Building Bridges for Building Bridges for EmploymentEmployment
Presented byPresented byAndy Sink, Liam McNabb and Jill Dorsi, NYS Office of Mental HealthAndy Sink, Liam McNabb and Jill Dorsi, NYS Office of Mental Health
Dan O’Shea, ACCES-VRDan O’Shea, ACCES-VR&&
Crystal Collins, Northeast Career Planning/PROS on BroadwayCrystal Collins, Northeast Career Planning/PROS on BroadwayAPSE Conference, May 2014APSE Conference, May 2014
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• 78% of people who are diagnosed with a 78% of people who are diagnosed with a serious mental illness are unemployed serious mental illness are unemployed
(2006)(2006)• This rate is lower than for people with other This rate is lower than for people with other
disabilities disabilities (30% employed vs 22%)(30% employed vs 22%)
• Stigma and misunderstanding of mental Stigma and misunderstanding of mental illness present a significant barrier to illness present a significant barrier to
employmentemployment
Employment and Mental IllnessEmployment and Mental Illness
SAMSHA Employment Intervention SAMSHA Employment Intervention Demonstration Program Demonstration Program
5 year study of employment programs 5 year study of employment programs nationwide evaluated a variety of supported nationwide evaluated a variety of supported employment approachesemployment approaches
Most successful outcomes occurred when:Most successful outcomes occurred when:programs integrated mental health services with programs integrated mental health services with
vocational servicesvocational services focused on rapid placement into jobs of the focused on rapid placement into jobs of the
person’s choiceperson’s choicecollaboration between the support providers and collaboration between the support providers and
the businesses employing the individualsthe businesses employing the individuals
Source: Supported Employment: a guide for mental health planning and advisory councils. www.samsha.gov
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Through integration and collaboration multiple Through integration and collaboration multiple barriers to employment can be overcomebarriers to employment can be overcome
Updates on Collaboration EffortsUpdates on Collaboration Efforts
Improved lines of communication between VR Improved lines of communication between VR Counselors and PROS practitionersCounselors and PROS practitioners
Worked together to update PROS Guidance Worked together to update PROS Guidance Documents for implementing ACCES-VR Documents for implementing ACCES-VR supports in combination with PROS Servicessupports in combination with PROS Services
ACCES-VR staff have presented at OMH Field ACCES-VR staff have presented at OMH Field Offices and with PROS providers and PROS staff Offices and with PROS providers and PROS staff have provided training to VR Counselorshave provided training to VR Counselors
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What we discovered…What we discovered… PROS is able to integrate mental health PROS is able to integrate mental health
supports in conjunction with supports supports in conjunction with supports provided to people through ACCES-VRprovided to people through ACCES-VR
Liaison connections between the PROS Liaison connections between the PROS and ACCES-VR office are essential to and ACCES-VR office are essential to seamless integrationseamless integration
How to coordinate ACCES-VR CRS How to coordinate ACCES-VR CRS Milestone Payments with PROS Ongoing Milestone Payments with PROS Ongoing Rehabilitation and Supports (ORS)Rehabilitation and Supports (ORS)
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What is PROS?What is PROS? Personalized Recovery-Oriented ServicesPersonalized Recovery-Oriented Services
Rehabilitation program with a treatment componentRehabilitation program with a treatment component
Core Value: Recovery is a reality for people with Core Value: Recovery is a reality for people with severe and persistent mental illnesssevere and persistent mental illness
PROS provides individualized services and PROS provides individualized services and interventions to support employmentinterventions to support employment
PROS Services and ACCES-VR Supports can work PROS Services and ACCES-VR Supports can work together to achieve employment goalstogether to achieve employment goals
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PROS Services that can be used PROS Services that can be used to support employmentto support employment
Intensive Rehabilitation Goal AcquisitionIntensive Rehabilitation Goal AcquisitionBenefits and Financial ManagementBenefits and Financial ManagementMedication ManagementMedication ManagementIntensive Relapse PreventionIntensive Relapse PreventionBasic Living Skills Basic Living Skills Structured Skill DevelopmentStructured Skill DevelopmentClinical Treatment Services/Health Clinical Treatment Services/Health
AssessmentAssessment
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Supporting PROS Participants Supporting PROS Participants who don’t have Medicaidwho don’t have Medicaid
Lack of Medicaid coverage DOES NOT prevent a Lack of Medicaid coverage DOES NOT prevent a person from receiving PROS Servicesperson from receiving PROS Services
Net deficit fundingNet deficit funding: PROS providers receive : PROS providers receive funding to offset providing supports to individuals funding to offset providing supports to individuals
without Medicaidwithout Medicaid
Sliding fee scalesSliding fee scales: PROS providers must charge : PROS providers must charge for PROS Services but can use a sliding scale to for PROS Services but can use a sliding scale to
make services affordablemake services affordable
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Managing Benefits to Support Managing Benefits to Support EmploymentEmployment
PROS Service: Benefits and Financial PROS Service: Benefits and Financial Management can provide informationManagement can provide information
Learn about SSI -budgeting protocol includingLearn about SSI -budgeting protocol includingPASS: Plan to Achieve Self SupportPASS: Plan to Achieve Self SupportIRWE: Impairment Related Work ExpensesIRWE: Impairment Related Work ExpensesMedicaid Buy-in: Allows individuals to work Medicaid Buy-in: Allows individuals to work
and continue to access Medicaid health and continue to access Medicaid health coveragecoverage
Hand-out: web addresses for more informationHand-out: web addresses for more information
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ACCES-VR MILESTONES & ACCES-VR MILESTONES & PROS ORSPROS ORS
How do the new ACCES-VR Milestone How do the new ACCES-VR Milestone Supported Employment payments work with Supported Employment payments work with PROS ORS?PROS ORS?
