Vocational Rehabilitation Program (Combined or General)

(j) Statewide Assessment.

(1) Provide an assessment of the rehabilitation needs of individuals with disabilities residing within the State, particularly the VR services needs of those:

MARYLAND DORS AND MARYLAND STATE REHABILITATION COUNCIL

Executive Summary

DORS and the Maryland State Rehabilita­tion Council (MSRC) continually assess the rehabilitation needs of Maryland citizens with disabilities, as part of its state and strategic planning process. DORS and the MSRC hold annual public meetings and the MSRC regularly provides input on Agency planning, policy development and recommendations. The results of the consumer satisfaction surveys are also reviewed in order to provide insight into the rehabilitation needs of Maryland citizens with disabilities.

This year, the Agency in collaboration with the MSRC undertook the triennial comprehensive needs assessment in compliance with the Code of Federal Regulations at 34 CFR (361.29). The 35-member team consisted of DORS staff, including participants in the Agency’s Leadership Exploration and Agency Programs (LEAP) and consultation from MSRC. The LEAP program is one component of the DORS Leadership Development Program. Through pairing with experienced staff, this program provides an opportunity to increase and expand a participant’s knowledge about the Agency, as well as, determine his/her inclination for leadership.  The Needs Assessment team (1) collected and analyzed relevant existing data, (2) conducted and analyzed findings of supplemental surveys, and (3) facilitated focus groups and key informant interviews, in order to ascertain the needs of individuals with disabilities throughout the state.

Required Elements

The results of the Needs Assessment include the following required elements:

1. The rehabilitation needs of individuals with disabilities residing within Maryland, particularly the VR needs of: ­           
   1. Individuals with most significant disabilities, including their need for supported employment services.
   2. Individuals with disabilities who are minorities and individuals with disabilities who have been unserved or underserved by the VR program.
   3. Individuals with disabilities served through other components of the statewide workforce investment system.
   4. Youth with disabilities, and students with disabilities, including:               
      1. Their need for Pre-Employment Transition Services (Pre-ETS) or other training services.
      2. An assessment of the needs of individuals with disabilities for transition services and Pre-ETS services, and the extent to which such services are coordinated with local education agencies and other education systems.
      3. Assessment of the needs of transitioning youth with disabilities entering two- and four-year colleges and the extent to which such services are coordinated with college disability support services staff.
      4. Assessment of the needs of students and their parents eligible for pre-employment transition services and the extent of which information regarding: getting a job, the job market, job shadowing and related activities, college or training opportunities, skills learned, and skills still needed have been provided to these students and parents.
2. An assessment of the need to establish, develop, or improve community rehabilitation programs within the State.

Recommendations from the Focus Areas of the Needs Assessment Addressing the Required Elements

