Employment First Pilot Project Summary Report

  

Training Feedback

  • Service system was greatly enhanced by training with Ellen Condon and materials that were supplied.  Especially helpful was to observe interactions between Ellen and consumers/families in the community.
  • Opportunity for staff to attend state and national conferences was greatly appreciated.  Did not effectively use the webinar programs and would like to have had a better way for the collective practice to improve.  Somewhat overwhelmed by all of the resources available and we were not able to use them as effectively as we should have. 
  • ODEP material and website has been shared and is being used by various staff.
  • Need to expand job development training to other staff and include all members of the team.
  • The live or in person training was the most effective.
  • Would be interested in matching our involved staff performing customized employment with staff doing the same from another organization.

Customized Employment Feedback

  • It is a critical model to move people with the most significant disabilities to integrated employment.  Integral to our system transformation also.
  • Discovery and Customized employment activities need to be integrated into all of our employment services.
  • Like the process as it encourages active engagement by consumer, families and team members
  • Challenge was staff capacity and push back from staff still performing segregated group activities. It was a change to get them out of their comfort zone considering individual, integrated community services.
  • It was a great benefit to have a specific IVRS Counselor assigned to the project.  Staff trained together and laid a positive foundation for their work locally.  We held regular meetings.
  • Implementing Discovery techniques into traditional job development provided effectiveness.
  • Involvement of client’s family and paid support from the beginning was a positive difference. Provided a more cohesive team. 
  • Difficult to judge time allowed for Discovery as it varies between individuals.  Might be interesting to determine range of time and number of barriers to identify if there is a correlation in Discovery with amount of barriers.
  • Provided an opportunity to look at an individual in a way we have never done before. 
  • We did not use the task analysis form for assessing an employer’s unmet needs.  Businesses are doing more with less so we found that it is better to do labor market research and understand the business prior to going in.
  • Loved Discovery.  Phases are somewhat confusing, we rolled up into Discovery. 
  • Participation in the project changed our approach to business development. We don’t have to wait for an advertised job.  Whole new world opens up. 

Systemic Barriers to Customized Employment Implementation

  • Current state-wide service system is geared for group services.
  • Customized Employment is intensive, expensive level of service, exploring opportunities for group discovery could be beneficial.
  • Staff attitudes and comfort levels were a barrier to implementation.  Should be ways to assist staff and consumers in segregated settings to remain viable.
  • Need to build employer awareness and education to improve understanding of customized employment
  • Transportation that is reliable
  • Not everyone believes that everyone can work
  • Lack of benefits planning
  • Sheltered employment is easier adjustment for family schedules 9-5, M-F
  • Transition – no plan is set up.  Need to establish realistic expectations as part of transition plan.
  • Problems with keeping families involved after Discovery and during job placement. They don’t want to burden friends/employers.
  • Increased reports and processing to manage funding is difficult and time consuming.
  • Can “onboarding” be streamlined?  Everyone has their own intake and onboard process.
  • Need to connect transition students prior to graduation.  Needs to be seamless.
  • More upfront training needed
  • Staffing levels are barrier to conducting Discovery with any sense of regularity and success. We have had staff turnover, which causes everyone including our clients to adjust. 
  • Staff have not been comfortable moving toward new service delivery and some fought the pilot project as just an experiment.  Staff like to control the process versus letting the information obtained from the job seeker guide them through Discovery. 
  • Discovery is not job carving.  It involves looking at skills and talents a job seeker can contribute to an employer.  The issue of job ready skills and behavior is a repeated conversation staff have – in hindsight, more upfront training and involvement with the SME with staff to dispel myths and to facilitate discussion would have been helpful.
  • Ongoing issues with some case managers not understanding current service descriptions and funding for supported employment, resulting in delays of service
  • Building a visual resume was a challenge and time consuming.  Questions on the real benefit vs. the time it takes, whether business understands it and knowing who and how to use it.  
  • Sometimes there are too many cooks in the kitchen.  Need clear defined roles. Employment is about relationships – allow time and opportunity for those relationships to be developed and not crossed over by to many people contacting the business.

