Let's Look at Some Real Life Scenarios....

IMPLICATIONS FOR VR SERVICE DELIVERY

WHAT MIGHT IT LOOK LIKE FOR FOUR INDIVIDUALS?

POLITICAL CONSIDERATIONS

     Political climate relative to the development of employment networks

     External pressures to form alliances and composition of those alliances

     The role of outside advocacy groups

     The impact on resources and reimbursement revenue

CASE STUDIES

 Jim - 40 years old

    Sustained a spinal cord injury in his early twenties

    Received multiple services from VR over a period of 18 years

    Services have included education, restoration and supports

    Used up almost all of his trial work months, but consistently did not exceed SGA

    Income requirements would depend on cost of buy-in

    Would be willing to give up Social Security if usable income increased

    Could benefit from placement assistance

    Needs a modified van for independent access to employment

DECISION POINTS AND OPTIONS:

    Has been marketed by an independent Employment Network

    They will provide placement services and have developed a plan that includes application to VR for assistance in the purchase of the van.

    Would have previously been a reimbursement case for VR.

    Reimbursement under the Ticket could come quickly given the previous utilization of Trial Work months.

    Is there an Agreement in place with this EN?

    How does it address:

    Cost sharing and service provision

Mr. T. -Gentleman in his early fifties

    Sustained an injury on the job

    Unable to return to his previous job,  had limited capacity for light duty employment

    Chose to obtain part time unskilled work, paying $7.00 per hour, working  15 hours per week.

SSDI  benefit: $1000.00

Earnings            420.00

Current income 1420.00

       Full time:        $1120.00

      To date has opted to remain at part time,  has used Trial Work months, but never exceeded SGA.

DECISION POINTS AND OPTIONS:

    Employer is a National Corporation that has decided to become an EN.

    Willing to provide On the Job Training, with a commitment from the employee to work full time.

    Mr. T. requires accommodations for classroom learning, job modifications and restructuring.

    Employer wants to partner with VR to provide the disability related services and will provide all of the technical training.

    Should VR accept referral that does not include Ticket provision?

    What is long term benefit to the program of developing this type of relationship and training model with such an employer?

Rene -- A woman in her thirties with chronic mental health issues

    Has received vocational services from Mental Health and VR

    Has used up Trial Work Months through cyclical employment attempts.

    Recovering from an acute episode and currently unemployed

    Currently  receiving monthly benefits in the Extended Period of Eligibility (EPE)

    Benefits would stop once she returned to work above SGA

    Wants to attempt work but is afraid of jeopardizing benefits

    lacking the confidence of being able to maintain employment and fearful of her periodic relapses.

DECISION POINTS AND OPTIONS:

    Needs comprehensive benefits planning

    Needs to develop a return to work plan that  allows for graduated increases in earnings and changes in benefits.

    The Mental Health Agency and VR could be part of a collaborative EN.

    How can VR and MH  use the service menu in existing MOU to develop a  Ticket Agreement?

JUDY - 20 year old woman with a developmental disability

    Graduating from High School within the next year

    Has applied for and been approved for SS disability as an adult

    Has been referred to the Area Agency for Adult Services

    Working with a VR counselor towards employment

    Family is living in Section 8 Housing and Judy's income would impact on the Family's housing status.

DECISION POINTS AND OPTIONS:

    Employment influenced by the need to maintain extended services paid  through Medicaid

    Family does not want to   jeopardize SSI eligibility

    Individual and family could benefit from a futures planning approach to identify goals and expectations

    Should VR be involved in an EN with Developmental Services? 

    Should this individual be served by VR with Ticket utilization not a significant factor in vocational service planning?