B.J. LeJeune: Greetings. We are meeting today with a panel of rehabilitation counselors and rehabilitation supervisors from around the country to discuss some of the policy and practice implications of the research that was done on the predictors of outcomes for SSDI beneficiaries.This is the follow up to some research that was done by Dr.Marty Giesenhere at the National Research and Training Center on Blindness and Low Vision. I’d like to go around and ask each of our panel members to introduce themselves and I would like to start with Felecia Williams.Could you introduce yourself Felecia?
Felecia:Good afternoon.My name is Felecia Williams. I am vocational rehabilitation counselorin Richmond, Virginia with the Department for the Blind and the Vision Impaired.
B.J. LeJeune:Great, and then moving on further north: Diane would you like to introduce yourself?
Diane:Sure.Good afternoon, my name is Diane Frigon and I work with the regional director for Department for the Blind and Vision Impaired in the Augusta and Rockland offices.
B.J. LeJeune:Great, and Joanne?
Joanne:Hello, my name is Joanne Lannan and I serve as a counselor for the blind in Atlanta, Georgia.
B.J. LeJeune:And then our last person, panelist Zenaida?
Zenaida:Good Afternoon my name is ZenaidaOlivas and I am a VR coordinator with the division for blind services in El Paso, TX.
B.J. LeJeune:Great.Now, I have some questions here based on the research and each of our panel members has been able to look through the research and listen to the lecture by Dr. Giesen and my first question I have is: What challenges have you experienced in moving people who are SSI recipients in competitive employment?We will just kind of go around as we did the introductions and Felecia, if you don’t mind, we will start with you?
Felecia:Some of the individuals that I have worked with they do want to go back to work but they fear when they start their job or when they get back into the working environment that if they don’t do well and they lose their benefits then it will take a long time for them to get that back. So that’s one of the things that we face with some of the fear associated with going back and losing their benefits.
B.J. LeJeune:Okay, and Diane do you have something to add to that?
Diane:Yes, I got to speak with one of my counselors here in Maine and what we are finding is that individuals do have some concern about losing their benefits and what we try to do is talk to them about some of the specific concerns, whether losing their insurance or not making enough income to pay their bills in full if their PI benefit is higher than they expect to make on a part time basis for example.They have some fears around that, so some of the things that we try to do is to find out what their concerns are and then we do the guidance and counseling then we put them up with benefits specialist that we have through the main medical center here in Maine and we just have them hopefully lessen their concerns and their fears of losing the benefits, but it is a challenge.
B.J. LeJeune:Sure. Joanne do you have anything to add to what you might have seen as some of the challenges in getting people with SSDI to return to work?
Joanne:Of course losing medical benefits, as well as the risk of the time going by to reinstate benefits after they have been lost because of employment,are concerns.In addition, I have come into contact with clients whose family members encourage them to keep their disability rather than participate in work incentive programs through SSA with or without VR services and sometimes that’s because individual and the individual’s family or whoever the caretaker is at that time, they can’t see beyond a seemingly decrease in earning potential because of the disability especially with newly acquired blindness or low vision. In addition, I guess the available work that is out there, depending on the labor market, whether it’s rural or metro, situation if not adding up to the amount that is to receive those benefits I guess in total.So, I think there needs to be time given upfront making sure that the client understands that transferable sales can be addressed and pulled from in order to look at different employment not just thinking in terms of what they have done in the past, getting them out of that mindset, because sometimes these people are in their 30’s or 40’s and 50’s and they have worked for a long time and can’t be learning a new skill so trying to get them to see beyond what they have done in the past and learning something new in order to come up with benefits and be at the same earning potential or beyond that, it can take time.
B.J. LeJeune:It does.So Zenaida anything to add to some of the challenges maybe that you have seen in trying to get people who are in SSDI to move into competitive employment?
