Lessons from Scaling a Customized Employment Program for Workers with Disabilities

Feb 26, 2020

Since the early 2000s, federal policy has encouraged customized employment strategies to help people with significant disabilities secure paid jobs. Through customized employment, the relationship between the job seeker and employer is personalized so that the needs of both are met through negotiation of the worker’s job duties and flexible work arrangements. About eight years ago, the nonprofit SourceAmerica launched a new program called Pathways to Careers that combined several types of customized employment strategies, such as an assessment of program participants’ strengths (called Discovery), paid internships and work experiences, and post-employment career support. Pathways started with a pilot site in Clearfield, Utah, and expanded to four other sites in Massachusetts; Michigan; Virginia; and Ogden, Utah.

Pathways is the focus of an evaluation that Mathematica is conducting, and it will also be the subject of a webinar that Mathematica is hosting on March 11. On this episode of On the Evidence, Shane Kanady, the vice president of workforce development at SourceAmerica, and Noelle Denny-Brown, a senior researcher at Mathematica, discuss findings from Mathematica’s evaluation as well as what’s next for the Pathways program.

Click here to listen to the full interview or read the following abridged and edited Q&A blog based on the conversation.

What is Pathways?

Denny-Brown: Several years ago, SourceAmerica developed the Pathways service model by working in consultation with a firm called Marc Gold & Associates. The overarching goal was to develop a package of customized employment supports that would help people with significant disabilities—namely, those with intellectual or developmental disabilities or those with autism spectrum disorder—secure competitive employment. In the past, many people with significant disabilities have predominantly worked in what are known as facility-based employment settings. They’re working alongside other people who have a disability. Oftentimes, they’re paid less than federal minimum wage, and they’re not engaged in work that is meaningful or skill building. Pathways offers an alternative to facility-based employment.

Kanady: One of the things that makes Pathways special—and this is true of customized employment in general—is that it starts with a presumption of ability and a presumption of the value that someone can create if given the opportunity to do so. By requiring the right alignment of their skills and interests with what the job market might hold, it creates a more sustainable match so that the person has career prospects going forward.

What did you learn from scaling up Pathways in the additional states and in the different program contexts?

Denny-Brown: So far, we’ve observed promising findings from the evaluation. Through the end of 2019, over 150 participants have enrolled in Pathways across all five of the sites. When we look at employment outcomes, over 60 percent of Pathways participants have secured competitive employment and have worked in their jobs for 20 months, on average. These are relatively long tenures in employment. Of course, we’re also tracking and monitoring earnings outcomes, and we know that employed participants are earning $10 per hour on average, which is considerably higher than the federal minimum wage of $7.25 per hour.

Last year, my colleague Purvi Sevak led a study where we looked at the employment and earnings outcomes of Pathways participants in the Utah site. We compared these outcomes to people with similar disability and demographic characteristics who were served by state vocational rehabilitation agencies. What we found is that Pathways participants and people receiving vocational rehabilitation services had similar rates of employment lasting 90 days or longer. However, the Pathways participants had higher earnings, $10 per hour, compared with the people receiving vocational rehabilitation services, who were earning $8.80 per hour. We also found that Pathways participants worked more hours on average each week, 28 hours per week, compared with about 20 hours per week that we saw for the vocational rehabilitation clients. Working more hours at higher wages, Pathways participants had greater weekly earnings on average than the similar vocational rehabilitation clients ($274 versus $175).

Were there any surprises in the findings?

Kanady: One of the things that struck me when we started to look at the evaluation data is the level of impact that [the Pathways program] had on individuals. While we’re talking about this program and the rigorous evaluation and policy change—at the end of the day, what we shouldn't lose sight of is that people are being impacted. It is incredible that the average annual earnings for a person, from before Pathways to their time in Pathways, increased by 387 percent. It’s incredible in terms of an individual’s context, but also in terms of how they’re supported potentially by their family. When persons with disabilities are disconnected from the labor market, it impacts their family members, their friends, their caregivers, and their communities. If we can have that level of positive impact on an individual level, and it has a ripple effect on the whole community, that is important to highlight.

The oldest of the Pathways sites in Utah has successfully braided different sources of funding to help make the program sustainable. Why is it important for the sites that implement Pathways, or components of it, to braid funding?

Denny-Brown: There are several different funding streams that support people with disabilities in achieving their employment goals. State vocational rehabilitation agencies generally provide more time-limited job placement support to help eligible people with disabilities secure employment. In some states, the demand for these services outweighs the availability and capacity of vocational rehabilitation agencies to provide that support, so there are waiting lists in place for people to receive these services.

Longer-term employment services and supports for people with disabilities are most often provided by either the state developmental disability agency or through a Medicaid Home and Community-Based Services waiver, which is where people with significant disabilities may receive day habilitation services, for example, or prevocational services, supported employment, or career planning services.

The inherent challenge is that these employment service programs are housed within different funding authorities. In some cases, there is an inherent lack of coordination and funding across these different service systems. Part of the goal of Pathways is to establish strong partnerships with state and local agencies to braid funding sources together in a coordinated way to help participants achieve integrated employment. Ideally, the funding would be provided in a way that is more streamlined and smoother for the end user and for the agency administering services. We have seen some Pathways sites succeed in building relationships with state and local agencies to secure outside funding, namely from vocational rehabilitation or the state Medicaid agency, to offset the cost of Pathways services.

Reflecting on the evaluation of Pathways, what gaps in knowledge still exist in terms of helping people with significant disabilities find employment? And what questions do you hope future research might explore?

Denny-Brown: People with disabilities face myriad barriers to securing employment. But, a big barrier is the fact that many employers have preconceived notions about hiring a worker with a disability. For example, they may have concerns about the person’s work quality or productivity, or [employers may be concerned about] managing unexpected behaviors in the workplace. I think an interesting area for future research is identifying strategies for engaging employers and educating them about the tremendous value that hiring workers with disabilities can add to an organization, not only in terms of filling a business need, but also in creating a richer, more inclusive culture in the workplace.

Another area for future research is looking at how employment is resulting in improved quality-of-life outcomes for people with disabilities. Not only does this population face limited job prospects, but they also face a number of pretty complex challenges related to accessing affordable housing and adequate health care, which makes this population vulnerable to poor health, employment, and quality-of-life outcomes. An interesting area for future research is looking at the connection between employment and improved quality of life outcomes for this population.

Kanady: [We need a clearer] understanding [of] the gaps between the methodologies that currently exist, how they’re funded nationally and at the state level, and where they fall relative to those idealized outcomes [we’re trying to achieve]. At some point, there needs to be a recognition that the funding is not there to get to the level of inclusive employment through systems that people expect. We can’t entirely try to shift the burden to the private sector and expect that they are going to be welcoming of the vast diversity of persons with disabilities. This isn’t a judgement statement [on private businesses], but if they were already predisposed to do that, we wouldn’t be having this conversation because there would not be this tremendous gap between the employment engagement of persons with disabilities and those without.

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The opinions expressed are those of the author(s) and do not represent those of Mathematica.