1 funding strategies to support employment services and customized employment outcomes michael...

1

Funding Strategies to Support Employment

Services and Customized Employment Outcomes

Michael Morris, DirectorLaw, Health Policy, and Disability CenterUniversity of Iowa College of Lawmmorris@ncbdc.org

ODEP Webinar - June 8, 2006

2

Americans with Disabilities Act of 1990

The Nation’s proper goals regarding individuals with disabilities are to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for such individuals.

3

Customization

Individualizing the relationship between jobseekers and employer to meet both their needs.

Nontraditional assessment of abilities, needs, and preferences.

Creation of an individual profile. Negotiating job role and

responsibilities Meeting ongoing support needs.

4

Blended or Braided Funding To Support Customized Employment Services Using separate funding streams in more

coordinated and flexible ways. Creating an individual or personal budget

that allows for greater direction and control of blended or braided funds from multiple sources.

Developing the knowledge and infrastructure to facilitate effective collaboration within and outside the One Stop to support customized employment services.

5

Blended Funding Involves more than one public

funder authorizing their dollars to be included in an individual budget to respond to identified needs or gaps in services and supports.

Blended funding can allow systems to fund activities that may be outside specified limits of categorical programs.

6

Braided Funding Also involves more than one public funder

authorizing their dollars to be included in an individual budget to respond to identified needs.

However, with braided funding, each public funder maintains control of dollars sufficient to track expenditures for agreed to purposes and outcomes to evaluate return on investment.

7

Five-Step Process

Navigating the Funding Maze to Achieve Common Golas

8

Blended or Braided Funding

Step One

Navigate the three tiered service levels in the One-Stop Career Centers

1. Assist job seekers with disabilities to be “registered” for services and move beyond core to intensive services.

2. Assist job seekers with disabilities to move beyond intensive services to training services

3. Identify and understand key decision making factors at each stage.

4. Identify key points to introduce non-traditional assessment and customized employment strategies.

9

Blended or Braided Funding

Step Two

Identify One-Stop services that could support a customized employment strategy.

1. “Intensive services” may be provided through contracts with service providers for

• Comprehensive and specialized assessment;• Development of an individual employment

plan; • Individual counseling; and • Career planning

10

Blended or Braided Funding

Step Two

Identify One-Stop services that could support a customized employment strategy.

2. “Training services” may include:• Entrepreneurial training;• Skill upgrading;• Customized training conducted with a

commitment of an employer to employ an individual upon successful completion of the training; and

• Individual Training Account.

11

Blended or Braided Funding

Step Three

Identify potential collaborators and funders to support customized employment strategy

1. Medicaid State Plan Services• Rehabilitative Services Option; • Targeted Case Management Option;

12

Blended or Braided Funding Five Step Process

Step Three2. Medicaid Home and Community Based

Services (HCBS) Waivers• Individual Budgeting• Service Coordination• Person Centered Planning Facilitation• Peer Support Services• Transportation• Financial Management Services• Supported Employment Services

13

Blended or Braided Funding

Step Three

3. Community Mental Health Services Block Grant

• Person Centered Recovery Plans• Rehabilitative Services• Service Coordination• Self-Directed Care• Behavioral Health Care

14

Blended or Braided Funding

Step Three

4. Vocational Rehabilitation • Skill development and training services; • Assessment; • Assistive technology; • Job development; • Transportation; • Supported employment; • Intensive services; • Transition services; • Technical assistance to conduct market analysis, develop

business plans, and pursue self-employment;• Post-employment services

15

Blended or Braided Funding

Step Three

5. Local Education Agency• Transition services; • On the job training; • Transportation; • Skills development; • Assistive technology; • Assessment; • Microenterprise development; and• Job search assistance.

16

Blended or Braided Funding

Step Three

6. Local and State Funded Programs• Community Service Boards; • Mental Retardation/Developmental

Disabilities Service Agency;• Mental Health Administration; • Other

17

Blended or Braided Funding

Step Four

Review and understand the details of eligibility, documentation, decision-making, service units, provider requirements, and appeal procedures.

18

Blended or Braided Funding

Step Four

For each resource identified1. Review and understand eligibility

requirements: • Definition of disability; • Means tested – income level and resource

limits; • Other requirements (preferences, order of

selection); • Any presumptive eligibility; • Frequency of redetermination of eligibility.

19

Blended or Braided Funding

Step Four

2. Review and understand documentation requirements:

• Proof of disability; • Proof of low income and resource

limits; • Proof of residence; • Other.

20

Blended or Braided Funding

Step Four

3. Review and understand application process

• Forms to be filled out; • Filing allowed on line; • Available from One-Stop; • Other locations; • Availability of application assistance; • Appeal process.

21

Blended or Braided Funding

Step Four

4. Review and understand menu of benefits/resources available:

• Identify benefits/resources available; • Definition of service unit; • Rate of reimbursement for each service

unit:• Annual funding limits per individual• Annual funding limits per service• Lifetime Caps or Funding limits

22

Blended or Braided Funding

Step Four

• Flexibility in rate setting and service units;

• Determination of need for benefits/services/or supports and decision making process;

• Appeal process;• Licensing and/or certification

requirements for service providers

23

Blended or Braided Funding

Step Five

You can’t do this alone. Build a work group with representatives of each of the potential funders, key decisionmakers with the LWIB and One-Stop, the benefits specialist (BPAO) in your area, and leadership from disability related organizations.

24

Blended or Braided Funding

Step Five

1. Introduce core concepts of customized employment.

2. Identify shared vision and values regarding individual choice and direction and employment outcome objectives.

25

Blended or Braided Funding

Step Five

3. Explore options to create an individual account to meet employment goals:

• Application process is simplified and coordinated across funders;

• Background information is centralized and shared for each applicant;

• Funders are flexible to allow services and benefits to be bundled in an individual self-directed account;

26

Blended or Braided Funding

Step Five

• Agencies are jointly engaged in a person-centered planning process that identifies resources to be committed to respond to individual needs and preferences;

• Policy barriers are identified and solutions crafted to reduce or eliminate barriers to a braided individual account with investment by multiple funders;

• One-stop and no wrong door approach is developed and implemented;

27

Blended or Braided Funding

Step Five

• Expenditures and results can be tracked and reported to multiple funders;

• An “Individual Account” Work Group with representatives of potential public funders within and outside the workforce development system continues to provide advice and oversight for the establishment and support of the individual self-directed account.

28

Funding Strategies Medicaid State Plan and Waiver Services –

CMS Individual Budgets – CMS Individual Development Accounts – HHS Work Incentives – SSA Cash-Out Benefits – VR, MH, Education Individual Training Accounts – Labor Housing Choice Vouchers – HUD Use of Earned Income Tax Credits - IRS

29

Braided Individual Accounts

Bundling public benefits across the domains of:

Housing; Personal Assistance; Social Security; Employment; Skills Development; and Asset Building

30

Agreement on Account ObjectivesRespond to multiple personal, individualized

goals including: Self-employment; Employment related supports. Affordable housing and homeownership; Education and skills development; Healthcare and emergency needs; and Savings for specific short and long-term needs:

• Transportation• Technology• Retirement

31

Collaboration Across Systems Multiple points of entry to start an

account. Benefits specialists are available

who are knowledgeable about multiple public benefits and successful approaches to braiding or bundling in an individual account.

Fiscal intermediaries are available to offer efficient financial management.