Rosemary Morales OCDD Program Manager June, 2015 Employment Overview Rosemary Morales OCDD Program Manager June, 2015

LA Data for Individuals with Developmental Disabilities 67% of individuals receiving employment services through OCDD are served in a facility-based work or non-work program. 33% of the individuals receiving employment services from OCDD are served in integrated employment. 10% are in integrated Individual Employment. The national average for individuals with DD in integrated Individual Employment is 20%.

OCDD Launches Employment First Initiative- July, 2011 EMPLOYMENT WILL BE THE PRIMARY OUTCOME FOR ALL PERSONS RECEIVING OCDD SERVICES WHO ARE OF WORKING AGE. Employment is characterized by typical jobs with competitive compensation that are fully integrated in the workforce.

Criteria for settings that isolate Settings that have the following two characteristics alone might, but will not necessarily, meet the criteria for having the effect of isolating individuals: The setting is designed specifically for people with disabilities, and often even for people with a certain type of disability. The individuals in the setting are primarily or exclusively people with disabilities and on-site staff provides many services to them.

Characteristics of settings that isolate Settings that isolate people receiving HCBS from the broader community may have any of the following characteristics: The setting is designed to provide people with disabilities multiple types of services and activities on-site, including housing, day services, medical, behavioral and therapeutic services, and/or social and recreational activities. People in the setting have limited, if any, interaction with the broader community. Settings that use/authorize interventions/restrictions that are used in institutional settings or are deemed unacceptable in Medicaid institutional settings (e.g. seclusion).

Changes To Vocational Definitions Aligns with CMS guidance Allows for flexibility for individuals to make choices in how they spend their day Focus on employment Adds career planning to allow for movement along a career path and to prevent staying stagnant Emphasizes the critical role of person centered planning in achieving employment outcomes Prevocational services is time limited so as not to be an end point but rather to be used to help individuals obtain employment

Day Habilitation Provides choice in daily activities Conducted in variety of community settings, (i.e. local recreation department, garden clubs, libraries) Focuses on interests, hobbies, clubs or sports Assists people to gain desired community living experience, including opportunities to contribute through volunteering May be coordinated with needed therapies through person-centered Plan of Care Individuals of retirement age may be supported in senior community activities or other meaningful retirement activities in the community, such as the local council on aging or senior centers. Career planning may be incorporated in Plan to develop learning opportunities and career options consistent with person’s skills and interests.

Prevocational Services Expected to last no longer than 4 years Individuals MUST have an employment goal as part of their POC Targeted goals for: employment at the individual’s highest level of work in the most integrated setting, with a job matched to the individual’s interests, strengths, priorities, abilities and capabilities, while following applicable federal wage guidelines. Intended to prepare person for paid employment or volunteer opportunities in the community at the participant's highest level. Focused on development of general, non-job-task-specific strengths and skills that contribute to employability in paid employment in integrated community settings Provided in a variety of locations in the community and not limited to a fixed site facility Should include volunteering, where applicable

Prevocational Services Intended to develop and teach general skills such as: ability to communicate effectively with supervisors, co-workers, and customers accepted community workplace conduct and dress ability to follow directions and attend to tasks workplace problem solving skills general workplace safety mobility training Individuals receiving prevocational services may choose to pursue employment opportunities at any time AND progression is not required.

Prevocational Services / Career Planning Career Planning MUST be a major component of prevocational services Should include activities such as: vocational assessment and discovery process ongoing career counseling benefits planning assessments as needed (i.e. assistive technology in the work place) job shadowing other activities that may assist the individual in deciding upon an employment goal All career planning activities should be focused on building a plan for a path to community employment at the highest level for each participant.

Supported Employment: Individual Participants who have the most significant disabilities may also need long-term employment supports to successfully maintain a job due to the ongoing nature of the waiver participant’s support needs, changes in life situations or evolving and changing job responsibilities and where natural supports would not meet this need. All career planning activities should be focused on building a plan for a path to community employment at the highest level for each participant. Does not include facility based or other types of vocational services furnished in specialized facilities that are not a part of the general work place.

Supported Employment: Group Services and training activities provided in regular business, industry, and community settings Must be provided in manner that promotes integration into the workplace and interaction between individuals with DD and people without disabilities in those workplaces All career planning activities focused on building plan for path to community employment at the highest level for each participant Does NOT include facility based or vocational services furnished in specialized facilities that are NOT a part of the general work place

The Workforce Innovation And Opportunity Act (WIOA) Signed into law on July 22, 2014 First legislative reform of the public workforce system in more than 15 years Replaced the Workforce Investment Act (WIA) of 1998 Retained and amended the Adult Education and Family Literacy Act, the Wagner-Peyser Act, and the Rehabilitation Act of 1973 (legal basis for the VR program) 300 pages of legistlation Unified state plan due January, 2016

