StateData: The National Report on Employment Services and Outcomes

John Butterworth, Frank A. Smith, Allison Cohen Hall, Alberto Migliore, Jean Winsor, Daria Domin

Institute for Community Inclusion (UCEDD)
University of Massachusetts Boston
Winter 2013

The StateData employment report is a product of Access to Integrated Employment, a project of the Institute for Community Inclusion (ICI) at the University of Massachusetts Boston, supported in part by the Administration on Intellectual and Developmental Disabilities, Administration for Community Living, U.S. Department of Health and Human Services, under cooperative agreement #90DN0295. The opinions contained in this report are those of the grantee and do not necessarily reflect those of the funders.

Acknowledgements

The authors would like to express sincere thanks to our collaborators at the National Association of State Directors of Developmental Disabilities Services, including Nancy Thaler, Chas Moseley, and Rie Kennedy-Lizotte. Additionally, the authors acknowledge the contributions of ICI's entire StateData team, including Bill Kiernan and Suzzanne Freeze, as well as David Temelini and Anya Weber, who assisted in the editing, layout, and production of this report.

The topical chapter in this year's report was authored by Daria Domin and John Butterworth.

Special thanks are directed toward the state administrators and key survey contacts in each state who consistently respond to the ICI's Intellectual and Developmental Disabilities Agency National Survey of Day and Employment Services. Their expertise, insights, and assistance have helped to make this report possible.

Contact

Institute for Community Inclusion
University of Massachusetts Boston
100 Morrissey Boulevard
Boston, Massachusetts 02125
ici@umb.edu
www.communityinclusion.org
www.statedata.info
www.selnmembers.org

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twitter.com/ICInclusion

Suggested citation

Butterworth, J.,Smith, F. A., Hall, A.C.,Migliore, A., Winsor, J., & Domin, D.(2014). StateData: The national report on employment services and outcomes. Boston, MA: University of Massachusetts Boston, Institute for Community Inclusion.

Executive Summary

Federral and state policy has paved the way to support opportunities for people with disabilities to have meaningful jobs in their communities (Kiernan, Hoff, Freeze, & Mank, 2011; National Association of Councils on Developmental Disabilities, 2011). With an increasing emphasis on integrated employment and an Employment First philosophy, the nation is poised for transformation that could put Americans with disabilities on a path out of poverty and towards self-sufficiency.

However, there remains a significant gap in employment rates between people with and without disabilities. The 2012 American Community Survey (ACS) estimates that 32.5% of working-age adults with disabilities are employed, compared with 71.4% of people without disabilities (Butterworth et al., 2013). Labor force statistics for December 2013 estimate that 16.5% of individuals with disabilities ages 16 and older are employed, compared with 64.0% of those without disabilities (Bureau of Labor Statistics, January, 2014).

For people with intellectual and developmental disabilities (IDD), the disparity in employment participation widens further. Data from the National Core Indicators (NCI) Project suggest that in 2010, only 14.7% of working-age adults supported by state IDD agencies were employed in integrated employment (Human Services Research Institute, 2012). Community rehabilitation providers reported in 2010 that only 27% of individuals with IDD supported by their organization worked in integrated jobs, including both individual jobs and group supported employment (Domin & Butterworth, 2012). Those who are employed typically work limited hours with low wages (Boeltzig, Timmons, & Butterworth, 2008; Human Services Research Institute, 2012). At the same time, participation in facility-based and non-work services has grown, suggesting that employment services remain an add-on rather than a systemic change (Butterworth, Smith, Hall, Migliore, & Winsor, 2013; Mank, 2003; Domin & Butterworth, 2012).

For over 25 years, the Institute for Community Inclusion (ICI) has been home to Access to Integrated Employment, a national data-collection project on day and employment outcomes funded by the Administration on Intellectual and Developmental Disabilities. Since 1988, this project has described the nature of day and employment services for individuals with IDD, and contributed to a comprehensive understanding of the factors that influence employment outcomes at the individual, service-provider, and state-policy level.

This report provides statistics over a 25-year period from several national datasets that address the status of employment and economic self-sufficiency for individuals with IDD. The report is divided into three major sections:

1. A comprehensive overview that describes national trends in employment for people with IDD.
2. A topical chapter that presents a state-by-state description of employment and non-work service participation of people with IDD as reported by community rehabilitation providers.
3. An appendix with individual state profiles and a national profile.

Data from four sources is included: the ICI's IDD Agency National Survey of Day and Employment Services (from FY1988, 1990, 1993, 1996, 1999, 2001, 2004, 2007, 2008, 2009, 2010, 2011, and 2012), and datasets from the Social Security Administration, state vocational rehabilitation (VR) programs, and the U.S. Census Bureau (the American Community Survey).

Data continue to highlight the economic disparities between people with and without intellectual and developmental disabilities. State investment in supports continues to emphasize facility-based and non-work services, rather than integrated employment services. In the VR system, earnings of adults with disabilities are substantially lower compared to those in the general population, and weekly earnings of individuals served by VR have declined slightly over time. Overall, the findings suggest that across datasets, people with intellectual disabilities experience greater levels of unemployment, underemployment, low wages, and poverty compared to those without disabilities. This year's data suggest:

• In the IDD system, national estimates suggest that there has been only modest growth in the number of individuals in integrated employment services since 1988. The estimated percentage of individuals participating in integrated employment services was 18.4% in FY2012, down from 19.3% in FY2011, while investment in non-work services continues to expand. However in FY2012, Connecticut, Maryland, New Hampshire, Oklahoma, Washington, and West Virginia all reported that at least 40% of individuals receiving day and employment services were receiving integrated employment services.
• In the VR system, the rehabilitation rate increased compared to 2011, but was still lower than in earlier years. Weekly wages have declined slightly over time. People with intellectual disabilities who exited the VR system in 2012 took about 710 days to gain employment, on average, from application. This represented 36 additional days compared to 2011, continuing a trend of increasingly more days from application to an employment outcome.
• American Community Survey data continue to show that people with disabilities are much less likely to work than their counterparts without disabilities. People with a cognitive disability who are receiving Supplemental Security Income (SSI), the group likely to include people who have the most significant cognitive disabilities, have the lowest employment rate of all disability subgroups examined, and are the most likely to live in a household that is below the poverty line. The positive impact of the economic recovery on employment appears to have been stronger for people without disabilities than it has been for people with disabilities.
• Data from the Social Security Administration show that work incentive programs for SSI recipients with disabilities remain underused. SSI recipients with ID work more than their counterparts with other types of disabilities, but participate in work incentive programs less frequently. Younger people who receive SSI appear to work more frequently than their older counterparts.

Data for FY2012 highlight the economic and employment disparities for individuals with intellectual and developmental disabilities. While some data suggest progress (e.g., the increasing number of IDD state agencies that are serving over 40% of individuals in integrated employment services), overall data demonstrate the increasing need for policies and initiatives that prioritize employment. The evolving shift in states toward Employment First policies can make an important contribution to raising expectations, improving outcomes, and increasing self-sufficiency for individuals with IDD.

Introduction

Federal and state policy has paved the way to support opportunities for people with disabilities to have meaningful jobs in their communities (Kiernan, Hoff, Freeze & Mank, 2011; National Association of Councils on Developmental Disabilities, 2011). With an increasing emphasis on integrated employment, the nation is poised for transformation that could put Americans with disabilities on a path out of poverty and towards self-sufficiency.

However, there remains a significant gap in employment rates between people with and without disabilities. The 2011 American Community Survey (ACS) estimates that 32.4% of working-age adults with disabilities are employed, compared with 70.5% of people without disabilities (Butterworth et al, 2012). Labor force statistics for October 2012 estimate that 28.4% of working-age adults (16 to 64) with disabilities are employed, compared with 71.0% of those without disabilities (Bureau of Labor Statistics, November 2012). Labor force data also indicate that workers with disabilities have had significantly higher levels of job loss and hardship during the recent recession (Kaye, 2010).

For people with intellectual and developmental disabilities (IDD), the disparity in employment participation widens further. Data from the National Core Indicators Project suggest that, in 2010, only 14.7% of working age adults supported by state IDD agencies participated in integrated employment (Human Services Research Institute, 2012). Community rehabilitation providers (CRPs) reported in 2010 that only 27% of individuals with IDD supported by their organization worked in integrated jobs, including both individual jobs and group supported employment (Domin & Butterworth, 2012). Those who are employed typically work limited hours with low wages (Boeltzig, Timmons, & Butterworth, 2008; Human Services Research Institute, 2012). At the same time, participation in facility-based and non-work services has grown, suggesting that employment services remains an add-on rather than a systemic change (Butterworth, Smith, Hall, Migliore, & Winsor, 2011; Mank, 2003; Domin & Butterworth, 2012).

Although resources and priorities have not coalesced nationwide, there is substantial evidence of progress across the country. In Fiscal Year (FY) 2011, CT, GA, NH, OK, and WA all reported that more than 40 percent of individuals receiving day and employment services were receiving integrated employment services. Recently, as an outgrowth of the Access to Integrated Employment project, 27 states have committed to expansion of integrated employment by joining the State Employment Leadership Network (SELN).

The SELN is a membership roundtable co-managed by the ICI and the National Association of State Directors of Developmental Disabilities Services. Its work is guided by the High Performing States Model, which identifies seven elements that transmit and maintain commitment to the goals of community inclusion and integrated employment (see Figure 1). Between 2004 and 2010, the reported percentage of individuals in integrated employment services grew from 32.1% to 36.4% for SELN states, and dropped from 19.9% to 18.4% in 2010 for non-SELN states (SELN, 2012).

Figure 1. High Performance Model

On the national level, integrated employment has emerged as a policy priority, both in the disability arena and beyond. The National Governors Association, under the leadership of Delaware governor Jack Markell, launched a blueprint for governors entitled A Better Bottom Line: Employing People with Disabilities. The purpose of this initiative is to increase employment for individuals with intellectual and other significant disabilities.

The Alliance for Full Participation, a coalition of disability advocacy organizations, established employment as the priority for their 2011 national summit, attended by over 1,250 people. This marked the mid-point in a campaign to double employment for people with IDD by 2015 (Walsh, 2011). The National Association of Councils on Developmental Disabilities released a report entitled The Time is Now: Embracing Employment First in conjunction with the AFP summit.

The Administration on Intellectual and Developmental Disabilities has issued multi-year system change grants to support states in cross-system collaboration to address increasing employment outcomes for youth and young adults, as well as grants to establish community of practice opportunities for states engaged in employment first practices. The Office of Disability Employment Policy at the U.S. Department of Labor (2009) has issued policy statements and developed grant opportunities and communities of practice to support implementation of Employment First in several states. The Centers for Medicare and Medicaid Services released guidance to the field clarifying their commitment to individual integrated employment as an outcome of employment-related services under the home and community- based services waiver program (CMS, 2011).

Finally, the Obama administration recently launched a new competitive grant program, Promoting Readiness of Minors in Supplemental Security Income (PROMISE). PROMISE is designed to improve the education and career outcomes of low-income children with disabilities, ages 14-16, who receive Supplemental Security Income.

At least 34 states have some form of Employment First initiative, which is nationally recognized as a policy path towards greater community employment for people with IDD. Employment First strategies consist of a clear set of guiding principles and practices promulgated through state statutes, regulations, and operational procedures. All these practices target employment in typical work settings as the priority for state funding, and the purpose of supports furnished to people with IDD during the day.

Employment First policies anchor a service delivery system, focusing funding, resource allocation, training, daily assistance, and the provision of residential supports on the overall objective of employment. This strengthens the capacity of all individuals receiving publicly financed supports to enter the workforce and become contributing members of society (Moseley, 2009).

Employment First represents a commitment by states, and state IDD agencies, to the propositions that all individuals with intellectual and developmental disabilities (a) are capable of performing work in typical integrated employment settings, (b) should receive as a matter of state policy employment-related services and supports as a priority over other facility-based and non‐work day services, and (c) should be paid at minimum or prevailing wage rates.

Services and Supports Used by People with Intellectual/Developmental Disabilities

Employment supports are provided within a context of state and federal disability policy, workforce development policy, income maintenance, and healthcare policy. These include supports related to transportation, housing, welfare, and childcare. Core supports are funded by state IDD and vocational rehabilitation (VR) agencies, as well as local education agencies, and employment supports are provided by a network of over 8,000 community rehabilitation providers.

State IDD agencies. State IDD agencies remain the primary source of long-term funding and service coordination. They provide, fund, and monitor a wide range of services, including employment supports, facility-based options (sheltered workshops and non-work day habilitation programs), community integration services, and self-directed options.

State vocational rehabilitation (VR) agencies. State VR agencies provide services to over one million people annually, closing approximately 600,000 cases in each fiscal year. Approximately 8.2%, or 48,540, of those case closures can be identified as individuals with IDD, a person with a primary or secondary impairment code of intellectual disability (formerly categorized as mental retardation).

Policy under the Medicaid HCBS program requires that individuals access VR for employment support prior to receiving Medicaid waiver funding. However, collaboration is impeded by a wide range of systemic barriers, including lack of agreement about target populations and differences in culture and resources (Timmons, Cohen, & Fesko, 2004).

One-Stop Career Centers. Established and supported under the Workforce Investment Act, these centers, also known as American Job Centers, provide an underused resource for individuals with IDD and other disabilities. In 2010, 617,314 individuals with disabilities registered as job seekers for Wagner Peyser-funded One-Stop services (U.S. Department of Labor, Employment & Training Administration). Six hundred and ninety-nine individuals with ID who closed out of state VR services in 2010 (1.5% of all VR closures with ID) were identified as referrals from One-Stop Career Centers.

Medicaid. Medicaid is both a primary source for health care for individuals with IDD and the largest federal source of funds for day and employment services under the Home and Community Based Services waiver program. While historically there has been no clear preference for integrated employment in Medicaid-funded services, in 2011 the Centers for Medicare and Medicaid Services (CMS) issued a policy bulletin that provides guidance for the development of employment and employment-related service definitions in 1915(c) waivers. This guidance establishes individual integrated employment as a priority goal (CMS, 2011). Over the past decade, CMS has expanded its focus on employment through the Medicaid Infrastructure Grant program and expansion of state Medicaid buy-in programs.

