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Welcome to: Getting to Work: A Training Curriculum for HIV/AIDS Service Providers and Housing Providers Module 2: Adopting an Employment and Training Mindset - Organizationally and Individually

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Value of Work

Getting back to work is essential to leading an independent, healthy life.

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Module 2

Adopting an Employment and Training Mindset - Organizationally and Individually

This module is the second in a three-part series. In it, we will explore what employment services are and how they can be delivered. This module will provide a broad overview of these topics as a foundation for Module 3, which will present in-depth information about the many different forms employment services can take.

Introduction to Module 2

Advances in treatment have resulted in more people with HIV/AIDS (PLWHA) living longer lives and experiencing greater health.

Key Terms

Employment services: Activities that help people prepare for, obtain, and keep jobs.
Vocationalizing: HIV/AIDS service providers adding employment services to their programmatic offerings.

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Transcript

In recent years, advances in treatment have resulted in more people with HIV or AIDS living longer lives and experiencing better health. Many want to work and have the ability to work, and a growing body of research indicates that doing so has many positive benefits. The term 'employment services' refers to a variety of activities that help people prepare for, obtain, and keep jobs. More and more HIV/AIDS service providers and housing providers are adding employment services to their programmatic offerings. In this training, we will call this process "vocationalizing." Before adopting such activities, service providers should understand:

The range of possible employment services
The stages of change that comprise the vocationalizing process for organizations and the employment process for individuals
Employment in the context of disability, including various disability non-discrimination laws and regulations
And how transitioning to work may impact individuals' eligibility for public benefits

This module will provide a broad overview of these topics.

This module, Adopting an Employment and Training Mindset - Organizationally and Individually (Module 2) considers:

The range of possible employment services

The vocationalizing process for organizations and the employment process for individuals

Employment in the context of disability, including various disability non-discrimination laws and regulations

How transitioning to work may impact individuals' eligibility for public benefits.

Learning Objectives

After completing Adopting an Employment and Training Mindset - Organizationally and Individually, you will be able to:

Articulate what it means for an organization to vocationalize, and the steps involved in moving toward an employment mindset.
Describe the various stages individuals experience in their consideration of employment and the vocational services that support individuals through each of those stages.
Describe employment services from the perspectives of individual job seekers and employers.
Discuss the main laws and regulations that support and protect the employment of people with disabilities, including people living with HIV/AIDS.
Provide preliminary guidance to clients on work incentive programs available and the impact employment may have on Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and other benefits.

List of Handouts and Resources

Unit 1:

What are Employment Services?

The information in this unit will help service providers define employment services and think about them in terms of "supply and demand."

What are Employment Services?

Employment Services

Is a general term used to describe a range of activities that facilitate employment for individuals
Are used by job seekers (supply side) and employers seeking workers (demand side)
Are sometimes called job services or workforce development services, the latter especially when they are publicly funded
Are typically delivered at the community level in response to variations in local economies and labor markets

Connecting Labor Supply and Demand: Supply

Individuals considering or seeking employment make up the "supply" side of employment services.

Individuals may access employment services using a range of resources, both publicly and privately funded, that can help them pursue their employment goals. To be effective, these services should be individualized and sufficiently flexible to meet the service needs of people at varying stages of readiness to work

Connecting Labor Supply and Demand: Supply

Employment services should meet the needs of people at varying stages of work readiness.

Employment services should "meet people where they are," as opposed to only benefiting those who already have a prescribed measure of skills or experience. Individualized employment services planning should be based upon job seekers' interests, preferences, and skills, as well as the types of jobs that are likely to be available locally.

Connecting Labor Supply and Demand: Supply

Employment services may include:

Training on "soft" skills such as communication and teamwork.
Job placement assistance, including help searching for and applying for jobs as well as, in some cases, direct introduction to employers or arrangement of internships or work tryouts.
Vocational training to develop skills related to specific jobs or industries.
Retention supports to help individuals retain employment and continue to progress towards their goals.

Connecting Labor Supply and Demand: Demand

Demand may occur on an individual basis, when an employer needs just one or a few employees, or on a group basis, when an employer has a need for many employees at once. HIV/AIDS service providers who integrate employment services into their service menus often focus on the supply side by strengthening the capacity of individuals to find and maintain employment.

Unit 2:

The Organizational Perspective

Employment services must be considered from both an organizational and individual perspective. This unit will help HIV/AIDS service providers to assess options related to integrating employment assistance into their service menus, or expanding existing programs.

Adopting an Employment Mentality as an Organization

"Vocationalizing" is a term used to describe the process a service provider undergoes as it begins to evaluate the employment services needs of its clients and develop strategies for meeting them.

Examples of vocationalizing through the enhancement of existing services and development of new programming include:

Structuring client volunteer or internship programs
Evaluating and improving computer access facilities
Providing weekly discussion groups for clients
Adding employment-related questions to client intake
forms related to employment status and interest

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Transcript

The process of vocationalizing is different for different organizations. For some, it might entail implementing modest revisions to existing services or developing strong referral partnerships with other organizations that already offer employment services. For others, vocationalizing might mean developing new employment services programs internally. Whatever approach an organization decides to take, the vocationalizing process requires identification of barriers clients experience related to considering and pursuing employment, and the development of strategies for overcoming or eliminating identified barriers.

Vocationalizing also includes enhancing existing services or developing new programming to maximize opportunities for clients to develop skills and to prepare for employment. Examples of possibilities include:

Structuring client volunteer or internship programs so that participants have the opportunity to gain more varied work experiences and responsibilities
Evaluating and improving computer access facilities so that clients have the opportunity to build job search skills and computer literacy
Providing weekly discussion groups for clients to learn about job experiences and opportunities, build resumes, or hear from guest speakers from local employment service providers or organizations
And adding questions to client intake forms related to employment status and interest

Employment and Training Services

Vocationalizing occurs in different ways, depending on the organization, clients' needs, and the local labor market.

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Transcript

Vocationalizing looks different depending on the setting, the clients' needs, and the local labor market. Some organizations have decided to vocationalize by offering additional services such as employment-focused case management; job training; vocational assessment; career counseling; job search skills training; job referral or job placement; and ongoing employment retention supports. Some have developed their own social enterprises, creating businesses to provide training and employment opportunities for their clients. Others have offered microenterprise development assistance for individuals seeking to launch their own businesses.

