1. 2 NYS OMH Commissioner Michael Hogan targeted improving employment outcomes for people with psychiatric disabilities. The NYS Most Integrated Setting

NYS Shared Vision: Transform Employment for

People with Psychiatric Disabilities

Prepared for: USPRA 36th Annual ConferenceBoston Massachusetts

June 13, 2011

1

Presenters

Douglas P. Ruderman, LCSW-RDirector, Bureau of Program Coordination & Support, NYS OMH

Aaron Vieira, LMSWAssociate Director, Center for Rehabilitation & Recovery

Paul Margolies, Ph.D.Associate Director, Center for Practice Innovations

Chacku Mathai, CPRPAssociate Executive Director, NYAPRS

Oscar Jimenez, MPH Director of Community and Economic Development, NYAPRS

Patricia DowseChief Operating Officer, NYSRA 2

Leadership Promotes the Vision

• NYS OMH Commissioner Michael Hogan targeted improving employment outcomes for people with psychiatric disabilities.

• The NYS Most Integrated Setting Coordinating Council (MISCC) formed an employment sub-committee to focus on integrated and competitive employment for people with disabilities.

• The Medicaid Infrastructure Grant (MIG) NYS committee devoted resources to developing employment opportunities for people with disabilities.

3

Partnership

• To create real change toward a recovery based and person centered employment support system you need partners from all sectors:– Recipients– Advocates– Trade Associations– Agency Leadership– Universities– Government

4

Targeted Change Supports the Vision

• Transform non-integrated employment to integrated and competitive employment

• Promote access to evidence-based practices for supported employment

• Utilize work incentives like the Medicaid Buy-In and Ticket-to-Work

• Use integrated treatment and rehabilitation services to support employment as a life role goal

5

Change Does Not Happen by Chance

• Looking at the issue from 50,000 feet and then implementing a plan at ground level

• Assessing the key impediments to success and creating a plan to overcome them

• Believing in what you are doing and what can be accomplished

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Change is supported by:

Incentives

Highlight the importance of work at all levels of a mental health service system:• Maintain financial support for integrated and

competitive employment• Debunk urban myths about work participation

and promote economic self-sufficiency• Promote the ticket-to-work program by

encouraging agencies to become Employment Networks and benefit from ticket revenue

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Organizational Level

• Beliefs: The system and its members must believe that people with psychiatric disabilities can succeed at work.

• Services: Services need to support integrated and competitive employment and incorporate evidence-based practices.

• Behaviors: State and local government, agency executives and direct care staff, people with psychiatric disabilities and their natural support systems must act in a manner that secures and supports employment.

8

Systems Level

• Redirect funding from sheltered workshops to support integrated employment programs

• Target other non-integrated employment programs (enclaves and mobile work crews)

• Partnership among many state agencies to create a shared smart system to link job banks to functional resumes

• Emphasize quality work incentive supports vs. benefits advisement

• Collect outcome data and make data available to the public

9

Funding

Employment supports are funded in the following ways:• State dollars: includes converting state dollars

used to support sheltered workshops into funds to support people in integrated and competitive employment

• Federal dollars: includes supports through Ticket-to-Work, Medicaid Infrastructure Grant, & Rehabilitation Option Services that help people overcome mental health barriers to employment

10

Models

• Support the evidence-based practice of Individual Placement and Support (IPS) and adapt it to integrated recovery and treatment programs

• Support programs that get people jobs

• Promote business models, including entrepreneurship, that employ people with psychiatric disabilities

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Evidence-Based Practice

• NYS OMH, partnering with the Center for Practice Innovations, provides technical assistance to implement the Individual Placement and Support (IPS) model and to adapt that model to recovery oriented services.

• Intensive IPS training – per the traditional model

• IPS training using a learning collaborative approach

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Building Hope

• The life role of employment has been turned into a distant dream.

• We have partnered to change that distant dream into real options so people can choose to work.

• Peers are speaking out through the “We Can Work” campaign to share their hopes and successes in employment.

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People with psychiatric disabilities have been told for so many years: “You can not and you should not work.”

