Employment First...Employment First A National Initiative Norine Jaloway Gill, MSW, CESP Good...
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Employment First A National Initiative Norine Jaloway Gill, MSW, CESP
Employment First...Employment First A National Initiative Norine Jaloway Gill, MSW, CESP Good morning and welcome to this session on Employment First – a national initiative. Today,
Good morning and welcome to this session on Employment First – a national initiative. Today, I hope to share with you some of the background and information on Employment First, what it means, the historical background and what it will mean for people with disabilities, family members and those who provide services and support in the future.
Employment First
“Employment in the general workforce is the first and preferred outcome in the provision of publically funded services for all working age citizens with disabilities, regardless of level of disability.”
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Although Employment First may have some variations from state to state in terms of how it is defined, APSE – the national organization for supported employment provides this statement on Employment First which is generally captured in most state efforts: Employment First is grounded in the values and principles of normalization, full inclusion and self-determination that impact all aspects of a person’s life. It uses the person-centered tools to plan and create successful community living, including where people live, achieving education and work goals, socializing and experiencing spiritual growth.
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The Employment First initiative is a national movement recognizing that the primary goal for working-age adults with disabilities is employment. The services funded by taxpayer dollars are intended to support realization of that goal. Despite the a proven record of success for supported employment as an evidence based practice, the need for an Employment First policy is evident in legislation, policy, practice and training. At its heart, it is an effort that changes the expectations about the ability of people with disabilities to work. As both a professional and family member, I find it interesting that a national initiative would be needed to convince others that employment is an expectation for people with disabilities. From my family and cultural upbringing, work and participating in work has always been an expectation of everyone – literally – you would need to be on your deathbed to be excused from school, work or church. Embracing the belief systems for “Employment First” is not difficult for me or for many others that I’ve met through the years. But apparently, it is a concept that runs counter to a significant portion of the service delivery system, and consequently, the beliefs and behaviors of the people who use the services provided by the system. Perhaps our first challenge to creating Employment First, then, is to raise the expectation that people with disabilities can work, contribute to the workforce, and earn a wage.
Segregation vs. Self Determination
• a place to live, with control over who comes in and out of their home
• relationships and contact with people who are important to them
• an opportunity to learn • participation in their community including
social, recreational, and cultural experiences; and
• a job with a living wage
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Can you imagine growing up and hearing someone tell you “you’ll never need to work because you’ll always be taken care of.” When I talk with young people exiting the school system to the world of adulthood, no one has ever said that their goal is to work at the “sheltered workshop” or take classes at the “day hab”. They want a life – usually doing what their non-disabled peers, brother, sister, mom or dad, do. What we know about people with disabilities, including individuals with significant intellectual and developmental, psychiatric or medical disabilities, is that their life of self-determination includes the same hopes and desires as any of us:
Self Determination
• The institutional service model presumes the need for care taking support for the person.
• These supports go well beyond the “care taker” service and require the staff that directly supports the person to know skills such as – supported decision-making, – job and task analysis, – networking and budgeting, – to name just a few.
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What data shows, however, results in most people who are determined eligible for services and receive support, are typically provided a special program. And in some cases, a program to prepare them to work. The institutional service model presumes the need for care taking support for the person. While the need for support is evident, it is equally important to recognize the gifts, talents, skills and capacities of the person. The self-determination approach to services and supports goes beyond what can be offered and achieved, and “care taking” is only one of many types of support that should be made available to a person. Designing the supports to match a self-determination model requires the system’s capacity to deliver services such as person-centered planning, supported living, consumer direction, and supported employment. These supports go well beyond the “care taker” service and require the staff that directly supports the person to know skills such as supported decision-making, job and task analysis, networking and budgeting, to name just a few.
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1990 1993 1996 1999
Day Services
People entering SE People entering segrated programs
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In the early 1980’s when supported employment emerged, there were hopeful signs that the support and strategies for community job placement would be a standard outcome of the service delivery system. By 1990, about 50% of persons with severe disabilities receiving agency supports entered into a job based program – equal to the number of people entering into sheltered or segregated programs. Over the following ten years, however, the trend reversed. Currently, for every one person entering supported, integrated employment services, four individuals will enter segregated, congregated habilitation and workshop programs – now comprising about 80% of the services in the system. While there is a slight increase in the number of people entering employment services, at the same time, a substantially larger number of people coming out of schools and off waiting lists entered into the day habilitation and sheltered workshop programs. For over 30 years, supported employment is proven to be a successful strategy for integration of people with severe disabilities in the community, earning wages, cost effective and beneficial to employers. It has passed the rigors of research and is considered an “evidenced-based” practice. It far exceeds the dominant model of segregated services in meeting desired outcomes of employment services, including number of hours worked and wages earned. Yet, it is overshadowed by the persistent and entrenched policies, practices and service delivery that perpetuates segregated services. How will Employment First change the status quo to move toward integrated jobs in the community for people with disabilities?
