DVR Supported Employment Service Provider Training

2016Shannon Huff

Clear Vision Consulting LLC

Overview

• Supported Employment Overview• Transitioning to Long Term Support • Best Practices to Include in Your Supported Employment Service

Provision

1992DVR focus on Competitive,

Integrated Employment

1990 IDEA

1986 Supported

Employment in Rehab Act as viable DVR

Outcome

1983 Supported

Employment Services added

to WI CIP Waivers

1973VR serves

people with severe

disabilities

Prior to 1970, few people with significant disabilities were included in the workforce.

Important changes have occurred. These changes have begun to change outdated programs and attitudes.

2015WIOA

2014HCBS

Settings Rule

2013DVR Fully Funded

2011 CMS

Guidance to States

2007 Family Care &

IRIS

2004 IDEA

Enhanced

1994DVR Order

of Selection

Prior to 1997, a person with DD must have been institutionalized at some point in their life to receive Supported Employment services.

Never before have we seen our systems so aligned to support people with significant disabilities to work in the community.

Supported Employment Principles

• Anyone can work with the right job match and the right support

• Genuine Integration and Contribution• Informed Choice and Self-Determination• Individualized and Person-Centered –

individual’s interests, strengths, skills and preferences drive the job search and job match

• Beyond Available Jobs• Opportunities for growth, skill building and

advancement

The Supported Employment DifferenceAssessment Non-comparative – What CAN the person do?

Not about readiness – What is the best fit NOW? How can barriers/challenges be addressed and managed WITH SUPPORT?

Planning Teamwork - Not just the job developer and job seeker Exploration and validation – finding the path and facilitating informed choice through experiences

Job Search Beyond open available jobs – networking, customization and job carving

Ongoing Support

Combination of natural support, job coaching and assistive technologyOn and off-the-job supports

Transitioning to Long Term Supports

Begin with the End In Mind1. When and where is the person at their best?

• Best time of day• Best environments• Best people • Transferable skills to maximize independence

2. Transportation • Proximity• Time of day• Sustainable options

3. Support• Amount of formal supports preferred and available (MCO guidelines & IRIS Budget)• Best ways for optimizing informal or natural support• Off-the-Job needs

Personality, Interests & Motivators

Environments & People

Skills & Experiences

?

Brainstorm with the team to get outside the typical job box.

Think Themes, Not Jobs.

Transportation & Targeted Job Seeking

Consider All the Options: • Where is transportation available? • When is transportation available? • Is it flexible? Is it reliable? • How much does it cost? • Is it a reasonable and sustainable

option over the long term? • Can the person use IRWE for

transportation?

Area it is available Times it is available Flexible?(check if yes)

Reliable?(check if yes)

Cost per ride (one way)

Training or Support Needed? (check if yes)

Long-term Option? (check if yes)

Walking

Biking

Public bus

Rides from family members

Ride Share - community member/coworker

Taxi

Driver’s license

Specialized transportation

Rides from job coach

Other:

Supported Employment & Long Term Care

• Involvement of Care Manager or IRIS Consultant• Employment Outcome on LTC Plan • Coordinating Plans with DVR - “Payer of Last Resort” • Job Hire – meet to discuss timelines and fading• Waiver Funds not for supervision, training, support and adaptations

typically available to other non-disabled workers filling similar positions in the business

• Funds cannot be used as incentive payments to employer or wages to worker

• Co-Worker Supports and SDS Independent Supports as long-term options• Personal care/assistance may be included in the reimbursement paid to the

supported employment provider, or may be reimbursed under the waiver service supportive home care or self-directed personal care.

Support & Forecasting Job Stability:

With the team, discuss: • Role of the job coach • Preferences or concerns of the job

seeker/family• MCO guidelines and expectations • SDS/IRIS Budget • DVR Timelines• Consider all methods of support

(informal/natural, assistive tech, job coach, personal care, workplace personal assistance)

Designing Long-Term Employment Supports

On-the-Job Supports: • Paying employers and co-workers for supports - Partners with Business Toolkit www.letsgettoworkwi.org• Hiring a family member or supportive home staff to provide job coaching supports• Workplace Personal Assistance• Using Assistive Technology • Individualized services from providers

Transportation for Work:• Paying co-workers for transportation• Mileage reimbursement for rideshare• Using supportive home staff to drive you to work• Traditional transportation options

Start to Develop Natural Supports the first day on the job

Questions to Consider:

• Have gains been made with fading? Is there potential for more fading? • Have natural supports been developed? • Have gains been made with independence? Can the person become more

independent? • Is person meeting the employer’s standards with as little support as possible given

their abilities? • If you believe the person has reached the highest level of independence possible,

what evidence do you have? • Will the available long term supports be adequate to help the person maintain this job? • When in doubt, continue support to ensure successful transfer. Avoid rushing and putting

the job in jeopardy!

