EXPECTING MORE

The 2013 Legislative Session began on Tuesday, January 8. It is the first year of the biennium which means the primary focus will be setting the biennial budget. The November election brought big changes in Minnesota state government. For the first time in 22 years, the Senate, House, and Governor’s office will all be controlled by the DFL. The election also brought 65 newly elected members of which nineteen have previously served in the legislature. The DFL has targeted balancing the budget, jobs creation, tax reform, and education as their top priorities. In the area of health care – health reform and adopting legislation to implement the health insurance exchange will be at the top of the list.

To better understand the legislative issues from the disability community perspective I reviewed the websites for The Arc of MN, Association of MN Counties, Association for Residential Resources in MN, Care Providers of MN, MN Consortium for Citizens with Disabilities, MN Council of Nonprofits; and the MN Day Activity Center Association. Some common themes that emerged include:

• Support a balanced approach to the 2014-2015 budget;
• Enact a Cost of Living Adjustment (COLA) also known as a rate increase;
• Fund the health insurance exchange requirements and other Affordable Care Act mandates;
• Monitor Medicaid Reform initiatives coming from the Department of Human Services;
• Modernize and strengthen Minnesota’s election system while increasing access to voting;
• Ensure rate frameworks preserve the ability of organizations to provide critical disability services; and
• Promote funding strategies that assure people with disabilities live at the maximum level of independence.

The important issues that Merrick will be tracking this session include the following:

1. Encourage stakeholders to: (i) have the definition of DT&H services updated to reflect current practices and deemed an “essential service” (thereby mandated for payment during a government shutdown); and (ii) reestablish rules prohibiting any licensed provider from having 24-hour control of a vulnerable adult (sunshine rule) as part of finalizing the new licensing rule 245D.

2. Support MnDACA’s efforts to: (i) work with DHS on the final values for the new rate frameworks and implementation plan; (ii) repeal the 1.67% rate cut scheduled for 7/1/13 – 12/31/13 because CMS did not approve the state’s early implementation of the new nursing facility level of care (NFLOC) criteria; and (iii) eliminate the $2.55 “family out-of-pocket” fee being applied to MA providers.

3. Revise MS 174.30 (Subd 1)(c) to exclude vendors from STS regulations that exclusively provides transportation services to individuals enrolled in licensed day programs, including adult day care, family adult day care, day treatment and habilitation, prevocational services, and structured day services; and transports 15 or fewer persons, including passengers and the driver.

4. Oppose any legislation that does not affirm the service recipient’s choice as primary and/or restricts voting rights for citizens with a disability.

With the change in party control there has been a complete changeover in leadership. The Senate DFL has elected Senator Tom Bakk as the Majority Leader and he has served previously as the Minority Leader. Senator David Hann was elected as the Minority Leader, previously served as the Health and Human Services Finance chair, and is a friend to the disability community. Senator Tony Lourey will chair the Health and Human Services Finance Committee and Senator Kathy Sheran will chair the policy committee. Both are familiar with disability issues. In the House, Representative Paul Thissen was elected as Speaker and previously chaired the Health Policy committee. Representative Erin Murphy was elected Majority Leader and has served on the Health and Human Services Committee. Finally, the House Republicans have elected Representative Kurt Daudt as the Minority Leader and this is only his second term. Representative Tom Huntley will chair the House Health and Human Services Finance Committee and Representative Tina Liebling will chair the Health Policy Committee.

The November forecast projected another deficit of $1.1 billion for the coming biennium of FY2014-15. However, the current biennium ended with a positive balance of $1.3 billion which under current law was used to buy back the school payment shift. The DFL leadership and Governor Dayton are calling for a balanced approach in dealing with the deficit, meaning both additional revenue and budget cuts. The Governor has said that he will push his proposal to tax the top 2% of income earners. The Legislature has not totally embraced that proposal and has indicated an interest in tax reform that might close loopholes and/or expand the sales tax to cover more items, (i.e. clothing). The talk of additional revenue has triggered a lot of “pent up” demand for increased spending so DFL legislators are trying to lower expectations. That “pent up” demand is being felt by disability providers as rates have been cut to balance the budget. In fact, there has not been a COLA (cost of living adjustment) since 2008 and many services have had rates cut since then to balance the budget.

