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Promising Practices in Employability Assistance for People with Disabilities (EAPD) Funded Programs and Services

Final Report

Evaluation and Data Development
Strategic Policy
Human Resources Development Canada

August 2002

SP-AH-196-08-02E
(également disponible en français)

Paper

ISBN: 0-662-34531-2
Cat. No.: RH63-2/196-08-02E

PDF

ISBN: 0-662-34532-0
Cat. No.: RH63-2/196-08-02E-PDF

HTML

ISBN: 0-662-34533-9
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The Promising Practices Project is a partial evaluation focused on what works with respect to program design / program delivery practices dealing with employability programming for people with disabilities. It yields a compendium of promising practices and is the first step in building a knowledge base that will facilitate information sharing and contribute to future evaluation activities.

The Promising Practices review was undertaken jointly by the Federal Government and five Provinces (Manitoba, British Columbia, New Brunswick, Nova Scotia and Prince Edward Island).

There were nine Promising Practices selected for this review providing different approaches to assisting people with disabilities in making the transition to or return to employment. The review was largely undertaken to document how these Promising Practices operate and to identify factors or characteristics that were critical for their success. The review team was able to identify factors that were common to all Promising Practices as well as project specific characteristics that could be transferable to other programs or services. These factors can now be used by federal and provincial jurisdictions in designing new initiatives or in evaluation and review processes of existing programs.

From the perspective of the Provinces, the report also provides a description of initiatives in the other participating provinces that can be considered for program enhancement or development within their jurisdiction. Therefore, the review and final report provides a document that not only identifies critical characteristics of employment services for people with disabilities, it also provides a reference document of already proven effective practices for provincial jurisdictions to consider for alternative or enhanced programming within their own jurisdictions.

The joint Federal-Provincial Promising Practices Sub-Committee that worked with the contractor throughout the review is satisfied that the objectives of the review have been met. In addition, the Sub-Committee believes that when the final report is distributed, it will promote information sharing and networking among those involved in the delivery of employability programming for people with disabilities. This in turn will have a positive benefit to the overall integration and inclusion of people with disabilities in Canadian society.

Disability issues have become more visible in public policy over the past few decades. Depending on how one defines "disability", there are between 2.5 and 4.8 million Canadians with disabilities.¹ These numbers are steadily increasing as the population ages.² In addition, proportionally more people with disabilities live below the poverty line compared to those without disabilities.³ The federal government's commitment to support people with disabilities includes spending more than $6 billion annually to provide programs, services and support, including employability and employment-related initiatives.⁴

Since 1986, when people with disabilities were guaranteed equality under the Canadian Charter of Rights and Freedoms, federal/provincial/territorial policies, programs and publications have approached disability as a citizenship rights issue. Citizenship means equality, inclusion, rights and responsibilities, and empowerment and participation in all aspects of Canadian society. By enshrining citizenship rights to all people with disabilities, the government acknowledges the important role people with disabilities have in shaping public policy and the contribution they make to Canada's social fabric and economy.

The focus on citizenship has changed the public's perception of disability. Instead of narrowly focusing on an individual's inabilities, attention is now given to measures such as accommodations in the workplace and barrier-free architecture to create more inclusive environments. Human rights and employment equity legislations have been passed to protect people with disabilities from discrimination and to remove disincentives and barriers in welfare and labour market programming.

In spite of these advances, barriers, disincentives and discrimination against people with disabilities remain, preventing their full economic participation in society. In early 1997, federal, provincial and territorial governments began working together to explore ways to improve and build on elements of the jointly-funded Vocational Rehabilitation for Disabled Persons (VRDP) program, a program that had been in place since 1962. In October 1997, Ministers responsible for Social Services endorsed a Multilateral Framework for Employability Assistance for People with Disabilities (EAPD). EAPD replaced VRDP.

The EAPD multilateral framework guided the subsequent negotiation of bilateral agreements between Human Resources Development Canada (HRDC) and provincial governments for the sharing of eligible costs of programs and services that help Canadians with disabilities acquire the skills, experience and supports necessary to prepare for, obtain and maintain employment.⁵

Review of EAPD Promising Practices

The Promising Practices Project (PPP) is a multilateral EAPD research project designed to provide a core base of knowledge on what works for whom in employability programming for people with disabilities. Specifically, the objectives of the PPP were to:

• Research and document nine Promising Practices case studies in employability projects and services cost-shared under EAPD in British Columbia, Manitoba, New Brunswick, Nova Scotia and Prince Edward Island;
• Provide a completed template for each of the nine Promising Practices, which clearly delineates the practice and includes the context /background, challenges faced, solutions, results, and future outlook; and
• Provide an integrated analysis of the cases and existing literature/knowledge in terms of lessons learned and what works in employability programming for people with disabilities.

Provincial representatives identified these Promising Practices (PPs), each of which is perceived as an organization that provides programs and services that are successfully improving the employability of people with disabilities.

Findings about What Works in EAPD Promising Practices

The following represents the core findings from the nine Promising Practices on what works for whom in employability programming for people with disabilities:

All nine Promising Practices are highly client focused. The basis for their success and high client satisfaction come from the fact that programs are flexible or tailored to the needs of each individual. This allows clients to enhance their learning and employment preparations. Employment or educational plans are created according to each client's abilities and limitations. Client centered services also tend to raise clients' self-esteem and confidence, an issue for all clients interviewed for this study.

All nine PPs look at their clients in a holistic way. They consider a person's likes and dislikes, abilities and limitations, housing and family situations, technological needs for school and work, and social and interpersonal skills. Clients appreciate this approach. The approach also allows for trust between the client and the Promising Practice.

All nine PPs recognize the importance of education and/or on-the-job training as a starting point in clients' employment pursuits. Many clients have few or no marketable skills. Others have skills that are outdated. Yet others have skills that they are no longer able to use as a result of a disability. Literature demonstrates that education is key to employment and level of income. Also, it shows that the nature of work is changing. As a result, initiatives to encourage people with disabilities to further their education and develop their skills are essential to their acquiring gainful employment.

Staff in all PPs mentioned educating and raising awareness of employers and the general public on the value that people with disabilities bring to our society and workplaces as highly important. Employers interviewed for the purpose of this study indicated that they knew very little about disabilities and accommodations before they entered into a partnership with a Promising Practice. Many staff members as well as the employers themselves indicated that educating employers is one of the most important activities to undertake for the purpose of increasing the representation of people with disabilities in the general workforce.

Staff in the PPs emphasized partnerships with employers as one of the most important tools to allow clients a chance to get a job placement as well as increasing their chances of employment after the placement. Employers interviewed for this study were mostly employers who had opened their doors for a job placement. In several cases, employers hired the client upon the completion of their placements. In other cases, when employers did not have the resources to hire anyone, they sometimes extended offers of volunteer work placements.

According to PP staff and their clients, volunteer work is valuable in that it allows clients a chance to enhance their skills and to build their resumes. Yet, volunteer work is not paid work and, in many cases, does not hold the promise of greater financial independence and getting off social assistance. As such, the focus should be to enter into partnerships with employers to balance clients' needs for work experience and skills enhancement with opportunities that have a chance of leading to permanent employment, and finding employment that pays more than minimum wage.

PPs that have work placements as part of their programs facilitate on-going communication that assists both employers and clients for the duration of the placement. Meetings and open lines of communication between Promising Practice staff, employer and client are instrumental in helping all parties understand what they can and cannot do. For example, employers may have certain work-related requirements that a client cannot meet. Clients and employers alike value this three-way communication as it provides both parties a point of contact to discuss issues that arise. Employers interviewed for this study indicated that this support is often a catalyst for them to provide job placement opportunities for PP clients.

The PPs reported having highly dedicated and committed leadership and staff. Staff are the backbone of these organizations. All PPs stressed the importance of getting to know their clients well in order to provide the individual services clients need. Their ability to develop client trust impacts on both the success of the programs as well as the employment opportunities the programs facilitate. Staff are highly knowledgeable about employability issues as they pertain to people with disabilities and see it as essential to be up-to-date on the latest approaches, methods and research to be able to continue providing the best services possible.

The PPs straddle the line between being supportive and challenging in their interactions with their clients. PP staff indicated that it is important to allow clients to make their own decisions (i.e., they are allowed to make their own mistakes) and assume certain responsibilities (i.e., showing up on time to courses and work placements). Some Promising Practices, such as Gastown Vocational Services, give clients two or three chances and if they still do not meet the expectations, they may be asked to come back to the program at a later time when they have addressed their issues and are ready to engage fully with the program. Others, such as the Behavioural Health Foundation, have a zero tolerance policy in place when it comes to any addictive substances. At the same time, support is given generously when needed, and assistance is provided to help clients graduate to greater levels of responsibilities and decision-making.

The Promising Practices have produced positive results. Clients' satisfaction with the service provided by the Promising Practices is high. Some clients are in the process of realizing their dreams of fully participating in society. For other clients, the Promising Practices offer the first rays of hope that they too can achieve their dreams.

There have also been positive results in terms of the number of individuals who became employed after graduating from a Promising Practice program (Appendix A features PP templates that outline their respective qualitative and quantitative results). Some Promising Practices are collaborating with federal and/or provincial governments to offer wage subsidies for employers. These financial incentives often make it more feasible for employers to provide job placements and allow for financial flexibility when taking on clients who may need a longer training period. Another factor that must be taken into account when talking about results and sustainability of results is that most disabilities are permanent and many are characterized by periods when the disability is more intense or debilitating.

Each of the nine Promising Practices can be defined as a creative or innovative employment focused project or service that has demonstrated solid performance or has demonstrated potential to achieve high levels of performance in meeting its employability objectives for people with disabilities.

Disability is a public policy issue in Canada for several reasons. Depending on the data source and definition of disability, there are between 2.5 and 4.8 million Canadians with disabilities.⁶ These numbers are steadily increasing as the population ages.⁷ Furthermore, proportionally more people with disabilities live below the poverty line compared to those with no disabilities.⁸ The costs to the federal government of providing programs, services and income support, etc. are more than $6 billion annually.⁹

Early in 1997, federal, provincial and territorial governments began exploring how to improve and go forward with the jointly funded Vocational Rehabilitation for Disabled Persons (VRDP) program. This program had been in place since 1962. In October 1997, the multilateral framework for the Employability Assistance for People with Disabilities (EAPD) was approved by Ministers for Social Services, and EAPD replaced the VRDP. The framework guided negotiation of bilateral agreements between the two orders of government to share the eligible costs of programs and services geared at helping people with disabilities acquire the skills, experience and supports they need to participate fully in the labour market.¹⁰

EAPD focuses on employment and employability for people with disabilities. The Promising Practice (PP) case studies prepared for this project are funded under the EAPD, meaning their programs and services focus on increasing the employability of people with disabilities. These services can relate to an individual's first steps towards working, support at work, ability to continue working, or retaining employment as in the case of vocational or employment crisis. These Promising Practices were chosen because of their contribution to assisting people with disabilities become employable or employed.

Research in Canada and abroad points toward several key considerations when developing policies and programs to enhance people with disabilities' employment related successes. For example, disability issues and topics are inter-related and often require a coordinated approach. Areas that seem independent, such as employment, transportation, housing, access to rehabilitation and training are directly linked. According to Project Coordinators of the Promising Practices, such complexity requires a holistic approach for successful program and policy development.

