RSM 1, Section 1300: Accreditation Of Community Rehabilitation Programs (CRPs)

Updated: 11/22

The Maryland Division of Rehabilitation Services (DORS) values our partnership with Community Rehabilitation Programs (CRPs). CRPs provide a myriad of employment services in communities throughout Maryland that individuals who are DORS consumers may receive as they prepare for, work to obtain, or maintain employment in the integrated labor market.

As a public agency, DORS is responsible for accrediting community rehabilitation providers. DORS strives to achieve a high standard of services for clients who are seeking competitive employment. DORS has established the policies and procedures outlined below to assure that programs are approved (or accredited) using standards that when applied consistently result in a high quality of service to consumers.

1301 Community Rehabilitation Program Approval

CRPs interested in providing employment services for individuals in the vocational rehabilitation (VR) program must be approved by the Division.

The Accreditation and Approval of CRPs to provide employment services is the responsibility of the Staff Specialist for CRPs.

Information for prospective providers and vendors is available on the DORS website.

1302 Accreditation

1302.01 Accreditation Standards

The Division purchases services for applicants and eligible individuals only from CRPs that:

Are licensed and/or certified according to state law, as appropriate.
Comply with federal and state laws regarding anti-discrimination, specifically, Title VII of the Civil Rights Act of 1964; Title V of the Rehabilitation Act of 1973, as amended; and Titles I, II and III of the Americans with Disabilities Act, as amended.

DORS approves private non-profit disability organizations to provide rehabilitation services to DORS consumers, as described in this section. Exceptions to approve a for-profit business include:

Private practitioners of Career Assessment Services.
For-profit organizations providing rehabilitation services to an unserved or underserved disability population or in an underserved geographic area, with the approval of the DORS Director.

1302.02 Types of Accreditation

Deemed – The CRP is licensed through the Department of Health to provide either Mental Health Vocational Services (MHVP) for the Behavioral Health Administration (BHA) or Vocational Services for the Developmental Disabilities Administration (DDA). In this situation, DORS will grant “deemed status” to these agencies to provide Supported Employment Job Coaching.
An agency with Deemed status that wishes to provide a service other than Supported Employment Job Coaching shall meet the guidelines in the DORS Standards Survey for that service.
Deemed Plus – The CRP meets the criteria required for Deemed and wishes to add Non-Supported Job Coaching. Essentially the service is the same, so DORS may approve this service based on the CRP’s ability to meet licensing requirements for supported employment job coaching but will conduct a file review prior to extending the cooperative agreement to assure that all criteria required in the DORS Survey Standards are being met. Deemed Plus only covers the addition of Non-Supported Job Coaching.
CARF – Commission on Accreditation of Rehabilitation Facilities. A CRP that is CARF accredited for each of the services they are interested in providing meets DORS accreditation standards.
An agency that is CARF accredited and wishes to provide a service other than what is identified within the CARF accreditation shall meet the guidelines in the DORS Accreditation Survey for that service.
DORS – To be DORS accredited, CRPs that are not BHA or DDA Deemed or CARF Approved shall submit documentation satisfying the DORS Survey (link to Survey). In addition DORS personnel will review a number of consumer files to verify the specific requirements for each service being offered. The CRP must meet the required criteria in all of the sections leading up to the Services Section and meet the specific requirements for the services they wish to provide.
At the conclusion of the review, the provider will receive a Monitoring Letter outlining the areas reviewed, the results of the review, and recommendations.

