REHABILITATION RESEARCH AND TRAINING CENTER AT VIRGINIA COMMONWEALTH UNIVERSITY

Part of the project's focus is to find individuals jobs of their choice using person-centered planning. During Robert's PATH meeting, he was asked, "what is your greatest fear related to employment?" His response: "I don't want just any job. I want a job that interests me." Unfortunately, Robert's first job had been found "for him". His only "choice" had been no job or a job working in an enclave. His fear was that this would happen again.

Often supported employment programs are quick to say that they promote customer choice. However, if probed further, many well meaning employment specialists have difficulty describing how their programs give customers choices in the services that they receive. There are many "Roberts" who must choose between no job or a job less than what they deserve. Customer choice becomes a buzz word rather than practice.

Some programs continue to justify employment in segregated options under the guise of customer choice. They argue that individuals choose to stay in these settings, because they are happier there than they would be working in the community. The question then becomes one of informed choice or the freedom to make informed decisions. In fact, Webster's dictionary defines choice as:

While this may seem a matter of semantics to some, it is interesting to think about these definitions in relationship to the services provided by supported employment programs. Are we giving our customers the "privilege" of choosing based on professional authority? Do we simply provide two alternatives and force people to choose the one which may be the lesser of two evils? Or are we truly providing a selection of choices and assisting individuals in carefully discriminating between their choices? Finally, is the power to make choices about their lives something that customers earn or is it a right?

Fortunately, there are many supported employment programs nationally that are wrestling with the definition of customer choice. They are designing and using best practice strategies that place the individual at the center of his/her employment process. Some of these best practices include choice, control, careers, full inclusion, long term supports, community and business supports, rehabilitation technology, and person-centered planning. This RRTC newsletter will highlight a number of these exciting best practices. ----- Katherine J. Inge, Editor

There are nine best practices that are encompassed in a customer-driven approach to supported employment. Central to the concept is the idea that the customer is in control of the process. The role of the employment specialist is to assist the customer in reaching his or her career goals. The best practices which include choice, control, careers, full inclusion, long term supports, community and business supports, total quality management, assistive technology, and person-centered planning form the foundation to this approach. Quality service providers will incorporate these practices into their daily activities of implementing supported employment services.

The opportunity to make choices concerning employment, living arrangements, and recreation has been limited or nonexistent for many individuals with disabilities. Choice in a customer-driven approach would dictate that all supported employment customers are presented with a variety of experiences, options, and supports to achieve career goals of their choice. If individuals are to experience personal satisfaction and quality of life, regardless of the level or type of disability, they must be given the opportunity and support to express preferences. Supported employment customers need to be directing the process by choosing the service provider, the subsequent employment specialist, and the specific support services that they may need to obtain and maintain employment.

The concept of control expands the above definition of choice to a broader concept of exerting control and ultimately self-determination. Control refers to an individual's ability to access supported employment services and to freely act upon his or her choices and decisions without fear of reprisal. Supported employment customers must be free to participate in supported employment services by choosing a service provider or employment specialist, by accepting or declining a specific job, or by electing to resign or continue employment with a particular company.

Career development is an important consideration for any adult seeking employment. The customer-driven approach to supported employment places an increased emphasis on the initial time that a direct service provider spends with the customer to assist with the identification of career goals. Service providers must be skilled in working closely with their customers to develop strategies for marketing their service, establishing a rapport with the business community, interviewing employers, and conducting in-depth job analysis of specific employment settings. Completing this process will yield an extensive amount of information for the customer to determine if the wages, benefits, conditions, supports, and corporate culture are sufficient for long term career development.

The concept of full community inclusion calls for a vision of society in which all persons are viewed in terms of their abilities and are welcomed into the mainstream of community life. Relationship building at the business site will be vital to building full community inclusion and achieving employment satisfaction. For example, working age adults spend, on average, 40 hours a week at their place of employment. The office or business setting is where many social relationships are formed. This same principle holds true for people with disabilities. However, because some people are still uncertain of how to approach someone with a disability, the employment specialist can assist by breaking down these artificial barriers from the first day of work. Assisting individuals with disabilities to obtain full inclusion in the work setting will facilitate a new vision of community where all members are valued.

Despite the importance of long term supports, it is the area of supported employment that has received the least amount of attention. Generally, service providers are very concerned with options for funding of this component of supported employment. Yet, the entire notion of type and level of support has been left open for individual interpretation. Long term supports should be designed to assist the customer in the identification and provision of supports and extended services which maintain and enhance the person's position as a valued member of the work force.

The entire notion of support has been vital to the national expansion of supported employment. An employment specialist must be prepared and have the necessary knowledge to develop community and business supports, facilitate informed choice, assist in assessing preferred choice, provide a variety of individualized supports, coordinate and monitor all types of assistance and respond to changes over time. The direct service providers of supported employment should be spending less time actually engaged in delivering a support and more time engaged in assessing a situation with a customer, sharing information about possible support options, assisting the customer in accessing the support option, and evaluating the effectiveness of the strategy.

