Organizational Change From Facility-based to Community-based Employment Services

1. Organizational Change From Facility-based to Community-based Employment Services Pat Rogan, Ph.D. Indiana University October 4, 2013

2. AGENDA • Introduction & current status • Critical features of states with high employment outcomes. • Organizational change processes & outcomes • Strategies & tips to address barriers • Q & A • Resources & contacts

3. Why Have Organizations Changed from Sheltered to Integrated Employment? • Leadership within the organization (“It’s the right thing to do.”) • People receiving services dissatisfied (Most want a job.) • Poor quality services & outcomes of sheltered facilities (“make work”, low wages, artificial setting; poor models) • Push from federal and state agencies • RSA (no funding for workshop placements) • Olmstead (“Most integrated setting”) • Employment First initiatives

4. How Are We Doing? • 27% of people with IDD in integrated jobs • Increased segregation + non-work community activities. • >625,000 in sheltered facilities earning subminimum wages. • The rate of movement from sheltered to integrated work: a mere 1-5%. State Data 2012 (Butterworth et al. ICI)

5. How are we Doing? • Medicaid spends 4X more money on segregated adult day programs than supported employment. • No preference for integrated employment within the Medicaid program. • Migliore 2007 – 63% of people with disabilities would like to work outside the facility.

6. Top Tier States • Washington • Oklahoma • Vermont • New Hampshire + Growing Number of “Employment First” States

7. Critical Features of States • Positive philosophy, policies, & adequate funding • Capacity building & advocacy efforts • Strong, consistent leadership • Data based decisions • Employment First policies & systems change initiatives

8. Understanding What to Change The Organization

9. Lessons For Organizational Change (Butterworth et al – T-TAP Mentor Guide)

10. Establish Clear Goals • By June 2014 we will place 40 people in individualized and integrated jobs that pay at least minimum wage average 20 hours per week. • By October 2014 we will cease all new entries into our sheltered facility, and cease all backfilling.

11. Clearly Communicate Expectations & Often! • Newsletters, website, presentations, etc. • Does your organization’s name convey your focus on employment? • Does your language focus on individuals’ capacities vs. deficits? • Celebrate successes!

12. Reallocate & Restructure Resources • Flatten the organizational structure • Unload “sunk” costs (buildings, equipment) • Restructure job descriptions • Empower front line staff (“community builders”) to make decisions. • Focus on staff development & mentoring.

13. Find Jobs One Person at a Time

14. Effective Employment Strategies Positive Community Services • No need to “get ready” - Teach in community. • Person-centered planning – Capacity search. Traditional Services • Focus on readiness • Move through the continuum • Deficit-based voc. evaluation

15. Effective Strategies (cont.) Community Services • Individual orientation • Design supports around person • Tap generic services & natural supports Traditional Services • Group orientation • Fit to programs • Human services orientation • “Special” services

16. Develop Partnerships • Engage key stakeholders from the start: • Parents • Board members • Case Managers • Funders • etc • Develop external partnerships: • Voc Rehab & DD • Community Living orgs • Business Leadership Network (BLN) • Benefits planning (BPAO)

17. Major Barriers & Tips for Change • Negative attitudes • Funding • Lack of expertise • Lack of leadership • Transportation • Safety net

18. Innovations in State Waivers • Vermont: Waiver is a model for managing supports for participants. • Connecticut: Flexible in terms of individual budgeting and self-determination. • Washington State: 4 Waivers are tailored to individual needs. • Indiana: One of 16 states with Supports Waivers, emphasizing employment, support brokers, financial management services and person-directed goods and services. Braddock et al, 2013

19. Tips from Those Who Have Been There • Involve all levels in discussion of vision & values. • Invest heavily in training. • Use the vision & inherent values to evaluate everything. • Communicate, communicate, communicate! • Use individual planning for all…tie the agency’s success to your customers’.

20. Q & A

21. THOSE WHO SAY IT CAN’T BE DONE SHOULD GET OUT OF THE WAY OF THOSE WHO ARE DOING IT!

22. You’re Invited! 7th National Organizational Change Forum  A Time for Change... Sheltered Workshop Conversion October 22-23, 2013 Burlington, Vermont

23. Resources • Nancy Brooks-Lane @Cobb/Douglas Community Services Boards –(nbrooks@cobbcsb.com) • John Butterworth @ ICI Boston (John.Butterworth@umb.edu) • Bryan Dague @ U. Vermont (bryan.dague@uvm.edu) • Suzi Hutcheson @ Helping People Succeed, Inc. (shutcheson@hpsfl.org) • Don Lavin @ Rise, Inc. (dlavin@rise.org) • Pat Rogan @ Indiana University (progan@iupui.edu)