National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ......

National Core Indicators: Employment Trends for Adults with ID/DD and Suggestions for Policy Development

Agenda

• Why are we looking at these data?

• Intro to NCI Methods, Measures and Sample

• Findings

• Policy opportunities

• Discussion/Questions?

National Core Indicators (NCI)

Why?• Rates of integrated employment among people with

ID/DD receiving services are low Remained essentially unchanged for the past 10 years.

• Systems change efforts underway in over 40 states State Employment Leadership Network

AIDD Partnerships and Employment Learning Community

ODEP employment first initiative

• NCI can offer an important perspective in employment and employment outcomes of people with ID/DD receiving services.

National Core Indicators (NCI)

WHAT IS NATIONAL CORE INDICATORS (NCI)?

• Multi-state collaboration of state DD agencies

• Measures performance of public systems for people with intellectual and developmental disabilities

• Assesses performance in several areas, including: employment, community inclusion, choice, rights, and health and safety

• Launched in 1997 in 13 participating states

• Supported by participating states

• NASDDDS – HSRI Collaboration

National Core Indicators (NCI)

CT

NCI State Participation 2013-14

HI

WA

AZOK

KY

AL

NC

PA

MA

TX

AR

GANM

NJ

MO

NH

OH*

IL

LA

NY

Wash DC

FL

CA*

SDOR

MN

UTCO KS

MS

TNSC

WIMI

INVA

DEMD

State contract awarded in 2013-14 through AIDD fundingCA*- Includes 21 Regional CentersOH*- Also includes the Mid-East Ohio Regional Council

39 states, the District of Columbia and 22 sub-state regions

ME

WHAT IS NCI?

• Adult Consumer Survey In-person conversation with a sample of adults receiving

services to gather information about their experiences Keyed to important person-centered outcomes that measure

system-level indicators related to: employment, choice, relationships, case management, inclusion, health, etc.

• Adult Family, Child Family, and Family/Guardian Surveys Mail surveys – separate sample from Adult Consumer Survey

• Other NCI state level data: Mortality, Staff Stability

National Core Indicators (NCI)

Data Source:Adult Consumer Survey

• Standardized, face-to-face interview with a sample of individuals receiving services Background Information Section I (no proxies allowed) Section II (proxies allowed)

• No pre-screening procedures states don’t filter anyone out of the sample.

• Conducted with adults only (18 and over) receiving at least one service in addition to case management

• Section I and Section II together take 50 minutes (on average)

National Core Indicators (NCI)

Methods, Measures and Sample:

• 2012-2013 data collection cycle

• 25 states, one regional council (Alabama, Arkansas, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Kentucky, Louisiana, Maryland, Mid-East Ohio Regional Councils, Missouri, Mississippi, North Carolina, New Hampshire, New Jersey, New York, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah, Virginia and Wisconsin.)

• Total N: 13,157 individuals

National Core Indicators (NCI)

