Supported Employment in a Lower Income Cont

The Case of Banco de Crédito del Perú and Centro Ann Sullivan del Perú

Carmen Gomez Mandic

Department of Society, Human Development, and Health, Harvard School of Public Health; now at the University of Wisconsin-Madison, Department of Population Health Sciences

Jody Heymann

Institute for Health and Social Policy, McGill University


This case study focuses on a supported employment program run by the Centro Ann Sullivan del Perú (CASP), a private center for children and youth with disabilities in Lima, Peru. The objectives were to learn about: (a) the history of the supported employment program operating at a large bank in Lima; (b) the bank's reception of the program; and (c) the benefits and challenges of supported employment in this understudied context. Interviews with bank management, direct and non-direct coworkers of supported employees, supported employees, their parents, and CASP staff provide insights about the feasibility of supported employment in this context, its impact on the workplace, and its meaning in the lives of supported employees and their families.

Background and Significance

Supported employment is recognized as an important means of integrating people with intellectual and developmental disabilities into the competitive workforce (American Association on Intellectual and Developmental Disabilities, 2009). The United States Department of Labor defines supported employment as "competitive work in integrated work settings for individuals with the most severe disabilities (i.e., psychiatric, mental retardation, learning disabilities, traumatic brain injury) for whom competitive employment has not traditionally occurred, and who, because of the nature and severity of their disability, need ongoing support services in order to perform their job" (United States Department of Labor, 1993). The basic components of supported employment include equitable benefits and wages, integrated work sites, and ongoing support.

Little research has focused attention on supported employment initiatives in lower to middle income countries, even though the social and economic inclusion of people with disabilities is recognized as a critical component of economic development (Global Partnership for Disability and Development, 2009). The experiences of supported employment programs that have emerged in the face of unfavorable socioeconomic contexts has potential to generate insights that may aid the growth of supported employment initiatives worldwide.

This case study focuses on the experiences of one such program run by the Centro Ann Sullivan del Perú (CASP), a private center for children and youth with disabilities in Lima, Peru. The objectives of the case study were: (a) to learn about the history of the supported employment program at one site, a large bank in Lima; (b) to explore the bank's reception of the program; and (c) to understand the benefits and challenges of supported employment in this context.

This case study makes unique contributions to the literature on supported employment in several ways. As mentioned, there has been little research on supported employment in lower to middle income countries. This perspective is valuable in part because, as our findings suggest, business leaders' willingness to hire people with disabilities may be especially influenced by the experiences of other businesses in similar contexts. Second, qualitative methods have not commonly been used in research on supported employment (for exceptions, see Butterworth & Pitt-Catsouphes, 1995; Buys & Rennie, 2001). Qualitative interviews are well-suited for understanding people's subjective experiences (Seidman, 1998). Third, although employer attitudes toward workers with disabilities have been extensively studied, the impact of employing people with intellectual and developmental disabilities on the workplace is not well understood (Olson, Cioffi, Yovanoff, & Mank, 2001). Finally, as noted by Unger (2002), few studies of employers' experiences with workers with disabilities have included the perspectives of frontline supervisors or direct co-workers of employees with disabilities (for exceptions, see Belcher & Smith, 1994; Butterworth & Pitt-Catsouphes, 1995; Shafer, Rice, Metzler, & Haring, 1989). This case study sought diverse perspectives, including those of upper and mid-level management, nondisabled coworkers with and without direct interaction with supported employees, supported employees, their parents, and CASP staff. The diversity of views represented allows for a unique look at this supported employment program operating in an understudied context.

The Peruvian Context

National policies addressing the employment of individuals with disabilities typically involve some form of financial incentive for employers, such as wage subsidies, tax deductions, and grants toward training costs; or investment in vocational training programs, such as funding of supported employment agencies (O'Reilly, 2003). In Peru, federal law allows companies that hire people with disabilities to take a tax deduction, prohibits discrimination in the workplace on the basis of disability, and mandates accessible public spaces and buildings (International Labour Organization, 2006; Mujica & Paredes, n.d.). However, the law does not specify sources of funding for support personnel or technology or for environmental adaptations (United States State Department, 2003). Furthermore, high unemployment rates in the general population likely contribute to an especially unfavorable hiring context for people with disabilities. As suggested by Roggero and colleagues, youth with disabilities have difficulty competing for jobs in this environment (Roggero, Tarricone, Nicoli, & Mangiaterra, 2005). In fact, according to the Institute for Social Security in Peru, less than one percent of individuals with severe disabilities worked in 2007 (United States State Department, 2008).

