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

National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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Page 1: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 2: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

Agenda

• Why are we looking at these data?

• Intro to NCI Methods, Measures and Sample

• Findings

• Policy opportunities

• Discussion/Questions?

National Core Indicators (NCI)

Page 3: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 4: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 5: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 6: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 7: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 8: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 9: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

• 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

Page 10: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 11: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 12: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 13: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 14: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 15: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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**

Page 16: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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…

Page 17: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

National Core Indicators (NCI)

2.3%

5.8%

91.9%

No In-between Yes

Page 18: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 19: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 20: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

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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)

Page 22: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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+

Page 23: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 24: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 25: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 26: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 27: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 28: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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%

Page 29: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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)

Page 30: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 31: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 32: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 33: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Why are we stuck?

Page 34: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 35: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 36: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 37: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 38: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

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

Page 39: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

Policy Questions

National Core Indicators (NCI)

Page 40: National Core Indicators: Employment Trends for Adults ... · Trends for Adults with ... relationships, case management, inclusion, health, etc. •Adult Family, Child Family, and

Contacts• Institute for Community Inclusion at UMASS Boston:

John Butterworth: [email protected]

• HSRI

Josh Engler: [email protected]

Dorothy Hiersteiner: [email protected]

• NASDDDS

Mary Lee Fay: [email protected]

National Core Indicators (NCI)