Long-Term Supports Using an Employee - Directed Approach to Supported Employment.

Supported employment is a unique vocational rehabilitation service option because it seeks to establish and maintain consistent services and work supports over the longevity of an individual's employment tenure. The notion of terminating services at case closure goes against the very premise of this employment service model. Long-term supports, also called extended services, are those ongoing supports designed to help an individual maintain employment stability and achieve career growth. In an employee-directed approach, long-term supports are designed to assist the rehabilitation consumer in the identification and provision of supports and extended services that maintain and enhance the persons's position as a valued member of the work force. This process requires the matching of employment work supports and funded services with the individualized support needs and preference of the employee with a significant disability.

Before analyzing in detail the specifics of employee-directed long-term supports, it is important to note the rapidly expanding use of supported employment among vocational rehabilitation offices and other agencies and programs. The Rehabilitation Act Amendments of 1986 added supported employment to the formal list of service options for use by state vocational rehabilitation agencies. It also added Title VI, Part C to provide formula grant funds to each state VR agency for the acquisition of supported employment services (Wehman, Kregel, & Shafer, 1989).

Since the passage of the 1986 Amendments, participation in supported employment nationally has grown from approximately 10,000 individuals with disabilities in Fiscal Year 1986 to over 139,000 in Fiscal Year 1995. The number of supported employment providers agencies has grown from 324 in FY 1986 to approximately 3,7000 in FY 1995 (Wehman, Revell, & Kregel, 1997). Supported employment services, by providing individualized work supports and assistance both at and away from the job site, have become a primary national resource for assisting persons with the most significant disabilities to work successfully in competitive employment.

There is also clear evidence that consumers of vocational rehabilitation services are increasingly turning to supported employment while decreasing their use of sheltered employment services. Table 1 is a comparison of costs and outcomes for persons closed by state vocational rehabilitation agencies in Fiscal Years 1994 and 1995.

Table 1

Comparison of Costs and Outcomes for Cases Closed in Status 26 by Vocational Rehabilitation Agencies in Sheltered or Supported Employment in Fiscal Years 1994 and 1995

                         Sheltered       Sheltered
                        Employment      Employment
                         Status at       Status at
                       Closure FY 94   Closure FY 95

Number of Status 26        8,888           8,481
Closures

Mean Cost of VR           $3,508          $3,361
Services per Closure

Weekly Earnings at        $55.32          $58.10
Closure

Hourly Earnings at         $2.03           $2.18
Closure

Hours Worked per            27.3            26.9
Week at Closure

                         Supported       Supported
                        Employment      Employment
                         Status at       Status at
                       Closure FY 94   Closure FY 95

Number of Status 26        13,950          18,142
Closures

Mean Cost of VR            $4,763          $4,691
Services per Closure

Weekly Earnings at        $112.00         $114.00
Closure

Hourly Earnings at          $4.48           $4.62
Closure

Hours Worked per               25            24.3
Week at Closure

Data Source: Rehabilitated Cases in Selected Work Status at Closure, FY 1994 and FY 1995. Rehabilitation Services Administration, US Department of Education, Washington, D.C.

In FY 1995, 18, 142 individual cases were closed working in supported employment, representing a 30% increase from 1994 supported employment total. The number of individual cases closed working in supported employment in FY 1995 more than doubled the total closed working that year in sheltered employment. As demonstrated in Table 1, the mean wages received in FY 1995 through supported employment, at a rate of $4.62 per hour and $114 per week, were approximately twice the comparable wages received through sheltered employment (Rehabilitation Services Administration; 1996, 1997). The outcomes achieved by participants of supported employment services and the return on public expenditures by people with significant disabilities becoming tax payers are important factors contributing to the success of supported employment as an employment service option for persons with the most severe disabilities.

Although the specific techniques involved in developing an effective, employee-directed, long-term support plan is supported employment's most unique and complex characteristic, these techniques represent the least analyzed, discussed, and researched feature of supported employment. Research efforts to date on long-term supports tend to concentrate on issues such as managing a caseload, staff development, and interagency cooperation (Griffin, Test, Dalton, & Wood, 1995); funding designs that inhibit or encourage the provision of consumer responsive services (West, Johnson, Cone, Hernandez, & Revell, In Press); long term support resource alternatives (Albin & Slovic, 1994); and the use of self-management and natural supports in achieving job retention (West, 1992; Hagner, 1995). The professional literature to date has not considered in detail the best practices involved in effectively integrating a variety of options and resources within a long-term support plan guided by an employee with a significant disability.

