From Employment Optional to “Employment First”: Explaining Two Cases of State-level Disability Policy Change

Under the label “Supported Employment,” services that promote competitive, integrated employment (CIE) for working-age adult with intellectual and developmental disabilities have been federally funded since the 1980s, alongside other more traditional day habilitation and segregated or sub-minimum wage employment services. However, since the early 2000s, over 30 states have adopted “Employment First” policy, prioritizing competitive, integrated employment (CIE) as the preferred outcome, and in some states, restricting alternative service options. And while disability researchers have made a considerable effort to understand system-level determinants of participation in CIE-focused services, little attention has been paid to the political factors driving these major changes in the overall policy mix. Moreover, the Employment First changes, which have attracted little public attention or controversy, vary considerably across states in timing, form and content, leading to the study’s main research questions: 1) what do these policy changes look like; and 2) how can we explain both the occurrence of major policy changes and the variations in timing? The study uses primary and extant data in a two-case comparative approach, finding that major shifts in the policy mix were associated with similar combinations of subsystem attention and coalition-based activity, including stakeholder mobilization and strategic use of framing and narrative, as well as heightened political attention and bureaucrat advocacy. Moreover, the timing differences are related to coalition defection by members of the service provider community and high pre-existing participation in supported employment services, which suggest a degree of path dependence in observed policy changes.