NYS Advocacy on Employment

• History of advocacy related to improved outcomes and relationships with State VR since 1993

• Supported advocacy for Ticket to Work legislation in late 90’s; NYS Implementation since 1998

• Direct involvement with NY Works Demonstration• Call for increased resources for supported

employment in 1998 • Medicaid Buy-In for WPD in 2003

NYS Campaign for Employment

• State Leadership on Employment• Interagency Task Force on Employment• Pursue Medicaid Infrastructure Grant (CES)• We Can Work Campaign • Redirect Resources to integrated employment• Develop integrated funding and data system• Connect employers with people seeking work

NYS OMH WORKCENTER TRANSFORMATION PROJECT

A commitment to moreemployment that is integrated

and leads to self sufficiency

Historical Notes2009 NYS OMH AmbulatoryRestructuring Report

NYS Ambulatory System serves almost 458,000 people annually

All mental health services that are provided in the community are included outside of clinics

Support – Vocational Supports: Sheltered Workshops, Assisted Competitive Employment, Ongoing Integrated Supported Employment Services, Transitional Employment, and Affirmative Business/Industry and Work Programs

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NYS Makes Work Pay NYS receives the Medicaid Infrastructure

Grant Mission:

Through research, policy analysis, training, and technical assistance, the New York Makes Work Pay Initiative provides policy and practice solutions to address New York State's estimated 70% of working-age people with disabilities who are not employed

NYSRA is a strategic partner and is asked to meet the following goals:

Identify and define best practice models for transitioning program priorities and resources to support competitive, integrated employment.

Influence state systems’ transformation by introducing and modeling customized and entrepreneurial approaches to employment.

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Our GOALS Facilitate a “Stakeholder” workgroup as recommended in

final paper of the “21st century SE Workgroup” that advocate for increased opportunities for integrated employment.

Develop with EDI of Cornell University and Burton Blatt Institute of Syracuse University an organizational assessment tool (CRP Assessment Tool and WORKqual) inclusive of a set of principles and practices that agencies can adopt to support organizational transformation to more integrated employment options. Options need to include not only individualized job placement but also

self-employment, self-employment incubators, cooperatively owned businesses or social enterprises consistent with established practices.

Ongoing consultation with community provider agencies (CRP’s) receiving state deficit financing from NYS OMH supporting their workcenter. Assist the agency to develop Business plans to transform programs and resources toward full competitive, integrated employment

Develop recommendations for policy changes, waivers, modifications to regulations etc. 19

INCLUSIVE WORKFORCE INITIATIVE

LDALearning Disabilities Association of New York State, Inc.

Correctional Educational Consortium

CMEP/Coalition of Mainstream

Employment Programs

20

Inclusive Workforce The Inclusive Workforce Workgroup began convening in

April of 2010 and has worked since that time to identify recommendations to be shared to all partners in New York State to assist in the development of a workforce development system that would be characterized by funding and services that demonstrate flexibility, responsiveness and collaboration.

For such a workforce to exist in our state, individuals with disabilities who are expressing an interest to work must be supported by their families, peers, the provider community, NY’s Businesses, as well as State and Local government.

It must be responsive to both Business and Job seekers’ needs.

The Inclusive Workforce Workgroup identified key factors necessary to establish an effective employment system in New York.

21

Key Factors to Development Success The system must provide seamless access

to services, timely response to individuals’ needs, and be inclusive to enable any and all individuals the opportunity to seek and gain employment.

New York State must have in place effective partnerships with businesses to meet their hiring needs and the needs of job seekers for the jobs they offer.

It is imperative that the needs of the business owners be met large and small. 22

True Accountability BOTH Job seekers and businesses are satisfied –

we need both business and ALL residents to feel New York wants and needs them in their workforce!

Businesses are educated, engaged, and supported in their quest to hire, train and retain employees that help them meet their bottom line;

Individuals are assisted to find, choose, and maintain employment which matches the person’s career goals, interests, and skills; and

Critical data on the attainment of outcomes in the system is collected so true progress in our State can be objectively measured. 23

CRP Assessment Tool & WorkQual

Offer an inclusive of a set of principles and practices that agencies can adopt to support organizational transformation to more integrated employment options.

Works to assist the agency to evaluate their Community Partners and resources for transformation.

