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4
OVERSIGHT AND REAUTHORIZATION HEARING ON
THE REHABILITATION ACT OF 1983
HEARINGS
BEFORE THE
SUBCOMMITTEE ON SELECT EDUCATION
OF THE
COMMITTEE ON EDUCATION AND LABOR
HOUSE OF REPRESENTATIVES
NINETY-EIGHTH CONGRESS
FIRST SESSION
HEARINGS HELD IN WASHINGTON, D.C. ON MARCH 21 AND 23, 1983
Printed for the use of the Committee on Education and Labor
OVERSIGHT AND REAUTHORIZATION HEARING ON
THE REHABILITATION ACT OF 1983
HEARINGS
BEFORE THE
SUBCOMMITTEE ON SELECT EDUCATION
OF THE
COMMITTEE ON EDUCATION AND LABOR
HOUSE OF REPRESENTATIVES
NINETY-EIGHTH CONGRESS
FIRST SESSION
HEARINGS HELD IN WASHINGTON, D.C. ON MARCH 21 AND 23, 1983
Printed for the use of the Committee on Education and Labor
U.S. GOVERNMENT PRINTING OFFICE
22-065 o
WASHINGTON : 1984
COMMITTEE ON EDUCATION AND LABOR
CARL D. PERKINS, Kentucky, Chairman
AUGUSTUS F. HAWKINS, California
JOHN N. ERLENBORN, Illinois
WILLIAM D. FORD, Michigan
JAMES M. JEFFORDS, Vermont
PHILLIP BURTON, California
WILLIAM F. GOODLING, Pennsylvania
JOSEPH M. GAYDOS, Pennsylvania
E. THOMAS COLEMAN, Missouri
WILLIAM (BILL) CLAY, Missouri
THOMAS E. PETRI, Wisconsin
MARIO BIAGGI, New York
MARGE ROUKEMA, New Jersey
IKE ANDREWS, North Carolina
STEVE GUNDERSON, Wisconsin
PAUL SIMON, Illinois
STEVE BARTLETT, Texas
GEORGE MILLER, California
RON PACKARD, California
AUSTIN J. MURPHY, Pennsylvania
(Vacancy)
BALTASAR CORRADA, Puerto Rico
(Vacancy)
DALE E. KILDEE, Michigan
PAT WILLIAMS, Montana
RAY KOGOVSEK, Colorado
HAROLD WASHINGTON, Illinois
MATTHEW G. MARTINEZ, California
MAJOR R. OWENS, New York
FRANK HARRISON, Pennsylvania
FREDERICK C. BOUCHER, Virginia
(Vacancy)
SUBCOMMITTEE ON SELECT EDUCATION
AUSTIN J. MURPHY, Pennsylvania, Chairman
GEORGE MILLER, California
STEVE BARTLETT, Texas
MARIO BIAGGI, New York
WILLIAM F. GOODLING, Pennsylvania
PAUL SIMON, Illinois
E. THOMAS COLEMAN, Missouri
JOSEPH M. GAYDOS, Pennsylvania
JOHN N. ERLENBORN, Illinois, Ex Officio
PAT WILLIAMS, Montana
BALTASAR CORRADA, Puerto Rico
CARL D. PERKINS, Kentucky, Ex Officio
(II)
CONTENTS
Hearings held in Washington, D.C. on:
Page
March 21, 1983
1
March 23, 1983
157
Statement of-
Bauer, Gary, Deputy Under Secretary, Office of Planning, Budget and
Evaluation, Department of Education
160
Cox, James A., Jr., executive director, National Association of Rehabilita-
tion Facilities,
126
DeJong, James, Access Living, Chicago, Ill
81
Krajczar, Norma, director, New Jersey Commission for the Blind; Elmer
Bartels, Director, Massachusetts Rehabilitation Commission; Vernon
Arrell, Commissioner, Texas Rehabilitation Commission; Donald
Wedewer, director, Division of Blind Services, Florida
173
Frieden, Lex, director, Independent Living Research Utilization Project,
Houston, Tex
86
Pietszak, Adelle M. Edward, candidate, rehabilitation counseling, Kent
State University
114
Spears, Marvin O., president, National Rehabilitation Association, St.
Paul, Minn
3
Walker, Martha, president, National Council on Rehabilitation Educa-
tion, Kent, Ohio
114
Prepared statements, letters, supplemental materials, et cetera:
Bauer, Gary L., Deputy Under Secretary for Planning, Budget, and Eval-
uation, Department of Education, prepared statement of
189
Cox, James A., Jr., executive director, National Association of Rehabilita-
tion Facilities, letter to Chairman Murphy enclosing requested informa-
tion, dated April 11, 1983
153
DeJong, James, Access Living, Chicago, Ill.:
Attachment A
83
Attachment B
85
Resolution from the National Council of Independent Living Pro-
grams
99
Frieden, Lex, director, Independent Living Research Utilization Project,
Houston, Tex.:
Prepared statement of
90
"For Immediate Release," dated March 21, 1983
102
"Project Overview,"
105
Resource Materials for Independent Living, article entitled
107
Krajczar, Norma F., executive director, New Jersey Commission for the
Blind, statement on behalf of the Council of State Administrators of
Vocational Rehabilitation
198
Melvin, Dr., the National Association of Rehabilitation Facilities, pre-
pared statement of
130
Murphy, Hon. Austin J., a Representative in Congress from the State of
Pennsylvania, and chairman, Subcommittee on Select Education, open-
ing statement of
158
Pietszak, Adelle, on behalf of the National Council on Rehabilitation
Education (NCRE), prepared statement of
116
Spears, Marvin O., president, National Rehabilitation Association:
Prepared statement of
6
Executive summary of Minnesota Division of Vocational Rehabilita-
tion fiscal year 1981 economic analysis
12
"Independent Living Centers in Region V," article entitled
26
"Promoting Rehabilitation Progress," pamphlet entitled
75
(III)
IV
Page
Prepared statements, letters, supplemental materials, et cetera-Continued
Walker, Martha, president, National Council on Rehabilitation Educa-
tion, statement on behalf of
120
APPENDIX
Bean, William J., Ph. D., Chief, Independent Branch, U.S. Department of
Education, letter to dear colleague dated July 5, 1983 with enclosure
385
Cooney, Rear Adm. David M., USN (Ret.), president and chief executive
officer, Goodwill Industries of America, Inc., prepared statement of
240
Conn, George A., Commissioner of Rehabilitation Services, U.S. Depart-
ment of Education, information memorandum dated June 21, 1983
408
Consortium for Citizens with Developmental Disabilities, statement of
277
Craig, Patricia Johnson, director, Department of Human Resources, Na-
tional Association of Counties, letter to Chairman Murphy, dated
March 10, 1983
303
Griswold, Peter P., president, Council of State Administrators of Voca-
tional Rehabilitation, Washington, D.C., letter to Chairman Murphy,
dated April 7, 1983
211
Hunt, Palmer S., for Commissioner of Rehabilitation Services, Office of
Special Education and Rehabilitative Services, U.S. Department of Edu-
cation:
"Economic Gains for Individuals and Governments Through Voca-
tional Rehabilitation," report entitled
307
"In-House Benefit/Cost Ratios: State-Federal Program of Vocational
Rehabilitation Fiscal Years 1971 to 1980," report entitled
312
"Characteristics of Persons Rehabilitated in Fiscal Year 1980," report
entitled
321
"Caseload Trends Through Fiscal Year 1982," report entitled
331
Kingsley, Roger P., Ph. D., director, congressional relations division, gov-
ernmental affairs department, the American Speech-Language-Hearing
Association, prepared statement of
251
Lorenz, Jerome R., professor and director, Southern Illinois University of
Carbondale, Carbondale, Ill., letter to Judy Wagner, dated June 30,
1983 with enclosure
373
McDonough, Dr. Patrick J., associate executive vice president and direc-
tor of professional and government affairs, American Personnel and
Guidance Association and American Rehabilitation Counseling Associ-
ation, prepared statement of
270
Petty, Robert H., executive director, the National Association for the
Blind, Norman, Okla., letter to Chairman Murphy, dated March 8,
1983
273
Rehabilitation Act: Subcommittee Explanation of Funding Recommenda-
tions
351
Romer, Joseph D., director of governmental affairs, National Easter Seal
Society, letter to Chairman Murphy, dated March 30, 1983
221
Schloss, Irvin P., director of governmental relations, American Founda-
tion for the Blind, statement of
232
Spears, Marvin O., president, National Rehabilitation Association, letter
to Chairman Murphy, dated March 21, 1983
212
The Rehabilitation Coalition, recommendation of
353
Tsosie, David J., chairman, Education Committee, Navajo Tribal Council,
letter to Chairman Perkins enclosing a statement, dated March 30,
1983
214
United Cerebral Palsy Associations, Inc., statement of
292
OVERSIGHT AND REAUTHORIZATION HEARING
ON THE REHABILITATION ACT OF 1983
MONDAY, MARCH 21, 1983
HOUSE OF REPRESENTATIVES,
COMMITTEE ON EDUCATION AND LABOR,
SUBCOMMITTEE ON SELECT EDUCATION,
Washington, D.C.
The subcommittee met, pursuant to call, at 10 a.m., in room
2261, Rayburn House Office Building, Hon. Austin J. Murphy
(chairman of the subcommittee) presiding.
Members present: Representatives Murphy, Williams, and Bart-
lett.
Staff present: Judith Wagner, professional staff; Tanya Rahall,
staff assistant; and Patricia Morrissey, minority legislative asso-
ciate.
Mr. MURPHY. Good morning.
This morning's hearing is the first of 2 days of oversight in prep-
aration for the reauthorization of the Rehabilitation Act. We are
fortunate in this subcommittee to have jurisdiction over several
programs that have always received strong bipartisan support in
Congress. The Rehabilitation Act is one of them.
Even during the year of Gramm-Latta, when the administration
was calling for block grants for almost every social program, in-
cluding the Rehabilitation Act, and while Congress was giving the
President much of what he wanted, not a voice was heard from
either side of the aisle in either the House or the Senate in support
of making changes in the Rehabilitation Act.
When the dust had finally settled in fiscal year 1981, Congress
had seen fit to extend the act and again increase its funding, al-
though modestly. When you have a winner, a program that works,
it only makes sense to stick with it. You don't abandon it. When
possible, you strengthen it.
For this reason I believe it is safe to say that the administration
will not find much support in Congress for its latest recommenda-
tion for abandoning the Rehabilitation Act, the New Federalism
block grants.
We have not yet received the additional proposal the administra-
tion says it will be sending us to amend the Rehabilitation Act, and
I am not sure why we need two bills since we already know what
they really want to do to the program.
Again, the administration should recognize that Congress will
not make changes in this act that might jeopardize its remarkable
record of success.
(1)
2
Last week a number of my colleagues and I introduced a reha-
bilitation bill that I believe Congress will support. In recognition of
the long history of success of the State grants portion of the act,
the bill would make the State grants entitlement a permanent au-
thority. It would also authorize increases in the State grants which
would, over the next 4 years, restore the spending power that has
been lost since 1979 due to inflation.
Since 1979, the drop in the number of both severely and non-
severely disabled cases shows a clear decline in the ability of the
States to serve eligible clients. At the very least our objective
should be to get back to the point where the decline began.
We want to hear this morning from rehabilitation practitioners
and from those who are on the receiving end of the programs au-
thorized by the act. We will welcome your comments on the bill we
have introduced, on the administration's proposals, and any recom-
mendations you may have on how we might strengthen and im-
prove the act. We appreciate your presence here today.
Mr. Steve Bartlett of Texas.
Mr. BARTLETT. Thank you, Mr. Chairman.
As a new member of this subcommittee, and as the ranking mi-
nority member of this subcommittee, I take special pleasure in
joining with you and our other colleagues in beginning work on
hearings and the markup this week of the reauthorization of the
Rehabilitation Act of 1973.
I will keep several important points in mind as we go about
reauthorizing and examining the Rehabilitation Act.
First, we have to remember that any State or Federal program
which helps Americans to obtain and retain private long-term
meaningful employment is significant. Because vocational rehabili-
tation goes a long way toward providing this kind of employment
future for the disabled, we must identify and expand the cost effec-
tiveness of the vocational rehabilitation program.
Second, the need is great. At this committee level we must deter-
mine how many persons can be helped by encouraging use of the
much larger resources available in the private sector. The burden
of preparing handicapped persons for employment must be shared
by the public and private sector with Federal dollars. being used for
leverage and as a catalyst.
Third, State vocational rehabilitation agencies are faced with the
same economic realities that we are faced with here at the Federal
level; that is, steadily declining purchasing power.
I do not believe that the solution to reversing the trend of de-
creasing purchasing power lies solely in increased appropriations.
Instead, we must explore new ways to use the Federal resources
that we now have as leverage to increase private sector funding.
Fourth, the handicapped are especially hard hit by unemploy-
ment, yet the handicapped share with all other Americans a stake
in the best and the most effective solution to unemployment; that
is, a healthy economy with low interest rates and low inflation and
a private sector that is vigorous enough to provide all Americans,
including the handicapped, with meaningful jobs. To achieve this
goal we must make a cooperative effort to control the growth of the
total size of Federal spending.
3
Fifth, one of the issues that this reauthorization will focus on is
the appropriateness of increased Federal dollars for the Rehabilita-
tion Act. There is a consensus on the need to help handicapped
Americans enter the work force. That should be the focus of this
act. However, we do need to look at all the methods that may be
available for achieving that end. The key is in leveraging existing
dollars, not necessarily in increasing those dollars.
Sixth, another issue that we will hear in this reauthorization is
the need to remove the drain on other Federal programs, such as
social security, that benefits to the handicapped represent. Reduc-
ing that drain in social security dollars will be accomplished by
training handicapped persons and placing them into private sector
jobs.
Last, I believe that we should examine the terms of the existing
formula to find a way to encourage and to reward programs that
are successful in placing people in permanent employment.
I look forward to this week's hearings on the Rehabilitation Act
reauthorization. I hope that this committee can produce a bill that
is in the best interest of all handicapped persons, SO their talents
and abilities can be maximized and they can live independent,
meaningful lives.
Thank you, Mr. Chairman.
Mr. MURPHY. Thank you, Mr. Bartlett.
The first witnesses we have this morning are a panel consisting of
Mr. Marvin Spears, president of the National Rehabilitation Associ-
ation in St. Paul, Minn.; Mr. Jim DeJong, Access Living, Chicago, Ill.;
and Mr. Lex Frieden, director of the Independent Living Research
Utilization Project, Houston, Tex.
Will the three of you gentlemen arrange yourselves at the wit-
ness table, and we will proceed in that order.
Mr. Spears, you may proceed first.
STATEMENT OF MARVIN O. SPEARS, PRESIDENT, NATIONAL
REHABILITATION ASSOCIATION, ST. PAUL, MINN.
Mr. SPEARS. Thank you, Mr. Chairman.
My name is Marvin Spears. As president of the National Reha-
bilitation Association I very much appreciate the opportunity to
present the views of NRA and its seven divisions.
The many years of hard work and dedication you and members
of the subcommittee have committed to increasing opportunities
and options to persons with disabilities is well known to our organi-
zation and deeply appreciated.
NRA, founded in 1925, has an active membership of 20,000. Our
association's mission and purpose is founded on advocacy, advocacy
for options and opportunities for our Nation's persons with disabil-
ities.
Today, Mr. Chairman, I would like to present the recommenda-
tions of NRA relative to the Rehabilitation Act of 1973 as amend-
ed. These recommendations will relate both to the act in its entire-
ty, and to specific sections.
First, Mr. Chairman, I would suggest that we feel strongly that
the act is a hallmark of intelligent, comprehensive and thoughtful
efforts to encompass public policy and national legislation. All
4
phases of the act have worked effectively. We have urged that you
maintain the integrity of the programs and rights contained in the
act.
The foundation of the programs authorized under the Rehabilita-
tion Act is the basic State vocational rehabilitation program. This
program is provided to persons with disabilities through a unique
Federal-State partnership that has functioned successfully for over
60 years. It is a proven, finely tuned program that has stood the
test of time, has been well managed and proven to be highly cost
effective.
The Rehabilitation Services Administration's latest report to
Congress estimates that the benefit-cost ratio exceeds 10 to 1. In
my own State of Minnesota, we have determined that the return
on a public investment in a basic State vocational rehab program is
34.8 percent. This is a very impressive return on any investment.
Of equal importance are the benefits of this program to the per-
sons with disabilities. Behind the cost benefit studies are individ-
uals who have been provided opportunities to earn money and gain
the self-esteem that comes from a paycheck.
To be working is to be part of mainstream America. This pro-
gram helps persons with disabilities work and enter that main-
stream.
However significant the benefits of the program are, funds have
not been made available at a level necessary to maintain the serv-
ices needed by persons with disabilities. Since this program pays
significant dividends on public investment, we urge that you in-
crease that public investment significantly.
Next I would like to discuss the program of services authorized
under title VII, Comprehensive Services for Independent Living.
This program has been partially implemented by the provision of
funds to establish and support Centers for Independent Living.
There are now 135 such centers providing services to people with
disabilities all over our Nation. Some State rehabilitation agencies
have opted to operate these programs directly; many more have
contracted with private, nonprofit, community-based, consumer-di-
rected organizations to provide the services.
I wish very much, Mr. Chairman, that I could present to you sig-
nificant nationwide statistics relative to this program. However,
this administration has not seen fit to institute a meaningful, na-
tionwide reporting system, nor apparently do they have plans to do
so this year. I believe that you, as the Nation's policymakers, are
entitled to this information.
Independent living services not only enable persons with severe
disabilities to live independently, but they reduce the public costs
associated with disability. Thirteen centers in Federal region V col-
laborated to accumulate a series of documented individual histories
showing clearly that the provision of independent living services is
not only of benefit to the individuals involved, but a cost savings as
well.
Of the 18 individuals portrayed in this report, 10 are likely to
become employed. Net savings in public expenditures to these indi-
viduals for various kinds of public assistance, including social secu-
rity benefits, has been reduced by $135,000 per year. This limited
evidence shows clearly that independent living services provide not
5
only personal benefit to the individuals served, but a cost savings
as well.
Currently, only part B has received funding and, as valuable as
the Centers for Independent Living are, it is essential the program
be fully implemented, as was intended in the amendments of 1978.
NRA urges that Congress now fund part A and maintain the exist-
ing level of funding for part B.
Next, Mr. Chairman, I would like to address the rehabilitation
research needs as reflected in the funding request for research di-
rected through the National Institute of Handicapped Research.
This institution is charged with increasing the knowledge which
will help us meet the challenges in serving individuals with disabil-
ities. NIHR is also charged with disseminating information in
order that persons with disabilities may benefit from research find-
ings quickly.
I would like to point out that we are entering a new era in this
country. Science and technology are increasingly brought to bear
on all aspects of our life. Increased funding for research activities
is vital if research findings are to be brought to bear on the prob-
lems faced by our Nation's citizens with disabilities. Increases in
research funding will pay direct dividends in the future.
Next I would like to address the need for training individuals
working to increase opportunities and options for persons with dis-
abilities.
Significant numbers of qualified rehabilitation professionals are
essential for assuring the availability of a broad range of services
needed to enable persons with disabilities to enter the work force
and to live and function independently.
The quality and scope of any program is directly related to the
quality of the persons providing services. NRA supports an in-
crease in funding for rehabilitation training activities.
Finally, Mr. Chairman, I would like to emphasize that although
time does not permit a full discussion of the other programs au-
thorized under the act, note should be taken that the special discre-
tionary grant categories are of importance to the overall scope of
the services in the act.
Of special mention are projects with industries which have dem-
onstrated that close ties with the business community can enable
persons with disabilities to become employed by a variety of inno-
vative, hands-on techniques. NRA supports increased funding for
these projects, as well as others in the special discretionary grant
category.
Mr. Chairman, in conclusion I would like once again to thank
you very much for the opportunity of presenting our views on this
very important matter.
Mr. MURPHY. Thank you, Mr. Spears.
[The prepared statement of Marvin Spears follows:]
6
PREPARED STATEMENT OF MARVIN 0. SPEARS, PRESIDENT, NATIONAL REHABILITATION
ASSOCIATION
Mr. Chairman, members of the Sub-Committee, my name is Marvin Spears.
As President of the National Rehabilitation Association, I very much
appreciate this opportunity to represent the views of NRA and its seven
divisions -- the National Rehabilitation Counseling Association, the
Job Placement Division, the National Association for Independent Living,
the National Association of Rehabilitation Instructors, the National
Association of Rehabilitation Secretaries, the National Rehabilitation
Administration Association and the Vocational Evaluation and Work
Adjustment Association.
The many years of hard work and dedication you and members of the Sub-
Committee have committed to increasing opportunities and options for
persons with disabilities is well known to our organization and deeply
appreciated.
For nearly 60 years, our organization has worked with you to ensure that
persons with disabilities obtain the rights to which they are entitled
and the special services that they need to become independent, productive
members of society.
NRA, founded in 1925, has an active membership of 20,000 individuals,
including professional workers in all phases of rehabilitation, persons
with disabilities, and other individuals who share our commitment. Our
Association's mission and purpose is founded on advocacy -- advocacy for
options and opportunities for our Nation's persons with disabilities to
work, live lives of their choosing, and contribute to our society.
Today Mr. Chairman, members of the Sub-Committee, I would like to present
the recommendations of NRA relative to the Rehabilitation Act of 1973,
as amended. These recommendations will relate both to the Act in its
entirety and to specific sections.
THE REHABILITATION ACT, AS AMENDED
First, Mr. Chairman, let me offer our Association's recommendations on
the Rehabilitation Act, as amended in its entirety. We believe strongly
that the Act, as amended, is a hallmark of intelligent, comprehensive and
thoughtful efforts at encompassing public policy in national legislation.
All phases of the programs and rights authorized in the Act have worked
effectively. We urge that you maintain the integrity of the programs and
rights contained in the Act and reject efforts to significantly alter the
basic dimensions of our Nation's rehabilitation programs. We believe it
would be folly to change the finely tuned elements contained in this Act
for purposes of satisfying the abstract needs of some ideology.
BASIC STATE VOCATIONAL REHABILITATION SERVICES PROGRAM
SECTION 100 (B) (1)
The foundation of the programs authorized under the Rehabilitation Act
is the basic state Vocational Rehabilitation services program which
ensures that a wide range of rehabilitation services are available to
persons with all types of disabilities. This service program is provided
7
through a unique federal/state partnership that has functioned very success-
fully for over 60 years. It is a proven, finely tuned program that has
stood the test of time and has been well managed and highly cost effective.
Indeed, the Rehabilitation Services Administration's latest report to
Congress estimates that the benefits/cost ratio exceed $10 to 1. Estimates
obtained from other than federal sources are even higher.
For instance, Mr. Chairman, in my own state of Minnesota, we have deter-
mined that the return on the public investment in the basic. state Vocational
Rehabilitation program is 34.8 percent. That is a very impressive return
on any investment!
The taxpayers of our community are well rewarded for their investment of
dollars in the rehabilitation program.
Of equal importance are the benefits of this program to persons with dis-
abilities. Behind the cost/benefit studies are individuals who have been
provided opportunities to earn money and gain the self-esteem that comes
from a paycheck. The economic gains for individuals with disabilities leads
to personal gains of a less tangible but equally significant order.
Economic independence gives persons with disabilities options for living
that are available no other way. According to the National Jaycee Creed,
"Work gives meaning and purpose to life". To be working is to be part
of mainstream America. This program helps persons with disabilities work
and enter that mainstream.
All of us in America benefit from the rehabilitation program. Our Nation's
economy improves as we more effectively utilize the productive capacities
of persons with disabilities. Employers are provided a ready source
of trained, willing workers. The rehabilitation program acts as a magnet
drawing funds and commitments from our communities designed to enhance
the options and opportunities for their community members with disabilities.
In summary, Mr. Chairman, members of the Committee, the benefits of the
state/federal rehabilitation program are very significant and touch the lives
of virtually every citizen in the country.
However significant the benefits of this program are, funds have not been
made available in sufficient amounts to maintain the level of services
and opportunities provided to persons with disabilities.
In recent years, Congress has placed an emphasis on first serving the
severely disabled, a mandate which NRA wholeheartedly endorses and which
rehabilitation agencies have sought diligently to carry out. Unfortunately,
this laudable goal has not been reinforced by a level of funding necessary
to maintain the level of service this program deserves. Fewer individuals
are now being rehabilitated under the state/federal rehabilitation program
though there has been an. increase in the proportion of severely disabled
persons served. Although appropriations are not within the scope of this
sub-committee, Congress should be made aware that it is estimated to be two
to two and one-half times more costly to provide rehabilitation services to
those individuals with severe disabilities. Federal funds must increase to
properly implement this important and significant mandate.
8
The basic state rehabilitation program has worked and is working effectively
to ensure that persons with disabilities can become personally and
economically independent. It is a program proven effective through
many years and returns to society's significant benefits.
We urge the sub-committee to authorize sufficient funds to enable the
program to better meet the economic and job needs of persons with
disabilities.
COMPREHENSIVE SERVICES FOR INDEPENDENT LIVING - TITLE VII
Next, I would like to discuss the program of services authorized under
Title VII, Comprehensive Services for Independent Living. Independent
Living services, authorized in the amendments to the Rehabilitation Act
in 1978, have been implemented by the provision of funds to establish
and support Centers for Independent Living. One hundred thirty five (135)
of these Centers have been established and are now helping persons with
severe disabilities live and function more independently in their homes, families
and communities. Some state rehabilitation agencies have opted to operate
these Centers directly, but many have contracted with private non-profit
community-based organizations to provide the services.
I sincerely wish, Mr. Chairman and members of the Sub-Committee, that I
could present to you significant nationwide information relative to the
implementation of this vital program. However, the Administration has not
seen fit to institute a meaningful nationwide reporting system, nor
apparently do they have plans to do.so this year as Comprehensive Services
for Independent Living is not a work plan priority within the current
Administration.
I believe that you, as the Nation's policy-makers, are entitled to this
information, as well as we in advocacy organizations.
Independent Living services have great significance to persons with severe
disabilities. All of us have needs which we meet routinely for housing,
transportation, personal help, access to our community's resources.
Persons with severe disabilities have these needs too and the fulfillment
of these needs and desires is what Independent Living services is all about.
Independent Living services provide options for persons with disabilities
SO that they can manage their lives themselves. When persons with severe
disabilities have a predictable source of income, hopefully, through
employment, when they have accessible and affordable housing, when they
have accessible and adequate transportation and when they have the support
of friends and associates, they can and, in fact, do live and function
independently and provide a significant enrichment to the communities in
which they reside. When these basic conditions necessary for individuals
with severe disabilities to live independently are met, a significant
portion of them can avail themselves of services offered through the basic
state rehabilitation program and become economically independent through
work.
9
These services, Mr. Chairman, members of the Sub-Committee, not only enable
persons with severe disabilities to live independently, but they reduce
the public costs associated with disability. The experience of the Centers
for Independent Living even though they have been operational only a few
years, has provided dramatic evidence that given Independent Living
services, persons with disabilities require smaller expenditures of state,
federal and local support dollars in addition to improving their
ability to function in the employment market or in preparation for
employment.
For instance, in Federal Region V, which encompasses the states of Minnesota,
Wisconsin, Illinois, Michigan, Indiana and Ohio, 13 Centers for Independent
Living collaborating voluntarily with the Chicago Regional Office of
the Rehabilitation Services Administration, accumulated a series of docu-
mented individual histories showing clearly that the provision of Independent
Living services are not only a benefit to society in providing opportunities
and options, but cost effective as well.
Ten of 18 individuals portrayed in this report will likely become (or are
currently) employed.
Net savings in public expenditures to these individuals for various kinds
of public assistance has been reduced by $135,750 per year.
This limited evidence shows clearly that Independent Living services produce
not only personal benefit to the individuals served, but cost savings to
society as well.
Currently, Mr. Chairman and members of the Committee, only Part B of
the Act has received funding. As valuable and significant as the services
provided by the Centers for Independent Living are, it is essential that
the program be fully implemented as was intended in the Amendments of
1978.
NRA urges that Congress now fund Part A of Title VII. Funds for Part A,
administered by the state rehabilitation agency, would enable this
important program to more fully reach the mandate envisioned in the
Amendments. Cooperatively with the Centers for Independent Living, services
made available under Part A would enhance, expand and stabilize the
Independent Living program.
NRA urges, additionally, a funding level adequate to support the existing
Centers.
REHABILITATION RESEARCH
Next, Mr. Chairman and members of the Committee, I would like to address
the rehabilitation research needs as reflected in the funding requests for
federal research directed through the National Institute of Handicapped
Research, Section 201, (A) (1). This institution is charged with coordinating
efforts to increase the knowledge which will help us overcome the challenges
associated with providing rehabilitation services to those individuals with
severe disabilities. Through rehabilitation research and training centers,
10
methodology and delivery systems are improved while rehabilitation
engineering centers seek to apply new and innovative methods to overcome
identified problems in the area of rehabilitation. NIHR is also charged
with the dissemination of such information in order that persons with
disabilities may benefit from the research findings as quickly as possible.
Together, these research activities provide a focused coordinated effort
to expand our ability to serve persons with severe disabilities and to
improve the overall effectiveness and success of the program.
Mr. Chairman, members of the Committee, I would like to point out that we
in this Nation are entering a new era. That era has been described as the
era of high technology. Basic science and technology are being increasingly
brought to bear on all aspects of life. Increased funding for research
activities are vital if the significant increase in research findings
and research capabilities are to, be brought to bear on the problems
faced by our Nation's citizens with disabilities. Indeed, much progress
has been made to date with the limited funds available. It is the view
of NRA that increases in funding research activities will pay direct
dividends in future years as the general field of science advances and
as our directed research enables us to utilize research findings to
minimize the impact of a disabling condition on the lives of persons
and to find increasingly effective ways to improve the opportunities and
options for persons with disabilities.
There are new scientific horizons that should be explored and new technological
advances in the areas of robotics, limb regeneration and bio-genetics, and
engineering could cause us to re-define our concept of disability.
REHABILITATION TRAINING
Next, Mr. Chairman and members of the Committee, I would like to address the
needs for training individuals working to increase opportunities and
options for persons with disabilities. Sufficient members of qualified
rehabilitation professionals are absolutely essential for providing a broad
range of services needed to enable persons with disabilities to enter the
work force and to live and function more independently. In recognition
of this fact, federal funds have been made available for rehabilitation
training for over 30 years. Currently, the rehabilitation training program
encompasses grants to states and public or non-profit institutions or
agencies, including universities, to support both long and short-term training
over the broad spectrum of rehabilitation specialties. Programs of con-
tinuing education designed to maintain and update high standards of services are
also authorized which help rehabilitation service providers respond to
changing priorities and needs within the scope of rehabilitation programs.
The quality and success of any program is directly related to the quality
of the service providers charged with turning rehabilitation goals into
realities. It is, therefore, disturbing to note that major shortages have
been documented in many rehabilitation professions. If allowed to continue,
the rehabilitation program will necessarily provide a lower standard of
service, consequently, weakening the overall effectiveness and success
of a heretofore exemplary program. That cannot be. allowed to happen.
11
Finally, Mr. Chairman and members of the Committee, I would like to
emphasize that although time does not permit a full discussion of the other
programs authorized under the Act, note should be taken that the special
discretionary grant categories are of great importance to the overall
comprehensive scope of the services authorized under the Rehabilitation
Act. These programs fill very special and specific needs and provide
unique opportunities for increasing the effectiveness of the program.
Of special mention are Projects With Industries, a program which has demonstrated
that close ties with the business community can enable persons with disabilities
to become employed in the business sector by use of a variety of innovative
hands-on techniques. NRA supports increased funding for these projects.
Mr. Chairman and members of the Committee, in conclusion, NRA would like
to once again thank you for the opportunity of presenting our views on the
Rehabilitation Act of 1973, as amended.
I would summarize our recommendations as follows:
I. The Rehabilitation Act of 1973, as Amended. We urge that the
Act be retained - in total - without substantial changes.
II. Basic Vocational Rehabilitation Services Program. We urge
increased funding to more adequately meet documented needs.
III. Comprehensive Services for Independent Living. We urge funding
for Title VII, Part A and Continuation funding for Part B.
IV. Rehabilitation Research. We urge increased funding.
V. Rehabilitation Training. We urge increased funding.
VI. Special Discretionary Projects. We urge increased funding.
The Rehabilitation Act and its programs have proven to be a marvelous
mechanism for meeting the needs of persons with disabilities and
giving significant benefits to society as well.
APPENDICES
I. Executive Summary of MINNESOTA DVR FY 1981 ECONOMIC ANALYSIS --
A Modified Cost/Benefit Procedure
II. Independent Living Centers in Region V -- THE ECONOMIC AND SOCIETAL
BENEFITS OF INDEPENDENT LIVING SERVICES
III. Promoting Rehabilitation Progress
12
Executive Summary
of
MINNESOTA DVR FY 1981 ECONOMIC ANALYSIS
A Modified Cost/Benefit Procedure
by
Han Chin Liu, Ph. D.
March 1982
Division of Vocational Rehabilitation
Minnesota Department of Economic Security
13
Executive Summary
This study analyzes the economic impact of vocational rehabilitation in
Minnesota using a modified cost/benefit procedure developed by the Oregon
Vocational Rehabilitation Division. The analysis was based on the fiscal year
1981 Client Service Report data compiled by the Minnesota Division of
Vocational Rehabilitation (MDVR).
The costs of rehabilitation are the total costs of the vocational
rehabilitation program for the fiscal year 1981 and the actual case service
expenditures for the FY 1981 rehabilitants incurred in prior years. Costs
excluding case service expenditures and some non-rehabilitation related costs
are termed overhead costs. Overhead costs are allocated to all closed cases
proportional to the length of time spent from application to closure.
The benefits of rehabilitation are client's earnings gain due to
vocational rehabilitation. This earnings gain is the difference between
client's referral earnings and earnings at closure. Client's earnings at
referral were adjusted for changes in wage rate over the period of time from
referral to closure before computing the difference. The difference was then
reduced to reflect the effects of (1) uncertainty (by discounting), (2) future
unemployment, (3) client mortality, (4) referral earnings underestimation, and
(5) gain not attributable to vocational rehabilitation on future earnings.
Fringe benefits are then added to the earnings to derive total clients
benefits.
The benefits of vocational rehabilitation cover not only the rehabilitants
because of their increased earnings resulting from vocational rehabilitation
but also "the taxpayers" due to increased taxes paid by the rehabilitants and
their decreased use of public assistance.
22-065 0 184 - 2
14
The study shows that the average additional income earned by each
rehabilitated person over his/her remaining working life will be $39,296.94. in
1981 dollars. The rehabilitated clients will increase their earnings by $11.44
for every vocational rehabilitation dollar spent.
The study also. shows that tax dollars spent to help disabled persons get
jobs are an outstanding investment of public money. In Minnesota, every tax
dollar spent by the joint state-federal vocational rehabilitation program is
returned to the state and federal government in 2.87 years. The annual rate of
return for the investment on vocational rehabilitation program is 34.8 percent.
The study estimates that Minnesota DVR will return $3.32 to "the taxpayers" for
every vocational rehabilitation dollar it spent.
The cost/benefit model used in this study can report economic costs and
benefits for all clients or for any subgroup of DVR clients. This study also
reports key findings by client's status on various public assistance or
insurance programs such as Supplemental Security Income (SSI), Social Security
Disability Insurance (SSDI), and Workers' Compensation (M/C). Also reported in
this study are the results of cost/benefit analyses of vocational
rehabilitation by referral sources, administrative units of the agency, and
client's characteristics including severity of disability, major disability
group, and sex.
15
Executive Summary of
Minnesota DVR FY 1981 Economic Analysis:
A Modified Cost/Benefit Procedure
Introduction
The Minnesota Division of Vocational Rehabilitation adopted, with
Vocational Rehabilitation Division to analyze the economic impact of vocational
modifications, a conservative cost/benefit procedure developed by the Oregon
rehabilitation , The advantages of utilizing this procedure are:
(1) The procedure is a conservative cost/benefit model. It utilizes a
series of adjustment factors to reduce gross earnings gain due to
vocational rehabilitation. These factors include clients' possible
underestimated clients' earning at referral, and earnings gain not
unemployment in future, clients' mortality prior to retirement,
attributable to vocational rehabilitation services.
(2) Costs in this model are computed on the individual client level,
which enable program managers to analyze cost/benefit data for
grouping of disabled clients in order to increase program efficiency. any
(3) The model is a computerized procedure which warrants data accuracy
and manpower saving in the cost/benefit analysis. Because of its
to suit program needs.
simplicity, program managers can conduct timely cost/benefit analyses
The Costs of Rehabilitation
vocational rehabilitation program for the fiscal year of interest, and
The costs of rehabilitation used in this model are the total costs of the
actual case service expenditures incurred in prior years for the rehabilitants the
of that year. Costs excluding cases service expenditures and some
non-rehabilitation include related costs are termed overhead costs. The overhead costs
of the expenditures for personnel and services related to the administration
supplies, staff training, travel, contracts and grants.
vocational rehabilitation program such as salary, rent, heat, lights,
28, 30) proportional to the length of time they spent in the vocational
This model allocates overhead costs to all closed cases (statuses 08, 26,
computed. The vocational rehabilitation cost for an individual client
rehabilitation process. Each individual client's share of overhead cost is
derived cost. by adding his/her actual case expenditures to his/her share of overhead is
costs for a given client group by its number of rehabilitants.
The average cost per rehabilitation is obtained by dividing the total
The Benefits of Rehabilitation
earnings difference gain due to vocational rehabilitation. This earnings gain is the
The benefits of rehabilitation designated by this model are client's
Clients' between client's referral earnings and earnings at closure.
difference time from referral to closure before computing the difference. over the
period of earnings at referral are adjusted for changes in wage rate
Future earnings:
is then reduced to reflect the effects of the following factors The on
16
1.
uncertainty (by discounting),
2. future short-term unemployment,
3. client mortality prior to retirement
4. referral earnings underestimation, and
5. gain not attributable to vocational rehabilitation services.
Fringe benefits are then added to the earnings gains to derive total
client benefits.
Assumptions
1.
The discount rate of 10 percent is used to derive an annuity discount
factor to estimate the present value of future earnings. Since
of the interest rate on government bonds is deemed. appropriate.
vocational rehabilitation's funding sources are governments, the use
2. The unempl oyment rate is assumed to be 4.53 percent, which is the
years. average of the unempl oyment rates in Minnesota for the last three
3. The mortality factor is assumed to be 3.5 percent, adopted from the
Oregon model.
4. The underestimate of earnings capacity at referral is assumed to be
39 percent, adopted from the Oregon model.
5. Gain not attributed to vocational rehabilitation is assumed to be 20
percent, recommended by RSA2.
6. Fringe benefits are assumed to be 20 percent of the total monetary
earnings suggested by the agency's accounting unit, which is more
Department of Labor³.
conservative than the rate of 23.3 percent reported by the U.S.
7. The tax rate is assumed to be 20 percent, recommended by the West
Virginia Rehabilitation Research and Training Center3.
8. Homemakers earnings. and upaid family workers are assumed to have zero
9. Gains obtained by 28 or 30 closures are not considered in the
computation of program benefits.
10. All non-monetary benefits of vocational rehabilitation programs are
not assessed by this model because of lack of data.
Glossary
1. The client's income cost/benefit ratio is the ratio of discounted
average future income gain to the average cost of rehabilitation. It
by the average cost per rehabilitaiton. For Minnesota DVR in FY
is obtained by dividing the average discounted expected earnings gain
by $11.44 for every vocational rehabilitation dollar spent.
this ratio was 11.44, implying that clients increased their earnings 81,
2. The average total client benefit is the average expected earnings
gain discounted over the remaining working lifetime of the
rehabilitated persons. On the average, each Minnesota rehabilitant
of FY 81 was expected to have an additional earnings of $38,296.94,
working lifetime.
resulting from vocational rehabilitation, in his/her remaining
17
3. The taxpayer's payback benefit/cost ratio is the ratio of the
discounted average increase in taxes paid and reduction in reduced
public assistance benefits to the average cost per, rehabilitation.
The tax rate used to calculate tax receipts is 20 3 percent of gross
earnings for state and federal income taxes and social security
withholding. For Minnesota DVR in FY 81, this ratio was 3.32,
suggesting that Minnesota DVR returned $3.32 to "the taxpayers" for
every vocational rehabilitation dollar it spent.
4. The taxpayer's net profit per rehabilitation is that amount of money
over the costs of rehabilitation which will accrue to the public
through increased tax receipts and reduced public assistance payments
over the remaining working lifetime of those rehabilitated. The
estimated net profit for Minnesota taxpayers due to vocational
rehabilitation in FY 81 was $7,758.25.
5. The number of years required to repay cost is obtained by dividing
the annual total cost of rehabilitation by the annual total
taxpayer's benefit, which is the combination of the annual increase
in taxes and the annual reduction in public assistance. The result
of analysis indicates that it would take 2.87 year for Minnesota DVR
to repay the total rehabilitation cost it spent in FY 81.
6. The annual rate of return is a percentage rate of return which is
computed by taking I to be divided by the number of years required to
repay cost. The annual rate of return for Minnesota DVR in FY 81 was
34.8 percent.
Footnote
1. F.C. Collignor et. al. Benefit/Cost Analysis of Vocational
Rehabilitation Services Provided by the California Department of
Rehabilitation (Berkeley, California: Berkeley Planning Associates,
1977), p. IV - 9.
2. Bureau of Labor Statistics, U.S. Department of Labor, Employee
Compensation in the Private Nonfarm Economy, 1977 (April, 1980),
Summary 80 - 5.
3. R.K. Majunder, et. al. Benefit/Cost Analyses in Vocational
Rehabilitation: A Simplified Approach (Dunbar, Mest Virginia: West
Virginia Rehabilitation Research and Training Center, 1978), p.5.
Table 1: Minnesota DVR FY 81 Economic Analysis by Client's SSI Status
SSI
Average Cost
Clients' Income
Average Total
Taxpayers' Payback
Taxpayers' liet.
No. of Years
Annual
Status
Per Rehab.
Cost/Benefit Ratio
Client Benefit*
Cost/Benefit Ratio
Profit Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (z)
SSI
Client
$4,227.59
4.02
$16,990.14
1.47
$1,999.05
6.47
15.5
Kon-SSI
Client
3,307.22
11.88
39,286.59
3.43
8,025.75
2.78
36.0
All
Agency
3,348.07
11.44
38,296.94
3.32
7,758.25
2.87
34.8
** Supplemental Security Income (SSI) payment recipients.
Table 2: Minnesota DVR FY 81 Economic Analysis by Client's SSDI Status
SSDI
Average Cost
Clients' Income
Average Total
Taxpayers' Payback
Taxpayers' Net
No. of Years
Annual
Status
Per Rehab.
Cost/Benefit Ratio
Client Benefit*
Cost/Benefit Ratio
Profit Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (x)
SSDI
Client
$3,415.31
6.84
$23,343.95
2.30
$4,429.25
4.15
24.1
Non-SSDI
Client
3,344.45
11.69
39,101.76
3.37
7,937.42
2.82
35.5
All
18
Agency
3,348.07
11.44
38,296.94
3.32
7,758.25
2.87
34.8
Client and taxpayer monetary benefit, resulting from Vocational Rehabilitation over the remaining working life of the rehabilitated
person, have been documented to estimate the present value of those future benefits.
** Social Security Disability Insurance (SSDI) payment recipients.
Table 3: Hinnesota DVR FY 81 Economic Analysis by Workers' Compensation Status
Workers'
Average Cost
Clients' Income
Average Total
Taxpayers' Payback
Taxpayers' Net
No. of Years
Annual
Comp.
Per Rehab.
Cost/Benefit Ratio
Client Benefit*
Cost/Benefit Ratio
Profit Per
Required to
Rate of
Status
Rehabilitation
Repay Cost
Return (I)
Workers'
Comp.
Client
$2,576.01
19.33
$49,803.06
5.03
$10,393.50
1.09
52.9
Non-Workers'
Comp.
Client
3,508.18
10.22
35,862.98
3.00
7,215.71
3.12
32.1
All'
Agency
3,346.43
11.44
38,201.19
3.32
7,767.13
2.87
34.8
Figures for all agency differ slightly from those shown in other tables because 18 cases did no have information on their Workers
Compensation Status.
Table 4: Minnesota DVR FY 81 Economic Analysis by Referral Sources
Referral
Average Cost
Clients' Income
Average Total
Taxpayers" Payback
Taxpayers' Net
No. of Years
Annual
Source
Per Rehab.
Cost/Benefit Ratio
Client Benefit*
Cost/Benefit Ratio
Profit Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (x)
Education
Institutions $4,825.57
7.89
$38,059.34
1.50
$ 2,914.56
5.94
16.8
Hospital
2,623.58
14.59
38,274.03
3.44
6,389.28
2.77
36.1
Health
Organization
3,195.96
10.51
33,586.46
4.24
10,346.48
2.25
19
44.4
Welfare
3,369.57
8.32
28,021.56
6.58
18,804.75
1.45
69.0
Public
Organization
2,859.01
14.54
41,576.98
4:14.
8,981.37
2.30
43.5
Private
Organization
2,727.06
14.15
38,584.72
3.98
8,117.68
2.40
41.7
Individual
2,874.30
13.61
39,108.65
3.94
8,460.91
2.42
41.3
All
Agency
3,348.07
11.44
38,296.94
3.32.
7,758.25
2.87
34.8
"Client and taxpayer monetary benefit, resulting from Vocational Rehabilitation over the remaining working life of the rehabilitated
person, have been documented to estimate the present value of those future benefits.
Table 5: Minnesota DVR FY 81 Economic Analysis by Administrative Area
Admin.
Average Cost
Clients' Income
Average Total
Taxpayers' Payback
Taxpayers' Net
No. of Years
Annual
Area
Per Rehab.
Cost/Benefit Ratio
Client Benefit*
Cost/Cenefit Ratio
Profit* Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (%)
East Metro
$3,519.45
12.05
$42,420.37
3.38
$ 8,372.11
2.82
35.5
West Metro
3,323.22
11.46
38,073.87
3.05
9,458.42
2.48
40.3
Central
3,230.14
13.71
44,269.36
3.44
7,869.23
2.77
36.1
Mortiwest
3,320.95
10.76
35,732.04
2.61
5,344.23
3.65
27.4
Northeast
3,460.13
11.79
40,794.17
4.00
10,590.92
2.35
42.6
Southwest
3,167.41
10.08
31,925.69
3.05
6,489.28
3.12
32.1
Southeast
3,336.23
9.60
32,289.83
2.35
4,502.65
4.25
24.7
All
Agency
3,348.07
11.44
38,296.94
3.32
7,758.25
2.87
34.8
Table 6: Minnesota DVR FY 81 Economic Analysis by Client's Severity of Disability
Severity
Average Cost
Clients' Income
Average Total
Taxpayers' Payback
Taxpayers' Net
No. of Years
Annual
Dis.
Per Rehab.
Cost/Benefit Ratio
Client Benefit*
Cost/Benefit Ratio
Profit"Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (3)
Severely
Disabled
$3,579.20
9.26
$33,154.81
2.94
$6,944.70
3.24
30.9
Non-Severely
Disabled
3,059.18
14.50
44,501.54
3.85
8,739.88
2.48
40.3
20
All
Agency
3,348.07
11.44
38,296.94
3.32
7,758.25
2.87
34.8
"Client and taxpayer monetary benefit, resulting from Vocational Rehabilitation over the remaining working life of the rehabilitated
person, have been documented to estimate the present value of those future benefits.
Table 7: Minnesota DVR FY 81 Economic Analysis by Disability Group
Disability
Average Cost
Clients' Income
Average Total
Taxpayers' Payback
Taxpayers' Net
No. of Years
Annual
Group
Per Rehab.
Cost/Benefit Ratio
Client Benefit
Cost/Denefit Ratio
Profit Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (2)
Visual
$2,151.05
15.26
$32,828.32
2.54
$ 3,320.38
3.75
26.7
Hearing
3,855.89
9.20
35,469.92
2.09
4,217.91
3.68
27.2
Orthopedic
3,251.73
13.40
43,505.49
3.67
8,695.32
2.59
38.6
Amputation
3,316.19
10.97
36,381.51
3.77
9,183.08
2.53
39.5
Personality
Disorder
2,733.43
14.27
39,004.79
4.99
10,893.14
1.91
52.4
Pentally
Retarded
3,913.80
5.48
21,440.19
1.37
1,437.90
6.97
14.3
Neoplasm
3,201.19
15.71
50,279.10
6.06
16,191.15
1.57
63.7
Allergic
4,674.48
10.41
48,673.26
2.13
5,295.51
4.47
22.4
Blood
Disease
3,674.42
12.45
45,734.31
3.01
7,377.46
3.17
31.5
Nerveus
System
Disorder
3,596.16
9.21
33,118.70
2.75
6,304.78
3.46
28.9
Cardiac
Condition
3,135.96
13.68
42,836.68
4.67
11,505.74
2.04
49.0
Respiratory
Disease
3,608.95
13.37
48,236.06
3.20
7,936.10
2.98
33.6
Digestive
Disease
3,173.33
10.85
34,441.97
4.43
10,891.52
2.15
46.5
Genito-
Urinary
Conditions
5,061.85
9.08
45,972.50
1.58
21
2,934.72
6.03
16.6
Speech
Impairment
3,910.20
7.90
30,871.18
2.48
5,784.80
3.84
26.0
Other
Disease
3,440.57
10.79
37,138.95
3.12
7,289.92
3.05
32.8
All
Agency
3,348.07
11.44
38,296.94
3.32
7,758.25
2.87
34.8
"*See Tables 8 for expanded data on these Disability Groups.
Client and taxpayer monetary benefit, resulting from Vocational Rehabilitation over the remaining working life of the rehabilitated
person, have been documented to estimate the present value of those future benefits.
Table 8: Minnesota DVR FY 81 Economic Analysis by Mental, Psychoneurotic, and Personality Disorders
Type of
Average Cost
Clients' Income
Average local
Taxpayers' Payback
Taxpayers' Net
No. of Years
Annual
Disorder
Per Rehab.
Cost/Benefit Ratio
Client Benef
Cost/Benef It Ratio
Profit Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (%)
Psychotic
Disorder
$2,947.59
9.85
$29,029.53
3.72
$8,005.10
2.55
39.1.
Psycho-
neurotic
Discrder
2,973.79
12.16
36,156.18
5.78
14,213.26
1.64
61.0
Other Mental
Disorders
Alcoholism
2,053.89
20.81
42,737.03
6.51
11,310.27
1.46
68.5
Drug
Addiction
2,845.99
18.03
51,304.20
5.34
12,346.84
1.78
56.2
Other
Behavior
Disorders
3,378.00
12.25
41,391.73
3.95
9,952.50
2.41
41.5
Mental
Retardation
Mild
Mentally
Retarded
3,627.89
7.18
26,037.16
2.07
3,877.22
4.60
21.7
22
Moderate
Mentally
Retarded
4,120.94
4.42
18,197.80
.00
(-562.07)
11.03
9.1
Severe
Mentally
Retarded
4,665.68
1.94
9,033.52
.11
(-3,160.09)
84.58
1.2
*Client and taxpayer monetary benefit, resulting from Vocational Rehabilitation over the remaining working life of the rehabilitated
person, have been documented to estimate the present value of those future benefits.
Table 9: Minnesota DVR FY 81 Economic Analysis by Sex
Average Cost
Clients' Income
Average Total
Taxpayers' Payback
Taxpayers' Net
No. of Years
Annual
Sex
Per Rehab.
Cost/Benefit Ratio
Client Benefit*
Cost/Benefit Ratio
Profit Per
Required to
Rate of
Rehabilitation
Repay Cost
Return (1)
Male
$3,268.59
12.95
$12,313.67
3.11
$7,896.15
2.79
35.8
Female
3,474.02
9.18
31,884.50
3.1/
7,539.74
3.00
33.3
All
Agency
3,348.07
11.44
38,290.04
3.32
7,758.25
2.87
34.8
*
Client and taxpayer monetary benefit, resulting from Vocational Rehabilitation over the remaining working life of the rehabilitated
person, have been documented to estimate the present value of those future benefits.
23
PERCENTAGE RETURN
0
10
20
30
40
0/0
G. E,
5.3%
DU PONT
5.5%
G. G.M, M,
0.27
10.3%
EXXON MONEY MKT. PRIME
as of March 10 I 1982
CURRENT RATES OF RETURN ON SELECTED INVESTMENTS
13.9%
16.0%
R 1
34.8%
24
25
Bibliography
Bureau Government of the Census, Pocket Data Book USA 1976 (Washington D.C: U.S.
Printing Office, 1976).
Bureau the Private of Labor Non-Farm Statistics, U.S. Department of Labor, Employee
Office, 1980). Economy, 1977 (Washington D.C.: U.S. Government Compensation Printing in
Vocational Collignon, F.C., Dodson, R.B., and Root, G., Benefit/Cost Analysis
Rehabilitation Rehabilitation Services Provided by the California of
(Berkeley, California: Berkeley Planning Associates, Department 1977). of
Conely, R.W., "A Benefit/Cost Analysis of the Vocational Rehabiliation
Program," Journal of Human Resources, IV., pp. 226-252, spring, 1969.
John Conley, Hopkins R.W., Press, The Economics 1973). of Vocational Rehabiliation (Baltimore, Maryland:
Conely, Program," R.W., American "Issues in Benefit/Cost Analysis of the Vocational Rehabilitation
Rehabilitation, November-December, 1975.
Vocational Majunder, R.K., Greever, K.B., and Palomba, H.A., Benefit/Cost
Virgina Rehabilitation Rehabiliation: A Simplified Approach (Dunbar, West Analysis Virginia: in West
Research and Training Center, 1978).
Keeck, Minnesota Cynthia, Minnesota's Ederly in the 1990's (St. Paul, Minnesota:
State Planning Agency, February 1981).
Minnesota Conditions, Department of Economic Security, Review of Labor and
Minnesota: February 1979, February 1980, and February 1981 (St_ Economic Paul,
Minnesota Department of Economic Security).
Rehabilitation Programs of Vocational Services Administration, Benefit/Cost Ratio: The
Rehabilitation (Washington D.C.: RSA, July State 15, Federal 1980).
26
INDEPENDENT LIVING CENTERS
in
REGION V
THE ECONOMIC AND SOCIETAL BENEFITS
of
INDEPENDENT LIVING SERVICES
TMENT OF EDUCATION
*
UNITED STATES OF AMERICA
REHABILITATION SERVICES ADMINISTRATION
U. S. DEPARTMENT of EDUCATION
CHICAGO, ILLINOIS
27
INDEPENDENT LIVING
Control over one's life based on the choice of acceptable
options that minimize reliance on others in making decisions
and in performing everyday activities. This includes managing
one's affairs, participating in day to day life in the community,
fulfilling a range of social roles, and making decisions that
lead to self-determination and the minimization of physical
or psychological dependence on others.
ILRU Source Book -
A technical assistance manual
on Independent Living Research
Utilization.
The Institute for Rehabilitation
and Research, Houston, Texas
Copyright, 1979
Ch
28
INTRODUCTION
Over the past 50 years the rehabilitation movement
has gained recognition as a major force in society's
concern for the disabled. During that period of time
the emphasis has been almost entirely on vocational
rehabilitation or training. Help has usually gone to
those who were most likely to become employable, or
able to return to work after injury. However, in the
last few years there have been increasing expressions
by the disabled for recognition of needs beyond employ-
ment, such as those related to improvement in their
quality of life, the need, to be integrated into the
mainstream of society or to make meaningful contri-
butions to our nation's well being.
Congress, when amending the Rehabilitation Act of
1973 several years ago, expanded it by adding Title VII,
Comprehensive Services for Independent Living. This
timely action has brought about great progress toward
independence for that part of the disabled population
which had previously received little attention and few
specific services. Through the authorization of fi-
nancial support, independent living services to the
severely disabled became a reality.
The appropriation of funds to implement Part B
of Title VII made possible the establishment of Centers
for Independent Living, staffed largely by the disabled
themselves. Such services as peer counseling and
advocacy, assistance with housing and transportation,
personal care assistant programs and independent living
skills have thus been made available to the severely
disabled.
A brief overview of how those funds have been used
over the last three years will be found in the pages
that follow. The achievements recounted here have been
made possible by Federal legislators who recognized
the basic human need for independence and took action.
It is a heartening story--a testament of indomitable
human courage in the face of what often seem to be
insurmountable obstacles.
Ralph A. Church
Regional Commissioner, RSA
29
ACKNOWLEDGEMENTS
This project was made possible through the cooperation of
staff members at the following Centers for Independent Living.
Their efforts in providing case histories and background infor-
mation are much appreciated.
ILLINOIS
Access Living, Chicago
Rockford Access and Mobilization Project -
RAMP, Rockford
MICHIGAN
Rehabilitation Institute CIL, Detroit
Center for Independent Living, Grand Rapids
Kalamazoo County CIL, Kalamazoo
Midland Independent Living Center, Midland
Mid-Michigan Urban CIL, Lansing
Northern Michigan Rural CIL, Gaylord
MINNESOTA
Rural Enterprises for Acceptable Living -
REAL, Marshall
Rochester CIL, Rochester
Metro CIL, St. Paul
OHIO
Services for Independent Living, Euclid
WISCONSIN
Stout Program for Independent Living,
University of Wisconsin, Menomonie
Theodore J. Witham and Helen Kupper, Project Directors
Helen Kupper, Editor
December, 1982
22-065 0 - - 84 - 3
30
FOREWORD
In today's world, with its concern for shrinking resources of
every kind, everyone eagerly looks for bright spots in an otherwise
rather gloomy picture. This is especially so for those in the
social service field, who are feeling increasing pressure to jus-
tify their existence, particularly in the fiscal area. The
"bottom line" is more and more being used as the yardstick against
which their work is measured. Is it cost effective? - is the
recurring question.
To keep a sense of perspective we must remember that our
society views itself as one which traditionally has looked after
the less fortunate and has not grudged the effort and the cost.
Of late, however, the social and economic climate having changed
somewhat, the beleaguered taxpayers expect more accountability
and justification for social expenditures.
What follows is documented information to support the position
that such expenditures, made through the Independent Living movement,
are cost-effective in the best and broadest sense. Many of these
vignettes, faithful presentations of data gathered from a number
of Centers for Independent Living in Region V, are truly financial
"success stories," demonstrating striking reductions in cost
after the clients received independent living services. While
others may show a cost increase, usually relatively small, they
are nonetheless successes. In some cases, the greater outlays
represent a short-term expense for training and/or medical and
personal-care assistance that will ultimately result in real
independence through employment. In still others, what has
31
been achieved is an improvement in quality of life, giving less
fortunate human beings hope for the future and helping those
who are unable to help themselves. If any lesson can be drawn
from these accounts, it is that there is no single way to assess
the value of the multi-faceted Independent Living movement.
Everyone has heard or read that able-bodied people only
temporarily possess that happy state, and accident or disease
or age will almost inevitably take its toll. When--or if--that
day arrives, it will be encouraging to know that Centers for
Independent Living and their skilled, compassionate staffs are
available for essential services.
Following the profile of Region V CILs are brief stories
about consumers who have used their services. The stories are
essentially true, though the names are all fictitious, a few
details have been changed and locations omitted to preserve
privacy.
32
INDEPENDENT LIVING IN REGION V - A PROFILE
In the stx states of Region V there are twenty-three Inde-
pendent Living Centers funded by the authority of Section 711
(Title VII, Part B) of the Rehabilitation Act of 1973, as amended.
Their programs are dedicated to the development and provision
of a variety of services which will assist severely handicapped
persons to realize the goal of maximum individual independence.
Consequently, the programs have been developed to serve the most
significant identified needs of disabled consumers in each com-
munity. This grass-roots response to particular needs has pro-
vided a rich and diverse offering of special services within
Region V.
A lengthy and individual description of each program would
be necessary to depict completely the total independent living
effort in the states of Illinois, Indiana, Michigan, Minnesota,
Ohio and Wisconsin; therefore, only some general characteristics
of the centers are provided.
Most of the centers receive Rehabilitation Services Adminis-
tration (RSA) grant funds on a contract basis from the State
Vocational Rehabilitation agencies. In all states but Indiana,
the state agency is the recipient of the RSA grant. In the two
state agencies serving the blind and visually impaired (Michigan
Commission for the Blind and Minnesota State Services for the
Blind), direct administration of center programs is maintained.
The majority of centers in Region V are consumer-based,
consumer-managed and consumer-staffed. Many are free-standing
private, not-for-profit corporations and are not affiliated
33
with established organizations or agencies. Several have
organizational relationships with established rehabilitation
centers or other rehabilitation organizations. In one instance
the affiliation is with a state university. In all centers
there is preponderant consumer policy input and control in
the administration of the programs.
The first center became operational in September, 1979 and all
others received initial grant/contract funds in 1980 and 1981. The
seven services most frequently offered are: information and referral;
personal care attendant prográms; peer counseling; housing assist-
ance; transportation assistance; independent living skills and advo-
cacy services.
A wide range exists in size of staff, funding levels, number and
types of disabilities served, services provided and other charac-
teristics. Nowhere is the extent of that range more clearly shown
than in staffing statistics. Full-time staff totals range from
one center with 21 to one center with none. The average is about
five to a center. The utilization of part-time employees shows
a maximum of eight in one center to--once again--one center with
none. On average, there are fewer than two part-time staff persons
to a center.
The following tables show sources and levels of support:
Table I
Table II
Funding Source*
Annual Budget
Title VII, Part B
23
Up to $30,000
1
State funds
9
$30,000-60,000
5
Private funds
8
$60,000-100,000
6
Other
7
$100,000-200,000
8
* Total exceeds 23 because
Over $200,000
3
some centers have multi-
ple sources of support
34
The following information, provided through one state's assess-
ment of the five centers under its contract management during a six-
month period, is not necessarily representative, but may be useful in
understanding the nature and especially the scope of center activities.
Of a total of 799 consumers who came to the centers for services,
301 were served and terminated and 394 remain for more prolonged
assistance. The others withdrew before any service was given. Follow-
ing are several characteristics of these persons and their distri-
bution as a percentage of the total group served:
Table III
Table IV
Major Services Provided
Disabilities Served
Service
Percent
Disability
Percent
Housing
19.0
Visually impaired
5.3
Community living skills
14.0
Hearing impaired
8.5
Attendant care
8.0
Cerebral palsy
10.9
Leisure & recreation
7.0
Cardiac conditions
8.0
IL skills
7.0
Spinal cord injury
17.7
Transportation
7.0
Arthritic/rheumatic/
other orthopedic
6.6
Peer/family counseling
6.0
Mental retardation
3.3
Health maintenance
6.0
Mental illness
2.1
Pre-voc./vocational
6.0
Other
37.6
Most of those served (83%) ranged
Table V
in age from 20-69. The largest
sub-group (26%) were 20-29 years
Education (Years of school)
old, clearly an optimum age-range
for maximum long-term benefits
5-8 years
13.0
to society.
9-12 years
58.0
13-16 years
24.0
Not reported
5.0
35
Of those served, 66.7% were considered to have shown improve-
ment at time of closure, 26.5% were not improved and improvement
could not be determined for 1.3%. In 5.5% of cases improvement
was not a reported item.
Of considerable significance were changes in residential
status during the course of service:
Table VI
Percent
Percent
Status
at Referral
at Closure
Difference
Hospitals/alcohol/
10.5
4.9
- 5.6
drug centers
Nursing homes
7.6
6.3
- 1.3
Community residential
2.0
1.0
- 1.0
facility
Special arrangements
.8
1.3
+ .5
Parent/relative's
22.0
12.0
-10.0
home
Own home
52.0
68.0
+16.0
Unreported
5.1
6.5
While most of the reductions in the right-hand column indi-
cate only modest improvements in clients' living situations, the
large increase in the "own home" category represents one of the
major triumphs of the independent living program. The movement
of disabled persons from dependent life-styles to independence
is nowhere more dramatically shown than here.
36
This brief description of some characteristics and benefits
of independent living centers provides only a "snapshot" of the
activities and programs currently in operation in Region V. It
is intended to be only an informational starting point; a more
comprehensive and sophisticated analysis of the programs and
outcomes must await the development and implementation of a uni-
form data base. Other human service programs have taken years
to develop and refine a useful data base. This makes it more
remarkable, then, that programs of independent living which have
existed for only two to three years can show evidence of such
substantial progress despite extremely limited resources.
The vignettes that follow are true stories about real people.
Reading them will give a vivid picture of the human aspect of
independent living services--essentially what the program is all
about.
37
Dan became a quadriplegic at age 17 because of an automobile
accident. Following lengthy physical rehabilitation he returned
home, where his over-solicitous-family prevented him from using
the skills he had learned during the rehabilitation process. His
feeling of uselessness increased to the point that he became
suicidally depressed.
Through the help of the State Vocational Rehabilitation (VR)
agency Dan was able to complete high school work and receive his
certificate of General Education Development (GED): Subsequently he
was evaluated and judged to have little vocational potential.
After a time Dan made an attempt to live on his own, but
through lack of sufficient self-care knowledge he developed severe
-decubitus ulcers and was forced to return to a full-care situation.
Because he thought it would be less restrictive than being with his
family he chose a nursing home, but soon found there was little difference.
About a year ago Dan learned about the CIL in his city through
publicity about the center's outreach program. The staff there
provided independent living skills training and counseling to
motivate him to adhere to his mandatory self-care program. They
also located an accessible apartment, federally-subsidized through
Section 8 of the Housing Assistance Payments Program for Lower-
Income Families, U. S. Department of Housing and Urban Development
and found a suitable personal care assistant.
Despite his limited physical function, Dan has been living
independently for some time, requiring only minimal assistance
38
in performing the necessary physical and logistical tasks. He
also has become a volunteer for the center, working as a peer
counselor and providing orientation to PCA trainees, activities
that have increased his sense of personal worth.
With the encouragement of a center staff member Dan, now
34, has decided to enroll in the local community college to work
toward a degree as a paraprofessional in human services. Thus,
through services provided by a center by independent living, this
young man's life has been completely turned around. From a totally
dependent, depressed individual with little to look forward to,
he has become a contributing member of society, with better days
ahead.
Dan himself describes the difference this way: "I have the
freedom to use my mind again and make my own decisions, right or
wrong."
LAST YEAR
THIS YEAR
SSDI*
$ 2,340
SSDI
$ 2,340
Medicaid
600
Personal care
4,342
assistant
Nursing home
14,965
Medicare/Medicaid
700
(Medicine, wheelchair
etc.)
Rent (subsidy)
3,600
Total
$ 17,905
Total
$ 10,982
Difference
$ 6,923
* Social Security Disability
Insurance
-39%
39
Emily, who is mentally retarded and has severe visual
impairment, was graduated from high school after completing a
special education curriculum. During her school years she lived
in several foster homes; after graduation she went to live in
the county health care center.
Less than a year ago, a university-affiliated independent
living program selected 21-year-old Emily for training to live
in a partially independent environment. She now lives and
actively participates in a cooperative housing arrangement in
which three developmentally disabled clients and two university
students share common household duties and assume responsibility
for their personal tasks, such as cooking and laundry. The stu-
dents serve as role models and provide crisis intervention.
She has also been admitted to a sheltered workshop, where
she is receiving pre-vocational training. Emily's potential
is now judged to be such that after another year to a year and
a half of developing good work skills and appropriate social
behavior she will be a good candidate for competitive employment.
On-going counseling and training in such independent living
skills as money management and budgeting, cooking, using public
transportation and planning use of leisure time have increased
Emily's sense of personal worth and greatly improved her quality
of life. Those who are working with her anticipate that after
perhaps two years in her present living and working situation she
will be capable of living as an independent individual.
40
LAST YEAR
THIS YEAR
SSI*
$ 4,608
SSI
$ 4,608
Health care center
14,027
Medicaid
144
Sheltered workshop
192
wages
Total
$ 18,635
Total
$ 4,944
* Supplemental Security Income
Difference
$ 13,691
-73%
41
Severely disabled by cerebral palsy, Norman lived at home,
where his mother provided the full range of personal care and
daily living services. Although he attended special schools
he never learned to read and his parents did not encourage him
to become involved in any community activities.
When Norman reached age 21 he moved to a nursing home in
an attempt to become more independent. That this course of
action did not satisfy his needs is obvious; in ten years he
lived in eleven different nursing homes. He also made one brief
try at apartment living, but lacking survival skills he was
forced to return to the home.
About a year ago Norman came to the independent living center
in his city for help with still another venture at living on his
own. The staff assessed his multiple needs: training in personal
care and independent living skills; learning to read; financial
assistance and accessible housing.
He was referred to the occupational therapy program at a
rehabilitation hospital, where he was trained in the use of
adaptive equipment to enhance his daily living skills. At the
center Norman attended a number of independent living seminars,
covering such topics as human potential; personal care assistant
(PCA) management; self-help aids in homemaking; self-image and
sexuality; and nutrition.
Within three months he was able to move into a supportive
living arrangement and now shares a federally-subsidized apart-
ment with another disabled man. He has hired and manages a_PCA
42
who supplies personal care and homemaking services. By attending
a center program of services for work and rehabilitation he is
continuing to upgrade his independent living skills, he is
learning to read and is receiving pre-vocational training.
Moving from a dependent environment to his present situation
has given Norman, an appreciation of his freedom to establish
social relationships by getting out in the community. He now
has goals: to completera high school equivalency program and get
his GED, and some day to obtain competitive employment.
Norman's definition of independent living: "To work and live
on my own."
LAST YEAR
THIS YEAR
SSDI
$ 4,992
SSDI
$ 4,992
Nursing home (Medicaid)
10,450
Personal care
6,114
assistant
Hospital
4,400
(Emergency care)
Medicaid/Medicare
300
(Wheelchair repair,
Wheelchair costs
300
medicines, etc.)
Rent (subsidy)
2,948
Total
$ 20,142
Total
$ 14,354
Difference
$ 5,788
-29%
43
Melanie, 42, has a long history of mental illness for which
she has been- hospitalized numerous times. Two years ago she was
released from a state hospital psychiatric ward with few survival
or coping skills and encountered severe financial and interper-
sonal problems.
Initially she came to the CIL for assistance in resolving a
dispute with her landlord. Staff then helped her to be assigned
to a different psychologist at the local mental health center.
Further efforts on Melanie's behalf have included money manage-
ment and assertiveness training and other related independent
living skills. She is learning how to take charge of her life:
to be responsible for monitoring her physical health, to recog-
nize when she needs professional help for emotional problems--
and to get it.
Melanie has beenimarried and divorced and receives $250
a month in alimony. This is her only income, as this amount
has made her ineligible for any public assistance--Medicaid,
SSI or food stamps. She stretches her meager income by sharing
living quarters with three other mentally or physically disabled
persons and by canning much of her own food from end-of-the-day
giveaways at the local farmers' market. For a little additional
cash she scavenges pop-top cans to sell for recycling; except
that she has a place to live, she could be called a "bag lady."
44
Probably. it is through the intervention and support services
she has received from the center that Melanie has been able to
survive outside of an institution. Even discounting her personal
preference for living independently, albeit in poverty, Melanie's
experience is a real "success story" for the taxpayers. The cost
comparison below shows dramatically the benefits to society
realized through CIL services.
TWO YEARS AGO
THIS YEAR
State hospital
$ 30,002
Counseling
$ 720
(custodial care)
(Social worker
at welfare office,
Psychiatric care/
est.)
medications
13,433
Total
$ 43,435
Total
$
720
Difference
$ 42,715
-98%
45
Injuries sustained in an automobile accident seven years
ago left William a quadriplegic. He was 14 years old.
After finishing school he became a client of the State
rehabilitation agency and successfully completed training as a
computer programmer. He obtained employment in that field and
bought a van which was fitted with adaptive aids by the VR
agency. This enabled him to get to and from work independently.
Because he was unaware of other options, through these
years William continued to live in the family home, with his
father supplying the needed attendant care. About a year ago,
at the suggestion of a family member, William came to the CIL
in his city to explore the possibilities for living more in-
dependently.
