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Service Models for Young Adults with Disabilities

From education to employment and community engagement, there are many service models available to young adults with disabilities that promote greater independence, community, and improve their overall quality of life. Let's take a look at the models.

Adult services are administered by various state agencies, each with its own set of eligibility criteria, and accessing these services requires separate applications. Government agencies, such as the Department of Developmental Disabilities, frequently contract with non-profit agencies to deliver the services and support. Waiting lists are not uncommon. It’s important to note that not all young adults will qualify for adult services, even if they have a disability and have previously received special education services. 

Transition tip

Your adult child will have to qualify for these services as part of your state’s adult disability services system. If found eligible, services may not be provided immediately; you may face waiting lists, as services are not mandated to be provided immediately. It’s important to work with your DDS Transition Counselor to learn options in your desired area and programs that will match your family’s vision for their future.

Lets take a look at the models

Vocational Rehabilitation Programs (VR)

Vocational Rehabilitation (VR) agencies focus on enhancing the employability of individuals with disabilities. These agencies offer a range of services, including vocational assessment, skills training, job placement, and ongoing support in the workplace. Young adults who are blind would access state services for the blind. VR services (such as travel training and technology) have to be requested. The goal is to enable individuals to achieve meaningful employment, fostering financial independence and a sense of purpose.

Vocational Rehabilitation serves young adults who can maintain work after the training period without direct support from job coaches or supervisors.  These are often young adults who are working toward college or competitive employment and are already connected to their state vision service agency.

Pre-ETS

The Workforce Innovation and Opportunity Act (WIOA) requires vocational rehabilitation agencies to allocate federal funds for Pre-Employment Transition Services (Pre-ETS) for students. Programming is available for students aged 14-21 or 22, depending upon the state. The goals include pre-vocational training to increase positive transition outcomes. Foundational skills in workplace readiness and work based learning are the focus areas. To learn more, ask your special education administrator or Transition Specialist what agency your school district collaborates with the program. Your local state vocational rehabilitation agency is also a starting point to learn more.

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Good to know

Consider vocational rehabilitation services for those individuals who plan to work competitively and can maintain the work without direct support from job coaches or supervisors. VR services may provide financial assistance for college tuition and other related post-secondary educational expenses. This varies state to state, depending on yearly budgets and the individual’s financial eligibility.

Day Habilitation Programs (DayHabs)

Day Habilitation programs are a medical model that offer a supportive environment for young adults with complex disabilities. Participants engage in various therapeutic, educational, and leisure activities that cater to their individual needs and preferences. These programs focus on socialization, skill development, and recreational activities while providing nursing and behavioral support. An individual’s State case manager will refer individuals to day habilitation programs. To explore these services in your state,discuss with your Department of Developmental Disabilities case manager. 

Transportation supports to Day Habilitation programs are usually provided; each individual is evaluated for transportation support. It is important to note that transportation considerations factor heavily into placement determinations by the state agencies.

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Good to know

The criteria for becoming eligible for Day Hab services is based on standardized testing and other health and medical related factors. For example, most states have eligibility requirements where standardized cognitive assessments indicate scores at or near 70. Consider Day Hab programs for those individuals who need constant monitoring and physical care.

Community Based Day Services (CBDS)

CBDS differs from Day Habilitation programming in that it is not a medical model and serves people with disabilities who are more independent and do not need nursing specific services. The goal is to enhance participants’ abilities and independence, preparing them for a more active and fulfilling life. Participants often volunteer, exercise in local gyms, and otherwise access their local communities, usually in small groups. Some CBDS programs are site-based, and sometimes individuals meet at different locations in the community. Individuals access transportation via para-transportation or their families often transport them. Your Department for Disabilities case manager and IEP team can help support your exploration for suitable programs.

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Good to know

CBDS  tend to have larger staff-to-participant ratios. Consideration is made for those who require sighted guide assistance. Young adults should be able to accurately report their  needs, for example, use public restrooms with minimal assistance.

You may have a choice how services and programs are organized and paid for, once you are found eligible. Let’s look at a few self-directed models. All states differ so your state Department of Disabilities can explore options available.

Self-Direction

Self-Direction provides a mechanism for a young adult to create a schedule based on their own preferences and goals. Through community-mapping strategies, participants create a schedule based on exercise, volunteerism, entrepreneurism and social fun. Self-direction is funded through an individual’s DDS budget, and is currently not offered in every state (check with your state’s DDS to see if it is available in your state). If available it is a viable choice for a meaningful life. 

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Need to know

Self-direction requires having a family/support system that has the willingness and flexibility to carry out the plan. These plans generally involve having a staff person assigned to support a variety of experiences based outside of the home. Families can use their self-direction budget to hire someone they know and who has been involved in the young adult’s life. There is a hiring process that needs to be followed, and transportation is usually provided by the support staff. In some cases, connecting with paratransit for a wheelchair equipped vehicle will be important.

ASL is a language all its own and a great way to communicate with someone who is deaf and also signs.

Participant Directed Program (PDP)

In the Participant Directed Program, the young adult and their family need to advocate for resources to hire staff and are granted flexible funding to support their vision for a productive life in the community. The family is responsible for hiring the staff, supervising the day to day schedule and managing the staff. Payroll and financial reporting are provided by an intermediary agency. The activities are community-based and are overseen in an individual service plan that is reviewed by DDS annually.

Transition tip

Doing the work of an agency, i.e. hiring, managing, attending to administrative tasks like payroll, frees up more money which translates to more hours of staff support.

Agency with Choice (AWC)

In Agency with Choice, an agency is selected by the family to create the schedule, hire, train and sustain staff, and take care of financial aspects.  The activities are community-based and are overseen in an individual service plan that is reviewed by DDS annually. Using Agency with Choice likely reduces the number of direct support hours the participant would have under self-direction.

Resources

Below is a list of resources that will be helpful in researching the types of programs that will be most beneficial as your child transitions into adult services.

Vocational Rehabilitation

Day Habilitation Services and Community-Based Day Services

Home & Community-Based Services (HCBS) Waiver Program Basics

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