Roadmap to Day, Employment, and Career Services

Roadmap to Day, Employment, & Career Services:
© 2015
Adults with Intellectual,
Developmental, & Other Disabilities

Note:
Along with the several factors involved when making decisions about day and employment services, the health
and safety of the individual remain the most important and no service can be arranged or provided with out
these considerations taken into account.
This roadmap is not to replace the importance of a discussing day and employment service options with the
regional center service coordinator, the Department of Rehabilitation, and other funding sources and service
providers.
The roadmap does not address employment trends or describe provider organizations or availability.
The definitions for the services described in this roadmap are primarily from the Department of Developmental
Services for the State of California.
© 2015 All Rights Reserved

A self-guided, self paced review intended to assist families and individuals on what
career, work, and other options are available for adults receiving services from
regional center , Department of Rehabilitation, and or other resources.
The next slide takes you to a flow chart on the factors to consider when making decisions about day and
employment services.

DAY ACTIVITY
PROGRAMS
Day, Employment, and Career Services for Adults with Intelectual and Developmental Disability
The level of support and other considerations drives the type of service to be recommended.
.
SUPPORTED EMPLOYMENT
INDIVIDUAL
(Habilitation Services)
WORK ACTIVITY PROGRAM
LEVEL OF SUPPORT
Locations of Service Delivery
Client to Staff Ratios &
Community Integration
Advancement Potential and
or Tailoring of Service
Wage Expectation
Assessment, Training, and
Skill Acquisition
Service Availability and
Program Viability
TYPE OF SERVICE
Low
Moderate
High
Microenterprises & Self
Employment
Services Offered and Quality
Income impact on Benefits
CONSIDERATIONS
Department of Rehabilitation
services
SUPPORTED EMPLOYMENT
GROUP
Training Programs & Job
Development
Note: As individual
progresses toward
career and life goals,
effective planning and
advocacy promotes
transition between
programs and services.
Click on the specific Level
of Support, Type of
Service, or
Considerations to get
definitions. Click on the
title of each slide to
return to this flow chart.
Click on any links to get a
more detailed
description.
Definitions Vendor Service DirectoryTechnical Support© 2015 All Rights Reserved

Levels of Support
• Historically a person's level of need was measured by the skills a
person lacked or by level of disability.
• Currently the focus has shifted to what supports a person with
intellectual or developmental disabilities needs to do the same
things as people without disabilities, such as go to work, keep up a
home, have relationships, etc. Supports can change based on skill
acquisition and passage of time. Supports are divided into the
following:
• Intermittent support (episodic need)
• Limited support (needed for specific periods of time)
• Extensive support (needed regularly for an extended period of time)
• Pervasive support (life-long, intense need)
• In general the lower the level of needed support, the greater the
range of day, employment, and career options for the individual.
Low
Moderate
High

Considerations: Things to Think About
• When arranging career, employment,
and or day services these lists of
considerations are to prompt further
review and discussion with the
regional center service coordinator,
rehabilitation counselor, program
manager, employers, and others
within the circle of support.
• These issues to consider are
applicable at varying levels within
each type of vocational service and
among all service providers.

Training Programs & Job Development:
• What vocational training is being provided in the classroom or program, does it match the service
plan?
• The importance of transition planning?
• Diploma vs. Certificate, post-secondary education, and career development?
• What is Workability?
• What is on-the-job training?
• Will the training lead to a job?
• What are the job placement rates of training programs?
• What is job development?
• How long should job development take?
• Job development accountability?
• Networking in job development.
• Is job development included in the training?
• How to acquire job searching skills?
• Training of new skills vs. maintaining current skills.
• What training is provided at a day program, a workshop, and in supported employment?
• What happens when skills are not acquired regardless of training?
• Job carving?
• Volunteering vs. training, how do they differ.
Considerations: Things to think about.

