Lessons Learned

We learned three lessons from those closest to the transition from subminimum wage to competitive integrated employment:

• Fear of change drives resistance. Fear of change is a significant barrier to progress, with resistance driven by uncertainty and comfort in the status quo. Individuals employed in subminimum wage jobs and their families often do not know any other option, or they have tried and failed doing something different. Some employers fear that transitioning could compromise their mission to support people with disabilities, result in job losses, or even force them to close their doors. These concerns highlight the urgent need for clear evidence to show that the transition to competitive integrated employment will protect and prioritize the needs of workers with disabilities, especially those with the most significant needs.
• A more coordinated system is needed. Individuals and families want a better system of employment and support that does not pit opportunity against individual need. For workers with disabilities and their families, the transition represents a chance for financial stability and a greater sense of independence. They express hope for both continued support services and fair wages, which would allow them to achieve a level of self-sufficiency not possible under subminimum wage employment. Employers and intermediate support providers point to the possibility that transitioning out of subminimum wage employment would enhance their business and service models, and help ensure that every worker has access to the resources and guidance needed to succeed in competitive integrated employment. All parties want a more coordinated, better functioning, integrated network of support and employment. The lack of alignment across services and funding streams leaves families confused and struggling to navigate fragmented supports.
• Fair wages and integrated employment is good for business. Many employers who have successfully transitioned away from subminimum wage say that the shift has not only expanded opportunities for workers with disabilities but also strengthened their businesses. Bringing a business orientation to nonprofit work is often key to a successful transition, as it encourages thoughtful financial planning and operational efficiency. Maintaining a mission focused on social impact does not conflict with running a successful business enterprise. When done well, it can improve an organization’s reach and effectiveness. Shifting entrenched views can be a challenge, and a smooth transition requires a solid business plan, innovative thinking, and negotiation or renegotiation of contracts. But with proper planning and support, employers can achieve self-sustainability while using Medicaid and state resources to support day habilitation and integrated community services. This way, disabled workers transitioning from subminimum wage receive both fair pay and essential day supports. State policies must prioritize both, rather than placing wages and supports in opposition.

The voices and perspectives of workers, families, employers, and support providers reinforced the need for cultural and structural change at the state, local, and employer levels. The three lessons above yield four recommendations:

• Make an economic case for transition. We know anecdotally from the employers interviewed and the documents reviewed that phasing out subminimum wage can result in better business. We also know that when people with disabilities are competitively employed, they are a substantial part of the American economy.¹ The economic case for transitioning away from subminimum wage to competitive integrated employment is strong and should be the grounding argument for transition. However, more research is needed to expand the evidence base and provide guidance for the transition. Policymakers should prioritize funding for large-scale cost-benefit analyses that examine the economic impact of transitioning employers, including productivity gains, workforce retention, and reductions in public assistance reliance. Strengthening the research base will provide the data needed to inform decision-making, refine transition strategies, and demonstrate the broad economic benefits of fully inclusive employment practices.
• Create state coordination for services. While coordination is needed at all levels, states are key to improving the difficult-to-navigate patchwork of support systems and services. Individuals and families may feel as though they are like a pinball being bounced around and may get what they need once in a while or fall back down the chute. Instead, states should create one-stop shop websites and service centers that improve access and coordination, in addition to more communication about the state and federal resources available. Service coordinators must be educated and trained on the range of services, and aware of how people with disabilities and their families access such services. When funding is disjointed and prioritizes certain services over others, a holistic approach—using incentivized funding to support blending, braiding, and sequencing of federal and state resources—can enhance coordination and improve service delivery during the transition.
• Develop process improvements. The transition away from subminimum wage involves many different elements of a system. Small but important process improvements will have significant impacts during employer, local, and state transitions. For example, in subminimum wage employment, the employer is often the case manager and the service provider for day habilitation. Separating case management and service delivery could enable more choice for individuals in selecting employment and could ensure integrated day services that best match their interests. Other process changes that employers, state agencies, and local governments should consider include taking advantage of new technology like artificial intelligence; improving data collection; increasing training; creating task forces of care coordinators; and improving transportation initiatives, for example. An incremental, phased approach will help sustain lasting change.
• Seat every stakeholder at the table. During a phaseout, workers and their families, employers, labor unions, and intermediary providers should be sharing their perspectives and be engaged in the process from the start. Various stakeholders and groups must listen to one another and realize that their goal is the same: creating service models that enable businesses to thrive and that provide support, independence, and dignity for workers with disabilities. Currently, many of the support providers for those transitioning from subminimum wage are not engaged or are engaged late in the process. For example, labor unions often enter the process too late to ensure correct application of labor laws.