1302.03 Accreditation Reviews

Purpose of Accreditation Reviews – Accreditation reviews are performed:
1. To monitor the services that a CRP has been approved to provide that are listed on the DORS fee schedule, or
2. In the case of a CRP requesting initial DORS approval, to assess the services the CRP proposes to offer.
The intended outcomes for the review are to:
1. Assure that services provided to individuals with disabilities are of the highest quality.
2. Improve and enhance the quality of services delivered to individuals with disabilities.
3. Assist the governing board of the CRP and other interested groups in the community to better understand what is required for a sound program.
4. Serve as a means for self-evaluation and education in current best practices and state of the art services by the CRPs, the board, administration, and staff.
Scheduling of Accreditation Reviews – Accreditation reviews are scheduled by the Staff Specialist for CRPs through correspondence with the CRP Executive Director or their representative. Once a date is secured, the CRP is provided with the Survey Instrument detailing all sections that will be reviewed and a list of consumer files for review (sent through secure channels). These reviews are conducted on site, at the CRP location.
Accreditation Review Team – The Accreditation review team consists of the Staff Specialist for CRPs and staff from the local DORS office.
Frequency and Timing of Accreditation Review:

Deemed – Accreditation is evaluated every three years. The CRP provides a current Department of Health license demonstrating adherence to continued licensing requirements.
Deemed Plus – Accreditation is evaluated every three years. The CRP provides a current Department of Health license demonstrating adherence to continuing licensing requirements. Prior to affirming the continuation of Non-Supported Job Coaching, the Staff Specialist for CRPs will conduct a file review to assure that the criteria related to that service is demonstrated in the provision of the service.
CARF – Accreditation is evaluated at the expiration of the current CARF accreditation. Prior to the expiration of the current CARF accreditation, the Staff Specialist for CRPs will correspond with the CRP to find our when the CARF review will take place. The pursuant accreditation length will reflect the accreditation result provided at the conclusion of the CARF review.
If a CRP is not pursuing continuing CARF Accreditation, the CRP will be accredited using the DORS Standards Survey.
DORS – Accreditation is evaluated every three years. Using the DORS Standards Survey, the Staff Specialist for CRPs will evaluate the CRP’s ability to meet the criteria for the program in general and for the specific services they provide.
In specific situations, such as the addition of a new service or where there may be concerns about a CRP’s ability to provide services, the Staff Specialist for CRPs may schedule an accreditation review prior to the expiration of three years.
In situations where the CRP has demonstrated that they have met the DORS Standards Survey over more than one comprehensive review, the Staff Specialist for CRPs may elect to review specific items from the survey, selected on a random basis, in conjunction with a file review.

Continuation/Discontinuation of Accreditation:

Three-year Review – A CRP that continues to demonstrate a consistent provision of services to DORS consumers will be reviewed every three years. Their ability to provide employment services will be confirmed through the development of the appropriate cooperative agreement.
Request to Discontinue as DORS-Approved Provider – A CRP may request to be removed from the DORS fee schedule, consistent with procedures established in the Cooperative Agreement. Upon notification by the CRP’s Executive Director, the Staff Specialist for CRPs will notify the Director of Administration & Financial Services of the pending action. The CRP will be removed from the DORS fee schedule and the DORS website as a provider of Employment Services.
Inactivity of Provider – A CRP that has not provided services to DORS consumers for a period of time that meets or exceeds 18 months will be contacted via regular mail to determine their capacity and/or interest in remaining on the DORS fee schedule.

If the CRP communicates a desire to remain on the fee schedule, the CRP will be asked to develop and submit a plan to the Staff Specialist for CRPs detailing the steps they will take to re-engage the local DORS Offices. The re-engagement process will be closely monitored with the desired outcome of a consistent level of service provision.
If the CRP does not respond to the initial contact, a second notice will be sent indicating a date that if a response is not received, DORS will remove the CRP from the Fee Schedule. If the CRP responds to the second contact that they wish to remain on the DORS fee schedule, they will be asked to follow the process outlined above. If the CRP does not respond to that contact, a final contact letter will be sent advising the CRP’s Executive Director and Board President that the CPR has been removed from the DORS fee schedule.

1303 Cooperative Agreements

Cooperative Agreements are developed between DORS and approved CRPs in order to assure a mutual understanding of the services to be provided to DORS consumers, referral procedures, expectations and responsibilities of all parties.

