Meeting of the Board of Regents | May 2010

Saturday, May 29, 2010 - 11:40pm

sed seal

THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234

TO:
FROM:	Rebecca H. Cort
SUBJECT:	Amendment to the State Plan for Vocational Rehabilitation and Supplement for Supported Employment Services Program
DATE:	April 29, 2010
STRATEGIC GOAL:	Goals 3 - 6
AUTHORIZATION(S):

Executive Summary

Issue for Approval (Consent Agenda)

The Board of Regents’ approval of the Amendment to the State Plan for the Vocational Rehabilitation and Supplement for Supported Employment Services Program.

Reason for Consideration

Required under the Rehabilitation Act of 1973, as amended in 1988.

Proposed Handling

This issue will come before the Full Board.

Procedural History

In accordance with the Rehabilitation Act of 1973, as amended in 1998, the Amendment to the State Plan for Vocational Rehabilitation and Supplement for Supported Employment Services Program, effective October 1, 2010, is presented for your approval.

Each year, the Board of Regents approves the Amendment to the State Plan that must be submitted to the Rehabilitation Services Administration by July 1.

Background Information

The Rehabilitation Act requires the Board of Regents to submit an annual Amendment to the State Plan outlining the goals, priorities and objectives in providing vocational rehabilitation and supported employment services to individuals with disabilities in New York State. The Amendment to the State Plan is attached for your review. The last attachment (Attachment 4.11(e)(2) Evaluation and Report of Progress) summarizes our results on the federal VR Performance Indicators. During FFY 2009, the VR Program did not meet all the of required performance standards due to the combined effects of a significant increase in the number of VR participants and the high unemployment rate during the recession.

Recommendation

VOTED: that the Amendment to the State Plan for Vocational Rehabilitation and Supported Employment Services, effective October 1, 2010, is approved.

Timetable for Implementation

Upon approval by the Regents of the State Plan, it will be submitted to the Rehabilitation Services Administration for review and approval, as required, prior to July 1, 2010.

Attachment

Amendment to the State Plan for

Vocational Rehabilitation Services and Supplement

for Supported Employment Services Program

Federal Fiscal Year 2011

New York State Education Department

Office of Vocational and Educational Services for

Individuals with Disabilities

Summary of Amendment to the State Plan for Vocational Rehabilitation Services and Supplement

for Supported Employment Services Program

Federal Fiscal Year 2011

State Plan Process

The Rehabilitation Act, as amended, requires that New York State prepare a State Plan that informs the public of the Office of Vocational and Educational Services for Individuals with Disabilities’ (VESID) goals, priorities and performance in providing vocational rehabilitation and supported employment services to individuals with disabilities in New York State. This document, entitled State Plan for Vocational Rehabilitation Services and Supplement for Supported Employment Services Program, Effective July 1, 2001, was previously submitted and approved by the Rehabilitation Services Administration (RSA). The Rehabilitation Act further requires that each state annually amend its approved State Plan in specific areas as requested. The Amendment to the State Plan consists of specific attachments that must be updated annually as required by RSA. The content and format of the Amendment to the State Plan are based on the most recent guidance provided by RSA. The Federal Fiscal Year 2011 State Plan continues to be an amendment to the original document since the Workforce Investment Act has not yet been reauthorized.

VESID, in conjunction with the State Rehabilitation Council (SRC), developed the Amendment to the State Plan for Vocational Rehabilitation Services and Supported Employment Services Program, Federal Fiscal Year 2011. VESID consulted with the SRC throughout the year on critical aspects of the State Plan development process, including the joint planning of the state plan public meetings and the design and implementation of the comprehensive statewide needs assessment, the results of which are reported as part of the FFY 2011 State plan. The SRC also reviewed drafts of the narrative attachments as they were developed and provided comments and advice on the content. The previous year’s Amendment to the State Plan (FFY 2010) was used to solicit input and recommendations from the public on planned activities related to the vocational rehabilitation of persons with disabilities for the next year.

The public comment period regarding the State Plan amendments extended from January 13, 2010 through March 1, 2010. As part of the State Plan development, VESID solicited public comment in identifying the vocational rehabilitation and employment needs of individuals with disabilities who are unserved and underserved and in developing priorities, goals and strategies to address those needs through three public meetings. Discussion questions focused on obtaining perspectives from participants on how the VR Program can better address the needs of individuals who are considered unserved and underserved, including specific strategies that could be implemented.

Public Meetings

To notify and inform the public about the meetings on the State Plan, VESID emailed flyers that gave specific details on the theme of the State Plan public meetings, the meeting dates, meeting times and locations. The flyers were sent to consumers, community agencies, schools, independent living centers and support groups. VESID also utilized the newsletters, faxes and the internal communication processes of several community rehabilitation providers and associations to advertise the public meetings.

VESID further advertised the public meetings through the VESID website and the public was able to provide written comments through the vrpolicy@mail.nysed.gov email box. VESID received several detailed comments, particularly from the Independent Living community, through this method. In addition, a few participants in the State Plan Public Meeting handed in written testimony to the facilitators at the meeting.

The public meetings were designed to provide ample opportunities for participants to review and discuss their ideas about VESID’s State Plan, policies, future direction, and the vocational rehabilitation needs of unserved and underserved individuals. At each of the three meetings, VESID provided a brief presentation on the State Plan and provided data and information related to the key questions. VESID staff facilitated the discussion, but public participants remained free to offer comments or recommendations on any part of the State Plan and its process. There was also time reserved at the conclusion of each meeting for participants to make specific statements or testimony.

The comments and recommendations received during the public comment period were reviewed for inclusion into VESID’s Amendment to the State Plan. Comments received are summarized and included in Attachment 4.11(a) Comprehensive Statewide Needs Assessment. Some of these comments do relate to specific implementation actions that VESID is currently planning over the next year, such as instituting a consumer advisory group in New York City for individuals with mental health disabilities. The public comments are being shared with VESID leadership and the State Rehabilitation Council for consideration.

Amendment of the State Plan: Required Attachments

The following attachments describe VESID’s plans, policies and activities in a number of required areas as part of this Amendment. The sections of the Amendment to the State Plan for Vocational Rehabilitation Services and Supplement for Supported Employment Services Program, Federal Fiscal Year 2011 include:

Summary of Input and Recommendations of the State Rehabilitation Council; Response of the Designated State Unit; and Explanation for Rejection of Input or Recommendations: Attachment 4.2(c)

Summarizes the advice of the State Rehabilitation Council (SRC) on the State Plan and policy development. VESID’s responses to SRC are also included.

Comprehensive System of Personnel Development (CSPD): Attachment 4.10

Describes VESID’s activities that ensure an adequate supply of qualified rehabilitation professionals in conformance with its CSPD. The CSPD calls for VESID to utilize the highest national standard, Certified Rehabilitation Counselor (CRC), as the goal in recruitment and retention of counselors.

Describes VESID and the SRC’s joint efforts to assess the vocational rehabilitation needs of persons with disabilities in New York State, including those with the most significant disabilities and the need for supported employment services. The findings include the VR needs of minority individuals, unserved and underserved populations; individuals served under other parts of the workforce investments systems and the capacity of community rehabilitation programs.

Annual Estimates of Individuals to be Served and Costs of Service: Attachment 4.11(b)

VESID estimates that, during Federal Fiscal Year 2010, 39,400 individuals with significant or most significant disabilities will become eligible for VESID services. This is a significant increase from previous years.

Goals and Plans for Distribution of Title VI, Part B Funds (Supported Employment): Attachment 4.11(c)(4)

This attachment indicates that VESID plans to continue to fund supported employment services utilizing Federal VIB and other funds.

Evaluation and Report of Progress in Achieving Identified Goals and Priorities and Use of Title l Funds for Innovation and Expansion Activities: Attachment 4.11(e)(2)

Describes VESID’s progress in achieving the goals and priorities, as required by regulation and agreed to with the State Rehabilitation Council.

Comprehensive System of Personnel Development (CSPD):

Attachment 4.10

VESID is committed to fulfilling its obligation to establish and maintain a Comprehensive System of Personnel Development (CSPD), designed to ensure an adequate supply of qualified rehabilitation personnel staff.

Qualified Personnel Providing Vocational Rehabilitation Services

VESID relies on several data systems to track the adequate number of qualified rehabilitation counselor professionals who work to meet the rehabilitation needs of individuals with disabilities. VESID uses a variety of data sources including the New York State Education Department’s (SED) Fiscal and Human Resources Information Management systems to track its vocational rehabilitation counselors who meet CSPD requirements.

VESID only hires vocational rehabilitation counselors (VRCs) who meet CSPD requirements to provide vocational rehabilitation services. Therefore, personnel data is relevant only to the vocational rehabilitation counselor series. As of September 30, 2009, VESID's data reflected an adequate supply of qualified rehabilitation professionals as summarized in the following table:

Full-time Vocational Rehabilitation Counselors (VRCs)	331
VRCs not meeting CSPD standards	30
VESID Consumers with Open Cases (Status 02-24)	68,015
Ratio of VRCs to Consumers	1: 205
Anticipated VRCs that VESID will need over the next five years due to retirement of current VRCs	135

As discussed in Annual Estimates of Individuals to be Served and Costs of Service: Attachment 4.11(b)(1), VESID uses trend data projections to estimate the number of individuals that will be found eligible for VESID services. Based on these projections, VESID determined the number of VRCs that will be needed to serve its consumers over the next five years.

VESID does not employ any other type of rehabilitation staff, such as mobility instructors or rehabilitation teachers. VESID does employ vocational rehabilitation counselor assistants (VRCAs) as part of a rehabilitation unit in a district office to perform a variety of paraprofessional tasks to support the VRCs in assisting individuals with physical, mental, or learning disabilities in obtaining or retaining employment. These individuals interact with consumers, performing administrative tasks to facilitate service delivery. VRCAs provide a substantial contribution to VESID’s overall capacity to serve applicants and eligible individuals, including individuals with significant disabilities.

Coordination with Higher Education in the Preparation of Rehabilitation Professionals

The Council on Rehabilitation Education (CORE) accredited Master’s programs in Rehabilitation Counselor Education provide evidence that a program complies with developing well-defined professional competencies. CORE accreditation is granted to programs that have been fully operational long enough to allow for the objective assessment of the professional performance of graduates. This recognition provides evidence that a program complies with all federal standards and is deemed able to maintain that level of compliance through the duration of the accreditation period.

New York State has three programs that prepare VRCs that are accredited by CORE. The rehabilitation counseling graduate programs at institutions of higher education are: University at Buffalo – State University of New York (SUNY), Hofstra University, and Hunter College – City University of New York (CUNY). The program at University at Albany - SUNY, closed December 2009. New York State has lost half of their CORE accredited rehabilitation counseling programs in three years, which has resulted in increased challenges to recruit qualified counselors.

