Department of Health and Human Services 
OFFICE OF 
INSPECTOR GENERAL 
Employment Programs for Persons with 
Developmental Disabilities 
JUNE GIBBS BROWN 
Inspector General 
AUGUST 1999 
OEI-07-98-00260  OFFICE OF INSPECTOR GENERAL 
The mission of the Office of Inspector General (OIG), mandated by Public Law 95-452, as 
amended by Public Law 100-504, is to protect the integrity of the Department of Health and 
Human Services programs as well as the health and welfare of beneficiaries served by them.  This 
statutory mission is carried out through a nationwide program of audits, investigations, 
inspections, sanctions, and fraud alerts.  The Inspector General informs the Secretary of program 
and management problems and recommends legislative, regulatory, and operational approaches to 
correct them. 
Office of Evaluation and Inspections 
The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 
Inspector General.  It conducts short-term management and program evaluations (called 
inspections) that focus on issues of concern to the Department, the Congress, and the public.  The 
inspection reports provide findings and recommendations on the efficiency, vulnerability, and 
effectiveness of departmental programs. 
OEI's Kansas City regional office prepared this report under the direction of James H. Wolf, 
Regional Inspector General.  Principal OEI staff included: 
REGION  HEADQUARTERS 
Dennis Tharp, Project Leader  Al Levine, Program Specialist

Tricia Fields, Program Analyst

Tim Dold, Program Analyst

To obtain copies of this report, please call the Kansas City Office at (816) 426-3697. 
Reports are also available on the World Wide Web at our home page address: 
http://www.hhs.gov/progorg/oei  E X E C U T I V E   S U M M A R Y  
PURPOSE 
To describe promising approaches and barriers to employment programs for persons with 
developmental disabilities. 
BACKGROUND 
Developmental disabilities affect a persons ability to work, live, socialize, and maintain

self-sufficiency.  Nationally, the number of persons with developmental disabilities is

estimated at approximately three to four million.  To enhance the environment in which a

person with developmental disabilities lives and to lessen the many barriers that they

encounter, Congress enacted the Developmental Disabilities Assistance and Bill of Rights

Act (42 USC 6000) to establish Developmental Disabilities Councils in each State.

The main goals of State Developmental Disabilities Councils include:  promoting

integration into work and community settings so that individuals with developmental

disabilities are not separated or isolated from others; protecting individual rights; ensuring

they will have accommodations they need; and ensuring they will have control over their

own resources.  Nationally, funding for State Councils was approximately

$65 million per year for 1996, 1997, and 1998.

We conducted this study in response to a request from the Commissioner of the

Administration on Developmental Disabilities (ADD), Administration for Children and

Families (ACF).  Our purpose was to identify, describe and assess promising approaches

to promote employment of persons with developmental disabilities.  We based our study

on information gathered from State Developmental Disability Councils, Vocational

Rehabilitation agencies, Mental Health agencies, Mental Retardation/Developmental

Disabilities agencies, job service agencies, and employers.

FINDINGS 
Promising Employment Programs 
While State Councils do not obtain direct employment for persons with developmental 
disabilities, they are instrumental in facilitating job opportunities for them.  State Councils 
initiate demonstration projects by providing seed monies for promising employment 
approaches.  These programs include public awareness, supported employment, and high 
school-to-work transition programs.  Also, innovative employment approaches which 
Council directors indicate yield successful results are consumer 
1 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  directed vouchers, entrepreneurial grants, and State hiring programs.  In addition, nearly 
all respondents report that these promising and innovative programs could be replicated in 
other States. 
Factors and Relationships Important in Obtaining Jobs 
Many factors are important in creating jobs and in ensuring success in employment 
programs, including the involvement of the employer community, collaborative 
arrangements among State entities, and planning for long term support systems. 
State entities also report that basing jobs on the personal interests of persons with 
developmental disabilities, effectively marketing them for appropriate jobs, and a unified 
State disability policy are critical to the success of employment programs. 
Less than Effective Approaches to Employment 
Ineffective approaches listed most frequently among respondents are:  poor job matching; 
high speed production jobs which are too stressful; traditional sheltered employment 
agencies; mobile work crews and groups; offering too many financial initiatives to 
employers; and outdated pre-vocational training models.  In many cases, these approaches 
also entail inherent barriers to employment of persons with developmental disabilities. 
Barriers and Ways to Address Them 
State entities report that some of the barriers which impede the development of 
employment programs are:  a lack of transportation; fear of losing Medicaid or a monthly 
Supplemental Security Income check; negative perceptions held by employers; and lack of 
flexible financing arrangements among State entities.  Respondents cite many methods to 
reduce or eliminate barriers, including individual transportation plans, cooperative 
financing, and business advisory councils. 
Limited Employment Outcome Data 
Very little management information exists on performance and outcomes of monitoring 
employed individuals with developmental disabilities.  Data we reviewed is limited and 
inconsistent from State to State. 
RECOMMENDATIONS 
A number of positive initiatives are being undertaken by State Councils directly or through 
collaborative programs with other State agencies.  However, identifying performance data 
is difficult.  While it may be challenging for State Councils to capture 
2 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  and measure extensive information on general effectiveness of employment programs, 
steps need to be taken to report the progress on individuals with developmental disabilities 
in obtaining and keeping jobs.  To accomplish this, the ACF should consider the following: 
Promising Practices Should be Shared Among States 
State Councils identify a number of promising and innovative practices and generally feel 
these could be replicated in other States.  In fact, some State Councils already require 
grantees to develop a replication manual for their demonstration projects. We believe that 
communicating these practices is in the best interest of employment programs and their 
effective operation.  Three specific actions that ACF/ADD should consider include: 
1) working with State Councils to develop an ongoing inventory of 
successful employment initiatives; 
2) working toward developing a formal mechanism to allow 
State Councils to share promising employment approaches on a 
national level; and 
3) communicating practices known to enhance the quality and 
efficiency of data documentation and reporting. 
Core Data Requirements Should be Established to Evaluate Job Initiatives 
State entities confirm the benefits of having outcome data to relate performance/ 
achievement, and to measure effectiveness.  Despite activities underway to develop and 
implement such outcome data, we believe it would be beneficial for ACF to develop 
mandatory performance measures with which all State Councils must comply.  We note 
that a beneficial tool in this effort may be the Core Indicators being developed by a 
workgroup of State Mental Retardation/Developmental Disabilities directors.  While these 
performance measures are largely focused on State mental retardation issues, some of the 
measures may be valuable to apply to all persons with developmental disabilities. 
AGENCY COMMENTS 
The ACF concurred with recommendations in this report.  We have made changes to the 
final report to reflect agency wording suggestions. 
3 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  T A B L E   O F   C O N T E N T S  
PAGE

EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1

INTRODUCTION  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  5

FINDINGS

Promising Employment Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  10

Factors and Relationships Important in Obtaining Jobs . . . . . . . . . . . . . . . . . . . . . . . . . 12

Less than Effective Approaches to Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Barriers and Ways to Address Them  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Limited Employment Outcome Data  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

RECOMMENDATIONS  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  19

APPENDICES

A: Recent Trends As Reported by Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

B: Ineffective Approaches/Barriers As Specifically Reported By Respondents  . . . . . . .  22

C: Barriers As Reported By State Councils  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

D: Agency Comments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

4 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  I N T R O D U C T I O N  
PURPOSE 
To describe promising approaches and barriers to employment programs for persons with 
developmental disabilities. 
BACKGROUND 
Developmental disability is defined in the Developmental Disabilities Assistance and Bill of 
Rights Act, as amended by Public Law 103-230, as a severe, chronic disability of an 
individual five years of age or older that is:  attributable to a mental or physical impairment 
or combination of mental and physical impairments; manifested before the individual 
attains age 22; likely to continue indefinitely; and results in substantial functional 
limitations in three or more areas of major life activity.  Nationally, the number of persons 
with developmental disabilities is estimated at approximately three to four million. 
Major life activities which may be affected by a developmental disability include:  self-care; 
receptive and expressive language; learning; mobility; self-direction; capacity for 
independent living; or economic self-sufficiency.  Developmental disabilities affect a 
persons ability to work, live, socialize, and maintain self-sufficiency in a community 
setting.  Individuals with developmental disabilities need a combination of special 
interdisciplinary services, supports, or other assistance of lifelong or extended duration. 
Such services or assistance are typically planned and coordinated individually.  Without 
appropriate services, people with developmental disabilities are isolated rather than fully 
integrated into mainstream society. 
State Developmental Disabilities Councils 
The Developmental Disabilities Assistance and Bill of Rights Act established 
Developmental Disabilities Councils in each State.  Their mission is to assure that 
individuals with developmental disabilities and their families participate in the design of 
and have access to culturally competent services, supports, and other assistance and 
opportunities that promote independence, productivity, employment, integration, and 
inclusion into the community.  The goals of the Developmental Disabilities Assistance 
and Bill of Rights Act include:  promoting integration into work and community settings 
so that individuals with developmental disabilities are not separated or isolated from 
others; protecting individual rights; ensuring they will have accommodations they need; 
and ensuring they will have control over their own resources. 
5 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  Specifically, State Councils are defined in the Statute as organizations designed to 
promote (through systemic change) capacity building, advocacy activities, the 
development of a consumer and family-centered comprehensive system, and a coordinated 
array of culturally competent services, supports, and other assistance designed to achieve 
independence, productivity, and integration and inclusion into the community for 
individuals with developmental disabilities. 
State Councils build on community and family resources to infuse new creativity and 
vision into policy and leadership of State, local, and private programs.  While there are 
general priority areas for State Councils (i.e., employment, community living, child 
development, system coordination, and community education activities), the only 
Federally mandated area for all Councils is employment activities. 
The Act specifies that State Councils will have administrative and program staff and must 
complete 3-Year State Plans.  The State Councils must submit annual reports of 
performance to the Administration on Developmental Disabilities (ADD) within the 
Administration for Children and Families (ACF) covering goals as identified in State Plans 
and the select areas of emphasis in which their States will specialize.  As of 1997, State 
Councils are required to select performance measures related to outcomes in the annual 
program performance reports to the ADD.  The Councils submit outcome information on 
at least one measure out of a group of 22 employment-related performance measures. 
Each year, State Councils must demonstrate that they have assisted persons with 
developmental disabilities in their State in obtaining and keeping employment consistent 
with their interests, abilities, and needs. 
State Council members are appointed by State Governors.  One-half of the membership 
must include a combination of (a) persons with developmental disabilities; 
(b) parents/guardians of such persons; and (c) immediate relatives of individuals with 
developmental disabilities who are not employees of State agencies which receive funds or 
provide services. 
State Councils are funded by Federal and State matching funds based upon a formula that 
involves the number of individuals in the States who are developmentally disabled. 
Nationally, funding for State Councils was approximately $65 million per year for 
1996, 1997, and 1998. 
Administration on Developmental Disabilities 
The Federal agency responsible for oversight of the State Councils is the Administration 
on Developmental Disabilities within ACF.  It provides guidance to State Councils, 
sponsors and funds training sessions, and conducts monitoring functions for oversight and 
compliance with program guidelines.  The ADD, along with ACF regional offices, 