DORS posts the most recent cooperative agreement on the CRP’s fee schedule in **RSM 5, Section 200**.

1303.01 Deemed

Frequency – Updated every three years.
Sections include:

Purpose statement
Responsibilities of each agency
Referral Procedures
DORS Eligibility and Plan Development
Description of the Supported Employment Service (specifying job development hours, job coaching hours, service intensity, the Supported Employment Plan, Confirmation of Extended Supports, Authorizations for Job Development/Job Coaching, and job coaching for volunteer work)
Reporting Requirements
Fees, Billing and Financial Procedures
Governing Law
Disputes
Indemnification
Multi-Year Contracts
Termination for Default
Termination for Convenience
CRP Represents and Warranty statement

Compliance with Civil Rights Laws
Fee Schedule
Supported Employment Certification Form
Fading Guide

Job Coaching Progress Report
Annual Review of Extended Employment in a Rehabilitation Facility, and/or
Supported Employment Certification

Signatures Required:

Assistant State Superintendent in Rehabilitation Services
Staff Specialist for CRPs
Office of Field Services Director or Regional Manager
Office for Blindness & Vision Services Director or Supervisor

Executive Director
Board President/Chairperson

1303.02 Deemed Plus

Frequency – Updated every three years.
Sections include:

Purpose statement
Responsibilities of each agency
Referral Procedures
DORS Eligibility and Plan Development
Description of the Supported Employment Service (specifying job development hours, job coaching hours, service intensity, the Supported Employment Plan, Confirmation of Extended Supports, Authorizations for Job Development/Job Coaching, and job coaching for volunteer work)
Description of the Non-Supported Job Coaching (specifying job development hours, job coaching hours, service intensity, the Supported Employment Plan, Confirmation of Extended Supports, Authorizations for Job Development/Job Coaching, and job coaching for volunteer work)
Reporting Requirement
Fees, Billing and Financial Procedures
Governing Law
Disputes
Indemnification
Multi-Year Contracts
Termination for Default
Termination for Convenience
CRP Represents and Warranty statement

Compliance with Civil Rights Laws
Fee Schedule
Supported Employment Certification Form
Fading Guide

Job Coaching Progress Report
Annual Review of Extended Employment in a Rehabilitation Facility, and/or
Supported Employment Certification

Signatures Required:

Assistant State Superintendent in Rehabilitation Services
Staff Specialist for CRPs
Office of Field Services Director or Regional Manager
Office for Blindness & Vision Services Director or Supervisor

Executive Director
Board President/Chairperson

1303.03 CARF

Frequency – Updated at expiration of current CARF Accreditation.
Sections include:

Purpose statement
Legal Basis
Role and Function of Each Agency
Responsibilities of Each Agency
Referral Procedures
Services and Reporting Requirements
Communication Regarding Persons Served, Fees, Billing and Financial Procedures
Hours of Operation
Supervision of Persons Served
Rights and Informed Choice of the Persons Served
CRP Outcomes Measurement
Development and Enhancement of Services
Governing Law
Disputes
Indemnification
Multi-Year Contracts
Termination for Default
Termination for Convenience
CRP Represents and Warranty statement

Compliance with Civil Rights Laws
Fee Schedule
Supported Employment Certification Form (if indicated)
Fading Guide (if Supported Employment)
List of Liaisons for the Cooperative Agreement

Training Progress Report
Job Coaching Progress Report
CAS Checklists
Annual Review of Extended Employment in a Rehabilitation Facility, and/or
Supported Employment Certification

Signatures Required:

Assistant State Superintendent in Rehabilitation Services
Staff Specialist for CRPs
Office of Field Services Director or Regional Manager
Office for Blindness & Vision Services Director or Supervisor

Executive Director
Board President/Chairperson

1303.04 DORS Accredited

Frequency – Updated every three years.
Sections include:

Purpose statement
Legal Basis
Role and Function of Each Agency
Responsibilities of Each Agency
Referral Procedures
Services and Reporting Requirements
Communication Regarding Persons Served
Fees, Billing and Financial Procedures
Hours of Operation
Supervision of Persons Served
Rights and Informed Choice of the Persons Served
CRP Outcomes Measurement
Development and Enhancement of Services
Governing Law
Disputes
Indemnification
Multi-Year Contract
Termination for Default
Termination for Convenience
CRP Represents and Warranty statement

Compliance with Civil Rights Laws
Fee Schedule
Supported Employment Certification Form (if indicated)
Fading Guide (if Supported Employment)
List of Liaisons for the Cooperative Agreement

Training Progress Report
Job Coaching Progress Report
CAS Checklists
Annual Review of Extended Employment in a Rehabilitation Facility, and/or
Supported Employment Certification

Signatures Required:

Assistant State Superintendent in Rehabilitation Services
Staff Specialist for CRPs
Office of Field Services Director or Regional Manager
Office for Blindness & Vision Services Director or Supervisor

Executive Director
Board President/Chairperson

1303.05 Private Practitioner – Career Assessment Services

Frequency – Updated every three years or upon expiration of CVE/PVE certification.
Sections include:

Purpose statement
Standards for Individual Practitioners
Service Provision and Reporting
CAS Options to be Provided
Communication With and Regarding Persons Served
Fees, Billing and Financial Procedures
Hours of Operation
Governing Law
Disputes
Indemnification
Multi-Year Contracts
Termination for Default
Termination for Convenience
Private Practitioner Represents and Warranty statement

Compliance with Civil Rights Laws

Ethics Standards Agreement

Signatures Required:

Assistant State Superintendent in Rehabilitation Services
Staff Specialist for CRPs
Director, Office of Field Services
Director, Office for Blindness & Vision Services

Name of Individual Certified as the Private Practitioner

1303.06 Cooperative Agreement Addenda and Amendments

At times, it becomes necessary to change a section of an agreement based on a DORS policy or process change or for other reasons. When this is the case, an addendum or amendment will be prepared that specifies the change, the reason for the change, any action required, and the start date for the change. This document will become part of the CPR’s file and the change will be incorporated into the next, updated Cooperative Agreement, as appropriate.

Signatures Required:

Assistant State Superintendent in Rehabilitation Services

Executive Director

1304 Approved CRP Services

1304.01 Types of Services CRPs May be Approved to Provide

Work Adjustment Training (WAT)/Employee Development Services (EDS)
Non-Supported Employment Job Coaching
SEP Job Coaching – DDA, BHA Approved sites
ABI Services

Head Injury Day Program – May include, but not limited to:

Cognitive Remediation and Speech/Language
Therapy: Psychiatric and Neuropsychological Consultation
Occupational and Physical therapies
Placement Consultation
Life Skills
Community Re-entry

Supported Job Development and Coaching
Long-Term ABI Extended Services (PES)

Employment Skills Training
Career Assessment Services

1304.02 Rates of Payment for Services – General

Fees for services to be provided by CRPs are established by the Division based upon analysis of budgetary costs and credentials of providers associated with those services as reported to DORS by the CRP. The program services and established fees are included in the Cooperative Agreements between the Division and the CRP, and are posted on the DORS intranet.

Work Adjustment Training/Employee Development Services – Fees for WAT/EDS are not pre-set. The rate of payment is established by DORS Director of Business Services based on analysis of budgetary costs submitted by the CRP, the length of the program, and anticipated number of consumers to be served within each cohort.
Supported Employment Job Coaching/Non-Supported Employment Job Coaching – A two-tiered rate is applied based on the CRP’s licensing status.

Tier 1 – CRPs that are licensed through the Department of Health as either a Mental Health Vocational Program (BHA) or as a Vocational Program (DDA), or are CARF accredited, receive the highest rate available.
Tier 2 – All other providers, not included in Tier 1, receive the lower rate available.