People with disabilities form a diverse group, comprised of individuals with varying needs, circumstances, types and severity of disability. As such, they face a range of barriers to employability. As noted by Project Coordinators, personalized approaches that are flexible as well as adaptable to the needs of the individual are most successful.

The overall purpose of this report is to present current findings on what works for whom in employability programming for people with disabilities. This report presents a synthesis of information gathered through site visits and documentation of nine Promising Practices in Canada.

1.1 Review Objectives

The Promising Practices Project (PPP) was designed to provide a core base of knowledge on what works for whom in employability programming for people with disabilities. This project was undertaken to enhance the knowledge of the operational effectiveness of EAPD and to set the stage for more comprehensive evaluation activities in the future. Specifically, the objectives of the PPP were to:

• Research and document nine Promising Practices case studies in employability projects and services cost-shared under EAPD;
• Provide a completed template for each of the nine Promising Practices that clearly delineates the Practice and includes the context /background, challenges faced, solutions, results, and future outlook; and
• Provide an integrated analysis of the cases and existing literature/knowledge in terms of lessons learned and what works in employability programming for people with disabilities.

The results of the review of the Promising Practices should promote information sharing and networking among those involved in the delivery of employability programming for people with disabilities. The results should increase awareness of innovative solutions and provide a basis for improved management practices. Ultimately, the results of these Promising Practices should spark ideas and stimulate further action by other EAPD-funded practices as well as other entities that focus on the employability and employment needs of people with disabilities.

1.2 Review Approach

Conducting this review involved two key phases:

Phase I: Identification of possible PPs
Phase II: Review of chosen PPs.

The section below discusses key steps followed during each phase.

Phase I:

The Promising Practices explored in this study were identified and nominated by the provinces. In preparation for the study, provinces selected an organization, a program or an approach and submitted their nomination to the Promising Practices Project Committee (PPPC) for review.

Two tools were used in this process: a pre-assessment checklist and a case study template. The pre-assessment checklist (see Appendix D) requires yes/no answers to 19 questions, which relate to the Promising Practices' relevance, innovativeness, replicability and existing documentation. If a province chooses to nominate a practice, the program administrator's approval must be solicited. Once this has been done, the second tool, the case study template, is used. Information is populated in this template and forwarded to the PPPC along with the pre-assessment checklist and other supporting documentation, if relevant. Programs are then referred for further research, validation and documentation.

This process assumes that there are many practices from which to choose. However, at the time when the practices were to be identified and selected for this study, there were only nine Promising Practices deemed appropriate to be put forward. As a result, all nine were selected after being assessed using the two tools described above.

Phase II:

The Promising Practices Project, which involves these nine Promising Practices, is primarily a qualitative research study that follows a case study approach. The case studies were developed using the following lines of evidence:

• Literature review/Internet research;
• Site visits; and
• Document reviews.

A brief description of each of these methods follows next.

Literature Review / Internet Research:

To ensure a thorough understanding of issues related to EAPD and to research more fully the nine Promising Practices, the first step in this process involved reviewing current literature on employment and employability of people with disabilities. The literature review provided a basis from which to interpret and synthesize findings and to develop the research tools.

Relevant Canadian and international literature was reviewed. This review included academic articles, government documents, and publications from non-government organizations and non-profit agencies published over the last five years. A bibliography of the literature reviewed is provided in Appendix B.

An extensive Internet search was conducted on key words (e.g., employment programs for people with disabilities, disability programs, labour market, employment equity), which revealed a number of additional pieces of highly useful information for this study. The more comprehensive and interesting websites are included in the bibliography in Appendix B.

Site Visits:

Site visits were conducted with each of the nine Promising Practices. The purpose of the site visits was to validate the information in the existing templates as well as to document progress and additional details of the programs. Interviews and focus group meetings were held with Project Coordinators, clients, former clients, family members, employers, funders, provincial representatives and others. These individual and group interviews, which encompassed a range of stakeholders, allowed the researchers to see the Practice from a variety of different angles and perspectives.

Document Reviews:

Each Promising Practice provided documentation on its success, number and type of clients and/or information on the services provided. The researchers reviewed the relevant documentation at each site to gain additional insight into the success of the program and to validate and add weight to the research findings. These documents included annual reports, videos, financial statements, client satisfaction surveys, follow-up surveys, press releases, news articles and promotional materials.

Table 1.1 lists each of the Promising Practices visited for this study, their location, their client target groups and the type of services provided by each. Detailed case study reports for each of these PPs can be found in Appendix A.

1.3 Organization of the Report

In order to present the integrated findings from the literature review, site visits and related documentation, the report is structured in the following way:

Section 2.0 of this report, Background and Context, provides a summary of some of the initiatives put in place by different orders of government in the context of this research.

Section 3.0, Challenges, describes the key challenges and barriers that are common to the Promising Practices studied. These include challenges and barriers that are also more specific to programs located in rural or mid-range communities as well as to those located in major urban centres.¹¹

Section 4.0, What Works Well in EAPD Promising Practices, presents the kinds of services, programs and approaches used by Promising Practices that have proven to be successful in addressing challenges and barriers.

Section 5.0, Conclusions, summarizes the findings from this research.

Over the last few years, federal and provincial/territorial governments have initiated a number of initiatives geared towards helping and supporting people with disabilities become employable or employed. This section describes several such initiatives.

One of these initiatives started in 1996 when Canadian First Ministers agreed to make the needs of people with disabilities a priority. The federal and provincial/territorial governments agreed that additional measures were needed to address negativity towards people with disabilities, realizing that this would not disappear on its own. Thus, a federal Task Force on Disability Issues ("the Scott Task Force") was created to seek the advice and guidance from Canadians with disabilities on future government actions. The Government of Canada saw this consultative approach as instrumental in setting the stage for allowing people with disabilities full and equal participation in society, be it in their communities or in the labour force.

Financial disincentives to work have traditionally been a key barrier to people with disabilities acquiring economic independence. For example, many welfare systems classify people with disabilities as "permanently unemployable". Similarly, the Canada Pension Plan used to require that a person be either entirely in or out of the workforce (i.e., employable or not employable). The reality is that many people with disabilities can work, given the appropriate accommodations and supports.¹² If finding employment means losing a financial safety net, it may perhaps be a more prudent choice not to work. People with disabilities need programs that provide assurance that income will continue when labour market participation is interrupted or not possible for a period of time.

The Canada Pension Plan recently underwent significant changes to respond to these challenges.¹³ The federal government created the CPP Disability Vocational Rehabilitation Program in 1997. The program was designed to make it possible for some people with severe disabilities to become part of and remain in the work force by personalizing a rehabilitation plan for each client.¹⁴ The plan includes elements such as the nature and level of guidance required, the process of how to return-to-work, skills and retraining requirements, and developing job search skills. The added incentives for people participating in this plan allow them to:

• Do volunteer work or attend school without fear of losing benefits (as long as they have a continuing disability);
• Continue to receive benefits for three months after they start/return to work; and,
• Have their income assistance application fast-tracked should the same disability prevent them from working in the future.¹⁵

In 1998, federal, provincial and territorial ministers gathered to develop In Unison : A Canadian Approach to Disability Issues, a framework that proposes a "Canadian Approach" to disability issues.¹⁶ The intent of this initiative is to pursue a seamless and coordinated system of benefits and services for people with disabilities to enhance their employability. It is meant to ensure that people with disabilities have the same opportunities as all other Canadians.

Since 1986, when people with disabilities were guaranteed equality under the Canadian Charter of Rights and Freedoms, federal/provincial/territorial policies, programs and publications have approached disability as a citizenship rights issue. Citizenship means equality, inclusion, rights and responsibilities, and empowerment and participation in all aspects of Canadian society. By enshrining citizenship rights for all people with disabilities, the government acknowledges the important role people with disabilities have in shaping public policy and the contribution they make to Canada's social fabric and economy.

The focus on citizenship has changed the public's perception of disability. Instead of narrowly focusing on an individual's inabilities, attention is now given to measures such as accommodations in the workplace and barrier-free architecture to create more inclusive environments. Human rights and employment equity legislations have been passed to protect people with disabilities from discrimination and to remove disincentives and barriers in welfare and labour market programming.

In order to acknowledge these changing attitudes, In Unison identified three key building blocks as critical success factors for including people with disabilities in society. These building blocks are as follows:

• Disability Supports: These refer to a range of goods, services and supports tailored to the individual requirements for daily living. It will always be necessary to provide for the availability and accessibility of disability supports (e.g., technical aids and devices; special equipment; homemaker, attendant or interpreter services; life skills; physiotherapy and occupational therapy; respite care) which respond to individual needs. These goods, services and supports are essential for active participation at home, at school and in the community and are a key component of maximizing personal and economic independence.
• Employment: Persons with disabilities require access to opportunities for education, training and employment which together comprise the basis for economic independence. The intent of In Unison is to enhance the employability of persons with disabilities, encourage (re)entry into the labour market and help promote more work and volunteer opportunities. Enhancing employability means supporting access to education, providing supports and flexibility in training programs, making job accommodation available and offering job seekers and employers adequate information.
• Income: Some individuals with disabilities may not be able to support themselves sufficiently or at all. Governments recognize the need for an income safety net which rewards individual work efforts to the greatest extent possible - but which provides financial assistance if self-support is impossible or insufficient to meet basic needs.

In Unison is a major stepping-stone towards the development of legislation that is inclusive and complementary.

EAPD and the nine Promising Practices exist within this context. While there have been changes to legislation and programs to encourage people with disabilities to develop their skills and participate in the labour market without being penalized, there are, nevertheless, a variety of challenges facing people with disabilities and organizations such as the PPs in moving forward. The next section presents these challenges.

This section describes the specific challenges faced by both the programs and services offered by the EAPD Promising Practices and the clients served (i.e., people with disabilities). Interviews with clients and former clients indicated that their challenges are more of a personal nature as opposed to a systemic nature.¹⁷

The first part of this section discusses challenges that are common to all Promising Practices. The second part looks at challenges that pertain to PPs operating in rural or mid-range communities. The last part of this section provides an overview of the key challenges experienced by people with different types of disabilities and what approaches worked well in meeting these challenges.

3.1 Key Challenges Common to all Promising Practices

An analysis of the nine Promising Practices indicates that they face numerous challenges. The following presents some of the key challenges encountered by each of the programs and their clients, either directly or indirectly.

Many people with disabilities interviewed for this study have experienced negative societal perceptions and stereotypes that contribute to a lack of self confidence.¹⁸ A lack of self-confidence may limit a person's willingness to try activities that for them represent a risk. Therefore, one of the greatest challenges when preparing people with disabilities for employment is to ensure that the environment for training or development is supportive of the individual client and helps to build his or her self-esteem.¹⁹ Program Coordinators and PP staff stated that building clients' self-confidence requires an ability to nurture relationships that result in trust. Interviews with clients and former clients of the PP's visited for this study said that when trust had been established, their coping, social and employment readiness skills were enhanced.

In order to provide employability and employment related programs and services, Project Coordinators noted that it is essential that a PP has staff with the expertise, experience and understanding required to address the barriers and issues faced by people with various types and degrees of disability. It can be challenging to find and retain staff with these skill sets, particularly if limited funding prevents the PPs from offering a perceived competitive salary. Having the "right" people in both staff and leadership positions is essential for a Practice to succeed according to Project Coordinators and representatives from the PPs' funding agencies.

