Reflections on Working with States

For the past couple of years, I have directed the activities of the Center for Workers with Disabilities. CWD is a technical assistance center for state Medicaid Infrastructure Grant projects that is housed in the National Association of State Medicaid Directors, an affiliate of the American Public Human Services Association. CWD is also part of the NTAR Leadership Center consortium. I came to the field of disability employment with experience in welfare reform, workforce development for low-income families, and youth development. Each of these areas has given me useful insights that help enhance efforts to promote employment of people with disabilities.

Welfare reform demonstrated the value of providing states with flexibility to craft “to work” policies and programs. The welfare reform experiences of states have given us lessons on what works (and doesn’t work) to support low-income families in employment. The field of workforce development has pioneered important new approaches, such as industry-based or sectoral employment strategies, that show real promise for creating pathways to good jobs and that states are beginning to incorporate into their disability employment efforts. The field of youth development uses an “SOS” framework – Services, Opportunities, and Supports. I think this concept can be applied broadly to support human capital development for all youth, and also for adults with barriers to employment.

Working with Medicaid Infrastructure Grant (MIG) projects provides a unique opportunity to be part of an “infrastructure development” initiative. MIG funds are used to support system-building activities designed to make lasting change to health and employment systems for people with disabilities. This, along with flexibility in the use of funds, has enabled states to improve coordination across complex systems, build leadership at the state level, develop policies and programs to better support access to health care and employment, and experiment with new approaches to employment for youth and adults with disabilities.

It’s no surprise then that a number of MIG projects are taking part in the NTAR Leadership Center’s activities, including the State Leaders Innovation Institute and the State Peer Leaders Network. Through the NTAR Leadership Center, we are able to support state leaders in bridging workforce development and disability employment initiatives, and in connecting to broader state economic development efforts. And through CWD and the NTAR Leadership Center, we are able to facilitate state-to-state peer exchange and networking, which is proving an invaluable component to supporting innovation in the field.

2010 will be an important year for MIGs and other disability employment efforts. If health care reform legislation is enacted, it will make significant change to Medicaid and private insurance with important implications for people with disabilities. Additionally, with the expiration of MIG funding in 2011, 2010 will be a pivotal year for “telling the story” of the MIGs and addressing sustainability. I look forward to working with our states and partners to build long-term sustainability for state systems change efforts.

Nanette Relave
Director, Center for Workers with Disabilities
American Public Human Services Association