Perspectives in Policy: Perspectives on Employment

Issue 5, 10/1/2013

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Articles in This Issue:

Perspectives in Policy: Perspectives on Employment

In October, we will celebrate National Disability Employment Awareness Month amidst a growing sentiment that the participation of people with disabilities in the workforce needs to increase. Evidence of that sentiment has included communications from the Centers for Medicaid & Medicare (CMS), the federal authority for Medicaid and decisions by the US Department of Justice that the integration mandate of the Americans with Disabilities Act (ADA) applies to all public services, programs and activities; “including segregated, non-residential employment and vocational programs such as sheltered workshops.”

This year, the Department of Justice (DOJ) continued their investigation of the use of facility based employment such as workshops. In a settlement agreement with Rhode Island and the City of Providence, the DOJ found that schools that used sheltered workshops for students discriminated against those students because they “cultivated, trained and prepared students to work at (the sheltered workshop) as adults.” The settlement agreement stated, “individuals served by the facility are to receive supported employment and integrated day services with the expectation individuals will work, on average, in a supported employment job at competitive wages for at least 20 hours per week.”

Conversations continue about the 75 year old practice of work services that allow people with disabilities to be paid subminimum wages for extended periods based on their productivity compared to those without disabilities. Though the original intent was to make jobs available for people who might not perform at the same rate as those without disabilities, workers received low wages, sometimes a few cents an hour, and had limited opportunities to develop skills or move into other areas in which they might be more successful. The US Senate’s Health Education, Labor and Pensions Committee included, in its reauthorization of the Workforce Investment Act, a plan to establish requirements that must be met before individuals with disabilities could be allowed to work for less than the federal minimum of $7.25 per hour. Some state and national advocates agree. The Association for Persons in Supported Employment says the practice results in a segregated work force and implies that a worker with a disability does not deserve minimum wage protections. Others including some providers and parents say the subminimum wage creates meaningful job opportunities for people with disabilities who don’t have other opportunities to work and make money. Regardless of the perspective, this is a practice that will likely be discussed and addressed by Congress this year.

Shifting the way employment services are delivered is not necessarily something providers object to doing. Many have recognized the need to consider how current services prepare, or fail to prepare, Iowans with disabilities to be productive, contributing members of their communities. However, the shift to other more individualized approaches will require adequate numbers of qualified staff and other resources including funding.

There are currently two federally funded projects supporting employment service providers in Iowa to test new methods to prepare, place and provide ongoing supports to clients they had previously considered unemployable. Twelve of the 30 clients in the program are now employed in community-based jobs. But, also important is the data that participating providers have collected and are using to inform decision makers and funders about the time, expertise and other resources needed to achieve the desired employment outcomes. This information is being used by the Department of Human Services and Iowa Vocational Rehabilitation Services in conversations with stakeholders to develop service definitions and reimbursement rates that support a shift in public funding from facility based to community based services. This issue of Perspectives in Policy includes information from the Department of Human Services on their work and perspectives from two employment providers; one has provided only community based employment services and another is adding a new option to its array of employment services for individuals with disabilities.

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Scott Witte, Hope Haven, Inc.

Scott WitteMy Choice Employment……a new service of Hope Haven, Inc.

Work is an integral part of our lives; we draw meaning, value, and a sense of contribution from our jobs.  Hope Haven, Inc. has provided employment services in northwest Iowa for over 45 years, assisting people with disabilities in achieving their dreams, desires, and aspirations.  Choice in employment has been emphasized, with some working in sheltered workshops, some in integrated settings, and some in a combination of both.  Hope Haven believes all work is good, and all people can, and ought to work.

Momentum is growing at the national and state levels to realign service and funding systems to support “Employment 1st” principles, which make integrated, competitive employment in business and industry the first and preferred outcome for people with disabilities.

To align with Employment 1st principles and increase the number of people with disabilities who obtain and maintain integrated, competitive employment, Hope Haven has established My Choice Employment.

To implement My Choice Employment, Hope Haven will:

1) Establish My Choice as a distinct service department; separated physically, fiscally, and organizationally from its facility based programs.

2) Create a new management position – Employment Services Manager; hire this position to be exclusively devoted to develop and implement the My Choice Employment model.

3) Establish office space that is not located in nor alongside of existing Hope Haven facilities so as to reduce pre-conceived perception of the ties to facility based employment.

4) My Choice Employment staff will be distinct from those working in facility based employment locations. In addition to the Employment Services Manager, My Choice Employment positions will include Employment Specialists and Vocational Instructors (Job Coach); numbers of each will be determined by demand.

5) All new referrals for Hope Haven Employment Services will enter through My Choice Employment to ensure Employment First approach is utilized.

