Transcript Document

Establishing Effective Partnerships
with
State Vocational Rehabilitation Agencies
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Agenda
•
•
•
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•
Welcome and Introductions
Overview of learning objectives and agenda
WIPA/VR Relationship survey
Overview of the VR process
Linking VR service delivery to the WIPA employment
continuum
• Benefits counseling along the employment continuum:
Negotiating expectations
Agenda - Continued
• Guest Speaker: Angie Howell, WIPA Program Manager,
Easter Seals Nebraska. Dennis King, VR Liaison,
Department of Education, Vocational Rehabilitation,
Nebraska.
• Questions
• Partnership Plus program overview
• Guest Speakers: Joyce Armstrong, Nora Bishop, Bureau
of Rehabilitation Services, Connecticut
• Questions
• Closing remarks
Learning Objectives
• To examine the various ways in which WIPA programs
across the country are working with Vocational
Rehabilitation and discuss strategies for establishing
effective policies and practices for appropriate referrals
between agencies.
• To incorporate the employment continuum while working
with VR consumers and counselors.
• To understand Partnership Plus, and how to counsel
beneficiaries so that they are empowered to use this
service delivery option to their advantage to obtain
necessary employment supports, and access the
protections afforded by the Ticket to Work program.
WIPA/VR Relationship Survey
Vocational Rehabilitation Basics
Purpose
Vocational Rehabilitation (VR) assists individuals with
disabilities to obtain, regain, or maintain and advance in
employment.
Goal: To maximize employment, independence and
integration into the workplace and the community
Eligibility
– Individuals must have a physical or mental impairment
that results in a substantial impediment to employment;
– Be able to benefit from VR services;
– Need VR services to gain and maintain employment.
Individuals receiving Supplemental Security Income (SSI) or
Social Security Disability Insurance (SSDI) are presumptively
eligible for VR services.
Understanding VR Performance Measures
•
Measured by the Federal Evaluation Standards and
Performance Indicators
•
Evaluation Standard
State agencies must assist any eligible individual,
including an individual with a significant disability,
to obtain, maintain, or regain high quality
employment.
•
Performance Indicators
The seven indicators are listed on the handout
titled – VR Performance Indicators
VR Agency must pass 4 out of 7 of the indicators
http://www.ed.gov/rschstat/eval/rehab/standards-archive.html
Stages of VR Case Progression
• Application
• Eligibility Determination - 60 days
• Assessment- May include vocational evaluation,
referrals for testing, gather information for the
development of the IPE
• Individualized Plan for Employment (IPE)- Defines job
goal and services necessary to achieve the goal
(informed choice)
• Case Closure
• Post-employment Services
Assessment
• Prior to developing the IPE there must be a comprehensive
assessment, to the extent necessary, to determine the
employment outcome, objectives, and nature and scope of
VR services.
• The assessment evaluates the unique strengths, resources,
priorities, abilities and interests of the individual.
• Assessments can include educational, psychological,
psychiatric, vocational, personal, social and medical factors
which affect the needs of the individual.
• May also include a referral for the provision of rehabilitation
technology services to assess and develop the capacities of
the individual to perform in a work environment.
The IPE
The IPE must include:
• The specific employment outcome, chosen by the
individual, consistent with the individual’s unique strengths,
concerns, abilities and interests.
• The specific VR services to be provided, in the most
integrated setting appropriate to achieve the employment
outcome.
• The timeline for starting services and achieving the
employment outcome.
• The specific entity, chosen by the individual, to provide the
VR services and the method chosen to procure those
services.
