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Posted at 04:52 PM in Autism, Habilitation | Permalink | Comments (1) | TrackBack (0)
On August 30 the PA Department of Public Welfare (DPW) Office of Developmental Programs (ODP) released ODP Announcement Number 113-11 on Quality Strategy and the ODP Home and Community Based Services (HCBS) Waivers. The purpose of ODP Announcement 113-11is to provide an update on Center for Medicare and Medicaid Services (CMS) Reports and the Quality Strategy for ODP Home and Community Based (HCBS) Waivers. ODP says that on June 30, 2011, DPW received final reports from the Centers for Medicare & Medicaid Services (CMS) on the CMS review of the Consolidated and Person/Family Directed Support (P/FDS) Home and Community Based Services (HCBS) Waivers. The reports are in accord with the CMS protocol to conduct a review and issue a report to the state prior to the expiration of each HCBS Waiver. ODP says that CMS continues to strengthen oversight of the waivers and has recently clarified and emphasized some important expectations for states. ODP encourages
stakeholders to read the reports in their entirety.
The report on the ODP Consolidated Waiver is at: http://www.dpw.state.pa.us/ucmprd/groups/webcontent/documents/report/p_011594.pdf
The report on the Person and Family Directed Services Waiver is available at
http://www.dpw.state.pa.us/ucmprd/groups/webcontent/documents/report/p_011593.pdf
Posted at 10:57 PM in Current Affairs, Habilitation, Mental Retardation, PA Dept. of Public Welfare | Permalink | Comments (0) | TrackBack (0)
Technorati Tags: chester county pa, community based services, home and community based services, montgomery county pa, office of developmental programs, PA Department of public Welfare
A Philadelphia nonprofit serving 3,600 people with disabilities announced Thursday that it was laying off 132 employees because of funding cuts from the state.
Liberty Resources Inc., which serves the Philadelphia region and Allentown, already had stopped accepting new clients because of a $13 million shortfall in its $89 million budget, said Thomas Earle, chief executive.
Most of the employees who lost their jobs were coordinators of services provided to people living independently outside of group facilities, Earle said. The layoffs represent 43 percent of Liberty's workforce.
The reduction in state funding also will affect several thousand home-care workers, Earle said.
The state in January implemented new reimbursement rates that were developed in the final months of the administration of Gov. Ed Rendell for providers such as Liberty Resources. Earle said the rates made it "unsustainable" to add clients.
"There has to be a solution or the system of home community-based services is going to collapse," Earle said.
Posted at 09:36 PM in Current Affairs, Habilitation, Home Respite Services, Respite Services | Permalink | Comments (1) | TrackBack (0)
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Posted at 05:21 PM in Current Affairs, Habilitation, Mental Retardation | Permalink | Comments (0) | TrackBack (0)
Devastating Changes Are Being Proposed For Those Who Receive
ODP Waiver Services
Who Live With their Families Or In Their Own Homes
Immediate Action is Needed
The Office of Developmental Programs (ODP) has proposed changes to the Waiver Service Definitions for the Consolidated Waiver.. These changes will cap habilitation services to 10 hours a day, limit therapy that people need and have other devastating negative effects on people with Intellectual Disabilities. This ONLY affects you if you live at home with your family or in your own home and receive habilitation services. YOU have been targeted to take the cuts. People living in group homes are provided habilitation services around the clock, and if needed, the same level of service should be provided to individuals in their own homes.
The very services you cherish under habilitation, the services giving you support to live in the community are now going to be limited. Services under home and community habilitation is unnecessarily restrictive and discriminatory since the same limit is not imposed on individuals living in group homes. Limiting habilitation to 10 hours per day will force individuals currently living in their own homes and apartments and those living with aging or ailing caregivers into licensed residential settings and licensed day programs.
Let us explain how this definition could harm you or the person you love. If Johnnie goes to a day program and uses transportation to get there, we could have already used 10 hours. If Johnnie wants to go out for the evening with a support person or you need respite, it won't be funded. If Johnnie has medical or behavioral needs requiring overnight help, sorry! It can't be done. ODP is toying with the idea of using a cheaper model called "Companion Services" to fill the time after the ten hours are used. For people who need a continuous level of quality supports, ODP could be playing with our lives. This new rule will cause people to lose community life and will force families to place their sons or daughters in to residential programs.
The Office of Developmental Programs received letters objecting to these changes and the comment period is now over. Comments do not tell the whole story. The bureaucracy needs to hear from families and people with disabilities as to how these changes will affect them. Your story will make a difference.
We know it is the Holiday, but we respectfully ask you to take a few minutes and write today. If these changes go through they will have devastating and long lasting effects on people who need these services and their families. Each individual and family member who will be affected by these changes needs to write to Mr. Michael Nardone, the Acting Secretary of the Department of Public Welfare this week.
Make your letter personal, tell your story and let them know how reducing the habilitation services and Therapy services will affect your son or daughter. Sending a letter by mail with a picture will have an impact. If you don't have time to mail - email. Here's what should be in your letter:
Talk about your true needs or those of your family member
Talk about how this change will hurt you or your family member. For example, if you cannot have your hours capped at 10 hours per day and if doing so will negatively affect you or your family member, explain why.
Contact us if we can assist you in writing your letter or answering your questions.
