Rural Routes: Promising Supported Employment Practices in America's Frontier
By Cary Griffin, Director of Training
at The Rural Institute
Produced in Collaboration with the National Supported Employment Consortium
at Virginia Commonwealth University
The Rural Big Picture
Today, it may be safe to say that "rural" is a state of mind rather than a geographic place. In the past, "rural" conjured up a clear picture in one's mind: a farm, a small schoolhouse, a few white churches, small towns with tree-lined streets connected via Elm or Main Street to a small and pragmatic town center, with businesses based on agricultural products of the surrounding county. While there remain many places fitting this description, the bucolic ideal has changed substantially. Many rural areas have become bedroom communities to adjacent large cities, bringing antiseptic housing developments, highways, and strip malls to once productive fields. Rural, in many cases, has become the safety valve for urbanites facing inner city decay, high housing prices, and crime. The predominance of the automobile, instead of mass transit, makes high speed access to distant communities possible for middle class Americans, while the poor in rural communities remain isolated. Where the small town once stood as the nexus of human interaction, in many cases today it exists as a resting place and haven from work life. It is no longer the economic foundation nor the natural tonic of the citizenry (Oldenburg, 1997; Federal Reserve Bank of Kansas City, 1996; Taylor & Wacker, 1996; Rifkin, 1995).
With that said, there remains a tremendous amount of the United States that exists unaffected by the development frenzy of the ubiquitous metroplex. These are the areas of concern for this paper. Not because the above issues are not critical, but because the impact is on a much smaller scale in rural communities surrounding Billings, Montana, or Sioux Falls, South Dakota, than in those places within commuting distance from Denver, Colorado, or Austin, Texas. In remote parts of this country, the economic boom of late appears less dramatic, and in many cases has breezed by without a trace. Farming and ranching communities on the eastern plains of Wyoming, Montana, and Colorado, for instance, continue to see a decline in population and economic health. Montana's strong 1980s economy now struggles with the highest per capita number of children living in poverty and the 46th lowest per capita income in the country (U.S. Dept. of Commerce, 1997; Billings, 1998; Missoulian, 1998).
Regardless of the current status of local economies, employment development is still possible. People consistently go to work in the morning, hiring continues, and there is much work to be done. While many rural areas do not appear to be the direct beneficiaries of the growth economy, the decrease in interest rates, the availability of low interest loans and venture capital, liberalized lending rules, increases nationwide in entrepreneurship, improved telecommunications infrastructure, government downsizing, et. al., make it easier to create jobs. The subtle, but important, shift in thinking and activity from job hunting to creation is critical.
Job development and placement are traditionally rooted in reactive strategy. That is, people with disabilities and organizations that assist them, prospect for what exists in the marketplace. Historically, job development techniques relied on testing that "predicted" employability in certain trades or occupations. When no surplus of those identified jobs existed, the person with a disability often went unemployed. Today, best practice suggests that approaching a job match using an "environmental validity" strategy makes more sense. In other words, looking at a person's desires and gifts makes more sense than trying to fit a person into a particular occupation. And, if that particular occupation does not exist, working to create that job becomes a logical step in this proactive process.
Along these lines, in rural areas it is often necessary to identify or reveal a need, then present a solution to satisfying that need. Small business grows historically through filling needs that others have not filled and by creating needs that can profit individuals. This is the essence of inventiveness, which is a primary requirement for success in rural employment. After all, no one needed a microwave oven until someone identified the technology and used it to satisfy the socio-economic phenomenon of single and double working parent households. Waiting for harried parents to formulate a desire for a high speed oven would have taken forever, if it ever happened. Expecting employers and communities to recognize the talents of people with disabilities is equally futile. Success in rural employment development comes from creating the need for employers to hire, or for customers to buy from, entrepreneurs with disabilities.
Defining Rural
Rural may be a state of mind or be culturally defined, but that does not mean there are not formal descriptors for such areas. The U.S. Census Bureau contends that rural is technically any community with 2,500 or fewer people (U.S. Census Bureau, 1995). Using this definition, there are 61,685,330 rural residents spread out over 75% of the land mass of the nation. This definition oversimplifies rural. Rural thereby includes communities and areas "adjacent" to major metropolitan areas that may be small, but benefit from their proximity to the services and activities of the neighboring city. Some rural practitioners debate the true "ruralness" of adjacent communities and argue for the more strict "frontier" definition offered by the Census Bureau (RTC: Rural, 1998). Frontier areas are described as those with population densities of fewer than 6 people per square mile. Only 2,447, 630 people live in frontier counties, and 15% of these residents have disabilities (McNeil, 1993). Frontier communities exemplify the remoteness and isolation of truly rural Americans. Regardless of definition, rural communities have the highest rates of poverty in the United States (Rojewski, 1992; Nord, 1997). Providing quality employment support in remote communities is often hampered (but certainly not impossible) by a lack of transportation options, a limited array of jobs, the availability of venture capital, the paucity of community rehabilitation options, and limited access to current information on best practices.
Regardless of the definitions used, rural supported employment is as challenging in its way as urban supported employment is challenging in its way. Both environments suffer unique barriers. And both environments present tremendous opportunities for community engagement and employment discovery.
