Addressing Employment Needs, Fighting HIV: A Message from NWPC's Board President, Liza Conyers

Celebrating 15 years of commitment to the financial and
personal well-being of people living with or more vulnerable to HIV.

Dear Friend,

The National Working Positive Coalition is marking our 15th anniversary of stepping up where no other national organization is focused – to improve employment opportunities for people living with or more vulnerable to HIV in the United States. In 2018, the services we provided reached 26 states and U.S. territories, to benefit over 3,500 people seeking information, services and resources to enter or return to work, or change jobs.

One of the beneficiaries of NWPC's efforts is Taylor:

“Getting critical information and linked to resources to prepare for work from the National Working Positive Coalition was a great relief. Finding resources through NWPC to pay for education was a major break for me. Getting healthy, living wage employment is important to many people living with HIV (PLHIV). How to work and maintain healthcare is a HUGE concern and was part of my hesitation in taking a job. My medical costs are complicated and expensive, so finding a resource that enabled me to keep my health insurance coverage was PIVOTAL to me saying yes to a job offer. NWPC is an invaluable resource for all of those seeking to return to work, and finding a purpose in life." (Taylor, 2018)

Developing the capacity of all HIV and employment service systems to become responsive to the needs of individuals like Taylor is central to the work of NWPC. Please help us to support others like Taylor by donating to support three key NWPC goals for 2019 listed below:

• Presenting up-to-date, accessible online information tools and resources about HIV and employment, for both jobseekers and service providers
• Amplifying our HIV and employment policy and advocacy work at federal, regional, state and local levels to create systems change and link jobseekers with effective, needed resources and opportunities
• Developing and supporting critical research on HIV and employment, and sharing findings to improve responses to the needs expressed by jobseekers

Every donation, large or small, is essential to our ability to achieve these goals. Can you maximize your impact by becoming a monthly sustainer of our work?

Your contributions will enable us to lead efforts in 2019 for all people living with or more vulnerable to HIV to have the chance - like Taylor has - to achieve goals they have set for themselves for employment, health and personal well-being!

Thank you!

Sincerely,

Liza Conyers, Ph.D.

Board President, National Working Positive Coalition

Founded in 2003, the National Working Positive Coalition (NWPC) is the only national organization linking HIV care and prevention with employment information, services and resources. Our mission is developing and sharing knowledge, supporting creation and optimal delivery of services, and strengthening policy dialogue and advocacy to address employment related impacts of HIV, social marginalization and poverty.

The National Working Positive Coalition Commends Douglas M. Brooks for His Leadership at the White House Office of National AIDS Policy

As Douglas Brooks brings his work to a close as Director of the White House Office of National AIDS Policy, the NWPC wishes to express our appreciation for his pioneering leadership in many areas, including his invaluable contributions to advancing responses in the U.S. to unmet employment needs in the continuum of HIV care and prevention. One month before being named to his role at ONAP, Douglas moderated a panel on HIV and Employment for the Presidential Advisory Council on HIV/AIDS. He expressed strong interest in developing integration of assessment and addressing of employment needs in the continuum of HIV services, and then carried it forward at ONAP throughout his tenure there.

Douglas has demonstrated a great understanding of the importance of social and economic security and wellbeing to improving the HIV Care Continuum, which is visible in the National HIV/AIDS Strategy: Updated to 2020, released in July of 2015. He engaged NWPC leadership in the planning and facilitation of meetings on HIV and Employment at the White House, and participated in support of a range of convenings including the 2015 Institute on HIV & Employment for the U.S. Conference on AIDS in DC. As the NWPC collaborates with community and government partners to build on this foundation, we do so with gratitude for Douglas’ commitment to advancing this work with key partners from the worlds of HIV, vocational rehabilitation, workforce development, housing, legal and other services and policy.

As a result of Douglas Brooks, and his including employment among his priorities working at ONAP, there is greater acknowledgement than ever before of the critical roles in health disparities played by economic insecurity and marginalization, by unemployment and underemployment. As we work to realize the needed access to information, services and resources to address employment needs of people living with or at greater risk for HIV, the National Working Positive Coalition extends our deep thanks to Douglas, and very best wishes to him for the next chapters of his life and work ahead.

(deadline Fri. 5/22) Superfast guide to vote for NWPC's employment recommendations for the National HIV/AIDS Strategy, add new ideas and review all posted for voting

Please take a minute to vote to help shape the new National HIV/AIDS Strategy to be released this summer. The deadline for votes and submitting new ideas is Friday, May 22nd. You can submit new ideas, review and vote on all posted ideas here. You will be asked to enter your email address to sign in to vote or enter new ideas.

