Moving Towards
Employment First in
Illinois
The Arc of Illinois
February 6, 2014
Integrated Employment
Choice?
Expectation?
Why Is Work Important?
 Our culture expects people to be
productive
 Considered a means for gaining status, self
definition and achievement of personal
goals
 Tied to various aspects of status:
•
•
•
•
•
Possessions
Prestige
Power
Control
Influence
What is Employment?
We know it when we see it…
What is “Integrated”?
1 : to form, coordinate, or blend into a functioning or
unified whole : unite
2:
a : to unite with something else
b : to incorporate into a larger unit
3:
a : to end the segregation of and bring into equal
membership in society or an organization
• Not “disability service” driven
“It is nearly impossible to make
your own future,
when you are not part of the
economic fabric
of the culture you live in.”
Patricia Deegan
20th World Congress Rehab International
Oslo, Norway – June 2004
2014
Employment
First In the U.S.
• 45+ states have some type of
“Employment First” movement
• About 2/3 of efforts are directed by
state policy units or are legislatively
based
• About 1/3 of efforts are grassroots
based – i.e., outsiders working to
influence state policy and practice
• At least 27 states have official
Employment First legislation and/or
polices
• Push for a Federal Definition in U.S.
Employment First: Why It’s Different
• Employment as first priority
• Broadly focused on all aspects of system
• May begin in the grassroots, ultimately must
be adopted and implemented by the system
• Primary focus is not on eliminating facilitybased services but on increasing integrated
employment
• A type of service strategy.
Employment
First IS NOT
• Just promotion of best
practices.
•
Employment
First IS
 A clear public policy of
employment as the first and
preferred option for
individuals receiving publicly
funded services.
 Policies, practices, and
resource allocation that
prioritize employment in the
general workforce.
Employment First: Where are we headed?
• Individuals with complex disabilities fully accepted
and supported in the general workforce
• Individuals with disabilities expected to go to
work
• Major evolution of service delivery system
• End of the “guarantee” 9-3 day program
• Individuals with disabilities increasingly part of the
economic mainstream
• Individuals with disabilities making full use of
their skills and abilities
Cultural Shift
System versus Person-Centered
System
Person Centered
What is the “problem”?
Disability
Society
Where is the “problem”?
In person
Systems/Environments
What is solution?
Classify/Place/Train
Educate/Empower
Who is in charge/decision
maker?
Professional
Individual/support team
Information focus?
Deficits – cannot do
Interests/Strengths – can
do
Outcome?
Dependence
Interdependence
What A Real Culture Shift Means
• All people with disabilities viewed as capable of successful
employment.
• No more asking “Do you want to work?” but instead
“Where do you want to work?”.
• Choosing not to work is no longer considered okay.
• No more “preserve benefits at all costs” mentality.
• Services: not “caretaking”, but investment in people.
• People with disabilities working is the norm, not the
exception.
Draw a picture of the person sitting
next to you…
What Prevents Us from Moving Forward?
Fear
Changing highly ingrained
culture
and beliefs
regarding employment of
people with disabilities
Insanity: doing the same thing
over and over again and
expecting different results.
~Albert Einstein
Employment
Readiness Myth # 1
• Facility-based programs prepare people
for employment
• In fact research shows the opposite is
true
Employment Readiness
Myth # 2
• Performance in simulated work environments
for people with developmental disabilities is
a predictor of employment readiness and
success
In fact the best predictor
of success is paid work
experience while still in
high school.
Employment Readiness
Myth # 3
•We can predict who
will succeed or fail in
employment.
Let’s see
what your employment
future holds…
Let’s see what
your employment
future is.
If that were the case then we would not
need HR Departments!
Employment
Readiness Myth # 4
• Rate of production is a primary factor in
determining employment readiness
• In fact, in today’s work environment, rate of
production is only one of many factors in
determining whether someone is a “good
employee” – and in many cases is not even a
consideration
Employment
Readiness Myth # 5
• You need to know how to conduct
a job search to be ready for
employment
80% of jobs are found through
networking with family and friends
Employment Readiness
Myth # 6
• Every employer
has the same employment standards
and same methods for hiring
Employment Readiness
Myth # 7
•Employer standards
are inflexible
We are all supported employees
with customized jobs
Employment Readiness
Myth # 8
•Employers are
expecting perfect
employees
• Couldn’t get along with
others?
