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 planning Habilitation Job searching Job experiences  Training 2 - April 2010; rev. 8/102

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. Training 2 - April 2010; rev. 8/103

Career Planning Component Career planning: Preparation for obtaining, maintaining or advancing employment. May not 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. Training 2 - April 2010; rev. 8/104

Habilitation Component Habilitation: Designed to focus on resume` building or creation of business plans, the acquisition of work skills, appropriate work behavior, and greater independence in mobility (i.e. transportation) to and within the workplace. Training 2 - April 2010; rev. 8/105

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. Training 2 - April 2010; rev. 8/106

Job Searching Component Job Searching: Help to locate a job or develop a job experience. It should involve the person on a one-to-one basis, but may be done on their behalf. Training 2 - April 2010; rev. 8/107

Job Experience Component Job experiences: May include paid employment alone or in workstations or enclaves; unpaid employment like volunteers, apprentices, interns, or job shadowing, etc. Training 2 - April 2010; rev. 8/108

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. Training 2 - April 2010; rev. 8/109

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. Training 2 - April 2010; rev. 8/1010

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. Training 2 - April 2010; rev. 8/1011

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. Training 2 - April 2010; rev. 8/1012

Keep in Mind o 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. Training 2 - April 2010; rev. 8/1013

Keep in Mind (continued) o Two components of “Vocational Planning” 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. Training 2 - April 2010; rev. 8/1014

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.) Training 2 - April 2010; rev. 8/1015

Integrated Community Employment (ICE)  Formerly called “Supported Employment”  More components/activities added, expected, and ‘billable’ Habilitation Stabilization services and supports Extended services and supports Training 2 - April 2010; rev. 8/1016

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. Training 2 - April 2010; rev. 8/1017

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. Training 2 - April 2010; rev. 8/1018

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. Training 2 - April 2010; rev. 8/1019

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. Training 2 - April 2010; rev. 8/1020

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. Training 2 - April 2010; rev. 8/1021

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. Training 2 - April 2010; rev. 8/1022

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. Training 2 - April 2010; rev. 8/1023

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. Training 2 - April 2010; rev. 8/1024

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. Training 2 - April 2010; rev. 8/1025

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. Training 2 - April 2010; rev. 8/1026

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. Training 2 - April 2010; rev. 8/1027

Limitations of ICE  Integrated Community Employment services do not include employment in group settings such as workstations, enclaves, classroom settings, or sheltered workshops. Training 2 - April 2010; rev. 8/1028

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. Training 2 - April 2010; rev. 8/1029

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. Training 2 - April 2010; rev. 8/1030

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. Training 2 - April 2010; 8/1031

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. Training 2 - April 2010; rev. 8/1032