Categorized In: Case Services - Procurement
Approved Date: February 24, 2025
Owner: Carla Lasley
A Service Agreement is required for the following services: Job Coaching, Job Coaching/Placement, Job Coaching/Interpreting, Job Readiness Training, Work Site Skills Trainer, Self-Employment Consultation, Business Plan Implementation/Revision, Interpreter—Foreign Language, Interpreter – Deaf or Hard of Hearing, Benefits Assessment, Benefits Planning, Benefits-PASS Development, Benefits Management, Rehab Technology – Rehab Engineering, Independent Living Training, Individual Supported Employment, and Customized Employment.
Background checks for specific types of providers are required prior to the provision of services unless the Exception Process is followed.
1. A VR Office Director or the VR Director may develop a Service Agreement when:
2. Identify the services to be provided. A Service Agreement is required for these services:
3. If the prospective provider will provide Individual Supported Employment or Customized Employment Services (SE/CE), VR will check to ensure they are properly credentialed, as follows:
4. If the prospective provider must be licensed or certified in his or her profession (such as when providing interpreter or benefits services) obtain certification and/or licensure documentation, as applicable. (Note: in the case of Benefits Services the Provider agency will ensure on-going licensure or certification of its staff.) Documentation should be current and the expiration date of the license or certification noted for entry into QE2.
5. Completion of Service Agreement:
A. The prospective provider completes the the top section of the Service Agreement including name and identifying information, and answers the questions about whether the entity employs persons who will provide direct services and whether the named entity will directly provide services.
B. VR Office Director/VR Director fills in effective dates and determines whether the prospective provider is an Independent Provider and whether mileage will be paid. Note: Mileage is already included in some rates, including those for Supported and Customized Employment.
C. If the ‘yes’ box is checked for Independent Provider, obtain the person’s Medicaid Provider Number and write it in the space provided.
D. Review the Service Agreement with the prospective provider to clarify provisions that are applicable to the provider, highlighting specific, applicable provisions for providers who employ persons providing direct services, those who will provide the services directly, and/or those who propose to provide services as an Independent Provider.
E. Check the services to be provided and complete fee/unit information. Note: Fees may not exceed those identified in Rule 72.
F. If the provider is an individual or an Independent Provider, assess their training and experience by obtaining and reviewing a resume. Complete an interview, if necessary, to obtain clarification on qualifications, deciding whether the individual or Independent Provider meets the general qualifications outlined on the Service Agreement form. Agency SE/CE providers will have credentials or certification from DDD or DBH; verify as outlined in #1, above. See bullet below regarding background check process to be followed.
G. If the Service Agreement is for Individual Supported or Customized Employment, review and provide copies and instruction on how to complete the required reporting forms.
H. Office Director reviews, discusses, and completes required documentation to obtain background checks applicable to the individual and Independent providers, as follows:
https://insidende.education.ne.gov/offices/human-resources/policies-procedures#HRPoliciesProcedures (>Filling vacant positions policy >Contractor/VR Background Check Request Process)
I. Once the signatures are received on the background check forms in AdobeSign, the Office Director forwards the AdobeSign email to Terri Donahue in NDE HR.
Notes to Office Directors:
J. The Service Provider completes the section of the Service Agreement to verify lawful presence in the US and completes/signs the applicable section of the Agreement.
K. The Office Director/VR Director signs the Service Agreement, obtains the prospective provider's signature, and explains the Agreement is not in force until background checks are received. EXCEPTION REQUEST: An Office Director may request an exception to policy to execute the Service Agreement before background check results are obtained. The rationale for the request will be made in writing to the Nebraska VR Director. The decision to grant an exception will consider whether the client and provider will have unobserved one-to-one contact in the workplace or home and the need for services to begin immediately. Upon granting of an exception, the service provider will be entered into QE2.
L. The Service Agreement is emailed to the State Office. NOTE: The effective date of the Service Agreement is the start date on the agreement OR the date it is received at the State Office, whichever is later.
6. The Office Director has the prospective provider complete the State of Nebraska Substitute Form W-9/ACH Enrollment Form. If applicable, complete the ACH portion of the form to arrange for direct deposit of payments and obtain one of the four documents listed in the lower right-hand corner of the W9/ACH Form.
7. The Office Director scans the following documents to vr.providers@nebraska.gov
8. Office Director enters provider in QE2 Create Provider, if applicable.
9. Lapses and Renewal of Service Agreements:
10. NDE HR receives and sends background check reports, when applicable, to vr.providers@nebraska.gov Nebraska VR evaluates the results. If there are concerns with a background check, the Nebraska VR Director will make the final decision about whether the Service Agreement will be executed.
11. When the prospective provider has passed the background checks, Nebraska VR State Office emails the Office Director and enters the Service Agreement in QE2.
12. The Office Director and other local VR staff, as applicable, meet with the service provider to complete arrangements to implement the Service Agreement, including monitoring service outcomes and effectiveness. The Office Director must review the Service Agreement annually with the service provider following the process outlined in #14, below.
13. Special note regarding the termination of Independent Providers: When an Independent Provider’s Medicaid enrollment is terminated, the VR Office Director is notified by email from the DDD Service Coordinator. The email is scanned to the client’s VR electronic case record and a copy is forwarded to the VR Office Director who ensures the Independent Provider is notified of the termination of the Service Agreement. (See Service Agreement for additional details to follow in terminating a Service Agreement.)
14. Process to complete and document annual review of Service Agreements: The Service Agreement is reviewed annually. This review is intended to ensure continued understanding of and adherence to each requirement of the ServiceAgreement and so any questions about the tenets of the Service Agreement may be discussed to ensure continued compliance. For providers with multiple Service Agreements, multiple area programs, and/or Service Agreements signed by different people for different programs, complete the review with each person who has signed the Service Agreement, i.e., if an agency representative signs all Service Agreements, the review of all is completed with that person or their local designee. If each area program’s Agreement is signed by a different person, the Service Agreement is reviewed with the person who signed the Service Agreement. Office Director completes the review using the following process:
Approved Date | ||
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August 13, 2024 | Show this Archived Version | |
January 08, 2024 | Show this Archived Version | |
October 14, 2022 | Show this Archived Version | |
February 26, 2019 | Show this Archived Version | |
February 26, 2019 | Show this Archived Version | |
January 02, 2019 | Show this Archived Version | |
March 09, 2017 | Show this Archived Version |