Integrated employment for people with disabilities: An evaluation of training for care managers within Wisconsin's Family Care program

Employment meets a myriad of social and financial needs and many people with even severe physical and developmental disabilities aspire to work. During the last 40 years, community integration in work, school, and home life have been identified by advocates as central to helping people with disabilites lead meaningful lives. Despite local and national efforts, the integrated employment rate of people with developmental and physical disabilities has remained far below that of people without disabilities. Using an experimental design, the aim of this dissertation was to test the relative impact of a specialized training for care managers working with adults with developmental and physical disabilities (within a managed long-term care program) on the development of care plan goals focused on employment as well as on actual employment obtained by program members. Care managers working with people with developmental or physical disabilities in a public Milwaukee managed care program were randomly assigned to one or two days of employment training or to a control group. Six months later, member care plans were examined for indications of either member goals related to integrated employment or actual achievement of integrated employment. Results show that one or two days of employment training for care managers led to modest improvements in goal planning for integrated employment among members, but not the achievement of integrated employment. Results also suggest that two days of training was not better than one day of training. Future research is needed that not only examines how to improve employment training for care managers, but also explores other barriers to integrated employment for people with disabilities, such as attitudinal and structural barriers held by or experienced by members and their families, barriers identified by organizations that employ care managers, and community barriers such as the availability of jobs for people with disabilities.