In 2016, Alabama’s Department of Mental Health (ADMH)/Division of Developmental Disabilities (DDD) contracted with the Alabama Department of Rehabilitation Services (ADRS) to train Community Partner Work Incentive counselors to provide benefits counseling to individuals served by ADMH who were moving from facilitybased day services into competitive integrated employment. State agency staff were aware that many individuals and their families chose not to pursue integrated employment for fear of losing Medicaid, cash benefits, and other income support programs.
Oklahoma’s Developmental Disabilities Services Division (DDSD) realized the need for increased attention towards the goal of community-based employment for individuals they served. Initially, rates were based on a vendor’s costs of providing direct services such as job development and job coaching. It became increasingly apparent that claims for vocational services oftentimes reflected staff activities (e.g., job development, client assessment, and service delivery documentation), which may have been occurring without the direct involvement of the service recipient.
In North Carolina, counties have been consolidated into Local Management Entities (LMEs). These entities contract for services with community providers and provide oversight on access, utilization, best practices, and community collaborations. The Mecklenberg County LME established the Best Practices Community Committee, comprising service providers, individuals and family members, advocacy agencies, community partners, interested community volunteers, and LME staff. Sub-committees addressed several areas, including employment.
Michigan's Department of Community Health, Mental Health and Substance Abuse Administration (MDCH) has expressed a strong desire to improve the state's employment outcomes among people with intellectual and developmental disabilities (IDD). Set against this desire is a major obstacle: Michigan is among the states hardest hit by the continuing economic recession, with the highest unemployment rate in the nation.
Contracts with Industry, implemented in the 1990s as the Natural Supports Initiative, is a program option that allows the Oklahoma Department of Human Services (OKDHS) Developmental Disabilities Services Division (DDSD) to contract directly with businesses to provide job coaching supports that become a part of the natural workplace. Individuals participating in this program are employed by a business and are paid minimum wage or better.