1 LIGHTLY EDITED FILE VRS Community Partners + VRS Staff Forum Vocational Rehabilitation Services June 1st, 2021 10:30 a.m. - 12:00 p.m. * * * * * This text is being provided in a lightly edited draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings. Due to the live nature of the event, some names and/or terms may be misspelled, and the text may also contain environmental sounds that occurred during the event. CART Provided by Megan Stumm, RPR Paradigm Reporting & Captioning, Inc. 612.339.0545 captioning-paradigm@veritext.com 2 Good morning, everyone. I am Kim Babine, I am Director of Community Partnerships with DEED Vocational Rehabilitation Services. 9 It's great to see everyone today. Our agenda for today is to really focus on Employment First Minnesota, E1MN and what's going on broadly there before July 1st, and also to look at the new E1 PBA that VRS has developed along with the changes, some changes that we're making to the general PBA at the same time. That's performance based agreement, that's how we do our job retention services -- or job placement and retention, and stay tuned for a little change on that. We'll also have plenty of time for questions and answers, so again, please submit those questions through the link in the chat. So I just want to welcome everyone, as I said, we are really happy to have VRS staff here, VRS community partners, and also our partners at State Services for the Blind. So partners with SSB and then SSB workforce development unit staff. I also think we have some potential VRS partners with us, we've started inviting organizations that might want to partner with VRS and provide services. We've started inviting you to these meetings so you can start to understand how this all works. So before we get started, I just wanted everyone to 10 kind of just take a deep breath and think about where we are on June 1st, 2021, and we are in the midst of a big shift in the employment services disability -- for people with disabilities across Minnesota. All the services are shifting and we are working together along with our partners at the Department of Human Services and lead agencies, counties, Department of Education is involved in a very exciting way, and we have new things that we are working on and working to accomplish. And I think it's important to remember when there's so much in front of us, we have a long way to go. July 1st is when a lot of things take effect, but we know that the road is long and Chris McVey and Amanda Jensen-Stahl like to say that in some ways July 1st is our deadline for a lot of things, but in a lot of ways it's the start, it's the start of how we provide services in Minnesota. And there's just a lot that will happen and it's so exciting and it's really important to just think about the last few years and how much transportation -- transportation, excuse me -- how much transition there has been and that it's been hard and change is hard and community partners, you have organizations to shepherd through these changes and VRS staff, you've had to help 11 move these pieces from point A to point B and sometimes point Z. And it's taken a lot of work and a lot of -- lot of energy to make this happen. And it's really good. I think we are at just a very exciting point in our work together. I think services for individuals that we serve are becoming stronger. I think our partnerships are stronger, and it's all because of the energy that folks have put in up until this point and will continue moving forward. And so even though there's a road ahead, remember that we've come a long way and that it's a really positive change. And so I want to thank everyone for their work up and to this point and thank you for the work that will come in the days, weeks, months, years to come. I think especially taking the time to remember that will give us the energy to move forward and to build on that. So that's my message for today is thank you. It is gratitude for being on this journey and doing it for the individuals that we serve. All right. 12 I am going to move us in our agenda to updates on E1MN, employment first Minnesota. I'll turn it over to Chris McVey. >> Chris: Good morning, everybody. Thank you, Kim. Chris McVey, I'm the Director of Strategic Initiatives for DEED VRS. And I've got some employment first MN, E1MN updates for you today. Next slide, please. Thank you to everyone, whether you are VRS staff, State Services for the Blind staff, community partners, prospective community partners, those that are 245D license providers that are thinking about developing a PT contract. Anybody else that's part of the world that serves individuals on waivers and helping them move forward to prepare for, obtain, or maintain competitive integrated employment because that's what this is all about. Wanting to share with you kind of the summary of trainings that we've provided thus far relating to E1MN. Number one is that in April and May of this year there were three E1MN core training sessions. These are recorded sessions. 13 Now, these were three sessions that were all the same, so it was a matter of identifying which of the three dates would work for people. But they've been recorded, which is wonderful. And we encourage anyone that is going to serve a person on a waiver who wants to pursue competitive integrated employment, CIE, that they avail themselves of this core training, make sure that they know the information that's within that training, and what's exciting for us that thus far we've had 1,285 people attend one of those sessions. And so we're really, really excited to see that that amount of folks have already tuned in and gotten access to that basic core training. We also know, and this is my own self-thinking about my days as a counselor is that it may be that those of you that are serving people on waivers that you may want to refresh your memory, perhaps there would be a lapse from when you first heard it to when you're really going to go deep and serve a person on a waiver move forward with their employment goals for competitive integrated employment. Definitely tune into that recorded session for more information. I'm really sorry, I have French bulldogs that are 14 really deeply sleeping right now so, the snoring if you hear any is not from me. Really the goals around this core training are about learning about E1MN, how to, you know, what your responsibilities are for it, why we're doing it, explain that framework of engage, plan, find, and keep. And have a high level understanding of the roles and responsibilities of the people, those of us as practitioners in, serving and supporting people on waivers who want to pursue competitive integrated employment. And then the fourth goal of that training is to be prepared for the next steps leading up to our launch of E1MN, MOU July 1st of 2021, which is only like four weeks away. So that is pretty incredible that we're already in June as of today and then in four weeks it will be July. Next slide. Just a little bit of feedback sharing with all of you what we heard. We had at following those core trainings surveys that we asked people to complete. 