The purpose of the Employment Support Services (ESS) Program is to assist individuals with severe disabilities to maintain successful employment.

• GENERAL POLICIES
• CLIENTELE
• ELIGIBILITY
• LEVELS OF SERVICES
• USE OF SSA WORK INCENTIVES
• SCOPE OF SERVICES AND SERVICE POLICIES
• DEFINITIONS
• PURCHASED EMPLOYMENT SUPPORT SERVICES
• CASEMANAGEMENT AND COUNSELING SERVICES
• VR POST EMPLOYMENT SERVICES

GENERAL POLICIES

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1. CLIENTELE
   RSA maintains continuing responsibility for clients of the Vocational Rehabilitation program who are successfully rehabilitated, but who require ongoing employment supports in order to maintain their employment because of the severity of their disability.
   
2. ELIGIBILITY
   Eligibility for the ESS program is based on the existence of a severe disability and the need for ESS services. The impairments that result from a severe mental or physical disability must be at a level of severity that employment has not traditionally occurred or has been interrupted or intermittent. Individuals must also, because of the nature and severity of their disability, be determined to need extended employment support services in order to maintain successful performance on a job. Access to ESS program services is through the ARSA Vocational Rehabilitation program.
   
3. LEVELS OF SERVICES
   The level of services provided by RSA staff will vary, as follows:
   1. All clients of the ESS program will be case managed. At a minimum, case management responsibilities involve doing one Annual Review per year.
   2. Some clients will receive RSA purchased ESS services, case management, and counseling;
   3. Some clients will receive case management and counseling only, while purchased ESS services are funded by other funding sources (BHS, Social Security Work Incentives, private pay, United Way/Agency, etc.) or need for purchased services are not necessary because they are provided without cost by family, the employer, or other groups or individuals.
4. USE OF SSA WORK INCENTIVES FOR INDIVIDUALS ELIGIBLE FOR SUCH INCENTIVES
   Clients may elect to pay for their own employment support services when other resources are not available. Submitting receipts to SSA for the cost of ESS services as "impairment related work expenses (IRWEs)" will lessen the impact of earnings on benefit levels. RSA counselors are available to assist clients to explore this, and other, options. Other options may include, as appropriate:
   • "Blind Work Expenses" for persons who are blind and eligible for SSI benefits.
   • "Student Earned Income Exclusion" for employed individuals who are also full time students eligible for SSI benefits.
   • "PASS" for those individuals whose employment plans include increased potential for self support by decreasing costs and reliance upon supports and/or increased potential for higher earnings.