VESID is working with institutions of higher education to increase the recruitment of students from diverse populations. During the 2008-2009 academic year, 78 of 163 students in the CORE programs, or 48 percent, identified themselves as individuals with a disability or non-white. This is an increase of four percent in the diversity of the qualified candidates from CORE accredited programs from the 2007-2008 academic year. Outreach efforts for recruitment from the CORE programs are made through disability groups and associations (in accordance with the Commissioner’s Action Plan for Increased Diversity in SED) targeting under-represented populations. VESID maintains a contact at each of these institutions of higher education and collects the following student data:

Institutions of Higher Education (CORE) Student Total

	SUNY-Buffalo	Hunter	Hofstra	SUNY-Albany	TOTAL
# of CORE Students	48	75	36	4	163
Students with Disability	10	9	10	0	29
Students as non-white	11	18	19	1	49
Graduated in 2009	7	39	7	3	56

Plan for Recruitment, Preparation and Retention of Qualified Personnel

VESID projects that 135 new VRCs will be needed over the next five years. This projection is based on the number of VRCs and supervisory counseling staff age 50 or older with 25 years of service who will be eligible for retirement within the next five years, others who may leave the agency, and the estimated number of individuals to be served. New qualified VRCs will be needed to fill counselor vacancies created by retirement and promotional opportunities. Although VESID remains concerned with a diminishing pool of qualified VRCs, we believe that the current level of counselors and counselor assistants allows us to adequately serve current numbers of eligible individuals.

As counselors retire or leave VESID, vacancies will be created that will need to be filled by qualified VRCs. VESID has four programs to promote the recruitment and preparation of qualified personnel that address projected needs. These programs include:

VESID’s recruitment plan;
the counselor internship program;
a program to assist counselors to meet the national standard; and
exploration of a counselor traineeship.

VESID’s recruitment plan identifies qualified VRCs who seek employment opportunities in New York State. VESID targets both colleges in close proximity to New York State and historically black colleges and universities in southeastern United States with CORE accredited programs in rehabilitation counseling to recruit a diverse population to meet consumer needs. Due to New York’s fiscal constraints that limited staff travels in 2009, activities to recruit students for internships and eventual employment focused on phone and video conferences, networking with other professionals to present information, and travel to CORE accredited programs within New York State. VESID continues to attend national conferences that attract both professional counselors and graduate students.

The counselor internship program enables VESID to provide opportunities for students to complete their practicum and internship requirements for their graduate programs. VESID offers both paid and unpaid internship opportunities three times each year that provide students with practical field experiences for their graduate programs in rehabilitation counseling. The program also allows recently graduated students to work in intern status while pursuing full time employment through the NYS Department of Civil Service. In FFY 2009, VESID provided two practicums and 36 internships; and hired two of the interns as VRCs after the completion of their internships.

To be in full compliance with the Rehabilitation Act’s personnel standards for vocational rehabilitation counselors, SED must ensure that its VRCs meet the national standard or a State-approved or recognized certification, licensing or registration requirement. Since New York does not have a State-approved or recognized certification, licensing or registration requirement, VRCs have to meet the national standard. The national standard is a Commission on Rehabilitation Counselor Certification (CRCC) certificate or a Master’s degree in Rehabilitation Counseling or Counseling and notice of eligibility to sit for the CRCC certificate examination.

VESID recently instituted a program to enable VRCs to meet the CRCC national standard in accordance with federal regulation. Elements of this program include:

financial assistance for VRCs to pursue a Master’s degree in Rehabilitation Counseling;
financial and administrative assistance for VRCs who do not meet the national standard to have CRCC review their credentials to determine CRC eligibility; and
outreach to colleges and universities that offer Master’s degrees in Rehabilitation Counseling to assist in the enrollment and matriculation of VRCs.

VESID is also working with the State Education Department’s Office of Human Resources, NYS Department of Civil Service and Master’s degree CORE accredited rehabilitation counseling programs in New York and other states to explore the development of counselor traineeships for graduate students that offer both an experiential and academic component. To successfully complete the traineeship, VRCs would need to complete a series of activities to become eligible to sit for the CRCC examination within a specified timeframe. This would complement current opportunities for interns and address projected needs for qualified VRCs.

Personnel Standards: Highest Standard for the Vocational Rehabilitation Counselor

VESID will employ vocational rehabilitation counselors (VRCs) who have, or are eligible to obtain, qualification as a Certified Rehabilitation Counselor (CRC). NYS Civil Service qualifications for the VRC title were amended to match the CRC eligibility requirement. All vocational rehabilitation counselors who are added to the Civil Service list for that title are required to have:

a current Commission on Rehabilitation Counselor Certification (CRCC) certificate; or
a Master’s degree in Rehabilitation Counseling, including a supervised internship, from a CORE accredited program; or
a Master’s degree in Rehabilitation Counseling or Counseling and notice of eligibility to sit for the Commission on Rehabilitation Counselor Certification (CRCC) certificate examination.

VRCs considered for appointment to a "Manual Communication" or "Spanish Language" position will be required to demonstrate proficiency in the manual sign language or in the Spanish language. Proficiency must be at a level which will permit them to perform the duties of the position satisfactorily.

In 2009, VESID provided financial and administrative assistance to VRCs who do not meet the national standard to have CRCC review their credentials to determine CRC eligibility. We anticipate that by FFY 2013, all VESID VRCs will either meet the national standard or be engaged in a program to meet the standard. The participation of VRCs in an educational program required to meet the national standard will be monitored on an ongoing basis to evaluate compliance with SED personnel standards, previously cited.

Personnel Standards: Civil Service Qualifications for Vocational Rehabilitation Counselor Assistant

VESID will employ vocational rehabilitation counselor assistants (VRCAs) to assist VRCs in the administrative, para-professional and routine communication tasks that enhance the vocational rehabilitation process. The VRCAs do not determine eligibility nor do they provide vocational rehabilitation services to consumers. VESID has 100 positions designated for VRCAs, of which 92.25 full time equivalent items are filled, and seven and three-fourths (7.75 ) items are vacant. This is a decrease in filled items since last year. VESID anticipates that it will need 35 VRCAs over the next five years due to retirement and trend data projections of consumers to be served.

VRCAs who qualify to be placed on the open competitive NYS Civil Service list for this title must meet the following qualifications:

Bachelor's degree in vocational rehabilitation, social work, counseling, or psychology; OR
Bachelor’s degree and one year of qualifying experience; OR
60 semester college credit hours and two years of qualifying experience; OR
Four years of qualifying experience.

VRCAs considered for appointment to a "Manual Communication" or "Spanish Language" position will be required to demonstrate proficiency in the manual sign language or in the Spanish language. Proficiency must be at a level which will permit them to perform the duties of the position satisfactorily.

Qualifying experience: In order for experience to be considered qualifying, the primary responsibilities of a position must have involved professional or paraprofessional duties in one of the following areas:

Either A. providing direct services beyond routine personal care or supervision to physically, mentally or learning disabled adults or adolescents in a rehabilitation program or facility.

OR B. providing vocational or educational services to disabled adults or disabled adolescents in the areas of assessment, counseling, job coaching, guidance, placement or job development.

Staff Development

VESID ensures that all personnel receive appropriate and adequate training through their In-Service Training Grant. The purpose of the grant is to develop and implement a statewide training program for VESID vocational rehabilitation staff that will provide them with the skills and knowledge necessary to assist persons with disabilities in achieving employment outcomes. This is both critical to enhancing staff knowledge and skills, as well as the vehicle for meeting the standards and requirements of the CSPD.

Staff Development Provided for Professionals and Paraprofessionals during FFY2009:

Assessment: Vocational Assessment for Beginners; Assessing and Managing Suicide Risks; Functional and Situational Assessment; Managing Challenging Behaviors; and World of Work Inventory.

Vocational Rehabilitation Counseling: Transitioning School-Age Students with Disabilities; Ethical Issues in Rehabilitation; Dimensions of Counseling: Ethics, Mentoring, and Leadership; Developing Cultural Awareness; Counseling Skills for Direct Service Providers; New York State Training Council - Sailing through Changing Times with Quality Training and Organizational Development; American Sign Language; Case Management System VR Database (CaMS); Orientation to Supported Employment; Transition and the Vocational Rehabilitation Process; and Vocational Implications of Psychiatric Disabilities.

Job Placement/Employment: Job Development I and II; Job Development Advanced; Job Development Web Course; Assuring Equal Opportunity for New Yorkers with Disabilities in Public Employment and Services; Exceptional Presentation and Training Skills; Nassau Placement Network - Blue Print for Success; New York Goes Back to Work; and The Home-Based Career Development Program.

Rehabilitation Technology: Technology Conference; Technology Exposition; Assistive Technology - Making the Right Choice; Case Management System (CaMS); and Technology Updates on CaMS.

Disability-Related Training: Window into the Deaf World; Working with Consumers Who Have Mood Disorders; Serving the Individual with a Hearing Loss; Invisible Disabilities - Tools for Success for Human Service Providers; Multiple Sclerosis and the Rehabilitation Process; Psychopharmacological Interventions; Brain Injury: Medical, Psychological and Vocational Aspects; Brain Injury in the Community: Giving Voice to the Silent Epidemic; Adults with Attention-Deficit/Hyperactivity Disorder and/or Learning Disability: Facilitating Transitions to Success; Advanced Autism; Fourth Annual Training for the Deaf/Hard-of-Hearing; Coexisting Conditions; Mental Health – Increase Advocacy Skills and Knowledge of Mental Illnesses; and Cerebral Palsy – Medicaid/Medicare Compliances.

Policies and Procedures: Referral & Application; Eligibility and Significance of Disability; Economic Need; Youth in School Transition; Updated College and University Training; Due Process; Individualized Plan for Employment; Unified Contract Services; and Policy and Procedure Training for New Staff.

Financial Procedures and Controls: Private College Contracts and Unified Contract Services.

Supported Employment: Orientation to Supported Employment (1 of 3 Series); Job Coach I and II; Job Development I and II; Career Development and Exploration; Functional and Situational Assessment; Extended Services and Natural Supports; Managing Challenging Behaviors; Documentation and Record Keeping; Job Retention for Supported Employment; Advanced Job Development; and Supported Employment Program Management I.

Other Related Training: Ask the Expert and Benefits Management for Individuals w/Criminal Justice Involvement; Consortia of Administrators for Native American Rehabilitation (CANAR); Defending a Worker's Compensation Claim; Reducing Youth Violence in NY State; NYC's 4th Annual Criminal Justice; New York Association of Training and Employment Professionals, Inc. (NYATEP) Workforce; New York State Rehabilitation Association (NYSRA); New York Association of Psychiatric Rehabilitation Services (NYAPRS); Association for Persons in Supported Employment (APSE); NY Association on Independent Living, Inc (NYAIL) - Improve The Quality Of Life and Safeguard The Rights Of People With Disabilities: Assistance With Housing, Education, Employment, Medical Needs, and Personal Assistance Services.

Procedures for Acquisition and Dissemination of Training

Staff receives training through a variety of training resources and modalities. These include the use of seminars, workshops, individual district office training, distance learning technology, and attendance at local, regional and statewide training programs and conferences. Consideration is given to the diversity of staff, skill levels, and experiences when developing training programs and VESID management priorities.

VESID also works with The Region II Technical Assistance Continuing Education (TACE) Center to provide VESID’s VR staff technical assistance and continuing education training to update their skills, knowledge and to expand their expertise to better serve individuals with disabilities. The agency also provides training opportunities for Certified Rehabilitation Counselors to help them renew their certificates to meet the Commission on Rehabilitation Counselor Certification (CRCC) criteria to maintain their certification status. The training topics includes training on technical assistance, consultation, case management, staff development, and individualized training specifically for our VR staff.

Personnel to Address Individual Communication Needs

To ensure that VESID adequately provides services to consumers who are not English proficient, have a cognitive disability, or are deaf, VESID has professional staff able to communicate in the native language of individuals who are non-English speaking or who use other modes of communication, such as sign language. When such staff is not available, VESID contracts with outside agencies and individuals for interpreter or communication services. VESID also ensures that vocational rehabilitation counselors are aware of how an individual's cognitive disability might affect his or her ability to participate in the vocational rehabilitation process.