• Acted inappropriately?
• Had behavioral outbursts?
• Was chronically late?
• Complained about
everything?
• Didn’t communicate well?
• Didn't work very fast?
• Got distracted easily?
• Didn’t take directions
well…or at all?
• Acted impulsively without
thinking?
• Refused to take public
transportation?
• Had a messy office?
• Wasn’t organized?
• Wasn’t always
professional?
• Was rude?
• Couldn’t take criticism?
• Was lazy?
• Wasn’t very good at their
job – but managed to still
keep it?
Have you ever worked with anyone who…
Job Preferences Are Important
More intensive intervention
Less intensive intervention
EMPLOYMENT STRATEGIES & TECHNIQUES
Full scale
discovery
Job creation
Job carving
Customized
strategies
Short-term job
trials
Comprehensive
person-centered
planning
Professional job
development
Job coaching
More complex
accommodations
Job skill training
More time & resources
Assistance with job
search plan
Standard job search
Job search guidance practices
& counseling
Resume assistance
Guidance on
Help with job leads
disability
issues/disclosure
Brush up interview
skills
Simple
accommodations
Less time & resources
What will be the best route to
employment success?
PersonCentered
Planning
Job
Development
Job
Creation
Employment
Success
Situational
Assessment
Community
Exploration
PASS
Pursue Job
Leads
Find a Job
Benefits
Planning
Develop
Resume
Plan Job
Search
The Trap of the “Dream Job”
We are not looking
for a dream job, just a
job that will lead to
the next job…
It’s A Time of
Enormous
Opportunity
National
Disability Rights
Network:
“Segregated &
Exploited”
• 2011 & 2012 reports stating
that service system has
failed in providing quality
employment services and
supports.
Segregated & Exploited
A Call to
Action!
The Failure of the Disability Service
System to Provide Quality Work
National Council on Disability
National Council
on Disability
Report
• Federal Agency calling for
phase out sub-minimum
wage as part of overall
systems change
• Make fundamental changes
in transition
An independent federal agency making recommendations to the President and Congress
to enhance the quality of life for all Americans with disabilities and their families.
LETTER OF TRANSMITTAL
August 23, 2012
The President
The White House
Washington, DC 20500
Dear Mr. President:
On behalf of the National Council on Disability (NCD), I am pleased to submit NCD’s
report, Subminimum Wage and Supported Employment.
Section 14(c) of the Fair Labor Standards Act allows employers certified by the United
States Department of Labor to compensate persons with disabilities for work at a rate
less than the minimum wage – a wage set by Congress for all other workers in the
United States. Many disability advocates argue that 14(c) should be abolished because
it discriminates against people with disabilities and is thus inconsistent with our national
disability policy goals enshrined in the Americans with Disabilities Act (ADA). Others
argue that the subminimum wage certification program still has an important role among
a range of employment options because it provides opportunities to people with
disabilities who are unable to obtain competitive employment jobs. Debates among
advocates and policy-makers about the future of Section 14(c) have often been divisive,
and consensus has been elusive.
NCD recognized it had a unique opportunity to develop a constructive path forward on
subminimum wage policy. Following discussion at a December 2011 meeting of the
Council, I appointed Council Member Clyde Terry as Chair of a Subminimum Wage
Committee to examine the issue and bring forward recommendations to the full Council.
The recommendations contained in this report reflect the considered judgment and
analysis of NCD. As part of our exploration we engaged in a series of site visits around
the country to learn from the ground up about how policies are actually working in the
lives of people with disabilities. Our report is not empirical in its approach, but we have
tried to capture the essence of all of the voices and perspectives we heard. Our
comprehensive recommendations seek to be responsive to all of the opportunities and
concerns identified.
