Addressing Threats to Pre-Vocational Services: Measuring Value

1. ADDRESSING CURRENT THREATS TO PRE-VOCATIONAL SERVICESBY MEASURING VALUEDr. Susan BoserIndiana University of Pennsylvania Colleen Stuart, CEO andSusanna Giesey, Compliance/Quality DirectorVenango Training and Development Center, Inc.

2. AGENDA • Review current policy actions affecting pre-vocational services. • Identify statistical trends in Home and Community-Based Services. • Summarize service strategies in PA an other states • Analyze the Strengths, Weaknesses, Opportunities and Threats of Pre-Vocational services in PA • Identify other SWOTs (Programmatic, Economic, and Public) • Define Program Evaluation in Human Services • Present a proposal to evaluate Pre-Vocational services in PA.

4. FUNDING, RIGHTS, & UNEMPLOYMENT: ENVIRONMENTAL FORCES FOR SYSTEMS CHANGE

5. SYSTEMS CHANGES THREATEN THE FUTURE OF PRE-VOCATIONAL SERVICES

6. HCBS WAIVERCOSTS EXCEED STATE INSTITUTIONS22

7. U.S. DATA TRENDS SHOW INCREASING PARTICIPATION IN DAY PROGRAMS23 Numbers are rounded to the nearest thousand.

8. PA’S PLANS FOR THE FUTURE • PA’s Transition Plan for HCBS Waivers • WIOA • ODP Futures Planning • OVR’s State Plan • Healthy PA

9. PROVIDER PERSPECTIVE – How Do Providers Need To Look at the Future? LET’S DO A “SWOT” ANALYSIS STRENGTHS • Currently approximately 10,000 Individuals with Intellectual Disabilities are Choosing Pre-Vocational Services in PA. • Pre-Vocational Providers in PA adapt to the needs of those we serve. • Providers have developed “Quality Management Plans”, following ODP Guidelines, to insure quality. • PA Bureau of Human Service Licensing holds us to a high standard of operations.

10. SWOT STRENGTHS cont. • Programs Provide real work opportunities for persons with significant disabilities. • Providers are linked to a strong employer base that depends upon our workforce. • Our non-profit agencies provide thousands of jobs, which makes us an integral part of the economic infrastructure in our local communities • There is a strong provider network through the Vocational Division of RCPA

11. SWOT WEAKNESSES • No consistent data measurement tool to track pre-vocational outcomes. • Providers are using different “benchmarks” for outcomes. • Not all providers have staff trained in data collection. • Many Providers are short staffed with high turnover.

12. SWOT WEAKNESSES cont. • Pre-Vocational Providers in PA have done a poor job of marketing our program successes. • Providers don’t have strong, family advocacy systems in place. • Pre-Vocational Providers have differing levels of access to subcontract work

13. SWOT OPPORTUNITIES • Access to the IUP Leadership Professors and the PA University system • Strong knowledgeable Pre-Vocational Provider membership vested in the project can provide valuable input. • Development and implementation of an “Outcome Measurement Tool” that can be replicated state wide. • Additional training in Quality Management and Program Evaluation that will enhance ODP requirements

14. SWOT OPPORTUNITIES cont. • Opportunity to establish additional partnerships that will enhance project outcomes • Data will reveal the importance of Pre-Vocational Sheltered Programs • Project will strengthen the quality and consistency of pre-vocational service provision in PA.

