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NCD Letter to Senate Finance Committee in Support of Amendment Language Regarding Supported Employment

Wednesday, December 11, 2013

December 11, 2013

The Honorable Max Baucus
Committee on Finance
United States Senate
Washington, DC 20510

The Honorable Orrin Hatch
Ranking Member
Committee on Finance
United States Senate
Washington, DC 20510

Cc:// Members of the Senate Committee on Finance

Dear Chairman Baucus and Ranking Member Hatch:

On behalf of the National Council on Disability (NCD), an independent federal agency charged with providing advice to Congress and the President on disability policy, I write to offer NCD’s strong support of the proposed Wyden-Grassley Amendment #1, as written, of the Pathway for SGR Reform Act of 2013. The Wyden-Grassley Amendment #1 would authorize the Secretary of the U.S. Department of Health and Human Services (HHS) to create a Medicaid demonstration program to create a bonus pool to incentivize states to engage in certain activities to increase the opportunities for youth with disabilities have to transition to independent living and work in the community.

NCD has reviewed the proposed amendment and finds it compatible with our research and recommendations to Congress to date on the subjects of youth transitions from school to employment as well as our recommendations regarding supported employment and the phase-out of subminimum wages.

Incentivizing states to increase its numbers of people with disabilities in integrated, individualized supported employment and reduce its numbers of people with disabilities in segregated sheltered workshops and facility-based day habilitation is entirely consistent with the long-established, bipartisan policy goals of the Individuals with Disabilities Education Act and the Americans with Disabilities Act – the promotion of equality of opportunity, full participation, independent living, and economic self-sufficiency—as well as the Supreme Court Olmstead v. L.C. decision’s integration mandate.

NCD applauds Amendment #1’s emphasis and priority on competitive, integrated employment of youth with disabilities, and its accordant de-emphasis and purposed reduction of segregated, sheltered workshop environments, which NCD believes represents a policy relic of the 1930s, when discrimination was inevitable because service systems were based on a charity model, and when societal low expectations for people with disabilities colored policymaking.

Although sheltered workshops are at times marketed to policymakers as transitional environments from which people with disabilities can move to community-based jobs, GAO research indicates that only 5% of sheltered workshop “employees” transition into community-based jobs,[[1]]( despite the intention[[2]]( that Medicaid-funded pre-vocational services to sheltered workshops be a time-limited service to help individuals obtain competitive employment.

In August 2012, NCD issued a report on subminimum wage and supported employment. In the process of conducting the work and exploration that culminated in our report, we engaged in a series of site visits around the country to learn from people with disabilities and their families and support networks just how this and related policies are actually working in their lives.

Some of the key findings of our research included:

  • Sheltered workshops are ineffective at transitioning individuals with disabilities to integrated employment;
  • Only 5% of sheltered workshop “employees” transition into community-based jobs;[[3]](
  • Research indicates that employees receiving supported employment services generate lower cumulative cost than employees receiving sheltered workshop services and that whereas the cost-trend of supported employees shifts downward over time, the opposite is the case for individuals receiving sheltered workshop services.[[4]](
  • Individuals in supported employment who had previously been served in sheltered workshop settings do not show a higher rate of employment as compared to those who had gone straight to supported employment without ever being in a sheltered workshop. However, research indicates that those who had previously been in sheltered workshops had higher support costs and lower wages than comparable individuals who had never been in sheltered workshop settings;[[5]]( and

On the basis of our major findings, the central theme of our report’s recommendations is for a systems change approach that enhances existing resources and creates new mechanisms for supporting individuals in obtaining integrated employment and other non-work services. The comprehensive system of supports we propose is designed to improve opportunities for persons with disabilities.

NCD views the language of Wyden-Grassley Amendment #1 as consistent with our policy recommendations on these topics and as important steps to closing the workforce participation gap for youth with disabilities with competitive, integrated employment options.

We stand ready to offer our support and research to the Committee in pursuing this policy path, in line with promotion of the bipartisan goals of the ADA and maintaining high expectations for all people with disabilities. Please do not hesitate to contact Anne Sommers, NCD’s Director of Legislative Affairs & Outreach, at 202-272-0106 or if we can be of further assistance.


Jeff Rosen


[1] General Accounting Office (GAO), September 2001, Special Minimum Wage Program, Centers Offer Employment and Support Services to Workers with Disabilities, But Labor Should Improve Oversight GAO-01-886, Page 4.

[2] Centers for Medicare & Medicaid Services, Center for Medicaid, CHIP and Survey & Certification (CMCS Informational Bulletin), Updates to the Section 1915(c) Waiver Instructions and Technical Guide regarding Employment and Employment-Related Services, September 16, 2011, Page 2.

[3] General Accounting Office (GAO), September 2001, Special Minimum Wage Program, Centers Offer Employment and Support Services to Workers with Disabilities, But Labor Should Improve Oversight GAO-01-886, Page 4.


[4] Robert Evert Cimera Ph.D., Does Being in Sheltered Workshops Improve the Employment Outcomes of Supported Employees with Intellectual Disabilities? Journal of Vocational Rehabilitation, Kent State University, (March, 2011), Pages 8, 9.

[5] Robert Evert Cimera, The cost-trends of supported employment versus sheltered employment, Journal of Vocational Rehabilitation, Kent State University (2008), 15-20, Pages 18, 19.

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