Supported Employment Models
Service delivery models are important for providing structure and benchmarks for the initial development and incubation of community employment, regardless of environment. However, strict adherence to any model—in the face of unique circumstances, such as those presented in remote areas—may limit effectiveness. For supported employment techniques to work, they must be flexible and pragmatic. What should not be compromised are the critical elements of any high performance employment process:
- Consumer Choice and Self-Determination: Typically, this
involves the use of Person-Centered Planning, which offers full access to
information and provides support for choice making (Griffin & Hammis,
1996).
- Functional Assessment of skills and desires in real workplaces:
Experiencing a host of possible work environments to afford the worker a comparative
assessment of possible jobs and co-workers (Flaherty, 1998).
- Thoughtful and formal (i.e. written) Job Analysis: A
detailed study of the whos, whats, whens, and wheres of particular worksites
(McLoughlin, et al., 1987).
- Thoughtful and formal (i.e. written) Job Match: An examination
of goodness of fit, as well as training supports necessary for employment
success (Moon, et al., 1990).
- Skillful utilization of Systematic Instruction: Strategic use of behavioral and planful teaching techniques on the job (Gold, 1980).
- Tactful acknowledgment of Worksite Culture: Understanding
the rites and rituals of unique worksites and minimizing the disruption of
the environment (Griffin & Sherron, 1999).
- Planful identification and facilitation of Natural Supports:
Assessing the interactions of co-workers, the availability of cues, and the
use of typically utilized methods and tools in a particular work environment
(Callahan & Garner, 1997; Griffin, 1992; Nisbet and Hagner, 1988).
- Customer friendly and respectful Consultation Services: Supporting both the employer and the employee in making the job a success.
Just as in urban areas, when shortcuts are taken problems occur. A pervasive myth in rural communities is that everyone knows everybody else, thereby making communication and working relationships easier and more casual than in anonymous city environments. This myth is further manifested in the belief that formal processes are restrictive and unacceptable in environments where people feel a cultural obligation to the folklore of informality. The fact is that business people do not do business on a handshake. They are used to complex contracts and agreements. So, using a formal job match process, structured on-the-job experience, and systematic instructional techniques, with close attention to honoring the work place culture and utilizing natural support methodologies, will not alienate or frighten employers; it could reassure them of your professionalism.
Growing Jobs
Typically, job development is constrained by the reactive methods traditionally employed in the field. Even today, many job developers are taught to review the labor market and test people with disabilities to see if they fit within the current economic environment. In areas of high commercial activity, this approach may work well enough to reinforce its premise, but in typical markets (and especially in depressed markets) this just labels people with severe disabilities as "unemployable." In rural areas (and urban, too), people get jobs through various networks of association, and by being competitive in the workplace.
Employer and Consumer Control of the Job Discovery Process
The power of networks for the job seeker cannot be overstated. Without "respected others" representation, the job seeker is just another name on an application. In interviews, job seekers may be just another applicant, except that they also have a disability. Job developers and job seekers alike must create networks that include people who influence those who hire. Typically, people use references such as their former bosses or professors, but many people with severe disabilities have no one of community standing representing them. If job developers (and this includes everyone in a community rehabilitation program, every VR employee, etc.) take action to become known as credible and giving members of their communities, the job development process gains the respect of employers.
One promising technique for growing jobs involves nurturing community relationships and networks by establishing Active Employment Councils (AECs) or Business Leadership Networks (BLNs). These councils meet monthly and members are required to bring at least one employment lead or "contact." One or two consumers are asked if they have an interest in exploring employment in the "contact s" business. This contact is then called and given the name of the council member who suggested calling, and an appointment to discuss employment opportunities is made. Sometimes contacts are suppliers to the council member s business and a natural business relationship already exists that can be leveraged into job development. Often, too, the council members find that they have jobs available in their own companies and can help minimize the red tape and other roadblocks inherent in job hunting. Because business and consumers participate in the council, employment outcomes are the absolute priority for all council activity, mutually beneficial and respectful relationships form that create a force for job development in the community (Griffin & Sherron, 1999; Hammis & Griffin, 1994).
Critical lessons are being learned through such councils that seem to have universal applicability to all communities. These include :
- In order to create employment and act as a representative
for people with disabilities, the job developer should be well known to the
business community, and should help people with disabilities actively and
visibly create business and personal relationships;
- Businesses are particularly concerned about the future
of students leaving public schools and many local Chambers of Commerce, service
clubs, and city/county governments have committees studying school improvement
that welcome contributing committee members and can assist with job development
efforts;
- Be careful not to overlook the public sector as an employment option. There are government jobs in large cities and in the smallest of communities. Washington state, which has a large rural population, recently announced a state government initiative to hire people with severe disabilities in public sector jobs utilizing supported employment techniques.
Employers understand their workforce and production needs much better than those of us who do not work in those businesses. Employers can assist in job restructuring and on-site training efficiently and more naturally than outside human service personnel who typically must learn jobs first, then teach the new worker. In numerous cases, co-workers effectively instructed new workers with disabilities in task performance while employment specialists offered instructional support and effective teaching/supervision strategies.