Centro Ann Sullivan del Perú

The Centro Ann Sullivan del Perú (CASP) was founded in Lima in 1979 by Dr. Liliana Mayo. CASP has grown from modest beginnings to become an internationally recognized program serving 450 individuals with developmental disabilities ranging in age from newborns to adults. CASP provides early intervention services, education, and vocational training and support for individuals with developmental disabilities and their families. CASP also provides training to other professionals, centers, and university students. CASP does not receive funding from governmental sources; it relies on donations from private enterprises and grants from primarily European foundations.

One of the sites of CASP's supported employment program, and the focus of this case study, the Banco de Crédito del Perú (BCP) is Peru's largest and oldest bank. As of 2006, BCP had 220 branches throughout the country as well as operations in Bolivia, Panama, and the United States. Approximately 63% of BCP's over 9000 employees work full time (48 hours per week), 35% work reduced time (36 hours per week), and the remaining less than 2% work part-time (22.5 hours per week). Conversations with company management and reviews of company literature (e.g., annual report, company newsletters) reflected a strong commitment to community service.


This case study was conducted as part of the Project on Global Working Families, which developed a series of in-depth studies of businesses as they implement policies affecting the working conditions and lives of low-wage workers and their families. This is the first to focus on the intersection of disability and employment in the context of a lower middle income country, and it is also the first study of CASP's supported employment program.

The senior author carried out the pilot interviews and the site determination, and the first author conducted all interviews onsite at BCP and CASP. A total of 65 interviews were conducted. Table 1 presents a summary of interviewee characteristics. Interviews of all non-management employees were confidential. Interviews with senior management were audiotaped and they were informed that their real names would be used as it is not possible to provide confidentiality to leaders of a company in a case study while identifying their role and the organization.

Separate semi-structured interview guides were developed for the CEO, HR personnel, non-HR employees, supported employees, parents, and CASP staff. Interviews with BCP and CASP management focused on the history and implementation of the supported employment program, the relationship between CASP and BCP, and the perceived benefits and challenges of the program. Interviews with supported employees and their parents focused on their experiences with supported employment and its value in their lives. Finally, interviews with non-HR employees focused on their experiences of the supported employment program as well as general workplace climate. The length of interviews varied: (a) for the CEO and HR executives, one-hour meetings were held at the beginning and end of the study; (b) interviews with parents lasted approximately one hour; (c) interviews with CASP staff took place on multiple occasions for varying durations; (d) and interviews with BCP employees lasted approximately 30 minutes.

Major themes from transcripts and extensive field notes from non-recorded interviews were first identified, followed by identification of data (i.e., quotes, or paraphrases) that related to those themes. In addition to in-depth interviews, this report also draws upon workplace observations of the supported employees at BCP and materials provided by BCP, including their Annual Report and a description of benefits provided by the HR department.

Table 1. Number of persons interviewed by organization and interviewee type

Organization / Interviewee Type

Number Interviewed

Banco de Credito del Peru



Director of Human Resources (HR)


Senior HR staff


Mid-level staff (e.g., division managers, consultants, project managers, section leaders, supervisors)

Direct co-workers/supervisors




Low-level/non-supervisory staff (e.g., secretaries, tellers, data entry staff)


Supported employees


Centro Ann Sullivan del Peru Director & senior staff


Parents of supported employees







Description of the Supported Employment Program

Begun in 1996, CASP's supported employment program operates on the principle that "everyone can have a real job based on their abilities" (Judith LeBlanc, personal communication). CASP works closely with company management at each worksite to match individual skills with employers' needs when evaluating a potential placement. All of the supported employees begin with supervision by a job coach, whose role is to facilitate learning the job and adjusting to the work environment. Employees' needs for coach supervision often decrease over time as job-specific and social skills improve, however, support is always available either on-site or by phone. In addition to providing orientations for co-workers when new employees begin, CASP offers retraining when new assignments arise, helps manage challenging behaviors, and provides ongoing consultations with co-workers and supervisors as needed.

