VR-SFP Chapter 18: Supported Employment Services (effective February 1, 2022)

Supported Employment (SE) services are based on a “Place, Then Train” model, designed to provide customers with the most significant disabilities the supports they need to achieve competitive integrated employment. SE services include individualized job development and placement services, ongoing supports such as intensive job skills training, and arrangement of extended services (funded, paid, and/or natural supports) to help customers sustain meaningful long-term employment.

For additional information about SE, refer to SFP 18.10: SE Resources.

SE is an all-inclusive service. Therefore, the following Vocational Rehabilitation (VR) services may not be purchased while a customer is receiving SE services from an Employment Services Provider:

• Bundled Job Placement
• Job Skills Training*
• Non-bundled Job Placement
• On-the-Job Training (OJT)
• Personal Social Adjustment Training (PSAT)
• Vocational Adjustment Training (VAT)
• Environmental Work Assessment
• Vocational Evaluation
• Project SEARCH
• Work Adjustment Training (WAT)
• Work Experience Services (WE)

*Under special circumstances, VR may purchase job skills training as an extended service for VR customers who are youth with disabilities. For information on how job skills training can be used as an extended service for VR customers who are youth with disabilities, refer to SFP 18.7.1.1: Youth with Disabilities and SFP Chapter 17, Section 17.5.1.1 Purchasing Job Skills Training for Extended Services for Youth with Disabilities.

Any request to change any SE service definition, process and procedure, or outcomes required for payment must be documented and approved by the VR director, using VR3472, Contracted Service Modification Request for Job Placement, Job Skills Training, and Supported Employment Services, before the change is implemented. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.

A Career Planning Assessment (CPA) must be completed before referring a customer to SE. If an Environmental Work Assessment (EWA) was conducted, then payment for the CPA may be prorated. When payment for the CPA is prorated, the work skills assessment is not completed on the CPA. For more information on EWAs and CPAs, refer to VR-SFP Chapter 4: Employment Assessments.

VR staff sends VR5000, Referral for Provider Services, and a service authorization (SA) to the SE specialist before the SE Plan meeting. The VR counselor should provide relevant documentation, such as a Benefits Planning Query (BPQY); case notes; psychological, vocational, or medical evaluations; and a copy of the CPA and EWA (if done by a different provider), to prepare the provider to work with the customer.

18.5.1 Supported Employment Job Development and Placement Benchmark Service Description

The SE specialist conducts job development and placement activities consistent with the customer’s preferences, interests, potential job tasks, and employment conditions identified in the SE Plan.

18.5.2 Supported Employment Job Development and Placement Benchmark Process and Procedure

During the job development and placement benchmark process, the SE specialist contacts employers that may have job opportunities for the customer that are consistent with the SE Plan. The SE specialist contacts employers that are within the customer’s preferred geographic region, including businesses known to the customer and his or her circle of support, previous employers, and networking communities. The SE specialist conducts job preparation activities with the customer, such as interview preparation, application completion, and résumé development.

The provider ensures the customer is placed in competitive integrated employment consistent with the preferences, interests, at least two potential job tasks, and all nonnegotiable conditions identified on VR1632. The job development and placement benchmark is not achieved until the customer works a minimum of five shifts on five different days.

Once the customer is placed, the SE specialist completes a job analysis to identify the:

• customer’s essential and episodic work tasks and responsibilities;
• physical, environmental, and work pace demands of the job;
• social interactions in the workplace;
• supervision at the worksite;
• employer’s orientation, training and supports;
• customer’s response to the job; and
• training and supports needed for ongoing supports and extended services.

After the job analysis is complete, the SE specialist identifies goals on the training plan to be used in the delivery of ongoing supports during job retention.

There are times when providing ongoing supports at a jobsite may not be possible or preferred. A customer with a disability may not wish to have an onsite job skills trainer, for example, because they do not want to draw attention from fellow coworkers or be the subject of a stigmatizing belief of coworkers. At times, an employer may not accommodate onsite training and support due to security requirements or safety. When these situations occur, and onsite training and support is not ideal, remote training and support may be a solution. Any remote training and support should align with a customer’s goals on the training plan and be designed to:

• meet the support and communication needs of the customer;
• be suitable for the customer's work environment;
• fit within the customer's work environment (can include telework environments);
• allow for "normal" work routines without disruption;
• allow for observation of interactions (verbal and non-verbal) between customer, coworkers, and supervisors; and
• allow for training, use of natural supports and foster the customer's acceptance in the work environment.