Some organizations have decided to vocationalize by implementing:

Employment case management
Job training, work readiness and skill building programs
Career counseling
Job search skills training
Job referral or job placement
Ongoing employment retention supports
Social enterprises - such as cafes or thrift shops - to provide structured, on-the-job training and to generate income to support agency functions
Microenterprise development assistance

Diagram: from upper left, clockwise: Contemplation (Assessment); Preparation (planning); Action (Implementation); Resolution (Evaluation). In center: Considering Work.

The Vocational Process for Organizations

Client-Focused Considering Work Model

Goldblum, P., & Kohlenberg, B. (2005). Vocational counseling for people with HIV: The client-focused considering work model. Journal of Vocational Rehabilitation, 22, 115-124.

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Transcript

The figure shown on this slide depicts the Client-Focused Considering Work Model. It provides a useful framework for assessing employment options for both organizations and individuals. Each of its stages is key to the vocationalizing process for an organization. The next few slides will describe each component of the model in detail.

Contemplation/Assessment

Assessing organizational capacity and the value of providing employment services

Before planning to implement employment services, HIV/AIDS service providers must assess how they would contribute to their organizational mission, vision, and values. This process may include a review of the research findings on the benefits of employment on HIV/AIDS health and prevention outcomes and a review of activities and outcomes of other HIV/AIDS service providers who are having success providing employment services - directly or through community partnerships.

It is also important to explore internal and external attitudes, client needs and interests, and current resources related to employment services. This information helps inform decision-making, planning, and outreach to potential community partners.

The Assessment Process

During the assessment process, members of an organization should gather information specific to the organization itself as well as information about the community in which it resides.

Internal Exploration:

Survey clients and other PLWHA
Solicit input from boards of directors, staff and volunteers
Explore possible internal resources
Identify needs for future education, training, and technical assistance

External Exploration:

Assess employment-related resources currently available in the community that PLWHA may be able to access
Identify service gaps
Gather information about prospective sources of funding support

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Transcript

During the assessment process, members of an organization should gather information specific to the organization itself as well as information about the community in which it resides.

During internal exploration, the organization may:

Survey clients and other people living with HIV AIDS to learn about their employment history and current status, as well as their interests and concerns related to employment, training, and education.
Solicit input from boards of directors, staff, and volunteers to illuminate already-existing attitudes, aptitudes, competencies, and knowledge about employment services.
Explore existing internal resources that may be helpful in developing a program, and
Identify needs for future education, training, and technical assistance.

During external exploration, the organization may:

Assess employment-related resources currently available in the community that people living with HIV AIDS may be eligible to access. These resources might include the public workforce system, state vocational rehabilitation agencies, Ticket to Work Employment Networks, community-based organizations, employers, and others.
Identify service gaps by considering information gained about existing employment services in light of lessons learned from internal exploration regarding service needs.
And gather information about prospective sources of funding support, whether public or private

Preparation/Planning

Choosing a service model and planning to vocationalize.

An HIV/AIDS service provider that has made the decision to integrate employment services is in the preparation phase of the model. In this phase, the organization develops a vocationalizing plan that supports its mission and takes into account community needs, existing resources, and information gathered during the contemplation phase. This plan should specify the types of services that the organization has decided to provide, as well as information about how they will be developed.

Preparing for Program Development

When preparing for program development, it is important to:

Establish a planning team to foster the effort;
Review internal agency policies and procedures to identify barriers to implementing employment services;
Recommend feasible changes to ensure success;
Evaluate current programming to identify areas for expansion that may result in greater vocational development and job readiness opportunities for participants; and
Identify an employment service model well suited to the needs of your clients and your organization's capacity.

Most HIV/AIDS service models were designed for caretaking, based on a condition that for many years was untreatable and stigmatizing. Offering employment services may require a significant shift in thinking for some HIV/AIDS service providers.

Action/Implementation

Developing and implementing a vocationalizing plan.

To implement the service model identified during the preparation phase, HIV/AIDS service providers should map planned activities back to program goals and objectives and identify needed "human capital" (e.g., staff, volunteers, board of directors) and other "inputs" (e.g., facilities, insurance, equipment, supplies and materials).

The plan should also outline structures for collecting, evaluating, and reporting data to assess effectiveness and identify areas for improvement. This may include creating client satisfaction surveys and systems for short- and long-term monitoring of client outcomes.

It is important to note that evaluation does not just happen at the end of service delivery. Evaluation should start at inception and be embedded in the organization's mission. For more information on developing an evaluation plan and how to conduct an evaluation, visit the Handouts and Resources slide.

Action/Implementation

Developing and implementing a vocationalizing plan

An organization's vocationalizing plan breaks down the steps necessary to integrate employment services. These vary depending on the organization and the services to be offered, but may include:

Reaching out to key partners and potential participants (including current clients);
Educating staff members and community stakeholders about the new services;
Revising policies and procedures;
Developing a budget and identifying resources to support new service elements;
Recruiting, hiring, and training new staff, or adapting existing staff members' roles;
Procuring equipment and supplies;
Identifying data elements to track in order to assess outcomes, and developing a methodology for collecting and reporting this data.

The plan is a living document and should be revisited and revised regularly to reflect lessons learned and new realities.

Resolution/Evaluation

Evaluating services, staff development, and continuous quality review

Resolution occurs when the employment services are implemented. Focus shifts to maintaining, evaluating, and working toward continuous improvement. Ongoing assessment and relationship development are key to sustaining success during this phase.

By measuring appropriate outcomes (e.g. number of clients who obtain jobs or complete job training programs) and using the data to adapt programming, organizations ensure that their employment services are effective.

It is also critical that organizations in this phase nurture ongoing collaboration with workforce development and vocational rehabilitation providers, employers, other HIV/AIDS service providers, PLWHA and other community partners.

Reflection Questions

Take a moment and answer these questions to deepen your learning.

Unit 3:

The Individual Perspective

The information in this unit is intended to help HIV/AIDS service providers better understand the experience of individuals considering work.

Diagram: from upper left, clockwise: Contemplation (Assessment); Preparation (planning); Action (Implementation); Resolution (Post-Employment Support). In center: Considering Work.

The Vocational Process for Individuals

Client-Focused Considering Work Model

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Transcript

The vocational process for individuals can be understood as a set of concrete steps that align with the four stages of "considering work." As we revisit the Client-Focused Considering Work Model, notice that "resolution" is actualized, not through evaluation, as at the organizational level, but rather through post-employment support. Depending on an individual's unique circumstances, each of these four steps might present different challenges and opportunities for employment service activities. Likewise, different state and federal agencies, departments, administrations, divisions, and offices may use these terms differently. It is important to determine on a case-by-case basis how these terms are used. Unit 4 will illustrate the vocational process of one individual as she moves through each of the four stages.

