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Julie, do you want to come on up? I hope everybody had enough food.There's plenty of food -- we should bring Ziploc bags or something, people can take home -- >>That's what your pockets are for.All right.I feel like we should make everyone have espresso shots after that delicious lunch that we all had.So welcome to the second part of our discussion.For those who weren't here this morning, there are a lot of new faces, a lot of folks were able to sort of take in and absorb a lot of this great data that the University of New Hampshire and others helped put together.One of the great things about this day is that it is in two parts.That we look at the data and then we marry that with the policy solutions.This afternoon really sort of what the panelists will be discussing is what are some of the policies that we can put in place, what are some of the things we can look at, what are some of the things we could do differently to really start to see a change in those numbers? Third thing in mind, which is the people.So forgive me.I'm going to ask for your indulgence for folks here this morning but I want to tell a quick story about why it's so important that we really keep people in mind when we look at all of these policies.You know, the unemployment numbers are staggering, and there are so many good people from so many different places, nonprofits, government, for profits, working to change that.And it's important, again, to just know that if we are going to make change, we're going to need to do some things differently.And a part of it is how do we get the stories like the one I'm about to tell to have a different outcome.And what are the things that we need to do here in DC to change the policies so that situations like this quite frankly start from a different place and end in a different place.So there's this young woman who I had the pleasure to work with, who is absolutely outstanding.She happened to be deaf.And was one of, literally one of the best employees I think I ever had.She was interested in doing some work at a company where I had a lot of friends that worked there.And she said: Mark, I want to do this.I was happy to pass on the resume.And nothing happened for quite some time.And after a series of phone calls, right, we finally get to a place where they're going to bring her in for an interview.But the first phone call went like this: Mark, you know we can't do this.I have no idea why you can't do this.And we went through the litany of accommodations and what not.The interview finally happens.She comes to me said I have an interview tomorrow but they aren't hiring an interpreter.Right? What should I do? So we collaborated, and brainstormed and decided let's go, she's going to go do the interview pray that this guy knows what he's doing but chances aren't going to know because interpreting is different than knowing how to sign in many cases and of course it went horribly.They had to pass notes back and forth, a lot of the big important ideas she wanted to relay to folks were lost in translation.And so I get a call the next day.So we brought her in for the interview but we aren't going to be able to hire it didn't go that well.Well, actually, right, first of all, what you did was illegal.You need to have someone who is certified in American Sign Language interpreting to interpret at an interview like that.So we go into questions.Well, we work really long hours here.Is she going to be able to put in long hours?She's deaf, right, it has nothing to do with her stamina.So we walked through a lot of things.She goes back in, they brought her back in.They had a professional interpreter.She knocked that interview out of the park.And more importantly, in my mind, she's actually done such good work that she has been promoted twice already.And that's saying something, right.But what it's saying even if you have really good people, these are folks I consider my friends who want to do the right thing, they don't know how, right? And when we talk about the millions of people who are unemployed and we talk about 75 percent of the folks with disabilities that are working age being unemployed, there are individual stories like that behind every single one of them.And that is what we need to sort of focus on and build policies around so that those outcomes change.And we are very fortunate to have four leaders with us today.Amy from representative Hoyer's office Patrick from senator Enz and Andy from Harkin, and there he is as well from representative sessions.So really outstanding leaders, AAPD is fortunate to work with them every day.And Andy I just want to give it a special nod to you for all of the work you did before your work at Harkin's really helping build AAPD to the amazing organization that now I am very fortunate to run.It is absolutely outstanding one of the main reasons I took the job is because I knew Andy had done such great work with that organization.And it's such an incredible place.It's because of the work you've done over so many years.I'll hand it over to Julie Arostegui who will walk through what the afternoon will look like moderate the panel.She's been with AAPD about a year she's brilliant on disability policy on a lot of other things that she focuses on as well.We actually are going to be missing Julie for about a month as she heads to Africa to do some work over there on gender issues and equality, which is also near and dear to her heart.So with that, I hand it over to Julie.>>Thank you, Mark.And welcome everybody.Thank you for being here today for those of you who were here this morning, thank you for staying.And for those of you who have just come, welcome.Several people have talked about how they're getting colds I've had a cough for a little while I'm a little hoarse I'll try not to talk too much.What we're going to do this afternoon, we've heard a lot about the research and so now what we're going to talk about is the next steps, what do we do with this research? We have all this wonderful information and how can we use it to really make a difference in the lives of people with disabilities.So we're going to hear first from our research ers, Andrew Houtenville and David Wittenburg who are going to give a little bit of overview of the research and the work they've been doing.We'll hear from David Keer from NIDRR and we'll hear from our panel here, we're very lucky to have folks from across the Hill who will talk about their work in the disability area and their priorities for the upcoming Congress now that we're through elections and we'll be settling in with the new Congress soon.We'll talk about how can and should disability research inform policy for the 113th Congress, and we hear from them about their work.And then we'll really open it up for discussion amongst our staffers, amongst our research ers how they can work together and how we can all really work together to use this information to push disability policy forward.And I would like to give a few thank you’s to Senator Hatch and his staff especially Susan Cobb and Julian Andrene helped us secure the room and John Connelly who was a great help with that.Don Ucheta vocational rehab director from Utah who helped us out and of course the folks from the University of New Hampshire institute of disability.Andrew Houtenville and his team and Debra Brucker who have worked very hard to put it all together and the Kessler Foundation for their support and NIDRR, of course, for their funding of this project.And I think with that I'll turn it over to Andrew.>>Thank you, Julie.I'm just going to be very quick, because some of you had heard this already.And I left this one slide on the screen for a pretty good reason, is that the rise in DI and NSI -- this is just SSDI but the same is true for SSI, the rise in the number of applicants during the recession and continued growth in the number of applicants.This program is under threat of going, the trust fund may be going insolvent in several years.And for me it's one of the biggest challenges that we face.The next slide that we had, that I wanted to remember, bring up, is the gap.And this is the unemployment rate.Labor force participation rates.Senator Harkin has been using in his work.This is the unemployment rate and the gap is just persistent.And I thought about coding up one of our long-term time trends.This is a gap that's long standing persistent and there's not been much that's moved it.This is the recession.I am concerned if you look at the one before it that the gap in employment has been rising recently.So six point -- 0.6 percentage points.I'm really concerned that the population with disability may not participate fully in the economic recovery, which as an economist I believe there will be a recovery when it happens I'm not sure.But I know it's kind of like the sun comes up the sun goes down, the economy goes up, the economy goes down but better it go up equally across people with and without disabilities.So I am concerned.I think there's been evidence in past recessions that people with disabilities have not fully participated in growth of the recovery and then growth of the economy.The last slide I wanted to harken back to.Harken back to, that was funny, is -- I didn't plan that one.Is this is relatively old but it shows the imbalance between Social Security disability programs versus, say, vocational rehabilitation.And how little attention in terms of federal spending that employment gets and also education.For the working age.Sorry, Margaret.For the working age.And that we have large investment in education with the IDEA services.But we kind of dropped the ball after that.And there's not a lot of support for post-secondary education for people with disabilities.And if DI goes insolvent, SSI has a target on its back because it's big and considered an entitlement.And VR is so small and scrapping for its life during the fiscal cliff discussions.What's going to happen when DI goes insolvent, is the field going to be ready to support people in returning to work? To lower the pressures on the trust fund.I think these are key issues.Dave will talk about it a little bit more.Now to my prepared slides.Sorry.I couldn't resist.The first half of the day was the statistic center, this is the employment policy center.Again, sponsored by NIDRR.Not sponsored, funded by NIDRR, and housed at the University of New Hampshire.The motivation for having a research center like this and the research that we're doing is persistent and far reaching employment gaps were people with and without disabilities despite advances in programs and policies the ADA and the ADAA, advances in technology, advances in inclusion, there's this gap is persistent.Another reason for having a center particularly funded out of NIDRR is adverse program interactions.Dave will highlight a couple findings about programs and program interactions.Also the need to measure accurately.Andy was involved.A lot of it is thanks to advocacy work he did back in the Clinton administration, is that right? >>There were a bunch of people.>>There were a bunch of people.But that measurement accurately is important.Why NIDRR, as Phil said it's a small agency with a big responsibility.It's truly the only government institute that focuses on disabilities broadly types and components of life.It's adopted the social model of disability.Recognizing the non-medical elements of disability and participation of people with disabilities.It doesn't provide direct services, and that actually means that it doesn't initially have a lot of skin in the game and a lot of things there.I mean, it is a part of OSRs it's quite distinct in it doesn't have its own agenda for its own services also positioned to facilitate multi agency agreements.NIDRR can use a little bit of money to help seed the way to have agencies at least collaborate with collecting and utilizing data for research.The priorities that we have for the RRTC is to look at policy impact that's the statistics was one thing.Policy impact is a whole other thing to be able to measure policy impact is very quite difficult to do at times.Measurement improving the capacity to measure implement outcomes for individuals with disabilities and also to translate and this is one of our efforts.This afternoon is about translating some of our findings and just having a dialogue with all of you especially on the legislative side.It's not -- I know a lot of agency folks, and I talked to agency folks, but the legislative side is a part that I think is a crucial element to moving policy forward and a major consumer of research.This is your Dave, David Wittenburg is the co-PI of the employment policy center and for math Mathematica research, Mathematica policy research.I'll turn it over to Dave and Margaret Campbell will come on behalf of David Keer to give comments from NIDRR.