ACCES-VR

Adult Career and Continuing Education Services-Vocational Rehabilitation

1310.00 Supported Employment Policy and Procedure

(Rev. July 2012)

Table of Contents

Policy

Procedure

Policy

Description

Supported employment is competitive work in an integrated work setting in which individuals work in an environment consistent with their employment factors., i.e. strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice with ongoing support services. Supported employment is for individuals with the most significant disabilities.

The goal of supported employment is job placement in an integrated setting for the maximum number of hours possible based on the individuals employment factors. A key characteristic which distinguishes supported employment from other employment services is the provision of ongoing support services for individuals with the most significant disabilities to maintain employment. Ongoing support services are provided throughout the intensive and extended phases of supported employment.

Definitions

Supported employment services are the ongoing support services and other appropriate services that are necessary to obtain and maintain an individual with a most significant disability in employment. The ACCES-VR phase of supported employment is referred to as intensive supported employment services.

Ongoing support services are defined as services that are needed to support and maintain an individual with a most significant disability in employment. Ongoing support services are to be provided as needed regardless of whether the individual is in the intensive or extended phase of supported employment.

Natural Supports are supports from supervisors and co-workers, such as mentoring, friendships, socializing at breaks and/or after work, providing feedback on job performance, or learning a new skill through the assistance of a supervisor or co-workers. These natural supports are particularly effective because they enhance the communication and social integration between the employee with a disability and his/her co-workers and supervisor. In addition, natural supports may be more permanent, consistently and readily available, thereby facilitating long-term job-retention. Friends and family members may also provide significant supports such as assistance with transportation and problem solving issues pertaining to work.

Extended services are those services that are needed to support and maintain the individual in supported employment. Extended services are provided after an individual has made the transition from intensive supported employment services provided by ACCES-VR to stabilization and may not be funded by VR program funds. Extended services are provided by a State agency, a nonprofit private organization, employer or any other appropriate resource. Funding for extended services is most often provided by the Office for People with Developmental Disabilities (OPWDD), the Office of Mental Health (OMH) or the NYSED Extended Services Funding.

The Role of the Rehabilitation Counselor

The vocational rehabilitation counselor has the primary role to determine the individual’s eligibility for vocational rehabilitation services, eligibility for supported employment, as well as planning and coordinating the supported employment services. In addition to determining who qualifies for supported employment, VR counselors are responsible for periodically reviewing the progress of the individual to determine if the services provided need action to assure the achievement of a quality employment outcome.

Requirements for Supported Employment Services

Supported employment is designed for individuals with the most significant disabilities:

  • For whom competitive employment has not traditionally occurred or for whom competitive employment has been interrupted or intermittent as a result of a most significant disability, and
  • Who because of the nature and severity of their disability need intensive supported employment services from ACCES-VR and the provision of extended services to maintain employment.

Before referring the individual to supported employment, the VR counselor must determine the individual meets all of the following criteria:

  • is eligible for vocational rehabilitation services;
  • meets all of the criteria for an individual who has a most significant disability;
  • has been unable to work, or has worked only intermittently, in competitive employment;
  • has had a comprehensive assessment of rehabilitation needs which identifies supported employment as the appropriate rehabilitation objective for the individual; and
  • requires ongoing supports in order to maintain employment.

NOTE: An individual may receive supported employment services during a trial work experience or extended evaluation, when appropriate, to determine eligibility.

Ongoing Support Services

Ongoing support services are identified based on a determination by the VR counselor of the individual's need as specified in an Individualized Plan for Employment (IPE). These services are provided by VR from the time supported employment services are initiated under an IPE until the transition to extended services. After VR funding ends, ongoing support services are thereafter provided by one or more extended services providers throughout the individual's term of employment in a particular job placement (or multiple placements if those placements are being provided under a program of transitional employment.)

Ongoing support services occur during both the intensive vocational rehabilitation services phase and the extended services phase and may consist of:

  1. necessary additional assessments at the work site;
  2. the provision of skilled job trainers (job coaches) who accompany the individual for intensive job skill training at the work site;
  3. job development and training;
  4. social skills training;
  5. regular observation or supervision of the individual;
  6. follow up services including regular contact with the employers, the individual, the parents, family members, guardians, advocates, and/or other authorized persons in order to reinforce and stabilize the job placement;
  7. facilitation of natural supports at the work site; and
  8. facilitation of any other services identified in the scope of vocational rehabilitation services at or away from the work site, such as transportation and personal assistance services.

