The Pathways to Careers initiative enables people with significant disabilities to have an informed choice of competitive, integrated employment options across a broad range of community settings.

1. An Overview of the
Pathways to Careers Initiative
Martin Gerry
Executive Managing Director
Therese Fimian
Senior Research Manager
October 16, 2014

2. Pathways to Careers Goal
All youth and adults with significant
disabilities will have both an informed
choice of competitive, integrated and
full wage employment options across
a broad range of community settings
and access to ongoing career support
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5. The Rhode Island Consent Decree and
The Pathways to Careers Initiative
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• The 2014 Consent Decree between DOJ and the State of Rhode
Island calls for transition over the next ten years to integrated, full-
wage employment for a maximum number of hours consistent with
individual abilities and preferences.
• Supported employment for at least 700 individuals now in sheltered
workshops and 300-350 special education transition students.
• Transition services and supports to 1,250 youth, ages 14 to 21
necessary to ensure meaningful opportunities to work in the
community after school exit, including integrated work-based
learning experiences.
• Mike Callahan and Martin Gerry were invited last June to present
the Pathways to Careers approach to a DOJ sponsored meeting in
Providence, RI.

6. Pathways State-of-the-Art Features
• Volunteer applicants from special education transition programs, the
Medicaid waiver waiting list and facility-based employment.
• Zero exclusion of randomly selected applicants.
• An individualized, informed choice process supported by “expanded
discovery.”
• Paid internships that offer an opportunity to impress employers and
test and finalize Employment Support Plans (ESPs) for the intern.
• An Employer Payroll Tax Adjustment (EPTA) that provides long-term
funding of needed employment supports as outlined in the ESPs.
• Benefits counseling and asset development assistance.
• A career outcomes focus with ongoing career support and an
individualized Career Plan.
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7. Pathways to Careers Core Strategies
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8. Expanded Discovery
• Discovery is a competency-based, qualitative look at a Pathways participant
in lieu of a traditional comparative assessment.
Involves conversations and interviews both with the participant and with persons
who know the participant .
Identifies participant interests, potential employment contributions and conditions
for success.
• A Discovery Meeting is held at the end of the initial discovery period to
identify a prospective paid internship or a job placement for the Pathways
participant and ongoing discovery continues during the internship period.
• After initial employment, ongoing discovery focuses on sustaining employ-
ment and on a Pathways Participant’s overall career development.
Uses paid internship experiences and/or initial employment to help expand the
understanding of participant interests and capabilities.
Helps in identifying and overcoming previously unrecognized challenges to
successful employment.
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9. Pathways Internships
• Internship job matches are identified during the Discovery Meeting
and are developed along multiple pathways and across a broad range
of employment sectors (i.e., 16 Career Clusters).
• Internship jobs are jobs in integrated, competitive and full wage
employment which the employer is seeking to fill.
• Internships are provided for 8 to 12 weeks during which time interns
are paid at the federal/state minimum wage or higher.
• Internship training is provided by Pathways staff and the employer,
employment supports are provided by Pathways and an Employment
Support Plan (ESP) for the intern is developed and finalized.
• A “safety net” is provided for interns who wish to change internships or
discontinue Pathways participation.
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10. Multiple Internship Pathways
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11. Annual Expenditures for Federal Cash and Health
Benefits for Persons With Severe Disabilities
FY 2008 – FY 2020
$426
$543
$861
$1,100
0
200
400
600
800
1000
1200
1400
2008 2012 2016 2020
MillionsofDollars
$1 Trillion
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12. Financing of the Pathways Initiative
• As of August 2014, the population of working age adults with significant
disabilities receiving SSI/Medicaid and SSDI/Medicare benefits was
more than 14 million.
Fewer than 1/2 of 1% of these working age adults leave the rolls for work each year.
Persons with intellectual/developmental disabilities and serious mental illness make up
the majority of these working age adults.
• The Institute asked Mathematica Policy Research to estimate the net
savings to the Federal Treasury when an SSI or SSDI beneficiary
works.
Study does not assume that most individuals will leave the benefit rolls.
Study only looked at reduced outlays for SSI, SSDI, Medicaid, Medicare and SNAP.
Study methodology vetted with staff of CBO, OMB and the Social Security Actuary.
• A Pathways objective is to expend no more than 75% of the net,
