorder.

The provider's staff member:

• ensures that all deliverables for the base service are provided; and
• provides interventions, as needed, to remove any barriers related to the customer's autism spectrum disorder or social communication disorder.

The staff member with the UNTWISE Autism Endorsement assigned to work with the customer must:

• provide the base service, as defined in the VR Standards for Providers (VR-SFP) manual;
• remain on-site providing all necessary interventions, as identified on the referral form and/or service authorization;
• identify interventions and compensatory techniques to address and/or remove the barriers directly related to the customer's diagnosis of autism spectrum disorder or social communication disorder; and
• complete and sign VR1882, Autism Service Premium Report.

The VR1882, Autism Service Premium Report, must be submitted each time a deliverable is submitted for the base service as indicated in the Premium fee schedule.

20.3.3 Outcomes Required for Payment

The services provider is eligible for an Autism Premium when:

• the VR counselor confirms and approves the customer has achieved all outcomes required for the base service, as outlined in the corresponding chapter of the VR-SFP manual; and
• the staff member providing the base service meets both the qualification for the base service and maintains a current Autism Endorsement.

VRS does not pay for fees related to excused or unexcused absences or holidays.

The premium is paid after:

• the documentation required for the base service is approved; and
• the VR counselor approves a complete, accurate, signed, and dated:
  • VR1882, Autism Service Premium Report; and
  • invoice.

20.3.4 Fee

For more information, refer to 20.12 Premium Fee Schedule.

20.5.1 Service Description

A service provider is eligible for the Deaf Premium when:

• the customer's primary mode of communication is a form of sign language (such as American Sign Language, Manually Coded English, Signed Exact English, and/or Pidgin Signed English); and
• services are delivered by a staff member qualified to communicate in the customer's primary mode.

To qualify for this premium, the staff member providing direct services must show proof of proficiency in sign language by providing documentation of certification from the Board for Evaluation of Interpreters (BEI), certification from the Registry of Interpreters for the Deaf (RID), or a Sign Language Proficiency Interview (SLPI) rating of intermediate plus.

The Deaf Premium may be available for the services covered in:

• Chapter 4: Employment Assessments
• Chapter 13: Work Readiness Services;
• Chapter 17: Basic Employment Services; and
• Chapter 18: Supported Employment.

For interviews and meetings with an employer, the customer may request an interpreter who is not providing the base service by contacting the customer's VR counselor.

20.5.2 Process and Procedures

A contracted provider's staff member who provides direct service to the customer must:

• meet the staff qualifications identified for the base service; and
• be certified by the BEI or the RID or hold an SLPI rating of intermediate plus.

The contracted provider receives authorization for both the base service and the Deaf Premium through a service authorization.

The provider's staff member:

• ensures all outcomes are achieved for the base service; and
• facilitates communication using the customer's primary mode of communication, such as American Sign Language, Manually Coded English, Signed Exact English and/or Pidgin Signed English.

The staff member facilitates communication with or for the customer while:

• providing the base service as defined in the corresponding chapter of the VR-SFP manual; and
• facilitating necessary communication for the customer to participate in the base service.

The provider's staff member must complete the required documentation for the base service, including the section for the Deaf Premium.

20.5.3 Outcomes Required for Payment

The services provider is eligible for the Deaf Premium when:

• the VR counselor confirms and approves the customer has achieved all outcomes required for the base service as outlined in the corresponding chapter of the VR-SFP manual; and
• the provider's staff member who facilitates communication attaches the current applicable credential of the staff member's proficiency in sign language.

VRS does not pay fees related to excused or unexcused absences or holidays.

The Deaf Premium is paid when the VR counselor:

• verifies communication was facilitated for the customer; and
• approves a complete, accurate, signed, and dated:
  • report for the base service, with the Deaf Premium section completed; and
  • invoice.

20.5.4 Fee

For more information, refer to 20.12 Premium Fee Schedule.

20.7.1 Service Description

A provider receives a Professional Placement Premium when the customer finds a job that meets all the criteria outlined in VR1845B, Bundled Job Placement Services Plan Part B and Status Report, or VR1632, Supported Employment Plan and Employment Report.

In addition to meeting the requirements in VR1845B or VR1632, the position obtained must require at least a bachelor's degree, and the requirement must be stated in the job description or job posting.

The Professional Placement Premium is paid only once, after achievement of the Bundled Job Placement Benchmark C or Supported Employment Closure  Benchmark.

