ESBD_516615_1778878904683_Form 04-TWC VR Standards for Providers Certification (VR 3443).pdf
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- Solicitation number
- 3202600157
- Issued by
- Texas
About this file
This is a Vocational Rehabilitation (VR) Standards for Providers Certification form from the Texas Workforce Commission (TWC). The document establishes certification standards and requirements for organizations seeking to provide vocational rehabilitation services under the TWC's VR program. The form outlines the comprehensive standards that VR service providers must meet to become certified and maintain certification status, covering organizational capacity, staffing qualifications, service delivery capabilities, and compliance with federal and state regulations. Providers must demonstrate their ability to deliver individualized vocational rehabilitation services to individuals with disabilities, including assessment, counseling, training, and job placement services. The certification process ensures that all VR providers meet consistent quality and performance benchmarks across Texas.
The certification standards address provider qualifications, including the credentials and experience required for staff members delivering VR services, as well as organizational infrastructure requirements such as facilities, equipment, and administrative systems. Providers must comply with all applicable federal regulations under the Rehabilitation Act and state TWC rules, including requirements related to case management, documentation, outcome reporting, and consumer rights protection. The standards also establish performance metrics and accountability measures for VR providers, with ongoing monitoring and recertification requirements to maintain provider status. This certification framework applies to both public and private agencies seeking to deliver vocational rehabilitation services within the state of Texas.
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Text version
VR3443 (03/20) Standards for Providers Certification Page 1 of 2
Texas Workforce Commission Vocational Rehabilitation Services
TWC VR Standards for Providers Certification
Instructions:
• For response to an Electronic State Business Daily (EBSD) posting, follow the instructions in the
ESBD posting, otherwise submit updated forms to the Quality Assurance Specialist for VR (Q) or Regional Program Support Specialist (RPSS) and Contract Manager.
• Follow instructions on the form and in the TWC VR Standards for Providers.
• Type all information on form using a computer and get all required signatures.
• Complete all sections of the form. Record “N/A” (not applicable) if a question does not apply.
• Keep a copy of your submitted form with attachments and supporting documentation for your records.
Reason for Submission Date of submission:
Application package Solicitation ID:
Update of information due to change in information on file. For example, qualifications change.
Other: Specify:
Entity’s Information Entity: The business that is requesting or has been granted the bilateral contract with TWC to provide services on behalf of VR customers.
Entity’s legal name:
Entity’s “doing business as” (DBA) name:
Provide at least one of the following:
Employer Identification Number (EIN) (9 digits, issued by IRS):
Last four digits of the sole proprietor’s Social Security Number:
VR3443 (03/20) Standards for Providers Certification Page 2 of 2
TWC Acknowledgment and Signature This acknowledgment is applicable to, and shall be considered active for, the following purposes:
• Processing of the respondent’s application
• Execution of the initial award, if applicable
• Continuation of the contract life through subsequent execution of renewals and/or amendments and/or updating information on file with TWC as applicable.
I, the legally authorized representative of the entity named in this application:
• certify that the entity staff and I have read and will abide by the TWC VR Providers’ Resource
Page, TWC VR Standards for Provider Manual and TWC VR forms;
• certify that that the entity will abide by any requirements prescribed in the Electronic State
Business Daily (EBSD) posting for which the entity applied; and
• acknowledge that failure to follow applicable standards in the TWC VR Standards for Provider
Manual, notices or publications on the TWC VR Providers’ Resource, instructions on TWC VR forms and requirement in the EBSD posting associated with the entity could cause adverse consequences for the entity, such as denial of payments, recoupment of payments, suspension of service provision to VR customers, loss of an awarded contract or processing of an application from an EBSD posting.
Legally authorized representative’s printed name:
Title:
Legally authorized representative’s handwritten signature:
X
Date:
Agency Use Only Comments:
http://www.twc.state.tx.us/partners/vocational-rehabilitation-providers-resources http://www.twc.state.tx.us/partners/vocational-rehabilitation-providers-resources http://www.twc.state.tx.us/partners/vocational-rehabilitation-standards-providers-manual http://www.twc.state.tx.us/forms/index.html
File details come from the government source that posted it. Updated .