Continuous quality improvement calls for service providers to focus their time and energy on improving the process, the product, and the service. The key to continuous improvement is driven and defined by the customer. Providers must listen to the wishes and desires of persons with significant disabilities to determine the agency's mission, goals and objectives. People with disabilities who are participating in supported employment or who are actively seeking services should be assisting in developing and evaluating services. Having job coaches, job developers, and customers working together will give the agency the necessary data to drive quality improvement.

Since the early 1970's, assistive technology has emerged and opened unlimited employment opportunities for persons with disabilities. Individuals who at one time were unserved and faced enormous barriers concerning accessibility, communication, and mobility can now optimize their intellectual and physical capabilities. With the use of voice synthesizers, people are able to express their wants and desires. Computers can be operated by a human voice or a simple gaze of an eye. This new technology is unlocking doors and providing opportunities for a greater number of people to obtain and maintain employment.

Supported employment has always been about assisting one person at a time in achieving employment satisfaction. Person-centered planning seeks to support the contributions of each person in his or her local community by building a support group around the individual. This support group or community network functions together to assist the focus person in obtaining his or her goals and aspirations. Person-centered planning provides an excellent tool for the customer to direct the career process.

Summary: Nationally, such complaints as "he just doesn't appreciate the job that I got him" or "if only I didn't have to deal with her family" have been common statements made by professionals. All too often, these professionals are making decisions for customers. Professionals who engage in this type of behavior are imposing their values or the agency's values on the people receiving services. When this occurs, the rights of people with disabilities are violated.

Fortunately, this method of "doing business" is coming to an end. People with disabilities are speaking out, taking control of their lives, and seeking to direct the services they need. This current movement of people with disabilities asserting choice and control over their destinies is having a major impact on supported employment services and has led to a "customer-driven approach" to supported employment. The following table outlines the values inherent to these new service delivery practices.

Customer-Driven Support Teams

Many supported employment customers are beginning to use support teams to assist them in identifying a career path. This has been referred to in the literature as a "Circle of Support" or "Circle of Friends". Typically, the team is made up of friends, family, professionals, and any other persons involved in the customer's life. A supported employment team may include the customer, his or her employment specialist, vocational rehabilitation counselor, case worker, friends and family members, and so forth. Only those individuals selected by the customer should be asked to be members of the team.

The customer-driven support team can use any number of person-centered approaches to assist in identifying employment interests and strengths. These strategies have been referred to as "personal futures planning", "lifestyle planning", "MAPS", and "PATH". Typically, a team meets to explore what the individual wants his or her future to be like. Planning sessions provide a forum for everyone to brainstorm and share their ideas and expertise. Finding out what the individual would like to do, remembering that he or she may not be able to articulate specific careers, offering suggestions, and determining whatever it takes for him or her to be able to pursue these interests and achieve the greatest degree of satisfaction is just one of the many major accomplishments resulting from a customer-driven approach to services.

Identifying the Career Path

PATH as a Planning Tool

The PATH process was designed by Jack Pearpoint, Marsha Forest, and John O'Brien and can be used to identify a customer's dreams and goals for employment. A PATH is led by a group facilitator and a graphic recorder. These individuals are preferably "neutral" and not members of the customer's support team. The following eight steps are completed and must be discussed in order to preserve the integrity of the process.

The facilitator's responsibility is to assist the team in addressing each of these eight steps of the PATH. The customer should be encouraged to "dream" what his/her future looks like without any limitations. Once this has occurred, the customer can talk about the goals that have been accomplished during a specified time period. This could be one year, six months, or any other length of time that is just past what the person can predict. The facilitator encourages the customer to think about these events as if they have already happened. Goals identified in this step should be positive and possible. If the customer has difficulty communicating or is unable to think of events in the future, the facilitator can encourage the team to assist by describing things that they feel have happened. These career goals or events always should be verified by the customer, before placing on the PATH.

The next steps require the customer to think about how he/she feels now, who needs to assist in the PATH, and how the customer builds strength. Obviously, identifying individuals to enroll in the support team is a critical step towards assisting a customer in meeting his/her career goals. For instance, one customer realized that she would need her personal care attendants enrolled in order to successfully get dressed and be prepared to go to work everyday in a timely fashion.

The final three steps of the PATH ask the customer and his/her support team to identify actions for the next few months. Again, the facilitator asks the group to talk in the past tense. Such as, "I have opened a checking account." "I have participated in three situational assessments to identify the type of career that I would like to pursue." The customer and the support team should be specific about who does what and when it will be accomplished. The employment specialist may assist the customer in monitoring the progress that occurs towards meeting the customer's career path. The following page presents some of the career planning activities that were identified during one supported employment customer's PATH meeting.

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