Collaborating for Change: National Relationship-Building to - PowerPoint Presentation

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Collaborating for Change: National Relationship-Building to Support Competitive, Integrated Employment

Employment First State Leadership Mentoring Program Evaluation

Social Dynamics, LLC

Gary Shaheen, MPADouglas Klayman, PhDEFSLMP Project OfficerSerena Lowe, PhD

Partnerships in Employment Systems Change Grant EvaluationThe Lewin GroupKathleen Tucker, MSPHCindy Gruman, PhDAIDD Project OfficerLarissa Crossen, MEdSlide2

Today’s Conversation

Two Federal Employment Systems Change InitiativesOffice of Disability Employment Policy’s Employment First State Leadership Mentoring Program (EFSLMP)Administration for Intellectual and Developmental Disabilities’ Partnerships in Employment Systems Change Project (

PIE)Evaluating Outcomes, Challenges, and Promising PracticesSpotlight on Iowa’s EFSLMP and PIE programsSpotlight on Tennessee EFSLMP and PIE programsSlide3

A National Imperative: Inclusion-Income Equality and the Right to Work

In order to address poverty, it is essential to address the issue of income.That means, at least in part, getting people into and keeping them in the labor marketSlide4

Understanding the Wage Gap

Data Source: American Community Survey, 2014

Kraus, Lewis. (2016). 2015 Disability Statistics Annual Report. Durham, NH: University of New Hampshire. Slide5

Understanding the Employment Gap

Data Source: American Community Survey, 2014

Kraus, Lewis. (2016). 2015 Disability Statistics Annual Report. Durham, NH: University of New Hampshire. Slide6

Definitions

Concepts

Employment First: A framework for systems change that is centered on the premise that all citizens, including individuals with significant disabilities, are capable of full participation in integrated employment and community lifeIntegrated, Competitive Employment (ICE):

Jobs that people want; are located in competitive, integrated settings; and that pay at least the federal minimum wageFederal InitiativesEmployment First State Leadership Mentoring Program (EFSLMP): The vehicle for implementing Systems Change, Capacity Building and states’ ability to Transform employment services from sheltered/day programs to ICEPartnerships in Employment (PIE): State coalitions formed to enhance cross-agency and cross-system collaboration, develop and conduct initiatives that expand ICE, and improve policies and practices for youth and young adults with intellectual and developmental disabilities (I/DD)Slide7

Employment First State Leadership Mentoring Program (EFSLMP)

National Evaluation OverviewSlide8

ODEP’s 3-Pronged Approach to EFSLMPSlide9

States Support, Sustain, and Scale Up Competitive, Integrated Employment for Individuals with Disabilities

EFSLMP Mission At a GlanceSlide10

Demand change among target populations;

Development of evidence-based practices and evolution of models in service delivery; Advances in the legal and policy landscape; Maximizing efficiencies through goal alignment and resource coordination across systems; and Demonstrated improvements in desired outcomes via rigorous performance measurement

http://www.leadcenter.org/system/files/resource/downloadable_version/Employment_First_Technical_Brief__3_0.pdf

ODEP’s 5 Criteria for Systems ChangeSlide11

2016: Current EFSLMP Growth -Now at 19 states

Employment First-Chronology of GrowthSlide12

Innovative Payment Schemes & Rate Restructuring

Leveraging & Coordination of Policy and Resources across Systems

EFSLMP Core State TA/Training

– Key Areas of FociSlide13

What we measure:

The impact of systems change in a 9-state sample on: Aligning policy, funding, and practice;Systems capacity building activities; and Improving front-line direct support professionals competencies in the provision of services that lead to and help sustain competitive, integrated employment.

Information obtained through:Data:Interviews

ObservationsPolicy Data ScansReport and Document ReviewsAnd includes developing new materials and the web platformhttp://employmentfirst.leadcenter.orgEFSLMP Evaluation Purpose and ProcessSlide14

http://employmentfirst.leadcenter.org/home

Employment First State Leadership Mentoring Program National Data PlatformSlide15

Systems Change Factors

Monitoring and reacting to changes in demand among individuals with significant disabilities for competitive, integrated employment servicesChanges in legislation/policy that positively affects individuals with disabilitiesImprovements in cost-effectiveness of services

Capacity Building FactorsUse of evidence-based practicesUse of rigorous performance measurement procedures that include key metrics such as employment placement and retention outcomes and receipt of wages

The evaluation measures 3 EFSLMP Systems Change and 2 Capacity Building factorsSlide16

Systems Change

Evidence of systems change policy, partnerships, or product completion;

Changes are demonstrated

Pending Change

Evidence of systems change policy, partnerships or product development;

Change expected subsequent to authorization by executive leadership

No evidence of systems change policy, partnerships, or product development

No Change

EFSLMP Systems Change Evaluation RubricSlide17

Training Plan (TAP) Evaluation RubricSlide18

32 states have implemented formal actions in support of EF (legislation, executive orders, and directives).