The central theme of our recommendations is that the 14(c) program should be phasedout gradually as part of a systems change effort that enhances existing resources and
creates new mechanisms for supporting individuals in obtaining integrated employment
1331 F Street, NW ■ Suite 850 ■ Washington, DC 20004
202-272-2004 Voice ■ 202-272-2074 TTY ■ 202-272-2022 Fax ■ www.ncd.gov
National
Governor’s
Association
Initiative
Requirements for
expanding community
employment
increasingly part of
settlement agreements
with states
Federal Agency Investments to Incentivize Systems Transformation
Administration on Intellectual and Developmental Disabilities
• Partnerships in Employment Systems Change
SSA, OSEP, HHS, DOL
• Promoting Readiness of Minors in Supplemental Security Income
(PROMISE)
Office of Disability Employment Policy at the Department of Labor
(ODEP)
• EFSLMP
Office of U.S. Special Education & Rehabilitative Services
• Customized Employment Funding Strategies expanded in several state
VR systems
Centers for Medicare & Medicaid Services (CMS)
• Federal Improvements to Medicaid Community First Choice Option
Balancing Incentives Program and Money Follows the Person
Illinois
Employment
First Summit
Massachusetts
Blueprint for
Success
Employment in the community
cannot be viewed as an
“add on” or something extra.
It must be viewed by everyone
as a core component of the
service delivery system.
Money Matters….
and Drives Practice
14%
12%
10%
Sheltered
Employees
8%
Supported
Employees
6%
4%
2%
0%
1
2
3
4
5
6
7
8
9
10
11
12
Fiscal Quarters
Percent of Total Program Costs
Cimera (2008)
Polices & Practices that Presume
Employability
• No work “readiness” criteria
• Consideration of employment mandated part of
service planning
• Require documentation for non-consideration of
employment
• Decision to not consider employment re-visited
regularly
• Follows tenants of person-centered planning –
“nothing about me without me”
Ohio Employment First Form
Major Barriers to Change
•Negative attitudes & resistance (e.g., staff,
families, Board)
•Funding (Inflexible, insufficient)
•Lack of expertise (re: organizational transformation)
•Lack of leadership
•Other: Transportation, safety net
•NOT: Resistance from people with
disabilities or the community.
Barriers to Integrated Employment
• Perceived benefits of sheltered services: consistent
schedule, safety, provision of transportation, less fear
about loss of disability benefits, social environment
• Funding: Must be sufficient and flexible
• “One Stop Shop” Approach: People with ID left behind
• Centralized/streamlined service coordination (“case
management”)
Achieving Social and Economic Inclusion:
From Segregation to ‘Employment First’
Why Have Organizations Changed from
Sheltered to Integrated Employment?
•Leadership within the organization
(“It’s the right thing to do.”)
•People receiving services dissatisfied (Most want a job.)
•Poor quality services & outcomes of sheltered
facilities (“make work”, low wages, artificial setting; poor models)
•Push from federal and state agencies
•Rehab Services Admin (no funding for workshop placements)
•Olmstead (“Most integrated setting”)
•Employment First initiatives
Employment First & Organizational Change
Means Changing Just About Everything
Strategy: What you do
The
Organization
Structure: Who does it
Systems: How you do it
Pat Rogan’s Top 10 Tips
for Organizational Change
1. Restructure: Flatten the organizational structure
• Revise job descriptions to focus on employment\
• Staff reapply for positions
• Work in small teams to serve individuals
2. Reinvest: Focus on staff development and
mentoring
• Empower front line staff to make person-centered
decisions.
Pat Rogan’s Top 10 Tips
for Organizational Change
3. Refocus: One person at a time
• Start with those who want to work. Include people with high
support needs from the start
• Individualized daily/weekly schedules based on person
centered planning
• Paid work as anchor of a meaningful day. Consider 2 part-time
jobs; 1 part time job and volunteer; etc.
