Tuesday, September 27, 2005

Customized Employment: A Winning Strategy for Somali Refugees with Disabilities

Editors Note:

Customized employment is designed to meet the job placement and support needs of people with complex lives. This includes individuals with significant disabilities and others who experience extraordinary challenges in finding competitive employment through a traditional job search approach. As I have shared in many other posts, an unacceptably high percentage (65-70%) of Americans with significant disabilities are unemployed in the United States (and presumably the world!).

People with disabilities often lack the job skills or necessary work experience they need to qualify for advertised employment vacancies. Further, many are unable to perform all standard duties in standardized job descriptions without some customization of functions. Still others may need physical workplace modifications or other types of accommodations during the hiring process (i.e. interpreting or translating assistance) to support them in obtaining competitive employment and performing essential job functions.

The concept of customizing employment was introduced to level the playing field and support people who want to work in finding competitive jobs in the local workforce. By design, customized employment offers a range of strategies to uncover the work interests and talents of people who are considered the most challenging-to-employ. Customized employment also features direct employer marketing and job development methods that engage a negotiation of job duties so businesses can employ these unique talents.

Therefore, customized employment often involves marketing and persuading business leaders to consider a restructuring of position duties or perhaps creating new positions to better match the skills of job seekers who live with complex disabilities and other job barriers. The customization strategy can also include a refining of hiring practices, job training techniques, or introducing other supports to enhance the employability of job seekers with unique work abilities.

The majority of stories shared on this blog thus far summarize my company’s experiences in finding or creating jobs in support of people served within the vocational rehabilitation, community rehabilitation, mental health, or adult day training and habilitation (DT&H) service systems in Minnesota. However, many people with diagnosed and undiagnosed disabilities are also served in Minnesota’s welfare system as well. The following article illustrates a model of customized employment used by a program that meets the unique job placement challenges of Somali refugees with disabilities who recently migrated to Minnesota.

This program entitled Somali Employment Solutions (SES) received a national award from the National Organization of County Organizations (NACO) for its successful customization of employment services for welfare recipients in Hennepin County, Minnesota in 2004. I recently interviewed two of our key managers for this program, Mr. Truc Pham, Director of TANF and Welfare-to-Work Services, and Ms. Amina Gesale, SES’s Program Manager, so they could share with others what has made SES a leading edge welfare-to-work program.
Lavin: “According to our State demographer, Minnesota has become the new home to 14,000 Somali refugees in the last five years. However, we know this data is a vast underestimate of the actual number of Somalis who have actually resettled here due to “secondary migrations” from other states. We are now hearing estimates that more than 30,000 Somali refugees now live in Minnesota with the largest concentrations being here in Twin Cities. This is by far the largest Somali community in the United States. My question is this: What is Minnesota doing to support this large migration of refugees into the Twin Cities area?”

Gesale: “Many Somali refugees are enrolling in local welfare as well as community resettlement programs to help them find affordable housing, adjust to life and cultural changes in their new homeland, and find competitive employment to support themselves and their families. After escaping a decade of civil war in Somalia and living in refugee camps, many Somalis experience traumatic memories, flashbacks, depression, and anxiety. Sadly, many Somali adults and children witnessed the murder or starvation of family members and friends during the war. Often Somali women and men endured torture or rape, both of which were widely used as a means of terrorizing the population. For these reasons, many Somali refugees now struggle with mental health conditions due to living through these highly emotional and traumatic life events. The Minnesota Department of Human Services (DHS) and local county welfare agencies, particularly Hennepin County, began to realize that many of the refugees were dealing with post-traumatic stress syndrome, major depression, anxiety disorders, and other mental health concerns upon their arrival.

Pham: “Many cultural, language, educational, and socio-economic factors block refugees from gaining access to mainstream mental health, chemical health, and psychological support services they desperately need to be successful. Unfortunately, there are so few culturally-appropriate, diagnostic testing resources available in the Twin Cities to support Somalis with disability assessment or testing services. This is critical to connecting people to suitable mental health treatment or rehabilitation services they need because access is typically based on disability eligibility criteria. Due to cultural and social stigma in the Somali community, there is also a lot of denial or embarrassment in admitting the presence of a psychiatric or substance abuse condition.”

Gesale: “But to say it simply, most mainstream community services did not have the educational outreach services nor language or cultural expertise to offer cross-cultural, diagnostic assessment and psychological testing for Somali individuals. For this reason, Rise formed an interagency alliance with two other community organizations named the Confederation of Somali Community in Minnesota (CSCM) and the Community University Health Care Center (CUHCC) at the University of Minnesota. Together, our three agencies are offering targeted outreach education, acculturation support, welfare assistance, career planning, job placement, customized employment, and ongoing supported employment for Somali refugees experiencing mental health symptoms.”

Lavin: “What does each partner do to customize services and make Somali Employment Solutions such a successful and award winning program?”