>>Thanks, not only am I co-PI but I appear to shop at the same sports coat shop as Andrew as well.In case you're wondering I guess they hand these out in two for one sales.All right.That was not planned.What I'll talk to you about today is an overview of our research activities and one of my main goals is to hopefully be a springboard for the conversation that the roundtable is going to have.And at the end of it, I had the selfish desire of trying to get ideas from you as well as ideas for the audience for things that we should be looking at that will stimulate the policy discussion.Because that is one of the key focuses of the employment policy RRTC.Policy is our middle name.So -- I work at Mathematica policy research.So we have three general areas I want to talk about today that we have been working on to notify.To alert the policy community of our findings.The first is these policy issues in forums.And as Andrew outlined that you saw during lunch, and maybe these weren't the best slides to see during lunch because they may make you sick to your stomach, a little queasy because of the impending fiscal crisis, but we've put out a series of policy briefs about the pending fiscal crisis and potential implication of those crises as well as policy proposals that are out there.Some of you may be familiar with attorney Duggins and berk Hasser report and Dave Staples proposal.It's to stimulate the conversation about these issues as potential alternatives for dealing with the fiscal crisis.As well as because we're dealing with employment, we're not just concerned about the increasing program roles.I mean, the declining employment is a major, major factor, and those two things are linked in terms of their trends.The second thing, area that we've been looking at in the employment RRTC is the actual research findings and the employment RRTC itself is a couple of years old.And so in that timeframe we've set up the policy framework, and we've had these forums.But we've also been able to produce some research finding with secondary data.Data from the CPS and American community service that goes a little bit farther than the starts StatsRRTC and look at a little bit of the trends I'll talk about it today.We've looked at there's been a number of demonstrations out there funded by Social Security Administration and CMS.And finally we've been setting up the infrastructure to use administrative capabilities for ongoing research.And I think that this is probably the most exciting aspect.This is an aspect I'm really interested in getting feedback on, because we have set up data use agreements and we have some projects in place to use data from the Social Security Administration as well that are linked to RSA administrative data.And there's a lot of data at the state level that can be used, I think, to stimulate some of the conversations because some of the innovations for interventions for people with disabilities is you think of an interventionist type of approach.Could actually occur at the state level.So what are some of our selected findings? Well, the first overarching finding one of the reasons, one of the priorities that Andrew mentioned was that programs influence behavior.First, what is the size of the programs? One of our papers we've estimated that 65 percent of working age people with disabilities participate in a safety net program.And this is a paper that was I believe led by Debra Brucker and her colleagues at UNH and what this tells us is when you think about employment and you think about the program participation slides, you have to think about these things joint ly.Program incentives influence behavior it has a much larger effect for people with disabilities.Those things go hand in hand.As I mentioned, we've looked at -- we've got policy briefs that I think are over on the wall over there but they're also available on the Internet.That look at the proposed alternatives to the current system and I suspect maybe some of the folks on the roundtable will be discussing these as they were also a topic at a recent congressional testimony at the hearings Ways and Means committees.The DI trust fund is projected to exhaust in 2016, and while there's several proposals that exist out there, one of the problems that we face, both as an employment RRTC but more broadly as a country, we don't know what will work.We have no evidence of effectiveness of alternative ideas, and this really emphasizes the importance and the need for innovation and additional testing to find out what works, because we might be able to develop a set of programs that do better than the current programs.We might also think a set of programs to do far worse.And it's important to know both.And I was asked yesterday a question that I kind of fumbled, what do we think the overall potential employment rate is of people with disabilities.And the right answer, actually, is we don't know.Because we've never tested an alternative to the existing system.We don't know what the upper bound is.And until we start doing some innovation and we really critically think about what we think of people with disabilities, because there's such heterogeneity in that population, there's a big difference between people with blindness and schizophrenia and the types of supports and as you heard Mark talk this morning, the importance of customized supports that people with disabilities need different types of supports.As they stay in the workforce.So another aspect of our findings which relates to something that I just said is we have reviewed what have we learned from the rigorous evaluations that have been previously been done? And unfortunately there aren't as many as we'd like.Certainly not relatively few compared to what has been done for the welfare populations.But one of the things that we generally know is that when they've targeted more narrow groups with more specialized interventions, the impacts on employment have been larger.So you think about some of the findings from the youth transition demonstration as well as the transition employment demonstration and training, which was funded back in the '80s and '90s those interventions targeted youth with very specialized customized supports and they had very large impacts relative to more broad base policy interventions like ticket to work, which has struggled to get participation and has undergone several changes to spur participation in that program.Another key aspect of the employment RRTC is the importance of tracking outcomes for subgroups.I had mentioned this idea of heterogeneity and I think it's an idea that a lot of people in this room probably very well understand.But we're now looking at administrative data.And the power of administrative data is that you get the universe of data on a particular population.The limitation of the administrative data is that you're looking at a specific population, which is usually program participants.But nonetheless we've done some work, and we've looked at SSDI beneficiaries, and maybe not surprisingly, we find that if you look at the overall employment rate, the overall employment rate of SSDI beneficiaries is low.But when you look at subgroups, there's large variations in these rates.By age, by those who are seeking employment services, and even by the determination level.Whether or not you're awarded at an initial level versus at a hearings level.So programs that influence behavior.I've already covered that.A second area that we're looking at that we just started in the employment RRTC the intersection between health and education, other demographics, and one of the studies looks at the important role that education plays.Particularly when looking at young adults.And one study led by Andrew Houtenville found that there are several returns on education for people with early onset physical disabilities.And people without disabilities, which suggests okay education matters.But those same returns were not found for people with early onset mental disabilities.Those are the youth that are most likely to fall out of the labor market.We see that consistently in the special education programs, in the child SSI programs, and now in the general data.And this mental disabilities is unfortunately poorly defined here.It probably should be defined as cognitive and psychiatric disabilities.But it's this general group is faring worse than those with more physical disabilities.So what are our current trend findings? Well, we've had the great recession.And as an employment policy RRTC what do we find after this? There was job loss as Andrew noted in his slides and there was substantial loss of blue-collar and goods-producing jobs.And I think the fear and the problem with these findings is the issue that this might result in permanent job loss.And a key in the economic recovery is to see if people with disabilities are actually coming back to these jobs.And this signals the types of interventions we may want to be thinking about as we move more to recovery models.And finally a final one, which relates to the statistics RRTC is that measures influence outcomes.There's a new supplemental poverty measure out there that covers poverty in a different way, and it shows a smaller gap in poverty relative to the previous measure for people with disabilities, which it's kind of good news, but actually this is where you have to be careful using data, because the new poverty measure measures post tax income.Because more people with disabilities use cash transfer programs, the gap will shrink.And so this sort of conflicts with other study findings out there when you look at needs-based food insecurity, rent insecurity.People with disabilities continuously report higher needs there.So informing the public, and this is kind of where I'm going to leave it to the roundtable.As we move into this next phase of the employment RRTC, and as we're starting to work much more with administrative, particularly administrative data at the state level, one of the things I heard this morning was the important roles that state maps can play in that discussion, we're also looking for other ideas that you may have.We do have a set of research ideas, but our RRT C has been fairly nimble in responding to emerging policy initiatives.And in the past year, we've had a number of ways that we've tried to get our policy message out to congressional staffers, to the newspaper citations and in the forms of congressional testimonies and presentations to state staff, journal articles, obviously, and presentations to the advisory board.And I think the second to last one, the presentations to state staff srks going to become increasingly important, particularly in the next decade.So in the upcoming year, as I mentioned, we're going to continue in our main three areas, which is focusing on studies that measure the relationship between employment, health and education.This important interaction of program interactions, particularly using administrative data, and what happens when we use different measures.And I'm going to now turn it over to the roundtable, and actually I'm not going to do that.I'm going to turn it over to you Margo.I apologize.As we listen to sort of NIDRR's needs in this area.