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For Disabled Workers, a Tight Labor Market Opens New Doors

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With Covid prompting more employers to consider remote arrangements, employment has soared among adults with disabilities.The strong late-pandemic labor market is giving a lift to a group often left on the margins of the economy: workers with disabilities.Employers, desperate for workers, are reconsidering job requirements, overhauling hiring processes and working with nonprofit groups to recruit candidates they might once have overlooked. At the same time, companies’ newfound openness to remote work has led to opportunities for people whose disabilities make in-person work — and the taxing daily commute it requires — difficult or impossible.As a result, the share of disabled adults who are working has soared in the past two years, far surpassing its prepandemic level and outpacing gains among people without disabilities.

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Share employed, change since Jan. 2020
Note: Includes workers between 18 and 64 years old. Data is not seasonally adjusted.Source: Current Population Survey, via IPUMSBy The New York TimesIn interviews and surveys, people with disabilities report that they are getting not only more job offers, but better ones, with higher pay, more flexibility and more openness to providing accommodations that once would have required a fight, if they were offered at all.“The new world we live in has opened the door a little bit more,” said Gene Boes, president and chief executive of the Northwest Center, a Seattle organization that helps people with disabilities become more independent. “The doors are opening wider because there’s just more demand for labor.”Samir Patel, who lives in the Seattle area, has a college degree and certifications in accounting. But he also has autism spectrum disorder, which has made it difficult for him to find steady work. He has spent most of his career in temporary jobs found through staffing agencies. His longest job lasted a little over a year; many lasted only a few months.This summer, however, Mr. Patel, 42, got a full-time, permanent job as an accountant for a local nonprofit group. The job brought a 30 percent raise, along with retirement benefits, more predictable hours and other perks. Now he is thinking about buying a home, traveling and dating — steps that seemed impossible without the stability of a steady job.“It’s a boost in confidence,” he said. “There were times when I felt like I was behind.”Mr. Patel, whose disability affects his speech and can make conversation difficult, worked with an employment coach at the Northwest Center to help him request accommodations both during the interview process and once he started the job. And while Mr. Patel usually prefers to work in the office, his new employer also allows him to work remotely when he needs to — a big help on days when he finds the sensory overload of the office overwhelming.“If I have my bad days, I just pick up the laptop and work from home,” he said.Workers with disabilities have long seen their fortunes ebb and flow with the economy. Federal law prohibits most employers from discriminating against people with disabilities, and it requires them to make reasonable accommodations. But research has found that discrimination remains common: One 2017 study found that job applications that disclosed a disability were 26 percent less likely to receive interest from prospective employers. And even when they can find jobs, workers with disabilities frequently encounter barriers to success, from bathroom doors they cannot open without assistance to hostile co-workers.The State of Jobs in the United StatesEconomists have been surprised by recent strength in the labor market, as the Federal Reserve tries to engineer a slowdown and tame inflation.September Jobs Report: Job growth eased slightly in September but remained robust, indicating that the economy was maintaining momentum despite higher interest rates.A Cooling Market?: Unemployment is low and hiring is strong, but there are signs that the red-hot labor market may be coming off its boiling point.Factory Jobs: American manufacturers have now added enough jobs to regain all that they shed during the pandemic — and then some.Missing Workers: The labor market appears hot, but the supply of labor has fallen short, holding back the economy. Here is why.Workers with disabilities — like other groups that face obstacles to employment, such as those with criminal records — tend to benefit disproportionately from strong job markets, when employers have more of an incentive to seek out untapped pools of talent. But when recessions hit, those opportunities quickly dry up.