7 Long Term Supports 
Long term supports represents one of 
the least analyzed, discussed, and researched 
components of supported employment. Yet, it 
remains one of supported employment’s most 
unique and distinguishing features. Unlike 
other rehabilitation service options, the notion 
of terminating services at case closure, is never 
discussed in supported employment. Rather, 
supported employment seeks to establish and 
maintain consistent services and support over 
the longevity of an individual’s employment 
tenure. 
By definition, once a new employee is 
able to complete his or her job duties under the 
conditions of the natural environment, he or she 
moves into the final phase of supported employment 
known as long term supports. Long 
term supports are dependent upon the work 
that has occurred prior to this final phase of 
supported employment and focuses on the 
changing needs of the employee. Specifically, 
the information that has been gathered, relationships 
that have been built, training that has 
been conducted, services that have been 
delivered, and supports that have been utilized 
will determine the success or failure of this 
phase. At times, the customer and employment 
specialist will wait until the initiation of fading 
assistance, either at or away from the job site, 
to discuss and plan for long term supports. If 
this happens, then it becomes extremely probable 
that there will be difficulty for the customer, 
employer, and/or employment specialist 
during this phase. Fading assistance and instituting 
critical long term supports are two concepts 
that must be discussed from the very 
beginning of employment. 
Today, supported employment is 
governed by new regulations and an ever 
increasing field of technology and support 
options. These options have expanded, and in 
some cases, changed our vision of long term 
supports. Supported employment customers, 
employers, and employment specialists now 
have access to an enhanced array of possible 
support options. These include new low and 
high assistive technology options, creative 
community and work place supports, federal 
work incentives, personal assistance services, 
person-centered planning techniques, and 
vouchers. However, these exciting options 
have increased the complexity of designing well 
developed plans of supports. In addition, 
establishing techniques for the systematic 
delivery and evaluation of the identified supports 
are of critical importance. 
The remaining section of this chapter 
will focus on the best practices associated with 
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planning, delivering, and evaluating the effectiveness 
of long term supports. Approaches, 
strategies, and techniques will be discussed to 
assist employment specialists in turning best 
practices into daily practices. 
B EST PRACTICES 
Long term support services are imperative 
for persons with significant disabilities 
to ensure their participation in today’s work 
force and career advancement. The nature and 
amount of support will vary from person to 
person and business to business. Factors that 
influence both the level and the type of supports 
that are ultimately used by a customer are 
related to employment satisfaction, expanding 
job duties, and career development in a variety 
of corporate cultures. 
The type and intensity of support required 
typically will change during an individual’s 
employment tenure with a specific 
company. 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. This may include such services as 
training, service coordination, orientation and 
mobility, employer and/or co-worker sup-port, 
and assistive technology. Individual and 
community supports are supports that are 
arranged and delivered away from the workplace. 
They include areas that, if left unresolved, 
directly or indirectly impact 
employment stability. Supports in this category 
include housing and/or personal living 
situation, leisure, financial support, transportation, 
and relationships. Using research data 
from the Rehabilitation Research and Training 
Center on Supported Employment, the 
following table lists primary reasons for providing 
long terms supports. The items are 
arranged by the type of support provided most 
frequently during this phase of supported 
employment. 
PRIMARY REASONS FOR 
PROVIDING LONG TERM 
SUPPORTS 
1. Monitor work performance including 
work quality and work rate. 
2. Facilitate job changes and career 
movement. 
3. Crisis intervention. 
4. Monitor socialization and overall integration. 
5. Support training for employer and/ 
or co-workers. 
6. Retraining of previously learned 
skills. 
7. Assess job satisfaction. 
8. Training in new skills. 
9. Support to family. 
10. Assess employer satisfaction. 
S ATISFACTION APPRAISAL 
Maintaining regular contact with both the 
supported employee, as well as the supervisor 
and co-workers at the job site will be vital to 
long term success. Establishing a plan for 
regular communication will allow the 
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employment specialist and the customer to be 
proactive in their approach to new situations 
and events. Life is a series of changes for all of 
us and employment is no exception. Business 
environments do not remain stable: supervisors 
leave; co-workers get transferred, building 
renovations occur, new equipment is bought, 
and work routines and job assignments change. 
Change is inevitable and should be embraced as 
positive. Quality services dictate that an 
employment specialist works closely with 
customers to plan for some of the predictable 
changes and to establish back-up plans and 
communication strategies for success. 
Employee Satisfaction 
Regular discussions with the customer, 
both at and away from the job site, regarding 
satisfaction and contentment with work will 
yield the best information. Customers 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 direction from the 
customer, also can meet and talk with the important 
people in the individual’s life. 
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 
Once the individual has moved into the 
long term supports phase of supported employment, 
it should be clear which supervisor has 
authority over employee performance and review. 
After identifying the supervisor, the 
format and schedule for the company’s employees’ 
performance review process should be 
determined. In the event that evaluation is a 
regular part of the business establishment, the 
supported employment program should adhere 
to the typical company schedule. Additional 
meetings between the employment specialist, 
customer, 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 informal checks and will occur 
approximately every 2 weeks, if everything is 
going well. This contact should gradually fade 
to the mandatory twice monthly contacts or 
other appropriate schedule as determined by the 
needs and requests of each customer. 