Initiation of long-term supports begins once the new employee demonstrates job stability by consistently completing required job duties under the conditions of the natural work environment, at a performance level acceptable to the employer. Primary examples of the most frequently provided long-term supports include: 1) monitoring the work performance, including work quality and work rate, and socialization of the supported employment participant; 2) crisis intervention; 3) delivering support training for the employee/coworkers; and 4) facilitating job changes and career movement (West et al, In Press). To be effective, long-term supports must focus on the changing needs of the employee and be built upon the work that has occurred prior to this final, ongoing phase of supported employment. Specifically, the success of long-term supports depends on an organizational commitment from the point of job development to gathering needed information, building supportive relationships with the employer and coworkers while providing the employment site with prescriptive training, and delivering and/or utilizing necessary community and workplace services and supports.

Vital to the success and expansion of supported employment is the critical need to expand and, in some cases, change its vision of long-term supports in response to an ever increasing field of technology and work support options. Supported employment participants, employers, and employment specialists now have access to an enhanced array of possible support options that include new low and high assistive technology options, creative community and workplace supports, federal work incentives, personal assistance services, person-centered planning techniques, and vouchers. However, these exciting options have increased the complexity of designing employee-responsive plans that result in the systematic delivery and timely evaluation of the identified supports. It is therefore the purpose of this paper to review the best practices in long-term supports within a framework of employee-directed planning, development, implementation, and evaluation. The remainder of this paper focuses on assisting employment specialists and rehabilitation counselors turn these best practices into daily practices.

Identifying Employee-Directed Long Term Supports

Long-term support services are imperative for persons with significant disabilities to ensure their participation in the competitive work force, as well as career advancement. The nature, amount, and intensity of support will vary among individuals and businesses. Generally, supports fall into one of two categories: 1) employment specific supports, and 2) individual or community supports.

Employment supports are those supports and/or services that are directly related to the employee's job. These supports may include training to enhance work quality or productivity, service coordination, orientation and mobility, employer and/or coworker support, and assistive technology.

In comparison, individual and community supports are arranged and delivered away from the workplace. These supports address issues that negatively affect employment stability if left unresolved. Supports provided outside of the workplace include assistance with housing and/or personal living situations, use of leisure time, financial support, transportation, and relationships.

Employee-directed long-term supports, whether employer specific or more community-oriented in nature, place the individual with a disability in control of the process. Seven focal points guide the employment specialist in utilizing long-term supports that assist the supported employment participant in reaching personal career goals. These focal points include satisfaction appraisal, expanding job responsibilities, careers, monitoring and coordinating supports, employee assistance programs, employment mentors, and funding support and services (Brooke, Revell, & Green, 1997). Each point is presented from a best practice perspective in the discussion that follows.

1. Satisfaction Appraisal

Maintaining regular contact with the employee (supported employment participant), as well as the supervisor and coworkers at the job site, is vital to long-term success. Establishing a plan for regular communication will allow the employment specialist and the employee to be proactive in their approach to new situations and events. Satisfaction with the present level of service must be evaluated at both the employee and the supervisor levels.

Employee Satisfaction. Regular discussions with the employee, both at and away from the job site, regarding satisfaction and contentment with work will yield the best information. Supported employment participants with very limited language should not be excluded from these discussions, since they are able to express satisfaction, as well as dissatisfaction, through facial expressions and behavior. The employment specialist, with guidance from the supported employment participant, can also meet and talk with the important people in the individual's life. Yet, conducting face-to-face interviews is only one way to gather important information. The employment specialist can make unobtrusive observations at the job site to review coworker and supervisor interactions, confirm job duty analysis, verify production, and review personal leave records. Each of these sources can be rich in data and assist in the development of a proactive plan for support.

