Business and rehabilitation factors in the development of supported employment programs for adults with developmental disabilities.

Segregated services for persons with developmental disabilities had been the rule and not the exception until the late 1970's (Scheerenberger, 1983). Traditionally services were provided in large or small custodial-like programs and facilities which resulted in severe restrictions on the individual's experience with a variety of non-disabled persons and integrated environments. These services while efficient in the maintenance functions of daily living did not provide a normalized lifestyle as compared to non-handicapped persons (Wolfensberger, 1977). Nevertheless, multiple services options did develop and expand, coinciding with the mandated deinstitutionalization movement (Scheerenberger, 1983) and developmental disabilities (DD) legislation which provided for comprehensive services to meet life-long needs for support-assistance.

Within the service delivery system, vocational services was a component that developed late (Kiernan & Payne, 1982). In fact, it was not until the late 1960's that vocational services for persons with developmental disabilities received substantial attention (Kiernan & Payne, 1982, Whitehead, 1979). Williams (1967), in his analysis of renumerative employment for persons with mentally retardation stated, "Discussion of the occupation of profoundly retarded adults is almost nonexistent in the literature" (p. 18). The vocational system that developed, however, followed the same principles of the residential service component. This new system involved the expansion of the existing system to provide services to a population which previously was unserved. The sheltered workshop model in the case of vocational and employment services had gained widespread acceptance in general rehabilitation by 1960. Subsequently, between the late 1960's and 1970's there was a 300% increase in the growth of sheltered programs for persons with disabilities with the bulk of the growth in programs for the developmentally disabled population (Whitehead, 1979). Work and day activity services were added to the sheltered workshop approach to form a continuum or "flow through" system for the development of work skills or for providing a non-work day programming option for persons with developmental disabilities. (Bellamy, Rhodes, Bourbeaux, & Mank, 1986). While the intent of the options for persons with developmental disabilities was to provide work opportunity, in fact, the evolving service system had a negative impact on persons served and their ability to function independently in the natural work environment (Bellamy et al., 1986, Defazio & Flexer, 1983; Greenleigh, 1975; Pomerantz & Marholin, 1977; Whitehead, 1977).

The traditional vocational service system that developed for the DD population has been a continuum of sheltered employment services and a variety of near-and non-work options. The basic criticisms of the workshop options (sheltered workshop or work activity) are: lack of training for "real" work, and conflicting service/employment goals or the duality of purpose problem. (Bellamy et al., 1986; Defazio & Flexer, 1983).

Lack of training for "real" work can be seen when comparing competitive work or transitional employment programs to sheltered employment services. This training problem evolves, in part, around the types of work that sheltered facilities perform versus what types of work are commonly available in the competitive job market. Generally speaking, the workshop subcontracts work that no other business performs or that other individuals would not want to do (Gold 1973). Much of the work that is performed involves tasks such as collating and sorting of material, which are not major duties in the competitive work place. As a result, skills that are specific to these restricted jobs are not generalizable to competitive jobs. Moreover, according to the data provided by Greenleigh Associates (1975), U.S. Department of Labor (1979), and Bellamy et al., (1986), the national rate of placement out of sheltered facilities was under 10% during the period surveyed.

An overriding factor, which relates to availability of work and remuneration for work performed is an issue referred to as the duality of purpose (Pomerantz & Marholin, 1977). This criticism is targeted at the inability of workshops to provide appropriate combinations of: normalized business practices and procedures and training/habilitation that either will move the individual out of the sheltered program and into the job market or provide significant remuneration within the sheltered program. From the habilitative standpoint, Flynn (1977), in evaluating 38 vocational services, found that these services did not meet the "minimal acceptable" level of service quality when looking at the overall program which included normalization as a factor. Wages are historically non-remunerative (Bellamy, Rhodes, Mank, & Albin, 1986; U.S. Department of Labor, 1979) while workshops have difficulty providing enough volume of work to even approximate a work-life atmosphere. In short, the typical sheltered program for people with developmental disabilities meets neither a business criteria nor a habilitation standard.

In summary, the basic findings of much literature support a negative evaluation from the standpoint of work opportunity either in preparation for competitive work or development of skill and meaningful work within the workshop program. All of the studies point to a need for alternative service delivery approaches to providing employment services to people with developmental disabilities.