Transcript

"I was surprised to learn there could be so much support for job training and actually looking for work. Through the American Job Center I have an appointment next week to meet with a Disability Program Navigator working there. I'm so excited to actually picture going back to work again. My life is moving in a whole new direction."

Preparation/Planning

Developing an individual vocational/career plan

Information obtained during the vocational assessment process will help in the development of an individual vocational/career plan. The purpose of the plan, developed collaboratively by the client and service provider, is to identify the client's short- and long-term employment goals and articulate the steps to achieve them. In addition to addressing the client's individual situation, the plan should also take into account relevant external factors, including current and projected labor market trends, available training and education programs, available employment services, and other resources.

Layla's Preparation and Planning:

A Case Study

When Layla first met with Angela, her Vocational Rehabilitation Counselor, she shared the information she had been gathering with her Case Manager Roberto's assistance. Together, Layla and Angela would develop Layla's Individual Plan for Employment (IPE).

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Transcript

"Thanks for working with me, Angela. I'm looking forward to hearing the ideas you have to help me develop an actual plan."

Layla Developing a Career Plan:

A Case Study

Angela and Layla developed an IPE that reflected all of the areas of support that Layla would need in order to pursue her goal of becoming a medical records clerk: accessible training programs, employment assistance resources, activities to hone her skills and to give her a competitive edge.

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Transcript

"I plan to enroll in an intro to health management course this fall at the community college. They have a co-op program where I can work in a clinic for course credit getting real hands-on experience. I'm going to ask the instructor if I can audit the course in case it becomes too much for me. I'm also going to pursue options for volunteering in the medical records field."

Layla Developing a Career Plan:

A Case Study

Layla's IPE also accounted for important non-vocational areas of her life: her health and healthcare. Her plan ensured her ability to:

Maintain consistent healthcare treatment with her current providers
Continue regular participation in the recovery meetings and activities which she found important to her strength and stability
Access child care resources, transportation, and other supports essential to her success in training and at work

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Transcript

"Angela made sure my plan also allowed for family responsibilities and other needs beyond my healthcare. I listed things like transportation, clothing, and other materials I'd need, like books and notebooks and access to a computer, and we identified resources to help me make sure I could get what I needed."

Layla Developing a Career Plan:

A Case Study

Layla and Angela used the IPE writing process to identify and document each of her goals, and to list the steps necessary to achieve them. One goal was to avoid or minimize expenses related to preparing for employment. Another was to learn about all available supports and resources that would help her do well in training.

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Transcript

"In my research with Roberto, I found out that at the college where I plan to take courses, students with disabilities could receive support services. So steps in my IPE include determining what exactly those services are and signing up for them. Angela is really good at helping me brainstorm less obvious goals that I didn't think of at first, and then breaking them down into steps for achieving them."

Action/Implementation

Accessing resources

Implementation services may vary depending on the individual goals and needs of the client. Implementation entails accessing the resources identified in the vocational/career plan to make progress toward identified goals. At this stage, the client is participating in activities to increase the likelihood of obtaining employment. For employment service providers, this means helping the client connect to:

Education or vocational training
Job readiness assistance (e.g., training on soft skills such as communication, professionalism, time management, problem solving, HIV self-management, disclosure and accommodations)
Employment or internship opportunities that align with goals

Layla Implementing her Career Plan:

A Case Study

When Layla decided to enroll in school, she enlisted a diverse support network that included people from different parts of her life:

Vocational rehabilitation counselor
Case manager
Family, friends
Healthcare providers
HIV support group
Recovery partners
Community Work Incentives Coordinator (CWIC) in her local Work Incentives Planning and Assistance (WIPA) Program
Disability Resource Coordinator in her local American Job Center
Disability Student Services Coordinators at her school

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Transcript

"Sometimes the coursework can feel overwhelming, or I find myself slipping out of my routine or just getting really tired. Roberto is constantly checking up on me and encouraging me to reach out to my friends or my sponsor. He makes sure I keep my medical appointments and take my meds. He hounds me if I miss a meeting or a support group. I don't know if I could make it without his support. I do feel like I'm challenging myself and really developing new 'muscles' for self-care and training, and I'm proud and excited. Soon I will be ready to actually start looking for a job."

Layla Implementing her Career Plan:

A Case Study

After completing her classes, Layla began working with Irena, an employment specialist Angela connected her with. Irena was known to be especially helpful to people looking for work with qualifications in the health care industry. She helped Layla develop her resume, prepare for interviews, and build other job search skills.

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Transcript

"I was really nervous about looking for a job. Working with Irena, my employment specialist, helped a lot. It was like having my own personal, well-informed coach, cheerleader, and researcher all rolled into one. Irena helped me apply for medical records clerk jobs available in two hospitals and a clinic that was easy for me to get to. She helped me get ready for my interviews, write thank-you notes, and follow up in a professional way. She also kept me from getting too discouraged when I didn't get hired by the first hospital or the clinic. Irena pushed me to keep trying. And it worked - I got a great job at the second hospital! I'm so excited. I can't wait to begin!"

Resolution/Post-Employment Support

After employment is achieved

Once employment is achieved, the focus of employment services shifts to post-employment support. For many people living with HIV/AIDS - as well as others who face employment challenges - support while adjusting to a new employment situation is critical to succeeding on the job. Examples of post-employment support include job retention services, job coaching, and ongoing career development to help plan for continued growth and advancement.

Layla: Support Beyond Employment

A Case Study

After more than five years of not working, Layla began her new job as a medical records clerk at a large hospital. The full range of her support network helped make this transition successful. Continued check-ins helped her navigate through adjustments to her new routine. Layla had prepared well for managing the reporting requirements related to her benefits and stayed on top of those responsibilities.

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Transcript

"It took a while for me to feel I could handle all the major changes in my life that come with being fully employed again. Working full time was a challenge to my self-care activities and I often relied on other people to help me stay on track. It helped to consult my IPE, which listed clear steps during this stage, including how to keep my benefits, and finding time for myself. If it weren't for Roberto, Angela, Irena, and the rest of my support network, I'm not sure I would have made it."

Layla: Support Beyond Employment

A Case Study

Eventually, Layla began shifting her roles in some of the places she'd depended on for services. Roberto developed an opportunity for her to connect with another woman who'd recently begun to consider working. Layla then proudly served as the first mentor in a new Getting to Work Mentorship Program for people living with HIV/AIDS in her community.