Social Security. Social Security Administration (SSA) work incentives, such as the Plan for Achieving Self-Support, Impairment Related Work Expenses, and the Student Earned Income Exclusion, support employment by allowing individuals who receive Supplemental Security Income to exclude money, resources, and certain expenses from total earned income. The SSA also administers the Ticket to Work program, which provides individuals with a ticket to buy VR, employment, and other support services from a participating employment network or state VR agency. Despite the SSA’s initiatives, work incentives and the Ticket to Work program remain underused (Butterworth et al., 2013).

Community Rehabilitation Providers (CRPs). CRPs and their staff are the primary source of day and employment supports for people with IDD. The ICI maintains a national provider list, and estimates that over 8,000 CRPs nationwide offer vocational services to individuals with disabilities. The majority (over 70%) of those served by CRPs are people with IDD (Metzel et al., 2007; Domin & Butterworth, 2012). Over two thirds of CRPs provide both work and non-work services (Metzel et al., 2007; Domin & Butterworth, 2012).

Factors that Influence Employment Outcomes

Despite state and federal initiatives, policy change, and emerging leadership, widespread integrated employment for people with IDD has not occurred. Nationally, an estimated 18% of individuals receiving day supports from state IDD agencies participated in integrated employment services during FY2012. This number has slowly declined after reaching a peak of almost 25% in FY2001. Overall growth in integrated employment slowed following the end of the RSA Supported Employment Systems Change grants in the mid–1990s (Butterworth et al., 2013; see Figure 2).

At the service delivery level, best practices evolved, including person-centered career planning, customized employment, job creation, and self-employment, but adoption of these practices is limited (Migliore et al., 2012). Continuing challenges for systems change include:

State and federal policy do not consistently prioritize employment. While more individuals with IDD are in integrated employment, the number participating in facility-based and non-work services has grown more rapidly. Despite investments in education, income supports, and healthcare for Americans with disabilities, few of these resources encourage or reward integrated community employment (Niemiec, Lavin, & Owens, 2009). Additionally, CRPs that have closed a facility-based program report that state agencies are rarely a catalyst for change (Butterworth, Fesko, & Ma, 2000).

Expansion of community-based non-work (CBNW) services has competed with integrated employment (Sulewski, 2010). Twenty-seven state IDD agencies reported supporting individuals in CBNW services in FY2011, and indicated that 45.5% of those served participated in CBNW in FY2011. Respondents to the ICI’s 2010-2011 National CRP Survey reported a more modest but still meaningful role for CBNW services, indicating that 16.4% of individuals with IDD participated (Domin & Butterworth, 2012).¹ CBNW is loosely defined with respect to requirements, activities, populations served, and goals (Sulewski, Butterworth, & Gilmore, 2008).

CRPs have not reallocated resources to community employment. Respondents to the ICI’s 2010-2011 National CRP Survey reported that 19% of individuals with IDD participated in individual employment services, a slight increase from the 18% reported in 2002-2003. An additional 9.5% of individuals were reported to be working inmobile work crews or enclaves. The majority of individuals participated in facility-based or non-work services (25.2% and 43%, respectively). The largest growth was in non-work services (facility-based or community-based). Between 2002 and 2010, participation in non-work services grew from 33% to 43%, offset by a decline in the percentage of individuals in facility-based work.

Funding mechanisms vary across states and do not always reflect policy priorities. In an environment of increasing fiscal limitations and individualized budgeting, there is a growing need for state employment systems to discuss rate-setting and funding. Analysis of five states’ employment funding structures suggests there is no “best” approach, but there are several key elements for success (Hall, Freeze, Butterworth, & Hoff, 2011). Rate and contracting structures should be selected with a clear intent regarding goals. Unambiguous definitions and service categories should also reflect these priorities. States with policy and funding alignment pay more for desired outcomes (a community job), and less or nothing at all for outcomes that are not a priority.

Work with states suggests that changes made to funding rates should be based in the real-world costs of providing high-quality integrated employment, and should not solely rely on the typical approach of revising funding based upon historical costs. When considering states’ funding methodologies, all state agencies that pay for employment services should be involved in the discussion. Past experience has shown that making fragmented changes to one or two service rates is not sufficient to address the underlying funding issues faced by providers and service recipients. Consideration of the entire funding system helps ensure that individuals receive services that support a whole-life, individualized, community-centered approach to employment.

Best practices in job supports are not consistently implemented. Research has investigated competencies and training needs of direct support professionals (DSPs) in residential settings (Larson & Hewitt, 2005; Larson et al., 2007). However, less has been done to examine the same issues regarding DSPs who assist job seekers. These DSPs face complex responsibilities, ranging from meeting business demands to addressing the personal needs of people with disabilities (Test, Flowers, & Hewitt, 2004).

Research suggests that employment specialists inconsistently use established promising practices, including spending time with individuals in community settings, working with families, and negotiating job responsibilities with an employer (Migliore et al., 2012; Migliore, Hall, Butterworth, & Winsor, 2010). Findings also suggest that job developers have limited opportunities for effective professional development, including both formal and informal chances for learning (Hall, Bose, Winsor, & Migliore, in press), though employment specialists who receive training and mentorship do improve the number and quality of the jobs they develop (Butterworth et al., 2012).

Individual employment outcomes have not improved. Data consistently show that the majority of individuals with IDD work part-time in entry-level positions, have low annual income, and have limited access to employee benefits (Human Services Research Institute, 2012; Boeltzig, Timmons, Gilmore, & Butterworth, 2007; Mank, Cioffi, & Yovanoff, 2003). Outcomes have also declined for individuals with IDD served by state VR agencies. Between 1991 and 2005, weekly hours worked at closure declined from 29 to 25, and weekly wages declined from $195 to $179 (Migliore & Butterworth, 2008).² Schur, Kruse, Blasi, and Blank (2009) found that employees with disabilities have less job security, receive less company-sponsored training, and have lower rates of participation in decision-making when compared to workers without disabilities.

Transition-age youth continue to face challenges. Data on youth and young adults with disabilities indicate that, similar to the adult population, they lag behind their peers without disabilities in measures of education, employment, and economic well-being. Nationally, compared to youth without disabilities, students with disabilities are less likely to receive a regular high school diploma, drop out twice as often, and enroll in and complete postsecondary education programs at half the rate (Chapman, Laird, & KewalRamani, 2010).

At two years post-high school, four in ten youth with disabilities are employed, compared to six in ten youth in the general population (Chapman, Laird, & KewalRamani, 2010). Students with IDD in particular have the lowest rates of education, work, and preparation for work after high school. Sulewski, Zalewska, and Butterworth (2012) found that outcomes for youth with IDD lag behind youth without IDD, and that this gap increases with age.

Poor employment outcomes for youth with IDD are a result of a confluence of issues. These include lack of emphasis on integrated employment outcomes within state IDD agencies (Butterworth et al., 2013), inadequate collaboration between the adult disability and education systems (Whelley, Hart, & Zaft, n.d.), limited vocational experiences in school (Carter, Austin, & Trainor, 2011), inadequate support to transition directly to jobs in the community (Certo et al., 2003), and limited development of self-determination and career-related decision-making skills (Shogren & Plotner, 2012).

While state IDD agencies widely view transition from school to adult life as an important time to establish a pathway into employment, National Core Indicator Project data suggest that only 6% of individuals with IDD ages 16-21 and 17% of individuals ages 22-30 are working in integrated employment. However, trend data suggest that participation in employment is on the decline for all young adults ages 16-21, including those without disabilities.

Methodology

This report provides statistics over 25 years from several existing national datasets that address the status of employment and economic self-sufficiency for individuals with intellectual and developmental disabilities. The authors use abbreviations for both intellectual disability (ID) and intellectual and developmental disabilities (IDD) in this report. We do this because data sources vary in the specific target groups that can be described.

We provide a comprehensive overview that describes national trends in employment for people with IDD, and the appendix provides individual state profiles with data from several sources.These include the ICI’s IDD Agency National Survey of Day and Employment Services (from FY1999, 2001, 2004, 2007, 2008, 2009, 2010, 2011, and 2012), and datasets from the Social Security Administration, Rehabilitation Services Administration, Bureau of Labor Statistics, and American Community Survey. The appendix provides a state-by-state analysis of trends across each dataset.

Data Sources

IDD Agency National Survey of Day and Employment Services.

This survey is part of a longitudinal study commissioned by the Administration on Intellectual and Developmental Disabilities to analyze community-based day and employment service trends. Data is presented for services received between FY1988 and 2012 for individuals with IDD and closely related conditions. Between 1988 and 2004, the survey was administered on a semi-annual basis; starting in 2007, information has been collected annually. The most recent version of the survey is focused on state IDD agency data for FY2012.

The survey is designed to provide the following information:

• Trends in the number of people served in integrated employment, facility-based employment, and facility- based and community-based non-work programs
• Trends in the number of individuals waiting for services
• Funding sources that are being used to support day and employment services
• The allocation of funds across day and employment services

The survey was developed with input and field-testing support from state IDD agency administrators. Core variables include the number of people served (total and by day and employment service categories), number of people on waiting lists, expenditures by service, and total funding by source. All questions focus on day or employment services monitored by the state IDD agency, including services funded by another state agency (such as the Medicaid agency), even if the IDD agency does not provide or directly contract for the service.

In 1996, the category of community-based non-work service was added to the survey. The most recent changes to the survey occurred in 2010. States are now asked not only to provide the number of individuals in each service category, but also to indicate if they provided each service. Additionally, states are now asked specific questions about the number of individuals that they serve who are working for pay in jobs in the community, in order to distinguish between services and employment outcomes. Beginning in FY2001, states were offered the opportunity to complete the survey using a secure website. Each state’s responses from the previous year are listed on the website for reference and updating if necessary.

The survey was most recently administered in June 2013 to IDD agencies in all 50 states and the District of Columbia. The agency director from each state and the staff members who responded to the previous survey were contacted to ensure consistency in the data reported. Initial contact was made by email, and follow-up was completed via email and telephone. States were asked to complete the most recent survey using data from FY2012.

The survey home page provides general information and instructions for completing the survey. Additionally, instructions and guidance for responding to the survey questions are included within each question. The survey requests data on the total number of individuals served; however, if a state does not have the capacity to adjust for individuals who enter or exit the system during a fiscal year and can only provide the number served at the end of the fiscal year (or at some other specific point in time), there is a place on the survey to provide this information.

Each step of the survey provides an opportunity for states to enter explanatory comments on their data. The final step of the survey offers states the chance to make suggestions for how the survey could be revised in the future. States are also asked to identify the information source used to provide service category data. There is a definitions page that can be referred to from any page of the survey. A summary of the service category definitions can be found in Table 1.

After a state has finalized its response to the survey, ICI staff review the data and follow up with states whose data shows an unexpected increase or decrease in the total number served, number served in a service category, or total funding.

Table 1. IDD Survey Service Definitions

Type of Setting/ Service:	Work	Non-Work
Community	Integrated employment: Integrated employment services are provided in a community setting and involve paid employment of the participant. Specifically, integrated employment includes competitive employment, individual supported employment, group supported employment, and self-employment supports.	Community-based non-work: Community-based non-work includes all services that are focused on supporting people with disabilities to access community activities in settings where most people do not have disabilities. It does not include paid employment.
Facility	Facility-based work: Facility-based work includes all employment services that occur in a setting where the majority of employees have a disability. These activities occur in settings where continuous job-related supports and supervision are provided to all workers with disabilities. This service category is typically referred to as a sheltered workshop, work activity center, or extended employment program.	Facility-based non-work: Facility-based non-work includes all services that are located in a setting where the majority of participants have a disability and does not involve paid employment of the participant.

This report used regression analysis to estimate the total number of individuals served by state IDD agencies and the number of individuals served in integrated employment when these figures were not reported. To increase stability of the estimates for states that did not report on these data points, data from the literature was added, with FY2006 and FY2009 data drawn from the most recent literature available (Braddock et al., 2011). This procedure was adopted for eight states.

Estimates were also computed for missing data regarding community-based non-work services and facility-based work and non-work services. For these variables, however, estimates were only accepted for missing data points that were comprised between two valid data points in each time series, and only if the missing data points did not outnumber the valid data points.

Rehabilitation Services Administration 911 (RSA–911) Database.

The RSA–911 is a public access database that captures individual characteristics, services provided, and employment outcomes at the point of closure from VR services. Records are at the individual level, covering over 600,000 case closures per year.

Table 2: RSA Service Definitions

Term	Explanation
Closure	Data in the RSA-911 are collected at the time of closure (conclusion) of VR services. The VR closure categories used in this report include closure with an employment outcome after receiving services (formerly Status 26) and closure without an employment outcome after receiving services (formerly Status 28).
Successful rehabilitation	Closure with an employment outcome including integrated employment (including supported employment), self-employment, state-agency-managed business enterprise, homemaker, and unpaid family worker.
Rehabilitation rate	The percentage of individuals receiving services who achieve a successful rehabilitation. Calculated as: closures with an employment outcome / closures with an employment outcome + closures without an employment outcome after receiving services. Individuals with a case that was closed prior to development of an Individual Plan for Employment are not included in this calculation.
Supported employment services	Supported employment may be funded from Title VI-b funds, funds dedicated to supported employment under the Rehabilitation Act, or general rehabilitation funds.

For the purposes of this report, a person was considered to have an intellectual disability (ID) if code 25 (mental retardation in the RSA–911 dataset) was reported as the cause of either a primary or secondary impairment to employment.

American Community Survey.