provides technical assistance on policy and other issues to numerous Councils each year. 
6 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  In addition, its staff conducts random, programmatic reviews of a small number of State 
Councils on management and technical issues.  State Councils submit annual program 
performance reports to ADD covering program goals and accomplishments, and priorities 
and functions related to the various State initiatives and activities. 
National Disability Associations 
There are two national associations which provide support and advocate programs for 
persons with developmental disabilities -- the National Association of Developmental 
Disabilities Councils and the Consortium of Developmental Disabilities Councils.  They 
encourage and promote activities of State Councils, and are active in legislative matters 
concerning developmental disability issues.  The National Association of Developmental 
Disabilities Councils recently was awarded a contract by ACF to provide technical 
assistance to State Councils.  This assistance is expected to strengthen State Councils 
capabilities to construct an effective data management system and also assist the States to 
meet the data requirements mandated by the Government Performance and Results Act of 
1994. 
Vocational Rehabilitation and Mental Health Agencies 
The Rehabilitation Act of 1973, as amended, authorizes the Department of Educations 
Vocational Rehabilitation program to provide comprehensive vocational rehabilitation 
services designed to help those with the most severe physical and mental disabilities return 
to the work force.  This is primarily done through Federal funding to State Vocational 
Rehabilitation Agencies that directly provide services.  These services include counseling, 
work evaluation, work adjustment training, job skills training, job-seeking skills training, 
and medical rehabilitation management. 
The Federal/State vocational rehabilitation program is operated and administered through 
a combination of State general and blind-only vocational rehabilitation agencies and 
various other State and private facilities.  These agencies provide individualized vocational 
rehabilitation services to accepted individuals according to a written rehabilitation plan 
that is jointly developed by a counselor and the individual.  Counselors evaluate whether 
there is a reasonable expectation that the individual will benefit from vocational 
rehabilitation services in terms of their employability.  This judgment is based on the 
individuals impairment and the availability of services and resources. 
State Mental Health agencies are advocates for individuals who have a mental illness, 
which may or may not include persons with developmental disabilities.  Their personnel 
interact with various institutions and organizations to assist individuals in their 
socialization and adaptive skills.  State Mental Health agencies assess appropriate job 
opportunities for individuals with developmental disabilities and are influential in setting 
7 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  Statewide goals and policies for persons with mental illness and developmental disabilities. 
The Health Care Financing Administration (HCFA) has Home and Community Based 
Services (HCBS) programs available to assist persons with developmental disabilities in 
their jobs.  These serve as waivers to the basic requirements that States have in operating 
their medical programs.  The HCBS waivers approved by HCFA allow for limited 
reimbursement of prevocational services and supported employment services. 
Prevocational services are aimed at preparing an individual for paid or unpaid 
employment, but are not job-task oriented.  Supported employment services are conducted 
in a variety of settings, particularly in work sites where persons without disabilities are 
employed.  Supported employment services consist of paid employment for which 
competitive employment at or above the minimum wage is unlikely.  In this manner, 
supported employment helps persons with developmental disabilities who, because of their 
disabilities, need intensive ongoing support to perform in a work setting. 
SCOPE AND METHODOLOGY 
The Commissioner of the Administration on Developmental Disabilities requested the 
Office of Inspector General to conduct this study. 
Our purpose was to identify, describe and assess promising approaches to promote 
employment of persons with developmental disabilities.  We based our study on 
information gathered from State Developmental Disability Councils, Vocational 
Rehabilitation agencies, Mental Health agencies, Mental Retardation/Developmental 
Disabilities agencies, job service agencies, and employers.  We asked our respondents 
what approaches they believed were effective and what barriers they were confronting. 
We compared answers from different respondent groups to identify commonalities.  We 
analyzed program performance reports and outcome data where available. 
Our method does not yield proof of program effectiveness, but it does provide the best 
assessment of promising approaches based on the insights and experience of responsible 
professionals and evidence available in administrative records and allied documents.  It 
provides leads and suggestions for approaches that appear worthwhile for further 
experimentation and development, and identifies some approaches which, based on 
experience to date, should probably be avoided. 
We selected a judgmental sample of nine State Developmental Disabilities Councils.  Six 
of the Councils are affiliated with the National Association of Developmental Disabilities 
Councils, while the remaining three Councils are affiliated with the Consortium of 
Developmental Disabilities Councils.  In addition, seven of the nine sampled States have 
numerical employment goals outlined in their three-year State plans.  We obtained a 
mixture of States with large populations and small populations.  We also conferred with 
8 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  ADD on State Council selection as to States which appear to have some promising

employment approaches.  The nine States are Florida, Massachusetts, Michigan,

Nebraska, New Mexico, Ohio, Oregon, South Dakota, and West Virginia.

