Appendix G: Orientation and Mobility Services

Revision 19-1, Effective March 1, 2019

Function of Orientation and Mobility Vendors

Orientation and Mobility (O&M) vendors offer complex, interrelated services designed to promote independent travel skills for people who are blind or visually impaired.

O&M training prepares consumers to travel independently with competence and confidence. Orientation is the process of using the available senses to establish one's position and relationship within the environment. Mobility is the ability to travel in the environment with the help of an established tool (including white canes, dog guides, and electronic travel aids).

Qualifications and Requirements

The O&M service provider must ensure that each person approved to provide O&M services to independent living consumers meets one of the following requirements:

  • The vendor is certified by either the Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) or the National Blindness Professional Certification Board (NBPCB).
  • The vendor is not certified at the start of the contract, but he or she:
    • has a degree in O&M from an accredited college or university with an established O&M training curriculum and will be certified by ACVREP or NBPCB within one year of the contract date; or
    • has at least two years of full-time work experience teaching O&M skills for an entity that the service provider recognizes, such as a rehabilitation center, Veterans Affairs (VA) hospital, or educational system; and also
    • has three professional references indicating the person's ability to teach O&M skills to blind or visually impaired people; and
    • will be certified by ACVREP or NBPCB within one year of the contract date.

To continue contracting for independent living services, all O&M vendors under the contract must maintain ACVREP or NBPCB certification.


In addition to meeting the education, training, and experience requirements described above, all prospective O&M vendors must participate in required training developed by HHSC. Each vendor is responsible for all costs related to attending the training.

Internship Requirements

O&M vendors who use interns to serve consumers must:

  • observe a minimum of 12 lessons during the internship;
  • document the observations; and
  • make the observations available for monitoring review by the service provider who may request them in any format for HHSC monitoring.

O&M interns must:

  • attend confidence builders training or its equivalent (interns are responsible for all training-related expenses);
  • be supervised by a certified O&M vendor for the duration of the internship;
  • be observed by the certified O&M vendor for a minimum of 12 lessons during the internship;
  • follow all standards for O&M services in this document; and
  • sign and forward reports to the supervising O&M vendor for his or her approval.

Scope of Services

Orientation and Mobility (O&M) services include:

  • an initial assessment of the consumer's O&M skills (if any) including strengths, challenges, and existing competency levels;
  • a review of the assessment results and training recommendations with the consumer; and
  • O&M skills training as agreed upon by the consumer, the service provider, and the O&M vendor.

Vendor Objectivity

The O&M vendor must remain impartial and objective.

Referral Information

Before contacting the consumer, the O&M vendor receives referral information from the service provider.

Initial Assessment

Assessments may be conducted using the consumer's functional vision, which is an opportunity for consumers to recognize that their vision may not meet all of their travel needs.

The initial assessment includes an evaluation of the consumer's O&M skills in multiple situations, which may include:

  • the consumer's home and immediate surrounding area;
  • public areas, such as a church, park, or college campus;
  • commercial areas, such as a bank, store, or mall;
  • transit systems, such as paratransit or taxis (if available);
  • local buses and similar public transportation (if available);
  • rural areas (if applicable);
  • residential areas (those with light vehicle and foot traffic and some stop signs);
  • small business areas (those with heavier traffic and simple traffic lights);
  • downtown areas (those with heavy vehicle and foot traffic and complex traffic lights);
  • commercial transportation systems, such as buses, trains, and airplanes (if applicable); and
  • travel using low-vision devices (if applicable).

Post-Assessment Discussion

Following the initial assessment, the O&M vendor reviews the results with the consumer and answers any questions that he or she may have about the recommended training. A meeting with the consumer, service provider, and O&M vendor is strongly recommended, so that all parties can agree on the overall O&M training plan.

Documenting the Initial Assessment

Initial assessment reports must be documented and submitted to the service provider in accordance with the service provider’s requirements.

The assessment report includes the:

  • O&M vendor's observations and comments;
  • recommendations for O&M skills training in each of the areas included in the initial assessment;
  • number of recommended training hours for each area;
  • total number of training hours being recommended;
  • anticipated period (beginning and ending dates) for recommended training;
  • consumer’s signature on the consumer's acceptance or rejection of the training recommendations;
  • height of the rigid cane that is most appropriate for the consumer (using the measurement between the consumer's chin and nose when standing up); and
  • description of all of the travel aids that the consumer uses or would benefit from using.

Training Authorization

After submitting an assessment report, the O&M vendor must contact the service provider to discuss the initial assessment and get authorization to provide training services.

