Grant Project Period: September 30, 2002 through September 29, 2007
Grant Project Name: Training and Technical Assistance to Providers / T-TAP
Grant Number: E-9-4-2-0117
Recipient Contact Person (Name & Phone Number): Dr. Katherine Inge, Project Director / 804-828-5956 / firstname.lastname@example.org
Principle Investigator/Project Director (Name & Phone Number): Dr. Paul Wehman, Principle Investigator / 804-828-1851
I. SUMMARY DESCRIBING THE PROGRESS ACHIEVED DURING THE GRANT IN ACCOMPLISHING GOALS AND OBJECTIVES OUTLINED IN SGA AND GRANT SUBMISSION. The U.S. Department of Labor (DOL), Office of Disability Employment Policy (ODEP) established the Training and Technical Assistance for Providers (T-TAP) Project in September of 2002. This cooperative agreement provided funds for the implementation of a national technical assistance and training effort designed to increase the capacity of community rehabilitation providers (CRPs) that provide services for people with disabilities. The desired outcome of the T-TAP effort was to work with providers to:
(1) Evolve their programs to provide integrated employment outcomes in non-stereotypical jobs based on customized employment strategies and individual choice.
(2) Increase wages of people with disabilities who are currently working at less than the federal minimum wage.
When T-TAP was funded in the fall of 2002, customized employment was a new initiative supported by the Office of Disability Employment Policy (ODEP). The actual term customized employment was coined in 2001 when the Office of Disability Employment Policy (ODEP) was created within the US Department of Labor (ODEP, 2004)1. Customized employment was conceived as a way for the generic One-Stop System to welcome and serve individuals with disabilities (Callahan, 2004)2. One of the first definitions published was in the Federal Register and is as follows:
Customized employment means individualizing the employment relationship between employees and employers in ways that meet the needs of both. It is based on an individualized determination of the strengths, needs, and interests of the person with a disability, and is also designed to meet the specific needs of the employer. It may include employment developed through job carving, self-employment, or entrepreneurial initiatives, or other job development or restructuring strategies that result in job responsibilities being customized and individually negotiated to fit the needs of individuals with a disability. Customized employment assumes the provision of reasonable accommodations and supports necessary for the individual to perform the functions of a job that is individually negotiated and developed. (Federal Register, June 26, 2002, Vol. 67, No. 123 pp 43154-43149)
Clearly, the legacy of the T-TAP project is the numerous community rehabilitation programs that have participated in both the direct and indirect technical assistance activities funded through the cooperative agreement from the U.S. Department of Labor, Office of Disability Employment Policy. This final report presents in detail how the 15 agencies that received direct technical assistance benefited from the project. This information is located in Section II, Objective 2 of this report as well as in Appendix B.
During the course of the five years, the 15 sites identified and followed a total of 297 individuals with disabilities with the goal of assisting them into integrated employment. As a result of the technical assistance, 97 of these target individuals entered jobs in the community. However, sites reported that an additional 115 individuals left 14c employment to enter individual jobs that were not originally targeted or included in the longitudinal data collection supported by T-TAP. In total, the T-TAP intensive technical assistance sites assisted 212 individuals with disabilities to enter individual community employment.
T-TAP maintained a database of the agency names and addresses to include the individuals that participated in the online courses and received materials from the project. An analysis of the database reveals that agencies in 49 of the 50 states participated in the training opportunities or received materials developed by T-TAP (Utah is not represented in the database). A total of 1,426 agencies were involved in the project's activities. While the database indicates that a total of 4,286 individuals received training or resources from T-TAP, the number is inflated, since individuals are counted multiple times if they participated in multiple activities. Please note that this does not count those individuals who received our materials indirectly. This could include individuals who did not register for a live webcast but used the username and password of another registered participant or viewed our CD-ROMs that were purchased by a coworker or agency program manager.
The T-TAP grant proposal emphasized the importance of establishing networks of providers who could serve as support once the cooperative agreement ended. We believe that T-TAP far surpassed its hope and intent for creating networks of support. The extensive networks that developed over the course of this project are obvious when reviewing the relationships that developed as outlined in Section V.