As evidenced by the recent election, citizens have grown weary of partisan dogma intending to restrict personal choice and political posturing on issues important to the wellbeing of our communities. It’s clear that our political and civic leaders are failing us – and it is our fault. As Sean Kershaw, Executive Director of the Citizens League, states in his recent Minnpost article – “I’m also tired of the pity-card being played by people like me who know better: who have enough time and energy and resources around them to do something differently; who recognize the silliness of whining and civic victimhood; and who realize that our leadership is a reflection of all of us and of a civic culture that has become too passive and a political culture that has become too toxic”. He goes on to discuss their new Quantum Civics program that sounds very intriguing and something to consider. Still it comes down to every citizen expecting that our civic and political leaders have a broader vision of what is good for our communities and the courage to find innovative strategies to confront the challenges we face. We have enough money, compassion, and intelligence to make Minnesota a better place for its citizens and we need to hold legislators in the 2013 session accountable for making progress to that end.

RESPONSE TO REAL JOBS

Jon Alexander is a respected colleague who sometimes challenges my messages. He is also the CEO of Kaposia, a supported employment and day training and habilitation provider, a co-manager of the Minnesota Employment Policy Initiative (MEPI) project, and a founding member of the MN Employment First Coalition. In the interest of full discussions leading to better outcomes, I invited him to share his thoughts on competitive employment through the Bark’s Bytes channel.

From Jon Alexander:

In 2009 and 2010, the MEPI conducted a series of listening sessions across disability groups to gather information focusing on the question, “What will it take to double the competitive employment of people with disabilities?” Over 200 individuals with disabilities, professionals, family members, and advocates participated. A series of policy briefs related to employment for people with intellectual or developmental disabilities, autism, physical disabilities, brain injuries, mental illness, deaf-blindness, or hearing loss, as well as youth in transition were presented.These policies briefs were then summarized in a final report. In the reports, the term “real jobs” was used in only one recommendation.

This recommendation pertained to students still attending school and is included below. Participants in the listening sessions used “real jobs for real pay” to clarify that they were recommending jobs similar to those secured by students without disabilities, not the types of “work experiences” available to students with disabilities as part of their school program. “Work experiences” were viewed as being developed by school personnel with the job belonging to the school program, not the individual. Listening session participants felt it was important for students with disabilities to have their own job prior to graduation to better inform their choice of employment upon leaving school.

Recommendation from one of the policy briefs: Ensure students with disabilities have real jobs for real pay while they are still attending school. There is no substitute for having a real job. Research on transition has documented that a positive correlation exists between the number of paid jobs held by youth with disabilities and their future competitive employment outcomes. A job is a powerful learning experience for a young person. It is the best way to learn about work and to start building a resume for future jobs. Students with more significant disabilities often have “work experiences” which are often unpaid, artificially created experiences that take place within the school setting or in groups in the community, rather than having real jobs while they are in school like other teenagers. While there is value in work experiences, they provide a limited opportunity for learning. There is usually no interview or selection process. Expectations are not the same as working directly for an employer for wages. In many work experiences, students are isolated from the paid workforce at the place of business, preventing them from fully experiencing the social aspects of a job. As a result, they do not learn some of the “soft” skills vital to successful employment or the direct connection and rewards of paid employment and work.

In his blog post titled, A Real Job, JWB connects the term “real jobs” with MEPI’s definition of competitive employment. MEPI does define the term “competitive employment” as “work in fully integrated settings, with or without supports, paid at prevailing wages.” We used this term because defining “employment” alone is a daunting task that is probably impossible given the differences of opinion on the issue as noted in a quote from the beginning of JWB’s post. We chose to emphasize “competitive employment” as it is the most consistently defined term and goal in statute and policy at both the state and federal level. We also typically include self-employment as part of our definition, though the quote used did not include this option.