46 states have integrated some or all of the principles of EF into their state agency policies and practices (Nord & Hoff, 2014).Seven of nine states achieved some level of Pending Change or Systems Change during the evaluation period using EFSLMP technical resources.

Systems ChangeMOUs (Arkansas)HCBS waiver modifications (Iowa, Tennessee)Drafts of revised reimbursement rates (Illinois, Michigan)

Draft State HCBS Plan Amendment (Maine)Pending ChangePlan to integrate customized employment as a VR employment strategy (Michigan)Formalizing and disseminating a “Transition Vision” guidance tool for local agencies (Ohio)Preliminary Results: Social Dynamics’ EFSLMP Evaluation (2015)ODEP’s EFSLMP ROISlide19

Partnerships In Employment Systems Change Grant (PIE)

National Evaluation OverviewSlide20

AIDD PIE Systems Change Project5-year grant awarded to 8 states

6 states in 2011, 2 states in 20128 states formed a state consortium of state agencies and other stakeholders6 of 8 states established statewide pilot demonstration projects for students with I/DD to gain employment skills

PIE Grant

8 states

Goal:

Transform state systems to promote integrated, competitive employment outcomes for youth and young adults with I/DD

What is Partnerships in Employment?Slide21

Goal:

Transform state systems to promote integrated, competitive employment outcomes for youth and young adults with I/DD

What aspects of systems change did PIE intend to effect?What changes to policies and practices are associated with PIE?

What implementation strategies are related to program outputs and outcomes?What components are necessary to create ICE opportunities at the state and local level?AIDD’s PIE Research QuestionsPolicy CollaborationRemoving Systemic BarriersCross-Agency CollaborationScaling-Up Promising PracticesAIDD’s PIE Objectives

AIDD’s Objectives and Research QuestionsSlide22

Ongoing Technical Assistance

Ongoing Evaluation

Projects Awarded

Final Project Years

Where Are We Now?Slide23

Each PIE state formed a consortium/coalition of state agencies and stakeholders

State Agencies

Developmental Disabilities Agency

Vocational Rehabilitation AgencyState Education AgencyState Developmental Disabilities Council

CommunitiesPilot sites/schoolsEmployersProviders

Youth and young adults with I/DD

Parents/Family members

Individuals with I/DD

How are the PIE Projects being implemented?Slide24

Passed E.F. legislation (3 states)

PIE assisted with stakeholder awareness and self-advocacy effortsIncreased legislator awareness (8 states)PIE shared project findings and supported legislative self-advocacy efforts

Increased capacity by hosting trainings (8 states)PIE led efforts to train educators, families, and other stakeholders Implemented Pilot Demonstration Projects (6 states)

PIE facilitated learning of skills necessary for employmentPIE showed meaningful gains in earnings and number of jobsPolicy CollaborationRemoving Systemic BarriersSelected findings from semi-annual reports to The Lewin GroupWhat changes to policies and practices are associated with PIE?Slide25

Signed additional MOUs and MOAs to advance ICE (4 states)

PIE promoted interagency dialogue to form new relationshipsIncreased youth and family expectations (8 states)PIE developed groups to support parent involvement, disseminated family resources, and held parent trainings

Raised employer awareness (8 states)PIE leveraged Community Conversations, job fairs, and new business partnerships

Improved shared data systems (7 states)PIE developed or working on shared data systems or employment toolsOther initiatives adopted PIE promising practices (1 state)PIE tools and coaching model adopted by two grantsCross-Agency CollaborationScaling-Up Promising PracticesSelected findings from semi-annual reports to The Lewin GroupWhat implementation strategies are related to program outputs and outcomes?Slide26

Improvements in:

Policies

Programs/Services

Individual OutcomesActivitiesDirect, on-site Training and TA Targeted, specific TA through Vision Quest National knowledge and capacity development through CoPs