>>Good afternoon, everyone.My name is Margaret Campbell.I'm a senior scientist for planning and policy support at NIDRR and I'm standing in for my colleague David Keer who could not be here this afternoon.So I do indeed want to welcome you on behalf of NIDRR, and what's exciting for me as I look out on the audience is I see people I don't typically see at NIDRR-type meetings, which means we're reaching new audiences, new stakeholders, and that's very exciting.So thank you to all of you for putting this on to provide that opportunity.How many of you don't know about NIDRR? Are there people in this room that don't know about NIDRR? One hand comes up.That's encouraging also.There is some evidence that indicates that we are probably the largest, federal funder of disability and research in the federal government.But that isn't saying much, because we're rounding there compared to all the other research components that you would care to compare us to.So I think what's on display today is how much we've done with our resources.It reminds me years ago in a previous lifetime I was affiliated indirectly with the Marine Corps, and the Marine Corps at that time had a wonderful saying.The Marine Corps has done so much with so little for so long that we can do practically anything with nothing.Sometimes it feels that way at NIDRR.Because we have done, through our funding, a great deal.And I want to use that to segue to say that NIDRR has really been honored, honored to have played a role through our funding, through channeling our resources, to help to be a pioneer, really.NIDRR served as a pioneer, in establishing this whole emerging field of disability employment policy research.The idea of doing research on disability employment policy.So can we -- so can we eventually talk about those things that NIDRR needs, like better measures, interventions, that we all need.I mean, it's so exciting to be sitting there and hear Dave talk about the possibility of interventions in the whole realm of disability employment policy.So we have been honored to play this role.And the truth is so far we're pretty pleased with our return on investment that we see so far because NIDRR really does work very collaborative ly and collegially with our grantees, funding in this area only 15 years.That's not a long time to give birth to a whole new resource and discourse.So I think we've made some real progress and we're encouraged about that.There's progress on the data side obviously in terms of the improvements made in the collection, dissemination and use of national disability data and statistics and also now on the research side.To be able to talk about linking disability isurvey information with administrative data, what we can learn about that from a research perspective, in terms of finding and testing out opportunity, evaluating opportunities for better interventions.So I want to thank the RRTC on disability employment policy on-under the leadership of Andrew and Dave for bringing us together to share data and build it together and build some common ground share different perspectives and really start working on the implication of the data and emerging research findings for improving not just the employment opportunities of people’s life chances, overall life chances.Thank you for coming.>>I wanted to share a few thoughts before I introduce our policy folks.First of all, mark wanted me to share with you he talked a lot about personal stories.At AAPD we're trying to collect personal stories.He asked me to ask you if you have stories like the ones he shared personal stories you can share with us please do that if you go on to our website at you can contact us or I'm happy to give you contact information and Mark apologized the reason he's been in and out today is because there's movement today on the convention on the rights of persons with disabilities.I see a lot of people nodding their heads.At least some are familiar with it international human rights treaty being heard probably as we speak on the senate floor.We're hoping that it will be ratified because it's an important tool to advance the rights of disability, of people with disabilities around the world.And also just on a more personal note, between before we bring it to the national levels, Mark mentioned I'm leaving for Africa tomorrow.And I do also gender work and people have asked me if that overlaps with disabilities work, and actually what I'm specifically working on in Africa is gender and conflict.And of course it does.Whenever there is it results in issues for women having disabilities and I just want to say that something that I've noticed in my international work is that it's slowly becoming more of a discourse.We hear more about working with people with women with disabilities, and I also work nationally, there's a U.S. national action plan on women peace and security and specifically within that they do address issues of women with disabilities.So just a little note to share.I'd like to introduce our panel going from left to right.We have Andrew Imparato, works with senator Harkin principal advisor on disability issues he's currently working on a bipartisan employment disability spurring 20 percent increase in the labor market of people with disabilities in the U.S. by 2015.Andy's perspective is informed by his own experience with bipolar disorder and he's been working in disability policy and advocacy for more than two decades including 11 years as president and CEO of the American Association of People With Disabilities.And I think he's going to need to leave us a little bit before this discussion is over.So he will be replaced by his colleague Michael Gammick McCormick, senior K through 12 education policy advisor with the HELP committee and his portfolio includes the elementary and secondary education act, the education sciences reform act Individuals With Disabilities Education Act.The child care development block grant and title four of the higher education act and he also has extensive experience and education so I think his perspective will be very informative as well.Next we have Towner French graduate of Duke University with a BA in political science.Originally from Germantown Maryland he began his service on Capitol Hill with Congressman Judy bigger of Illinois.Spent over eight years with Congressman Lincoln Diaz belllard where he worked as legislative director finally chief of staff.He came to Congressman Pete Sessions office from the house committee on Homeland security where he served as chief parliamentarian manages the rules committee work and health policy as chief of staff.And to my right we have Patrick Murray who current ly serves as education policy advisor to Senator Mike Enzi of Wyoming, his focus on career and technical education.Prior to coming to the committee Patrick worked as a middle school science teacher as a member of teach for America native of Denver, Colorado received a bachelor of arts from holy cross and masters of education from Arizona university and from Georgetown University.And we have Amy Schultz serves as policy advisor to Hoyer, as a part of the team she focus on labor and disability policy.Previously she served as a legislative assistant to Representative David Scott of Georgia.In February 2013 will mark Amy's seventh year as an aide on Capitol Hill.Holds a bachelor and masters from the George Washington University.I think with that I'll ask everyone to speak a little bit about their work and their upcoming priorities and after that we'll have a discussion about how we can all work together to push those forward.So shall we start with Andy? >> >>I apologize I can't stay for the whole thing but we'll have people from the office of disability at the U.S.Department of Labor.They're helping us.I'll explain the project she's working on.I'm happy to be here.I really appreciate NIDRR's leadership in funding this kind of research and I appreciate Andrew Houtenville and David Wittenburg and the whole team, the diverse team including AAPD and others who work on this research and training center.One of the things that I think has been a goal for me for a long time before when I came back to the hill was trying to have a stronger bridge between NIDRR and the research that NIDRR funds and the folks that are trying to make policy based on data and based on evidence.And I'll give you just a recent example.We have a team that is in Michael's shop who are working on the reauthorization of the higher education act which may be one of the bills that the help committee takes up relatively early in the next Congress.A lot of these decisions are still to be made because we still don't have our new ranking member and obviously those discussions all need to take place.But the team for Harkin working on this wanted to know what's the latest data on how students with disabilities are faring in higher education.How are we doing on graduation rates, how are we doing, what do we know about debt burdens and other things that would matter in the context of the reauthorization.So we reached out to Charlie Lakin, the head of NIDRR, and said can you get us up to date data.And he got us a response within a few hours of things that he was aware of and had assigned a team to work with us and they followed up and got us a lot more data.And I mean I know that we probably should have gone through legislative affairs and protocols, but I just really appreciate that it's possible to get quick and relevant answers to data as you're starting a process of doing a reauthorization.And I know one of the questions Dave that you asked is kind of what type of research is relevant.I would look at what's coming down the pike for reauthorizations, what are some of the hot issues that are getting attention in Congress.Michael's going to be working on ESEA and IDEA so data that we have around K through 12 education, we're always going to be interested in what happens with kids after they leave school to the extent that we can have indicators that we're measuring while kids are in school that would help get schools to focus on the right things, as kids are in high school so they'll have better outcomes after school.Those are the kinds of things that I'd be looking for.And I wouldn't be shy about sitting down with the chair and ranking members on the committees of jurisdiction and asking them what are you all working on, how can we support what you're doing, what are some of the issues that you're grappling with.But, again, I really want to commend Andrew Houtenville because both when I was at AAPD and on the hill.He responds very quickly with very good information whenever we need it.And we appreciate how available he is and how flexible he is on getting us what we need.We had a number of ways we used him in the last year.We had a CEO summit that Towner French and his boss Pete Sessions participated in it was hosted by the CEO of Walgreens.We wanted to have some charts that could tell the story of disability employment in a way that CEOs could understand it.Andrew quickly helped us figure out how to do that and that's just an example.And I think over the course of the year we've called on him a lot.And working with our partner senator Enzi we've had ten hearings in this Congress on different aspects of disability employment.And I just as an example of a way we used the compendium that you all produced and the statistics RRTC we had a hearing on higher education.Now, this is actually a hearing that senator Enzi's staff spearheaded but hearing on higher ed and the impact of higher ed on deaf students.And we did it as a field hearing at Gallaudet.But through the compendium, we were able to figure out that Wyoming, I think, was the number one state in the country in terms of labor force participation for the deaf community.So obviously we were happy to point that out at our opening statement.But I think there's just a lot of ways in