Supervisor Satisfaction. In the event that evaluation is a regular part of the business establishment's procedures, the supported employment program should adhere to the company's plan. Additional meetings between the employment specialist, employee, and supervisor should occur regularly during the early phase of long-term supports to solicit everyone's input and degree of satisfaction. Initially, these meetings will take the form of weekly job site visits and informal checks, provided everything is going well. This contact should gradually fade to the mandatory twice monthly contacts or other appropriate schedule as determined by the individual's needs and requests.

2. Expanding Job Responsibilities

In many cases, a new employee with a significant disability and no work experience may be hired to perform a limited work scope. Yet, after working for several months, the now-experienced employee may be ready to expand upon original job duties. Generally, employees who enjoy a long tenure with a company will have their job duties or work responsibilities increased or expanded over time. This occurs naturally as employees seek to add variety to their daily routine and as employers begin to learn individual employee strengths.

When job expansion occurs, the employee and employer may ask the employment specialist to return to the job site for a period of time. Depending upon the needs of the employee, support may be required in the area of job reorganization, scheduling, skill acquisition, and/or production. It is important to remember that the decision to expand job duties is based upon the employee's desire and ability to increase the present work scope and the company's need or interest to increase work performance.

Becoming a valued member of a company's work force should be a goal of all employees. A willingness on the part of the supported employment participant to accept expanded job responsibilities is an excellent way to become a highly valued worker. Expanding job responsibilities is an excellent way to accomplish this goal. However, successful job expansion usually requires adjustments in the long-term support plan. The employment specialist must commit to anticipating and planning for these supports from the point of hire. Typically, the most successful employment situations are those that have coworkers and employers provide the needed support and assistance directly to the supported employment participant. The employment specialist must continue to work with the individual to analyze and select the most feasible support option and to evaluate the effectiveness of the type and level of support provided.

3. Careers

Supported employment is not just about obtaining and maintaining a job. It is about identifying and pursuing a career. This career process begins during the customer profile and job acquisition phases of supported employment and remains a focal point throughout the entire process. During the long-term supports phase, the supported employment participant reconvenes the employment support team, consisting of individuals who are close to the new employee and who were actively involved during job seeking and employment selection phases of supported employment, to identify and evaluate future work that needs accomplishing. Part of this process will include revisiting or reevaluating previously identified career interests, dreams, and goals.

An individual who obtains the "right job," in the "right company," on the first try is extremely rare. Generally, an individual who is new to the labor market or who is attempting to reenter the labor force after an injury will seek to gain several different work experiences over a period of time. The accumulated work history is then used to identify career goals. However, career development is only one reason why a person accepts an employment position. There are numerous other reasons, not the least of which is a paycheck. Therefore, while a supported employment participant may accept an employment position and perform well at his or her job, additional career supports may be necessary. When supported employment programs ask participants to envision and identify career interests and desires, there is an obligation and responsibility to follow-up with each individual. On-going supports must be offered to determine if aspirations and career interests are being met or if personal goals and interests have changed.

4. Monitoring & Coordination of Supports

The development of strategies that ensure the maintenance of past, present, and future supports is vital to the continuing job success of the supported employment participant. Regardless of the type and number of supports that are in place throughout the individual's employment tenure, provisions for the extended coordination and monitoring of the supports must occur. Developing a well-established plan for long-term supports with the employee ensures that the necessary supports are maintained.

Many different factors can affect the quality and stability of an established support, including changes in the employee's needs and preferences, a new supervisor, the resignation of coworkers, and change or redesign in a workstation. Change in any one of these critical areas could result in an interruption of work routine or quality. When these issues are left unaddressed, job termination can occur. Monitoring and coordination of a support plan includes the following key features: documentation of support need, identification of need area, confirmation of need status, description of potential options to meet need, substantiation of employee support option preference, selection of primary support, designation of back-up support, and identification of additional resources.

5. Employee Assistance Programs

Employee Assistance Programs (EAP) have been part of the corporate world since the latter part of the 19th century. However, it was not until the 1970s that these programs broadened their range of service options and began to develop comprehensive plans for company employees. Today, EAPs have developed a variety of services to include child/elder care, retirement options, fitness and health maintenance programs, counseling, and drug or AIDS testing and supports. In general, EAPs can be described as company supports for employees in resolving personal and family issues. These programs offer assistance and in some cases, a remedy designed to support workers in maintaining that delicate balance of roles and responsibilities between work and home life.