Individualized Plan for Employment

Intensive supported employment services are the vocational rehabilitation services authorized under an IPE.

The Individualized Plan for Employment (IPE) for an individual for whom an employment outcome in supported employment has been determined to be appropriate must:

  1. specify the supported employment services to be provided by the ACCES-VR Program;
  2. specify the expected extended services, which may include natural supports;
  3. identify the source of extended services or, to the extent that it is not possible to identify the source of extended services at the time the IPE is developed, include a description of the basis for concluding that there is a reasonable expectation that those sources will become available;
  4. provide for periodic monitoring to ensure that the individual is making satisfactory progress toward meeting the weekly work requirement established in the IPE by the time of transition to extended services;
  5. provide for the coordination of services provided under an IPE with services provided under other individualized plans established under other federal or state programs;
  6. to the extent that job skills training is provided, identify that the training will be provided on site; and
  7. include placement in an integrated setting for the maximum number of hours possible based on the individual’s employment factors.

Supported employment does allow the individual to work on a full-time or part-time basis in an integrated setting as long as it is consistent with the individual’s employment factors. The standards for an employment outcome for individuals in supported employment must meet the same criteria as all VR employment outcomes.

Note: The maximum number of hours based on the individual’s employment factors must be determined by the VR counselor and documented in the record of services.

Wage Requirement

Under supported employment, the individual must be compensated in accordance with the Fair Labor Standards Act. In order for an individual to be closed as a competitive closure (closed with an employment outcome, status 26), the individual must be compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals who are not disabled. Supported Employment can result in a non-competitive employment outcome when the individual is working toward the competitive employment wage but has not yet achieved that standard.

Unpaid work and summer employment do not qualify as supported employment. Seasonal employment is allowable only if it is typical of the local labor market.

Duration of Supported Employment Services

Supported employment services funded by ACCES-VR are limited to 18 months beginning on the first day the consumer works at the job site which is intended as the individual's permanent placement. It is a cumulative total for the life of the current case, unless, under special circumstances, the individual and the rehabilitation counselor involved jointly agree to extend the time in order to achieve the employment outcome identified in the IPE. If the individual requires more than 18 months of supported employment services, a waiver is required.

Requirements for Waiver of Ongoing Support Services

The purpose of ongoing support services is to support and maintain an individual with a most significant disability in supported employment. When the individual has been placed in the job, at a minimum, twice-monthly monitoring visits at the worksite of each individual in supported employment is required. At least one contact per month with the employer is also required.

If under specific circumstances, especially at the request of the individual, the VR counselor can waive the on-site visits but will instead provide for twice monthly off-site monitoring meetings. If the consumer contact is provided away from the work site, it must be documented in the record of service and still consist of at least two meetings with the individual. If the individual has not disclosed his or her disability to the employer, then employer contact is prohibited by law.

Stabilization

Stabilization occurs when the individual's work performance reaches a performance level acceptable to the employer, and the job coaching and related ongoing support services have diminished to the level necessary to maintain the individual in employment. At this point stabilization is agreed upon by the VR counselor, the supported employment provider/job coach and the consumer. When stabilization occurs, the worker is ready to transition from ACCES-VR-funded intensive supported employment services to the appropriate source of ongoing support services known as extended services. This transition must not occur until all aspects of the individual’s placement indicate that the employment situation is secure and consistent with the individual’s functional capabilities and employment factors. At this point the individual’s case should enter status 22.

Transition to Extended Services

The decision to transition from intensive supported employment services to extended services should be made jointly by the individual (i.e. the supported employee), the employer (unless the individual has elected not to disclose the disability to the employer), the VR counselor and the staff of the supported employment program. The transition to extended services must be approved by the VR counselor. The record of service should show that the individual’s placement has been satisfactory in all respects before a determination is made that stabilization has been achieved.

Models of Supported Employment

ACCES-VR considers individual placement in competitive employment with ongoing supports as the primary goal for supported employment. Individual placement focuses on locating community jobs for specific individuals. Supported employment models such as an individual placement model, enclaves, mobile work crews, and affirmative business models offer a wide range of experiences, and must be evaluated based on each individual’s employment experience. Regardless of which supported employment model is used, the work setting must meet the definition of an integrated setting, as defined in the Employment Outcome Policy. Supported employment for individuals with a most significant disability due to mental illness does allow the individual to hold a series of temporary job placements in competitive work in integrated settings with ongoing support services that includes continuing sequential job placements until job permanency is achieved. This strategy is known as transitional employment.

