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- Ensuring sustainable employment outcomes for people with serious and persistent mental health conditions and substance use conditions.
- Effects of COVID-19 on the Texas economy and workforce, and especially on those with mental health conditions.
- Lack of ongoing federal financial assistance for people impacted by the COVID-19 pandemic.
- Establishing accountability for outcome-based vocational rehabilitation services for individuals living with serious and persistent mental health conditions
- Lack of available information and data regarding employment outcomes for people experiencing mental health conditions.
- Long wait times for people seeking assistance accessing unemployment benefits through the Texas Workforce Commission.
- The Texas unemployment rose from 2.5 percent in February 2020 to 13 percent in May 2020 and 8 percent in July 2020. The national unemployment rate went from 3.5 percent in February 2020 to 13.3 percent in May 2020 to 10.2 percent in July 2020. These numbers were impacted significantly by the COVID-19 pandemic. The unemployment rate is the ratio of the population that is unemployed and seeking employment to the current labor force.
- During a month-long period from May-June 2020, over 291,000 jobs were added into the Texas economy.
- A June 2018 TWC report indicated that there were about 1.5 million Texans aged 18-64 (standard working age-range) who had a disability.
- The national and state unemployment rates do not always reflect the prevalence of unemployment for people with serious mental illness or intellectual and developmental disabilities (IDD). The National Alliance on Mental Illness (NAMI) reported that the national unemployment rate for individuals receiving public mental health services was approximately 80 percent in 2012. The same year, the unemployment rate for individuals receiving services through the public mental health system in Texas was 85.6 percent.
- In 2018, about 40.2 percent of Texans with disabilities living in the community (ages 18-64) were employed compared to 76.4 percent of people without a disability. In the same year, the national unemployment rate for people with a disability was 8 percent, over twice that of people without a disability who had a 3.7 percent unemployment rate.
CDC – Center for Disease Control
COVID- 19 – Coronavirus disease of 2019
FUTA – Federal unemployment tax
HHSC – Health and Human Services Commission
IDD – Intellectual and other developmental disabilities
NAMI – National Alliance on Mental Illness
SEAL – Summer Earn and Learn
SNAP E&T – Supplemental Nutrition Assistance Program Employment and Training
TANF – Temporary Assistance for Needy Families
TVLP – Texas Veterans Leadership Program
TWC – Texas Workforce Commission
VR – Vocational rehabilitation
Source: Texas Workforce Commission (2020). Organizational Chart. Retrieved from https://www.twc.texas.gov/files/agency/agency-organizational-chart-twc.pdf
The Texas Workforce Commission (TWC) is the state agency charged with overseeing and providing workforce development services to both employers and job seekers across the state. TWC works toward the end goals of the Governor’s economic development strategy by providing the needed workforce development component. Three commissioners are appointed by the governor to represent the agency, each assigned to represent labor, employers, or the public.
TWC’s major functions include:
- Developing the workforce;
- Providing support services, including child care, for targeted populations participating in workforce training; and
- Administering the unemployment benefits and tax programs.
TWC is part of Texas Workforce Solutions, a local and statewide network comprised of TWC, 28 Workforce Development Boards, and their contracted service providers and community partners. Workforce Development Boards allow for regional planning and service delivery. Through this network, TWC reaches consumers at the local level in Workforce Solutions offices across the state and five Tele-Centers.
Texas Workforce Solutions provides workforce development services that are intended to: 1) help consumers find and maintain employment, and 2) help employers hire the skilled workers needed to conduct business. Workforce partners include community colleges, adult basic education providers, local independent school districts, economic development groups, private businesses, and other state agencies. Collaboration and coordination across these various stakeholders are both necessary to meet TWC’s overall mission to “promote and support a workforce system that creates value and offers employers, individuals, and communities the opportunity to achieve and sustain economic prosperity.”
Source: Texas Workforce Commission. Retrieved from https://www.twc.texas.gov/
Individuals with disabilities, including serious mental health conditions, often experience barriers associated with joining and participating fully in the labor force (for a list of what TWC’s use of the term “disability” encompasses, see here: https://workquest.com/wp-content/uploads/2018-Disability-Determination-Worksheet.pdf). People with disabilities are more likely to work part-time and, on average, earn less than individuals without disabilities at every level of educational attainment. Because of the unique challenges individuals with disabilities face in the job market, national and state-level unemployment rates do not always reflect the prevalence of unemployment for people with serious mental illness or IDD. NAMI reported that the national unemployment rate for individuals receiving public mental health services was approximately 80 percent in 2012. The same year, the unemployment rate for individuals receiving services through the public mental health system in Texas was 85.6 percent. Yet for persons living with serious mental illness, employment can play a primary role in recovery and well-being. In 2014, The Bazelon Center for Mental Health Law reported that at least two-thirds of people with a serious mental illness want to work, and many have been previously employed.