which the data can be used in real time on the hill that can help influence policy and help tell a story about what's working and what's not working.So I want to be brief because I do want to be here for some of the Q and A. But I think the way that we're looking at this, and the help committee and senator Harkin's office we don't want to celebrate another major milestone anniversary of ADA and IDEA without having significant improvement in labor force participation.And the reason that senator Harkin is focused on labor force participation and not as focused on unemployment rates is we feel that the unemployment rate is kind of missing a big part of the adult population of people with disabilities.Who are not in the labor force at all but that doesn't mean that there aren't people in that population that could be in the labor force or might want to be in the labor force.So we feel like if we look at labor force participation, we're capturing what we see as more of a real number, if you just look at working age folks, the participation number I think is around 32 percent right now.The absolute number is a little over five million.So a little over five million working age adults with disabilities are in the labor force as of the last month that we have statistics for, which is October.What Senator Harkin has done he did it at a summit that the U.S. chamber of commerce hosted.They endorsed his goal the same week which we were delighted to see but he said let's try to get that number up to six million.So from five million to six million guy 2015.So that would be about a 20 percent increase.It may sound hard to do.But that number has gone down a lot since we started collecting the numbers in 2008.I think the high point of the months that we've been collecting it we started around April of 2008, if I'm remembering.The high point was September.Of 2008.Where we were at I think close to f5.8 million people with disabilities in the labor force.So we've had a big drop from that.It's been a disproportional drop on a percentage basis compared to workers without disabilities which is something that Andrew referenced in his slides.So from Senator Harkin's perspective as we try to grow jobs which is a bipartisan goal for the next Congress, people with disabilities need to be front and center.They need to be part of that effort.They need to explicitly be part of that effort, and we think it helps to have goals and to be looking at that number every month and see how we're doing.And the last two or three months it's actually been going up.And it hasn't been going up long enough for us to say it's statistically relevant because it's not seasonally adjusted and there's a lot of factors that can affect that.But still it's better than having it go down.So at any rate, that's kind of a frame for us, we want to get to six million by 2015.Just briefly, some of the reasons why we have some hope and excitement around this that the way we talked about it in a piece that Senator Harkin wrote in July when he issued a report on the state of disability employment, we feel like we're at a tipping point as a country on this issue.One of the reasons is there's more attention on this issue from the state level.We're delighted that governor markel chair of the national governor association has made disability employment his signature issue as chair of NGA we had a great meeting with the governor of Iowa on this who wants to be part of this initiative.The governor of South Dakota whose parents are deaf came and participated in a forum on this that governor markel hosted.We anticipate at their mid winter meeting in February that there's going to be a lot of attention on this issue that all of the governors who participate in that meeting will be exposed to.So we see that as a positive.We think governors could be coming to the federal government looking at Dave your statistics and saying this dynamic that you all are describing is affecting us, it's affecting us in our Medicaid budgets.It's affecting us in a lot of other budgets that hit us at a state level.And we want to be empowered to test out new ways to provide supports for people with significant disabilities that have employment as an expectation.And I think the employment first movement is a good example of states showing leadership to try to change the way we approach disability employment and that's particularly focused on the developmental disabilities youth population as they're leaving school.We also feel like OMB and the White House are paying more attention to this issue than they have historically.A number of you participated in a forum that jack smallGwen hosted at Brookings, he was on a one-year I don't know what they call it but assignment to Brookings, and now he's back at OMB.But he spent a year studying this issue, and at the end of the year he put out some ideas and got reaction to that.I was amazed and delighted that Nancy under Paul high White House person was there for four hours learning about this topic, that tells me that there's some interest at a high level of the White House in looking at the issue.And one of the things that I think is important is that I think if we just frame the issue as SSDI insolvency, we miss the opportunity to have a much more interesting, much more to me potentially positive conversation about improving disability labor force participation where SSDI innovation is part of it but the whole driving force of it is not the solvency of the SSDI trust fund.And I think there was some good dialogue at that forum about that.We're excited about the leadership in the private sector.The reason we did the CEO summit we felt like Walgreens had a real good story to tell to other CEOs.They've been making commitments and following through on commitments on a scale that we have not seen in the private sector.20 percent made a commitment.20 percent of all their distribution center employees would be people with disabilities.Based on positive success there, they've now made 10 percent of all their new retail hires will be people with disabilities.They make over 50,000 new retail hires every year.So that's in the first year they're going to be implementing that is 2013.That's 5,000 jobs for people with disabilities in 2015.I think we calculated that just on percentages about 250 of those jobs would be in Iowa.Walgreens has a big footprint to do it on that scale can have a ripple effect.And Randy Lewis has a group of people he's been cultivating in other companies who are following the Walgreens model.So we see a lot of potential there I know Congressman Sessions is looking to set it up with a different set of CEOs we'd love to see it happening with other places, that was part of the discussion with the Iowa governor.Lastly senator Harkin is excited about what he calls the ADA generation.We feel like we've got a generation of young people, we've had a lot of folks from this generation in our office as interns over the last several years we've got people who came of age post ADA post IDEA with and without disabilities and I think from our perspective, this generation does have high expectations for people with disabilities.They do have high expectations for labor force participation in integrated environments for people with disabilities and we feel like this generation can drive change in the workplace kind of in spite of some of the policy barriers that we've created but inspire better innovations and policies.TerRen working on a report follow up to our report that will get into some of the details but we hope that report can be a call to action and to the extent we're looking at reform in Medicaid and SSI and other programs, we feel like young people with disabilities are a great place to start and a great population to do the innovation around because you're going to get a return on investment.One of the things that statistics that was shared when I was on the ticket to work panel which I'll never forget it's probably gone up since then but the average length of time that a young person stays on SSI, when they enter the S S SI rolls before age 18 is 27 years.And a lot of these young people die before 27 years.For many it's much longer than 27 years.But the point is that the federal government and the state government through Medicaid are going to be in relationship with this child and with whatever supports they have in their life for a long period of time.It's the relationship how it will affect the interaction between the government and the young adult over the course of their lifetime.I'm going to stop there.I really appreciate my colleagues.We have a close relationship with all three of the other offices, this is a very good bipartisan issue.Senator Enzi sat through hours and hours of this And we appreciate it.And notwithstanding the negativity around Congress and our ability to get things done we do think this is an issue we can get things done.And the UN convention will be hopefully exhibit A on that.>>Thank you very much.[Applause] .>>I toyed with the idea of saying I agree with everything he says and pass it on down.That's not fair.I'm Towner French from Texas, and I apologize for my delay running up here as fate would have it I ran into the Walgreens executives literally in the hallway got to talking a bit.I feel I had a previous panel I sat on in the middle of the Dirksen hall way.I do want to say I pretty much agree with everything Andy said.We come from an interesting place in that my boss has a son with Down's syndrome, 18 years old.And his experiences in life have sort of led him to different policy objectives as his son has aged we're at the point, 18, where they're trying to figure out what does he do for the rest of his life? And so it's led us to speaking to senator Harkin and the other folks in Congress that are working on these issues.I'd also point out Kathy McMorris Rogers who doesn't have somebody on the panel but has been very active is along with our collective bosses, I believe.I wanted to talk a little bit about the summit we had in Dallas.There's some -- or in Connecticut, I should say, with Walgreens.We learned a lot when we were up there.We had a good group of CEOs, and it's a model that I think we want to expand a little bit.I think there was some fear from the CEOs that they didn't know how much investment they would have to do.They didn't know how much workforce training they would have to do.The interesting thing I think we found most of the changes we found were Randy said under 25 bucks.Simply associating pictures with the workstation or animals with a workstation.So better memory acknowledgment or some very minor changes to some of their packaging lines for those with physical disabilities.But nothing was drastic change from their model.And I think in keeping with that, we have an ability to raise the employment for those with disabilities in the current system.UCED before that we went to, from f5.8 million folks in the workplace down to five million folks in the workplace.As we gained back jobs, as the recovery continues, I think that regardless of the recovery, we're doing a better job of integrating those with disabilities into current workplaces, and we're going to see a rise at least back to the 5.8 as a baseline, without having to make drastic additions to the overall workforce.We're doing a very good job of starting the process with the CEOs to institute reforms in their companies.Couple other things we want to do the same thing in Dallas we want to bring that model governor markel in Delaware has been exceptional in that regard and has helped with the national governor's s association to bring a little bit more information to the governors and I would say that's due to a lot of the work senator Harkin working with the governor he's taken his own initiative as well that's very encouraging to see.I think we're going to -- one of the things we learned is a lot of the changes that need to be made are made on the state and local level.They're not necessarily federal programs.They're not necessarily federal dollars that go into it.It's a lot of state and local efforts.And I think we can be helpful from an information sharing perspective through the federal folks that we have through the federal partners.I think that's it.I think the Q&A will be more important to you guys but thank you for having me here and looking forward to continuing the fight.