Issues and Trends in the Employment of People with Disabilities Mary Podmostko January 17, 2000 Introduction The decade of the 1990s in the United States may be described as a period of increasing awareness of the nation's growing diversity by social, educational, and business entities. The economic boom of the latter part of the decade and the resulting search for qualified employees for a global marketplace raised the profile of diversity issues in the job market as employers sought to grow and stay competitive. However, not all minority groups benefited from these trends to the same degree. At the end of the decade, people with disabilities still had significantly lower employment and income rates that the general population. This paper will examine some of the issues and trends in the employment of people with disabilities. The intent is to assist in the development of policy for people with disabilities which will lead to meaningful and more successful employment outcomes. Context Employment Statistics According to 1995 data compiled by the Census Bureau, the Social Security Administration, and Louis Harris and Associates (La Plante, Kennedy, Kaye & Wenger, 1996), there was a large employment gap for people with disabilities. These statistics show that of the 10.1% of the working-age population (ages 16-64) who had disabilities, only 27.8% had jobs, compared to 76.3% of people without disabilities. Given that 67.9% of people with disabilities did not participate in the labor force, the result was an unemployment rate of 13.4% for people with disabilities, compared to a 5.6% rate for people without disabilities. In other words, of the 16.9 million people with disabilities of working age in 1995, 11.4 million did not participate in the labor force, 5.4 million were working, and 723,000 were unemployed and actively looking for work. La Plante, Kennedy, Kaye and Wenger (1996) also identified an income gap for people with disabilities. Within the working age population of people with disabilities, 30.0% lived below the poverty line, compared to 10.2% of people without disabilities. Of those who were working, people with disabilities earned 63.6% as much as those without disabilities. For full-time employment, the rate increased to 85.8%. In addition, wages for people with disabilities were not increasing at the same rate as those for people without disabilities. During the 1980's wages for men and women without disabilities increased 45.3% and 57.2% respectively. During the same period, wages for men and women with disabilities increased 29.0% and 49.5% respectively. An education gap was also identified by La Plante et al (1996). Of the working age population examined, 66.7% of the people with disabilities graduated from high school, compared to 82.4% of those without disabilities. Further, 22.9% of people without disabilities graduated from college, compared to 9.6% of people with disabilities. The employment and education gaps for people with severe disabilities were even wider. Of this group of 10.4 million people, 7.5% were employed, 35.8% lived below the poverty line, 57.4% had high school diplomas, and 6.9% had college degrees. LaPlante et al (1996) noted an increase in the number of people receiving SSI and SSDI, especially among young people. Between 1982 and 1993, the number of working-age people receiving SSI/SSDI increased 50% to 6.7 million people. Between 1989 and 1993, the number of young adults under 30 years of age receiving SSI/SSDI increased 43%. However, LaPlante et al (1996) also noted that 79% of working-age people with disabilities said they want to work, and 35% of SSDI beneficiaries under medical review requested services "to help them gain employment" (p.2). Also, 42% of people with disabilities who were not working say they were able to work. The statistics cited above show that the discrepancy in employment rates between working-age people with disabilities and those without disabilities cannot be explained by lack of desire or lack of ability to work on the part of all people with disabilities. Most people with disabilities want to work and are able to work in large numbers. Lower education and training rates may account for some of the discrepancy. Other reasons include "program constraints related to staffing resources, the ready availability of part-time jobs in many communities and the 'benefits trap' of the potential loss of Social Security Benefits and Income as a result of working more than part-time" (Mank, O'Neill & Jensen, 1998, p. 84). Employer attitudes and concerns about hiring people with disabilities is also frequently cited for their low employment rates (Nietupski, Hamre-Nietupski, VanderHart & Fishback, 1996). Paradigm Shifts The 20th Century experienced profound changes in the ways society viewed people with disabilities which resulted in significant changes in services provided by public and private institutions. Two examples of these changes will be examined. According to Susan Daniels, Associate Commissioner for Disability in the Social Security Administration (1995), the paradigm for disability policy at the beginning of the century was initially based on the "Medical" or "Individual Defect" model where the person with a disability was impaired and therefore needed to be "fixed"-and if the defect was so severe that it could not be fixed, the person was warehoused away from society. The blame was then shifted to society during the "Civil Rights" model adopted during the 1960s when civil disobedience, political action, legislation and litigation were used to "fix" the problem. The current "Ecology/Technology" model