Employment and Community Services program list

Descriptions of the programs/services available for accreditation in the Employment and Community Services Standards Manual.

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Affirmative business enterprises (ABE) are designed to provide significant economic benefits to their employees in a businesslike, integrated setting. In order for a program to seek accreditation as an ABE, wages are at or above minimum wage and a benefits package is provided for all employees. Business enterprises may be provided as many different business models, including franchises, manufacturing settings, and community businesses such as stores, restaurants, and other commercial or social enterprises.

An ABE is designed to assist the employees/persons served to overcome barriers to employment.

Some examples of the quality results desired by the different stakeholders of these services include:

Employment.
Earnings and benefits.
Increased skills.
Career development.
Employment in an integrated environment.
Meaningful work.
Opportunities to feel valued.

By providing an array of assistive technology services, which may be specialized to a specific population, an organization assists the persons served in making informed decisions and choices to increase access to or participation in employment options, education, independent living, interdependence, and/or inclusion in the community. Services reflect the latest knowledge in the field.

Services and supports may include assisting persons served in the assessment, evaluation, selection, acquisition, use, support, design and fabrication, follow along or follow up, modification, or maintenance of an assistive technology device; providing or arranging for training; providing information about referrals for and observations and trials of assistive technology devices; and/or exploring alternative strategies. Training is an important component of services and supports because assistive technology is often abandoned if persons have not been properly trained in its use.

Strategies for accommodation may include the use of assistive technology applications in:

Communication
Community living
Employment
Environmental control
Mobility, orientation, or destination training
Education and training
Activities of daily living/independent living
Recreation
Transportation
Meeting other needs as defined by the persons served

Assistive technology services and supports may be provided by an organization as part of its service delivery program, by a department within an organization, or by an organization with the sole purpose of providing assistive technology services. Services are provided by personnel who practice only in their area(s) of competency.

Some examples of the quality results desired by the different stakeholders of these services and supports include:

Increased independence.
Increased community access.
Participation of the persons in the community.
Increased employment options.
Increased wages.
A flexible, interactive process that involves the person served.
Individualized, appropriate accommodations.
Decreased family or caregiver support.
Timely services and reports.

The focus of Behavioral Consultation Services is to increase the ability of persons served to express more effective and acceptable behaviors. Behavioral strategies are implemented to teach the persons served better ways to manage environmental and personal stressors so that targeted behaviors are reduced and positive behaviors are learned and maintained. Through redirection of a targeted behavior to a more socially and culturally acceptable behavior, persons served are able to achieve increased participation in mainstream community activities. Behavioral Consultation Services includes services to address targeted behaviors such as eating disorders, disruptive behaviors, or self-injurious behaviors in the home or community.

Centers for Independent Living (CILs) are consumer-controlled, community-based, cross-disability organizations designed and operated by individuals with disabilities to provide nonresidential services and advocacy by and for persons with all types of disabilities. CILs provide five core services:

Advocacy.
Independent living.
Information and referral.
Peer counseling.
Transition services.

CILs serve as a strong advocacy voice on a wide range of national, state/provincial, and local issues. They work to ensure physical and programmatic access to housing, employment, transportation, communities, recreational facilities, and health and social services. Designed to provide a service environment of informed choice, CILs continuously improve the quality of individual services, expand the capacity of their organizations, and strive for enhanced accessibility in their communities.

Accreditation of CILs assists them in:

Being recognized for comprehensive, coordinated, effective, efficient, and accountable individualized services and programs.
Increasing community presence.
Increasing quality services for persons served.
Conducting outreach and building sustainable community partnerships.
Meeting grant requirements and assurances.
Providing services and operating according to established national CIL standards.
Assuring authorities and funding sources that grant provisions and specifications are carried out appropriately and effectively.
Generating leadership and growth in the community.

The desired outcomes of CILs are defined by the persons served, governance, staff, funding sources, and the community. Outcomes expectations include:

Inclusion for all persons into societies and communities.
The creation and provision of supports.
Advocacy for collaboration and creation of community resources.
Provision of supports to persons served to develop skills to enhance their lives.

Organizational change is continuously made based on input from the persons served, results of
services, and outcomes achieved.

Community employment services assist persons to obtain successful community employment opportunities that are responsive to their choices and preferences. Through a strengths-based approach the program provides person-directed services/supports to individuals to choose, achieve, and maintain employment in integrated community employment settings.

Work is a fundamental part of adult life. Individually tailored job development, training, and support recognize each person’s employability and potential contribution to the labor market. Persons are supported as needed through an individualized person-centered model of services to choose and obtain a successful employment opportunity consistent with their preferences, keep the employment, and find new employment if necessary or for purposes of career advancement.

Such services may be described as individualized competitive employment, individual placements, contracted temporary personnel services, competitive employment, supported employment, transitional employment, mobile work crews, contracted work groups in the community, community-based SourceAmerica® contracts, and other business-based work groups in community-integrated designs. In Canada, employment in the form of bona fide volunteer placements is possible.

Individuals may be paid by community employers or by the organization. Employment is in the community.

The following service categories are available under Community Employment Services (please refer to the indicated page for program descriptions and applicable standards):

Job Development (CES:JD)—page 200
Employment Supports (CES:ES)—page 205

If an organization provides only Job Development or Employment Supports, then it may be accredited for only that service. If it is providing both Job Development and Employment Supports, then it must seek accreditation for both. If any clarification is needed, please contact your CARF resource specialist. There is no charge for consultation.

Note: In making the determination of what an organization is actually providing in comparison to these service descriptions, these factors are considered: the mission of the services, the program descriptions, brochures and marketing image for these services, and the outcomes of the services.

Depending on the scope of the services provided, some examples of the quality outcomes desired by the different stakeholders of these services include:

Persons obtain community employment.
Persons obtain individualized competitive employment.
Employment matches interests and desires of persons.
Wages, benefits, and hours of employment achieved as desired.
Average number of hours worked per week increases.
Average number of hours worked per week meets the desires of the person served.
Full-time employment with benefits.
Transition-age youth move directly from their educational environment into community employment.
Potential for upward mobility.
Self-sufficiency.
Integration.
Responsive services.
Safe working conditions.
Cost-effective for placement achieved.
Performance level achieved meets requirements of job or position.
Increase in skills.
Increase in productivity.
Increase in hours worked.
Increase in pay.
Employment retention.
Increase in natural supports from coworkers.
Persons served treated with respect.
Minimize length of time for supports.
Type and amount of staff interaction meets needs.
Employer satisfaction.
Responsiveness to customers.