>>Like Towner I could say the same thing it's not too often you have two Republicans follow a Democrat and say I agree completely.But from senator Enzi's perspective it's very much a bipartisan effort.Like Andy said he's very much enjoyed working with senator Harkin on those issues and working in the past Congress.That being said I'll be looking more as a data use in the past rather than going forward, because of conference rule senator ensy will be transitioning out there will be a new ranking member moving in I can't speak to the new ranking member's position or what he'll be focused on going forward.But it's been a bipartisan effort in the past I believe it's going to be the same going forward.And I know that senator Enzi as he continues with the committee as a committee member will be focused on that as well.Enzi working with Harkin was very much interested in finding or learning more about the low participation rate particularly of youth and finding ways we could change and that low participation rate and find the same incentives that Andy was talking about, find ways we could change that and improve those outcomes.Andy alluded to several times the July report, June or July report that senator Harkin released that's an incredible document that they released and I think that that's really going to be something that people in the Legislature are going to be looking to going forward because it has some very striking information about business components and also like towner said the state and local components that can help drive and incentivise people persons with disabilities participating in the labor force.I think that senator Enzi is very interested in removing barriers to entry into the workforce.So that 65 percent participation rate, what exactly are the barriers that are keeping people participating in those systems and how can we reform that SSDI system so that we get better outcomes both for the program and for participants.So I'm going to, like towner, I'm going to look more forward to the question-and-answer session and pass it along.But thank you very much for having me.>>Last but not least.When I started working for Mr.Hoyer about four years ago I didn't realize I'd be handling disability policy.I didn't really know a whole lot.So this has been a good journey for me, and I learned a ton from Andy.So, of course, I have to agree with everything Andy said.But that's because he taught me everything I've known.There have been other people obviously, but this is a really interesting issue.One aspect I don't think others have touched on but I wanted to talk about was the human aspects.Mr.Hoyer participated in the house administration committee's life program last year for the first time.Which had students who participated in this program for students with intellectual disabilities at George Mason university will be paired with offices and have internships in offices, and it was a great experience because for the first time we had a student with an intellectual disability interning for us.We've been participating with the AAPD summer internship program for several years, but it was the first time that a person with an ID was being an intern.Making copies.Doing a data entry, passing out newspapers.Everything that an intern would do in our office, practically.It was such a good experience for Adriane who was our intern for that semester he asked if he could do more.We realized that his participation in our office, with that particular internship program was very brief.He was doing maybe a couple hours a day.And I realized that he didn't have as much parity so to speak with some of the other interns.So we increased his hours.And he did a great job.So we were really happy to have him in the office.It was a good experience for him.But it was also a good experience for us.And I think that's one area we need to focus on more is having greater interactions for people with and without disabilities so they have a better understanding.of empathy but also a better understanding of what people are capable of instead of what they're not capable of or what holds them back.I think that's kind of what should drive a lot of our motivation when we talk about increasing disability participation, is how can we reduce prejudices essentially, how can we make it the incentives greater not only for employers but for employees as well that they find that these colleagues are capable and wonderful to work with and positive and productive.They have the soft skills that so many kids leaving high school don't have.frankly.So that's one thing that I wanted to focus on.But I do agree with Andy, and the note that I made about trying to frame this issue away from SSDI solvency is really important.But I do think that this is a really critical time for our country and as much as we, everyone throws around the term fiscal cliff, there's a lot at stake for vulnerable populations and so there's a lot to think about.But we should be very, very focused on what we can do in a time when we have better data, better technology.How can we facilitate employment opportunities when things have been perhaps better than ever.Unfortunately, the labor participation rate should be going down.It should be going up.Mr.Hoyer is committed to increasing disability employment and he has been really, really serious about this issue since before the ADA was passed and when Tony Qualo asked him to carry the mantel in the house it's over 22 years now he's still very focused on it and very much concerned about inclusion and full participation for people with disabilities.So thank you very much for allowing me to speak on the panel and look forward to your questions.>>I'll host from over here.Thank you to our panelists for sharing with us.Before we open it up to the audience for Q&A I want to get some perspectives amongst the panel.Andy I think framed pretty well about how research and statistics can really support the work that you're doing.But any thoughts or reactions from our research ers, questions? >>Andy I like the way you framed getting back to 5.8 million as the goal.And the one thing I think to get to that goal is we can't do nothing to get back to that goal since going from 5.8 to five million we've seen SSDI applications rise substantially.And so we've seen a number of people potential ly get taken out of the labor force permanent ly.So in order to get to that goal, there needs to be an approach.And I was -- my question for the panelists, given that this is a goal, how do you get there? What sort of interventions do you see what sort of policy changes if any? >>Why don't I ask my second one because then you guys can take them both.It's similar.Although both Dave and I have been doing research on youth, and some of that is the returns of education.And Andy you talk about the lifetime commitment to children and they grow up basically at poverty level.It's not a very comfortable place.This is a really great bipartisan issue, because from one perspective it's full inclusion.Participation the other part could be work, paying taxes, so no matter what perspective, it's a win for all.However, I think the question is how much are you, how much, if any, could be invested? It takes a lot of courage to go out and say we're going to invest in youth and that stuff hoping that it pays off with 27-year savings of DI.27.And it's longer.I mean, if they live for -- it's not retirement age that they're going to be off the programs.So would something like instead of a GI-like bill because IDEA takes you up to 21, 22.And there's really nothing after that.Voc rehab was set up during Theodore Roosevelt under Hughes and Smith for voc rehab for military and then it was voc rehab for difficulty.So it has a history of following military returning veterans.And GI bill is kind of a no brainer, easy to do.Not always easy to fund, of course, given the constraints we're under.But I don't know, I'll stop there.It wasn't really a question as much as a soap box.>>I'll start to field it we'll turn it over to the expert.I think there's couple things that factor into that, the first from my perspective is that one of the guys we talked to in Connecticut was 26 years old and we asked him you know what have you been doing since you essentially left school when he was 20, 21 years old.He said I've been sitting on my couch.And that's what I've been doing for the last five years.I think there's a number of barriers.The first being in a lot of cases, especially with intellectual disabilities it costs families more for them to have a job than it does for them not to have a job.I mean, just the transportation some of the changes that need to be made so that they can perform the job.It's unbelievable.I think there's a couple of companion bills, able act is one in the house and senate allow some of these individuals to have some savings, have some ways of building up some income.to pay for, frankly, them having a job to a certain degree without losing those government benefits.And so you put people in the workplace.They become productive individuals and they don't necessarily immediately lose those vital benefits that they would have through the federal government.I think that there's a number of other changes that can be made but a lot of what we're focusing on right now is easing those barriers to the workplace especially for those families.The long-term healthcare problems are going to be persistent.If you look at Down's syndrome alone we have nearly 100 percent rate of those with Down's syndrome grow into Alzheimer's.They have Alzheimer's.And so the healthcare costs at end of life are only going to increase as those, especially in the Down's syndrome community that I'm using as an example hit 45, 50, 55 years old.But I think there's things that we can do to ease the transition into the workplace so we don't have a kid in Connecticut sitting around for five years before his family's finally able to afford for him to have a job.>>I'll throw out two ideas that I think might respond to both your comments and questions.I think one of the things that we've come to believe is that the solution to boosting labor force participation is going to require federal government leadership, state government leadership and private sector leadership.And we are intrigued by what could be done in the way of a public/private partnership similar to some of the public/private partnerships that President Clinton pursued around some of his signature domestic policy priorities like welfare reform.He got commitments from a lot of companies to hire people.And people can argue about whether welfare reform worked or didn't work.Certainly didn't save a lot of money but it did generate a lot more labor force participation within that population.So that's the kind of thing that we're talking with governor markel about is there a way that we can leverage his interests, get more governors engaged maybe get some of the bigger under funders that fund workforce development and education to have more disability employment as more of a signature priority, which as you Noah's not been the case historically.And the federal government can play a useful role but it can't start and end with the federal government.So that's the kind of thing that we want to leverage markel and launch something while he's the chair of the NGA we're working on an event in May that might be an opportunity to do that the other thing I'll say is one of the things that has changed in the last three years is not just in terms of the monthly numbers that we get from the Bureau of Labor Statistics, but I think leadership in this space is about setting goals.It is about actually knowing how many employees with disabilities you have and having a goal around that.And one of the things I've been pushing recent ly which is you would think you wouldn't have to, is when I meet with large disability service providers.So these are folks in the business of helping people with disabilities get jobs, I ask them what percentage of your workforce are people with disabilities.Not the people that you're serving but your staff.A lot of them don't know the answer to the question.So I think if we're going to push the private sector through section 503, if President Obama's going to have 100,000 work roll for the federal government the disability service provider sector should have goals.To me if everybody's starting to count we're never going to have perfect numbers we'll rely on people's self-identification but it still helps to know how many folks you have.One of the things that does it encourages you to have strategies to retain folks because part of it as Margaret knows we have an aging workforce.Part of it is retaining people and keeping them in the labor force as they age into disability.So those are some ideas in terms of how you move the number up.