Transcript HVRP & The 21st Century Workforce: Diversity & Opportunity

Teleconference Session
January 25-26
Mary Huber, PhD
Director of Research
SARDI Program
School of Medicine
Wright State University
Melissa Jones, MRC, PCCS, LICDC
Clinical Director of CAM Program
Wright State University
Debbie Joseph, M.Ed., LPCC, LICDC
Program Manager
The Traumatic Brain Injury Network (TBI Network)
The Ohio State University
Mary Huber (15 min)
1. Welcome and Introduction of the Guest Speakers (2 min)
2. Overview of the Problem –Background and statistics, unique
injuries of veterans returning from Iraq and Afghanistan
Deborah Joseph (15 min)
3. Employee/Employer Relations –Employment and substance abuse
case examples - Strategies to use in approaching employers to provide
a context for hiring homeless veterans with disabilities
Melissa Jones (15 min)
4. Supervising Strategies – Supervising and motivating staff to work with
dual-diagnosis populations. Review of training materials and resources for
clinicians and administrators
5. Q&A (10-15 min)
6. Closing Comments (2 min)
Overall Homeless Statistics
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Estimated homeless veterans: 131,000 (conservative estimate)
Most from the Vietnam War
Estimated homeless female veterans: 13,100 or 10%
One in four homeless people are military veterans
Recent Homeless and Employment Statistics
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VA has pinpointed 3,717 homeless veterans of Iraq and Afghanistan but
estimated post-9/11 homeless veterans: 7,400
Estimated number of female post-9/11 veterans: 740 or 10%
Jobless rate for post-9/11 veterans: 11.3%
2% of homeless veterans younger than 34 are women
Sources: Department of Veterans Affairs, Bureau of Labor Statistics
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Typical homeless Veteran is male, single, most
come from poor, disadvantaged communities,
45% suffer from mental illness, and 50% have
substance abuse problems. More than 67%
served our country for at least three years.
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http://www1.va.gov/homeless/
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TBI - increasing evidence that combat-related TBI are a frequent occurrence.
One half of all injuries are TBI due to explosion (mostly mild). Most common
physical injury.
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PTSD - the VA defined PTSD as a type of anxiety that affects people who’ve
experienced a particular traumatic event that creates intense fear,
helplessness or horror. 20% (one of five) of Iraq veterans (seeking help) have
PTSD with women suffering more pronounced and debilitating forms of PTSD.
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SUD – includes both abuse and dependence of alcohol and drugs. SUD can
create or exacerbate problems for homeless veterans looking for work or
starting new jobs. On the other hand, employment can provide a powerful
motivator for people to re-examine their behaviors related to substances.
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High correlation between PTSD and SUD.
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Military experts concerned about the rise in drug
abuse among military personnel.
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NIDA, VA, and Defense Department joined
together to find solutions to this problem.
Six Recommendations Thursday, July 26, 2007:
1.
2.
3.
4.
5.
6.
Immediately Create Comprehensive Recovery Plans
Completely Restructure the Disability and Compensation
Systems
Aggressively Prevent and Treat Post-Traumatic Stress Disorder
and Traumatic Brain Injury
Significantly Strengthen Support for Families
Rapidly Transfer Patient Information Between DoD and VA
Strongly Support Walter Reed by Recruiting and Retaining FirstRate Professionals Through 2011
VA Doubles Disability Aid for Iraq War Veteran
Department Responds to Appeals of PTSD
Veteran- after his PTSD worsened and he was unable
to hold a job. Saturday, October 20, 2007 VA
spokeswoman, raising his monthly check from $1,352
to $2,781
Public Law 110-387: VA to develop a supportive services
program for very low-income Veteran families. It is the VA’s
goal to identify Veterans in unstable living situations and then
intervene to “close the front door” on their potential entry into
homelessness.
Veterans and the family members in their household. Sometime
in 2010, the VA expects to announce a notification of funding
availability (NOFA) that will offer non-profit organizations and
consumer cooperatives the opportunity to apply for grants to
assist these very low-income Veterans. As additional details
about the NOFA become available on this website
http://grants.gov.
The HUD-VASH VA Program, through a cooperative partnership, provides
long-term case management, supportive services and permanent
housing support. Eligible homeless Veterans receive VA provided case
management and supportive services to support stability and recovery
from physical and mental health, substance use, and functional
concerns contributing to or resulting from of homelessness.
