How to Apply
Resources
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Policy & Law
Alternate Format?
If you have comments regarding any documents on DVR's website or need an alternate format, you may contact us via email at dvr@dwd.wisconsin.gov, or you can reach us by phone at 800-442-3477 (Toll Free), 608-266-1133 (FAX), or 888-877-5939 (TTY).
Information for DVR's Service Providers
2012-2013 Service Agreements
Service agreement documents are provided individually below. Please use the checklist to help guide your completion of the necessary steps. To insure that your service agreement is approved and listed by July 1 2012, you must have ALL of the steps and forms FULLY completed and submitted by June 8, 2012, to allow for processing time.
Required Training Opportunities
Each staff person working with DVR should view the following DVR Statewide Service Provider Training (web based training):
- Module 1 - Service Provider Partnerships (11 minutes)
- Module 2 - Technical Specifications (15 minutes)
- Module 3 - Fee Review Policy (4 minutes)
- Module 4 - Future Enhancements (4 minutes)
Each staff person working with DVR should take both modules of Security Awareness Training:
Required in 2013-2014: Service Provider staff must take an ethics course. An ethics course is in development by TACE specifically for service providers and will be made available as a free web-based course in the FALL of 2012.
- Web resource: http://www.tace5.siu.edu/webcourses/frmCourseList.aspx
Required Documents
List of Documents and Steps:
Documents Requiring Signature:
- Service Provider Information Cover Sheet and Agreement Form 1
- Certification Regarding Debarment, Suspension and Other Responsibility Matters (Attachment 4)
- Certification Regarding Lobbying (Attachment 5)
- Certification Regarding Drug-Free Workplace Requirements (Attachment 6)
- Criminal Background Check (Attachment 11)
Required Forms for Completion:
- Service Provider Location Form 2
- Service Provider Personnel Form 3 (NOTE: Requires dates of completion of security awareness training basic and refresher modules and criminal background check for all personnel.)
- Subcontractor Information Form 4 (Complete as needed. NOTE: Requires additional assurances/forms.)
Required Service Agreement Reference Documents:
- Agreement for Services DRAFT (Attachment 1)
- Agreement Standard Terms and Conditions DRAFT (Attachment 2)
- Instructions for Certification Regarding Debarment, Suspension and other Responsibility Matters (Attachment 3)
- Technical Specifications (Attachment 7)
- Benefits Analysis Services
- Internship/Temporary Work DRAFT
- Job Coaching -- Other Than Supported Employment
- Job Preparation, Development & Placement Services
- Supported Employment
- Vocational Evaluation Services
- Statewide Service Fee Structure DRAFT (Attachment 8)
- Service Provider Sample Invoice (Attachment 9)
- Criminal Background Check Policy (Attachment 10)
- Undue Hardship Policy (Attachment 12)
When completed - fax, mail or email (PREFERRED) Service Provider Agreement forms to:
Contracts Specialist
Division of Vocational Rehabilitation
PO Box 7852
Madison, WI 53703-7852
dvrserviceproviders@dwd.wisconsin.gov
FAX to 608-266-1133
Service Agreement Change Information:
- Adding an Employee
- Adding a Subcontractor
- Adding a Service/Removing a Service
- Ending a Service Agreement
Important Links:
List of Providers & Service Agreements (07/01/11 - 06/30/12) - Only those listed are eligible to receive authorizations for statewide services.
Vendor Reporting Requirement / DVR FAX Flyer (DVR-16979-P)
Frequently Asked Questions (FAQs) -- Submissions and Responses for Your Information
Technical Assistance Guide for Adults Seeking Integrated Employment
Alternate Models of Supported Employment - (Customized Employment and Individual Placement and Support) - DVR has provided these materials to offer assistance to DVR Consumers, Staff and Service Providers with information about approved alternate models of supported employment.
Inter-Agency Agreements, Cooperative Agreements, Data Sharing/Confidentiality Agreements & Memorandums of Understanding (MOUs)
- Client Assistance Program (CAP) Memorandum of Understanding
- Department of Corrections (DOC) Memorandum of Understanding
- Department of Health Services (DHS) / Division of Long Term Care (DLTC) - Managed Care Organizations (MCO) & Family Care Programs
- Department of Health Services (DHS) DMHSAS Evidence Based Practice in Supported Employment with Mental Health Consumers
- Department of Public Instruction (DPI)/Department of Health Services (DHS) Interagency Agreement
- Department of Transportation (DOT) Memorandum of Understanding
- Division of Family Supports - Wisconsin Works (W-2) Memorandum of Understanding
- Great Lakes Inter-Tribal Council (GLITC) Memorandum of Understanding
- Randolph-Sheppard Vendors of Wisconsin (RSVW) Contract
- Unemployment Insurance (UI) Data Sharing/Confidentiality Agreement
- University of Wisconsin System (UWS) Memorandum of Understanding
- Wisconsin Technical College System (WTCS) Memorandum of Understanding
- Cooperative Agreements:
- College of Menominee Nation (CMN)
- Great Lakes Inter-Tribal Council (GLITC)
- Lac Courte Oreilles (LCO)
- Oneida Nation
For additional information, contact:
- Kathleen Enders at (414) 750-0268 or via email at kathleen.enders@dwd.wisconsin.gov

