Supported Employment is competitive integrated employment (including customized employment in an integrated setting) in which the customer is working toward a competitive integrated employment outcome.
Often, these customers have been:
- excluded from community services;
- institutionalized; or
- in segregated work programs, such as sheltered workshops or enclaves for long periods of time.
These customers need assistance to:
- compete in the open market;
- meet potential employers;
- develop and coordinate extended services and long-term support to maintain employment after Vocational Rehabilitation Services (VRS) closes the case; and
- benefit from a place-and-train model.
Supported Employment (SE) Services provide individualized training and support to assist customers in finding competitive integrated employment that is consistent with their unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. SE also establishes extended services and long-term support within the work environment to maintain employment.
Definitions of key terms related to Supported Employment Services can be found in the Standards for Providers Chapter 8: Standards for Employment Services, 8.2 Key Terms.
Supported Employment Services are only purchased through contracted providers.
For more information on general purchasing policies and procedures, refer to:
For a table of fees for Employment Assistance Services, including Supported Employment, refer to:
To ensure accountability and quality of services to Vocational Rehabilitation customers, VRS staff must be familiar with and apply the contracting program requirements as published.
For specific information about purchasing outcome-based Supported Employment Services, refer to:
Level of Significance for Supported Employment Cases
A State may provide services under this part to any individual, including a youth with a disability, if:
(a) The individual has been determined to be:
(1) Eligible for vocational rehabilitation services in accordance with 34 CFR 361.42; and
(2) An individual with a most significant disability;
(b) For purposes of activities carried out under §363.4(a)(2), the individual is a youth with a disability, as defined in 34 CFR 361.5(c)(59), who satisfies the requirements of this section; and
(c) Supported employment has been identified as the appropriate employment outcome for the individual on the basis of a comprehensive assessment of rehabilitation needs, as defined in 34 CFR 361.5(c)(5), including an evaluation of rehabilitation, career, and job needs.
*34 CFR 363.3
All Vocational Rehabilitation (VR) customers who use Supported Employment Services must have their case files designated in ReHabWorks as "most significant." The level of significance is determined prior to eligibility. However, this designation can be updated any time thereafter if new information becomes available to support the change in the level of significance.
Manager review and approval is required to change the level of significance for customers who have received Supported Employment Services, if the level of significance is being changed from "most significant" to any other level of significance.
For more information about determining the level of significance, refer to:
Types of Disabilities
Supported Employment Services can be used for customers with any type of disability; however, the services are most commonly used for customers with intellectual and developmental disabilities (IDD), significant mental health conditions, or autism.
For more information about determining eligibility, refer to RPM Chapter 3: Eligibility and VRM Chapter 3: Eligibility.
Customer characteristics appropriate for SE Services are:
- needs ongoing assistance and/or Extended Services (long-term support) to establish and maintain resources to address other issues, such as:
- personal assistance services;
- child care;
- Social Security reporting and benefits analysis;
- food; and
- financial needs;
- needs Extended Supports (Long-term Support Services or LTSS) and repetitive instruction to:
- communicate with employers and others;
- identify interests, strengths, and weaknesses related to employment;
- motivate one's self to learn skills and participate in tasks related to employment;
- manage steps and goals related to obtaining and/or maintaining employment;
- assist with problem solving; and
- assist with disability management (such as medication management); and
- needs extensive and comprehensive training in areas such as grooming, hygiene, and suitable work attire.
Supported Employment must be identified as an appropriate rehabilitation objective for the individual on the basis of a comprehensive assessment to determine the individual's unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice and must be included in the customer's Individualized Plan for Employment (IPE).
If the original IPE did not specifically identify Supported Employment as a planned service, the IPE must be amended to include Supported Employment and the specific provider for these services. All changes to planned Supported Employment Services must be documented in an IPE or in an IPE amendment. (Use of service justification case notes in lieu of an IPE or IPE amendment is not allowed).
