WORK INCENTIVES PLANNING (NON-CREDENTIAL) $292.00 FLAT FEE WORK INCENTIVES PLANNING (CREDENTIAL) $321.25 FLAT FEE WORK INCENTIVES COORDINATION (NON-CREDENTIAL) $6.50 6 MINUTES WORK INCENTIVES COORDINATION (CREDENTIAL) $7.00 6 MINUTES COMMUNITY BASED ASSESSMENT $240.00 (HALF DAY) FLAT FEE COMMUNITY BASED ASSESSMENT $420.00 (FULL DAY) FLAT FEE VOCATIONAL EVALUATION $1,016.75 FLAT FEE VOCATIONAL CONSULTATION $6.50 6 MINUTES CAREER EXPLORATION $6.75 6 MINUTES TRAVEL TRAINING $6.00 6 MINUTES JOB READINESS TRAINING (SCHOOL BASED) $54.50 (HALF DAY) FLAT FEE JOB READINESS TRAINING (SCHOOL BASED) $87.50 (FULL DAY)) FLAT FEE JOB READINESS TRAINING (NON-SCHOOL BASED) $87.50 (HALF DAY) FLAT FEE JOB READINESS TRAINING (NON-SCHOOL BASED) $153.00 (FULL DAY) FLAT FEE SUMMER YOUTH (CAREER EXPLORATION) $853.50 (WEEK) FLAT FEE SUMMER YOUTH (WORK EXPERIENCE) $1,138.00 (WEEK) FLAT FEE WORK ADJUSTMENT $230.00 (HALF DAY) FLAT FEE WORK ADJUSTMENT $402.50 (FULL DAY) FLAT FEE JOB SEEKING SKILLS TRAINING $6.00 6 MINUTES JOB DEVELOPMENT (UOS) $6.50 6 MINUTES PERFORMANCE BASED JOB DEVELOPMENT TIER I $1,167.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER II $1,110.25 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER III $1,580.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER III PREMIUM A (RAPID PLACEMENT) $1,980.50 FLAT FEE
PERFORMANCE BASED JOB DEVELOPMENT TIER III PREMIUM B (SGA PLACEMENT) $1,980.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER III PREMIUM C (RAPID & SGA) $2,380.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT SUBSEQUENT PLACEMENT $339.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER I $1,459.25 FLAT FEE SUPPORTED EMPLOYMENT JD TIER II $1,387.75 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III $1,975.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III RETENTION PREMIUM A (RAPID PLACEMENT) $2,375.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III RETENTION PREMIUM B (SGA PLACEMENT) $2,375.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III RETENTION PREMIUM C (RAPID & SGA PLACEMENT) $2,775.50 FLAT FEE SUPPORTED EMPLOYMENT SUBSEQUENT PLACEMENT $424.25 FLAT FEE ON-THE-JOB SUPPORTS $6.00 6 MINUTES TABLE 2: GROUP FEE SCHEDULE RATES SERVICE DESCRIPTION NUMBER IN GROUP (#) UNIT (DURATION) 2 (50%) 3 (37.1%) 4 (31.4%) TRAVEL TRAINING $3.00 $2.23 $1.88 6 MINUTES SUMMER YOUTH CAREER EXPLORATION (WEEK) $426.75 $316.65 $268.00 FLAT FEE SUMMER YOUTH WORK EXPERIENCE) (WEEK) $569.00 $422.20 $357.33 FLAT FEE WORK ADJUSTMENT (HALF DAY) $115.00 $85.33 $72.22 FLAT FEE WORK ADJUSTMENT $201.25 $149.33 $126.39 FLAT FEE
JOB READINESS SERVICES Services provided to prepare a participant for the world of work (e.g., appropriate work behaviors, getting to work on time, appropriate dress and grooming, increasing productivity). SERVICE DESCRIPTION RATE PER UNIT UNIT (DURATION) JOB READINESS TRAINING (SCHOOL BASED) $54.50 (HALF DAY) FLAT FEE JOB READINESS TRAINING (SCHOOL BASED) $87.50 (FULL DAY)) FLAT FEE JOB READINESS TRAINING (NON-SCHOOL BASED) $87.50 (HALF DAY) FLAT FEE JOB READINESS TRAINING (NON-SCHOOL BASED) $153.00 (FULL DAY) FLAT FEE SUMMER YOUTH (CAREER EXPLORATION) $853.50 (WEEK) FLAT FEE SUMMER YOUTH (WORK EXPERIENCE) $1,138.00 (WEEK) FLAT FEE WORK ADJUSTMENT $230.00 (HALF DAY) FLAT FEE WORK ADJUSTMENT $402.50 (FULL DAY) FLAT FEE SERVICE DESCRIPTION NUMBER IN GROUP (#) UNIT (DURATION) 2 (50%) 3 (37.1%) 4 (31.4%) SUMMER YOUTH CAREER EXPLORATION (WEEK) $426.75 $316.65 $268.00 FLAT FEE SUMMER YOUTH WORK EXPERIENCE) (WEEK) $569.00 $422.20 $357.33 FLAT FEE WORK ADJUSTMENT (HALF DAY) $115.00 $85.33 $72.22 FLAT FEE WORK ADJUSTMENT (FULL DAY) $201.25 $149.33 $126.39 FLAT FEE JOB READINESS TRAINING (JRT) Job Readiness Training is utilized to assist participants to develop the necessary skills and abilities to become successfully employed. JRT is a group based service in which OOD, the host business, and the provider have an established relationship which includes an OOD approved
