Implementation of WIOA: Lessons from Research on Employmentrespectabilityusa.com/Resources/WIOA...
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Jennifer Laszlo Mizrahi David Stapleton David Wittenburg October 7, 2014 Implementation of WIOA: Lessons from Research on Employment
Transcript of Implementation of WIOA: Lessons from Research on Employmentrespectabilityusa.com/Resources/WIOA...
Jennifer Laszlo Mizrahi David Stapleton
David Wittenburg
October 7, 2014
Implementation of WIOA: Lessons from Research on Employment
WIOA = Opportunities
EVERY STATE must produce a unified, performance-based plan to provide training, employment services and vocational education in a coordinated way. See http://www.doleta.gov/wioa/pdf/WIOA-Key-Implementation-Dates.pdf
• Today 12% of Federal spending ($400 Billion/year) goes to pay for working age people with disabilities who are outside of the work force
• Despite this, employment outcomes for PwDs are WORSE
• For every young person with a disability who goes on benefits until retirement age it will cost taxpayers a minimum of $380K plus Medicare/Medicaid
• SSDI Fiscal Cliff in 2016: 20% shortfall
• Most people with disabilities want to work
• 503: See www.fedspending.org
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New Poll: Public Wants Results
• Majority of likely voters either has a disability or family member/close friend with a disability
• Majority do not feel government is doing enough to help people with disabilities (PwDs) get jobs and become independent
• When given a long list of reasons PwDs aren’t working, top reasons chosen are: “People with disabilities could lose benefits if they work” and “Employers are unwilling to hire someone with a disability”
• Consumers want to source goods and services from inclusive employers
• Data: http://respectabilityusa.com/by-huge-margins-swing-voters-in-key-battleground-states-more-likely-to-vote-for-candidate-committed-to-jobs-for-people-with-disabilities
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Theory of Change Must Work!
A+B+C=D For example, ADA is necessary, but not sufficient. Vocational Rehabilitation is necessary, but not sufficient. In order to succeed, new plans must:
• Work closely with employers (BLNs/Chambers/Workforce Development Teams etc.) to understand their current and future workforce/talent needs
• Avoid the mistake of just looking at who shows up at voc rehab – look at the larger group of PwDs in the talent pool and pipeline
• Budget and plan work to reduce stigmas surrounding disability employment
• Bring together stakeholders: employers, PwDs, non-profits, faith-based community, education etc. to collaborate on new plans, goals and performance metrics
• Go for BEST PRACTICES – which is the purpose of this call today!
Note:
• RespectAbility will release “SCORECARD” for best practices soon
• RespectAbility will host a call for each of the 50 states after the election
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Today’s Presenters
Jennifer Laszlo Mizrahi
David Stapleton
David Wittenburg
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Acknowledgements
Preparation of this presentation was supported by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (ED). The presentation was funded through NIDRR’s Rehabilitation Research and Training Center on Employment Policy and Measurement grant to the University of New Hampshire Institute on Disability, under cooperative agreement H133B100030. The contents do not necessarily represent the policy of the ED or any other federal agency (Education Department General Administrative Regulations, 75.620 [b]). The authors are solely responsible for all views expressed and any errors or omissions.
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● The support system context for WIOA ● The nature of WIOA disability provisions ● The evidence to support implementation
Overview
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Today’s System, Simplified
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Elephant in the room: inability to work is the central eligibility criterion
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Others try to adapt to the public support system
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Further Simplified: A Poverty Trap
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● The elephant is still in the room ● The system is still highly complex and
fragmented
Enter WIOA
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● “Early intervention” initiatives – Slow the flow into the poverty trap – Youth transitioning to adulthood – Workers experiencing onset or worsening of a
significant medical conditions ● Promote
– Employer engagement – Competitive, integrated employment – Collaboration, coordination and efficiency – Measurement and accountability
WIOA reforms reflect the reality of the broader system and the nature of the evidence
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● Youth transitioning to adulthood ● Workers experiencing the onset/worsening of
significant medical condition
What’s the evidence?
