Employment is highly valued by people generally and by people with intellectual and developmental disabilities (IDD) specifically. Having a job fulfills an important social role in our society. Research on the lived experience of people with IDD who have competitive jobs in their communities indicates that having a job promotes participation in the community, provides a source of social contacts, and enhances quality of life.1 In addition, having a job leads to greater economic security, provides benefits to physical and mental health, and helps foster autonomy for people with IDD.2 These findings were underscored in an analysis of the National Core Indicators data regarding the positive outcomes experienced by people with IDD in paid community jobs,3 who were more likely to have friends, like where they live, feel safe and be involved in their communities, make choices, and have their rights respected. Finally, a meta-analysis that reviewed employment outcomes found that people with IDD who are employed have enhanced self-esteem and self-confidence, resulting in greater independence and enhanced opportunities to contribute to the economy.4

Conversely, people working in facility-based programs are isolated from their communities and take home lower hourly wages than their non-disabled peers, partly due to the provisions of Section 14(c) of the Labor Standards Act of 1938 that permit employers to pay subminimum wages to people with disabilities.5 Research consistently suggests that people working in segregated facility-based programs and those earning subminimum wages have lower rates of community inclusion and higher rates of poverty.2,6 In addition to the negative outcomes of segregated work, a recent systematic review found that segregated employment did not prepare people for competitive integrated employment and in fact was detrimental to securing paid employment in the community.7 Further, integrated vocational service models that directly promote community employment such as supported and customized employment lead to substantially improved outcomes in terms of economic well-being, quality of life, and mental health.7

The importance of employment for people with disabilities has been reinforced through a range of significant federal mandates and initiatives over many years. Acknowledgement of the need to provide employment support dates back to 1920 when President Woodrow Wilson signed the National Civilian Vocational Rehabilitation Act which ushered in the first federally funded employment program for people with disabilities.8 While the Vocational Rehabilitation (VR) program grew steadily over the next several decades, advocates for people with IDD argued that the program discriminated against people with more significant disabilities who were unable to get access to federal training and job placement. The disability community lobbied for change and helped to pass the Rehabilitation Act of 1973.9 In addition to accessibility and non-discrimination provisions, the amendments made clear that people with disabilities, regardless of the nature or severity of their disability, should be considered for VR services. Despite these changes, people with IDD still do not access VR services at the same rate as peers with physical and sensory disabilities.10

The Workforce Innovation and Opportunity Act passed in 2014 and the 2022 Subminimum Wage to Competitive Integrated Employment demonstration projects funded by the Rehabilitation Services Administration further reinforced the need for state VR systems to support individuals with all disabilities and to be held accountable for helping them to seek active employment in competitive settings.11,12

Other federal initiatives that contributed to the employment of people with disabilities included the Americans with Disabilities Act (1990)13 that outlawed discrimination against people with disabilities in employment and the ABLE Act (2014) that reduced some of the disincentives to employment by allowing people to put money into a dedicated savings account without threatening Supplemental Security Income (SSI) and Medicaid eligibility.14 In 2012, the Office of Disability Employment Policy launched the Employment First Community of Practice urging publicly financed systems to commit to competitive integrated employment as a funding priority for services and supports to people with disabilities.15 Finally, in 2014, the Centers for Medicare and Medicaid Services issued the Home and Community Based Settings (HCBS) Final Rule.16 The Final Rule conditions HCBS funding on whether services and supports provide community access and engagement, are directed by person centered planning, and include the availability and opportunity for employment of all HCBS participants.

However, in spite of all of the mandates at the federal level, only a small minority of people with IDD have community integrated jobs.4,17,18,19 In 2021, 22% of people receiving employment and/or day services from a state IDD agency were participating in integrated employment.10 Given the stubbornly low numbers of people with IDD who have paid community employment, it is incumbent on advocates and researchers to look below these top line numbers to understand the factors that are associated with securing employment, in addition to exploring the range of job settings, pay, benefits, hours and other features of people's employment. As part of the 2022 State of the Science Conference convened by the Institute for Community Integration at the University of Minnesota,20 researchers stressed the importance of understanding the characteristics of people with and without paid employment to uncover potential disparities among different racial, gender and income groups.21

The purpose of this analysis is to take a more granular look at the quality of the employment experiences of people with IDD. Our aim was to explore the associations between employment outcomes and key service-related and demographic characteristics. We hypothesized that there would be strong, positive association between having an employment-related goal in one's service plan and having competitive, integrated employment.