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Revised 2/2001

Philosophy

General Guidelines

Definitions

Purchase of Services

Federal Regulations: 34 CFR 363.11 and 34 CFR 361.46(b)

Rehabilitation Act of 1973 as amended, Section 102 (b)

Supported employment is a means to assist individuals with the most significant disabilities to become competitively employed. The core values are:

Integrated (inclusive) work environment;

Consumer choice and involvement, with services and supports based on individual interests and abilities;

A career path made possible through the provision of on-going support and extended follow-up services; and

Parity in wages and other employment benefits.

Supported employment focuses on assisting the consumer in finding employment in a position suitably challenging for his/her skill level and interest. Job-site training and/or ongoing follow-up and support are also provided so the consumer can be successful. This eliminates the barrier that often occurs in a typical "train-then-place" model, where training is provided prior to placement and support services are either time-limited or non-existent after the consumer begins working. Because of this, Supported Employment opens up the door of opportunity to people with the most significant disabilities who otherwise may be excluded from community-based jobs.

Unlike other services of Vocational Rehabilitation, supported employment is built on the premise that long-term, permanent support, individually determined as to amount and intensity, throughout the duration of the consumer’s employment is a key factor in determining that consumer’s vocational success. Although supported employment services that are paid for by the Department will remain time-limited, consumers served in supported employment will continue to receive services from a supported employment agency long beyond case closure.

The following features of supported employment are what make it innovative and responsive to the needs of people with the most significant disabilities.

The supported employment concept assumes that all persons, regardless of degree of disability, have the capacity to participate in real employment with appropriate ongoing support;

Supported employment focuses on providing appropriate support services to assist a person in getting and keeping a job. Each service is tailored to specific need;

Individuals are offered choices in the selection and maintenance of jobs. Decisions about appropriate services are made jointly with the consumer and/or the family and all of the "stakeholders" involved in the process. Person-Centered Planning concepts are used to make the process successful;

Emphasis is placed on recognizing and maximizing opportunities for integration and inclusion in the workplace;

Contact and relationships with people who are not disabled and who are not caregivers is emphasized, both on and off the job; and

The purpose of the program is employment with all of the general expectations of a job such as wages, job security, and performing meaningful work.

Extended, ongoing support services are provided by supported employment personnel, and will vary based on the amount, intensity, and kind of support needed by each consumer. Supported employment offers more than just the assistance needed to find and learn a job. It provides the necessary ongoing support to help the consumer maintain employment.

 

ELIGIBILITY

Eligibility for supported employment shall be based upon general eligibility criteria in accord with regulations and on the person’s specialized needs that can only be met by supported employment. The case file must document that the consumer is Most Significantly Disabled based on Department criteria.

The consumer’s disability must constitute a need for intensive support services and extended services that only supported employment can provide. The need for this service, rather than a particular diagnosis, will be the basis for this service. The counselor must document the specific functional limitations that verify the need for supported employment versus other employment options. Eligibility is to be determined separately from availability of services.

Under the federal regulations, the consumer is determined to be potentially employable through the provision of supported employment services and must be found eligible even if a key resource(s) needed to provide those services is currently unavailable. In other words, the federal regulations do not allow for the Counselor to find a consumer ineligible for Department services because the resource for providing extended services cannot be identified. In this instance, the Counselor would:

certify the consumer eligible for Department services;

inform the consumer that supported employment services cannot be initiated until an extended services resource is obtained; and

seek out the needed extended services resource.

The Workforce Investment Act of 1998 defines supported employment as

"a term that, in general, means competitive work in integrated work settings, or employment in integrated work settings in which individuals are working toward competitive work, consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the consumer, 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 significant disability; AND

who, because of the nature and severity of the disability, need intensive supported employment services."

Further, according to the Workforce Investment Act of 1998, Supported Employment services means:

"On-going support services and other appropriate services needed to support and maintain an individual with a most significant disability in employment, that—

are provided signally or in combination and are organized and made available in such a way as to assist an eligible individual to achieve competitive employment;

are based on a determination of the needs of an eligible individual, as specified in an IPE, and

are provided for a period of time not to extend beyond 18 months, unless under special circumstances the eligible individual and the Counselor or coordinator jointly agree to extend the time in order to achieve the rehabilitation objectives identified in the IPE."

