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StateData: The National Report on Employment Services and Outcomes, 2008 (book)

Originally published: 10/2008

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Institute for Community Inclusion (UCEDD)
University of Massachusetts Boston

Fall 2008

The StateData employment report is a product of Access to Integrated Employment, a project of the Institute for Community Inclusion at UMass Boston, supported in part by the Administration on Developmental Disabilities, U.S. Department of Health and Human Services under cooperative agreement #90DN0216. 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 (NASDDDS) including: Nancy Thaler, Chas Moseley, and Rie Kennedy-Lizotte. Additionally, the authors would like to acknowledge the contributions of ICI's entire StateData team including Bill Kiernan, Suzzanne Freeze, Samita Bhattarai, Monica Cox, Brooke Dennee-Sommers as well as David Temelini, who assisted in the layout and production of this report. Lastly, Marcos Elugardo has provided significant database management and assistance and we thank him for these efforts.

Special thanks are directed towards the state administrators and key survey contacts in each state who consistently respond to ICI's ID/DD Agency National Survey of Day and Employment Outcomes. Their expertise, insights and assistance have helped to make this report possible.

Institute for Community Inclusion (UCEDD)
University of Massachusetts Boston
100 Morrissey Boulevard
Boston, Massachusetts 02125
ici@umb.edu

www.communityinclusion.org
www.statedata.info
www.selnmembers.org

Table of Contents

• Executive Summary
• Introduction
  • Policy and practice challenges
  • Services and supports used by people with intellectual and developmental disabilities
  • Factors that influence employment outcomes
• Methodology
  • Data sources
• National Trends in Employment
  • ID/DD Agency National Survey of Day and Employment Outcomes
  • Trends in Rehabilitation Services Administration outcomes for individuals with ID/DD
  • Trends in American Community Services (ACS) data
  • Trends in Social Security Administration data
• Conclusion
• References

Executive Summary

Policy shifts over the past 20 years have created an agenda for sustained commitment to integrated employment for individuals with disabilities. But despite these clear intentions, unemployment of individuals with disabilities continues to be a significant and pressing public policy concern. The 2006 American Community Survey (ACS) estimates that 36 percent of working-age adults with disabilities are employed, compared with 74 percent of people without disabilities. For people with intellectual and developmental disabilities (ID/DD) the disparity in labor market participation increases. In FY2003, only 26 percent of individuals with ID/DD supported by community rehabilitation providers (CRPs) worked in integrated jobs (Metzel, Boeltzig, Butterworth, Sulewski, & Gilmore, 2007). At the same time, participation in sheltered or facility-based employment and non work services have grown steadily, suggesting that employment services continue to be viewed as an add-on service rather than a systemic change (Winsor & Butterworth, 2008; Mank, 2003).

States vary widely in their commitment to integrated employment. In recent years, we have worked with and documented individual state ID/DD agencies that have employment working groups, employment initiatives, and employment-first policies and agendas. The efforts of some of these states are being reflected in their employment outcomes data despite the fact that the federal government, through the Medicaid program, continues to spend four times more money on segregated adult day programs (day habilitation and sheltered work) than on supported employment ($488 million and $108 million, respectively) (Rusch & Braddock, 2004). Nationally, an estimated 20 percent of individuals receiving day supports from state ID/DD agencies participated in integrated employment. This number has slowly declined following the peak of 24 percent of individuals in integrated employment in FY2001.

For the past 20 years, ICI's Access to Integrated Employment, the national data collection project on day and employment outcomes funded by the Administration on Developmental Disabilities, has described the nature of day and employment services for individuals with intellectual and developmental disabilities, and contributed to a comprehensive understanding of the factors that influence employment outcomes at an individual, service provider, and state policy level. This report provides statistics over a twenty-year period from several national data sets that address the status of employment and economic self-sufficiency for individuals with intellectual and developmental disabilities (ID/DD).

We provide a comprehensive overview that describes national trends in employment for people with ID/DD, and the Appendix provides individual state profiles with data from four sources: ICI's ID/DD Agency National Survey of Day and Employment Outcomes from FY 1988, 1990, 1993, 1996, 1999, 2001, 2004, and 2007, and datasets from the Social Security Administration, Vocational Rehabilitation, and the American Community Survey.

From varying perspectives, each dataset that is included in this report sheds light on the economic disparities that people with intellectual and developmental disabilities have experienced over the past decade and beyond. More individuals continue to be supported in facility-based employment, earning sub-minimum wage, than in integrated employment. A disproportionate number of individuals with disabilities work in low wage settings as compared to the general population. In the Vocational Rehabilitation (VR) system, the gap between earnings of adults with disabilities at closure and personal income in the general population is large and widening over time. Overall, the findings suggest the need for a renewed and shared focus across several systems:

• ID/DD state agencies show a continued investment in facility-based and non work services, and an uneven commitment across states towards the expansion of community employment. While individual states show promise, as a whole trends continue to challenge the vision of greater employment opportunity.
• Overall, some VR trends are encouraging, most notably an increased engagement with individuals at the point of transition from educational services and growth in earned income at closure. The VR program has made substantial progress by discontinuing the counting of closures in extended employment as an employment outcome; moreover, earnings at closure were showing a growing trend even after adjusting for inflation and in spite of a reduction in work hours. Other, more challenging trends, however, include limited rates of closures in employment, and expanding timeframes for achieving outcomes.
• ACS data suggest that people with disabilities were disproportionately represented in the occupational category with the lowest projection for job growth. This suggests that community rehabilitation providers and individuals need to focus their efforts on developing employment opportunities in fields that have higher potential for growth and expand their search into non-stereotypical career areas. Moreover, the data show that people with disabilities are substantially over-represented in labor categories with the lowest wages.
• ACS data also show that employment is on the decline for individuals with any disability, and for individuals reporting a mental disability. Moreover, while wages increased slightly for all working-age individuals, wages declined for individuals with any disability and individuals reporting a mental disability. Mean weekly hours worked declined slightly for all individuals, including those with any disability and those with a mental disability.
• Despite federal efforts to increase the utilization of work incentives-- such as PASS, IRWE, and BWE programs--SSA data show consistently low numbers of enrollment in the work incentive programs across states.
• Multiple data sets offer varying perspectives on the employment situations of individuals with disabilities, and specifically intellectual and developmental disabilities. While the data do show some progress within particular systems over time (e.g. the gradual reduction in number of individuals working in sheltered employment, increased earnings for individuals who are exiting the VR system), there continues to be an urgent need for a re-investment of attention, priority, and resources dedicated towards expanding both economic and employment opportunities for individuals with intellectual and developmental disabilities.

