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Employment Data Systems : Washington State's Division of Developmental Disabilities

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Originally published: 3/2011

Series Introduction

The increasing emphasis on government accountability at the state and federal levels has increased interest in and use of outcome data. Moreover, research has found that high performing states in integrated employment generally have a clear and visible data collection system that provides individual outcome data (Hall, Butterworth, Winsor, Gilmore, & Metzel, 2007). But what are the most important elements in designing and using such a system? Stakeholders have raised questions regarding creating effective data collection systems, identifying variables with the most utility for influencing policy, and using data as a strategic planning tool. This series is intended to shed light on the successes and challenges of collecting data on day and employment services across several states and to provide strategies for other states as they examine their own data collection systems and the systems' impact on their priorities for employment for individuals with intellectual and developmental disabilities (ID/DD). During the spring and summer of 2008, Institute for Community Inclusion (ICI) researchers conducted interviews with key state and local informants who were recommended as being knowledgeable about their states' data collection system. State policy documents and state websites also contributed to data collection.

Background

Washington State's Division of Developmental Disabilities (DDD) policy "designates employment supports as the primary method of furnishing state-financed day services to adult participants." All individuals not currently employed in the community are to be working toward obtaining a job in the community (WA DSHS, DDD, "County Services for Working Age Adults" Policy 4.11). While data on individual service outcomes in the state have been collected for many years, the data collection has been incorporated into the formal collection of billing and reporting data. The collection of billing and reporting data on individual outcomes is an additional method to ensure that providers are fulfilling their obligation to support individuals in community employment or in services that support the individual's employment plan.

Data system basics

The design of the data system

In Washington State, the state DDD office subcontracts with county Developmental Disabilities (DD) offices for the administration of state-funded employment and day program services, and statewide, counties typically contract with private providers (vendors) for the delivery of these services. In a few small counties, county staff may provide the employment services. The data collection system is an integral part of the billing and reporting process that vendors, counties, and DDD engage in to provide and fund services. Vendors provide outcome data on the activities that each individual they support participated in during the billing month. The vendor or a county DD staff member enters the data into an Excel spreadsheet which is then uploaded to the state DDD office. These data are used by the state DDD to reimburse county DD offices for the funds used to pay vendors.

What data elements are collected

Data are collected on the basic demographic identifiers of each adult, as well as the data on each of the following services that an individual receives:

Please see the Appendix section for a detailed overview of the employment variables DDD collects.

Who it is collected on

Data are collected on each adult who received day and employment services in WA during the timeframe of the data collection.

Frequency of data collection

In WA, data collection occurs monthly. This is because the data collection system is tied to the billing system and billing occurs on a monthly basis.

Standardization across the state

WA developed standard definitions for each of its service delivery categories and for the data collected through the billing system. Respondents noted the importance of having standardized definitions for ensuring that the information is accurate. The definitions are documented in the Budget Accounting and Reporting System (BARS) manual. The BARS manual prescribes "accounting, budgeting and reporting requirements for all local governments (WA State Auditors Office, 2009)", and is the basis for determining the activities that county DD offices are allowed to enter into contract with vendors to provide. The manual is made available to county DD staff and provider staff.

It is believed that because the data is linked to the service billing system, both providers and counties take great care to ensure that data submitted for individuals is accurate. The ultimate responsibility for ensuring that the services vendors have billed for were provided rests with the counties.

Linked systems

Respondents reported that the collection of employment data has been linked to the service billing system since the mid-1980s. State administrators note that linking these systems reinforces the importance that the state places on seeing people employed.

Data sources

In WA, employment outcome data are collected as part of the billing system. Data are collected on a monthly basis from the billing information provided by vendors and submitted to the state from the county DD offices.

How the data are used, shared, and analyzed

Using the data at the statewide level

The state DDD uses the data collected through the billing system to produce standardized reporting measures. The measures include the ratio of funding provided to income earned, total number of individuals receiving services, total and average hours worked, total and average earnings achieved, total and average DDD funding share, and total and average service hours. The analysis is reported by region, county, and provider. The data system also allows for the analysis of individual service outcomes, and DDD is able to determine on a monthly basis individuals who are employed vs. those individuals who are between jobs or participating in job development.