The seven recommendations below are from the National Working Positive Coalition (NWPC) for increasing access to employment opportunities and services for people living with or at higher risk for HIV (click "Vote here" to see a short description and consider voting for each recommendation). 

Address workforce participation inequities for key populations (homeless LGBT youth, trans women of color, people with criminal records).

Vote here

Implement a multi-state HIV employment services demonstration project where HIV prevalence, infection rates and mortality are high.

Vote here

Access to accurate information is needed on work earnings-related policies for key health care, housing and economic stability programs.

Vote here

Employment status and needs assessment, along with economic status, should be integrated into HIV data collection and evaluation.

Vote here

Increase access to employment opportunities and services by linking HIV, employment/vocational, education and housing service systems.

Vote here

Prevent unnecessary loss of employment, and reduce poverty, unemployment and underemployment among people living with and at higher risk for HIV.

Vote here

Existing and developing employment initiatives targeted for people living with or at higher risk for HIV need capacity building assistance.

Vote here

(vote by 5/22) NWPC Employment Recommendations for Updating the National HIV/AIDS Strategy

NWPC has listed 7 policy recommendations online on the site that the White House Office of National AIDS Policy has developed to solicit public input for the new National HIV/AIDS Strategy to be released this summer (2015). The public is asked to list new ideas and/or to vote for ideas that have been listed, by the deadline of this Friday, May 22^nd: https://nhas.uservoice.com 

After you create a profile by entering your email address, you can vote for a recommendation, and/or enter your own recommendation. You get 25 votes for each of the four “feedback forums,” organized by the four goals of the National HIV/AIDS Strategy.

National Working Positive Coalition: Recommendations to Update Employment Provisions in the National HIV/AIDS Strategy

Poverty, unemployment, and underemployment are key social and economic determinants of health, and critically influence outcomes along the HIV care continuum. Achieving the goals of the landmark National HIV/AIDS Strategy (NHAS) - improving HIV health outcomes, reducing health disparities and reducing new HIV infections - requires both medical and structural interventions. The employment provisions of the NHAS need to be strengthened with measurable objectives and timelines established for Federal agency activities, to a) prevent unnecessary loss of employment, and (b) reduce poverty, unemployment and underemployment among people living with and at higher risk for HIV.

Here are the 7 recommendations across the four goals of the NHAS that have been prioritized by the NWPC for updating the employment provisions of the National HIV/AIDS Strategy.

To increase employment opportunities for people living with and at higher risk for HIV:

Goal 1: Reducing New HIV Infections

Address workforce participation inequities for key populations (homeless LGBT youth, trans women of color, people with criminal records).

HIV prevention and care services need to be developed with effective cross-training, linkage and coordination with workforce participation and vocational rehabilitation programs, as well as housing substance use treatment and mental health services. Key populations at disproportionate risk of new HIV infections include communities with histories of stigma and discrimination in the workplace, and inadequate access to healthy living wage employment. Existing resources designed to meet employment needs of individuals with barriers to employment (e.g., workforce development and vocational rehabilitation programs) need capacity building to effectively serve communities with disproportionate risk of new HIV infections. Targeted HIV employment initiatives for key populations need to be developed and scaled up.

Goal 2: Increasing Access to Care and Improving Health Outcomes for People Living with HIV

Implement a multi-state HIV employment services demonstration project where HIV prevalence, infection rates and mortality are high.

Implementation of a multi-state HIV employment demonstration project in diverse high prevalence communities is needed that will integrate employment services in HIV service organizations, and coordinate with state/local vocational rehabilitation and workforce development programs. Assessment is needed of multiple forms of employment outcomes in addition to job placement rates, including engagement/retention in care, biomarkers (i.e., viral load/suppression), and self-care. Services should be designed for key populations, including young Black and Latino MSM, transgender and cisgender women of color, and individuals who are formerly incarcerated, and should be responsive to diverse community (urban, suburban, rural) and job market factors.

Access to accurate information is needed on work earnings-related policies for key health care, housing and economic stability programs.

Well-informed decision-making about working and transitions to employment depends on access to information to maintain or improve linkage to health care, housing and economic stability. Direct service providers and people with HIV need access to information and training about work earnings-related policies for key programs including SSI/SSDI, Medicaid, Medicare, ADAP and other health coverage, and subsidized housing (HOPWA, Section 8). Individual benefits advisement is needed by people with HIV, as well as education about community-level resources available for vocational training, education and employment services.

Goal 3: Reducing HIV-Related Disparities and Health Inequities

Employment status and needs assessment, along with economic status, should be integrated into HIV data collection and evaluation.