INDIVIDUAL PLAN OF EMPLOYMENT

An IPE will be developed for each consumer served in supported employment and will include all mandatory components of the IPE as described in Section 7.

Additionally, the case file must contain documentation of the following:

a description of the supported employment services to be provided;

a description of the ongoing services to be provided (e.g., help with finding subsequent jobs); and

the name of the program that will provide the extended, ongoing support services.

ON-GOING SUPPORT SERVICES

"On going support services", as referred to in the Workforce Investment Act of 1998, include training and other services that are needed to support and maintain an individual with the most severe disabilities in employment. These services are determined based on an assessment of the consumer’s needs, as specified in the IPE. These services may be provided for a period not to exceed 18 months, unless a longer period to achieve job stabilization has been established in the IPE.

ECONOMIC NEEDS TEST EXCLUSION

Time-limited supported employment services are excluded from the economic needs test. Other services a consumer may require will be based on eligibility and provided through Title I funds, and may be subject to the financial needs test as applicable.

 

WORK SETTING AND BENEFITS

The supported employee must be paid in accordance with the Fair Labor Standards Act, and not less than the customary wage and level of benefits provided by the same employer to non-disabled workers who perform the same or similar work. The employee’s work setting must be an integrated environment that provides the opportunity for daily interaction with people without disabilities who are not paid service providers. The employees work hours should be individually determined.

 

SUCCESSFUL CASE CLOSURE

Before the Department can provide for the transition of a consumer in a supported placement to the provider of extended services (and close a case as a successful closure), three minimum requirements must be met:

The consumer must be stabilized in the job. (Stabilization is not easily defined and is often a "judgment call" based on considering such things as the consumer’s satisfaction with the job, level of interaction between the consumer and the co-workers and supervisors, etc., and level of services needed and/or anticipated.); and,

The consumer must have substantially met the employment goal; and

The extended services must be immediately available to preclude any interruption in the provision of the ongoing support needed to maintain employment.

If a consumer stabilizes in employment at a level of hourly work less than the goal originally established, the supported employee, the Supported Employment Provider, and the Counselor must agree that the job represents substantial and suitable employment in order for successful status closure. The consumer must maintain employment for at least 30 days after the transition to extended services before case closure can occur.

Department staff must be careful not to close cases too quickly. The closure narrative must indicate the name of the supported employment agency that will provide extended and ongoing support services after the Department case file is closed.

Before closing the case, the Counselor should talk with the consumer, the supported employment specialist, and possibly with the employer and others such as family members, etc. The counselor must be assured that the customer is functioning well at the job not only in terms of general satisfaction, number of hours worked, performance of job duties and other basics, but also in comfort level on the job, in interacting with coworkers and supervisors, and in other "less visible," but essential, aspects of the job which, if unattended, could jeopardize the worker's future.

 

POST EMPLOYMENT

Following Department case closure, selected services can be provided as discrete post-employment services. It must be ascertained that they are unavailable from the Supported Employment Provider and that they are necessary to maintain the job placement, such as job station redesign and repair, maintenance, or replacement of assistive technology devices. In instances of under-employment or a need for extensive retraining, discrete post-employment services shall be used and consideration should be given to opening a new case with the Department if appropriate.

 

NATURAL SUPPORTS

Successful supported employment is not solely a matter of physical integration (i.e., a work setting which is "natural" rather than created for people with disabilities and where a low percentage of workers has a disability). A community is also a social space: A network of interactions, relationships, and supports. Natural supports should be emphasized in order for supported employment to be successful and for the worker to feel included in the workplace.

The job coach approach to supported employment does not by itself always maximize the social integration of workers with severe disabilities. Narrowly practiced, job coaching can develop unnecessary dependency on external supports, stigmatize workers as deviant, and result in social isolation. Task analysis, work skill training, and other "job coach" functions need to be carried out in the context of a wider perspective.

A common mistake is to create a self-contained job position that requires few interactions. Jobs designed should to be interdependent and some tasks should be performed jointly with other workers. At several points in the workday a supported employee’s job and other jobs shall intersect in a way that requires communication. Job routines should be flexible, with allowance for disruptions of the usual pattern. A priority for support consultants must be insuring that there is a procedure for asking for help and notification of problems.

