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DSL Memo Series 2002-14

September 13, 2002

STATE OF WISCONSIN
Department of Health and Family Services
Division of Supportive Living

To:
Area Administrators/Assistant Area Administrators-Adult Services
Bureau/Office Directors
County COP Contacts
County COP-Waiver Contacts
County LTS Planning Committee Chairpersons
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
COP Lead Agency Directors
Section Chiefs
Tribal Chairpersons/Human Services Facilitators

From:
Sinikka McCabe, Administrator

Re: VOCATIONAL FUTURES PLANNING PROCESS: EXPANDED HABILITATION SERVICES UNDER COP WAIVER AND CIP II.

Document Summary

This memo describes Vocational Futures Planning services as allowable employment services for participants of COP Waiver and CIP II, beginning July 1, 2002.

Wisconsin has received approval from the Center for Medicare and Medicaid Services (CMS) to expand Habilitation services under COP Waiver/CIP II to include employment services for the elderly and persons with physical disabilities. Effective July 1, 2002, employment services, defined as Vocational Futures Planning (VFP), was added as an allowable service for COP Waiver/CIP II participants. Vocational Futures Planning is a consumer directed, team based comprehensive service package that supports a waiver participant’s efforts to obtain, maintain or advance in employment.

Long-term care participants depend every day upon the health and long-term care system for their ability to live and work. Participants who are working or are seeking employment may require additional supports, such as assistive technology, modifications to home or car, food stamps, and housing/energy assistance, and navigate through numerous systems. However, among current service systems (e.g., SSDI/SSI, Division of Vocational Rehabilitation, Long-Term Support and local support services) there is no focal point that assures that systems work together for the employment success of the participant.

Vocational Futures Planning provides an opportunity for various support service providers to communicate and learn about other community programs. VFP facilitates maximum flexibility in funding and coordination among employment, long-term care and other supplementary support programs on a state and local level. As a result, consumers will have a greater opportunity to obtain, maintain and/or advance in employment.

Vocational Futures Planning provides a safe transition plan for long-term care participants who want to explore the feasibility of work but fear losing their benefits. At the request and direction of the consumer, team activities include: 1) identification of the barriers to work and need for assistive technology, 2) benefits analysis, 3) resource team coordination, 4) career exploration, 5) job seeking support, and 6) ongoing support. This service would be available at various stages of employment whether it is to obtain, maintain or advance in employment.

The agency providing Vocational Futures Planning (VFP) services will be responsible for ensuring that the six activities of the VFP services listed above are offered as a package to every individual served by the waiver. The VFP team, at a minimum, would consist of the consumer, employment consultant, benefits specialist, assistive technology consultant, and long-term care manager. Other potential members of the team such as a nurse and/or employer will be identified during the activities and will be invited to join the team as needed.

The term "Vocational Futures Planning" describes a consumer centered and directed, team based set of activities designed to develop the career aspirations of waiver participants. The term subsumes a number of popular and effective service models, including one of the same name used by the Pathways to Independence project. The use of this term does not imply that services of this type cannot be provided under different working titles. In this context "Vocational Futures Planning" is used as a generic term, similar in meaning to Comprehensive Team-based Employment Services or CTES in use by the Wisconsin Division of Vocational Rehabilitation.

1. Employment Planning and support may only be funded through the waiver when not available through the Division of Vocational Rehabilitation. (Section 110 of the Rehabilitation Act of 1973 (29 U.S.C. 730))
2. Excludes services such as job coaching and supportive employment as defined in SPC 615 or work related services such as sheltered workshops as defined in SPC 108.
3. Vocational Futures Planning must be provided at the request and the direction of the consumer.
4. The Vocational Services Planning agency responsible for providing waiver services will ensure that the six components of the employment planning and support services are offered as a package to every individual served by the waiver. The six components are; 1) identification of the barriers to work and need for assistive technology, 2) benefits analysis, 3) resource team coordination, 4) career exploration, 5) job seeking support, and 6) ongoing support.
5. The agency must ensure that the Employment Consultant and Benefits Specialist are qualified professionals, that they receive initial training in the VFP process, and that they continue to receive ongoing training to remain current on all state and federal requirements.
6. Within 30 thirty days of completion of each of the six components described in #4, activity reports must be placed in the participant's record. Component #6, Ongoing Support, requires monthly reports when a participant receives this service.