While EAPs appear to be a valuable resource for many supported employment participants, these programs remain underutilized by employees with significant disabilities. By providing these services to all employees, EAPs have the potential to reduce the stigma that may be associated with a local disability organization designed to provide many of the same services. In addition, using EAPs can serve to increase the integration of supported employment participants into the general employee population and potentially increase the range of services offered.

Typically, EAP service information is disseminated during an employee orientation meeting or simply handed to the employee when tax forms are signed. For many individuals, the information will not be provided in an accessible format and, therefore, is often discarded. The employment specialist can assist by including EAPs as a potential source for many vital work place supports. However, follow-up investigation should occur to determine the strengths and limitations of each support option available through the EAP. This will provide an opportunity for the supported employment participant to direct this process and to make proactive decisions regarding the use of EAP services.

6. Employment Mentor

Business settings are dynamic, making change inevitable. The job of the employment specialist is to work with the employee to plan for predictable changes in the employment setting. New management is one of the most predictable changes that will occur in most job settings. Therefore, it is critical to understand why this factor can lead to the termination of an employee.

If the supported employment participant and the employment specialist have been successful, the employer will be an integral partner in the employee's career. In most situations, the employer has received supported employment marketing materials, agreed to a thorough job analysis, hired the new employee, assisted in problem solving work issues, and observed the skill acquisition process. In general, the employer takes on a mentoring role with the supported employment participant. This important factor is the result of the establishment of excellent rapport among the employer, the employee, and the employment specialist.

As with any partnership or teamwork situation, the loss of a valued member of the employment group has a serious impact on the remaining members. Therefore, strategies need to be developed to reduce the potential negative side effects of a change in management and/or mentor.

One of the best strategies that an employment specialist can develop is maintaining a strong communication network with the employer. Sharing issues and concerns with the mentor-employer regarding change of management and its impact on the employment stability of the supported employment participant is an important first step. This should be done in all cases, even in employment situations where the potential for management transfer or job change appears remote. Begin by requesting that the employer inform the employee and/or employment specialist when a transfer is being discussed or scheduled. Generally, a two-week notice allows the employee and the employment specialist to develop a plan. A variety of creative strategies can be developed and implemented to address this change. However, it will be important to ensure that the strategies match the corporate culture and are respectful of the new mentor's time. Therefore, when developing strategies, include the mentor in the planning process.

7. Funding Supports & Services

Obtaining and maintaining funding for long-term, supported employment services is an important and complex issue. A wide variety of services and funding approaches are possible for the long-term supports component of supported employment, often referred to as "extended services" by state vocational rehabilitation services. Combinations of these approaches are increasingly used across states and within local communities by individuals with disabilities and employment service providers as alternative funds and/or services are identified.

Differences in individual support needs and funding resources will require creativity in how and from whom services are purchased and provided. Diversity and flexibility within approaches to long-term supports facilitates access to new dollars, use of nontraditional resources, and expansion of ongoing service capacity. Essentially, funding models come in all different shapes and sizes and are typically tied to the mission, goals, and objectives of supported employment organizations and/or agencies.

Vocational rehabilitation (VR) dollars made available through the Rehabilitation Act can pay for supported employment services until the employee is stabilized in employment, but these funds cannot be used for long-term supports. State vocational rehabilitation agencies define supported employment stabilization in many different ways; however, it is generally related to the achievement of the Individual Written Rehabilitation Program (IWRP) goals and the employee's ability to maintain work performance with limited assistance from the employment specialist. Yet, a level of continuous assistance is always maintained in supported employment to include a minimum of at least twice monthly checks from the employment specialist. A resourceful supported employment service provider will need to develop multiple funding sources to assist in maintaining supports and services at a level necessary to successfully maintain employment satisfaction among participants.

In order to meet the growing demand for long-term supports and services, new sources of funding must be identified and utilized. All existing service funding must be reanalyzed to determine if resources, services, and funding can be redirected for the funding of long-term supports. This needs to occur at all levels to help ensure a quality service.

