Narrative: q. 1.

DVR continues to provide a wide range of supported employment services to individuals with the most significant disabilities for whom employment has not traditionally occurred or has been interrupted or intermittent and who need supported employment services and extended support services to attain and maintain competitive integrated employment.

Any other necessary vocational rehabilitation service may also be provided to prepare and support the individual in supported employment. Such services include, but are not limited to, physical and mental restoration services; work adjustment and other vocational or academic training; occupational licenses, tools and equipment; specialized services for the blind and/or deaf; and support services, such as maintenance, transportation, services to family members, and personal assistance services.

DVR uses Title I (Vocational Rehabilitation Services) and, when available, Title VI-B (Supported Employment Services) case service funds to provide supported employment services for individuals with the most significant disabilities. The resources available through the Title VI-B program are used only to provide supported employment services, as identified in the Individualized Plan for Employment (IPE), to assist eligible individuals with the most significant disabilities to obtain and secure competitive integrated employment.

To ensure supported employment services are meeting an individual’s employment goals, the DVR counselor documents the individual’s weekly work goal, job stabilization criteria, the supported employment services to be provided, the type and frequency of monitoring contacts, and a description of extended services needed. While extended services are most often coordinated with another community provider and funding source, DVR’s policy does allow for DVR to provide these services for up to four years for youth with disabilities. Currently, Medicaid funding for extended services is limited to individuals who qualify for an HCBS I/DD waiver or receive services community behavioral health centers. For individuals who do not have access to these extended services, local teams carefully explore other options, such as Social Security work incentives, private pay, and natural supports.

Effective supported employment services require collaboration with a variety of partners and service providers. To this end, DVR has cultivated extensive partnerships with the Colorado Department of Health Care Policy and Financing’s (HCPF) Office of Community Living (OCL) and the Colorado Department of Human Services’ (CDHS) Office of Behavioral Health (OBH), along with various community partners and supported employment service providers to improve supported employment services. Also involved in this effort is the Employment First Advisory Partnership, an inter-departmental and stakeholder advisory group recommending policy and strategic initiative to ensure competitive integrated employment is the first and preferred choice for working age adults with disabilities. While all partners are committed to the availability of high quality supported employment services, systematic barriers have been identified and all partners are exploring strategies to improve the system.

For example, concern regarding the skills and qualifications of supported employment providers is being addressed, in part, through the implementation of Senate Bill 18-145, which requires supported employment service providers to complete nationally recognized training or obtain nationally recognized certification in supported employment. The legislation included funding to reimburse providers for the costs associated with completing the required training or certification. While this legislation is early in its implementation, it is hoped that consistency in provider qualifications will ensure a baseline knowledge of supported employment and lead to more effective service delivery. Additional concerns about the reimbursement rate structures for supported employment services have also been raised as a barrier to more effective service delivery. DVR and other partners will continue to explore and evaluate potential strategies to combat these barriers, in partnership with the new Colorado Office of Employment First. 

As described elsewhere in the State Plan, DVR has recently begun implementing customized employment. DVR received additional funding to expand training in customized employment and is currently exploring options for ensuring a sustainable training approach to build system capacity. Individual Placement and Supports (IPS) is implemented by most community mental health centers providing supported employment services and this model is continuing to expand in Colorado, including a current pilot to develop a program specializing in implementing IPS with individuals with dual diagnoses.

DVR is also committed to providing supported employment services to Colorado’s youth. Local offices coordinate with transition staff to support timely referrals of students with most significant disabilities to DVR prior to their completion of the high school transition program. DVR also coordinates services with the Mental Health Center of Denver in their Emerson St. Program for Teens and Young Adults. As a result, DVR has not had difficult expending 50% of its Title VI B funds on youth with disabilities.