Input from the participant on his/her vocational preferences; his/her of his/her physical and mental capabilities to do the job; and potential concerns. Providers shall provide a participation log signed by the participant outlining dates, time started and ended, and any breaks, if applicable. And Questions posed by VR Counselors or Contractors in the Referral to Community Rehabilitation Program. Providers must be pre-authorized by VR Staff or VR Contractor to compensate participants for actual work performed utilizing the Vocational Training Stipend (VTS). Providers shall submit a participant log that has been signed by the participant that documents dates of work performed, start and end times, and breaks 30 minutes or longer. VTS shall not be paid for breaks that last 30 minutes or longer. Providers shall submit the invoice and report, on the appropriate template, within 21 calendar days of the completion of service or the last date of services defined on the VR authorization, whichever comes first. Providers shall submit a report at a minimum of at least once per month. TECHNICAL GUIDANCE Since service is a Flat Fee (Half- or Full-Day), providers do not need to document all contacts. Report only needs to document the activities delivered as part of the Half/Full Day of service. Providers shall immediately notify the VR Counselor and/or Contractor if the Individual misses more than two (2) days during the service and/or when sufficient information has been obtained to answer the referral questions. VR Counselors and/or VR Contractors will then determine if services should continue. Flat Fee includes a staffing as required or requested by the VR Counselor/VR Contractor. The staffing will discuss progress and need for continued services. For the purpose of staffing the term bi-weekly shall mean once every two weeks. JOB RELATED SERVICES Services which support and assist a participant in searching for and securing an appropriate employment outcome. Job Related Services also includes services provided to a participant who has been placed in employment in order to stabilize the placement and enhance job retention. Services
may include, but are not limited to activities such as: resume preparation, identifying appropriate job opportunities, developing interview skills, making contacts with companies on behalf of participants, on the job supports, etc. SERVICE DESCRIPTION RATE PER UNIT UNIT (DURATION) JOB SEEKING SKILLS TRAINING $6.00 6 MINUTES JOB DEVELOPMENT (UOS) $6.50 6 MINUTES PERFORMANCE BASED JOB DEVELOPMENT TIER I $1,167.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER II $1,110.25 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER III $1,580.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER III PREMIUM A (RAPID PLACEMENT) $1,980.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER III PREMIUM B (SGA PLACEMENT) $1,980.