Narrative: d. 2. Q. i.

The Division continues to take steps to ensure the quality of Supported Employment. Our management information system reports provide information on weekly wages, hours worked, and public assistance at the time of application and closure. The reports also provide information on the type of disabilities being served, the cost per case, and the average cost by counselor, region, and state. Planning discussions continue with both Developmental Services and Mental Health Services to work with DVR in tracking employment outcomes. We are able to document individuals who are eligible for VR, but who lack long–term support preventing plan development. Maine strives to improve the quality of supported employment services through the provision of various training opportunities. The Division continues to work with the Maine DHHS to oversee the implementation of a comprehensive workforce development system for Employment Specialists and case managers. The inclusion of cases managers in these events is to educate about the importance of work in our consumers’ lives, the sharing staff training is supported by the MOUs between BRS and DHHS. In 2011 classes were held for case managers on employment tools and resources at four different CareerCenters throughout the state. The Division regularly shares relative training and webinar announcements with the Provider community and provides ongoing staff development. We have identified minimum training requirements for the new CRPs to become approved providers. CRPs must provide evidence that all Employment Specialists and Job Coaches have completed one of the BRS approved training curricula. The Division and DHHS have agreed that any curriculum must be ACRE certified in order to be added to the list of approved Employment Specialist or Job Coach Certification training programs. DVRs expectation is that this training requirement and a comprehensive workforce development system, along with other established standards for service provided through the Commission on Accreditation of Rehabilitation Facilities (CARF) and our in–state accreditation process will continue to improve services to all DVR consumers. The CARF and In–State approval process for CRPs consists of a number of facets such as reviewing policies and procedures that reflect knowledge and application of quality supported employment services in adherence to APSE standards for Supported Employment. Areas evaluated are: • mission statement, • admission criteria, • policy and practice on Assessments, • case coordination, client input, • health and safety issues, • human resource issues such as staff qualifications and background checks, • client rights and • appeal procedures. Other parts of the approval process include interviews with key stakeholders such as clients, employers, funding agents, etc. 1. Scope of Supported Employment The primary services provided to clients in supported employment continue to be • Assessment, • Job Skills Coaching, and • Job Placement. These direct services are provided by an Employment Specialist or a Job Coach, who supports the client through activities such as: intervention with supervisors and peers, and aids integration into the company’s social environment. Other allowable services that are provided when a need is identified include supplemental assessments, social skills training, observation or supervision of the individual, transportation, and facilitation of natural supports. The Division provides whatever is required to achieve and maintain integrated competitive employment. Based on ongoing commitments from the DHHS Office Adult Mental Health Services to provide extended support to all individuals using the supported employment model when they have stabilized and are ready for extended support, the DVR continues to expand the percentage of individuals with long–term mental illness who require ongoing supports to sustain employment. Changes through the DHHS approved June 1, 2006 increased resources available for the extended support funds for individuals with developmental disabilities. This results in up to 600 hours of Supported Employment services available per year expanding opportunity for extended job supports for an estimated 1400 individuals. We anticipate that 300 to 400 hundred of these individuals will be applying for VR during the next year. In this past year extended support services have been more limited for individual with developmental disabilities. Developmental Services did implement a new Medicaid waiver program shifting resources from day habilitation services to community supports which includes employment. This has resulted in additional individuals with developmental disabilities being eligible for supported employment with Developmental Services providing extended supports. We developed an agreement which coordinates the delivery of supported employment services including extended supports. Unfortunately, due to funding cuts the new waiver is not open to new applicants at this time. DVR and Developmental Services are committed to working with those individuals already on the waiver. The Division continues to receive funds from the state to provide extended support to individuals with traumatic brain injuries. We estimated in 2012 that between 25 to 30 individuals with traumatic brain injury will be able to participate in supported employment using state funded extended support. DVR ended 2012 having served 46. Another state funded program providing long term supports is the Basic Extended Support Program that purchases extended support for all disability groups. The annual services CAP for individuals receiving long term supports from this fund is $3000. This funding supported 144 individuals during 2012. Presently, the disability groups this program funds includes any individuals who have been closed successfully in the DVR or DBVI program, who require no more than $3000 a year in long term support (for job coaching). Transitional employment is also available to individuals with chronic mental illness. Transitional employment recognizes that persons with mental illness, in some cases, can learn a skill at a community based training site and transfer those skills to an actual work site. It also recognizes that the primary need is not always job skills training but emotional support, reinforcement, and evaluation of the client’s mental health. 2. Extent of Supported Employment Services We anticipate three to four hundred of these individuals will be applying for VR during the next year. In this past year extended support services have been more limited for individual with developmental disabilities. Developmental Services did implement a new Medicaid waiver program shifting resources from day habilitation services to employment. The new waiver program has resulted in additional individuals with developmental disabilities being eligible for supported employment with Developmental Services providing extended supports. DVR developed an agreement which coordinates the delivery of supported employment services including extended supports. Unfortunately, due to funding cuts the new waiver is not open to new applicants at this time. DVR and Developmental Services are committed to working with those individuals already on the waiver. DVR continues to look closely at the true need for ongoing supports and reserving this model for those with the most severe disability. There were a number of individuals that benefited from the "place" and "train" model without necessarily needing the extended support. There is also greater emphasis on natural supports.