For additional information about remote services, refer to SFP 18.10: SE Resources.

Any remote training must be in compliance with VR-SFP 3.4.8 Remote Service Delivery and 3.2.7 Confidentiality.

When the customer’s situation requires remote service delivery and the VR counselor supports the delivery of remote training, as indicated on the VR1632, the SE specialist evaluates the customer's and employer's training needs during the job analysis. The SE specialist must coordinate the equipment and software necessary to facilitate remote service delivery during job retention.

Once the customer is placed, the SE specialist and/or the job skills trainer provides ongoing supports at or away from the jobsite. Ongoing supports may include a variety of support activities chosen by the provider to help the customer maintain employment, such as:

• job orientation and assessment;
• transportation or travel training;
• evaluating the customer’s training and support needs;
• intensive job skills training;
• developing and maintaining production levels as expected by the employer;
• advocating for the acceptance of the worker and his or her integration into the workplace;
• advocating in support of the customer’s employment to his or her support network, treatment service providers, and benefits program coordinators;
• helping the customer understand employment benefits (for example, vacation, sick leave, and insurance);
• discussing reasonable accommodations with the employer;
• developing a support network that accommodates and positively reinforces the customer’s role as an employee; and
• communicating with the VR counselor regarding the job development and placement.

The SE specialist completesVR1632, Supported Employment Plan and Employment Report; VR1633, Supported Employment Job Development and Job Analysis Report; and the training plan section on VR1634, Supported Employment Training Plan and Job Retention Report.

18.5.3 Supported Employment Job Development and Placement Benchmark Outcomes Required for Payment

The SE specialist documents all information require on VR1632, VR1633, and VR1634, as well as verifies that the customer:

• has worked a minimum of five shifts on five different days; and
• is working in competitive integrated employment that meets the preferences, interests, at least two potential job tasks, and all nonnegotiable employment conditions identified in the SE Plan.

The VR counselor must verify that the customer is working in competitive integrated employment and meeting the preferences, interests, at least two potential job tasks, and all nonnegotiable employment conditions on the VR1632 before payment of a benchmark.

For payment, the provider submits:

• a signed, accurate, and complete VR1632, VR1633, and VR1634; and
• an invoice.

18.5.4 Fees

For information about fees, refer to 18.9 Benchmark Schedule and Fee Schedule.

18.7.1 Supported Employment Job Stability Review Service Description

A job stability review is completed when the customer:

• appears he or she will be job stable at the completion of the current job retention benchmark; or
• appears to need additional job retention services after two 28-day job retention benchmark periods.

The customer must complete at least one 28-day job retention benchmark to be eligible for job stability. To establish job stability, the provider must be prepared to transition any remaining support needs to a funded, paid, and/or natural support extended service provider and notify the VR counselor.

Job stability occurs when the customer:

• is satisfied with the employment;
• continues to work in a job that meets the definition of competitive integrated employment;
• is meeting the preferences, interests, at least two potential job tasks, and all nonnegotiable employment conditions on VR1632;
• has reliable transportation to and from the jobsite with a backup plan;
• is meeting the employer’s expectations regarding job performance;
• is meeting the physical and environmental demands of the job;
• has all necessary accommodations in place and working;
• has extended services (funded by other local or state agencies or Social Security, private pay, and/or natural supports) in place to ensure continued employment with this support; and
• has achieved all goals, unless a goal has been determined to be “no longer applicable” or is scheduled to be transferred to extended services, on VR1634.

The VR counselor and customer make the final determination about job stability and the purchase of any job retention benchmarks. The VR counselor must consult with the VR supervisor for six or more job retention benchmarks.

18.7.1.1 Youth with Disabilities

When all other available resources for extended services, such as Medicaid Waiver programs, natural supports, other public agencies, and/or private nonprofit organizations are not available to the customer, TWC-VRD can provide extended services to VR customers who are “youth with a disability.” Services can be provided for a period not to exceed four years or until the youth reaches the age of 25 and no longer meets the definition of a "youth with a disability," whichever occurs first. See the glossary for the definition of "youth with a disability."

