PHILOSOPHY
Henrico Area Mental Health and Developmental Services Community Support Services Division serve persons with Intellectual Disabilities and children with developmental delay. Our Mission is to Support, Train, Educate, and Partner, thus making a positive difference in the lives of people we serve.
It is the philosophy of this program that services be driven by the individual using the service and provided in the community. Staff provides person centered supports by promoting informed decision making by the individual through informational and experiential opportunities in the community. Work in an integrated setting is considered the optimal choice. It is our belief and ongoing commitment that all community employment sites will be integrated into a business and will pay at least minimum wage to each individual.
The individual’s quality of life is dependent on the opportunity to make decisions about their life, build relationships in the community, and be accepted as valued members by the community. Opportunities are provided for individuals to develop and attain personal goals, maximize their potential, develop natural supports, utilize community resources and become integral members of the community.
DESCRIPTION OF SERVICES
We offer a full range of Employment services in both the Group employment model and the individualized placement model.
Group Supported Employment and mobile crews provide opportunities for integrated employment and work training in community work locations with ongoing supervision and support. Emphasis is placed on supporting individuals in work activities of their choice, with the goal to reach their maximum level of independence. While performing paid work, individuals receive training in enhancing functioning in daily living, social, and communication skills and safety skills. Staff provides assistance in the development and implementation of each individual’s anticipated outcomes and actions that support those outcomes. As individuals meet their objectives, they are encouraged to expand their skills through more difficult work, other mobile crews, other enclaves and individual supported employment. For some individuals, particularly those who were once in individual supported employment and now need more support to maintain employment, maintenance of their skills is their primary objective. Most Group SE sites operate five days per week and at least 6 hours per day. Sites vary based on the needs and agreements with the community business partners.
Mobile crews are often of a limited duration or offer minimal work hours. Some are seasonal. These sites are used for providing options for individuals who have been in the center based work program and want to work more integrated settings. These positions provide training, exposure and experience to community work. In conjunction with Supported Employment staff, the staff assigned to the ERP (Employment Resource Program) within Hermitage Enterprises will offer the names for those who have an interest in the job. Placement occurs with support from the Employment Specialists.
Individual Supported Employment is offered through a Vendor Agreement with the Department of Aging and Rehabilitation Services. This service is provided to anyone meeting eligibility and is interested in employment services. Services are not contingent on funding resources.
Assistance is provided in exploring the type of work wanted, looking for and finding a job, training on the job and ongoing follow along services. In addition, for those individuals who need more intensive follow-along, Workplace Assistance may be offered as an option and are services and supports provided to someone who has completed (or nearly completed) individual job development and job placement training but requires more than typical follow-along services to maintain stabilization in their employment. The addition of this service would be considered on a case by case basis.
For each individual served, a person-centered plan is developed with the participation and input of the individual in order to assist them in meeting the goals they have identified to obtain and maintain employment. Information from assessments is shared with the individual during the planning process. Plans are reviewed quarterly to insure continued satisfaction and evaluation of service effectiveness. Staff works closely with other service providers so that services are coordinated appropriately. Staff also provides training and support related to job acquisition and retention such as arranging and accessing transportation, improving social skills and work behavior, and improving personal hygiene.
We encourage individuals to be aware of their wages and how these impact their benefits. We encourage individuals to understand the impact of working on their benefits. We have a staff person certified as a Work Incentive Specialist (WISA) to ensure individuals have access to benefits analysis.
For individuals who have been identified with substance use issues, the Case Manager will be notified for services to address these issues. We will notify them if the individual is pregnant to ensure timely and appropriate treatment.
Location/Hours/Days These services are provided in the community. Support is provided to the individual on the job site during their regular work hours or as convenient for the employer if a special meeting is required. These hours may be in the evening or weekends. Staff may also meet with individuals in their homes or other community locations to provide training and support related to work. Supported Employment staff offices are at Hermitage Enterprises, which has office hours from 8:30am to 4:30pm Monday through Friday.
Admission/Continued Stay/Exclusion Criteria Individuals expressing an interest in working and requesting Supported Employment services will first work with the Case Manager . If eligible, a referral will be made to the Department of Aging and Rehabilitation Services (DARS), who will then contact HAMHDS Supported Employment. The Case Manager can make a referral directly using the Request for Services form.