24

The Tool Series of questions to assess an

organizational, resource and market environment. These categories develop a profile of your organizational environment, available resources, and market situation.

Key to the use of the tool understanding your organization’s current status and not projecting where you would like to be.

An important baseline is provided that then allows you to conduct an organizational assessment. 25

WorkQual OnlineFind it herehttp://www.ilr.cornell.edu/edi/allqual/workqual-login.cfm

26

http://www.ilr.cornell.edu/edi/allqual/workqual-login.cfm

NYS OMH WorkcenterTransformation

Consultation with 28 agencies began in October of 2009 Host for videoconference on “Business Planning” utilizing

the State Small Business Development Centers in April 2010

June 2010 unveiled the CRP Assessment Tool and WorkQual

Affirmative Business White paper - July 2010

http://www.ilr.cornell.edu/edi/nymakesworkpay/docs/Transforming_NYS_business_072010.html

September 2010 – Held Employment Institute showcasing ideas for change and business strategies

Ongoing consultation offered by NYSRA, NYS OMH, Cornell University and Burton Blatt Institute of Syracuse University

December 31, 2010 – Deadline for Business Concepts to NYS OMH 27

http://www.ilr.cornell.edu/edi/nymakesworkpay/docs/Transforming_NYS_Business_072010.html

http://www.ilr.cornell.edu/edi/nymakesworkpay/docs/Transforming_NYS_Business_072010.html

Business Ideas and Initiatives

Three Year Plan – pending NYS Budget

Shifting funds to Personalized Recovery Oriented Services (PROS)

Incubator Businesses Realignment of Prevailing wage

employment opportunities Corporate Partnerships Wage Subsidies

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Future Steps

Revisit and redo regulations Identify Alternative uses for

“workcenter” space Building an Inclusive Workforce Student transition Planning Policies that “include” all

29

Center for Practice Innovations brings

IPS Supported Employment to PROS Programs in NYS

Paul Margolies, Ph.D.Center for Practice Innovations

at Columbia Psychiatry

USPRA ConferenceJune 13, 2011

Public-Academic Partnership

Individual Placement and Support

What is Supported Employment?

• Supported Employment helps people diagnosed with mental illnesses find and keep meaningful jobs in the community.

• These jobs exist in the open labor market, pay at least minimum wage, and are in work settings that include people who are not disabled.

SAMHSA Supported Employment Tool Kit

Individual Placement and SupportPrinciples

• Competitive employment is the goal• Eligibility is based on consumer choice – zero exclusion• Consumer preferences are important• Supported employment is integrated with treatment • Personalized benefits counseling is provided• Rapid job search -- starts soon after a consumer expresses

interest in working• Follow-along supports

Individual Placement and SupportPractitioner Skills

• Engagement• Assessment: Career / Vocational profile• Employment planning• Benefits counseling• Job development• Working with ACCES-VR• Follow-along supports

CPI’s efforts to bring IPS to consumers in NYS

Two approaches to implementation

Begin with focus on PROS programs• Significant on-site technical assistance• Regional learning collaboratives and

training sessions

Significant on-site consultation, coaching and training

Methods

Hands-on work with program and agency leadership, supervisor(s), and team members with special emphasis on employment specialists(s)

Significant on-site consultation, coaching and training

PROS Programs Now Involved• HALI• Clubhouse of Suffolk• FEGS• Federation of Organizations• Putnam Family and Community Services• Occupations, Inc.

Joining a Learning Collaborative

A learning collaborative establishes a resource panel who work with providers to improve outcomes through the use of basic quality improvement strategies.

Learning Collaborative

• 69 PROS programs and soon-to-be PROS programs now participating

• Implementation support for program leaders

• Training for employment staff


Methods• Regional meetings• Regional conference calls• Program-specific consultation calls• Webinars


Examples of activities:

January regional conference calls with PROS program leadership focused on: • Engagement of staff, consumers and others• Adaptation of IPS fidelity to PROS• Updates on implementation efforts



February and April regional two-day training workshops for employment staff focused on 7 core clinical components of IPS, with lots for exercises, role plays and video



March statewide webinar for program leadership focusing on the use of an implementation guide – 18 questions that leadership may consider in developing program-specific implementation plans

Sample Training Exercise

This training exercise is used to teach employment staff about recovery values, engagement, and the “zero exclusion” principle of IPS. It raises issues that are then covered in a debriefing session.