Systemic Barriers impacting employment services delivery success

  • Case flow of referrals from IVRS waiting list is a problem.  We seem to get waves of referrals at one time.
  • Employment system seems to start with segregation and we need to reverse.  Value seems to be in community assessments and evaluations. 
  • School systems still refer to segregated settings, may not have the capacity for individual, community based support.
  • Need improved skills set training to build on transferable skills.
  • Many struggle to retain their jobs even with job coaching.  We get referrals to add a job or find a better job.
  • Mixed messages regarding piece rate options from county providers.
  • Time it takes to find a job – expectations sometimes are not realistic
  • Transitioning from human service perspective to salesman perspective is not easy. Need to know business jargon, not human service jargon.
  • Misconceptions regarding the role of job coaches – need transition to natural supports
  • Sharing of medical information was a problem due to HIPAA regulations. Would be nice to have a “team release” that would effectively communicate among the players.
  • Social skill development on our job candidates is an issue.  It is being taught on the fly, usually on the job, but a more organized process and strategies would be an asset. 
  • If funding goes to 100% IVRS, not everyone who should be in customized training will be due to VR eligibility criteria.
  • VR staff are not familiar with d-code services and often don’t use community assessments, career exploration or job shadows.
  • Struggle between Day Habilitation Services and Supported Employment Services.  Additional TA on transformation is needed.
  • Work site assessments have been difficult to arrange, with employers citing liability as a reason.  Need improved understanding of how to market this.   
  • Lack of knowledge and experience in self-employment for job seekers
  • Difficulty in finding job coaches who are available for flexible work hours that are required to support individuals on the job. 
  • Funding to support services
  • The length of time it takes for state programs to make eligibility decisions and authorize service impacts timely delivery.
  • One assigned staff person appeared to work better with consumers than a group, diversified approach. Problems with staff turnover.
  • Asking questions through Discovery is a good thing. 

Pilot Project Results

  • Individuals participants had significant barriers to employment and had not been previously successfully employed in the community. 
  • Consumers, families and staff felt satisfied due to improved engagement and participation.
  • Customized employment was integrated into our service delivery system.
  • Clients are truly known by staff and have no doubt that this will lead to a better, long term employment for the individual. 
  • Job seekers, families, staff, and referral sources have positively responded to Customized employment.  Job seekers who had previously worked in sheltered employment have appreciated and enjoyed the opportunity to explore integrated, community employment.  The Discovery process is seen as effective in uncovering skills and interest to help in job negotiation.  Staff have a new found spark and enthusiasm as they respond to the engaged job seekers
  • Ten candidates are now working.
  • These participants had no successful community, integrated competitive work experience.
  • Four are working a minimum of 20 hours a week.  Two at 16 hours a week.
  • Average hours are 13.9 hours a week.
  • Wages per hour on average:  $7.65.

Service Reimbursement Success

  • Braiding funding is a positive thing
  • IVRS Menu is a model that should be used for other regions – we were effective with it in our region.
  • Also found ways to use prevocational and habilitation funding for some Discovery when IVRS funding was not available.
  • Combination of Waiver, VR and placement fee through the County was adequate, but keeping track of all the funding streams and billing was cumbersome and time consuming. 
  • Success with getting funding for Community Assessments and Career Explorations but not for job shadows.  Many of the funded activities did not allow for full Discovery, because it gave no full picture of a person’s life experiences or opportunity to investigate more in depth. 
  • Job Development and Employer Development were used and funded
  • Lots of variance between VR d-codes between area office supervisors. 
  • Discrepancies in VR regarding supporting job seekers between 10-20 hours and less than 10 hours – this caused confusion and delays.