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Transcript

"All the people in my network of supporters had everything to do with me getting to where I am today. Becoming a mentor to others living with HIV or AIDS who want to go back to work is so rewarding. And it has given me the confidence I need to believe that eventually I can move into even more challenging positions at work."

Stigma/Discrimination

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Transition-to-Work Issues

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Transcript

When transitioning to work, whether for the first time or after a period of unemployment, people living with HIV or AIDS confront a variety of considerations. It is important for those who provide services to people living with HIV or AIDS to be aware of these factors and their implications for clients' transition to work and to understand what community supports may be available to help. These considerations can be organized into four categories: medical, legal/financial, psychosocial, and vocational.

Medical considerations might include:

Strategies for staying healthy as daily activities and routines change
Or Health insurance, medication adherence, and staying engaged in care

Legal and financial considerations might include:

Benefits and work incentives planning (to be discussed in detail later in this module)
Or credit, debt or tax issues, or application for seal of criminal records

Psychosocial considerations might include:

How employment will affect a client's family
Or how employment will affect a client's social life

Vocational considerations might include:

Determination of any necessary job accommodations
Or identifying opportunities for advancement once on the job

Of course these are only a few examples. Because each individual's situation is unique, there is no one-size-fits-all method to supporting clients as they transition to work. Thoughtful and thorough planning is essential. The remainder of this module addresses some additional important factors to consider during clients' transition to work.

When transitioning to work, people living with HIV or AIDS confront a variety of considerations.

Medical

When transitioning to work, people living with HIV or AIDS confront a variety of considerations.

Medical
Legal/financial

When transitioning to work, people living with HIV or AIDS confront a variety of considerations.

Medical
Legal/financial
Psychosocial

When transitioning to work, people living with HIV or AIDS confront a variety of considerations.

Medical
Legal/financial
Psychosocial
Vocational

Of course these are only a few examples. Because each individual's situation is unique, there is no one-size-fits-all method to supporting clients as they transition to work. Thoughtful and thorough planning is essential. The remainder of this module addresses some additional important factors to consider during clients' transition to work.

The Right to Seek, Keep, and Advance in Employment Free of Discrimination

In the U.S., it is a civil right to live free from discrimination on the basis of having, being perceived as having, or being associated with someone who has HIV or AIDS. HIV/AIDS service providers play an important role in educating their clients about the laws that protect the civil rights of PLWHA to seek, keep, and advance in

employment while being free from discrimination. Federal law protects individuals with HIV/AIDS from stigma and discrimination in transportation, housing, and the provision of public and private services. These laws provide protections for clients so they can determine whether to disclose HIV/AIDS status or seek workplace accommodations.

Though not all PLWHA think of themselves as having a disability, HIV/AIDS is covered by laws that prohibit discrimination and provide other protections based on disability status in the workplace. Pages that follow summarize these laws and regulations, with further detail in the Handouts and Resources slide.

Laws That Protect

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Cecilia Chung, Senior Strategist, Transgender Law Center

Relevant Laws and Regulations

Americans with Disabilities Act, as amended
(ADA or ADAAA)

Makes it illegal for a private employer (applies to employers with 15 or more employees) or a state or local government employer to discriminate on the basis of disability. Note: Some state and local laws also extend disability-related discrimination protections to employees of companies with fewer than 15 employees.
Prohibits employers from making disability-related inquiries during the application and pre-offer interview process or once hired (with certain exceptions, including for affirmative action purposes).
Affords people living with HIV/AIDS or other disabilities the right to enjoy equal benefits of employment and to receive reasonable accommodations that allow them to perform the essential functions of their job (and affords them confidentiality of any medical documentation disclosed during that process, except on a need-to-know basis for the provision of the accommodation).
Makes it illegal to retaliate against a person because the person complained about discrimination.
http://www.ada.gov/aids/index.htm

Rehabilitation Act of 1973

Section 501: Makes it illegal for a federal agency to discriminate on the basis of disability and requires affirmative action to hire, retain and promote qualified people with disabilities in federal government employment.
Section 503: Makes it illegal for covered federal contractors and subcontractors to discriminate on the basis of disability and requires them to take affirmative action to hire, retain and promote qualified people with disabilities, including a 7 percent utilization goal for employment of people with disabilities.
Section 504: Makes it illegal to discriminate on the basis of disability in programs and activities that receive federal financial assistance. This includes applicants and employees with disabilities, as well as discrimination in the services and activities provided by federal agencies to the public. Each federal agency has its own set of regulations and is responsible for enforcing its own regulations.

Workforce Investment and Opportunity Act of 2014

Makes it illegal to discriminate on the basis of disability in employment or in provision of services by organizations or entities that receive federal financial assistance under WIOA, and by any program or activity that is provided as part of the nation's American Job Center network by an American Job Center partner. Under WIOA, people with disabilities, including HIV/AIDS, can expect to participate equally and fully in federally funded job training and employment services. Passed in 2014, WIOA supersedes the Workforce Investment Act of 1998 (WIA) and includes a specific focus on increasing competitive, integrated employment opportunities for people with disabilities, including significant disabilities.

Family and Medical Leave Act (FMLA)

Provides eligible employees up to 12 weeks of unpaid, job-protected leave for a range of health reasons, with continuation of group health care coverage under the same terms and conditions as if the employee had not taken leave. It is important to note that a number of states and some localities have their own family leave statutes, and if a provision of a state or local law is more beneficial to the employee, that provision will prevail. As a result, in some states and localities, individuals may be eligible for more than 12 weeks. Employees may also be entitled to more than 12 weeks as a reasonable accommodation under the ADA (discussed earlier in this section).

The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Provides rights and protections for participants and beneficiaries in group health plans.

Title I of HIPAA protects health insurance coverage for employees and their families when they change or lose jobs.
Title II of HIPAA addresses privacy and security.
The "Privacy Rule" sets rules and limits on who can look at and receive an individual's health information. It applies to all forms of individuals' protected health information, whether electronic, written, or oral.
The "Security Rule" requires security for health information in electronic form.