Overall, the data are used at the state level to provide information for the DDD Director's reports to the state legislature, to evaluate the success of initiatives to increase employment outcomes, to track the use of Legislative Proviso and Medicaid Waiver expenditures, and to respond to national surveys. The data have also been used as a measure of the state's longitudinal success in the provision of employment services.

Using the data at the county level

The state provides county DD offices with standardized reports based upon the data collected through the billing system, although there is not a consistent statewide method for using the reports at the county level. Many counties also have the ability to retain their billing data and produce standardized reports that focus on their county. Counties can also access the state data system and retrieve data for their county. Some counties also have customized software that gave them more flexibility to analyze their billing and reporting data.

Use of the data varies on a county-to-county basis. Information collected from several different counties found that data are used to assess county employment outcomes, provide feedback to employment services vendors, and to assess individual employment services. One interviewee noted that the individual-level outcome data are a crucial piece of information that is used to determine whether employment providers are offering the services needed to ensure that the Working Age Adult Policy is implemented for every individual.

Several counties used the data to assess their overall success providing employment services. The ability to track the number of people employed, wages earned, and hours worked over time, was reported as being valuable. Additionally, the ability to link dollars spent on employment services to wages earned was an important tool in measuring the ability of the county to maximize the utility of available funds.

Two counties noted that they use the data to provide information to county-level elected officials and county- level advisory boards. One county specifically outlined the use of the data with their elected officials and advisory board members. Over time these groups have become vested in not only assessing the county's employment outcomes (wages, hours, private sector employers, and public sector employers) but in improving the outcomes. Members of these groups now offer to facilitate relationships between employment service providers and employers to support better employment outcomes. This county also reported using data on the wages earned to illustrate the tax revenue that would be lost if employment services were reduced for people with IDD. The county examines their data on a quarterly basis and tracks its progress over time. Data are reported not only in narrative form but also in chart form so that changes over time can be fully understood.

Counties varied in their use of data with providers. Several counties have used the data to identify weaknesses within their contracted employment providers and develop plans to correct the problems. Some counties use the data as a way to supply feedback to providers about the amount and types of employment outcomes they have provided. One county noted that they have used the data to have conversations with providers about the relationship between services and outcomes. One respondent felt that providers appreciated that the data were being shared with them, reinforcing the sense of ownership providers feel about the types of outcomes they produce. Counties did not consistently share data about each provider's outcomes. In counties that did share outcomes with other employment vendors, respondents noted that the information helped create a healthy sense of competition amongst providers and served as a challenge to continue to produce better outcomes.

Data are also used at the county level to assess individual employment services. One county noted that they share individual-level data with case managers. Another county shared that they have used the data as a way to initiate conversations about the specific services an individual was receiving, and as a tool to monitor service provision. For example, one respondent noted, "We would take the data with us to onsite monitoring visits with providers. A provider would report 10 hours of support, and we could ask what activities happened during those 10 hours.

Counties reported that they share data with individuals, their families, and advocacy groups when requested. One county noted that while this does not happen frequently, individuals who self-direct services and their families do request data on wages earned, hours worked, and employer names on a provider-level basis.

Using the data at the local level

DDD does not directly share the data or the results of the analysis of the data with providers, individuals and families, or advocacy groups. However, the data are considered a part of the public record and anyone can request the information from DDD, although these requests are not typical. Also, some county DD offices initiate the sharing of data at the local level as described above.

An analysis of the system: successes and challenges

What's working well

Respondents noted that the billing and reporting system is viewed as a tool that produces accurate data. The standardized administration of the data collection system ensures that the data are consistent across the state and allows for the comparison of employment outcomes on a county and regional basis. Counties like that they are able to produce ad hoc reports from the state system and can also create additional reports on their counties.