In addition to the 9 State Councils, we also obtained information from 9 Vocational

Rehabilitation agencies, 8 Mental Retardation/Developmental Disabilities agencies,

4 Mental Health agencies, 10 employers, and 13 job agencies.  We conducted telephone

surveys of Executive Directors for the nine Councils to determine specific employment

activities supported by those Councils during 1996, 1997, and 1998.  We obtained and

examined performance information submitted to ACF on program performance reports,

reviewing the types, extent, and outcomes of employment programs supported by the

State Councils which specifically assist individuals with developmental disabilities. 

We conducted on-site visits at four of the nine sampled States.  On-site visits were

selected in part based on promising approaches identified in the telephone surveys.  During

these visits, we interviewed the Executive Director of the State Council and Council staff,

the State Vocational Rehabilitation Director, the State Mental Health Director, the State

Mental Retardation/Developmental Disabilities Director, a job agency, and at least one

employer that participates in programs to hire persons with developmental disabilities.  We

gathered additional insights and perceptions on promising employment programs which

expanded upon and substantiated our prior telephone discussions.

For the remaining five States, we gathered information from directors of Mental Health,

Vocational Rehabilitation, and Mental Retardation/Developmental Disabilities agencies, as

well as job agency directors and employers.  In all, we gathered information from

53 State entities, employers, and job agencies.  We gathered information on systematic

processes, roles of various State entities, key factors and relationships among State

entities, documentation of employment activities, and barriers and how to minimize them. 

We conducted our review in accordance with the Quality Standards for Inspections issued

by the Presidents Council on Integrity and Efficiency.

9 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  F I N D I N G S  
Promising Employment Programs 
While State Councils in most cases do not obtain direct employment for persons with 
developmental disabilities, they are instrumental in facilitating job opportunities for 
persons with developmental disabilities.  The Councils initiate demonstration projects by 
providing seed monies for promising employment approaches.  These demonstration 
projects are often in conjunction with State Vocational Rehabilitation, State Mental 
Retardation/Developmental Disabilities agencies, and local community providers and job 
agencies. 
We found a number of promising program strategies to assist individuals with 
developmental disabilities to obtain jobs.  Some employment programs have wide 
application, and are generally considered quite successful by all State Councils.  These 
employment activities which are actively endorsed by all nine State Councils are public 
awareness initiatives, supported employment programs, and high school-to-work 
transition programs.  A second category comprising innovative employment programs are 
consumer directed vouchers, entrepreneurial grants, and State hiring programs which 
Council directors indicate yield successful results.  In addition, nearly all respondents 
report that these promising programs could be replicated in other States. 
Public Awareness 
All nine State Councils work to increase public awareness of the employability of persons 
with developmental disabilities through poster campaigns, periodic newsletters, legislative 
proposals, resource guides, videos, and conferences.  They are also heavily involved in 
advocacy efforts to change perceptions and attitudes about persons with developmental 
disabilities.  They work to place them in visible settings, thus raising the level of awareness 
of the competencies and abilities of persons with developmental disabilities.  Some State 
Councils reduce and remove attitudinal barriers by highlighting current employment 
programs on an Internet website and by providing public recognition of exemplary 
employers. 
Supported Employment 
Supported employment includes paid work in a variety of integrated settings.  It is 
directed to individuals for whom competitive employment at or above minimum wage has 
not traditionally occurred, and who, because of their disability, may need intensive 
ongoing support to perform in a work setting.  Supported employment work sites range 
10 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  from regular work sites without any physical accommodations to work sites especially 
designed for severely physically or cognitively challenged individuals.  Examples of work 
sites we visited include a woodworking facility, a graphics arts company, and a factory 
with light assembly work.  Supported employment programs traditionally have job coaches 
who provide initial training and adaptation to the job setting for a period of a few weeks 
to several months, usually until the person with a developmental disability can function 
virtually independently.  As an example, the Developmental Disabilities Services agency in 
Florida reported that the number of individuals with developmental disabilities in 
supported employment programs in that State has increased approximately 38 percent 
from 1996 (2,840 persons) to 1998 (3,931 persons). 
High School-to-Work Transition 
High school-to-work transition programs create career opportunities for persons with 
developmental disabilities.  These transition programs were developed because 
traditionally many persons with developmental disabilities had limited career options upon 
high school graduation.  Transition programs promote the concept that if individuals with 
developmental disabilities acquire jobs right before or immediately after high school 
graduation, they are more likely to work and are prone to continue working during their 
adult years.  The programs we examined appear to be very promising because students are 
allowed input in the decision-making processes of their individualized career plans. 
Michigan reports that transition programs for youth with developmental disabilities served 
in special education settings up to age 26 increased approximately 31 percent from 
1996 (7,169 persons) to 1998 (9,398 persons). 
Consumer Directed Vouchers 
In five of nine States, we found examples of successful consumer directed voucher 
programs.  Following the concept of person-centered planning found in transition 
programs, consumer directed voucher programs allow families and individuals with 
developmental disabilities to control a selection process of purchasing services and 
supports which will result in employment.  Through the consumer directed vouchers, 
persons with developmental disabilities design individual employment plans to facilitate 
their goals.  Families, friends, and the person with developmental disabilities work 
together to choose their own employment advisors, community-based providers of 
services, job coaches, and job agencies.  Through this activity the Oregon family grants 
voucher program serves 25 families per year.  In 1997-1998, the voucher program in 
Oregon helped to place 50 persons with developmental disabilities in employment. 
Entrepreneurial Grants 
Entrepreneurial grants provide financing for creative, individual business plans submitted 
by persons with developmental disabilities.  Entrepreneurial grants support specifically 
tailored business plans which are often nontraditional ideas launched by forward-thinking 
persons with developmental disabilities wishing to pursue a unique job opportunity on 
11 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  their own.  We note that three of the nine States sampled (Massachusetts, South Dakota, 
and West Virginia) are actively seeking requests for entrepreneurial grant proposals. 
Entrepreneurial grants provided the start-up costs for a lawn care service, an antique 
business, a typing service, and a shredding service for developmentally disabled individuals 
in West Virginia. 
State Hiring Initiatives 
We found State government hiring programs in Florida and Massachusetts, in which State

