This Web site is a component of the SAMHSA Health Information Network
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Work as a Priority: A Resource for Employing People who have Serious Mental Illnesses and are HomelessHelping People who are Homeless and The employment needs of people who are homeless and have serious mental illnesses cannot be met with a "one size fits all" approach. Often, to provide the array of services needed, approaches must be offered in combination. Providers need to be flexible, creative, and innovative in program design and delivery. Many programs throughout the country are successfully addressing the housing, treatment, employment, and support needs of consumers who are homeless. In doing so, these programs embody the elements essential to help people with mental illnesses attain employment, including: integrating services, responding to individual preferences regarding employment, adapting employment service approaches to address the impact of homelessness, and managing the workplace support needs of people with mental illnesses who are, or have been, homeless. In this way, recovery from mental illnesses and addictions are supported as part of a larger strategy that cares for the whole person. As described in previous chapters, employment programs that work with people who are, or who have recently been, homeless share a set of underlying principles, summarized in Table 5.1. Table 5.1 Key Ingredients of Employment Programs for People with Mental Illnesses Who Have Been Homeless
Listen to Consumers Employment programs are more successful when participants’ interests are accommodated. While meeting individual preferences may not always be possible, consumers appreciate staff who offer employment services and opportunities consistent with the consumers’ expressed short- or long-term goals. This can be as simple as listening carefully and responding directly to what consumers say, or as formalized as involving participants in program design, delivery, and evaluation. The well-known tenet of the self-help movement, "nothing about us without us," is a good guideline to observe. Allow for the Process of Recovery Employment programs designed for short-term interventions are not equipped to respond to the long-term and relapsing nature of many mental and addictive disorders. In general, they fail to recognize that change occurs gradually over time. Recurrence of symptoms or behaviors related to an individual’s mental or substance use disorder should be acknowledged as part of the normal course of events; employment services should be flexible and adjusted accordingly. Challenge Traditional Concepts of Readiness Vocational training and rehabilitation programs typically exclude individuals exhibiting active symptoms of mental illness, difficult behaviors, and/or substance abuse because they do not meet "readiness" criteria for program participation. Yet, offering job options can provide motivation to address recovery in other areas of a person’s life, even if that person has not indicated an interest in work on program entry.[2] The key is to strike a balance between requiring total abstinence or freedom from symptoms, and tolerating some substance use-related behaviors or symptoms of mental illness on the job. This can be done by widening readiness prerequisites without ignoring health and safety considerations. Provide Ongoing Assessment
Extensive readiness prerequisites can dampen motivation and discourage people eager to resume or begin work. While assessment of skills, aptitudes, and interests are valuable, they should be viewed as tools available, not only during the pre-employment process, but after a person has obtained a job. In fact, they may be most accurate in evaluating job skills and assisting in job goal development when a person is in a work experience that provides a real-time context for vocational growth. Offer Work In-house Offering options for work in jobs that the agency "owns" or controls is an effective means of responding to consumers’ interests in rapid job entry. It provides the opportunity to assess job preferences and motivation, to regain exposure and experience in the world of work, and to develop a plan for job and career growth. Nevertheless, the goal and primary focus should be on competitive employment in integrated settings whenever possible. Address Non-work Issues Job success includes the ability to manage personal interactions in the workplace as well as the ability to perform work tasks. Gaining the support of co-workers can be critical to enable an individual to navigate the culture of the workplace. In addition, a person’s life outside work often may "travel to work" with the employee, affecting job performance or attendance. Learning how to manage these issues and to use natural supports, such as the assistance of co-workers, is essential to helping people with mental illnesses retain employment. Develop Clear and Reasonable Goals Participants must be clear from the beginning about the services offered by the employment program, the possibilities and resources available, and the requirements for program participation. Skills and interests should be assessed at intake to ensure a match between applicant needs and expectations, and program services. Program goals should be achievable and appropriate for consumers served by the program. Staff must be clear about where they "fit" in the process of meeting program goals, and must have the skills and knowledge to successfully carry out their roles. Staff also must have expectations that participants can and will achieve their goals and be able to convey these expectations to participants. Employ Flexible Outcomes Commonly, employment programs are evaluated based on the number of people who achieve and retain full-time gainful employment. While a desirable goal, the path for people with serious mental illnesses with histories of homelessness may or may not lead to this outcome. When it does, the length of time to achieve this goal can vary. Individual employment paths usually include intermediate outcomes such as working part-time, increasing hourly wages, total income or the number of hours worked, or retaining a position over time. Where possible, providers should establish