SSDI Beneficiaries – Socio-demographic Factors Predictors of Outcomes for SSDI Beneficiaries – Socio-demographic Factors J. Martin Giesen & Brenda S. Cavenaugh

Broad Project Overview Focus: Consumers of Vocational Rehabilitation (VR) Services Blind or visually impaired (BVI) and Social Security Disability Insurance (SSDI) beneficiaries Goals: What factors affect competitive employment outcome? Identify: What Hurts (Risk factors) What Helps (Facilitation factors) What Works (best sets of services) – later phase Strive for practice and policy recommendations to improve competitive outcomes Approach: Draw from previous outcome research Research with all disabilities & research specific to persons who are blind or visually impaired Examine recent national VR data Multi-level: Individual-level characteristics (e.g., education) State- and agency-level (e.g., state unemployment rate)

Current Focus How Demographic and Socioeconomic Factors Affect Competitive Employment outcomes For VR consumers who are SSDI beneficiaries and are blind or visually impaired (BVI) Selected findings & implications

Background Why SSDI Beneficiaries? Consider the Total Federal Budget (FY 2012) ~$3.8 Trillion ~$829 Billion annual federal cost for Social Security Administration (SSA) programs (SSA at 22% - is largest single expenditure in Federal Budget) Within SSA ~$200 billion annually for SSDI and Supplemental Security Income (SSI) expenditures

Dept of Education - RSA 2013 – About $3 billion available to state VR agencies for employment-related services >25% of all VR consumers are SSA beneficiaries About 1/3 of VR consumers who are legally blind are SSDI beneficiaries (2008 data) In 2010 also 33% (4308 of 13,021 legally blind) SSDI population generally considered at greater risk for poor employment outcomes How much? (we’ll see)

Background: Why SSDI Beneficiaries? Considering program costs and goals both SSA and the VR Program would have interest in improved employment outcomes for SSDI beneficiaries – including those who are blind or visually impaired (BVI)

Some Study Details Purpose Data What affects competitive employment Of SSDI-beneficiary consumers with visual impairments in VR Determine what predicts competitive employment: Consumer factors State factors Agency factors Data RSA Case Service Report-911 data: 4,478 consumers (FY 2010), age 18 to 75, legally blind or visually impaired, were receiving SSDI at application, and were… CLOSED AFTER RECEIVING SERVICES!

What is Competitive Employment? Competitive Employment Closure Included employment in an integrated setting, self-employment, Business Enterprise Program (BEP), and supported employment in an integrated setting; and was full or part-time, and compensated at the maximum of the State or Federal minimum wage (RSA Case Service Report, 2008). Noncompetitive Closure Included homemaker, unpaid family worker, or when the above income criterion was not met, and Unsuccessful closures–those who exited without an employment outcome, after receiving VR services (Old Status 28). (Includes Extended Employment) (Note: not the same as Competitive employment indicator in RSA Case Service Report, due to inclusions of Unsuccessfuls.)

Predictors Individual Level Age at application Race/ethnicity (5) Cognitive secondary disability Noncognitive secondary disability Legal blindness vs. VI, not LB Education level at application Earnings at application SSDI amount at application SSI recipient at application

Predictors State or Agency Level State Population State Unemployment Rate State Per Capita Income State Agency Structure Type blindness vs. combined or general Note: blindness agencies serve consumers who are BVI; combined agencies serve all disabilities; general agencies serve consumers not BVI. Predictors not discussed served as “controls”

Analysis Method Logistic Multilevel Modeling (HLM) – type of multiple regression Special advantages – three ways employment outcomes can be effected Direct Effects – from Consumer factors Direct Effects – from State or agency factors Interactions of Consumer and State/agency factors – called “cross-level interaction”

Expectations and Perspective Old research found receipt of SSI or SSDI, or both were risk factors (detrimental) for employment. Disincentives for employment In the 1970s, realizing placement difficulties, the VR Program had counselors with caseloads that were devoted to SSI & SSDI recipients. (co-author) Present study looked at just SSDI recipients (although small number were also SSI recipients) What Would You Expect – How much lower for competitive closure rate of SSDI consumers vs. all consumers who are BVI? 10, 20, 30, or 35% lower? 600 were SSI at appl.

