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Supported and Customized Employment -Intellectual/Developmental Disabilities-Independent Provider

Categorized In: Case Services - Planned Services

Approved Date: October 02, 2018

Owner: Carla Lasley

Individuals served in the Supported Employment or Customized Employment using the Independent Provider service model must be in Priority Group 1 and be eligible for funding and services from the Division of Developmental Disabilities.

VR does not participate in the selection of the Independent Provider other than ensuring the Independent Provider has the skills and resources to provide the needed services.

VR would not participate in job placement assistance.

VR will accept the DHSS-Medicaid background check unless the Provider has lived/worked out of State. If there is a work history elsewhere, initiate a Nebraska VR Background Check.  Confirmation that the background check was completed and the Independent Provider has been approved by DHSS-Medicaid.  The Independent Provider can bring a copy of the Medicaid Provider Acceptance and the Medicaid Provider number. Ensure the Independent Provider is not a legal guardian. A task entry stating confirmation has been obtained will be entered into QE2.

If Medicaid is terminating a service contract with the Independent Provider, the local DHSS Service Coordinator recieves an alert from Medicaid and the authorization is automatically closed in NFOCUS. The Service Cordinator will notify the VR Office Director with written notification in the form of an email. The email will include the name of the Independent Provider, his/her address, Social Security Number, type of termination, and the date of the termination. The email should be printed and placed in the client's case record. The email should then be forwarded to Cathy Callaway. She will be responsible for formally notifying the Independent Provider that VR is terminating its Service Agreement with them. VR cannot provide payments to a Independent Provider for milestones occurring.

The job must be competitive and in an integrated setting.

Compensation must be at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by non-disabled individuals, at the time of transition to long-term support services.

Any limitations in work hours or level of pay must result directly from the client’s disability-related impediments that cannot be overcome by services.

Benefits include worker's compensation, paid holidays, paid vacations, paid sick time, health insurance, etc. The client must receive the same benefits available to any other employee of the company or service provider (when the service provider is the employer).

Job placement must be in an integrated setting means a setting typically found in community competitive employment in which individuals with disabilities interact with non-disabled individuals (other than those who are providing services to them) to the same extent that non-disabled individuals in comparable positions interact with other individuals.

  • Acknowledge receipt of client referral from a DD Service Coordinator
  • Follow the same VR processes as with a non-Supported Employment case from referral through outcome/termination.
  • Refer a client who receives Social Security Benefits for a Benefits Orientation.
  • Determine Eligibility
  • Confirm QE2 case is in Priority I.
  • Convene a meeting with client, parent or guardian, DD Service Coordinator and the Independent provider(s) to agree on supported employment as an appropriate service, to ensure the Independent provider(s) has the skill and the resources to provide the SE services, and to confirm and to document DHSS-Medicaid has completed a background check on the Independent provider(s) and the provider is not a legal guardian.*** (Document in a task note)
  • Have Independent Provider submit Work Resume.
  • If Provider has lived/worked out of state, request a VR Background Check
  • Develop Service Agreement if all criteria met.
  • Develop the IPE – Supported Employment. The plan mutually developed by the client, DD Service Coordinator, the Independent provider and VR Specialist should include other needed VR services.  Refer as needed for other services such as Assistive Technology, Benefits Planning and Analysis.
  • Enter IPE in QE2.
  • Send the DD Service Coordinator a copy of the IPE and all Milestone Reporting Forms submitted by the vendor. Send a copy of the 30 day reporting form.
  • Move client to “Services Initiated: Employment Services” in QE 2.
  • Use appropriate Milestone Payment Standards as a guide to process payments and QE 2 services.
  • VR liaison meets with Independent provider monthly for client progress reports. Enter client progress QE 2 task notes.
  • VR liaison meets with client face to face/telephone a minimum of every 90 days to verify progress and satisfaction with services.
  • VR liaison agrees with Independent provider to every milestone payment and to successful outcome or discharge from the Supported Employment Program.
  • VR Specialist must have contact with client prior to closure to ensure job satisfaction and the move to long-term supports. 
    • Termination: VR Specialist must agree to any discharge from the SE program. Follow VR Program Manual: Closing the Case-Termination.
*** CHECKLIST FOR AGREEMENT FOR INDEPENDENT PROVIDER