Evidence-Based Practice in Supported Employment – Milestone rates are paid to CRPs approved to provide mental health supported employment, that have met the additional fidelity requirements to be approved as an Evidence-Based Program. See **Milestone Fact Sheet (RS-7L)**.

Once the Individualized plan for employment is completed and signed, prior to initiation of services, DORS forwards an authorization to the provider for job development activities. The provider may send DORS an invoice for the entire amount once job development is initiated.
Once a job is secured for the consumer and the provider confirms the job with the DORS counselor, DORS forwards an authorization for the initiation of job coaching, including an amount job coaching and an amount for stabilization/job retention.

The provider may send DORS the invoice for job coaching once initiated.
The provider may send DORS an invoice for stabilization/job retention once the job has been maintained for 45 days.

ABI Services

Head Injury Day Program – Fees are not pre-set. The rate of payment is established by DORS Director of Administration & Financial Services based on analysis of budgetary costs submitted by the CRP, the length of the program, and anticipated number of consumers to be served within each cohort.
Supported Job Development and Coaching – Rates are established based on a provider’s licensing status.
Long-term ABI Extended Services (PES) – Job Coaching (Supported Employment. Ongoing. The rate for the service is $500 per month, including $100 case management and $400 job coaching.

Employment Skills Training – Fees for Employment Skills Training are not pre-set. The rate of payment is established by DORS Director of Business Services based on analysis of budgetary costs submitted by the CRP, the length of the program, and anticipated number of consumers to be served within each cohort.
Career Assessment Services – Five Career Assessment options are available: Itemized, Focused, Exploratory, Community Based, and Comprehensive. (See **RSM 5, Section 200, Career Assessment Services Descriptions**.)
A two-tiered rate is applied based on credentials demonstrated by the CRP. The rate of payment for each Career Assessment Option was determined by comparing the historical rates and a current cost of living.

Fee A is the enhanced rate. It is available to CRPs who have a Certified Vocational Evaluator (CVE), or Professional Vocational Evaluator (PVE) on staff or are CARF-Accredited for Comprehensive Career Assessment.
Fee B is the standard rate and is applied to CRPs that do not have a certified individual on staff or are not CARF-Accredited for Comprehensive Career Assessment.

1304.03 Rates of Payment for Services – Special Circumstances

DORS may offer an enhanced rate of payment for services provided by community programs (Community Rehabilitation Providers (CRPs) and Career Assessor providers) with certain expertise and credentials to underserved disability populations and/or geographic areas of the state.

DORS will provide an enhanced rate to approved providers who demonstrate qualification for ASL-enhanced communication services. (See ASL Enhanced Rate Fact Sheet (RS-9L).)
Providers that complete training from the Office for Blindness & Vision Services (OBVS) will receive an enhanced rate to offer services to individuals requiring those specialized services. (See Blindness & Vision Services Enhanced Rate Fact Sheet (RS-9u).)
Providers who are approved to support individuals requiring a different spoken language (an individual’s native or first language).

In accordance with RSM 3, Section 1008.02, if the provider charges a fee that is lower than the DORS rate, DORS will pay the lower of the rates.

1305 Approval to Provide CAS Services – CRPs and Private Practitioners

1305.01 CAS Approval Requirements

DORS may approve CRPs to provide CAS services that meet established criteria, including credentials, qualifications and experience of the practitioner. DORS may also approve private practitioners to provide CAS services that demonstrate current credentials as a Certified Vocational Evaluator (CVE) or Professional Vocational Evaluator (PVE) and meet similar criteria.
The applicant is required to provide:

A description of each option to be provided.
A sample report for each option to be provided.
A list of all instruments, tools and methods to be used for each option.
The qualifications of staff providing the assessment options, including copies of credentials.

The Staff Specialist for CRPs, in determining whether a CRP or individual practitioner meets criteria, may require participation in CAS training or job shadowing experience with a qualified CAS professional.

