Consumer Cost Sharing Procedure • Does not include excluded services • Assessment for determining eligibility and rehab needs • Counseling, guidance and referral • Services provided by staff at state owned facilities • Placement • Rehab tech under $10,000 • Communication assistance in consumer’s native language • Supported Employment
Consumer Cost Sharing Procedure • Excluded Services (Cont) • Interpreter services • Reader services for the blind • Personal assistance services • Tutors, notetakers, and assistive technology educational aides • Other training: Driver training, OJT, job coach • Books, supplies, tools and equipment for vocational and other training
Consumer Cost Sharing Procedure • Will be completed by all eligible individuals except SSI/SSDI recipients • Takes into account family income (pg 6 & 7) • Income verification only for those individuals who receive a non-excluded service • Does not include individual assets
Consumer Cost Sharing Procedure Available Income Based On Family Size Subtract Disability Related Expenses Percentage of Consumer Cost Participation
Cost participation percentage based on available income after family size and disability related costs have been deducted. The form also determines the maximum amount the individual will have to contribute towards non-excluded services in a calendar year. Consumer Cost Sharing Procedure
Consumer Cost Sharing Procedure • Income verification – • Household income tax from previous year • Pay Stub • Award letter • Letter from group home, shelter or other agency • Return tax documentation • Not concerned with liquid or non liquid assets
Consumer Cost Sharing Procedure • Costs related to disability – May be an estimate • Impairment related work expenses • Physical restoration services • Mental restoration • Medical devices/equipment • Medical supplies • Transportation • Health insurance premiums, co-pays, deductibles • Vehicle Modifications – $10,000 • Self Employment Costs – Out of Pocket Expenses towards business for first year
Consumer Cost Sharing Procedure • Estimating VR Cost of Services • Heavy emphasis on estimate • Form can be completed as often as necessary • In Rehab Tech, only include amount over $10,000 because first $10,000 is exempt.
Consumer A – Tuition Family Size – 2 Income - $62,972 Disability Related Expenses – Medical Insurance & Copays - $5000 Transportation - $1000 Scenario
Step #1 • Enter Name • Enter Date • Enter Caseload # • Enter the Income/Total Adjusted Income • Enter Number in Household • Exclusion Amount will be automatically subtracted from Total Family Income • Will this this individual receive only excluded services or does he/she receive SSI/SSDI? If you answer yes to either of these questions, the form is complete. If you answer no to both, then continue. • Is this amount above $0?
Step #2 • Disability Related Expenses • Costs related to disability – May be an estimate • Impairment related work expenses • Physical restoration services • Mental restoration • Medical devices/equipment • Medical supplies • Transportation • Health insurance premiums, co-pays, deductibles • Vehicle Modifications – $10,000 • Self Employment Costs – Out of Pocket Expenses towards business for first year • Is this Amount Greater Than $0?
You now have the cost participation percentage (item 10), Maximum yearly participation percentage and amount (item 11 & 12) Enter the anticipated costs of non-excluded services Do not exceed the allowable expense for any particular service unless an exception has been granted. This will give you the cost for non-excluded services (Item 14) The anticipated estimate for OVR’s contribution to non-exempt services is presented in (Item 17) The consumer’s projected cost participation is presented in Item (item 18) The counselor may then negotiate with the consumer to determine how best cost participation requirements can be made Step 3#
Step #4 (Optional) • Can Track Consumer Cost Participation • Sheet 2 tab at bottom of page • When consumer purchases an Item, it can be entered into Column B4-17 and the form will automatically tell you when the consumer has met their obligation. • Especially helpful if they are agreeing to pay for multiple items
Frequently Asked Questions • Are all consumers required to participate in cost sharing? – No, individuals receiving SSI/SSDI, receive only exempt services, or do not meet minimal income levels, are not required to cost share. However, all cases are required to have a completed OVR-6C, documenting the individual’s cost sharing status. • What about tuition to national programs for the deaf, such as Gallaudet? Tuition and initial registration fees may be provided at post-secondary programs for individuals who are deaf that are recognized by the United States Congress as national programs without regard to financial needs testing. One hundred percent of tuition may be paid to these institutions. • When is the OVR-6C completed? – The counselor must complete the OVR-6C prior to completion of the IPE. • When are counselors required to verify income? Individuals receiving SSI/SSDI benefits and/or only receiving exempt services do not require income verification. Individuals anticipated to receive non-exempt services will require income verification.
Frequently Asked Questions • What documentation can be used to verify income? – OVR typically recommends utilizing the Adjusted Gross Income from the previous year tax form. If that information is not available, you can utilize a pay stub, W-2 form, or any other documentation where income is identified. • Can I use the FAFSA? – Yes. It contains all of the information necessary to verify income. • What if the individual has no current or previous documentation of income? – Document this in a case note and describe what actions you took to obtain necessary information.
Frequently Asked Questions • What if the individual’s income has changed since the previous year? – We utilize previous income to predict future income. In certain cases, this may not be appropriate and the counselor may utilize current income to determine the individual’s cost sharing. • Does the same logic apply to disability related expenses? - Yes. In rare cases, the anticipated disability related expenses may be significantly higher than those of the previous year. In those cases, the counselor may utilize the anticipated expenditures. Because of the difficulty in confirming future disability related expenses, counselors should minimize the use of anticipated expenses to only cases in which there will be a significant change in costs.
Frequently Asked Questions • What amount do I enter in the estimate cost of service column? – You may enter the anticipated cost of the service up to the maximum allowable cost for that particular service (ex: training - $2500).Please note it is understood this is an estimate and can change for various reasons. • Does that include textbooks? - No. Books are an exempt service and are not included in cost participation. • Can we include a vehicle as a disability related expense? Only if the vehicle will be modified and if that is the case, only $10,000 can be utilized as a disability related expense.
Frequently Asked Questions • How do we inform the training sites or colleges of how much we are paying in terms of tuition? Counselors have the option of utilizing the OVR-19 Training Notification Worksheet notify the post-secondary institution of OVR’s contribution. • In the section presenting the estimated cost of the VR program on the Cost Participation Form, do we include all costs related to the case, including the anticipated costs of the consumer? No. Only include the costs to OVR for non-exempt services. Exempt costs are not included on the form.
Frequently Asked Questions • Can training expenses be considered a disability related expense? No. Only training costs related to the disability may be utilized. • Do we have a reconsideration form for the new cost sharing or do they just use the old one? You may use the old form, as that did not change. • Can we include the consumer contributions related to cost of attendance above $2500? No. Unless there is an exception, the amount contributed by the consumer and the agency cannot be more than $2500.