The IPE
(continued)
• The criteria for evaluating progress
• The responsibilities of the VR agency, the individual (to
obtain comparable benefits) and any other agencies (with
regard to obtaining comparable benefits)
• In states that have a financial needs test , any costs for
which the individual will be responsible
• For individuals with the most significant disabilities who are
expected to need supported employment, the extended
services to be provided
• The projected need for post-employment services, if
necessary
Examples of Services that VR can Fund
• Counseling, guidance and job placement services
• Vocational and other training, including higher education
and the purchase of tools, materials and books
• Diagnosis and treatment of physical or mental impairments
to reduce or eliminate impediments to employment, to the
extent financial support is not available from other sources,
including health insurance or other comparable benefits
• Maintenance for additional costs incurred during
rehabilitation
VR Service Examples (continued)
• Transportation, including adequate training in the use of
public transportation, vehicles, and systems needed by the
individual to achieve an employment outcome
• Personal assistance services while receiving VR services
• Interpreter services for individuals who are deaf, and
readers, rehabilitation teaching and orientation and
mobility services for individuals who are blind
• Occupational licenses, tools, equipment, initial stocks and
supplies
More VR Service Examples
• Technical assistance for those who are pursuing
telecommuting, self employment or small business
operation
• Supported employment
• Rehabilitation technology (i.e., AT), including vehicle
modification, telecommunications, sensory, other aids
and devices
• Transition services for students with disabilities to
facilitate the achievement of the employment outcome
identified in the IPE.
Closing the Record of Service
In order for VR to Close a record of services as a
successful employment outcome, the following
conditions must be met:
• the individual must be employed at a competitive wage
for no less than 90 days
• the individual and VR counselor must agree that the
employment outcome is satisfactory
• The VR agency must also notify the individual that postemployment services may be available even after the
record is closed.
Post Employment Services are discrete
services
• Necessary for the individual to maintain, regain or advance
in employment.
• Example - maintain employment: the individual’s
employment is jeopardized because of conflicts with
supervisors or co-workers and the individual needs mental
health services and counseling
• Example - regain employment: the individual’s job is
eliminated through reorganization and new placement
services are needed
• Example - advance employment: the employment is no
longer consistent with the individual’s strengths,
resources, priorities, concerns, abilities, capabilities,
interests, and informed choice
What VR Counselors Want
• Consumers who want to work – VRCs are evaluated by the
number of their consumers that go to work.
• Case movement - cases that move forward to employment.
Every state has cases that have been with them for over
ten years with no hope of employment.
• A manageable caseload with an adequate budget.
• Successful closures – clients employed at competitive
wages for over 90 days.
• Limited Post-Employment Cases - clients who return for
services within three years after being successfully closed.
WIPA Basics
Purpose
• To promote employment and enhance self sufficiency
for individuals receiving a benefit from Social Security
based on disability. (including 1619(B) and EMPC)
Eligibility
• Be at least age of 14, but not yet full retirement age,
• Be disabled per Social Security’s definition, and
• Already receiving a benefit from Social Security based
on disability (SSI, SSDI, CDB or DWB).
The Employment Continuum
• Contemplative Stage: deciding whether to work, few to
no steps taken toward employment.
• Preparatory Stage: decision made to pursue work, some
steps taken in refining job goal
• Job Search Stage: actively looking for employment/
business ownership, clear vocational goal, using
employment services
• Employment Stage: working, begun self-employment,
changing jobs, promotion
Beneficiaries at each stage have unique requirements for
work incentives counseling , information and support
The Employment Continuum and VR Services
• Pre-eligibility and Eligibility DeterminationBeneficiaries are likely to be at the Contemplative
or Preparatory Stage- may not have a career goal,
uncertainty about services available.
• Assessment- Beneficiaries are likely to be in the
Preparatory Stagedecision has been made to go to work, beginning to
decide on a job goal, taking steps to begin job
search
The Employment Continuum and VR Services
• IPE- Beneficiaries are in the Preparatory or Job
Search Stage- may be acquiring training or
education, supported employment, actively looking
for work. At the completion of the IPE, they will be
in the Employment Stage.
• Case Closure- Beneficiaries are in the Employment
Stage- have begun working for pay/selfemployment. May be considering promotion,
change in hours, etc.
