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Occasional Paper

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


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


In North Carolina, counties have been consolidated into Local Management Entities (LMEs). These entities contract for services with community providers and provide oversight on access, utilization, best practices, and community collaborations. The Mecklenberg County LME established the Best Practices Community Committee, comprising service providers, individuals and family members, advocacy agencies, community partners, interested community volunteers, and LME staff. Sub-committees addressed several areas, including employment. Based on their recommendations, a pilot project that uses an outcome-based funding model for follow-along employment services was developed. Follow-along employment supports are ongoing supports that are necessary to assist a person with an intellectual/developmental disability to remain successfully employed in the community. Typically, follow-along services, also called long-term vocational services (LTVS), have been funded entirely by periodic, hourlybased payments and an authorization system. This process was seen as micromanagement and both time- and clerical-intensive, and was not associated with achieving quality outcomes. The new outcomes-based funding approach sought to address these issues and develop a system that focused on accountability, efficiency, and outcomes.


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