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Perspectives of the Healthcare Sector on the Disabled Workforce
Brigida Hernandez, Ph.D.
Katherine McDonald, Ph.D.
DePaul University
Study commissioned by disabilityworks
in collaboration with
David Hanson, Commissioner
Rosemary McDonnell, Project Coordinator/EO Officer
Mayor's Office of Workforce Development
Karen Tamley, Commissioner
Mayor's Office for People with Disabilities
Gerald Roper, President and CEO
Peggy Luce, Vice President
Chicagoland Chamber of Commerce
Karen McCulloh, Executive Director
Joe Chiappetta, Managing Director of the Chicagoland Provider Leadership Network
Jennifer Schindl, Managing Director of Chicagoland Business Leadership Network
Sarah Lawrence, Executive Assistant & Community Outreach
disabilityworks
Funded by the Illinois Department of Commerce and Economic Opportunity (Grant #02-79114). The opinions expressed here are of the authors and not necessarily of the funding organization.
Project Overview
Approximately, 54 million individuals have a disability. Although they represent one of the largest minority groups in the United States, the disability community experiences the highest rate of unemployment. Current figures indicate that 65 to 70 percent of people with disabilities are unemployed (National Organization on Disability, 2004; U.S. Department of Labor, 2005). Despite federal and state initiatives to combat this employment crisis, progress has been painstakingly slow.
Mayor Daley recognized that the Chicagoland area needed to take action and made the employment of disabled individuals a local priority. In 2002, he commissioned the Mayoral Task Force on Employment of Individuals with Disabilities (Task Force). This Task Force assembled leaders from the local city government, private businesses, not-for-profits, and universities to promote employment opportunities for people with disabilities. One of the initiatives that emerged from this Task Force was the Economic Impact Study (EIS), which aims to examine the economic costs and benefits associated with hiring people with disabilities. This study will involve approximately 24 businesses from three sectors (healthcare, hospitality, and retail) and will track and compare data on workers with and without disabilities across a number of variables (for example, tenure, absenteeism, and performance ratings).
The EIS involves five phases:
(1) Advisory Group: An advisory group for each business sector provides feedback on the research design and instruments, and assists with participant recruitment.
(2) Focus Groups: Participants attend a project orientation session, contribute to a discussion on their experiences with hiring individuals with disabilities, and coordinate a disability training session at their site.
(3) Survey Administration: Participants collect data on their employees with and without disabilities.
(4) Feedback on Results: Participants provide reactions to research findings.
(5) Education Campaign: Research findings are disseminated to Chicagoland businesses.
This report highlights findings from the Healthcare Focus Group (Phase 2), which explored their experiences with hiring people with disabilities. These data were collected in January, 2006.
Participants
Twelve individuals from seven hospitals were represented in the healthcare focus group. These participants included:
- Directors and Vice Presidents of Human Resources (6)
- Recruitment and Employment Specialists (3)
- Director and Assistant Director of Recruitment and Staffing/Career Services (2)
- President and CEO (1)
Most of the participants had been involved in the health care sector for several years, with only two participants having less than two years of healthcare experience.
In addition to the focus group, participants completed a brief survey on disability practices and procedures at their hospitals. One survey was completed per organization for a total of 6 surveys (1 organization did not complete the survey). From the surveys, we learned
- Individuals from five organizations reported being very knowledgeable about the ADA (83%)
- Three sites offered ADA training to their managers (50%)
- One company offered ADA training to their employees (17%)
- Four sites had an ADA compliance officer, department, or division (67%)
- Three sites had a reasonable accommodations policy (50%)
After completing the survey, participants took part in a focus group that lasted approximately 90 minutes. Focus group questions explored:
- recruiting, interviewing, hiring, retaining, and promoting people with disabilities
- providing accommodations for disabled workers
- perceptions of costs and benefits associated with the disabled workforce
A verbatim transcript of the focus group was produced and analyzed to identify core themes. As a reminder, participants in the focus group were generally associated with upper management in Human Resources.
Findings
Disabled Workforce in the Healthcare Sector
Focus group participants reported that most of their known disabled workforce was employed in entry level and semi-skilled positions (for example, clerical, food service, environmental services, and laundry), with only a few people with disabilities in professional positions. Participants speculated that professionals with disabilities might be employed outside of the healthcare sector, where they are likely to receive higher pay.
Recruiting Individuals with Disabilities
The Usefulness of Disability Employment Agencies
Several participants highlighted the value of working with disability employment agencies. These agencies were instrumental in identifying qualified applicants with disabilities and providing job support.
In fact, five hospitals had existing relationships with disability employment agencies. These participants felt that success was more likely when such agencies were in continual contact with hospitals and when they brought forth well-qualified applicants with disabilities.
Interestingly, participants noted that individuals with disabilities did not typically apply for jobs independent of their affiliation with a disability employment agency (or at least they were not disclosing their disability status to their employer). Therefore, most of their disabled workforce came from employment agencies.
The Need for Disability Champions
Participants spoke about the need to have "champions" who actively advocate for the inclusion of people with disabilities in the workforce. Such champions were considered vital for cultivating a culture of diversity. In addition, participants expressed that a critical mass of champions was needed and these individuals should have substantial power and influence in the organization.
The Persistence of Manager Bias
Despite disability legislation and training, most participants felt that bias against people with disabilities persisted among managers in their hospital. Participants believed these managers were reluctant to hire disabled individuals and tended to have unfounded concerns about supervisory time demands and budgetary strains related to providing accommodations.
