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Supported employment is competitive integrated employment in which an individual, including youth, with a most significant disability requires intensive services and long-term support to maintain employment following DVR services. Supported employment services begin with the start of a job. This document explains the process, from start to closure of a DVR case, for serving an individual who needs supported employment services to be successful.
Supported employment should be considered following a comprehensive assessment of a consumer's rehabilitation needs and employment goal. Every consumer's employment goal should be consistent with their unique strengths, priorities, concerns, abilities, interests, and informed choice. Supported employment should not be considered the first choice automatically when a DVR applicant is identified as having funding through Long-Term Support.
Note: In this document, ongoing support services refers to services provided by DVR up to 24 months from the time of job placement until transition to Long-Term Support. Long-Term Support refers to services needed to support an individual in employment after the individual has made the transition from the ongoing support services provided by DVR.
Supported employment definitions are provided at the end of this document.
There are different approaches for consumers who require supported employment services to achieve competitive integrated employment. Each service approach is a statewide service and has technical specifications, associated fees, and established reports.
Supported employment is competitive integrated employment for a consumer who, with the assistance of systematic instruction, can perform the necessary tasks of an existing job.
Customized employment is competitive integrated employment for a consumer with a significant disability that has job duties assigned based on the consumer's unique strengths, needs, and interests; designed to match the consumer's abilities with the employer's business needs.
Consumers may benefit from customized employment services if they cannot perform necessary tasks of an existing job. The customized employment provider will identify the strengths of the consumer and work with an employer to create a job to meet the business's needs. Long-term supports are provided via systematic instruction. It is not necessary to have attempted typical supported employment before providing customized employment services.
Note: It is possible to provide customized employment services to a consumer who does not need long-term supports and is not considered to be a supported employment consumer. In those cases, the technical specifications can be used, and the service and payment will not be provided for transition to Long-Term Support because they are not necessary.
Individual Placement and Support (IPS) is competitive integrated employment using an evidence-based model of supported employment for consumers who have a primary diagnosis of serious and persistent mental illness or substance abuse and may need long-term support to maintain a job. IPS services are intended to assist a consumer with planning, job development, job placement, on-the-job support, transition to Long-Term Support, and successful employment. IPS also includes a strong partnership with a county mental health program.
Note: IPS is only provided at approved county-based sites. No service provider or DVR staff can authorize or provide an IPS service without approval from the DVR Contract Specialist and IPS State Team.
DVR provides consumers support services that are necessary for them to be successful in performing their job duties. DVR seeks to use existing natural supports and fade DVR supports once an employee learns the essential functions of their job and reaches stability.
If necessary, DVR may provide ongoing support services for up to 24 months from the time of job placement until transition to Long-Term Support. Under special circumstances, the eligible consumer and the DVR Counselor may agree jointly to extend the time to reach the employment goal identified in the IPE.
For youth who do not have an identified source of long-term support available, DVR must provide long-term support (extended services) funding for a period up to 48 months or to the consumer's 25th birthday, whichever comes first.
Note: Funding available through other sources (e.g., Family Care, IRIS, Children's Long-Term Support Waiver Program) must be explored and, when available, used as a comparable benefit.
| Participant (with a most significant Disability) | Up to 24 Months Ongoing Support Services | Up to 48 Months Long-Term Support Services |
|---|---|---|
| Youth (Up to Age 25) | X | X |
| Adults (Age 25 or Older) | X |
DVR staff must determine a consumer's need for supported employment services before developing the consumer's IPE. Early identification of a source for long-term support funding does not indicate an automatic need for supported employment services.
A supported employment assessment should be completed for each consumer considering supported employment services via a Career Profile referral. If customized employment is deemed more appropriate for the consumer, the Discovery process is used. This information helps in vocational planning, job searching, determining the level of support needed, and identifying resources for support once the consumer begins work.
It is expected that the consumer will need long-term support to maintain competitive integrated employment, so the consumer's supported employment team should be identified and involved in the completion of the Career Profile or Discovery Report.