>>Any other thoughts on the panel? >>Just something briefly that Andy mentioned before.The unique opportunity to inject this topic into each of the bills that are set to be reauthorized is something that shouldn't be taken lightly.I mean, Andy mentioned the higher education act.But elementary, secondary education act, the Perkins career technical education act workforce investment act, each of those has a component that if focused on during reauthorization would be extraordinarily helpful in supporting that we in particular vocational rehabilitation an emphasis that the senate bill focused on, that's something that came from the data that we were provided.So in each of those reauthorizations, I think there's a potential to help achieve those goals that you mentioned earlier.>>Glad you mentioned that.That feeds into a question I had.One of my roles with APPD is to work with RTT Cs to work with their research translate it into terms the rest of us can understand, I've spent many an hour reading Andrew and Dave's other people's research in statistics and trying to make sense of it and write policy briefs and putting them in terms that our audiences can understand and they can use and so I guess my question is as advocates, what's the best way for us to get this information out there and like UCED support you, get, activate our networks, advocate to get this information to you to the people that need it so that you can push these reauthorizations forward, get support for these bills? >>I was just talking to someone in higher education in the state of Maryland literally just asked the same question.And I facetiously said:Use social media.I'm not a communications specialist but over the past several years I've seen a greater use of the images that people share on Facebook.There's a word.I'm missing it.It's not instagram.But good idea.Something like that.The idea is that facts are taken and put into something pictorial.>>[Inaudible].>>Something like that.But an organization that I work with in education called the Education Trust at least once a week will send out some sort of e-mail.It's not a newsletter but it just has a fact related to something that they're really focused on.And I always feel like it kind of hits me in a particular way, because they're particular ly focused on issues especially for students with disabilities and students who need to graduate high school and greater numbers.But they'll have a fact and they'll put it right in the e-mail and it kind of hits you hard.I think the advantages of social media is that you can kind of spread your message in short er characters or images and new ways to catch people 's attention.So I would say this is a great opportunity to take data that's out there and make it into a message that's really palpable for people and for us who sign, who are on the APPD's list in particular and others.It's a good opportunity to get your message across without us having to read a long newsletter brief on something.I'll think of the term.It will come to me.I'm having a senior moment.>>If I could add, one of the things that we need to be hearing from you all are redundancies potentially with current federal programs.As we go through reauthorization processes, we need to know what you guys are seeing on the ground.What you're seeing every day, what's being helpful, what isn't.I was reminded the other day of I think George Miller member of the house from California requested a GAO report on employment opportunities for those that are disabled, with, that had findings that out of the 40 some odd programs that were run through the federal government, there was numerous redundancies and there needs to be some work done on the congressional side on the oversight side by those who are sitting on this side of the tables to keep an eye out.But we don't know about it without some feedback from you all.And that's very important as we go through this process.>>Just one thing that I would encourage right now the only group in the disability community that seems to read the monthly numbers from B LS and react in the same news cycle is disability Disability Scoop which in general I would say is a pretty extraordinary site that tries to keep up to speed with developments in disability policy.And I assume they do it with not a huge staff.But they're focused on unemployment rates.So when the unemployment rate goes down month -to-month, they talk about that as a positive thing.And they don't always look at, is that because fewer people are in the labor force or is it because more people got jobs, and we feel like that's a pretty important distinction.So I don't know that AAPD has the staff capacity to do this.But there are a lot of groups represented in this audience.But I'd love to see disability advocacy groups, those statistics come out every month I'd love to see groups jump on that this is the number this month this is what's happening we're trying to get to six million and just use that so people get used to looking at that number and seeing it as an important indicator.And I think something like that could be done at the state level.You can tell me if we can drill down to the state level but I'd love to see governors have indicators that they're tracking month-to-month as well so that people are actually paying attention.>>We are building an app and it's going to have the top five statistics honestly that you use typically and it probably will be a website.That monthly number will come up.We'll have a disability clock the size of the population of the disability.>>Somebody's ahead of you.>>I just remembered it it's an infographic.So there you go.It came to me.>>You looked at your iPhone.>>No, I didn't.The interesting thing is I looked at the iPhone I didn't search anything and it just came.But what Andy said is you take that information on the first Friday and immediately we at 8:31 we get something in our in-boxes that says the participation rate is this.We can have that information into our in-boxes in pretty much real time.And so it's just a matter of using what's out there and communicating effectively using new ways of communicating with Capitol Hill.>>I think we'll open it up to the audience, if you have a question raise your hand and we'll bring a microphone so we can all hear and also for the webcast.>>Good afternoon.I'm Sara helm work at the University of Tennessee for career opportunities for students with disabilities.I actually just finished my Ph.D.in higher education administration and rehab counseling and I looked at college students who had psychological disabilities and I asked them about their career development engagement and their employment concerns, and it was a very small study.My dissertation chair told me to call it modest.But it was small.But it certainly showed that there are quite a few concerns.And my main concern when looking at the reseearch there really is very little as you all know.And my colleague Allen mur executive director of career opportunities for students with disabilities and I have been trying to get some research funded to look at the employment outcomes of university graduates with psychological disabilities.And we've had a really difficult time trying to find funding.Sort of in this room it's sort of talking to the choir and I know funding is really difficult, but I just wondered if you had any ideas for those of you who are engaging in research in any advice or suggestions as to who we should discuss this with and who we should talk to about our research ideas.>>I'm going to answer first because I need to run and this will be a good last one for me.I imagine you know some of this because COSD is pretty well connected but there's a disability funders network, and within that there are a number that have youth and transition as a priority including the Mitsubishi electric American foundation, the HSC foundation, the Kessler foundation, and there seem to be some new ones that are cropping up that are putting more money into disability employment.So it seems like that's a good conversation to have with them.But from the Harkin office perspective we want to see some of the brand name funders that are known for being the leader funders in education and workforce development like the gates foundation Joyce foundation, there are a number that have much larger budgets than the ones focused on disability to recognize this is a huge population and that if they fund research in this area it can result in strategies and innovations that can help lots of disadvantaged populations not just students with disabilities.So I'll stop there.Appreciate the opportunity.Again I apologize for having to leave.And Michael if you want to come replace me I'd appreciate it.Thank you.>>Any other comments from the panel or next question.>>One person to talk to might be John O'Neill from the Kessler foundation in the back there.The Kessler foundation is currently the president of Kessler is currently the head of the disability funders group, right, John? That's private foundation.Getting private foundation money might be the first step.It's sometimes easier but not as lucrative.Getting federal funding there's two strategies, go at it yourself and it's a fishing expedition.Cast it out there.But also collaborating with somebody who already has experience getting resources from federal agencies.Because a lot of times that's the signal.It helps to collaborate, because they know the tricks of the trade and how to write a proposal.I would also recommend that you do field initiate grant review for NIDRR.They're always -- you did.So you know a lot now about what to do and not to do.But keep doing that.Sure.>>Thank you, Margaret Campbell again NIDRR.I recently was at a small policy forum I guess you'd call it, it was convened by the helldredge center at Rutgers, it was on a concept that kind of related to disability employment that kind of turned me around in terms of how I look at it.And they were featuring this woman by the name of Dr.Jennifer Christian, actually an MD.She comes at disability issues from an occupational medicine and occupational health perspective.But not necessarily -- she started in workers comp but she's not there anymore.But she has a model.And what this forum was all about was discussing the concept of the prevention of unnecessary work disability.And what I particularly resonated to was this whole idea of prevention.What I think is so exciting personally from my professional perspective about the ACA the Affordable Care Act, it's shifting to a prevention agenda that includes people with disabilities.Why shouldn't they be entitled to prevention of other health problems? But what about applying that same approach, not to solvency, not approaching SSDI or SSDI insolvency, but in terms of preventing unnecessary work disability.So there's no -- NIDRR has no research agenda under that umbrella, so to speak, at all.We've invited her to come to NIDRR to talk, and we were so sorry that she wasn't able to come to this day, to meet you all and whatnot.But I'm just wondering what the NIDRR funded research ers think but what you all think but her focus is enlisting the medical profession in this agenda because they play a big role in facilitating unnecessary and preventible work disability.But really doing this in a systematic way but involving workforce development organizations and NVR and, et cetera,.So I'm just -- it's a big concept, big idea.But I'm just wondering whether you think it has traction from your perspective and whether you think it's something that would help build common ground around these issues and advance the cause.