1. Continue to monitor, strengthen, and foster relationships with MD Labor, Department of Health, and MSDE. Continue to explore data sharing strategies to demonstrate collaboration for the provision of services, and to ensure a smooth referral process between partners.
2. Evaluate the staffing needs within DORS, with a focus on the number of full-time VR counselor positions across the state to ensure an effective and manageable caseload distribution and to ensure that there is a sufficient number of VR counselors who provide services to transitioning youth and students with disabilities to accommodate the anticipated increase in the number of student referrals to DORS VR and Pre-ETS programs.
3. Provide continued opportunities for mutual training and collaboration between DORS and other workforce programs.
4. Enhance and expand the provision of Pre-ETS services statewide to include: increase the number of Pre-ETS services for individuals who are Deaf or Hard of Hearing, Blind or Visually Impaired, and Intellectually or Developmentally Disabled; expand outreach to Pre-ETS students and families whose first language is not English; align staffing and caseload assignments for better collaboration with local education agencies and other education systems; ensure consistent interpretation and implementation of policies and procedures and quality assurance standards; and improve cooperation between DORS Pre-ETS VR counselors and school staff monitoring 504 plans as DORS has limited access to students with 504 plans.
5. Improve information and referral services to AJCs and other workforce partners for individuals on the DORS waiting list, especially Social Security beneficiaries who may benefit from employment network services while waiting for DORS services to be available. Referral information should pertain to the closest and most relevant employment network for the individual.
6. Improve the variety of employment opportunities available to DORS consumersby increasing staff knowledge of current labor market trends, collaborating with community colleges to develop Pre-Apprenticeships and RA programs for high growth industries in Maryland.  Expand and continue the collaboration with the Maryland Apprenticeship Think Tank to increase the number of individuals with disabilities participating in youth Pre-Apprenticeship and RA programs, outreach to WIOA partners, and identify community colleges and employers to provide training for a variety of apprenticeship programs for individuals with disabilities.
7. Re-establish the Agency’s Multicultural Access Committee to ensure equal access for minorities to DORS services. This committee needs to ensure that the resources needed by DORS field staff have been developed and implemented.
8. Promote comprehensive rehabilitation services for Deaf-Blind individuals by reconvening the Deaf-Blind workgroup and filling the vacant Deaf-Blind specialist position to collaborate closely with grassroots organizations, community partners, advocacy groups and the Helen Keller National Center, ensuring that Deaf-Blindness remains a priority for the Agency. Services should focus on statewide Support Services Program (SSP); employment services, and employer education and awareness.
9. Continue to examine the updated DORS policy regarding supported employment with a focus on the newly introduced supported employment opportunities for individuals without access to long-term funding for extended supported employment services, and the impact of supported employment intensive job coaching supports focused on achieving job stability and retention.
10. Expand employment services for individuals who are Deaf or Hard of Hearing by developing enhanced relationships with businesses. Employment specialists and VR counselors serving Deaf and Hard-of-Hearing consumers should have an employment toolbox which contains information on how to approach businesses and develop working relationships.
11. DORS should explore a rate increase for DORS-approved community rehabilitation programs.
12. Enhance relationships with community rehabilitation programs for increased collaboration in the following areas: knowledge and understanding of DORS policies and procedures; understanding benefits counseling and when it is to be provided; communication; and timely submission of documents, reports, and invoices.
13. Continue to work with 14c certificate holders to explore the number of individuals remaining in sub-minimum wage, how that may impact the number of referrals to DORS, and the barriers that 14c certificate holders are experiencing in moving individuals off 14c work sites. 

IMPACT OF FEDERAL FUNDING AND STATE GOVERNMENT PERSONNEL ACTIONS ON STAFF CAPACITY

As emphasized in the previous Needs Assessments, the DORS waiting list and delays in service provision remain a prominent concern and constitute the most prominent barrier to VR services for individuals with significant disabilities in Maryland. As of the completion of this Needs Assessment, over 2,500 eligible individuals with significant disabilities are placed on a waiting list for VR services lasting up to 32 months. Clearly, individuals on the waiting list are the most seriously unserved of populations. Several factors currently prevent DORS from moving people from the waiting list.

SEQUESTRATION

Maryland DORS’ funding for the three-year period of FY 2017 to FY 2019 has increased from $43,855,573 to $45,197,460; a three percent increase over the last three years, while inflation over that same period has increased at a rate of 4.7 percent.  This difference is the result of sequestration, which is a cut in funding for mandatory programs. For example, in FY 2019, if the mandatory sequestration cuts had not been imposed, DORS funding would have been $48,135,376 compared to $45,197,460; a difference of $2,937,916.

PRE-EMPLOYMENT TRANSITION SERVICES: AT LEAST 15 PERCENT RESERVE FUND REQUIREMENT

The Rehabilitation Act of 1973, as amended by the WIOA, requires VR agencies to reserve no less than 15 percent of the federal VR allotment. This money is reserved to provide or arrange for the provision of Pre-ETS for students with disabilities transitioning from school to postsecondary education programs and employment in competitive integrated settings. This requirement for the Agency to reserve at least 15 percent of the state grant also applies to re-allotted funds. This leaves only 85 percent of the annual budget remaining for services to adults. Over the last three years, DORS has seen a dramatic increase in the number of individuals the Agency is serving that met the definition of students with disabilities. In FY 2019, DORS is serving over 4,700 students, compared to FY 2016 when DORS served 418 students.