Employment support services promote successful training of a person to a new job, job adjustment, retention, and advancement. These services are based on the individual employee with a focus on achieving long-term retention of the person in the job. The level of employment support services is individualized to each employee and the complexity of the job.

Often supports are intensive for the initial orientation and training of an employee with the intent of leading to natural supports and/or reduced external job coaching. However, some persons may not require any employment supports at the job site; others may require intensive initial training with a quick decrease in supports, while some will be most successful when long-term supports are provided.

Supports can include assisting the employee with understanding the job culture, industry practices, and work behaviors expected by the employer. It may also include helping the employer and coworkers to understand the support strategies and accommodations needed by the worker.

Supports are a critical element of the long-term effectiveness of community employment. Support services address issues such as assistance in training a person to complete new tasks, changes in work schedule or work promotion, a decrease in productivity of the person served, adjusting to new supervisors, and managing changes in nonwork environments or other critical life activities that may affect work performance. Routine follow-up with the employer and the employee is crucial to continued job success.

Individuals may be paid by community employers or by the organization. Employment is in the community.

The following service categories are available under Community Employment Services (please refer to the indicated page for program descriptions and applicable standards):

Job Development (CES:JD)—page 200
Employment Supports (CES:ES)—page 205

Depending on the scope of the services provided, some examples of the quality outcomes desired by the different stakeholders of these services include:

Persons obtain community employment.
Persons obtain individualized competitive employment.
Employment matches interests and desires of persons.
Wages, benefits, and hours of employment achieved as desired.
Average number of hours worked per week increases.
Average number of hours worked per week meets the desires of the person served.
Full-time employment with benefits.
Transition-age youth move directly from their educational environment into community employment.
Potential for upward mobility.
Self-sufficiency.
Integration.
Responsive services.
Safe working conditions.
Cost-effective for placement achieved.
Performance level achieved meets requirements of job or position.
Increase in skills.
Increase in productivity.
Increase in hours worked.
Increase in pay.
Employment retention.
Increase in natural supports from coworkers.
Persons served treated with respect.
Minimize length of time for supports.
Type and amount of staff interaction meets needs.
Employer satisfaction.
Responsiveness to customers.

Successful job development concurrently uses assessment information about the strengths and interests of the person seeking employment to target the types of jobs available from potential employers in the local labor market. Typical job development activities include reviewing local employment opportunities and developing potential employers/customers through direct and indirect promotional strategies. Job development may include facilitating a hiring agreement between an employer and a person seeking employment. Some persons seeking employment may want assistance at only a basic, informational level, such as support for a self-directed job search.

Comprehensive suicide prevention programs are designed to reduce the incidence and impact of suicide events and promote hope and healing in the population served. Suicide prevention programs work to reduce risk factors and increase protective factors through the implementation of universal, selected, and indicated strategies that address the needs and reflect the culture and environment of the population served. They take a strategic approach to the design and implementation of activities that will be accessible to and have the greatest impact on persons served and their families/support systems, personnel, and partners and other stakeholders in the community.

Personnel in a comprehensive suicide prevention program receive competency-based training on suicide prevention, intervention, and postvention. Suicide prevention activities must be integrated into numerous community and clinical environments to be successful. To that end, comprehensive suicide prevention programs engage with stakeholders, including persons with lived experience, regarding capacity building; communication and messaging; and outreach, education, and training to increase awareness and expertise related to evidence-informed suicide prevention practices.

The program collects and analyzes data to measure its performance, inform capacity building to address gaps in resources and services, and further reduce risks and build resilience in the population served.

Community housing addresses the desires, goals, strengths, abilities, needs, health, safety, and life span issues of the persons served, regardless of the home in which they live and/or the scope, duration, and intensity of the services they receive. The residences in which services/supports are provided are typically owned, rented, leased, or operated directly by the organization, or may be owned, rented, or leased by a third party, such as a governmental entity. Providers exercise control over these sites in terms of having direct or indirect responsibility for the physical conditions of the facility.

Community housing is provided in partnership with individuals. These services/supports are designed to assist the persons served to achieve success in and satisfaction with community living. They may be temporary or long-term in nature. The services/supports are focused on home and community integration and engagement in productive activities. Community housing enhances the independence, dignity, personal choice, and privacy of the persons served. For persons in alcohol and other drug programs, these services/supports are focused on providing sober living environments to increase the likelihood of sobriety and abstinence and to decrease the potential for relapse.

Community housing programs may be referred to as group homes, halfway houses, three-quarter way houses, recovery residences, sober housing, domestic violence or homeless shelters, and safe houses. These programs may be located in rural or urban settings and in houses, apartments, townhouses, or other residential settings owned, rented, leased, or operated by the organization. They may include congregate living facilities and clustered homes/apartments in multiple-unit settings. These residences are often physically integrated into the community, and every effort is made to ensure that they approximate other homes in their neighborhoods in terms of size and number of individuals.

Community housing may include either or both of the following:

Transitional living that provides interim supports and services for persons who are at risk of institutional placement, persons transitioning from institutional settings, or persons who are homeless. Transitional living is typically provided for six to twenty-four months and can be offered in congregate settings that may be larger than residences typically found in the community.
Long-term housing that provides stable, supported community living or assists the persons served to obtain and maintain safe, affordable, accessible, and stable housing.

The residences in which Community Housing services are provided must be identified in the survey application. These sites will be visited during the survey process and identified in the survey report and accreditation decision as a site at which the organization provides a Community Housing program.

Note: The term home is used in the following standards to refer to the dwelling of the person served, however CARF accreditation is awarded based on the services/supports provided. This is not intended to be certification, licensing, or inspection of a site.

