Chapter 16 - Supported Employment

RSB shall provide vocational rehabilitation services that will lead to supported employment for severely disabled individuals who are eligible for these services.

(A)  The following definitions apply to the supported employment program:

1.   Supported Employment means competitive work in an integrated work setting with ongoing support services for individuals with the most significant disabilities

A.   For whom competitive employment has traditionally not occurred or has been interrupted or intermittent as a result of significant disabilities; and

B.   Who, because of the nature and severity of their disabilities, need intensive supported employment services from the designated State Unit and extended services after transition in order to perform this work; or

C.   Transitional employment for individuals with most significant disabilities due to mental illness. 361.5(b)(53), Sec.6(35), 361.5(b)(33)

2.   Competitive employment is employment in the competitive labor market that at the time of transition to extended services is performed weekly on a full-time or part-time basis in an integrated setting.

A.   Hourly goals for employment are for the maximum number of hours possible based on the unique strengths, resources, interests, concerns, abilities, and capabilities of the individual and are included as part of the individualized written rehabilitation program.

B.   Wage compensation must be in accordance with the Fair Labor Standards Act.

(1)   Wages must be paid on a basis consistent with those wages paid to workers who are non-disabled with similar job functions within the host business (prevailing wage).

(2)   Supported employment does not require the payment of minimum wage. 361.5(b)(11), Sec.625(b)(6)(G)

3.   Integrated work setting means a job site where-

A.   Most employees are not disabled; and

B.   An individual with a severe disability interacts on a regular basis in the performance of job duties, with employees who are not disabled; and

C.   If an individual with a severe disability is part of a distinct work group of only individuals with disabilities, the work group consists of no more than eight individuals;

D.   If there are no other employees or the only other employees are individuals who are part of a work group as described in item "c" above, an individual with a severe disability interacts on a regular basis, in the performance of job duties, with individuals who are not disabled including members of the general public.

NOTE:     The interaction required in the definition of "integrated work setting" may not be satisfied by contact between an individual with a severe disability and individuals who provide on-going support services at the job site.361.5(b)(33)(ii)

4.   Ongoing support services means services that are:

A.   Needed to support and maintain an individual with a most significant disability in supported employment;

B.   Identified based on a determination by RSB of the individual’s needs as specified in an IPE; and

C.   Either:

(1)   Time-Limited Services:  Provided singly or in combination and are organized and made available in such a way to assist an eligible individual in entering or maintaining integrated, competitive employment

a.   On-going support services: Provided by RSB through a supported employment service provider, or as natural supports from the time of job placement until transition to extended services. 

b.   Provided for a period not to exceed 9 months, unless an exception is made by the RSB State Office.

c.   Post-employment services following transition to extended services that are unavailable from an extended services provider and that are necessary to maintain the job placement. (e.g. job station redesign, repair and maintenance of assistive technology, and replacement of prosthetic and orthotic devices).              

d.   May be provided as natural supports.

     OR

(2)   Extended Services

a.   Provided by one or more extended services providers such as a State agency, a private non-profit organization, or any other appropriate resource including natural supports, after an individual has made the transition from RSB financial support.

b.   Provided throughout the individual’s term of employment in a particular job placement or multiple placements if those placements are being provided under a program of transitional employment.

c.   Must include, at a minimum, twice-monthly monitoring at the work site of each individual in supported employment to assess employment stability, unless the IPE provides for off-site monitoring, and based upon that assessment, the coordination or provision of specific services at or away from the work site, that are needed to maintain employment stability. 

d.   If off-site monitoring is determined to be appropriate, a minimum of two meetings with the individual and one contact with the employer each month.361.5(b)(38), 361.5(b)(20), Sec.6(27), Sec.6(13)

5.   Transitional employment means employment in a series of temporary community based competitive jobs in integrated work settings for individuals with serious mental illness. 

A.   The typical transitional employment eligible individual may be employed part-time for different employers over the same amount of time that the typical supported employment eligible individual is employed during the time-limited ongoing support phase of supported employment. 