• People under the age of 22 who were enrolled in public schools (or for whom this information could not be determined) were excluded from most of the NCI 2012-13 analyses in this presentation, except where indicated. 12,720 adults remained in the data.

~~~~~~~~~~~~

Residence Type:

National Core Indicators (NCI)

4.4%

34.0%

14.6%

37.1%

9.8%

Specialized Institutional Settings Community-Based Residences

Independent Homes or Apartments Parent or Relative's home

Other

Number of Respondents in Integrated Employment/Paid Community Jobs:

Different Datasets

National Core Indicators (NCI)

8.6%14.7%

18.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

ACS Cognitive Disability +SSI

NCI 2012-13 IDD Agency Survey FY12

Employment:• Integrated Employment:

Paid job in a place where most other workers do not have disabilities (e.g. competitive or supported employment, enclave, work crew)

• Unpaid Community Activity Unpaid activity in a place where most other workers do not have

disabilities(e.g. volunteer activities, skills training, community experiences)

• Paid Facility-Based Work Paid job in a place where most people do have disabilities

(e.g. workshop, activity center)

• Unpaid Facility Based Activity Unpaid activity in a place where most people do have

disabilities (e.g. day habilitation, prevocational, seniors programs)

National Core Indicators (NCI)

NCI 2012-13: What Do NCI Respondents Do During the Day?

National Core Indicators (NCI)

14.7%

22.6%27.0%

44.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

IntegratedEmployment

Unpaid CommunityActivity

Paid Facility-BasedWork

Unpaid Facility-Based Activity

What ELSE?

• 46.1% of those in integrated employment also took part in another type of day activity/employment

29.1% also in unpaid community activity

16.6% also had a paid facility-based job

22.3% were also in an unpaid facility-based activity

National Core Indicators (NCI)

NCI 2012-13: Type of Employment by Residence

National Core Indicators (NCI)

1.4%

11.1%

24.3%

16.2%13.6% 12.3%

8.4%

21.5% 22.3%24.6%

27.3%23.5%

34.9%

28.6%26.7%

26.2%19.4%

26.8%

46.0%

55.8%

24.2%

41.3%

48.4%

36.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Institution Community-basedresidence

Independenthome/apartment

Parent/relative'shome

Foster care/hosthome

Other

Integrated Employment Unpaid Community-Based Activity

Paid Facility-Based Job Unpaid Facility-Based Activity

Paid Work Vs. Non-Work

National Core Indicators (NCI)

--Denominators do not include missing or don’t know responses**Includes unpaid facility-based and community-based activities

18.0%14.7% 15.3% 13.4% 14.7%

30.0% 28.3%24.6%

27.5% 27.0%

67.9% 68.0%

61.7%

71.0%66.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2008-09 2009-10 2010-2011 2011-12 2012-13

Integrated Employment Paid Facility-Based Work Unpaid Activities**

NCI 2012-13: Integrated Employment?

National Core Indicators (NCI)

14.7%

85.3%

Paid job No paid job

47.1%

52.9%

Wants a job

Does not want a job, or in between

30.0%

70.0%

Job goal in ISP

No job goal in ISP

Of those WITHOUT integrated employment….

Of those WITHOUT integrated employment who would LIKE integrated employment…

NCI:2012-13: In Integrated Employment and Likes Job

National Core Indicators (NCI)

2.3%

5.8%

91.9%

No In-between Yes

NCI 2012-13: Working in Integrated Employment but Wants to Work Somewhere

Else

National Core Indicators (NCI)

61.2%9.4%

29.4%

No In-between Yes

NCI 2012-13: Participation in Integrated Employment By State

4.6%

13.2%

37.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

National Core Indicators (NCI)

NCI 2012-13: Average Hours Worked in 2 Wk. Period in Integrated Job by State

14

25

33

0

10

20

30

40

50

60

70

80

90

100

National Core Indicators (NCI)

NCI 2012-13: Average Wages Earned in 2 Wk. Period in Integrated Job by State

$100.41

$186.88

$264.35

$0.00

$50.00

$100.00

$150.00

$200.00

$250.00

$300.00

National Core Indicators (NCI)

NCI 2012-13: In Integrated Employment by Age Group

National Core Indicators (NCI)

15.1%19.2%

16.0% 13.9%10.7%

5.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

18-25 26-35 36-45 46-55 56-65 65+

NCI 2012-13: Younger Adults

National Core Indicators (NCI)

17.8%

26.0%22.7%

38.5%

15.2%

21.4%

30.8%

46.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Integrated Employment Unpaid Community Activity Paid Facility-Based Work Unpaid Facility-BasedActivity

18-34 35-54

NCI 2012-13: Selected Outcomes

81.6% 81.9%

62.2%

75.1%78.4%

58.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Has friends other thanfamily or staff