Supported employment is a delivery model that has developed over the last 10-12 years as an alternative to the flow-through continuum of vocational and employment services. Durand and Neufeldt (1977) were among the first to coin the term "Employment with Support", which has now developed into the expression "Supported Employment". The supported employment model involves a few basic components (Mank, Rhodes, & Bellamy, 1986). The first is that a supported work program provides "normal benefits of working" and the second is that the service should accommodate all disabilities, even the most severe. Achieving the benefits of working for all people with disabilities requires the development of a "full range of outcomes, including income, good working conditions and other work benefits and providing ongoing support that allows persons with severe disabilities to perform available work" (Mank, Rhodes, & Bellamy, 1985, p. 140).

The next section of this article reviews approaches to supported employment from the business/habilitation perspective to document how a business approach can be blended with a habilitation function to achieve real employment opportunity for persons who are developmentally disabled. Following this review, an overview on marketing supported employment and business incentives will be provided. The purpose of these reviews is to illustrate the role of supported employment in meeting business needs and in turn how employment service delivery can also be targeted at the goal of work opportunity for the population served.

The Business/Habilitation Base for Real Work Opportunity

The Developmental Disabilities (DD) Act of 1984 (Public Law 98-527) defines supported employment as paid employment which:

1. is for persons with developmental disabilities for whom competitive employment at or above the minimum wage is unlikely and who, because of their disabilities, need intensive ongoing support to perform in a work setting;

2. is conducted in a variety of settings, particularly worksites in which persons without disabilities are employed; and

3. is supported by any activity needed to sustain paid work by persons with disabilities, including supervision, training and transportation.

Building on the DD Act Congress passed, in 1986, the Amendments to the Rehabilitation Act of 1973 defined and expanded supported employment services as an option for individuals with severe disabilities who are being served by Vocational Rehabilitation programs.

Supported employment is defined by the Rehabilitation Act Amendments of 1986 as: competitive work in integrated settings (a) for individuals with severe handicaps for whom competitive employment has not traditionally occured, or (b) for individuals for whom competitive employment has been interrupted or intermittent as a result of a severe disability and who, because of their handicap, need ongoing support services to perform such work. Supported employment is further defined by the refinement of its components (i.e., competitive work, integrated settings, severe handicaps, and ongoing support services) in the Final Regulations (Federal Register, May 12, 1988).

Several broad guidelines in the development of the supported employment approach revolve around the business/habilitation duality problem. Supported employment approaches first require a sound business base (Bellamy et al.,1988). A need for goods and/or services within the specific locale must be established, and, then, marketing and operational procedures must be developed in order to sell and to deliver competitively to meet the identified need. The major difference between supported employment business/operations and that of other business is that development of labor resources involves the process of providing employment services and training to people with disabilities. The learning and performance variables in terms of individual work completion involves a longer and/or modified personnel development procedure.

To achieve a sound business base two basic business approaches have been recommended: one approach is that of a personnel service (Bellamy et al., 1988). An organization with this focus helps persons with developmental disabilities to locate and to perform jobs as employees in other companies. This type of support organization functions much like personnel placement agencies and personnel departments of bigger companies. The support organization provides a service to the employer (needed labor) and provides training and normative employment outcomes to consumers. Supported Competitive Employment (Kregel, 1989; Wehman, 1985) and Enclaves in Industry (Rhodes & Valenta, 1985, and 1989) are the primary examples of support organizations with a personnel development focus.

The second approach which includes Mobile Work Crews (Bourbeau, 1985) and Small Business efforts (Mank, Rhodes, & Bellamy, 1986) are primarily entrepreneurial in emphasis. These approaches are like any other small business engaged in selling services and products but also combine features of a support organization. Each of these approaches is distinct and provides a range of services and business approaches to assist in developing employment options for employees who are developmentally disabled.

