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 17: Purchasing Goods and Services for Consumers

(Revised 07/16)

17.1 Overview of Purchasing Policies and Procedures

This chapter describes the requirements for purchasing goods and services for DARS consumers. Information about goods and services that have additional requirements for purchasing (such as approvals, consultations, or specific documentation) is located in the section of the manual for that service (for example, assistive technology or in-house providers).

This policy establishes statewide operating procedures for vocational rehabilitation programs that:

17.1.1 Staff Responsibilities

All agency staff members are responsible for ensuring compliance with purchasing processes. The caseload carrying staff member and his or her supervisor are responsible for all service authorizations.

The authorization for a good or service must be documented clearly in a case note in ReHabWorks before initiating a purchase with a service authorization. Authorization and/or exceptions to policy will not be granted for certain goods and services. For more information on restricted goods and services, see 17.7 Purchasing Thresholds and Restrictions.

All purchasing activities are subject to internal and or external review, audit, and investigation at any time. As public servants responsible for assisting Texans and serving the taxpayers of this state, DARS employees are expected to maintain the highest level of ethical conduct. Violation of these policies may result in disciplinary action, up to and including dismissal, and, in some cases, referral to state or federal law enforcement agencies. For more information see Chapter 1: Foundations, Roles, and Responsibilities, 1.2.5 Building Ethical Relationships and TWC Personnel Manual 1.9 Ethics/Standards of Conduct.

Internal Program Resource Staff

The following persons are available to provide specialized oversight, support, and consultation for purchasing:

If subject matter experts have questions that are not addressed in this chapter, manual, or in other policy and procedure manuals, they must consult with the appropriate internal program resource staff members before completing a service authorization for a good or service.

17.1.2 Documentation

ReHabWorks is the electronic case management system that interfaces with the agency's financial system and the state comptroller's system to document authorized services as well as to authorize and track payments for all consumer goods and services. Purchasing documentation is maintained in both ReHabWorks and in the paper case file.

For more information on documentation requirements, see RPM Chapter 1: Foundations, Roles, and Responsibilities: 1.2.8 Reflecting Quality Program Management in Documentation, VRM Chapter 5: Training Overview, 5.3 IPE Documentation and VRM Chapter 30: Supported Employment Services, 30.7 Case Note Documentation. Information about documentation requirements is also located in chapters and/or manuals.

Paper Case file Documentation

All documents related to the purchasing process are legal records and must be maintained in the consumer's paper case file.

Purchasing documents include but are not limited to

Purchasing documentation must be date-stamped on the date that it is received in the DARS office. Purchasing documentation must be filed in the consumer's paper case file once the purchasing documentation has been processed.

ReHabWorks does not maintain copies of service authorizations (SA) as they are revised. Print, sign, and file a paper copy of the SA in the consumer's paper case file when the SA is generated.

To ensure that the provider's file accurately reflects the purchasing activities in ReHabWorks, a copy of the SA must be sent to the provider when it is generated. If an SA is changed in any manner, a copy of the new signed SA must also be kept in the consumer's paper case file and sent to the provider as notification of the change. A staff member also must send documentation to service providers when the remaining open-balance quantity is reduced or reaches zero.

For more information about paper case file documentation for DBS consumers, see the VRM Chapter 40: Case Management, 40.2 Case Folder Documentation.

For more information about paper case file documentation for DRS consumers, see RPM Chapter 1: Foundations, Roles and, Responsibilities, 1.2.8 Reflecting Quality Program Management in Documentation.

17.1.3 Legislation, Policy, Procedures, and Resources

Legislation

Purchasing goods and services for DARS consumers is subject to state and federal laws. These include

DARS does not discriminate on the basis of race, color, sex, national origin, age, disability, or veteran status in purchasing consumer goods and services.

Policy and Procedure Manuals

DARS caseload carrying staff, designated technicians, and other DARS staff members that purchase goods and services for consumers also are subject to the policies and procedures throughout the following manuals:

17.2 Key Terms

After-the-Fact Purchase occurs when a good or service is provided before the issue of a valid service authorization in ReHabWorks. For more information, see 17.5.1 After-the-Fact Purchases.

Arranged (Service) is a good or service that will be provided by a source other than DARS. For example, a referral for ongoing mental health services to a community mental health center is an arranged service.

Backdated Ancillary Service Authorization is an additional service authorization issued after the service has been provided when additional services are needed to directly support the existing service authorization.

Backdated Replacement Service Authorization is a service authorization that is issued to replace an existing service authorization after the delivery of services or goods. This occurs when there is a need to change the level-four descriptions on an existing service authorization in ReHabWorks.

Begin Date is the date that the service is expected to start or that the initial delivery of a good is expected.

Best-Value Purchasing is a purchasing decision that is based on a balance between quality, timeliness, service after the sale, and cost. For more information, see 17.3.2 Best Value Purchasing.

Caseload Carrying Staff is the agency personnel assigned a specific group of cases in one of the programs that provide services to consumers. This includes counselors, vocational rehabilitation counselors, vocational rehabilitation transition counselors, and supervisors.

Comparable Benefits are resources for goods or services that are paid for by another entity, such as

Competitive Bid is an offer to contract with the state that is submitted in response to an invitation for bids. For more information about competitive bidding, see the Contracting Processes and Procedures Manual Glossary.

*Community Rehabilitation Program (CRP) is a program that provides directly, or facilitates the provision of, one or more of the following vocational rehabilitation services to enable individuals who have disabilities to maximize their opportunities for employment, including

*Based on 34 CFR Section 361.5

Date Payment Authorized is the date the pay request is recorded in ReHabWorks.

Discount is a reduction in the price of a purchased product or service offered by a vendor in exchange for quick payment of an invoiced item. When the discount amount is applied to the invoiced price, the cost of the purchased product or service is reduced.

Employment Service Provider (ESP) is a provider that has a bilateral contract with DARS to provide work-oriented services to consumers. Employment Service Provider was previously referred to as a Community Rehabilitation Program.

End Date is the anticipated date that a good is to be delivered or a service is to end. An end date on a service record must fall within the fiscal year for the program.

Free on Board (FOB) Destination is a designation applied to the delivery of goods whereby the receiver does not own the goods until they arrive at their destination. The FOB destination refers to the point at which the title to goods transfers. This term does not relate to freight charges.

Health Care Provider is a professional provider that provides health care services to consumers. See 17.23 Health Care Professionals—Required Qualifications for more information.

Health Care Facility is a facility such as a general or specialty hospital or an ambulatory surgical center that provides inpatient or outpatient medical services to consumers. See 17.24 Health Care Facility—Required Qualifications for more information.

Individualized Plan for Employment (IPE) is a plan that is developed jointly by the consumer and the counselor to help the consumer reach a specific competitive integrated employment outcome. It is developed within the framework of informed consumer choice. The IPE does not take effect or allow for authorization or payment of any good and/or service until it is agreed to and signed and dated by the consumer or consumer's representative and counselor. See RPM Chapter 4: Assessing and Planning and VRM Chapter 4: Assessing and Planning.

Informed choice is an ongoing process in the vocational rehabilitation (VR) program in which the consumer and the caseload carrying staff members cooperate to gather and evaluate information that the consumer uses to make informed choices about outcomes, objectives, and services that could lead to a positive competitive integrated employment outcome. For more information, see RPM Chapter 1: Foundations, Roles, and Responsibilities, 1.2.6 Applying Principles of Informed Choice; VRM Chapter 4: Assessing and Planning, 4.1.1 Purpose of Comprehensive Assessment; and 34 CFR Section 361.52(b)(4)(i–v).

