Organizational ChangeFrom Facility-Based to

Community-Based Employment Services

Pat Rogan

September 13, 2012

Why Change from Sheltered to Integrated Employment?

People receiving services dissatisfied

Poor quality sheltered services & outcomes

Knowledge of best practicesPush from external entities

How are we Doing?Integrated employment declined to 20.1% in FY2011 (Butterworth, 2008)

Increased segregation + non-work community activities.625,000 in sheltered facilities earning subminimum wages.The rate of movement from sheltered to integrated work: a mere 1-5%.

How are we Doing?Medicaid spends 4X more money on segregated adult day programs than supported employment.No preference for integrated employment within the Medicaid program.Many (if not most) in sheltered day programs prefer to work in a real job in the community.

(Migliore et al, 2007)

Looking Back…

1990s: Systems change grants & initiatives supporting organizational change, e.g.,:

Albin, Rhodes, & Mank, 1994Murphy & Rogan, 1995Rogan, Held & Rinne, 1998Butterworth & Fesko, 1998, 1999Petty, Brickey, Verstegen & Rutherford, 1999

Philosophy, policies & funding support integrated employment.

Statewide capacity building & advocacy efforts; systems change initiatives.

Strong, consistent leadership.Data based decisions.

Critical Features of States with Highest Employment Outcomes

Major Barriers to Change

Negative attitudes & resistance (e.g., staff, families, Board)

Funding (Inflexible, insufficient)

Lack of expertise (re: organizational transformation)

Lack of leadership Other: Transportation, safety netNOT: Resistance from people with disabilities

or community.

Understanding What to Change

Strategy: What you do

Systems: How you do itStructure: Who does it

The Organization

Organizational Change Strategies

Create a Vision for the Future (Strategic Plan)

Mobilize Commitment (Stakeholder Buy-in)

Develop Strong Leadership (Change Management Team)

Align Services, Org Structures, & HR Practices

.

SERVICES: CE Competency Model

Traditional ServicesFocus on readinessMove through continuum Deficit-based voc. evaluation

Positive Community ServicesNo need to “get ready” - Teach in community. Person-centered & directed planning – Capacity search.

Effective Employment Strategies

HR: Develop Entrepreneurial Leaders

Teach skill sets (Discovery, Job Development, etc.) alongside leadership abilities.Widen agency vision to include front-line staff as community builders.Focus on staff development through active mentoring from supervisor (community-based staff positions cannot be supervised by a building-based manager).

In the past a leader was a boss. Today’s leaders must be partners with their people…they no longer

can lead solely based on positional power

Ken Blanchard

What Maintains a Structure

HierarchyExpertiseSpecializationMisunderstanding of missionTraditionsFear…it is the hardest change of all!

Structure: Think about it…

If You Add Specialists:It’s not my jobYou have to talk to my bossHow are we going to pay for it?The result: Incremental change.

To Change Your Structure:It’s everyone’s roleBuild rapport and permission will comeKnow your stuffDo the right thing and the money will come.The result: Real change.

Tips from Those Who Have Been There

Involve all levels in discussion of vision & values.Invest heavily in training.Use the vision & inherent values to evaluate processes/outcomes.Use individual planning for all.Communicate, communicate, Communicate!

If you don’t like change, you’re going to like irrelevance a lot less.

Tom Feltenstein

It is not the strongest of the species that survive, nor the most intelligent,

but the one most responsive to change

Author unknown

Partnerships – Critical to Success!

It’s all about Relationships!People servedFamiliesStaffBoardCommunity; EmployersFunders

FUNDING

Economic Development & DiversityRelationships with Funding SourcesDiversify—pros and consBusiness Approach

SustainabilityCoalitions start at home. Align leadership with visionary outcomes.Staff need more than a financial reason to believe in the work. Managers and agency leadership have to be vested through actions.New skill sets can be taught if they are illustrated rather than only benchmarked.

Recommendations…National Level

Develop a national agenda for changeNational OC ForumsEmployment First InitiativesComprehensive Transition ServicesShift funding from shelteredSupport for leaders to learn how to change

Recommendations….State Level

State Level Leadership! Employment First InitiativesPost-secondary Ed InitiativesFunding controlled by people with disabilities and families“Training Arm(s)” in each State

Recommendations….Local Level

Share Success StoriesProvide Staff Training and SupportPartner with Self-AdvocatesLearn from Success

We are far too patient with the passage of time for people with

disabilities…time is as precious for a person with a disability as it is for

all of us!

Gary Provencal

ResourcesRogan, P. & Rinne, S. (2011). National call for organizational change from sheltered to integrated employment. Intellectual and Developmental Disabilities, 49 (4), 248-260. Butterworth, J. et al (2011). StateData: The national report on employment services and outcomes. ICI – U-Mass, Boston.http://www.communityinclusion.org/page.php?id=17&page=get_article&scope=all&type=topic