The center provided referrals to varied sources of help:
affordable, accessible housing; a credit agency for a loan for
initial expenses of establishing his own residence; possible
avenues for locating personal care assistants.
For almost a year now, William has been living in a barrier-
free, Section 8, federally-subsidized apartment, with a live-in
personal care assistant on a room-and-board-for-services arrange-
ment. He is also becoming active socially; one of his greatest
pleasures is going camping with his girlfriend.
While there is no direct, immediate dollars-and-cents benefit
to taxpayers in this story, benefits to society are incalculable--
and obvious: William, at age 21, has progressed to a higher
22-065 0 - 84 - 4
46
level of independence through the services of a CIL and will have
a productive, self-reliant life. As his skills and income increase,
the present taxpayer subsidies will no longer be necessary. His
family, especially his father, surely is pleased at his present
accomplishments and his brighter future, as well as relieved of
a physical burden that would have become increasingly difficult
to sustain as the years pass.
47
Marjorie is 32 years old and has a progressive neuro-
muscular disease which so far has defied precise identification.
The disorder has forced her to use a wheelchair for the past
four or five years.
When she first learned about the CIL in her city she was
living in an unsuitable apartment, had no knowledge of avail-
able transportation services, had no plans or goals and was
extremely depressed.
Since utilizing the center's services Marjorie's life
situation has undergone a striking change. She now lives in a
Section 8, federally-subsidized, accessible apartment; through
counseling she became aware of her rights as a disabled citizen
and is an effective self-advocate; she has learned about and
frequently uses the city's bus service for the handicapped; she
has enrolled in junior: college to become an occupational therapy
assistant; to the degree her physical condition permits she is
active in a sports program at the center; and she contributes
as a volunteer to the center, working on the newsletter and
doing telephone research to locate accessible housing for other
CIL clients.
In this story about Marjorie it is difficult to present
accurate before-and-after costs. Some "before" information is
not available, e.g., medical and surgical costs paid through
Medicare/Medicaid. Certain "after" costs are difficult to assess
48
also, such as how much Marjorie's use of the bus system costs
the city, or the total financial assistance she receives from
the junior college, both in tuition and Handicapped Student
Services time.
While it would be gratifying always to be able to point
to substantial dollar savings, at times there may be either a
trade-off or even an increase of costs through the intervention
of independent living specialists. In Marjorie's case this may
be a short-term increase in order to get eventual long-term
reduction of taxpayer burden. However, as the comparison below
shows, the progressive nature of her disease has required addi-
tional services (homemaker care).
Even if her future condition calls for still more assistance,
as long as Marjorie can remain in her own apartment her total
maintenance cost will be substantially lower than that in a nursing
home, which would total, at a minimum, $18,000 to $20,000 annually.
LAST YEAR
THIS YEAR
SSI
$ 3,708
SSI
$ 3,708
Homemaker care
-0-
Homemaker care
3,360
Rent (subsidy)
2,376
Rent (subsidy)
3,132
Total
$ 6,084
Total
$ 10,200
Difference
$ 4,116
+68%
49
Because of severe cerebral palsy, Lillian had spent the
last 14 years in a nursing home. Eight months ago, at age 39,
she requested admission to a center for independent living.
This CIL is, associated with a rehabilitation institute (part
of a major urban medical center), and offers residential
services and training.
Lillian's strong motivation and eagerness to learn prac-
tical, fundamental skills enabled her to make rapid progress
and to gain needed confidence and self-reliance. After two
months, she had acquired such personal care competence that
her need for assistance was reduced by half. Indeed, she pro-
gressed so rapidly that she completed the usual six-month course
in four months.
In spite of extreme spasticity, Lillian gained independent
living skills to such a degree that she is now living in a
federally-subsidized (Section 8), barrier-free apartment,
virtually independent. Her only needs are part-time personal
care assistance and help with heavy housecleaning.
The CIL provided services and training in the whole range
of independent living skills, among them cooking; cleaning;
personal care assistant management; health and hygiene; leisure
planning; assertiveness and advocacy training; and physical
fitness. Having achieved such competence in daily living, Lillian
is now receiving help in remedial reading and writing and is
looking toward the possibility of vocational training some time in the
future.
50
This account of how Lillian moved from complete dependency
to virtual autonomy, with every reason to hope for a better
future, is a success story about society's care of the less for-
tunate. However, society is also concerned about what it costs
to achieve these triumphs. The chart below gives striking evi-
dence that in many cases it is not only socially, but also
fiscally desirable to make such successes possible. Finally,
no matter which way the benefits may be viewed, if Lillian were
asked she might say that for her, Life Begins at Forty.
LAST YEAR
THIS YEAR
SSDI
$ 3,720
SSDI
$ 3,984
Medicaid
6,012
Personal care
2,478
assistant
Nursing home
14,950
(15 hrs/wk)
Rent (subsidy)
3,204
Total
$ 24,682
Total
$ 9,666
Difference
$ 15,016
-61%
51
Walter, who is legally blind, lives with his wife in a
senior citizens apartment complex. Within the last year his
need for cataract surgery became acute--he could distinguish
only between light and dark--and his hearing deteriorated to
almost total deafness.
Because of his limited income, Walter could afford neither
the cataract surgery, estimated to cost about $2,500, nor a new
hearing aid at approximately $200. The combined handicaps
obviously presented serious obstacles to physical and social
functioning. Lacking improvement in his condition, a move to
a nursing home seemed almost inevitable.
At this point the CIL in his city became involved. The
staff obtained diagnostic evaluations and for $229 purchased
a hearing aid which brought Walter's hearing up to normal.
The center also secured financial assistance totaling $700
from the local Lions Club to supplement the Medicaid payments
for surgeon's fee and hospital costs for the cataract surgery.
As a result of these services Walter is functioning quite
independently; even if his wife could no longer help him he
would probably be able to remain in his own home. His improved
condition has also enabled him to resume his former leadership
position in the organization for the blind in his city.
Thus, through the expenditure of $812 from the center
(hearing aid and diagnostic tests) and $700 from the Lions Club
(cataract surgery), a previously active and involved older
citizen was enabled to become so again. In addition, by
52
virtually eliminating the need for institutional care, the
center, through its efforts, has achieved significant cost
avoidance: a conservative estimate places the cost of such
care at no less than $16,000 a year.
53
Jennifer is a young woman of above-average intelligence
who has moderately severe speech and mobility problems
because of cerebral palsy. She does not articulate clearly
and uses a walker. These limitations made her unsure of
her ability to succeed in college, so after graduation from
high school she remained at home and entered a sheltered
workshop program, doing general office work.
Nearly a year ago she attended a workshop on independent
living at the local CIL. Meeting and talking with other
attendees, some more severely disabled than she, Jennifer
realized that taking charge of her own life and taking risks
was something she could do. She began by inviting other
disabled persons to join with her in a social club and she
received a positive response. From this she has progressed
to training in the center's peer counseling program, with
emphasis on social and recreational program ideas.
The encouragement the center has given Jennifer has
enabled her to take a big step forward. This fall, at 26,
she enrolled in a nearby college, with a tentative career
goal of rehabilitation counseling. Every day brings more self-
confidence as Jennifer learns how to make adult, independent
decisions about herself--now and for the years to come.
Cost savings are difficult to compute. Jennifer will
remain at home for the present; since she has been in a sub-
sidized workshop and is receiving financial assistance in
college, taxpayer costs will probably remain fairly constant.
54
However, her future earning power will be substantially
greater after achieving a college education, so she can
become a fully contributing member of society.
Inevitably, Jennifer's parents will some day be unable
to take care of her. And then, lacking survival skills,
she would be completely dependent on custodial care in an
institution. However, with the impetus and training fur-
nished by the center, she has taken the risk to develop
her potential and she can face the future with optimism.
55
As the result of an automobile crash on his high-school
graduation night, Tim has been a quadriplegic for 23 of his
40 years. After a fall early this year, he was hospitalized
for six months. When he was ready for discharge he had
nowhere to go, as his room in a group home was no longer
available.
There were several obstacles to be overcome at that
time. Because he no longer required medical care Tim had
to leave the hospital within two weeks; the hospital was
100 miles distant from his home city, making the housing
search more difficult; if no suitable housing could be
found, the only alternative was placement in a nursing
home, a solution previous experience had made unacceptable
to him because of "age difference and emotional trauma,"
in his words.
At this point, Tim was referred to the CIL in his
city. In a race against time, center staff obtained an
accessible unit in a newly-opened federally-subsidized
housing complex and helped Tim move in a day ahead of the
hospital discharge deadline. Subsequently they helped
him find permanent live-in attendants and obtain Title XX
(Social Security Medicare) funds to pay for housekeeping
services in his apartment.
At one time Tim had operated a small business, but when
that was no longer feasible, the State Division of Voca-
tional Rehabilitation made it possible for him to attend college.
56
He is majoring in rehabilitation counseling and expects
to get his bachelor's degree in about two years.
The figures below show substantial current cost
reductions in Tim's living situation achieved through the
CIL's efforts. It is also clear that in the future, because
of services he is receiving from DVR, Tim will become a
truly independent, tax-paying citizen.
LAST YEAR
THIS YEAR
SSI/SSDI
$ 3,648
SSI/SSDI
$ 3,648
Nursing home care
29,172
Rent (subsidy)
3,600
Medications
780
Attendant care
12,000
Chore services.
6,000
Medications
540
Total
$ 33,600
Total
$ 25,788
Difference
$ 7,812
-23%
57
Howard's elderly parents, in failing health, were con-
cerned about his future when they could no longer provide
around-the-clock care for him. Mentally retarded and with
multiple physical problems, 46-year-old Howard had lived
at home all his life.
When his family enlisted the assistance of the local
CIL nearly a year ago, it was clear that Howard needed the
full range of its services, as family members had relieved
him of all responsibility for his own survival duties.
Staff at the center located an accessible, federally-sub-
sidized apartment and trained Howard in the daily living
skills he needed to maintain himself in it. He also learned
to use the city transportation system and to do his own
shopping. Functioning at a higher level than ever before,
Howard has established social relationships with his neigh-
bors and participates in a bowling league.
While he has never been employed and vocational prospects
are not bright at present, his marked improvement in social
functioning and competence in living independently suggest
the possibility that a vocational goal may be attainable
one day.
Whatever the future may bring, Howard's family are
relieved that he is now in a suitable living situation and
competently managing his own affairs. Indeed, one family
member, impressed with the value of the CIL, has become a
volunteer, locating housing for center clients.
58
Although the cost comparison below shows a present
increase, it is minimal compared to what it would be if
Howard, lacking independent living skills, were forced
to enter a nursing home for custodial care. Present cost
of maintenance in an intermediate care facility is conser-
vatively estimated at $15,000 to $20,000 annually.
LAST YEAR
THIS YEAR
SSI/SSDI
$ 5,052
SSI/SSDI
$ 5,052
Rent (subsidy)
-0-
Rent (subsidy)
3,552
Medical care
-0-
Medicaid
384
(covered by
family policy)
Total
$ 5,052
Total
$ 8,988
Difference
$ 3,936
+78%
59
Suzanne has been paralyzed on the right side of her
body following a stroke 13 years ago. She has been living
in a nursing home ever since, confined to a wheelchair.
She is very soft-spoken and has some speech difficulties.
Although she has independent living skills, and at
first thought she wanted to attempt apartment living with
a personal care attendant and homemaker services, Suzanne,
now 55, felt unsure of her abilities after so many years
of dependency. For the present, therefore, she opted for
a transitional living situation, with roommates who are
also disabled. Attendant care and homemaker support are
available around the clock.
The center gave her information on housing and attend-
ant care possibilities; the center worker thinks that in
a year or two she will quite likely be on her own, as her
feeling of capability increases. A measure of Suzanne's
growing self-confidence is that her reluctance to use the
phone because of her speech problems seems to be lessening.
As her speech improves, she uses the phone more and more,
one indication of life-quality improvements attributable
to independent living services.
60
LAST YEAR
THIS YEAR
SSDI
$ 420
SSDI
$ 3,408
Nursing home
17,338
Attendant care
10,800
Medicaid (medicine)
480
Rent (subsidy)
852
Total
$ 17,758
Total
$ 15,540
Difference
$ 2,218
-13%
61
Despite the effects of multiple sclerosis, which have
left her legally blind and a double amputee confined to a
wheelchair, Myra has maintained her independence and lives
alone in her own home. She must also cope with many other
medical problems, including pulmonary difficulties that are
aggravated by heat and humidity. To enable her to remain
at home, her doctor recommended the installation of a room
air conditioner.
As a client of the State Commission for the Blind,
learning handicraft and homemaker skills, Myra tried first
to obtain the appliance through that agency. However, the
equipment was not deemed necessary for her to complete her
program and achieve her vocational goal.
Myra then turned for help to the CIL in her community,
as the "agency of last resort." Staff there were able to
obtain funding from the National Multiple Sclerosis Society
for two-thirds of the cost of the air conditioner, with the
Commission for the Blind supplying the balance. Through
the CIL's timely intervention and imaginative approach to
locating the resources, Myra was able to remain in her
home and continue her rehabilitation plan without undue
stress during the hot and humid months.
Thus a total expenditure of $460 for the air conditioner
($295 from MS, $165 from the State agency) helped an inde-
pendent, 39-year-old woman remain. so, to her own and society's
22-065 0 - 84 - 5
62
benefit. The comparative chart below shows approximate
maintenance costs for Myra in her own home versus what it
would cost, likely for many years, had she been forced to
move to a nursing home. Thus, this success story is not
one of cost-reduction, but of cost-avoidance.
DEPENDENT
INDEPENDENT
Social Security
$ 4,068
Social Security
$ 4,068
(survivor's benefits)
(survivor's benefits)
Nursing home (Medicaid,
11,940
Medicaid (supplies,
1,800
incl. supplies/medicine/
medicine/doctor)
doctor)
Homemaker assistance
2,520
Total
$ 16,008
Food stamps
432
Total
$ 8,820
Difference
$ 7,188
-45%
63
When Ethel was six years old she became a quadriplegic
as the result of an attack of polio. After finishing high
school she became a client of the State Vocational Rehab-
ilitation agency and completed university training as a
rehabilitation counselor. Throughout these schooling years
she lived at home, where her mother attended to her personal
care needs, encompassing the full range--bathing; dressing/
undressing; bed and wheelchair transfers; meal preparation;
housekeeping; transportation, etc.
About a year and a half ago Ethel, then 33, found a
counseling position that made it necessary for her to move
from her parents' home to an apartment closer to her job.
At her request, the CIL in her city helped her to locate an
accessible apartment and subsequently was instrumental in
finding appropriate candidates to satisfy her need for a
permanent personal-care assistant.
Ethel's income is too high for her to receive Medicaid/
Medicare services, so the center's attendant care coordinator
explored other options with her. She then found a suitable
live-in attendant in exchange for room and board plus much
free time during the day.
In addition to supplying her housekeeping, health and
personal hygiene needs, Ethel's attendant drives her to and
from work in the used, fully-equipped van Ethel has purchased
from her earnings.
64
This up-beat story is one to hearten everyone in the
social service field, and to encourage the heavily-burdened
taxpayer as well. Without the support and training supplied
by VR and the services and creative alternatives offered by
the center for independent living, this severely-disabled
woman would probably have spent her life completely dependent
on her family--and later, the taxpayers. Instead, Ethel
is a contributing, tax-paying member of society, successfully
leading an independent life.
DEPENDENT
INDEPENDENT
SSI
$ 3,000
None
(No other taxpayer
costs, as she
lived with her
parents.)
65
Anna, who is in a wheelchair, was living in a county
medical care facility because of multiple physical handicaps--
diabetes, severe visual problems and suspected multiple
sclerosis. About a year ago, at age 37, she decided to
make an effort to become more independent, and requested
help from the CIL in her city. The staff furnished training
in independent living skills, much needed because she had
never lived alone, helped her to locate an accessible
apartment and made sure she received a low-vision evaluation.
Anna is now living on her own in an accessible apartment,
doing her own cooking and most of the cleaning, administering
her own medication, handling her personal finances, and
performing other tasks appropriate to living independently.
Although her vision is still very limited, her functioning
has greatly improved because she has three new pairs of
glasses. These were acquired through the efforts of the
CIL, which obtained financial support of $400 from the
local Lions Club. In short, Anna is living virtually on
her own, with some assistance in transportation and shopping
supplied by friends.
She is also active in her church, running Sunday School
sessions and helping with Bible study classes. Anna plays
the piano and with a musical group regularly visits several
nursing homes to entertain the patients. She began a steady
babysitting job this fall and is carrying out those duties
satisfactorily.
66
Anna's story is unquestionably impressive: within one
year moving from total dependency in a nursing home environ-
ment to independence--a woman in charge of her life, living
alone, helping others and gainfully employed. This is not
only a success for Anna, but one for the taxpayers, too, as
a reading of the figures below will demonstrate.
LAST YEAR
THIS YEAR
SSDI
$ 324
SSI/SSDI
$ 3,912
Care facility
22,630
Medicaid
780
(Medicaid/Medicare)
(medicines/doctors)
Total
$ 22,954
Medicare
132
Rent (subsidy)
1,440
Food stamps
132
Total
$ 6,396
Difference
$ 16,558
-72%
67
On crutches because of cerebral palsy, Betsy, 24,
successfully completed college with a bachelor's degree
in paralegal studies. Since no jobs were available in
her small town, last spring she moved to a nearby large
city and requested information on housing and transporta-
tion from the CIL there.
Among the services Betsy received were assistance in
locating an accessible federally-subsidized (Section 8)
apartment, information on the city's bus system for the
handicapped, and referral to the State DVR for job training
and job placement services.
Having completed the center's training program, Betsy
is volunteering as a peer visitor. Now she has started
training to learn to counsel center clients in their search
for accessible, affordable housing. This will give her a
paid, part-time position that will provide valuable work-
experience and needed additional income.
At present the state of the economy presents obstacles
to Betsy's placement in a position in the paralegal field
for which she trained. However, living in a large city
gives her the opportunity to take advantage of any openings
that may occur. In the meantime, as a satisfied former
client, she is contributing skill and enthusiasm to the
center, while acquiring useful experience.
68
While the comparison below does not show an immediate
taxpayer benefit, Betsy's improved living situation and
availability for future paraprofessional employment
counterbalance the temporary increase.
LAST YEAR
THIS YEAR
SSI
$ 3,180
SSI
$ 3,180
Total
$ 3,180
Rent (subsidy)
2,808
Total
$ 5,988
Difference
$ 2,808
+88%
69
Mildred spent 20 of her 35 years in a state mental
institution, classified as mildly to moderately retarded
(mostly institutional retardation) and with emotional
problems as well. When she was released about two years
ago she had little or no knowledge of how to live "outside."
As might be expected, she had many problems with obtaining
needed services and establishing friendly social relationships.
After moving to a different city Mildred was totally
indigent and lived on park benches--a "bag lady." Later,
through the intervention of the person who was designated
to manage her social security income on her behalf, she
moved into a boarding home. There, with help from the
local CIL, she began to learn to manage her money and cook
her own meals. As Mildred's skills and self-confidence
grew, it was clear she had the capability to live alone.
Soon she moved to a federally-subsidized (Section 8) apart-
ment where she is managing to solve her problems--with
minimal assistance from the CIL--and is handling her own
finances.
At this point Mildred is being tested and evaluated
by the State VR agency to assess her capability for employ-
ment. She continues to receive counseling through community
mental health services, has attended adult basic education
classes and is planning to participate in Special Olympics.
70
She also volunteers at two nursing homes, serving meals
and contributing other assistance to the residents.
While the chart below shows no present savings to
taxpayers (instead there is an increase) Mildred's ex-
perience is a striking example of how a severely disabled
person can move from long-term institutionalization and
no apparent vocational potential to an independent life-
style with a good prospect of future employability. When
the day comes that Mildred can convert her volunteer ser-
vices to paid employment, the taxpayers stand to reap a
substantial return on society's investment in her.
LAST YEAR
THIS YEAR
SSI
$ 3,307
SSI
$ 3,468
Medicaid
500
Rent (subsidy)
1,344
Food stamps
288
Food stamps
288
Total
$ 4,095
Total
$ 5,100
Difference
$ 1,005
+25%
71
Twenty-six-year-old Hazel is severely disabled by
cerebral palsy. She gets around in a motorized wheelchair
which was bought in anticipation of a move to independent
living from the rehabilitation center which had been her
home for almost two years. Prior to that she had been
in a nursing home for seven years, after leaving her parents'
home.
Less than a year ago, when she heard about the local
independent living center through an outreach program, Hazel
immediately requested their services. With the center's
help she located an accessible apartment in a housing complex
occupied by disabled persons and she has become active in
a support group there. She also attends church regularly
and goes shopping, community activities she was not able
to participate in while living in a nursing home.
The center helped Hazel to learn budgeting and other
independent living skills. Very important was counseling
in how to structure her days, since a long-term nursing
home resident has little idea of how to manage time when
living independently.
According to a center staff member who has worked
closely with her, Hazel is so severely disabled that she
really should have a personal care assistant and homemaker
services. However, she is strongly motivated and determined
to do everything on her own--and against great odds she is
managing successfully.
72
Hazel now volunteers 25 hours a week at the center,
doing peer counseling and receiving on-the-job training
in a variety of office skills. She makes phone calls to
locate housing and other services for the center's clients,
does filing and fills in as receptionist. Estimates are
that Hazel will soon be able to work 30 hours a week,
using the vocational skills she has been learning, and
within five years she will probably be able to work a full
40-hour week in competitive employment.
LAST YEAR
THIS YEAR
SSDI
$ 420
SSDI
$ 3,408
Rehabilitation
32,850
Motorized wheelchair*
660
Center
Medicare (wheelchair
300
Total
$ 33,270
repair)
Rent (subsidy)
2,196
Total
$ 6,564
Difference
$ 26,706
*
Wheelchair purchase $3,300,
-80%
average life 5 years.
Annual cost $660
73
AFTERWORD
Human services providers and government agencies are
constantly searching for ways to document reductions in
taxpayer burden achieved as a result of their program
efforts. Precise measurement of such economic benefit is
a desirable but elusive goal. Despite the difficulties,
however, these accounts demonstrate that significant
individual and aggregate benefits are being provided to
severely handicapped persons by the 23 Independent Living
Centers in Region V.
Part of the difficulty arises from the large variety of
problems and disabilities presented to the centers and the
broad range of individualized services and programs needed
to deal with them. Another obstacle exists simply because
independent living is a new program, as social programs go,
and has so far developed cost-benefit documentation methods
of only limited scope and meaning. A universally-applicable
system awaits longer experience and more sophistication in
the program.
Our society is founded on certain intangible humanistic
values, especially that of individual worth. For the
independent living movement to reach its full potential
and acceptance, the intangible benefits accruing through
its efforts to individuals, families, communities--and the
taxpayers--must be recognized. These benefits must then
bei included as part of the "bottom line" in any assessment
of financial cost and benefit.
74
There is an interesting--and possibly unexpected--aspect
of the independent living program emerging through these
case histories. The movement was conceived as a means of
assisting the isolated severely-disabled into the mainstream,
even though no vocational goals seemed realistic. It is
now becoming apparent that many heretofore unlikely
candidates are moving into programs where employment may be
attainable. Thus, this unanticipated development may prove
to be one of the most valuable benefits of independent
living services.
* U.S. GOVERNMENT PRINTING OFFICE: 1983-654-006/348
Promoting
Rehabilitation
Progress
ХП
National
Rehabilitation
76
Rehabilitation
A Cost Effective,
People Responsive Program
Economic independence for persons with
disabilities is the basic goal of the nation's
vocational rehabilitation program. Since 1921,
a partnership of state, federal and private ef
forts has made that goal a reality for more than
3.4 million Americans with disabilities.
The partners in vocational rehabilitation get
people with mental or physical disabilities back
to work. Individualized rehabilitation pro-
grams meet the unique needs of each person
served. Competent rehabilitation professionals
provide job counseling and arrange for job ser-
vices so that persons with disabilities can
become workers and taxpayers. Many who can-
not work can live more independently.
Rehabilitation is a national investment that
pays off!
Each partner plays a vital role in this com-
prehensive, econcomically sound program.
The State partner provides:
state-generated financial resources
state-level responsiveness
coordination of local services for max-
imum cost-effectiveness
The Federal partner provides:
nationwide financial resources
nationwide, coordinated research and
training programs
nationwide program standards and
assurance of access to services
The Private partner provides:
competitive, cost-effective services to aid
persons with disabilities
access to local employers
community volunteer efforts
Rehabilitation Works!
77
Rehabilitation
What It Does For All Of Us
Persons with disabilities achieve
greater personal and economic in-
dependence.
Persons with disabilities contribute
their time and talents to their com-
munities, as full participants.
The program is highly cost
beneficial: Ten ($10) dollars are
returned to state and federal
governments for every dollar in-
vested.
Our nation's economy improves
with the utilization of the produc-
tivity of persons with disabilities.
Employers are provided a ready
source of trained, willing workers.
Monies to provide rehabilitation
services are spent in local com-
munities throughout the nation.
As an effective program,
rehabilitation acts as a magnet,
drawing funds from the private
sector.
As a locally run program with na-
tional standards, high quality ser-
vices are assured, as is the proper
use of taxpayers monies.
22-065 0 - 84 - 6
78
The National
Rehabilitation Association
Its Mission and Purpose
The National Rehabilitation Association
(NRA), founded in 1925, is a private voluntary
organization whose purpose is to advance the
rehabilitation of all persons with disabilities.
With a membership, including disabled per-
sons, of over 20,000; the association is an effec-
tive advocate for persons with disabilities.
NRA achieves its purpose through:
Legislative Advocacy: including support for the
Rehabilitation Act of 1973, as amended and the
Education for All Handicapped Children's Act.
Advocacy for the Removal of Barriers: barriers to
full enjoyment of the rights and benefits of
American citizenship: NRA engages in appropri-
ate court action when needed.
Increasing Public Awareness: of the rights and
needs of persons with disabilities.
Improving Professional Skills: by sponsoring edu-
cational conferences and workshops, supporting the
Mary E. Switzer leadership seminars, publishing
the Journal of Rehabilitation, and sponsoring
achievement awards.
Promoting High Quality Personal and Program
Standards.
NRA operates its programs through seven
divisions and state chapters in all' states. The
national office in Alexandria, Va., provides
support and leadership to NRA's action.
National Rehabilitation Association
633 South Washington Street
Alexandria, VA 22314
(703) 836-0850
17
4
79
NRA Legislative Priorities
NRA supports full funding of all programs
authorized by the Rehabilitation Act of
1973 as amended.
NRA supports strong efforts to assure the
basic rights and opportunities for persons
with disabilities as embodied in Title V of
the Rehabilitation Act and in Public Law
94-142 -- The Education for All, Handicap-
ped Children Act. This means:
NRA supports efforts to eliminate
disincentives to employment of persons
with disabilities contained in Social Securi-
ty programs.
NRA supports legislation providing added
tax deductions for severely disabled per-
sons, where needed, and tax incentives to
employers who hire persons with severe
disabilities.
NRA supports a variety of programs and
rights designed to assure the full participa-
tion of persons with disabilities in
American society.
5
80
Rehabilitation is Cooperation
The National Rehabilitation Association
maintains cooperative relationships with a
wide range of organizations and groups con-
cerned with rights and programs for persons
with disabilities.
State rehabilitation agencies cooperate fully
with programs of health, welfare, education
and training in providing services to persons
with disabilities.
Rehabilitation is Opportunity
The opportunity for persons with disabilities
to full and meaningful participation in all of
life's activities.
For More Information: Contact
6
81
Mr. MURPHY. Mr. DeJong.
STATEMENT OF JAMES DeJONG, ACCESS LIVING, CHICAGO, ILL.
Mr. DEJONG. Mr. Chairman and members of the subcommittee,
my name is James DeJong. I thank you for inviting me to testify
on behalf of the National Council of Independent Living Programs
and persons with disabilities.
Presently, 144 centers are operating and funded under title VII,
part B of the Rehabilitation Act of 1973 and its amendments. We
are deeply committed to the development of a strong and stable
base of financial support for community-based independent living
centers which serve a cross-disability population and are adminis-
tered and staffed by persons with disabilities:
To reach this goal, independent living centers must have ample
time and funds to establish their programs, train personnel, deliver
quality services and establish credibility within their local commu-
nities. Only then will we be viewed as a viable and integral part of
the rehabilitation process. Only then will we be competitive in ob-
taining private funding and in the marketing of our services.
Having been with the Chicago program, Access Living, since it
was a mere idea to its present state of service, I speak from experi-
ence about the need for adequate establishment time. The needs
and demands of the community are SO great that it takes time to
establish priorities and a stable structure to meet those demands.
The purpose of the program of services authorized under title
VII is to assist persons with severe disabilities to live more inde-
pendently in their homes and communities. By increasing these op-
tions to persons with disabilities, we are also seeing tremendous
savings to the taxpaying public.
Let's look at an example which highlights these savings. Betty
and Peggy, both in their late forties with cerebral palsy, had been
residing in a nursing home for the past 15 years when they con-
tacted Access Living. Their combined living costs were $27,580 per
year. Peer counseling and independent living workshops were pro-
vided to both women immediately. A search for accessible, subsi-
dized housing was then initiated, resulting in these two women
moving into the community, sharing an apartment.
By also being able to share personal care assistance costs, these
two women have reduced their costs to $20,956 per year. Peggy's
and Betty's experience resulted in a total savings of $6,954 per year
to the taxpayer. If this story were repeated for half of the 22,000
plus nonelderly disabled residing in Illinois nursing homes, it
would be a phenomenal cost saving to society.
This figure does not reflect the enhanced lifestyle or quality of
life now experienced by these two persons. Our independent living
center succeeded where efforts by others in the previous 15 years
had failed.
Experiences like this are occurring in each State, in each major
city and in each rural area where an independent living center is
operating. The names may differ, the disability may vary, but the
improved life options and the related savings continue to mount
throughout our country.
82
We are a relatively young program, but we have already seen
the growth of a strong commitment from persons with disabilities
and the entire community for the alternatives independent living
provides.
The business community has found the independent living cen-
ters to be a valuable resource, also. For example, in one major city
a large corporation recently contacted the local independent living
center to learn about accessible design and to provide sensitivity
training for their employees. The personnel department requested
this training SO disabled and able-bodied persons could work more
comfortably and productively. together.
The independent living center presented workshops and one-on-
one consultation to this company over the past year and now I am
happy to say the corporation has an accessible facility and a pro-
gressive, open policy toward hiring persons with disabilities.
This example shows the versatility of services offered by inde-
pendent living centers which benefit persons with disabilities and
in turn reward and benefit society at large.
Our services offer an exciting and important opportunity to our
entire society. We urge you to allow this important progress to con-
tinue and grow by providing adequate funding to title VII, part B,
maintaining existing centers and allowing for the development of
new centers in areas which demand their existence.
We also hope you will see the funding of part A as an immediate
priority SO independent living centers are able to make the transi-
tion successfully away from the part B moneys. Only then will
there be a coordinated, economical plan to insure the continued ex-
istence of your investment in independent living. To have any ma-
chine working efficiently, one must have all the parts functioning
well.
We also take this opportunity to urge you to continue the title I
program as it is presently administered and funded. It has made
the work of independent living centers easier and more proficient.
We also support the research and training centers, so they may de-
velop effective evaluation methods to continually improve our un-
derstanding and service delivery to persons with disabilities.
In conclusion, the independent living movement for severely dis-
abled people is far too important for us to allow it to diminish. It is
still in its early stages and needs Government support to enable it
to reach its full potential.
We seek your continued support to assure the future of independ-
ent living by increasing title VII funding and to fund part A. You
have demonstrated your commitment in the past, and we know you
will continue to do SO.
We thank you for what you have done and for giving us the op-
portunity to urge your support for continued funding of title VII
and its related programs SO the future may hold greater options for
persons with disabilities:
Thank you, Mr. Chairman.
Mr. MURPHY. Thank you, Mr. DeJong.
[The attachments to James DeJong statement follow:]
83
ATTACHMENT A
INDEPENDENT LIVING -- A DREAM COME TRUE FOR BETTY AND PEGGY
Just a year ago, Ann Margaret Noble (Peggy) and Elizabeth Umlauf
(Betty) were living in a nursing home. They both have cerebral palsy
and had experienced more than ten years of institutional living. "There
was little freedom of movement, lack of privacy, and 'no say' as far
as personal care was concerened," Betty told us.
"We began to look into the idea of living on our own." Peggy then
continued, "Neither one of IIS had any experience, SO we started calling
different places that offered services to disabled people. After contacting
other agencies, we heard about Access Living."
At Access Living, Betty and Peggy, with guidance from the staff,
developed a plan to live independently in the community. By utilizing
several components of the Access Living services program, they were able
to reach their goals.
"They not only helped us find our present apartment, but WC received
the household management training we needed to maintain our home efficiently,"
Betty said. "We both feel fortunate that Access Living had enough confidence
in us to invest as much time and effort as they did to, help us achieve our
dream. Now as we celebrate our fifth month of liberation and our first
Christmas in our new home, we encourage others to venture into independent
living."
Betty and Peggy have taken control of their own destinies. Living
on their own has improved the quality of their lives and has saved taxpayers.
money.. It costs less to provide appropriate support services than it does
to pay the bills in a jursing home. Consider the following data which
compares Betty and Peggy's nursing home expenses to the cost of independent
living.
84
Cost Data
Yearly Dependent Living Costs
(to taxpayers)
SSI
$ 5280
Medicaid
20440
Hospital
1200
Motorized Wheelchair**
260
2 Manual Wheelchairs ***
400
Total
27580
Yearly Independent Living Costs
(co taxpayers)
SSI*
$ 5280
Personal Care Assistant
9490
Medical Supplies and Wheelchair Repair
600
(Paid by Medicaid/Medicare)
Rent (Federal Subsidy)
5616
Total
20986
Federal and State Subsidized Funds Saved
Per Year Through Independent Living
$ 6594
* Covers utilities, phone, food, transportation, non-subsidized
portion of rent and miscellaneous expenses.
** Motorized wheelchair purchase price 10 $2,300 and will be
utilized approximately 5 years. Therefore, average cost is $260.
*** 2 Manual wheelchairs purchase price is $1200 and will be utilized
approximately 3 years. Therefore, average cost is $400.
85
ATTACHMENT B
ILLINOIS
STATE OF ILLINOIS
DEPARTMENT OF PUBLIC AID
JEFFREY C. MILLER
316 SOUTH SECOND STREET
DIRECTOR
January 31, 1983
SPRINGFIELD, ILLINOIS 62762
Mr. James DeJong
Assistant Director
Access Living of Chicago
505 N. LaSalle Street
Chicago, Illinois 60601
Dear Mr. DeJong:
My letter of January 4, 1983, was in error. Per our conversation
today I have corrected the statistics.
Non-elderly nursing home residents-either blind or disabled-June
1982 (our most current tabulation for these groups):
State of Illinois
BLIND
DISABLED
69 persons
22,932 persons
Cook County
BLIND
DISABLED
27 persons
9,148 persons
I hope these new figures will assist you in your work and I
apologize for any inconvenience' the incorrect figures may have
caused you.
Sincerely,
DAN Pil/man
Dan Pittman
Public Information Office
86
Mr. MURPHY. Mr. Lex Frieden.
STATEMENT OF LEX FRIEDEN, DIRECTOR, INDEPENDENT LIVING
RESEARCH UTILIZATION PROJECT, HOUSTON, TEX.
Mr. FRIEDEN. Mr. Chairman, members of the subcommittee, my
name is Lex Frieden. I am director of the independent living re-
search utilization project at the Institute for Rehabilitation and Re-
search in Houston. I am assistant professor of rehabilitation at
Baylor College of Medicine and chairman of the Consumer Consul-
tation Committee of the Texas Rehabilitation Commission.
I am speaking today on my own behalf in support of reauthoriza-
tion of the Rehabilitation Act. The Rehabilitation Act to many of
us with disabilities is the single most important piece of legislation
affecting our lives. Let me give you some idea from my own person-
al perspective about how important this particular piece of legisla-
tion is.
I broke my neck in an automobile accident in 1967. At that time
I had an opportunity to go to one of the few comprehensive medical
rehabilitation centers in the country-it happened to be in Hous-
ton-and I took part in 90 days of comprehensive medical restora-
tion.
At that point, being confined to a wheelchair and with little use
of my arms and hands, there were few options open to me. In fact,
the social worker gave me two: I could go and live in a nursing
home and they would be able there to provide the kind of assist-
ance that I needed on a day-to-day basis, or perhaps my parents
had the resources and the physical abilities to take care of me at
home.
At 18 years of age, neither one of those options seemed to be par-
ticularly attractive to me, but I took the lesser of two evils and
moved back home with my parents.
At that time I had difficulty getting into school because I was
disabled. I was turned down by one university because, in fact, I
was handicapped. I found a school that, although it wasn't accessi-
ble, agreed to make what accommodations it could as I continued
to work in the school and finally, in 3 years, graduated from the
University of Tulsa.
It was difficult to find a job at that time, in 1972, because people
really didn't see the benefits of hiring a person with a disability. In
fact, it was difficult for me to prove my value to them as an em-
ployee. It was difficult to get back and forth to school, and it would
have been difficult to get back and forth to work because there
were no public transportation systems in the United States at that
time that could provide service to a person in a wheelchair.
There were very few public or private buildings that were acces-
sible to people in wheelchairs. Frankly, there were no systems of
community-based personal care available to help me live anywhere
besides an institution or my parents' home.
Now, 15 years later, as a result of improvements that have been
made by us and as a result of the Rehabilitation Act, particularly
the 1973 version of that act, I am able to live in my own home,
which I own. I am able to use public transportation to get back and
forth to work.
87
I have worked for Baylor College of Medicine for roughly 6½
years, I have been able to travel all over the United States and
many other countries in the world, and I have the benefit of an in-
dependent living center in my community which is able to provide
assistance to me and personal care activities.
Rather than depending on taxpayers, dollars to support me in an
institution, I am able to contribute to the tax base. I think much of
this is a result of improvements that we have made in the Reha-
bilitation Act, SO I would like to urge your support of that act.
Title I of the Vocational Rehabilitation Act provides support to
State vocational rehabilitation agencies which are teaching people
how to get jobs and training those individuals.
Prior to 1973 there was a problem with the act because there was
no focus on people with severe disabilities. In 1973 that focus was
added to the act. As a result of that, more people who are severely
disabled are found eligible for services. But in 1978 we made an-
other significant addition to the act. That was title VII, which pro-
vides for independent living services.
Title VII includes four parts, the most important of which are
part A, which has not been funded, and part B, which has been
funded at a level now of roughly $17.28 million per year. That
$17.28 million supports 135 programs funded by the Federal Gov-
ernment. In addition to that, our research in the independent
living research utilization project indicates there are roughly 25 ad-
ditional independent living programs that are not funded by Feder-
al dollars.
The principal services of these programs are peer counseling,
peer support and assistance in problem solving with day-to-day ac-
tivities. The basic characteristics of these programs that make
them different from other human service programs, and particular-
ly other rehabilitation programs, is that they are community-based,
they depend on the services available in that community, they
serve the people in an individual community, and they are basical-
ly run by people with disabilities themselves. They provide an ex-
cellent model for people who require their services.
It is important to recognize the extent to which these programs
are cost effective. I agree with Mr. Spears that the Rehabilitation
Services Administration needs to institute an evaluation program
SO that we have accurate information on the cost effectiveness of
these programs, but our research at ILRU seems to indicate that
the programs are cost effective. Let me give you one example from
the Austin Resource Center for Independent Living.
Last year the ARCIL program helped tò place in employment 88
people with severe disabilities. During the year, these individuals
paid in taxes $160,160. At the same time, the Government saved
$697,728 in funds that before that time had been paid to these indi-
viduals in SSI benefits, social security disability insurance benefits,
and medicare payments. Altogether that is a total savings to the
taxpayer of $857,888.
At the same time, the program that assisted in this employment
was receiving a Federal grant totaling $200,000. So you must be
aware by now that the programs are, in fact, very cost effective. I
would like to be able to have national data to justify the programs
to the same degree.
88
I have a number of recommendations which are included in my
written testimony. I hope you will accept that for the record.
Among those recommendations is one that relates to a suggestion
made by Mr. DeJong, that we do fund part A of title VII of the act.
Part A was intended to provide funds to State governments,
State rehabilitation agencies, SO that they could purchase services
necessary to help severely disabled people reach independent living
goals.
Part B was enacted to provide a basis for establishing Centers for
Independent Living. I think it has fulfilled its purpose. We now
have centers located in every State of the Union. It may be neces-
sary to establish more in the future, SO I would recommend main-
taining part B at some level, but I think that the funding for these
programs now should be delivered through part A SO that the
States can purchase services from centers as they are needed.
I would also like to suggest that priorities be established within
the National Institute for Handicapped Research for independent
living as an area of research. I would like to suggest that the Reha-
bilitation Services Administration establish priorities and technical
assistance, using presently available salaries and expenses funds, to
provide technical assistance to independent living centers.
I believe we need to establish training priorities in the area of
independent living, both within the Rehabilitation Services Admin-
istration and the National Institute of Handicapped Research, in
order to provide sufficient personnel to staff these centers and to
provide training to State agency personnel to better utilize these
centers.
Finally, I have one suggestion that I think, perhaps, is signifi-
cant. I believe our research in the area of independent living
during the past 10 years seems to indicate a great savings in
human potential and a great savings in the Federal budget could
be made by reprograming certain entitlement funds which are now
used to foster dependent, institutionalized living by people with dis-
abilities to more progressive, independence-oriented programs of
the sort we are discussing here today.
I would propose the appointment of a national commission or
study group to investigate and make recommendations for elimi-
nating the many disincentives to independent living by disabled
people which are a result of Federal legislation, regulations, and
programs.
In particular, this commission should be charged with making
recommendations to resolve the apparent inconsistencies between
certain institutionalized welfare entitlements and more independ-
ence and productivity-oriented rehabilitation programs.
Mr. Chairman, members of the subcommittee, I believe it is pos-
sible to help people move out of nursing homes and State-supported
institutions, move into the community, to be more productive, and
enjoy a better quality of life. I believe it is possible to save money
from these entitlement programs, and I believe we should be able
to transfer those funds to more progressive rehabilitation and inde-
pendent living programs.
If you have any questions, I would be more than happy to try
and answer them.
Thank you.
89
Mr. MURPHY. Thank you very much, Mr. Frieden.
I thank all three members of the panel. Your entire testimonies
will be included as part of the record.
[The prepared statement of Lex Frieden follows:]
90
PREPARED STATEMENT OF LEX FRIEDEN, DIRECTOR, INDEPENDENT LIVING RESEARCH
UTILIZATION PROJECT
Members of the Committee and friends:
My name is Lex Frieden. I- am director of the
Independent Living Research Utilization Project (ILRU)
at The Institute for Rehabilitation and Research (TIRR)
in Houston, Texas. I am also assistant professor of
Rehabilitation at Baylor College of Medicine, and
chairman of the Consumer Consultation Committee of the
Texas Rehabilitation Commission. I am speaking today
on my own behalf in support of reauthorization of the
Rehabilitation Act.
To many of us who are disabled, the Rehabilitation Act
is the single most important piece of legislation
affecting our lives. Title I of this Act provides the
basis for a state-federal program of vocational
rehabilitation which has helped thousands of disabled
citizens, including myself, to acquire education and
training necessary for employment. Title II provides
for a coordinated program of research under the
auspices of the National Institute of Handicapped
Research. Title IV authorizes the National Council on
the Handicapped, through which we, as consumers and
professionals, have an opportunity to influence the
policy and direction of the National Institute of
Handicapped Research and other programs affecting the
lives of people with disabilities. Title V contains
Sections 503 and 504 which many of us regard as an
affirmation of our equality as citizens. The
Architectural and Transportation Barriers Compliance
Board, which we value, is also authorized in Title V.
Altogether, the Rehabilitation Act must be one of the
most comprehensive, best balanced pieces of legislation
ever conceived. It is the proven product of years of
experience and input by legislators, professionals, and
disabled people themselves.
I believe that Title VII of the Rehabilitation Act,
better than any other section, epitomizes the
progressive, need-oriented nature of this legislation.
Title VII authorizes the provision of comprehensive
services to support independent living. Although it
has not been funded since it became a part of the
Rehabilitation Act in 1978, Part A of Title VII
91
establishes the basis of a nationwide program of
services to support and encourage independent living
and productivity by severely disabled people. Most
importantly, Part B of Title VII, in less than five
years, has led to the establishment of more than 150
community based, consumer oriented centers for
independent living. Research over the past five years
by the ILRU project indicates that the most frequent
services provided by. these centers, and those which
distinguish them from other types of rehabilitation and
human service programs, are peer counseling, attendant
care training and referral, self advocacy training, and
assistance in solving problems related to housing,
transportation, and employment. The most unique aspect
of these programs is that they all involve consumers,
people with disabilities, in substantial ways as
managers, staff members, board members, and advisors.
These programs are uniquely capable of helping people
with sevene disabilities to reach goals of
independence, and to be productive, contributing
members of their communities.
Let me give you some idea of the importance and
potential of these independent living centers. When ,I
became disabled 15 years ago, my options for leading a
comparatively normal lifestyle were quite limited. I
had the option of living at home with my parents and
depending on them to meet my day-to-day physical needs,
or I could live in a nursing home and receive the
assistance which I required in an institutional
environment. Today, as a result of the progress we
have made during the past decade in providing
accessible transportation, educational opportunities,
affirmitive action mandates, independent living skills
training, and other support services provided by
independent living centers, I, and many other people
with disabilities can lead a comparatively normal,
productive life. We can live in our own homes in the
community, we can travel, we can work, and we can
contribute to improving the quality of life for all
people in our communities by being active, responsible,
tax paying citizens. Independent living programs have
filled a vital gap in the human service continuum.
There are several adjustments and additions to this
legislation which I recommend that you consider making
in this reauthorization process.
1. In order to establish a basis for purchase of
independent living services by state rehabilitation
agencies, Part A of Title VII should be funded with
such sums as necessary distributed to states which have
submitted an approved state plan for providing
independent living services.
2. In order to assure that the independent living
92
program retain those characteristics which make it
uniquely effective at facilitating self-reliance by
severely disabled people, legislation should require
that Title VII, Part A funds should be expended to
purchase services only from programs which insure
substantial involvement in policy making and
operational activities by people with disabilities, and
only from programs which provide a broad range of
noninstitutionalized services to people with a wide
variety of disability types.
3. In order to provide sufficient support for
independent living centers funded under Part B of Title
VII to become established and stable before federal
funds are withdrawn, legislation should specify that
all Title VII, Part B grants will be for a period of
five years, provided they meet acceptable performance
standards.
4. In order to insure fair and objective judgment
in determining the assignment of grant funds to
independent living centers under Title VII, Part B,
sufficient funding and instruction should be provided
to the Rehabilitation Services Administration to enable
them to employ nonfederal peer reviewers, a majority of
whom should be disabled people, to review all new
project grants and to assist in evaluating applications
for continuations.
5. In order to provide a basis for comparing
programs and for determining the effectiveness and
cost-benefits of independent living programs, the
Rehabilitation Services Administration should be
assigned the responsibility for carrying out an ongoing
evaluation of federally funded independent living
programs and should be given sufficient funding to
engage in this activity.
6. In order to provide technical assistance in
the development and operation of independent living
programs, priorities in the area of independent living
should be assigned to technical assistance funds
administered by the Rehabilitation Services
Administration and sufficient funds should be provided
to support this activity.
7. In order to insure continued innovation in
programming, priorities related to independent living
should be assigned to both research and demonstration
project funds and research and training center funds
administered by the National Institute of Handicapped
Research.
8. In order to insure a sufficient number of
qualified individuals to manage and operate independent
living programs, priorities related to independent
93
living should be assigned to training funds
administered by both the Rehabilitation Services
Administration and the National Institute of
Handicapped Research.
Finally, I believe, and our research in the area of
independent living during the past ten years seems to
indicate, that a great savings in human potential and a
great savings in the federal budget could be made by
reprogramming certain entitlement funds which are now
used to foster dependent, institutionalized living by
people with disabilities to more progressive,
independence oriented programs of the sort we are
discussing here today. I would propose the appointment
of a national commission or study group to investigate
and make recommendationsfor eliminating the many
disencentives to independent living by disabled people
which are a result of federal legislation, regulations,
and programs. In particular, this commission should be
charged with making recommendations to resolve the
apparent inconsistencies between certain
institutionalized welfare entitlements and more
independence and productivity oriented rehabilitation
programs.
I thank you for the opportunity to present this
testimony and these recommendations on the
Rehabilitation Act. I am convinced that by working
together, disabled people, rehabilitation
professionals, and members of this subcommittee can
insure a sound basis and a firm foundation for future
growth of this program which is the most
cost-effective, productivity-oriented human service
program yet conceived.
22-065 0 - 84 - 7
94
Mr. MURPHY. Mr. Bartlett, do you have any questions or com-
ments?
Mr. BARTLETT. Thank you, Mr. Chairman. I have a series of ques-
tions.
First of all, I commend the panel for an outstanding presenta-
tion. You have packed probably more information into less time
than any panel that I have heard since I have been here. You have
my commendation.
I have some specific questions. First, taking off on what Mr. Frie-
den said, which I think is a terribly good idea, it seems to me that
what you are suggesting is one of those commonsense things that
is probably contrary to every Federal law and every Federal regu-
lation in the book; that is, to permit the vast sums of entitlement
programs that are now being expended for simply maintenance, to
be used for independent living and as catalysts to allow people to
find ways to support themselves and then turn back around and
pay taxes.
I wonder if the other panelists would have any comments or sug-
gestions as to how that could be best achieved, or if Mr. Frieden
would like to elaborate on that.
Mr. DEJONG. Obviously, representing the independent living pro-
grams, I support such a commission. As to the actual process of set-
ting up that commission, I am not quite well versed enough to be
able to assist you.
I know that the independent living center operators would view
this as tremendous progress, though, and would totally agree that
we should move toward helping persons to be on their own and in-
creasing their options for returning to work, rather than just main-
taining them within confined environments.
Mr. FRIEDEN. One of the problems we have is that it takes a
great deal of resources and energy and personnel, a problem solv-
ing capability, in fact, to help people move from an institutional-
ized setting into the community.
There are no real incentives to help us do that at the present
time. I think that if we could prove, for example, that somebody
who is now living in an institution, supported with Federal dollars
in a nursing home at the cost of roughly $15,000 a year, if we could
show some indication that that same individual might be able to
live in the community at less cost, then there should be the possi-
bility to transfer the same amount of funds to the center to help
provide those services and that assistance in making that move
from the institution back into the community, and perhaps eventu-
ally to gainful employment.
Mr. SPEARS. Mr. Chairman, Representative Bartlett, I think that
NRA would support that concept very strongly. The idea of using
the savings as essentially a measure of reinvestment in providing
more opportunities and options for independent living is an out-
standing one.
Also, the establishment of a study group of some sort could very
easily deal with the many technical and very specialized problems
that are associated with creating that kind of a reinvestment situa-
tion. The idea is an outstanding one.
Mr. BARTLETT. For any of the panelists, what sources of funds are
currently available, other than Federal funds, for either the Access
95
Living Center or other Centers for Independent Living? Are there
sources of funds other than Federal funds today?
Mr. FRIEDEN. Many of the centers are seeking private funds to
help support their programs, through private foundations, through
fee for service payment when that is feasible. The fact is, however,
that more than 50 percent of the disabled population in this coun-
try is now unemployed. Most of those are people who need these
services. Consequently, they are not able to pay for the services.
We need to subsidize those services some way, either through
grants from the Federal Government, through private foundations,
through subsidized fee for service payment mechanisms, or through
private contributions. Most of the centers are aggressively pursuing
each one of those avenues.
Mr. DEJONG. I would also agree that there is a difficulty with fee
for service directly to the consumer. Our first 800 clients that we
saw at Access Living had an average income of $227 per month.
Obviously, they were not able to both purchase services and main-
tain a lifestyle in the community.
Therefore, we do need to look for a purchase of service, possibly
through the State rehabilitation agency; 50 percent of our budget is
through title VII. The other 50 percent we have gotten through
fund raising. The difficulty is to establish services, as I stated.
To be able to establish a program and go out to private founda-
tions all within the same year is virtually impossible. It takes time
to establish your credibility in a community. Particularly in a com-
munity the size of mine, that is SO highly competitive for those pri-
vate dollars, one must have a very well run program and be able to
show the cost effectiveness of that program to the various funding
sources.
Mr. SPEARS. In my state we are approaching it slightly different-
ly. Our Minnesota Legislature has shown considerable interest in
providing a certain baseline support for our Centers for Independ-
ent Living.
We have received in the last two biennial budget periods State
funds that are used along with the Federal funds that have been
made available to support centers. The State legislature is current-
ly considering a bill that would create a permanent subsidy for the
centers in our State.
One of the things we have seen, and I believe it is true in other
parts of the country, is that to present funding requests to private
funders, you need to demonstrate a minimum level support, SO that
in essence the private funders are adding on to the funding that is
already available through public sources.
Private sources are less inclined to support organizations that
don't have a foundation of public support, be it State or Federal, so
we in Minnesota are trying a slightly different approach.
Mr. BARTLETT. Would shifting funding or increasing funding in
part A, assist you in obtaining private sources or would it decrease
the availability of private sources or State sources?
Mr. SPEARS. It would not substitute for private funds. It would
put on a more stable, long-term basis the funding for the centers in
the country. Part B is funded on a project basis. Each year a
project application has to be written, reviewed and approved. Part
A funding, through the administration of the State rehab agencies,
96
can be much more flexible, can be much more simple in terms of
delivering the public support to the centers:
I think that both Mr. Frieden and Mr. DeJong would agree that
a baseline of public support for the centers is critical, but it will
never substitute nor ever fill the entire financial need. There will
always be need for private dollars, and the public dollars can and,
in fact, are being used right now for the leveraging of private dol-
lars made available to the centers.
Mr. BARTLETT. Having that stable, long-term source through part
A would actually make it easier to raise money, either from State
or local governments or from private sources? Is that what you are
saying?
Mr. SPEARS. Yes.
Mr. BARTLETT. So you would have an increased leverage of Feder-
al funds.
Mr. DEJONG. We might add also, from the center viewpoint, that
it would create a cooperative relationship between the centers and
the vocational rehab agency within their State that does not exist
in every State today.
Many times the centers are viewed as the renegades or the new
kids on the block and are not accepted as a service delivery re-
source and, therefore, I think funding part A would force a cooper-
ative relationship that does make sense.
Mr. FRIEDEN. I think it is important not to jump one way or the
other, but to begin now to make a transition. from that part B de-
pendence for the centers to part A funding. Perhaps this year the
appropriations could reflect a movement in that direction, funding
both part B and part A, and eventually we may get to the point
where we can support the centers entirely through part A.
Mr. BARTLETT. One last specific question for Mr. Spears.
With regard to Projects with Industry, the statute lists those
agencies with whom the commissioner may enter into agreements
for the purpose of establishing jointly funded projects.
It is my understanding there is some confusion regarding the
status of State vocational rehabilitation agencies and whether the
commissioner can enter into agreements with the State.
Do you find that that needs some clarification? If so, how would
you clarify it?
Mr. SPEARS. I am not familiar with the nature of the problem. It
very well could exist. Projects with Industries, I think, would be en-
hanced by closer relationships with the State rehab agencies, what-
ever it would take to accomplish. that. I am not familiar with the
fine details of the law relative to that program.
Mr. BARTLETT. So a closer relationship with the State agencies
would enhance the partnership with projects with industry.
Mr. SPEARS. Yes.
Mr. BARTLETT. Thank you, Mr. Chairman.
Mr. MURPHY. Thank you, Mr. Bartlett.
Mr. Williams?
Mr. WILLIAMS. Thank you, Mr. Chairman.
Mr. Spears, in your testimony you mention that in Minnesota it
has been determined that the return on the public investment in
the basic State vocational rehabilitation program is almost 35 per-
97
cent. I also agree with your ending statement that that is a very
impressive return on any investment.
Does your association have any mechanisms in place to measure
the relative success of the independent living centers or of other
efforts under this legislation?
Mr. SPEARS. The Centers for Independent Living?
Mr. WILLIAMS. Yes.
Mr. SPEARS. NRA is a private organization that does not engage
in evaluation, nor do we engage in any very extensive statistical
reporting and developing of nationwide statistics. We feel that that
really is the responsibility of the Rehabilitation Services Adminis-
tration.
As I mentioned, I think that the Rehabilitation Services Admin-
istration ought to be clearly directed to develop nationwide report-
ing systems which can then be used as evaluation mechanisms so
that you and we together know exactly what our efforts are pro-
ducing.
Mr. WILLIAMS. Later in your testimony you make this statement,
that we are coming into an era that has been described as an era of
high technology.
What would you recommend we do to bring the benefits of tech-
nology and research findings to bear on the problems faced by the
disabled, including, of course, the most severely disabled people in
our society?
Mr. SPEARS. I think that one of the key things is that increased
funding be made available for the National Institute for Handi-
capped Research. It is the design of the act that the National Coun-
cil on the Handicapped acts as a focusing body for the needs and
priorities of research in the area of problems related to people with
disabilities.
The statement that I made was designed to call attention to the
fact that the increases in technology of all sorts, the standard elec-
tronic technology that we think about, bioengineering technology,
should be brought to bear on the problems faced by people with dis-
abilities so that the nature of those disabilities and the nature of
the handicaps arising from them are less critical in affecting their
daily living needs and their employment needs.
Mr. WILLIAMS. Thank you, Mr. Chairman.
Mr. MURPHY. Thank you, Mr. Williams.
I guess that you leave us with one final wrap-up question. You
have all seemed to indicate that the centers have performed their
tasks well and that perhaps now we should fund part A.
Do you have a recommendation of any level of funding that we
should recommend to the Appropriations Committee for part A?
How much would you recommend that we put in part A?
Mr. DEJONG. From the national council's viewpoint, Mr. Chair-
man, we would request to submit that to you at the end of this
week. Our national conference is Friday, Saturday, and Sunday
and the first item on the agenda is dealing with that exact recom-
mendation to you. So, I am not prepared today to give the view-
point of the national council, but we will submit that to you by the
early part of next week.
Mr. MURPHY. Where is your council meeting?
Mr. DEJONG. Right here in Washington.
98
Mr. MURPHY. We would appreciate that. We are having a con-
tinuation of this hearing on Wednesday, and certainly it would be
quite timely if we get that next week.
Mr. DEJONG. We will do SO.
[The information referred to follows:]
99
National Council
of
Independent Living Programs
RESOLUTIONS
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Brograms assembled in Washington, D. C., Sunday, March 27, 1983 does
hereby unanimously recommend funding of Part B, Title VII of the Rehab-
ilitation Act in the following amounts:
1984
$35,000,000
1985
45,000,000
1986
55,000,000
1987
65,000,000
1988
85,000,000
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983, does
hereby unanimously recommend funding of Part A, Title VII of the Rehab-
ilitation Act in the following amounts:
1984
$55,000,000
1985
65,000,000
1986
75,000,000
1987
85,000,000
1988
115,000,000
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983, does
hereby unanimously recommend amendment of Part B, Title VII of the Rehab-
ilitation Act to provide for grants of 8 years with 5 years of full fund-
ing, and descending funding in years 6, 7 and 8 at a rate of 90%, 80%
and 70% respectively.
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983, does
hereby unanimously recommend amendment of Part A, Title VII of the Rehab-
ilitation Act to provide for a preference in funding under this Part and
community based, consumer operated Independent Living Programs, includ-
ing those funded under Part B, Title VII of the Act.
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983, does
hereby unanimously recommend that the Rehabilitation Services Adminis-
tration establish a priority for providing technical assistance and
training to support Independent Living Programs.
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983, does
hereby unanimously recommend that the National Institute of Handicapped
Research establish a priority for conducting research and training in
areas related to Independent Living.
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983, does
100
hereby unanimously recommend that the National Council on Handi-
capped establish a priority for supporting education and research
efforts in the area of Independent Living.
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983 does
hereby unanimously recommend that the Rehabilitation Services Adminis-
tration conduct a comprehensive, on-going evaluation of Part B
funded Independent Living Programs, and that this evaluation should
be designed and conducted in consultation with the National Council
of Independent Living Programs.
BE IT HEREBY RESOLVED, that the National Council of Independent Living
Programs assembled in Washington, D. C., Sunday, March 27, 1983 does
hereby unanimously recommend that the Rehabilitation Services Adminis-
tration should employ non-federal peer reviewers, a majority of whom
are qualified and knowledgeable persons with disabilities, to review
all new applications and continuation proposals for Part B funding,
and that criteria for selecting said peer reviewers be designed in
consultation with the National Council of Independent Living Programs.
PASSED UNANIMOUSLY
March 27, 1983
101
Mr. BARTLETT. If the chairman would yield, I would also com-
ment that if you possibly could, have your council perhaps at least
indicate to our staff informally what parameters you are thinking
of. Since we are going into markup on Wednesday, the earlier we
could get information on your recommendation, even if it is infor-
mal, the more useful it would be for this committee.
Mr. Chairman, I would take one moment to commend one
member of the panel in particular, as well as the entire panel, and
that is Lex Frieden, who has a tremendous reputation in the State
of Texas in this area. He has done a tremendous job.
I count him as a friend and as an almost constituent. He lives in
Houston, which is 200 miles south of my district-
Mr. MURPHY. That is pretty close in Texas.
Mr. BARTLETT [continuing]. And the way the Texas Legislature
draws redistricting lines every year, he may well be a constituent
before long. I thank him for coming.
Mr. FRIEDEN. Thank you.
Mr. Chairman, with your permission I have a number of support-
ing documents and specific recommendations that I would like to
enter into the record, in addition to my written testimony.
Mr. MURPHY. Thank you. We appreciate having those.
If you have any other specific information between now and full
committee markup, it would be appreciated. Even though we are
going to mark up in subcommittee on Wednesday, even following
that we will be very happy to hear from you.
Thank you very much.
[The information referred to follows:]
102
ilruint formation
3-21-83
FOR IMMEDIATE RELEASE
According to : a recent research study conducted by the
Independent Living Research Utilization (ILRU) project of 147
programs across the country that are providing independent
living services to disabled people,
104 programs are consumer controlled, with disabled
people composing at least 51 percent of the board of directors
or 51 percent of the program staff.
123 programs provide services to many different
disability types rather than focusing on just a single
disability type; disability types frequently served at these
programs include spinal cord injury, visual impairment,
hearing impairment, cerebral palsy, mental illness, stroke,
brain injury, deaf-blindness, mental retardation, and others.
120 programs provide a comprehensive set of multiple
services that enable disabled people to live independently in
their communities; typical services include registries of
attendants, readers, and interpreters; peer counseling;
advocacy; housing assistance; independent living skills
training; and other services.
(more)
independent living research utilization
p.o. box 20095
houston. texas 77225
(713) 797-1440
103
115 programs are non-residential and are able to serve a
fairly high number of isabled people annually; for instance,
last year, the nation's independent living programs served
well over 23,000 disabled people.
For additional information about independent living
programs, contact the ILRU project, a national center for
information, training, and technical assistance in the field
of independent living.
INDEPENDENT LIVING PROGRAMS
ALASKA
IN THE UNITED STATES
REGION
WASH
MINN.
T.N
MONT.
CONN A1 Boston
N. OAK
WIS
REGIONIC
New York
MICH.
OREG
.
S. DAR.
WYO.
REGION.V
NJ
IDAHO
REGIÓN
REGION VIII
"PA.
.
ILL.
Philadelphia
CALIF
X
IOWA
IND
Chicago
OHIO
NEBR,
MD
DEL.
NEV.
UTAH
REGION VII
REGION IX
COLO.
MO.
REGION VA. III
REGION II
KANS
San
Kansas City
Francisco
KY.
PUERTO RICO
08
104
US
ARIZ
N.C.
TENN.
VIRGIN ISLANUS
S.C.
N. MEX.
OKLA.
ARK.
ALA.
GA.
TEX.
MISS.
Atlanta
REGION IV
LA
FLA
.
Dallas
REGION VI
6
MAYABI
.
10-82
105
ruinformation
INDEPENDENT LIVING RESEARCH UTILIZATION PROJECT (ILRU)
P. 0. Box 20095
Houston, Texas 77225
(713) 797-1440 Ext. 504
Lex Frieden, Director
PROJECT OVERVIEW
The ILRU (Independent Living Research Utilization) project is a
national center for information, training, and technical assistance for
independent living. Its goal is to improve the spread and utilization
of results of research programs and demonstration projects in the field
of independent living.
Since ILRU was established in 1977, it has developed a variety of
strategies for collecting, synthesizing, and disseminating information
related to the field of independent living. ILRU project staff serve in-
dependent living programs, state rehabilitation agencies, federal and
regional rehabilitation agencies, consumer organizations, rehabilitation
service providers, educational institutions, medical facilities, and other
organizations active in the field, both nationally and internationally.
Initially established by the Rehabilitation Services Administration,
ILRU is now sponsored in part by the National Institute of Handicapped
Research, U. S. Department of Education. Additional support for the proj-
ect is provided by grants from both public and private sources and by sales
of its products and services.
MAJOR ACCOMPLISHMENTS
sponsored nine major conferences of national scope, training more
than 1,200 persons from all over the country;
provided on-site technical assistance to independent living programs
in 28 states and five foreign countries;
distributed more than 20,000 books, pamphlets, and videotapes related
to independent living;
developed a comprehensive set of definitions and a method for cate-
gorizing models of independent living programs;
compiled and updated continually a national registry of independent
living programs; and
directed the design of a comprehensive management training program
using a simulation format for directors and administrative staff of
independent living programs.
independent living research utilization
p.o. box 20095
houston. texas 77225
(713) 797-1440
106
MAJOR SERVICES
producing resource materials related to independent living;
developing and conducting training programs on independent living
issues; and
providing technical assistance and consultation on independent living.
RESOURCE MATERIALS AVAILABLE
The following items have been produced by the project and are avail-
able for distribution. A complete list of ILRU resource materials may be
obtained by writing the project.
ILRU Source Book: A Technical Assistance Manual for Independent Living;
On the Right Tract: Foundations for Operating an Independent Living
Program;
Issues in Independent Living: A Technical Report Series;
ILRU Insights: a national newsletter for independent living;
Independent Living: Six Model Programs--a 60-minute, color, 3/4-inch
videocassette;
Planning for Independent Living: Using the Individualized Independent
Living Plan as a Counseling Tool--a 17-minute, color, 3/4-inch video-
cassette;
America Needs All Its Citizens--a poster series depicting severely dis-
abled people in non-sterotypical activities; and
A Computerized Registry of Independent Living Programs.
USER GROUPS
ILRU is open to the public. Project staff will respond to all requests
for information related to independent living. Fee schedules and price lists
for ILRU services and products are available on request.
6/82
107
Resource Materials for Independent Living
The ILRU project staff and
of Handicapped Youth," 12 pages.
associates have developed a variety
Vol. 3: "A Guide for the Per-
of resource materials related to
sonal Care Attendant, " 24 pages.
independent living. These materials
include books, handbooks in three-
Soft-bound books: $3.50 each;
ring notebook binders, monographs,
$10.50 a set.
pamphlets, selected reprints, video-
tapes, and posters.
Cole, Jean A., Jane C. Sperry,
Mary Ann Board, & Lex Frieden. New
Options. Houston: The Institute
This brochure is designed to
for Rehabilitation and Research,
provide information about the prod-
1979.
ucts, including brief descriptions,
prices, and the procedure for or-
The book explores processes
dering.
through which severely physically
disabled individuals become inde-
In addition to developing re-
pendent members of the community,
source materials, ILRU staff respond
and examines the New Options pro-
to inquiries related to independent
ject as one model for teaching
living, preferably by mail.
skills necessary for participating
fully in community life.
Soft-bound book, 113 pages:
PUBLICATIONS
$4.00.
Board, Mary Ann, Jean A. Cole,
Lex Frieden, & Jane C. Sperry.
Cole, Jean A., Jane C. Sperry,
Independent Living with Attendant
Mary Ann Board, & Lex Frieden. New
Care. 3 Vols. Houston: The Insti-
Options Training Manual. Houston:
tute for Rehabilitation and Re-
The Institute for Rehabilitation
search, 1980.
and Research, 1979.
Vol. 1: "Guide for the Person
The manual deals with specific
with a Disability," 20 pages.
issues related to operating a pro-
Vol. 2: "A Message to Parents
gram to teach community living
108
skills to severely physically dis-
seven Questions and Answers,' by
abled individuals.
Bruce Curtis, 1980, 16 pages.
No. 3: "Independent Living and
Loose-leaf notebook, 129 pages:
Evaluation: Basic Principles for
$6.00.
Developing a Useful System," by
Timothy Muzzio, 1981, 19 pages.
Frieden, Lex, Laurel Richards,
No. 4: "Independent Living and
Jean Cole, & David Bailey. ILRU
Mental Retardation: The Role of the
Source Book: A Technical Assis-
Independent Living Program, by
tance Manual on Independent Living.
Carol Sigelman & Jerry Parham,
Houston: The Institute for Reha-
1981, 28 pages.
bilitation and Research, 1979.
Soft-bound books: $5.00 each.
The Source Book contains de-
tailed information on independent
living and is intended to be use-
New Life Options: Independent
ful to persons who want to develop
Living and You, Washington, D.C.
independent living programs, to
& Houston, Tx.: The Institute for
persons who operate independent
Information Studies & ILRU Project,
living programs, and to persons
1979.
who anticipate using independent
This book describes new oppor-
living programs as a resource for
tunities available to people with
their clients.
severe disabilities as a result of
The Source Book includes: a
the passage of the Rehabilitation
glossary related to independent
Act Amendments of 1978. Informa-
living programs; matrices portray-
tion is provided about different
ing federal, state, and local re-
kinds of independent living pro-
sources for independent living;
grams and sources of technical
techniques for community organiz-
assistance and financial support
ing; and an annotated bibliography.
available to organizations inter-
Loose-leaf notebook, 90 pages:
ested in establishing programs in
$20.00.
their communities.
Soft-bound book, 14 pages:
$2.00.
Issues in Independent Living.
Ed. by Laurel Richards. 4 Vols.
to date. Houston: ILRU Project,
1980-81.
REPRINT PACKAGE
No. 1: "Independent Living and
Deafness: Incorporating Deaf Cli-
A reprint package has been
ents into the Independent Living
compiled of selected articles
Network," by Marla Petal, 1980,
written by ILRU project staff
29 pages.
which provide a broad-based per-
No. 2: "How to Set Up an Inde-
spective of developments that
pendent Living Program: Twenty-
have taken place within the inde-
109
pendent living field. The reprint
39 pages: $10.00.
package includes the following
(Reprints not sold separately.)
articles:
Cole, Jean A. "What's New
About Independent Living?"
AUDIO-VISUAL PRODUCTS
Archives of Physical Medicine and
Rehabilitation, 60 (10), October
Board, Mary Ann, Laurie
1979, PP. 458-462.
Gerken, & Lex Frieden. Planning
for Independent Living: Using the
Frieden, Lex. "Independent
Individualized Independent Living
Living Models." Rehabilitation
Plan as a Counseling Tool. Houston:
Literature, 41, No. 7-8 (July-
ILRU Project, 1981.
August 1980), pp. 169-173.
The videotape depicts a coun-
Frieden, Lex. "IL: Movement
seling session which might occur
and Programs." American Rehabili-
at a typical independent living
tation, 3, No. 6 (July-August
program. Using individualized
1978), PP. 6-9.
program planning methodology, the
Frieden, Lex & Joyce Frieden.
counselor, herself disabled, helps
"Independent Living in Sweden and
the severely disabled client de-
the Netherlands." Mainstream, 7,
fine her independent living goals
No. 1 (November 1981), PP. 6-9.
and identify specific steps that
would lead to achievement of the
Frieden, Lex & Joyce Frieden.
goals. The videotape is designed
"Organized Consumerism at the
to supplement in-service training
Local Level." American Rehabilita-
activities for counselors with in-
tion, 5, No. 1 (September-October
dependent living case loads.
