Introduction to Supported Employment

Differentiate between individual and group approaches to employment

An individualized approach allows the employer employee match to focus on the strengths of that individual and how they meet the needs of the employer. A group approach does not allow for jobs to be tailored to everyones strengths because not everyone has the same strengths/ interests.

The Americans with Disabilities Act (ADA)

Prohibits employment discrimination, based on disability on both a state level as well as for private employers. In addition, the ADA also establishes anti disability related discrimination mandates in the following areas: public accommodation, transportation, telecommunications, and public services. ADA also has the non-disclosure laws.

self determination

Self-determination is the process of defining one's own direction. To achieve a successful employment outcome, it is important that the job seeker actively drives and controls his or her own job search

Medicaid Waivers

States can provide specific employment supports to individuals through Home and Community Based Services (HCBS) under Section 1915(c) waivers or Section 1915(i) state-plan services 1915(c) waivers provide long-term care for individuals who would receive institutional care without a waiver. 1915(i) services provide HCBS to individuals who meet state-defined criteria.

unique characteristics of Supported Employment

Supported employment is based on the principle that individuals with severe disabilities have the right to be employed by community businesses where they can earn comparable wages, work side-by-side with co-workers with or without disabilities, and experience all of the same benefits as other employees of the company. This idea is often referred to as "Employment First." Supported employment assists people with severe disabilities by providing individualized supports that enable them to choose the kind of job they want and to become successful members of the workforce.

DOL

The Department of Labor (DOL) fosters and promotes the welfare of the job seekers, wage earners, and retirees of the United States by improving their working conditions, advancing their opportunities for profitable employment, protecting their retirement and health care benefits, helping employers find workers, strengthening free collective bargaining, and tracking changes in employment, prices, and other national economic measurements. In carrying out this mission, the Department administers a variety of Federal labor laws including those that guarantee workers' rights to safe and healthful working conditions; a minimum hourly wage and overtime pay; freedom from employment discrimination; unemployment insurance; and other income support.

The Equal Employment Opportunity Commission (EEOC)

The Equal Employment Opportunity Commission (EEOC) is the United States federal agency that is responsible for eliminating and overseeing employment discrimination issues in the United States. The EEOC enforces anti-employment discrimination as it pertins to numerous laws and legislation including Title VII of the Civil Rights Act of 1964[1], the Equal Pay Act[2], the Age Discrimination in Employment Act (ADEA)[3], the Rehabilitation Act of 1973 and the Title I of the Americans with Disabilities Act.

The Ticket to Work and Work Incentives (TWWIIA)

The Ticket to Work and Work Incentives Improve upon current work incentives and to help increase employment service choices for Social Security beneficiaries through a client driven employment services selection process under the new Ticket to Work incentive.

WIA

The Workforce Investment Act is a federal act that "provides workforce investment activities, through statewide and local workforce investment systems, that increase the employment, retention, and earnings of participants, and increase occupational skill attainment by participants, and, as a result, improve the quality of the workforce, reduce welfare dependency, and enhance the productivity and competitiveness of the Nation."[1] The law was enacted to replace the Job Training Partnership Act and certain other Federal (outlined below in History) and job training laws with new workforce investment systems (or workforce development). The law was enacted during Bill Clinton's second term and attempts to induce business to participate in the local delivery of Workforce Development Services through Workforce Investment Boards (WIBs) which were to be chaired by private sector members of the local community. A majority of Board members were also required to represent business interests.[2]

identify how support strategies can enhance or distract from the image of a worker with a disability

You need to find the balance between good teaching and use of natural supports. It is important to fade supports to natural supports as soon as individual is ready, highlight the individual is capable of doing the work on his own without be ing intrusive to the employer. Whenever possible training should be turned over to the employer/employees. If the supports do not allow the individual to shine or highlight his strengths/if the put a burden on the employer the likelihood that the job placement will be successful decreases.