According to participants, when managers have had actual experiences with disabled workers, positive experiences often counteracted their biases. However, if there was a negative experience with a disabled worker, some managers focused on and unfairly generalized it to the entire disabled workforce, thereby reinforcing their bias.
"When you meet somebody through an organization and they get support, you seem to have more success."
"There has to be a champion in the organization and the champion doesn't always have to be the CEO, but the champion has to be somebody that can gravitate and bring in formal power to the organization."
"We have to somehow help the managers with both of those, to get beyond the speaking disability and get to the person's skills somehow."
Interviewing Individuals with Disabilities
Concerns with the Legal Aspect of Interviewing Applicants with Disabilities
Participants expressed concerns about appropriate and legal questions to ask of applicants with disabilities. Participants whose organization had less disability experience were more likely to express this concern. A lack of knowledge and understanding of the Americans with Disabilities Act (ADA) may have contributed to this issue.
Discussing the Need of Accommodations with Disabled Applicants
Job descriptions were viewed as a useful tool to discuss accommodation needs with applicants. Specifically, applicants were asked to review the job description to determine whether they can perform the essential functions of a job. Typically, these conversations have been easier with individuals who have visible disabilities because they are more likely to disclose their disability and discuss their accommodation needs.
Having Individuals with Disabilities in the Workforce
Successes and Challenges
Overall, participants reported positive experiences with hiring people with disabilities. In some instances, the support of job coaches and/or vocational rehabilitation services helped disabled employees succeed in their positions.
Participants also noted a few cases where workers with disabilities were unsuccessful in their positions. Problems that arose were often unrelated to the disability per se and more related to employees' work habits and skills. Unfortunately, when these experiences did emerge, participants felt that managers had a tendency to focus on and relate them to the disability. Therefore, a critical mass of employees with disabilities in the workplace was viewed as essential to combat manager biases.
Providing Accommodations
Participants noted that the majority of employees with disabilities did not need accommodations. One participant shared results of a survey that was conducted with individuals who had received vocational rehabilitation services at her worksite; this survey found that only 4% required an accommodation. Other participants were surprised to learn of this number and expressed the need to share such information with management, particularly given their unfounded concern that accommodations would be costly.
Participants also noted that managers seemed more receptive to providing accommodations to existing employees than new employees. Having existing relationships seemed to facilitate managers' responses to employees' needs.
"Also, I think it is scary ... you are afraid that you are going to be charged with discrimination."
"I think what is more difficult for me is someone with a hidden disability and someone who may not be as forthright about talking about talking about what kind of accommodations, or disclosing their disability and kinds of accommodations might help them."
Costs and Benefits of Hiring Individuals with Disabilities
Costs
Despite manager concern that accommodations may be costly, participants reported that these costs were typically minimal and under $500. Further, costs incurred were viewed as monetarily worthwhile, given disabled employees' loyalty and retention.
Participants also noted that they were uncertain about costs associated with health insurance. Participants viewed this particular concern as more relevant for small employers. In addition, participants felt that managers with the authority to hire were not so concerned about healthcare costs because typically these costs did not impact department budgets.
Benefits
According to participants, employing people with disabilities has brought many benefits, including employees with low absenteeism rates and long tenure. Participants also reported that employing disabled workers has the added value of diversifying their workforce, which often has had a positive impact on co-workers and clients seeking services from their facilities. Given that hospitals often have patients with disabilities, employing people with disabilities has sent a positive message of independent living and community inclusion.
"I think [the assumption of the high costs of accommodations is] a myth, by and large."
"I think that [accommodation costs are] an easy crutch."
"They are the people that show up when it snows, when other people have a tendency to call in sick."
Promoting Individuals with Disabilities
Participants reported that most of their employees with disabilities did not seek promotions within their organizations. Instead, it was more common to see them move from part-time to full-time positions, a clear gain for both employees and employers.
Participants speculated that reasons for not seeking promotions might include:
- Lack of opportunities for promotions within an organization.
- Employee concern with the accessibility and work environment of new positions.
- Employee concern with new probationary periods that come along with new positions.
- Manager bias inhibiting promotion opportunities for workers with disabilities, even when these workers have received positive performance reviews.
"The risk is greater for someone with a disability to move out of [a current position] than for someone without." Recommendations
Based on findings from the Healthcare focus group, a number of recommendations are suggested:
1. There is a great need for ongoing information and education on disability issues and the Americans with Disabilities Act. Although some participants offer such a training already, it appears to not be enough as legal questions persist.
2. To increase employment opportunities for workers with disabilities, a critical mass of "champions" is needed to advocate and promote the disabled workforce. Ultimately, the work of these champions should translate into a broad organizational culture that values the diversity of their employees, including those with disabilities.
3. Manager biases have a strong impact on the hiring of people with disabilities, and they need to be addressed. Positive experiences with the disabled workforce help counter these biases, and they should be actively sought and encouraged by organizations.
4. Concerns with the costs of accommodations persist, despite evidence that costs are minimal. Thus, there is a need to disseminate accurate information associated with accommodation costs.
5. Advocacy and outreach by disability employment agencies needs to continue (especially when good candidates with disabilities are available). However, hospital recruitment efforts should also focus on outreach to qualified disabled applicants, who are not associated with these agencies.
6. Given that most known individuals with disabilities were employed in semi-skilled positions, companies might also derive benefit from focusing their recruitment efforts on professionals with disabilities as well.