Implementation Strategies

The employment specialist must consider many factors when providing long-term supports to persons with significant disabilities. Regardless of the employee's type or level of disability, the employment specialist should stay abreast of employee satisfaction, employer satisfaction, expansion of job duties, career goals, coordination of supports, mentors, employee assistance programs, and funding. The following portion of this article will provide strategies for implementing long-term supports using an employee-directed approach to supported employment.

Developing a Plan

The employment specialist can use formal and informal methods to develop a long term support plan. Informal methods may include conversations with the employee, supervisor, coworkers, and family members, as well as any additional individuals who have agreed to provide supports either at or away from the job site. Formal records should also exist that describe past, present, and future areas of the employee's needs, as well as strategies for supports. Once developed, these records must be maintained throughout the individual's employment tenure.

Identification of Employee's Needs

The process of identifying a community access or support need begins by engaging the employee in discussions to document personal preferences, concerns, and future directions. The employee's career plan, developed prior to employment, will be an important tool to guide these discussions. This employment plan should contain career goals and objectives, as well as the names of people who have expressed an interest in supporting the individual to achieve personal ambitions. The supported employment participant can reconvene his or her employment support team throughout the long-term support phase of supported employment to celebrate successes and to provide needed supports.

At this point of employment tenure the employer and coworkers have become part of the individual's support team as contributing team members. If this has not occurred, the employment specialist and employee must determine the employer's and coworkers' perceptions of current and future support needs by, for example, arranging a meeting to obtain this information. The supported employment participant's full participation in discussions about employment support needs is an important component in the employee-directed process. Therefore, it is very important for the employee to lead or, if that individual is not interested in leading, at least attend any meeting with the employer to ensure personal views are represented. Setting this expectation will reduce possible confusion for the employer related to the employee's role and responsibility.

Brainstorming Options

Once past, present, and future supports have been documented, it is time to begin the process of brainstorming possible options for each of the current needs on the list. This can be accomplished by organizing a small group of interested individuals to participate in a brainstorming meeting. The objective of the session is to generate as many ideas as possible for the identified support needs.

The location of the meeting is left up to the supported employment participant. However, the supported employment organization's meeting room is not recommended. The idea is to make this a planning session of support, not an evaluation of the individual. The group accepts all ideas through a creative and unlimiting process.

If it is impossible to organize a small group to brainstorm solutions, then the employee and the employment specialist can work together to review and build upon all resources that were identified prior to employment. In addition, the supported employment participant should list all currently utilized supports. Family members should be approached to determine other possible ideas for support options. Finally, it is critical to analyze the supports offered by the employment setting. The employee, employment specialist, and employer can generate a list of options.

Choosing a Support Option

Once a comprehensive list is generated, it is time for the employee to select the preferred support option(s). The employment specialist can begin this process by reviewing and explaining each of the support options that appear on the list. Regardless of the individual's disability, it is useful to have concrete examples and experiences to assist in making a choice. As the employment specialist, employer, and/or others participating in the process review each option, an unbiased attempt should be made to give the pros, cons, and consequences of each choice. This would assist the employee in rank-ordering the options in a most to least favorable hierarchy. Many factors will influence the selection process, such as the immediate availability of the support and the ability to identify primary and backup plans specific to each high-ranking support option identified by the employee.

If key support persons did not participate in the meeting, the employment specialist should contact each person involved to determine their interest in providing support. Many times, individuals will express an interest in providing assistance. However, it is the employment specialist's responsibility to ensure that the support person understands and accepts the responsibility. The employment specialist needs to provide the assistance that is requested by the employee, as well as additional supports necessary to ensure success.

Determining Level of Support

Determining the level of support needed by the employee will be critically important in selecting the support option and/or the method of delivering the support or service. The overall guiding rule governing all interactions is to move from the least intrusive to the most intrusive level of support. An employment specialist should not provide any more assistance than the employee actually needs. This same philosophy should guide interactions when selecting long-term supports and services.

Sometimes the needed level of a long-term support is hard to determine because the identification of a support or service is in response to a presenting problem or crisis. Once the plan is implemented, the employment specialist must monitor the situation closely. Careful evaluation of the plan will be critical for long-term success.

