As of 10/1/2017, this manual has been retired. For current policies, procedures, and standards for the Texas Workforce Commission Vocational Rehabilitation Division, please refer to the following manuals:

In this manual, references to DARS now refer to TWC. The manual includes both links to public content and links to content available only to staff.

Chapter 1: Foundations, Roles, and Responsibilities

1.1 Using this Policy

(Revised 02/11, 05/11, 07/16)

This policy is designed as a framework for counselors in making decisions and delivering quality services to eligible consumers. Links to other information provide

First-time users should read the manual sequentially from beginning to end to get a broad perspective of the organization and content of policy.

In this policy, the word "you" refers to the counselor or the rehabilitation services technician (RST), as appropriate. The term "consumer" refers to anyone who applies for or receives vocational rehabilitation (VR) services.

Chapters of policy follow the rehabilitation process from initial contact to closure and post-closure services. Each chapter describes the activities that may take place during that phase of the rehabilitation process. However, the rehabilitation process may not always be linear, and you may need to repeat activities, skip activities until later in the process, or begin more than one process at the same time. For example, once the individualized plan for employment (IPE) is completed and service provision started, you may need to revisit the plan if circumstances change.

1.1.1 Philosophy

The Division for Rehabilitation Services (DRS) is committed to a philosophy of partnership based in guiding principles, values, and beliefs that support our vision of a Texas where people with disabilities

On this foundation, DRS has developed policies that comply with federal and state law, statutes, and rules, while allowing you to use your professional judgment and sensitivity in administering the VR program.

Although many policies and procedures are mandatory, their application is individualized to the consumer's situation and rehabilitation needs. You must understand that every interaction with a consumer is unique and therefore requires a unique response.

1.1.2 The Intent of the Policy

This policy is written for counselors and other professional DRS staff. It is not intended to be a guide for consumers, although some consumers, family members, and providers may wish to use the policy as a reference. The policy is designed to promote effective decision making and efficient delivery of rehabilitation services, not to be prescriptive or to create limits or barriers to achievement. It is designed to clearly indicate what is required and what is not permissible by law. When policy is based on law, no exceptions are permissible. Text marked with asterisks (*) and shading indicate policy that is based on law or regulation and may not be excepted.

DRS may make exceptions to policy not based in law with demonstrated need.

1.2 Cornerstones of Quality Vocational Rehabilitation

1.2.1 Overview

VR is a dynamic process with a measurable outcome. By definition, it is not a static relic of a legislative mandate, but a viable, pliable model that comprises global concepts and parameters within which the counselor operates. VR relies on your expertise as a qualified professional counselor to act.

Understanding the intent of the Rehabilitation Act of 1973 and its accompanying regulations as a "means to an end" can help you focus the strategies and solutions you offer to a consumer. You should view the VR process as a series of opportunities to strategically design life-changing steps toward progress. By virtue of your knowledge and experience, you "own" the beginning of the process for a consumer. But with the rights of ownership comes the obligation to inform, guide, and facilitate the process in a way that productively transfers the rights of ownership to the consumer. When the consumer is fully aware of processes, expectations, alternatives, resources, and methods, the consumer can engage in rehabilitation and begin to progress. The concept of informed choice for the consumer begins with your first contact with the consumer and continues throughout the VR process.

1.2.2 Believing in the VR Process

Among the many reasons for the VR program's long history of success are that it is

We at DRS celebrate the success of the public VR program and attribute its success in Texas to our staff. We believe that our employees are the keys to achieving our mission to work in partnership with Texans with disabilities to help them achieve their goals of employment, living independently, and overcoming barriers to communication and community access. We believe in quality and that the cornerstones of quality are our

1.2.3 Understanding the VR Process

(Revised 08/11)

At your first meeting with a consumer and throughout the case, the most important message to convey is that employment is the purpose—and prized outcome—of the VR process. Clearly explain the expectations for partnership between you and the consumer to achieve the goal of employment. At each step of the process, you must move the consumer through a series of decisions about goals, services, and providers to achieve outcomes you and the consumer have agreed upon. Gather and organize relevant evaluation information about the consumer and involve the consumer in analyzing that data.