There is an expectation that ongoing support services will remain available for as long as necessary and required for the individual to maintain employment, and will be available to assist in obtaining new employment if necessary.

Procedures

Supported Employment Referral to ACCES-VR

An individual who has a disability which results in a substantial impediment to employment can be referred to ACCES-VR and apply for services. Individuals with disabilities may:

  1. seek ACCES-VR services directly, or
  2. be referred by family members, guardians, friends, schools, independent living centers, Federal, State or local agencies, medical providers, and other sources. Whether an individual with a most significant disability is self-referred or referred by another source such as a community rehabilitation provider, the ACCES-VR counselor will gather and review material to first determine eligibility for VR services. Once a determination of eligibility is made, the VR counselor will then complete a comprehensive assessment to determine the need for supported employment services.

ACCES-VR Referral to a Community Provider

A VR counselor can make a referral to an appropriate Supported Employment Program for an eligible individual with a most significant disability. A VR counselor initiates this referral by using the CaMS Supported Employment Referral (SEREFFRM) form.

Referrals should include the following information:

  • the consumer's name
  • the ACCES-VR identification number
  • date of referral
  • the Provider's information including name and contract number
  • ACCES-VR contact information that includes the District Office along with the ACCES-VR counselor's name and telephone number
  • the consumer's information including address, telephone number, Social Security number and date of birth
  • the basis for the referral (i.e. an explanation of why competitive employment has not occurred and why the counselor expects the individual requires extended services to maintain employment.)
  • issues other than disability that may affect the individual’s opportunity for employment
  • anticipated extended services provider
  • consumer's disability/impairment
  • functional limitations
  • educational/vocational history
  • current vocational interests
  • suggested vocational goal
  • most recent medical/psychological information
  • attitudinal/behavioral/environmental factors
  • assistive devices/transportation/ADL needs
  • other concurrent services or treatment
  • list reports attached to the SE Referral form

The attached reports should include the most recent information and reports and the Supported Employment Referral Form. In order for the provider to begin services for the individual, the authorization for services and the signed IPE with the stated employment goal or the CaMS Supported Employment Letter to Provider (SEPROLTR) -either one is sufficient- must also be sent to the provider.

Documentation of Comprehensive Assessment

A comprehensive assessment of the individual’s employment factors, including the need for supported employment, is required prior to development of a supported employment goal. The assessment should be limited to information necessary to identify the rehabilitation needs of the individual and to develop the individualized plan for employment (IPE) of the eligible individual. In addition the assessment must also include:

  • a statement by the VR counselor identifying the basis for supported employment as the most appropriate service;
  • a description of the requirements for ongoing supports;
  • a statement that the individual has the ability to engage in a vocational program leading to stabilized supported work;
  • evidence of a need for ongoing support services in order to perform and sustain competitive work; and
  • a statement that the individual is anticipated to meet criteria for extended services funding.

The VR counselor should also begin to identify all known natural supports including the availability of transportation.

The comprehensive assessment must be documented by the VR counselor in the IPE for Development Case Note or the Supported Employment Referral Case Note. The Supported Employment Referral Case Note and the Supported Employment Referral Form should always include a statement by the VR counselor, in the counselor’s own wording, indicating that based on the comprehensive assessment of rehabilitation need, supported employment is determined to be the most appropriate service given the individual’s unique employment factors. The use of Standard Language Phrases (SLPs) alone to document the individual’s need for supported employment services is not sufficient.

The IPE Development Case Note

Individualized Plan for Employment (IPE) Development Note: After supported employment is determined to be an appropriate goal for an individual, all services provided by ACCES-VR must be written in the Individualized Plan for Employment. The IPE Development Case Note should include:

  • a description of the intensive vocational services that will be provided to help the individual achieve and maintain employment;
  • a description of ongoing supports, natural supports and other services that are expected to be needed during the extended services phase;
  • identification of the extended services provider and source of extended services funding, or if not possible during the development of the IPE, an explanation of why there is reasonable expectation that such sources will be available; and,
  • the coordination of VR services with vocationally-relevant services provided under other individualized plans under related Federal or State programs (e.g. DOL WIA, OPWDD, OMH or DOH Medicaid Waiver). In these situations, coordination will be documented in the record of services.