452 folks completed those surveys, an overwhelming majority of the survey people agreed that they understood the training's content in all areas which 15 was very encouraging. And that there was some areas of disagreement particularly where that high level of understanding about E1MN team member roles and responsibilities and feeling prepared for the July 1st E1MN launch. And I so understand why people would feel nervous about that. And so I'm looking forward to additional opportunities to provide information and support to you as you prepare for that July 1st launch and beyond about how best to serve people on waivers who want to pursue competitive integrated employment. So more to come there. Next slide. Additional training feedback is that some respondents provided suggestions on how the training could be improved, about having materials available to participants before and after the training and making time to have question and answer time available. And that nearly half of the respondents primarily worked in the metro area. We had much more of a response metro versus greater Minnesota, and I'm just really -- it's all helpful information to us as we are continuing to develop additional training modules or supports to help people 16 as practitioners help their individuals, their people on waivers move forward with their competitive integrated employment goals. Next slide. We want to make sure that you are all aware of the coffee chat that is coming up June 10th. That's next week. I had to think about that for a minute. We had one in March, April, and May, and now we have one scheduled June 10th. There's a link to -- within this PowerPoint for the FAQs, the frequently asked questions. That is a very important document for people to review whether you are policy level folks or whether you are practitioners that are supporting people directly. The FAQs are really great questions that come from people that are doing the work and supporting people. And according to Amanda Jensen-Stahl the questions are getting tougher and tougher as we goat closer to the launch of the MOU, so it's a good thing. We want those questions, we will be responding to each of them. We will get lots of -- we get lots of the similar questions, so people may not see their actual questions but it's going to be a composite of all the questions 17 people have asked about the same subject. It's important that we review the FAQs along with the policy that we have. I know DEED VRS has policy guidance that will be coming out. But anyway, I just wanted to share that the FAQs is a very important document that will continue to be updated as before launch, after launch, and an important component to be reviewing when considering how you as a practitioner especially are serving and supporting your person. And then the expectations of your team, which includes of course VRS counselor, SSB counselor, the county case manager or contracted case manager, and then the community rehabilitation partner, whether 245D or -- and hopefully a PT contract holder. We've had about 526 people attend the coffee chats on average, and we think that's a great number, but encourage others to please join on. And then just to let you know as well, we plan to continue those coffee chats in July, August, and September. While we don't record those sessions, the PowerPoints are available with the questions and the answers that I believe then live on the E1MN website. 18 Next slide. There's a provider alignment webinar that we're hoping those of you that are 245D license providers and not yet PT contract holders and you're desiring to serve people on waivers interested in competitive integrated employment to join. We're also interested in supporting people that -- entities that are PT contract holders and not yet 245D, also avail yourself of this webinar. It's all about the benefits of becoming both 245 -- licensed and a VRS/SSB service provider. We have had the trainings on April 8th, 225 people registered. We had breakout sessions focused on 245D and VRS/SSB. And excuse me, the webinar is not yet to come, it's already been provided. So it's recorded and available on that E1MN website under provider trainings. It's available, and I'm so glad, thanks to the folks putting this PowerPoint together that we have those links. It's wonderful. Thank you. Next slide. Okay. 19 As far as the training and technical needs assistance ahead, we know that when we launch on July 1st will be day one, and that there will be many days to come. And we know that there will be as people have their annual plans that will begin starting in September, that's when we'll largely see a lot of these referrals getting made from the waiver -- from the community partner and the contracted case manager to VRS or SSB. And then also as the person obtains employment, they've held the job for at least 30 days and they're doing well, to then have VRS and SSB staff coordinate with the waiver provider -- I'm sorry, not the waiver provider, the contracted case manager and the CRP about moving that person into the long-term supports. So there's two -- two hand-offs or warm hand-offs that will occur and it's not only about making that referral initially through VRS or SSB, it's also about making that transition back over to waiver funds. We will, as I said in the previous slide, we'll continue those coffee chats. July will be -- you see the dates there -- July, August, and September we have the dates that are laid out in this PowerPoint. July 22nd, August 26th, and September 23rd. We will provide trainings based on specific audience 20 needs and joint trainings. We'll try for and look to as much as possible have on-demand trainings, because we've heard that people appreciate that. We also recognize that the people that we're training now, that there will be new staff coming on, whether they're community partner, VRS/SSB, or case managers. We want to make sure that it's replicable and available when people need it. And then we are also planning regional forums and trainings in the fall. For those of you that are joining us, both VRS, SSB, community partners, as well as any counties, waiver providers, we are hopeful that at the local level we can have you joining one another on your natural teams to avail yourselves of the trainings that we're planning. So rather than going to 87 different counties to provide this training individually, we're looking to provide that one training, which I think we'll have multiple dates, but the 87 counties and their partners including VRS, SSB, and community partners could look to join those at the same time and have opportunities for discussion. We do have -- we're developing a centralized E1MN 21 e-mail for questions, and that's just an FYI. I think that might be the end of my updates. Thank you. >> Kim Babine: Great, Chris. Thank you. This is Kim. Thanks, Chris, for that. So just a reminder that those -- the presentation is in the chat and so for links that were in there, that's where you can find those links and we've put a couple in the chat just directly as well. I'll note that we've already gotten a few questions coming in for this forum, for the question and answers. Some of them are related directly to E1MN and so we actually won't be taking those questions right now because the DHS, DEED interagency crew are the ones that need to come up with the answers to those. So the best place for those E1MN questions is that coffee chat question forum that's linked in the chat as well. >> Chris: And maybe what I'll do, because I don't want people to feel like they have to then extend separately, I can take those questions and make sure that they get over to the chat. >> Kim Babine: Yes, definitely. 22 That sounds good. Thanks, Chris. So I'll turn it over to Evie wold and Sara Sundeen for? Some new information about the E1 PBA and changes to our general PBA. >> Thanks, Kim. This is Sara Sundeen and I'm on the community partnerships team. And Evie and I are going to just do a review of what is new with the E1 PBA and some changes we're making with the general PBA. There's going to be more in-depth trainings specifically on both the general PBA changes and on the -- PBA on June 29th. Continue to use that Microsoft form for questions as we present. You can ask as many as you want and submit as many questions as you have. So our goal today in this session is just to review those PBA changes. We want to give you an update on the work in progress items that we shared with you. We'll talk a little bit about the next steps and as Kim had said, we'll have lots of time for questions and answers. 