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National Center on Secondary Education and Transition

In Their Own Words: Employer Perspectives on Youth with Disabilities in the Workplace

Searching for a Reliable Workforce:
Cincinnati Children’s Hospital Medical Center

by J. Erin Riehle

Cincinnati Children’s Hospital Medical Center is dedicated to serving the health care needs of infants, children, and adolescents and to providing research and teaching programs that ensure delivery of the highest quality pediatric care to our community, the nation, and the world.

High Quality Care Requires High Quality Staff

In a typical hospital, 70% of the staff members are professionals such as doctors, nurses, therapists, and other personnel who are highly trained and educated. For the most part, the rest are support staff who receive the greater portion of their training on the job. At all levels, however, hospitals need people who are committed and well prepared. Hospitals also need to connect directly with their communities, both as healthcare providers and as employers. Therefore, beginning in the mid-1990s, Cincinnati Children’s Hospital Medical Center began a significant diversity initiative to attract and retain the entire spectrum of the community’s potential workforce. This initiative especially targeted people with disabilities. The reasons were three-fold:

  • We were experiencing a particular problem attracting and keeping good entry-level support staff. We needed to upgrade and expand our recruitment approaches to include the large segment of job seekers who have disabilities, want to work, and, as we learned, who are often represented by a variety of organizations that assist them in job preparation and job search.
  • We needed to bolster the quality and intensiveness of our on-the-job education of new staff so that they were prepared well, performed better, and stayed on the job longer. Some of these employment organizations offered assistance to the hospital in designing ways of improving job training and support for people with disabilities.
  • We had adopted as a guiding principle a 1995 policy of the American College of Healthcare Executives, which states: “Healthcare organizations must lead their communities in increasing employment opportunities for qualified persons with disabilities and advocate on behalf of their employment to other organizations.”

As we quickly learned, hospitals can be very good at providing medical services to people with disabilities who are in their care, but they are not always so good at recognizing the productivity that is possible for people with disabilities when they have the right kinds of opportunity and support. We had to take some baby steps before we were able to develop what is now a well-designed partnership with outside schools and organizations that enabled us to eventually hire more than 100 people with disabilities in a wide range of jobs.

Search for Assistance Begins

As the head of the hospital’s Emergency Room in the mid-1990s with hiring and firing authority, I decided to look into this recruitment avenue. Not knowing exactly where to start, I used the phone book to locate such resources. After a few dead ends, I found the Great Oaks Institute of Technology and Career Development, a special needs vocational school, and the Hamilton County Board of MR/DD, a government agency serving people with mental retardation and other developmental disabilities. After many planning meetings, we initiated a training experience where youth and adults with disabilities were taught to stock supplies for the Emergency Room.

The arrangement worked so well that other departments wanted to try a similar approach. We soon identified another area of opportunity—the hospital needed reliable couriers to deliver mail, packages, and materials to labs and locations throughout our nine-building campus. Before long, 13 people were hired as lab couriers. We formalized the relationship with Great Oaks and the Board of MR/DD with a legal contract specifying the roles of all partners, and I soon found myself out of the ER and directing this new effort, now known as Project SEARCH.

Experience Leads to Adjustments in our Approach

The initiative worked so well that we decided to significantly expand it. We put out a call to a number of agencies that serve job seekers with disabilities, resulting eventually in the involvement of six different agencies that provided a total of 13 different job coaches at any given time. Unfortunately, this turned out to be a very unwieldy—and ultimately unworkable—arrangement. We found ourselves dealing with multiple organizations whose staff had little direct knowledge of our needs. We had to train them and the employees with disabilities. We also had no control over who was hired to be a job coach (and if they were late or tardy, we were at their mercy). If they were not of the caliber we desired, we had little influence over improving their selection, training, or development. Overall, this was not a very employer-friendly arrangement.

So we changed the model. Through a contract with Hamilton County Board of MR/DD, we now hire our own job coaches. We have developed our own support program for individuals with disabilities whom we hire. In this way we can make sure that the performance of both the coaches and the employees meets our standards. The job coaches become thoroughly acquainted with the hospital’s needs, and consequently are better able to train and support the people with disabilities we hire. And we can more rapidly and conveniently address any performance or accommodation issues that may arise.

We have made Project SEARCH a single point of entry, so that it is easier for us to make contacts with schools and agencies representing people with disabilities. We coordinate referrals, the application process, all hiring decisions, and manage on-the-job support, such as job coaching, adaptations, accommodations, final task definitions for specific jobs, and travel training. We also maintain employment status through on-site follow-along service and provide opportunities for career advancement. Project SEARCH now provides employment and educational opportunities for more than 75 individuals with disabilities who have a range of disabilities and accommodation needs. They are employed in a range of positions, with almost all of the positions at full-time status.

Project SEARCH Targets Youth

Participants in Project SEARCH learn through demonstration, outreach, and education, combined with technical assistance, in several distinct programs. One of these programs is called the High School Transition Program, now in its sixth year of operation. This program offers a one-year transition program for students with disabilities who are in their last year of school. The program is geared toward students whose main goal is employment and who are interested in career exploration in a healthcare setting. It is a major vehicle for preparing and recruiting new hospital employees, although a number of the participants go on to work in other places.