HUD provides 20,000 “Housing Choice” Section 8 vouchers designated
for HUD-VASH to participating Public Housing Authorities to assist with
rent payment. This program was designed to address the needs of the
most vulnerable homeless Veterans. To be eligible for this program,
Veterans must be VA Health Care eligible, homeless and need and
participate in case management services in order to obtain and sustain
permanent independent community housing.
1.
Accelerated learning curve.
Veterans have the proven ability to learn new skills and concepts. In addition, they can enter your
workforce with identifiable and transferable skills, proven in real-world situations. This background can
enhance your organization's productivity.
2.
Leadership.
The military trains people to lead by example as well as through direction, delegation, motivation, and
inspiration. Veterans understand the practical ways to manage behaviors for results, even in the most
trying circumstances. They also know the dynamics of leadership as part of both hierarchical and peer
structures.
3.
Teamwork.
Veterans understand how genuine teamwork grows out of a responsibility to one's colleagues. Military
duties involve a blend of individual and group productivity. They also necessitate a perception of how
groups of all sizes relate to each other and an overarching objective.
4.
Diversity and inclusion in action.
Veterans have learned to work side by side with individuals regardless of diverse race, gender,
geographic origin, ethnic background, religion, and economic status as well as mental, physical, and
attitudinal capabilities. They have the sensitivity to cooperate with many different types of individuals.
5.
Efficient performance under pressure.
Veterans understand the rigors of tight schedules and limited resources. They have developed the
capacity to know how to accomplish priorities on time, in spite of tremendous stress. They know the
critical importance of staying with a task until it is done right.
6.
Respect for procedures.
Veterans have gained a unique perspective on the value of accountability. They can grasp their place
within an organizational framework, becoming responsible for subordinates' actions to higher supervisory
levels. They know how policies and procedures enable an organization to exist.
7.
Technology and globalization.
Because of their experiences in the service, veterans are usually aware of international and technical
trends pertinent to business and industry. They can bring the kind of global outlook and technological
savvy that all enterprises of any size need to succeed.
8.
Integrity.
Veterans know what it means to do "an honest day's work." Prospective employers can take advantage
of a track record of integrity, often including security clearances. This integrity translates into qualities of
sincerity and trustworthiness.
9.
Conscious of health and safety standards.
Thanks to extensive training, veterans are aware of health and safety protocols both for themselves and
the welfare of others. Individually, they represent a drug-free workforce that is cognizant of maintaining
personal health and fitness. On a company level, their awareness and conscientiousness translate into
protection of employees, property, and materials.
10.
Triumph over adversity.
In addition to dealing positively with the typical issues of personal maturity, veterans have frequently
triumphed over great adversity. They likely have proven their mettle in mission critical situations
demanding endurance, stamina, and flexibility. They may have overcome personal disabilities through
strength and determination.
http://hirevetsfirst.dol.gov/10reasons.asp
America's Heroes at Work
http://www.americasheroesatwork.gov/
10 top reasons link:
http://www.americasheroesatwork.gov/links/links2#hiring
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TBI is a growing concern among veterans
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68% of more than 33,000 wounded soldiers have
experienced blast related injuries
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TBI effects of these injuries are far reaching;
emotional, vision, hearing, speech, dizziness,
sleep disorders, and memory loss
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Effects are cumulative for those involved in
multiple blasts
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Behavior issues
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Untreated psychosocial disorders
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Drug/Alcohol use/abuse
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Lack of income
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Homelessness
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Legal issues
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Untreated medical problems
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Studies show that using a supported employment
model like the Individual Placement and Support
Model designed by Dr. Robert Drake and Deborah
Becker works well in helping persons with
drug/alcohol and mental health problems return to
work.
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A study of homeless veterans with psychiatric
disorders, addiction disorders or both,
Implementation of Supported Employment for
Homeless Veterans with Psychiatric or Addiction
Disorders: Two-Year Outcomes, Rosenheck, M. C.
and Mares, PH.D. show improved rate for days of
competitive employment when compared to a
comparison cohort.