Staff at the Rural Institute at the University of Montana develop and create jobs in rather remote sections of the country. Often, no formal jobs exist. The strategy is to look for products or services that are needed and either create a consumer-run enterprise or help established businesses expand through the use of formal partnership agreements.
Recent business start-ups include a small engine repair business, run as a sole proprietorship but located within another "fix-it shop" in Plains, Montana; a stuffed animal concession at a Nature Center in Red Lodge, Montana, (where the Nature Center receives 10% on all sales in exchange for housing the business run by an entrepreneur with serious disabilities, and others); the possibilities are limitless (Hammis & Griffin, 1998). Active Employment Councils help identify local entrepreneurs and companies willing to incubate partnerships and businesses within businesses, and individual members bring priceless expertise and advice concerning local market conditions.
At the heart of these councils is peer marketing—having an employer influence other employers to hire individuals with disabilities. This is much more powerful and effective than human service representatives acting as sole job developers. Employment development benefits from creative professional rehabilitation expertise, but there is a major role to be played by having business folks work face to face with people with disabilities in need of employment, and with their peers in the business world. Hiring people with disabilities is, unfortunately, still viewed as a business risk. Hearing of successful employment from both businesses and workers with disabilities, provides powerful support to employers who have not yet hired. Human service roles seem most appropriate in the context of getting these constituents together and providing technical and strategic support until a quality employment relationship is solid.
Job Carving /Job Creation
The process of breaking down jobs into their key components and reassigning those pieces in more efficient or understandable ways is called job carving. This strategy is a creative extension of job development that results in job restructuring or job creation (i.e., typical work duties are reassigned to one or more workers or a new job is created to address efficiency needs). While full-time employment is certainly a reasonable outcome, job carving is often used with individuals in transition from school-to-work or supported employment who, for a variety of reasons (including physical disability, psychiatric illness, medical fragility, available supports, and choice) may not be in the market for full-time employment (Griffin & Sherron, 1999). Care must be taken not to create jobs that devalue people with disabilities by physically separating them from other workers or by having them perform tasks that are considered bothersome, dangerous, or unpleasant.
Job carving entails analyzing work duties of specific jobs and identifying specific tasks that could be assigned to employees with severe disabilities who have a proficiency for these tasks and who want to perform these jobs. Job carving can be a useful tactic for helping individuals gain experience in paid situations, and for helping employers reach a new comfort level with employees with disabilities.
Many variables influence job carving. For instance, the marketing approach in job carving is deliberate and businesslike. Job developers should approach potential employers as diagnosticians, ready to determine needs and offer solutions to productivity challenges. Another variable is consumer employment objectives. No job development effort can take place without a thorough understanding of the type of work that is suitable and acceptable to a particular individual.
In some remote communities, it may be necessary to carve positions in several businesses for a person to be able to earn a livable wage. In such cases, transportation issues may arise that challenge the problem-solving skills of the most inventive employment specialists, consumers, and employers. Always consider transportation a key element in any job match. A person must be able to get to work before he/she accepts the job, otherwise the person is at risk of failure and the employment relationship is jeopardized.
Some examples of rural job carving include:
- Clerical Assistant: Duties include photocopying, formatting
and copying computer disks, answering phones, assembling documents. Hours:
Monday, Wednesday, and Friday, 20 hours per week.
- Mail Delivery: Duties include mail, parcel, and message
delivery for rural county government offices. Hours: Monday - Friday, 12.5
hours per week.
- Pet Groomer: Duties include washing dogs, general animal
care. Hours: Monday - Friday, 20 hours per week.
- Bank Teller Assistant: Duties include sorting documents,
operating coin counter equipment, paper shredding, etc. Hours: Monday - Friday,
15 hours per week.
- Taxidermist Assistant: Duties include salting hides,
preparation work. Monday - Friday, 20 hours per week.
- Seamstress: Duties include guiding material through computerized
sewing machine, quality control, packaging, etc. Monday - Friday, 40 hours
per week.
- Car Wash Attendant: Duties include cleaning wash bays,
refilling soap and liquid wax reservoirs, emptying vacuum cleaner bags, policing
the grounds. Hours: Monday - Saturday, 22 hours per week.
- Grocer's Assistant: Duties include "facing"
cans on shelves, arranging produce, unloading delivery trucks, light cleaning,
recycling shipping boxes. Hours: Saturday & Sunday, 16 hours per week.
- Gas Station Attendant: Duties include: Pumping gasoline,
washing windshields, checking oil and fluid levels, washing and detailing
vehicles. Hours: Monday - Friday: 30 hours per week.
- Farm Hand: Duties include: moving cattle, clearing irrigation
ditches, feeding cattle, bucking bales, assorted tasks performed in partnership
with the manager. Hours: 7 days per week, 35 hours per week.
Supported Self-Employment, Business Partnerships, and Ownership
Moving supported employment into the next century requires new options and new tools for employment specialists. Significant barriers seem to be in our beliefs and expectations. The business world has been and is ready to do business. Employers are interested in hiring employees who own substantial employment related resources, forming limited partnerships, and supporting sole proprietorships with people of similar interests and dreams.
