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From NACDD's 2014 Annual Conference
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Bringing Employment First to Life
• Framework for employment systems • The Employment Learning Community • State strategies and perspec=ves
Ø Washington DC - Rebecca Salon and Germaine Payne
Ø Maryland – Cathy Lyle Ø Idaho – Tracey Warren Ø Kentucky – Jeff White
Why now? • People with disabilities are asking for real job opportunities
Ø Young people are having a different set of life experiences and have different expectations
Ø Advocates are raising concerns about fair wages
• State level Ø Employment First policies and legislation Ø State level initiatives such as the MA Blueprint for Success
• Federal level Ø DOJ activity in Oregon and Rhode Island Ø Concerns about the continued use of
subminimum wage under Title 14(c) Ø CMS guidance that increasingly emphasizes
integrated employment and is redefining community settings Ø RSA TAC on Transition Planning and Services
This represents a unique convergence like we have never
seen before
It is a time of considerable
challenge but also of opportunity
Improving Employment Systems and Services for Individuals with IDD
Funded by AIDD Partnership between:
Ø Institute for Community Inclusion Ø NASDDDS Ø Luemar Consulting/TransCen
Working collabora=vely with: Ø ODEP Employment First CoP Ø Partnerships in Employment
Delphi Panel
• Convening a panel of experts
• Solici=ng input on key ques=ons
• Synthesize responses and ask follow up ques=ons
• Will inform work with states, our CoP and policy recommenda=ons
Key Elements:
State Level Consortiums
• Seven states selected in first round to develop and implement
state level consor=um. Addi=onal states to be added in next year
• ELC Liaison will provide TA, facilitate peer learning
• Topical communi=es of prac=ce • Periodic topic webinars
High Performing States Framework
• Goals & opera=ng policies • Leadership • Financing and contrac=ng • Training and technical assistance • Interagency collabora=on • Services and service innova=ons • Performance measurement, quality • assurance, and program oversight
Employment First in the District of Columbia:
Capacity and Partnership Building
Presentation at 2014 NACDD Conference by Rebecca S. Salon, State Office of Disability Administration
District of Columbia Department on Disability Services [email protected]
D.C.’s VISION FOR EMPLOYMENT FIRST
11
DDS formed an Employment First Leadership
Workgroup representing a broad group of stakeholders, which created a vision for Employment First, which is:
The District of Columbia expects that all people of working age, including
people with disabilities, will work and earn the prevailing wage in the
career path they choose
HOW DID WE & ARE WE
SUPPORTING EMPLOYMENT FIRST? DDS acknowledged that we would have to work at
mul=ple levels concurrently, including: q Placing an emphasis on employment as a priority outcome in DDA and RSA for people with IDD, including inves=ng in staff posi=ons to maintain a focus on employment q Establishing an Administra=ve Employment Network for the Ticket to Work program q Clarifying and aligning policies and prac=ces between RSA and DDA q Inves=ng resources into systems change q Inves=ng in building the capacity of the service system to implement high quality supports q Demonstra=ng strong, clear, consistent leadership and consistent messaging q Involving stakeholders and partners
12
The Specifics: Supporting Systems Change Engaged in capacity-‐building ac=vi=es:
q Worked with partners to re-start D.C.’s APSE chapter 2 years ago, with DDS currently hosting bi-monthly Chapter meetings
q Trained Trainers on Customized Employment q Systematized and supported referral and planning
processes between DDA and RSA q Held 2 Employment First Summits with partners q Became an AIDD Employment Learning Community state
and a Vision Quest state to support a cross-disability and youth focus
13
DDA-‐Led Initiatives
• Provided support for organizational change efforts for providers who wanted to convert their services to employment and/or Individualized Day Supports (IDS)
• Incentivized employment and individualized day supports in the Medicaid HCBS Waiver
• Designed IDS to provide wrap-around and career exploration opportunities-can be used at the same time as day habilitation, employment readiness, supported employment, volunteering or retirement if desired
• In the process of creating an Employment and Meaningful Day Community of Practice (CoP) for all employment and day providers, which will merge two CoPs that DDS supports—an Employment First CoP and an Individualized Day Supports CoP
14
MORE DDA-‐LED INITIATIVES
• Maintained membership in the State Employment Leadership Network (SELN)
• Are requiring Discovery Assessments as part of the implementa=on of Employment First, to support Customized Employment opportuni=es and as an extension of the Person-‐Centered Thinking tools and processes used in individualized planning
