240889 Long-Term Supports and Services (LTSS): Supportive Employment for Adults with Disabilities

Tuesday, November 1, 2011: 8:30 AM

Jennifer N. Howard, MPP, MSW , Health and Long Term Care, IMPAQ International, Washington, DC
Sarah A. Ruiz, PhD , Aging and Long Term Care, IMPAQ International, Washington, DC
Oswaldo Urdapilleta, PhD , IMPAQ International, Columbia, MD
Federal mandates and initiatives (e.g., Americans with Disabilities Act, Olmstead Decision) provide an impetus for states to pursue community integration for all individuals. As states continue to reform their long-term supports and services (LTSS) systems, there is a growing interest in determining their success in providing a balance between home and community-based services (HCBS) and institutional alternatives, specifically supportive employment options for adults with disabilities. Objectives: The purpose of this study is to evaluate the LTSS systems of ten states through the NBIP. Despite substantial research efforts to study rebalancing, a gap remains in the availability of common indicators to measure rebalancing efforts. To address this gap, the NBIP is assisting the Centers for Medicare & Medicaid Services (CMS) in the development and refinement of several indicators to assess states' progress towards a balanced and person-driven LTSS system. One area of interest that is being examined is the extent to which states support individuals' integration and inclusion in the community across disability types through supportive employment options. Findings: States' efforts to support employment options for persons with disabilities were one aspect of community integration that was explored. This was measured by examining whether a State offered a Medicaid Buy-In to support working-aged adults with disabilities in seeking and maintaining employment. Seven of the ten States surveyed had such programs. Another measure evaluated employment rates of working-age adults with disabilities using American Community Survey (ACS) data. Employment rates in the disability community ranged from 30.2% (Kentucky) to 51.6% (Iowa).

Learning Areas:
Advocacy for health and health education
Provision of health care to the public
Public health or related public policy
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Discuss disparities in state LTSS systems providing supportive employment options and employment rates for individuals with disabilities. 2. Discuss the NBIC developed LTSS indicators to assess the integration of people with disabilities into the community by providing employment services and states’ performance on these measures. 3. Develop recommendations for reducing gaps in the provision of supportive employment options and employment rates for individuals with disabilities.

Keywords: Disability, Labor

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am managing the project that is the subject of the presentation. I am currently serving as Project Manager on the Centers for Medicare and Medicaid Services (CMS) National Balancing Indicator Project related to state balancing of long-term support and service (LTSS) systems. Also, I provide support on a multi-year Administration on Aging project evaluating aging and disability programs and services. I have substantive knowledge of LTSS programs and policies for adults with disabilities and older adults. During my career I have worked on disability and aging program evaluation projects at the state and national levels.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.