Exercise

Person #1 is the consumer. You want to work full time. You have had some difficulty with drinking and smoking marijuana. You haven’t worked in 15 years, except for 4 months in a transitional employment position in a copy center two years ago.

Person #2 is the practitioner. You are convinced that this consumer should not be working at this point in time, for many reasons. Your task is to explain this to the consumer.

Additional Implementation Supports Under Development

Guidebook for consumers and staff (NASMHPD/SAMHSA grant)• Will focus on key activities for choosing, getting and keeping

competitive employment• Will be used by consumers working directly with employment

staff • Each topic will have

- Important information- Questions to answer/decisions to make/personalized

worksheet- Next steps

• Should reduce the need for staff training


Online training module

Introduction to IPS

Will include video clips. Examples may include:• consumer discussing how IPS helped him/her find and keep a

meaningful job • consumer discussing how fear about losing benefits hurt

motivation to work and once he/she learned the facts, his/her motivation increased tremendously

• consumer who had been actively using substances found the motivation to cut back on this use because he/she was working

• practitioner discussing how his/her attitude about zero exclusion has changed once working with consumers in IPS program


Online training module (continued)

Content outline• What is IPS?

• Why is it important?

• 7 key principles

• 7 core skill competencies

Building the Capacity of Psychiatric Rehabilitation Programs to Promote

Employment and Economic Self-SufficiencyUSPRA 2011Conference

Chacku Mathai, CPRP

Associate Executive Director

Oscar Jimenez, MPH

Director of Community and Economic Development

New York Association of Psychiatric Rehabilitation Services (NYAPRS)

Unemployment among adults in the Mental Health system in NYS

53

• Between 50% and 70% of adults in the MH system in NYS indicate that they want to work, but only 12% to 15% are actually employed (OMH, 2009)

• Less than ½ of those who work have a full-time job

• 40% of people with a mental disability live in poverty (American Community Survey, 2008)

Poverty causes psychiatric disability!

• Living in poverty makes it more likely to develop serious psychiatric problems

• Not having enough resources contributes stress, anxiety, and depression

• Poverty is a barrier to rehabilitation, recovery and wellness

• Preventing and overcoming poverty MUST be a mission of mental health and rehabilitation programs! 54

The Systemic Barriers to Employment and Economic Inclusion

Institute for Community Inclusion- NYAPRS- Burton Blatt

Institute policy research project (2009-2010): • Illness-orientation still predominating in mental health, vocational

and workforce systems: limited capacity to facilitate full recovery in all areas of life, including employment and economic self-sufficiency.

• Availability, accessibility and utilization of employment services seriously compromised by fragmentation:– “Silo” funding structures, – Services not well-coordinated – duplication of services and inefficiency in the use of available resources,– complex eligibility criteria, – lack of prompt access to services– and limited program capacity to provide integrated care that addresses

mental health, vocational, and wraparound support needs.

• Misinformation, isolation and lack of hope

Key Recommendations:• Build upon ongoing transformation initiatives in order to improve the

systemic capacity for providing recovery-oriented employment services in ways that:– maximize the utilization of funding available, – integrate recovery-oriented mental health, vocational and

wraparound services– increase accessibility to services, and – improve economic self-sufficiency outcomes

Want more information or a copy of the report?

“Policy and Programmatic Recommendations to Address the Systemic Barriers to Employment of People with Psychiatric Disabilities in New York State: A Report to the NYS MIG” (Marrone, J., Jimenez, O, Mathai, C., et al, 2010) at:

http://www.ilr.cornell.edu/edi/nymakesworkpay/docs/MIG_policy_recommend_report_012010.pdf



Growing PROS license in NYS: Key Opportunity

20062007

20082009

2010-June

2010-Dece

mber

2011-June

010203040506070

Number of Personalized Recovery-Oriented Services (PROS) in New York State

The Ticket–to-Work Program: Opportunities for braided funding

• The Ticket-to-Work (TTW) program: long-term and sustainable opportunity for PROS programs to increase scope and intensity of services to meet the complex employment support needs of individuals with psychiatric disabilities in NYS:– A focus on promoting long-term employment and greater

levels of economic self-sufficiency that provides ongoing funding for an extended period of time;

– A flexible funding source for program areas not funded through Medicaid, such as general job development, job coaching, peer support, career advancement, and asset development strategies; and

– A stable funding stream authorized through a federally-funded program and Ticket-to-Work legislation.

