Adult-Serving Partners
Regarding Adults Jointly served by CPSA and RSA in
Cochise, Graham, Greenlee and Santa CruzCounties
Purpose:
This document serves as a basic guide that allows for an inclusive, collaborative service approach in the way our community works with adults and their families who are jointly served by the Community Partnership of Southern Arizona (CPSA) and the Arizona Department of Economic Security (ADES)/Rehabilitation Services Administration (RSA). Our mission is to work together in an atmosphere of mutual respect, dignity and joint responsibility.
Coordination of Treatment Planning and Services:
With the mutually shared values of a) the efficacy of work in individuals’ lives and b) consumer choice in vocational service selection, CPSA and RSA work closely together to fulfill the following vision:
All people diagnosed with a serious mental illness (SMI) and/or a co-occurring disorder have options and opportunities which allow them to obtain and maintain meaningful employment.
Our system-wide goal is to increase employment of people diagnosed with a serious mental illness and/or co-occurring disorder.
Within this context, we will continue to fulfill the following objectives:
  1. Promote a belief in recovery, the therapeutic value of work, and the ability of people diagnosed with SMI and/or a co-occurring disorder to work.
Action steps:
  • Continue to include work in recovery service plans.
  • Continue to work as a team using a collaborative decision-making process which is consistent with Arizona’s Principles of Person-Centered Planning and the Adult Recovery Team Model for all adult behavioral health recipients.
  • The vision reflected by these principles and model is that all adults in the behavioral health system participate in an Adult Recovery Team. This team will, at a minimum, consist of the person served and a qualified behavioral health representative/clinical liaison. The size, scope and/or intensity of the involvement of the team members are determined by the acuity and intensity of the service needs, objectives established by the person and the individuals that are needed to develop and coordinate an effective service plan. For persons jointly served by CPSA and RSA, the RSA Vocational Rehabilitation Counselor and vocational service provider will be invited to be part of the member’s Adult Recovery Team, if the member so desires.
  1. Promote best and evidence-based practices throughout the entire system.
Action steps:
  • Promote the sharing of success stories at all meetings.
  • Increase effectiveness of existing vocational services, including prevocational, services offered by RSA, and extended supported employment.
  • Improve access and flexibility of behavioral health services to accommodate working individuals.
  1. Across agencies, establish clear employment expectations, outcomes and measures. Share the data with the rest of the system.
Action steps:
  • Continue to educate staff about employment expectations, outcomes and measures.
  • Refine the reporting capabilities of the CPSA Vocational Database which tracks vocational activities of members across systems.
For individuals diagnosed with serious mental illness, vocational services delivered by CPSA and RSA are coordinated under the statewide Interagency Service Agreement (ISA) (Attachment A).
This agreement supports the Arizona Department of Health Services (ADHS)/Division of Behavioral Health Services (DBHS) Practice Improvement Protocol for Adult Clinical Teams and the RSA State Plan.
The CPSA Vocational Rehabilitation Specialist and RSA Program Representative work closely together to uphold the guidelines presented in this document and advance the shared vision and mission of CPSA and RSA related to vocational service delivery.
The following outlines the various ways CPSA and RSA coordinate and collaborate in vocational service delivery:
RSA/VR Referral Process:
Upon a request/agreement by the member to be referred to and make an application for RSA services, the Network Clinical Liaison contacts the assigned RSA Vocational Rehabilitation Counselor and makes the referral. The Clinical Liaison provides the RSA Vocational Rehabilitation Counselor with the following information, at a minimum:
  • Completed SEABHS Vocational Rehabilitation Referral Form (Attachment B)
  • Face Sheet
  • Current (within one year) SMI Checklist
  • Current psychiatric evaluation/psychosocial summary
  • Copy of current Service Plan update reflecting a vocational goal
  • Current medication list
  • Copy of Drivers’ License
  • Copy of Social Security card
  • Copy of most recent/current benefits letter
  • Copy of relevant case note
  • Signed release of information form to release information from Vocational Rehabilitation to SEABHS
  • Signed release of information on substance abuse treatment (if applicable)
  • Completed VR application (if possible)
  • Optional forms, if available: Vocational Assessment (Attachment C), Intake Vocational Addendum and copy of progress note related to vocational services or employment.
The RSA Vocational Rehabilitation Counselor schedules an appointment with the member to initiate RSA orientation and application processes.
Vocational Rehabilitation (VR) Counselors are to include clinical staff in the development of the Individualized Plan of Employment (IPE).
Similarly, clinical staff is expected to involve VR staff in a member’s service planning. In particular, clinical staff is to encourage the member involved in receiving VR services to include their VR Counselor in the member’s Adult Recovery Team.