To be eligible for Supported Employment individuals must:
- Be a resident of Charles City, Henrico or New Kent County
- Be at least 18 years old
- Have a disability of Developmental Disability ( and have an assigned Support Coordinator/Case Manager)
- Be able to work in integrated employment with supports determined in their annual person-centered plan
- Have completed their education or will complete their education in 6 months, i.e. out of school or with plans to transition out of school within 6 months.
Anyone denied Supported Employment services can appeal the decision by following the HAMHDS grievance procedure.
Termination/Discharge/Re-Admission Criteria Individuals will continue to receive services until they are no longer employed at a Group Site and express no desire in continued services. Individuals in Individual SE will continue to receive services until the person chooses another provider, a person no longer wishes to work or until the team determines that the supports provided are no longer needed or wanted. Those seeking employment should demonstrate they want employment services and may be closed if they are no longer participating in their employment process. Other reasons for discharge may include: person no longer desires services, person moves from the catchment area, Supported Employment no longer meets the person’s needs, the person quits their job or loses the job through their own actions, or refuses to participate in their program. Any discharge from Supported Employment will be documented in the record. The individual’s team will provide appropriate planning for follow up as warranted.
Plans for discharge and follow up are completed with the individual’s input and documented in the record. Individuals may receive copies of the plan if they wish. When an individual moves from the catchment area every effort will be made, with the individual’s consent, to link them with needed services.
If Supported Employment no longer meets the individual’s needs, there will be a planning meeting with the staff, the individual and family (if applicable) to discuss the changes and develop a plan for meeting the new level of need. Individuals who quit or lose their jobs may again request Supported Employment services. The Case Manager/Support Coordinator will work with the individual around employment or day options if they choose not to continue working with HAMHDS Employment programs.
Special Needs Individuals with special needs will be assisted with meeting these needs in a way that allows them to participate in the Supported Employment program. Special considerations are provided to those with the need for assistive technology. Jigs and job modifications are offered or linked with resources. These may include special apparatus for a specific task, assistance with mobility or adjustment in work hours to accommodate medical needs. Coordination with employers occurs as needed; education may be provided to employers about reasonable accommodations and employers will be encouraged to consider reasonable accommodations.
CONTRACT SERVICES
There are no contractual services provided in this program.
STAFFING
Type of Staff
All Supported Employment staff are trained in CPR, First Aid, Infection Control, Therapeutic Options, Client Rights, and other required Agency training. They have a valid Virginia driver’s license, have been screened for tuberculosis and have gone through a criminal background check at hire.
Direct service staff are both full and part time with the job title of CSS Employment Specialist or Training Specialist. Group Supported Employment and Workplace Assistant may be a Training Assistant for day to day operations. Employment/Training Specialists are required to have a bachelor’s degree in a related field or experiential equivalent in the field. Training Assistants have a high school diploma and experience with persons with disabilities. A CSS Program Supervisor supervises staff in their work activities. Program Supervisors receive the same required training, except Prevention of Violence may be substituted for Therapeutic Options, as well as training in supervisory skills. All Program Supervisors are required to have a bachelor’s degree and experience in the field of Developmental Disability.
Staff Role
Staff provide on-going training and support to individuals based on the individual’s stated needs and preferences. Individual Supported Employment services are provided using the established Individual Supported Employment model. Assessment, job development, placement and job training as well as follow along services are provided. For Group Supported Employment, the staff member serves as the liaison between the workers and the employer as well as with the Case Manager and family/care giver. Duties on site may vary and are negotiated with the employer. The role of the HAMHDS staff is to support the individuals and not be an additional employee for the business. Workplace Assistants mirrors that of a group of SE specialist role, but they are assigned in a one to one role with the individual and provides supports at the direction of the ISP written by an employment specialist.
Staff also provide training in employer specific requirements unrelated to routine tasks of the job. Supports are provided as developed in the person-centered plan and will vary based on the location, the phase of supported employment and whether in the group or individual model.