20.7.2 Process and Procedures

The contracted provider receives authorization for the Professional Placement Premium through a service authorization.

The service authorization for the Professional Placement Premium for Job Placement must be received when the service authorization for Job Placement Benchmark A is received. For Supported Employment, the service authorization must be received when the service authorization for Supported Employment Job Development and Placement Benchmark is received.

The provider's staff member working with the customer must provide the Bundled Job Placement or Supported Employment service as defined in the VR-SFP manual.

The provider's staff member must complete the required documentation for either Bundled Job Placement or Supported Employment, including the section for the Professional Placement Premium. The Professional Placement Premium is paid only after all outcomes have been achieved and approved by the VR counselor for Bundled Job Placement Benchmark C or Supported Employment Closure Benchmark.

20.7.3 Outcomes Required for Payment

The direct services provider is eligible for the Professional Placement Premium when the customer achieves all deliverables required for either Bundled Job Placement Benchmark C or Supported Employment Closure Benchmark, as outlined in the corresponding chapters of the VR-SFP manual.

Proof that a degree is required for the position obtained by the customer must be submitted with the invoice.

The services provider is eligible for the Professional Placement Premium when:

• the VR counselor confirms and approves that the customer has achieved all outcomes required for the base service, as outlined in the corresponding chapter of the VR-SFP manual; and
• proof that a bachelor's degree or higher was required for the position obtained by the customer is demonstrated by either a copy of the job posting or the customer's job description.

The Professional Placement Premium is paid when the VR counselor verifies that the position required a bachelor's degree or higher and approves a complete, accurate, signed, and dated:

• report for the base service, with the Professional Placement section completed; and
• invoice.

20.7.4 Fee

For more information, refer to 20.12 Premium Fee Schedule.

This Travel Premium allows contracted providers to be reimbursed for mileage and other travel-related costs, such as lodging, food, and third-party transportation. When only mileage travel is being submitted, manager approval is not required. For all other travel expenses, VR manager approval is required before the travel occurs.

The Travel Premium may be available to contracted providers serving VR customers who receive the services described in

• VR-SFP chapters:
  • Chapter 5: Orientation and Mobility Services
  • Chapter 7: Diabetes Self-Management Education Services
  • Chapter 9: Assistive Technology for Sight-Related Disabilities
  • Chapter 10: Independent Living Services for Older Individuals Who Are Blind (IL-OIB)
• Vocational Rehabilitation Services Manual (VRSM) B-403-3: Comprehensive Vocational Evaluation System.

20.9.1 Definitions

Provider Location

The provider's location is defined as the provider's headquarters, as stated in the provider's contract, or the location of the provider's staff that is providing the service, whichever is closest to the location where the service will be provided.

Round Trip

A trip where the starting point and final destination are the same (for example, start and end at the provider's location).

20.9.2 Service Description

The Travel Premium is based on round-trip travel and payment can include reimbursement of approved:

• lodging,
• per diem,
• airfare (if necessary),
• mileage when provider's own vehicle is used, and
• transportation by taxi, bus, other form of mass transit, or network transportation driver (for example, Uber or Lyft).

The VR program does not reimburse for travel expenses

• to transport customers; or
• if the customer does not show up for a scheduled service (referred to as a "no show").

Providers do not qualify for a state tax exemption.

The Travel Premium may be available to contracted providers serving VR customers:

• who require an eligible SFP service to achieve the long-term goals as identified on the customer's individualized plan for employment (IPE) or independent living goals established under the (IL-OIB) program;
• when there is not a qualified SFP provider available within a 50-mile radius of the location where the authorized service is to be provided; and
• who require the provision of a billable service, excluding travel for the sole purpose of obtaining a customer's signature on required documents).

A request to change a Travel Premium requirement listed in the Service Description, Process and Procedures, or Outcomes Required for Payment, must be documented and approved by the VR director using the VR3472, Contracted Service Modification Request.

20.9.2.1 Mileage Only

When considering the cost of personal vehicle travel (mileage) as a transportation alternative, the VR provider considers all related costs, such as the cost of meals, parking, vehicle rental, fuel, or taxi.

VR Manager approval is not required for the provider to be reimbursed for mileage only.

The mileage reimbursement is based on direct travel for each mile traveled over 50 miles within a round trip.

Before traveling, the provider must receive a service authorization from VR that includes the anticipated distance and the number of trips to be traveled.

After traveling, the provider must submit VR3436, Travel Premium Travel Plan and Report with all sections related to the mileage reimbursement completed.