Send your letter to Secretary Michael Nardone at:
Michael Nardone, Secretary
Department of Public Welfare
333 Health and Welfare Building
Box 2675
Harrisburg 17110-2675
mnardone@state.pa.us
Send a copy of your letter to -
Kevin Casey, Deputy Secretary
Office of Developmental Programs
Department of Public Welfare
502 Health and Welfare Building
Box 2675
Harrisburg 17110-2675
kecasey@state.pa.us
And,
Jeannie Meikrantz
Department of Public Welfare
502 Health and Welfare Building
Box 2675
Harrisburg 17110-2675
jmeikran@state.pa.us
Share your letters with the PA Waiting List Campaign: sstasko@pawaitinglistcampaign.org
Posted at 09:02 PM in Habilitation, Respite Services | Permalink | Comments (0) | TrackBack (0)
Technorati Tags: base fund waiver, consolidated waiver, Office of Developmental Programs, personal family driven, waivers
Below are proposed changes to the service definitions issued by the Office of Developmental Programs (ODP). The public comment period for this draft ends on December 1, 2010. Comments can be sent to:
ra-ODPComment@state.pa.us.
Some of these changes are significant. The first document, which includes a summary of what ODP considers the most important changes, is set forth below. Once finalized, ODP will be amending the waivers to incorporate these changes.
Feel free to contact me with any questions.
Ilene Shane
Disability Rights Networkof Pa
800-692-7443, x 302
--------------------------------------------------------------------------------------------
Dear Colleague:
Please find below the draft bulletin entitled “Service Definitions for FY 11/12 for the Pennsylvania Mental Retardation Program” (Word; pdf; cover page – Word; pdf) and related documents.The related documents were contained in the FY 10/11 service definitions. Due to comments from the field regarding the length and redundancy of the service definitions document, the draft FY 11/12 service definition packet reflects changes to attempt to address those concerns. These changes resulted in the following four documents. #1: Draft Definitions for Services (Word; pdf); #2: Management Information System Requirements (Word; pdf); #3: Relative Policy (Word; pdf); and #4: Travel Policy (Word; pdf).
The following list is being provided to highlight what ODP considers to be the most notable proposed changes reflected in this draft. It is important to note that there are a number of items included in the list below that are actually policy clarifications to the existing fiscal year 10/11 service definitions. These items are included in the fiscal year 11/12 service definitions and will also be clarified in either a re-issuance of the 10/11 service definitions or in separate policy clarifications. The items are asterisked below:
Supports Coordination:
· Added TSM – Supports Coordination and Base-Funded Supports Coordination.
Home and Community Habilitation Unlicensed:
· *Added language that everyone receiving and providing this service must be awake.
· Reduced the number of hours an individual can receive the service to a maximum of 10 hours per day.
· *Alternative therapies, sessions and lessons (i.e.; massage, horseback, aqua, art, music, dance, karate, etc.) are not permitted to be provided under this service definition.
Unlicensed Residential Habilitation Services:
· Removed this as an eligible service under the Person/Family Directed Supports Waiver.
Licensed Residential Habilitation Services:
· *Added language that relatives and family members, legal guardians and legally responsible individuals, spouses, (including spouses of the individual, relatives, legal guardian or legally responsible individuals) may not be the host family.
· Removed bed reservation and permanent and temporary vacancy information due to proposed changes within residential rate setting (Occupancy Factor).
· Removed respite procedure codes related to residential respite (W9591, W9592, W9593 and W9594).
Companion Services:
Removed the word minimal from the definition. (Possibly add a second level of companion service).
Prevocational Services:
· *Added language that individuals receiving this service must have an employment outcome.
Supports Broker Services:
· Revisions made to clarify the role of the supports broker and expand the availability of providers. (Includes recommendations that were made by the Stakeholder Planning Team, Power to the People Workgroup)
Nursing Services:
· Added language to clarify that Individuals can only receive waiver funded nursing services if they are age 21 or older.
· *Added language that an SC must obtain a written denialto verify that the State Plan and/or private insurance limitations have been exhausted prior to funding through the Consolidated or P/FDS Waiver.
Therapy Services:
· Removed Behavior Therapy as a service covered under the waivers.
· *Added language that an SC must obtain a written denialto verify that the State Plan and/or private insurance limitations have been exhausted prior to funding through the Consolidated or P/FDS Waiver.
Respite Services:
· *Added language that the regular care giver can be present in the setting in which the respite is provided.
· Added language related to respite in a residential vacant bed.
· Deleted respite ineligible procedure codes.
Assistive Technology Services:
· Added a discreet list of eligible items.
· *Added language that an SC must obtain a written denialto verify that the State Plan and/or private insurance limitations have been exhausted prior to funding through the Consolidated or P/FDS Waiver.
Specialized Supplies:
· *Added language that an SC must obtain a written denialto verify that the State Plan and/or private insurance limitations have been exhausted prior to funding through the Consolidated or P/FDS Waiver.
Administrative Services:
· Revised W0026; deleted W0027.
Family living:
· *Clarified that a spouse may not be the host family.
Other Policy changes:
· *Relative policy: Added language that relatives/legally responsible individuals, who function as the employer or managing employer through an FMS, may not provide supports broker services to the individual who they are employer or managing employer for. In addition, relatives, legal guardians and legally responsible individuals may only provide the services listed in this policy regardless of the capacity they provide the service (agency employee, provider agency, support service worker (SSW), individual/practitioner, volunteers, etc.).
· Travel policy: Added language that the provision of home and community-based services during travel is limited to no more than 30 calendar days per fiscal year.
This document is being forwarded to you for review and comment. Your input will assist ODP in the completion of a final bulletin. In order to assure timely review and revision of the draft bulletin and attachments, please provide comments via email to:
ra-odpcomment@state.pa.us with a subject line of “FY 11/12 Service Definitions”.
You can also provide written comments to:
Office of Developmental Programs
Attn: Policy: Service Definition Comments
Pennsylvania Department of Public Welfare
Room 502 Health and Welfare Building
P.O. Box2675
Harrisburg, Pa 17120
Comments will be accepted no later than close of business, December 1, 2010. All comments received by that date will be considered in preparation of the final bulletin.
Thank you in advance for your input.
