The TennesseeWorks Partnership: Elevating employment outcomes for people with intellectual and developmental disabilities

5.1Chasing (and raising) aspirations

Since the beginning, we have remained convinced that all of our work must be aimed toward the aspirations of young people with disabilities. There is no separate set of dreams for these young people; no parallel paths they plan to pursue. Our own conversations with Tennesseans with IDD affirm what research elsewhere confirms: the presence of a disability label does not reliably predict people’s aspirations for their own lives (Carter, 2015). Nationally, more than three fourths (79% ) of all high school students with an intellectual disability have a transition goal aimed toward work in the community (Wagner, Newman, Cameto, Garza, & Levine, 2005). They do not have dreams of underemployment, they do not aspire to piece-rate wages, and they do not say they anticipate for themselves a lifetime of exclusion from the workforce. More than half (53% ) of students with an intellectual disability nationally have a transition goal to live independently in the community. They do not have dreams of living in congregate settings and they envision much more than a life on the couch. And more than one fourth (26% ) of all high school students with an intellectual disability nationally have a transition goal to attend some type of post-secondary educational program. They do not want to miss out on lifelong learning opportunities, challenging coursework, and a real career pathway.

To this end, we strived to keep the aspirations of young people with IDD at the forefront of our work by engaging them in experiences to further elevate their aspirations and involving them actively in all aspects of this work. Although people with disabilities contributed to all of our workgroups, we established a designated workgroup focused on self-advocates (i.e., Individuals and Families). We designed our annual employment summit (called ThinkEmployment!) with youth and young adults with IDD as a primary audience. Area high schools and inclusive postsecondary programs bring scores of students for a day of vision casting, learning about career pathways, preparing for the workplace, and networking with employers. At our last two conferences, more than 250 young people with IDD were in attendance. In addition, we have supported the presence of students with disabilities at our annual Disability Day on the Hill events. Students learn about recent policy developments, meet individually with their legislators, and advocate for issues that impact their career and community aspirations.

5.2Elevating expectations

The expectations families, educators, other professionals, and others hold can have a direct impact on the employment outcomes of youth with IDD. More than almost any other factor, expectations shape outcomes (Carter, Austin, & Trainor, 2011; Doren, Grau, & Lindstrom, 2012). Nationally, high school students with severe disabilities whose parents expected them to work were 5 times as likely to have paid, community employment in the early years after graduation (Carter, Austin, & Trainor, 2012). Similarly, the expectations of educators and service providers significantly influence the employment opportunities available to students during adolescence and beyond. High school students with severe disabilities who have teachers who expect them to obtain a summer job are 15 times more likely to obtain that paid job in the community (Carter, Austin, et al., 2010). Yet, too many parents struggle to envision a future for their child that involves integrated employment in the community. Furthermore, secondary transition programs inconsistently embed a strong commitment to preparing students for competitive work. We recognized the importance of working toward ensuring every child with IDD in Tennessee hears the message— from a very early age and from multiple people— that they have something of value to contribute in the workplace.

We have undertaken myriad efforts to help individuals across our state develop a vision for and commitment to integrated, competitive employment as the first and desired option for young people with IDD. Early in our project, we launched a study aimed at understanding the views of more than 2,400 parents across our state on employment for their daughters and sons with IDD: their post-school expectations, the factors that shape those expectations, and the concerns they hold (Blustein et al., 2016; Gilson, Bethune, Carter, & McMillan, in press). We learned that a large proportion of parents (83% ) placed considerable importance on part- or full-time employment in the community for their child in the early years after leaving high school. Indeed, more than twice as many parents in our state considered community employment to be important relative to sheltered employment. Moreover, these parents prioritized more qualitative dimensions of work life (e.g., having a job that brings personal satisfaction, matches their child’s interests, provides opportunities for interaction, allows for friendship development) over elements we more often tend to measure (e.g., rate of pay, number of hours). Understanding these priorities provide us with important insight into the kinds of experiences that might matter most for these families.

We also have taken steps to raise expectations among educators charged with preparing transition-age youth with IDD for college and career pathways after high school. We completed three large-scale surveys involving more than 1,500 middle and high school special educators (e.g., Bethune et al., 2016; TennesseeWorks, 2013-2014). Each helped us identify and develop resources teachers would need to strengthen their commitment toward improving post-school employment outcomes. This information has been incorporated into multiple live and online trainings designed to equip teachers throughout the state.

The expectations of employers have also garnered our attention. Deficit-based views of people with disability still dominate in many corners of our communities— statewide and nationally (Burke et al., 2013). For many employers, invitations to hire a person with IDD are accompanied more by impressions of what such a person cannot do or might struggle to do than by the contributions they have to make. To introduce a counterpoint to prevailing societal attitudes, we launched an annual statewide employment awareness campaign called “Hire my Strengths” (www.hiremystrengths.org). This coordinated and collaborative effort is highlighting the strengths, talents, and gifts people with disabilities have to offer within the workplace (Carter et al., 2015), as well as helping more employers see the “business case” for integrated employment (TennesseeWorks, 2014).