benchmarks that capture these important milestones and allow longer timeframes for success. For individuals who do not have full-time, competitive employment as their goal, providers need to recognize that alternatives, such as part-time work, can represent success for those consumers. Redefine Failure Despite thorough assessments and supports, individuals with serious mental illnesses may have setbacks, experience problems in the workplace, and sometimes lose jobs. Staff should prepare participants for these possibilities and explain that it is normal for most people to have some problems at work and occasionally to lose a job. By encouraging individuals to use the experience as a learning opportunity, staff can help participants determine what went wrong and how to better manage the situation in the future. Integrate Employment with Case Management and Other Supports Many employment programs offer other services through different programs within their organizations. While the specific services vary, coordination and integration across programs is critical to successful outcomes. In particular, if case management services are offered, employment goals should be integrated into the service or treatment plan. Case managers should be aware of a person’s involvement in work and integrate that into the plan for obtaining or retaining housing, treatment, or other support. Case managers can be especially helpful in the critical transition period immediately after an individual first becomes employed, a period during which he or she may need considerable ongoing support. Also, the case manager may be in a good position to see how a person deals with non-work issues that may provide insight into strengths and weaknesses in an employment setting. For example, difficulty being on time may lend itself to training and reinforcement across a number of life activities, including work. Integration across programs can be achieved through regular interdisciplinary/departmental meetings, through coordination of documentation procedures, and through interdepartmental staff collaboration. In addition to working from a set of underlying principles, employment programs for individuals with serious mental illnesses who also are, or have been, homeless, offer a range of flexible, individualized services. Based on a review of the literature and conversations with others in the field of employment services for homeless people, these key services and supports are described in Table 5.1. Employment Outreach Offering vocational services in shelters, soup kitchens, or even as part of mobile outreach, can help people who are homeless and who have serious mental illnesses explore the possibility of rehabilitation and employment. The message at this stage is clear and simple, "If you believe you can work, we can help you get a job that works for you." However, agencies must be able to deliver on this promise. The importance of meeting individuals on their own turf cannot be overstated. This is widely accepted and practiced within the homeless services field; however it is less common for vocational rehabilitation to be part of the outreach process. It is also uncommon for mainstream vocational programs to offer services in places where homeless people are most often found. A prerequisite for success is active collaboration with homeless shelters and soup kitchens, other homeless housing and service providers, peer outreach specialists, and welfare and social service staff. This is a slow process that works to build trust and credibility, and to overcome initial resistance and skepticism on the part of both recipients and professionals. One way to gain credibility is to hold meetings and orientation sessions at shelters rather than at the community mental health center or vocational program. In addition, the employment specialist should become a familiar face to the staff of homeless shelters and street-outreach programs. In this way, they may be seen as a resource when issues involving employment are raised, and as helpful in finding ways to engage those motivated by the possibility of work.
Managing the Transition to Work The transition in role from "consumer" or "homeless person" to "worker" is significant. Assistance in managing this transition is usually critical, particularly for those who have experienced repeated failure. Staff can help by understanding the work histories of individual participants, the meaning of work in their lives, and concerns about fulfilling the new role. Discussions about participant expectations and concerns, help in identifying achievable goals, and developing a career plan are important in facilitating the transition. Goal Setting Goal setting helps the consumer and practitioner examine the need for, and commitment to, change, and what it will take to achieve success and sustained employment. Goal setting has two main elements:
Practitioners should resist the temptation to rush through this process and remember that goal-setting can and should be an ongoing process. The best approach is to let the needs and preferences of the consumer dictate the time frames for this process. For example, if an individual is anxious to start work but is likely to drop out of an extended planning process, help in obtaining a job as quickly as possible and ongoing assessment to enable him/her to develop long-term goals, may be an effective strategy. In contrast, another person might be nervous or reluctant to work at all, and would benefit from the time to prepare for the demands and expectations of a work environment. Sometimes, during the goal-setting process, an individual may select an employment goal the practitioner believes is "unrealistic". Rather than trying to convince the person that the goal is unattainable, practitioners should help the individual focus on short-term steps to achieving the longer-term goal. Individuals should be free to choose, reconsider, and modify goals with the practitioner acting as navigator rather than as a captain. Employment Assessment For many participants, the concepts of a job path and career planning are new. Participants also may need general education about the world of work. Career planning includes an assessment of skills, interests, and work history, resulting