When VR sponsors extended services for youth with disabilities, the case must continue to maintain job stability status. Job skills training is how TWC-VRD purchases extended services for a customer. For information on how job skills training may be used as an extended service, refer to VR-SFP Chapter 17, Section 17.5.1.1 Purchasing Job Skills Training for Extended Services for Youth with Disabilities.

18.7.2 Supported Employment Job Stability Review Process and Procedure

The provider notifies the VR counselor that the customer needs a job stability review meeting.

The VR counselor arranges for a job stability review meeting either in person or remotely to determine whether the customer has achieved job stability status or whether there is a need for an additional job retention benchmark. The meeting is held at least one week before the current job retention benchmark ends in order to prevent any gap in the timeline or SAs.

18.7.2.1 Supported Employment Job Stability Review Meeting

During the job stability review meeting, the VR counselor, SE specialist, customer, and circle of support discuss and review the customer’s employment and whether the customer meets the service definition of “job stability” or needs one additional job retention benchmark.

During the job stability review meeting, the VR counselor:

• evaluates the customer’s job stability status, as defined in the service definition section in 18.7.1;
• reviews and discusses the VR1632 (employment conditions, extended services, and employment information sections) and VR1634 (training plan section) for the current job retention benchmark period;
• communicates with the provider and customer regarding the need for an additional job retention benchmark;
• provides counseling and guidance, per VRSM C-1206-4;
• documents:
  • one additional job retention benchmark, if approved; or
  • job stability status; and
• requests that VR staff issue SAs to the SE specialist for:
  • either one job retention benchmark before the next job retention benchmark begins or the SE closure benchmark; and
  • any relevant premiums.

The job stability date is the day after the current job retention benchmark is completed.

Once job stability is determined, the customer remains in job stability status for at least 90 cumulative calendar days unless the status of job stability is lost. When job stability status is lost, it must be reestablished.

It is a best practice to schedule the SE closure meeting at the job stability review meeting when the job stability date is set.

Reestablishing Job Stability

Loss of job stability occurs if the:

• customer requires ongoing support services, such as additional job skills training by the SE specialist;
• extended services (funded, paid, and/or natural supports) are not working and the customer requires ongoing supports, such as additional job skills training by the SE specialist;
• customer loses the job;
• customer obtains a new position or new job;
• employer is not satisfied with the customer’s performance; and/or
• job no longer meets the preferences, interests, potential job tasks, and nonnegotiable employment conditions on VR1632.

If job stability is lost, the SE specialist communicates with the VR counselor and provides the needed interventions via one or more job retention benchmarks. This intervention is necessary to ensure that the customer’s performance meets the employer’s expectations and the extended services (funded, paid, and/or natural supports) are established and trained. It may be necessary to review and update the SE Plan and the training goals on VR1634. Once the additional job retention benchmarks are completed and the SE specialist’s and/or job skills trainer’s services have decreased to the level necessary for the customer to maintain employment, then another job stability review meeting is held to reestablish the customer’s job stability. At least 30 cumulative calendar days must pass before job stability is reestablished with a new job stability meeting.

To reestablish job stability, the VR counselor:

• requests that VR staff issue an SA to the provider for the SE specialist to participate in another job stability review meeting;
• schedules an job stability review meeting; and
• follows the procedures for establishing job stability listed in SFP 18.7.2.1.

18.7.3 Job Stability Review Outcomes Required for Payment

During the job stability review meeting, the SE specialist participates in and contributes to the discussion.

After any job stability review meeting, the provider submits an invoice for participation in the meeting. The job stability review meeting date is used as the date of service on the invoice.

18.7.4 Fees

For information about fees, refer to 18.9 Benchmark Schedule and Fee Schedule.

A provider may not collect money from a VR customer or the customer's family for any service. If VR and another resource are paying for a service for a customer, the total payment must not exceed the fee specified in the Standards for Providers manual.

Premium Services may be available for some SE services. Premium Services are paid after all deliverables for the service have been made. For more information, refer to Chapter 20: Premiums.