Jonathan Duvall University of Pittsburgh Department of Rehabilitation Science and Technology 1

 Approximately 18.7% of Americans have a disability ◦ Difficulty performing certain functions ◦ I.e. seeing, hearing, talking, walking, climbing stairs, lifting and carrying  12.6% have what qualifies as a severe disability ◦ Someone who is unable to perform one or more activities ◦ Needs assistance from another person to perform basic activities  Numbers will continue to rise ◦ Improved health care and longer length of life 2 Brault MW. Americans with disabilities: 2010: Current population reports. Household Economic Studies. July 2012:

 August 2013  National unemployment rates ◦ % of people currently looking for jobs ◦ People with disabilities: 14.1% ◦ People without disabilities: 7.1%  Labor force participation rates ◦ % of people actually working ◦ People with disabilities: 20.5% ◦ People without disabilities: 69.1% 3 Department of Labor Bureau of Labor Statistics.

 Employment rates after the ADA (1990) ◦ ↓ for people with disabilities ◦ Remained constant for people without disabilities  Why? ◦ Employer accommodations (or lack thereof) ◦ Costs of accommodations  Ramps, readers for the blind, sign language interpreters, etc. ◦ Difficult-to-measure costs  Flexible schedules, part-time work vs. full-time, providing less-stressful or -complex environments ◦ Attitudes toward disability ◦ Social Security policy  Loss of goods and services with higher income 4 Bound J, Waidmann T. Accounting for recent declines in employment rates among working-aged men and women with disabilities. Journal of Human Resources 2002;37(2):

 ≈ $357 billion on assistance for working-aged people with disabilities (2008) ◦ ≈ 12% total federal outlays  Significant market of consumers ◦ Discretionary spending > $200 billion/year  Clinical and technological innovations ◦ Assistive technology ◦ Healthcare  Diversity in the workplace ◦ Improve employee performance ◦ Expand customer base  Increased income tax revenue  Replace jobs lost after retirement of baby- boomers 5 Brault MW. Americans with disabilities: 2010: Current population reports. Household Economic Studies July 2012;

 Psychological ◦ Provides valued social role in our society ◦ Sense of personal efficacy ◦ Higher life satisfaction and better adjustment 1  Social ◦ People with disabilities less likely to participate in social activities 2 ◦ Increase social integration ◦ Reduce isolation 6 1. Yasuda S, et al. Return to work after spinal cord injury: A review of recent research. Neuroreahbilitation 2002;17: National Organization on Disability Survey of Americans with disabilities. National Organization on Disability/Louis Harris and Associates.

 SSI pays 4.6 Billion dollars to 8.2 million disabled people every month (Aug ’12 to Aug’13)  Average payment is $520  SSDI paid 10.2 Billion to 10.6 million in 2012  Average payment was $

 SSA program participants represented 8.3% of all undergraduates with disabilities or 125,000 students. Of these, 57% or 71,000 were SSDI participants, 36% or 45,000 were SSI participants, and 7% or 8,000 received both SSI and SSDI.  For all groups, students with orthopedic impairments represented roughly a third of all undergraduates with disabilities. Students with mental illness and health impairments were the second and third most predominant disability groups represented. 8

 Pubmed Keywords: ◦ Student ◦ Disability ◦ Disabilities ◦ Employment ◦ University ◦ Attendant ◦ State Medicaid Policy ◦ Personal Assistant(s) Services ◦ Medicaid Income Limits ◦ Social Security Income limits

 Statistics on employment of people with disabilities  Federal registrar bulletins  Entitlement employment predictors  Creation and evaluation of potential solutions  Nothing to solve the problem 10

 Allow people with disabilities to receive attendant care and other social services regardless of income  Deduct/Charge a percentage of income to offset costs. 11

 Person receives $900 SSI and attendant care waiver for 56 hours/week at $12/hr (~$2,880/month)  Government pays $3,780/month, Person receives $900/month  Under current policy where person would gain employment and receive $2500/month salary (30k)  Government pays $0, Person receives -$380 12

 Person receives $900 SSI and attendant care waiver for 56 hours/week.  Government pays $3,780, Person receives $900  Under New policy where person receives $2500/month salary and pays 25% fee  Government pays $2,255-taxes, Person receives $1,875-taxes 13

14 Current PolicyGovernmentIndividual Status Quo$3,780$900 Employment$0-$380 Proposed PolicyGovernmentIndividual Status Quo$3,780$900 Employment$2,255$1,875

 More people with disabilities will want to be employed  The person with the disability will make more money, will be integrated into the community and may possibly obtain private health insurance through employer.  The amount of money paid out by government will be lowered. Amount of money paid by SSI and Attendant care services will be reduced based on the individual’s income  There is a fear that more employed people would request services, but if they don’t need the services, why would they pay a percent of their income for an unneeded service. 15