does not place blame, but rather seeks to improve the interface between people with disabilities and society through assistive technology, universal design, self-determination, integrated service delivery systems, and other inclusive approaches. Polloway, Smith, Patton & Smith (1996) chronicle parallel shifts in the paradigm for providing services to people with mental retardation and developmental disabilities. The first part of the century saw a "facility-based" model where people were removed from society and placed in institutions, many of which were essentially warehouses which provided notoriously poor living conditions and little or no interaction with the inmates. The first paradigm shift occurred in mid-century to a "services-based" model in which "there was an attempt to provide special services to individuals, as a preparation for their subsequent integration into society" (Polloway et al, 1996, p. 5). This was the era of self-contained classes and sheltered workshops, which were later shown by efficacy studies to be ineffective in moving people into mainstream classes and employment. The final paradigm shift was toward "supports-based" and "empowerment" models characterized by inclusion, community integration, integrated employment, and self-determination. Since paradigm shifts occur through messy, revolutionary processes, not all stakeholders in a system accept the changes at the same time-and some never do. However, these shifts help explain trends in employment of people with disabilities and the context in which decisions and policies are made. They also provide a structure for the examination of the employment of people with disabilities. Employment Models Facility-based Work and Non-work Services Facility-based work programs are characterized by "continuous job-related supports and supervision provided to all workers with disabilities" (Butterworth, Gilmore, Kiernan & Schalock, 1999, p. 10). Sheltered workshops are included in this category. The facility-based non-work option "include[s] but is not limited to psycho-social skills, activities of daily living, recreation activities, and/or professional therapies (e.g., O.T., P.T.). In addition, continuous supports and supervision are provided to all participants with disabilities. Examples include day activity and day habilitation programs" (Butterworth, Gilmore, Kiernan & Schalock, 1999, p. 10). Data from state Mental Retardation/Developmental Disabilities (MR/DD) agencies for the period federal Fiscal Year (FY) 1988 to FY 1996 show that the number of people in facility-based MR/DD programs, both work and non-work, increased to 320,359, an increase of close to 12%. However, the relative percentage of people in these activities decreased from 87% to 61% due to the growth of integrated employment and community-based non-work sectors. Rehabilitation Service Administration (RSA) data show that employment placements into sheltered workshops have declined during this period. (Butterworth, Gilmore, Kiernan & Schalock, 1999). Wages for people in facility-based work programs were significantly lower (as much as half to three-fourths lower in some cases) than those in supported and competitive employment (Wehman, Revell & Kregel, 1998; Butterworth, Gilmore, Kiernan & Schalock, 1999; Kregel, 1997; Zivolich, Shueman, & Weiner, 1997). Transition rates from sheltered workshops to supported or competitive employment were also very low, and for most people, placement in facility-based work programs was a final placement (Polloway, Smith, Patton, & Smith, 1996). Integrated Employment Integrated employment "includes any individual working in a community based job. In general this definition includes individuals who are receiving supported, transitional, or competitive employment services from a state agency or community rehabilitation provider, and includes both individual and group models" (Butterworth, Gilmore, Kiernan & Schalock, 1999, p. 10). Data from state MR/DD agencies for the period FY 1988 to FY 1996 show that the number of people in integrated employment increased over 200% to 98,315, with the relative percentage of people in these programs (compared to other service models) grew from 13% to 23% during the same period. RSA data for the same period showed significant increases in the number of people entering competitive employment. RSA data also shows a 63% increase in the number of people receiving supported employment services between FY 1991 and FY 1995 (Butterworth, Gilmore, Kiernan & Schalock, 1999). Wages for people with disabilities in supported employment in FY 1995 averaged $4.70 per hour ($5.33 per hour for people with visual disabilities) with a high of $7.00 per hour (Wehman, Revell & Kregel, 1998). Wages for people with MR/DD in competitive employment increased slightly between FY 1985 and FY 1995 to an average of $148.00 per week; however when this number was adjusted for inflation, the real earnings decreased 42% during this period (Butterwork, Gilmore, Kiernan & Schalock, 1999). Mean hours of weekly employment in FY 1995 were 23.8 in supported employment (Wehman, Revell & Kregel, 1998) and 28.6 in competitive employment for people with MR/DD disabilities (Butterworth, Gilmore, Kiernan & Schalock, 1999). Trends and Issues While the number of people with disabilities placed in supported and competitive employment was increasing (Wehman, Revell & Kregel, 1998), so was the number of people placed in facility-based programs (Butterworth, Gilmore, Kiernan & Schalock, 1999). This data coupled with RSA funding information appears to indicate that integrated employment may be an "add-on service