Small business is the fastest growing segment of the business sector today (Friedman, 1996). All of the options in the business world are possible for people with disabilities. Acting on this belief makes it possible to achieve employment. For instance, in a small rural town in Montana, a "challenging" person who was identified as having multiple and significant disabilities, shared his work dreams. The place he identified for his work dream was a local Nature Center. On a tour, he clearly demonstrated the interest and relationships he had already developed there. In attempting to job develop here, multiple objections were offered from the manager, including the lack of funding for new employees. The manager agreed to any volunteer help, but "had no money" for new employees.
Acting on the belief that it is possible to create employment for anyone, a business plan for a sole proprietorship was developed and given to the Nature Center manager. The proposal was to operate a retail sales business at the Nature Center, and in return the Center would receive 10% of the profits. The manager reviewed and assisted in refining the business plan and then submitted it to the Board of Directors for approval. The business is owned by the person, and we were able to clearly create a business outcome following our process for job creation.
Another example involves a young man in a rural town, where an employer was approached to develop a position as an entry level mechanic assistant. The employer did not have an adequate cash flow to hire him. A limited partnership proposal was written for the young man to become a part owner of a small segment of the business by utilizing funds from a Social Security Plan for Achieving Self Support (PASS). The wealth of knowledge of the business world came into play again, as the owner advised, amended, and assisted with creating an entirely new proposal for a sole proprietorship for the young man, based on a $28.00 per hour contracted rate for the individual's new small business, with a 25% consignment fee for the use of space at the principle owner's garage and a clear method for sharing of customers and work loads. The Business Plan and PASS were approved, and an absolute "no" from a potential employer was turned into a mutually profitable sole proprietorship and partnership. Once more the business world taught us that it is possible to achieve employment even in this economically depressed community of 1,500 people.
Import Substitution
Discussion of entrepreneurial approaches in rural communities must include the concept of Import Substitution. This practice is being employed around the world in developing nations and in many rural communities. Quite simply, Import Substitution is a process that identifies goods and services that a local economy purchases from an outside source, and then creates the mechanism for providing those goods and services locally (Hong, 1993; Marston, 1997). Job developers can use this practice to create employment, but should be cautious not to fall into the trap of having the market need drive the employment opportunities of people with disabilities. The job seeker needs to remain at the center of job creation.
Using proper person-centered techniques, the person with a disability establishes an employment direction. In one case, for instance, a young woman being served in a local institution for persons with developmental disabilities explained that she wanted to work in an office environment performing clerical duties. Further exploration and job tryout indicated that she enjoyed paper shredding. The job developer visited a small clinic in the community, as well as the 2 banks. He discovered that they indeed needed confidential document destruction, and also found several other businesses (accounting firms, doctors' offices) that required such assistance. All these businesses, however, contracted out their services to a large city service and shipped their work there monthly. None of the businesses generated enough work individually to justify the expense of hiring someone and purchasing the equipment.
The job developer was able to convince the local businesses to shred their paper locally. He enlisted the local Vocational Rehabilitation office to purchase a small but powerful portable paper shredder for the job seeker. She then contracted with each of 4 businesses and visited their offices one day a week for 2 to 4 hours to shred their sensitive documents. The cost to the businesses was reduced, and the service was more secure and confidential because the young woman could not read.
Other examples of Import Substitution include a recent business start-up plan for a Native American-run household appliance store on an Indian Reservation and a custom embroidered clothing retail store (Hammis, 1998). These were established by beginning with a consumer desire to work in a particular location and perform jobs they liked, then identifying the related products and services the community previously purchased from a distance as part of the business plan and job match. And while these particular examples represent small business developments, there are many jobs that are out-sourced in rural communities that clever employment specialists could "carve back into" existing companies.
Resource Ownership
In the above examples, the employees utilized a variety of resources to become successful. One used a paper shredding machine, the others used their sales experience and their local connections with people of influence. Most people served in supported employment have little or no competitive employment experience, little or no formal education, and few typical relationships in the community. Knowing that employment is secured by having respected others speak on your behalf and by having recognized skills instead of deficits and needs, there is little wonder that people with disabilities remain the nation's most heavily unemployed and underemployed minority group.
Employment is based on competition. Applicants use their connections, skills, and assets to sell themselves to the employer. The basic arrangement is that the employee agrees to be "exploited" by the employer in return for wages. The employer maintains employment as long as the revenue generated by the employee is greater than the amount expended to retain the employee. In this basic capitalist model, workers with severe disabilities who have no positive reputation, no apparent exploitable skills, or who are seen as poor investments, stand little chance of being hired (Hammis & Griffin, 1998).
To change this circumstance, it makes sense to augment an applicant's profile by helping him or her procure skills training (this is not "readiness," it is employment-specific education such as learning computer programs or small engine repair), tools or equipment of value to the employer that the employee can use in performing the job (an auto mechanic is required to supply his/her own tools; a truck driver provides his/her own truck), or personal transportation which makes the person more reliable than other applicants.
These items require cash. Creative rural service providers can set aside a certain percentage of their revenues to provide these critical elements. These are common-sense expenditures for organizations whose missions are community employment. Still, some expenses are too great, so supplemental funding could be provided through the local Vocational Rehabilitation or Job Training Partnership Act (JTPA) counselor. One of the most underutilized but lucrative sources of funds is the Social Security Plan for Achieving Self Support (PASS).