STATE GOVERNMENT PERSONNEL ACTIONS

From 2006-2019, the VR program has seen a 19 percent reduction in its permanent workforce due to statewide budget constraints and the State's desire to reduce the overall size of the State's workforce. In addition, staff turnover is affecting VR specialists/counselors. In State FY 2019, the Agency had 14 full-time PINs or ten percent of its VR counseling staff positions vacant.  Also, five VR counseling contractual positions have been eliminated in the past year.

THE NEED OF INDIVIDUALS WITH MOST SIGNIFICANT DISABILITIES FOR SUPPORTED EMPLOYMENT SERVICES IN MARYLAND

An increased need for supported employment services, including extended services for youth with most significant disabilities for a period not to exceed four years, is anticipated for several reasons. Since the Ken Capone Equal Employment Act became law in Maryland in 2016, information obtained indicates a reduction in the use of 14c certificates since the last Needs Assessment. The 2019 MD Labor data shows 1,462 individuals remaining in sub-minimum wage employment, representing a 58 percent decrease compared to 2016. With a total phase out of sub-minimum wage by October 1, 2020, DORS will need to continue to monitor the influence of 14c and the potential for increased supported employment needs.

On July 1, 2018, DORS introduced updated supported employment policy, including processes for eligible individuals without long-term funding available for extended supported employment services, including Agency-funded Youth Extended Services. Updated supported employment policy further includes an emphasis upon transitioning to job stabilization, where intensive job coaching supports decrease according to a fading schedule, to a predictable level of support which may be provided via ongoing support or extended services.

METHODOLOGY: DORS DATA REVIEW

DORS data was reviewed to assess the number of initial Individualized Plans for Employment (IPEs), identified as Supported Employment plans, developed during FY 2016 through FY 2018.

Discussion

Number of Supported Employment Plans Developed Each Year:

• In FY 2016, of 5097 plans initiated, 1,726 (34 percent) were supported employment plans. Out of 1,726 supported employment plans, 296 (17 percent) were developed for youth with disabilities age 24 and younger.
• In FY 2017, of 4,486 plans initiated, 1,596 (36 percent) were supported employment plans. Out of 1,596 supported employment plans, 252 (16 percent) were developed for youth with disabilities age 24 and younger.
• FY 2018, of 3,883 plans initiated, 1,660 (43 percent) were supported employment plans. Out of 1,660 supported employment plans, 313 (19 percent) were developed for youth with disabilities age 24 and younger.
• Through seven months of FY 2019, 2545 plans initiated, 897 (35 percent) were supported employment plans, 153 (17 percent) were developed for youth with disabilities age 24 and younger.

Specific Populations Provided Supported Employment Services each year:

• The number of Evidenced-Based Practice Supported Employment (EBPSE) individuals served declined seven percent from 1486 in FY 2016 to 1384 in FY 2018.
• The number of EBPSE individuals served ages 24 and under increased 41 percent from 138 in FY 2016 to 195 in FY 2018.
• The number of individuals receiving non-EBPSE supported employment has decreased 15 percent from 413 in FY 2016 to 352 in FY 2018.
• The number of youth with disabilities age 24 and younger receiving non-EBPSE supported employment has increased nine percent from 57 in FY 2016 to 62 in FY 2018.

NEEDS/CONCERNS IDENTIFIED

• With a total phase out of sub-minimum wage by October 1, 2020, DORS will need to continue to monitor the influence of 14c and the potential for increased supported employment needs.
• Although the overall number of plans developed during FY 2016 through FY 2018 has decreased by an average of 12.5 percent, the number of supported employment plans has remained within the same range, averaging 1,660 individuals per FY.
• Supported employment services for youth with disabilities age 24 and younger is expected to continue to increase due to ongoing emphasis upon services for students with disabilities and final phase-out of 14c programs in the state of Maryland.

