PROS AND EMPLOYMENT RELATED SERVICES: Some Remaining Issues

February 24, 2004

A number of issues exist which we require clarity on. Some of these are:

Documentation:
What will documentation for VS services look like? What specific information regarding employment status or hours worked will be required? And, how will this documentation differ from IR and CRS service components that are employment-focused?

Competitive and Integrated Employment:
How is SOMH defining the terms ‘competitive’ and ‘integrated’ as they relate to employment positions and billing the VS add-on? What are the criteria that providers can utilize to measure the ‘integrated’ or ‘competitive’ nature of consumer-jobs?

Group Placements:
Some mental health employment programs provide group placement opportunities where consumers work in close contact with one another. For example, work crews in porter maintenance or horticulture, running a retail store, or working exclusively in a specific department within a large corporation. Some jobs may be considered ‘transitional’, others ‘permanent’. Some jobs are employer-paid (discrete from the agency), others are agency-paid. Clarity is required to understand if and when providers can bill VS services in these and similar circumstances.

ORS - Ongoing Rehabilitation and Support:
ORS has replaced VS as a program component of a PROS program. We are uncertain as to whether this is strictly a name change. Are the services that were originally conceptualized as part of the VS component now part of the ORS component? What exactly are these services? Are the parameters for billing ORS identical to those of VS? Do these services have to be provided off-site?

Work Experiences:
Are there any circumstances under which a stipend is an allowable expense under Medicaid? Can a provider bill for the VS add-on if a consumer is supported in an unpaid ‘internship’ position working at least 15 hours a week?

VESID and VS services:
Given the existence for a Memorandum of Agreement between VESID and OMH for the delivery of supported employment services, how will individuals who have received VESID intensive services receive extended services when they are affiliated with a non-PROS provider?

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