You may consider a myriad of strategies for employment, such as part-time employment, supported employment, self-employment, or regular full-time competitive integrated employment. Always use language that reflects an employment outcome, such as "When you're working..." and "The connection between the service we're planning and work is..." Employment is a keystone in upgrading quality of life, and the VR process allows the consumer to make choices and engage in meaningful employment at the level at which he or she is capable.

Application and Diagnostic Procedures

The VR process begins with the application and diagnostic procedures upon which you base your eligibility decision. Your role as the counselor is to initiate, analyze, and evaluate information considering the overall process. Understanding the consumer's knowledge of employment opportunities and requirements, particularly if he or she has never worked, is essential. Even before the consumer has chosen a specific work goal, focus on work in general by discussing how application and diagnostic procedures lay the foundation for obtaining a job. "Begin with the end in mind." Consider what outcomes are needed from each step in the process to lead the consumer to successful employment.

At application and throughout the diagnostic interview, you have the first opportunity to investigate the impact of disability on the consumer and on the consumer's ability to work. Use the diagnostic interview to explore the consumer's experience of and knowledge about work. If a consumer has never worked, introduce the concept of learning how to manage the impact of his or her disability at a worksite. You must be prepared with the right questions and focus on the outcome to ensure that you can gather necessary information, if it is not readily available.

You may consider part of the interview as a service orientation in which you explain your role of counselor as

The consumer must glimpse what is possible, even if the person does not yet fully understand the role he or she will play in becoming successful. Depending on the level of participation possible from the consumer, you should also explain any further diagnostic procedures, the eligibility process, and decision making that influences further planning. A sensitive, thorough interview is necessary, since one outcome may be that you find no indication of a disability and recommend that the person seek services from another source.

The level and extent of evaluations you request to supplement the interview should be based on your diagnostic appraisal. Conserving funds and time dictates obtaining only the amount of information needed to evaluate the individual consumer. Again, "beginning with the end in mind" helps you to clarify the decisions you must make for eligibility when you first meet the consumer. The application, diagnostic interview, and subsequent diagnostic procedures are the first of several cornerstone pieces of a sound plan of services to reach the agreed-upon outcome.

Having sound diagnostic information leads you to determining eligibility. The diagnostic interview is a significant vehicle for collecting information because it allows the consumer to provide you with needed social and vocational history. If you have not sufficiently developed this piece, you may fail to realize the need for a medical, psychological, educational, or vocational evaluation, a failure that could lead to a poor eligibility decision or developing a less than optimal plan for employment. You must see the diagnostic interview as a critical part of planning and decision making. Your role is to listen effectively and to ask questions as necessary. Observation can also provide invaluable insight into the consumer's personality, mood, social functioning, and other characteristics and key attributes. The outcome of the diagnostic interview should be

Decisions regarding eligibility are often complex and can be confusing if you stray from the criteria and intent of the rehabilitation process. The consumer's situation may call for medical intervention, training for personal or professional growth, or relief of symptoms related to physical or mental conditions. However, if the intervention or relief is not directly related to the consumer's ability to access work, engage in work, or maintain work, then it may not be relevant to his or her vocational picture. You must carefully assess all factors leading to eligibility and determine whether continuing services is appropriate and required. You are also obliged to guide an ineligible consumer to alternative sources for resolution of his or her situation.

Developing a Plan

Assessing the eligible consumer is the next opportunity to prepare and plan for a successful employment outcome. Though described in many ways, the assessment for developing the IPE may best be described by what it is not. The assessment is not an event, not a case note, not a single piece of information, not a moment in time. It is a logical process of analyzing information with a consumer to identify potentially appropriate employment goals. The process greatly depends on the sufficiency of information gathered in the diagnostic interview, medical evaluation, and other available records or diagnostics. To the extent that it is relevant, you should be able to review the consumer's

The information you gather helps to distill the factors that will affect this consumer's progress through the VR process. Understanding knowledge, skills, abilities and other key worker attributes, the local job market, and the consumer's desires eliminates unsuitable alternatives for employment goals.