To calculate mileage-only amount of the Travel Premium:

1. Determine the round-trip mileage from the provider's location to the service location(s) (can include travel within the customer's community) using MapQuest Route Planner with shortest distance and round-trip options selected
2. Subtract 50 miles from the round-trip total; and
3. Multiply the total by the state-approved mileage rate

Example:

• The provider is located in Lubbock.
• The customer lives in Amarillo (126 miles from Lubbock).
• The provider traveled a total of five (5) miles within Amarillo to provide services at several locations. (e.g. Walmart to United Grocery store for a total of 5 miles),
• The provider returns to Lubbock (126 miles).
• The mileage reimbursement is calculated as follows:
   

  126 + 5 + 126 = 257

  257 – 50 = 207 miles

  207 x (state-approved mileage rate) will equal the mileage reimbursement.

Mileage is reimbursed at the approved state automobile mileage rate found on the Texas Comptroller of Public Accounts webpage: https://fmx.cpa.texas.gov/fmx/travel/textravel/rates/current.php.

20.9.2.2 Other Travel Cost (Excluding Mileage)

To be reimbursed for any other travel costs (excluding mileage) such as meals, lodging, and transportation, the provider must submit a VR3436, Travel Premium Travel Plan and Report, which includes the projected cost of travel for each customer to be served during the trip. The VR counselor and VR Manager review the projected cost on the VR3436 and supporting documentation. When the VR Manager approves projected cost of travel on the VR3436, then a service authorization is received by the provider to authorize travel cost. The service authorization must be received before the travel occurs.

When applicable, the provider must use the guidelines below when completing the VR3436, Travel Premium Travel Plan and Report. Copies of all receipts for all costs, excluding mileage, must be submitted with the invoice.

Lodging

The cost of lodging is reimbursed only if it is incurred at a commercial lodging establishment.

The provider should use the least expensive lodging available. The provider cannot exceed the rates allowed on the published U.S. General Services Administration’s (GSA) Federal Domestic Maximum Per Diem Rates website. If the city is not listed but the county is listed, use the daily rate of the county found on the GSA Federal Domestic Maximum Per Diem Rates website.

Reimbursement includes:

• the cost of the room;
• city, county, state and other hotel taxes; and
• fee for self-parking when applicable.

Meals

Meals are only reimbursed if:

• the provider is away from the identified provider location for at least six consecutive hours, and
• overnight travel is required for the trip.

Receipts are required for meals to be reimbursed.

Gratuities are not reimbursed. Taxes are reimbursed but are already included in the allowed per diem rate. Alcohol expenses are not reimbursed.

To determine the per diem rate, refer to the Domestic Maximum Per Diem Rates published by the GSA. If the appropriate city is not listed, but the county is listed, the VR counselor uses the daily rate for the county

Air Transportation

Airfare can be purchased to meet a provider's transportation needs only if:

• airfare is the most cost-effective method (flying versus driving);
• airfare is an appropriate means of transportation for the provider based on potential disability-related factors; or
• no reasonable alternative exists.

When considering the cost of airfare as a transportation alternative, the VR provider considers all related costs, such as the cost of transportation to and from the airport, parking, vehicle rental, fuel, or taxi. The VR provider documents the cost comparison clearly, including supporting documentation and submits this as an addendum to the VR3436, Travel Premium Travel Plan and Report. A brief justification for the need for air transportation must be included on the VR3436.

For a provider to be reimbursed for commercial air transportation expenses, a copy of a complete passenger receipt issued by a commercial airline company or an itinerary issued by the company or a travel agency is required.

The commercial air transportation expense receipt or itinerary must include the following:

• name of the provider and airline
• ticket number
• class of transportation
• travel dates
• amount of the airfare
• origin and destination of each flight
• proof of payment

The provider should select the most cost-effective airfare available between the airport closest to the identified provider location and the city where services will be provided.

Ground Transportation

A provider may be reimbursed for the actual cost of transportation by taxi, bus, other form of mass transit, form a network transportation driver (for example, Uber or Lyft), if needed for the provider to travel to the location where the service will be provided.

• The most cost-effective mode of transportation available must be used
• Receipts for all travel-related expenses must be provided.

20.9.3 Process and Procedures

After the VR counselor and regional quality assurance program specialist or regional program support specialist determines there is not a provider to serve the customer within his or her local community, the following process and procedures apply.

