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 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: Why It’s Different

Employment First IS NOT Employment First IS  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. A type of service strategy. Just promotion of best practices.

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 System Disability In person Classify/Place/Train Professional Deficits – cannot do Dependence Person Centered Society Systems/Environments Educate/Empower Individual/support team Interests/Strengths – can do Interdependence What is the “problem”? Where is the “problem”? What is solution? Who is in charge/decision maker? Information focus? Outcome?

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. What A Real Culture Shift Means

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

“There is nothing wrong with change if it’s in the right direction.” - Winston Churchill “All progress occurs because people dare to be different.” - Harry Millner “The key to change… is to let go of fear.” - Susanne Cash “The secret to change is to focus all your energy not on fighting the old, but on building the new.” -Socrates “Change is Good. You go first.” -Dilbert

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 is. Let’s see what your employment future holds… 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

Have you ever worked with anyone who… 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?

Job Preferences Are Important

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

What will be the best route to employment success? Community Exploration PASS Job Development Plan Job Search Job Creation Person- Centered Planning Situational Assessment Benefits Planning Develop Resume Pursue Job Leads Employment Success Find a Job

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.

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 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

Percent of Total Program Costs Cimera (2008)

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 Systems: How you do it Structure: Who does it The Organization

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! APSE 416 Hungerford Drive Suite 418 Rockville, MD Laura Owens, Ph.D., CESP CEO 1421 N. Water Street Milwaukee, WI