1979), PP. 3-6.
It received a Certificate of
Frieden, Lex & Laurel Richards.
Merit award at the 1981 Interna-
"Independent Living: Choosing from
tional Rehabilitation Film Festi-
a Variety of Programs.' Disabled
val.
USA, 2, No. 9, 1979, pp. 11-14.
17-minute, color, 3/4" video-
"A Glossary for, Independent
cassette: $100.00.
Living." In ILRU Source Book. Hous-
ton: The Institute for Rehabilita-
Independent Living: Six Model
tion and Research, 1979, PP. 1-7.
Programs. Houston: ILRU Project,
1978.
Widmer, Mary L., Lex Frieden,
This videotape describes six
& Laurel Richards. "Characteristics
early independent living programs.
of Independent Living Programs in
It depicts the different approaches
the United States." National Spinal
each program utilizes in providing
Cord Injury Foundation Convention
or coordinating housing, attendant
Journal, 1981, PP. 46-51.
care, transportation, advocacy,
Package of 8 reprints,
and information/referral services
22-065 0 - 84 - 8
110
to disabled consumers.
Frieden, Lex, David Sharp, &
The videotape received a Cer-
Tim Fleck. CBFL Conference Report
tificate of Merit award from the
1978. Houston: The Institute for
1979 International Rehabilitation
Rehabilitation and Research, 1978.
Film Festival.
This report describes a re-
62-minute, color, 3/4" video-
gional training project for handi-
cassette: $100.00.
capped consumer leaders which was
sponsored by a Houston-based dis--
abled rights organization. De-
signed to serve as a primer for
POSTER
similar conferences, this report
documents the logistical arrange-
"America Needs All Its Citi-
ments involved in planning the
zens." Houston: ILRU Project, 1981.
conference. It also includes
Part of an ongoing series,
presentations given by keynote
this poster aids in promoting the
speakers, Eunice Fiorito and Frank
image of severely disabled indi-
Bowe.
viduals making valuable contribu-
Soft-bound book, 83 pages.
tions to society. Designed to
alter people's perceptions and
expectations of persons with disa-
Stock, David D., & Jean Cole.
bilities, this poster depicts a
Cooperative Living. Houston: The
man in an electric wheelchair work-
Institute for Rehabilitation and
ing at a construction site.
Research, 1977:
Poster, color, 18x24: $5.00.
The report examines Coopera-
tive Living, a cooperative self-
support residential system for
severely physically disabled young
AVAILABLE FROM CLEARINGHOUSES
adults. This early independent
living program is discussed in
The following publications.
terms of its background and purpose
which are out of print may be ob-
as a research and demonstration
tained from the following national
project, its residents, research
clearinghouses: National Clearing-
methodology and findings, and
house of Rehabilitation Training
special considerations which arise
Materials, Oklahoma State Univ.,
when developing living arrangements
115 Old U.S.D.A. Bldg., Stillwater,
for persons with severe physical
Ok. 74078; National Rehabilitation
impairments. The epilogue focuses
Information Center (NARIC), Catho-
on the individual, following the
11c Univ. of America, 4407 Eighth
courses that the forty residents
St., N.E., Washington, D.C. 20064;
and ERIC Clearinghouse on Handi-
took since the beginning of the
project.
capped and Gifted Children, 1920
Association Dr., Reston, Va. 22091.
Soft-bound book, 132 pages.
111.
COPYRIGHT INFORMATION
ments must be made in U.S. cur-
rency.
All ILRU resource materials
are copyrighted with all rights
reserved. No part of any publica-
REFUND POLICY
tion or audio-visual product may
be used or reproduced in any manner
ILRU guarantees the quality
whatsoever without written permis-
of its products. Postage and
sion except in the case of brief
handling charges will be de-
quotations embodied in critical
ducted from refunds on any mater-
articles or reviews. In all cases
ials returned. All requests for
of citation, appropriate acknow-
refunds must be made within 30
ledgements must be given.
days of receipt of materials.
ABOUT ILRU
HOW TO ORDER
To order ILRU materials,
The ILRU (Independent Living
please fill out and return the
Research Utilization) project is
enclosed order form or make
a national resource center for in-
specific written requests (in-
dependent living. Its goal is to
cluding item description and
improve the spread and utilization
of information related to independ-
price) to:
ent living.
ILRU Project
P. 0. Box 20095
Since ILRU was established in
Houston, Tx. 77225
1977, it has developed a variety
Prepayment or purchase order
of strategies for collecting, syn-
form is required. Checks and
thesizing, and disseminating in-
formation related to the field of
money orders should be made pay-
able to ILRU PROJECT. Purchase
independent living.
orders are acceptable for orders
of $10.00 or more. A 10% discount
ILRU project staff serve in-
is allowed on purchases totaling
dependent living programs, state
$500.00 or more. Please allow up
rehabilitation agencies, consumer
to six weeks for delivery. Prices
organizations, rehabilitation ser-
are subject to change without no-
vice providers, educationalinsti-
tutions, medical facilities, and
tice.
other organizations active in the
International orders (except
field, both nationally and inter-
Canada) must be accompanied by a
nationally.
$3.00 surcharge to cover costs of
international shipping. All pay-
ILRU was established by the
112
Rehabilitation Services Adminis-
tration, and it is now sponsored
in part by the National Institute
of Handicapped Research, U.S. De-
partment of Education. Support
for the project is provided by
grants from both public and pri-
vate sources and by sales of prod-
ucts and services.
ILRU PROJECT STAFF
Lex Frieden, Director
Laurel Richards, Training &
Materials Development Coordinator
Laurie Gerken, Technical Assistance
Coordinator
Mary L. Widmer, Research Analyst
Shirley Herzog, Administrative
Secretary
ilru
113
ILRU RESOURCE MATERIALS - ORDER FORM
ITEM #
TITLE
PRICE
QUANTITY
AMOUNT
Independent Living With Attendant Care:
01
A Guide for the Person With a Disability
$3.50 X
=
$
02
A Message to Parents of Handicapped Youth
$3.50 X
=
$
03
A Guide for the Personal Care Attendant
$3.50 X
=
$
04
New Options
$4.00 X
=
$
05
New Options Training Manual
$6.00
X
=
$
06
ILRU Source Book
$20.00 X
=
$
Issues in Independent Living:
07
No. 1: Independent Living and Deafness
$5.00 X
=
$
08
No. 2: How to Set Up an Independent Living
Program
$5.00 X
n
$
09
No. 3: Independent Living and Evaluation
$5.00 X
=
$
10
No. 4: Independent Living and Mental Retardation
$5.00 X
=
$
11
Reprint Package
$10.00 X
=
$
12
Videocassette: Planning for Independent Living
$100.00 X
=
$
13
Videocassette: Independent Living: Six Model
Programs
$100.00
X
=
$
14
Poster: America Needs All Its Citizens
$5.00 X
II
$
15
New Life Options: Independent Living and You
$2.00 X
=
$
TOTAL
$
International Orders (Except Canada) Surcharge
$3.00
$
TOTAL
$
Check, Money Order, or Purchase Order Form payable to ILRU PROJECT must be in-
cluded with all orders. (U. S. Currency Only) A $3.00 surcharge must be included with
international orders (except Canada) Purchase Orders are not accepted on orders totaling less
than $10.00. A 10% discount is allowed on orders totaling $500.00 or more. Allow six weeks for
delivery.
SHIPPING ADDRESS
Name
Address
City
State
Zip Code
Send Order Form to: ILRU Project
P. 0. Box 20095
Houston, TX 77225
--PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE--
114
Mr. MURPHY. We now have the second panel this morning, con-
sisting of John Melvin, president, national association of Rehabili-
tation Facilities, of Milwaukee, Wis.; and Martha Walker, presi-
dent of the National Council on Rehabilitation Education, from
Kent, Ohio, accompanied by Adelle Pietszak, a master of education
candidate, rehabilitation counseling, at Kent State University.
I have just been advised that Dr. Melvin missed his plane. Mil-
waukee must be snowed in. Mr. Cox is here from the national asso-
ciation, if he would care to appear. If he has Dr. Melvin's state-
ment to present, we can accept it into the record and he can
answer questions in lieu of Dr. Melvin.
We will proceed first with Ms. Walker.
STATEMENT OF MARTHA WALKER, PRESIDENT, NATIONAL
COUNCIL ON REHABILITATION EDUCATION, KENT, OHIO
Ms. WALKER. Mr. Chairman and members of the subcommittee;
my name is Martha Lentz Walker, and I am here today represent-
ing the National Council on Rehabilitation Education, which is a
group of educators, researchers, trainers, and students whose pur-
pose is to improve the quality of rehabilitation services through
education and research.
Although the importance of training has been recognized for
almost 30 years in the field of rehabilitation, often the necessity for
training has been overlooked It is no easy job to assist a disabled
person in making adjustments in living, learning, and working.
It requires someone who is flexible, someone who has a firm,
staunch belief in the capacity of the disabled person to live to their
fullest potential, and who also believes in this society's commit-
ment to the right to work for every U.S. citizen and their right,
also, to live as full a life as they can.
I would like today to introduce to you Adelle Pietszak, who is ac-
companying me, who is an individual like many who have been re-
cruited through Federal moneys and through efforts of rehabilita-
tion educators to this rather difficult field.
Adelle knows perhaps better than anyone and will be able to de-
scribe much more clearly than I the importance of training, not
only for a rehabilitation counselor, who is the key person in the re-
habilitation process, but also the importance of training for herself
as a student.
I would like to ask Adelle at this point to tell you her story.
Mr. MURPHY. Thank you.
Adelle.
STATEMENT OF ADELLE PIETSZAK, M. ED. CANDIDATE,
REHABILITATION COUNSELING, KENT STATE UNIVERSITY
Ms. PIETSZAK. Mr. Chairman, members of the subcommittee, I
would like to briefly summarize my written statement, if that is all
right, for the sake of time.
The Rehabilitation Act of 1973 had a dramatic effect on my life,
and I would like to tell you a little bit about that.
As a person who has had a severe disability, muscular dystrophy,
since infancy, I received most of my early education at home and
115
in institutions. When I graduated from high school, I applied for
rehabilitation services in the State of New York.
That was 22 years ago. At that time, providing services for se-
verely disabled persons wasn't really a priority for the rehabilita-
tion system. I was denied services based on a poor medical progno-
sis, and also I believe because I was assigned to a counselor who at
that time seemed unable to meet my needs.
I struggled for 12 years, living a life that was frustrating and un-
productive. I stayed at home most of the time and watched televi-
sion. I was able to get a few small jobs that I could do at home, but
for the most part I really did very little.
I knew I could do more, SO I applied for rehabilitation services a
second time, and again I was denied. Finally, 12 years later, the
third time I applied, I was assigned a qualified rehabilitation coun-
selor who had a master's degree, and with her intervention I was
able to get some services on a limited basis.
In 1973, with the advent of the present Rehabilitation Act, my
life really changed. Since the act mandated the provision of serv-
ices for severely disabled persons, I was given assistance SO that I
could live in my own apartment, hire personal care attendants, and
go to college.
In 1980 I received my bachelor's degree in psychology at Kent
State University. I am currently working on a master's degree in
rehabilitation counseling, and I also teach a sociology course at
Kent State. Within a year I hope to receive my certification as a
qualified rehabilitation counselor.
Mr. Chairman and members of the subcommittee, I am con-
vinced-no, I know-that without the assistance of that Rehabilita-
tion Act of 1973 and without the intervention of a qualified reha-
bilitation counselor, I would still be living that unproductive life,
probably in a nursing home.
Mr. MURPHY. Thank you very much.
[The prepared statement of Adelle Pietszak follows:]
116
PREPARED STATEMENT OF ADELLE PIETSZAK, ON BEHALF OF THE NATIONAL COUNCIL ON
REHABILITATION EDUCATION
My name is Adelle Pietszak. I am a permanent resident of New
York State and am presently studying rehabilitation counseling
at Kent State, in Kent, Ohio. I have a unique position in that I
have experienced rehabilitation as a consumer and as a student.
Twenty-two years ago, when I was 18, I applied for rehabilitation
services after graduation from high school. Although I say "graduation
from high school," all my elementary and secondary education took
place in my home or an institution. I had been diagnosed as having
muscular dystrophy at the age of 18 months and never walked.
In 1960, when I applied for rehabilitation services, severely
disabled clients were not a priority for the state-federal VR
system. Rehabilitation education was in its infancy, and the
counselor. who came to my home to interview me left seeming uncomfortable
and saying "We'll look over the medical records." He was unprepared
for helping me, and I was unprepared to help him, being sheltered and
unsure about my vocational possibilities. The result was that I was
deemed "ineligible" on the basis of a poor medical prognosis. No
vocational evaluation or counseling was provided.
In the five years that followed I had no educational or
vocational experiences; I stayed at home and watched TV alot. I felt
discontented with my life; I knew I could do more than I was, and I
grew tired of waiting.
I discovered a telephone job that could be performed at home.
I sought the job and got it, working 22 hours a week for 60¢ an
hour. A rádio monitoring job supplemented the telephone work, and
I earned about $120 per month in that additional employment. Although
I was working, and continued to for years, I still felt my capabilities
were not being realized. I was living in a dependent setting, and I
longed for more independence.
Fastening my interest on psychology, which I had discovered
through reading in my spare time, I applied again for rehabilitation
assistance to attend a state university to major in Psychology. Again,
I was rejected due to my medical records.
My savings from working at home were my remaining option. I
enrolled as a part-time student in. a community college. After
succeeding in the coursework there, I once again contacted the office
of Rehabilitation Services, with my academic record in hand. Fortunately,
I was reassigned to a qualified counselor.
The visit from my new counselor was very different. She seemed
informed, interested, and sensitive to my needs. I was curious about
the difference between counselors and asked, "How do you know SO much?"
She answered that she had a master's degree in Rehabilitation Counseling.
As she left, I felt hopeful that I would at last be judged "eligible"
for rehabilitation services. And indeed I was.
117
I was evaluated for vocational potential and for assistive
devices that I might need. My further academic training was approved,
and I was given funding on a limited basis. The 1973 rehabilitation
legislation affected my life dramatically, for I was able to hire
an attendant and live in my own apartment, attend a university program
as a fulltime student, and receive my bachelor's degree in Psychology
in 1980.
Today I continue to receive services through the state-federal
program, am pursuing a master's degree in Rehabilitation Counseling,
and teach a sociology class at the college level. Within a year,
I expect to graduate and to begin my career as a certified rehabilitation
counselor.
I am convinced that without the assistance of a qualified
rehabilitation counselor, I would probably be living with my parents,
watching TV most of my day. Training does make a difference; I am
daily learning how much there is to know about rehabilitation. I
am grateful to have a qualified rehabilitation counselor, and I am
equally grateful for the training I am receiving as a graduate
student that will adequately prepare me to work with severely
disabled persons.
118
Mrs. WALKER. Rehabilitation clients who depend upon a qualified
person for access to the system and for utilizing that system are
many, and Adelle is one representative of that.
The need for persons who are competent and who are committed
to this field is greater now than it has ever been, and I would like
to say for three reasons.
First, the most recent census figures say that there are 26 mil-
lion adults in the United States who have a work disability, mean-
ing that their work has been interrupted or discontinued because
of disability.
Mr. MURPHY. What is that figure?
Mrs. WALKER. The census figure is 26 million for work disabil-
ities.
Rehabilitation counselors are transitional agents, the persons
who can get those people back to work. At this time, rehabilitation
counseling programs produce approximately 1,500 graduates annu-
ally. That means to me that there is a clear need.
Second, the nature of the population served by the rehabilitation
program has changed. You have heard this morning I think from
several sources that the Rehabilitation Act of 1973, which focused
on severely disabled persons, increased the difficulty factor of reha-
bilitation. Coupled with our economy, which today makes entry
into employment even more difficult for a disabled person, these
are two severe difficulty factors that show the need for a qualified
person.
Finally, we have had damage to this rehabilitation education net-
work in the past 5 years. In 1979 the funding level was such that
when we compare it to 1983 in real dollars, rehabilitation training
has lost 39 percent of the funding that was then present.
The result of that is that we have a little more than half the
numbers of universities providing training programs for rehabilita-
tion counseling funded through Federal dollars than we had in
1979. That is damage to a system that was built over 30 years, and
it is severe.
I think that that translates into need for the system and need for
qualified personnel, and I would like to suggest that the reauthori-
zation of the Rehabilitation Act of 1973 should reflect our mutual
concern about the quality of service and the qualifications of the
service provider.
The National Council on Rehabilitation Education would like to
suggest one small, but very important amendment to the Rehabili-
tation Act. We propose that the word "qualified" be inserted before
the word "personnel" wherever it appears.
We define the word "qualified" to mean certification and/or li-
censure by the appropriate State and national certifying body, such
as the American Board for Certification in Orthotics and Prosthet-
ics, the American Board of Physical Medicine and Rehabilitation,
the American Occupational Therapy Association, and the Commis-
sion on Rehabilitation Counselor Certification.
Inclusion of this terminology would provide specific standards for
every member of the rehabilitation team, improving all rehabilita-
tion clients' chances of receiving quality services from a broad
range of qualified individuals.
119
Finally, Mr. Chairman, our paramount request is that the Reha-
bilitation Act be extended for a minimum of 3 years with increased
authorizations for the rehabilitation training program. Specifically,
we recommend authorizations of $25.5 million in fiscal year 1984,
$30.5 million in fiscal year 1985, and $35.5 million in fiscal year
1986.
Thank you for this opportunity to explain the importance of re-
habilitation training to the success and effectiveness of the overall
rehabilitation program and the need for increased support for this
key component in the highly successful Rehabilitation Act.
Mr. MURPHY. Thank you very much, Mrs. Walker.
[The prepared statement of Martha Walker follows:]
120
PREPARED STATEMENT OF MARTHA WALKER, PRESIDENT, NATIONAL COUNCIL ON
REHABILITATION EDUCATION
Mr. Chairman and members of the Subcommittee, my name is
Martha Lentz Walker, and I am here today representing the National
Council on Rehabilitation Education, an organization of educators,
researchers, trainers, and students from more than 80 institutions
of higher education whose purpose is to improve rehabilitation
services through preparation and continuing education and research.
Thank you for this opportunity to express the position of the
National Council on Rehabilitation Education on the reauthorization
of the Rehabilitation Act of 1973, and in particular, the value of
rehabilitation training.
Although the importance of a qualified professional in the
delivery of rehabilitation services has been recognized for nearly
thirty years, often the necessity for such personnel has been
overlooked. Assisting persons with disabilities in making
adjustments to living, learning, and working is no easy job.
The rehabilitation process requires flexibility, discrétion, and
belief in the disabled person's capacity to respond constructively
to unwanted change or differences. The process requires the most
resourceful providers of service who have been thoroughly prepared
for tough going.
Federal training dollars have enabled educators and researchers
to recruit capable persons for this difficult field. While no other
occupations are more intrinsically rewarding, many do offer higher
salaries and less complicated problems. Consequently, shortages
121
of qualified professionals exist in many rehabilitation fields.
I am accompanied today by a student recruited for her promise
and partially supported by a traineeship from the Rehabilitation
Services Administration. Research has shown that someone with a
disability who has received professional preparation, is most
likely to be perceived by another disabled person as trustworthy
and expert. The importance of training to a client receiving
rehabilitation services as well as to a graduate student in
rehabilitation counseling is best described by Adelle Pietszak,
so I will ask her to tell her story now.
Mr. Chairman, Adelle's "story" is shared by many rehabilitation
clients who depend upon the judgment of a qualified professional for
access and utilization of the rehabilitation system. The need for
competent and committed rehabilitation personnel was first
recognized in 1954; today that need is even greater than in
earlier years. Let me make several points which reinforce this
need.
First, rehabilitation workers are "transition experts" serving
the .27 million persons with work disabilities as reported in the
1983 census. When deinstitutionalization efforts are added as
markets for "transition experts", the public agencies serving
mentally retarded, psychiatrically disabled, offenders, and aging
populations could absorb all the graduates of rehabilitation
education programs. The parent agency, state vocational rehabilita-
tion agencies, experience annual turnover rates of 14 - 16%.
122
Attrition alone, in the state agencies, would consume the 1500
graduates currently completing academic programs each calendar
year. In other words, we are not able to meet current demands
for qualified rehabilitation professionals, and this situation
is not likely to improve if we fail to shore up eroding federal
support for rehabilitation training
Second, the need for qualified personnel is greater than
ever because of changes in the nature of the population served
in the state-federal program, and economic factors. Because of
the 1973 Congressional mandate for serving the severely handicapped,
the rehabilitation worker has increased responsibilities for serving
the severely disabled who are trying to enter an economic system
that is less permeable than ever before. These are more difficult
rehabilitations which require the attention of well prepared
professionals to achieve a successful outcome. Also, limited case
service dollars mean that rehabilitation counselors must take on
additional functions. For example, they are called upon to perform
appraisal and counseling, rather than purchasing these services
from psychologists or medical screening teams. These activities
require solid training to be accurate and productive.
The need for training to meet new priorities is not limited
to those just entering rehabilitation professions. Continuing
education is needed to ensure that personnel already in the field
also maintain up-to-date techniques and skills, keep up with
rapidly changing technology, and can respond to these changing
123
priorities and needs within the rehabilitation program. This is
the conduit for insuring that new research results are used in
the field. If such training is not provided, then the quality of
services will necessarily be lower, and we will be denying the
rehabilitation client the best possible outcome. As the April 1980
Rehabilitation Services Administration's Rehabilitation Manpower
Plan states, "The ungrading of skills of employed personnel is at
all times an important aspect of manpower supply and demand and
the shortage of personnel who have been trained to their fullest
contributes to any overall rehabilitation "personnel shortage."
Third, damage has been heavy to a carefully developed
educational and research system due to the reduction of training
funds in the past five years. Since FY 1979, federal support for
rehabilitation training has declined from $30.5 million to $19.2
million in FY 1983 -- a loss of 39% in actual dollars, and a
staggering decline of roughly 58% when inflation is considered.
As a result, today only half as many rehabilitation counselor
education programs receive training funds as in 1979. The training
funds that are available primarily support students like Adelle
in their pursuit of professional training. Authorization levels
have been greatly reduced, as well. The 1978 Rehabilitation
Amendments authorized funding for rehabilitation training to
increase- from $34 million in FY 79 to $50 million in FY 82.
However, the Reconciliation Act of 1981 reduced that level to only
$25.5 million.
124
These reductions in training have a direct impact on the
success of the overall rehabilitation program and the quality
of services provided. When research evidence is added to the
personal account you have heard today, the effect of a qualified
professional is clear. Rehabilitation workers with professional
training:
1. have a greater awareness of motivational problems,
2. accept more difficult cases, and
3. achieve successful closure with satisfied clients more
frequently than untrained workers, often in a shorter
time.
The need for services and qualified personnel is evident; the
reauthorization of the Rehabilitation Act of 1973 should reflect
our mutual concern about the quality of services rendered and
the qualifications of the service provider.
It took much effort on the part of Congress, educators, and
researchers to create the educational system that is still in place,
despite the severe cutbacks in federal training dollars. Ninety
universities located throughout the United States offer rehabilita-
tion specific curriculum. Accreditation standards insure critical
instructional components and the learning of essential compentencies,
such as:
developing an evaluation plan and synthesizing information
to recommend training or job selection,
knowing the effects of medical conditions on clients,
125
facilitating, client understanding and involvement,
knowing the job requirements of specific occupations and
being able to suggest modifications for disabled workers.
With this in mind, Mr. Chairman, NCRE would suggest one small,
but important, amendment to the Rehabilitation Act. We propose
that the word "qualified" be inserted before the word "personnel"
whenever it appears. We define the word "qualified" to mean
certification and/or licensure by the appropriate state and national
certifying body, such as the American Board for Certification in
Orthotics and Prosthetics, the American Board of Physical Medicine
and Rehabilitation, the American Occupational Therapy Association,
and the Commission on Rehabilitation Counselor Certification.
Inclusion of this terminology would provide specific standards for
every member of the rehabilitation team, improving all rehabilitation
clients' chances of receiving quality services from a broad range of
qualified professionals.
Finally, Mr. Chairman, our paramount request is that the
Rehabilitation Act be extended for a minimum of three years with
increased authorizations for the Rehabilitation Training program.
Specifically, we recommend authorizations of $25.5 million in FY 1984;
$30.5 million in FY 1985; and $35.5 million in FY 1986.
Thank you for this opportunity to explain the importance of
the Rehabilitation Training program to the success and effectiveness
of the overall Rehabilitation Program, and the need for increased
support for this key component in the highly successful
Rehabilitation Act.
22-065 0 - 84 - 9
126
Mr. MURPHY. Mr. Cox, do you have a summary of Dr. Melvin's
comments?
STATEMENT OF JAMES A. COX, JR., EXECUTIVE DIRECTOR,
NATIONAL ASSOCIATION OF REHABILITATION FACILITIES
Mr. Cox. Thank you, Mr. Chairman.
I am Alan Cox. I am executive director of the National Associ-
ation of Rehabilitation Facilities.
Dr. Melvin was indeed snowed in in Milwaukee and was not able
to be here this morning. Thank you for allowing me to substitute.
The National Association of Rehabilitation Facilities is the pri-
mary national organization of community-based vocational and
medical rehabilitation facilities. These organizations are vocational-
ly oriented, providing a wide range of services to physically and
mentally handicapped persons, including evaluation, testing, skills
training, work adjustment training, sheltered employment, and job
placement. In addition, many hospitals and rehabilitation centers
provide restorative and rehabilitation care to persons who, are
physically disabled.
The rehabilitation program has always been a cooperative agree-
ment between the Federal Government, the States and the thou-
sands of private, nonprofit facilities providing these services to dis-
abled people.
As much as one-third, Mr. Chairman, of the persons served
under this act, and an equal amount of dollars, have been spent an-
nually in these community, nonprofit rehabilitation facilities and
hospitals.
These facilities are the basic community source of services for
disabled persons and historically have been a catalyst for the devel-
opment of new and innovative rehabilitation programs.
The Rehabilitation Act was written with that in mind, and the
particular section of the act, the innovation and expansion grants
section, has been used to stimulate these new and creative ap-
proaches to rehabilitation.
Title III of the act authorizes construction and loan programs for
facilities. These and other programs, including projects with indus-
try, were intended to act as a stimulus to establish the most effec-
tive services.
The President's 1984 budget has proposed that services to severe-
ly disabled be increased to 64 percent of individuals served. Most of
these individuals will at some time in their service spectrum be
served in a community-based rehabilitation facility.
When the act was last amended in 1978, when independent
living, community services and several other provisions were added
to the act, there were certain features which we had hoped in the
succeeding years might be given attention. Specifically, we had
hopes that the loan program which was authorized under the act
might receive implementation. That has not occurred.
Specific authorization levels were set for the basic State pro-
grams in the 1978 amendments, replacing the formula which would
have allowed the program to grow with inflation. Many program
authorizations were frozen at the level for funding they had re-
127
ceived in fiscal year 1981. These programs included research, train-
ing and independent living.
The Reconciliation Act specified that certain other programs
were not authorized to receive appropriations in fiscal year 1982 or
fiscal year 1983. These programs include evaluation, innovation
and expansion, facility construction, vocational training services,
comprehensive centers, community service employment, and com-
prehensive independent living services.
We support the reauthorization of the Rehabilitation Act
through fiscal year 1986 and would like to bring specific attention
to the importance of these special programs within the act.
The board of directors of our association have adopted a position
that major changes in the Rehabilitation Act are not warranted at
this time. There are, however, several modifications to the act
which we feel would strengthen the Rehabilitation Act and en-
hance services to disabled persons.
If these recommendations are adopted, rehabilitation facilities
will continue to provide the services necessary for continued im-
provement of services to disabled Americans.
Among the specific provisions which we have referenced in our
written testimony submitted for the record, and which I would like
to highlight this morning, sufficient authorization levels should be
set for basic State grants and other parts of the Rehabilitation Act.
Language should be added to make it clear that the authoriza-
tion for basic State grants is an entitlement and is not subject to
reduction by the Appropriations Committee if States are unable to
meet the Federal share.
The authorization levels recommended by the Council of State
Administrators of Vocational Rehabilitation of $1.037 billion for
fiscal year 1984 and the subsequent figures in fiscal year 1985 and
fiscal year 1986 are supported by our association as well.
We note with interest that CSAVR, in its statement to the
Senate Subcommittee on the Handicapped, stated that a "well
funded program of direct services" was essential to the rehabilita-
tion program.
Our board adopted a position last month to support increased ap-
propriations for direct services to disabled persons. Funds appropri-
ated under title I of the Rehabilitation Act for basic State grants
should be maximized for direct case services to the greatest extent
possible and should not be diminished for nondirect case service
functions at the State level. This should be especially emphasized
for any funds appropriated above current levels.
Inflation has eroded much of the purchasing power of increases
to the rehabilitation basic State grant program over the past sever-
al years. Increased costs at the State level have negated the in-
creased allocation from the Federal level. These increased costs,
coupled with added costs of working with a more severely disabled
population, have resulted in a decrease in the number of persons
served and rehabilitated.
We. urge the committee to monitor closely the allocation of reha-
bilitation funds to the States and to limit future increases in fund-
ing to direct services to disabled persons.
Further, we feel that 1 percent of the amount appropriated for
title I, basic State grants, should be set aside in a discretionary
128
fund for the Commissioner of the Rehabilitation Services Adminis-
tration, to be used for new and creative approaches to rehabilita-
tion. Such a provision could act as a catalyst for new ideas and pro-
vide an alternative for nontraditional approaches.
We feel that the 1-percent amount would be both reasonable and
appropriate. We note that the Director of the National Institute of
Handicapped Research has a discretionary authority of up to 10
percent.
A significant amount of funds have been returned to the U.S.
Treasury each year when funds allocated to States could not be
matched or utilized during the year the funds were appropriated.
In fiscal year 1982, over $5.8 million in title I funds were re-
turned to the U.S. Treasury, principally from American Samoa,
U.S. trust territories and Púerto Rico, with some lesser amounts
from other States.
Section 120, innovation and expansion, we feel should receive a
separate appropriation and should be administered on a national
level to recognize and encourage more effective programs.
We share the concern expressed for training programs and be-
lieve continued emphasis must be placed on the training programs
under the Rehabilitation Act. Emphasis should not be diminished
on the training of rehabilitation personnel, including facility man-
agers, administrators and allied medical rehabilitation profession-
als.
As disabled populations become more severely disabled, more ex-
tensive and specialized personnel are required to serve their needs.
A recent study from the University of Wisconsin-Stout predicts
that community facilities will need to double their staff by 1990 to
meet the increased need to serve the disabled population.
Programs targeted to rehabilitation facilities in title III of the
Rehabilitation Act should be authorized for funding at specified
levels for documented needs. Section 301, construction of facilities,
and 303, loan guarantees, are especially needed to allow facilities
to develop the physical plants and equipment needed to compete in
more sophisticated markets, and to train handicapped persons in
marketable skills. The reauthorization should direct RSA to imple-
ment the loan guarantee program authorized under the 1978
amendments.
Projects with industry should be given a separate title within the
act and be authorized at a $25 million level. PWI is not a single
program model but a concept that placement into competitive jobs
should be the goal of vocational rehabilitation and that the busi-
ness community should have a strong role in the rehabilitation
process.
The development of rehabilitation programs over the years has
placed much needed emphasis on the identification of handicapping
conditions and the evaluation of a handicapped person's capabili-
ties.
Much progress has also been made in adapting training pro-
grams and special equipment to the needs of handicapped persons.
For many years, however, efforts to get these handicapped persons
into jobs did not receive the same emphasis that evaluation and
training received. Projects with industry emphasizes closure of the
rehabilitation process.
129
PWI has demonstrated that with concerted efforts severely dis-
abled persons can be placed into competitive jobs much more quick-
ly and at lower costs than had previously been experienced. The
key to the projects with industry concept has been the involvement
of the business community in the rehabilitation process.
Nationally, PWI programs have placed over 50,000 disabled per-
sons into competitive jobs. The average salary paid to the PWI
graduates has been over $9,000 per year. Seventy-five percent of
the disabled persons enrolled in PWI were in fact placed.
The cost to the Federal Government has been less than $1,000
per placement. The Federal funds were supplemented by other
State and local funds, including vocational rehabilitation funds.
Over 11,000 businesses have participated in the PWI program. The
program has proven its worth over 10 years by placing a higher
percentage of handicapped persons into private sector jobs at a
lower cost to the Federal Government than any other job training
or placement program.
A community service employment pilot program was added to
the act in 1978. Patterned after the Older Americans Act, it would
have promoted useful employment opportunities in public and non-
profit agencies providing community services.
In these times of high unemployment, handicapped persons have
a particularly difficult time finding employment. The reauthoriza-
tion should direct implementation of this program, which has gone
unaddressed since being added to the act in the 1978 amendments.
Research regarding the development and improvement of reha-
bilitative treatment methods and rehabilitation engineering meth-
ods and devices is critical to an effective rehabilitation service
system. The National Institute of Handicapped Research is under
new leadership, and its programs are being administered well. The
problem we now face is essentially one of inadequate financial, re-
sources.
In this fiscal year, only 50 percent of the applications recom-
mended for funding were funded. Major funding increases are
needed in fiscal year 1984 and future years to support meritorious
applications and to initiate and expand new programs in research
training and small investigator-initiated grants.
Mr. Chairman, these are just some of the recommendations
NARF would like to make as this cómmittee considers reauthoriza-
tion. A more comprehensive statement detailing our review has
been submitted to staff for the record.
We would like to commend you, and particularly the staff, for
the outstanding job which this committee has performed. We stand
ready to continue to work with your staff and with your committee
toward an early reauthorization of the act.
Thank you.
[The prepared statement of Dr. Melvin follows:]
130
PREPARED STATEMENT OF DR. MELVIN, NATIONAL ASSOCIATION OF REHABILITATION
FACILITIES
NARF is the primary national membership organization of community-based
vocational and medical rehabilitation facilities. Over 350 of these
organizations are vocationally-oriented, providing a wide range of ser-
vices to, both physically and mentally handicapped persons. These ser-
vices include evaluation and testing, skills training, work adjustment
training, sheltered employment and job placement. One hundred and fifty
of NARF's members are medical facilities offering restorative and reha-
bilitation services.
The Rehabilitation Act of 1973, as amended, has for many years provided
the foundation for the provision of services to mentally and physically
disabled persons. The modern federal rehabilitation program has its
roots back to the 1920s and has served as a clear indication of the
federal government's responsibility and commitment to provide meaningful
programs for America's disabled citizens.
The vocational rehabilitation program has always been a cooperative
arrangement between the federal government, the states and the thousands
of prvate, non-profit community facilities providing services to dis-
abled persons. NARF is proud to represent the private, non-profit sector
of the rehabilitation community.
Rehabilitation facilities are the basic community source of services for
disabled persons. Historically they have been the catalyst for the
development of new and innovative rehabilitation programs. The Rehabil-
131
itation Act was written with that in mind. The Innovation and Expansion
Grant section of the Act was to be used to stimulate these new and
creative approaches to rehabilitation. Title III of the Act authorized
construction and loan guarantees for facilities. These and other pro-
grams, including Projects With Industry, were intended to act as a
stimulus to establishing the most effective services. The President's
1984 budget- proposed that services to the severely disabled be increased
to 64% of individuals served. Most of those individuals will be served
in community-based rehabilitation facilities.
The Rehabilitation Act of 1973, as amended, is up for reauthorization in
1983. The Rehabilitation Act was last amended in 1978 when Independent
Living, community services and several other provisions were added to
the Act. The Omibus Reconciliation Act of 1981 extended authorization
of the Act through fiscal year 1983. Specific authorization levels were
set for the basic state grants at that time, replacing a formula which
would have allowed the program to grow with inflation. Many programs'
authorizations were. frozen at the level they received funding for in
fiscal year 1981. These programs included research, training and indepen-
dent living. The Reconciliation Act specified that certain other pro-
grams were not authorized to receive appropriations in fiscal years 1982
or 1983. These programs include evaluation, innovation and expansion,
facility construction, vocational training services, comprehensive
centers, comunity service employment and comprehensive independent
living services.
132
It has been five years since any changes have been made in the
Rehabilitation Act. The NARF Board of Directors adopted a position that
major changes in the Rehabilitation Act are not warranted at this time.
There are, however, several modifications to the Act that NARF feels
would strengthen the Rehabilitation Act and enhance services to disabled
persons. If these recommendations are adopted, rehabilitation facilities
can continue to provide the services necessary for the continued im-
provement of services to disabled Americans. NARF supports reauthoriza-
tion of the Rehabilitation Act through fiscal year 1986.
1. Sufficient authorization levels should be set for basic state
grants and other parts of the Rehabilitation Act. Language should
be added to make it clear that the authorization level for basic
state grants is an entitlement and is not subject to reduction by
the appropriations committee if states are able to match the
federal share.
The authorization levels recommended by CSAVR of $1037.1 million
for fiscal year 1984, $1141.1 million for fiscal year 1985 and
$1254.8 million for fiscal year 1986 are supported by NARF. We
noted with interest that CSAVR, in its statement to the Senate
Subcommittee on the Handicapped, said that a "well funded program
of direct services. " was essential to the rehabilitation program.
The NARF Board adopted a position last month to support increased
133
appropriations for direct services to disabled persons. Funds appro-
priated under Title I of the Rehabilitation Act of 1973 for basic
state grants should be maximized for direct case services to the
greatest extent possible and should not be diminished for
non-direct case service functions. This should be especially empha-
sized for funds appropriated above current funding levels.
Inflation has erroded much of the purchasing power of increases to
the rehabilitation basic state grant program over the past several
years. Increased costs at the state level have negated the
increased allocation from the federal level. These increased
costs, coupled with the added costs of working with a more
severely disabled population, have resulted in a decrease in the
numbers of people. served and rehabilitated. NARF urges this
Committee to monitor closely the allocation of rehabilitation
funds to the states and to limit future increases in funding to
direct services to disabled persons.
2. One percent of the amount appropriated for Title I, Basic State
Grants, should be set aside in a discretionary fund for the
Commissioner of RSA to be used for new and creative approaches to
rehabilitation. Such a provision could act as a catalyst for new
ideas and provide an alternative for non-traditional approaches.
NARF thinks that the one percent amount would be both reasonable
and appropriate. The Director of the National Institute for Handi-
134
capped Research has complete discretion with 10 percent of the
funds available to NIHR each year. Ninety-one percent of the total
dollars appropriated to the Rehabilitation Services Administration
in fiscal year 1982 were passed on directly to the states. Most of
the remaining nine percent is part of a catagorical discretionary
program that gives the RSA Commissioner little, if any, leeway.
The discretionary fund could serve as a source of setting national
priorities by funding a variety of experimental, demonstration or
evaluation projects of national significance. While projects in
the states under the Innovation and Expansion Program (Sec. 120)
could help implement some of the more creative and innovative
approaches, the discretionary fund should be viewed as a more open
process to explore new approaches to rehabilitation.
Funding a discretionary program for RSA would not be difficult and
would not take money away from states' basic grant programs.
Almost every year, rehabilitation funds are returned to the U.S.
Treasury because the funds were not expended before the end of the
federal fiscal year. Last year, $5.8 million was returned because
11 states and territories had not obligated the funds by September
30. In some instances, these leftover funds were due to differ-
ences in state and federal fiscal years. In other cases, antici-
pated expenditures were not made.
Technical language should be added to the Rehabilitation Act
135
authorizing unexpended federal funds for basic state grants to be
carried into the next fiscal year by the Commissioner of RSA to be
used to fund projects to further rehabilitation of handicapped
persons. Additional funds should be authorized to be appropriated
to bring the Commissioner's discretionary fund to no more than one
percent of the basic state grant appropriation for that fiscal
year
3. Section 120, Innovation and Expansion, should receive a separate
appropriation and should be administered on a national level to
recognize and encourage more effective programs.
Innovation and Expansion funding has been alloted to the states on
a formula basis to fund the cost of planning, preparing for and
initiating special programs to expand vocational rehabilitation
services. Special emphasis in the Innovationand Expansion program
is placed on serving the most severely disabled and other handi-
capped populations with special needs. In the past, Innovation and
Expansion projects have brought the mentally retarded and cerebral
palsied into vocational rehabilitation programs when previously
they were thought to be too severely disabled to qualify for
rehabilitation services.
Innovation and Expansion projects have not been appropriated
separate funds since 1979 when funding for them was combined with
136
basic state grants. In its last year of appropriation, $12 million
was allocated to the states for Innovation and Expansion.
Innovation and Expansion funds are one of the few ways the
Rehabilitation Services Administration can identify and affect
national priorities for the rehabilitation of disabled persons.
Under provisions of Section 121, the Commissioner of RSA may
require the states to spend 50 percent of the Innovation and
Expansion allocation on' projects approved by the Commissioner.
The Committee should use this opportunity to place renewed
emphasis on the Innovation and Expansion Program and to recommend
an appropriation of at least the amount appropriated in fiscal
year 1978.
4. Continued emphasis should be placed in training programs. Emphasis
should not be diminished on the training of rehabilitation person-
nel, including facility managers, administrators and allied
medical rehabilitation professionals. As disabled populations
become more severely disabled, more extensive and specialized
personnel are required to serve their needs. A recent study from
the University of Wisconsin-Stout predicts that facilities will
have to double their staff by 1990 to serve the need.
Training programs fund projects to help increase the number of
137
personnel trained in providing vocational rehabilitation services
to disabled people. Grants are awarded in fields related to
vocational rehabilitation of the physically and mentally disabled,
such as rehabilitation counseling, rehabilitation medicine, phys-
ical and occupational therapy, prosthetic-orthotics, speech path-
ology and audiology, and rehabilitation of the blind and deaf.
Rehabilitation personnel need more extensive and special training
as more and more severely disabled and mentally ill people seek
services. Prior to the 1973 and 1978 amendments, many of the
people seeking vocational rehabilitation services could be
employed and were considered easily rehabilitated, successfully
closed cases. The new population seeking services presents differ-
ent, more complex, longer term problems that place new and differ-
ent demands on the people helping them. Rehabilitation personnel
must be prepared to respond to these changes and require training
in new skills.
5. Programs targeted to rehabilitation facilities in Title III of the
Rehabilitation Act should be authorized for funding at specified
levels for documented needs. Section 301, Construction of Facili-
ties, and Section 303, Loan Guarantees, are especially needed to
allow facilities to develop the physical plants and equipment
needed to compete in more sophisticated markets and to train
handicapped persons in marketable skills.
138
The reauthorization should direct RSA to implement the loan guar-
antee program. The loan guarantee program under Section 303 allows
the Commissioner of RSA to guarantee the payment of principle and
interest on loans made to non-profit rehabilitation facilities for
the construction and equipping of such facilities. In addition to
guaranteeing the loan, RSA will pay to the holder of the loan
amounts sufficient to reduce the interest rate on the loan by 2
percent. There are safeguards in Section 303 to verify the
viability of the loans sought to be guaranteed. There are also
provisions in Section 303 to minimize the level of appropriation
needed to fund the loan guarantee.
Rehabilitation facilities have proven to be good credit risks. The
Handicapped Assistance Loan program administered by the Small
Business Administration has the lowest default rate of any SBA
direct loan program. The Handicapped Assistance Loan program makes
loans up to $100,000 to rehabilitation facilities. The loan guar-
antee provision is needed to make larger loans needed for major
capital improvement projects available to rehabilitation facili-
ties at reasonable rates.
6. Projects With Industry should be given a separate title within the
Act and authorized at $25 million. Projects With Industry is not a
single program model but a concept that placement into competitive
jobs should be the goal of vocational rehabilitation and that the
business community should have a strong role in the rehabilitation
139
process. The development of rehabilitation programs over. the years
has placed much needed emphasis on identification of handicapping
conditions and evaluation of a handicapped person's capabilities.
Much progress has also been made in adapting training programs and
special equipment to the needs of handicapped persons. For many
years, however, efforts to get these handicapped persons into jobs
did not receive the same emphasis that evaluation and training
received. Projects With Industry emphasizes closure of the reha-
bilitation process.
Projects With Industry has demonstrated that with concentrated
efforts severely disabled persons can be placed into competitive
jobs much more quickly and at lower costs than had previously been
experienced. The key to the Projects With Industry concept has
been the involvement of the business comunity. Among the several
Projects With Industry models that have been developed, all have
business playing a central role. In some cases, it is the actual
business concern that administers the program and places the
handicapped trainees. IBM and Control Data have had impressive
programs. In other instances, national trade associations have
taken the lead such as the National Restaurant Association. Most
Projects With Industry programs, however, are administered in
local communities by local rehabilitation facilities. Projects
With Industry programs at the New Haven Easter Seal-Goodwill
Rehabilitation Center is one of the oldest programs and one of the
140
best examples of what such a program can accomplish. In these
local programs, a business advisory council helps establish actual
job needs in the community, sets standards for training and
placement and assists in the actual placement process. The
business community brings new measures of success to the rehabili-
tation process. These measures exemplify productivity, cost effec-
tiveness, accountability and bottom line results. Social service
principles and values are still important but they should not be
an excuse for poor results.
Nationally, Projects With Industry programs have placed over
50,000 disabled persons in competitive jobs. The average salary
paid to these graduates has been over $9,000 per annum. Seventy-
five percent of the disabled persons enrolled in Projects With
Industry were placed. The cost to the federal government was less
than $1,000 per placement. The federal. funds were supplemented by
other state and local- funds, including vocational rehabilitation
funds. Over 11,000 businesses have participated in the Projects
With Industry program.
NARF has administered a national Projects With Industry program
since 1978. NARF works with five NARF state chapters and 20
rehabilitation facilities to develop programs which use transi-
tional workslots in industry and training based on the recommenda-
tions of local employers. Last year, the NARF project placed 493
141
handicapped persons through a combination of federal, state and
local funds. Most of the clients were severely handicapped with
the vast majority being diagnosed as mentally ill and devel-
opmentally disabled. The salary range for these persons placed was
between $6,432 and $19,200.
An independent survey undertaken by Portland State University
found that in fiscal 1981 the average hourly range earned by
Projects With Industry clients was $4.75. The average cost per
placement was $737 in federal funding. In a survey of clients
placed through Projects With Industry and other placement
programs, it was found that twice as many Projects With Industry
clients were likely to be promoted.
NARF believes that the proven success of PWI over the past 15
years clearly justifies expansion of the Projects With Industry
concept. Although Projects With Industry has received increased
funding over the past several years, it is time that Projects With
Industry be given higher visibility. Congress should provide a
funding level which will encourage programs in all states and will
allow expanded programs in certain industries which hold the most
promise for jobs. NARF recommends an authorization level of at
least $25 million for fiscal 1984. The current funding level is $8
million and an additional $5 million was added to the fiscal 1983
appropriation- for Projects With Industry in the Emergency Jobs
22-065 0 - - 84 - 10
142
Bill, bringing the fiscal 1983 appropriation to $13 million. The
Reagan Administration has recommended $11 million for fiscal 1984.
It would take much more than $25 million to meet the needs of
handicapped persons who could be placed into competitive jobs.
NARF firmly believes that rehabilitation facilities and the
business community could meet that need given adequate resources.
NARF realizes that an increase of threefold to the appropriations
for Projects With Industry would not be easily obtained, therefore
this recommendation is for an authorization level of $25 million
to emphasis the need to expand Projects With Industry. NARF feels
this figure is fully justified given the reduction in public
assistance costs and the increased tax revenues that would be
realized from the more than 18,000 handicapped persons that could
be employed if the full authorization of $25 million was appropri-
ated.
PWI should be given a separate title in the Rehabilitation Act as
a concrete indication of Congress' commitment to providing mean-
ingful employment opportunities to handicapped persons. The 1978
amendments also created a grant program for Business Opportunities
for Handicapped Individuals in Title VI along with Projects With
Industry. NARF recognized the need for providing capital resources
and technical assistance to handicapped individuals to enable them
to establish and/or operate small businesses. NARF feels that the
Handicapped Assistance Loan program at the Small Business Adminis-
143
tration best fulfills that role. Therefore Title VI could become
the separate title for Projects With Industry.
Projects With Industry should continue as a discretionary national
program within the Rehabilitation Services Administration. The
flexibility of cooperative agreement between the RSA Commissioner,
the private business sector and the private non-profit sector
should continue. The flexibility afforded under the current
program has allowed and encouraged many businesses to participate
in the program when they might not otherwise have been willing to
take the initiative to take part in these programs. This flexi-
bility has also allowed local rehabilitation agencies to tailor
Projects With Industry programs to meet local needs. If anything,
added emphasis should be placed on the cooperative nature of the
program between the business comunity, and the local rehabili-
tation agencies that can assist business in training and placing
handicapped persons into meaningful jobs.
7. Section 12 of the Rehabilitation Act states that the Commissioner
of Rehabilitation Service. Administration may provide consulta-
tive services and Technical Assistance to public or non-profit,
private agencies and organizations." This authority and an earlier
provision in Title III were traditionally used to provide tech-
nical assistance to rehabilitation facilities in areas such as
contract procurement, high technology, cost accounting, marketing,
144
etc., to help facilities improve their performance in providing
services to disabled persons. Technical Assistance, provided under
Section 12, allowed facilities to be operated in a more business-
like manner and to become more self-sufficient and less dependent.
In the past, Technical Assistance had been funded at $250,000 per
year. Although a small amount when compared to other programs,
the appropriation was spread among many facilities since most
Technical Assistance provided W3S of short duration and the amount
of money needed for each consultation was relatively small.
The addition of Section 506 of the Act in 1978 caused confusion in
the Technical Assistance program since it provided for Technical
Assistance to "persons operating rehabilitation facilities" but
only for the purpose of removing architectural barriers. Funding
was shifted from Section 12 to Section 506 without the realization
that this would not allow funding traditional Technical Assistance
to rehabilitation facilities.
Two hundred and fifty thousand dollars should be appropriated in
fiscal year 1984 for Technical Assistance to rehabilitation facili-
ties under Section 12.
Rehabilitation facilities need access to experts to advise them on
issues relevant to providing employment and rehabilitation
145
services to disabled persons. The low cost per consultation and
the improvement in services resulting from the consultations make
the small appropriations most worthwhile.
8. A Community Service Employment Pilot Program was added to the Act
in 1978. Patterned after the Older Americans Act, it would have
promoted useful employment opportunities in public and nonprofit
agencies providing community services. In these times. of high
unemployment, handicapped persons have a particularly difficult
time finding employment. The reauthorization should direct imple-
mentation of this program.
9. Research regarding the development and improvement of rehabili-
tative treatment methods and rehabilitation engineering methods
and devices is critical to an effective rehabilitation service
system. The National Institute of Handicapped Research is under
new leadership and its programs are being administered well. The
problem now is essentially one of inadequate financial resources.
In this fiscal year, only 50% of the applications recommended for
funding were funded. Major funding increases are needed in fiscal
year 1984 and future years to support meritorious applications and
to initiate and expand new programs in research training and small
investigator-initiated grants.
10. There is a real need for a strong advisory panel to the Commis-
146
sioner of RSA for rehabilitation services and other programs
affecting handicapped persons. The National Council of the Handi-
capped was formed in 1978. to play both an advisory role and to set
policy for Rehabilitation Service Administration and to establish
research criteria for the National Insititute for Handicapped
Research. Because of the dominant role of politics in the selec-
tion of National Council of the Handicapped members and a lack of
independent staff, it has not been as effective as it could be as
an advisor to Rehabilitation Service Administration and NIHR. The
President's Committee on Employment of the Handicapped has been in
existence for many years but has never provided the leadership or
independence needed to be effective. The National Council of the
Handicapped has a budget of less than $200,000 while PCEH has a
budget of close to $2 million. A more effective advisory panel
might result from consolidating PCEH and the National Council of
the Handicapped. The Subcommittee should study the possibility of
this merger and hold hearings to determine whether this would be a
feasible approach. Legislative changes could be considered after
hearings and a thorough study.
11. Section 101 of the Rehabilitation Act should be amended to require
that states establish uniform rates of payment systems so that
facilities are adequately reimbursed for their services.
There is a direct federal interest in the rates of payment for
147
services utilized by state agencies which relates to cost effec-
tiveness. The Rehabilitation Act of 1973, as amended, both in the
state plan requirements and special provisions for facilities in
Title III indicates that the Rehabilitation Services Adminis-
tration and state agencies have responsibilities which transcend
the immediate purchase of services for vocational rehabilitation
clients. There is a clear mandate to these units of government to
insure that the rehabilitation system as a whole, including facili-
ties, be maintained with the capacity to render effective quality
service to vocational rehabilitation clients. The ability of facil-
ities and other providers to render services is a function of
their ability to cover the cost of rendering of such services.
Virtually all support for facilities other than payment for
services has been- excised from the federal budget. Facility
Improvement Grants, Innovation and Expansion funds, and the like
are no longer available. Accordingly, if rehabilitation facilities
are to retain the capacity to render services both in terms of
quantity and quality, it is essential that they both generate
revenues from operation at or above their costs.
State agencies cannot fulfill their responsibilities for mainten-
ance of facilities and utilization thereof while eroding the
capital base of facilities by paying less than the cost of
services rendered. It is suggested that the Act require only
payment of the actual cost of services provided. Such a provision
148
would be cost effective, as it will insure that the services
capacity of facilities does not deteriorate by virtue of rendering
services to clients under the state/federal program. The sugges-
tion that payment for services at rates less than cost is- "cost
effective" is inconsistent with the maintenance of a sound rehabil-
itation system. The federal government prescribes methods of pay-
ment to providers in such programs as Medicare and Medicaid. The
latter is analogous in legal structure and funding to the voca-
tional rehabilitation program as it involves state administration
and matching of federal funds for provision of services to desig-
nated beneficiaries. Accordingly, there is precedent for such
action which is presumably "appropriate."
12. Amend the requirements in the state planning process to require
greater public participation. Currently the Act does not require
public participation in the preparation of the state plan for
rehabilitation services. Specified times and methods of oppor-
tunity for public participation are needed to insure that all
persons affected by the rehabilitation program may play an active
role in the process.
13. Require RSA to have an office, bureau or division devoted to
rehabilitation facilities. At least 30 percent of basic state
funds are spent in facilities and a much higher percentage of
severely handicapped persons are probably served in facilities,
149
yet only two persons are assigned to the facilities branch- in RSA.
NARF urges the Subcommittee to consider the 13 points listed above when
they mark-up the bills reauthorizing the Rehabilitation Act of 1973.
NARF's staff is willing to offer any assistance requested by Subcom-
mittee members and their staffs that may be of help.
NARF appreciates the hard work this Subcommittee has performed on
behalf of disabled persons and looks forward to working with the
Subcommittee and staff.
150
Mr. MURPHY. Thank you, Mr. Cox.
Mr. Bartlett, do you have any questions?
Mr. BARTLETT. I do have a few questions.
First, Mrs. Walker, if we were to insert into the act the term
"qualified" counselor, as you suggested, I wonder what the immedi-
ate effect of that would be. Would you urge us to do that with no
phase-in? Would there be counselors throughout the country who
would then be unqualified, and thus be laid off? Would those posi-
tions then be unfilled? Do you have any idea as to the number of
unqualified or nonqualified counselors there are?
Mrs. WALKER. It varies widely between States, SO it is almost a
State-by-State number where you would find persons with graduate
training, preprofessional training in rehabilitation. NCRE and I
would not encourage an immediate action of that sort, but thinking
that this is a moment when the State agency has shrunk and per-
sonnel is at an all-time low, it is an opportunity to redirect for the
future and to assure that those persons who have had the specific
training would be hired as those agencies grow. That is why we
recommended it at this time. It has never been in the act before
this time.
Mr. BARTLETT. So you would tend to make it applicable to new
hires?
Mrs. WALKER. Yes.
Mr. BARTLETT. The second question is, can you give us some
sense or quantify the number of potential clients that are un-
served? You have recommended for training almost a doubling of
the budget over a 3-year period. Can you quantify the number of
clients that are served now and the number of clients that are left
unserved because of budgetary restraints?
Mrs. WALKER. I am afraid I can't give you a number. I am not
prepared to do that now. I think the caseloads have greatly in-
creased in State agencies with the reduction of case service funds
and with reduction of staff, but I don't have that information for
you. I would be happy to get that to you.
Mr. BARTLETT. I think what the committee would like to know is,
are you suggesting it is not so much a case of clients being un-
served but the quality of the service? Is it the case that as the case-
load increases per counselor, the quality goes down? People aren't
being turned away at the door, are they? I guess that is what I am
asking. Are people being turned away at the door because of budg-
etary constraints or are they just being served less effectively than
they would otherwise?
Mrs. WALKER. As I say, I do not know exactly. I will get that in-
formation to you. You understand, from what you are saying, that
quality is in a direct reciprocal relationship to the amount of hours
that staff has on the State agencies to devote to persons who are
coming for services?
Mr. BARTLETT. Yes.
Mrs. WALKER. That is correct, and I will try to supply you imme-
diately with that.
Mr. BARTLETT. Hence my question, and I would appreciate some
quantifiable numbers, if you could.
Mr. Cox?
151
Mr. Cox. Mr. Bartlett, if I may. Our data is largely anecdotal.
We lack a national aggregate data base to thoroughly document
unmet need; but our experience has led us to believe that as many
as three to four times the number of persons being served in facili-
ties are not able to be served because of the lack of available fund-
ing through the State agencies who purchase the services or pay
for the training slots.
There is a significant unmet need at the community level which
the agencies then seek to have met through other funding sources,
including charitable donations within the community. We have no-
ticed over the years that a reported unmet need of three to four
times the current number being served is being experienced in our
community agencies.
Mr. BARTLETT. One other question very quickly, and that is with
regard to the projects with industry, PWI. Is it your conclusion
that State agencies should be permitted to compete for those part-
nerships and for those grants?
I wonder what information you might have to help determine
whether we need a clarification in law to permit State agencies to
participate with PWI's. There are some 18 States, I am told, that
have applied and been denied because the statute, or at least the
administration's interpretation of the statute, doesn't permit it.
Mr. Cox. Where a State agency can show an effective liaison
with industry, the private sector partnership that is the intent of
the act, I feel that their application should be favorably considered.
The primary problem has been the limited amount of appropri-
ation available for projects with industry and the many good oppor-
tunities to form partnerships with industry. There has been great
success working hand in hand with specific sectors of industry.
There have been problems where projects have been developed in
States and grant applicants have not adequately coordinated with
State agencies in the application stage.
I believe this problem has been improved significantly, particu-
larly in the last 2 years, but I would not see any problem with
State agencies being considered as an applicant for these funds if
the appropriate link with industry had been formed and if it, in
fact, was not supplanting other State vocational rehabilitation re-
sources.
Mr. BARTLETT. You would not deny State agencies the ability to
compete for those private sector grants?
Mr. Cox. That has been the process, a competitive grant process,
and there have been far more applications than there have been
resources available.
Mr. BARTLETT. Thank you.
A very good panel, Mr. Chairman. Thank you.
Mr. MURPHY. Thank you, Mr. Bartlett.
To carry that one step further, do you have any specific recom-
mendations on how we can improve the coordination between the
State agencies and the placement in Projects with Industry SO that
it is not just a haphazard placement?
Mr. Cox. Mr. Chairman, you recall the A-76 process in the past
has required Federal grant applicants at the State level to coordi-
nate with appropriate agencies within the State.
152
While these coordination requirements may not be the same
today as they have been in recent years, an appropriate require-
ment for any applicant under PWI would be to notify the State VR
agency in the State from which they are applying of their intent;
also, there should be inclusion of representatives from State voca-
tional rehabilitation agencies in the panels that review these com-
petitive applications with RSA.
I believe that the coordination liaison, the communication prob-
lem, has improved significantly in the last couple of years, but
there has been a problem in State agencies not knowing, in fact, if
there was a PWI grant application or sometimes until the date of
award that it was coming into that State. This should be minimized
through better communication liaison between the applicant and
the State agencies.
Mr. MURPHY. Do you have any information on what percentage
of PWI placements last year were severely disabled?
Mr. Cox. No, sir, I do not, but we will certainly look into that
and see if we can provide some information to staff on that point.
[The information referred to follows:
153
NARE
NATIONAL ASSOCIATION OF REHABILITATION FACILITIES
P.O. Box 17675, Washington, D.C. 20041
(703) 556-8848
April 11, 1983
James A. Cox, Jr., Executive Director
The Honorable Austin Murphy
Chairman
Select Education Subcommittee
Education and Labor Committee
U.S. House of Representative
Washington, D.C. 20575
Dear Congressman Murphy:
At the hearing you conducted on March 23, 1983 you asked me a
question concerning the number of severely handicapped persons
served by Projects With Industry. PWI has been a program which
focuses on the end result of the rehabilitation process; the
placement of handicapped persons into competative jobs. All
handicapped persons placed into jobs under PWI have been
clients under the state rehabilitation programs. They may or
may not have received services previously from the state
rehabilitation agency.
While we do not have precise statistics on the number of
severely handicapped persons as opposed to non-severely handi-
capped person being served by PWI, the enclosed portion of a
memo from the Rehabilitation Services Administration indicates
that most of the 11,000 disabled persons participating in
Projects With Industry in FY 1982 were severely handicapped.
Please let me know if NARF can be of further assistance to you
or your staff.
Sincerely,
James James Executive A. Cox, Director a. Jr. Cox Jr.
JAC:dsg
Enclosure
154
7. PROGRAM INFORMATION
The Projects With Industry program is a. major private business
initiative involving corporations, labor organizations, trade
associations, foundations and voluntary agencies which operate
through a partnership arrangement with the rehabilitation community
to create as well as expand job opportunities for handicapped
people in the competitive market. As part of this program, train-
ing is provided for jobs in a realistic work setting, generally within
a commerical or industrial establishment coupled with supportive
services to enhance pre- and post-employment success of handicapped
people in the marketplace.
The Advisory Committee established for each project provides the
mechanism for members of the private sector to participate in policy-
making decisions. This active involvement affords business and
industry the opportunity to provide significant input into the
design and character of training programs needed to fill essential
jobs in the marketplace. Training, therefore, is generally geared
to existing job needs. As a direct result more than 75 percent of
trainees succeed in being placed in permanent jobs in business.
In FY 1982. about 11,000 disabled individuals mest of whom were
severely disabled, received services under this program. Seventy-
five percent of these individuals, or about 0,250 were placed
jobs In the competitive labori market. Fifty noncompeting
continuation projects and 15 new projects affiliated with more
than 2,500 private corporations were funded in FY 1982.
Because all Fiscal Year 1983 funds have been earmarked by the
Congress specifically for those projects which were funded in
Fiscal Year 1981, there will be no competition for new projects.
8. If additional assistance is needed, contact Walter J. Devins,
Division of Special Projects, Rehabilitation Services Administration,
Department of Education, 400 Maryland Avenue, S.W., Room 3518,
Mary E. Switzer Building, Washington, D.C. 20202, Telephone
(202) 245-3189.
Harold F. Shay
Hawed F. Shay
Director, Division of Special Projects
155
Mr. MURPHY. There is one point you made earlier that I don't
understand. You had a statement in your testimony that a substan-
tial amount of money is being returned by the States every year
when it cannot be matched or utilized during the year. Last year it
was $5.8 million, I believe.
Isn't it true that in each fiscal year there is some slippage be-
cause we do not coordinate the fiscal year of the States with the
Federal fiscal year and that these are not really moneys that are
not needed or that could not be matched?
Mr. Cox. No, sir. It is not a question that the appropriations are
not needed. They are needed, and increases, in fact, are needed. It
is a problem which can be attributed in part to the fiscal year that
will differ from State to State from the Federal fiscal year.
Many States begin their fiscal year without any real awareness
of what their final appropriations for that year will be. This has
led many times to cessation of services in the second or third quar-
ter because of the uncertainty of appropriation or to the dumping
of funds into grants in the final days of the last quarter. This is a
rather inefficient management system, and it is perpetuated in
part by the differences in fiscal years.
The specific request for consideration of the discretionary fund is
intended to show that the Commissioner could establish as national
policy some direction, some sense of priority if the discretion was
available and that it would not necessarily penalize or hurt the
States and their basic State allocations in that the approximately
$6 million figure, a significant sum of money, is perhaps going unu-
tilized under the current approach.
Mr. MURPHY. Would the situation be resolved if we were to actu-
ally forward fund to the State governments, something which the
act permits but we don't do?
Mr. Cox. That, I believe, has been helpful in the case of some
training program grants and also in special education. I am sure
the State administrators would welcome the opportunity to com-
ment on that when they testify. That could perhaps alleviate some
of the uncertainty which interferes with good management at the
State level of the appropriations.
Mr. MURPHY. Are there any further questions, Mr. Bartlett?
Mr. BARTLETT. No, thank you.
Mr. MURPHY. I want to thank the panel very much. We enjoyed
hearing you.
Mrs. WALKER. Thank you.
Mr. Cox. Thank you, Mr. Chairman.
[Whereupon, at 11:25 a.m. the subcommittee adjourned.]
OVERSIGHT AND REAUTHORIZATION HEARING
ON THE REHABILITATION ACT OF 1983
WEDNESDAY, MARCH 23, 1983
HOUSE OF REPRESENTATIVES,
COMMITTEE ON EDUCATION AND LABOR
SUBCOMMITTEE ON SELECT EDUCATION,
Washington, D.C.
The subcommittee met, pursuant to call, at 10 a.m., in room
2261, Rayburn House Office Building, Hon. Austin J. Murphy
(chairman of the subcommittee) presiding.
Members present: Representatives Murphy, Simon, Miller,
Biaggi, Corrada, Gaydos, Bartlett, Erlenborn, and Coleman.
Staff present: Judith Wagner, majority professional staff
member; Patricia Morrissey, minority legislative associate; and
Tanya Rahall, majority staff assistant.
Mr. MURPHY. Good morning. We apologize for starting a few min-
utes late. We also will give you an advance apology. We may not be
able to conclude the hearing this morning. We may not be able to
conclude markup today due to the rescheduling of the budget
debate on the floor and, of course, if any member of the subcom-
mittee objects to the continuance of markup, we then must imme-
diately discontinue, under the rules of the House.
But we will proceed. We will waive the reading of opening state-
ments, both Congressman Bartlett and myself, in order to expedite
the hearing and get to the witnesses we have this morning.
[Opening statement of Chairman Murphy follows:]
(157)
22-065 O - 84 - 11
158
OPENING STATEMENT OF HON. AUSTIN J. MURPHY, A REPRESENTATIVE IN CONGRESS
FROM THE STATE OF PENNSYLVANIA, AND CHAIRMAN, SUBCOMMITTEE ON SELECT
EDUCATION
THIS IS THE SECOND DAY OF OUR REAUTHORIZATION HEARINGS ON
THE REHABILITATION AcT. ON MONDAY WE HEARD FROM THOSE IN THE
FIELD, ON THE RECEIVING END OF FEDERAL REHABILITATION FUNDS. TODAY
WE WILL HEAR FROM THOSE WHO ADMINISTER THE PROGRAMS AT THE STATE
AND FEDERAL LEVELS,
CONGRESS HAS NOW RECEIVED TWO ADMINISTRATION PROPOSALS
AFFECTING THE FUTURE OF REHABILITATION PROGRAMS, THE FIRST,
THE NEW FEDERALISM BLOCK GRANT, WOULD GIVE COMPLETE AUTHORITY
TO THE STATES TO USE REHABILITATION FUNDS AS THEY CHOOSE, THE
JUSTIFICATION THE ADMINISTRATION GIVES, IN THEIR OWN WORDS, IS
"STATES CAN BEST DETERMINE THE REHABILITATION NEEDS OF THEIR OWN
CITIZENS AND THE MEANS OF MAKING THEM EMPLOYABLE". So UNDER
THE BLOCK GRANT PROPOSAL STATES COULD CHOOSE TO SERVE ONLY THE
SEVERELY DISABLED, OR NONE OF THE SEVERELY DISABLED; OR THEY COULD
EVENTUALLY CHOOSE TO TRANSFER ALL OF THEIR REHABILITATION MONEY
INTO PROGRAMS FOR NEGLECTED CHILDREN OR FOR LOW INCOME ENERGY
ASSISTANCE AND SERVE NO HANDICAPPED PERSONS AT ALL,
THE SECOND ADMINISTRATION PROPOSAL, WHICH WE RECEIVED
IN OUR OFFICE JUST YESTERDAY AFTERNOON, SO HAVE NOT FULLY
ANALYZED YET, TAKES A DIFFERENT APPROACH, IN THIS PROPOSAL,
THE ADMINISTRATION IS so CONCERNED ABOUT THE STATES PRESENT
SERVICE TO THE SEVERELY DISABLED THAT THEY WOULD RADICALLY ALTER
THE METHOD BY WHICH STATES ARE ALLOCATED FUNDS, AGAIN, TO
QUOTE THE ADMINISTRATION: "CURRENT LAW SIMPLY DOES NOT PROVIDE
ADEQUATE INCENTIVES FOR STATE REHABILITATION AGENCIES AND
159
PROFESSIONALS,
"
AT THE SAME TIME, HOWEVER, THIS NEW PROPOSAL ELIMINATES
THE SPECIFIC REQUIREMENTS FOR WHAT REHABILITATION SERVICES A
STATE MUST PROVIDE WHEN THEY ARE APPROPRIATE.
THE CONTRADICTIONS BETWEEN THESE TWO BILLS, AND WITHIN
THE SECOND ONE, LEAVE US PERPLEXED. WHAT DOES THE ADMINISTRATION
REALLY WANT TO DO TO A PROGRAM THAT HAS PROVEN ITSELF ONE OF
THE MOST SUCCESSFUL SOCIAL PROGRAMS AND ONE OF THE BEST INVEST-
MENTS THE FEDERAL GOVERNMENT HAS EVER MADE?
BECAUSE OF THE BRIEF TIME AVAILABLE THIS MORNING, AND
THE CONFLICTING MARK-UPS SOME OF US HAVE IN OTHER COMMITTEES,
WE MAY BE SUBMITTING SOME OF OUR QUESTIONS IN WRITING, BUT
WE LOOK FORWARD TO A THOROUGH DISCUSSION OF THE ISSUES, AND
APPRECIATE YOUR BEING HERE.
160
Mr. MURPHY. We're pleased to welcome Mr. Gary Bauer, Deputy
Under Secretary of the Office of Planning, Budget, and Evaluation
with the Department of Education. Mr. Bauer, you may proceed.
STATEMENT OF GARY BAUER, DEPUTY UNDER SECRETARY,
OFFICE OF PLANNING, BUDGET, AND EVALUATION, DEPART-
MENT OF EDUCATION
Mr. BAUER. Thank you, Mr. Chairman.
Mr. MURPHY. Thank you.
Mr. BAUER. Let me begin by introducing the other individuals
with me this morning. At my left is Mr. George Conn, Commission-
er, Rehabilitation Services Administration and Acting Assistant
Secretary for Special Education and Rehabilitative Services. Also,
at his left, is Wilmer Hunt, Acting Deputy Commissioner, Rehabili-
tation Services Administration. And to my right is Carol Ci-
chowski, Acting Director, Division of Special Education, Rehabilita-
tion and Research Analysis, Office of Planning, Budget, and Evalu-
ation.
If I may, I will try to go through my statement rather quickly
and see if we can have some time for some questions and answers.
I am pleased to present the testimony for the Department of
Education on the subject of reauthorization of the Rehabilitation
Act of 1973, as amended. The act, as amended, authorizes the allo-
cation of Federal funds on a formula basis to States to provide serv-
ices to assist disabled individuals to prepare for and engage in gain-
ful occupations. Significant progress has been achieved over six
decades to develop a service delivery system in the States to reha-
bilitate disabled persons.
However, we are proposing amendments to the act as part of our
reauthorization effort because we believe there is room for im-
provement in the rehabilitation outcomes that can be achieved for
the severely disabled. For example, about three-quarters of all re-
habilitants are placed in the competitive labor market, but for the
severely disabled the proportion is only about 65 percent.
In fiscal year 1981 the mean weekly earnings at closure of se-
verely disabled rehabilitants with earnings was $148. For the non-
severely disabled, $168.