The ultimate goal of the nine Promising Practices is to help people with disabilities find and/or maintain employment. Both employers and clients pointed out that a good match between the needs of the employer and the client's skill sets and abilities is a challenge that must be met in order for the results to be successful. While this is important for the employer, it is perhaps even more important for clients as an unsuccessful match may erode confidence, preventing clients from taking on other opportunities.

Unique challenges exist to ensure that the specific needs of Aboriginal peoples with disabilities are met. It is estimated that about one in six Canadians of all ages has a disability.²⁰ Statistics reveal that as many as 30% of Aboriginal adults report a disability.²¹ Many Aboriginal peoples with disabilities lack trust in the entire system of government-sponsored support. The challenge for the PPs, according to Project Coordinators and staff, is in nurturing relationships that build trust and confidence in the program and in promoting awareness of the support that is available. Staff need to be culturally sensitive to Aboriginal peoples as well as sensitive to their unique needs.

Many employers expressed a lack of general knowledge about people with disabilities and the value they can offer as employees. Employers are often unaware of the various supports, accommodations and technologies that are available to them. PP staff indicated that educating employers is one of the most important activities they engage in. Partnerships with employers create opportunities for their clients. Yet PP Project Coordinators and staff also see it as a challenge to continually promote and create greater awareness of the opportunities that exist for employers in hiring a client. Furthermore, it is a challenge to find employers that are willing to focus on the individual's abilities as opposed to disabilities.

Project Coordinators and staff's experience has shown that it is highly beneficial to provide on-going support to both employers and the people with disabilities working for them. Yet in the working world, tasks change, circumstances change and the impact or degree of the disability may change. It is a challenge for the PPs to ensure that the on-going support is adequate to meet the needs of both, as it is often key to maintaining the employment arrangement.

PP staff have found that it is a challenge to improve access to disability supports while at the same time ensuring that costs are affordable. Some clients cannot afford the supports that can cost from $3,000 to $16,000.

A related issue is the fact that supports are frequently tied to eligibility for income support or other programs. In other words, supports provided for use at home cannot be used in school or work and likewise, accommodations in the workplace cannot be brought home. Supports are generally not portable. Statistics from the Health and Activity Limitation Survey (HALS) suggest that 33% of adults with a disability cover support costs associated with a disability and are not reimbursed by either a public or private plan.²²

One of greatest challenges for people with disabilities is finding a job that provides enough hours of work at a salary high enough to achieve economic independence. For those who find a job, education is the most important determinant of earnings. People with disabilities with higher levels of education are more likely to have work-related training and be employed in some of the more lucrative occupations.²³ Project Coordinators and staff stress that education, training and transition programs must be flexible and accessible to ensure better educational attainment and as a result, a better economic future through employment.

All PPs have some criteria for whether or not their program is suitable for clients who are either referred to the program or who approach the program themselves. It is a challenge for PPs to make sure that there is flexibility in their selection criteria while being cognizant of the fact that not all clients may be likely to benefit from their services. According to Project Coordinators and staff, this up-front screening is important to the success of the program.

Please note that this report does not make a distinction between women and men in the analysis. The reason for this is that the Promising Practices visited do not focus exclusively on either gender and few have programs that are targeted at only women or only men. The research findings therefore pertain to both women and men. However, the literature review revealed that women and men are affected in different ways and to different degrees by the same challenges. In fact, statistics show that women with disabilities have one of the lowest rates of labour force participation and one of the highest rates of poverty.²⁴ This phenomenon is sometimes referred to as double disadvantage, i.e., a person is a member of two groups that are both at a disadvantage in the labour market.

3.2 Challenges Specific to Rural and Mid-Range Communities

Canada's communities are spread across vast geographic regions. In rural areas, it is a challenge for employment and employability services organizations to cover the distances to reach the target population for the purposes of promoting awareness of available programs, supports and opportunities.

Many Aboriginal communities are dispersed geographically. According to Project Coordinators (i.e., THEO and CCI), PPs have limited resources and do not have the capacity to perform outreach in distant communities. As with any partnership, trust needs to be established before the working relationship can be effective.

Transportation is a huge challenge in rural areas and mentioned as an issue by all those interviewed who live and operate in such areas. Lack of transportation can prevent people with disabilities from accessing programs, educational institutions and employment. Other challenges associated with rural areas include limited access to housing, health and wellness facilities, and support groups.²⁵

In rural areas, lack of employment opportunities adds to the challenges faced. Rural communities often have seasonal employment opportunities rather than more stable year-round employment. Adequate training opportunities and technical support are also often lacking. It has been noted that in such areas, there may also be a lack of adequate funding to increase supported employment.²⁶

3.3 Specific Challenges for People with Different Types of Disabilities

Similar barriers and challenges to employment affect all people with disabilities. However, they are not always affected in the same way or to the same degree. The type of disability one has also appears to affect one's employment status. Figure 3.1 shows that in 1991, those with mental or psychiatric disabilities were the most likely of all people with disabilities to be unemployed. Those with agility, mobility and verbal impairments also had higher unemployment rates than persons with sight or hearing impairments.²⁷ It should be noted that the figure below does not specifically categorize people with addictions.

The PPs studied collectively serve people with all types of disabilities, although some specialize in certain disabilities. Table 3.2 below shows an overview of the key challenges for each of the disability groups and some of the programming and service solutions used by the PPs to address the specific issues. People with disabilities have an issue around self-confidence, but how this is best addressed, according to Project Coordinators, depends on the type of disability.

Table 3.2
Overview of Key Challenges and What Works Well²⁸

	Key Findings of What Works Well
Disability Type and Related Challenges	Comprehensive Assessments	Work Readiness & Skills Training	Knowledgeable Staff	Employer Education	Adaptive Technology	Job Placements	Job Coaching	Flexible Work Arrangements	On-going Support
Psychiatric Disabilities (Mental)
Low self-esteem and confidence
Lack of knowledge of personal strengths and limitations
Stigmas in the workplace
Negative side-effects of medication
Cyclical nature of the disability
Physical Disabilities (Mobility, Agility)
Physical limitations (e.g. fatigue, stamina)
Lack of access to adaptive technology and accommodations
Low self-esteem and confidence
Negative attitudes and perceptions
Learning Disabilities
Significant learning curve
Lack of confidence and self-esteem
General lack of awareness about the disability
Sensory Disabilities (Seeing, Hearing, Speaking)
Lack of knowledge of and access to accommodations and adaptive technology
Negative attitudes and perceptions
Lack of confidence and self-esteem
Developmental or Intellectual Disabilities
Lack of confidence and self-esteem
Incorrect perceptions and myths about developmental disabilities
Addictions
Lack of self-confidence
Complex personal issues
Lack of basic living skills and routine
Other Non-Visible Disabilities (Environmental Sensitivities, Depression)
Lack of understanding about the disability
Lack of support groups
Lack of confidence and self-esteem

Based upon the findings from both the literature review and the review of the Promising Practices, this section describes the things that work well in employability programming for people with disabilities. The section begins by describing processes used by PPs to serve their client groups. It is important to note that the PPs visited are highly diverse and that this discussion pertains to processes common to most PPs.

4.1 Client Service Process

The client service process can be a complicated, multi-faceted process. The whole process from intake to exit or goal attainment could potentially involve a variety of service providers at one or more stages in the process (i.e. rehabilitation practitioners, intake workers, counsellors/case managers, assessment specialists, employer relations personnel, etc.). Moreover, it is common for additional services or programs to be utilized sequentially and/or simultaneously to assist a client. The extent to which these providers are involved in the process depends upon the specific barriers to employment that the individual client may face, the type and severity of the disability and the program and/or service interventions that are needed to help.

The key steps and processes in serving clients are as follows:

• Referral or self-referral;
• Screening;
• Assessment;
• Identification of employment related goals;
• Development of plan;
• Implementation of plan, including employment or further educational/training programs;
• Progress monitoring and adjustment; and
• Goal attainment.

Clients are often referred to the PP through either their health or rehabilitation practitioners. In some cases, potential clients may have heard about the program through their friends who are former clients, and approach the PP on their own. Potential clients attending a university or college may have been referred to a PP by a counsellor in these institutions.

The first stages in the process (as displayed in Figure 4.1) are the screening and assessment of applicants. These activities (especially the assessment part) often take time. The assessment of a client is a key stage as it lays the foundation for understanding what kinds of services and programs individual clients need in order to make progress towards employment.

Once the assessment has taken place, counsellors help clients identify employment related goals. At this point, clients have a better sense of their strengths, abilities, desires and limitations, which facilitates the development of a plan of action. Once this plan is implemented, clients start moving forward. The implementation stage often involves enrolling in courses, skills enhancement, job placements and other services required to increase a client's employability.

Next, there is a monitoring of the progress to date and possibly an adjustment to the initial plan. Clients may then pursue further education or skills training, start looking for work or enter the workforce.

On-going support is the core foundation of success for each of these stages. It is extremely valuable for clients - even for those who have been working or studying for a significant period of time - to know that they can obtain the assistance and support they need if any issues or concerns arise. Many clients shared that they would not have been successful without this on-going support.

It should be noted that success in any one stage is highly dependent upon the results from the previous stages. For example, the formulation of goals depends on the program's ability to assess a person's strengths, abilities and limitations accurately.

4.2 Reducing Attitudinal and Perception Barriers

Negative perceptions of and attitudes towards people with disabilities are described in the literature as the most significant barriers towards the full participation of people with disabilities' in the labour market. Such attitudinal barriers usually come as a result of a lack of understanding and awareness of what disabilities are about.²⁹

This lack of public awareness about disabilities and disability issues is also sometimes referred to in the literature as societal barriers.³⁰ Also grounded in negative perceptions, societal barriers often exclude people with disabilities from decisions about things that affect them. These individuals are often blamed for the consequences of their disabilities when the causes of inequity should be looked for in the social environment. For example, some adults with learning disabilities are conditioned to believe they are incompetent, lazy and lack the ability to function normally in society.³¹ It is also a function of this barrier that highly visible disabilities often hide the true abilities of a person.³²

It is suggested in the literature that negative perceptions towards people with disabilities exacerbate the systemic barriers affecting them.³³ These negative attitudes potentially limit opportunities for employment; therefore, it is necessary for stereotypes to be broken down and to focus on the abilities of people with disabilities. Government bodies and community organizations have a responsibility to enforce this positive attitude in support of promoting what people with disabilities can bring to the community.

According to PP clients, former clients and clients' family members, public attitudes and prejudices impact an individual's self-esteem. Low self-esteem generally leads to a lack of confidence, preventing good performance during job interviews, for example.

Promising Practices work on breaking down these barriers. The fact that they are funded through EAPD signals governments' commitment to address both societal and perceptual barriers. The PPs do community awareness raising to address attitudinal and perception barriers, while their programs and services give clients tools to deal with negativity both from the outside and from within.

According to Project Coordinators, programs must be highly focused on the client if barriers and challenges are to be addressed realistically. The PPs reviewed in this report are exemplary in assessing the needs of people with all types and degrees of disability. Each PP uses an individualized, unique, tailored or customized approach to assisting their clients. Although the assessments vary for each PP according to the service offered, the PP study found that much emphasis was placed on the value of assessing clients' needs, aspirations and limitations. Client centered services assist individuals in taking responsibility for their future, which in turn increases self-esteem and confidence levels. This is an important first step in the process of overcoming many of the attitudinal and societal barriers to employability.