Some examples of the quality results desired by the different stakeholders of these services/supports include:

Safe housing.
Persons choosing where they live.
Persons choosing with whom they will live.
Persons having privacy in their homes.
Persons increasing independent living skills.
Persons having access to the benefits of community living.
Persons having the opportunity to receive services in the most integrated setting.
Persons’ rights to privacy, dignity, respect, and freedom from coercion and restraint are ensured.
Persons having the freedom to furnish and decorate their sleeping or living units as they choose.
Persons having freedom and support to control their schedules and activities.
Settings that are physically accessible to the individuals.

Community integration is designed to help persons to optimize their personal, social, and vocational competency to live successfully in the community. Persons served are active partners in determining the activities they desire to participate in. Therefore, the settings can be informal to reduce barriers between staff members and persons served. An activity center, a day program, a clubhouse, and a drop-in center are examples of community integration services. Consumer-run programs are also included.

Community integration provides opportunities for the community participation of the persons served. The organization defines the scope of these services and supports based on the identified needs and desires of the persons served. This may include services for persons who without this option are at risk of receiving services full-time in more restrictive environments with intensive levels of supports such as hospitalization or nursing home care. A person may participate in a variety of community life experiences or interactions that may include, but are not limited to:

Leisure or recreational activities.
Communication activities.
Spiritual activities.
Cultural activities.
Pre-vocational experiences.
Vocational pursuits.
Volunteerism in the community.
Educational and training activities.
Development of living skills.
Health and wellness promotion.
Orientation, mobility, and destination training.
Access and utilization of public transportation.
Interacting with volunteers from the community in program activities.
Community collaborations and social connections developed by the program (partnerships with community entities such as senior centers, arts councils, etc.).

Note: The use of the term persons served in Community Integration may include members, attendees, or participants, as appropriate.

Some examples of the quality results desired by the different stakeholders of these services include:

Community participation.
Increased independence.
Increased interdependence.
Greater quality of life.
Skill development.
Slowing of decline associated with aging.
Volunteer placement.
Movement to employment.
Center-based socialization activities during the day that enable persons to remain in their community residence.
Activity alternatives to avoid or reduce time spent in more restrictive environments, such as hospitalization or nursing home care.

A comprehensive benefits planning organization creates and continuously improves its services and staff competencies to enhance the economic standing, well-being, and self-sufficiency of persons served. Through trained and professional benefits planning specialists, comprehensive individual and family benefits planning enhances lives, provides support in learning what resources are available and how to advocate for benefits, and provides support in learning how and when to access needed resources. Benefits planning demonstrates a willingness to revise planning as the person served grows, changes, experiences change, and has new goals.

Benefits planning that is comprehensive assists individuals through collaboration and coordination with a wide range of potential resources and agencies. There is a network of resources that fill in the many aspects of daily living. The following is not an exhaustive list, but suggests some examples of these:

Social Security Disability Insurance (SSDI) (SSA)
Supplemental Security Income (SSI) (SSA)
Vocational Rehabilitation Services
Work Incentives Planning and Assistance (WIPA)
Workers Compensation
Unemployment compensation
Veterans Benefits
Medicare and Medicaid (CMS)
Provincial/territorial health insurance systems
Provincial/territorial social services disability benefits/Canada Pension Plan (CPP)—Disability Benefits
Housing assistance
Energy assistance
Food stamps
Temporary Assistance for Needy Families (TANF)
Tax credits
Transportation assistance
Private insurance (short- and long-term disability policies)

Some examples of quality results desired by the different stakeholders of these services include:

Access
Information presented in understandable format or manner.
Individual disability or employment challenges are met.
Service locations are accessible.
Benefits planning meetings use effective mediums such as face-to-face meetings, phone conferences, email, and video conferencing.
Effectiveness
Persons served are able to identify specific benefits applicable to their work and living situations.
Advocacy skills are developed for specific benefits issues.
Informed choices are made with regard to employment and benefits planning.
Self-sufficiency in personal resource management is achieved.
Skills for resource planning are achieved.
Enhanced economic well-being of the person served is achieved.
Asset building potential of persons served expanded.
Efficiency
The time from intake to referral is minimized.
A comprehensive and individualized plan is developed in minimal time.
Benefits planning reports are returned to referral authorities and persons served within designated times.
The caseload of benefits planning specialists is maintained at the level of “break-even” efficiency.
Person Served Satisfaction
Persons served express satisfaction in:
The knowledge they gained about benefits and community resources.
The reduction of their fears regarding the potential loss of benefits.
Trust and confidence of the benefits planning process and its result.
The personal and employment choices made based on quality benefits information.
Stakeholder Satisfaction
Family members and other stakeholders:
Gain knowledge to help with benefits management and return-to-work economic support strategies.
Express reduced fear of losing benefits.
Identify methods for “navigating the system” and connecting to resources.
View benefits as tools to help youth transitioning from school reach their employment and community living goals.

Comprehensive vocational evaluation services provide an individualized, timely, and systematic process by which a person seeking employment, in partnership with an evaluator, learns to identify viable vocational options and develop employment goals and objectives. A vocational evaluator or vocational specialist provides or supervises the services.

An accredited comprehensive vocational evaluation service is capable of examining a wide range of employment alternatives. The following techniques are used, as is appropriate to the person being assessed, to provide comprehensive vocational evaluation services:

Pre-evaluation assessment of assistive technology needs.
Assessment of functional/occupational performance in real or simulated environments.
Work samples.
Employment exploration model.
Psychometric testing.
Preference and interest inventories.
Personality testing.
Extensive personal interviews.
Other appropriate evaluation tests, depending on the individual.
Analysis of prior work and/or volunteer experience and transferable skills.

Some examples of the quality results desired by the different stakeholders of these services include:

Realistic job opportunities are explored and identified for individuals.
Employment barriers are identified and ways to overcome these are suggested.
Assistive technology or other accommodations needed are identified.
The evaluation is completed within the authorization period.
The person served understands the results.
The cost per evaluation is acceptable.
Interests of the persons served are thoroughly explored.
Evaluation reports lead to job goals.
Transferable skills are identified.

Employee development services are individualized services/supports that assist persons seeking employment to develop or reestablish skills, attitudes, personal characteristics, interpersonal skills, work behaviors, functional capacities, etc., to achieve positive employment outcomes.