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT TIER III PREMIUM C (RAPID & SGA) $2,380.50 FLAT FEE PERFORMANCE BASED JOB DEVELOPMENT SUBSEQUENT PLACEMENT $339.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER I $1,459.25 FLAT FEE SUPPORTED EMPLOYMENT JD TIER II $1,387.75 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III $1,975.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III RETENTION PREMIUM A (RAPID PLACEMENT) $2,375.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III RETENTION PREMIUM B (SGA PLACEMENT) $2,375.50 FLAT FEE SUPPORTED EMPLOYMENT JD TIER III RETENTION PREMIUM C (RAPID & SGA PLACEMENT) $2,775.50 FLAT FEE SUPPORTED EMPLOYMENT SUBSEQUENT PLACEMENT $424.25 FLAT FEE ON-THE-JOB SUPPORTS $6.00 6 MINUTES
INTAKE PROVIDER INTAKE ACKNOWLEDGEMENT INTERPRETER SERVICES (FOREIGN & SIGN LANGUAGE) INTERPRETING SITE DEVELOPMENT JOB DEVELOPMENT – MONTHLY TRACKING TRANSPORTATION TRANSPORTATION VOCATIONAL TRAINING STIPEND VOCATIONAL TRAINING STIPEND WORK INCENTIVES PLANNING WORK INCENTIVES PLAN WORK INCENTIVES COORDINATION WORK INCENTIVES COORDINATION COMMUNITY BASED ASSESSMENT CBA OJS JRT WA SYWE VOCATIONAL EVALUATION VOCATIONAL EVALUATION VOCATIONAL CONSULTATION VOCATIONAL CONSULTATION CAREER EXPLORATION CAREER EXPLORATION SYCX TRAVEL TRAINING TRAVEL TRAINING JOB READINESS TRAINING (SCHOOL & NON-SCHOOL BASED) CAREER EXPLORATION SYCX SUMMER YOUTH (CAREER EXPLORATION) CAREER EXPLORATION SYCX SUMMER YOUTH (WORK EXPERIENCE) CBA OJS JRT WA SYWE WORK ADJUSTMENT CBA OJS JRT WA SYWE JOB SEEKING SKILLS TRAINING JOB SEEKING SKILLS TRAINING JOB DEVELOPMENT (UOS) JOB DEVELOPMENT – MONTHLY TRACKING PERFORMANCE BASED JOB DEVELOPMENT TIER I JOB DEVELOPMENT – MONTHLY TRACKING & JOB DEVELOPMENT PLAN PERFORMANCE BASED JOB DEVELOPMENT TIER II JOB DEVELOPMENT – MONTHLY TRACKING & EMPLOYMENT VERIFICATION PERFORMANCE BASED JOB DEVELOPMENT TIER III JOB DEVELOPMENT – MONTHLY TRACKING & EMPLOYMENT VERIFICATION PERFORMANCE BASED JOB DEVELOPMENT SUBSEQUENT PLACEMENT JOB DEVELOPMENT – MONTHLY TRACKING & EMPLOYMENT VERIFICATION SUPPORTED EMPLOYMENT JD TIER I JOB DEVELOPMENT – MONTHLY TRACKING & JOB DEVELOPMENT PLAN SUPPORTED EMPLOYMENT JD TIER II JOB DEVELOPMENT – MONTHLY TRACKING & EMPLOYMENT VERIFICATION SUPPORTED EMPLOYMENT JD TIER III JOB DEVELOPMENT – MONTHLY TRACKING & EMPLOYMENT VERIFICATION
FIELD ENTRY TYPE INFORMATION SERVICE DESCRIPTION DROP DOWN Select the service from the drop down menu. SERVICE TOTAL Field is calculated based on information entered in the report form. Providers may not edit this field. SAM TOTAL Field is calculated based on information entered in the report form. Providers may not edit this field. INVOICE TOTAL Field is calculated based on information entered in the report form. Providers may not edit this field. EMPLOYMENT GOAL Dishwasher # OF MONTHS IN JOB DEVELOPMENT 2 # OF EMPLOYER CONTACTS JOB DEVELOPER MADE 2 # OF EMPLOYER CONTACTS JOB SEEKER MADE 1
WAGES DOLLAR AMOUNT TEXT Enter the amount of wages paid to the Individual. It is possible that the wage amount may change between the time of placement and final check. Enter the current wage amount at the time of the specific report. WAGES FREQUENCY DROP DOWN Enter the schedule or frequency of the Individual’s pay check. Hourly Weekly Bi-Weekly Monthly Quarterly Annually DATE OF FIRST PAYCHECK DATE Enter the date that the Individual received their first pay check. EMPLOYER PROVIDED MEDICAL INSURANCE AVAILABLE? CHECK BOX Check “YES” if the Employer makes Medical Insurance available, regardless