The Employment Transformation Project consisted of three main phases: Startup, Development, and Establishment of Sustainability. The startup process had two parts. The project began with six participant counties (Butler, Cameron/Elk, Fayette, Erie, Philadelphia and Washington) selected through an RFP process. These first six counties received consultation and technical services from Dr. Donegan. Those services were delivered in about eighty hours, structured as follows:

1. Two days of training for practitioners. (16 hours)
2. A meeting with stakeholders to develop support for the project.
3. Two days of consultation and technical assistance focused on the establishment of a pilot project using the evidence based practice of Supported Employment. (16 hours)
4. 15 hours days of general consultation and technical assistance.
5. Remaining hours were assigned to planning, preparation and travel.

The following year nine counties were added to the group, again through an RFP process (Armstrong/Indiana, Allegheny, Beaver, Berks, Crawford, Centre, Cumberland/Perry, Franklin/Fulton, and Montgomery), bringing the total number of counties in the project to fifteen.

The process for the nine new participants was the same as that for the original six. However, given the expanding workload, Northern Management Consultants and Norman Council joined Dr. Donegan in the work. The fifteen counties were divided in to three groups. The original six continued into the second year with Dr. Donegan, she also picked up Berks and Crawford counties who began as new participants in the project.

During the second year of the project, two counties or joinders, Franklin/Fulton and Centre County, dropped out of the project. A third, Berks County seemed to be getting insufficient support from the County executive and was withdrawn from the project.

At the end of the second year of the project, Northern Management Consultants and OMHSAS sponsored a roundtable discussion amongst all of the participating counties and joinders, including Centre and Franklin/Fulton, but not Berks. At the forum, participants who had achieved some level of success in moving forward with implementation of SE – Allegheny, Beaver, Butler, Cumberland/Perry, and Montgomery Counties presented their efforts in order to disseminate effective strategies for implementation. In addition, a representative from AHEDD facilitated a discussion about work incentives that could be of assistance in address some of the concerns of consumer and family members about the potential loss of benefits. The participants considered the forum a useful tool. Email addresses were shared to facilitate cross talk amongst participants and suggestions were made to repeat the event as the project moved forward.

State budget problems contributed significantly to a reduction of forward movement in the third year of the project. County participation and projections of successful implementation resulted in further reductions in the pool of participants. Counties continuing as active in the project were: Allegheny, Beaver, Cumberland/Perry, Erie, Fayette, Montgomery and Washington counties were selected to receive specialized technical assistance based on their identification of key issues which served as roadblocks or opportunities for implementation.

Observations by the consultants during the years of the project also lead to a re-framing of objectives for the project, as it was configured. Each of the current participants had had some measure of success in establishing SE activities. However, their implementations were effected by a tendency in the service environment to “silo” or isolate services into separate service centers, with referrals accounting for the availability of services to individual users. The result was the employment supports staff were being overburdened with tasks that were in fact the domain of other service professionals – case managers for instance, and therapists – who either were not aware of the person’s participation in employment, or did not consider that activity to be a segment of their own service agenda.

Consequently the consultants determined that, with each of the remaining counties, an effort would be made to re-interpret SE as a recovery oriented service that permeated the user’s activity throughout the service setting. The hoped-for result would be that the different service professionals throughout the service environment would use other Evidence Based Practices – Illness Management and Recovery and Family Psycho-education for example – or other recognized self-management tools such as Wellness and Recovery Action Plans (WRAP) to support the user and help them to address self management of symptoms sufficient to increase their chances of success in gaining and maintaining employment.