Challenges and Opportunities for Implementing the Ticket-to-Work Program

• Misconceptions about, and negative attitudes towards, the TTW• Little or no information about the (2008) TTW regulation changes • A training needs survey revealed that PROS administrators identified

several perceived barriers to becoming an Employment Network, with half to two-thirds indicating that:– The payment scheme was unrealistic for the earning potential of their

program participants, and too complex; – They felt not to have the necessary staff – The upfront costs to implement the program were too high.

• Multiple supports were available to NYS providers for establishing and operating Employment Networks (e.g., CESSI, MAXIMUS), but providers were often confused about the many online resources, technical assistance organizations, events, and contact persons.

Providers’ perceptions about the economic self-sufficiency potential of participants

What proportion of

your participants do

you believe could…?

Control their own finances

Earn enough to depend less on

benefits

Earn enough to save and build

assets

Earn enough to get off of benefits

Less than 20% 19% 24% 39% 48%

21% to 40% 23% 33% 24% 24%

41% to 60% 17% 15% 17% 10%

More than 60% 37% 26% 20% 16%

Provider survey with administrators and middle-management (n=70) in Jan 2010

Providers’ knowledge about economic self-sufficiency supports in the community

Providers indicated to have significant knowledge about:

• Financial education supports : 81%• Earned Income Tax Credit and tax

preparation assistance: 67%• First-time home-buyer programs: 60%• Individual Development Accounts: 27% • entrepreneurship opportunities: 27%• Asset development coalitions in my

community: 27%

61

Providers’ perceptions about the importance of and their potential to promoting self-sufficiency

Providers agreed or strongly agreed to the following:• It is important for our program and similar programs

to provide information about economic self-sufficiency supports : 92%

• Currently, our program provides individuals with economic self-sufficiency supports : 46%

• With our current level of staff, training and capacity our program can provide economic self-sufficiency supports: 19%

• With training and technical assistance, our program can provide economic self-sufficiency supports: 69%

62

Level of Desire to Seek Work and Economic Self-sufficiency among PROS Participants *

Do you want?Paid job in community

Earn enough to build assets

**Earn enough to make choices

Earn enough to get off benefits

Yes 60.8% 68.0% 82.5% 62.0%

I don’t know 27.5% 20.0% 7.5% 12.0%

No 11.8% 12.0% 10.0% 26.0%

Total 100.0% 100.0% 100.0% 100.0%

* Survey with participants of PROS programs (n=71) in December 2010-January 2011

Level of Self-Efficacy to Seek Work and Economic Self-sufficiency among PROS Participants *

Do you believe you

could?

Have a paid job in

community

Control how you spend on a daily

basis

Earn enough to save and build assets

Earn enough to depend

less on benefits

Earn enough to get off of

benefits

Agree 63.3% 87.2% 61.7% 53.2% 29.2%

I’m not sure 22.4% 8.5% 17.0% 17.0% 31.3%

Disagree 14.3% 4.3% 21.3% 29.8% 39.6%

Total 100.0% 100.0% 100.0% 100.0% 100.0%

* Survey with participants of PROS programs (n=71) in December 2010-January 2011

PROS WORKS! Project Strategies and Activities

• Implementation-oriented training and TA: Tools for Ticket assignment, provision of services, tracking of outcomes and billing

• Web-based seminars:– Ticket 101: Introductory webinar – Ticket 201: Application walk-thru webinar– Ticket 301: Training on Operating an

Employment Network– Ticket 302: Tools for Ticket Assignment and

Tracking Milestones/Outcomes • Individualized Technical Assistance (face-to-

face, electronic, phone)

Composition of Programs Engaged in Project Activities by PROS Status

PROS Licensed35.3% (n=53)