The sources for extended services funding include OPWDD, OMH, NYSED Extended Services Funding, NYCDMHMRAS (for New York City only), community rehabilitation programs, local assistance, and other approved sources including natural supports. The extended services provider should be identified at the time the intensive supported employment services are being planned. If the extended funding source cannot be identified at the time of IPE development but there is reasonable expectation that a source will become available, a statement must be included in the IPE Development Note regarding the reasonable expectation that the extended funding source will become available. This statement must be put into the IPE Development Case Note before supported employment services can be provided.

When there are multiple supported employment providers, the individual should be involved in selecting his/her service provider. The VR counselor is encouraged to utilize the Supported Employment Information Directory (SEID) to enhance consumer choice.

The IPE Development Case Note should include available information concerning the individual’s employment factors and interest in full-time or part-time work, interest in shift work and availability of necessary transportation, child care, etc., and document the consumer’s choice as well as identify natural supports.

Work Try Out (WTO) and On the Job Training (OJT) may be combined with supported employment when it is deemed necessary by the VR counselor to achieve the employment outcome. When a WTO or OJT is authorized in conjunction with supported employment, it must be clearly documented to be necessary to meet the rehabilitation needs of the individual and will not duplicate other services.

The IPE Development for Change Case Note should reflect when the individual requests off-site monitoring visits. An individual may request off site monitoring visits when the consumer is unwilling to disclose his/her disability to the employer.

It is the responsibility of the provider agency to pursue the application and eligibility for extended services funding and the VR counselor should monitor the status of funding eligibility by reviewing the monthly VR-416.

CaMS Procedure for IPE Development:

1. Main Tab - The Employment Goal section should reflect the competitive job title the individual is expected to achieve. CaMS will display “supported employment’ in front of the employment goal on the printed IPE if the “SE Goal” box is checked on the IPE.

2. Services Tab - The Services Tab should be completed by selecting supported employment and any other services that are needed by the individual to reach their employment goal.

When providing services under a supported employment contract, the Services section of the IPE should indicate:

  • Authorization Type: SE Contract;
  • The service provider and the contract name under which the service is being provided;
  • case service description 569X; and
  • the start and end dates of service
  • quantity;
  • unit;
  • unit price;
  • total cost; and
  • VR cost.

3. Extended SE Tab - Complete the fields for “Service Provider” and “Funding Source”. In order for a provider to be reimbursed for supported employment services provided to an ACCES-VR consumer, a case must be active and in status18 when the supported employment services begin. Also, written documentation which is either the “signed” IPE or the CaMS Supported Employment Letter to Provider (SEPROLTR) must be provided by the ACCES-VR counselor to the provider authorizing entry into the supported employment program and identifying the IPE employment goal. The SE goal must be checked in order for the extended SE Tab to be enabled.

Authorizing Case Services -Case Service Code 569X is used to authorize supported employment intensive services.

Items requiring a Waiver

The supported employment provider must request a waiver from the VR counselor and the VR counselor must document the waiver approval decision in the record of service for either of the following circumstances:

  • A waiver for off-site monitoring visit (the individual requests monitoring visits away from the work site; however, monitoring will still consist of at least two off-site meetings with the individual); and
  • A waiver for more than 18 months of intensive services after job placement.

The VR counselor must verify that the consumer requests off-site monitoring visits and document this request in the record of service. All waiver requests must be based on consumer need. Waiver requests are not based on program or employer need. If the individual has not disclosed the disability to the employer, then employer contact is prohibited by law. Again, the record of service should clearly document this choice.

The counselor must notify the provider of the waiver decision through the CaMS SEWAIVLTR (or return the signed VR-416 request).

Provider Progress Reports

The Consumer Monthly Progress Report (VR-416) - The VR-416 Report by the provider is a required monthly report. It should address the skills the consumer is learning, additional tasks that must be mastered, training strategies to be utilized, and level of job site support needed for stabilization. The Consumer Monthly Progress Report should also indicate the number of job coaching hours provided, hours worked by the consumer, and the hourly wage earned by the consumer.

The provider is required to submit the VR-416 reports each month following service delivery and the VR-416 reports should be reviewed in their entirety by the VR counselor by the following month.

