Run Date: 03/23/2023 Department of Education Page 1

Division of Vocational Rehabilitation Production

Individualized Plan for Employment

Tristan Gorman, VR0990504

2100 Park Central Blvd. North, Suite
Pompano Beach, FL 33064

Tristan Gorman and counselor Dorian Hutchins have developed together the following Supported
Employment plan for services. Hairdressers, Hairstylists, And Cosmetologists is the desired
employment outcome for Tristan Gorman and he/she will become employed by 3/22/2024 for 30 hours
per week in an integrated work setting and compensated in accordance with the Fair Labor Standards
Act. Progress toward achievement of Tristan Gorman's employment outcome shall be measured by:
Progress In Placement
Progress In Counseling/Guidance
Progress In Health Stabilization

Service(s):
(1) MENTAL RESTORATION beginning 03/22/2023 to be provided by The Sands
will be paid for by Other.
(2) JOB COACHING beginning 03/22/2023 to be provided by Pathways2work
will be paid for by Voc. Rehab.
(3) EXTENDED SERVICES beginning 03/22/2023 to be provided by Pathways2work
will be paid for by Other.
(4) OTHER GOODS AND SERVICES beginning 03/22/2023 to be provided by
Burlington Or JC Penney will be paid for by Voc. Rehab.
(5) PLACEMENT beginning 03/22/2023 to be provided by Pathways2work
will be paid for by Voc. Rehab.
(6) SUPPORTED EMPLOYMENT beginning 03/22/2023 to be provided by Pathways2work
will be paid for by Voc. Rehab.
(7) COUNSELING/GUIDANCE beginning 03/22/2023 to be provided by
Vocational Rehabilitation will be paid for by Voc. Rehab.
(8) TRANSPORTATION beginning 03/22/2023 to be provided by Bct
will be paid for by Voc. Rehab.

Along with services as outlined in plan, Vocational Rehabilitation will:

•Provide Guidance & Counseling toward goal of employment.
•Provide information on AA/NA meetings in consumer's area for further substance abuse recovery
support.
•Monitor status of mental health to ensure health stability is maintained. VR will periodically request
and review medical records
•VR will provide interview/work clothing from Burlington/JC Penny
•VR will authorize a voucher for up to $200.00 to Burlington/JC Penny for the consumer to purchase
outfits. If additional specialty items are needed, an increase can be reviewed by VR.
•Provide short-term bus passes via Broward County Transit to assist client in attending interviews,
participating in training and or meeting with job coach. This will end no later than the client’s first
paycheck and all other requirements on this IPE must be met.
•Provide referral to Pathways2Work, for support employment services, VR will provide for Phase I of
supported employment services. Phase I services are not to exceed 24 months unless under special
circumstances services once consumer has successfully completed.
•Provide information to CareerSource Broward for further employment support.
•Successfully close case once client is employed and working for a period of 180 days.
Run Date: 03/23/2023 Department of Education Page 2
Division of Vocational Rehabilitation Production
Individualized Plan for Employment

Tristan Gorman, VR0990504

Other provider responsibilities include:

•Community health insurance & The Sands Treatment Ceneter, will continue to pay for
medical/mental health needs/conduct randon drug testing.
•Available comparable services/benefits are always the primary payer of services on IPE.
•Extended Services- Pathways2Work will assume Phase II of Supported Employment. This will
include providing guidance and counseling, job seeking skills, placement, job coaching, retention,
developing natural supports, and helping the consumer to understand work culture, industry
practices, work behaviors, and facilitation of natural supports. This will also include limited job
coaching and replacement as needed. As part of extended services, Pathways2Work will assist with
continued sequential job placements if transitional employment is part of supported employment.
Specifics will be listed with the referral. This may also include social skills training, case
management, replacement of employment (if needed) as part of Phase II services, and follow up
with the consumer and employer to ensure stability

