The Works: archive of past columns

The Works is a regular news feature apearing in the Coalition Briefs.

September 10, 2004

VESID's Deputy Commissioner meets with the New York Work Exchange

Dr. Rebecca Cort, Deputy Commissioner from the New York State Education Department, Vocational Services for Individuals with Disabilities (VESID) met with the New York Work Exchange staff and representatives from the Work Exchange's Advisory Board on August 18th. The purpose of the meeting was to promote a dialogue between the mental health employment community and VESID and to discuss ways to enhance services for mental health recipients.

Dr. Cort described VESID's ongoing plans to solicit input from stakeholders through the agency's "Designing Our Future" initiative. She spoke passionately about the need to improve service provision to consumers through partnerships with providers and employers. At the same time, Dr. Cort emphasized VESID's need to correct systemwide deficiencies and lax procedures that have historically characterized the way the agency does business. She indicated that VESID will be tightening up internal control systems to better ensure fiscal responsibility and accountability. New procedures and policies will impact upon vendors and consumers, requiring additional documentation from providers and strict adherence to timelines. When discussing the diverse needs of mental health consumers in New York City, Dr. Cort acknowledged that VESID could improve access to services and more actively reach out to members of highly marginalized communities.

New York Work Exchange Recovery Conference Video

Key points from the conference, "Recovery: From Promise to Practice Integrating Recovery-Oriented Services in the Mental Health System," held last October, are now available on videotape for distribution by the New York Work Exchange. The conference featured Dr. Courtney Harding, Director of the Institute for the Study of Human Resilience, Boston University, Edythe S. Schwartz, Executive Director of Putnam Family and Community Services, and Martha Long, Director of Village Integrated Service Agency, California.

The video highlights research providing strong evidence for consumers' recovery from serious mental illnesses such as schizophrenia. Speakers also discuss the role of work in recovery and organizational considerations in transforming a traditional agency into a recovery-oriented agency. The video is approximately two hours in length and can be purchased from the Coalition for $15. Interested parties may contact the New York Work Exchange at 212-742-1122.

Consumer Forum on PROS

The NYC Dept. of Health and Mental Hygiene in collaboration with the NYS office of Mental Health, NYC Field Office is presenting a Consumer Dialogue on PROS (Personalized Recovery Oriented Services) on Sept. 23, 1:30-4:40pm. PROS is an OMH initiative to provide comprehensive recovery oriented programs for adults. The Forum will address consumer concerns and answer questions and is located at Lincoln Medical & Mental Health Center, 234 E. 129th St. in the Bronx. The registration deadline is Sept. 18th. For more information go to www.omh.state.ny.us/omhweb/pros or call 212-219-5181.

July 26, 2004

Evidence-Based Practices, PROS and Employment Services

The New York Work Exchange presented a session on July 9th reviewing supported employment as an evidence-based practice and the potential implementation of employment services under PROS (Personalized Recovery Oriented Services). David Lynde with the New Hampshire Dartmouth Psychiatric Research Center, and Dave Bucciferro and Susan Friedlander from the New York State Office of Mental Health (SOMH), combined information and expertise in their areas.

Doug Ruderman, the Director of Rehabilitation and Recovery Services for the New York State Office of Mental Health, was also present to provide comments and respond to questions.

David Lynde provided an overview of supported employment including staff roles in integrating mental health and employment services and how New Hampshire's treatment planning model relates a consumer's personalized goals and objectives to assessment, functional impairments and service interventions.

SOMH provided a comprehensive review of the PROS philosophy, its program components and services. Reference was made to how CRS (Community Rehabilitation and Support), IR (Intensive Rehabilitation) and ORS (Ongoing Rehabilitation and Support) services can be used to support employment-related activities such as a vocational assessment, placement in varied work settings, and other supports and interventions assisting consumers in both obtaining and sustaining employment.

We learned that Medicaid does not pay for some employment related activities: client wages; job development that does not include the accompaniment and involvement of the individual for whom the job is being sought; and specific job skills training. Participants and presenters discussed the difference between Medicaid-billable services that are utilized to help a consumer struggling with task completion because of an emotional-related problem, and the need for skills training on how to 'do the job'.

Examples of PROS billable services such as 'coping skills training' or 'problem solving skills training', as part of 'wellness self management', were reviewed as options for provision. While details will be spelled out in SOMH's forthcoming PROS Handbook, it was recommended that the intent of any employment-related activity, the status and goals of the client in the activity, the service environment, and the intensity of the intervention, be well detailed in documentation.

For consumers who have not yet achieved the level of 15 hours of competitive employment weekly, suitable IR or CRS services can be delivered either at or away from the PROS site. When alternative funding sources, such as VESID, are available to assist consumers with employment goals, the alternative source should be billed as Medicaid is the payor of last resort.

More information on PROS can be found at the OMH website, the Coalition's website, and the New York Work Exchange's website PROS section.

June 25, 2004

Workshop and Executive Session on Supported Education

The NY Work Exchange hosted a training on Supported Education on June 2nd and 3rd. This training was facilitated by Dr. Carol Mowbray from the School of Social Work at the Univ. of Michigan. Dr. Mowbray, a national expert in the area of Supported Education, provided extensive data on evidence-based education practices. Some of the topics included: researching and gathering resources and stakeholders that could sustain supported education; the principles and practices of a supported education program; and recognizing and promoting mental health consumers and their long- range career aspirations towards more meaningful employment.

The training was followed by an afternoon executive session with stakeholders in the NYC area. There were attendees from such institutions as New York University, Columbia University, NAMI/NYC, and the Mt. Sinai Hospital School of Medicine. The discussion opened with an overview of the basic tenets of supported education and data from evidence-based education practices. Questions and concerns raised included: the quality of mental health systems in college settings and the visibility of supported education program staff in those settings; defining a workable supported education program; enrollment criteria; and utilizing cognitive remediation techniques in tandem with supported education to the benefit of both. At the end of the executive session, a core committee was identified and it was agreed that the existing intra-state supported education consortium would be a helpful forum to promote supported education initiatives in NYC. For more information contact the NY Work Exchange.

