Chapter 4: Initial Contact

4.1 Overview

This chapter explains how to gather information necessary to develop a case and to support the eligibility determination. The initial contact date is very important to the consumer because it may affect the services received. The chapter explains the appropriate steps taken to complete an initial contact for a consumer who is seeking services for CRS.

4.2 Sources of Incoming Referrals

Numerous community sources, such as organizations, schools, clinics, employers, hospital case managers, and doctors, refer persons to the CRS program for assistance. Outreach efforts by CRS program staff members inform potential referral sources of the services available and the purpose of the CRS program. Accurately record the referral source in ReHabWorks.

The CRS program and Texas Workforce Solutions Vocational Rehabilitation Services (VRS) collaborate on referrals.

If you receive a referral from VRS:

  1. enter the initial contact in ReHabWorks (RHW), with VRS entered as the referral source; and
  2. keep a separate running log outside of RHW to track the VRS referrals that will be submitted to the CRS central office.

4.3 Outgoing Referrals to Other Resources or Vocational Rehabilitation Services

If a consumer applies for services and you close the case before determining eligibility, refer the consumer to another community resource program if the consumer is available and needs other services.

You may use the 211 Texas Information and Referral Network (Finding Help in Texas) to identify other resources the consumer may be available for or needs.

Once you have confirmed that services are available from another community resource:

  1. describe the services to the consumer;
  2. contact the other resource to set up an appointment for the consumer; and
  3. provide the other resource with information requested about the consumer, when appropriate.

If the consumer is not eligible for services from the CRS program or decides whether to apply for community-based services, you must provide the consumer with ample information on alternatives. Information related to community-based services can be vast and can include options such as comparable benefits and living in an institution (such as a group home or nursing home).

When helping a consumer make an informed choice about where to live, you must inform the consumer about any community support that may help him or her function in the most independent setting possible. Such support services vary by community.

By definition, settings such as nursing homes, intermediate care facilities for individuals with intellectual disabilities, sub-acute programs for coma management, and group homes are considered institutional residency.

When the consumer needs vocational rehabilitation, refer the consumer to Texas Workforce Solutions Vocational Rehabilitation Services (VRS). The CRS program and VRS collaborate on referrals.

For outgoing referrals, the CRS program and VRS share:

  • contact information about the consumer and the consumer’s family;
  • demographic information about the consumer; and
  • disability information about the consumer.

If available, additional information is shared, including:

  • details about the type of injury the consumer sustained;
  • the date of the consumer’s injury;
  • historic details about the injury, including the results of physical examinations; and
  • recommendations from CRS or VRS.

The CRS program or VRS provides the consumer with education and guidance on the referral process and the contact information for the receiving state agency.

The CRS program and VRS tracks the referrals made and received.

4.4 Completing the Initial Contact

The first contact that a consumer makes with the CRS program is a critical point in the rehabilitation process. It is a time for the consumer not only to exchange information with a CRS program staff member, but also to form an impression about the staff member's sincerity, concern, and professionalism. A successful exchange of information means that both the counselor and consumer fully understand what is being discussed. You are responsible to communicate in a way that best accommodates the consumer’s limitations.

During this contact with a consumer:

  1. develop an understanding of the consumer's needs;
  2. identify the CRS service that seems most suited to meet those needs; and
  3. explain the purpose of the CRS program to the consumer.

The initial contact date for the CRS program is the date that the consumer or the consumer's representative first contacts the CRS program about services.

Document the consumer’s initial contact in ReHabWorks (RHW). Complete the Initial Contact entry (for instructions, see the RHW Users Guide, Chapter 5 Initial Contact, regardless of the consumer's current level of functioning. Once the Initial Contact is documented in RHW, the consumer is added to the Interest List. Once the case is assigned to the appropriate counselor, the case status updates to Initial Contact with Case Assignment status.