E XPANDING JOB 
RESPONSIBILITIES 
In many cases, a new employee with a 
significant disability who has never worked 
before may be hired to perform a limited work 
scope. Yet, after working for several months, 
the now-experienced employee may be ready to 
expand her or his 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 
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begin to assess individual employee strengths. 
Employers will match and delegate new job 
responsibilities to their work force as the 
business grows and improves. A business 
should not view a customer associated with a 
supported employment program differently than 
any other employee. However, adding new job 
duties or responsibilities to an existing work 
routine may prove problematic for some 
individuals. 
Approaching the expansion of job duties 
from a proactive stand point can prevent 
employee and employer frustration. The employment 
specialist can initiate these discussions 
with the customer and employer, and as 
a team identify areas for future expansion. 
Assisting the customer in developing a list of 
possible areas for growth gives the individual 
support to direct his or her career path and stay 
focused on goals and objectives rather than on 
a single job. 
When job expansion occurs, the customer 
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, 
she or he may require assistance with 
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 his or her present work scope and 
the company’s need or interest to increase work 
performance. 
Becoming a valued member of a company’s 
work force is important to all supported 
employment customers. Expanding job responsibilities 
is an excellent way to accomplish this 
goal. However, this requires a commitment on 
the part of the employment specialist to be 
thinking about this from the point of hire. 
Typically, the most successful placements are 
the ones which have co-workers and employers 
providing the needed support and assistance 
directly to the customer. Yet, the employment 
specialist must continue to work with the individual 
to analyze support options, to select the 
most feasible ones, and then to evaluate the 
effectiveness of the type and level of support 
provided. 
C AREERS 
As discussed in the previous sections of 
this manual, 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 customer reconvenes her or 
his employment support team to identify and 
evaluate further work that needs accomplishing. 
Part of this process will include revisiting 
or re-evaluating previously identified 
career interests, dreams, and goals. 
An individual who obtains the “right 
job”, in the “right company”, and on the first try 
is extremely rare. Generally, an individual who 
is new to the labor market or who is attempting 
to re-enter the labor force after an injury will 
seek to gain several different work experiences 
over a period of time. The ac-cumulated work 
history is then used to identify 
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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 these is a paycheck. 
Therefore, while a supported employment 
customer may accept an employment 
position and perform well at his or her job, 
additional career supports may be necessary. 
When supported employment programs ask 
customers to dream and to identify career interests 
and desires, there is an obligation and 
responsibility to follow-up with each customer. 
On-going supports must be offered to determine 
if dreams and career interests are being 
met or if personal goals and interests have 
changed. 
For example, Mary Beth, a supported 
employment customer, accepted a position at a 
local grocery store; however, her dream was to 
work at a health spa. After working for several 
months at the grocery store, Mary Beth decided 
that she really liked her job and had become 
aware of many employment opportunities 
available within the store chain. At a follow-up 
employment meeting she shared new dreams 
and career aspirations and together the employee 
and employment specialist discussed 
potential career interests with her current employer. 
They developed a new plan for career 
advancement that was included as part of Mary 
Beth's long term support plan. 
ONITORING & COORDINATION 
OF SUPPORTS M
The development of strategies that ensure 
the maintenance of past, present, and 
future supports is vital to the continuing job 
success of supported employment customers. 
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 customer 
ensures that the necessary supports are 
maintained. 
There are many different factors that can 
affect the quality and stability of an established 
support to include changes in a customer's 
needs and preferences, a new super-visor, coworkers 
resigning, change or re-design in a 
workstation, and so forth. Change in any one 
of these critical areas could result in an 
interruption of work routine or work quality. 
When these issues are left unaddressed, job 
termination can occur. 
Key features of a long term support plan 
include clear delineation of responsibilities, 
specific schedule for monitoring, and a stable 
point of contact that can temporarily provide 
services to the customer in the event that a 
community or work place support becomes ineffective. 
Vital to this plan is the careful 
documentation of pertinent customer-specific 
information such as identification of necessary 
supports, status of the supports, list of 
potential options to meet the needs, customer 
preference, including a primary and a backup, 
and, if necessary, additional support resource. 
Typi-cally, the employment specialist, working 
with the customer, serves as the stable point of 
contact for all long term supports. The 
following table overviews key ingredients for a 
long term support plan. 
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FEATURES OF A LONG TERM 
SUPPORT PLAN 
1. Documentation of Support Need 
2. Identification of Need Areas 
3. Confirmation of Current Status of 
Needs 
4. Description of Potential Options to 
Meet Needs 
5. Substantiation of Customer Support 
Option Preference 
6. Selection of Primary Support 
7. Designation of Back-up Support 
8. Identification of Additional Resources 
MPLOYEE ASSISTANCE 
PROGRAMS E 
Employee Assistance Programs (EAP) 
have been part of the corporate world since the 
latter part of the 19th century. However, it 
wasn’t until the 1970's 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, 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 customers in supported employment, 
these programs remain under-utilized 
by employees with significant disa-bilities. 
Providing these services to all em-ployees, 
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 customers 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 cus-tomers, the 
information will not be provided in an accessible 
format and therefore is often discarded. The 
employment specialist can assist the customer 
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 oppor-tunity for the customer to 
direct this process and to make proactive 
decisions regarding the use of EAP services 
prior to the need arising. 