In 2018, about 11.4 percent of citizens in Texas, or over 3.2 million people, had a disability. This was the second largest total number per state in the nation. Individuals with disabilities, including serious mental illness, can enhance workforce diversity and offer employers unique skill sets and perspectives when integrated into the labor force. Employing people with disabilities is advantageous to businesses as it results in lower turnover, increased productivity, and access to a wider pool of skilled workers.
For those experiencing mental health conditions, employment can promote social acceptance and community integration that leads to lifelong recovery and wellbeing. Work also gives people a sense of purpose, self-esteem, and self-worth. The Center for Disease Control (CDC) has multiple recommendations to manage mental health and stress in the workforce. They have proposed that healthcare providers ask patients about depression or anxiety, and that health professionals be part of core treatment teams. Public health researchers can create guides that outline the implementation and evaluation of mental health programs in the workplace, including the development of mental health scorecards for employees to rank their workplace and employee training and recognition programs. The CDC recommends community leaders and businesses promote mental wellness through educational programs to working adults through different agencies, support existing community programs that reduce risks of mental illness, and establish a system to easily access these community-based programs. The Texas Legislature is encouraged by the CDC to provide resources, coursework, and decision-making tools to organizations and employers delivering mental health education. In addition, the CDC recommends that the state collect data on workers’ wellbeing and on biomedical research to guide mental health innovations, and to promote techniques to help people in underserved communities to obtain mental health treatments.
Read about the TWC and their 2019-2023 Strategic Plan here https://twc.texas.gov/files/twc/strategic-plan-fiscal-years-2019-to-2023-twc.pdf.
View TWC’s financial reports here https://www.twc.texas.gov/agency/texas-workforce-commission-financial-grant-information.
TWC’s funding is comprised of both federal and state dollars, with the majority of funding coming from federal sources. TWC provides grants through allocation formulas to Workforce Development Boards that plan and administer the Workforce Investment Act, Temporary Assistance for Needy Families Choices, Employment Services, Supplemental Nutrition Assistance Program Employment and Training, childcare, and other workforce and support services. Employer-paid state unemployment taxes and reimbursements pay for state unemployment benefits. The U.S. Department of Labor allocates funds from the Federal Unemployment Tax to the states to pay for administrative and operational costs. TWC’s budget from FY 2018-19 increased by about 23 percent, from almost $3,087 billion to over $3,794 billion in FY 2020-21.
Source: Zerwas & Nelson. (2019). H.B. No. 1 General Appropriations Act Eighty-Sixth Legislature. Retrieved from https://capitol.texas.gov/BillLookup/History.aspx?LegSess=86R&Bill=HB1
Source: Zerwas & Nelson. (2019). H.B. No. 1 General Appropriations Act Eighty-Sixth Legislature. Retrieved from https://capitol.texas.gov/BillLookup/History.aspx?LegSess=86R&Bill=HB1
Several pieces of legislation passed during the 86th legislative session that impacted TWC and Texas’s mental health shortage. One such bill was HB 2813 (Price/Nelson), which requires a representative from TWC to serve on the statewide behavioral health coordinating council. Detailed breakdowns of these bills can be found in the Hogg Foundation for Mental Health’s Texas 86th Legislative Session Summary: https://hogg.utexas.edu/wp-content/uploads/2019/09/86th-Legislative-Summary.pdf.
Transfer of Services from the Department of Assistive and Rehabilitative Services to TWC
Prior to September 2016, TWC did not provide any direct behavioral health treatments or supports to Texans with a mental health condition. However, in 2016 the state transitioned employment-related programs from the Department of Assistive and Rehabilitative Services to TWC as part of the HHSC transformation process. As a result, TWC began to work directly with individuals with disabilities primarily through the Vocational Rehabilitation (VR) program. The VR program provides services for people with disabilities to help them prepare for, obtain, retain, or advance in employments. More information is provided in the Vocational Rehabilitation For Persons with Physical and Mental Disabilities section of this chapter.