of whether the Individual opts to accept the insurance or not. If no Employer provided health insurance is available, check “NO.” DATE OF FINAL EMPLOYMENT VERIFICATION DATE Enter the date of the final contact for the purpose of employment verification. Date must occur between day 83 and day 90 of successful employment. Start date of successful employment shall be determined by VR Staff or VR Contractor. SOURCE OF MEDICAL INSURANCE AT TIME OF FINAL EMPLOYMENT VERIFICATION DROP DOWN Enter the source of the Individual’s medical insurance at the time of the final employment verification. None Information Not Available Not Yet Eligible For Employer Medical Employer Medical Insurance Medicaid Medicare State/Federal Affordable Care Act Other Public Insurance Other Private Insurance COMMENTS TEXT Enter any information that was provided by the Individual that may be important for VR Staff or VR Contractor to be aware of. SIGNATURES FILL IN Signatures must be original signatures, e.g. “wet ink” or image captured through a signature pad. Signatures may not be stored for future use.
TASK BRIEF DESCRIPTION DATE COMPLETED INDIVIDUAL'S SELF-EVALUATION OF PERFORMANCE 1 How to complete job applications 10/02/17 Individual completed a sample job application. He indicated that he felt comfortable with answering questions and had a sheet with employment dates, employer’s addresses, etc. to help him complete the application. He indicated that he did have a question about a specific area of the application. Job Coach reviewed it with him and helped him formulate an acceptable response. 2 How to locate job openings 3 How to write a resume and cover letter 4 How to dress and appearance for interviews 5 How to interview for a job (e.g. 1:1, panel, telephone interview; how to address employment gals, reasonable accommodations, legal histories, etc.) 6 How to follow up after an interview (e.g. thank you notes, follow up calls, etc.) 7 Mock Interview 8 Impact of and how to manage social media and profiles 9 Ohio Means Jobs Registration 10/02/17 Individual has his login name/password. He demonstrated how to log into OMJ. He was able to navigate independently to the job leads area. 10 Other FIELD ENTRY TYPE INFORMATION DATE DATE FIELD MM/DD/YY Enter the date that the Individual mastered the Task and could complete it independently, or with the minimum level of support required. INDIVIDUAL'S OF PERFORMANCE TEXT Enter the Individual’s self-evaluation of how they feel that they are doing in the specific area, including their comfort level in performing the task on their own. should be in the Individual’s own words; however, Provider Staff may have to ask clarifying questions. One word or simple phrases, e.g. “I did well.” are not acceptable.
situations differently and turned inappropriate behaviors into appropriate ones. Noah participated in the scenarios, made comments during discussion, and was respectful of other Participants ideas. FIELD ENTRY TYPE INFORMATION DATE DATE FIELD MM/DD/YY Enter the date that the service took place. SUMMER YOUTH CAREER EXPLORATION ONLY SUMMARY OF EDUCATIONAL TOPICS TEXT Enter a summary of the educational topic covered that date and specific comments on Individual’s participation. TRANSITIONAL YOUTH BENCHMARKS EXPECTATIONS INDIVIDUAL CAN ARTICULATE THE DESIRE TO WORK? YES INDIVIDUAL CAN ARTICULATE DIFFERENCES BETWEEN VARIOUS EMPLOYMENT OPTIONS? YES INDIVIDUAL IS AWARE OF THEIR STRENGTHS AND WEAKNESSES? YES