Competitive Integrated Employment (CIE)

Employment First Policies come in various forms — legislation, executive orders, and state plans. Regardless of the form, an effective Employment First policy defines CIE and describes the roles of various state agencies and partners to achieve CIE as a choice for people with disabilities.

• Employment First Community of Practice (E1st CoP) Webinar Series — This webinar series provides Employment First technical assistance. E1st CoP participants benefit from national subject matter experts (SMEs) presenting information and resources to support Employment First efforts.
• The LEAD Center — The National Center on Leadership for the Employment and Economic Advancement of People with Disabilities (LEAD Center) helps states, workforce development professionals, and American Job Centers implement the Workforce Innovation and Opportunity Act (WIOA) to advance employment success for Americans with disabilities, while helping employers hire and retain skilled workers.
• Criteria for Performance Excellence in Employment First State Systems Change & Provider Transformation — The EFSLMP developed a set of criteria to help states and service delivery systems successfully implement systems change within a comprehensive Employment First strategic framework. A blended approach of top-down systems-change strategies, combined with community-based capacity building activities initiated by key stakeholders, is critical to the successful implementation of an Employment First strategic framework.

Rate reimbursement restructuring requires states to determine which employment services they incentivize and which they do not. To increase CIE choices, rates may need to be revised to promote employment services that result in CIE.

• Medicaid Buy-in Q & A — Created collaboratively by the Administration for Community Living (ACL), Centers for Medicare & Medicaid Services (CMS) and ODEP, this guide answers questions on Medicaid Buy-in programs. Medicaid Buy-in is an optional Medicaid eligibility group that allows workers with disabilities with income above traditional limits to access Medicaid community-based services.
• Value, Outcome, and Performance-Based Payment Methodologies to Advance CIE: A Three-Part Webinar Series — ODEP hosted a three-part webinar series highlighting strategies that states and their systems used to enact Medicaid rates that incentivized services leading to CIE opportunities.

Capacity building is the creation of policy and funding priorities that promote CIE choices along with community agencies with skilled personnel to deliver supported and customized employment to individuals with disabilities. Building capacity at the state level requires (but is not limited to) funding priorities, use of outcome data, skilled personnel, and leadership from federal and state agencies.

• Staffing to Provide CIE — This webinar, presented by Employment First SME Rick McAllister, discusses the recruitment, development, and retention of staff who will effectively promote CIE.
• Most Integrated Employment Setting — State Self-Assessment — This tool helps governors and state administrations understand and voluntarily meet their obligations to provide publicly-funded employment and non-work day services to persons with disabilities.

Interagency coordination means that state agencies and other partners serving people with disabilities work together seamlessly. To increase coordination and collaboration, some states sign formal memorandums of understanding (MOUs), but other states find that a comprehensive state plan to increase CIE opportunities can achieve interagency coordination.

• Blending, Braiding, and Sequencing (BBS) — BBS are innovative strategies to maximize the efficient and effective use of federal funds across systems for supporting individuals with disabilities to secure CIE opportunities and maintain them.
• Guide for Creating Successful MOUs — This guide provides a step-by-step process that walks agencies through MOU development by illustrating who should be at the table, key areas to include in an MOU, strategies for completing the MOU, and tips for implementing it effectively.
• Model Cooperative Agreements Between VR Agency and Medicaid, Mental Health, and Intellectual and Developmental Disabilities Agencies — The model MOU can serve as a template for vocational rehabilitation (VR) and other agencies to use when discussing and negotiating MOUs with state partners from mental health, intellectual and developmental disabilities, and Medicaid agencies.

Provider Transformation is the realignment of a disability service provider's agency business model to increase focus on providing more CIE choices for the people with disabilities they serve. Provider transformation is a gradual process that starts with the disability service provider partnering with the local state agencies followed by a self-assessment.

• Transforming Employment Services from Sheltered Work to CIE for Job Seekers with Disabilities — This brief focuses on how ODEP assists states in achieving provider transformation to increase the number of people with disabilities working in CIE.

