Provider strategies on ten elements of organizational transformation

3.1. Clear and consistent goals

Providers worked to make an explicit commitment to increasing integrated employment. All the four providers developed goals that were measurable, flexible to the needs of individuals, compelling and easy to grasp, and specific to an established time frame. One senior leader noted that during strategic planning, his organization “debated long and hard about what [their] core mission is,” noting that “everything has to be mission-centered.” Although it was not an easy debate, at the end, they decided that everything they did had “to support an employment opportunity for the individual.” Developing a clear and consistent vision creates a platform for an organization to debate and align its core mission and establish a future plan with measurable goals and time frames. Such plans enable organizations to take incremental steps while remaining focused on the longer-term goal of total workshop closure:

The process of developing strategic plans and goals took several forms. One provider hired a consultant to guide the strategic planning process. Such a consultant may work in collaboration with an internal cross-functional strategic planning team, but they also bring their own skills and perspective. Two providers formed cross-functional teams or task forces comprised of a range of internal stakeholders. Teams allowed for multiple points of view, while also creating a sense of cohesion and unification to achieve the goals collectively, and a shared responsibility for the plan’s implementation. They promoted intra-agency learning, reduced fragmentation, and a holistic approach.

3.2. An agency culture that supports inclusion

Providers indicated that transformation was evolutionary, requiring a shift in the agency culture into one that supports full inclusion so that daily practices and decisions are in line with the organization’s core beliefs. By creating a culture that values new ideas, nurtures staff, is adaptable, and continually evolves, interviewees noted that staff felt ownership over the transformation. Providers noted that, while having a mission statement about inclusion is important, if agency culture isn’t aligned with those values, the mission statement is meaningless. Providers needed to build the agency culture around a new vision, mission, policies, and practices.

As part of the shifting culture, some providers redesigned former workshops into office space “to express the values” of integrated employment. Over time, providers moved from a philosophy of providing care and safety, to supporting and promoting increasing independence, community contribution, and social inclusion:

Interviewees noted that agency cultures that are built on strong philosophical beliefs around inclusion are far more likely to make progress than those that are transforming because of mandates. Providers should set their vision and create their culture because they believe in it. This takes strong leadership who will ensure that policy and practice decisions match the organization’s core values, goals remain clear and consistent, and forward momentum continues despite occasional setbacks.

Effective agency leadership cultivates a mission-focused staff through stimulating trust, teamwork, and high expectations. Providers noted that everyone should feel that they have a role in evolving and improving the agency, and should share an investment in the new culture. As many staff have grown accustomed to the workshop model, they will need to be engaged in the new vision and subsequent cultural shift.

3.3. Active, person-centered job placement

Active, person-centered job placement prioritized the placement of individuals into integrated employment, one person at a time, and helped providers not to feel overwhelmed. All four providers reported using a deliberate placement plan that identified priority individuals from the workshop that would be influential to others and create a positive snowball effect. One provider started with the individuals who expressed the most interest or enthusiasm, while another prioritized individuals who are seen as leaders in the workshop and can encourage others who are cautious. Although persistence is required, momentum is created as individuals are placed, one job seeker at a time.

Person-centered discovery was essential to uncover each individual’s interests, skills, and passions. This process included family members, friends, neighbors, and anyone else requested by the job seeker. Providers also used exploration opportunities to help people develop employment-related interests and skills. This included workplace tours, where different job roles and responsibilities are identified, or volunteer positions that aligned with each person’s preferences. Such opportunities enabled providers and families to understand job accommodation and support needs. These exploration opportunities were also used to build human and social capital whereby individuals learned both job-search skills and soft skills that are critical for employment as well as expanding social connections. Providers applied best practices in job development, including networking, job creation and job carving, work trials, and post-hire follow-up, to increase the likelihood of effective matches and success after hire.

3.4. A strong internal and external communications plan

Providers agreed that organizations must communicate clear, authentic expectations to all stakeholders who will be impacted by the transformation to create investment. Internally, this included all levels of staff, individuals with IDD, and their families. One staff member noted that “transformation of our organization is almost always on that agenda” at staff meetings. Externally, organizations marketed their new service philosophy throughout the community.