Roles and responsibilities of administrators and program managers in facilitating supported employment

know evidence based practices, hire the right staff and train staff and evaluate the program as a whole in order to make changes. Provide:• Individual choice and Self-Directed services • Respect and dignity for people receiving services • Competitive employment is the goal • Services are integrated with other treatments and supports such as mental health care • Individuals have the opportunity to pursue work interests of their choice • Individuals have control of their own resources • Providers encourage and support a person's career growth and skill development even if it means quitting a job to pursue something different • The organization routinely assesses their quality of services through the development and implementation of a total quality management system (e.g., service satisfaction surveys, focus groups, service exit interviews, open forums) • Staff conduct customized job searches and job placements according to individual preferences, strengths, and work experiences • Follow-along supports are available to the individual if and when they are needed • The organization offers other resources and information for the individual, especially for services it may be unable to provide • Services are accessible to all people with disabilities

Quality Indicators for Supported Employment Personnel

• School personnel involved in transition assist youth to explore career opportunities, develop work skills and behaviors, and develop self-determination skills through active participation in information gathering, experiential learning, and decision-making. • Transition team members support students to direct their transition plans to the maximum extent possible, with support as needed. • School and adult service personnel assist youth in transition to obtain desired adult services, including generic supports, after high school. • Providers get to know job seekers via activities such as spending time together in multiple settings, observing the individual work, talking with others who know the person best, etc. • Providers assist job seekers, including individuals with significant disabilities, to participate maximally in job development and employer contact activities according to their individual plan for employment. • Providers rely heavily on personal networks and referrals for job leads. • Providers assist individuals to negotiate individual job descriptions/position titles, hours, commensurate wages (paid directly from the employer), work tasks, work location, and necessary accommodations prior to beginning a job, with the goal of maximizing presence and participation in the work setting. Providers are knowledgeable about job carving and restructuring. • Providers do not group people together for the convenience of support or job availability. Section 4: Appendix B 117 3 • Providers work in partnership with supported employees on the best employment training approaches to meet the person's needs, emphasizing typical workplace supports and the use of discreet, status enhancing teaching techniques. • Providers work in partnership with supported employees and workplace personnel to develop assistive technology and individualized supports that are as typical to the workplace as possible and that maximize individual performance. • Providers treat individuals in a manner appropriate to their age, gender, and culture, and in accordance with the norms of their job and the workplace. • Providers assist individuals as needed to develop relationships within and outside of their job. • Providers support individuals as needed to access social activities (e.g., parties, holiday functions) and employer-sponsored activities (e.g., sports, community service projects) within and outside of their job. • Providers encourage typical probation and performance appraisal processes within each workplace. • Providers assist individuals as needed to access reliable transportation. • Providers assist individuals to manage their finances (e.g., banking, budgeting, benefits) as needed. • Providers monitor individual job satisfaction and support people to pursue career development and advancement opportunities. • Providers support people of retirement age to pursue activities according to their interests, including employment and integrated community activities for senior citizens. • Providers assist individuals as needed to access housing, community connections (e.g., church/synagogue, YMCA, service/civic clubs), and other necessary services and supports, with an emphasis on generic services. • Providers interface with family members and other service providers according to the method (e.g., telephone, meetings) and schedule (e.g., weekly, monthly) determined by the individual and team. • Providers develop long-term, mutually beneficial partnerships with businesses that result in career exploration activities, quality jobs, marketing efforts, etc. on the part of businesses, and consultation, training, accommodation strategies, etc. from providers. • Providers interface with businesses and the larger community through connections with chambers of commerce, service clubs, and other organizations.