As of October 2006, CASP had placed 90 of its students in 26 businesses across Peru. Within the program at BCP, there is a wide range of cognitive, social, and verbal communication skills among the supported employees. Some perform administrative tasks in archival and legal departments, classifying and filing documents and entering data, and others pick up, prepare and deliver mail or classify credit card applications, obtaining and entering supporting documentation. As observed by the authors, all of the supported employees work in integrated settings within various departments throughout the bank, consistent with the individual supported employment model of integrated employment (Boeltzig, Timmons, & Butterworth, 2008).

BCP's HR management and CASP's directors emphasized that the supported employees receive the same wages and benefits as their non-disabled colleagues. Like all employees, they have individual contracts, undergo the same salary determination process, and are subject to annual performance evaluations. All employees are also entitled by law to receive a pension as well as paid vacation, sick leave, and health insurance. BCP gives supported employees the flexibility to take paid days as needed for additional training and support at CASP to address work-related issues. Although these days are rarely used, it is understood that this flexibility benefits both the supported employees and their work teams. Such days are not unlike the paid days off that other non-disabled employees arrange informally with their supervisors in times of need (i.e., when a child is ill). In fact, interviews revealed considerable discretion exercised by employees' immediate supervisors with respect to paid time off.

History & Implementation of the Supported Employment Program at BCP

Interviews with BCP's top management and CASP's directors indicated that CASP had a long-standing relationship with BCP prior to the implementation of the supported employment program at BCP in early 2004. BCP had provided support for various CASP fund-raising activities during the previous two decades. Since the inception of the program, their support has expanded to include significant scholarship funding for the neediest families at CASP.

CASP approached BCP toward the end of 2003 regarding supported employment placements for some of its graduates. No other bank in Peru had a supported employment program to serve as a model, and BCP's HR department was uncertain whether the graduates would work well in the bank setting. Prior to implementing the program, BCP's Director of Selection and Training visited two companies that had implemented supported employment programs with CASP, and this helped convince her that these employees could be integrated successfully into the workplace:

I had the opportunity to visit two companies where they had employees with disabilities and I was really amazed at how these young people could perform. That helped me decide to support the program. There aren't too many companies (hiring employees with disabilities) but the ones that are doing it are doing it well. This motivates you, doesn't it? I think companies are afraid that those young people with disabilities may not be able to succeed in becoming a part of the work team.

In January 2004, after several months of meetings with BCP's executive management and key HR personnel, CASP placed nine of its graduates in positions matched to their skill levels. In January 2005, four additional CASP graduates were placed at BCP, one of which replaced one of the original nine. One more graduate was hired in June 2006, bringing the total to 13 supported employees at two main locations in Lima. At the time of the case study, all supported employees worked part-time, or 22.5 hours per week.

As CASP's Director of Inclusion explained, BCP identified managers that were predisposed to incorporate supported employees into their teams. Some of these managers had children or relatives with disabilities and they seemed especially sensitive to the issue of providing opportunities for skill development. For example, one section leader, who had a son with a disability, described how he had facilitated the transfer of a supported employee from a routine role in his own department to another department where the employee's computer skills could be better used. Two other managers, both having close relatives with disabilities, noted that they had responded to the company's request for those interested in incorporating supported employees into their teams.

Benefits & Challenges of the Supported Employment Program

The BCP perspective The executive management of BCP initially viewed the supported employment program primarily as an act of charity. As the CEO recalled:

What I was thinking is that we were giving help with few expectations... It was not that we thought that the program would fail, but we wanted [the supported employees] to feel appreciated, and so we felt we were doing an act of charity or generosity.

Two years later, a shift in the perceived value of the program was evident. From the bank's perspective, one of the benefits has been the example set by the supported employees' excellent work ethic and positive attitudes. One top-level HR staff member described how the program challenged assumptions about the working abilities of people with disabilities:

[The program] has definitely served to help people individually break their old paradigms with respect to whether people with disabilities can or can't perform ordinary jobs... [and] it has helped people... realize that these young people are capable of doing excellent work. [The program has also been able] to motivate people because when they run into a CASP supported person and see him/her so dedicated and content in his/her job, they say to themselves, "I should feel the same about my own job and also do excellent work."

