Models of Integrated Employment AFP Summit November, 2011 Debra Martin Luecking, Moderator, TransCen, Inc., Rockville, MD Bob Sexton, Director, Cerebral Palsy Center, Knoxville, TN Anthony Hills , Housekeeper , Service Solutions

Integrated Employment Issues Low employment rate among job seekers with significant disabilities Low employment rate overall for people with disabilities Limited belief in “Everyone Can Work”

Issues Lack of unified vision at federal, state, and local level Employment is based on “readiness” Scarce quality employment resources Focus is on funding framework vs. customer needs “Silo” approach to delivering services

Effective Integrated Employment Practices Implementing policies that focus on integrated, community-based employment earning at or above the minimum wage as the first option for individuals with intellectual and other developmental disabilities

Effective Practices Tapping the skills and strengths of job seekers to match employer demand for a reliable, productive workforce through customized employment opportunities Going beyond sub-minimum wages and non-work day activities

A Holistic Approach to managing change encompasses: Establishing a vision of the desired outcome Strong leadership keyed to that vision An Action-bias dedicated to change Development of a supportive learning culture Continued realignment of administrative and programmatic systems consistent with the new vision Magis-Agosta, 1994: “From Facilities to Inclusive Employment”, Creating Individual Supports for People with Developmental Disabilities

Model of Integrated Employment Cerebral Palsy Center of Knoxville: An Employment 1st Agency

Who Do We Serve? Persons with Multiple Disabilities Intellectual Disabilities Physical Disabilities Living in Natural Home Living in Agency Residential Sites Previously Institutionalized

What Did We Look Like Before Changeover? 100% Facility-based services Work activities Recreation Group homes

Why We Changed? Customer desires/dissatisfaction Intense change in the disability field Funders’ changing what and/or how much they pay for outcomes Society of greater inclusion Intrinsic knowledge of right vs. wrong (values)

Changes in What Funders Pay No pay for sheltered employment Higher pay for individual placement vs. group placement (mobile work crew/enclave) Higher pay for employment-based day vs. community-based vs. facility based day TN became an Employment 1st state (2002)

What Changed? From: only a few in individualized employment “selling disability” employment approach what funding sources wanted WE do it all ourselves

What Changed? To: 50% of those served in individualized employment “customized” employment approach two customers: employers and job seekers community collaboration

Structure: Work Teams Cross functional group of employees (usually 8 to 15 members) responsible for direct supports for a designated group of individuals. Cross functional includes employment, day, residential support staff. Management delegated to the team authority to plan, do, check, and improve all work processes.

Change to “Person-centered ” Values Are unique human beings Have talents, capabilities Need individualized supports Most enhancing Interdependence Community Communication/Build on Strengths Natural Support Holistic Participation Values, Outcomes, Satisfaction

Mission Sets organization purpose Sets principles Sets long-range goals

Leadership Style Leadership vs. Management—director is visionary Customer-Oriented—redefining quality Organizational Design—leading from the bottom Organizational Realignment—teams, flattened structure Job Seeker Empowerment—coach or mentor the decision making process

Staff Roles: Team Member May be direct support professional, case manager, driver, therapist, etc. Provide comprehensive services and supports to customers Every staff is on a team Receives team training

Customer Services One person at a time Understanding employer needs Focus on job seeker’s interests vs. program/resource needs Focus on employment and valued non-work activities……..”Quality Day”

What Support did we get? Read Visited other agencies Joined workgroups in local community (support groups) Participated in network groups Sought technical assistance

Change is a door that can only be opened from the inside! 21

What’s In It For Those We Support? Personal growth Increased self-esteem Increased wages Status and connections More appropriate behavior More friends and relationships Increased status with own family Improved self-advocacy Public transportation, bank account, car, marriage, children

What’s In It For Me (Us)? Agency growth Personal growth Increased status in business community Increased staff competence Increased staff morale Expanded customer base Increased revenues Lower staff turnover rate Better communication

Change Brought Opportunity Knoxville System Integration Program : A Seamless Transition Approach for Youth with Disabilities

What Center / Services Look Like Today 85% Young Adults Working 52% Older Adults Working Civic Club Membership Volunteerism Hobbies Health/Fitness Relationships Relationships Leisure/Vacation

Is it all worth it? See what you think….