Kevin T. Casey
The Model
The Individualized Career Planning Model is designed to enable students with disabilities—particularly those with a significant impact of disability—to transition from school to work, and from student services to adult services without incurring significant loss in employment opportunities, funding, services, or supports. The Model uses Social Security Work Incentives, natural supports, and linkages between Workforce Investment, Vocational Rehabilitation, and other adult agencies to enhance transition planning and career development for students. The ultimate goal is paid, community-based employment or self-employment for each student upon graduation, regardless of the severity of his or her disability.
The Model offers schools a template for individualizing vocational curriculum and preparation of students with disabilities. One significant advantage of the Model is that its innovative features and focus on the individual can be implemented—either in part or in whole—within existing school services and frameworks.
The innovative features of the Individualized Career Planning Model include:
The Model is designed for students aged 14 (or younger if appropriate) through 21, or graduation from high school. It promotes individualized vocational planning within recommended benchmarks and timelines for vocational activities. To ensure individualization, vocational activities—whether school-based jobs for students under the age of 16 or community-based jobs for students 16 and older—are guided by the student’s support needs, strengths, and contributions. Thus, the first step in the Individualized Career Planning process is to answer the question ‘who is this student?’ What are her interests, preferences and passions? What environments, supports, and teaching strategies enable her to be at her best? What skills and abilities does she possess? What job tasks does she currently perform? The process of gathering this information is called Discovery. Discovery culminates in the writing of a qualitatively rich and detailed Vocational Profile—a written picture of the student. The information from the Profile is then summarized and compartmentalized in a person-centered, Customized Employment Planning meeting. During this meeting several things happen: a plan to develop a customized job is formulated; the actual terms of employment—the Ideal Conditions—are identified and agreed upon and then translated into language understandable to future employers; and information describing the student’s skills and abilities—her Contributions—is captured. Following the meeting, the information is translated into a picture and narrative format called a Representational Portfolio. The job developer uses this Portfolio to represent the job seeker to potential employers, or in those instances where self-employment is chosen, to develop self-employment alternatives with appropriate supports. Throughout this process, the Individualized Career Planning Model promotes creative funding arrangements, either by supporting students to access Social Security Administration (SSA) Work Incentives or utilizing funding in more collaborative ways, such as blending funds from schools, SSA, Workforce, and Vocational Rehabilitation.
Entrepreneurial and self-employment alternatives, collaborative funding agreements, and non-traditional agency linkages are especially important in places like Montana where resources and opportunities are significantly limited by demographics and geography. Indeed, a primary impetus for developing this Model arose from a need to get beyond or around the constraints and limitations imposed upon students with disabilities, their families, service providers, and schools by shrinking funds, lack of options for students with significant disabilities, and the inherent economic and geographic challenges in a rural state.
The Case for Customization
The traditional labor market approach (matching people to existing job openings) does not typically result in jobs for people with more significant disabilities. When required to compete against applicants without disabilities for job openings, or when one’s skills and abilities are compared against an existing job description, people with a more significant impact of disability simply do not measure up (Callahan, 2002). However, if an individualized approach is used to represent a person’s contributions to employers needing those contributions, skills, abilities, and personal characteristics, a satisfying employment experience becomes much more likely for both employee and employer.
For this reason, the ultimate goal of the Individualized Career Planning Model is to tailor employment experiences and paid jobs to fit the skills, interests, strengths, and abilities of students, while at the same time meeting the needs and expectations of the employer. This includes unpaid school-based experiences for younger students, or paid, community-based experiences for older students. “Customized employment” essentially means “individualizing the employment relationship between employees and employers in ways that meet the needs of both” (Callahan, 2002).
Why customize? For students with a significant impact of disability, customizing an experience or employment setting enhances their opportunities for participation. By tailoring a position—removing or avoiding tasks a person cannot do well or at all, creating supports and environments wherein we know a student is at his or her best—we can maximize a student’s independent and competent performance. This not only increases the student’s self-esteem, but also promotes her as a competent employee to coworkers and employers. If, on the other hand, we place a student in a job environment or ask the student to perform a task that does not match his ideal conditions, we set the student up to be perceived as less productive and competent, and more dependent upon specialized, external supports than is actually the case. Inevitably, employer and employee dissatisfaction or frustration ensues, or worse yet, the employee becomes labeled “unemployable.”
Discovery
In order for schools to customize work experiences or post-school employment, the first step is to get to know the student. The Individualized Career Planning Model uses the process of Discovery. This process answers the question, “Who is this student?” and the information gathered provides direction for all subsequent career development activities.
In Discovery, information is gathered about a student’s interests and strengths, the types of environments and activities in which a student is at his or her best, the types of supports that are most effective, and the present level of performance in actual life activities. This information is gathered through a series of interviews, activities and observations. Information is collected from family members, friends, teachers, neighbors, —anyone who knows the student well. The person facilitating the Discovery process spends time at the student’s home and school, and in the community with the student, observing the student in familiar as well as unfamiliar activities.
The Vocational Profile
The information gathered in Discovery is then recorded in a written format called the Vocational Profile. This information about the individual student guides the negotiation and creation of school and community-based jobs.
Vocational Profiles are an alternative to standardized vocational evaluations (Callahan & Garner, 1997; Rogan, Grossi & Gajewski, 2002). The advantage of the Vocational Profile for a student with a more significant disability is that it provides concrete direction toward employment and furnishes a detailed picture of the ideal employment conditions and settings. The Profile also provides information on and examples of supports, accommodations, or adaptations that a student currently uses to be successful within his or her school, home, or work environments. The Profile differs from a traditional vocational evaluation in that it does not numerically measure skills or abilities, compare the individual student’s performance against some standardized norm, or attempt to predict employment success or failure. Instead, the Profile qualitatively describes a student’s performance, the activities and environments best suited to success, and the supports currently in use in familiar environments. Most importantly, perhaps, the Profile is not a tool for weeding out “unemployable” students; its sole purpose is to identify those situations in which a student can be most successful and to aid in the customization of an employment relationship that will foster that success. In other words, the ability to work in the community is presumed; the task for the job developer is to locate employment settings which match the person, and negotiate the appropriate supports and job tasks to make the work experience successful.