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TRANSITION AGE YOUTH
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– System challenges – Promising approaches – Youth Transition Demonstration
Overview
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System Challenges
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● System fragmentation ● Work disincentives ● Local/state variation in services/programs
Services for Youth Not Aligned to Promote Employment
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● Respectability will produce state data profiles – Contact: Jennifer Laszlo Mizrahi – Example statistics (Maryland)
▪ 22,000 persons age 16 to 20 have a disability ▪ 294,800 persons aged 21 to 64 have a disability ▪ 56,600 people with disabilities aged 18 to 64 receive
benefits ▪ 2,506 people obtained jobs through VR
● Additional Resources – Disability Compendium
▪ Release conference: December 3, 2014
Using State Data to Plan Services
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● Service “silos” inhibit creativity/new approaches
● Challenges in understanding “what works” – Key measures do not exist or are not linked – Lack of comparison groups to estimate impacts – Short-time horizon
Current System Limits Program Testing and Innovation
Livermore and Goodman (2009)
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● Transition problems – High risk of program participation – Dropout – Arrest – Social isolation
● Experiences vary by impairment groups – Youth with psychiatric impairments at “high” risk
for poor outcomes
Challenges in Transitioning to Adulthood
Wittenburg (2011) and Wagner and Newman (2003)
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Promising Approaches
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● Comprehensive review of descriptive intervention findings
● Components – School preparation – Youth development – Career preparation – Connecting activities – Family involvement
Guidepost to Success
National Alliance for Secondary Education and Transition (2005) and National Collaborative on Workforce and Disability (2014)
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● Review of employment demonstration projects involving people with disabilities
● Findings: Larger impacts in projects with: – Well defined target populations – Customized supports to meet the youth’s need
▪ Difference between necessary and sufficient supports – Intensive supports with a clear focus on
employment ● Pilot testing programs is important
Review of Demonstration Findings
Wittenburg, Mann, and Thompkins 2013
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● Maryland Seamless Transition Collaborative (MSTC)
● Oregon Youth Transition Program
● Promoting Readiness of Minors in Supplemental Security Income (PROMISE)
Other Examples of Coordinated Services
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Youth Transition Demonstration (YTD)
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● Transition-age youth (ages 14 to 25) on SSI or at risk of becoming SSI-eligible
● Random assignment design in six sites ● Interventions differed by site ● Applied example of Guideposts framework
Overview
Fraker and Rangarajan (2009) and Fraker et al. (2012)
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● Operated by Human Resource Development Foundation (HRDF)
● 455 treatment cases (397 control cases) ● State-wide: operated in 19 counties in West
Virginia
Youth Works Overview
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● Program built from scratch ● HRDF had extensive employment service
experience – But, very limited disability service experience
West Virginia Youth Works Program: Start up
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● Staff flexibility to implement creative approaches – Met youth at homes,
school, workplace – Services/placements self-
directed ▪ Types of placements varied:
restaurants, veterinary clinic, child care, and even…a Zumba placement.
Youth Works Staff Were Creative
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● Monthly reports tracked goals – Outcome focused: hours, employment
placements – Aggregate and individual goals
● Clear focus on employment – Understood by staff – Youth participants – Partners
Strong Emphasis on Measurement and Employment
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Impacts: Promising First Year Findings
Fraker et al. (2012)
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● Set up is potentially informative – Built from scratch – Private organization example
● Services reinforce general themes for promising impacts – Focus on employment – Customization of services – Intensive service delivery/focus on employment
Implications for YTD Example in State Planning
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EXPERIENCED WORKERS
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SSDI beneficiary return to self- sufficiency is unusual, often temporary
1996 adult awardees followed for 10 years
Liu and Stapleton (2011) http://www.ssa.gov/policy/docs/ssb/v71n3/v71n3p35.html
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● Efforts to increase beneficiary return to self-sufficiency have had little success – Ticket to Work and Work Incentives Improvement
Act of 1999 – Impacts of Ticket to Work prior to 2008 regulatory
changes ▪ Recent SSDI-only beneficiaries under age 40 at award ▪ ~2% increase in enrollment for employment services ▪ No impact on SSDI exit for work