rather than a true systems change (Butterworth, Gilmore, Kiernan & Schalock, 1999, p. 27). Butterworth et al (1999) also point out the wide variation in priorities and service mixes among the states in employment services for people with disabilities. People with mental retardation were the largest group of people served in supported employment, although their relative share dropped to 60.5% in FY 1995. People with mental illness served in supported employment increased to 26.0% in FY 1995, while people with physical disabilities comprised 9.7% of the total (Wehman, Revell & Kregel, 1998). The preferred placement for supported employment participants was individual placement (77.4%), a significant increase from the 52.1% reported in FY 1988. Other options included group placements, entrepreneurial models and other placements (Wehman, Revell & Kregel, 1998). Funding for supported employment totaled over $500 million in FY 1995 with $136.6 million coming from VR funds, $313.3 million from MR/DD agencies, $40.4 million from mental health agencies, and the balance of $25.5 million from Medicaid waivers, the Department of Education, the Job Training Partnership Act, Development Disabilities Planning Councils and other sources (Wehman, Revell & Kregel, 1998). Funding for facility-based and community-based programs, both work and non-work, were comprised of state funds, Social Services Block Grants, and Medicaid funds, including the Medicaid Home and Community-Based Waiver program (Butterworth, Gilmore, Kiernan & Schalock, 1999). It is estimated that for every person with disabilities who received supported employment services, as many as seven or eight people who could benefit from these supports did not receive them (Mank, O'Neill & Jensen, 1998). Virginia's 1998 needs assessment study showed that the demand for long term supports in both facility-based and supported employment placements grew faster than its funding capacity (Revell, 1999). Based on the waiting lists for services, it appears that many states experienced a greater demand for services than could be met (Butterworth, Gilmore, Kiernan & Schalock, 1999). Funding issues are made more complex by the changes in the service delivery system. For example, Butterworth, Gilmore, Kiernan & Schalock (1999) have noted that services delivered to people with mental retardation and developmental disabilities now include service mixtures which may include integrated employment, community-based non-work services, and facility-based services and that community integration and participation now comprise a growing service category. Integrated employment options are cost-effective based on employment outcomes, the cost of facility-based and day programs, and tax savings (Kregel, 1997). Studies have shown that the benefit-to-cost ratio is higher (better) for supported employment programs than sheltered workshops and higher still for supported employment programs using natural supports (Mank, O'Neill & Jensen, 1998; Zivolich, Shueman & Weiner, 1997). In other words, supported employment generates economic outcomes for both participants and local economies that are superior to facility-based work programs and day programs (Mank, O'Neill & Jensen, 1998; Kregel, 1997). These are strong arguments in the current environment of tighter budgets, reduced resources, and increased accountability (Zivolich, Shueman & Weiner, 1997). An issue of increasing concern for integrated and facility-based employment is the sub-minimum wage certified by the Department of Labor to be paid to people with disabilities (Branigan, 1999; Mank, O'Neill & Jensen, 1998). This certification is based on a lower productivity rate calculated for disabled workers multiplied times the prevailing wage for a specific occupation. Since low wages, part-time hours, and minimal benefits are part of the reason that many people with disabilities live below the poverty line, there is growing sentiment that jobs with better pay, hours and benefits need to be developed for people with disabilities (Mank, O'Neill & Jensen, 1998). Assistive technology (AT) is included as an employment support for people with disabilities. It appears that the patent system is working well in terms of the increasing number of patents relating to assistive technology, and numerous designs and products are being developed to assist people with disabilities (Berven & Blanck, 1998). However, the lack of available funding and the cost of some assistive technologies are major impediments for the provision of these supports to people with disabilities (Berven & Blanck, 1998). The number of people with disabilities who are in the welfare systems is also raising concerns. Although many state welfare agencies have trouble identifying and tracking people with disabilities, in one study of five state welfare programs participation estimates ranged from 7% to over 80% of TANF recipients, and these numbers were expected to increase as caseloads continued to drop (Storen & Dixon, 1999). Concerns include inadequate training on disability issues and management for caseworkers who must use their discretion in deciding programs and services for clients, the effect of time limits on people who continue to need services after they time out, the ripple effect on other agencies if services are discontinued to clients who have timed out, the lack of programs targeted toward people with disabilities, and the lack of coordination between agencies. (Storen & Dixon, 1999). Policy Considerations The discussion of integrated employment is complicated by the lack of coordination of services and the lack of consistency in