Benefits Counseling along the Employment
Continuum/ VR Services Timeline
• Contemplative Stage- (Pre eligibility, eligibility)
Beneficiary concerns- impact of work on
benefits/health insurance, family. Unsure about
employment options. WIPA ServicesInformation and referral, fact sheets, SSA
publications, general information. Follow up
contacts as needed. BSA/WIP development
would be rare, but may be appropriate in
isolated cases.
Benefits Counseling along the Employment
Continuum/ VR Services Timeline
• Preparatory Stage- (Assessment, IPE)
Beneficiary concerns- How potential job goal
might affect benefits, what services do they
need. WIPA Services- Referrals, screen for work
incentives, including PASS. Explain
advantages/requirements of Ticket to Work.
BSA/WIP development as appropriate- as job
goal is defined. Follow up to ensure progress is
being made, problem resolution.
Benefits Counseling along the Employment
Continuum/ VR Services Timeline
• Job Search Stage (IPE) - Beneficiary concerns- how
the particular job will affect benefits,
choices/protections for health insurance, benefits for
other family member. Other benefits, such as food
stamps, HUD. WIPA Services- Probe for potential
future use of work incentives, provide more detailed
explanations that are individualized. Examine the
cost/benefit of job offers. Provide more detailed
counseling on health insurance options. Information
about recordkeeping/reporting requirements.
BSA/WIP development or updated.
Benefits Counseling along the Employment
Continuum/ VR Services Timeline
• Employment Stage- (IPE, Case Closure) Beneficiary concerns- changes in employment
status, benefit cessation, health insurance,
overpayments. WIPA services- Encourage focus
on financial outcome- maximize employment
when feasible. Provide detailed , individualized
written information. BSA/WIP updates. Followup at critical touchpoints
WIPA/VR Partnerships
WIPA collaboration requirements include:
• Communicating directly with agencies to build understanding
of their missions, eligibility rules, policies and procedures, and
services provided.
• Educating employment service community on role of WIPA in
directly supporting employment efforts of beneficiaries.
• Identifying, developing, and implementing formalized
processes for joint employment and work incentive/support
planning for beneficiaries.
• Implementing strategies to build knowledge of use of work
incentives to provide access to employment services and
supports and how use of these incentives can be incorporated
into vocational planning, job development, and employment
support efforts.
Why Should VR Want to Partner With WIPA?
• It is generally agreed that job seekers are much more likely
to achieve and sustain a work goal when fully informed
about work incentives.
• Benefits systems are complex-beneficiaries need ongoing
benefits resources to support their transition to work.
• Through collaboration, VR can focus on employment, while
WIPA can support benefits issues.
• WIPA and VR could be substantially stronger by using each
other’s expertise to help beneficiaries to achieve their
employment goals.
How VR Helps WIPA
• By providing quality referrals to ensure that beneficiaries
get work incentives information. They are working with a
beneficiary on an employment goal, so can “prescreen”
referrals to WIPA. This can help limit the initial screening
process to determine eligibility, which in turn saves valuable
time.
• The Work Incentive Plan (WIP) is largely directed by the
beneficiary with the assistance of the CWIC. Some tasks on
the WIP can be delegated to VR counselor. Conversely,
some WIP steps may be taken from the IPE
How VR Helps WIPA
(continued)
• Other partners also have access to information and services
that may be outside the CWIC’s area of expertise. VR
counselors are advisors in the employment process and
can help to connect beneficiaries to other necessary
services.
How WIPAs Help VR
• CWICs have direct access to SSA, and can assist in
development of previous work that may impact future work
and benefits.
• CWICs help VR to meet their agency goals in relation to
placements via the information they provide to both
beneficiaries and providers. Addressing fears of work impact
on benefits increases the likelihood that VR consumers will
work, as well as set higher targets for work effort and
earnings.
• CWICs can provide technical information on Ticket options.
• CWICs can help identify an EN for ongoing support services
How WIPAs Help VR
(continued)
• CWICs identify, develop, and support management of work
incentives to assist with costs of employment.