Direct co-workers and immediate supervisors of the supported employees also described having witnessed the supported employees' professional development and vocational competence. They were impressed by the supported employees' engagement in their work and, for some, greater efficiency in their assigned tasks compared to other employees. Two supervisors noted that their supported employees had taken on increased responsibilities and more complex tasks during their tenure at BCP. At the time of the study, four of the 13 employees were working independently without a coach. One supervisor estimated that the productivity of his group had increased by 20%, growth which was attributable to one particular supported employee. He described what disability employment specialists call job carving, which involves "reassigning duties from current staff to supported employees in such a way as to maximize employee productivity and organizational efficiency" (Nietupski & Hamre-Nietupski, 2000, p. 104).

The development of social relationships also motivated non-supported employees to invest in the success of their supported co-workers. They create natural supports, described as "human or technical resources that are available or can be developed in a setting to facilitate a person's integration, acceptance, and satisfaction, and to promote the goals and interests of all individuals in the setting" (Trach & Shelden, 1999, p. 2). For example, one manager described an innovative data entry interface developed by one of his employees for one of the supported employees to enhance her efficiency and concentration. The supervisor of two of the supported employees also described how she had observed more collaboration over time; for example, she noted that she heard co-workers offering assistance to supported employees.

Another recurrent theme in interviews with BCP staff at all levels was the program's impact on employee morale and the work environment. According to the CEO:

What I perceive, and what surprised me the most, is that people around the (supported employees) are... much better off than they were before, including being more satisfied professionally with themselves... That generates a better work environment at the bank... It makes the whole organization feel and perform better and for me, that is the payback.

His perceptions were supported by numerous comments from employees. For example, one branch manager believed that the supported employees had contributed to both "productivity and morale." Another manager felt that the supported employees had "generated good feelings" among all of the employees. A staff member in the HR department commented that the supported employees brought with them a "contagious good attitude." Almost all employees interviewed, in fact, talked about the social impact of the program on the workplace, contending that it inspired employees to be more "compassionate" and "sensitive." Positive effects on morale were also reflected in employees' sense of pride in the supported employment program. Many seemed aware that they were the only bank in Peru with such a program, and expressed satisfaction over the bank's demonstrated social responsibility. Company annual reports that described BCP's relationship with CASP, as well as outside press coverage about the supported employment program, provided further evidence of perceived benefits to the company's public and self-image.

Although many employees interviewed talked about the supported employees' contributions to the bank in terms of both their social impact on the workplace, and in terms of their work ethic, skills, and productivity, there were some interviewees who discussed the value of the supported employment program solely in terms of the bank's service to people with disabilities. Notably, none of these interviewees were direct co-workers or supervisors of the supported employees. For example, one employee felt that the supported employment program was more about the "company's social role" than about the employees "helping or completing their tasks." Another employee commented that he believed the contribution of the supported employees was "not so much financial" as it was "moral" - that perhaps a non-disabled employee could do the same work in less time. In fact, as previously mentioned, direct co-workers and supervisors of the supported employees, as well as others, contradicted this sentiment. For example, one supervisor felt that, in some tasks, the supported employees did even better work than the employees without disabilities. Another manager stated that the supported employees "are not here on vacation... they are carrying their share of the workload like any other employee."

The supported employee and family perspective. Interviews with supported employees and parents suggested high levels of satisfaction with their experience at BCP, and two supported employees suggested that they would like to work longer hours. Two supported employees also commented that they enjoyed working in teams. The fact that they were earning their own salaries and contributing to their households also seemed to be a source of great fulfillment. One supported employee commented that he liked working because it allowed him to help his family. When asked what he did with his salary, he explained that he paid for electricity and water, helped purchase food for the family, and bought a DVD player. Another supported employee explained that he liked to work in order to earn a salary, and that he was saving up money to travel.

The family perspective also provides a moving account of the value of the supported employment program in their lives. For one family, after having lost hope that their daughter would ever have a "useful life," finding CASP was "like being born again." Indeed, these jobs provide the primary source of income for approximately a third of all of CASP's supported employees' families (Liliana Mayo, personal communication, August 9, 2006). In addition, parents emphasized the importance of the pension since it provides long-term financial security for their children after they pass away. In addition to the economic value and security provided by employment, parents also discussed the value of employment for their children's self-respect and social standing. One parent described how her son proudly told others that he was working. Another parent talked about how her son's employment status had increased his siblings' respect for him.