VESID requires the use of certified or State-approved interpreters for the deaf when sign language interpreter services are required in the provision of vocational rehabilitation services. When a VRC is considered for a vocational rehabilitation counselor (Manual Communication) position, the individual is required to demonstrate proficiency in manual sign language with consumers who are deaf or hearing-impaired. Proficiency must be at a level that will assure the VRCs ability to properly perform the duties of the position.

As previously stated in the personnel standards section of this attachment, VESID also requires a specific communication skill level for vocational rehabilitation staff working with Spanish-speaking consumers. VESID will continue to use these standards and make adjustments when appropriate.

Coordination with Personnel Development and Training under the Individuals with Disabilities Education Act (IDEA)

VESID administers special education, vocational rehabilitation and independent living programs. The coordination of meaningful transition services for students with disabilities from school-age to postsecondary settings is a priority area for vocational rehabilitation and special education collaboration. VESID’s special education and vocational rehabilitation program managers jointly review and share training information and, when relevant, coordinate efforts by inviting our respective staff to receive training on transition, accommodations, assessment and knowledge of specific disabilities.

The chart below indicates that new applications for youth (ages 14-21) have significantly increased, as well as the number of youth served and the school districts with which VESID is working.

VESID continues to work closely with schools to enable the smooth transition of students with disabilities from school to work. There is a significant increase in total numbers of youth served and in successful employment outcomes for youth. Most promising is the continued increase in employment outcomes for youth.

Youth with Disabilities (Applicants age 14-21)	FFY 2005	FFY 2006	FFY 2007	FFY 2008	FFY 2009
New youth applicants (age 14-21)	10,665	11,777	13,566	18,036	18,406
Youth served	29,441	29,614	31,696	38,241	44,279
Youth employed as a result of VESID services	3,585	3,575	3,690	4,140	4,202
School districts with students in VESID open caseload	617	644	669	682	693

VESID has a number of VRCs across the State dedicated solely to transition. In some offices, VESID is demonstrating a “transition team” concept to determine if this approach leads to better outreach to school districts and to students with disabilities.

Results of a Comprehensive Statewide Assessment of the Rehabilitation Needs of Individuals with Disabilities and the Need to Establish, Develop or Improve Community Rehabilitation Programs: Attachment 4.11(a)

The 1998 Amendments to the Rehabilitation Act require that a needs assessment be conducted jointly with the State Rehabilitation Council (SRC) every three years to collect data about the rehabilitation of New Yorkers with disabilities. The needs assessment must identify the vocational rehabilitation needs of:

Individuals with the most significant disabilities, including their need for supported employment services;

Individuals who are minorities and individuals who are unserved and underserved by vocational rehabilitation; and

Individuals who are served through other components of the workforce investment system.

In addition, the assessment must identify the need to establish, develop or improve community rehabilitation programs.

The New York State Office of Educational and Vocational Services for Individuals with Disabilities (VESID) jointly conducted the comprehensive statewide needs assessment with the SRC to determine the rehabilitation (and other) needs of individuals with disabilities residing in New York State. During 2009 and 2010, VESID and the SRC jointly developed and agreed to a work plan and conducted targeted activities to address each of the regulatory requirements. The SRC and VESID agreed that the primary purpose of the comprehensive statewide needs assessment was to identify gaps in VR services. We adopted the definition that a gap is the difference between the real and ideal conditions that is both acknowledged by community values and potentially amenable to change.

Information was gathered from consumers, advocacy groups, disability advisory councils, community rehabilitation programs, VR staff, and other partner agency representatives. The comprehensive statewide assessment process also includes a review of New York State’s disability statistics, RSA 911 data, a focus group, a community forum and public input gathered by VESID and its State Rehabilitation Council (SRC) members during FFY 2011 State plan public meetings. VESID also conducted or collaborated on several key surveys that directly address the requirements of this comprehensive statewide needs assessment. This document represents the FFY 2011 Comprehensive Statewide Needs Assessment as required by Section 101(a)(15)(A) of the Rehabilitation Act and 34 CFR 361.29 in describing the results of a comprehensive, statewide assessment, jointly conducted by VESID and the SRC.

Methodology: Assessment Activities

The SRC and VESID jointly developed a work plan for the comprehensive statewide needs assessment that included the following:

An analysis of population statistics for New York State that describe the numbers and percentages of people with disabilities in New York State, their employment status, educational levels and income;

A description of VR participation rates of minority individuals in comparison to individuals in the overall population in New York State and to national VR statistics;

An analysis of VR services to individuals with the most significant disabilities, individuals with mental health disabilities, youth, individuals receiving SSI or SSDI, individuals with intellectual and developmental disabilities, including individuals with autism spectrum disorder and individuals with substance use disorders;

The Council of State Administrators of Vocational Rehabilitation in the Fifth Edition 2008 Model State Plan (MSP) for Rehabilitation of Persons who are Deaf, Deaf-Blind, Hard of Hearing or Late Deafened report that hearing loss is the most prevalent, chronic, physically disabling condition in the United States today;

The findings from the State Plan Public meetings, held in January and February 2010, which focused on asking participants about the vocational rehabilitation needs of minorities, unserved and underserved individuals;

The results of a focus group discussion on youth with mental health disabilities (conducted in May 2009) and a community forum with MH service recipients on VR services in New York City (July 2009);

The results of the consumer satisfaction survey for individuals served during FFY 2009 (SUNY Potsdam February 2010);

The results of an analysis for data from the Model Transition Program in comparison to the VR Program’s overall services to youth (Cornell University, February 2010);

An analysis of critical issues facing individuals with disabilities served through other components of the workforce investment system based on a survey of the NYS Department of Labor Disability Program Navigators (January 2010);

The results of a study of community rehabilitation programs by the Chapter 515 Interagency team focused on expanding the statewide assessment of needs by conducting a survey of supported employment providers. (Center for Essential Management Services, March 2010); and

An analysis of the results of a survey of community rehabilitation providers on what is needed to effectively transform our rehabilitation service support system to increase integrated employment for individuals with disabilities (December 2009).

VESID is committed to making effective use of the findings from the comprehensive statewide needs assessment, moving from research to practice and using what is learned to shape policy, procedures, training, operations and practice.

Key Findings of Population Statistics for New Yorkers with Disabilities

The New York State Disability and Employment Status Report issued by the Employment and Disability Institute, Industrial Labor Relation School of Cornell University, provides information on individuals with disabilities in New York State. Based on the most recent study, the following findings provide an overall context for the vocational rehabilitation program to consider the potential needs of individuals with disabilities in New York State:

The employment and earnings gap between New Yorkers with disabilities and those without, like the rest of the U.S., continues to grow exponentially. According to the 2007 American Community Survey (Cornell University, 2009), there are over 1.4 million working-age adults with disabilities in New York State (11.1% prevalence rate). The prevalence rate is slightly lower in NYS than the national average of 12.3%.

The employment rate of working-age people with disabilities (ages 21-64) is 33% as compared to 72% for people without disabilities, a gap of 39%.

The education system continues to struggle to adequately prepare students with disabilities for employment and financial independence. Even with recent growth in the performance outcomes for students with disabilities, the gaps in performance remain significant with only approximately 43% of New York’s students with disabilities graduating with a regular high school diploma.

Opportunities to participate in higher education are limited. Many institutions of higher education have not put in place the level of supports needed by individuals with disabilities to succeed. Only 16% of working-age individuals with disabilities in New York hold a Bachelor’s degree as compared to 36% of non-disabled individuals.

For working-age individuals with disabilities working full-time/full-year, the median annual labor earnings equaled $34,500 compared to $41,800 for those without disabilities, a gap of $7,300.

The median household income of working-age adults with disabilities in New York is $35,200 and $71,100 for families without disabilities in New York, a gap of $35,900.
The poverty rate of working-age adults with disabilities in New York is 28% as compared to 11% for non-disabled adults, close to 2.5 times the poverty rate for people without disabilities.

In addition to these statistics, one in five working-age adults with disabilities in New York are recipients of SSI (279,000 individuals). These findings draw a clear link between the experiences of poverty and disability. New findings from the Center for Economic Policy Research (CEPR) show that the share of people experiencing income poverty who have physical or mental health impairments and/or learning disabilities is far larger than conventionally understood. The paper, “Half in Ten: Why Taking Disability into Account is Essential to Reducing Income Poverty and Expanding Economic Inclusion” (September 2009), reviews recent research on disability and poverty. Disability is both a fundamental cause and consequence of poverty. This understanding has implications for the VR Program and its interests in working closely with programs in New York State aimed at alleviating poverty or assisting persons from public assistance to employment. Currently, two percent of individuals served came to VESID as TANF recipients and 12.7% came to VESID as Safety Net participants.

The employment gap is an issue of vital concern to the public-private vocational rehabilitation system, but should also be a concern to the entire workforce investment system and all partners under the Workforce Investment Act. The employment rate for individuals with disabilities is suppressed by factors such as access to housing, transportation, health care (including treatment for mental illness, substance abuse and chronic disabilities), childcare, and opportunities for asset accumulation. All of these factors impact the employment rate for individuals with disabilities and closing the employment gap will require a much broader public policy approach across federal, state and local economic initiatives and programs.

Based on estimates from the 2008 American Community Survey (ACS), 49,300 individuals with disabilities between the ages of 21 and 64 are not working but are actively looking for work, based on the disability definitions in the ACS. (Retrieved on March 17, 2010 from www.disabilitystatistics.org) The ACS disability definitions are not the equivalent of the eligibility criteria for vocational rehabilitation (VR) services, so it is not valid to infer that all of these individuals would necessarily be VR eligible. VESID’s open caseload (Status 02-24) at the end of FFY 2009 was 68,000 individuals, which exceeds the measure of job seekers with disabilities, based on the ACS definition.

Characteristics of Individuals Served including Minority Individuals and Individuals with the Most Significant Disabilities

During FFY 2009, the characteristics of people who participated in vocational rehabilitation services reflected the diversity of the general population in New York State as follows:

68.7% White persons not Hispanic, a higher percentage than in the general population of New York State (60.0%);
29.1% Black or African-American, a higher percentage than in the general population of New York State (17.3%);
13.3% Hispanic, which is below the percentage of persons of Hispanic or Latino origin in the general population of New York State (16.7%);
1.9% American Indian/Eskimo/Aleut a higher percentage than in the general population of New York State (.6%);
2% Asian-American, which is below the percentage of persons of Asian-American origin in the general population of New York State (7.0%); and
0.6% Pacific Islander, a higher percentage than in the general population of New York State (.1%).

Based on an analysis of individuals whose cases are closed after receiving VR services (based on FFY 2008 RSA-911 data, retrieved from http://www.rsamis.ed.gov on March 17, 2010), at the time of services:

Almost 39% had mental and emotional (psychosocial) disabilities, nearly 8 percentage points higher than the national average for VR agencies;

Almost 35% had cognitive impairments, about 8 percentage points above the national average for VR agencies; and

More than 20% had physical impairments and about 5 percent had visual or communication impairments.

Needs of Special Populations including Individuals with Most Significant Disabilities and those Individuals considered Unserved and Underserved

In order to better understand the needs of individuals with the most significant disabilities, including the need for supported employment and those that are unserved and underserved, VESID, jointly with the SRC, conducted a range of activities, one of which was an analysis of data on participation in VR services.