In-house providers (DBS only) is an agency staff member that is not a member of the caseload carrying staff (CCS) and that provides direct services to consumers at the request of the CCS, such as training by a DBS vocational rehabilitation teacher, the Criss Cole Rehabilitation Center (CCRC), the Assistive Technology Unit (ATU), or a vocational evaluation by a DBS Vocational Diagnostic Unit staff member.

Interagency Transaction Voucher (ITV) is a request for payment from one state agency to another; the state comptroller transfers funds from one agency to another instead of issuing a warrant.

Invoice Date is the date an invoice was date-stamped by the DARS office that is named on the service authorization. If the invoice had an error, the invoice date is the date the corrected invoice was received and date stamped.

Non-competitive Purchase is the purchase of goods or services that involves dealing directly with the vendor using an application or enrollment process, or a purchase totaling less than $5,000.00.

Obligating Funds is the process by which program funds are committed through a service authorization to pay a provider for specific goods and/or services provided.

Payee is the individual or entity who receives payment from DARS for goods or services.

Periodic Payment is an expenditure used when a service is provided and paid over a defined but recurring period of time, such as training programs that bill monthly.

Program Year is the period which begins on July 1 of a calendar year and ends on June 30 of the next calendar year.

Proprietary Purchase is a purchase characterized by only one product, service, or provider meeting specifications because of distinctive features or characteristics that are not available from competing companies, similar products, or comparable services.

Provided Good and/or Service is a service that is delivered directly by a member of the DARS staff, such as counseling and guidance by a DARS counselor, training by a DBS vocational rehabilitation teacher, CCRC vocational rehabilitation teacher or a vocational evaluation by a DBS Vocational Diagnostic Unit staff member. This can also be a good that is provided directly to the consumer with no direct cost to the agency, such as a re-issued tool or textbook.

Provider is any individual or business from which DARS can obtain goods and services for consumers (also see vendor).

Purchased Good and/or Service is a good or service that is acquired on behalf of a consumer by using DARS funds.

Receive Date is the date a good was received or a service was completed. For detailed information on determining the appropriate date to use for the receive date, see ReHabWorks Users Guide, Chapter 18: Case Acknowledgement and Receipt.

*Rehabilitation Technology is the systematic application of technologies, engineering methodologies, and scientific principles to meet the needs of and address the barriers confronted by individuals with disabilities in areas that include education, rehabilitation, employment, transportation, independent living, recreation, and home and vehicular modification. It refers also to other assistive devices including, but not limited to hearing aids, low vision aids, and wheelchairs. Rehabilitation technology includes rehabilitation engineering, assistive technology devices, and assistive technology services.*

*Based on 34 CFR Section 361.5(b)(45)

Report Receive Date is the date entered into ReHabWorks when a complete and accurate report and all required forms or other documentation are received from the provider.

Restricted Donation is a cash donation made to DARS to use for services to DARS consumers. The donor can specify a purpose, program, DARS office, or caseload for which the funds are to be used. If the funds are accepted in accordance with the donor's wishes, they may be used only for the stated purpose.

Separation of Duties requires that at least two staff members complete each consumer purchase—one staff member to issue the service authorization and another staff member to authorize payment.

Service Authorization (SA) is an official approval for a provider to supply goods or services to meet the stated specifications in accordance with defined terms and conditions. A service authorization obligates funds from the caseload budget. It is the only valid way to authorize purchases.

Service Completion Date is the date the consumer product is received, the date the consumer service is completed (including receipt of the provider's written report, if applicable), or the date the provider's invoice is received, whichever is later.

Service Justification Case Note is a case note or series of case notes entered into ReHabWorks to authorize a service or good for a consumer. The case note must include the type of service, goal of service, specific provider, begin and end dates of service, information about available comparable benefits, and information about how the consumer exercised informed choice.

Service Record is a planning document created in ReHabWorks for services and/or goods that are arranged, provided, or purchased for the consumer. The service records in a case also document the substantial services provided to a consumer. For a purchased good or service, a service record contains information that is used to create a service authorization. The caseload-carrying staff or his or her support staff may need to create service records to request services from an in-house vendor.

Sole Source is a product or service that is available for purchase only through the identified vendor. These vendors are usually the manufacturer. For example, a type of software that is available from only one provider.

Specification is a description of the good or service that tells the vendor exactly what will be purchased.

Specification Customization is the process of adding detailed information to a level-four specification in ReHabWorks so the provider has a clear understanding of DARS expectations. See also specification and specification levels. For more information, see ReHabWorks Users Guide, Chapter 16: Case Service Record, 16.2.4 Select Specification.

Specification Levels are the descriptions of goods or services used when creating a service record in ReHabWorks. The levels increase in detail from general (level one) to detailed (level four), allowing buyers to locate what they need to buy. See also "specification."

Spot Purchase is the purchase of good or service costing less than $5,000.00.

Start Date (Service Record) is the date a good is ordered or the date a service is expected to begin. For more information, see ReHabWorks Users Guide, Chapter 17: Case Purchase Order.

State Fiscal Year is the twelve months beginning September 1 and ending August 31.

Third Party Payment is a payment to a provider received from a source of comparable benefits used for goods or services arranged for consumers. For example, Medicaid or private insurance as the payer for a medical good or service instead of DBS or DRS is a third party payer.

Texas Identification Number (TIN) is a 14-digit number issued to entities (that is, sole owner, individual recipient, partnership, corporation or other organization) that bill DARS for goods or services. The state comptroller requires the TIN on requests from any party receiving payment from the State of Texas.

Vendor is an individual or business entity that offers goods or services to the state for sale, lease, lease-purchase, or contract. Vendors are sometimes referred to as providers. The characteristics of a vendor include

Note: a vendor may also be referred to as a provider, particularly when the entity provides services to DARS consumers.

17.3 Principles of Purchasing

All purchases must be authorized in a consumer's valid Individualized Plan for Employment (IPE) and/or in a service justification case note by a caseload carrying staff member or a designee. The IPE and/or service justification case note must be entered into ReHabWorks before obligating funds with a service authorization.

17.3.1 Making Purchasing Decisions

*When selecting a good or service, consider

*Based on 34 CFR Section 361.52(c)(1-6)

17.3.2 Best Value Purchasing

DARS staff members must apply the best-value purchasing approach when making consumer purchases. This approach ensures that staff members authorizing a purchase are not restricted to considering only the initial cost of a purchase; they must also evaluate the factors that will influence the total cost and value to the consumer and the agency. These factors include but are not limited to

17.3.3 Informed Consumer Choice

*The consumer and as appropriate, his or her representatives, must be involved in decision making in all aspects of his or her vocational rehabilitation services, including selecting the goods, services, and providers during the purchasing process.*

*Based on 34 CFR Section 361.52

The counselor must document in a case note the consumer's involvement in the selection of goods, services, and/or providers.

For more information about informed choice, refer to RPM Chapter 1: Foundations, Roles, and Responsibilities, 1.2.6 Applying Principles of Informed Choice; VRM Chapter 3: Determination of Eligibility, 3.1.3 Role of the Applicant or Consumer; and VRM Chapter 4: Assessing and Planning, 4.1.1 Purpose of Comprehensive Assessment.

