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Payment of Milestones 5A/5B

Categorized In: Administrative - COVID-19 Policies

Approved Date: June 29, 2020

Owner: Carla Lasley

Providers of Developmental Disabilities, Acquired Brain Injury, and Autism Supported Employment may receive payment for Milestones 5A and 5B if a client has maintained the job held at successful closure for a period of 6 and 12 months, respectively.  During the pandemic some clients may have been laid off or furloughed. Some may have expectations and assurances their job is intact and they can return to it, while others have been given no assurance they will be able to return to their former employment.  This temporary policy addresses payments to providers for milestones 5A and 5B for those laid off or furloughed due to business circumstances resulting from the pandemic.

 

In the 5th month or 11th month after successful closure, as applicable, the VR Specialist contacts the Supported Employment provider to obtain answers to the following questions about the client’s employment status:

  • Is the person working at the same job/employer they held at closure? 
    • If yes, authorize Milestone 5A / 5B, as applicable, per policy
  • Is the person laid off or furloughed?  If yes, seek response to the following questions:
    • Has the provider helped the client maintain contact with their employer to determine a return to work date and plan for return to work?  AND
    • Is there certainty that the client will return to work—a date of return or employer assurance the client will be able to return to work?
      • If yes to both questions, authorize Milestone 5A / 5B and ask the provider to include return to work details on the Milestone 5A/5B form submitted with the invoice for payment 
      • If no to both questions, VR staff or the provider will contact the employer to determine if the client is expected to return to work and projected return date; authorization / payment of milestone 5A / 5B is contingent upon whether the client will return to work
    • VR Specialist will instruct providers billing for Milestones 5A and 5B to include in the Comments section of the Milestone 5A/B form:
      • A statement about supports provided to the client to maintain contact with the employer, and
      • The expected date of the client’s return to work or other details of the plan for the client to return to work
    • VR Specialist will document details of client's employment status and decision to authorize and pay, or not pay Milestones 5A/5B in Task Note 



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