Effective Connections: Community Mental Health Providers and Employers

On June 8th, Columbia University's Workplace Center presented a debriefing on the NY Work Exchange's research project examining the potential of vendors as employers of consumers. Dr. Sheila Akabas, Dr. Lauren Gates, and staff reviewed the accomplishments of five agencies receiving intensive technical assistance during the second project year. The five agencies involved (The Bridge, Inc., Brooklyn Bureau of Community Service, Community Access, Riverdale Mental Health Association, and South Beach Psychiatric Center) undertook a new process of establishing internal partnerships to act as labor market intermediaries to expand consumer employment opportunities.

Results have included: the formulation of sophisticated job development and data base systems and procedures; enhanced relationships with vendors; greater understanding of employers' perspectives and labor needs; improved internal partnerships and intra-agency communication; and increased collaboration of various agency programs and departments in working toward the employment goals of consumers. Columbia will return to the New York Work Exchange on January 18th of next year to provide a training using the evidence-based model of job development implemented among study participants.

June 9, 2004

Organizational Change to Achieve Recovery-Based Outcomes

On May 6th the New York Work Exchange hosted an all day training called "Organizational Change to Achieve Recovery-Based Outcomes". Joe Marrone, a well known authority in the area of organizational change from the Institute for Community Inclusion, Boston, Massachusetts, presented various concepts and practical suggestions on the topic of organizational change from a recovery-based perspective. The current shift in New York State to Personalized Recovery Oriented Services (PROS) made this event timely and pertinent as achievable and measurable outcomes will become one of the centerpieces of mental health services under PROS. Marrone's topics included: recovery viewed as a tangible practice; defining successful leadership and supervisory roles as well as line staff; system change viewed from the perspective of behavior roles; and designing institutional supports in overcoming obstacles towards the achievement of solid recovery outcomes.

A definition of recovery was discussed from more of a concrete perspective related to specific outcomes versus an approach that is more philosophical. With organizational change, it is crucial to provide an accurate picture of recovery outcomes and how they are measured. Marrone raised the question of how "good" outcomes are defined and if the outcomes truly measure effectiveness, recovery, and accomplishments? He explained the importance of defining staff roles towards the attainment of outcomes instead of only focusing on the mission of the agency. Marrone stated that in most organizations anywhere from one third to one half of staff may leave when an organization undertakes significant change.

In discussing employment and vocational programming, Marrone stated that all mental health recipients need to work. Employment is a significant part of recovery and needs to be an integral part of treatment. Marrone feels that problems lie more with motivation rather than with skills or diagnoses. He feels that vocational interventions could happen earlier on in the treatment process.

Marrone stated that three factors must be in place and working in accordance with each other for organizational change to happen: mission and values of the agency, economic factors in place to support change, and empowered and supported staff. In addition to these, there needs to be links to external resources, a holistic focus including consumer needs, involvement of direct service staff in the design of organizational change, and an ongoing emphasis on continuous improvement.

NYWe-Works Electronic Circular

On May 10th the New York Work Exchange began circulating a monthly electronic circular through e-mail called NYWe-works. NYWe-works will have current information obtained by the Work Exchange. NYWe-works is another way for the Work Exchange to support our constituents by providing information on issues regarding mental health and employment as soon as we receive it.

If individuals want to be added to the NYWe-works list of recipients, please e-mail NYWe-works@nyworkexchange.org.

May 5, 2004

Understanding Benefits: A Three Day Training

Ed Lopez-Soto, Esq. conducted a comprehensive training at the Work Exchange on April 19, 20, and 21 entitled "Understanding Benefits: Everything You Always Wanted to Know About Entitlements for Individuals with Psychiatric Disabilities." Forty-eight individuals from various mental health agencies throughout the city including social workers, case managers, and persons with disabilities participated.

Specifically, the training simplified the very complex benefits system so that attendees could return to their agencies and apply this information in a productive and disentangled way. It provided information on how employment can affect such benefits as SSI, SSDI, Medicare, and Medicaid.

The promotion of career development through work incentives was discussed at length. Other topics covered: overpayments and how this can complicate a consumer's income; eligibility requirements for SSI or SSDI; subsidies; and Plans for Achieving Self-Support. New legislative changes were touched on as well.

Mr. Lopez-Soto returns to the Work Exchange for the popular Benefits' Breakfast on May 26th to discuss the details of Medicaid Buy-In including: key features; what it offers people with disabilities; understanding eligibility criteria; and strategies for overcoming barriers to the program. An update will be given on the implementation of the program on both a state and city level with a close look at what is working and what isn't.

The NYWE Web Site Modifications

The Work Exchange web site has undergone changes over the past few months. One of the most significant and timely changes has been the "Critical Issues" option. This option has up to date information on topics of current importance within the mental health field including: PROS and specific employment information on this new initiative from the State Office of Mental Health.

There is a current informational page on both the Medicaid Buy-In and the Ticket to Work with the latest statistics on Substantial Gainful Activity (SGA) and Employment Networks (EN) within NYS and nationally. All of these pages will be updated continuously as the Work Exchange obtains new information.

In addition to these changes, look for "Other Resources" which provides information on Professional Development, Funding Links and T.R.A.I.N. Professional Development is a new page that provides visitors with educational and training opportunities, facts on relevant organizations, and publications that pertain to employment and mental health. This link can assist individuals in the field with professional enrichment and advancement. Funding Links presents a list of funding sources that are federal, state, and city based. T.R.A.I.N., the database of NYC help programs, aids providers with training program knowledge for their consumers within NYC. "Our Projects" collates information from many of the Work Exchange research, technical assistance, and demonstration projects. Visitors can access each project's purpose. "The WORKbook", a comprehensive listing of NYC mental health programs assisting individuals in employment, can still be accessed on line. The "Job Listing" option will remain the same.