Care managers should assess a participant's employment goal and if he/she will benefit from participation in the Vocational Futures Planning process. Although functional ability indicates a level of support a participant may require, it should not rule out employment as a goal. For instance, in calendar year 2001 30 counties reported over 100 COP-W/CIP II participants who received COP funding for supported employment or prevocational services. For some participants, these were the only employment services available. Moreover, there are waiver participants who are employed or are participating in the VFP process.

Pathways to Independence (PTI) reports that approximately 120 out of 705 or 17 percent of participants reported they were receiving long-term care services at the time of enrollment in PTI.

Listed below are indicators of potential consumers who may benefit from participating in the Vocational Futures Planning process.

The care manager may use the above listed indicators as a basis for identifying consumers and initiating discussions with them. If the consumer responds positively to the indicators, the care manager should document the consumer's employment goal in the care plan and refer the consumer for Vocational Futures Planning services in the following way.

• Work with the consumer to complete an application for services with the Division of Vocational Rehabilitation (DVR). If DVR approves the application or if the consumer already has an established case with DVR, the care manager should advocate that the consumer receive Vocational Futures Planning. The care manager will identify the Vocational Futures Planning agency as the provider and DVR as the funding source on the care plan.

• In the event that DVR does not approve the consumer's application or if the consumer has had an unsuccessful experience with DVR in the past, the care manager may then refer the consumer directly to a Vocational Futures Planning provider. Refer to attachment A for a current list of VFP providers. The care manager will identify the provider on the care plan and either COP Waiver or CIP II as the funding source.

Depending on the number of and type of identified barriers and consumer direction, the units of service and frequency will be determined by the consumer and the Vocational Futures Planning team, including the care manager.

Effective July I, 2002, VFP is available for COP-W/CIP II participants. COP Waiver/CIP II funds may not be used to purchase job coaching services or sheltered workshops.

As previously mentioned, a number of consumers are receiving Supported Employment or Prevocational services through COP. A waiver participate who is able to self direct, participate fully in the VFP and who does not need continuous supervision, may have been referred to Prevocational or Supported employment services. The services may have included development of work and related abilities, removing barriers to gainful employment, assessment or transitional employment. These individuals may benefit from the VFP process that will be able to provide those services mentioned above and related services, such as benefit analysis and assistive technology assessment. Counties should consider making these consumers a priority to determine appropriate employment goals and the services needed to meet those goals.

REGIONAL OFFICE CONTACT:
Assistant Area Administrator - Adult Services

CENTRAL OFFICE CONTACT:
Mary Ellen Barone
Office for Persons with Physical Disabilities
Bureau of Aging and Long Term Care Resources
P.O. Box 7851
Madison, WI 53707-7851
Phone: (608) 266-9303
Fax: (608) 267-3203
E-mail: baronme@dhfs.state.wi.us

cc: Charlene Dwyer, Department of Vocational Rehabilitation

WEB SITE: http://www.dhfs.state.wi.us/LTC_COP/cop.htm

Attachment

Many Vocational Futures Planning providers are located at Pathways to Independence sites. Pathways to Independence, a joint program of the Department of Health and Family Services and DVR, offers the VFP process to SSI and SSDI beneficiaries that are authorized for service by DVR. Sites are located throughout the state and may serve one or more counties.

The following table identifies the current Vocational Futures Planning sites. Care managers should phone the VFP provider in their region to identify counties served by the provider.

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