Introduction

Enabling people with disabilities to enter the labor market is a priority concern for federal and state policy makers (Silverstein, Julnes, & Nolan, 2005). President Bush's New Freedom Initiative articulates a commitment to increase access and achieve better employment outcomes. Policy shifts over two decades have established an increasing emphasis on integrated employment, and the federal government has set the tone for broad-based systems change (Rogan, Novak, Mank, & Martin, 2002).

Even with this clear policy intent, there remains a significant gap in employment rates between people with and without disabilities. The 2006 American Community Survey (ACS) estimates that 36 percent of working-age adults with disabilities are employed, compared with 74 percent of people without disabilities. For people with intellectual and developmental disabilities (ID/DD), the disparity in employment participation widens further. In FY2003, only 26 percent of individuals supported by community rehabilitation providers (CRPs) worked in integrated jobs (Metzel, Boeltzig, Butterworth, Sulewski, & Gilmore, 2007), and data suggest that those who are employed work limited hours with low wages (Mank, 2003; Boeltzig, Gilmore, & Butterworth, 2006). At the same time, participation in sheltered employment and non work services has grown steadily, suggesting that employment services continue to be viewed as an add-on service rather than a systemic change (Winsor & Butterworth, 2008; Mank, 2003).

Although nationwide resources and priorities have not realigned to expand employment, there is substantial evidence that individual states and CRPs are expanding community employment and focusing on outcomes. In FY2007, Connecticut, New Hampshire, Oklahoma, and Washington all reported that more than 40 percent of individuals receiving day and employment services were supported in integrated employment. Analysis of the FY2004-2005 National Survey of Community Rehabilitation Providers showed that the majority (81 percent) of those entering some type of integrated employment worked in individual jobs. Of those people, most earned incomes above federal and state minimum wage levels from their employers and received paid time off (Boeltzig, Timmons, & Butterworth, in press). More recently, as an outgrowth of ICI's Access to Integrated Employment project, 15 states have joined the State Employment Leadership Network, a membership roundtable co-managed with the National Association of State Directors of Developmental Disabilities Services dedicated to expanding employment for individuals with ID/DD. In 2006 employment was introduced as a continuing strand at the annual Reinventing Quality Conference, a hallmark national meeting of state ID/DD agencies and key stakeholders.

Policy and Practice Challenges

Despite advances in federal policy and the leadership of some high-performing states, widespread expansion of integrated employment has not occurred. Several factors present continuing challenges:

State systems continue to invest in sheltered employment and non work services. While the number of individuals with ID/DD in integrated employment is growing, the number participating in sheltered employment and non work services has grown even more rapidly over the past decade, and 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 services has competed with integrated employment, despite evidence that these services are poorly defined and do not consistently achieve their stated goals of community membership (Sulewski, Butterworth, & Gilmore, 2006). Braddock, Rizzolo, and Hemp (2004) attribute 58 percent of the growth in ID/DD services between 1988 and 2002 to the increase in segregated service participants alone.

CRPs have not reallocated resources to community employment. In a national survey of CRPs that provide sub-minimum wage employment, 89 percent of respondents indicated that sheltered employment was a necessary service, 69 percent responded that individuals with intellectual/developmental disabilities were unable to earn minimum wage, and only 47 percent indicated that their organization had a formal plan to expand integrated employment (Wehman, Inge, Revell, Butterworth, & Gilmore, 2007).

Best practices in job support and job development are not consistently implemented. Emerging practices such as job creation, customized employment, and facilitation of natural supports are rarely used in practice at the direct support level, reflecting a need to address direct-support professional training, qualifications, and job roles. For example, in the 2002-2003 ICI Survey of CRPs, only 35 out of more than 38,000 individuals with ID/DD were identified as supported in self-employment.

Individual employment outcomes have not progressed. Findings from ICI's FY2004-2005 Individual Employment Outcomes Survey show that the majority of individuals with ID/DD work part-time and predominantly in the entry-level service industry, annual income remains low, and individuals have limited access to employee benefits such as health care (Boeltzig, Timmons, Gilmore, & Butterworth, 2007). A longitudinal comparison of the quality of supported employment outcomes shows comparable results: despite slight improvements in some areas such as worksite integration, work rate, and work quality, individuals obtaining jobs in the late 1990s worked similar hours, earned similar wages, and held similar types of jobs compared to those obtaining jobs in the early 1990s (Mank, Cioffi, & Yovanoff, 2003).

Services and Supports Used by People with Intellectual and Developmental Disabilities

Employment supports are provided within a context of state and federal disability policy, workforce development policy, income maintenance and healthcare policy, and a wide array of work-related supports including transportation, housing, welfare, and childcare. Core supports are funded by state ID/DD and Vocational Rehabilitation (VR) agencies, and delivered by a network of over 8,100 CRPs. This section will address the influence of state funding for employment support, Medicaid and Social Security Administration policy, and CRPs in supporting employment outcomes.

State ID/DD agencies. State ID/DD agencies remain the primary source of long-term funding and service coordination for individuals with ID/DD, providing, funding, and monitoring a wide range of day and employment services. These services include employment supports, traditional facility-based options including sheltered workshops and non work day habilitation programs, community integration services, and more individualized options. Given their essential role, examining state ID/DD policies and practices is vital for understanding the factors that influence employment outcomes.
State VR agencies. State VR agencies provide services to over one million people annually with approximately 600,000 completing services and having their cases closed in each fiscal year. Approximately 12 percent, or 72,000 of those case closures can be identified as individuals with ID/DD (persons with a primary disability of mental retardation, cerebral palsy, epilepsy, or autism).

One-stop career centers. One-stop career centers, established and supported under the Workforce Investment Act, provide a largely underutilized resource for individuals with ID/DD. Only 1,337 individuals with ID/DD were referred to VR for services from one-stop centers in 2007.

