Roadmap to employment, career and day services

Roadmap to Day, Employment, & Career Services: © 2015

Adults with Intellectual, Developmental, & Other Disabilities

© 2015 All Rights Reserved

Note: Along with the several factors involved when making decisions about day and employment services, the health and safety of the individual remain the most important and no service can be arranged or provided with out these considerations taken into account.

This roadmap is not to replace the importance of a discussing day and employment service options with the regional center service coordinator, the Department of Rehabilitation, and other funding sources and service providers.

The roadmap does not address employment trends or describe provider organizations or availability.The definitions for the services described in this roadmap are primarily from the Department of Developmental Services for the State of California.


A self-guided, self paced review intended to assist families and individuals on what career, work, and other options are available for adults receiving services from regional center , Department of Rehabilitation, and or other resources.

The next slide takes you to a flow chart on the factors to consider when making decisions about day and employment services.


DAY ACTIVITY PROGRAMS

Day, Employment, and Career Services for Adults with Intelectual and Developmental DisabilityThe level of support and other considerations drives the type of service to be recommended.

.

SUPPORTED EMPLOYMENT INDIVIDUAL

(Habilitation Services)

WORK ACTIVITY PROGRAM


LEVEL OF SUPPORT

Locations of Service Delivery

Client to Staff Ratios & Community Integration

Advancement Potential and or Tailoring of Service

Wage Expectation

Assessment, Training, and Skill Acquisition

Service Availability and Program Viability

TYPE OF SERVICE

Low

Moderate

High

Microenterprises & Self Employment

Services Offered and Quality

Income impact on Benefits

CONSIDERATIONS

Department of Rehabilitation services

SUPPORTED EMPLOYMENTGROUP


Training Programs & Job Development

Note: As individual progresses toward career and life goals, effective planning and advocacy promotes transition between programs and services.

Click on the specific Level of Support, Type of Service, or Considerations to get definitions. Click on the title of each slide to return to this flow chart. Click on any links to get a more detailed description.

Definitions Vendor Service DirectoryTechnical Support


Levels of Support• Historically a person's level of need was measured by the skills a person

lacked or by level of disability.

• Currently the focus has shifted to what supports a person with intellectual or developmental disabilities needs to do the same things as people without disabilities, such as go to work, keep up a home, have relationships, etc. Supports can change based on skill acquisition and passage of time. Supports are divided into the following:

• Intermittent support (episodic need)• Limited support (needed for specific periods of time)• Extensive support (needed regularly for an extended period of time)• Pervasive support (life-long, intense need)

• In general the lower the level of needed support, the greater the range of day, employment, and career options for the individual.

Low

Moderate

High


Considerations: Things to Think About • When arranging career, employment,

and or day services these lists of considerations are to prompt further review and discussion with the regional center service coordinator, rehabilitation counselor, program manager, employers, and others within the circle of support.

• These issues to consider are applicable at varying levels within each type of vocational service and among all service providers.


Training Programs & Job Development: • What vocational training is being provided in the classroom or program, does it match the service plan?

• The importance of transition planning?• Diploma vs. Certificate, post-secondary education, and career development?• What is Workability?• What is on-the-job training?• Will the training lead to a job? • What are the job placement rates of training programs?• What is job development?• How long should job development take? • Job development accountability?• Networking in job development.• Is job development included in the training?• How to acquire job searching skills? • Training of new skills vs. maintaining current skills. • What training is provided at a day program, a workshop, and in supported employment?• What happens when skills are not acquired regardless of training?• Job carving?• Volunteering vs. training, how do they differ.

Considerations: Things to think about.


• The number of peers an individual will work with during the day with the support of one staff person: • 1 to 1, 1 to 3, 1 to 8, 1 to 20, or working independently.

• How much of day is spent at the center and/or within the community?

• Do the community groups integrate or inundate the area where they are located?

Staff Ratios & Community Integration:



• Where the services are provided:• in the center (center based), in the

community (community based), or a percentage combination of both?

• Transportation Expectations: • public, para, private, or center based

vehicles? • availability of transportation training?

