Rehabilitation Services

Performance-Based Agreements

Common Job Retention Elements

Although service providers will develop their own unique reporting formats, the following elements must be included in any Job Retention Report before the VR counselor may authorize the retention milestone payment:

1. Consumer
1. Name
2. Phone number
2. Employer Information
1. Name
2. Address
3. Phone number
3. Job Information
1. Job title
2. Job responsibilities
3. Number of hours per week
1. Days and times
4. Benefits
5. Wages
4. Accommodations
5. Follow-Up or Job Retention Support to be Provided
6. Consumer Comments Regarding Job Satisfaction
7. Employer Comments on Job Performance
8. Date
9. Support provider signature