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Employment is considered an integral component
of treatment rather than a separate service
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Competitive employment is the goal
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Persons can be successful without preemployment training
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The vocational assessment is continuous and
based in competitive work experiences
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Follow along supports continue for a time that fits
the individual, rather than terminating at a set
point after starting a job
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Job finding, disclosure and supports are based on
the person’s preferences
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Services are provided in the community
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A multidisciplinary team approach is used rather
than parallel services
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Have a good understanding of how involved the
applicant wants you to be in the process
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Create a support network/treatment team around
the applicant
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Maintain regular contact with applicant and team
scheduling regular meetings so that all members
keep each other updated
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Get a benefits analysis for anyone receiving Social
Security benefits
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Make contact with potential employers prior to
their filling out application
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Explain your program to potential employer (we
can make or break the deal)
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Try to schedule a face to face with the applicant
and the hiring person as a way to eliminate being
screened out prior to reaching that level
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Practice interviewing skills and be supportive
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Join the applicant in the face to face
meeting/interview if appropriate
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Allow the applicant processing time after the
interview
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Maintain follow-up contact with potential
employers
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Remember, a lost job is not a failure, but an
opportunity to learn
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Traumatic brain injury
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Recent and sporadic crack and alcohol use
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5 Felony thefts with multiple incarcerations
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Impulsive and disinhibited behavior
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Difficulty with authority figures
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Anger management issues
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The supervisor that is leading the implementation
must have backing from key leaders and decision
makers.
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Focus on consumer centered goals.
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Progress should be measured by consumer
outcomes, those in competitive employment, as
oppose to hours in treatment.
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Must advocate for funding, keep the momentum going
with all clinical staff. Ex. Provide updates in staff
meetings, show outcomes
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Build momentum for change
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Enact the Change
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Maintain and extend the gains
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Establish planning meetings
with other agencies, such as
Division of Vocational
Rehabilitation
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Bring in outside speakers to
inspire staff. Particularly a
presenter that is a
practitioner. Ex. A specialist
on TBI from the VA.
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Work with NAMI (National
Alliance on Mental Illness)
to identify consumer and
family that can talk to your
team, about the importance
of work for their loved one.
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Educate your staff about
supported employment and
it’s proven effectiveness
shown by scientific
research.
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Address the bias that may exist that the mentally
ill population cannot work.
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Have staff reflect on the role work plays in their
own life.
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Work is part of getting on with life despite mental
illness and injury.
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Challenge staff’s arguments of why work may not
be useful to this population.
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Generally it takes one year for staff to feel
confident in providing Supported Employment
Services.
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Will Supported Employment impact other
revenue? Ex. Will you see a reduction in
attendance because of employment?
Selection should focus on
positive, hopeful people who
believe in the model and have
a passion for the work.
Training is a MUST: how to
elicit employment history, seek
jobs, talk to employers, “job
saves”, self disclosure issues.
Employment Specialist should
Position should be full time with
be open to working with
employment work being job
internal or external clinical
focus. Caseload should not
team on behalf of the
exceed 25 consumers.
consumer.
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The supervisor MUST be
actively involved
Weekly structured meetings
should occur
◦ Identify road blocks
◦ Continue discussion about
mental illness and TBI impact on
job placement
◦ Should be in the field with ES to
support and guide efforts
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Celebrate Success
Employment Specialist
should network with
other ES’s in the field to
discuss job leads and
build relationships.
Supervisor should be
doing the same.
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Supervisor should set aside a part of regular
weekly/monthly staff meeting for employment
discussion.
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Employment Specialist needs to be an active
participant in this meeting, whether the meeting is
internal/external.
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These direct, personal, clinical contacts provide a
wealth of information to the ES.
Keep Paperwork to a minimum
EX. Voc. Profile
Employment plan
Monthly note – This may be
impacted depending on funding
stream, and requirements of
governing bodies
Track Outcomes
*Know job gains and losses
Display Outcomes – stats, graphs, %
that are employed
*This helps the team stay focused
and committed to the model
Review Policies and Procedures
*Make certain your policies identify
your commitment to Supported
Employment.
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Complete the Supported Employment Fidelity Scale at
least one time per year.
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Conduct regular meetings with management staff to review
program implementation.
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Recognize staff who have had success with the model, and
find out what they did correct.
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Devote time to “good news” in meetings.
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Make a BIG deal out of achievements, bring in the
consumers who are showing gains, provide a platform to
share their success story.
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Pass on your knowledge and experience to others.
Access for any veteran in
the US who has suffered
TBI/secondary MI issues
*Johnstown, PA nearest
access for Ohioians
Focused on rehabilitation for
veterans with emphasis on
return to work. Utilization of
individualized, evidence
based practice model.
Website provides a host of
information on the impact of
cumulative concussions,
blast injuries, sport vs.
military concussion, includes
a 30 minute video on TBI.
Provides a family TBI
curriculum developed by
a 15 member panel, with
multiple educational
modules. Including –
how to navigate service
benefits.
DV Brain Injury Center
services are provided to
veterans with TBI who are
insured through Tricare or
Veteran Affair Benefits.
They accept self referrals,
PCP referrals, or other
healthcare provider referrals.
