Westside Regional Center Employment First Informational Session CMS Final Rule Workforce Innovation and Improvement Act (WIOA) Employment First Movement & Practice
CMS FINAL RULE CMS 2249-F and CMS 2296-F (HCBS Rules) Published January 16, 2014/Effective March 17, 2014 *Full compliance by March 17, 2019* To ensure that individuals receiving long-term services and supports through home and community based service (HCBS) programs under the 1915(c)*, 1915(i) and 1915(k) Medicaid authorities have full access to benefits of community living and the opportunity to receive services in the most integrated setting appropriate To enhance the quality of HCBS and provide protections to participants
What The Final Rule Does Defines community What is not community (SNF, IMD, ICF/IID, Hospital) What is likely not community What is community Requires person-centered planning Codifies requirements Requires conflict-free case management What was best practice is now the rule
HCBS Setting Requirements Setting is integrated and supports access to the greater community Provides opportunities to seek employment and work in competitive integrated settings, engage in community life and control personal resources Ensures the individual receives services in the community to the same degree of access as individuals not receiving Medicaid home and community-based services
HCBS Setting Requirements Ensures an individual’s rights of privacy, dignity, respect, and freedom from coercion and restraint Optimizes individual initiative, autonomy and independence in making life choices Facilitates individual choice regarding services, supports and who provides them
CMS Guidance: Settings that may isolate individuals Settings that are presumed to have the qualities of an institution : Any setting that is located in a building that is also a publicly or privately operated facility that provides inpatient institutional treatment Any setting that is located in a building on the grounds of, or immediately adjacent to a public institution Any other setting that has the effect of isolating individuals receiving Medicaid HCBS from the broader community of individuals not receiving Medicaid HCBS
Assessing Compliance Programs will be asked to do a self-assessment to determine their compliance with Final Rule standards Sample Questions: Do the participants regularly access the larger community outside of the HCB setting? Are there restrictions while at the HCB setting on access to the community outside the HCB setting? If this is an employment setting, are participants provided with the opportunity to participate in negotiating work schedules, break/lunch times, and leave and medical benefits?
Final Rule Compliance … Provider self-assessment will be verified by Regional Center, DDS and DOR Transition plans will be developed with RC, DDS and DOR to help non-compliant providers achieve compliance Some providers may choose not to continue services rather than change programming for compliance
What Does This Mean for Supported Employment? SE Groups cannot work only for the agency provider’s programs SE Groups may not be able to work at businesses outside of normal business hours, unless other workers do the same Work activity programs who do not meet the new standard must to find ways to integrate the workforce and services or close
Applying The Standards Does the client have input into their job selection? Is the client working alongside people without disabilities? Does the client take breaks with co-workers? Do workers get to move around freely in the setting or are they restricted to one area?
Workforce Innovation and Opportunity Act (WIOA) President Barack Obama signed WIOA into law on July 22, 2014 WIOA brings significant change to DOR’s Supported Employment Program The intent of the WIOA is to empower individuals with the most significant disabilities to maximize employment, economic self-sufficiency, independence, inclusion and integration into society
Under WIOA The definition of Supported Employment now includes employment in an integrated work setting in which individuals are working on a short-term basis at Sub Minimum Wage (SMW) toward Competitive Integrated Employment (CIE) Placements in SMW are no longer the end goal, but rather a path forward to CIE; therefore, DOR established policy and procedures for VR teams to capitalize on opportunities for consumers to achieve CIE
Individualized Plans for Employment (IPE) Goals Must be for CIE (effective 1/1/16) Limitations on use of SMW as a successful Employment outcome for consumers currently in plan and for individuals 24 years or younger SMW placement in an integrated setting allowed only on a temporary basis and if the consumer will achieve CIE with necessary supports and services while the consumer is working in the integrated SMW placement Consumers placed into SMW in an integrated setting on a short-term basis will have a Rehabilitation Counselor evaluate, monitor and review progress toward CIE, including ascertaining the need for additional services Evaluation timeframe is determined on a case-by-case basis by the Rehabilitation Counselor and is dependent upon the consumer’s progress toward CIE
Progress Considered Measurable Improvement In one or more of the following areas: Employment preparation services Independence Self-advocacy Social skills Interpersonal skills Work ethics Work skills Efficiency Productivity Use of public transportation Time management Other measurable advancement or skill improvements
Limitations on use of SMW for Individuals 24 years or younger As of July 22, 2016, DOR shall not place any individual under the age of 24 in SMW placement, even on a temporary short-term basis unless the following conditions are met prior to placement: The individual has documentation that pre-employment transition services have been provided The individual has applied for VR services and has been found ineligible The individual was found eligible and was not able to achieve CIE and his or her record of services was closed The individual has received career counseling and information and referral about VR services as well as available CIE opportunities
WIOA brings significant change to California’s SEP Many of our Supported E mployment providers’ current business models will be impacted by these changes Implementing these changes will be challenging; however, we believe that by working together we will ensure all Californians are afforded the opportunity to realize their maximum employment potential
California’s Employment First Legislation From Welfare and Institutions Code 4869(a)(1) It is the policy of the state that opportunities for integrated, competitive employment shall be given the highest priority for working age individuals with developmental disabilities, regardless of the severity of their disabilities Students 16 and over, and their families, should be told about opportunities for work, or higher education, after high-school Employment should be considered before any other service is offered College and vocational training, if needed and wanted will also be considered
California’s DDS & DOR Budgets Support Competitive Integrated Employment Schools will focus more on Post-Secondary & Employment Students and families will be offered Employment options First Working age adults will be expected to have an Employment and/or Post- Secondary goal…and a path to Employment Regional Centers and providers will offer programs and resources to support Employment
Community Integrated Employment Settings Owning a business Being employed by a company Attending secondary education to learn a trade On a career certification track M eans….. Everyone participates We look at skills, talents and interests We change the way we see things We talk about possibilities and seek out opportunities, regardless of challenges
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