Working with the consumer through this process helps you determine which options are the most logical, reasonable, and cost-effective choices to support a plan you and the consumer agree upon. Beginning the assessment with the end in mind prepares you to guide and facilitate problem solving and decision making in the VR process and secures the consumer's sense of ownership in planning for his or her goals. Do not be paternalistic. Your role is to

In some cases, DRS may not be able to support the consumer's choice. If so, you must acknowledge the validity of such choices, refer the consumer to alternative resources, and close the case before engaging in a plan for employment that is not viable.

To achieve the consumer's meaningful involvement in planning for an employment outcome, you and the consumer must become co-managers. You must prepare the consumer to solve problems in the future, when the VR program is no longer sponsoring his or her actions. Goal setting, information evaluation and processing, decision making, action planning, and self-evaluation of progress are all skills that you should build with the consumer to the extent the consumer is capable. Although every consumer may not be able to direct all life activities, the effective counselor identifies those systems that the consumer can direct and helps build systems that are externally directed, with consumer input, to address employment needs. Again keeping the end in mind will help you to develop a program that reasonably achieves the employment goals. A holistic approach to ensuring that consumers can participate and contribute in their home, work, and community is most desirable. Counseling is an essential and substantial service when delivered with this focus.

Building the individualized plan for employment is also a fluid and intuitive process, relying heavily on the information you gather and analyze through assessment. Reviewing findings in each relevant category of physical, psychosocial, educational, and vocational information and setting goals accordingly will help to ensure that each area is addressed. An effective plan allows both you and the consumer to objectively monitor progress. The consumer who receives positive feedback continues to progress at the rate at which he or she is capable. The person's confidence is built by knowing that there is a "safety net" should there be setbacks. Ongoing counseling and guidance that focuses on short-term problem-resolution strategies, building external and long-lasting supports, and effective partnerships will help to maintain the long-term movement toward achieving an employment outcome.

The evaluation and planning components should result in reasonable and necessary services to enhance the consumer's productivity and quality of life. However, ineffective counselor performance at the point when the consumer is ready to pursue employment can lead the consumer to disengage from VR, causing underemployment or unemployment.

Finding Employment

Job development and job search assistance are critical functions of the vocational rehabilitation counselor. To provide this service effectively, you must devote time and attention to employment activities that result in quality job opportunities for the consumer. At the level at which the consumer is capable, the roles in the rehabilitation partnership again shift. You may, in fact, have two customers: the consumer and the employer. The consumer is expected to take relative responsibility for participating actively in positioning for employment. While any number of strategies may be used to conduct a job search with the consumer (for example external resources, paid providers, personal contacts), there is no substitute for your knowledge and direct involvement. To ensure the widest array of employment options with the consumer, you may be required to

Implementing the VR process is a fluid and hopefully seamless journey to a strategically planned destination. You and the consumer share the navigation role as you make your way together. You often act as the pilot to get the plan in flight, but then you teach the consumer to take the controls, to fly on his or her own, or to know when to call for help.

1.2.4 Believing in Value-Based Service-Delivery Systems

DRS embraces the following core values, which require us to consider the best interest of the consumer first in all decisions about service delivery:

This approach to service delivery by all staff contributes to quality, opportunities for innovation, and the growth of positive human experiences for the consumer. To achieve our mission, each staff member must be committed to holding himself or herself accountable for serving the consumer in ways that foster high levels of goal attainment.

1.2.5 Building Ethical Relationships

(Revised 06/10)

Solution-focused, respectful, nonexploitative, and empowering counseling relationships are built on high ethical standards. Understanding the principles listed in the Code of Professional Ethics for Rehabilitation Counselors (the Code) is at the heart of the ethical decision-making process. The Code reflects a level of competency needed in professional relationships that promotes and protects the spirit of caring and respect for individuals with disabilities.

High ethical standards are also involved in best-value purchasing and the wise use of funds. See DARS Procurement Manual Chapter 2: Procurement Requirements, 2.17 Best Value Purchasing.

DRS is committed to helping all staff make ethical decisions. It is essential that staff

The Code comprises the following six basic principles of ethical behavior:

Rehabilitation counselors who violate the Code are subject to the actions defined by DARS performance management policies. For counselors who are certified through the Commission on Rehabilitation Counselor Certification (CRCC), violations of the Code are also subject to CRCC action.