“We have a last-in, first-out labor market, and disabled people are often among the last in and the first out,” said Adam Ozimek, chief economist at the Economic Innovation Group, a Washington research organization.Remote work, however, has the potential to break that cycle, at least for some workers. In a new study, Mr. Ozimek found that employment had risen for workers with disabilities across industries as the labor market improved, consistent with the usual pattern. But it has improved especially rapidly in industries and occupations where remote work is more common. And many economists believe that the shift toward remote work, unlike the red-hot labor market, is likely to prove lasting.More than 35 percent of disabled Americans ages 18 to 64 had jobs in September. That was up from 31 percent just before the pandemic and is a record in the 15 years the government has kept track. Among adults without disabilities, 78 percent had jobs, but their employment rates have only just returned to the level before the pandemic.“Disabled adults have seen employment rates recover much faster,” Mr. Ozimek said. “That’s good news, and it’s important to understand whether that’s a temporary thing or a permanent thing. And my conclusion is that not only is it a permanent thing, but it’s going to improve.”Before the pandemic, Kathryn Wiltz repeatedly asked her employer to let her work from home because of her disability, a chronic autoimmune disorder whose symptoms include pain and severe fatigue. Her requests were denied.Ms. Wiltz’s new job allows her to work from home permanently.Sarah Rice for The New York TimesWhen the pandemic hit, however, the hospital in Grand Rapids, Mich., where Ms. Wiltz worked in the medical billing department sent her home along with many of her colleagues. Last month, she started a job with a new employer, an insurance company, in which she will be permanently able to work remotely.Being able to work from home was a high priority for Ms. Wiltz, 31, because the treatments she receives suppress her immune system, leaving her vulnerable to the coronavirus. And even if that risk subsides, she said, she finds in-person work taxing: Getting ready for work, commuting to the office and interacting with colleagues all drain energy reserves that are thin to begin with. As she struggled through one particularly difficult day recently, she said, she reflected on how hard it would have been to need to go into the office.“It would have been almost impossible,” she said. “I would have pushed myself and I would have pushed my body, and there’s a very real possibility that I would have ended up in the hospital.”There are also subtler benefits. Ms. Wiltz can get the monthly drug infusions she receives to treat her disorder during her lunch break, rather than taking time off work. She can turn down the lights to stave off migraines. She doesn’t have to worry that her colleagues are staring at her and wondering what is wrong. All of that, she said, makes her a more productive employee.“It makes me a lot more comfortable and able to think more clearly and do a better job anyway,” she said.The sudden embrace of remote work during the pandemic was met with some exasperation from some disability-rights leaders, who had spent years trying, mostly without success, to persuade employers to offer more flexibility to their employees.“Remote work and remote-work options are something that our community has been advocating for for decades, and it’s a little frustrating that for decades corporate America was saying it’s too complicated, we’ll lose productivity, and now suddenly it’s like, sure, let’s do it,” said Charles-Edouard Catherine, director of corporate and government relations for the National Organization on Disability.Still, he said the shift is a welcome one. For Mr. Catherine, who is blind, not needing to commute to work means not coming home with cuts on his forehead and bruises on his leg. And for people with more serious mobility limitations, remote work is the only option.Many employers are now scaling back remote work and are encouraging or requiring employees to return to the office. But experts expect remote and hybrid work to remain much more common and more widely accepted than it was before the pandemic. That may make it easier for disabled employees to continue to work remotely.The pandemic may also reshape the legal landscape. In the past, employers often resisted offering remote work as an accommodation to disabled workers, and judges rarely required them to do so. But that may change now that so many companies were able to adapt to remote work in 2020, said Arlene S. Kanter, director of the Disability Law and Policy Program at the Syracuse University law school.“If other people can show that they can perform their work well at home, as they did during Covid, then people with disabilities, as a matter of accommodation, shouldn’t be denied that right,” Ms. Kanter said.Ms. Kanter and other experts caution that not all people with disabilities want to work remotely. And many jobs cannot be done from home. A disproportionate share of workers with disabilities are employed in retail and other industries where remote work is uncommon. Despite recent gains, people with disabilities are still far less likely to have jobs, and more likely to live in poverty, than people without them.