5.3Adopting a data-driven approach

Decisions about policy and practice should draw upon the best available data. In their conceptual model of variables marking states making the most movements on integrated employment, Hall, Butterworth, Winsor, Gilmore, and Metzel (2007) stressed the role of data both in communicating the importance of employment and to introduce accountability. Likewise, calls throughout the fields of transition and special education have emphasized data-based decision making and the contributions research has made to spurring noticeable improvements in outcomes of transition-age youth (Carter et al., 2013). To this end, we embedded research and other data collection throughout all of our activities to ensure we could make wise decisions about what we should do, how we should do it, and whether it worked.

One aspect of this approach has involved identifying and sharing already available and newly acquired data. We mapped existing data sources across agencies and other sources (e.g., education, labor, higher education, vocational rehabilitation), creating a publicly available dashboard. The purpose of the dashboard (www.tennesseeworks.org/data-dashboard) has been to describe the Tennessee landscape on issues related to transition and employment, to make accessible data that were previously difficult to find or interpret, and to identify gaps in available information that the Partnership could work to fill. Moreover, we are drawing upon these data to identify benchmarks as we continually refine our state’s Employment First Strategic Plan. As we continue this work, we plan to draw more heavily upon the state’s integrated, longitudinal data system. This dataset combines and integrates data from multiple agencies, enabling a long-term look at the experiences and outcomes of young people with and without disabilities in our state.

Another important accent has been on designing new studies that answer questions of importance to the TennesseeWorks Partnership. The involvement of a research-intensive university like Vanderbilt introduces both interest in and capacity to embed rigorous studies throughout our systems-change work. As referenced elsewhere in this article, we have undertaken studies addressing how “community conversation” events can inform and spur local changes in employment opportunities (Bumble et al., in press; Carter et al., 2016; Bumble, Carter, McMillan, Manikas, & Bethune, in press), parental expectations and resource needs related to employment and other post-school outcomes (Blustein et al., 2016; Gilson et al., in press), transition-related professional development needs and pathways among special educators (Bethune et al., 2016), family perspectives on the conversion of sheltered workshops (Carter, Bendetson, & Guiden, 2016), and employer attitudes and recommendations regarding hiring people with disabilities (currently underway). In addition, we are undertaking secondary analyses of employment and transition data available within selected state-level data sources (e.g., National Core Indicators, Tennessee Longitudinal Data Systems). This complementary investment in scholarship recognizes that the answers and approaches we discover in Tennessee likely have relevance to other states that also are striving to expand employment opportunities for their residents with IDD. At the same time, we have been conscious of the importance of first sharing study findings back within the Partnership before disseminating them in professional journals beyond our state.

5.4Building capacity and competence

To shift employment outcomes in substantive ways, we knew that educators, service providers, families, employers, and others across our state would need to be fluent in those strategies and supports shown to have the very best chance of making an impact. As is true elsewhere across the country, these stakeholders often report difficulty finding effective training and practical resources addressing best practices related to transition and integrated employment (Brock, Huber, Carter, Juarez, & Warren, 2014; Gilson et al., in press; Morningstar & Benitez, 2013). The more pressing challenge lies not in the absence of research-based practices, but rather in the extent to which the best of what we know works is actually penetrating practice in widespread ways. Therefore, we have taken considerable efforts to design and implement professional development and training for educators, families, employers, providers, and others so their efforts are steeped in and marked by best practices. Through a review of relevant research and policy— as well as consideration of those barriers mentioned previously in this article— we initially identified six areas of emphasis: high expectations for competitive work, effective transition planning, enhancing work-related skills and attitudes, access to early work experiences, individualized and natural supports, and knowledge of Tennessee systems and resources.

To ensure individuals across the state were equipped and supported to implement these core practices with every young person with IDD, we have been building a tiered and multi-faceted approach to training and resource dissemination (see Fig. 2). Specifically, this involves developing:

Fig.2

Multi-Faceted Approach to Training and Resource Dissemination.

Fully developed, all three tiers will operate concurrently and serve to build capacity and commitment throughout every region across the state.

