Impact: Customized Employment

February 2011 - Medicaid Infrastructure Grant (MIG) Brief

Gary Shaheen, M.P.A.– Senior Vice President
Burton Blatt Institute at Syracuse University

New York Makes Work Pay is a Comprehensive Employment System Medicaid Infrastructure Grant (#1QACMS030318) from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) to the Office of Mental Health on behalf of New York State.  It is a joint effort of the Burton Blatt Institute at Syracuse University and the Employment and Disability Institute at Cornell University with the collaborative support of the Employment Committee of the New York State Most Integrated Setting Coordinating Council (MISCC) to develop pathways and remove obstacles to employment for New Yorkers with disabilities.

IMPACT: Customized Employment*

* note that all outcomes indicated are based upon an actual implementation timetable of 13 months over the 2009–2010 contract years given contractual delays

Building upon 10 Customized Employment regional learning communities implemented by BBI and its experts during 2009 and continued in 2010, Customized Employment principles and practices are being introduced and replicated as tools to increase employment access and outcomes for people with disabilities, especially those with complex needs. Customized Employment pilot projects initially developed in 2009 in Hempstead and Utica, NY were replicated in other NYS locations, augmented by deployment of mentors trained in Customized Employment techniques are demonstrating validity of the approach. Specific outcomes directly attributable to MIG training and technical assistance includes:

• Creation/use of interagency Advisory Group comprised of state disability agency staff from OPWDD, DOL, ACCES-VR, CBVH and OASAS to guide and improve utilization of Customized Employment practices for clientele served by their agencies
• Expansion of statewide training locations: 4 training sites serving NYC/L.I., Mohawk Valley, Central NY and the Finger Lakes
• Number of staff trained: 101 (Hempstead=50, New York City=39, Mohawk Valley=7, CNY=15)
• Number of people using Customized Employment: (Hempstead=20, New York City=30)
• Number of people obtaining jobs using Customized Employment: 8 (Hempstead=2, New York City=5, Mohawk Valley=1)
• Development of a Customized Employment Mentorship network that lays the foundation for Customized Employment distance learning Certification and follow–along training and technical assistance in 2011
• Work with State Agency Advisory Group to embed ‘Discovery’ as alternative assessment in state funded employment programs
• Added Customized Employment as a stage 2 category in the integrated agency employment (OSOS) database and as a component of the 2011 data base training program for employment program providers
• Cross–state information exchange with the S10 state southeast TACE to exchange best practices for implementing Customized Employment (CE)
• Growing evidence of cost–effectiveness for people who have not had employment success/had multiple attempts in the past (For example: A person closed successfully in Sept. had 3 prior unsuccessful experiences in the system. This time ACCES-VR paid for 127 hrs of Customized Employment over a 4–month period @ a cost of $5,493 compared to the most recent unsuccessful SE experience (330 hrs over 4.5 yrs) costing $13,500.

IMPACT: Addressing ‘Supply–Side’ Employment issues:

During 2010, BBI partnered with NYAPRS to develop and provide training on Employment Network Development to current and prospective mental health providers receiving Medicaid reimbursement for services under the OMH ‘PROS’ (Person–Oriented Recovery Services) license. Highlights of this effort include:

• Developed and delivered Ticket Orientation Webinars “101 and 201” for PROS Programs with 100% participation on at least 1 session
• Held 5 Regional Ticket “301” Training sessions attended by at least 75% of those attending the 101 events
• Developed a PROS EN network database, ‘Ticket Tracker’, EN ‘Decision Tree’ and other tools for planning and implementing ENs
• 150 mental health and vocational PROS programs received Ticket–to–Work info.
• Approximately 312 people across 150 programs participated in one or more Training activity.
• Increase in PROS–licensed programs which reported to be active ENs (from 14% to 28%), and increase among those in the process of applying to become ENs (from 11% to 22%).

EN Status of Currently Licensed PROS programs (N=53 as of 12–1–10)

Current ENs – 53% (n = 28)
In Process of applying – 17% (n=9)
Interested – 23% (n=12)
Unknown Status – 8% (n=4)

Contact Information

Gary Shaheen, Senior Vice President
Burton Blatt Institute at Syracuse University
900 S. Crouse Avenue
Crouse–Hinds Hall, Suite 300
Syracuse, New York 13244
geshahee@law.syr.edu
Tel. 315.443.9818

Partnering Organizations

New York State Office of Mental Health
John Allen, Special Assistant to the Commissioner
44 Holland Avenue, 8th Floor
Albany, New York 12229
corajba@omh.state.ny.us
Tel. 518.473.6579

Employment and Disability Institute (Cornell University)
Thomas P. Golden, Associate Director, Employment and Disability
ILR School–201 Dolgen Hall
Ithaca, New York 14853
tpg3@cornell.edu
Tel. 607.255.2731