April 13, 2004

Update on VESID's Supported Employment Direct Service Funds

On March 16th the Work Exchange among other Coalition groups in Albany met with VESID for an update on the direct services RFA for Supported Employment. What follows is a summary of important issues for providers including news from VESID dated March 26th.

The shifting of funds has resulted in an increase of dollars to a number of counties, with NYC receiving the greatest shift in additional funds. The total amount allocated for direct service SE across the state is $25,197,689. The NYC amount based on the '04 RFA results is $6,689,946. VESID amended all ratios of persons served and persons rehabilitated to 1.5:1. According to VESID, this change was made due to the limited available funds to address existing need. Anyone who applied for the RFA should have received an award letter by the end of March. The turn around time for signing contracts and meeting administrative requirements is quick, as VESID wants counselors to begin the authorization process in June so that providers are ready to offer services in July. A significant number of new providers are entering the VESID supported employment system, including a number of NYC mental health providers.

VESID will deliver training to supported employment providers across the state. In NYC, training will be held on May 11th at the OMRDD NYC Regional Office at 75 Morton St., 9:30AM or 1:00PM. Training will include the basics of the supported employment process and required VESID procedures.

This educational opportunity is especially important for new providers entering the supported employment system. Training specific to reimbursement and authorization is planned for September. In order to help shape the training agenda and expedite general information sharing, questions can be forwarded prior to the training to: VESIDSERFA@mail.nysed.gov.

Developing and Operating Diversified Employment Programs: The Clubhouse Experience

The Work Exchange offered a two-day training on transitional employment, supported employment, and independent employment, and how these approaches interrelate to create an integrated employment support network for consumers attending Clubhouse programs.

Ralph Bilby of the International Center for Clubhouse Development (ICCD) in New York, along with Mark Maragnano, Charles Webster and Caroline Cutter of Potter Place in Massachusetts, Kevin Bradley of Genesis Club in Massachusetts, Bea Leiberman of Fountain House in New York, and Colleen McKay from the Program for Clubhouse Research at the University of Massachusetts, presented a range of materials including research identifying outcomes associated with transitional employment.

Job development efforts and strategies were examined as well as resources useful in expediting supported employment. The training was attended by 45 registrants.

March 16, 2004

NYWE Releases Report: Consumers' Perspectives on PROS

As announced in the last issue of Briefs (2/26/04), the Work Exchange and Howie T. Harp partnered to offer two consumer focus groups providing consumers with an opportunity to comment on the proposed service changes to the mental health system via PROS. The full report documenting the feedback and implications of these findings can now be downloaded in PDF format on the Work Exchange web site under PROS: Critical Issues.

Consumers identified as a core component of a service delivery system the availability of multiple, varied, flexible and individualized services. They felt that having this type of availability added to their treatment choices and subsequently enhanced their recovery. Staffing issues were also discussed at length, particularly the importance of empathic and caring staff and the option for employment positions to be filled by peers. Consumers were disapproving of any changes that would limit choice and recipient control over service provision. It was asserted that many variables, including staff, physical setting, and the nature of activities, define and distinguish programs of choice.

Concerns were also expressed that the purpose of PROS is primarily to capture funds, with the potential for individual needs and individualized services to take a back seat. Ominous feelings were associated with a system void of opportunities for self-determination.

Recognition of these concerns among a representative group of NYC consumers suggests that City and State should offer ongoing consumer education and orientation to PROS. Routine educational forums, including outreach efforts to consumer groups, providing accurate and timely information could help to alleviate the anxiety and concerns associated with PROS and equip individuals to navigate the proposed system.

A recommendation emanating from these findings is that a consumer advisory council on PROS be established in NYC to provide ongoing feedback and recommendations as implementation proceeds. The sheer size, diversity and complexity of New York City's mental health system warrants a process for genuine and effectual involvement by its community of recipients.

VESID's Notification of the RFA Direct Service Awards for Supported Employment

The Vocational and Educational Services for Individuals with Disabilities (VESID) has accelerated review of the RFAs submitted for supported employment direct services and applicants should be informed of the status of their proposals in early April. Members of the Stakeholder Committee, including the NYWE, have been invited to Albany so that VESID can discuss the results of this process. We will disseminate additional information via e-mail as it becomes available.

February 26, 2004

Focus Groups for Mental Health Recipients on PROS

The past year has generated many questions regarding service delivery changes under the State Office of Mental Healths new framework of PROS (Personal Recovery Oriented Services), particularly from the consumer community. The NY Work Exchange and Howie T. Harp have responded to this need by partnering to present two focus groups. A total of 42 consumers participated. These groups allowed consumers a rare opportunity to hear about the basic tenets of PROS and voice opinions and concerns.

Some of the themes that emerged were: availability of multiple services, independence and choice, treatment vs. recovery, staffing, Medicaid eligibility and billing. Significant consumer feedback on PROS was documented in a formal report by the NYWE, which is being disseminated to our constituents and will be posted on the web site shortly.

Update on VESID's Supported Employment RFA

VESID received approximately 900 applications from over 200 organizations in response to their recent RFA on Supported Employment. When distributed across each county and borough, there were approx. 2,700 applications in total in New York State. All reviews have been completed and it is expected that applicants will be notified of their status by early April 2004 in time for the July 1, 2004 start-date.

For providers interested in other funding opportunities through VESID, we will keep you informed of the UCS (Unified Contract Services) RFA to be released in the spring. Regarding non-direct services to consumers, VESID released an RFP on Feb. 13th for Supported Employment Enhancement Services. They are seeking proposals in training/technical assistance and/or services to build new affiliations and local services arrangements. More information is available at their website: http://www.vesid.nysed.gov/rfp/.

New PROS Button at the NYWE Web Site

Our website now has a link for critical, up-to-date information on PROS. The link is called PROS: Critical Information. In addition to some basic PROS information and links to current documents, there is an entire section devoted to employment services, how these will be impacted by PROS and issues needing clarity.