**Call the regional office
nearest you for more
information, or contact the
Washington D.C.
headquarters at
1-800-870-9244 to be
directed to services.
SOURCES for this presentation:
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http://www.samhsa.gov/ (Supported Employment Resource Tool Kit)
http://www.dvbic.org/ (Defense of Veterans Brain Injury Center)
iava.org - Iraq and Afghanistan Veterans of America - a site that
addresses critical issues facing new veterans and their families,
including mental health injuries, a stretched VA system, inadequate
health care for female veterans, and GI Bill educational benefits.
mirecc.va.gov - The Mental Illness Research, Education and Clinical
Centers (MIRECC) were established by Congress with the goal of
researching the causes and treatments of mental disorders and
using education to put new knowledge into routine clinical practice
in the VA.
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AbilityOne
Provides employment opportunities for people who are blind or have other severe disabilities in the manufacture and delivery of products and
services to the federal government.
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American Corporate Partners
A nationwide mentoring program dedicated to helping veterans transition from the armed services to civilian employment through career counseling
and networking with corporations.
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DirectEmployers
Provides employment opportunities through a non-profit consortium of leading U.S. corporations.
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DoDVets
Provides information for disabled veterans. Includes federal employment information, Q&As for disabled veterans and managers, internships,
scholarships and fellowships, grants, education and training and transition centers.
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Employer Assistance & Recruiting Network (EARN)
Offers a one-stop source for disability employment information. Includes information on recruiting services, resume writing tips, fact sheets,
employer success stories and more.
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Employer Support of the Guard and Reserve
Promotes cooperation and understanding between Reserve component members and their civilian employers and assists in the resolution of
conflicts arising from an employee's military commitment.
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Entrepreneurship Bootcamp for Veterans with Disabilities (EBV)
Offers experiential training in entrepreneurship and small business management to soldiers, sailors, airmen and marines disabled as a result of their
service supporting Operations Enduring Freedom and Iraqi Freedom.
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Hire Vets First
Comprehensive career Web site for hiring veterans of America's military. Search the directory for the One-Stop Career Center near you or call 1877-US2-JOBS for direct assistance.
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Hire Heroes USA
Provides links to career opportunities nationwide for returning service men and women, specifically those who have been wounded or with any level
of disability.
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Operation Warfighter (OWF)
Sponsored by the DoD Military Severely Injured Center, OWF is a temporary assignment or internship program for service members who
are undergoing therapy at military treatment facilities within the US.
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Resources for Hiring Veterans and Returning Service Members
One-stop information to help employers find out why, where and how to recruit and hire veterans.
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Resources for Recruiting and Hiring People with Disabilities
Vast collection of resources on hiring people with disabilities sponsored by the Virginia Commonwealth University Rehabilitation Research and Training Center
on Workplace Supports and Job Retention.
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Understanding Employer Rights and Responsibilities under USERRA
Provides information on the basic provisions and requirements under the Uniformed Services Employment and Reemployment Rights Act (USERRA).
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VetCentral
Provides online career resources for vets. Includes resume, spouse career center, transition assistance and more.
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Veterans Community Initiatives
Based in Western Pennsylvania, provides employment assistance to veterans and family.
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Veterans Employment Coordination Service (VECS)
Established to advance efforts to attract, recruit and hire veterans into the VA, particularly severely injured veterans returning from Operation Enduring
Freedom and Operation Iraqi Freedom.
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Veterans Employment Specialist Locator
Offers the ability to quickly locate Disabled Veterans Outreach Program Specialists (DVOPs) and Local Veterans Employment Representatives
(LVERs) in your area. These specialists assist vets who are seeking employment.
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Veterans Green Jobs
Offers training, education and career development programs through the Veterans Green Jobs Academy to help veterans expand on their military experience
in order to serve the country in a new way – by helping to rebuild the economy, restore the environment and renew our communities.
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VetFran
Helps veterans transition to civilian life by offering financial incentives to become franchise owners.
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VetSuccess
Information about the services that the Vocational Rehabilitation and Employment (VR&E) program provides to veterans with service-connected disabilities.
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Vocational Rehabilitation & Employment Program Services for Employers
Information for employers from the VA regarding Vocational Rehabilitation & Employment Program, which helps veterans with service-connected disabilities
find and keep suitable jobs.
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Warriors To Work Program
Helps individuals recovering from severe injuries received in the line of duty connect with the support and resources they need to build a career in
the civilian workforce. Provides assistance with writing resumes, interviewing, career resources and more.
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