Community: Status and Outcomes of People with IDD in Integrated - - PowerPoint PPT Presentation

Working in the Community: Status and Outcomes of People with IDD in Integrated Employment

Dorothy Hiersteiner: HSRI dhiersteiner@hsri.org John Butterworth: ICI UMass Boston John.Butterworth@umb.edu

National Core Indicators (NCI)

Agenda

• NCI
• Sample
• Results
• Policy Implications
• Questions

National Core Indicators (NCI)

NCI State Participation

HI WA AZ OK KY AL NC PA MA TX AR GA NM NJ MO NH OH* IL LA NY Wash DC FL CA* SD OR MN UT CO KS MS TN SC WI MI IN VA DE MD

New in 2015-16 New in 2016-17

CA*- Includes 21 Regional Centers OH*- Also includes the Mid-East Ohio Regional Council

As of 2016-17: 46 states, the District of Columbia and 22 sub-state regions

ME

VT CT RI WY AK NV ID NE MT ND IA WV

2014-15 National Core Indicators (NCI) Adult Consumer Survey

• 25,820

adults

• 33 states

NCI Offers Unique View

• Individual characteristics of people receiving services
• The locations where people live
• The nature of their experiences with the supports that

they receive (e.g., with case managers, ability to make choices, self-direction)

• The context of their lives – friends, community

involvement, safety

• Health and well-being, access to healthcare
• The activities they engage in during the day including

whether they are working

National Core Indicators (NCI)

Goals of NCI

• Document the effect of services on the day-to-day lives of the people

who receive them

• Document the experience of program participants
• Manage service delivery and improve policy and practice
• Track key performance goals and outcomes
• Assess the impact of regulatory activities on individual experience
• Respond to the demands of consumers and families for information on

system responsiveness

• Assess the impact of financial actions

National Core Indicators (NCI)

What do NCI Data show about employment?

National Core Indicators (NCI)

Sample

• 2014-15 National Core Indicators (NCI)

Adult Consumer Survey

• 25,820 adults from 31 states, Washington,

D.C. and one sub-state entity

• Excluded people under 22 in public school
• 23,321 remained in sample

The numbers presented in this presentation may differ slightly from those found in the NCI Adult Consumer Survey report. The report demonstrates the average of state averages, while this presentation demonstrates the average of all respondents.

Residence type

37.2% 31.1% 9.5% 14.7% 7.5%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Parent or Relative's home Group home ICF Independent home/apt Other

National Core Indicators (NCI)

What do people do during the day?

14.8% 19.0% 19.9% 43.7% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Integrated Employment (N=22,527) Unpaid Community Activity (N=22,064) Paid Facility-Based Work (N=22,181) Unpaid Facility-Based Activity (N=21,924) National Core Indicators (NCI)

40.4% of people in Paid Community Job were also reported to take part in at least one other kind of day activity or program

People's daily activities by residence type

• People in ICF

(59.5%) and group home settings (54.9%)were more likely to participate in unpaid, facility- based activities

• People in

independent homes were the most likely to have paid community jobs (27.8%) and those in ICF least likely (3.5%)

National Core Indicators (NCI)

3.5%

11.2%

27.8%

15.2% 18.2% 10.6% 10.7% 17.6% 18.1% 20.2% 36.9% 12.5% 20.9% 22.8% 19.7% 18.5% 13.5% 17.0%

59.5% 54.9%

22.8% 39.2% 43.8% 32.3% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% ICF or Specialized Institutional Setting Group Home or Agency Operated Apartment Independent home/apartment Parent/relative's home Foster care/host home Other Paid Community Job Unpaid Community-Based Activity Paid Facility-Based Job Unpaid Facility-Based Activity

Who has job, wants job, job goal

National Core Indicators (NCI)

State Variation

National Core Indicators (NCI) 41.7% 4.5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% CT VT NH CO SD MN OK SC IN ME UT LA TN DE PA OH CA NY MI KS MEORC NC GA AR IL VA TX MO FL KY DC NJ HI

Percentage in integrated community employment

Average: 17.0%

Only people living in the community are included in the rest

• f this presentation.
• -Group homes and agency-operated apartments
• -Independent homes or apartments
• -Parents’ or relatives’ homes
• -Foster care/host home.
• -Total number of people remaining in the data is 20,464.

National Core Indicators (NCI)

Community Based Employment Support:

• An individual job without supports (competitive)
• An individual job with supports (individually supported)
• Group supported

Types of employment support

N Per ercentage of

• f 20

20,464 Per ercentage of

• f to

total nu number in integrated em employment (N (N=3,1 ,185) In In integrated em employment 3,185 15.6% 100.0% In In individual l job

• bs

1,730 8.5% 54.3% Com Competitiv ive em employment 821 4.0% 25.8% Ind Individ idually su supported 909 4.4% 28.5% In In gr group-supported 770 3.8% 24.2% Type of

• f em

emplo loyment su support no not t spe specified 685 3.3% 21.5% Independent home/apt: more likely to have individual jobs (competitive or individually supported)

Hours and Wages

• Paid community jobs
• Worked 30.16 hours in a two-week period
• Earned $225.59 or $7.71 per hour

National Core Indicators (NCI)

Hours (in two weeks) Wages (in two weeks) Hourly wage In Competitive 30.58 $266.80 $8.66 In Individually supported 26.34 $226.75 $8.76 In Group-supported 32.05 $186.62 $6.02

Types of jobs

Food prep and service Building and ground cleaning/ maintenance Retail In competitive 28.1% 20.5% 22.0% In individually- supported 23.6% 27.5% 22.9% In group- supported 7.7% 44.7% 11.3%

National Core Indicators (NCI)

Satisfaction

National Core Indicators (NCI)

91.3% 91.7% 91.7% 25.6% 28.8% 34.3% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Competitive Individually-supported Group-supported Likes job Would like to work somewhere else

American Community Survey

1970s

Supported Employment

1980s

1990s –2000s

ADA Rehabilitation Act Amendments IDEA TWWIIA Workforce Investment Act CMS

Customized Employment

Policy Influences CMS Employment Guidance CMS Settings Rule Department of Justice WIOA Federal initiatives ACL, DOL, SSA

• APSE. (2014). Employment First Across the Nation: Progress on the

Policy Front. Policy Research Brief. RRTC on Community Living University of Minnesota, 24(1).

Employment First Efforts

Any activity Formal policy

50

Employment and Day Supports IDD Agencies: Nation

100,000 200,000 300,000 400,000 500,000 600,000 700,000 1990 1993 1996 1999 2004 2008 2014

Total Served Integrated Employment

Source: ICI National Survey of State IDD Agencies

115,557 605,301

Employment and Day Supports Facility-based work

0% 50% 100% 1988 1993 1999 2004 2009 2014

49.1% 18.8%

Source: ICI National Survey of State IDD Agencies

CMS feedback to Kentucky

States cannot comply with the rule simply by bringing individuals without disabilities from the community into a setting; compliance requires a plan to integrate beneficiaries into the broader community.

26

Participation in integrated employment services varies widely

0% 20% 40% 60% 80% 100%

Source: ICI National Survey of State IDD Agencies 2014

High-Performing Framework

Holistic view

Federal Policy Community & Labor Market Workplace State Policy & Strategy Community Rehabilitation Provider Practices Individuals & Families Employment Supports Individual Employment Outcomes