The employment section delineates CRS and other employment related issues and defines elements of existing and proposed services under PROS. This section of the website will be updated regularly as the NY Work Exchange becomes privy to new information specifically affecting employment programs.

Free Job Postings

The NY Work Exchange has a free job posting link on its website. Go to the website and click on 'The Job List' then on 'add a job'. Your posting will be reviewed by the NYWE staff and added to the list. Our job list includes openings in various areas of mental health, particularly employment related positions such as vocational counselors or job coaches. We have found that this is an expeditious way to enhance recruitment efforts and that it is visited frequently by numerous job seekers. If there are any questions utilizing this service please contact us at (212) 742-1122.

January 14, 2004

Vendor Project

The New York Work Exchange and the Workplace Center of Columbia University have undertaken a two-year study with eleven mental health agencies in NYC to explore the potential of vendors as a source of consumer employment for the agencies of the companies with whom they do business (vendors). Those agencies are: The Bridge, Inc., Brooklyn Bureau of Community Service, Brooklyn Community Housing and Services, Inc., Center for Urban Community Services, Community Access, Goodwill Industries of Greater New York & Northern New Jersey, Inc., Institute for Community Living, Inc., Jewish Board of Family and Children's Services, Project Renewal, Riverdale Mental Health Association, and South Beach Psychiatric Center.

Programs involved in the vendor project met in November. Staff involved in the study from The Workplace Center reviewed their research and presented their approach to working with agency- vendors using a unique business model. Suggestions were made as to how an employer is secured and how this relationship is nurtured towards successful job development.

The study explored tailoring marketing strategies, efficient ways to contact employers and determine employers' sensitivity to hiring consumers. The results underscored the job development process in supported employment programs, and the tremendous amount of time required to seek employers, make contact with appropriate personnel, and nurture business relationships in the development of consumer jobs.

Many key questions are raised in this study. Can providers work with vendors? Is this a potentially lucrative placement pool for consumers of mental health services? Could education on topics such as productivity, reliability, safety and working with individuals with a mental health history benefit the employer relationship? Could staff look at new ways to assess consumers' skills and core competencies? Look to the Work Exchange web site for a full description of this study.

Cognitive Remediation

Dr. Susan McGurk from the Mt. Sinai School of Medicine, Dept. of Psychiatry presented an update on data from the cognitive remediation study undertaken by the Work Exchange at the following sites: the Brooklyn Bureau of Community Service, Goodwill Industries of Greater New York and Northern New Jersey, Inc., the Institute for Community Living, Inc., and the Mental Health Association.

It is becoming clear, from the study and Dr. McGurk's research, that many cognitive impairments exist prior to a diagnosis of severe mental illnesses such as schizophrenia or bi-polar disorder. In working with these supported employment sites and training staff on cognitive remediation it is hoped that more individuals will not only secure employment, but also maintain employment. Discussion at a meeting December 8th meeting raised the need for additional practice sessions on work tasks for the more common memory deficits encountered by consumers. Screening procedures need to be more closely examined because intake processes do not necessarily reveal all cognitive difficulties. Many job upgrades are refused by consumers due to an increase in tasks and responsibilities, a direct reflection of cognitive impairments. Job development staff need to consider the role of compensatory strategies with individuals receiving supported employment services and cognitive remediation.

December 8, 2003

VESID's Supported Employment RFAs

The VESID bidders' conference for the recently released RFA was held in New York City on Nov. 19th. Answers to questions providers submitted to VESID are now posted on VESID's website: www.vesid.nysed.gov/supportedemployment/ Details regarding applications due December 16th can also be found at the web site.

In 2002 the Work Exchange undertook a Cost Analysis Project to determine the actual cost of members' supported employment programs. The purpose of this study was to provide information that would help agencies prepare knowledgeable responses to the previous VESID RFA. Project results may assist mental health providers in preparing a response to the current RFA. Should applicants be interested in receiving additional information please contact Alysia Pascaris at the Work Exchange.

The Ways to Work Project

Agencies involved in the Ways to Work demonstration project with the NY Work Exchange met with David Lynde from the NH Dartmouth Psychiatric Rehabilitation Center on Nov. 20th. To examine how PROS may impact vocational initiatives within CDT Programs, the Work Exchange and the five demonstration sites - Brooklyn Bureau for Community Service, JBFCS, Postgraduate Center, Riverdale Mental Health Association, and Transitional Services for New York, Inc.- were joined by David Bucciferro, from the State Office of Mental Health (SOMH) and Susan Friedlander, NYC Field Office SOMH.

Current service definitions and proposed PROS service definitions were discussed in detail, as well as Medicaid language for reimbursement. David Lynde, who is providing technical assistance for this project focused on the New Hampshire Dartmouth 'treatment plan' model, reviewing strategies for documentation of consumer goals, objectives, and interventions.

Videos Available on Consumers and Work

The Work Exchange has obtained two videos that may be of interest to providers offering employment and/or clinical services. Sponsored by the Dartmouth Psychiatric Rehabilitation Center and Johnson and Johnson, the videos are entitled, "It's My Business, Partners" and "3 Faces, 3 Lives". Both videos are 10-15 minutes long and portray consumers working in businesses in Maryland, Connecticut and Vermont. They demonstrate the benefits of collaboration between businesses and supported employment teams and the therapeutic gains through work for consumers of mental health services. Individuals interested in viewing these tapes, please contact Michele Fontaine or Alysia Pascaris at the NY Work Exchange.

Focus Groups for Recipients of Mental Health Services to Discuss PROS

In partnership with Howie T. Harp, our first focus group was held at 90 Broad Street on November 24th. A total of 18 consumers attended; participation was substantial regarding the proposed change of service delivery under PROS. Comments will be analyzed after following the second scheduled group at Howie T. Harp on December 4th.

November 21, 2003

VESID's Supported Employment RFA

Bill Deschenes, Manager of Business, Interagency and Policy Development for VESID has informed us that the Request for Application will be available on the VESID website as of Fri. Nov. 14th. It will also be mailed to all providers in the NYISER system on that day. To permit applicants more time for the writing process e-mail submission of applications will be possible. Applications are due on Dec. 16th, 2003. New contracts will start on July 1st, 2004.

