When the School Bus Stops Coming: The Employment Dilemma for Adults with Autism (continued)

If it is determined that students with autism will require post-education living and employment supports, it is important that they be added to the waiting list for Division of Developmental Disabilities/Mental Retardation Services. Waiting until the student requires post-educational adult supports is not advised, as the wait may be many years (Hinkle, 2004).

Upon graduation from school, two plans must be established for the student, an IHP (Individualize Habilitation Plan), through the Division of Developmental Disabilities/Mental Retardation, and an Individualized Plan for Employment (IPE), through the Division of Vocational Rehabilitation. Both of these plans will serve as the new design for employment, day services and residence services for the person through his adult life.

Under the Division of Developmental Disabilities/Mental Retardation, every state has a Medicaid waiver program called the community care waiver (CCW). Under this waiver, the federal government will match state dollars paid for services to those with autism and other disabilities on a 50% basis. As such, it is critical that the graduating student with autism be determined as Medicaid eligible to access these funds.

The criteria for eligibility under Medicaid reflect the degree of disability and financial need. When it is determined that an adult with autism has significant social, behavioral and cognitive challenges, and therefore is eligible to receive services under the Medicaid waiver, the second criteria is to ensure that the individual has fewer than $2,000 in actual assets (Hinkle, 2004). To this end, if the person has resources in excess of $2,000 or expects to receive, through inheritance or otherwise, resources that will exceed that amount, a special needs trust must be established for the person to supplement, rather than supplant, dollars for services rendered (Hinkle, 2004).

Dollar supports from the Office of Vocational Rehabilitation supplement the Medicaid waiver funds. Every state has a Division of Vocational Rehabilitation Services with the statutory requirement to afford its citizens employment opportunities. Vocational rehabilitation dollars for supported employment, as well as continuing education, can be used to supplement Medicaid waiver dollars. A graduating student with autism must petition the Division of Vocational Rehabilitation Services for such supports.

Once funding has been secured, it is time to determine the best and most appropriate employment opportunities. Identifying the person’s sensorial, social, behavioral and cognitive qualities, and analyzing available jobs to ensure that they will compliment the person’s profile, is important.

After a job has been identified and the proper supports have been put in place, constant monitoring and assessment is necessary. Remember that those with autism are more affected by seasonal changes and other environmental conditions in the workplace than others. As such, accommodations must be adjusted more frequently and with greater immediacy.

Progress Being Made

The needs for adults with autism in America are significant, and the capacity of agencies to meet those needs is not keeping up with the current demand, yet alone the projected significant demand increase, in the not too distant future. To this end, stakeholder groups such as ASA have increased their advocacy at the federal level to free up additional dollars to create greater service opportunities for adults with autism (ASA, 2001).

Additionally, service providers and their organizations also have increased initiatives to step up capacities going forward. The Office of Rehabilitation Services has just completed its 32nd Institute on Rehabilitation Issues (IRI) focusing on adults with autism and their employment needs (Dew and Alan, 2007); the International Easter Seal Society—which recently joined forces with ASA on service delivery for autism—also has increased its initiatives to secure expanded capacities for serving adults with autism (www.easterseals.com); and the Counsel for the Accreditation of Rehabilitation Facilities (CARF) recently completed its assessment of quality indicators for rehabilitation services for adults with autism.

The timing is right for petitioning local, state and federal government to secure appropriate adult employment services. And with hundreds of thousands of adults with autism who are unemployed or under-employed, it is interesting to note that “over, the next 10 years, a record number of people are set to retire, creating what experts expect will be a shortage of 10 million to 15 million jobs” (Michele Harris, 2007, The Erickson Tribune). The job market will have a huge void, and finding people to fill the void, will be a challenge. Adults with autism are able, and willing and, with proper supports, capable of meeting the challenge.

About the Author

Dr. David L. Holmes is board certified in forensic science, behavioral science and psychology. He is immediate past president and founder of The Eden Family of Services and the longest standing chairman of the Panel of Professional Advisors of the Autism Society of America. Dr. Holmes is currently the chairman and CEO of Lifespan Services, LLC, a full service consulting company established to help families and individuals with autism and related disabilities get what they need and what they are entitled to have. Lifespan Services has offices in Princeton, N.J. and Naples, Fla.