Moving Towards Employment First in Illinois

Moving Towards Employment First in IllinoisThe Arc of IllinoisFebruary 6, 2014

Integrated Employment

Choice?Expectation?Why Is Work Important?Our culture expects people to be productiveConsidered a means for gaining status, self definition and achievement of personal goalsTied to various aspects of status: Possessions Prestige Power Control Influence3What is Employment?We know it when we see it

What is Integrated?1 : to form, coordinate, or blend into a functioning or unified whole: unite2 :a: to unite with something elseb: to incorporate into a larger unit3 :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 fabricof the culture you live in.

Patricia Deegan20th World Congress Rehab InternationalOslo, Norway June 2004

62014Employment First In the U.S.45+ states have some type of Employment First movementAbout 2/3 of efforts are directed by state policy units or are legislatively basedAbout 1/3 of efforts are grassroots based i.e., outsiders working to influence state policy and practiceAt least 27 states have official Employment First legislation and/or policesPush for a Federal Definition in U.S.

7Employment as first priorityBroadly focused on all aspects of systemMay begin in the grassroots, ultimately must be adopted and implemented by the systemPrimary focus is not on eliminating facility-based services but on increasing integrated employment

Employment First: Why Its Different8Employment First IS NOTEmployment First ISA 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. 9Employment First: Where are we headed?Individuals with complex disabilities fully accepted and supported in the general workforceIndividuals with disabilities expected to go to workMajor evolution of service delivery systemEnd of the guarantee 9-3 day programIndividuals with disabilities increasingly part of the economic mainstreamIndividuals with disabilities making full use of their skills and abilities

10Cultural ShiftSystem versus Person-CenteredSystem Disability

In person

Classify/Place/Train

Professional

Deficits cannot do

DependencePerson CenteredSociety

Systems/Environments

Educate/Empower

Individual/support team

Interests/Strengths can do

InterdependenceWhat 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 Means12Draw a picture of the person sitting next to you

What did you think or say?Im not creativeI cant drawIm so sorry

I cant show a crazy side researchers show we lose 90% of our creativity by the time we are 7 years oldCreativity and problem solving go hand in hand13What Prevents Us from Moving Forward? Fear

14The Biggest ChallengeChanging highly ingrained cultureand beliefsregarding employment of people with disabilitiesThere is nothing wrong with change if its in the right direction. - Winston ChurchillAll progress occurs because people dare to be different. - Harry MillnerThe key to change is to let go of fear.- Susanne CashThe 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.-DilbertInsanity: doing the same thing over and over again and expecting different results.~Albert Einstein

Employment Readiness Myth # 1Facility-based programs prepare people for employment

In fact research shows the opposite is true

Employment ReadinessMyth # 2Performance 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 ReadinessMyth # 3We can predict who will succeed or fail in employment.Lets see what your employment future is.

Lets seewhat your employment future holdsIf that were the case then we would not need HR Departments!Employment Readiness Myth # 4Rate of production is a primary factor in determining employment readinessIn fact, in todays 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 # 5You need to know how to conduct a job search to be ready for employment

80% of jobs are found through networking with family and friendsEmployment ReadinessMyth # 6Every employerhas the same employment standards and same methods for hiring

Employment ReadinessMyth # 7Employer standardsare inflexible

We are all supported employees with customized jobsEmployment ReadinessMyth # 8Employers are expecting perfect employees

Have you ever worked with anyone whoCouldnt get along with others?Acted inappropriately?Had behavioral outbursts?Was chronically late?Complained about everything?Didnt communicate well?Didn't work very fast?Got distracted easily?Didnt take directions wellor at all?

Acted impulsively without thinking?Refused to take public transportation?Had a messy office?Wasnt organized?Wasnt always professional?Was rude?Couldnt take criticism?Was lazy?Wasnt very good at their job but managed to still keep it?

Job Preferences Are Important27EMPLOYMENT STRATEGIES & TECHNIQUESFull scale discoveryJob creationJob carvingCustomized strategiesShort-term job trialsComprehensive person-centered planningProfessional job developmentJob coachingMore complex accommodationsJob skill trainingAssistance with job search planJob search guidance & counselingGuidance on disability issues/disclosureSimple accommodationsStandard job search practicesResume assistanceHelp with job leadsBrush up interview skillsMore time & resourcesLess time & resourcesMore intensive interventionLess intensive intervention28What will be the best route to employment success?Community ExplorationPASSJob DevelopmentPlan Job SearchJob CreationPerson-Centered PlanningSituational AssessmentBenefits PlanningDevelop ResumePursue Job Leads

Employment Success

Find a Job

29The Trap of the Dream JobWe are not looking for a dream job, just a job that will lead to the next job

30Its A Time of Enormous Opportunity

National Disability Rights Network: Segregated & Exploited2011 & 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 transitionNational Governors Association Initiative