23 So as a refresher, this is the employment first Minnesota model with the engage, plan, find, and keep. And seeing where the funding changes between VRS and DHS. Regarding performance based agreements, we are going to focus on the find section. So with employment first Minnesota, the waiver case manager is now part of the employment plan development and there will be a conversation and a commitment from them about the keep part of the process. VR will know what long-term supports the waiver will provide prior to job placement services being added to our employment plan and it if someone is on one of the four qualifying Medicaid waivers and long-term funding is available, we will start an E1 PBA. So just as a review from our meeting in May, starting July 1st, 2021, so a month from today, we will have two models of performance based outcome payments. And to help distinguish them we're calling the one that everyone is familiar with, the General PBA and this new model called the E1 PBA. And as I said, if the job seeker comes to VR with one of those four Medicaid waivers, then it will be an E1 PBA. In a review for those who need it, the general PBA is 24 $3,800, pass three milestones and is for non-Medicaid waiver VR participants. The E one PBA is $5,000 with four milestones, and for individuals on one of the Medicaid waivers listed. When we worked on the new model for the E1 PBA we knew it would influence and affect the general PBA and we tried to align the two of them as closely as possible. So here is a side-by-side of the two payment structures for you. You can see in the general PBA where, and the E1 PBA where milestone 1, initial placement plan is the same. And E1 PBA has the E1 milestone at 120 days of service. Milestone 2 is the same for both. First shift of new job completed. And milestone 3 is the same for both. 90 days successfully employed. >> Evie: Good morning, everybody, I'm Evie Wold from VRS and I work in placement services as a program specialist. I just wanted to talk a little bit about the E1 PBA and the general and what both will have in common. We really wanted to simplify the two PBAs and have the alignment where we could, so you'll see some of the commonalities include both of course we have informed choice on the part of the consumer. 25 I know it's very popular, we are unbundling 20 hours of job coaching we had wrapped into the PBA. We're going to be unbundling that and authorizes separately for both general and E1. There will be layering of services like the job coaching I just talked about, maybe job tryouts. We'll be changing also a big change from biweekly communication updates to a monthly progress report. We'll talk more about that in a little bit. We're going to continue having 60-day meetings when the participant's in job search. As Sara showed you the milestones would be the same for 1, 2, and 3. We're eliminating the placement plan summary. This is something that we had requested from our partners to send a summary of the placement plan meeting to VRS and we're shifting that responsibility over to the VRS staff to document that meeting. Also we heard from our partners that -- some semantics. We are changing what we call internally at VRS, we used to call it placement and retention services, we're now calling it placement and follow-up services. We heard our partners, they use the word "retention" to refer to long-term or extended kind of supports, extended employment situations and so it was just a 26 little bit confusing. We like to use the same words where we can, so we're changing our language to mirror that. And so you'll see it referred to now as placement and follow-up services. So we'll be changing that in our policy as well. All right. So some new features, so as you know with the E1 PBA the waiver case manager will be a team member. We're working with DHS right now as to the extent of their roles and responsibilities in that placement process, but there will be important for securing those long-term supports and having that seamless service. The E1 milestone will also have that extra payment milestone as you saw. The expectation of more individualized and intensive services and supports. We know it's likely that people coming to us through the E1 process may never have experienced work before in the community so there may be some more support that they'll need during that job search, more intensive services. So this will all come to be on July 1st. Any partner can provide the E1 PBA as long as they have it on a PT contract. 27 And there won't be a PT contract amendment needed if you are a provider for VRS and were providing general PBAs, there will be no contract amendment for providing E1 PBAs. All right, so let's talk a little bit about who can provide placement services with the E1 PBA. So the informed choice really engages the participant in the process of choosing which partner they want that will best meet their needs. The VR participants, they all go through the same process of informed choice, whether they're on a waiver or not. So E1 or general. They can choose internal or external Placement Specialists. As many of you know, we have VRS placement coordinators that work for VRS or our partners that have contracts with them -- with us. They do not, like I said, have to be 245D licensed to provide the E1 PBAs. Now, we know that being said, in a lot of cases the participant will already be connected with a community partner who may have worked with them in that engage and plan part of the E1MN process. So that person may choose to continue with the same 28 partner to assist them in the Find phase. And then hopefully continue working with them when they move back into the Keep phase with DHS. So there is a benefit to being, you know, 245D license provider and duly enrolled that they -- that participant would have a seamless continuum of services. However, community partners who don't have that license can also provide the service and could be selected. [ phone chiming ] >> So it just depends on the best match for that person. >> Sara: So let's review the components of each milestone again and how our partners get paid. In milestone 1 it starts with that initial meeting, and minimally it's the counselor, placement provider and job seeker, for the E1 PBA the waiver case manager also needs to be at this meeting. All parties will come prepared to create that placement plan and the creation of the placement plan including roles and responsibilities will be completed. The same requirements for a general PBA and E1 PBA and for the milestone 1 payment the provider sends the placement plan -- and an invoice. >> For the E1 milestone which is a new milestone at 120 29 days of service, this mile stone is paid at 120 days whether the person is in job search or in follow-up. For the E1 payment we would expect we would have had all four monthly progress reports since that placement plan, and a record of the 60-day meetings occurring when they're in active job search, and then we would have those with an invoice. For milestone 2, which is the same for the E1 and the general milestone, we would have monthly progress reports with the employment and follow-up information detailed on that report. And for payment all the monthly progress reports would be submitted since that last milestone would have been paid and an invoice from the provider. For milestone 3 also using the monthly progress report with the section on employment information and the final information on placement and follow-up service closure and then we would have milestone 3 payment, all those reports in, as well as the invoice from our provider. >> Evie: So let's look at a couple of scenarios or examples to show this process. So this would be an E1 PBA, and this would be where the participant has their placement plan, they then meet the 120 days, then get a job. 30 So that's kind of the process for this first one. So Abdi starts his job and has initial placement plan meeting on February 1st, so the partner would submit that placement plan and an invoice for that first milestone. Continues in job search and has 60-day meeting, everybody agrees that it's going well and they're going to continue, so then the partner's submitting those monthly progress reports. He continues in job search and has reached the 120 days of service, so that is that E1 milestone marker so we'd be sure we have all those progress reports, that should be 4, since the first milestone, and an invoice for that E1 milestone. And then Abdi accepts a competitive integrated job, works his first shift on August 16th. So then partner has submitted those reports and in that monthly progress report there will be a section on the employment and follow-up information, all those employment details are laid out in that form, so we would get that plus an invoice for milestone 2. Then Abdi successfully maintains and happy with his job, so then we'd get that -- we make sure we have all those monthly progress reports with the section on closure and the invoice for milestone 3. 