INDIVIDUAL HAS THE ABILITY TO DESCRIBE THEIR STRENGTHS AND WEAKNESSES? YES INDIVIDUAL CAN ARTICULATE BASED EMPLOYER/EMPLOYMENT EXPECTATIONS? YES INDIVIDUAL HAS ABILITY TO PERFORM WORK TASKS WITH SUPPORT? YES INDIVIDUAL CAN DEMONSTRATE BASIC WORK BEHAVIORS? (E.G. RESPECT FOR OTHERS, ABILITY TO COMMUNICATE NEEDS, ABILITY TO IDENTIFY APPROPRIATE WORKPLACE CONVERSATIONS, ETC.) YES INDIVIDUAL HAS SUCCESSFUL COMPLETED CAREER EXPLORATION AND IS RECOMMENDED TO MOVE FORWARD WITH A WORK EXPERIENCE? YES FIELD ENTRY TYPE INFORMATION EXPECTATIONS DROP DOWN Enter “YES” if the Individual meets the specific benchmark. Enter “No“ if the Individual does not meet the specific benchmark. ACTIVITIES OF DAILY LIVING ORIENTATION & MOBILITY TRAINING REHABILITATION TECHNOLOGY
FIELD ENTRY TYPE INFORMATION INVIDUAL'S COMMENTS (SELF ASSESSMENT) TEXT Summary of how the Individual feels that they performed during the service. Summary should be in the Individual’s own words; however, Provider Staff may have to ask clarifying questions. One word or simple phrases, e.g. “I got this.” are not acceptable. PROVIDERS RECOMMENDATION & SUMMARY TEXT Discussion of progress with current benchmarks and recommendations for further services. Providers should be specific on what still needs to be accomplished, how it will be measured, and an estimated amount of time needed to accomplish the goal. WORK INCENTIVES PLAN INVOICE SECTION SERVICE DESCRIPTION INVOICE TOTAL $0.00 FIELD ENTRY TYPE INFORMATION SERVICE DESCRIPTION (UOS SERVICES) DROP DOWN Use this field for “Work Incentives Plan” or “Work Incentives - Credential”. If the Bilingual Supplement has been approved and authorized for the case select the “Bilingual Work Incentives Plan” or “Bilingual Work Incentives – Credential” option. This field will load the associated rates, individual and/or group, as applicable. BENEFITS SUMMARY BENEFIT PROGRAM BENEFIT AMOUNT VERIFIED BY WHOM & HOW SOCIAL SECURITY DISABILITY INSURANCE (SSDI) $540.00 BPQY from Social Security Administration SUPPLEMENTAL SECURITY INCOME (SSI) $200.00 BPQY from Social Security Administration MEDICAL BENEFIT 1 (MEDICARE) MEDICAL BENEFIT 2 (MEDICAID) Traditional Medicaid (e.g. not MBIPWD) Telephone contact with Defiance County Jobs & Family Service. HOUSING BENEFIT BENEFIT 1 BENEFIT 2 BENEFIT 3 BENEFIT 4 BENEFIT 5
FIELD ENTRY TYPE INFORMATION SERVICE DESCRIPTION (UOS SERVICES) DROP DOWN Use this field for “Benefits Coordination - Credential” or “Benefits Coordination – Non-Credential. If the Bilingual Supplement has been approved and authorized for the case select the “Bilingual Benefits Coordination - Credential” or “Bilingual Benefits Coordination – Non-Credential.” option. This field will load the associated rates, individual and/or group, as applicable. SERVICE AREA MODIFIER Field is calculated based on information entered into the report form. Providers may not edit this field. INVOICE TOTAL Field is calculated based on information entered in the report form. Providers may not edit this field. SPECIFIC BENEFITS CONCERN(S) THAT VR STAFF OR VR CONTRACTOR WANTS THE PROVIDER TO WORK WITH THE INDIVIDUAL TO RESOLVE. Individual has recently started work and needs assistance in reporting their income to Social Security. VR Staff wants Planner to work with the Individual to teach them how to report income and then also coach them while the Individual does it themselves to make sure they know the process. FIELD ENTRY TYPE INFORMATION SPECIFIC