Building Bridges for Employment

1. Building Bridges for Employment Presented by Andy Sink, Liam McNabb and Jill Dorsi, NYS Office of Mental Health Dan O’Shea, ACCES-VR & Crystal Collins, Northeast Career Planning/PROS on Broadway APSE Conference, May 2014

2. Employment and Mental Illness • 78% of people who are diagnosed with a serious mental illness are unemployed (2006) • This rate is lower than for people with other disabilities • (30% employed vs 22%) • Stigma and misunderstanding of mental illness present a significant barrier to employment

3. SAMSHA Employment Intervention Demonstration Program • 5 year study of employment programs nationwide evaluated a variety of supported employment approaches • Most successful outcomes occurred when: • programs integrated mental health services with vocational services • focused on rapid placement into jobs of the person’s choice • collaboration between the support providers and the businesses employing the individuals Source: Supported Employment: a guide for mental health planning and advisory councils. www.samsha.gov

4. Through integration and collaboration multiple barriers to employment can be overcome

5. Updates on Collaboration Efforts • Improved lines of communication between VR Counselors and PROS practitioners • Worked together to update PROS Guidance Documents for implementing ACCES-VR supports in combination with PROS Services • ACCES-VR staff have presented at OMH Field Offices and with PROS providers and PROS staff have provided training to VR Counselors

6. What we discovered… • PROS is able to integrate mental health supports in conjunction with supports provided to people through ACCES-VR • Liaison connections between the PROS and ACCES-VR office are essential to seamless integration • How to coordinate ACCES-VR CRS Milestone Payments with PROS Ongoing Rehabilitation and Supports (ORS)

7. What is PROS? • Personalized Recovery-Oriented Services • Rehabilitation program with a treatment component • Core Value: Recovery is a reality for people with severe and persistent mental illness • PROS provides individualized services and interventions to support employment • PROS Services and ACCES-VR Supports can work together to achieve employment goals

8. PROS Services that can be used to support employment • Intensive Rehabilitation Goal Acquisition • Benefits and Financial Management • Medication Management • Intensive Relapse Prevention • Basic Living Skills • Structured Skill Development • Clinical Treatment Services/Health Assessment

9. Supporting PROS Participants who don’t have Medicaid • Lack of Medicaid coverage DOES NOT prevent a person from receiving PROS Services • Net deficit funding: PROS providers receive funding to offset providing supports to individuals without Medicaid • Sliding fee scales: PROS providers must charge for PROS Services but can use a sliding scale to make services affordable

10. Managing Benefits to Support Employment • PROS Service: Benefits and Financial Management can provide information • Learn about SSI -budgeting protocol including • PASS: Plan to Achieve Self Support • IRWE: Impairment Related Work Expenses • Medicaid Buy-in: Allows individuals to work and continue to access Medicaid health coverage • Hand-out: web addresses for more information

11. ACCES-VR MILESTONES & PROS ORS • How do the new ACCES-VR Milestone Supported Employment payments work with PROS ORS? • Assuring milestone payments are billed before any ORS (extended services) are provided

12. Quality Outcome Payments • Incentive payment for providers • Bonus to provider for obtaining employment at higher hourly wage and/or more than 30 hours/week • Bonus payment and ORS: conflicts?

13. Coordinating Supports through “non-PROS” Agencies • What happens when a non-PROS agency provides ACCES Intensive Supports and a PROS provides ongoing supports? • Example: Putnam County

14. Additional ACCES-VR Services • Education: college tuition and room and board; vocational training • Work Try-Outs (WTO) & On The Job Training (OJT) • Career counseling & guidance • Rehabilitation & assistive technology • Assessment to identify skills, interests, abilities, and limitations • Job placement and job retention

15. Best Practices: Northeast Career Planning • Identifying point person/liaison at ACCES-VR local office: makes collaboration easier and more effective • Referrals go both ways: PROS to ACCES-VR; ACCES-VR to PROS: identify barriers to employment and necessary supports • Invite local ACCES-VR office into PROS to share information with participants and practitioners • Providing ORS to people who don’t have Medicaid

16. PRINCIPLES INFORMING PRACTICE • For the first time, the OMH model of choice is a rehabilitation model • Implementing IPS and Supported Employment principles in your PROS is not only possible, it’s a must! • Unique opportunity for doing real rehab…

17. Overlapping Circles of Support • PROS and Supported Employment programs overlap • No wrong door of entry • PROS and ACCES-VR Services can be simultaneous

19. Working together improves employment outcomes

20. Discussion & Comments