Individual SE: During the follow along phase face to face support is given at least one time per month and may or may not be at the individual’s work site. In general, there are at least two activities per month with or on behalf of the individual. Each staff person serves approximately 15 – 25 individuals who are in various phases of Supported Employment.
Group SE: Support is provided as needed. The ultimate goal is to slowly phase out supports to allow the individuals in the Group Setting to build independence, to work with natural supports in the work environment and to encourage movement into more individual placements. Ratios vary from 1 to 3 to no more than 1 to 8.
Workplace Assistance is a one to one service.
The Supported Employment staff person works as a member of a Team that provides Case Management/Support Coordination to the consumer. All service providers attend meetings with the consumer to develop service plans. The Program Supervisor works with the Supported Employment staff person to problem solve issues, provide general guidance and insure that regulatory requirements are met.
PROGRAM GOALS
The goal of the Individual Supported Employment program is to provide person centered support and opportunities for individuals with Developmental Disability to experience full participation as a valued member of the community through support in obtaining and maintaining employment. A secondary goal is to educate the business community about the benefits of employing individuals with disabilities within their work environment.
PROGRAM OBJECTIVES
On an annual basis objectives are developed to measure service access, effectiveness, efficiency, consumer and stakeholder satisfaction within the program. These measures may consider three important factors: program quality, customer value and/or financial performance. See program specific performance improvement goals and objectives.
FEES
These services are billable to DARS, Medicaid waiver or self-pay. A vendor agreement with the Division of Rehabilitative Services is negotiated annually. Medicaid and self-pay for this service is based on the vendor rate. Individuals provide financial information which may result in adjustment to the self-pay amount based on the Agency fee scale. Medicaid Waiver rates are consistent with DARS rates and may be billed if the person is eligible and has a Medicaid Waiver slot. Medicaid is the payer after DARS funding has been exhausted. There is an effort at the State level to braid services to ensure the availability of services to individuals. Workplace Assistance is a Medicaid waiver only service. Long Term Follow-Along funding (LTESS) is available through DARS for those without Waiver. The County of Henrico also supports SE services with funding.
In Group Supported Employment, a fee for transportation may be charged if the person utilizes the contracted service provided by the County.
PROCEDURES FOR REFFERAL, SCREENING, ADMISSION AND RE-ADMISSION
Referrals/Screening/Admissions
When a Case Manager/Support Coordinator becomes aware that an individual is interested in Supported Employment he or she will discuss the option of working with the Department of Aging and Rehabilitative Services (DARS). In addition, they will be offered a choice of provider, including the HAMHDS operated Supported Employment program.
When the individual has chosen the HAMHDS program, a Request for SE Services form will be completed and sent to the Employment and Day Services Program Supervisor, who will discuss with the employment specialists and assign the individual to a caseload. Transition students will be given priority.
For Group Supported Employment, notice of openings at a specific site will be sent to the Support Coordinators/Case Managers requesting individuals who may be interested. Assessments will be completed to find the best match. Priority will be given to those who are currently in Organizational Employment at Hermitage Enterprises or Cypress Enterprises to assist them in entering more integrated employment opportunities.
An initial interview and assessment will take place to assist in determining the individual’s ability to benefit from Supported Employment or plans will be made for further assessment if this is a question. This interview will be a face to face meeting with the Employment Specialist and the individual to discuss jobs of interest, service needed, and DARS as a resource. Preliminary discussions around work hours, transportation resources and other supports occur with the individual and family, when appropriate. Situational assessments may be arranged at that time.
If the individual is found to be able to benefit from SE services, the admission will continue and within 24 hours, a program plan will be developed with the individual. Relevant data sheets and schedules are developed as necessary.
If the individual is found ineligible for Supported Employment they will be informed, in writing, regarding the reasons and the individual’s Case Manager/Support Coordinator will assist with appropriate referrals.
Re-Admission Criteria:
Individuals who were discharged voluntarily from Individual Supported Employment will be admitted to the program using the same criteria as for a first time admission. Individuals involuntarily discharged and re-applying to the program will be evaluated based on progress addressing the reasons for the involuntary discharge. Supported Employment will not be an appropriate option if the individual’s health and safety needs cannot be met, the individual cannot meet expectations in competitive jobs with support, or the individual does not want to work.