So what’s my point?

I agree the term “real job” is one which can create at best, confusion and at worst, hard feelings. This term is used by many critics of our system who would like to see people move from low paying jobs where they work on a limited number of tasks and are paid directly by a provider into ones that are more typical of the general population, namely competitive employment. The MEPI reports however did not intend to use the term “real jobs” in the way JWB describes. In fact, the MEPI team worked hard to communicate its findings and recommendations in ways that attracted not repelled potential collaborators to its long range goal—increasing the number of Minnesotans who participate in the community workforce.

If JWB had asked whether or not MEPI established a preference of “competitive employment” to other types of employment, the answer is “yes.” We view employment that focuses on individual skills, offers market rate pay and benefits, encourages higher levels of integration, and offers capacities for employers to supervise and support their employee naturally as a preferred option to traditional practices. But valuing naturally supported competitive employment over center-based employment or other community employment like work crews or enclaves, does not equate to saying those options are not “real.”

Finally, I would like to add that there is a great deal of tension between differing sides in the on-going debate about how to improve the outcomes realized by the individuals who receive services from organizations like Merrick or Kaposia. Both sides need to do a better job of listening and communicating without the use of terms that create more rigidity in our positions. JWB and I met and discussed how we might do this on a personal level in the hopes that we can be role models to our colleagues on both sides of this debate. I’d like to thank him for this opportunity to respond to his latest editorial. ~ Jon Alexander

A REAL JOB

In July 2012 someone in our field was quoted in the local paper saying that the work clients at Merrick do and get paid for is “like an activity with an allowance” and “I don’t consider that work”. This person is also a constant voice within the Minnesota Employment Policy Initiative (MEPI). Visiting the MEPI website (http://www.mn-epi.org/first/index.asp) you can find their January 2012 policy statement that “Employment First is the vision of making integrated competitive employment (with or without supports) the first priority and preferred outcome of Minnesotans with disabilities”. In MEPI’s 2011 report “Policy Brief on Employment of Minnesotans With Intellectual and Developmental Disabilities”, they define competitive employment as “work in fully integrated settings, with or without supports, at prevailing wages.” From these two statements I understand MEPI to assert that a job must be both fully integrated and paid at a prevailing wage to be “real”.

Let’s examine their first assertion that a job must be fully integrated to be “real”. Not only do I struggle with their undefined use of the phrase “fully integrated” (see http://www.merrickinc.org/barks-bytes/247-numbers.html), I am perplexed by the notion that where one works can make a job any more or less real. What of an Internet entrepreneur working from a home office or a professional golfer that earns their money on 18 beautifully landscaped holes? As Jim Chicone said in his 9/20/12 Thoughts on Thursday’s Facebook post “While individuals, groups, and society at-large can place a higher value on some features of a job over other features, a job is a job; it is what it is”.

Their second assertion that to be “real” a job has to be paid at a prevailing wage is even less true than their first assertion. What of an artist that may work months or years on a sculpture only to sell it for a few hundred dollars? Or a real estate agent that works on a full commission? While what one gets paid certainly influences what one can buy, if a person performs an activity for any amount of compensation don’t they have the right to call it a real job?

Consider Luke Haley (http://www.twincities.com/ci_21338651) who takes an art class three times a week and volunteers at Trinity Lutheran Church, Feed My Starving Children, and Good Samaritan Nursing Home. In the article his mom reflects on the unique value he brings to the world when she says “It’s not easy to show that kind of generosity to your fellow humankind, but he does it boldly, and he does it with passion, and he never gets discouraged. He’s been such a teacher for me.” From the article the reader certainly gets the impression that the organizations that Luke interacts with count on him to greet visitors, package food, and deliver the mail – tasks that need to be done. Why does MEPI consider the wage the only factor in valuing the work being done and ignore Luke’s satisfaction and the gratitude of those he serves.

At Merrick we have narrowed our definition of meaningful work as having the following four criteria:
• a preferred task;
• in a setting of choice;
• with dependable hours; and
• for a satisfactory wage.