Medicaid. Medicaid is both a primary source for health care for individuals with ID/DD and the largest federal source of funding for day and employment services under the Home and Community Based Services waiver program. In 2007, nine states also continued to support non work day habilitation services with Medicaid state plan funds. Despite expansion of Medicaid initiatives to support employment, including the Medicaid Infrastructure Grant program and expansion of state Medicaid buy-in programs, there is no preference for integrated employment in Medicaid funded services, and state Medicaid agencies have limited involvement in employment initiatives. In a study by Sulewski, Gilmore, and Foley (2006), state Medicaid agencies were asked about the provision of services to working people with disabilities and collaboration with disability- and employment-related agencies and services. Only one-third to one-half of respondents were involved in Workforce Investment Act implementation at the state level and/or were implementing a Medicaid buy-in option for working adults with disabilities. Collaboration with disability- or employment-focused agencies occurred at similarly moderate rates.

Social Security. SSA work incentives such as the Plan for Achieving Self Support (PASS) and Impairment-Related Work Expenses (IRWE) are designed to support employment by allowing individuals to exclude money, resources, and certain expenses from total earned income calculations. SSA also administers the Ticket to Work program, designed to provide beneficiaries with the ability to purchase Vocational Rehabilitation, employment, and other support services from any participating employment network or state VR agency of their choice. Despite SSA's initiatives, work incentives and the Ticket to Work program remain largely under-utilized. In 2006, on average only 35 SSI recipients per state had PASS plans and 115 recipients per state had IRWEs in place. That same year, only 6 percent of individuals on SSI were identified as working (SSA, 2006).

Community Rehabilitation Providers (CRPs). CRPs and their staff are the primary source of day and employment supports. Menz, Napp, Koopmann, and Hagen-Foley (as cited in Menz, 2004) estimated that over 8,100 CRPs nationwide offer vocational services to individuals with disabilities. The majority (70 percent) of those served by CRPs are individuals with ID/DD (Metzel et al., 2007). Over two thirds of CRPs provide work and non work services in both integrated and facility-based settings (Metzel et al., 2007). Findings indicate that 74 percent of individuals with ID/DD were supported in sheltered employment, day habilitation services, or non work community integration supports, while only 26 percent were working in integrated employment. Furthermore, 8 percent of those in integrated employment were in group supported employment models, including enclaves and mobile work crews. In a national survey of CRPs that provide sub-minimum wage employment, respondents reported that only 8.7 percent of staff work with individuals earning minimum wage or higher (Wehman et al, 2007).

Factors that Influence Employment Outcomes

States vary widely in the extent to which they support integrated employment. Research suggests a range of factors that influence access to employment opportunities and areas of focus for state policy and strategy.

High performing state ID/DD agencies. ICI's research on "high performing" state ID/DD agencies has identified policies and practices that support improved employment outcomes. ICI identifies high-performing states based on the percent of those served by the state's ID/DD agency that participate in integrated employment and the rate of growth in integrated employment. Strategies that characterize high-performing states include flexibility in funding and policies, communication of values through data, rewards and funding incentives, and innovation diffusion through relationships and training (Hall, Butterworth, Winsor, Gilmore, & Metzel, 2007). These strategies are most successful when they are embedded within the context of a solid values base, a network of dedicated stakeholders, and clarity about systemic goals.

Community-based non work (CBNW). As an emerging service model, participation in CBNW has grown steadily over the past 15 years, with state ID/DD agencies reporting that 31 percent of those served participated in FY2007. Results from a module in the 2001 survey of state ID/DD agencies indicated that CBNW (activities that do not involve paid employment and take place in the community) is loosely defined with respect to requirements, activities, populations served, and goals (Sulewski, Butterworth, & Gilmore, 2006). Although CBNW has the potential to enhance the lives of people with disabilities, these findings raise concerns, including how CBNW can be provided without taking resources or focus away from expanding integrated employment (Sulewski, Butterworth, & Gilmore, 2006) and the extent to which CBNW services support true community inclusion. CRPs, for example, have indicated that they more often support group and disability-specific community-based non work activities compared with other more individualized and integrated activities (Sullivan, Boeltzig, Metzel, Butterworth, & Gilmore, 2004).

Collaboration with VR. While policy under the Medicaid Home and Community Based Waiver program requires that states refer individuals to VR for employment support prior to providing ID/DD agency supports under waiver funding, collaboration is impeded by a wide range of systemic barriers, including disagreement about target populations, differing commitment to the goal of employment, differences in language and culture, and differences in resource availability (Timmons, Cohen, & Fesko, 2004; Timmons, Fesko, & Cohen, 2004). Despite such barriers, collaborative initiatives between VR and ID/DD agencies are beginning to emerge (Boeltzig, Timmons, & Marrone, in press; Hall, Boeltzig, Hamner, Timmons, & Fesko, 2006).

CRPs and integrated employment. Considerable variation exists industry-wide in the quality of CRP service provision (Surdick, Pierson, Menz, Hagen-Foley, & Ussif, n.d.). Some providers have successfully shifted emphasis to integrated employment support, including closing one or more facility-based programs (Brooks-Lane, Hutcheson, & Revell, 2005; Butterworth, Fesko, & Ma, 2000). Butterworth, Gilmore, Timmons, Inge, and Revell (2007) found that smaller organizations (those serving one to 40 individuals) had significantly higher rates of participation in individual and integrated employment. In addition, organizations that served all or mostly individuals with ID/DD had significantly lower participation in individual employment and significantly higher participation in sub-minimum wage employment. The survey results also suggest that organizational priorities and goals are critical influences in outcomes and may play a more central role than commonly accepted factors such as fear of benefits loss, family concerns, or transportation availability.

CRPs and direct support personnel. Although researchers have investigated the competencies and training needs of direct support professionals (DSPs) in residential settings (Larson & Hewitt, 2005; Larson et al., 2007), very little has been done to examine the same issues regarding DSPs who assist job seekers with disabilities. Yet, DSPs in integrated employment face complex responsibilities, ranging from dealing with the dynamics of a business world driven by profit to addressing people with disabilities' personal needs (Fesko & Temelini, 1997; Test, Flowers, & Hewitt, 2004; Wehman & Targett, 2001). Expanding knowledge about the roles and competencies of DSPs in employment is an area in need of further research.