terminology and policy guidelines across federal and state government departments and agencies. The lack of coordination and consistency makes the implementation of federal and state policies difficult at the local service provider level. For example, the Vocational Rehabilitation system considers supported employment as an employment closure separate from competitive employment (Butterworth, Gilmore, Kiernan & Schalock, 1999) while federal regulations define supported employment as competitive employment (Wehman, Revell & Kregel, 1998) and others do not. The wide variation in state commitments to integrated employment placements (Butterworth, Gilmore, Kiernan & Schalock, 1999) and policy conflicts such as that between the "Work First" philosophy of the welfare system and the career path orientation of the vocational rehabilitation system are other examples (Storen & Dixon, 1999). A more basic policy consideration is the ultimate goal of services provided to people with disabilities by public programs. Is the goal meaningful employment or community integration or both? What should the service mix be? Should the emphasis be on integrated employment or facility- and community-based day programs? If the emphasis should be on integrated employment options as many in the field believe (Butterworth, Gilmore, Kiernan & Schalock, 1999; Wehman, Revell & Kregel, 1998), then 1) how can system change and community support be generated in support? 2) how can federal and state policies and funding mechanisms, which appear to encourage facility-based programs, be rerouted? (Butterworth, Gilmore, Kiernan & Schalock, 1999; Kregel, 1997), and 3) how can service providers be assisted in making the transition from facility-based programs to integrated employment models? Program data reveal that supported employment overwhelming serves people with mental retardation, developmental disabilities, and mental illness (Wehman, Revell & Kregel, 1998) and those with mild or moderate cognitive disabilities (Kregel, 1997). What policy changes are needed to expand supported employment opportunities to include people with other disabilities, including the severely disabled? Since most supported employment placements are in entry-level, low skill jobs, how can employment training and placements be better aligned with high skill, high wage jobs and careers? Information on integrated employment options is not readily available to parents, employers and other stakeholders, including the general public (Kregel, 1997; Wehman, Revell & Kregel, 1998). This lack of information compounds the documented concerns of employers who have not hired people with disabilities. Their concerns regarding the employment of people with disabilities included extra training and supervision, necessary job skills, business efficiency, behavior at work, work quality and quantity, and safety risks (Nietupski, Hamre-Nietupski, VanderHart & Fishback, 1996). Other employer concerns include the restrictions imposed by the Americans with Disabilities Act which make it difficult to discuss barriers to employment and the perception that the employment of people with disabilities is not a mainstream issue and affects only a small number of people (Butterworth & Pitt-Catsouphes, 1995). Policy issues related to assistive technology include equity issues such as access, availability, allocation determination, and who the decision-makers are (Berven & Blanck, 1998). Coordination of funding streams and policies is also required to make assistive technology more readily available to people with disabilities (Berven & Blanck, 1998). . Policy must be developed which allows people with disabilities to establish career ladders and become economically self-sufficient, including those with severe disabilities (Kregel, 1997). This includes removing disincentives from the system such as the loss of Medicaid for SSI/SSDI recipients who opt for employment, the promotion of integrated employment options, and the evaluation of existing policies on subminimum wages and other practices (such as time limits on training and education programs) which depress income and reduce self-sufficiency for people with disabilities. Conclusion The literature cited above shows that the employment and self-sufficiency levels of people with disabilities are unsatisfactory if this segment of the population is to be fully included in the workforce and the larger community. Leadership in the public sector has been cited as a major contributing factor to successful integrated employment models and outcomes (Mank, O'Neill & Jensen, 1998), and the bottom line is that leadership is needed in all sectors, public, private, and non-profit-and must include people with disabilities-in order to find more effective ways of moving people with disabilities into meaningful, financially rewarding career paths. People with disabilities currently experience significant gaps in wages, employment, and education compared to the general population; they cannot afford a leadership gap in the development of policies and practices which will include them as contributing, gainfully employed members of society. References Berven, H.M. & Blanck, P. (1998). The economics of the Americans with Disabilities Act part II: Patents and innovations in assistive technology. Notre Dame Journal of Law, Ethics and Public Policy, 12 (9). Branigan, W. (1999, December 12). 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An exploratory cost-benefit analysis of natural support strategies in the employment of people with severe disabilities. Journal of Vocational Rehabilitation, 8 (3), 211-21. Issues and Trends 16