Feature Issue on Employment and IDD

In 2021, officials at Rise, Incorporated voluntarily chose to end the organization’s 50-year-old, subminimum wage employment program by April 2024 as part of an incentive that the Minnesota Department of Human Services offered all providers in the state. As part of this process, Rise staff supported more than 200 people with intellectual and developmental disabilities (IDD) as they prepared to leave their long-held center-based, subminimum wage jobs.

The transition included helping people choose their future services. Would they retire into day services? Choose competitive, integrated employment? Opt for a Supported Employment Team (SET), which is a semi-independent, community-integrated, supported employment site, or something in-between?

Our 45 years of placement experience suggested that people we served would have barriers to saying yes to competitive employment after subminimum wage work. These barriers to community-based employment included limited transportation access, fear of losing income-limited benefits, safety concerns, low expectations, lack of training, and guardian discomfort with community-based work.

We sought to address these barriers so that a person with subminimum wage work history could reasonably consider employment if they chose to do so right away or in the future.

The Rise team created a SET program using the principles of supported decision-making (SDM).

Four experienced direct support staff were hired internally as SDM experts.

Each professional worked with 50-75 individuals during our three-year phase-out period, providing individualized supports for each person. Case managers initially matched with persons served based on previous relationships. Then, our employment exploration specialists got to know them through program activities during participants’ work day, because we didn’t want to disrupt their ability to earn an income. For some, this would be the last opportunity to earn an income before retiring. Specialists performed a needs assessment to determine what potential barriers and skill gaps might affect future employment decisions. Then, they developed a service delivery plan for activities to target these barriers and skills.

The majority of interventions we provided fell into a few categories:

• Transportation support: doing transit assessments; signing up people for MetroMobility (the disability transit system in Minnesota) and Lyft; teaching people to use those services; working with guardians and other staff to support transportation use.
• Benefits coaching: setting up a “vault” at Disability Benefits 101, which helps people with disabilities estimate how their pay could affect their health coverage and benefits.
• Job tryouts: short-term paid opportunities to test out different work duties, environments, and levels of independence.
• Job shadowing and workplace tours: researching jobs with input from support teams; virtual job shadow and workplace tours; formal job shadow experiences.
• Pre-vocational training: communication, safety, workplace norms, self-management, and goal development.

Not every person received all services. Some worked primarily with their assigned DSP, others matched based on expertise. One is a parent of two adults with IDD, so her coworkers called her in for support with hesitant guardians. Another knows American Sign Language and excelled at communication training, so she worked with deaf and hearing folks alike to develop better occupational communication skills. Another is an expert on the rural barriers people with disabilities face. We supported one DSP through training to become a benefits coach.

Tailoring the programming to individual needs and desires has resulted in wildly different experiences. Some people needed little or no support and were ready to retire into day services or move to a competitive placement immediately. Our team continued to work with those who had larger barriers. Eventually, we see this program as an intake process for people beginning services at Rise or for people already receiving services at Rise who want to explore employment.

Community-Based Research

As Rise was implementing this program in 2022, we received a request for proposal from the Shavlik Family Foundation for data grants. Initially, we had intended to evaluate our program internally. As a former academic who was completing a graduate certificate in program evaluation at the University of Minnesota, I suggested we partner with social science researchers to make our process and the results of our program to end subminimum wages more public so that other providers and researchers could learn from our experience.

Having previously worked with Brian Valentini, associate professor of special education, and Marcy Young Illies, associate professor of institutional and organizational psychology at Saint Cloud State University (SCSU), we approached them about collaborating on a joint research inquiry and program evaluation. They agreed to help develop an evaluation plan that sought to identify what specific SDM interventions and what client background factors might influence a person’s choice about services. The goal was to understand what affects decisions so that we can tailor services to address individuals’ specific barriers. Our core evaluation questions for the inquiry included:

• Which supported decision-making interventions increase the likelihood of seeking out community-based employment? Which interventions work for specific demographic categories?
• What services will participants choose, and what factors predict these choices?
• Does the supported decision-making process change people’s ideas about employment? Specially, does it increase self-efficacy, or the belief in oneself that they can hold a community-based job?
• In what ways does the participant experience a change in their community integration and/or quality of life because of this program?