The CASP perspective. Since the program at BCP has been so successful in Lima, both BCP and CASP have made efforts to expand it by increasing the number of supported employees placed at BCP sites in Lima and extending the program to the provinces. Interviews with CASP leadership highlighted the challenges in reaching these goals. For example, the availability of job coaches remains one of the most pressing barriers to increasing the number of supported employees in both Lima and the provinces. Most coaches are volunteers, including parents and siblings of supported employees.

Expansion of the program to the provinces also requires the development and implementation of a long-distance education program. At the time of the study, CASP lacked the funds to fully develop this critical aspect of its program. CASP's director believed that one of the reasons CASP's supported employment program had been so successful in Peru as opposed to other Latin American countries is that CASP was always on-hand to handle crises. The importance of CASP's constant presence to the development and performance of the supported employees was also emphasized by a senior HR person at BCP: "[CASP staff] are always monitoring. They are constantly here at the bank's offices... always evaluating how those employees are doing and how they have been performing. There is great follow up."

The placement of students outside of Lima has been slow due to the difficulty of sustaining this level of follow-up in the provinces, however improvements are forthcoming. As of 2008, CASP had received funding from the United States' National Institutes of Health to expand its distance-learning program, which is already being used to train and support over 400 professionals, students, and family members throughout Peru (Liliana Mayo, personal communication, April 17, 2008).

A lack of funding is foremost among the challenges to the success of CASP's supported employment program. CASP is committed to providing family-centered support to people with disabilities over the lifespan, however, many families cannot cover the costs of this support. Much of CASP's budget is consumed by basic living and communication skills-training and parental support. This leaves little money for job coach salaries, instructional technology tools, and other necessities. The intensive start-up costs associated with preparing a student to enter the workforce are estimated at $400 to $600 per month, per student for at least two months. After this initial intensive period, support costs usually go down to $150 per month, substantially less than earnings at BCP (Liliana Mayo, personal communication, April 18, 2008).


The CASP-BCP supported employment program has been successful on many levels. Individuals with significant disabilities have been placed and retained in integrated employment, received equal compensation, and contributed economically and socially to their workplaces and families. The program has given supported employees and their families an opportunity for greater social inclusion and self-respect while providing a secure income and vital employment-related benefits. With respect to influences on companies' willingness to hire the supported employees, BCP emphasized the importance of successful models, even in different industries. BCP also stressed the importance of CASP's high level of support and availability, a finding consistent with research in higher-income contexts (Buys & Rennie, 2001).

The successes of the supported employment program are consistent with arguments regarding "the business case" for hiring people with disabilities (Employer Assistance & Recruiting Network, n.d.). Evidence of "the business case" for hiring people with developmental disabilities include perceptions of co-workers, supervisors, and upper management that workers with disabilities meet or exceed performance standards, and may even influence their non-disabled coworkers to improve their performance. Some evidence for the development of natural supports also bodes well for the success of the supported employees. Moreover, evidence of the positive impact of the program on the workplace, and perceived benefits to company image, were evident throughout interviews with bank staff, in company literature, and outside press reports. It is notable that these perceived benefits in the Peruvian context are consistent with findings from higher income settings such as the U.S., U.K., and Australia (Buys & Rennie, 2001; Olson, et al., 2001; Unger, 2002).

At the same time, the case study suggests that the program faces a number of challenges. First, the program is challenged by its lack of governmental support and its resulting need for continual fund-raising. Although CASP has been successful in piecing together resources for various programs, this is not a reliable long-term solution for sustainable programming. The program's potential to reduce poverty among people with disabilities and their families, to support more employees and possibly more hours of work for current employees, is limited by its dependence on family volunteers as job coaches, as their own availability for paid employment is significantly impacted. Questions remain regarding the potential for sustained growth of supported employment initiatives that must struggle with these constraints.

