Integrated Day Activities and Supported Employment


Settlement Agreement Provision

a. To the greatest extent practicable, the Commonwealth shall provide individuals in the target population receiving services under this Agreement with integrated day opportunities, including supported employment.

b. The Commonwealth shall maintain its membership in the State Employment Leadership Network (“SELN”) established by the National Association of State Developmental Disability Directors. The Commonwealth shall establish a state policy on Employment First for the target population and include a term in the CSB Performance Contract requiring application of this policy. The Employment First policy shall, at a minimum, be based on the following principles: (1) individual supported employment in integrated work settings is the first and priority service option for individuals with intellectual or developmental disabilities receiving day program or employment services from or funded by the Commonwealth; (2) the goal of employment services is to support individuals in integrated work settings where they are paid minimum or competitive wages; and (3) employment services and goals must be developed and discussed at least annually through a person-centered planning process and included in ISPs. The Commonwealth shall have at least one employment service coordinator to monitor implementation of Employment First practices for individuals in the target population.

                     i.        Within 180 days of this Agreement, the Commonwealth shall develop, as part of its Employment First policy, an implementation plan to increase integrated day opportunities for individuals in the target population, including supported employment, community volunteer activities, community recreational opportunities, and other integrated day activities. The plan will be under the direct supervision of a dedicated employment service coordinator for the Commonwealth and shall:

A. Provide regional training on the Employment First policy and strategies throughout the Commonwealth; and

B. Establish, for individuals receiving services through the HCBS waivers:

1. Annual baseline information regarding:

a.    The number of individuals who are receiving supported employment;

b.    The length of time people maintain employment in integrated work settings;

c.    Amount of earnings from supported employment;

d.    The number of individuals in pre-vocational services as defined in 12 VAC 30-120-211 in effect on the effective date of this Agreement; and

e.    The length of time individuals remain in pre-vocational services.

2. Targets to meaningfully increase:

a.    The number of individuals who enroll in supported employment each year; and

b.    The number of individuals who remain employed in integrated work settings at least 12 months after the start of supported employment.

c.    Regional Quality Councils, described in Section V.D.5 below, shall review data regarding die extent to which the targets identified in Section III.C.7.b.i.B.2 above are being met. These data shall be provided quarterly to the Regional Quality Councils and the Quality Management system by the providers. Regional Quality Councils shall consult with those providers and the SELN regarding the need to take additional measures to further enhance these services.

d.    The Regional Quality Councils shall annually review the targets set pursuant to Section III.C.7.b.i.B.2 above and shall work with providers and the SELN in determining whether the targets should be adjusted upward.


Employment Data Reports

Quarterly Employment First Plan Update

Integrated Employment and Day Services

Compliance Indicators

Compliance Indicators III.C.7.a

1. All case managers are required to take the on line case management training modules and review the case management manual. Information contained includes:

a. The Employment First Policy with an emphasis on the long term benefits of employment to people and their families and practical knowledge about the relationship of employment to continued Medicaid benefits;

b. Skills to work with individuals and families to build their interest and confidence in employment;

c. The importance of discussing employment with all individuals, including those with intense medical or behavioral support needs and their families;

d. The importance of starting the discussion about employment with individuals and families as early as the age of 14 (when transition begins under IDEA) with goals that lead to employment (e.g., experiences in the community, making purchases, doing chores, volunteering);

e. The value of attending a student’s IEP meeting starting at age 14 to encourage a path to employment during the school years and to explore how DD services can support the effort;

f. Developing goals for individuals utilizing Community Engagement Services that can lead to employment (e.g., volunteer experiences, adult learning).

g. Making a determination during their monitoring activities as to whether the person is receiving support as described in the person’s plan and that the experience is consistent with the standards for the service.

2. The Commonwealth will achieve compliance with this provision of the Settlement Agreement when:

a. At least 86% of individuals (age 18-64) who are receiving waiver services will have a discussion regarding employment as part of their ISP planning process.

b. At least 50% of ISPs of individuals (age 18-64) who are receiving waiver services include goals related to employment.

c. At least 86% of individuals who are receiving waiver services and have employment services authorized in their ISP will have a provider and begin services within 60 days.

d. At least 86% of individuals who are receiving waiver services will have a discussion regarding the opportunity to be involved in their community through community engagement services provided in integrated settings as part of their ISP process.

e. At least 86% of individuals who are receiving waiver services will have goals for involvement in their community developed in their annual ISP.

f. At least 86% of individuals aged 14-17 who are receiving waiver services will have a discussion about their interest in employment and what they are working on while at home and in school toward obtaining employment upon graduation, and how the waiver services can support their readiness for work, included in their ISP.

3. New Waiver targets established with the Employment First Advisory Group:

Data Targets:

Fiscal Year


Actual Total


Actual ISE


Actual GSE


































* FY2021 numbers are included for reference only and are not intended to bind the Commonwealth.

Compliance with the Settlement Agreement is attained when the Commonwealth is within 10% of the targets.

• The Commonwealth has established an overall target of employment of 25% of the combined total of adults age 18-64 on the DD waivers and waitlist.

4. DBHDS service authorization data continues to demonstrate an increase of 3.5% annually of the DD Waiver population being served in the most integrated settings as defined in the Integrated Employment and Day Services Report (an increase of about 500 individuals each year as counted by unduplicated number recipients).


The indicators for III.C.7.a serve to measure III.C.7.b.