Location of Service Delivery:



• Program’s philosophy.• Policies and procedures alignment with philosophy.• Ability and openness toward training and arranging

individuals most desired employment, career, volunteer or day service options.

• Availability of tailored day services.• Program offers value based activities vs. those that

have little practical or career value. • Effective, accurate, on time service planning and

skill training.• Part-time vs. Full time


Advancement, Career vs. Job vs. Avocation:


• Types of income arrangements made by program or employer:• minimum wage or more• contractual • fee for service • micro-enterprises• sub-minimum wage (sub-minimum wages possibly

being phased out in a few years)• Non-paid volunteer opportunities.

• Program’s advocacy for wage increases, and promotions.


Wage expectations:


• The qualifications and availability of staff. • Type of assessments used by program.• Training methodology and documentation. • Provision of direct and faded support. • Hard and soft skill training. • Contingency planning and dealing with layoffs. • Matching skill building with career

advancement.


Assessment, Training and Skill Acquisition:


• Locality.• Waiting lists.• Program expansion or contraction. • Source and stability of funding. • Status of program licensure, CARF accreditation, and other QA compliance standards.• HCBS compliance. • Quality of interaction with management including call backs and response time to email. • Fair and active intake, planning and complaint procedures. • Opportunities for volunteers. • Stability, in-house training, and turn over of staff and management. • Program collaboration with community partners.


Service Availibility, Quality, and Program Viability:


• What services does provider offer?• Habilitation• Vocational Rehabilitation

• Staff and managements qualifications (staff education, background, and rate of turnover).

• Length of time to develop and arrange job placement.• Accuracy of Job Match• Ease of communication with staff and management.


Services Offered and Quality:


• What are Microenterprises & Self Employment?• Starting a business through provider or

independently.• Income based on contracting or delivery of a

service. • Where and how to get technical support?• Self Determination and Self Employment.


Micro Enterprise and Self Employment:


• The differences between SSI, SSA (SSDI), and dual benefits.

• How much income can be earned?• Reporting income to SSA.• Dealing with SSA.• Continuation of Medi-Cal, and Medi-Care• What is Disability101? What is the Redbook?• Overpayments and appeal rights.• Full-time vs. part-time work• Dealing with the acronyms.


Impact on SSI, SSA (SSDI) Benefits:


• Vocational Rehabilitation Services• Habilitation Services• Habilitation vs. Day Program Services• Applying & Qualifying (Order of selection).• Coordinating DOR with Regional Center• Program Funding• Planning, case management and closure.


Department of Rehabilitation:


• There is no one way to getting a job, building a career or spending time during the day. Each person has their own unique skills and interest. To respond to the diverse number of needs, a variety of programs and service types are available and funded through a variety of resources.

• In general there are three types of services: day activity, work activity, and supported employment (individual and group). Within these types of services, through the individual program planning process a person can arrange a variety of job and career objectives and supports that can lead to employment satisfaction and personal well-being.

Type of Service


Supported Employment: Individual • Supported Employment (SE) services through the Department of Rehabilitation can be provided either through

the vocational rehabilitation program or the Habilitation Service Provider (HSP). Supported Employment services are aimed at finding competitive work in a community integrated work setting for persons with disabilities who need ongoing support services to learn and perform the work. Supported Employment placements can be individual placements, group placements (called enclaves), and work crews, such as landscaping crews.

• Individual Placement is usually provided by a job coach who meets regularly with the individual on the job to help him or her learn the necessary skills and behaviors to work independently. Job Development is usually provided by the service provider. Upon placement, the first stage of support is intensive on the job training and direct support . As the individual gains mastery of the job, the second stage of training is faded supervision. As the individual becomes secure in the job, the job coach will provide maintenance support or if appropriate may gradually phase out support.

• The Department of Rehabilitation is the main funder of SE service provision for adults with developmental disabilities during the first two stages of service delivery (intensive and faded). Through HSP, regional center is to continue funding to help individual maintain the job and job skills to continue work in an integrated work setting.

