The Administration for Community Living is an operating division of the 

U.S. Department of Health and Human Services. Visit ACL.gov.

Research Supporting 

Competitive, Integrated Employment

Last Updated: 7/2022

Competitive, integrated employment (CIE) – working 

in the community, alongside people with and without 

disabilities, at competitive wages – offers a direct 

pathway to greater independence and self-sufficiency for 

people with disabilities. 

CIE is defined as work that is performed on a full-time or 

part-time basis for which an individual is compensated at 

a rate not less than minimum wage (Workforce Innovation 

and Opportunity Act, Public Law 113–128). CIE also 

incorporates work where the employee with a disability 

interacts with other persons who are not individuals with 

disabilities and where opportunities for advancement 

are similar (Ibid.). The benefits for CIE workers include 

improved earnings, wages, or salaries when compared to 

peers who worked in segregated workplaces (Taylor, et 

al., 2021a). Moreover, CIE was associated with positive 

psychological and physical health outcomes as well as 

improvements in self-determination, independence, and 

quality of life for people with significant disabilities (Ibid.). 

However, people with disabilities – particularly people 

with intellectual and developmental disabilities (ID/

DD) – often face barriers to employment. These barriers

include lack of access to the support they need to find

a job and succeed in the workplace, lack of employer

awareness of the benefits of recruiting and retaining

people with disabilities, and misunderstandings about the

cost of providing accommodations, to name just a few.

Further, although CIE is the preferred option for people

with significant disabilities (Migliore et al., 2007; Rogan

& Rinne, 2011; Wehman et al., 2018), people with ID/

DD often have been steered to sheltered workshops and

other programs that employ only people with disabilities,

at sub-minimum wages, under certificates issued by the

Department of Labor in accordance with Section 14(c) of

the Fair Labor Standards Act.

The Administration for Community Living is working 

to dismantle these and other common barriers and 

to expand employment opportunities for people with 

disabilities. In addition to funding programs that provide 

direct employment support services to people with 

disabilities and advocating for policies and practices 

that prioritize and support CIE as a key element of 

community living, ACL also is investing in research to 

increase knowledge about the benefits of employment of 

people with disabilities – both for the individual and for 

the employer – and to increase the availability of effective 

interventions to support employment. 

CIE is increasingly becoming the expectation across the 

country. Ten states have or will phase out use of 14(c) 

labor certificates and 11 other states have pending 

legislation targeting similar outcomes (Association of 

People Supporting Employment First, 2022). As progress 

occurs toward eliminating 14(c) programs, research 

about CIE is more important than ever to highlight what 

is known, what challenges exist, and what still needs to 

be explored. Further, as sheltered workshops are phased 

out, it is important that states and employment systems 

build capacity to support CIE (Advisory Committee 

on Increasing Competitive Integrated Employment for 

Individuals with Disabilities, 2016). To support that 

capacity-building, the National Institute on Disability, 

Independent Living, and Rehabilitation Research 

(NIDILRR) has also funded several projects that focus 

specifically on competitive, integrated employment for 

people with significant disabilities. 

Customized Employment

Virginia Commonwealth University (VCU) is studying 

customized employment as an intervention to assist 

individuals with intellectual disabilities and/or autism 

spectrum disorder to achieve integrated employment 

outcomes (Virginia Commonwealth University, 2022). 

Customized employment is a process for individualizing 

the employment relationship between a job seeker and 

an employer based on a match between the unique 

strengths, needs, and interests of the job candidate 

with a disability, and the identified business needs of 
the employer (Riesen et al., 2019). Components of 

customized employment include: 1) exploration and 

discovery; 2) customized planning for guiding the 

job search; and 3) job negotiations that establish a 

customized relationship between the employer and 

employee (Inge et al., 2018; Federal Register, 2002). 

Customized employment may also be integrated with 

ongoing, supported employment services that help 

workers with the most significant disabilities maintain 

employment.

An early exploratory study of autistic individuals who 

participated in a customized employment program 

showed that all 64 workers obtained employment, and 

that supports were successfully reduced over time 

(Wehman, et al., 2016). The study reported that this 

was the first employment experience for most of the 

workers, a relevant point when considering former 14(c) 

participants who may also have limited or no experience 

in integrated settings. Limitations were that the study was 

a retrospective review only and did not include a control 

group. That is, customized employment took place before 

the study was initiated, and autistic participants were not 

selected on a randomized basis. The level of evidence 

was therefore not as strong as would be available 

through a randomized, control trial intervention.

To examine the effectiveness of customized employment 

further, the five-year VCU project included the following: 

• Operationalizing the term “customized employment” 

as an evidence-based practice using a survey of 

employment specialists conducted to clarify the 

essential components of customized employment 

– what it is and is not – which created a consistent 

starting point for researchers. 

• A randomized control trial to evaluate the 

employment outcomes of individuals who received 

customized employment services as compared to a 

control group.

• Knowledge translation activities, including outreach 

to vocational rehabilitation professionals, to facilitate 

implementation of customized employment as an 

evidence-based practice. 

The intervention demonstrated success. Predictive 

statistical analyses of the first three cohorts showed that 

a final planned cohort would most likely achieve a similar 

positive outcome. Therefore, ethical considerations 

led VCU to suspend the randomized control trial and 

expand the intervention to include both treatment and 

control groups in the final year. Results of this study are 

expected to be published later this year. 

Evaluating Return on Investment for 

Supporting CIE 

NIDILRR-supported research also has looked at 

return-on-investment and cost-benefits of CIE. Dean, 

et al. (2015) examined vocational rehabilitation and 

other administrative data to study short- and longterm employment impacts for people with cognitive 

impairments who applied for vocational rehabilitation 

services in Virginia. Econometric modeling incorporated 

labor market data and allowed for analyses based on 

different vocational rehabilitation service options. The 

authors found that vocational rehabilitation services 

generally provided positive long-run labor market 

outcome effects that appeared to substantially exceed 

the cost of providing services. That is, for people with 

cognitive impairments, the mean five-year benefits 

of $21,175 exceeded the mean costs of vocational 

rehabilitation services by four to six times (Ibid., 2015).

A more recent scoping review by Taylor, et al. (2021b)

analyzed and synthesized micro and macroeconomic 

analyses of vocational services for people with ID/

DD. Most of the 26 studies reviewed reported that the 

benefits of customized and supported employment within 

integrated work settings exceeded costs. The authors 

found no studies that showed similar positive cost-benefit 

ratios for 14(c) sheltered workshops and, in some cases, 

the costs of sheltered work exceeded the benefits. 

The authors concluded the study with a call to action: 

“There remains a critical need to close the gap as 

youth with [ID/DD] transition from school to adulthood 

and ensure that all are set on a seamless trajectory to 

CIE. Although a reform of this magnitude may come at 

considerable cost, it is important to evaluate continued 

inaction in contrast to the invisible cost of lost talent if 

another generation of individuals with [ID/DD] continues 

to receive the same outcomes” (Ibid., p. 204).
References

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state-legislation/

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