Narrative: f.

(Formerly known as Attachment 4.8(b)(4)). Describe the designated State agency’s efforts to identify and make arrangements, including entering into cooperative agreements, with other State agencies and other appropriate entities in order to provide supported employment services and extended employment services, as applicable, to individuals with the most significant disabilities, including youth with the most significant disabilities.

DVR continues to partner with other state and local agencies, including the Department of Health Care Policy and Financing (HCPF), Office of Community Living (OCL), Department of Human Services (CDHS), Office of Behavioral Health (OBH), Community Centered Boards (CCB), and Community Mental Health Centers to ensure the availability of supported employment services to individuals with the most significant disabilities. Over the last several years, these partnerships have focused on expanding evidence-based and promising practices in supported employment, including customized employment and Individualized Placement and Support (IPS).

In 2016, the Employment First Advisory Partnership (EFAP), was created through state legislation and tasks with developing recommendations to implement Employment First policies in Colorado. Membership includes representatives from 5 key state agencies, including DVR, CDE, HCPF, OBH, and Department of Higher Education (CDHE), along with various stakeholders, service providers, advocates, and individuals with disabilities. EFAP recommendations have supported collaboration throughout the system and have called for further developing system capacity through provider transformation and training. As a result of this work, additional state legislation was passed in 2018 requiring DVR and HCPF to require providers of supported employment services to obtain nationally recognized training or nationally recognized certification in supported employment. Together HCPF and DVR engaged in a stakeholder process to identify core competencies required of any training or certification to meet the provider standard. Providers may be eligible for reimbursement of associated training and/or certification costs and must meet the new standard by July 1, 2024.

Ongoing evaluation of supported employment services will continue as DVR and partners explore other systematic barriers, such as rate structures, the professionalism of the job coach, and the availability of benefits counseling, with the guidance of the EFAP. DVR also received funding beginning July 1, 2019, to establish the Office of Employment First (COEF) through an interagency agreement with the University of Colorado Medical Center. While COEF is just now developing, it is expected to be an integral partner for DVR in ensuring the availability of supported employment services for individuals with the most significant disabilities, including building capacity to ensure supported employment services are available across disabilities.

In Colorado, collaboration among relevant state agencies, private nonprofit organizations, and other community resources for the provision of extended ongoing support services takes many forms, ranging from informally established local cooperative working relationships between direct providers and clients of supported employment services to formally negotiated statewide agreements among state agencies. Informal working agreements are developed to coordinate activities such as transition from intensive supported employment services to extended services, the types of extended services to be provided, identifying qualified individuals to provide extended support.

The primary entities involved in these types of collaborative efforts are local rehabilitation offices, local school districts, Workforce Centers, Centers for Independent Living (CIL), local community rehabilitation programs, mental health centers, developmental disabilities service providers, CCBs, and other available service providers, including advocates, family members and private vendors. Although supported employment depends on these informal collaborative efforts, more efforts are needed to enhance the availability of extended support services following completion of intensive supported employment services authorized under WIOA.

Office of Behavioral Health, Department of Human Services

OBH and DVR have maintained a formal interagency agreement to provide vocational services to individuals with the most significant mental health disabilities. This agreement represents a collaborative effort to increase access to quality vocational services and to ensure the availability of supported employment opportunities for individuals with the most significant disabilities due to behavioral health impairments.

The agreement stipulates collaborative planning and coordination of services by the local mental health centers, private agencies, and rehabilitation offices to eliminate duplication of services and maximize available resources. It also contains provisions for purchase of supported employment services, including transitional employment services. Such services are only purchased from vendors approved by both OBH and DVR, such as mental health centers, and community–based programs. However, the rehabilitation counselor and client are responsible for determining the appropriate services and developing the supported employment Individualized Plan for Employment. Service providers must be registered with DVR to provide supported employment services under the DVR/OBH cooperative agreement.

Improvements have been realized in interagency planning, training, information sharing, and resolving mutual programmatic and procedural concerns. There has been ongoing cooperation at the State level between DVR and OBH. OBH has included funding for ongoing supports as part of its contracts with mental health centers. OBH has a full time Individual Placement and Support (IPS) trainer to assist the increasing number of Mental Health Centers that have adopted this service model. DVR recently added a Behavioral Health Supported Employment Coordinator/Trainer to further support local teams in developing these partnerships and skills in IPS.

For program year 2019, DVR has 16 Mental Health Supported Employment Programs around the state to providing services to participants eligible for supported employment, with most of these sites implementing the IPS model. For participants living in areas where there is not an available program, DVR utilizes vendors qualified to provide supported employment services and the mental health centers provide extended services.

Office of Community Living (OCL), Department of Health Care Policy and Financing (HCPF)

HCPF and DVR have a formal memorandum of understanding to increase access to quality supported employment services and to ensure the availability of supported employment opportunities for individuals with the most significant intellectual and developmental disabilities (I/DD). The agreement stipulates collaborative planning, coordination of services, and funding responsibilities between DVR and Home and Community Based Services (HCBS) Medicaid I/DD waivers to eliminate duplication of services and maximize available resources.

There has been ongoing cooperation at the State level between DVR and HCPF, including increased staffing on both sides of the partnership to support implementation of Employment First and recommendations made by the Employment First Advisory Partnership (EFAP). The increase in staffing is expected to fully develop provider capacity and competence, provide training to DVR staff in evidence based and promising practices of supported employment, including Customized Employment. These key staff meet regularly to facilitate effective coordination of services between the two systems. Jointly, DVR and OCL host periodic training opportunities and roundtable discussions to support collaboration between all partners engaged in providing supported employment services. The State of Colorado is a member of the State Employment Leadership Network (SELN). This membership is sponsored by HCPF, OCL.

DVR does not currently have formal cooperative agreements in place with any local CCBs. However, at the local level CCBs are important partners in DVR’s effort to assure the availability of quality vocational rehabilitation services throughout the state. In most areas of the state, DVR has identified counselors who serve as a primary contacts for CCB staff. These counselors and district supervisors meet frequently with CCB staff to coordinate service delivery. These counselors focus on promoting successful competitive integrated employment outcomes for individuals with I/DD who have been determined eligible and are recipients of services through the CCB system. For individuals who receive HCBS-IDD Medicaid waiver funding, the CCB works cooperatively with DVR counselors to ensure the provision of extended support services and the success of the individual’s supported employment outcome. DVR staff, working together with CCB staff, assist and facilitate each eligible individual’s informed choice in service delivery options, employment outcomes, and providers of services through networks of “approved service agencies”. DVR staff attend board and committee meetings to facilitate an effective working relationship between our agencies.

DVR has lead I/DD Supported Employment counselors to support effective coordination and quality services for individuals with I/DD. These counselors serve as regional liaisons, providing training, guidance and support to all counselors in their areas to establish standards of practice with the local Community Centered Boards (CCBs) serving persons with intellectual and development disabilities. Additionally, these counselors serve as a liaison between the CCB, various community partners, vendors and independent contractors, and the local DVR office A Supported Employment Steering Committee works with the Supported Employment Program Manager to identify emerging trends and challenges, develop new and/or unique services in the community, and evaluate existing programs for individuals with IDD.