The following summaries are intended to provide a context by which VESID can systematically assess the demand for VR services from special populations that are considered to have unique needs. This data analysis will focus on the following populations who are consistently identified as unserved and underserved as well as their participation in the supported employment program:

individuals with mental health disabilities;
youth (application to VR prior to age 22);
individuals on SSI or SSD;
individuals with intellectual disabilities and developmental disabilities;
individuals with autism spectrum disorders;
individuals with substance use disorders; and
individuals who are deaf, deaf-blind, hard of hearing or late deafened.

Of the total number of individuals served during FFY 2009 in all statuses, 55.4% or 60,748 individuals served were considered to have a most significant disability. The designation of most significant disabilities will be examined for each of the special populations.

Individuals with Mental Health (MH) Disabilities

Individuals with mental health diagnosis have consistently made up 19.5% of the total number of consumers served by the VR Program (who are eligible and/or receiving services). In 2009, this represented 11,717 individuals.

The overall number of individuals with psychiatric disabilities who are eligible and/or engaged with a plan for employment increased by close to 1,000 additional persons during 2009.

In FFY 2009, the percent of individuals with psychiatric disabilities who achieved an employment outcome (Status 26) was 18.6% of all employment outcomes, representing 2,261 individuals. This is a decrease of 175 individuals when compared to the previous year and mirrors an overall decrease in employment outcomes.

Of the total services in all VR statuses, 72.8% of individuals with mental health disabilities were considered to have a most significant disability.

Strategies to improve outcomes for this population were gathered from the focus group on youth with MH disabilities, the Community Forum with MH recipients and at the State Plan public meetings. The findings from those activities related to services to individuals with MH disabilities will be described later in this narrative.

Youth in Transition

The overall number of youth with disabilities (individuals who applied for VESID VR services prior to age 22) increased significantly, by almost 3,000 individuals during 2009.

Youth with disabilities now make up 44.4% of the total number of consumers served by the VR Program (who are eligible and/or receiving services). In 2009, this represented 26,717 individuals.

Of the total services in all VR statuses, 61.7% of youth (applicants prior to age 22) were considered to have a most significant disability.

In FFY 2009, youth who achieved an employment outcome (Status 26) was 34.6% of all employment outcomes, representing 4,202 individuals. This is an increase of 62 individuals when compared to the previous year.

The increase in outcomes for youth, while small, is significant in a year where the overall employment outcomes for VESID consumers decreased. It is an indicator that changes in VESID policy and practice with transition age youth are having an impact on performance.

Individuals receiving Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)

Individuals receiving SSI or SSDI comprised 26.3% of the total number of individuals served by the VESID’s VR Program (who are eligible and/or receiving services). In 2009, this represented 15,818 individuals.

The overall number of individuals receiving SSI or SSDI who are eligible and/or engaged with a plan for employment increased by more than 350 during 2009.

Of the total services in all VR statuses, 70.3% of individuals receiving SSI or SSDI were considered to have a most significant disability.

In FFY 2009, the percentage of individuals receiving SSI or SSDI who achieved an employment outcome (Status 26) was 26.5% of all employment outcomes, representing 3,216 individuals. This is a decrease of 475 individuals when compared to the previous year and mirrors an overall decrease in employment outcomes.

On a positive note, the percentage of individuals receiving SSI or SSDI who are eligible and/or receiving services matched the percentage achieving employment outcomes, indicating that individuals may be achieving employment outcomes at a rate commensurate with their overall participation in VR services.

VESID, working with the SRC, examined data on consumers who receive SSI and SSDI and their service utilization patterns, average wages, and functional limitations. It is clear from the data that SSI/SSDI beneficiaries earn less in average wages and cost more for a successful outcome. Strategies to improve outcomes for this population were suggested which include:

Increased use of benefits planning services;
Analyzing data for services that are correlated with successful closures for this population;
Using consumer satisfaction surveys of closed cases to determine whether SSI/SSDI beneficiaries are more or less satisfied than other recipients of public benefits; and
Utilize other sources of information about successful practices with this population through wage reporting data and surveys of District Managers and counselors.

The VR Program has been engaged in a strategic collaboration with the New York State Office of Mental Retardation and Developmental Disabilities (OMRDD) for several decades, and over the past 20 years, has worked extensively in the joint implementation of supported employment services. In order to better understand the rehabilitation needs of individuals with intellectual and developmental disabilities (including individuals with autism spectrum disorders), we conducted an analysis of those currently served.

Individuals with intellectual or developmental disabilities comprised 17.9% of the total number of individuals served by the VESID’s VR Program (who are eligible and/or receiving services). In 2009, this represented 10,799 individuals.

Of the total services in all VR statuses, 80.4% of individuals with intellectual and/or developmental disabilities were considered to have a most significant disability.

In FFY 2009, the percentage of individuals with intellectual and/or developmental disabilities who achieved an employment outcome (Status 26) was 18.6% of all employment outcomes, representing 2,263 individuals.

In FFY 2008, VR performance on US Department of Education (RSA) Indicator 1.2 was 59.8% and at 59.5% for individuals with intellectual and developmental disabilities, essentially even.

For FFY 2009, VR performance on Indicator 1.2 for all individuals dropped to 52.8%, but was slightly higher at 54.1% for individuals with intellectual and developmental disabilities.

Note: For the purposes of this comprehensive statewide needs assessment, intellectual disability and developmental disability is defined as primary impairment due to attention deficit hyperactivity disorder, autism, cerebral palsy, congenital condition or birth injury, epilepsy, or mental retardation.

Individuals with Autism Spectrum Disorder (ASD)

VESID was a key participant on the NYS Interagency Task Force on Autism that examined how New York supports people diagnosed with ASD within the State’s multiple service systems that exist to support individuals with many different needs.

Individuals with ASD comprised 2.4% of the total number of individuals served by the VR Program (who are eligible and/or receiving services). In 2009, this represented 1,472 individuals.
Of the total number of individuals with ASD served, 88% were considered to have a most significant disability.

In FFY 2009, the percentage of individuals with ASD who achieved an employment outcome (Status 26) was 1.5% of all employment outcomes, representing 183 individuals.

The number of Americans diagnosed with an ASD has risen dramatically in recent years. Estimates vary, but generally place the present incidence rate of ASD among children between one in every 91 to 150 individuals.

New York State’s service agencies, including VESID, held public forums in 2007 and heard about the tremendous needs facing people living with a diagnosis of ASD. In 2008 and 2009, VESID worked with the New York State OMRDD and other state agencies on the Interagency Task Force on Autism, that examined how New York supports people diagnosed with ASD within service systems that exist to support individuals with many different needs. The recommendations were presented in a formal report to the governor of New York State in the Interagency Task Force on Autism Report, issued in January 2010, to guide New York State to improve its support of individuals with ASD in the coming years.

The documented needs for the New York State service delivery systems, including the vocational rehabilitation program, were:

increased ability of physicians and specialists to screen for, assess and competently diagnose individuals with ASD;
greater availability of accurate and reliable information about ASD and available services and supports;
greater availability of evidence‐based services and practices;
additional assistance for individuals to prepare for post‐school employment;
improved provision of service coordination across the lifespan;
improved coordination of service delivery across multiple systems;
more information about the needs of those who don’t now meet standards for service eligibility;
overcoming language barriers in the provision of information and services; and
a coordinated research agenda that can deliver improved ASD practices across the State.

Individuals with Substance Use Disorders

VESID formed a cross-agency work team in March 2009 to identify the vocational rehabilitation needs of individuals with substance use disorders and to develop technical assistance, guidance and training for VR counselors and an updated Memorandum of Understanding with the New York State Office of Alcoholism and Substance Abuse Services (OASAS). The work team represented VESID field office counselors and supervisors, OASAS staff and individuals from treatment and community rehabilitation programs. This team was provided with the following data related to individuals with substance use disorders currently served by the VR Program:

Individuals with substance use disorders make up 17.3% of the total number of consumers served by the VR Program (who are eligible and/or receiving services). In 2009, this represented 10,439 individuals.

In FFY 2009, the percent of individuals with substance use disorders who achieved an employment outcome (Status 26) was 19.4% of all employment outcomes, representing 2,359 individuals.

Of the total served in all VR statuses, 43.4% of individuals with substance use disorders were considered to have a most significant disability.

The OASAS-VESID Statewide Team identified the need to integrate recovery principles into the practice of vocational rehabilitation and supporting recovery for individuals with substance use disorders with employment as an integral part of that recovery. The Team identified the following principles as being necessary to meet the vocational rehabilitation needs of individuals with substance use disorders:

Recovery is an experience that encompasses the belief, hope and expectation that a person with a substance use disorder can move beyond the limitations of the disorder and engage in a process of healing;

For the individual, the recovery process may be marked by transformational or incremental change, occurring at a different pace across a number of zones: physical, intellectual, emotional, relational, personal (daily living) and spiritual. It is non-linear and reflects the natural process of growth and self-awareness, where there may be occasional setbacks. It involves transcending the stigma of addiction and using language as a means for individuals in recovery to give voice to their experiences and aspirations for personal and social change; and

The challenge for vocational rehabilitation is to understand how vocational rehabilitation services can significantly contribute to an individual’s recovery by enabling individuals to pursue high quality employment outcomes consistent with the person’s strengths, resources, priorities, concerns, abilities, capabilities, interests and informed choice.

Individuals who are Deaf, Deaf-Blind, Hard of Hearing or Late Deafened

The Council of State Administrators of Vocational Rehabilitation in the Fifth Edition 2008 Model State Plan (MSP) for Rehabilitation of Persons who are Deaf, Deaf-Blind, Hard of Hearing or Late Deafened report that “Hearing loss is the most prevalent, chronic, physically disabling condition in the United States today.” Applying estimates of the prevalence of the population to contemporary population data from the United States Census, it is estimated that more than one in every ten Americans, or 30.6 million among 300 million, have a hearing loss. Approximately 18 million of these persons are of working age (16 to 64 years old). The employment status of working age (21-64) persons with hearing loss varies depending on level of loss. McNeil (1993) reported that 63.6% of persons with some functional limitation in their hearing ability were employed and 58.2% of those totally unable to hear normal conversational speech were employed. In comparison, 80.5% of all persons ages 21-64 without a disability were employed.

Hearing loss is becoming more prevalent among the general population. In an analysis of National Health Interview Surveys from 1971 to 1981, Ries (1985) reported that prevalence rates for hearing problems across all ages have increased steadily from 71.6 to 82.9 per 1,000 of the general population. The greatest increases occurred in the under 17 age group and 45 to 64 age groups. These trends have continued with the aging of the “baby boomer” population who are experiencing age-related hearing loss, and with people living longer.

The Cornell University 2008 Disability Status Report (for New York) report that although self-reported, NYS prevalence of hearing impairment among non-institutionalized people ages 21 to 64 in 2008 was 1.6% or 188,400 individuals.

As of September 30, 2009 there were 1,502 (3.0% of all open cases) VR consumers identified as deaf and 700 (1.0%) consumers identified as hard of hearing, as a primary or secondary impairment.

On August 11, 2009, NYS VESID participated in the Model State Plan Survey sponsored by CSAVR Committee on VR Services for Individuals who are Deaf, Deaf-Blind, Hard of Hearing, & Late-Deafened. Results are pending.