• The number of peers an individual will work with during the
day with the support of one staff person:
• 1 to 1, 1 to 3, 1 to 8, 1 to 20, or working independently.
• How much of day is spent at the center and/or within the
community?
• Do the community groups integrate or inundate the area
where they are located?
Staff Ratios & Community Integration:

• Where the services are provided:
• in the center (center based), in the
community (community based), or a
percentage combination of both?
• Transportation Expectations:
• public, para, private, or center based
vehicles?
• availability of transportation training?
Location of Service Delivery:

• Program’s philosophy.
• Policies and procedures alignment with philosophy.
• Ability and openness toward training and arranging
individuals most desired employment, career,
volunteer or day service options.
• Availability of tailored day services.
• Program offers value based activities vs. those that
have little practical or career value.
• Effective, accurate, on time service planning and
skill training.
• Part-time vs. Full time
Advancement, Career vs. Job vs. Avocation:

• Types of income arrangements made by program
or employer:
• minimum wage or more
• contractual
• fee for service
• micro-enterprises
• sub-minimum wage (sub-minimum wages possibly
being phased out in a few years)
• Non-paid volunteer opportunities.
• Program’s advocacy for wage increases, and
promotions.
Wage expectations:

• The qualifications and availability of staff.
• Type of assessments used by program.
• Training methodology and documentation.
• Provision of direct and faded support.
• Hard and soft skill training.
• Contingency planning and dealing with layoffs.
• Matching skill building with career
advancement.
Assessment, Training and Skill Acquisition:

• Locality.
• Waiting lists.
• Program expansion or contraction.
• Source and stability of funding.
• Status of program licensure, CARF accreditation, and other QA compliance standards.
• HCBS compliance.
• Quality of interaction with management including call backs and response time to email.
• Fair and active intake, planning and complaint procedures.
• Opportunities for volunteers.
• Stability, in-house training, and turn over of staff and management.
• Program collaboration with community partners.
Service Availibility, Quality, and Program Viability:

• What services does provider offer?
• Habilitation
• Vocational Rehabilitation
• Staff and managements qualifications (staff education,
background, and rate of turnover).
• Length of time to develop and arrange job placement.
• Accuracy of Job Match
• Ease of communication with staff and management.
Services Offered and Quality:

• What are Microenterprises & Self Employment?
• Starting a business through provider or
independently.
• Income based on contracting or delivery of a
service.
• Where and how to get technical support?
• Self Determination and Self Employment.
Micro Enterprise and Self Employment:

• The differences between SSI, SSA (SSDI), and dual
benefits.
• How much income can be earned?
• Reporting income to SSA.
• Dealing with SSA.
• Continuation of Medi-Cal, and Medi-Care
• What is Disability101? What is the Redbook?
• Overpayments and appeal rights.
• Full-time vs. part-time work
• Dealing with the acronyms.
Impact on SSI, SSA (SSDI) Benefits:

• Vocational Rehabilitation Services
• Habilitation Services
• Habilitation vs. Day Program Services
• Applying & Qualifying (Order of selection).
• Coordinating DOR with Regional Center
• Program Funding
• Planning, case management and closure.
Department of Rehabilitation:

• There is no one way to getting a job, building a career or
spending time during the day. Each person has their own
unique skills and interest. To respond to the diverse
number of needs, a variety of programs and service types
are available and funded through a variety of resources.
• In general there are three types of services: day activity,
work activity, and supported employment (individual and
group). Within these types of services, through the
individual program planning process a person can arrange a
variety of job and career objectives and supports that can
lead to employment satisfaction and personal well-being.
Type of Service

Supported Employment: Individual
• Supported Employment (SE) services through the Department of Rehabilitation can be provided
either through the vocational rehabilitation program or the Habilitation Service Provider (HSP).
Supported Employment services are aimed at finding competitive work in a community integrated
work setting for persons with disabilities who need ongoing support services to learn and perform
the work. Supported Employment placements can be individual placements, group placements
(called enclaves), and work crews, such as landscaping crews.
• Individual Placement is usually provided by a job coach who meets regularly with the individual on
the job to help him or her learn the necessary skills and behaviors to work independently. Job
Development is usually provided by the service provider. Upon placement, the first stage of
support is intensive on the job training and direct support . As the individual gains mastery of the
job, the second stage of training is faded supervision. As the individual becomes secure in the job,
the job coach will provide maintenance support or if appropriate may gradually phase out support.
• The Department of Rehabilitation is the main funder of SE service provision for adults with
developmental disabilities during the first two stages of service delivery (intensive and faded).
Through HSP, regional center is to continue funding to help individual maintain the job and job skills
to continue work in an integrated work setting.
• When applying for SE services ask your regional center service coordinator for help and to receive
instructions on applying to DR in your community.

