Building Bridges for
Employment
Presented by
Andy Sink, Liam McNabb and Jill Dorsi, NYS Office of Mental Health
Dan O’Shea, ACCES-VR
&
Crystal Collins, Northeast Career Planning/PROS on Broadway
APSE Conference, May 2014
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Employment and Mental Illness
•
78% of people who are diagnosed with a
serious mental illness are unemployed
(2006)
• This rate is lower than for people with other
disabilities
(30% employed vs 22%)
• Stigma and misunderstanding of mental
illness present a significant barrier to
employment
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SAMSHA Employment Intervention
Demonstration Program
 5 year study of employment programs
nationwide evaluated a variety of supported
employment approaches
 Most successful outcomes occurred when:
 programs integrated mental health services with
vocational services
 focused on rapid placement into jobs of the
person’s choice
 collaboration between the support providers and
the businesses employing the individuals
Source: Supported Employment: a guide for mental health planning and
advisory councils. www.samsha.gov
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Through integration and collaboration multiple
barriers to employment can be overcome
4
Updates on Collaboration Efforts
 Improved lines of communication between VR
Counselors and PROS practitioners
 Worked together to update PROS Guidance
Documents for implementing ACCES-VR
supports in combination with PROS Services
 ACCES-VR staff have presented at OMH Field
Offices and with PROS providers and PROS
staff have provided training to VR Counselors
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What we discovered…
 PROS is able to integrate mental health
supports in conjunction with supports
provided to people through ACCES-VR
 Liaison connections between the PROS
and ACCES-VR office are essential to
seamless integration
 How to coordinate ACCES-VR CRS
Milestone Payments with PROS Ongoing
Rehabilitation and Supports (ORS)
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What is PROS?
 Personalized Recovery-Oriented Services
 Rehabilitation program with a treatment
component
 Core Value: Recovery is a reality for people with
severe and persistent mental illness
 PROS provides individualized services and
interventions to support employment
 PROS Services and ACCES-VR Supports can
work together to achieve employment goals
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PROS Services that can be used
to support employment
Intensive Rehabilitation Goal Acquisition
Benefits and Financial Management
Medication Management
Intensive Relapse Prevention
Basic Living Skills
Structured Skill Development
Clinical Treatment Services/Health
Assessment
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Supporting PROS Participants
who don’t have Medicaid
 Lack of Medicaid coverage DOES NOT
prevent a person from receiving PROS
Services
 Net deficit funding: PROS providers receive
funding to offset providing supports to
individuals without Medicaid
 Sliding fee scales: PROS providers must
charge for PROS Services but can use a
sliding scale to make services affordable
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Managing Benefits to Support
Employment
 PROS Service: Benefits and Financial
Management can provide information
 Learn about SSI -budgeting protocol including
PASS: Plan to Achieve Self Support
IRWE: Impairment Related Work Expenses
Medicaid Buy-in: Allows individuals to work
and continue to access Medicaid health
coverage
 Hand-out: web addresses for more information
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ACCES-VR MILESTONES &
PROS ORS
 How do the new ACCES-VR Milestone
Supported Employment payments work with
PROS ORS?
 Assuring milestone payments are billed before
any ORS (extended services) are provided
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Quality Outcome Payments
 Incentive payment for providers
 Bonus to provider for obtaining
employment at higher hourly wage
and/or more than 30 hours/week
 Bonus payment and ORS: conflicts?
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Coordinating Supports
through “non-PROS” Agencies
 What happens when a non-PROS agency
provides ACCES Intensive Supports and
a PROS provides ongoing supports?
 Example: Putnam County
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Additional ACCES-VR Services
 Education: college tuition and room and board;
vocational training
– Work Try-Outs (WTO) & On The Job Training (OJT)
 Career counseling & guidance
 Rehabilitation & assistive technology
 Assessment to identify skills, interests, abilities,
and limitations
 Job placement and job retention
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Best Practices:
Northeast Career Planning
 Identifying point person/liaison at ACCES-VR
local office: makes collaboration easier and
more effective
 Referrals go both ways: PROS to ACCES-VR;
ACCES-VR to PROS: identify barriers to
employment and necessary supports
 Invite local ACCES-VR office into PROS to
share information with participants and
practitioners
 Providing ORS to people who don’t have
Medicaid
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PRINCIPLES INFORMING
PRACTICE
 For the first time, the OMH model of
choice is a rehabilitation model
 Implementing IPS and Supported
Employment principles in your PROS is
not only possible, it’s a must!
 Unique opportunity for doing real
rehab…
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Overlapping Circles of Support
 PROS and
Supported
Employment
programs overlap
 No wrong door of
entry
 PROS and
ACCES-VR
Services can be
simultaneous
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Working together improves employment outcomes
Evidence-Based
Practice:
IPS
PROS: ORS, IR,
& CRS
On the Job
Training
&
Worker
Try-out
ACCESIntensive
EMPLOYMENT
Education
Medicaid
Buy-in
Benefits &
Financial
Management
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Discussion & Comments