One primary example of work in this area has been our development of Transition Tennessee, the state’s new online portal for high-quality, on-demand professional development (www.transitiontn.org). This funded partnership with the Tennessee Department of Education ensures comprehensive and free training on best practices in transition is available to educators working in all of the state’s 142 school districts. Courses address multiple topics (e.g., guiding principles in transition, transition assessment, transition planning, pathways to employment, pathways to community living, pathways to postsecondary education, supports and partnerships) and incorporate engaging presentations, practical resources, reflection tools, illustrative videos, success stories, searchable databases, and case examples. For employers, we have held more than 50 employer outreach presentations (involving more than 1,600 employers) addressing why businesses should hire Tennesseans with disabilities, as well as delivered shared trainings with agencies and American Job Centers in the state. For parents, we have supported the launch of new family coalitions in multiple cities addressing topics such our state’s new waivers, the ABLE Act, advocating among state legislators, and futures planning. Finally, as a venue for joint training across stakeholder groups, we host an annual summit (called “Think Employment!”) and integrate employment- and transition-focused training into existing professional development events (e.g., local, regional, and state conferences and workshops).

5.5Making information accessible

Within academic circles, peer-reviewed journals, policy documents, and conference gatherings are the primary pathways through which research-based practices are shared. Yet, our surveys of parents and educators found they prioritized alternative pathways for accessing needed information, such as practice guides, downloadable resources, websites, videos, and apps (Bethune et al., 2016; Gilson et al., in press). Likewise, employers and community leaders were unlikely to be part of formal groups focused on disability issues. We knew we would have to provide multiple pathways for getting timely, accessible, and actionable information into the hands of professionals, employers, and families across the state. Moreover, this information could not be locked behind journal subscriptions, organizational memberships, or technical jargon.

We began by creating a one-stop online clearinghouse for information and resources related to promoting employment and successful transitions for individuals with disabilities (www.tennesseeworks.org). The website provides an overview of the TennesseeWorks Partnership and organizes targeted content by stakeholder group (i.e., self-advocates, families, educators, employers, agencies). It also features upcoming events, our data dashboard, success stories, a video library, and searchable resource databases. Although the website is maintained by our backbone organization, resources and events are contributed by all of our partners. The site draws thousands of unique visitors per month. In addition, we push out news and information to our growing number of subscribers through social media (e.g., Facebook, Twitter), weekly blogs, a monthly newsletter, and other just-in-time avenues. Each of the workgroups suggests content for these dissemination pathways to ensure their relevance and completeness.

5.6Refining policies

Meaningful policy change is a primary purpose of AIDD’s investment in states through PIE. Through the work of our Employment Roundtable policy workgroup (described previously), we have strived to align state policies in ways that more strongly prioritize and support integrated and competitive employment. These monthly meetings of key agency and organization representatives provide the consistency, focus, and leadership required to carefully identify state polices that need to be recommended, reviewed, revised, or repealed. Numerous examples of the effectiveness of working in a coordinated manner have been evident throughout the short history of this Partnership.

Among the earliest successes of our project was the signing of the Employment First Executive Order by Gov. Bill Haslam in 2013. The order established the Governor’s Employment First Taskforce and requested an annual report to the governor. Another early success was retaining age 14 as the beginning of transition planning in Tennessee. Although the Individuals with Disabilities Education Improvement Act had increased the age to 16, Tennessee had not followed suit. When a proposal went to the State Board of Education to increase the age to 16, the TennesseeWorks Partnership organized individuals with disabilities, families, educators, and policymakers to articulate the significance of retaining this earlier starting point for planning. Through written and oral testimony at a public hearing, we were successful in convincing the State Board not to make this change.

Recognizing college as an important pathway to future careers, we also worked to develop inclusive higher education programs in Tennessee through the Tennessee Alliance for Inclusive Higher Education. When The Arc Tennessee and the Tennessee Disability Coalition proposed legislation to provide students with IDD in inclusive higher education programs the same lottery-funded scholarship that other Tennessee students receive, our Partnership encouraged stakeholders to let members of the Tennessee Legislature know about the elevated employment outcomes graduates of these programs experienced. Tennessee’s STEP UP law now supports college students with IDD for up to 4 years of scholarship funding.

Our involvement in shaping policies cuts across multiple agencies. For example, the Tennessee Department of Intellectual and Developmental Disabilities’ provider manual, so key to systems change, has been amended multiple times. Throughout this process, the department has shared information about these changes with the Partnership and invited the employer and provider workgroup to provide comments and suggest revisions as it was being updated. Likewise, we have contributed substantively to developments related to Tennessee’s implementation of the Workforce Innovation and Opportunity Act (WIOA). Although we had originally planned to create a new MOU related to serving adults with disabilities, we decided that involvement in the new comprehensive state plan would be more effective. As the state plan was developed by the Tennessee Department of Labor (the lead agency), the Partnership received updates, offered feedback, and provided many of the working relationships required by the law. We also worked closely with TennCare— our state’s Medicaid agency— to develop and introduce Tennessee’s Employment and Community First choices programs. From the beginning of the Partnership, we knew long-term services and supports provided by Medicaid would be key to finding and keeping integrated, competitive employment for Tennesseans with the most significant needs. In 2012, more than 7,000 Tennesseans with disabilities were on the waiting list and waiver services were offered only to individuals with an intellectual disability. Managed care programs now have several priority categories, including transitioning youth who want to work, and services have also been expanded to include those with developmental disabilities.

