With Clear Goals and a Holistic Approach, Organizations Can Move from Sheltered to Integrated Services to Benefit Clients with IDD

A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

People with intellectual and developmental disabilities (IDD) have lifelong conditions that may affect their ability to communicate, learn, or make decisions. Historically, adults with IDD have often received services in job or recreation facilities that are segregated or sheltered, where they may only interact with other people with disabilities and support staff, rather than an integrated setting where they may interact with people with and without disabilities.

Recent policy changes require agencies to switch their services away from these sheltered programs, and to instead provide services and supports to adults with IDD that will integrate them into their communities whenever possible. These include employment supports to help people with IDD find jobs in their communities where they work alongside people without disabilities, and supports for community life engagement (CLE, defined as involvement in non-work community activities like volunteering, socializing, education, or recreation). Service agencies may face challenges when switching to these integrated programs, such as needing to reallocate funding, retrain staff, and partner with community employers.

In a series of recent NIDILRR-funded studies, researchers asked people involved with integrated employment and community life engagement programs to describe the most important elements for successful transition to integrated employment supports, as well as the essential components of high quality CLE supports. They wanted to find out what factors are most important for the success of an integrated employment program, and what agency leaders think are the most important components of high-quality CLE supports.

Researchers at the Rehabilitation Research and Training Center on Advancing Employment for Individuals with Intellectual and Developmental Disabilities and the project on Community-Based Non-Work: Developing Research-Based Guidance for States and Service Providers conducted surveys and interviews with experts in employment and community life engagement. They also looked at data collected by a community service provider that successfully transitioned from sheltered to integrated recreation services for individuals with IDD.

First, the researchers conducted a survey of 36 experts involved with employment programs. The participating experts identified the most important elements supporting the success of transitioning to integrated employment programs. These experts were leaders, staff, or individuals supported by service agencies that had successfully transitioned from sheltered to integrated employment services. The experts completed two online surveys where they generated elements of successful transformation and then ranked them in order of importance.

Second, the researchers conducted interviews with experts on CLE. The researchers interviewed a small group of experts including individuals with IDD, their family members, service providers, and other researchers to find out what they thought are the most important components of a successful CLE program.

Finally, the researchers looked at data on individuals with IDD who received services from Starfire, an organization that had successfully transformed its services from sheltered recreation services to individualized CLE supports in individuals’ local communities. These individuals were provided one-on-one coaching to discover their talents and support their engagement in the broader community instead of interacting primarily with other people with IDD. Staff at Starfire collected and used a number of outcome measures to find out whether people with IDD who received their services were successful in the integrated program.

From the survey, the researchers found that the employment experts identified ten important elements that organizations should have for successful transformation to integrated employment. In order of importance, these were:

• Clear, consistent goals to increase employment in the community;
• An agency culture that values inclusion;
• Person-centered job placement, finding jobs for one person at a time;
• Strong communications conveying a belief in integrated employment;
• A strong plan to reallocate resources from sheltered employment facilities into community-based employment supports;
• Ongoing professional development for staff;
• Focus on customer engagement and fostering relationships with self-advocates, funders, and business partners;
• Effective performance monitoring;
• A holistic approach that treats each individual as a whole person; and
• Multiple, diverse community partnerships.

From the interviews with experts about the key elements of CLE, the researchers found that four main elements were mentioned:

• Tailoring supports to each individual, and taking time to learn about each person’s particular strengths and interests;
• Helping each individual to be a valued member of their community and make a contribution;
• Supporting each individual to develop their skills and social networks so they can depend less on staff support; and
• Monitoring individual and organizational outcomes and goal achievement.

Finally, according to Starfire’s records comparing individuals with IDD’s outcomes before and after participating in Starfire’s integrated CLE program, most individuals increased the number of social connections they had in the community. Most found a role in their community, such as a volunteer position, an internship, or a job within 1 year of starting the program. Their families also became more active in helping build their social networks. The percentage of individuals reporting a high quality of life doubled after 1 year of participating in the integrated CLE program.

From the study’s findings, the authors noted that many elements of a strong integrated employment program were also described as elements of a strong integrated CLE program. These elements include having clear goals and accountability; tailoring the supports to each person’s unique strengths and preferences; taking a holistic approach that focuses on the whole person; and moving funds away from specialized facilities and instead toward staff time for individual coaching. The authors also noted that employment and CLE are linked, so that a person who has strong connections in their community is well-positioned to find employment, and vice versa. Evidence from Starfire shows that connecting people with IDD to others in the community may improve their quality of life and well-being. Service providers may want to engage in similar organizational change processes for both employment and CLE supports in order to develop holistic, community-based services for people with IDD.

To Learn More

The Rehabilitation Research and Training Center on Advancing Employment for Individuals with IDD continues to conduct research and development in organizational transformation. Their website includes many research briefs and two webinars on the topic: http://www.thinkwork.org/rrtc/otcrp

ThinkWork also has research briefs and other resources on community life engagement for people with IDD: http://www.thinkwork.org/topics/community-life-engagement/

The US Department of Labor Office of Disability Employment Program (ODEP) offers an Integrated Employment Toolkit, that pulls together critical resources, organized by six stakeholder groups: Employers; Community Employment Agencies (CEA); Families and Individuals (both youth and adult); Policymakers, and Researchers. The assembled information allows the user to access, and in some cases adapt the resources they need to implement integrated employment in their state, organization, or locale. https://www.dol.gov/odep/topics/IntegratedEmployment.htm

To Learn More About this Study

Sulewski, J.S., Timmons, J.C., Lyons, O., Lucas, J., Vogt, T., and Bachmeyer, K. (2017). Organizational transformation to integrated employment and community life engagement. Journal of Vocational Rehabilitation, 46(3), 313-320. This article is available from the NARIC collection under Accession Number J76363.