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Slide 2 Moving Towards Employment First in Illinois The Arc of Illinois February 6, 2014 Slide 3 Integrated Employment Choice? Expectation? Slide 4 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 Slide 5 What is Employment? We know it when we see it Slide 6 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 Slide 7 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 Slide 8 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. Slide 9 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 Its Different Slide 10 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. Slide 11 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 Slide 12 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? Slide 13 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 Slide 14 Draw a picture of the person sitting next to you Slide 15 What Prevents Us from Moving Forward? Fear Slide 16 Changing highly ingrained culture and beliefs regarding employment of people with disabilities Slide 17 There is nothing wrong with change if its 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 Slide 18 Insanity: doing the same thing over and over again and expecting different results. ~Albert Einstein Slide 19 Employment Readiness Myth # 1 Facility-based programs prepare people for employment In fact research shows the opposite is true Slide 20 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. Slide 21 Employment Readiness Myth # 3 We can predict who will succeed or fail in employment. Lets see what your employment future is. Lets see what your employment future holds If that were the case then we would not need HR Departments! Slide 22 Employment Readiness Myth # 4 Rate of production is a primary factor in determining employment readiness In 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 Slide 23 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 Slide 24 Employment Readiness Myth # 6 Every employer has the same employment standards and same methods for hiring Slide 25 Employment Readiness Myth # 7 Employer standards are inflexible We are all supported employees with customized jobs Slide 26 Employment Readiness Myth # 8 Employers are expecting perfect employees Slide 27 Have you ever worked with anyone who Couldnt 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? Slide 28 Job Preferences Are Important Slide 29 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 Slide 30 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 Slide 31 The Trap of the Dream Job We are not looking for a dream job, just a job that will lead to the next job Slide 32 Its A Time of Enormous Opportunity Slide 33 National Disability Rights Network: Segregated & Exploited 2011 & 2012 reports stating that service system has failed in providing quality employment services and supports. Slide 34 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 Slide 35 National Governors Association Initiative Slide 36 Requirements for expanding community employment increasingly part of settlement agreements with states Slide 37 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 Slide 38 Illinois Employment First Summit Slide 39 Massachusetts Blueprint for Success Slide 40 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. Slide 41 Money Matters. and Drives Practice Slide 42 Percent of Total Program Costs Cimera (2008) Slide 43 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 Slide 44 Ohio Employment First Form Slide 45 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. Slide 46 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 Slide 47 Why 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 Slide 48 Employment First & Organizational Change Means Changing Just About Everything Strategy: What you do Systems: How you do it Structure: Who does it The Organization Slide 49 Pat Rogans 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. Slide 50 Pat Rogans 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 Slide 51 Pat Rogans 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 Slide 52 Slide 53 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 Slide 54 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 Slide 55 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 Slide 56 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 Slide 57 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 Slide 58 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 Slide 59 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 Governors office Coordinated plan for state agencies Data integration Integrate strategic plans Tie dollars to outcomes Monitoring of plan Slide 60 Were 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 Slide 61 Actions Speak Louder than Words Slide 62 Thank you! APSE 416 Hungerford Drive Suite 418 Rockville, MD. 20850 lowens@apse.org www.apse.org Laura Owens, Ph.D., CESP CEO 1421 N. Water Street Milwaukee, WI 53202 laura@ceomke.com www.ceomke.com