17.3.4 Use of Comparable Benefits

*Available comparable benefits—similar services to those provided by DBS or DRS but paid for by another entity— must be used before authorizing or encumbering DARS funds for a purchase.* See 17.2 Key Terms for additional information.

*Based on 34 CFR Section 361.53

Exploration and/or use of comparable benefits must be documented in a case note before completing a service authorization for a good or service

For more information about comparable benefits, see RPM Chapter 4: Assessing and Planning, 4.5 Comparable Services and Benefits and VRM Chapter 4: Comparable Benefits and Resources.

17.3.5 Separation of Duties

A minimum of two staff members must complete—issue, receive and authorize payment—each consumer purchase in order to ensure that integrity is maintained throughout the purchasing process.

ReHabWorks is designed so that the same person cannot authorize payment for a service authorization (SA) that he or she created or made changes to at any point in the purchasing process. For additional information about processing an SA in ReHabWorks, see ReHabWorks Users Guide, Chapter 17: Case Purchase Order, 17.4 New PO.

17.4 Purchasing Process

The process of purchasing a good or service for a consumer is primarily initiated by a caseload carrying staff member.

Purchases made before the completion of the individualized plan for employment (IPE)) must be for goods and/or services that are necessary to complete diagnostics, support the completion of diagnostics, assess eligibility, or develop the IPE. Purchases initiated before the completion of an IPE are documented in a service justification case note.

Purchases made after the IPE is completed must be included on the IPE, an IPE amendment, or in a service justification case note.

All goods and services purchased must support a consumer's employment outcome.

17.4.1 Purchasing Process Steps

Step 1

Identify purchase of a needed good or service.

Research and collect required approvals by referring to appropriate program manuals.

For information about types of purchases, see 17.11 Types of Purchases. For information about specific goods and services, consult the appropriate program manuals: the Vocational Rehabilitation Manual (VRM) and the Rehabilitation Policy Manual (RPM).

For information about approvals, see RPM Chapter 19: Technical Information and References, 19.1 Required Approvals and/or Consultations and the VRM Chapter 41: Required Approvals and Consultations.

Step 2

Document the need and type of purchase in

Step 3

Create a service record. For more information, see ReHabWorks Users Guide, Chapter 16: Case Service Record .

Complete the specification on the service record to identify precisely the item or service. Document required approvals according to policy.

Edit the level-four specification descriptions to match what you want to buy. All specifications can be customized except

Step 4

Create a service authorization (SA) to obligate budget. For more information, see ReHabWorks Users Guide, Chapter 17: Case Purchase Order .

If the consumer is eligible, use the pre-employment transition services budget. For more information, see RPM Chapter 10: Transition Services, 10.4.1 Providing Pre-Employment Transition Services .

Step 5

Print the SA. The printed SA must be signed by the issuer and then sent to the vendor by mail, fax, or encrypted email. Depending on the manner in which the SA is sent to the vendor, the staff member files the original signed SA or a copy of it in the consumer's case folder.

Anytime the SA is revised, these steps must be completed again, and the new or updated SA must be sent to the vendor and filed in the paper case file. For more information about revising an SA, see 17.5 After-the-Fact Purchases and Other Revisions to a Service Authorization .

Step 6

If it becomes apparent that the total committed budget will not be used, reduce the quantity and/or unit cost in the SA. For information about closing out an SA, refer to ReHabWorks Users Guide, Chapter 17: Case Purchase Order, 17.10 PO Change .

Step 7

Receive and document the receipt of goods and services. Verify that goods and/or services were delivered in good condition and met the specifications. (See 17.9 Verifying Receipt of Goods and Services .)

Step 8

Within seven days, process the invoice. (See 17.10 Invoices for more information.)

17.5 After-the-Fact Purchases and Revisions to Service Authorizations

Before contacting the vendor to order, request, or schedule the delivery of goods or the provision of services, it is the requester's responsibility to ensure that a service authorization was generated and sent to the service provider.

A state agency must not obligate funds in an amount greater than the amount listed on the service authorization. If a staff member obligates funds without following policy, the state comptroller is required to deduct the total amount of the over-obligation from the staff member's salary or other compensation.

For more information see

17.5.1 After-the-Fact Purchases

When a delay of services may endanger a consumer's well-being, a caseload carrying staff member may authorize hospital or medical services before the completion of a service authorization in ReHabWorks (RHW). The caseload carrying staff member's manager or regional management team must be consulted, and approval of the after-the-fact purchase must be documented in a case note before the service authorization is generated in RHW.

17.5.2 Backdated Ancillary Service Authorizations

A backdated ancillary service authorization is issued after the service has been provided and additional services are needed to directly support an existing service authorization.

Backdated ancillary service authorizations do not require management approval, but must be completed immediately when the need appears. Backdated ancillary service authorizations (SA) must be justified in a case note before generating the SA in ReHabWorks. The case note must include the SA number of the original related SA. The comments section of the backdated ancillary service authorization must include the SA number of the original SA.

After the start date of an existing SA, it may be necessary to

For more information about revising an SA, see ReHabWorks Users Guide, Chapter 17: Case Purchase Order, 17.10 PO Change.

17.5.3 Backdated Replacement Service Authorizations

The specifications in a service authorization (SA) may change after the delivery of services. If services are delivered by the same vendor and there is a revision to services, such as a change in Maximum Affordable Payment Schedule codes, and manager or medical director approval was required on the initial SA, manager or medical director approval is required on the backdated replacement service authorization.

Approval by the manager or medical director must be documented in the paper case file before the replacement service authorization is issued. If no approvals were required for the original service authorization or the new service authorization, then no additional approvals are required.

Staff must document the need for the backdated replacement service authorization in a case note before generating the replacement SA. The comments section of the backdated replacement service authorization must reference the original SA number.

17.6 No-Show Payments

A "no-show" occurs when a DARS consumer

DRS accepts for consideration only the no-show billings received from a psychiatrist, social worker, licensed professional counselor, or psychologist. No-show occurrences for other disciplines, specialties, and contractors are not subject to or eligible for no-show payments from DRS. The service provider must notify the caseload carrying staff member within one working day of the consumer's failure to appear. For more information see the DRS Standards for Providers Manual Chapter 2: Standards for Work Readiness, 2.4.3 Procedures and Process.

If a no-show occurs and if the provider chooses to bill DARS for the no-show, the acceptable fee is limited to 50 percent of the payment allowed by the Maximum Affordable Payment Schedule for the codes authorized on the service authorization.

For DBS only, refer to Standards Manual for Consumer Services Contract Providers for details regarding payment for no-shows.

Process the No-Show Payment

A no-show specification is different from the specification for the service that would have been provided. Therefore, the original service authorization must be closed so a new service authorization can be created.

No-show payments are processed in the same manner as any other provider payment. For more information, see ReHabWorks Users Guide Chapter 16: Case Service Record.

Create a service record and select No Show for the specification and enter the correct Begin Date and End Date (even though both dates occurred in the past).

17.7 Purchasing Thresholds and Restrictions

Purchasing thresholds are established to ensure management oversight of high-cost and high-risk purchases. Thresholds are division-specific. The caseload carrying staff must review associated chapters in the Rehabilitation Policy Manual or Vocational Rehabilitation Manual in addition to reviewing the charts below.

If the product or service is not under contract or a Maximum Affordable Payment Schedule purchase and the cost is less than $5,000.00, the purchase should be completed using a commercial source. This process is known as a spot purchase.

Purchasing restrictions apply to all DARS purchases.