Yet, in the case of most employees, 
EAP information and services are typically left 
undiscovered until an employee has an immedate 
need for a particular service. This was the 
case for Jane, a thirty year old woman who sustained 
a brain injury as a result of a car accident. 
Jane had been a supported employment 
customer working for a large national retail 
corporation as a gift wrapper when a co-worker 
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and the employment specialist noticed a marked 
change in her behavior. Some of the behavioral 
changes that were noted included a pattern of 
mood swings, weight loss, and an inability to 
focus on her job duties. The em-ployment 
specialist spoke to Jane and her sister about this 
behavior pattern. As a result of this meeting, 
they agreed to contact the county mental health 
and substance abuse program which Jane had 
attended sporadically for sub-stance abuse 
services. 
On the following day Jane’s co-workers 
presented her with a packet of information 
about the company’s EAP. Listed among the 
array of available services was psychotherapy 
and substance abuse counseling. In the end, 
Jane decided that she would use her company’s 
EAP services, because they were provided at a 
local medical center and were part of her 
employee benefit package. 
E MPLOYMENT MENTOR 
As discussed earlier in this section, 
business settings are dynamic. Change is going 
to occur. 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. Before reviewing strategies for a proactive 
approach to dealing with new management, 
it is critical to understand why this factor 
can lead to the termination of a customer. 
If the customer and the employment 
specialist have been successful, the employer 
will be an integral partner in the customer’s 
employment. In most situations, the manager 
has received the supported employment 
marketing materials, agreed to a thorough job 
analysis, hired the customer, assisted in problem 
solving work issues, and observed the skill 
acquisition process. In general, the manager 
takes on a mentoring role with the customer. 
This is an important factor and is the product of 
establishing an excellent rapport between the 
manager, the employee, and the employment 
specialist. 
As with any partnership or team-work 
situation, when a valued member of the group 
leaves, the loss has a serious impact on the 
remaining members. This is clearly the situation 
in supported employment. Many employment 
specialists refer to a customer’s supervisor 
as the employment mentor or job site 
advocate. This is not surprising for all the 
reasons that were listed above. Therefore, 
strategies need to be developed to reduce the 
loss and 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 
manager. Sharing issues and concerns with the 
mentor-manager regarding change of management 
and its impact on the employment stability 
of the customer, 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 manager inform the 
customer and/or employment specialist when a 
transfer is being discussed or 
211
is scheduled. If this happens with approximately 
two weeks notice the customer and the 
employment specialist can work together 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 manager's 
time. Therefore, when developing strategies, 
do not leave the mentor-manager out of the 
planning process. The following is a process 
that has proven to be useful for many supported 
employment customers who have been confronted 
with the loss of an employment mentor. 
CHANGE OF MANAGEMENT 
1. Ask the manager for ideas on 
addressing this issue. 
2. Ensure that all supervisor evaluations 
have been filed in personnel file. 
3. Ask the “old” manager to write a letter 
of recommendation. 
4. Develop a plan for marketing supported 
employment to the new 
manager. 
5. Develop brief packets of supported 
employment materials. 
6. Implement plan during the manager’s 
first week on the job. 
7. Evaluate effects of marketing plan. 
8. Revise plan as needed. 
UNDING SUPPORTS & 
SERVICES F 
Obtaining and maintaining funding for the 
long term supports and services of a customer 
in supported employment is an important and 
complex issue. Funding of long term supports 
is important, because it ultimately determines 
the retention strategies that are utilized for 
supporting the career advance-ment of a 
supported employment customer. In addition, 
funding is an extremely complex issue, because 
it requires collaboration among local, state, and 
federal agencies. 
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 
customers and individual providers as alternative 
resources are identified. 
natural resources can reduce the burden on any 
service system or provider. Yet, using these 
resources successfully necessitates flexi-bility in 
service and funding structures due to policy and 
procedural differences across funding resources. 
This will mean adjustments in activities, service 
fees, or payment ap-proaches for supported 
employment service providers. 
A wide variety of services and funding 
Utilizing a mixture of new, existing, and 
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 non-traditional 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 sup- 
212
ported employment organizations and/or 
agencies. Key to establishing the appropriate 
mix of long terms supports with customers is 
understanding the following five concepts defining 
a successful employment experience. 
SUCCESSFUL EMPLOYMENT 
EXPERIENCES INCLUDES: 
1. Satisfying Work; 
2. Mutually Enjoyable and Supportive 
Relationships; 
3. Career Advancement; 
4. Improved Resources; and 
5. Reduced Reliance on the Service 
System. 
Federal vocational rehabilitation (VR) 
dollars are the largest single source of funding 
for supported employment services. These 
funds are typically used to pay for the initial 
training phase and continue until the supported 
employment customer reaches employment 
stabilization. The Rehabilitation Act restricts the 
use of these funds for long term supports. 
State vocational rehabilitation agencies define 
supported employment stabilization in many 
different ways across the country. Essen-tially, 
stabilization and ultimately VR case closure will 
be related to the achievement of the Individual 
Written Rehabilitation Program (IWRP) goals 
and the customer’s ability to maintain 
employment performance with limited 
assistance from the employment specialist. 