Over one-half of the severely disabled rehabilitants received less
than the Federal minimum wage in 1981 while 21 percent received
no wages at all at case closure. Current law simply does not pro-
vide adequate incentives for State rehabilitation agencies and pro-
fessionals to provide services that produce lasting functional and
economic independence at the highest possible levels to the most
severely disabled clients.
Regardless of performance, the States receive their funds accord-
ing to a formula based on population and per capita income. The
current measure of success used by the program assigns credit on,
we believe, an overly simplistic basis, by combining into a single
category employment in the competitive job market and sheltered
workshops, unpaid work of homemakers, and unpaid family work.
Several audits and evaluation reports have also indicated that
changes are needed in the current rehabilitation system to improve
rehabilitation outcomes, especially for the most severely disabled.
161
In 1976 the General Accounting Office reported to the Senate
Subcommittee on the Handicapped that since counselors have tra-
ditionally been rated on the basis of the number of persons they
rehabilitate and the severely disabled are more costly to rehabili-
tate, counselors would naturally have some reluctance to allocate a
significant portion of their resources to rehabilitating the severely
disabled, which would result in rehabilitating a smaller number of
clients.
GAO noted that rehabilitation counselors believed that a system
which accounted for the cost and difficulty of the cases would give
added incentive to increasing services to the severely handicapped,
since the emphasis on sheer numbers would be reduced.
There have been several other studies in recent years that make
the same points and we will submit those for the record.
We recommend that the Congress consider changes to the Reha-
bilitation Act of 1973, as amended, that would advance the follow-
ing principles: Reward States for good performance in rehabilitat-
ing the severely disabled; establish a more meaningful measure of
program success capable of influencing the talents and energies of
State vocational rehabilitation agencies, which will ultimately pro-
duce greater functional and economic independence for disabled cli-
ents; provide greater State flexibility in the provision of services;
and promote stricter accountability to standards in such areas as
client eligibility and case closuré.
We propose that title I be amended to reward State performance
in rehabilitating the severely disabled by distributing part of the
funds appropriated for State grants on the basis of a weighted case
closure system. Beginning in 1985 one-third of the State grant
funds would be allocated to the States on the basis of their per-
formance in rehabilitating the severely disabled.
Rehabilitation would be weighted to maximize the financial in-
centive for placement in jobs that achieve economic independence.
Rehabilitations resulting in employment at or above the Federal
minimum wage, which would incorporate statutory or regulatory
exceptions for sheltered workshops and work activity centers,
would receive a weight of 1.5. Each rehabilitation resulting in em-
ployment below the Federal minimum wage would receive a weight
of 1.
In recognition of the economic and independence value of unpaid
homemaking and family work, these rehabilitations would receive
a weight of 0.5.
To insure that employment outcomes are stable as well as finan-
cially rewarding, the definition of "successful rehabilitation" would
be strengthened to require 120 instead of 60 days of employment.
The remaining two-thirds of the appropriations would be allotted to
the States using a simplified version of the current formula based
on population and per capita income squared.
To provide sufficient time for the States to adjust to the proposed
changes in the formula, hold harmless provisions have been includ-
ed for fiscal years 1985 and 1986.
We're also proposing changes to take effect in fiscal year 1984 de-
signed to provide greater State flexibility in the planning, adminis-
tration, organization and delivery of rehabilitation services. For ex-
ample, the amendments retain the requirement for a sole State
162
agency to administer the program, but eliminate the detailed provi-
sions prescribing how that agency is to be organized and adminis-
tered.
The bill would retain and improve the provisions which provide
protections and rights for the handicapped. The bill would retain
requirements relating to the priority for providing services to the
severely disabled, the individualized written rehabilitation pro-
gram, the availability of personnel trained to communicate in the
client's native language, the prohibition against residency require-
ments, the review of sheltered workshop closures, and affirmative
action for the employment of qualified handicapped individuals.
The bill would revise appeal procedures concerning State review
of agency determinations, to include both determinations concern-
ing eligibility of an individual as well as the appropriateness of the
rehabilitation services provided.
The bill would also add a provision requiring the State agency to
provide client assistance services to all clients and client appli-
cants, including information and advice concerning the benefits
available under the act, assistance in pursuing legal, administra-
tive, or other remedies under this act, and appropriate referrals to
other State and Federal programs.
In addition, the bill includes a new provision protecting the confi-
dentiality of personal information provided by clients to counselors
and agencies.
In order to provide for the continued development of a compre-
hensive and coordinated program of handicapped research and the
dissemination of information on the most effective practices, title II
authorizing the conduct of handicapped research through a Nation-
al Institute of Handicapped Research, is retained under the bill.
A variety of existing discretionary programs are included in title
III under a single authorization of appropriation. The purpose of
title III is to authorize grants for projects of national or regional
significance or projects that meet the unique needs of special
handicapped populations.
Although we are not proposing to change the scope or type of ac-
tivities funded under these authorities, we are proposing some
modifications. For example, we are proposing to extend eligibility
for grants and contracts under these activities to for-profit organi-
zations. We are also proposing to eliminate specific matching rates
and to authorize the use of Federal funds to pay all or part of the
cost of projects funded under these programs.
For the longer term it is the administration's goal to reorganize
Federal-State delivery of rehabilitation services by returning reve-
nue sources and full program authority to the States. On February
24 the administration transmitted proposed legislation to the Con-
gress that would give States the option of designating a number of
programs for turnback during the period of 1984 through 1988.
The vocational rehabilitation program is included in the list of
programs that may be designated by participating States because
the administration believes the ultimate responsibility for rehabili-
tating the disabled population can appropriately be assumed by the
States.
163
Rehabilitation services have long been delivered by State agen-
cies. States can best determine the needs of their own citizens and
the means of making them employable.
In summary, we believe that the administration's proposal would
improve rehabilitation outcomes for the disabled by enhancing
both the incentive and the capability of State agencies to make the
most effective use of Federal, State, and local resources in serving
the disabled. I'd be happy to answer any questions that you may
have.
Mr. MURPHY. Thank you very much. Do you have all of your pro-
posals in bill form, the amendments that you have suggested?
Mr. BAUER. Yes; everything has been sent in bill form to the
Congress.
Mr. MURPHY. OK, fine. I haven't seen it, but apparently it did
arrive late yesterday afternoon.
Mr. BAUER. Yes; I believe it was yesterday.
Mr. MURPHY. I have not had an opportunity to compare it with
our bill. We will make an effort to do that before we have full com-
mittee markup.
Mr. BAUER. Thank you.
Mr. MURPHY. Mr. Bartlett, do you have any questions?
Mr. BARTLETT. Thank you, Mr. Chairman. I have a number of
questions, if the Secretary would help to sort of lead me through
some of the answers. Like Mr. Murphy, I hadn't seen the actual
bill form and I suppose perhaps as we work down the line on this,
it would help us, as Members of Congress, before we get right up to
a few days before markup, to have a chance to really sit down and
do a section-by-section analysis of the proposal because it's very de-
tailed and I think many of the proposals may be very helpful in
terms of providing better rehabilitation services.
Let me first begin, there have been, as I understand it, 18 State
agencies that have requested to compete for the projects with in-
dustry grants and have been denied because States are not includ-
ed in the actual statutory language. Can you clarify where that
stands and would it require, then, if this committee and if Congress
wanted to include State agencies as qualifying for PWI, would that
require an amendment in the bill?
Mr. BAUER. I will ask Mr. Conn to address that question.
Mr. CONN. Mr. Congressman, the States are presently permitted
to participate in projects with industry programs under section 110
of title I of the Rehabilitation Act. At the State level they have the
full flexibility to develop their own PWI programs and many have
done so.
The statute does not state that State VR agencies are to be par-
ticipants in the discretionary PWI program.
It is intended, and I think appropriately so, to address the needs
of how to develop rehabilitation capabilities and components
within the private sector, and that's what we're trying to do at this
time with that discretionary program.
Mr. BARTLETT. So at the present time a State agency is prohibit-
ed fron applying for a discretionary program under PWI?
Mr. CONN. Under the statute.
Mr. BARTLETT. Under the statute?
164
Mr. CONN. On the discretionary side, sir. Under the State grants
program, however, they can utilize their own moneys to develop
projects with industry with local. corporations or with small busi-
nesses.
Mr. BARTLETT. Two days ago I suppose we all received a commu-
nication from the Vice President on section 504 that the adminis-
tration contemplates no changes in the regulatory structure of 504
and I wonder if you could confirm that this morning or could you
tell us what the status is? Do you anticipate that there will be no
regulatory changes in 504 during this session or this year or the
next 2 years or for the foreseeable future?
Mr. BAUER. No; we don't anticipate any changes.
Mr. BARTLETT. You have suggested, in your testimony and in the
bill, the removing of-and I don't have the page number to refer
to-removing of certain minimum services. I wonder if you could
elaborate on that somewhat and describe how that would improve
the program.
Ms. CICHOWSKI. Currently the statute requires the State agencies
to make available a variety of services, including counseling, train-
ing, and evaluation. We have eliminated the requirement that the
States provide these specific services. This is not to suggest that the
States would not, in the exercise of their discretion, choose to pro-
vide these services, but we thought it was appropriate to give the
States the broadest discretion to put together a service package
that they think is most appropriate to achieve rehabilitation out-
comes for their clients.
With our emphasis on outcome, we thought the States should
have the flexibility to determine what is the best way of meeting
that goal and achieving those outcomes for individuals.
Mr. BARTLETT. So it would leave it to the States to set that appro-
priate level of services as they compete for the grants?
Ms. CICHOWSKI. Yes. Our amendments would put the emphasis of
the program on rehabilitation outcomes. We are proposing changes
because we've been concerned that the current law does not give
enough attention to outcomes. Currently, the definition of rehabili-
tation does not distinguish between placements in competitive em-
ployment and unpaid work. A counselor is given credit for a suc-
cessful rehabilitation regardless of the type of job the individual is
placed in, regardless of the length of employment. If the individual
has retained employment for 60 days, the placement is counted as
a successful rehabilitation.
What we're proposing to do is to change the statute SO that there
will be more attention paid to the quality of the outcome that is
achieved. In doing so, we think it's appropriate to give the States
increased discretion in determining the kind of services they think
are most appropriate for achieving those outcomes.
They may opt to put their emphasis in a different place, for ex-
ample, pay more attention to job placement and training versus
physical and medical restoration.
Mr. BARTLETT. Under your reward system or the performance
system, let me see if I understand it precisely. You would change
the formula, beginning in fiscal year 1985 in a way that would
reward States for their performance in terms of number of cases
closed? Is that generally the criteria? If so, I would ask if, in your
165
formula, you have given any special weight to assisting severely
handicapped as opposed to
Mr. BAUER. Yes; the formula, beginning in 1985, would allocate
one-third of the money that the States receive on a competitive
basis based on the performance of the State in rehabilitating a
weighted number of severely disabled persons.
Mr. BARTLETT. So it would weight the number of severely dis-
abled?
Mr. BAUER. Yes. The whole competition would be based specifi-
cally on that category of the disabled.
Mr. BARTLETT. Would it be prospective competition or retrospec-
tive? That is to say, would it be based on the number of rehabilita-
tions that are contemplated in the application or as it happened
last year in the State?
Ms. CICHOWSKI. The competition would be based on their per-
formance in the prior year.
Mr. BARTLETT. And that's only one-third of the funds?
Ms. CICHOWSKI. Yes.
Mr. BARTLETT. And you would also include a hold-harmless
agreement SO that no State would receive less money than they
had on what base year?
Ms. CICHOWSKI. We have included hold-harmless provisions for
fiscal years 1985 and 1986, the first 2 years of performance-based
funding. In fiscal year 1985 a State would receive no less than 90
percent of what it received in fiscal year 1984 and in the following
fiscal year, fiscal year 1986, the hold-harmless allotment would be
decreased to 75 percent of what each State received in fiscal year
1984. The purpose of the hold harmless provisions is to ease the
transition from the current law to performance-based funding.
Mr. BARTLETT. OK.
Mr. CONN. Mr. Bartlett?
Mr. BARTLETT. Yes, sir, Mr. Conn?
Mr. CONN. Some of the thinking that went into this proposal
came out of the congressionally mandated White House Conference
on Handicapped Individuals between 1975 and 1977. I headed for a
while, and was overall director of planning for the economics con-
cern section of that conference. A number of disincentives to em-
ployment were identified for handicapped.
The desire to have the independence, self-sufficiency, and the dig-
nity of a job that has been thwarted, to some extent, by these disin-
centives. That was a major topic of the conference. The materials
are available to Members of Congress if they wish to review them,
and much of our thinking was based on the results
Mr. BARTLETT. Could we get a summary of that?
Mr. CONN. Yes.
Mr. BARTLETT. Of that conference and the result of that and per-
haps put it in the record.
Mr. CONN. Yes.
There was a report made to Congress made at the termination of
the White House Conference, and it should be available to you.
We'll see that you get it.
Mr. BARTLETT. OK.
On the subject of State flexibility, I wonder if you could outline
or give examples or quantify in some way those areas in which you
166
think that State agencies don't have sufficient flexibility now. In
what ways could State agencies improve their programs if they
were given more flexibility?
Mr. CONN. For quite some time the successive commissioners of
Rehabilitation Services have met with the Council of State Admin-
istrators of Vocational Rehabilitation. The State administrators
from time to time have identified what I think is a serious prob-
lem, and that is the influence of the Federal Government on the
operations of rehabilitation activities at the State level.
We are simply trying to give the States more flexibility and we
have found over the years, especially in the past 5 to 10 years, that
the amount of dialog and cooperation between constituent groups
of disabled people, other professionals in the field of rehabilitation,
and the State directors, has increased and improved dramatically
and that the States now are ready to do an excellent job of fully
administering the programs at their level, with all the flexibility
that they need.
We don't feel that the Federal Government has to have as great
an interest or presence as it's had in the past.
Mr. BARTLETT. One last factual question, if you know the answer.
If not, if you could send it to us. If you could tell us, of the total
number of cases that have been placed or closed for each year since
1978, what percentage of those closed cases have been classified as
unpaid homemakers?
Ms. CICHOWSKI. The only figure I can recall is for fiscal year
1981. I believe approximately 20 percent of the
[Audience reacts.]
Mr. BAUER. I detect a note of protest.
Mr. BARTLETT. I think we'd like to have that number, that quan-
tified number. [Laughter.]
Ms. CICHOWSKI. Twenty percent of severely disabled rehabilita-
tions were in unpaid employment. The percentage of cases closed
as homemakers is lower than that. But placement in paid work is
one of the concerns we have. We think there may be excessive reli-
ance on placement in unpaid jobs which is why, although we're
proposing to give some weight to those closures, we're proposing a
lesser weight for closures in that type of work to give an increased
incentive to placement in paid jobs and competitive employment.
Mr. BARTLETT. So you would have a lesser weight?
Ms. CICHOWSKI. Yes.
Mr. BARTLETT. Thank you, Mr. Chairman.
Mr. MURPHY. Thank you, Mr. Bartlett. We have since been
joined on the panel by Mr. Miller of California, and Mr. Conte of
Massachusetts. Mr. Conte must return to the floor within a few
minutes and would like the opportunity of introducing Mr. Bartels
from his home State of Massachusetts. Mr. Conte?
Mr. CONTE. Thank you, Mr. Chairman.
I want to thank you for this opportunity. It seems as though I
just left this subject last week, when I had these witnesses before
the Appropriations Subcommittee on Health and Human Services
and Education.
It gives me great pleasure to present to you today an outstanding
professional in the field of vocational rehabilitation. Commissioner
Elmer C. Bartels will be testifying before you in a few minutes on
167
the valuable contribution the Rehabilitation Act of 1973 has made
to the physically and mentally handicapped persons in the Com-
monwealth of Massachusetts.
In 1977 Elmer Bartels was appointed by Gov. Michael Duka-
kis as Commissioner of the Massachusetts Rehabilitation Commis-
sion. Since then great advances have been made in providing
much-needed services for eligible disabled persons. Through this
successful program and through the efforts of Elmer Bartels,
handicapped people have been put to work. In fact, I'm pleased to
report that this year alone over 4,600 handicapped persons have
been placed in suitable positions in Massachusetts. This has re-
duced their dependency on programs such as supplemental security
income and the social security disability insurance, while increas-
ing their own financial independence.
Here is a program which will assist those in need and which,
with relatively very little money, will help those people become self
sufficient. For every dollar spent on such services, $10 in benefits
are generated to offset this expenditure.
This program has proven itself to be cost-effective and invalu-
able. There can be no argument to refute the need for this program
on the basis of its 63-year successful track record. I have committed
my support to the Rehabilitation Act of 1973 and I urge you to do:
the same and to give your full attention to the man who helped
contribute so much to making this program the success it is today.
May I introduce to you the Commissioner of the Massachusetts Re-
habilitation Commission, Elmer C. Bartels. Thank you again for
your courtesy and your kindness here this morning. I'll see you at
the Appropriations Committee, Commissioner Bartels.
Mr. BARTELS. Yes.
Mr. CONTE. I'll be there, Mr. Chairman and Commissioner Conn,
when you need me.
Mr. MURPHY. We're happy to have you in that capacity, Mr.
Conte.
Thank you very much; Mr. Conte. We will get to Mr. Bartels' tes-
timony shortly. I do have one or two questions remaining for the
administration:
The administration has proposed to apply an incentive mecha-
nism to the distribution of one-third of the amount available for
the basic State program. But an incentive provision based on post-
rehabilitation earnings might encourage State agencies to select for
service those severely handicapped cases which are easiest and
cheapest to rehabilitate in order to improve their record. Don't you
see the danger of that occurring?
Mr. BAUER. Well, I think to some extent there is a danger in the
program as it is currently conducted of what may be called cream-
ing. Without any competitive procedure at all in the program,
States may, in fact, take limited dollars and apply them to the
most easily rehabilitated cases. Something of the same danger may
exist to some extent in our proposal, but at least we are trying to
guarantee that a significant portion of funds be awarded on the
basis of service to the most severely disabled and creaming, to the
extent it takes place, would at least take place in that category
that most needs the assistance.
168
Mr. MURPHY. But you would be encouraging the creaming by
your method of reimbursement, rather than encouraging the States
to treat every severely handicapped person with equal fervor. They
are going to attempt to improve their weighted closures. That's
really creaming.
Mr. BAUER. Well, by definition, under our proposal, one-third of
the money will be awarded on the basis of performance in rehabili-
tating the severely disabled.
Mr. MURPHY. Mr. Conn.
Mr. CONN. Mr. Chairman, I might point out that the problem of
dealing with the easy rehabilitation is, one that was addressed by
the GAO in the past and in their most recent report. We discussed
that with our own staff and we also called in representatives from
the Council of State Administrators of Vocational Rehabilitation to
see what the situation was SO that we could respond to the GAO.
We found that the State directors have made an excellent effort
to reduce the amount of so-called creaming going on, to a point
where it is almost nonexistent. Our effort here is a sincere one to
comply with the recommendations of GAO. Incidentally, we were
not asked by the GAO to respond in writing to their recommend-
ations, but we're glad we have the opportunity to do SO today in
testimony.
Our effort here is a sincere effort to add another incentive to
allow the State directors to direct their best efforts toward meeting
the needs of severely handicapped. people.
Mr. MURPHY. Your proposal does not say the "most" severely
handicapped. It just says the "severely handicapped". You have
also just pointed out, another reason why I'm reluctant to change
the present language. You have indicated the great success that
the State directors have had in not skimming, not taking the
cream, not taking the best, that they have reduced "creaming" to a
minimum.
Mr. CONN. Yes.
Mr. MURPHY. And I'm afraid that your proposal. is going to en-
courage creaming, as we refer to it.
Mr. CONN. Well, we would respectfully disagree, sir. We feel that
that's the type of an incentive that could be used very well.
Mr. MURPHY. It's an incentive to show a better statistics rate and
not a better rehabilitation process.
Mr. CONN. No, sir.
Ms. CICHOWSKI. Mr. Chairman, if I may add to that. The States
may have made progress with respect to accepting severely dis-
abled clients and getting them into the caseload and, in fact, clos-
ing them as successful rehabilitants.
What we're concerned about is the quality of the case closure.
The current program does not address the kind of closure, or the
retention of employment.
A State agency gets credit for closing a case as successful regard-
less of the type of job the individual was placed in, and that's the
emphasis we're proposing to put into the program. We believe that
credit for a closure should take into account not only the severity
of the disability but also the kind of job and the wage level. We
think this will better assure that severely disabled individuals are
169
given the maximum opportunity for placement in competitive em-
ployment.
Mr. MURPHY. Well, I laud your goals as you state them but it
concerns me. What if we have States with high unemployment
rates and they work feverishly and then they are penalized because
there's no place to put even non-handicapped workers into mean-
ingful employment?
We would be taking money away from programs that in the long
run could be successful but in the short run won't show the statis-
tics to get the dollars for the next year. This again would lead to a
greater incentive to skim. I guess we want to accomplish the same
purpose, but we don't agree on the paths.
Mr. CONN. Mr. Chairman, I went through this process after being
injured on active duty with the Air Force in 1957 in the State of
Illinois. First at Scott Air Force Base near Representative Simon's
area.
We have worked in the past in the State of Illinois as colleagues
on this very subject of assisting disabled people, especially those
who are severely disabled. With two baccalaureates and a semester
of law school following Air Force service, I came out as a paraple-
gic and it took me 2 years and 175 interviews to get the first job
that I had.
Subsequent to that, I have listened to the desires of my fellow
disabled people in Illinois, and the States of Washington, Mary-
land, and Virginia, and I have heard them ask for more help, fewer
disincentives, and greater incentives for the opportunity to find a
job for which they are qualified, at or above the minimum wage.
We are trying to give the rehabilitation agencies the credit for
doing that type of a quality placement, to the best of our ability,
and nothing less than that. We feel that's a very laudable goal.
Mr. MURPHY. Well, I think it is a laudable goal, I really do, and I
don't want to nit-pick with you, Mr. Conn. You've gone through it
and you know your business better than I, but wouldn't it be far
better to provide all the necessary rehabilitation services and not
depend on statistics?
You went for 175 interviews. Why should we hold that negative
statistic against the State of Illinois so that it would not receive
what it needs to conduct a program while you are a negative statis-
tic?
Mr. CONN. By improving the placement process, by providing an
incentive, by stream-lining, we can reduce that..
Mr. MURPHY. I just don't know whether a placement process im-
provement will be accomplished by saying you don't get the money
if you don't place them.
Ms. CICHOWSKI. Mr. Chairman, regardless of whether Congress
chooses to adopt any of the changes we are proposing, there contin-
ues to be a considerable interest on the part of both the Congress,
our agency, and the State legislatures in the statistics and that's
our concern. There has been too much focus on the sheer numbers,
numbers of rehabilitations, numbers of closures, and not enough in-
terest in the quality of the closure. That's our point here today,
that, unfortunately, counselors are rated and judged on the basis of
these numbers by the State legislatures, by the Congress, and that
170
not enough attention is paid to the kinds of jobs the individuals are
placed in and whether or not they retain their jobs over time.
Mr. MURPHY. OK.
Do my colleagues have any questions of the administration?
Mr. SIMON. Just an observation. As I look at the figures of the
numbers who are served, and the total cases served, it appears to
me that what we need is not SO much incentive as just plain old
dollars out there to get the job done.
My instinct, and I particularly respect a man who even knows
where southern Illinois is--
Mr. SIMON. My instinct, my observation, is the people who are
working in this field really do not lack motivation. The motivation
is there. But we need to give them the tools.
I have no questions other than that, Mr. Chairman.
Mr. MURPHY. OK.
Yes, Mr. Miller?
Mr. MILLER. I don't quite understand the statement about the
goals you're trying to achieve. The suggestion would seem to be
that the people who are involved in this process today are only
finding crummy jobs for people. Aren't they trying to find the best
paying, the most rewarding, the most career oriented job that they
can for clients today?
Mr. BAUER. Yes.
Mr. MILLER. Well, then that's allowable under the law. We don't
require crummy job placement? [Laughter.]
I just don't understand the suggestion that somehow your propos-
al would SO dramatically change the goals and allow something to
take place that's not allowed to take place today.
Mr. CONN. This is not something that we consider frivolous at
all.
Mr. MILLER. It's not a matter of frivolity: It's a matter of wheth-
er we embark on an entirely new program.
Mr. BAUER. There apparently is a matter of frivolity to the audi-
ence.
Mr. MILLER. Just a second. The matter is whether we evolve an
entirely new program to replace that which is already allowed
under the law today.
Mr. CONN. The rehabilitation field has had a problem with defi-
nitions for quite some time, as the program has become more so-
phisticated, as the law has been broadened, and as more elements
have been brought into the act, such as in the Rehabilitation
Amendments of 1974 and 1978, the so-called civil rights portion, et
cetera.
But to give you an example of what we're concerned about and
how we're trying to resolve this, for a long time we depended on a
medical model or a medical definition of disability. A person was
either minor, moderate, or severely disabled.
On the other hand, we found that the Department of Labor and
other committees in the Congress were using another definition
which was an occupational definition. The person was either em-
ployable or unemployable. The two definitions worked at odds with
one another.
The rehabilitation field has worked long and hard to try to blend
the two together to try to come up with a functional assessment.
171
Each time the Rehabilitation Act has been amended we have tried
to address the definition of what is a rehabilitation as opposed to
what is a placement.
Right now we have a definition of a successful rehabilitation,
meaning a placement on the job for 60 days. We simply find that
that is an unsatisfactory definition. Both in terms of the service
provider and the service recipient. We feel that the challenge must
be greater and the incentive greater to insure a better job, that
measures up to the capabilities of the individual, a job for which
the individual is qualified, and that the person should be employed
in that job at least at or above the minimum wage to get the great-
est credit for the rehabilitation.
Mr. MILLER. Isn't there some internal inconsistency, and correct
me if I'm wrong, that employment for 60 days may be the goal be-
cause that may be somewhat difficult to achieve, and yet at the
same time the administration, if I am correct, is withdrawing from
regulations the availability of postemployment counseling, services
for independent living, those kinds of items that would allow, per-
haps, individuals to stay on the job or improve their job status
after a period of time.
You may increase the success of the 60-day achievement by pro-
viding additional services after a person becomes employed.
Ms. CICHOWSKI. Mr. Miller, we haven't proposed any changes in
authorized services under the program. I don't know what you're
referring to with respect to independent living and postemploy-
ment services.
Mr. MILLER. Well, it seems to me that under your block grant
that services for independent living, all this gets mixed with a lot
of other funding. You have this incentive on placement while post-
employment services has become somewhat less of a priority. And
I'm just determining what is the mix that this substantial change
in the law would provide that is not provided for today?
Ms. CICHOWSKI. If I may comment on postemployment services,
our proposed change that would strengthen the definition of suc-
cessful rehabilitation by increasing the number of days in suitable
employment from 60 to 120 that would be required to count a
placement as a successful rehabilitation. That should enhance the
incentive to provide postemployment services, if those services are
required to assist the client in retaining employment.
Mr. MILLER. OK.
Mr. CONN. Mr. Miller, another thing that we are trying very
hard to do is to open up the private sector. We are seeing more and
more that the private sector has recognized the value of the reha-
bilitation process and as companies become more involved in this
directly they are beginning to build rehabilitation into their own
corporate structure.
Through our discretionary programs we hope to continue this
process, primarily through projects with industry and other pro-
grams.
Eighty-five percent of the jobs that exist in the United States
exist in the private sector, either in large corporations or in small
businesses. The rehabilitation program is really an evolutionary
program. It is the last of the most vulnerable subpopulation groups
172
in the United States to be served in terms of direct governmental
services, private sector initiatives, and also civil rights.
Mr. MILLER. Do those efforts remain mandatory under your pro-
vision?
Mr. CONN. Yes.
Mr. MILLER. Within the State block grant?
Mr. CONN. Within the State block grant, no. It would give the
states greater flexibility.
Mr. MILLER. Flexibility worries me coming from this administra-
tion. [Laughter.]
We ought to withhold the applause and comments from the audi-
ence.
Mr. MURPHY. Yes, the audience should withhold its reactions.
Mr. BAUER. Thank you very much.
Mr. MILLER. Just one final question. On this question of postem-
ployment services, was not that eliminated from State plan re-
quirements under the most recent go-around?
Ms. CICHOWSKI. What I was suggesting is that postemployment
services continue to be authorized services.
Mr. MILLER. But previously weren't there required assurances by
the States that they would provide professional development train-
ing for counselors, and that they would develop postemployment
plans?
Ms. CICHOWSKI. We have eliminated a State plan requirement
that relates to the provision of postemployment services, yes. But
the point I was making is that the agencies continue to have the
authorization.
Mr. MILLER. Is the State still required to assure the Federal Gov-
ernment that they're making that effort or is that just one of the
things they may choose to do?
Ms. CICHOWSKI. No. It would be an authorized service but the
States would not have to assure us that they are providing this
service. Though again, I would emphasize that they would have an
incentive to provide postemployment services to the extent that
that would help enable a client to retain employment.
Mr. MILLER. Well, why are we not requiring them to continue to
assure us that that's what they are going to do? Why would you
change that in the middle of this operation?
Ms. CICHOWSKI. To the extent we've strengthened an incentive to
provide those services it wouldn't be necessary to require them to
include this item in their State plan.
Mr. BAUER. We're trying to focus on outcomes and not proce-
dures, Mr. Miller.
Mr. MILLER. Do you know how you get to outcomes? You go
through procedures.
Mr. BAUER. Well, I would assume the people closest to the prob-
lem can choose the procedures that best reach the outcomes in
their particular State.
Mr. MILLER. Do you want to relive the Florida experience?
Mr. BAUER. Well, no. I just think we have a lot of faith in many
of the people in this audience to make the right decisions when at-
tempting to reach appropriate outcomes for their clients.
173
Mr. CONN. I don't think we'll have to in Florida, Mr. Miller, be-
cause the new State director there is a disabled woman and I doubt
that will be the case.
Mr. MURPHY. Any further questions, anyone?
OK, we thank the panel very much and welcome your testimony.
We will also review the material you sent up to us yesterday before
we have full committee markup.
Mr. BAUER. Thank you, Mr. Chairman.
Mr. MURPHY. Thank you.
Our next witnesses are a panel, Norma Krajczar-I may be
mispronouncing that name-Elmer Bartels, Vernon Arrell, and
Donald Wedewer.
STATEMENT OF A PANEL OF WITNESSES: NORMA KRAJCZAR, DI-
RECTOR, NEW JERSEY COMMISSION FOR THE BLIND; ELMER
BARTELS, DIRECTOR, MASSACHUSETTS REHABILITATION COM-
MISSION; VERNON ARRELL, COMMISSIONER, TEXAS REHABILI-
TATION COMMISSION; AND DONALD WEDEWER, DIREC-
TOR, DIVISION OF BLIND SERVICES, FLORIDA
Mr. MURPHY. Norma Krajczar, the director of the New Jersey
Commission for the Blind, will be the first witness. Let me add, my
colleague from California made the point about the rules of the
House. I understand why the audience wants to applaud or boo or
whatever, but under the rules of the House that is not permitted.
Ms. Krajczar, am I doing reasonably well on your last name?
Ms. KRAJCZAR. As well as anyone does, Mr. Chairman. Crytz-er.
Mr. MURPHY. Crytz-er. All right.
Ms. KRAJCZAR. Mr. Chairman, in view of the introduction by
Congressman Conte of Commissioner Bartels, with your permission
I would like to defer the introduction of this panel's comments to
Commissioner Bartels.
Mr. MURPHY. Mr. Bartels, we will be pleased to hear from you,
the Director of the Massachusetts Rehabilitation Commission.
Mr. BARTELS. Thank you, Mr. Chairman. It's a pleasure to be
with you and with members of this honorable subcommittee. I
would also like to formally thank Congressman Conte from Massa-
chusetts, who has been so helpful to the rehabilitation program
through his membership on the House Appropriations Committee
and particularly his leadership in the area of disability with re-
spect to the other programs of this Nation, particularly the social
security program.
I think this subcommittee has an outstanding history of support-
ing the vocational rehabilitation program. I would personally like
to thank you for that and also on behalf of the Council of State
Administrators of Vocational Rehabilitation.
Our council represents the State directors of every program in
this country. We are an organization committed to be supportive of
the Rehabilitation Act and to be supportive of disabled people in
the United States.
The vocational rehabilitation program, we feel, is a very impor-
tant one and one that we are all committed to.
22-065 0 84 - 12
174
We are committed to the vocational rehabilitation program as
administrators and in performing the program in a quality way
back home, SO to speak.
The rehabilitation program, as we have heard this morning,
helps handicapped people get to work. Where the rubber hits the
road in this program is in the relationship between the counselor
and the client at the caseload level. Each counselor has approxi-
mately 90 to 100 clients on a caseload and the counselor helps the
individual develop a vocational rehabilitation plan which has a vo-
cational objective and defines the services that will help that indi-
vidual become financially independent through work.
The counselor typically has available "purchase of service"
moneys which the counselor would use to buy training, transporta-
tion, physical restoration, psychotherapy, and other types of physi-
cal restoration that would help to support the vocational plan to
enable the individual to become employable in the job market.
We are firmly committed to the belief that skilled handicapped
people are employable, and I think we have proved that through
the history of statistics in this very important program, and that,
in fact, it is very important that people become financially inde-
pendent through work.
The cost/benefit figures are clear that for every dollar spent
there are $10 in benefits returned, plus the reduction in dependen-
cy on other Federal programs such as supplemental security
income, the social security disability insurance program, AFDC,
and general relief at the local level, as well as other support pro-
grams such as medicaid, medicare, section 8 subsidies, and other
federally funded programs.
In Massachusetts in this past year we served 33,000 handicapped
people. We have an active caseload of about 16,000 people and we
rehabilitated to work 4,600 handicapped people, 10 percent of these
into sheltered employment, which is in fact, from our perspective, a
very important closure for severely handicapped people who cannot
compete in the competitive job market but who can work effective-
ly and efficiently in a sheltered setting and provide a positive expe-
rience for themselves. In fact, out of our sheltered work program
each year about 10 percent of the people in the program, move out
of sheltered employment into the competitive, working, world.
At this point I would like to ask Norma Krajczar from the New
Jersey Blind Agency to give some further background on the pro-
gram.
Ms. KRAJCZAR. Thank you, Elmer.
Mr. Chairman, I am the executive director of the New Jersey
Commission for the Blind and Visually Impaired. I am also the sec-
retary-treasurer of the Council of State Administrators of Vocation-
al Rehabilitation, and this morning Mr. Wedewer on my left and I
also have the honor of representing the National Council of State
Agencies for the Blind, which has its membership among the 50
States who provide specific and unique services for blind and visu-
ally impaired persons in their States.
The position which we will be presenting this morning is shared
by both organizations and is, we feel, very crucial and important. I
would just like to set the stage for the balance of this panel's dis-
175
cussion by reviewing with you the position statement of the Coun-
cil of State Administrators of Vocational Rehabilitation.
That paper has been provided for your committee. It is not our
intention to take your valuable time this morning to read it. But I
would like to highlight some of the main points of the position.
It is our contention that this is a most crucial period in time for
disabled people. It is a time when the Rehabilitation Act is under
review by the Congress for continuation action in some fashion. It
is also a period in time when, as we all know, the unemployment
rolls have been greatly swelled throughout our country and it is
easy to understand that the numbers of disabled people who are
unemployed or who must find it extremely difficult to secure em-
ployment is disproportionately greater than that of the already-un-
fortunate population of people seeking work. So the time at which
the Congress is being asked to consider the Rehabilitation Act is
particularly critical for us.
It's a program which, through 63 years, has proved its value, has
a proven track record. It is the result of congressional work on a
program and on legislation which perhaps has produced one of the
most balanced programs under the Federal system. It's a program
which provides direct service to disabled people. It provides the op-
portunity for innovative programing. It provides opportunity for re-
search and development, for training, for the development of facili-
ties, services, and for cooperative effort with the private sector.
We feel that at this point in time the best course of action for
the Congress to take is to support the continuation of this program
with appropriate levels of funding, and our position statement rep-
resents exactly that point of view. We feel that the program needs
three foundations for its success. One is good legislation, and that
exists.
The second is appropriate levels of authorization, and as you will
note from our position, the bill which is under your review at the
moment provides for a level of authorization for a minimum of the
next 3 years which will return the purchasing power of that pro-
gram to the year 1979, which was the strongest year of the pro-
gram's implementation.
We also believe that the program demands and requires strong
Federal leadership and Federal cooperation. It is a program which
depends upon State and Federal partnership, and we believe that
the Federal partnership has recently been weak and perhaps in-
tends to be weakened.
We feel that that can be very destructive to what is a very good
program. If I may speak very briefly about our situation in New
Jersey, we are an agency serving blind and visually impaired per-
sons, including persons who are multiply handicapped. And we op-
erate on a very simple philosophy. We know that blindness is gen-
erally accepted as a fearful handicapping condition, one which gen-
erates a great deal of emotional response on the part of the general
public. But we also recognize that it is a handicap which can be
dealt with, whose handicapping conditions can be coped with
through proper training and proper rehabilitation in such areas as
mobility, communications, the learning of braille, and of proper
travel.
176
Obviously, counseling to help one adjust to the condition of his
blindness is important. It is a handicapping condition which ren-
ders itself to rehabilitation. And with the advent of technology and
such devices as, for example, talking calculators, talking computer
terminals, braille output on cassette tape, the sky is the limit in
terms of employment opportunities and opportunities for gainful
activity by blind persons and by severely multiply handicapped
blind persons.
I would like to share with you, if I may, two brief case commen-
taries from our agency which I think represent what vocational re-
habilitation is all about. It's about people. It's not about providing
service for people. But it's about providing service with people. And
in these cases this is exactly what has occurred in our agency.
The first case is of a gentleman, 35 years of age, who is diabetic
and whose diabetes is so severe as to require dialysis on a regular
basis. His vision, through retinal hemorrhaging, deteriorated and
virtually disappeared within a 1-week period of time. He was in a
middle management position with the Thomas Lipton Co.
Very fortunately, the company turned to us and said, "This is a
valuable employee. We would like to continue him on our rolls. We
would like to be able to continue to take advantage of his expertise.
Can you help?"
Over a period of time and after analyzing his job on the site, we
assisted him, through our rehabilitation center, and through on-
the-job continuing training in braille and in mobility to secure and
retain that job, and he is now what he was prior to the onset of his
blindness, a contributing member of the staff of Thomas Lipton Co.
and, I suggest, of his community.
The second case is of a young woman, 34 years of age, with very
limited vision and at a point during the pregnancy with her second
child, the vision she had failed her and she became totally blind.
She was now faced with the task of having to bring up a family
with a 2-year-old, and to maintain a household for her working
husband, During the period of our training with her in her home,
in- terms of home management, child management, and again, com-
munications skills, she presented her family with twins.
She is now the mother of three and a housewife maintaining her
household. That is a legitimate, viable, very important and very ex-
citing role for her to be playing, and we are proud to have been
responsible for the rehabilitation that resulted from our service
with this young woman.
I hope that I have set the stage adequately to show you how
keenly concerned. we are about the rehabilitation program, and
with that I will defer my comments back to Commissioner Bartels.
Mr. BARTELS. Thank you, Norma.
One of the other very important programs under the Rehabilita-
tion Act I'd like to talk about just for a moment is title VII, which
was added to the program in 1978. That is comprehensive services
for independent living.
We have often recognized in the rehabilitation world that there
are some individuals who at some point in time are not able to
engage in vocational rehabilitation and for whom work is not an
objective because their life just hasn't got them to the point of
being able to live independently in the community. Title VII au-
177
thorized a program-a very comprehensive program-of services
that included both the service delivery system under what we call
part A, a centers project that would develop centers of excellence
in independent living under part B, and services for the older blind
under part C.
We were fortunate in getting part B funded back in 1979 under
the assumption that parts A and C would be funded in following
years.
Under the B program we've been able to develop kind of a patch-
work of independent living centers around the country that have
shown the promise and the ability of these centers, with the direct
involvement of many disabled people in the operations of the cen-
ters, to help handicapped people to live independently in the com-
munity and then look to the vocational rehabilitation program to
help them take the next step into the working world.
I think there has been a good deal of demonstration that, in fact,
independent living is a good concept and that, in fact, the promise
under part A needs to be brought along in order to develop the full
flower of independent living rehabilitation.
To give you a couple of examples: In Massachusetts we are main-
taining, in this year, 350 handicapped people living independently
in the community and also are helping 80 individuals to move into
an independent living setting in the community and will be helping
to maintain them in the community.
The cost effectiveness of such a program can be thought of in
very simple terms in that it can cost up to $30,000 a year to keep
an individual in a nursing home or a chronic disease hospital,
whereas it can cost $15,000 a year or less to assist a handicapped
person to live independently in the community. I think the cost ef-
fectiveness figures there are clear.
We are suggesting that the independent living services program
under parts A, B, and C, be funded at a $60 million level.
Some other comments in the area of funding, from the Massa-
chusetts perspective again, over the last 5 years we have basically
been level funded, when you take into account the Federal funding
that we've been able to attract.
Most importantly, under the Social Security Administration
changes in 1980 for the reimbursement program, we had our Feder-
al funding cut by 10 percent. That is to say, in fiscal year 1981 we
had $2.6 million provided to us by the Social Security Administra-
tion to rehabilitate people that were under the SSI or SSDI
program.
Under the reimbursement program that went into effect in 1982
we got zero dollars to help rehabilitate handicapped people. There-
fore, the program under the Rehabilitation Act of 1973 had to come
in and support handicapped people under SSI and SSDI to return
to work. That's not to say we should not be providing those serv-
ices. The point is that the Social Security Administration basically
backed out of the program while they got their act together for the
reimbursement program. That act still is not together.
Moreover, the effect of inflation has taken its toll on the pro-
gram. The funding for other community services around the voca-
tional rehabilitation program that we depend upon to help handi-
capped people to achieve vocational goals has diminished.
178
We talked about the lack of keeping up with the program in
terms of appropriations. Our best year in providing vocational re-
habilitation services was in 1977 and in that year we served 41,000
people and helped 6,500 get into the working world. Because of the
toll of inflation, the level of funding of the Federal dollar, in this
past year we served 32,000 people and rehabilitated 4,600.
I think my point is we have a great capacity to serve. We have
shown that in years past. As the Congressman, the chairman, has
recognized, our real problem is that of the Federal and State re-
sources, in terms of dollars to do the job.
Many States, in fact, are helping to supplement the Federal dol-
lars over and above the 20 percent that is required by the program.
But the Federal leadership here is most important-in terms of
congressional support for the Rehabilitation Act as it is presently
defined and for the Appropriations Committee to follow through
with the availability of the Federal dollars-to enable us to, in fact,
live up to the capacity and the promise of the program, as we see
it.
I would like to ask Don Wedewer of Florida, the Florida Blind
Services Division director, to speak on that part of the program.
Mr. WEDEWER: Thank you.
Mr. Chairman, I am Don Wedewer, director of the Florida Divi-
sion of Blind Services in the Florida Department of Education. It is
a pleasure to be here and to testify once more before this subcom-
mittee, which is so sensitive to the needs of the Nation's handi-
capped. It has been SO sensitive that marvelous legislation such as
the Rehabilitation Act of 1973, as amended, has been put on the
books and allowed us, as administrators, to administer a program
that has, indeed, done a great deal of wonderful things to put se-
verely handicapped people back in the mainstream of our society.
I was blinded and lost both my limbs as a result of combat
wounds in World War II. I benefited from the Army and Air Force
and Veterans' Administration rehabilitation programs, and fortu-
nately, the rest of the handicapped people in this country have a
program that has been set up for 63 years to benefit them.
We are very cognizant of the need and the desire of all of us to,
particularly, rehabilitate the most severely handicapped. The Reha-
bilitation Act of 1973, I believe, is one of the finest pieces of legisla-
tion that has ever been passed because it addresses that very issue
in à very significant way and has permitted us, the State directors,
to act on it. In fact, we are doing just that.
I don't think anyone has mentioned the fact that since the act
has been passed, that the concentration has been on the severely
handicapped. The State directors aren't number conscious. We are
not numbering people. I worked as a counselor and as a placement
person and a local supervisor and all that before becoming director,
as most of us have. We're aware of that problem and the so-called
numbers game.
As a matter of fact, we don't like the numbers game at all, and I
think that if you read statistics at all about this program you will
know that in the last few years the numbers of severely handi-
capped being rehabilitated has gone up. The percentage has gone
up. And that's exactly what we're doing. I don't think we need any
more incentive. We've got all the incentive we need.
179
The only thing we need is probably more money because of the
cost of high technology, which is required to rehabilitate our multi-
ply handicapped people.
Now, in the agency I run in Florida, we also serve the preschool
blind and the school children who are blind and the elderly, but we
keep a very detailed registry. We have registered, in our marvelous
State of Florida, 8,500 people, on average, for the last 7 years, a
total of 60,000 new people, who are blind and visually handicapped.
Of the 2,000 children we have registered and who are now on the
rolls, two-thirds are multiply handicapped. That is not just Florida;
it's- like that in every State. All the States have neonatal clinics
and they're all seeing this happen. It's a challenge to us, but it's
also an opportunity to develop these young people into the same
citizens that many of us have been developed into through rehabili-
tation.
That doesn't scare us; I think it doesn't scare you.
We hear that unemployment is great right now and I know the
statistics are thrown out that 50 percent of all severely handi-
capped people are unemployed-in the blind sector, maybe 70 per-
cent-but the truth is we are rehabilitating many, many severely
handicapped people into good jobs. In the private sector too, I
might add.
Now, just for example, Norma Krajczar mentioned a couple of
people. I will mention two examples which are just happening. We
had a blind student we started working with in junior high; he
went through the University of Florida; he got a degree in electri-
cal engineering last June. His grade point average was 3.9. He's to-
tally blind. He was honored as one of the Nation's outstanding
blind students here at the White House in the rose garden last
year and immediately was offered two jobs by IBM and General
Dynamics and took one with IBM for $25,000.
We worked with him. We bought some expensive equipment for
him, a range of computers and speech output equipment, but there
he is, a success story. And those success stories are all over the
country.
We have another young student at Florida State University who
is just finishing a degree in computer science. We already have a
State agency he's working with on an experience level that has of-
fered him a job, not as a computer programer but as an analyst
with a good salary, and he's about to graduate in June.
These young people are just two examples of what is an everyday
occurrence, almost, around the country. Furthermore, we just grad-
uated a class of people trained to work in the electronic industry,
which is pretty common in Florida because of NASA, and all of the
entire class was hired by a corporation in Fort Lauderdale, the
entire class of young blind people, very young people, with their
skilled training.
This is all a result of what you have proposed with your legisla-
tion, the money you have provided, and what we can do with it
when we have it.
The truth is that all of our States are providing enough money to
match Federal funds and, as a matter of fact, in my 10 years now,
10th year as a State director, the State of Florida has increased
money for rehabilitation every year. It's not ever gone backward.
180
We don't anticipate it to. We are with you in meeting the needs of
our citizens and we're proud that you are doing it and proposing to
continue to do it.
None of us overlook the severely handicapped these days because
that's really who everyone is serving, as I think we have explained
here this morning.
We have been hurt, of course, by cuts in the SSI and SSDI pro-
gram. We have been hurt because of similar benefit cuts in other
categories where we've had to make up for it. We have reduced
staff, sometimes cut vacancies. We've done everything in the world
to find more dollars for the people we serve, and with high technol-
ogy it's very expensive.
But the marvelous thing is that with all this high technology,
our severely handicapped people can now compete both in the pri-
vate sector and everywhere, pretty much with everyone else, and
that's where the excitement is and, you know, the truth is it's
working.
We have plenty of flexibility, I might add. That word bothers me
some too, Congressman, and I don't know where it is lacking. We
probably can use a little more direction and help from up here in
what we do. I'm not familiar with what their proposal is about this
incentive business, but the truth is that I'm a competitor and
would love to compete. But on the other hand, someone should not
be punished because their State is not doing quite as much. The
severely handicapped shouldn't be punished anywhere. And there's
no more incentive in the world that is needed.
Flexibility, we have plenty of it. In fact, we're hearing mixed sig-
nals. That's our problem. We're told by OMB they don't want our
statistics. On the other hand, they're telling us that we have statis-
tics to show we're not doing something, or they want us to do some-
thing else, and they're even going to give their monéy out based on
those statistics. I don't know where they're going to get their infor-
mation, unless they start giving us one signal, Congressman, and
not a whole group of signals.
So with that I'd like to say I appreciate the opportunity of being
back with you again and assure you that Florida is doing well and
I invite you down for your Easter holiday.
Mr. MURPHY. I accept. [Laughter.]
Mr. ARRELL. Would you invite the rest of us down too?
Mr. WEDEWER. Yes.
Mr. ARRELL. Thank you.
My name is Max Arrell. I am commissioner of the Texas Reha-
bilitation Commission in Austin, Tex. We are an independent
agency established by our legislature. I work for a board and it's
appointed by our Governor. As each of us, I believe, are under sep-
arate types of organizations, some under the education agency,
some under larger agencies, I think it's very important for every-
one to understand that regardless of the type of agency or the type
of organization that we have, it's very possible to have a very effi-
ciently run, effective organization in State rehabilitation, which we
do have, and will continue to have.
I do appreciate very much and it is sincerely my pleasure to
come here today and advocate and speak in favor of the best
human service delivery system for the disabled community that's
181
ever been known to this country, the 63-year-old State/Federal vo-
cational rehabilitation program. It's a tried and proven program.
It's one that has been unparalleled by any other program in this
country. I have been a part of this program for 23 years. I worked
as a counselor, an administrator, and now a chief executive officer
of a State rehabilitation agency, which, by the way, is the hub of
the rehabilitation program and has been and should continue to be.
What makes this all possible for us is a very good piece of legisla-
tion called the Rehabilitation Act. It's a tried and proven act. It's
probably the most complete and well-balanced legislation in the
human services field. It's one that has served us very well, and leg-
islation that serves you well, I feel, is one that you don't abandon
and you don't fragment.
Now is the time to extend and enhance and better fund rather
than fragment, and I feel that there is that very real possibility
with some of the testimonies I've heard here today, of fragmenting
a program that has been proven and successful for 63 years.
The thing that we would indicate to you here today and ask your
sincere consideration, as my colleagues here on the panel have
said, would be to extend the Rehabilitation Act as is, consider fund-
ing to a point that it would bring us to the level where we would be
back to our 1979 buying power.
I think that the extension of the Rehabilitation Act will again
insure stability in our State/Federal program and allow us to con-
tinue to provide the comprehensive services that are needed for the
severely disabled. The severely disabled of this country, at least in
my State and I'm sure it's the same everywhere, have come to real-
ize, understand, and expect good, comprehensive, services from the
vocational rehabilitation program. They have received those serv-
ices, they should continue to receive them, and I think that we
should give them nothing less.
I would like to take just a few minutes to talk to you about the
Texas experience that we've had since 1975.
In 1975 the vocational rehabilitation division of our agency,
which is the division that carries out the basic vocational rehabili-
tation program, had 1,600 employees, 593 vocational rehabilitation
counselors. That was one counselor for every 29,000 population. At
that time only 32 percent of the individuals we were rehabilitating
were in the severely disabled category.
In comparision, we went from 593 counselors in 1975 to 345 coun-
selors in January 1983, or 1 counselor for every 45,000 popula-
tion. However, the percentage of severely disabled has reached 62
percent. We've gone from 32 percent in 1975 to 62 percent in 1983.
In fiscal year 1982 the Texas Rehabilitation Commission and
staff of the commission, rehabilitated 13,908 individuals into em-
ployment. Again, as I told you, 62 percent of the individuals we're
serving now are severely disabled. The 13,908 has a 96-percent ver-
ification factor, which means I have an evaluation team, a program
evaluation team that reports directly to me, that verifies employ-
ment and closures in this program, and I can document a 96-per-
cent verification on this number I gave you.
Twenty-four percent of the 13,908 individuals that we rehabilitat-
ed in 1982 had a monthly income of $1.7 million when they were
182
accepted; 38 percent of the $1.7 million was from some form of
State or Federal tax supported programs.
After rehabilitation, the 13,908 individuals had an income of $9.6
million per month or 5½ times as much as before they were ac-
cepted, and as has already been stated here, each one of these indi-
viduals over the work history of their lifetime will pay back $10 for
every dollar invested in them through our rehab program. We feel
that this is an investment, this is an investment in human energy, in
human potential, in human dignity.
The vocational rehabilitation program in Texas, and I'm sure
throughout the States, does not work-throughout the country-
does not work in a vacuum. We have some very good partners. We
have a very strong Federal/State partnership in our part of the
country. We also have a very strong partnership with our consum-
er groups.
Mr. Lex Frieden, who I believe testified earlier in the week, is
chairman of my consumer consultation committee, and we also
work very closely with Mr. Justin Dart, who is the chairman of the
Governor's Committee on Employment of the Handicapped.
With the help of these two organizations and 28 other consumer
groups we have designed and implemented a program that I feel is
unparalleled for the disabled handicapped community of our State
and the country.
There has been some talk about efficiency and, again, I'd like to
continue talking just a little bit about the Texas experience. Our
previous Governor, Mr. William Clements, initiated a program in
our State called the State government effectiveness program. It
was a program implemented by the Governor to enhance and try to
bring into practice in State government good, sound, business man-
agement practices.
In a called board meeting, Governor Clements recognized the
Texas Rehabilitation Commission as the outstanding agency in im-
plementing his State government effectiveness program, and I only
mention that to you to let you know that the vocational rehabilita-
tion programs in this country are effective; they are efficient; they
are tried; they are proven.
Given the right amount of funding and the continuation of the
Rehabilitation Act, we will continue to serve the disabled commu-
nity of our State and this country, I think, in a fashion that you
will be proud of and that will be in the best interest of the severely
disabled of Texas and the country.
Thank you, Mr. Chairman.
Mr. SIMON. We thank all of you very, very much. I don't mean to
be cutting off any questions here of any member, but we are going
to have to move to the markup very shortly. Do any members have
questions?
Mr. MILLER. I do, Mr. Chairman.
Mr. SIMON. Mr. Miller?
Mr. MILLER. I'd like to say for the record that, given the testimo-
ny of this panel and the historical trends that you mentioned earli-
er that show we clearly have been moving over the last 5 or 6
years to a much higher percentage of the severely disabled in cases
that have been served, it's a little bit contrary to what the adminis-
183
tration has suggested, at least in their letter to the Speaker of the
House, when they transmitted their proposals.
They recognized that to rehabilitate the more severely disabled is
more costly. Yet they failed to provide additional funding for this
purpose, whether it's under a flexible means or any other means.
At the same time they cite a GAO report where they provide
that 35 percent of the cases have no apparent relationship between
the clients' job at closure and the vocational rehabilitative services.
Granted, I'd like that to be improved, but that also suggests that
65 percent of the cases do have this relationship and that encom-
passes both the severely disabled and the nonseverely disabled.
I find it interesting that this administration would have us
choose between the disabled and the severely disabled. I think
what most people in the field would suggest is they both need simi-
lar types of services, some more intensively than others.
Finally, I think California does about as good a job as anyone,
but I'm concerned after the testimony from Florida that under this
incentive grant program all the money would end up in Florida.
[Laughter.]
Mr. MILLER. If you turn out a couple more electronic engineers, I
think at that point you win all of the money in the pool.
But I think it's interesting that they decide they are going to pro-
vide an incentive program based upon the incomes of the individ-
uals who are employed. Apparently they don't recognize a differen-
tial here with whether or not it's an entry-level job that may lead
to a career. That would not be as rewarded as much as a temporar-
ily high placed job of 120 days.
It's also interesting that while they're going to give the financial
incentives to the States under their program, they make it more
difficult to achieve those levels. Rather than 60 days, apparently
from the prior testimony, it's going to go to 120 days. You get re-
warded if you place somebody over the minimum wage, but it indi-
cates that they expect to expand the exemptions from the mini-
mum wage.
If you look at their proposal, what you find out about the incen-
tive for States who need this rehabilitative money, is that three
unpaid homemakers are worth two people working above the mini-
mum wage. So to keep the flow of funds coming into your State you
must then, all of a sudden, start targeting toward total numbers
rather than placement and you can get reimbursed. So, if you place
enough people at less than the minimum wage you will do just as
well as if you evenly target your services and try to recognize the
need for services. This is the most asinine program I've ever read.
[Laughter.]
I just think that it has no bearing on what happens with
people who work in the field of trying to rehabilitate the
handicapped. It's not an easy field to work in. We see the historical
trends which the Congress has tried to encourage through this act,
and that States are endeavoring to meet those. We see up to 60
percent of the severely disabled receiving services in 1982, even
under the budget constraints that have been outlined by the panel,
and I would just hope that we would follow the chairman of this
committee's direction and reject this proposal. I think there are
going to be some amendments by Mr. Bartlett and others to im-
184
prove it at the full committee level and I would hope that we
would move in that direction.
As the southerners in the Congress are SO fond of saying, "If it
ain't broke, don't fix it." [Laughter.]
Mr. MILLER. I think that may apply to this case.
I'm done.
Mr. SIMON. Mr. Corrada?
Mr. CORRADA. Mr. Chairman, I don't have any questions but I
would like to state my appreciation to all of the members of the
panel for their very impressive testimony. I believe that we should
be ready to get on with the business of the day by promptly passing
this bill here at the subcommittee level and moving it on to the full
committee.
I would hope, Mr. Chairman, that we would not tamper with a
program that has worked well. What we need is to restore funding
levels that, based on the cost of living increases, were prevailing in
1979 and I agree with some of the statements made here that they
need neither more flexibility nor more incentives. What more flexi-
bility or incentives do you want for people who are out there in the
field working with those that they serve directly? I, therefore,
would like to state in commending the witnesses about their testi-
mony that I intend to fully support this reauthorization and the ef-
forts of the committee to move this bill promptly in this Congress.
Thank you, Mr. Chairman.
Mr. SIMON. Thank you.
Mr. Bartlett, do you have any comments or questions?
Mr. BARTLETT. Mr. Chairman, I have some questions of the panel
and some thoughts and ideas for during markup which I will say to
several members on the other side of the aisle.
Mr. Erlenborn had mentioned to me on the way back to the floor
that he, of course, has to be on the floor because of the importance
of the budget debate, and also, of course, has to be in markup
today, and we are trying to get word from him now as to what is
happening on the floor, I think Mr. Murphy is in the same posi-
tion. So whether we go through markup today or delay it for a
short period of time, I'd leave to your discretion.
Here comes the chairman now.
Mr. MURPHY. OK. We're just about ready.
Mr. BARTLETT. Mr. Chairman, you missed the finest presentation
based on the Texas experience that I believe I've ever heard.
[Laughter.]
Mr. MURPHY. I apologize to the panel. We have a markup going
on in the Interior Committee as well.
Mr. BARTLETT. I do have some questions of an exploratory nature
because these four, this panel, represent people who are on the
front lines. Then, as far as my preference, we can either go to
markup or wait and do markup at a future time. I'd leave that to
the discretion of the chairman. I'm prepared either way.
As to the flexibility question, I suppose I'd like to explore that
with the four of you a little bit more and to see if you all concur or
whether there are areas of difference. And maybe, since Mr. Miller
has expressed reservations about that word, we could come up with
a better word, with a word that might indicate allowing the States
to use more of your limited resources on direct services and less of
185
your limited resources on requirements that don't make sense for
your State.
My question is do your States or do other States that you know
of find problems and have to add costs that you believe are unnec-
essary to comply with the statute. For example, one of the items
contained in the law which the administration bill proposed to take
out, is the requirement that you provide, and I am quoting here,
"At a minimum for the provision of the vocational rehabilitation
services specified in clauses one through three," and also of subsec-
tion A of 103 and then it gives a laundry list, as you all are well
aware, evaluation, counseling, vocational-several pages of require-
ments.
This is obviously very serious and very central to your operation
and so I suppose I would seek to learn from you whether these re-
quirements add to your costs unnecessarily or, in fact, you would
provide those anyway even if these requirements were deleted from
Federal law?
Mr. BARTELS. Mr: Chairman, the Council of State Administrators
of Vocational Rehabilitation have reviewed the act of 1973 with the
services that are recommended. We have also looked at many of
the regulations that define the program in further specificity, and
have no recommendations on where they should be changed. We
are very comfortable with the Rehabilitation Act.
Speaking from my perspective as head of the agency in Massa-
chusetts, if those services were deleted from the Rehabilitation Act,
they would continue to be carried out in the Commonwealth of
Massachusetts, and I would expect that that would be the case in
every other voc-rehab agency around the country.
What is in the act of 1973 is based upon a long history and expe-
rience of good vocational rehabilitation programing. From our per-
spective that should remain in there.
Mr. BARTLETT. So the States that you represent and that you've
talked with don't find those clauses to be burdensome administra-
tively in any way?
Mr. BARTELS. No, they don't.
Ms. KRAJCZAR. Not at all.
Mr. WEDEWER. No, Mr. Chairman, or Mr. Bartlett. I haven't
heard any of my staff complain about it or any of the other States
in the South. There isn't really a problem with that. We're going to
provide the services, as Mr. Bartlett said, and we're going to try to
rehabilitate people, whether it's a laundry list or not. We're going
to provide those services to get them to that bottom line, which is
employment and independence.
We don't have any problem with it and I think probably we're
faced with a problem that isn't a problem. I don't recognize the
problem.
Mr. BARTLETT. Well, Mr. Miller has SO eloquently tripped me up
by my favorite expression of, "If it ain't broke, don't fix it," SO I
will move on to another
Mr. MILLER. See, you guys have an impact on the North here.
[Laughter.]
Ms. KRAJCZAR. Mr. Congressman, if I may, I think you're ad-
dressing yourself to the issue of accountability and I would suggest
that it would be certainly expected of me as a public administrator
186
in the State of New Jersey to be equally accountable to the taxpay-
ers and the administration of my State as we are to the Federal
Government in this instance in the kinds of issues that you are dis-
cussing.
Mr. ARRELL. I would also suggest that we are accountable to the
consumers in our State and I would suggest that leaving the things
delineated would be in the best interest of the disabled handi-
capped community.
Mr. BARTLETT. Leaving these clauses in Federal law?
Mr. ARRELL. Yes.
Ms. KRAJCZAR. Yes.
Mr. ARRELL. I believe it would be in the best interest to leave
them. It gives a protection to the severely disabled, I think, that
they deserve.
Mr. BARTLETT. Thank you.
Mr. ARRELL. Mr. Chairman, it appears as though the administra-
tion is making some proposed changes just for the sake of making
changes, that really have no bearing in fact with respect to pro-
gram operations.
Mr. BARTLETT. Have your States and others-it's been my gener-
al impression but I don't have any way to quantify it-can you
quantify the increases that you have received from your State leg-
islatures in the past several years, and are you still receiving in-
creases in funding from your State legislatures? I know that there
are-I don't know of any States that are merely doing the mini-
mum of the 20-percent matching, but as I understand the match-
ing, it runs anywhere from 26 to 55 percent. Do you find the State
legislatures to be increasingly receptive?
Mr. ARRELL. Mr. Congressman, as you know in our State, the last
session of the legislature did increase our funding. The legislature
today in our State is marking up my bill, this afternoon, and I will
know a little bit more about it tomorrow. But I do anticipate an
increase.
Mr. BARTLETT. You do anticipate an increase?
Mr. ARRELL. Yes, sir.
Mr. BARTLETT. Another subject which was not raised-I am
sorry, it was raised today, almost tangentially-and that is if there
were a way, and this is not in this bill, but if there were a way over
the next session of this Congress to find a way to use existing funds
that are spent through various entitlement programs-whether it's
social security or SSI or other entitlement types of programs-and
use those existing funds for rehabilitation purposes and therefore
decrease the amount of entitlement money in the future that's re-
quired, would that be a direction that you would urge this Congress
to go? It was mentioned in testimony on Monday and it may be
something that this committee or other committees of Congress
may explore in the next 12 months.
Mr. ARRELL. I would think, if I could speak, that that would be a
very good possibility. I think with one danger in that, and I would
want to be very careful about it, taking money away from those
programs that perhaps we use as other sources. In other words, we
utilize a tremendous number of other programs to help supplement
our program to rehabilitate people, and I don't think it would be a
wise decision to take money away from some of those programs
187
that we use now to help supplement the rehabilitation program or
help us carry out our program. I think we'd just be shifting money
from one place to another.
Mr. BARTLETT. So you would urge caution?
Mr. ARRELL. Very much.
Mr. BARTLETT. But some exploration of the idea?
Mr. ARRELL. Not knowing the details, I would say that there is a
possibility that some of that could be done, but I would be very cau-
tious.
Mr. BARTLETT. Because on the back side, if we were to-when
you successfully rehabilitate someone and get them into permanent
employment, you then dramatically decrease the amount of entitle-
ment funding that's required. So there should be some way to
almost advance the money from the Government to itself and allow
people to lead more productive and satisfying lives and also save
the Government money.
Mr. ARRELL. Of course, that's the premise that we worked on in
the social security program-that if we rehabilitated those people
on social security then they would be taken off of social security
and would no longer be drawing that money.
Mr. BARTLETT. In title VI do you believe that state agencies
ought to be allowed to be eligible for projects with industry fund-
ing, PWI funding?
Mr. ARRELL. Yes.
Mr. BARTLETT. You do?
Mr. ARRELL. Yes, sir.
Mr. BARTLETT. Have any of your States applied for this?
Mr. ARRELL. Yes.
Ms. KRAJCZAR. Yes.
Mr. WEDEWER. Yes; Florida has.
Mr. BARTLETT. Texas has, Florida has. OK.
In the part B part, in the part A, back on to title VII, the way
the part A is written now, only 20 percent, as I recall, of part A
money would be required to be used in part B centers. If we were
to somehow prevail upon the Appropriations Committee in restruc-
turing that section and prevail upon appropriations to fund part A,
would part B centers have been SO effective and if they have
proven themselves SO well would you anticipate wanting to use
more of that part A money to just permanently fund part B cen-
ters, the independent living centers?
Mr. ARRELL. I think we'd look to a combination of continuing
funding in part B to make sure that the centers were funded, at
the same time that part A was brought into play to begin planning
for a fullscale part A service delivery system for the next fiscal
year and the subsequent 2 or 3. So I think it would have to be a
combination of those points.
Mr. BARTLETT. One last question. On page 3 of your prepared tes-
timony, of your written testimony, you asked for a 3-year extension
of the act rather than permanent authorization. Is that because
you would anticipate in 3 years being able to come up and again
testify before Congress and, if nothing else, find just technical
amendments or cleanup amendments or ways to improve the pro-
gram every 3 years? Was that a deliberate testimony on your part?
188
Ms. KRAJCZAR. I believe, Mr. Bartlett, that the wording suggests
a minimum of 3 years and I think that our concern or the concern
of the Council of State Administrators at this point in time is to try
to act with some dispatch in addressing the critical nature of the
timing that's before us and to suggest perhaps a no-end extension
at this time was beyond our capability to design, although certainly
we would be more than happy to entertain that kind of thinking on
the part of the committee.
Mr. ARRELL. We would not oppose that. [Laughter.]
Mr. BARTLETT. Thank you, Mr. Chairman. I yield back the bal-
ance of my time, if any.
Mr. MURPHY. Thank you, Mr. Bartlett. We are going to move to a
markup as soon as the committee is ready. Are there any remain-
ing questions of the panel?
OK, the panel is dismissed with our thanks for being with us
today and for giving us some great insight into the reauthorization.
Thank you, ladies and gentlemen. We will immediately proceed to
mark up. We have more members here than is usual and I think it
shows the concern that all of the members have on this very vital
reauthorization.
[The prepared statements submitted for inclusion in the record
follow:]
189
PREPARED STATEMENT OF GARY L. BAUER, DEPUTY UNDER SECRETARY FOR PLANNING,
BUDGET, AND EVALUATION, DEPARTMENT OF EDUCATION
Mr. Chairman and Members of the Committee:
I am pleased to present testimony for the Department of Education
on the subject of reauthorization of the Rehabilitation Act of 1973,
as amended. The Act presently authorizes programs of the Rehabilita-
tion Services Administration (RSA), the National Institute of Handicapped
Research, and the activities of the National Council on the Handicapped.
The Rehabilitation Act of 1973, as amended, authorizes the alloca-
tion of Federal funds on a formula basis to States to provide services
to assist disabled individuals to prepare for and engage in gainful
occupations. Significant progress has been achieved over six decades
to develop a service delivery system in the States to rehabilitate
disabled persons. However, we are proposing amendments to the Act.
as part of our reauthorization effort because we believe there 18 room
for improvement in the rehabilitation outcomes that can be achieved for
the severely disabled.
For example, about three-quarters of all rehabilitants are
placed in the competitive labor market; for the severely disabled the
proportion is about 65 percent. In fiscal year 1981, the mean weekly
earnings at closure of severely disabled rehabilitants with earnings was
$148; for the nonseverely disabled, $168. These figures understate
22-065 O - 84 - 13
190
the actual hourly wage rates since many rehabilitated persons work only
on a part-time basis. Nonetheless, over one-half of the severely disabled
rehabilitants received less than the Federal minimum wage in 1981, while
21 percent received no wages at all at case closure. In the last two years,
increasing proportions of the severely disabled have been placed as unpaid
homemakers.
Current law simply does not provide adequate incentives for State
rehabilitation agencies and professionals to provide services that pro-
duce lasting functional and economic independence at the highest possible
levels to the most severely handicapped clients. Regardless of perfor-
mance, the States receive their funds according to a formula based on
population and per capits income. The current measure of success used by
the program assigns credit on an overly simplistic basis by combining into
& single category employment in the competitive job market, in sheltered
workshops, unpaid work of homemakers and unpaid family work. Moreover,
the definition of successful rehabilitation only requires 60 days in
employment.
Several audits and evaluation reports have also indicated that changes
are needed in the current rehabilitation system to improve rehabilitation
outcomes, especially for the most severely disabled. In 1976, the General
Accounting Office (GAO) reported to the Senate Subcommittee on the Handi-
capped that since counselors have traditionally been rated on the
basis of the number of persons they rehabilitate and the severely
disabled are more costly to rehabilitate, counselors would naturally have
some reluctance to allocate a significant portion of their resources to
191
rehabilitating the severely disabled, which would result in rehabilitating
a smaller number of clients. GAO noted that rehabilitation counselors
believe that a system which accounted for the cost and difficulty of the
cases would give added incentive to increasing services to the severely
handicapped since the emphasis on sheer numbers would be reduced.
In 1978, Berkeley Planning Associates reported that rehabilitated
clients were often placed in jobs that are low paying, unstable, or not
in conformity with the original employment objectives. They concluded
that if meaningful rehabilitation is to be achieved for more clients,
an incentive must be provided for counselors to pursue services which
assure that clients achieve stable employment with earnings of at least
the minimum wage. The Berkeley Report suggested the introduction of a
performance measure that directly appraises the quality of client
services or outcomes such as the wage level or whether the benefits are
retained over time.
In 1982, the GAO reviewed a sample of rehabilitated clients in five
States and found that in 35% of the cases there was no apparent relation-
ship between the client's job at closure and the vocational rehabilita-
tion services provided. Other problems identified by GAO included failure
of State rehabilitation agencies to observe the requirements for eligibility
and case closure as well as identifying the use of similar benefits. Similar
problems have been reported in 1973 and 1979 by the Department of Health and
Human Services' internal audit agency. GAO recommended that the administra-
tion of the Vocational Rehabilitation program be strengthened to provide ser-
vices only to individuals who have substantial handicaps to employment and
can reasonably be expected to become gainfully employed.
192
The Department recomends that the Congress consider changes to
the Rehabilitation Act of 1973, as amended, that would advance the follow-
ing principles:
- reward States for good performance in rehabilitating the
severely disabled;
- establish a more meaningful measure of program success
capable of influencing the talents and energies of State
vocational rehabilitation agencies, which will ultimately
produce greater functional and economic independence for
disabled clients;
- provide greater State flexibility in the provision of services;
and
- promote stricter accountability to standards in such areas
as client eligibility and case closure standards for successful
rehabilitation.