Business and Habilitation in the Personnel Service Approach

Supported Competitive Employment (SCE) provides training/support services to the individual in order to accomplish independent work in a competitive non-segregated employment setting (Kregel, 1989). The SCE model has two basic strategies (Bates, 1986; Lagomarcino, 1986; Moss, Dineon, & Ford, 1986; Volgelsberg, 1986; Wehman, 1986). The first strategy requires securing a placement for a prospective employee and has a three steps: Job Development and Placement, Job Site Training and Advocacy and Follow-up and Transition (Volgelsberg, 1986; Wehman 1986). The second type usually has a four stage sequence because job site training is provided prior to placement in a competitive job and requires components of: Survey, Train, Place and Follow-up (Bates, 1986; Lagomarcino, 1986; Moss, Dinen, & Ford, 1986).

The place then train strategy focuses on training in a negotiated competitive job. Jobs are located, matched to the prospective employee, and training is provided on the chosen job. Preplacement planning is vital because the goal is to match a worker with a disability to an optimal job. Analysis in this stage involves understanding what jobs are available and making some initial assessment as to what jobs might be an acceptable match. A second level to Job Development and Placement is that of establishing potential job placements, which is achieved with specific employers that have jobs meeting the pre-established criteria in terms of employee needs.

During the Job Site Training and Advocacy Phase the specific strategy for teaching the job to the worker is developed. A variety of survival skills are the focus in this phase, ranging from learning the specific job duties to independent transportation, co-worker relationships and employee/family counseling (Kregel, 1989). The full range of survival skills for adaptation/autonomy is trained and promoted by the trainer. Additionally, through each step of the process independence is fostered until the worker may be transitioned to the third and final step.

The Follow-along and Transition component of SCE is a series of steps which follows training activities in which the employee has learned the complete job and has been trained to a level of independence. During this phase, the trainer systematically fades out of the work site and maintains contact on a periodic basis. In short, this phase of the program is to assure job retention.

The train then place strategy adds a component of "preemployment training" in either a community-based job site or a specially designed training site. Further, this training is based upon "social and vocational survival skills identified through an assessment of job requisites in the local community" (Lagomarino, 1986, p.68). After planning activities to determine the requisite skills of the jobs in the local community, targeted skills are formulated, a curriculum is developed, and a training program is implemented. Generally, this component is a "time-limited" training strategy in which community-based training stations are utilized to provide a normalized instructional environment (Lagomarcino, 1986). Ostensibly, this preemployment training period is designed to instill all the skills necessary for independent work and to screen out most inappropriate behavior which, if exhibited in a regular placement site, could set back the regular placement process (Lagomarcino, 1986). Once trained to criteria the trainee would then move into a placement/training/ follow-up sequence similar to the place then train strategy.

Another approach which uses a personnel service business base for Supported Employment is Enclaves in Industry (Rhodes & Valenta 1985 a & b). Mank, Rhodes, & Bellamy, (1986) define an Enclave as, "a group of individuals who are trained and supervised among nonhandicapped workers in an industry or business," (p.43). In this model, no more than eight individuals with severe to moderate retardation or other severe handicaps are employed. The training is achieved in a company providing benefits and pay to these employees commensurate to those provided to the non-disabled worker (Rhodes & Valenta, 1989). Further, this small group of individuals perform duties that are guaranteed to be performed accurately and at a "fixed cost" of productivity (Mank et al., 1986). Examples of the type of work that Enclaves perform are: production lines (Rhodes & Valenta, 1989], kitchen dishwashers (Burr, 1985), and building janitorial crews (Conti, 1982). In all of the above situations, the enclave works as a group in a single location performing specific duties with the support of trained staff.

SCE and Enclave models utilize a personnel service business base (Bellamy et al., 1988). Qualified employees, job completion, a reduction in turnover are marketed along with a "program of training and support" to insure employee job performance and retention. Employee habilitation and training are achieved in the meeting of employer labor demands and achieving a blend of business/habilitation components.

Business and Habilitation in the Entrepreneurial Approach

The Mobile Work Crew Model is a commercial enterprise that provides work opportunities for persons who are MR/DD, as well as providing supportive services (Mank et al., 1986). Generally, work crews work from vans or trucks, in groups of five to six, performing service jobs in a variety of locations in the business or general community. This service structure is usually developed in areas where an industry base doesn't exist, making untenable utilization of one of the other supported work models (Bourbeau, 1985). Typically, the crews work is subcontracted from individuals or businesses with jobs being temporary in nature. Some jobs may be long term; however, these jobs require periodic completion (e.g., once/week) and can be performed on a part-time basis. Common jobs performed by work crews are: grouds maintenance, house renovations, house cleaning, and farm work (Lasko, 1985). This work is generally easily mastered and thus provides a medium for quick performance.