1.2.6 Applying Principles of Informed Choice

It is important for each person involved in the rehabilitation process to consistently apply the concepts of "informed consumer choice."

The principles of informed consumer choice are found in regulations that implement the Rehabilitation Act of 1973, as amended, which *requires that the consumer must be informed about and involved in choosing among alternative

*Based on 34 CFR Section 361.52(b)(4)

The consumer should enjoy the same rights as any person to make decisions that affect his or her life. DRS feels strongly that to achieve positive outcomes, the consumer must be involved in decision making at the greatest level at which the consumer is capable.

Informed consumer choice begins at the first meeting, when you explain concepts of

The consumer and you jointly choose providers for assessments and other information necessary to determine eligibility. During IPE development, you and the consumer jointly

After you have identified rehabilitation needs, you provide information about available services that meet the consumer's needs and are consistent with laws, policies, and the highest ethical standards. Your good judgment leads to the development of reasonable options to discuss with the consumer, facilitating his or her ability to make an informed choice. In some cases, there may be only one appropriate alternative that meets the consumer's needs and can be supported by DRS policy. If alternatives developed by DRS are not acceptable to the consumer, or if preferences expressed by the consumer are not among the alternatives presented, discuss options until you and the consumer reach a mutually acceptable decision. If you and the consumer cannot reach a compromise, inform the consumer of his or her right to appeal.

1.2.7 Using Principles of Good Stewardship

Counselors make purchasing decisions using principles of good stewardship.

*Before using DRS funds, you must use available comparable services and benefits to pay for services in whole or part.* You must provide the consumer with information on available public and private comparable services and benefits. The consumer, as a partner in the VR process, must use comparable services and benefits from other programs for which he or she is eligible. Using comparable services and benefits ensures that VR dollars are spent efficiently.

*Based on 34 CFR Section 361.53(c)

For policy regarding the use of comparable services and benefits, see Chapter 4: Assessing and Planning, 4.5 Comparable Services and Benefits.

1.2.8 Reflecting Quality Program Management in Documentation

(Revised 09/09, 03/10, 11/10, 05/11, 12/15)

The management of the Texas VR program is largely reflected in the case file documentation of each consumer. A key to the program success is your ability to demonstrate accurate and timely decisions that

Case file documentation includes:

Use case notes to compile information gleaned from the other two sources, and from your interactions with the consumer, the consumer's family or representative, referral sources, service providers, and others, in order to:

Clear written communication is required to achieve these expectations. Policy often refers to the need for incidental case notes to explain or justify a course of action. You should write these case notes objectively, clearly, and concisely for the reasonable reader to understand. Documentation must add value in the public VR program by revealing relevant information about

In addition to prescribed incidental case notes, at a minimum, every RHW case file must document the activity that was performed for or with the consumer, as described in the following table.

Activity

Documentation

Application and diagnostic interview

A case note or series of case notes that describes pertinent information garnered from the consumer, the consumer's family or representative, and any available records.

The case note must include:

  • a thorough examination of the consumer's work history;
  • enough information to determine the consumer's eligibility for services (or to identify the information that still is needed for determining eligibility);
  • the information that will be needed during assessment to develop an Individualized Plan for Employment (IPE) for the eligible consumer;
  • the consumer's perspective on his or her disability and how it affects the consumer's ability to prepare for, obtain, maintain, keep, and advance in competitive integrated employment;
  • information about the discussions with the consumer related to informed choice, such as the consumer's initial goals and expectations for VR services; and
  • detailed plans for obtaining records or scheduling necessary assessments to determine the consumer's eligibility.

Opening or reopening a previously closed case

A case note or series of case notes that describes:

  • the circumstances surrounding previous closures and the need for opening a case;
  • the changes that will lead to a successful outcome; and
  • consultation with the area manager, if applicable.

See Chapter 2: Initial Contact and Application, 2.7 Opening a New Case or Adjusting the Phase of a Previously Closed Case, for more information.