The American Community Survey (ACS) is a national survey designed and administered by the U.S. Census Bureau to better understand changing communities. The ACS collects information from all 50 states and D.C. on topics such as disability, age, race, income, commute time to work, home value, veteran status, and other demographic and personal data (www.census.gov). To gather information on people with disabilities, the Census Bureau asks six questions on long-lasting conditions and functional impairments. Any person who indicates having at least one of these conditions or functional impairments is coded as having a disability. The individual items used to collect these data points are outlined in Table 3.

Due to changes implemented in the ACS beginning in 2008, data for people with disabilities for 2007 and earlier years should not be compared with data beginning in 2008. The sensory disability item used from 2000-2007 was eliminated, and two distinct items for visual and hearing disabilities were added in 2008. The employment disability variable that was used from 2000-2007 was eliminated from the survey in 2008. Additional changes in wording for other disability items included removing the duration of impairment from some questions and adding the term “serious” to focus on long-term/more severe impairments.³

Table 3: ACS Definitions

Term	Explanation
Employment rate	The percent of civilian, non-institutionalized working-age (16-64 years old) individuals who have a job.
Disability categories	The 2000 through 2007 ACS classifies individuals as having a disability based on: 1) Presence of a long-lasting condition in one or both of the following areas: Blindness, deafness, or a severe vision or hearing impairment (sensory disability). Substantial limitation in the ability to perform basic physical activities, such as walking, climbing stairs, reaching, lifting, or carrying (physical disability). And/or 2) Difficulty doing any of the following activities because of a physical, mental, or emotional condition lasting six months or more: Difficulty learning, remembering, or concentrating (mental disability). Difficulty dressing, bathing, or getting around inside the home (self-care disability). Difficulty going outside the home alone to shop or visit a doctor's office (go-outside-the-home disability). Difficulty working at a job or business (employment disability). The 2008 and 2009 ACS classify individuals as having a disability based on: 1) Answering affirmatively to one or more of the following items: Is this person deaf or does he or she have serious difficulty hearing (hearing disability)? Is this person blind or does he or she have serious difficulty seeing even when wearing glasses (vision disability)? Does this person have serious difficulty walking or climbing stairs (ambulatory difficulty)? Does this person have difficulty dressing or bathing (self-care difficulty)? Because of a physical, mental, or emotional condition, does this person have difficulty doing errands alone such as visiting a doctor's office or shopping (independent-living difficulty)? Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions (cognitive disability)?

Social Security Administration (SSA).

These data are abstracted from the Supplemental Security Income (SSI) Annual Statistical Report. The SSA reports work- incentive participation and the number of individuals receiving SSI who are working. Beginning with the 2010 SSI Annual Statistical Report, tables showing data by diagnostic group provide more specific details for mental disorders in these categories: autistic disorders, developmental disorders, childhood and adolescent disorders not elsewhere classified, intellectual disability, mood disorders, organic mental disorders, schizophrenic and other psychotic disorders, and all other mental disorders. Data from previous years use three categories for mental disorders: retardation, schizophrenia, and other.

Table 4: Work Incentive Program Definitions

Program	Definition
Plan for Achieving Self Support (PASS)	Allows a person with a disability to set aside income or resources to support achieving a specific work goal. Money set aside under a PASS plan is excluded both as current income and from the SSI resource limits.
Impairment-Related Work Expense (IRWE)	Allows people to exclude the cost of certain impairment-related services or items needed to earn income when determining the beneficiary's current earned income for SSI eligibility and benefits.
Section 1619(a)	Allows people with disabilities to continue receiving SSI income even if their earned income is at Substantial Gainful Activity levels, i.e., the amount that would normally make them ineligible for SSI.
Section 1619(b)	Allows individuals to continue receiving Medicaid benefits if their earnings disqualify them from eligibility for SSI cash payments but are not enough to afford medical insurance.

State Demographics.

State demographics are from multiple data sources. State population data is taken from the U.S. Census website (www.census.gov). Unemployment data is taken from the Bureau of Labor Statistics website (www.bls.gov).

National Trends in Employment

IDD Agency National Survey of Day and Employment Services (FY1999-FY2012)

The data reported here are the core elements of the Institute for Community Inclusion’s IDD Agency National Survey of Day and Employment Services. These data focus on participation in integrated employment, community-based non-work, and facility-based services. Data are solicited from all 50 states and the District of Columbia. The number of reporting states varied from 37 to 45 over the time studied (1999-2012).

The researchers calculated national estimates for the total number of people served by state IDD agencies, as well as the total number of people who received integrated employment services. For some states, data reported by service setting represent duplicated counts because individuals were served in multiple settings. For these states, the percentage served across settings may add up to more than 100%. Other services, including services for individuals who are elderly, are not reported.

Major findings include:

• National estimates suggest that there has been modest growth in the number of individuals in integrated employment since 1988.
• The estimated percentage of individuals participating in integrated employment services was 18.4% in FY2012.
• Growth in supported employment primarily occurred between the mid–1980s and mid–1990s, and there has been a decline in the number of people with IDD in integrated employment since 2001.
• Growth in community-based non-work services has continued for states that report offering this service.
• There is large variation across states in participation in integrated employment.

Table 5: Participation in Day and Employment Services in FY2012

State	Total Served	Percent Integrated Employment	Percent Community- Based Non-Work	Percent Facility-Based Work	Percent Facility-Based Non-Work
AK	1641	24%	0%	0%	97%
AL	4873	5%	0%	1%	94%
AR	-1	-1	-1	-1	-1
AZ	7217	20%	0%	12%	68%
CA	76845	13%	74%	13%	0%
CO	7570	24%	77%	0%	65%
CT	9543	50%	50%	5%	0%
DC	1577	13%	12%	0%	84%
DE	-1	-1	-1	-1	-1
FL	19182	13%	0%	-1	-1
GA	19833	14%	26%	0%	61%
HI	2188	2%	56%	2%	0%
IA	9581	21%	0%	26%	53%
ID	6316	3%	38%	0%	34%
IL	24013	6%	0%	-1	92%
IN	13259	17%	72%	35%	41%
KS	5948	15%	65%	58%	56%
KY	7533	16%	43%	0%	61%
LA	5340	32%	0%	30%	39%
MA	14769	26%	16%	21%	53%
MD	12218	40%	0%	0%	61%
ME	3362	27%	0%	0%	-1
MI	-1	-1	-1	-1	-1
MN	16493	17%	34%	72%	11%
MO	5135	11%	4%	0%	91%
MS	-1	-1	-1	-1	-1
MT	2042	13%	0%	-1	-1
NC	21601	16%	44%	15%	25%
ND	-1	-1%	-1	-1	-1
NE	-1	-1	-1	-1	-1
NH	2944	41%	59%	-1	0%
NJ	11993	11%	0%	22%	63%
NM	3285	35%	27%	0%	100%
NV	2175	21%	1%	42%	35%
NY	-1	-1	-1	-1	-1
OH	32540	22%	0%	54%	42%
OK	4054	62%	29%	55%	0%
OR	10712	32%	30%	24%	27%
PA	23257	15%	6%	41%	38%
RI	-1	-1	-1	-1	-1
SC	7435	29%	12%	38%	42%
SD	2452	18%	30%	67%	32%
TN	6848	16%	88%	52%	52%
TX	46103	4%	34%	-1	-1
UT	3017	24%	80%	0%	-1
VA	13647	20%	5%	5%	69%
VT	2717	38%	62%	0%	0%
WA	8364	87%	9%	9%	>1%
WI	15504	22%	20%	46%	50%
WV	2222	43%	0%	-1	66%
WY	1393	18%	100%	9%	73%

-1 Data not provided

In FY2012, an estimated 605,680 individuals received day or employment services from state IDD program agencies. This number grew from 457,405 in FY1999. The estimated number of individuals in integrated employment services increased from 108,680 in FY1999 to 111,670 in FY2012. However, state investment continues to emphasize facility- based and non-work services, rather than integrated employment services.

Figure 4 shows trends in the percentage of people served in integrated employment and facility-based and non-work settings between FY2004 and FY2012. In FY2012, an estimated 18.4% of individuals receiving day supports from state IDD agencies received integrated employment services. These data demonstrate a decline in the estimated percentage of people served in integrated employment services (from 24.6% in 2001), suggesting that the growth seen in supported employment between the mid–1980s and mid–1990s has not continued.

The data also demonstrate an increase in the percentage of people served in facility-based and non-work settings. Variability in the number of states that are able to report data in these three individual service categories (facility-based work, facility-based non-work, and community-based non-work) limits our ability to pinpoint the specific setting in which growth is occurring. However, analysis using data from states that are able to report data in each of the three service categories suggests that participation in facility-based work has remained stable or declined slightly, and the percentage of individuals served in non-work settings is increasing.

In FY2012, twelve states reported that their state agencies did not support individuals in facility-based work services. Data from State Employment Leadership Network member states and Partnerships in Employment grantee⁴ states indicate that several state IDD agencies are engaged in strategic efforts to place time limitations on pre-vocational work services, reduce the number of new entrants into facility-based work services, and support individuals who have engaged in facility-based work services to pursue employment in more integrated settings.

State efforts to increase the number of individuals in integrated employment are expanding through investments such as Employment First initiatives, membership in the State Employment Leadership Network, and participation in the Alliance for Full Participation, although the results of these efforts on national trends are not yet clear. Data were examined for 36 states that provided the total number of individuals served and the number of individuals in integrated employment services. Of these 36 states, six reduced the total number of individuals they served between 2001 and 2012, and the average reduction was 4,120 individuals (range: 1,093-10,166); 30 states increased the total number served, and the average increase was 3,936 (range: 244-25,117).

Twenty of these 36 states reduced the number of individuals receiving integrated employment services, and the average reduction was 1,016 (range: 1-5,460). However, in the 16 states that increased the number of individuals in integrated employment, the average increase was 918 individuals (range: 122-3,181). States that increased the number of individuals served in integrated employment by more than 500 individuals between 2001 and 2012 were CT, LA, MA, MD, NC, OK, OR, VA, and WA. Each of these states has engaged in strategic efforts and systematic changes to their service delivery system to make integrated employment the preferred service outcome for adults with IDD in their state.

States vary in their ability to report on funding for day and employment services by service setting. Figure 5 shows trends in funding allocation by service setting for states that reported these monetary figures. Facility-based and non-work settings continue to make up the largest percentage of expenditures for day and employment services. Collectively, states that reported funding facility-based work and non-work services (n=35) allocated 86.5% of the funding for all day and employment services to these settings in FY2012. In contrast, states that reported funding for integrated employment (n=35) allocated 13.5% of the funding for all day and employment services to integrated employment services in FY2012.

There has been a net decrease in the percentage of reported funds allocated toward facility-based services since 1999. However, there has been little fluctuation over time in the percentage of funding allocated toward integrated employment, which peaked in 2001 at 16.6%, but otherwise has ranged between 9.6% and 13.5 % in all other years since 1999.

There are more individuals participating in integrated employment services than are working in the community. In FY2009, the survey began asking states about their ability to provide data on the number of individuals working for pay in integrated community jobs, including competitive employment, individual supported employment, group supported employment, and self-employment. These questions were added because the percentage of individuals in integrated employment services does not reflect the number of individuals working for pay in the community. The percentage in integrated employment reflects times when individuals are looking for work or between jobs, and in some cases, integrated or supported employment services may include other activities.

While in FY2012 more than half of states (n=27) that responded to the survey reported collecting data on the number of individuals working for pay in the community, many states do not engage in this practice. One characteristicof states that support a high percentage of individuals in integrated employment services is the presence of a comprehensive employment outcome data-collection system (Hall et al., 2007).

Twenty-five states were able to report on the total number of individuals served in any day and employment service who were working for pay in community jobs. The total number of individuals who worked in paid integrated employment in FY2012 as reported by these 25 states was 67,448. In these 25 states, 26% of individuals who received any day and employment service were working in the community in integrated jobs. These data indicate that there are some individuals with IDD working for pay in the community who are not receiving paid employment supports from their state IDD agency, but are receiving other non-integrated employment day services.

States were also asked how many of the individuals participating in integrated employment services work for pay in the community. Twenty-five states were able to report on the total number of individuals receiving integrated employment services who are working in paid integrated employment positions in FY2012 (n=51,960). In these 25 states, 89.5% of individuals who receive integrated employment services are working in the community in integrated jobs. Nationally, the number of individuals earning wages who receive integrated employment services from their state IDD agency is lower than the total number receiving these services. In other words, not every person that receives integrated employment services is working for pay. This difference may grow in future years as states add integrated employment services such as Discovery and Career Exploration that are intended to support individuals to transition into individual integrated jobs.

Community-based non-work (CBNW) continues to grow. First added to the survey as a service option in FY1996 in response to state feedback, the number of states reporting providing CBNW services has grown from 18 in FY1996 to 30 in FY2012. Nationally, reported participation in CBNW has grown steadily for states that report it as a service, from 18.7% in FY1999 to 42.3% in FY2012. CBNW services accounted for 46% of state IDD agency expenditures for FY2012, for states that reported expenditures for this service (n=30).

The rapid growth in CBNW services may reflect a growing emphasis on community presence, although the nature of the service that is being reported and the contribution of this service to community participation remain unclear. Data reported by CRPs in a national survey suggest that only 16.4% of individuals with IDD participate in CBNW (Domin & Butterworth, 2012). While CRP and IDD agency responses are not directly comparable, and may reflect differing approaches to reporting duplication of service, the disparity raises concerns about how state agencies are defining and categorizing services. There is currently a limited amount of data on the structure, activities, and outcomes of this service, and states have not established clear service expectations or quality-assurance strategies (Sulewski, Butterworth, & Gilmore, 2008; Sulewski, 2010).

While some states report service requirements for how much time CBNW participants spend in the community, it is possible that in some cases states have reclassified services from facility-based to community-based as the emphasis on community participation grows, even though substantial time is still spent in facility-based settings. The trend toward CBNW services raises concerns about the clarity of the service system’s goals for community employment. It is highly likely, due to the lack of specificity of the goals of CBNW services (Sulewski, Butterworth, & Gilmore, 2006), that as funds transition to the community, non-work services are seen as an alternative to (rather than a complement to or an avenue towards) integrated employment services.

