Guide to customized/supported employment

Guide to Customized/ Supported Employment
The Georgia Department of Behavioral Health and Developmental Disabilities provides Supported Employment services as ongoing supports to assist individuals with disabilities in locating and maintaining meaningful employment in their communities. Supports are designed to capture the individual's strengths, needs, and interests.

Why Employment?
Most adults get a sense of identify and self-worth from employment. Our society values work and expects those of working age to be contributing members of the community. DBHDD is committed to assuring that the opportunity for employment is available to all who wish to participate. Recent National Core Indicators (NCI) indicate that when people in services were asked if they would like a job, 49% said yes.
Although nearly half of the people surveyed want a job, our data indicate that only 12% of all the people served are in supported employment. This is a concern because we know we can do better. The best performing state is Washington with 86% of the people with IDD served in supported employment. This guide outlines a new state funding structure that is available in addition to medicaid to provide long term supports. Georgia Vocational Rehabilitation Agency dollars are used to create the early job training supports. The outcome is that public dollars are used to maximum efficiency to support people who wish to work!
How does DBHDD work with GVRA?
GVRA's single mission is to assist people with a range of disabilities to enter or return to the workforce. This mission aligns with the DBHDD's interest in supporting people with

IDD in living a life so that their contribution to their communities is manifested. The Venn diagram below illustrates the area of collaboration:

Look at two agencies....

RSA
Time-limited services
All services geared toward
employment
GVRA providers
Serve people with a wide range of disabilities

Serve many of the same
people
Dual providers
Emphasis on community & employment

CMS
Long-term support
Wide variety of services
DD providers
Serve people with DD & BH (DD division serves
people with DD)

Federal legislation in the Workforce Innovation Opportunity Act (WIOA) and the settings rules as outlined in the Home and Community Based Services (HCBS) have created the perfect opportunity for collaboration between GVRA and the Division. WIOA requires that youth and others must be given the chance to work in a typical job at above minimum wage before they can work in a sheltered workshop at sub-minimum wage. Further, those working at sub-minimum wage must be given the opportunity annually to pursue regular wage employment. GVRA is the agency responsible for implementing these regulations.
The HCBS settings rules guide the use of medicaid funding. The rules focus on people receiving services in typical places with ordinary community members. When these rules are applied to work, this naturally means that people will have jobs with employers who employ other community members.

So how does this collaboration work?
GVRA funds time limited supported-employment services. There are two types of supported employment; traditional supported employment and customized supported employment. Both types require long-term follow-up support in order to assure continued success for people who experience the most significant disabilities. It is DBHDD's responsibility to provide those long-term supports.
GVRA has defined the phases of each of these forms of supported employment (SE) in the following way:
5 Phases of Traditional SE
1. Services Identification 2. Job Development/Placement 3. Training and Initiation of Ongoing Supports 4. Stabilization 5. VR Services Completion and Transition to Extended Services
6 Phases of Customized SE
1. Plan Meeting Service Identification 2. Discovery Assessment and Profile 3. Job Placement/Development 4. Training and initiation of Ongoing Supports 5. Stabilization 6. VR Services Completion and Transition to Extended Services
Many of the people who are served by both GVRA and the Division will qualify and benefit from Customized Supported Employment. Customized SE focuses on identifying a person's strengths, interests and contributions. This information is utilized to negotiate with an employer for a job that builds on these while simultaneously meeting an employer's unmet need. This form of employment is specialized and requires that employment specialists who offer this service must have advanced training and certification in Discovery. Some of the organizations that offer this training are Marc Gold and Associates, Griffin Hammis and APSE.
As has already been stated GVRA provides the early supports up through stabilization, which can occur as early as sixty days after a placement. It is at this point that new state funding offered by the DBHDD is implemented. This new funding strategy is called the Employment Express.

Employment Express
This funding is available as long as the job lasts and is paid at a monthly maintenance rate to the provider.
So who is eligible?
GVRA has a much broader eligibility than that of the DBHDD. People with IDD who meet the qualifications for the medicaid waiver but do not have waiver funding are eligible for the Employment Express. The graphics below illustrate the process:
EMPLOYMENT EXPRESS
Individual Presents to DBHDD Intake and Evaluation (I&E) and says, "I want a job."
I&E refers to GVRA and continues intake process. GVRA begins eligibility process
I&E determines individual "pre-eligible"; GVRA determines individual eligible for GVRA services

PLA Supervisor informs GVRA that individual has a source for long term funding
GVRA designates a provider agency and develops with the provider the Individual Plan for Employment (IPE)
The provider implements the plan for customized/supported employment.
The provider begins supporting the individual through the 5/6 Phases
The individual approaches stabilization & GVRA
informs DBHDD of projected date
DBHDD prepares to begin funding long-term supports.
Individual reaches stabilization Provider agency begins long term support utilizing DBHDD funding.. Support Coordination begins

Individual is employed an average of 10 or more hours per week
Provider agency is paid by DBHDD for long term supports.
If the individual loses their job or says "I want another job", individual is referred to GVRA and the cycle begins again.

