Required Documentation by OVR – Traditional Supported Employment:

• PCEP Activity Note
• PCEP (Person Centered Employment Plan)
• Job Development Activity Note
• Work Summary – Job Start Plan
• Stable Employment Activity Note
• 30 Day Stable Employment Summary
• 60 Day Stable Employment Summary
• 90 Day Stable Employment- Long Term Support Plan 
• 120 Day Stable Employment Summary
• 150 Day Stable Employment Summary
• 180 Day Stable Employment Summary
• Flow Chart of Services/OVR Documentation & Billing
• OVR phases of service, documentation and billing

Required Documentation by OVR – IPS Supported Employment:

• Career Profile & Job Search Plan
• Job Development Activity Note
• Work Summary – Job Start Plan
• Job Support Plan
• Stable Employment Activity Note
• 30 Day Stable Employment Summary
• 60 Day Stable Employment Summary
• 90 Day Stable Employment Summary – Long Term Support Plan 
• 120 Day Stable Employment Summary
• 150 Day Stable Employment Summary
• 180 Day Stable Employment Summary
• Job End Report
• Flow Chart of Services/OVR Documentation & Billing (IPS)
• OVR phases of service, documentation and billing (IPS) 

Required Documentation by OVR – Customized Supported Employment
NOTE: An Employment Specialist MUST receive the appropriate advanced certifications specific to services in order to bill this particular SE service. If you are interested in learning about these certifications, visit the Leadership Series page

• PCEP Activity Note
• Vocational Profile: Part 1, Part 2, and Part 3
• Job Development Activity Note
• Work Summary – Job Start Plan
• Stable Employment Activity Note
• 30 Day Stable Employment Summary
• 60 Day Stable Employment Summary
• 90 Day Stable Employment Summary – Long Term Support Plan 
• 120 Day Stable Employment Summary
• 150 Day Stable Employment Summary
• 180 Day Stable Employment Summary

Additional Optional forms

• Information Organization Form
• Contact Log
• Sample format for interview/activity notes
• Representational Considerations Form
• Job Search Bracket / Example of a Job Search Bracket
• Disclosure Worksheet
• Worksheet for explaining criminal history
• Job Analysis Form

Supported Employment & OVR

• OVR Service Fee Memorandum – revised 10/1/2020
• OVR Continued Education Submittal Form
• OVR Supported Employment/CRP Vendor Application (MS Word)
• Presentation – Overview of Supported Employment Services in KY (PDF)
• OVR SE Toolbox, 7/12 (PDF)
• KY Supported Employment Providers (PDF)

Examples of Some OVR Forms

• Example – OVR Person-Centered Employment Plan Activity Note (MS Word)
• Example – OVR Person-Centered Employment Plan (MS Word)
• Example – OVR Job Development Note (MS Word)
• Example – OVR 30 Day Stable Employment Summary (MS Word)
• Example – OVR 90 Day Stable Employment Summary – Long-Term Support Plan (MS Word)
• Example – OVR 60 Day Stable Employment Summary (MS Word)

• COVID19 Resources for Employment Providers, rev Jan 2021
• Individual Placement and Support (IPS) Toolkit  January 2021 (PDF)
• Working Together: An IPS and ACT Guide (PDF)
• The International IPS Learning Community Program Description (PDF)
• Making the Case for IPS Supported Employment (PDF)
• IPS Trainer’s Guide to IPS Supported Employment: A Practical Guide (PDF)
• Family Member/Caregiver Advocacy for IPS Supported Employment (PDF)
• Clark’s Story (PDF)
• Employment Works Newsletter – Winter 2018 (PDF)
• Employment Works Newsletter – Summer 2015 (PDF)
• Employment Works Newsletter – Winter 2012 (PDF)
• Introduction to IPS Supported Employment (PPT)
• Evidence for the Effectiveness of Individual Placement and Support Model of Supported Employment (PPT)