For more information on exceptions to policies, refer to RPM Chapter 1: Foundations, Role, and Responsibilities, 1.1.2 The Intent of the Policy and VRM Chapter 41: Required Approvals and Consultations, 41.1 Required Approvals and/or Consultations.

17.7.1 DBS purchasing threshold approval requirements

Purchase costs per item Approval is needed from Are Competitive Bids Required?
$0 to $5,000 Caseload carrying staff No
$5,001 to $7,500 Caseload carrying staff Yes
$7,501 to $10,000 Vocational rehabilitation supervisor or field director Yes
$10,001 to $15,000 Director or programs manager Yes
$15,001 and more Director of blind services division Yes

For information about exceptions to the competitive bid process, see ReHabWorks Users Guide, Chapter 17: Case Purchase Order, 17.4.2 Separation of Duties.

For information about obtaining required bids, email the TWC Purchasing Team (e.g., for RHW bid requests).

17.7.2 DRS purchasing threshold approval requirements

Purchase costs per item Approval is needed from Are Competitive Bids Required?
$2,000 or less Caseload carrying staff No
Greater than $2,000 but less than or equal to $5,000 Pre-purchase review by management support specialist or unit support technician required No
Greater than $5,000 Area manager

Required for goods or services greater than $5,000 if the purchase is

  • Not a contracted item;
  • Not using the Maximum Affordable Payment Schedule; and/or
  • Not educational tuition.

For all purchases over $2,000, a case review must be completed in TxROCS and approval from the management support specialist or unit support technician must be noted in ReHabWorks. See RPM Chapter 19: Technical Information and References, 19.5 Case Reviews.

For additional information about required approvals, refer to RPM Chapter 19: Technical Information and References, 19.1 Required Approvals and/or Consultations.

For information about obtaining required bids, email the TWC Purchasing Team (e.g., for RHW bid requests).

17.7.3 Purchasing Restrictions

The following goods and services may not be purchased by DARS for consumer use (management exceptions are not permitted):

Check with the Department of Public Safety for information about specific regulations (for example, some small trailers do not require a title of ownership).

Do not pay dues to a professional association or trade union unless the purchase is justified as critical to the success of the consumer's employment. Enter a case note in the consumer's file to justify the purchase.

17.7.4 Payee Restrictions

To prevent a conflict of interest, DARS must not purchase goods or services for the consumer from a provider who is serving as the consumer's representative.

Goods and services may be purchased from a provider who is serving as the consumer's representative only

The manager must not make an exception to this policy.

17.8 Ordering Goods for Consumers

Goods and services must be authorized with a service authorization (SA) before obtaining a good or service. The Issue Date of the SA must be dated on or before the Start Date.

17.8.1 Free On Board (FOB) Destination

When issuing a service authorization (SA) for goods that will be shipped to the DRS or DBS office or directly to the consumer, include "FOB destination" on the service authorization as a condition of the purchase.

If the provider will not ship FOB destination, locate another resource, if possible.

Free On Board means that DARS does not own the goods until they arrive and are accepted at the destination identified on the service authorization. The risk of loss to goods does not pass to DARS until the goods are delivered and the shipment is accepted.

When the goods are damaged in transit or are not accepted or received, the provider is responsible for shipping new or replacement goods without additional expense to DARS.

17.9 Verifying Receipt of Goods and Services

Verifying receipt and accuracy of orders is an essential part of the purchasing process to confirm that

17.9.1 Accepting Delivery of Goods

When consumer purchases are delivered to a DARS office, the deliveries are processed the same way other administrative deliveries are processed. A DARS staff member follows the procedure below.

Before accepting the delivery

Acknowledge the shipment by signing the shipping document if the shipment

Assess and document the shipment status in a ReHabWorks case note.

If the shipment appears damaged but the damage seems minor

If the damage is or appears to be severe

Do not accept collect or cash on delivery (COD) deliveries or deliveries made to the wrong office. If a vendor erroneously ships collect or COD, refuse the shipment.

If goods or services do not meet the appropriate conditions listed above, initiate corrections. When the goods or services meet the conditions, document their receipt in ReHabWorks.

17.9.2 Documenting Receipt of Services

Contact the consumer or the consumer's representative by email, phone, in person, or get written documentation that includes the consumer's or his or her representative's signature to verify that services were delivered. Document this communication in a case note in ReHabWorks. If the consumer is not available to verify receipt of the service, you must document in case notes all attempts to verify receipt of the service in a timely manner.

Contact the consumer to verify that the service met the specifications, and document this in a case note.

If 20 days have elapsed since the receipt of the invoice and the consumer has not been contacted, continue to attempt contact with the consumer. Record in case notes each attempt to contact the consumer.

Get the consumer's signature, if required, that the service met specifications and file the signed document in the paper case file. If a signature is not required, record the consumer's response in case notes.

If the consumer cannot be contacted, consult the area manager for guidance.

If you contact someone other than the consumer or the consumer's representative, see Business Procedures Manual, Chapter 20: Confidentiality and Use of Consumer Records and Information.

For maintenance or transportation payment, ReHabWorks automatically creates an action item to receive the records once a service authorization is generated.

17.9.3 Provider Reports

In some cases, TWS-VR purchases a service that requires the provider to submit a report. For example, medical examination results in a medical report. The receive date is the date the examination (service) takes place. The report receive date in ReHabWorks is an additional date required for all services with reports. The report receive date is the date the report is received in the office listed on the service authorization.

For a detailed list of report requirements, refer to RUG Appendix G: Service Category Descriptions.

Enter the report date in ReHabWorks within seven working days of receipt of a complete and accurate report.

General VR only: See RPM Chapter 9: Employment Services, 9.4.9 [Supported Employment Services] Quality Criteria for guidance about supported employment services reports.

17.10 Invoices

Vendors must submit invoices to the office address listed on the service authorization. The invoice must comply with

Within seven calendar-days of receiving an invoice, the staff member must

17.10.1 Date Stamping Invoices

The front of all invoices must be date-stamped upon receipt in the DARS office. If the envelope is date-stamped, keep the envelope as part of the paper case file. If the invoice is received via email, print the invoice and stamp it with the date received in the office. For faxed invoices, if the date on the fax tagline is correct and up-to–date, then that date reflects the date received in the office. Document the fax in the paper case file.

17.10.2 Elements of an Invoice

The invoice must include the following:

Additional documentation might be required, subject to the specific program's published standards in the DRS Standards for Providers and DBS Standards for Consumer Service Contract Providers.

Optional Information on the invoice might include the

For outcome-based services, such as job placement and supported employment, the date of service is the date on which the consumer achieved the benchmark.

For medical billings that lack required invoice data, the ReHabWorks system-generated invoice for the service authorization may be attached to the medical billing and used in place of an invoice if all other information on the medical billing is accurate and complete.

17.10.3 Incomplete Invoices

Do not authorize payment for a product or service without an accurate and complete invoice from the provider. When an invoice is inaccurate or incomplete, return it to the vendor for correction. You must

Note: The date of resolution should be used as the invoice received date in ReHabWorks, and the invoice should be date-stamped with that date.

For medical billing invoices, attach the ReHabWorks-generated invoice to the medical billing invoice.

17.10.4 Invoice is Not Received

Do not enter an invoice-received-date in ReHabWorks before receiving the invoice.

When vendors do not submit invoices in a timely manner, follow up with the service provider by contacting its accounts payable department.