government vacancies are specifically marketed for individuals with developmental

disabilities.  In Massachusetts, vacancy announcements are amended to emphasize the

search for applicants with developmental disabilities across all levels of State government. 

In Florida, a program coordinator with developmental disabilities was hired through a

grant from Vocational Rehabilitation.  Through this program, over

20 individuals with developmental disabilities obtained (and many retained) their positions

through this government hiring initiative from fiscal year 1996 - 1998. 

Related to employment programs and their potential for promising outcomes, respondents

identify a number of trends which have influenced employment programs over the past

three years.  Some of these trends are:  a prevalence toward service industry jobs;

increased public and employer awareness of hiring persons with developmental disabilities;

and more focus on hiring persons with severe disabilities.  Also, while a growing economy

increases the availability of jobs for individuals with developmental disabilities, modern

jobs requiring the ability to perform multiple tasks simultaneously render some persons

with developmental disabilities incapable of conducting certain work.  See Appendix A for

a listing of trends reported by respondents. 

Factors and Relationships Important in Obtaining Jobs 
We identified a number of activities that are important in creating jobs and obtaining 
success in employment programs.  These activities are based on comments from State 
Councils, State Mental Health agencies, State Vocational Rehabilitation divisions, State 
Mental Retardation/Developmental Disabilities agencies, employers, and job agencies. 
Out of a total of 53 respondents, numerous factors are identified as important in creating 
jobs, including involvement of the employer community, building long term support 
systems for persons with developmental disabilities, and effectively marketing the skills of 
persons with developmental disabilities to businesses.  Table 1 on the next page lists the 
major factors respondents believe are important to create jobs. 
12 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  Table 1 
Factors in Creating Jobs for Persons w/ Dev. Disabilities1 
Involvement of employer community  23  respondents 
Planning for long term support; building natural supports2  19  respondents 
Effective marketing (filling an employers human resource need)  10  respondents 
Basing job choices on personal interest  9  respondents 
Including family members and agencies in the job search effort  5  respondents 
Changing public and employer perceptions of abilities  4  respondents 
Opportunities for job try-outs  3  respondents 
A positive attitude towards persons with developmental disabilities  2  respondents 
1S  tudy participants may have indicated more than one response.
2  Natural supports are coworkers, friends, neighbors, and family upon which the person with
developmental disabilities relies. 
Source: Office of Evaluation and Inspections (OEI) Survey, 1999 
State entities, employers, and job agencies also indicate that there are many methods to 
foster and enhance important relationships.  Out of 53 total respondents, the following 
relationships are cited in Table 2 as critical to the success of employment programs for 
persons with developmental disabilities. 
Table 2 
Relationships Important for Success in Employment Programs1 
Collaborating with other State agencies and entities to establish 
effective approaches  23  respondents 
Educating employers on hiring persons w/developmental disabilities  9  respondents 
Developing a unified State disability policy across agencies  6  respondents 
Working with agencies to implement coordinated, flexible funding  4  respondents 
Creating public awareness for supported employment  3  respondents 
1S  tudy participants may have indicated more than one response.
Source: OEI Survey, 1999 
13 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  When asked how employment programs can be enhanced, a job agency director said that 
common definitions and terms could be an asset to implementing better employment 
programs, and a State Vocational Rehabilitation director noted that a common database 
could enhance relationships in the employment programs.  Also, a director of a State 
Mental Retardation/Developmental Disability agency said, No ones work is ever 
finished, that after placement of a person with a developmental disability into a job, many 
entities, including job coaches, the State Council, Vocational Rehabilitation, and 
community providers must remain integrally involved in the continued oversight of 
achievements and problems of the newly hired employee. 
Less than Effective Approaches to Employment 
State Councils and entities that work with persons with developmental disabilities indicate 
there are a number of approaches which are less than effective in obtaining employment. 
Ineffective approaches listed most frequently among respondents were: 
<	 Poor job matching 
Merely filling slots, as opposed to assessing the vocational interests of the 
person with developmental disabilities.  Respondents say the more individualized 
the match, especially if a job has been specifically carved out, the more likely the 
job will last; 
<	 Jobs demanding high production 
These types of jobs are often very stressful, placing the person with developmental 
disabilities in an uncomfortable, high-speed, high pressure situation; 
<	 Sheltered agencies/segregated work sites 
Employees in these settings generally earn less than minimum wage with no 
benefits, and do not have opportunities for promotion.  We were also told that 
some supervisors at sheltered agencies may retain their best workers to keep up 
with production demands, rather than allowing persons with developmental 
disabilities to compete in the private sector or move into a supported employment 
setting; 
<	 Mobile work crews/enclaves 
We were told that placing individuals in roving work crews which perform 
cleaning and other custodial tasks in office buildings (perhaps spending 
10 minutes in 20-25 different offices) does not allow for full integration of persons 
with developmental disabilities; 
14 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  <	 Offering too many financial incentives to employers 
It is important not to overemphasize tax incentives or oversell potential 
employees with developmental disabilities.  Rather, job agencies and placement 
specialists should work to fill actual human resource needs which companies have. 
We were cautioned by one State that businesses might terminate an employee 
should financial incentives expire; and 