Role of employers

Employers are responsible for adhering to all applicable federal and state laws, regulations, and standards regarding employment, including disability specific rules. Below are some of the key areas for employers to consider when hiring or employing people with or without disabilities. Employers MUST: • Provide a non-discriminatory work environment as defined by the Equal Employment Opportunity Commission. • Provide appropriate leave of absence benefits as outlined in the Family Medical Leave Act. • Ensure that employees are working in a healthy and safe environment as outlined by the U.S. Department of Labor's Occupational Safety & Health Administration. • Provide a readily accessible workplace environment for job applicants and employees with disabilities as described in the 1990 Americans with Disabilities Act and the 1973 Rehabilitation Act. • Consider and provide a reasonable accommodation, if a job applicant or current employee requests one. • Provide a workplace that is non-discriminatory, nonthreatening, non-hostile, and non-retaliatory for all employees. For employers, complying with these and other employment related regulations, allows job candidates with disabilities an equal opportunity at employment. Everything including the initial job posting, job application, pre-employment testing, job interview, formal job offer, and subsequent employment are all essential steps in the employment process for people with or without disabilities. It is the employer's role and responsibility to ensure that these steps are equally accessible and available to job applicants with disabilities.

Factors that lead to the emergence of supported employment.

Historically, people with disabilities, and particularly developmental disabilities, have experienced unemployment, underemployment, and poverty at rates that far surpass their peers without disabilities. Additionally, people with disabilities are less likely to find steady or satisfying employment. Employment first and supported employment was developed in an effort to improve these outcomes for people with disabilities.

8. Best practices in supported employment services from intake to follow-along. 9. Best practices in school-to-work and community living transition.

Learn the Quality Indicators

The Rehabilitation Act

Mandates non-discrimination by the federal government in its hiring and requires affirmative action, insures accessibility of buildings constructed with federal funds, mandates non-discrimination and affirmative action by federal contract recipients, prohibits discrimination in programs and activities, and requires standards for electronic and information technology. Section 504 of the Rehabilitation Act created and extended civil rights to people with disabilities. Section 504 has provided opportunities for children and adults with disabilities in education, employment and various other settings. It allows for reasonable accommodations such as special study area and assistance as necessary for each student. [1]

Fair Labor Standards Amendment

Allows people with disabilities, in addition to those with visual impairments, into Sheltered Workshops. This leads to the prolific establishment of sheltered workshops and adult day centers.

Readiness Model of employment or Train-place model

A model of employment placing that used to be used. It was believed that an individual had to first gain the skills necessary for the job by training somewhere else before being placed in the actual work setting. Often this training took place in a segregated or sheltered setting without peers.

place-train model

A model of finding the job first and then providing training on site through the use of a job coach to provide close, flexible and individualized follow-up.

History and Status of supported employment services OHIO

Employment First History: History Historically, people with disabilities, and particularly developmental disabilities, have experienced unemployment, underemployment, and poverty at rates that far surpass their peers without disabilities. Additionally, people with disabilities are less likely to find steady or satisfying employment. Ohio's developmental disability service delivery system has long recognized the importance of employment for individuals and their families. In fact, Ohio currently ranks 8th nationally, per capita, regarding the number of individuals served in integrated community settings. The National Report on Employment Services and Outcomes; Butterworth, Hall, Smith, and Migliore. In 2011, the Department of Developmental Disabilities partnered with the Ohio Developmental Disability Council to become a member in the State Employment Leadership Network (SELN). The SELN is a cross-state cooperative venture of state intellectual and developmental disability agencies that are committed to improving employment outcomes for youth and adults with developmental disabilities. In October 2011, the SELN completed its Findings and Observations Report of the Ohio developmental disabilities system, summarizing the results of a comprehensive assessment process using input gathered from a broad stakeholder group. As a result of this report, stakeholders determined that a concerted Employment First effort was necessary in Ohio and recommended a Governor directive. Ohio launched its Employment First Initiative by Governor Kasich's Executive Order in March 2012 (Executive Order 2012-05K). The Executive Order required state cabinet level agencies from the Ohio Ohio's Path to Employment First 4 | Page Departments of Education, Medicaid, Job and Family Services, Mental Health and Addiction Services, Opportunities for Ohioans with Disabilities Agency and the Ohio Department of Developmental Disabilities to partner in the development of a coherent strategic plan identifying each agency's responsibility and contribution to having employment be the primary expected goal for working age adults with developmental disabilities. The Governor's Executive Order charged the Taskforce with collaborating, coordinating and improving employment outcomes, and to identify best practices, effective partnerships, sources of available federal funds, opportunities for shared services among existing providers and county boards of developmental disabilities, and the means to expand model programs, to increase community employment opportunities for those with developmental disabilities. Ohio has already shown preliminary success in improving employment outcomes for people with developmental disabilities. In the six-month Employment First status report, DODD set a goal of increasing community employment by 10% or 7,727 adults by June 30, 2014. As of the end of December 2013, 7,626 adults were classified as engaged in integrated employment services, or an increase of 8.5%.

