24 Miss. Code. R. 2-24.5 - Supported Employment for Serious Mental Illness Service Requirements

A. Any person who determines that employment is a treatment goal must be referred to the Supported Employment Specialist. The agency provider must develop policies and procedures to design a referral system throughout the agency provider.

B. Supported Employment Services must:

1. Be individually tailored for each person to address the preferences and identified goals of each person.

2. Be mobile and develop relationships with local businesses to establish employment opportunities.

3. Be delivered in an ongoing rather than time-limited basis to aid the process of recovery and ensure permanent employment.

C. Supported Employment Specialists will conduct job discovery with each person served and find and maintain competitive work in the community. The Supported Employment Specialist and other members of the treatment team will offer on-going support to the person to help ensure that employment is maintained.

D. A vocational profile will be completed, updated, and maintained for each person utilizing the service.

E. Each Supported Employment Specialist carries out all phases of vocational services, including engagement, assessment, job placement, and follow-up before stepping down to less intensive employment support from another mental health practitioner.

F. Supported Employment Specialists serve as members of one (1) or two (2) mental health treatment teams from which a Supported Employment Specialist's caseload is comprised.

G. Supported Employment Specialists will attend mental health treatment team meetings and participate actively in treatment team meetings. The Supported Employment Specialist should help the team assess employment possibilities for people who have not been referred to Supported Employment Services.

H. The Supported Employment Specialist's office must be in close proximity to (or shared with) the specialist's mental health treatment team members.

I. The Supported Employment Specialist must communicate with the Mississippi Department of Rehabilitation Services/Office of Vocational Rehabilitation counselors at least monthly for the purpose of discussing shared people and identifying potential referrals. The Supported Employment Expansion Specialist will work directly with the local office of VR to make referrals for employment. The Supported Employment Specialist will assist with any required documentation that must be completed and sent to VR (VR referral form, vocational profile, and requested documentation).

J. The agency provider's quality assurance process includes an explicit internal review of the Supported Employment Service, or components of the service, at least every six (6) months through the use of the Supported Employment Fidelity Scale or until achieving high fidelity, and at least yearly thereafter by DMH. The agency provider's quality assurance process uses the results of the fidelity assessment to improve supported employment implementation and sustainability. The agency must provide Supported Employment according to fidelity, as determined by DMH.

K. Supported Employment Specialists or other mental health practitioners must offer people assistance in obtaining comprehensive, individualized work incentives planning by a specially trained work incentives planner prior to starting a job. They must also facilitate and document access to work incentives planning when people need to make decisions about changes in work hours and pay. People are provided information and assistance about reporting earnings to the Social Security Administration (SSA), housing programs, etc., depending on the person's benefits.

L. Supported Employment Specialists provide people with accurate information and assist with evaluating their choices to make an informed decision regarding what is revealed to the employer about having a disability. Supported Employment Specialists discuss and document specific information to be disclosed (e.g., disclose receiving mental health treatment or presence of a psychiatric diagnosis, difficulty with anxiety, or unemployed for a period of time, etc.) and offer examples of employer discussions. Supported Employment Specialists discuss disclosure on more than one (1) occasion (e.g., if people have not found employment after two (2) months or if people report difficulties on the job).

M. Supported Employment Specialists must complete an initial vocational assessment (which can occur over two - three (2-3) sessions), and information is documented on a vocational profile form which includes preferences, experiences, skills, current adjustment, strengths, personal contacts, etc. The vocational profile form is used to identify job types and work environments. The vocational profile form is updated with each new job experience. The assessment aims at problem solving using environmental assessments and consideration of reasonable accommodations. Sources of information include the person, treatment team, people's records, and with the person's permission, family members and previous employers. Supported Employment Specialists help people learn from each job experience and also work with the treatment team to analyze job loss, job problems, and job successes.

N. The initial employment assessment and first face-to-face employer contact must occur within one (1) month after services begin.

O. Employer contacts are based on the person's job preferences (relating to what they enjoy and their personal goals) and needs (including experience, ability, symptomatology, and health, etc., and how they affect a good job and setting match) rather than the job market (i.e., what jobs are readily available).

P. Each Supported Employment Specialist makes at least six (6) face-to-face employer contacts per week on behalf of the person desiring employment. An employer contact is counted even when a Supported Employment Specialist meets the same employer more than one (1) time in a week, and whether the person is present or not present. Person-specific and generic contacts are included. Employment Specialists must use a weekly tracking form to document employer contacts that is reviewed by the Supported Employment Supervisor on a weekly basis. Supported Employment Expansion Specialists must conduct employment contacts at least two (2) days per week on behalf of the project for people desiring employment. The Expansion Specialist must follow the tracking method as required for fidelity measurement.

Q. Supported Employment Specialists must build relationships with employers through multiple visits in person to learn the needs of the employer, convey what the Supported Employment Service offers to the employer, and describe people's strengths that are a good match for the employer.

R. Supported Employment Specialists must assist people in obtaining different types of jobs. Employment Specialists provide job options that are in different settings.

S. Supported Employment Specialists must assist people in obtaining jobs with different employers.

T. Supported Employment Specialists must provide competitive job options that have permanent status rather than temporary or time-limited status. Competitive jobs pay at least minimum wage and are jobs that anyone can apply for and are not set aside for people with disabilities. (Seasonal jobs and jobs from temporary agencies that other community members use are counted as competitive jobs).

U. People must receive different types of support that are based on the job, people's preferences, work history, needs, etc. These supports are individualized and ongoing. Employment Specialists also provide employer support (e.g., educational information, job accommodations) at people's request. The Employment Specialist helps people migrate to more preferable jobs and also helps people with school or certified training programs.

V. Supported Employment Specialists must have face-to-face contact with people within one (1) week before starting a job, within three (3) business days after starting a job, weekly for the first month, and at least monthly for a year or more, as desired by the person. People will be transitioned to step down job supports from a mental health worker following steady employment.

W. Vocational services such as engagement, job finding, and follow-along supports are provided in natural community settings. Supported Employment Specialists must spend seventy percent (70%) or more time in the community. Supported Employment Expansion Specialists must provide follow-along supports (vocational assessment and support service's needs [appointment, medication, etc.]) in the office or community setting as required by the project.

X. Assertive engagement and outreach must be implemented by an integrated treatment team. There must be evidence that all six (6) strategies for engagement and outreach are used:

1. Service termination is not based on missed appointments or fixed time limits.

2. Systematic documentation of outreach attempts.

3. Engagement and outreach attempts made by integrated team members.

4. Multiple home/community visits.

5. Coordinated visits by the Employment Specialist with integrated team members.

6. Connection with family, when applicable.

Y. Agency providers should organize and utilize Community Business Advisory Boards as part of their community engagement and outreach efforts. At least one (1) member of the agency provider's executive team must actively participate on the Board. Meetings must occur at least every six (6) months for high fidelity services and at least quarterly for services that have not yet achieved high fidelity.

Z. Agency providers should adhere to data and record keeping requirements for Good IPS Fidelity (according to DMH-established guidelines).

Notes

24 Miss. Code. R. 2-24.5

Miss. Code Ann. § 41-4-7

Adopted 7/1/2016 Amended 9/1/2020 Amended 11/1/2024