“When we say it’s historically high, that’s absolutely true, but we don’t want to send the wrong message and give ourselves a pat on the back,” Mr. Catherine said. “Because we’re still twice as likely to be unemployed and we’re still underpaid when we’re lucky enough to be employed.”Disability issues are likely to become more prominent in coming years because the pandemic has left potentially millions of adults dealing with a disability. A recent study by the Federal Reserve Bank of New York estimated that close to two million working-age Americans had become disabled because of long Covid.Employers that don’t find ways to accommodate workers with disabilities — whether through remote work or other adjustments — are going to continue to struggle to find employees, said Mason Ameri, a Rutgers University business professor who studies disability.“Employers have to shape up,” he said. “Employers have to pivot. Otherwise this labor shortage may be more permanent.” More

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    Biden Takes On Sagging Safety Net With Plan to Fix Long-Term Care

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    The proposal to spend $400 billion over eight years faces political challenges and a funding system not designed for the burden it has come to bear.President Biden’s $400 billion proposal to improve long-term care for older adults and those with disabilities was received as either a long overdue expansion of the social safety net or an example of misguided government overreach.Republicans ridiculed including elder care in a program dedicated to infrastructure. Others derided it as a gift to the Service Employees International Union, which wants to organize care workers. It was also faulted for omitting child care.For Ai-jen Poo, co-director of Caring Across Generations, a coalition of advocacy groups working to strengthen the long-term care system, it was an answer to years of hard work.“Even though I have been fighting for this for years,” she said, “if you would have told me 10 years ago that the president of the United States would make a speech committing $400 billion to increase access to these services and strengthen this work force, I wouldn’t have believed it would happen.”What the debate over the president’s proposal has missed is that despite the big number, its ambitions remain singularly narrow when compared with the vast and growing demands imposed by an aging population.Mr. Biden’s proposal, part of his $2 trillion American Jobs Plan, is aimed only at bolstering Medicaid, which pays for somewhat over half the bill for long-term care in the country. And it is targeted only at home care and at community-based care in places like adult day care centers — not at nursing homes, which take just over 40 percent of Medicaid’s care budget.Still, the money would be consumed very fast.Consider a key goal: increasing the wages of care workers. In 2019, the typical wage of the 3.5 million home health aides and personal care aides was $12.15 an hour. They make less than janitors and telemarketers, less than workers in food processing plants or on farms. Many — typically women of color, often immigrants — live in poverty.The aides are employed by care agencies, which bill Medicaid for their hours at work in beneficiaries’ homes. The agencies consistently report labor shortages, which is perhaps unsurprising given the low pay.Raising wages may be essential to meet the booming demand. The Labor Department estimates that these occupations will require 1.6 million additional workers over 10 years.It won’t be cheap, though. Bringing aides’ hourly pay to $20 — still short of the country’s median wage — would more than consume the eight-year outlay of $400 billion. That would leave little money for other priorities, like addressing the demand for care — 820,000 people were on states’ waiting lists in 2018, with an average wait of more than three years — or providing more comprehensive services.The battle over resources is likely to strain the coalition of unions and groups that promote the interests of older and disabled Americans, which have been pushing together for Mr. Biden’s plan. And that’s even before nursing homes complain about being left out.The president “must figure out the right balance between reducing the waiting list and increasing wages,” said Paul Osterman, a professor at the Massachusetts Institute of Technology’s Sloan School of Management who has written about the nation’s care structures. “There’s tension there.”Elder care has long been at the center of political battles over social insurance. President Lyndon B. Johnson considered providing the benefit as part of the creation of Medicare in the 1960s, said Howard Gleckman, an expert on long-term care at the Urban Institute. But the chairman of the House Ways and Means Committee, Wilbur Mills, warned how expensive that approach would become when baby boomers started retiring. Better, he argued, to make it part of Medicaid and let the states bear a large chunk of the burden.This compromise produced