The beauty of this definition is that every client gets to define each of those four criteria for themselves and proudly call it their real job. It even works for Luke. What the people at MEPI fail to acknowledge is that, while a job can certainly enhance one’s life, it does not define it like choice. If government, providers, and advocates can work together to meet the four criteria above for citizens with disabilities we can stop wasting our energy on irrelevant employment policy and legislation. Finally, for the people at MEPI, what makes your job so “real”? If it is just pay and spending 40 hours in your definition of an integrated workplace – you might be missing the bigger picture and need to have a conversation with Luke.

Over the past year, Merrick, Inc., has focused our messaging to show why clients and our community are better for our services having been delivered. One of the key messages is that between 2004 and 2011 annual client wages increased from $331,775 to $542,970; an increase of 64%. This would be impressive anytime but even more so given the last three years of economic recession. Yet all statistics can be skewed to tell a more effective story… so, what is the data behind our numbers?

In 2004, we reported wages for 230 clients to the IRS and 289 clients in 2011 for a net increase of 26% client workers. Whereas, the average annual wage in 2004 was $1,442, it was $1,879 in 2011 – an increase of 30% (the average is $2,260 if you only count the 80% most productive clients an increase of 57%). In addition, according to a Ramsey County report, in 2011 we had 42 clients hired directly by a business averaging 17.8 hours a week at $7.71 an hour. You might think that a 30% increase sounds good and $7,136 in annual wages for clients hired directly by employers is nice – but isn’t $1,879 a year in average wages for 289 clients working on crews or in our facility rather low? If you consider that we only serve clients six hours a day and about one hour of that time is for transportation, one hour for breaks or other program elements, and perhaps a half-hour due to downtime, the average client is working approximately 3.5 hours a day or 787 hours a year.

Wait – how can Merrickpay clients $2.40 an hour ($1,879/787 hours) when the minimum wage is $7.25? We have what is called a commensurate wage certificate that is monitored and enforced by the Fair Labor Standards Act permitting us to pay a special minimum wage. The process to obtain a commensurate wage certificate is rigorous, reported on annually, subject to renewal procedures, and enforced by the U.S. Department of Labor. Calculating a special minimum wage requires us to establish the local market wage ($8.70 in 2011), and the output of a worker who is non-disabled to determine the “unit rate” for the work to be completed. We must then track the number of units each client produces and multiple this by the rate to determine each person’s earnings. For example, if a non-disabled worker can assemble 87 widgets an hour, then the unit rate is 0.10 cents a widget ($8.70/87 = 0.10) and that is what clients get paid for every widget they assemble. Everyday we have clients that are paid more than $7.25 an hour because they produce units at a rate exceeding the standard and we support one client that is working full-time and making more than $10.00 an hour with benefits. For more information on the benefits of the commensurate wage certificate, please read my editorial entitled “Commensurate Wage Is Not a Turkey”.

Okay – I understand this concept but how can clients live on $2.40 an hour? They can’t and you have to also consider the value of other support they receive. For example, the Jobs Now Coalition estimates that in 2009 a single adult in Ramsey Countyhad to earn $20,832 annually to pay for food, housing, healthcare, transportation, and other necessities. For most of our clients theses expenses are paid for by government funding along with as much as $8,376 annually in Supplemental Security Income (SSI) benefits of which I will only consider 25% or $2,100 annually, for personal expenses. When you add these three items together, clients are receiving the equivalent of $11.93 (20,832 + 1,879 + 2,100/2,080) an hour or $24,810 annually. Now some may say that if clients were paid more they could pay for more of their living expenses and reduce government spending. That sounds nice, and the state does have a program called MA-EPD which essentially does this when appropriate; however, in most cases these 289 clients have significant disabilities that limit their activities of daily living (ADLS) and independent activities of daily living (IADLs) that qualified them for services in the first place.