Individual and family factors. Research has demonstrated that wages and hours worked increase dramatically as individuals move from facility-based to integrated employment, and suggests that less tangible benefits include expanded social relationships, heightened self-determination, and more typical job acquisition and job roles (Cohen, 2005; Mank, 2003; Murphy, Rogan, Handley, Kincaid, & Royce-Davis, 2002). Despite these advantages, individuals continue to enter facility-based and non work services at a higher rate than integrated employment. Researchers investigated what factors influence adults with ID/DD and their families to choose a facility-based setting over community-based employment (Migliore, Grossi, Mank, & Rogan, 2007; Migliore, Mank, Grossi, & Rogan, 2007), and found that the majority of respondents would at least consider community employment. Long-term placement, safety, and social environment emerged as the most important concerns when choosing an employment setting.

Methodology

For the past 20 years, the Access to Integrated Employment project, funded by the Administration on Developmental Disabilities, has described the nature of day and employment services for individuals with intellectual and developmental disabilities, and contributed to a comprehensive understanding of the factors that influence employment outcomes at an individual, service provider, and state policy level. This report provides statistics over twenty years from several national data sets that address the status of employment and economic self-sufficiency for individuals with intellectual and developmental disabilities (ID/DD).
We provide a comprehensive overview that describes national trends in employment for people with ID/DD, and the Appendix provides individual state profiles with data from four sources: ICI's ID/DD Agency National Survey of Day and Employment Outcomes from FY 1999, 2001, 2004, and 2007, and datasets from the Social Security Administration, Vocational Rehabilitation, and the American Community Survey. The Appendix provides a state by state analysis of major trends across each data set.

Data Sources

Data source: ID/DD Agency National Survey of Day and Employment Outcomes

The National Survey of Day and Employment Outcomes is a longitudinal study commissioned by the Administration on Developmental Disabilities to analyze community-based day and employment service trends between FY 1988 and FY 2007 for individuals with intellectual and developmental disabilities and closely related conditions. Between 1988 and 2004 the survey was administered on a semi-annual basis, however beginning in 2007 information will be collected on an annual basis. The most recent version of the survey is focused on state ID/DD agency data for fiscal year 2007.

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; and
• The allocation of funds across day and employment services.

The survey has been developed with input and field testing support from state ID/DD agency administrators. Core survey variables include the number served (total and by day and employment service categories), waiting lists, and expenditures by service and total funding by source. All questions focus on community-based day or employment services monitored by the state ID/DD agency, including services funded by another state agency (such as the Medicaid agency), even if the ID/DD agency does not provide or directly contract for the service. These items have not been changed since 1996, when the new category of community-based non work service was added. In FY01 states were offered the opportunity to complete the survey using a secure website. On the website, states' previous year's responses are listed for reference and updating if necessary.

The survey was most recently administered in March 2008 to ID/DD agencies in all 50 states and the District of Columbia. The agency director from each state and the previous respondents were contacted when the survey was first implemented. Initial contact was made by email and follow up was completed via email and phone calls.

For the most recent survey, states were asked to complete the survey using data from FY 2007. 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 location on the survey to provide this information. There is also a definition page that can be referred to from any page of the survey. States could also amend their FY 2004 data by clicking the "Edit 2004 Values" link at the bottom of the page.

State Demographics

State demographics are from multiple data sources. State population is taken from the Census web site. Unemployment data is taken from the Bureau of Labor Statistics web site, and earnings data is taken from the Bureau of Economic Analysis's website.

National Trends in Employment

ID/DD Agency National Survey of Day and Employment Outcomes

The data reported here are the core elements of the Institute for Community Inclusion's ID/DD Agency National Survey of Day and Employment Services. These data focus on participation in integrated employment, community-based non work services, and facility-based services. Data are solicited from the 50 states and the District of Columbia. The number of reporting states by variable varied from 37 to 45 over the time studied, with data projection used to estimate national totals for service participation. 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 to more than 100 percent. In addition, other services, including services for individuals who are elderly, are not reported.

Major findings include the following:

• There continues to be growth in states' investment in facility-based and non work services;
• Growth has continued in community-based non work services; and
• There is large variation across states in participation in integrated employment.

Growth in state investment in facility-based and non work services.

In Fiscal Year (FY) 2007, an estimated 566,895 individuals received day or employment supports from state intellectual disability/developmental disability (ID/DD) program agencies. This number grew from 412,602 in FY 1996. Despite this growth, the number of individuals supported in integrated employment only grew from 98,829 in FY1996 to 115,293 in FY2007. State investment in supports continues to emphasize facility-based and non work services rather than integrated employment services.

In FY2007, an estimated 20.3 percent of individuals receiving day supports from state ID/DD agencies participated in integrated employment, whereas 53.4 percent of individuals were supported in facility-based settings. Although the data demonstrate a decline in the percentage of people served in facility-based settings (from 72 percent in 1996 to 53.4 percent in 2007), they also indicate a slight decrease in the percentage served in integrated employment following the peak of 24 percent in 2001. The data also suggest that the growth seen in supported employment between the mid-1980s and mid-1990s has not continued.

Facility-based settings continue to make up the largest percentage of expenditures for day and employment services. Nationally, states report that facility-based work and facility-based non work services received 47 percent of the funding for day and employment services, whereas integrated employment received 11.2 percent of the funding in FY 2007. These data have fluctuated slightly since 1996, when a reported 11 percent of funding was allocated to integrated employment and 66 percent toward facility-based work and non work services.

Growth in community-based non work.

Nationally, participation in community-based non work services has grown steadily for states that report it as a service, from 12.5 percent in FY1996 to 31 percent in FY2007. First added to the survey as a service option in FY1996 in response to state feedback, the number of states reporting the total number of individuals in community-based non work has grown from 18 in FY1996 to 30 in FY 2007 (see Table 5). Community-based non work services accounted for 41.8 percent of state ID/DD agency expenditures for FY2007, for states that reported the service. Growth in supports for community-based non work may reflect a growing emphasis on community presence, although the contribution of this service to community participation remains unclear. There is currently limited data on the structure, activities, and outcomes of this service, and states have not established clear service expectations or quality assurance strategies (Sullivan, Boeltzig, Metzel, Butterworth, & Gilmore, 2004).

Figure 1: Service Distribution by Service Category by Year

Participation in integrated employment varies widely across states.

The substantial variability in participation in integrated employment across the states suggests that some states have been effective in developing policy and strategy that expand community membership (see Table 5). Four states reported serving less than 15 percent of individuals in facility-based settings, and since FY2004 Vermont has reported that the state did not serve any individuals in facility-based settings. Four states reported serving more than 40 percent of individuals in integrated employment. Data from these states suggest that individual states have the ability to institute policies and practices that support improved employment outcomes.