Evaluation is needed of HIV health and prevention outcomes in relation to employment and economic status. Linkage to information and community-level services should be provided in response to identification of employment needs of people living with or at higher risk for HIV identified at all points of service provision. Diverse factors and outcomes need to be evaluated, including for those who: do or don’t use employment/vocational services; work full time or part time; and/or are engaged in self-employment and micro-enterprise development.

Increase access to employment opportunities and services by linking HIV, employment/vocational, education and housing service systems.

Federal agencies including HHS, DOL, DoEd, and HUD need instruction to work in coordination across agencies and their own programs to develop effective, targeted outreach, service needs assessment, information access, linkages and coordination between HIV services, workforce development, vocational rehabilitation, education and housing service systems at federal, state and local levels. Grantees and staff across service sectors need training and technical assistance to develop knowledge and skills to reduce HIV stigma and discrimination, and meet employment and vocational rehabilitation information and service needs of people living with or at higher risk for HIV. Education must be designed to ensure effective trauma-informed services for key populations, including young Black and Latino MSM, transgender women of color, and individuals who are formerly incarcerated.

Goal 4: Achieving a More Coordinated National Response to the HIV Epidemic

Prevent unnecessary loss of employment, & reduce poverty, unemployment & underemployment among people living with & at higher risk for HIV.

Poverty, unemployment, and underemployment are key social and economic determinants of health, and critically influence outcomes along the HIV care continuum. Achieving the goals of the landmark National HIV/AIDS Strategy (NHAS) requires both medical and structural interventions. The employment provisions of the NHAS need to be strengthened with measurable objectives and timelines established for Federal agency activities, to a) prevent unnecessary loss of employment, and (b) reduce poverty, unemployment and underemployment among people living with and at higher risk for HIV. Lead Federal agencies needed to coordinate and maximize resources to increase access to employment opportunities and vocational services for people living with or at higher risk for HIV include HHS (HRSA/HAB, CDC, SAMHSA), DoEd (RSA), DOL (ETA, ODEP), HUD (OHAH). Mechanisms need to be developed linking these initiatives and key Federal agencies including HHS, DOL, DoEd, and HUD for sharing of best practices, capacity building needs assessment and resources, training and technical assistance. Data collection support must be provided to expand knowledge of HIV health and prevention outcomes for employment/vocational program participants, and effective HIV employment service strategies.

Existing and developing employment initiatives targeted for people living with or at higher risk for HIV need capacity building assistance.

Mechanisms need to be developed linking these initiatives and key Federal agencies including HHS, DOL, DoEd, and HUD for sharing of best practices, capacity building needs assessment and resources, training and technical assistance. Data collection support must be provided to expand knowledge of HIV health and prevention outcomes for employment/vocational program participants, and effective HIV employment service strategies.

114 Organizations Endorse NWPC Letter to RSA

114 Organizations Endorse NWPC Letter to RSA

A letter from the National Working Positive Coalition, endorsed by 114 organizations, was sent to the Rehabilitation Services Administration in support of retaining high standards for the vocational rehabilitation counseling workforce to meet the employment and vocational rehabilitation needs of eligible individuals with disabilities, including people living with HIV.

In the letter sent February 25, 2015, the National Working Positive Coalition is partnering with the Council of State Administrators of Vocational Rehabilitation (CSAVR) to advocate for the regulations now being developed to implement the Workforce Innovation and Opportunity Act (WIOA) to maintain standards for a qualified and effective vocational rehabilitation counseling workforce.

Many people living with HIV, and other disabilities, need to be able to access effective vocational rehabilitation services to achieve their goals for employment. The state-federal vocational rehabilitation services system is the most comprehensive employment resource for people with disabilities. Services include access to benefits counseling, comprehensive rehabilitation evaluation to determine skills, interests, and abilities, as well as case management, vocational counseling, employment services, assistance with finding and keeping a job, and on the job and other training/education.

Rehabilitation counselors can also authorize medical referrals, job training, and supportive rehabilitation services, including mental health counseling, if these services will remove barriers to employment. Individuals with disabilities, including people living with HIV, often face significant barriers to employment including dealing with complex medical and psychological aspects of their diagnosis as well as social, educational, financial, legal, and vocational factors that can limit their ability to achieve viable employment outcomes that ensure continued access to care and improved economic and health outcomes.