During the first half of the school year, up to 12 students spend the day at Cincinnati Children’s or at Clinton Memorial Hospital and rotate through three to four work site experiences. These site rotations allow participants to build various skills, including communication, problem solving, and specific job duties as they become ready for competitive work environments. During the second half of the school year, individualized job development and placement occurs based on the student’s experiences, strengths, and skills. Students are given support with accommodations, adaptations, and on-the-job coaching by on-site staff. As the school year ends, linkages are made to appropriate community services in order to ensure a successful transition to work as well as retention and career advancement. Many stay on and become permanent employees of Cincinnati Children’s.

What Makes it Work

In the past, our human resources department was typically approached by many different education and job placement professionals. We had no way of understanding all the organizations and people they represented. It also seemed that the approaches they used were based on sympathy, so that we would consider hiring a person with a disability. It is not a model that works for business. It is too complicated and confusing, too inconvenient, and too out-of-touch with our real human-resource needs. Most often, applications from such sources ended up in the circular file. We have been able to develop a viable alternative that is very effective in meeting our needs. The keys to making it work to our benefit are:

  • There is a single point of entry (Project SEARCH). We post jobs and make them known to schools and organizations representing people with disabilities who access one place for job information and through which the various hospital departments can screen applicants.
  • Our internal position in the hospital allows us to constantly evaluate job opportunities and determine options, such as job restructuring, that meet our needs and that also offer unique opportunities for job seekers.
  • On-site staff, employed by the hospital, facilitate direct coaching and the support necessary for many of our employees with disabilities to perform well.
  • A clear cooperative agreement with selected school and disability service partners gives us a direct connection with special educators and rehabilitation professionals for expertise in accommodations and training methodology when we need it. We no longer have to use the phone book to find resources for expertise in disabilities and employment.
  • We strongly believe in the policy statement of the American College of Healthcare Executives on increasing employment of people with disabilities. Our approach creates internal advocates for disability employment.

Our project, which has received local and national awards, has now expanded beyond our own hospital complex. In addition to linking our efforts with other healthcare facilities, we are now negotiating with a prominent bank and two retail stores to organize similar opportunities for people with disabilities. Every industry has the need for a well prepared, highly functioning workforce. We want to equip companies in other industries to develop internal structures that will enable them to successfully recruit, hire, and manage employees with disabilities. Our experience with an employer-driven approach clearly illustrates very effective ways to both meet company human-resource needs and to increase the employment options for people with disabilities.

J. Erin Riehle, M.S.N., R.N., is Director of the Division of Disability Services at the Convalescent Hospital for Children, an affiliate of Cincinnati Children’s Medical Center. A long-time healthcare professional and former Emergency Room administrator, she founded Project SEARCH. Project SEARCH and the Division of Disability Services at Cincinnati Children’s now encompass eight programs, including the High School Transition Program, Adult Employment Program, Healthcare Training Program, Vocational-Education Clinic, Intern Program, Virtual Academy, Incumbent Worker Program, and SEARCH for Fitness. For additional information, go to http://www.projectsearch.us/

Table of Contents

Cover Page


Publish or Perish: Macworld Magazine by Shelly Ginenthal

Reaching Out to Youth: Microsoft Corporation by Mylene Padolina

Boosting the High Tech Workforce: Kennedy Space Center, NASA by Cassandra Black

Finding Premium Volunteers: Port Discovery by Leah Burke

Investigating Human Resource Options: American Institute for Cancer Research by John McIlveen

Manufacturing & Production Technician Youth Apprentices: Generac Portable Products Corporation by Bob Hurd

Infrastructure for Success: Kemtah Group, Inc. by Keith Harris

Quality Products, Quality Employees: Medtronic Physio-Control by LaDrene Coyne

Searching for a Reliable Workforce: Cincinnati Children's Hospital Medical Center by J. Erin Riehle

Keeping Stock of Personnel Needs: Safeway by Grace Louie

Brokering Achievement: Old Colony Insurance Service, Inc. by S. Brooks May, Jr.

Summary & Conclusion

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Citation: Luecking, R., Ed. (2004). Essential tools: In their own words: Employer perspectives on youth with disabilities in the workplace. Minneapolis, MN: University of Minnesota, Institute on Community Integration, National Center on Secondary Education and Transition.

Permission is granted to duplicate this publication in its entirety or portions thereof. Upon request, this publication will be made available in alternative formats. For additional copies of this publication, or to request an alternate format, please contact: Institute on Community Integration Publications Office, 109 Pattee Hall, 150 Pillsbury Drive SE, Minneapolis, MN 55455, (612) 624-4512, icipub@umn.edu.

This document was published by the National Center on Secondary Education and Transition (NCSET). NCSET is supported through a cooperative agreement #H326J000005 with the U.S. Department of Education, Office of Special Education Programs. Opinions expressed herein do not necessarily reflect the policy or position of the U.S. Department of Education Programs, and no official endorsement should be inferred. The University of Minnesota, the U.S. Department of Education, and the National Center on Secondary Education and Transition are equal opportunity employers and educators.