Organizational Change From Facility-based to Community-based Employment Services

Organizational Change From Facility-based to Community-based Employment Services

Pat Rogan, Ph.D.Indiana University

October 4, 2013

AGENDAIntroduction & current status

Critical features of states with high employment outcomes.

Organizational change processes & outcomes

Strategies & tips to address barriers

Q & AResources & contacts

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 RSA (no funding for workshop placements)Olmstead (“Most integrated setting”)Employment First initiatives

How Are We Doing?27% of people with IDD in integrated jobsIncreased segregation + non-work community activities.>625,000 in sheltered facilities earning subminimum wages.The rate of movement from sheltered to integrated work: a mere 1-5%.

State Data 2012 (Butterworth et al. ICI)

How are we Doing?Medicaid spends 4X more money on segregated adult day programs than supported employment.No preference for integrated employment within the Medicaid program.Migliore 2007 – 63% of people with disabilities would like to work outside the facility.

WashingtonOklahomaVermontNew Hampshire

+ Growing Number of “Employment First” States

Top Tier States

Positive philosophy, policies, & adequate funding

Capacity building & advocacy effortsStrong, consistent leadershipData based decisionsEmployment First policies &

systems change initiatives

Critical Features of States

Understanding What to Change

Strategy: What you do

Systems: How you do itStructure: Who does it

The Organization

Lessons For Organizational Change

(Butterworth et al – T-TAP Mentor Guide)

Lesson 1: Establish clear and uncompromising goals. Lesson 2: Communicate expectations to everyone, often. Lesson 3: Reallocate and restructure resources. Lesson 4: Just do it! Find jobs one person at a time! Lesson 5: Develop partnerships.

Establish Clear Goals

By June 2014 we will place 40 people in individualized and integrated jobs that pay at least minimum wage average 20 hours per week.

By October 2014 we will cease all new entries into our sheltered facility, and cease all backfilling.

Clearly Communicate Expectations

& Often!

Newsletters, website, presentations, etc.

Does your organization’s name convey your focus on employment?Does your language focus on individuals’ capacities vs. deficits?

Celebrate successes!

Reallocate & Restructure Resources

Flatten the organizational structureUnload “sunk” costs (buildings, equipment)Restructure job descriptionsEmpower front line staff (“community builders”) to make decisions.Focus on staff development & mentoring.

Find Jobs One Person at a Time

Traditional ServicesFocus on readinessMove through the continuum Deficit-based voc. evaluation

Positive Community ServicesNo need to “get ready” - Teach in community. Person-centered planning – Capacity search.

Effective Employment Strategies

Traditional ServicesGroup orientationFit to programsHuman services orientation“Special” services

Community ServicesIndividual orientationDesign supports around personTap generic services & natural supports

Effective Strategies (cont.)

Develop Partnerships

Engage key stakeholders from the start:

ParentsBoard membersCase ManagersFundersetc

Develop external partnerships:

Voc Rehab & DDCommunity Living orgsBusiness Leadership Network (BLN)Benefits planning (BPAO)

Major Barriers & Tips for Change

Negative attitudes Funding Lack of expertise Lack of leadership Transportation Safety net

Innovations in State Waivers

Vermont: Waiver is a model for managing supports for participants. Connecticut: Flexible in terms of individual budgeting and self-determination. Washington State: 4 Waivers are tailored to individual needs. Indiana: One of 16 states with Supports Waivers, emphasizing employment, support brokers, financial management services and person-directed goods and services.

Braddock et al, 2013

Tips from Those Who Have Been There

Involve all levels in discussion of vision & values.Invest heavily in training.Use the vision & inherent values to evaluate everything.Communicate, communicate, communicate!Use individual planning for all…tie the agency’s success to your customers’.

Q & A

THOSE WHO SAY IT CAN’T BE DONE

SHOULD GET OUT OF THE WAY OF THOSE WHO ARE DOING IT!

You’re Invited!

7th National Organizational Change Forum 

 A Time for Change...

 Sheltered Workshop Conversion

October 22-23, 2013

Burlington, Vermont

ResourcesNancy Brooks-Lane @Cobb/Douglas Community Services Boards –(nbrooks@cobbcsb.com)John Butterworth @ ICI Boston (John.Butterworth@umb.edu)Bryan Dague @ U. Vermont (bryan.dague@uvm.edu)Suzi Hutcheson @ Helping People Succeed, Inc. (shutcheson@hpsfl.org)Don Lavin @ Rise, Inc. (dlavin@rise.org)Pat Rogan @ Indiana University (progan@iupui.edu)