Impact of COVID-19 on Disability Employment Services and Outcomes: Preliminary Results from a National Provider Survey
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July 7, 2020
The COVID-19 pandemic has challenged every aspect of our society and economy, including employment of people with disabilities. Both the wide shut down of businesses and the mass shift to “work from home” directives have directly and negatively impacted employees and job seekers with disabilities and the delivery system for disability employment services.
Of utmost concern has been maintaining continuity of critical supports to employees with disabilities who have remained on the job as “essential workers” throughout the healthcare crisis. Indeed, many people with disabilities work in the types of businesses identified as essential during the pandemic, such as grocery stores, retail distribution centers and medical/healthcare facilities. Many of these essential workers regularly rely on supports from job coaches and employment specialists to navigate changes in business practices and job responsibilities. These direct support professionals are crucial in ensuring the safety and health of people with disabilities. Supported workers need assistance to understand universal precautions fully, to adjust to work responsibilities that are changing in real-time, and to ensure communications are understood. Additionally, there is often a need to assist in mitigating anxiety and other emotional responses as best as possible.
Vocational rehabilitation (VR) or Medicaid typically fund employment services via payments to community-based service providers. However, when the economy quickly shut down, the regular flow of VR and Medicaid dollars at the local level was hampered by complicated state and federal regulations that define how services are delivered. In the early weeks of the crisis, community-based service providers needed to quickly pivot to provide supports remotely, utilizing various forms of readily available technology, often without complete assurance that remote service delivery would be reimbursed. Despite a relatively quick response from state and Federal VR and Medicaid authorities to enhance flexibility and adjust funding requirements, these efforts were not fast enough to avoid the fact that many community-based services providers had to shut down programs and furlough staff.
Since the start of the pandemic, the Association of People Supporting Employment First (APSE) has collaborated with the broader disability advocacy community to ensure that emergency response efforts to COVID-19 included an intentional focus on addressing the needs of people with disabilities. Of vital concern has been maintaining supported employment and other employment services in local communities so that people with disabilities who can work have the supports they need to remain successful and safe on their jobs.
To understand the direct impact of COVID-19 on disability employment and to identify immediate needs, APSE conducted a national survey of community-based service providers who offer employment services and supports. This effort aimed to understand the impact of COVID-19 on employment service provision, the direct support workforce, supported workers and job seekers with disabilities.
Summary of Preliminary Findings
The findings in this summary reflect responses from more than 600 surveys collected between June 15 – June 18, 2020. At least one survey was received from 47 states. Data collection is ongoing, due to a resurgence of COVID-19 cases being reported across the country as of early July 2020. A full analysis of findings will be available in August 2020.
- Only 23% of disability employment services provider agencies received a Paycheck Protection Program (PPP) loan. Agencies with less than 50 employees were less likely to apply for and receive a PPP loan.
“We were in a precarious position when entering this pandemic, we may not be able to withstand the coming cuts to an already underfunded system. Providers need the flexibility to use all tools in their arsenal to provide people with services they need in a way that works for the person, and to be reimbursed at a level that covers the basic cost of providing the service.” (New York Provider)
- 43% of provider agencies have laid off or furloughed staff. Currently, only 51% of these direct support professionals are likely to be rehired based on current fiscal projections. This equates to a 22% overall loss of direct support professional jobs.
“As an agency that heavily relies on fee-for-service programs through VR, we need to assess if our funding will be able to pick back up or if our reduction in referrals and invoicing will continue.” (Kentucky provider)
- 40% of provider agencies (n=244) reported having to close services as a result of the pandemic. This includes 48% of facility-based day habilitation programs, and 30% of facility-based pre-vocational programs (often referred to as work centers or workshops) that have closed. This closure of services has resulted in a large number of individuals with disabilities to require individualized services in their communities, which are typically funded via Medicaid Home and Community-Based Services (HCBS). Additionally, HCBS services that were operating prior to the pandemic were also impacted, with 32% of day habilitation programs and 23% of pre-vocational programs closed due to challenges with funding and maintaining the direct support workforce.
“We can only operate at a 50% capacity. The next few months will determine if working at that capacity, and still adhering to state and federal regulations regarding the individuals we work with and number of staff/resources required, we can continue to provide our services.” (Pennsylvania Provider)
- Provider agencies (76%) witnessed substantial job losses for people with disabilities as a result of the COVID-19 pandemic (n=423). However, 57% of provider agencies were successful in supporting job seekers with disabilities to fill essential jobs during the pandemic (n=400). Job gains were primarily in the retail and general services sectors.
In the next 4-6 months, provider agencies need “funding and support to implement changes and safety measures for the adults in our program and our staff, and support for our re-entry plans for getting adults safely back into the community.” (California Provider)
Recommendations for Moving from Crisis to Recovery
A healthy and robust workforce is critical to the recovery of our economy. For people with disabilities to continue to participate in and contribute to the labor market, we must ensure the sustainability of the disability employment services sector. To accomplish this, the following provisions must be included in future COVID-19 response packages:
- Increased funding for states for home and community-based services (HCBS)
- HCBS funding makes it possible for direct support staff, including job coaches, to provide supports so that individuals with disabilities who are working at this time can do so safely and effectively.
- Funding for HCBS will ensure that people with disabilities who can work are able to enter or return to the workforce quickly as part of our country’s overall recovery efforts. HCBS funding can also be used for assistive technologies to facilitate virtual work as needed.
- Vocational rehabilitation (VR) service supports for states
- We ask that the federal match for VR be waived for two years to ensure that states can pull down their full allocation of VR dollars so that individuals with disabilities, including those who have become suddenly disabled because of COVID-19, will be able to access VR services.
- VR funding supports employment specialists who guide individuals with disabilities to access training to meet business needs, help them apply for meaningful employment, and assist them in being successful on the job.
- Funding for businesses and nonprofits through the Paycheck Protection Program (PPP)
- Programs like PPP have allowed businesses who employ individuals with disabilities to keep them on their payroll during this crisis and have allowed nonprofits that support individuals with disabilities during this time to continue to do so.
- A national survey of disability employment services providers indicates that only 25% of organizations successfully applied for a PPP Loan (APSE, 2020).
- Expanding the eligibility and timeframe required to spend the PPP funding will help businesses and nonprofits that support individuals with disabilities to be able to continue doing so.