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 Rebecca.Salon@dc.gov

D.C.’s VISION FOR EMPLOYMENT FIRST

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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  

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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

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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

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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  

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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  

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• 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  Tracy.Warren@icdd.idaho.gov  

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)

jeff.white@ky.gov

Maryland  Employment  Consortium  

NACDD  Panel  on  the  Employment  Learning  Community  

July  7,  2014  

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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  Cindy.thomas@umb.edu  617-­‐287-­‐4312