PASS is a part of the original supplemental security (SSI) statute of the Social Security Act and is designed to increase a person's earning potential. A PASS, and other related Social Security Work Incentives, such as Impairment Related Work Expenses (IRWE), Blind Work Expenses (BWE), Subsidy, Trial Work Period, etc., acknowledge the fact that for people who are classified by Social Security as Blind or Disabled, achieving self support may be a gradual and on-going process. A PASS allows a person with a disability to have multiple jobs along a career path while setting aside funds that increases his/her resource ownership and decision-making responsibilities. A PASS results in a very flexible type of written guide for one's future and personal agreement "voucher" between SSA and the person with the PASS.
Rural Institute staff have written, developed, and managed over 500 approved PASS plans, typically generating $1,000 to $5,000 per year in "voucher" type resources for individuals with disabilities with the average single PASS extending 3 years, with the option of unlimited revisions along a career path. Of the plans written to date, people with disabilities have used PASS funds to purchase: new and used vehicles; computerized sewing machines; computerized embroidery equipment; livestock; personal assistants and care attendants; college tuition; laptop computers; motorized wheelchairs; paid taxi and alternative transportation; personally chosen therapy not covered by Medicare/Medicaid; mechanic's tools; business clothing; dental improvements; augmentative communication devices; paid co-worker support at work; long term one-to-one tutoring; a variety of low and high tech assistive technology for work and education. Each person involved owns the resources purchased through the PASS. PASS provides a very personalized and customized incentive to ownership and community employment. Successful PASSes simultaneously educate and combat the fears of losing Social Security benefits prior to earning a reasonable wage and securing health coverage in the community.
PASS is a rural resource that is utilized extensively in the Rocky Mountain West. At this time, Montana, Wyoming, and Colorado are leaders in the use of PASS Plans (Social Security Administration, 1998). In rural communities, resources such as Social Security Work Incentives cannot be ignored; they are essential to consumer choice, power, and control in employment matters. And with training in SSA Work Incentives available through a number of quality sources, there is no excuse for them not being employed whenever possible to support job development and retention.
Choice & Self-Determination
The new watch-words of rehabilitation are Choice and Self-Determination (Common Sense, 1998). As with almost any radical shift away from tradition, incrementalism threatens these concepts. Choice and Self-Determination are rooted in person-centered planning techniques of the 1980s. Enlightened vigilance is required to guard against diluting these approaches to support.
There is mounting evidence that person-centered planning has become tremendously bastardized and ineffective due to shortcuts and misuse. True person-centered planning is an extra-legal process that guarantees the individual power in planning his/her own life, and provides supports that make it possible to advocate for outcomes in systems that do not traditionally respond quickly or uniquely to those served. Across the country, person-centered techniques are being employed within service system environments, with service system personnel, and within the framework of system service arrays. At least one software package is available to speed the development of the person-centered planning process. In other words, the language of rehabilitation may have changed—of constructing "maps" fills conference rooms. But the mapping process is only a small piece of person-centered planning. Its strength lies in the commitment of those attending the meetings in making certain that things change for and with the person. The real strength and promise of person-center planning is gone in many organizations. The power of person-centered planning is that it challenges people to radically change from a model of control and continuum to a model of support and invention. Once person-centered planning becomes mandated and/or practiced at the convenience of state or local rehabilitation or school programs, its power is forever vanquished.
There are places, however where Choice and Self-Determination are driving change. The Choice Access Project, funded by the Rehabilitation Services Administration and operated by the United Cerebral Palsy Association national employment projects office, is working in several rural communities. The project offers individuals with severe and multiple disabilities vouchers for work experience, job coaching, job development, and related supports. In Montana, one young man of transition age has secured a variety of work experiences and summer employment support that would not have been available through the high school in his small community of fewer than 1,000 people (Condon, 1998).
In South Dakota, the state Vocational Rehabilitation agency leads the nation in granting service vouchers to numerous people residing in remote communities. In such areas, service delivery is either not available or the choice of providers is severely limited. By offering vouchers, customer service improved, consumers could remain in their home communities, and typical citizens and family members were enlisted to support the employment and rehabilitation goals of the individual (Grimme, 1998).
In Oregon, a relatively rural state, a recently funded project assists families of transition age children. The Family Management Grants (FMG) is part of Oregon Transition Project and provides families with up to $3,000 to implement their child's employment plan. Fifty families have received financial assistance in purchasing job development and coaching, resulting in 40 individuals gaining community employment at better than minimum wage (Toews, 1998).
In Montana, four rural communities are coming together through a series of structured town meetings and Active Employment Councils to develop supported employment for individuals with psychiatric disabilities. The project is funded through the national Substance Abuse and Mental Health Services Administration (SAMHSA) and is designed to build community consensus on ways to solve the unemployment problem for people with mental illness. Currently, the rate of joblessness for people with psychiatric disabilities is greater than for any other disability group. By recognizing the hopes and aspirations of consumers, then identifying the strengths of the community, the project will create employment. A variety of partners is being enlisted to focus on community building. These partners include: consumers, Vocational Rehabilitation, the local affiliates of the Alliance for the Mentally Ill, the Coalition of Montanans Concerned with Disability, Montana Community Partners (the Managed Care Organization), the state Mental Health Division, the regional Mental Health Centers, local businesses, families, and civic entities (Griffin, 1998).