in the development of an individualized employment plan. However, assessment services need not be limited to those provided in classroom settings. Often, the best way to assess a person’s skills, work tolerance, and work adjustment ability in a mainstream work environment is through situational assessments in a real work setting. These assessments can occur during the course of transitional employment placement[3] or as part of short-term supported assessment. Whether provided in classrooms or on the job, an essential aspect of the employment assessment is examining and understanding the individual’s interests, skills, strengths, and knowledge as they pertain to a particular job. When making an assessment, program staff should pay attention to aptitudes that may not relate directly to a particular job, but that may be transferable to the work place, such as navigating the shelter or entitlements systems and managing bureaucracies. A thorough assessment should examine an individual’s situation regarding:
Employment Counseling and Planning As part of a comprehensive plan that addresses the housing, treatment, employment, and support needs, a case manager also may provide employment counseling to people who are homeless. A rehabilitation counselor may provide specialized vocational counseling. Career plans delineate specific employment goals and the tasks required to achieve these goals, and provide participants with a clear sense of the path to work and advancement. Additionally, plans identify needed educational or skills training as well as supports that can help with maintaining employment. The plan should be assessed with participants over time and, similar to service plans, reviewed and modified on a regular basis, especially in the early stages of the job placement process. Revisiting an individual’s work goals periodically helps incorporate new experiences and insights gained while working and also helps avoid the risk of failure. Work Readiness Development Readiness development includes all activities that help an individual to improve his/her likelihood for employment success. While work readiness services often are termed "pre-vocational," they might more aptly be called "pro-vocational", because they often are needed on an ongoing basis. Such services are critical to successful employment for people with serious mental illness and may be provided by case managers or vocational counselors depending on the structure of the program. Unlike other pre-vocational approaches, readiness services prepare people to achieve a specific job they will want to keep that will provide them with both desired income and satisfaction. Therefore, readiness services should be available for those who are unemployed as well as for those who are dissatisfied in their current working environment. For people who are homeless, this can include individuals in temporary, transitional, or day labor employment; or workfare positions. Readiness activities may encompass:
Work Experience Work experience means all activities, paid and unpaid, that help individuals learn more about the world of work and refine their interests and vocational goals. The best way to gain experience in competitive employment is to work in competitive jobs. However, volunteer work, mentoring/internships, temporary employment, and transitional employment also can help individuals gain experience. Volunteer work is unpaid and performed for a community or charitable organization. Internships generally are also unpaid, although stipends or paid internships sometimes are available. It is important to be fully aware of, and compliant with, Department of Labor wage and hour standards in all situations involving unpaid internships. Transitional employment usually lasts three to six months and is provided or arranged by a rehabilitation agency. Temporary employment includes day labor or other short-term employment for a pre-determined duration. Transitional and supported work experiences provide workers with extra support and training, and may offer opportunities for advancement. The amount of time participants need in transitional positions varies, emphasizing the need for flexibility. Occupational Skills Training Occupational skills training helps participants develop or upgrade their skills in a particular trade or occupation. Skills training increases the opportunity for higher paying jobs with more career potential than does entry-level, unskilled employment. In particular, the presence of skills linked to specific jobs, rather than general skills, is a better predictor of employment success. Many programs have developed a variety of ways to meet the need for skills training, including traditional training programs, supported and transitional employment opportunities, and in-house positions within their organizations. For several reasons, skills training may be most successful after an individual has obtained recent work experience. First, many people need or want to get a job quickly, whether due to financial demands or welfare sanctions. They cannot wait to complete a training program. Second, if unemployment has been long-term, most likely the individual will need to re-establish positive work habits, social behaviors, structured learning skills, and stamina. A classroom setting, with the pressures of coursework and tests, may not be effective for someone in the early stages of re-engaging in work. Third, once individuals have experienced some vocational success and are more aware of their current abilities, interests, and potential work opportunities, they are more likely to be motivated to successfully complete occupational training. Finally, employment can help an individual identify the specific job or field in which he or she is interested and the types of skills training needed for that position. In many cases, the best strategy is a combination of part-time employment and part-time training after some period of successful employment has been achieved. If tuition or training subsidies are required, VR financial assistance is available for occupational education. In addition, educational institutions and trade schools often offer scholarships, some of which are funded by the Department of Labor, to provide low-cost or free training to various target groups, including individuals who were recently homeless. In addition, SSI recipients may include the cost of education related to achieving a vocational goal as part of his/her PASS plan. In general, occupational skills training, closely linked with existing jobs in the local labor market, can help people move from entry level jobs to jobs with advancement potential. Developing relationships with various businesses and business associations in the community may be an effective means, not only to identify potential job openings, but also to understand the skills needed by employers. Establishing close working relationships with specific businesses can have numerous other advantages:
Job Development and Placement Employment and training agencies serving people who are low income and disadvantaged have emphasized job placement services as the next step after assessment and training. This is particularly true for those who may be unlikely to obtain or sustain employment on their own. Job placement assistance becomes the point at which an individual’s experiences, goals, and support needs are matched, to the greatest degree possible, with the conditions and demands of the local labor market. An effective job development and placement strategy combines knowledge of the real-life demands of business and industry with an understanding of the preferences and skills of the job applicant. A successful job developer has strong relationships with both employers and program participants. In an ideal job placement situation, the participant has been actively involved in the process of selecting and securing a job, even if a job developer or placement specialist made the initial contact with the employer. Similarly, the employer sees the intrinsic advantages of hiring this individual, and appreciates the extra support offered by the job developer. Effective job development and placement for individuals with mental illnesses who are or have been homeless involves special attention to activities that meet their specialized needs. Such activities include job re-placement assistance, specialized case management, peer support, and education concerning the rights of disabled workers, and employer incentives. Re-placement. Many people will need several work experiences before they find the right "fit". Job loss and the need for re-placement assistance should not be considered a failure. Instead, it should be reinforced that most people have to try several jobs when first entering the workforce, and that each experience can contribute to understanding what it takes to be a happy and successful employee. Specialized case management. Job development also addresses barriers to employment posed by homelessness and poverty. Many people who have been homeless have been unable to maintain their health and appearance. For example, dental care may be necessary to improve self-esteem and appearance. Job placement specialists must ensure the individual is able to meet the dress and grooming code for the workplace, and should help the individual obtain the appropriate clothing for job interviews and work. People living in shelters may have limited access to a telephone, and some may not want to list the shelter’s phone number as their own. A job developer may serve as a communication link between the prospective employer and job seeker. Alternatively, the job developer may help the individual acquire a community voice mailbox where they can receive messages. The latter option allows the individual to take more responsibility for follow-up. Peer support. Some people prefer to obtain their own jobs while maintaining some degree of program support. Peer support may be obtained through job search workshops or "job clubs" where job seekers come together to learn and share information on job leads, interviewing techniques, networking strategies, and applications and resume development. Job clubs or support groups can add structure to the job search process, with placement specialists helping individuals according to their particular needs and challenges. Though job clubs can be a valuable way to facilitate peer support, no clear evidence has shown that they deliver better outcomes than people seeking jobs on their own.[4] Rights, incentives, and disclosure issues. Effective job development also involves a thorough understanding of the incentives available to employers, including Work Opportunity Tax Credit and economic development-related tax credits or incentives. Job developers should be experts in these incentive programs and should help employers obtain them. As discussed in Chapter Seven, the landmark Americans with Disabilities Act of 1990 (ADA) provides extensive protection and accommodation for people with disabilities during the employment process. The stigma associated with mental illness and homelessness often is compounded by a criminal record and/or a history of substance abuse. Participants may need counseling to make decisions about what and how much to disclose. With guidance, the individual can decide whether the benefits of on-site support from staff, along with employer accommodations, outweigh the risk of being stigmatized. Whether helping individuals understand the implications of disclosure or helping employers understand the benefits of the ADA, it is essential that employment specialists be knowledgeable about and comfortable discussing these issues directly.
Benefits Management and Advocacy Many people with serious mental illnesses have relied on public benefits for much of their adult lives. Potential changes in these arrangements can generate fear and anxiety, making them reluctant to pursue employment at all. Despite numerous advance notices and repeated discussions about how their benefits will change as they earn other income, when they receive their first decreased benefits check, some people may consider quitting their job. It is no small wonder that both practitioners and consumers are concerned about the potential loss of benefits resulting from earning income. Perhaps more important than the loss of cash benefits is the threat of losing medical assistance, especially since many of the jobs that consumers obtain are unlikely to provide health insurance benefits.