20.9.3.1 Mileage Only Reimbursement

To be reimbursed for mileage only, the provider does the following:

• receives a service authorization including the anticipated distance and number of trips to be traveled;
• schedules the services with the customer(s);
• makes travel arrangements;
• travels from the defined provider location to the location(s) of the service;
• provides the service;
• returns to the defined provider location;
• completes all sections of the VR3436, Travel Premium Travel Plan and Report that are related to mileage reimbursement;
• obtains required signatures; and
• submits the required documentation for payment.

To calculate mileage reimbursement, use the form and guidelines below:

1. determine the round-trip mileage from the provider's location to the service locations, including travel within the customer's community, using MapQuest Route Planner with shortest distance and round-trip options selected;
2. subtract 50 miles from the round-trip total; then
3. multiply the total by the state-approved mileage rate.

After the provider submits all required documentation for payment, a VR staff member:

• reviews the provider's documentation,
• verifies mileage on MapQuest Route Planner with shortest distance, and round-trip options selected, and
• authorizes payment if all requirements are met.

20.9.3.2 Reimbursement of Mileage and Other Travel Costs

To be reimbursed for mileage and any other travel costs, such as the costs for meals, lodging, and transportation, the provider and VR staff does the following:

• Provider submits the projected cost on the VR3436, Travel Premium Travel Plan and Report, to the VR counselor to gain preapproval for travel expenses.
• VR counselor reviews VR3436, Travel Premium Travel Plan and Report and submits to the VR Manager for review.
• VR Manager approves or disapproves the projected cost by documenting the decision on the VR3436.
• VR counselor issues service authorization or multi-customer service authorization (when multiple customers are to be seen in the round-trip travel) for the approved projected cost, after all appropriate approvals are in place and submits the service authorization to the provider. (The service authorization includes separate line items for each of the allowable expenses. The expenses will be split equally between all customers seen within the round-trip.)
• Provider schedules the services with the customer and makes travel arrangements.
• Provider travels from the defined provider location to the location(s) of the service, provides services before returning to the provider location.
• Provider completes all applicable sections of the VR3436, Travel Premium Travel Plan and Report recording the actual cost.
• Provider obtains required signatures.
• Provider submits the required documentation for payment.

To calculate mileage reimbursement, use the form and guidelines below:

1. determine the round-trip mileage from the provider's location to the service locations, including travel within the customer's community, using MapQuest Route Planner with shortest distance and round-trip options selected;
2. subtract 50 miles from the round-trip total; then
3. multiply the total by the state-approved mileage rate.

When other travel cost such as meals, lodging and transportation are included on the VR3436, the provider follows all guidelines in the service definitions on the form and submits copies of all receipts related to:

• lodging,
• meals,
• air transportation, and/or
• ground transportation.

After the provider submits all required documentation for payment, a VR staff member:

• reviews the provider's documentation,
• verifies mileage on MapQuest Route Planner with shortest distance, and round-trip options selected (if any),
• verifies all actual travel expenses with receipts and any other required documentation,
• compares actual expense to the approved projected cost recorded on the VR3436 to ensure expenses were allowed and
• authorizes payment if all conditions are met.

20.9.4. Outcomes Required for Payment

The service provider is eligible for the Travel Premium when:

• the customer(s) receives the provision of a billable service, excluding travel for the sole purpose of obtaining a customer's signature on required documents
• there is no provider for the service within a 50-mile radius of the customer's location, or the staff of the provider within the 50-mile radius do not meet the qualifications necessary to provide the service; and
• all information required on VR3436, Travel Premium Travel Plan and Report is provided.

The VR3436 must include:

• case ID for all customers served during the round trip;
• purpose of the visit provided;
• provider's location at which travel was initiated and completed;
• all addresses traveled to during the round trip;
• For mileage reimbursement
  • each segment of the round-trip travel according to MapQuest shortest mileage and route settings; and
  • mileage calculation for the premium (Total mileage for the round trip, according to MapQuest shortest mileage and round-trip settings minus 50 miles)
• For other travel cost such as meals, lodging and transportation:
  • VR3436 that includes the Management approval for the projected travel expenses;
  • VR3436 that records the actual expenses, following all requirements in the services definition, for the round-trip travel
  • copies of receipts and supporting documentation for all expenses.
• Required signatures

The VR program does not reimburse for travel expenses

• to transport customers; or
• if the customer does not show up for a scheduled service (referred to as a "no show").

Providers may not be paid when customers do not show up for scheduled service.