Assuring milestone payments are billed before Assuring milestone payments are billed before any ORS (extended services) are providedany ORS (extended services) are provided
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Quality Outcome PaymentsQuality Outcome Payments Incentive payment for providers Incentive payment for providers
Bonus to provider for obtaining Bonus to provider for obtaining employment at higher hourly wage employment at higher hourly wage and/or more than 30 hours/weekand/or more than 30 hours/week
Bonus payment and ORS: conflicts?Bonus payment and ORS: conflicts?
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Coordinating Supports Coordinating Supports through “non-PROS” Agenciesthrough “non-PROS” Agencies What happens when a non-PROS agency What happens when a non-PROS agency
provides ACCES Intensive Supports and provides ACCES Intensive Supports and a PROS provides ongoing supports?a PROS provides ongoing supports?
Example: Putnam CountyExample: Putnam County
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Additional ACCES-VR ServicesAdditional ACCES-VR Services Education: college tuition and room and board; Education: college tuition and room and board;
vocational training vocational training – Work Try-Outs (WTO) & On The Job Training (OJT) Work Try-Outs (WTO) & On The Job Training (OJT)
Career counseling & guidanceCareer counseling & guidance Rehabilitation & assistive technologyRehabilitation & assistive technology Assessment to identify skills, interests, abilities, Assessment to identify skills, interests, abilities,
and limitationsand limitations Job placement and job retentionJob placement and job retention
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Best Practices: Best Practices: Northeast Career PlanningNortheast Career Planning
Identifying point person/liaison at ACCES-VR Identifying point person/liaison at ACCES-VR local office: makes collaboration easier and local office: makes collaboration easier and more effectivemore effective
Referrals go both ways: PROS to ACCES-VR; Referrals go both ways: PROS to ACCES-VR; ACCES-VR to PROS: identify barriers to ACCES-VR to PROS: identify barriers to employment and necessary supportsemployment and necessary supports
Invite local ACCES-VR office into PROS to share Invite local ACCES-VR office into PROS to share information with participants and practitionersinformation with participants and practitioners
Providing ORS to people who don’t have Providing ORS to people who don’t have MedicaidMedicaid
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PRINCIPLES INFORMING PRINCIPLES INFORMING PRACTICEPRACTICE
For the first time, the OMH model of For the first time, the OMH model of choice is a rehabilitation modelchoice is a rehabilitation modelImplementing IPS and Supported Implementing IPS and Supported Employment principles in your PROS is Employment principles in your PROS is not only possible, it’s a must! not only possible, it’s a must! Unique opportunity for doing Unique opportunity for doing real real rehab…rehab…
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Overlapping Circles of SupportOverlapping Circles of Support PROS and PROS and
Supported Supported Employment Employment programs overlap programs overlap
No wrong door of No wrong door of entryentry
PROS and ACCES-PROS and ACCES-VR Services can VR Services can be simultaneousbe simultaneous
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SOCIALSUPPORTS
HOUSINGSUPPORTS
SOCIALIZE
LIVE
PROSEMPLOYMENTSERVICES WORK EDUCATION
SUPPORTSLEARN
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Working together improves employment outcomes
Discussion & CommentsDiscussion & Comments