The Profile and the Individualized Education Plan (IEP)
The Individualized Career Planning Model timelines suggest beginning a Vocational Profile for students at age 14 for the benefit of utilizing this information to guide transition planning, career exploration and vocational preparation. The Discovery process complements the IEP process in that strengths, preferences, and interests are identified and support needs and successful accommodations are described. The Discovery process also identifies skills that a student needs to master or enhance which enables them to increase participation or independence in activities in their home, school or community. These skills form the foundation of the instructional plan and drive the goals and objectives outlined for instruction in the IEP. The ultimate objective of the IEP is the desired post-school outcome (employment), and the instructional plan is tailored accordingly. Some schools have begun substituting the Vocational Profile for some of the assessments traditionally used to measure student capabilities because the Profile provides more meaningful information and a better indication of the skills a student needs to learn to achieve their desired post-school outcomes.
For students aged 16 and older (since students without disabilities are setting their sights on paid employment), the Profile guides the development of individualized, paid, community-based jobs or, in some instances, the development of a student-owned business. Additionally, the Vocational Profile would make an excellent summary of student performance document which could transition with the student from school to adult services.
Customized Employment Planning Meeting
Once the Profile is complete an Employment Planning Meeting is held. The student and his or her family have the final vote in who is invited to this meeting. Participants generally consist of family members, school staff, friends, employers, Vocational Rehabilitation staff, the future job developer, and anyone who knows the student well. The meeting works best if the number of professionals is more or less equal to that of friends, family, and community members. The purpose of the meeting is to establish a road map for developing a specific job for the student which identifies: 1) the parameters needing negotiation to customize a successful job, 2) a list of contributions the person can bring to an employer, 3) a list of Job Tasks that the employee can perform, and 4) a prospecting list of employers within the person’s community who may meet the Ideal Conditions and be in need of the services identified in the individual’s Job Tasks. In this meeting, the information gathered during Discovery and captured in the Profile is summarized into the following categories: Ideal Conditions, Preferences, Contributions, Job Tasks, and Potential Employers. It is essential that the person who will be developing the customized job attend the Employment Planning Meeting.
Ideal Conditions for employment include a description of any critical factors which must be present (or absent) for the student to be successful. Included might be necessary supports, environmental conditions, and teaching strategies. This section defines the parameters of the job for which the job developer will be negotiating on behalf of the individual student. Preferences are the areas of interest identified for or by the student. These may or may not be work-related but could potentially lead to the job developer to an employment site or an employment connection. Contributions are the skills, experiences, personal attributes, or credentials that a student brings to an employer. Job Tasks are those tasks that the student can perform, or based upon what was learned in Discovery, what the interviewer believes the student is capable of performing with training.
Using all of this information, meeting participants either identify potential employers in the community or identify training activities that can be created in the student’s school, depending on the student’s age. Employment activities of nondisabled peers serve as the reference point for students with disabilities. Job tasks, work or learning environments, as well as supports and on-the-job training are structured according to the information provided in the Profile which was summarized in the Planning meeting. The Individualized Career Planning process complements the IEP process in that information gathered during Discovery helps support staff to form a picture of each student’s present level of performance, strengths and interests, and provides a vision of the student’s post-school outcomes. It also highlights areas or skills where instruction is needed and identifies transition goals which are functional for each individual student.
For students 16 and older, once the Profile is completed and the Ideal Conditions of employment are identified, a list of Potential Employers is compiled. Potential Employers are those employers within the community who match the Ideal Conditions of employment described for the individual and who may have a need for the skills or Contributions that the individual can provide. This list directs the job developer in her efforts on behalf of the job seeker.
The Representational Portfolio
The Representational Portfolio is one marketing tool job developers can use to represent job seekers to employers when making presentations on their behalf. The Portfolio translates the information gathered during Discovery, captured in the Profile, and summarized in the Employment Planning meeting into a presentation format for an employer. It is a narrative and pictorial representation of the individual’s contributions and capabilities, and is comprised of two components. The first half of the Portfolio introduces the concept of Customized Employment to the employer thereby paving the way for the job developer to negotiate those terms of employment that best meet the individual’s necessary or ideal conditions for success. The second half of the Portfolio uses narrative and pictures to introduce the job seeker and to share information about her potential contributions.
Schools, agencies and families report that both the Vocational Profile and Employment Portfolio are useful tools for sharing information about students with adult agencies who may be serving the student upon graduation from high school.
Below is a very brief sketch of how information collected in Discovery leads to the identification of Contributions and Ideal Conditions. These, in turn, guide the job search and establish the parameters of employment.
Carley had participated in a few school and community-based work explorations prior to looking for a paid job. Based on these experiences and the information gathered during the Discovery, we learned that Carley’s Contributions included:
• the ability to memorize the layout of large stores, including where items in various departments are housed;
• meticulously returning items to their appropriate spots;
• recognizing when stock was out of place;
• asking for help when she needed it.
Carley is a dedicated worker; her attendance is good and she is a reliable employee. She is also friendly and outgoing, and works well and collaboratively with many coworkers and customers. Some of the Job Tasks that she can perform for an employer include:
• returning items to the appropriate shelves;
• facing items on shelves;
• performing quality checks to ensure that displays in the store are neat and accurate;
• scanning merchandise for price checks or inventory;
• assisting customers in locating desired items.
Carley’s Ideal Conditions include an environment that can accommodate her electric wheelchair. If she is to return or handle merchandise it must be light, small and easy to grasp. When interacting with coworkers, supervisors or customers, she needs time to respond using her Delta talker, an augmentative communication device. It is best for her to have a structured routine of familiar job tasks that she feels confident she can physically perform; however, new tasks can be introduced to the routine. Carley does best when the supervisor takes time to help her figure out ways to perform pieces of tasks differently in instances where some physical limitation prevents her from performing the task in the typical way.