Community-based employment or job placements are highly successful in allowing people with disabilities greater exposure to a range of employment opportunities according to clients, former clients, Project Coordinators and staff. Unlike "sheltered workshop" models, community-based employment gives individuals a chance to develop employability skills within realistic employment environments. This approach also allows clients, employers and other employees a chance to break down attitudinal and perception barriers and create a productive place for people with disabilities in society.

In order to deal with perceptional barriers up front, PPs often make on-site facilitators or job-coaches available to employers who are providing employment or job-placements to clients. Employers find this highly useful as it gives them an opportunity to learn how to create a supportive environment. Clients as well are highly satisfied with this arrangement as it makes them feel safer asking questions or requesting clarifications. In addition, it provides an opportunity for clients to learn at their own pace and it gives the employer a sense of comfort knowing that the individual is being trained adequately. Facilitators and coaches also help educate people in the workplace about people with disabilities, thereby reducing negative perceptions.

Staff in the Promising Practices that conduct long-term follow-up and provide continued support for both clients and employers also feel they have been successful in breaking down the societal barriers. They are able to address a lack of awareness by employers about the disabilities themselves and help employers see how people with disabilities can contribute in a positive way to the company as well as to Canadian society in general.

Many clients entering the PPs' programs come with complex issues. These issues include unstable housing, family responsibilities, medical limitations, side-effects of required medication, interpersonal skills and behaviours, addictions, technological needs as well as personal likes and dislikes. From the PPs' perspective, this requires a client to be looked at in a holistic way. It is also an approach that is highly valuable to their clients.

4.3 Reducing Environmental Barriers

People with disabilities were guaranteed equality under the Canadian Charter of Rights and Freedoms in 1986. Full citizenship is exercised when barriers that significantly reduce the ability to participate in the community are eliminated.³⁴

Environmental barriers refer to barriers that exist in the working environment itself.³⁵ The literature shows that many people with disabilities are outside the labour force, not because their disability prevents them from working, but because the labour market operates in an environment that produces barriers. In other words, the work environment, the broader policy and program environment and the pace of work create barriers and disincentives. The lack of available accommodations and support is regarded as a major environmental barrier.³⁶

Furthermore, support services that enable people with disabilities to enter and remain in the workforce are often not coordinated to adequately meet the needs of each individual. These support services include income support bridge, transportation, training, and other disability-related supports and services.³⁷

Most complaints made to the Canadian Human Rights Commission by people with disabilities relate to a failure by employers to accommodate their needs. Amendments to the Canadian Human Rights Act (CHR Act) included a message to employers and organizations: "people with disabilities are full members of society. If accommodation is necessary for "More employers need to be them to participate equally, it must be provided."³⁸ While this appeals to the social responsibility of technologies and their potential employers, providing accommodation also represents a for positive results in the cost to employers. While the literature reviewed for workplace." Employer the purposes of this report did not provide information related to the impact of this amendment to the CHR Act, it is possible that the costs as well as employers' lack of awareness of programs to cover accommodations costs in part or in full, may run the risk of acting as a deterrent to hiring people with disabilities.

The Project Coordinators of the Promising Practices visited for this study recognize the importance of educating employers about supports that are available to them and how they can obtain them. Creating awareness is a critical factor in overcoming environmental barriers.

People with disabilities have varying characteristics and needs. Because these various needs are unique to each individual, Project Coordinators noted that it is important for support structures — at the workplace and at home — to not only be adaptable for the day-to-day activities of people with disabilities, but to also be portable to follow the person as they move from one job to another. Most people with disabilities that are served by the PPs can live independently and participate in the community, when they have the supports they need.

Due to the holistic approach adopted by all nine PPs, staff make every effort to assist people with disabilities obtain the accommodations and supports required that would enable them to function independently and compete on an even ground in the labour market. Each PP addresses this barrier in a different way depending on the type of service provided. All programs assess the individual needs of the client. In order to address environmental barriers, many programs have developed close relationships with government programs to assist in providing such accommodations (i.e., ASP, THEO and CCI). Some programs (i.e., THEO and CCI) conduct a task analysis in the workplace to determine the "real" needs of the individual.

Some government programs in Canada (i.e., Manitoba Health Home Care Program and Alberta's Persons with Developmental Disabilities Initiatives) provide supports through self-managed funding where clients are given the opportunity to manage their own supports, such as hiring attendant services. This is intended to foster greater independence for people with disabilities. This practice has effectively demonstrated the importance of strong partnerships among the federal and provincial governments, community organizations, employers, learning institutions and people with disabilities. However, because eligibility for disability supports is linked with eligibility for other programs, many people with disabilities are ineligible for some supports they require. De-linking disability supports from eligibility for other programs may address this issue.³⁹

Establishing adaptive aids "loan banks" is an approach that appears to work well. These loan banks enable clients to exchange equipment and experiment with technological options in the event that the client's disability or her/his tasks change. ASP, the PP with a loan bank, assesses technology needs on an individual basis, provides the required training and support, and evaluates success on an on-going basis. The Project Coordinator and staff stress that the individualized approach ensures a good match between the person's needs and the technology required. Such initiatives have been highly effective in reducing accommodation related barriers in both employment settings as well as educational settings according to clients, former clients and PP Project Coordinator and staff.

One PP visited for this study (THEO) has taken the approach of linking the adaptive aid to the client rather than to the employer. For example, the PP asks the employer to purchase the aid in the client's name and the employer is then reimbursed by a government funding agency. The advantage is that the individual has a greater degree of independence when trying to change jobs. It also reduces costs in that the subsequent employers do not need to purchase or make arrangements for aids. THEO reports it has proven to be an effective means of reducing accommodation barriers in the workplace.

Interviews with PP clients and the literature review indicate that both men and women with disabilities report fatigue as a result of having a disability and associated difficulties when performing what are considered routine tasks.⁴⁰ These in themselves are barriers. Some tasks require significant amounts of time and energy to complete, or are beyond the client's capability. Provision of adequate supports such as washroom accessibility, flexible transportation, affordable child care and coordinated transportation systems between childcare and the workplace reduce the fatigue experienced by people with disabilities. This in turn leaves them with more energy to look for or maintain employment.

4.4 Reducing Educational Barriers

Higher education appears to be one of the most valuable mechanisms available to reduce the difficulty people with disabilities face in trying to get into and stay in the paid labour market. Increases in educational attainment of working-age people with disabilities (between 1986-1991) may be responsible for about a third of the overall increase in their labour force participation during that period (the increase in government initiatives and awareness of the "disability movement" have also added to an increase in the representation of people with disabilities in the labour force).⁴¹

The role of education in assisting people with disabilities in trying to get into and stay in the paid labour market cannot be over-emphasized. In looking at HALS statistics, the higher the level of education, the greater the chance of labour force participation. Figure 4.2 below captures this trend. It is noteworthy that women with disabilities are under-represented in the labour force compared to men with disabilities regardless of level of education. However, the difference is less for those with post-secondary education. While education is key to opportunity, PP staff and Provincial representatives interviewed for this study recognize that the severity of disability also affects the chances of labour force participation.

There is a debate among experts in the field of vocational and educational supports for people with mental illness as to whether a person with a disability should be trained or educated before finding employment or whether results are acquired faster by a person with a disability getting a job first, and then learning on the job.⁴² For people with psychiatric disabilities, employment seems to have many benefits above and beyond the more immediate financial and personal rewards. Research indicates that employment often results in improvements in psychiatric symptoms, reduced hospitalization, lower levels of anxiety and overall improvement in quality of life and sociability for these clients. The place-train approach is promising in that it may produce the desired results faster than pre-employment programs. However, with the great diversity in this client group, both approaches are probably beneficial and depend on the individual. It is also acknowledged by these experts that the place-train model may also only work for some jobs, usually entry-level positions.⁴³

According to Project Coordinators, many people with disabilities have few or no marketable skills upon entering employability programs. In some cases, their skills may be outdated or no longer relevant due to a recently acquired or progressive disability. Programs designed to teach the "basics" are highly beneficial. Literacy skills, computer skills, life skills, inter-personal skills and job-readiness skills are essential to successful integration into the work force. The clients interviewed for this study appreciated these skills a great deal. A few had never gone to a job interview before, and being coached through the process was a most beneficial learning experience.

Some clients identify employment goals that require a diploma or degree at a college or a university. The PPs will often help these clients access funding or adaptive aids as well as lend support through the application process. Whether a client gets employment or is accepted at an educational institution, Project Coordinators and staff regard both outcomes as successful. This is based on a belief that in a knowledge-based economy, having an education is essential for success in the labour market. Again, as Figure 4-2 above shows, the more education a person with disabilities has, the greater the possibility for participation in the labour force.

Thus, improving access to education, supports and adaptive aids is a successful approach to increasing the education levels of people with disabilities. Several of the PPs operate "loan banks" of technological aids. Their focus is primarily on people with disabilities who need technological support to enhance their education. Another key element of facilitating access to education is the partnership and communication between Promising Practices and the educational institutions. According to Project Coordinators and other staff, this bridge provides invaluable support for clients who desire to move on.

4.5 Reducing Financial Disincentives

Systemic disincentives are also considered barriers in the literature in that people with disabilities are often penalized for entering or returning to the workforce.⁴⁴ They may lose income support, support for assistive devices, medications, transportation, etc. Often they are employed in low-wage jobs. Eligibility requirements of some income systems (i.e., Canada Pension Plan and welfare systems) are such that a person must be considered "unemployable" to receive assistance. This becomes a barrier when those who are capable of working to some degree do not for fear of losing a safety net (also referred to as the "welfare trap").⁴⁵

While the review of the Promising Practices did not focus on financial disincentives, the report makes the following observations.

1.   For example, some income support programs exempt a portion of wage earnings allowing people with disabilities to financially benefit from making the transition to work. Clients interviewed saw this as beneficial as it allowed them the opportunity to "try things out" without the fear of losing benefits. Some clients saw this as an incentive to work, even if the amount allowed was minimal. Clients and former clients pointed out that even a modest job has a significant motivational impact on a person with disabilities. Being productive increases an individual's self-esteem and confidence and creates a desire for independence and self-sufficiency.

2.   Lack of adequate transportation is a major barrier for many people with disabilities. While this is a particularly difficult challenge in rural areas, it also exists in urban areas. Interviews with clients, employers and staff in all PPs revealed that availability, access and costs of transportation are issues in terms of participation in programs as well as studying and being employed. Some PPs in urban areas (i.e., GVS, POLARIS) provide clients with a public transit (bus) pass to allow them to participate in the programs offered. Clients in rural areas tend to rely on friends and family to provide transportation.

3.   Accommodations and access to adaptive technologies represent a challenge for both people with disabilities as well as employers. Linking portable accommodations and aids to the individual rather than the program has been a successful approach, according to PPs such as THEO and ASP. This reduces costs for employers who would like to hire people with disabilities, thereby breaking down the barrier of financial disincentives. It has the added benefit of providing the individual with flexibility to transition from one job to another without the fear of losing supports.