At the point when a member has been working in a job, is considered to be stable in the job, and needs ongoing supports to maintain employment, a team meeting is called by the VR Counselor. At a minimum, the member, clinical staff person working with the member, the SEABHS vocational liaison, and provider of vocational services are present.
Once completed, the IPE sent to SEABHS medical records for inclusion in the member’s clinical chart.
Information Sharing:
In 2004, CPSA and RSA signed a Business Associate Agreement (BAA) allowing for specific Protected Health Information (PHI) under HIPAA to be shared on mutually served individuals. (Attachment D) Exception: individuals in HIV and substance use disorder treatment require a signed release of information specifically requesting this information. At the Network and RSA contractor level, releases of information are required to share information.
Resources:
The availability of services under ADHS/DBHS Covered Services necessary for vocational success:
  1. Services provided by SEABHS:
  • TreatmentServices
  • Rehabilitation Services (including Supported Employment Support Services such as: early vocational and extendedemployment support services such as: Pre-Job Training/Education and Development, Job Coaching and Employment Support including emergency responses to prevent regression/loss of job, peer and other social support services, as needed);
  • Medical Services;
  • Support Services (including Personal Assistance services - Extended, Peer Support);
  • Crisis Intervention Services;
  • Inpatient Services;
  • Residential Services;
  • Day Programs.
2.Vocational rehabilitation services provided by RSA, such as:
  • Vocational Counseling/Guidance;
  • Career exploration, vocational assessment, job planning;
  • Work exploration and work adjustment activities;
  • Specific job preparation (including educational opportunities, on-the-job training, other skill building activities, retraining);
  • Individual job development and placement;
  • Transitional employment placements;
  • VR post employment services;
  • Vocational support services such as tools, supplies and assistive technology services (including adaptive aids/devices, etc) as needed.
Arrangement for Co-Location:
The RSA staffing pattern requires that one Specialty VR Counselor serve individuals with SMI for all of CochiseCounty. General VR Counselors in Graham/Greenlee and Santa Cruz counties also serve individuals with SMI. Due to this arrangement, co-location of VR and clinical staff is achieved through pre-arranged appointments for the Counselor to meet with SEABHS members. For the specialty counselor serving individuals with SMI, SEABHS makes space and office equipment available as needed for the VR Counselor to meet on site with members.
Problem Solving:
General Principles
  1. Strive to resolve issues and barriers at the Adult Recovery Team level.
  1. If consensus by the Team has not been achieved, Network staff will involve the support of their supervisors. Supervisors will assist in issue resolution and assist the Adult Recovery Team to be responsive to mandatory time frames imposed by the various functions of our state agencies.
  1. If issues remain unresolved (or concerns remain), supervisors will involve CPSA Member Services and/or request a Review of a Counselor Determination. (This should reflect whatever the RSA process for appeal is.)
  1. If consensus is still not achieved, the Advocate(s) will advise the member and/or provider of the right to file grievance(s) or appeal(s) and provide assistance in filing such a formal appeal or grievance.
TheCPSA Vocational Rehabilitation Specialist and RSA Program Representative are available to troubleshoot and resolve cross-system issues that arise.
Service Delivery Issues Involving Members
  • For Network vocational services issues not resolved by above resources, CPSA Grievance and Appeal staff is available to assist in problem resolution.
  • For RSA issues not resolved by above resources, the Client Assistance Program (CAP) is available to assist in problem resolution.
Training:
Jointly available training topics are first identified through two assessments – one local/regional and one at the state ISA level.
Training opportunities consist of:
  • Interagency Service Agreement (ISA) training with different topics jointly agreed upon by RSA, CPSA and other RBHAs on an annual basis. The training is made available to members, Network, RSA, vocational, and consumer-run provider staff.
  • Monthly training through CPSA is available to any interested party.
  • Using a team consisting of Network and RSA staff and a CPSA member, the CPSA Vocational Rehabilitation Specialist coordinates vocational training targeting clinical staff. Each session is jointly prepared, conducted, and evaluated after its presentation.
  • General training topics offered throughout the entire system include: Recovery principles and practices, Vocational Best Practices, and issues involving barriers to members returning to work.
Summary:
Each participating agency/entity will ensure that all staff/contractors are familiar with and adhere to these guidelines in working with all jointly served adults.
This agreement will be reviewed on a yearly basis and more often as needed and revised as necessary by agreement of the undersigned:

Neal Cash
President/Chief Executive Officer
Community Partnership of Southern Arizona / Date
Craig Warren
Administrator
Rehabilitation Services Administration / Date
Bertha Villegas-Kinney
Deputy Administrator
Rehabilitation Services Administration / Date
Dana Johnson
Chief Executive Officer
SouthEastern Arizona Behavioral Health Services, Inc. / Date