Such services/supports are time limited and can be provided directly to persons seeking employment or indirectly through corporate employer/employee support programs. These services/supports can be provided at community job sites, within formal and organized training and educational settings, through coaching, by tutorial services, or within the organization. These services may be offered in a free-standing unit or as a functional piece of other services.

Some examples of the quality outcomes desired by the different stakeholders of these services include:

Person served obtains employment.
Person served moves to a training program or better employment.
Person served retains employment.
Person served obtains improved benefits.
Increased wages.
Increased skills.
Increased work hours.
Movement to individualized competitive employment.
Employment in an integrated environment.
Job advancement potential increases.
Job-seeking skills are developed.
Job-keeping skills are developed.
Career growth and development.
Level of support needed is reduced.
Exposure to and availability of a variety of jobs.
Program is kept at capacity.
Services are cost-effective for the results achieved.
Responsiveness (days from referral to starting services).

The design of employment and career centers is results oriented and focused on the employment and career development goals of job seekers. To be successful, employment and career centers must also consider the personnel needs of employers in the local job market, the community resources available, and the trends and economic considerations in the labor market. The services are designed to meet current and future labor market demands; to break the cycle of unemployment and public assistance; and to provide opportunities for skill, educational, and career development for persons served to become productive members of the workforce.

An employment and career center provides a comprehensive array of services and resources that may include a coordinated, cooperative system of service delivery with partner organizations. Partner organizations may be co-located, based in the community, or virtual.

The provision of quality services requires consideration of the individual needs of job seekers. Through the individual planning process the center obtains relevant information from job seekers about their employment and career development objectives and goals and provides services and resources tailored to meet their needs. The center provides persons served with information and guidance they can use to make informed choices and career decisions.

A system exists for accountability, reporting of outcomes, and performance improvement. Information regarding outcomes is shared with relevant stakeholders in accordance with their needs and interests. Services are revised based on input from job seekers, input from employers in the local job market, and the results of the center’s performance management system. The goal is to deliver ever-improving value to persons served and other stakeholders.

Services are provided in a business-like environment and job seekers, partner organizations, and employers in the local job market are all treated with respect and as valued customers of the employment and career center.

Some examples of the quality results desired by the different stakeholders of these services include:

Easy access to services for job seekers.
Responsiveness to employers.
Efficiency, effectiveness, and flexibility of service delivery.
Employment in the local labor market with or without ongoing support.
Employment that meets the individual’s desires and goals as identified in the service plan.
Employment services that result in job retention and advancement in position, earnings, and/or benefits.
Career development, including education and training, as desired.
Referral to other services or supports that may assist the person served to meet identified needs or goals.

Employment planning services are designed to assist a person seeking employment to learn about employment opportunities within the community and to make informed decisions. Employment planning services are individualized to assist a person to choose employment outcomes and/or career development opportunities based on the person’s preferences, strengths, abilities, and needs. Services begin from a presumption of employability for all persons and seek to provide meaningful information related to planning effective programs for persons with intervention strategies needed to achieve the goal of employment.

Employment planning uses some type of employment exploration model. This may involve one or more of the following:

Situational assessments.
Paid work trials.
Job tryouts (may be individual, crew, enclave, cluster, etc.).
Job shadowing.
Community-based assessments.
Simulated job sites.
Staffing agencies/temporary employment agencies.
Volunteer opportunities.
Transitional employment.

Some examples of quality outcomes desired by the different stakeholders of these services include:

Work interests are explored and identified.
Recommendations for employment options are appropriate.
Employment planning reports lead to job goals.
Transferable work skills and employment barriers are identified.
Benefits planning is included.
Services are timely in their delivery.
Services are cost-effective.
Individuals served understand recommendations that are made.
Individuals served identify desired employment outcomes.

The design of an Employment Services Centre (ESC) is results oriented and focused on the employment and career development goals of the job seeker. The centre maintains a businesslike environment, and the job seeker and employer are treated with respect as valued customers. To be successful, these services consider the personnel needs of the employers in the local job market, the community resources available, and the trends and economic considerations in the labour market. The services are designed to meet current and future labour market demands; to break the cycle of unemployment and public assistance; and to provide opportunities for skill, educational, and career development for individuals to become productive members of the workforce.

The centre develops and maintains relationships with partner service providers to provide services within an ESC. A contract or other written agreement clarifies the division of service provision and decision making. It is the designated lead operator of the centre that applies for and maintains accreditation status and fulfills the government accountability reporting requirements.

The ESC ensures that comprehensive services are provided in a seamless manner, meaning that the centre has a consolidated, coordinated, and cooperative system of service delivery by its participating partner service providers. Partner service providers are committed to delivering services that strive to achieve excellent outcomes. An ESC usually has only one primary physical location and may also provide services at satellite or itinerant locations, including online services or virtual locations.

An ESC has a system for financial and government contract accountability, reporting of outcomes, and continuous quality improvement. The goal is to deliver ever-improving value to persons served, employers, and other community stakeholders. Services are revised based on contractual obligations with the funder, input from job seekers, input from employers in the local job market, and the results of the centre’s outcomes management system. Information regarding outcomes is shared with all stakeholders for various reasons, including:

Improving services, marketing, and outreach efforts.
Informing the community about the value of the centre to the community.
Advocating on behalf of persons served who need additional services within the greater community of supports.

The ESC maintains its strategic positioning in the employment sector of the community by designing and improving its services based on input from the persons served and employers and results of the organization’s outcomes management system, which is focused on the persons served achieving their employment goals and meeting the personnel needs of employers.

The provision of quality ESC services requires an individualized, customer focus that considers the individual needs of job seekers. An ESC establishes its methods for providing self-serve/non-case-managed services as well as an individualized case management process that captures various levels of intensity of services. Case management planning considers the level of services and supports needed for persons served to achieve and maintain employment, achieve educational and career development objectives, develop attachments to community services, and sustain each family’s economic well-being.