Determination of eligibility

A case note or series of case notes that describes:

  • the information that supports how each eligibility criterion is met; or
  • justification for using pre-eligibility trial work, and the circumstances leading to a determination of ineligibility; including the clear and convincing evidence for that determination, if the ineligibility decision was due to the severity of the consumer's disability.

For Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) cases that are presumed eligible, document the presumption of eligibility and the reported disability.

For cases involving SSI or SSDI and that are not immediately presumed eligible for DRS services, document in a case note what precluded immediate presumption of eligibility.

Level of Significance

or

Document the disability's level of significance as a stand-alone case note or as part of a case note for eligibility or assessing and planning.

Assessing and planning

A case note or series of case notes that shows how the assessment:

  • provided information on the consumer's disability (including a review of existing records, when available, and a review of new assessments, when necessary);
  • resulted in the identification of the consumer's strengths, resources, priorities, concerns, abilities, capabilities, and interests;
  • resulted in the identification of the consumer's potential employment goals;
  • led to the making of decisions that support the goals, objectives, and services identified in the consumer's IPE;
  • led to the consumer's participation in informed choice; and
  • led to the development of the plan for making contact with the consumer.

For consumers who are high school students, the case file must demonstrate coordination of the IPE with the goals, objectives, and services identified in the consumer's Individualized Education Program (IEP) or the consumer's 504 plan.

Changes to the original IPE that result from:

  • a joint annual review;
  • other amendments; or
  • post-employment services

A case note or series of case notes that describes:

  • the results of the plan review;
  • the reasons for changes that do not require an amendment; or
  • the reason for an amendment and the nature and scope of the changes, including how objectives, services, and a plan for communication with the consumer were developed, when applicable.

Service delivery notes

A case note or series of case notes that describes:

  • the decisions that support the necessary provision, extension, or addition of a VR service;
  • the consumer's role in the decision making process;
  • the actions taken to provide the service, such as:
    • considering best-value information;
    • taking purchasing or technical actions;
    • making or receiving service delivery contacts; or
    • conducting follow-up service delivery activities.

General contact notes

A case note or series of case notes that describes the consumer's rehabilitation story that includes relevant conversations, observations, decisions, and actions that support the consumer's progress and informed choices.

Counseling and guidance

A case note or series of case notes that reflects the skillful application of counseling strategies and interventions, on topics such as:

  • barrier removal;
  • problem solving;
  • information and support to help the consumer make informed choices; and
  • the consumer's adjustment to their disability.

Whenever possible, use the case note title "counseling and guidance" in ReHabWorks to clearly demonstrate that counseling and guidance was provided.

Joint annual review (JAR)

A case note or series of case notes that describes activities related to a joint annual review (JAR), such as review and discussion of the consumer's:

  • personal information;
  • progress in achieving the employment goal;
  • intermediate goals; and
  • responsibilities.

If an amendment to the IPE is required, see the table row (above) on "Changes to the original IPE that result from:

  • a joint annual review;
  • other amendments; or
  • post-employment services."

All closures

A case note or series of case notes that describes:

  • the reason the case was closed;
  • the circumstances that led to the decision to close the case; and
  • how the case meets the criteria required for closure.

See Chapter 16: Closure, 16.2.9 Closing Successful Cases or Chapter 9: Employment Services, 9.13.10 Closing a Case as Rehabilitated for self-employed consumers.

Certain circumstances in policy require specific documentation to implement a service or take some other action. The following table describes the minimum documentation required for these circumstances.

Action

Documentation

Services to family members

A case note or series of case notes that describes:

  • why services are needed;
  • which family member or members need the services (name and Social Security number);
  • what services are needed; and
  • how the services are expected to contribute to the consumer's employment.

Identification and/or use of comparable benefits

A case note or series of case notes that describes the progress made in accessing and applying for identified comparable services and benefits, including applying for and obtaining or being denied a Pell grant, when applicable.

Data integrity

A case note or series of case notes that describe changes in system data for correction.

"Consumer requires special attention"

A specific and factual report including

  • the date,
  • the location,
  • the names and addresses of witnesses and people involved,
  • what was said or done, and
  • the names of those willing to testify.

If it is later determined that the consumer no longer poses a threat, enter a new case note that describes the change in circumstances.

