Westside Regional Center Employment First Informational Session CMS - - PowerPoint PPT Presentation

Westside Regional Center

Employment First Informational Session

 CMS Final Rule  Workforce Innovation and Improvement Act (WIOA)  Employment First Movement & Practice

CMS FINAL RULE CMS 2249-F and CMS 2296-F (HCBS Rules) Published January 16, 2014/Effective March 17, 2014 *Full compliance by March 17, 2019*

 To ensure that individuals receiving long-term services

and supports through home and community based service (HCBS) programs under the 1915(c)*, 1915(i) and 1915(k) Medicaid authorities have full access to benefits of community living and the opportunity to receive services in the most integrated setting appropriate

 To enhance the quality of HCBS and provide

protections to participants

What The Final Rule Does

 Defines community  What is not community (SNF, IMD, ICF/IID, Hospital)  What is likely not community  What is community  Requires person-centered planning  Codifies requirements  Requires conflict-free case management  What was best practice is now the rule

HCBS Setting Requirements

 Setting is integrated and supports access to the greater

community

 Provides opportunities to seek employment and work in

competitive integrated settings, engage in community life and control personal resources

 Ensures the individual receives services in the community

to the same degree of access as individuals not receiving Medicaid home and community-based services

HCBS Setting Requirements

 Ensures an individual’s rights of privacy, dignity,

respect, and freedom from coercion and restraint

 Optimizes individual initiative, autonomy and

independence in making life choices

 Facilitates individual choice regarding services,

supports and who provides them

CMS Guidance: Settings that may isolate individuals

Settings that are presumed to have the qualities of an institution:

 Any setting that is located in a building that is also a publicly or

privately operated facility that provides inpatient institutional treatment

 Any setting that is located in a building on the grounds of, or

immediately adjacent to a public institution

 Any other setting that has the effect of isolating individuals

receiving Medicaid HCBS from the broader community of individuals not receiving Medicaid HCBS

Assessing Compliance

 Programs will be asked to do a self-assessment to determine their

compliance with Final Rule standards Sample Questions:

 Do the participants regularly access the larger community outside of

the HCB setting?

 Are there restrictions while at the HCB setting on access to the

community outside the HCB setting?

 If this is an employment setting, are participants provided with the

• pportunity to participate in negotiating work schedules, break/lunch

times, and leave and medical benefits?

Final Rule Compliance…

 Provider self-assessment will be verified by Regional

Center, DDS and DOR

 Transition plans will be developed with RC, DDS and

DOR to help non-compliant providers achieve compliance

 Some providers may choose not to continue services

rather than change programming for compliance

What Does This Mean for Supported Employment?

 SE Groups cannot work only for the agency provider’s

programs

 SE Groups may not be able to work at businesses outside of

normal business hours, unless other workers do the same

 Work activity programs who do not meet the new standard

must to find ways to integrate the workforce and services or close

Applying The Standards

 Does the client have input into their job selection?  Is the client working alongside people without

disabilities?

 Does the client take breaks with co-workers?  Do workers get to move around freely in the setting or

are they restricted to one area?

Workforce Innovation and Opportunity Act (WIOA)

 President Barack Obama signed WIOA into law on July 22,

2014

 WIOA brings significant change to DOR’s Supported

Employment Program

 The intent of the WIOA is to empower individuals with the

most significant disabilities to maximize employment, economic self-sufficiency, independence, inclusion and integration into society

Under WIOA

 The definition of Supported Employment now

includes employment in an integrated work setting in which individuals are working on a short-term basis at Sub Minimum Wage (SMW) toward Competitive Integrated Employment (CIE)

 Placements in SMW are no longer the end goal, but

rather a path forward to CIE; therefore, DOR established policy and procedures for VR teams to capitalize on opportunities for consumers to achieve CIE

Individualized Plans for Employment (IPE) Goals Must be for CIE (effective 1/1/16)

 Limitations on use of SMW as a successful Employment outcome for

consumers currently in plan and for individuals 24 years or younger

 SMW placement in an integrated setting allowed only on a temporary basis and

if the consumer will achieve CIE with necessary supports and services while the consumer is working in the integrated SMW placement

 Consumers placed into SMW in an integrated setting on a short-term basis will

have a Rehabilitation Counselor evaluate, monitor and review progress toward CIE, including ascertaining the need for additional services

 Evaluation timeframe is determined on a case-by-case basis by the

Rehabilitation Counselor and is dependent upon the consumer’s progress toward CIE

Progress Considered Measurable Improvement In one or more of the following areas:

 Employment preparation services  Independence  Self-advocacy  Social skills  Interpersonal skills  Work ethics  Work skills  Efficiency  Productivity  Use of public transportation  Time management  Other measurable advancement or skill improvements