● SSDI entry process – Detaches awardees from the labor force – Creates vested interested in “inability to work”
The case for early intervention
Stapleton, Mamun and Page (2014) http://www.izajolp.com/content/3/1/6
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Premise: large numbers fall through the cracks
Courtesy of Dr. Jennifer Christian, Webility Corporation
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Premise: expectations of health system are unrealistic
● Workers, employers, insurers, program administrators and others have unrealistic expectations of clinicians – Often require to make decisions about work – Lack of training and little experience – Poorly informed about context, environment – Overprotective—bias toward avoiding work, instead of
modifying work – Decisions rarely questioned – Practices that are not evidence based
▪ Excessive prescription of opioids ▪ Spinal fusion
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Right supports to right workers at the right time improves outcomes
● Extensive evidence base demonstrates positive impacts
▪ Waddell G et al.(2008) - what works, for whom, and when? Vocational Rehabilitation Task Group. London: The Stationery Office, 2008 www.workingforhealth.gov.uk/documents/vocational-rehabilitation.pdf
▪ Becker, D.R., et al. (2011). Best practices: A national mental health learning collaborative on supported employment. Psychiatric Services, 62(7), 704-706. PMID: 21724779
▪ Bonnie O’Day et al. (2014) Improving Employment Outcomes for People with Psychiatric Disorders and Other Disabilities. Washington, DC: Mathematica Policy Research, 2014. http://aspe.hhs.gov/daltcp/reports/2014/EmpOut.pdf
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How can states deliver the right supports to the right workers at the right time? ● Outreach to workers via employers, health
care providers – State vocational rehabilitation agencies – American Job Centers
● Expedite service delivery – WIOA: VR state plan must ensure priority is given
to eligible workers at risk of losing their jobs unless they receive available services
● Coordinate/integrate services – Across AJC, VR programs – Medicaid – Mental health services – Workers compensation (WC)
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Example: Center of Occupational Health and Education (COHE)
● State of Washington WC – Labor and Industries operates WC fund – Target: new WC claimants
● COHE objectives: – Prevent disability – Expedite return to health and reduce lost work
time
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Jeanne M. Sears; Thomas M. Wickizer; Beryl A. Schulman, Improving vocational rehabilitation services for injured workers in Washington State. Evaluation and Program Planning. 2014;44:26-35. http://www.sciencedirect.com/science/article/pii/S0149718913001109
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COHE Features
● Trained care coordinators – Work with worker, clinician, employer, state fund – Provide specialized expertise
● Voluntary
– Clinicians choose to use – Workers choose clinician
● Clinician incentives
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COHE incorporates:
● Right services to right worker at right time
● Employer engagement
● Collaboration and coordination
● Measurement and accountability
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COHE Implementation
Wickizer, Thomas, Gary Franklin, Deborah Fulton-Kehoe, Jeremy Gluck, Robert Mootz, Terri Smith-Weller, Roy Plaeger “Improving Quality, Preventing Disability and Reducing Costs in Workers’ Compensation Healthcare,” Medical Care, Vol. 49, No. 12, 2011, 1105-1111.
http://www.pubfacts.com/fulltext_frame.php?PMID=22015667&title=Improving%20quality,%20preventing%20disability%20and%20reducing%20costs%20in%20workers%27%20compensation%20healthcare:%20a%20population-based%20intervention%20study.
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COHE Evaluation ● Well received by workers, clinicians,
employers ● More than paid for itself through lower cash
benefits and medical costs ● Results for lower back pain especially strong
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Recommended focus of WOIA implementation for workers
● Use existing programs, institutions and funding streams to increase delivery of the right supports to the right workers at the right time – Engage with employers and insurers – Target workers with significant conditions
before they leave their jobs – Collaborate and coordinate – Measure and hold accountable
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Additional Resources for Evaluations of Disability Employment Policy
● Clearinghouse for Labor Evaluation and Research – Review of existing literature – Causal analysis ratings (low to high)
● Disability Employment Policy
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Contact Information
Center for Studying Disability Policy Mathematica Policy Research 1100 1st Street NE, 12th Floor Washington, DC 20002 (202) 484-9227 http://www.DisabilityPolicyResearch.org
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Let Us Know if We Can Help We have many resources for policy makers and employers on our
website and are ready to help! RespectAbilityUSA
4340 East-West Hwy, Suite 350
Bethesda, MD 20814
www.RespectAbilityUSA.org
Cell: (202) 365 – 0787
Jennifer Laszlo Mizrahi
President
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