Employment First Initiatives

There is growing consensus in Iowa and around the country that employment in the general workforce should be the expected and preferred outcome of employment-related services. A job establishes someone as a contributor to, and full participant in, the community. In addition, the U.S. Department of Justice has affirmed in numerous settlements that the Olmstead community integration mandate applies not only to where a person lives, but to what that person does during the day. Meaningful daytime activity is an essential part of an individual's successful transition from institution to community living.

Employment plays a key role in someone's sense of well-being, and facilitates and solidifies community inclusion and self-sufficiency. Real jobs and income are how most people maintain independence and create economic security for themselves and their families. Community based integrated employment is now the gold standard in employment service outcomes, receiving national attention.

Comprehensive employment services system change is the focus of CDD technical assistance. Specifically:

  • Realignment of the Medicaid service definitions and reimbursement methodology for employment services
  • Employment outcomes data collection and reporting
  • Training and development of direct employment services staff
  • Supports for center-based community providers' efforts to transition to primarily community services

For more than 10 years, CDD administered Iowa's Medicaid Infrastructure Grant (MIG) on behalf of Iowa's Department of Human Services, with funding from the Centers for Medicare and Medicaid Services. MIG helped Iowa Medicaid members learn about work incentives, benefits planning, and increasing economic self-sufficiency. In collaboration with many Iowa partners, thousands of Iowa job seekers with disabilities were introduced to Home and Community-Based Services that support employment, Small Business/Microenterprise Development, Ticket-to-Work, AmeriCorps, and other employment services and supports available to people with disabilities.

If Everybody Works - Success Stories

Iowa now has several success stories of people with disabilities who are employed and earning wages or who are self-employed as small business owners. Local Community Rehabilitation (CRP) Iowa Vocational Rehabilitation Services (IVRS) may have assisted achieving these successes. Follow the links below to view their stories:

Information on working and benefits is available from Disability Rights Iowa.

Medicaid Claims and Employment Research

The University of Iowa Public Policy Center researched the effects of employment on health care costs of Medicaid members. The dramatic results show that Medicaid members with disabilities participating in Iowa’s Medicaid for Employed Persons with Disabilities (MEPD) program and covered only by Medicaid have $161 per month lower Medicaid claims than Medicaid members who are not participating in MEPD. By multiplying the average saving of $161 per month by the 129,259 eligible months for MEPD members covered during the study period, we estimate the cost reductions are over $20 million during 2011. Cost reductions for MEPD participants also covered by Medicare are estimated to be twice that much. Read more about the Costs of Health Care study.

Iowa Initiatives Assisted by CDD

 Additional Resources

Archived Materials

Several years ago, community conversations on expanding the array of employment services in Iowa took place. These conversations provided an opportunity to discuss changes needed in Iowa’s service system to make the choice of competitive employment a real choice for more Iowans. The conversations also focused on these two reports: “Stakeholder Brief: A Systematic Approach to Revising Iowa's Integrated Employment Funding System” and “Capacity Building.”

These previously published materials may still offer support: