For Regional Centers and Vendors

• Coordinated Career Pathways
• Paid Internship Program
  • Guidelines for Implementation of Paid Internship Program
  • Enclosure A
  • Enclosure B
• Participant-Directed Services – Supported Employment
• Tailored Day Services
  • Enclosure A – Tailored Day Services Vendorization and Program Design Addendum
  • Enclosure B – Tailored Day Services Individualized Service Design
  • What a Regional Center Service Coordinator should consider before making a referral for Tailored Day Services
  • Information for Consumers and Family Members

• Rates for all services
• WAP Billable Days

• Competitive Integrated Employment: Information regarding implementation and funding available to regional center service providers for placement and retention of regional center consumers in competitive, integrated employment may be found here:
  • Guidelines for Implementation of Competitive Integrated Employment Incentive Payments
  • Enclosure A
  • Enclosure B
• Paid Internship Program: Information regarding paid internships to increase the vocational skills of consumers and create a pathway to a competitive integrated job may be found here:
  • Guidelines for Implementation of Paid Internship Program
  • Enclosure A
  • Enclosure B
• Regional Center Performance Measures: Information regarding this initiative and the corresponding measures and incentives.
• Quality Incentive Program (QIP): Information regarding this program and the corresponding measures and incentives.

Supported Employment – Individual Placement

• DS 1961 SEP – SEP/Individual Habilitation Services Plan: This form is the standardized service plan Supported Employment Program (SEP). Providers use to implement the consumer’s vocational goals of the Individual Program Plan (IPP). Users: SEP service providers.
  • DS 1961 SEP (6/2016)
  • Instructions (6/2016)
• DS 1972 SEP IP – SEP/Supported Employment Individual Placement Consumer Monthly Report: Outcome data for consumers provided Supported Employment Program- Individual Placement services are documented on this form. Users: SEP Services Providers; Regional Center can preload consumer names and identification numbers.
  • DS 1972 SEP IP (10/2019)
  • Instructions

Supported Employment – Group Placement

• DS 1962 – Request For New SEP Groups: A Supported Employment Program-Group Placement (SEP-GP) approval request is submitted by service providers to DDS to obtain approval of new SEP Groups. Users: SEP-GP service providers.
  • 1962 (1/2005)
  • Instructions (8/2012)
  • 1962/Supplemental Narrative Summary Guidance Template (4/2020)
• DS 1963 – Request For Approval of SEP Group Changes: This form is submitted by service providers to request changes in a specific approved supported employment program group. Users: SEP-GP service providers.
  • 1963 (6/2016)
  • Instructions (6/2016)
• DS 1964 – Supported Employment Group Billing and Attendance Form: This form must be completed as an excel file, password protected and submitted to regional centers, DOR and DDS monthly. After downloading the file, enter the vendor information at the top of the form and consumer and job coach information up to the “Funded By” column. Save a copy of this file as a “master”. Should any problem arise with the form, the “master” is available to start over.
  • 1964 Large (1–900 lines – April 2022) – 64Bit compatible
  • Macro Instructions

Work Activity Program

• DS 1961 WAP – WAP/Individual Habilitation Services Plan: This form is the standardized service plan Work Activity Program (WAP). Providers use to implement the consumer’s vocational goals of the Individual Program Plan (IPP). Users: WAP service providers.
  • DS 1961 WAP (6/2016)
  • Instructions (6/2016)
• DS 1971 WAP – WAP/Work Activity Program Consumer Monthly Report: Outcome data for consumers provided Work Activity Program services is documented on this form. Users: WAP Services Providers; Regional Center can preload consumer names and identification numbers.
  • DS 1971 WAP (7/2006)
  • Instructions

Other

• DS 1968 – Vocational Rehabilitation Referral: This form is used to refer consumers to the Department of Rehabilitation for Vocational Rehabilitation Services. Users: Regional Center Service Coordinators.
  • DS 1968 (4/2004)
  • Instructions
• DS 1969 – Vocational Services Exit Report: This form is completed when a consumer exits a habilitation services program. Users: Regional Center Service Coordinators and Habilitation Services Providers.
  • DS 1969 (4/2004)
  • Instructions

• College of Employment Services
• Association of Community Rehabilitation Educators (ACRE)
• The Credentialed Employment Support Professional™ (CESP) Program
• Information for Service Providers (Department of Rehabilitation)
• Commission on Accreditation of Rehabilitation Facilities (CARF)
• Federal Contract Work (SourceAmerica)
• How to enroll as an Employment Network (Social Security Online)

• Workforce Innovation and Opportunity Act (at DOR)
• Habilitation Services For Persons With Developmental Disabilities (Welfare and Institutions Code, Division 4.5, Chapter 13)
• Habilitation Services Program (California Code of Regulations, Title 17, Public Health)