RECOMMENDATIONS

• Continue to examine DORS policy regarding supported employment, and evaluate the use of newly introduced supported employment opportunities for individuals without access to long-term funding available.
• Monitor the impact of supported employment intensive job coaching supports focused on achieving job stability and employment retention statistics on a quarterly basis using post-exit wage data.
• Develop strategies to streamline processes to support potentially eligible students with disabilities receiving Pre-ETS, with those potentially eligible for VR services.
• Partner with Developmental Disabilities Administration (DDA), Behavioral Health Administration (BHA), and 14c certificate holders to ensure compliance with Section 511 requirements.

INDIVIDUALS WHO ARE BLIND/VISUALLY IMPAIRED AND DEAF-BLIND

As reported in the 2016 Needs Assessment, DORS and the Office for Blindness & Vision Services (OBVS) are committed to providing quality and specialized services to Maryland citizens who are Blind, Visually Impaired, and Deaf-Blind. Together, OBVS and the MSRC Blind Services Committee provides oversight and leadership in guiding policies and enhancing services to Maryland citizens.  OBVS operates the following programs and services for eligible participants:

1. VR counselors are located throughout the state in DORS field offices and at the Workforce & Technology Center (WTC).  The staff is providing employment and independent living services for individuals who have a goal of employment.
2. Rehabilitation Teachers for the Blind are also located throughout the state in DORS field offices and at WTC.  The staff is providing independent living assessments and services to individuals who have a goal of employment.  Additionally, these rehabilitation teachers are providing in-home teaching for Independent Living Older Blind (ILOB) grant.  They assess for areas such as:  mobility training, household management skills, and communication device training. 
3. OBVS is in the process of interviewing for a Deaf-Blind Specialist whose role will be to provide technical assistance and support to all staff on issues pertaining to Deaf-Blindness. Another major component of the role is to communicate with the Deaf-Blind community, expand program development, and assist with job development and placement.
4. The Maryland Business Enterprise Program for the Blind (MDBEP) is also operated through OBVS. MDBEP provides opportunities for individuals who are legally blind to operate vending, gift shops, or other food service facilities on federal and other property.
5. Services for the Blind and Visually Impaired (SBVI) is a program for individuals who are blind or Visually Impaired and is located at WTC. SBVI addresses areas of independent living, mobility, technology, and communication training in a residential setting.  The program also collaborates with the WTC for the facilitation of a support group for individuals in need of this service.

PREVALENCE (BLIND/VISUALLY IMPAIRED)

According to the 2016 American Community Surveys, there are 58,094 individuals in the State of Maryland with vision loss who are between the ages of 18 and 64. During the past three years, DORS served 2,151 individuals for whom Blindness was reported to be their primary impairment, and 429 of these were youth in transition when applying for services.

There is limited data available on individuals experiencing a dual sensory loss in Maryland, but the number does appear to be relatively low. The 2017 National Child Count of Children and Youth who are Deaf-Blind, administrated by the National Center on Deaf-Blindness, identified 188 children or youth with significant levels of dual sensory loss in Maryland. Over the past three years, DORS has provided VR services for 136 individuals who are Deaf-Blind, and 25 of these were transition age youth.

METHODOLOGY: BLINDNESS SERVICES SURVEY

 A survey regarding Blindness and Deaf-Blind services was distributed to stakeholders, consumers, community partners, caregivers and DORS staff via email, Facebook and the DORS website to solicit feedback regarding the unmet needs of individuals who are Blind, Visually Impaired or Deaf-Blind. DORS received 125 completed surveys via email. 

NEEDS/CONCERNS IDENTIFIED

• Increase the use of benefits counseling for individuals seeking employment. 
• Need to explore different options for job placement methods to ensure individuals, especially those who have completed trainings and internships, receive continuous assistance and have access to job leads through various mediums.
• Lack of efficiency in the service delivery and follow-up by DORS staff.
• Need to increase comprehensive and intensive Blindness skills training to help consumers become proficient in independent living skills such as cooking, Braille, cleaning, non-visual literacy, and orientation and mobility.  
• Concerns related to technology, especially the lack of advanced technology/computer training being offered to consumers.
• Concerns regarding employers not hiring individuals who are Blind or Visually Impaired and their lack of knowledge regarding Blindness and workplace accommodations.
• Concerns regarding the lack of affordable and reliable transportation for consumers, including the shortage of options available in rural areas.
• Lack of support groups, role models and peer support to help consumers deal with vision loss.

