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 facility based services but on increasing integrated employment

Employment First

IS NOT

Employment First IS • • • A type of service strategy.

Just promotion of best practices.

 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

What is the “problem”?

Where is the “problem”?

What is solution?

Who is in charge/decision maker?

Information focus?

Outcome?

System

Disability

Person Centered

Society In person Systems/Environments Classify/Place/Train Educate/Empower Professional Individual/support team Deficits – cannot do Interests/Strengths – can do 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

More time & resources

Less intensive intervention

Full scale discovery Job creation Job carving Customized strategies Short-term job trials EMPLOYMENT STRATEGIES & TECHNIQUES Comprehensive person-centered planning Professional job development Job coaching More complex accommodations Job skill training Assistance with job search plan Job search guidance & counseling Standard job search practices Resume assistance Guidance on disability issues/disclosure Help with job leads Brush up interview skills Simple accommodations Less time & resources

What will be the best route to employment success?

Situational Assessment

Job Creation Job Development

Community Exploration

PASS Employment Success

Benefits Planning

Person Centered Planning Find a Job Pursue Job Leads

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 Report

• Federal Agency calling for phase out sub-minimum wage as part of overall systems change • Make fundamental changes in transition

National Council on Disability

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 phased out 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 S treet , 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% 8% 6% 4% 2% 0% 1 2 3 4 5 6 7

Fiscal Quarters

8 9 10 11 12 Percent of Total Program Costs Cimera (2008) Sheltered Employees Supported Employees

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

• Success is not widespread • Comfortable with “status quo” • • • Lack of opportunities Learned helplessness Limited understanding of benefits • Not a priority

Vision

• 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

Education and training for providers Eliminate “status quo” mentality Sustainability for service providers Availability of different types of services Change expectations Sustainability of providers

Action steps to change

• 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

• • • 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 • • • • • •

Vision

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

• • • • 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 • Evidence based • Numbers of certified job coaches • • •

Action Steps

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

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

Stronger coordination Integrated planning Coordinated dollars/maximize resources Clarify responsibilities Equal access with supports Consistent information sharing Evaluation/re-evaluation process Financial incentives • • • • • •

Actions for Change

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 [email protected]

www.apse.org

CEO 1421 N. Water Street Milwaukee, WI 53202 [email protected]

www.ceomke.com