  • Convene a meeting with client, parent or guardian, DD Service Coordinator and the Independent provider(s) to ensure the Independent provider(s) has the skill and the resources to provide the SE services, and to confirm and to document DHSS-Medicaid has completed a background check on the Independent provider(s). 
  • Provider submits work resume.
  • Ensure that the Independent Provider is not a legal guardian.
  • Contact Service Co-ordinator to ensure the Independent Provider has passed Medicaid background check or
  • Provider may bring in the notice of Acceptance by Medicaid along with the Medicaid Vendor number
  • If Provider lived/worked out of state, request a VR Background Check
  • Develop and approve a Service Agreement with the selected Independent provider.
  • Provide the packet of information to the Independent provider.
  • Authorize for the Supported Employment Service. 
    • Intellectual Disabilities (DD) Supported Employment Milestone Payment Schedule
  • Provider submits Standard Milestone Reporting Forms for payment for each milestone. 
    • Intellectual Disabilities Supported Employment Fee Schedule
  • Acknowledge receipt of referral from a DD Service Coordinator
  • Follow the same VR processes as with a non-Supported Employment case from referral through outcome/termination.
  • Refer a client who receives Social Security Benefits for a Benefits Orientation.
  • Determine Eligibility
  • Confirm QE2 case is in Priority I.
  • Convene a meeting with client, parent or guardian, DD Service Coordinator and the Independent provider(s) to agree on customized employment as an appropriate service, to ensure the Independent provider(s) has the skill and the resources to provide the Customized services, and to confirm and to document DHSS-Medicaid has completed a background check on the Independent provider(s) and the Provider is not the legal guardian. (Document in task note)
  •  Have Independent Provider submit a Work Resume.
  • Have Independent Provider submit DHHS-Medicaid documentation and Medicaid vendor number.
  • If Independent Provider lived/ worked out of state, submit for a VR Background Check.
  • Develop Service Agreement if all criteria met.
  • Provide the packet of information to the Independent provider.
  • Develop the IPE – Customized Employment. The plan mutually developed by the client, DD Service Coordinator, the Independent provider and VR Specialist should include other needed VR services.  Refer as needed for other services such as Assistive Technology, Benefits Planning and Analysis.
  • Enter IPE in QE2.
  • Authorize the total amount for the Customized Employment Service. 
    • Intellectual Disabilities (DD) Customized Employment Milestone Payment Schedule
  • Provider submits Standard Reporting Forms for payment for each milestone. 
    • Intellectual Disabilities Customized Employment Reporting Forms
  • Move client to “Services Initiated: Employment Services” in QE 2.
  • Send Service Coordinator a copy of the IPE and copies of all Milestone reporting forms including the 30 day form.
  • Use appropriate Milestone Payment Standards as a guide to process payments and QE 2 services.
  • VR liaison meets with Independent provider monthly for client progress reports. Enter client progress QE 2 task notes.
  • VR does not participate in the placement process.
  • Invite provider to attend WIN meetings.
  • VR liaison reviews the customized job description with the Independent Provider
  • VR liaison meets with client face to face/telephone a minimum of every 90 days to verify progress and satisfaction with services.
  • VR liaison agrees with Independent provider to every milestone payment and to successful outcome or discharge from the Customized Employment Program.
  • VR Specialist must have contact with client prior to closure to ensure job satisfaction and the move to long-term supports. 
    • Termination: VR Specialist must agree to any discharge from the SE program. Follow VR Program Manual: Closing the Case-Termination.

  1. Acknowledge receipt of referral from a DD Service Coordinator of a client interested in work with Nebraska VR and using the Independent Provider service model.
  2. Follow the same VR processes as with non-Supported Employment cases.
    • Referral
    • Employment Discussion & Application
    • Eligibility
    • Benefits Orientation
    • Career Exploration
    • Individualized Plan for Employment

Convene a meeting with the client, parent or guardian, DD Service Coordinator, and the Independent provider to agree on supported/customized employment as an appropriate service. VR will request a resume to ensure the Independent provider(s) has the skill and the resources to provide the Supported or Customized services, and to confirm and to document DHSS-Medicaid  has completed a background check on the Independent provider(s) and is not the legal guardian. (Document in task note) If the Independent Provider lived/worked out of state, initiate a Nebraska VR Background Check. A Service agreement is developed using the appropriate Milestone Payment Form.