Employer engagement involves engaging with businesses and employers on disability employment, with emphasis on individuals with learning/developmental disabilities and other significant disabilities. It specifically recognizes that effective marketing to promote disability employment includes featuring businesses that successfully recruit, hire, and retain employees with disabilities and share their experiences with other businesses.

• Customized Employment and Discovery — Customized employment can be a tool that leads to CIE when the relationship between employee and employer is personalized in a way that meets the needs of both. It is a universal strategy that benefits many people, including disabled people who might not have found employment success through other employment strategies. Discovery is the foundation for securing customized employment.

Increasing CIE choices for people with mental health conditions requires identifying specific applications of Medicaid and other funds and joining them with services necessary for working-age people who use mental health supports for other life needs that must be addressed to pursue employment. Expanding best practices such as the Individual Placement and Support (IPS) model of supported employment can help streamline the various funding sources. 

• IPS for People with Co-Occurring Substance Use Disorder — This issue brief examines challenges and effective strategies for helping job seekers with mental health conditions and co-occurring substance use disorders.
• Cost-Effectiveness of IPS — This issue brief explores whether the benefits of IPS are worth the costs. It provides a nontechnical description of several types of economic analyses, statistics on the direct costs of IPS services, a summary of published economic analyses of IPS, and a discussion of key areas of IPS impact on costs.
• State-Level Barriers and Facilitators to IPS Implementation — This issue brief uses the findings from a 2019 national survey of state mental health and VR leaders to help state leaders identify common barriers and facilitators to implementing IPS-supported employment and strategies to overcome the barriers, leading to successful implementation, maintenance, and growth of IPS programs.

Seamless transition is the transition of youth with disabilities from school to CIE with a clear career path.

• The Implications of WIOA for Seamless Transition for Youth with Significant Disabilities — This webinar dives into employment transition under seamless transition and its application.
• Seamless Transition from School to CIE: The Oregon Story — This webinar explores the SME and state perspectives on Oregon’s work through its Employment First State Leadership Mentoring Program to help youth transition to CIE.
• Seamless Transition from School to CIE — State Examples from Michigan and Utah — This webinar explores the process Michigan used to develop an MOU between multiple state agencies to support the transition to employment for students and youth with disabilities, the process Michigan is using to develop pilot sites to demonstrate a single transition design, and how to leverage resources and gain buy-in from state partners when developing seamless transition models.

Data and information systems that collect and report a number of important pieces of information about employment and integration outcomes are important in helping states understand where they are and where they need to go.

• Participant Individual Record Layout (PIRL) Data Visualization Tool — There are 10 required disability-related data elements for WIOA adult, dislocated worker, and youth. Explore data by region, state, and county, in addition to other variables such as type of participant and services received.
• PIRL Disability Elements: Focus on Data Quality — Access to quality data makes good policy possible and workforce services accessible for everyone. This webinar discusses strategies for improving the quality of the WIOA disability-related reporting elements.
• WIOA Reporting Tips — While voluntary, all participants seeking services from within American Job Centers have the opportunity to indicate whether they have a disability. View tip-sheets that provide descriptions of the 10 disability-related data elements and guidance on how to record them.
• Understanding WIOA Disability-Related Reporting: Tools for Data Visualization — In part one of this two-part webinar series by the LEAD Center, presenters share an online interactive data visualization tool that helps states and local areas better understand the comprehensiveness of their disability-related reporting. It also discusses Wisconsin's workforce system practices and how they benefit programs, employers, and participants with disabilities.
• WIOA Disability-Related Reporting: A Deep Dive into the PIRL — In part two of this two-part webinar series by the LEAD Center, presenters discuss the definitions and coding for each of the 10 disability-related PIRL data elements, why to collect this data, and how it benefits participants and programs. Additionally, Wisconsin’s Department of Workforce Development highlights best practices related to their case management system, guidance for their local areas, and staff training.