RECOMMENDATIONS

• Collaborating with other government or private sector businesses that provide employment training.
• Provide disability education and offer more incentives to employers for hiring consumers.
• Advocate for and consider additional job development and placement hours because the placements are usually more challenging.
• Empower consumers and teach them how to advocate for themselves.
• Increase funding to hire additional DORS staff with specific knowledge of Blindness and Visual Impairments including staff specialists, orientation & mobility specialists, rehabilitation teachers, employment specialists, and VR counselors; to ensure more personalized services, increase counseling services, and a fully embraced customer service approach that is focused on the individual.
• Enhance and emphasize counselor role in:        
  • Advising consumers about the full scope of services, the rehabilitation team and process, including expediting services to those in job jeopardy to ensure the consumer has the opportunity to gain knowledge and skills necessary to maintain current employment.
  • Focusing on capabilities and individualized needs and learning styles.
  • Facilitating access to assistive technology.
  • Minimizing gaps in the provision of services.
  • Increasing timeliness of the services provided.
• Increase staff knowledge about self-employment opportunities and how they can be accessed.
• Provide updated technology trainings to DORS consumers including more advanced trainings on software/devices and access technology used in competitive integrated employment.
• Explore possible solutions to issues related to limited transportation to assist those in more rural areas to have full access to DORS services.
• Expand staff and advocate for community resources to provide a full range of independent living and employment services to Deaf-Blind individuals within DORS and community programs/providers (qualified interpreters, technologists, teachers, counselors, therapists, psychologists, psychiatrists, and other professionals).

INDIVIDUALS WHO ARE DEAF, HARD OF HEARING, AND LATE DEAFENED

PREVALENCE

Per the FY 2017 annual report from the Maryland Governor’s Office of the Deaf & Hard of Hearing, it is estimated that there are approximately 1.2 million Marylanders who are Deaf or Hard of Hearing. For FYs 2017 and 2018, DORS has served 1,737 individuals who reported Deaf or Hard of Hearing as their primary disability (AWARE Case Management System Report: Annual All by Primary Disability).

METHODOLOGY: SUBJECT MATTER INTERVIEWS

Information regarding employer engagement when hiring individuals who are Deaf or Hard of Hearing was obtained through individual interviews with Kathy West-Evans, Director of Business Relations, Council of State Administrators of VR and John Evans, Co-Owner of Abilities United and former Program Administrator for Business Relations with the Washington State Department of Social Health Services.

During these interviews, strategies for expanding employment opportunities for Deaf and Hard-of-Hearing individuals were discussed. The interviews focused on developing trusting work relationships with employers, educating employers, accommodations, and supporting the employers needs when hiring Deaf and Hard-of-Hearing individuals. Suggestions provided included: sharing success stories with employers, presenting communication strategies, education and disability awareness.  Both agreed that once you have the trust of business, you can build further relationships and begin to provide education and awareness. When you have that trust with the employer it increases comfortability levels for the employer to ask about accommodations and supports needed.

Both emphasized that ensuring that the employment specialists and VR counselors have a toolbox which contains information on how to approach businesses is vital for success. This toolbox should include but not be limited to strategies for:  how to approach businesses, listening to employers and their needs, strategies for communication, and education and awareness. Mr. Evans suggested:

1. DORS should invite employers to the WTC Business Advisory Board meetings to share their experiences and highlight their successes in working with Deaf and Hard-of-Hearing individuals and where they need support.
2. DORS employment specialists need to follow-up with businesses, complete quality assurance checks, and continue to build the working relationships that exist.

In addition, both agreed that DORS employment specialists need to understand data which will help to facilitate an understanding of which consumers are working, where they are working, their earnings, and those businesses who have hired Deaf and Hard-of-Hearing individuals. Mr. Evans expressed his personal experience with data and how understanding the data helped him to continue to maintain positive business relationships and successful networking with other employers in the same area.

