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What are they?

There is no universal definition of “employment first,” however, the policies and practices aim to develop systems of integrated, community-based employment for individuals with disabilities. Employment First programs utilize a clear set of guiding principles to raise the expectations and implement better practices regarding employment for individuals with disabilities. These policies are articulated and enforced by state statute, a regulated and unified definition of employment, and funding community-based businesses. Employment here typically becomes defined as jobs, wages, and business settings that aren’t pared down to cater to an assumed inability or diminished ability of individuals with disabilities. The ultimate goal of these initiatives is to create a single employment standard and expectation applicable to any working-age adult, including those with disabilities. In this way, individuals with disabilities and their families are encouraged to fully participate in the community and are supported in their efforts to cultivate an independent lifestyle.

What are the objectives of employment first?

Initially, a grassroots movement implemented in a select few states, Employment First has grown into a national agenda. The Office of Disability Employment (ODEP), nested within the U.S. Department of Labor, has defined integrated employment as, “…work paid directly by employers at the greater of minimum or prevailing wages with commensurate benefits, occurring in a typical work setting where the employee with a disability interacts or has the opportunity to interact continuously with co-workers without disabilities, has an opportunity for advancement and job mobility, and is preferably engaged full-time.” States have formally committed to integrated employment through either official executive proclamation or formal legislative action.

In order to assist with states’ efforts, especially those without the capacity or resources to implement programs on their own, ODEP has instituted the Employment First State Leadership Mentoring Program (EFSLMP). The objectives of the program are as follows:

  • Provide mentoring, technical assistance, and training from national experts and peer mentors to states as they alter policy, service delivery systems, and reimbursement structures to reflect the Employment First approach
  • Facilitate training and knowledge translation on effective practices
  • Facilitate dialogue on shared experiences related to effectuating Employment First practices
  • Link participating states with current Federal initiatives
  • Evaluate the impacts of investing in state Employment First systems change efforts over time to identify common challenges and validate innovation and efficacy

The technical assistance offered by EFSLMP spans multiple categories: strategic guidance, practice & policy reform, provider transformation, capacity building, and peer-to-peer mentoring. This assistance walks states through the multiple challenges associated with mass restructuring to fit the Employment First model. In addition to offering states assistance to states, the program as resulted in the creation of the National Employment First Policy & Data Platform. The database is supposed to serve as a comprehensive resource for policy-makers, researchers, and external stakeholders on national trends and state Employment First activities. It contains individual profiles of each state’s legislation, policies, funding initiatives, pilots, and strategic partnerships as they relate to increasing integrated employment.

How can they be improved?

The Association of People Supporting Employment First (APSE) created a comprehensive guide to establishing Employment First on a national scale early in 2014. This guide thoroughly explored a multi-faceted approach to integrated employment, both on national and state scales. Their agenda focuses on a few core principles: building on communities, clarifying “employment,” and “employment first,” emphasizing policies that enact real systems change, focusing on strengths-based practices, and measuring and evaluating practices. Their full website packed with resources, advocacy centers, fact sheets, policy guides, clearly defined goals. They also host multiple conferences workshops on national and regional levels. APSE has identified the key goals of their 2017 agenda to include multiple qualitative and quantitative goals.

Legislation

Workforce Innovation and Opportunity Act (WIOA):

WIOA’s partnerships with Vocational Rehabilitation, educational agencies, public developmental disability, and public mental health agencies, shifts the current perspective of our systems that assume those with disabilities can’t work to assume that they can.

Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities (ACICIEID):

This committee was created under the WIOA of 2014. Its purpose is to increase employment opportunities for individuals who are intellectually or developmentally disabled, or others with significant disabilities and limit the use of waivers that allows employers to pay those with disabilities below minimum wage. The committee issued its final recommendations in 2016 for capacity building, programmatic changes, and improved oversight. APSE is working to support any initiatives resulting from the committee’s recommendations.

Americans with Disabilities Act (ADA) and the Olmsted Decision:

The ADA requires state and local governments to administer services and programs allowing for “individuals with disabilities to interact with nondisabled persons to the fullest extent…” In the Olmsted Decision, the Supreme Court ruled that unjustified segregation is unlawful. Despite this, segregation of disabled individuals continues at high rates relatively unchecked. APSE is supporting advocacy efforts to encourage the Administration to support civil rights of individuals with disabilities that when denied can create significant barriers to employment and self-sufficiency.

Medicaid

As many persons with disabilities rely primarily on Medicaid (~10 million individuals), and as they generally do not have access to employer-based coverage, have greater medical needs, and often require assistance with daily living throughout their lifetimes, APSE advocates for the continued protection of Medicaid Long-Term Services and Supports.

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