15. SWOT THREATS • Ability to access sufficient funding to support the initiative • CMS Waiver Final Ruling segregation language and community/family interpretation • Workforce Innovation & Opportunity Act “Work First” interpretation • Ability of all Pre-Vocational Providers in the State to participate (i.e.- staffing capacity and competency)

16. SWOT THREATS cont. • ODP’s quality management priorities only measure competitive employment as success. • L&I proposed legislation, HB 831, which removes subminimum wage certificates

17. SWOT OTHERS? • PROGRAMMATIC • PUBLIC • ECONOMIC

18. PROGRAM EVALUATION AND PRE-VOCATIONAL SERVICESDr. Susan BoserIndiana University of Pennsylvania

19. PROGRAM EVALUATION IN HUMAN SERVICES • What program evaluation is — and what it isn’t • Defining “outcomes” data • Challenges with collecting outcomes data in nonprofit human services • Special challenges in collecting outcomes data for pre-vocational services

20. PROPOSAL: Create a standardized assessment & data tracking tool by: • Research • Inventory existing tools & create a matrix • Literature search • Exploratory qualitative research with key groups • Collaborative review of findings, decision about tool’s structure and design.

21. PROPOSAL: Create a standardized assessment & data tracking tool by: • Test & refine the tool • Review by focus groups • Pilot test • Analyze and refine • Implementation • Training and administration • Integrated data management system • Reporting mechanisms

22. QUESTIONS: • Who must participate in the focus groups? • What challenges do you foresee in implementing a standardized outcome assessment tool? • What potential uses do you see for a standardized outcome assessment tool? • Any fears or concerns?

23. IUP/RCPA PRE-VOCATIONAL EVALUATION AND RESEARCH PROJECT CONTACT INFORMATION: Colleen Stuart E-mail: castuart@vtdc.org Dr. Susan Boser E-mail: sboser@iup.edu Susanna Giesey E-mail: sgiesey@vtdc.org

24. SOURCES 1Benjamin Franklin image from Hulton Archive/Getty (n.d.). [online image]. Retrieved August 4, 2014 from http://www.thedailybeast.com/articles/2013/04/14/benjamin-franklin-america-s-first-storm-chaser.html 2Sandlin, Leo. (April 13, 2013). “Benjamin Franklin, America’s First Storm Chaser”. Retrieved August 4, 2014 from http://www.thedailybeast.com/articles/2013/04/14/benjamin-franklin-america-s-first-storm-chaser.html 3ACCSES. (n.d.) ACCSES Public Policy Principles and Issues for 2013. Retrieved July 22, 2014 from http://www.accses.org/CMS/Resources/dropbox/accses2013publicpolicyprinciplesandissues.pdf 4ACCSES. (n.d.) ACCSES Public Policy Principles and Issues for 2014. Retrieved July 22, 2014 from http://www.accses.org/CMS/Resources/dropbox/accses2014publicpolicyprinciplesandissues.pdf 5Special Olympics Press Room., (February 17, 2014). “Unemployment of People with Intellectual Disabilities More than Twice as High as General Population”. Retrieved on May 1, 2014 from http://www.specialolympics.org/Press/2014/Special_Olympics_Unemployment_Survey.aspx 6National Disability Institute News. (July 22, 2014). “NDI report finds adults with disabilities continue to be economically shortchanged despite ADA’s guarantee.” Retrieved on August 4, 2014 from http://www.realeconomicimpact.org/News.aspx?id=427

25. SOURCES 7U.S. Department of Justice logo. (n.d.). [Online image]. Retrieved on July 29, 2014 from http://blawg.law.sc.edu/wp-content/uploads/2012/09/department-of-justice-logo.gif 8U.S. Department of Labor logo. (n.d.). [Online image]. Retrieved on July 29, 2014 from http://www.wagehourblog.com/files/2014/04/DOL1.png 9The White House logo. (n.d.). [Online image]. Retrieved on July 29, 2014 from http://upload.wikimedia.org/wikipedia/commons/5/5e/US-WhiteHouse-Logo.svg 10The Centers for Medicare and Medicaid Services. (n.d.). Retrieved on July 29, 2014 from http://radiationtherapynews.com/wp-content/uploads/2014/07/Centers-for-Medicare-Medicaid-Services.jpg 11 “Employment First State Leadership Mentoring Program Community of Practice Evaluation: Notice.” Federal Register 79:131 (9 July 2014) p. 38960-38961. Retrieved July 21, 2014 from https://www.federalregister.gov/articles/2014/07/09/2014-16057/agency-information-collection-activities-submission-for-omb-review-comment-request-employment-first 12Harkin, T. (2012). “Unfinished Business: Making employment of people with disabilities a national priority”. United States Senate Committee on Health, Education, Labor and Pensions. Retrieved on August 8, 2014 from http://www.harkin.senate.gov/documents/pdf/500469b49b364.pdf. 13Barry, D. (April 8, 2014). "Rhode Island settles case on jobs for the disabled". In www.nytimes.com. Retrieved on July 11, 2014 from http://www.nytimes.com/2014/04/09/us/developmentally-disabled-get-more-workplace-protections.html?_r=0