The topics covered during the discussion include:

  • the vendor's recommendations for training (if any), including recommendations on the:
    • O&M skills needed;
    • proposed completion date of the training; and
    • number of training hours authorized by the consumer's service provider;
  • anticipated delays in services, if any;
  • special considerations or extended dates for direct training, if any;
  • the consumer's readiness to begin nonvisual O&M skills training; and
  • the consumer's understanding of O&M skills training and its potential benefits.

Monthly Progress Reports

After receiving authorization to provide training services, the O&M vendor must document each consumer's monthly training progress.

Monthly progress reports must be submitted within 30 days of the end of each calendar month until the consumer's O&M services are completed or services are no longer recommended by the consumer's service provider.

Each consumer's monthly progress report must include:

  • the number of training hours provided in each training area; and
  • a detailed narrative of each skill area addressed during the reporting period and the training location for each lesson.

Training locations include:

  • home (indoors and outdoors);
  • public areas (bank, church, doctor's office, and so on);
  • commercial areas (grocery store, mall, and so on);
  • transit systems (public transportation, paratransit, taxi, and so on);
  • rural areas;
  • residential areas (light traffic and stop signs);
  • small business areas (heavier traffic and simple traffic lights);
  • downtown areas (heavy traffic and complex lights);
  • commercial travel (trains, planes, and so on);
  • a detailed explanation of anticipated training for the upcoming month;
  • an explanation of deviations from assessment recommendations, if any; and
  • a detailed narrative of cumulative progress, if training is complete.

Expectations of Training

It is expected that O&M training services for independent living consumers be conducted using nonvisual (blindfold) techniques and a rigid (nonfolding) cane. All exceptions must be discussed with the service provider before training services begin, and must be fully documented in the O&M vendor’s required reports.

O&M vendors will discuss the benefits of nonvisual training with each consumer. Role modeling and peer support for nonvisual training are encouraged.

Travel Aids

The service provider provides one rigid, long, white cane for each consumer for O&M assessment and training, to be distributed by the O&M vendor. The O&M vendor conveys to the service provider the appropriate length for the consumer using the consumer’s height and other information.

If a consumer has a dog guide, the consumer is assessed by the O&M vendor to ensure that the consumer has proficient cane skills. O&M training can occur with either a cane or a dog guide.

The O&M vendor must include observations and recommendations of cane skills in the initial assessment. Recommended hours for training must include the consumer's travel needs, regardless of the mobility tool (dog or cane). Additional hours are not requested for training with a dog guide.

In addition, O&M vendors give information about cane purchasing to each consumer. Consumers are responsible for acquiring all replacement canes, cane tips, back-up canes, and so on.

O&M vendors may recommend additional travel aids or other items to the consumer's service provider; but the decision to purchase additional items rests solely with the service provider.

O&M vendors are not reimbursed for items provided to a consumer by the service provider.

Providing Services

The O&M training may not exceed the extent of services (type of training and total number of hours) authorized by the consumer's service provider.

O&M vendors cannot provide more than six hours of training on any given day, even if multiple consumers are served in that day. Lessons are approximately two hours long. Without prior authorization from a service provider, an individual consumer must not receive more than four hours of O&M instruction on any given day.

A consumer’s training lessons are approximately two hours long. Without prior authorization from a service provider, an individual consumer must not receive more than four hours of O&M instruction on any given day.

Consistent and frequent scheduling is recommended to maximize consumer learning.

For independent living consumers, the service provider authorizes two to three hours for the initial assessment. If training is recommended, the service provider allows no more than five hours of training per month. If additional training time is needed (because of safety-related concerns, secondary disability, or a specific consumer request), the O&M vendor sends a written request to the service provider, including the number of additional hours requested and the reason more hours are needed. Requests for additional training are made as part of the initial assessment, when possible.

Transporting consumers does not count toward training time. O&M vendors are not reimbursed for time spent in the car, even when a consumer is present.

The O&M vendor must notify the service provider within 24 hours about all:

  • no-shows, cancellations, or rescheduled appointments;
  • issues, concerns, or circumstances that might impact or delay planned services; and
  • issues that might delay the completion of services.

O&M vendors must get written approval from the service provider before deviating from any of these standards during training (even when based on an individual consumer's needs).

If Services Are Interrupted

If training cannot be completed as planned or if services are postponed indefinitely because of unexpected circumstances, the O&M vendor must notify the service provider within 24 hours. The service provider will then document the postponed services.