benefits of integration at the workplace for people with disabilities.

Employment First enhances lives by creating greater opportunities for all people to advance their careers. Individuals can use their strengths and talents in order to increase their economic wealth, have a sense of accomplishment and create their own social identity. The community benefits from community employment provide diversity and enrichment to the community, promote equal opportunity within the community and decreases dependency on public funding. Employers benefit from community employment as it will provide more value to their businesses because of access to dependable and qualified employees.

Individuals with Disabilities Education Act (IDEA)

Expands educational rights for students with disabilities including replacing the phrase "handicapped child" with "child with a disability" and provision of Transition Services for students by age 16.

Rights and Responsibilities of individuals in supported employment

Rights of the Individual The right to work in a clean and safe environment including conditions to reasonable accommodate disability or behavior patterns. The right to know what you are being paid and to be paid for all work completed. The right to be told about services and programs that are provided and if they will meet my needs. The right to know the cost of service regardless of who pays and to be notified if there is a change in cost. The right to staff that is qualified and trained to meet my needs and support. The right to information about other choices and agencies that are available. This allows you to make informed choices. The right for assistance in transferring to another provider to ensure continuity of care. The right to be included in creating an employment plan while working at Winona ORC. The right to pertinent information so that you can make an informed decision to choose to accept or refuse services. If you refuse services, we will explain the risks and adverse consequences associated with the refusal. (consent form) The right to know the program admission criteria and policies related to temporary service suspension and termination of services. The right to access or referral to legal aid, self help and advocacy support services. The right to timely information so that you can make an informed decisions. The right to have personal, financial and medical information kept private and confidential. The right to have access to my program records The right to be treated with dignity and respect and consideration of my preferences. The right to be free from physical and verbal abuse, sexual harassment, retaliation, humiliation, neglect and financial or other exploitation. The right to be free from staff using manual restraints or seclusion to control my behavior; except if and when manual restraint is needed in an emergency to protect me and other from physical harm. To be allowed to reasonably follow my cultural and ethnic practices and religion and to be free from prejudice and harassment regarding my race, gender, age, disability, spirituality and sexual orientation. The right to access my program records and information that Winona ORC has about me as allowed by Federal and state rules and regulations. The right to a break after four (4) hours of work. To know the names, addresses and phone numbers of people who can help me, including the ombudsman and to be given information about how to file a complaint with these offices. To exercise my rights on my own or have a family member or another person help me to exercise my rights, without retaliation from Winona ORC. In the event that your rights are violated, you may use the grievance procedure outlined in the Worker' Handbook. The Director of Client Services will maintain documentation of the incident, follow all steps of the grievance procedure and monitor the time frames to assure all parties are informed. Any substantiated Human Rights violations will be reported to the Program Committee at the earliest opportunity. Your Responsibilities Along with rights, there are always responsibilities. These are as important as your rights. Taking responsibility for yourself is a powerful step towards being in charge of your own life. You are responsible for working safely. You are responsible for coming to work on time and staying to the end of your shift. You are responsible for calling the office when you are not able to get to work before your shift begins. You are expected to act in ways that will not harm other people. You are responsible for knowing the rules at Winona ORC and following them. You are expected to tell the staff at Winona ORC when you are having problems that are affecting your work. You are responsible for keeping your break area and work station clean People with disabilities should advocate for equality. • People should advocate for the right to make their own decisions and choices. • People should advocate for their own rights, responsibilities, and chances to speak up and empower themselves. • People should advocate for the right and ability to make new friendships and renew old friendships just like everyone else. • People should advocate for the ability to take chances and risks and be able to learn from their mistakes like everyone else. Basic understanding of career and life goals including immediate or short-term work goals as well as long-term employment aspirations. • Attend scheduled appointments and activities. • Be an active partner in the job search. • Be respectful of staff and other professionals who are involved in the employment services process. • Advocate on behalf of yourself when the direction or decision for employment services differ from your expectations and desires. • Be an informed consumer by knowing what you want and need in a particular service provider, such as their area of expertise, methods of job development, average time it takes to find someone a job, number of employment specialists employed. Also, consider the geographic region that the agency primarily serves, and methods or resources used to assess a job candidates employment skills, abilities, and interests. • Express the desire and willingness to want to work, whether verbally or through other means of self-expression, such as non-verbal gestures, body language, picture boards, or augmentative communication devices.