Has a best friend Never feels lonely

Relationships

Has Integrated Job Does Not Have Integrated Job

National Core Indicators (NCI)

NCI 2012-13: Selected Outcomes

21.6%

49.3%

27.7%

1.4%

11.3%

43.2% 40.7%

4.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Excellent Very Good Fairly Good Poor

Reported Health Status

Has Integrated Job Does Not Have Integrated Job

National Core Indicators (NCI)

NCI 2012-13: Selected Outcomes

69.9% 72.0%63.2%

93.7% 97.0%

47.3%

60.3%

38.6%

80.1%

89.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Choosing home Choosing staff Choosingroomates

Choosingschedule

Choosing whatto do in freetime

Choice: Individual had at least some input in:

Has Integrated Job Does Not Have Integrated Job

National Core Indicators (NCI)

Paid Community Jobs

• A integrated job can be of one of three types:

an individual job without supports (competitive),

an individual job with supports (individual-supported) and

group-supported.

• All three are types of “integrated” employment.

Individually-supported employment and competitive employment make up “individual” jobs.

National Core Indicators (NCI)

NCI 2012-13: Type of Employment Support

National Core Indicators (NCI)

N % of total in integrated jobs

Integrated Job 1779 100%

• Individual Job (Individually-supported and Competitive)

971 55%

• Individually-supported

520 29%

• Competitive 451 25%

• Group Supported 433 24%

Type of employment support not specified

375 21%

NCI 2012-13: Percent of Those in Integrated Employment in Group-Supported Employment-

By State

3%

23%

54%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

National Core Indicators (NCI)

NCI 2012-13: Hours and Wages in a Two Week Period

Hours Gross Wages Hourly Wage

Integrated Job 25.4 $182.76 $7.83

• Individual Job (Individually-supported and Competitive)

24.5 $192.67 $8.38

• Individually-supported

23.9 $186.27 $8.49

• Competitive 25.3 $200.26 $8.27

• Group Supported 27.6 $172.93 $6.76

Paid Facility-based Job 32.2 $56.87 $2.39

National Core Indicators (NCI)

***Information on type of community job is not available for all individuals in integrated jobs

Federal Minimum Wage: $7.25/hr

NCI 2012-13: Benefits

National Core Indicators (NCI)

Receives paid vacation and/or sick time at his/her job

Paid Community Job 24.8%

• Individual Job (Individually-supported and Competitive)

• 26.5%

• Individually-supported • 24.9%

• Competitive • 28.3%

• Group Supported • 26.0%

***Information on type of community job is not available for all individuals in integrated jobs

NCI 2012-13: Volunteering“Do you do any volunteer work?”

National Core Indicators (NCI)

71.4% 70.5% 70.1%66.7% 67.3%

28.6% 29.5% 29.9% 33.3% 32.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2008-09 2009-10 2010-11 2011-12 2012-13

No Yes

Somebody has to do something and its just incredibly pathetic that it has to be us.

Why are we stuck?

Policy opportunities…

• Employment first policy and practice

• Prioritize $ for employment at transition

• Seamless movement between systems

• Redefining non-work and prevoc services

• Adequate funding for IE

• Investment in capacity building

• Robust & transparent employment data

• State hiring practices

Emerging Influences

• Department of Justice (DOJ)

• Centers for Medicaid and Medicare Services (CMS)

• Advocacy efforts

• Legislative and executive initiatives

• Federal initiatives: AIDD, DOL, SSA, DOE

Policy opportunities…

• Employment first policy

• Prioritize $ for employment at transition

• Seamless movement between systems

• Flexible use of funds

• Adequate funding for integrated employment

• Robust & transparent employment data

• State hiring practices

New York Road to Reform

• No new workshop admissions (7/1/2013)

• Increase competitive employment by 700

• Plan: transition to employment (10/2013)

• Plan for workshop closure (10/2013)

• Redesigned “front door”

• Restructure case management

• Redesign funding structure

• Employment data

Massachusetts

Blueprint for Success

• Close front door to workshops 1/2014

• Close sheltered workshops by 7/2015

• Transition workshop participants to IE or CBDS

• Transition individuals from CBDS to integrated

work

• Phase out group employment settings that pay less

than minimum wage

11/2013

Policy Questions

National Core Indicators (NCI)

Contacts• Institute for Community Inclusion at UMASS Boston:

John Butterworth: John.Butterworth@umb.edu

• HSRI

Josh Engler: jengler@hsri.org

Dorothy Hiersteiner: dhiersteiner@hsri.org

• NASDDDS

Mary Lee Fay: MLFay@nasddds.org

National Core Indicators (NCI)