Supported Employment: Group
• Supported Employment (SE) services through the Department of Rehabilitation
can be provided either through the vocational rehabilitation program or the
Habilitation Service Provider (HSP). Supported Employment services are aimed at
finding competitive work in a community integrated work setting for persons with
disabilities who need ongoing support services to learn and perform the work.
Supported Employment placements can be individual placements, group
placements (called enclaves), and work crews, such as landscaping crews.
• Supports provided by job coaches in group placements are generally provided at
100% + of time on the job. Therefore such arrangements can serve individuals
needing greater amounts of support. Group services are divided into two
categories:
– Enclave: a group placement of three to eight individuals with an employer in the community.
The group must represent a minority of the employer’s work force. Group consumers can be
paid minimum wages and above or they can be paid sub-minimum wages. Either the employer
or the service provider can also pay them. Job coaching is provided 100% of the time the
consumers are working. In some cases, lunch and breaks are also supervised.
– Work Crews: a group placement of three to eight individuals in the community that travel
from one job site to another job site. They can be paid minimum wages and above or they can
be paid sub-minimum wage. The service provider normally pays consumers in this type group
placement. Job coaching is provided 100% of the time the consumers are working. In most
cases, lunch and breaks are also supervised.

Work Activity Program
• Work Activity Program (WAP) services through the
Regional Center or the Department of Rehabilitation
(VR WAP) include paid work, work adjustment and
supportive habilitation services (HSP) in a sheltered
work shop setting. WAPs provide paid work in
accordance with Federal and State Fair Labor Standards
and may include wages below sub-minimum.
• Work adjustment services may include developing
good work safety practices, money management skills,
and appropriate work habits.
• Supportive habilitation services may include social skill
and community resource training as long as the
services are necessary to achieve vocational objectives.

Day Activity Programs
• Day programs are community-based programs for individuals served
by a regional center. They are available when those services are
included in that person's Individual Program Plan (IPP). Day program
services may be at a fixed location or out in the community.
• Types of services available through a day program include:
• Developing and maintaining self-help and self-care skills.
• Developing the ability to interact with others, making one's
needs known and responding to instructions.
• Developing self-advocacy and employment skills.
• Developing community integration skills such as accessing
community services.
• Behavior management to help improve behaviors.
• Developing social and recreational skills.
• There are many different types of day programs that provide a diverse
range of opportunities for persons with developmental disabilities. If
you are interested in learning more about day program services, ask
your regional center representative for assistance.

Vocational Rehabilitation: Department of Rehabilitation
• DEPARTMENT OF REHABILITATION
– The Department of Rehabilitation (DOR) provides information, evaluation, and funding for technology to
help working and/or older individuals go to work or live more independently.
• DOR ELIGIBILITY
– An individual with a severe physical or mental impairment which seriously limits one or more functional
capacities in terms of employment outcome. Examples of functional capacities are: mobility,
communication, self-care, self direction, interpersonal skills and work tolerance.
– A person with vocational rehabilitation needs who can be expected to require multiple supports over an
extended period of time.
– A person with one or more physical or mental disabilities resulting from: amputation, arthritis, autism,
blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease,
hemiplegia, respiratory or pulmonary dysfunction, intellectual disability, mental illness, multiple sclerosis,
muscular dystrophy, muscular-skeletal disorders, neurological disorders, paraplegia, quadriplegia and other
spinal cord conditions, sickle cell anemia, specific learning disabilities, end-stage renal disease. A disability
or combination of disabilities determined on the basis of an assessment for determining eligibility and
vocational rehabilitation needs which cause substantial limitations.
• SERVICES AND EQUIPMENT FUNDED BY DOR
– Vocational and training services includes evaluation and assessment to determine the needs for
rehabilitation technology.
– Vocational rehabilitation provides training on the use of artificial limbs, hearing aids, and eyeglasses. DOR
assists people with disabilities use telecommunications, sensory and technological aids and devices which
are used to improve or substitute for one or more of a person's senses or for impaired mobility or motor
coordination.

