Narrative: j. 1. A.

Every three years, the Colorado Division of Vocational Rehabilitation (DVR) and the State Rehabilitation Council (SRC), jointly develop and conduct a comprehensive statewide 

assessment of the rehabilitation needs of individuals with disabilities in Colorado. The triennial Comprehensive State Needs Assessment (CSNA) was developed and conducted in the fall of 2021. 

A majority of individuals served by DVR continue to be those with the most significant disabilities.  When it comes to meeting the rehabilitation needs of this population, the key findings from the CSNA demonstrate a need for increased provider development, particularly for supported employment and customized employment services. DVR has not seen a significant increase in demand for these services over the last several years. However, as Employment First is implemented in Colorado, there are changes within the system that may be contributing to this need for provider development, especially when coupled with a changing labor force as a result of COVID-19. 

In 2018, the legislation was passed requiring DVR to establish minimum provider standards for supported employment that require providers to complete nationally recognized training or obtain nationally recognized certification in supported employment. The legislation allowed for a 5-year transition period for existing providers and new providers must be fully qualified within 1-year. While the legislation included an appropriation to assist providers with the cost of training, reimbursement rates for these services have remained stable. The rate of implementation was restricted by COVID-19 mandates and shifting priorities for everyone involved. This requirement also coincided with implementation of Customized Employment in Colorado, which was also hindered by COVID-19 response. While some providers are completing training, the capacity lags what is anticipated to fully meet demand, with just under 300 providers being  fully qualified. As Employment First principles and policies continue to be further developed in Colorado, demand is expected to increase. Additionally, Colorado recently passed legislation phasing out subminimum wage by July 1, 2024. While relatively few individuals (less than 200) currently work in subminimum wage employment, it is hoped that many of these individuals will choose to pursue supported or customized employment, making it critical to ensure sufficient and appropriate services are available to meet their support needs.

Within both DVR and other supported employment funding sources, namely Medicaid Home and Community Based Services waivers, reimbursement rates for these services have remained stable. As the cost of business has increased for provider agencies, reimbursement rates have not allowed agencies to pay wages commensurate with the skill and competency required to perform this work. Low wages are believed by most provider agencies and many stakeholders to be a contributing factor to what has become a direct service labor crisis throughout much of Colorado.  This wage discrepancy has been increasing challenging for providers as minimum wages have increased and many low-skilled, entry level positions in other industries now pay similar or higher wages, yet those who are successful providing job development and job training services to individuals with the most significant disabilities demonstrate competence in a number of areas. 

Similar findings were found related to access to universal technology. As DVR, providers, and people receiving services continue to adjust to hybrid services, it is critical for all people receiving services to have access to necessary technologies, as well as the digital literacy needed to be successful. Further, DVR has begun to take advantage of various technological methodologies for delivery disability related skills training and job training services. As various applications are developed that allow for these services to be provided remotely by a trained provider through a smartphone or similar device, individuals are able to more efficiently access the necessary support. Others with significant disabilities may be more independent and have more expanded options for competitive integrated employment through the availability of assistive technology. DVR has found that nearly all applicants have access to  and comfort using the internet and a smartphone, but access and comfort diminishes across other types of technology, with many individuals reporting they are not aware of what assistive technology might be available to them and/or they do not have experience using assistive technology.