An organization seeking CARF accreditation for an ESC provides individualized services and supports to achieve identified employment outcomes. The array of services and supports may include:

Identification of employment opportunities and resources in the local job market.
Development of viable work skills that match workforce needs within the geographic area.
Development of realistic employment goals.
Establishment of service plans to achieve employment outcomes.
Identification of resources and supports to achieve and maintain employment.
Coordination of and referrals to employment-related services and supports.

Depending on the level of individual services provided, the centre obtains relevant information from job seekers, including resources and services they want or require to meet their identified needs, and offers an array of services it provides or arranges for through collaborations including partnerships, contracted service provision, and use of community services.

The centre provides individuals with information they can use to make informed choices and career decisions. Services often include outreach to potential customers in the community to inform them about available services.

Examples of the quality results desired by the different stakeholders of these services include:

Easy access to services for job seekers.
Responsiveness to employers.
Efficiency, effectiveness, and flexibility of service delivery.
Employment in the local labour market with or without ongoing support.
Employment that meets the individual’s desires and goals.
Wages, hours per week, and benefits at a level required to maintain the family.
Employment services that result in job retention and advancement in position, earnings, and/or benefits.
Career development, including education and training, as desired.
No wrong door, including attachment to other community services.
Individualized, appropriate accommodations.
A flexible, interactive process that involves the person served.
Increased independence.
Increased employment options.
Knowledgeable staff who have the expertise to address barriers to employment.
Timely services and supports.
Persons served obtain and maintain employment consistent with their preferences, strengths, and needs.
Persons served obtain and maintain jobs with appropriate benefits.

Employment skills training services are organized formal training services that assist a person seeking employment to acquire the skills necessary for specific jobs or families of jobs. Such services can be provided at job sites in the form of apprenticeships, on-the-job training, and/or volunteer situations; within formal and organized training and educational settings (such as community colleges and trade and technical schools); or within the organization.

Some examples of the quality outcomes desired by the different stakeholders of these services include:

Persons show improvement in skill level.
Specific marketable skills are developed.
Persons served achieve employment in the area of training.
Persons secure employment with benefits.
Persons retain employment.
Training is completed in a timely manner.
Training is cost-effective for the results produced.

Family services are provided to persons served and/or their families, either to enable the person and the family to stay together or to enable persons served to remain involved with their family. Families, including the persons served, are the key decision makers in identifying the services/supports needed and in choosing how those services/supports will be delivered.

Some examples of the quality results desired by the different stakeholders of these services include:

Resources to support family stability.
Availability of respite services.
Emergency response system for family relief.
Families remaining together.

Foster family services are provided under a contract or agreement for the temporary placement of an individual, regardless of age, in a family setting outside the birth or adoptive family home. Foster family services are provided to a foster family provider to establish and maintain a home on a temporary basis for the person served. The courts may be involved in establishing this relationship.

Foster family services are comprehensive and establish a system of supports and services for the individual, the family of origin when appropriate, and the foster family provider. These services focus on establishing stability in the life of the person served.

Although the “home” is generally the foster family provider’s home or residence, it may also be the home of the person served.

Some examples of the quality results desired by the different stakeholders of these services/supports include:

Temporary placements for persons.
Stability in a person’s life.
Appropriate matches of persons with foster families.
Safe placements.

Home and community services (HCS) are person centered and foster a culture that supports autonomy, diversity, and individual choice. Individualized services are referred, funded, and/or directed by a variety of sources. In accordance with the choice of the person served, the services provided promote and optimize the activities, function, performance, productivity, participation, and/or quality of life of the person served.

The Home and community services may serve persons of any ages, from birth through end of life. Services may be accessed in a variety of settings including, but not limited to, private homes, residential settings, schools, workplaces, community settings, and health settings.

Services are provided by a variety of personnel, which may include health professionals, direct support personnel, educators, drivers, coaches, and volunteers and are delivered using a variety of approaches, supports, and technology.

Services are dynamic and focus, after a planning process, on the expectations and outcomes identified by both the person served and the service providers. The service providers are knowledgeable of care options and linkages to assist the person served; use resources, including technology, effectively and efficiently; and are aware of regulatory, legislative, and financial implications that may impact service delivery for the person served. The service providers are knowledgeable of their roles in and contribution to the broader health, community, and social services systems.

Home and community services must include at least one of the following service delivery areas:

Services for persons who are in need of specialized services and assistance due to illness, injury, impairment, disability, or a specific age or developmental need.
Services for persons who need assistance to access and connect with family, friends, or coworkers within their homes and communities.
Services for persons who need or want help with activities in their homes or other community settings.
Services for caregivers that may include support, counseling, education, respite, or hospice.

Note: A service provider seeking accreditation for home and community services is not required to provide all four of the service delivery areas identified in the service description. However, it must include in the site survey all of the service delivery areas it provides that meet the service description.

Host family/shared living services assist a person served to find a shared living situation in which the person is a valued person in the home and has supports as desired to be a participating member of the community. An organization may call these services, which are provided under a contract or written agreement with the host family/shared living provider, a variety of names, such as host family services, shared living services or supports, alternative family living, structured family care giving, family care, or home share.

Getting the person in the right match is a critical component to successful host family/shared living services. The organization begins by exploring with the person served what constitutes quality of life for the individual and identifies applicant host family/shared living providers who are a potential match with the person’s identified criteria. The person served makes the final decision of selecting a host family/shared living provider.

Safety, responsibility, and respect between or amongst all people in the home are guiding principles in these services. Persons are supported to have meaningful reciprocal relationships both within the home, where they contribute to decision making, and in the community. The host family/shared living provider helps the person served to develop natural supports and strengthen existing networks. Relationships with the family of origin or extended family are maintained as desired by the person served. The host family/shared living provider supports the emotional, physical, and personal well-being of the person.

Persons develop their personal lifestyle and modify the level of support over time, if they so choose. The host family/shared living provider encourages and supports the person served to make decisions and choices.

The host family/shared living provider does not necessarily have to be a family, as it could be an individual supporting the person. Although the “home” is generally the host family/shared living provider’s home or residence, it may also be the home of the person served.