If the provider does not have an invoicing system or template

17.10.5 Invoice Included Late Payment Fee

Late fees are automatically calculated and paid by the state comptroller to meet the requirements of the Texas Prompt Payment Act. The determination of a late fee is based on the receive date and invoice date that are entered into ReHabWorks. DARS does not pay late fees that are directly invoiced by the provider.

If a provider submits an invoice that includes a late payment fee:

17.10.6 Acknowledging Receipt of an Invoice in ReHabWorks

See ReHabWorks Users Guide, Chapter 18: Case Acknowledgement of Receipt, 18.1.3 Adding or Updating a Receive Item for detailed instructions.

17.11 Types of Purchases

Goods and services can be purchased for consumers from a variety of community rehabilitation programs (CRP) and vendors, including contracted providers, non-contracted providers, and medical service providers.

For more information, see 17.2 Key Terms.

Each type of purchase has steps that must be completed to ensure compliance with state comptroller purchasing requirements.

17.11.1 Non-competitive Purchases

Purchases of goods and/or services in the amount of $5,000 or less from a single vendor do not require competitive bids, but they must conform to the purchasing guidelines and principles stated in this chapter. All purchases (except contracted services) such as tuition costing more than $5,000 must be competitively bid or approved as a Proprietary or Sole Source Purchase. (See 17.11.2 Proprietary and Sole Source Purchases.)

When a service authorization (SA) for more than $5,000 is entered into ReHabWorks, ReHabWorks automatically creates a draft SA. The draft SA (called a draft purchase order in ReHabWorks) generates an action for Health and Human Services Procurement Services Customer Services to get bids and assign a buyer if appropriate. (See ReHabWorks Users Guide Chapter 19: Case Authorizing Payment, 19.6 PO Close).

For information about obtaining required bids, email the TWC Purchasing Team (e.g., for RHW bid requests).

17.11.2 Proprietary and Sole Source Purchases

A proprietary or sole source purchase occurs when only one brand name (manufacturer) or only one provider can meet the agency's specifications for the product or service because of distinctive features or characteristics that are not provided by competing companies, similar products, or comparable services. When the specifications limit consideration to one product or supplier, the paper case file must contain a written and approved DARS1322, Proprietary Purchase Justification.

A proprietary or sole source purchase justification is required, if the above condition and one or more of the following, applies:

A proprietary purchase or sole source transaction may not exceed $25,000; this cost-limit is not subject to area-manager exception.

An example of a proprietary purchase is a Humanware BrailleNote Notetaker, a unique device that is available from only one provider.

17.11.3 Contracted Goods and Services

When purchasing contracted goods and services, refer to

Contract administration staff members solicit and manage contracts for DARS goods and services. Some goods or services must be purchased under contract. Before purchasing a good or service, use ReHabWorks to find out if a contract is required. When the service authorization is generated, ReHabWorks assigns the contract number based on the vendor and the type of purchase. Refer to the ReHabWorks User's Guide, Chapter 16: Case Service Record for more information about creating a service record.

Consumer goods and services that are purchased under contract include, but are not limited to:

Ensuring a Valid Contract

DARS must note contract numbers on documentation related to the goods or services purchased under contract and ensure that the contract number is current on the service record before issuing the service authorization.

When creating a service record in ReHabWorks to purchase goods or services that require a contract, make sure the contract for the selected good or service is valid during the entire planned period of service by using the procedure below.

Review the provider contract information in ReHabWorks from the Service Record page by

Read the contract details carefully to ensure that the contracted good or service is included in the contract and the dates of service are within the contract start and end dates.

If the contract is not valid when the good or service is purchased or delivered, do not use that good or service. Instead, be sure to

In the comments section of the service authorization, enter all special instructions or requirements for the specific good or service being purchased.

17.12 Medical and Psychological Services Billing

Payment for medical and psychological services must be authorized by DARS and must support the vocational rehabilitation services and goal. Medical and Psychological Services purchased for consumers must be use Maximum Affordable Payment Scheduling (MAPS) coding and pricing in ReHabWorks. No other type of service authorization can be issued.

Medical and psychological services, including medical goods and supplies, are purchased using MAPS coding and pricing. MAPS codes establish the maximum payment that can be authorized for these services. Staff members should work closely with the provider to ensure that payment corresponds to the correct MAPS code(s). Treatment decisions and accurate identification of the applicable MAPS code are the responsibility of the consumer's healthcare provider and designated program staff members or consultants. Staff members must consult the MAPS Guidelines for instructions about MAPS-related purchases before generating a service authorization in ReHabWorks.

DRS uses the Medical Services Required Practices Handbook to provide guidance to the medical services coordinator (MSC), medical services technician (MST), DRS caseload carrying staff, and rehabilitation services technician (RST) who coordinate medical services for DRS consumers.

For additional information about purchasing medical services, refer to RPM Chapter 6: Physical Restoration Services.

For additional information about purchasing medical services, refer to VRM Chapter 24: Physical and Mental Restoration Services .

17.12.1 Exceptions to Contracted Fees and MAPS Fees

Fees in excess of the contracted fee for a specific service or for Maximum Affordable Payment Schedule (MAPS) fees are not authorized; managers are not permitted to authorize exceptions to fees that exceed the contract rate or MAPS fee.

17.13 Exceptions to Contracts

17.13.1 Providers without a Contract

Contracts are required for the purchase of most goods and services. Before creating a service record, check ReHabWorks to verify whether a contract is required. If a contract is required, case-by-case exceptions to a contract requirement may be approved only in situations where the exception is

Exceptions are reviewed by the manager, regional director, and approved by the director of rehabilitation services division or the director of blind services division.

17.13.2 Process for Exceptions to Contracts

The following process applies to all contracts except for hospital contracts. For more information about exceptions to hospital contracts, see 17.13.3 Exceptions to Hospital Contracts.

Caseload carrying staff member

  1. documents a contract-exception request in an email or memo that describes the consumer's need for a specific contracted good or service. (The request explains that a non-contracted vendor is needed to best serve the consumer in achieving his or her plan objective.); and
  2. sends the contract exception request email or memo to the manager for review and approval.

Manager

  1. reviews and concurs with the request or denies the contract exception request; and
  2. sends the requested documentation to the regional director or director for programs management for review and concurrence or denial.

Regional director or director for programs management

  1. reviews and concurs with or denies the request; and
  2. sends the request documentation to the director of rehabilitation services division or the director of blind services division for review and approval.

Director of Rehabilitation Services Division or Director of Blind Services Division

  1. reviews and approves or denies the request; and
  2. sends approved documentation to the chief operating officer (COO) for review and approval.

COO and Director of Rehabilitation Services Division or Director of Blind Services Division

  1. make final approval.

COO

  1. sends the approved exception to the director of rehabilitation services division or the director of blind services division.

Director of Rehabilitation Services Division or Director of Blind Services Division

  1. returns the approval through the chain of command to the caseload carrying staff member.

If at any time the request for a contract exception is denied, the document is returned through the chain of command to the caseload carrying staff member.

Hospitals without DARS Contracts—DRS Only

DBS does not purchase services from hospitals without contracts. The following information applies to DRS only.

If a consumer needs a medical service at a hospital that does not have a DARS contract, the assigned medical service coordinator (MSC) must contact the regional program specialist for contracts (RPSC) to negotiate a payment rate for the medical service. A DARS3423, Exception to Contracted Hospital Purchase, must be completed and submitted through the regional director to the director of rehabilitation services division for final approval by the chief operating officer.

For more information see RPM Chapter 6: Physical Restoration Services and the Medical Services Required Practices Handbook.

