Developmental Disabilities Administration (DDA)
Pathway to Employment
Transition Plan Pre-Vocational Services (PVS) addressing
Centers for Medicaid (CMS) Home and Community Based Setting Requirements
Past to Present
1980’s started moving people and services to community settings out of institutional
settings. Developed County Guidelines promoting the basic interdependent benefits of
quality living: Power and Choice; Relationships; Status Contribution; Integration;
Competence; Health and Safety.
1997 to 2003 A stakeholder workgroup comprised of 94 members worked on developing
”Strategies for the Future Long Range Plan”, the outcome reports Phase I and II .
Workgroup recommendations, within the report, included persons of working age (21 thru
61 years of age) should be gainfully employed, participating, and contributing to community
life using a variety of strategies to reach this status in the community. Specifically, the
report states, “Pathways to Employment: Each individual will be supported to pursue his or
her own unique path to work, a career, or his or her contribution to/participation in
community life. All individuals, regardless of the challenge of their disability, will be afforded
an opportunity to pursue competitive employment.”
2004 Working Age Adult policy was issued and established employment supports as the
first use of employment and day program funds for working age adults (people age 21 thru
61). The policy is intended to promote gainful employment in integrated settings in the
community. Counties were given a timeline of July 2006 for full implementation.
2008 CMS releases Instructions, Technical guide and Review Criteria for the Home and
Community Based (HCBS) Waiver. Pages 131-132 state, “Waiver funding is not available
for the provision of vocational services (e.g. sheltered work performed in a facility) where
individuals are supervised in producing goods or performing services under contract to third
parties.”
2011 CMS updates the HCBS Waiver Technical guide and Review Criteria page 5 states,
“Pre-Vocational services should be designed to create a path to integrated community
based employment for which an individual is compensated at or above the minimum wage,
but not less than the customary wage and level of benefits paid by the employer for the
same or similar work performed by individuals without disabilities.”
2014 CMS Final Rule Home and Community Based Setting requirements states, “Provides
opportunities to seek employment and work in competitive integrated settings; ensures the
individual receives services in the community to the same degree of access as individuals
not receiving HCBS Waiver.”
Between 2011 and 2014 there has been a decrease of 311or 49% in the number of people
in Pre-Vocational services (PVS).
2014
Developmental Disabilities Administration (DDA)
Pathway to Employment
Transition Plan Pre-Vocational Services (PVS) addressing
Centers for Medicaid (CMS) Home and Community Based Setting Requirements
In 2013 DDA received a grant for Technical Assistance hours from the Office of Disability
and Employment Policy (ODEP) to help provider agencies develop transformation plans (a
business plan for an agency to move to a fully integrated service model), third party
planning, and a variety of provider staff training.
Today there are 350 clients receiving Pre-Vocational service in 11 Counties (Asotin,
Benton, Franklin, Chelan, King, Pierce, Skagit, Snohomish, Spokane, Whitman, and
Yakima) from 15 different service providers. Two of the service providers have
transformation plans courtesy of the ODEP grant.
Washington defines Pre-Vocational services as part of an individual’s pathway to integrated
jobs in typical community employment. These services and supports are intended to be
short term and designed to further habilitation goals that will lead to greater opportunities for
competitive and integrated employment and career advancement at or above minimum
wage. Pre-Vocational services are provided by agencies qualified to deliver services to
people with disabilities and offer training and skill development for groups of workers with
disabilities in the same setting as well as individual support. Participants are provided the
opportunity to experience typical community settings in support of their pursuit to integrated
employment at least monthly
Transition Plan
Over the past couple of years there has been an attrition rate of 100 people in PVS each
year. DDA expects all people receiving employment support to be in integrated employment
within three years through partnership work and natural attrition unless a shorter timeline is
required by CMS.
DDA will close the front door to PVS immediately. This means no new persons will enter
into PVS so that focus can be given to those currently receiving this service.
DDA has asked Counties to work with PVS providers to:
 Develop agency transformation plans;
 Assure each person has a solid individualized employment plan;
 Utilize Individualized Technical Assistance (ITA) as necessary; and
 Assure accurate outcome data, on the individualized support provided to people to
help them move towards their employment goal, is documented and provided.
DDA will provide Counties with:
 PVS outcome data reports on a regular basis;
 ADSA Web Access training on outcome and billing data; and
 Any available resources to support:
o Agency transformation plans; and
o Person Centered Plans
2014