We propose that Title I be amended to reward State performance in
rehabilitating the severely disabled by distributing part of the funds
appropriated for State grants on the basis of a weighted case closure
system. Beginning in 1985, one third of the State grant funds would
be allocated to the States on the basis of their performance in re-
habilitating the severely disabled. Rehabilitations would be weighted
to maximize the financial incentive for placement in jobs that achieve
economic independence. Rehabilitations resulting in employment at or
above the Federal minimum wage (which would incorporate statutory or
193
regulatory exceptions for sheltered workshops and work activity centers)
would receive a weight of 1.5. Each rehabilitation resulting in employment
below the Federal minimum wage would receive a weight of 1.0. In
recognition of the economic and independence value of unpaid homemaking
and family work, these rehabilitations would receive a weight of .5.
To assure that employment outcomes are stable as well as financially
rewarding, the definition of successful rehabilitation would be
strengthened to require 120 instead of 60 days of employment. The
remaining two-thirds of the appropriation would be allotted to the
States using a simplified version of the current formula based on popula-
tion and per capita income squared. To provide sufficient time for
the States to adjust to the proposed changes in the formula, hold
harmless provisions have been included for fiscal years 1985 and 1986.
We are also proposing changes to take effect in fiscal year 1984
designed to provide greater State flexibility in the planning, admini-
stration, organization, and delivery of rehabilitation services. For
example, the amendments retain the requirement for a sole State agency to
administer the program, but eliminate the detailed provisions prescribing
how that agency is to be organized and administered. The bill would
also eliminate a number of State plan provisions which address admini-
strative issues we believe are better left to State discretion. These
include: the requirements for maintenance of personnel standards,
application of the plan in all subdivisions of the State, and the
provision of mechanisms for cooperative agreements. The amendments
would continue to allow a State agency to provide any or all of the
services described in section 103 of the Act, but would not require
194
the State agency to provide certain "minimum services" as
a part of its rehabilitation program. Instead, we believe that performance
based funding would give States the incentive to provide services
necessary to achieve rehabilitation of its disabled citizens. In order
to continue to ensure the maximum utilization of Federal rehabilitation
dollars, the bill would continue to require that States make use of
similar benefits available under other programs and maximum use of other
public and private resources in the State and community.
The bill would retain and improve the provisions which provide pro-
tections and rights for the handicapped. The bill would retain requirements
relating to the priority for providing services to the severely disabled,
the individualized written rehabilitation program, the availability
of personnel trained to communicate in the client's native language, the
prohibition against residence requirements, the review of sheltered
workshop closures, and affirmative action for the employment of qualified
handicapped individuals. The bill would revise appeal procedures
concerning State review of agency determinations to include both determinations
concerning eligibility of an individual as well as the appropriateness
of the rehabilitation services provided. The bill would also add a
provision requiring the State agency to provide client assistance
services to all clients and elient applicants, including information
and advice concerning the benefits available under the Act, assistance
in pursuing legal, administrative, or other remedies under this Act,
and appropriate referrals to other State and Federal programs. In
addition, the bill includes a new provision protecting the confidentiality
of personal information provided by clients to counselors and agencies.
195
In order to provide for the continued development of a comprehen-
sive and coordinated program of handicapped research and the dissemina-
tion of information on the most effective practices, Title II authoriz-
ing the conduct of handicapped research through a National Institute of
Handicapped Research is retained under the bill. The bill would extend
the authorization of appropriations for handicapped research under
Title II through fiscal year 1988. The bill would continue to provide
that the National Institute of Handicapped Research could pay for all,
as well as for part of the cost of research and demonstration projects.
The bill retains Title IV authorizing a National Council on the Handi-
capped, but provides that the Council would provide advice to, rather
than establish general policies for, the Institute of Handicapped Research.
This change would make the Council's role consistent with other such
councils in the Department.
A variety of existing discretionary programs are included in Title III
under a single authorization of appropriation. The purpose of Title III is
to authorize grants for projects of national or regional significance or
projects to meet the unique needs of special handicapped populations. It
includes authorizations for the following activities: Training, Grants
to Indians, Projects with Industry, Centers for Independent Living, Special
Demonstration Programs (including Projects for the Severely Disabled),
Migratory Workers, the Helen Keller National Center, and Special Recreational
programs. Title III also includes authority for the Commissioner to provide
consultative services and technical assistance, to provide for the
collection and dissemination of information, and to evaluate any of the
programs or activities carried out under the Act.
196
Although we are not proposing to change the scope or types of activities
funded under these authorities, we are proposing some modifications. For
example, we are proposing to extend eligibility for grants and contracts under
these activities to for-profit organizations. We are also proposing to
eliminate specified matching rates and to authorize the use of Federal
funds to pay all or part of the costs of projects funded under these
programs. In the Training program, we are proposing to delete the
specific requirements concerning the types of projects and application
content in order to enable us to focus resources on the most critical
training needs. In the Independent Living program, we are proposing to
eliminate the statutory priority for agencies designated in the State plan
in order to open up eligibility to a variety of State, public, and private
organizations. The bill would also remove unfunded or duplicative
authorities.
For the longer term, it is the Administration's goal to reorganize
Federal-State delivery of rehabilitation services by returning revenue
sources and full program authority to the States. On February 24, the
Administration transmitted proposed legislation to the Congress that
would give States the option of designating a number of programs for
turnback during the period 1984 through 1988. The Vocational Rehabil-
itation (VR) program is included in the list of programs that may be
designated by participating States because the Administration believes
the ultimate responsibility for rehabilitating the disabled population
can appropriately be assumed by the States. Rehabilitation services
have long been delivered by State agencies. States can best determine
the rehabilitation needs of their own citizens and the means of making
them employable. It is thus appropriate to include VR in the Federalism
proposal.
197
States that initially choose not to designate VR as part of their
State block grant under Federalism would operate the program under
current law. For those States (for all- States should Federalism not
be enacted), we are proposing amendments which we believe will help
the States to develop stronger, more effective programs.
In summary, we believe the Administration's proposal would improve
rehabilitation outcomes for the disabled by enhancing the both the incentive
and the capability of State agencies to make the most effective use of
Federal, State and local resources in serving the disabled. The bill is
designed both to simplify the administration of the program and strengthen
achievement of program goals. We appreciate this opportunity to discuss
our proposal with the Committee and hope that you will give it favorable
consideration.
198
STATEMENT PRESENTED BY NORMA F. KRAJCZAR, EXECUTIVE DIRECTOR, NEW JERSEY
COMMISSION FOR THE BLIND, ON BEHALF OF COUNCIL OF STATE ADMINISTRATORS OF
VOCATIONAL REHABILITATION
The Council of State Administrators is an association
comprised of the chief administrators of the public rehabili-
tation agencies for physically and mentally handicapped persons
in all the states, the District of Columbia, and our Nation's
territories. These agencies constitute the State partners in
the State-Federal Program of Rehabilitation authorized by the
Rehabilitation, Comprehensive Services, and Developmental
Disabilities Amendments of 1978, Public Law 95-602, as amended.
Since its inception in 1940, the Council has enjoyed a
quasi-official status as an active advisor to the Federal
administrators in the formulation of national policy and
program decisions and has been an active force in strengthening
the effectiveness of service programs for disabled Americans.
The Council also serves as a forum for State Rehabilitation
Administrators to study, deliberate, and act upon matters
bearing upon the successful rehabilitation of persons with
disabilities.
The core of America's Rehabilitation Program is the
63-year old State-Federal Program devoted to providing a
combination of rehabilitation services to physically and/or
mentally disabled adults. At the center of this Program is the
State Rehabilitation Agency which provides for a wide range of
services for eligible, disabled persons. Most often these
services are provided with the cooperation of, or through,
private, non-profit service providers.
The primary purpose of the provision of vocational rehabili-
tation services is to render "employable" those persons with
disabilities who, because of the severity of their handicaps,
199
are unable to secure and to hold employment.
The Rehabilitation Act is the most complete and
well-balanced legislation in the human services field.
In one Act, there are included provisions for a compre-
hensive and individually-tailored program of vocational rehabili-
tation services to individuals with physical and/or mental
disabilities; an innovation and expansion program; a training
program; a research program; a rehabilitation facility program;
a program providing comprehensive services in independent living;
a community services employment program; and a special projects
program.
Experience has shown that this balanced approach embodies
all of the elements necessary for the successful rehabilitation
of persons with disabilities.
Essential, of course, to maintaining this balance is a
well-funded program of direct services to help individuals
with disabilities become employable. It is vital that this
program have strong, experienced and effective National leadership.
However, there must also be research to reveal new knowledge;
special demonstration projects to test this knowledge in
practical settings; trained personnel to work with persons who
are disabled; and a comprehensive program providing independent
living services to persons who are so severely disabled that
they cannot benefit from traditional rehabilitation services.
Agencies must also be encouraged to initiate new programs and
expand existing ones to apply new knowledge to new groups of
individuals with disabilities. Likewise, rehabilitation
facilities must be developed or improved, in which severely disabled
individuals may be served with optimum care and expertise.
200
It is this balanced approach which enables the rehabili-
tation movement to make the widely-acclaimed progress that has
been evident throughout its history.
The Council of State Administrators of Vocational Rehabili-
tation fully supports each facet of this process and every
provision of the Rehabilitation Act.
EXTENSION OF THE ACT
We are here to strongly urge the extension of the
Rehabilitation Act of 1973, as amended, for a minimum of, at
least, three years. This will provide authorization levels
through Fiscal Year 1986. This extension is needed to insure
program stability in the State-Federal Rehabilitation Program and
to continue the provision of quality services to the millions of
disabled Americans who are in desperate need of rehabilitation.
The Rehabilitation Act of 1973, as amended, is a model of
what can be done in the human services field. We are of the
strong contention that to amend or rescind portions of this law
might severely unsettle the balance that makes this program
one of the most--if not the most--balanced program in the
human services area, as well as one of the most effective.
We further urge swift action on the part of the Congress in
the reauthorization of this law. It is imperative that the
states be given the necessary lead time in planning for future
needs. State legislatures, many of which will be in session for
short, specified periods of time, require advance knowledge of
Federal Authorization levels for future years in order to provide
the state matching financial contributions. Early reauthorization
201
by the U.S. Congress will have a significant, favorable impact
on state appropriations and programmatic decisions affecting the
rehabilitation program for future years.
The need for the extension of the Rehabilitation Act is but
one of the three main needs of the Vocational Rehabilitation
Program, for any program must have at least three main pillars
to support its effective operation. It needs wise enabling
legislation, effective leadership, and adequate appropriations.
During the past several years, the Rehabilitation Program
has been without effective, strong leadership at the Federal
level. The State-Federal Rehabilitation Program--in fact any
program--vitally needs strong, committed, and knowledgeable
national leadership. We look to the current Administration, as
we have looked to past Administrations, to provide this.
It is also vitally important that the U.S. Congress appropriate
funds that will enable the State-Federal Rehabilitation Program to
serve as many individuals who are eligible for rehabilitation
services, as is possible.
For the past few years, the number of persons served and
rehabilitated has been decreasing. This unfortunate--indeed
tragic--occurrence can be attributed to the continually-rising
costs of doing business resulting from years of suppressed funding
and debilitating inflation; the growing focus of the states on
serving more severely disabled individuals; and the recent loss of
over $100 million annually in direct service monies by the
amending of the Social Security Vocational Rehabilitation
Programs.
Despite present expenditures, there still are not sufficient
funds to serve all those eligible, disabled persons who have the
202
potential and desire to work and who need rehabilitation.
services to attain employment or self-sufficiency.
Alarmingly enough, our best estimate is that State
Rehabilitation Agencies are only able to serve one out of
every twenty persons who are eligible for services.
We are sure that there does not exist any sector of our
Nation's workforce which is experiencing more unemployment than
that experienced by persons with disabilities.
The Council strongly recommends that the Congress provide
legislation which contains authorization levels for the Basic
State Vocational Rehabilitation Program that will help to
reverse the decreasing number of persons who are being served
and rehabilitated into employment and assist in addressing
the severe and debilitating employment problems which face
persons with disabilities.
The Council recommends that the legislation extending the
Rehabilitation Act contain authorizations for Basic State Grants
under Section 100(b)(1) of the Rehabilitation Act of 1973, as
amended, equal to $1,037.8 million in Fiscal Year 1984; $1,141.1
million in Fiscal Year 1985; and $1,254.6 million in Fiscal
Year 1986.
It is vital that this Subcommittee and other Members of the
Congress understand the rationale behind this organization's
recommendations for authorization amounts for Vocational
Rehabilitation Services for the next three fiscal years:
Advocates, when giving serious consideration to their
recommendations for service monies, are always torn between
basing such figures upon need or tempering that need with
economic restraints placed upon those who control Federal.
203
appropriations.
Our recommendations would work to achieve the goal of
restoring the purchasing power of the Rehabilitation dollar to
the 1979 Section 110 Federal spending level. To achieve this,
increases in Section 110 funding would have to occur for the
next four fiscal years, at a rate equal to the above authorization
recommendations, which average approximately 9.95 percent per
year.
Fiscal Year 1979 is viewed as the last year in which the
State-Federal Rehabilitation Program operated at full strength,
for ever since that year, there has been a steady decline in the
number and types of persons with disabilities who have been served,
due to economic and programmatic factors.
We have utilized this "formula" for our recommendations,
thereby attempting to balance "need" with the reality of the
current economic climate.
While the Council of State Administrators is recommending--
based upon need as well as fiscal reality--authorization levels
for many other provisions of the Rehabilitation Act in the
chart attached to this written testimony, we do wish to
highlight the importance of Title VII of the Act.
COMPREHENSIVE SERVICES FOR INDEPENDENT LIVING
This section establishes a state grant program to meet
the current and future needs of individuals with disabilities
so severe that they do not presently have the potential for
employment, but may benefit from rehabilitation services
in order to live and function independently.
204
When this law was enacted, a substantial new service program
was envisioned with, as the U.S. Senate Report declared,
"sufficient funds" available to develop "effective long-range
plans and services. Such funds have never been made available.
The time to implement a new Comprehensive Services Program
is now. The existing Independent Living Centers across the
country have proven--and continue to prove on a daily
basis--the effectiveness of, and the need for, the full
implementation of the independent living concept.
We need desperately to supplement the services provided
by the existing Centers. This can be done by implementing
the already authorized--yet unfunded--statewide service
delivery system in independent living for the severely
disabled, under Title VII, Part A.
The CSAVR's recommendation of a $60 million authorization
for FY 1984 for this program is justified based on the need
for devising an equitable state distribution procedure for
Part A Service Grants; allowing a continued adequate funding
base for the Centers for Independent Living as authorized under
Part B; and funding for the first time an Older Blind
Individuals' Program, as authorized by Part C.
Our recommendations for authorizations for Title VII for
Fiscal Years 1985 and 1986, would also provide modest increases
in each of the Programs established under this Title. We urge
that they be given every consideration.
205
RECOMMENDATIONS FOR OTHER PROVISIONS OF THE ACT
The Council, in conjunction with many organizations
representing service providers and persons with mental and/or
physical disabilities, has agreed upon recommendations for
many of the other programs established under the Rehabilitation
Act.
As has been stated previously, each of the provisions
in this well-written statute is important to the entire mosaic
of rehabilitation services.
This organization yields to no other in advocating the
importance of each of these programs; however, we do leave to
others the role of presentation to you and the Congress of
testimony outlining the need for a continuation of each.
SUMMARY
Our justification for higher authorization amounts
arises from the purpose for which the money is spent -- the
prevention of an incalculable waste of human potential, a
purpose on which no price tag can be placed.
Whatever the cost, there is no other human service
program whose funds are spent in such a cost-effective manner
to help people to live more self-sufficient and productive
lives.
Vocational Rehabilitation has consistently more than
paid for itself by helping persons with disabilities increase
their earning capacity, by decreasing the amount of public
assistance payments they might need, and by assisting them
to become taxpayers.
22-065 0 - - 84 - 14
206
Moreover, the value of rehabilitating a person's spirit
and life, is, above all else, immeasurable.
The need is desperate. For the past months, all have
heard reports of the high levels of unemployment that our
Nation endures.
Unemployment is now hovering at a level near or above
that of the Great Depression. Currently, more than one person
in ten is out of work. In some cities and states, and among
some minorities and other societal groups, unemployment is much
higher, ranging from twenty to as high as fifty percent.
Out of need, the nation is responding to this tragedy. The
President and the Congress have apparently reached agreement
on Public Jobs legislation to provide relief to those
individuals and their families who have been affected by this
Recession.
However, we must also recognize that there does not exist
in our society any group of persons who are experiencing more
unemployment than that which is experienced by persons with
disabilities.
To begin to adequately address the severe and debilitating
employment problems of persons with disabilities, the Congress
must act swiftly to maintain and enhance the foundation of the
only major Federal program that exists to provide vital,
desperately-needed services to persons with disabilities for the
primary purpose of rendering them "employed."
The Rehabilitation Program has a successful, sixty-three
year history of providing, literally, any service demand
necessary to bridge the gap between dependency and independence
and employment.
207
It would be tragic to become mired in the "process" of
extending the Rehabilitation Act of 1973, as amended. The
task before us is clear, and great -- to prevent the
incalculable waste of human potential.
The solution, perhaps the best that government could ever
hope to offer, is before us in the form of a well-balanced
State-Federal-Private Sector Rehabilitation Program. One that
continues to provide comprehensive, cost-effective, humane,
and desperately-needed services at the community level to persons
with mental and physical disabilities who desire to work, but
lack the training, occupational skills and other services
required to actively compete in the labor force.
COUNCIL OF STATE ADMINISTRATORS OF VOCATIONAL REHABILITATION
RECOMMENDATIONS FOR AUTHORIZATIONS OF PROGRAMS ESTABLISHED BY THE REHABILITATION ACT
FOR FISCAL YEARS 1984, 1985, and 1986
(in millions)
ITEM
Proposed
Proposed
Proposed
FY 1984
FY 1985
FY 1986
BASIC
VOCATIONAL REHABILITATION
SERVICES
$1,037.8
$1,141.1
$1,254.6
(Sec. 100 (b) (1)
CLIENT ASSISTANCE PROJECTS
3.5
3.5
3.5
(Sec. 112(a)
NATIONAL INSTITUTE OF
HANDICAPPED RESEARCH
40.0
50.0
60.0
(Sec. 201 (a) (1)
208
TRAINING PROGRAM
25.5
30.5
35.5
(Sec. 304(e)
COMPREHENSIVE SERVICES FOR
INDEPENDENT LIVING
60.0
90.0
120.0
(Title VII)
ALL OTHER PROGRAMS IN ACT
"such sums"
"such sums"
"such sums"
(Various Sections)
209
[Whereupon, at 11:40 a.m., March 23, 1983, the hearing was ad-
journed.]
APPENDIX
COUNCIL OF STATE ADMINISTRATORS OF VOCATIONAL REHABILITATION
Suite 401, 1055 Thomas Jefferson Street, N.W., Washington, DC 20007
Telephone 202-638-4634
April 7, 1983
Executive Director
Joseph H. Owens, Jr.
Hon. Austin J. Murphy
Chairman
Subcommittee on Select Education
U.S. House of Representatives
Washington, D.C. 20515
Dear Mr. Chairman:
Officials of the Department of Education and the Rehabilitation
Services Administration presented testimony on March 23, before.
the House Subcommittee on Select Education, relative to the
Rehabilitation Act of 1973, as amended.
During that testimony, RSA Commissioner George Conn stated in
his remarks that this organization, the Council of State
Administrators of Vocational Rehabilitation (CSAVR), is working
cooperatively with the RSA. Placed in juxtaposition to
Mr. Conn's comments are the recommendations of the Administration
for amendments to the Act, implying that there is, at least, tacit
approval of them or the need for them by this organization.
As President of the CSAVR, I wish to state as emphatically as is
possible that this organization does not support the Adminis-
tration's proposals and has made this known to the Commissioner
on many occasions.
We do not wish to have the Subcommittee or the full Committee
misled by Mr. Conn's remarks that the CSAVR is a willing partner
in altering the Rehabilitation Act of 1973.
In summary, the view of this organization is clearly stated in
its written testimony provided, by invitation, to the Subcommittee
that it "fully supports each facet of the (rehabilitation process)
and every provision of the Rehabilitation Act."
Sincerely,
Pater P. Griseoold
Peter P. Griswold
President
Membership consists of the chief administrative officers of the state rehabilitation agencies responsible
for administration of the state-federal rehabilitation programs in each of the states
(211)
212
National
Rehabilitation
Association
633 South Washington Street
Alexandria, VA 22314
David L. Mills
(703) 836-0850
Executive Director
March 21, 1983
Representative Austin Murphy
Chairman
House Education and Labor Committee
Subcommittee on Select Education
Washington, D.C. 20515
Dear Representative Murphy:
Thank you very much for the opportunity to present the views of National
Rehabilitation Association related to the Rehabilitation Act of 1973 as
amended. I was most impressed with the interest shown by you and members
of the Subcommittee in the Act in its entirety.
I have some added comments relative to Title VII that I thought I would
communicate to you.
Currently, only Part B of Title VII is funded. These funds are issued to
support 135 Centers for Independent Living across the country. We urge
that Part A, as well, be funded, which will, as a result of the language in
the Act cause Part B to be implemented.
We recommend that 33 million dollars be authorized for Part A; 24 million
dollars be authorized for Part B and 3 million dollars be authorized for
Part C.
Funding for Part A will provide a vital link between the Centers for Independent
Living and the State Vocational Rehabilitation Agencies. It will afford persons
with severe disabilities the option of pursuing employment possibilities.
The initial intent of Title VII was to meet the needs of those persons with
severe disabilities not yet ready for vocational rehabilitation services.
Part A, when implemented will enable this laudable goal to be addressed.
As testimony was presented to your committee on March 21, I was struck by
the high degree of inter-relatedeness of all parts of the Rehabilitation Act.
Each part of the Act is vital to the whole.
We know you are faced with difficult financial choices; we also know that
reduction in funding in any section or title of the Act will have deleterious
effects on all parts.
213
We hope that our views and the other views which you will receive, support our
conclusion that the public investment in the programs in the Rehabilitation Act
deserves an increased public investment across all titles of the Act.
Once again, thank you for your dedication and deep commitment to the concern of
persons with disabilities.
Yours truly,
Marvin OSpears
Marvin 0. Spears
President
NATIONAL REHABILITATION ASSOCIATION
214
THE NAVAJO NATION
WINDOW ROCK. NAVAJO NATION (ARIZONA) 86515
PETERSON ZAH
THE OF TRIBE
EDWARD T. BEGAY
CHAIRMAN, NAVAJO TRIBAL COUNCIL
VICE CHAIRMAN, NAVAJO TRIBAL COUNCIL
March 30, 1983
The Honorable Carl D. Perkins
U. S. House of Representatives
Washington, D. C. 20515
Dear Congressional Delegate:
Enclosed please find a written testimonial by the Navajo Tribe
addressing the recommended considerations for amendments to Public
Law 95-602, the 1978 amendments to the Rehabilitation Act. This
testimony specifically addresses Title I, Part D, Section 130,
Rehabilitation Services to American Indians.
We hope that you can lend your support and advocacy to the serious
consideration and implementation of these recommendations. We are
confident that your concern is for appropriate vocational rehabi-
litation services to all disabled people, and in particular, to
disabled American Indians.
We, as American Indians, will be ever grateful and appreciative of
your support of the recommendations and concerns outlined in this
testimony. For further information, contact Mr. Elmer J. Guy,
Director of the Navajo Vocational Rehabilitation Program, P. 0.
Box 1420, Navajo Tribe, Window Rock, Arizona 86515, (602)
871-5076.
Respectfully,
David Prosi
David J. Tsosie, Chairman
Education Committee
Navajo Tribal Council
Enclosures
/mth
215
TESTIMONY BY THE NAVAJO TRIBE FOR
AMERICAN INDIAN REHABILITATION SERVICES
Until the recent past, services to rehabilitate disabled people
were administered totally by the states and the Federal Government
with little or no regard for the special needs of handicapped
Native Americans. The experiences of disabled American Indians
with these services have demonstrated the inadequacy of state
rehabilitation services to meet their needs. Disabled Navajo
clients have been closed out for "failure to cooperate", "no
contacts" or "unsuccessful" for when they had not responded to
written communication because they could not read, had not
returned calls because they had no telephones, they had no trans-
portation to attend appointments, etc. Rehabilitation is a
numbers game and in order to claim successful closures among
Navajos, state vocational rehabilitation (V.R.) counselors would
close them out as "successful" sheepherders.
In the mid-1960s the Navajo people themselves took the initiative
to intervene on behalf of their disabled clansmen. They
challenged the inefficient, unfair, and unrealistic practices of
State VR Programs. These deficiences included:
1. Lack of adequate and appropriate counselor orienta-
tion to the culture and heritage of Navajo clients -
office providing statewide VR services were, for the
most part located in large metropolitan areas within
the state. Counselors in these cities were familiar
only with the circumstances of clients who had ready
access to such conveniences as telephone, public
transportation systems, timely delivery of mail, in-
dustries and support services. Navajo clients
living in remote areas, hundreds of miles away from
from these counselors and many miles away from paved
roads were expected to respond and comply with the
same system being implemented in the cities. These
state counselors made infrequent visits to the homes
of Navajo clients and were heavily dependent upon
written communication. Many Navajo VR clients,
however, could not read or write. In the event of a
home visit, counselors could not communicate effec-
tively with clients because of the language barrier.
Interpreters were often of minimal help and, some
cases, created greater problems through misinter-
pretations. Delivery of mail to Navajo families
was, and in some instances still is sporadic,
untimely, undependable and communal (i.e. it's de-
livered to the trading post and families pick it up
when they come in for supplies). Telephones, were
and are few and far between and clients have had no
access to local public transportation.
2. Limited Services - State VR Programs had no pro-
216
visions, or active plans to recruit Counselor who
were familiar with the Navajo people and their
language, life styles and locale. As stated before
State VR offices were not located in proximity to
Navajo clients. In addition, State VR Counselors
were often selective in the clientele they would
serve. Severely disabled Navajo clients were often
placed as low priority. Their cases were too often
dismissed with the explantion: "too severely disabled",
"unwilling to relocate", "failure to cooperate", etc.
State VR Services will primarily focused in cities and
border towns.
3. Irrelevant Goals - Goals and objectives which were
set by State VR Programs often took into consider-
ation only urban settings with their conveniences
and industrialization. NO consideration was given
to rural isolated Indian communities, their culture,
or their economy.
4. Lack of cross-governmental coordination - The Navajo
reservation and its population extend into three
states (Arizona, New Mexico, Utah) and three federal
regions (VII, VIII, IX). Each governmental unit
claimed jurisdiction and responsibility over only a
portion of the reservation. There was little, if
any, interstate and interregion coordination. The
Navajo people were impelled to contend with three
different state programs, as well as their own
tribal government and the Bureau of Indian Affairs.
5. Native Healing Services - State VR Programs had no
provisions to incorporate the use of Native healing.
services into the rehabilitation process of disabled
Navajos. The use of such services by Navajos is an
essential aspect of their lives and plays a vital
role in their treatment of disabilities. Disallow-
of the use of Native Healing Services by traditional
rehabilitation systems represented disrespect to
Navajo people and Navajo clients and actually
impeded the rehabilitation. process in many cases.
This situation changed in 1978. In that year an amendment to the
Rehabilitation Act of 1973 (P.L. 93-112) added Section 130.
Section 130 specifically addresses the rehabilitation of American
Indians. It contains provisions for earmarking funds of up to 18
of the overall rehabilitation allotment to support the Indian
Tribal vocational rehabilitation programs. Funds were not avail-
able under this provision until fiscal year 1981.
In the immediate years preceding receipt of federal vocational re-
habilitation dollars by the Navajo Tribe, The Tribe undertook the
coordination and consolidation of VR services for the Navajo
people. This was the beginning of cross-governmental coordination
217
for the provision of appropriate VR services to disabled Navajo
clients. The Navajo Vocational Rehabilitation Program has been
the sole project funded under Section 130 of P. L. 95-602. It has
had an annual appropriation minimally of $650,000, an amount which
impacts only a portion of the needs. This project, administered
by Navajos with a staff which is over 90% Navajo, has made
measurable progress towards the delivery of appropriate VR ser-
vices to its clientele. The program serves over five hundred
(500) disabled Navajos annually. Navajo clients have found
employment in welding, clerical work, pastor, computer operator,
etc The Program now has rehabilitation workers who are
familiar with the local economy, the language, the culture and
habitat of the people. The program is making the local government
aware of the employment needs and desires of disabled Navajos.
Local employers are becoming sensitized to the potential of this
work force.
The Navajo Vocational Rehabilitation Program was established in
1975. It has been in operation for eight years. The program has
grown much during this time:
1. Beginning as a State VR sub-office, it now
operates as an autonomous program.
2. Beginning with a staff of five, the program is
now staffed by nineteen dedicated and qualified
individuals.
3. Beginning as a small seemingly insignificant sub-
component program within the Navajo Division of
Education it has now attained Branch status. within
the Division with a total staff of over thirty in
four handicapped service related programs.
4. Beginning with a caseload of less than 75 the pro-
gram now maintains a caseload of over 400 active
files.
Viewing these accomplishments, the Navajo Tribe feels that it has
proven its capability for administering a VR program to serve its
disabled citizens. The Navajo Tribe feels that the Navajo Vo-
cational Rehabilitation Program should receive recognition commen-
surate to its proven abilities and be granted secure funding,
comparable to state and trust territory programs. Such funding
can be justified based upon area served, population served,
program uniqueness, governmental status, and federal responsi-
bility to Indian Tribes. The Navajo Tribe seeks your support in
attaining status comparable to a state or trust territory under
Title I of the Rehabilitation Act. There are trust territories of
the United States of America which are afforded this status. Some
of these trust territories have a population less than that of the
Navajo Nation (160,000), occupy a geographical area less than that
of the Navajo Nation (25,000 square miles), and yet receive a
greater funding allocation.
218
In addition, we are seeking this status in order to make the
funding of specific VR services to Navajo people more secure.
Under Section 130, we have been required annually to secure a
special congressional appropriation for our program under Section
130. It was the understanding of the Navajo Tribe from reading
Section 130 that upon receipt of federal dollars to the Navajo
Vocational Rehabilitation Program, states formally providing VR
services to the Navajo Nation would cut back in those services and
in funds requested for those services one-third each year, giving
total VR responsibility to the Navajo Vocational Rehabilitation
Program in the third year. The States have followed this proce-
dure in case management, but not in fiscal matters. They are
still receiving formula allocations based upon the inclusions of
the Navajo disabled population. We are still receiving "special
project" funding with year-to-year funding under Section 130, and
with the withdrawal of VR services by states, the Navajo Vo-
cational Rehabilitation Program fears for the lack of long-term
provision of VR services to Navajo people. We are soliciting the
support of this subcommittee for the continuance and stabilization
of funding for the Navajo Vocational Rehabilitation Program
through appropriate legislation.
The need remains for appropriations under Section 130 of P.L.
95-602 to support innovative initiatives for the provision of
appropriate and relevant VR services to American Indians. Should
the recognition of the Navajo Vocational Rehabilitation Program as
a State Status Program not receive favorable action, there is a
need to increase funding appropriations under Section 130 to meet
the expansion of the Navajo Vocational Rehabilitation Program as
well as the. possible development of VR programs among other Indian
Tribes. Failure to increase appropriations under Section 130 will
result in intense competition by Indian groups for minimal allo-
cations and/or reduced services as more programs are added.
There is an additional need to assure and guarantee continual
fiscal support of successful VR programs for American Indians.
Many man hours are devoted annually to securing appropriations
under Section 130. This time could be better spent serving our
clients. We hope you will assist us in securing the legislation
necessary to give our program the legal support and financial
support it needs to continue.
Thank you.
219
FACT SHEET FOR NAVAJO TRIBE'S , TESTIMONY
CURRENT CASE STATUS
August 1982 - March 1983
AGENCY:
TOTAL
00
02
06
08
10
12
14
16
18
20
22
24
26
28
30
Chinle
97
3
20
16
22
5
1
5
1
4,
1
1
5
0
7
6
Crownpoint
46
3
14
7
15
0
0
4
0
1
0
0
1
0
0
1
Ft. Defiance
98
2
38
3
35
0
0
2
0
6
1
3
0
2
6
0
Shiprock
72
6
24
7
18
1
0
5
0
4
0
2
0
2
3
0
I
Tuba City
89
11
23
2
6
0
4
4
1
14
1
3
3
11
4
2
$
Blind Clients
37
83220100100000
0
TOTAL:
439
33
132
37
108
6
6
20
2
30
3
9
9
15
20
9
371 Severely Disabled
84.5% Severely Disabled
SUCCESSFUL REHABILITATION CLOSURES IN SEVEN MONTH PERIOD
(August 1982 - March 1983)
JOB TITLE:
Sheltered employment
Pastor
Stock Boy
Dishwasher
Drafting Assistance
Truck Operator
Fiberglass Moduler
Clerk Typist
Computer Operator
Construction Carpenter Aide
Maintenance Man
Residential Aide
Alcoholism Guidance Counselor
Welder
Cashier Clerk
Assistant Manager.
Para-Legal Advocate
Number of clients awaiting VR services: Sixty-three (63)
220
E. NAVAJO NATION STATUS SYSTEM:
Navajo Vocational Rehabilitation Program Status. Provision for native healing
services include as authorize by Public Law 95-602, Title I, Part D, Section
130, 1362.45 "Projects for American Indian Vocational Rehabilitation Services,"
Status 00. REFERRAL This is the date client is first brought to the attention
of Vocational Rehabilitation.
STATUS 02. APPLICANT A referred individual becames an applicant when the
applicantion document requesting vocational rehabilitation services is
signed. Native healing service diagnostic provision.
STATUS 06. EXTENDED EVALUATION An applicant is placed in extended evaluation
if counselor certifies: 1) the presence of a handicap to employment, and
2) an inability to make a determination-thes services might benefit the
client unless there is an extended evaluation to determine rehabilitation
potential. A case may remain in stacus 06 no longer than 18 months.
Native healing service provision.
STATUS 08. CASE CLOSED FROM REFERRAL, APPLICANT OR EXTENDED EVALUATION A
case is closed in status 08 if client does not meet the basic eligibility
requirements to be accepted into status 10.
STATUS 10. IWPP DEVELOPMENT After establishing the presence of an employment
handicap and the reasonable expectation services will benefit the client
in terms of employability, a case is placed in status 10 while case study
and diagnostic are completed to provide the basis of a rehabilitation
program
STATUS 12. IWRP READY FOR IMPLEMENTATION A case is placed in status 12 when
the rehabilitation program is written and approved and until such time as
at least one service/has been initiated.
STATUS 14. COUNSELING AND GUIDANCE ONLY Under a rehabilitation program,
counseling and guidance by the Vocational Rehabilitation Counselor and
placement are the only services which may be provided in this status.
STATUS 16. PHYSICAL AND MENTAL RESTORATION A case is placed in status 16 at
the time restoration services are initiated. Training may be provided
simultaneously with restoration in status 16 if the restoration service
is expected to run for the longer period of time. Native healing service
provision.
STATUS 18. TRAINING The case is placed in status 18 when training services
are initiated. Restoration services may be provided simultaneously with
training in status 18 if the training is expected to run for the longer
period of time.
STATUS 20. READY FOR EMPLOYMENT The case. is placed in status 20 when the
renabilitation program has been completed or terminated and client is
ready to accept employment.
STATUS 22. IN EMPLOYMENT The case is placed in status 22 when client
actually begins employment.
STATUS 24. SERVICE INTERRUPTED The case is placed in status 24 when services
are interruped in statuses 14, 16, 18, 20 or 22. The case remains in
status 24 until client returns to one of these statuses or case is closed.
STATUS 26. CLOSED REHABILITATED Case is closed status 26 when client has
been proviced all appropriate services, the rehabilitation program has
been completed insofar as possible, and client has been suitably employed
for a minimir of 60 days.
STATUS 28. CLOSED NOT REHABILITATED AFTER PROCRAM INITIATED A case is closed
status 26.14 at least one service was provided (status 14, 16 or 18) but
client is unable to continue the program.
STATUS 30. CLOSED NOT REHABILITATED BEFORE PROGRAM INITIATED A case is closed
status 30 it client. was accepted for services (status 10 or 12) but was
unable to actually begin a rehabilitation program.
221
State
SERVING THE
HANDICAPPED
national
Le
easter seal society
60 YEARS OF SERVICE TO HANDICAPPED PEOPLE
Office of Governmental Affairs
March 30, 1983
The Honorable Austin J. Murphy
Chairman
House Subcommittee on
Select Education
Room 617, House Annex #1
Washington, D. C. 20515
Dear Mr. Chairman:
The National Easter Seal Society appreciates the opportunity to contribute
to the evaluation and improvement of the programs under the Rehabilitation Act.
As the nation's oldest and largest voluntary health agency, Easter Seals has ac-
tively participated in the growth and development of the rehabilitation movement.
The National Society believes that the reauthorization process provides an excel-
lent opportunity to assess once again the effectiveness of Rehabilitation Act
programs and services. In addition, it provides an occasion for the many federal,
state, local and private rehabilitation agencies to reaffirm their commitment to
providing quality services to persons with disabilities.
Historically, Easter Seal involvement in the provision of rehabilitation
services to the public predates the federal role in this area. Easter Seals was
founded in Ohio in 1919, in order to provide rehabilitation services to children
with disabilities. A year later, the federal government established its first
non-military rehabilitation program under the National Civilian Vocational Rehabili-
tation Act (also known as the Smith-Fess Act).
In the more than sixty years that have elapsed, the Easter Seal Society has
expanded in size and scope of services. The National Easter Seal Society current-
ly represents 827 state and local societies. These societies offer a wide range
of rehabilitation, health care and related services to both children and adults.
In 1982, Easter Seals served over 759,000 individuals. Many of these people
were served under programs authorized by the Rehabilitation Act. It is through
this level of involvement and through our role as an advocate for persons with
disabilities that the National Society has developed the views expressed in
this statement.
As written, the Rehabilitation Act embodies one of the most comprehensive
and effective systems of providing human services. The National Society wholly
supports the Rehabilitation Act and urges Congress to extend authorization for
a period of five years. It is our belief that the programs authorized under the
1435 G STREET, N.W. SUITE 1032 WASHINGTON, D.C. 20005 (202) 347-3066
22-065 0 - 84 - 15
222
Rehabilitation Act represent a broad and balanced approach to meeting the rehab-
ilitation needs of persons with disabilities. We encourage Congress to retain
all of the programs provided for under the Act, regardless of their funding status.
Each of these programs and the services they provide represents a unique and vital
aspect of the overall rehabilitation process.
Easter Seal Proposals
This statement reflects the concerns of the National Society and the organiza-
tions it represents relative to programs under the Rehabilitation Act. For the
most part, these concerns focus on the ability of nonprofit rehabilitation centers
to participate effectively in the vocational and related rehabilitation programs
in the Act. These programs represent one of the largest, most comprehensive sources
of rehabilitation services available to people with disabilities. We believe, there-
fore, that every effort should be made to improve the Rehabilitation Act as written
and as administered.
The National Society has identified several provisions in the Act which re-
quire either amendment, report language or simply the attention of Congress. These
include the "work center" definition, support services for rehabilitation facilities,
the federal role relative to Rehabilitation Act programs and the need for recrea-
tion services. The National Society urges Congress to examine these areas during
reauthorization and, in so doing, consider Easter Seals' recommendations. We also
ask that Congress consider the testimony prepared by the Consortium for Citizens
with Developmental Disabilities, which was submitted on behalf of Easter Seals and
thirteen other organizations.
The New "Work Center" Terminology
The National Society proposes that the Rehabilitation Act be amended to in-
clude the definition of the term "work center". This term describes those voca-
tional rehabilitation facilities formerly referred to as "sheltered workshops".
It is our belief that the old, familiar "workshop" label no longer projects an
acceptable, and in some cases, accurate image of today's vocational rehabilitation
facilities. This amendment, therefore, is intended to establish the "work center"
term in the Act to more clearly define the positive and productive nature of these
vocational rehabilitation facilities.
In an effort to reflect the positive development of vocational rehabilitation
facilities in the Rehabilitation Act, the National Society proposes that the "work
center" term be added. This can be accomplished by adding the "work center" defi-
nition as Section 7(16), which would read. as follows:
The term "work center" means a rehabilitation facility, or that
part of a rehabilitation facility, engaged in production or service
operation for the primary purpose of providing employment as an in-
terim step in the rehabilitation process or as an extended work op-
portunity for those invididuals who cannot be readily absorbed in
the competitive labor market.
The National Society proposes that the term "work center" be substituted for the
term "workshop" wherever it is used in the Act. The adoption of the term "work
center" provides needed recognition for the substantial changes that have occurred
in vocational rehabilitation facilities. During the past several years, such faci-
lities have initiated new and innovative work programs. These programs have
greatly expanded the vocational rehabilitation process and, as a result, have in-
223
creased the opportunities available to individuals with disabilities. In addi-
tion, new types of personnel have been employed by these facilities to achieve a
range of skills more comparable to those found in competitive employment. The new
"work center" terminology sends a signal to the community that a definite and posi-
tive transition has taken place within those facilities known as "sheltered work-
shops".
A major benefit of the "work center" amendment is the incentive which the new
terminology provides to vocational rehabilitation facilities to reassess their roles
in the community. Consideration of the "work center" concept by facilities will
bring about a review of organizational goals and structure. For many facilities,
the adoption of the "work center" identity will be accompanied by a revised sense
of mission and an improved vocational rehabilitation program.
In this regard, the adoption of the "work center" designation by a facility
represents an important step in its organizational evolution. The transition of
a "workshop" to a "work center" demonstrates to the community an effort on the part
of the facility to redefine its purpose. This transition can be viewed as a means
by which the facility signals its intention to become more businesslike. In ef-
fect, the new name upgrades the image of the facility to a more productive, work-
oriented center for rehabilitation. This new image can be used to promote greater
involvement of employers and, consequently, will lead to an increase in the number
of contracts and improved placement of persons with disabilities in the competitive
labor market. The National Society believes that adoption of the "work center"
identity represents much more than a superficial substitution of terms. It represents
a timely and significant opportunity in the development of vocational rehabilitation
facilities.
Support for Rehabilitation Facilities
Rehabilitation facilities are a critical component in the provision of services
to individuals with disabilities. Although these facilities vary in size, range of
services and sophistication, they are all devoted to providing high quality, cost-
effective rehabilitation services. For many persons with disabilities, the local
rehabiliation facility represents much more than a service provider. The facility
and its staff represent a vital source of assistance through which personal fulfill-
ment, independence and vocational goals can be achieved.
The Rehabilitation Act has placed considerable emphasis on the utilization of
rehabilitation facilities. Under Title I, rehabilitation facilities provide the
means for evaluating, treating and training persons with disabilities. In fact,
a significant percentage of the funds expended by state vocational rehabilitation
agencies each year is spent on services to individuals in rehabilitation facilities.
In 1979, rehabilitation facilities provided services to 185,000 or 20% of all state
vocational rehabilitation clients. That year, the services provided by rehabilita-
tion facilities to vocational rehabilitation clients represented 33.9% of the total
state agency budget.
Although some rehabilitation facilities are operated by state and local gov-
ernments, the majority are operated by voluntary agencies. Approximately 30% of the
vocational rehabilitation services financed annually by state agencies are delivered
in nonprofit rehabilitation facilities. In addition, these facilities are often
the site of a vast array of support services, including recreation, transportation
and independent living.
224
Given the substantial role of nonprofit rehabilitation facilities in the
provision of vocational and related rehabilitation services, the National Society
believes that the federal government has a strong interest in the continued suc-
cess of these facilities. In terms of the quantity and quality of services pro-
vided by nonprofit rehabilitation facilities, the federal stake is considerable.
For this reason, the National Society proposes that federal support for nonprofit
rehabilitation facilities under the Rehabilitation Act be proportionate to the
level of services provided by these facilities under the Act.
Currently, there are a number of provisions contained in the Rehabilitation
Act (funded and unfunded) which provide support for nonprofit rehabilitation facili-
ties. These include programs for facility construction, loan guarantees and federal
improvement grants, rehabilitation training and rehabilitation research. The
National Society believes that federal financial assistance for facility construc-
tion and improvement is a cost-effective means of assuring the future presence of
nonprofit facilities in the national rehabilitation effort. Similarly, the level
of investment in facility-oriented rehabilitation training and research has a
direct impact on the personnel and technology available to rehabilitation facili-
ties. Furthermore, provisions exist under the Act to provide technical assistance
to nonprofit rehabilitation facilities. These provisions must be restructured in
order to restore the level of assistance to nonprofit rehabilitation facilities
originally intended by Congress.
As written, the Rehabilitation Act provides ample evidence of a federal com-
mitment to the construction and periodic improvement of nonprofit rehabilitation
facilities. Under Title III, Sections 301, 302 and 303 of the Act, provisions were
established which would make funding available to build, equip and staff rehabili-
tation facilities, assist in the financing of facilities through federal loan
guarantees, and assess and improve facility services and staff. Unfortunately,
the provision regarding loan guarantees has never been funded and the construction
and improvement grant programs have not received funding in recent years. It should
be noted, however, that when such monies were available, these programs proved very
effective.
The lack of federal finanical support at this time is especially damaging.
Many rehabilitation facilities are in critical need of repair and modernization.
Built decades ago, these facilities need an infusion of funds in order to retain
their effectiveness as competent providers of rehabilitation services. In addition,
population shifts have created a strong demand for rehabilitation services in many
areas of the south and southwest. Many communities are ill-equipped to meet these
needs. Similarly, the emphasis on deinstitutionalization has greatly increased
the demand for outpatient rehabilitation services. The combined effect of these
trends and the aging of existing rehabilitation facilities makes the need for
federal support clear.
The National Society urges Congress to recognize the need for a strong federal
role in the construction and improvement of nonprofit rehabilitation facilities.
Despite an authority to spend as much as ten percent of their rehabilitation budget
on construction, states have not demonstrated a willingness to acknowledge this
area of need. Furthermore, present economic conditions make it much more difficult
for nonprofit facilities to raise independently the needed monies. Unless Congress
reaffirms an interest in these programs, the share of rehabilitation services pro-
vided by nonprofit facilities could soon be jeopardized.
225
A similar challenge has developed in the fields of rehabilitation training
and rehabilitation research. Under the Act, the Rehabilitation Training program
was established to ensure that skilled rehabilitation professionals would be
available to meet the needs of persons with disabilities. Similarly, the National
Institute of Handicapped Research was created in order to promote research and
technological advancement in areas of importance to people with disabilities. Un-
fortunately, as these programs have evolved, the resources devoted to facility-
oriented fields diminished. This has occurred despite language within the Act
which specifically addresses the needs of nonprofit rehabilitation facilities.
As an advocate for individuals with disabilities and a major provider of re-
habilitation services, Easter Seals believes that facility-related training and
research projects should be established in each of these national programs. Again,
the large-scale involvement of nonprofit facilities in the field of rehabilitation
demands that greater emphasis be placed on facility needs within training and
research. Easter Seal facilities are often forced to operate with reduced staff,
due to the shortage of trained rehabilitation personnel. The need for pre-service
and in-service training for nonprofit facility staff is glaring. Furthermore, the
National Society and many other nonprofit agencies support valuable research ac-
tivities in the area of rehabilitation. However, a commitment is required at. the
national level to see that the unique aspects of the facility environment are con-
sidered. The National Society urges Congress to restate the importance of facility-
oriented training and research activities under the Act. The amount of resources
devoted to rehabilitation training and, to a lesser degree, research might well be
linked to the level of rehabilitation services provided by facilities. This would
guarantee that facility-specific needs are given adequate attention and, as a result,
provide a reliable source of skilled personnel and the benefits of research.
Another important concern of rehabilitation facility administrators is the need
for technical assistance under the Rehabilitation Act. Nonprofit rehabilitation
facilities are continually searching for new ideas and alternatives to enhance the
quality and delivery of services. In the past, federal technical assistance proved
invaluable to nonprofit facilities. Under the Act, RSA coordinated the matching
of consultants to the needs of specific rehabilitation facilities. These expert
consultants provided technical assistance on a wide range of topics, including
accounting, contract procurement, safety, work evaluation, engineering and program
services. In addition to the benefits realized by facilities in implementing the
consultants' recommendations, the use of "internal" experts provided a substantial
cost-savings with respect to purchasing consultation services. At an estimated
average cost of $500 per consultation, this federally-sponsored assistance cost
considerably less than comparable assistance purchased in the marketplace.
Unfortunately, the provision which enabled this technical assistance for non-
profit rehabilitation facilities was greatly weakened as a result of the 1978
amendments. In 1973, technical assistance was extended to nonprofit organizations
other than rehabilitation facilities, but only for advice on the elimination of
architectural and transportation barriers. In an effort to expand this provision,
the authority regarding technical assistance was revised to make rehabilitation
facilities and other nonprofit agencies eligible for full federal technical assis-
tance. However, this change led to a condensation of the language in the Act. As
a result, the Office of General Counsel interpreted the new wording to mean that
technical assistance was available only for barrier removal both for facilities
and other nonprofit agencies. Authority for the provision was moved from Title
III, Section 304(e)(1) to Title V, Section 506, of the Act. Following this change,
226
technical assistance to rehabilitation facilities continued through 1981 under
Section 12 of the Act. No general assistance or assistance regarding barrier
removal has been provided to rehabilitation or other nonprofit agencies under
Section 506 since the authority was revised.
The National Society believes that federal technical assistance is critical
to the successful operation of nonprofit rehabilitation facilities. Consequently,
the National Society proposes that the authority for technical assistance to non-
profit rehabilitation facilities and other organizations be restored to Title III
of the Act. This can be accomplished by rewording Section 506(1) of Title V to
read: "The Secretary shall provide by contract with experts or consultants or
groups thereof, technical assistance --
A) to rehabilitation facilities; and
B) to any public or nonprofit agency, institution,
organization, or facility."
The language in Sections 506(2) and (4) need not be changed. The revised provision,
comprised of Sections (1), (2) and (4), should be moved to Part A under Title III.
The National Easter Seal Society believes that this amendment will effectively
restore the authority for facility-directed technical assistance. In addition to
the direct benefits, such as better fiscal management and improved marketing and
program services, the consultations introduce a diverse group of technical special-
ists to the rehabilitation environment. It is our belief that the revitalization
of federal technical assistance to nonprofit rehabilitation facilities is a necessary
and cost-efficient means of helping such facilities effectively meet the needs of
persons with disabilities.
At the same time, the intent of the 1978 amendments should not be lost. Al-
though assistance regarding the removal of architectural, transportation and com-
munications barriers has never materialized under Section 506, a definite need for
such targeted assistance exists. Nonprofit rehabilitation facilities and other
agencies have demonstrated an eagerness to remove barriers confronting persons
with disabilities. However, the funding allocated to the Architectural and Trans-
portation Barriers Compliance Board to provide technical assistance in this area
severely limits the amount of assistance available. The National Society urges
Congress to adopt report language during reauthorization which strengthens the
Board's role in providing technical assistance to nonprofit rehabilitation facili-
ties. Such language should also instruct the Board to cooperate with facility
representatives and Rehabilitation Services Administration personnel to identify
the specific needs of facilities relative to the removal of barriers. Moreover,
report language should expand these efforts to include facility-oriented barrier
research and technological development.
Lastly, the formula of reimbursement for services provided to vocational
rehabilitation clients by nonprofit rehabilitation agencies is a point of contention.
The National Society would like to go on record in opposition to the use of chari-
table contributions as an offset to reimbursement for services provided by rehabili-
tation facilities. As noted earlier, the state vocational rehabilitation agencies
rely heavily on nonprofit facilities to provide a broad range of rehabilitation
services. What wasn't noted, however, was the degree of control exercised by state
agencies over such facilities through determination of reimbursement amounts.
Reimbursement is generally made through the payment of fees which are negotiated
with nonprofit facilities. The fees ordinarily reflect salaries, depreciation of
227
the building and equipment, supplies, utilities and other operating expenses.
Unfortunately, certain state agencies have, in the past, elected to consider the
unrestricted charitable donations of a facility as an offset to reduce the re-
imbursement amount. This practice acts as a disincentive to facilities to raise
funds within their communities. Such donations are extremely important to many
facilities and contribute significantly to the scope and quality of the services
they provide. Moreover, contributed income often compensates the facility for
rehabilitation services that are not reimburseable or are provided to persons
unable to pay for them. At a time when the Administration is advocating the
maximum use of private sector resources, the offset of charitable contributions
by state agencies is conspicuously inconsistent.
The National Society urges Congress to amend the Act to prohibit the offset
of charitable contributions in the formula used to determine reimbursement for
rehabilitation facility services. These facilities are entitled to adequate
payment for the rehabilitation services they provide. We believe that guidelines
to this effect, at the federal level, will ensure that rehabilitation facilities
across the nation receive reimbursement comensurate with costs.
The Federal Role
As an advocate for people with disabilities, the National Society is very
concerned about the role of the federal government relative to programs under
the Rehabilitation Act. Traditionally, federal involvement in service programs
administered by states has been meant to ensure that the intent of Congress is
met, that the program is administered uniformly across states, and that innovative
projects are funded in order to demonstrate new methods, services and technologies.
The National Society believes that this active federal role is advantageous and
appropriate for the effective provision of quality rehabilitation services.
Recently, however, there has been a noticeable decline in the level of
federal participation in Rehabilitation Act programs. For this reason, the
National Society proposes that Congress use the reauthorization process to re-
view the federal role regarding programs under the Act. Our statement focuses
on several issues relevant to federal involvement, including the collection and
analysis of program data and the use of resulting statistics to evaluate program
effectiveness.
For the past sixty-three years, state and federal agencies, rehabilitation
facilities and others have cooperated in the provision of vocational and related
rehabilitation services. Under Title I, the vocational rehabilitation program
has clearly demonstrated the success of the state-federal partnership in pro-
viding needed services to persons with disabilities. In an effort to maintain
an ongoing assessment of the success and substance of these services, the
Rehabilitation Services Administration (RSA) collects a wide range of program in-
formation. This information is analyzed and delivered to Congress on an annual
basis. The Congress uses this information in its oversight activities. In addition,
RSA disseminates the results of these assessments to all state vocational rehabili-
tation agencies. State administrators rely on the statistics prepared by RSA to
compare individual program performance to that of other states. Through comparison,
state agencies can identify programs in need of improvement and take steps to bring
them in line with similar programs in other states. Furthermore, RSA uses these
statistics to regulate the delivery of vocational rehabilitation services and
administer efficiently this substantial human service program.
228
The National Society believes that current and accurate statistics are fun-
damental to every facet of program administration. Reliable statistics contribute
much to the skillful administration and delivery of vocational rehabilitation
services. Unfortunately, the collection and analysis of program data has been sig-
nificantly reduced in recent years. In the interest of lessening the burden of
federal paperwork requirements, RSA has been instructed to limit its data proces-
sing activities. Much of the data that was previously collected and analyzed
with respect to the services delivered under Title I, is no longer being gathered
by RSA.
The National Society recognizes the intent of the regulatory reform efforts,
but we believe that accurate program statistics are invaluable to the effective
administration of the vocational rehabilitation program. It is our understanding
that the familiar reporting form R-300 has been replaced by a shorter form, the
911. Under the 911, data regarding the client's family and the amount of public
monies received at application to the program and at closure will no longer be
required. This represents a loss of information that has traditionally provided
a better understanding of the client's background and a measure of the program's
impact with respect to the client's reliance on public assistance. In addition,
state agencies have been given the option of reporting 911 data on a sample basis.
Fortunately, few states are expected to exercise this option, as essentially all
of the information required by the 911 is collected by states for their own use.
Although considerably abridged, the National Society believes that the 911 form
is an effective data collection instrument. However, we also believe that it rep-
resents the absolute minimum amount of information that should be collected in the
evaluation of the vocational rehabilitation program.
The National Society certainly supports efforts directed at reducing the
burden of paperwork required by the federal government However, the limitation
on RSA to collect needed program information does not seem to be in the best in-
terest of the program. The statistics formerly collected by RSA are, for the
most part, still collected by state vocational rehabilitation agencies. These
statistics are basic to the administration of the vocational rehabilitation
program at the state level. It would follow that they are of equal importance
at the federal level.
In addition, the revision of reporting forms to lessen paperwork requirements
has, in some cases, meant that simple procedures to insure accuracy have been elim-
inated. For example, RSA has been directed by the Office of Management and Budget
(OMB) to refrain from collecting certain derivative data. What this means is. that,
on some forms, states are not required to provide totals for columns of figures
reported to RSA. As a result, RSA staff are often required to seek verification
for much of the data, SO as to avoid the use of figures which may have been in-
correctly recorded on the form. Consequently, a quick and simple calculation
at the state level has been traded for the expense of follow-up calls and the
greater risk that inaccurate program information will go undetected.
Under the Act, the Secretary is directed to report annually to Congress on
the effectiveness of the vocational rehabilitation program. It would be extreme-
ly unfortunate if the efforts aimed at deregulation were to erode the data base
available to Congress for meaningful oversight. The National Society urges Congress
to consider carefully the information currently available regarding the programs.
under Title I of the Rehabilitation Act. A detailed review of the data, collected
and analyzed relative to the provision of. vocational rehabilitation services should
229
be conducted, so that the statistics needed by Congress are readily available.
In addition, the National Society urges Congress to include in its review an eval-
uation of the role of the Office of Management and Budget (OMB) in the operation
of Title I programs. During the past few years, OMB has actively pursued the de-
regulation of these programs. In particular, OMB has targeted the information
collected by RSA from state agencies in its efforts to reduce burdensome paperwork.
The National Society lauds these activities in that they eliminate the reporting
requirements no longer of benefit to the rehabilitation process. However, it is
our belief that the extent of the burden can best be determined by the state
vocational rehabilitation agencies themselves. Once program participants have
identified data reporting elements that are no longer of value, it would seem
appropriate to involve OMB in the process of revising forms and data collection
procedures.
The National Society proposes that the Act be amended to include a provision
which directs that the RSA-SSA Data Link be maintained. The RSA-SSA Data Link
is a useful tool for the assessment of the impact of vocational rehabilitation on
the lives of persons with disabilities. In November, 1982, RSA released a report
summarizing the Data Link study results. The report, entitled "The Long Term
Impact of Vocational Rehabilitation, By Severity of Disability", revealed that:
1) The post-closure earnings and employment experience of disabled
persons rehabilitated in the State-Federal program of vocational rehab-
ilitation was found to be superior to that of persons who could not be
rehabilitated. The study applies to the period ranging from the year
before referral, 1973 on the average, to the third year after case
closure, 1977.
2) The failure to be rehabilitated had a much harsher enconomic
impact on severely disabled persons than on those who were not severe-
ly disabled in terms of employment and earnings in the three years
after case closure.
The same report provided the earnings per dollar of expenditure and an earnings
summary record for severely disabled and non-severely disabled individuals.
The information obtained from this cooperative effort between RSA and the
Social Security Administration provides a valuable measure of the impact of rehabi-
litation on the employment and earnings of persons with disabilities. Unfortunately,
no Data Link data beyond calendar year 1977 are available. The National Society
believes that the RSA-SSA Data Link should be established on a long-term basis, so
that similar reports can be periodically produced. We propose that the Rehabili-
tation Act be amended to require that, at a minimum, an assessment of the employment
and earnings status of the 1975 cohort be completed every three years. Moreover,
it is our belief that new groups should be established every five years and moni-
tored at three year intervals thereafter. The information supplied by this inter-
agency study represents one of the few sources of post-closure feedback on the
impact of vocational rehabilitation. The National Society urges Congress to amend
the Act to require that the RSA-SSA Data Link be continued and that the funds and
personnel needed for this unique and valuable study be provided under the Act.
The justification for the collection and data analysis activities under Title
I is equally applicable to all other Rehabilitation Act programs. Each year, mil-
lions of dollars are dispersed under the Act for the provision of rehabilitation
and related services to persons with disabilities. In order to insure that the
decisions regarding these programs are made in an informed manner, the ongoing
230
collection and analysis of program information is needed. The National Society
believes that accurate and up-to-date statistics at the federal level are a
prerequisite to effective program administration. For this reason, Congress is
urged to develop report language which emphasizes the value of evaluation to the
success of the rehabilitation movement. Under Section 14 of, the Act, the Secretary
is directed to evaluate all Rehabilitation Act programs. The National Society sup-
ports the comprehensive evaluation efforts authorized under Section 14. We en-
courage Congress to include report language which strengthens the nonpolitical
role of these evaluation efforts.
Lastly, within the context of the federal role, the National Society would
like to call attention to a concern that has been raised relative to the location
of rehabilitation agencies within state governments. During the past year, Easter
Seal staff has interviewed a wide range of rehabilitation professionals. One of
the concerns expressed by rehabilitation counselors and others in the vocational
rehabilitation system was the potential for the erosion of program effectiveness
due to a. loss of direct control over program resources. It was reported that
state agencies located in large "umbrella" departments of the state bureaucracy
were often more subject to external fiscal and operational constraints. The fear
was expressed that agencies so situated were sometimes required to allocate funds
for overhead costs and other indirect expenses not necessarily related to the pro-
vision of vocational rehabilitation services. Similar constraints were also said
to affect the management of personnel within the state agency.
The National Society is not in a position to thoroughly evaluate these con-
cerns. However, it seems in the best interest of the program that as much res-
ponsibility as possible remain with the state vocational rehabilitation agency
regarding the allocation of financial and personnel resources. Under the Act,
states are provided with detailed instructions as to the organizational respon-
sibility, level and status of vocational rehabilitation agencies. Moreover, the
intent of this statutory language has been tested and validated on several occasions,
as in the U. S. District Court of the Northern District of Florida ruling. The
National Society believes that state vocational rehabilitation agencies should
have organizational unit status within the hierarchy of state government and urges
Congress to evaluate this issue during reauthorization.
Recreation Services
One of the more important aspects of federal involvement in programs under
the Rehabilitation Act is the support provided for innovative projects and ser-
vices that might not otherwise be established. This function is particularly
true of the federal role relative to the provision of recreation services to in-
dividuals with disabilities. Easter Seals has taken an active interest in the
development of recreation programs to serve children and adults with disabilities.
In fact, during 1982, Easter Seal societies provided recreational services to over
40,000 individuals in a variety of settings, including resident camps, day camps
and structured recreation programs. Our direct experience with the provision of
recreation services has served to reinforce our commitment to this important, but
often overlooked aspect of the rehabilitation process.
Under Title III, Section 316 of the Act, grants are made to states and other
public and nonprofit agencies to pay part or all of the cost of establishing rec-
reation programs to aid in the mobility and socialization of persons with disabili-
ties. The role of recreation in rehabilitation is an important one. Recreation
231
and rehabilitation professionals maintain that there is a therapeutic value to
participation in recreation programs and that recreational activities are an
essential element of a balanced lifestyle. Programs established under Section
316 encompass a broad range of activities, including sports, music, dance, arts
and crafts and camping. Provisions under the Act specify that existing resources
be used whenever possible, thereby discouraging the development of new facilities
and encouraging the integration of persons with disabilities into established com-
munity recreation programs.
The National Society urges Congress to develop report language which identi-
fies the provision of recreation services as a priority under the Act. In order
to bring about the balance of services under the Act as intended, it is necessary
to emphasize the full compliment of rehabilitation services, including recreation.
The National Society believes that the recreation programs established under Sec-
tion 316 represent the quickest and most cost-efficient way to make recreational
opportunities available to persons with disabilities.
New Federalism
The National Easter Seal Society would like to go on record as opposed to the
Administration's proposal to turn the vocational rehabilitation program back to
the states. This proposal would include the vocational rehabilitation program
among the thirty-four programs slated to be "turned back" to the states during
the period of 1984 through 1988. It is our belief that this action is not in the
best interest of the vocational rehabilitation program or the people it is meant
to serve.
The intent of the turnback proposal is to give states greater flexibility in
the administration of the vocational rehabilitation program. Experience has shown,
however, that this state-federal partnership has traditionally allowed states a
great deal of discretion in providing rehabilitation services. The National Society
believes that there is a definite need to maintain a strong federal presence in the
vocational rehabilitation program. At a minimum, the federal government is respon-
sible for overseeing the use of the millions of dollars it invests each year in the
program. More importantly, the federal role is intrinsic to effective program ad-
ministration and the assurance that quality vocational rehabilitation services are
available to persons with disabilities. For these reasons, the National Society
urges Congress to resist any efforts to further transfer the responsibility for the
vocational rehabilitation program to the state level.
The National Easter Seal Society appreciates this opportunity to comment on
programs under the Rehabilitation Act during reauthorization. We hope that the
Subcomittee will find our recommendations useful.
Sincerely,
Joseph D. Romer
Director of Governmental Affairs
Randall J. Rutta
Randall L. Rutta
Legislative Analyst
232
AMERICAN FOUNDATION FOR THE BLIND, INC.
1860 STREET, N.W.
WASHINGTON, D.C. 20038
TEL: 202 467-5998
STATEMENT OF IRVIN P. SCHLOSS, DIRECTOR OF GOVERNMENTAL RELATIONS,
AMERICAN FOUNDATION FOR THE BLIND, TO THE SUBCOMMITTEE ON SELECT
EDUCATION, COMMITTEE QN EDUCATION AND LABOR, HOUSE OF REPRESENTATIVES,
ON PROPOSALS TO EXTEND AND IMPROVE THE REHABILITATION ACT OF 1973
March 30, 1983
Mr. Chairman and members of the Subcommittee, I am pleased to
have this opportunity to present the views of the American Foundation
for the Blind, the national voluntary research and consultant agency
in the field of services to blind persons of all ages, on proposals
to extend and improve the Rehabilitation Act of 1973.
The American Foundation for the Blind endorses enactment of the
following recommendations designed to strengthen the Rehabilitation
Act of 1973:
1. Permanent extension of the program of basic state
grants and extension of all other programs under the
Act through September 30, 1986, with increases in the
authorizations of appropriations.
2. Modification of the program of Independent Living Services
for Older Blind Individuals under Section 721 of the Act,
FIELD OFFICES
Region
15 West 16th Street, New York, New York 10011 (212) 620-2039
Region 11
15 West 16th Street, New York, New York 10011 (212) 620-2037
15 WEST 16TH STREET, NEW YORK. N.Y. 10011 / TEL: (212) 620-2000
Region III
203 North Wabash Avenue, Chicago, Illinois 60601 (312) 269-0095
CABLE ADDRESS: FOUNDATION. NEW YORK/AN EQUAL OPPORTUNITY EMPLOYER
Region IV
100 Peachtree Street, Atlanta, Georgia 30303 (404) 525-2303
Region V
1111 West Mockingbird Lane, Dallas, Texas 75247 (214) 630-8035
Region VI 760 Market Street, San Francisco, California 94102 (415) 392-4845
Legislative Office - 1660 L Street, N.W., Washington, D.C. 20036 (202) 467-5996
233
THE LEGACY OF HELEN KELLER
Helen Keller inspired millions
throughout the world by her triumph
over deafness and blindness. She
used her personal miracle of com-
munication to open the world for
other blind and deaf-blind people.
She appeared before legislatures,
gave lectures, wrote articles, and
above all, made herself an example
of what a severely handicapped per-
son can accomplish. When the
American Foundation for the Blind
was established in 1921, she found
in it a national organization that
shared her purpose. From 1924 until
her death in 1968, Miss Keller was a
member of the Foundation staff,
serving as counselor on national and
international relations. It was also in
1924 that she began her campaign
to build an endowment fund
for the-Foundation. Through
this fund and the kindness of present
benefactors her work is continued.
OFFICERS
JANSEN NOTES, JR.
JOHN 8. CROWLEY
WILLIAM M. FOLBERTH, III
*WILLIAM F. GALLAGHER
Chairman, Board of Trustees
President
Treasurer
Executive Director
J. MAX WOOLLY, LL.O.
MITCHELL BROCK
Vice President
Secretary
BOARD OF TRUSTEES
MITCHELL BROCK
WILLIAM M. FOLBERTH, III
THOMAS R. MOORE, Esq.
EDNA BONN RUSSELL, Ed. D.
TRUSTEES EMERITI
Sullivan & Cromwell
Smith Bamey, Harris Upham
Breed, Abbott and Morgan
San Jose State University
New York, New York
& Co., Inc.
New York, New York
ENOS CURTIN
San Jose, California
New York, New York
New York, New York
NANCY J. BRYANT, Ph.D.
JANSEN NOYES, JR.
GERALDINE T. SCHOLL, Ph. D.
New York Institute for the
JOSEPH J. LARKIN
Noyes Partners, Incorporated
EBER L PALMER
Education of the Blind
University of Michigan
Industrial Home for the Blind
New York, New York
Ann Arbor, Michigan
Marshall, Minnesota
New York, New York
Brooklyn, N. Y.
ROBERT E. O'DONNELL
STEWART SANDERS
RICHARD G. UMSTED, Ed. D.
WILLIAM T. COPPAGE
*ORAL O. MILLER
NY Statewide Senior Council
Association for Education
Whitefield, New Hampshire
Dept. for the Visually Handicapped
American Council of the Blind
New York, N. Y.
of the Visually Handicapped
Richmond, Virginia
Washington, D. C.
BYRON M. SMITH
Jacksonville, Illinois
HAZARD E. REEVES, SR.
Tucson, Arizona
JOHN S. CROWLEY
*RONALD L MILLER, Ph.D.
New York, New York
J. MAX WOOLLY, F D.
Xerox Corporation
Past President
Arkansas School for the Blind
HELEN ZIEGLER STEINKRAUS
Stamford, Connecticut
Blinded Veterans Association
*LOUIS H. RIVES, JR.
Little Rock, Arkansas
Noroton, Connecticut
Sacramento, California
Sun City, Arizona
'JERRY DUNLAP
American Assocation of
Workers for the Blind, Inc.
Oklahoma City, Oklahoma
*Blind
234
so that it will have its own authorizations of appropri-
ations.
3. Establishment of an independent client advocacy pro-
ject in each state with separate authorizations of
appropriations and advocacy responsibility for all
Federally financed activities useful to handicapped
persons.
4. Establishment of the Helen Keller National Center for
Death-Blind Youths and Adults as a special institution.
5. Accreditation of local voluntary agencies serving handi-
capped persons as a prerequisite for grants or contracts
by state rehabilitation agencies.
Extension of the Rehabilitation Act of 1973
The American Foundation for the Blind recommends extending
the authorizations of appropriations for basic state grants on a
permanent basis and extension of other programs under the Act through
September 30, 1986. For implementation of the basic vocational
rehabilitation program under Section 110 of the Act, we recommend
authorizations of appropriations of $1.040 billion for FY 1984,
$1.145 billion for FY 1985, $1.255 billion for FY 1986, $1.380 billion
for FY 1987, and increases in subsequent fiscal years based on
increases in the Consumer Price Index. As a result of high inflation
rates and virtually level funding for basic grants in recent years,
fewer handicapped persons have been rehabilitated for gainful em-
ployment, thereby increasing their dependence on the Supplemental
Security Income (SSI) program under Title XVI of the Social Security
235
Act. By increasing authorizations for basic state grants and by
subsequent indexing in accordance with increases in the Consumer
Price Index, reduction in essential rehabilitation services to
handicapped individuals would be prevented.
Rehabilitation Services for Older Blind Persons
One of the major gaps in services to blind persons in the United
States continues to be lack of provision of adequate rehabilitation
services for middle-aged and older blind persons, According to the
National Society for the Prevention of Blindness, three-fourths of
the legally blind population is 40 years of age and older; and three-
fourths of all new blindness occurs in the same age group. The
National Center for Health Statistics of the U.S. Public Health Ser-
vice reports that 1,185,000 of the estimated 1.4 million people in
this country with severe visual impairment are 45 and older.