This letter calls for regulations to be written based on the understanding that vocational rehabilitation (VR) counselors need to be appropriately trained to adequately address the complex and interconnected issues of individuals with disabilities, including people living with HIV:

February 25, 2015

Commissioner Janet LaBreck

Rehabilitation Services Administration

U.S. Department of Education

400 Maryland Ave., SW

Washington, DC 20202-2800

Dear Commissioner LaBreck:

The undersigned organizations are joining to urge that regulations developed to implement the Workforce Innovation and Opportunity Act (WIOA) clarify the skill set that vocational rehabilitation counselors need to have to meet the complex and diverse employment needs of individuals with disabilities, including people living with HIV. The National HIV/AIDS Strategy (NHAS) includes a number of employment-related provisions to help achieve the three primary goals of the NHAS: 1) increase access to care and improve health outcomes for people living with HIV, 2) reduce new HIV infections, and 3) reduce HIV-related health disparities.

The state-federal vocational rehabilitation services system is the most comprehensive employment resource for individuals with disabilities, including people living with HIV. To adequately address the complex and interconnected needs of this population, we believe that vocational rehabilitation (VR) counselors need to be appropriately trained and credentialed.

Therefore, we request that the WIOA regulations specifically require that all vocational rehabilitation counselors have the skill set identified by the Council of State Administrators of Vocational Rehabilitation (CSAVR) in the CSPD comments they submitted for consideration for the federal regulations: (a) knowledge of the medical and psychological aspects of disability, (b) knowledge and implementation of vocational assessment strategies, (c) a working knowledge of the labor market and, d) competence in counseling and guidance, and providing the services required to develop and implement the individualized career plan that enables the person to be successfully employed in a competitive, integrated work environment.

In the states where hiring efforts fail to identify an individual qualified at the Master’s level, clearly the skill set identified by the CSAVR should be the preferred standard that a qualified VR counselor should meet. We continue to believe the ideal standard for qualified VR counselors is the attainment of a Master’s degree and the ability to sit for the Certified Rehabilitation Counselor (CRC) exam, as was defined in the Rehabilitation Act prior to the passage of the WIOA. This level of knowledge and expertise has been found to be most effective in achieving successful employment outcomes for individuals with disabilities, including people living with HIV. We were extremely concerned when these standards were downgraded in the WIOA.

The training that qualified VR counselors receive includes a focus on the impact of stigma and financial/benefits issues along with key medical and psychosocial concerns that impact the economic well-being and health of many individuals with disabilities, including people living with HIV. Research findings indicate that use of VR services by people living with HIV increases the chances of successful employment among those who use these services, and of achieving the primary goals of the National HIV/AIDS Strategy. Access to income supports and quality vocational rehabilitation services that can help improve the economic well-being of people with HIV are essential to these goals. To achieve this end, the NHAS Federal Implementation Plan specifically directs federal agencies to “consider ways to increase supports for employers to hire and maintain employment of people with HIV and how to integrate them in broader employment initiatives for people with disabilities” and to “develop a joint initiative to consider ways to help individuals living with HIV access income supports, including job skills and employment.”

In summary, in light of the important role that vocational rehabilitation services can play in addressing the goals of the National HIV/AIDS Strategy and in increasing access to income supports and job training, we urge you to ensure that the WIOA regulations state the requirement that vocational rehabilitation counselors are adequately trained to address the complex vocational development and employment needs of individuals with disabilities, including people living with HIV. It is imperative that these regulations clearly require that vocational rehabilitation counselors demonstrate the skill set that is known to lead to improved employment outcomes for people with disabilities.

Sincerely,

30 for 30 Campaign

ActionAIDS, Philadelphia, PA

ADAP Advocacy Association (aaa+), Washington, DC

AIDS Action Baltimore, Inc., Baltimore, MD

AIDS Alabama, Birmingham, AL

AIDS Connecticut, Hartford, CT

AIDS Foundation of Chicago, Chicago, IL

AIDS Legal Council of Chicago, Chicago, IL

AIDS Project Los Angeles, Los Angeles, CA

AIDS Resource Center Ohio

AIDS United, Washington, DC

The Albany & Schenectady Damien Centers, Albany & Schenectady, NY

Alexian Brothers Housing and Health Alliance, Chicago, IL

The Alpha Workshops, New York, NY

American Sexual Health Association, Research Triangle Park, NC

APLA Health & Wellness, Los Angeles, CA

ASCNYC, New York, NY

BOOM!Health, Bronx, NY

Boulder County AIDS Project, Boulder, CO

Cascade AIDS Project, Portland, OR

Catholic Charities Community Services of Rochester, Rochester, NY

The Center for Black Equity-Baltimore, Baltimore, MD

The Center for HIV Law & Policy, New York, NY

The Center for Independence of the Disabled, NY, Kew Gardens, NY

CenterLink: The Community of LGBT Centers

Chicago House and Social Service Agency, Chicago, IL

CHOICES. Memphis Center for Reproductive Health, Memphis, TN

Christie’s Place, San Diego, CA

Coalition of HIV/AIDS Nonprofits and Governmental Entities (CHANGE), New Orleans, LA