Sulewski, Butterworth, and Gilmore (2008) recommend that states use CBNW services as a supplement to integrated employment services. As the prevalence of CBNW services grows, additional research is needed on whether these services enhance or impede integrated employment outcomes, and how CBNW services can be individualized to support a person during the hours s/he is not working in the community.

Medicaid Title XIX Waiver services are the primary funding source for day and employment services. Medicaid Title XIX Waiver funds are the largest sources of funds for day and employment services, representing 64.5% of all funds. Medicaid Waivers as a funding resource to support individualized integrated employment have received significant attention in recent years. Based upon feedback from State Employment Leadership Network member states, in September 2011, CMS released an information bulletin, “1915(c) Waiver Technical Guidance Revisions,” on waiver program employment services. The bulletin emphasized the importance of integrated employment and person-centered planning, and distinguished between pre-vocational and supported employment services.

The bulletin also discussed best practices. It split supported employment into two core service definitions, individual and small group (two to eight people), and added a new core service definition for career planning (Kennedy-Lizotte & Freeze, 2012). Additionally, many states are making use of technical assistance available through the State Employment Leadership Network, two AIDD-funded grants (Partnerships in Employment and Community of Practice for Supporting Competitive Integrated Employment for Individuals with Intellectual and Developmental Disabilities), and the Office of Disability Employment Policy’s Employment First State Leadership Mentor Program to support the redesign of their Medicaid Title XIX Waivers to increase individualized integrated employment outcomes.

States vary in their ability to report Medicaid Title XIX Waiver funds allocated to specific IDD agency services. As the number of states able to report these figures increases, it will be important to examine both the cross-sectional and trend data for this type of funding. For states that have been able to report these figures, the allocation of these funds has varied based upon year and service category: integrated employment, community-based non-work, facility-based work, and facility- based non-work.

In FY2012, 31 states reported expenditures by day and employment service for Medicaid Title XIX Waivers. These funds represent both the federal dollars allocated to the state and the state matching dollars. The percentage of waiver funds spent by state IDD agencies on integrated employment services was 13.5%, mirroring the percentage of all day and employment dollars spent on this service. Expenditures on facility-based non-work services made up the greatest percentage of dollars spent (41.5%), and expenditures on community-based non-work services made up 26% of dollars spent, representing a continued investment in all non-work services.

Butterworth, Kennedy-Lizotte, & Winsor (2012) suggest several reasons why, despite the increased emphasis on individual integrated employment as a priority in the development and administration of Medicaid Title XIX Waivers, dollars from this source continue to be overwhelmingly spent on non-work services. These include overly complicated funding systems that are not easily understood by provider agencies, case management staff, resource allocation staff, and individuals and their families; the inability of service providers to bill for non-direct services needed for successful job development; the failure to capture the real-world cost of providing individual integrated employment services, and an over-reliance on the historical cost; the failure to include the cost of individual integrated employment when developing individual service budget allocations; the expectation that transportation of the individual to a job in the community will be paid for out of the integrated employment rate; and the failure to identify transportation as separate service that has a distinct payment rate from the payment for an employment or day service.

Trends in Vocational Rehabilitation (FY2003-FY2012)

In this section we describe the employment and postsecondary education outcomes of all adults with intellectual disabilities who exited the state and territory vocational rehabilitation (VR) programs during fiscal years 2003 through 2012. To provide context, we compare the findings with the corresponding outcomes of people with other disabilities. We also describe selected employment outcomes disaggregated at the state level for fiscal year 2012. In this section we focus on integrated employment defined as work in integrated settings with or without support.

Major findings regarding people with intellectual disabilities included the following:

• Over time, fewer people exited the VR program.
• A slightly smaller percentage of people received services compared to 2011.
• The rehabilitation rate slightly increased compared to 2011, but was still lower than in earlier years.
• Hourly earnings remained about the same, but weekly wages declined slightly.
• Weekly work hours remained the same compared to 2011, but were slightly lower when compared to earlier years.
• Gaining employment took more time compared to 2011, continuing a trend initiated in earlier years.
• The percentage of people receiving postsecondary education services remained about the same compared to earlier years.
• The percentage of people who attained a postsecondary outcome while in the VR system, such as a degree or certificate, has remained about the same for most of the decade.
• The majority of people receiving services were male, most were white, and most were transition-age young adults.
• Outcomes varied considerably across states.

Over time, fewer people exited the VR program. As Table 6 shows, in 2012, a total of 46,672 people with intellectual disabilities exited the VR program. This figure was lower than in 2011 (47,812) and the lowest reported during the past ten years. The maximum figure was reported in 2003, when 69,645 people with intellectual disabilities exited the program. The corresponding figure for people with other disabilities was 484,330 in 2012, a lower figure than in 2011 (494,273), but not the lowest reported during the years examined.

Table 6. Trends in Employment Outcomes in 50 States and DC: 2003-2012

	Total closures		Received services		Rehabilitation rate		Hourly wage		Weekly hours		Employed in one year
	ID	Other	ID (%)	Other (%)	ID (%)	Other (%)	ID	Other	ID	Other	ID (%)	Other (%)
2003	69,645	568,882	60%	58%	55%	54%	$8.13	$12.12	26	34	37%	40%
2004	57,113	533,137	72%	64%	55%	52%	$7.93	$12.01	26	34	36%	38%
2005	56,332	498,250	71%	63%	55%	55%	$7.83	$11.94	25	34	35%	37%
2006	56,487	500,072	71%	62%	56%	56%	$7.79	$12.02	26	34	35%	37%
2007	53,620	491,016	70%	62%	58%	57%	$7.93	$12.11	25	33	35%	38%
2008	53,974	506,005	69%	62%	56%	55%	$7.99	$12.16	25	33	36%	39%
2009	49,382	488,824	66%	59%	53%	53%	$8.33	$12.28	24	32	35%	37%
2010	49,697	511,441	65%	58%	48%	49%	$8.51	$12.11	24	32	33%	37%
2011	47,812	494,273	66%	60%	51%	51%	$8.31	$11.75	24	32	32%	36%
2012	46,672	484,330	65%	60%	52%	53%	$8.25	$11.59	24	32	30%	35%

Note. ID = Intellectual disabilities; Other = Other disabilities

A slightly smaller percentage of people received services compared to 2011. Receiving services is the first step toward an employment outcome. As Table 6 shows, about 65% of the people with intellectual disabilities who exited the VR program in 2012 received services, a lower figure compared to earlier years. For instance, in 2004, about 72% of individuals with ID received services. Nevertheless, the percentages of people with intellectual disabilities who received services were consistently higher compared to the corresponding figures for people with other disabilities across the years examined.

In 2012, only 60% of people with other disabilities who exited the program received services, and the maximum was 64%, in 2004 (Table 6). The most frequent reasons for people with intellectual disabilities to exit the program without receiving services—in 2012—included refusal or failure to cooperate (47%); inability to locate or contact applicant (26%); and other reasons including disability too significant, death, job seeker’s relocation, no disability-related needs for services, or other non-specified reasons. People with other disabilities reported similar reasons for exiting the program without receipt of services.

The rehabilitation rate slightly increased compared to 2011, but was still lower than in earlier years. The rehabilitation rate is the percentage of people who gained employment out of the total number of people who received services. As Table 6 shows, 52% of people with ID who received services exited with an employment outcome in 2012, compared to 51% the year before. This is the third year in a row that shows an increase in the rehabilitation rate. The maximum reported in earlier years was 58% in 2007. Overall, the figures reported for people with other disabilities reflected a similar trend: 51% in 2012, down from a maximum of 57% in 2007, but growing for the third year in a row.

Hourly earnings remained about the same, but weekly wages declined slightly. The hourly earnings of people with intellectual disabilities, adjusted for inflation, remained about the same during the period examined: $8.13 in 2003 and $8.25 in 2012. For people with other disabilities, hourly earnings adjusted for inflation declined slightly, from $12.12 in 2003 to $11.59 in 2012.

As Figure 6 shows, inflation-adjusted weekly wages of people with intellectual disabilities who exited with an employment outcome in 2012 were slightly lower compared to the previous years: $199 in 2012 compared to $201in 2011. The weekly wages of people with other disabilities also declined over time, though this group earned almost twice as much as their peers with ID. People without disabilities reported the highest wages across the years examined, although declining over time, since 2007.

Weekly work hours remained the same compared to 2011, but were slightly lower compared to earlier years. In 2012, people with intellectual disabilities who exited the program with employment worked an average of 24 hours per week, the same amount of hours reported in the previous three years. Weekly work hours peaked at 26 in 2003, 2004, and 2006. People with other disabilities reported more weekly work hours: 32 hours in 2012.

Gaining employment took more time compared to 2011, continuing a trend initiated in earlier years. People with intellectual disabilities who exited in 2012 took about 710 days to gain employment, on average, from application. This represented 36 additional days compared to 2011, continuing a trend of a longer period of time between application and an employment closure. The shortest amount of time to an employment outcome was reported in 2003, when finding employment took only 637 days.

With respect to time it takes to gain employment, individuals with ID fared better than those with other disabilities. In 2012, people with other disabilities reported 747 days from application to closure in an employment outcome. The shortest amount of time was reported in 2003, with 691 days.

Another way of looking at this outcome is to examine the percentage of people with disabilities who gained employment within one year from application. Of the people with ID who exited the program in 2012 with an employment outcome, about 30% reported gaining employment in one year or less, down from 37% in 2003. The corresponding figure for people with other disabilities was 35% in 2012, down from 40% in 2003.

The percentage of people receiving postsecondary education services remained about the same compared to earlier years. Attaining a postsecondary education degree or other educational credentials after high school can be a critical step in one’s career path. The VR program provides services that support academic training leading to a degree, a certificate, or another educational credential beyond high school. About 8% of people with intellectual disabilities received either college or occupational/vocational training services in 2012, essentially the same figure reported throughout the 10 years examined, with the exception of 2003-2004, when the figure was 9%.

People with other disabilities were more likely to receive postsecondary education services. About 25% of people with other disabilities received either college or occupational/vocational training services in 2012, the same figure reported in 2010-2011, but slightly lower compared to earlier years (it reached 29% in 2005).

The percentage of people who attained a postsecondary outcome such as a degree or certificate remained about the same for most of the decade. Between 2005 and 2012, about 3% of people with intellectual disabilities exited the VR program with one of the following postsecondary education outcomes after reporting they had no postsecondary outcome at application: post-secondary education, no degree; associate degree or vocational/technical certificate; bachelor’s, master’s, or a higher degree. In earlier years, only 2% reported a postsecondary education outcome. Between 2007 and 2012, about 11% of people with other disabilities reported exiting the program with greater postsecondary education outcomes than at application. This figure was slightly lower than in earlier years, when it reached 12%.

The majority of people were male, most were white, and most were transition-age young adults. The majority of people with intellectual disabilities who exited VR in 2012 were male (58%), the same figure as the prior year, although slightly greater compared to earlier years. Similar figures were reported for people with other disabilities: 57% in 2012 (Table 7). 

Table 7. Trends in Demographic Characteristics in the 50 States and DC: 2003-2012

	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012
Intellectual Disability
Gender
Male	53%	55%	55%	55%	55%	55%	56%	57%	58%	58%
Female	47%	45%	45%	45%	45%	45%	44%	43%	42%	42%
Race and ethnicity
White (non-Hispanic)	61%	59%	60%	60%	59%	58%	58%	56%	56%	55%
Black (non-Hispanic)	30%	32%	32%	33%	32%	33%	33%	34%	34%	35%
Hispanic	7%	7%	7%	7%	7%	7%	7%	8%	8%	7%
Other	2%	2%	2%	1%	2%	2%	2%	2%	2%	3%
Other disabilities
Gender
Male	55%	55%	55%	55%	55%	56%	56%	57%	57%	57%
Female	45%	45%	45%	45%	45%	44%	44%	43%	43%	43%
Race and ethnicity
White (non-Hispanic)	67%	66%	67%	68%	66%	66%	66%	64%	64%	64%
Black (non-Hispanic)	22%	22%	22%	22%	22%	22%	23%	24%	24%	24%
Hispanic	9%	9%	9%	9%	9%	9%	9%	9%	10%	10%
Other	2%	2%	3%	1%	3%	3%	3%	2%	3%	3%

The majority of people with intellectual disabilities who exited VR in 2012 were white (55%), showing a downward trend from 2003, when white people comprised 61% of people with ID. The second largest racial group for people with intellectual disabilities was black. This group increased slightly from 30% in 2003 to 35% in 2012. People of Hispanic ethnicity represented 7% of the total in 2012.

People with other disabilities included a greater proportion of white people: 64% in 2012, down from 67% in 2003. Also in the case of people with other disabilities, the second largest racial group was black: 24% in 2012, up from 22% in 2003. People of Hispanic ethnicity represented 10% of the total in 2012.

A substantial number of VR closures for individuals with ID take place during the transition from school to adult life. About 48% of the people with intellectual disabilities who exited the VR program in 2012 were between 16 and21 years old at application, a figure consistent with previous years. The remaining closures of people with intellectual disabilities in 2012 included young adults who were 22 to 30 years old (22% of closures with ID) and adults who were over 30 years old at application (30% of closures with ID).

These figures contrasted with the figures reported for people with other disabilities from the same age group: only 26% of people with other disabilities who exited the program in 2012 were 16 to 21 years old at application, although this was a larger figure compared to 21% in 2004. Moreover, in 2012, only 16% of youth with other disabilities were 22 to 30 years old at application, and the remaining 58% were over 30 years old.

Outcomes varied considerably across states. As Table 8 shows, the extent of services provided by the VR program and employment outcomes achieved by people with disabilities varied considerably across states. Some of these differences can be attributed to the size of the states’ general population. For example, whereas North Carolina reported 4,924 people with intellectual disabilities exiting the program, a smaller state like Alaska reported only 72. For people with other disabilities, the highest number of people exiting the program was 32,933 in New York, whereas the smallest figure was 1,400 in Hawaii.

