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·	From Theory To Practice

1. There are many misconceptions about the potential of people with disabilities to work.

A common perception is that persons with disabilities who are not in the labour force are either unable or unwilling to work. There is strong evidence, however, that a substantial proportion of people with disabilities who are not currently in the labour force are capable of being employed in some way, given proper supports and removal of barriers. One study demonstrated that the lack of availability of accommodations and supports is a bigger barrier to employment than severity of disability. Also, some people with severe disabilities, while limited in the amount of work they are able to do, can still do productive work given the proper support. Saying that it is possible for people with severe disabilities to work does not mean that it is easy. Since many barriers must be overcome, successful intervention may require significant up-front costs, although there is potential for long-term savings.

Barriers to employment include lack of affordable transportation, limited education and training opportunities, various disincentives, lack of supports, and other factors. Failure to recognize and address these barriers may result in discrimination and exclusion of people with disabilities from the workplace. The need for a coordinated approach has been well documented, but has proved elusive at the policy level.

2. An all-or-nothing view of employability results in disincentives to work.

Eligibility requirements of disability income systems such as the Canada Pension Plan (CPP), which defines people as either "employable" or "unemployable", act as a powerful disincentive for people receiving social benefits to search for and to accept employment. Many people with disabilities are nonetheless capable of some degree of work, or can work if they are given appropriate supports.

3. Job accommodations, usually of nominal cost, can enable many people with disabilities to be fully employed.

Accommodations are "any modification of the workplace, or in workplace procedures, that make it possible for a person with special needs to do the job." Accommodations include technical aids and devices as well as physical alterations to the workplace. Current experiences in this area indicate that most accommodations are of low cost, with half costing less than $250 and many not involving any cost. Employers who have provided job accommodations say that the savings they have achieved average 27 times the cost of providing accommodations. Barriers to accommodation include both attitudes and lack of information about the potential of accommodation, as well as the methods to implement accommodation requirements in specific situations.

4. Disability management and return-to-work strategies offer considerable potential for very significant cost savings.

Disability management, or active follow-up and management of employees who are off work due to work-related or non work-related disabilities or injuries, has been shown to result in cost savings. Because of these savings, disability management strategies are becoming more commonplace, especially in the private sector. Disability management can also be effective in enabling participants on disability benefit programs such as CPP to re-enter the workforce. It has been estimated that up to 10 per cent of CPP beneficiaries have potential for rehabilitation and return to the workforce. Lessons learned from evaluations of return-to-work programs in a variety of settings emphasize the importance of early intervention and active case management.

5. Vocational rehabilitation has the potential to enable people with disabilities to get into employment.

Evaluations have identified a significant cost benefit of rehabilitation to the taxpayer, to income support programs and insurers. In general, vocational rehabilitation is most effective when it is individualized and closely oriented to the labour market. A recent evaluation of the pilot project on the CPP National Vocational Rehabilitation shows that the biggest limitation to the effectiveness of rehabilitation is lack of access. Indeed, only a small proportion of people who could benefit from rehabilitation services are able to access them. Also, without attention to respond to needs after a person starts or returns to work, short-term gains may not endure.

6. The effectiveness of wage subsidies and employer incentives is mixed.

Wage subsidies are put in place by governments as an incentive to the private sector to increase the training and employment opportunities for persons with disabilities. They are intended to compensate employers for lost productivity, and are of limited duration. Their effectiveness is mixed.

Wage subsidies are intended to help with entry into the labour market, especially for people with little or no work experience. They can provide work experience for people who may have trouble obtaining it without some form of assistance. But subsidies can have a number of disadvantages. For example, being categorized as eligible for a wage subsidy can reflect negatively on the capabilities of those so categorized and lessen their chances of employment. In particular, people not retained following a subsidized placement may have difficulty obtaining employment in the future. Thus it is not certain whether wage subsidies, once completed, will result in long-term employment. Alternative approaches, such as barrier removal, generally appear to be more successful.

Subsidies appear to be most effective when they are part of a coordinated approach with other forms of support for the individual and the employer. The supports usually are specifically tailored to address the identified needs of the individual, and include follow-up and monitoring processes.

7. Supported employment has proved a better and more cost-effective alternative to sheltered work.

Supported employment involves training and work at regular work settings. Its unique feature is the provision of a job coach who gives support and training to the individual using the program. As the worker demonstrates independence, the amount of support is gradually reduced. Supported employment has been used primarily with people who are considered unable to work competitively, and who would otherwise be placed in a sheltered workshop. The supported employment model of integration provides opportunities to work in regular employment settings, and results in a higher degree of satisfaction among participants in this program over those participating in sheltered workshop placements.