Patient Protection and Affordable Care Act (ACA)

Significantly increases employment options for PLWHA and other disabilities by expanding access to health care, eliminating annual or lifetime benefit limits, and prohibiting discrimination based on pre-existing conditions. http://www.aids.gov/federal-resources/policies/health-care-reform/

Disclosure

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Disclosure

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Transcript

Concerns about disclosure often loom large for people living with HIV or AIDS who are considering work. Unaddressed, they can thwart progress and even willingness to access needed services and resources outside familiar HIV/AIDS service systems. Ultimately, whether or not to disclose is a personal decision that needs to be determined and supported on an individual basis, including how it will be handled in an employment setting.

In addition to concerns regarding disclosing HIV or AIDS status, some people with histories of legal convictions, incarceration, or addiction require support and guidance determining if, when, and how to share this information with employers. For instance, it may be daunting to anticipate discussing gaps in work history related to these issues during job interviews or workplace interactions.

It is valuable for service providers to help their clients to explore scenarios related to disclosure - to consider when it may or may not be in an individual's best interest to disclose their status, or more broadly the existence of a disability. Some individuals may not want to disclose their status in an employment setting, while others may choose to be open in all settings.

HIV/AIDS service providers can directly, or through partnerships, provide essential training and access to information and guidance about the protections under the ADA, HIPAA, and other laws that cover people living with HIV or AIDS. Doing so can reduce anxieties that may otherwise inhibit progress towards employment. Providing accurate information and resources to address disclosure concerns can also increase individuals' confidence in managing workplace concerns and ultimately, the likelihood of achieving employment goals.

Concerns about disclosure often loom large for people living with HIV/AIDS.

Some people with histories of legal convictions, incarceration, or addiction require support and guidance determining if, when, and how to share this information with employers.

It is valuable for service providers to help their clients to explore scenarios related to disclosure - to consider when it may or may not be in an individual's best interest to disclose their status.

HIV/AIDS service providers have a key role to play in educating PLWHA about their rights and protections under the ADA, HIPAA, and other laws.

Post-Employment Supports

While a significant focus of vocational services is preparing for and obtaining work, post-employment supports (also called post-placement or retention supports) are just as essential. Post-employment supports may include assisting people living with HIV/AIDS to access important resources including reliable transportation, back-up child care, and suitable work clothing. These supports may also include helping people to sharpen their problem-solving and other "soft" skills, and gain the confidence and resources to manage the challenges that often accompany transitioning to work, including those related to job demands, health (for example, treatment adherence, regular lab and medical appointments, self-care), personal life, and co-workers and/or supervisors.

For some people living with HIV/AIDS, accommodations may also be critical to employment success once on the job. Under the ADA, an accommodation:

Is any modification or adjustment to a job or work environment that enables a qualified person with a disability to apply for or perform a job
Encompasses alterations to ensure a qualified individual with a disability has rights and privileges in employment equal to those of employees without disabilities.

Reasonable Accommodations Under the ADA

For some people living with HIV/AIDS, reasonable accommodations may be critical to employment success once on the job. Under the ADA, a reasonable accommodation is any reasonable modification or adjustment to a job, the job application process, or the work environment that enables a qualified person with a disability to apply for a job, perform the essential functions of the job, or enjoy equal access to benefits and privileges available to other individuals in the workplace.

Examples of "reasonable accommodations" include:

Making existing facilities readily accessible to and usable by employees with disabilities
Restructuring a job
Modifying work schedules
Reassigning a current employee to a vacant position for which the individual is qualified
Acquiring or modifying equipment
Allowing time off for treatment for a disability, such as HIV/AIDS

Accommodations

Video Player

Requesting Accommodations Under the ADA

If an individual with HIV/AIDS needs an accommodation in order to apply for a job, they (or someone authorized on their behalf) must request one by letting the employer know that they need an adjustment or change because of a disability. This can be done at any time during the application process. If an employee needs an accommodation once on the job, the employee (or someone on their behalf) should request one from the employer.

Once a request for a reasonable accommodation has been made by an employee, the employer should discuss available options with the employee and work together to determine an appropriate accommodation. The employer must provide the accommodation unless the employer can demonstrate that the requested accommodation would impose an undue financial or other hardship on the operation of the business.

Requesting an accommodation is an interactive process.

Requesting Accommodations Without Disclosing HIV/AIDS Status

In some cases it may be possible for an individual, or a service provider communicating with an employer on behalf of that individual (with permission), to disclose that the individual has a disability without revealing that the individual has HIV/AIDS. It may be sufficient to say that he or she has a medical condition or disability covered by the ADA, or that the medical condition adversely affects the immune system.

When doing so, they should be prepared to answer two key questions:

What symptoms or limitations is the individually experiencing that may affect their job performance?
What accommodations would reduce or eliminate the limitations related to performing job tasks?

An Employer May Require Medical Documentation

An employer can require medical documentation of the employee's disability and the limitations resulting from that disability, so disclosure may be necessary at some point during the reasonable accommodation request process. If an employee discloses his or her HIV status, the ADA requires that this information be kept apart from general personnel files as a separate, confidential medical file available only under limited conditions.

Service providers, job seekers, employees and employers can obtain expert guidance on job accommodations for people with disabilities, including HIV/AIDS, from the Job Accommodation Network (JAN), a free service of the U.S. Department of Labor's Office of Disability Employment Policy (ODEP).

Contact information for Job Accommodation Network is provided in the Handouts and Resources slide of this module.

Three examples of accommodations for people living with HIV/AIDS in different work environments are described on the following slide. You will be able to hear their stories.

Requesting Accommodation

Job Accommodation Network

Video Player

Lou Orslene, Co-Director, Job Accommodation Network (JAN)

Discrimination

Discrimination based on HIV and AIDS is illegal. This includes the unlawful denial of reasonable accommodations. For more information, visit www.ada.gov/AIDS.

An applicant or employee who believes that he or she is being unlawfully denied a reasonable accommodation by an employer may file a charge with the nearest Equal Employment Opportunity Commission (EEOC) office. There are time limits for filing a charge. For more information about the ADA's employment provisions, or to file a charge of discrimination, please call the EEOC at 800-669-4000 (Voice) or 800-669-6820 (TTY), or visit www.eeoc.gov/employees/charge.cfm.

Discrimination is against the law. Resources are available to support PLWHA.

Reflection Questions

Take a moment and answer these questions to deepen your understanding of this module.

Quiz

Unit 4:

Benefits and Work Incentives

The information in this section is intended to help HIV/AIDS service providers improve their understanding of clients' concerns regarding the impact employment may have on their benefits, and the safeguards and resources that exist to assist with these issues. It should not be considered a comprehensive source of information on the topic of benefits and work incentives.

