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Economics and Workplace PAS > Promising Practices > Connecticut Bureau of Rehabilitation Services

Promising Practice in Workplace PAS:

Outsourced personal assistance services (PAS) to a qualified agency

Employer: Connecticut Bureau of Rehabilitation Services

Joan Ripple
Lewis Kraus M.P.H., M.C.P.
Lita Jans Ph.D.
Susan Stoddard Ph.D.
2008.

Center for Personal Assistance Service
InfoUse
2560 Ninth Street, Suite 320
Berkeley, CA 94710-2566

Summary of the promising practice

The Bureau of Rehabilitation Services provides workplace personal assistance services (PAS) to its staff with disabilities, viewing it as similar to providing clerical and administrative support to any employee. For about eight years, the Bureau has out-sourced the provision of PAS to a qualified agency, Marrakech. The personal assistants (PAs) provide both task-related and personal care assistance at work, as needed. Marrakech recruits, hires, trains, supervises, and schedules the PAs who get the same state-paid holidays and vacation time as other any other state employees.

The primary responsibility of the PAs is to the person with the disability. However, PAs also can provide clerical services to other staff (with or without disability) when the person with a disability is not using the PA. The employee supervises his or her PA, and the administrative assistant supervises the PA when he or she is performing clerical work for other employees.

Outsourced PAS are funded centrally through the Bureau budget.

Organization that uses the practice

Connecticut’s Bureau of Rehabilitation Services is part of the Department of Social Services. The Bureau has a 25 million dollar budget. The Bureau has a long history of providing PAS to employees for personal care or work tasks. The Bureau has provided interpreters for persons who are deaf or hard of hearing and readers for persons with visual impairments since the 1970’s, and other PAS since the 1980’s. The Bureau’s policy is to hire the best person for the job and to pay for whatever accommodations are needed to enable that person to do the job.

Description of the promising practice

The practice of outsourcing PAS to a qualified organization evolved over time. Initially, PAs were hired by the state directly and were on the state payroll. The Bureau had difficulty finding back-up when staff PAs were ill, on vacation, or left their jobs. The practice of outsourcing PAS to a qualified agency was started in 1999. Interpreters and readers, however, are hired internally and are on the state payroll.

To solve the problem of providing consistent PAS, the Bureau sought a reliable organization that would be responsible for assuring the availability of PAS, including back-up when a regular PA is not available. The Executive Director of Marrakech had served on an Advisory Board and had provided consulting services to the Bureau. The Bureau explored out-sourcing the PAS to Marrakech, which functions as a staffing agency for the Bureau.

Marrakech is a multi-faceted non-profit agency with 465 full-time employees, 143 part-time employees, and 82 substitutes or per diem staff. Marrakech provides a range of residential and independent community-based services for persons with disabilities. For the outsourced personal assistance services project Marrakech collaborates with the Department of Social Services and its Bureau of Vocational Rehabilitation. Marrakech, in consultation with Bureau staff, developed a Workplace Personal Care Assistant (PCA) Policy and Procedure Book that covers goals and objectives, daily routine and documentation, transportation, PA staff training requirements, benefits (including health, vacations and holidays), evaluations and dress code.

Full-time Marrakech staff who work 32 hours or more receive medical and dental benefits, a pension as a percentage of salary, and the same vacation and holidays as the State employee, which creates a stability for the users of workplace PAS. One part-time PA, who provides back up services, receives pro-rated pension, vacations and holidays. Full-time PAs earn $13- $15 per hour and part-time PAs earn $12.50 per hour. Using Marrakech has helped to overcome some of the barriers presented by other models of workplace PAS. For example, an employee with a disability has access to backup PAS when the regular PA is not available. Also, if the employee misses work due to vacation or illness, the Bureau does not have to pay a PA in the workplace with no PAS user. However, the regular PA, if requested, may perform other work even if the PAS user is not working.

PAs do not perform medical tasks. They do provide rest room assistance, basic hygiene, and grooming. PAs may provide transportation and mobility assistance. Most PA work is work tasks: filing, paperwork, checking email, voicemail, faxing, making copies, and taking notes. If a person with a disability has the qualifications for a job and needs accommodations, the staff looks at the PAS needs, the work to be done, and the best way to fulfill those needs. The department contacts Marrakech, tells them about the person with the disability, the hours to be worked, the frequency of service, and what type of help is needed. Then the employee with the disability is put in touch with Marrakech to participate in the recruitment and hiring process. Marrakech works closely with the employee with a disability throughout a highly individualized process.