However, a level of continuous assistance is 
maintained for at least twice monthly checks 
from the employment specialist. A resourceful 
supported employment service provider will 
need to develop a multiple of funding sources to 
assist in maintaining supports and services at 
the level that is necessary to successfully 
maintain employment satisfaction among 
customers. 
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 
re-analyzed to determine if resources, services, 
and funding can be re-directed for the funding 
of long term supports. This needs to occur at 
all levels of government and service delivery. 
The following two examples demonstrate how 
this can be done on a service level and a state 
level. 
Case Study Examples of Redirecting 
Services and Resources 
Case Study: Redirection of 
Organizational Resources 
Mark, his employment specialist, and 
the supported employment program manager 
realized that Mark’s long term support needs 
would, at times, be greater than his financial resources 
(PASS and other community supports). 
They recognized that other funding would be 
needed. The day program that Mark attended 
prior to employment had two staff responsible 
for 15 individuals. This support generally 
occurred at the program site, but individual offsite 
services had been provided on occasion. 
The day program is funded by the local mental 
health/mental retardation agency which pur- 
213
chases days of attendance by individuals. 
Mark’s funding averaged about 12 days per 
month. The organization decided that these 
funds could be used to purchase 3 hours a week 
of day program support staff time for Mark. 
This support would be provided away from 
Mark’s employment site, but was necessary for 
maintaining employment. These funds would 
be coordinated to supplement job coaching 
services covered by his PASS. 
(Rheinheimer et al., 1993) 
F 
Case Study: Redirection of State 
Level Resources and Funding 
In the early 1990's, the state of Oregon 
recognized the need to expand the long term 
support options for supported employment customers. 
To accomplish this goal, the State 
Developmental Disability office incorporated 
strong policy language for integrated employment 
as the option of choice. Long term supports 
were determined as a priority area along 
with the proactive encouragement for the conversion 
of segregated facilities to integrated 
community employment. Many different steps 
have been taken to encourage and support these 
policy decisions to include the redirection of 
funds to provide for incentives grants aimed at 
facilitating partnerships with providers, statewide 
forums on long term supports, and the 
development of flexible funding and service 
arrangements with providers. 
(M. Holsapple, personal 
communication, 11/16/96). 
UNDING SOURCE 
DESCRIPTIONS 
To effectively serve supported employment 
customers, employment specialists must 
become extremely knowledgeable about the 
vast array of possible funding sources and the 
strengths and weaknesses of each resource. 
Developing this knowledge base will allow the 
employment specialist and customer to select 
the best combination of long term support 
resources that specifically match the customer’s 
needs. Identifying and utilizing alternative 
resources involves the work of many individuals. 
There remains no single source of 
funding which supports everyone in need. This 
would be neither practical nor advisable. 
Collaboration efforts are essential for the 
ultimate growth of funding and resources. This 
section presents some overview information on 
an array of possible funding sources, a short 
description of each, and specific advantages and 
possible limitations of each identified funding 
resources. 
State Mental Health Mental 
Retardation Agencies 
The State Mental Health Mental Retardation 
Agency is the single most significant 
contributor to long term funding of supported 
employment services. The growth in these 
funds has been dramatic over the last several 
years. Continued growth will be found in 
reallocating existing resources to supported 
employment by defining integrated employment 
as the option of choice. The funds 
214
available through this agency are the traditional 
source of long term funding for people with 
mental retardation, mental illness, and other 
developmental disabilities. Funds cannot be 
accessed by persons who do not experience a 
developmental disability (i.e., brain injury, 
physical disability, sensory disability). 
Medicaid Home and Community-Based 
Waiver Program 
This program is a waiver, applied for 
by states, that allows federal Medicaid money 
to be spent on community-based rather than 
institutionally-based services. The states must 
pay a match percentage that varies from state to 
state, from 20% to 50%. To be eligible an 
indi-vidual with developmental disabilities 
must have been institutionalized in the past. 
This program is the largest source of 
federal funding for on-going specialized 
services to people with developmental disabilities. 
It can be used for initial training or 
long term supports. Many fears and myths 
exist about the program, such as complexity 
and predictability. 
Social Security Work Incentives — Plan 
for Achieving Self-Support (PASS) and 
Impairment-Related Work 
Expenses (IRWE) 
These work incentives are available 
through the Social Security Administration. 
They allow a person with a disability to set 
aside income or resources to pay for costs 
associated with reaching an educational or 
vocational objective. For example, funds may 
be used for paying job coaches. 
IRWE’s are job-related expenses that 
enable an individual to work. PASS & IRWE 
can assist an individual to purchase employment 
supports. Having the power to purchase 
services gives an individual greater control of 
the service and reduces the reliance on other 
funding systems. These incentives offer a possible 
alternative for purchasing long term services 
for individuals who are on waiting lists 
and who have no other funding sources. 
Individuals must make enough money 
to warrant the use of the incentives and the 
plans have to be approved by Social Security. 
Sometimes it is easier to use a PASS plan for 
initial job placement than for long-term support, 
since it is time limited. 
State Legislatures 
Some states have been successful and 
effective in securing funds from their legislatures 
by developing advocacy coalitions to 
request funding for supported employment. 