A major factor for successful business engagement is networking. The Agency needs to network with other professionals serving Deaf and Hard-of-Hearing individuals. It was highly recommended that DORS staff serving Deaf and Hard-of-Hearing individuals attend national conferences with those from other states.

METHODOLOGY: SURVEY

An online survey was distributed to Rehabilitation Counselors for the Deaf (RCD) at DORS, their supervisors and regional directors to evaluate the effectiveness of the eligibility forms (Functional Limitation Checklist and VR Priority Category Checklist) for Deaf and Hard-of-Hearing individuals. The online survey also evaluated the effectiveness of DORS staff communicating with Deaf and Hard-of-Hearing individuals through the use of technology available within the offices. The online survey was available to 24 individuals within DORS. Of the 24, 15 individuals responded (62.5 percent).

NEEDS/CONCERNS IDENTIFIED

• The VR Priority Category Checklist and eligibility determination forms should be reviewed to determine effectiveness regarding Deaf and Hard-of-Hearing individuals.
• Ensure RCDs receive timely training to effectively complete forms in the AWARE case management system when determining eligibility.
• Communication devices (e.g., VRI, Sorenson, and Purple) and software should be purchased or replaced, as needed.
• Communication devices should be available to all field offices that demonstrate a need for such devices.
• Routine maintenance on communication devices should be completed in field offices.
• Training on the use of communication devices should be provided on a regular basis.
• Employment Specialists need to better understand and utilize data.

RECOMMENDATIONS

• Update eligibility forms and provide training to RCDs regarding appropriate use of forms when determining eligibility for Deaf and Hard-of-Hearing consumers.
• Communication devices should be checked every six months to ensure they are in working order.
• Purchase or replace communication devices, as needed, to ensure effective communication between hearing and Deaf and Hard-of-Hearing staff or consumers.
• All staff in each office should be trained at least once a year on the communication devices in their office to ensure effective communication with consumers.
• Data reports regarding employment information should be disseminated to appropriate staff on a regular basis.
• Employment specialists and RCDs serving Deaf and Hard-of-Hearing individuals should have an employment toolbox which contains information on how to approach businesses.

INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITY, INCLUDING SECTION 511 CONSIDERATIONS

WIOA Section 511 does not require a Designated State Unit (DSU) to identify individuals who are currently earning sub-minimum wage.  However, in 2016, DORS examined the number of individuals in Maryland who were earning wages below minimum wage to determine the impact of their potential referrals to DORS.  DORS is interested in knowing the number of individuals remaining in sub-minimum wage, how that may impact the number of referrals, and the barriers that 14c certificate holders are experiencing in moving individuals off 14c work sites.  Since the Ken Capone Equal Employment Act was signed into law in Maryland in 2016, with a total phase out of sub-minimum wage by October 1, 2020, DORS anticipated a much lower number then in the previous report (2016). 

PREVALENCE

Data was reviewed from the MD Labor Wage and Hour Division for Maryland.  The data was current through June 2019.  Information was compared to the DORS fee schedule to determine which Regions the providers primarily service. 

Within the five DORS Regions, the Wage and Hour Division information translates as follows:

Information from 2016 indicates there were 3,469 individuals served across 36 CRPs versus 2019 data demonstrating 1,462 individuals in sub-minimum wage being served by 16 CRPs.

Information obtained indicates a reduction in the use of 14c certificates since the last Needs Assessment. However, it is also noted that there remains a significant number of individuals who will be exiting sub-minimum wage employment over the next several months.

NEEDS/CONCERNS IDENTIFIED

• The number of individuals and providers working under 14c certificates has decreased significantly.  While DORS has provided the required counseling and guidance to individuals, questions remain regarding the steps the 14c certificate holders will put in place to ensure a total phase out of sub-minimum wage.
• Need to identify where the remaining CRPs are in their transition from sub-minimum wage to Competitive Integrated Employment.
• Need to identify the barriers CRPs and individuals are facing in transitioning individuals into Competitive Integrated Employment.