4.   Volunteer work is beneficial in that it allows clients a chance to enhance their skills and gain experience. Just like paid employment, PP clients noted that volunteer work has the potential to increase an individual's self-esteem and confidence. However, volunteer work is not paid work and generally does not hold the promise of greater financial independence. It is important PPs do not lose sight of the importance of paid employment for clients.

5.   Promising Practices are helping people with disabilities prepare for, find and maintain employment. The positions that many find in the workplace, however, are often entry-level. It is recognized by Project Coordinators and staff that gaining experience at this level is an essential first step. They also recognize that entry-level positions are usually paid minimally and consist of repetitious tasks. Helping clients get such jobs is beneficial from the point of view that they get experience and start off doing tasks that are not too demanding or challenging. However, for those that are capable of more, these positions are not particularly interesting and low wage positions are a disincentive as they do little to change an individual's lifestyle, housing situation etc. There is still a challenge to incorporate people with disabilities into higher level and more highly paid positions.

4.6 Essential Services for Success

The above discussion presented an overview of how the Promising Practices deal with specific types of barriers. This section provides an overview of what each PP visited does for their clients. Specifically, the following table (Table 4.1) highlights the services or features that those interviewed considered essential for client success. The PPs are highly diverse in terms of the clients they serve and the approach they take. As a result, what is essential in one Practice may not be essential in another.

The PPs' success in providing employability and employment related services to their clients is in large part based on an extensive network of partners. For example, in addition to employers who create employment opportunities, PPs work in partnership with all orders of government. They partner with agencies providing complementary services and financial assistance to people with disabilities. PPs work with medical professionals who are caring for their individual clients as well as educational institutions. Other partners include clients' family members and the community of people with disabilities, who often serve on boards and committees, providing expert advice and advocacy services.

The Promising Practices identified the following services as essential for success.

This report highlights linkages between literature on employability and employment programming for people with disabilities and the work performed by nine Promising Practices in five Canadian provinces. This final section of the report summarizes the overall findings from the research.

All nine Promising Practices are highly client focused. The basis for their success and high client satisfaction come from the fact that programs are flexible or tailored to the needs of each individual. This allows clients to enhance their learning and employment preparations. Employment or educational plans are created according to each client's abilities and limitations. Client centered services also tend to raise clients' self-esteem and confidence, an issue for all clients interviewed for this study.

All nine PPs look at their clients in a holistic way. They consider a person's likes and dislikes, abilities and limitations, housing and family situations, technological needs for school and work, and social and interpersonal skills. Clients appreciate this approach. The approach also allows for trust between the client and the Promising Practice.

All nine PPs recognize the importance of education and/or on-the-job training as a starting point in clients' employment pursuits. Many clients have few or no marketable skills. Others have skills that are outdated. Yet others have skills that they are no longer able to use as a result of a disability. Literature demonstrates that education is key to employment and level of income. Also, it shows that the nature of work is changing. As a result, initiatives to encourage people with disabilities to further their education and develop their skills are essential to their acquiring gainful employment.

Staff in all PPs mentioned educating and raising awareness of employers and the general public on the value that people with disabilities bring to our society and workplaces as highly important. Employers interviewed for the purpose of this study indicated that they knew very little about disabilities and accommodations before they entered into a partnership with a Promising Practice. Many staff members as well as the employers themselves indicated that educating employers is one of the most important activities to undertake for the purpose of increasing the representation of people with disabilities in the general workforce.

Staff in the PPs emphasized partnerships with employers as one of the most important tools to allow clients a chance to get a job placement as well as increasing their chances of employment after the placement. Employers interviewed for this study were mostly employers who had opened their doors for a job placement. In several cases, employers hired the client upon the completion of their placements. In other cases, when employers did not have the resources to hire anyone, they sometimes extended offers of volunteer work placements.

According to PP staff and their clients, volunteer work is valuable in that it allows clients a chance to enhance their skills and to build their resumes. Yet, volunteer work is not paid work and, in many cases, does not hold the promise of greater financial independence and getting off social assistance. As such, the focus should be to enter into partnerships with employers to balance clients' needs for work experience and skills enhancement with opportunities that have a chance of leading to permanent employment, and finding employment that pays more than minimum wage.

PPs that have work placements as part of their programs facilitate on-going communication that assists both employers and clients for the duration of the placement. Meetings and open lines of communication between Promising Practice staff, employer and client are instrumental in helping all parties understand what they can and cannot do. For example, employers may have certain work-related requirements that a client cannot meet. Clients and employers alike value this three-way communication as it provides both parties a point of contact to discuss issues that arise. Employers interviewed for this study indicated that this support is often a catalyst for them to provide job placement opportunities for PP clients.

The PPs reported having highly dedicated and committed leadership and staff. Staff are the backbone of these organizations. All PPs stressed the importance of getting to know their clients well in order to provide the individual services clients need. Their ability to develop client trust impacts on both the success of the programs as well as the employment opportunities the programs facilitate. Staff are highly knowledgeable about employability issues as they pertain to people with disabilities and see it as essential to be up-to-date on the latest approaches, methods and research to be able to continue providing the best services possible.

The PPs straddle the line between being supportive and challenging in their interactions with their clients. PP staff indicated that it is important to allow clients to make their own decisions (i.e., they are allowed to make their own mistakes) and assume certain responsibilities (i.e., showing up on time to courses and work placements). Some Promising Practices, such as Gastown Vocational Services, give clients two or three chances and if they still do not meet the expectations, they may be asked to come back to the program at a later time when they have addressed their issues and are ready to engage fully with the program. Others, such as the Behavioural Health Foundation, have a zero tolerance policy in place when it comes to any addictive substances. At the same time, support is given generously when needed, and assistance is provided to help clients graduate to greater levels of responsibilities and decision-making.

The Promising Practices have produced positive results. Clients' satisfaction with the service provided by the Promising Practices is high. Some clients are in the process realizing their dreams of fully participating in society. For other clients, the Promising Practices offer the first rays of hope that they too can achieve their dreams.

There have also been positive results in terms of the number of individuals who became employed after graduating from a Promising Practice program (Appendix A features PP templates that outline their respective qualitative and quantitative results). Some Promising Practices are collaborating with federal and/or provincial governments to offer wage subsidies for employers. These financial incentives often make it more feasible for employers to provide job placements and allow for financial flexibility when taking on clients who may need a longer training period. Another factor that must be taken into account when talking about results and sustainability of results is that most disabilities are permanent and many are characterized by periods when the disability is more intense or debilitating.

Each of the nine Promising Practices can be defined as a creative or innovative employment focused project or service that has demonstrated solid performance or has demonstrated potential to achieve high levels of performance in meeting its employability objectives for people with disabilities.

EAPDP⁴⁶ Promising Practices Report

A. Promising Practice Title and Description

B. Promising Practice Overview

Scope and Purpose:

• The Adult Services Program (ASP) conducts assessments of technological needs to increase access to training and employment opportunities for adults with disabilities. ASP then provides the loan of adaptive technology, training, repair, and ongoing support in the use of the technologies.
• Service delivery and expertise is available throughout the province of BC - even in small communities.
• The complete range of services provided by ASP is not duplicated elsewhere in the province. Without their services, many of the educational and vocational needs of adults within its mandate would go unmet.
• Promising Practices are eligible for cost sharing under Employability Assistance for People with Disabilities (EAPD), which is a bilateral funding agreement between Human Resources Development Canada and individual provinces.

Highlights:

• In addition to providing adaptive technologies to people with disabilities, ASP provides services that directly contribute to the overall effectiveness of their program. These include a review of clients' medical, audiology and psycho-educational documentation. A Collaborative Implementation Plan is developed during the initial intake process.
• ASP assists clients through technology troubleshooting, and does repairs and upgrading of hardware and/or software. The program allows clients to return, exchange and add additional equipment as required due to changes in the disability, curriculum or employment demands.
• ASP holds follow-up consultations with training institutions/employers to ensure that the technology provided to clients continues to meet the needs of those involved.

Challenges:

• ASP provides service to all disability groups. Of the new referrals in 2000-2001, 24% have visual impairments, 7% are deaf or hard of hearing, 14% have neurological disabilities, 5% have psychiatric disabilities, 10% have learning disabilities, 12% have multiple disabilities, 7% have mobility restrictions and 21% have chronic medical disabilities. ASP has met the challenge of meeting the demands of adults with a variety of disabilities who live across the province and who are working and studying in a broad range of environments by individualizing its approach.
• It is a challenge to ensure that technology does not turn into a barrier as opposed to an enabler for people with disabilities.
• BC has many rural communities. The challenge is to reach these communities and promote awareness of the technologies that are available.

Results:

• Program statistics as well as follow-up interviews demonstrate that the goal of the program (i.e. to enable people with disabilities to enter a post-secondary educational institution or gain employment) is being accomplished.
• A follow-up study conducted in 1999 revealed that approximately 78% of clients were either employed or still in school.
• In 2000-2001, ASP provided technology-related support and services to 473 participants in training and employment settings. Of the 473, 268 were new or re-referrals and 205 were participants who had borrowed equipment for at least part of the fiscal year.
• ASP participants report greater independence, increased access to opportunities, ease with communicating, reading and writing, and enhanced ability to compete successfully in the labour market as a result of their participation in the program.
• Providing a program that supports people with disabilities' transition between high school, post-secondary education and employment fills a critical need in British Columbia.

Costs:

• Average cost per participant is approximately $3,000. Costs vary from person to person depending on type and severity of disability and individual needs.

C. Background and Context

The creation of the Adult Services Program arose from a 1992 study by the Ministry of Advanced Education, Training and Technology to examine the special technology needs of post-secondary students with physical or sensory impairments. The Adult Services Project (later renamed the Adult Services Program) was formed in 1993 as a joint project between the Ministry of Human Resources (then the Ministry of Skills, Training and Labour) and Vancouver School District No. 39.

ASP was established to meet these needs by providing:

• A continuum of services from the public school system to the end of post-secondary education, including graduate training;
• An equipment loan bank;
• Expertise in the selection and maintenance of equipment; and,
• Consistency of service across the province.

ASP services are consistent with the EAPD Agreement's principles in that direct support of employability through its services is provided, preparing people with a disability for economic and labour market participation, as well as assisting them in retaining employment.

ASP provides service to all disability groups. Of the new referrals in 2000-2001, 24% have visual impairments, 7% are deaf or hard of hearing, 14% have neurological disabilities, 5% have psychiatric disabilities, 10% have learning disabilities, 12% have multiple disabilities, 7% have mobility restrictions and 21% have chronic medical disabilities.

D. The Challenge

• The changing pace of technology provides a challenge when adaptive hardware and software do not keep up with it. As a result, software conflicts occur as adaptive technologies are not always compatible with newer software.
• Every new version of software applications require greater processing speeds and larger amounts of memory than their predecessors, making such technologies obsolete within 4 years.
• Providing technology alone is insufficient. The challenge is in ensuring that clients know how to use the technology in an effective way.
• In order to be cost-effective, ASP must ensure that there is a good match between the needs of the person and the technology that is provided to them.
• It is a challenge to help people with disabilities to overcome a general fear of technology.
• It is a challenge to promote a general awareness of the technologies that are available as well the impact and benefits to be derived from the technologies.
• BC has many rural communities. Promoting awareness of the technology that is available in these communities and reaching the target population is a challenge.
• It is challenge to reach the entire target population. Some educational institutions choose not to use ASP due to perceived bureaucracy. Therefore, students attending such institutions do not have the opportunity to access ASP's technologies.
• A key challenge is to ensure that adaptive technology is provided to those who have the ultimate goal of finding employment. In many cases, students take courses for social reasons or to fulfil an eligibility requirement for another program.
• The eligibility criteria for the program is enrolment in two courses. The rationale for this is based on the belief that a person enrolled in two courses or more is doing so with the intent of finding employment upon graduation. It is challenging, however, to ensure flexibility so that people do not "fall between the cracks" should they be unable, due to their disability, to enrol in two courses. ASP will therefore consider clients with extenuating circumstances as exceptions to the rule.