ActivitiesDeveloped state coalitionsProvided training on ICEEstablished pilot sites for students with I/DD to gain employment skillsEFSLMPPIEEFSLMP and PIEShared Values/Complementary Strategies/Demonstrable OutcomesSlide27

State highlights

IowaSlide28

Iowa: EFSLMP and PIE Capacity Building

EFSLMP advisory group members are members of the Iowa Coalition for Integrated Employment Coalition and Core Team

EFSLMP

PIEActivitiesEmployment First Core State Team 13 members-4 required state agencies, PIE project leads, family groups, and representativesIntensive TA to (7) providers in 2013; expanded to 12 providers in 2014-15 (receiving assistance through PIE)Website and webinarsMaterials developedIowa Coalition for Integrated Employment (ICIE)221 Coalition members-4 required state agencies and other stakeholders

45 to 70 Coalition members regularly attend quarterly meetingsTrainings and initiatives to support ICECollaborative OutcomesIowa Community of PracticeJoint capacity building effort to host monthly webinars on employment topicsSlide29

Iowa: Improving Policies—Transforming Sheltered Workshops

Continue to distribute the Employment First Guidebook and make the Guidebook accessible to families

EFSLMP

PIEActivitiesEmployment First Executive OrderIowa Governor’s annual E1st Proclamations Community Rehabilitation Providers14 community providers participating in voluntary transformation efforts (receiving assistance through PIE)

Rate RestructuringPIE pilot sites provided feedback to state agenciesEngagement with case managers and care coordinatorsStatewide meetings to solicit feedback on Employment First GuidebookCollaborative OutcomesMedicaid Rate Restructuring/Employment Rules RedesignRoundtables and workgroups for Medicaid rebalancing funded in part by PIEIowa Vocational Rehabilitation Services integrated both Discovery and Customized Employment service options in its array of services

New

Employment Rules finalized and

effective May 2016

Iowa’s Employment First Guidebook

Collaborated to develop and distribute Employment First Guidebook for Case Managers, Care Coordinators, and ProvidersSlide30

Iowa: Improving Programs/Services—Shared Data Systems

Continue to support common definitions and collection of common data elements, and work together to discover what joint reporting is possible in the future

EFSLMP

PIEActivitiesStakeholder meetingsStakeholders met to define and agree on data elements to help inform future statewide data collection projectsStakeholder meetingsPIE hosted and supported stakeholder meetingsEmployment Data Collection Pilot19 providers collected data representing 12 Mental Health and Disability Services regions in 2015

Completed Employment Outcomes Data Collection ReportCollaborative OutcomesIdentify common data elementsSupported efforts to identify and collect common data elementsEmployment data elements embedded into every effort (Mental Health Redesign)Department of Human Services building data elements into its Outcome Measures collection and reportingSlide31

Iowa: Improving Individual Outcomes—Improving Integrated, Competitive Employment

Continue to engage providers, families, and individuals with disabilities in pilot projects and sustainability efforts

EFSLMP

PIEActivitiesCommunity Rehabilitation ProvidersSMEs working with Pilots on transformation goals Model Education Transition Sites 5 sitesCommunity Rehabilitation Providers7 sites

Collaborative OutcomesCommunity Rehabilitation Providers7 original Pilot Projects received intensive Customized Employment trainingOver 30 providers are interested in transformation and are actively involvedCurrently, 9 providers are receiving

EFSLMP SME TASlide32

Iowa: EFSLMP and PIE Provider Transformation Micro-Case Study (CRP pilots)

ICIE and EFSLMP partnered to pool and leverage resources to support 7 original Community Rehabilitation Provider (CRP) Pilot SitesEFSLMP 2016 CRP "Pilot" Providers

CRP Pilot Participant Data

201320142015# of Providers61218# of Jobs14427725# of Customized Employment Jobs

-86150Average hourly wage$7.70$7.81$8.31Average hours worked1417.3

15.9

*Reported by ICIE on a semi-annual basis to The Lewin Group

PIE and EFSLMP CRP Pilot Data by Year,

2013-2015Slide33

Iowa: Improving Individual Outcomes—Increasing Parent Expectations

Continue to engage parents and educate them on the shift to managed care and other employment topics

EFSLMP

PIEActivitiesParent EngagementSMEs supported creation of Family/Parent CoalitionParent EngagementFamily/Parent Coalition Survey to identify impact of participation on actions, attitudes, beliefs, knowledge, and skills