Requirements for expanding community employment increasingly part of settlement agreements with states

Claims placement in sheltered workshop is violation of ADAUS Dept. of Justice is now a plaintiff in this suit

35Federal Agency Investments to Incentivize Systems TransformationAdministration on Intellectual and Developmental DisabilitiesPartnerships in Employment Systems ChangeSSA, OSEP, HHS, DOLPromoting Readiness of Minors in Supplemental Security Income (PROMISE)Office of Disability Employment Policy at the Department of Labor (ODEP)EFSLMPOffice of U.S. Special Education & Rehabilitative Services Customized Employment Funding Strategies expanded in several state VR systemsCenters 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 forSuccessEmployment in the community cannot be viewed as anadd on or something extra.

It must be viewed by everyone as a core component of the service delivery system.

SLOW

39

Money Matters. and Drives Practice40Percent of Total Program CostsCimera (2008)

Polices & Practices that Presume EmployabilityNo work readiness criteriaConsideration of employment mandated part of service planningRequire documentation for non-consideration of employmentDecision to not consider employment re-visited regularlyFollows tenants of person-centered planning nothing about me without me

42

Ohio Employment First Form43Major Barriers to ChangeNegative attitudes & resistance (e.g., staff, families, Board)Funding (Inflexible, insufficient)Lack of expertise (re: organizational transformation)Lack of leadership Other: Transportation, safety netNOT: Resistance from people with disabilities or the community.44Barriers to Integrated EmploymentPerceived benefits of sheltered services: consistent schedule, safety, provision of transportation, less fear about loss of disability benefits, social environmentFunding: Must be sufficient and flexibleOne Stop Shop Approach: People with ID left behindCentralized/streamlined service coordination (case management)

Achieving Social and Economic Inclusion: From Segregation to Employment First

45Why Have Organizations Changed from Sheltered to Integrated Employment?Leadership within the organization (Its 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

46Employment First & Organizational Change Means Changing Just About EverythingStrategy: What you doSystems: How you do itStructure: Who does itThe Organization47In a community based service frontline staff are responsible for the continuous redesign and improvement of administrative processes and program and service delivery

However most change only the role of the direct service staff without realizing the need to focus on the entire organizations structure

All this is overlayed within the environment you work within

ALL has to changeAlign Services, Org Structures, & HR Practices

Pat Rogans Top 10 Tips for Organizational Change1. Restructure: Flatten the organizational structureRevise 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.

48Pat Rogans Top 10 Tips for Organizational Change3. 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 planningPaid work as anchor of a meaningful day. Consider 2 part-time jobs; 1 part time job and volunteer; etc.4. Reallocate: Unload sunk costsRent, lease, or sell the building. Spin off free standing supported employment service5. Re-Message: From a safe, secure place to a viable labor source6. Reconnect: Engage key stakeholders from the start

49Pat Rogans Top 10 Tips for Organizational Change7. Plan the work; work the plan8. Restrict Entry School to WORK TransitionClose the back door after job loss9. What you count, counts!Collect accurate data regarding outcomes10. Develop Partnerships: DRS, DDAPSE ChapterCommunity Living organizationsBusiness Leadership NetworkBenefits Planning & Assistance

50Illinois Employment First

Service & Support Capacity/DevelopmentCurrent StatusSuccess is not widespreadComfortable with status quoLack of opportunitiesLearned helplessnessLimited understanding of benefitsNot a priority VisionService providers are able to connect job seeker and employerUnderstanding of goals and needsConnect peopleService & Support Capacity/DevelopmentWhat needs to changeEducation and training for providersEliminate status quo mentalitySustainability for service providersAvailability of different types of servicesChange expectationsSustainability of providersAction steps to changeCreate common language in systemsChange mindsetShare success storiesCommunicate visionCreate clear standards for service providers (certification, quality assurance)Create ongoing staff developmentEducate regarding benefitsBuild provider networks/roundtablesTransition Planning Committees

Funding/Creating IncentivesCurrent StatusInflexible funding Medicaid match drives funding no general grantsWide variation in funding systems requirementsInsufficient rates to provide qualityDDD currently needs prior approval for SEVisionIdentify support needs holisticallyFlexible funding unlink to living settingFunding moved to support integrated employment versus facility basedSmooth transition of funding from DRS to long term supportRataes provide incentive for integrated employmentSeamless transtion from school to adult service fundingFunding/Creating IncentivesActions for ChangePresume funding/eligibility for SE/approval for sheltered/facility based programsDevelop cost/benefit of employment services compared to faciility based programsSystematically increase use of work incentives PASS, IRWE, BWE, Student Earned Income as fundingExamine 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 employmentUse funding from SODC closure toward community employmentDevelop clear mechanism for transitioning between DRS and MH/DDMaximize funding from education and other sources

