Step 1 - Initiation

• A Service Agreement may be initiated by a Office/Program/VR Director when
  • There is an identified need for specific types of services in the area and Nebraska VR invites potential providers to discuss
    • the type of service needed
    • the estimated number of people who need the service
    • characteristics of the population to be served, if applicable
  • A service provider - including an Independent Provider - contacts a Nebraska VR office or the SE Program Director to request a Service Agreement with VR
    • NOTE - An Independent Provider is
      •  enrolled in and maintains their status as a medicaid provider through DHHS's contractor, Maximus
      • a provider of services authorized by the Division of Developmental Disabilities (DDD)
      • a potential provider of Individual Supported Employment or Customized Employment services for people with Intellectual/Developmental Disabilities (I/DD) under a Service Agreement with VR
      •  

Step 2 - Required Services and Provider Qualifications

• Identify Services to Be Provided (All services requiring agreements are listed in Policy section)
• If the provider (agency or Independent Provider) will offer Individual Supported Employment (SE) or Customized Employment (CE) services, refer to the Supported Employment chapter for detailed requirements
• If the provider must be licensed or certified for their profession (such as when providing Interpreter or Benefits services), obtain their current certification or license, as applicable.
  • For Benefits Services, the provider agency is responsible for ensuring its staff maintain ongoing licensure or certification
  • For Interpreter Services record the expiration date so it can be entered into QE2.

Step 3 - Completion of Service Agreement Form

• Provider Information - The prospective provider completes the top section of the Service Agreement including:
  • their name and identifying information
  • whether they employ staff who will provide direct services
  • whether they themselves will directly provide services
• The Office/Program/VR Director
  • enters the effective dates
  • determines whether the provider is an Independent Provider
  • determines whether mileage will be paid
    • NOTE: Mileage is already built into some rates, such as Supported/Customized Employment and Benefits Services

Step 4 - Review Agreement with Provider

• Meet with the provider to go over the Service Agreement. Highlight the following:
  • provisions for providers who employ direct-service staff
  • provisions for those providing services themselves
  • provisions specific to Independent Providers

Step 5 - Identify Services and Fees

• Mark which services the provider will deliver
• Complete the fee and unit information (including attachments for specific service descriptions and instructions, if applicable)
• NOTE: Fees cannot exceed those listed in Rule 72

Step 6 - Verify Qualifications for Individual Providers

• If the provider is an individual
  • review their resume for applicable training and experience
  • interview them, if needed, to clarify qualifications
  • ensure their qualifications match the duties they will perform (Example: If a provider will not be transporting clients, a driver's license is not required)

Step 7 - Conduct Background Checks

• The Office/Program/VR Director must obtain background checks for individual providers when both conditions apply
  • They answered "yes" to the question about whether the owners or principles will directly provide services
  • They will provide any service marked with an asterisk (*) on the Service Agreement
• Background checks are completed by the Nebraska Department of Education (NDE).  Follow the NDE provider background check process in this User Guide
• Process the Background Check
  • Once the background check forms are signed through AdobeSign
    • The Office/Program/VR Director forwards the AdobeSign email to NDE HR nde.hr@nebraska.gov
• NOTES for Office/Program/VR Director
  • Follow up with the prospective provider to make sure they are checking both their inbox and their junk/spam folders for the background check emails
  • If any information in the DHHS follow up email is entered incorrectly the provider will be required to meet with a notary to verify their identify.  To help prevent this, you may want to review this guide with them.  It shows the first few screens they must complete for the DHHS check.
  • After those initial screens, they will also need to answer identity-verification questions (for example, selecting a vehicle they have owned or a previous address). These questions must all be completed in one session, on a computer - not a cell phone - and must be finished within the allotted time.
• Do not release background checks to anyone as they are the property of Nebraska VR.

Step 8 - Lawful Presence Verification

• The service provider completes and signs the section of the Service Agreement that verifies lawful presence in the U.S.

Step 9 - Signatures and Exception Requests

• Explain that all agreements will be reviewed annually
• The Office/Program/VR Director signs the Service Agreement and obtains the provider's signature
• Explain that the Agreement is not active until background checks are received
• Exception Request
  • An Office/Program Director may request permission to activate the Agreement before background check results are received
  • The request must be made in writing to the Nebraska VR Director
  • The decision by VR Director will consider
    • Whether the provider will have unobserved one-on-one contact with a client
    • Whether services must begin immediately

Step 10 - Submission to State Office

• Email the completed Service Agreement to the State Office
• The effective date of the Service Agreement is the later of the listed start date or date received by the State Office

Step 11 - W-9/ACH Setup

• Have the provider complete the Nebraska W-9/ACH Enrollment Form
• If using direct deposit, complete the ACH section and obtain one of the four required documents listed on the form
• Email the following to vr.providers@nebraska.gov
  • Signed Service Agreement and attachments (if any)
  • Signed W-9/ACH form and required ACH documentation (if applicable)

Step 12 - QE2 Entry

• The Office/Program Director enters the provider in QE2 - create provider, if needed

Step 13 - Lapses and Renewals

• If the Agreement has lapsed more than one year
  • A new background check is required
  • Complete Step 7
• If the Agreement has not lapsed more than one year
  • No new background check is required
  • The provider must attest to any new convictions/charges by signing the attestation on page 3 of the Service Agreement

Step 14 - Background Check Results

• NDE HR sends background check results to vr.providers@nebraska.gov
• Nebraska VR reviews the results
• If concerns arise, the Nebraska VR Director makes the final decision about executing the Service Agreement

Step 15 - Activation of Service Agreement

• Once the provider passes background checks
  • The State Office emails the Office Director
  • The Service Agreement is entered into QE2

Step 16 - Implementation and Ongoing Monitoring

• The Office Director and Program Director for Supported Employment, others when applicable) meet with the provider to
  • finalize service arrangements and
  • discuss how the provider will monitor service outcomes and review effectiveness of services
• The Office/Program Director reviews the Agreement with the provider every year.

 

 

Step 1 - Each year Office/Program Director meets with the person who signed the Service Agreement (or their designee) 

• Highlight specific items such as
  • No subcontracting
  • Background check obligations
  • Qualification requirements
  • Any items needing compliance reminders

Step 2 - Obtain updated credentials or licensure documentation, as applicable

Step 3 - Document the review in QE2

• Under the Provider record using a "New Comment" that includes:
  • Date of review
  • Name of person who completed the review
  • Any other relevant notes