Individual Service Providers

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Individual Service Providers (ISPs) are independent contractors who assist individuals with disabilities to participate in vocational rehabilitation services and to achieve and maintain an employment outcome.

The DOR defines independent contractors as an individual:

• who establishes his/her own working hours
• who procures his/her own tools, equipment or licenses necessary for his/her work
• whose service and completion of work are delivered in a stipulated period of time for an agreed-upon amount

An ISP must personally provide direct services to a DOR consumer. He/she may not subcontract services to any other individual or entity.

Requirements for Becoming a Service Provider

An ISP is an independent contractor who provides vocational rehabilitation services to assist individuals with disabilities to achieve their employment goals. The ISP Handbook describes the DOR's policy, procedures and standards for becoming an ISP and providing services.

ISPs are required to complete Fraud, Waste, and Abuse (FWA) training every calendar year. This training is for Individual Service Providers and explains fraud, waste, and abuse and how it can be prevented. Click on a training version below to open and complete the FWA training. The available versions for this training include:

• Fraud, Waste, and Abuse Training for Individual Service Providers

Getting Started

The DOR reviews and approves all Individual Service Providers (ISP) applications prior to the provision of services. To apply, individuals must first contact their local branch offices to determine if there is a demonstrated need for the services they wish to provide within that geographical area. If there is a need for services in the region, ISP applicants must complete, sign and submit the DR 171, STD 204 and the ISP Agreement to their local DOR office. Find the DOR office closest to you.

Click on a link below to download a form to your computer.

• DR 171 - ISP Application (PDF): This double-sided application is the first step in the process. Please see the ISP Handbook for more information on this form.
• STD 204 - Payee Data Record (PDF): All new vendors doing business with the state must complete, sign and return this form. The DOR's Accounting section must have this form on file to process your invoice for payment.
• ISP Agreement (DOC): This two page document features details on the conduct and professionalism that the DOR expects from its ISP contractors. Both the DOR and the ISP will sign the document.

Once the documents above have been completed, they must be submitted to your local DOR office.

If an ISP has been approved to provide a service, and there is a need for that service, DOR staff will issue an authorization form and refer a consumer to the ISP for services.

Billing Forms

Invoices are submitted at the end of each month. The ISP will use the below forms to bill the DOR for service provision. Please see the ISP Handbook for instructions on this process.

• DR 296 - ISP Invoice (PDF): This is the form ISPs use to bill the DOR for services. It is submitted at the end of every month to the branch / district Rehabilitation Counselor. The ISP fills out one invoice per counselor, listing all the consumers that the counselor referred for services.
• DR 296A - Worksheet (PDF): This required form goes with the Invoice. It's designed to help an ISP track his / her hours of service per consumer per month. An ISP will fill out one worksheet for every consumer served during the month.
• DR 174 - Progress Report (PDF): This is the third form an ISP will submit for monthly billing. This form assists the counselor with tracking the improvement of the consumer. One form per consumer served.