These concerns have discouraged many consumers and their counselors from examining employment as a desirable, viable option. Thus, employment service providers need to hire or become experts in entitlement benefits, particularly Social Security. These individuals must keep abreast of changes in policies and programs to offer the most accurate and up-to-date information. In the early stages of returning to work, especially for SSI beneficiaries, part-time employment often is the preferred strategy to develop work experience and increase income without immediately losing benefits. There are a number of additional ways to help people utilize the resources available to them, while continuing to move towards increased self-sufficiency. Unfortunately, many of those resources are poorly known and understood. For example, the Program to Achieve Self Support or PASS, a Social Security Work Incentive program, is estimated to be used by only .025% of eligible beneficiaries.[6] Similarly, many are unaware that, in some states, people on SSI may earn over $25,000 per year and remain eligible for Medicaid. The Work Incentives Improvement Act of 1999 (discussed in Chapter Seven) provides continued access to Medicaid and Medicare coverage while working, and addresses the earned income disincentives that are significant barriers to employment for people with mental illness. To make informed decisions about work and entitlements, participants need:
Creating Employment Opportunities An increasing number of agencies are creating jobs for people with mental illnesses who are or have been homeless, by developing businesses. They may also choose to support consumer-run businesses and consumer-run employment support programs as a way to create jobs. The Roberts Foundation Homeless Economic Development Fund (REDF) has been a leader in this field since 1990. Its progress report on non-profit business planning and start-up is considered by many to be the defining text on social entrepreneurship.[9] REDF’s study of 22 social enterprises serving homeless people in the San Francisco area concluded that:
The availability of immediately accessible jobs when consumers express a desire to work is a powerful tool to engage them in other services. Within the limits of the market, the agency as employer has control over jobs and makes the hiring and firing decisions. The agency also acquires direct experience in employing the target population and is in a better position to understand the various issues employers face. The job creation approach can also use a range of incentives and financial support, including those targeted toward economic development. Developing new partnerships for employment. Employment programs must be connected to the commercial marketplace. Many agencies have established strategic alliances with the private sector to support their programs. Employing people with mental illnesses who have histories of homelessness may offer opportunities to partner with groups that many non-profits have not yet considered. Business improvement districts and public housing authorities are two non-traditional partners and funding resources for employment. In many downtown business districts, homelessness is viewed as an impediment to economic growth, resulting in the adoption of restrictive ordinances and forcible removal of street-dwelling homeless people in some cities. In other cities, human service providers and business improvement districts (BID) have been working in partnership to develop alternatives such as intensive outreach, hotlines for businesses to request assistance for someone on the street, drop-in centers, supportive housing and employment services.[10] Partnerships with BIDs may include employing people with mental illnesses who are homeless in small businesses, such as street cleaning, security, distribution of sales, marketing, tourist and cultural information, property management, and maintenance services. With a steady source of transitional and day labor jobs at their disposal, providers can make the offer of work part of their engagement strategy for street-dwelling homeless people. By focusing first on services that homeless people want, a bond between case manager and consumer is established that may lead the consumer to treatment, shelter, and other services. Establishing a partnership with a local BID means developing conversations that acknowledge and respect each party’s unique objectives, building trust among respective parties, and establishing a common purpose.[11] Many people with mental illnesses and histories of homelessness are eligible to receive employment/self-sufficiency services through public housing agencies utilizing HUD-McKinney funds targeted to that purpose. To be eligible, individuals must be a current tenant, on a public housing Section 8 waiting list, or living in the neighborhood surrounding the public housing agency. Both the HUD Family Economic Development and Residential Opportunity and Support Services (ROSS) Program, and Hope VI Program can provide funds for employment and training services to increase the economic self-sufficiency of eligible individuals and families. The Quality Housing and Work Responsibility Act of 1998 (QHWRA) reduces the concentration of poverty in public housing, protects access to housing assistance for the poorest families, and supports families making the transition from welfare to work. The Act also charges HUD with developing a mental health action plan for tenants of public housing and project- and tenant-based Section 8 programs. Housing and mental health advocates have encouraged HUD to consider employment one of the services under this provision. Mental health providers can become valuable resources for public housing authorities (PHAs), providing technical assistance, training, and collaborations that facilitate recovery and self-sufficiency for their tenants with mental illnesses.
