A Comprehensive Strategy

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A Comprehensive Strategy ...






    A Report for:

the California Health Incentives Improvement Project

    Prepared by:

    Curtis Richards

    The Center for Disability Issues

    & the Health Professions,

    February 2006

This report was developed for the California Health Incentives Improvement Project through funding from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, grant number P-92399-9/02




     A. Expectations & Attitudes

     B. Disability Awareness & Sensitivity Training

     C. Education & Training

     D. Career Preparation & Development

     E. Connecting Activities

     F. Addressing Employer Needs

     G. Leave No Youth Behind

     H. Working With Veterans

     I. Injured Workers

     J. Aligning Systems


Appendix A: Stakeholder Input List

Appendix B: Summary of Stakeholder Input by Method & Strategy Framework

Comprehensive Strategy: 2

    Stakeholder Input Report


In early 2005, the Governor‟s Committee on the Employment of People with

    Disabilities issued the first draft of a Comprehensive Strategy, as called for under

    Assembly Bill 925. In conjunction with the California Health Incentives

    Improvement Project (CHIIP), the Governor‟s Committee launched an aggressive

    effort to solicit public input into the Comprehensive Strategy by advertising that it

    was posted to a public website and asking stakeholders to review it and offer

    comments. It also took testimony at its Spring and Summer public meetings.

Both organizations were committed to building a Comprehensive Strategy around

    evidence-based practices and extensive input from people with disabilities, their

    families, employers, service providers, and other stakeholders during the 2005

    calendar year. The comment solicitation recognized that the “complexity of

    coordinating programs administered at State and local levels by government,

    education, and community-based organizations requires a comprehensive

    strategy that is clearly and universally articulated. California must use a

    comprehensive strategy across multiple employment, healthcare and support

    services to impact employment outcomes for people with disabilities, especially

    as we acknowledge the continuum and diversity of disability in our society.

The input solicitation went on to declare that the Comprehensive Strategy will:

    ? Support the goals of equality of opportunity, full participation,

    independent living and economic self-sufficiency for people

    with disabilities that will bring adults with disabilities into

    gainful employment at a rate that is as close as possible to

    that of the general adult population;

    ? Ensure that State government is a model employer of

    persons with disabilities; and

    ? Support State coordination with, and participation in, benefits

    planning training and information dissemination projects

    supported by private and federal grants.

In March of 2005, the CHIIP leadership, in consultation with the Governor‟s

    Committee staff, decided to augment the public comment on the Comprehensive

    Strategy by launching three additional sets of stakeholder input collection

    activities. The CHIIP wanted to organize a series of informal, non-scientifically-

    based focus groups, host an online discussion group with people with disabilities,

    and conduct key informant interviews of human resource professionals

    knowledgeable in Return to Work strategies for injured workers. To assist in

    these additional stakeholder input sessions, CHIIP also engaged Western

    University‟s Center on Disability Issues and the Health Professions (CDIHP) to

    handle the logistics of the focus groups, conduct the key informant interviews,

    and complete this stakeholder input report.

Comprehensive Strategy: 3

    Stakeholder Input Report

This report does not reflect, or in any way include, any comments on the

    Comprehensive Strategy received directly by the Governor‟s Committee at public

    hearings or through its website. That data was not available, and would have

    been well beyond the scope of this project. Rather, this report addresses the

    three additional stakeholder input groupings supported directly by the CHIIP, at

    times in concert with the Governor‟s Committee.

It should be noted that the Comprehensive Strategy that was “on the street”

    during the bulk of this stakeholder input process was the initial Strategy released

    in April of 2005 and revised that November. By the time of the third, more

    substantive draft Strategy released in mid-December, all stakeholder input

    sessions had come to a close.

Initially, CDIHP developed an interview protocol that could be used for the key

    informant interviews, and was adapted for use in most of the informal focus

    groups. The Governor‟s Committee had a shorter set of questions that it began

    using in informal focus groups it began to host as well. Both sets of questions

    were geared toward soliciting opinions about barriers and successes around

    employment of people with disabilities. They were not geared directly to the draft

    Comprehensive Strategy.

Human Resource Key Contact Interviews: Beginning with a list from an

    experienced human resource disability management specialist, CDIHP attempted

    to contact employers, businesses and business consultants to be key contacts,

    representing the business/employer segment for input into the Comprehensive

    Strategy. These first contacts led to others and those led to more. Some of the

    original interviewees also recommended other individuals that were contacted,

    screened and a few interviewed. Gaps in representation were noted and other

    contacts from both past Governor‟s Committee members, local and state boards

    and contacts of contractor and/or CHIIP staff were contacted for interviews

    and/or recommendations.

Over 100 contacts were made or attempted to identify and screen for the final 10

    individuals to be interviewed. Brenda Premo, director of CDIHP and former

    director of the California Department of Rehabilitation, conducted all 10

    interviews, each of which was a 1.5 hour telephone phone interviews. Each

    interview was taped with permission; tapes were then transcribed and used for

    this report. Interviews were conducted with:

    ? a small business owner and CA Small Business Network


    ? a consultant and mediator with health care businesses and

    occupational health (WC) issues with other businesses;

    ? a consultant with large companies and medium size

    companies (e.g. HP, Levi etc)

    ? a consultant with insurance companies;

    ? a consultant with large companies; Comprehensive Strategy: 4

    Stakeholder Input Report

    ? a director of a small business resource center;

    ? a chief of occupational health at a major hospital;

    ? a chief financial officer at a large disability agency with prior

    experience with one of the big four accounting/consulting


    ? a senior counselor with the Department of Rehabilitation who

    has a high job placement record; and,

    ? an human resources director for large to medium software

    and hardware companies.

A complete list of interviewees and affiliations appears in Appendix A. All

    interviewees were promised confidentiality, so no names are used in this report.

Two Virtual Classroom Sessions The California Foundation for Independent

    Living Centers (CFILC) offered to host some stakeholder input sessions using its

    online “virtual classroom” as a means of efficiently collecting input directly from

    people with disabilities and CFILC members. This new technology provided for

    live interactive web based electronic classroom sessions for up to 17 sites per

    session, in addition to a line for the presenter and another one or two sites for

    accommodations like interpreters for the deaf or hard of hearing and/or

    descriptive listening narrative for blind or low vision participants. Each site was

    able to have between two and five participants viewing the computer screen and

    listening via phone conference lines to the presenters. Both on line chat

    functions and phone conversations via the conference line were available to each


The first virtual classroom session was held on Thursday, July 28, 2005 with 12

    sites connected and 24 participants registered. The second session was held on

    Wednesday, August 3, 2005 with 15 sites connected and 33 participants

    registered. Participants for sites were primarily advocacy and disability service

    agencies, including many independent living centers, the World Institute on

    Disability‟s California Work Incentives Work Group members, and the

    Department of Rehabilitation‟s Bridges Transition Project sites.

Informal Focus Groups: In addition to these two groupings of stakeholders,

    the CHIIP and Governor‟s Committee staff wanted to reach out to other targeted

    groups for input into the Comprehensive Strategy. In all, 12 informal focus

    groups were conducted, with participants either being selectively recruited to

    participate or being a captive audience of an existing program or site. Some of

    the targeted groups recruited into these informal focus groups included

    employers, labor union and apprenticeship programs, veterans and youth and

    family members. There were, however, two open-ended forums---one held at a