E. The Results

Outcomes:

A Client satisfaction survey conducted in 1999, funded by HRDC, revealed the following results:

• • Most former clients indicated that they would not be where they are today if it were not for the services they received from ASP;
  • 88% felt that the adaptive equipment was useful or very useful;
  • 77% felt that the consultation was useful or very useful;
  • 84% agreed or strongly agreed that the technology support/equipment assisted them in graduating; and
  • 66% felt that they had a better chance of getting a job as a result of receiving services from ASP.

• A follow-up study conducted in 1999 revealed that approximately 78% of clients surveyed were either employed or still in school.
• In 2000-2001, ASP provided technology-related support and services to 473 participants in training and employment settings. Of the 473, 268 were new or re-referrals and 205 were participants who had borrowed equipment for at least part of the fiscal year.
• In 1999-2000, ASP provided technology-related support and services to 674 participants in training and employment settings. Of the 674, 361 were new and re-referrals and 313 were participants who had borrowed equipment for at least part of the fiscal year.
• The reduction in number of participants can be attributed to:
  • The impact of the Technology Services Support Program (TSSP) and the Canada Study Grant program as students are eligible to draw upon their services when taking only one course; and
  • The revised ASP eligibility guidelines.

• ASP spent 536 hours on individualized training and follow-up support during fiscal year 2000-2001.

Qualitative results:

• ASP participants report greater independence, increased access to opportunities, ease with communicating, reading and writing, and enhanced ability to compete successfully in the labour market.
• Providing a program that supports people with disabilities' transition between high school, post-secondary education, and employment fills a critical need in British Columbia. Analysis of the client satisfaction survey indicates that clients are better prepared to make the transition from school to work or from job to job as a result of the services provided by ASP.

The following are comments made by ASP's clients regarding the impact that the program has had on them:

"Having the aids provided by ASP not only allows me to do my job, but it puts me on a level playing field with my colleagues."

"While having the equipment is definitely nice to have, having your needs addressed on an individual basis is of much more value. ASP made me feel good about my situation and about myself."

"The staff of ASP are willing to find the best possible solution for me....unlike other programs."

"Having access to the equipment prior to actually starting to work would have helped. It would have allowed me to get up to speed as is expected by my employer."

The following are comments made by employers regarding ASP's services:

"More employers need to be made aware of the adaptive technologies and their potential for positive results in the workplace."

"Educating employers is essential to improving employability."

"The employee had the majority of skills she required when she was hired...additional skills applicable to the position were learned quickly and with relatively little difficulty."

"Employers need to know what is available, how to obtain it and what it will do for them."

F. What Works Well in This Promising Practice

• The loaning of equipment to participants is vital as it allows users to determine the appropriateness of the loaned technology for current training or employment settings. The loan bank concept enables participants to exchange equipment and experiment with technology options in the event there are changes to the participant's disability, the job or school tasks, or the on-site equipment provided by the training institution or employer. This approach helps reduce accommodation-related barriers.
• Upon becoming a participant, a Collaborative Implementation Plan (CIP) is developed. This plan includes a needs assessment where the required services and technologies to reduce identified barriers are determined. The CIP is developed collaboratively with the participant, the referring agent, the ASP representative and other key services providers.
• ASP uses a broad range of expertise to effectively conduct needs assessments and deliver appropriate adaptive technology services to people with the target disabilities. Expertise includes: Psychologist, Learning Specialist, Special Education Teacher, Speech and Language Pathologist, Occupational Therapist, Computer Teacher, Learning Assistance Teacher, and Bio-Medical Technician.
• ASP provides one-on-one technology training and on-going support for users. In some cases, basic computer skills need to be taught before technology training can commence. On-going support and follow-up are provided by ASP staff or referral agents to see if the equipment is working as anticipated.
• Enhancing the training component of the program would contribute to greater success.
• ASP provides adaptive technologies to PILAT (Program for Institutional Loans of Adaptive Technology). This allows students with disabilities greater access to technologies in both the Vancouver region as well as in more remote locations.
• ASP staff often travels to remote areas to provide service to an individual.
• Technology orientations are scheduled at the beginning of each educational year to allow referring agents to learn about and discuss new technology and provide this information to students who may require adaptive technologies.
• Maintaining a good relationship between ASP and the referral agents is key to reaching the target population.
• Prior to purchasing new technologies, extensive evaluations are conducted to determine the potential impact and compatibility with the technologies already in use by ASP. This process greatly contributes to the efficiency of the program.
• Enrollment in two courses is required as it is generally felt that a person enrolled in two courses is doing so with the intent of finding employment upon graduation. Depending on the circumstances, ASP will bend this rule.
• ASP donates technology that has become out of date or insufficient to meet its needs to colleges and institutions.
• Openness, honesty and communication are essential to the success of the program. Additionally, ASP strives to find the best possible technology solution for their clients and values solution over cost. This is a key success factor.

Critical Success Factors:

Essential services that are required for success:

• The Collaborative Implementation Plan (CIP), including a needs assessment to identify what services and technologies are required, is essential for success.
• Open and honest partnerships with educational institutions, referral agents and funding agents are essential both in Vancouver and in the rural communities of BC. These partnerships are currently the only way of reaching the target population.
• Providing technology, and service repairs in an efficient manner is valuable to both clients and employers.
• Providing up-to-date technology that is as compatible as possible with existing technology is extremely important.
• Conducting extensive evaluations of new and updated technologies as they enter the market is essential for on-going success.
• The program must continue to provide individualized service to people with disabilities. This is essential to ensure the effectiveness of the program.

To provide these essential services, the following is required:

• ASP must have qualified, professional staff that meet the level of expertise required to provide optimal service.
• On-going relationship building and partnerships with key people or institutions as well as employers is necessary to promote program awareness. Open and honest communication between stakeholders is essential to on-going success.
• Achieving the goal of employability requires ongoing promotion and awareness activities directed at employers. Employers need to be educated with respect to what programs are available, how they can be used and how the employer can benefit from them.
• The development of adaptive equipment is always one step behind. For example, the design and subsequent release of speech recognition programs for blind computer users generally takes six months to a year after the release of a new generation operating system. It is essential that ASP keeps up-to-date with the advances in technology and assesses the impact for users.
• Many adults have limited computer skills, which means that they cannot take full advantage of the adaptive hardware and software until their computer skills are well developed. It is essential that ASP ascertain individual abilities to ensure optimal use of the technology provided.
• Promoting and raising awareness of adaptive technology and its benefits in rural and remote areas of BC is necessary for reaching target populations in these areas.

G. Next Steps for the Promising Practice

On-going Activities:

• The Adult Services Program intends to continue collaborating with the Ministry of Advanced Education, which administers the Canada Study Grant (a federal financial aid program), to allow for long range planning and for students to access the full spectrum of technology solutions. Current practice is for post-secondary students to either purchase their own equipment if they are eligible for a grant through the Canada Study Grant, or apply to borrow equipment from ASP if they are not.
• ASP will continue to keep up-to-date with the new adaptive technologies and assess their impact on the users to find the best solution for each of their clients.
• The goal of ASP is to continue to make mainstream programming more accessible for people with disabilities.
• ASP will continue to assess clients' needs and abilities to ensure that the best possible solution is found for each individual.
• ASP is currently making modifications to their database with enhanced capabilities (i.e. relational database capabilities) that will enable them to function more efficiently.

Future Endeavours:

• Solicit additional funding to track the results from the 2000-2001 fiscal year to determine the continued success of the program. Specifically, ASP would like to find out whether the participants are employed, pursuing further training or are unemployed at the time of the study.
• Ideally, a 'common core of values' between all orders of government would improve efficiency of service to the target population. ASP will address this in the long range planning activities with the Ministry of Advanced Education.

EAPD⁴⁷ Promising Practices Report

A. Promising Practice Title and Description

B. Promising Practice Overview

Scope and Purpose:

• This promising practice provides a creative 'train-to-work' framework for one young adult who does not qualify for access to typical college or skills training programs. Skills are learned at a worksite so the young adult can prepare for employment in the competitive labour market.
• This service demonstrates the benefits of co-ordinated transitional vocational planning for a young person with a developmental disability through a partnership with the community, including family, employer, Douglas College, employment service and behavioural consultant with the support from provincial and federal governments.
• This is a pilot project. The capacity to take on other clients has not been developed yet and consequently, the program is not being advertised.

Highlights:

• POLARIS' client does not meet the usual entrance criteria for special education programs (i.e. career awareness or skills training programs) at colleges.
• This client learns best in the environment in which she will later be expected to display the relevant work skills and work habits. As a result, her skills development takes place on the job site.
• It is estimated that it may take close to two years for this client to perform the skills required independently. The worksite is essentially hosting an extended college work experience. The goal is to assist the individual to become competitive in the labour market.

Challenges:

• Getting the client to a point where she is more independent and becomes a productive member of the work environment and society is the challenge that POLARIS works to overcome.
• Choosing a job coach with whom the client can work, allowing for sufficient time to allow them to get to know each other before entering the work environment is a challenge. Client trust is an important component to making the process a success.
• There is a need for on-going support. For example minor changes in work responsibilities or processes may necessitate some client re-training.

Results:

• The employer has accommodated the client and adjusted to the unexpected issues coming from someone who is just learning about the world of work. At the same time, the employer has made it clear that business needs come first.
• The client has developed increased autonomy and independence through the use of various communications tools (i.e. verbal cues, cue cards). She uses pictorial cues at home when preparing for work and also on the job site when performing her work.
• Pictorial cues are also used to develop her public safety skills, which also have contributed to greater independence. For example, the client uses Handidart independently to get to and from the workplace.
• Her enhanced self-confidence is resulting in better communication and interactions with co-workers as well as improvement of the skills needed to work in a team setting.
• The client has demonstrated a willingness to make decisions in the workplace.
• The client is experiencing the reality of working in a competitive environment.
• The employer, co-workers, supervisors and general public see the value of this individual's contribution to society. This is important in building support for this type of training in the community.

Costs:

Human Resources Development Canada's Opportunities Funding funds this pilot project. Phase 1 of the project received $13,000 in funding while $1,690 have been received for Phase 2.

C. Background and Context

• The family and the employer were the driving forces of this promising practice. Both parties agreed to create a learning environment where business needs come first. The pilot required a co-operative spirit amongst many players: the social worker, the employment service staff, the college staff, the family, the family supports, the employer and his staff, and the funding agents. Only when the client began to experience what work was like and her desire to participate and learn became evident to everyone involved were fears put to rest.
• Young people with a developmental disability between the ages of 16-25 benefit from integrated schooling and life experiences in that it prepares them and their families to be involved in all aspects of their community, including competitive employment.
• Opportunities for successful employment for this client were increased when the skill development occurred in the actual environment where the skill will be used. Community colleges, employment services and day programs, to date, do not have programs to fit these individuals, and they and their families are now "pushing" the systems to create such experiences.
• The limitations of the practice are in appreciating the time investment needed for long-term results. The scope of the required supports is often not fully appreciated and needs to be evaluated as the training is delivered. Transitional planning and service delivery for young adults with developmental disabilities are necessary and this pilot project demonstrates the success of creative spirit to 'try another way'.

