Goals and Plans for Distribution of Title VI, Part B Funds (Supported Employment): Attachment 4.11(c)(4)
Federal Title VI, Part B funds for supported employment services were initially used to develop model programs to determine the most effective structure for supported employment and to determine what types of services and supports work best with different populations. However, Title VI, Part B resources alone do not provide sufficient funds to meet the overall demand for supported employment services. For FFY 2010, ACCES-VR’s total funding level for supported employment contracts was $31 million of which $1.3 million was Title VI, Part B funds. The $1.3 million Title VI, Part B funds served approximately 14,800 individuals. At present, Title VI, Part B funds represent less than five percent of the total funds ACCES-VR uses for intensive supported employment services. ACCES-VR will continue the operation of the supported employment services established under Title VI, Part B. These funds will continue to be used to supplement, but not supplant, Title I funds.
Supported Employment Programs
ACCES-VR is in the second year of a five-year cycle of supported employment contracts with approximately 200 supported employment providers. While these continue the hourly fee-for-service payment system, ACCES-VR has begun planning for a performance-based contracting system that would fund based on specific milestones and outcomes. Over the past year, ACCES-VR conducted a survey of supported employment providers to identify potential payment points and levels that would work best in a performance-based contract. As ACCES-VR develops more specific proposals, community rehabilitation programs will be consulted as appropriate to the procurement process. ACCES-VR has also begun more closely monitoring utilization of both intensive and extended costs due to funding limitations.
Through the authority of Chapter 515 of the NYS Laws of 1992, ACCES-VR is assigned the responsibility for administering, establishing standards and monitoring the intensive service component of all supported employment programs in New York State. ACCES-VR also has the responsibility for the provision of extended service to individuals who are not eligible for such service through other sources.
ACCES-VR, with the cooperation of the New York State Office of Mental Health (OMH), the Office for People with Developmental Disabilities (OPWDD) and the Commission for the Blind and Visually Handicapped (CBVH) established the Chapter 515 Interagency Implementation Team in October 2006 to discuss ongoing concerns with the implementation of supported employment intensive and extended services in New York State. The Chapter 515 Interagency Implementation Team consists of employment program managers from the respective State agencies. The Team meets monthly to discuss program, data and funding issues, facilitate cross-systems implementation and identify opportunities for program improvements.
During the past year, the Chapter 515 Interagency Implementation Team worked on the following areas:
- Interagency Communication on Program Changes – ACCES-VR and OMH Central Office managers are meeting regularly to coordinate service delivery in counties where OMH Personalized Recovery Oriented Services (PROS) is being implemented. OMH and ACCES-VR coordinate technical assistance to local areas where changes in extended service providers have occurred to maintain collaboration around service delivery. OMH and ACCES-VR have started planning discussions on an Individualized Placement and Supports demonstration pilot in Suffolk County that would implement evidence-based supported employment practices.
- OPWDD Supported Employment Initiative - OPWDD and ACCES-VR continue to meet regularly to discuss areas of mutual interest. In examining the respective eligibility protocols for each program, OPWDD developed a directory of assessment providers and clinics who are capable of generating specific documentation necessary to pursue OPWDD eligibility. This will be used by VR Counselors and community service providers when working to establish OPWDD eligibility. OPWDD, ACCES-VR and Independent Living (IL) are also exploring ways that VR and IL services may be able to ensure more youth with intellectual and developmental disabilities enter employment or postsecondary education upon school exit. Local discussions will be held between the ACCES-VR District Offices and the OPWDD regional office on how to best coordinate supported employment services.
- Supported Employment Memorandum of Understanding (MOU) - The State agencies are continuing discussions on revisions to the Supported Employment MOU. The State agencies will continue to enhance their collaboration and deliberate on revisions to the Supported Employment MOU to reflect a renewed commitment and higher expectations for achieving integrated employment outcomes for individuals with disabilities. These dialogues help to assure that ACCES-VR is meeting program needs for individuals with significant disabilities in NYS.
- New York Interagency Supported Employment Reporting (NYISER) Data System Conversion – The Medicaid Infrastructure Grant in New York State is held and led by the Office of Mental Health (OMH). OMH and the NYS Department of Labor (DOL) have embarked on a project to transform the DOL information system, known as the One Stop Operating System, into a data and case services system that includes consolidation with all the components of NYISER. There are confidentiality and other administrative issues which will need to be resolved prior to implementation.
ACCES-VR combines Title VI, Part B and Section 110 funds to provide supported employment services to individuals with the most significant disabilities. Individuals served through supported employment services include individuals with all types of disabilities. ACCES-VR maintains agreements (Memorandum of Understanding and Integrated Employment Implementation Plan, Chapter 515 of the Laws of 1992) with OPWDD, OMH, and CBVH, which define ACCES-VR as the sole source for intensive funding. Program evaluation includes review of data from interagency quarterly reports as well as on-site reviews, including consumer interviews. Successful and exemplary practices have been disseminated to the staff of the State agencies involved and to other project sites.
Supported Employment Goals and Priorities
ACCES-VR’s Title VI, Part B program goals are to:
- provide services to individuals with the most significant disabilities who might not be traditionally considered appropriate for competitive employment; develop techniques for unserved and underserved populations, such as persons with acquired brain injuries, deafness, multiple disabilities, autism spectrum disorders, significant learning disabilities and significant mental illness;
- develop quality programs that could be used for replication purposes; and
- establish successful supported employment programs that will provide technical assistance to other programs.
The discussions that occur in the Chapter 515 Interagency Implementation Team monthly meetings help to achieve the above goals as well as to meet our challenge to close the employment gap between individuals without disabling conditions and individuals with disabilities. Program performance and costs are reviewed at least annually. Service re-negotiations occur based on overall performance, including performance on projected outcomes agreed to by ACCES-VR and the provider.
ACCES-VR vocational rehabilitation counselors manage the individual program of each consumer participating in intensive supported employment. This includes developing the Individualized Plan for Employment (IPE) and monitoring its implementation. The programs funded under Title VI, Part B represent previously underserved individuals. Every effort is made to improve the project's performance through continuing technical assistance and service delivery improvements.