As soon as you determine that a case is not warranted, close the Initial Contact case by coding it as Ineligible (for instructions, see RHW Users Guide, Chapter 21 Closure, 21.1 Closure Before Case Assignment and Before or After Application). This action removes the consumer's name from the Interest and/or Waiting List. If an Initial Contact is created but an application is not completed, the consumer’s initial contact information is not automatically removed from RHW.

4.5 Purchases Made While on the Interest and Waiting Lists

Only items and services listed in this section may be purchased while a consumer is on the Interest and Waiting Lists.

You may purchase medical records and assessments for all consumers on the Interest and Waiting Lists.

You may purchase services in this section for consumers who have been determined eligible but have one or more of the conditions listed:

If a consumer experiences contractures that are expected to cause permanent damage if not treated in a timely manner (as documented in a case note), CRS may sponsor services to address this issue only. The consumer remains on the Interest and Waiting Lists for all other purchased services, and the services provided under this exception:

  • are included in the total limit of 120 hours of outpatient therapy; and
  • may be provided without an Individualized Written Rehabilitation Plan (IWRP).

If a consumer experiences violent behavioral dyscontrol to the extent that the consumer risks significant bodily harm, incarceration, or psychiatric commitment (as documented in a case note) CRS may sponsor up to 14 days of inpatient medical behavior management at:

  • a comprehensive medical rehabilitation hospital specializing in brain injury; or
  • a residential post-acute brain injury rehabilitation facility.

If necessary, the service:

  • may be extended for an additional seven days; and
  • may include medication, and as needed, medical follow-up appointments;

The consumer remains on the Interest and Waiting Lists for all other purchased services, and services provided under this exception:

  • are included in the total limit of 90 days of inpatient rehabilitation or six months of post-acute brain injury rehabilitation; and
  • may be provided without an IWRP.

When funds become available and a consumer can be removed from the CRS Waiting List, the CRS central office staff member or a designee must allocate funds for any services other than those referred to in this section.

4.6 When CRS Is Not the Right Resource

Individuals referred to the CRS program must be given the opportunity to apply for CRS services and meet with a counselor, regardless of whether the information obtained during the initial contact or application for services appears to support the individual's eligibility for the CRS program. Only a counselor can decide whether an individual is eligible or needs to be referred to a more appropriate community resource.

For additional information about how to appropriately refer consumers, see 4.3 Outgoing Referrals to Other Resources and or Vocational Rehabilitation Services.

4.7 Consumer Needs CRS Services

If the CRS program is appropriate for the consumer, obtain the information necessary to document the Initial Contact in ReHabWorks (RHW).

The consumer must be assigned to a caseload when the initial contact is entered into RHW (for instructions, see RHW Users Guide, Chapter 5 Initial Contact, 5.4 Assign Case).

If the consumer cannot be seen for an application at the time of the initial contact, schedule an appointment with the consumer for the earliest date available.

An application for services must be completed within 30 calendar days of initial contact. If the application cannot be completed within 30 calendar days, the documentation in the case file must indicate a good-faith effort to meet the 30-day standard.

4.8 Social Security Numbers

When entering an initial contact in ReHabWorks (RHW), ask for the consumer for his or her Social Security number (SSN), but do not deny services to a consumer solely because the consumer does not provide a Social Security card or SSN.

Section 7(a) of the Federal Privacy Act of 1974 prohibits "any federal, state or local government agency" from denying any "right, benefit, or privilege provided by law" because a person refuses to disclose his or her Social Security number.

If the consumer does not have a SSN or does not provide it, RHW assigns a temporary SSN when the initial contact is saved. For instructions, see RHW Users Guide, Chapter 5 Initial Contact, 5.1.2 Completing the Initial Contact Using a Temporary SSN.

If the consumer later presents a Social Security card or provides a SSN, replace the temporary number with the consumer’s SSN. For instructions, see RHW Users Guide, Chapter 9 Other Case Management, 9.2 Change SSN.