After the adoption of the Employment First policy in Oregon in 2010, state administrators identified the critical role of case managers for people on the support services waiver, and acknowledged the need for their buy-in and investment in the Employment First agenda. The case managers’ knowledge of the individuals they serve, the conversations they have with individuals and their families, and their knowledge of the community are critical to each individual’s success in finding employment, as well as to the forward movement of the Employment First initiative.
The University of Maine’s Center for Community Inclusion and Disability Studies (CCIDS), along with the Maine Department of Behavioral and Developmental Services (BDS) and the Bureau of Rehabilitation Services, developed the Maine Employment Curriculum (MEC). The comprehensive curriculum fosters best practices in employment supports for people with disabilities statewide by using a cadre of trainers who are supported by the Maine Employment Curriculum project staff.
Project Income was a joint venture between the Tennessee Microboards Association (statewide organization that supports individual microboards, which procure and oversee supports and services) and People First of Tennessee (a statewide self-advocacy organization for people with intellectual and developmental disabilities). The focus of the project was to educate people with intellectual and developmental disabilities (ID/DD) and their families about the benefits of and opportunities for community employment.
In the mid-1980s, the state of Washington was awarded a five-year federal systems change grant to kick-start their supported employment efforts via the Washington State Employment Initiative. Funding from this grant was used to develop training on best practices and to generate high-quality integrated employment supports among agencies.
1998, five state agencies formed the Governance Group. Partner agencies included: Iowa Workforce Development, Department of Human Services, Department of Education, Iowa Vocational Rehabilitation Services and Department of Human Rights. The group was developed in response to a Rehabilitation Services Administration (RSA) request for proposals that included an advisory group for systems change efforts to expand employment opportunities to individuals with disabilities.
The state of Florida has implemented a five-year employment initiative for people with ID/DD. The goal is to enable at least 50% of adults (ages 18 to 55) receiving APD-funded day services as of July 1, 2004, to achieve community employment by July 1, 2009. APD- funded services include adult day training, supported employment, and non-residential supports and services. Florida is specifically targeting a total of 25% of individuals who were in Adult Day Training (ADT) on July 1, 2004, to be employed by July 1, 2009.
King County's program to employ people with disabilities in county jobs is an example of Washington's commitment to the use of innovative approaches to increase integrated employment. In 1989, a training resource funded by Washington State and the county Division of Developmental Disabilities, O'Neill and Associates, submitted a grant application to the Rehabilitation Services Administration to develop public sector jobs for people with developmental disabilities within the state.
Case management services in Missouri’s Division of Developmental Disabilities underwent a shift from a state structure to a regional structure. Within this structure, 12 regions each serve approximately 12–15 counties. Each region has a technical assistance (TA) position designed to support each of the designated priority work areas. These include self-determination, family supports, individual supports and services, Employment First, and accessible housing.
The Ad Hoc Committee on Employment and Community Participation began meeting in the winter of 2004 in an effort to promote integrated employment opportunities for people with disabilities in Colorado. The committee was comprised of representatives from the Division for Developmental Disabilities (DDD) administration; the Division of Vocational Rehabilitation; local Community Centered Boards (private nonprofit organizations responsible for authorizing services); advocacy groups; and self-advocates, parents, and service providers.
The Tennessee Division of Mental Retardation Services (DMRS) implemented the Employment First! initiative in 2002. The goal of Employment First was to make employment the first day service option for adults receiving supports funded by DMRS, Medicaid, or the state. Employment First set the standard that employment was the preferred service option for adults with mental retardation and developmental disabilities (MR/DD).