The fourth and final supported work model is that of the Entrepreneurial/Small Business Model (O'Bryan, 1989). This model is designed to function as a small business subcontracting electronics assembly work or similar low overhead assembly work. The focus of the subcontracting is on developing work that requires skills or duties that exist in other businesses in the community and that can be maintained for long periods. The business, which consists of no more than eight persons with mental retardation or developmental disabilities and having a staff-to-worker ratio of 1:4, is generally located proximal to a variety of normalized settings in which multitude of interactions can occur. While the literature has generally discussed electronics work, Mank et al., (1986) provide three components which, if met, could be used for other types of businesses.

"First, large capital investments are not required to begin operation... Second, there are small initial requirements for space Third, the manufacturers of small assemblies having little space allows companies to contract work from customers several hundred miles away without incurring excessive shipping expenses" (p.147).

Thus, if one looks for small component assemblies, that require a small amount of space and limited initial outlay of funds, the model could be replicated.

The mobile crew and small business models utilize an entrepreneurial approach. Real work opportunity is provided through the business goal of selling products and services that are needed (for which there is a market) while the support organization provides training, support and habilitation, meeting employer needs for job completion and carrer goals of employees. Further, the integration requirements must be met through providing for interactions by hiring other non-disabled workers or planning and implementing interactions with non-disabled persons during break and lunch activities.

Analysis of Marketing Factors in Supported Employment

Marketing of supported employment services to employers is perhaps the "crucial" factor in developing supported employment services. Without work opportunity the benefits of working can not be realized by consumers while market analysis is the first and prerequisite step in developing a supported employment program. Moreover, rehabilitation staff typically have the least experience, knowledge and comfort in dealing with the business world (Defazio & Flexer, 1983).

The marketing step, therefore will be given an overview treatment. We would like to re-examine the process from two angles, one is by looking at the literature on factors in hiring decisions (positive and negative) as file another angle would be analysis of market planning to determine the history of business interaction with rehabilitation and to determine the possible motivation structure of employers. From this, we derive a set of basic assumptions in terms of "selling" the idea of employing persons with developmental disabilities.

A second perspective are the incentives for employers to get involved in supported employment. While the former considerations may pique employers' interest, the incentives may be utilized to "seal the deal."

Factors in Hiring Decisions

Bellamy et al., (1988) cite the more general reasons that employers choose to employ persons with disabilities. Among the reasons are: 1. The company benefits from having good employees, which

assists in problems in absenteeism, turnover, motivation

and job performance. 2. Hiring people with disabilities benefits community relations 

through demonstrating corporate responsibility and enhancing

the companies public image. 3. Hiring persons with disabilities enriches a company's culture

and serves to show their concern for all employees. 4. The capability to hire persons with disabilities gives companies

an edge in a labor short economy. 5. Because work opportunity reduces social service needs, businesses

taxes can be positively affected. 6. Employment of persons with disabilities demonstrates responsiveness

to affirmative action requirements and allows

the company to take advantage of government incentive (p.

288-249).

A survey conducted at RRTC at Virginia Commonwealth University (Shafer, Hill, Seyfarth, & Wehman, 1987) polled three groups of employers (those using supported employment; those using traditional job placement services; and those never hiring) to determine factors important in hiring decisions of individuals with mental retardation. A commitment to provide an opportunity to works for persons with developmental disabilities was the most often mentioned reason cited for hiring for all employer groups. Besides having an available position, follow-along services and assured job completion provided through supported employment were among the strongest factors which determined hiring decision for the group which used supported employment services. Employees with developmental disabilities also were rated favorably in their work performance, particularly attendance and punctuality, by the employer group. It appears from these data that a concept of supported employment for employers must incorporate strong philosophical, motivational and factual bases - an employment and business point of reference must be coupled with advocacy if favorable hiring decisions are to be made.