Table 5: Participation in Day and Employment Services in FY2007

State	Total Served	% Integrated Employment	% Community- Based Non work	% Combined Facility-Based Settings
AK	1,394	24%	54.5%	-*
AL	5,269	5%	0%	95%
AR	--	-	-	-
AZ	-	-	-	-
CA	78,250	11%	74%	15%
CO	5,731	27%	59%	62%
CT	8,433	56%	44%	9%
DC	1,449	7%	10%	78%
DE	1,546	26%	1%	68%
FL	18,692	23%	27%	58%
GA	-	-	-	-
HI	2,865	4%	98%	56%
IA	-	-	-	-
ID	6,980	5%	30%	58%
IL	25,500	10%	0%	94%
IN	12,491	25%†	12.5%	62%
KS	5,991	19%	54%	80%
KY	7,975	17%	29%	54%
LA	4,139	34%	2%	64%
MA	14,038	22%	12%	65%
MD	9,768	38%	0%	62%
ME	-	-	-	-
MI	-	-	-	-
MN	-	-	-	-
MO	4,030	9%	2%	94%
MS	5,904	7%	70.5%	40%
MT	-	-	-	-
NC	-	-	-	-
ND	1,782‡	-	-	-
NE	3,668	33%	0%	77%
NH	2,159	45%	49%	5%
NJ	9,081	15%	5%	80%
NM	3,056	32%	31%	65%
NV	1,919	20%	2.5%	77%
NY	55,420	15%	67%	32%
OH	32,133	23%	4%	66%
OK	4,168	61%	30.5%	53%
OR	3,834	5%	10.5%	67%
PA	-	-	-	-
RI	-	-	-	-
SC	7,549	30%	0%	83%
SD	2,307	24%	24%	100%
TN	7,770§	22%	-	-
TX	40,038	9%	28%	46.5%
UT	2,670	33%	72%	0%
VA	11,259	21%	2.5%	79%
VT	2,252	39%	61%	0%
WA	7,183	57%	4%	11%
WI	10,338**	33%	-	-
WV	-	-	-	-
WY	1,216	20%	15%	65%

*Data not provided.
†Percent served in integrated employment, community based non work, and combined facility based settings only represents individuals receiving state, county, or local IDDD funds.
‡State only reported total served.
§FY2007 data furnished from source outside of state ID/DD Agency.
**State only reported total served and total integrated employment.

Trends in Rehabilitation Services Administration outcomes for individuals with ID/DD

This section describes trends in outcomes of the VR program for adults with intellectual and developmental disabilities (ID/DD) during the period of fiscal years 1995 to 2007 .

In summary:

• The majority of closures for people with ID/DD were for people with intellectual disabilities, and about half of the closures in 2007 were young adults of transition age.
• Whereas the overall number of closures remained relatively constant, the number of closures in employment declined.
• Weekly earnings in integrated employment slightly increased, even after adjusting for inflation and in spite of a decline in the weekly work hours. However, earnings are substantially lower than those of the general population.
• The time from application to closure in integrated employment increased.
• The VR outcomes for individuals with ID/DD varied substantially across states.

The majority of closures for people with ID/DD were for people with intellectual disabilities and about half of the closures were young adults of transition age.

In 2007, 83 percent of the VR closures for people with ID/DD were of people with intellectual disabilities; 6 percent of closures were for people with epilepsy; 7 percent for people with cerebral palsy, and 3.7 percent for people with autism. The percentage of closures for people with epilepsy declined from 10 percent in 1995 to 7 percent in 2007, and the percent of closures for people with autism increased from 1 percent in 1995 to 3.7 percent in 2007.

The majority of VR customers with ID/DD were male (57 percent) and the average age at application was 27. Of all the closures in 2007, 49 percent were between 16 and 21 years old. This figure increased over the years from 28,805 (40 percent) in 1995 to 34,894 (49 percent) in 2007. Most closures in 2007 involved people of white ethnicity (69 percent).

Whereas the overall number of closures remained relatively constant, the number of closures in employment declined.

In 2007, VR closed 70,993 cases for people with ID/DD, of which 27,859 were closures in employment, a figure 15 percent smaller than in 1995. The decline occurred mostly between 2001 (N = 33,485) and 2002 (N = 29,992), when VR discontinued counting extended employment (sheltered workshop) as an employment outcome.

Figure 2: Total Closures and Employment Closures

In 2007, 99 percent of the closures in employment were in integrated employment (N = 27,524), with the remaining closures in self-employment (0.5 percent) and unpaid family worker, homemaker, and Business Enterprise Programs. Over the years, the percentage of closures in each of these types of employment did not substantially change. It is noteworthy that some whose cases were closed in integrated employment already held that status at the date of application. In 2007, for example, 16 percent of people who were placed in integrated employment had an integrated job at application (N = 4,417). The figure fluctuated between 13 percent (N = 3,507) in 1995 and 19 percent (N = 5,471) in 2001. In contrast, the percentage of closures in integrated employment for applicants who were in extended employment (sheltered workshops) at the time of application decreased steadily from 10 percent (N = 2,730) in 1995 to only 1 percent (N = 390) in 2007.
We found that the variation of the number of closures in integrated employment over the period from 1995 to 2007 was correlated with the unemployment rate in the general population. Specifically, about 32 percent of the variation in VR closures in integrated employment could be explained by the variation in unemployment rate in the general population (Pearson coefficient r = - 0.57).

Weekly earnings in integrated employment increased slightly, even after adjusting for inflation and in spite of a decline in the weekly work hours. However, earnings are still substantially lower than in the general population.

In 2007, weekly earnings in integrated employment averaged $211; this figure grew from $147 in 1995, showing a 3 percent average annual increase. If adjusted for inflation based on the Consumer Price Index (US Department of Labor, 2006) and expressed in 2007 dollars, however, weekly earnings only increased from $200 in 1995 to $211 in 2007, with a top figure of $219 during the years 2000 through 2003 (See Figure 3). In 2007, people who were placed in integrated employment worked, on average, 26.3 hours per week, the minimum recorded during the period studied. The highest average number of work hours per week was 28.5 in 1995 (M = 27.3; SD = 0.8).
It is noteworthy that, as Figure 3 shows, the gap between earnings of adults with ID/DD at closure and personal income in the general population is very large and widening slightly over time.