estimated Treasury savings for all Pathways-related costs, including
the EPTA.
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13. • Concept: A pay-as-you-go model that lowers an employer’s Federal payroll
tax payment (FICA) based on the direct employment of persons who receive
(or have received) federal disability (SSI or SSDI) benefits.
Directly addresses the need for long-term funding for ongoing employment supports.
 A risk management model is used by private disability insurers to adjust the premium
charged by private disability insurers to corporate clients.
• Strategy: The employer has 8-12 weeks to get to know the intern on the job,
know the cost of the intern’s needed employment supports and know the
amount of payroll tax reduction the employer would receive annually.
• Employment Impact: Upon permanently hiring an intern, an employer will
receive a FICA tax reduction as the individual is employed.
• Budget Impact: The tax adjustment is budget positive to the Federal
treasury.
*In the model, an amount equal to the FICA tax reduction is being paid to employers for up to 5 years from the date of hire as long as the individual
remains employed.
The Employer Payroll Tax Adjustment
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14. • An employer may use the EPTA as a resource to offset the costs and
supports outlined in the ESP of a Pathways employee, including any
needed mental and behavioral health services, transportation, assistive
technology, and career counseling.
The employer can purchase services (e.g., job coaching) from any provider.
The employer can build other capacity internally to provide supports, such
as through an Employee Assistance Program (EAP), or by increasing or
offsetting a co-worker’s salary who is providing on-the-job supports.
• The development of an action-based Career Plan for the Pathways
employee that:
Focuses on professional advancement and tracks changes in interests and
skills and identify and plan for education or training.
Tracks what does and does not work at the current work situation.
Identifies potential changes in current job tasks, to the ESP.
Targets career advancement activities (e.g., certification; higher education).
Post-Employment Support
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15. Pathways Evaluation Components
• A process analysis to document the nature of the Initiative, how it was
implemented, and stakeholder perspectives on the factors that hindered
and facilitated implementation and ongoing operations.
• A participation analysis to assess characteristics of Pathways interns, the
reasons why non-participants offered chose not to participate, and the
intern’s tenure in the project and reasons for any dropout.
• An outcomes analysis to assess the employment outcomes of Pathways
interns both pre- and post-participation and compare outcomes to a comp-
arison group of similar individuals who did not participate in the Initiative.
• A cost savings analysis to assess the extent to which the employment
outcomes of Pathways interns are likely to result in cost savings to state
and federal programs.
• A systems change analysis to document the extent to which existing
procedures, funding sources, and services were modified, why modific-
ations were considered beneficial and necessary, and the extent to which
changes are likely to be sustainable and replicable.
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16. Utah Pathways to Careers Overview
• Initial focus on 60 youth and adults living in Davis County, Utah with intellect-
ual and developmental disabilities (I/DD) randomly selected (zero exclusion)
from volunteers recruited from among:
School District special education transition students
Individuals on the Utah Medicaid HCB Waiver waiting list
Facility-based employees of PARC
• Currently beginning 3rd year of full operation with 25 new participants.
• 17 participants offers of employment (14 acceptances), 46 participants
currently in paid internships or expanded discovery and 4 drop-outs
• Average wage of employed participants = $11.50 per hour; the average
number of hours per week of employment = 24+.
• 36 participating employers across 16 Career Clusters; the annual EPTA
payment ranges from $4,500 to $7,000 for employees who work 30 or more
hours per week; $2,000 to $5,000 for those working 24 to 29 hours per week.
• Expansion in FY2015 to serve 20-25 additional youth and young adults with
Autism Spectrum Disorder (ASD) and Serious Mental Illness (SMI).
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17. Pathways to Careers Expansion – FY2015
• New partnership with the Dartmouth Psychiatric Research Center
including creation and operation of an Autism Learning Community.
• Initiation operation of a Pathways Initiative in Boston, MA that will serve
40 students with SMI, ASD and I/DD.
• Initial operation of a Pathways Initiative in Greater Detroit, MI that will
serve 100 youth with I/DD, ASD and SMI.
• Initial operation of a Pathways Initiative in Fairfax County, VA that will
serve 40 youth with I/DD and ASD.
• Dissemination of a Pathways to Careers Guidebook (I/DD) and
development of a companion Costs and Finance Manual.
• Development (with Marc Gold & Associates) of a Pathways certification
process to support further expansion of the Pathways Initiative.
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