Management resets PIN

A case note or series of case notes entered by management that describes:

  • an action taken; and
  • the reason that the consumer's PIN was reset.

Action requiring management approval

A case note or series of case notes entered by the approving source that describes:

  • the decision requiring approval;
  • the parameters of approval; and/or
  • the extent to which a relevant policy is being waived.

1.3 Roles and Responsibilities of the Rehabilitation Team

1.3.1 Overview

In order for the VR process to progress smoothly, the consumer must be engaged. But the core of that process involves a group of partners who share responsibility for informing, educating, advocating, facilitating, and encouraging. Each partner must contribute his or her expertise to make the professional relationships with the consumer as productive as possible. Partnership-building is an active process. You must be open to

To effectively model behavior expected of others, leaders must first be clear about their guiding principles and lead from those principles. You must lead from what you believe. You must lead in all relationships that contribute to the success of the consumer. People have a tendency to follow first the person, then the plan. Your building partnerships with community, schools, family, business, other agencies, and consumers directly reflects the DRS core values. Other staff, consultants, the consumer and/or consumer's representative, and providers must be informed of the goals and their responsibilities in helping the consumer attain them. This section of policy addresses the specific roles and responsibilities of all team members who are a network of support for and with the consumer in the rehabilitation process.

1.3.2 Roles of Key Players

Consumer

DRS values the consumer-counselor relationship and encourages the following consumer roles:

Counselor

You are a

Area Manager

As a vital partner in facilitating quality, the area manager is a

Rehabilitation Services Technician

The RST

1.3.3 Responsibilities of the Courtesy Counselor

A courtesy counselor provides rehabilitation services to a consumer who is receiving services outside the consumer's home area. Examples include

Variations exist regarding

The primary focus, however, is on who can best serve the consumer to maintain continuity of quality services.

A courtesy counselor, who may perform courtesy work at one or more organizations, manages timely delivery of all services described in the IPE. The courtesy counselor

Also see 1.3.5 Responsibilities of the Community Rehabilitation Program (CRP) Liaison Counselor.

1.3.4 Responsibilities of the Medical Services Coordinator (MSC)

(Revised 12/09, 08/10, 02/11, 10/11, 07/16)

The medical services coordinator (MSC)

Medical Services Arranged by the MSC

The MSC arranges all

Procedures to Request Services of an MSC

Complete the following steps to request services of an MSC.

  1. Email or delegate an action item to the appropriate in-region MSC. If you are unsure of the MSC assignment, contact the regional office for guidance.
  2. Enter a case note stating the service to be arranged and the hospital or facility selected.
  3. Provide the following information to the MSC:

    Note: The MSC accesses the application information, the current Individualized Plan for Employment (IPE), and pertinent case notes including necessary area manager and medical director approvals (if applicable) in ReHabWorks if needed.

  4. Approve adequate funds to cover the cost of the requested medical services and any unexpected medical complications when notified by the MSC.
  5. If contacted by a medical provider about services arranged by the MSC, refer the provider to the MSC.

Note: To arrange out-of-region medical services, email or delegate an action item, enter a case note, and send the information to your home MSC. If you are unsure of your home MSC assignment, contact the regional office for guidance. The home MSC refers the request to the appropriate out-of-region service MSC for the coordination of the requested medical services.

Refer to the Medical Services Best Practice Guide for more information on the role and responsibilities of the medical service coordinator and procedures for coordinating medical services for consumers.

1.3.5 Responsibilities of the Community Rehabilitation Program (CRP) Liaison Counselor

(Revised 12/08)

The primary responsibility of the community rehabilitation program (CRP) liaison counselor is to develop an active relationship with the CRP that contributes to the successful employment of DRS consumers. The liaison serves as a DRS resource to the CRP on issues pertaining to implementing standards, invoicing for services, individual consumer case issues, and other topics of mutual interest to VR Counselors and CRPs.

A liaison counselor is assigned by the area manager or regional office to each CRP. The CRP liaison counselor is the primary communication link between the CRP and DRS. The CRP liaison counselor must know about

Duties of the CRP liaison counselor vary, according to the CRP being served. At least quarterly, the CRP liaison counselor must

Documenting Quarterly Visits

The CRP liaison counselor

The area manager reports any significant irregularities or trends he or she identifies to the regional director.