<	 Prescribing outdated pre-vocational training models 
We were told that too much emphasis on skills building and job preparedness is a 
less than effective approach.  While training of the employee with developmental 
disabilities is important, many employers are now conducting training themselves, 
reducing the need for extensive, pre-placement training. 
Highlights of comments regarding ineffective approaches to employment are contained in 
Appendix B, which includes various responses from State Councils, State agencies, job 
agencies, and employers. 
Barriers and Ways to Address Them 
State entities informed us of many barriers which impede the development and 
administration of employment programs, with the greatest barrier that persons with 
developmental disabilities encounter being a lack of transportation.  All State Council 
directors list transportation as one of the top five barriers to employment for persons with 
developmental disabilities.  (Appendix C reflects the barriers rated by State Council 
directors). 
The general consensus of Councils to remedy transportation problems is to assemble a 
task force of the friends, parents, siblings, relatives, neighbors, job coaches, and 
prospective coworkers of the person with developmental disabilities to devise an 
individualized transportation plan so that he/she has the ability to go to work on a 
dependable basis with a reliable mode of transportation. 
Respondents also said that fear of losing a monthly Supplemental Security Income (SSI) 
check is a disincentive to work.  People with developmental disabilities may also have 
chronic medical conditions, yet may not have health insurance to pay for the care.  These 
two barriers may be addressed by the proposed Work Incentives Improvement Act of 
1999, which will expand Medicaid options for States and encourage SSI beneficiaries to 
return to work by providing an assurance that cash benefits will remain available if 
employment proves unsuccessful. 
15 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  Negative perceptions held by employers about the employability of a person with 
developmental disabilities are a common obstacle.  Raising public awareness and support 
for obtaining jobs for persons with developmental disabilities can be accomplished through 
presentations to civic groups such as Chambers of Commerce, Lions and Rotary clubs, 
and employer groups, and by developing business advisory councils.  Such advisory 
councils are groups of employers which periodically assemble to discuss employment 
needs in the community and how to effectively hire individuals with developmental 
disabilities.  They can assist employers in understanding their responsibilities in regards to 
the Americans with Disabilities Act, specifically any physical accommodations which must 
be made to adapt their workplace for a prospective employee with developmental 
disabilities.  Also, of the employers surveyed, 7 of 10 indicate that assistive technology is 
not needed for their newly hired individuals with developmental disabilities. 
Communicative skills in a professional business setting are traditionally a weakness of 
persons with developmental disabilities.  Work and social skills may be enhanced on the 
job with the assistance of a job coach and a supervisor.  Also, a practical way to address 
concerns of employers is to demonstrate the various skills and abilities that the person 
with developmental disabilities can contribute to the job.  Job agencies can work 
specifically with individual employers to make successful one-on-one matches. 
Lack of flexible financing arrangements among State entities is a commonly expressed 
barrier by State Councils, Vocational Rehabilitation, State Mental Health, and State 
Mental Retardation/Developmental Disabilities agencies.  Several State entities in 
Massachusetts recently developed a mixed funding stream through years of collaborative 
meetings where the various agencies used creativity to devise a manageable, cooperative 
arrangement of financing where community based providers charge the same amount for 
certain pre-approved services.  This mixed funding stream is an outcome based payment 
system which allows funding to be assigned to developmentally disabled individuals who 
can choose their service components as well as providers of service. 
Limited Employment Outcome Data 
We talked to 53 respondents and reviewed 1998 program performance reports from the 
nine State Councils.  We found data is limited and inconsistent from State to State. We 
could not find where outcome data is generally available for use in determining success, 
effectiveness, and performance aspects of employment programs.  Respondents indicated 
in many cases that such data is not available or is questionable in terms of its usefulness 
and reliability.  They believe that greater detail and more extensive data would be 
beneficial in their evaluation of employment programs and their effectiveness. 
16 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  We found that very little management information exists on performance and outcomes of 
monitoring employed individuals with developmental disabilities.  While State Councils 
obtain some data on a grant-by-grant basis, few State entities perform extended follow-up. 
Therefore, information on the length or range of time persons with developmental 
disabilities and employers participate in employment programs is generally not available. 
Also, in 34 CFR 361.56(d), Vocational Rehabilitation is permitted to close out 
successful job placements after 90 days.  This makes it difficult to perform extended 
evaluations or comprehensive, longitudinal studies of the successes of employment for 
persons with developmental disabilities. 
While State Vocational Rehabilitation agencies keep demographic information by certain 
disability categories, their data does not specifically discern which individuals served have 
developmental disabilities.  Also, State Mental Health and State Mental 
Retardation/Developmental Disabilities agencies may follow different definitions for 
developmental disabilities. 
The Nebraska and Oregon State Mental Retardation/Developmental Disabilities agencies 
advise us that two promising performance management initiatives are being conducted 
which assess the need for baseline performance information.  A partnership between the 
National Association of State Directors of Developmental Disabilities Services and the 
Human Services Research Institute was formed in January 1997 to conduct the Core 
Indicators Project.  The purpose of this project is to develop nationally-recognized 
performance and outcome indicators that will enable individual State Developmental 
Disabilities Services agencies to benchmark performance in comparison with other 