Many co-workers and supervisors enjoy training and providing other supports. Many companies have formal or informal mechanisms for the training and orientation of new employees (for example, pairing a new worker with an experienced worker or "mentor"). Support consultants look for these opportunities and work with them. For example, a support consultant may observe the mentoring process, meet periodically with the mentor, and offer training pointers. By giving away training and behavior management skills, support consultants avoid communicating the message that it takes some special kind of person to interact with the supported employee. Job training should not appear mysterious.

It is important that everyone is clear about whom the supervisor is and that the supervisor gives job orders to the worker. Also, supported employees must understand whom to go to when they have a problem at work; the support consultant should not solve the problem. Co-workers and others at the setting should be enlisted in the search for solutions to job design, work method, or adaptation problems. Sometimes redesigning or renegotiating a job is better than lengthy instruction.

A few cautions must be kept in mind when implementing natural supports:

Supported employment is not a rigid service or fixed package of techniques but a flexible, open-ended approach. "Co-worker support" is not a new model to be imposed on businesses. The relationship between support consultant, supported employee, co-workers and supervisor will be different at each work setting. Occasionally, traditional job coaching may be perfect. The only thing "fixed" is the commitment to success of the employee.

"Natural support" must never be used as an excuse for providing inadequate services or withdrawing agency support. A "laissez-faire" or "place and hope" approach is incompatible with facilitating natural supports. Agencies may perform their support function in a less direct and intrusive way, but supported employees remain entitled to receive whatever ongoing agency support they need for as long as they need it.

Co-workers must not be turned into human service paraprofessionals. For example, it is generally unnecessary to conduct classroom-style-training session for co-workers in behavior management or to load co-workers down with data sheets and stop watches. Inclusion of co-workers in the support process must be directly related to a specific need, respectful of their existing skills, and tailored to fit the cultures of work settings.

Source: Excerpts from "Natural Supports Presentation" by David Hagner, Ph.D., Concord, NH. 1996

SUPPORTED EMPLOYMENT VENDORS ("providers," "agencies," etc.)

Supported employment providers must be approved by the Supported Employment Branch and received a Supported Employment Services Agreement Contract. Vendorship will be reviewed regularly and updated as necessary. All supported employment vendors must be able to fund and provide extended, ongoing support services for all consumers served.

Vendorship applications are available from the Supported Employment Branch and may be submitted any time during the year. All supported employment programs need to have both internal and external review policies in place to ensure continued quality of services. Internal reviews should include regular evaluations of staff, as well as through financial and program audits. External reviews should include consumer satisfaction surveys, and other feedback from consumers, family members, and employers. All vendors must assure that staff will participate in "Fundamentals of Supported Employment Training" which is available through the University of KY-Interdisciplinary Human Development Institute.

JOB CARVING

Job carving (sometimes called job creation or restructuring) is the process of analyzing and identifying specific tasks within a given job that might be reassigned to another position. This process can be extremely effective in assisting Employment Consultants (job coaches/job developers) to secure well-matched jobs for persons with the most severe disabilities. Therefore, it is often an important and valuable step in the job development process.

Working with employers to move away from standard job descriptions that include many generalist tasks and can create opportunities for securing valued positions for supported employment consumers. Individuals with severe cognitive disabilities, serious mental illness and/or physical challenges can often benefit from finding a job specifically created with their unique talents and competencies in mind.

In addition, the idea of job carving can be appealing to employers. By utilizing job carving strategies, an employer can free up the company’s more technical or skilled personnel. This can often increase efficiency and productivity of these positions, generate savings in overall labor costs, and/or improve customer service. Employers may also find that certain tasks within the carved position are now assured of completion and that turnover in certain positions is reduced.

It is extremely important to start this process with assisting the employer to do a thorough job analysis of the related position(s), taking into account all of the required tasks, the skills and competencies of the existing employees, and the overall efficiency of the employees. It is critical to listen to the employer’s needs and concerns, and to involve the employer in the entire process. By directly observing the work routine and interviewing the employer and employees, the Employment Consultant can analyze what tasks do not get done that need to band what tasks could be handled by someone else. The Employment Consultant must listen carefully to any efficiency and productivity concerns of the employer and employees as well as ask if thee are any tasks that are particularly time-consuming or whether turnover is a problem. In multi-department companies, it is important to schedule time in each department to understand particular needs.

