Department of Health and Human Services 

OFFICE OF 

INSPECTOR GENERAL 

JUNE GIBBS BROWN 

Inspector General 

AUGUST 1999 

OEI-07-98-00260 

Employment Programs for Persons with 

Developmental Disabilities 
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 
EXECUTIVE SUMMARY 

PURPOSE 

To describe promising approaches and barriers to employment programs for persons with 

developmental disabilities. 

BACKGROUND 

Developmental disabilities affect a person’s 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 

Employment Programs for Persons w/ Dev. Disabilities 1 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 

Employment Programs for Persons w/ Dev. Disabilities 2 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. 

Employment Programs for Persons w/ Dev. Disabilities 3 OEI-07-98-00260 
TABLE OF CONTENTS 

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

Employment Programs for Persons w/ Dev. Disabilities 4 OEI-07-98-00260 
INTRODUCTION 

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 

person’s 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. 

Employment Programs for Persons w/ Dev. Disabilities 5 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. 

Employment Programs for Persons w/ Dev. Disabilities 6 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 Education’s 

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 

individual’s 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 

Employment Programs for Persons w/ Dev. Disabilities 7 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 

Employment Programs for Persons w/ Dev. Disabilities 8 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 President’s Council on Integrity and Efficiency.

Employment Programs for Persons w/ Dev. Disabilities 9 OEI-07-98-00260 
FINDINGS 

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 

Employment Programs for Persons w/ Dev. Disabilities 10 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 

Employment Programs for Persons w/ Dev. Disabilities 11 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. 

Employment Programs for Persons w/ Dev. Disabilities 12 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 supports”2 19 respondents 

Effective marketing (filling an employer’s 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 

Study participants may have indicated more than one response. 1 

“Natural supports” are coworkers, friends, neighbors, and family upon which the person with 2 

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 

Study participants may have indicated more than one response. 1 

Source: OEI Survey, 1999 

Employment Programs for Persons w/ Dev. Disabilities 13 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 one’s 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; 

Employment Programs for Persons w/ Dev. Disabilities 14 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. 

Employment Programs for Persons w/ Dev. Disabilities 15 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. 

Employment Programs for Persons w/ Dev. Disabilities 16 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. 

Employment Programs for Persons w/ Dev. Disabilities 17 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?" 

Don’t 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 

Employment Programs for Persons w/ Dev. Disabilities 18 OEI-07-98-00260 
RECOMMENDATIONS 

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. 

Employment Programs for Persons w/ Dev. Disabilities 19 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 ACF’s comments are 

included in Appendix D. 

Employment Programs for Persons w/ Dev. Disabilities 20 OEI-07-98-00260 
APPENDIX 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 supports”2 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 

Study participants may have indicated more than one response. 1 

"Natural supports” are coworkers, friends, neighbors, and family upon which the 2 

person with developmental disabilities relies. 

Source: OEI Survey, 1999 

Employment Programs for Persons w/ Dev. Disabilities 21 OEI-07-98-00260 
APPENDIX B 

Ineffective Approaches,

As Specifically Reported By Respondents

State 

Councils 

Vocational 

Rehabilitation 

Mental Health; 

MR/DD1 

agencies Employers Job Agencies 

Sheltered 

workshops. 

Large 

conferences. 

Local coalitions 

cease when 

funding stops. 

Treat the person 

as “charity.” 

Don’t oversolicit 

businesses. 

Meaningless 

jobs. 

Segregated 

worksites. 

Persons with 

severe 

disabilities need 

more than just 

“natural 

supports.” 

Grants: when 

payments are made 

rendered. 

Work crews (these 

should only be used 

as a last resort). 

Persons with severe 

disabilities require 

Training without 

job development. 

Begging for jobs. 

Granting money to 

groups. 

before services are 

more than “natural 

supports.” 

Program-based 

approach, rather 

centered planning 

concept. 

Offering too many 

financial incentives. 

Lack of transition 

services. 

Use of vocational 

assessment tools 

Non-supportive 

parents. 

Pre-vocational 

training models. 

Local advisory 

groups tend to fall 

apart. 

Slotting. 

than person 

and tests. 

Too much 

paperwork; 

in the way. 

Tax credit 

paperwork is 

difficult. 

Overanxious 

expectations. 

Employer not 

taking the time 

Poor job 

matching. 

Harsh 

treatment, 

Inventing/ 

making up 

work to keep 

the person 

busy. 

bureaucracy got 

to train. 

reprimands. 

Unwillingness of the 

employer to “carve out” 

person with a 

developmental disability. 

High pressure jobs with 

stress and heavy 

production schedules. 

Inadequate screening. 

Poor fit between person 

Poorly organized small 

businesses with unsafe 

Placing a person before 

they are ready. 

Lack of individual 

attention. “One size fits 

Jobs which involve a lot 

of change or which 

demand mastery of many 

tasks. 

Jobs at less than 

an appropriate job for the 

and job. 

working conditions. 

all” thinking. 

minimum wage. 

1

Mental Retardation/Developmental Disabilities agencies 

Source: OEI Survey, 1999 

Employment Programs for Persons w/ Dev. Disabilities 22 OEI-07-98-00260 
APPENDIX 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. 

Employment Programs for Persons w/ Dev. Disabilities 23 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 

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APPENDIX D 

Agency Comments

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