• Informational Interviews – by Cary Griffin (PDF)
• What is (and isn’t) Person Centered Job Selection (PCJS)
• Career Profile Tip Sheet (also helpful in PCJS)
• Reasonable Accommodation Fact Sheet (PDF)
• What is (and Isn’t Job Development)
• Importance on Natural Supports
• Examples of Job Supports
• Enhancing Employment Opportunities for Individuals with a Criminal Record — Dartmouth College (PDF)
• The Vocational Profile and the Profile Meeting: A Process, Not a Form – by Marc Gold & Associates (PDF) (good explanation of PCJS/Career Profile & Job Development work)
• Strengthening the role of the employee: An analysis of supported employment using social role valorization theory (PDF)
• The Big Sign Syndrome: The Job Developer’s Small Business Advantage, Cary Griffin & Dave Hammis (PDF)
• National Job Development Survey Results: Time To Think Outside The Box Store, Cary Griffin (PDF)
• Strategies Used by Employment Service Providers in the Job Development Process: Are they consistent with what employers want? (PDF)
• The Productivity Fallacy: Why People Are Worth More Than Just How Fast Their Hands Move (PDF)
• Personal Reflections on Walgreens Anderson Distribution Center and REDI, Milt Tyree (PDF)
• Life After High School: The Next Chapter (PDF)
• “Segregated & Exploited,” document by the National Disability Rights Network (January 2011) (PDF)
• “Beyond Segregated & Exploited” document by the National Disability Rights Network (April 2012) (PDF)
• Self-Employment FAQ – Griffin-Hammis Associates, LLC (PDF)
• Toolbox for Employment: Customized Self-Employment and Benefits Planning, Griffin-Hammis Associates, LLC (PDF)
• Plans for Achieving Self-Support – Griffin-Hammis Associates, LLC (PDF)
• Social Security Considerations for Small Business Owners with Disabilities – Griffin-Hammis Associates, LLC (PDF)
• Customized Employment: Put It to Work for Your Business – ODEP (PDF)
• Customized Employment Works Everywhere – ODEP (PDF)
• An Overview of Social Role Valorization Theory, Joe Osburn (PDF)
• What One Person Can Do, Michael Kendrick (PDF)

Marc Gold & Associates Materials:

• Order Form – “MG&A Discovery Books” (PDF)
• MG&A Discovery questions (MS Word)
• MG&A Profile Part 1 Form Blank (MS Word)
• MG&A Profile Part 1 Sample (PDF)
• MG&A Profile Part 1 Guide (PDF)
• MG&A Profile Part 2 Form Blank (MS Word)
• MG&A Profile Part 2 Sample (PDF)
• MG&A Profile Part 2 Guide (PDF)
• MG&A Profile Part 3 Form Blank (MS Word)
• MG&A Profile Part 3 Sample (PDF)
• MG&A Profile Part 3 Guide (PDF)
• MG&A Discovery Profile Activity Log (MS Word)

• 2021 Trial Work Period Fact Sheet (PDF) – Text Only (TXT)
• 2021 Impairment Related Work Expense for SSDI Fact Sheet (PDF) – Text Only (TXT)
• 2021 Subsidy and Special Conditions Fact Sheet (PDF) – Text Only (TXT)
• 2021 Extended Period of Eligibility Fact Sheet (PDF) – Text Only (TXT)
• 2021 Extended Medicare Coverage Fact Sheet (PDF) – Text Only (TXT)
• 2021 Expedited Reinstatement of Benefits Fact Sheet (PDF) – Text Only (TXT)
• 2021 SSDI Self Employment Fact Sheet (PDF) – Text Only (TXT)
• 2021 SSDI What is SGA? Fact Sheet (PDF) – Text Only (TXT)
• 2021 SSI and Earnings Fact Sheet (PDF) – Text Only (TXT)
• 2021 Student Earned Income Exclusion Fact Sheet (PDF) – Text Only (TXT)
• 2021 Impairment-Related Work Expense for SSI Fact Sheet (PDF) – Text Only (TXT)
• 2021 Blind Work Expense Fact Sheet (PDF) – Text Only (TXT)
• 2021 1619b Fact Sheet – KY Threshold (PDF) – Text Only (TXT)
• 2021 Plan to Achieve Self Support Fact Sheet (PDF) – Text Only (TXT)
• 2021 Property Essential for Self Support Fact Sheet (PDF) – Text Only (TXT)
• 2021 SSI Self Employment Fact Sheet (PDF) – Text Only (TXT)
• 2021 HUD Earned Income Disregard (PDF) – Text Only (TXT