Providers emphasized the importance of communicating about the intended transformation as early as possible, even if the leadership does not have all the answers. One provider pointed out that staff need to understand changes in their roles and responsibilities, noting that direct support staff in particular have a lot of insight to add to the planning and implementation process. This transparency and honesty was critical because while providers agreed that having confidence in the organization’s vision is important, leadership should not hesitate to admit what they don’t know. Providers held regular meetings to keep stakeholders updated, answering questions honestly.

Another communication strategy was the identification of a champion, or someone influential who could assist in getting their peers on board. Champions “became kind of like our cheerleaders” and helped to “make sure that the buy-in starts from the bottom up,” explained an agency leader. For some providers, champions emerged naturally as participants shared successes. Others were intentionally identified.

Various communication modes were described for facilitating the transformation process. Providers used written communication that clearly explained their agency’s philosophical shift. The message was woven into all of agencies’ procedures, including staff orientation, staff training, newsletters, email and regular mail correspondence, board reports, and social media. Many interviewees suggested creating a campaign of thoughtfully constructed marketing materials including emails, a revised brochure, and refreshed website text. One provider’s new vision was “Experience, Educate and Explore,” which they “put on posters with our own people on the pictures,” positively framing their campaign and creating a unifying effort through a common language.

3.5. Reallocated and restructured resources

Providers agreed that financial preparation and creativity in reallocating and restructuring resources were essential in creating alignment with the organization’s new mission. Many noted that successful transformation calls for making changes to how the organization funds services, and how it directs its staff to budget their time and energy. This requires an ongoing investment in realigning all fiscal, material, and staff resources.

Almost all providers agreed that fully committing to organizational transformation involved embracing some risk. They recommended undertaking active budget analysis throughout the process so that the risk is calculated, and financial expectations are set. Most providers had to critically examine costs per hour, costs per staff, revenue needed to break even, and any hidden costs. Providers underscored the importance of mitigating risk and preparing for some level of anticipated financial loss. This required a robust budgeting and planning process:

Providers examined their budgets to identify how and where funding was not aligned with the mission. As one respondent noted, “if there’s no mission, there’s no margin.” For example, a provider found they had financial capital tied up in buildings and in money-losing workshops. They “reduced square footage by 60%  …   by going from a very large center in [a city] to a much smaller one.” They used the freed-up resources to create job developer positions and invest in staff training. Interviewees explained that they needed to diversify their funding sources to supplement transitional costs. All of the providers explored fundraising initiatives, including grants and private foundations, as well as state and local revenue sources, such as community development funds. One provider obtained $100,000 through their city, which they used to hire employment consultants at the beginning of the transformation.

3.6. Ongoing professional development

Providers agreed that an engaged and educated workforce is key to providing sustained, high-quality job development and coaching supports. Frequent training, continuing education, conference participation, and mentoring are critical to maintain core competencies and implement best practices. Organizations supported employees at all levels to meaningfully contribute their ideas and energy to the mission. Professional development encouraged this to happen, as staff increased their skills and investment.

Although there is an associated cost, one agency leader said that he looked “at training more as an investment than as an expense, and it is part of our culture.” He further noted that “investment in direct support professionals is the key ingredient to this field’s future. And until that’s done, every provider is going to continue to spin their wheels with people in, people out.” Those interviewed recommended that providers should invest in professional development before moving individuals out of the workshop as “a huge part of helping make the shift is the trainings  …   is making sure staff really have those tools.” Providers acknowledged that investing in professional development increased staff confidence with their new responsibilities and changing roles.

Those interviewed identified gaps in capacity among all levels of staff prior to the transformation using training needs assessments, and tailored professional development accordingly. They used a combination of training methods including online, classroom, and informal trainings. Some providers brought trainers and consultants into the organization, while others sent staff to conferences or did a combination of both. Organizations experimented to see what was most effective and inspiring for their staff. Combining formal training opportunities with mentoring and small-group options helped build a professional development infrastructure and allowed staff to practice competencies on the job. Reputable accredited programs for professional credentialing, such as the Association of Community Rehabilitation Educators (ACRE), were also accessed to ensure that staff had the set of skills and tools they needed.