Quality Practices

  • Advancing Employment First philosophy in Iowa
  • Using Discovery as a tool to find personal genius
  • Rebalancing our system toward integrated services
  • Stop providing segregated services to students transitioning to adult system
  • Developing sector based (time-limited) training opportunities that increase transferable skills
  • Involvement of Board of Directors for Job Development – getting ideas, expanding contacts.
  • Our organization structure identified issues with client hand offs.  We found advantages in conducting the Employer Survey at the initial meeting prior to asking employer to come in for second meeting to do the Job Site Survey.  Create a Hiring Proposal based off employer’s needs and connect them with the job seeker who is the best match.  Transition support from Job Developer to Employment Consultant slowly. Need to keep Job Developer in loop as challenges do arise at the workplace.
  • Developing strong relationships with client and family early
  • Going where the job is makes sense.  Focus on what an individual contributes to a work environment rather than having him/her compete with pre-existing job titles
  • Focus on small/local business
  • Networking vs. cold calling
  • Including natural supports is beneficial to the success and length of the Discovery and Job Development process
  • Following Profiles to guide service – forces the team to get to know someone so there is no stone left unturned. Provides for improved accountability.
  • Negotiation – not just meeting the job description, but negotiating job responsibilities.
  • Having one staff focus on customized employment was successful – now beginning to share with others.
  • Staff will be hired using a different method and outlining expectations differently.  Expectations for job development were identified in the interview and a list of resources to search and discuss in future interviews was provided.  The resources were gleaned from the Community of Practice Webinars.  This was a significant change from previous interviews and provided valuable information on our candidates. 
  • Have found ways to improve provision of Day Habilitation activities in the community versus in-house.  This is directly in line with the vision of our employment services team.  We are hopeful that this information can be used to influence our observation and information gathering and we need to figure out a way to capture the time as this is a step in the right direction for us.
  • Meeting with employers about unmet needs – directly related to helping six people get access to jobs and we are just learning the process.
  • Developing career interests, exploration and community exposure was helpful. 
  • We are committed to talking with businesses. Staff are assigned two new contacts per week.  Staff also visit with two people each week in the work center.  Gathering information on education, training, employment, hobbies, interests, passions, dream jobs and all of this information is entered into a data base.
  • Positive participation in all training provided which included: 
    • Initial two day APSE training and Customized Employment Process by SME
    • Monthly Community of Practice Calls
    • Regular Conference calls with Employment First, Iowa
    • Two on-site visits with contract consultants and SME
    • Grantee Roundtable for Iowa Employment First including meeting with ODEP evaluators
    • Ellensburg Conference attendees
    • Have also applied and approved for APSE Membership
    • Held monthly meetings to review grant progress
    • New strategic plan being developed to have strong focus on integrated employment.

Staff Development Needs

  • Technical Assistance on job development and effectively communicating with employers about customized employment
  • Additional training on microenterprise and the differences between self-employment
  • Consultation around organizational change and strategies to keep it moving forward
  • Marketing materials for success
  • How to apply Customized to different populations of disability
  • Learning about Assistive Technology, specifically for those with significant physical barriers
  • The opportunity to attend Ellensburg was special.  The ability to network with other professionals is inspiring. 
  • Job Development activities are not adequate.  Staff and families struggle with this and we have a weakness in our general methodology.  We are now more focused on job development during the interviews and getting the discussion up front. 
  • Amount of information was overwhelming.  Takes time to sort it all out.  Excellent training and participation in all available activities supported by Iowa Employment First was valuable.

Recommendations for rates

  • Retain outcome based payments, but provide an initial fee to cover up from job development activities
  • Rates need to reward and incentivize hours, higher pay
  • Job Coaching and extended coaching hours need to be incentivized to promote use of natural supports and reward successful efforts at helping transition job candidates to employment.
  • Overall rates for individual service need to increase and expand the use of technology Skype, Face Time…
  • Transportation needs to be factored into costs and delivery of service
  • Funding and documentation for services must be simplified
  • Interested in developing funding wheel through Nancy Gurney
  • Clear Discovery line in funding (includes Profiles 1-3)
  • Streamline
  • Activities with a start and finish date work well with outcomes. We don’t know how long it takes someone to find a job – hourly rates would be better.  Incentives could be built into rate. 
  • Funding for Discovery is essential – it is an added cost and a different service
  • Transportation rates need to be separated