D. The Challenge

• Supporting the client to a point where she is more independent and becomes a productive member of the work environment and society represents a challenge.
• Funding agents and employers may expect too much from the client too soon. Balancing the pressures for results with assisting the client in making progress can be challenging.
• Choosing a job coach with whom the client can work, allowing them to get to know each other before entering the work environment takes time. Client trust is important to making the process a success.
• People with developmental disabilities may be concrete thinkers and therefore may have difficulty expressing themselves about something without first experiencing it. Assisting the employer and other employees to understand the client's learning style requires time and effort.
• Clients must be supported to learn about the new responsibilities and employer expectations they face when participating in the workforce.
• Ensuring clear, consistent communication between the client, her family, employer, co-workers, and other members of her support team.
• The need for on-going support is essential as minor changes in work responsibilities and processes may require some re-training of the individual.
• It is important to support parents and siblings in their effort to promote their family member's success.
• Competition in the workplace can make it difficult for people with disabilities to acquire employment. To facilitate employment opportunities, education of employers on the value that people with disabilities bring to a workplace is essential to meet this challenge.
• The diversity among people with disabilities requires creativity in programming and openness on the part of funding agencies.

E. The Results

Outcomes:

• Since this is a pilot project with only one client, there is a lack of data to strengthen and/or support this service. POLARIS usually provides anecdotal information to the government in the absence of quantitative data.
• The service is in the beginning stages of measuring the client's performance at the worksite. Industry benchmarks such as absenteeism rates, time it takes to perform certain tasks, etc. are used to measure her performance. The goal of the program is to measure quality first, quantity second. It is important that employer expectations and performance criteria be measurable and timelines set.
• POLARIS has developed an approach for their client that could work for other people with developmental disabilities. There are approximately another 30 individuals in the area who would benefit from a similar program.

Qualitative results:

• Since being at the worksite, the client has become more independent, is more interested in her own life and what she's going to do "tomorrow", more confident and more socially developed. She has developed more skills than she would have acquired through any other training program (i.e., "you can't talk about a job if you don't have one").
• While working at the site, the client has developed relationships with other staff members. The management team involves the client and makes her feel like she is a part of the group. The client attended a staff Christmas party in December 2001 on her own for the first time.
• Staff and managers at the job site are satisfied with the arrangement and support from POLARIS.
• The communication between POLARIS and the client's parents has improved and the parents understand the service's purpose.

The following are comments made by the client's family members regarding the impact POLARIS' services have had on them and the client:

"She now believes in herself that she can do something."

"[This work placement] has opened the doors to social opportunities for her."

"There are more people out there who need this service, but they don't have the help or support."

The following are comments made by the employer regarding POLARIS' services:

Expectations and performance criteria should be measurable. You shouldn't confuse effort with results."

"The effort from the management team is to involve the client and make her feel like part of the group."

F. What Works Well in This Promising Practice

• Learning by doing is essential for those individuals with disabilities who have difficulty transferring classroom skills to the workplace. Having an employer who is willing to provide a work opportunity is allowing this client to progress.
• A service like this must have qualified staff in order to operate effectively and efficiently. POLARIS has a network of qualified staff, pulled together by the Executive Director.
• POLARIS has been able to balance the needs of the government (accountability) with a customized approach to assist an individual towards becoming employed.
• This pilot has demonstrated that individualized services and activities can function within larger service delivery programs. All activities are tailored to an individual client. POLARIS coordinates all programming activities around their client.
• The employer and POLARIS have stated over time what is expected of the other. In subsequent phases of this service, the same boundaries will be coordinated upfront with the employer, client and POLARIS.

Critical Success Factors:

Essential services that are required for success:

• Addressing issues as they occur is helpful in assisting the client to maximize their retention of learning.
• Support and patience from employer/staff, family and community are essential ingredients for success as are buy-in and trust from people in all areas of client's life.
• Consistent messages to the client from all aspects of her life, as well as communications between client, her family, employer, co-workers, social workers, behavioural consultants, funders, etc. are essential for success.
• One-on-one instruction in the work environment and the support of co-workers, supervisors and the general public must take place.
• Having employers who operate in the same community as the client is important as this helps the client feel comfortable and safe and enhances her self-confidence.

To provide these essential services, the following is required:

• Staff with the appropriate qualifications and experience is needed to provide the required services.
• Regular and frequent communications with all key players must take place to ensure the progress of the client.
• On-going commitment by governments to explore new systems of school - work transition that would serve young people with a developmental disability is imperative.
• The success of the arrangement with the employer is based on an understanding that the employers' business needs come first.

G. Next Steps for the Promising Practice

On-going Activities:

• POLARIS has been successful in getting funding for this pilot. POLARIS will continue to build and develop strong community partnerships.
• The pilot program is moving ahead for this individual. She is in the first year of what will likely be a two-year program to prepare her for competitive standards in the workplace and being a part-time employee.

Future Endeavours:

• To maintain this type of service, POLARIS is working with the province to become more flexible in the funding it provides. It is also looking to champion the cause/need of this service as well as to acquire further support from within the federal and provincial governments and post-secondary institutions.
• Expansion of the program to meet the demand (i.e., there are approximately 30 people in the area that could take advantage of such a service).
• To support the governments' agenda of enhancing employability and employment opportunities for people with disabilities.
• As of April 2002 POLARIS is expanding their pilot project to include a second individual and a new employer. POLARIS would like to develop a relationship with the client prior to placing him/her in a work setting to allow the client to slowly adjust to the new environment.
• Staff at POLARIS sees this service as a long-term engagement.

EAPD⁴⁸ Promising Practices Report

A. Promising Practice Title and Description

B. Promising Practice Overview

Scope and Purpose:

• GVS was established in 1991 to provide vocational/psychological assessments, prevocational work readiness programs, career exploration opportunities, job placement services and work experience to individuals with a variety of psychiatric disabilities within a comprehensive 3-phase program.
• GVS' broad goal is to improve the individuals' job readiness skills and support network in order to assist them to become vocationally independent in the community.
• Using a graduated self-directed approach as much as possible, GVS encourages each individual to attain their employment or educational goals based on their interests, strengths and abilities.
• Supported employment services were added to GVS' range of services in 2001 to support and facilitate their clients' transition towards competitive employment.

Highlights:

• GVS fulfils the need of individuals with psychiatric disabilities who require specialized vocational rehabilitation services within a supportive environment as recognized by the mental health community.
• GVS offers assessment, skill building, work experience, career exploration and supported employment services, all geared toward assessing the client's job readiness and to delineating a specific career/job and/or educational training goal. GVS offers a wide range of group programs as well as individual vocational programming in order to meet the wide range of client employment needs.
• Group programs consist of a 8 or 10-week Phase I work readiness program, a 6-week fast track work readiness program, a four-week Career Exploration program, as well as comprehensive vocational/ psychological assessments for each program participant and individualized options.
• Clients that are thought to benefit from an individually tailored program are provided with individual vocational counselling and career exploration in addition to a comprehensive assessment.
• Recently, GVS has been provided with funding to offer supported employment/job placement services.
• The GVS program is readily accessible to clients in the community via self-referral, or alternatively, clients can be referred via their general practitioner, psychiatrist, mental health therapist, family member or advocate in their community.
• A high percentage of clients receiving psychiatric treatment at the mental health teams identify employment and/or education goals as their primary need for rehabilitation intervention.

Challenges:

• The greatest challenge in preparing people with psychiatric disabilities for employment is to develop their self-esteem and confidence as well as coping skills and social skills.
• Many clients do not know their strengths and limitations, or what they would like to do.
• The stigma attached to psychiatric disabilities is a result of misunderstandings and a lack of good information of what these disabilities are all about. When their condition has been disclosed, they are treated differently in the workplace.
• Educating employers and provide strategies for how to accommodate people with mental disabilities is essential to support people with such disabilities obtaining gainful employment.

Results:

• GVS serves approximately 100-120 clients from the Lower Mainland at any one time and currently has a waitlist of 60 clients awaiting the group program.
• It is estimated that about 80% of clients complete the program. Those dropping out of the program typically do so in the first two weeks, usually because: they are not quite ready yet to take on the learning and discipline required to complete the program; due to their psychiatric condition being unstable; or to a lesser degree, due to physical illness or stress external to the program.
• Of the 91 clients served between January 1999 to September 30, 2000 (this only includes clients whose files were closed at the time the report was compiled), 21.9% are employed, 31.5% are enrolled in or referred to college, 7.6% are in skilled training programs; 8.7% work as volunteers, and 6.5% are active in job search. The remaining have either been referred out to other agencies, are not employable at this time or have moved away and contact with them has been lost.
• An evaluation study conducted in 1999 showed that clients referred to GVS over a two-year period by the local mental health centre or vocational rehabilitation consultants underwent a significant positive change in their work behaviours, which was sustained over time. Twenty-two percent had obtained competitive employment at the six-month follow-up.

Costs:

• Clients come to GVS with complex issues and it takes professional expertise to guide them through a graduated step-by-step process. Cost per client is approximately $7,183 per participant per full program, including psychological/vocational assessment, work readiness program, work experience(s) and job placement. It is acknowledged that the program is costly, but also that it is a cost-efficient program as it is meeting its objectives.
• A participant is enrolled in the program for about six to ten months and some choose to come to on-going support sessions.

C. Background and Context

• The target group is adults whose primary barrier to employment is a mental health disability. Typically people with mental health disabilities encounter a variety of barriers in obtaining and maintaining gainful employment.
• GVS is multi-disciplinary and has a full complement of professional staff, including psychologists and occupational therapists. GVS focuses on work adjustment and transferable skills as opposed to training, responding to client needs.
• Studies indicate that the unemployment rate for this disabled population group is as high as 75 — 90%.
• GVS is a funding partnership through the Ministry of Health Services, Mental Health Services (through three health regions) and the Ministry of Human Resources, Vocational Rehabilitation Services.
• The services provided by GVS reflect the philosophy of the best practices for psychosocial rehabilitation and recovery in BC's Mental Health Reform.⁴⁹ Client involvement in developing and realizing their personal care and life goals is emphasized by GVS. As well, GVS provides the treatment and support clients need to both manage their symptoms and build on their strengths.
• Since its inception in 1991, GVS has had a waitlist of approximately six months for clients to access the program.
• The waitlist is a result of limitations of space and staffing, and the volume of referrals. Over the past two years, the number of individuals on their waitlist has increased as a result of increased volume of client referrals with no increase in funding to accommodate this increased number of referrals. The actual time on a waitlist continues to be approximately six months as a result of some programs having been shortened.