SCOPE OF SERVICES AND SERVICE POLICIES

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1. DEFINITIONS
   1. Competitive Employment
      Competitive, as it relates to employment, means work that is performed on a full-time or part-time basis in an integrated setting for which an individual is compensated at, or above, the federal minimum wage
   2. Extended Supported Employment
      The Arizona Dictionary and Taxonomy defines Extended Supported Employment as a service which provides long term on-going support for an employed individual including, but not limited to: counseling; regular contacts with the individual and/or the employer, parents or guardians; job monitoring; finding a new job when necessary; maintaining established and on-going natural and peer supports; and providing other discrete services such as repair or maintenance of assistive technology used at the work site, on-going attendant care or interpreter services at the work site, transportation, reader services and other activities needed to maintain employment.
   3. Integrated Setting
      Integrated setting means that the client is NOT engaged in training or work which is being performed within a self-contained work environment (including janitorial, maintenance and landscaping which directly benefits that self-contained work environment).
   4. Real Work
      Real work means work generated by the client which results in tangible product(s) or service(s) rendered for which the employee is covered under DOL regulations issues pursuant to the Fair Labor Standards Act.
   5. Self Continued Work Environment
      Self-Contained work environment means a placement setting in which the employer accepts responsibility for the safety and well being of employees working on the employer's premises, including one or more of the following:
      1. extra supervision/mentoring on the job as related to a disability issue
      2. availability of support services on the premises, such as medical services (e.g. nurse), counseling, etc.
      3. work which is structured specifically for persons with disabilities
      4. 50% or more of the individuals are working under a subminimum wage certificate.
      This definition does not apply if the work environment includes or expects a flow of the general public as part of the operation of the work being performed.
   6. Service Setting
      "Service setting" descriptions are used to differentiate the various settings in which contracted employment related training/adjustment services are provided, as follows:
      1. Group training means two or more individuals who are part of a work cluster in the same training area, work station, or self-contained work environment.
      2. Individual training means that the service is provided one-on one with an individual who is not part of a group of clients in the same training area, work station, or self-contained work environment.
      3. Level I (Sheltered Employment) training/employment means a client who is currently receiving Sheltered Employment services for a job which does not meet RSA's definition of Employment Outcome.
      4. Level II (Work Adjustment, Sheltered Employment) employment/training means the client is engaged in training/employment which is performed within a self-contained working environment, including work such as janitorial, landscaping, etc., which directly benefits the self-contained work environment.
      5. Level III (Work Adjustment, Supported Employment, or Extended Supported Employment) training/employment means the client is engaged in training which is integrated or pays at least minimum wage, but not both.
      6. Level IV (Work Adjustment or Supported Employment) training/employment means the client is engaged in training/employment which is integrated and pays at least minimum wage.
   7. Sheltered Employment
      The Arizona Dictionary and Taxonomy of Services defines Sheltered employment as a service which provides a controlled and protected work environment, additional supervision and other supports for individuals engaged in remunerative work either in a sheltered workshop or in the community (e.g. in enclaves and/or mobile work crews).
   8. Supervised Employment
      Supervised employment is a category of services which includes Extended Supported Employment and Sheltered Employment.
2. PURCHASED ESS SERVICES
   The following service options are available for clients of the ESS program. These options define the RSA ESS service program. Services purchased in the ESS program are those services that are necessary on an extended basis to help maintain the individual in employment. The purchase of services depends on the availability of resources to fund these services. Therefore, maximum efforts must be made to utilize all other available resources including: family supports, SSA Work Incentives, community resources, public transportation, AHCCCS, private insurance, etc.. In the case of "locally planned" SSBG dollars, the type of service to be provided, the geographic area in which the funds can be expended and the amount of funds available are restricted.
   1. Supervised Employment
      Supervised Employment includes both Extended Supported Employment and Sheltered Employment. The employment is gainful (i.e. the client receives salary based on productivity), productive (i.e. the activity is real work), and regular (i.e. the client has a fixed work schedule).
      1. "Extended Supported Employment"
         "Extended Supported Employment" is purchased only from DES/RSA contractors. There are two levels of services (see definitions for levels 3 and 4).
      2. "Sheltered Employment"
         "Sheltered Employment" is purchased only from DES/RSA contractors. There are two levels of services (see definitions for Levels 1 and 2).
   2. "Work Activities"
      This service provides work training and therapeutic activities. This service is purchased only from DES/RSA contractors.
   3. "Personal Assistance Services" (PAS)
      Personal Assistant Services means a range of services, provided by one or more persons, designed to assist an individual with a disability to perform daily living activities on the job that the individual would normally perform independently if the individual did not have a disability.
      This service is purchased and paid for separately only when the client is competitively employed in an integrated setting and not receiving sheltered or extended supported employment services provided by a Community Rehabilitation Program.
   4. Other Purchased Services
      ALL SERVICES LISTED BELOW MUST HAVE SUPERVISORY APPROVAL BEFORE BEING AUTHORIZED OR PURCHASED BY THE COUNSELOR