Recommendations for future implementation

  • Streamline paperwork
  • Share successes
  • Increase staff competency around employment, continue with interagency staff training and dialog
  • Create a resource clearing house for customized employment
  • Clarify funding responsibilities between players
  • Find a way to help all job seekers access services at all levels in a timely manner
  • Keep caseload small
  • Continue with onsite training and TA
  • ICIE coordination of workshop transformation is important. It helps to hear from those that have done it.
  • Transition services need to be involved
  • This is a shift in culture.  Efforts should be expanded to allow additional providers participate. It takes time, effort and funding to move through the culture shift.
  • Need consistency in D-code interpretation by VR. 
  • Credentialed and professional Employment Specialists need to be prioritized.
  • Adequate training needs to be in place to help provider staff move through shift from traditional job development techniques to the individual approach of customized employment.
  • Job development and employer/business negotiation training across all providers.
  • Collaborative efforts need to occur to develop strategies on informing Iowa’s business and industry partners on the value and benefits of hiring those with disabilities while familiarizing them with Employment First Language. 
  • Special Education needs to re-focus efforts surrounding transition. Trainings in self-determination, self-directed career planning, building of work habits and soft skills necessary in employment and hands on work experience. Curriculum changes and consideration for how this applies to graduation credits.
  • Need to develop flexibility in service descriptions. Needs to shift to an approach that we will do what it takes to help the person be successful. Current system is to prescribing and narrow.
  • Funding an incentivized program and reflects a diverse range of functioning levels.  Consider outcomes of hours worked.  How to incentivize strong natural supports? Consider efforts from Wisconsin pilot project.

Future Sustainability

  • Need to make paperwork more manageable
  • Need help in reorganizing staff responsibilities to commit and align resources toward integrated employment. 
  • Lingering concerns about system and provider capacity
  • Use more community based work training and adjustment as a job development strategy
  • Concerned regarding how to build a system/structure within the agency that leads to sustainability.  Does one person get assigned, does everyone?
  • It will take time to evaluate all of the project results and consider long term success and how this process impacts results. 
  • Direct and indirect costs should be allowable costs.  Rates should allow professional Ba/MA staff to deliver employment services.  Job coaching can be done by Para professional staff level.  A funding mechanism that reflects a diverse range of functioning levels of job seekers, along with incentivizing CRP services providers based upon outcomes obtained, hours consumers work, in integrated community employment would go far in moving Iowa ahead in employment of people with disabilities and growth in the use of natural supports. 

Recommendations on Service Delivery Models

  • Should focus on student transition and early engagement
  • Ensure students have a paid employment or a community based work experience prior to graduation
  • Align county services with state and Employment First
  • Develop a common data and outcome reporting system
  • Reward and encourage innovation
  • Recognize that job growth has to start somewhere.  It may not be 40 hours a week, but let’s get started with something. 
  • Fees for service based on hourly payments for job development and job coaching need to occur. Job Shadows, Career Exploration, Community Work Site Assessments would be OK for outcome payments. 
  • Ensure staff professionals are held to high standards of service delivery
  • Provide as many services as possible in community
  • Provide service delivery improvement based on evidence based practices
  • Continue to find strategies for improving state agency, provider, business partnerships
  • Learned the importance of taking time to know the individual.  This changes the mindset from competing to contributing and has a huge impact on where energies are focused. 
  • Need assistance with broad/statewide marketing – Marketing is excluded from Medicaid cost reports.
  • Initial training program was good, but staff felt it was all about Discovery and it took us awhile to figure out the entire model.
  • On-line training library would be good. 
  • Need ideas on effective marketing of agency employment services including web presence.

VR Staff Feedback

  • Getting new providers for service delivery required providing lots of information on the VR process.
  • Exposure to work is a good thing.  Customized Employment is a valuable tool as it increases exposure to community employment.
  • Community involvement really helps.
  • Found I could be flexible and innovative applying the D-Codes.
  • Discovery got us out of my comfort zone and did lead to discussions creating different decisions than what I would have considered.
  • Created opportunities for job carving.
  • Partnering/communication is vital.
  • Created opportunities that were not available in normal job development routine.
  • Community assessments were valuable.
  • Would like further definitions and clarifications on who is appropriate for Discovery.
  • Each individual was different.  We already have lots of information available if we look at it in different ways such as RIOT, CBA/Career Explorations, and Job Shadows.
  • Participation in the project created forward thinking – our standard assessment does not necessarily apply.
  • Discovery should be considered as a place to start.  It will open up different doors. Another tool to be considered.
  • Great question was to consider what are the necessary supports for the person to work in the community.
  • We are all equal partners in the process