At the final Supported Employment stakeholders group met in Albany on Oct. 29 th, we were informed that an hourly reimbursement rate was set at $53 applying to all disability groups. VESID will be distributing awards by region and disability groups to the top six submissions. NYC needs may result in additional selections.

If you are a current VESID supported employment provider and have questions about your past outcomes and documented NYISER data, contact your district manager as soon as possible. If you are considering applying for the RFA, check the website at: www.vesid.nysed.gov/supportedemployment/. Mental health providers are urged to apply for this RFA.

Consumer Focus Groups Discuss PROS

The New York Work Exchange and Howie T. Harp will be co-sponsoring two consumer focus groups to discuss PROS. This is an opportunity for consumers to receive information on PROS and comment on proposed changes to mental health services. These groups will be held at 90 Broad Street, 8th floor on November 24th from 2-4 PM and at the Howie T. Harp Advocacy Center at 2090 Adam Clayton Powell Blvd., 12th floor on December 4th from 1-3 PM. Recipients of mental health services who wish to attend can pre-register by calling Cindy Peterson at the Howie T. Harp Center at 212-865-0775, ext. 118. Refreshments and carfare will be provided.

New Staff Member for the New York Work Exchange

We are pleased to announce that Michele Fontaine has joined the staff of the New York Work Exchange as Employment Projects Coordinator. Michele formerly managed Project Renewal's Job Links Supported Employment Program and she has extensive experience both clinically and administratively in the fields of mental health and substance abuse.

October 28, 2003

Recovery Conference

"The speakers were inspiring, exciting and passionate." "I liked the message of hope; the practicality of recovery; the hard evidence of the research." These comments were made by attendees of the New York Work Exchange conference "Recovery: From Promise to Practice," held on October 22, 2003

More than 200 individuals attended and heard Dr. Courtenay Harding give the keynote address: "The New 3 Rs — Resilience, Rehabilitation & Recovery." She presented on research findings from 10 long-term studies of schizophrenia that demonstrate evidence for improvement and recovery for individuals with mental illness.

Edythe Schwartz, Executive Director of Putnam Family and Community Services, described the process used at her agency to transform from a traditional organization into a recovery based service agency. Martha Long, Director of The Village Integrated Service Agency in California, described methods used at her agency to engage people in a treatment process that promotes hope and recovery.

This conference was funded with a generous educational grant from Eli Lilly and Company, U.S. Public Health Division. For a copy of materials from the conference please call Deborah Short at 212-742-1122 x235. A videotape of the conference will be available in a few months and we hope to have a video excerpt available on our website soon.

Adult Home Educational and Vocational Forum

The New York Work Exchange was invited to participate in an Educational and Vocational Forum for the residents of the Queens Adult Home on October 15, 2003. Numerous representatives from the NYS Department of Health, the State Office of Mental Health, the Governor' s Office, and State Education Department attended the event.

Glenn Liebman from the New York State Department of Health, organized the forum to provide the residents of adult homes with information on employment and educational services. Recently, many residents completed a comprehensive assessment survey that revealed a significant interest in work and education.

In addition to Alysia Pascaris and Shaleigh Tice from the New York Work Exchange, presenters included staff persons from VESID, Transitional Services of NYC, Inc., New York Psychotherapy and Counseling Center , Queens Independent Living Center, and the State Education Department.

September 29, 2003

Recovery Conference

Registrations are pouring in for the conference, "Recovery: From Promise to Practice... Integrating Recovery-Oriented Services in the Mental Health System," sponsored by the York Work Exchange and funded with a generous grant from Eli Lilly and Company. The conference will be held on Oct. 22, 2003, from 8:30am-1pm at the Lighthouse International, Ames Auditorium.

Dr. Courtney M. Harding, Boston University, will give the keynote address, "The New 3 Rs - Resilience, Rehabilitation, " Recovery." She will present on research evidence for improvement and recovery in schizophrenia and other serious and persistent psychiatric disorders.

Co-President of NYAPRS, Edythe S. Schwartz, Putnam Family and Community Services, will speak on "Breaking Down the Barriers to Recovery-Oriented Services: An Agency's Experience." She will describe the process used at Putnam Family to transform a traditional organization into a recovery based service agency.

Martha Long, Village Integrated Service Agency, California, will present on "Overcoming Labels: Working Together to Promote a Self- Motivated Journey of Recovery." She will discuss practical methods used to engage people in a treatment process that stems from hope, recovery and the notion that most people, including people with psychiatric disabilities, want to 'get a life'.

For more information or to register on-line, please visit our website, www.nyworkexchange.org, or email Deborah Short at dshort@nyworkexchange.org.

Dr. Judith Cook Coming to the New York Work Exchange!

The New York Work Exchange is pleased to offer a special session with Judith A. Cook, Ph.D., University of Illinois at Chicago, as part of the Fall '03/Winter '04 Program of Study. Dr. Cook will present on "The Employment Intervention Demonstration Program (EIDP): Lessons Learned on Evidence-Based Supported Employment," on Oct. 10th, 2003 at our 90 Broad Street headquarters.

Dr. Cook is the principal investigator of the EIDP, a national, five-year, multi-site SAMSHA study of best practice in vocational rehabilitation for mental health consumers. Come and learn about the models tested and results from data collected from sites in eight states. Participants will learn about the critical characteristics and outcome s of employment approaches found to be most successful in helping consumers attain competitive employment, earn higher wages, and work a greater number of hours.

Space is limited! To register or for more information, contact Deborah Short at 212-742-1122 x235.

Staff Announcement

Congratulations to Chester Rhodes, New York Work Exchange staff member, for being accepted into the Fall 2003 Mental Health Consumer Advocacy Course offered by the Urban Justice Center. This fourteen week course covers a wide range of topics that impact the lives of those in the New York City mental health community, including welfare, community organizing, criminal justice advocacy, work incentives, and supportive housing.

