Document Type

Occasional Paper

Publication Date



Funding & Service Contracting, Intellectual and Developmental Disabilities, I/DD, Developmental Disabilities, Employment, Access to Integrated Employment, ThinkWork


Organization Development | Rehabilitation and Therapy | Social and Behavioral Sciences | Social Work | Sociology | Vocational Rehabilitation Counseling


Michigan’s Department of Community Health, Mental Health and Substance Abuse Administration (MDCH) has expressed a strong desire to improve the state’s employment outcomes among people with intellectual and developmental disabilities (IDD). Set against this desire is a major obstacle: Michigan is among the states hardest hit by the continuing economic recession, with the highest unemployment rate in the nation. MCDH delivers supports through local Community Mental Health Services Programs (CMHSPs). These CMHSPs not only experience differences in employment rates but also have high variability in their funding levels and structures, payment methodologies, and reimbursement mechanisms. Local CMHSPs individualize their contracts with providers to emphasize employment outcomes in some areas, but the practice is not consistent across the state. Within this structure, however, one CMHSP in Wayne County decided to experiment with outcome-based incentives to improve integrated employment, creating a payment system for job development supports.


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