Re-cap: Focus on Employment DDD’s Waiver Amendments

and Answers to questions frequently asked

Vocational Planning and Integrated Community Employment

(ICE) services

April, 2010 (Revised 8/10)

Re-cap of Vocational Planning

“Vocational Planning” replaces the term “Supported Day”

More components/activities added, expected and billable:Career planningHabilitation Job searching Job experiences

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Focus of Vocational Planning

“Vocational Planning” services are delivered with the person or on their behalf.

The focus is on obtaining work experience with a goal of attaining integrated community employment.

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Career Planning Component

Career planning: Preparation for obtaining,maintaining or advancing employment. Maynot exceed 3 months time & includes: o Assessing skills, abilities and needs to develop a self-awareness of career

direction and goals.o Writing a resume`, developing a business plan for a home business, etc.

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Habilitation Component

Habilitation: Designed to focus onresume` building or creation ofbusiness plans, the acquisition of work skills, appropriate work behavior, and greater independence in mobility (i.e.transportation) to and within theworkplace.

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Habilitation Component (cont.)

Direct training and supports designed for face-to-face instruction necessary to learn work-related responsibilities, work skills, and appropriate work behavior.

Habilitation may take place in the individual’s residence and at the job experience, but not a fixed-site sheltered workshop facility.

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Job Searching Component

Job Searching: Help to locate a job ordevelop a job experience. It shouldinvolve the person on a one-to-onebasis, but may be done on their behalf.

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Job Experience Component

Job experiences: May include paidemployment alone or in workstationsor enclaves; unpaid employment like volunteers, apprentices, interns, or jobshadowing, etc.

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Job Experience (continued)

Job experiences are not provided in fixed-site DD facilities. Provider staff may be intermittently available, based on the individual’s needs.

The outcome of job experiences is a customized integrated community employment opportunity for the individual.

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Limitations to Job Experiences

o Teams should consider unpaid job experiences based on what is ‘typical.’

o If anyone without DD would be paid to perform the task, the job experience may not last more than 6 months;

o If anyone without DD would NOT be paid to perform the task, it isn’t a ‘job experience’ and is not time-limited.

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Limitations (continued)

No more than 3 individuals may participate in the same paid or unpaid job experience at the same time.

Larger workstations may continue & will be operated as assisted settings. Starting 5/1/10 those settings will be paid at the current Assisted Day rate.

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Limitations (continued)

At the next meeting for a person currently at a large workstation, he or she will decide to stay in the assisted service, or

Change to a smaller, *temporary work group operating as a workstation, or choose another job experience. *Six months time-limited service begins.

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Keep in Mindo Before displaying independence in

accessing transportation, the cost of transportation is included in the rate paid.

o Services billed under an ‘Assisted’ service code don’t qualify as Voc. Planning or ICE.

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Keep in Mind (continued)

o Two components of “VocationalPlanning” may take place at the same time so long as it doesn’t result in double-billing for the same period of time.

o Because Habilitation runs through all components of Vocational Planning, when paired with any other component there is no concern of double-billing.

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Keep in Mind (continued)

o For example, “Vocational Planning” may take place at the same time as “Integrated Community Employment.” (e.g., a person could be in a job experience and also be searching for more work. However, the provider could not bill for those activities separately during the same hours of the day.)

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Integrated Community Employment (ICE)

Formerly called “Supported Employment”

More components/activities added, expected, and ‘billable’HabilitationStabilization services and supportsExtended services and supports

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Focus on ICE

ICE services are the ongoing support needed to acquire and maintain an individually customized job/position in the general workforce, at or above the state’s minimum wage.

The acceptable outcome is sustained, paid employment in an integrated setting in the general workforce that meets personal and career goals.

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Focus on ICE (continued)

ICE services are designed to address the individual’s particular needs for: ongoing or intermittent

habilitation,stabilization services, or, extended ICE services and

supports.

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Focus on ICE (continued)

Enable competitive employment at or above the minimum wage for people who likely require the provision of supports to perform in a regular work setting.

ICE is primarily delivered in a variety of work settings, particularly work sites where persons without disabilities are employed.

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Customized Home-based Businesses

ICE services may include customized home-based businesses that only operate out of the individual’s private residence; not in fixed-site congregate DD facilities such as group homes or sheltered workshops.

Income generated may not be commensurate with minimum wage requirements.

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Habilitation: Intensive or Intermittent

Intensive, continuous face-to-face habilitation is designed to teach work-related responsibilities, work skills, and appropriate work behavior.

Intermittent face-to-face habilitation is provided to assist the individual in maintaining employment.

Habilitation may take place in the individual’s private residence and at other job experience sites.

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Stabilization Services Component

Stabilization services are a component of ICE, with staff intermittently available to provide ongoing support needed to maintain employment in an integrated, competitive employment site, or customized home-based employment site.

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Stabilization (continued)

It is provided when the staff intervention time required at the job site is 20% - 50% of the individual's total work hours.

Regular contacts are made with the individual.

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Stabilization (continued)

Regular contacts made with the employer on behalf of an individual also qualify for payment.

Stabilization services are not time limited - individuals work at least 40 hours/month utilizing the ‘Habilitation’ and ‘Stabilization’ components of ICE.

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Billing for ICE stabilization service

To bill, at least 40 hours of work/mo. is required that is paid at minimum wage or a wage consistent with that earned by the general working population, whichever is higher.

Minimum total number of hours worked for the last three months (including the current month) is more than 120 hours of work (or an average of 40 or more hours per month for those three months).

Multiple jobs that meet the wage requirements may be worked to reach 40 hours of employment per month.

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Extended ICE Services

Extended services are a component of ICE and are provided to persons who need ongoing, intermittent support to maintain employment.

Shift from ‘Stabilization’ to ‘Extended’ when the staff intervention time required at the job site is less than 20% of the individual's total work hours.

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Extended ICE Services (continued)

The provision of Extended ICE is limited to either the work site or the individual’s private home if operating a home-based business.

Extended ICE Services must include at a minimum, twice-monthly monitoring at the work site.

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Limitations of ICE

Integrated Community Employment services do not include employment in group settings such as workstations, enclaves, classroom settings, or sheltered workshops.

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Limitations of ICE (continued)

ICE does not include services provided in provider-controlled (Assisted) residential environments.

No more than 2 individuals may participate in a home-based business at the same private residence.

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Limitations of ICE (continued)

Extended services are time-limited and may not take place at the same time as other Vocational Planning services or other ICE service components, except Habilitation.

Claims for Extended ICE services may be made for up to 24 months.

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Limitations of ICE (continued)

If the individual is unable to meet their personal and career goals within 24 months, an in-person team meeting must be held to change the service plan.

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Billing for ICE extended service

To bill, at least 80 hours of work/mo. is required that is paid at minimum wage or a wage consistent with that earned by the general working population, whichever is higher.

Minimum total number of hours worked for the last three months (including the current month) is more than 240 hours of work (or an average of 80 or more hours per month for those three months).

Multiple jobs that meet the wage requirements may be worked to reach 80 hours of employment per month.

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