• Engaged a team of voca=onal evaluators to provide addi=onal support for people in addi=on to Discovery and/or for people for whom community-‐based voca=onal assessment would add insight
• Created opportuni=es in Individualized Day Supports, Day Habilita=on and Employment Readiness to engage in career explora=on and discovery
15
The Importance of Self-Advocates and Family Members in Moving Employment First Forward
Presentation at 2014 NACDD Conference by
Germaine Payne, Project ACTION! District of Columbia
How Advocates & Family Members Make a Difference in Promoting
Employment First
17
• Working with self-advocacy groups and coalitions, like Project ACTION! • Working with family advocacy groups and coalitions, like the Supporting Families Community of Practice • Joining work groups focusing on Employment First, like the Employment Learning Community
Idaho’s Employment First Initiative
• Statewide Consor=um of stakeholders hWp://www.icdd.idaho.gov/projects/employment%20first.html
• Focus on improving processes and building system capacity Ø Currently limited use of Medicaid to fund supported employment services Ø Waitlist for state-only funded Extended Employment Services program Ø State law change related to individual Medicaid budgets in HCBS system Ø Coordination with state-level Collaborative Workgroup (CWG) on improving
adult DD service system
• Outreach and awareness with policymakers, employers, families, communi=es Ø Take Your Legislator to Work Day Ø Disability Mentoring Day Ø Local focus groups with individuals with developmental disabilities, families,
others
Awareness Activities Support Law Change
• Take Your Legislator to Work Event Ø First annual event for Idaho – fall of 2013 Ø Modeled after the Wisconsin project Ø 27 legislators participated Ø Planning for 2014 event includes Congressional representatives
and Governor
• State law changed in March 2014 Ø Allows individuals to request additional Medicaid dollars for
services to obtain or maintain employment Ø Rules development with advocacy organizations as key partners Ø Development of informational materials for service coordinators and
others
Goals and Activities to Increase System Capacity and Awareness
• Employment Outcome Data Collec=on Ø IEFC driving the development of data collection system Ø Start with utilizing currently collected systems data Ø Using technical assistance from the Employment Learning
Community
• Awareness – Building Community Capacity and Poli=cal Will Ø Expansion of Disability Employment Awareness Month Activities
• Take Your Legislator to Work – policymakers • Disability Mentoring Day – employers, students, local planning
teams Ø Regional School District Trainings – teachers, administrators Ø Able to Work website http://www.abletowork.idaho.gov/
For more information contact:
Tracey Warren Idaho Council on Developmental Disabili=es [email protected]
Kentucky Action Plan Strategic Goals and Operating Policies: We are in the process of developing standard policies for the provision of Supported Employment for people with disabilities, mental illness, and substance abuse utilizing any stream of funding. For those desiring to work, integrated community employment must be the first and primary goal on the person’s plan of care. Further, the employment goal should be supported by the other services received by the person without regard to the stream of funding for their employment services. Leadership and Technical Assistance: We are moving toward cross-training our Medicaid Waiver field staff and Vocational Rehabilitation supported employment consultants to ensure that there are specific people at the local and regional level who are responsible for assisting with the development of employment services and supports including modeling and mentoring. Financing and Contracting Methods: We have nearly doubled the reimbursement rate for Supported Employment through the Medicaid Waiver, essentially matching the outcome payments paid by Vocational Rehabilitation, while reducing the rates for Day Training. In addition we are exploring performance-based funding to encourage providers to meet employment-related goals and establishing financial incentives to increase integrated employment outcomes. Training and Qualifications: We continue to require six days of intensive competency-based Employment Services training though the University of Kentucky. In addition, we require six hours of competency-based continuing education annually and have established a minimum educational requirement of a Bachelor’s Degree plus one year of experience or, as a replacement for the educational requirement, the completion of the SCL Supported Employment credentialing process. Also, we are developing a plan to ensure that state personnel, including legislators, along with conflict-free case managers receive training on employment supports and outcomes.
