Posted on Jul 15, 2014

 

The Minnesota Department of Human Services (DHS) recently requested comments on its Employment First Polity. Implementation of this policy will lead to tremendous changes in employment service delivery for all people with disabilities. 

Following is a letter submitted to the Minnesota Department of Human Services by Rise President Lynn Noren:

Rise supports people with a broad range of disabilities and other barriers to employment, housing and inclusion in the community.  We have been providing employment supports since 1971 when a group of parents created the organization to support their family member with a disability.  Over the years, there have been many policy changes that have impacted service delivery, and we at Rise, have always worked to be innovative leaders at the forefront of implementing policy change.  We are supportive of an employment first policy and we do envision a community in which people with disabilities are able to live, work and thrive.  We have staff members working hard every day supporting people we serve in job development and have developed significant relationships with the business community.

Rise has been a leader in the placement of people with disabilities into community-based employment.  I have no doubt that we can continue to seek new and innovative service delivery models to continue to be successful in supporting people with significant disabilities to work.  Having said that, we have several concerns with the policy as stated and the implementation process, especially the concepts that actually limit choices for people moving forward.

Our first concern is that the proposed Employment First policy is so narrowly focused that it limits choice for people who are currently successful in working in group settings.  Rise has developed business partnerships with notable community employers such as Pentair, Cummins Power Generation, HOM Furniture, and many others.  Over the years, these partnerships have provided excellent, long-lasting employment opportunities for people we serve.  In most cases, the people we serve are making competitive wages, working between 20-28 hours per week during the days and hours that are preferred by the individual.  Staffing supports and transportation resources are built into these services, and we receive high satisfaction feedback from the people we serve who are employed in group settings.

Based on the new policy, however, it is clear these arrangements will no longer meet the definition of a preferred or funded outcome.  It seems incredibly counter-productive not to honor people’s employment choices and to force one choice, when there are many people for whom employment options are not yet developed.

Another challenge that we currently experience is the current limitation of funding resources for people who want to transition to an independent job in the community.  Job placement supports funded through DEED are not typically available to the many people who have intellectual/developmental disabilities that we serve. Rise staff team actively works with service teams to identify the potential for competitive placement services.  For people transitioning from group work settings, application for DEED services to obtain funding for placement often involves an assessment of employability. Many people who have been through this process are deemed “unemployable” because their productivity is less than competitive.

Additionally, the use of Medicaid funds is also limited.  People are unable to get new funds because of county budget constraints in managing their waiver allocations.  Without adequate resources for job development, it will not be possible to provide the situational assessments and job placement supports people need.

The area that gives us the most concern, however, is for people with significant disabilities who do not see employment as a priority need — those who rely on Rise supports to meet their health and safety needs.  For instance, in the early to mid-1980s, our organization made a decision to respond to county requests to develop services for people leaving Minnesota RTCs.  We developed person-centered habilitation services to meet the needs of these individuals, many of whom had complex medical or behavioral conditions.  Over the years, we have been identified as a preferred provider of these services and the programs have grown considerably.  We work very closely with families in providing these supports due to the complexity of the individuals served; their preferences lead to detailed service plans from which we provide employment and community-based habilitation services.  The current plan will force an informed consent process on these individuals, when the core of their preferences is not related to employment.  It seems harsh and inconsistent with person-centered service delivery.

Service providers like Rise have long, trusting relationships established with the people we serve and their families.  Whenever there are policy or regulatory changes, they will look to us for information and support.  We feel the current process for seeking input on this policy was extremely limited and short-term.  Families of people receiving services are not connected with DHS’s public website.  In most cases, this information is shared with families by providers.  Posting the notice on the afternoon before a major holiday and limiting the input to two weeks is unacceptable.  When questioned about this, a DHS employee reminded us that there had been previous “listening and feedback sessions offered through MEPI and the Community Action Teams sponsored through MNTAT.”  Very few of the thousands of people that will be impacted by this policy participated in any of those opportunities.

The process for vetting this policy is going to become a significant barrier to its acceptance by providers, families and other stakeholders.  Taking the time to get it right, will lead to the implementation of a much more informed process. Right now, a very small group of people are trying to push their agenda. If that is not DHS’s intent, it is nonetheless the perception, because of the rushed implementation without proper vetting.

Rise will actively engage in developing supports to meet the policy changes required by the HCBS Settings Rule and Olmstead.  We are committed to meeting the needs of the people we support and we believe there are, in fact, MANY ways to meet their preferences and needs.  We would like to be part of the continued conversation that is necessary for the implementation of this policy. Minnesota has several committees working on these issues.  It may be difficult for the people we serve and their families, providers and other stakeholders to navigate the information coming from the Employment First Community of Learning, the HCBS Rule Compliance and Transition Plan Development Process Advisory Committee, and other groups that are making decisions related to the new HCBS rules and Olmstead Plan.

Rise advocates for open communication in a streamlined manner from the Department of Human Services.  We will do our best to pass along information and feedback as we receive it.

Sincerely,

Lynn Noren, President