In closing, client wages have increased more over the past eight years than at any other time in our history which is indeed an accomplishment during these difficult economic times. This appears to be validated by 90% of the 243 respondents to the 2011 client satisfaction survey agreeing, “They were generally satisfied with the amount of money Merrickhelps me earn”. While others state that “they [sic clients] can do something – I am not sure what it is” we listen to client preferences and do our best to find their desired work. While others only focus on clients with the most capabilities and suggest that others be given the option of “staying at home”, we celebrate with clients that make less because of the effort involved and the pride in their paycheck. If the people we serve are doing work they enjoy, mostly on their own, in a setting of their choice, for the hours desired, at satisfactory wages – then we are living up to our mission to provide meaningful work that will guide them towards realizing their goals and dreams. To promote this message we have added two new tools to our communication toolbox:

• Infographic: http://bit.ly/ECSInfographic
• Video: http://youtu.be/3ClMUR7s4rw

I urge you to take a few minutes to educate yourself on this issue through our new tools and join with us in showing others why our communities are better off for having DT&H programs around.

Like the invasive milfoil that clouds our lakes and zebra mussels that kill our native species – Bob Shaw’s article ‘Is it exploitation of disabled, or a lifeline” (St. Paul Pioneer Press 7/8/12) makes our pond murkier and diminishes the progress made in the last decade by people with disabilities. Mr. Shaw’s article had three critical flaws that destroyed a potentially good story and I will try to correct each for the record.

First, we are not “segregating a minority class” as Scott Schifsky, Program Director of The Arc of Minnesota, is quoted as saying in the article. Integration has become a hot topic recently and, because misguided zealots don’t seek reasonable consensus, it is unlikely that we will have an agreeable definition anytime soon. Moreover, in a very real way integration is a choice. For example, a retired couple that chooses to live in an assisted living complex with their same-aged peers would not think of themselves as being segregated. Therefore, if integration is chosen by the individual, perhaps defining segregation would be helpful in this discussion and I offer the following – “Segregation is the forcible separation of a group or class from the rest of society”. From my view “segregation” does not apply to the nearly 16,235 people with intellectual and developmental disabilities (I/DD) served by Day Training & Habilitation (DT&H) programs in Minnesota because their placement was chosen by an interdisciplinary team that included themselves, their guardian/family, and an independent county case manager. Therefore, if people with I/DD are not segregated, they must be integrated. End of story.

Second, and perhaps forgivable because even Mr. Shaw’s expert sources don’t report the numbers correctly, the unemployment rate for people with I/DD is not 77 percent. To begin, it is important to remember that the employment goal is not 100% as, according to the StateData Book 2011 published by the Institute for Community Inclusion (ICI) at the University of Massachusetts, only 75% of all Minnesotans of working age (16 – 64) are employed. Now to the numbers (updated on 7/12/12 with new MDE data).

• The ICI reports that Minnesota has 131,744 citizens with a cognitive disability of working age and 75% of that number is 98,808 of which 48,705 are reported as employed.
• The Minnesota Department of Human Services reports that in 2009 DT&H programs served 16,235 people with I/DD of which only 1,677 were not pursuing work with 14,588 either hired by an employer, working on a crew, or completing facility-based work.
• In Minnesota most students with I/DD enter a transition program when their peers graduate until age 21. For school year 2010 – 2011, the Minnesota Department of Education website reports 127,863 unduplicated special education students of which 24,129 are ages 16 – 21.

Consequently, of the estimated 98,808 working age people with I/DD, 32,470 (48,705 – 16,235) are placed into jobs by the Minnesota Department of Employment and Economic Development or others making at least minimum wage, 14,588 people with I/DD in DT&H programs are working, and 24,129 people with I/DD are 16 – 21 year olds still in school. As a result 71,187, or 72% of our citizens aged 16 – 64 with I/DD are either working or in school compared with 75% of all Minnesotans. So, Minnesota has done a great job of providing work to people aged 16 – 64 with I/DD and their unemployment rate is not 77 percent. End of story.