Other differences across states may reflect their socio-economic environments or policies in favor of employment of people with disabilities. For example, whereas Vermont reported 85% of people with intellectual disabilities receiving services, Nevada reported only 36%. In the case of people with other disabilities, the variation in percentage of people receiving services across states was slightly smaller: from 78% in South Carolina to 36% in Ohio. These figures are significant because receiving services is a necessary step toward employment; those who do not receive services exit the program without employment.

Wyoming reported the highest rehabilitation rate (percentage of people who gained employment out of the total number of people who received services) for people with intellectual disabilities (77%), whereas Rhode Island reported the lowest figure (22%). For people with other disabilities, the highest rehabilitation rate was in West Virginia (74%), and the lowest in Hawaii (20%).

The hourly wage of people with intellectual disabilities varied from $7.14 in California to $9.86 in the District of Columbia. For people with other disabilities, earnings varied from $9.70 in South Dakota to $18.22 in Connecticut.

Weekly work hours varied greatly across states as well. People with intellectual disabilities in Georgia worked the most hours: 32. In contrast, people with intellectual disabilities in Maine reported the lowest amount of hours: 12. Among people with other disabilities, the longest work hours were reported in West Virginia (36 weekly work hours), and the shortest work hours in Massachusetts, Maryland, Maine, and Illinois (26 weekly work hours).

People with intellectual disabilities in Vermont were the most likely to find jobs within one year of application for services (62%), whereas their peers in Virginia were the least likely to find jobs within one year (7%). In regard to people with other disabilities, finding jobs within one year was most likely in Michigan (62%), and least likely in both Iowa and New Mexico (6%).

Table 8. State Outcomes in 2012

	Total closures		Received services		Rehabilitation rate		Hourly wage		Weekly work hours		Employed in one year
	ID	Other	ID(%)	Other (%)	ID (%)	Other (%)	ID	Other	ID	Other	ID (%)	Other (%)
AK	72	1,726	72	55	63	60	$9.62	$13.84	18	33	48	41
AL	1,097	9,042	80	68	55	65	$8.06	$10.09	28	33	37	36
AR	258	6,621	57	65	36	64	$7.82	$11.53	24	35	36	41
AZ	350	5,455	60	54	42	35	$8.31	$11.56	21	31	15	9
CA	2,343	28,443	78	61	66	54	$7.14	$11.99	27	29	50	25
CO	642	6,089	67	54	68	60	$7.61	$12.37	15	28	49	50
CT	256	3,459	56	59	57	60	$9.21	$18.22	23	30	29	50
DC	227	2,485	64	64	41	28	$9.86	$12.37	31	35	30	25
DE	256	2,316	61	58	66	71	$8.50	$10.79	27	32	31	42
FL	1,844	23,540	68	57	38	46	$8.41	$10.99	22	31	12	24
GA	2,160	14,345	64	51	48	59	$8.13	$9.96	32	34	38	47
HI	175	1,400	78	62	26	20	$8.76	$13.74	24	28	17	9
IA	872	5,598	55	54	61	62	$8.86	$12.30	27	34	11	6
ID	420	6,405	73	64	41	42	$8.38	$11.10	24	32	42	43
IL	1,647	15,298	60	58	51	50	$8.93	$10.68	21	26	26	39
IN	1,872	12,040	62	59	55	55	$8.11	$12.07	22	30	35	45
KS	567	6,413	67	47	53	45	$8.19	$10.10	22	31	33	33
KY	1,303	9,341	48	58	56	63	$8.37	$12.15	23	32	22	32
LA	676	8,150	61	45	41	49	$8.01	$12.42	23	34	8	19
MA	400	10,941	79	68	53	46	$8.82	$13.17	17	26	28	22
MD	716	7,336	60	52	64	54	$8.39	$10.94	21	26	46	31
ME	316	2,857	55	52	59	46	$8.07	$12.36	12	26	13	32
MI	1,272	21,588	74	66	40	51	$7.83	$13.41	22	32	46	62
MN	531	6,833	69	61	61	55	$8.67	$11.15	25	29	29	25
MO	2,218	12,180	52	56	68	59	$8.27	$10.62	25	30	37	47
MS	1,035	8,522	50	69	37	61	$7.91	$11.46	30	35	9	43
MT	174	3,534	55	47	54	43	$8.52	$11.45	18	28	27	33
NC	4,924	16,248	69	57	56	56	$8.23	$10.18	26	30	22	31
ND	197	2,098	60	52	62	56	$8.75	$12.93	26	34	18	27
NE	358	4,086	71	68	62	61	$8.43	$10.36	26	34	48	55
NH	125	2,696	82	64	55	57	$8.33	$13.34	16	28	26	47
NJ	554	11,476	65	62	48	54	$8.79	$12.17	24	30	30	35
NM	164	3,267	62	47	46	40	$8.41	$11.88	18	30	9	6
NV	124	3,081	36	55	49	49	$8.40	$11.66	23	32	32	56
NY	2,390	32,933	69	63	51	53	$8.40	$11.41	21	29	37	28
OH	1,754	17,161	54	36	48	45	$8.18	$10.92	23	29	14	14
OK	708	8,482	82	68	33	44	$8.09	$11.39	28	31	15	32
OR	541	6,918	58	47	59	57	$9.06	$12.20	19	27	48	52
PA	1,864	24,023	77	71	48	53	$8.41	$12.26	24	33	29	30
RI	242	2,925	58	67	22	29	$8.63	$11.54	19	27	23	24
SC	603	13,497	71	78	41	59	$8.27	$10.78	29	35	21	50
SD	277	2,286	75	57	65	61	$7.98	$9.70	23	30	51	41
TN	1,471	6,532	56	51	45	43	$7.95	$10.44	24	28	19	11
TX	1,718	31,306	66	67	50	57	$8.10	$12.36	21	32	30	40
UT	284	8,327	79	68	55	56	$8.30	$11.41	19	33	21	22
VA	1,529	9,462	69	64	45	38	$8.45	$10.91	26	30	7	16
VT	319	3,825	85	76	71	52	$9.40	$11.72	16	28	62	55
WA	961	10,436	64	46	65	51	$9.79	$12.62	14	28	49	38
WI	1,308	12,989	50	43	59	50	$8.28	$11.69	19	28	10	9
WV	451	6,587	60	65	59	74	$8.07	$12.93	24	36	39	55
WY	107	1,732	81	63	77	55	$8.48	$12.11	17	33	28	33
Average	915	9,497	65	59	52	52	$8.43	$11.80	23	31	29	34
Min	72	1,400	36	36	22	20	$7.14	$9.70	12	26	7	6
Max	4,924	32,933	85	78	77	74	$9.86	$18.22	32	36	62	62

Note. ID = Intellectual disabilities; Other = Other disabilities

US Territories

This year, we are including, for the first time, a description of the VR program outcomes reported for the five US territories of American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands. The main findings include:

• The number of closures peaked in 2010.
• The percentage of people who received services has increased since 2011.
• The rehabilitation rate remained consistent throughout the period examined.
• Hourly earnings increased slightly over time.
• Weekly work hours remained about the same.
• Only a small percentage of people gained employment within one year of application.
• The vast majority of VR closures from the territories are from Puerto Rico.

Table 9. Trends in Employment Outcomes in the Five Territories: 2003-2012

	Total closures		Received services		Rehabilitation rate		Hourly wage		Weekly work hours		Employed in one year
	ID	Other	ID(%)	Other (%)	ID (%)	Other (%)	ID	Other	ID	Other	ID (%)	Other (%)
2003	683	5,966	64%	52%	57%	57%	$6.96	$9.77	26	34	5%	7%
2004	544	5,894	59%	51%	66%	61%	$6.88	$9.61	27	34	4%	6%
2005	639	6,736	60%	51%	65%	61%	$6.59	$9.63	28	34	3%	5%
2006	638	7,141	59%	47%	64%	60%	$6.52	$9.20	28	34	5%	6%
2007	566	7,198	59%	44%	63%	64%	$6.54	$8.90	27	34	4%	8%
2008	570	7,838	54%	42%	54%	61%	$6.82	$9.22	28	34	8%	8%
2009	600	7,922	57%	40%	60%	56%	$7.72	$9.73	27	33	4%	6%
2010	775	8,913	46%	38%	51%	57%	$7.91	$9.77	26	33	5%	5%
2011	728	7,740	55%	46%	53%	58%	$7.77	$9.22	26	33	7%	5%
2012	498	6,826	67%	56%	56%	63%	$7.82	$8.99	27	34	7%	5%

Note. ID = Intellectual disabilities; Other = Other disabilities

The number of closures peaked in 2010. As Table 9 shows, disabilities exited the VR program. This figure was lower than years examined. The maximum figure was reported in 2010, when 775 people with intellectual disabilities exited the program. The corresponding figure for people with other disabilities was 6,826 in 2012, a lower figure compared to 2011 (7,740), but not the lowest figure reported during the years examined (5,894 in 2004).

The percentage of people who received services increased between 2011 and 2012. Receiving services is the first step toward an employment outcome. As Table 9 shows, the percentage of people with intellectual disabilities who received services declined significantly between 2003 (64%) and 2010 (46%). However, beginning in 2011, the figure has been increasing, reaching 67% in 2012. The same pattern applies to people with other disabilities, with 52% receiving services in 2003, only 38% in 2010, and 56% in 2012. These data show that people with intellectual disabilities were more likely to receive services compared to their peers with other disabilities.

The rehabilitation rate remained consistent throughout the period examined. The rehabilitation rate is the percentage of people who gained employment out of the total number of people who received services. As Table 9 shows, in 2012 the rehabilitation rate of people with intellectual disabilities was 56%, slightly greater compared to 51% in 2010, but smaller than 66% as reported in 2004. Overall, the figures reported for people with other disabilities reflected a similar trend: 63% in 2012, up from a minimum of 56% in 2009.

Hourly earnings increased slightly over time. Inflation-adjusted hourly earnings of people with intellectual disabilities slightly increased, from $6.52 in 2006 to $7.82 in 2012. In contrast, hourly earnings of people with other disabilities slightly declined, from $9.77 in 2003 to $8.99 in 2012.

Weekly work hours remained about the same. In 2012, people with intellectual disabilities who exited the program with employment worked an average of 27 hours per week, a figure close to the minimum (26) and maximum (28) reported during the period examined. People with other disabilities reported more weekly work hours: between 33 and 34 during the period examined.

Only a small percentage of people gained employment within one year from application. At most, only 8% of people with intellectual disabilities and people with other disabilities gained employment within one year from application. The figure ranged between 3% and 8% during the period examined.

The vast majority of VR closures from the territories are from Puerto Rico. Puerto Rico likely has a larger number of closures than other territories because its total population is much greater than that of the other four territories. Other reasons for the differences may include the number of individuals in any given year that request employment services from their territory’s vocational rehabilitation agency and the availability of expertise in employment supports for individuals with ID in each territory.

Trends from American Community Survey (ACS) Data (2008-2012)

Data show that people with disabilities are consistently less likely to be working than their non-disabled counterparts. The ACS allows us to compare employment participation and outcomes for civilian working-age people with and without disabilities, and provides a population estimate that includes people who do not receive formal supports from a human service agency. Thus, it offers a broader view of employment outcomes for working-age people with disabilities than system-specific data sources, such as the RSA–911 data.

We define “working-age people” as civilian non-institutionalized people ages 16-64. The data presented below will emphasize people with a cognitive disability who received SSI as the closest proxy for individuals with intellectual and developmental disabilities. We emphasize the importance of looking at multiple demographic, economic, and employment outcome indicators in order to get the best understanding of the employment situation for individuals with ID.

Recent trends and key data points that emerged from the dataset:

• People with disabilities are much less likely to work than their non-disabled counterparts.
• People with a cognitive disability who are receiving Supplemental Security Income, the group likely to include people who have the most significant cognitive disabilities, have the lowest employment rate of all disability subgroups examined.
• The positive impact of the economic recovery on employment appears to have been stronger for people without disabilities than it has been for people with disabilities.
• Among working-age Americans, people with any disability and people with a cognitive disability are more likely to live in a household that is below the poverty line.
• People with disabilities who are employed are less likely to live in a household that is below the poverty line than people with disabilities who are not employed.
• Among those who are employed, individuals from disability population subgroups work fewer weeks per year on average than their nondisabled counterparts.

Employment and Labor Market Benchmarks for Population Subgroups

People with disabilities are much less likely to work than people without disabilities. In assessing employment outcomes, it is important to review multiple indicators to get a full understanding of the employment experiences of people with disabilities. Indicators commonly used in labor market and population studies include:

• Employed: People with jobs.
• Unemployed: People who do not have jobs and have actively looked for work in the past four weeks. These people are considered part of the labor force.
• Not in the labor force: People who do not have jobs and have not actively looked for work in the past four weeks.
• Employment rate (employment-to-population ratio): Number of people employed / number of people in the working-age population
• Unemployment rate: Number unemployed / (number employed + number unemployed)

Reporting meaningful indicators of labor market success for individuals with disabilities, particularly ID, is challenging for a number of reasons. Measures that allow people to indicate specific disabilities like ID are uncommon in large national datasets. Additionally, the use of the “traditional” unemployment rate reported by the Department of Labor as an indicator of labor market success for people with disabilities leaves people who are not in the labor force, a significant group when it comes to subpopulations of people with disabilities, out of the calculation.

For this reason, we focus primarily on employment rate as an indicator of successful employment outcomes for people with disabilities. Because a large proportion of people with disabilities are not in the labor force, an employment-to- population ratio is a more descriptive measure of this population’s economic situation (Brault, 2010).

