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NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services

NC Employment First

employment first

Employment First is a declaration of both philosophy and practice:

“Employment in the general workforce is the first and preferred outcome in the provision of publicly funded services for all citizens with disabilities regardless of level of disability, in a job of their choosing with supports and accommodations provided as necessary to achieve and maintain employment.”

Employment First is an “umbrella” term where states and programs align to emphasize the importance of employment services focusing on “ability” versus “disability.” It does not mean that employment is the only outcome for all; rather, that employment is the expectation, not the exception.

Some of the goals and guiding principles of Employment First include:

  • Cross-disability effort
  • Integrated Employment
  • Individual choices
  • Appropriate accommodations and supports
  • Resources for youth in transition
  • Resources for self-employment
  • Employer education and awareness
  • Employment-enhancing education and career advancement
  • Asset development and overcoming poverty

The NC Alliance on Full Participation (NCAFP) drafted a Position Paper that was approved on October 24, 2011 that promotes this initiative. To learn more, click here: Employment First Initiative and Position Paper

The NC Employment First Steering Committee

is a statewide workgroup that formed in 2011 with more than 30 members currently representing various disability groups- Mental Illness, Intellectual and Developmental Disabilities, Substance Abuse/co-occurring, Autism, Deaf and Hard of Hearing, and Traumatic Brain Injury. The goals of this group are to:

  • Develop the future of employment services in this state
  • Strengthen the broad-based collaborative effort between the state divisions, advocates, organizations, stakeholders, consumers and families 
  • Be a launching point for ideas, issues, initiatives

For more information about this committee, or employment services and supports in North Carolina, please contact Emery Cowan, Community Policy Management Section Best Practices Team, at or 919-715-2774.

Employment Services

In addition to employment services provided through the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS), services also are available through DHHS’ Division of Vocational Rehabilitation Services (VR) and the Division of Medical Assistance (DMA) for individuals with Intellectual and Developmental Disabilities (IDD) through the Innovations Waiver (formerly the CAP MR/DD Waiver).

Provider agencies that offer employment supports and services are called Community Rehabilitation Programs (CRP's). There are more than 100 CRPs around the state. To find out about the programs, follow this link: 

Employment Service Policies and Definitions

DHHS is expanding the Supported Employment and Long Term Vocational Support definitions based on the requirements set forth in the Department’s settlement agreement with the Department of Justice. The DMH Best Practices Team has been providing training on the new implementation plans and service definition in order to educate providers, LME-MCOs and families and consumers on the upcoming changes.

Read the new SE/LTVS definition here.

DHHS is working to implement measures to provide Supported Employment services to individuals with a diagnosis of serious mental illness, who are in or at risk of entry to an adult care home. While DMHDDSAS has developed a definition that is cross-disability, it will ensure individuals with a diagnosis of serious mental illness have access to evidenced based Supportive Employment Services. 

The Division is designing infrastructures to implement the model for individuals with a diagnosis of Serious Mental Illness as well as develop training and technical assistance processes for ongoing Supportive Employment program fidelity evaluation, performance outcome data, employment specialist workforce development and employment support professional credentialing, and quality improvement consultation. Through the settlement agreement 2,500 individuals with a diagnosis of Serious Mental Illness will have access to Supportive Employment Services by July 1, 2019. 

North Carolina Employment Initiatives


State Employment Leadership Network (SELN)

North Carolina is a member of the national network of state agencies committed to improving employment outcomes for adolescents and adults with disabilities. DMH/DD/SAS joined on October 1, 2011 and plans to address cross-disability employment outcomes, funding, data, and policy.

Upon receiving our SELN State Findings & Observation Report, North Carolina will be prioritizing activities and developing a work plan to continue building the leadership necessary to promote implementation of an Employment First policy.

SELN in North Carolina is sponsored by the North Carolina Council on Developmental Disabilities (NCCDD). It is a joint program of the National Association of State Directors of Developmental Disabilities Services and the Institute for Community Inclusion at the University of Massachusetts Boston.

Employment First State Leadership Mentoring Program

North Carolina is one of 23 states participating in the federal Department of Labor Office of Disability Employment Policy’s (ODEP) Community of Practice (CoP) for Employment First.

To advance Employment First, ODEP created the Employment First State Leadership Mentor Program. This program helps states align policies, regulations and funding priorities to encourage integrated employment as the primary outcome for individuals with significant disabilities. Through the initiative, ODEP is providing support and informational resources for selected states that desire systems change reflecting the Employment First approach but have struggled to fully implement it as the primary service delivery system for people with disabilities.
Read more about this national initiative here at ODEP.

NC Business Leadership Network (NCBLN)

As a business to business network, the North Carolina Business Leadership Network (NCBLN) will support the business community with information and resources to: source, hire and promote people with disabilities; to do business with organizations owned and operated by people with disabilities; and to market their products and services in an accessible manner to people with disabilities, across the State of North Carolina.


Employment-Specific Organizations & Advisory Groups

Mental Health & Substance Abuse

Intellectual/Developmental Disabilities

General Information Ready NC Connect NC