There are many local, state, and national initiatives to guarantee Choice and Self-Determination. The best recognize that communities are capable of solving their own problems once they know they exist. Rural communities, where local pride and local control are topics of daily conversation, are fertile ground for experimentation. In many rural communities, little formal infrastructure exists to serve people with serious disabilities, thereby allowing local solutions to flourish rapidly, unhampered by bureaucratic infrastructure.
Rural Staff Recruitment and Training
One of the most critical issues facing rural Community Rehabilitation Programs (CRPs) is the recruitment, training, and retention of quality front line staff. The role of direct line staff in CRPs has evolved dramatically. Twenty years ago, as a front line staff person, all that was expected of front line staff was to help folks get through the day safely and make certain the contract work in the workshop got done. That was pretty much the extent of many job descriptions. In my own career I saw that evolution; I went from working in a group home, to starting a supported living program, to taking over as director of the adult vocational program. Within six months my duties and responsibilities had changed drastically. My salary also improved.
Today, a front line staff person has fewer opportunities for advancement because the systems are more bureaucratized, professionalized, and complicated. The pay at the front lines is relatively the same as it was twenty years ago—slightly better than minimum wage. Also, with the move to community integration, the demands on front line staff have increased. Now, direct support staff work and make decisions often in full view of the community and business. We expect them to be directed by consumers, and we expect serious outcomes such as home ownership and employment. Certainly they are not solely responsible for these outcomes, but front line staff are major contributors to success.
This level of responsibility and stress, coupled with meager or out-dated training, leads naturally to high turnover on the front line. Turnover rates vary from coast to coast, but 80% annual staff replacement for a CRP providing vocational and residential services is common. In fact, it is this high turnover rate that is often blamed for the unmanageable cycle of resignations and hirings. CRPs are continually forced to re-invest in recruitment and basic training rather than increasing salaries, providing better management support of staff, offering advanced training, and increasing support resources used to achieve community outcomes. The reasons CRPs universally give for not using PASS Plans (a significant source of consumer-directed revenue for achieving career goals), is that management is too busy putting out fires, and front line staff do not have time to learn how to use this Social Security Work Incentive. The same reason is true for effective partnering with Vocational Rehabilitation, the use of assistive technology, and the creation of business collaborations that lead to employer-initiated jobs.
Turnover saps the potential of CRPs, and, therefore, seriously undermines the potential of talented staff and consumers who rely on these agencies to support them in non-segregated environments. Couple this with Non-Value Added activities in the CRP daily routine, and outcomes become very difficult to achieve (Griffin, 1999).
Non-Value Added activities do not directly relate to achieving essential consumer outcomes, such as home ownership and real jobs. The types of Non-Value Added activities are many and varied, and are found in most social service systems. They include such items as staff meetings that perpetuate inactivity, certifications of quality that do not have a direct and obvious influence on consumer community outcomes, standardized or norm-referenced testing and evaluation, readiness or pre-vocational training, various day activity classes performed in artificial environments, cost-response behavior approaches emphasizing behavior change instead of finding ecological validity. If CRPs focused on providing just what the consumer needed to be supported in community environments, many of these wasteful accouterments of rehabilitation would be eliminated. Small, rural CRPs are plagued by insufficient economies of scale. If efficient means are not employed, resources for experimentation and invention are quickly squandered just doing what has always been done. Functional approaches, such as on-the-job experience and situational assessment save significant resources, can generate funds from partners such as Vocational Rehabilitation, give front line staff and consumers real world experience and success, and build adaptive corporate cultures focused on outcomes achieved through systematically defined and implemented operational processes.
Eliminating or significantly reducing front line turnover and increasing consumer outcomes requires that organizations immediately quit doing things that do not work. Telling the truth about our efforts is job one. For over fifty years, the promise of community rehabilitation has gone unfulfilled. Today, approximately 1,000,000 people with developmental disabilities are served in sheltered workshops and other segregated day programs. Despite the promise that a system of adult services would train and place many people in the community, only slightly more than 15% of consumers have successfully achieved community employment.
Another significant action is identifying those Non-Value Added activities. In one organization in the Mid-west, we performed a systematic audit of staff time expenditures. We discovered that this agency (with a $3.5 million annual budget) has 30 standing committees or meetings and that in one year, salary and benefits expended in attending these meetings topped $800,000. These were all meetings that had no direct connection to an individual consumer, but were procedural or reporting events that did not produce measurable results. Certainly meeting to share information and plans is critical, but not worth almost 25% of operating income. The agency had no significant outcomes, except that staff turnover remained constant at about 85% per year. The cost of turnover was approximately $100,000 when training time, paperwork, advertising, interviewing, and overtime pay for staff coverage was computed. This is an extreme example, but even in well-run organizations, finding $200,000 or so in waste typically is not difficult. And, $200,000 will provide significant wage increases and training for staff, and foster substantial community outcomes for consumers.