• When applying for SE services ask your regional center service coordinator for help and to receive instructions on applying to DR in your community.

http://www.dds.ca.gov/RC/RCList.cfm


Supported Employment: Group• Supported Employment (SE) services through the Department of Rehabilitation can be provided

either through the vocational rehabilitation program or the Habilitation Service Provider (HSP). Supported Employment services are aimed at finding competitive work in a community integrated work setting for persons with disabilities who need ongoing support services to learn and perform the work. Supported Employment placements can be individual placements, group placements (called enclaves), and work crews, such as landscaping crews.

• Supports provided by job coaches in group placements are generally provided at 100% + of time on the job. Therefore such arrangements can serve individuals needing greater amounts of support. Group services are divided into two categories: – Enclave: a group placement of three to eight individuals with an employer in the community. The group

must represent a minority of the employer’s work force. Group consumers can be paid minimum wages and above or they can be paid sub-minimum wages. Either the employer or the service provider can also pay them. Job coaching is provided 100% of the time the consumers are working. In some cases, lunch and breaks are also supervised.

– Work Crews: a group placement of three to eight individuals in the community that travel from one job site to another job site. They can be paid minimum wages and above or they can be paid sub-minimum wage. The service provider normally pays consumers in this type group placement. Job coaching is provided 100% of the time the consumers are working. In most cases, lunch and breaks are also supervised.


Work Activity Program• Work Activity Program (WAP) services through the

Regional Center or the Department of Rehabilitation (VR WAP) include paid work, work adjustment and supportive habilitation services (HSP) in a sheltered work shop setting. WAPs provide paid work in accordance with Federal and State Fair Labor Standards and may include wages below sub-minimum.

• Work adjustment services may include developing good work safety practices, money management skills, and appropriate work habits.

• Supportive habilitation services may include social skill and community resource training as long as the services are necessary to achieve vocational objectives.


Day Activity Programs• Day programs are community-based programs for individuals served by a

regional center. They are available when those services are included in that person's Individual Program Plan (IPP). Day program services may be at a fixed location or out in the community.

• Types of services available through a day program include:• Developing and maintaining self-help and self-care skills.• Developing the ability to interact with others, making one's needs

known and responding to instructions.• Developing self-advocacy and employment skills.• Developing community integration skills such as accessing

community services.• Behavior management to help improve behaviors.• Developing social and recreational skills.

• There are many different types of day programs that provide a diverse range of opportunities for persons with developmental disabilities. If you are interested in learning more about day program services, ask your regional center representative for assistance.

http://www.dds.ca.gov/RC/RCList.cfm


Vocational Rehabilitation: Department of Rehabilitation

• DEPARTMENT OF REHABILITATION– The Department of Rehabilitation (DOR) provides information, evaluation, and funding for technology to

help working and/or older individuals go to work or live more independently.• DOR ELIGIBILITY

– An individual with a severe physical or mental impairment which seriously limits one or more functional capacities in terms of employment outcome. Examples of functional capacities are: mobility, communication, self-care, self direction, interpersonal skills and work tolerance.

– A person with vocational rehabilitation needs who can be expected to require multiple supports over an extended period of time.

– A person with one or more physical or mental disabilities resulting from: amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, respiratory or pulmonary dysfunction, intellectual disability, mental illness, multiple sclerosis, muscular dystrophy, muscular-skeletal disorders, neurological disorders, paraplegia, quadriplegia and other spinal cord conditions, sickle cell anemia, specific learning disabilities, end-stage renal disease. A disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs which cause substantial limitations.

• SERVICES AND EQUIPMENT FUNDED BY DOR– Vocational and training services includes evaluation and assessment to determine the needs for

rehabilitation technology.– Vocational rehabilitation provides training on the use of artificial limbs, hearing aids, and eyeglasses. DOR

assists people with disabilities use telecommunications, sensory and technological aids and devices which are used to improve or substitute for one or more of a person's senses or for impaired mobility or motor coordination.


Habilitation Services Program (HSP)• A set of regional center services and funding

that provides work and work related activities to regional center clients in a work activity program or receiving supported employment services.

• Habilitation services may include social skill and community resource training as long as the services are necessary to achieve vocational objectives,.