Effective Dates For Implementation Act takes effect on July 1, 2015 Exceptions: Amendments to Rehabilitation Act in Title IV took effect immediately - July 22, 2014 WIOA state unified and local plans due January, 2016 WIOA performance accountability provisions will take effect July 1, 2016 Section 511 (limitations on sub-minimum wage) will take effect July 1, 2016 Implementing Federal Regulations not yet published but should be sometime in April, 2015

Purpose Of WIOA To help job seekers access employment, education, training, and support services to succeed in the labor market and to match employers with the skilled workers they need to compete in the global economy

WIOA Programs WIOA brings together the core programs of Federal investment in skill development: Employment and training services for adults, dislocated workers, and youth and Wagner-Peyser employment services administered by the Department of Labor (DOL) Adult education and literacy programs and Vocational Rehabilitation state grant programs that assist individuals with disabilities in obtaining employment administered by the Department of Education (DoED).

WIOA Programs Authorizes the following programs: Job Corps YouthBuild Indian and Native Americans Migrant and Seasonal Farmworker programs Evaluation and multistate projects administered by DOL Other programs administered by DoED and the Department of Health and Human Services

HIGHLIGHTS of WIOA Requires States to Strategically Align Workforce Development Programs Promotes Accountability and Transparency Fosters Regional Collaboration Improves the American Job Center (AJC) System Improves Services to Employers and Promotes Work-Based Training Provides Access to High Quality training WIOA ensures that employment and training services provided by the core programs are coordinated and complementary so that job seekers acquire skills and credentials that meet employers’ needs. WIOA promotes alignment of workforce development programs with regional economic development strategies to meet the needs of local and regional employers. WIOA increases the quality and accessibility of services that job seekers and employers receive at their local AJCs. WIOA contributes to economic growth and business expansion by ensuring the workforce system is job-driven – matching employers with skilled individuals WIOA helps job seekers acquire industry-recognized credentials for in-demand jobs. Every state will develop and submit a four-year strategy – in the form of a single unified strategic plan for core programs - for preparing an educated and skilled workforce and meeting the workforce needs of employers. States can include other key partners in their plans such as Temporary Assistance for Needy Families (TANF) and Perkins career and technical education programs.

HIGHLIGHTS of WIOA Enhances Workforce Services for the Unemployed and Other Job Seekers Improves Services to Individuals with Disabilities Makes Key Investments in Serving Disconnected Youth and Other Vulnerable Populations Enhances the Job Corps Program Reinforces Connections with Registered Apprenticeship (RA) Streamlines and Strengthens the Strategic Roles of Workforce Development Boards WIOA ensures that unemployed and other job seekers have access to high-quality workforce services. WIOA increases individuals with disabilities’ access to high quality workforce services and prepares them for competitive integrated employment WIOA prepares vulnerable youth and other job seekers for successful employment through increasing the use of proven service models services. WIOA increases the performance outcomes and quality of Job Corps WIOA promotes the use of RA, a proven model that provides workers with career pathways and opportunities to earn while they learn. WIOA makes state and local boards more agile and well-positioned to meet local and regional employers’ workforce needs

Movement of Federal Programs Agencies moving from the Department of Education to the Administration for Community Living (ACL) at the Department of Health and Human Services. Offers better coordination with the Administration on Intellectual and Developmental Disabilities National Institute on Disability, Independent Living, and Rehabilitation Research Community Living under the Department of Health and Human Services Independent Living Program

Vocational Rehabilitation (VR) WIOA mandates VR as a core program in the workforce development system. Four Core Programs: Adult, Dislocated Worker, and Youth Workforce Investment Programs State Employment Service (Wagner-Peyser) Adult Education and Literacy Public Vocational Rehabilitation VR- is Louisiana Rehabilitation Services (LRS)

Purpose of the VR Program In addition to the continued emphasis on informed choice, WIOA places a greater emphasis on economic self-sufficiency for individuals with disabilities.

New Cooperative Agreement Requirement for formal cooperative agreement between state VR (LRS) and state ID/DD agency (OCDD), state mental health and state Medicaid agency, with respect to VR services for individuals with most significant disabilities determined eligible for Home and Community Based Services (Waivers) OCDD is currently working with LRS, OBH and Medicaid to draft an MOU.

Role of VR in Transition At least 15% of each state’s Title I VR funds must be used for “pre-employment transition services” Required Pre-employment Transition Services Job Exploration Work-based Learning Experiences Counseling on post-secondary education opportunities Workplace Readiness Training Instruction in self-advocacy

Role of VR in Transition Each VR agency, in collaboration with local school districts, must provide, or arrange for the provision of pre-employment transition services for ALL students with disabilities in need of these services eligible or potentially eligible for VR services, using funds from VR and other sources as necessary

Role of VR in Transition Each local VR office must undertake “pre-employment transition coordination” which includes the following: Attending IEP meetings Working with workforce development boards, One-stops and employers to develop opportunities Coordination with Schools for provision of pre-employment services ATTENDING PERSON-CENTERED PLANNING MEETINGS FOR INDIVIDUALS RECEIVING WAIVER SERVICES