VR Counselors will review the VR-416:

  • for the quality and appropriateness of services;
  • for reasonableness of billed hours;
  • to determine whether a waiver approval is needed
  • to review any additional required documentation that is attached, i.e. extended services plan;
  • to determine that the service plan information is appropriate and consistent with the individual’s employment factors as documented in the IPE; and
  • to ensure that the VR-416 form is signed.

If the VR counselor denies a VR-416, the declination should be clearly stated so that a payment will not be made to the service provider. The VR counselor should check the “No” box on page 2 of the VR-416 and notify their finance unit if the payment is on hold or has been cancelled. The VR-416 will be returned by the Finance Unit or the VR counselor to the provider agency for correction/revision.

Community-based Situational Assessment Reports may be provided with the VR-416 report or separately as necessary for timely communication of the results to the VR counselor. This report should include:

  • the feasibility of the goal through supported employment (ability to relate to the expectations of a work environment, including but not limited to ability to learn specific job duties, relationship with co-workers, response to supervision, etc.);
  • recommendations regarding suitable vocational goal (taking into account the individual's employment factors);
  • identification of ongoing support service needs for the individual to maintain employment (type, intensity, frequency);
  • potential to benefit from job coaching intervention;
  • possible training strategies (method, duration);and
  • job and task analyses (if a particular work site is already identified) including possible accommodations.

Job Development and Placement Reports are also reported by using the VR-416 and should summarize job development efforts and their results. If placement has not occurred, the report should list employer contacts made on behalf of the consumer. Once placement has occurred, the ACCES-VR counselor must be provided with a description of the specific job developed for the consumer as well as the name of the employer, location, hours, and wages.

Monthly Supported Employment Status Report

In addition to furnishing monthly VR-416 reports to ACCES-VR counselors regarding specific consumers, supported employment providers must also submit a Monthly Supported Employment Status Report to the ACCES-VR District Office. This report provides a list of new referrals received during the month, the consumers on a waiting list, the active consumers and the consumers who left intensive service in the previous month, the stabilization and transition date, the provider and the funding source for extended service, and the date of achievement of satisfactory employment for 90 days following transition, as applicable. This information enables each District Office to track movement of consumers through the supported employment process.

The Provider Services Plans

The Intensive Services Plan is developed by the provider and the individual and a copy of the plan is sent to ACCES-VR. The plan should summarize relevant information, outline the consumer’s goals and describe the intensive services that are provided to accomplish the goals. The intensive services plan should be consistent with the documented IPE employment goal.

The Extended Services Plan should be submitted to the VR counselor with the VR-416 upon stabilization, prior to transition to the extended services contract. Monthly VR-416 reports should be provided for at least the first three months after the consumer has been transitioned to the extended services contract. The Extended Services Plan must be developed by the provider with the individual at the time of transition to extended services; signed and dated by provider and individual, with documentation that the consumer received a copy. A copy of this plan is also to be sent to ACCES-VR.

The Extended Services Plan should clearly note the job title, the type of placement (individual or group), the date of transition, the hours and wages, an identification of natural supports, the service needs, the services planned and who will provide them, the funding source, whom to contact if problems arise, and how to make direct contact to obtain help with those problems.

Case Status Recording Requirements

Status 18- In Training: A case is entered into Training Status 18 after the IPE is completed. The consumer is regarded as being in training, status 18, until stability is achieved.

Placement in a job starts the 18 month limit for supported employment services. When it is anticipated that intensive on-site training and supports are needed beyond 18 months, a waiver must be requested by the provider (see above Waiver section). Once an individual is placed on the job that they are expected to keep, the VR counselor should document placement in the Supported Employment Placement in Training Case Note (CNSEPT) using the date reported by the provider on the VR-416 Placement Report. Complete the Job Placement Information header. The date of the case note should be the date that the individual started the job, as reported in the VR-416 or through contact with the consumer or supported employment provider. When the case note is finalized it will generate an overnight program code: SE Initial Job Placement. This will enable ACCES-VR to track the length of pre-placement intensive services and the 18 month duration limit.

Ensuring maximum hours of employment: At the time of stabilization, the VR counselor must review the VR-416 and the Extended Services Plan to ensure and document in the record of service that the individual is working the maximum number of hours consistent with his or her employment factors. If the number of hours is not consistent with the individual’s employment factors, the VR counselor must notify the supported employment provider and the individual should not be considered as having reached stabilization. The supported employment provider should continue services until the individual is working the maximum number of hours consistent with their employment factors.