Developing PROS 19.3% (n=29)

Interested in Developing

PROS 20.0% (n=30)

Not Interested in Developing PROS

8.7% (n=13)

Other 16.7% (n=25)

Composition of Ticket Training Series Attendance by PROS Status

T101T201

T101&/or T201 T301

T302

0%

20%

40%

60%

80%

100%

3.0% 10.8%5.7% 12.9%

9.1%

17.9%21.6%

21.6% 12.9%

9.1%

29.9%24.3%

26.1%21.4%

15.9%

38.8% 29.7% 35.2%

35.7%

45.5%

10.4%13.5% 11.4%

17.1%20.5% Other

PROS Licensed

Developing PROS

Interested in Developing PROS

Not Interested in PROS

Ticket Training Series Event

Com

posi

tion

of T

rain

ing

Even

t A

tten

danc

e n=67 n=37 n=88 n=70 n=44

Improvements in implementation-related knowledge

• On a scale of 1-10, the average self-perceived knowledge increased from 3.66 (Pre Ticket 301) to 6.45 (Post ticket 301)

• Over 80% of Ticket 301 participants indicated that they received information about key aspects of Employment Network operation, including:– Developing a business model;– Braiding TTW funding with Medicaid, State aid and other

sources;– Recruiting and assessing individuals for the TTW program; – Developing Individual Work Plan (IWPs);– Tracking and billing for Ticket milestones and outcomes; &– Accessing work incentives, financial education and asset

development.

Comparison of EN Status among PROS-Licensed Programs at Baseline (June-July 2010) vs.

End-of-Intervention (December 2010)

Not interested Interested in EN

Applying EN Certified ENs0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

5.4%

37.8%

10.8%

45.0%

20%22%

58%

June-July '10 (Base-line)

December '10

Employment Network Status by PROS Status (December 2010)

PROS Licensed Not PROS Licensed

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%

58.0%

25.8%

42.0%

74.2%

Employment Network

Not Employ-ment Network

Increase in Employment Network Activity in 2010: Number of Assigned Tickets and Revenue among

Agencies with PROS-ENs

January 2010 June 2010 November 2010

Number of Tickets

49 58 87

Revenue $66,164 $77,553 $127,817

Cumulative data provided by MAXIMUS (January, 2011) in regards to 17 agencies with PROS licenses by the end of November 2010.

Conclusions and recommendations

• The outcomes of and data generated by this project suggest that a training and TA intervention to improve the number and capacity of mental health programs providing Employment Network services is feasible, and may indeed increase significantly the knowledge and implementation capacity of providers in regards to the Ticket-to-Work program.

Conclusions and recommendations• The overall level of readiness of PROS participants to pursue

employment and increasing levels of self-sufficiency indicate a significant potential for the expansion of the Ticket to Work program in New York State.

• More than two-thirds of PROS participants indicate a desire to achieve greater levels of self-sufficiency. However: – Less than half believe they can rely less on benefits– Less than one-third believe they can end their dependency on benefits. – About sixty-percent had never heard about the Medicaid Buy-In for

Working People with Disabilities or Ticket-to-Work programs– Less than 10% had heard about the Earned Income Tax Credit, PASS and

other economic supports. • Individuals receiving services ought be engaged in activities and

support to improve their sense of hope and self-efficacy.

Conclusions and recommendations

• A majority of providers find crucial to offer economic self-sufficiency supports. However:– Most providers feel that only a minority of program participants can

achieve Ticket-to-Work earning levels and higher levels of self-sufficiency.

– A comparison between the consumer and provider surveys suggest a twenty to forty percent gap in the perceived efficacy of program participants to achieve greater levels of self-sufficiency, with a much less optimistic view among providers.

• Providers ought to receive information about the high level of desire among program participants to pursue work and economic self-sufficiency.