Employment Consultants will want to assess the company culture and attitudes towards hiring persons with disabilities, as well as to identify what natural supports are available to assist a new employee learn and maintain their job. Special care needs to be given to make sure that a created or carved position would not devalue an individual by having them perform tasks that no one wants to do or that coworkers feel are unnecessary. Employment Consultants will want to target overlapping or intersecting job tasks to allow for increased interaction with coworkers. As always, Employment Consultants must make sure that the consumer would not be physically separated from other employees or excluded from any applicable staff meetings or company events.

After the analysis, the Employment Consultant must determine if there is sufficient work and tasks to warrant the creation or carving of a position, and if the available tasks and the culture of the company match to the needs of the consumer. If this is the case, the proposal should be put in writing to the employer, clearly outlining the benefits to the employer, the proposed job duties, hours and wages, and an overview of the supports the supported employment organization will provide. It is also important to include specific information about the consumer the Employment Consultant has in mind, including a resume and/or completed application. The Employment Consultant will also want to set up a time for the employer to interview the applicant.

The process of job carving can be an excellent opportunity to develop jobs for persons with severe disabilities and to establish strong relationships between an employer and the supported employment organization.

The following guidelines pertain to purchase of supported employment services for eligible consumers with the most significant disabilities. The DVR Supported Employment Branch must approve all supported employment service providers as vendors. An application process is required to become a vendor. The Counselor must authorize the services for each consumer.

Payment documents must be processed promptly by the Department upon attainment of appropriate outcomes, pending receipt of necessary documentation of service provision and individual progress from the supported employment service provider.

PERSON-CENTERED JOB SELECTION (formerly "Vocational Profile")

Becoming well prepared to represent customers who need supported employment to prospective employers is an important activity before the initiation of job development efforts. It is vital for the supported employment specialist to know the person and to gather all relevant information possible on the needs, skills, preferences, and experiences of the consumer’s who shall be employed. This information serves as the basis for successful job matches.

Person-centered job selection provides:

a way based on the concept that every person has strengths and skills to build upon to reach an employment goal so that the Employment Specialist can get to know the individual who is possibly seeking a job for the first time—a way to break past preconceived notions about what a person can and cannot do, and a way to discover new and positive job possibilities with the person;

a thoughtful framework for planning job development and job negotiation—a means for service providers to "get ready" for job development;

a way to be thoughtful about the nature of an ideal job for a consumer—as opposed to "slotting" him or her into a readily available job, guessing whether or not it will work out.

An hourly fee may be paid for time invested by the Supported Employment Specialist in doing this sort of preparation for job development. There is no automatic outcome fee guaranteed to a vendor. Amounts will vary based on the time required in each circumstance. In most cases, at least a few hours in this service category should be authorized so that the supported employment service provider may spend time to become acquainted with the supported employment candidate. This may include:

spending time with the consumer to get a picture of his or her current day. For example, asking the consumer to spend time with him/her in current human service programs, school, community routines, family gatherings, time around the house, and so on.

spending time with the consumer to expand his or her understanding of options and/or to get further information about desirable work conditions, or consumer preferences. For example, arranging a visit to a cabinet-making shop for someone who has an interest in wood working, running family errands to get an idea of the person’s current ability to negotiate all of the things to be known about making a purchase at a department store or grocery, introducing the person to another community member who is accomplished in the area of interest.

asking the consumer for names of trusted others and talking to them for the purpose of expanding his or her job search network and gaining additional employment ideas;

talking to the consumer and family members (and others given consumer’s permission) about significant life experiences;

reviewing records for information relevant to employment (understanding the consumer’s background, things that have worked well, things that have been disastrous);

writing a report and/or summary of key issues describing desirable job characteristics, the goal for the number of hours to be worked per week, and relevant issues needing addressed for employment (copy must be submitted with bill);

convening a meeting or meetings for the purpose of refining the employment list of ideal job characteristics.