In fall 2022 we received funding from the Shavlik Family Foundation to move forward on the evaluation.

Like most disability service providers, we don’t have the internal capacity or the staff expertise to support as much research and evaluation as we would like. At that time, I was completing a graduate certificate in program evaluation, taking both a doctoral level internship supervised by David Johnson, a professor at the University of Minnesota and a disability advocate, and a class on survey design. We received funding at the beginning of September, just in time for my internship proposal. This graduate certificate bolstered my social science research skills and put me in the position to bring together academic researchers and human services agencies.

During my fellowship, I worked with persons served, direct support staff, and program leadership to adapt survey questionnaires to be disability inclusive. I worked with our employment exploration specialists to design the survey administrative process and then trained them to deliver surveys. I cleaned data from our case management system to get a usable list of survey participants.

Over the next two years, we surveyed parents and guardians and are now completing our survey administration with program participants. . Our employment exploration specialists are our survey administrators, helping interpret questions for the people they support. Having DSPs do survey administration posed some administrative challenges, but it ultimately helped ensure our survey administration was as inclusive as possible because they are the staff members closest to survey participants. It also helped DSPs better understand their roles and made them feel connected to the mission of their roles.

Results

In early 2024, we submitted two proposals to the American Association on Intellectual and Developmental Disabilities about our research. The first was a panel discussion where we spoke about the benefits and challenges of community-based research that includes providers. We discussed our collaborative process to and how agency-researcher partnerships provide unique opportunities to include people with the highest support needs in research as both participants and leaders.

In the other presentation, Illies and Valentini presented our initial findings from the parent survey. While more comprehensive analysis is coming in both academic and nonacademic venues, the first results suggest that parents and guardians of adults with disabilities with subminimum wage work history are more skeptical of the possibility of employment than previous research has suggested.

These results were not surprising and targeting parent hesitation is something Rise had already been looking to mitigate. We’re currently working with The Arc Minnesota to set up a parent support program for parents of people served by Rise. A Rise DSP who is also a parent to adults with IDD will co-lead the sessions with a planning specialist with The Arc.

What’s Next

Rise worked with more than 200 people with disabilities to decide their future services after the end of subminimum wage work.

Some were open to employment, but had much larger barriers, so our DSPs supported them to transition to their new program (usually a day program) while still working with them on their employment goals. Technical assistance from the Institute on Community Integration helped Rise keep the door open to employment during this transition to day services. Maybe employment wasn’t the choice in 2024, but our goal is to play the long game.

We’ve learned people with disabilities living in more rural areas have greater, specific barriers to employment. We’re working on a pilot project that is designed to target the specific barriers faced by people living in rural communities.

Lessons Learned

Our core learnings from Rise’s journey into ending subminimum wage work, SDM, and community-based research include:

Rising tides do lift all boats: We realized quickly that many people leaving subminimum wage jobs were open to employment, but a market-wage SET site was a better first step than a completely independent community-based job. Yet, we had no room in SET sites for new workers! We adjusted our approach early on to accommodate this reality by dedicating a DSP to support people working on SETs to make the decision to move to competitive employment. By working with them through a SDM process, we were able to move people ready for new opportunities for competitive, integrated jobs to create space for new workers on the team.

Get creative with funding: Our first funder was the nVent Foundation, part of an electrical manufacturer and one of Rise’s longest standing business partners, hiring people with disabilities through Rise for more than 45 years. From the academic side, we received funding to do the research project from the Shavlik Family Foundation, which typically funds nonprofit work.

Get comfortable with a variety of outcomes: While we designed the program to help people working in subminimum wage jobs choose employment, many are choosing other options, and that’s okay. Because so many people working subminimum wage jobs at Rise are over 40, many are choosing to retire into Rise’s community-integrated day programs. Rise sees this as a success because we all desire a dignified retirement, which is a secondary benefit that the process allows for our older workers.

Be open to the transformational benefits of community-based research: Rise and SCSU both took risks for this partnership. Highly regulated providers must grapple with the discomfort of the spotlight that researchers can shine onto highly complex operations. Researchers must give up some control to truly work collaboratively with an agency partner. We both gained more than we risked, however, and as a result, people with disabilities with higher support needs can participate and are represented in research about their lives and outcomes.