Collaborative Solutions, Inc., Birmingham, AL

Colorado Organizations Responding to AIDS (CORA)

Community Access National Network (CANN), Washington, DC

Community Access Services, Buffalo, NY

Community Servings, Boston, MA

Desiree Alliance-USA

Family and Medical Counseling Service, Inc., Washington, DC

Federation of Protestant Welfare Agencies, New York, NY

Friends For Life, Memphis, TN

Gay Men’s Health Crisis (GMHC), New York, NY

The Global Network of People Living with HIV, North America (GNP+NA)

The G.R.E.E.N. Foundation, Santa Ana, CA

HealthHIV, Washington, DC

HIPAtlanta, Atlanta, GA

HIV Alliance, Eugene, OR

HIV Arkansas, Fayetteville, AR

HIV Prevention Justice Alliance, Chicago, IL

Housing Works, Brooklyn, NY

Howard Brown Health Center, Chicago, IL

I'm Still Josh - http://imstilljosh.com

International AIDS Empowerment, Las Cruces, NM; El Paso, TX

International Community of Women Living with HIV-North America (ICW-NA)

Iowa Unitarian Universalist Advocacy/Witness Network

Iris House, New York, NY

Knew Choices, Inc., Cartersville, GA

Latino Commission on AIDS, New York, NY

Legal Action Center, New York, NY

The Lesbian, Gay, Bisexual & Transgender Community Center, New York, NY

Life Linc Baltimore, Baltimore, MD

Lifelong, Seattle, WA

The Living Affected Corporation, Little Rock, AR

Louisiana AIDS Advocacy Network

Love Alive International Foundation of New York City, New York, NY

Love Alive International Sanctuary of Praise Worship Center, New York, NY

Making A Way Housing, Inc., Atlanta, GA

Moveable Feast, Baltimore, MD

Nashville CARES, Nashville, TN

National AIDS Housing Coalition, Washington, DC

National Alliance of State & Territorial AIDS Directors (NASTAD), Washington, DC

National Business & Disability Council (NBDC) at The Viscardi Center, New York, NY

National Center for Lesbian Rights, Washington, DC

National Council on Rehabilitation Education

National Coalition for LGBT Health, Washington, DC

National Minority AIDS Council, Washington, DC

National Women and AIDS Collective, Washington, DC

National Working Positive Coalition

New York City Faith in Action, New York, NY

New York HIV Employment Network

Okaloosa AIDS Support and Informational Services, Inc. (OASIS), Ft. Walton Beach, FL

Ohio AIDS Coalition

One in Four Chronic Health, Portland, OR

Pediatric AIDS Chicago Prevention Initiative (PACPI), Chicago, IL

Philadelphia Center, Shreveport, LA

Positive Opportunities, Inc., Harrisburg, PA

Positive Resource Center, San Francisco, CA

Positive Women’s Network-Colorado

Positive Women’s Network – USA, Oakland, CA

Pozitively Healthy, Washington, DC

Poz Vets USA-INTL, Atlanta, GA

Professional Association of Social Workers in HIV/AIDS, Birmingham, AL

Project Angel Food, Los Angeles, CA

Project Inform, San Francisco, CA

Ribbon Consulting Group, Washington, DC

The San Francisco EMA HIV Health Services Planning Council, San Francisco, CA

The San Francisco Mayor's Disability Council, San Francisco, CA

Sero Project, Milford, PA

SisterLove, Inc., Atlanta, GA

Southern HIV/AIDS Strategy Initiative (SASI), Durham, NC

START at Westminster, Westminster Presbyterian Church, Washington, DC

Street Works, Nashville, TN

Thresholds, Chicago, IL

TILTT, Inc. (Transgender Individuals Living Their Truth, Inc.), Atlanta, GA

Transgender Law Center, Oakland, CA

Treatment Access Expansion Project, Boston, MA

Treatment Action Group, New York, NY

Unity Fellowship Church NYC, Harlem, NY

US PLHIV Caucus

VillageCare, New York, NY

Virage Community Services, New Orleans, LA

VOCAL-NY, Brooklyn, NY

Watchful Eye, Brooklyn, New York

Wateree AIDS Task Force, Sumter, SC

Women Organized to Respond to Life-threatening Diseases (WORLD), Oakland, CA

The World Foundation for Medical Research and Prevention, Houston, TX

World Institute on Disability, Berkeley, CA