The Shafer et al. study (1987) would suggest that getting good employees and an edge in labor short economies (business reasons) at least initially are stronger than altruistic or sociological motivational factors. An overall marketing plan of supported employment should include development and implementation of strategies which are based on employer needs. The marketing strategies should be aimed at enhancing the image of persons with developmental disabilities as employees and at explaining the role of supported employment options in meeting community/business labor needs. While the mission and philosophy of the Supported Employment organization is the driving force behind the marketing approach, the final outcome of any marketing plan is to increase supported employment options for persons with developmental disabilities.

Market Planning in Supported Employment

The problem with most traditional marketing approaches in increasing employer awareness is that awareness alone is the only objective these approaches achieve. Available print and video media utilized in marketing in rehabilitation makes the employer more aware, but willingness to employ persons with disabilities or to work cooperatively with professionals to develop new options are not increased or systematically addressed. (Shafer, Hill, Segfarth, & Wehman, 1989). We think that this is because previous efforts have been directed at awareness and not education and the methods used lack a systematic approach to tapping into the needs of employers and to describing the capability of the population of persons the employment service is representing.

In developing a marketing plan, there is a need to develop strategies which are specifically geared to employers as the consumers of the marketing program. The broad consensus which must be incorporated in the marketing approach include: persons with developmental disabilities as productive employees, and a labor resource and supported employment as service with additional benefits beyond providing a qualified pool of potential employees. Another component in the marketing process for supported employment involves concerns, attitudes, and misconceptions (Mithuag, 1979; Renzaglia, 1986). Among employers there are minorities at either end of the continuum of willingness to try supported employment - those who need no great realignment of their beliefs and attitudes to be "sold" and those who would not try it no matter what. The large majority sitting on the fence must be systematically cultured to help them overcome their reluctance and to improve their ideas about the capabilities of persons with disabilities. Enhancing images of our consumers as people worth knowing and as competent employees (McCord, 1983; Wolfensberger, 1986) must be coupled with strong factual information dealing with workman's compensation and related concerns (Bellany, Rhodes, Mank, & Albin, 1988; E.E. Dupont, 1982). Although philosophical and motivational factors have had some impact in hiring decisions, it is obvious that from the employer's point of view there still remain objections to employment of persons with disabilities in the areas of insurance, physical modification, safety and special privileges. As in the Dupont study (1982), a supported employment concept must include answers to these objections-supported employment options are safe, require no great costs in modification or insurance, and reflect an expectation of equal treatment with accomodations to which other employees have no objection.

Marketing strategies need to be developed that go beyond awareness and impact upon willingness. Based upon the authors review of the literature and our experience, broad guidelines in developing a marketing approach should include; 1. People with developmental disabilities are their own best

salesperson. Any approach to changing willingness must

utilize people with developmental disabilities displaying

their competence (enhancing their image) as employees and

must allow them to speak and advocate for themselves

(Vandergoot, 1986). 2. Employers have the most credibility with other employers.

Presentations of ideas of supported employment and viability

of the approach must be communicated by employers

who have found it successful - has met their labor needs

without disruption and with relatively little risk (Vandergoot,

1986). 3. Supported employment network must be described as a program

in a common sense way and with business oriented 

concepts. A variety of situations in which it has worked

must be used to highlight the highly individualized approach

that is utilized. (Kiernan, Carter, & Bronstein,

1989; Shafer, Parent, & Everson, 1989). 4. Education/awareness programs must be developed and

tested both to determine criteria for the content to be delivered

to employers and formats of delivery. (Kiernan et al.,

1989; Shafer et al., 1989).

Business Incentive for Use of Supported Employment

Employers have a whole array of values/needs through which their perception of supported employment may be affected. The values/needs come from two areas/concerns: 1. What are advantages/disadvantages from business perspectives; 2. How compatible is supported employment with how work gets done (Kiernan, et al., 1989; Shafer et al., 1989; Vandergoot, 1986). We have addressed the business compatibility issues and some major advantages and disadvantages. To round off our discussion, a description of incentives will be provided. This description will include the delineation of areas relative to financial supports for employees with disabilities, tax benefits, skill training for persons with disabilities, and special supports in the areas of accomodation and job enabling.