Challenges within the system

While overall the data system has worked well for many years, there have been some recent challenges related to the transition to a new online data system. The challenges described were a reduction in the level of detail of the infor- mation collected, a reduction in the types of ad hoc reports that are available to counties, and the absence of a method to amend previously submitted data within the new online system. Counties have expressed these challenges to DDD staff and there is a shared expectation that these challenges will be addressed in future revisions of the online system.

Moving forward: areas for future development

In April 2008 the new online version of the data collection system was launched. Training was provided across the state to instruct county DD staff how to use the online server. Despite some challenges related to the transition, overall the change is viewed as an improvement over the old paper process. DDD is hopeful that the online system will, over time, reduce the time it takes to enter a new individual into the system and allow the provider to more quickly begin billing for services, reducing the need for providers to back bill. In the future DDD hopes to collect information on employers, benefits planning, and employment benefits.

DDD has recently begun assessing the level of employment support needed for each individual receiving services and has added this information as a data collection variable. Level of employment support need for individuals is determined from scores on assessments of behavior, medical needs, interpersonal support, activities of daily living (ADL), mobility, the Employment Activities Supports Intensity Subscale (SIS)1 , and environment (work history, transportation, job match, and other barriers).

Lessons learned and implications for other states

Recommendations from stakeholders in WA to other states that are developing a data collection system include:

Conclusion

WA has been collecting employment outcome data as a component of its billing and reporting system for many years. Respondents noted the importance of their longitudinal data collection system in assessing state and county progress towards fulfilling the goal of employment for all people with ID/DD. The data also allow WA to measure whether individuals are earning wages that allow them to live outside of poverty, to assess the relationships between funding support cost and wages earned for specific types of employment services, and to determine the impact of local economic conditions on the employment of people with ID/DD. Stakeholders felt strongly that without the data collection system, WA would not be challenged to provide high quality employment services.

1 The Employment Activity Support Subscale is Part D on the AAIDD Supports Intensity Scale (SIS). This subscale assesses an individual's general support needs to find and keep a job based upon the following activities: accessing/receiving job/task accommodations; learning/using specific job skills; interacting with co-workers; interacting with supervisors/coaches; completing work-related tasks with acceptable speed; completing work related tasks with acceptable quality; changing job assignments; and seeking information and assistance from an employer. Individuals are scored on the frequency of support, time devoted to support, and type of support needed.

References

Hall, A.C., Butterworth, J., Winsor, J., Gilmore, D.S., & Metzel, D. (2007). Pushing the employment agenda: Case study research of high performing states in integrated employment. Intellectual and Developmental Disabilities, 45(3), 182-198.

Washington State Department of Social and Health Services, Division of Developmental Disabilities. (2008). Proposed policy: County employment program, 2008 Legislative Proviso Report: Olympia, WA.

Washington State Auditor's Office. (2009). Budget accounting and reporting system. Retrieved February 27, 2009 from http://www.sao.wa.gov/LocalGovernment/BARS/Index.htm

Appendix

The following information is collected for: individual supported employment, group supported employment, prevocational services, person-to-person services, and community access services, with the exception that gross wages are not reported for individuals in community access services.

Demographic Data:

Topical Area Data Requested
Billing Information Authorization Number
Service Year and Month
Service Code
Fund Source
Service Month
Individual Information Client Name
Client ID
Residence County ID
Provider Information Provider Name
Provider Number
Provider County ID

Service Data:

Topical Area Data Requested
Services Received Unit Type (hourly, daily)
Number of Units (minutes, hours, days)
Unit Rate
Individual Outcomes Client Hours Paid
Client Hours Volunteer
Client Hours Other
Gross Wages
Provider Services Provider Staff Hours

Acknowledgments:

The authors would like to thank the stakeholders in Washington State for their contributions to and review of this brief.

This project was supported, in part, by cooperative agreement #90DN0216. from the Administration on Developmental Disabilities, Administration for Children and Families, US Department of Health and Human Services. The opinions contained herein are those of the grantee and project participants and do not necessarily reflect those of the Administration on Developmental Disabilities.

For more information, please contact:

Jean Winsor
Research Associate
Institute for Community Inclusion
University of Massachusetts Boston
jean.winsor@umb.edu
703.542.6799