D. The Challenge

• People with mental health disabilities encounter a number of barriers to obtaining and maintaining gainful employment. These include difficulties dealing with stress, low self-confidence and low self-esteem. Many struggle to be assertive or manage their feelings and emotions. Others have cognitive impairments, making it challenging to concentrate, memorize or process information rapidly.
• People with mental health disabilities may experience considerable periods of time when they are unable to work due to illness. Consequently they require up-to-date labour market trend information, assessment of current skills and abilities, and identification of skills transferable from past employment and experience.
• Many clients require skill upgrading to become competitive in today's labour market.
• Another barrier experienced by people with mental health disabilities is stigmatization. False negative perceptions about the abilities and attitudes of people with mental illness are common in society.
• People with mental health disabilities may lack work-related behaviours such as communications skills, hygiene, punctuality and handling feedback.
• Many have limited work experience or gaps in their work history.
• The recurrent or ongoing nature of many mental health disabilities often requires ongoing support from professionals to maintain employment, or alternatively, support while pursuing education or skills training in order to enhance their employability.
• Competitive employment is possible with this population group by providing clients with accurate information regarding vocational strengths and limitations, teaching them coping skills, providing them with practical, hands-on supported work experiences and providing assistance in job placement.
• Individuals should not have recent active major drug or alcohol problems (although there are exceptions made. GVS found in their last demographic data collection activities that 11% had polysubstance abuse problems). They must demonstrate a motivation to return or enter competitive employment.
• Lack of stable housing is counterproductive for clients engaged in vocational rehabilitation.
• Different funders have different requirements. For example, one set of funders permit a certain flexibility of time for clients to undergo services (i.e. clients can have one to three work experiences lasting up to three months each) provided the clients are demonstrating progress, another would like to see the program services shortened. It becomes a challenge to provide services that clients need. As a result of the different requirements and client needs, GVS has responded by creating programs of different lengths, yet maintaining their client-focused services.

E. The Results

Outcomes:

• GVS' outcomes include the following based on 91 clients served between January 1999 and September 30, 2000 (this only includes clients whose files were closed at the time the report was compiled): 21.9% are employed; 31.5% are enrolled in or referred to college; 7.6% are in skill training programs; 8.7% work as volunteers; and 6.5% are active in job search.
• This does not include clients that have either been referred out to other agencies, are not employable at this time or have moved away/contact has been lost.
• A program evaluation research study on program effectiveness published in 1999 in the Canadian Journal of Community Mental Health indicated that 22% of participants were employed at six-month follow up. Another 56% were on work experience placement.
• The same study also showed that compared to a control group consisting of individuals on GVS' waiting list, GVS clients underwent a significant positive change in their work behaviours, which were sustained over time. The study showed that clients with depression improved their score on the Beck Depression Inventory pre-to post program and that the score was maintained at the six-month follow-up.

Qualitative results:

• Client Satisfaction results indicated that 97% of the clients enrolled in the work readiness program rated the GVS program as helpful (N=63).
• 91% of clients expressed that the GVS program helped prepare them for a work experience placement (N=63).
• Review and analyses of client satisfaction survey results has led to changes in programming over the past two years. This includes adding programming options to increase client choice, streamlining some programs, and changing the group skill building curriculum (e.g. more sessions on assertiveness training for the job, more self-esteem/confidence building sessions, fewer sessions on anger management).
• Clients find GVS' program highly beneficial. They indicate that they have acquired greater self-esteem as a result of the program, they value the training on how to approach job interviews, and for many, assistance in developing their CVs is invaluable. Furthermore, the support given over time, either through the biweekly drop-in groups or calling on GVS staff for questions, allows many clients a safety net they feel they need as they transition to paid employment.
• Clients interviewed indicated that they had or would recommend the program to others.

The following are comments from GVS clients regarding the impact that the program has had on them:

"GVS is one of the better things you can do to get people back to work!"

"It has helped me understand my limitations and can-dos. It has given me a chance to try a dream opportunity."

"I have a hard time getting up and going in the morning. GVS required that I show up on time for my course. It is good that they don't "baby" people. At least, it helped me showing up on time and the time-management section of the course taught me things I still do."

"The course I took at GVS filled a hole on my CV. Without the job placement I did, I wouldn't have had anything to put on my CV for that year."

"There is too much homework and information given to you at the course. I felt stressed over not being able to deal with all the information. I discussed it with GVS staff, and they helped me figure out whether to continue or not."

"The work preparation was good. I wouldn't have been able to get that mental readiness to go looking for work without the program. I didn't think I was worthy."

According to employers who have provided job placement opportunities, GVS provides solid support for both client and employer and is instrumental in making both parties understand what they can and cannot do. The open lines of communications between the three parties are highly valued by clients and employers as both parties feel they have someone to go to should there be any issues at all. It is this support that allows several employers to continue providing job placement opportunities to GVS' clients.

The following are comments made by employers regarding GVS' services:

• "It is important to provide the right opportunities to prevent failure. An employer must pay attention to any fears or misunderstandings and deal with these right away. Also, it is important to manage other employees so that they feel comfortable."
• "The GVS clients that have come to us have little or no skills, but this was the understanding ahead of time. I find it really interesting to see people come out of their shell. One of the clients has paid employment with us now, another is still volunteering and another former client is working part-time for another organization doing similar work."
• "We have had great success with GVS clients. It is mutually beneficial to have them come for their job placement portion of the program: they get experience; we get work done that otherwise would not be done. GVS clients want to be there, they are enthusiastic, they have some skills that can be applied here and many of them are mature. We have hired two clients after their placements in our organization."
• "An employer needs to be flexible to fit clients' schedule. They start off three days a week and they can set their own hours. And then you ease them into full-time level."
• "Many of the clients are looking for particular experiences such as filing or data entry. But our workplace has changed, we now outsource all mailing and distribution and as a result, we don't have as many opportunities anymore for those looking for these types of jobs."
• "The relationship with GVS is really good. We usually have three or four meetings. The client is evaluated half-way through the program and then at the end. The meeting provides a chance for employers and clients to evaluate the client's performance. It is interesting to note that clients tend to rate themselves lower than we do. The success of these meetings depends on clients being positive, honest and open and that it is done to help them grow and improve."

F. What Works Well in This Promising Practice

• Clients benefit from an individually tailored program based on their comprehensive vocational/ psychological assessment results. This information (and the process of feedback to the client) provides the client with increased clarity regarding their cognitive/intellectual capacities, their personality/emotional functioning, their inter and intra-personal functioning as well as their vocational strengths, abilities and interests. Strategies for on-the-job success, or educational accommodations are recommended to them.
• The work readiness program is designed to assist clients who have not been in the workforce recently and who may require a more gradual step-by-step approach to achieve their employment or training goals.
• The fast track focus group is for people who have recent work experience and may need a "refresher" in coping skills and career exploration to delineate a competitive employment goal.
• Individual programming is for clients who are not comfortable in the group environment to have the opportunity, following an assessment, for career exploration via job shadow or work experience and assistance with job placement services, if required.
• The career exploration program provides clients with an opportunity to systematically learn modern job search techniques, how to access educational resources and research occupational options via computer research and informational interviews leading to a work experience or job.
• The addition of supported employment services to supplement the current vocational services at GVS will be an asset in terms of providing the continuity of vocational rehabilitation services from assessment to work readiness/skill training to job placement.
• Providing ongoing support and continuity of vocational rehabilitation services is considered essential for a client's success.
• Many clients come to GVS with complex issues, requiring a graduated step-by-step process. These clients benefit from the wealth of expertise that GVS has.

Critical Success Factors:

Essential services that are required for success:

• Both psychological and vocational assessments as well as an on-the-job assessment are essential.
• Placing people out to work quickly is very important to not lose the momentum built up during the program.
• Ongoing communication regarding vocational planning with GVS staff and with the client's mental health team or general practitioner or psychiatrist, and family members (as relevant) is essential to ensure that clinical treatment augments rehabilitation pursuits.
• Ongoing, regular evening support groups for individuals in employment have proven to be invaluable.
• Partnerships with funders, referral sources and educational institutions and regional coordination of employment service providers are essential for success.

To provide these essential services, the following is required:

• An organization must have experienced, professional staff.
• An organization must provide one-to-one vocational counselling and ongoing support.
• Referral sources, family members, hospital staff, community rehabilitation staff and individuals must be provided information regarding vocational, educational supports and services.
• An organization must have computer and support services to facilitate career and labour market research.
• An organization must have facilities that are accessible to clients by transit.
• Many people with mental health disabilities in unstable housing situations may require more appropriate housing in order for them to focus on their vocational/employment/educational goals.

G. Next Steps for This Promising Practice

On-going Activities:

• GVS is continuing to more clearly assess which types of clients would most benefit from the eight to 10-week work readiness program and which types of clients would be best served by immediate job placement services following a brief assessment. It is important for clients to get a blend of support and challenge, as this is the environment in which people function best.
• GVS is completing data collection and analysis from the Emotional Quotient Inventory as a pre/post program outcome measure.
• GVS is continuing to increase flexibility of programming options, and to evaluate the success of the newly developed job placement service component.
• GVS will continue to advocate for employment for individuals with psychiatric disabilities through coordinated marketing strategies with current vocational agencies in the community.

Future Endeavours:

• GVS plans to continue its research into program effectiveness, including exploring different program lengths depending on the needs of the clients. In addition, GVS plans to continue to explore inventories and tools to help determine which individuals benefit from which type of programming interventions.
• GVS plans to conduct exit interviews on clients who withdraw from the program prior to its completion to get a better picture of what factors are involved in withdrawing.
• GVS will be offering supported educational services at GVS versus referring clients out to another agency for this service (i.e. current practice). GVS will also be assisting clients in looking for work, and transition into the labour force will be an important addition to the services currently offered.
• GVS will continue to offer clients flexibility and choice in vocational programming options. GVS will also facilitate and advocate for increased coordination of vocational and educational supports in the community.
• GVS plans to review process objectives formulated for the year 2001, and establish priorities for 2002 in terms of program quality, efficiency and effectiveness.

EAPD⁵⁰ Promising Practices Report

A. Promising Practice Title and Description

B. Promising Practice Overview

Scope and Purpose:

• THEO BC supports people with disabilities living in Kamloops to choose, get and keep paid employment. The program assists clients to increase their economic independence and self-esteem, and pursue their employment and training goals. THEO BC is the delivery agent for this program.
• In August 2001, THEO BC extended its services to Aboriginal people with disabilities with the overall purpose of increasing their employment opportunities. Approximately 2,500 Aboriginal people in the Shuswap area have some form of disability. The geographic area is large and includes about 40 communities both on and off reserve.
• THEO BC utilizes a single entry point (everyone begins with two to three career assessment sessions), leading to a series of flexible options depending on client goals. For example, upon completion of the career assessment process, a program participant may choose to progress through each option available to him/her (occupational training, job search workshops, and then to job placement) or he/she may want to go directly into a job placement.
• Staff works one-on-one with participants. Participants receive ongoing support once they have been placed in a job. They also continue to receive support after their goals are met. This includes short-term job coaching, one-, three-, six-, and 12-month follow-up. Files are not closed until the participant has been employed for a year.

Highlights:

• THEO BC provides services in Kamloops that include career assessments and planning, resume workshops, job skills training, independent or assisted job search, on-the-job support and continued support and follow-up for maintaining paid employment. They also provide an up-to-date resource centre with labour market information and have a computer lab for participants to use.
• THEO BC opened The Gardengate Training Centre in July 2001 to expand their services. The contributions of many community volunteers, individuals and organizations helped to make this unique project a reality in Kamloops. Gardengate offers four 'ha