BENEFITS CONCERN(S) THAT VR STAFF OR VR CONTRACTOR WANTS THE PROVIDER TO WORK WITH THE INDIVIDUAL TO RESOLVE. TEXT Enter what you specially want the Provider to accomplish as part of the service. Consult the VR Fee Schedule to determine specifically what types of activities are allowed as part of the service. DATE START TIME END TIME UNITS SAM Level SUMMARY OF ISSUE(S)/CONCERN(S) CONTACTS & SUMMARY OF STEPS TAKEN TO RESOLVE ISSUE(S)/CONCERN(S) STAFF INITIALS 0 0 FIELD ENTRY TYPE INFORMATION DATE DATE FIELD MM/DD/YY Enter the date that the service took place. (REQUIRED FIELD) START TIME TIME FIELD AM/PM Enter the time that the actual service started, not the scheduled start time. (REQUIRED FIELD) END TIME TIME FIELD AM/PM Enter the time that the actual service ended, not the scheduled end time. (REQUIRED FIELD)
UNITS Field is calculated based on information entered in the report form. Providers may not edit this field. SAM LEVEL DROP DOWN Enter the SAM Level if VR Counselor or VR Contractor has pre-authorized SAM Level for the service. SUMMARY OF ISSUE(S)/CONCERN(S) TEXT Enter a summary of the issue that was worked on that specific date. CONTACTS & SUMMARY OF STEPS TAKEN TO RESOLVE ISSUE(S)/CONCERN(S) TEXT Enter documentation of the type of contact or what actions were taken to resolve the issue on that specific date. STAFF INTIALS TEXT Enter the initials of the Provider Staff who provided direct service to the Individual on the date. VOCATIONAL EVALUATION INVOICE SECTION SERVICE DESCRIPTION (UOS SERVICES) SERVICE TOTAL $0.00 SERVICE AREA MODIFIER (SAM) TOTAL $0.00 INVOICE TOTAL FIELD ENTRY TYPE INFORMATION SERVICE DESCRIPTION (UOS SERVICES) DROP DOWN Use this field for “Vocational Evaluation”. If the Bilingual Supplement has been approved and authorized for the case select the “Bilingual Vocational Evaluation” option. This field will load the associated rates, individual and/or group, as applicable. SERVICE AREA MODIFIER TOTAL Field is calculated based on information entered in the report form. Providers may not edit this field. INVOICE TOTAL Field is calculated based on information entered in the report form. Providers may not edit this field. INTEREST TEST(S) ADMINISTERED SUMMARY OF TEST RESULTS FIELD ENTRY TYPE INFORMATION INTEREST TEST(S) ADMINISTERED TEXT Enter the name of any standardized vocational tests that were used to measure this characteristic. If no standardized tests were used to collect data explain how the conclusion was derived. SUMMARY OF TEST RESULTS TEXT Enter a summary of the information and explain how that it was used to formulate the identified vocational goal(s) as realistic and viable (e.g. within the Individuals interests, abilities, and capabilities.)
Date Start Time End Time Units SAM MEETING LOCATION INDIVIDUAL's SIGNATURE STAFF INITIALS 0 0 FIELD ENTRY TYPE INFORMATION DATE DATE FIELD MM/DD/YY Enter the date that the service took place. (REQUIRED FIELD) START TIME TIME FIELD AM/PM Enter the time that the actual service started, not the scheduled start time. (REQUIRED FIELD) END TIME TIME FIELD AM/PM Enter the time that the actual service ended, not the scheduled end time. (REQUIRED FIELD) UNITS Field is calculated based on information entered in the report form. Providers may not edit this field. SAM LEVEL DROP DOWN Enter the SAM Level if VR Counselor or VR Contractor has pre-authorized SAM Level for the service. MEETING LOCATION TEXT Enter the name of the location where