Other DVR services can be provided to those identified as supported employment consumers. Services such as internship/temporary work may help identify the consumer's IPE goal or build skills to assist them in maintaining employment. Pre-employment transition services (Pre-ETS), such as student work-based learning, can also help consumers identify and reach their goals.
A Work Incentive Benefits Analysis should be used early in the DVR process to assist in exploring possible long-term support options. A benefits analysis will also identify work incentives that a consumer may access to assist with job retention.
Note: It may be necessary to complete an IPE extension request if the comprehensive assessment and benefits analysis cannot be completed within the 90-day IPE timeframe.
Through completion of the Career Profile, Discovery process, other services, and in consultation with members of the supported employment team, the consumer's long-term support needs should be clearly identified. Details including how much support is needed and with what types of tasks should be provided.
Based on this information, all possible sources of long-term support should be explored and documented in the consumer's case file. In some cases, a combination of supports may be used to best meet the consumer's needs. Support options include, but are not limited to:
Note: Natural supports can be a great option for some consumers to achieve their employment goals, but they should not be expected to be successful in all cases. If the consumer, DVR Counselor, and team are considering natural supports as an option to meet the consumer's needs, a clear understanding of those needs and how the team feels natural supports could successfully meet them is essential before pursuing this long-term support option.
Note: When working with Family Care, IRIS, CLTS, or other long-term support programs, DVR must coordinate with the program to identify the type of supports needed and when those services should be implemented and identified in corresponding consumer service plans. The communication should be documented and include an agreement for planned services, employment, payment, timing, and outcomes for the consumer.
A review of the coordinated plans should take place at the following three points in the process:
Supported Employment Coordination Planning
Additional Considerations when Determining Long-Term Support Needs and Sources
Supported employment services are provided as a working team with the DVR consumer at the center. The makeup of the team is individualized based on the needs and expressed wishes of the consumer. The team typically includes the consumer, the DVR Counselor, a supported employment service provider, a guardian (if applicable), family members, representatives of the entities providing funding and service coordination following DVR case closure, and any other individuals identified who support the consumer's employment goals.
The IPE for an individual identified as a supported employment consumer must:
*Refers to the expectation that the identified source will be available to the consumer within the 24-month timeframe outlined in the definition of supported employment for adults.
DVR's goal is to maximize the hours worked and wages earned by consumers in employment. DVR Counselors should encourage consumers to work up to 40 hours per week if possible. The supported employment team, in agreement with the consumer, should identify the expected number of work hours per week to be included in the IPE along with the job goal. The reasons for the number of hours determined must be detailed in the IPE casenote.
DVR does not require that a supported employment service provider have a formal agreement or contract with funders of long-term support services. It is important that DVR Counselors address informed choice considerations with consumers who choose to work with a service provider without a formal agreement in place.
While DVR does not require a formal service provider agreement, Long-Term Support does, so before transition from DVR to Long-Term Support a formal agreement will need to be developed or the consumer must transition to a different provider with a formal agreement. This may require the consumer and employer to adjust while they learn to work with someone else.
The source of funding for ongoing services and long-term support should be identified in the IPE for youth under the age of 25. DVR can provide up to 24 months of ongoing services. Following ongoing services, DVR must fund long-term support services for up to 48 months or to the consumer's 25th birthday, whichever comes first. During this time, alternative funding sources for long-term support should continue to be explored. There is a maximum lifetime cap of 48 months of long-term support provided by DVR.
Initially, an IPE for a student may contain pre-employment transition services (Pre-ETS), which can assist in identifying potential employment goals and the type and length of possible supports. The IPE for a student should be updated to reflect the specific job goal following Pre-ETS. If the consumer needs supported employment services, the IPE should also include identified needs and services to maintain employment following DVR services.
Students and their DVR Counselors should work together to update their IPEs to reflect a permanent employment goal. Reference the Basic Steps in Supported Employment as outlined in this document to identify what should be considered in an IPE.