Microenterprises and Self Employment• "Microenterprises" means small businesses owned by

individuals with developmental disabilities who have control and responsibility for decision making and overseeing the business, with accompanying business licenses, taxpayer identification numbers other than social security numbers, and separate business bank accounts. Microenterprises may be considered integrated competitive employment.

• "Self-employment" means an employment setting in which an individual works in a chosen occupation, for profit or fee, in his or her own small business, with control and responsibility for decisions affecting the conduct of the business.


Center for Medicare &Medicaid Services, Home and Community Based Services: CMS, HCBS• Medicaid, known as Medi-Cal in California, is a jointly-funded, federal-state health insurance program

for certain low income and needy people that includes long-term care benefits. In 1981, President Reagan signed into law the Medicaid Home and Community-Based Services (HCBS) Waiver program, section 1915(c) of the Social Security Act. The legislation provided a vehicle for California to offer services not otherwise available through the Medi-Cal program to serve people (including individuals with developmental disabilities) in their own homes and communities. The HCBS Waiver program recognizes that many individuals at risk of being placed in medical facilities can be cared for in their homes and communities, preserving their independence and ties to family and friends at a cost no higher than that of institutional care.

• In early 2014, CMS published final regulations affecting 1915(c) waiver programs, 1915(i) State Plan programs, and 1915(k) Community First Choice State Plans for HCBS provided through Medicaid. (42 CFR Part 430, 431, et al.) The purpose of the regulations is to ensure that individuals receive HCBS in settings that are integrated in and support full access to the greater community. The regulations also aim to ensure that individuals have a free choice of where they live and who provides services to them, and that individual rights and freedoms are not restricted, among other provisions. CMS has moved away from defining HCBS settings based on specific locations, geography, or physical characteristics, to defining them by the nature and quality of the individual's experiences. Basically, the regulations set higher standards for HCBS settings in which it is permissible for states to pay for services using federal financial participation under Medicaid. The regulations became effective March 17, 2014, and allow states up to five years to implement home and community-based settings requirements.


Vendor Directories

• http://sarc.org/– Click: Service Providers– Click: Service Provider Directory

– Click: http://www.php.com/resources

San Andreas Regional Center

Parents Helping Parents

http://sarc.org/

http://sarc.org/

http://sarc.org/

http://www.php.com/resources




Definitions

Department of Developmental ServicesCommunity Development Branch

Work Services SectionGlossary of Terms/Acronyms

Used By Habilitation/Vocational RehabilitationFunded Programs

http://www.dds.ca.gov/WorkServices/docs/HabVocRehabGlossaryTermsAcronyms.pdf

http://www.dds.ca.gov/WorkServices/docs/HabVocRehabGlossaryTermsAcronyms.pdf


Technical Support:It is important to work with the regional center service coordinator, and or the Department of Rehabilitation vocational counselor when planning for day and employment services. Schedule a time to talk to vocational instructors to get a better understanding of transitions services, and program managers of individual service providers and each program’s operation. Below is a list of resources and website that can also be helpful in planning for day, employment, and career services.

Santa Clara County Disabiltiy Collaborativie:SCDD Silicon Valley / Monterey Bay: 408-324-2106, [email protected] Parents Helping Parents, (408) 727-5775, http://www.php.com/

Disability 101: http://ca.db101.org/ Department of Rehabilitation: http://www.rehab.cahwnet.gov/ Department of Developmental Services: http://www.dds.ca.gov/ Social Security Redbook: http://www.ssa.gov/redbook/ Special Education Rights, Transition Services: http://www.disabilityrightsca.org/pubs/504001Ch10.pdf San Andreas Regional Center: 408-374-9960, http://sarc.org/

mailto:[email protected]

http://www.php.com/

http://www.php.com/

http://www.php.com/

http://ca.db101.org/

http://ca.db101.org/

http://www.rehab.cahwnet.gov/

http://www.rehab.cahwnet.gov/

http://www.dds.ca.gov/

http://www.dds.ca.gov/

http://www.ssa.gov/redbook/

http://www.ssa.gov/redbook/

http://www.disabilityrightsca.org/pubs/504001Ch10.pdf



http://sarc.org/

http://sarc.org/

Government & Nonprofit

Roadmap to employment, career and day services