Issue 10: Employment and Training

Goal: Ensure that mental health consumers have equal opportunities for employment and training, without sacrificing health care benefits or other basic life maintenance services.

Discussion

Being a contributing member of the community is a goal for most people with psychiatric disorders. To the extent that this contribution can be as an employed worker, the individual and society benefits. There are obstacles to achieving this goal however, including the nature of the disability, the need for adequate training and support, concern about losing a job when an acute episode occurs, and the fear of losing medical insurance once an individual leaves public assistance. For many individuals, the value of assistance with psychiatric services and medications outweighs the feasibility of working, especially if that work is often at minimum wage. For those with education and skills prior to the onset of mental illness, the task of obtaining appropriate employment is even more challenging and frustrating.

Employment issues for adults with serious mental illnesses are a component of an initiative spearheaded by the Governor's Council on Disabilities and Special Education, in which the Alaska Mental Health Board is participating as a steering committee member. The Division of Vocational Rehabilitation in the Department of Education is the lead agency. The initiative, known as the Work Incentives Project, has been funded by the Alaska Mental Health Trust Authority for three years; it serves individuals with developmental, mental, and physical disabilities. The project consists of three components which are described in actions 1 through 3 below.

Actions

233. Disincentives to employment: Complete a study to identify barriers to employment faced by people with disabilities, including: fear of losing health benefits; financial disincentives; fragmented systems; lack of knowledge of Social Security work incentives; lack of vocational services; and limited work opportunities. The contractor will look at work incentive programs elsewhere and identify specific disincentive in Alaska. The contractor will assess the population looking to work and their experience with disincentives. A program of incentives for all stakeholders including people with disabilities, employers, and public and private insurers will be recommended. Changes at the state and federal level will be identified and pursued. System cost analyses will be part of the project.

234. Pilot project: Complete a project to develop and implement specialized vocational rehabilitation services. Services include benefits counseling, career planning, education, training, job development, and placement. The Division of Vocational Rehabilitation is funding training, job accommodations, and other services needed by individuals to reach vocational goals.
Responsible party (actions 1-2): Governor's Council on Disabilities and Special Education

235. Training and pilot in additional communities: Based on the pilot project, training and assistance will be provided to additional pilot grantees in rural and remote areas to implement similar services. In addition, training will be offered to individuals including those with disabilities, vocational rehabilitation counselors, public assistance workers, case managers, policymakers, and others.
Responsible party: Division of Vocational Rehabilitation

236. The Alaska Mental Health Board and other advocates will seek changes in state law to allow Medicaid recipients to maintain health insurance coverage if affordable coverage is not available through employment.
Responsible party: Alaska Mental Health Board, Disability Law Center

237. Mental health advocacy groups will seek enhancements to federal parity legislation which will allow mental health consumers to have greater access to mental health services through employer insurance policies.
Responsible party: Alaska Mental Health Board, Building Bridges Campaign, advocacy groups

238. The Division of Vocational Rehabilitation, Division of Mental Health and Developmental Disabilities and advocacy groups will establish educational programs aimed at increasing employer awareness of mental illness and eliminating barriers to employing persons with mental illnesses.
Responsible party: Division of Vocation Rehabilitation

239. Service providers and advocacy groups will work with community organizations to find volunteer opportunities for individuals with psychiatric disorders.
Responsible party: Service providers, advocacy groups

240. The Department of Health and Social Services will ensure that all state funded case management services for mental health consumers include employment and training as an element of individual case plans.
Responsible party: Department of Health and Social Services

241. Explore ways for Division of Vocational Rehabilitation to extend services beyond the current restrictive time limits for mental health consumers who require additional supports.
Responsible party: Division of Vocational Rehabilitation