Organizational change from facility based to community based employment services
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Organizational Change From Facility-based to Community-based Employment Services. Pat Rogan, Ph.D. Indiana University October 4, 2013. AGENDA. Introduction & current status Critical features of states with high employment outcomes. Organizational change processes & outcomes

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Organizational Change From Facility-based to Community-based Employment Services

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Organizational Change From Facility-based to Community-based Employment Services

Pat Rogan, Ph.D.

Indiana University

October 4, 2013


AGENDA

  • Introduction & current status

    • Critical features of states with high employment outcomes.

  • Organizational change processes & outcomes

    • Strategies & tips to address barriers

  • Q & A

  • Resources & contacts


Why Have Organizations Changed from Sheltered to Integrated Employment?

  • Leadership within the organization

    (“It’s the right thing to do.”)

  • People receiving services dissatisfied (Most want a job.)

  • Poor quality services & outcomes of sheltered

    facilities (“make work”, low wages, artificial setting; poor models)

  • Push from federal and state agencies

    • RSA (no funding for workshop placements)

    • Olmstead (“Most integrated setting”)

    • Employment First initiatives


How Are We Doing?

  • 27% of people with IDD in integrated jobs

  • Increased segregation + non-work community activities.

  • >625,000 in sheltered facilities earning subminimum wages.

  • The rate of movement from sheltered to integrated work: a mere 1-5%.

    State Data 2012 (Butterworth et al. ICI)


How are we Doing?

  • Medicaid spends 4X more money on segregated adult day programs than supported employment.

  • No preference for integrated employment within the Medicaid program.

  • Migliore 2007 – 63% of people with disabilities would like to work outside the facility.


Top Tier States

  • Washington

  • Oklahoma

  • Vermont

  • New Hampshire

    + Growing Number of

    “Employment First” States


Critical Features of States

  • Positive philosophy, policies, & adequate funding

  • Capacity building & advocacy efforts

  • Strong, consistent leadership

  • Data based decisions

  • Employment First policies & systems change initiatives


Understanding What to Change

The Organization


Lessons For Organizational Change (Butterworth et al – T-TAP Mentor Guide)


Establish Clear Goals

  • By June 2014 we will place 40 people in individualized and integrated jobs that pay at least minimum wage average 20 hours per week.

  • By October 2014 we will cease all new entries into our sheltered facility, and cease all backfilling.


Clearly Communicate Expectations & Often!

  • Newsletters, website, presentations, etc.

    • Does your organization’s name convey your focus on employment?

    • Does your language focus on individuals’ capacities vs. deficits?

  • Celebrate successes!


Reallocate & Restructure Resources

  • Flatten the organizational structure

  • Unload “sunk” costs (buildings, equipment)

  • Restructure job descriptions

  • Empower front line staff (“community builders”) to make decisions.

  • Focus on staff development & mentoring.


Find Jobs One Person at a Time


Effective Employment Strategies

Positive Community Services

  • No need to “get ready” - Teach in community.

  • Person-centered planning – Capacity search.

Traditional Services

  • Focus on readiness

  • Move through the continuum

  • Deficit-based voc.

    evaluation


Effective Strategies (cont.)

Community Services

  • Individual orientation

  • Design supports around person

  • Tap generic services & natural supports

Traditional Services

  • Group orientation

  • Fit to programs

  • Human services orientation

  • “Special” services


Develop Partnerships

  • Engage key stakeholders from the start:

    • Parents

    • Board members

    • Case Managers

    • Funders

    • etc

  • Develop external partnerships:

    • Voc Rehab & DD

    • Community Living orgs

    • Business Leadership Network (BLN)

    • Benefits planning (BPAO)


Major Barriers & Tips for Change

  • Negative attitudes

  • Funding

  • Lack of expertise

  • Lack of leadership

  • Transportation

  • Safety net


Innovations in State Waivers

  • Vermont: Waiver is a model for managing supports for participants.

  • Connecticut: Flexible in terms of individual budgeting and self-determination.

  • Washington State: 4 Waivers are tailored to individual needs.

  • Indiana: One of 16 states with Supports Waivers, emphasizing employment, support brokers, financial management services and person-directed goods and services.

    Braddock et al, 2013


Tips from Those Who Have Been There

  • Involve all levels in discussion of vision & values.

  • Invest heavily in training.

  • Use the vision & inherent values to evaluate everything.

  • Communicate, communicate, communicate!

  • Use individual planning for all…tie the agency’s success to your customers’.


Q & A


THOSE WHO SAY

IT CAN’T BE DONE

SHOULD GET OUT OF THE WAY

OF THOSE WHO ARE DOING IT!


You’re Invited!

7th National Organizational Change Forum 

A Time for Change...

Sheltered Workshop Conversion

October 22-23, 2013

Burlington, Vermont


Resources

  • Nancy Brooks-Lane @Cobb/Douglas Community Services Boards –([email protected])

  • John Butterworth @ ICI Boston ([email protected])

  • Bryan Dague @ U. Vermont ([email protected])

  • Suzi Hutcheson @ Helping People Succeed, Inc. ([email protected])

  • Don Lavin @ Rise, Inc. ([email protected])

  • Pat Rogan @ Indiana University ([email protected])


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