• Goal: Build hope and share information to improve employment and economic self-sufficiency

• Key Strategies and Outcomes:• Established grassroots advisory committee (2008)• Developed and distributed recovery-oriented tools :

– WE Can Work: The Employment Tool: over 7,500 copies (2008-2011)

– WE Can Work DVD: Our Stories of Recovery and Employment Success: over 500 copies (2009-2011)

• Training of regional Peer Facilitators: 55 (2010-2011)• Reaching directly over 2,000 people in recovery and

providers through workshops at statewide conferences, regional forums, and program-based events and several thousand more indirectly (2008-2011)

A Provider’s Guide to Promoting Economic Self-sufficiency:

A recovery-oriented approach

A Workbook for People in Recovery Seeking Economic Self-sufficiency

Oscar Jimenez, MPH

Kelly Stengel, MPH

Leslie Kuhn, MPH

7th NYAPRS Executive Seminar (April 27-28, 2011)

New York Association of Psychiatric Rehabilitation Services

Provider Guide: Contents Lesson 1: Why Is Economic Self-sufficiency Important to

Recovery?

Lesson 2: What Can Providers Do to Support Economic Self-

Sufficiency?

A recovery-oriented approach to financial wellness

What providers can do to support economic self-sufficiency: An overview Engaging individuals through conversations about life dreams Assessing readiness to pursue economic self-sufficiency Developing readiness to pursue economic self-sufficiency Creating a plan towards self-sufficiency Empowering through financial skills and asset-building Linking and referring individuals to economic self-sufficiency services

Lesson 3: Strategies and Tools to Engage, Assess and Develop

Readiness towards Economic Self-Sufficiency

Lesson 4: Strategies and Tools to Create a Plan towards Self-sufficiency

Lesson 5: Strategies and Tools to Empower through Financial Skills and Asset-building

– Module 1: Budgeting – Module 2: Accessing work incentives to increase earned income– Module 3: Filing taxes– Module 4: Saving – Module 5: Clearing and building credit – Module 6: Dealing with predatory lending – Module 7: Getting help with addictions and financial stressors– Module 8: Increasing social capital– Module 9: Essential skills to achieve self-sufficiency: a review – Module 10: Accessing services and supports to pursue self-sufficiency

Lesson 6: Developing programs to promote self-sufficiency

Provider Guide: Contents

Contact information

Chacku Mathai, CPRP


[email protected]

518-527-3651

Oscar Jimenez, MPH


[email protected]

518-436-0008


mailto:[email protected]


Provider Guide: Contents Lesson 1: Why Is Economic Self-sufficiency Important to

Recovery?

Lesson 2: What Can Providers Do to Support Economic Self-

Sufficiency?

A recovery-oriented approach to financial wellness

What providers can do to support economic self-sufficiency: An overview Engaging individuals through conversations about life dreams Assessing readiness to pursue economic self-sufficiency Developing readiness to pursue economic self-sufficiency Creating a plan towards self-sufficiency Empowering through financial skills and asset-building Linking and referring individuals to economic self-sufficiency services

Lesson 3: Strategies and Tools to Engage, Assess and Develop

Readiness towards Economic Self-Sufficiency

Lesson 4: Strategies and Tools to Create a Plan towards Self-sufficiency

Lesson 5: Strategies and Tools to Empower through Financial Skills and Asset-building

– Module 1: Budgeting – Module 2: Accessing work incentives to increase earned income– Module 3: Filing taxes– Module 4: Saving – Module 5: Clearing and building credit – Module 6: Dealing with predatory lending – Module 7: Getting help with addictions and financial stressors– Module 8: Increasing social capital– Module 9: Essential skills to achieve self-sufficiency: a review – Module 10: Accessing services and supports to pursue self-sufficiency

Lesson 6: Developing programs to promote self-sufficiency

Provider Guide: Contents

Contact information

Chacku Mathai, CPRP


[email protected]

518-527-3651

Oscar Jimenez, MPH


[email protected]

518-436-0008




Working TogetherThe Key to ImprovingEmployment Services & Outcomes

Aaron Vieira, LMSWAssociate Director

Center for Rehabilitation and RecoveryThe Coalition of Behavioral Health Agencies90 Broad Street, 8th FloorNew York, NY 10004212.742.1600 [email protected] www.coalitionny.org

CenterforRehabilitationandRecovery

USPRA 36th Annual Conference / June 13-16, 2011 / Boston, MA 85


http://www.coalitionny.org/

CenterforRehabilitationandRecoveryPresentation Objectives

• Describe CCRR’s contribution to NYS OMH’s employment initiative;

• Explain CCRR’s approach to collective transformation;

• Discuss tools used to engage stakeholders in authentic conversation and action.