The third flaw, and what I was most disappointed in, was Mr. Shaw’s decision to highlight the differences in the people with I/DD he met instead of recognizing the vast majority of sameness with the non-disabled population. I am certain that if I visited Mr. Shaw’s office I would observe unshaven men, women with a bad hair day, people dressed slovenly, messy work areas, and some eccentric behaviors. Still they are people doing their job and evaluated by their performance not solely their appearance or character traits. Why is it that Mr. Shaw chose to describe people with I/DD as though he was explaining to his children why animals in the zoo look and act differently than us? His comments were disrespectful and only reinforce the stereotypes that self-advocates, families, and providers have been trying to change for many years. I am privileged to be around over 350 people with I/DD on a regular basis and I mostly see individuals who want to be respected, given choices in their lives, and valued in their communities. Isn’t that what most of us want? One of the clients at Merrick is quoted as saying “We do have disabilities, but we’re capable of doing pretty much anything we want to do. Just like you. We work really hard. We have our goals and we want to make our dreams come true.” What constitutes fulfilling work is an individual choice and can be found as an employee of a business, a member of a crew, or in a facility-based setting even if that doesn’t jive with a fictional book someone is writing for self-aggrandizement. If you want a good story, read “Hiring People with Disabilities” written by Maura Keller in the February 2012 Minnesota Business and then call a DT&H in your area to talk about options to provide meaningful work to people with I/DD. By the way, Mr. Shaw, I sleep with my mouth open too – what does that mean? You missed a great chance to promote people with I/DD as valuable workers. End of story.

OUTREACH

With the 2012 Legislative Session in our rearview mirror, I am more convinced than ever that DT&H programs need to be educating their communities about how they make a positive difference in the lives of citizens with disabilities. As an example, whether you were a proponent of the stadium bill or not, it is clear that Vikings’ fans contacting their legislators in the last few weeks made a difference in the result. It is no longer acceptable to just do good work. We must also work hard to tell others about the good we do or accept not being valued by policymakers.

Outreach became a focus at Merrick, Inc., in March of 2011 when the Board of Trustees approved a plan to engage a communications consultant for a period of 13-months to accomplish some very specific deliverables. After soliciting for proposals, an internal ad hoc committee selected Kristi Hamilton of En Root Marketing & Communications as our consultant and she began her contract on 6/1/11. Her work with us has included conducting focus groups to refine our key organizational messages, leading us through a refresh of our branding, launching a virtual tour on our website, and laying the groundwork for proactive outreach with the community at large and potential business partners. 

In addition to the communication consultant, we planned for a 20-hour communications specialist position and in late September of 2011 welcomed Emberly (Em) Hermann-Johnson to the company. During the interviews, I asked each applicant their thoughts on my Bark’s Bytes editorials. Em’s response was the best with, “You seem to know what you are talking about and it was TLDR (Too Long Didn’t Read).” I knew then we had found the right person for the job.

As our communication specialist, Em seems to be involved in most everything happening at Merrick and is principally responsible for:

• training Trustees and Managers to effectively use social media to advance the company’s mission;
• managing email messaging, enewsletters, social media pages, and the website;
• producing program and annual report print media;
• coordinating the company’s stakeholder database;
• tracking and reporting web and social media analytics; and
• supporting my civic and business outreach activities.

A goal of mine is to make at least one presentation a month to a local business about the capabilities of our client workforce and to one civic organization about the benefits of our program. To do this, we use a “Point of Entry” model to identify, research, qualify, and schedule presentations with potential business partners and civic organizations in our community. All of this to accomplish two primary objectives:

1. To find meaningful work for clients at Merrick, which we define as work preferred by the client, done mostly by the client, in a setting of the client’s choice, with consistent desired hours, and satisfactory wages.
    
2. To have citizens understand that the clients we serve and their communities are better for the services having been delivered.

A reality for the clients we serve is that work is an essential part of being genuinely integrated in their communities because either they work at a business and/or their earnings give them the discretionary income needed to be an active citizen. Modifying a quote from Martin Luther King, Jr., “True integration will be achieved by true businesses who are willingly obedient to unenforceable obligations” encourages us to educate businesses on the benefits of employing people with disabilities and they will then voluntarily find those opportunities.