Rehabilitation programs tend to concentrate on blind and visually
impaired individuals of optimum employable age and serve very few
middle-aged and older blind persons. Yet with appropriate training
in mobility and other techniques of doing things without sight, middle-
aged and older individuals can frequently be assisted to retain their
jobs--jobs in which they have had many years of experience. Others
may require vocational retraining as well and can take advantage
of old skills and extensive work experience to train for a new job,
given the proper vocational rehabilitation assistance. The important
thing is that age should not be regarded as a barrier to vocational
rehabilitation of blind and visually handicapped persons.
236
Prior to the 1978 amendments to the Act, a small program of
special projects in the rehabilitation of older blind persons
was implemented in a few states.
A Rehabilitation Services Administration report on one of those
projects states II Two of the more important but frightening find-
ings of this project are: (1) overwhelming need for the special ser-
vices provided under this type program demonstrated by the number of
referrals made to the project during its initial three year period,
and which continues to be demonstrated during the fourth year; and
(2) prior to the start of the project, no public or private agency
existed that provided the manpower or funds to deliver these special
services nor to even identify and locate this special target popu-
lation "
For the projects in operation during fiscal year 1977, some 1,850
individuals were referred for services; 1,650 received services; and
400 were closed from the projects as rehabilitated.
The 1978 amendments added Independent Living Services for Older
Blind Individuals as Part C of Title VII of the Act, with the author-
izations of appropriations limited to 10 percent of the funds appro-
priated for Part A of that title. Since Part A, which provides
for grants to the states for comprehensive independent living services,
has not been funded through the appropriations process, the program
of services for older blind persons has not received any funding. In
view of the success of the special projects for older blind persons
in effect prior to the 1978 amendments in providing both independent
living and vocational rehabilitation services, we strongly urge a
separate authorization of appropriations to implement Part C of
Title VII.
237
Client Advocacy Projects
At present, client assistance projects under Section 112 of the
Act are in effect in 38 states at an estimated cost of $1.7 million
for fiscal year 1983. We believe that this program should be ex-
panded over the next three years to cover all states and that the
program should have a specific authorization of appropriations.
As a result of the impact of Section 504 and the provisions
prohibiting discrimination against handicapped persons in the State
and Local Fiscal Assistance Amendments of 1976, there is a great need
for technical assistance on matters affecting the civil rights of
the disabled. The expanded client assistance program we recommend
could play an important role in integrating the handicapped into
society. This role should not be limited to advocacy of client rights
under programs authorized by the Rehabilitation Act of 1973. It
should also cover Federal assistance programs which may materially
help handicapped individuals, such as higher education, social services,
health care, and income maintenance.
To reflect the expanded role of the client assistance projects,
we recommend that they be renamed "client advocacy projects," with
specific authorizations of appropriations of $3.5 million for the
fiscal year 1984, $4 million for the fiscal year 1985, and $5
million for fiscal year 1986. This will allow for orderly expansion
in a program which is demonstrating that it is of substantial help to
handicapped persons and their families. This expanded program
should be administered through the state vocational rehabilitation
agencies with assurances of maximum independence for the client
advocates.
22-065 0 - 84 - 16
238
Helen Keller National Center
The Helen Keller National Center for Deaf-Blind Youths and
Adults and its affiliated network provide services to individuals
with one of the most severe forms of disability These services
are designed to help deaf-blind persons become "self-sufficient,
independent and employable."
The authorization for the services of the Center to deaf-blind
persons, as well as training of highly specialized personnel and
research and demonstration projects, is currently provided under
Section 313 of the Rehabilitation Act of 1973. The American
Foundation for the Blind believes that adequate funding for the
increasing number of deaf-blind persons now reaching adulthood as
well as older blind persons who also lose hearing would best be
accomplished by authorizing the Secretary of Education to include
the Helen Keller National Center as a special institution in the
annual budget of the Department of Education, Therefore, we recommend
repeal of Section 313 of the Rehabilitation Act of 1973 and enactment
in its place of the provisions of H.R. 1810.
Accreditation of Local Voluntary Agencies
The American Foundation for the Blind firmly believes that the
key to effective rehabilitation services for handicapped persons
is assurance of high standards through an accreditation mechanism.
Therefore, we urge amendments to the Rehabilitation Act of 1973 to
require state vocational rehabilitation agencies and state agencies
serving-blind persons to contract for rehabilitation services to
clients with local voluntary agencies and rehabilitation facilities
239
accredited by an accrediting agency recognized by the Department
of Education. For example, the National Accreditation Council for
Agencies Serving the Blind and Visually Handicapped (NAC) is recognized
by the Eligibility and Agency Evaluation Section of the Department
of Education as a standard-setting and accrediting body for the field
of special schools for the blind and visually handicapped. NAC has
also developed standards and accredited various. agencies serving
blind persons, including those which operate rehabilitation facilities.
We recommend that the role of the Eligibility and Agency Evaluation
Section be expanded to include recognition of accrediting bodies for
rehabilitation services.
Conclusion
In conçlusion, Mr. Chairman, the American Foundation for the
Blind endorses permanent extension of the program of basic state
grants under the Rehabilitation Act of 1973, as well as extension
of the other programs under the Act through September 30, 1986. In
addition, we urge that the target program of Independent Living
for Older Blind Individuals under Part C of Title VII of the Act
be given its own authorization of appropriations. We also urge creation
of an extensive and meaningful client advocacy program; accreditation
of voluntary agencies with which state agencies contract for services
to handicapped persons; and establishment of the Helen Keller National
Center for Deaf-Blind Youth and Adults as a special institution in
the Department of Education.
We believe that our recommendations will greatly improve services
to handicapped persons under the Rehabilitation Act of 1973 and urge
your favorable consideration.
240
PREPARED STATEMENT OF RADM DAVID M. COONEY, USN (RET)., PRESIDENT AND
CHIEF EXECUTIVE OFFICER, GOODWILL INDUSTRIES OF AMERICA, INC.
Goodwill Industries of America welcomes the opportunity to
comment on the proposed reauthorization of the Rehabilitation Act
Continued authorization of the Act is of vital concern and importance
to disabled citizens and to the purposes and operations of Goodwill
Industries. Goodwill Industries is a nonprofit membership organization
of 177 rehabilitation facilities in North America with 44 affiliates
in 31 countries outside of North America. As such, we are the largest
network of privately operated, vocational rehabilitation workshops
in the world. Currently, Goodwill Industries provides rehabilitation
services to 67,700 disabled people and employs almost 33,000 disabled
clients in our production facilities, retail outlets and industrial
contract programs. Goodwill Industries provide a wide variety of
rehabilitation services, including vocational evaluation, job training,
employment, adjustment services, job seeking skills, and placement.
Thus, we feel particularly involved and qualified to comment on proposed
changes to the Act.
Since its enactment in 1973, the Act has been successful in
serving the needs of disabled citizens and the Rehabilitation Services
Administration has administered various provisions of the current law
effectively. We believe that reauthorization of the Act, for a
minimum of three years, is of primary and fundamental importance and
we wholeheartedly support that action. The rehabilitation program
has been a successful partnership between the federal government, state
agencies, and the non profit rehabilitation community. It should be
extended to give, both the states and rehabilitation agencies an
insurance of continuity and the time to plan ahead.
241
Of the previous testimony submitted by various organizations
involved with the Act, we would like to state for the record, that
we basically concur with and support the opinions and positions
expressed by the National Association of Rehabilitation Facilities.
Additionally, we support the recommendations offered by the Consortium
for Citizens With Developmental Disabilities, especially as they
relate to proposed authorization levels and implementation of various
provisions of the Act. Because of this support, we do not intend to
burden the record by reiterating the various points raised by both
these organizations.
What we do not support are certain positions, as we understand
them, by the Department of Education before the Senate Subcommittee
on the Handicapped and the House Subcommittee on Select Education.
First, we strongly oppose the proposal to finance the
Rehabilitation Services program in a block grant to the states. It
is our view, clearly stated in the past, that block grants have no
role in addressing the problems of America's handicapped population.
Under the Administration's proposal for a New Federalism block grant,
there would be no requirement that the states spend any money on
rehabilitation services after five years. We believe that only a
national program administered to meet national needs will ensure
that uniform standards and an equitable distribution of resources are
enforced in each state.
It is a fact of life that the allocation of block grant funds
within a state will be strongly influenced by local political
pressures. In most cases that is proper in a democracy. Nevertheless,
242
although America's handicapped citizens constitute its largest
social minority, they are not now organized as a political action
group nor because of current social attitudes have they been
encouraged to so organize, nor because of their handicaps are they
able to organize and speak for themselves on many issues. It is
thus fitting and proper that their interests be addressed by an
knowledgeable and prestigious body in the federal establishment
and that their viewpoints be received and considered by Congressional
committees like this one in order to provide reasonably attainable
national standards of rehabilitation. The proper role of the federal
government is to make the tough choices and exercise oversight.
Without that national role for rehabilitation services, the quality
and availability of these services would vary too widely between
the states, to the detriment of handicapped individuals and the general
population. Therefore, we recommend that the proposal for block
granting be immediately disregarded as counter-productive.
The full intent of the Department of Education becomes clear
when block grant funding of the rehabilitation program is combined
with Section 5 of their proposed bill, which removes many of the
State plan provisions and eliminates the requirements for certain
minimum services. These two proposals in combination reveal a long
term intent to abolish a federal rehabilitation services program.
We find this totally unacceptable and detrimental to all citizens.
Secondly, the Administration's proposal to establish a system
of rewards to those states who have been able to achieve higher levels
243
of rehabilitation similarly disregards the needs of disabled individuals
and penalizes states for circumstances over which they may have no
control. For example, such a system would penalize those states with
high unemployment rates regardless of their success in rehabilitating
severely disabled individuals. As a case in point, in the State of
Michigan, unemployment in some communities has been as high as 20%.
Despite that fact, rehabilitation agencies in the state have continued
active vocational rehabilitation programs and have been successful
in equipping individuals to enter the job market when the economy improves.
The fact that they did not become immediately employed is not an
indication of any ineffectiveness of the Michigan State Director of
Vocational Rehabilitation or of the management of local rehabilitation
facilities. It is rather an indication of the fact that there is
unemployment in the State of Michigan and that unemployment impacts
on handicapped people as well as the able bodied. To punish the State
of Michigan, already in serious economic difficulty, for a situation
not of their creation, is poor economics and poor social practice.
There are other states and regions with similar problems familiar to
the committee, Michigan is merely a clear example.
Unemployment is not the only potential cause of such anomalies.
Social structure of communities, the impact of weather, the onset
of pregnancy, seasonable variables in employment rates are but a few
of the economic and social variables which make the proposal unworkable
and probably counter-productive. Additionally, to be fair, the
system proposed by the Administration would require a standardized
system of measurement applied universally by an agency other than the
state itself. The requirement for the creation of such a bureacracy
244
would consume resources needlessly.
Thirdly, we oppose the Administration's proposals to include
programs under Title III of the Act in a single authorization and
to delete authorizations for currently unfunded authorities.
Specifically, we feel there should be reauthorization and funding
for Innovation and Expansion Grants and for Facility Construction
Grants
While opposing the Department of Education's proposals, Goodwill
Industries finds itself hindered in making affirmative, substantative
recommendations for what we believe are necessary changes, in the current
law because of an overriding problem with the Act. The Act as presently
written and implemented does not provide for meaningful feedback
concerning the effectiveness of delivery of rehabilitation services.
There is a paucity of any reliable, standardized data on which to
evaluate the effectiveness of the Act over the past ten years. We
question the figures that the Rehabilitation Services Administration
has set forth in its testimony, since our inquires to RSA have only
gained responses based on data as, much as three years old. There is
no information available concerning the utilization rate or cost
savings realized from the use of private non profit facilities for the
delivery of rehabilitation services. Requests for data concerning
the number of clients processed and the cost for delivery of services
to these clients have been unsuccessful. Additionally; the state
directors of vocational rehabilitation have either been reluctant or
unable to provide such information to private organizations, such as,
Goodwill even when our purposes parallel their own.
245
We do know from our own in-house audits that certain trends
are developing which are of concern. The number of clients being
referred to nonprofit facilities is declining and the states'
share of costs of servicing the clients has also been reduced. In
some states, sponsored clients have virtually disappeared and in
others, Goodwills no longer seek state sponsored clients because of
unrealistic compensation levels for work performed or extensive
bureaucratic burdens. In some cases, the Goodwill accepts total
responsibility for the client as a less expensive and more efficient
technique of meeting community needs than becoming involved with the
state program.
Our experience with the various states on how they are
administering their programs has also varied widely. In some states,
the state bureaucracy's have grown without any seeming increase in
service to clients, while in other states they have been able to
reduce their administrative overhead and increase service by
referring more clients to private facilities. Moreover, there
has been no uniformity or consistency on how the states determine
their cost of services and fees. This experience of the past
several years causes Goodwill Industries to make certain recommendations
for changes in the Act. Clearly these recommendations are in need
of further refinement: However, we believe that it is not in the
best interest of the disabled citizens simply to reauthorize the Act,
without the inclusion of these measures.
First, there needs to be more specific inclusion in the Act for
more detailed data collection, especiall as it relates to administra-
tive costs. Provisions need to be made to mandate that RSA collect
246
data on the utilization of all service providers, including private
nonprofit facilities, and their effectiveness in delivering services
to clients. The Secretary's annual report and evaluation of the
Act's program, required by Sections 13 and 14 of the Act, should
specify that such reports and evaluations include comparisons between
public and private facilities. Similar requirements should be
included in the state's recordkeeping requirements and studies and
reviews, specified by Sections 101 (a)(10), (15) and (16) of the Act.
Only in this way will it be possible to evaluate fully the effective-
ness of the states in delivering rehabilitation services to handicapped
individuals. The review of expenditures to rehabilitation outcomes
would be the basis for determining how future rehabilitation dollars,
are effectively and efficiently spent.
Secondly, more emphasis needs to be placed on providing funding,
under Title I of the Act, for the provision of direct services to
clients. This could be accomplished by amending the Act to mandate that
a set percentage of Basic State Grants to be spent on direct rehabili-
tative services and that a concurrent limitation be set on allowable
administrative costs. Such a provision would increase the accountability
of state agencies and provide a reasonable measure of uniformity in the
distribution of rehabilitation: services between states.
The limited and dated information, currently available, reveals
wide variations between the states on administrative expenses. A
limited in-house Goodwill Industries survey that one state's expendi-
ture of funds for administrative purposes was as low as 9% whereas
another state's administrative expenditures: was 59%. A study conducted
247
by the National Association of Rehabilitation Facilities, based
on 1978 data, shows that states averaged 44% of their administrative
expenditures on administration and counseling as opposed to case
services. In one of the states, the administrative expenses were as
high as 70%. Clearly, these inadequate statistics standing alone
may be meaningless, for the raw figures do not reveal what items are
included in administrative expenses nor do they necessarily indicate
how effective a state is in delivering services to clients. However,
what they do reveal is that there is currently no adequate way to
measure whether funds are properly being administered to provide
direct services to clients.
Before a limit could be set on the amount that states could
expend for administrative purposes, it would be necessary to define
exactly what constitutes administrative expenses. Once such a
definition is developed, a statutory limitation on administrative
expenditures would provide an uniform means for measuring states'
effectiveness in delivering services and help guarantee that the
basic purposes of the Act are being fulfilled.
Thirdly, Goodwill Industries believes that more disabled clients
can be served, at less cost to the government, if the Act is amended
to encourage greater utilization by the states of private nonprofit
facilities. Goodwill's experience demonstrates that private facilities
can be highly successful in providing rehabilitative services at limited
cost to the government. Currently, on a national average basis, for
every dollar expended by Goodwill facilities on rehabilitation services,
$.83 is earned from sources other than the states' fees.
248
This actually means that Goodwill subsidizes state and Federal
programs. In 1982 Goodwill's contribution to the national
rehabilitation effort was approximately $225 million. This figure
represents income and services provided to or for disabled individuals.
Of this amount, $187 million was earned from sources other than State
VR fees for services. Thus, Goodwill's contribution equals
approximately 25% of the total federal expenditures in the Basic
State Grants program in 1982. This sort of investment entitles
us to a partner's voice in establishing program objectives and costs.
Greater utilization of community-based private organizations
would not only keep costs down through reasonable competition, but
would provide an incentive to create private nonprofit facilities
where no rehabilitation facilities presently exist. The result
would be broader-based care that would not require handicapped
individuals to travel significant distances to receive that care.
In conjunction, with this recommendation, we urge that any
consideration of the Administration's proposal to allow grants to
for-profit organizations be modified to provide that such grants be
given to for-profit organizations only when state or nonprofit
agencies are not available and where the purpose is to provide
geographical coverage where none is available Such a modification
is not contradictory with the philosophy of encouraging private
sector utilization. Where nonprofit agencies exist they can keep
costs down, but to do so they need broad-based community support.
If that support is decreased by federal grants or subsidies to
for-profit agencies, which then perform work previously accomplished
by the nonprofit agency, unit costs will increase in the nonprofit
249
agency and overhead will become burdensome. This could have an
overall negative effect on the costs of service delivery, dictating
a reduction in client loads.
We urge that Sections 101 (a) (5) and (12) of the current Act
should be amended to require that states place a priority on utilizing,
to the maximum extent possible, private facilities for rehabilitation
services when they are reasonably available at competitive costs.
Funding for the states should be contingent on satisfactory demonstration
to the Commissioner that they adhere to these provisions. This type
of provision, in conjunction with the above recommendation concerning
data collection on utilization on private sector facilities, would
provide the basis for long term evaluation on the effectiveness of
delivery systems.
In summary, Goodwill urges the Congress to reauthorize the
Rehabilitation Act with the inclusion of the three recommendations
stated above and the positions taken by the National Association of
Rehabilitation Facilities and the Consortium for Citizens With
Developmental Disabilities. Such action would ensure that the
Rehabilitation Act becomes an even more effective vehicle for serving
the needs of disabled Americans. We appreciate the opportunity to
submit this statement and look forward to working with the Committee
on implementing necessary changes. For the Committee's consideration,
we are attaching to this statement a copy of a resolution passed by
the Board of Directors of Goodwill Industries of America, Inc., which
sets forth our basic recommendations.
250
GOODWILL INDUSTRIES OF AMERICA, INC.
BOARD OF DIRECTORS
March 19, 1983
It was moved, seconded and carried that the Board adopt the following
resolution:
WHEREAS, the Rehabilitation Act of 1973, as amended, is
pending reauthorization before the 98th Congress;
and
WHEREAS, the Rehabilitation Act has proven its effectiveness
in assisting people with disabilities and the
reauthorization provides an opportunity to recommend
certain structural changes to the Act that will
result in the provision of more efficient and direct
services to disabled individuals, and
WHEREAS, insufficient data is currently available to provide
effective oversight, implementation, and enforcement
of the program authorized by the Act,
THEREFORE, BE IT RESOLVED by the Board of Directors of Goodwill
Industries of America, Inc., to support the
reauthorization of the Act with changes that will
set a limitation on administrative expenses, increase
the utilization of private rehabilitation facilities
when available, and increase the reporting of data
by the Rehabilitation Services Administration.
251
PREPARED STATEMENT OF ROGER P. KINGSLEY, PH. D., DIRECTOR, CONGRESSIONAL
RELATIONS DIVISION, GOVERNMENTAL AFFAIRS DEPARTMENT, THE AMERICAN
SPEECH-LANGUAGE-HEARING ASSOCIATION
The American Speech-Language-Hearing Association (ASHA) welcomes the
opportunity to present its views and recommendations concerning rehabilitation
programs serving citizens with handicapping conditions. Physically and
mentally handicapped persons comprise a substantial portion of the nation's
population - around 35 million people. Among the most prevalent handicapping
conditions are speech, language, and hearing impairments. Because the ability
to communicate effectively is so fundamental to other life activities - learn-
ing, interpersonal relationships, and vocational pursuits - any loss or
limitation of this ability can be detrimental to individual human development
and performance.
ASHA is the professional and scientific society representing over 37,000
speech-language pathologists and audiologists nationwide, including many who
provide rehabilitation services to handicapped adults. Our members work in
hospitals, speech and hearing clinics, outpatient rehabilitation centers,
skilled nursing facilities, home health agencies, Head Start programs,
Veterans Administration and Department of Defense hospitals, public and
private schools, and independent practice.
The Rehabilitation Act is widely judged to be one of the most significant
and successful statutes relating to human services and human rights. Broad in
scope, this one Act provides America's handicapped citizens with the promise
of fulfilling their life's potential through basic rehabilitation services,
assistance from quality trained professionals, opportunities for independent
living, and guarantees of basic rights. We support each of these sections of
the Act: the Vocational Rehabilitation State Grant Program, Rehabilitation
252
Training, Comprehensive Services for Independent Living, Projects With
Industry, the National Institute for Handicapped Research, the National
Council on the Handicapped, and Title V, particularly a strongly enforced
Section 504 prohibiting discrimination against qualified handicapped persons
in all programs and activities receiving federal financial assistance.
This statement will briefly examine several of these sections and will
provide ASHA's recommendations for authorization levels for each of the major
programs in the Rehabilitation Act of 1973 (P.L. 93-112), as amended by the
Rehabilitation, Comprehensive Services, and Developmental Disabilities Act of
1978 (P.L. 95-602). Then we will focus in more depth on two areas which we
believe have weakened the effectiveness of the Act's implementation and are in
need of congressional review and legislative reform: the "balanced" program
of Rehabilitation Training assistance and the Office of Deafness and
Communicative Disorders.
Basic Rehabilitation State Grants (Section 110)
The Vocational Rehabilitation State Grant program has been a model of
working federalism - an effective federal state partnership - for sixty-two
years. Since 1921, the program has served about 23 million persons and has
rehabilitated more than six million of them. The cost-effectiveness of the
program is very high (a ratio of better than 1 to 10) and it is estimated that
the benefit to governments at all levels is about $280 million, including in-
come and payroll taxes and funding saved as a result of decreased dependency
on public welfare and institutional care. 1
253
About one million handicapped individuals are served annually, although
the number has been declining for the past six years since funding has not
kept pace with inflation and because a larger proportion of severely (and hard
to rehabilitate) persons are being served. The number of persons successfully
rehabilitated and the number of new cases have also been declining.
This year we have an opportunity to reverse these trends and to enable
more handicapped citizens to benefit from vocational rehabilitation services.
This Association recommends that Congress raise the authorization levels for
Basic State Grants to $1,037.8 million for FY 1984; $1,141.1 million for FY
1985; and $1,254.6 million for FY 1986.
Rehabilitation Training (Section 304)
The Rehabilitation Training program was established by Congress in 1954
to provide for the preparation and maintenance of a qualified rehabilitation
work force. The program was expanded in 1973 to meet the demand for more
specialized personnel qualified to work with persons suffering from a variety
of disabling conditions and to improve the skills of those already engaged in
rehabilitation of the handicapped. The program supports training in the broad
range of established rehabilitation fields identified in the Rehabilitation
Act including speech-language pathology, audiology, physical therapy, occupa-
tional therapy, rehabilitation counseling, and interpreters for the deaf.
Despite the need for greater numbers of rehabilitation professionals to
serve the handicapped and despite serious shortages of adequately trained
professionals in many fields, federal support for this program has been
22-065 0 - 84 - 17
254
declining since fiscal year 1980. We recommend that the authorization level
for Rehabilitation Training be set at $30.5 million for fiscal years 1984
through 1986.
We also favor amending Section 304 to clarify the responsibility of RSA
in allocating training funds. The term "balanced" program has no clear mean-
ing and should either be defined or eliminated. Either way, Congress should
require the Commissioner to submit to Congress, along with the RSA budget
proposal, a detailed explanation of how funds will be allocated among the
rehabilitation disciplines and how these allocations are related to legitimate
findings of personnel shortages.
National Institute of Handicapped Research
The National Institute of Handicapped Rsearch was established by the
1978 rehabilitation amendments (P.L. 95-602) "to promote and coordinate
research with respect to handicapped individuals (Sec. 202(a)).
According to the NIHR, research funds in fiscal 1982 were provided to
centers conducting long-term studies and utilizing teams of medical, allied
health and technical health professionals. Core areas of research have
included comprehensive rehabilitation, vocational rehabilitation, aging,
:
mental illness, deafness and hearing impairment, sensory and communicative
systems, and blindness. The Institute has provided support for important work
in the development of communication aids, and through its grants has recog-
nized the importance of research into the special problems of the elderly
disabled population.
255
Innovative research is essential to the overall effectiveness of the
rehabilitation program. Yet, funding for NIHR has lagged for several years.
We recommend that authorization levels be established at $35 million for FY
1984 and $40 million for fiscal years 1985 and 1986.
National Council on the Handicapped
The Rehabilitation Act Amendments of 1978 established a National Council
on the Handicapped. The Council is responsible for establishing general poli-
cies for NIHR and for advising the Commissioner of RSA and the Assistant
Secretary for Special Education and Rehabilitative Services (OSERS) with
respect to policies relating to the Rehabilitation Act of 1973, as amended.
Membership on the Council has included handicapped individuals, community
leaders, and experts in the disability field.
Recently, the work of the Council has been hampered by insufficient
resources and staff. We believe that the Council has an important leadership
and coordinating role in rehabilitation of the handicapped policies and should
be continued and strengthened. We recommend that the authorization ceiling of
$256,000 be retained for fiscal years 1984-1986.
Rehabilitation Training: Unbalanced
Legislative Requirements
As in any professional service area, vocational rehabilitation services
are only as good as the personnel who provide them. Personnel who specialize
in the rehabilitation of handicapped individuals must receive quality training
256
and must be trained in numbers adequate to ensure accessibility for persons in
regions throughout the country and with a variety of disabling conditions.
Congress has recognized these needs by making rehabilitation training an
integral part of the overall federal-state vocational rehabilitation program.
Authorization is provided for states and public or nonprofit agencies and
organizations, including institutions of higher education, to fund projects to
increase the number of personnel trained in providing vocational and social
rehabilitation services to handicapped individuals. Section 304(b) of the
Rehabilitation Act of 1973, as amended, states that
In making such grants or contracts, funds made available for
any year will be utilized to provide a balanced program of
assistance to meet the medical, vocational, and other personnel
training needs of both public and private rehabilitation programs
and institutions, to include projects in rehabilitation medicine,
rehabilitation nursing, rehabilitation counseling, rehabilitation
social work, rehabilitation psychiatry, rehabilitation psychol-
ogy, physical therapy, occupational therapy, speech pathology and
audiology, workshop and facility administration, prosthetics and
orthotics, specialized personnel in providing services to blind
and deaf individuals, specialized personnel in providing job
development and job placement services for handicapped individ-
uals, recreation for ill and handicapped individuals, and other
fields contributing to the rehabilitation of handicapped individ-
uals, including homebound and institutionalized individuals and
handicapped individuals with limited English-speaking ability.
(emphasis added)
Despite the congressional mandate for a "balanced" program, the
Rehabilitation Services Administration has consistently reduced the number of
trainng projects in speech-language pathology and audiology (see Appendix A).
As recently as FY 1979, 50 projects were funded with expenditures of
$1,351,000. Three years later, in FY 1982, only 17. projects were funded with
$405,359. This represents a 70 percent decline which is explained only in
257
part by the overall reduction in Rehabilitation Training funds (37 percent).
Similar reductions in training support are evident in other disciplines, such
as physical and occupational therapy. (see Appendix B).
The statute does not explicitly define "balanced program," thus leaving
considerable discretion to RSA. Training priorities are often established
more on the basis of political and budgetary factors than the actual need for
different kinds of rehabilitation services. Several years ago, a report con-
cerning the impact of rehabilitation training support on the service delivery
system found that "RSA does not use data on the characteristics of existing
rehabilitation personnel for planning purposes "2 The report concluded that
"there has been no way to systematically estimate the demand for rehabilita-
tion personnel in many of the established disciplines other than by contacting
professional organizations. However, in recent years, RSA has shown no
interest in receiving or utilizing information on training needs from this
professional association.
Funding for Rehabilitation Training this year is at the same level as in
FY 1982 - $19.2 million. Despite this, we have recently learned from RSA
officials that no new training grants will be awarded to speech-language
pathology and audiology programs this year. What was supposed to be a
"balanced" program of assistance for rehabilitation training has obviously
become seriously unbalanced.
Rehabilitation Service Needs: the Communicatively Handicapped
In its most recent Annual Report to the President and Congress, the
Rehabilitation Services Administration states that training grants are
258
authorized by the Rehabilitation Act of 1973, as amended, to ensure that
skilled personnel "are available to provide the broad scope of vocational
rehabilitation services needed by severely handicapped individuals served by
vocational rehabilitation agencies and rehabilitation facilities. "4 There are
several points to be made about this statement. The first is that, although
the Rehabilitation, Comprehensive Services, and Developmental Disabilities Act
of 1978 (P.L. 95-602) placed greater emphasis on the rehabilitation of severe-
ly handicapped adults, it did not eliminate the less-severely handicapped from
inclusion in the program.
The purpose of this Act is to develop and implement, through
research, training, services, and the guarantee of equal oppor-,
tunity, comprehensive and coordinated programs of vocational
rehabilitation and independent living. (Section 2 of the
Rehabilitation Act of 1973, as amended)
And, the purpose of Title III = Supplementary Services and Facilities -
includes the authorizing of grants and contracts
to assist in the provision of vocational training services to
handicapped individuals. (Section 200(2))
As defined in the Act, the term "handicapped individual" means any individual
who
(1) has a physical or mental disability which for such indiviudal
constitutes or results in a substantial handicap to employment
and (ii) can reasonably be expected to benefit in terms of
employability from vocational rehabilitation services (Section
7(7) (A) of the Rehabilitation Act of 1973, as amended)
This Association believes that it would be bad policy and a misinterpretation
of congressional intent to target rehabilitation services exclusively to the
259
severely handicapped. Yet, in recent testimony before the Senate Subcommittee
on the Handicapped, a Department of Education official stated that the
Administration's Rehabilitation Act revisions are designed to direct resources
away from individuals who are "marginally handicapped."
This leads to a second point: although all handicapped individuals are
potentially eligible to receive rehabilitation services, an important
criterion is the capacity to benefit from such services. In this context, it
it is important to note that persons with moderate and severe communication
disorders can often be rehabilitated to a degree that enables them to function
effectively in day-to-day activities. The ability to communicate is a neces-
sary skill in almost all walks of life. The importance of adequate communica-
tion ability in interpersonal relationship, educational and vocational
pursuits is undeniable. Based on current population estimates, approximately
22.6 million Americans suffer from speech, language, and hearing impairments,
making communication disorders the nation's most prevalent category of handi-
capping conditions. 5 It has been estimated that among adults ages 18 to 79,
seven to eight percent suffer from some degree of hearing loss. The annual
deficit in earning power among the hearing handicapped is estimated at over
one and one-quarter billion dollars. 6
Due to non-identification and underreporting of speech and language
impairments in the U.S. population, prevalence of these disorders is uncer-
tain. However, it is generally assumed that at least 10 million individuals,
including children and adults; suffer from speech and language impairments.
260
As a result of congenital impairments, accidents, and severe illness, the
number of persons with speech, language and hearing disorders is constantly
growing. As the communicatively handicapped population increases, so does the
demand for well-trained speech-language pathologists and audiologists to serve
in rehabilitation settings.
Most speech and language disorders can be corrected when appropriate
diagnoses and treatments are available and are provided. Although hearing
loss is usually irreversible, many hard-of-hearing (as opposed to deaf) indi-
viduals can also be helped through professional rehabilitation and the use of
hearing aids. Because the ability to communicate effectively is so important
in the work environment and because communicative disorders have such a high
potential for successful rehabilitation, programs designed and funded to serve
this population are very cost-effective.
RSA reports that in fiscal year 1981, 255,881 individuals were rehabili-
tated through the federal-state program. Yet, despite the significant poten-
tial for rehabilitation, relatively few persons with speech, language and
hearing impairments have been served. Only 20,300 of the individuals rehabil-
itated in 1981 had communication disorders, including 7,700 deaf, 10,800 hard-
of-hearing, and 1,800 with speech and language impairments. 8 Over one and
one-half million Americans are prevented from working as a result of communi-
cation disorders, and among the estimated 16.5 million people with a partial
work disability are one million who suffer from speech, language and hearing
impairments. 9
261
A final point here is that communication impairments are often related to
severe handicapping conditions like Parkinsonism, cerebral palsy, and multiple
sclerosis. Individual rehabilitation programs for persons with these neuro-
logical conditions frequently include the services of speech, language and
hearing professionals. About one in five stroke patients have communication
problems and need specialized rehabilitation in order to regain the use of
their speech and language mechanisms.
Training Needs: Speech-Language Pathology and Audiology
In a 1979 report prepared by the HEW-HRA Bureau of Health Manpower for
the Senate Committee on Labor and Human Resources and the House. Committee on
Interstate and Foreign Commerce (now Energy and Commerce), serious shortages
were found in the availability of speech-language pathologists and audiolo-
gists. (See Appendixes C and D) Using conservative estimates of prevalence
of communication disorders and data from a National Institutes of Health
study, the Bureau concluded that "at least three or four times more speech
pathologists are needed and approximately four times as many audiologists are
needed to provide required services it. appears that the supply of speech
pathologists and audiologists is not adequate to meet either current or future
demands and needs 10
Although the extent and location of these shortages is not known, there
is clearly no contrary evidence that warrants RSA's dissolving of future
training funds in the field of speech-langauge pathology and audiology. Quite
the opposite - the large and ever-increasing population of persons with pri-
mary and secondary communication disorders requires the on-going training of
262
professionals who will be available to meet their rehabilitation needs. A
"balanced" program of assistance would certainly seem to imply this, and we
ask this Committee to reemphasize the importance of an adequate supply of
quality trained professionals in the various rehabilitation disciplines and to
require that RSA base its allocation of training funds on actual need.
The Deafness and Communicative Disorders Program
Finally, ASHA wishes to bring to the attention of this Subcommittee a
little noticed but highly significant report concerning the federal role in
the rehabilitation of adults with communication handicaps.
The Rehabilitation Services Administration is the federal agency respon-
sible for providing leadership and coordination of rehabilitation programs for
adult Americans. As such, RSA is responsible for planning, developing,
implementing and evaluating rehabilitation programs for communicatively handi-
capped persons. The Deafness and Communicative Disorders Office (DCDO) is the
unit within RSA charged with these tasks. However, this office has histori-
cally lacked the authority and the resources necessary to provide adequate
representation of the rehabilitation needs of over 20 million Americans with
speech, language and hearing disorders.
There are several problems related to the weak record of DCDO. Unlike
administrative strutures for the blind and visually impaired and the develop-
mentally disabled population, the program for the deaf and communicatively
impaired has no legal base. The former programs are situated in the Office of
Program Operations while DCDO is located in the Office of Advocacy and
263
Coordination. DCDO exists only by administrative authority and receives no
direct appropriations. As the Task Force Report on the Deafness and Communi-
cative Disorders Program states, "Of all the programs dedicated to persons
with specific disabilities, the program for the communicatively impaired is
the most susceptible to the precariously changing currents in the American
political stream. It already gets too little funding when economic and
political conditions are good, but it gets even less when times are bad. 11
Another problem is that DCDO has focused most of its meager resources on
a small minority of the overall population that it is supposed to serve. Of
the more than 16 million hearing impaired people in the United States only
about 2 million are totally deaf. 12 The vast majority are hard-of-hearing,
speech and/or language impaired. Deafness is certainly one of the most
serious handicapping conditions, and we support continuing federal and state
efforts to assist in the special education and vocational rehabilitation of
this group. However, while many deaf persons have been underserved, most
speech, language and hard-of-hearing persons have been unserved. As an illu-
stration of this imbalance, DCDO personnel have spent only about 13 percent of
their time on activities directed at the needs of the non-deaf communicatively
impaired population. 13
These problems must eventually be addressed through Congressional action.
The DCDO should be given statutory authority and placed in the RSA Office of
Program Operations. In the meantime, however, there is much that could be
done administratively to improve the effectiveness of this program and to
better address the rehabilitation needs of communicatively impaired
264
Americans. The Commissioner of RSA has the authority to provide a larger
measure of resources for the program. We would also hope that the
Commissioner would support the effort to secure a legal base, for the DCDO.
The Task Force Report sets forth a detailed plan for establishing a comprehen-
sive and effective program to provide better leadership and services for the
rehabilitative needs of citizens with communication disorders. To our knowl-
edge, no steps have been taken to implement this plan since the Report was
presented to RSA over three years ago. We believe that it is time for the
Administration to start taking this Report seriously. We have provided a copy
of this Report to the Subcommittee staff and hope that the Congress will work
toward implementing its objectives over the next several years.
265
1. Rehabilitation Services Administration,, Office of Special Education and
Rehabilitative Services, Annual Report to the President and the Congress
on Federal Activities Related to the Administration of the Rehabilitation
Act of 1973 as amended (Fiscal Year 1981), i-ii.
2. JWK International Corporation, "An Assessment of the Impact of
Rehabilitation Training Grant Support in Selected Areas of Academic and
Non-Academic Training on Improving the Effectiveness of the Vocational
Rehabilitation Service Delivery System." Final Report submitted to
RSA/OSERS (December 1980), II-5.
3. JWK International Corporation, "An Assessment " II-7.
4. Rehabilitation Services Administration, Fiscal Year 1981 Annual Report,
P. 38.
5. National Institute of Neurological and Communicative Disorders and Stroke,
Report of the Panel on Communicative Disorders to the National Advisory
Neurological and Communicative Disorders and Stroke Council. U.S. Depart-
ment of Health and Human Services (June 1979).
6. National Institute of Neurological Diseases and Stroke, Human Communica-
tion and Its Disorders: An Overview. U.S. Department of Health,
Education and Welfare (1970).
7. National Center for Health Statistics, unpublished data from the 1977
Health Interview Survey.
8. Rehabilitation Services Administration, Fiscal Year 1981 Annual Report,
P. 5.
9. National Center for Health Statistics, Health Interview Survey (1977).
10. Bureau of Health Manpower, Health Resources Administration, A Report on
Allied Health Personnel (November 1979), p. XIV-5.
11. The Deafness and Communicative Disorders Program: Recommendations for the
Future, A Task Force Report Prepared for the Commissioner of Rehabilita-
tion Services (December 1979), p. 4.
12. National Center for Health Statistics, Health Interview Survey (1977).
13. DCDO Task Force Report, Appendix.
266
VOCATIONAL REHABILITATION SERVICES ADMINISTRATION TRAINING GRANT PROGRAM
SUPPORT FOR SPEECH PATHOLOGY AND AUDIOLOGY
150
148
125
Number 100
of
Projects 75
7.0
72
61
58
Funded
52
52
50
47
50
34
17
25
11
0
oi
Year
1971
1972
1973
19741
1975
1976
1977
1978
1979
1980
1981
1982
19834
Pro-
iected
$5.0-
$4.5-
Actual
$4.0 $4,017
Expendi- $3.5
tures $3.0
$2,855
(In thou- $2.5
$1,757
sands) $2.0
$1,785
$1,516 $1,589
$1,351
$1.5
$1,012
$1.0
$1,054
$604
$ .5
$405 $292
S 0
Unformation unavailable
for
11
continuing S?/A Projects Proposed. No Funding for new SP/A projects proposed.
Appendix A.
American Speech-Language-Hearing Association
Governmental Affairs Department
3/83
REHABILITATION TRAINING EXTENDITURES: PROGRAM/FISCAL DATA
FY 1979 FY 1912
Actual Expenditures
FY 1902 Projected
TY 1902 Actual
Category
# of
# of
# of
/
or
Entimated
FY 1979
Pro-
FY 1980
Pro-
FY 1901
Tro-
Continu-
Continu-
Pro-
# of
Thousand)
jects
(Thousand)
jects
(Thousand)
Jects
ation
New
Total
ation
New
Total
jects
Trainess
DIC IN ESTABLISHED REHABILITATION
CIPLINES
Illtation Counseling
$ 5,062
00
$ 4,612
no
$ 4,435
76
$1,719,000
#
781,000
$ 2,500,000
$1,730,124
$
761,076
$ 2,500,000
44
450
diffation Medicine
3,096
56
2,906
51
1,721
45
1,943,000
157,000
2,400,000
1,935,571
457,005
2,392,576
35
160
Illiation Facility Administration
1,620
13
1,514
13
1,470
12
742,000
450,000
1,200,000
741,580
450,420
1,200,000
11
500
helice and Orthotice
.
1,048
7
1,322
7
320
5
149,000
1,151,000
1,300,000
140,907
1,151,000
1,299,907
7
100
J Health Professiona
2,948
112
2,040
104
1,551
72
531,000
469,000
1,000,000
529,946
472,843
1,002,709
34
212
ech Pathology and Audinlogy
1,351
50
1,012
47
601
34
230,000
100,000
330,000
230,350
175,001
405,359
17
70
impational Therapy
509
20
200
19
375
18
73,000
69,000
142,000
72,404
74,774
147,170
5
30
goical Therapy.
605
26
401
23
296
14
66,000
75,000
141,000
65,464
82,440
147,904
6
42
eing
68
1
71
1
66
1
51,000
75,000
126,000
50,932
;
50,932
1
10
tal Work
205
3
132
3
60
2
60,000
--
60,000
68,000
---
60,000
1
10
ebology
40
"
46
"
70
3
100,000
100,000
--
07,569
67,569
2
25
repentie Recreation
150
0
20
7
00
3
13,000
50,000
93,000
42,700
53,059
95,047
2
25
Sevelopment and Pincement
197
2
197
2
144
2
1,000,000
1,000,000
1,000,000
1,000,000
5
350
doont Evaluation
902
10
664
10
547
10
200,000
512,000
000,000
275,344
512,020
787.364
11
220
Twental Innovative
1,622
18
1,317
10
1,291
15
740,000
--
740,000
739,301
:
739,301
8
&
-
860
9
855
9
Boo
10
347,000
353,000
700,000
303,856
333.697
637;553
10
90
1,026
10
GUT
9
656
0
224,000
276,000
500,000
249,572
275,990
525,562
7
80
ally 111
109
3
179
3
179
3
87,000
113,000
200,000
86,720
113,000
199,720
2
40
genduate Education
070
28
554
20
454
27
155,000
145,000
300,000
155,000
214,281
369.361
24
1,206
,
990
9
025
0
560,000
232,000
800,000
525,533
209,443
014,976
7
160
Sub-Total
$22,262
357
$17,045
3'13
$14,775
296
$7,493,000
$5,917,000
$13,40,000
$7,429,614
$6,039,575
$13,469,189
205
2,532
267
rpretera for the Dent
-
900
10
900
10
--
900,000
900,000
:
900,000
900,000
10
r DEVELOIMENT & TRAINING FOR EMPLOYED
HADILITATION WORKERS
11:1ation Continuing Education Programs
3,172
15
3,017
15
2.944
15
--
2,000,000
2,000,000
--
2,000,000
2,000,000
12
1.750
: In-Service Training
2,792
70
3,151
TO
3,377
74
--
2,000,000
2,800,000
--
2,800,000
2,000,000
74
L-Term
1,846
54
557
0
-
--
60,000
60,000
--
30,011
20,811
arch Fellowahips
97
7
30
2
-
--
Sub-Total
7,907
511
6,755
56
1019
395
$7,493,000
$1,707,000
$19,200,000
$7,429,614
11,770,386
$19,200,000
301
4,282
CRAID TOTAL
$30,169
511
$27,500
456
$21,596
392
7,493,000
$1,707,000
$19,200,000
7,429,614
11,770,306
$19,200,000
301
4,202
Appendix B
Table 3. Clinical Manpower Needs for Audiologists Compared to Manpower Resources, 1973-1985
Process five the probal
1973
1914
1973
1916
1972
1978
1919
17Mg
1981
1982
1783
syns
1981
Audiological service needs:
Sereening (infants)
733
739
746
752
718
761
771
777
783
790
796
802
809
Screening (1-18)
777
776
775
774
773
772
771
769
768
767
766
763
764
Habititation (1-18)
4978
1990
4981
4976
4260
4961
4954
4946
4939
4932
4924
4917
4910
Hab. severely impaired (3-18)
5811
5822
3814
5805
3796
5788
3779
5771
5762
5754
3745
5736
3728
Testing medical purposes
3047
3079
3112
3143
1177
3210
3243
3275
3308
3341
3,173
1406
3439
REhabilitation (adults)
MAI
3537
3391
3645
3700
3754
3008
1862
3916
3971
4025
4079
4111
Testing in industry
96
96
'H'
96
76
26
%
%
96
96
96
96
96
Total need
18965
19039
19117
1919)
19268
19346
19422
19426
19572
19651
19725
19801
19879
9-AIX
Audiology workforce resultces:
Continuing mudiologists
2330
2565
2819
3094
3390
3706
4013
4401
4779
3170
5397
6038
6498
New muliologists
II.S. graduates
68
73
77
82
B6
91
91
100
104
108
113
117
122
268
M.S. graduates
145
373
401
429
457
483
513
341
569
597
625
633
681
Ph.D. genduates
7
7
R
a
9
9
10
10
11
11
12
12
13
Attrition
144
154
163
172
181
190
192
208
217
226
233
244
253
Inactive
41
45
48
51
53
58
61
63
68
71
74
78
81
Projected supply of andiologists
2565
2819
3094
3390
3706
4043
4401
4779
3178
5597
6038
6498
6980
Net need
16400
16220
16021
15803
11562
15303
15021
14717
14394
14034
13687
13303
12899
Source: Speech Pathology and Audiology: Manpower Resources and Needs Washington, D.C.: Government Printing
Office, 1977.
Appendix C
22-065 0 - 84 - 18
Table 4. Clinical Manpower Needs for Speech Bathologists Compared to Hanpower Resources, 1973-1985
P.M the period
1773
1774
1971
1976
1977
1775
1977
1780
1981
IVER
1783
1981
1981
Speech pathology service needs:
Screening (3.18)
SIR
517
317
316
515
314
314
513
312
311
311
510
307
Habilitation (3-18)
62971
62879
62786
67691
62601
62508
62416
62323
62230
62138
62015
61952
61860
Habititation and testing (ndults)
3242
3292
1141
1191
3414
3494
3543
3395
1646
3696
3747
3797
3847
Hab. severaly hearing Impaired
3811
3872
3814
5803
37%
1788
5779
5771
5762
5754
3745
3716
3728
Total need
72562
72510
72460
72407
72356
72304
72234
72202
72150
72099
72048
71995
71944
L-AIX
Speeth pathology workforce resoluces:
Continuing speech pathologists
18377
20226
22221
24368
26662
29103
31692
34430
37316
40349
43530
46860
30338
New speech pathologists
B.S. genduates
2714
2358
2501
2643
2788
7932
3075
3219
3362
3306
1619
3793
1936
269
M.S. graduates
1684
1821
1957
2094
2211
2368
2505
2642
2778
2915
3052
3189
3326
Ph.D. guaduates
34
36
19
41
43
45
4A
30
"
34
57
39
as
Atteition
1690
1797
1903
2007
2113
2222
2328
2411.
2540
2617
2753
2839
2'M.5
Inactive
391
421
449
477
506
334
562
591
619
647
675
704
732
Projected supply of speech pithologists
20226
2222.1
24169
26662
29103
31692
344.10
37316
40349
43530
46860
50338
33964
Net need
52336
30787
48092
45745
43233
40612
17824
34886
31801
28569
21188
21657
17980
Source: Speech Pathology and Audiology: Manpower Resources and Needs. Washington, D.C.: Government Printing
Office, 1977.
Appendix D
270
PREPARED STATEMENT OF DR. PATRICK J. McDoNouGH, ASSOCIATE EXECUTIVE VICE
PRESIDENT AND DIRECTOR OF PROFESSIONAL AND GOVERNMENT AFFAIRS, AMERICAN
PERSONNEL AND GUIDANCE ASSOCIATION AND AMERICAN REHABILITATION COUNSEL-
ING ASSOCIATION
The American Personnel and Guidance Association (APGA) and its 41,000 members,
including the American Rehabilitation Counseling Association (ARCA), a division
of APGA, appreciate the opportunity to present our views on the reauthorization
of the Rehabilitation Act of 1973, as amended.
Our statement is directed toward the need for realistic authorizations of the
Rehabilitation Act of 1973, as amended, for at least a three-year period. This
extension is vitally needed to add a measure of stability in the Rehabilitation
programs that span our nation and serve to develop the potential of millions of
disabled people.
The Rehabilitation Act of 1973 is a model of positive thinking and direction of
what can be done in the area of human services. The State-Federal partnership
and its effects over the past six decades stands as a shining example of the
importance of Federal leadership in reaching those that need services the most.
We wish to go on record as encouraging the Congress to maintain the mandate as
it currently exists. We are also aware of the fact that several sections of the
law have not been implemented due to a lack of appropriations. Some examples of
Congressionally mandated, but unfunded sections include: Evaluation (Section 14)
Innovation and Expansion (Section 120), Comprehensive Rehabilitation Centers
(Section 305), to name but a few.
A balanced approach to providing rehabilitation services was what the Congres-
sional architects had in mind, and this is expressed in the law itself. Direct
services are stressed, however, the research component and the training section
are sadly underfunded.
271
The trend in the past three years has been less and less students selecting
careers in Rehabilitation, and unless this catastrophic trend is reversed,
the number of competent and well-trained Rehabilitation staff will continue
to diminish. The complex job of Rehabilitation simply cannot be done without
trained personnel.
Our Recommendation: We urge that the authorization for "Rehabilitation Training"
be at least $29 million (up from the current level of $19.2 million) These
funds would help to reverse the dangerous circumstance that now exists.
We also urge the Congress to increase authorizations for the research activities
of the National Institute for Handicapped Research (NIHR). The efforts of this
Institute are geared toward the development of new techniques and devices to
enhance the independence of disabled persons, thus reducing the tax burden.
Our Recommendation: We. urge that authorizations for Research efforts (through
NIHR) be increased to $50 million from its current level of $30 million. This
type of increase, while not overwhelming, would certainly help to generate new
and cost-saving approaches and devices for disabled persons in their goal of
independence.
"Few, if any, resources offer more potential, I think, than our 35 million
disabled Americans. Too often they are relegated to the sidelines in spite of
outstanding abilities. I am proud to participate in this International Year
(referring to the International Year of Disabled Persons, 1981) to help increase
the awareness of each and every one of us, committed that we'll make that extra
effort to assist the disabled in moving into the mainstream of American Life."
President Reagan made that statement, and we would have to agree on its worth,
and it is just as relevant in 1983 as we plan for the years ahead.
272
We will not bore you with the well-known statistics of just how much "Rehabili-
tation pays" and how expensive neglect can be to the taxpayer.
On behalf of the 41,000 members of APGA and the American Rehabilitation Counsel-
ing Association, we urge you to consider the following:
1. Keep the Rehabilitation Act of 1973, as amended, in its current form.
2. Increase the authorization levels for FY '84 and beyond for Training
of Rehabilitation Staff.
3. Increase the authorization levels for Research for FY '84 and beyond.
4. DO not allow Rehabilitation programs, as authorized by the Act, to be
a part of any Block Grant or "megablock grant" as currently proposed
by the Administration.
Speaking for our membership, but more important, the beneficiaries of the
Rehabilitation programs, we urge you to keep in mind that your deliberations
and action will help millions of handicapped citizens partake in the American
Dream.
273
THE NATIONAL ASSOCIATION
FOR THE
DEAF - BLIND
2703 Forest Oak Circle
Norman, Oklahoma 73071
March 8, 1983
PRESIDENT
ROBERT PETTY
South Central Reg.
1st VICE PRESIDENT
BARBARA ROSS
The Honorable Austin J. Murphy,
Northwest Region
Chairman
2nd VICE PRESIDENT
Select Education Subcommittee
U.S. House"of Representative
Frank Campbell
617 House Annex #1
Southeast Region
Washington, D.C. 20515
GEORGE H. HIBBLER
Mid-Atlantic Reg.
TREASURER
Dear Mr. Murphy:
CHARLENE PETTY
South Central Reg
I have been informed that you will hold hearings on Voca-
BOARD MEMBERS
tional Rehabilitation on 21 and 23 March. My written testimony
DRYDEN. MARILYN
Southwest Region
follows:
Sandra Woodson
Southeast Region
Phyllis Stokes
My name is Robert H. Petty, Executive Director, the National
South Central Region
Dolores Lindstrom
Association for the Deaf-Blind. I am also a Due Process Hearing
Midwest Region
KNOWLES. AUDREY
Officer, State Department of Education, State of Oklahoma and a
New England Region
LAMON. MARLENE
member of the Governor's Advisory Committee for Handicapped Con-
South Atlantic Region
O'DONNELL. MARY
cerns, State of Oklahoma. I am the father of a 28 year old deaf-
Mid Atlantic and
Caribbean Region
blind son. He is the first deaf-blind student to graduate from
RUSE. ROBBIE
Mountain Plains Region
the University of Oklahoma. Over the last 25 years I have been
Patricia McCallum
Texas Region
officially involved with the deaf-blind, as well as other disabled,
from the school district to the White House.
There is no question that Vocational Rehabilitation has
enjoyed much success. However, if we are to improve the system,
it may be more constructive to examine its possible faults rather
than point to its merits.
First, existing programs tend to serve those who are least
disabled or handicapped. Additionally, existing programs usually
274
fail to serve those who are most disabled. Therefore, the programs may not be
in compliance with public law. (See P.L. 93-112 "with special emphasis on
services to those with the most severe handicap.") Moreover, they violate the
basic tenents of cost-effectiveness.
The foregoing practices result from the manner in which the disabled are
perceived by service providers. They also result from how service providers
perceive their own self interests (i.e., job security). Most are caught up in
a "Catch-22" situation. Conventional Vocational Rehabilitation wisdom subscribes
to the proposition that "case closure" equates to "rehabilitation." To put the
point in another way, the higher the percentage of "successful" case closures, the
more successful the Vocational Rehabilitation Counselor is perceived to be by his
superiors and by the system. This reality disposes counselors to select those
clients who are less disabled and, therefore, have the highest probability of
successfully completing a training program in the shortest time possible, However,
in the larger and more significant context, in terms of the national interest,
this is a myopic and costly. attitude in terms of the expenditure of tax dollars,
and the manner in which the disabled are served.
The obvious consequence of not training or of undertraining those "with the most
severe handicaps" is that they will be institutionalized or placed in some other
inappropriate setting. Many will be so placed for some thirty or forty years at
an expense of at least $20,000 a year in terms of present day dollars. This
situation needs to be changed. This can be done if vocational rehabilitation
adopts a program akin to "weighted" case closures. This system presupposes that
some clients may need services for a protracted period, some for a lifetime.
THis would remove the temptation of vocational rehabilitation personnel to favor
those clients who are less disabled and would remove the penalty for "unsuccessful" or
275
premature case closures of clients who are more severely handicapped. I am
informed by policy level vocational rehabilitation personnel in Washington, D.C.
that they can "successfully" close a'case of a severely handicapped client in 24
months. However, upon closer examination, the reality is that upon completion
of training most of these people are simply returned home. Many are officially
classified as "homemakers."
Such practice may be consistent with the letter of the law, but it violates the
spirit of the law in a most egregious fashion. I would also suggest that P.L. 95-
602 Title VII be funded at a realistic level. (Part A--Comprehensive Services,
Part B--Centers for Independent Living, and Part C--Independent Living Services for
Older Blind Individuals.) Again, adequate funding is a less costly and a more
humane approach than the "normal" alternative of institutionalization.
Vocational Rehabilitation personnel should make common cause and effort with
authorities in education so that they could acquire a client upon the completion
of his/her conventional education and should have a vocational rehabilitation plan
and training program "in-place."
The handicapped should be viewed and defined essentially in terms of how well,
or poorly, they function and in terms of their potential, rather than placing an
undue reliance on the medical model.
A precedent for this suggestion is the change of classification of the severely
disabled from a specific disability (e.g., retardation and epilepsy) to a func-
tional definition (see P.L. 95-602, Title V.)
At present, Vocational Rehabilitation Counselors who receive a college degree
in this field, receive relatively little training in how to effectively interface
a client with the "work world". Curriculum should be modified to accommodate this
need.
276
P.L. 95-602, Part B., Section 621 and 622 are concerned with "Projects with
Industry and Business Opportunities for Handicapped Individuals." Both programs
or Sections should be adequately funded.
At present, Vocational Rehabilitation Counselors and Service Providers require
partial or entire new "workups" on clients. This is required even though recent
and definitive information exists. This requirement is expensive and should be
terminated.
To the maximum extent possible, rehabilitative services and programs should
be provided in the community. You could change the present practice simply by
changing the present funding arrangement. In those unusual instances, when deaf-
blind clients require a variety of services at a single location, support services
could be provided at Regional Centers for the Deaf-Blind (i.e., Talladega, Alabama
or Sacramento, California.) This approach is more cost-effective than programs
presently in place.
On behalf of the organization which I represent, I sincerely appreciate the
opportunity provided to comment on matters pertaining to Vocational Rehabilitation.
I trust that my remarks are not seen as harsh or accusatory. They have been
proffered honestly, without stint or favor.
I further hope that they will make a modest contribution to your review and
hearings.
Sincerely,
Robert H. Petty
Executive Director
277
Consortium for
Citizens with
Training and Employment Task Force
Charles F. Dambach, Chairman
Developmental
Epilepsy Foundation of America
4351 Garden City Dr., Suite 406
Landover, MD 20785
Disabilities
(301) 459-3700
Training and Employment Task Force
of the
Consortium for Citizens with Developmental Disabilities
Statement Relative to
REAUTHORIZATION OF THE REHABILITATION
ACT OF 1973, AS AMENDED
March 18, 1983
Members of the Training and Employment Task Force include:
Association for Children/Adults with Learning Disabilities
Association for Retarded Citizens
Disability Rights Education & Defense Fund
Epilepsy Foundation of America
Goodwill Industries of America
National Association of Private Residential
Facilities for the Mentally Retarded
Council of State Administrators
of Vocational Rehabilitation
National Rehabilitation Association
National Association of Protection & Advocacy Systems
National Association of Rehabilitation Facilities
National Easter Seal Society
National Society for Children and Adults with Autism
United Cerebral Palsy Association, Inc.
278
Introduction
The Training and Employment Task Force of the Consortium for
Citizens with Developmental Disabilities (CCDD) is composed of
organizations which serve persons with disabilities. A list of Task
Force members endorsing this statement is on the cover page. These
organizations provide services for and represent the needs of
millions of developmentally disabled Americans. The Task Force
members wish to thank the Subcommittee for its continued interest in
and support of the Rehabilitation Act and its programs. Many of the
people who are served by programs of the Rehabilitation Act are
affiliated with our organizations, and a significant portion of the
people we serve have been helped by Vocational Rehabilitation
programs. Therefore, we are vitally concerned with the extension of
the Act.
Persons with developmental disabilities often have substantial
impairments which offer a unique challenge to the rehabilitation
community. The purpose of this statement is to highlight those
programs within the Rehabilitation Act which have an impact upon the
lives of persons with life-long and severe disabilities. Some of
the persons whom we represent may only require a minimum of services
in order to achieve independence and employability. Other
individuals may require more intensive habilitation/rehabilitation
services in order to reach their full human potential. All
279
components of the Act are vital and if they all were funded and
worked together, then a full continuum of services would be
available for persons with disabilities. This Task Force is ready
to assist the Subcommittee as it continues its deliberations on
programs which are authorized within the Rehabilitation Act.
The Task Force endorses extension of the Act for at least three
years and increased authorized funding levels to meet the need for
services. The Task Force firmly believes that all programs within
the Rehabilitation Act should be renewed. Vocational Rehabilitation
programs are a proven, cost-effective method of providing vital
services to persons with disabilities. Since there has been a
decrease in the number of disabled persons served and rehabilitated
over the past few years, we feel particularly strongly that the
authorization should be increased for the Basic State Grant Progam.
In addition, certain programs have exceptional potential for
increasing the number of disabled persons placed into competitive
jobs and expanding the independence of disabled persons. The Task
Force feels that programs such as Independent Living and Projects
With Industry should receive significantly increased authorizations
to accomplish these purposes. We also wish to suggest a
modification in the Client Assistance Program.
280
New Federalism
This year, the Reagan Administration has again proposed that the
Rehabilitation Act be included in New Federalism or block grant
proposals. These proposals would dilute the focus of the program
and would take away the strong financial base needed to provide
continuity. The Rehabilitation Program has always been a
cooperative arrangement between the federal government, state
government and the private, nonprofit rehabilitation community. The
Vocational Rehabilitation Program is already a predominantly
state-run program. In FY 1983, 91 percent of the monies available
under the Rehabilitation Act were allotted to and matched by the
states to provide services to disabled people. The balance of the
funds are spent on research, training, independent living and
various demonstration programs which can best be managed from the
national level. The federal presence helps assure equitable
distribution of resources and reasonably uniform standards. Thus,
turning the program completely over to the states would not achieve
administrative savings and could cause duplication of research and
training programs. The dissemination of knowledge gained from
national level experimental and demonstration projects would be lost
since few states would have the resources necessary to engage in
such large-scale efforts. Therefore, this Task Force is opposed to
any attempts to include the rehabilitation programs in any block
grant or "New Federalism proposal.
281
State Grants
The central component of the Rehabilitation Act is the State/Federal
Rehabilitation Program. Now in its 63rd year, this program
continues as the focus of our nation's effort to assist disabled
Americans in their effort to become gainfully employed. In recent
years, however, the caseload volume has declined significantly. The
number of persons rehabilitated in FY 1982 declined 11.3% from the
previous year. This decline can be partially attributed to
decreases in the purchasing power of the rehabilitation dollar
resulting from the effects of high inflation. The resources
available to state agencies were further reduced when Social
Security Vocational Rehabilitation funding was cut from $124 million
in FY 1981 to approximately $3 million in FY 1982. Approximately
110,000 eligible persons went unserved by state vocational
rehabilitation agencies as a result of this funding decrease.
Finally, continued emphasis on providing services to persons with
severe disabilities requires more intensive rehabilitation efforts.
We fully support this emphasis, but recognize that it places a
greater demand on the limited funds available. In FY 1982, 59.6% of
all persons served were severely disabled; the highest such
proportion ever recorded.
282
Despite the inadequate resources, the program continues to serve and
rehabilitate disabled persons who have the potential to work.
Financing should be increased in order to serve more of the eligible
persons who go unserved. Therefore, the Task Force recommends that
the legislation extending the Rehabilitation Act contain
authorizations for Basic State Grants under Section 110(b) (1) of
the Rehabilitation Act of 1973, as amended; equal to $1,037.8
million in Fiscal Year 1984; $1,141.1 million in Fiscal Year 1985;
and $1,254 million in Fiscal Year 1986.
These authorizations would in part achieve the goal of restoring the
purchasing power of the rehabilitation dollar to the 1979 Section 110
federal spending level. FY 1979 is viewed as the last year in which
the State/Federal Rehabilitation Program operated at full strength.
In order to adequately and effectively meet the vocational needs of
disabled persons, it is imperative that we increase the
authorization to these levels.
Independent Living
Title VII of the Rehabilitation Act authorizes several different
approaches to promoting independent living services, particularly
services to persons too severely disabled to qualify for vocational
rehabilitation. The 1978 amendments to the Act envisioned a major
statewide service delivery system, Comprehensive Services for
283
Independent Living," in Part A. However, the Administration and
Congress have restricted the program to the federally administered
Part B Centers for Independent Living by failing to request and
appropriate monies for the Independent Living state grant program.
These centers are often staffed by professionally-trained disabled
persons who assist clients in obtaining appropriate services,
training and employment necessary to achieve independence. More
importantly, the staff also provides crucial peer support that can
be the key to the successful transition from dependence to
independence.
The primary concern of the Task Force with the Independent Living
program is how to create a transition from a federally-administered
series of model and demonstration centers which have proven their
value to a statewide service delivery system for the severely
disabled- population. A key factor to implementing this transition
is the start-up of Part A while maintaining funding continuity for
existing Part B centers. The Task Force believes the success of
Part B justifies the expansion of the program at this time.
When enacted, Title VII of the Act offered great potential. It
remains a vital key to the door of employment opportunity for
disabled people. But we are dismayed that Parts A and C have not
been funded. Title VII is's comprehensive attempt to provide the
284
support, resources and assistance crucial to gaining independence.
For many severely disabled people, the Independent Living program
provides the alternative to costly institutional care. Now is the
time to let Title VII begin to reach its full potential.
The Task Force recommends that $60 million be authorized for
independent living services. This would allow for $33 million to
initiate Part A; $24 million to maintain Part B and $3 million to
initiate Part C.
Projects With Industry
The Projects With Industry (PWI) program authorizes contracts or
jointly-financed cooperative agreements with employers and
organizations for projects designed to prepare disabled individuals
for gainful employment. Such projects provide training, employment,
and other services in work settings. PWI increases the chances for
successful placement because the client is exposed to and placed in
a real work environment. The process of permanent placement is
simplified because the employer already knows the client and only a
payroll transfer may be required to hire a PWI graduate. Business
and industry are more involved with the client, and attitudinal
barriers are reduced. PWI is part of an overall rehabilitation
program with special emphasis on placement. Last year, 72 PWI
projects were funded at $8 million. Over 9,000 placements, costing
285
an average of $946 each, made this a successful job-training
program. Placement retention rates were over 75%. The average
annual wage for PWI graduates was $9,000; total income for persons
placed by the program was $78 million. Taxes paid by PWI graduates
alone offset the cost of the program.
The success of the PWI program and its positive cost benefit ratio
justify an authorization amount of $25 million for the next three
fiscal years: Documented savings in public assistance and taxes
paid by the program clearly exceed the authorization for this
program.
Other Progams of Significance
The Task Force has addressed authorization levels for some of the
major components of the Act. But the Act is composed of a variety
of programs concerning training, research, recreation and
rehabilitation services. Each component reinforces the others,
together constituting a program capable of providing a statutory
base for the appropriate rehabilitation services necessary for each
individual. Following are some of the programs vital to the
continued strength of the Act:
22-065 o - 84 - 19
286
Rehabilitation Training
Rehabilitation, because it is individually tailored to the
unique needs of each disabled person, depends upon
well-prepared professionals to deliver a wide range of
services. Whether the service is medical, psychological,
social, or vocational, the quality of the service provided
is directly related to the qualifications of the provider.
A strong training program to provide qualified personnel is
integral to an effective service delivery program, and we
regret that funding for Rehabilitation Training has
gradually declined over the past six years from $30.4
million in 1977-78 to $19.2 million in FY 1983.
Special Demonstrations
The Rehabilitation Act authorizes Special Demonstrations
"which hold promise of expanding or otherwise improving
services to (severely) handicapped individuals." Special
Demonstration Projects and centers are on the cutting edge
of developing and refining methods by which the vocational
rehabilitation program improves its capability to
successfully serve severely disabled persons. The scope of
the projects is national, with the emphasis on the
development of projects which can be replicated in all
states once service delivery models have been refined.
287
Recreation
The role of recreation in rehabilitation is an important
one. Recreation and rehabilitation professionals indicate
that there is a significant therapeutic value to
participation in recreation programs and that recreational
activities are an essential element of a balanced
lifestyle. When Congress passed Section 316, it recognized
that the lack of adequate recreation programming for
disabled individuals was one of the most glaring gaps in
our existing social service funding. Continued support for
Section 316 programs is essential to make recreational
opportunities accessible to persons with disabilities.
Client Assistance
The Client Assistance Program was established in 1973,
along with due process procedures, to strengthen the
clients' voice in the rehabilitation process and provide
the clients with a means of redress if the process was not
responsive to their needs. Gradually 37 states have agreed
to participate. In most states, the VR agencies have opted
to run the program within the agency. Approximately five
states have placed the CAP program in external independent
advocacy agencies. To guarantee that all clients can
obtain the information and services necessary for
successful rehabilitation, the Task Force suggests
the following modifications within Section 112 of the Act.
288
a)
Makie it mandatory for all states and territories to
provide a Client Assistance Program.
b)
Authorize funds necessary for a minimum allocation
to each state and territory.
c)
Revise the language to state more clearly that
rehabilitation agencies have the option to operate
the Program internally or to place it in an external
independent advocacy agency.
National Institute of Handicapped Research
The National Institute of Handicapped Research (NIHR), which
was established under the "Rehabilitation, Comprehensive
Services and Developmental Disabilities Amendments of 1978,"
promotes expanded research in both traditional and
innovative fields of rehabilitation. The Institute also
provides support for the dissemination of information
acquired through such research and coordinates federal
programs and policies related to research in rehabilitation.
Despite initial Congressional intentions of significantly
expanding research in the area of rehabilitation, the
NIHR budget has consistently received a smaller
appropriation than the initial funding level of $31.5
289
million in FY 1979 and FY 1980. In addition to fewer
absolute dollars, NIHR funding has also been further
eroded by inflation. By shortchanging the research
aspects of vocational rehabilitation, as has been the
case since the establishment of NIHR, we are denying
the best possible services and outcomes to persons with
disabilities, as well as undercutting the success of the
vocational rehabilitation program. The Task Force
recommends an authorization level of $40 million:
Innovation and Expansion
Innovation and Expansion Grants are authorized by Section
120 of the Act. These monies allow state vocational
rehabilitation agencies to pursue innovative programs which
might not otherwise be funded by the basic state grant
program. Traditionally these monies have been used to
serve unserved or underserved populations such as mentally
retarded individuals, persons with cerebral palsy, and
disabled persons who are also disadvantaged. This program
was last funded in FY 1980 at a level of $11.775 million.
The Task Force recommends that Innovation and Expansion
Grants be authorized at the 1980 level, at a minimum. We
believe that these monies can be used for a number of
activities which will enhance employment opportunities for
the severely disabled. For instance, a part of these monies
could be used to apply rehabilitation engineering to the
290
worksite, thus enabling many persons heretofore thought
to be "unemployable" to take their rightful place in the
working world. Finally, the Task Force believes that these
grants should be reauthorized because they provide the
opportunity for rehabilitation agencies to use creative
methods to help the hard-to-serve client. While we are
fully cognizant of the fact that these are difficult
economic times, we feel that unless such innovative
programs are allowed to continue, rehabilitation for
the severely disabled will suffer both now and in future
years.
Reauthorize Unfunded Programs
The Task Force also asks the Subcommittee to reauthorize the
programs that have remained unfunded. As we noted previously, the
Rehabilitation Act must be viewed as a comprehensive plan addressing
all the rehabilitation needs of a diverse disabled population. We
will urge Congress to appropriate funds for these programs and
projects. The unfunded programs include: Grants for Construction
of Rehabilitation Facilities (Sec. 301); Vocational Training
Services for Handicapped Individuals (Sec. 302); Loan Guarantees for
Rehabilitation Facilities (Sec. 303); Comprehensive Rehabilitation
Centers (Sec. 305); Community Service Employment Programs for
Handicapped Individuals (Title VI, Part A); Business Opportunities
for Handicapped Individuals (Sec. 622); and Protection and Advocacy
of Individual Rights(Sec. 731).
291
The Act Must be Extended
The primary point that the Task Force wishes to make is that the Act
must be extended. The various components of the Act have proven
their ffectiveness in providing the best possible balance of
rehabilitation services to a diverse client population. We must
maintain and, in some cases, expand research, training programs, and
services to meet needs that are currently not being met. We
appreciate the opportunity to submit this statement to you and look
forward to working with the Subcommittee to ensure that all disabled
persons have the opportunity to become productive, independent
individuals.
292
STATEMENT
RESPECTFULLY SUBMITTED TO THE
SUBCOMMITTEE ON SELECT EDUCATION
OF THE HOUSE COMMITTEE ON
EDUCATION AND LABOR
ON
THE
EXTENSION OF THE REHABILITATION ACT
ON BEHALF OF
UNITED CEREBRAL PALSY ASSOCIATIONS, INC.
THE CHESTER ARTHUR BUILDING
=
425 "EYE". STREET, N.W., SUITE 141
WASHINGTON, D.C. 20001
Prepared by Kathleen M. Roy, Policy Associate
With Contributions by Dr. E. Clarke ROSS, Director
March 18, 1983
U.C.P.A. Governmental Activities Office Washington, D.C.