Legislators are interested in letters and calls 
from their constituency as well as good, 
reliable data to support requests. Collaboration 
among advocacy groups is important to avoid 
mixed messages and to ensure a successful 
outcome. 
Once the legislation is passed and funds 
have been allocated in the state budget bills, 
funding is usually stable. It also allows the 
state rehabilitation agency to assist with long 
term supports for underserved populations such 
as individuals with physical or sensory disabilities. 
Some states are continuing to face 
serious shortages and limited resources at a 
time when most states do not want to raise 
taxes to cover the additional costs. In some 
215
areas, coalitions are hard to build and 
legislative contact is a time consuming process 
for everyone concerned. 
Job Training Partnership Act 
This program is designed to reduce welfare 
dependency and increase employment and 
earnings of youth, unskilled adults, the 
economically disadvantaged, individuals with 
disabilities, and others facing serious barriers 
to em-ployment. Funding is available at the 
local level through the Private Industry 
Councils (PIC’s) to establish job assistance and 
training programs. 
Once supported employment programs 
have a contract and are showing successful outcomes, 
funding usually continues. Programs 
can use the money for job coach salaries and 
provide initial training, as well as follow-up 
services. However, there are no assurances of 
funding from year to year. Funding decisions 
are based on the needs of the locality and 
amount of dollars from the federal government. 
Business Supports 
Companies are gaining greater experience 
in dealing with a more diverse work force. 
Employers are becoming aware of the wise 
investment of hiring individuals with disabilities. 
Employers who make decisions that they can 
train individuals, re-structure jobs, and manage 
the day-to-day activities of employees with 
disabilities, typically rely on the employment 
specialist as a consultant. Supports that are 
provided by the employer to other employees 
should also be extended to workers with 
disabilities (Employee Assistance Programs). 
If the customer can access business 
supports, then typically he or she will require 
less intervention from the external service system. 
Generally, this increases reliance on coworkers, 
and produces a “typical” work environment 
for the worker with a disability. 
However, some employers might not be able to 
handle the array of supports needed by some 
workers with significant disabilities. Back-up 
plans must not be overlooked by the rehabilitation 
and provider agency representatives. 
Community Supports 
There are numerous community 
resources which can be tapped for assistance 
with long term supports for individuals with 
severe disabilities in supported employment. 
Churches, volunteer groups and agencies, college 
internship programs, local transportation 
funds, civic groups, friends and neighbors are 
all local supports to explore for assistance. A 
positive feature of using community supports is 
that they are local and exist to be of assistance 
to individuals who have specific needs. Rules 
and eligibility issues usually are not a problem. 
When identifying a community support, 
the employment specialist needs to realize that 
some local community programs have limited 
resources and serve only a particular group. 
Centers for Independent Living 
In the 1980's federal funds were given 
to state rehabilitation agencies to assist people 
with disabilities to become more independent 
in their lives, including vocationally. Funds 
are available through the Federal Rehabilitation 
Act, Title VII-A, B,& C. Title A is to be used 
to establish Independent Living State Coun- 
216
cils. Title B is for services. Title C is for the 
establishment of Independent Living Centers 
(ILC). Each local ILC board decides how the 
funds are spent, and who will be served. Title 
B funds can be allocated for supported employment 
services for individuals with disabilities. 
This is a good source of local funds for 
supported employment and long term support 
services. If approved by the local board, any 
disability group may be approved for services. 
However, Centers for Independent Living have 
to gain their board’s approval to provide employment 
services. Some ILC’s don’t have an 
abundance of funds, and may show resistance 
using the funds for supported employment 
services. 
Small Business Tax Credit 
This tax credit is for small businesses 
which incur expenses for providing access to 
individuals with disabilities. The amount of 
credit is 50% of eligible expenses for the year 
that are more than $250 but not more than 
$10,250. The maximum amount of credit is 
$5,000 per year. Eligible small businesses are 
those with either $1 million or less in gross receipts 
for the preceding tax year, or 30 or fewer 
full-time employees during the preceding tax 
year. Businesses can recover some cost of providing 
a coach, mentor, assistant, etc. to a person 
with a severe disability at the job site. 
Previously unused credit may be used in an 
earlier or later year, but not before a tax year 
ending November 5, 1990. 
Education Resources 
State and federal dollars are available 
through vocational and technical programs and 
adult basic education programs. The Carl D. 
Perkins Vocational Education and Applied 
Technology Education Act of 1990 offers states 
opportunities to assure equal access to vocational 
programs for students with disabilities. 
This program offers a wide range of integrated 
and supportive services to help individuals 
obtain and/or maintain employment. 
Curriculum can be adjusted. Training activities 
can make it possible to use vocational 
education dollars to provide long term supported 
employment services. However, rules 
and administrative policies sometime make it 
difficult for students with disabilities to access 
these funds. 
Private and Community 
Foundations 
Many private foundations across the 
country provide grants to service organizations 
for program development, education, and employment. 
Some are more interested in start-up 
activities, but many are interested in long term 
success, follow-up activities, career enhancement 
and business assistance to entrepreneurs 
with disabilities. Community foundations are 
not as abundant but are available in some areas. 
Foundations are supported by private donations 
and public interest and may be more willing to 
fund risky projects than private foundations. 
Private and community foundations can 
be excellent sources for start-up costs while 
exploring other long term resources. A variety 
of projects can be funded with these dollars. 