Wal-Mart, an employer in Carley’s town, needed someone to stock merchandise that customers had returned to the store. They valued having an employee who returns items to the correct place rather than replacing the merchandise incorrectly in any convenient spot. A strong work ethic, positive attitude and good attendance were desired employee traits. Wal-Mart hired Carley after recognizing that she could make a valuable contribution to their workplace. Carley worked at Wal-Mart for over a year and then chose to resign from this position to pursue her next job.
Promoting Self-Determination and Informed Choice
At age 16, few students—with or without disabilities—have much firsthand experience with employment. They often do not know what their preferences and interests are in a job, much less have a clear, singular vision of what they would like to do for a job after high school. Work exploration allows a student to investigate an area or job type in which he may have some interest. The experience enables the student to make more informed choices about environments, features of work, and job tasks in future employment decisions and it has the added benefit of providing the job developer with more information about an individual’s skills, performance, and support needs within various environments.
The work exploration is not an attempt to “evaluate” an individual’s “readiness” to work. The philosophy of the Model is that everyone is “ready” and has some contribution to make; it is simply a matter of discovering the individual’s contributions and desires, and matching those to an employer’s needs. Building a model that incorporates flexibility as a fundamental feature provides students with disabilities the same latitude to explore possible career alternatives and to grow and change over time as that enjoyed by those without disabilities. As a student gains experience and skills, their preferences, the parameters which need to be negotiated on their behalf, and the job tasks they can perform will also evolve and change.
One word of caution in regard to work experiences is that the more significant the impact of disability on a student’s performance, the more critical it is to customize and individualize their employment experiences. Customization allows the student to experience maximum independence and participation and leads to job performance that promotes a positive and competent image of the person to the community and future employers.
Maclean’s Profile identified characteristics of an ideal job which led to placement in a paid position at a local video and music store. But it also identified an interest in working around dogs and animals as another potential career goal. In addition to his paid job, Maclaen chose to volunteer at a local Humane Society to explore whether or not he would like to pursue some type of work with animals and possibly start his own dog boarding business. Maclaen was able to explore two very different types of work simultaneously. Each experience was customized for him. The experience was valuable not only because it provided Maclaen with information he could later use to make informed choices about what he wanted to do, but also because it enabled him to make connections with others in the community who might be helpful in his future job searches.
Before graduating from high school, Maclean’s teacher developed several part-time jobs for him which totaled 20 hours a week. He worked at the local video store on Friday nights, and at the courthouse, the school administration building, and the city library during the week. All of these jobs were customized and developed using the information provided in Maclaen’s Profile.
Self-employment as a Post-school Outcome or Career Experience
Data from a Rehabilitation Services Administration (RSA)-funded Choice Projects found that when given the option of self-employment or traditional wage employment, people with disabilities chose self-employment at the same rate as people without disabilities (Callahan, 2000). Self-employment is a growing trend especially in more rural areas where limited job opportunities exist for everyone (Griffin & Hammis, 2003). People choose to be self-employed for a variety of reasons, including a lack of existing employment opportunities, a desire to customize work schedules and tasks to fit lifestyles, or a passion for a product or service that cannot be realized in any other employment setting.
For students with a more significant impact of disability, the list of Ideal Conditions—those factors that must be present (or absent) in order for a student to be most successful—will likely be longer than that of someone with less impact of disability. This means that finding a suitable employment match in existing markets may be more difficult. In some cases, supported self-employment could be an alternative, but the inability to locate traditional employment should not be the only factor involved in this decision.
While the self-employed person has more control over the design of the work environment, definition of job tasks, use of time, and a host of other factors that can be tailored to best meet the needs of the worker rather than the demands of the product or employer, it is not for everyone. There are a multitude of additional factors which need to be considered prior to choosing this option, including: What supports will the person need for their business such as: marketing, sales, or bookkeeping? Does the person or their family have experience or expertise in small business? If not, are there local resources that could provide assistance? How much will the person need to earn to support himself or herself and grow the business? While independent performance of these activities is not a prerequisite to becoming self-employed, these are supports that will need to be negotiated on behalf of the individual or provided by a family member, friend, or employee to ensure that the business is successful.
Self-employment can serve as both work experience and as a post-school outcome. The strategies and principals intrinsic to supported employment also apply to a supported self-employment model (Griffin & Hammis, 2000). And, as is the case for small business owners in the mainstream workforce, students or adults with disabilities need not master all components or perform all tasks of owning and running their own business for self-employment to be considered a feasible option. Partial participation with ongoing supports is by no means out of the ordinary.
Lance began his small business while he was still in high school. From his Discovery process his planning team knew that he liked to be on the go—driving around, visiting with familiar people. As part of his Transition preparation, he participated in school and community-based work experiences that involved making deliveries. Lance lived in a small rural community. When his job developer could not find a business that matched his ideal conditions of employment, as well as his preferences (making deliveries), his family urged the job developer to pursue self-employment. Lance started a delivery business which delivered lunches for local restaurants. He had a contract with one of the larger businesses in town to provide lunch to their employees twice weekly. As Lance’s business grew, the goal was to hire a partner who could also meet some of Lance’s ongoing support needs. In the meantime, his family used funding from state Developmental Disabilities to pay someone to drive his van, assist with deliveries, and support his participation in his business.