The Urban Justice Center offers this course every semester. Those interested in applying for next semester should contact Teena Brooks at (646) 602-5665. Good luck Chester!

July 24, 2003

The NY Work Exchange "Fall 2003/Winter 2004 Program of Study" will be available in August

Trainings will include: Understanding New York's Medicaid Buy-In Work Incentive Program; Evidence-Based Supported Employment for People with Psychiatric Disabilities: Lessons Learned from the Multi-Site Employment Intervention Demonstration Project (EIDP); Understanding Benefits: Everything You Always Wanted to Know About Entitlements for Individuals with Psychiatric Disabilities; and others. To request a copy, please contact Deborah Short at 212 742-1122 x235.

June 11, 2003

Medicaid Buy-In: a program for working people with disabilities

The long-anticipated Medicaid Buy-In Program for New York State is poised to begin. The Medicaid Buy-In Program allows disabled individuals earning up to 250% of the Federal Poverty Level to purchase Medicaid coverage on a sliding scale. Individuals can apply for the Buy-In program at their Local Department of Social Services starting July 1.

In addition to questions regarding implementation details, there are also many questions about the interpretation of the program rules. According to regulations, an individual will be eligible if s/he: has a disability diagnosis as defined by the Social Security Administration; is between the ages of 16 and 65; is working part or full-time and has a gross income not more than to $46,170; and has resources (excluding house or car) of a value less than $10,000.

Individuals earning less than 150% of the Federal Poverty Level will pay no premiums. Those with income between 150-250% will pay premiums calculated at 3% of their earned income and 7.5% of their unearned income.

Decisions on applications are expected to take 45 days for most and up to 90 days for those requiring additional evidence. Those who successfully enroll can expect Medicaid expenses to be covered retroactively.

Due to the lack of an automated premium collection and tracking system, Governor Pataki has issued a moratorium on premium payments until April 2004. This means all individuals found to be eligible for the Buy-In Program will not have to pay any premiums until the automated system is operational.

For more information on the Medicaid Buy-In Program, call the Medicaid Help Line at 1-800-541-2831 or contact your local Department of Social Services. Address and phone numbers can be found online at www.health.state.ny.us/nysdoh/medicaid/ldss.htm .

For regional or local training on the Buy-In for consumers and providers in the mental health community, contact the NYAPRS Collectives Director of Regional Education, Stephanie Mitchell at 518-436-0008 x14 or email at nyaprssteph@aol.com.

May 19, 2003

Picnic for Parity

The 8th Annual Picnic for Parity will be on Wednesday, May 21, 2003 at Bryant Park from 12:00 - 3:00pm. This year’s picnic, 'Back to Work. Back to Life,' promotes equal treatment for people with mental illness with themes on Timothy's Law and the Medicaid Buy-In.

Timothy's Law is a bill to enact mental health "parity" in New York to get adequate treatment and insurance coverage for mental heath services. The picnic will also celebrate the passage of the Medicaid Buy-In Program, which will allow working people with disabilities to purchase Medicaid health insurance on a sliding scale. The Buy-In was slated to begin on April 1st, but has been delayed until July.

Members of the disability community, state and local legislators, the media, and representatives from a broad array of grassroots advocacy organizations for people with disabilities are encouraged to attend. There will be an information fair, an awards ceremony, live music, an art show and free food, rain or shine. Organizations wishing to reserve a table should contact Miriam Wexler at 212-614-5757 or fax 212-694-420. Be sure to visit The Work Exchange’s and The Coalition's Tables

Setting a Precedent

A recent New York State Appellate Court decision ruled that welfare recipients with mental illnesses cannot be penalized for missing appointments or paperwork deadlines due to their disability. Juana Diaz, a Manhattan resident, lost her public assistance benefits in January 2001 because she failed to respond to a request for information about her income from the state Office of Temporary Disability Assistance (OTDA).

Diaz said she forgot about the form and missed the deadline because she is clinically depressed. She presented a medical report that explained that she is "easily overwhelmed" and "acutely depressed and dysfunctional." Initially her benefits were not reinstated because the state argued that depression is not a medical condition, a decision that was upheld at her fair hearing. The state appeals court disagreed with this decision stating that the law says that if a welfare client can show "good cause" for failing to comply with certain requirements, the client is exempt from those mandates. The judges pointed out that physical and mental conditions such as clinical depression are considered "good cause."

This ruling sets a precedent for people with mental disabilities and could affect hundreds of New Yorkers on welfare. It was reported in a study published in February 2000 that roughly one-fourth to one-third of current TANF (Temporary Assistance for Needy Families) recipients have a serious mental illness.

April 8, 2003

SSA to Revise Eligibility

The Social Security Administration recently announced a plan to update and revise the rules used to evaluate mental disorders in both and adults and children when determining eligibility for Social Security disability benefits (SSDI) or Supplemental Security Income (SSI) benefits based on disability.

Before drafting any revisions, SSA is inviting the public to send comments and suggestions for revising their rules. They are also interested in ideas about how to improve programs for individuals with mental disorders, particularly those who would like to work in a supportive setting. SSA will accept comments no later than June 16.

The invitation to send comments is published in the "Advance Notice of Proposed Rulemaking" in the Federal Register, (March 17, 2003, vol. 68, No. 51). The electronic version may be accessed in one of three ways: 1) www.access.gpo.gov/su_docs/aces/aces140.html; 2) visit Social Security's website at www.ssa.gov/regulations/what-is-new.htm, or 3) the 'fyi' section of the New York Work Exchange's website.

Benefits Training

Members of the New York City Mental Health Community are invited to attend the training " Understanding Benefits: Everything You Always Wanted to Know About Entitlements for Individuals with Psychiatric Disabilities." This will be held on April 30, May 1 & 2, 2003, from 9:00 AM-4:00 PM at the New York Work Exchange.

