I have been hesitant to write this post, due to the intense controversy that the topic tends to generate. Ironically, this controversy is not so heated in conversations with consumers, but tends to be a philosophical discussion between different organizations. Personally, I tend to be on the fence, as I see very good arguments on both sides. Besides, similar to the “meaningful day” issue, it is pretty presumptuous for me or anyone else without a disability to talk about what is in the best interest of another.
The argument against the workshop, obviously, is that it is not an inclusive atmosphere- that being in this environment does not allow integration into the community. The change in waiver service definitions that prohibit any specific job skills training makes the use of pre-vocational services as a stepping stone to community employment more challenging than ever.
The argument for sheltered work is mostly found in conversations with consumers who attend this service, and have done so for a long time. In multiple interviews, I hear the same thing: “I like it here.” “This is my job, why should I get another?” “My friends are here.”
So, the people directly able to choose (consumers and families) choose sheltered work as an option, even as providers and advocates work to find the most inclusive environment possible.
First, addressing Mr. Callahan’s concern, transition programs must assure that all options are open, starting with post-secondary or community employment. As Indiana VRS already supports this program, these options should be the first ones on the list. Facility-based options can be discussed at parental or consumer request. As the Medicaid Waiver service definitions state, facility based employment programs should not approached as a final destination, but as needed training with the goal of community-based employment. It becomes part of a continuum that is regularly reviewed for each consumer.
In order for this to work, however, the service definition for Pre-Vocational Services would need to allow for job-specific training. That way, in following the community-based employment model, skills are taught that are in line with the consumer’s desired outcomes and specific needs. Training tracks could be utilized to prepare an individual for the job in which they plan to apply.
Finally, for any community-based training alternative, funding must be made available to support it. An individual who has multiple or significant disabilities may need job coaching for a very long time, if not indefinitely. In order to be supported individually, this will probably be costly. The bottom line, however, is that strong beliefs remain strong beliefs only, unless there are resources to put them into effect.
There are solutions to be found, certainly. These solutions will only be found, though, by open and frank discussion that does not devolve into anger. Service models change over time, but abrupt change or unsupported change are disastrous to all.
Christiaan
Great post my friend. That is the kind of thinking I like. The discussion is an interesting one with many issues to solve. The most important being it must be an option. The other you hit on is it needs to be a stepping stone and not a landing spot. Too may providers out there and they know who they are don’t want the client to leave because they will lose the funding. I am glad to say I know you are not one of those folks.
Keep the faith and keep up the great work and thinking.
Peace
Great post. My chief concern with sheltered work is the built in financial incentive to a) keep the least disabled and best workers on the ranch so as to maximize the gross profit line and b) not give sheltered work to those with the most severe disabilities as they cannot produce at level to maximize said gross profit. In other words, those who should be moving on, don’t, and those who need sheltered work opportunities don’t get it. Instead they must settle for a “meaningful day”, which is basically code for entertainment without work or a paycheck.
You are absolutely correct, Tim. That is precisely the reason, I think, that there is so much controversy over sheltered work in general. Some of the latest discussions we have had with the state may do something to improve that situation. I agree with your assessment- the way that it is set up makes it a financial disincentive to work toward community-based alternatives. Check this out, though- if we can have small-ratio groups in pre-voc, then we can have the staff support to dramatically increase options for people who want to work. If we also put “teeth” in the employment policy that requires continuous movement toward competitive employment, those providers that are focusing on profit over progress (if such exist) would be unable to continue the practice. I think all of us believe in work first, and want to keep every option open. I have thought a lot about pre-voc and sheltered work as we have dealt with this year’s crisis. Providers with integrity will alway strive toward maximizing self-sufficiency, and pre-voc is an excellent modality if used to further that purpose.
I don’t use the term “Meaningful Day” if I can help it. It is a buzz word made up by people without disabilities arguing over what is in other people’s best interest. Meaningful day is self-defining. If there are 50 people in a room, there are 50 definitions.