A national needs assessment completed by the National Consortium of Interpreter Education Center identified current and future needs of interpreter education programs. The results of the assessment indicated that the number of interpreters available for deaf staff and consumers has decreased. A major factor impacting the availability is increased employment with agencies providing video relay services.

2010 State Plan Public Meetings

As part of the Comprehensive Statewide Needs Assessment for FFY 2011, VESID and the SRC focused the state plan public meetings on identifying and discussing the vocational rehabilitation needs of individuals with disabilities residing in New York State, including those who are minorities and those with the most significant disabilities. Along with a review of data, the intent of the three public meetings held in Buffalo, Albany and New York City during January and February 2010 was to discuss with our partner agencies and individuals with disabilities the needs of unserved and underserved people with disabilities residing in New York State. The main questions asked of all public participants were:

Who are the groups that may be unserved or underserved by the VR Program?
In what ways are these groups unserved or underserved?
What are your suggestions on how VESID can close these identified gaps?

The SRC jointly developed this approach, approved the strategy and attended these meetings.

Key informant data was gathered and analyzed to develop an understanding of common themes and elements that currently affect the rehabilitation needs of individuals. The following themes emerged from the meetings, as well as from other verbal and written information obtained from participants:

Young adults with mental illness have a set of needs distinct from adults with mental illness;

Individuals with mental illness continue to be underserved by the VR Program and VR counselors need to have confidence in the employment potential of mental health recipients and to be recovery-oriented in the practice of VR;

Individuals receiving social security disability or supplemental security income need benefits counseling to have better outcomes;
Inconsistencies in implementation of policy or certain practices in different regions affect how certain groups or individuals are served by VR counselors across the State;
Transition services provided to youth need to include work experiences prior to school exit;
Students with disabilities need job coaching and assistance to secure after school or summer jobs for youth;
Individuals with most significant disabilities need supported employment to leave segregated work and program settings;
Individuals with developmental and intellectual disabilities need to have opportunities for postsecondary training in integrated settings, such as community colleges, with supports;
Veterans, particularly Iraqi and Afghanistan War vets with Post Traumatic Stress Disorder, Traumatic Brain Injury and substance use disorders are not making use of Veteran Affair’s or State VR programs;
Individuals with disabilities over age 50 and displaced older workers with disabilities still need VR services;
Many individuals receiving TANF or Safety Net have disabilities and need substantial supports to succeed in work;
Individuals with limited English proficiency with disabilities are underserved due to language and/or cultural barriers;
Individuals who are deaf or deaf/blind don’t participate as fully in VR services;
Individuals with substance use disorders may not realize they could be eligible for VR services;
VR counselors need to spend more personal time with individuals in order to be effective; and
Transportation is still a factor in rural areas and for individuals in all areas who cannot use public transportation due to accessibility limitations.

Roundtable Discussion of Experts on VR Needs of Youth with Mental Health Disabilities

VESID conducted a discussion with individuals who specialize in services for youth with mental health disabilities with experts representing the NYS Mental Health Association, the NYS Office of Mental Health and VESID Special Education staff. The discussion identified the following critical needs for this population of youth:

Diagnostic challenges exist in identifying the “mental impairment” necessary for VR eligibility. Schools use the broad term “emotionally disturbed”;
The adolescent brain changes significantly between the teen years and mid-twenties lending difficulty to determining VR eligibility. Youth with mental illness have diagnoses that are fluid, not permanent;
An absence of a coordinated system of service delivery presents significant challenges for youth and young adults with mental illness as they age out of youth services. Aging out of the youth service, many youth between the ages of 18-22 straddle multiple educational and service systems. They can simultaneously be a youth in one system and an adult in another;
There is a high unemployment rate for youth with mental health issues. They face unemployment, underemployment, stigma and discrimination when trying to enter the workforce.

Roundtable Recommendations

Several recommendations were made by the experts who participated in this roundtable:

Engage youth with mental health issues in their own future planning process, focusing on each individual’s strengths;

VESID should develop a systems approach to provide care by having multi-agency (i.e. NYS Office of Mental Health and their local providers) sharing of resources and responsibilities, including professionals, families and youth, to develop and design individual service programs based upon the individual’s needs and strengths; and

Employment should focus more on a “place and train” model rather than a “train and place” model.

Specific actions steps for future consideration are:

Conduct focus groups with youth and with Parent Centers as part of the VR State Plan Public Meeting Process; and

Develop a learning collaborative with the VESID Youth in School Policy Development Team and related interagency partners (e.g. NYS DOL Youth Employment Coordinator, OMH, DDPC). Schedule a series of two or three roundtable discussions to identify and prototype effective practices.

Findings and tentative recommendations will be shared with SRC and VESID leadership to develop goals, priorities and strategies as appropriate.

Community Forums with Mental Health Service Recipients

In July 2009, VESID’s New York City District offices, with the VESID Director of Operations, participated in a consumer forum sponsored by the New York Association of Psychiatric Rehabilitation Services (NYAPRS) and Community Access, a New York City-based non-profit community agency. NYAPRS is a statewide coalition of people who use and/or provide recovery-oriented community based services. Approximately 160 consumers participated. The format allowed for a constructive exchange of information and ideas, questions and answers among VESID, NYAPRS and individuals with MH disabilities, who sometimes refer to themselves as “recipients” in the MH system.

The participants identified challenges in their experiences including:

Difficult communication issues between the consumer and VESID counselors;
Reported delays by VR counselors in responding to phone calls;
Vocational planning appears arbitrary to the consumer rather than based on unique employment factors of the individual;
Consumers report that they are unaware of due process despite multiple notifications by VESID at key points in the VR process;
Consumers report they are required to participate in multiple and unnecessary evaluations and that often the results are not helpful or shared with the individual;
Individuals are denied a vocational goal or service of choice based on the evaluation and that training is limited to menial jobs and higher education is discouraged; and
VESID services do not seem to be mental health friendly and the eligibility process takes too long.

The following recommendations were identified as next steps:

Development of Consumer Advisory Council – VESID agreed to start with a pilot advisory council for the NYC Offices. This is in the process of being implemented.
Supported Employment Pilot – VESID will work with OMH to address service needs for individuals with psychiatric disabilities. The pilot will incorporate application of the “Individualized Placement and Support” model with existing providers who are jointly funded by VESID and OMH. Further meetings are scheduled with OMH to identify potential pilot sites.

Consumer Satisfaction Survey

In 2009, VESID contracted with the Potsdam Institute for Applied Research at SUNY Potsdam to have a consumer satisfaction survey conducted. The survey was sent to consumers who had completed the service delivery process sometime during the previous year (2008), and who terminated from services either employed (status 26) or not employed (status 28).

The survey consisted of 23 questions which were printed in English and Spanish. Participants were selected randomly, controlling for status, gender and district office. A total of 5,001 persons were selected for the pool. Of these, 2,500 were closed in status 26 and 2,501 were in status 28.

There were 533 surveys returned. This is a 10.7% response rate. The following represents a summary of responses to key areas:

When asked about general satisfaction with quality of service 77% of respondents indicated satisfaction with VESID service. Approximately 79% of respondents would recommend VESID to someone else. The level of satisfaction has fallen 3% since the previous survey in 2008.

Questions were asked about the time it took to reach counselors, the time it took to begin receiving services and treatment by staff. Almost 77% (81% in 2008) of respondents indicated that VESID staff could be reached within three days. Sixty-eight (75% in 2008) percent of respondents felt that the time it took to begin receiving services was acceptable to them. Almost 89% (93% in 2008) felt they were treated courteously by reception staff and approximately 87% (90% in 2008) agreed that they were treated courteously by counseling staff.

Almost 72% (76% in 2008) of consumers surveyed in 2009 agreed they were encouraged to participate in planning. Since all of these respondents should have had a plan in place given their closure statuses, it is puzzling that only 68.7% (72.5% in 2008) recognized this at the time of the survey. It is consistent with the previous finding regarding the extent to which consumers felt encouraged to participate in planning. This result also suggests that counselors need to emphasize the plan and planning process during counseling. It is important to keep focused on the plan for consumers during service delivery so they can see how they are accomplishing their goals. This clarity of purpose and action may assist the consumer in achieving their goals.

Approximately 60% (65% in 2008) of consumers recall being informed about due process.

With regard to employment, over 78% (75% in 2008) of respondents indicated being satisfied with their jobs.

In summary, the general satisfaction with VR services dropped slightly in this most recent consumer satisfaction survey. It also continues to be below the established target of 95 percent. These results also reflect that 23 percent of the responders rated VESID services as poor or very poor. As VESID and the SRC Quality Assurance and Improvement Committee review and analyze the findings, we will jointly explore what the findings mean in terms of practice and what aspects of the findings are most significant from the VR participant’s perspective.

Model Transition Program Assessment

Cornell University investigated the effectiveness of the Model Transition Program (MTP) that ran from 2007 through November of 2009. They conducted an online survey to learn about how VESID counselors evaluate the MTP from their experiences and to establish the best practice strategies for youth with disabilities through collaborating with local high schools. The VESID Case Management System (CaMS) identified a total of 184 VR counselors or staff who has worked with one or more consumers who were referred by the MTP. Of them, 84 participated in the voluntary survey.

The Cornell evaluators identified the following findings.

Collaboration between schools and VR agency was improved by MTP staff, which resulted in their students having well prepared VESID application packages.
VR counselors saw that the MTP consumers were more exposed to job search resources and job experiences.
Sixty-eight percent thought that the MTP caused an increase of their caseload size; however, they did not expect that their job will be less busy after the MTP is over.
VR counselors appeared to think that MTP led VR counselors to attend more events developed by the MTPs, which resulted in more and better collaboration between schools and community partners including VESID. Forty-five percent of them thought having a liaison between schools and VR was helpful.

The Cornell evaluators identified the following best practice strategies.

VR counselors believe that a students’ level of motivation, students’ social skills and the extent of family support are important factors in students’ successful employability outcomes.
Students who had measurable post-secondary goals on their Individualized Education Program, graduated with a regular or Regents diploma and completed a comprehensive vocational assessment are more likely to become employed.
Paid/unpaid work experiences in the community or in school prior to VR referral were perceived as the most important factor to achieve successful employment outcomes.
When asked to identify factors related to successful outcomes, VR counselors felt that students who identify realistic goals for the future are more likely to have a successful employment outcome.

An early referral process supports a stronger linkage between high school and adult agencies, promoting the employment and community integration of young adults with disabilities.

Rehabilitation needs of individuals with disabilities who have been served through other components of the statewide workforce investment system

Department of Labor (DOL) Disability Program Navigator

During fall 2009, the New York State Department of Labor (DOL), through its Disability Program Navigators (DPN), conducted an online survey of One-Stop Career Centers on the critical issues facing individuals with disabilities in New York State.

VESID funded eight DPN positions through a Memorandum of Understanding (MOU) with DOL for project years 2009 and 2010 (through June 30, 2010). The purpose of the MOU was to promote programmatic and systemic accessibility of the One Stops. The second purpose was to ensure any systemic changes would be sustainable; therefore, DPNs were requested to set up advisory panels at One Stops to meet the needs of individuals with disabilities at the One Stops.

As part of this project, VESID established a State-level program liaison to DOL and to all of the DPNs. Over the past year, the DOL and VESID program liaisons met monthly with the DPNs to better understand and coordinate cross-systems services and to better meet the needs of individuals with disabilities. A statewide list of local liaisons was identified between the DPNs and the VESID District Offices to facilitate stronger communication linkages.