agencies, as well as to provide longitudinal data to determine performance level from one 
period to the next.  Employment data such as average hourly wages, number of hours 
worked, and length of time on the job is being considered for the indicator set. 
The Oregon Office of Developmental Disabilities Services has a contract with the 
University of Oregon to collect employment data from local job agencies on a 
semi-annual basis.  Information is monitored for all employment consumers.  Performance 
measures include type of work, duration of employment, hours worked, and hourly 
earnings for each recipient. 
In response to employment performance measures established by ACF in 1997, seven of 
the nine State Councils have established one or more numerical employment goals. 
Because employment performance measures are included in the current State Council 
Three-Year Plans (1998-2000), we asked each of the nine State Councils whether 
numerical employment goals influence the implementation and success of employment 
programs.  Four of seven States with numerical employment goals respond affirmatively, 
noting the need to be outcome oriented for success.  State Council directors perspectives 
are shown in Table 3 on the next page. 
17 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  Table 3 
Importance and Impact of Numerical Employment Goals 
Do numerical goals have a 
positive effect on the 
outcome of employment 
programs?  Comments 
Yes.  We look at outcomes, not just the process. 
Yes.  We have become more outcome oriented. 
No.  Didn't change our strategy/methodology; it forced us to look at 
outcomes and ask, "So what?" 
Dont Know.  Puts pressure on a job agency/employment service provider to put 
a person in a job. 
Not applicable.  This State chose not to have numerical employment goals. 
Not applicable.  This State chose not to have numerical employment goals. 
No.  Not enough experience with goals yet to tell. 
Yes.  We are trying to be more in compliance with the Govt. Performance 
and Results Act.  We look at end result, not just the process. 
Yes.  We don't have a lot of experience with goals; accountability is a 
good factor. 
Source: OEI Survey, 1999 
18 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  R E C O M M E N D A T I O N S  
A number of positive initiatives are being undertaken by State Councils directly or through 
collaborative programs with other State agencies.  However, identifying Statewide performance 
data is difficult.  While it may be challenging for State Councils to capture and measure extensive 
information on general effectiveness of employment programs, steps need to be taken to report 
the progress of persons with developmental disabilities in obtaining and keeping jobs.  To 
accomplish this, ACF should consider the following: 
Promising Practices Should be Shared Among States 
State Councils identify a number of promising and innovative practices and generally feel 
these could be replicated in other States.  In fact, some State Councils already require 
grantees to develop a replication manual for their demonstration projects.  We believe that 
communicating these practices is in the best interest of employment programs and their 
effective operation.  Three specific actions that ACF/ADD should consider include: 
1) working with State Councils to develop an ongoing inventory of 
successful employment initiatives; 
2) working toward developing a formal mechanism to allow 
State Councils to share promising employment approaches on a 
national level.  One method for accomplishing this is by ACF 
publishing and updating reports of State Council innovative practices 
on the ACF/ADD website at http://www.acf.dhhs.gov/programs/add, and 
by disseminating materials through mailings and conferences; and 
3) communicating practices known to enhance the quality and 
efficiency of data documentation and reporting. 
Core Data Requirements Should be Established to Evaluate 
Job Initiatives 
State entities confirm the benefits of having outcome data to relate performance/ 
achievement, and to measure effectiveness.  Despite activities underway to develop and 
implement such outcome data, we believe it would be beneficial for ACF to develop 
mandatory performance measures with which all State Councils must comply. 
19 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  The current system of selectively choosing a small portion of the overall set of 
performance measures severely limits the ability of ACF to adequately assess operational 
effectiveness and outcomes of Council-sponsored employment initiatives.  The ACF/ADD 
should consider working with State Councils to identify those specific mission-critical 
performance measures which must be addressed annually by each Council. 
We note that a beneficial tool in this effort may be the Core Indicators being developed 
by a workgroup of State Mental Retardation/Developmental Disabilities directors.  While 
these performance measures are largely focused on State mental retardation issues, some 
of the measures may be valuable to apply to all persons with developmental disabilities. 
AGENCY COMMENTS 
The ACF concurred with recommendations in this report.  We have made changes to the 
final report to reflect agency wording suggestions.  The full text of ACFs comments are 
included in Appendix D. 
20 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  A P P E N D I X  A  
Recent Trends As Reported By Respondents1 
Low unemployment rates in the general population  19 respondents 
Substantial increase in service industry employment for the 
general population  13 respondents 
Increase in employer/public awareness  7 respondents 
Low wages and benefits; part-time work  7 respondents 
Increase in supported employment activities  6 respondents 
More opportunities for persons w/ severe disabilities  5 respondents 
Multi-tasking required of modern jobs  4 respondents 
Increasing number of home-based, self employed and 
entrepreneurial businesses  4 respondents 
Emphasis/move to natural supports2  3 respondents 
Increased use of temporary job agencies which do not accept 
or employ persons w/ developmental disabilities  3 respondents 
Difficulty of finding jobs in rural areas  3 respondents 
Decrease in sheltered agencies/workshops  3 respondents 
Welfare-to-work population competing with persons with 
developmental disabilities for jobs  2 respondents 
1S  tudy participants may have indicated more than one response.
2"  Natural supports are coworkers, friends, neighbors, and family upon which the
person with developmental disabilities relies. 
Source: OEI Survey, 1999 
21 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  A P P E N D I X  B  
Ineffective Approaches,