The Travel Premium is paid when the VR counselor verifies the travel reimbursement and approves a complete, accurate, signed, and dated:

• VR3436, Travel Premium Travel Plan and Report;
• required supporting documents, such as receipts; and
• invoice.

20.9.5 Travel Premium Fee

For more information, refer to 20.12 Premium Fee Schedule.

20.11.1 Service Description

A service provider is eligible for the Blind Premium if:

• The customer has been determined to have one of the following TWC eligibility criteria related to a visual impairment:
  • Blindness - a visual acuity with best correction of 20/200 or less in the better eye; a visual field of 20 degrees or less; or a combination of both;
  • Low vision - a visual acuity with best correction of 20/70 or less in the better eye; a visual field of 30 degrees or less in the better eye; or a combination of both; or
  • Significant Visual Impairment - a condition or disease of the eye that does not meet the definitions of Blind or Low Vision but does create a significant impediment to employment and cannot be corrected with glasses or contact lenses;
• The VR counselor determines that the customer requires intervention to remove barriers to employment that are directly related to a visual impairment; and
• the direct service provider has a current University of North Texas Workplace Inclusion and Sustainable Employment (UNTWISE) Blind Premium Endorsement.

The service provider, as needed, removes any barriers related to the customer's visual impairment. Intervention can include, but is not limited to developing compensatory strategies, skills training, and setting up accommodations.

In order to obtain the UNTWISE Blind Premium Endorsement, the direct service provider must complete the following prerequisite training and receive certificates of completion from:

• the National Rehabilitation Training Center on Blindness & Low Vision (NRTC) trainings, which include:
  • Improving Business Development Skills: A Training for Rehabilitation Professionals (17.25 hours); and
  • Working with Employers: What is Important and What Successful Agencies do (1 hour)

For a contactor to be eligible to invoice for the blind premium, a service authorization must be issued, and the contractors' staff member must:

• maintain the staff member's qualifications for the services being delivered to the customer; and

• have a current University UNTWISE Blind Premium Endorsement.
  https://wise.unt.edu/user.
  
  Note: The free, self-paced NRTC Trainings can be found online at https://nrtc.catalog.instructure.com/

The Blind Premium may be available for the services covered in:

• Chapter 4: Employment Assessments
• Chapter 13: Work Readiness Services
• Chapter 14: Work Experience Services
• Chapter 17: Basic Employment Services
• Chapter 18: Supported Employment Services
• Chapter 19: Self Employment

20.11.2 Process and Procedures 

A contracted service provider's staff member who provides a direct service to the customer must:

• meet the staff qualifications identified for the base service; and
• maintain a current UNTWISE Blind Premium Endorsement.

The contracted service provider receives authorization for both the base service and the Blind Premium through a service authorization.
The referral and/or service authorization for both the primary employment service and UNTWISE Blind Premium Endorsement identified the categories in which the customer may need intervention to remove barriers related to the customer's visual impairment.

The service provider's staff member:

• ensures all deliverables for the base service are provided as outlined in the VR Standards for Providers; 
• must remain onsite or be remotely available to provide interventions, as needed, to remove any barriers related to the customer's visual impairment;
• identifies interventions and compensatory techniques to address and/or remove the barriers directly related to the customer's visual impairment; and
• completes and signs the VR1883, Blind Premium Report.

The VR1883, Blind Premium Report, must be submitted each time the primary service is invoiced. 

The Blind Premium is paid only after all outcomes have been achieved and approved by the VR counselor for primary service.

20.11.3 Outcomes Required for Payment

The service provider is eligible for the Blind Premium if:

• the VR counselor confirms and approves the customer has achieved all outcomes required for the base service, as outlined in the corresponding chapter of the VR- Standards for Providers manual; 
• the staff member providing the base service must maintain the current UNTWISE Blind endorsement; and
• the staff member with the current UNTWISE Blind Premium Endorsement provides interventions, as needed, to address any barriers related to the customer's visual impairment.

The premium is paid after:

• the documentation required for the base service is approved; and
• the VR counselor approves a complete, accurate, signed, and dated:
  • VR1883, Blind Premium Report; and
  • invoice.

Note: VR customers who qualify for the Blind Premium can also qualify for the Deaf Premium simultaneously.

Vocational Rehabilitation Services does not pay for fees related to excused or unexcused absences or holidays.

20.11.4 Fee

For more information, refer to 20.12 Premium Fee Schedule.