Need to establish, develop, and/or improve community rehabilitation programs

Chapter 515 Interagency Team Survey of Supported Employment Providers

In May 2009, VESID focused on expanding the statewide assessment of needs by conducting a survey of supported employer providers to promote greater success for consumers with the most significant disabilities by making services more efficient and effective. The survey was conducted as a cooperative effort among OMH, OMRDD, CBVH and VESID with the Center for Essential Management Services (CEMS) under the auspices of the Disability Statistics Research and Training Center at Hunter College. The survey was sent electronically to 198 supported employment provider organizations.

The Chapter 515 Interagency Team initiated the survey to gain information from providers to improve the supported employment service delivery system in NYS, particularly to get data on how well the referral process is working and how it might be improved.

Although there are a variety of information sources used by supported employment providers to help identify the needs of consumers, there are three that particularly stand out. These are psychological evaluations, information from the consumer and family members, and information from the referring counselor. When asked to rate each of the information sources on several qualities, these three again are viewed favorably in terms of the amount of information made available, the content of the information, and the overall value of the information.

The results of this survey, including each state agency’s response to the findings, are described in the Chapter 515 Statewide Supported Employment Survey: Final Report issued in March 2010. For VESID, this process is one component of its State Plan Comprehensive Statewide Needs Assessment.

A presentation of the survey findings was shared with supported employment service providers at the annual conference of the New York State Rehabilitation Association (NYSRA) in September 2009. The State agency representatives (VESID, OMH, OMRDD and CBVH) and researcher (CEMS) summarized the findings and engaged the providers in a dialogue on what were the most significant findings and listened to provider perspectives on what recommendations should emerge as priorities. These included:

Consumers should be referred with a job goal that is realistic so that their motivation is more in line with the labor market possibilities;
Situational assessments would be desirable for all consumers but there is not adequate funding to support this;
Consumers should be referred only if they have adequate work supports, such as ability to manage transportation;
Referral information should include explanations of past vocational efforts of consumers, particularly those that failed;
Regarding eligibility for extended funding, it would be good to know as soon as possible if consumers are eligible for Medicaid;
CBVH and VESID assessment standards should match Medicaid waiver requirements for extended follow-along. Often, individuals’ motivation drops while they are waiting for Medicaid issues to be resolved.
Early assessments need to identify supports both on and off the job;
Only Article 16 clinics know how to assess and provide documentation for OMRDD. VESID should not use independent psychologists for that purpose;
Article 31 clinics (OMH) are often sources of referral, but they don’t understand the vocational side. These clinicians need to be on board.

NY Makes Work Pay and Developing Integrated Employment Options through the Community Rehabilitation Providers

New York State is presently engaged in a Medicaid Infrastructure Grant, entitled New York Makes Work Pay (NY-MWP) that will assist New York in removing obstacles and creating new pathways to employment for New Yorkers with disabilities. Under the auspices of the NY-MWP, the Cornell University Employment and Disability Institute worked with the New York State Rehabilitation Association (NYSRA), a statewide association of community rehabilitation providers, to survey the community rehabilitation providers of vocational services across the State to identify the overarching issues that they face in building the infrastructure necessary to improve employment outcomes for people with disabilities, while identifying new or existing opportunities to enhance employment services. One primary focus is to move more individuals with most significant disabilities from segregated employment to integrated employment.

The initial survey identified barriers to integrated employment for people currently participating in segregated programs. A few of these barriers included reliance on Medicaid funding, lack of alternative integrated program models, and employer-based alternatives to sheltered employment. These findings will be the basis of an ongoing effort by NYSRA, in conjunction with the NY-MWP, to support community rehabilitation providers in developing plans for transforming their segregated work centers into integrated employment programs.

Impact of Findings and Results on VESID’s Priorities, Goals and Strategies

During FFY 2011, VESID will work closely with the SRC to systematically review and discuss the finding of each section of this report and develop specific recommendations related to priorities, goals and strategies. As needed, additional data will be gathered, particularly in areas related to serving transition-age youth and individuals with the most significant disabilities through supported employment. VESID will work with the SRC to refine its goals and enhance existing strategies or develop new ones to achieve the goals that are identified in the current State Plan or that are added in the future through the review of this report.

Evaluation and Report of Progress in Achieving Identified Goals and Priorities and Use of Title I Funds for Innovation and Expansion Activities: Attachment 4.11(e)(2)

Section 106 of the Rehabilitation Act, as amended in 1998, requires the Rehabilitation Services Administration (RSA) to evaluate State vocational rehabilitation (VR) agencies based on their performance on evaluation standards and indicators. Performance on these standards is used to determine whether a State VR agency is complying substantially with the provisions of its State Plan. States that do not meet the performance criteria will be required to develop a program improvement plan jointly with RSA. In addition to the required performance indicators, VESID has established additional measures related to the priorities and goals described in Attachment 4.12(c)(1) Annual Goals and Priorities. The following results are based on the most recent data available on the federal performance indicators and the priorities and goals, as described in Attachment 4.12(c)(1).

Priority #1: Individuals with disabilities, including youth, will be employed in integrated work settings consistent with their abilities, interests and achievements.

Goal 1.1.1: Increase the total number of individuals who achieve an employment outcome (RSA Performance Indicator 1.1).

Performance for FFY 2008: 13,236, an increase from FFY 2007 (13,198)

Performance for FFY 2009: 12,151, a decrease from FFY 2008

Results: VESID had a significant decrease in the number of individuals achieving an employment outcome for FFY 2009. In FFY 2009, the number of employment outcomes decreased by 1,085 placements.

The employment outcome numbers are influenced by many factors, including the overall economic climate in the State. Unemployment in New York State increased during 2009 as the recession deepened. The most recent data also indicate that the annual average number of unemployed in New York State climbed from 514,300 in 2008 to 813,400 in 2009, an increase of 299,100 or 58.1 percent. The annual statewide unemployment rate increased from 5.3 percent in 2008 to 8.4 percent in 2009, its highest annual level since 1992. The over-the-year increase of +3.1 percentage points in the statewide rate is the largest on record with data extending back to 1976. In New York City, the unemployment rate is higher still at 10.4% (Phil Weinberg, Executive Director of NYC Workforce Investment Board in an address to the NY Statewide Workforce Investment Board on March 24, 2010).

With an increased supply of skilled workers available to employers due to these job losses, job seekers with disabilities, who may not have the experience of these more seasoned workers, are at a distinct disadvantage in the job market. The decrease in VR performance was most likely influenced by the significant downturn in the economy. The downturn in the economy also resulted in an increase in the number of VR applicants during the fiscal year. More than 48,000 individuals applied for VR services during FFY 2009 which put an additional strain on the overall VR service delivery system.

Goal 1.1.2: Increase the total number of youth (applicants at age 14 – 21) who achieve an employment outcome.

Performance for FFY 2008: 4,140, an increase from FFY 2007 (3,690)

Performance for FFY 2009: 4,202, an increase from FFY 2008

Results: VESID continues to focus on effectively assisting youth in transition, and this particular indicator shows a continued increase (+62) in FFY 2009. The overall increase in youth served is a promising indicator that we will continue to increase employment outcomes in future years. This is the third year that VESID is reporting the results for this goal related to its priority on integrated quality employment. Youth accounted for a significant portion of the overall increase in employment outcomes. In 2007, VESID implemented the Model Transition Program which generated an unprecedented increase in school-age referrals. VESID also revised the Youth-in-School Transition Policy in August 2008. It is likely that the results of this indicator have been affected by the collaboration of the VESID VR counselor with students, families and school personnel. Even though the MTP projects concluded on November 30, 2009, the results are clear that continued collaboration with schools and work experiences for students are essential benchmarks of successful transition to work.

Goal 1.2.1: Increase the percentage of individuals exiting the VR Program after receiving services who achieve an employment outcome and exceed the national standard of 55.8 percent (Performance Indicator 1.2).

Performance for FFY 2008: 59.8 percent exceeds the standard

Performance for FFY 2009: 52.8 percent does not meet the standard

Results: The percentage of individuals with disabilities who achieved employment after receiving vocational rehabilitation services from VESID in FFY 2009 is 52.8 percent which is below the national standard of 55.8 percent by three percentage points. Although VESID District Offices continue to make significant efforts to increase employment outcomes, the results are affected by the significant downturn in the economy. In order to reverse this trend, the VR Program will have to work diligently with its community partners to identify employment opportunities for VR participants and use strategies such as Work Try Out or On the Job Training to provide a competitive advantage when appropriate.

Goal 1.2.2: Increase the percentage of youth with disabilities (applicants at age 14-21)

exiting the VR Program after receiving services who achieve an employment outcome and exceed the national standard of 55.8 percent.

Performance for FFY 2008: 60.2 percent exceeds the standard

Performance for FFY 2009: 51.1 percent does not meet the standard

Results: This employment goal for youth had been steadily increasing, but experienced a decrease during FFY 2009. While the percentage of youth at application who had previously achieved an employment outcome after receiving services exceeded the standard and increased for three consecutive years (FFY 2006 through FFY 2008), the downturn in the economy combined with a significant increase in the number of youth participating in VR services resulted in a high number of status 28 closures during FFY 2009 (4,020).

Goal 1.3: Increase the percentage of individuals achieving an employment outcome who earn at least minimum wage (RSA Performance Indicator 1.3) and exceed the national standard of 72.6 percent.

Performance for FFY 2008: 94.7 percent exceeds the standard

Performance for FFY 2009: 94.4 percent exceeds the standard

Results: The FFY 2009 rate of 94.4 percent is a slight decrease from the FFY 2008 rate of 94.7 percent of individuals obtaining employment through VESID earning at or above minimum wage. For both years, VESID far exceeds the national benchmark standard of 72.6 percent. The slight decrease does not seem to be significant and it is unlikely that the change in the rate is related to any specific program improvement strategies.

Goal 1.4: Increase the percentage of individuals having significant disabilities who achieve competitive employment (RSA Performance Indicator 1.4) and exceed the national standard of 62.4 percent.

Performance for FFY 2008: 98.4 percent exceeds the standard

Performance for FFY 2009: 98.3 percent exceeds the standard

Results: Individuals are considered to have a significant disability when they have a physical or mental impairment which seriously limits one or two functional capacities such as mobility, communication, self-care, self-direction, interpersonal skills, cognition, work tolerance, or work skills and whose vocational rehabilitation will require multiple vocational rehabilitation services over an extended period of time. VESID assisted a substantially greater percentage of individuals with significant disabilities to achieve competitive employment compared to the national standard. For FFY 2009, 98.3 percent of individuals obtaining employment through VESID earning at least minimum wage had significant disabilities, a slight decrease from the FFY 2008 rate of 98.4 percent. Since 2000, VESID has sustained a significantly high percentage of individuals having significant disabilities who achieve competitive employment. The national benchmark standard is 62.4 percent. VESID is serving a high percentage of individuals with significant disabilities and has developed a strong infrastructure to competently serve these individuals through its partnerships with the State offices for mental health, developmental disabilities, blind and visually impaired, health (AIDS Institute) and alcoholism and substance abuse services.

Goal 1.5.1: Increase the average hourly earnings of individuals employed after receiving VESID services when compared to the average hourly earnings of all employed individuals in the State and approach the national benchmark ratio of .52. (RSA Performance Indicator 1.5 - Average hourly earnings of individuals employed through VESID who earn at least minimum wage compared to the average hourly earnings of all employed individuals in the State.)