Limitations on use of SMW for Individuals 24 years or younger

As of July 22, 2016, DOR shall not place any individual under the age of 24 in SMW placement, even on a temporary short-term basis unless the following conditions are met prior to placement:

 The individual has documentation that pre-employment

transition services have been provided

 The individual has applied for VR services and has been found

ineligible

 The individual was found eligible and was not able to achieve

CIE and his or her record of services was closed

 The individual has received career counseling and information

and referral about VR services as well as available CIE

• pportunities

WIOA brings significant change to California’s SEP

 Many of our Supported Employment providers’

current business models will be impacted by these changes

 Implementing these changes will be challenging;

however, we believe that by working together we will ensure all Californians are afforded the opportunity to realize their maximum employment potential

California’s Employment First Legislation

From Welfare and Institutions Code 4869(a)(1) It is the policy of the state that opportunities for integrated, competitive employment shall be given the highest priority for working age individuals with developmental disabilities, regardless of the severity of their disabilities

 Students 16 and over, and their families, should be told about

• pportunities for work, or higher education, after high-school

 Employment should be considered before any other service is offered  College and vocational training, if needed and wanted will also be

considered

California’s DDS & DOR Budgets Support Competitive Integrated Employment

 Schools will focus more on Post-Secondary & Employment  Students and families will be offered Employment options First  Working age adults will be expected to have an Employment and/or

Post-Secondary goal…and a path to Employment

 Regional Centers and providers will offer programs and resources to

support Employment

Community Integrated Employment Settings

 Owning a business  Being employed by a company  Attending secondary education to learn a trade  On a career certification track

Means…..

 Everyone participates  We look at skills, talents and interests  We change the way we see things  We talk about possibilities and seek out opportunities, regardless

• f challenges

WRC Employment First Policy

DRAFT

Westside Regional Center Employment First Policy



It is Westside Regional Center's mission to empower people with developmental disabilities and their families to choose and access community services that facilitate a quality of life comparable to persons without disabilities.



Employment enables adults to lead independent and productive lives while contributing to their community. Consistent with the Lanterman Act, inclusive and competitive work will be the first option considered by planning teams for every WRC working age adult. Integrated, inclusive and competitive employment will be given the highest priority for working age individuals with developmental disabilities, regardless of the severity of their disability.



This policy will be applied to individuals currently attending non-inclusive work activity programs, sub minimum wage employment, day programs and those clients seeking new services. This policy will be facilitated through the individual planning process.



WRC will work collaboratively with local school districts, educational institutions, transition programs, and community organizations to ensure the administration of this policy. Transition age clients and their families will be educated regarding Employment First and students will have active goal development and transition planning to this end.



Individuals who may require training and/or other support to achieve integrated employment will receive assistance in the form of individual or group job coaching, job exploration, technical or vocational training, post -secondary education, internship and apprenticeship programs.



Competitive work is income-producing activity for which the individual receives the same compensation as a nondisabled worker and includes employment, self-employment and micro-businesses. When paid work is not an

• ption for an individual, as determined and documented in the IPP by the individual planning team, volunteer work
• pportunities will be explored and supported.



Individuals not participating in competitive employment shall have daily access to meaningful, integrated, age- appropriate activities that are based on individual needs, interests, abilities, and promote the development of critical skills, leading to independence and full inclusion in their communities.



To ensure successful implementation of this policy, WRC will provide education and training to all stakeholders, advocate for and promote employment of people with developmental disabilities, assist service providers in transition and work collaboratively with all service systems to promote Employment First. WRC supports new program development demonstrating facilitation of this policy in practice.

Be in the Know:

 Participate in HCBS, WIOA and EF discussion groups  Attend Regional Center, DDS and DOR meetings  Educate yourselves, your staff, your clients and families  Start reviewing your programs and services now  Plan for the future strategically  Discuss possible changes with Regional Center, DDS & DOR

Community Liaisons

Perspective is Everything

 A NEGATIVE THINKER SEES A DIFFICULTY IN

EVERY OPORTUNITY

 A POSITIVE THINKER SEES AN OPPORTUNITY IN

EVERY DIFFICULTY Employment First allows the people we support to have more opportunities than ever before!

Resources

 www.westsiderc.org  www.dds.ca.gov  www.dor.ca.gov  www.cde.ca.gov  www.scdd.ca.gov  www.griffinhammis.com  www.cacareerzone.org  www.laedc.org  www.sba.gov  www.db101.org  www.wid.org  www.apse.org  www.tash.org  www.workfirst.us

Questions?

Contact: Pamela Arturi Westside Regional Center Community Services (310) 258-4276 pamelaa@westsiderc.org