Employment incentives, many established in law, are the last group of factors that could have a significant impact on employers' hiring decisions and should be part of marketing strategy. Besides monetary incentives, funds may be made available to absorbed excess costs in hiring a disabled person incurred either because of more On the Job Training (OJT) or accommodations required. These funds are available from three basic sources: Vocational Rehabilitation (VR), United States Employment Services (USES), and the Private Industry Council (PIC). While both agencies have different criteria, the basic intent of the program is to support employers for training workers with a disability. These funds are restricted to training only, are time limited, reimburse the employer on a ratio or need basis and must result in the person being employed. Another monetary incentive is Targeted Jobs Tax Credits (TJTC). With the TJTC "for-profit" businesses can obtain tax credits for hiring workers with handicaps. Generally speaking for each individual with a handicap hired, up to $2,400 may deducted from the employing business' taxes. The resultant tax relief varies with each business; however, there is generally significant savings (Internal Revenue Service, 1989).

A third incentive available to the employer that may be interested in hiring a person with a disability is that of tax deductions for expenditures related to the modification or adaptation of business facilities. This benefit allows the employer to deduct up to $35,000 in expenses relative to accessibility related modifications to enable persons with disabilities to work. This deduction can be taken in one year verses amortizing their business expense over a number of years (Internal Revenue Service, 1989).

Rehabilitation engineering is also available to employers as a result of the Amendments to the 1973 Rehabilitation Act. The federal/state VR program can provide employers with assistance in adapting specific jobs in their attempts to accommodate the specific needs of the prospective employee. Examples of adaptations might be specialized chairs, adaptive machinery, or a computer with special adaptations. In every case, the equipment is the property of the consumer and the state agency and the employer does not retain the use of the adaptation if the consumer is not maintained in the position.

Another significant but little known incentive that exist is the "Second Injury provision" of the Workman's Compensation Fund that affords a protection for the business if an injury occurs on the job that is a direct result of the employee's disability (Larson, 1952). In Ohio, for example, the accidents are reviewed and the outcome (the sharing of cost) is determined on a percentage basis as to the degree to which the disability "caused" the accident.

An overlooked benefit that many employers view as necessary is that of the employment specialist that provides placement, training, and long term support to the consumer and the employer. Many employers consider this benefit a very strong incentive if the placement program is capable of demonstrating that they are willing to train, support and maintain the consumer in their new work setting. Many employers are concerned that they have little or no ability in dealing person with disabilities and it is the supports of the "experts" in the field that will be the deciding factor as to whether the individual will be hired (Vandergoot, 1986).

Related to the employment specialist incentive there is the availability of funds for specific skill training and related training for persons with disabilities. These funds are available in a grant type service delivery method through State Employment Services or local PIC. Grants are reviewed and funded according to their effectiveness and the grant's specifications in meeting the PIC's criteria of need. These funds can be accessed through either private "non-profit" or "for profit" business.

A final employer incentive related to hiring persons with disabilities is that of special Department of Labor (DOL) regulations which enables an employer to hire consumers that are not, at present, able to produce work at competitive rates. The mechanism for accessing this program is a simple application that specifies only the necessary information and can be filled out with ease. This information has to be updated semi-annually and can be incorporated in the employers usual employee review process. The focus of this DOL waiver is to allow the employer time to train the individual and apply them at below commensurate rates (the usual wages that is earned in the market place). The intent of this waiver is to provide a temporary reduction wage and that, after the training period is concluded, the consumer would be producing at competitive rates. This reduction in wages, however, can go on indefinetely if the consumer continues to demonstrate below competitive production (Federal Register, May 20, 1988).

Several government and other incentive programs have been developed to assist in the acquisition of employment for persons with disabilities. However, states and localities may vary in terms of utilization and implementational. Inequality does exist and uniformity must be sought.

SUMMARY

A systematic method/approach must be developed which is directed at employers beliefs, attitudes and willingness and which is validated with employers. The approach recommended would utilize examples of successful supported employment placements of persons with developmental disabilties as the primary means of communicating to employers.

The future success of the employment programs for persons with DDrests squarely on the supported employment movement. We have attempted to trace the roots and relationships of supported employment in terms of traditional sheltered workshop services. Supported employment was described as a refined approach to developing work opportunity and also meeting the needs both of consumers for training and support and of employers for needed labor resources. Approaches to supported employment were described which provide a blend of strategies dealing with the business/habilitation duality problem. Critical factors in the marketing of supported employment were examined to highlight the initial steps in the building of a positive and effective interface with the business community in the development of work opportunity.

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