Cincinnati’s Children’s Hospital Shares a
Unique Model to Tap into the Talent of People with Significant
Disabilities
In the United States only about 30%
of people with significant disabilities, many of those having
cognitive disabilities, are employed. Typically employers look
at that situation and conclude that it is because people with
significant disabilities aren’t capable of being productively
employed. This is not true, however, of Erin Riehle, nor the
other employees of the Cincinnati Children’s Hospital Medical
Center. Their experience over the past ten years has
dramatically changed their beliefs, changed their hiring
practices, and allowed them to benefit from the talents of a
formerly overlooked workforce.
Through an internal program called
Project SEARCH, Children’s Hospital has developed a model of
training and support that has enabled numerous people with
significant disabilities to become productive and valued
employees – many of them performing jobs with a level of
complexity that has far surpassed anyone’s expectations. Part of
their mission is now to share this example of best practice with
other businesses.
Erin Riehle is the Director of
Project SEARCH and she readily accepted our invitation to be
interviewed for this article in Inclusion@Work.
OBLN: Erin,
let’s start at the beginning. Can you tell us how Cincinnati
Children’s Hospital began Project SEARCH?
Erin
Riehle: Almost eleven years ago now, I was director of the
emergency room here at Children’s. I had a lot of entry-level
positions and high turnover was a problem. The folks that I
hired just weren’t staying long. Clearly these positions weren’t
careers or even long-term jobs for them, but transition jobs or
just something to add to their resumes.
At about the same time, I realized how
much of the hospital’s business was devoted to providing medical
care to children with chronic illnesses and disabilities. Back
then, I didn’t know much about people with disabilities but it
occurred to me that we should try to hire some of them for these
entry-level positions. It was really just putting one and one
together to see if it might work out.
When we started, I hired one person to
stock the emergency department. We weren’t certain she could do
it and neither were the folks from the community agency that
supported her. There are 58 rooms in our emergency department.
In every room, there are a series of cabinets and carts. All of
the cabinets and carts have equipment in them. Every day, that
equipment has to be restocked to the correct number of items in
each place– not more, not less. There are hundreds and hundreds
of items that have to be accurately stocked daily.
Within three months, this woman, who
happened to have Downs Syndrome, was doing such a stellar job
that other departments were hearing about it. I received a call
from the dental clinic asking if she might be able to do a far
more complex job for them. She was soon hired into the dental
clinic and transferred. Shortly after, we began to hire other
people with disabilities to work in the emergency department and
throughout the hospital. We pay every employee the prevailing
wage for each job.
The people with disabilities who work
here have become role models for our patients and their
families. They have also helped us see our patients in a
different light – not just as patients, but as young people who
can one day be productively employed adults.
OBLN: A lot
of other companies have implemented programs to employ people
with significant disabilities, but have not experienced the kind
of success that you have. What makes your model different?
Erin Riehle: There are a couple
of things that are really different about what we do. Number
One: Instead of taking a person with a disability from every
agency in town that wanted to send us one, we decided to partner
with only two agencies and develop a working relationship with
them – so that they learned to understand our business and we
learned to understand theirs. That strategy set us apart from
the beginning and has turned out to be a great business model.
Secondly,
we decided early on in our program that we were not going to
hire people for the types of jobs that people with disabilities
have typically been hired for. We were aware that 60% of people
with significant disabilities work in food services, grounds
keeping and similar stereotypical jobs. We didn’t open up those
types of jobs.
Having said that, if a particular
individual wants to work in food service, we know that it is
absolutely honorable work and if that is what they want, that is
what they should do. We just don’t assume that the first place
that we should look for a job for someone with a disability is
in the kitchen.
We wanted to break out of the mold,
however, and focus on jobs that were complex, but systematic.
That has led to very different job placements and very different
mindsets about what people with significant disabilities can do.
OBLN: Can
you tell us some more about how your success relies on limiting
your suppliers/partners to only two agencies?
Erin Riehle: What we have found is that
it is not that people with significant disabilities cannot do
complex difficult work. It is that the way they are typically
supported by community agencies does not allow them to learn on
a consistent and constant basis.
If I was a person with a disability
employed through a traditional placement program, program staff
might come back a couple of times a month to follow up and see
how I am doing. The problem is that my job is going to change a
lot more frequently than that. Today I might be using a Myers
abbocath but tomorrow I might get an email saying I need to
switch to an Abbot abbocath. I may have been doing a really good
job at stocking equipment and doing what I was taught, but I am
going to have to respond to daily and weekly changes. If I am
relying on support from a person who is just dropping in
periodically to check on me, I’m never going to be able to keep
my job.