Partnership
• Policy – the guidelines or rules for service delivery and funding mechanism intended to produce the desired outcome
• Practice – the capacity of the agencies to offer quality services and produce the desired outcome
• Individual and Family – being prepared to make decisions about the job seeking and support process
• Staff – the ability of staff to effectively work with the job seeker and the employer to meet the employment goal
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Simply put, Employment First requires a partnership with everyone involved – from the job seeker and their family, to the service providers, community networks, the employers and the agencies that govern them. Systems change requires strategies that impact many levels of performance. An Employment First policy needs to consider Policy – the guidelines or rules for service delivery and funding mechanism intended to produce the desired outcome Practice – the capacity of the agencies to offer quality services and produce the desired outcome Individual and Family – being prepared to make decisions about the job seeking and support process Staff – the ability of staff to effectively work with the job seeker and the employer to meet the employment goal The people that operate Federal, state, regional and local agencies have an enormous responsibility to wisely spend the taxpayer dollar. But our systems have become complex and often in conflict from once service to the next. For instance, it isn’t unusual for some people to become lost between the goals set while in school and movement to vocational rehabilitation services once they exit education services. Another problem is to have a job – you need to be able to get there. Transportation is a significant issue for many employees and more so for a person with a disability. Or, the dilemma of earning wages while reducing the social security check. There are resolutions to these dilemmas that do take a concerted, focused effort – and fortunately, we already see Employment First strategies emerging happening in a variety of ?????
Action by State
Source: http://rtc.umn.edu/prb/214/
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Since the conversation of Employment First started around 2005, a number of efforts have emerged throughout the country. Several states have created the environment and the capacity to move forward on the Employment First initiative. Not only do they provide a framework for creating policy, but the experience and services can assist new initiatives to learn what has worked or not worked.
Washington“Supports to pursue and maintain gainful employment in integrated settings in the community shall be the primary service option for working age adults.” And if or when there is an exception the “must have the prior written approval of the regional administrator based on county input.”
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A strategy used by the Washington Division of Developmental Disabilities promotes employment outcomes, while severely limiting access to the front door of segregated services: “Supports to pursue and maintain gainful employment in integrated settings in the community shall be the primary service option for working age adults.” And if or when there is an exception the “must have the prior written approval of the regional administrator based on county input.”
State Employment First Policies
Vermont’s 1999 System of Care plan stated that DDAS funds could not be used to increase the capacity of sheltered workshops (or congregate residential settings).
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Vermont’s 1999 System of Care plan stated that DDAS funds could not be used to increase the capacity of sheltered workshops (or congregate residential settings). The 2002 updated plan expanded this such that state funds cannot be used to increase the capacity of group employment settings such as enclaves or work crews. All existing sheltered workshops were successfully closed in 2005. The System of Care plan stated that DDAS funds could not be used to fund sheltered workshops at all. Also of interest, Vermont has closed all of the state institutions as residential services.
State Employment First PoliciesOregon
1. Employment services shall be specifically addressed in the Individual Support Plan;
2. Employment services shall be considered and provided using person-centered planning concepts, based on informed choice, and consistent with the philosophy of self-determination;
3. Minimum or competitive wages and benefits shall be the goal of integrated employment;
4. All natural as well as paid supports will be considered in service planning; and
5. Employment supports will be provided outside of the individual’s living environment unless necessary for a self-employment plan or for the individual’s medical or safety needs.
This policy statement will be accompanied by a more thorough implementation statement that further details definitions, desired outcomes, and operational procedures.
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Oregon’s Office of Developmental Disabilities Services has established a State Employment Task Force on Employment First and created a policy statement Perhaps more prescriptive than other Implementation of this policy shall be based on the following procedures and principles: 1. Employment services shall be specifically addressed in the Individual Support Plan; 2. Employment services shall be considered and provided using person-centered planning concepts, based on informed choice, and consistent with the philosophy of self-determination; 3. Minimum or competitive wages and benefits shall be the goal of integrated employment; 4. All natural as well as paid supports will be considered in service planning; and 5. Employment supports will be provided outside of the individual’s living environment unless necessary for a self-employment plan or for the individual’s medical or safety needs.This policy statement will be accompanied by a more thorough implementation statement that further details definitions, desired outcomes, and operational procedures.