Quality Indicators for Individuals in Supported EmploymentIndividual Choice and Control of Resources and Supports

Individuals explore career opportunities based on their interests, abilities, and needs via such experiences as vocational education classes, job shadowing, job try-outs, and actual employment. • Individuals have ongoing opportunities to develop self-determination skills through active participation in information gathering, experiential learning, and decision-making. • Individuals direct their transition plan and/or IPE to the maximum extent possible, with support as needed. • Individuals control the resources, if desired, to purchase services and supports. Family members, personal advisors, and other trusted advocates assist individuals as needed. • Individuals are assisted as needed to secure employment according to their individual desires, including the type of work environments, activities, hours, pay, supports, etc. • Individuals participate maximally in interviews and in choosing training and support procedures typical to workplaces. • Individuals have necessary and appropriate accommodations, assistive technology, and individualized supports within and outside of their job. Section 4: Appendix B 116 2 • Individuals are connected to desired adult services, including generic supports, in order to pursue desired lifestyles. • Individuals pursue career advancement opportunities in order to develop skills, increase pay and responsibilities, or other desired outcomes. • Individuals develop satisfying relationships within and outside of their job, as desired. • Individuals are supported to participate in social activities within and outside of their job, as desired. • Individuals are compensated commensurate with others in their position. • Individuals have access to reliable transportation. • Individuals are assisted to manage their finances (e.g., banking, budgeting, benefits) as needed and desired. • Individuals of retirement age are supported to pursue a variety of employment and/or post-employment options.

define normalization and its guiding principals

Normalization involves the acceptance of people with disabilities, with their disabilities, offering them the same conditions as are offered to other citizens. It involves an awareness of the normal rhythm of life - including the normal rhythm of a day, a week, a year, and the life-cycle itself (e.g., celebration of holidays; workday and weekends). It involves the normal conditions of life - housing, schooling, employment, exercise, recreation and freedom of choice previously denied to individuals with severe, profound, or significant disabilities. Informed Choice The individual seeking services is given choices when it comes to service provider selection and type of services provided. Control Similar to choice, individuals are provided control as to where, when, and what services they receive. Careers The concept of a career path as opposed to simply having a job is a defining value among quality service providers. Full Inclusion Full inclusion means not only involvement in the work place but also in other areas of an individual's life, such as residential arrangements and community activity. Long-Term Supports Identifying and implementing long-term supports is a critical factor for long-term employment success. Assistive Technology Use of suitable assistive technology is key to employment success for many individuals with severe disabilities. Self-Determination& Person Centered Services Focus is on the individuals' wants, needs, and desires, and forms the appropriate services around such information. Quality Assurance Service providers use a total quality management system to determine if they are successfully meeting the needs of all their primary stakeholders. This information is shared with everyone involved in their supported employment services including the individual, family, funders, agency employees, employers, and community representatives.