Performance for FFY 2008: .37 does not meet the standard (.37 for FFY 2007)

Performance for FFY 2009: .38 does not meet the standard

Results: The average FFY 2009 VR wage is $10.55, compared to an average State wage of $27.70. To meet the standard for this indicator in 2009 in New York State, the average VR wage would need to be $14.41. This indicator increased slightly at .38 from FFY 2008, but the change is due primarily to the drop in the overall state average wage. VESID results for this standard remain below the national benchmark, which is set at a ratio of .52. This ratio reflects the relationship of hourly wages earned by individuals at the time of closure (typically 90 days after attaining employment) to the average hourly wage for all workers in the State. The benchmark ratio of .52 is set at just above half of the overall hourly wage.

There are many structural forces in the New York State economy that make it challenging for individuals participating in VR to earn a livable wage. Many of the individuals served by VESID, given the economic need criteria for many VR services, are low income individuals. A high percentage of individuals served by the VR Program are determined to have significant and most significant disabilities. The wide gap in wage distribution in New York State also makes this performance measure particularly problematic for low income individuals participating in VR services. New York State also has the highest average wage of all 50 states. A recent study by the Center for an Urban Future (www.nycfuture.org, New York by the Numbers, December 2009) substantiated that nearly a third of all adult workers in New York City are employed in low wage jobs. Statewide, the percentage of workers in low wage jobs is only slightly lower at 31 percent. When New York is compared to other states, only Rhode Island and Hawaii have a higher percentage of adult workers in low wage jobs. Given these factors, VESID is still committed to improving its performance on this indicator and assisting VR participants in obtaining higher wage employment outcomes.

As an alternative to this performance indicator, VESID did begin to examine the percentage of individuals who earn above the 200% poverty level, which is a commonly accepted standard for economic self-sufficiency.

Wage Earners at or above 200% of Poverty for FFY 2005: 4,221 individuals or 33%

Wage Earners at or above 200% of Poverty for FFY 2006: 4,053 individuals or 32%

Wage Earners at or above 200% of Poverty for FFY 2007: 4,184 individuals or 33%

Wage Earners at or above 200% of Poverty for FFY 2008: 4,170 individuals or 33%

Wage Earners at or above 200% of Poverty for FFY 2009: 3,444 individuals or 30%

Overall, slightly less than one third of VR wage earners are above the 200% of poverty level. VESID will continue to look at alternative measures to track progress on wages for VR participants. Through its efforts to promote greater participation in postsecondary education and training, VESID still expects that this strategy will eventually yield more significant increases in earnings.

Goal 1.5.2: Increase the average hourly earnings of individuals employed after participating in postsecondary training when compared to the average hourly earnings of all employed individuals in the State and exceed the national benchmark ratio of .52 (Variation on RSA Performance Indicator 1.5).

Performance for FFY 2008: .40 does not meet the standard

Performance for FFY 2009: .41 does not meet the standard

Results: The average VR wage of individuals who participate in postsecondary training had remained steady over the last three years (FFY 2006 at $11.65, FFY 2007 at $11.65 and FFY 2008 at $11.64 per hour), but dropped slightly in FFY 2009 to $11.49. As would be expected, individuals who participate in postsecondary training are earning significantly higher wages on average when compared to all VR participants. However, these individuals are still securing jobs, on average, at wages below the .52 threshold established by RSA. These individuals are earning about $2.92 less per hour than the required threshold. One factor that might account for lower wages is that VESID job seekers, while gaining postsecondary training to increase their overall wages, may still be at a disadvantage in comparison to their non-disabled counterparts who may have more work experience, in addition to training, upon entering the job market. Job seekers without disabilities may be tapping into the higher wage opportunities at a greater rate than job seekers with disabilities. VESID will continue to use the strategy of supporting higher education and workforce credentials as a means to higher wage employment and careers.

Goal 1.6: Of all individuals who achieve paid employment, increase the percentage of individuals who report their own income as the largest single source of economic support at the time they exit the VR Program when compared to what was reported at application.

(RSA Performance Indicator 1.6 is the percentage increase of individuals who report their own income as the largest single source of economic support from the time of application for VESID services to the time of successful closure in employment with earnings of at least minimum wage. The national standard is a difference greater than or equal to 53 percent.)

Performance for FFY 2008: 63.0 percent difference exceeds the standard

Performance for FFY 2009: 61.1 percent difference exceeds the standard

Results: In FFY 2008, a difference of 61.1 percent of individuals with disabilities reported their own earnings as the largest single source of support from the time of application to successful closure. This was a decrease (1.9 percentage points) from FFY 2008, but significantly exceeds the national benchmark of 53 percent. Even though there is a slight decrease in FFY 2009, it does not appear to be a significant change. This factor is probably most affected by the quality of placements that VESID and its network of providers are able to achieve with VR participants. It indicates an incremental move toward economic self-sufficiency, even if most individuals are not able to earn above 52 percent of the New York State average wage (Performance Indicator 1.5).

Priority # 2: All services for which VESID has responsibility will be consumer-focused, cost-effective, meet high standards and continuously improve.

Goal 2.1: The service rate for individuals from minority backgrounds will exceed the national standard and will be comparable to the service rate for individuals not from minority backgrounds (RSA Performance Indicator 2.1, national standard >= .80).

Performance for FFY 2008: .89 exceeds the standard

Performance for FFY 2009: .87 exceeds the standard

Results: In FFY 2009, minority individuals with disabilities received vocational rehabilitation services at a rate of 87 individuals for every 100 non-minority individuals.

VESID continues to exceed the national standard on this indicator. The national standard ratio is .80. VESID has consistently met the performance standard for this indicator since its inception. It is also noteworthy that VESID seems to be serving a higher percentage of black or African-American individuals in comparison to the general New York State population. One factor assisting VESID in meeting this standard is its efforts to hire staff whose diversity reflects the communities we are serving.

Goal 2.2: Consumer satisfaction with VESID services will increase annually toward the target of 95 percent of respondents expressing satisfaction on key questions contained in VESID consumer satisfaction surveys.

Performance for FFY 2008: A consumer satisfaction survey was conducted during FFY 2008; results again indicate that 80 percent of VESID consumers who received services under an IPE report an overall satisfaction rating of VESID services as good or very good. Eighty-four percent of the respondents would recommend VESID to someone else.

Performance for FFY 2009: Consumers were surveyed again during 2009. Results indicate that 77 percent of VR participants who received services under an IPE report general satisfaction with VR services and 79 percent would recommend VR services to someone else.

Results: The general satisfaction with VR services dropped slightly in this most recent survey. It also continues to be below the established target of 95 percent. These results also reflect that 23 percent of the responders rated VESID services as poor or very poor. As VESID and the SRC Quality Assurance and Improvement Committee review and analyze the findings, we need to explore what the findings mean in terms of practice and what aspects of the findings are most significant from the VR participants’ perspective.

Evaluation of Supported Employment Goals

VESID’s Title VI, Part B program goals are to:

provide services to individuals with the most significant disabilities who might not be traditionally considered appropriate for competitive employment;

Results: Through the cooperative efforts of VESID, CBVH, the NYS Office of Mental Health (OMH) and the NYS Office of Mental Retardation and Developmental Disabilities (OMRDD), as tracked by the Chapter 515 Interagency Implementation Team, during the State Fiscal Year 2009 (April 1, 2008 – March 31, 2009), a total of 14,716 individuals with the most significant disabilities were working in supported employment as a result of intensive services provided by VESID and CBVH and in extended services by OMH, OMRDD and VESID. These individuals require the supports available through the supported employment strategy to maintain competitive employment. This is a slight decrease from last year when a total of 14,731 individuals participated in supported employment intensive and extended services. New York State continues to demonstrate a substantial commitment to a coordinated supported employment program.

develop techniques for unserved and underserved populations, such as persons with acquired brain injuries, deafness, multiple disabilities, autism spectrum disorders, significant learning disabilities and significant mental illness;

Results: VESID is engaged in a number of initiatives to develop the quality of supported employment services, as described in the Chapter 515 Annual Report. For example, OMRDD developed a pilot project which is designed to demonstrate innovative employment strategies for individuals who want to work but who have been unable to become successfully employed for a variety of reasons. VESID and OMRDD will use what they learn from this initiative to enable individuals with the most significant intellectual and developmental disabilities, including brain injury, multiple disabilities and autism spectrum disorders, to become successfully employed consistent with their strengths, abilities and interests. VESID and OMH have also discussed developing a pilot project with selected mutual providers that demonstrates fidelity to the evidence-based Individualized Placement and Support principles developed by Dartmouth University and validated by SAMHSA.

develop quality programs that could be used for replication purposes; and

Results: Another major effort is ongoing training for supported employment providers. VESID awarded a contract to SUNY Buffalo for the purpose of providing statewide training to the entire network of supported employment providers across the State through the Supported Employment Training Institute (SETI). This intensive effort highlights the best practices of existing programs and help to replicate those practices. Working in close collaboration with VESID Central and District Office staff, SETI provides technical assistance to these programs in their efforts to provide high quality supported employment services. SETI also covers topics related to techniques for serving emerging and challenging populations, i.e. individuals with autism spectrum disorders or multiple learning disabilities. VESID also continues to conduct periodic monitoring visits to supported employment providers and engages the providers in making technical improvements and taking corrective action when necessary.

establish successful supported employment programs that will provide technical assistance to other programs.

Results: The State agency partners (OMH, OMRDD, CBVH and VESID) will continue to enhance their collaboration and deliberate on revisions to the Supported Employment Memorandum of Understanding (MOU) that reflect a renewed commitment and higher expectations for achieving integrated employment outcomes for individuals with significant disabilities. This MOU will outline principles for State level coordination and local implementation. While considerable progress was made on the content of the supported employment agreement across agencies, there are a few procedural items that need further refinement.

Over the past year, VESID has continued its collaborative role in facilitating a focused dialogue around supported employment with our State agency and community rehabilitation program partners. VESID has met monthly with the Chapter 515 Interagency Implementation Team, consisting of representatives from VESID, CBVH, OMH and OMRDD. Cooperatively, the Chapter 515 Team conducted a survey of supported employment providers. The Chapter 515 Team worked with the staff of the Center for Essential Management Services (CEMS) under the auspices of the Disability Statistics Research and Training Center at Hunter College to design and implement the survey. The survey was sent electronically to 198 supported employment provider organizations. The purpose of the survey was to understand how providers determine the support needs and develop service plans of individuals referred for supported employment. The entire process was collaborative, including a workshop session at the annual conference of the New York State Rehabilitation Association, a statewide organization of community rehabilitation providers, in September 2009 where the State agencies and researcher shared findings and asked the providers for feedback on what was most significant and what recommendations should emerge as priorities from their perspectives. The results of this survey, including each state agency’s response to the findings, are described in a final report issued in March 2010, and summarized in the FFY 2011 Attachment 4.11(a) Comprehensive Statewide Needs Assessment.

At the beginning of FFY 2010, VESID launched its new supported employment contracts with 194 provider agencies in the first year of a planned five-year contract cycle. This contract cycle also incorporated several new providers who serve underserved populations such as individuals with serious mental illness. VESID will be exploring the possibility of milestone and outcome based contracts for the next cycle.