For more information on eligibility for SE Services, refer to:
SSI and SSDI Recipients
If a customer is eligible for Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) benefits, counselors must obtain a Benefits Planning Query (BPQY) from the Social Security Administration (SSA) and share this information with the SE provider as a part of the referral packet.
If the customer is eligible for any Social Security work incentives, such as a Plan to Achieve Self Support (PASS) or Impairment-Related Work Expenses (IRWE), the counselor works with the customer to facilitate access to these resources.
For more information about this process, contact the program specialist for benefits for the Rehabilitation Services Division (DRS) or Blind Services Division (BSD) or the designee (unit or regional subject matter expert) and refer to:
Medicaid Waiver Programs
Home and community based waivers—such as the Home and Community-based Services (HCS) program, Texas Home Living program, and Community Living Assistance Support Services (CLASS) program, or a managed care organization (MCO)—must be used as a comparable benefit when establishing extended services and support for the customer.
For more information about using a comparable benefit, refer to:
If the customer is a current participant in a Medicaid waiver program and is going to need Extended Services and support, the MCO case manager and/or service coordinator and provider must be involved in coordinating services beginning with the Supported Employment Assessment.
Extended support must be approved for payment on the customer's waiver plan by no later than the end of Benchmark Four [Title]. For assistance in coordinating Medicaid Waiver services, contact the appropriate benefits subject matter resource staff person.
Note: This section applies only to customers who have a Medicaid waiver already available to them.
Other Sources for Extended Support
Extended services can be provided by other public agencies, private nonprofit organizations, or other sources, including employers and other natural sources of support, following the provision of authorized Supported Employment Services.
The IPE must include:
- a list of the specific employment support needs that have been identified, including:
- natural sources of support;
- assistive technology and equipment; and
- training needs, both on and off the employment site;
- a benefits analysis and planning for customers who receive Social Security benefits to determine if there are benefits that the customers can access to support their employment;
- benefits that can be used to assist customers in achieving their chosen employment outcome or in the provision of extended services;
- expected Extended Services needed, including natural support;
- name of the individual, organization, or other resource that is reasonably expected to agree to provide Extended Services after the VRS-funded services cease (if such a resource cannot be identified when the IPE is developed, document why there is a reasonable expectation that a source for the Extended Services will become available before case closure);
- a plan for how frequently the vocational rehabilitation counselor will monitor the case to ensure progress is being made toward competitive integrated employment that meets all negotiable and non-negotiable employment conditions, targeted job tasks, and long-term support needed by the customer; and
- an explanation of the coordination of services provided under other individualized plans for other federal or state programs; for example:
- an Individualized Education Plan (IEP);
- an Individualized Transition Plan (ITP-BSD);
- HCS; or
- other available programs.
Refer to RPM Chapter 4: Assessing and Planning (general services) and VRM Chapter 4: Assessing and Planning (blind services) for additional information on developing an IPE.
Before successfully closing a case with a Supported Employment outcome, in addition to the requirements outlined in RPM Chapter 16: Closure, all of the following conditions must be met:
- The supported employment specialist has successfully placed the customer in a job consistent with the job task and employment conditions identified in the Supported Employment Support Summary (SESP), Part 1.
- The customer has worked at least 90 days without substantial services funded by VRS and without any provision of services other than monitoring the established extended support.
- Support services have been established as outlined in the SESP Part 2 to ensure successful placement.
- Monitoring of support is the only service that the Supported Employment specialist has performed for at least 90 days after achievement of Benchmark 5—Job Stability.
The vocational rehabilitation counselor must select Supported Employment as the employment status on the Successful Closure window in ReHabWorks.