But what about benefits like SSI, SS and Medicaid?

Many people supported and their families have questions related to benefits. GVRA has staff who are dedicated experts to help people understand how to weigh the pros and cons of going to work and the possible impact on their benefits. These staff are spread around the state and are known as Work Incentive Navigators (WINs).

WINs map and contact:
Adrienne.Williams@gvs.ga.gov 470-426-1847 Janice.Irwin@gvs.ga.gov 404-308-4708 Ron.Burse@gvs.ga.gov 706-331-2926 Tonya.Hawkins@gvs.ga.gov 229-886-6372 Mary.Quarles@gvs.ga.gov 912-424-4078

DBHDD WIN Coverage Map

DBHDD Regions: Region 1

Dade

Catoosa

Whitfield Walker

Murray

Fannin Gilmer

Towns Union
White

Rabun

Region 2 Region 3 Region 4

Habersham

Janice Irwin Regions 1 ,3 & 6

C1hattooga Floyd
1

Gordon

Pickens

Bartow

Cherokee

REGION 1

Lumpkin

Stephens

Dawson Forsyth

Hall

Banks Franklin Hart

Jackson

Madison

Elbert

Region 5 Region 6

Polk Cobb
Paulding

Gwinnett
2

Barrow Clarke Oconee

Oglethorpe

Haralson

Walton

Wilkes

Douglas

DeKalb REGION 3

Rockdale

Carroll

Fulton

Newton

Morgan

Greene Taliaferro REGION 2

Lincoln Columbia

Ronald Burse Region
2

McDuffie

Clayton

Fayette

Henry

Warren

5

Heard

Coweta

Spalding

Jasper Butts

Putnam

Hancock

Glascock

Richmond

Troup Meriwether

Pike Lamar Monroe

Jones

4
Baldwin

Jefferson

Burke

REGION 6 Upson

Washington

Harris

Talbot

Crawford

Bibb

Wilkinson

Twiggs

Johnson

Jenkins

Screven

State Hospitals: 1 Northwest Georgia Regional Hospital 2 Georgia Regional Hospital at Atlanta 3 West Central Georgia Regional Hospital 4 Central State Hospital (DD & Forensic
only) 5 East Central Regional Hospital 6 Southwestern State Hospital 7 Georgia Regional Hospital at Savannah

Tonya Hawkins Regions
4 & 6

Muscogee

Taylor

Peach

Emanuel

Chattahoochee Marion
3
Schley

Macon

Stewart Webster Sumter

Quitman

Houston Bleckley

Laurens

Treutlen

Candler Bulloch

Effingham

Montgomery

Dooly Crisp

Pulaski Dodge

Wheeler

Wilcox

Telfair

Toombs

Evans

Tattnall

Bryan Liberty

Chatham 7

Terrell Randolph

Lee

Clay Calhoun

Dougherty

Turner

Worth

Tift

Ben Hill Irwin

Jeff Davis

Appling

Long

REGION 5

Coffee

Bacon

Wayne

McIntosh

Early Miller

Baker
Mitchell REGION 4

Colquitt

Berrien Atkinson Cook

Pierce

Ware

Brantley

Glynn

Lanier

Mary Quarles Region
5

Seminole

Decatur

Grady Thomas Brooks

Clinch

Charlton

Camden

6

Lowndes

Echols

So are there people who have benefitted from customized supported employment in Georgia?
Yes there are and they live in both rural and urban areas of our state. Read the stories included below:
Ryan Carroll works as a Stocking Technician in the Laboratory at Children's Healthcare of Atlanta at Scottish Rite. His duties include: picking up specimens from outlying clinics and delivering them to the Lab, decreasing patient wait times and increasing satisfaction rates amongst families. His contributions have made such an impact that the Departments he services held a "Ryan Carroll Appreciation Day" to recognize him for his work.
Charlie is a farm hand at J and L Farm and Stables in Hephzibah, Georgia, The farm is an organic working farm. Charlie is responsible for the animals, feeding, gathering eggs, watering, and taking them in and out of pasture as needed.
He is also responsible for his garden.

He has been raking the area and getting rid of weeds and debris to get the soil ready for spring planting. Charlie has learned to use/drive the farm equipment.
Charlie also helped get the farm cleaned up after winter for a tour with the Department of Agriculture. He mowed, cleared dead limbs and cleaned out flowerbeds to ready the farm for spring and the tour. Charlie is busy and likes to stay working.
These stories are just a few of the stories of people who when given the opportunity and the right supports have gotten jobs. Their work enhances their lives and helps the employer's bottom line!
Employment is an option for everyone no matter where you live.