National Core Indicators: Employment Trends for Adults with ID/DD and Suggestions for Policy Development
Agenda
• Why are we looking at these data?
• Intro to NCI Methods, Measures and Sample
• Findings
• Policy opportunities
• Discussion/Questions?
National Core Indicators (NCI)
Why?• Rates of integrated employment among people with
ID/DD receiving services are low Remained essentially unchanged for the past 10 years.
• Systems change efforts underway in over 40 states State Employment Leadership Network
AIDD Partnerships and Employment Learning Community
ODEP employment first initiative
• NCI can offer an important perspective in employment and employment outcomes of people with ID/DD receiving services.
National Core Indicators (NCI)
WHAT IS NATIONAL CORE INDICATORS (NCI)?
• Multi-state collaboration of state DD agencies
• Measures performance of public systems for people with intellectual and developmental disabilities
• Assesses performance in several areas, including: employment, community inclusion, choice, rights, and health and safety
• Launched in 1997 in 13 participating states
• Supported by participating states
• NASDDDS – HSRI Collaboration
National Core Indicators (NCI)
CT
NCI State Participation 2013-14
HI
WA
AZOK
KY
AL
NC
PA
MA
TX
AR
GANM
NJ
MO
NH
OH*
IL
LA
NY
Wash DC
FL
CA*
SDOR
MN
UTCO KS
MS
TNSC
WIMI
INVA
DEMD
State contract awarded in 2013-14 through AIDD fundingCA*- Includes 21 Regional CentersOH*- Also includes the Mid-East Ohio Regional Council
39 states, the District of Columbia and 22 sub-state regions
ME
WHAT IS NCI?
• Adult Consumer Survey In-person conversation with a sample of adults receiving
services to gather information about their experiences Keyed to important person-centered outcomes that measure
system-level indicators related to: employment, choice, relationships, case management, inclusion, health, etc.
• Adult Family, Child Family, and Family/Guardian Surveys Mail surveys – separate sample from Adult Consumer Survey
• Other NCI state level data: Mortality, Staff Stability
National Core Indicators (NCI)
Data Source:Adult Consumer Survey
• Standardized, face-to-face interview with a sample of individuals receiving services Background Information Section I (no proxies allowed) Section II (proxies allowed)
• No pre-screening procedures states don’t filter anyone out of the sample.
• Conducted with adults only (18 and over) receiving at least one service in addition to case management
• Section I and Section II together take 50 minutes (on average)
National Core Indicators (NCI)
Methods, Measures and Sample:
• 2012-2013 data collection cycle
• 25 states, one regional council (Alabama, Arkansas, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Kentucky, Louisiana, Maryland, Mid-East Ohio Regional Councils, Missouri, Mississippi, North Carolina, New Hampshire, New Jersey, New York, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah, Virginia and Wisconsin.)
• Total N: 13,157 individuals
National Core Indicators (NCI)
• People under the age of 22 who were enrolled in public schools (or for whom this information could not be determined) were excluded from most of the NCI 2012-13 analyses in this presentation, except where indicated. 12,720 adults remained in the data.
~~~~~~~~~~~~
Residence Type:
National Core Indicators (NCI)
4.4%
34.0%
14.6%
37.1%
9.8%
Specialized Institutional Settings Community-Based Residences
Independent Homes or Apartments Parent or Relative's home
Other
Number of Respondents in Integrated Employment/Paid Community Jobs:
Different Datasets
National Core Indicators (NCI)
8.6%14.7%
18.4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
ACS Cognitive Disability +SSI
NCI 2012-13 IDD Agency Survey FY12
Employment:• Integrated Employment:
Paid job in a place where most other workers do not have disabilities (e.g. competitive or supported employment, enclave, work crew)
• Unpaid Community Activity Unpaid activity in a place where most other workers do not have
disabilities(e.g. volunteer activities, skills training, community experiences)
• Paid Facility-Based Work Paid job in a place where most people do have disabilities
(e.g. workshop, activity center)
• Unpaid Facility Based Activity Unpaid activity in a place where most people do have
disabilities (e.g. day habilitation, prevocational, seniors programs)
National Core Indicators (NCI)
NCI 2012-13: What Do NCI Respondents Do During the Day?