Understanding Employment Options

The many policies that impact financial, medical, or housing benefits can be challenging to understand - for recipients and their service providers.

Categories of benefits to consider in employment-related benefits planning include:

Cash benefits SSI/SSDI, Unemployment Insurance, Temporary Assistance for Needy Families (TANF), general assistance
Subsidies
Medical/health care Medicaid, Medicare, AIDS Drug Assistance Program (ADAP)
Supplemental Nutrition Assistance Program (SNAP), food banks, etc.

Audio Player

Transcript

The many policies that impact financial, medical, or housing benefits can be challenging to understand - for recipients and their service providers. This complexity and concerns about undermining financial stability and health care may make some PLWHA and service providers reluctant to even explore employment options. However, there are safeguards in place that make working a viable option for PLWHA who are receiving benefits. Categories of benefits to consider in employment-related benefits planning include:

Cash benefits: SSI/SSDI, Unemployment Insurance, Temporary Assistance for Needy Families, and general assistance
Subsidies such as rent or utilities
Medicaid, Medicare, and the AIDS Drug Assistance Program
Services such as the Supplemental Nutrition Assistance Program or food banks

What are SSI and SSDI?

SSI and SSDI are actually two different federal benefit programs, although some people receive both (called "blended benefits"). Both programs are managed by the Social Security Administration (SSA).

Some people living with HIV/AIDS may be receiving Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) benefits, commonly referred to as "disability benefits." If the beneficiary's health improves and he/she wants to work, there are rules and incentives that can help.

SSI pays benefits based on financial need. The monthly payment varies up to the maximum federal benefit rate. Furthermore, some states add money to federal SSI payments. In most states, beneficiaries are automatically eligible for Medicaid, the state-federal health care program for low-income individuals.

SSDI pays benefits to individuals and certain members of their families if they are "insured," meaning that they worked long enough

and paid Social Security taxes; the monthly payment is based on the Social Security earnings record of the insured worker. The worker is automatically eligible for Medicare after receiving SSDI for two years.

Note: When working with a client who is receiving benefits, it is important to first determine whether they are receiving SSI, SSDI, or both.

Work Incentives for SSI and SSDI

SSI and SSDI have their own "work incentives" - special rules that make it possible for people receiving SSI or SSDI to work and still receive monthly payments and Medicaid or Medicare.

The Ticket to Work and Work Incentives Improvement Act of 1999 aimed to remove disincentives to work for Social Security beneficiaries with disabilities, including through the Ticket to Work and Self Sufficiency Program. This program, which is free and voluntary, allows all SSI/SSDI beneficiaries to access career counseling and job placement services from authorized employment service providers.

You will learn more about this program in Module 3 of this course. Work incentives allow people with disabilities who receive SSI or SSDI to keep their benefits while they explore employment, receive vocational rehabilitation, and gain work experience. Cash benefits and/or Medicaid or Medicare can also often continue throughout their transition to work.

In addition, there are protections in place to help individuals return to these benefit programs if they are unable to continue working due to their disability.To learn more about these work incentives, visit http://www.chooseworkttw.net/about/frequently-asked-questions/index.htm.

SSA Resources

SSA offers several resources to help beneficiaries understand work incentives and services available to them.

The Work Incentives Planning & Assistance (WIPA) projects, which are staffed by Community Work Incentive Coordinators (CWICs), offer in-depth counseling about working, earning more money, and how working may affect benefits.

Work Incentive Seminar Events (WISE) are also available, which provide free, accessible online learning opportunities for beneficiaries to learn about various programs and work incentives. Visit the Handouts and Resources slide for additional information on WIPA and WISE.

The following slides will address how work impacts SSI and SSDI benefits and various work incentive programs.

The Impact of Employment on SSI

Individuals receiving SSI will not automatically lose their SSI benefits if they transition to work. Income is counted to determine a new monthly payment using a simple calculation. In many cases, individuals who receive a combination of SSI or SSDI benefits and income from a job earn more per month than they would if relying on public benefits alone.

When countable income and earnings are reduced, the client's SSI cash benefit is increased. Additionally, as long as the individual's income does not exceed a certain amount, he or she will not lose the SSI cash benefit.

It is important to remember, however, that for many, getting off of SSI benefits entirely and achieving self-sufficiency is the ultimate goal. Also, many states have "Medicaid Buy-In Programs."

These programs allow adults with disabilities to earn more than would otherwise be possible and keep their Medicaid health care coverage.

for every two dollars earned, SSI benefits are reduced by one dollar

The SSI Cash Benefits Calculation

Using the SSI Cash Benefit Calculation

Audio Player

Transcript

It is vital that SSI beneficiaries access individualized benefits counseling when planning for employment. The following example illustrates how employment can impact benefits but should not be considered comprehensive or a substitute for consultation with a trained benefits counselor.

In simplest terms, SSI work incentives reduce an SSI recipient's monthly benefit amount by $1 for every $2 earned - this is the central baseline formula. Countable income and earnings are reduced for all beneficiaries by two exclusions - a General Income Exclusion and an Earned Income Exclusion - intended to help offset expenses incurred while working.

It is vital that SSI beneficiaries access individualized benefits counseling when planning for employment.

SSI work incentives reduce an SSI recipient's monthly benefit amount by $1 for every $2 earned.

The SSI Cash Benefits Calculation Continued

This table shows how to make the calculation described in the audio. It is built up step-by-step, so it might be easier to read it after the audio has completed and all of the steps have been written to the screen.

$685	Gross Earned Income
-$85	Subtract Exclusions
$600	Divide by 2
$300	Countable Earned Income
$721	SSI Cash Amount
$300	Subtract Countable Earned Income
$421	New SSI Cash Amount
$1,106	Total Monthly Income
+ $385	Monthly Difference

Audio Player

Transcript

The monthly maximum SSI amounts for 2014 are $721 for an eligible individual, $1,082 for an eligible individual with an eligible spouse, and $361 for an additional person. Two exclusions apply to all beneficiaries. The first is the General Income Exclusion, which is $20; and the second is the Earned Income Exclusion, which is $65. Thus, you would subtract both exclusions, which together equal $85, from the monthly income the beneficiary earns by working. Once you have subtracted this $85, you will divide the remaining work income by 2 to determine countable earned income. When you subtract that amount as your countable earned income from your SSI payment, you can determine the new monthly SSI payment amount.