17.13.3 Process for Exceptions to Hospital Contracts

The following process applies only to exceptions to hospital contracts. For more information about exceptions to all other contracts, see 17.13.2 Process for Exceptions to Contracts.

Caseload Carrying Staff Member

  1. documents a contract exception request in an email or memo that describes the consumer's need for a specific contracted good or service. (The request explains that a non-contracted vendor is needed in order to best serve the consumer in achieving his or her plan objective.); and
  2. sends a DARS3472, Contracted Service Modification to the manager for review and approval.

Manager

  1. reviews and concurs with or denies the contract exception request; and
  2. sends the request documentation to the regional director for review and concurrence or denial.

Regional Director

  1. reviews and concurs with or denies the request; and
  2. sends the request documentation to the director of rehabilitation services division or director of blind services division for review and approval.

Director of Rehabilitation Services Division or Director of Blind Services Division

  1. reviews and approves the request or denies the request; and
  2. sends approved documentation to the chief operating officer (COO) for review and approval.

Chief Operating Officer (COO) and Chief Financial Officer

  1. review and make the final approval.

COO

  1. sends an approved exception to the director of rehabilitation services division or director of blind services division.

Director of Rehabilitation Services Division or Director of Blind Services Division

  1. returns approval through the chain of command to the caseload carrying staff member.

17.13.4 Exceptions to Hospital Contracts

Hospital contracts permit payments below the contracted rate or in addition to the contracted rate when the consumer's circumstances warrant. See "Exceptions to payment rate limits" in the RPM Chapter 6: Physical Restoration Services, 6.3 Hospital and Ambulatory Surgery Center (ASC) Services for instructions including the use of DARS3422, DRS Reduced Payment Agreement.

17.13.5 Process for Documenting Modifications to Contracts

When the caseload carrying staff member's manager reviews and concurs with an exception to a policy regarding a service provided under a contract, such as changes in the service description so that the service is individualized for a specific consumer, approval must be recorded on the DARS3472, Contracted Service Modification.

The DARS3472, Contracted Service Modification, must be

A copy of the completed DARS3472 must be retained in the consumer file.

The caseload carrying staff member forwards a copy of the completed DARS3472 to the contract manager.

See DRS Standards for Providers, Chapter 1: Basic Standards, 1.11 Record Keeping, Changes to Services.

Exceptions to Contracted Fees

Fees in excess of the contracted fee for a specific service are not allowed and managers may not authorize an exception.

17.13.6 Required Approvals and Consultations

For more information about required approvals and consultations for contract exceptions, see RPM Chapter 19: Technical Information and References, 19.1 Required Approvals and/or Consultations for DRS and VRM Chapter 41: Required Approvals and Consultations for DBS.

17.14 Noncontract Purchases from Contract Providers

Goods or services that do not require a contract can be purchased from a provider that already supplies contracted goods or services to DARS. In this instance, when creating a service record and service authorization in ReHabWorks, do not select a contract number; instead choose "none" when prompted.

17.15 Program Year

To determine the program year for services

For goods and supplies, select the program year in which the goods were ordered.

For more information about how to prorate cost, see 17.16.1 Prorating Services.

17.16 Crossing State Fiscal Years

The federal fiscal year starts October 1 and ends September 30. The state fiscal year starts September 1 and ends August 31.

Ordering and Receiving

Charge goods to the state fiscal year in which they were ordered. The receive date does not have to fall within the start and end dates and may be in the following fiscal year.

Example: A special order of a wheelchair on August 3, 2015, using Program 2015 VR Basic Support. The start date is the date the order was placed—06/03/2015.

The end date is the anticipated receipt date and, because of ReHabWorks requirement, must be within the state fiscal year. In this case, the anticipated receipt date is after the end of the fiscal year, so enter in ReHabWorks the end date of the fiscal year, 08/31/2015.

Since the chair is a good, the chair's receive date can be later than the anticipated end date. If the chair arrives September 27, 2015, enter 09/27/2015 as the receive date.

17.16.1 Prorating Services

If there are funds available in the budget in ReHabWorks, it is not necessary to prorate services across fiscal years.

Charge most services to the state fiscal year in which the service occurred. For more information, see 17.15 Program Year.

When part of a service falls in the next state fiscal year, charge that part to that state fiscal year. When setting up the service record, create two line items—one for each state fiscal year—and prorate the charge proportionately.

Example: When one week of service occurs in August and two weeks in September, charge one-third to August and two-thirds to September.

Tips for Prorating

When prorating

For more information about prorating payment see ReHabWorks Users Guide, Chapter 16: Case Service Record, 16.2.8.4 Prorating Payments for Services.

17.17 Other Types of Payments and Purchases

17.17.1 Periodic Payments

Periodic payments are used when a consumer service is provided and paid over a defined but recurring period of time (for example, training programs that bill monthly, or reader services that bill at regular intervals).

The receive date for periodic payments is the last day of the billing period. When the periodic payment is for one month, for example, the receive date for each payment is the last day of the month.

For information about how to enter a periodic payment in ReHabWorks, see ReHabWorks Users Guide, Chapter 19: Case Authorizing Payment.

17.17.2 Paying in Advance

Advance payment or prepayment occurs when payment for a consumer service is issued before the service is delivered. Payment usually is not made in advance of service.

In many cases, advance payments are issued directly to the consumer or a member of the consumer's family.

Consumer services for which advance payment may be authorized include

The table below lists the only circumstances when advanced pay may be issued. Advance payments may be received and authorized anytime from the "as early as date" to the actual completion date of the service. The date entered in the receipt acknowledgment in ReHabWorks is the receive date.

Advanced Pay Situations Pay as early as

Maintenance and transportation paid to the customer

Seven days before the start date

Academic and vocational training and training-related services (when provided by an accredited college or university over a semester or quarter)

Examples:

  • Tuition at an accredited college
  • RN or LVN training at a tax-supported hospital

Time of enrollment

Vocational or technical training (when provided by an accredited college or university)

Time of enrollment

Room and board paid to an accredited college or university

14 days before the start date

State board licenses

14 days before the start date

For example, if room and board had a start date of 8/16/2015 and an end date of 12/17/2015, caseload carrying staff could receive payment any day between 8/2/2015 and 12/17/2015. If the receipt is entered on 8/7/2015, the receipt date is 8/7/2015.

17.17.3 Setting Up and Paying Providers

Individuals may need to be set up as providers to issue payment for services such as reader services, maintenance, or transportation.

Before the service record is generated and before the service authorization is issued, ensure that the individual has been

State law prohibits the state comptroller from issuing a warrant to pay funds directly to anyone who owes the state for delinquent taxes or a defaulted debt, such as a guaranteed student loan.

If the individual is not already set up as a provider, complete a DARS1768, Application for Payee Identification Number, as follows:

  1. Complete Section 1 of the form;
  2. Use Federal Facility Code 12 if the payee is a consumer or Federal Facility Code 13 if the payee is the consumer's parent or legal guardian; and
  3. In Section 4:
    • indicate if the payee is a consumer or the parent/legal guardian of a consumer;
    • specify the type of payments that will be made to the payee; and
    • request that the payee be tied to the specifications for that type of payment.

When advance payment is authorized, payment authorization must be delegated in accordance with current ReHabWorks procedures.