4. Reallocate: Unload “sunk” costs
• Rent, lease, or sell the building. “Spin off” free standing
supported employment service
5. Re-Message: From “a safe, secure place…” to “a viable labor
source…”
6. Reconnect: Engage key stakeholders from the start
Pat Rogan’s Top 10 Tips
for Organizational Change
7. Plan the work; work the plan
8. Restrict Entry
• School to WORK Transition
• Close the ‘back door’ after job loss
9. What you count, counts!
• Collect accurate data regarding outcomes
10. Develop Partnerships:
• DRS, DD
• APSE Chapter
• Community Living organizations
• Business Leadership Network
• Benefits Planning & Assistance
Service & Support Capacity/Development
Current Status
Vision
• Success is not
widespread
• Comfortable with “status
quo”
• Lack of opportunities
• Learned helplessness
• Limited understanding of
benefits
• Not a priority
• Service providers are
able to connect job
seeker and employer
• Understanding of goals
and needs
• Connect people
Service & Support Capacity/Development
What needs to change
Action steps to change
• Education and training
for providers
• Eliminate “status quo”
mentality
• Sustainability for service
providers
• Availability of different
types of services
• Change expectations
• Sustainability of
providers
• Create common language in
systems
• Change mindset
• Share success stories
• Communicate vision
• Create clear standards for
service providers
(certification, quality
assurance)
• Create ongoing staff
development
• Educate regarding benefits
• Build provider
networks/roundtables
• Transition Planning
Committees
Funding/Creating Incentives
Current Status
Vision
• Inflexible funding
• Medicaid match drives
funding – no general
grants
• Wide variation in funding
systems requirements
• Insufficient rates to
provide quality
• DDD currently needs
prior approval for SE
• Identify support needs
holistically
• Flexible funding – unlink to
living setting
• Funding moved to support
integrated employment
versus facility based
• Smooth transition of
funding from DRS to long
term support
• Rataes provide incentive
for integrated employment
• Seamless transtion from
school to adult service
funding
Funding/Creating Incentives
Actions for Change
• Presume funding/eligibility for SE/approval for sheltered/facility
based programs
• Develop cost/benefit of employment services compared to faciility
based programs
• Systematically increase use of work incentives – PASS, IRWE, BWE,
Student Earned Income – as funding
• Examine how Ticket to Work could be leveraged to fund
employment
• Develop strategies to utilized workforce development for
supplemental sources of funding and services (e.g., WIA funded
training, youth services, education/training funds at community
colleges)
• Develop rate system based on true costs that provide incentives for
employment
• Use funding from SODC closure toward community employment
• Develop clear mechanism for transitioning between DRS and MH/DD
• Maximize funding from education and other sources
Data, Evaluation, Accountability
Vision
Action Steps
• Collect right data for
quality assurance
• Set targets to achieve
within timeframes
• Individual receives
printout of what they
receive
• Employment needs to be
outcome measure
• Create multi agency survey
of current data being
collected
• Create state agreement of
employment indicators
• Create database for
individuals to see services
• Include families and
individuals in data
collection
• Evidence based
• Numbers of certified job
coaches
Public Agency Systems Change
Current Status
• Silos
• Non-coordinated
• Funding: separate
resources/priorities
• Individuals drive levels of
coordination
• Organizational cultures
foster fragmentation
Vision
•
•
•
•
•
•
•
•
Responsive
Easy access
Coordinated/Seamless
Person-centered
Measurable objectives
Interagency shared goals
Eliminate silos
Same data system
Public Agency Systems Change
What needs to change
Actions for Change
• Stronger coordination
• Integrated planning
• Coordinated
dollars/maximize resources
• Clarify responsibilities
• Equal access with supports
• Consistent information
sharing
• Evaluation/re-evaluation
process
• Financial incentives
• Qualified coordinator at
Governor’s office
• Coordinated plan for
state agencies
• Data integration
• Integrate strategic plans
• Tie dollars to outcomes
• Monitoring of plan
We’re far too patient with the passage of
time for people with disabilities…
Time is as precious for a person with a
disability as it is for all of us.”
~Gerry Provencal
Actions Speak Louder than
Words…
Thank you!
Laura Owens, Ph.D., CESP
APSE
416 Hungerford Drive
Suite 418
Rockville, MD. 20850
lowens@apse.org
www.apse.org
CEO
1421 N. Water Street
Milwaukee, WI 53202
laura@ceomke.com
www.ceomke.com