LTC Principles for Authorizing Job Coaching

• How many hours per week is the member working? • How long has the member been in the job, including any time when the

member's on-the-job supports were funded by DVR or the school system?• How long has the member been at the current level of job coaching support?• Has there been any recent changes impacting the member’s need for job

coaching?• What were the results of member's most recent performance reviews by his/her

employer/supervisor?• How does the member (and guardian if one is appointed) feel?• What is the opinion of the job coach?• What is the opinion of the employer/supervisor ?• What are the individual member's unique support needs?

From WI DHS Family Care - RS Memo 12-02

Case Scenario 1

After 8 months of job coaching, fading (but remaining on site) and developing natural supports, Kim is working more or less independently on the job. However, her supervisor knows that there is a slim chance that Kim could have a seizure at work. He is concerned and wants the job coach to stay near Kim during her entire shift. Kimscare manager will not authorize 100% job coaching on her plan. What avenues can you pursue to move Kim closer to transfer to long term support?

Case Scenario 2

• Andres lives 20 miles from his job and does not have public transportation available to him. He works a 3 hour shift every weekday morning. He needs job coaching intermittently – but not always consistently - through his shift for some reminders to stay on task and not wander away, assistance getting supplies ready for new projects if assigned, knowing when to come back from break, and checking his work quality on certain tasks. The supported employment agency has been taking him to work and staying on the job site even though he doesn’t need support 100% every shift because the shift is short and they cannot get to another job site and back in time. His IRIS budget cannot not cover the job coach to take him to and from work and stay on the site. What options to you have to move Andres closer to transfer to long term support?

Part 2: Best Practices and Communications

Don’t Go it Alone

Benefits of Cultivating a Supported Employment Resource Team: • Complete Information• More Effective Communication - Sharing Info

Saves Time and Mistakes• Job Seeker Support and Encouragement• Creative Ideas, Resources, and Job Leads• Braiding Resources• Higher Expectations and Accountability (Yours

and theirs!) • Consumer Satisfaction

Bad Listening Habits Activity

Interrupting, impatient Finishing the other person’s

sentences Faking attention Jumping to conclusionsNot providing a response Making up your mind before

having all the informationChoosing/focusing only on what is

easy

Answering with advice – being parental Taking notes compulsively Becoming contrary or defensive when

hearing information you don’t agree with Abruptly changing the subject Responding by talking about your own

experiences Thinking more about your response

than what the person is saying

Teamwork makes the dream work, but a vision becomes a nightmare when the leader has a big

dream and a bad team. John C. Maxwell

Effective Partnering Tips

Understand organizational structure Understand organizational rolesUnderstand organizational goalsUnderstand what similarities/differences exist

12 Practical Tips for Effective Team Meetings

1. Ask team members to talk about their roles with each other.2. Get the team together regularly.3. Establish a meeting agenda.4. Ask someone to take notes.5. Start each meeting by reviewing where you are at in the planning

process and what you’ve done since the last time you met.6. Use the meetings to problem solve and get ideas from your team

members.

12 Practical Tips for Effective Team Meetings

7. Foster collaboration and a positive outlook. 8. Summarize the plan of action at the end of the meeting.9. Create a “to do” list with a name attached to each action item.10. Set a date and time for the next meeting before the meeting ends.11. Send a summary of the meeting and the “to do list” to all team

members.12. Check in with team members between meetings to let them know

what you’ve accomplished and ask what they have done on your behalf.

Family Involvement

‘We found that young adults with significant disabilities whose parents definitely expected them to obtain post-school work way back in high school were more than five times as likely to have paid, community employment within two years after exiting…

The unexpected finding was that these expectations were a stronger predictor than anything else we examined…’

Carter, Austin, & Trainor, 2012

Ways to Collaborate with Families

• Identifying Transferable Skills • Developing and Reinforcing Skills• Creating a List of Favorite Places • Determining Support Needs • Developing a Set of Ideal Conditions • Identifying Non-Negotiables• Creating a List of Connections• Building Work Ethic

Point of View - Factors that Hinder Family Involvement

• Navigating and accessing multiple, complex, and fragmented systems

• Understanding roles, processes, and supports available• Using the “correct language” and rationales to justify

services• “Systems Trauma”• Learned Dependency• Feeling judged by professionals• Exhausted from caring for their loved one• Thinking about disability first – rather than strengths and

vocational themes

Top 10 Tips for Involving Families

1. Provide strong coordination of services with other resources/programs.

2. Recognize the influence you have and use it positively to enhance partnership.

3. Take time to listen and learn –respect their point of view.

4. Reduce hoops that hamper communication and timely progress.

Top 10 Tips for Involving Families

5. Provide context and summarize plan of action.

6. Break down large processes into achievable, specific tasks.

7. Find flexibility in the program to respond to individual needs.

Top 10 Tips for Involving Families

8 . Clarify roles and responsibilities.