Status 22 - In Employment: Once a consumer has reached stabilization and transitioned to an extended services support system, the individual's case must be entered into Status 22. The status effective date should be the same as the date of transition to extended services. It is from this point that the count towards 90 days in employment begins. Decisions regarding stabilization should be made jointly by the consumer, the employer, supported employment provider (including the job coach) and the ACCES-VR counselor. Documentation of this decision must be included in the record of service in the Status 22 Case Note. Transition to extended services must be approved by the VR counselor.

Status 26 – Rehabilitated (Closed with an employment outcome): When an individual has successfully maintained employment at the stabilization level for a period of at least 90 days, and extended ongoing supports are in place, the case is moved into Status 26. The consumer must be in an integrated work setting, earning minimum wage and level of benefits the employer pays other workers who are not disabled and who perform the same or similar work. The individual should be satisfied with their job and supports. Supported Employment can result in a non-competitive employment outcome when the individual is working toward the competitive employment wage but has not yet achieved that standard. The case is closed in Status 26, non-competitive, when wages are below minimum wage but consistent with the requirements of the Fair Labor Standards Act.

Important considerations for determining if an individual has achieved an employment outcome:

  • the individual and the rehabilitation counselor consider the placement to be satisfactory and agree that the individual is performing well on the job;
  • the employer reports continued satisfaction with job performance;
  • there is a reasonable expectation that the placement will be sustained; and
  • the provision of services under the individual’s Individualized Plan for Employment has contributed to the achievement of the employment outcome.

At the time of case closure, the individual must be earning at or above minimum wage but not less than the customary wage and benefits paid by the employer for the same or similar work performed by individuals who are not disabled. If the individual does not meet this wage requirement when the case is closed, then the closure status is Status 26, but it is a non-competitive closure.

Addressing Service Needs in Extended Services or Following Case Closure

After a case is in extended services or closed in an employment outcome (Status 26), services may become necessary in order for the consumer to maintain employment or obtain new employment. Possible reasons for this may include changes in the individual’s job duties or the work site, supervisory requirements, medical problems, disability related limitations, or other factors that jeopardize the individual’s ability to maintain employment without additional intensive services. These services may be provided by utilizing the extended services contract, reopening the case or the use of Post-Employment Services (Status 32).

The supported employment extended services provider and ACCES-VR counselor should communicate as early as possible when it is thought the individual will need assistance either maintaining or obtaining new employment.

Extended Services Contract: It is the purpose of extended services to provide ongoing support services to maintain the individual in the job, restore stability, and place an individual in a new job when a job is lost or for the purpose of career improvement. Through the Extended Services Contract, ongoing support services can be used as needed to reestablish stabilization when the service need is anticipated to be brief. Action by the ACCES-VR counselor and/or ACCES-VR district office is not required when the ongoing support services are provided by the extended services provider. However, if at any point it is determined that extended services are not going to be sufficient to reestablish stabilization, the ACCES-VR counselor and/or district office, with the consumer and supported employment provider, should determine whether providing post-employment services or reopening a case are appropriate.

Post Employment Services: If the extended services contractor documents that they are unable to provide ongoing support services required for re-stabilization through the extended services contract, the counselor should consider the provision of these services through Post Employment Services (PES). If the service needed to reestablish stabilization is a short term discrete service (i.e. hearing aid, assistive device), that is not available through the extended services contract, post employment services should be utilized. PES must be limited in scope and duration but may include any vocational rehabilitation services that are not complex or comprehensive. Ongoing, extensive or multiple services require opening a new case with eligibility determination. PES requires a new IPE and a new determination of economic need and/or comparable benefits if a service to be provided under PES is contingent upon economic need and/or comparable benefits.

Opening a new case: If the ACCES-VR counselor, after consulting with the provider and the individual, determines that intensive vocational rehabilitation services are required to secure a new job, then a new case should be opened.

The individual must meet eligibility requirements for vocational rehabilitation services and a new employment goal and IPE would then be established accordingly. Individuals who are currently employed can be determined eligible for services to advance in employment if their impairment results in a substantial impediment to advancing or retaining employment, or if the individual is substantially under-employed based on an assessment of employment factors.

