The benefits of employment often stretch far beyond the lifespan of a paycheck.
Having a steady job can provide a sense of purpose, self-esteem, social interaction and community involvement. For people with mental health and substance use challenges, these rewards can be vital in helping achieve – and sustain – both recovery and hope.
That’s why Vaya Health is participating in a pilot initiative to strengthen the way North Carolina helps individuals with behavioral health needs find and maintain competitive employment. About 160 Vaya Medicaid and non-Medicaid members are currently participating in the pilot, which launched in December 2019 in partnership with the N.C. Division of Mental Health, Developmental Disabilities and Substance Use Services (DMH/DD/SAS) and the N.C. Division of Vocational Rehabilitation (DVR).
Known as the North Carolina Collaborative for Ongoing Recovery through Employment, or NC CORE, the initiative features a shared caseload between Vaya and DVR. The model offers a milestone payment methodology, rather than fee-for-service, and braids funding from both agencies to support Western North Carolinians receiving Individual Placement and Support (IPS) services.
A quarter of participants have already found employment, and 18 Vaya members have successfully completed the full program, said Vaya Network Management Coordinator David Boyd. The partnership with DVR has been key, he said.
“Members are more effectively engaged,” Boyd said. “IPS providers and DVR are seen as one team, which increases confidence in the service and reduces confusion. Also, because providers don’t have to bill based on 15-minute increments of time with the member, they’re spending less time with paperwork and can put more focus on the individual. There’s a clear objective to meet.”
Program milestones include first engaging with the process, developing a career profile, finding and keeping a job, getting a promotion or completing additional education. Depending on the milestone reached, either Vaya or DVR pays the provider for meeting the milestone. The braided funding allows greater financial stability.
Stacy Smith, DMH/DD/SAS Adult Mental Health Team Lead, praised NC CORE as an innovative, value-based pilot. The initiative is already receiving national attention through the U.S. Department of Labor’s Office of Disability Employment Policy, she said, where a researcher plans to include the pilot in an upcoming white paper on innovative payment models for employment services.
“It successfully addresses the barriers that IPS teams had integrating with DVR and allows IPS staff to spend more time directly supporting individuals as their administrative work is reduced, and it supports the long-term sustainability of services by requiring all funding sources to be utilized,” Smith said.
Participants continue to hit IPS milestones despite COVID-19 and nationwide increases in unemployment. While some lost jobs, at least temporarily, providers report that Vaya members have found employment working for the U.S. Census, in manufacturing facilities and even in Asheville-area hotels and restaurants as local economies begin to reopen.
Participants are served by dedicated IPS teams that include peer, provider and employment specialists, with benefits counseling available. Some participants, about 15%, are also involved in the Transitions to Community Living Initiative (TCLI), which connects adults with serious mental illness to healthcare services that help them maintain a home in their own name, instead of living in a facility. Vaya is currently working to refer more TCLI participants to IPS services.
Providers delivering IPS services through the pilot are Daymark Recovery Services, Meridian Behavioral Health Services, Family Preservation Service of NC and RHA Health Services.