Let's think of this in real terms. Simon is an SSI recipient with no spouse or dependents. Before he started working, Simon was receiving a monthly SSI benefit payment of $721. He started working part-time making $685 per month and has no exclusions other than the General Income Exclusion of $20 and the Earned Income Exclusion of $65. So, to calculate Simon's countable income, you would start with his $685 in wages, then subtract both the $20 General Income Exclusion and the $65 Earned Income Exclusion, which leaves $600. We divide this $600 by 2 to derive Simon's countable income, which is $300.

In order to calculate Simon's new SSI payment, we subtract this $300, which is his countable earned income, from the original SSI payment of $721. The resulting $421 will be Simon's new SSI payment. In Simon's case, his new total monthly income will include his $685 in wages, as well as his new SSI payment of $421. This equals $1,106, which is $385 more than the monthly income he received when he was not working.

The monthly maximum SSI amounts for 2014 are

$721 for an eligible individual
$1,082 for an eligible individual with an eligible spouse
$361 for an additional person

Two exclusions apply to all beneficiaries.

The first is the General Income Exclusion, which is $20.00
The second is the Earned Income Exclusion, which is $65.00

Thus, you would subtract both exclusions, which together equal $85, from the monthly income the beneficiary earns by working. Once you have subtracted this $85, you will divide the remaining work income by 2 to determine countable earned income. When you subtract that amount as your countable earned income from your SSI payment, you can determine the new monthly SSI payment amount.

Let's think of this in real terms. Simon is an SSI recipient with no spouse or dependents. Before he started working, Simon was receiving a monthly SSI benefit payment of $721. He started working part-time making $685 per month and has no exclusions other than the General Income Exclusion of $20 and the Earned Income Exclusion of $65.

So, to calculate Simon's countable income, you would start with his $685 in wages, then subtract both the $20 General Income Exclusion and the $65 Earned Income Exclusion, which leaves $600. We divide this $600 by 2 to derive Simon's countable income, which is $300. In order to calculate Simon's new SSI payment, we subtract this $300, which is his countable earned income, from the original SSI payment of $721. The resulting $421 will be Simon's new SSI payment.

In Simon's case, his new total monthly income will include his $685 in wages, as well as his new SSI payment of $421. This equals $1,106, which is $385 more than the monthly income he received when he was not working.

Exclusions to Reduce Countable Income

Impairment Related Work Expenses (IRWE)

These are out-of-pocket expenses for items and services related to the SSI beneficiary's impairment and are needed to work.

Blind Work Expenses

Individuals receiving SSI based on blindness may exclude earnings used for expenses involved in being employed.

Plan to Achieve Self-Support (PASS)

The PASS program allows for the accumulation of assets beyond the standard eligibility limits for SSI ($2,000/month for an individual; $3,000/month for a couple). A PASS must be in writing and approved by SSA. To get started contact your local SSA office and ask for an application, which is SSA Form 545 BK. The set aside assets under a PASS are for expenses related to this plan.

Property Essential to Self-Support

Under the PESS program, SSI does not count some resources that are essential to means of self-employment when deciding initial and continuing eligibility for SSI. For example, property such as tools, equipment or business inventory are not counted.

Student Earned Income Exclusion

SSI beneficiaries under the age of 22 who are regularly attending school or training, including those participating in the AmeriCorps program, may be eligible to exclude some work earnings. In 2014, the allowable monthly exclusion is $1,750, with an annual maximum of $7,060.

The Impact of Employment on SSDI

SSA offers employment supports to protect SSDI beneficiaries.

Protections are in place to ensure that individuals receiving SSDI will not automatically lose their SSDI benefits if they transition to work.

Fear - If benefits are terminated because they exceed earning thresholds, an SSDI recipient may fear that they will be left with nothing if they find themselves needing to leave their jobs and face a lengthy period with no income while they reapply for SSDI.

Reality - The reality is that SSA allows individuals in this situation to forego the application process and begin receiving benefits again through a streamlined process called Expedited Reinstatement.

Medicare for most working people with disabilities:

Will continue for at least 93 consecutive months
Individuals must be enrolled in Medicare after the nine-month Trial Work
Some beneficiaries may be able to buy continued Medicare coverage
Individuals with low incomes and limited resources may be eligible for state assistance under Medicare Savings Programs

Audio Player

Transcript

Just as safeguards exist to support workforce entry or reentry for individuals receiving SSI, protections are in place to ensure that individuals receiving SSDI will not automatically lose their SSDI benefits if they transition to work. SSA offers employment supports to help SSDI beneficiaries protect their cash and medical benefits while they work. Many individuals fear that if their benefits are terminated because they exceed earning thresholds they will be left with nothing if they find themselves needing to leave their jobs, and will face a lengthy period with no income while they reapply for SSDI. In reality, SSA allows individuals in this situation to forego the application process and begin receiving benefits again through a streamlined process called Expedited Reinstatement. More details regarding expedited reinstatement and other SSDI work incentives and safeguards are available in the next slides.

Most Medicare beneficiaries who work will be able to continue their Medicare benefits for at least 93 consecutive months. However, these individuals must be enrolled in Medicare after the nine-month Trial Work Period (to be described further in this module). Some beneficiaries whose Medicare coverage ends due to work may be able to buy continued Medicare coverage, as long as they remain medically disabled. Some individuals with low incomes and limited resources may also be eligible for state assistance under various Medicare Savings Programs.

The SSDI SGA Principle

To receive Social Security Disability Insurance (SSDI), a person cannot perform "Substantial Gainful Activity (SGA)." If an SSDI beneficiary returns to work and earns more than a certain amount each month (in 2014, the threshold is $1,070 for people who are not blind, and $1,800 for people who are blind), they are considered to be engaged in SGA. However, there are several work incentives in place to protect SSDI beneficiaries engaged in work.

SSDI Work Incentives

Through the Trial Work Period (TWP), a work incentive for SSDI, an individual may still be able to receive benefits after returning to work and meeting the SGA income threshold. Through TWP, SSDI beneficiaries are able to work for at least nine months and continue to receive full benefits, regardless of how much they earn, as long as they remain eligible based on their disabling impairment and participate in required reporting of their income.

Upon completion of the nine TWP months, the SSDI beneficiary begins an Extended Period of Eligibility (EPE). The EPE is a consecutive 36-month period during which the beneficiary receives their SSDI cash amount for any month during which the individual's earnings do not exceed the SGA limit (with the exception of a grace period).

