Return on Investment: Accommodating an Employee s Return to Work after Injury, Illness or Disability

1. Return on Investment: Accommodating an Employee�s Return to Work after Injury, Illness or Disability Patrick Reinhart, Business and Industry Liaison Rich Sanders, Alaska Works Program Coordinator Governor�s Council on Disabilities and Special Education

2. Who Are We? The purpose of the Governor's Council on Disabilities and Special Education is to create change that improves the independence, productivity and inclusion of people with disabilities in their communities. The Council conducts advocacy, capacity building and systems change activities to create change for Alaskans with disabilities.

3. Alaska Works Initiative Mission: Alaskans who experience disabilities are employed at a rate as close as possible to that of the general population. Goal 1: Transform Medicaid programs to emphasize employment and meet the needs of working Alaskans with disabilities. Build the capacity of behavioral health programs and home and community based waiver programs. Implement strategies to increase work as an expectation amongst Adult Public Assistance (APA) recipients. Facilitate targeted improvements to Medicaid programs to support employment of people with disabilities.

4. Alaska Works Initiative Goal 2: Ensure access to resources needed by Alaskans with disabilities to secure and maintain employment. Provide training and information to increase use of the Medicaid Buy-in, Ticket-to-Work, benefits counseling and other work-related resources. Implement strategies to meet employment needs of youth with disabilities. Assist people with disabilities to accumulate assets. Increase affordable housing, transportation and other resources.

5. Alaska Works Initiative Goal 3: Collaborate with business and industry to assist youth and adults with disabilities to secure employment in Alaska�s labor market. Implement strategies to make the State of Alaska a model employer. Market abilities of individuals with disabilities to business and industry. Develop strategies to increase amount of Alaskans with disabilities in apprenticeships, vocational training and post-secondary education. Develop policy to promote self-employment of people with disabilities.

6. Why Do We Care The percentage of people with disabilities in the labor force is 22.2 % compared with 71.2% for persons with no disability. The unemployment rate for with disabilities is 16.9%, compared with 9.3% for persons with no disability, not seasonally adjusted. By most estimates, a vast majority (over 60%) of persons with disabilities age 18-64 are not working and depend upon some type of government assistance. In Alaska, there are over 18,000 people on SSI or SSDI age 18-64 who could work if given the opportunity.

7. Goals of today�s session: Learn ways to get injured or ill workers back in the workplace. Learn demonstrated Employer Successes. Lean about assistive technologies and job accommodations, that are easy and won�t �break the bank.� Learn about recent changes to the ADA and what it means for the employer.

8. Facilitating Return to Work after Injury, Illness or Disability Primary Strategies Open lines of communication Contact with the insurance company Reintegration to work Flexibility Protecting the returning worker�s privacy Support and continuing support Sources: The Office of Disability Employment Policy, U.S. Department of Labor "When Catastrophe Strikes: What Employers Can Do," SPINAL Column, the Magazine of Shepherd Center, Summer 2000 Dr. Joel Moorhead, M.D., a former member of the President's Committee on Employment of People with Disabilities, and currently with Disability Management Services, Prudential Insurance

9. Open Lines of Communication Maintain contact with the individual or their family (if appropriate). Answer questions about leave and benefits. Pay them a visit (if possible and appropriate). Ask they what they want shared (if anything). Maintain contact and keep them informed of workplace developments. Assure them you welcome hearing from them.

10. Contact with the Insurance Company Provide the worker with insurance and/or worker�s compensation information and forms. Be available to answer questions from the carrier. Contact the benefits department. Shows your interest in the employee and their well being and expect them to be treated well. If the insurance company provides a nurse consultant, ensure they get in contact.

11. Reintegration to Work Let them know you are interested in their return to work Discuss possible work modifications with the employee and a professional rehabilitation specialist (A.T. Specialist, O.T., P.T., V.R. Counselor, etc.) If changes are being made prior to returning to work, make sure the employee is kept informed of them.

12. Flexibility Offer flexible work schedules and methods in the early stages. Make sure you discuss the length of these arrangements and prepare for changes. If requested and appropriate send the employee�s mail, memos and informational materials home prior to their return. Make work schedule accommodations for rehabilitation.

13. Protecting the Worker�s Privacy Federal laws protect worker privacy. You may share information with person�s at the workplace if: the worker's duties or abilities will be restricted, you may give the supervisors and managers the information about those restrictions or accommodation. the worker's condition might require emergency treatment, you may inform first aid and safety personnel about the condition, where appropriate. Otherwise, do not share the worker�s condition, health status or physical limitations with anyone.

14. Support and Continuing Support Be open to co-workers positive suggestions to make their colleagues return easier and less stressful. Provide support to co-workers during the return to work process. Continue to keep open lines of communication with the returning worker. Let them know they continue to be a valuable member of the work team.