If long-term support funding is available from a Managed Care Organization (MCO), IRIS, or a CLTS Waiver Program, this is considered a comparable benefit and the case should be transitioned to that source of supports following 90 days of stability on the job. It may be necessary to complete an IPE extension request if DVR and the consumer agree that additional time is needed, and the IPE cannot be written within the allowed 90-day period.
DVR cannot fund long-term supports for adults. Adult consumers with no source of long-term supports identified and without a reasonable expectation that a source will become available, including natural supports, should clearly understand that DVR is not able to provide long-term services. The IPE can be developed for supported employment services and the search for long-term support options should continue.
If long-term supports are identified and action needs to be taken by the consumer to access them, these responsibilities can be included in the IPE progress measures. In these cases, a discussion on how to proceed should take place between the DVR Counselor, the consumer, and the consumer's representative, as appropriate. Available assessments should be reviewed to determine if the consumer can reasonably be expected to retain employment without long-term support. DVR should also verify that all sources for possible support have been ruled out.
For youth, DVR must provide long-term supports for up to 48 months and should continue to identify another source of long-term support to ensure there is no interruption of services. For adults, DVR may provide ongoing supports for up to 24 months. It may be necessary to complete an IPE extension request if DVR and the consumer agree that additional time is needed, and the IPE cannot be written within the allowed 90-day period.
Upon completion of IPE development, job development and other services can begin, and any other needed assessments can continue. DVR will provide information and support to the consumer to maximize the number of hours the consumer can work. A job or customized position obtained by a provider for a consumer must be consistent with the consumer's employment goal listed in their IPE.
The service provider will use systematic job development strategies by selecting potential jobs based on consumer preferences, visiting businesses, and learning about their hiring needs. Systematic job development relies on relationship-building and time spent in the community. The systematic approach to job development allows for a good job match and reduces the need for workplace support while maximizing consumer independence and job satisfaction.
During job development, meetings should take place with the supported employment team every 90 days to discuss progress and adjust the IPE goal or strategies used by the service provider as needed.
Upon an offer of employment, the service provider will conduct a job and task analysis before the consumer starts the job to determine the best ongoing support strategies for the consumer, emphasizing independence and use of natural supports on the job. The service provider will identify the needed supports and use them in coordination with the employer and the consumer.
While systematic instruction and DVR services focus on developing job skills, it is important that consumers also develop soft skills in the initial phases of employment. Soft skills can help consumers maintain their employment and be successful. Systematic instruction can include soft skills and specific job skills.
If a consumer needs other types of support that fall outside of soft or hard job skills, the supported employment team should be consulted, and a plan to provide those supports should be developed. Services such as personal attendant services are not a part of systematic instruction and would be provided separately. If a consumer requires another person to be present at the request of an employer or for the purposes of safety, the supported employment team must convene to decide about the appropriateness of the job placement.
A meeting with the supported employment team and the employer must take place in the second month of employment to review the consumer's initial progress on the job. This meeting serves to identify strategies to support the consumer on the job, identify accommodation needs of the employer, and make early adjustments as needed for job retention. The number of work hours should also be reviewed at this time to ensure that the consumer is working the maximum number of hours possible, consistent with the hours identified in the IPE.
The agreement of the team should be documented and include planned services, continuing employment, payment of services, timing of services, and outcomes for the consumer.
Stability can occur at any time. Once stability is achieved the case should be transitioned to Long-Term Support, though transition cannot occur before the consumer reaches 90 days on the job. While additional independence and progress may still occur, stabilization happens when the consumer has learned the job and is performing at a level where they are able to accurately complete the required job tasks with a reasonable level of support given the timeframe on the job and in the timeframe agreed upon with the employer.
A consumer's IPE should include progress measures that, once met, will clearly identify when the transition to Long-Term Support should occur. This transition will typically take place once a consumer is stable on a job, has met the IPE progress measures identified by the supported employment team as agreed to in the IPE, and has received the services identified in the IPE.