a patchwork of services that has left millions of seniors and their families in the lurch while still consuming roughly a third of Medicaid spending — about $197 billion in 2018, according to the Kaiser Family Foundation. By Kaiser’s calculations, Medicaid pays for roughly half of long-term care services; out-of-pocket payments and private insurance together pay a little over a quarter of the tab. (Other sources, like programs for veterans, cover the rest.)Unlike institutional care, which state Medicaid programs are required to cover, home and community-based care services are optional. That explains the waiting lists. It also means there is a wide divergence in the quality of services and the rules governing who gets them.Although the federal government pays at least half of states’ Medicaid budgets, states have great leeway in how to run the program. In Pennsylvania, Medicaid pays $50,300 a year per recipient of home or community-based care, on average. In New York, it pays $65,600. In contrast, Medicaid pays $15,500 per recipient in Mississippi, and $21,300 in Iowa.A home health aide accompanies a patient to a vaccine appointment. Elder care has long been at the center of political battles over social insurance.James Estrin/The New York TimesThis arrangement has also left the middle class in the lurch. The private insurance market is shrinking, unable to cope with the high cost of care toward the end of life: It is too expensive for most Americans, and it is too risky for most insurers.As a result, middle-class Americans who need long-term care either fall back on relatives — typically daughters, knocking millions of women out of the labor force — or deplete their resources until they qualify for Medicaid.Whatever the limits of the Biden proposal, advocates for its main constituencies — those needing care, and those providing it — are solidly behind it. This would be, after all, the biggest expansion of long-term care support since the 1960s.“The two big issues, waiting lists and work force, are interrelated,” said Nicole Jorwic, senior director of public policy at the Arc, which promotes the interests of people with disabilities. “We are confident we can turn this in a way that we get over the conflicts that have stopped progress in past.”And yet the tussle over resources could reopen past conflicts. For instance, when President Barack Obama proposed extending the Fair Labor Standards Act of 1938 to home care workers, which would cover them with minimum-wage and overtime rules, advocates for beneficiaries and their families objected because they feared that states with budget pressures would cut off services at 40 hours a week.“We have a long road ahead of passing this into law and to implementation,” Haeyoung Yoon, senior policy director of the National Domestic Workers Alliance, said of the Biden proposal. Along the way, she said, supporters must stick together.Given the magnitude of the need, some wonder whether there might be a better approach to shoring up long-term care than giving more money to Medicaid. The program is perennially challenged for funds, forced to compete with education and other priorities in state budgets. And Republicans have repeatedly tried to curtail its scope.“It’s hard to imagine Medicaid is the right funding vehicle,” said Robert Espinoza, vice president for policy at PHI, a nonprofit research group tracking the home care sector.Some experts have suggested, instead, the creation of a new line of social insurance, perhaps funded through payroll taxes as Social Security is, to provide a minimum level of service available to everyone.A couple of years ago, the Long-Term Care Financing Collaborative, a group formed to think through how to pay for long-term elder care, reported that half of adults would need “a high level of personal assistance” at some point, typically for two years, at an average cost of $140,000. Today, some six million people need these sorts of services, a number the group expects to swell to 16 million in less than 50 years.In 2019, the National Academy of Social Insurance published a report suggesting statewide insurance programs, paid for by a dedicated tax, to cover a bundle of services, from early child care to family leave and long-term care and support for older adults and the disabled.This could be structured in a variety of ways. One option for seniors, a catastrophic insurance plan that would cover expenses up to $110 a day (in 2014 dollars) after a waiting period determined by the beneficiary’s income, could be funded by raising the Medicare tax one percentage point.Mr. Biden’s plan doesn’t include much detail. Mr. Gleckman of the Urban Institute notes that it has grown vaguer since Mr. Biden proposed it on the campaign trail — perhaps because he realized the tensions it would raise. In any event, a deeper overhaul of the system may eventually be needed.“This is a significant, historic investment,” Mr. Espinoza said. “But when you take into account the magnitude of the crisis in front of us, it’s clear that this is only a first step.” More