Role of family and friends

Participation of an individual's immediate family members, extended family, as well as friends, mentors, and other significant people in a person's life play a critical part in the employment process. As we saw with the example of Darren, his parents had a significant impact on his employment choices and career path direction.

Informed choice

The first step is to have a strengths-based discussion to explore the person's interests skills and abilities develop an action plan to achieve goals. The third step is to follow up regularly on action items identified in the plan and to identify next steps.

Organizational Practices That Support Quality Services

The organization has established a clear vision and mission that promotes integrated employment, community inclusion, and zero exclusion. Section 4: Appendix B 118 4 • The organization works toward a flat organizational structure, with most personnel in direct service roles. • The organization promotes stakeholder involvement in planning and decision-making through various informal and formal means. • The organization supports staff to be involved in person-centered/person-directed planning that addresses individual interests, preferences, and support needs. • The organization supports individualized jobs and related supports for all service recipients, including people with high support needs. • The organization pursues flexible, individualized funding that allows sufficient support for individuals with high support needs. • The organization has job descriptions that promote the focus on integrated employment and related community supports. • The organization configures staff to provide holistic supports in a collaborative fashion (e.g., full service, self-directed teams), and supports reasonable staff-to-individual ratios. • The organization has a staff recruitment and retention process that promotes hiring and keeping high quality personnel. • The organization invests in staff development through extensive, ongoing training and support. • The organization promotes a learning culture in which creativity, innovation, and risk taking are supported and where staff feel empowered. • The organization operates with an action bias, focusing on continuous evaluation and improvement of outcomes. • The organization collects and uses data on consumer outcomes, staff productivity, customer satisfaction, cost efficiency, and other process and outcome variables. • The organization has a staff compensation and reward process that reinforces desired outcomes. • The organization promotes leadership at all levels of the organization. • The organization has developed marketing materials and approaches that coincide with common business practices and promote a positive and professional image. • The organization has developed partnerships with the business community and other external entities in the community, state, and nation.

Fuding Assistance for Mental Health (MH) and Developmental Disabilities (DD)

Think Board of DD ( A local county agency that relies on local taxes and grant money to provide services) The largest dollar source of extended-service funding in supported employment is state or local mental health/mental retardation or developmental disabilities agencies. Services from MH/MR/DD vary substantially across the country, some are contracted for on a state basis, but most are arranged on a more local basis. In some instances, a local mental retardation agency will contract with the supported employment provider just like the vocational rehabilitation on a fee basis to provide supported employment services. In another instance, a local mental retardation agency might be a provider of supported employment services itself. In this situation where vocational rehabilitation has arranged for supported employment services through an employment service organization, the mental retardation agency provides extended services itself. Potentially a problematic situation can occur where extended service responsibility is passed on to the employment organization to the mental retardation service agency. Then the relationships with the employer and others developed during the initial supported employment stages are jeopardized.

Difference between supported employment and traditional vocational services

Typically, when it came to publicly funded services, employment in the community has been among a number of choices presented to people with disabilities, and in many cases individuals have been shuttled to facility-based segregated services. Under Employment First, assistance to find a job in the community, and become a tax-paying citizen, is the preferred choice. Employment First starts with a presumption that a person with a disability can work. Unlike other individuals of working age in our society, where it's presumed they will become employed, people with disabilities have too often had to demonstrate their "readiness" for employment. Under Employment First, it is assumed that individuals are capable of working until proven otherwise, and employment in the general workforce is the first option pursued. If a decision is made that the individual won't pursue employment at the current time is made, then other service options can be explored - i.e., Employment First is not Employment Only.

Funding Support through VR (Vocational Rehabilitation)

Vocational training may be purchased or secured by OOD when needed and available. Training might include vocational school, college, technical or business school, or on-the-job or supported employment training in an industrial or commercial firm. If supplies such as textbooks or tools are required for vocational training, or licenses and equipment are necessary to begin an occupation, OOD can help with those items. Physical and mental restoration may be necessary to correct or substantially modify an impairment so that you can attain employment. (OOD can not assist/run medical programs However)