The project's mentor model demonstrated its potential for supporting organizational change. The results of the project data shows that without mentor support in some of the organizations that received T-TAP technical assistance, the organizational change goal would have been too overwhelming. The mentors supplied a balance in working with the agencies' administration staff and the direct line staff in facilitating integrated community employment. The experiences of the mentors and project TA sites formed the foundation for a manual. This mentor manual will be disseminated nationally through the VCU and ICI networks and will be an enduring product.
The lessons learned by the project are many and detailed throughout Section II. However, the lessons learned from the interactions between the project staff, the project mentors, and the intensive TA sites are best summarized from the final T-TAP project meeting, which was held in Washington, DC in the fall of 2006. The focus of the meeting was to discuss the best practices that promote customized employment outcomes for workers with disabilities as they move from segregated facility-based programs into the community, as well as the barriers.
On day one of the meeting, the sites that received technical assistance from the project, mentors from the T-TAP CRP Leadership Network, ODEP staff, and T-TAP project staff participated. On day two, key stakeholders and leaders in disability programming, mentors, ODEP staff, and T-TAP staff continued the discussion. Questions to guide the discussions were sent to the participants in advance of the meeting in preparation for the event. The intent was to identify lessons learned from the T-TAP project in three target areas including the factors that facilitate and inhibit outcomes at the individual, organizational, and
State and Federal Levels.
Participants discussed what works in terms of expanding competitive employment opportunities and outcomes, what continues to get in the way of progress, and what next steps are needed. This included reducing or eliminating existing barriers to expand the availability and use of customized employment. The discussion of next steps led to specific action recommendations by the participants. The detailed report is located in Appendix A of this document. The conversations and findings that emerged from this meeting actually summarize the findings of the T-TAP project. Some of these highlights follow specifically as they relate to the steps needed to expand customized employment outcomes for individuals with disabilities.
What Next Steps Are Needed to Expand Participation in Customized Employment at the Organizational Level?
Competitive employment must be promoted as the first choice. Employment is frequently not a focus for many community organizations. Community rehabilitation programs need to establish an employment-first mentality and have a clearly defined mission statement. Then, resources must be organized to support that mission. Expectations for staff are built around the vision and mission of the organization. The competitive employment goal must drive the conceptual structure of the organization.
Market success at the organizational level. CRPs should use multiple approaches to marketing success such as newsletters, banners, and websites. All of these need to publicize stories about organizational successes around people moving into competitive employment. Families and consumers can be involved in marketing the success, both as a target audience and as storytellers. Organizational celebrates define the organization for staff, for its consumers, families, and for the community.
License quality programs. Organizations that meet quality standards in providing customized employment should receive credit for that accomplishment. One approach would be a licensing program where licensed agencies have public documentation of their accomplishments.
Publicize organizational success stories to assist other organizations. Organizations need information on programs that are successfully making the transition to a focus on competitive employment. It was noted that a change from center-based programming is challenging. The example was given of a program still working at change after a 7-year conversion effort. Published success stories will help programs in the change process or contemplating entering the process persevere.
Create organizational structures and staff role assignments that support competitive employment. An example was given where staff assignments within an organization were changed so that enclaves would no longer be staffed/managed by employment services. The message was clear that the focus of the employment staff was on competitive employment placements. Organizations need to focus on employment outcome in its staff design and assignments. Another strategy would be to target community employment for all new referrals to an agency.
Money must follow the person as he/she moves to employment. An example was given of a program that places a priority on using its limited transportation funds to support competitive employment instead of transportation to the center. Funding that the individual needed to support employment was redirected to fulfill that support need. As focus changes from workshop support to job development and employment, money needs to be redirected to support those activities.
Use a 30-day placement plan approach. Developing a 30-day placement plan works to focus on short-term steps to support an individual’s move to employment. The plan can include outreach to families, networking, marketing with employers; functional community assessments to help clarify and solidify job goals and individualized job development. Planning helps keep focus on direct relationships between career development and employment outcomes – time spent meeting with and getting to know the needs of employers yields jobs.