Social Security Work Incentives: Funding Transition Planning and Ongoing Supports
Perhaps the single most innovative and important feature of the Individualized Career Planning Model is its use of Social Security Work Incentives to fund transition planning and career development activities for high school students. Work incentives such as the PASS (Plan for Achieving Self-Support) plan have been in existence since 1974. PASS plans can be used to fund a variety of services and supports (assessments, job coaching, job development, transportation, education, equipment, etc.) at different stages in the career development and transition planning process for people who are eligible for them. PASS plans can augment what schools and/or agencies provide for student employment; fund interim employment supports between graduation (and the subsequent loss of school services) and the onset of receiving adult agency services; or purchase tools, equipment, or services needed for a student to begin his own business. Accessing these funds has the added advantage of enabling students, families and support staff to leverage other funds and services that the individual may need (Shelley, Hammis, & Katz, 2002).
The PASS Plan
PASS plans are one of the Social Security Administration’s work incentive programs. PASS plans allow an SSI recipient to set aside resources or income, thereby decreasing the amount of the person’s countable income and increasing their monthly SSI check. The money that is set aside can be used to fund many items, supports, or services needed to assist an eligible person in reaching a Vocational Goal (2003 SSA Administration Red Book). Nationally only four PASS plans exist for people under the age of 18, and only 80 PASS plans are in existence for people age 18-21 (SSI Disabled Recipients who Work Quarterly Report, March 2003). Only two tenths of one percent of those individuals eligible for SSA Work Incentives use this resource (Hill, 1995). Reasons for underutilization include: fear of losing benefits, lack of qualified personnel to write PASS plans, and lack of awareness that the resource exists (National Transition Network, 1994).
To be eligible for a PASS plan, a student must meet medical eligibility requirements for Supplemental Security Income (SSI), which is income- and disability-based, AND have countable income or resources that reduce her SSI payment below the Federal Benefit rate of $603/month (2006 federal benefit rate). As long as the individual is a student, wages do not reduce the SSI checks until the student earns more than $1,460/month, up to $5,910/year (2006 rates; Student Earned Income Exclusion). However, once an individual graduates, wages reduce the monthly SSI check by fifty cents for every dollar earned over $85 monthly. This reduction in SSI makes an individual eligible for a PASS plan, which allows the individual to shelter the amount by which the SSI checks are reduced in a PASS plan account. These funds can then be used to furnish the supports necessary for them to work.
Alicia was 17 years old when her IEP team discovered she was eligible for a PASS plan. Her SSI check was being reduced by her monthly SSDAC (Social Security for Disabled Adult Children) checks which she began receiving following the death of her father. She was able to shelter the amount of the SSDAC check ($290/month) for a period of 3 years in a PASS which totaled over $9,000. Her PASS was originally intended to purchase transportation services, job development and job coaching while she was in school and to later bridge the potential gaps in support between school and post-school supports. Since the school and Vocational Rehabilitation funded her job development and coaching she amended her PASS, and with Social Security’s approval, purchased a wheelchair accessible van.
PASS plans are a perfect tool for transition planning because they can be used to bridge the gap in services between school and post-school supports. They are flexible in what they fund—anything a person needs to obtain and maintain employment. And PASS plans promote consumer and family choice and control: the individual or their Representative Payee chooses what to purchase and from whom to purchase it; payment is made out of the individual’s designated bank account as the individual authorizes. PASS plans can also be modified, with the PASS Cadre’s permission, as circumstances and funding or service needs change. If a person’s Vocational Goal changes they can also have more than one PASS plan.
Lance, the young man who began his own delivery business, and his brother combined their PASS plans to purchase a van for their business. Vocational Rehabilitation funds were used to adapt the van to make it accessible and fund some of the initial job coaching. While Lance was still in school, the school provided a paraprofessional as a job coach and driver. After Lance graduated, his family provided supports for his business.
The Individualized Career Planning Model encourages the use and development of PASS plans for eligible students. The Model recommends that as part of transition planning Social Security Benefits Analyses be completed to identify those students who might be eligible for Social Security Work Incentives such as a PASS plan. In some cases a student could become eligible for a PASS plan and SSI simultaneously by sheltering income or a resource in the PASS. Ideally a student’s eligibility is reviewed annually at their IEP, or whenever there is a change which could impact her eligibility for SSA benefits (a parent retires, becomes disabled, or dies; the student’s income changes; parents’ income changes; family composition changes; the student turns 18 or is about to exit school).
Information about Social Security Work Incentives such as PASS plans is being disseminated to schools, families, Workforce agencies, Vocational Rehabilitation, and Developmental Disabilities case managers with the hopes that more students who are eligible for these work incentives will access them. Vocational Rehabilitation may fund the development of a PASS plan for students who are in their exit year of high school. Some Vocational Rehabilitation offices have committed to utilizing work incentives as a long-term signoff for students requesting extended employment services through Vocational Rehabilitation. Workforce agencies are exploring the option of offering PASS plans as a service for eligible Workforce consumers.
Access to funds such as those provided in a PASS plan give the family and person with disabilities more choices in designing transition plans and selecting career options. And in rural areas where employment opportunities and support services are scarce, creativity and choice are essential.
Forging Linkages: Collaboration between Agencies, Schools, and Individuals
One of the overarching objectives of the Individualized Career Planning Model is to effect a nearly “seamless” transition from student life to post-school adult life so that the person does not lose—permanently or temporarily—skills and abilities, or employment and established supports acquired while in school. Connecting students and families with appropriate adult agencies, accessing and blending all available funds and striving to place students into permanent jobs prior to high school exit is needed. Fostering interagency collaborative arrangements that support these activities will build community capacity to support better outcomes for exiting students.
A major difficulty in planning for successful transitions from school to adult life for students with ongoing support needs is overcoming the differences in how schools and adult agencies provide services. School-sponsored special education services are entitlements; if a student has a disability, he or she receives the service. By contrast, adult agencies such as Vocational Rehabilitation and Developmental Disabilities Agencies provide services based upon eligibility and availability; even when a person is deemed eligible, availability can limit access. Across the country waiting lists for Developmental Disabilities Services average five years (Wehman, 2001). To further complicate matters, available services may or may not fit the needs of transitioning graduates; what they need may simply not be available in their area. Another challenge is in obtaining and administering services. For the student, the necessary services are primarily provided within the school and by the school; school personnel manage and oversee the provision of these services. For adults, the task of identifying, selecting, applying for, and coordinating services from the confusing array of adult agencies is often times left to the graduate and his family.