B.   Multiple placements may also be provided after the individual has made the transition to extended services.361.5(b)(56)

6.   Traditionally time-limited post-employment services means services that RSB provides to support and maintain an eligible individual in supported employment following case closure.  Post-employment services are provided when:

A.   Needed services are unavailable from the extended services provider.

B.   They are necessary to maintain the job placement.

C.   Include services such as job station redesign, repair and maintenance of assistive technology, and replacement of prosthetic and orthotic devices.Sec.627(b) 361.5(b)(42)

7.   Supported Employment Consumer is an individual:

A.   Who is eligible for vocational rehabilitation services;

AND

B.   Who has been determined to be a person with the most severe disability(ies), and for whom competitive employment has not traditionally occurred or has been interrupted or intermittent as a result of the disability.  RSB defines most severely disabled as an individual who has functional limitations to the extent that they have been unable to perform or maintain work or work related tasks with or without accommodations.  For these eligible individuals, traditional VR methods have been ineffective or are viewed as being ineffective to achieving competitive employment;

AND

C.   Whose comprehensive assessment identifies supported employment as the appropriate rehabilitation objective, i.e. there is:

(1)   A need for intensive time-limited supported employment services as well as extended ongoing support services in order to perform competitive work;

(2)   The ability and desire to work in a supported employment setting.361.5(b)(30), Sec.6(21)(E)

8.   Job coaching means a service that includes, but is not limited to:

A.   Ongoing assessment at the work site of the individual’s ability to successfully perform job tasks.

B.   Job development and placement.   

C.   Job modification

D.   The provision of intensive on-the-job training that is necessary to teach the eligible individual job skills/duties and job-related responsibilities.

E.   Social and/or behavioral training.        

F.   Assistance in adjusting to the work environment.    

G.   The facilitation of natural supports at the worksite. 

H.   Training in use of transportation to/from the worksite with assistance from RSB Orientation and Mobility Specialist as appropriate.

I.   Assistance in achieving family support.

J.   Assistance with wage subsidies as requested by RSB counselor.

K.   The provision of advocacy services for the eligible individual with employer, supervisor, and co-workers to assure integration of the eligible individual as an employee.

L.   The provision during extended services, of services to include regular contact with employers regarding eligible individual performance and employer satisfaction, training on new job duties, and other responsibilities that assure job retention.

M.   Other services needed for the individual to achieve and maintain job stability.

9.   Service provider means a rehabilitation facility or other community-based agency that will provide supported employment placement services to and provide ongoing job support to an eligible individual. The services provided by the facility or agency may include, but are not limited to:

A.   Functional assessment;

B.   Survey of businesses and assurance of potential work sites suited to the needs of the eligible individual;

C.   Analysis of all relevant job-related variables, such as transportation, job restructuring, and tax credit for employers;

D.   Provision of direct training at employment sites until eligible individual is working to the employer’s standards;

E.   Development of internal advocacy system;

F.   Gradual decrease in job coach assistance, to be replaced with employer supervision; and

G.   Provision of long-term follow-up service as necessary;

10.  Community service agency means the Department of Mental Health, Senate Bill 40 Boards authorized by sections 205.968- 205.972, RSMo, relatives, employers and other public and private agencies that are perceived as the long-term support system for eligible individuals who have severe disabilities due to developmental disabilities, sensory impairments or chronic illness.

(B)  RSB shall provide a number of rehabilitation services through the use of regular vocational rehabilitation case service funds in order to facilitate the delivery of services to severely disabled or visually impaired eligible individuals under the provisions of the supported employment program. These services include:

1.   Evaluation of rehabilitation potential, to determine an individual’s eligibility for regular vocational rehabilitation services and eligibility for services through the supported employment program;

2.   Counseling and guidance;

3.   Personal and vocational adjustment evaluation and training;

4.   Physical and mental restoration; and

5.   Adaptive equipment that an eligible individual may need prior to participating in supported employment activities.

(C)  RSB shall use supported employment case service funds for purchase of supported employment services from rehabilitation facilities with which Missouri has contracts for the provision of supported employment services. The services RSB purchases from rehabilitation facilities will consist primarily of job placement services that include development of job sites; contacts with potential employers to encourage them to accept severely disabled blind or visually impaired eligible individuals; and on-the-job skill training and support during the nine (9)-month period following job placement. RSB may use supported employment case service funds to provide these services.

(D)  At the end of the nine (9)-month period following the eligible individual’s job placement during which supported employment case service funds may be used to meet the cost of on-the-job skill training and support, the responsibility for providing ongoing support to the eligible individual is transferred to the local funding agency that has contracted with rehabilitation facilities to provide this support. RSB cannot spend either regular vocational rehabilitation case service funds or supported employment case service funds for supported employment activities after the end of the nine (9)-month period.

(E)  After an eligible individual has been determined to be eligible to receive supported employment services, RSB shall meet the cost of those services with supported employment case service funds. If RSB exhausts the supported employment case service funds that are available to it, RSB may meet the cost of supported employment services for an eligible individual with regular vocational rehabilitation case service funds up to, but not exceeding, the nine (9)-month period following the eligible individual’s job placement. 

(F)  All service limitations expressed in this Chapter are subject to the exception provisions expressed in Chapter 26.

For detailed information regarding RSB’s Supported Employment services, see RSB Supported Employment Guidelines

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