Long Term Supports Case Study

In Brad's junior year of high school, he sustained a brain injury. Following his injury, he dropped out of high school and did not return to obtain his diploma. As a result of the injury, Brad experienced a variety of cognitive disabilities, including short-term memory difficulties, impulsive behavior, and mobility challenges. During Brad's nine month rehabilitation, he progressed from using a wheelchair to walking with a cane. Currently, he walks very slowly and experiences poor balance; however, he is not interested in using assistive mobility devices.

Prior to his injury, Brad worked part-time as a gas station attendant. After dropping out of high school, Brad found employment at several different community businesses. Each job situation lasted between one to three months before Brad quit or was fired by his employer. Some of the reasons which were given for terminating employment included change of residence, better job, and verbal aggression towards the employer.

For the past six months, while receiving the assistance of supported employment services, Brad has worked successfully as a parking attendant. Brad experienced minor obstacles learning the necessary skills associated with his job and reached 100% accuracy by the third week of employment. However, Brad has dealt with a variety of support issues that have a direct impact on his work attitude, quality, and production to include: 1) financial concerns; 2) domestic difficulties; 3) taking instruction from female co-workers; 4) inappropriate touching of female employees; and 5) verbal aggression when under pressure.

Brad is currently satisfied with his employment situation, and his employer just gave him an above average employee performance evaluation. Brad's vocational rehabilitation counselor has talked to him about terminating services due to his consistent work performance. In preparation for closing his state vocational rehabilitation (VR) case, Brad called a meeting of his employment support group. The group included his girlfriend, mother, father, neighbor, employer, a coworker, rehabilitation counselor, and his employment specialist. Under Brad's direction, his employment support group developed the long-term support plan presented in Figure 1.

Figure 1 Brad's Long-Term Support Plan

A. Identified Need: Financial Concerns

(1) For the three months Brad has not had money to pay his share
    of the monthly rent.

(2) Social Security will need to be informed when Brad's income
    changes.

(3) Adaptive devices can be purchased by using Social Security
    Work Incentive Program.

A. Potential Options: Financial Concerns

(1) Budgeting support persons: girlfriend, brother, employment
    specialist, or Uncle John (banker).

(2) Social Security: Brad or Brad's father sends a form letter,
    designed by the employment specialist, to Social Security
    with a copy of Brad's most recent pay stub.

A. Employee Preference: Financial Concerns

(1) Brad would like his brother to assist him with the
    development of a budget. The least acceptable option is for
    his girlfriend, mother, or father to know how much money
    he has or the amount of his bills.

(2) Brad will contact Social Security when his income increases
    or decreases.

(3) Employment specialist will assist Brad to access Social
    Security Work Incentive Program, if needed.

A. Primary Support: Financial Concerns

Brad's brother, Jack Smith 980-1651, has agreed to develop a
monthly budget with Brad and pay bills with him on the 1st and
the 15th of every month.

A. Back-up Support: Financial Concerns

The employment specialist, Martha Stone, can be reached through
her beeper number at 770-8900. Leave a voice message and she
will provide back-up support to Brad and his brother as needed.

A. Status (check one):

-- Past
-- Present
-- Future

Identification of Funding Sources (check one):

-- Title 19            -- SSA (attached)
-- Medicaid            -- VR State Funding
-- MR/MH/DD Services   Other Specify: --

B. Identified Need: Domestic Difficulties

Three months ago Brad moved from his parent's home into an
apartment with his girlfriend and her 9 year old daughter. Some
domestic difficulties have been related to:

(1) Sharing household expenses

(2) Respecting people's need for privacy

(3) Using vulgar language

B. Potential Options: Domestic Difficulties

(1) Obtain counseling support from a local clinic.

(2) Ask for family support from mother or father.

(3) Get together with mutual friends who are in relationships
    to discuss relationships.

(4) Look into Employee Assistance Programs at work.

B. Employee Preference: Domestic Difficulties

Brad agreed to check out EAP services at his place of employment.
In addition, Brad and his girlfriend have agreed to check out
support from a local clinic and talk with friends who are in
similar living situations.

B. Primary Support: Domestic Difficulties

EAP, Personnel Office, 2114 Drake Street, or local clinic at 1925
Chester Street, 828-2194. Brad and his girlfriend deal
independently with domestic issues.