15. Types of Job Accommodations Workplace modifications Environmental Ergonomic Assistive Technologies Work schedule modifications Workday adjustments Flexible hours Changes to daily schedule Tele-work Work task modifications Interpreters Readers

16. Environmental Accommodations Lighting Noise reduction Temperature Level of customer contact Access to the workspace

17. Ergonomic Accommodations Seating Access to files Lazy Susans Computer access Heights Monitor Keyboard/mouse Desk Access to computer bays Office equipment and tools Automatic staplers, hole punches, scissors, Ergonomic writing tools

18. Assistive Technologies �Barrier Busters� Computer Access Low Vision / Blindness Hard of Hearing / Deaf Augmentative Communication Environmental Controls Aids for Daily Living

19. Computer Access and Use Voice Recognition Screen Reading Screen Magnification Alternative Keyboards and Mice

20. Low Vision / Blindness Magnifiers Video Magnification Scan and Read Software Screen Reader Software Large Print (phones, copies, labels)

21. Hard of Hearing / Deaf Personal amplification Phone amplification FM Systems Alert systems TTY�s Video Relay Services

22. Augmentative Communication Voice output devices (Aug Comm devices) Low Tech High Tech Laptop with voice output Dual input devices

23. Environmental Control Computer based Voice recognition �Switch� access Noise reduction systems Alternative lighting

24. Aids for Daily Living Talking Watches Pocket Magnifiers Reminder devices Cell Phones

25. Resources for Assistive Technologies Assistive Technology of Alaska (www.atlaak.org) Wisconsin Assistive Technology Checklist ( http://www.tcnj.edu/~caties/documents/ATChecklistWATI.pdf ) ABLEDATA (http://www.abledata.com ) Alaska�s One Stop Job Center Network (http://www.jobs.state.ak.us/) Alaska�s Independent Living Centers Access Alaska (http://www.accessalaska.org/) S.A.I.L. (http://www.sailinc.org/) Kenai Peninsula Independence Living Center (http://www.peninsulailc.org/)

26. Job Accommodation Process Step 1: Decide if the employee with a disability is qualified to perform the essential functions of the job with or without an accommodation. Step 2: Identify the employee's workplace accommodation needs by: involving the employee who has the disability in every step of the process; employing confidentiality principles while exploring ways to provide workplace accommodations; consulting with rehabilitation professionals, if needed; using job descriptions and job analyses to detail essential functions of the job; and identifying the employee's functional limitations and potential accommodations

27. Job Accommodation Process Step 3: Select and provide the accommodation that is most appropriate for the employee and employer. Costs should not be an undue hardship. Accommodations selected should be effective, reliable, easy to use, and readily available for the employee needing the accommodation. An employee should try the product or piece of equipment prior to purchase. Step 4: Check results by: monitoring the accommodation to see if the adaptation enables the employee to complete the necessary work task(s); and periodically evaluating the accommodation(s) to ensure effectiveness. Step 5: Provide follow-up, if needed, by: modifying the accommodation if necessary; or repeating these steps if appropriate.

28. Available Tax Credits Disabled Access Tax Credit: This is a tax credit available to an eligible small business in the amount of 50 percent of eligible expenditures that exceed $250 but do not exceed $10,250 for a taxable year. Architectural Barrier Tax Deduction: Businesses may deduct up to $15,000 of the costs incurred each year to remove physical, structural, or transportation barriers in the workplace.

29. Available Tax Credits Work Opportunity Tax Credit A tax credit for employers who hire certain targeted low-income groups, including vocational rehabilitation referrals, former AFDC recipients, veterans, ex-felons, food stamp recipients, summer youth employees, and SSI recipients. The consolidated WOTC for hiring most target group members can now be as much as: $2,400 for each new adult hire; $1,200 for each new summer youth hire, $4,800 for each new disabled veteran hire, and $9,000 for each new long-term family assistance recipient hired over a two-year period.

30. The Ticket to Work and Employer Networks Employment Networks Any agency or instrumentality of a state (or political subdivision), or a private entity that takes responsibility for the actual delivery of services or the coordination/referral of services is eligible to apply to be an Employment Network (EN). Employment Networks can be a single entity, a partnership or alliance of entities (public and/or private), or a consortium of organizations collaborating to combine resources to serve Ticket-holders.