      1. "Personal and Social Adjustment"
         These services are ESS program services only when used to help maintain an individual in employment and are required intermittently or as short term assistance. This service helps individuals to maintain employment by providing the training/skills to be self-sufficient, to have confidence in basic living skills, and to understand and adjust to disability. These services are purchased separately only when it is not normally part of sheltered or supported employment services provided by a Community Rehabilitation Program or an employer. Examples of such services include: orientation and mobility instruction to an employed individual with visual impairments who moves to a new work site or has a new work procedure, rehabilitation teaching to an individual who needs continued assistance to manage pay check deposits, etc..
      2. "Rehabilitation Technology Services"
         This service category includes assistive technology assessments, the purchase of technological aids and/or devices, installation and repair of assistive technology, and training in the use of of assistive technology aids and/or devices. Assistive Technology devices which are a client asset may be purchased and provided when necessary to facilitate employment. However, technological aids and devices which are an employer asset are the responsibility of the employer to provide.
      3. "Interpreter and Note Taking Services"
         Interpreter Service is the provision of a person to facilitate communication. Note-taking services are the use of another individual to transcribe oral material, whenever such material pertains to the employment support program of services. These services may be purchased on an intermittent basis as necessary to assist an individual to maintain his/her employment. This service is not normally purchased separately when a client is receiving sheltered or supported employment services provided by a Community Rehabilitation Program.
      4. "Reader Services"
         Reader Service is the provision of a person to read written materials aloud. This service may be purchased on an intermittent basis as necessary to assist an individual to maintain his/her employment. This service is not normally purchased separately when a client is receiving sheltered or supported employment services provided by a Community Rehabilitation Program.
      5. "Transportation"
         Transportation services are purchased only when they are directly required for the individual in relation to his/her work, are not already included as part of another purchased service, and no comparable benefit is available. Payment of transportation is made only under unique circumstances. The client's family must experience economic need as a condition for receipt of this service.
3. CASE MANAGEMENT/COUNSELING SERVICES
   The counselor responsible for ESS will provide counseling and case management services in accordance with policies, regardless of whether the individual is receiving RSA paid extended employment support services or not.
   In general, the level of counselor involvement after VR closure should be individualized and determined at the time that the case is transferred from VR to ESS. The level of involvement must, at a minimum, be re-evaluated at least annually as part of the Annual Review.
   1. Annual Reviews
      1. Annual reviews are done for all clients in the ESS program. The Annual Review is used to determine:
         1. Whether the individual is satisfied with current situation or whether changes need to be made in the client's current program, including the provision of Post Employment Services;
         2. Whether the individual desires, and could benefit from, VR services in terms of making a progressive move to a more integrated, more competitive and/or non-supported employment; or
         3. Whether the individual continues to need monitoring because he/she has dropped out of the labor market or is competitively employed and no longer needs supports and the case should be closed.
      2. The annual review involves a comprehensive review of the client's situation, on-going needs, and potential for a progressive move. This review involves the client and all significant individuals involved with the client.
   2. Case Management/Counseling for RSA funded Clients Counseling and case management services should be provided based on decisions made about the expected need for these services when the case was transferred from VR to ESS and during Annual Reviews thereafter. Case management involves regular reviews of the individual's support systems, contact with CRPs and/or significant others to ensure that there are early interventions when/if problems arise which threaten employment; receipt, review and payment of provider (CRP) billings; review of monthly progress reports; and periodic contacts with clients, client representatives and significant others.
   3. Case Management/Counseling for Non-RSA funded Clients Case management services and counseling for non-RSA funded clients include the Annual Review of the client's progress and counseling as needed when specific employment problems arise. When another agency is funding the client's ESS, that agency's case manager is the primary case manager.
   4. Management of SSA Work Incentives Although the client (and/or the client's representative) is responsible for management of his own SSA work incentive program (such as the IRWE), the assigned RSA counselor will ensure that the client's use and management of SSA work incentive resources is monitored for as long as the individual is a client of RSA. The counselor must work closely with the Community Rehabilitation Program (CRP) providing services. The CRP is in a good position to monitor the use of the IRWE, to provide support and training, and to be an advocate for the client.
4. VR POST EMPLOYMENT SERVICES
   1. Purpose
      The purpose of Post Employment Services (PES) is to provide services to a client who is successfully employed (as a result of VR services) to help maintain or regain such employment.
   2. Policies
      VR post employment services are available to meet rehabilitation needs that do not require a complex and comprehensive provision of services and, thus, should be limited in scope and duration. If more comprehensive services are required, a new rehabilitation effort should be considered. Post-employment services are provided as an amendment to the last individualized written rehabilitation program (IWRP). A re-determination of eligibility is not required. The provision of post-employment services is subject to the same service policies as under an original IWRP.