Collaborative OutcomesFamily/Parent CoalitionDevelopment of an EFSLMP/PIE Family/Parent Coalition with membership increasing from 0 members to 87 members (as of Sept. 2015)Hosted events and trainings and developed tools to inform parents and family members about managed care transition and other employment topicsSlide34

State highlights

TennesseeSlide35

Tennessee: EFSLMP and PIE Capacity Building

EFSLMP partners are members of the TennesseeWorks Partnership and both groups support the Governor’s Employment First Task Force

EFSLMP

PIEActivitiesEmployment First Core State Team Direct provider training/TA by SMEsDemonstration providers in each region (4 partners) with intensive TAWebsite/Social media marketingMaterials developedTennesseeWorks (TNWorks) PartnershipAverage 45 members-4 required state agencies and other stakeholders

Website/Social media marketingTrainings and self-advocacy eventsCollaborative OutcomesSocial Media MarketingOver 230 state agency and provider staff trained 2013-2016Direct, continuous on and off site training/TATNWorks website: http://www.tennesseeworks.org/ with Success Story videosAverage 3,936 page views per month192 followers on Twitter/640 likes on FacebookEF website: http://www.tn.gov/did/topic/employment-first with DIDD Way2Work vignettes645 followers on Twitter/958 likes on Facebook/YouTube videosSlide36

Tennessee: Improving Policies—Transforming Sheltered Workshops

Continue to collaborate on the implementation of the HCBS Statewide Transition Plan and Employment and Community First CHOICES Program

EFSLMP

PIEActivitiesPolicy RecommendationsRate/Reimbursement Restructuring for VR and Medicaid HCBSInteragency Agreements (8 agencies)State Employment First Executive Order and Strategic Plan to GovernorLetters of Intent with providers for DD/VRTicket 2 Work TA arrangements between Workforce Investment and DD/VR networksPolicy RecommendationsTNWorks suggested revisions to state and federal policies

Held educational sessions and focus groups for new programSupported self-advocatesCollaborative OutcomesDevelopment of Shared MaterialsDeveloped Youth MOUCreated a Tennessee Transformation ManualReviewed and provided recommendations on the Tennessee HCBS Statewide Transition Plan and new Employment and Community First CHOICES ProgramSupported the Employment First Task Force and Employment RoundtableSlide37

SRVS, Inc. (Memphis, TN, http://www.srvs.org/)

Tennessee’s largest provider of services for individuals with intellectual and developmental disabilities, founded in 1963Workshop Size before EF: 110 peopleNumber of people obtaining ICE: 42 (6/16/16)Number of people participating in meaningful, employment focused day activities:

62 (6/16/16)Key Steps:Executive level buy-inFinancial diversificationExternal stakeholder communicationsProgram design and staff development

Micro-Case Study (SRVS, Inc.)—ProfileEFSLMP Provider TransformationSlide38

Tennessee: Improving Programs/Services—Shared Data Systems

Continue to strengthen data collection efforts and evaluate evidence of statewide improvements in policies, practices, and employment outcomes

EFSLMP

PIEActivitiesTennessee Longitudinal Data SystemTrack individual employment progress from secondary education through handoff adult services Discussions and analyses to ensure individual protections before full scale state agency participationData DashboardGathering and posting national and state employment data of people with disabilitiesShared Data SystemsRecruiting agencies to participate in existing Tennessee Longitudinal Data System

Collaborative OutcomesTennessee Longitudinal Data SystemJointly addressed database personal information safeguardsEFSLMP partners provided feedback on the employment Data Dashboard hosted on the TNWorks websiteSlide39

Tennessee: Improving Individual Outcomes—Increasing Expectations

Continue to engage individuals with disabilities, parents, and family members to increase expectations

EFSLMP

PIEActivitiesFamily CoalitionsSMEs provided TA to TNWorks Parent CoalitionsTNWorks and The Arc of Tennessee provided Employment First inputTurn-keyed to The Arc of TennesseeFamily CoalitionsProvided input on state and federal policiesYouth and adults with disabilitiesParticipate in Disability Day on the Hill and TNWorks Think Employment! Summit

Collaborative Outcomes3 Family CoalitionsSupport families to share and improve ICE opportunities and expectations“Conversations that Matter”Hosted 8 “Conversations that Matter” in 2014 to share information with families about state and federal policies and gather information from families about sheltered work and community employmentStatewide Parent Expectations SurveySurveyed 2,400 parents with 83 percent of families considering some type of employment in the community to be importantSlide40