Zenaida:It is definitely a challenge. I find, though, that people are willing to go to work.The problem is when they start working and they get a promotion and keeping them. I have an example of a gentleman that I closed last week and he was earning 11.50 per hour and when he started at that job it was 9.50 per hour and he was working I think 30 hours a week and they hired him permanently and so you know after they hired him permanently it was 11.50 per hour at 40hours per week and you would think that anyone would be excited about that but for him it was like he was at a point where he was ready to go talk to the supervisor so that his hours could be reduced and I think maybe we definitely need to get the social security benefits planners involved from the very beginning I almost think that anybody who is on SSDI should have a meeting with the planner so that they can be aware of just how much they can earn and how earnings can affect their benefits and in addition to what I did was I spoke to this gentleman and I said is there any way that before you make that decision can you look into the Affordable Care Act because his fear of course was the Medicare because he has an eye condition where he is going to need ongoing care and I don’t blame him but I told him before you make that decision can you look into the Affordable Care Act and see if there is anything that might be reasonable before you make this decision to go part time but it is a big fear.Like I said, if I were in their shoes it would be difficult but in this instance we are not even talking about a minimum wage job we are talking about 11.50 per hour with the potential for him to move up the career ladder there and still he has that fear.
B.J. LeJeune:Well, and I think I have heard that quite a bit, this is B.J. again, that maybe the salary is one thing but loosing that healthcare is a big thing and especially if you have any chronic health concerns or if you are older too you may acquire a health issue that you may not have had in the past and I wondered if any of you have seen any impact to this point of the Affordable Care Act has that made a difference in terms of how people have talked to you or the counselors you have worked with about returning to work.
Zenaida:This is Zenaida. I really haven’t but we are encouraging people to look into it for sure, especially if it’s something like I said where they are going to be requiring ongoing medical services we also get of course a lot of people who don’t have any insurance period and we encourage them to use that to try to get linked with some type of an insurance benefit but I up to this point not seen anything but I think too part of that is that I’ll be honest I am not very well informed about the Affordable Care Act and just how it can impact them so maybe that’s something that would be good for us to receive as training on what exactly can we tell our consumers to expect and if it is something that is even beneficial to them versus staying on Medicare.
Joanne:This is Joanne. I had a client who he had just gotten his SSDI benefits and so he was waiting on Medicare and whatever reason I don’t know what it was that he wasn’t eligible for Medicaid in the meantime during those two years he went and applied for benefits and it was still going to be way out of his budget to be able to afford what was offered to him and his family so I don’t know that it was accessible to him.
B.J. LeJeune:That was through the Affordable Care Act that you could not afford that insurance is that what you are saying?
Joanne:Correct.Went to the healthcare.gov I believe to apply, and it was just out of this world he said it was going to be about $500.00 a month.
Zenaida:This is Zenaida and I think they do have other plans that are a little bit lower but like I said I still think we all need more training in that area to be able to say maybe work with the local agency that is helping people to get involved in this type of programs but I think we definitely do need to be more informed because I have heard all sort of different stories I have heard that yes they are as high as $500.00 but I have also heard that there is some plans that are as low as $300.00.
Joanne:This is Joanne. I agree I think training would be helpful but also a contact maybe who can be an expert so that they always have the most recent information that we can refer our clients to. Again, I couldn’t sit there and go through the process with him while he was applying so I don’t know if he was missing out on opportunities where he could claim additional subsidies.
B.J. LeJeune:Well, I have heard that there is concern that some of it is more expensive than what was originally anticipated it would be.So, in terms of the challenges loosing benefits is the big one that you have mentioned and then concerns about getting reinstated in particular I think getting reinstated with health insurance because that can take up to two years to get back on Medicare if you were to have to return unless you manage to hit 62 before then.So let’s move on to our next question. One of the surprising outcomes of the study was that there was basically no impact of the racial ethnic factor in the outcome of competitive employment.In the past, I think we have often thought that people who are members of the minority groups it might have been that they were not as likely to return to employment as maybe somebody who is Caucasian and in fact there is some research that would back that up.But one of the changes here in the research that Dr.Giesen had done is that he felt that there was an impact of work history that was common among people that had SSDI, that they were more likely to be able to return to work because they had that strong work history, what strategies do you find effective to capitalize on previous work history when you are working with somebody that is an SSDI recipient? Maybe we can start with Felecia again?
Felecia:One of the things that seems to be working a little bit better for me is trying to get people that don’t have a long work history, or been for a while they worked, and try to get them some type of internship or volunteer experience. I have also gotten permission from other people that may be working in the field that they want to work in to be a mentor to them and especially if they also have a vision impairment because it helps them to connect with what going on in that environment and they seem to be comfortable asking questions about how they are doing their job and that seems to be working for me.
