Partnership! – 1
Supported Employment
The seeds for independent employment for people with the most significant disabilities began in the 1950s and 1960s. Prior to that time, people with intellectual disabilities (and other developmental disabilities) were primarily restricted to sheltered workshops where they were limited to sub-minimum wage, paid by the piece work. It was essentially an environment where individuals were warehoused because it was assumed that competitive integrated work was not a viable option. For people with severe mental illness, it was assumed that work was not appropriate. The primary belief was that work would make their symptoms worse and it should not be considered. However, concepts like supported employment and transitional employment began as an earnest response to increase independence, inclusion, and opportunity. A move away from the community separation of day programs for people with mental illness and sheltered workshops for people with developmental disabilities was important. This movement created what is now an essential partnership between community rehabilitation programs and state vocational rehabilitation agencies and state developmental disability agencies.
John Beard, the founder of transitional employment in the Fountain House movement (clubhouse movement for people with severe mental illness), argued that work, real work, was both habilitative and rehabilitative. Work gives meaning to all our lives. It gives purpose. It provides opportunity beyond the restrictive limitations of Social Security Disability (SSDI) and Supplemental Security Income (SSI). Fountain House began their employment programs in the late 1950s and early 1960s. Employment was the focus. This is where I first became exposed to options for employment for people with disabilities.
I learned about transitional employment in the early 1980s and had the opportunity to begin transitional employment services in 1983 as part of a mental health center (which became Cirrus House in western Nebraska). Our first jobs were the usual suspects; janitorial services, fast food workers, and dishwashers. However, we were able to get other kinds of work including stockers in grocery stores, donut delivery drivers, client pick up drivers for mental health, and short order cooks. What was interesting was it did not matter what kind of work we found; our members were clamoring for the opportunity to get a job. Later, as a state vocational rehabilitation counselor, I supervised relationships with supported employment programs and transitional employment programs. It was clear then, and remains clear now, partnerships with community rehabilitation programs (CRPs) who provide quality supported employment services are essential to the success of state vocational rehabilitation (VR) programs and meaningful opportunities for people with disabilities.
Legislation
From a vocational rehabilitation perspective, the 1986 Amendments to the Rehabilitation Act of 1973 were foundational to the current community rehabilitation program movement. It specifically authorized funding for supported employment for the first time. Until this moment, CRPs and VR agencies struggled to find ways to fund supported employment. This financial support was crucial in expanding the availability of supported employment services across states and localities. The legislative changes underscored a shift towards promoting the integration of individuals with disabilities into mainstream employment settings. Supported employment programs were designed to facilitate this integration by providing necessary supports and accommodations tailored to individual needs. The Americans with Disability Act of 1990 was important because it provided a legal framework to prevent discrimination against people with disabilities in the workplace. The Workforce Investment Act of 1998, and later the Workforce Investment and Opportunities Act of 2014, expanded financial support and increased services for meaningful employment as part of supported employment. Other recent state and federal actions have called for the elimination of sub-minimum wages and sheltered workshops. The focus is on person-centered opportunities, choice, integrated employment in regular work environments, and work at prevailing wages.
Critical Partnership
What began as independent ventures in the mental health and developmental disabilities communities, has now become one of the most important partnerships to serve people with the most significant disabilities in vocational rehabilitation. Community rehabilitation programs serve both VR agencies and developmental disability agencies. In a sense, they are a cog in the middle supporting both agencies. They provide supported employment initiatives to get people started with the financial support of the VR agency and then serve as a partner with the developmental disabilities agency to provide long term supports. Without the critical roles provided by CRPs many people with significant disabilities would never get the opportunity to have competitive integrated, long term, stable employment. CRPs provide key services such as situational assessment, vocational evaluation, job development, job placement, job coaching, workplace supports, long term supports, and effective employer partnerships. They negotiate integrated work opportunities for supported employment in regular positions and they negotiate customized employment positions to fit the specific needs of the consumers they serve. They serve as the front line in an essential role for both the VR agency and the developmental disabilities agency. They are critical partners for the vocational rehabilitation counselor to provide successful services. More recently they have stepped in to help VR agencies successfully provide pre-employment transition services (Pre-ETS). In many cases, a vocational rehabilitation counselor could not effectively serve most of the consumers served by CRPs.
Although CRPs provide many services, there are two key types of employment that are critical to vocational rehabilitation agencies. Supported employment and customized employment drive successful partnerships with VR agencies. Supported employment is focused on existing jobs with competitive wages in integrated settings. CRPs use job developers to develop relationships with employers and job coaches to provide supports to help the individual be successful in the position. The job coach learns the position, trains the person, and remains connected to them at the job sight to ensure success and then gradually reduce the supports as the person becomes stabilized in the job. Although customized employment is like supported employment, it differs in that seeks to create jobs based on the strengths, interests, and skills of the individual with a disability, often by negotiating job responsibilities and conditions with employers. It is a process of individualized negotiation to design a job that meets both the employer’s needs and the individual’s abilities and preferences. It ultimately creates a job with tasks needed by the employer, but unique to the individual performing the tasks. Critical for both supported employment and customized employment is choice for the individual, person-centered supports, and focus on long term-success. Without supported employment and customized employment, many vocational rehabilitation consumers would not be able to go to work. CRPs partner with VR agencies and counselors, the employer, and the consumer for consumer job satisfaction and employer satisfaction with a job well done.
Other Key Players
There are other organizations that are important in the success of CRPs. The state developmental disability agency provides an alternative source of funding for the CRP through Medicaid (and sometimes county agencies). They serve as the source of on-going long term supports after vocational rehabilitation steps out of the picture. APSE (Association of People Supporting EmploymentFirst) offers professional development opportunities, training programs, conferences, and resources for professionals in the field of supported employment. This helps to enhance the skills and knowledge of service providers, job coaches, educators, and advocates involved in supporting individuals with disabilities in the workforce. They offer professional development opportunities, training programs, conferences, and resources for professionals in the field of supported employment. They are also key in driving national and state policy development to ensure Employment First options. They have created a credential for practitioners – Certified Employment Support Professional (CESP). The Institute for Community Inclusion is an important contributor. They provide essential training and supports to both VR agencies and CRPs. They have also created a credential to support the field through the Association of Community Rehabilitation Educators (ACRE).
A Partnership for Choice, Employment, and Independence
CRPs are an essential partner for VR agencies, and in particular, vocational rehabilitation counselors. They serve as a link between employers and consumers. They help individuals with significant disabilities, who might not otherwise have choice about work obtain competitive integrated employment. People with disabilities who are employed are less likely to live in a household that is below the poverty line than people with disabilities who are not employed. Supported employment leads to more competitive, higher-paying employment opportunities for individuals with disabilities, particularly intellectual and developmental disabilities compared to other job-readiness training programs. One study published in the National Library of Medicine found that between 40% and 60% of individuals enrolled in supported employment successfully obtain competitive employment, compared to less than 20% of similar individuals not enrolled in a supported employment program. In the end, CRPs and VR agencies build success for one another and most importantly for the consumers they serve.