While the ACS does not collect information on people with ID specifically, it does allow people to self-report on six disability questions. Any individual who answers yes to one or more of these six items is categorized as having any disability. Someone with a cognitive disability has indicated that because of a physical, mental, or emotional condition lasting six months or more, s/he has difficulty learning, remembering, and concentrating. Table 10 below displays indicators of labor market success for four groups of working-age individuals: people who do not have a disability, people who indicated they have at least one disability (any disability), people with a cognitive disability, and people with a cognitive disability who received Supplemental Security Income (SSI) in 2012. This last group is likely to include people who have the most significant cognitive disabilities.

Table 10. Labor Market Success Indicators by Disability Status: 2012

	No Disability	Any Disability	Cognitive Disability	Cognitive Disability with SSI Income
A. Percentage Employed (Employment Rate)	71.4	32.5	22.5	8.1
B. Percentage Unemployed	7.1	7.5	8.5	3.3
C. Percentage Not in the Labor Force	21.6	60.0	69.0	88.7
Total (A+B+C)	100	100	100	100
Unemployment Rate (number unemployed / number employed + number unemployed)	9.0	18.8	27.5	28.9

The table confirms the low levels of employment for individuals with disabilities. People with any disability or a cognitive disability are employed at much lower rates (32.5% and 22.5% respectively) than those without disabilities (71.4%). People with cognitive disabilities who receive SSI have the lowest employment rate (8.1%).

There are striking differences in outcomes between disability subgroups and their nondisabled counterparts with regard to the percentage not in the labor force, as displayed in Table 10. Across disability subgroups, all are much less likely to be in the labor force when compared to people without disabilities.

The high rate of individuals with disabilities who are not in the labor force suggests that a significant majority of this population are not actively looking for work, despite the fact that the majority of individuals with disabilities who are not working report that they would prefer to work (U.S. Senate Committee on Health, Education, Labor and Pensions, 2011). People with disabilities who are not in the labor force are more likely to rely on publicly funded poverty prevention programs such as Supplemental Security Income, and experience increased marginalization from society because of the lack of community attachment that comes with work.

Individuals with disabilities also fare poorly, comparatively, using the traditional calculation of unemployment rate favored as a labor market indicator by the U.S. Department of Labor. Unemployment rates for subgroups of people with disabilities who are in the labor force are two to three times the unemployment rate for people without disabilities. These figures may reflect a longer job search and the difficulty individuals with disabilities face in reentering the workforce after a job loss.

These data suggest the importance of examining both 1) the percentage employed, percentage unemployed, and percentage not in the labor force (indicators A, B, and C in Table 10) and 2) the unemployment rate in order to gain a full understanding of the employment experiences of individuals with disabilities.

The Effect of the Economic Recovery on Employment of People with Disabilities

The positive impact of the economic recovery on employment appears to have been stronger for people without disabilities than it has been for people with disabilities. An analysis of trends over 21 months of data from the Current Population Survey (CPS) reveals strong evidence that the 2007-2009 recession disproportionately affected workers with disabilities, resulting in a 9% decline in the presence of people with disabilities in the employed labor force (Kaye, 2010). Other research shows that, despite a decline in the employment gap between people with and without disabilities between 2004 and 2010, people with disabilities had a bigger drop in employment in percent terms over the same period (Harris Interactive, 2010). Evidence from the recent economic recession suggests that people with disabilities were the first to be laid off, and the upswing in job exit has a larger magnitude and occurs earlier for workers with disabilities than for others (Kaye, 2010).

Some data suggest hiring for people with disabilities during the economic recovery may lag behind hiring for their nondisabled counterparts. An examination of employment data in recent years shows that the benefits of the economic recovery, in terms of employment, have had less impact on people with disabilities than on people without disabilities.

Figure 7 shows the percentage change in employment rate from one year to the next for the examination period (2008-2012) for each of the four population subgroups. Looking at the first set of bars in Figure 7, which represents the percentage change in employment rate between 2008 and 2009, the final full year of the economic recession, we see that employment dropped for all four subpopulation groups. The drop in employment was least severe for people without disabilities, and progressively more severe as we look across disability subgroups.

Looking at the second set of bars, we see a similar pattern for the change between 2009 and 2010, albeit a less severe drop for each group than the previous year. People from disability subpopulation groups still show greater drops in employment than their counterparts without disabilities.

The third set of bars best exemplifies the lag of the economic recovery for people with disabilities in terms of employment. Between 2010 and 2011, employment for people without a disability increased 0.3%. While this change is very small, it is positive in direction. Despite the growth in employment for people without disabilities, the employment rates for people with any disability and people with a cognitive disability continued to decline.

The fourth set of bars in Figure 7, representing the change in employment rate between 2011 and 2012, clearly demonstrates the impact of the economic recovery on employment for most of the working-age population. There is a positive impact of the economic recovery on employment rates for people with any disability and people with a cognitive disability. The absolute value of the increase between 2011 and 2012, however, was much smaller than the absolute value of the decrease in employment rate each of the three years prior. Thus, despite this positive turn, employment rates for people with any disability and people with a cognitive disability have yet to approach pre- recession rates.

Looking specifically at the employment rate for people with a cognitive disability who received Supplemental Security Income (SSI), Figure 7 shows that the percent employed increased 3.6% between 2010 and 2011, but declined 5.8% between 2011 and 2012. This observed decrease is unfortunate, as this group already has the lowest employment rate among all of the population subgroups examined. In none of the years studied did the employment rate for this subpopulation group reach 10%.

Disability, Employment, and Poverty Status

Among working-age Americans, people with any disability and people with a cognitive disability are more likely to be living in a household that is below the poverty line than people without a disability. In 2012, only 13.4% of all people without a disability lived in a household that was below the poverty line, compared with 28.6% for people with any disability, 34.1% for people with a cognitive disability, and 40.5% for people with a cognitive disability who received SSI payments as part of their income. It is not surprising to see this last group having the highest percent living in a household below the poverty line, since eligibility for the SSI program includes having limited financial resources.⁶

Table 11 compares poverty rates for population subgroups of working-age people who are employed and who are not employed. Chi square tests, which determine whether or not there is a statistical relationship between categorical variables, were run for each subgroup, and the results in each instance showed that a statistical relationship exists. People who are working are less likely to be living in a household below the poverty line than people who are not working.

The difference in poverty rates between people who are employed and people who are not shows how critical work is to economic self-sufficiency. Nearly half of the people who had a cognitive disability, received SSI payments as part of their income, and were not working (42.8%) were living in a household that was below the poverty line, compared with 14.6% of people in this same subgroup who were working.

Although people in disability subgroups who worked were less likely to be living in poverty than their non-working counterparts, the poverty rates for disability subpopulations who did work are still higher than the poverty rates for their non-disabled counterparts who work. This finding suggests that people with disabilities may have a greater likelihood of being underemployed, i.e., working in jobs that do not provide them with the earning potential to get above the poverty line.

Table 11. Poverty Rates in 2012 for Disability Subgroups by Employment Status

	Percentage living below the poverty line (poverty rate)
	Not employed	Employed
People with no disabilities	28.8	7.4
People with any disability	36.6	12.0
People with a cognitive disability	38.8	17.5
People with a cognitive disability who received SSI	42.8	14.6

Disability, Employment, and Consistency of Work

Among those who are employed, individuals from disability population subgroups work fewer weeks per year on average than their nondisabled counterparts. Figure 8 shows that in 2012, individuals from disability sub- population groups who were employed worked fewer total weeks out of the year, on average, than their counterparts without disabilities. The majority of employed people from each subgroup worked between 50 and 52 weeks in 2012.

Across the population subgroups however, individuals in disability subpopulations are concentrated in the top bar segments, which represent less frequent work over the course of the year. Nearly one-quarter of working individuals with a cognitive disability worked fewer than 40 weeks during the 12 months previous to answering the survey. Fully one quarter of individuals with a cognitive disability who received SSI worked fewer than 40 weeks in the 12 months previous to responding to the survey. By contrast, only 11% of individuals without a disability worked fewer than 40 weeks.

This analysis shows that the lack of consistency with which individuals with disabilities, particularly cognitive disabilities, maintain paid employment (measured here in number of weeks worked per year) is an additional barrier to economic self-sufficiency. In order to achieve a path to self-sufficiency, individuals with disabilities not only need to be employed at higher rates, but also need to be working in jobs that promote stable and long-term employment.

Trends in Social Security Administration Data (1996-2012)

The Supplemental Security Income (SSI) program administered by the Social Security Administration (SSA) provides cash assistance to low-income individuals who are seniors, are blind, or have a disability. Analysis of the SSA dataset revealed these key findings:

• Overall, work incentive programs for SSI recipients with disabilities remain underused.
• SSI recipients with ID work more than recipients with other types of disabilities, but participate in work incentive programs less frequently.
• Younger people who receive SSI appear to work more frequently than their older counterparts.

Work incentives remain largely underused. Congress has enacted a number of work incentive programs for SSI recipients with disabilities, after concluding that additional incentives were necessary to help these individuals become self-supporting. Moreover, Congress has noted that individuals who could work in integrated employment might have been discouraged from doing so by the fear of losing their benefits before they were earning enough money to support themselves.

To encourage employment for individuals with disabilities, the SSA offers special provisions that limit the impact of earnings from work on eligibility for SSI or Social Security Disability Insurance benefits. These work incentives include the Plan to Achieve Self-Support (PASS), Impairment-Related Work Expenses (IRWE), Blind Work Expenses (BWE), section 1619(a) benefits, and section 1619(b) benefits.

PASS, IRWE, and BWE allow individuals to set aside money, resources, and expenses to be excluded from total earned income calculations. PASS allows people to set aside money and resources to be used for attaining a work goal, such as going back to school, finding a better job, or starting a business. IRWE allows people to exclude impairment-related expenses that are necessary for work from their income. Examples include attendant care, transportation, medication, or specialized equipment. BWE allows workers who are blind to exclude expenses related to earning income. These expenses include service animal expenses, income taxes, visual/sensory aids, and professional or union dues.

Section 1619(a) allows people with disabilities to continue receiving SSI income, even if their earned income is at Substantial Gainful Activity levels, i.e., the amount that would normally make them ineligible for SSI. Section 1619(b) allows individuals to continue receiving Medicaid benefits if their earnings disqualify them from eligibility for SSI cash payments, but are not enough to allow them to afford medical insurance.

A notable trend is the sharp drop in the number of people enrolled in the PASS program between 1995 (10,322) and 1997 (1,998). This decline followed a publication by the General Accounting Office that criticized the SSA for being too lenient in accepting applicants into a program deemed ineffective for achieving the goal of self-support. The procedures for acceptance were then reevaluated by the SSA and amended, resulting in fewer approvals in subsequent years. Data have also shown almost a 30% decrease in the average number of IRWE and BWE enrollees in the last four years.

Table 12. Number of People Enrolled Nationally in Work Incentive Programs from 1996-2012 (Even Years Only)

	1996	1998	2000	2002	2004	2006	2008	2010	2012
PASS	4,704	1,074	1,382	1,721	1,598	1,583	1,559	1,393	1,116
IRWE	9,799	9,301	9,402	8,047	6,874	5,650	4,572	3,491	3,157
BWE	4,230	3,802	3,895	3,385	2,827	2,370	1,925	1,847	1,410

SSI recipients with ID have a higher employment rate, but participate in work incentive programs less frequently than their counterparts with other types of disabilities. One fifth of all SSI recipients with disabilities ages 18-64 in 2011 (19.1%) were individuals with an intellectual disability (ID). With the expansion of additional “mental disorders” categories by the SSA,7 this is now the largest disability subgroup among SSI recipients.

SSI recipients with ID have had relative success with employment participation compared to recipients who do not have ID. In 2012, the rate at which SSI recipients with ID worked was almost three times that of SSI recipients without ID (12.8% versus 4.6%). The rate of employment among SSI recipients with ID was third among all diagnostic groups and subcategories, behind people with autism (18%) and people with congenital anomalies (16.9%).

SSI recipients with ID participate in the 1619(a) and 1619(b) work incentive programs at lower rates than SSI recipients with other disabilities (see Table 13). SSI recipients with ID participate in the IRWE program at about the same rates as recipients with other disabilities. A number of factors could explain these differences in participation. Analysis of other data sources, e.g., the RSA–911, has shown that people with ID often work fewer hours and earn less than individuals from other disability subgroups. As a result, individuals with ID who work are less likely to have earnings close to SGA, and may be at lower risk of losing benefits because of earnings.

The low rates of participation in work incentive programs by SSI recipients with ID should not overshadow the overall impact of these programs. For instance, in 2012, section 1619(b) benefits allowed more than 19,096 individuals with ID to work and to continue receiving Medicaid benefits. Better explanations of incentives and greater encouragement of participation in incentive programs by employment and disability services professionals could lead to higher rates of employment and better employment outcomes for individuals receiving SSI.

Table 13. Employment Outcomes and Participation in Work Incentives for SSI Recipients with Disabilities (2012)

	Intellectual Disability	All Other Disabilities
Percentage of SSI recipients with disabilities who work	12.8%	4.6%
Percentage of working SSI recipients who participate in 1619(a)	2.7%	4.7%
Percentage of working SSI recipients who participate in 1619(b)	16.0%	25.7%
Percentage of working SSI recipients who participate in IRWE	1.1%	1.0%

Younger people who receive SSI appear to work more frequently than their older counterparts, suggesting that transition plans may be focusing more on employment and indicating that greater numbers of people on SSI can work. Young adults with disabilities between the ages of 18-25 are a significant demographic of people who receive SSI, constituting 14.8% of recipients in 2012. Approximately eleven percent (10.5%) of SSI recipients with disabilities between the ages of 18-25 work, which is higher than the percentage of all people ages 18-64 on SSI who work (6.1%).

Looking at Figure 9, younger SSI recipients—those between the ages of 18 and 39—are more likely to be working than SSI recipients 40 and older. If we look more closely at the groups of recipients ages 22-25 and 26-29, we see that the percentage of these SSI recipients working is twice that of the overall percentage for recipients ages 18-64. These findings merit further exploration into why younger SSI recipients are more likely to be working, and how recipients can receive supports that will allow them to continue working as they age.