Provision of Contracted Services

ACCES-VR supported employment services are provided only through the Supported Employment contract.

Appendix

Personalized Recovery Oriented Services (PROS) PROS is a comprehensive recovery-oriented program for individuals with severe and persistent mental health conditions. The goal of the program is to integrate treatment, rehabilitation and support in a manner that facilitates an individual's recovery. The objective of employment-related services in PROS is to help individuals obtain and retain integrated, competitive jobs. The PROS program model is flexible and allows providers to develop an array of services to assist individuals to obtain and retain the employment goals of their choice.

Ongoing Integrated Supported Employment (OISE) OISE is an OMH funding stream in non-PROS counties. OISE provides services related to ongoing job maintenance including job coaching, employer consultation and other relevant supports needed to assist an individual in maintaining a job placement. These services are intended to complement the intensive training phase of supported employment by ACCES-VR.

Models of Supported Employment

Individual Placement in competitive employment with ongoing support services is considered by ACCES-VR to be the primary goal for supported employment. Individual placement focuses on locating community jobs for specific individuals. The worker's strengths, preferences and abilities are considered along with the job requirements. The individual is paid at or above the minimum wage but not less than the customary wage and benefits paid by the employer for the same or similar work performed by individuals who are not disabled. The company employing the individual usually pays the person directly. Although more than one person with a disability may work at the same site, this practice stresses finding the most suitable options for each individual. Typically a trained job coach develops the job, matches an individual, trains the individual on the job until he or she meets the employer’s performance criteria and has developed the work and social skills necessary for integration into the work setting. The job coach then provides extended services to the individual and the employer.

Affirmative Business is an agency-operated work site organized as a business. With affirmative business, there may be up to six employees with disabilities, but not more than the number of employees without disabilities. The affirmative business operates like any business, generating work and paying employees from revenues received. The affirmative business is located within the community.

Enclaves consist of a small group of people with disabilities (no more than 8) who are trained and supervised among employees who are not disabled at the host company’s work site. Persons in the enclave work as a team at a single work site in a community business or industry. Initial training, supervision, and support are provided by a specifically trained on-site supervisor, who may work for the host company or the Supported Employment placement agency. Another variation of the enclave approach is called the “dispersed enclave.” This model is used in service industries (e.g., universities, restaurants, and hotels). Each person works a separate job, and the group is dispersed throughout the company. In both the individual placement and enclave models, the availability of interaction with non-disabled individuals during the course of the work day is a crucial requirement.

Mobile Crew is a small crew of persons with disabilities (up to 6) who work as a distinct unit and operates a self-contained business that generates employment for their crew members by selling a service. The crew typically works at several locations within the community, under the supervision of a job coach. Methods of payment are similar to those used in the enclave approach; paid through the agency. The type of work usually includes janitorial or grounds-keeping. People with disabilities work with non-disabled people in a variety of settings, such as offices and apartment buildings.

Transitional Employment Program (TEP) is a series of temporary job placements in competitive work in integrated settings with ongoing support services for individuals with the most significant disabilities due to mental illness. The purpose of TEP is to strengthen an individual’s skill level and work history with the goal of achieving assisted or unassisted competitive employment at or above the standard minimum wage. These placements provide time-limited employment and on-the-job training in integrated employment settings. In transitional employment, the provision of ongoing support services must include continuing sequential job placements until job permanency is achieved. There are very few operating TEPs.

Evidence Based and Promising Practices

Individual Placement with Supports (IPS) is an evidence based practice focused on assisting individuals with severe mental illness to secure competitive employment. This model relies on rapid job placement with ongoing support. It seeks to find employment opportunities consistent with the individuals’ unique employment factors by providing employment supports that are individualized, flexible and available for as long as needed and by assisting the individual and their family with benefit advisement.

Customized Employment is a practice that includes the following steps: Discovery (assessment), Profile, development of an employment plan, development of a resume, job development and job analysis. Services are more focused during the front end of the process; i.e. 25 - 30 hours for the assessment phase and it relies on developing and maximizing natural supports for extended services. Flexible strategies are applied to fit the specific strengths of the individual with the business needs of the employer.

Reference

Rehabilitation Act:

  • Section 7; Section 102, Section 634, Section 635

Federal Regulations:

  • 34CFR Part 361

State Laws:

  • Chapter 515, Laws of 1992

Policies:

Procedures:

Last Updated: August 16, 2012