Obtain buy-in from leadershipSeek input from self-advocates and community membersDevelop rapport and trust with partners

Identify and address common goals and vested interestsAddress the structure of policy and fundingTake steps to restructure funding to incentivize ICEDevelop knowledge and materials that build capacityDisseminate outcomes widely to sustain the initiativeConclusions Common to Each InitiativeSlide41

EFSLMP and PIE Collaboration: Systems Change

DiscussionSlide42

SYSTEMS Change Questions

What systems level changes are necessary in your state to improve integrated employment outcomes for people with disabilities?Who are the partners and what do they provide?

Who are the leaders and what are their roles?What are the next steps you need to take to address systems change?Within the next three months with resources that you have now?

Within the next six months with other resources that you need?By the end of 12 months to achieve what types of outcomes?Slide43

EFSLMP and PIE Collaboration: Capacity Building

DiscussionSlide44

Changes in POWERWho are your leaders that are responsible for the new initiative?

Change in MONEYWhere can you leverage new or blended & braided $$?Change in HABITSHow does ICE become the norm, not the exception in your state?Change in TECHNOLOGY and SKILLS

What new knowledge and competencies do you need to implement, sustain, and bring your initiative to scale?Change in IDEAS and VALUESHow will you achieve consensus among diverse stakeholders that leads to new understanding of problems and solutions?

Adapted from: Building Blocks of Systems Change (Corporation for Supportive Housing 2005)What do we need to Build, Sustain and Scale-Up?Slide45

Capacity Building Questions

What capacity building changes are necessary in your state to improve integrated employment outcomes for people with disabilities?Who are the partners and what do they provide?Who are the leaders and what are their roles?

What are the next steps you need to take to address capacity building?Within the next three months with resources that you have now?Within the next six months

with other resources that you need?By the end of 12 months to achieve what types of outcomes?Slide46

Thank You!

Additional Resources and Contact InformationAIDD Partnerships in Employment Projectshttp://www.acl.gov/programs/aidd/Program_Resource_Search/Results_PNS.aspx ODEP Employment First State Leadership Mentoring Program

https://www.dol.gov/odep/topics/employmentfirst.htm Slide47

Partnerships in Employment Consortium and Coalition Resources

Alaska: Alaska Integrated Employment Initiativehttp://www.trusttrainingcoop.org/training/aieip.html

California: California Employment Consortium for Youthhttp://www.semel.ucla.edu/tarjan/employmentIowa: Iowa Coalition for Integrated Employmenthttp://dhs.iowa.gov/mhds/disability-services/employment

Mississippi: Mississippi Partnerships for Employmenthttp://www.mspeidd.org/ Missouri: Show-Me-Careershttp://showmecareers.org/?catid=326 New York: New York State Partnerships in Employment Projecthttps://www.urmc.rochester.edu/strong-center-developmental-disabilities/programs/partnerships-in-employment.aspx Tennessee: TennesseeWorkshttp://www.tennesseeworks.org/ Wisconsin: Let’s Get to Workhttp://www.letsgettoworkwi.org/Slide48

Contact Information

Employment First State Leadership Mentoring Program Evaluation

Social Dynamics, LLC

Gary Shaheen, MPA | gshaheen@socialdynamicsllc.com

Partnerships in Employment Systems Change Grant EvaluationThe Lewin GroupKathleen Tucker, MSPH | Kathleen.Tucker@lewin.comIowa Coalition for Integrated Employment Iowa Partnerships in EmploymentAmy Desenberg-Wines | adesenbergwines@gmail.com Jess Pruitt | pruittjess@gmail.com Website: http://dhs.iowa.gov/mhds/disability-services/employment http://www.idaction.org/videos/ TennesseeWorks

Tennessee Partnerships in Employment

Elise McMillan |

Elise.McMillan@Vanderbilt.edu

Website:

http://www.tennesseeworks.org/

Tennessee EFSLMP

Tennessee DIDD

Amy Gonzalez |

Amy.Gonzalez@tn.gov

Website:

http://www.tn.gov/did/topic/employment-first

Iowa EFSLMP

Iowa Vocational Rehabilitation Services

David Mitchell |

david.mitchell@iowa.gov

Website:

http://www.ivrs.iowa.gov/