31 So the next scenario, this one is a little bit different where the E1 milestone is paid after the person starts their job. So because it's at 120 days of service it, may happen before or after someone gets -- finds work. So in this case Dillon starts job placement, placement meeting on February 1. Again, partner submits that placement plan and invoices for milestone 1. Dillon finds a job quickly and works his first shift on March 15th so we're getting that progress report with the employment information and the invoice for milestone 2. Continues working and is still in service at 120 days, so there's no meeting required since he's working, but we would get that E1 milestone invoice and make sure we have those monthly progress reports. And then he's working, doing well June 15th so the partner submits that monthly progress report with the closure information completed and invoices for milestone 3. So you may have seen that there will be people who don't get to employment and the full $5,000. So we'll be -- there may be people who decide not to continue in their job search, is there may be people 32 who get a job very quickly, we anticipate that to be very rare, so if someone got a job within the first 30 days of employment, they would not hit that 120 days of service mark. We're going to be pulling data too to be looking at how often this is going to be happening. Like I said, we expect it to be very rare, but we are aware that that could be a scenario. So today what we have going on since May's forum meeting, today we are still working with our workgroups preparing for that launch. You'll see June 29th we are going to be having the training. So we know that there's a lot of questions kind of lingering out there, some things we need to button up and we'll be going into a lot of that -- all of that at the trainings toward the end of the month. July 1st of course you know the new E1 MOU begins and the changes to the general PBA as well as the E1 PBA will begin on July 1st. And that's when that E1 PBA becomes an option as a -- for job placement and follow-up services. So our work in progress list, as I alluded to, some of the things we're working hard on right now is updating that job placement and follow-up, we're updating all 33 the forums -- forms to reflect the new processes and the new language that we're using. We're going to be working on the 90-day clocks, so we know there's been some confusion on this. I think Sara will talk a little bit about that too. We're providing more guidance around holds. We know our partners, you've told us that sometimes people get referred, they have the placement plan, and then something happens and they go into a hold status. We know that's difficult for our partners to manage with waitlists and caseloads and moving that around, so we're looking at more guidance and more definition around that. Preparing for that July 1st transition for general PBA and E1 PBA. [ background conversations ] >> Evie: If you could put your mute on if you're not me talking. [ Laughter ] >> Evie: That would be great. And then reminder, Pre-ETS and PBAs, I think we have a slide on that, Sara, or should I talk about that now? Okay, we'll talk about that in a second. So as I talked about, we'll be updating the forms, so some of the forms affected will be that progress 34 update, placement plan, invitation to placement and the job coaching. So with the monthly progress report we expect these will be used for all PBAs, whether general or E1. That form will be flexible for both of those PBA options. The first monthly progress report then would be due by August 10th. So July would be the first month we'll be using it. It will be due then in August for the period of July 1st through the 31st. So we want to get all those in by the 10th of the following month, so just to give you some time to complete those. The placement plan, we have all those roles and responsibilities for all the team members listed, the job seeker, the counselor, the placement professional, and now we're adding the waiver case manager and what their roles and responsibilities will be, and we're working with DHS on that right now. Invitation to placement is getting updated so we're not going to be sending after July 1st the full VR assessment of needs. There's a lot of sections in there we've found that may not be relevant to the job search and may not be 35 important to send. So the counselors are going to be getting some training on making decisions about what is relevant to that job search and we'll be training around that. And then also customized employment documents we want sent along with that invitation as well we're adding in. And then job coaching communications. So if we're unbundling that from the PBA, we want to have some good way for documentation to happen back and forth on that. So we'll be looking for weekly updates, kind of check-ins on that and monthly progress reports during that time. All right. Oh, go ahead, Sara. >> Sara: I'll take over. >> Evie: Okay. >> Sara: So a couple of the other things we're working on our to do list is clarifying the 90 day clock clocks and holds. And as Evie said we acknowledge there has been a lot of confusion and some inconsistency when milestone 3 is paid and how long a PBA should be on hold. And so both of those are going to be clarified and 36 we'll train on the guidance at our June 29th meeting. But we've definitely heard your feedback and we will clarify and talk more about that then. So in anticipation of these July 1st changes, we wanted to give a little bit more clarification around a couple things. Again, as Evie said, June 30th of this month will be the last submission of your biweekly communication updates for your general PBAs. And on July 1st, partners are going to start using that monthly progress report template. This will be used by everyone both internal and external, and as Evie said, that would -- woops, excuse me -- that would be due on August 10th. Also, starting July 1st, those -- or really ending on June 30th, but 20 hours of job coaching will no longer be part of the PBA. So any job coaching that is needed will be paid for on an hourly basis to our PT contract partners who have job coaching on their contracts. So this is a great time right now to make sure that if you are working with job seekers who you think are going to need job coaching after July 1st and they are part of a PBA to have a conversation and make sure that job coaching is an option on the employment plans and 37 to start discussing this change with our job seekers and making sure we're ready. Also just a reminder that July 1st is the beginning of a fiscal year for both rehab services, so all authorizations will start on July 1st. So the transition time is good in that respect. Also, a question that we frequently had is will E1 PBAs be paid retroactively? The answer is no. Because July 1st is when E1 PBA will become a payment option for PBA, the individuals who are currently in a VRS general PBA will continue in that general PBA for the remainder of their job placement and follow-up, VRS will not change the authorization to an E1 PBA. For individuals who are in a VRS general PBA and attain a waiver while the general PBA is in place, they will continue in the general PBA for the remainder of their job placement and follow-up. We are guessing that another question might be what about -- what should we do with individuals who are on a waiver right now during this month of June? And we are saying that if a job seeker wants to start job search right now and they have a waiver, that a general PBA should be started. If the job seeker and their team agree that waiting 38 until July 1st to begin their job search is appropriate, then an E1 PBA can be started in July. Counselors should be discussing with the job seekers the pros and cons of waiting to July 1st to start a PBA. And we also want to note that if a job seeker does decide to wait until July 1st, VRS has other resources and hourly services that they may want to consider and add to the employment plan, maybe it's looking at some independent living services, job seeking skills, informational interviews, self-advocacy. There are some