Some examples of the quality results desired by the different stakeholders of these services and supports include:

Quality of life as identified by the person served is enhanced.
Increased independence.
Increased community access.
Persons served choose whom they will live with and where.
Participation of the persons in the community.
Community membership.
Support for personal relationships.
Increased natural supports.
Strengthened personal networks.
Supports accommodate individual needs.
Persons feel safe.
Persons feel that the supports they need/want are available.
Persons decide where they live.
Persons feel valued.
Persons have meaningful relationships.
Persons develop natural supports.
Persons participate in their community.

Mentor services are designed for and dedicated to the recruitment, training, and support of community supports and volunteers who provide coaching, community activities, and networks to assist persons with disabilities and/or disadvantages to achieve goals as desired in education, employment, and/or self-sufficiency in life.

Some examples of the quality results desired by the different stakeholders of these services and supports include:

Successful life transitions, including completing school, adjusting to disability, overcoming personal or family crisis, loss, and aging.
Completion of academic, career, and personal goals.
Achieving and maintaining employment.
Self-sufficiency.
Increased community access and independence.
Increased social capital.
Building confidence and self-esteem.
Support in self-advocacy.
Economic improvement.
Tax benefit to the community.
Housing.
Network of supports in the local community.
Reduction in negative encounters with legal systems.
Respite and resources for families.

A network is a legal entity that contracts with two or more organizations that deliver health or human services to persons served (“participating providers”) to coordinate functions between or on behalf of the participating providers. Various types of networks exist and they may have different purposes in the field. For example, business networks may be formed to establish strategic business arrangements with or among participating providers, and service delivery networks may establish an integrated system of service provision by participating providers to persons served. Other types of networks may combine the functions of business and service delivery networks. To promote service excellence and minimize risk, service delivery networks establish and implement a process for quality review of participating providers.

Network leadership is identified and guides:

Participating provider contracts that address, depending on the type of network, business functions and/or service delivery.
Operational links and integration with or among participating providers.
A system to facilitate cooperation with participating providers, including:
Integrated strategic and financial planning.
Resource coordination.
Technology integration.
Performance measurement.
Development and improvement of participating providers.
Geographic areas served.

Networks that provide services to persons served may offer value in any or all of the following ways:

Choice of services.
Access to services based on the needs of the persons served and expectations of other stakeholders.
Improved coordination of services among participating providers.
Improved effectiveness and efficiency of service delivery.

Note: A legal entity is an organization formed in accordance with and recognized by applicable law or decree. A legal entity is separate and distinct from its stakeholders and other persons and entities and is typically identified by a unique government-issued number or code.

Organizational employment services are designed to provide paid work to the persons served in locations owned, leased, rented, or managed by the service provider. A critical component and value of organizational employment services is to use the capacity of the organization’s employment and training service design to create opportunities for persons to achieve desired employment outcomes in their community of choice, including individualized competitive employment.

Service models are flexible and may include a variety of enterprises and business designs, including organization-owned businesses such as retail stores, restaurants, shops, franchises, etc.

Some examples of the quality outcomes desired by the different stakeholders of these services include:

Movement to individualized competitive employment.
Movement to an integrated environment.
Increased wages.
Pay at or above minimum wage.
Increased skills.
Increased work hours.
Minimized downtime with meaningful activities available.
Exposure to and availability of a variety of jobs.
Increased ability to interact with others as part of a professional team and to resolve interpersonal issues appropriately.

Personal supports services are designed to provide instrumental assistance to persons and/or families served. They may also support or facilitate the provision of services or the participation of the persons served in other services/programs, such as employment or community integration services. Services and supports, which are primarily delivered in the home or community, are not provided by skilled healthcare providers (please see the Glossary for a definition of skilled healthcare provider), and typically do not require individualized or in-depth service planning.

Services can include direct personal care supports such as personal care attendants and housekeeping and meal preparation services. Services can also include transporting persons served, information and referral services, translation services, senior centers, programs offering advocacy and assistance by professional volunteers (such as legal or financial services), training or educational activities (such as English language services); music therapy; recreation therapy; mobile meal services; or other support services, such as supervising visitation between family members and aides to family members.

A variety of persons may provide these services/supports other than a program’s staff, such as volunteers and subcontractors.

Rapid rehousing and homelessness prevention programs are short-term crisis response programs for persons and households that are experiencing homelessness or are at imminent risk of homelessness. These programs engage in ongoing outreach activities to maximize opportunities for contact with persons who, without assistance, are likely to remain or become literally homeless. Interventions are designed to reduce barriers to housing and help persons served and their families rapidly exit homelessness and return to stable housing or maintain stable housing. The programs are knowledgeable about and link with community resources as desired by the persons served.

Incorporating a housing first approach, individualized, person-centered housing plans guide service delivery. Each person served participates in the development of a housing plan that considers the person’s desired housing outcomes, barriers to housing, the need for financial assistance, and the financial resources available. As needed, the program offers education for the persons served on landlord-tenant relationships, self-advocacy, and rights and responsibilities as a tenant to support achievement of housing-specific goals. Personnel are trained in areas necessary to achieve the desired outcomes of persons served using a person-centered approach.

Key to the programs’ ability to secure housing for persons with high housing barriers are recruitment and retention of landlords who are willing to offer flexibility in applying tenant screening criteria and rent to persons exiting or at imminent risk of homelessness. The programs work to maximize suitable housing options and to access and manage the available financial resources to facilitate rapid rehousing and/or reduce the risk of homelessness.

Respite services facilitate access to time-limited, temporary relief from the ongoing responsibility of service delivery for the persons served, families, and/or organizations. Respite services may be provided in the home, in the community, or at other sites, as appropriate. An organization providing respite services actively works to ensure the availability of an adequate number of direct service personnel.

Some examples of the quality results desired by the different stakeholders of these services/supports include:

Services/supports are responsive to the family’s needs.
Services/supports are safe for persons.
Services/supports accommodate medical needs.

Many community organizations, in partnership with individuals, families, and funding sources, are redesigning their resources to embrace a self-directed community supports and services approach. For many individuals, this is one more significant and evolutionary step away from institutional settings. This customer-designed and delivered approach utilizes an individually controlled budget. The budget is developed according to guidelines from the funding source.