State-Operated Developmental Centers55Data, Evaluation, AccountabilityVisionCollect right data for quality assuranceSet targets to achieve within timeframesIndividual receives printout of what they receiveEmployment needs to be outcome measureEvidence basedNumbers of certified job coachesAction StepsCreate multi agency survey of current data being collectedCreate state agreement of employment indicatorsCreate database for individuals to see services Include families and individuals in data collectionPublic Agency Systems ChangeCurrent StatusSilosNon-coordinatedFunding: separate resources/prioritiesIndividuals drive levels of coordinationOrganizational cultures foster fragmentationVisionResponsiveEasy accessCoordinated/SeamlessPerson-centeredMeasurable objectivesInteragency shared goalsEliminate silosSame data system

Public Agency Systems ChangeWhat needs to changeStronger coordinationIntegrated planningCoordinated dollars/maximize resourcesClarify responsibilitiesEqual access with supports Consistent information sharingEvaluation/re-evaluation processFinancial incentivesActions for ChangeQualified coordinator at Governors officeCoordinated plan for state agenciesData integrationIntegrate strategic plansTie dollars to outcomesMonitoring of planWere far too patient with the passage of time for people with disabilitiesTime is as precious for a person with a disability as it is for all of us.~Gerry Provencal59Actions Speak Louder than Words

January 13, 1982 "Lenny" Skutnik, was employed as a low-level government worker in the print shop of the Congressional Budget Office. Prior to that, he had held a variety of jobs, working as a painter, fast food cook and at various times as an employee in a meat packing plant, furniture factory and supermarket. In short, there was nothing remarkable or extraordinary about Lenny Skutnik.

On that cold January day, Air Florida Flight 90 clipped the 14th Street Bridge on take off, crashing into the Potomac River Observing the rescue operations from the shore of the river, Lenny Skutnik, who was just a by-stander, watched as Priscilla Tirado struggled to grab hold of a lifeline dropped to her from a rescue helicopter. As her hands slipped from the lifeline, she started to sink into the frozen river. Seeing the disaster unfold before him, Skutnik tore off his boots and coat and dove into the snowbound Potomac River.

After being dragged to the shore, Priscilla Tirado, though nearly frozen from the icy waters, was taken to the hospital and miraculously survived.

As a result, Skutnik was rightfully hailed as a hero. Although he had no training as a "first responder," he didnt need it. He simply saw someone in need and acted without hesitation. Of course, many ordinary people do heroic things. Many times, they are never known or recognized by others.

60Thank you!APSE 416 Hungerford DriveSuite 418Rockville, MD. 20850lowens@apse.org www.apse.org Laura Owens, Ph.D., CESPCEO 1421 N. Water StreetMilwaukee, WI 53202laura@ceomke.com www.ceomke.com

Chart10.06803730550.11783335770.07586584310.1269265170.08019480050.12130253110.0713775090.08941694040.0829036870.11629725050.08934941330.11424745280.07596229430.05619731210.087895940.09110467820.0945386950.09309545450.09111287160.06224730920.07315798810.01133142760.1096036526

Sheltered EmployeesSupported EmployeesFiscal Quarters

Chart21319.11779.91071428571470.89840.09615384621554.82802.87234042551383.87591.82926829271607.34769.74358974361732.31756.17647058821472.76371.95652173911704.136031832.92616.17647058821766.54121418.39752125

Sheltered EmployeesSupported EmployeesFiscal Quarters

Sheet1Fiscal Quarterpercent of total average costaverage cost per quarternumber of Sheltered EmployeesSheltered EmployeesSupported EmployeesSheltered EmployeesSupported Employees16.80%$1,319.1117111.78%$779.91566.80%11.78%$1,319.11$779.9127.59%$1,470.8915912.69%$840.10527.59%12.69%$1,470.89$840.1038.02%$1,554.8214012.13%$802.87478.02%12.13%$1,554.82$802.8747.14%$1,383.871218.94%$591.83417.14%8.94%$1,383.87$591.8358.29%$1,607.3410911.63%$769.74398.29%11.63%$1,607.34$769.7468.93%$1,732.319711.42%$756.18348.93%11.42%$1,732.31$756.1877.60%$1,472.76855.62%$371.96237.60%5.62%$1,472.76$371.9688.79%$1,704.13769.11%$603.00208.79%9.11%$1,704.13$603.0099.45%$1,832.92669.31%$616.18179.45%9.31%$1,832.92$616.18109.11%$1,766.50316.22%$412.0059.11%6.22%$1,766.50$412.00117.32%$1,418.3971.13%$75.0017.32%1.13%$1,418.39$75.001210.96%$2,125.00210.96%$2,125.00average cum cost$19,388.04$6,618.76

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