3.7. Customer focus and engagement

Making strong, vital connections with job seekers with disabilities and their families was essential for transformation. One provider engaged with individuals and families one-on-one or in small groups as this changed the dynamic. Rather than confronting a large group of people who were mostly uncomfortable with the transformation, they started with the most receptive families. Similarly, providers combined both formal and informal strategies to keep individuals and families involved and inspired. Formal strategies included print or online newsletters, social media, and email. Informal strategies included gatherings, such as barbeques, picnics, and regular “office hours” at a local coffee shop. Providers observed that a key advantage of the informal efforts was building family-to-family connections and trust. Such forums provided opportunities for providers to address family concerns and fears, and allowed providers to set up plans to reassure them, keep them informed, and ensure transparency.

In addition to engaging individuals and families, providers engaged employers in their transformation. One provider hosted an annual employer breakfast to celebrate employers that had hired individuals with IDD. They also used the breakfast to engage new employers, legislators, and community leaders. They found it was more effective for employers to be their “salespeople” in sharing with other employers about successful experiences integrating people with disabilities into their workforce:

Providers also built relationships with the business community through staff and board participation in local/county business associations, acting as powerful connectors. Providers engaged with employers about the positive effects of hiring people with IDD on their bottom line. They researched how to improve an employer’s efficiency and profitability, underscoring the value a job seeker would add, and selling employee skill sets that met a business need.

3.8. Performance measurement, quality assurance, and program oversight

Those interviewed underscored the importance of establishing a clear framework for implementing and measuring administrative, management, and program strategies over defined periods of time. Providers noted that this helped them determine the impact of their work and progress towards their goals. While all the providers interviewed participated in data collection, approaches differed in terms of uses of data, types of data collected, and data input structures. Many of the providers used data for decision making, to demonstrate success, to create buy-in, to track performance, and to create benchmarks to remain accountable to their goals.

Types of data collected included both process and outcome measures that ranged from simple measures (number of people employed) to more complex ones (amount of time each individual spent doing various activities in the community). Providers recommended starting the data collection process at the onset to allow the organization to make the best strategic decisions. How data was collected varied, but overall, providers agreed that each organization should determine their data needs and identify tools to track what is important to their mission. All the providers emphasized the importance of sharing data with all of their stakeholders to promote engagement and buy-in:

3.9. A holistic approach

Providers considered the whole person with wrap-around life supports and used a career planning process that involved parents, friends, and staff. At the individual level, a holistic approach enhanced the career planning process with a broader set of resources and perspectives, as well as a deeper, more well-rounded understanding of the job seeker, thus enabling a seamless blending of employment and the rest of one’s community life from the beginning. As such, employment plans should relate to the other community engagement activities, including opportunities to socialize and build relationships. Therefore, it is fundamental to engage everyone the individual knows, while making sure he or she remains at the center of the process.

Another way that providers ensured a holistic approach in promoting integrated employment was the use of non-work day supports for skills building and job finding. Providers used the supports provided in their day program to more intentionally build skills, explore interests, and develop a clear plan for integrated employment. This involved making concerted efforts to create opportunities for individuals to volunteer and build both hard and soft skills.

Providers acknowledged that using a holistic approach also had implications at the organizational level. It required creating a more integrated model of service delivery that made the goal of integrated employment every staff person’s business. For example, one provider got residential staff involved in the discovery and exploration process and trained them to provide job-coaching supports. Breaking down silos fostered efficiency and a shared sense of responsibility and created opportunities for cross-departmental quality improvement and greater understanding of staff people’s roles. Broader collaboration helped staff make the most of everyone’s resources. One administrator discussed his effort to build a culture where all staff are informal job developers:

3.10. Multiple and diverse community partnerships

Interviewees spoke of the importance of developing community partnerships to leverage resources. Providers developed partnerships with school districts, state agencies, colleges and universities, local business councils, employers, social service agencies, other providers, and disability-specific employment systems such as vocational rehabilitation. These partnerships provided a range of resources including new funding opportunities, new jobs, expanded opportunities for exploration and discovery, volunteering and internships, and community membership. One provider said these partnerships provided their job seekers a “safe place to fail” as they developed skills. Partnerships facilitated the sharing of ideas, and created a larger, invested coalition.