Instead, our partner agencies have two
full-time staff here on site to support all of their folks
working here. When emails go out to department heads saying that
we are going to switch abbocaths today, the staff from our
partner agencies also get that email and know to go down to the
emergency department and make sure that the employee knows to
switch abbocaths today. This way, because we have support staff
right on site, we can keep people on jobs that are complex and
that change frequently.
OBLN: If I
am a manager who is now employing someone with a significant
disability in my department and I run into a performance issue,
how would I respond?
If you are their direct supervisor, you
are ultimately responsible for that employee – just as you would
be responsible for any other employee. However, you would be
able to contact the in-house support staff and discuss possible
ways to resolve the situation – like new ways of interacting
with the employee, additional job coaching needs, more education
for the rest of the staff, additional accommodations or
adaptations – all of those things.
OBLN: I
understand that much of your hiring success is based on an
internship program that you developed. Can you tell us about
that?
Erin Riehle: Within the first
year, we worked with one of our partners to set up a high school
transition program. Twelve students with a teacher and some job
coaches spent an entire school year within a business here. We
started with that one class and we now have classes here in
southwest Ohio at eight different businesses - Children’s
Hospital, Mercy Hospital, Fifth Third Bank, Xavier University,
Clinton Memorial Hospital, Otterbein Retirement Village,
Middletown Regional Hospital, and Hamilton County Park District.
We have a teacher and twelve students at each site – a total of
ninety-six students.
Over
the course of the school year, the students rotate between three
to four sites within their business. They are learning complex
and systematic jobs and becoming part of that business culture.
These students have to dress like us. They come to work each
morning and leave there each afternoon. They never go to another
school site. This is their whole experience.
This is not high school. This is an
adult transition experience for them, with the expectation that
they are going to learn the skills necessary to be employed. We
are serious about it. They aren’t studying academics. They are
only studying employability skills and work skills. They use our
evaluation forms and our discipline forms.
There is an important quote fixed to my
bulletin board. In 1998, Stephen Simon said; ‘People with
disabilities have a right to choose a path towards education and
employment. However, while freedom of choice is given, the right
to work is earned. Earning the right to work is dependent upon
the student’s preparation.’ To us, that means that people with
disabilities have the right to become educated and employed but
they also have the obligation to become prepared. Part of that
obligation is to seek training. We are a training program and,
here in Cincinnati, we are impacting ninety-six kids.
The ultimate goal of this internship
program is employment for the students. Our success rate is 84%.
This is a program for people that really want to be employed –
and it works.
OBLN: For
participating businesses, has this internship model proven to be
an effective way to recruit new employees?
Erin Riehle: If our business
tried to work with every agency in town to hire a person here or
there, we might have two or three employees with significant
disabilities. They wouldn’t be supported well enough to keep a
complex job and they would really be almost like token
employees. Those numbers are not enough to change culture or
practice.
However,
when you take twelve student interns and, in the course of a
year, move them through three to four departments where they are
learning real skills, you immediately begin to change culture in
an organization. You make it more acceptable to consider a
person with a significant disability as becoming a permanent
part of that environment. Although there is no requirement to do
so, our businesses themselves hire about 30% of the graduating
students.
OBLN: You
are very proactively recruiting people with disabilities for
your jobs, you are focusing on jobs that are complex and
systematic, you are contracting with a limited number of
suppliers, and you have on-site job support. Is there anything
else that makes your model stand out and makes it successful?
Erin Riehle: It is a business
model. It is focused on the needs of the business. For instance,
we don’t go to HR and say, “Hey we’ve got Billy here. Do you
have any jobs for Billy?” Instead, we go to HR and ask them what
jobs are open and we look for candidates that are interested in
the job and that can do the job.
OBLN: Erin,
Western Washington University is bringing you to Oregon this
January to speak on
The Business Case for Employing People with Disabilities.
What messages do you intend to bring to employers here?
Erin Riehle: I will be speaking
about how we have discovered the incredible value, on many
levels, of hiring people with significant disabilities. It will
be about shattering the myths about what people with significant
disabilities are and are not capable of. It will be about
universal design and how anything you put in place for an
employee with a disability benefits your entire workforce. I
will be sharing a business model that is driven by the business
and makes good business sense.
The
Project SEARCH graduates have been hired to work in a variety of
departments doing filing, data entry, mail sorting and delivery,
call center support, document scanning, etc. One of these
employees is now the main front desk receptionist for
their Central Operations Center. Another employee has excelled
in a data-entry position – averaging 12,000 keystrokes vs.
7,000 keystrokes for typical employees. This program has
diversified our recruiting strategy by expanding our pool of
talented candidates. 
But
the future seemed uncertain for Rick when he was born. The
remarkable story of these two champions is captured in a
4-minute online video at