Trial Work Experiences “shall provide the individual with the opportunity to try different employment experiences, including supported employment, and the opportunity to become employed in competitive, integrated employment”

Assistive Technology and VR It is appropriate to utilize assistive technology throughout the VR process and particularly if needed to achieve the employment outcome. Not after they become employed

New Definitions Modified to clarify that supported employment is integrated competitive employment, or an individual working on a short-term basis in an integrated employment setting working towards integrated competitive employment. Post-employment support services have been extended from 18 to 24 months Competitive integrated employment for an individual with a significant disability, that is based on an individualized determination of strengths, needs, and interests of the individuals with a significant disability and carried out through flexible strategies Is included in supported employment and an available service from public VR agencies Full or part-time work at minimum wage or higher, with wages and benefits similar to those without disabilities performing the same work, and fully integrated with co-workers without disabilities

Technical Assistance for Post-Secondary Education The new law allows the RSA commissioner to fund technical assistance to “better enable individuals with intellectual disabilities and other individuals with disabilities to participate in postsecondary educational experiences and to obtain and retain competitive integrated employment.” Rehabilitation Services Administration

Subminimum Wage Limitations Section 511: As of July 2016, requires a series of steps before an individual 24 and younger can be placed in a job paying less than minimum wage (sheltered workshops or enclaves) Receive pre-employment transition services Apply for vocational rehabilitation services, and if eligible, make a serious attempt at competitive integrated employment Receive counseling, information and referral about alternatives to subminimum wage employment Prohibits schools from contracting with sub-minimum wage providers

Section 511: Subminimum Wages No entity – including a contractor or subcontractor of the entity – who holds a 14(c) certificate may compensate an individual with a disability who is age 24 or younger a “subminimum wage” unless one of the following conditions is met: The individual is currently employed by an entity that holds a valid 14(c) certificate The individual provides proof that each of the following steps have been completed: The individual has received pre-employment transition services   The individual has applied for Vocational Rehabilitation (VR) services The individual has been found ineligible for VR Services Or The individual has been found eligible for VR services and has an IPE. He/she has been working toward an employment outcome for “a reasonable period of time” without success and the VR case is closed. The individual has also been given career counseling and I&R to enable him/her “to explore, discover, experience and attain” competitive, integrated employment and such counseling/referrals are not for subminimum wage employment opportunities.

Section 511: Subminimum Wages These actions should be carried out every 6 months for the first year and every year thereafter for the duration of the subminimum wage employment. If the individual is a student with a disability, the receipt and completion of the required activities shall be documented by the VR agency or by the appropriate school official responsible for the provision of transition services. VR should provide the final documentation showing the completion of the student’s pre-employment transition services within a “reasonable time” following its completion.

Section 511: Subminimum Wages In order to continue to employ an individual at a subminimum wage, the entity shall verify completion of the necessary requirements, including the review of any relevant documents provided by the individual and the entity shall maintain copies of the documentation. The entity shall be subject to review of individual documentation by a representative from the VR agency or from the Department of Labor at a time and in a manner necessary to fulfill the intent of this section.

Supports Waiver ‘Transition From School To Work’ Slots Criteria: exiting the school system desire an individual, integrated job in the community require supports and/or services to obtain and/or maintain employment in the community, specifically Supported Employment services 50 slots allotted Waiting CMS approval ARE LGE’S A PART OF THE LOCAL TRANSITION CORE TEAM?

Pilot For Employment POC Attachment SC’s will begin utilizing the “Participant’s Path to Employment” form which will be used to have conversation with each individual about employment. Pilot will run July, 2015-September, 2015 Feedback will be accepted and changes made as needed Form will be completed and/or follow up will be made at each quarterly visit/POC Meeting Data from this form will be input into CMIS prior to entering billing for each individual This form will help in documenting the employment conversation that we must have with each individual we serve We must be able to show that options are being presented to the individual and that we are not just letting them make a decision one time and never talk about it again

Working Together To Improve Employment Individual- (wants to work) guides the process Family- supports in helping to find employment, assists in getting to/from the job SC- follows individual through employment process, ensures everything accounted for, attends meetings with LRS, IEPs, etc., collects quarterly employment data to report in CMIS School- works to get individual ready to go to work through pre-employment transition counseling along with LRS Work Incentive Coordinator - helps in educating about benefits LRS- attends POC meetings, assists individual in getting assessments, presents employment providers, first agency to pay- then falls to waiver to follow up upon closure from LRS Employment Provider - assesses individuals for employment, assists individual in finding employment, job coach for on the job and get them as independent as possible on the job, reports to LRS and SC Support staff- supports individual in looking for employment by exploring local community, assists with personal care on the job and assists in getting to/from the job LGE- assists in monitoring of the process and ensures individuals are going to work It takes all of us to help the individuals we serve go to work and maintain work. It’s not just one persons job- it’s

Resources CMS Guidance http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html LEAD Center http://www.leadcenter.org/resource-center WIOA http://www.doleta.gov/wioa/