Finally, we found that about 35 percent of the amount of earnings in integrated employment --expressed in 2007 dollars-- was explained by per capita income in the general population (Pearson coefficient r = - 0.59)

Figure 3: Inflation Adjusted Weekly Earnings and Per Capita Income

The time from application to closure in integrated employment increased.

VR typically closes cases when applicants have been in employment for at least 90 days. In 2007, each closure in integrated employment required 723 days on average from the time of application. This figure was the greatest over the period studied, whereas the smallest figure was 673 days in 2003 (M = 698; SD = 14). The average number of days from application to closure was substantially smaller if excluding applicants who were students or received postsecondary services, or who already had a job at the time of application (563 days in 2007).

VR outcomes varied substantially across states.

Table 6 shows that the VR outcomes varied substantially across the 50 states and the District of Columbia (FY 2007). The rehabilitation rate, for instance, ranged between 30 percent in Hawaii and 79 percent in Vermont and Utah (mean = 60 percent). The rehabilitation rate is calculated as: closures with an employment outcome / closures with an employment outcome + closures without an employment outcome after receiving services. Weekly earnings at closure ranged from $145 in Wyoming to $359 in the District of Columbia (mean = $214). Finally, the weekly work hours varied from 18 in Vermont to 34 in the District of Columbia (mean = 26).

Table 6: VR Outcomes for Individuals with ID/DD across States and DC in FY 2007

State	Total closures	Rehabilitation rate*	Weekly earnings	Weekly hours
Minimum	69	30%	$145	18
Maximum	5,809	79%	$359	34
Mean	1,377	60%	$214	26
Median	909	61%	$216	26
Alabama	2,059	66%	$218	30
Alaska	159	70%	$284	25
Arizona	761	63%	$255	28
Arkansas	567	40%	$270	30
California	5,809	61%	$223	29
Colorado	909	69%	$192	23
Connecticut	405	53%	$239	25
Delaware	267	75%	$256	30
DC	69	64%	$359	34
Florida	2,303	51%	$191	24
Georgia	2,900	57%	$236	32
Hawaii	295	30%	$208	26
Idaho	557	70%	$158	21
Illinois	2,999	63%	$204	25
Indiana	2,559	59%	$171	23
Iowa	1,355	59%	$228	28
Kansas	824	65%	$185	25
Kentucky	1,586	66%	$218	26
Louisiana	1,020	42%	$233	28
Maine	480	59%	$168	19
Maryland	1,237	55%	$235	26
Massachusetts	1,026	61%	$236	23
Michigan	2,433	52%	$187	24
Minnesota	1,196	69%	$237	27
Mississippi	879	48%	$219	30
Missouri	2,824	72%	$215	27
Montana	279	62%	$163	22
Nebraska	447	63%	$228	30
Nevada	268	60%	$236	28
New Hampshire	255	72%	$170	21
New Jersey	1,022	65%	$233	25
New Mexico	441	56%	$223	24
New York	3,893	59%	$211	24
North Carolina	4,227	52%	$188	25
North Dakota	242	66%	$214	27
Ohio	3,368	55%	$204	26
Oklahoma	762	33%	$246	31
Oregon	1,249	69%	$216	24
Pennsylvania	3,018	57%	$240	27
Rhode Island	317	66%	$175	21
South Carolina	747	59%	$256	33
South Dakota	428	70%	$175	24
Tennesse	1,927	65%	$161	22
Texas	3,099	54%	$235	27
Utah	500	79%	$213	26
Vermont	389	79%	$168	18
Virginia	1,956	64%	$213	28
Washington	1,684	60%	$194	22
West Virginia	571	56%	$228	30
Wisconsin	1,520	45%	$178	22
Wyoming	139	77%	$145	20

*Based on people who received VR services

Trends in American Community Survey (ACS) Data

Data show that people with disabilities are consistently less likely to be working than their non-disabled counterparts. This data set 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. We define "working-age" as non-institutionalized people ages 16-64. The employment rate is calculated by dividing the number of people who are employed by the total civilian working-age population in the state. The data presented below will emphasize the ACS disability category of mental disability as the closest proxy for individuals with intellectual and developmental disabilities.

Several major trends emerged in the data set:

• Employment declined for individuals with any disability, and for individuals reporting a mental disability.
• While wages increased slightly overall, wages declined for individuals with any disability and individuals reporting a mental disability. Mean weekly hours worked declined slightly for all individuals, including those with any disability and those with a mental disability.
• Rate of employment for the general population is correlated with rate of employment for persons with disabilities.
• People with disabilities are disproportionately represented in the field with the lowest projection for job growth and in the lowest paying professions.

Employment declined both for individuals with any disability, and individuals reporting a mental disability.

In 2000, 48.3 percent of those reporting any disability were employed. By 2006, only 35.7 percent of individuals with any disability were working, with the biggest decrease occurring between 2002 and 2003 (from 44.2 percent to 37.3 percent). The percent of those with a mental disability who were employed decreased steadily from 33 percent in 2000 to 26.8 percent in 2006. In contrast, the percentage of all people who were employed decreased only slightly, from 71.7 percent to 69.6 percent between 2000 and 2006.

While wages increased slightly overall, wages declined for individuals with any disability and individuals reporting a mental disability. Mean weekly hours worked declined slightly for all individuals, including those with any disability and those with a mental disability.

Weekly wages increased from $532 in 2000 to $601 in 2006 for all working-age residents. People with disabilities experienced a trend in the opposite direction. Weekly wages for people with any disability decreased from $353 in 2000 to $288 in 2006. Similarly, wages for people with a mental disability decreased from $234 in 2000 to $188 in 2006. Mean weekly hours worked remained more consistent, shifting only slightly from 40 hours in 2000 to 39 hours in 2006 for all working-age residents. For people reporting any disability, the number declined from 38 to 37 during the same time period, while those with a mental disability reported a decline from 35 to 33 hours.

Rate of employment for the general population is correlated with rate of employment for persons with disabilities.

In 2005, employment rates for people with disabilities averaged 37.4 percent, ranging from 25.4 percent in West Virginia to 54.2 percent in North Dakota. Employment rates for people without disabilities ranged from 70.4 percent in West Virginia to 82.7 percent in North Dakota. The gap in employment rate between people with and without disabilities ranged from 24.2 percent in Utah to 45.3 percent in Kentucky, with a national average of 37 percent.