B. Back-Up Support: Domestic Difficulties

The employment specialist will provide support for accessing
information if Brad has any trouble. Martha Stone's beeper number
is 770-8900 (leave a voice mail message).

B. Status (check one):

-- Past
-- Present
-- Future

B. Identification of Funding Source (check one):

-- Title 19            -- Title 19
-- Medicaid            -- Medicaid
-- MR/MH/DD Services   Other Specify: --

C. Identified Need: Taking instruction from a female coworker,
inappropriate touching of female coworker and verbal
aggression when under pressure.

Two months ago, Brad had an incident where he refused to listen
to a coworker who was relaying a message from his employer. On
the same day the female coworker yelled at Brad after he touched
her back side in the employee break room. To date, Brad's verbal
aggression has been limited to the one occasion with the same
female.

C. Potential Options: Taking instruction from a female coworker,
inappropriate touching of female coworker and verbal aggression
when under pressure.

(1) Set up a mentor program to address employee and customer
    relations.

(2) Sign a contract with a clear company consequence.

(3) Find a job where Brad does not have any female coworkers.

C. Employee Preference: Taking instruction from a female
coworker, inappropriate touching of female coworker and verbal
aggression when under pressure.

(1) Enter a mentor program.

C. Primary Support: Taking instruction from a female coworker,
inappropriate touching of female coworker and verbal aggression
when under pressure.

(1) Employer, Mark Adams: 817-2231

(2) Coworker, Jack Smith: 817-2259

(3) Mentoring will begin two weeks form today with a
    weekly evaluation.

C. Back-Up Support: Taking instruction from a female coworker,
inappropriate touching of female coworker and verbal
aggression when under pressure.

The employment specialist will assist providing training to
the mentor.

C. Status (check one):

-- Past
-- Present
-- Future

C. Identification of Funding Source (check one)

-- Title 19            -- SSA (attached)
-- Medicaid            -- VR State Funding
-- MR/MH/DD Services   Other Specify: --

Key to the development of Brad's Long-term Support Plan (Figure 1) was a strong and committed employment support team of persons truly interested in assisting Brad achieve competitive employment success. During one support team meeting, members assisted Brad in identifying possible supports and then proceeded to rank order these options from least to most intrusive, with Brad selecting the option of choice. The form used in Figure 1 is a very useful tool for identifying, selecting, and tracking long-term supports.

Summary

In some supported employment programs, the individual who provides the initial support services to the new employee may not be the person who assists during the long-term supports component. Charting all successful and unsuccessful supports, services, and strategies from the beginning of employment will help to ensure that there is a smooth transition for the employee when there is a change in employment specialist. It is important to note that at some point in time the employee may resign or be terminated from employment. When this occurs, it can be very beneficial to conduct an exit interview. During this time, the supported employment participant, employer, program manager, rehabilitation counselor, and employment specialist can review the entire employment experience to determine the events that led to job separation. This information may be useful for the individual and employment specialist as they develop strategies for future employment opportunities. Using this type of process the supported employment participant, the supported employment service provider, and the rehabilitation counselor have an opportunity to voice concerns, issues, and possibly dissatisfaction with the services in an attempt to shape future outcomes.

References

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Wehman, P., Kregel, J., & Shafer, M.S. (1989). Emerging trends in national supported employment initiative: A preliminary analysis pf twenty-seven states. Richmond, VA: Virginia Commonwealth University-Rehabilitation Research and Training Center on Supported Employment.

West, M. (1992). Job retention: Toward vocational competence, self-management, and natural supports. In P. Wehman, P. Sale, & W. Parent (Eds,), Supported employment, Strategies for integration of workers with disabilities (pp. 176-203). Stoneham, MA: Andover Medical Publishers.

West, M. Johnson, A., Cone, A., Hernandez, A., & Revell, G. (In Press). Extended employment support: Analysis of implementation and funding issues. Education and Training in Mental Retardation and Developmental Disabilities.

Valerie Brooke Grant Revell Howard Green Virginia Commonwealth University

Valerie Brooke, Virginia Commonwealth University Rehabilitation Research and Training Center on Supported Employment, P.O. Box 842011, Richmond, VA 232843