The Ohio Department of Developmental Disabilities along with numerous stakeholder groups have been working on supported employment rules, regulations, ratios and rate structures. When Ohio’s Employment First initiative started a few years ago, there was a lot of push back. Simply put, local systems and providers were not aligned with what was being hailed as a new path forward for employment. Fast forward to present day, and after an on-going dialogue among all the stakeholders, there may still be many questions but, we have all started speaking the same language and realizing where the end point needs to be in regards to meeting meeting new CMS guidelines. Revised rules, that include new employment definitions and expectations, as well as the new service/rule ‘Career Planning’ are great starting points if a provider wants to jump in and start looking at how their services need to adjust and expand. In this article I will outline the proposed Career Planning rule as well as give some comparisons to how BVR pays for a similar service (Bureau of Vocational Rehabilitation).
The proposed Career Planning rule through the Ohio Department of Developmental Disabilities was made public June 2, 2016. Review and commentary on the rule were due to be submitted on June 17, 2016. DODD expects the effective date for the rule to be October 1, 2016. The Career Planning Service would be available to individuals receiving Home and Community-Based Services Waivers (HCBS) funded through Individual Options, Level One or Self-empowered Life.
Undoubtedly one of the main concerns from providers and county board personnel regarding employment services was the lack of consistency and availability of a solid rate structure. Most employment services that individuals have been seeking require a 1:1 ratio with staff. In the past, if an individual was seeking competitive employment the next step would be to ‘open a case’ with the Bureau of Vocational Rehabilitation (BVR) an outward facing, engagement focused department within Opportunities for Ohioans with Disabilities (OOD). However, with the recent change in Employment First, these avenues have been broadened and many more individuals can enjoy the path to employment without as many road blocks. Let’s take a closer look.
Career Planning as defined in the proposed rule, means;
…. individualized, person-centered, comprehensive employment planning and support that provides assistance for individuals to attain or advance in competitive integrated employment. Career planning is a focused and time-limited engagement of an individual in identification of a career direction and development of a plan for achieving competitive integrated employment and the supports needed to achieve that employment.
There are nine specific components to this service that include:
- Assistive Technology Assessment
- Benefits Education and Analysis
- Career Discover
- Career Exploration
- Employment/Self Employment Plan
- Job Development
- Self Employment Launch
- Situational Observation and Assessment
- Worksite Accessibility
Other points of interest to review:
The expected outcome of career planning is the individual’s attainment of competitive integrated employment and/or career advancement in competitive integrated employment.
Career planning may be provided in a variety of settings but shall not be furnished in the individual’s residence or other residential living arrangement except for a home visit conducted as part of career discovery component of career planning or when the individual is self-employed and the residence is the site of self-employment.
Career planning shall be provided at a ratio of one staff to one individual.
Payment for adult day support, career planning, group employment support, individual employment support, and vocational habilitation, alone or in combination, shall not exceed the budget limitations
- The rule allows for a behavioral support and medical assistance rate modification(s)
- The rate Appendix is attached to the rule and is broken down based on the service component(s) that is provided
If you are familiar with the past ways of conducting employment services, BVR or Bureau of Vocational Rehabilitation was the primary source. As I have reviewed the Career Planning rule, I can’t help but see the similarity between it and the services that BVR provides. Here is a quick overview from their website:
The Bureau of Vocational Rehabilitation (BVR) provides individuals with disabilities services and supports necessary to help them attain and maintain employment. Disabilities may include physical, intellectual, mental health, or sensory disabilities. Vocational Rehabilitation (VR) services are customized for each individual through assessments and one-on-one meetings with professional VR Counselors. VR services are available in all 88 counties and include:
- Evaluation and treatment of an individual’s disability;
- Information and referral services;
- Vocational counseling and training;
- Job search and job placement assistance;
- Educational guidance (tuition resources and other support);
- Transportation services;
- Occupational tools and equipment;
- Personal attendant services (reader, interpreter, etc.).
BVR Services are still a viable option for individuals with disabilities when seeking employment services. However, now with the Career Planning service available to individuals specifically with developmental disabilities their waiver can be utilized in a broader more pertinent way that provides the assistance they need. Providers and county board personnel will have a better means to align the Employment First vision within the confines of a system that feels familiar. Again, as the title implies, it’s exciting to see the rubber hit the road when it comes to providing an improved means for Ohioans with disabilities to gain and maintain employment…Let’s keep the momentum!