Employment Trends and Overall Outcomes
Employment rates of people with disabilities had been improving prior to the COVID-19 pandemic. Nationally, labor force participation rates (the number of people available for work as a percentage of the total population) and employment rates for people with disabilities had been increasing while unemployment rates for people with disabilities had been decreasing. However, employment outcomes for people with disabilities continued to be far worse than for people without disabilities. In 2018, about 40.2 percent of Texans with disabilities living in the community were employed compared to 76.4 percent of people without a disability. In the same year, the national unemployment rate for people with a disability was 8 percent, over twice that of people without a disability who had a 3.7 percent unemployment rate. Figure 117 below illustrates unemployment trends for those living with disabilities.
Source: Division of Labor Force Statistics. (March 29, 2019). Persons with a Disability, 2018. Presentation to Office of Disability Employment Policy (ODEP). Retrieved from https://www.dol.gov/sites/dolgov/files/odep/pdf/dol_odep_2018_briefing_with_notes_odep.pdf
Texas Mental Health Workforce Shortage
Texas has a shortage of mental health professionals in the state. As Figure 118 from the 2019 Texas Statewide Behavioral Health Strategic Plan shows, over 80 percent of counties in the state are deemed Mental Health Professional Shortage Areas, where there are more than 30,000 residents per clinician.
Source: (page 54) Texas Health and Human Services Commission. (2019, February). Texas Statewide Behavioral Health Fiscal Years 2017 – 2021 Strategic Plan Update and the Foundation for the IDD Strategic Plan. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/hb1-statewide-behv-hlth-idd-plan-feb-2019.pdf
In order to address the mental health and substance abuse workforce issues in Texas, advocates have proposed a statewide, cross-agency strategic workforce plan to address these needs. In the 86th Legislative Session, HB 1669/SB 429 (Lucio/Lucio) failed to pass on a point of order in the final days of the session. The bill would have required HHSC to develop and implement a strategic plan to address workforce issues. While HHSC has moved forward independently to develop such a plan, there is currently no directive to implement the recommendations included in the workforce workplan and there are no available funds to cover the costs associated with implementation.
Two bills that did pass in 2019 to address the mental health workforce shortage are HB 1065 (86th, Ashby/Kolkhorst) and SB 11 (86th, Taylor/Bonnen). HB 1065 created a rural resident physician grant program to encourage the creation of new graduate medical education positions in rural and non-metropolitan areas. The intent was to place particular emphasis on the creation of rural training tracks. SB 11 established the Texas Child Mental Health Care Consortium that included provisions for creating new opportunities for integrated health care for children, funding for psychiatry residencies, and development of the Child Psychiatry Access Network.
See the Mental Health Workforce section in the Policy Environment chapter of this Guide for more information on efforts to reduce the Texas mental health workforce shortage.
Programs for People Experiencing Mental Illness
TWC’s partnership with the Texas Governor’s Committee on People with Disabilities and Texas Workforce Solutions led to the Texas HireAbility campaign. This statewide initiative raises awareness about how hiring Texans with disabilities is beneficial to employers by highlighting their contributions to the state’s workforce. During Disability Employment Awareness Month in October, the campaign plays a major part in the promotion of hiring and disability awareness events around Texas.
A Tri-Agency Workforce Initiative was initiated between TWC, the Texas Higher Education Coordinating Board, and the Texas Education Agency to support students with disabilities in their efforts to pursue educational opportunities and achieve employment goals. In support of the Tri-Agency’s objectives, in FY 2017 TWC established its Summer Earn and Learn (SEAL) work-based learning program. The initiative launched with all 28 local workforce development boards and their employer partners around Texas. Over 1,500 students with disabilities gained work-readiness training and paid work experience from their participation in SEAL.
In FY 2019, a partnership between TWC’s Purchasing from People with Disabilities program (known as the State Use Program) and Community Rehabilitation Programs (CRPs) employed nearly 6,000 Texans with disabilities in 106 local nonprofit CRPs.
Vocational Rehabilitation for Persons with Physical and Mental Disabilities
For people experiencing mental illness, work can play a primary role in their lifelong recovery and well-being. Employment promotes social acceptance, community integration, and gives people a sense of purpose, self-esteem, and self-worth. People with mental illness face unique challenges to employment including stigma, discrimination, and fear of losing benefits. However, there are employment programs to help minimize these challenges, assist individuals with work readiness, and help them achieve long-term success in the workplace.