In order to be eligible for payment of the hourly fee, the agency must have a DVR Supported Employment vendorship. Also Supported Employment staff must attend the training offered by the Human Development Institute/Supported Employment training project. These components are required, and other training offered by this project are optional.

1--A Person-Centered Approach to Job Selection (or the former Vocational Profile training); and

2--Job Development.

These training’s are offered periodically. Staff may proceed with provision of supported employment services if working under the supervision of staff who have had the training and if they are registered to attend future training’s, or are on a waiting list for the training’s.

Each hour of service must be documented/described and submitted monthly with the bill during the process. Once recommendations have been finalized, a report and final bill must be submitted for payment. Reimbursement will be based on the number of hours that have been used for that particular consumer.

PERSON-CENTERED JOB SELECTION REPORTS

A person-centered job selection report must be submitted to the counselor once the Supported Employment Provider has completed the process and is ready to begin job development. The report should include :

A plan for job development based on the findings of the person-centered job selection activities, including the vocational goals and the goal for the number of hours to be worked per week;

Description of the consumer’s strengths;

Identification of the consumer’s employment issues/barriers to successful achievement of the vocational objectives;

Strategies and Resources planned to address these issues and barriers;

Suggestions for potential worksites;

Nature and intensity of supports that the consumer will need in order to maintain employment; and

Description of work and non-work needs and goals that may impact achievement of the vocational goal.

JOB DEVELOPMENT SERVICES

Because of the need for extremely individualized planning and delivery of job development services, the supported employment provider should provide for each consumer all services necessary to secure the best job. Accordingly, the Department has established an hourly fee for specialized job development services. There is no automatic outcome fee. Amounts will vary based on the number of hours needed for each consumer.

Job development services may focus on interviewing skills/interview support, particular work environments, job types and settings, learning styles, transportation needs, hours required, potential for natural supports, job carving, job creation, needs for accommodations and assistive technology, and/or many other services based on the consumer’s individual needs.

Each consumer's need for job development services will vary and supported employment agencies must not budget their programs to receive the "maximum amount" allowed for each supported employment consumer. An authorization should be issued for individually-designed job development services at an appropriate number of hours suitable for that consumer when the supported employment provider describes and outline these services (generally submitted as part of the Person-Centered Job Selection Report).

Hourly intervention documentation and Progress Reports will be required for this service and must be submitted to the Counselor in order for services to be paid.

Following are examples of activities that may be reimbursed by the Department:

Researching information about businesses relevant to the job goal for the particular consumer;

Networking and establishing common-ground with relevant businesses (e.g., getting a referral from a highly regarded public official to assist in getting in the door of a local industry);

Preparing a resume with and/or on behalf of the consumer seeking employment;

Writing letters of introduction to relevant employers with and/or on behalf of the consumer seeking employment;

Phone calls, visits, and tours with relevant employers with and/or on behalf of the consumer seeking employment;

Performing a job analysis of relevant jobs using information taken from Marc Gold and Associates, Seven Phase Sequence for Balancing Naturalness and Individual Employee Needs;

Doing a study of a company’s typical ways of doing business including job methods, schedules, routines, important cultural/social aspects, issues of particular importance (e.g., production, quality, cleanliness), policies (written and unwritten), language, interactions between people on the job (between co-workers, management and workers, workers and public), demands (physical, cognitive, sensory, judgment, academic), environmental conditions (sounds, smells and aesthetics), apparent organization or the lack of organization within the company;

Doing a study of the means typically used for employees to learn jobs (orientation, training materials, classes, mentoring);

Doing a study of people typically involved in instruction of new employees (roles of management or co-workers);

Negotiating with an employer possible job responsibilities with and/or on behalf of the consumer seeking employment;

Negotiating with an employer suitable instructional methods with and/or on behalf of the consumer seeking employment;

Assisting the consumer seeking employment in preparing for an interview, and/or orchestrating an adapted interview for the person and employer;

Supporting the consumer seeking employment with his or her interview with employer (perhaps accompanying, providing transportation, following-up); and

Reasonable time for transportation to perform these activities.