ORIENTATION OF THE CLIENT TO THE SERVICE
Within 10 working days of assignment to an Employment Specialist, individuals and their legally authorized representative if applicable, will be oriented to the Supported Employment program through the use of the Consumer Handbook. Documentation of the orientation meeting will be made in the progress note and on the Program Orientation Checklist. Included in the orientation is information about how to contact the Employment Specialist.
EMERGENCY CLINICAL CONSULTATION
Henrico Area Mental Health and Developmental Services Emergency Services staff provides emergency consultation. The Emergency Services Program serves as primary back up for emergency clinical consultation. Emergency services are available on a 24 hours a day/7 days a week basis. Case Manager/Support Coordinators link individuals in need of clinical services to HAMHDS or private providers of clinical and psychiatric services. Individual preference determines referral made.
TRANSFER/DISCHARGE PROCEDURES
Process/Documentation:
Individual SE:
Supported Employment is an on-going service designed to be continued indefinitely in order to assist the individual with retaining community employment. Individuals do not normally complete Supported Employment but leave the program when they no longer desire services or the service is no longer appropriate.
Once an individual is discharged or requests discharge from Supported Employment, the Employment Specialist will document that request in the progress notes and notify the Case Manager/Support Coordinator. Individuals will be voluntarily discharged when they request discharge or move from the catchment area. The Employment Specialist will complete the Agency Transfer/Discharge with input from the individual. This information will be shared with the individual.
The Case Manager/Support Coordinator will complete activities and paperwork required if the person is moving to another area and will notify the Employment Specialist.
An involuntary discharge may be done when it is determined that Supported Employment no longer meets the individual’s needs or when the individual quits or loses their job through their own actions. Supported Employment is not an appropriate vocational option when health and safety needs are not met, the individual consistently is not able to perform as expected in competitive jobs with job coach support or when the individual is unwilling to perform work or intentionally demonstrates poor performance or work behaviors.
In the case of involuntary discharge the Employment Specialist, Case Manager/Support Coordinator, Program Supervisor, and possibly, the Program Manager will discuss the situation before a decision is made. The Employment Specialist will notify the individual and if appropriate, his/her family, of the decision to discharge. An Agency Transfer/Discharge will be completed by the Employment Specialist and shared with the individual.
Group SE:
Individuals are encouraged to expand their opportunities through participation in more difficult jobs, less structured work environments or to explore their options in individual supported employment. The continued need/desire for the Group Employment service will be determined at the quarterly review. When individuals indicate interest in other mobile crews or groups, the Employment Specialist will notify the Program Supervisor. This individual will be offered opportunities as they arise. These discussions of the interest in other work activities will include the individual, the family/caregiver, the Support Coordinator/Case Manager and the Legally Authorized Representative, if appropriate. If interest in a work program or another day program is expressed, the Employment Specialist notifies the Support Coordinator/Case Manager, who will assist the individual and their family in exploring other day support or employment options. This interaction will be documented in progress notes.
Discharge from this program may occur when the individual:
- no longer desires to attend
- moves from the catchment area
- is no longer having their needs met by the program
- no longer meets eligibility criteria.
- violates program rules, demonstrates inappropriate/dangerous behavior which requires a staffing intensity that interferes with the provision of services or is asked by the employer to leave.
Individuals may appeal the discharge decision by following the Henrico Area Mental Health and Developmental Services grievance procedure.
Any discharge from Group Supported Employment will be documented on the agency discharge form and placed in the individual’s record. Recommendations will be made as to continued services. Program Staff will contact the Support Coordinator/Case Manager, who will work with the individual around day support/employment options.
When an individual is discharged due to behaviors or a change in needs, a team meeting involving the Support Coordinator/Case Manager, the individual, the family/caregiver and the Program Supervisor may occur. All attempts to serve the individual on another enclave will be made, if appropriate. The meeting and the discharge will be documented in the record.
When an individual leaves the Group Supported Employment program to enter a new site or move to individual employment, the program space will be held for 60 days if the option is available from the employer. If within that 60-day period, the individual determines they would like to return and are still appropriate for the site; all efforts will be made to accommodate the individual. They may be placed at a different work location. After the 60-day period, the individual will be viewed as a new referral.