31. Employment Networks Payments New EN Milestone-Outcome Payment System (2009 figures)* Payment Type Beneficiary Earnings SSDI Payment SSI Payment Amount Amount Phase 1 Milestones Milestone 1 $350 for one calendar month $1, 211 $1, 211 Milestone 2 $700/mo. x 3 mos. w/in 6 mos. (cumulative) $1, 211 $1, 211 Milestone 3 $700/mo. x 6 mos. w/in 12 mos. (cumulative) $1, 211 $1, 211 Milestone 4 $700/mo. x 9 mos. w/in 18 mos. (cumulative) $1, 211 $1, 211 Total Potential Phase 1 Milestones $4,844 $4,844 Phase 2 Milestones Gross Earnings > SGA ($980/$1640)** $363 a month for $207 a month for up to 11 months up to 18 months $363 x 11 = $3,993 $207 x 18 = $3,726 Total Potential Phase 1 + 2 Milestones $8,837 $8,570 Monthly Outcome Payments Earnings > SGA ($980/$1640/month)** $363 a month for $207 a month for and federal cash benefit = $0 up to 36 months up to 60 months $363 x 36 = $13,068 $207 x 60 = $12,420 Total Potential Milestone and Outcome Payments $21, 905 $20,990

32. Demonstrated Employer Success

33. JAN � Job Accommodation Network Service of the Office of Disability Employment Policy Free resource for questions about: Job Accommodations The Americans with Disabilities Act Confidential Maintains a database of previous accommodations

34. Navigating the ADAAA Business and Advocate Support Passed 9/25/08 Effective 1/1/09

35. Navigating the ADAAA Provide a National Mandate for the Elimination of Discrimination Reinstate a Broad Scope of Protection to Be Available Under the ADA = Broader Definition of Disability ADAAA: Overall Purpose

36. Navigating the ADAAA Definition of Disability: Same as the Old Definition An individual who: has a physical or mental impairment which substantially limits one or more major life activities; has a record of such an impairment; or is regarded as having such an impairment.

37. Navigating the ADAAA Definition of Disability: Substantially Limits � Will Not Be As High a Standard �No regulations yet EEOC is writing them

38. Navigating the ADAAA Examples From Old Definition: Multiple Sclerosis, extreme fatigue ? disability (not enough, can still do things) Sleep Disorder, 2 � hours of sleep ? disability (can still sleep) Stroke, problems learning new tasks ? disability (just glitches) Cancer, side effects from chemo ? disability (short-term)

39. Navigating the ADAAA Definition of Disability: Mitigating Measures � Will Not Be Considered Things Such As: �medication, medical supplies, equipment, low-vision, prosthetics, hearing aids and cochlear implants, mobility devices, oxygen therapy equipment and supplies use of assistive technology reasonable accommodations or auxiliary aids or services learned behavioral or adaptive neurological modifications � NOT: Ordinary eyeglasses or contact lens

40. Navigating the ADAAA Definition of Disability: Major Life Activities � Expanded Definition� Include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, working. �Also includes the operation of a major bodily function, including but not limited to, functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, reproductive functions.

41. Navigating the ADAAA Definition of Disability: Episodic or in Remission Consider as if active 

42. Navigating the ADAAA Definition of Disability: Regarded As � Very Broad, No Substantially Limits Requirement Subjected to an action prohibited under the ADA because of an actual or perceived physical or mental impairment whether or not the impairment limits or is perceived to limit a major life activity Does not apply to impairments that are transitory (6 months or less) and minor

43. Reasonable Accommodation: Same As It Was Employers: can choose among effective accommodation options do not have to provide accommodations that pose an undue hardship do not have to provide personal use items needed in accomplishing daily activities both on and off the job do not have to make an accommodation for an individual who is not otherwise qualified for a position do not have to remove essential functions, create new jobs, or lower production standards

44. Benefits & Costs Employers who contact JAN were asked if they would be willing to participate in a user-satisfaction survey. Approximately 8 weeks after the initial call, they were contacted. They were asked a series of questions about their experience with JAN and what occurred after that contact. JAN Study

45. Benefits & Costs 1,182 employers interviewed between January, 2004, and December, 2006 366 employers interviewed between June 28, 2008, and July 31, 2009 Total of 1,548 Employers

46. Benefits & Costs RESULTS: Over half of accommodations (56%) were made at no cost. Of the 37% who experienced a one-time cost to make an accommodation, the typical cost of accommodating an employee was $600. Only 23 (5%) said the accommodation resulted in an ongoing, annual cost to the company and 9 (2%) said the accommodation required a combination of one-time and annual costs.

47. Benefits & Costs

48. Contact JAN (800) 526-7234 (V) (877) 781-9403 (TTY) http://www.jan.wvu.edu jan@jan.wvu.edu

49. What Can You Do?

50. Upcoming events for Businesses Disability Employment Awareness Month Career X Disability Employment Forum November 12 � Anchorage

51. Let us be your resource!Contact Information Patrick Reinhart Business and Industry Liaison (907) 269-8554 patrick.reinhart@alaska.gov Rich Sanders Alaska Works Program Coordinator (907) 269-5703 richard.sanders@alaska.gov