Habilitation Services Program (HSP)
• A set of regional center services and funding
that provides work and work related activities
to regional center clients in a work activity
program or receiving supported employment
services.
• Habilitation services may include social skill
and community resource training as long as
the services are necessary to achieve
vocational objectives,.

Microenterprises and Self Employment
• "Microenterprises" means small businesses owned by
individuals with developmental disabilities who have
control and responsibility for decision making and
overseeing the business, with accompanying business
licenses, taxpayer identification numbers other than
social security numbers, and separate business bank
accounts. Microenterprises may be considered
integrated competitive employment.
• "Self-employment" means an employment setting in
which an individual works in a chosen occupation, for
profit or fee, in his or her own small business, with
control and responsibility for decisions affecting the
conduct of the business.

Center for Medicare &Medicaid Services,
Home and Community Based Services: CMS, HCBS
• Medicaid, known as Medi-Cal in California, is a jointly-funded, federal-state health insurance program
for certain low income and needy people that includes long-term care benefits. In 1981, President
Reagan signed into law the Medicaid Home and Community-Based Services (HCBS) Waiver program,
section 1915(c) of the Social Security Act. The legislation provided a vehicle for California to offer
services not otherwise available through the Medi-Cal program to serve people (including individuals
with developmental disabilities) in their own homes and communities. The HCBS Waiver program
recognizes that many individuals at risk of being placed in medical facilities can be cared for in their
homes and communities, preserving their independence and ties to family and friends at a cost no
higher than that of institutional care.
• In early 2014, CMS published final regulations affecting 1915(c) waiver programs, 1915(i) State Plan
programs, and 1915(k) Community First Choice State Plans for HCBS provided through Medicaid. (42
CFR Part 430, 431, et al.) The purpose of the regulations is to ensure that individuals receive HCBS in
settings that are integrated in and support full access to the greater community. The regulations also
aim to ensure that individuals have a free choice of where they live and who provides services to
them, and that individual rights and freedoms are not restricted, among other provisions. CMS has
moved away from defining HCBS settings based on specific locations, geography, or physical
characteristics, to defining them by the nature and quality of the individual's experiences. Basically,
the regulations set higher standards for HCBS settings in which it is permissible for states to pay for
services using federal financial participation under Medicaid. The regulations became effective March
17, 2014, and allow states up to five years to implement home and community-based settings
requirements. © 2015 All Rights Reserved

Vendor Directories
• http://sarc.org/
– Click: Service Providers
– Click: Service Provider Directory
– Click:
http://www.php.com/resources
San Andreas Regional Center
Parents Helping Parents

Definitions
Department of Developmental Services
Community Development Branch
Work Services Section
Glossary of Terms/Acronyms
Used By Habilitation/Vocational Rehabilitation
Funded Programs
http://www.dds.ca.gov/WorkServices/docs/HabVoc
RehabGlossaryTermsAcronyms.pdf

Technical Support:
It is important to work with the regional center service coordinator, and or the Department of Rehabilitation vocational counselor
when planning for day and employment services. Schedule a time to talk to vocational instructors to get a better understanding
of transitions services, and program managers of individual service providers and each program’s operation. Below is a list of
resources and website that can also be helpful in planning for day, employment, and career services.
Santa Clara County Disabiltiy Collaborativie:
SCDD Silicon Valley / Monterey Bay: 408-324-2106, ab7@scdd.ca.gov
Parents Helping Parents, (408) 727-5775, http://www.php.com/
Disability 101: http://ca.db101.org/
Department of Rehabilitation: http://www.rehab.cahwnet.gov/
Department of Developmental Services: http://www.dds.ca.gov/
Social Security Redbook: http://www.ssa.gov/redbook/
Special Education Rights, Transition Services:
http://www.disabilityrightsca.org/pubs/504001Ch10.pdf
San Andreas Regional Center: 408-374-9960, http://sarc.org/

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