The intervention plan for this particular agency consisted of increasing the use of communications technology (voice and e-mail) to broadcast vital and report information, eliminating most of the non-outcomes directed meetings, managing remaining meetings with quality improvement techniques, and creating staff position profiles of front line positions to use in recruitment. This last item requires a shift in thinking about front line staff. Instead of accepting turnover as inevitable, the situation calls for managing the situation and solving the problem for the long term.
Establishing front line staff as an organization's most valuable investment, after consumers, dramatically changes corporate culture. Such a change requires an investment mind set. Exit interview data reveal that many front line staff leave for three primary reasons:
- Low pay
- Frustration with management's lack of focus and support for outcomes
- Restricted autonomy or power in decision making
In the organizational example above, the agency could realistically capture over $500,000 if wasteful processes and meetings were eliminated. Reducing turnover to 30% would result in an additional savings of $70,000. That increases fund liquidity to the agency by $570,000. Most organizations could change overnight if this money existed as cash, but until it is saved over the first year or two of a change program, the money is largely theoretical. It cannot be saved until the turnover and waste problems have been solved. So, without an investment strategy, the process is slow. But, by eliminating wasteful activities, which costs little to do, the nest egg can be developed within a year or two. At this point, it is important to create the recruitment profile for each department's front line staff. This means identifying places where probable candidates might be found, the competencies they should have and those the agency will invest in developing, and designing a salary scale equivalent to similar positions in the private sector. The money exists in human services to do just this; it has been done. But it has not been done without a leadership commitment to drastically change operations.
One of the first steps in accomplishing such dramatic change is identifying the necessary front line Core Competencies. A competency is a set of skills and attributes that influences job performance. Because competencies are based on skills, they can be measured and improved through training and practice. Personalities do not appear to change through training. So, new hires should not only exhibit critical competency potential, but also have personality traits that support an organizational culture focused on outcomes and quality customer service. Achieving this match of skills and personality takes much more work than simply hiring warm bodies; it is a long-term investment-based strategy to achieve consumer-desired outcomes. A supported employment specialist might need to exhibit competency in the following areas:
- Negotiation
- Image/Marketing/Public Relations
- Customer Service
- Systematic Instruction
- Self-Management
- Communication
- Problem-Solving
Training in these skills is available through turnover savings and by partnering with local universities and businesses. Further, good recruitment entices people away from other businesses that have already trained these staff in many related and complimentary skills. The key here is that the CRP must compete on salary as well as working conditions, work autonomy, and clarity of outcome expectations. It is true that front line staff leave for income reasons as much as for other reasons. It is not the only reason, but it is essential that staff be able to feed and house themselves. By re-investing the savings from organizational re-engineering, salaries can be significantly improved, and training can be high quality.
Initiating a "Save the Front Line" program requires the following basic steps:
- Analyze organizational outcomes data in relation to the baseline
that all people with disabilities should live, work, and recreate
in typical community settings.
- Account for all staff time and effort over approximately
a 2 month period. Compare the work that's being done to the
work that needs to be done. Recent research studies indicate
that many rehabilitation personnel are not actively engaged
in outcome related work most of the day (Marrone, 1994). Calculate
unproductive personnel time in terms of salaries, benefits,
and if possible, in terms of lost opportunities and billables.
- Calculate the cost of personnel turnover throughout the agency
in terms of over-time pay for coverage, lost billables, advertising,
interviewing, orientation and training time. If possible, calculate
the stress to consumers, staff, and managers turnover causes.
Consider also the lost opportunities, the impact of a crisis
orientation when scrambling to find staff, the inconsistency
of customer service to community employers, et al.
- Create a competency-driven staff recruitment profile that
focuses on finding and retaining the best staff possible.
- Develop an equitable salary scale that makes CRPs competitive
with business.
- Change the organization's rhythm to one of continuous communication, refinement, invention, and quality. Avoid falling victim to the myth that rehabilitation is doomed to forever pay people less than they are worth, and that people with disabilities deserve less than the absolute best. Think future development and capacity building.
Civic Entrepreneurship and Leadership: the Changing Role of the Human Service Sector
A major challenge for rehabilitation programs in any community is projecting a positive image of individuals with disabilities. Years of paternalism and public misinformation about the "specialness" and inability of people with severe disabilities must be overcome in order for sweeping employment reform to occur. The establishment of segregated programs for people with disabilities (i.e. group homes, special schools, workshops) conveyed the message to the public that people with disabilities were "the system's problem;" that the community at-large was not prepared or properly trained to deal with such folks; that "they'd rather be with their own kind anyway." In many small towns, the citizenry took pride in fund raising efforts that helped establish local programs that were state-of-the-art for their time. The change to a philosophy of integration and inclusion devalues these community efforts. Without a planful approach to community re-entry, the best efforts of employment specialists may be met with both external and internal resistence.
Staff training, as mentioned above, is one critical element in linking the community and the rehabilitation effort. Staff must know the agency's mission, proper conflict management approaches, respectful language, and efficacious worksite training approaches to overcome years of systems-driven stereotyping. The role of the CRP, its leaders, consumers, families, and Board changes to that of network builder and link to the wealth of the public sector and the opportunities available within the private sector. Attention is turned to creating an environment where the community recognizes people with disabilities as citizens who should no longer be denied the rights of housing and economic self-sufficiency.