Continuous Quality Improvements

VESID remains committed to continuous quality improvement in vocational rehabilitation services. VESID will use data to evaluate the impact of its policies, procedures and practices. Priorities and goals will be measured and modified to respond to findings from VESID’s comprehensive statewide needs assessment (See Attachment 4.11(a)). These evaluation and assessment activities will be used by VESID and the SRC to align policies, procedures, training and practice to achieve the goals of the program. NYSED, with the joint efforts of the SRC, is committed to operating a statewide comprehensive, effective, efficient and accountable VR Program that provides vocational rehabilitation services to eligible individuals with disabilities, consistent with their strengths, resources, priorities, concerns, abilities, capabilities and informed choice, so that they may prepare for and engage in gainful employment.

Summary of Input and Recommendations of the State Rehabilitation

Council; Response of the Designated State Unit; and Explanation for

Rejection of Input or Recommendations: Attachment 4.2(c)

The State Rehabilitation Council (SRC) is mandated under the Rehabilitation Act to work in partnership with the Office of Vocational and Educational Services for Individuals with Disabilities (VESID). Together, the SRC and VESID partner to ensure that individuals with disabilities receive timely and effective vocational rehabilitation services. The SRC relies on the following committees to carry out its responsibilities: the Executive Committee; the Membership Committee; the Policy and Procedures Committee; the Quality Assurance and Improvement Committee; and the Workforce Development Committee. The SRC Chairperson, Committee Chairpersons and the VESID SRC Liaison constitute the Executive Committee that coordinates the work of the committees based on their strategic planning and the statutory obligations of the SRC.

VESID and the SRC work cooperatively in setting strategic priorities and in developing agency policy for the delivery of vocational rehabilitation services for eligible New Yorkers with disabilities. VESID convenes ad hoc policy development committees when undertaking substantive policy changes. These committees are typically chaired by a VESID policy and partnerships unit staff person along with representation from VR management, vocational rehabilitation counselors and key stakeholders. A SRC representative has served as an integral part of every VESID ad hoc policy development team convened over the course of the reporting period.

The following is a summary of recommendations made by the New York State State Rehabilitation Council to VESID concerning the State Plan and policy development and the corresponding responses from VESID to the recommendations:

SRC Recommendation: The SRC requests VESID management outreach to the Department of Labor’s (DOL) Statewide Workforce Investment Board (SWIB) and VESID’s Special Education division to identify a SWIB and Special Education representative to serve on the Council as required by the Rehabilitation Act.

VESID Response: Deputy Commissioner Cort has requested the VESID Special Education Division identify a representative. The current DOL Council representative has explored the opportunity for SWIB representation and recommended the Council advance a request for representation directly to the SWIB Chairperson and efforts are underway to advance the request to the SWIB Chair.

SRC Recommendation: SRC endorses the adoption of a revised federal funding formula for allotments to states for the delivery of vocational rehabilitation services. The SRC is in the process of developing correspondence to RSA and encourages VESID to also communicate the importance of adopting a more equitable funding formula for New York to RSA and other policy makers.

VESID Response: VESID fully concurs with the need for a revised federal funding formula for state administered vocational rehabilitation services. VESID has communicated this position to the SED Office of Government Relations and the Council of State Administrators of Vocational Rehabilitation (CSAVR).

SRC Recommendation: SRC expressed disappointment with the early termination of the Model Transition Program (MTP) that has resulted in a substantial increase in the number of new youth referrals to the VR Program. The SRC also expressed the need for more federal technical assistance and enforcement associated with transition from school to adult life for students with disabilities. The SRC encourages the federal and state government to consider dedicated funding to support transition service coordinators at the high school and district level.

VESID Response: Increased demand for VR services coupled with funding shortfalls necessitated the termination of the MTP program in its third year. The VESID Special Education Program provides extensive monitoring and technical assistance to school districts and schools through implementation of its special education State Performance Plan (SPP). The VESID VR Program will advance the recommendation for dedicated funding to support transition services for students with disabilities with CSAVR and the SED Office of Government Relations.

SRC Recommendation: The SRC recommended Cornell University's contract to conduct data and program analysis and develop information/training materials to promote transition best practices and sustainability of the 60 Model Transition Projects be extended for an additional year.

VESID Response: VESID agreed, and continued funding of the Cornell initiative for a second full year.

SRC Recommendations: In order to preserve the gains made by the MTP, VESID should advise local school districts to use American Recovery and Reinvestment Act (ARRA) dollars to hire transition coordinators. VESID should provide technical assistance and formal guidance to MTP districts on how to sustain key elements of the MTP initiative. VESID should also disseminate MTP best practice information and trainings to all school districts statewide.

VESID Response: VESID communicated with MTP districts and encouraged utilization of ARRA dollars and other mechanisms to sustain MTP initiatives and partnerships. VESID will continue to monitor transition through the Special Education State Performance Plan. The VR Program will utilize the research findings and training materials developed by Cornell University to promote transition best practices statewide upon completion of their MTP program evaluation.

SRC Recommendation: The SRC requested the City University of New York’s (CUNY) Linking Employment, Academics and Disability Services (LEADS) program produce more definitive outcome data in light of VESID’s decision to curtail the MTP initiative and amend economic need policies. The SRC requests LEADS program data on graduation rates, wages, employment rates and related services associated with the project.

VESID Response: VESID joined with the SRC and invited representatives of the LEADS initiative to present to the full SRC and at the January meeting of the NYS Board of Regents. The reports to the Regents were shared with the SRC and included comprehensive program data and analysis.

SRC Recommendation: SRC recommends that going forward VESID ensure that all new initiatives and programs should have sustainability plans in place and approved prior to the start up of any new initiative.

VESID Response: VESID has undertaken a series of fiscal management reforms and improved internal controls to facilitate more accurate long term planning and budgeting. Sustainability plans will be a key component of future VESID initiatives.

SRC Recommendation: The SRC fervently asserts that VESID must avoid imposing the order of selection.

VESID Response: VESID has undertaken a series of initiatives to maximize the efficient use of available funding and resources including, but not limited to: improved fiscal management and internal controls, revised postsecondary policies related to college and business and trade schools, and shortened the duration of the Model Transition Project and the CUNY LEADS program. VESID also continues to engage in substantial efforts to secure additional District Office hiring of counselors and supervisory staff.

SRC Recommendation: The SRC requests more information and the opportunity for input into SED deliberations on the development of a new diploma or credential to replace the current IEP diploma. The SRC is particularly concerned with how students and their families will be accommodated in the new credentialing process. The SRC is also concerned about what communication strategies will be employed to inform students and families of the value and shortcomings associated with any new credentialing process.

VESID Response: The VESID Special Education Program has undertaken a broad-based effort to solicit stakeholder input with regard to the development of an alternative credential to the IEP diploma. Five public forums across the State were held on the topic that included participation by some 1,500 participants. VESID Special Education has also sought the guidance of the Board of Regents and efforts remain underway to develop a diploma/credential that promotes individualized learning, growth and will be recognized as a valid indication of an individual’s accomplishments and abilities.

SRC Recommendation: In light of additional American Recovery and Reinvestment Act (ARRA) resources made available to the Department of Labor, the SRC recommends VESID develop a strong relationship with the Department of Labor with the particular focus on youth services, increasing employment options and successful outcomes.

VESID Response: VESID’s Policy and Partnerships Unit has worked extensively to develop strong working relationships with the Department of Labor as has VESID’s Director of Marketing. VESID has embarked on research efforts and dialogue with DOL to determine if ARRA funding and/or other resources are available for VESID/DOL collaboration on youth services.

SRC Recommendation: After grappling with the new and complex Comprehensive Needs Assessment, the SRC recommends that the next VESID needs assessment include consumer satisfaction surveys of VESID consumers with both open and closed consumer cases. This would address the importance of assessing consumer satisfaction at each stage of service delivery (e.g., after eligibility determination, assessment, IPE development, and goal achievement).

VESID Response: VESID appreciates the substantive input the SRC has provided to assist VESID in reconfiguring its approach to the comprehensive statewide needs assessment. VESID is considering different approaches to the consumer satisfaction surveys, including the idea of surveying both open and closed cases.

SRC Recommendation: SRC recommended that the consumer satisfaction survey be sent to consumers in the process of receiving services on a quarterly basis.

VESID Response: The recommendation has been referred to the VESID Quality Assurance Unit and will be considered within the context of limited capacity.

SRC Recommendation: SRC recommends providing feedback and advice on the design and implementation of the VESID Vendor Report Card for Supported Employment Services and suggests VESID explore opportunities to integrate data from related service agencies with VESID data. Data collection and quality improvement efforts should be changed from an emphasis on regulatory compliance to a focus on the impacts of VESID services on people’s lives.

VESID Response: VESID incorporated a comprehensive set of performance requirements for supported employment contracts with community rehabilitation providers statewide.

SRC Recommendation: SRC recommends that VESID evaluate the quality and scope of services provided to consumers of service who rely on Supplemental Security Income/ Social Security Disability Insurance (SSI/SSDI). VESID provided the SRC with data regarding the consumers’ service utilization patterns, average wages and functional limitations. The SRC recommends that VESID utilize this data to redirect services for improved outcomes for these consumers. The data clearly demonstrates that SSI/SSDI beneficiaries earn less in average wages than VESID’s overall caseload.

VESID Response: Individuals receiving SSI/SSDI comprised 26.5 percent of the total number of individuals served by the VR Program (who are eligible and/or receiving services). In 2009, this represented 15,818 individuals. The percentage of individuals receiving SSI/SSDI who are eligible and/or receiving services matched the percentage achieving employment outcomes, indicating that individuals may be achieving employment outcomes at a rate commensurate with their overall participation in VR services.

VESID will continue to work on a number of fronts to improve employment outcomes for SSI/SSDI participants in VR services. Efforts are underway to effectively integrate the Social Security Ticket to Work program with VR services. VESID continues to monitor for presumed eligibility and has made a concerted effort to integrate benefits counseling as an integral component of the VESID counseling and plan development.

SRC Recommendation: SRC recommends two changes in the draft Work Try-Out (WTO) and On-the-Job Training (OJT) policy changes that had placed the burden of accommodations strictly on the employer. The SRC recommends that the policy should clarify VESID’s responsibility for the purchase of adaptive technology associated with WTO for assessment. The SRC also strongly endorses the inclusion of community rehabilitation service providers as eligible for WTO or OJT assistance when they are functioning as potential employers.

VESID Response: The VESID WTO/OJT policy was changed to reflect these two recommendations. Under this new policy, adaptive tools and devices are now separate and distinct from ordinary tools and equipment required for a job. Under “General Criteria for WTO or OJT”, WTOs and OJTs may be authorized for a for profit business and not for profit business, including community rehabilitation providers.

SRC Recommendation: SRC recommended VESID issue a policy directive under Deputy Commissioner Cort’s signature outlining the new WTO/OJT policy for all schools, Boards of Cooperative Education Services (BOCES) and special education technical assistance networks.

VESID Response: VESID Deputy Commissioner Cort issued a statewide memorandum summarizing the new WTO/OJT policy and options. The memo was directed to all VESID rehabilitation staff and community rehabilitation programs. VESID District Offices were directed to conduct training to address WTO/OJT implementation and undertake initiatives to publicize these programs to community-based stakeholders.

SRC Recommendation: Preliminary recommendations with regard to the pending SED reorganization include linking Special Education parent centers with the adult education Literacy Zones.

VESID Response: As VESID and Adult Education workgroups are under development, VESID is committed to achieving strong effective collaboration between Literacy Zones, VR, Independent Living and Special Education Parent Centers.

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