Pham: “In 1999, Hennepin County adopted a Strategic Diversity Plan promoting a goal of cultural congruence. This Strategic Diversity Plan supports: (1) recruiting and retaining staff who reflect Hennepin County’s culturally-diverse population; (2) ensuring direct service providers are culturally-competent; and (3) using performance measures that reflect the importance and value of diversity in delivering day-to-day services. In the spirit of this diversity plan, our three organizations formed a partnership with a shared vision to combine our interagency expertise and resources to meet mutual goals. SES is the outcome of this interagency vision. Our collaborative project was funded by Hennepin County in a competitive grant competition called Work Incentives & Solutions to Employment or WISE.”

Gesale: “In this partnership, CSCM offers its expertise in providing educational outreach to Somali refugees arrivals to inform them about SES and our job placement services. CSCM offers education about mental illness recovery, community mental health services, and why it is OK to get treatment and go to work just like a physical medical condition. CSCM also offers education about western culture, making cultural adjustments to transition successfully in their new homeland, and learning about American work ethics including the goal of family self-support.

“CUHCC offers cross-cultural diagnostic assessment and testing services to all referred refugees who are exhibiting symptoms of a serious mental illness (SMI). Most psychological service agencies have huge challenges serving Somali refugees due to language difference and cultural barriers. CUHCC, however, employs trained mental health professionals who can speak the native languages of refugee groups. They are also knowledgeable about cultural and religious norms. And they are trained to identify symptoms of SMI requiring professional attention including the need for individual therapy, or perhaps, medication treatment to better control illness symptoms.”

Pham: “At Rise, we handle the job placement and employment focus of our partnership. We offer coordinated welfare assistance, employment and career planning, job development, transitional employment, customized employment, and ongoing supported employment to assist our participants in taking steps to self-sufficiency outcomes. SES staff can speak the languages of Somali refugees and they are astute in the refugee acculturation process. In fact, many of Rise’s welfare-to-work managers and staff are former refugees themselves. This knowledge is very important to educating employers about specific cultural or religious understandings and transitions that are crucial to community assimilation and workplace integration.”

Lavin: “What are the objectives of SES? How is this program making difference in offering employability services to Somali refugees with mental health disabilities?”

Pham: “SES has five core project objectives: (1) connecting Somali welfare recipients with cross-cultural diagnostic assessment and testing services; (2) offering seamless connections to community mental health treatment and rehabilitation programs based on documented disability eligibility; (3) providing education and advocacy support to assist some participants in accessing Social Security disability benefits where appropriate; (4) offering job placement, transitional employment, and customized employment services for 25 Somali refugees with SMI annually to increase competitive employment, wage, and self-sufficiency outcomes; and (5) assisting businesses to build their internal capacities to train, supervise, and support their Somali employees through education and technical assistance.”

Gesale: “The SES alliance is creating a new service network to address our community’s emerging need for culturally-appropriate, diagnostic assessment and testing services. Refugees are referred to SES by either Hennepin County or one of 23 TANF or welfare-to-work providers serving the local area. We recognize that unless SMI is treated effectively, it will negatively impact on the acculturation process and abilities of refugees to obtain competitive employment. Also, since many Somali refugees speak English as a Second Language (ESL), we hired bilingual staff to assist with communications and translation assistance with the career planning and job interview process.”

“Education is key to our success. Many women do not work in Somalia, so identifying job skills and going to work is whole a new way of thinking for many of them. Still, many other refugees need extra time and assistance to determine what interests and skill sets to market here in America because their education or training prepared them for working in a country with a completely different economy and set of employment standards.”

Pham: “For very this reason, SES uses transitional employment strategies for some participants to introduce fundamental work concepts, teach job skills, and build employment references right away. This is only offered for individuals who are uncertain about their job goals or those want to go to work as soon as possible. Since Rise observes person-centered principles, we are always looking to place people in jobs that match their specific interests and skills. In short, we are always searching for opportunities to assist our participants with job progression and building skills to promote career advancement and better wages. This is fundamental to reaching self-sufficiency goals”

Lavin: “In what ways is SES helping employers with their recruiting and hiring practices?”

Pham: “SES helps employers in several ways. We employ trained job developers who know the Twin Cities’ job market very well. They work with Somali participants to support them with their career planning and finding the right job. Our job developers also work closely with TANF (Temporary Aide to Needy Families) counselors. They help pave the way to successful employment outcomes by identifying and removing known personal and employment barriers such as child care or transportation assistance. In other words, we know all of the people we are placing very well. For this reason, we can help businesses match job placement candidates with the right jobs, working environments, and supports they need.”

“All SES staff know Somali language and culture, so they are able to help employers communicate effectively with job seekers who have limited English proficiency (LEP). This is essential to building the internal capacities of employers and helping both parties communicate effectively concerning work policies, supervisory expectations, etc. SES staff also educates employers and co-workers about Somali customs and practices. For example, most Americans don’t understand about the unusual dress customs of Somali women or Muslim religious practices. Our staff help all people in the workforce to learn more the cultural similarities and differences of Somali people. Finally, SES staff are also trained in customized employment principles and strategies so they are able to market the unique talents of welfare recipients who want and need to go to work.”

