WPC  1,ԷNWo{ idXa1>[;/'' Ed:I2(u1z`gBE .l"0լu0pͫG 5z3Bu}~CͥKK_6F*94xS [K Brvrb 36Co؈vfb$o`%WUy" a|.+)"ï_4ATg9ʪ`A⒗6FphgS 껷A9C$)V|I>Npd.iQA1r)yb h/T7 b%wZ{^—wj]D] aS&*ft.N&` e: =~h̹Ote>PwnA+Ř;Oe#U*>O % 0: ^ w 4   m N U0 NK U@M U)@ B A D-  HP LaserJet 4100 Series PCL,,,,0,! Z&Georgia RegularX($USUS.,Ta4 Dk4X/vBackup3|xU ,! ZGeorgia (O Z(Times New Roman (9 Z(Times New Roman  ddc&Draw Object =8C HKKKK)!dxdxLevel 1Level 2Level 3Level 4Level 5 !USUS.,  _   X XXX Section8/Part54  EffectiveDate:April10,2006  Lengthofdocument:2pages X X  x # X X # X X  # X X /#  }X X RequestforExceptionForm# } }@##X X }u#  f    `    _     Thispagewasleftblankintentionally.    XX XKansasDepartmentofSocialandRehabilitationServices  IntegratedServiceDeliveryDivision r RehabilitationServices#X XX#  4   0 @    XX RequestforException #X X  # 2 Date:0  0` (#(#0 ` (#` (# X (# (# Counselorsname:  D Clientname:0 ` 0 ` (#` (#0 (# (#0h(#(#0h(#h(# 0(#(# _ SSN_ :    Clientscurrentstatus:0    (#(#  TypeofRequest :   򀀀#X X XX#X XXX Ԁ0  Exceptiontocounselorsspendingauthority(costcap)(ManualSection3/Part8) (#(#   Servicecode: l    Servicedescription: X    Counselorsspendingauthority: D   Amountrequestedabovethecounselorsspendingauthorityforthisrequest: 0 0  Amountalreadyspentonthisserviceduringthelifeofthecase*:l(#(# X XX  0 `  ` (#` (# 0  *Amountspentforthelifeofthecaseisavailableinclienthistory/viewclientcasecosts,orthrough  authorizationreports/byclient/bypayment.#X XXu#(#(# 򀀀0  Exceptiontograntmorethanonemonthemergencymaintenance@(#(#   (ManualSection3/Part8) ,| 򀀀#X X XXR#X XXX 0  ExceptiontoallowmorethanthreemonthsofmaintenanceduringjobplacementT(#(#   (ManualSection3/Part8) @ 򀀀#X X XX #X XXX 0  Exceptiontoestablishedrate h     (#(#   SpecifythecurrentrateandManualreference:  0   #X X XX #X XXX   Exceptiontoallowprovisionof_ VR_ Ԁservicesforatransitionstudentpriorto18monthor !  3semester_ timeline_ Ԁ(ManualSection3/Part12)x"!(#(# 򀀀#X X XX #X XXX Ԁ0  Exceptiontoallowastudenttotakelessthan30collegehoursperyearorlessthanfull P$# timeparticipation(ManualSection3/Part17)<% $(#(# 򀀀#X X XX#X XXX 0  Exceptiontoallowfor1324psychotherapysessions(ManualSection4/Part6)'d"&(#(# 򀀀#X X XX+#X XXX 0  Exceptiontocounselorsauthoritytoauthorizesurgery/surgeriesexpectedtocost (<$( $10,001ormore(ManualSection4/Part11))(%)(#(# 򀀀#X X XX#X XXX 0  Other,specify:+'+(#(#   ,', _  Rationaleforexception :X XXMustincludeananalysisofthecomparablebenefitssearchundertaken,including  theavailabilityandtimelinessofsuchcomparablebenefits;theimpactoftheserviceontheclientsprogressin  his/herrehabilitationplanoremployment;andasummaryofthecounselingandguidanceprovidedrelatedto d futureexpendituresinthiscategory,ifappropriate. (x #X XX##X X XX#X XXX #X X XX#X XXX #X X XX#X XXX  #X X XX`#X XXX ActionTaken:     X XXStaffwillusetheproceduresestablishedbytheRSRegionalProgramAdministratorforapprovalsandroutingof t   recommendations:#X XX# 8   Level1:RSManager  8  Name: $  Date:   򀀀0  Approve0 (#(#0 (# (#0h(#(#򀀀#X X XX#X XXX 0h(#h(#RecommendapprovaltoLevel2#X X XX#X XXX  (#(# 򀀀0  #X X XX>#X XXX Deny0` (#(#0 ` (#` (#0 (# (#0h(#(#򀀀#X X XX#X XXX 0h(#h(#RecommenddenialtoLevel2(#(# #X X XXY#XkXXX Rationale: `    #X XXXk#X XXX  Level2:RSProgramAdministrator  4 #X X XXd#X XXX Name:  p Date:  \ #X X XX#X XXX 򀀀0  Approve0 (#(#0 (# (#0h(#(#򀀀#X X XXY#X XXX 0h(#h(#RecommendapprovaltoLevel2#X X XX#X XXX H(#(# 򀀀0  #X X XXw#X XXX Deny0` (#(#0 ` (#` (#0 (# (#0h(#(#򀀀#X X XX#X XXX 0h(#h(#RecommenddenialtoLevel2#X X XX#X XXX 4(#(# #X X XX#XkXXX Rationale:#X XXXkd#XkXXX     Level3:RSCentralOfficeFieldLiaison    #X XXXk#X XXX Name: l!  Date: X"! #X X XXM#X XXX 򀀀0  Approve0 (#(#0 (# (#0h(#(#򀀀#X X XX#X XXX 0h(#h(#RecommendapprovaltoLevel2#X X XXm#X XXX D#"(#(# 򀀀0  #X X XX#X XXX Deny0` (#(#0 ` (#` (#0 (# (#0h(#(#򀀀#X X XXZ #X XXX 0h(#h(#RecommenddenialtoLevel2#X X XX #X XXX 0$#(#(# #X X XXm!#XkXXX Rationale:#X XXXk!#XkXXX  %l $    `  ?XXkUponfinalaction,copiesoftheformshouldbeemailedtotheCounselor,RSManager,RSProgramAdministrator ($( andRSPolicySpecialistintheCentralOffice(MaryHirsch).TheCounselorshouldfileacopyinthecaserecord. )$) #XkX?x"#?XXk  0406#?"##X X##