For the eighth straight year, client earnings went up and in 2011, clients paid through Merrick earned over $565,000. Still, we seek meaningful work for about 16 clients on-site, 18 clients on work crews, and six clients looking for independent placements. So, if you know of a business and/or civic group we should be driving home our messaging to, please send me your leads at jwb@merrickinc.org. I firmly believe through networking and spreading the message of the good work we do, we will be able to successfully continue our journey of empowering adults with disabilities.

NUMBERS

For the past few decades, a tremendous amount of time and money has been spent on integrating people with disabilities into the non-disabled community. As part of this process, how employment integration is defined continues to evolve and there is a small group advocating for “Employment First” legislation that would embody the following definition:

“Expecting, encouraging, providing, creating, and rewarding regular integrated employment in the workforce at minimum or competitive wages and benefits as the first and preferred outcome for working-age youth and adults with disabilities especially for those with complex and significant disabilities, for whom job placement in the past has been limited, or has not traditionally occurred” (MN Employment First Report – September 30, 2011).

According to this same report – “The employment rate for individuals with disabilities reported by the Office of Disability Employment Policy, is less than one-third that of people without disabilities (21% compared to 70% respectively)”. I do not consider this statement accurate. Conservatively speaking, at least two percent of our state’s population of 5,303,925 (2010 MN Office of Geographic and Demographic Analysis) has a developmental or intellectual disability (D/ID, formerly referred to as mental retardation) resulting in a total state population of at least 106,000 people with D/ID. Again referring to the MN Office of Geographic and Demographic Analysis, 84% of the population is of working age (16 – 64) which means that 89,000 (106,000 x .84) citizens with D/ID are of working age. According to the “Minnesota State Profile Tool:  An Assessment of Minnesota’s Long-Term Support System” (Eiken, S., L. Gold, S. Larson and K.C. Lakin, 2009, Table 2.2) 27,750 citizens (1,859 ICFs/MR, 14,056 DD Waiver, 11,855 CADI) with D/ID are served on a monthly basis. That would leave 78,250 (106,000 – 27,750) citizens with D/ID that are not “in the system” of which 65,730 (78,250 x .84) are of working age. Therefore, it could be argued that 74% (65,730 / 89,000) of people with D/ID of working age are in the workforce at minimum or competitive wages and benefits since they are living in their communities without any public support – not the 21% cited in the MN Employment First Report.

This leads to the second part of this issue concerning the definition of “integration” and it seems unlikely that the stakeholders supporting the D/ID population will soon come to a consensus definition. Moreover, in a very real way integration is a choice. For example, a retired couple that chooses to live in an assisted living complex with their same-aged peers would not think of themselves as being segregated. So, if integration is defined and chosen by the individual, perhaps defining segregation would be helpful in this discussion and I offer the following:

“Segregation is the forcible separation of a group or class from the rest of society”.

From my view this term does not apply to the 27,750 people with D/ID served by group homes and DT&H programs in Minnesota because their placement was chosen by an interdisciplinary team that included themselves, their guardian/family, and an independent case manager. Therefore, if people with D/ID are not segregated, they must be integrated. Beyond the reality of integration as an individual choice, as Martin Luther King, Junior said – “True integration will be achieved by true neighbors who are willingly obedient to unenforceable obligations.” This quote suggests to me that if we genuinely listen to the person with D/ID to identify their preferences, determine and build on their skills, and actively search for connections in their neighborhoods – businesses will hire them and communities accept them because they add value, not out of charity or because of some government mandate. It all comes down to doing the right thing, at the right time, one person at a time, without all the hyperbole coming from the ivory tower.

Is working in a facility-based DT&H program a good choice for people with D/ID? Yes if that is the individual’s preferred choice. Moreover, having state legislation that makes “minimum or competitive wages and benefits the first and preferred outcome” is contrary to person-centered planning and legislators need to hear the thoughts of their constituents on this issue.