Build on mentor model used in T-TAP. The mentor model used in the T-TAP project demonstrated its potential to support organizational change. Without mentor support in some of the organizations that received T-TAP technical assistance, the organizational change goal seemed too overwhelming. The mentor supplies balance in working with administration and staff in organizations undergoing change.
Create incentives for organizational change. Community rehabilitation programs could "self-correct" to provide customized employment if they were paid appropriately to provide that service. It is a business risk to change without financial supports.
Create and disseminate information on business plans for organizational change. The business and financial risk involved with organizational change was mentioned frequently. Business planning is critical in the change process. Training and resource guides around business planning for community rehabilitation programs are needed.
What Next Steps Are Needed to Expand Support for Customized Employment at the State and Federal Level?
State government could impact employment outcomes significantly by implementing an "employment first" policy. This would include establishing a clear message with expectations and accountability measures. In addition, states could create financial incentives to promote change at the organizational level. Nurture the leaders, the pockets of people trying to change. State agencies should not take "no" for an answer in terms of organizational change that supports an employment first goal.
Establish conversion grants to provide funds that help support the organizational change process. Grants can serve as conversion support to help programs redirect staff and resources to support customized employment.
State vocational rehabilitation and Mental Health/Hygiene Department in Maryland are jointly participating in a grant-funded initiative for evidence-based practice demonstration model on employment of persons with severe mental illness. Interagency agreements are being developed that break down eligibility barriers and streamline services to expedite movement to employment. Higher rates are being paid to community programs that follow employment model. The Maryland initiative is part of a multi state project funded by a grant from the Johnson and Johnson Foundation.
Develop funding designs to reward customized employment. Funding incentives to achieve specified employment outcomes can be effective. Indiana has created a change in funding policies to include performance-based incentives to develop person-centered plans for consumers as well as to focus on job retention. As a result, programs put more focus on both areas, and job retention increased. Another example can be seen in the ODEP Customized Employment grants. These grants have helped to generate new state policies that support customized employment. For example in Georgia, the Medicaid Waiver allows more flexibility in employment services. VR policies have been rewritten to support resource ownership. VR now pays for vocational profiles. In Florida, customized employment is being written into the VR policy as a billable service.
Organize efforts that focus attention on interstate cooperation. For example, the Institute for Community Inclusion is working with the National Association of State Directors of Developmental Disabilities Services to develop the Supported Employment Leadership Network. Thirteen states are working together to share information and strategies on how to systematically expand competitive employment.
Educate governors on the importance and success of customized employment. There is evidence that when governors understand the importance of employment for people with disabilities that they will be proactive in supporting it. For example, New Hampshire is serving as the lead state and the governor uses political pull with peers to move ahead with the National Governors Association. The intent is to work with ADD and CMS on how to institute and sustain Supported Employment.
State and Federal agencies interested in customized employment must promote leadership. Leadership has two components. Leaders are needed at the state level, such as the MR/DD/MH Directors and their counterparts at VR and Workforce Development. There is a need for state level and regional institutes to educate them on customized employment. Leadership development is also needed for emerging leaders at the organizational level and for new staff coming into the field.
Papers are needed that disseminate information on state and federal strategies. There is very limited information in the professional rehabilitation literature on state and federal strategies to enhance the use of customized employment. Four to five solid papers are needed to affirm the credibility of CE that provide examples of state and federal successes in enhancing use of CE.
ODEP needs to disseminate data on use of customized employment and work to influence federal policy. House and Senate bills on workforce development have a lot of disability language. Potential for federal initiatives in CE exist in coming years. ODEP can work to influence federal direction and policy.