Findings: Competitive Employment Rates Found: About 10% lower – surprising! About 48% of a recent audience of VR administrators & staff guessed “30% lower.” The overall competitive closure rate for all consumers who are BVI was 53%. The rate for the subsample receiving SSDI was 43%. only about 10% lower Understand we included all consumers with employment outcomes plus those closed unsuccessfully after services in computing our rates. Different from RSA indicator that only includes those with employment outcomes. 9% difference - 82% vs. 73% if using RSA-Defined competitive closure, but has 40% reduction in sample size

Implications Now appears that SSDI recipients may have substantial employment potential. Perhaps SSDI-recipient consumers have been “under-rated” in terms of their potential for competitive employment. Decades-old thinking that SSDI or SSI receipt creates disincentives for employment. These receipts are negative factors, but for BVI consumers may not be as great as previously thought. Lack of specificity in thinking - “combining” SSI and SSDI recipients and thinking the same way about both of these. Possible? “Combining” often done in older outcome research, which found receipt was negative factor. Is VR – at least VR serving consumers who are BVI– doing a better job? A viable possibility.

Findings: Economic Factors At application- Weekly earnings – receipt vs. non-receipt SSDI amount What do you think would be the effect of each of these factors on the rate of competitive employment?

Findings: Economic Factors Chance of competitive employment increases for BOTH presence of weekly earnings and higher amounts of SSDI Were you at all surprised that CE rate increased for both? About 45% of a recent audience of VR administrators & staff guessed “increase for weekly earnings but not for higher SSDI checks.”

Observations: Economic Factors Earnings and SSDI receipt indicate employment Current or previous Other research with adults and transition-age youth—plus cross-disability studies—say work experience is very important for subsequent employment 1) Our findings further support importance of work experience in increasing the likelihood of competitive employment. 2) Our SSDI sample has sufficient work quarters to qualify for SSDI, and payment amounts reflect duration and/or level of previous work. Given this - Not surprising this group has reasonable base rate of competitive employment (as seen).

Findings: Glorious Interactions Interactions with Agency Structure Type and Individual factors Age at application and Agency Structure But first, let’s consider competitive employment rate trends by age. How would chance of competitive employment change as age increases (starting at about 18 to 65 and older)?

Interaction – Age and Agency Structure Overall – competitive employment rate increases and peaks in mid-to-late 30s, then declines for those older at application but… Agency structure had a strong impact on this trend: As age at application increased, those served in blindness agencies had a higher competitive employment rate Those served in combined or general agencies had a declining competitive rate Graph shows patterns

Interaction – Age and Agency Structure Older SSDI clients (mid-30s or older) did better in blindness agencies than in combined or general agencies. Service in blindness agencies mitigated the general decline in competitive employment rate with increased consumer age. New evidence that consumers tend to have better outcomes when served in agencies exclusively serving consumers who are BVI Implications for Policy?

Interaction – Race and Agency Structure Asian consumers overall had a lower chance of competitive employment (relative to White), but Asians clearly did better when served in blindness agencies Reasons unclear but this discovery adds, yet again, to evidence of heightened effectiveness of blindness agencies

What about Competitive Employment for Other Race or Ethnicity Groups? What differences would you expect in competitive employment rate between white, African American, Hispanic consumers?

Findings: Race and Ethnicity NO SIGNIFICANT DIFFERENCES in chance of competitive employment among African American, White, and Hispanic consumers! Highly unexpected! Only about 23% of a recent audience of VR administrators & staff expected there would be no differences. Amazing and historic finding! Recently, Hispanics have fared as well as (or better than) Whites. African American consumers have consistently not done as well – until now. Statistical Accident?? We say NO. With N= 4,478 we have tremendous statistical power to detect differences – if present.

Implications: Lack of Race Differences Why no differences? Almost all previous employment outcome research has utilized ALL VR consumers We investigated consumers receiving SSDI Key difference: Virtually all SSDI consumers had history of work experience Suggest their work experiences have a “leveling effect” – appearing to moderate race differences on chance of subsequent employment If so, enhanced work experiences during VR process may be important for overcoming race/ethnicity differences in employment outcomes

Final Thoughts Findings for work history point to the importance of work experience—a broad effect across age and disability groups. Consumers need to participate in as many work experiences as available, as well as take opportunities for work experiences during the VR process. Our findings – for Asian, female (not discussed), and a wide age range of older consumers—add to existing evidence of the advantages of services in blindness agencies and of specialized services in general.

More Details Other findings – for this study may be found in other NRTC dissemination products, on our website, and in research publication. Read More About It: Giesen, J. M. & Cavenaugh, B. S. (2013). Disability insurance beneficiaries with visual impairments in vocational rehabilitation: Socio-demographic influences on employment. Journal of Visual Impairment & Blindness, 107(6), 453-467.