B.J. LeJeune:Okay that’s a good strategy, Diane any thoughts?
Diane:Here in Maine, what we do is we have a variety of different strategies and I’ll just list a few of them. First of all, we do use O*Net to identify and clarify work options requirements.Other strategies that are being used is the transferable skills approach with formal assessment as well as work history discussions and typically what our counselors are doing and I would do as part of the team is we’ll have our vision rehab therapist, our orientation and mobility specialist, and our assistive technology specialist, if they are involved, identify strategy before they are needed for new work experiences based on the previous work skills and building from there.As you know, being in the profession sometimes we need to be modified, adapted, and if there is a significant loss of vision then we need to develop a new strategy because invariably we have people who have a tremendous amount of existing skills so using that approach and just the counseling and guidance that is so critical to identify with the individual client, you know what the job market looks like, and that back up their sufficient skills and values are and clarifications of these things so that we can move forward in helping somebody to be employed in the new job.
B.J. LeJeune:Diane, since you are a separate supervisor do you feel like your counselors are well equipped to have those discussions?
Diane:Yes, I do believe that our counselors are. They have a good solid base, I think, to work from and the newer counselors that we have come from a background, a couple I am thinking about particularly in my region,are licensed social workers and so they work with different types of assessments, but I believe that right now, across the state, we have people that are very comfortable with using different approaches and strategies.
B.J. LeJeune:Joanne do you have something you might want to add here?
Joanne:Well, I was going to say definitely any kind of early intervention sometimes some people are earning those benefits I think they might take the time off with the income coming in to do their adjustments rather than doing their adjustments through the agency and I do think that the person who does the counseling for blindness the person that we have here in Georgia is great specific counseling that speaks to an individual’s specific concerns that they have at work.For instance,a client who was formally a truck driver loved driving a truck, helping them wrap their mind about not being able to do that anymore but you know it’s that approach early on before someone’s is being sitting too long becoming depressed, feeling worthless. I love Felecia’s mentoring idea all the same lines the same as job shadowing early on.If there are going to be new skills presented for new jobs something much different than they have done in the past, college and technical schools training opportunities,in addition to all the job readiness and the resume development, to make sure that we stay employment focused rather than solely independence focused early on in the process, especially for our folks who are blind or low vision who do have so much independence skills training that is needed upfront in their training programs.I believe Diane touched on the vocational evaluations including the transferable skills analysis to rally pull out what they already know and what’s the valuable experience and knowledge they have to give to the workforce and making sure that we highlight that and we don’t brush over that and think small in terms of jobs which is a big border line but truly looking at opening up the workforce and the competitive labor marketto the jobs that can be accommodated for people who are blind.
B.J. LeJeune:You have all made great points.Helping people to identify what their skills are, because a lot of times people don’t realize what their skills are they may you know be able to name some computer programs they can use but the more soft skills sometimes allude them a little bit they are not as good at articulating what their skills might be.
Joanne:The other note that I put down was returning to that previous employer to talk about the ‘same employer different job’ return to work strategy so customizing a job for that individual so that he can return to an environment that will be supportive, someone that knows his knowledge, knows what he or she has to contribute to the company already. I don’t think that is utilized enough but certainly has been helpful for some of our placement specialists andbusiness relations specialists to talk to the previous employer, that they are going to get a great character, as well as some ideas to bolster their resume, including opportunities to return to that employer.
B.J. LeJeune:You know we think of the perfect placement is being ‘same job same employer’ but the next step is ‘different job same employer,’ especially where you have an employer that feels really good about that person. Some of that may have to do with disclosure to, we see that some people start having difficulties seeing and they don’t disclose that and people think that they are just becoming inefficient because they haven’t learned the techniques to use in order to be more efficient.So, when they are let go or they leave they may not leave with the best of relationship with that company, whereas if they can identify and start learning on those skills early on as they begin to lose their vision, or in the process, that might prepare them better in the future but getting the employees that are out there and the employers to know those resources early on is sometimes a little challenging.Zenaida, do you have any comments on the strategies to capitalize on previous work experience?