1. Answer Critical Case Questions: Prior to the purchase of any goods and/or services the VR Specialist must answer these questions. 
   • Are the goods and/or services being requested necessary for the client to achieve his/her vocational objective on the Individualized Plan for Employment (IPE)?
   • 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, 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?
     • Worksite items need to be addressed with the employer as a reasonable accommodation.
     • Medical items need to explore insurance and community resources.
     • Is the assistive device available through the reuse program?
     • Applicants for and recipients of services must apply for and accept any existing comparable services or benefits. Have we completed a thorough search for comparable services and benefits to offset a part or all of the costs?
     • 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? 
     • An SSA approved Plan for Achieving Self Support (PASS) does not constitute a comparable benefit or service. A PASS is a Social Security work incentive that allows an SSI recipient to set aside income and/or resources for a specified time in order to achieve an employment goal. While funds from a PASS cannot be considered a comparable benefit, PASS resources can complement VR services, particularly to cover additional costs of services, such as home and vehicle modifications, post-secondary training, and self-employment. The development and submittal of a PASS should be encouraged but the choice to do so is the recipient’s decision and is strictly voluntary. The recipient’s decision to not pursue a PASS will have no impact on VR funding for appropriate and necessary goods and 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 conclusion, then the appeal process is available for the client.
3. Seek out available resources for assistive technology - If having answered the critical case questions the VR Specialist determines the necessary goods and/or services cannot be provided without exceeding the Fee Schedule, the VR Specialist will refer the client to the Easterseals loan program. This program is designed to assist individuals with impairments to qualify for lower interest rate loans and is also more likely to approve a loan than a traditional bank. 
   • Easterseals Alternative Financing Solutions contact information (402) 930 - 4106 or 1(800) 471-6425 loan@ne.easterseals.com 
   • Three separate Easterseals loan funds are available:
     • Alternative Financing Program: For any assistive device or service (selection, acquisition or use of an assistive technology device) requiring a loan between $2,000 - $35,000. 
     • Telework: For an assistive device or service necessary to secure a telework opportunity from home or overcome a barrier to employment requiring a loan between $1,000 - $35,000
     • Credit Building Mini-loan: For any assistive technology device or service requiring a loan between $100 - $1,999. Can include financial coaching and building up credit report.
4. Request exception needed:
   • 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 may request in writing an exception to the Fee Schedule for the remaining amount.
   • Still has costs that exceed the Fee Schedule because the client in unable to secure financial assistance from other resources or is unwilling to apply for or accept a loan, the VR Specialist may request in writing an exception to the Fee Schedules. If the client says they are ineligible for a loan he/she must 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. 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. Include specific amounts of the cost, client contribution, loans, comparable services and benefits and verification of loans, resource denials and any extenuating circumstances. 
6. Exception Decision: If an Office Director or appropriate Program Director:
   • Agrees to make an exception to the Fee Schedule: the VR Specialist will proceed to secure the necessary services, goods and/or supports.
   • Does not agree to make an exception to the Fee Schedule: the VR Specialist will provide a full consultation to the client on the decision. The VR Specialist is responsible to understand the rational of the decision and to fully explain the determination to the individual. If there are questions, the specialist needs ask for clarification to provide a unified and accurate report to the individual of the program's decision. 
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 include the appeal procedures.

The purpose of Rule 72 fee schedule for services, goods, and supports is to contain costs and to assure the availability of program services to the largest number of individuals with significant disabilities. The intent of the schedule is to assure costs are the lowest reasonable cost for program services, goods, and supports while allowing for sufficient flexibility to meet the individual's needs.

Rule 72:

006.02 Exception to fee schedule. Exceptions may be granted if the Office Director or Program staff determines there is no alternative to addressing a recipient's needs for a service or support necessary to complete an assessment for determining eligibility and vocational rehabilitation needs or to achieve the employment outcome on the recipient's approved Individual Plan for Employment. 

Only an Office Director or the appropriate Program Director can make a decision to exceed the Fee Schedules. Comparable services and benefits, client contribution, least cost option and other relevant program criteria 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, based on individual circumstances other than for the following:

Program staff have the authority and discretion to make reasonable cost exceptions to:

• Home modification 
• Vehicle modification
• Self-employment and establishing a small business operation

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.