SUPPORTED EMPLOYMENT INDIVIDUAL PLACEMENT OUTCOME

Once the consumer has obtained employment, the outcome-fee should be authorized to the supported employment provider so that individualized supported employment services can be provided to assist the supported employee in achieving job success.

The list of possible supported employment services covered under the outcome fee is extensive. These services can occur both on and off the job site. Services are not limited to skills training by a job coach only, but must be individually tailored based on the needs of the particular consumer.

The supported employment provider must give feedback to the Counselor as needed, furnish written progress reports on a monthly basis and a final report when the service is completed. Successful completion of the service means that the consumer has been employed at least 60 calendar days in a job or jobs consistent with the IPE, is satisfied with the job, has a satisfactory number of hours of work scheduled each week, and has the extended services support in place to continue on after the Department closes the case file. The fee will be paid to the supported employment provider if the above criteria are met. Department case closure could then occur after another 30 days of successful employment, for a total of at least 90 days in "employment status" before case closure.

Before closing the case file, the Counselor should talk with the consumer, the supported employment specialist, and possibly with the employer and other "stakeholders" such as family members, etc. The counselor should be assured that the consumer is functioning well at the job not only in terms of general satisfaction, number of hours worked, performance of job duties and other basics, but also in his/her comfort level on the job, in interacting with co-workers and supervisors, and in other "less visible" but essential, aspects of the job which, if unattended, could jeopardize the consumer’s future.

The time after the Department stops paying for services is not always trouble-free. The supported employment agency is responsible for provision of all ongoing support services during this period, which are necessary to help the consumer remain employed. The supported employment agency will use funds other than Department dollars to cover the cost of these services. Only in specialized circumstances will the Department authorize additional services.

 

ADDITIONAL SUPPORTED EMPLOYMENT SERVICES (by special approval only)

An additional hourly fee has been established for provision of services by a supported employment specialist, who may provide extra necessary support services beyond the outcome fee for up to 18 months (unless otherwise specified in the IPE) by special approval from the Supported Employment Branch.

Stabilization is not easily defined and is often a "judgment call" based on considering such factors as the consumer's satisfaction with his/her job, level of interaction with his/her coworkers and supervisors, etc., and level of services needed and/or anticipated. Also, the consumer may need time to substantially meet the goal for hours of employment established in the Work Plan. The extended services may not be in place and Department services are needed for a specific time to preclude any interruption of services. All issues that are deemed to be "exceptions to the rule" will be taken into consideration and decisions made on an individual basis.

Department case closure can occur after a minimum of 30 days has elapsed beyond Department payment of services. Extended services must be in place so that interruption of services does not jeopardize the consumer's employment.

TRANSITION FROM SCHOOL-TO-SUPPORTED EMPLOYMENT

Transition Services is a set of activities for a student, designed within an outcome-oriented process, which promotes movement from school to post-school activities, included supported employment. According to IDEA (Individuals with Disabilities Act) each IEP (Individual Education Plan) must include a statement of needed transitions services for students no later than age 16. The ARC (Admissions and Release Committee) annually reviews and revises the need for transition services. Often the ARC (which may include the Counselor) may determine that a student will require supported employment services even though he has successfully completed a community-based program.

If a student is participating in his last semester of community-based training, the ARC, or other decision-makers, may agree to involve a supported employment provider prior to graduation. In this situation, the Counselor may elect to begin purchasing services prior to graduation at an hourly fee of $30.00 from the supported employment provider. It is important to involve all parties in this decision in order to insure a seamless transition from high school to work.

If a student who is eligible for supported employment successfully exits from a community-based school program in a job but still needs support services to become stable on that job, the Department may either provide the service through an hourly fee authorized to a supported employment vendor based on individually determined numbers of hours, OR through authorization of the "outcome fee for individual placement" when a more comprehensive effort will be required in order for the student to stabilize in employment.

Each individual situation will require varying numbers of hours and kinds of support services. The counselor and supported employment provider must discuss this to determine the number of hours to authorize, or whether an outcome fee is merited. Progress reports and/or hourly intervention documentation must be submitted to the Counselor by the supported employment program in order for services to be paid.

When the student exits the school program, is not employed, is eligible for and needs supported employment, the full array of supported employment services purchased from a supported employment provider should be considered.