17.17.4 Restricted Donations

A restricted donation is a cash donation made to DARS for use in providing services to DARS consumers that specifies a purpose, program, DARS office, or caseload for use. When a restricted donation is received, the receiving office immediately forwards it, along with any accompanying instructions, to the DARS accounting office in accordance with the published cash receipts procedures found in Business Procedure Manual, Chapter 23: Accounting, 23.1 Cash Receipts.

The following process describes the approvals required for the use of a restricted donation.

DARS Accounting

  1. records the information pertaining to the donation on the deposit including
    • donor name;
    • donation amount;
  2. assigns the unique donation number if not specified by receiving office;
  3. deposits funds into the appropriate DARS budget;
  4. notifies the office of the director of rehabilitation services division or director of blind services division that the donation has been received; and
  5. updates the Regular and Restricted Donation spreadsheet monthly and sends it to the DBS budget analyst and to the DARS Budget department.

Director of Rehabilitation Services Division or Director of Blind Services Division

  1. sends a letter of appreciation to the donor.

Using Restricted Donation Funds

For more information regarding how to use restricted donations see ReHabWorks Users Guide, Chapter 16: Case Service Record, 16.1 Service Record List .

17.17.5 Payment Discounts

For information on how to apply payment discounts, See ReHabWorks Users Guide, Chapter 18: Case Acknowledgement of Receipt, 18.1.1 Payment Discounts.

17.17.6 Multiconsumer Purchases

Multiconsumer purchases can be completed when services from a single provider are purchased for multiple consumers on the same caseload or for multiple consumers on different caseloads. A multiconsumer service record (SR) completed in ReHabWorks serves the same function as an individual service record and is used to create a multiconsumer service authorization (SA).

An invoice with multiple consumers' names is kept in a separate file. Information with multiple consumers' names must never be filed in an individual consumer file.

For additional information on creating a multiconsumer service record and a multiconsumer service authorization, refer to the ReHabWorks Users Guide, Chapter 20: Multiconsumer Purchases, 20.1 Multiconsumer Service Record.

17.17.7 Food Purchased for Consumer Training (DBS Only)

This section describes the procedure for DBS purchases of bulk food orders to be used in consumer training activities, including

Food that is provided in conjunction with other consumer activities, such as seminars and workshops and activities in the community, is not categorized as bulk food orders and should be purchased through ReHabWorks.

Processing Bulk Food Orders

Bulk food orders should be purchased through ReHabWorks if possible. However, bulk food orders also may be requisitioned in the Health and Human Services Administrative System (HHSAS) using an HHSAS requisition and purchase order, particularly when the situation does not lend itself to the multiconsumer service authorization consumer allocation, processing and payment requirements. To make these purchases, follow standard HHSAS purchasing guidance for consumer supplies.

17.17.8 Used Goods

DARS should purchase new equipment unless it is necessary or advantageous to purchase used equipment and supplies. Used equipment is most frequently purchased because

When you buy used and demonstration equipment, process the order according to the applicable procurement method, which is based on the estimated cost of the equipment.

Provide the following information in the paper case file of used goods:

17.18 Contractor Performance Issues

DARS staff members other than the contract manager routinely work closely with contractors and might identify a contractor performance or noncompliance issue outside the scope of the formal statewide monitoring process led by the Consumer Services Monitoring Unit (CSMU). If the staff member determines that the performance issue is significant, he or she must notify the contract manager even if the issue has been resolved.

The staff member must send this notification in writing and include the

Staff members use DARS1303, Contractor Performance Report, to document the performance issue or noncompliance and invoice issues. The form can also be used to document exceptionally good contractor performance. The DARS1303 is an internal document.

When the contract manager is notified of a contractor performance issue, he or she takes appropriate action and can request a remedial action review.

Refer to the following sections in the Consumer Processes and Procedures Manual for examples of what may constitute a significant issue:

17.19 When ReHabWorks is Not Available

If ReHabWorks is not functioning, the staff will receive directions from the executive central office staff.

17.20 Using Provider Credit Accounts

A service authorization (SA) is the only valid authorization by which purchases are made. No purchase may be made using a provider credit card.

Some providers (for example, Wal-Mart, Sears, Home Depot, Office Depot, and Hobby Lobby) require the use of a credit account. Credit account purchases must be made using the SA. Only existing provider account numbers may be used; no new provider accounts may be created.

For providers that require use of a credit card, each DARS office should have an assigned account number. See the ReHabWorks ADMIN "Accounts" Menu" for a list of existing account numbers for the user's office. Before using one of these accounts, the DARS staff issuing the service authorization should verify with the vendor that the account is still active.

When the issuer's office has an account with the provider, the account number is printed automatically on the SA. If an account number is not printed on the SA, then the office does not have an account and that vendor should not be used.

17.21 Interagency Transfer Vouchers

Texas state agencies provide a variety of goods and services for each other. For example, the Department of Aging and Disability Services provides medical records, and the Texas Cosmetology Commission provides state cosmetology licenses.

For some agencies, the state comptroller transfers funds from one agency to another through interagency transfer vouchers (ITV) instead of issuing a warrant to make the payment.

Receiving and Paying Interagency Transfer Vouchers (ITVs)

When receiving and paying interagency transfer vouches (ITVs), the staff member in the field office

  1. verifies its accuracy (See 17.10 Invoices for more information.);

    Note: If the invoice or ITV does not have a recurring transaction index (RTI) number, call the performing agency to get the RTI number and write it on the invoice or ITV.

  2. verifies that the goods or services have been received (See 17.10.6 Acknowledging Receipt of an Invoice in ReHabWorks);
  3. acknowledges receipt of the invoice, goods, and/or services, and documents (if applicable) in ReHabWorks:
    • the invoice number in the Invoice Number field in the Receive Items List window if the performing agency provided an invoice number (if an invoice number is not provided, the consumer's Social Security number);
    • the 6-digit RTI number,
  4. writes the voucher document number assigned in ReHabWorks on the invoice or ITV (the number begins with a T).

Note: Request payment using the SA Payment Authorization window. If the invoice includes fees for late payment, do not pay them.

The state comptroller maintains an Interagency Transactions Contact List, which is a list of agency contacts for Recurring Transaction Indicator numbers.

17.22 Purchasing Reviews and TxROCS

DARS completes case reviews as a part of oversight and monitoring of consumer purchasing activities. Texas Review, Oversight, and Coaching System (TxROCS) is an application for entering case reviews.

Refer to RPM Chapter 19: Technical Information and Resources, 19.5 Case Reviews and VRM Chapter 40: Case Management, 40.6 Quality Assurance Improvement Methods (Quality AIM) for additional information about technical and purchasing reviews.

17.23 Health Care Professionals—Required Qualifications

Listed below are the required qualifications for physicians, specialists, and other health care professionals.

The DRS Central Office program specialist for physical restoration at darsrhw.maps@twc.state.tx.us verifies in ReHabWorks the required qualifications of health care professionals.

For information about certification or licensure of other health care professionals, contact the DRS Central Office program specialist for physical restoration at darsrhw.maps@twc.state.tx.us.

For inquiries related to required qualifications for DBS, contact the mailbox at mapsinquiry.dbs@twc.state.tx.us.

Note: When an intern working under the supervision of a licensed provider provides counseling services, they are purchased at the supervising licensed provider's payment rate.