The three keys to successful implementation will be payment rates that cover service costs, employer development, and a shared commitment to increasing – not reducing – employment choices.

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Marcy M. Davis, Candeo

Iowa is embarking on a very significant change with regard to employment services for individuals with disabilities and it is an emotional topic. It may help to first understand a small bit of history. For many years Iowa providers have been supporting individuals with disabilities to work in sheltered workshops at sub minimum wage. Sheltered work exploded in the late 1970’s and at the time it was a revolutionary service and a great advancement from the institutional living with no vocational experience or activity. For the first time ever some of these individuals earned some income and began to work and contribute to society. Today we get the opportunity to raise the bar and increase our expectations for people with disabilities.

As a society we have learned from our peers with disabilities that they have so much more to offer and they wish to contribute to the work force just as much as anyone else. This is a perfect time to move forward and reach the next level of achievement.

Integrated employment – one person, one job, at minimum wage or above is the desired outcome and our peers with disabilities can achieve this goal with   supports like any other goal. I have personally both employed individuals with disabilities and supported a number of individuals to achieve integrated employment in the community and am always pleasantly surprised to see them grow faster and more than I had imagined. Not every placement is successful but you and I have to change jobs and our peers with disabilities should be allowed to change jobs as well. People without disabilities are fired or make mistakes on the job and so will employees with disabilities. This should never be an excuse to take away the opportunity of integrated employment.

I am saddened to say our peers with disabilities are only held back by our own fears, inability to recognize or value their contribution and our inability to see past a barrier. Integrated employment is achievable for every person regardless of disability – it only requires that we get imaginative, creative and flexible. As support professionals, family members, employers and friends we need to work on our own attitudes first (I speak from my own growth experience) so we can support our peers to obtain integrated employment. It is time we accept the statistics that have been presented to us that our peers with disabilities can contribute to our workforce, are reliable employees, and are worth minimum wage and more and they belong beside us in the workplace.

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Lin Nibbelink - DHS - Division of Mental Health & Disability Services


The Iowa Department of Human Services (DHS), the Iowa Department of Vocational Rehabilitation Services (IVRS), and the Department for the Blind (IDB), in partnership with the Iowa Coalition for Integrated Employment (ICIE), have engaged employment service stakeholders in the process of rebalancing Iowa’s disability employment services. Iowa is currently spending 80 percent of the Medicaid dollars on facility based services and only 20 percent on integrated community employment.

The goal of this effort is to expand the array of employment services available to Medicaid ID and BI waiver and Habilitation services members throughout the state, and increase the number of members who are employed in integrated community based jobs. To accomplish this we are reviewing and updating the service definitions, the provider and direct service staff qualifications, and the funding methodologies. DHS released a “Stakeholder Brief” regarding the rebalancing of Iowa’s employment services funding and policy system and a companion “Building   Provider Capacity” study, which can be seen at

One hundred fifty two (152) people attended one of five public forums held in early June throughout Iowa to solicit input and feedback from a diverse group of stakeholders. Out of that process an intensive workgroup of providers, county representatives, family members, and funders was formed to delve into Medicaid employment service definitions, capacity building, and shifting the balance to encourage integrated community based employment. This workgroup has been meeting since early July with technical assistance provided by national subject matter experts (SMEs) affiliated with the U.S. Department of Labor Office of Disability Employment Programs (ODEP) and the State Employment Leadership Network (SELN).

This work will continue in the year to come and include continued collaboration with IVRS, IDB, and the ICIE.

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National Disability Employment Awareness Month

National Disability Employment Awareness MontOctober is National Disability Employment Awareness Month, and all Iowans are encouraged to participate. The purpose of National Disability Employment Awareness Month is to educate about disability employment issues and celebrate the many and varied contributions of America’s workers with disabilities.

ID Action will be sharing the employment stories of Iowans throughout the month. Go to to hear their stories. ID Action will also be conducting the Take Your Legislator to Work Campaign. If you have great things to say about your job and an important message for legislators call us at 866-432-2846, email us at or go to to find more information and get involved!

Gov. Terry Branstad and Lt. Gov. Kim Reynolds, in conjunction with Sen. Tom Harkin, will co-host a forum on “Empowering Individuals with Disabilities through Employment” on October 17, 2013. “This event will explore avenues to enable all Iowans an opportunity to contribute in the workplace and to help create jobs and grow family incomes throughout our state,” said Lt. Gov. Reynolds. “We look forward to learning from business leaders who have established best practices for training, hiring, and retaining individuals with disabilities as an important part of their strategy to improve their business’s bottom line.” The event will take place from 11:00 a.m. to 1:00 p.m. on Thursday, Oct. 17 at the FFA Enrichment Center in Ankeny. For more details, please visit

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