• 2021 Social Security Changes (PDF) NEW
• 2021 SSI and SSDI Comparison Grid (PDF)
• The Truth about SSI (KDE Video Link)
• Trial Work Period Infographic (PDF)
• The Truth About Working While Receiving SSDI in 2021 infographic (PDF)
• The Truth About Working While Receiving SSI in 2021 infographic (PDF)
• OVR Service Fee Memorandum about Fees for a Benefits Analysis (PDF)
• Prioritizing Beneficiaries Under the New WIPA Service Model (PDF)
• WIPA Services Counties in KY – Center for Accessible Living and Goodwill Industries (PNG)
• The Center for Accessible Living Benefits Counseling Services (PDF)
• Goodwill WIPA Program Services (PDF)
• Goodwill WIPA Program Services Referral Form (PDF)
• SSA Consent for Release of Information Form – 3288(PDF)
• BPQY Handbook (PDF)
• Sample IRWE letter – from Georgia DOL/VR Tools for Life Program (PDF)
• Reporting Tips for Beneficiaries of Social Security Disability Programs (PDF)
• SSI Mobile Wage Reporting app from the Apple iTunes Store or the Android Google Play Store (PDF)
• Reporting Changes is Your Responsibility (SSA Blog Link)
• Notification of Change of Earnings Form (MS Word)
• Working While Disabled — How We Can Help, 2021 – Social Security document (PDF)
• What You Need to Know About Your SSI When You Turn 18 (PDF)
• SSA Red Book 2016 (PDF)
• SSI for Groups and Organizations, 2012 – Social Security document (PDF)
• Student Earned Income Exclusion Infographic (PDF)
• SSI Worksheet 2021 (MS Excel)
• SSI Worksheet 2021 (MS Word)
• Adjustments to SSI Chart 2021 (PDF)
• SSDI Calculation Chart (MS Word)
• Past TWP and SGA Amounts (PDF)
• Medicaid Waiver Share of Cost or Patient Liability, P&A – Feb 2012 update (PDF)
• Medicaid Waiver Share of Cost or Patient Liability, KY Medicaid Manual (PDF)
• Patient Liability Information from the Medicaid Manual (PDF)
• MAP 552K “Share of Cost” 2019 (MS Excel)
• Social Security Acronym Glossary (PDF)
• PASS form (PDF)
• State Guardianship and Compensation – FAQ (PDF)
• How to Change or End Guardianship: Restoration of Rights (PDF)

• APSE Supported Employment Quality Indicators (PDF)
• APSE Ethical Guidelines For Professionals in Supported Employment (PDF)
• Supported Employment Competencies (PDF)
• APSE Employment First 
• Join APSE 

• Ten Things You Can Do to Support A Person With Difficult Behaviors (PDF)
• The Importance of Belonging (PDF)
• Toolbox for Change: Reclaiming Purpose, Joy, and Commitment in the Helping Profession (PDF)

• Disclosure (PDF)
• Employment Supports for Individuals with Severe Mental Illness (PDF)
• Assistive Technology (PDF)
• Employment Negotiations (PDF)
• Customized Employment Q & A (PDF)
• Developing a Business Plan for Organizational Change (PDF)
• Successful Organizational Change (PDF)
• Changing Staff Roles (PDF)
• Addressing Parental Concerns (PDF)