Researchers calculated a rank-order correlation to test the relationship between employment rates for people with and without disabilities across all states. The results showed a moderate to strong relationship (rs = .671 significant at = .01): states that have a high employment rate for people without disabilities tend to also have a high employment rate for people with disabilities.

Table 7: Employment Rates (Working-Age Population) in 2005

State	With disability (%)	Without disability (%)	Rate gap (%)
AK	48.1	72.7	24.6
AL	32.5	73.2	40.7
AZ	37.9	73.6	35.7
AR	34.2	75.4	41.2
CA	36.7	71.2	34.5
CO	45.1	77.1	32.0
CT	42.3	76.9	34.6
DE	43.0	76.6	33.6
DC	35.0	73.1	38.1
FL	36.5	73.9	37.4
GA	35.7	74.0	38.3
HI	41.2	74.8	33.6
ID	43.5	75.3	31.8
IL	38.6	73.9	35.3
IN	39.5	75.6	36.1
IA	43.7	81.4	37.7
KS	44.7	79.7	35.0
KY	28.5	73.8	45.3
LA	32.0	70.5	38.5
ME	37.6	80.0	42.4
MD	42.4	77.5	35.1
MA	37.1	77.1	40.0
MI	35.1	73.2	38.1
MN	44.9	80.8	35.9
MS	30.2	71.8	41.6
MO	38.5	77.1	38.6
MT	49.5	77.6	28.1
NE	43.6	81.2	37.6
NV	39.6	75.0	35.4
NH	40.4	81.6	41.2
NJ	38.9	74.5	35.6
NM	37.8	72.2	34.4
NY	35.1	72.2	37.1
NC	36.5	75.5	39.0
ND	54.2	82.7	28.5
OH	36.7	75.7	39.0
OK	38.0	74.8	36.8
OR	41.1	74.8	33.7
PA	35.5	75.3	39.8
RI	38.4	79.2	40.8
SC	32.2	74.1	41.9
SD	51.7	81.4	29.7
TN	32.1	74.8	42.7
UT	52.2	76.4	24.2
TX	39.3	72.1	32.8
VT	43.5	81.6	38.1
VA	40.0	76.5	36.5
WA	41.9	74.3	32.4
WV	25.4	70.4	45.0
WI	43.5	79.1	35.6
WY	50.9	79.9	29.0
US total	37.4	74.4	37.0

People with disabilities are disproportionately represented in the field with the lowest projection for job growth and in the lowest paying professions.

While it is well-documented that people with disabilities have a significantly lower rate of employment than people without disabilities (36 percent versus 74 percent according to the 2006 ACS), less is known about the types of jobs they hold. Using the occupational classification system within the ACS, researchers explored the prevalence of people with disabilities within occupational groupings and its relationship to occupational growth . Future analysis will address variation across disability groups.

People with disabilities constitute 6.5 percent of all working-age individuals who are employed in the United States. Figure 4 shows the prevalence of people with disabilities across the occupational groupings. The group "management, business, and financial operations" has the lowest percentage of people with disabilities (4.4 percent). The categories with the highest prevalence of people with disabilities are "production, transportation, and materials moving" (8.7 percent) and "service occupations" (8.4 percent). Detailed occupational categories can be found in Figure 5.

The US Department of Labor projects that approximately 18.9 million new jobs will be created between 2004 and 2014. Of the occupations shown in Figure 4, "production, transportation and materials moving," which presently has the highest percentage of people with disabilities within any category, is projected to have the lowest number of new jobs (approximately 1 million). The greatest growth in jobs is projected to be in "professional and related occupations," an area where very few people with disabilities presently work. Moreover, "production, transportation, and materials moving," and "service" occupations were the two lowest paying occupational groups.

Figure 4: Percentage of People with Disabilities across Occupational Groups

Figure 4: Percentage of People with Disabilities across Occupational Categories

Trends in Social Security Administration Data

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

States' economies impact all workers, including those who receive SSI.

• Work incentives remain largely underutilized.
• States' economies impact all workers, including those who receive SSI.

Many people who receive SSI benefits are unemployed. However, in 2006 the percentage of SSI recipients who were working varied considerably by state. To understand this variation, researchers correlated the percentage of employed SSI recipients with 2006 state unemployment rates. The following table shows the percentage of SSI recipients who were working in 2006 and state unemployment rates (UR), rounded to the nearest percentage point.

A significant inverse correlation was determined, r = -.669, p < .001, indicating that the higher percentages of SSI recipients who were working in 2006 correlate to lower state unemployment rates. This finding suggests that a state's economic situation impacts all workers, including those who receive SSI benefits.

Table 8: Percentage of SSI Recipients who Worked and Unemployment Rate by State for 2006

State	Percent Working	Unemployment Rate
AK	7.0%	8.9%
AL	3.0%	7.0%
AR	5.0%	7.2%
AZ	5.0%	5.1%
CA	5.0%	6.6%
CO	8.0%	5.4%
CT	8.0%	6.3%
DC	4.0%	8.9%
DE	7.0%	5.8%
FL	4.0%	5.5%
GA	4.0%	6.9%
HI	6.0%	4.6%
IA	17.0%	4.8%
ID	9.0%	5.3%
IL	6.0%	7.3%
IN	6.0%	7.0%
KS	12.0%	5.0%
KY	3.0%	7.1%
LA	4.0%	7.8%
MA	7.0%	5.9%
MD	8.0%	5.4%
ME	7.0%	5.1%
MI	7.0%	9.5%
MN	15.0%	5.4%
MO	7.0%	6.3%
MS	3.0%	8.9%
MT	13.0%	4.7%
NC	5.0%	6.7%
ND	19.0%	3.2%
NE	15.0%	5.1%
NH	9.0%	4.3%
NJ	6.0%	6.4%
NM	5.0%	6.9%
NV	7.0%	5.2%
NY	6.0%	6.6%
OH	7.0%	7.3%
OK	6.0%	5.9%
OR	8.0%	6.4%
PA	5.0%	6.3%
RI	6.0%	5.6%
SC	5.0%	7.3%
SD	18.0%	4.0%
TN	4.0%	7.5%
TX	4.0%	7.1%
UT	12.0%	4.2%
VA	6.0%	4.7%
VT	10.0%	5.6%
WA	6.0%	6.6%
WI	12.0%	5.9%
WV	3.0%	6.4%
WY	16.0%	3.6%
Mean of all states	7.6%	6.1%

Work incentives remain largely underutilized.