the interpreting took place, e.g. if at a business enter ABC Placements, Defiance, OH. INDIVIDUAL’S SIGNATURE TEXT Enter the signature of the person receiving the service. If the Individual is unable to sign then the Job Developer/Job Coach, VR Counselor/VR Contractor, may sign to document that the service has been provided. STAFF INTIALS TEXT Enter the initials of the Provider Staff (Interpreter) who provided direct service to the Individual on the date. VOCATIONAL TRAINING STIPEND DATE START TIME MEAL PERIOD (IN MINUTES) END TIME DAILY UNITS OF SERVICE (UOS) FIELD ENTRY TYPE INFORMATION DATE TEXT Enter the date that the service took place. (REQUIRED FIELD)
Only), Stark, Summit, & Trumbull (RCD Only) NE Akron BVR James Lake Portage & Summit NE Akron BSVI BVR Nikki Miraglia Training Supervisor NE Akron BSVI BVR EF Jennifer Wells Lake, Medina, Portage (EF Only), & Summit NE Cleveland BVR EF OTSP Camille Ali Ashtabula (EF Only), Cuyahoga, Geauga (EF Only), & Lake (EF Only) NE Cleveland BVR OTSP Mallory Fisher Cuyahoga NE Cleveland BVR Nicholas McDowell Cuyahoga NE Cleveland BVR RCD Carolyn O’Connor Carolyn.o’connor@ood.ohio.gov Cuyahoga NE Cleveland BSVI BVR Brandon Wray Cuyahoga, Erie (BSVI Only), Huron (BSVI Only), Lake (BSVI Only), Lorain (BSVI Only), NE Youngstown BSVI BVR EF Tina Copeland Columbiana, Mahoning, Trumbull NE Youngstown BVR OTSP Brain Eskridge Ashtabula, Geauga (OTSP Only), Lake (OTSP Only), Mahoning, & Trumbull NW Defiance BSVI BVR Sherry Markley Defiance, Fulton, Hancock (BSVI Only), Henry, Lucas (BSVI Only) Paulding, & Williams NW Lima BSVI BVR Kristen Rodabaugh Allen, Auglaize (BSVI Only), Erie (BSVI Only), Hancock (BVR Only), Hardin (BSVI Only), Mercer (BSVI Only), Putnam, Seneca (BSVI Only), Wood, & Wyandot (BSVI Only) NW Lima BVR Michelle Steinke Allen, Auglaize, Hardin, Mercer, & Van Wert NW Mansfield BSVI BVR Helen McNamara Ashland, Crawford (BSVI Only), Huron (BSVI Only) Knox, Marion (BSVI Only), Morrow (BSVI Only), & Richland
NW Mansfield BVR Nanette Warnecke-Flood Crawford, Marion, Morrow, Sandusky, Seneca, & Wyandot NW Toledo BSVI BVR Jeanette Bostelman Training Supervisor NW Toledo BSVI BVR Merriam Kindle Fulton (BSVI Only), Lucas, Ottawa, Sandusky (BSVI Only), Williams (BSVI Only), & Wood NW Toledo BVR Michael Roelfsema Lucas NW Toledo BVR Michelle McDougall Lucas & Wood NW Toledo BVR Sandra Burtscher Erie, Huron, & Lorain SE Canton BVR EF OTSP Cindy Dyer Ashland (EF Only), Carroll (EF Only), Columbiana (EF Only), Holmes (EF Only), Richland (EF Only), Stark, Tuscarawas (EF Only), & Wayne SE Canton BVR Mark Manheim Carroll, Holmes, Jefferson, Start, Tuscarawas, & Stark SE Columbus BSVI BVR Beth DeMarco Training Supervisor SE Columbus BVR OTSP Jeremy Gildow jeremy Fairfield & Franklin SE Columbus BVR Amanda Linard Franklin SE Columbus BVR EF Rose Reed .ohio.gov Delaware & Fairfield SE Columbus BVR Rob Schaller robert.schaller@ood.ohio.gov Franklin SE Zanesville BVR Travis Steward Travis.stewart@ood.ohio.gov Belmont, Coshocton, Guernsey, Harrison, Licking, Muskingum, & Noble SW Cincinnati BVR OTSP Teji Adeyemon omoteji.adeyemon@ood.ohio.gov Hamilton SW Cincinnati BSVI BVR EF OTSP Kim Colyer kimberly.colyer@ood.ohio.gov Adams, Brown, Clinton (BSVI & EF Only), Fayette (BSVI & EF Only), Clermont, &Highland SW Cincinnati BVR Crystal Hutzel Hamilton SW Cincinnati BSVI BVR Jennifer Roeder jennifer.roeder@ood.ohio.gov Butler (BSVI Only), Hamilton, Preble (BSVI Only), & Warren (BSVI Only)