• Long term planning for benefit transitions throughout the
employment process to reduce benefit bumps in the road
and increase the likelihood that beneficiaries stay employed
Communicating Clear Expectations
Parameters of Expectations
• Level/Intensity of Work incentives Counseling
• Type of documentation provided to VR staff and when
provided
• WIPA programs obligation to provisions of SSA cooperative
agreements
• Differences between role of CWICS who work in WIPA
programs vs. Community Partners
Strategies for Success
• Development of agreements at the agency level
• Provide clear, written guidelines for referral and services
provided
• Have a clear understanding of VR services and regulations
Establishing effective policies / practices for
appropriate referrals between agencies
• Best to establish an interagency agreement between VR
(state level) and all WIPAs in the state, if possible.
– How referrals will be made by each party
– What documentation will be shared and process for
this
– Addresses confidentiality and conflict of interest
issues (e.g. release of information)
– Addresses data sharing and QA issues
• Follow up interagency agreement development with
negotiation of protocol/procedure discussions with
each local office
Best Practices / Strategies
• Provide VR with written referral guidelines that:
– Address eligibility for WIPA services
– Indicates the prioritization set by SSA and the
implications for beneficiaries referred before IPE/goal
development is completed
– Provides examples of each of the above
– Identifies paperwork that will be shared by VR with WIPA
and vice-versa related to shared customers
– Identifies who to contact if there is an issue that is not
resolved at the counselor/CWIC level
• Meet at least twice yearly with field office supervisor to
modify procedures based on lessons learned
Guest Speaker
Angie Howell, WIPA Program Manager
Easter Seals, Nebraska
Dennis King, Department of Education,
Vocational Rehabilitation, Nebraska
Questions?
• We will now take some time for the audience to
ask questions about any of the topics that have
been presented so far.
• How to ask a question:
– Follow operator instructions to ask your
question verbally, OR
– Type your question in the text chat box.
Partnership Plus - Overview
• In 2008, the Social Security Administration (SSA) issued
revised regulations that significantly improved the
Ticket to Work (Ticket) program. This included the
advent of Partnership Plus
• SSA hopes to encourage more organizations to become
Employment Networks (ENs) and increase the types and
number of ENs available to serve Ticket Holders
• Promote partnering between organizations and expand
the range of services available to Ticket Holders
• Improve the coordination of Vocational Rehabilitation
(VR) and EN services and the various SSA Work
Incentives.
Partnership Plus- In-Use SVRA
• In most states, VR has chosen the Cost Reimbursement (CR)
system for almost all beneficiaries served. The CR system
reimburses State VR agencies for money that is spent
rehabilitating beneficiaries.
• A VR agency may submit for CR when a beneficiary has
completed a continuous period of Substantial Gainful Activity
(SGA) for 9 out of 12 months.
• The new regulations create a new status, “in-use SVRA,” for
those situations where VR is serving a beneficiary under the
traditional CR program.
• Affords beneficiaries the same protections against Medical
Continuing Disability Reviews (CDRs) as associated with Ticket
assignment. When a Ticket is in this status, it is not otherwise
available for assignment to another EN.
Partnership Plus – Sequential Services
• Under the Partnership Plus option, the beneficiary may
initially receive VR services to meet his/her intensive upfront service needs under the CR system (in-use SVRA).
• After the VR case is closed, the Ticket Holder may assign
his/her Ticket to an EN and receive job retention
services or ongoing support services.
• The EN has the potential to earn Phase 2 Milestone and
Outcome payments.