Infuse the definition of customized employment into key legislation and federal and state policies. It is important for key federal and state funding agencies to recognize and support customized employment. This includes The Rehabilitation Act; the Home and Community Based Medicaid Waiver; the Developmental Disabilities Act; and the Workforce Investment Act. Each of these key pieces of federal legislation impact funding of employment services. Although there was some caution among the group about the timeline involved in the legislative change process, there was agreement that customized employment needs to be brought into the funding stream of these key legislative authorities. ODEP has the ability to look at terms and policy changes that would enhance employment outcomes and should explore the possibility. For example, an administrative mechanism that would allow RSA Commissioner and principle players to include the term customized employment legislation is needed. The same is true for CMS. It was noted that many of the Medicaid Infrastructure Grants include references to expanding use of customized employment.
Support research and demonstration grants on best practices in customized employment. The National Institute on Mental Health has funded a series of grants to research effective practices in the employment of persons with severe mental illness. From that research has come well-defined, credible package of evidenced based practices, including a fidelity scale to measure level of implementation of the employment model. The same type of initiative is needed for customized employment, including the development of a CE fidelity scale.
Expand funding for United-We-Ride and other transportation initiatives. Transportation continues to be a major barrier to employment for many individuals. The United-We-Ride Initiative has potential, but funding is very limited at present. Funding for this and related transportation initiatives that focus on employment of persons with disabilities needs to be expanded.
Form and support coalition of like-minded people around customized employment. Leaders need to craft a strategy that would bring together a coalition of people to focus on national implementation of customized employment. APSE could serve as a coalition vehicle.
Section II provides the details regarding T-TAP's accomplishments. Virginia Commonwealth University and the Institute for Community Inclusion successfully met the goal established for the T-TAP project in our original proposal. This goal was defined by four specific objectives that guided the project activities. The following section will use these four objectives to organize the project's accomplishments.
II. SPECIFIC GOAL TO BE ACCOMPLISHED DURING THE GRANTGoal: Assist providers in evolving their programs to provide integrated employment outcomes (i.e., non section 14 (c) employment) and to increase wages of people with disabilities who are currently working at less than minimum wage through the use of customized employment strategies and individual choice.
Objective #1: Develop and implement training at the programmatic and systematic levels that promote change from segregated work and non-work options to integrated employment based on customer choice.
Objective #2: Provide on-going coaching and technical assistance to a total of 20 providers utilizing 14 c certificates and WIA partners over 5 years.
Objective #3: Act as a central locus of information and expertise on customized, community-based employment for people with disabilities.
Objective #4: Conduct policy studies conduct evaluation of project activities and collect and analyze policy related information to increase integration, customized employment, choice and wages for individuals with disabilities.
Accomplishments Objective #1: Develop and implement training at the programmatic and systematic levels that promote change from segregated work and non-work options to integrated employment based on customer choice.
During the five years of the project, staff members were involved in actively providing training and resources to promote change from segregated work and non-work options to integrated employment. This included providing regional trainings funded by the project, participation in trainings sponsored by other agencies and national organizations, and the use of online distance education strategies. Distance education opportunities included live web casts, recorded online seminars, and web courses that could be accessed at any time from the convenience of a participant's home or office computer. All of the intensive technical assistance sites were provided access to the T-TAP training events free of charge. A nominal fee was charged for participation by other agencies to further the mission of the project. Over the course of the project, the use of the project's resources gradually increased as more and more agencies took advantage of the opportunities offered. Specific details follow.
Live Webcast Series: T-TAP offered a minimum of six live webcasts in years 1, 2, 3, and 4 of the project funding. In year five, webcasts were not offered due to a decrease in funding. However, the intensive TA sites were offered free access to the live webcast series funded by VCU's CRP-RCEP. At the end of each project year, a CD-ROM was developed that contained all of that year's webcasts. These were disseminated to the project mentors, to the TA sites, and to individuals who attended training events that were sponsored by T-TAP or at events attended by project staff. The events for each year and the number of participants registered for the live events are in the following tables.
YEAR ONE: T-TAP WEBCAST SERIES
Organizational Change Strategies & Conversion
Suzanne Hutchinson, Tri County Tec / (T-TAP mentor)
Marketing and Job Development
Karen Flippo, VP of the Brain Injury Association of America