The consumer, counselor, consumer's representative, and Long-Term Support provider, along with other team members, should agree on the timeframe for transitioning to Long-Term Support. Several discussions should take place between the consumer, all members of the supported employment team, and the employer so that all parties, including the Long-Term Support provider and employer, are aware when the case approaches the appropriate point to transition to Long-Term Support. This communication will ease the transition of the consumer's paid services from DVR to the Long-Term Support provider.
In instances where the consumer is a participant in a Long-Term Care waiver program but is privately paying for long-term employment services, DVR staff should have a discussion with the consumer at IPE development to plan future support needs.
If the consumer is a participant in a Long-Term Care waiver program, DVR staff should have discussions with the supported employment team at IPE development to plan future support needs and agree on the appropriate time to transition to long-term support once the consumer is stable on the job.
If a consumer is supported by the IRIS wavier, they will need to account for employment support needs in their individualized IRIS budget. If the consumer needs funds in their IRIS budget, the IRIS consultant may request additional funds to cover the cost of employment supports.
If transition to IRIS Long-Term Support includes a personal care worker, DVR will ensure that this is acceptable for the consumer, the supported employment team, and the consumer's employer. DVR and IRIS staff will confirm that the Long-Term Support provider is qualified to provide long-term support services in a way that allows the consumer to keep their job.
If a consumer is supported by a Managed Care Organization, Interdisciplinary Team (IDT) staff will assess the need for long-term care supported employment services.
If a youth under the age of 25 does not have other funding sources available, DVR must fund long-term support services for up to 48 months or to the age of 25, whichever comes first. During this time, alternative funding sources for long-term support services should continue to be explored.
If long-term support funding is available from an MCO, IRIS, or a CLTS Waiver Program, this is considered a comparable benefit and the case should be transitioned to that source of supports following 90 days of stability on the job.
If no long-term supports are identified as a consumer nears age 25, a plan to transition the consumer to natural supports should be developed in consultation with the supported employment team and the employer. Every effort should be made to identify natural supports and other strategies to assist the consumer in performing the job independently.
Transition to Long-Term Support is not just a transition of funding for long-term support services, it also signifies that an individual in supported employment has learned the essential functions of a job and is meeting the employer's job performance expectations.
Transition to Long-Term Support should occur as quickly as possible once the consumer is stable on the job. DVR can provide up to 24 months of ongoing support, though this level of need is rare. The supported employment team should be involved at each step during the supported employment process and work together to reduce the need for job coaching support while maximizing independence.
While the six-month mark is not necessarily the point at which transition to Long-Term Support occurs, it is significant in that the provider cannot receive a transition to long-term support bonus payment if transition to Long-Term Support occurs after the sixth month of supported employment systematic instruction. This benchmark is not necessarily the appropriate point of transition to Long-Term Support for all consumers, as each consumer's needs should be considered on an individualized basis.
The transition agreement should be documented and include planned services, continuing employment, payment of services, timing of services, and outcomes for the consumer. It is a best practice to obtain signatures from all parties at the time of transition to Long-Term Support to show that all parties agree with the transition; however, the only requirement is that it is documented that all parties agreed on the transition to Long-Term Support.
Guidelines for Maximum Amount of Ongoing Support
Guidelines for Maximum Amount of Long-Term Support Provided by DVR for Youth
To close a case successfully, the consumer's job must be in a competitive and integrated setting earning commensurate wages to other employees performing similar job duties.
The following must also be satisfied to demonstrate achievement of an employment outcome in supported employment as set forth in 34 CFR §363.54 of the regulations:
County mental health programs may be a resource for supports for an individual who is enrolled in a Community Support Program (CSP), Comprehensive Community Services (CCS), or other mental health services.
Consider including a county case worker when developing a supported employment team for a consumer in CSP or CCS. The case worker may be able to provide off site support related to the disability after DVR closes the case and identify job types and environments that may lead to employment success. Depending on the county's available services, more specific job supports may be options for comparable benefits.