Providers developed partnerships based on existing relationships of their staff, including senior and middle managers, direct care staff, and the board, and leveraged these relationships to further the employment agenda. Some of the providers also used their own families to expand their connections, noting that, the more diverse the professional contacts, the better. One provider in a populated city established a new position solely responsible for creating partnerships. Providers noted that describing their transformation effort to pre-existing partners engaged them in the idea of integrated employment, and sometimes re-defined their relationship.

4.1. Offering clear and consistent messaging to all stakeholders

Each of the four providers a made an unwavering commitment to increasing integrated employment. They committed to a culture with a shared belief that integrated employment should be the preferred outcome, and that opportunities for employment should be available to everyone interested in working (Boeltzig-Brown, 2017; Institute for Community Inclusion, 2016). They set incremental and measurable goals that were reflective of their core mission, each with established time frames. Their efforts were consistent with others who have successfully transformed away from sheltered settings: establishing multi-level commitment, developing and implementing a comprehensive strategic plan, and engaging all stakeholders (Lulinski, Timmons, & LeBlois, 2017).

These providers used their message to guide their daily practices and create a paradigm shift in their agency culture. Using their new vision as the core of their messaging, these providers recognized the importance of transparency and the reality that they needed to reassure stakeholders who were resistant. Through consistent and clear explanation of their new organizational goals, they could engage a broad range of stakeholders both internally (individuals, families, front-line staff) and externally (employers, community collaborators) in a way that created momentum and built a coalition of invested partners. These providers not only focused on making strong connections with individuals and their families, but also with employers. While families may resist engagement out of fear for the safety of their family member, they are often against sheltering their family member once having experienced the change to community employment (Dague, 2012). Engaging the individual and the family builds trust and their investment in the job development process, while building relationships with employers creates career opportunities.

4.2. Leveraging day supports

Another theme across the findings is the use of day supports to meet the transformation goals around employment (Sulewski et al., 2017). All of the providers leveraged their day supports for skill building, career exploration, and discovery while simultaneously helping each individual search for integrated employment. In many cases, the providers used their “multiple and diverse” community partnerships to ensure that the broadest and most enriching resources were made available to individuals. They adopted a holistic perspective, rather than seeing employment and day supports as separate services. This included consideration of day supports as leading to or complementing employment (Timmons & Sulewski, 2016) and focusing their organizational change processes holistically across both employment and day supports. New research is working to define and measure high-quality day supports and characteristics of services that support individuals to be full participants in their community. These efforts seek to understand how supports for community life engagement can, in turn, support employment outcomes (Sulewski, et al., 2017).

4.3. Delivering best practices in job development

The providers in this research study committed to delivering the highest quality job development supports as they moved individuals out of sheltered employment. This is especially promising as research suggests that employment specialists inconsistently use established promising practices, including spending time with individuals in community settings, working with families, and negotiating jobs with employers (Migliore, Butterworth, Nord, Cox & Gelb, 2012; Migliore, Hall, Butterworth & Winsor, 2010).

Providers maintained a robust commitment to a combination of staff training options, and followed up such training with mentoring and supervision. This is beneficial because staff also experience confusion about job development responsibilities, do not feel prepared to engage the mainstream business community, and have little training in providing appropriate supports to individuals with IDD in community settings (Migliore et al., 2012; Rosenthal et al., 2012; West & Patton, 2010). An investment in staff training with an emphasis on job development and other effective practices including customized employment can prove fruitful as individuals move out of sheltered workshops (Harvey, Henderson, & Wilson, 2016; Migliore et al., 2011). Training was also seen as an investment, resulting in increased staff engagement and buy-in to the transformation.

Providers emphasized the importance of finding jobs for one person at a time, using a placement plan for each job seeker, and offering individualized, comprehensive discovery activities that lead to job offers. Because employment consultants do not always implement best practices and have limited opportunity for training, researchers have begun to articulate and translate the latest practices into clearer, more easily communicated elements. These practices include building trust, getting to know the job seeker, addressing supports planning, finding tasks or jobs, and providing supports after hire, all in the context of identifying the best job match (Butterworth, Migliore, Bose, Lyons, & Nye-Lengerman, 2017). Maintaining an emphasis on best practices, while strategically identifying individuals in the workshop who created momentum for the change process, facilitated a successful transformation.