National Core Indicators (NCI)
14.7%
22.6%27.0%
44.3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
IntegratedEmployment
Unpaid CommunityActivity
Paid Facility-BasedWork
Unpaid Facility-Based Activity
What ELSE?
• 46.1% of those in integrated employment also took part in another type of day activity/employment
29.1% also in unpaid community activity
16.6% also had a paid facility-based job
22.3% were also in an unpaid facility-based activity
National Core Indicators (NCI)
NCI 2012-13: Type of Employment by Residence
National Core Indicators (NCI)
1.4%
11.1%
24.3%
16.2%13.6% 12.3%
8.4%
21.5% 22.3%24.6%
27.3%23.5%
34.9%
28.6%26.7%
26.2%19.4%
26.8%
46.0%
55.8%
24.2%
41.3%
48.4%
36.2%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Institution Community-basedresidence
Independenthome/apartment
Parent/relative'shome
Foster care/hosthome
Other
Integrated Employment Unpaid Community-Based Activity
Paid Facility-Based Job Unpaid Facility-Based Activity
Paid Work Vs. Non-Work
National Core Indicators (NCI)
--Denominators do not include missing or don’t know responses**Includes unpaid facility-based and community-based activities
18.0%14.7% 15.3% 13.4% 14.7%
30.0% 28.3%24.6%
27.5% 27.0%
67.9% 68.0%
61.7%
71.0%66.9%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2008-09 2009-10 2010-2011 2011-12 2012-13
Integrated Employment Paid Facility-Based Work Unpaid Activities**
NCI 2012-13: Integrated Employment?
National Core Indicators (NCI)
14.7%
85.3%
Paid job No paid job
47.1%
52.9%
Wants a job
Does not want a job, or in between
30.0%
70.0%
Job goal in ISP
No job goal in ISP
Of those WITHOUT integrated employment….
Of those WITHOUT integrated employment who would LIKE integrated employment…
NCI:2012-13: In Integrated Employment and Likes Job
National Core Indicators (NCI)
2.3%
5.8%
91.9%
No In-between Yes
NCI 2012-13: Working in Integrated Employment but Wants to Work Somewhere
Else
National Core Indicators (NCI)
61.2%9.4%
29.4%
No In-between Yes
NCI 2012-13: Participation in Integrated Employment By State
4.6%
13.2%
37.5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
National Core Indicators (NCI)
NCI 2012-13: Average Hours Worked in 2 Wk. Period in Integrated Job by State
14
25
33
0
10
20
30
40
50
60
70
80
90
100
National Core Indicators (NCI)
NCI 2012-13: Average Wages Earned in 2 Wk. Period in Integrated Job by State
$100.41
$186.88
$264.35
$0.00
$50.00
$100.00
$150.00
$200.00
$250.00
$300.00
National Core Indicators (NCI)
NCI 2012-13: In Integrated Employment by Age Group
National Core Indicators (NCI)
15.1%19.2%
16.0% 13.9%10.7%
5.5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
18-25 26-35 36-45 46-55 56-65 65+
NCI 2012-13: Younger Adults
National Core Indicators (NCI)
17.8%
26.0%22.7%
38.5%
15.2%
21.4%
30.8%
46.0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Integrated Employment Unpaid Community Activity Paid Facility-Based Work Unpaid Facility-BasedActivity
18-34 35-54
NCI 2012-13: Selected Outcomes
81.6% 81.9%
62.2%
75.1%78.4%
58.0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Has friends other thanfamily or staff
Has a best friend Never feels lonely
Relationships
Has Integrated Job Does Not Have Integrated Job
National Core Indicators (NCI)
NCI 2012-13: Selected Outcomes
21.6%
49.3%
27.7%
1.4%
11.3%
43.2% 40.7%
4.8%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Excellent Very Good Fairly Good Poor
Reported Health Status
Has Integrated Job Does Not Have Integrated Job
National Core Indicators (NCI)
NCI 2012-13: Selected Outcomes
69.9% 72.0%63.2%
93.7% 97.0%
47.3%
60.3%
38.6%
80.1%
89.9%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Choosing home Choosing staff Choosingroomates
Choosingschedule
Choosing whatto do in freetime
Choice: Individual had at least some input in:
Has Integrated Job Does Not Have Integrated Job
National Core Indicators (NCI)
Paid Community Jobs
• A integrated job can be of one of three types:
an individual job without supports (competitive),
an individual job with supports (individual-supported) and
group-supported.