Items to Consider when Determining Long-Term Support Needs and Sources
DVR can provide long-term supported employment services for youth under age 25 for a period not to exceed 48 months. DVR cannot provide long-term support services beyond 48 months and the 48-month limit is a lifetime cap.
Through completion of the Career Profile, Discovery process, other services, and in consultation with members of the supported employment team, the consumer's long-term support needs should be clearly identified (how much support is needed and with what tasks). Transition to Long-Term Support should occur as soon as the consumer reaches stability on the job, as defined by the consumer, support team, and employer.
Customizing job duties may be another way to address specific tasks that are not a good fit with the consumer's abilities and interests and reduce dependence on systematic instruction.
If no long-term supports are identified as a consumer nears age 25, a plan to transition the consumer to natural supports should be developed in consultation with the supported employment team and the employer. Every effort should be made to identify natural supports and other strategies to assist the consumer in performing the job independently.
It may be necessary to update the IPE to include the new strategies identified. DVR cannot fund long-term supports beyond 48 months or beyond age 25. The 48-month limit is a lifetime cap. If a consumer under age 25 returns to DVR for supported employment the previous case should be reviewed to determine the balance of months that may be used if no other source of long-term support services has been identified.
DVR can provide ongoing supported employment services to any consumer, regardless of age, for up to 24 months. This 24-month limit is not a lifetime cap and resets at case closure. Under special circumstances (i.e., we have identified an ongoing long-term support provider that will not be available until a month or two beyond 24 months), the consumer and counselor may jointly agree to extend the time beyond 24 months to achieve the employment outcome identified in the IPE.
While 24 months for ongoing support is identified as the maximum, need for this length of ongoing support is rare. Through completion of the Career Profile, Discovery process, other services, and in consultation with members of the supported employment team, the consumer's long-term support needs should be clearly identified (how much support is needed and with what tasks). Transition to Long-Term Support should occur as soon as the consumer reaches stability on the job, as defined by the consumer, support team, and employer.
Customizing job duties may be another way to address specific tasks that are not a good fit with the consumer's abilities and interests and reduce dependence on systematic instruction.
DVR must provide pre-employment transition services (Pre-ETS) to any high school student with a disability who is eligible or potentially eligible for DVR services and still participating in secondary education. The five types of Pre-ETS give students the opportunity to explore career options. Once their long-term goal has been identified, the IPE should be updated to reflect the specific job goal and transition from student work-based learning and other Pre-ETS to needed supported employment.
Pre-ETS may lead to a consumer learn that their initial Pre-ETS employment opportunity is the employment they want to maintain permanently, with or without long-term supports. Pre-ETS are viewed as a foundation for future career development and allow a student with a disability to gain valuable career exploration experience and receive soft skills training as appropriate.
Once a student has decided that their current job goal will be used as their IPE long-term goal for case closure, services should transition from Pre-ETS to supported employment services to help the consumer maintain permanent competitive integrated employment. Because individual circumstances are often unique to the situation, it is critical to consult with the supported employment team and DVR colleagues.
A consumer who is closed successfully and receiving long-term support can come back to DVR for needed services. Once eligibility is reestablished, DVR will only provide services that are necessary and appropriate for the consumer to reach their IPE goal. As in all other cases, comparable benefits should be explored.
DVR can provide long-term supported employment services for youth while under age 25, for a period not to exceed 48 months. DVR cannot provide long-term supports beyond 48 months and the 48-month limit is a lifetime cap.
DVR can work with individuals who are working in subminimum wage employment. Individuals interested in gaining competitive integrated employment, consistent with DVR's definition of an employment outcome, can apply for and receive DVR services. DVR can also provide services to consumers who choose to work in subminimum wage employment while looking for a job that meets their goals. DVR can continue to serve these individuals if they are working and making timely progress in achieving the benchmarks included in their IPE.
DVR cannot provide services within a sheltered workshop or non-integrated setting. DVR assumes that all consumers are capable of competitive integrated employment, therefore wages and settings supported by DVR must be consistent with that core value.