For these reasons and many others, transition planning that incorporates IEP team assistance in forging early links between schools, adult services, funding agencies, families, and individuals with disabilities is essential to post-school employment success. The Model is specifically designed to encourage the early formation of these linkages.
For Maclaen, early interagency collaboration and the use of Social Security work incentives made the difference between employment and unemployment when he graduated. Prior to his graduation from high school, Vocational Rehabilitation funded his initial wages during the time he was learning the job, and a PASS plan was written and submitted to Social Security with the intent to begin funding follow-along supports and transportation the day after graduation. Maclaen was referred to Supported Employment Services through the Developmental Disabilities Agency and was on a waiting list for these services for 3 years. While waiting, his PASS plan funded his follow-along supports.
In Carley’s case, obtaining her job at Wal-Mart required the school and Carley’s mom to perform the job development. Tribal Vocational Rehabilitation (Section 121 of the Rehabilitation Act), provided funding for the job coach during the summer between her junior and senior year when Carley was not in school, and the school used their paraprofessional to job coach once school began again. By the time she graduated, Carley was working at Wal-Mart without the support of a job coach. She utilized her Personal Care Attendant funds to pay for some minimal assistance that she still required at the job.
During Ryan’s transition planning his IEP team discovered that he was eligible for a PASS plan. His SSI check was being reduced because he also received SSDAC (Social Security for Disabled Adult Children) through his father’s retirement account. A PASS plan totaling $7,780 was approved and used to fund job coaching and computer tutoring while Ryan was still in school. The PASS continued after he graduated at age 20. Funds targeted for people with disabilities at the local Workforce agency were utilized to purchase computer equipment to support Ryan’s employment.
Ryan applied for Supported Employment Services through the local Developmental Disabilities office but there was a waiting list in the county where he lived. In the meantime, he received funds from a Developmental Disabilities Medicaid Waiver program called Community Supports in the amount of $7,800/year. He, his family, and case manager identified his priority needs to be employment and recreation and leisure supports, and blended the available money to address these needs.
The Montana Experience
California and Maryland piloted a Transition Service Integration Model which combined funds from schools, Vocational Rehabilitation, and Developmental Disabilities agencies to support employment for students during their last year of high school (Certa, N., Sax, C., Pumpian, I., Mautz, D., Smalley, A., Wade, H., and Noyes, D., 2002). In Montana, our Model and demonstration projects share the same end-goal of placement into paid employment with necessary supports prior to graduation. However, in Montana we have additional challenges. Montana is a predominantly rural state, and funding for career development and transition planning, to say nothing of on-going supports, is scarce even in the best of times. Not all schools in Montana provide special education services to students through age 21, so there is less time to prepare students for life as adults and to connect them with necessary adult services. Waiting lists for Developmental Disabilities and Mental Health services are growing and not all agencies are equipped to provide supported employment services to students with the most significant disabilities.
Vocational Rehabilitation has only recently begun funding assessment and employment activities for students during their exit year of high school. (Previously Vocational Rehabilitation in many towns accepted applications for services only in the second semester of the student’s senior year which did not leave much time for accessing these funds prior to student graduation.) If the student is found to be in need of ongoing supports to maintain employment, Vocational Rehabilitation may not continue to fund employment services until and unless an adult agency such as Developmental Disabilities or VR Extended Employment Services is also serving the student. Some Vocational Rehabilitation offices will accept natural supports or Social Security Work Incentives as a demonstration of long-term support (or long-term signoff) for people who need ongoing supports, but this is not a consistent practice across the state. Thus, the majority of students with ongoing support needs graduating from special education services risk waiting for Vocational Rehabilitation Services AND Developmental Disabilities Services.
Putting the Model to Work in Montana Schools
Implementation of the Model or its components varies from school to school. In schools which receive related services from the Bitterroot Valley Education Cooperative, a student may receive a Vocational Profile as an Occupational Therapy service. In Great Falls schools, Vocational Resource Educators (who primarily oversee vocational curriculum for the students) are writing the Profiles. Hamilton High School ran a pilot program which combined the student’s Child Study Team meeting (the three-year re-evaluation meeting used to redetermine the student’s eligibility for special education services) with an Employment Planning meeting in which identification of Ideal Conditions, Preferences, Contributions, and Job Tasks replaced the usual review of the student’s deficits. In addition, instead of the School Psychologist, Occupational Therapist, Physical Therapist, and Speech Therapist submitting independent evaluations as is typically done, each contributed information to the Vocational Profile. The result was a single, rich, detailed, and integrated picture of who the student was, his current levels of performance, and his support needs rather than a collection of disconnected pieces of information detailing test scores.
For students in their exit year in Missoula schools, Vocational Rehabilitation offered the Vocational Profile as one option of a Vocational Evaluation that they would fund, and they provided a limited amount of funding for employment supports such as: job coaching, job development, transportation, or assessment which was provided by a VR-enrolled employment vendor. In instances where either of these options was chosen, the school, family and selected adult agency negotiated to decide who would provide each component: the Profile, the Marketing Portfolio, Job Development, and Job Coaching, thereby blending their available funds and services and maximizing the supports for the student.
In the Mission Valley schools, the school psychologist and teachers took the lead in performing Discovery and writing Profiles. Adult agencies, including Vocational Rehabilitation, Workforce Investment, and Developmental Disabilities case managers were invited to the Employment Planning meetings. For several students paid work experiences were developed based upon the information from their Employment Planning meetings. The Workforce Youth Coordinator developed the job sites and paid the student’s wages for the length of the job trial. State Vocational Rehabilitation funded the job coaching that was purchased from a local employment vendor.