• All three are types of “integrated” employment.
Individually-supported employment and competitive employment make up “individual” jobs.
National Core Indicators (NCI)
NCI 2012-13: Type of Employment Support
National Core Indicators (NCI)
N % of total in integrated jobs
Integrated Job 1779 100%
• Individual Job (Individually-supported and Competitive)
971 55%
• Individually-supported
520 29%
• Competitive 451 25%
• Group Supported 433 24%
Type of employment support not specified
375 21%
NCI 2012-13: Percent of Those in Integrated Employment in Group-Supported Employment-
By State
3%
23%
54%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
National Core Indicators (NCI)
NCI 2012-13: Hours and Wages in a Two Week Period
Hours Gross Wages Hourly Wage
Integrated Job 25.4 $182.76 $7.83
• Individual Job (Individually-supported and Competitive)
24.5 $192.67 $8.38
• Individually-supported
23.9 $186.27 $8.49
• Competitive 25.3 $200.26 $8.27
• Group Supported 27.6 $172.93 $6.76
Paid Facility-based Job 32.2 $56.87 $2.39
National Core Indicators (NCI)
***Information on type of community job is not available for all individuals in integrated jobs
Federal Minimum Wage: $7.25/hr
NCI 2012-13: Benefits
National Core Indicators (NCI)
Receives paid vacation and/or sick time at his/her job
Paid Community Job 24.8%
• Individual Job (Individually-supported and Competitive)
• 26.5%
• Individually-supported • 24.9%
• Competitive • 28.3%
• Group Supported • 26.0%
***Information on type of community job is not available for all individuals in integrated jobs
NCI 2012-13: Volunteering“Do you do any volunteer work?”
National Core Indicators (NCI)
71.4% 70.5% 70.1%66.7% 67.3%
28.6% 29.5% 29.9% 33.3% 32.7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2008-09 2009-10 2010-11 2011-12 2012-13
No Yes
Somebody has to do something and its just incredibly pathetic that it has to be us.
Why are we stuck?
Policy opportunities…
• Employment first policy and practice
• Prioritize $ for employment at transition
• Seamless movement between systems
• Redefining non-work and prevoc services
• Adequate funding for IE
• Investment in capacity building
• Robust & transparent employment data
• State hiring practices
Emerging Influences
• Department of Justice (DOJ)
• Centers for Medicaid and Medicare Services (CMS)
• Advocacy efforts
• Legislative and executive initiatives
• Federal initiatives: AIDD, DOL, SSA, DOE
Policy opportunities…
• Employment first policy
• Prioritize $ for employment at transition
• Seamless movement between systems
• Flexible use of funds
• Adequate funding for integrated employment
• Robust & transparent employment data
• State hiring practices
New York Road to Reform
• No new workshop admissions (7/1/2013)
• Increase competitive employment by 700
• Plan: transition to employment (10/2013)
• Plan for workshop closure (10/2013)
• Redesigned “front door”
• Restructure case management
• Redesign funding structure
• Employment data
Massachusetts
Blueprint for Success
• Close front door to workshops 1/2014
• Close sheltered workshops by 7/2015
• Transition workshop participants to IE or CBDS
• Transition individuals from CBDS to integrated
work
• Phase out group employment settings that pay less
than minimum wage
11/2013
Policy Questions
National Core Indicators (NCI)
Contacts• Institute for Community Inclusion at UMASS Boston:
John Butterworth: [email protected]
• HSRI
Josh Engler: [email protected]
Dorothy Hiersteiner: [email protected]
• NASDDDS
Mary Lee Fay: [email protected]
National Core Indicators (NCI)