The vocational rehabilitation counselor (VRC):
- completes a comprehensive assessment of rehabilitation needs, including an evaluation of rehabilitation, career, and job needs;
- identifies, addresses, and documents any medical, psychological, or physical issues that could interfere with successful employment;
- completes the Individualized Plan for Employment in ReHabWorks (RHW):
- identifying that the customer is eligible for and will be receiving SE Services via check box option in RHW; and
- including Extended Services, as listed in the IPE, as a comparable benefit;
- works with the benefits planning specialist to obtain a Benefits Planning Query (BPQY) from SSA for any customer who has Social Security benefits, shares this information with the SE provider as part of the referral packet, and includes the information in the IPE;
- coordinates the provision of any Social Security work incentives such as a Plan to Achieve Self-Support (PASS) or Impairment-Related Work Expenses (IRWE);
- coordinates the provision of any Texas Department of State Health Services (DSHS), Texas Health and Human Services Commission (HHSC), or managed care organization (MCO) funding for LTSS;
- leads the SE process, providing guidance and monitoring throughout to ensure successful employment for the customer;
- serves as the team lead for any VRS staff—including the rehabilitation services technician (RST), rehabilitation assistant (RA), and customer case coordinator (CCC)—who are assisting with the case;
- completes DARS1610, Supported Employment Service and Supported Self-Employment Referral, and sends it to the provider ensuring whether any physical, cognitive, or emotional limitations related to employment need to be evaluated during the completion of the Supported Employment Assessment (SEA);
- initiates and leads the SEA review meeting, which takes place prior to the SESP1 meeting, to determine if:
- an appropriate employment outcome for the customer can be achieved through SE Services; or
- no employment outcome will be pursued, requiring the identification of next steps that must take place;
- helps the employment services provider coordinate the SE Service Plan meeting lead by the customer and/or customer's representative, if any, ensuring that:
- the customer's circle of support attends; and
- DARS1613A, Supported Employment SESP1 Demographics; DARS1613B, Supported Employment SESP1 Benchmark Reports; and DARS1613C, Supported Employment SESP1 Extended Supports, are completed by VRS staff and accurately identify the interests, preferences, skills, job tasks, employment conditions, Extended Services (long-term support), and potential employers that will help determine the long-term placement goal for the customer;
- submits electronically completed DARS1613A, Supported Employment SESP1 Demographics; DARS1613B, Supported Employment SESP1 Benchmark Reports; and DARS1613C, Supported Employment SESP1 Extended Supports using encrypted email to the community rehabilitation program (CRP);
- monitors, after the placement is made, the customer's employment to ensure that all (100 percent) non-negotiable employment conditions, at least 50 percent of negotiable employment conditions, and at least one Targeted Job Task are maintained throughout the delivery of SE Services;
- verifies that the Standards for Providers have been followed and all deliverables have been achieved prior to paying a provider;
- verifies that the Extended Services (long-term support) are in place and working prior to the achievement of Benchmark 5—Job Stability;
- leads the job stability meeting to evaluate the customer's employment placement for achievement of job stability;
- verifies that Extended Support remains in place and works effectively without the CRP providing direct services for 90 days prior to approving achievement and payment of Benchmark 6—Service Closure;
- documents the agreement on the extended period of time necessary for the customer to reach job stabilization in the customer's Individual Plan of Employment, when a customer must participate in SE Services for more than 24 months; and
- ensures that DARS3472, Contracted Service Modification Request is completed following the policy in RPM Chapter 17: Purchasing Goods and Services for Consumers or VRM Chapter 30: Supported Employment, any time the SE benchmarks:
- need to be purchased more than once;
- are not purchased due to changes in providers; and/or
- need to be extended beyond 24 months for a customer.
Program Support Staff
The Rehabilitation Services Technician (RST), Rehabilitation Assistant (RA), and Customer Case Coordinator (CCC), under the direction of the VRC, can:
- request records;
- create service records and issue service authorizations, ensuring that SE funds are used, when available;
- schedule and/or coordinate meetings with the customer, customer's circle of support, provider, and counselor; and
- review provider reports and forms:
- to ensure that all criteria are satisfied per the SE Standards for Providers and VRS-Only section of the applicable forms; and
- correct errors and/or return reports to the provider for corrections using DARS3460, Vendor Invoice Additional Data Request.