Chapter 13: Case Closure and Post-Closure Services

13.1 Overview

This chapter discusses different closure scenarios and appropriate ways to address those scenarios. It also outlines when and how to use the post-closure services option.

13.2 Closing a CRS Case as Successful

Close a case as successful:

  • when the goals documented in the consumer’s Individualized Written Rehabilitation Plan are met to the fullest extent of the consumer's abilities;
  • when the services provided have improved the consumer's ability to function independently at home and in the community;
  • when documentation in the case file shows how the consumer functions more independently as a result of the services provided; and
  • after reviewing the case for open service authorizations and associated financial actions that are no longer needed.

Notify the consumer in person, by telephone, and/or in writing that the case is closed.

13.3 Closing a CRS Counseling and Guidance-Only Case

Before closing a CRS counseling and guidance-only case as successful, confirm that the consumer has received one or more of the following treatments as a comparable benefit or an arranged service, from:

  • Traumatic Brain Injury (TBI) or Traumatic Spinal Cord Injury (TSCI) inpatient hospitalization;
  • TBI or TSCI outpatient services; and/or
  • TBI or TSCI Post-acute rehabilitation injury (PARS) rehabilitation services.

If counseling and guidance is the only service provided for CRS, explicitly document in the case file that:

  • the consumer received counseling and guidance;
  • the counseling and guidance helped the consumer function more independently in terms of mobility, self-care, and/or communication; and
  • the counseling and guidance helped the consumer and the consumer’s family to:
    • select and/or maintain suitable, realistic independent living goals;
    • select suitable treatment providers and use comparable services and benefits;
    • adjust to treatment, as circumstances required; and/or
    • access relevant support services.

13.4 Closing a CRS Case as Unsuccessful

End the consumer's services and close the case as unsuccessful when you determine that the consumer cannot benefit from services for CRS and/or improve his or her ability to function more independently at home and in the community.

Make this decision only after considering all of the facts and circumstances and exhausting every appropriate resource and service.

13.5 Documenting CRS Closure in ReHabWorks

Use the table below to determine the appropriate reason for closing the case and follow the procedure for closing it. Document the closure in ReHabWorks.

Table: Required Closure Documentation and Procedures

Reason Closed

Procedure

Severity of the Disability – The severity of the disability prevents the CRS program from helping the person function more independently at home and in the community.

Document how the disability prevents the CRS program from helping the person function more independently.

Notify the consumer or the consumer’s guardian or representative that the case is closed.

Other -- Services may be denied or ended for reasons other than those described in this list.

Describe the reason for closure in a case note.

Notify the consumer that the case is closed.

Unable to Locate or Moved out of State

Document:

  • that repeated attempts to contact the consumer, the consumer’s family or representative by telephone and mail have failed over a reasonable period; and/or
  • that the consumer moved out of state and explain the reason that you believe there is no evidence that the consumer is going to return.

Consumer Is Not Functioning More Independently (valid after confirming eligibility) – You cannot verify that the consumer is functioning more independently at home and in the community.

Notify the consumer that the case is closed.

Services for CRS are Not Required --

The consumer:

  • does not need services from CRS to function more independently at home and in the community;
  • is receiving needed services or services are readily available without the CRS program arranging, coordinating, paying for, and/or providing the services; or
  • does not need CRS counseling and guidance.

Notify the consumer that the case is closed.

Refused Services – The consumer does not intend to follow through with the program.

Be certain that the consumer:

  • knows about available services; and
  • has consistently refused services.

Notify the consumer that the case is closed.

Failure to Cooperate – The consumer fails to follow through with the program.

Document examples of the consumer’s failure to cooperate.

Notify the consumer about:

  • your intent to close the case; and
  • his or her right to appeal.

Institutionalized

The consumer:

  • entered an institution (such as a hospital, nursing home, or treatment center);
  • will not be available for services for an indefinite or considerable time; and
  • will not benefit from keeping the case open.

Provide information about community-based services, and document the action in a case note, as appropriate.

For more information, see Chapter 4: Initial Contact, 4.3 Outgoing Referrals to Other Resources or Vocational Rehabilitation Services.

Notify the consumer that the case is closed.

Death

Contact the family only to reclaim equipment that the CRS program purchased. Be sensitive. Minimize disruption to the family.

Consult with the CRS central office program specialist for rehabilitation technology about which items to reclaim.

Transferred to Another Agency or Program

When it is apparent that services from another program or another agency are more appropriate than the CRS program:

  • discuss the transfer with the consumer;
  • set up an appointment for the consumer with the other agency, if appropriate; and
  • provide the other agency with any appropriate information requested.

Notify the consumer that the case is closed.

13.6 Post-Closure Comprehensive Rehabilitation Services

When post-closure services are combined with services previously provided, the post-closure services must not exceed the following time limits:

Services

Time Limit

Inpatient comprehensive medical rehabilitation

90 days

Outpatient comprehensive rehabilitation

120 hours

Post-acute rehabilitation services

180 days

To provide time-limited post-closure services, one of the following criteria must be met:

  • A planned service was inadvertently not provided before case closure.
  • The consumer did not receive the full complement of services for CRS, and you later determine that the consumer could benefit from post-closure services.
  • Post-closure services are needed to protect the initial investment made by the CRS program.

13.7 Post-Closure Procedure

When the consumer’s Individualized Written Rehabilitation Plan (IWRP) does not list post-closure services, complete an amendment to the IWRP.

Following completion of post-closure services, notify the consumer that the case is closed by sending the form letter DARS5210 CRS Successful Closure. (DARS5210 available only in ReHabWorks)