Gesale: “SES is developing multiple paths to employment for welfare recipients with disabilities. We can support people in the welfare-to-work system if they prefer or refer them for community rehabilitation services so they can access supported employment services. The excellent diagnostic assessment support through CUHCC helps SES to open opportunities to effective mental health treatment and determining eligibility for supported employment. Many of these services are fundamental to mental health recovery, acculturation, and successful job placement outcomes. To summarize, we can offer employers a range of front-end technical assistance and ongoing support to help with hiring, supervision, training, or addressing the career development needs of their Somali employees with disabilities. It’s a win-win strategy.”

Lavin: “Can you share one story with me about how SES has customized employment services for an individual?”

Gesale: “Well, we have placed more than 60 people in our three years of program operations so it is hard to pick just one. However, Fatima’s story comes to mind. Fatima and her family came to the United States as political refugees from Somalia in 2001. After arriving, she experienced many of the challenges associated with being a refugee in a new country. She didn’t speak the English language very well, she needed assistance in finding a place to live, and her family needed a lot of guidance from government agencies and the Somali community to become acclimated to her new homeland. Fatima was referred by Hennepin County for welfare assistance and she was assigned to the TANF program located at Lutheran Social Services (LSS) in Minneapolis.”

Pham: “Fatima was referred to SES by her TANF counselor at LSS. This counselor was concerned about possible symptoms of depression and mental illness as well as Fatima’s need for treatment to guide a successful job placement process. She received counseling assistance on many levels from her TANF counselor to address her needs for self-support. This includes assistance with affordable housing, childcare, family budget planning, transportation, and enrollment in ESL classes to learn functional English skills. SES referred Fatima to CUHCC for a mental health diagnostic assessment to determine if the observed symptoms were indicative of a SMI. CUHCC’s mental health professional determined that Fatima was living with Major Depression and Post-Traumatic Stress Disorder (PTSD), two common diagnoses for refugees who flee war and political persecution.”

Gesale: “Once her diagnostic assessment was completed, a mental health treatment plan was developed to support Fatima in managing her mental illness symptoms. The treatment plan included individualized therapy and medications to help reduce the symptoms of clinical depression and PTSD. Rise’s SES staff worked one-on-one with Fatima to assist her in choosing a suitable job goal. In examining her interests and skills, we found she had a strong interest in working with people and becoming involved in the health care professions. The possibilities of becoming certified to work in human services as a personal care attendant were researched with her and local business organizations. Fatima was excited about the idea of working in the health care industry and set an employment goal to become a certified personal care attendant (PCA). She studied to take the state exam and was provided tutoring assistance to assist in understanding English terminology.”

Pham: “One of the exciting things about Fatima’s case is that our staff took a possible negative and transformed it into a positive asset. To illustrate my point, Fatima’s grasp of the Somali language became a positive asset because she was able to market this helpful skill to personal care attendant organizations. With a rapidly growing Somali population in the Twin Cities, this skill gave prospective employers a trained PCA worker who is already knowledgeable about Somali language and culture. When we combined her language and cultural skills with health care training and certification, it made Fatima’s resume’ a distinctive and a highly marketable asset to prospective employers.”

Gesale: “To make a long story short, Fatima passed her exam and has been working for a PCA firm for almost one year now. She loves her job and she is assisting others from the Somali community with their health care support needs. Fatima’s family is doing very well and they are gradually becoming more acclimated to their new life in the Twin Cities. Her children are attending local schools in the Minneapolis area and the family is steadily moving forward toward increased self-sufficiency. Fatima is now managing her mental illness recovery on her own with clinical supervision from her mental health professional. And she continues to receive supported employment services from Rise. Recently, she told me that our SES program gave her hope and a fresh start in her newly adopted homeland. We are very proud of creative partnership SES brings to change people’s lives.”

Lavin: “My congratulations to the two of you, the SES staff, and our outstanding partners at CSCM and CUHCC for a job well-done. The national recognition that SES has received is certainly well deserved. Also, it is quite flattering that the nomination for this national award came from Hennepin County, the funding partner of SES. It speaks volumes.

Pham: “Thank you. It just goes to show you what can be accomplished when organizations work together toward a common goal.”

Gesale: “Thank you. We will share your kind remarks with our staff and partners at CSCM and CUHCC.”

For more information about the Somali Employment Solutions (SES) program, contact Amina Gesale at agesale@rise.org or Truc Pham at tpham@rise.org. For more information about the Confederation of Somali Community in Minnesota (CSCM), please visit their web site at http://www.cscmn.org/xoops/modules/news/. Information about the mental health services provided at the Community University Health Care Center (CUHCC) is available on their web site http://www.ahc.umn.edu/cuhcc/


Anonymous Blue Cross of California said...

Health care is a major importance to many and we should work to get everyone covered.

4:51 PM  

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