Some are geared to a specific target group and 
selected geographic areas. The research and 
development of these resources requires a large 
217
amount of time from staff. 
Private Rehabilitation and 
Insurance 
Individuals who are injured workers 
may be paid up to a year while receiving 
training and support in order to return to productive 
activity. Insurance companies that 
want individuals to return to work quickly may 
deliver their own vocational services or purchase 
them from other agencies such as a supported 
employment provider. If there is settlement 
of a case, there could be a life-care plan 
which includes supported employment 
services. 
The duration of services for an individual can 
be over a period of years. Settlement costs 
could cover long term supported employment 
for the life of one person. 
Private insurance companies may not 
understand the role of supported employment 
service providers. Insurance may push for 
quick results and not care as much about 
quality and customer choice. 
Veteran’s Administration Special 
Training Benefits 
The Veteran’s Administration has funds 
for training known as “Special Training Benefits.” 
These benefits are for disabled veterans 
and children of disabled or deceased veterans. 
Each VA office has a rehabilitation specialists 
who understands this program. VA will fund 
long term support until an individual reaches 
95% independence from an employment 
specialist presence. The money is paid to the 
individual who then pays the support provider 
directly. This arrangement gives the individual 
more choice in selecting a vendor. Some VA 
offices may not be familiar with supported 
employment. Time may be needed to secure 
approval and there may be a four year time 
limit. 
Federal and State Assistance 
Financial assistance for various projects 
are available from the state, federal, and 
sometimes local government. Federal grants 
can be written to offer technical assistance, or 
develop and demonstrate new approaches for 
long term supports. State agencies provide incentive 
monies for pilot projects which demonstrate 
innovative strategies that can be 
replicated across the state. The Developmental 
Disabilities Planning Councils, State Rehabilitation 
Agencies, and Mental Health & Mental 
Retardation Agencies are examples of federal 
and state programs. 
Funding is available for creative approaches 
and usually spans long periods of 
time. After initial funding, services can be built 
into other existing delivery mechanisms. This 
requires a cooperative effort between agencies 
and local organizations. However, keeping 
abreast of available grants and possible requests 
for proposals with varying due dates is time 
consuming. 
TRATEGIES FOR 
IMPLEMENTATION 
The employment specialist must 
S 
consider many factors when providing long 
term supports to persons with significant 
disabilities. Regardless of the customer's type 
or level of disability, the employment specialist 
should stay abreast of customer satisfaction, 
218
employer satisfaction, expansion of job duties, 
career goals, coordination of supports, mentors, 
employee assistance programs, and funding. 
The following portion of this chapter will give 
strategies for implementing a customer-driven 
approach to long term supports. 
Developing a Plan 
The employment specialist can use 
formal and informal methods to develop a long 
term supports plan. Informal methods may 
include conversations with the customer, 
supervisor, co-workers, 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 customer's needs as well as strategies 
for supports. Once developed, these 
records must be maintained throughout the individual’s 
employment tenure. These documents 
can provide a record of customer preferences 
and successful support strategies. The 
form at the end of this chapter is a planning 
tool that may be useful in assisting customers 
and their support teams in identifying and 
maintaining a permanent account of support 
needs. 
Identification of Customer's Needs 
The process of identifying a community 
access or support need begins by engaging the 
customer in discussions to document personal 
preferences, concerns, and future directions. 
The customer'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 his or her personal 
ambitions. The customer 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. 
Hopefully, 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 customer must determine the employer’s 
and co-workers' perceptions of current and 
future support needs. This can be accomplished 
by arranging a meeting to obtain this 
information. 
As stated in other sections, it is 
important for the customer to lead any meeting 
with the employer. Obviously, the customer's 
participation in discussions about her or his 
support needs is an important component in the 
customer-driven process. Setting this expectation 
will reduce possible confusion for the 
employer related to the customer's roles and 
responsibilities. In the event that the customer 
is not interested in leading meetings, he or she 
should attend to ensure that his or her views are 
represented. The table below summarizes 
points to remember for identifying the customer's 
support needs. 
219
IDENTIFICATION OF 
CUSTOMER'S NEEDS 
# Ask the customer. 
# Review customer's career plan. 
# Ensure that career plan is current. 
# Discuss the support needs with the 
customer, employer, co-workers, and 
other members of the support team. 
# Talk with family members about 
their expectations and concerns. 
# Review previous need areas. 
# Update the support plan with a list of 
past, current, and future needs. 
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 brain 
storming meeting. The objective of the session 
is to generate as many ideas as possible for the 
identified support needs. 
In most cases, a brainstorming group 
will consist of the customer’s employment 
support team. Sessions should be limited to 12 
individuals, however; 5-6 people are usually 
present. Participants should be comfortable and 
arranged in a circle or semi-circle with an area 
for a group facilitator and recorder. 
The location of the meeting is left up to 
the customer. However, the supported employment 
organization's meeting room is not 
recommended. The idea is to make this a 
planning session of support and not an evaluation 
of the customer. All ideas are accepted by 
the group; this is a creative process, and 
members should not limit themselves. 