As Specifically Reported By Respondents

Mental Health; 
State  Vocational  MR/DD1 
Councils  Rehabilitation  agencies  Employers  Job Agencies 
Sheltered  Grants: when  Program-based  Too much  Unwillingness of the 
workshops.  payments are made  approach, rather  paperwork;  employer to carve out 
before services are  than person  bureaucracy got  an appropriate job for the 
Large  rendered.  centered planning  in the way.  person with a 
conferences.  concept.  developmental disability. 
Local coalitions  Work crews (these  Offering too many  Tax credit  High pressure jobs with 
cease when  should only be used  financial incentives.  paperwork is  stress and heavy 
funding stops.  as a last resort).  difficult.  production schedules. 
Treat the person  Persons with severe  Lack of transition  Overanxious  Inadequate screening. 
as charity.  disabilities require  services.  expectations.  Poor fit between person 
more than natural  and job. 
supports. 
Dont oversolicit  Training without  Use of vocational  Employer not  Poorly organized small 
businesses.  job development.  assessment tools  taking the time  businesses with unsafe 
and tests.  to train.  working conditions. 
Meaningless  Begging for jobs.  Non-supportive  Poor job  Placing a person before 
jobs.  parents.  matching.  they are ready. 
Segregated  Granting money to  Pre-vocational  Harsh  Lack of individual 
worksites.  groups.  training models.  treatment,  attention. One size fits 
reprimands.  all thinking. 
Persons with  Local advisory  Inventing/  Jobs which involve a lot 
severe  groups tend to fall  making up  of change or which 
disabilities need  apart.  work to keep  demand mastery of many 
more than just  the person  tasks. 
natural  Slotting.  busy. 
supports.  Jobs at less than 
minimum wage. 
1Mental Retardation/Developmental Disabilities agencies 
Source: OEI Survey, 1999 
22 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  A P P E N D I X  C  
Barriers As Reported By State Councils1 
Florida  1.  Transportation 
2.  People who need job coaches 
3.  Loss of SSI/Medicaid 
4.  Limited support of school systems/curriculums 
5.  Performance-based funding leading to creaming 
Massachusetts  1.  Attitudinal and systemic hiring barriers 
2.  Transportation 
3.  Cost-sharing agreements between service delivery systems 
4.  Maintaining competent and qualified staff 
West Virginia  1.  Transportation 
2.  Loss of SSI/Medicaid 
3.  Loss of health insurance 
4.  Availability of employers 
5.  Attitude 
Michigan  1.  Transportation 
2.  Job readiness skills of persons with developmental disabilities 
3.  Loss of SSI/Medicaid 
4.  People who need attendant care at work 
5.  People with little or no communication skills 
Ohio  1.  Loss of health insurance 
2.  Transportation 
3.  Loss of SSI/Medicaid 
4.  People who need attendant care at work 
5.  Employer ignorance, perceptions, and fears 
Oregon  1.  Use of alternatives to employment for persons with 
severe disabilities 
2.  State offset of disposable income for residential services 
3.  Transportation 
4.  Federal work disincentives (SSI/Medicaid) 
5.  Minimum wage increase to $6.50 in Oregon 
1 Barriers are listed in descending order of importance. 
23 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  Nebraska  1.  Attitudes of employers 
2.  Loss of health insurance 
3.  Transportation 
4.  Lack of social skills of employees 
5.  Availability of employers 
New Mexico  1.  People believe persons w/developmental disabilities cannot work 
2.  Limited support of residential service providers 
3.  Limited support of school systems/curriculums 
4.  Loss of SSI/Medicaid 
5.  Transportation 
South Dakota  1.  Transportation 
2.  Availability of employers 
3.  People who need job coaches 
4.  Limited mentoring/training opportunities 
5.  Loss of SSI/Medicaid 
Source: OEI Survey, 1999 
24 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  A P P E N D I X  D  
Agency Comments

25 
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Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  27 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  28 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  29 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260  30 
Employment Programs for Persons w/ Dev. Disabilities  OEI-07-98-00260