1305.02 CAS Approval Notification

Initial approval to provide CAS services is temporary. The DORS CAS Statewide Monitoring Committee, or its designee, will review all reports completed for each approved option until three reports have been determined to satisfactorily meet the criteria for each option. The completed assessment reports for each option must be sent to the Staff Specialist for CRPs.
Private Practitioners/CRPs determined to be in full compliance with the standards shall be approved by DORS and notified of their approval.

1306 Selection of CRP or CAS Provider

Selection of the approved CRP or CAS practitioner for provision of services shall be based the following, as applicable:

Program capacity
Needs, preferences and informed choice of the individual served
Location
Cost of the program
Quality of services provided and staff credentials
Program's record of success

1307 DORS Purchase of Services Requirements

In addition to the procedures for purchase of services as identified in RSM 3, Section 1000, the following guidelines are to be followed when purchasing services from a CRP:

DORS will not pay for any program services (i.e., vocational services) which have not been approved or accredited by DORS and for which DORS fees have not been established under the Cooperative Agreement and currently included in the CRP Fee Schedule.
DORS purchase orders/authorizations may be written only for those approved services and amounts listed in the current Fee Schedule.
Services requested by DORS will not begin until the appropriate purchase orders are written and authorized. DORS is not responsible for the payment of any fees charged by the CRP for services provided prior to the time authorized by DORS.
CRPs providing services authorized by DORS may not charge or accept any payment from the individual, or the individual's family, or a third party for those services unless, prior to providing the services, the amount of the individual's responsibility has been:

Preauthorized by DORS.
Agreed to by the eligible individual in writing as part of their Individualized Plan for Employment.
Approved by the DORS counselor in keeping with the Division's financial need policy.

When the individual served participates in the cost, the amount will be indicated on the purchase order and charged by the CRP directly to the individual. The total amount, including that charged to the individual and the Division, may not exceed that indicated in the DORS Fee Schedule.
The CRP/Individual Practitioner (CAS) may not bill DORS for an amount greater than the fees indicated in this current Fee Schedule.
The CRP must agree to charge DORS a fee no greater than the fee charged other purchasers of their services, and may bill for services only for the authorized time period.

New/revised fees may not be applied retroactively.
New/revised fees may be applied to individuals served already enrolled in the program effective the date of the increase.

1308 Eligibility for Preferred Provider Status – Maryland Works

Non-Profit Status – For a provider to be considered eligible for Maryland Works Contracts, as an approved DORS CRP, the provider must be organized as a non-profit organization (501(c)3).
Provider Preference for Set-Aside Contracts – DORS does not enter into cooperative agreements with CRPs for the sole purpose of enabling their eligibility for such set-aside contracts. DORS enters into agreements with CRPs interested in providing certain approved services to DORS consumers. DORS will monitor the CRP’s provision of services to DORS consumers and may withdraw approval of a CRP providing few if any employment services to DORS consumers.

1309 Eligibility for ABI Preferred Provider Status

A CRP may be approved as an ABI Preferred Provider upon:

Submitting documentation that evidences licensure by Department of Health for either DDA or BHA Supported Employment Job Coaching or meeting the DORS Accreditation standards for Supported Employment Job Coaching.
Maintaining active membership in the DORS ABI Consortium.
Providing documentation detailing staff experience in working with individuals with ABI or ABI certification.
Agreeing to accept Extended Services rate as defined in Section 1304.02(d).

1310 Role of Staff Specialist for CRPs

The Staff Specialist for CRPs has the primary responsibility to:

Coordinate conduct of accreditation reviews and approval of services.
Assure that Cooperative Agreements are completed in a timely manner according to schedule.
Address CRP requests for increases in fees or for the addition of program services.
Address concerns expressed by CRP staff and DORS staff, sharing with DORS management as appropriate.
Assure that the CRP Fee Schedule on the DORS intranet is up to date and accurate.
Assure that the criteria for provision of CAS services is met, coordinating the initial review of reports submitted, and scheduling on-going, random quality reviews of CAS reports.

RSM 1: Administration

​Section 1300