November 18, 2011
Hello, and thank you for that kind introduction, Nancy.
I want to recognize a few people who are vital to our department’s mission: Henry Claypool, our Director of the Office on Disability, and Sharon Lewis Commissioner of our Administration on Developmental Disabilities. They’ve spent their careers working to improve the lives of Americans with disabilities, and they’re invaluable advisors to me.
I also want to thank Cindy Mann and Barbara Edwards at CMS for their leadership behind many of the Medicaid programs that provide opportunities for individuals with disabilities.
The Obama Administration believes that in our country, every person has value and should have the opportunity to reach their full potential.
This is especially true for people with disabilities. Helping them achieve the most out of life is the right thing to do and it makes us a stronger country.
But today, Americans with intellectual and developmental disabilities face many obstacles to living full and meaningful lives in their communities.
Far too many people with disabilities have faced an impossible choice between living in an institution away from their loved ones, without the opportunity to work and play in their community...or living at home without the supports they need to contribute.
Our philosophy is simple: we want to give them better choices.
That’s why over the last two and a half years, the Obama Administration has launched an ambitious agenda to make it easier for Americans to live their lives at home and in the community.
For a person with disabilities, that starts with having more access to health care in a system that historically discriminated against their needs.
Thanks to the Affordable Care Act, we’ve removed barriers to services for people with disabilities such as dollar limits on the amount of care a person can receive. We’ve also made it illegal for insurance companies to refuse to cover children with pre-existing conditions, a benefit that will extend to all Americans in 2014.
Our agenda also emphasizes the importance of transitioning people from institutional settings into housing that supports their needs while allowing them to live near family and friends as part of a community.
On this front, the Affordable Care Act is the most far-reaching commitment to home and community based services since the Americans with Disabilities Act became law 21 years ago.
The health care law extends the life of our Money Follows the Person program for another five years and will help tens of thousands of people move from an institution to home and community based services by 2016.
It contains the Community First Choice option, which provides extra money to state Medicaid programs to improve the quality of the services and supports people receive at home. And we’re giving states tools to monitor and track their direct care workforce – the largest and fastest growing workforce in the nation.
Our administration has also worked across the government and with states to breathe new life into the promise of Olmstead with our Community Living Initiative. That has meant partnering with the Department of Housing and Urban Development and the Department of Justice to smooth the transition from institution to a home in the community and protect the civil rights of people with disabilities.
Taken together, these efforts constitute the most significant agenda a President has ever set to help Americans with disabilities live in their communities. But our Department is also working to improve another, equally important aspect of helping people with disabilities become contributing members of their community: employment.
For people with disabilities, finding a job is a major component of independent living.
It’s not just about a paycheck, it’s about developing self-esteem, skills, relationships and a path to lifelong learning that can be an extremely positive part of a person’s life. And it’s about pursuing your passions.
But as everyone in this room knows, there have always been barriers to meaningful work for Americans with disabilities.
For example, issues may arise when a person with developmental disabilities decides to go out and find a job. They may be able to perform well in the workforce, but need additional supports, such as job coaches or targeted skills development. They have to battle the stigma and low expectations often cast upon them by potential employers. Low rates of high school graduation and lack of school-based job experiences often compound the problem.
These obstacles may lead an employer to go in search of someone who they imagine to be, quote, “easier” to hire, employ and retain.
We don’t even have a full grasp of the problem because we lack concise statistics on Americans with developmental disabilities in the workforce. But what we do know from the hard work of so many in this room is that only about 15 to 20 percent of people with intellectual and developmental disabilities are currently participating in the integrated workforce.
These are the challenges we face under normal circumstances, but in today’s economic environment, the challenge only grows.
Right now a person with developmental disabilities searching for work not only has to overcome our country’s economic woes, but also all of the other issues they face when seeking employment.
It’s the responsibility of the people in this room to make sure that there is a structure in place that allows anyone with disabilities who wants to work, to find employment. And all of you are here today because, like President Obama and me, you’re committed to the idea that everyone can work.
Every day, our Administration is working to make that vision a reality. In order to use our policies and resources as effectively as possible, we’re taking a two-pronged approach.
First, we’re using existing initiatives to help Americans with disabilities find work.
The programs that states use to provide services for individuals with disabilities contain a lot of flexibility to create new initiatives, particularly Medicaid waivers. But what we’ve found is that many states didn’t realize that they had all of these options.
For example, in Washington state they have used their flexibility within the waiver to create an “employment first” policy. It’s simple: if you’re eligible for Medicaid waiver services in Washington, they’re going to encourage you to use your supports to find a job along with the other services you receive from the state. It doesn’t sound so revolutionary, but with this policy, Washington has achieved the best employment rates for people with developmental disabilities in the country.
That includes people like Brooke, a young woman with intellectual disabilities serving as staff in the King County Council’s office, who speaks about how her job has changed her life and earned her tremendous respect from her own family. Thanks to Washington’s approach, she’s an individual with significant disabilities earning competitive wages in a real career.
We’ve seen similar approaches catch on in other states, and we wanted to urge all states to think creatively about how to use waivers.
So this September CMS released an informational bulletin to answer questions and outline the ways that states could take advantage of their Medicaid waivers to bolster employment, using person-centered planning and supported employment services, for people with disabilities.
It gave states guidance on how they could expand the types of work support available to people with disabilities to create more opportunity for a wider population. And it was also careful to clarify what did and what did not classify as paid, integrated, community employment in order to make sure that states are meeting their obligations.
We’ve also incorporated employment efforts into our Money Follows the Person initiative. This program not only supports the transition from institutions into the community. It also represents the perfect opportunity to start a person with disabilities on the path to meaningful employment.
We’ve seen this idea really come to life in Iowa.
Initially, many Iowans with developmental disabilities had been placed in pre-vocational services, because it was assumed they were unable to work. In reality, many more could work and wanted to work. So this January, the state brought an employment specialist in to join their Money Follows the Person efforts. This position was completely funded with federal dollars and made sure there was a voice at the table solely focused on meaningful employment for Iowans with disabilities.
Because of Iowa’s success, we announced in March that any state that wanted to follow this model could create the same employment specialist position, with the same matching federal funds. We hope to see more states take advantage of this great opportunity.
But we’re not stopping with the programs we already have on the books. We’re continuing to support and spur innovation amongst the governments and advocates that provide services and supports for people with disabilities.
For example, many in this room are already working with Henry Claypool and our Assistant Secretary for Health, Dr. Howard Koh, on a health disparities action plan for people with disabilities. This will not only identify the health challenges this population faces but also create concrete steps that stakeholders at every level can take to reduce them – a vital issue for people with disabilities searching for a job or maintaining one.
We are also working with the Department of Education and other agencies to organize a national conference to focus on the transitions of youth with disabilities from school into their communities, post-secondary education and employment, that is scheduled to take place next May.
And this year, our Administration on Developmental Disabilities awarded over $3 million in grants to help states collaborate across their agencies that serve people with disabilities to increase employment opportunities for youth and young adults with intellectual and developmental disabilities.
All of you are here today because you know how important employment is to the disability community. You’re the people on the frontlines who can make the biggest difference.
You’ve already accomplished a lot, but we all know there is a lot of work left to do. You have set an admirable goal, in seeking to double the employment rate for people with developmental disabilities. And I hope that we can use this summit as an opportunity to move closer to making that goal a reality.
By continuing to work together, we can ensure that all Americans with disabilities have the opportunity to find a real job for a real wage, and we can strengthen our nation and communities in the process.