METHODOLOGY:  INDIVIDUAL SURVEY AND CRP SURVEY

Of the CRPs that completed the survey, 31 responders indicated that they serve DDA consumers.  Of the eight that reported they are still using sub-minimum wage, six agencies indicated that they are in transition to end the use of sub-minimum wage.  Of the six, current needs include benefits counseling and training for jobs. CRPs expressed concerns regarding a need to provide transportation and benefits counseling to individuals and their families, intensive job search, and a more efficient process to obtain authorizations when working with DORS counselors.

NEEDS/CONCERNS IDENTIFIED

• 14c certificate providers are not addressing training needs and opportunities to be included in DORS trainings.
• Benefits counseling information needs to be made available to individuals with intellectual disabilities.
• Assistance is needed with vocational skills training.

RECOMMENDATIONS

• Continue to work with providers to address training needs and opportunities to include providers in DORS trainings.
• Provide benefits counseling to beneficiaries working under 14c certificates once they are referred to DORS.
• Establish a collaborative process with CRPs to assure that vocational training needs for individuals are being met.
• Establish a process to identify the individuals who continue to work under 14c certificates.

INDIVIDUALS WITH SEVERE AND PERSISTENT MENTAL ILLNESS

Information from the 2016 Comprehensive Needs Assessment noted that the utilization of mental health supported employment services varies by county. DORS and BHA have a long-standing collaborative history and work within a well- established braided funding mechanism to assure that services are available and reach the maximum number of participants.

PREVALENCE

BHA reports that claims paid through April 30, 2019 include 281,179 individuals in Maryland being served by BHA and 3,720 of those individuals are receiving long-term funding for supported employment. The previous 2016 Needs Assessment noted 68,000 individuals receiving BHA services in general.  The significant increase in individuals receiving services is due to BHA adding addictions services under their overall service delivery.  In the previous needs assessment, those individuals were not included in the general count.

METHODOLOGY:  BHA AND DORS DATA COMPARISON

The results of the comparison are provided in the table below.  For each county the table displays the total number of individuals receiving BHA services, the total receiving BHA supported employment funding, the DORS Region, and the total number of CRPs approved both by DORS and BHA to provide services in each county.

The table below reflects the number of providers by Region, and the number of DORS staff assigned to the behavioral health supported employment providers (including evidence based providers).

Fewer individuals are receiving supported employment services through BHA as compared to 2016.  Comparing DORS staff allocations for behavioral health supported employment CRPs, the data appears that DORS has an adequate number of staff assigned to the providers in each Region.  Many of the providers have a very large referral base which keeps the caseloads of field staff large as well.

METHODOLOGY:  INDIVIDUAL SURVEY AND CRP SURVEY

Forty-two responses were received from the All Disability Groups, Individual Survey.  Of those responses, six individuals indicated that they receive supports from BHA.  They noted that they receive the following supports from their service provider: 

• job development
• help with applications
• extended support services
• housing assistance
• guidance
• transportation
• education

These individuals indicated the supports they receive are adequate. Most indicated the VR services they received helped them prepare for employment. When asked what could have been done differently, the responses were that DORS could have provided benefits counseling, schedule more meetings, and provide a work try-out to see if the individual could perform the tasks of their vocational goal.

Forty responses were received from the CRP survey. Thirty-two respondents indicated that they work with individuals with behavioral health diagnoses.  Eighteen indicated that the primary population they serve is behavioral health.  Overall, responses indicate a need for an increase in collaboration between DORS and the providers, continued need for benefits counseling, and improved responsiveness from DORS’ staff when communicating either through email or by telephone.

NEEDS/CONCERNS IDENTIFIED

• Benefits counseling is needed covering both federal and state benefits.
• Improved communication between providers and DORS’ staff.
• Use of alternative methods, such as a work trial, to see if an individual has the ability to perform a position.

RECOMMENDATIONS

• Assure that benefits counseling is offered and provided to individuals served by behavioral health providers, who are beneficiaries, when that individual becomes a consumer of DORS.
• Improve communication DORS staff and providers to enhance the delivery of quality services.