9. Discuss self-determination and what it means with the services you are providing.

10. Provide information multiple times & ongoing.

Best Practices to Include in Your SE Service Provision • Creating Urgency and Rapid Engagement • Strengths-based Assessment• Team-based Planning (which we already covered!)• Tapping the Hidden Job Market – Community and Relationship

Mapping• Informational Interviews, Job Shadows, Tours for Identifying Employer

Needs• Intentional development of Natural Supports Natural Supports

Tips for Involving Job Seekers with Significant Disabilities

• Worksheets• Drawing• On-line modules• Pictures • Collages• Focus on interests & Motivators• Provide processing time• Observation/Discovery• Set up new experiences• Motivational Interviewing -

OARS

Strengths-Based Assessment

• Focused on positives and strengths of the person

• Thoughtful evaluation of self-determination skills and how they can be enhanced/supported

• Honors point of view – what have we seen or heard?

• Assumes we are valuing the person and what they want to achieve more than the service

Community and Relationship Mapping:

David Wetherow

If we only look to services: If we start with Community:

We exist in a world focused on needs, deficits and competition for scarce resources.

We exist in a world of connections, interests,

contribution, and cooperation.

5 Ideas Activity

Networked Job Development

Community AffiliationsMine and My People

Places/Work/LearningMine and My People

Skills/InterestsMine and My People

38

Mitch is a 17 year old guy who is very social . He wants to get more involved in his community and e is

looking for his first job. He likes books, people, animals and

making food at home with his mom. He is active and wants to

live a healthy lifestyle. (Invitation and Networking MapCindy Kernan with Dave and

Faye Wetherow)

Names Their Place of Employment Their Interests & Community Involvement

1. Sandy2. Ralph3. Joe4. Sarah5. Eric6. Andrew7. Chris

1. Call Center Rep, Phoenix Services2. Service Specialist, Action HVAC3. Area Manager, Culvers4. Stay at home mom5. Customer Service, Sears6. Busser, Allen’s Kitchen7. Office at Kobeck Bus Company

1. Rotary Club, Weekly Book Club, & Library Volunteer2. Bowling League, yard work, making bird houses3. Chamber member, car racing, softball team4. Library Board, school volunteer, women’s group at

church5. Softball team, biking, going to the gym6. Car repair, movies, Karate7. Music, movies

1. Susan2. Franny

1. Art teacher, Wheaton Elementary & Part time Yoga Instructor

2. Choir Director at church, piano instructor

1. Volunteer for Very Special Arts, Painting and pottery, Humane Society volunteer

2. Music, church, Rotary Club, volunteer/writer with community newspaper

1. Allen2. Emily 3. Sue4. Mike

1. Barber at A Cut Above the Rest2. Respite staff, Kitchen Manager at

Fordem High School3. Respite staff, Case Manager,

Sumware County4. Support Staff, Options Day Services

1. Weightlifting, prepares food at shelter on weekends, hunting

2. Organizes a knitting group, volunteer at community gardens

3. Family farm (cattle), farmers market4. Going to the gym, biking, delivers pizzas part time for

Pizza Stop 39

Identifying Employer Unmet Needs• Unfinished work• Disorganization• Backlog, rush times• Unattended areas or materials• Customer dissatisfaction• Customers waiting• Missed opportunities • Errors or quality issues• Workflow management issues

• Employees being pulled from primary duties to complete episodic tasks

• Exact or detailed oriented tasks• Staff turnover• Seasonal work fluctuations, and • Future business growth/workplace

staffing needs

Natural Supports

• More likely when a good match is made• Begin to develop the first day on the

job!• Varies by individual and workplace –

Conduct a Workplace Analysis!• Supporting reciprocation and social

inclusion• Coworkers should never be expected to

replace paid supports such as personal care or specialized job coaching

Common Mistakes that Undermine Natural Supports:

• Developing jobs in isolated settings or in high turnover fields• Sharing concerns about the individual with the employer• “Hovering” and being the first point of contact at the job site.• Getting involved in employer functions and not having clear

boundaries with the employer• Failure to observe workplace culture and be intentional and

thoughtful about making connections. • Lack of patience and persistence!

Employment Support Professional Evaluation Tool

www.letsgettoworkwi.org/wp-content/uploads/2012/05/ESPro-Eval-Tool.pdf

Questions?

Far and away the best prize that life has to offer is the chance to work hard at work worth doing. - Theodore Roosevelt

Shannon Huff shannon@incontrolwisconsin.org

608-318-0700