293
INTRODUCTION
United Cerebral Palsy Associations, Inc., is pleased to submit written testimony
to the House Subcommittee on Select Education concerning the reauthorization of the
"Rehabilitation Act of 1973" as amended. We commend the Subcommittee for giving
consideration to the programmatic needs of our nation's disabled citizens as the
Rehabilitation Act is reauthorized. At the outset UCPA, Inc., would like to endorse
the comments submitted to the Subcommitted by the Consortium for Citizens with
Developmental Disabilities Task Force on Training and Employment. This statement
is the result of thoughtful deliberations of several national agencies who represent
persons with severe disabilities who require a continuum of rehabilitation services
in order to reach their full human potential. UCPA is an active member of the Task
Force and we feel that this statement will give the Subcommittee significant direction
in a number of programmatic areas including the Basic State Grant Program, Independent
Living, Projects with Industry, Client Assistance, NIHR, and other programs which
serve persons with disabilities.
In recent years, UCPA has become increasingly concerned about improving
employment opportunities for persons with severe disabilities. While many clients
are served by the vocational rehabilitation system, all too often these services
either do not lead to employment opportunities for disabled individuals or result in
employment which may not fully utilize the clients employment skills. We point this
out not to be critical of any one segment of the rehabilitation community. Rather, we
believe that this is a problem that those concerned about rehabilitation, especially
the members of the Subcommittee, should give further consideration. Therefore, our
testimony will focus on one solution to this problem: Improving rehabilitation
engineering as it relates to employment. UCPA firmly believes that if we improve
our ability to adapt the work place, many persons heretofore thought to be "unemploy-
able" will be able to take their rightful place in the working world. Further, our
statement will outline some of the problems encountered in the production of adaptive
equipment and the response being made by the National Institute of Handicapped Research
to this problem. Finally, we will consider how the Independent Living Program serves
persons with cerebral palsy.
The Cooperative Agreement
In April 1981, UCPA entered into a Cooperative Agreement with the Rehabilitation
Services Administration, the National Institute on Handicapped Research and the Council
of State Administrators of Vocational Rehabilitation. The purpose of the Agreement
is to improve rehabilitation services and thus, employment opportunities for persons
with cerebral palsy. As the Agreement states:
"While many advances have been made in vocational rehabilitation
in the last several decades, the vast majority of persons disabled
by cerebral palsy have not been served
Another critical area for intervention involves increasing employ-
ability and employment options. Unfortunately many persons with
cerebral palsy are labeled as unemployable, inappropriately placed
in sheltered workshops or limited to few employment options. Also,
many persons with cerebral palsy have been underserved by the
educational system and this factor has further limited their
employment options."
294
The Agreement outlines tasks which each agency will undertake in order to improve
employment opportunities for severely disabled individuals. These tasks include
the following: long range planning, case finding and referral, data retrieval,
professional training, consultation services, regional review and a focus on
rehabilitation and independent living skills. Throughout the Agreement the
importance of improving rehabilitation engincering as it relates to employment
has been stressed.
Since the signing of the Cooperative Agreement, progress has been somewhat
slower than our agency had originally anticipated. However, this past fall we
hired a full-time rehabilitation professional in our national office to work on the
implementation of the Agreement. The following examples of UCP affili ite activities
indicate that the agreement will ultimately lead to improved employment opportunities
in the future for persons with cerebral palsy:
Perhaps the best example of cooperation between UCPA and the vocational
rehabilitation system can be seen by the efforts of UCP of New York City.
This affiliate is involved in placing persons who are currently in
sheltered workshop programs into competitive employment. UCP of NYC also
provides post employment services which may be needed by these clients.
Two years ago, this program had been so successful that the New York
Office of Vocational Rehabilitation has signed a contract with UCP of
NYC to provide these services to other severely disabled persons.
UCP of Indiana has hired a full-time rehabilitation engineer to improve
employment opportunities for developmentally disabled persons who are
currently working in sheltered workshops. This individual serves as a
resource person on what technology is commercially available to the
employer. He also offers recommendations on how to adapt a worksite for
a particular disabled individual. When such worksite modifications are
recommended, the rehabilitation engineer focuses not on a single job,
but two or three jobs which the person may be able to perform, thus
increasing that person's employment potential.
UCP of the North Shore has undertaken a direct training/on-the-job
training program for severely disabled adults. There are currently nine
enrollees in the program. UCP has met with the Massachusetts Rehabilitation
Commission concerning possible funding for this program. It appears that
the Massachusetts Rehabilitation Commission will enter into a "purchase-of-
service" agreement some time in the future. It is hoped that such an
agreement will foster other cooperative ventures.
As a result of the Cooperative Agreement, UCP of Wisconsin has entered
into joint agreement with the Wisconsin Department of Rehabilitation.
Specifically, UCP of Wisconsin is working with rehabilitation counselors to
make them aware of the services which can be provided through the use of an
occupational therapist and/or rehabilitation engineer in adapting the worksite
for severely disabled persons. UCP of Wisconsin is using the work done by
the Job Development Laboratory at George Washington University as a model.
UCP of Alameda-Contra Costa Counties has been working with RSA Region IX to
improve services for persons with cerebral palsy. The affiliate and the
regional office have had extensive information sharing including statistics
concerning the number of persons with cerebral palsy served in the state of
295
California. At the local level, UCP of Alameda-Contra Costa Counties is
working with DVR to develop an on-the-job training program for persons with
severe disabilities.
Need for Technology
Persons who are involved with the employment of the severely disabled
generally agree that rehabilitation engineering and job adaptation are
essential to assuring that these persons obtain suitable employment. One
rehabilitation professional put it this way:
"The potential contribution of rehab technology toward the
employability of persons with cerebral palsy is immeasurable
My sense is that a great deal of technology is already in
place and the difficulty lies in applying it to the individual
consumer at a cost which can be borne. At the present time it
appears that only a very small segment of consumers have had
the opportunity to benefit from rehab engineering for purposes
of employment. My thought is that unless the rehab technology
is in place during the consumer's period of education/training,
the chances of matching the technology to a job is decreased.
What a consumer needs (is) the input and equipment available
through rehabilitation engineering techniques early in life
because if not, they probably will not be "tracked" for
employment.'
Perhaps more important is the fact that a government study has
reached similar conclusions. The Berkely Planning Associates, in
conjunction with Harold Russell Associates, has recently completed a
study concerning the accommodations made on behalf of handicapped workers
by federal contractors. This study for the Department of Labor "sought
to provide a better base for implementing Section 503 of the Rehabilitation
Act of 1973 The 20-month study surveyed 2,000 federal contractors
concerning the nature and extent of the accommodations made for disabled
employees but only 367 responded. In addition, 85 telephone interviews
were conducted to obtain more detailed information concerning the types
of accommodations made. A survey of disabled workers was also taken to
"learn about any accommodations that may have been made for them." Finally,
case studies were done of ten firms who were identified as having "exemplary
accommodation practices."
The study made the following conclusions which may interest the
Subcommittee:
An overall conclusion of the analysis is that for firms which have
made efforts to hire the handicapped, accommodation is "no big deal"
Only 8% of the accommodations cost more than $2,000.
"Accommodation efforts are generally perceived as successful in
allowing the worker to be effective on the job."
296
"Accommondations for individual workers take many forms:
adapting work environments and location of the job, retraining
or selectively placing the workers in jobs needing no accommodation;
providing transportation, special equipment or aides, redesigning
the worker's jobs and re-orienting or providing special training to
supervisors and co-workers. No particular type of accommodation
dominates. Most workers received more than one kind of accommodation."
The study draws a number of conclusions, but the following may be of special
interest to the Subcommittee. They recommend the government:
"Provide technical assistance and possibly cost-sharing in accommodation.
This may particularly be needed with the small business sector, which
is both the source if a disproportionate share of new jobs being created
by the economy, and also the sector least likely to hire and accommodate
the handicapped due to limited personnel systems, diversity of
occupations, and inexperience with accommodations Government-funded
rehabilitation engineering centers are one possible source of expertise,
but more locally available sources are needed, possibly drawing on state
VR programs for supply. (Emphasis added)
It should be pointed out that of the firms surveyed 28% reported having
no handicapped workers. An additional 17% have made no accommodation. Only
55% have made some form of accommodation. Thus, while this study demonstrates
the value of adapting the worksite to disabled individuals, it also points out
the need to increase our focus in this area.
Efforts of Vocational Rehabilitation
As we have already illustrated through some examples of the ways in which
our Cooperative Agreement is being implemented, several vocational rehabilitation
agencies have become involved in rehabilitation engineering as it relates to
employment. The following are some examples of efforts being made by vocational
rehabilitation agencies either on their own or in conjunction with other agencies
or institutions. By using these illustrations, we do not wish to infer that
these are the only efforts vocational rehabilitation is making in this area.
Rather, these examples are meant to offer the Subcommittee ideas of how
rehabilitation engineering can be used by vocational rehabilitation agencies.
The Iowa Department of Rehabilitation was funded as a Comprehensive
Rehabilitation Center during FY 80 and 81. Drawing on the work done
by Dr. Kali Mallik at the Job Development Laboratory at George
Washington University, the Iowa DVR developed a unique method to
increase employment opportunities for severely disabled persons.
A team of professionals composed of a rehabilitation counselor,
a professional in job training and development, and an individual
knowledgeable in adaptive equipment work together to solve the
unique problems faced by severely disabled clients. This team looks
at problems encountered at the worksite and other environmental
factors including the individual's living arrangements. While this
project is no longer funded as a Comprehensive Rehabilitation Center,
at this point they have been able to maintain this valuable service.
In New York, Rensselaer Polytechnic Institute was awarded a Research
and Training grant from NIHR to work with the New York Office of
Vocational Rehabilitation. Through this grant, students from
Rennselear were used to assist placement staff with job analysis
297
and work site modifications to maximize employment opportunities
for persons with severe disabilities. This newly established
relationship will provide OVR with placement and counseling staff
with first-hand information on the effective use of rehabilitation
engineering techniques to maximize client employability.
The Department of Vocational Rehabilitation in Michigan has applied
rehabilitation engineering in a variety of ways. First, in
cooperation with Michigan State University, DVR of Michigan supplied
two students, who are both severely disabled by cerebral palsy and are
nonverbal, with a computerized speech device. This device enables these
students, to speak and pursue work in computer programming. DVR of
Michigan in conjunction with the University of Michigan has also
developed a Mobile Laboratory to develop worksite modifications.
This Mobile Laboratory visits the client's worksite and makes
recommendations about any modifications the client might need. DVR
of Michigan also works directly with clients to prepare them for the
work experience and teach them how they might also modify their work
environments themselves. DVR of Michigan feels strongly that the
majority of modifications which need to be made for the disabled
employee often are similar, if not identical, to those modifications
which private industry makes in order to increase productivity.
In New Jersey, the Department of Vocational Rehabilitation is working
with the Metheaney School to improve rehabilitation engineering
services for clients. The Metheaney School serves severely disabled
children and adolescents, many of whom are multiply disabled. DVR is
trying to develop a cadre of volunteers who have some type of
engineering skill and are willing to assist in making modifications
for these clients. DVR will pay for any purchase of equipment or
materials which may be needed in order to complete a given modification.
This technique matches the skills of the volunteer to the needs of the
individual client and also stretches scarce service delivery dollars
further. Since many of the students at the Metheaney School are
adolescents who are either employed or preparing for the world of work,
this program will no doubt increase their employability.
These are a few examples of efforts being made by various state departments
of Vocational Rehabilitation. The professionals we surveyed in preparing the
above examples all agree on one important point: While some efforts are being
made to increase the utilization of rehabilitation engineering, much more needs
to be done. Many feel that the practical application of rehabilitation
employment, (i.e., the modification of the worksite to meet the functional
needs of the client), is essential to placing severely persons in the work place.
NIHR Initiatives
Currently, the National Institute of Handicapped Research funds 18 Rehabilitation
Engineering Centers (RECs). Of these only one, Center Industries Corporation,
(which is affiliated with UCP of Kansas) is concerned primarily with employment.
The Center Industries Corporation of Wichita, Kansas, aided by technical assistance
from Wichita State University, is primarily a job shop operation providing support
for local Wichita in the basic areas of fabrication, matching, and assembly.
It employs the physically handicapped alongside the able-bodied in a 75% handi-
capped-25% able-bodied ratio. Diagnostic test procedures and testing hardware
298
have been designed to determine the physical capabilities and job requirements. As
a result, severely disabled workers are generally meeting industrial norms and
receiving unsubsidized wages, thus taking their new status as contributors to society.
Recently, Center Industries Corporation has begun to work with employers to
provide incentives for industry to hire severely disabled persons. They continue
to believe that, while much progress has been made in recent years toward improving
worksite modifications for disabled workers, much more should be done. They also
believe that much knowledge exists which is not always shared throughout the
rehabilitation community. They point out that many exemplary programs could be
replicated if such information were disseminated. They hasten to point out that
many people envision rehabilitation engineering as an expensive endeavor when in
fact the majority of worksite modifications can be made at a reasonable cost.
Beyond the problems of timely dissemination of this information, the problem
arises of who will manufacture adaptive equipment at a cost disabled persons can
afford. The NIHR Long-Rang Plan, developed in 1981, has this to say about the
manufacturing of adaptive equipment:
"Technological devices can be largely developed and distributed
through the facilities, research capacity, staff, management,
market expertise, and distribution networks of private industry.
However, there are now several disincentives to private industry
investment in this area: lack of adequate information about
market demand; obstacles caused by the patent system, the third-
party payment system, and liability insurance requirements; and
the fact that some of these undertakings may be unprofitable because
of high investment costs for a very limited market. NIHR's
immediate goals are to reduce these obstacles by (1) initiating
a program of demographic research, including market surveys of the
handicapped population; (2) determining the necessary incentives to
offset the low returns anticipated from investment; and (3)
studying and testing policy modifications to offset other specific
obstacles."
We are pleased to learn that NIHR intends to award a grant this year to focus on the
above cited goals. In addition, this grant will look at performance standards and
evaluation of adaptive equipment to assure the quality of equipment produced for
use by disabled persons. UCPA intends to work with NIHR on this matter.
The Office of Technology Assessment of the Congress has also considered the
unique problems in the production of technology. to meet the needs of handicapped
individuals. In their report entitled Technology and Handicapped People specifically
addresses the problems of production, marketing and diffusions of disability-related
technologies.
"The production, marketing, and diffusion of technologies are steps
that are most often appropriate private sector activities, and yet
a number of factors work against that sector's willingness and ability
to engage in those activities. Research and development (R&D) organi-
zations have typically placed a low priority on production, marketing,
and diffusion activities. The National Aeronautics and Space
Administration's (NASA's) activities in technology transfer illustrate
an exception. In general, however, the ultimate commercial production
and distribution of technologies being developed with Federal funds
have not been given sufficient attention."
299
To address this problem the OTA report recommends the following:
"Congress could amend current legislation to create a
consistent and comprehensive set of fiscal and regulatory
incentives encouraging private industry to invest in the
production and marketing of disability-related technolo-
gies."
The report goes on to explain that:
"
this option recognizes the current confusing and often
detrimental collection of competing incentives set up
by such laws. It implicitly is based on several ideas:
1) that a great many technologies, though certainly not
all, could be serving far more people than currently;
2) that some, perhaps many, technologies' development
and subsequent distribution depends less on further
research than on the willingness and ability of private
industry to develop, próduce, and market them; 3) that
policies of the Government greatly affect private
industry's willingness and ability to produce and market
these technologies; and 4) that current legislation and
regulations do not create adequate positive incentives for
those firms to do so."
We believe that this and other OTA recommendations warrant further consideration
by the Subcommittee. This is clearly a complex issue and there are no easy answers.
However, production and dissemination of technology is essential to improving the
quality of life for disabled persons. We have focused our attention in this statement
on technology as it relates to employment, but we readily acknowledge that technology
can improve the quality of a disabled person's life in other areas including
independent living and increased mobility. NIHR has made some laudable first steps
in improving technology in general and rehabilitation engineering specifically. But
much remains to be done, especially in the area of dissemination of information and
production of equipment.
Comprehensive Services For Independent Living
One of the most exciting federal initiatives of the last decade was the enactment
in 1978 of the Independent Living program. Part A of Title VII of the Rehabilitation
Act envisioned a major statewide service delivery system. UCPA is very concerned that
both the Congress and the Carter and Reagan Administrations have restricted the program
to the federally administered Part B Centers for Independent Living, CILs.
The primary concern of UCPA with the Independent Living program in 1983 is how
to create a transition from a federally administered series of model and demonstration
centers which have proved their value to a statewide service delivery system for the
severely disabled population. UCPA recommends the reauthorization of and funding
for the Part A program.
Importance to Persons with Cerebral Palsy
Individuals disabled with cerebral palsy are a primary category of persons served
through the existing CILs. For example:
300
of the 799 individuals served by the five CILs in Wisconsin between
October 1, 1980 and March 31, 1982, 87 or 11% were disabled with
cerebral palsy.
of 322 consumer respondents from 12 of the then 16 existing CILs in
California in 1978, 11.3% were disabled by cerebral palsy. A comparison
group or quasi-control group was used in this California Department of
Rehabilitation study (June 1982). The comparison group was a random
selection of applicants who had been denied state VR services and
were not being served by either DVR or the CILs. Only 4.2% of the
286 comparison group were disabled with cerebral palsy.
Of 23 CILs in California serving 8,606 clients between October 1, 1981
and September 30, 1982, 639 (or 7.37%) were developmentally disabled.
Service Contributions of CILs
CILs provide an array of services generally not available from other government
programs or offered only to persons meeting means tested eligibility programs such as
Medicaid. For example:
Of the 4,131.7 monthly average number of clients served by California's 23
CILs between October 1, 1981 and September 30, 1982, the monthly average of
clients by service were:
1) Peer Counseling, 887.0
2) Unique direct service, 844.2
3) Attendant Care, 742.4
4) Housing Assistance, 678.4
5) Advocacy, 636.2
6) Transportation, 370.9
7) Communication, 341.9
8) Independent Living Skills, 246.1
9) Employment, 215.3
10) Equipment repair/loan, 148.8
With little variance from center to center, the most frequently needed services
in Wisconsin's five centers between October 1, 1980 and March 31, 1982 were the
following: Personal Care Assistance/Attendant Care, Information and Referral,
Independent Living Skills Assessment and Training, Peer Counseling, Housing
Assistance, and Transportation.
Of considerable significance in the five Wisconsin centers were changes in
the residential status during the course of service. As a Region V Rehabilitation
Services Administration report observes, "The large increase in the 'own home'
category represents one of the major triumphs of the independent living program."
The residential status change follows:
301
Percent
Percent
Status
at Referral
at Closure
Difference
Hospitals/alcohol/
10.5
4.9
- 5.6
drug centers
Nursing homes
7.6
6.3
- 1.3
Community residential
2.0
1.0
- 1.0
facility
Special arrangements
.8
1.3
+ .5
a
Parent/relative's
22.0
12.0
-10.0
home
Own home
52.0
68.0
+16.0
Unreported
5.1
6.5
When clients are terminated from a Wisconsin center program, the counselor is
asked to assess the overall independent living status of the individual as to
whether his/her situation has improved, not improved, or can not be assessed.
For the 301 clients that were closed between October 1, 1980 and March 31, 1982,
the following status changes were indicated:
Improved
201 (67%)
Not Improved
80 (27%)
Not possible to Assess/Not Indicated 20 (6%)
UCPA Recommendations
To live and work in the community is the goal of severely disabled Americans.
We believe that this goal can be achieved through expanding the current Independent
Living Program and through encouraging the development, dissemination and utilization
of rehabilitation engineering. We believe that rehabilitation engineering can be
provided inexpensively and can improve working conditions for most disabled persons
who are or wish to be employed. The following are our specific recommendations as the
Congress seeks to reauthorize the Rehabilitation Act:
Congress should support the CCDD Training and Employment Task Force
recommendation that the legislation extending the Rehabilitation Act
contain authorizations for Basic State Grants under Section 110 (b) (1)
of the Rehabilitation Act of 1973, as amended, equal to $1,037.8 million
in Fiscal Year 1984; $1,141.1 million in Fiscal Year 1985; and $1,254
million in Fiscal Year 1986. These authroizations would in part achieve
the goal of restoring the purchasing power of the rehabilitation dollar
to the 1979 federal spending level.
Congress should reauthorize Innovation and Expansion Grants which are
authorized through Section 120 of the Act. Historically these monies
have been used to serve unserved and underserved populations such as
persons with cerebral plasy. This program was last funded in FY 1980 at
a level of $11.775 million. We recommend that Innovation and Expansion
22-065 0 - 84 - 20
302
Grants should be requthorized at the 1980 levels at a minimum. Further
the Congress may wish to specificly direct a portion of these monies to
be specificly directed to expanding employment opportunities through
rehabilitation engineering.
RSA should be directed to increase their efforts to improve dissemination
of information concerning rehabilitation engineering so that counselors
are aware of 1) the availability of such technology and how it can be
utilized to improve employment opportunities for severely disabled
individuals and, 2) where to contact persons who have expertise in making
worksite modifications for persons with disabilities.
UCPA recommends that both Part A and B of Title VII be reauthorized and that
the authorizing committees of the Congress instruct the appropriations
committees to fund Part A. The Consortium for Citizens with Developmental
Disabilities (CCDD) Task Force on Budget and Appropriations, cochaired by
UCPA, has recommended an appropriation of $45 million which would allow
$25 million to initiate Part A, $18 million to maintain Part B, and
$2 million to initiate Part C.
Through increased funding, NIHR should be directed to fund other Rehabilitation
Engineering Centers which are specifically directed to employment.
The Congress should direct NIHR to improve their efforts to disseminate the
knowledge which they, have already gained through existing Rehabilitation
Engineering Centers as well as other exemplary programs which provide
assistance in worksite modification.
Congress should give further consideration on how to improve the incentives
to manufacturing adaptive equipment through drawing on knowledge gleaned
from current studies being done at NIHR as well as the work which has been
done by the Office of Technology Assessment.
We appreciate the opportunity to submit written testimony concerning the
reauthorization of the Rehabilitation Act. We look forward to working with the
Subcommittee as the Act is extended.
Independent Living Citations
1) Hichle, Gene and Robins, Bridget. Programs for People: The California
Independent Living Centers. Sacramento, CA: State of California
Department of Rehabilitation, June 1982.
2) State of Wisconsin, Department of Health and Social Services, Department
of Vocational Rehabilitation. Centers for Independent Living. Madison,
WI: State of Wisconsin Department of Vocational Rehabilitation,
September 15, 1982.
3) U.S. Department of Education, Rehabilitation Services Administration, Region V.
The Economic And Societal Benefits of Independent Living Services. Chicago, IL:
U.S. Rehabilitation Services Administration, Region V, December, 1982.
303
National Association of Counties
Offices
440 First Street, N.W. Washington, D.C. 20001
Telephone 202/393-NACO
March 10, 1983
The Honorable Austin Murphy
U.S. House of Representatives
Chairman, Subcommittee on
Select Education
Committee on Education and Labor
Washington DC 20515
Dear Mr Murphy:
Thank you for this opportunity to submit written testimony
regarding the reauthorization of the Vocational Rehabilitation
Act of 1973.
Should you or your staff have any questions regarding the
attached testimony, please contact me at 393-6226.
Sincerely,
Patricia Johnson Craig
Director
Department of Human Resources
Attachment
304
WRITTEN TESTIMONY SUBMITTED ON BEHALF OF THE NATIONAL ASSOCIATION
OF COUNTIES (NACO) TO THE SENATE SUBCOMMITTEE ON THE HANDICAPPED
AND THE HOUSE SUBCOMMITTEE ON SELECT EDUCATION IN REGARD TO AUTHORI-
ZATION OF THE REHABILITATION ACT OF 1973.
THE NATIONAL ASSOCIATION OF COUNTIES WOULD LIKE TO THANK YOU
FOR THIS OPPORTUNITY TO SHARE OUR VIEWS AND CONCERNS REGARDING RE-
AUTHORIZATION OF THE VOCATIONAL REHABILITATION ACT OF 1973.
NACo CONTINUES TO SUPPORT EQUAL OPPORTUNITY FOR HANDICAPPED
AMERICANS IN ALL ASPECTS OF AMERICAN LIFE, INCLUDING EMPLOYMENT,
PROGRAMS, ACTIVITIES, EDUCATION AND SERVICES, WE FEEL THAT THE
PROGRAMS FUNDED THROUGH THE VOCATIONAL REHABILITATION ACT HAVE
PROVIDED A GOOD BEGINNING TOWARD THE PROMOTION OF SELF-SUPPORT AND
SELF-RELIANCE OF DISABLED PERSONS.
ALTHOUGH VOCATIONAL REHABILITATION PROGRAMS ARE, FOR THE MOST
PART, FUNDED AND ADMINISTERED THROUGH THE STATE LEVEL, THESE PRO-
GRAMS HAVE HAD A SIGNIFICANT AND BENEFICIAL IMPACT ON COUNTY
GOVERNMENTS AND CONSTITUENTS. MOST COUNTIES NOW DIRECTLY REFER
DISABLED PERSONS WHO NEED INFORMATION OR ASSISTANCE WITH TRANSPORTA-
TION OR EMPLOYMENT CONCERNS TO VOCATIONAL REHABILITATION AGENCIES.
IN MANY STATES, THERE ARE VIRTUALLY NO OTHER SERVICES SPECIFICALLY
GEARED TO MEET THE NEEDS OF DISABLED PERSONS AVAILABLE FOR ADDITIONAL
*NACo IS THE ONLY NATIONAL ORGANIZATION REPRESENTING COUNTY GOVERNMENT IN
AMERICA. ITS MEMBERSHIP INCLUDES URBAN, SUBURBAN, AND RURAL COUNTIES JOINED TO-
GETHER FOR THE COMMON PURPOSE OF STRENGTHENING COUNTY GOVERNMENT TO MEET THE NEEDS
OF ALL AMERICANS, BY VIRTUE-OF A COUNTY'S MEMBERSHIP, ALL ITS ELECTED AND APPOINTED
OFFICIALS BECOME PARTICIPANTS IN AN ORGANIZATION DEDICATED TO THE FOLLOWING GOALS:
IMPROVING COUNTY GOVERNMENT, SERVING AS THE NATIONAL SPOKESMAN FOR COUNTY GOVERNMENT;
ACTING AS A.LIAISON BETWEEN THE NATION'S COUNTIES AND OTHER LEVELS OF GOVERNMENT,
AND ACHIEVING PUBLIC UNDERSTANDING OF THE ROLE OF COUNTIES IN THE FEDERAL SYSTEM.
305
REFERRALS OF THIS KIND. VOCATIONAL REHABILITATION OFFICIALS OFTEN
PARTICIPATE IN VARIOUS COMMUNITY RELATIONS ACTIVITIES SUCH AS INTER-
AGENCY COMMITTEES AND BOARDS WITH COUNTY OFFICIALS. VOCATIONAL
REHABILITATION OFFICIALS OFTEN SERVE ON PRIVATE INDUSTRY COUNCILS
AND LOCAL CHAMBERS. OF COMMERCE. THESE KINDS OF FORMAL INTERAGENCY
LINKAGES ASSIST COUNTIES TO EFFECTIVELY SERVE DISABLED CONSTITUENTS
BY PROVIDING PERSONS WITH EXPERTISE IN HANDICAP EMPLOYMENT ISSUES.
VOCATIONAL REHABILITATION STAFF ASSIST COUNTIES WITH CONSULTATION
REGARDING ARCHITECTURAL ACCESS QUESTIONS OR QUESTIONS RELATING TO
MODIFICATION OF EQUIPMENT FOR HANDICAPPED EMPLOYEES, IN MANY CASES,
SUCH AS SANTA CLARA COUNTY, CA, THE STATE VOCATIONAL REHABILITATION
AGENCY PROVIDES FUNDS TO SUPPORT A LOCAL INDEPENDENT LIVING CENTER.
SANTA CLARA COUNTY ALSO PROVIDES FUNDING TO THIS CENTER IN RECOGNITION
OF ITS VALUE TO COUNTY CONSTITUENTS. OTHER COUNTIES UTILIZE VOCATIONAL
REHABILITATION'S PROVISION OF INTERPRETER SERVICES TO HEARING-IMPAIRED
STUDENTS OF COMMUNITY COLLEGES.
NACo IS CONCERNED TO NOTE THAT, ALTHOUGH VOCATIONAL REHABILITATION
PROGRAMS HAVE NOT RECEIVED SIGNIFICANT CUTS IN FUNDING, THE PURCHASING
POWER, DUE TO INFLATION, HAS BEEN REDUCED STEADILY SINCE 1975. THE
NUMBER OF CLIENTS SERVED BY VOCATIONAL REHABILITATION HAS STEADILY
DECREASED SINCE 1979,
AT THE COUNTY LEVEL, THIS DECREASE HAS RESULTED IN A NOTICEABLE
CUTBACK IN SERVICES TO COUNTY CONSTITUENTS. WHILE STILL PROVIDING
DIRECT REFERRAL TO VOCATIONAL REHABILITATION, COUNTY OFFICIALS NOW
CAUTION DISABLED CALLERS THAT THEY MAY NOT RECEIVE THE SERVICES THEY
NEED. OFFICIALS HAVE NOTED THAT VOCATIONAL REHABILITATION CASES ARE
SOMETIMES CLOSED PREMATURELY, LEAVING DISABLED PERSONS NOT READY FOR
306
COMPETITIVE EMPLOYMENT AND WITH NO OTHER ALTERNATIVE FOR ASSISTANCE.
A RECENT INSTANCE OF THIS OCCURRED IN MONTGOMERY COUNTY, MARYLAND WHEN
GRADUATES OF MAINSTREAMED PUBLIC EDUCATION CLASSES WERE DENIED VOCA-
TIONAL TRAINING.
DISABLED PERSONS UNABLE TO RECEIVE VOCATIONAL TRAINING ARE NOT
ABLE TO FIND COMPETITIVE EMPLOYMENT. THE END RESULT IS THAT DISABLED
PERSONS WHO ARE CAPABLE OF SELF-SUFFICIENCY BECOME BURDENS TO ALREADY
OVERTAXED INCOME-SUPPORT PROGRAMS, POTENTIAL TAXPAYERS BECOME
RECIPIENTS OF FEDERAL, STATE AND COUNTY ASSISTANCE.
NACo URGES YOUR SUBCOMMITTEE TO CAREFULLY REVIEW THIS SITUATION
AND TO BEGIN TO PROVIDE APPROPRIATIONS AUTHORITY THAT REFLECTS IN-
CREASES IN THE CPI TO VOCATIONAL REHABILITATION PROGRAMS. THIS ACTION
WOULD ASSURE COUNTIES THAT THE LEVEL OF VOCATIONAL REHABILITATION
SERVICES WILL REMAIN CONSTANT.
307
U.S. DEPARTMENT OF EDUCATION
OFFICE OF SPECIAL EDUCATION
AND REHABILITATIVE SERVICES
REHABILITATION SERVICES ADMINISTRATION
WASHINGTON, D.C. 20202
INFORMATION MEMORANDUM
RSA-IM- 82-29
July 7, 1982
TO
: STATE REHABILITATION AGENCIES (GENERAL)
STATE REHABILITATION AGENCIES (BLIND)
RSA REGIONAL COMMISSIONERS
SUBJECT: Economic Gains for Individuals and Governments Through Vocational
Rehabilitation
The accompanying two reports provide estimates of the economic
gains to individuals and governments attributed to the provision
and successful completion of rehabilitation services in the
State-Federal program.
One report, prepared in April and issued at the time to RSA
staff, presents a series of benefit/cost ratios through Fiscal
Year 1980 which express the long-term benefits to individuals.
A large portion of this report is devoted to an explanation
of the methodology used to derive the national ratios. The
other report, dated July, 1982 summarizes the key findings
from the earlier effort and adds the following: a) a chart
illustrating the trend in the benefit/cost ratios for the
last ten years for which data are available, b) a first-
time statement on the different benefit/cost ratios for
severely and non-severely disabled persons, and c) a text
and table describing the benefits that accrue to Federal, State
and local governments because of the rehabilitation of disabled
individuals.
The projections in these reports are complete for cases closed
through Fiscal Year 1980. They reveal that the State-Federal
program is cost-beneficial whether one considers only the im-
pact on individuals or only the gains to governments. It is
estimated, however, that these gains, both to individuals and
governments, will be somewhat lower when the benchmark data
for Fiscal Year 1981 are available.
Hund
Commissioner of Rehibilitation Services
Attachments
308
ECONOMIC GAINS THROUGH VOCATIONAL REHABILITATION:
PROJECTED BENEFITS FOR INDIVIDUALS AND GOVERNMENTS
Rehabilitation Services Administration
Division of Program Administration
Basic State Grants Branch
July, 1982
309
Economic Gains Through Vocational Rehabilitation
A. Benefits for Individuals
It is estimated that lifetime earnings for persons rehabilitated in Fiscal
Year 1980 through the State-Federal program will improve by $10.4 for
every dollar spent on services for all clients whose cases were closed in
that year. This was the fifth consecutive year for which the projected
benefit/cost ratio has been greater than $10 to $1 but less than $11 to $1.
On the whole, State rehabilitation agencies have been fairly successful in
maintaining the benefit/cost ratios within this narrow range despite
a) rising costs, b) decreasing numbers of persons being rehabilitated and
c) increasing proportions of severely disabled persons for whom remunerative
outcomes are less likely.
The Fiscal Year 1980 projection of $10.4 to $1, however, was $0.5 to $1
less than the projection for the previous year. The main reasons for this
decline were a) a loss in the number of rehabilitations between the two
years of 11,200 and b) a continuing rise in the proportion of severely
disabled persons among those rehabilitated, this time to 51 percent. In
light of an additional loss of 21,300 rehabilitations in Fiscal Year 1981
and a further increase in the proportion of the severely disabled to
54 percent, another decline in the benefit/cost ratio is expected, quite
possibly below $10 to $1, when the latest earnings and cost data become
available.
The calculated benefit/cost ratios for severely and non-severely disabled
persons whose cases were closed in Fiscal Year 1980 show a considerable
difference in the apparent impact of rehabilitation services on the two
groups. For the severely disabled the estimated lifetime improvement in
earnings came to $8.0 for each dollar of cost. For the non-severely disabled,
the ratio, came to $14.6 for each dollar. This difference is brought about
by the greater likelihood of the severely disabled to be rehabilitated with-
out earnings or with low earnings in sheltered workshops.
B. Benefits for Governments
In the first year after case closure, persons rehabilitated in Fiscal Year
1980 are expected to pay to. Federal, State and local governments an estimated
$211,5 million more in income, payroll and sales taxes than they would have
paid had they not been rehabilitated. In addition, another $68.9 million
will be saved as a result of decreased dependency on public support payments
and institutional care. The grand total first year benefit to governments,
therefore, will be $280.4 million. At this rate, the total governmental
benefit will equal the total Federal, State and third-party cost of rehabili-
tation for Fiscal Year 1980 closures in four years. The projected governmental
benefits in subsequent years, however, are expected to decline because of known
and expected losses in rehabilitations and higher proportions of severely
disabled persons who have reduced earnings potential.
Benefit/Cost Ratios, Persons Rehabilitated, and
Proportion of Severely Disabled Persons Rehabilitated, Fiscal Years 1973 - 1981
Dollars
Persons (000)
14
350
12
300
10
250
Benefit/Cost Ratios (see scale at left)
310
Rehabilitations (see scale at right)
8
200
Percent of rehabilitated persons
who are severely disabled
49.9%
51.4%
54.1%
6
40.5%
43.8%
47.0%
150
35.7%
31.6%
4
100
1973
1974
1975
1976
1977
1978
1979
1980
1981
Fiscal Year
311
Estimated First-Year Benefits to Governments Resulting
From Rehabilitations in Fiscal Year 1980
Annualized Projections
Governmental benefits
Before VR
After VR
Difference
(millions of dollars)
1. Social Security payroll
taxes
$18.0
$106.7
$88.7
2. Income taxes: Federal
18.6
105.4
86.8
3. Income taxes: State and
local
2.9
15.5
12.6
4. Sales taxes: State and
local
6.0
29.4
23.4
5. Subtotal: Governmental
revenues (lines 1 to 4)
$45.5
$257.0
$211.5
6. Public assistance
payments
103.3
70.3
33.0
7. Public institutional
costs
86.0
50.1
35.9
8. Subtotal: Governmental outlays
(lines 6 and 7)
$189.3
$120.4
$68.9
9. TOTAL governmental benefits
(lines 5 and 8)
-
-
$280.4
NOTE
1: Governmental revenues are projections annualized from weekly earnings
at referral and at rehabilitation closure as reported on Form RSA-300.
Public assistance payments are projections annualized from monthly
receipts at referral and at rehabilitation closure from the same source
document. Institutional costs have as their base the numbers of persons
residing in institutions at referral as also reported on Form RSA-300.
NOTE
2: Other benefits to government such as savings in Social Security Disability
Insurance benefits are not included.
312
IN-HOUSE BENEFIT/COST RATIOS:
STATE-FEDERAL PROGRAM OF VOCATIONAL REHABILITATION
FISCAL YEARS 1971 TO 1980
Rehabilitation Services Administration
Division of Program Administration
Basic State Grants Branch
April, 1982
313
In-House Benefit/Cost Ratios: State-Federal
Program of Vocational Rehabilitation - Fiscal Years 1971 to 1980
SUMMARY ANALYSIS
The State-Federal Program of Vocational Rehabilitation provides a wide variety of
services to persons with mental and physical disabilities to enable them to find or
sustain employment to the limit of their capacities. The benefits of this program
accrue not only to private individuals, however, but also to Federal, State and local
governments. These benefits can be as obvious and tangible as an increase in earnings
and tax contributions among rehabilitated persons, or as intangible as a heightened
sense of personal worth.
The Rehabilitation Services Administration makes annual estimates of the cost-
beneficial status of the State-Federal Program. Currently, it utilizes a very simple,
straightforward methodology which focuses on only one among many benefits of voca-
tional rehabilitation. 1/ This benefit is the projected increase in lifetime earnings
of rehabilitated persons attributed to their receipt of vocational rehabilitation
services under the State-Federal Program, per dollar of expenditure on all persons
for whom services are terminated. Even this less than comprehensive effort drama-
tically reveals the impressive gains that disabled persons derive from this program,
as the benefit/cost ratios have ranged from 10:1 to nearly 14:1 in the ten years
shown in Table A under one series of assumptions. (A methodological summary is
presented with this. paper.)
One finding derived from Table A is that the projected benefit/cost ratios generally
rise and fall with increases or decreases in the number of persons who are rehabilitated.
It is highly probable, therefore, that when projections based on earnings and cost
data for Fiscal Year 1981 can be made, that the benefit/cost ratio will decline
again, perhaps below 10:1, because the number of rehabilitations fell sharply by
more than seven percent to about 256,000 for that year. Another factor causing a
decline in the benefit/cost ratio would be the rise in the proportion of rehabili-
tated persons who are severely disabled. This group, less likely to achieve an
income-producing outcome, accounted for 54 percent of all rehabilitations in
Fiscal Year 1981 compared to 51 percent a year earlier.
Another way to view Table A and, in particular, the benefit/cost ratios in
column (4) is to note that the ratios have ranged narrowly from 10.1:1 to 10.9:1
in the last five years despite the persistent decline in rehabilitations in each
year but one. This means that State rehabilitation agencies have thus far been
fairly successful in combatting the effects of decreased numbers of clients and
relentlessly increasing costs by obtaining jobs for rehabilitated clients at
wage levels that have risen nearly as much as have costs through the years. For
example, the increase in the projected improvement in lifetime earnings between
Fiscal Year 1976 and Fiscal Year 1980 was 30 percent compared to an increase of
36 percent in projected total costs on all closures, and a loss of nearly nine
percent in persons rehabilitated between the same two years.
It must be noted that no earnings are calculated or assumed in the in-house RSA
methodology for the one individual in seven who is traditionally rehabilitated as
a homemaker. The rehabilitation costs on these individuals, however, are incorporated
into all cost projections. The highly probable future declines in the cost-beneficial
status of the State-Federal Program can be offset, at least in part, by encouraging
State agencies to find wage-paying employment for higher proportions of their clients.
Other economic benefits such as returns to government are calculated elsewhere
and are not included in this report.
314
This should have the salutary effect of not only maximizing
the benefit/cost ratio but also intensifying the employment and wage-finding
efforts of State agencies on behalf of their clients.
Table A - Summary of Benefit/Cost Ratios: State Federal Program
of Vocational Rehabilitation, Fiscal Years 1971 - 1980
Improved
Total costs
Benefit/
Fiscal
Rehabilita-
lifetime
on all
cost ratios
Year
tions
earnings
closures
(2) * (3)
($ billions)
(1)
(2)
(3)
(4)
1980
277,136
$11.535
$1.106
$10.4
1979
288,325
11.567
1.066
10.9
1978
294,396
10.890
1.005
10.8
1977
291,202
9.650
.954
10.1
1976
303,328
8.869
.815
10.9
1975
324,039
9.094
.802
11.3
1974
361,138
9.867
.748
13.2
1973
360,726
8.852
.652
13.6
1972
326,138
7.201
.538
13.4
1971
291,272
5.872
.480
12.2
315
Methodological Summary and Assumptions
Benefit - The only benefit calculated in this projection is improvement in the
earnings of rehabilitated wage-earners. No account was taken of increased work
activity on the part of rehabilitated homemakers and unpaid family workers, nor
were any benefits assumed for clients served but not rehabilitated.
Cost - Costs are estimated for all cases closed, whether rehabilitated, not
rehabilitated, or not accepted for services. They encompass purchased services,
agency administration and counselor salaries as paid for through Federal, State
and other funds. Not included in costs are expenditures for research, counselor
training and a variety of discretionary activities.
Source - RSA-300, the Case Service Report, is the source for data on client earnings
at the time of referral for services and at rehabilitation closure. The same
source provided information on amounts of money spent by State agencies to purchase
services for disabled clients. These are the case service costs. Form RSA-2,
the annual report on expenditures was, through Fiscal Year 1979, the source of
information on the proportion of program expenditures devoted to services for
individuals. This proportion is critical to the estimation of total costs on all
closed cases and had to be estimated for Fiscal Year 1980.
Key assumptions - The most important assumptions, not previously indicated, are these:
1. The increase in the earnings of rehabilitated persons from referral to closure
can be attributed to the provision of rehabilitation services.
2. Earnings at the time of referral for services are indicative of what clients
could have earned without the intervention of vocational rehabilitation.
3. The rehabilitated clients will work for no more than thirty years after closure.
They will drop out of the job market at the rate of six percent per year because of
death, new or recurrent disability, and retirement. At this rate, only 16 percent
will work for the full. thirty years. (The mean age at referral of persons reha-
bilitated in Fiscal Year 1980 was 32.6, with as many as three persons in eight
under 25 years of age.)
4. Those who remain employed will improve their productivity by a rate of three
percent per year.
5. The stream of projected future earnings is to be discounted at the rate of ten
percent a year to reflect the preference for having a stated amount now rather
than in the future. Discounting is needed to avoid inflating the long-term
benefits derived from rehabilitation services. For example, a salary of $20,000
this year cannot be thought of as equivalent to the same salary ten years from
now. Under a discount rate of ten percent per year, the $20,000 salary ten years
in the future has a present value of only $7,700. If a higher discount rate is
used the resulting benefit/cost ratios will be reduced.
Finally, the decrease in employment of six percent per year, the increase in productivity
of three percent per year and the discount rate of ten percent per year, when combined
into a single rate, produced a discounting function of twelve percent per year. Thus,
the first year's projected improvement in earnings was discounted by twelve percent
a year up to thirty years, the assumed "working lifetime". (Had a discounting function
of 16 percent per year been used, the resulting benefit/cost ratio would have been
8:0:1 instead of 10.4:1.)
316
Table 1 -- Mean weekly earnings of rehabilitated clients at referral
and closure projected to annual rates, Fiscal Years 1971
to 1980
Mean weekly earnings 1/
Annual aggregate earnings 2/
Fiscal Year
Rehabili-
At Referral
At Closure
At Referral
At Closure
Difference 3/
tations
(millions of dollars)
1980
277,136
$22.20
$125.60
$308
1,740
1,432
1979
288,325
19.15
118.74
276
1,712
1,436
1978
294,396
17.27
109.11
254
1,606
1,352
1977
291,202
15.91
98.17
2321
1,429
1,198
1976
303,328
16.23
88.84
246
1,347
1,101
1975
324,039
15.81
85.47
256
1,385
1,129
1974
361,138
14.36
82.21
259
1,484
1,225
1973
360,726
14.26
76.17
257
1,356
1,099
1972
326,138
15.12
69.96
247
1,141
894
1971
291,272
14.44
64.49
210
939
729
Encompasses all rehabilitated clients, even those with zero earnings.
Weekly earnings were annualized by multiplying by 50 and then by the total
number of rehabilitations.
3/ This is a measure of earnings improvement in the first year after rehabilitation
assumed attributable to the vocational rehabilitation process.
317
Table 2 -- Computation of costs used in projecting benefit/cost ratios
relative to clients whose case were closed out in Fiscal Years
1971 to 1980
COST: From Form RSA-300
Adjusted case
Case service $ for
service cost on
rehabs as prop. of
all closures 2/
Total
Mean case
case service $ on
($ million)
Fiscal Year
rehabilitations
service cost1/
all closures
(1 X 2) : (3)
(1)
(2)
(3)
(4)
1980
277,136
$1,446
.697
$574.9
1979
288,325
1,361
.708
554.2
1978
294,396
1,276
.705
532.8
1977
291,202
1,215
.703
505.4
1976
303,328
1,066
.721
448.4
1975
324,039
1,003
.737
441.0
1974
361,138
869
.791
396.5
1973
360,726
821
.797
371.6
1972
326,138
771
.793
317.1
1971
291,272
742
.789
273.9
(See footnotes on next page)
22-065 0 - 84 - 21
318
COST: From Form RSA-2 ($ million)
Case service
Adjusted total
Total
costs as pro-
cost on
Total program
case service
portion of total
closures 5/
Fiscal Year
costs
costs 3/
(6) ÷ (5)
(4) : (7)
(5)
(6)
(7)
(8)
1980
$1,202.3
NA
.52 est.
$1,105.5
1979
1,238.2
$644.7
.52
1,065.8
1978
1,152.5
611.3
.53
1,005.3
1977
1,093.4
583.4
.53
953.6
815.3
1976
1,046.4
571.3
.55
1975
997.6
552.4
.55
801.8
1974
877.5
464.6
.53
748.1
1973
772.6
437.6
.57
651.9
1972
727.2
426.5
.59
537.5
1971
655.8
376.5
.57
480.5
For rehabilitated clients on whom State agencies incurred case service expense.
2. Assumes that non-State agency sources incurred costs at the same rate as State
agencies for cases where services were provided without cost to State agencies.
3/ Includes annual Basic Support, Trust Funds, SSI Funds and I & E expenditures.
4/ Includes annual cost of services for individual and the business enterprise program.
5/ This is the estimated grand total cost on_all cases closed out each year. Cost
encompasses services for individuals, program administration, counselor salaries, etc.
as incurred by Federal and State governments and third parties, including clients
themselves.
This is an estimate of expenditures based on grants to States.
NA-Not available. Expenditure data for Fiscal Year 1980 not collected.
319
Table 3 1-- - Present value of improved earnings projected for five to thirty
years for clients rehabilitated in Fiscal Years 1971 to 1980
and discounted at twelve percent a year (billions of dollars)
Improvement in earnings discounted at 12% per year
Years after rehabilitation closure
Fiscal Year
5
10
15
20
25
30
of closure
1980
$5.162
$8.091
$9.753
$10.696
$11.231
$11.535
1979
5.177
8.113
9.781
10.725
11.263
11.567
1978
4.874
7.639
9.208
10.098
10.604
10.890
1977
4.319
6.769
8.160
8.948
9.396
9.650
1976
3.969
6.221
7.499
8.223
8.635
8.869
1975
4.070
6.379
7.690
8.433
8.855
9.094
1974
4.416
6.921
8.343
9.150
9.608
9.867
1973
3.962
6.209
7.485
8.208
8.619
8.852
1972
3.223
5.051
6.089
6.677
7.012
7.201
1971
2.628
4.119
4.965
5.445
5.718
5.872
NOTE: The values in the table were derived by multiplying the single-year earnings
improvement (Table 1, last column) by the following factors:
For the five-year period, 3.605;
For the ten-year period, 5.650;
For the fifteen-year period, 6.811;
For the twenty-year period, 7.469;
For the twenty-five-year period, 7.843;
For the thirty-year period, 8.055.
These factors are the present value of one dollar a year, i.e. an, annuity of one
dollar discounted at 12 percent per year for the stated number of years.
320
Table 4 - Benefit/cost ratios: Present value of improved earnings projected
for five to thirty years, and discounted at twelve percent per
year for clients rehabilitated in Fiscal Years 1971 to 1980 per
dollar of cost for every case closed out in Fiscal Years 1971 to
1980
Improvement in earnings per dollar of cost
Years after rehabilitation closure
Fiscal. Year
of closure
5
10
15
20
25
30
1980
$4.7
$7.3
$8.8
$9.7
$10.2
$10.4
1979
4.9
7.6
9.2
10.1
10.6
10.9
1978
4.8
7.6
9.2
10.0
10.5
10.8
1977
4.5
7.1
8.6
9.4
9.9
10.1
1976
4.9
7.6
9.2
10.1
10.6
10.9
1975
5.1
8.0
9.6
10.5
11.0
11.3
1974
5.9
9.3
11.2
12.2
12.8
13.2
1973
6.1
9.5
11.5
12.6
13.2
13.6
1972
6.0
9.4
11.3
12.4
13.0
13.4
1971
5.5
8.6
10.3
11.3
11.9
12.2
321
CHARACTERISTICS OF PERSONS REHABILITATED IN FISCAL YEAR 1980
State-Federal Program of Vocational Rehabilitation
Rehabilitation Services Administration
Office of Program Operations
Division of Program Administration
Basic State Grants Branch
322
Characteristics of Persons Rehabilitated in Fiscal Year 1980
Introduction
The State-Federal Program of Vocational Rehabilitation is the major national
program dedicated to serving disabled individuals to enable them to participate,
as fully as possible, in the workforce. The program has played a significant
role in its 60-year history in restoring millions of persons to more productive
lives. The program has undergone many changes over the years, usually to encompass
groups of disabled individuals previously unserved, and to provide better and more
comprehensive services to eligible handicapped individuals. As a result of the
Rehabilitation Act of 1973 and its amendments, a number of new initiatives were
started, most particularly in providing services to those who are the most
severely disabled. This latter thrust has had to take place in the face of
ever-diminishing resources brought about by inflationary trends in the economy,
and the greater cost entailed in serving the severely disabled.
The report provides, in broad terms, insights into who the disabled clientele
are in the State-Federal Program, and what happens to them through the receipt
of rehabilitation services. The focus is on clients successfully rehabilitated
in Fiscal Year 1980 with trends for the two prior years SO that inferences are
possible about the directions in which the program is heading. One key finding,
for example, is that the caseload of rehabilitated persons is increasingly being
made up of older persons. This trend explains other changes. Fewer persons are
being referred by educational institutions, fewer are mentally retarded, more are
orthopedically impaired, and fewer have earnings at closure. These and other
trends are seen in Section A of the report.
Not all clients, of course, can be vocationally rehabilitated and this report
features a measure showing which characteristics of the clients and the service
delivery system lend themselves to a greater likelihood of rehabilitation success.
This measure is called "rehabilitation rate" and is derived by dividing the number
of rehabilitationsby the sum of successful (rehabilitated) and unsuccessful
(not rehabilitated) closures. The rehabilitation rates add analytical depth to
the understanding of characteristics and are found in Section B of the report.
The source for the information in this report is the Case Service Report
(RSA-300) submitted annually by State rehabilitation agencies. Data will be
tabulated for Fiscal Year 1981 as well from the same source. Thereafter, the
status of continued reporting on client characteristics is uncertain.
323
Characteristics of Persons Rehabilitated in Fiscal Year 1980
Summary Observations
Age
The mean age at referral for persons rehabilitated in Fiscal Year 1980 was 33.3
years. In the last few years, the mean age has edged upward with decreasing numbers
and proportions of persons under 25 years of age showing up among rehabilitated
clients. Despite a loss of more than 11,000 rehabilitations in Fiscal Year 1980
from the year before, increases in the absolute number of persons 55 years old
and over at referral occurred. Persons 45 years old or over at referral were
likelier than younger clients to be rehabilitated. Indeed, the older the
individual, the likelier that a rehabilitation success was achieved. The highest
rehabilitation rate was 87.4 percent for those 65 years of age and over at
referral. The greater rate of successful rehabilitations of older persons may
reflect both a stricter selection for eligibility and the readier acceptance and
use of homemaking as a suitable closure status.
Sex
While men continued to comprise the majority of rehabilitations, 51.9 percent in
Fiscal Year 1980, the proportion of women rehabilitated continues to grow, 48.1
percent in Fiscal Year 1980 versus 45.8 percent in 1978. Also, women continue
to have a higher rate of rehabilitation (68.9 percent versus 60.7 percent). This
higher rate reflects the greater likelihood of women being rehabilitated as
homemakers.
Race/ethnicity
Racial minorities (Blacks, Asiatics, American Indians) represented a little over
one-fifth of the rehabilitations in Fiscal Year 1980 (as well as in the two
prior years). Hispanic persons, as an ethnic minority, represented 5.9 percent
of the rehabilitations. The rehabilitation rates by race ranged between 56.2
percent for Indians to 65.8 percent for the white majority of rehabilitated
clients. The rate for persons of Hispanic origin was 63.2 percent.
Highest grade completed
Forty-eight percent of persons rehabilitated in Fiscal Year 1980 had at least
completed high school at the time of referral. This compares to 45 percent
among persons rehabilitated two years earlier. This same group was likelier to
be rehabilitated than persons who started but did not complete high school.
Interestingly, however, the highest rehabilitation rates were noted for persons
who did not complete elementary school. These persons were generally older
individuals whose rehabilitation rates were, as previously observed, quite high.
324
Dependents
More than three-fifths (62.5 percent) of the clients rehabilitated in Fiscal
Year 1980 had no dependents at all when referred to VR. While no large differences
in the rehabilitation rates were seen, the likelihood of success was at its lowest
when there were five or more dependents.
Family size
Well over one-fourth (29.1 percent) of the rehabilitated clients lived alone or,
possibly, in an unrelated household when referred to VR. This proportion has
been rising steadily in recent years. The rehabilitation rate for people who
live alone (59.7) was the lowest for any family size grouping. Absence of family
support appears to work against rehabilitation success.
Family income
The median monthly income for families of rehabilitated clients, when referred
to VR, was estimated at only $349. Only 27 percent of the families had incomes
of $600 a month or more. Rehabilitation rates increased progressively with
income level, beginning at 58.6 percent for those whose families had incomes
under $150 a month, levelling off at about 70 percent for the $500 category
and above. Lower incomes clearly are related to diminished rehabilitation
success.
Marital status
Among persons rehabilitated in Fiscal Year 1980, 43.1 percent had never married,
32.0 percent were married, 5.0 percent were widowed, and 20.0 percent were
divorced or separated. Widowed and married clients were the most likely to
be rehabilitated, with rates of 77.2 and 69.4 percent, respectively. This
finding is age-related since older clients who are likelier to be either
widowed or married typically have higher rehabilitation rates.
Primary source of support
"Family and friends" was the most common primary source of support at referral
(45.6 percent of the rehabilitated clients), followed by current earnings
(19.3 percent), and public assistance (13.9 percent). Persons who were
primarily dependent on public sources of income for support were less likely to
be rehabilitated. For example, the rehabilitation rates were 53.8 percent for those
primarily supported by public assistance, 48.9 percent for persons in public
institutions, and 52.1 percent for those whose SSDI payment was the largest single
support source. This compares to 80.4 percent for clients primarily supported by
current earnings and 66.7 percent for those supported mostly by family and friends.
Dependence on public sources may work as a disincentive to accept employment,
because employment can result in the withdrawal or reduction of public support.
325
Type of institution at referral
Among persons rehabilitated in Fiscal Year 1980, 10.0 percent were residing in a
public or private institution when referred to VR. The comparable percentage two
years earlier was 11.3 percent. Such clients were rehabilitated at the low rate
of 53.7 percent in Fiscal Year 1980, compared to 65.8 percent for clients not
residing in an institution at referral. Among types of institutions, there was
a wide difference in rehabilitation rates, from only 33 percent for persons in
correctional institutions for children to 66 percent for those coming from general
hospitals.
Source of referral
Approximately one-fifth (20.2 percent) of the rehabilitated clients had sought VR
services on their own. This is typically the single most common referral source
of all and the proportion has been rising steadily in recent years. This could
indicate a greater awareness of the availability of rehabilitation services on
the part of disabled individuals. One grouping of referral sources with large
relative declines among rehabilitated clientele were educational institutions,
down from 14.6 percent in Fiscal Year 1978 to 13.3 percent in Fiscal Year 1980.
This is an outgrowth of the increasing age of State agency clients. Case
outcomes varied considerably by source of referral, with the sharpest contrast
existing between public and private sources. The cases most, likely to be rehabili-
tated were those referred by private sources such as artificial appliance
companies (92.9 percent), physicians (75.2 percent) and individuals other than
the clients themselves (69.9 percent). The least likely to be rehabilitated
had been referred by mental hospitals - these are usually public - (46.8 percent),
correctional institutions (50.4 percent), and Social Security Administration
(52.1 percent). Perhaps, clients referred to VR on a voluntary basis have more
incentive to pursue rehabilitation than those who are referred to VR to satisfy
legislative or administrative requirements. This greater incentive may be
related to a lessened eligibility for public support payments.
Major disabling condition/Cause of disability
Orthopedic impairments were the most common disability grouping, accounting for
21.7 percent of the cases closed rehabilitated in Fiscal Year 1980, followed
by mental illness (19.4 percent), and mental retardation (11.7 percent). The
distribution of disabilities among VR clients reflects the continuing change
in emphasis from less to more severely disabled persons as mandated by the
Rehabilitation Act of 1973. Rehabilitations among groups of clients thought
of as usually, if not always, severely disabled are rising proportionately and,
sometimes, absolutely. These include the orthopedically impaired, the deaf and
those with psychotic disorders. Also, cases of spinal cord injuries have increased
dramatically from 932 rehabilitations in Fiscal Year 1973, when first reported,
to 4,522 in Fiscal Year 1980.
There are exceptions to this trend, however. Rehabilitations of blind and
severely mentally retarded persons have declined in number in the last two years
although their proportions of the total have held fast. A reverse phenomenon,
326
i.e. absolute and relative declines is occurring among groups of clients generally
unlikely to be severely disabled. This includes those with character, personality
and behavior disorders; genitourinary system disorders; hay fever/asthma;
digestive system disorders; and non-blind visual impairments. Yet, even this
trend has an exception in the non-deaf hearing impaired who have increased in
number both absolutely and proportionately in the last two years.
Rehabilitation rates, by type of disability, often do not conform to the conventional
understanding of severity of disability. For example, above average rates occurred
among severely disabled groups such as the blind, the deaf, those with missing
limbs, and the severely mentally retarded. Similarly, below average rehabilitation
rates were noted among persons with character, personality and behavior disorders;
and the mildly mentally retarded. At best, therefore, the rehabilitation rate is
a crude measure of severity. Other factors besides type and severity of disability,
such as age, motivation, work experience, family support and educational background
play an important role in determining eventual rehabilitation success.
Severity of disability
The proportion of severely disabled persons among the rehabilitated continued to
increase, reaching an all-time high of 51.4 percent in Fiscal Year 1980. As
expected, despite the exceptions noted above, severely disabled persons were less
likely to be rehabilitated than the non-severely disabled (60.9 percent versus
68.7 percent).
Public assistance status at referral and closure
Almost seventeen percent of the clients rehabilitated in Fiscal Year 1980
were on public assistance at the time of referral, receiving approximately
$8.6 million per month, as a group. By the time of closure, 10.6 percent were
on public assistance, receiving an aggregate of $5.9 million per month. The
net reduction in monthly assistance payments has been declining in recent years.
The net reduction of $2.7 million for persons rehabilitated in Fiscal Year 1980
compares to $3.5 million for those rehabilitated two years earlier. Public
assistance clients, especially those in receipt of payment at closure, were
less likely to be rehabilitated than non-recipients.
Veteran status
Of clients rehabilitated in Fiscal Year 1980, 4.1 percent were veterans. Their
rehabilitation rate was 58.5 percent compared to the overall rate of 64.5 percent
in Fiscal Year 1980.
SSDI applicants
Those who were applicants for Social Security Disability Insurance benefits (SSDI)
at closure comprised 14.7 percent of the rehabilitated clientele in Fiscal Year 1980,
over one-half of whom who had been allowed benefits. The rehabilitation rates for
both SSDI applicants and beneficiaries were only 53.7 and 51.6 percent,
respectively, compared to 67.0 percent for non-SSDI applicants. Most applicants
and all beneficiaries are severely disabled and favorable outcomes are less likely.
327
SSI applicants
Among clients rehabilitated in Fiscal Year 1980, 13.4 percent were applicants
for Supplemental Security Income payments (SSI) at the time of closure, the
majority of whom had been allowed benefits. Both SSI applicants and recipients
were less likely to be rehabilitated than were non-applicants among active
case closures (53.9 percent and 52.5 percent, respectively, versus 66.7 percent
among non-SSI applicants). Here, too, most applicants and all recipients were
severely disabled and rehabilitation success is less assured.
Interestingly, among both SSDI applicants and SSI applicants, the lowest rehabili-
tation rates were noted for those whose eligibility had not yet been determined
(status pending). Conversely, the highest rates among applicants were for those
whose benefits had been terminated. This suggests that the hope of a public
support payment militates against rehabilitation success, while the loss of such
support acts as a spur to a favorable outcome.
Trust Funds cases/SSI funded cases
Cases meeting the special selection criteria permitting the use of Trust Funds
for VR services comprised 5.1 percent of the rehabilitations in Fiscal Year 1980,
while those meeting such criteria permitting the use of SSI monies for VR services
accounted for 3.7 percent. Both groups were much less likely to be rehabilitated
than the non-funded cases.
Ever referred by Social Security
One rehabilitated person in eight (12.4 percent) had been referred by the Social
Security Administration at some time during the rehabilitation process. Those so
referred had a rehabilitation rate of only 57.2 percent compared to 65.6 percent
for non-SSA referrals
Social Security Cases-Summary
The lower rehabilitation rates for Social Security cases, whether applicants,
beneficiaries, "special selection criteria" cases or referrals from Social
Security are probably indicative of the greater severity of their disabilities
compared to non-Social Security cases. The expectation or availability of Social
Security payments could readily act as a disincentive to rehabilitation success.
Nevertheless, Social Security cases have generally accounted for increasing
proportions of rehabilitated cases in recent years.
Time spent in the VR process
Clients rehabilitated in Fiscal Year 1980 spent, on the average, 3.6 months in the
referral and applicant statuses, and another 19.7 months from acceptance to
closure. The overall mean months spent in VR was about 23 months. The number
and proportion of clients spending more than two years in VR has declined
somewhat in recent years. The highest rehabilitation rates are associated with
persons spending four to twelve months in rehabilitation and, most particularly,
four to six months where the rehabilitation rate was 74.1 percent. Clients re-
maining in the active statuses for a year and a half or more had only about a
60.0 percent chance of being rehabilitated.
328
Previous rehabilitation experience
Of clients rehabilitated in Fiscal Year 1980, 6.0 percent had been previously
rehabilitated and 4.4 percent previously closed not rehabilitated. The rehabili-
tation rate for persons previously rehabilitated was high, 75.7 percent, while
that for persons previously not rehabilitated was low, 51.1 percent.
Types of services provided
A wide range of services is available to disabled persons with potential for
gainful employment. Major services provided through the State-Federal rehabili-
tation program include a variety of training and medical restoration services.
If needed, maintenance payments to clients undergoing rehabilitation are provided.
Required equipment and occupational licenses are purchased and arrangements for
transportation to work are made. Diagnosis and evaluation as well as guidance,
counseling and job placement are provided without charge.
Apart from diagnosis and evaluation which virtually every client receives,
training was the service most often provided to clients (51.3 percent) followed
by physical and mental restorative services (43.2 percent). Within the different
types of training, personal and vocational adjustment was the most common
(20.6 percent), with college and vocational training next at 12.8 percent and
12.7 percent, respectively. Maintenance was provided to 21.1 percent of the
rehabilitated clients. About one-third (35.6 percent) received "other" services
which include transportation, business equipment, occupational licenses, and reader
and interpreter services. Persons rehabilitated in Fiscal Year 1980 were a little
less likely to have received training and a little more likely to have been
provided with a medical service than persons rehabilitated one year earlier. This
finding, also, is probably related to age since the older client, becoming more
numerous in agency caseloads, is likelier to receive medical services and
less likely to get training.
Rehabilitation rates varied by type of service. Training was associated with a
lower rehabilitation rate (66.8 percent) than were physical and mental restorative
services (77.8 percent). However, the highest rehabilitation rate of all was
reported for on-the-job training (78.2 percent). It may be assumed that this
type of training arranged in concert with private industry, best helps to develop
the productive potential of the disabled individual and increases the chances for
favorable rehabilitation outcomes. It is, therefore, unclear why only 5.8 percent
of persons rehabilitated in Fiscal Year 1980 had received this service compared
to 6.0 percent of persons rehabilitated in, Fiscal Year 1979 and 6.9 percent in
Fiscal Year 1978. In absolute terms, the loss has been over 4,000 persons
between Fiscal Year 1978 and Fiscal Year 1980.
Cost of purchased services
The average case service cost per case rehabilitated in Fiscal Year 1980 was
$1,343. This represents a 13 percent increase from the average case service
cost of $1,187 in Fiscal Year 1978. Increasing proportions of cases are costing
$2,000 or more each year, reaching 20.4 percent of all persons rehabilitated
in Fiscal Year 1980. The likelihood of being rehabilitated rose consistently.
329
with increasing case service cost, from 50. percent for those served at no
cost to the State agency, to 77.7 percent for cases served at a cost of $3,000
and over. Lower amounts of money are spent on persons who are not rehabilitated
because services to them are not completed and, sometimes, not even started.
Work status at referral and closure
The economic situation for rehabilitated persons typically improves dramatically
from referral to closure. For clients rehabilitated in Fiscal Year 1980, for example,
only 18.5 were salaried or self-employed at referral compared to 84.1 percent at
closure. Since Fiscal Year 1978, however, the rehabilitated client has been
increasingly likely to be employed in the competitive labor market at referral, but
less likely to be so employed at closure. In the same span of time, sheltered
workshop placements have increased both absolutely and proportionately, while a
fairly sharp incline in homemakers occurred in Fiscal Year 1980 compared to Fiscal
Year 1979 (a gain of 1,000 homemakers while rehabilitations overall declined by 11,000).
These trends may be attributed to the continuing increase of severely disabled
persons among those rehabilitated who are less likely to be competitively employed.
Whether a client was gainfully occupied at referral made a marked difference in
the rehabilitation outcome. Persons who were competitively or self-employed had
rehabilitation rates of nearly 82 percent while those who began the rehabilitation
process as homemakers stood an 84 percent chance of being rehabilitated. Persons
least likely to be rehabilitated were those with no identifiable activity at referral,
the "not working-other" category, for whom the rehabilitation rate was only 58 percent.
Occupation at closure
The wide range of occupations into which clients are placed upon completion of
the rehabilitation process reflects their different backgrounds in educational
attainment, work history, job skills and type and severity of disability which
they bring to the program. Trends in the distribution of rehabilitated clients by
occupation for the three years in this report are mixed. For example, the proportion
of closures into professional and related fields declined slightly in Fiscal
Year 1979 from Fiscal Year 1978, but increased to 13.3 percent in Fiscal Year 1980.
Similarly, homemakers continued a four-year decline in their proportion in Fiscal
Year 1979 reaching 14.1 percent that year, but rose fairly sharply to 15.1 percent
in Fiscal Year 1980. Other trends, however, were steadier. Clerical placements
have increased both proportionately and absolutely in the last two years while
jobs in industry have decreased in both measures, in the same time span.
Weekly earnings at referral and closure
The mean earnings of clients rehabilitated in 1980 was $126 per week at the
time of closure including those with zero earnings (i.e. homemakers and unpaid
family workers). At referral, the same group was averaging only $22 a week.
Increasing proportions of rehabilitated clients are earning $150 per week or more
(from 26 percent in Fiscal Year 1978 to 36 percent in Fiscal Year 1980), but much
of this gain may be attributed to inflationary trends.
330
The mean weekly earnings at closure for persons rehabilitated in Fiscal Year 1980,
exclusive of homemakers and unpaid family workers, was $149 or 6.9 percent more
than Fiscal Year 1979's rehabilitated wage-earners earned at closure. In turn,
the $139 earned at closure by wage-earners in Fiscal Year 1979 was 8.7 percent
more than the comparable mean earnings for persons rehabilitated in Fiscal Year 1978.
These two percentage increases, 6.9 percent and 8.7 percent, did not keep pace
with the increase in the Consumer Price Indices between Calendar Years 1979 and
1980 and Calendar Years 1978 and 1979 of 13.5 percent and 11.3 percent, respectively.
A partial explanation would be the increase in placements into sheltered employment
which is typically paid at low wage rates.
331
Caseload Trends Through Fiscal Year 1982
INTRODUCTION
Fiscal Year 1982 was a year in which the number of persons in State agency
caseloads, as measured in a variety of ways, continued to decrease and, in
most instances, decrease sharply. Compared to Fiscal Year 1981, fewer persons
applied for services, fewer were accepted for services, fewer were rehabilitated
and served, and fewer were still in receipt of services as Fiscal Year 1982
ended. Even cases of severely disabled persons were not spared from the over-
all decline, although their losses were not as steep as those for the non-
severely disabled population. The severely disabled continued to account for
increasing proportions of clients in State agency caseloads. In terms of
total caseload volumes, the State-Federal program is no larger than it was
about 12 to 14 years ago. For caseloads of severely disabled persons,
volumes in Fiscal Year 1982 resembled those five years earlier.
REHABILITATIONS
In Fiscal Year 1982, 226,924 disabled persons were vocationally rehabilitated
in the State-Federal program. This result represented (a) a decline of
11.3 percent from the 255,881 rehabilitations attained in Fiscal Year 1981,
(b) the fewest successful closures in 14 years, and (c) the seventh decline
in the last eight years following the peak performance of 361,138 rehabilitations
in Fiscal Year 1974.
Rehabilitations of severely disabled persons in Fiscal Year 1982 numbered
129,866. This accomplishment represented (a) a loss of 6.2 percent from the
138,380 rehabilitations effected in Fiscal Year 1981, (b) the fewest such
successes in five years, and (c) the third year in a row of a decline in this
key target group of disabled persons after a high of 143,375 rehabilitations
was reached in Fiscal Year 1979. The percentage of all persons rehabilitated
in Fiscal Year 1982 who were severely disabled rose to 57.2 percent, the highest
ever recorded.
PERSONS SERVED
In Fiscal Year 1982, there were 958,537 persons who received vocational
rehabilitation services. This finding represented (a) a decline of 7.7 percent
from the 1,038,232 persons served in Fiscal Year 1981, (b) the smallest such
number recorded. in the last 12 years, (c) the first time in 12 years that the
number served fell below one million persons, and (d) the seventh decline in
as many years since the high point of 1,244,338 persons served was reached
in Fiscal Year 1975.
The number of severely disabled persons served totalled 571,542 in Fiscal
Year 1982. This was (a) 4.9 percent below the total of 600,727 for the prior
fiscal year, (b) the fewest served in five years and (c) the third consecutive
decline in as many years after a high of 611,994 was established in Fiscal
Year 1979. Of all persons served in Fiscal Year 1982, 59.6 percent were severely
disabled, the highest such proportion recorded.