Milestone Payments to EN when VR is
Involved
• Ticket payments are based on work-related milestones and
outcomes occurring after Ticket assignment and after job
placement
• VR provided services leading to job placement and initial
efforts at self-supporting employment
• When a beneficiary’s VR CR case is closed successfully
(person is employed), the Phase 1 milestones are not
available to the EN that subsequently gets the Ticket
assignment
• Level of employment at case closure (hours, earnings) does
not matter
• Even with the loss of the Phase 1 Milestone payments, each
Ticket still has a value of $16,000 to $17,000
Facilitating Informed Choice
• SVRAs are mandated to provide information to
facilitate informed choice by their consumers. Options
include:
• Refer beneficiaries to the MAXIMUS web site for a list of
approved ENs: www.yourtickettowork.com
• Provide beneficiaries with a list of approved ENs serving
the area
• Provide beneficiaries with a list of ENs that offer the
specific services the beneficiary needs
• Refer a beneficiary back to an EN that provided services
to him/her under a VR vendor agreement while the VR
case was open
VR-EN Agreements
State VR agencies and ENs should enter into written
agreements when:
• An EN is referring Ticket Holders to VR and keeping the
Ticket assignments: Only time an agreement is “required” in
Ticket regulations
• Creating a coordinated system of services that includes
structured referrals
• Information on beneficiary service needs, earnings, etc. will
be shared
• Revenue obtained through EN payments will be shared
• VR is purchasing post-employment or job retention services
from an EN as identified in IPE
Partnership Plus Models
A variety of Partnership Plus models are emerging
• A few VR agencies have pilot projects where VR functions as
an EN for certain populations (e.g., SE, MH) –Some are
sharing Phase 1 Milestones with ENs
• A few VR agencies are partnering with CRPs to function as a
single EN
• To address the loss of Phase 1 Milestone payments, a few VR
agencies are purchasing needed post-employment services
from ENs that are VR vendors (services added to IPE based
on discussion of post-employment needs)
Partnership Plus Models
A variety of Partnership Plus models are emerging
(continued)
• A few VR agencies are providing short-term job retention
payments to VR vendor/ENs that assist beneficiaries to retain
or advance in employment (e.g., case closed below SGA and
EN helped beneficiary achieve nine months of SGA level
earnings)
Advantages of Partnership Plus
• Strengthening partnerships between VR agencies and
ENs to expand the scope of services and supports
available to assist beneficiaries in entering and reentering the workforce.
• Improving the coordination of services provided by VR
agencies and ENs.
• Proving a longer period of employment support to
increase the beneficiary's successful sustained
employment.
Advantages of Partnership Plus
• Providing funding to support ongoing services and supports
for beneficiaries in Supported Employment programs.
• Maintaining and expanding best practices, ethical standards,
and support for consumer rights and choices.
• Maximizing CR payments for VR agencies and Ticket
payments for ENs.
• Minimizing the administrative tasks associated with CR and
Ticket payments.
• Ensuring that beneficiaries understand their options and
choices under the TTW program and how work can affect
their benefits.
The Future of Partnership Plus
• New approaches to service delivery are evolving . There are
many opportunities for meaningful cooperation under the
Ticket to Work (TTW) program.
• Exciting new prospects for VR-EN partnerships mean a better
mix of services for beneficiaries and improved coordination of
services.
• The Partnership Plus option represents the first influx of new
monies in many years into the service delivery system.
• Partnership Plus represents an opportunity for service
providers and beneficiaries to exercise increased control over
employment services.
• Success depends on beneficiaries understanding options under
Ticket program after VR case closure
• This could represent a win-win situation for all involved.
WIPA and VR- Ticket to Work
• CWICs counsel beneficiaries on the TTW program, including
defining good Ticket candidates, explaining the benefits of
using a Ticket, timely progress reviews, and Ticket
assignment issues
• CWICs help beneficiaries understand the implications of
ticket assignment or “in use SVR” when working with VR,
especially timely progress reviews and CDR protections
• VR counselors can defer to CWICs to explain the implications
of ticket assignment or “in use SVR” to the Beneficiary
• CWICS can provide ongoing follow up services to encourage
beneficiaries to utilize ticket assignment under Partnership
Plus to maintain employment
Guest Speakers
Joyce Armstrong and Nora Bishop
Bureau of Rehabilitation Services - CT
Questions/Closing Remarks
• We will now take questions on the Partnership
Plus program, and any other concerns from the
audience
• Closing remarks