This training is designed to clarify and break down the complicated world of entitlements into user-friendly information necessary to provide expert benefits counseling. Participants will learn about how employment effects federal disability benefits (such as SSI, SSDI, Medicare, Medicaid) and the steps one can take to use federal work incentives to promote career development.

The trainer, Edwin Lopez-Soto, Esq., will cover topics such as overpayments, Social Security work incentives, subsidies, IRWE's, plans for achieving self-support, income & resources, and new legislative changes. This training is targeted for rehabilitation professionals, advocates, case managers, social workers, persons with disabilities, family member and others, who are new to benefits counseling or experts.

March 14, 2003

VESID Supported Employment RFA Update

The Office of Vocational and Educational Services for Individuals with Disabilities (VESID) recently released a letter to stakeholder groups regarding the Supported Employment Request for Applications (RFA).

The letter states that, upon review of responses to the RFA, "it became clear that some consumers might be adversely affected by the changes resulting from the contracting process." Further discussion with the Office of the State Comptroller has led VESID to recommend a shift in supported employment services to a rate-based system modeled on the one currently used by OMRDD.

Employment providers have been waiting for the results from an RFA, due last September, that outlined a new structure and process by which VESID will fund agencies providing supported employment. Current contracts were extended until June 30, 2003.

VESID reports that they hope to use much of the cost and programmatic data included in the RFA to identify regional needs, and rates for each region and disability group. VESID also hopes to use multiple rates based upon the level of service. The Office of the State Comptroller is currently evaluating the proposal. Consequently VESID lacks approval to proceed with a rate-based system at this time.

If the new system is approved, that current supported employment contracts will likely require further extensions until the new system is in place. Over the next few weeks, VESID staff will meet with stakeholder organizations to provide more details and to discuss how stakeholders can be involved in the development of a new system. The New York Work Exchange has organized a meeting with VESID for New York City employment providers. The meeting will be on Monday, March 17 at The Work Exchange. Contact Deborah Short (x235, or dshort@nyworkexchange. org) for more information.

Program of Study

The first training, in the Work Exchange's Spring/Summer 2003 Program of Study will be "Ethical Issues in Rehabilitation." Scheduled for March 4 and 5, this training is designed to increase awareness and understanding of ethical issues for rehabilitation professionals and to further develop skills for dealing with ethical dilemmas in the field. Expert Tom Duffy, RRCEP, will help participants update their knowledge of ethical practices using the new Code of Ethics for Certified Rehabilitation Counselors as a guide.

Other Spring/Summer Program of Study training sessions include:

• Cognitive Remediation and Employment Services: What is the Connection? April 23, 2003
• Understanding Benefits: Everything You Always Wanted to Know About Entitlements for Individuals with Psychiatric Disabilities April 30, May 1, 2, 2003
• The Ticket to Work and Medicaid Buy-In Program: Where Do We Stand? May 29, 2003
• Choosing, Getting and Keeping Employment: A Recipe for Success June 18, 19, 20, 2003

The Program of Study curriculum is designed to address the critical skills needed by providers, peers and advocates in their efforts to help people with mental illness acquire and sustain meaningful work. The The Program of Study curriculum is online, or to request a printed copy, please contact Deborah Short at 212-742-1122 x235, dshort@nyworkexchange.org.

February 13, 2003

ADA Training

The New York Work Exchange is pleased to offer a one-day training on "Guidelines for Hiring Consumers: Understanding Legal Rights, Responsibilities, the Americans with Disabilities Act (ADA) and New York Human Rights Laws." Conducted by Lawrence Berg, Ph.D., Esq., the seminar will take place on February 26. Participants will learn about personnel practices that avoid discrimination and ease integration of people with disabilities into the workforce.

This seminar looks at the impact of the ADA and New York Human Rights Laws on personnel practices. Participants will examine how and when to make an accommodation and discuss what is considered 'reasonable.'

As a result of the seminar, employers will be able to develop policies around recruitment, hiring, firing, and supervising staff with disabilities. An overview of Federal, State and local anti-discrimination laws, as well as recent Supreme Court decisions will be provided.

To RSVP or for more information, please call Deborah Short at 212-742-1122 x235.

Free training material on EAPs and unions

Training materials are available, upon request, for NYC mental health service providers which help consumers understand the potential role of Employee Assistance Programs (EAPs) and unions in job retention. The curriculum, including a short video on unions, can be used in facilitating groups or career clubs for consumers in employment services.

These training materials complement two reports from Columbia University's Workplace Center for the New York Work Exchange. One explains the largely untapped and poorly understood role of unions in the workplace. The other describes a study on disability related services currently provided by EAPs, barriers to service provision, and ways in which EAP professionals perceive the establishment of better connections with providers.

For more information, call Shaleigh Tice at (212) 742-1122 x238.

January 21, 2003

SWEAB Report Released. The New York Work Exchange will release the Statewide Educational Advisory Board (SWEAB) Report on January 21, 2003. This report, "Employment and Mental Health Services," offers a range of recommended actions that can move New York State further along in the direction of improving career-oriented employment services for consumers.

The report resulted from a request by the Office of Mental Health Division of Community Care Services in the fall 2001 to the New York Work Exchange to develop a portfolio of employment services and educational curricula for use throughout New York State.

To assist in this task, the Work Exchange convened the SWEAB, with members drawn from public and private universities, think tanks, consultants, consumer organizations, and selected state, city and federal agencies . Throughout its work the SWEAB sought to meld evidence-based practices and a recovery perspective.

The resulting report identifies existing curricula founded on evidence-based practices, notes areas where significant gaps need priority attention, and highlights organizational actions essential to improved employment outcomes.

For a copy of the complete report, please visit our website at www.nyworkexchange.org or call Deborah Short at 212-742-1122 x235.

Goodbye, hello! As of February 1, 2003, Director Alysia Pascaris will be taking a six-month leave of absence from the New York Work Exchange. She will maintain regular contact with the Work Exchange and will return to full-time work in August.

In her stead, The New York Work Exchange is pleased to announce Gene Aronowitz will serve as Acting Director.

