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Advancing Customized Employment: Building Careers for People with Disabilities via One-Stop Centers:
Sustainability

07/2007

Project Overview

Grant number, name, and location: Advancing Customized Employment: Building Careers for People with Disabilities via One-Stop Centers, Chicago IL, #E-9-4-3-0104

Grant recipient: Chicago Workforce Board

Subcontractors: Thresholds, Inc.; University of Illinois at Chicago National Research and Training Center

The key focus of Advancing Customized Employment (ACE) was to enhance the capacity of local One-Stop Career Centers to provide Customized Employment services to individuals with psychiatric disabilities. The project entailed collaboration between the Chicago Workforce Board and two partners. The first was the University of Illinois at Chicago: National Research and Training Center on Psychiatric Disability (NRTC). Among other activities, NRTC tracked all data on participants, facilitated focus groups, and provided training to project and One-Stop staff. The second partner was the largest psychiatric rehabilitation agency in Illinois, Thresholds, Inc., which has operated for over 40 years. They were responsible for the Customized Employment service delivery and provided the direct service staff for the project.

Key Lessons

  • Project activities need to be closely linked to city and statewide system change efforts to ensure that the grant's accomplishments inform these larger efforts.
  • The Chicago Ticket to Work pilot demonstration provided "milestone" payments, which allowed project partners to take Tickets without concerns about the risk of reimbursement.

ACE used very innovative methods to institutionalize the project's best practices. The state of Illinois had a work group called Brand New Day that addressed issues around funding vocational services for people with mental illness. An ACE staff person was very active with this group. A goal for the work group was to streamline the terminology and eligibility of similar services available to individuals with mental illness. This group also provided technical assistance to the state's Department of Human Services to develop a conversion system from a grant-funded to a fee-for-service billing system for services rendered.

The Chicago Workforce Board (CWB) submitted comments supporting the reauthorization of legislation and funding to the Social Security Administration. They were champions in the sustainability process. Through the ACE project manager, who was a CWB staff person, the board was very active in local and state-level activities that affect policy for individuals with disabilities. Project staff worked with the following entities to integrate employment for individuals with disabilities into their efforts:

  • The Mayor's Office of Workforce Development
  • Disabilityworks, an employment initiative for people with disabilities at the Chicagoland Chamber of Commerce
  • The advisory panel for a Department of Education five-year initiative to increase career opportunities for individuals with a disability who are homeless or formerly homeless
  • Department of Commerce and Economic Opportunity, to discuss a state- and region-wide disability employment initiative
  • Community Providers Leadership Network, a regional initiative to increase employment for people with disabilities
  • Social Security regional commissioner's Work Incentives Advisory Group
  • Mayor's Office for People with Disabilities
  • Employment Leadership Group, the Illinois policy work group
  • A work group investigating recommendations to the Department of Public Aid to rectify issues regarding earnings retention for residents of nursing homes

ACE also worked very closely with state representative Sara Feigenholtz, chair of the Department of Human Services appropriations committee, to discuss funding options for employment services.

ACE partner Thresholds, Inc. was one of three Employment Networks selected to participate in the Chicago Ticket to Work pilot demonstration. The city initiated a pilot to test a "capital investment" approach to assist Employment Networks to overcome some perceived disincentives of the current payment system. This city-based project allowed 4-5 payments for service over the year, with the money coming through the state Department of Rehabilitation Services and the Mayor's Office for People with Disabilities.

Under this pilot, Thresholds had accepted over 20 tickets at the time of this writing and was receiving payment from the pilot. If this demonstration proved successful, it may be extended and could provide financing for employment services of some individuals through the project. In addition, this pilot was monitored nationally as an example of the capital investment approach.

The state was awarded a Johnson & Johnson Foundation grant to fund a year of planning and infrastructure development to create incentives and expertise for supported employment as a sustainable service. The new initiative planned to integrate elements of Customized Employment through the efforts of Thresholds, Inc, a partner in this grant. ACE worked with the state partners of this project to develop models for cost-sharing when two state agencies provide services to the same customer. ACE planned to adapt this model to aid cost-sharing between the state and city agencies in Chicago. This would increase funding options for individuals with mental illness.

Accomplishments

Policy Efforts Underway to Sustain Grant Efforts (See Access Plan)

  • ACE created an access plan for each of its One-Stops that clearly outlined the career center's responsibilities around accommodations and universal design, in addition to procedures and forms to address issues and requests.
  • ACE continued to struggle with the Medicaid income limit of $55.00/month for individuals residing in nursing homes, and was working with the state legislature to change this policy. Many individuals with mental illness moved into nursing homes after the state hospitals closed.
  • The state of Illinois continued to try to work with the state Medicaid Infrastructure grant to use Medicaid dollars to pay for some services related to employment for individuals with mental illness. The state had very limited money available through its mental health system to pay for employment services for these individuals. In addition, ACE worked actively with the state VR system to provide more comprehensive services to individuals with mental health issues as a way to obtain resources for these consumers.
  • WIA performance measures continued to be a disincentive to serve customers who were perceived as "hard to serve," including those with disabilities. The salary requirements and the focus on a goal of full-time employment made it very difficult for individuals with mental illness to receive services through WIA.