26. SOURCES 14H.R. 831--113th Congress: Fair Wages for Workers with Disabilities Act of 2013. (2013). In www.GovTrack.us. Retrieved July 22, 2014, from http://www.govtrack.us/congress/bills/113/hr831 15“Affirmative Action and Nondiscrimination Obligations of Contractors and Subcontractors Regarding Individuals With Disabilities; Final Rule." Federal Register 78:185 (24 September 2014) p. 58682-58752. Retrieved July 23, 2014 from https://www.federalregister.gov/articles/2013/09/24/2013-21228/affirmative-action-and-nondiscrimination-obligations-of-contractors-and-subcontractors-regarding 16H.R. 803--113th Congress: Workforce Innovation and Opportunity Act. (2013). In www.GovTrack.us. Retrieved July 23, 2014, from http://www.govtrack.us/congress/bills/113/hr803 17Increasing Federal Employment of Individuals With Disabilities, Executive Order 13548." Federal Register 75:146. (30 July 2010) p. 45039-45041. Retrieved August 6, 2014 from http://wwaw.gpo.gov/fdsys/pkg/FR-2010-07-30/pdf/2010-18988.pdf. 18"Establishing a Minimum Wage for Contractors, Executive Order 13658." Federal Register 79:34     (20 February 2014) p. 9851-9854. Retrieved July 22, 2014 from http://www.gpo.gov/fdsys/pkg/FR-2014-02-20/pdf/2014-03805.pdf. 19“Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Home and Community-Based Setting Requirements for Community First Choice and Home and Community-Based Services Waivers; Final Rule”., Federal Register 79:11     (16 January 2014) p. 2948-3039. Retrieved January 24, 2014 from http://www.gpo.gov/fdsys/pkg/FR-2014-01-16/pdf/2014-00487.pdf.

27. SOURCES 20Center for Medicaid Services. CMS Bulletin, September 16, 2011. “Updates to the 1915 (c) Waiver Instructions and Technical Guide regarding employment and employment related services.” Retrieved July 23, 2014 from http://downloads.cms.gov/cmsgov/archived-downloads/CMCSBulletins/downloads/CIB-9-16-11.pdf 21National Disability Institute Lead Center. (2014). “Medicaid Managed Care and Its Implications on Employment Services”. Retrieved July 21, 2014from Lead Center https://www.leadcenter.org/webinars/medicaid-managed-care-and-its-implications-employment-services. 22Braddock. D., e.a. (February 27, 2013). “Intellectual and developmental disabilities services in the U.S.: 2013”. Coleman Institute for Cognitive Disabilities and the University of Colorado. Retrieved on August 5, 2014 from www.stateofthestates.org/imagtes/documents/2013_02_27AAIDDSOSWebinar_rfinal.pdf. 23Braddock. D., e. a. (2013). The State of the States in Developmental Disabilities 2013. Coleman Institute for Cognitive Disabilities and University of Colorado. 24Braddock. D., Challenges in developmental disabilities. State of the states, state of the nation, 2011. The Arc of the United States 60th Annual Convention, Denver, CO, September 17, 2011.. 25Rehabilitation Community Providers Association. (2014). Personal Communication. Harrisburg, PA: May 2, 2014.