The steps in achieving this are familiar. They demand a strong effort on behalf of the CRP in becoming contributors to community building, using staff expertise to help solve community challenges, and a fundamental change from reliance upon a specialized system to reframing disability issues as community issues. Unemployment, for instance, is not a disability issue. It is a community issue that begs for community action. The CRP can bring light to the high local unemployment rate of persons with disabilities. When this has been done in places such as Greeley, Colorado, the community has responded by taking action through its Active Employment Council (Griffin & Sherron, 1999). In Missoula, Montana, the need for small business start-up loans for entrepreneurs with severe disabilities led to substantially increased access to existing loan funds and technical assistance especially relevant to borrowers who also received Social Security and needed to protect portions of their benefits package. The loan funds were accessed through local business development sources and with a loan guarantee/risk pool funded by the City Council.
Efforts to bring the public and private sectors together are incubated by civic entrepreneurs, which can include CRPs. The civic entrepreneur leverages or augments existing resources in the community, such as low-interest/high risk loan funds, transportation, medical care, etc., without creating a "separate but equal" resource for citizens with disabilities. Even in the most remote communities, resources exist to address many human problems that are not unique to people with disabilities (Henton, et al., 1997).
Transportation
A commonly shared challenge to employment and health care services in rural areas is the lack of accessible transportation. And, even when money is available to purchase transportation, often there is simply none available at any price. Rural Americans make up 27% of the U.S. population, but only 5% of federal transportation funds are allocated to rural communities. Where transportation is available, it is typically unreliable because over half the vehicles are beyond their useable life, and fully 60% of mass transit in rural areas is not wheelchair accessible (Bernier & Seekins, 1996). Add to this the cost of transportation for a population that lives in poverty, as well as the challenges of geography and weather, and isolation remains as the predominant factor in frontier communities.
As mentioned earlier, one approach to transportation is to make certain that the job analysis process includes a studied examination of access resources. A job that one cannot get to is simply not a good job. Transportation is another issue that supports the role of the civic entrepreneur. Transportation in remote areas is everybody's problem and benefits from community-wide solutions.
One example of rural problem solving occurred in southern Colorado in the early 1980s. The CRP played a leading role in forming a transportation cooperative in Colorado's remote and poor San Luis Valley. Several human service organizations pooled their vehicles and formed a new corporation to provide both fixed route and door-to-door services. This CRP also utilized private citizens for transportation from remote to hub communities. Service consumers were matched with commuters from nearby areas. The commuter transported the individual to and from work and received payment from the CRP to underwrite the driver's costs. These approaches have been replicated with success in rural Michigan, Kansas, Montana, and South Dakota (Bernier & Seekins, 1996).
Finally, the use of vouchers is a promising practice as self-determination approaches to rehabilitation gain favor (Callahan, 1998; Bernier & Seekins, 1996). The use of Social Security Work Incentives, such as PASS and the pending Ticket to Independence, to underwrite commuting and private transportation costs is a potential solution (Griffin, et al., 1998). And as portability of money allotted for service delivery becomes a reality, perhaps more options will arise.
Conclusion
The challenges of the rural population are many. Isolation due to a paucity of accessible transportation, waiting lists for services, highly competitive markets for low-paying and repetitive jobs, underpaid and overworked front-line CRP staff, continued stereotyping of people with severe disabilities, etc., all contribute to making rural supported employment one of the toughest challenges communities face at the turn of this century. After ten years of federal systems change projects, training programs, increased funding rates, and a growing civic awareness of the employment rights of people with disabilities, the prospect of attaining a good job in a remote community remains difficult.
A brief review of state developmental disability plans reveals that few states currently provide financial incentives for assisting people with severe disabilities into community employment. Rural programs with limited economies of scale face greater risks because their financial status is typically more tentative than larger urban programs. Therefore, experimentation is sometimes limited for fear of fiscally jeopardizing the program. A review of final reports of rural state Supported Employment Systems Change projects funded in the 1980s and 1990s showed that little effort was directed at engaging the communities as problem solvers and addressed few of the challenges faced by remote CRPs and consumers.
The agenda for the next decade certainly must include a reformulating of our efforts at community employment. States must take a lead role in offering incentives to CRPs for assisting people in attaining and retaining community employment. States must start granting personal service vouchers, especially in rural areas, to create consumer-control of outcomes and to spark competition where none now exists. States must set some community employment outcomes expectations where none now exist. Training must change for vocational counselors and staff to include emphasis on rural issues, the work abilities of people with even the most significant disabilities, the role of self-employment and microenterprise. Programs must de-emphasize predictive validity via vocational testing and instead make a commitment to funding supports that augment community success.
Finally, and perhaps most difficult of all, professionals and consumers alike must face the community and engage the populace. Years of separation and isolation have produced a fear of the greater community. Our neighbors share many of the same hopes and concerns that we in the public sector and disability community share. Engaging employers, townspeople, and city governments is a crucial step in addressing community and employment access. A fundamental shift in thinking will change our view of the community from a Pandora's Box to that of a resource rich Treasure Chest.
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