Even though younger SSI recipients are more likely to be working than their older counterparts, older SSI recipients are more likely to use work incentives (see Figure 9 and Table 14). Work incentive usage gradually increases from the ages 22-25 group, peaks at the ages 40-49 group, and then gradually declines. Within the 18-21 and 22-25 groups, the percentage of work incentive usage is much lower than that of the overall percentage for recipients ages 18-64.

Table 14: Work Incentives Use and Earnings by Age Group (2012)

Age group	Recipients who work (N)	Section 1619(b) participants (N)	Percent of those working who use work incentive 1619(b)	Average earnings of recipients who work ($)
18-21	29485	2310	7.8%	467
22-25	47213	8828	18.7%	534
26-29	40061	9755	24.4%	572
30-39	64031	16249	25.4%	563
40-49	51171	13287	26.0%	563
50-59	50885	11387	22.4%	506
60-64	15708	3357	21.4%	442

A correlation analysis was conducted in order to explore the relationship between use of work incentives by SSI recipients and their earnings. State-level data was used for this analysis. A Spearman’s Rank Order correlation determined that there was a moderate to strong, positive correlation between the percentage of those working who use 1619(b) and average earnings, which was statistically significant (rs = .505, p < .001). Table 15 displays earnings and 1619(b) use state-by-state.

Table 15: Work Incentives Use and Earnings by State (2012)

State	Percent of those working who use work incentive 1619(b)	Average earnings of recipients who work ($)
Alabama	24.5	1,405
Alaska	32.7	1,637
Arizona	24.3	1,477
Arkansas	19.1	1,346
California	20.8	1,561
Colorado	18.3	1,227
Connecticut	20.5	1,180
Delaware	23.6	1,390
DC	31.2	1,852
Florida	28.1	1,361
Georgia	22.7	1,425
Hawaii	29.7	1,567
Idaho	23.4	1,223
Illinois	20.4	1,316
Indiana	21.6	1,152
Iowa	21.2	982
Kansas	18.9	1,052
Kentucky	22.1	1,386
Louisiana	25.9	1,290
Maine	26.6	1,189
Maryland	23.8	1,434
Massachusetts	26.3	1,447
Michigan	19.0	1,160
Minnesota	18.9	1,036
Mississippi	24.7	1,364
Missouri	20.6	1,037
Montana	17.2	1,275
Nebraska	16.4	1,187
Nevada	20.3	1,405
New Hampshire	28.6	1,147
New Jersey	20.8	1,361
New Mexico	27.3	1,320
New York	22.5	1,445
North Carolina	21.7	1,217
North Dakota	25.4	1,191
Ohio	16.6	1,140
Oklahoma	22.7	1,084
Oregon	18.1	1,017
Pennsylvania	21.5	1,334
Rhode Island	18.3	1,371
South Carolina	16.0	1,291
South Dakota	20.7	1,005
Tennessee	19.9	1,318
Texas	26.6	1,385
Utah	20.0	1,135
Vermont	30.0	1,235
Virginia	21.9	1,224
Washington	26.8	1,369
West Virginia	26.3	1,566
Wisconsin	16.0	1,024
Wyoming	*	*

* = Suppressed to avoid disclosing information about particular individuals. 

Conclusion

Data continue to highlight the economic disparities between people with and without intellectual and developmental disabilities (IDD). State investment in supports continues to emphasize facility-based and non- work services, rather than integrated employment services. In the vocational rehabilitation (VR) system, earnings of adults with disabilities are substantially lower compared to those in the general population, and weekly earnings of individuals served by VR have declined slightly over time. Overall, the findings suggest that across datasets, people with intellectual disabilities experience greater levels of unemployment, underemployment, low wages, and poverty compared to those without disabilities.

• In the IDD system, national estimates suggest that there has been only modest growth in the number of individuals in integrated employment services since 1988. The estimated percentage of individuals participating in integrated employment services was 18.4% in FY2012, down from 19.3% in FY2011, while investment in non-work services continues to expand. However, there are encouraging signs that integrated employment is becoming a priority in certain states. In FY2012, Connecticut, Maryland, New Hampshire, Oklahoma, Washington, and West Virginia all reported that at least 40% of individuals receiving day and employment services were receiving integrated employment services.

• In the VR system, the rehabilitation rate increased between FY2011 and FY2012, but was still lower than in earlier years. Weekly wages declined slightly over time. People with intellectual disabilities who exited the VR system in 2012 took about 710 days to gain employment, on average, from application. This represented 36 additional days compared to 2011, continuing a trend of increasingly more days from application to an employment outcome.

• American Community Survey data continue to show that people with disabilities are much less likely to work than their counterparts without disabilities. People with a cognitive disability who are receiving Supplemental Security Income (SSI), the group likely to include people who have the most significant cognitive disabilities, have the lowest employment rate of all disability subgroups examined, and are the most likely to live in a household that is below the poverty line. The positive impact of the economic recovery on employment appears to have been stronger for people without disabilities than it has been for people with disabilities.

• Data from the Social Security Administration show that work incentive programs for SSI recipients with disabilities remain underused. SSI recipients with ID work more than their counterparts with other types of disabilities, but participate in work incentive programs less frequently. Younger people who receive SSI appear to work more frequently than their older counterparts.

Data presented for FY2012 highlights the economic and employment disparities for individuals with intellectual and developmental disabilities. While some data suggest progress (e.g., the increasing number of IDD state agencies that are serving over 40% of individuals in integrated employment services), overall data demonstrate the increasing need for policies and initiatives that prioritize employment. The evolving shift in states toward Employment First policies can make an important contribution to raising expectations, improving outcomes, and increasing self-sufficiency for individuals with intellectual and developmental disabilities.

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Topical Chapter:

State Differences in Services Provided by Community Rehabilitation Providers

Introduction

Community rehabilitation providers (CRPs) and their staff are the primary source of employment supports for people with intellectual and developmental disabilities (IDD). Defined as community-based organizations that provide employment and day supports to individuals with disabilities, CRPs vary widely in their size, the population they serve, and the services they provide. Their outcomes in serving individuals with IDD in integrated employment settings also vary by state.

Nationally, CRPs maintain a limited investment in integrated employment. In a national survey of CRPs that provide sub-minimum-wage employment, respondents reported that only 8.7% of staff worked with individuals earning minimum wage or higher (Inge et al., 2009). Eighty-nine percent of respondents indicated that sheltered employment was a necessary service, 69% responded that individuals with IDD were unable to earn minimum wage, and only 47% of CRPs indicated that their organization had a formal plan to expand integrated employment (Inge et al., 2009). Agency leaders report multiple obstacles to transitioning into integrated employment services, including staff resistance, family resistance, and funding structures that do not adequately support community-based services for people with high support needs (Rogan & Rinne, 2011).

In 2011, the Institute for Community Inclusion administered the 2010-2011 National Survey of Community Rehabilitation Providers (CRP Survey) (Domin & Butterworth, 2013). The goal of the survey was to collect organizational characteristics and service information from CRPs in all U.S. states with a focus on individuals with IDD. This chapter presents a state-by-state description of employment and non-work service participation of people with intellectual and developmental disabilities (IDD) as reported by CRPs. Provider outcomes by state are compared to ICI’s IDD Agency National Survey of Day and Employment Services (IDD Survey) (Butterworth et al., 2011).

Both of these surveys collect data on participation in services, not on employment outcomes. Because of this, individuals reported to be in integrated employment may be searching for a job or between jobs. While we expect the data to be consistent, state IDD agencies rely on billing data to describe service participation, and CRPs report program participation.

In addition, the National Survey of CRPs collects data on individuals with IDD funded by any source, including vocational rehabilitation and schools. As a result, it may include more individuals engaged in time-limited services prior to entering employment. The National Survey of IDD Agencies only includes individuals who are receiving funding support from the state IDD agency.

Research questions addressed include:

• How do states vary in participation in integrated employment and related services?
• What is the relationship of investments across services (integrated employment, facility-based work, and non- work)?
• How do states differ in participation in individual integrated employment versus group supported employment?
• What is the relationship between participation in integrated employment services as reported on the CRP Survey compared to the IDD Survey?
• What is the relationship between participation in integrated employment as reported on the CRP Survey and other key employment metrics?

Data Sources

The 2010-2011 National Survey of Community Rehabilitation Providers.

The survey population for this study was CRPs from all 50 states and the District of Columbia that provide employment and/or day services to individuals with disabilities. A final sample frame of 11,712 organizations was assembled. Working from the list of 11,712 CRPs, the organizations were grouped by state using stratified sampling. The following steps were implemented to compile a final sample.

Integrated employment services include competitive employment, individual supported employment, self- employment, enclaves, and mobile crews.

For states that had fewer than 100 organizations on the list, every identified CRP was included in the sample. For states with at least 100 CRPs, a simple random sampling approach was used, and 100 organizations were randomly selected in each state, resulting in a sample of 4,418 CRPs for all 50 states and the District of Columbia. Graduate assistants then verified whether these organizations met the study’s criteria for being a CRP and had valid contact information (address and phone number) for follow-up purposes (see Domin & Butterworth, 2013). If an organization failed to meet these criteria, it was replaced by another randomly selected organization from that particular state. If the state had fewer than 100 CRPs to begin with, then the CRP would be eliminated from the sample and not replaced. This process resulted in a final sample of 3,551 CRPs.

Of the 3,551 CRPs in the final sample, a total of 1,309 completed the survey questionnaire, yielding a 36.9% response rate. Seventy-eight percent of respondent organizations completed the full-length survey (n=1,016), and 22.3% (n=293) completed a condensed version of the survey. Findings for this chapter are based on the 1,016 responses to the 2010-2011 National Survey of Community Rehabilitation Providers full-length survey. The condensed version was excluded from analysis, because it did not ask about non-work services.

Fourteen states and the District of Columbia were eliminated from state-by-state analysis for this chapter based on two exclusion criteria: states that had less than a 20% response rate, and states that had fewer than 10 responses. These criteria excluded Alabama (AL), Alaska (AK), Delaware (DE), District of Columbia (DC), Hawaii (HI), Idaho (ID), Kansas (KS), Nebraska (NE), North Dakota (ND), Nevada (NV), New Hampshire (NH), New Mexico (NM), South Dakota (SD), Utah (UT), and Vermont (VT). Four states fell under both criteria: AL, AK, DC, and NH. These criteria were established to preserve the integrity of the data and ensure validity and reliability.

FY 2011 Intellectual and Developmental Disabilities Agency National Survey of Day and Employment Services.

This survey is part of a longitudinal study commissioned by the Administration on Intellectual and Developmental Disabilities to analyze community-based day and employment service trends for individuals with IDD and closely related conditions. Data are available for FY1988 through FY2012. The survey is designed to provide information on trends in the number of people served in employment and non-work services and allocation of funds and funding sources to support those services. For more detailed information about this data, please consult the methodology section of this publication.

Since CRP survey data collection occurred in 2010/2011, FY 2011 IDD survey data was selected for this analysis to ensure comparison consistency. The FY 2011 IDD Survey data set contained missing data for a key data point to this analysis–the integrated employment percentage rate–for the following seven states: Arkansas (AR), Delaware (DE), Hawaii (HI), Idaho (ID), Maine (ME), North Dakota (ND), and New Jersey (NJ).

The integrated employment percentage for individuals with IDD for HI, ME, and NJ was replaced with FY 2010 IDD survey data. The integrated employment rate for AR, DE, ID and ND was filled in with the supported employment percentage from FY 2011 data provided by the University of Colorado’s State of the States in Developmental Disabilities publication (Braddock et al., 2013), which most closely mirrors the IDD survey data. There is a very strong, statistically significant correlation between the Braddock et al supported employment percentage rate and the IDD Survey integrated employment rate, r (46)=.84, p<.001. FY 2011 data for Georgia was replaced with FY 2012 IDD survey data because it was determined to be a more accurate representation of integrated employment outcomes and funding. Additional missing data points from the IDD survey used in correlational analysis were filled in with FY 2010 data.

Other data sources included in this chapter are as follows and are described in detail earlier in this report:

• 2011 Rehabilitation Services Administration (RSA) 911
• 2011 American Community Survey (ACS)
• 2011 U.S. Bureau of Labor Statistics

Findings

CRPs across states vary in their employment and non-work outcomes. There is a large variation in integrated employment participation across states, which suggests that states do not consistently emphasize employment as a policy priority. Arkansas CRPs reported the lowest participation rate (6%), while Washington had the highest at 76%.

Table 1: Participation of Individuals with IDD in Employment and Non-work Settings by State: 2010-2011 (CRP Survey)

State	Total reported with IDD (n)	Integrated employment	Individual integrated employment	Group supported employment	Facility-based work	Community and facility based non-work
AR	4983	6%	6%	0%	15%	79%
AZ	2812	25%	12%	52%	22%	51%
CA	7232	44%	17%	61%	17%	33%
CO	1921	19%	9%	53%	34%	47%
CT	3856	29%	14%	52%	7%	63%
FL	4524	32%	29%	9%	37%	30%
GA	1870	19%	11%	42%	14%	66%
IA	6296	15%	8%	47%	41%	43%
IL	7715	15%	12%	20%	29%	55%
IN	5733	31%	28%	10%	26%	42%
KY	1897	45%	42%	7%	16%	39%
LA	2155	28%	17%	39%	33%	39%
MA	3233	32%	22%	31%	25%	42%
MD	4392	49%	25%	49%	19%	32%
ME	953	37%	29%	22%	0%	62%
MI	4210	31%	20%	35%	35%	32%
MN	4919	40%	16%	60%	32%	27%
MO	1542	11%	10%	9%	54%	35%
MS	1428	19%	14%	26%	72%	5%
MT	1209	18%	12%	33%	28%	55%
NC	3493	52%	48%	8%	28%	20%
NJ	5572	15%	8%	47%	19%	66%
NY	11500	21%	16%	24%	29%	50%
OH	4871	18%	12%	33%	27%	52%
OK	1409	35%	17%	51%	42%	24%
OR	2281	27%	12%	56%	25%	48%
PA	2751	22%	16%	27%	31%	46%
RI	1321	11%	8%	27%	10%	79%
SC	3320	33%	16%	52%	28%	39%
TN	2425	22%	12%	45%	41%	36%
TX	2248	21%	21%	0%	35%	42%
VA	3565	46%	38%	17%	26%	28%
WA	4518	76%	66%	13%	10%	14%
WI	3226	17%	14%	18%	43%	36%
WV	1088	8%	5%	38%	41%	51%
WY	744	23%	18%	22%	12%	65%

CRPs report considerable variation in the use of facility-based work as a service option. Despite the absence of a correlation between participation in integrated employment and participation in facility-based work, CRPs report considerable state-to-state variation in the use of facility-based work, ranging from no participation (0% in Maine) to a reported 54% of all service participation in Missouri and 72% in Mississippi.