Interagency Collaboration: Our initial step was to strengthen our already cooperative relationship with the Office of Vocational Rehabilitation and the Office of the Blind by developing a memorandum of understanding braiding funding for services. This formed the basis for the development of a coalition that now includes twenty-two non-provider agencies.
Services and Service Innovation: We are working to ensure that the Case management / Service Coordination process promotes employment as primary goal. In addition we are working to ensure that appropriate resources are available to individuals and their families waiting for services to encourage them to choose employment over other service options. Employment Performance Measurement: We have developed an online Supported Employment data collection system with the assistance of The University of Kentucky. We will begin field testing soon to ensure that we collect accurate data on individual employment outcomes that will allow us to recognize and reward excellence. In addition we have developed a three stage quality assurance process for all services. Stage one involves the monthly completion of the Kentucky Focus Tool by independent Case Managers. The focus tool requires the monthly monitoring of individual outcomes, health and wellness, loneliness, and employment. Stage two employs the use of the Kentucky Quality Indicator which measures the quality of individual services to a participant on a 4.0 scale. And, stage three involves the application of the Kentucky Best Practice Index. Jeff White, MBA, CWIC
Quality Assurance Coordinator Division of Developmental and Intellectual Disabilities
100 Fair Oaks Lane 4W-C, Frankfort, KY 40621 502.564.7702 x4440 (Phone) 502.564.8917(Fax)
Maryland Employment Consortium
NACDD Panel on the Employment Learning Community
July 7, 2014
24
Purpose of the MD Employment Consortium
To improve the employment outcomes of people with developmental disabili=es through a collabora=ve systems change process. The goal will be accomplished by development, implementa=on and evalua=on of a strategic state plan.
Opportunities • Maryland DD Council took the lead in submieng the applica=on in collabora=on with DDA
• Consor=um members agreed on shared vision • Charter developed • Defined rela=onship with other employment groups
• Strategic planning process started
Maryland Employment Outcome
Information System
Purpose: To provide longitudinal data that support Maryland’s goals to improve both par=cipa=on in integrated employment and the quality of employment outcomes.
Maryland’s core principles for development and implementation of
a data system • Data collec)on is a tool to focus on improving employment outcomes
• Data can be used to inform individual choices • Data helps to demonstrate accountability • Data collec)on is an opportunity to support adop)on of common defini)ons/common language across the state
• Employment outcomes are different than service defini)ons
• Data collec)on systems should be simple • Data collec)on should be at the individual level
Maryland Results Number Percent Mean hours
worked/2 weeks
Mean gross income/2 weeks
Any integrated job (unduplicated)
Individual competitive job
1,963 16.7% 38 $365
Individual contracted job
399 3.4% 35 $324
Group integrated job
1,549 13.1% 33 $237
Self employment 31 .3% 26
Sheltered employment 2,888 24.5% 18 $58
Community Based Non-Work 3,496 29.7%
Facility Based Non-Work 5,653 48.0%
Unduplicated Total 11,782
Outcome Comparison – State & National Integrated Employment
Facility Based Work
Facility Based Non-‐Work
Community-‐Based Non-‐Work
Maryland (2013)
33.5% 24.5% 48% 29.7%
United States* (2011)
19.3% 25.8% 41.7% 46.6%
* Butterworth, J., Hall, A.C., Smith, F.A., Migliore, A., Winsor, J., Domin, D., & Sulewski, J. (2013). StateData: The National Report on Employment Services and Outcomes. Boston, MA, University of Massachusetts Boston, Institute for Community Inclusion, pg. 59.
New Day for Day Services: full community day services
• Focus on helping providers shining to full community day supports (work and non-‐work)
• Individual receives flexible, customized supports
• Employment is the primary goal • TA provided by LueMar Consul=ng Group & TransCen’s WorkLink of San Francisco, CA
For more informa=on, contact:
Cathy Lyle Maryland Developmental Disabili=es Council
catherinel@md-‐council.org 410-‐767-‐3669
For more information about the ELC contact:
Karen Flippo Ins=tute for Community Inclusion University of MassachuseWs Boston 617-‐287-‐4344
Cindy Thomas Ins=tute for Community Inclusion University of MassachuseWs Boston [email protected] 617-‐287-‐4312