Gene has a Ph.D. in Social Work and has worked in the mental health field for over 30 years - including a ten-year stint as Commissioner of Community Mental Health in Westchester County. He can be contacted at 212-742-1122 x202 and by email at earonowitz@nyworkexchange.org.

Welcome Gene and Bon Voyage Alysia!

December 20, 2002

Work and Recovery Project Begins. The New York Work Exchange will launch the Work and Recovery Project this month, an initiative aimed at improving employment opportunities and outcomes for mental health consumers attending Continuing Day Treatment Programs (CDTPs) in New York City. Participating agencies include F.E.G.S., Fordham-Tremont Community Mental Health Center, New York Psychotherapy and Counseling Center, St. Luke's-Roosevelt Hospital Center, and Upper Manhattan Mental Health Center.

The four CDTPs will receive expert consultation and technical assistance focusing on employment and recovery-based concepts and activities. The project will be implemented in four phases over a two-year period. The phases include: site assessment, curriculum delivery, consultation to service provision and treatment planning, and follow-up support and networking. Leadership from the participating CDTPs will meet to discuss the experience, what was learned, and plan for next steps.

CR and SE Services study. Participants in the Cognitive Remediation and Supported Employment Services study will be receiving two full days of training in December by Dr. Susan McGurk from Mt. Sinai Medical School, principal investigator for the research project.

The New York Work Exchange has undertaken this study to evaluate the effects of cognitive remediation and supported employment services for consumers with mental illness. There is increasing evidence to support the view that individuals with psychiatric disabilities experience difficulties in the work setting due to cognitive impairments.

Participating New York City mental health supported employment programs will explore the feasibility and effect of offering cognitive remediation interventions in supported employment services. Participants will be using neuropsychological evaluations and computer-based interventions designed to address cognitive skills such as memory, speed in handling tasks, and problem solving.

November 21, 2002

Cognitive Remediation and Supported Employment Project Grantees. The NY Work Exchange is pleased to announce the following recipients of the Cognitive Remediation and Supported Employment Project grants: Goodwill Industries in the Bronx and Brooklyn, the Mental Health Association, and the Institute for Community Living. These exciting projects will evaluate the feasibility and effectiveness of combining cognitive remediation and supported employment services for mental health consumers.

This program is designed to help consumers quickly attain work and to evaluate the effectiveness of cognitive remediation in helping clients in supported employment reach their work goals. To achieve these goals, a Cognitive Remediation Intervention (CRI) has been developed. The CRI consists of neuropsychological assessment, computer-based cognit ive exercises, integration of cognitive rehabilitation and supported employment services, and development of compensatory strategies for areas of cognitive weakness.

We look forward to sharing with the community the results of this innovative program. For more information about this dynamic project, contact Alysia Pascaris at 212-742-1122.

NYWE Community Presence. The New York Work Exchange was pleased to make presentations on its mission and goals to the NYC Dept. of Health and Mental Hygiene's Queens Mental Health Council and Brooklyn Mental Health Council. The two November presentations were well attended and the questions were insightful as well as revealing.

Director Alysia Pascaris and Deputy Director Alan Menikoff explained the WorkExchange's mission to promote work and career opportunities for consumers of mental health services by offering expert trainings, focused technical assistance, information updates, research and evaluation and special projectsto the NYC provider community through.

The Work Exchange's innovative Program of Study, which helps inform and educate professionals and consumers with practical, skilloriented training, was described along with the curriculum. The curriculum is designed to address the knowledge and critical skills necessary to help people with mental illness acquire and sustain work.

The Work Exchange's community presence was also felt at the HireDisability Career Expo at the New Yorker Hotel on November 5. The Work Exchange staffed an exhibit booth while informing and interacting with the heavy stream of participants and job seekers. The team provided information about training programs and resources available to consumers and service providers alike. The NYWE's WORKbook, a guide to NYC's Mental Health Employment Programs, was in heavy demand.

The Career Expo was also attended by companies like Microsoft, Pitney-Bowes, and agencies like VESID, and the Social Security Administration. Also, the New York Times had a reporter present writing about this event. The event was reported in the November 10, 2002, Job Market section of the New York Times in an article by Maggie Jackson.

October 28, 2002

New VESID Manager visits New York Work Exchange. On Wednesday, October 23, the new VESID manager for NYC, William ("Bill") Ursillo, Ph.D, visited the NYWE offices to meet with a group of stakeholders from the mental health provider community. For many this was a 'get to know you meeting', at which Dr. Ursillo covered a range of important issues. His primary interest was in data-driven issues related to unmet needs. There was also some discussion about redistribution and redirection of existing funding, and other subjects associated with the recent VESID Request for Applications. Dr. Ursillo also alerted the group to a large anticipated turnover among VESID counselors: as much as 50% turnover over five years, mostly due to retirements. Despite the disruptions associated with such turnover, Dr. Ursillo also felt it was an opportunity for practice innovations within the VESID offices. Mr. Ursillo comes to his new position having worked for several years with VESID in Westchester County. In his new position he is replacing Bill Janowitz who recently retired.

Employment Support Services and Clinical Services: How do they fit together? On Thursday November 21, 2002 Susan Musante, LPCC, CPRP will once again present a workshop on integrating employment and clinical services. This program is designed for clinical and other staff committed to exploring the value of integrating employment supports and services into clinical practice for individuals with mental illness. This training will offer practitioners tools that promote consumer recovery through the support of meaningful work experiences. Among other things, participants will learn about policies, trends and the role of treatment, rehabilitation and recovery in assisting consumers in their employment goals. In addition, the workshop will focus on the range and effectiveness of employment supports and services, and benefits of integrating employment and clinical approaches. It is hoped that participants will examine individual and systemic barriers to work and strategies to help consumers overcome these barriers as well as explore ways to create a culture that supports employment and promotes integration in your organization. To register please call Deborah Short at 212.742.1122 x235 or email her at dshort@nyworkexchange.org.!