On a case-by-case basis, DVR can assist as needed to help identify community-based locations for providing DVR services. Staff must ensure all technical specifications are followed. Federal rules identify sheltered work as Extended Employment.
Systematic instruction should be provided on an hourly basis when the consumer is participating in non-supported employment activities such as an internship or temporary work. During all supported employment activities and after permanent hire, including during on-the-job training (OJT), the Supported Employment Monthly Skill Instruction should be authorized and provided.
In most cases, systematic instruction will involve a service provider working with the consumer to learn the specific tasks of a job; however, it can also be used for soft skills such as working as a team, maintaining a positive attitude, and discussing disagreements at work productively.
If a consumer's long-term support plan requires the consumer to receive services above and beyond employment-related support, such as a personal care worker or a mentor to monitor inappropriate behaviors, those services would be negotiated through Long-Term Support as DVR would not pay for them. If instruction in soft skills related to the job are appropriate and would otherwise not be provided outside of an employment setting, then DVR can authorize systematic instruction.
Competitive Integrated Employment: Work in the competitive labor market performed on a full-time or part-time basis in an integrated setting; and for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities.
Extended Employment: Work in a non-integrated or sheltered setting for a public or private nonprofit agency or organization that provides compensation in accordance with the Fair Labor Standards Act. In Wisconsin, this is identified by the terms sheltered work, congregate work or subminimum wage employment.
Extended Services: Ongoing support services and other appropriate services needed to support and maintain an individual, including youth, with a most significant disability in supported employment. Extended services must be organized and made available, singly or in combination, to assist an individual in maintaining supported employment; based on needs specified in the IPE; provided by a State agency, a private nonprofit organization, employer, or any other appropriate resource after an individual has made the transition from support from the VR agency. For youth who do not have a source of extended services (long-term support) available, DVR must provide extended services not to exceed 48 months or until such time a youth reaches the age of 25. In Wisconsin, this service is called long-term support.
Job Stability: A consumer is considered stable on the job once the level of stability defined by the supported employment team and included in the IPE progress measures has been met. Stability has been reached when the employer is satisfied with the consumer's job performance given the level of supports provided. While further independence and progress may still be made, the consumer has learned the job and is performing at a level with supports where the required job tasks can be accurately completed in the timeframe agreed upon with the employer and employment can be maintained.
Long-Term Support Services: Employment support services and other appropriate services that are needed to support and maintain an individual with a most significant disability in supported employment and that are provided by a State agency, a private nonprofit organization, employer, or any other appropriate resource, from funds other than funds received under this part and 34 CFR part 363 after an individual with a most significant disability has made the transition from support provided by the designated State unit. Federal rules identify long-term supports by the term Extended Services.
Natural Supports: Methods of inclusion and assistance that exist in any workplace, which an employee with a disability can use to assist with job performance and retention. These supports help the person perform in their role and feel socially included. Natural supports can involve people, procedures, customs, tools, and benefits that are typically available in the workplace, along with individualized supports developed on the job site.
Ongoing Support Services: Support services provided by DVR for up to 24 months from the time of job placement until transition to Long-Term Support.
Sheltered Work: Sheltered work is work performed for wages less than the federal minimum wage or work performed in a setting that is not integrated with other people without disabilities. Federal rules identify sheltered work as Extended Employment.
Systematic Instruction: Training provided on the job in which job tasks are separated into steps. The instruction is designed to provide a reduction in the level and method of supports and an increase in independent functioning. The goal is to transition to natural supports as quickly as possible given individual consumer circumstances. Use of a personal care worker or a mentor to monitor behaviors is not considered systematic instruction.
Student with a Disability: An individual with a disability in a secondary, post-secondary, or other recognized education program under age 21.
Youth with a Disability: An individual between the ages of 14 and 24 who has a disability.
DWD Contact Information
201 E. Washington Ave
P.O. Box 7946
Madison, WI 53707
(608) 266-3131
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