Division of Mental Health Services Greatly Expands Supported Employment Initiative Across the State

/ September 6, 2022

By Stephanie Cooper

We have exciting news to share from the Tennessee Department of Mental Health and Substance Abuse Services — we are expanding our Individual Placement and Supported Employment Initiative by 37 employment specialist positions! I will explain how we are able to do this, but first let me start with some background on Individual Placement and Support and its history in Tennessee.

Individual Placement and Support is an evidence-based model of supported employment that helps individuals living with mental health, substance use, and/or co-occurring disorders find and maintain competitive employment. Competitive integrated employment is work that is performed on a full-time or part-time basis for which an individual is:

A. Paid at or above minimum wage and similar to the rate paid by the employer to employees without disabilities performing similar duties and with similar training.
B. Getting the same level of benefits provided to other employees without disabilities in similar positions.
C. At a location where the employee interacts with other individuals without disabilities.
D. Given opportunities for advancement similar to other employees without disabilities in similar positions.

IPS started in Tennessee in 2013 with four pilot sites and has expanded to 14 different providers with more than 30 different IPS teams supporting different populations. If you want to learn more about IPS, check out IPS Works. Nationally, across 28 randomized control trials, IPS showed a competitive employment rate of 55% compared to 25% with other supported employment models.

The IPS model of supported employment is based on eight principles:

  1. Open to anyone who wants to work
  2. Focus on competitive employment
  3. Rapid job search
  4. Targeted job development
  5. Client preferences guide decisions
  6. Individualized long-term supports, such as job coaches
  7. Integrated with treatment
  8. Benefits counseling included

Providing IPS services was made possible through a partnership between the Tennessee Department of Mental Health and Substance Abuse Services and the Department of Human Services, Vocational Rehabilitation. Through this partnership, as well as the federal dollars from the Substance Abuse and Mental Health Services Administration and some state funding, we have been able to develop our IPS Supported Employment Initiative and provide these services through contracts with our wonderful community mental health agencies across the state. These contracts allow for the state Department of Mental Health and Substance Abuse Services to pay for the salaries, benefits, and travel of the IPS team staff while Vocational Rehabilitation awards payments to the agencies when the individuals seeking employment hit certain milestones, such as completing the career profile or maintaining employment for 30 days.

Now for the exciting part, the expansion of IPS services!

Vocational Rehabilitation receives a formula grant from the U.S. Department of Education for State Rehabilitation Services, which allows Vocational Rehabilitation to draw down federal dollars through a 4-to-1 match program. So, what does that mean and how does that allow for our department to expand IPS services? It means that we can take a significantly smaller amount of state money and use that to get significantly more federal dollars (nearly 4 times as much in federal dollars). The Department of Mental Health and Substance Abuse Services and Vocational Rehabilitation are able to use the recurring $900,000 that Commissioner Marie Williams included for the Creating Jobs Initiative in the department’s budget for fiscal year 2023 to bring in $3.3 million in federal dollars. This means we now have $4.2 million to expand IPS teams by 37 positions across the state as well provide “milestone payments” as these agencies connect with more Tennesseans looking for work.  These additional positions will allow our state to expand the number of people served by about 740 individuals.

Data shows that 66% of individuals living with severe mental illness want to work, though only 15% are currently working, and only 2% have access to an evidence-based supported employment model. Those of us at the Department of Mental Health and Substance Abuse Services are dedicated to improving access and removing barriers to needed services. This expansion is one step toward the goal of all Tennesseans with mental health, substance use, and/or co-occurring disorders having access to supported employment services!

In other exciting news, this budget request was the largest request for the Department of Mental Health and Substance Abuse Services in state history and includes funding to help with the behavioral health worker shortage we are seeing in this state as well as across the nation!

If you would like more information about the IPS Supported Employment Initiative or where the nearest IPS team is, visit the department’s IPS webpage.

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Some of us are very glad to see this expansion of the IPS program, because we know there are many individuals with mental health, substance use, and/or co-occurring disorders who have been on waiting lists for these employment supports. I’m delighted that Stephanie was able to share this news with us! If you know of someone who might benefit from the IPS program, please let them know about this good work. If you have questions, please email me at janet.shouse@vumc.org, and I’ll try to find answers. Thank you for reading!

Stephanie Cooper is the assistant director of Wellness and Employment at the Tennessee Department of Mental Health and Substance Abuses Services, helping oversee the My Health, My Choice, My Life Peer Wellness Initiative as well as the Individual Placement and Support Supported Employment Initiative. Prior to this role, Stephanie worked for Centerstone, a community mental health agency, in multiple roles, serving as the program manager for the Keys to Recovery program, working on the Supported Services for Veteran Families program, as well as the WellConnect program. In these roles she worked with multiple vulnerable populations, including those living with mental health and substance use disorders as well as those experiencing homelessness.

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