Professional Job Function Required Qualifications

Advanced practice nurse

Provides medical evaluation and/or treatment

Licensed by the Texas Board of Nursing

Audiologist

  • Provides audiological examinations
  • May dispense hearing aids
  • May provide basic audiometric assessments

Licensed by the State Board of Examiners for Speech-Language Pathology and Audiology

To dispense hearing aids, the audiologist also must be licensed by the State Committee of Examiners in the Fitting and Dispensing of Hearing Instruments

Certified registered nurse anesthetist (CRNA)

Administers anesthesia

Certified by the American Association of Nurse Anesthetists

Chiropractor

Provides manipulative treatment of the spine and functional capacity assessments (For restrictions, see RPM Chapter 6: Physical Restoration Services, 6.4.5 Chiropractic Treatment.)

Licensed by the Texas Board of Chiropractic Examiners

Cognitive rehabilitation therapist

Provides cognitive rehabilitation therapy, which focuses on the development of cognitive skills (the ability to perceive, recognize, conceive, judge, imagine and reason) lost or altered as a result of neurological damage

The aim of treatment is to enhance functional competence in real-world situations. The process includes

  • direct retraining
  • use of compensatory strategies, and/or
  • use of cognitive tools.

One of the following:

  • A psychologist licensed by the State Board of Examiners of Psychologists
  • A psychiatrist licensed by the State Board of Medical Examiners
  • An occupational therapist licensed by the Executive Council of Physical Therapy and Occupational Therapy Examiners
  • A speech and language pathologist certified by the State Committee of Examiners for Speech and Language Pathologists and Audiologists

Dentist

Provides dental evaluations and/or treatment

Licensed by Texas State Board of Dental Examiners to practice in the state where services are rendered

Hearing aid specialist

Dispenses hearing aids

May provide basic audiometric assessments (MAPS 92551 - 92559)

May provide hearing aid evaluations

Licensed by the Texas Board of Examiners in the Fitting and Dispensing of Hearing Aids

Licensed marriage and family therapist (LMFT)

Provides goal-oriented or problem-centered counseling services as recommended or prescribed by a psychiatrist or psychologist

Licensed by the Texas State Board of Examiners of Marriage and Family Therapists

Licensed professional counselor

Provides goal-oriented or problem-centered counseling services as recommended or prescribed by a psychiatrist or psychologist

Licensed by the Texas State Board of Examiners of Professional Counselors

Licensed surgical assistant (LSA)

Provides assistant surgeon services

Licensed by the Texas Medical Board

Occupational therapist

Provides

  • occupational therapy services recommended or prescribed by a physician,
  • home modifications assessment, and/or
  • job analysis and job-site modifications assessment.

Licensed by the Executive Council of Physical Therapy and Occupational Therapy Examiners to practice in the state where services are rendered

Optometrist

Provides vision examinations

Licensed by the Texas Optometry Board

Ophthalmologist

Specializes in diagnosis, treatment, and surgery for diseases of the eye

M.D. (doctor of medicine) licensed by the state of Texas State Board of Medical Examiners to practice in the state where services are rendered

Pedorthist

Fabricates and supplies below-the-ankle orthotics

Certified by the Board for the Certification in Pedorthics (C.Ped: certified pedorthists).

Physical therapist

Provides

  • physical therapy services recommended or prescribed by a physician,
  • home modifications assessment, and/or
  • job analysis and job-site modifications assessment.

Licensed by the Board of Physical Therapy and Occupational Therapy Examiners to practice in the state where services are rendered

Physician

Provides medical examinations and/or treatment

Exception: A podiatrist licensed in the state where services are rendered may provide medical or surgical services limited to foot conditions.

M.D. (doctor of medicine) or D.O. (doctor of osteopathy) licensed by the Texas State Board of Medical Examiners to practice in the state where services are rendered

Physician assistant

Provides medical examinations, medication management, and/or treatment

Licensed by the Texas Physician Assistant Board

Podiatrist

Provides medical examinations and treatment for foot conditions

Licensed by the Podiatric Medical Examiners Board. (D.P.M.: doctor of podiatric medicine)

Prosthetist and orthoptist

Fabricates and supplies prostheses and orthotics

Licensed by the State Board of Orthotics and Prosthetics

Psychiatric-mental health advanced practice nurse

Provides evaluation, goal-oriented or problem-centered counseling services, and/or medication management

Licensed by the Texas Board of Nursing

Psychologist

Provides or supervises the provision of psychological services

When an individual under the supervision of the licensed psychologist provides services, the licensed psychologist must sign all reports

Licensed by the Texas State Board of Examiners of Psychologists or licensed to practice in the state where service rendered (unless exempt)

Community-based behavioral health and developmental disability services centers and some state agencies are exempt from the licensing act

Registered nurse first assistant (RNFA)

Provides assistant surgeon services

Licensed by the Texas Board of Nursing

Social Worker

Provides goal-oriented or problem-centered counseling services for consumers as recommended or prescribed by a psychiatrist and/or psychologist

Licensed Clinical Social Worker (LCSW) licensed by the Texas State Board of Social Work Examiners

Community-based behavioral health and developmental disability services centers and some state agencies are exempt from the licensing act

Specialist physician

Performs examinations, treatment, and/or surgery

Physician certified by an American Medical Specialty Board, or the American Osteopathy Specialty Board in the needed specialty

When a board certified physician is not available, refer the consumer to the Texas Medical Board Look Up a License page to gather information about the education and experience of physician without board certification.

Speech and language pathologist

Provides, with concurrence of a physician, speech and hearing therapy after surgery or trauma affecting speech

Certified as a speech-language pathologist by the State Board of Examiners for Speech-Language Pathology and Audiology

Speech trainer

Provides speech training in both expressive (speech language production) and receptive (lip and speech reading) language

May also evaluate and provide training in the use of speech augmentation devices

Certified as a speech-language pathologist by the State Board of Examiners for Speech-Language Pathology and Audiology

17.24 Health Care Facilities—Required Qualifications

The required qualifications for health care facilities are listed below.

The DRS Central Office program specialist for physical restoration at darsrhw.maps@twc.state.tx.us verifies the required qualifications of health care facilities in ReHabWorks.

For information about certification or licensure of health care facilities, contact the DRS Central Office program specialist for physical restoration at darsrhw.maps@twc.state.tx.us.

For any information about required qualifications for DBS, contact the mailbox at mapsinquiry.dbs@twc.state.tx.us.

Health Care Facility Activity Required Qualifications

General hospital

Provides inpatient and outpatient hospital services

A current contract with DRS and/or DBS, and

  • Medicare certification,
  • accreditation by the Joint Commission for Accreditation of Health Care Organizations (JCAHO), or
  • accreditation by the American Osteopathic Association.

General or specialty hospital providing inpatient comprehensive medical rehabilitation services

Provides inpatient comprehensive medical rehabilitation services

A current contract with DRS and/or, and

  • licensure by the Texas Department of State Health Services for comprehensive medical rehabilitation services, unless exempt by law (for example, University of Texas Medical Branch);
  • accreditation by the JCAHO; or
  • accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF). CARF accreditation must be as a
    • "Medical Rehabilitation Program—Comprehensive Inpatient Category One" if accredited before July 1, 1998, or
    • "Comprehensive Integrated Inpatient Rehabilitation Program" if accredited July 1, 1998, or later.

Ambulatory surgical center

Primarily provides surgical services to patients who do not require overnight hospital care

Current licensure as an "ambulatory surgical center" by the Texas Department of State Health Services or accreditation by the American Association for Accreditation of Ambulatory Surgery Facilities

Nursing home

Provides nursing home or convalescent care

Licensed by the Nursing Home division of Texas Department of Aging and Disability Services

Approved by Medicare and Medicaid