Through the development and management of individualized community support options, individuals take an active role in the decisions that affect their lives. In Employer of Record services, the person served is the managing employer—responsible for hiring, firing, and managing details surrounding employment of their support workers, such as duties, work hours, and performance expectations. The provider is the employer of record that supports the person served in ensuring that governmental payroll requirements are met. In some cases, the person served may be considered the employer of record and contract or hire the organization as a fiscal agent to be responsible for payroll and related governmental reporting.

In Employer of Record for Support Services important objectives include:

Integrating supports and services within the set individual budget plan.
Establishing policies and procedures for filing claims and receiving reimbursement.
Establishing policies and procedures for dealing with government tax reports and filings for employers and employees.
Providing policies and procedures for risk management, notably in the areas of corporate compliance to prevent fraud, waste, and abuse of government funds.
Continuously improving the local service provider accredited in Self-Directed Community Supports and Services based on decision making and true participation of persons served in service and organizational design.

Self-directed supports and services are based on the assumption that individuals receiving support have the authority to determine the role the provider will play in their lives and that personal preferences for supports should drive, or at least heavily influence, the planning process.

Some examples of the quality results desired by the different stakeholders include:

Persons have a budget over which they have control.
Persons have free choice among providers, within funding guidelines.
Persons get help as desired in finding community resources.
Persons select, hire, fire, and manage the workers who provide their supports and services.

There are two program categories in which an organization can seek accreditation in Self-Directed Community Supports and Services:

Flexible Supports Planning (Section 4.N. SDCSS:FSP) allows an organization to manage the assessment, development, and planning of services to help persons served gain access to supports as needed.
Employer of Record for Support Services (Section 4.O. SDCSS:EOR) work with persons served as the managing employer, ensures that governmental payroll requirements are met, and often acts as a human resource consultant.

When an organization is accredited in both Flexible Supports Planning and Employer of Record for Support Services, consideration is made for dealing with potential conflicts of interest.

Through the development and management of individualized community support options, individuals take an active role in the decisions that affect their lives. Flexible Supports Planning services provide information and assistance for persons served to plan and direct their individual budgets for supports and services.

Due to budgetary constraints, at times the individual budget development process may need to separate wants from needs for treatment and support. Some important objectives include:

Identifying an individual’s needs.
Selecting supports and services within an approved context that best address those needs.
Determining the amount of supports or services necessary to adequately address each identified need.
Determining a cost or amount to reimburse providers.
Integrating supports and services within the set individual budget plan.
Providing policies and procedures for risk management, notably in the areas of corporate compliance to prevent fraud, waste, and abuse of government funds.
Continuously improving the local service provider accredited in Self-Directed Community Supports and Services based on decision making and true participation of persons served in service and organizational design.

Some examples of the quality results desired by the different stakeholders include:

Persons lead the planning process and have support of their choosing to do so.
Persons decide which supports and services to direct.
Persons get help as desired to direct their supports and services.
Persons direct how their supports and services are provided, including their nature.
Persons have a budget over which they have control.
Persons have free choice among providers, within funding guidelines.
Persons get help as desired in finding community resources.
Persons make decisions to redirect funds among supports and services as desired.

There are two program categories in which an organization can seek accreditation in Self-Directed Community Supports and Services:

Flexible Supports Planning (Section 4.N. SDCSS:FSP) allows an organization to manage the assessment, development, and planning of services to help persons served gain access to supports as needed.
Employer of Record for Support Services (Section 4.O. SDCSS:EOR) work with persons served as the managing employer, ensures that governmental payroll requirements are met, and often acts as a human resource consultant.

When an organization is accredited in both Flexible Supports Planning and Employer of Record for Support Services, consideration is made for dealing with potential conflicts of interest.

Self-employment presents an opportunity for persons with disabilities to gain financial equity often not available through wage employment in entry-level positions. Self-employment services provide supports that lead an individual toward earning income directly from one’s own business, trade, or profession, rather than as salary or wages from an employer. They may include small business development, micro-enterprise, or telecommuting. In order to achieve a desired level of income, an individual may have several enterprises.

Some of the quality results desired by the different stakeholders of these services may include:

Earnings.
Successful self-employment.
Increased self-esteem.
Independence.
Self-sufficiency.
Employment in the community.

Services coordination programs provide goal-oriented and individualized supports focusing on improved self-sufficiency for the persons served through assessment, planning, linkage, advocacy, coordination, and monitoring activities. Successful services coordination results in community opportunities and increased independence for the persons served. Programs may provide occasional supportive counseling and crisis intervention services, when allowed by regulatory or funding authorities.

Services coordination may be provided by an organization as part of its individual service planning and delivery, by a department or division within the organization that works with individuals who are internal and/or external to the organization, or by an organization with the sole purpose of providing community services coordination. Such programs are typically provided by qualified services coordinators or by case management teams.

Organizations performing services coordination as a routine function of other services or programs are not required to apply these standards unless they are specifically seeking accreditation for this program.

Some examples of the quality results desired by the different stakeholders of these services include:

Access to a variety of services/supports.
Access to choices of services.
Individualized services to meet needs.
Persons achieving goals.
Persons achieving independence.
Access to vocational training.
Persons achieving employment.
Access to career development.

Services for children and youth include prevention, early intervention, preschool programs, early years programs, after-school programs, outreach, and services coordination. Services/supports may be provided in a variety of settings, such as a family’s private home; the organization’s facility; and community settings such as parks, recreation areas, preschools, or child day care programs not operated by the organization. In all cases, the physical setting, equipment, and environment meet the identified needs of the children and youth served and their families. Families are the primary decision makers and play a critical role, along with team members, in the process of identifying needs and services.

Child and adolescent services focus on the development of skills needed by children/adolescents to succeed in school, their family, and their community. An organization may provide an array of distinct services that fall under the heading of child and adolescent services, with different service delivery models that incorporate different practices. Services are individualized to meet the changing needs of the children/adolescents served. Child and adolescent services empower the child/adolescent to develop skills in decision making, including maximizing their participation in the service planning process. Involvement of other team members depends on what the child/adolescent needs and the scope of the services provided. Team members could come from several agencies and may include therapists, child development specialists, social workers, educators, medical professionals, and others.