Marrakech recruits, finds candidates and does the initial interviews and screening to identify the most likely candidates to meet the needs of the person with a disability. When the job of the person with a disability requires the PA to have heightened skills, the selected PA is put in the entry-level supervisory category. This type of PA is able to adapt to the client work environment. The second interview is conducted in tandem with the person with a disability. Marrakech staff and the employee with the disability discuss the candidates and their strengths and weaknesses, and jointly select the PA to be hired.

Marrakech provides four to five days of new hire training that includes safety training, agency philosophy, agency physical training, procedures, professional boundaries, certification in first- aid, CPR, and seizure training. Then the PA may shadow a current PA, if there is one, or the client with the disability provides orientation to the job. The client introduces the PA to co-workers and supervisor. The PA also may have other trainings throughout the year, such as sexual harassment training that is refreshed every two years and Health Insurance Portability and Accountability Act (HIPAA) training that is renewed annually.

A high level executive, a PAS user, said that all parties involved need to understand that workplace PAS is different than PAS at home. She stated, “PAS works better when workplace personal assistants have a familiarity with office etiquette. A PA who is flexible in and about performing work tasks also makes it work better.” This employee also reported that she personally paid her PA to transport her between home and work. (The state contract includes transportation to work-related meetings but does not include transportation to and from work.)

Employees who have used PAS through Marrakech have had the following disabilities: multiple sclerosis, spinal cord injury, quadriplegia, post polio syndrome and cerebral palsy.

Costs of the promising practice

Overall costs for all PAS including interpreters, readers and PAs are $262,000 annually. This includes four interpreter assistants on staff providing ADA accommodations to five rehabilitation counselors for people who are deaf. One of the four provides American Sign Language (ASL) interpreting for two counselors and 100 % of her salary, benefits and indirect costs are for PAS. The other three interpreters provide half time interpreting and half time clerical support. The total for these services, less clerical support, is $232,500 annually. In addition, at this time, one Bureau of Rehabilitation employee is using workplace PAS for work tasks and personal care from Marrakech. The state cost for this is $44,150. However, the PA spends about one-third of her time doing clerical duties for others. Thus, the cost of the PA for workplace PAS other than interpreters and readers is about $29,400 annually.

Marrakech’s hourly contract rate is $21.51 per hour and covers supervision, management, wage and administrative costs (business office overhead costs). Each year there is a cost of living adjustment to the contract.

Benefits and challenges

The main benefit to the Bureau is that the practice allows them to hire the best person for the job regardless of disability status. The practice helps with retention of employees who become disabled and with newly hired people who have severe disabilities. As with private companies that hire through temporary agencies, it is less expensive for the state to hire PAs through an outside contractor who also pays for the benefits. The PA receives comparable wages and benefits.

The practice provides backup when the PA is not available, a previous challenge for the Bureau. People who work for Marrakech to provide back-up PAS also receive some PAS training, which would not be true for many other temporary agencies.

Transferability to other organizations or industries.

Marrakech has not yet marketed its workplace PAS to other employers, but the practice could be adopted by others. Infrastructure that is needed to develop this practice includes the following: The qualified out source agency should have a developed training program for the PAs and be willing to work as a partner with the company regarding employee and employer needs.

The qualified agency should understand that a workplace PA is different from a PA in the home or community. The screening, interviewing and recruitment are different. The PA working in an office needs a different set of skills, demeanor, and level of tolerance compared to a PA working at home. The company, the outsource agency and the employee must remember that a workplace PA is an extension of the employee, and represents both that individual and the company in business settings.

The qualified out source contractor must be flexible enough to tailor the PA’s job to the needs of the employee. Some executive or professional level employees require PAs who could be trusted to handle confidential information, and in some cases be required to have the same HIPAA and ethics training as the employee.

The qualified organization to which workplace PAS is outsourced should have internal resources including adequate staffing and human resources expertise to do recruiting. Outsourcing workplace PAS could be replicated if the qualified organization has solid funding, a broad sense of what is required for workplace PAS and access to diverse personnel.

Governmental organizations that have a contract standard of open bidding, because of the specific and special needs for services of PAs, may wish to arrange approval for sole source contracts with qualified agencies.

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