State Employment First Policies
Wisconsin Employment First is a cross-disability coalition of people with disables, family members, advocates, providers, community organizations and businesses working together to increase integrated employment options for people with disabilities. Goal: Double the number of people with disabilities in integrated employment by 2016
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Wisconsin Employment First is a cross-disability coalition of people with disabilities, family members, advocates, providers, community organizations and businesses working together to increase integrated employment options for people with disabilities. Right now, only about 20% of working-aged people with disabilities in our state enjoy the benefits of integrated employment. Less than 10% of working-age individuals with intellectual and developmental disabilities in Wisconsin’s long-term care system are in community employment, and only 4% of people with physical disabilities are in community employment. Other states that are focused on Employment First are achieving integrated employment rates as high as 70%. Wisconsin can do better!
Federal LegislationTHE WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) • WIOA replaces the Workforce Investment Act of
1998 and retains and amends the Adult Education and Family Literacy Act, the Wagner-Peyser Act, and the Rehabilitation Act of 1973.
• Every state will develop and submit a four-year strategy – in the form of a single unified strategic
plan for core programs - for preparing an educated and skilled workforce and meeting the
workforce needs of employers.
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Federal Legislation and Employment First Although the new Federal legislation, Workforce Innovation and Opportunity Act does not explicitly state and define Employment First, the language in many of its provisions support and Employment First philosophy and outcome. Signed into law in July of this year, WIOA makes significant advancements for people with disabilities in employment throughout the service system. THE WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) 1. WIOA replaces the Workforce Investment Act of 1998 and retains and amends the Adult Education and Family Literacy Act, the Wagner-Peyser Act, and the Rehabilitation Act of 1973. 2. Every state will develop and submit a four-year strategy – in the form of a single unified strategic plan for core programs - for preparing an educated and skilled workforce and meeting the workforce needs of employers.
Increased Role of Vocational Rehabilitation in Transition
15% of the state’s public Vocational Rehabilitation Funds must now be used for transition services, specifically pre-employment transition services.
Limitations on Use of Subminimum Wage
Rehabilitation Act, Section 511 demands a series of steps before an individual under the age of 24 can be placed in a job paying less than minimum wage.
Requirement for Formal Cooperative Agreement between Vocational Rehabilitation and State Medicaid and Intellectual Developmental Disabilities Agency
Targets the responsibility and delivery of long-term supports for people with disabilities.
Competitive Integrated Employment Defined
“full or part-time work at minimum wage or higher, with wages and benefits similar to those without disabilities performing the same work, and fully integrated with co-workers without disabilities.”
Customized Employment and Supported Employment
• Customized Employment – “ competitive integrated employment, for an
individual with a significant disability, that is based on an individualized determination of the strengths, needs and interest of the individual with a significant disability…designed to meet the specific abilities of the individual with a significant disability and the business needs of the employer…carried out through flexible strategies.”
Customized Employment and Supported Employment
• supported employment results in integrated competitive employment
• post-employment support services are extended from 18 to 24 months.
Increased Emphasis on Role of General Workforce Development System • include community organizations that provide
or support competitive integrated employment for individuals with disabilities.
• sufficient service providers in the local areas• develop strategies to support the use career
pathways for job seekers with disabilities to enter and retain employment
• 15% of general workforce development funds for statewide employment training activates
Home & Community-Based Waiver Services • Be typical of where people without disabilities
live and work (houses, condos, and apartments in neighborhoods).
• Provide the same access to community resources given to people without disabilities.
• Allow people control over their spending money and other personal resources.
• Support people to be in community employment alongside people without disabilities and earn minimum wage or higher.
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Home & Community-Based Waiver Services There are new rules from the Centers for Medicare and Medicaid Services (CMS). CMS is the federal agency that provides funds for Home and Community-Based Waiver Services for people with disabilities. These rules will help more people with disabilities be included in their communities. CMS has said they want people with disabilities to have the benefits of integration and community living. Be typical of where people without disabilities live and work (houses, condos, and apartments in neighborhoods). Provide the same access to community resources given to people without disabilities. Allow people control over their spending money and other personal resources. Support people to be in community employment alongside people without disabilities and earn minimum wage or higher. Further guidance will be given on requirements for day and workplace settings, but CMS has said that the requirement to be in the general community and with others who do not have disabilities does apply to employment and day services, so segregated work and day support services will need to change.
Employment First – A National Initiative
U.S. DEPARTMENT OF LABOR, THE WORKFORCE INNOVATION AND OPPORTUNITY ACT OVERVIEW, July 22, 2014 http://www.doleta.gov/wioa/pdf/WIOA-Overview.pdfhttp://www.communityinclusion.org/pdf/IB31_F.pdf
APSE Employment First Statement, http://www.apse.org/employment-first/statement/
Training Resource Network, https://www.trn-store.com/employment-first
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U.S. DEPARTMENT OF LABOR, THE WORKFORCE INNOVATION AND OPPORTUNITY ACT OVERVIEW, July 22, 2014 http://www.doleta.gov/wioa/pdf/WIOA-Overview.pdf