States vary in their investment in group supported employment. Table 1 reports the rate of participation in both integrated employment and individual integrated employment. Overall, about one third of individuals in integrated employment are in group supported employment (Domin & Butterworth, 2013). The percent of those who are in integrated employment that participate in group supported employment ranges from 0% to 61%, with eight states reporting that 50% or more of individuals in integrated employment are in group supported employment, and six states reporting 10% or fewer. Some states with relatively high levels of participation in integrated employment overall also have high investments in small group supported employment, including California, Maryland, and Minnesota, while other states with a high overall rate of integrated employment report very few individuals participating in group supported employment (see Table 2). There is not a significant correlation between the overall rate of integrated employment and the rate of individuals in group supported employment.

Table 2. Percent in Group Supported Employment for States with 40% or More Individuals Participating in Integrated Employment: 2010-2011 (CRP Survey)

State	Percent in integrated employment	Percent in group supported employment of those in integrated employment
California	44%	61%
Kentucky	45%	7%
Maryland	49%	49%
Minnesota	40%	60%
North Carolina	52%	8%
Virginia	46%	17%
Washington	76%	13%

There is a strong negative correlation between integrated employment and non-work services. A correlation coefficient was used to examine the relationship between integrated employment and other service outcomes of CRPs across states (see Table 1). We found that there is a strong association between the integrated employment rate and non-work services. As the integrated employment rate among states increases, participation in non-work services tends to decrease (r (36)=-.59., p<.001).

A similar finding would be expected for facility-based work. However, there is a statistically insignificant weak correlation between the integrated employment rate and facility-based work (r (36)=-.311, p<.10), suggesting that the opposite of integrated employment is non-work rather than facility-based work. There is a significant correlation between participation in non-work and facility-based work services that mirrors that of non-work and integrated employment. As participation in non-work services increases, facility-based work decreases (r (36) =-.52, p<.001).

How does state-level CRP Survey data compare to IDD Survey data? As noted, the CRP Survey and the IDD Survey target different but overlapping populations. The level of overlap cannot be determined, but likely differs from state to state based on the state policy and the structure of services. The CRP Survey includes all individuals with IDD receiving services regardless of funding source. For some CRPs this may include a significant number of individuals funded by vocational rehabilitation, education, or other services who do not receive funding or case management from the state IDD agency. The IDD survey includes all individuals who receive day or employment services funded or monitored by the state IDD agency. It does not include individuals who receive other services, such as case management or supported living, but who do not participate in a day or employment service. Among others, this would exclude individuals who work independently in a competitive job but need other supports.

Table 3 compares the integrated employment rates between IDD Survey and CRP Survey data. There is a significant correlation between the two data sets, showing some consistency of information (r (36)=.59, p<.001). This suggests that the two surveys are measuring related constructs, although other variables such as state policy and service structures also make a meaningful contribution.

Table 3: Percent of People with IDD Working in Integrated Employment

State	Integrated employment rate (IDD Survey)	Integrated employment rate (CRP Survey)
AR	7%***	6%
AZ	19%	25%
CA	14%	44%
CO	21%	19%
CT	51%	29%
FL	20%	32%
GA	14%**	19%
IA	20%	15%
IL	9%	15%
IN	19%	31%
KY	9%	45%
LA	33%	28%
MA	25%	32%
MD	40%	49%
ME	23%*	36%
MI	23%	31%
MN	19%	40%
MO	6%	11%
MS	11%	19%
MT	13%	18%
NC	20%	52%
NJ	14%*	14%
NY	13%	21%
OH	24%	18%
OK	61%	35%
OR	34%	27%
PA	15%	22%
RI	26%	11%
SC	30%	33%
TN	18%	22%
TX	5%	21%
VA	22%	46%
WA	88%	76%
WI	23%	17%
WV	22%	8%
WY	17%	23%

*FY10 IDD Survey

**FY12 IDD Survey

***FY11 from Braddock et al.

Table 4: Employment Data Points from Various Sources by State: 2011

State	Percent of people with IDD in integrated employment (CRP Survey)	Percent of people in integrated employment (IDD Survey)	Money spent per person on integrated employment (IDD Survey)	Percent of funds spent on integrated employment services (IDD Survey)	Unemployment rate 2011	Percent of closures with ID into employment (RSA 911)	Percent of total closures that are ID (# of closures with ID / total # of closures) (RSA 911)	Percent of individuals working with cognitive disability (ACS)	Percent of individuals working with any disability (ACS)
AK	-1	27%	$13,976	17%	8%	46%	3%	38%	46%
AL	-1	5%	$11,116	5%	9%	45%	12%	16%	25%
AR	6%	7%	-1	-1	8%	19%	4%	22%	30%
AZ	25%	19%	$9,496	14%	10%	23%	5%	21%	31%
CA	44%	14%	$7,877	10%	12%	44%	7%	20%	31%
CO	19%	21%	$4,636	10%	8%	46%	11%	27%	41%
CT	29%	51%	$9,896	27%	9%	27%	7%	27%	38%
DC	-1	21%	$35,964	35%	10%	26%	7%	26%	31%
DE	-1	19%	-1	-1	7%	37%	9%	24%	35%
FL	32%	20%	$3,102	8%	11%	25%	6%	18%	29%
GA	19%	14%	$3,662	8%	10%	35%	14%	19%	29%
HI	-1	7%	-1	-1	7%	24%	8%	22%	37%
IA	15%	20%	$3,503	10%	6%	31%	13%	32%	41%
ID	-1	12%	-1	-1	9%	30%	6%	26%	37%
IL	15%	9%	$4,181	4%	10%	33%	10%	24%	34%
IN	31%	19%	$2,337	9%	9%	30%	13%	23%	34%
KS	-1	15%	-1	-1	7%	33%	8%	32%	43%
KY	45%	9%	$3,152	2%	10%	30%	10%	17%	25%
LA	28%	33%	$7,358	39%	7%	26%	8%	22%	32%
MA	32%	25%	$9,399	15%	7%	33%	4%	24%	31%
MD	49%	40%	$17,241	36%	7%	31%	8%	24%	36%
ME	36%	23%	-1	-1	8%	26%	10%	23%	30%
MI	31%	23%	$5,622	13%	10%	33%	6%	20%	28%
MN	40%	19%	$2,134	3%	6%	37%	8%	36%	46%
MO	11%	6%	$5,671	4%	9%	32%	16%	21%	32%
MS	19%	11%	$7,010	15%	11%	27%	10%	17%	29%
MT	18%	13%	$4,835	5%	7%	26%	5%	28%	44%
NC	52%	20%	$5,472	7%	11%	38%	19%	21%	29%
ND	-1	17%	-1	-1	4%	38%	8%	37%	47%
NE	-1	5%	$5,098	2%	4%	42%	7%	32%	45%
NH	-1	49%	$5,110	10%	5%	36%	5%	23%	37%
NJ	14%	14%	$5,559	5%	9%	26%	4%	21%	35%
NM	-1	37%	$6,875	19%	7%	37%	5%	21%	35%
NV	-1	23%	$7,678	17%	14%	17%	3%	25%	35%
NY	21%	13%	$5,142	4%	8%	34%	7%	21%	31%
OH	18%	24%	$11,317	12%	9%	24%	10%	23%	32%
OK	35%	61%	$7,250	52%	6%	26%	6%	26%	35%
OR	27%	34%	$3,281	-1	10%	29%	6%	26%	34%
PA	22%	15%	$4,800	7%	8%	34%	7%	23%	33%
RI	11%	26%	-1	-1	11%	35%	7%	23%	30%
SC	33%	30%	$5,131	20%	10%	27%	3%	17%	27%
SD	-1	18%	$950	3%	5%	45%	10%	36%	42%
TN	22%	18%	-1	-1	9%	20%	18%	17%	28%
TX	21%	5%	$3,473	3%	8%	33%	4%	24%	36%
UT	-1	27%	$6,406	17%	7%	37%	3%	26%	40%
VA	46%	22%	$12,099	17%	6%	40%	14%	21%	33%
VT	-1	35%	$11,540	29%	6%	62%	6%	26%	39%
WA	76%	88%	$5,900	87%	9%	43%	8%	24%	35%
WI	17%	23%	$7,731	12%	8%	33%	7%	28%	37%
WV	8%	22%	-1	-1	8%	40%	8%	14%	24%
WY	23%	17%	$2,808	3%	6%	49%	5%	33%	46%

-1 Data not provided

Relationship between the CRP Survey rate of integrated employment and other employment metrics.

A correlation matrix with key variables was run to examine relationships between the CRP survey’s integrated employment rate and other variables that could help shed light on employment outcomes for states. The data points and sources are outlined in Table 4. Results suggest that:

• There is a significant relationship between the percentage of employment funds spent by IDD agencies on integrated employment and the CRP Survey integrated employment rate (r (30)=.62, p<.001), suggesting that IDD agency decisions about policy and funding investments make a meaningful contribution to outcomes.
• The percentage of vocational rehabilitation closures with an intellectual disability into employment (RSA 911) almost correlates significantly with the integrated employment rate from the CRP survey (r (36)=.28, p<.10). It does not correlate with the IDD Survey’s integrated employment rate, suggesting the importance of the role of state vocational rehabilitation agencies in supporting individuals who are not supported by state IDD agencies.
• Vocational rehabilitation results closely track with labor market statistics:
• As the state unemployment rate increases, the percent of closures with an intellectual disability into employment (RSA 911) decreases (r (51)=-.38, p<.01).
• As the unemployment rate decreases, a higher percentage of people with cognitive disabilities work (American Community Survey; r (51)=-.58, p<.001). The same is true for individuals with any disability (r (51)=-.64, p<.001).

Also interesting are the variables that do not correlate significantly with the integrated employment rate. The average dollars spent annually per person for integrated employment (as reported on the IDD Survey) and the unemployment rate of a state do not correlate with the integrated employment rate on either the CRP Survey or the IDD Survey. This suggests that while dollars spent may have an impact on vocational rehabilitation closures, other factors such as policy and funding may have a greater impact on individuals with IDD.

Discussion

This analysis illustrated both the high level of variation in participation in integrated employment, and the likely impact of a complex array of factors including state IDD agency policy and strategy on employment. The limited relationship between CRP service participation, IDD agency service participation, and VR outcomes suggests that the IDD and Vocational Rehabilitation systems play complementary but not entirely parallel roles in supported employment opportunities. As a service system that has a primary focus on employment, VR system outcomes had a stronger and significant relationship to the state unemployment rate, while the unemployment rate did not have a significant or meaningful relationship to participation in integrated employment in the IDD Survey or the CRP Survey. This suggests that culture and policy of the service system for individuals with IDD is a critical area of focus.

References

Braddock, D., Hemp, R., Rizzolo, M., Tanis, E. S., Haffer, L., Lulinski, A., & Wu, J. (2013). The state of the states in developmental disabilities. Boulder, CO: University of Colorado.

Butterworth, J., Hall, A. C., Smith, F. A., Migliore, A., Winsor, J., Timmons, J., & Domin, D. (2011). StateData: The national report on employment services and outcomes. Boston, MA: University of Massachusetts Boston, Institute for Community Inclusion.

Domin, D., & Butterworth, J. (2013). The role of community rehabilitation providers in employment for persons with intellectual and developmental disabilities: Results of the 2010-2011 national survey. Intellectual and Developmental Disabilities, 51(4), 215-225.

Inge, K. J., Wehman, P., Revell, G., Erickson, D., Butterworth, J., & Gilmore, D. S. (2009). Survey results from a national survey of community rehabilitation providers holding special wage certificates. Journal of Vocational Rehabilitation, 30(2), 67-85.

Rogan, P., & Rinne, S. (2011). National call for organizational change from sheltered to integrated employment. Intellectual and Developmental Disabilities, 49(4), 248-260.

footnotes

¹ This difference reflects both the ability of CRPs to more accurately report on individual service settings, and the inclusion of data from more states.

² This decline is reported in 2005 dollars after adjusting for inflation.

^{3 Source: www.disabilitystatistics.org/faq.cfm#}

⁴ Funded by the Administration on Intellectual and Development Disabilities, the Institute for Community Inclusion and the National Association of State Directors of Developmental Disabilities Services provide training and technical assistance to eight Partnerships in Employment states. The purpose of these efforts is to change state systems to improve employment outcomes for youth and young adults with intellectual and developmen- tal disabilities.

⁵Earnings of the general population were computed by dividing the annual wages of civilians, ages 16-64, by 52 weeks, using data from the Ameri- can Community Survey. At the time of compiling this report, the 2012 data were not available.

⁶ www.ssa.gov/ssi/text-eligibility-ussi.htm

⁷ Beginning with the 2010 SSI Annual Statistical Report, tables showing data by diagnostic group provide details for mental disorders in these categories: autistic disorders, developmental disorders, childhood and adolescent disorders not elsewhere classified, intellectual disability, mood disorders, organic mental disorders, schizophrenic and other psychotic disorders, and all other mental disorders.