>>I might tackle it a little bit to say that I couldn't agree more, frankly.This is a very touchy subject to a certain degree.I don't want to get too far under water here.But I think SSDI has been a parachute to a number of folks through especially the economic downturn, and we're not contemplating the ways that we can help those before they go to S SDI.That being said, I think we're not only at an insolvency problem already, something that's going to have to be addressed whether we like it or not.But there should be reforms in place on the back end of that addressing of the insolvency.And I agree with you completely we need to engage the medical community to not use SSDI as an easy out to folks who could get -- and that's the wrong terminology -- but to folks that can take advantage of the current medical community to address whatever disability they're facing.>>It's not cheap.>>It's not cheap.Never cheap.>>Prevention.>>True prevention is not cheap.Interesting thing Congress does a pretty good job of scoring, CBO does a pretty good job of scoring prevention lately.Why don't we score economic benefits very well.We do score future preventive actions fairly well.So within the context of the budgets we look at and the scoring of SSDI, from a monetary standpoint in the future, in the 10 or 50 year windows I think we can do a pretty good job of paying for preventive measures in that realm.>>I can actually jump in or David did you want to? >>My initial response is that incentives matter.Right now we don't have large incentives to provide preventive medicine.Employers just don't have -- to oversimplify the research, accommodations occur from employers for those particularly for those employees that they think are going to provide a long run return to them and the accommodations don't occur for employees that employers don't think in general.It's an overgeneralization.And where I mean I think one of the proposals on the table that would stimulate sort of like the prevention that you're thinking about is both -- I think author dug D.J.ins and others they're one with in the same in getting the employers focused on the idea if you have on set of disability in the workplace you should start caring about -- you'd be than sent advised to make sure that that person doesn't go into a permanent disability program.And it changes the culture of providing supports.And I think that's a lot of what Andy was talking about.So before we even engage the medical community, I think you actually have to engage the employer and making sure that they have the right incentives to serve a person with a disability.Because right now all the incentives work against not serving them.They work towards pushing them to workers comp, which those state workers agency haves their ies have their own incentives.Those incentives may actually put that person right to SSDI or SSI.So there's a lot of things.And one of the things that I didn't mention it's not only the incentive for the accommodations but it's also the incentive to, one thing that can happen on the medical side is the electronic health record revolution to getting those types of records to SSA, if those could -- if there could be a format where that would occur.That would substantially speed up the process and being able to make a disability determination.But those types of innovations I think require fundamental restructuring of incentives.And perhaps one of the places to start is actually within the workers' compensation program because they deal directly with the employers and so there's where your intervention at the state level could potentially occur.>>I just wanted to say I have to leave.But I just wanted to thank AAPD for the opportunity to participate and to just express my appreciation for everyone's interest in this issue and convey that Mr.Hoyer appreciates it as well.So thank you very much.>>Thank you, Amy, for being with us.>>Let me jump in and do kind of a broader answer to your question.I'll look to Patrick senator Harkin and Ensi did a hearing that addressed stay at work incentives and were looking at not just things like work ers comp but also private disability insurance making sure employers knew about accommodations, if you have a 42-year-old who develops a chronic condition and he's been working for your company you've invested a ton in that employee if it's a valuable employee you're losing a lot of investment what we dant to do is create want to do is create types of incentives there's talk about an employer can hold onto that person because as we have an aging workforce it's going to become more and more of an issue.If we're going to talk about people aging in place and that includes not just their communities but also their employment, places as well, we need to talk about this more seriously.So whether it's through looking at the stuff that towner talked about or some of the incentives, I think we need to look at this prevention as even broader than you described it.And think about not just as individuals who are coming into the workforce at 18 or at 21 or whatever age who have disabilities, but also those who develop disabilities throughout their lifetime.And address their needs and help get the supports there to make sure they stay in place as well.>>We had a question in the back and I know you've been waiting.>>This is Eric Lawer work on the institute of disability for UNH actually for Andrew Houtenville.Considering the complex nature of disability policy and research and the need for communication and advocacy the way we discussed, I had a friend who worked for a senator for about seven years, and as I got into research his comment to me was that if I could not distill a research finding down to something that he could explain in an elevator, a walk between meetings or a quick car ride, it wasn't going to be heard due to the amount of information that they were bombarded with both the staff and the senator.And in terms of advocacy or getting a message across, I was wondering how much you found that to be true in terms of spreading that message across to senators and staff who maybe aren't as attuned to individuals with disabilities and their advocacy.>>I'm sorry, what was your question? That was a joke.[Laughter].>>Either or.I wanted -- I think for a lot of folks that's probably true.I think you have -- I think you have to know who your target audience is, too,.I think you're going to find great reception in all the offices that are represented here and I'd add probably another ten members on both sides of the aisle and both sides of the capital to the list of folks that are up here.I think as we get into SSDI issues you're going to see a lot more members get involved.When we get into those fairly large physical issues that we're dealing with even now, SSDI on the table or not, that you're going to have a much larger audience to engage about long-term fiscal health.But I think we're very fortunate that both on the house and the senate side we have groups of members that are on the relevant committees that are very interested and concerned in these issues, and I think you're going to get a fair shake from them.That being said, you want to go talk to your local member of Congress, absolutely.But keep in mind, keep a healthy dose of skepticism sometimes when you go into that meeting don't be too disheartened it might not be their first focus but they need to hear the information.>>I guess it's not necessarily your job to condense that information and provide it to them.That would definitely be ours.Like towner said, we're not good to ask that question because our bosses are definitely focused on it and the committee, the help committee is very focused on this.The only recommendation I could give you is cultivate those relationships with staff so that when that conversation, that Towner's talking about comes up and the member becomes extreme ly interested in it, you've laid the ground work with an individual that you can make sure they have the correct information to make sound choices and provide that information to their member.>>I'd add so Andy has my cell phone number.Whenever he needs it to -- if you are interested I'll give you my cell phone number and if it ever comes up can't say we'll budget score something for you to predict what the CBO score will be.But that will be fun to try to do.But I think NIDRR in particular has a dual role to play in terms of providing, conducting research but also providing it and they've always been eager for grantees like us to provide that support for the legislative action, either at the federal or state level.And Dave being Mathematica policy research they certainly have a lot of high powered people there that can provide information quickly as well.>>I would actually say we need this.But we need to be able to call Andrew and say, so walk me through the methodology, because we care about that stuff.These offices care about that.I think I'm incredulous when a group comes in and presents me with a one-pager, and I really want to drill down into that information and they're not able to because I will say that is part of the job.To bring us that information.We don't build policy only on sound bites or one pagers, and we have to have the data.>>But in a lot of places that sound bite is also a gateway.>>Agreed.Absolutely.>>If you came in sat with me and handed me this, you know even though I'd like to think I work on these issues a lot, I'm probably not going to go home at night and read that.So -- >>Come on.>>I love you.But what I'm going to do is I'm going to go to the intro pages here I'm going to get a little bit of information then I'm going to pick through it and find what information I think may be relevant to whatever matters are coming up.That's a good thing.But I think you need to, when you're coming in hand in this, you need to find the relevant tie to that member of Congress.And a lot of cases it's a personal issue or it's something that statistically is out of whack maybe with their district, maybe with their state.There needs to be a reason for them to care or else they're going to put this beautiful booklet down and they're going to push over to the side of the desk it will get lost in that pile that sits there until they clean it out a few weeks later.The personal hook for those members and senators is key.