The Vocational Rehabilitation (VR) program is a state-federal partnership designed to help individuals with disabilities (physical and developmental disabilities as well as serious mental health conditions) prepare for, find, and keep jobs. The VR program is also intended to help individuals with disabilities transition from high school to a work environment.
An individual may be eligible for VR services if they:
- Have a disability which results in substantial barriers to employment
- Require services to prepare for, obtain, retain, or advance in employment
- Are able to obtain, retain or advance in employment as a result of services
People receiving social security disability benefits also qualify for VR services. People who are eligible to receive VR services work with a VR counselor to determine what services are appropriate and needed. VR services are consumer-focused, meaning that those who receive services have a voice in their services. Consumers work with their VR counselors to create an individualized plan for employment, which outlines what employment goals an individual has and how VR services can assist in achieving those goals. VR services are based on an individual’s needs and vary greatly depending on disability, needs, and employment goals. Work-related services may include counseling, training, medical treatment, assistive devices, job placement assistance, and other services.
Consumers can obtain these vocational rehabilitation services by applying with their local Texas Workforce Solutions – Vocational Rehabilitation Services Office; eligibility decisions are typically made within 60 days. If deemed eligible, the person will work with their assigned counselor to develop an Individualized Plan for Employment within 90 days that will include the services necessary for the person to reach their employment goals.
VR service providers partner with businesses to develop new employment opportunities. Program staff also work with public school districts to target students with disabilities who need services to help them transition from secondary education to post-secondary school or work. In FY 2019, 69,873 Texans with disabilities received VR services, and 13,577 of them had a successful employment outcome.
More information on the VR program can be found online at http://www.twc.state.tx.us/jobseekers/vocational-rehabilitation-adults.
Programs for Veterans
The June 2020 national veteran unemployment rate was 8.8 percent, lower than the non-veteran unemployment rate was of 11.1 percent. TWC provides services specifically for veterans, who are at higher risk of mental health conditions and suicide compared to the general US population.
Texas Veterans Leadership Program
The Texas Veterans Leadership Program (TVLP) targets veterans returning from Iraq and/or Afghanistan. The program helps them find employment and transition back into civilian life. TVLP Veterans Resource & Referral Specialists use referrals to help their fellow veterans address employment, training, medical/educational needs, case management, life skills, and more. Each of the 28 workforce development areas receives one specialist, who coordinates with staff from both the Workforce Solutions and Texas Veterans Commission. All TVLP Resource & Referral specialists are veterans of Iraq and/or Afghanistan, and they do the following tasks:
- Seek out veterans in need of services;
- Serve as resource and referral agents, directing returning veterans to resources tailored to their needs;
- Make referrals and coordinate with different programs ranging from employment and training to medical care, mental health and counseling, veterans’ benefits, and other programs to address the varying needs of veterans; and
- Coordinate a chain of volunteer veterans familiar with the obstacles faced by returning veterans to assist in mentoring and serving returning Iraq/Afghanistan veterans.
TWC also offers the following services for veterans:
- Priority service for all workforce services;
- Base Realignment and Closure National Emergency Grant;
- Hard-to-Serve Veterans Initiative;
- Comprehensive Veterans Initiative;
- Two-day hold on new job postings in WorkInTexas.com to ensure veterans get first viewing;
- Integration points between WorkInTexas.com and USnlx.com; and
- Veteran-specific job search portal in WorkInTexas.com via the Texas Veterans Portal.
Veterans Workforce Outreach Initiative
TWC selectively provides services to “hard-to-serve” veterans who have one or more barriers to employment. These barriers include: homelessness, substance use history, a physical/mental/learning disability, post-traumatic stress disorder, criminal history, or recent discharge from the military. The Veterans Workforce Outreach Initiative was created to:
- Engage in outreach to hard-to-serve veterans who are not currently being served through Workforce Solutions Offices;
- Address employment barriers faced by hard-to-serve veterans; and
- Reintegrate hard-to-serve veterans into meaningful employment.
In addition to receiving employment services such as assessments, job development/placement, and case management, veterans in this initiative can also receive support services. These include: mental health assistance, clinical counseling, medical resources such as wheelchairs/crutches/medical beds, food/utility/rent/financial assistance, and transportation. In the one-year grant period starting March 2018, the project helped 816 veterans receive assessment and case management services, with 258 receiving employment.