To encourage employment for individuals with disabilities, the Social Security Administration (SSA) offers special provisions that limit the impact of work on Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. These work incentives include the Plan to Achieve Self-Support (PASS), Impairment-Related Work Expenses (IRWE), and Blind Work Expenses (BWE).
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 current expenses from income that are necessary for work, such as wheelchairs, transportation, or specialized equipment. BWE allows the exclusion of expenses such as service animals, income taxes, and visual/sensory aids.

A notable trend is the sharp drop in the number of people enrolled in the PASS program in 1996. This decline followed a publication of the General Accounting Office that criticized SSA for being too lenient in accepting applicants into a program they deemed to be ineffective for achieving the goal of self-support. The procedures for acceptance were then reevaluated by SSA and amended, resulting in fewer approvals in subsequent years.

Table 9: National Mean Number of People Enrolled per State in Work Incentive Programs from 1990 to 2006

	1990	1992	1994	1996	1998	2000	2002	2004	2006
PASS	44	115	203	92	21	27	34	32	35
IRWE	106	153	186	192	182	184	158	137	115
BWE	86	87	86	83	75	76	66	57	47

Conclusion

From varying perspectives, each dataset that is included in this report sheds light on the economic disparities that people with intellectual and developmental disabilities have experienced over the past decade and beyond. Vastly more individuals continue to be supported in facility-based employment, earning sub-minimum wage, than in integrated employment earning a living wage. A disproportionate number of individuals with disabilities work in low-wage settings as compared to the general population. In the Vocational Rehabilitation system, the gap between earnings of adults with disabilities at closure and personal income in the general population is large and widening over time. Overall the findings suggest the need for a renewed and shared focus across several systems:

• ID/DD state agencies show a continued investment in facility-based and non work services, and an uneven commitment across states towards the expansion of community employment. While individual states show promise, as a whole trends continue to challenge the vision of greater employment opportunity.
• Overall some VR trends are encouraging, most notably an increased engagement with individuals at the point of transition from educational services and growth in earned income at closure. The VR program has made substantial progress by discontinuing the counting of closures in extended employment as employment outcomes; moreover, earnings at closure were showing a growing trend even after adjusting for inflation and in spite of a reduction in work hours. Other, more challenging trends, however, include limited rates of closures in employment, and expanding timeframes for delivering outcomes.
• ACS data show that people with disabilities are disproportionately represented in the occupational category with the lowest projection for job growth. This suggests that community rehabilitation providers and individuals need to focus their efforts in developing employment opportunities in fields that have higher potential for growth and expand their search into non-stereotypical career areas. Moreover, data shows that people with disabilities are substantially over-represented in labor categories with the lowest wages.
• ACS data also show that employment was on the decline for individuals with any disability, and for individuals reporting a mental disability. Moreover, while wages increased slightly overall, wages declined for individuals with any disability and individuals reporting a mental disability. Mean weekly hours worked declined slightly for all individuals, including those with any disability and those with a mental disability.
• Despite federal efforts to increase the utilization of work incentives such as PASS, IRWE, and BWE programs, SSA data show consistently low numbers of people enrolled across states.

Multiple data sets offer varying perspectives on the employment situations of individuals with disabilities, and specifically intellectual and developmental disabilities. While the data do show some progress within particular systems over time (e.g., the gradual reduction in the number of individuals working in sheltered employment and increased earnings of individuals who are exiting the VR system), there continues to be an urgent need for a re-investment of attention, priority, and resources dedicated towards expanding both economic and employment opportunities for individuals with intellectual and developmental disabilities.

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Staff Directory Barbour, Quinn Bayard, Lucy Berman, Lauren C. Birnbaum, Margot Boeltzig, Heike Bose, Jennifer Boyle, Molly Bozeman, Laura Butterworth, John Coburn, Jeff Cohen Hall, Allison Cote, Gil Cox, Monica Crocker, Allen Cully, Julisa D'Alotto, Brenda Enein-Donovan, Lara Fallon, Erin Fesko, Sheila Lynch Flippo, Karen Foley, Susan Freeze, Suzzanne Gandolfo, Cecilia Gelb, Amy Germaine, Jill Glazier, Drew Gobert, Chad Gragoudas, Stelios Halliday, John Harrison, Pam Hart, Debra Haven, Valerie Claire Helm, David Hoff, David Hurley, Nancy Hutchinson, Mark Jordan, Melanie Keleher, Jon Keyes, Kristen Kiernan, William Klemm, Martha Kramer, John Kugler, Rick Kusminsky, Matthew Lombardo, Angela Love, Mary Lu Marrone, Joe Matulewicz, Holly L. McCulley, Bob Migliore, Alberto Munir, Kerim NCWD/A, Nemeth Cohen, Rachel Osborne, Priscilla Paiewonsky, Maria Porter, Stephanie Putnam-Franklin, Sandy Reyes-Albino, Berenise Robbins-Cureau, Amelia Rubin, Emily Shea, Joshua Silverstein, Robert Smith, Frank A. Smith, Sandy (Alexandra) Soloff, Elesheva Sotnik, Paula Speach, Kate Sulewski, Jennifer Sullivan Szymanski, Ludwik S. Temelini, David Theriault, Su Thomas, Cindy Timmons, Jaimie Ciulla Tobar, Alvaro Van Thiel, Lisa vanBruinswaardt, Caroline Webb, Rachael Weir, Cate Wheeler, Jason Winsor, Jean E.

Project Directory About ICI Access to Integrated Employmen... Boston Ready Culture Brokering Down Syndrome Program E-Government for All EEOnline.org Emerging Disabilities For the Media Gopen Fellowship ICI Employment Services ICI ForEmployers LEND Program Linking Hands MA FOCUS Making Connections Mass. Partnership for Youth in... MASSTART MassWorks MCAS-Alt MI-CEO Natl Ctr on Workforce & Disabi... Natl Service Inclusion Project NE Job Development Training NE Regional Ctr. for Vision Ed... Opening Doors Partnerships for Employment Project FOCUS Academy Project Impact Special Ed & Disability Policy... StateData.info T-TAP TACE Center ThinkCollege.net Twa Zanmi Project US/UK routes to work for peopl... VR-RRTC Workforce Development Excellen...