BCP and CASP also share the challenge of overcoming a perception that supported employees have been hired for charitable reasons. This challenge is complicated by the fact that the program relies on public charity and philanthropy for operation. Direct co-workers and supervisors of the supported employees recognized their vocational competence as well as the positive impact of the program on employee productivity, whereas some of those who did not have direct contact with supported employees emphasized only the moral aspects of their presence (i.e., inspiring compassion). In a U.S. based study, Belcher and Smith (1994) also found that direct contact between supported employees with autism and their coworkers was associated with more positive perceptions of vocational competence. In another U.S. based study, Shafer et al. (1989) did not find a difference between direct and non-direct co-workers in attitudes about social and vocational competence of supported employees with mental retardation. These studies, however, did not address the impact of the supported employees' presence on the productivity of others in the workplace or on morale. These findings, together with evidence from higher income contexts linking experience (v. inexperience) to identification of advantages to employing people with disabilities (Morgan & Alexander, 2005; Unger, 2002) suggests that further in-depth, perhaps qualitative study of the role of co-worker experience with supported employment may shed light on efforts toward true integration.

Implications for Practice

Findings regarding the history and implementation of the supported employment program at BCP offer several potential insights that may be particularly salient for vocational training specialists in countries where there is relatively little experience with supported employment. These recommendations include seeking out employer partners with a demonstrated commitment to social responsibility; connecting prospective employer partners with existing successful programs; and, upon implementing a program within a site, identifying managers who are predisposed to incorporating supported employees into their teams. In addition, supported employment specialists should work with employers to emphasize to non-disabled employees and society at large the value of supported employment in terms of its potential to tap into an underutilized pool of human resources.


Several limitations of this case study should be noted. In order to gain access to employees at two different locations in Lima during paid work time, the human resources department assisted with coordinating interviews. Although we assured participants of the voluntary and confidential nature of the interview, it is possible that some interviewees felt a sense of official sponsorship of the study - a limitation common to studies of agencies and organizations requiring access through a formal gatekeeper (Seidman, 1998). Furthermore, there was possible selection bias in that those bank employees who were interviewed may have held particularly favorable views of the supported employment program.


In spite of these limitations, we believe that this case study demonstrates the feasibility of supported employment for individuals with developmental disabilities in the context of a lower middle income country with high unemployment and minimal governmental support. However, it also highlights constraints to growth in such a context. The successes of the CASP program speaks to the agency's efficacy in helping create effective employee-job matches and in coordinating and maintaining support for employers and employees. It also emphasizes the strengths that the supported employees and their families bring to the workplace. Employees attested to the supported employees' contributions to productivity, to the company's public image, and to the overall workplace environment. Even with a relatively small number of supported employees, the potential benefit for society is great. Combined with efforts to promote understanding of supported employment as an important tool for harnessing underutilized human resources, increased exposure in the workplace to individuals with developmental disabilities can raise awareness about the rights and abilities of people with these disabilities to be integrated into the workforce.


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1. This study was funded by the Ford Foundation.

2. We would like to acknowledge the supported employees and their families, their coworkers and supervisors who generously gave their time and openly shared their experiences. This study would not have been possible without CASP's and BCP's willingness to provide the study team access to management and employees for interviews. We are grateful to Liliana Mayo (Founding Director), Enrique Burgos (Coordinator of the Inclusion Area), Hilda Salazar (Director of the Inclusion Area), and Yemi Oyama (Director of the Training Area) at CASP, and Raimundo Morales (CEO and General Manager), Franco Giuffra (Director of HR), and Maria Teresa Merino (Direction of Selection and Training, HR) at BCP. Special thanks goes to Magda Zegarra and Marcia Arbulú (HR Analysts) who coordinated interviews. We would also like to thank Alvaro F. Gómez, a Case Study volunteer who donated his time and energy throughout the study by providing exceptional assistance with the fieldwork and the analysis of the findings, as well as Melanie Benard for her superb editorial and staff assistance.


Carmen Gomez Mandic, MPH, ScD, Department of Society, Human Development, and Health, Harvard School of Public Health; now at the University of Wisconsin-Madison, Department of Population Health Sciences


Jody Heymann, MD, PhD., Institute for Health and Social Policy, McGill University


International Journal of Disability, Community & Rehabilitation
Volume 8, No. 1
ISSN 1703-3381