other things that could be done to help get that job seeker ready for a July 1st start so they're not just sitting for the month of June with nothing to do. There are a lot of options. We've also had a few questions about how these changes with the PBAs might affect students. Basically the guidance remains the same as before for students and PBA. If a student is seeking a short-term work experience or intermediate job, they would not use a PBA. If the student is looking for a permanent job, a PBA is appropriate whether they have a waive -- whether or not they have a waiver, and that will determine if it is a 39 general PBA or an E1 PBA. So just as a reminder. >> Evie: Yep, go ahead, Sara. >> Sara: Just as a reminder, we do have our PBA training on June 29th from 9 to noon. That will be training, our community partners and VR staff together. Again, we recommend that you use the PBA question form for today's presentation and then also we put the information if you have questions about Employment First Minnesota and where those questions would go. >> Evie: So thanks, everyone, for listening. I like what Dee Torgerson said is we're going to move forward on July 1st and it won't be perfect, but it's progress. So we'll be continuing to look at, like I said, the data, making changes, and collecting feedback. So I appreciate all of your feedback. So pass it off to Kim. >> Kim Babine: Thank you, Evie. Thank you, Sara. This is Kim again, and just building on what Evie mentioned, we -- even if we spent years thinking, you know, working on an E1 PBA or changes to the general PBA, there would still be things that we found after 40 you start it that we didn't anticipate. So we know that's going to happen, that's a known, and so we just will want to maintain good communication as it gets rolling. What are the questions, you know, are you running into road blocks here and there, we'll make adjustments as it makes sense and, you know especially in those initial, we'll be wanting to hear from you as -- and then we'll be doing more formal kind of comprehensive review as well. So know that it's not -- we know it's not going to be perfect. It's going to be good, and we'll make tweaks along the way if necessary. So thank you so much for that presentation, Evie and Sara. The link for the questions is in the chat and so we are going to take those questions now. I am going to -- I have a few to start out with. Let's start with a few for Chris McVey. One is, do you know when DHS is training county case workers about the E1 PBA framework and the MOU? That person had spoken with some case workers and contracted case workers in particular who were not familiar with this. 41 So, Chris. >> Chris: Yes, can you hear me, Kim? >> Kim Babine: Yes. >> Chris: Okay. So I know that on both the VRS side and SSB side as well as DHS, we are preparing training for our respective staff. And in the case of the VRS and SSB, we are developing training for VRS and SSB as well as some training that will come from Kim Babine's team and informed by other training that we're developing for our community partners. We also know that there is training that's in development on the DHS side that will be specific to case managers. It will follow to the T the documents that we've already created or that framework of explore, plan, find, and keep. And so while, you know, we do want to provide specific training to our respective staff about what our responsibilities are within that framework and supporting the person on a waiver who wants competitive integrated employment, it is my expectation, although I do not know the timing of when the training will come 42 out from DHS. I felt safe enough to be able to respond to you all with this question today and that I do know that it's in development. The training on the DEED VRS and SSB side will not be available July 1st, but we will be rolling out training that will be on demand and available to staff. We know that there's not going to be an initial onslaught of referrals more than likely that we'll see is and so it gives us a little bit of time to be able to prepare the training that we anticipate for VRS and SSB staff and I'm guessing the same is true that DHS in preparing their training for case managers and contracted case managers. Thanks. >> Kim Babine: Great. Thank you, Chris. This is Kim. This one is to Sara and Evie, I believe. So there's some questions around the placement plan. So I'm going to read them both. It was mentioned that the responsibility for placement plan summary was now going to be changing, and there was some communication -- or some confusion between whose responsibility it is. 43 So could you explain the elimination of that summary versus -- so elimination of placement plan summary versus PBA placement plan, and who's responsible for those. >> Evie: Yep, so that's a little bit confusing. A few years ago when we wrote some new procedures, you might remember the Next Gen that we went to for placement, based on that we had some procedures that we put in place. We had the placement plan meet along we do the placement plan, all the people have the rights and responsibilities on their, their roles and responsibilities, rather, and then after that meeting was done, we asked our providers to write up a summary on that meeting and extend to VRS. We found that that was not being done widely and that placement plan summary wasn't being done, so we're now asking our VRS staff to go into our case record of Workforce One and complete that summary. We still are going to look for that placement plan along with the invoice for that first milestone, but after that meeting we'll expect that our counselors will go back and as they've been doing widely, you know, putting in a case note on what happened at that meeting as a summary. 44 So that's basically what that is. For most of us it won't be a big change since not a lot of people were following that little piece but that's what that is about. >> Kim Babine: Thanks, Evie. This is Kim. Chris, back to you. If a person has a waiver and they lose their job, do they have to go be re-referred to VRS and go through the Find phase again, or can they work with their community partner to find another job without going through VRS again? >> Chris: Yeah, that's a really great question. And it's really to the individual. So I'm wanting each of us in our roles to be thinking about the person and where they're at in the process. So if we look at that engage, find, plan piece, if a person loses the job and they are, you know, say they're on their job for more than 90 days -- I mean, see all of these nuances factor in. Perhaps they've already been referred back to waiver funds for the ongoing employment, or it could be that their day 85 and they're moving back into job search. When it comes to whether they'd need to go through the 45 exploration or planning phase again, it is it really is specific to the person. Does the job goal still make sense? What were the conditions as to why the person did not -- the job was not maintained or retained? Were there issues where they needed to have specific skills training that they're missing? Was it due to any number of factors? And ultimately, you know, the VRS counselor is going to make decisions about, you know, kind of where that person's at and the next job goal. But it should all be informed by the team. First and foremost the person, the person on a waiver who has interests and skills and abilities and wants to be in competitive integrated employment, but also by other members of the team. So members of the team are enlarged, you know, when it comes to placement by are now joined by our waiver case managers. There may be other people that factor in and help to, you know, give information to that counselor about what some next steps should be. It is not an automatic that if the person loses the job that they have to go back to exploration or planning. It really is to the individual and the team decision, 46 but ultimately the counselor decision that's made. There may be services that are required that would benefit the person in exploring some other options in which case they would go back to planning and that would not be VRS's responsibility. So the information that