If it is impossible to organize a small 
group to brainstorm solutions, then the 
customer and the employment specialist can 
work together to review and build upon all 
resources that were identified during the 
customer profile phase. They can use such instruments 
as the community analysis and the 
customer profile form. In addition, the customer 
should list all the supports that she or he 
is currently using. Family members, also should 
be approached to determine other possible ideas 
for support options. Finally, it is critical to 
analyze the supports that the employment 
setting has to offer. From this process, the 
customer, 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 customer to select the preferred 
support option(s). The employment 
specialist can begin this process by reviewing 
and explaining each of the support options that 
appears on the list. Regardless of the individual’s 
disability, it is useful to have concrete 
examples and experiences to assist the 
customer 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 customer in rank ordering the 
220
options in a most to least favorable hierarchy. 
Many factors may influence the selection 
process, such as the immediate availability 
of the support and the ability to identify a 
primary and backup plan specific to each highranking 
support option. For example, Tom 
needed to review his long term support options 
for transportation, because he was preparing to 
move into an apartment of his own. Prior to 
Tom’s move, he had lived at home with his 
parents, and his father provided daily transportation 
to and from work. During an employment 
support planning meeting, all support 
options were reviewed and Tom selected riding 
public transportation. Tom’s brother offered to 
assist him in learning how to ride the city bus, 
and his father agreed to provide transportation 
as a backup strategy in the event of a problem. 
Tom always wanted to ride the bus to work, but 
his father preferred driving Tom. During his 
planning meeting, Tom shared with the employment 
specialist and family members that he 
had selected an apartment near the bus stop so 
that he could ride the bus like everyone else. 
In this example, a dependable primary 
support option was identified along with backup 
support. Judging from Tom’s closing statement, 
his apartment selection was, in part, 
motivated by the location of the city bus stop. 
Therefore, the employment specialist can feel 
confident that riding public transportation is 
clearly Tom’s support option preference. 
Before closing the meeting, the employment 
specialist began to assist in confirming roles, 
responsibilities, costs, and time commitment. In 
Tom’s case, his brother would provide the 
primary support of teaching Tom to ride the 
bus. Tom’s brother took the employment specialist’s 
phone number to call her in case he had 
a problem. The employment specialist agreed 
to meet Tom and his brother in one week to ensure 
that Tom was learning to ride the bus 
independently. 
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 wanting to provide 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 customer, as well as necessary 
to ensure success. For example, in the case of 
Tom and his brother the employment specialist 
provided the following: 1) a bus schedule with 
the most efficient route to Tom’s job from his 
house, 2) information on cost for riding a bus, 
3) a brief task analysis for riding the bus, 4) 
safety tips and rules of etiquette for riding a city 
bus which had been published by the bus 
company, and 5) a telephone paging system to 
contact the employment specialist in the event 
of a problem. In this example, the employment 
specialist left nothing to chance. 
Determining Level of Support 
Determining the level of support needed 
by the customer will be critically important in 
selecting the support option and/or the delivery 
of the support or service. The overall guiding 
rule governing all interactions should be to: 
221
move from the least intrusive to the most 
intrusive level of support. An employment 
specialist should not provide any more assistance 
than the customer actually needs. The 
previous chapter on systematic instruction presented 
a process for providing the least amount 
of assistance and a method for tracking results. 
This same philosophy should guide interactions 
when selecting long term supports and services. 
Sometimes the needed level of long term 
support gets confusing, because the identification 
of a support or service is occurring due 
to a presenting problem and/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 experiences 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 parttime 
as a gas station attendant. After dropping 
out of high school, Brad found employment at 
several different community businesses. Each 
of these jobs 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, Brad has been 
successfully employed as a parking attendant 
with the assistance of supported employment 
services. Brad had minimal obstacles learning 
the necessary skills associated with his job; he 
reached 100% accuracy by the third week of 
employment. However, Brad has worked on 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. 
Presently, Brad is 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 Brad’s consistent work performance. 
In preparation of closing his VR 
case, Brad called a meeting of his employment 
support group. The group included his girlfriend, 
mother, father, neighbor, employer, a 
co-worker, rehabilitation counselor, and his 
employment specialist. Under Brad’s direction, 
his employment support group developed the 
following long term support plan. 
222
BRAD'S LONG TERM 
SUPPORT PLAN 
Identified Need: Financial Concerns 
1. Over the last three months Brad has not had 
enough 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 
the Social Security Work Incentive Program. 
Potential Options: 
1. Budgeting support from: girlfriend, 
brother, employment specialist, or Uncle 
John who works with the local 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. 
Customer Preference: 
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 monthly bills. 
2. Brad will contact Social Security when 
income increases or decreases. 
3. Employment specialist will assist Brad with 
accessing the Social Security Work 
Incentive Program if needed. 
Primary Support: 
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 15th of 
every month. 
Back-up Support: 
The employment specialist, Martha Stone 
beeper number 770-8900 (leave a voice 
message), will provide back-up support to Brad 
and his brother as needed. 
Status (check one): Past 
x Present 
Future 
Identification of Funding Source (check one) 
MH Services 
x SSA (attach 
VR State Funding 
Title 19 
Medicaid 
MR Services 
Other (specify: 
Identified Need: Domestic difficulties 
Three months ago, Brad moved out of his 
parent's home and 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, and 
3. using vulgar language. 