When the CRP regularly provides services for consumers for three or more hours per day (for example, for post-acute brain injury [PABI], residential services, work adjustment training), the CRP liaison counselor interviews 10 percent of the total number of consumers quarterly. See Tips for Conducting Consumer Interviews for additional guidance.

The CRP liaison counselor must report any concerns related to or raised by a particular consumer to the home counselor immediately.

To ensure compliance with 24-hour supervision requirements, at least one of the liaison counselor's quarterly visits each year for residential CRPs must be unannounced and outside of normal working hours (for example, during evenings or weekends).

CRPs without Permanent Locations for Delivering Consumer Services

If the CRP to which the CRP liaison counselor is assigned does not maintain a physical location where DRS consumers are served, the CRP liaison counselor must meet face-to-face with the CRP contractor at least once quarterly.

CRPs with Permanent Locations for Delivering Consumer Services

If a CRP liaison counselor is assigned to a CRP that maintains a physical location and serves DRS consumers in that location, the CRP liaison counselor must visit the location at least quarterly.

If a CRP has not served consumers for an extended period, the CRP liaison counselor may request an exception to the regular quarterly monitoring cycle. A request for exception must be approved by both

The CRP liaison counselor must copy the regional CRP specialist on all exception requests and approvals.

1.4 Responsibilities of Consultants

1.4.1 Local Medical Consultant (LMC) Services

Each field office has a local medical consultant (LMC), who is available for advice and guidance on the medical aspects of the VR process.

While the LMC provides guidance to DRS staff about individual consumers, the LMC does not

The LMC consults regarding the following areas.

Medical Reports

LMC guidance, preferably in person, may help assess a consumer's medical condition (etiology, prognosis, recommended examinations, need for a second opinion, and quality of care issues).

Surgery

When surgical services are planned, an LMC review is required before approving the purchase. The LMC records comments and/or recommendations regarding the following on DARS3101, Consultant Review:

Other Decisions about Medical Services

Contact the LMC, when appropriate, for medical guidance about the following:

The LMC records comments and/or recommendations on DARS3101, Consultant Review.

LMC Training Services

The area manager may invite the LMC to review medical reports and instruct individual counselors in the medical aspects of individual consumer rehabilitation. The LMC may also instruct counselor groups regarding

LMC Review and Evaluation Services

When the clarity or completeness of medical reports are in question, the counselor or area manager may invite the LMC to review reports from a particular physician or medical facility.

LMC Relationship with Medical Community

The LMC may

Limitations on LMC Consumer Services

The LMC does not examine or treat DRS consumers, except when

Other cases may be referred to the LMC for treatment only when

1.4.2 Regional Psychological Consultant (RPC) Services

The regional psychological consultant (RPC) is available for

RPC Consultation Services

When appropriate, contact the RPC for review of

For tests not listed in the Maximum Affordable Payment Schedule (MAPS),

RPC Training Services

The area manager may contact the RPC to instruct counselors, individually or in a group, about the psychological aspects of rehabilitation, for example,

RPC Review and Evaluation Services

At the area manager's request, the RPC

RPC Relationship with Psychologists

The RPC may

Limitations on RPC Services

The RPC does not administer psychological tests or provide counseling to consumers, except when the

Other cases may be referred to the RPC for testing only when

1.4.3 Regional Dental Consultant (RDC) Services

While essential dental services are being determined, the regional dental consultant (RDC) is available for advice and guidance.

Dental treatment may be

When appropriate, contact the RDC for

When specific dental procedures are planned, the RDC's review is required before approving the services. The RDC records comments and/or recommendations regarding the following on DARS3101, Consultant Review:

RDC Training

The area manager may contact the RDC to instruct

RDC Review and Evaluation Services

At the request of the area manager, the RDC

RDC Relationship with Dentists

The RDC may

Limitations on RDC Services

The RDC does not examine or treat DRS consumers, except when

Other cases may be referred to the RDC for treatment only when