I would share with all of you is that communication, tight teamwork is absolutely 100% the core piece of success for helping people on waivers move forward with their competitive integrated employment goals. So really when you take it to the person and where they're at and what they need and what they're saying they want, what were the circumstances of them being terminated, those are all factors that play into what's next for that person. Thanks. >> Kim Babine: Thanks, Chris. That's very helpful. I'm going to sneak in here and answer one. Lots of questions about the June 29th training! You will be get be an e-mail -- oh, sorry, this is Kim. You will be getting an e-mail with registration information for that. It is from 9:00 a.m. to noon, and it will be on Zoom. So June 29th, 9:00 a.m. to noon. 47 I'll be sending an e-mail that will go through our listserv and actually I might be able to copy and paste the registration information right here in the chat while we're talking too. But just know it will be coming out. All right. Then I'll turn it to Evie and Sara to talk about billing. With E1 PBA, do you bill at intake or do you bill for an intake or at 120 days, or both? Take it away. >> Sara: Sure. For billing for an E1 PBA you're going to bill at each of those milestones. So there will be after the milestone 1 is the placement plan, and so once you have the placement plan you'll send an invoice with the placement plan and that will be the first milestone payment. The second milestone as Evie had said could be that milestone 2 which will be first day of the job or it could be second milestone payment could be the E1 milestone payment at 120 days. But when you want to be paid you would submit your invoice and the most recent report that would follow that. 48 What VRS will look at is if all of those monthly progress reports have been submitted since the last invoice was paid. So it's a little hard to say because of the timing, but if it -- you have your milestone 1 payment and then the next payment that you're due is that E1 milestone at 120 days, you would submit an invoice for that E1 payment at 120 days with the most recent monthly progress report. VR would check to see that they had also received the other progress reports that have no payment. >> Kim Babine: Excellent. Thank you. All right. The next one I think is for Chris. And it -- add any detail, but what I understand, the question is can we add a question to our VRS application about if a person is on waiver, and the question of how do we figure that out. And what I understand from Amanda Jensen-Stahl is that DHS is working on a way so that VRS staff will be able to get that information. So it's in process. I don't think there's instructions, like this is how you do it right now, but I understand that they're 49 working on it so that we can have that information from our point of view. Chris, did you want to add anything to that? >> Chris: Yeah. Just from the VRS team perspective, I know that every rehab area manager is -- works with their team on how the referral process happens. Like when calls come in or contacts come in of someone who wants to apply for VRS services. We know with covid it's totally upended a lot of different way that's we typically make those connections. But absolutely we want to be thoughtful about when we have people that are calling in or someone calls in on their behalf. We're not looking to divide and say, oh, yep, you're a waiver person so it's this. It's really about tracking and understanding about who we have that are coming in and being referred to our agency and it helps us with data and helping to know like how many people we're serving and we -- but during that referral process where we're making a phone call to let's say a VR tech if it's a phone call or if there's some other mode of making that referral is that 50 we're not looking to separate or discriminate, you know, waiver or non-waiver. So I think internally we'll have some more discussion with our RA Ms about how best to make sure, let people know we're open for business but also to manage the flow of referrals that are coming in, whether they're waiver or they're not waiver. We are very aware that there could be a flood at some point, and not just a flood that occurs just throughout the state but maybe certain pockets of the state or certain offices might be seeing increases. And so just being really mindful and supporting our staff and supporting our R A Ms around what is that reasonableness of the numbers of referrals that counselors are seeing, serving, and supporting on a weekly basis or on a monthly basis. So more conversation that we need to have internally. Thank you. >> Kim Babine: Great. Thanks, Chris. Let's see. I am also going to jump in here because it's a one-word answer but Evie and Sara, feel free to jump in. Will the E1 PBA have an OCSS option for those who need it? 51 And the answer is yes, that can be a part of either -- or both the general PBA and the E1 PBA. Anything else, Sara and Evie? One-word answer? Okay. Sounds good. Someone also asked what is the hourly rate for job coaching? And there is not one set standardized statewide rate for job coaching, so for providers who currently have job coaching on their contract, it is whatever you have on your contract for if there's any potential providers who are on the line, that's something that is negotiated while we negotiate your contract. So that depends from contract to contract. Okay. So to Chris, do VRS's internal placement staff too do in-person job training and coaching? If not, would VRS placement staff be an informed choice option for consumers receiving waivered services? >> Chris: That's a great question. And one that we've been having discussion about as we're planning for the E1MN launch. When it comes to a person on a waiver wanting to have 52 consistent services throughout so that there's not unnecessary waits and stops and starts, there's also informed choice that plays in as well, what is the person interested in in terms of whether it's a community rehabilitation provider, maybe they say I want work with a man or I want to work with a woman. You know, we know we'll have folks that have some very set ideas on what they'd be most comfortable to work with. I can see that our placement coordinators may at times play a role, especially in areas where we don't have any service provision. Maybe that person's going to be waiting six months for -- to be able to served by a community partner in that area. In other areas of the state there are still pockets of the state where we have no capacity in that -- of our community partners to provide job development, placement, and initial support services. So really I believe that that is one of the key ways that we'll call on our internal placement coordinators to assist. The best case scenario is that we have our community partners that are both 245D licensed and have PT contracts with DEED so that there can be that full 53 spectrum of service and support that follows that person throughout exploration, planning, development -- planning, finding, and then keeping. So it depends is the answer, but bottom line is that we want to be able to stand in the gap where there's no services available or there would be a significant delay in the person getting access to services. Certainly if the person was served by the internal VRS placement coordinator for placement supports, we would want to as soon as possible bring on a community partner to provide those initial job coaching supports or prepare for the long-term supports. We do on occasion have our placement coordinators provide some intensive job coaching supports. Oftentimes this is relating to individuals with very specific needs based on their disability, but I'll also again when there's just nobody else available to provide the service, we know that there's a huge, huge gap in terms of the available job coaches. I want to just kind of like put a disclaimer in here, however that, since covid, March of 2020, no one from DEED VRS has been able to go out and meet with clients in-person, meet with businesses in-person, go to sites and provide that direct job coaching support. So until that lifts and we still don't know the