As part of our state’s three-year Employment First Strategic Plan, we have identified a number of needed emphases. For example, we continue working to address subminimum wages by identifying policy changes and developing practice briefs with Alaska and the Institute for Community Inclusion. At the request of almost every partner, we launched a working committee on supported decision making. Our plans include developing a white paper, educating key groups, and introducing new legislation. And we are outlining additional policy and practice movements spanning the areas of education, family supports, vocational rehabilitation, and workforce. The full strategic plan, updated annually, is available at http://www.tn.gov/didd/article/employment-first-task-force.

5.7Engaging communities

A central thrust of AIDD’s Partnerships in Employment grant mechanism is to enhance collaborations across existing state systems and to improve statewide policies and practices. Although improving formal services and supports is essential to this endeavor, it is at the local level that polices and practices are carried out to improve the outcomes of individual citizens. Yet many communities are uncertain about how to move in coordinated ways that lead to expanded employment opportunities for their residents with IDD. And rarely are the ideas of local communities seen as an essential source of input for systems change efforts. A hallmark of our project has been our efforts to hear from, engage, and raise awareness among community members who are outside of the service system, but still comprise critical allies and advocates for employment (e.g., businesses, civic leaders, community groups, congregations, families).

Community conversations have been our primary approach for listening to and learning from Tennesseans about promoting pathways to employment and other aspects of community life. These creative and engaging gatherings invite a cross-section of diverse stakeholders into an asset-based dialogue on practical ways of addressing local employment barriers (Carter & Bumble, in press; Carter et al., 2016). Individuals from within and beyond the disability service system come together for a two-hour conversation in which they share their best ideas for expanding opportunities locally (e.g., What can we do as a community to increase meaningful employment opportunities for people with intellectual and developmental disabilities? How might we work together in compelling ways to make these ideas happen here in this community?). Across the multiple rounds of conversation, several hundred ideas are generated that reflect the community’s commitments, culture, and capacity. To date, we have hosted or supported more than 25 community conversation events across the state involving more than 1500 citizens. Examining themes emerging within and across events held across geographically diverse locales enabled us to identify a common set of needs around which to focus our statewide change efforts (i.e., developing employment opportunities, undertaking community-wide efforts, strengthening school and transition services, equipping people with IDD to be competitive applicants, enhancing inclusive workplaces, supporting families in transition). Examples of follow-up actions have included developing new resources for families and employers, creation of the new professional development portal for educators, and the sharing of success stories of individuals and employers.

Other efforts also reflect our commitment to exploring possibilities beyond the service system. For example, we held 15 listening forums for parents whose sons and daughters with IDD were served within sheltered workshops. These events— which involved an adaption of the community conversation approach— focused on what supports or assurances would need to be in place for parents to consider pursuing integrated employment in the community (Carter, Bendetson, & Guiden, 2016). We developed a host of online resources, toolkits, and videos to encourage and equip employers to hire people with IDD. These materials responded to a recurring theme from community conversations that potential employers would remain reluctant without successful examples and practical guidance. And we assisted congregations in implementing the Putting Faith to Work model, which empowers faith communities to support people with disabilities as they find and maintain employment aligned with their gifts, passions, and skills (Carter, Endress, et al., 2016). Congregations assembled small teams who personally learned about a member’s passions and gifts, drew upon their social networks (within and beyond the congregation) to identify employers who might need exactly those assets, and provided the support and encouragement needed to obtain and maintain that job.

5.8Telling compelling stories

From the outset, we knew it would be important to tell Tennessee stories about the importance of integrated employment in Tennessee; the pathways for making it happen in Tennessee; and the impact on Tennesseans with IDD, their families, and their communities. In other words, our partners and allies wanted local examples illustrating how meaningful employment experiences could happen here. We also recognized these stories needed to be shared in multiple venues and using diverse modes of communication. Therefore, we undertook extensive efforts to craft and communicate these stories throughout the state. For example, our Partnership has collaborated on more than 50 short videos illustrating promising practices, core principles, stakeholder perspectives, and successful employment experiences (see www.tennesseeworks.org/videos). We gathered and shared the employment stories of individuals, families, employers, educators, (Vanderbilt Kennedy Center, 2014; www.tennesseeworks.org/success-stories). We have encouraged and equipped individuals with IDD and their families to tell their stories in person to legislators at our annual Disability Day on the Hill event.