Along with your general responsibilities outlined on the attached statement of rights and
responsibilities, you will:
•Maintain regular monthly communication with VRC to provide updates and complete annual
reviews of this IPE.
•Follow through with recommendations provided by mental health and medical providers to maintain
health stabilization and assist with providing updated medical records to VRC as needed, especially
during Annual Reviews.
•Actively seek out comparable benefits throughout the life of the case.
•Understand that all expenses must be preauthorized and that VR cannot reimburse for any
expenses paid out-of-pocket by individual or support team.
•Register with CareerSource Broward and follow up with recommended services.
•Visit one of the three CareerSource Broward locations monthly for additional employment support.
• Participate in 12 Step Program for additional support in substance abuse recovery.
•Remain clean and sober or DVR case may be reviewed for closure.
•Attend scheduled appointment with Rehab Specialist to select interview/work clothing at Burlington
or JC Penny. Will also care for items once purchased.
•Pick up buss pass at this VR office between the 1-15th of each month and assume responsibility of
bus pass costs after first paycheck is received or if all responsibilities within this IPE are not met.
•Follow up on AA/NA meetings for further substance abuse recovery support.
•Keep all scheduled appointments and reschedule all missed appointments
•Actively participate in job placement services and inform VRC of any difficulties experienced in
seeking employment; accept suitable employment; contact VRC once employed; maintain
employment for at least 180 days; provide updates to VRC as needed.

Individual Comments:
"I agree with the listed services and responsibilities of this plan"
Run Date: 03/23/2023 Department of Education Page 3
Division of Vocational Rehabilitation Production
Individualized Plan for Employment

Tristan Gorman, VR0990504

Counselor Signature Date Consumer Signature Date

Dorian Hutchins Tristan Gorman

Signature of Parent or Guardian Date

Run Date: 03/23/2023 Department of Education Page 4
Division of Vocational Rehabilitation Production
Individualized Plan for Employment

Tristan Gorman, VR0990504

ELIGIBILITY

You have been determined to be eligible to receive vocational rehabilitation services. This means that:

a) you have a physical or mental impairment which causes a substantial impairment to employment and
that you can benefit from vocational rehabilitation services in terms of an employment outcome, and

b) you require these services to prepare for, enter, engage in, or retain gainful employment.

YOU HAVE THE RIGHT TO:

Develop your Individualized Plan for Employment (IPE) with your counselor including your job goal
based on your unique strengths, resources, priorities, concerns, abilities, capabilities, interests and
needs, the services and steps you need to reach your job goal and who provides them.

Freedom from discrimination based on sex, race, color, religion, national origin, age, marital status,
political affiliation, disability or veteran status.

APPEALS:

SUPERVISORY REVIEW: If you and your counselor cannot agree, you may ask to speak with your
counselor's supervisor. The supervisor will meet with you and your counselor to try to solve the
problem.

INFORMAL REVIEW: You may ask for a meeting with the Area Director. If you have received a written
denial of services, you have 21 days in which to request an Informal review. If the problem is in another
area, you can request the review at any time. You should write a letter to the Area Director, explaining
your problem and how you think it can be solved. You will then be contacted to set up a meeting.

ADMINISTRATIVE HEARING: If you are dissatisfied with the Informal Review or decide to bypass it,
you may request an Administrative Hearing. This hearing will be conducted by an impartial Hearing
Officer - someone who is not employed by the Division of Vocational Rehabilitation (DVR). You must
request an Administrative Hearing within 21 days from the time you receive the written Informal Review
decision. You must write the Director of the Vocational Rehabilitation to request an Administrative
Hearing.

MEDIATION: At the time of requesting an Administrative Hearing, information will be provided

regarding the availability of mediation. Mediation is a process in which a person called a mediator acts
to encourage and facilitate the resolution of a dispute between the Division and you and/or your
authorized representative. It is an informal and non-adversarial process with the objective of helping
those in disputes reach a mutually acceptable and voluntary agreement.

CLIENT ASSISTANCE PROGRAM (CAP)

There is a Client Assistance Program (CAP) in Florida. CAP staff can give advice and provide
Run Date: 03/23/2023 Department of Education Page 5
Division of Vocational Rehabilitation Production
Individualized Plan for Employment

Tristan Gorman, VR0990504

There is a Client Assistance Program (CAP) in Florida. CAP staff can give advice and provide
clarification or assistance with the services provided by Vocational Rehabilitation and other agencies.

If you are dissatisfied with services, CAP staff can work with you and VR to help resolve the problem.
They may also assist you with an Informal Review or Administrative Hearing. Services are free and
CAP is independent of all state agencies providing services to individuals with disabilities. CAP is a
statewide program and can be contacted by calling, toll free:

1 (800) 342-0823 (voice)

1 (800) 346-4127 (TDD)