timing 54 of that, we're relying on our community partners for all of that. So that's my answer. Thank you. >> Kim Babine: Thanks, Chris. Couple of questions on forms, I think they'll go to Evie or Evie and Sara. The first is why isn't the employment verification included on the job hire and 90-day retention forms instead of the communication updates or monthly progress reports? More interested about the timeliness of how that information is shared and then the follow-up -- another question is when will these beautiful forms be available, community partners needing to update their computer programs. >> Evie: So the forms will be available just before July 1st so we can start using them July 1st. The forms will have sections in them for the employment verification details. So we will have all of our requirements to pay an invoice that RSA requires us to collect employment information, you fill that out, we expect everyone to use our forms. If they're filled out, you'll have all the information 55 you need there for us to pay your invoice. We know that they're monthly forms so we don't want to wait, so this monthly progress report should not take the place of regular communication. So if someone gets a job, of course we want to know, we want to communicate back and forth with the waiver case manager, the counselor, the placement person, and the job seeker, we need to have that communication going all the time. So the monthly progress report will simply be a snapshot of the work for the month, and all of the details that we need to ensure that we're able to pay your invoices. >> Kim Babine: Thanks, Evie. This is Kim. Let's see. So a few questions around our new partner -- our refreshed partnership with VRS and lead agencies, counties, case managers, contracted case managers. So a few in this vein. The -- so I'll pause after each one and I'm not sure who the best one to answer is, so someone, Evie and Sara and Chris, jump in. With the addition of the case manager to the team, who is responsible for coordinating next meetings, calling 56 and updating new information, things like that? >> Chris: I can take that one. Initially prior to VRS and SSB being part of that team we fully expect that our community partners that have -- that are 245D licensed that have individuals that are not -- that want to move into competitive integrated employment but are either in center or they are with a crew in an enclave that they're likely going to know maybe even before case manager about the person's interests in moving forward. We believe that while the person is in that finding -- sorry, engaging and planning phase, that the case manager is in a lead role or they may say to the community partner we need you to be in a lead role to bring together the team. During that finding phase, we are looking to the VRS counselor to be the lead, and then making that leap over into the ongoing supports, which is the Keep part, would then bring it back to convene that case manager and placement -- sorry, case manager, community partner, and VRS/SSB at the table until the opponent that the person is moved back over to the waiver funds for long-term supports that the counselor would be in that lead capacity. 57 So whoever's leading in those areas, typically if we look at the explore, plan, find, keep, the case manager is the lead for those three areas and that one piece around development is counselor responsibility. I'll be really honest with you is that if it may not turn out to look that way. And we have examples in some counties where we have VRS counselors that are standing in the gap and providing leadership under their manager to coordinate, to bring to the table, encourage to the table the -- maybe the manager rather than the contracted case managers to try to get some semblance of how we're going to do this work, how people are going to be referred and that sort of thing. So we're not mandating how it happens, in terms of how it has to happen organically, but I would say just in terms of who's responsible for setting meetings it really is case manager or whoever they designate for explore, plan. While VRS has responsibility or SSB around placement and initial supports, that's our responsibility, and then moving it back to the county for long-term supports. >> Kim Babine: Thanks, Chris. So the next few are variations on that theme, but I'm 58 going to ask them individually just in case they hit on something different. So what happens if a waiver case manager is a no-show for an initial meeting? Will another meeting need to be held or is there some flexibility in those situations? >> Chris: We are veering off into coffee chat territory, but I'm going to say this. What's really, really important and that I have been listening ears to the ground a number of successes that have been happening. Because number one, VRS and SSB have been getting referrals from people -- for people who are on waivers for a long time. So this is not new in many ways, but what I hear from our VRS counselors is the secret to success is engaging the case manager at the table during the planning, during the placement process, and initially to say are you in regarding long-term supports. We don't need to have people in-person, we're not in-person, we're virtually, so we want to be flexible with our case managers, our partners about their availability. We know that they're stretched for time but it's 59 absolutely essential they be at the table for some key conversations and one of them is around the placement plan and the employment plan. And so we'll have much more to come about that. But I would say that if the case manager is not available for that meeting, you set another meeting because you -- it's absolutely essential that we have all members, and the paying members, those that are going to authorize funding and where it really counts especially, but you need the community partners as well, but you need the case managers and you need the VRS or SSB staff at the table with the person. Virtual table. >> Kim Babine: Thanks, Chris. This is Kim. Generally the point of the question here is that communication is important between VRS and the case manager and the community partner who's being used. And so the question is will there be a communication form to use for that communication between -- there are times when VR gets updates from participants and that doesn't always get to the community partner, so how do we best facilitate two-way communication? And I would say the short answer and then the other three can pipe in, but I liked what Chris said about 60 that, you know, some of this happening organically. So go ahead, Chris. >> Chris: Yeah, we don't want to prescribe -- I mean, so like one more form, one more document, we know how stressed and stretched everybody are. We already are. And we don't want to add more than what we've already been adding, and when we set expectations around that it can lead to, you know, that additional frustration and people like not remembering it or whatever. So what has to happen, you all, is that there has to be that communication so. Whatever the mode of communication that's set at a local level, whatever is agreed to at those planning meetings about how the communication is going to come, that's how it's going to come. And it will be up to the, you know, VRS and SSB, we have Workforce One, our staff can case note what the communication was. We can't over -- I mean, it's already quite bureaucratized as it is because we need to do this, certain pieces so that we can we can reflect the work that's being done. We don't want to overburden more than already exists additional forms. 