Visit the Handouts and Resources slide of this module to learn more about the above incentives and about a number of additional work incentives for SSDI beneficiaries, including the Impairment Related Work Expenses (IRWE), Extended Medicare, Expedited Reinstatement (EXR), and "Section 301" Payment Continuation.

Housing: The Earned Income Disallowance

The Earned Income Disallowance (EID), sometimes called Earned Income Disregard, is a U.S. Department of Housing and Urban Development (HUD) program that allows tenants who have been out of work to accept a job without having their rent increase right away. Its goal is to encourage people who qualify to seek employment, rather than be discouraged from work due to the belief that much of what they earn will be spent on higher rent. Also, EID participants are better able to pay for the costs of keeping employment, such as transportation and work clothing. The following slide offers a more detailed look at the EID.

Earned Income Disallowance (EID) Eligibility

To qualify for EID [24 CFR 574.310 (d) (1)], one of the following must be true of the tenant's living situation:

Lives in public housing; or
Has a disability and either participates in the Housing Choice Voucher Program or lives in housing subsidized with HOME Investment Partnership Program (HOME), or Supportive Housing Program (SHP) funds.
For Housing Opportunities for Persons with AIDS (HOPWA), if the head of household is the qualifying household member, then EID is an automatic deduction. [24 CFR 574.310 (d) (1)].

In addition, one of the following must be true of the household's increased income:

Income has increased as a result of the employment of a family member who was "previously unemployed," meaning that the family member has not worked at all in the past 12 months, or has worked at no more than the minimum wage (federal, state, or local minimum wage - whichever is highest) for 500 hours or less during the past 12 months; or
Income of a family member increased as a result of employment during that family member's participation in any economic self-sufficiency or job training program; or
Income of a family member has increased as a result of employment while that family member was receiving - or within six months after receiving - welfare (TANF) payments, benefits, or services worth at least $500.

Time Limits

EID may be used for a total of 24 months, but a tenant can receive the benefit over a 48-month period. The 48-month period begins on the date when the family member first begins employment and can stop and start along with employment. For example, a person could start and maintain employment for three months, and use EID, then stop working. If he or she began working again within 48 months of the first use of EID, he or she would be able to use EID to fully disregard up to nine more months of employment income.

How to Calculate EID

100 percent of any increase in income from work is ignored for up to 12 months. 50 percent of any increase in income from work is ignored for another 12 months

100% Increase	Ignored for Year 1
50% Increase	Ignored for Year 2

This table shows how to make the calculation described in the audio. It is built up step-by-step, so it might be easier to read it after the audio has completed and all of the steps have been written to the screen.

Before Simon's Employment
$721	Monthly SSI Income
x .30	x 30%
$216	Rent payment per month

This table shows how to make the calculation described in the audio. It is built up step-by-step, so it might be easier to read it after the audio has completed and all of the steps have been written to the screen.

After Simon's Employment
100%	Year 1
50%	Year 2 Income Disallowed
$685	Gross Earned Income
50%	Income Disallowed
$342.50	Income Disallowed
$721	Monthly SSI Income
+$342.50	Allowed 50% Income
$1,063.50	Total Income
30%	Multiplied by 30%
$319.05	Adjusted Rent Payment per Month

Audio Player

Transcript

The exact Earned Income Disregard benefit amount depends on the tenant's income. Starting from the base income prior to employment, 100 percent of any increase in income from work is ignored for up to 12 months that is, the 1st year and rent does not increase.

After those 12 months, up to 50 percent of any increase in income from work is ignored for another 12 months, or Year 2.

For families that qualify for Earned Income Disregard because a family member with a disability has gained employment, only the earnings of the individual with the qualifying disability are excluded from income calculations.

Let's return to the example of Simon, the SSI recipient who got a job earning $685 per month.

Before Simon's employment, his monthly SSI income was $721, and he had no other earnings. His monthly rent was calculated by taking 30 percent of $721. The result was a rent of $216 per month.

For the first year after Simon starts working and earning $685 in wages per month, his rent will not increase.

During Simon's 2nd year of employment, only 50 percent of his income from wages will be counted in his rent calculation. The new calculation will be based on Simon's new income, which includes his $721 in SSI plus 50 percent of his $685 in monthly wages, which is $342.50. This brings Simon's countable income to $1063.50. 30 percent of $1063.50 is $319.05, so that will be Simon's new monthly rent.

The exact Earned Income Disregard benefit amount depends on the tenant's income. Starting from the base income prior to employment, 100 percent of any increase in income from work is ignored for up to 12 months. That is, in the 1st year (Year 1), rent does not increase.

After those 12 months, up to 50 percent of any increase in income from work is ignored for another 12 months, or Year 2.

For families that qualify for Earned Income Disregard because a family member with a disability has gained employment, only the earnings of the individual with the qualifying disability are excluded from income calculations.

Let's return to the example of Simon, the SSI recipient who got a job earning 685 per month. Before Simon's employment, his monthly SSI income was $721, and he had no other earnings. His monthly rent was calculated by taking 30% of $721. The result was a rent of $216 per month.

For the first year after Simon starts working and earning $685 in wages per month, his rent will not increase. During Simon's 2nd year of employment, only 50% of his income from wages will be counted in his rent calculation.

The new calculation will be based on Simon's new income, which includes his $721 in SSI plus 50% of his $685 in monthly wages, which is $342.50. This brings Simon's countable income to $1063.50. 30% of $1063.50 is $319.05, so that will be Simon's new monthly rent.

Module 2 Conclusion

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List of Handouts and Resources

Conclusion

Adopting an Employment and Training Mindset - Organizationally and Individually

You have completed Module 2 of the Getting to Work Training Curriculum, Adopting an Employment and Training Mindset - Organizationally and Individually. In this module, we discussed what employment services are and how they are delivered.

This included the range of possible employment services, the vocationalizing process for organizations, and the employment process for individuals.

We also explored employment in the context of disability and how transitioning to work may impact individuals' eligibility for public benefits.

Acknowledgements

The U.S. Department of Labor and U.S. Department of Housing
and Urban Development would like to acknowledge the following organizations and agencies for their substantial contributions to
this project:

National Working Positive Coalition
Victory Programs, Inc
Building Changes
Concepts, Inc.
U.S. Department of Justice
U.S. Department of Education
White House Office of National AIDS Policy

In addition, we would like to thank the numerous individuals - members of the HIV/AIDS community, HIV/AIDS service provider community, researchers, government personnel, and advocates - who reviewed content, were featured in videos, and/or whose work in the area of HIV/AIDS and employment provided the foundation for content herein.