Ongoing Job Support After people are placed in jobs, they frequently need help to manage and retain the positions. These services should be flexible as some people will need support weekly, daily, or some hardly at all. Further, practitioners need to help service recipients make choices about the kinds of support they receive on the job. Often, participants want assistance around particular challenges or problems and don’t necessarily want to meet with staff when no issues are present. If staff is familiar with a participant’s job environment they can anticipate problems and stresses that may occur. Additionally, case managers or vocational counselors should reinforce successes and skills developed, and help relate them to the individual’s employment goals. Some programs use on-site job coaches who periodically visit the work site to observe and coach participants. Often, the presence and assistance of a job coach is a valuable resource to employers and can improve the employee job tenure and success. However, some participants are embarrassed by the presence of a job coach at the work place. As a result, some programs have eliminated this intervention as long as the placement and participant are stable. Employment Accommodations Job accommodation often can be a critical factor in keeping a job. Some individuals may need help to negotiate reasonable accommodations with their employers (discussed in Chapter Seven). An important facet of employment counseling is to help the individual decide whether to request a job accommodation during the interview, after an offer to hire has been made, or after employment has begun. To request an accommodation, the job candidate/employee must disclose that he or she has a disability—something many mental health consumers are reluctant to do. There is no single answer to this issue. Each person must address it from his or her own perspective. Table 5.2 highlights the most frequently requested accommodations. Table 5.2 Reasonable Accommodations Frequently Requested by People with Mental Illnesses [12]
Chapter Summary The training and employment needs of people with serious mental illnesses who also are, or have been, homeless cannot be met by any single approach. By understanding and incorporating job-related service elements, from initial engagement through job retention, the employment specialist can more effectively help guide individuals toward a vocational future of hope and success. The task of increasing employment among people with mental illnesses cannot succeed if the mental health system acts alone. Collaboration with area businesses and public housing authorities is an effective way to expand and enhance jobs available to individuals with serious mental illnesses who are also homeless. Chapter 5 Notes [1] This Chapter contains material adapted from: White, A., and Wagner, S. "Effective strategies: Employment for homeless people with serious mental illness" and Shaheen, G., Bianco, C., Falco, A. "Employing people with mental illness who are homeless: Surveying the field." Papers prepared for the CMHS Sponsored Employment and Vocational Rehabilitation for Homeless People with Serious Mental Illnesses Workshop, Washington, DC, September 1999; and Bianco, C., and Shaheen, G. Employing Homeless People with Mental Illness: Principles, Practices and Possibilities. Unpublished draft prepared for the CMHS PATH Program. Albany, NY: Advocates for Human Potential, July 1999. [2] Macias, C. "An Experimental Comparison of PACT and Clubhouse." Final report of the Massachusetts Employment Intervention Demonstration Project. Available at http://www.fountainhouse.org. [3] Bianco, C., Shaheen, G., and Golden, T. Integrated Employment for People with Serious mental illness: A Rehabilitation and Recovery-Based Approach. Ithaca, NY: Cornell University, 1997. [4] Ridgeway, P., and Rapp, C. The Active Ingredients in Achieving Competitive Employment for People with Serious Mental Illness: A Research Synthesis. Lawrence, KS: University of Kansas School of Social Welfare, 1998. [5] Double Trouble for Recovery, Inc. Informational literature. Albany, NY: The Mental Health Empowerment Project, 2000. [6] Corporation for Supportive Housing. Work in Progress: An Interim Report of the Next Step: Jobs Initiative. New York, NY: Corporation for Supportive Housing, 1997. [7] For comprehensive information on these and other topics, including development of a benefits support plan, see McAlees, D.C. Effective Strategies to Improve the Employment of SSI/SSDI Participants. Menomonie, WI: Stout Vocational Rehabilitation Institute, 2000. [8] Section 1619b is an extremely important provision of the Social Security Act as it not only protects an individual’s Medicaid coverage, but also maintains their eligibility to receive SSI cash benefits in future months that countable income falls below the allowable limits, provided that they meet all other eligibility requirements for SSI. [9] Emerson, J., and Twersky, F. (eds). New Social Entrepreneurs: The Success, Challenge and Lessons of Non-Profit Enterprise Creation. San Francisco, CA: Roberts Foundation Homeless Economic Development Fund, 1996. [10] International Downtown Association. Addressing Homelessness: Successful Downtown Partnerships. A Report of Strategies to Assist Homeless People with Serious Mental Illnesses. Washington, DC: August, 2000. [11] Ibid. [12] Granger B., Baron, R., and Robinson, S. Findings from a national survey of job coaches and job developers about job accommodations arranged between employers and people with serious mental illness. Journal of Vocational Rehabilitation 9: 235-251, 1997. |
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