61 So I would say that what works for the team is what works for the team. And it may be that there are some differences across providers or across case managers. But we just have to find ways to make that work at the local level so the person gets served. And I think that if we all, again, the lens is the person. And how do we need to communicate with one another about what we've heard or what's important for the other team members to know. Thanks. >> Kim Babine: Great. Thanks, Chris. Let's see. So there was another question on this, so regarding that communication that comes in on the monthly report or other information that we get from the community partner, how does that -- does the waiver case manager get that, and again, we're not being prescriptive but just everyone have in their mind it's a teaming approach in a way that we haven't done it before, but we need to be sure that we're doing that and we hope not to get more prescriptive but if necessary we could come up with some options but really just the idea is 62 try and keep, you know, keep everyone in the loop. This one's really specific and so it might be a ask the coffee chat, but will the counties provide information about guardianship when VRS receives the referral from them? >> Chris: So this is Chris, and I would say that when the individual is moving from the plan phase to the engage -- to the find phase, there is a packet of information that should follow the person that the community partner provides. And it's really the jumping off point for the person to start a job search or to write that plan that lays out what the job goal is. We are encouraging through the training that we've had with DHS and DEED around the Vault, around the availability of that. It's anticipated and expected that as a team, the case manager and VRS staff and then also our community partners share information that is going to be relevant to that person. Now, with the Vault, and I won't get into that, but it's a method and a way to store information that the person can share with entities without having to go through the whole getting these signed release sort of 63 thing. They can send it out themselves rather than it coming from one entity to the next. But it is my expectation that when we have partners working together, that that is something that we need to the VRS said and SSB side that our case managers, partners, would be able to provide for us. But more to come from the coffee chat. That's dangerously close to coffee chat material. >> This is Kim. Careful, Chris McVey. There was a question, and folks can feel free to jump in, but the question was around the change with the referral information that VRS provides to community partners and that assessment of VR needs. So I wanted to clarify that you will still be getting the information that you need to serve these individuals with the vocational goal, it's just going to come in a slightly different package. And so test it out, see how it goes. If there's something that's really a problem then of course let us know, but it should -- the plan, it will still give you the information that you need. So just in a little different form. Let's see. 64 There are some clarifications on authorizations and when those are -- when they change, when they don't. So just be in touch with your local office if you have any questions on that to clarify. Another question is since job coaching is being unbundled from PBAs, if the community partner doesn't currently have job coaching on their contract, how do we get that on our contract? And so, yes, if that is you, dear community partner, please contact -- so Sara Sundeen, Anne Paulson, we also have Janeen Oien and Jess Outhwaite who are on the community partnerships team and we will work with you to get that amendment done as quickly as possible. We know that that will be important by July 1st, it might not be exactly July 1 but we'll get it done as soon as possible. Just so you know all of those contract amendments not only have to be negotiated with you, then our DEED fiscal has to okay it and a lot of times they have strong feelings about what we amend, and so sometimes that's a negotiation, us on your behalf, really, and then goes for your signature, VRS's signature, VR director's signature, but then the last stop is the Office of State Procurement at the Department of Administration. 65 And July 1 is the state fiscal year start. And so -- and it's the end of a biennium which means all the contracts in the state need to -- so many of them need to be redone, so their workload is through the roof in June. And same with DEED fiscal, they're doing grants and contracts that are on that state fiscal year cycle. So contact us as soon as possible but also we will appreciate your patience as we get those through as quickly as we can. But, yes, it should go faster than it has in the past because now we have four community partnerships program specialists who are just working on this. That was my dog yawning if you heard that in the background. Okay. We are almost at time. We're going to do a couple more here, but stay tuned for other trainings and coffee chats and just hope that you can get on as many of those as possible in the coming days. O-- or in the coming week so that we get all these questions answered. Let's see. We put -- there's questions more about the coffee chat 66 when those are happening or where to find more information about that. Check out the chat there. Let's see. Sometimes people lose their waiver, they move, they're hospitalized, et cetera. What happens if a person loses a waiver during an E1 PBA? And I think that's a question that I don't think we've spent a lot of time considering. And so we'll add it to our to-do list to consider and it will be really important that VRS staff and others, and community partners communicate to us when that is happening so that we can make sure that we're responding appropriate -- you know, responding and making sure that we have that down. There was a question about considering a different milestone structure. So would you do a payment here or if we did this, could there be a payment here or if it's larger here and less here. And we appreciate those comments. Just know that we went through about a billion scenarios, what if we put a milestone here, and what if we put a payment here, and there's -- there were pros 67 and cons with any, and there are pros and cons with the one that we chose. And so we're going to do this one for now, we've landed here and again, we are going to be looking at how that goes, what's the data, what happens, is it really -- are providers really missing out on they need a payment here or incentive there. So we'll be looking at that and we'll change it if the -- kind of the information that we're receiving supports that. So I actually -- there's some other good questions and a lot of them are -- will be to be determined. So I'm not going to name them all now with the time that we have left. But Evie, Sara, Chris, do you have -- we'll wrap up now. Do you have any closing comments or last things that you'd like to say? >> Chris: This is Chris. I would just say thank you, everyone, both that are attending now but also maybe that are tuning in later. This is big change work as Kim had mentioned. We're a few years in and we have come a long ways and there's so much more to do. 68 So just appreciate everyone joining and seeking to understand and get a sense for what's coming, what is, where we're heading. So just thank you. Have a great Tuesday, feels like Monday. >> Kim Babine: Thanks, Chris. All right. Sara and Evie aren't coming off mute so we'll wrap up. Again, we are so grateful for all of you. We have the best partners, we have the best staff, and I think what we're doing is really exciting and it's because all of you are putting in the hard work so. Keep those questions coming, keep those comments coming so that we can keep shaping this and make it the best that it can be, so I hope you all had good Memorial Day and have a good start to -- continued start to the week. So thanks, everyone. Have a good day. We'll see you June 29th if not before. 69 DISCLAIMER This text is being provided in a lightly edited draft format and is the work product of the CART captioner. Any reproduction, publication, or other use of this CART file without the express written consent of the captioner is strictly prohibited. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility, and this lightly edited CART file may not be a totally verbatim record of the proceedings, nor should it be considered in any way as a certified document. Due to the live nature of the event, some names and/or terms may be misspelled. This text may also contain phonetic attempts at sounds and words that were spoken, and environmental sounds that occurred during the event.