>>Hi I'm Harriet litwin from voc rehab Delaware general.I have a couple of questions, first a statement.One of the things that I think we need to be -- and I think Towner touched on that, was encouraging employers to use universal design, because when he was talking about the accommodations and the warehouses, the Walgreens warehouses, and I think -- I don't know how we can kind of make that a policy.But we can sort of see how we can bring that into our policy.The other question I had was regarding what used to be known as WIPA, and that also relates to something that UCED because you had an individual who was sitting on a couch and the cost of -- and you had mentioned that the cost of an individual going into employment was great er than what they were going to be getting through, say, Social Security, and how there isn't enough education in spite of what's happened or used to be happening depending on where you are, related to how to use an employee-related work expense to offset what the benefit loss so that they can, the family can end up with a net gain, not a cost to being employed.And I think if there's some sort of legislation related to that that's developed or redeveloped in terms of a WIPA program, have to kind of decide whether the focus of the program is going to be the use of work incentives or the use or the goal of getting people completely off benefits because I think that's one of the, it was one of the issues that with the previous legislation or the previous opportunities to have those programs in the states and is anything being looked at to replace or to improve what used to be known as WIPA? >>I think I'll address your last question first only to say that I think the main policy drive lately has been the able act.I think having that savings account that folks can contribute to that also the individual can work and put money into that savings account and still be qualified for federal benefits is pretty crucial at this point.We're doing a lot of work at the end of the year to try to get that through.It's got a score of with the congressional budget office of $1.2 billion, which is a high tax deferral, but pales in comparison to anything in tax deferral 529 tax education account that costs six billion Roth IRAs 43, 4$44 billion when it was all said and done and I don't think people would go back and say those are two programs we don't need to have.So providing those options is crucial.I mean there has to be some sort of, even if you don't want to do a savings account type thing like the able act you have to have -- it was a mainstay of welfare to work, getting people in the workplace, and Andy talked and touched on the fact that whatever you think of welfare to work it got people into the workplace, and we saw a rise in employment, because people were available and they had the means in that case and the back-up of the federal help to get out and get in the workplace.On your first question, the workforce design, I think the interesting thing that I think we learned from Walgreens to a certain extent is a lot of those things are individualistic.From a universal design standpoint, there really isn't -- Walgreens as they've set up their distribution facilities sort of puts the general model out there, but a lot of the changes that we saw were quite literally tailored to each individual.And so you have to have a buy-in from the company if you're going to make those changes you have to have somebody in that company that's either a disability coordinator or is helping to make those things under the corporate structure.So hopefully I got both of yours.But if anybody -- >>I just had a response as well.One a bit of reaction to one of your comments.The move David Wittenburg can talk a little bit more, more towards early intervention as opposed to working specifically towards current beneficiaries.And that you may get a bigger bang for your buck if you go early on in applying for DI or SSDI.And that that's where the focus could be.But all these same things need to be in place for many of those individuals to succeed as well.So it's not -- but it's hard to judge W.IPA on the basis of current beneficiaries.It's kind of a monument all task.The other thing is that when you think about we lfare reform, Dave, I'm stealing your statement I'm surprised you didn't grab the mic.He said it yesterday and that was part of that jack smallgen Brookings event that took place about a month ago that welfare reform it was planned for -- there wasn't great evidence.But that evidence base was collected in the '70s and 80s and the welfare to work was something that the negative income tax experience, this is a long time in coming, and with DI we're not going to have much time.There are some interventions being discussed and planned and disability has its new disability research consortium.But there's not going to be a lot of time for when that occurs, but a lot of the same lessons from welfare reform and welfare to work can be translated.It's the same kind of disincentives that we're talking about.>>I think, too, Andrew's point about catching people early on the front end, making sure that we're talking about youth who are moving forward, it goes back to what Patrick said when he was talking about the interrelationship of a lot of the legislation that's up for reauthorization.If we look at WIA, look at IDEA look at ESCA look at Perkins they actually have to integrate together to support individuals to get into the workforce.We have to address some of the issues of the reality of sometimes we have individuals with disabilities who have chronic conditions that get worse at certain points and then get better and we have to think about what's the flexibility of the support for those individuals so it keeps them in work and doesn't penalize them when they have to go out for an extended period of time.So we have to be subtle, I think, with our policies here.But we're -- and the senator in particular is looking very seriously at the front end in recognition of that's where we're actually going to I think.Not only see some of the best supports but also some of the best savings in the long run.>>And I think your specific question was actually at a different group.It's kind of the back end it's the SSDI beneficiaries and also the SSI recipients who they have these interesting work incentives.But nobody knows how to use them.You mentioned ERWE there's actually a return to work, and now WIPA is gone.So now presumably the amount of information that beneficiaries have is even less.And in answer to your direct question I don't know what's going to happen to WIPA.And I do know there's these ideas floating around, the work incentives simplification pilot which is essentially trying to take all of the complexity out of the SSDI beneficiaries to return to work decision, the trial period the grace period earnings above -- if you earn above this you lose benefits otherwise you keep benefits.They're playing around with these different ideas of trying to simplify benefits.There's this movement for this growing back to people interested in going to work I don't know na there's been anything done a more radical idea which is let me keep my pay initiative.And I forget who did this, but it's essential ly just testing whether or not remove all work disincentives from SSDI and see what labor force are let them keep their benefit and work now that's just a test of a concept not a test of a policy because that could result in induced demand but I think it would answer a lot of questions on what is the potential for return to work policy for the specific population of SSA beneficiaries.So that's a long winded answer.I don't know what's happened with WIPA but there's these thoughts of changing incentives and they run the spectrum in terms of their ambitious ness.I prefer to see ambitious test with small populations so we can learn more about the concepts that might work.>>We have a Web question OC Harrison, project director of the DIB tech institution on the human center design in mass.Massachusetts.She says we know from the NLTS 2012 and other research funded by NIDRR that the majority of students with disabilities transition from hospital to public two-year community colleges munity colleges have lower retention and graduation rates than four-year public and two and four-year private colleges.Today you have shown that educational attainment correlates with employment.What can be done at the national state and local level to support students with disabilities to go to college and graduate? The last comment being armed with education and training students with disabilities would have a better chance of getting a job.>>We have a couple of initiatives out there TIPSID grands the transition grants looking at individuals of individuals with disabilities.I can't remember offhand how many are there but they're both in two-year and four-year colleges going forward.Finally this year we're getting some data around them, and seeing some good results and some not so good results.One of the things that the chairman has said is he wants to see what the employment outcomes are for those efforts.But those grants I think are in place for five years so we're looking closely what those outcomes are.There's programs in California that actually have some very good long-term outcomes because they've been in place and they've been funded through multiple state federal and local efforts for upwards of 15 years we have data from them showing some good outcomes but they're very, very small.type of programs.But that's one thing that we have put in place at this point.>>I would say to a certain extent it doesn't answer the question in a positive way, but community colleges, two-year institutions are availability to get closer to home to be able to get an education.It's a model education.Somebody with a disability, for example, is less likely to go away to a four-year institution because they're around their support system at home.The community college system is there.I think we've done a pretty good job especially in the early 2000s, you know, no child left behind sort of stole all the headlines but I think we did a pretty good job working with community colleges to increase some funding availability there.But that being said, to a certain degree that's the viable option right now.And I'm not sure that's going to change in the near term to be honest.>>If I can quickly piggyback on one thing that Towner said.That support system, we actually have some policies in place that make that harder, that we need to address.And specifically I'm going to talk about individuals with physical disabilities.And this got brought home to me two summers ago we had an intern in the office who uses a wheelchair, she goes to school at Stanford.She lives in California -- I'm sorry, she lives in Pennsylvania.She was working here.The ability to transfer her support network was so difficult.It wasn't because we couldn't find support personnel, it was because of the payment process through Medicaid.So we need to be better in terms of what we're doing to make -- because I want that woman going to Stanford.If she can get into Stanford I want her going there.So we've got to figure out a way to actually make that happen at a better rate.>>I would like to respond as well to just saying what we've done in our state is we've put together through our community college program a supported education program that is in place for students with disabilities who are attending our community college network.And we have it in all of our locations, and the students receive additional support, training in their initial year to get through some of their basics, their study skills, their math basics, their language arts basics and we've had a greater success in keeping students in the program.>>I think with that we're going to need to wrap up the panel.So I really want to thank all of our panelists for being here today.I know you took time out of your busy schedules and we appreciate it.And I think this was a very fruitful discussion.And I will turn it over to Andrew for some closing comments.>>Just one or two comments.I actually appreciate the comment of being aware of the legislative calendar.The information that may be coming up that might be useful in conveying that in a way that can be quick but instantly drilled downable.If you need more information and also to be responsive quickly, because a lot of this happens in a very compressed timeframe.And also take away is that the disability programs will become increasingly, the dialogue is going to increase, not decrease.And it's up to us to be prepared for that.So thank you very much.We appreciate your time.Thank you very much.[Applause] . ................
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