In the last few years, the New York State Office of Mental Health has launched several initiatives that have created substantial momentum towards making employment and economic independence a fundamental priority of the mental health system as well as one for New York State and all people with disabilities. These initiatives include the SAMHSA-funded WE Can Work/WE Can Save Campaign, the CMS-funded Medicaid Infrastructure Grant and, most recently, and OMH's new collaborations with the NYS Department of Labor to encourage the creation of numerous peer specialist positions within the community mental health system. At the same time, the Most Integrated Settings Coordinating Council's emphasis on employment offer important collateral support for putting employment at the center of regional and state efforts. OMH's progressive new outpatient license Personalized Recovery Oriented Services (PROS) represents the most significant opportunity for New Yorkers with psychiatric disabilities to get the support necessary to achieve their employment and economic goals.

Over the past few years, PROS licenses have been established in Clinton, Orange, Putnam, Suffolk and Erie Counties with significant interest and increasing readiness in Rockland, Nassau, Monroe, Greene, Niagara Counties and in New York City. To date thirty-five PROS licenses have been granted and it is expected that over 60 will be issued by the end of 2010. The Center for Practice Innovations at the New York State Psychiatric Institute (Columbia University) has been funded to provide technical assistance in order to move evidence-based practices into real clinical practice within the programs OMH funds. This Center has already started providing training and technical on the Individual Placement Support (IPS) model of Supported Employment throughout NYS. OMH will begin implementing IPS in the personalized recovery-oriented services program (PROS). Regional IPS forums will introduce the IPS model to licensed and soon to be licensed PROS programs. The rollout will include traditional mentoring to a small number of PROS programs and non-traditional use of distance learning systems in order to bring IPS to scale with the PROS programs.

The rollout of PROS and IPS provides an excellent opportunity to enhance the overall capacity of such programs to offer meaningful services and supports to assist individuals to achieve employment and greater levels of economic self-sufficiency. Since the growing number of PROS programs primarily represents conversions from a continuing day treatment model that typically focused on symptom management and often discouraged person centered employment goals, there is a need to expand their capacity by offering training and technical assistance to assist those programs to transform their culture, focus and outcomes.

The new Ticket to Work program offers a great opportunity for New York State to improve the capacity, scope, and effectiveness of employment programs to provide individuals with psychiatric disabilities in NYS with integrated and comprehensive services and supports. The focus of the Ticket on promoting long-term employment and economic self-sufficiency requires that providers and consumers place their attention on a wide array of services needed to achieve independence. This funding stream may allow for a flexible spending source for program areas not funded through Medicaid, such as job development, job coaching, peer support, career advancement, and asset development strategies. Through this project NYAPRS will seek to increase the number of PROS programs that become Employment Networks, maximize the utilization of funding opportunities provided by the Ticket to Work and ultimately improve the capacity of PROS programs to reliably support people with psychiatric disabilities towards achieving employment and economic self-sufficiency outcomes.