  • Agree on supported or customized employment as an appropriate employment outcome for the client considering skill level, employment opportunities in the community, transportation, and other critical factors.
  1. Confirm QE2 case is coded as a Priority 1 and develop IPE.
  2. Develop and approve the IPE. 8.Authorize the total amount for the Supported Employment or Customized Employment services using the Intellectual Disabilities Supported Employment Fee Schedule or the Customized Employment Fee Schedule
  3. Move the case into the appropriate milestone and activity in QE2 as the case progresses through the SE or CE Milestones.
    • Intellectual Disabilities Supported Employment Fee Schedule
    • Intellectual Disabilities Customized Employment Fee Schedule
  4. Meet with the Independent Provider a minimum of monthly to review the client’s progress.
    • Enter a monthly progress task note in QE 2.
  5. Meet with the client every 90 days to verify his/her progress and satisfaction.
    • Enter a meeting summary task note in QE 2.

INDEPENDENT PROVIDER SERVICE AGREEMENT

  1. Develop and approve a Service Agreement with the selected Independent provider.
    • Ensure the Independent provider(s) selected by the client has the skill and resources to provide the needed service considering his/her work record, knowledge of the community, and skills to provide job coaching.  Obtain a resume.
    • Confirm and document in a QE2 task note that DHSS-Medicaid has completed a background check on the Independent provider(s).
    • If the Independent Provider has lived/worked out of state, initiate a Nebraska VR Background Check.
    • NOTE: The Service Agreement will be with the Independent provider who will be the sole or primary provider of service. If there are multiple providers a primary provider will be designated. The SE Milestone/Outcome payments will be paid to the primary provider. The primary provider will be responsible for determining the appropriate amount of the Milestone/Outcome payment the other providers will receive and will pay them directly for the services they provided. VR staff will explain in detail the payment process to the CSP providers.
  2. Provide a packet of information for the Independent provider that includes:
      1. Overview of Nebraska VR’s Supported Employment Services and Customized Employment
      2. Definition of Terms
      3. Intellectual Disabilities-Supported Employment Fee Schedule or Customized Employment Fee Schedule
      4.  Billing Forms & Milestone reporting forms
      5. Job Coach Training Manual













  3.  

Supported employment services are intended for those individuals for whom, because the severity of his/her disabilities, competitive employment has not been achieved, or has been intermittent or interrupted, and who will need continuing support to maintain integrated competitive employment.

Supported employment services may also be provided for a client who has selected the Independent Provider placement option through Health and Human Services, Division of Developmental Disabilities. This option allows a client to select and hire his/her own provider, such as a family member, neighbor, or other trusted person in the community to provide the initial job coaching and necessary ongoing supports. The provider selected does not have to be a specialized provider. Supported employment would be included under the “Community Living and Day Supports” service category available under the Independent Provider service model.

Customized employment services may also be provided for a client who has selected the Independent Provider.  The same guide lines apply as selection for an Independent Provider for Supported Employment Services.  The Individual Provider  customizes a job description, work schedule, worksite location and specifics of supervision based on an individualized determnation of the client's strengths, needs and interests that is designed to meet both the individual's abilities and the business needs of the employer.

The concept of “place and train” is central to supported employment. The individual is placed into an integrated competitive employment setting, and then provided with the necessary training and other supports and services needed to acquire job performance skills.

The primary role of vocational rehabilitation in supported employment is to fund the initial training and other supports and services needed to achieve stable job performance. Other agencies, organizations, and individuals (including natural supports at the workplace or in the community) have the primary role of providing the long-term support services needed to maintain the employment and stable job performance.


Approved Date
September 27, 2017 Show this Archived Version
May 15, 2017 Show this Archived Version
May 12, 2017 Show this Archived Version


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