CenterforRehabilitationandRecoveryCCRR’s Work on Employment

• Support NYC agencies in implementing PROS programs.

• Deliver training on “IPS Supported Employment” and “Benefits Management” to direct service providers.

• Organize and participate in conferences on Economic Self-Sufficiency.

• Developed and maintain The WORKbook, an online guide to NYC’s mental health employment programs.

• Developed and maintain a “Peer Job Board” to facilitate the hiring of peers in community rehabilitation programs like PROS.

• Conducted strategic outreach to increase awareness and enrollment in MBI-WPD, as part of NY MIG grant.

• Coordinate efforts with NYS OMH, NYC DOHMH, CPI, NYAPRS, and NYRSA.


CenterforRehabilitationandRecoveryThe Challenge of Transformation

• How do we improve employment services in systems and organizations?

– WRONG QUESTION! We know what works, but we’re not doing it.


We cannot solve our problems with the same thinking we used when we created them.

Albert Einstein

CenterforRehabilitationandRecoveryThe Challenge of Transformation

• How do we engage people in ways that inspire commitment and accountability for change?

– RIGHT QUESTION! Developing answers to this question requires a shift in awareness, a new mental model.


If we change the system, but don’t change ourselves, nothing will really change.

Mark Ragins, MD

CenterforRehabilitationandRecoveryThe Key to Successful Transformation

• ENGAGEMENT is key– The way we gather together

to create and problem solveis what matters most.

– Shifts in intangibles — relationships, motivation, commitment and accountability — are what make transformation succeed.*

*Adapted from work of Peter Block.


CenterforRehabilitationandRecoveryCCRR’s Approach to Transformation

• Values Driven Approach– Center staff make a conscious effort to apply recovery

values in our internal operations & external activities• We emphasize hope, strengths, shared decision-making,

responsibility and positive outcomes when interacting with each other and stakeholders.

• Methodology: Focus on Relationship & Process– Convene meetings in ways that promote inclusion,

collaboration, and commitment to improve access to and quality of employment services.


CenterforRehabilitationandRecoveryCCRR’s Approach to Transformation

• Values into Action– Supporting NYC agencies in implementing PROS

• Convene 4 “NYC PROS Learning Collaborative” mtgs per yr– Clarifying the intent

– The invitation

– Setting the context

– Structuring the experience

– Maximizing participation

– Authentic conversation

– Creating

– Commitment to action


Approach informed by work of Craig and Patricia Neal

CenterforRehabilitationandRecoveryTools to Engage Stakeholders

• Assessing Readiness to Change– Engaging questions:

• Do you feel our program needs to convert to PROS? Why or why not?

• If we did convert, what would motivate you to take part in the conversion process?

• How will PROS improve services, such as employment?

• What risks do you see in converting our program to PROS?

• What could leadership be doing to demonstrate that PROS would be a different, more improved program?

• What would interfere with your desire/ability to take part in the PROS conversion process?



• Inspiring a Shared Vision– Meaningful process


Reflect on the Past

Attend to the Present

Envision the Future


• Inspiring a Shared VisionReflect on the Past

• What did we like and not like about our old program?

• What elements of our old program can we preserve in PROS?

• What elements of our old program must we let go of?

Attend to the Present

• What changes do we see taking place among the people that we serve?

• What are the most influential trends in our field?

• What resources will we have available to create a PROS program?

Envision the Future

• What do we want to create together?

• What will our PROS program look like?


CenterforRehabilitationandRecoveryBenefits of Authentic Engagement

• Authentic Engagement leads to….


These process improvements are critical to achieving better outcomes.

Why?

Because quality improvement is always local, customized, unfolding and emergent. So we need to work together more closely to improve our system, organizations and ourselves!

Greater Energy

Better Relationships

More Creativity

Innovative Solutions

Stronger Commitment

Increased Accountability

Documents

1. 2 NYS OMH Commissioner Michael Hogan targeted improving employment outcomes for people with psychiatric disabilities. The NYS Most Integrated Setting