Can more people currently served by DT&H programs be competitively employed? If that is their choice – yes and better progress will be made if we stop setting goals that are based on statewide statistics. For instance, the MN Employment First Report references the Fourth Summit of the Employment First Coalition that was held on September 30, 2011, around the question, “What will it take to double employment of Minnesotans with disabilities by 2015?” The answer is we cannot double the 74% employment rate of the statewide D/ID population, however, we can work on increasing the number of DT&H clients of working age in the workforce at minimum or competitive wages if that is the individual’s preferred choice.

Fueled by an egregious situation involving an Iowa turkey farmer, there have been some provocative media stories and federal committee hearings calling for the repeal of the commensurate wage provisions of the Fair Labor Standards Act (FLSA). To be clear, the review and discussion of the commensurate wage provisions to ensure that outcomes are meeting original intents should be encouraged. Unfortunately, statements in the National Disability Rights Network document entitled Segregated & Exploited – A Call to Action are both misleading and one-sided; and those who are championing the repeal of the commensurate wage provisions at committee hearings are only telling half the story.

Presuming most of the readers have worked at some point in their life I assume that everyone understands that not every worker in America is paid a guaranteed wage. There are many examples of workers that are non-disabled who get paid a special minimum piece-rate, sub-minimum wage plus tips, or 100% commission (assembly worker, food server, sales professional) that result in earnings commensurate with their productivity.

Unlike Greece that is struggling with an economy where workers are paid more because of their personal connections than productivity, I believe that one of the most important elements of capitalism is that most often workers and businesses are paid based on the value of what they produce – nothing more and nothing less. Few among us would choose to leave a server at a breakfast diner a 15% gratuity if we knew that person was earning $15 an hour.

The following points are an attempt to quickly tell the other half of this story and explain why the commensurate wage certificate is an important option in providing meaningful work to people with disabilities.

• Providers are NOT paying sub-minimum wages to anyone. Providers with a commensurate wage certificate are paying special minimum wages that are monitored and enforced by the FLSA. The process to obtain a commensurate wage certificate is rigorous, reported on annually, subject to renewal procedures, and enforced by the Department of Labor.

• Calculating a special minimum wage requires the provider to establish the local market wage, not the minimum wage, and the output of a worker who is non-disabled to determine the “unit rate” for the work to be completed. The provider must then track the number of units the worker who is disabled produces and multiply this by the rate to determine each individual’s earnings. Everyday workers who are disabled are paid more than the minimum wage because they produce units at a rate exceeding the standard.

• Human service providers are able to secure contracts with businesses that offer meaningful work to clients who are disabled because the cost to produce the units matches the market. To expect businesses to pay more than “market value” for a unit is asking the private sector to subsidize the human service system. This added cost would have to be passed onto the consumer inflating the cost of living and essentially become a hidden tax.

• Facility-based programs are usually located near other similar businesses within the community. Furthermore, according to the most recent MN State survey of DT&H providers, 61%, of the workers who are disabled are facility-based, 34% work as part of a crew at an employer-based setting, and 12% are hired directly by a business. Facility-based programs offer an important choice for vulnerable adults not ready or interested in working within an employer-based setting.

• Finally, let’s talk about choices for workers who are disabled and their families. No one is required to be served by a provider with a commensurate wage certificate. By definition, segregation is to impose the separation of a group or class from the rest of society and that simply does not apply to clients with guardians and independent case mangers that choose commensurate wage providers. If a person with a disability does not want to be paid a special minimum wage, they are free to find a job on their own for a wage they find acceptable. There is no need to destroy an option that permits human service providers and businesses to offer meaningful work at a fair wage to millions of our citizens with disabilities.

In closing, what the opposition doesn’t tell anyone is that the repeal of the commensurate wage provisions will result in the loss of meaningful work and wages for millions of citizens with disabilities without any alternative options. At Merrick, the loss of the commensurate wage provisions would result in the loss of work for more than 200 clients that last year made more than $565,000 in wages. These individuals have been certified as disabled, by law are vulnerable adults, rely on transportation services, require 24-hour support and supervision, and cannot function independently at a business or they wouldn’t be in our program. What are they to do if there is no work?