1. Answer Critical Case Questions- Prior to the purchase of any goods and/or services the VR Specialist (Rehabilitation or Service) must answer these questions. This may include discussions with the Office Director, Team, Program Directors, and CAP.

   • Are the goods and/or services being requested necessary for the client to achieve his/her vocational objective?
   • Have we determined there are no other options to addressing the client’s needs? For example, rather than purchasing a piece of adaptive equipment so the client can perform a particular task independently, is it reasonable and feasible for a family member to do the task; or would it be more cost effective to hire a particular task done?
   • If there are several options to addressing the client’s need have we ensured the selected goods and/or services are the least cost options?
   • Have we completed a thorough search for comparable services and benefits to offset a part or all of the costs? For example, if the client is a Social Security beneficiary and/or recipient, have we explored whether an Impairment Related Work Expense [IRWE] or Plan for Achieving Self Support [PASS] might be possible to offset a part or all of the costs? Applicants for and recipients of services must apply for and accept any existing comparable services or benefits.
   • Has the client sought out and are they using all financing available from grants, loans, personal or family resources, and other resources, to offset a part or all of the costs for necessary goods and/or services?
   • Can the client afford to maintain, repair, and replace the goods being requested?

2. Determine need for exception - If having answered the critical case questions the VR Specialist determines the necessary goods and/or services can be provided without exceeding the Fee Schedules the VR Specialist will proceed to secure the necessary goods and/or services and an exception request will not be necessary. If the client does not agree with the VR Specialist’s conclusions then the appeal process is available for the client.
3. Seek out all available resources - If having answered the critical case questions the VR Specialist determines the necessary goods and/or services cannot be provided without exceeding the Fee Schedules the VR Specialist may on a case by case basis refer the client to a traditional lending institution (bank, credit union, etc.) to make application for a loan. Reasonable consideration should be made in determining the appropriateness of referring the client to a lending institution.
4. Request exception – If the client:

   • Is able to secure funds from other resources and/or is eligible for and accepts a loan for part of the costs that exceed the Fee Schedules the VR Specialist will request in writing an exception to the Fee Schedule for the remaining amount.
   • Still has costs that exceed the Fee Schedules because the client is unable to secure financial assistance from other resources or is unwilling to apply for or accept a loan, the VR Specialist will request in writing an exception to the Fee Schedules. If the client says they are ineligible for a loan he/she should provide a loan refusal letter to verify denial of the loan and the reasons for the denial. The fact a client is not willing to apply for or accept a loan will be considered as part of the rationale used to either grant or deny an exception.

5. Document rationale - The request for an exception to the Fee Schedules will be made to the Office Director or appropriate Program Director. Consult the Fee Schedule Exception Guide which lists who has the authority to make exceptions for each service, goods or supports. The written request will be in the form of a task entry titled Exception Rationale. The task entry will answer the critical case questions and outline the rationale that led to the determination there are no alternatives to exceeding the Fee Schedules.
6. Make exception - If an Office Director or appropriate Program Director:

   • Agrees to make an exception to the Fee Schedules the VR Specialist will proceed to secure the necessary services, goods and/or supports.
   • Does not agree to make an exception the VR Specialist will inform the client of the decision and the rationale for making it.

7. Document decision – The Office Director or appropriate Program Director will document his/her decision to make or not make an exception to the Fee Schedules in a QE2 task entry titled OD/PD Approval/Disapproval. The task entry will outline the rationale that led to the decision.
8. Correspond with client – If the Office Director or appropriate Program Director does not agree to make an exception and the client disagrees with this decision the Office Director will send a letter to the client. The letter will outline the rationale for not making the exception and will outline the appeal procedures

Exception Authority - Only an Office Director or the appropriate Program Director can make a decision to exceed the Fee Schedules. Comparable services and benefits will be considered when an exception is requested.

• Office Directors have the authority and discretion to make reasonable exceptions to the Fee Schedules in Rule 72, Appendix B & C, based on individual circumstances other than for the following.
• The Program Director of Community Services has the authority and discretion to make reasonable exceptions to home and vehicle modification regulations based on individual circumstances.
• The Program Director of Counseling has the authority and discretion to make reasonable exceptions to the limit on financial assistance for self employment and establishing a small business operation.
• The VR Director has the authority and discretion to make exceptions to any services, goods or supports, but is the only one authorized who can make exceptions to Interpreter - Hearing Impaired.

Undue Delay – The requirement to determine the availability of comparable services and benefits, seeking out all other available resources, and applying for a loan[s] does not apply if this would interrupt or delay:

• The provision of program services to any recipient who is at “extreme medical risk.” Extreme medical risk is a probability of substantially increasing functional impairment or death if medical services are not provided expeditiously. The determination of extreme medical risk is based upon medical evidence provided by an appropriate licensed medical professional; or,
• An immediate job placement; or,
• The progress of the recipient for more than thirty [30] days toward achieving the employment outcome on the recipient’s approved Individualized Plan for Employment.
• Provisions regarding undue delay are found in Rule 72, Section 003, Comparable Services and Benefits, Subsection 003.04.