Some examples of the quality outcomes desired by the different stakeholders of services for children and youth include:

Services individualized to needs and desired outcomes.
Collection and use of information regarding development and function as relevant to the scope of the services.
Children/youth acquiring new skills.
Collaborative approach involving family members in services.
Transition planning that supports continuity of services and developmental transitions.
Increased responsibility of children/youth to make decisions.
Personal safety of youth in the community.

Early intervention services are structured and coordinated to facilitate the achievement of optimal development through the provision of prevention, assessment, education, development, and/or therapeutic services to infants and toddlers with disabilities or who are at risk of developmental delay and their families. Early intervention focuses on helping infants and toddlers learn the basic and brand-new skills that typically develop during the first years of life. Broadly speaking, developmental delay means a child is delayed in some area of development. There are five areas in which development may be affected:

Cognitive development.
Physical development.
Communication development.
Social or emotional development.
Adaptive development.

Assessment is conducted to determine each child’s unique needs and the early intervention services appropriate to address those needs. Families are the primary decision makers in the planning of early intervention services along with personnel relevant to the services being provided. Family-directed services also help family members understand the specific needs of their child and how to enhance the child’s development.

Short-Term Immigration Support Services encompass a range of services that promote integration, independence, and active participation for persons in their new land. ISS assist persons to feel at home in their new community and integrate into society, while being respectful of the culture from which they came. Preferably services are offered when the organization is able in the first language of the person served by multilingual and culturally diverse staff. Services include provision of information and orientation to the new culture of the person, community referrals, and support. Workshops may be offered on a variety of topics such as general advocacy, legal advocacy, community supports, and cultural awareness. Other services may include employment supports provided at drop-in resource sites, outreach services, and English acquisition services. Interpretation and translation services may be offered to help limit language and communication barriers.

Services provided are generally short term. Persons with more extensive needs are given appropriate referrals to other programs, which may be within the organization or another service in the community.

Supported education reflects the assumption that education is a community resource to which all should have access. Society today has a greater emphasis on lifelong learning and development for persons to maintain employment and career development. Often there are cycles of education and career transition and development that persons pass through during their lifetime. Sometimes persons have dropped out of high school before graduating and later seek to attain their GED or high school diploma. The supported education program provides resources that help persons to achieve their educational goals. It creates collaborations with other community partners to meet the needs of the persons served in various educational settings.

Supported education expresses the belief that individuals can attend classes, learn, and improve their options. Practices promote participation in education programs for all who express interest. Supported education occurs in the community in settings such as an academic campus, vocational/trade school, college, and other post-secondary educational settings, and may include online learning venues. It may even provide tutoring services to at-risk youth who may be likely to fall behind or drop out of school. The purpose of supported education is to provide supports to individuals who are enrolled or want to enroll in an education program to achieve their learning goals.

Supported education provides individualized services and supports. Supported education services address transitional or remedial academic needs, develop strategies for educational success, and secure resources and accommodations for students to access activities of post-secondary education as desired. Program staff work with students to create a foundation of skills and to secure supports necessary to achieve success.

Note: The services are integrated with other services that the individual may be receiving. Follow-along supports are continuous, and the preferences of the individual guide services.

Some examples of quality results desired by the different stakeholders of these services include:

Students served attain General Education Development certificate (GED).
Students served attain their high school diploma.
Students served are able to access adult learning options in their community.
Students served gain access to meaningful employment, community integration, and the fulfillment of life goals.
Students served attain job skills needed for employment.
Students served obtain a degree or certificate.
Students served experience a decrease in symptoms and a decrease in hospitalizations.
Students served achieve economic self-sufficiency through employment and/or a combination of employment and benefits.

Supported living addresses the desires, goals, strengths, abilities, needs, health, safety, and life span issues of persons usually living in their own homes (apartments, townhouses, or other residential settings). Supported living services are generally long-term in nature but may change in scope, duration, intensity, or location as the needs and preferences of individuals change over time.

Supported living refers to the support services provided to the person served, not the residence in which these services are provided. A sample of people receiving services/supports in these sites will be visited as part of the interview process. Although the residence will generally be owned, rented, or leased by the person who lives there, the organization may occasionally rent or lease an apartment when the person served is unable to do so. Typically, in this situation the organization would co-sign or in other ways guarantee the lease or rental agreement; however, the person served would be identified as the tenant.

Supported living programs may be referred to as supported living services, independent living, supportive living, semi-independent living, and apartment living; and services/supports may include home health aide and personal care attendant services. Typically there would not be more than two or three persons served living in a residence, no house rules or structure would be applied to the living situation by the organization, and persons served can come and go as they please. Service planning often identifies the number of hours and types of support services provided.

The home or individual apartment of the person served, even when the organization holds the lease or rental agreement on behalf of the person served, is not included in the survey application or identified as a site on the accreditation outcome.

Some examples of the quality results desired by the different stakeholders of these services/supports include:

Persons served achieving choice of housing, either rent or ownership.
Persons served choosing whom they will live with, if anyone.
Minimizing individual risks.
Persons served have access to the benefits of community living.
Persons served have autonomy and independence in making life choices.

Transition services are integrated, community-oriented, systematic services for students/transition-age youth and their families provided through a jointly planned approach, involving broad-based community collaboration, linkages, advocacy, and natural supports.

Transition services/supports are planned and coordinated for multiple outcomes for youth leaving school, including post-secondary education, supported education, vocational assessments and targeted training, community employment (including supported employment and volunteer placement), independent or supported living, and community participation. The organization demonstrates early active outreach to and connection and partnership with school districts to address the transition needs of students and their families. The purpose of this collaboration and early planning is focused on ensuring that transition-age youth are not “missed” as they move from one system to another.

Some examples of the quality results desired by the different stakeholders of these services include:

Community-oriented services.
Post-secondary education.
Transition-age youth move directly from their educational environment into community employment.
Transition-age youth explore alternative community employment situations.
Access to targeted vocational training or apprenticeships.
Independent or supported living.
Community participation.
Employment.
Volunteer placement.
Connections to community resources.
Appropriate benefits/supports as persons leave school.

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