Potential Options: 
1. Obtain counseling support from local clinic. 
2. Ask for family support from mother and 
father. 
3. Get together with mutual friends who are in 
relationships to discuss relationships, and 
4. Look into Employee Assistance Program. 
Customer Preference: 
Brad agreed to check out the 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. 
Primary Support: 
EAP, Personnel Office, 2114 Drake Street, or 
local clinic at 1925 Chester Street, 828-2194. 
Brad and his girlfriend independently deal with 
domestic issues. 
Back-Up Support: 
The employment specialist will provide back-up 
support for accessing information if Brad has 
any trouble. Martha Stone's beeper number is 
770-890 (leave a voice message). 
223
Status (check one): Past 
Present 
Future 
Identification of Funding Source (check one) 
MH Services 
SSA (attach 
VR State Funding 
Title 19 
Medicaid 
MR Services 
Other (specify: 
Identified Need: Taking instruction from 
female co-worker, inappropriate touching of 
female co-workers and verbal aggression 
when under pressure. 
Two months ago, Brad had an incident where he 
refused to listen to a co-worker who was 
relaying a message from his employer. On the 
same day the female co-worker 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 coworker. 
Potential Options: 
1. Set up a mentor program to address 
employee and customer relations. 
2. Sign contract with clear company 
consequences. 
3. Find a job where Brad does not have any 
female coworkers. 
Customer Preference: 
Enter a mentor program. 
Primary Support: 
Employer Mark Adams: 817-2231 
Coworker Jack Smith: 817-2259 
Mentoring will begin two weeks from today with 
a weekly evaluation. 
Back-Up Support: 
The employment specialist will assist with 
providing training to the mentor. 
Status (check one): 
Identification of Funding Source (check one) 
Title 19 
Medicaid 
MR Services 
Other (specify: 
MH Services 
SSA (attach 
VR State Funding 
S EPARATION FROM 
EMPLOYMENT 
At some point in time, the customer 
may be terminated from employment or may 
choose to leave his or her job. When this 
occurs, it can be very beneficial to conduct an 
exit interview. During this time, the customer, 
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 customer 
and/or employment specialist as they develop 
proactive strategies for future employ-ment 
opportunities. In some cases, a contract can be 
drawn up and implemented when the individual 
returns to work again. Using this type of 
process, a customer who was dis-satisfied with 
the delivery of services could ensure that future 
service would be shaped by 
224 
Past 
Present 
Future
the contract. If the supported employment 
service provider was not satisfied with the 
customer’s performance, this too could be 
addressed through a contract. In both cases, 
the rehabilitation counselor may have 
suggestions for increased efficiency and 
improved out-comes that may be addressed 
directly with the customer; for the performance 
of the employ-ment specialist or the supported 
employment agency. 
S UMMARY 
The form on the following page can be 
used for identifying, selecting, and tracking 
long term supports. Employment specialists 
and customers should begin using this form 
from the beginning of employment. However, 
during the long term supports component of 
supported employment, this form can be 
invaluable. In some supported employment 
programs, the individual who provides the 
initial support services to the customer may not 
be the person who is assisting him or her during 
the long term supports component. Ensuring 
that all successful and unsuccessful supports, 
services, and strategies are charted from the 
beginning will help to guarantee a smooth 
transition between professionals with all parties 
committed to a customer-driven process. 
225
R EFERENCES 
Rheinheimer, G.B., Van Covern, D., Green, H., Revell, Grant, & Inge, K.J. (1993). Finding 
the common denominator: A supported employment guide to long-term funding supports and 
services for people with severe disabilities (monograph). Richmond, VA: Virginia Commonwealth 
University, Rehabilitation Research and Training Center on Supported Employment. 
226
A PPENDIX
Long Term Supports Plan # 
227
Person with overall 
monitoring responsibilities: 
Name: 
Address: 
Employer: 
Address: 
Rehabilitation Counselor: 
Case Manager: 
Employment Specialist: 
School Personnel: 
Other: 
Identified Need: 
Potential Options: 
Customer 
Preference: 
Long Term Supports Plan 
Date Completed: 
SS#: 
Telephone #: 
Supervisor: 
Telephone #: 
Hire Date: 
Telephone #: 
Telephone #: 
Telephone #: 
Telephone #: 
Telephone #: 
228
Primary Support: 
Back-up Support: 
Status (check one): Identification of Funding Sources (check one): ___ Past 
___ Present 
___ Future 
Title 19 MH Services 
Medicaid SSA (attach 
MR Services VR State Funding 
Other (specify: 
Identified Need: 
Potential Options: 
Customer 
Preference: 
Primary Support: 
Back-Up Support: 
229
Status (check one): ___ Past 
___ Present 
___ Future 
Identified Need: 
Potential Options: 
Customer 
Preference: 
Primary Support: 
Back-Up Support: 
Status (check one): ___ Past 
___ Present 
___ Future 
© Virginia Commonwealth University, Rehabilitation Research & Training Center on Supported Employment, 1997 
Identification of Funding Source (check one) 
Title 19 MH Services 
Medicaid SSA (attach 
MR Services VR State Funding 
Other (specify: 
230 
Identification of Funding Source (check one): 
Title 19 MH Services 
Medicaid SSA (attach 
MR Services VR State Funding 
Other (specify: 231