The Future
Components of the Individualized Career Planning Model, such as the Vocational Profile, Employment Planning meeting, and Employment Portfolio have proven to be effective tools in creating employment and self-employment opportunities for students with significant disabilities. When utilized in transition planning, these components enable schools to increase their compliance with Individuals with Disabilities Education Act of 1997 (IDEA) legislation. These tools identify students’ interests and preferences; define current levels of performance in relation to real life activities at home, work, school, and in the community; establish a plan for developing one post-school outcome - employment; identify accommodations and supports that enhance student success; and highlight areas where further instruction is needed in the context of the person’s environment.
While the components are undeniably effective and make sense from the perspective of individuals with disabilities, families, adult services, and schools, we are finding that incorporating these tools into existing practices requires a somewhat larger commitment on the part of school staff than was expected. Engaging in Discovery and writing the Profile require that teachers change their typical evaluative or quantitative style of writing to a more descriptive and qualitative style. The process also requires a change in philosophy: instead of getting kids “ready” for employment through education and skill building, the Model assumes they are ready and all that is needed is to discover each individual’s ideal conditions of employment and potential contributions. Yet another challenge for schools is that the Model asks them to strive for placement into a paid job as an outcome of school. This goes against the conventional methodology in which the job of the school is to provide training experiences for young adults and the job of the adult agencies is to find employment after graduation. Implementing the Model also requires changes in staff roles and how they use their time. Although most teachers who participated in home visits during the Discovery process reported that the exercise was extremely valuable in gathering information about the student, these visits typically were not part of a teacher’s routine or completed within their typical work hours.
The feedback from adult agencies has been positive. Employment providers assisting with job development for students say that the time it takes to develop a job is much reduced when they have a clear picture and plan (the Profile and the Customized Employment Planning meeting minutes) to guide their job development efforts. Agencies that will eventually support a student after she graduates from school have expressed enthusiasm for the comprehensive summary of information (the Vocational Profile) which accompanies the student upon graduation. Now that funding from Montana Vocational Rehabilitation may be available to pay for Vocational Profiles for students in their last year of school, several Montana agencies have begun offering this service to schools and other adults whom they serve. We continue to explore where Workforce Investment Services and funds fit into this model. The model has been piloted in two Workforce Offices in the state, Bozeman and Lewistown. Ideally the model components will be added to their existing menu of employment services offered to consumers.
The next steps include fine-tuning the Technical Assistance format to better and more efficiently enable schools and communities to implement the Individualized Career Planning Model components, and incorporate these components into their transition practices, and pilot testing the model with other populations who experience substantial barriers to employment, such as young adults with deaf-blindness, autism, significant emotional disturbances, or significant physical challenges.
Technical assistance and support during the development of this model was provided by Marc Gold and Associates, Gautier, MS.
References
Callahan, M. (2002). Employment from Competitive to Customized. TASH Connections, 28, (9/10).
Callahan, M. (2000). Experiences in self-employment in RSA’s National Choice Demonstrations 1993-1999. Gautier, MS: Marc Gold and Associates.
Callahan, M. & Garner, J. (1997). Keys to the Workplace: Skills and supports for people with disabilities. Baltimore: Brookes Publishing.
Certa, N., Sax, C., Pumpian, I., Mautz, D., Smalley, A., Wade, H., & Noyes, D. (2002). Transition Service Integration Model. In C. Sax & C. Thoma, Transition Assessment: Wise Practices for quality lives (pp.119-131). Baltimore: Brookes Publishing.
Griffin,C. & Hammis, D. (2003). Making Self Employment Work for People with Disabilities. Baltimore: Brookes Publishing.
Griffin,C. & Hammis, D. (2000). What Comes After What Comes Next: Self-Employment as the Logical Descendant of Supported Employment. In Wehman, P., Supported Employment in Business. St. Augustine: TRN Press.
Hill, M. (1995). Underutilization of PASS and other SSA Work Incentives. ESI Newsletter, 2 (1). Richmond, VA: Virginia Commonwealth University, School of Business.
Hughes, C., Swang, B., Jin-Ho, K., Killian, D.J., Harmer, M.L. & Alcantara, P.R. (1997). A preliminary validation of strategies that support the transition from school to adult life. Career Development for Exceptional Individuals, 20 (1), 1-14.
National Transition Network. (1994). Policy update: Youth with disabilities and the School to Work Opportunities Act of 1994. Minneapolis, MN-University of MN.
Rogan, P., Grossi, T., & Gajewski, R. (2002). Vocational and Career Assessment. In C. Sax & C. Thoma , Transition Assessment: Wise Practices for quality lives (pp.103-117). Baltimore: Brookes Publishing.
Shelley, R., Hammis, D. & Katz,M. (2002). It Doesn’t Take a Rocket Scientist to Understand and Use Social Security Work Incentives 5th Edition. Missoula, MT; University of Montana Rural Institute on Disabilities.
Social Security Administration, Office of Disability and Income Security Programs (2003). RedBook: A Summary Guide to Employment Support for People with Disabilities under the Social Security Disability Insurance and Supplemental Security Income Programs. Washington, DC: Author.
Social Security Administration, Office of Research, Evaluation and Statistics (2003). Quarterly report on SSI disabled workers and work incentive provisions: March 2003. Washington, DC: Author.
U.S. Department of Education. (1997). Individuals with disabilities education act: IDEA ’97 (DPHHS Publication). Washington, D.C.: U.S. Government Printing Office.
Wehman, P. (2001). Life beyond the classroom: Transition strategies for young people with disabilities. Baltimore, MD: Paul H. Brookes Publishing Co.
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