332
NEW APPLICATIONS FOR SERVICES
The number of persons newly applying for rehabilitation services was 564,443
in Fiscal Year 1982. This was (a) a loss of 11.6 percent from the 638,542
new applicants the year. before, (b) the fewest number of new applicants in
14 years and (c) the sixth decline in the last seven years after the all-time
high of 885, 737 was experienced in Fiscal Year 1975.
ACCEPTANCES FOR SERVICES
The number of persons accepted for vocational rehabilitation services in
Fiscal Year 1982 was 333,439. This was (a) a loss of 10.5 percent from the
373,310 newly accpeted clients in the prior year, (b) the fewest number accepted
into the program since Fiscal Year 1968, and (c) the sixth time in the last
seven years of a decreasing trend after a high of 534,491 acceptances occurred
in Fiscal Year 1975.
Severely disabled persons among those newly accepted for services totalled
200,601 in Fiscal Year 1982. This was (a) a loss of 10.6 percent from the
224,309 acceptances in the previous year, (b) the fewest number of new active
cases recorded in the seven years for which data are available and (c) the
third consecutive decrease after a high of 226,287. acceptances occurred in
Fiscal Year 1979. The proportion of new active cases that were of severely
disabled persons remained at 60.1 percent for the second year in a row
APPLICANTS STILL IN PROCESS
The number of applicants whose eligibility for services was still being evaluated
as of September 30, 1982 was 232,245. This represented (a) a decrease of
9.8 percent from the 257,610 persons in evaluation on the same date one year
earlier, (b) the fewest number of end-of-year applicants in 13 years, and
(c) the fifth decline in the last seven years after the highest backlog of
applicants of 357,653 was attained at the end of Fiscal Year 1975.
CLIENTS STILL RECEIVING REHABILITATION SERVICES
The number of persons still in receipt of rehabilitation services on September 30,
1982 was 589,038. This represented (a) a loss of 5.7 percent from the 624,669
persons receiving services on September 30, 1981, (b) the fewest number of
end-of-year cases in 12 years and (c) the seventh consecutive decline since the
highest backlog of 778,448 persons still receiving services was reached at the
end of Fiscal Year 1975.
The number of severely disabled persons still receiving services on September 30,
1982 was 351,109. This was (a) a decrease of 4.3 percent from the 366,885
severely disabled persons in receipt of services on the same date one year
earlier, (b) the fewest number of end-of-year cases in six years and (c) the third
reduction tn a row since the highest backlog of 381,078 cases of severely disabled
persons occurred at the end of Fiscal Year 1979.
333
CAUSES OF CASELOAD DECLINES
The declines in caseload volumes in recent years are attributed to
(a) decreases in the purchasing power of the rehabilitation dollar
including the near total loss of funding from Social Security monies
in Fiscal Year 1982 and (b) continued emphasis in providing services
to the severely disabled for whom rehabilitation efforts are more
costly. It is estimated that the purchasing power of funds available to
State rehabilitation agencies declined by 31.0 percent in the relatively
short perfod from 1979 to 1982. In dollar terms, the loss was
approximately $384 million. (In actual as opposed to constant dollars,
the loss was only $103 million, or 8.3 percent.) Of the $384 million
decrease in purchasing power between 1979 and 1982, $209 million is
attributed to the impact of inflation on Federal and State monies
expended under Basic Support, and $175 million to the cutoff of funding
from Social Security and a small Innovation and Expansion grant program.
It was subsequent to Fiscal Year 1979 that numbers of severely disabled
persons accepted into, rehabilitated by, and served by the rehabilitation-
program began to decline.
22-065 0 - 84 - 22
Table 1
Selected Caseload Volumes: Fiscal Year 1982
VS. Fiscal Year 1981 and All-Time High
All Time High
Caseload
Fiscal Year
Percent
Percent
Measure
change:
Fiscal
change: 82
1982
1981
82 vs. 81
Year
Number
vs. high
Total applicants
821,332
934,209
-12.1%
1975
1,204,262
-31.8%
New applicants
564,443
638,542
-11.6
1975
885,737
-36.3
Applicants on hand,
end of year
232,245
257,610
-9.8
1975
357,653
-35.1
Total active cases served
958,537
1,038,232
- 7.7
1975
1,244,338
-23.0
New active cases
333,439
373,310
-10.7
1975
534,491
-37.5
Rehabilitations
226,924
255,881
-11.3
1974
361,138
-37.2
334
Non-rehabilitations
142,575
157,682
- 9.6
1976
179,139
-20.4
Active cases on hand,
end of year
589,038
624,669
- 5.7
1975
778,448
-24.3
Severe active cases served
571,542
600,727
- 4.9
1979
611,994
- 6.6
New severe active cases
200,601
224,309
-10.6
1979
226,287
-11.4
Severe rehabilitations
129,866
138,380
- 6.2
1979
143,375
- 9.4
Severe non-rehabilitations
90,567
95,462
- 5.1
1981
95,462
- 5.1
Severe active cases on hand,
end of year
351,109
366,885
- 4.3
1979
381,078
- 7.9
335
FIGURE 1
NUMBER OF PERSONS REHABILITATED AND NOT
REHABILITATED, AND REHABILITATION RATES,
FY 1972 - FY 1982
Number (000)
350
REHABILITATIONS
FY 1982 - 226,924
FY 1981 - 255,881
300
250
REHABILITATION RATES
FY 1982 - 142,575
FY 1981 - 157,682
200
75.0
74.1
73.4
69.6
64,8
62.9
64.5
150
64.0
64.9
61.9
\61.4
/ NON-REHABILITATIONS
100
50
0
1972
1974
1976
1978
1980
1982
Fiscal Year
336
FIGURE 2
SEVERELY AND NON-SEVERELY DISABLED PERSONS
REHABILITATED, FY 1974 - FY 1982
Number (000)
250
NON-SEVERE
FY 1982 - 97,058
FY 1981 - 117,501
200
150
SEVERE FY 1982 - 129,866
57.2
54.1
FY 1981 - 138 380
51.4
49.7
47.0
43.8
100
40.5
35.7
31.6
50
SEVERE AS PERCENT OF, ALL RÉHABILITATIONS
0
1974
1975
1976
1977
1978
1979
1980
1981
1982
Fiscal Year
337
FIGURE 3
SEVERELY AND NON-SEVERELY DISABLED PERSONS:
ACTIVE CASES SERVED, FY 1976 - FY 1982
Number (000)
700
NON-SEVERE
FY 1982 - 386,995
FY 1981 - 437,505
600
SEVERE
FY 1982 - 571,542
FY 1981 - 600,727
500
400
300
59.6
57.9
55.3
54.3
51.4
47.2
44.8
200
SEVERE AS PERCENT OF ALL CASES SERVED
100
0
1976
1977
1978
1979
1980
1981
1982
Fiscal Year
338
FIGURE 4
NEW APPLICANTS AND NEW ACTIVE CASES
DURING FY 1972 - FY 1982
Number (000)
1,200
1,000
800
NEW APPLICANTS
FY 1982 - 564,443
YY 1981 - 638,542
600
400
NEW ACTIVE CASES
FY 1982 1. 333,439
FY 1981 - 373,310
200
0
1972
1974
1976
1978
1980
1982
Fiscal Year
339
FIGURE 5
NUMBER OF APPLICANTS ACCEPTED AND NOT ACCEPTED
FOR VOCATIONAL REHABILITATION SERVICES,
AND ACCEPTANCE RATES, FY 1972 - FY 1982
Number (000)
600
ACCEPTED
FY 1982 - 333,439
FY 1981 - 373,310
500
400
NOT ACCEPTED
FY 1982 260,518
FY 1981 - 308,173
300
ACCEPTANCE RATES
200
63.1 64.5
65.1
63.8
57.5
57.5
57.8
57.5.
56.1
58.2
54.8
100
0
1972
1974
1976
1978
1980
1982
Fiscal Year
340
Table 1. - Number of cases in caseloads of State vocational
rehabilitation agencies during Fiscal Years 1972 - 1982
Applicants and Active Cases
Active Caseload Only
Number of Cases
Percent Change
Number of Cases
Percent Change
Fiscal
(Statuses 02-30)
From Previous
(Statuses 10-30)
From Previous
Year
Year
Year
1982
1,473,313
- 9.7
958,537
- 7.7
1981
1,631,167
- 5.7
1,038,232
- 5.2
1980
1,728,987
- 1.3
1,095,139
- 2.9
1979
1,751,862
- 3.5
1,127,551
- 3.5
1978
1,815,564
- 2.7
1,167,991
- 3.0
1977
1,866,707
- 3.0
1,204,487
- 2.7
1976
1,925,049
- 0.7
1,238,446
- 0.5
1975
1,937,872
+ 5.2
1,244,338
+ 3.6
1974
1,824,545
+ 6.2
1,201,661
+ 2.1
1973
1,798,132
+ 5.4
1,176,445
+ 5.9
-
1972
1,706,110
+ 9.9
1,111,045
+10.9
Table
Number of active cases served and persons rehabilitated by State
vocational rehabilitation agencies, Fiscal Years 1921 - 1982
Fiscal
Cases
Persons
Fiscal
Cases
Persons
Year
Served
Rehabilitated
Year
Served
Rehabilitated
1982
958,537
226,924
1981
1,038,232
255,881
1951
231,544
66,193
1980
1,095,139
277,136
1950
255,724
59,597
1979
1,127,551
288,325
1949
216,997
58,020
1978
1,167,991
294,396
1948
191,063
53,131
1977
1,204,487
291,202
1947
170,143
43,880
1976
1,238,446
303,328
1946
169,796
36,106
1975
1,244,338
324,039
1945
161,050
41,925
1974
1,201,661
361,138
1944
145,059
43,997
1973
1,176,445
360,726
1943
129,207
42,618
1972
1,111,045
326,138
1942
91,572
21,757
1971
1,001,660
291,272
1941
78,320
14,579
1970
875,911
266,975
1940
65,624
11,890
1969
781,614
241,390
1939
63,575
10,747
1968
680,415
207,918
1938
63,666 1/
9,844
1967
569,907
173,594
1937
11,091
341
1966
499,464
154,279
1936
10,338
1965
441,332
134,859
1935
9,422
1964
399,852
119,708
1934
8,062
1963
368,696
110,136
1933
5,613
1962
345,635
102,377
1932
5,592
1961
320,963
92,501
1931
5,184
1960
297,950
88,275
1930
4,605
1959
280,384
80,739
1929
4,645
1958
258,444
74,317
1928
5,012
1957
238,582
70,940
1927
5,092
1956
221,128
65,640
1926
5,604
1955
209,039
57,981
1925
5,825
1954
211,219
55,825
1924
5,654
1953
221,849
61,308
1923
4,530
1952
228,490
63,632
1922
1,898
1921
523
Data prior to 1938 not available
Table 3 -- Number of persons rebabilitated and not rehabilitated by State vocational
rehabilitation agencies, Fiscal Years 1972 - 1982
Persons Rehabilitated
Persons Not Rehabilitated
Fiscal
Percent Change
Percent Change
Rehabilitation
Year
Number
From Previous
Number
From Previous
Rate
Year
Year
1982
-11.3
142,575
- 9.6
61.4
226,924
1981
255,881
- 7.7
157,682
+ 3.3
61.9
1980
277,136
- 3.8
152,672
- 2.3
64.5
1979
288,325
- 2.1
156,258
- 2.2
64.9
342
- 2.4
64.8
1978
294,396
+ 1.1
159,846
1977
291,202
- 4.0
163,706
- 8.6
64.0
1976
303,328
- 6.4
179,139
+26.3
62.9
1975
324,039
-10.3
141,851
+ 8.4
69.6
1974
361,138
+ 0.1
130,871
+ 3.9
73.4
1973
360,726
+10.6
125,991
+15.8
74.1
1972
326,138
+12.0
108,784
+12.5
75.0
1/ Rehabilitation rates show the number of persons rehabilitated as a percent of all
active case closures, whether rehabilitated or not.
Table 4 -- Number of applicant and extended evaluation cases accepted and
not accepted for VR services by State vocational rehabilitation
agencies, Fiscal Years 1972 - 1982
Persons Accepted
Persons Not Accepted
Fiscal
Percent Change
Percent Change
Year
Acceptance
Number
From Previous
Number
From Previous
Rate 1/
Year
Year
1982
333,439
-10.7
260,518
-15.5
56.1
1981
373,310
- 9.5
308,173
+ 1.2
54.8
1980
412,356
+ 0.2
304,525
+ 1.1
57.5
1979
411,560
- 1.9
301,077
- 2.8
57.8
343
1978
419,590
- 3.6
309,624
-. 0.9
57.5
1977
435,144
- 5.3
312,515
- 7.9
58.2
1976
459,620
-14.0
339,494
+12.1
57.5
1975
534,491
+ 4.6
302,942
+ 7.7
63.8
1974
511,226
+ 1.6
281,376
- 4.4
64.5
1973
503,318
+ 1.3
294,271
+10.5
63.1
1972
496,680
+ 6.1
266,312
+ 8.0
65.1
1/
Acceptance rates show the number of cases accepted for VR services as a percent
of all applicant and extended evaluation cases accepted and not accepted.
Table 5 -- Number of new applicants, new extended evaluation cases and new active cases in the
caseloads of State vocational rehabilitation agencies during Fiscal Years 1972 - 1982
New Applicants
New Extended Evaluation Cases
New Active Cases
(Status 02)
(Status 06)
(Status 10)
Fiscal
Percent Change
Percent Change
Percent Change
Year
Number
From Previous
Number
From Previous
Number
From Previous
Year
Year
Year
564,443
-11.6
28,778
-18.3
333,439
-10.7
1982
1981
638,542
-11.7
35,224
-15.0
373,310
- 9.5
1980
722,847
+ 3.6
41,426
+ 1.5
412,356
+ 0.2
1979
697,873
- 2.4
40,843
- 1.0
411,560
- 1.9
344
1978
715,367
- 4.2
41,240
- 1.7
419,590
- 3.6
1977
746,377
- 2.3
41,948
+ 8.1
435,144
- 5.3
1976
763,714
-13.8
38,792
- 7.3
459,620
-14.0
1975
885,737
+ 9.9
41,848
+28.5
534,491
+ 4.6
1974
806,000
+ 1.2
32,556
+ 6.8
511,226
+ 1.6
1973
796,116
+ 1.3
30,486
+ 6.6
503,318
+ 1.3
1972
786,117
+ 7.8
28,587
+12.0
496,680
+ 6.1
Number of applicant, extended evaluation and active cases remaining at the end
of the fiscal year in caseloads of State vocational rehabilitation agencies,
Fiscal Years 1972 - 1982
Total cases remaining
In applicant status
In extended evaluation
In active statuses
(Statuses 02 - 24)
(Status 02)
(Status 06)
(Statuses 10 - 24)
Fiscal
Number
Percent change
Number
Percent change
Number
Percent change
Number
Percent chan
Year
from previous
from previous
from previous
from previou
year
year
year
year
1982
843,301
- 7.3
232,245
- 9.8
22,013
-18.9
589,038
- 5.7
1981
909,431
- 8.6
257,610
-13.3
27,152
-15.6
624,669
- 6.1
1980
994,654
- 1.1
297,148
+ 1.9
32,175
+ 2.2
665,331
- 2.6
345
1979
1,006,202
- 4.3
291,730
- 4.5
31,504
- 2.9
682,968
- 4.3
1978
1,051,698
- 4.3
305,514
- 3.5
32,435
- 1.8
713,749
- 4.8
1977
1,099,284
- 0.3
316,662
+ 0.4
33,043
+ 4.7
749,579
- 0.8
1976
1,103,088
- 5.6
315,549
-11.8
31,560
- 4.2
755,979
- 2.9
1975
1,169,040
+ 1.1
357,653
+12.4
32,939
+41.9
778,448
+ 9.7
1974
1,051,160
+ 3.3
318,297
+ 4.1
23,211
+ 7.9
709,652
+ 2.9
1973
1,017,144
+ 1.2
305,902
- 0.8
21,514
+ 5.3
689,728
+ 2.0
1972
1,004,876
+ 9.6
308,331
+ 8.0
20,422
+12.8
676,123
+10.2
Table 1
Selected Caseload Volumes: Fiscal Year 1982
VS. Fiscal Year 1981 and All-Time High
All Time High
Caseload
Fiscal Year
Percent
Percent
Measure
change:
Fiscal
change: 82
1982
1981
82 vs. 81
Year
Number
vs. higi
Total applicants
821,332
934,209
-12.1%
1975
1,204,262
-31.8%
New applicants
564,443
638,542
-11.6
1975
885,737
-36.3
Applicants on hand,
end of year
232,245
257,610
- 9.8
1975
357,653
-35.1
Total active cases served
958,537
1,038,232
- 7.7
1975
1,244,338
-23.0
New active cases
333,439
373,310
-10.7
1975
534,491
-37.5
346
Rehabilitations
226,924
255,881
-11.3
1974
361,138
-37.2
Non-rehabilitations
142,575
157,682
- 9.6
1976
179,139
-20.4
Active cases on hand,
end of year
589,038
624,669
- 5.7
1975
778,448
-24.3
Severe active cases served
571,542
600,727
- 4.9
1979
611,994
- 6.6
New severe active cases
200,601
224,309
-10.6
1979
226,287
-11.4
Severe rehabilitations
129,866
138,380
- 6.2
1979
143,375
- 9.4
Severe non-rehabilitations
90,567
95,462
- 5.1
1981
95,462
- 5.1
Severe active cases on hand,
end of year
351,109
366,885
- 4.3
1979
381,078
- 7.9
347
Table 6 - Number of persons rehabilitated and served by State
vocational rehabilitation agencies per 100,000 population, 1/
Fiscal Years 1971-1982
Rehabilitations
Active Cases Served
Fiscal
Resident
Rate per
Rate per
Year
Population 2/(mil)
Number 3/
100,000 population
Number 3/
100,000 population
1982
229.3
222,940
97
936,543
409
1981
227.2
251,483
110
1,014,518
447
1980
224.6
272,204
121
1,069,853
476
1979
222.1
283,185
127
1,101,015
496
1978
219.8
289,531
132
1,141,024
519
1977
217.6
286,906
132
1,177,993
541
1976
215.5
297,147
138
1,209,791
561
1975
213.3
318,251
149
1,214,585
570
1974
211.4
355,528
168
1,172,906
555
1973
209.3
355,614
170
1,150,772
550
1972
206.8
321,612
156
1,089,825
527
1971
204.0
288,158
141
984,982
483
1/ Rates are based on the estimated total resident population on July 1
of each fiscal year except for Fiscal Years 1971 and 1981 which are
based on the Decennial Census as of April 1, 1970 and 1980, respectively.
Source: U.S. Bureau of the Census, "Current Population Reports,
series P-25, Nos. 802 and 903.
2/ Resident population does not include information from Puerto Rico or any
of the outlying territories.
3/ Excludes data from Puerto Rico, Virgin Islands, Guam, American Samoa,
Trust Territories of.the Pacific Islands and Northern Mariana Islands.
348
Table 8. -- Number of applicant, extended evaluation and active.
cases in State vocational rehabilitation agencies,
percent change and percent distribution,
Fiscal Years 1981 - 1982
Fiscal Year
Percent
distribution
Percent
Fiscal Year
Caseload item
1982
1981
Change
1982
1981
Applicants (02)
Number available
821,332
934,209
-12.1
100.0
100.0
On hand, Oct. 1
256,889
295,667
-13.1
31.3
31.6
New since Oct. 1
564,443
638,542
-11.6
68.7
68.4
Number processed
589,087
676,599
-12.9
71.7
72.4
Accepted for VR (10)
317,461
354,041
-10.3
38.7
37.9
Accepted for EE (06)
28,778
35,224
-18.3
3.5
3.8
Not accepted for VR
or EE (08)
242,848
287,334
-15.5
29.6
30.7
Total on hand, Sept. 30
232,245
257,610
- 9.8
28.3
27.6
Extended evaluation
cases (06)
Number available
55,661
67,260
-17.2
100.0
100.0
On hand, Oct. 1
26,883
32,036
-16.1
48.3
47.6
New since Oct. 1
28,778
35,224
-18.3
51.7
52.4
Number processed
33,648
40,108
-16.1
60.5
59.6
Accepted for VR (10)
15,978
19,269
-17.1
28.7
28.6
Not accepted for VR (08)
17,670
20,839
-15.2
31.7
31.0
Total on hand, Sept. 30
22,013
27,152
-18.9
39.5
40.4
Active cases (10-30)
Number available-
958,537
1,038,232
1-0 7.7
100.0
100.0
On hand, Oct. 1
625,098
664,922
- 6.0
65.2
64.0
New since Oct. 1
333,439
373,310
-10.7
34.8
36.0
Number closed
369,499
413,563
-10.7
38.5
39.8
Rehabilitated (26)
226,924
255,881
-11.3
23.7
24.6
Not rehabilitated (28)
104,615
116,156
- 9.9
10.9
11.2
Not rehabilitated (30)
37,960
41,526
- 8.6
4.0
4.0
Total on hand, Sept. 30
589,038
624,669
- 5.7
61.5
60.2
Active cases served.
349
Table 16. -- Persons rehabilitated by State vocational
rehabilitation agencies and percent change
from previous year, by severity of disability:
Fiscal Years 1974 - 1982
A. Severely Disabled
Fiscal Year
Rehabilitations
Percent Change 1/
1982
129,866
- 6.2
1981
138,380
- -2.9
1980
142,545
- 0.5
1979
143,375
+ 3.6
1978
138,402
+ 8.5
1977
127,522
+ 3.7
1976
122,938
+ 6.3
1975
115,746
+ 1.5
1974
113,997
2/
B. Non-Severely Disabled
Fiscal Year
Rehabilitations
Percent Change 1/
1982
97,058
-17.4
1981
117,501
-12.7
1980
134,591
- 7.1
1979
144,950
- 7.1
1978
155,994
- 4.7
1977
163,680
- 9.3
1976
180,390
-13.4
1975
208,293
-15.7
1974
247,141
2/
1/ Comparison to same period of previous year.
2/ Data not available.
22-065 O - 84 - 23
350
Table 17. -- Total, Severely and Non-Severely Disabled Cases
Rehabilitated by State Vocational Rehabilitation
Agencies and Percent Severe, Fiscal Years 1974-1982
Fiscal
Severely
Non-Severely
Percent
Year
Total
Disabled
Disabled
Severe
1982
226,924
129,866
97,058
57.2
1981
255,881
138,380
117,501
54.1
1980
277,136
142,545
134,591
51.4
1979
288,325
143,375
144,950
49.9
1978
294,396
138,402
155,994
47.0
1977
291,202
127,522
163,680
43.8
1976
303,328
122,938
180,390
40.5
1975
324,039
115,746
208,293
35.7
1974
361,138
113,997
247,141
31.6
Table 18. -- Rehabilitation Rate. for Severely and Non-Severely
Disabled Clients of State Vocational Rehabilitation
Agencies, Fiscal Years 1976 - 1982
Rehabilitation Rate 2/
Fiscal
Year
Total
Severe
Non-Severe
1982
61.4
58.9
65.1
1981
61.9
59.2
65.2
1980
64.5
60.9
68.7
1979
64.9
62.1
67.8
1978
64.8
62.5
67.0
1977
64.1
61.4
66.3
1976
62.9
60.0
65.0
1 Severe as a percent of severe and non-severe cases.
21 Rehabilitations ÷ (All active cases. closed)
351
REHABILITATION ACT: SUBCOMMITTEE EXPLANATION OF FUNDING RECOMMENDATION
WHY IS THE INCREASE IN STATE GRANTS PARTICULARLY NEEDED RIGHT
NOW?
At a time when unemployment is seriously affecting
millions of Americans, disabled Americans are suffering
even more.
The unemployment rate among disabled persons who
are able to work is more than 50% --a conservative
estimate.
State rehabilitation agencies are able to serve
only about one out of every 20 eligible clients.
HOW DID YOU ARRIVE AT A $1037.8 FUNDING RECOMMENDATION FOR
STATE GRANTS?
This a 9.95% increase. Over a four year period, increases
of this percentage will bring the level of funding to. its
FY 1979 equivalent in purchasing power.
WHY IS RESTORATION TO THE FY 1979 FUNDING EQUIVALENT AN
APPROPRIATE OBJECTIVE?
Although the decline in overall service levels by the
states--in both severely disabled and non-severely disabled
cases--began in 1975, it might be argued that prior to 1979
the decline represents a shift in resources to more expensive
severely. disabled cases. Since 1979, however, the drop in
both severely- and non-severely disabled cases shows a clear
decline in the states' ability to-serve eligible applicants.
--Since 1979 the actual number of severely disabled
persons states are rehabilitating has declined by
10%.
WHY IS IT IMPORTANT TO PROVIDE THE STATES THE RESOURCES TO
SERVE THE SEVERELY DISABLED?
Although it is more costly to serve the severely disabled,
the cost/benefits to the government are far greater. According
to Rehabilitation Services Administration studies, the severely
disabled are more dependent on public support and much less
likely to find employment without rehabilitation services than
are the non-severely disabled.
352
WHAT DATA JSTRATE THE DECLINE IN REHABILITATION SERVICES
DURING THE RECENT PAST?
Between 1979 and 1982 there was a 31% loss in purchasing
power.
--In terms of dollars, the purchasing power loss was
$384 million.
$209 million represents loss due to inflation
$175 million represents loss due to cuts in funding
through the SSI and SSDI rehabilitation program
and cuts in the innovation and expansion grants
part of the Rehabilitation Act.
State's' all-time high in rehabilitations was in 1974.
--Between 1974 and 1982 there was a 37.2% drop in
number of rehabilitations.
In 1982, cases, served dropped below one million for
the first time in 12 years.
In 1982, rehabilitations were the lowest in 14 years.
WHAT DATA ILLUSTRATE THE COST/EFFECTIVENESS OF THE PROGRAM?
Most recent data from =RSA shows that in the first year
after case closure, persons rehabilitated paid=$211.5
million more in income, payroll and sales taxes than
they would have paid without rehabilitation. Another
$68.9 million was saved as a result of decreased dependency
on public support payments and institutional care. In
just one year, the benefits to governments was $280.4
million. In four years the entire cost of the rehabilitations
was returned.
The lifetime earnings of disabled persons is increased
by $10 for every one dollar spent on their rehabilitation.
WHAT DOES CBO SAY ABOUT THE IMPORTANCE OF INVESTMENT IN
REHABILITATING THE DISABLED?
In a letter dated May 8, 1981, Alice Rivlin, CBO Director,
wrote: "Since expenditures for vocational rehabilitation
are associated with offsetting savings in other government
programs, a reduction in funding for rehabilitation.
would generate increases in other parts of the federal
and state budgets. "
353
April 1983
RECOMMENDATIONS OF THE REHABILITATION COALITION
WITH RESPECT TO
FY 1984 APPROPRIATIONS
FOR PROGRAMS AUTHORIZED UNDER THE REHABILITATION ACT OF 1973
The Rehabilitation Coalition* consists of national organizations
representing rehabilitation professionals, institutions, consumers,
and others who are concerned with strengthening the vocational
rehabilitation program and improving the lives and opportunities
of persons with disabilities.
The Rehabilitation Coalition views the Rehabilitation Act of
1973, as amended, as one of the most complete and well-balanced
pieces of legislation in the human services field. The Program of
Vocational Rehabilitation is a cornerstone in the governmental effort,
at both the federal and state levels, to assist disabled Americans.
In one Act, provisions are included for a comprehensive and indivi-
dually-tailored program of services to physically and mentally dis-
abled persons, a training program, a research program, a special
projects program, a comprehensive services program for independent
living, and other specially targeted programs.
With its focus of rehabilitating people with mental and physical
disabilities to employment and self-sufficiency, the Rehabilitation
Program has served many millions of disabled individuals, and has
rehabilitated and placed over five million people into meaningful,
productive jobs during its 63 years of existence, making it one of
the most cost-effective programs in our nation's history. These
comprehensive rehabilitation services are provided by and through
State Rehabilitation Agencies, often through cooperative agreements
and contracts with other public and private, nonprofit, community-
based organizations and facilities.
People with disabilities comprise a significant portion of the
nation's population; 35 million is the estimate. The size of the
disabled population is not static, but continues to grow through
accidents, injuries, illnesses, and birth defects at an estimated
rate of 500, annually. Of the total population, approximately
10 million people may be categorized as severely disabled.
The Rehabilitation Program signifies the nation's recognition of
its responsibility to provide disabled citizens with the opportunity
to be a part of the mainstream of life as full participants.
The information contained on the attached pages outlines more
specifically the unique needs served by each aspect of the Rehabili-
tation Program. Also provided are justifications for the provision
of funds for each of these vital programs.
*
Members of the Rehabilitation Coalition are listed on the following
page.
354
The following members of the Rehabilitation Coalition endorse the
recommendations contained in this document:
American Academy of Physical Medicine and Rehabilitation
American Association of Workers for the Blind
American Coalition of Citizens with Disabilities
American Congress of Rehabilitation Medicine
American Council. of the Blind
American Deafness and Rehabilitation Association
American Foundation for the Blind
American Occupational Therapy Association
American Physical Therapy Association
Association for Retarded Citizens
Conference of Educational Administrators Serving the Deaf
Convention of American Instructors of the Deaf
Council for Exceptional Children
Council of State Administrators of Vocational Rehabilitation
Epilepsy Foundation of America
Goodwill Industries of America
National Association of the Deaf
National Association of Private Residential Facilities for
the Mentally Retarded
National Association of Rehabilitation Facilities
National Association of Rehabilitation Research and Training Centers
National Association of State Mental Health Program Directors
National Council on Rehabilitation Education
National Council of State Agencies for the Blind
National Easter Seal Society
National Multiple Sclerosis Society
National Rehabilitation Association
National Society for Children and Adults with Autism
Paralyzed Veterans of America (non-member of Coalition)
State Mental Retardation Program Directors Association
United Cerebral Palsy Associations, Inc.
american assn M Mental Deficiency
For further information, contact:
The Rehabilitation Coalition
738 9th Street, S.E.
Washington, DC 20003
232-6963 / 785-3388
355
VOCATIONAL REHABILITATION STATE GRANTS
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81
FY 82
FY 83
AUTHORIZATION
FY 84 REQUEST
RECOMMENDATION
854.259
863.04
943.9
PENDING
943.9
1,037.8
(in millions)
PROGRAM DESCRIPTION: The State-Federal Rehabilitation Program
begins its 63rd year of providing comprehensive services to
persons with mental and physical disabilities. Authorized by
Section 110 of the Rehabilitation Act of 1973, as amended, this
Program continues as the focus of our Nation's effort to assist
disabled Americans in their efforts to become gainfully
employed.
According to government projections and statistics, this
program is a proven, cost-effective, and cost-efficient method of
providing vital services to persons with disabilities.
Regardless, the purchasing power of the "rehabilitation dollar"
has been weakened over the past years due to inflation and
suppressed funding. Furthermore, due to the decrease in funds
available to the States through Social Security Vocational
Rehabilitation Programs, from approximately $124 million in FY
1981 to approximately $3 million in FY 1982, the State
Rehabilitation Agencies were unable to provide services to
approximately 110,000 persons.
IMPACT OF ADMINISTRATION'S PROPOSALS: The Administration is
requesting that Federal funding for Section 110 be "frozen" at
the FY 1983 level of $943.9 million. The effect of this proposal
will be:
The continued weakening of the purchasing power of the
rehabilitation dollar.
o The continued decline. in the number of persons served
and the number rehabilitated into employment.
O The continued lessening of additional resources for the
rehabilitation of beneficiaries of SSDI and SSI, due to
the minimal increases in the Administration's request
for funding for these programs.
REHABILITATION COALITION RECOMMENDATION: The Rehabilitation
Coalition recommends that the Congress appropriate $1,037.8
million for the funding of grants to the States for the provision
of Rehabilitation Services to persons with mental and physical
356
disabilities, in FY 1984.
JUSTIFICATION: This recommendation, if appropriated by the
Congress, would in part achieve the goal of restoring the
purchasing power of the "rehabilitation dollar" to the 1979
Section 110 Federal spending level. Increases would have to be
made over the next four fiscal years to fully achieve this goal.
FY 1979 is viewed as the last year in which the State-Federal
Rehabilitation program operated at full strength. Ever since
that year, there has been a steady decline in the number and type
of persons with disabilities served, due to economic and
programmatic factors.
In this time of historically high unemployment, it must be
remembered that there is no group in our society experiencing
more unemployment than that experienced by persons with
disabilities. This program is the only major Federal effort
geared fully towards the goal of gainful employment for persons
with disabilities.
357
REHABILITATION TRAINING
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATION
FY 84 REQUEST
RECOMMENDATION
21.68 19.20 19.20
pending
19.20
25.50
(in millions)
PROGRAM DESCRIPTION AND NEED: The Rehabilitation Training
Program supports training in all of the professional disciplines
related to rehabilitation including medicine, physical therapy,
occupational therapy, speech-language pathology and audiology,
rehabilitation counseling, rehabilitation facility
administration, interpreters for the deaf, and personnel to serve
the blind. Approximately one-fourth of its budget is spent on
in-service training and related short-term training and
continuing education programs. Support for the rehabilitation
training program has decreased dramatically over the past five
years. The current funding level is only $19.2 million, whereas
the program received $30.4 million in FY 1977-78.
Evidence of manpower shortages accumulated through various
studies shows the need for additional rehabilitation
professionals.
O The Congressionally mandated analysis of rehabilitation
manpower needs, completed by RSA, found major shortages
throughout the rehabilitation field in medicine, prosthetics and
orthotics, rehabilitation counseling, physical therapy,
occupational therapy, and speech-language pathology.
O The Graduate Medical Education National Advisory Committee
(GMENAC) has found, generally, a surplus of physicians but nearly
a 100% shortage of physicians in rehabilitation medicine.
o A 1980 Bureau of Labor Statistics' Report indicates a need
for 65% more occupational therapists, 53% more physical
therapists, and 47% more speech-language pathologists and
audiologists during the 1980s.
Vocational rehabilitation is a team effort of rehabilitation
and vocational experts. Efficient and effective rehabilitation
occurs only when an adequate supply of all team members is
available.
IMPACT OF PRESIDENT'S 1984 BUDGET REQUEST: The Administration
has proposed that the FY 84 Rehabilitation Training budget be
frozen at the FY 83 level of $19.2 million. This would be the
third consecutive year that training funds have been frozen,
which would represent a real reduction of nearly 20% from the FY
358
81 appropriation of $21.68 million. The Department of Education
estimates that at $19.2 million, approximately 6% fewer
rehabilitation personnel would be trained in FY 84 than in FY 83.
Yet major personnel shortages have been documented in many of the
rehabilitation professions.
REHABILITATION COALITION RECOMMENDATION: The Rehabilitation
Coalition recommends an appropriation of $25.5 million, which is
equal to last year's FY 83 authorization level.
JUSTIFICATION: Due to advances in life saving techniques,
many more persons are surviving trauma and illness, increasing
the need for rehabilitation services. In FY 1981 a little over
one million clients were served by the Department of Vocational
Rehabilitation. In the same year almost one-half million eligible
clients were turned away. At the same time graduates in many
allied health fields have leveled off due to reductions in
federal training support. Technological advances in the field of
rehabilitation necessitate a highly trained team to provide
services. Additional training funds are needed just to slightly
increase the graduates in rehabilitation.
359
COMPREHENSIVE SERVICES FOR INDEPENDENT LIVING
APPROPRIATIONS.
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATION
FY 84 REQUEST
RECOMMENDATION
18.0 17.28 17.28
pending
17.28
45
(in millions)
PROGRAM DESCRIPTION: Title VII of the Rehabilitation Act of
1973, as amended, authorizes several different approaches to
promoting independent living services, particularly to persons
too severely disabled to qualify for Vocational Rehabilitation.
The 1978 amendments to the Act envisioned a major statewide
service delivery system, "Comprehensive Services for Independent
Living, in Part A. However, the Administration and Congress have
restricted the program to the federally administered Part B
Centers for Independent Living.
IMPACT OF THE PRESIDENT'S 1984 BUDGET REQUEST: For the first
time in the President's three budget submissions, the
Administration has proposed level funding for the (Part B)
Independent Living (IL) program. No funding is requested for
Part A.
The President's budget request would permit continued
operation of the approximately 150 centers currently operating
with at least one in each of the 50 states. However, level
funding since FY 1982 would require the centers to continue to
reduce their level of operation to reflect the impact of
inflation over the past two years.
REHABILITATION COALITION RECOMMENDATION: For the first year
of operation, P.L. 95-602, the 1978 authorizing statute,
earmarked $80 million for Parts A, B and C (older blind persons
set-aside). The Rehabilitation Coalition recommends an
appropriation of $45 million and urges Congress to reauthorize
Parts A. B and C. The $45 million would allow $25 million to
initiate Part A. $18 million to maintain Part B and $2 million to
initiate Part C.
JUSTIFICATION: The primary concern of the Rehabilitation
Coalition with the Independent Living program is how to create a
transition from a federally administered series of model and
demonstration centers which have proved their value to a
statewide service delivery system for the severely disabled
population. A key factor to implementing this transition is the
start-up of Part A while maintaining funding continuity for
existing Part B centers.
360
NATIONAL INSTITUTE OF HANDICAPPED RESEARCH
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATIONS
FY 84 REQUEST
RECOMMENDATION
29.75 28.56 30.06
pending
30.06
37.5
(in millions)
PROGRAM DESCRIPTION: The Institute is responsible for
research related to medical, social, psychological and vocational
rehabilitation services. It is also responsible for research
involving engineering related to environmental aspects of
rehabilitation and equipment and devices. The statutory
priorities for the Institute are support of rehabilitation
research and training centers, engineering research projects and
centers, spinal cord injury research, and research regarding the
aged and children.
IMPACT OF THE PRESIDENT'S 1984 BUDGET REQUEST: The budget of
the Institute and its predecessor program has not increased
overall in the last 15 years. In constant dollars, the program
has decreased by more than 50% in that period. In 1969 and 1970,
$32 million was spent on rehabilitation research, whereas only
$30.5 million is being spent this year and only $30.5 million is
in the President's FY 1984 budget request. The President's
budget only allows $3 million to $4 million for new projects in
FY 1984. An additional $7.5 million above the President's budget
is needed. The President's budget has no funds for new
programs.
COALITION RECOMMENDATION: The Rehabilitation Coalition
recommends tht NIHR funding be increased to $37.5 million in FY
84
JUSTIFICATION: In FY 1983, 228 applications for center and
project grants were submitted. Only 48, or about 22%, were
funded. Eighty-six projects and centers were approved for
funding if funds were available. Thirty-eight centers and
projects which were approved for funding went unfunded.
Twenty-seven of those received scores that were 375 or above on a
scale of 1 to 500 and on the average the centers and grants
funded scored at just about 400. At least two approved projects
and centers which scored at very high levels went unfunded in the
spinal cord injury area, the mental retardation area, and the
rural service delivery area.
An additional $7.5 million above the President's budget would
enable NIHR to undertake the following initiatives:
1. Establish a research training program funded at $1 million
361
CLIENT ASSISTANCE PROJECTS
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATION
FY 84 REQUEST
RECOMMENDATION
3.0
3.0
1.734
pending
0.
3.0
(in millions)
PROGRAM DESCRIPTION: The Client Assistance Program was
established in 1973, along with due process procedures, to
strengthen the clients' voice in the rehabilitation process and
provide the clients with a means of redress if the process was
not responsive to their needs. Gradually 37 States have agreed
to participate. In most States, the VR agencies have opted to
run the program within the agency. Approximately five states
have placed the CAP program in external independent advocacy
agencies. The programs operated outside the State agencies have
been particularly effective. All the projects have enabled VR
clients to learn about available services and their right to
them. Many have helped clients overcome barriers to the
provision of services.
IMPACT OF THE PRESIDENT'S 1984 BUDGET REQUEST: The
Administration has recommended a phase out of the program, with
no further funding for 1984. States will be encouraged to fund
the programs with existing State dollars.
O Handicapped persons in need of rehabilitation services will
lose an important source of information and advocacy services
which enable them to effectively use the rehabilitation services
provided by Federal monies.
o The rehabilitation system will lose the one monitoring
component which acts as a check on the program and assures more
effective operation.
o
VR clients who are not developmentally disabled (and
therefore not eligible for services from the DD P&A system) will
have their only advocacy resources removed.
REHABILITATION COALITION RECOMMENDATION: The Rehabilitation
Coalition recommends continued funding at $3 million.
JUSTIFICATION: The recommended funding level would permit CAP
agencies to provide a level of services comparable to FY 1982.
362
which would support about 50 research trainees and fellows. No
program presently exists.
2. Establish a new $3 million program to support individual
research investigators initiating their own research projects.
This amount would support about 40 new investigators and 40
individual projects.
3. Fund with about $3.5 million 12 new centers and projects
that were approved and unfunded with highly meritorious scores in
FY 1983 or have a competition to fund the 12 new projects and
centers.
It is estimated that with the same interest as FY 1983, a
$7.5 million addition over the President's budget for new
competition would still result in only about 30% of all approved
centers and projects being funded and at scores substantially
above. 400. These standards are higher than those currently
applicable to NIH.
These funds would enable major efforts to begin in pediatrics
rehabilitation research and research related to independent
living services. It would enable a major and needed expansion of
activity for spinal cord injury research, mental retardation
research, and research related to multiple sclerosis and
arthritis.
363
SPECIAL PROJECTS FOR THE SEVERELY DISABLED
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATION
FY 84 REQUEST
RECOMMENDATION
9.765 8.855 11.259
pending
10.295
12.21
(in millions)
PROGRAM DESCRIPTION: This program authorized by Sec. 311,
entitled "Special Demonstration Programs," is often referred to
by the two operative programs it encompasses: "Special Projects
for the Severely Disabled" and "Regional Spinal Cord Injury
Centers." The Special Projects are focused on VR projects
concerning blindness, deafness, mental illness, epilepsy,
cerebral palsy, multiple sclerosis, mental retardation,
arthritis, learning disability, deaf/blind and other broader
disability focuses on Hispanic access, general severe disability
and telecommunications.
These demonstration projects and centers are developing
improved VR service models and paving the way for State Agencies
to build into their systems more efficient and successful
programs to serve severely disabled persons from currently
"underserved populations."
IMPACT OF THE PRESIDENT'S 1984 BUDGET REQUEST: Because of the
possible reallocation of funds from Discretionary Service
Projects to Independent Living Centers to fulfill the
Congressional mandate to continue funding those Centers which
received funding in FY 1981, Special Projects for the Severely
Disabled may only receive approximately $9.8 million in FY 1983.
If this is the case, the President's request would provide
sufficient resources to fund continuation projects in the second
and third years, and about $1.3 million for new FY 84 projects.
This would be more than $3 million less than is available for new
projects in FY 83. (Only one new project was funded in FY 82.
However, if Special Projects for the Severely Disabled does
receive its full $11.259 million in FY 83, then the President's
request would represent nearly a $1 million reduction in this
important program.)
COALITION RECOMMENDATION: Funding at the level of $12.21
million for FY 84 is recommended in order to provide for adequate
resources for new FY 84 projects.
JUSTIFICATION: The area of improving the capability of the
rehabilitation system to successfully serve the needs of severely
disabled persons depends substantially on this program. The need
for this improvement is broadly accepted, and the potentials for
individuals and the federal budget on a cost-benefit basis are
very significant.
364
TECHNICAL ASSISTANCE
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATION
FY 84 REQUEST
RECOMMENDATION
.23
.25
0
pending
0
.25
(in millions)
PROGRAM DESCRIPTION: Section 12 of the Rehabilitation Act states
that the Commissioner of RSA may provide
"
consultative
services and Technical Assistance to public or non-profit,
private agencies and organizations." This authority was
traditionally used to provide technical assistance to
rehabilitation facilities in areas such as contract procurement,
high technology, cost accounting, marketing, etc., to help
facilities improve their performance in providing services to
disabled persons. The Technical Assistance provided under
Section 12 allowed facilities to be operated in a more
business-like manner, become more self-sufficient and less
dependent.
In the past, Technical Assistance had been funded at $250,000
per year. Although a small amount when compared to other
programs, the appropriation was spread among many facilities
since most Technical Assistance provided was of short duration
and the amount of money needed for each consultation was
relatively small.
The addition of Section 506 of the Act in 1978 caused
confusion in the Technical Assistance program since it provided
for Technical Assistance to "persons operating rehabilitation
facilities" but only for the purpose of removing architectural
barriers. Funding was shifted from Section 12 to Section 506
without the realization that this would not allow funding
traditional Technical Assistance to rehabilitation facilities.
RECOMMENDATION: $250,000 should be appropriated in FY 1984
for Technical Assistance to rehabilitation facilities under
Section 12.
JUSTIFICATION: Rehabilitation facilities need access to
experts to advise them on issues relevant to providing employment
and rehabilitation services to disabled persons. The low cost
per consultation and the improvement in services resulting from
the consultations make the small appropriations most worthwhile.
365
PROJECTS WITH INDUSTRY
APPROPORIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81
FY 82
FY 83
AUTHORIZATION
FY84 REQUEST
RECOMMENDATION
5.25
7.51
13.0
pending
11.0
13.0
(in millions)
PROGRAM DESCRIPTION: The Projects With Industry (PWI) program
authorizes contracts or jointly-financed cooperative agreements
with employers and organizations for projects designed to prepare
disabled individuals for gainful employment. Such projects
provide training, employment and other services in work
settings. Under PWI, the Rehabilitation Services Administration
engages business, industry, labor unions and nonprofit
organizations in employment of the handicapped. PWI increases
the chances for successful placement because the client is
exposed to and placed in a real work environment. The process of
permanent placement is simplified because the employer already
knows the client and only a payroll transfer may be required to
hire a PWI graduate. Business and industry are more involved
with the client; attitudinal barriers are reduced. PWI provides
the client with financial incentives almost immediately and
requires less time than the traditional rehabilitation process.
At the same time, PWI is part of an overall rehabilitation
program, but with more emphasis on the end results. In FY 1982,
72 PWI projecs were funded at $7.51 million. Over 9,000
placements, averaging $946 per placement, made this a successful
job-training program. Placement retention rates were over 75%.
The average annual wage for PWI graduates was $9,000; total
income for persons placed by the program was $78 million. Taxes
paid by PWI graduates alone offset the cost of the program.
IMPACT OF THE PRESIDENT'S 1984 BUDGET REQUEST: With the
addition of $5 million in funding for FY 1983 under the emergency
Jobs Bill, PWI will receive a total of $13 million in FY 1983.
The President's budget proposal would be $2 million less than
that. An additional 1500 handicapped persons could be placed
into competitive jobs.
RECOMMENDATION: PWI should be funded at the FY 83
appropriation level of $13 million.
JUSTIFICATION: The success of the PWI program and its
positive cost benefit ratio justify a substantial increase in
funding. Documented savings in public assistance and taxes paid
by the program would clearly exceed the appropriation for the
program.
22-065 O - 84 - 24
366
EVALUATION SECTION 14
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATION
FY 84 REQUEST
RECOMMEND.
1.820
0
0
pending
0
2.0
(in millions)
PROGRAM DESCRIPTION: Section 14 of the Rehabilitation Act
calls for the Secretary to "evaluate the impact of all programs
authorized by the Act, their general effectiveness in relation to
their cost, their impact on related programs, and their structure
and mechanisms for delivery of services. This section of the
Act has not been funded since FY 1981, at which time it received
$1.820 million. The evaluation section funded projects which
reviewed such aspects of the legislation as training, placement,
Projects with Industry, the Client Assistance Program, and other
programs authorized by the Act. Along with the review of these
programs, important statistics were collected which gave an
accurate profile of the clients being served and also indicated
the cost-effectiveness of the programs.
RECOMMENDATION: The Rehabilitaiton Coalition recommends that
Section 14 receive $2 million in appropriations for. FY 1984.
JUSTIFICATION: Programs authorized by the Rehabilitation Act
have proven cost-effective throughout their history. However,
the Rehabilitation Coalition firmly believes that the evaluation
data is critical to assuring the continued success of these
programs. We are very disturbed that RSA has diminished efforts
to collect client data and other evaluation statistics in recent
years. Without such evaluation data, it may be difficult to
accurately assess the quality of services rendered to disabled
persons.
367
AMERICAN INDIAN VOCATIONAL REHABILITATION SERVICES PROJECTS
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATIONS
FY 84 REQUEST
RECOMMENDATION
.650
.624
.650
Pending
.650
.650
(in millions)
PROGRAM DESCRIPTION: Section 130 of the Rehabilitation Act of
1973, as amended, authorizes the provision of funds to the
governing bodies of Indian tribes located on State and Federal
lands, to provide vocational rehabilitation services for
handicapped American Indians residing on such reservations.
JUSTIFICATION: The environment of the Indian reservation
offers a severely limited range of employment opportunities for
disabled American Indians. Thus, the rehabilitation services
provided through Section 130 are different from those in the
Basic State Vocational Rehabilitation Program.
In FY 1983, it is estimated that 575 persons with
disabilities will be served by this program. This represents a
slight decrease in the number of persons served in FY 1982. The
Rehabilitation Coalition recognizes the unique need for the
provision of services under Section 130, and recommends $650,000
for FY 1983.
368
SPECIAL RECREATION PROGRAMS
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATIONS
FY84 REQUEST RECOMMENDATION
2.0
1.884
*
pending
0
2.0
(IN MILLIONS)
PROGRAM DESCRIPTION: The 1978 amendments to the
Rehabilitation Act of 1973 authorize a program for initiating
special recreation projects for individuals with disabilities.
Under Title III, Section 316 of the Act, grants are made to
states and other public and non-profit agencies to pay part or
all of the cost of establishing recreation program to aid in the
mobility and socialization of persons with disabilities. The
role of recreation in rehabilitation is an important one.
Recreation and rehabilitation professionals maintain that there
is a therapeutic value to participation in recreation programs
and that recreational activities are an essential element of a
balanced lifestyle. Programs established under Section 316
encompass a broad range of activities, including sports, music,
dance, arts and crafts, camping, scouting and 4-H activities.
Provision under the Act specify that existing resources be used
whenever possible, thereby discouraging the development of new
facilities and encouraging the integration of persons with
disabilities into established community recreation programs.
Congress indicated that funds appropriated under Section 316
should initiate programs and activities which could eventually be
assumed by local public and private agencies. The program has
proven successful in this regard, as most programs initially
funded under Section 316 have received continued community
support.
IMPACT OF PRESIDENT'S 1984 BUDGET REQUEST: the Administration
has proposed that the Section 316 special recreation programs
receive no funding in fiscal year 1984. The effect of this
proposal includes:
o
The elimination of a successful program to initiate
cost-effective recreation projects and activities serving persons
with disabilities. It should be noted that the twenty-three
programs funded under Section 316 in 1982 served approximately
18,330 individuals.
o The loss of federal support for recreation as a valuable
means of improving the health, social integration, and personal
growth of persons with disabilities.
RECOMMENDATION: The Rehabilitation Coalition recommends an
369
ARCHITECTURAL AND TRANSPORTATION BARRIERS
COMPLIANCE BOARD
APPROPRIATIONS
FY 1984
PRESIDENT'S
COALITION
FY 81 FY 82 FY 83
AUTHORIZATION
FY84 REQUEST
RECOMMEND
2.3
1.9
2.02
pending
1.7
2.02
(in millions)
PROGRAM DESCRIPTION: The Architectural and Transportation
Barriers Compliance Board (ATBCB) is the only federal agency
focusing exclusively on the accessibility needs of persons with
disabilities. The Board provides federal agencies with minimum
guidelines and requirements for federal accessibility standards
issued under the "Architectural Barriers Act of 1968. The ATBCB
also investigates alternative approaches to architectural,
transportation, communications and attitudinal barriers
confronting individuals with disabilities. Funds are used to
sponsor research in a broad range of accessibility-related
fields, including new. technologies of informational cuing to
assist with the identification of rooms and spaces, the
evaluation of ground and floor surface treatments and the
analysis of design considerations affecting people with multiple
disabilities. Lastly, the Board is responsible for assessing the
measures taken by federal, state and local governments and other
agencies to eliminate barriers. The ATBCB provides technical
assistance. to these agencies and makes recommendations to
Congress and the Administration regarding barrier removal.
IMPACT OF THE PRESIDENT'S 1984 BUDGET REQUEST: The
Administration's budget request of $1.7 million for Fiscal Year
1984 represents a reduction of 15.8 percent. A funding decrease
of this size would effectively eliminate the discretionary monies
used for Board activities. The effects of the President's budget
proposals include:
O The loss of funding available to sponsor research.
O The termination of technical assistance programs designed
to aid states and local governments in meeting federal
accessibility standards and developing state codes regarding
accessibility.
O The potential inability of the ATBCB to meeting its
Congressionally-mandated function regarding federal accessibility
guidelines reduction. and requirements as a result of the proposed funding
RECOMMENDATION: The Rehabilitation Coalition recommends that
the ATBCB be funded at $2.02 million in FY 1984.
370
appropriation of $2.0 million for the Special Recreation
Programs.
JUSTIFICATION: In passing this provision, Congress recognized
that the lack of adequate recreation programming for disabled
individuals is one of the most glaring gaps in our existing
social service funding. Continued support for Section 316
programs is the quickest and most cost-effective way to make
recreational opportunities accessible to persons with
disabilities.
*As this document goes to press, the RSA does not intend to
allocate any of the FY 1983 Service Projects appropriations for
Special Recreations Programs. Many observers contend, however,
that the Congress intended to appropriate $1.884 million for
these programs.
JUSTIFICATION: The ATBCB has a unique role in setting federal
standards for accessibility. In addition, the research and
technical assistance programs conducted by the Board represent
critical components of efforts to eliminate the barriers
confronting individuals with disabilities.
REHABILITATION COALITION'S FY 84 APPROPRIATION RECOMMENDATIONS FOR PROGRAMS
AUTHORIZED UNDER THE REHABILITATION ACT OF 1973, AS AMENDED
($ in millions)
Rehabiliation
Appropriations
FY 1984
President's
Coalition
Program
FY 1981 FY 1982 FY 1983
Authorization
1984 Request
Recommendation
Basic State Grants
854.259
863.04
943.9
Pending
943.9
1,037.8
Training
21.68
19.2
19.2
Pending
19.2
25.5
Independent Living
18.0
17.28
17.28
Pending
17.28
45.0
National Institute of
Handicapped Research
29.75
28.56
30.06
Pending
30.06
37.5
Discretionary Service
Projects:
Client Assistance
371
3.0
3.0
1.734
Pending
-0-
3.0
Special Projects for
the Severely Disabled
9.765
8.855
11.259
Pending
10.295
12.21
Migrant Workers
1.325
.942
.951
Pending
.741
.942
Helen Keller Center
3.2
3.137
3.5
Pending
3.5
3.5
Comprehensive Rehab-
ilitation Centers
1.82
-0-
-0-
Pending
-0-
2.0
Technical Assistance
.23
.25
-0-
Pending
-0-
.25
Projects with Industry
5.25
7.51
13.0
Pending
10.908
13.0
Evaluation
1.82
-0-
-0-
Pending
-0-
2.0
Service Grants to
Indian Tribes
.65
.624
.65
Pending
.65
.65
(CON. 'T)
Rehabilitation
Appropriations
FY 1984
President's
Coalition
Program
FY 1981 FY 1982 FY 1983
Authorization
1984 Request
Recommendation
Discretionary Service
Projects (con. t) :
Special Recreation
2.0
1.884
*
Pending
-0-
2.0
National Council on
the Handicapped
.205
197
.193
Pending
.193
.193
Architectural and Trans-
portation Barriers
Compliance Board
2.3
1.9
2.02
Pending
1.7
2.02
372
*
As this document goes to press, RSA does not intend to allocate any of the 1983 service
project appropriations for Special Recreation Programs Many observers contend, however,
that the Congress intended to appropriate $1.884 million for these programs.
373
Southern Illinois
SIU
University at Carbondale
Carbondale, Illinois 62901
Rehabilitation Institute
Division of the College of Human Resources
618-536-7704
June 30, 1983
Judy Wagner
House Sub Committee on Select Education
U. S. House of Representatives
Washington, D.C. 20515
Dear Ms. Wagner:
During a discussion at the National Rehabilitation Association
(NRA) Second Legislative Seminar, March 22-25, 1983 in Washington,
D.C., I raised some concerns about a proposal to use a weighted case
outcome system for distributing case service funds to the states
for their basic state grant Vocational Rehabilitation (VR) programs.
My primary objections were that the proposed system was overly
simplistic, i.e., it ignored both the experience of business and
industry as to the pitfalls of Management by Objectives (MBO),
and the deficiencies of the research base in related areas of
rehabilitation. At that time, you and several others asked if I
would share copies of this research information, to which I agreed.
Unfortunately work and personal commitments precluded my delivering
on that promise in a timely fashion and for that I sincerely apologize.
I am, however, providing a summary of the requested information
herewith.
In 1978, I reviewed the literature from both general management
and rehabilitation on the use of objectives for improved management
of the rehabilitation system. Enclosed is a copy of the published
results of that study, the proper citation for which is:
Lorenz, J.R. Setting performance objectives & evaluating
individual performance in rehabilitation settings.
Journal of Rehabilitation Administration, 1979, 3, 5-12.
The reference list at the end of the article includes those studies
and papers upon which my conclusions were based. I have under-
lined those sections from the article which document my concerns.
I will, however, attempt here, to summarize for your convenience,
the essence of what we know and do not know both from business and
industry, as well as rehabilitation about MBO type systems. This
helped form the bases of my objections to the proposed systems. We know
that the use of outcome measures for management purposes does have
an effect on the entire production or service enterprise involved.
374
The implementation of such a system nationwide, without adequate
research and demonstration, could, and likely would, cause undesirable
side effects. One need only examine the undesirable impact of the
use of the current "26 closure" system in Vocational Rehabilitation,
or the "body count" in Viet Nam to see the potential abuse about which
I am talking. Adequate research and demonstration could avoid such
negative surprises.
We know that for any such system to work, it must have had
major involvement at the developmental stages from those who will
implement it. The system which was proposed had no such meaningful
input. Moreover, the responsible use of such a system mandates
the need for appropriate training for administrators and supervisors
throughout the system prior to or at least concurrent with implementa-
tion. Nothing in the proposal even remotely addressed this issue.
Finally, the clearest findings from business and industry
show that such systems must not only include the "what" objectives,
but also the "how" objectives. The one thing we can conclude from
the rehabilitation research literature is that we know very little
about the "how" component. If our true concern in this proposed
federal legislation is ensuring that handicapped people get
appropriate and high quality service (remember most VR clients only
get one opportunity with one counselor for these services); then
it is essential that we emphasize a growth and development model
with the states. To use a judgement and punishment model would only
ensure that clients in states with poorer track records would get
even less in the way of needed services and resources.
In short, the basic concept underlying this proposal, while
having some merit, was naive when existing research results are
considered. It is far too simplistic in its design since it ignores
the research capability of the NIHR as well as the training capacity
within RSA. I would be most pleased to address any further questions
you might have, or to embellish any additional areas of the literature
upon. request. Let me also assure you that I am now able to provide
a much more timely response. I hope that this is still of some help
to you, thank you for your patience.
Yours sincerely,
Jerome R. Lorenz, Ph.D., CRC
Professor and Director
JRL/jlh
cc: Jack Duncan
375
SETTING PERFORMANCE OBJECTIVES
AND EVALUATING INDIVIDUAL
PERFORMANCE IN REHABILITATION
SETTINGS
Jerome R. Lorenz
Southern Illinois University at Carbondale
This paper constitutes an attempt to bridge, the
individual performance, and to the type of objectives
gap between rehabilitation and management re-
to set, are explored. The concepts of "what" and
search by a review of the current literature from
"how" objectives are investigated and a specific ap-
both fields as it relates to setting performance objec-
proach for setting objectives and evaluating individ-
tives and evaluating individual performance in reha-
ual performance in a rehabilitation setting is
bilitation settings. Questions relating to the reasons
discussed.
for setting performance objectives and evaluating
Giblin and Ornati (1977) define the optimization
(p. 17). Harvey (1977) contends that this dehuman-
of human resources as "the condition in which a set
izing process is done on purpose:
of interdependent, goal related relationships, each
peculiar in its component parts to a specific organi-
All organizations have two essential purposes.
zation, are simultaneously satisfied to the highest
One is to produce widgets, glops and fillips.
possible degree without unacceptably lessening the
The other is to turn people into phrogs. In
satisfaction of other significant goals" (p.5). To that
many organizations, the latter purpose takes
end, they state, it is essential that tasks performed
precedence over the former. For example, in
by employees be related to organizational goals. In
many organizations, it is more important to fol-
contrast to the optimization of human resources,
low the chain of command than to behave sen-
Harvey (1977) uses a humorous satire to tell us the
sibly. (p. 17)
many ways in which organizations reduce compe-
tent, dedicated employees to the status of phrogs.
A second essential condition put forward by
According to Harvey, phrog is spelled with a ph be-
Giblin and Ornati (1977) is that the majority of
cause all persons reduced to that lowly status "try to
work time must be devoted to tasks which relate to
hide their phroginess, from themselves and others
organizational goals. But Harvey (1977) maintains
Jerome R. Lorenz, is Associate Professor and Director of the
Rehabilitation Institute. Southern Illinois University at Carbon-
Special thanks are given to Irene B. Hawley, Ph.D., Assistant
dale. He received his MA-in Counseling and Behavioral Studies
Professor, Rehabilitation Institute, Southern Illinois University at
(Rehabilitation Facility Administration) and his Ph.D. in Be-
Carbondale for her critical comments and suggestions on the
manuscript.
havioral Disabilities (Rehabilitation Counseling Psychology) both
from the University of Wisconsin-Madison. He has worked as a
rehabilitation facility administrator. vocational evaluator, and
rehabilitation counselor. He has authored and conducted
This paper is based upon a presentation made on April 26.
numerous research, training. and service grant projects for
1978 at St. Petersburg Beach, Florida, for the Region IV
various state and federal agencies. He has authored numerous
Short-Term Training Conference entitled "Human Resource
research and practice articles in a variety of professional jour.
Optimization in State Vocational Rehabilitation Agencies." The
nals. Presently he is President of the National Rehabilitation Ad-
conference was conducted by the Emory University Rehabilita-
ministration Association.
tion Research and Training Center with funds from the Rehabil-
itation Services Administration (Grant #45-P-20613/4-01).
376
that "most phrogs (organizational employees) spend
the face of decreasing or; at least, nonexpanding re-
more time flicking flies in the fog than in draining
sources. Programs that are not highly productive
the swamp. As best as I can tell, their behavior is
will be eliminated or reorganized. Such pressures are
circular. If they spend time draining the swamp,
somewhat new to the field of rehabilitation; unti
there would be no flies to flick and no phrogs. For
recently it had been assumed that "doing good
that reason, it is very important to maintain the
things for handicapped people" was the "Lord':
swamp as it is rather than drain it" (p. 18).
work" and thus was to be supported without ques
tion. One need only to look at the strong bipartisar
Thirdly, Giblin and Ornati (1977) believe that the
support of rehabilitation legislation prior to 1973
tasks a worker performs should reflect the highest
However, as Rule and Wright (1974) point out, the
ability level of that worker; Harvey (1977), on the
1973 Rehabilitation Act was the first such legislation
other hand, suggests that the better a phrog can
in history to be vetoed, not just once but twice in
tolerate the loneliness of his lily pad, the more com-
two years, on grounds of being inflationary and
petent he becomes at speaking the Language of Rib-
relatively ineffective, i.e., providing services which
bit, the more facile he becomes in flicking flies, the
resulted in jobs that paid poverty wages to a rela
more skillful he becomes at appropriating others lily
tively small number of the least disabled persons
pads, and the more adroit he becomes at maintain-
Rule and Wright (1974) strongly suggest that what i
ing the swamp, the more likely he is to become
needed is better accountability, including the setting
fresident" (p. 18).
and attainment of clear goals reflecting the basi
purpose of rehabilitation programs in this country
Finally, Giblin and Ornati (1977) take the
and that performance in relation to those goals mus
position that structure and technology must be inte-
be tied to the intrinsic and extrinsic reward system
grated to ensure improved-task performance. Harvey
of the agency.
(1977) however states that most organizations really
engage in organizational development by deception
(ODD) or cosmetic organizational development. He
Unfortunately, according to Coven (1977), th
describes ODD as "any activity designed to facilitate
fact that accountability goals and methods ar
phrog kissing phrog chorus building, interlily-pad
viewed by staff as imposed from the top in a nor
conflict resolution, phrog sensing, phrog style assess-
democratic fashion while failing to meet eithe
ment, marsh groups, tadpole development and
counselor or client needs frequently results in resi:
phrog coaching in the absence of swamp drainage
tance and conflict: Since they almost always enta
and area reclamation are examples (p. 18). With
the appraisal of individuals, the concepts an
regard to performance appraisal Harvey (1977) notes
processes of accountability produce a great deal (
that phrogs "are ultimately evaluated for what they
anxiety among those likely to be evaluated.
do in their own mud flats," not "for how well they
sing in the chorus" (p. 17).
Now the supervisors' and managers' dilemma be
comes clear. If we are to survive in today's politics
Is it all as bad as Harvey (1977) sees it, or as cut
arena, it is absolutely essential for management 1
and dried and mechanistic as Giblin and Ornati
set clear and relevant performance objectives and 1
(1977) suggest? The purpose of this article is to help
evaluate individual performance against those objed
answer this question by reviewing the literature
tives. On the other hand such procedures produc
dealing with bridging the gap between rehabilita-
anxiety, resistance, and conflict among employee
tion and general management research in an effort
Managers and supervisors have traditionally ha
to identify ways of setting performance objectives
three primary roles: (a) to achieve organization
and evaluating individual performance so as to
goals, (b) to judge (evaluate) individual performan
optimize human resource utilization in rehabilita-
and make decisions about salary and promotio
tion.
and (c) to help develop effective and promotab
employees (Beer and Ruh, 1976). Effective perforr
ance in that third role is best accomplished by firs
Why Set Performance Objectives & Evaluate Indi-
line supervision which emphasizes guidance ar
vidual Performance?
feedback. Beer and Ruh (1976) go on to point o
that even in business and industry these roles oft
We in rehabilitation are living in an age of ac-
become confused and conflicting. In most organiz
countability. Given the nation's economic condition,
tions. it is that third role, employee developmer
it is highly unlikely that large amounts of new re-
that is most difficult.
sources will be allocated to the rehabilitation system.
In fact, it is far more likely that there will be in-
Unlike business and industry, rehabilitation in t)
creasing pressure for greater and greater output in
country has devoted very few resources to increasi
377
the effectiveness of supervisory personnel (Aiken,
ing to Beer and Ruh (1976), that it produces results
Smits, and Lollar, 1972). Exclusive emphasis on pro-
while avoiding any discussion of how the goals are
duction and on obtaining organizational objectives
accomplished. In effect, it allows the supervisor to
only results in initiation of structure at the expense
avoid dealing with "emotionally laden interpersonal
of staff development and satisfaction. We need (a)
situations" (p. 59). The question becomes quite
more research into the staff development component
simply, "did you or didn't you accomplish the goal?"
of the rehabilitation supervisor's job and (b) better
Of course, if employees are to improve they need to
training of supervisors for that job (Aiken et al.,
understand what behaviors must be modified or
1972). Beer and Ruh (1976) cite research in business
adopted for best results. Moreover, if management is
and industry to show that the supervisor's role as a
to help employees to develop, it must be able to
judge interferes with his/her role as staff developer
identify the behaviors that lead to the desired per-
They go on to suggest the Performance Management
formance; this, however, is not always the case
System (PMS) as a potential solútion (to be explored
(Beer and Ruh, 1976). In addition, failure to attend
more fully below). Giblin and Ornati (1977) point
to the "how" of accomplishment can result in short-
to the underutilization of large numbers of em-
term gains but long-term damage to the organiza-
ployees, resulting in high turnover and less than
tion. An example might be a regional supervisor
optimal mission accomplishment. They suggest that
who, in an effort to increase closures for an ex-
a goal-orientated management process would help to
tended time period, provides services only to the
alleviate this situation by improving leadership prac-
least severely handicapped; as a result, a number of
tice, communication, and morale, and by a gener-
the resources serving the severely handicapped go
ally more efficient utilization of human resources.
out of business and thus are no longer available to
the region.
Performance appraisal in terms of the established
goals is essential if there is to be accountability in
the system. Burke and Wilcox (1963) recognize per-
In a study by Downes, McFarland, and Alston
formance appraisal as a widely practiced manage-
(1974), there was considerably more agreement
ment activity used to provide (a) a rational basis for
among rehabilitation counselors on the use of pro-
promotions and salary increases, (b) a framework
cess objectives for performance appraisal than there
for long-range personnel planning, and (c) a device
was on outcome objectives, in particular "Status 26"
for training and coaching. It is in this third area
criteria. While the methodology of that study was
that most problems seem to develop, and where the
weak and not entirely consistent with other litera-
least research is available. As a result, the develop-
ture, it is still interesting to note that process or
mental aspects of many performance appraisal
"how" objectives seemed to be more agreeable and
systems are at best hard to find and all too often
less anxiety-producing to rehabilitation counselors
nonexistent.
than outcome objectives.
Levinson (1976) summarizes the thinking in this
What Types of Objectives Should Be Set?
area quite well. While outcomes are important and
most performance appraisal systems focus only on
Performance objectives can be classified into two
results, there may be some truth to the old adage,
types: those related to the "what" of performance
"it's not the winning or losing that counts, but how
f(or outcome) and those related to the "how" of per-
you play the game" (p, 50). It would seem then that
formance (or process). Outcome objectives, which
both types of objectives should be set and appraised.
specify the status of the client following provision of
The remainder of this section will deal with the
service, should reflect the benefits the client has re-
"what" and "how" objectives related to rehabilita-
ceived as a result of the program. Process objectives,
tion.
which relate to specific tasks performed by staff
during the rehabilitation process, are formulated on
The "what or outcome objectives. The type of
the basis that, if these tasks are performed properly,
outcome measure used impacts on the entire system,
the probability of a successful client outcome is en-
including the management information system
hanced (Commission on Accreditation of Rehabilita-
(MIS); the agency organizational structure; clients'
tion Facilities [CARF], 1977).
hopes and expectations; performance evaluation of
counselors, including advancement and motivation;
In recent years, Management By Objectives
the program evaluation system; and the training of
(MBO) has enjoyed increasing popularity. This
new counselors (Backer, 1977); in effect, it literally
approach focuses on the results or the "what" of
defines the reality of rehabilitation services. In
production rather than on the means or "how" of
recognition of this impact, and in the face of strong
production. The reason for its popularity is, accord-
demands for accountability, both the Department of
378
Health, Education, and Welfare's Rehabilitation
system which gives equal credit for each "26"
Services Administration (DHEW/RSA) and the
closure regardless of inputs, throughputs, and out-
Commission on Accreditation of Rehabilitation Fa-
puts may motivate counselors to behave in ways that
cilities (CARF) have required the institution of Pro-
are not in the best interests of the client, such as
gram Evaluation (PE) systems and set standards for
creaming (Hawryluk, 1972; Rule and Wright, 1974).
these systems in the various state vocational rehabili-
tation (VR) agencies and accredited rehabilitation
Other criticisms of the "Status 26" closure include
facilities. At a minimum both agencies require that
the following: It treats temporary data as if they
the PE system provide the information needed to
were permanent, is a very crude indicator, fails to
judge the worth of a program and to make neces-
recognize quality of placement, fails to recognize
sary program improvements. The most frequently
client gain, may militate against good rehabilitation
used and long revered outcome measure/objective,
practice, fails to recognize why client sought services
the "Status 26" closure, clearly falls short of both
in the first place, ignores differences in caseload and
sets of standards for PE systems (Backer, 1977). Since
geographic difficulties, misses "Status 28" made
the "Status 26" closure has been so popular as an
significant gains, militates against the severely
outcome measure/objective it would seem worth-
handicapped, is not helpful in improving counselor
while to examine it in some depth.
performance, completely ignores nonvocational fac-
tors, and treats clients' achievement as if it were the
Why has the "Status 26" closure been used so con-
agency's (Backer, 1977; Coven, 1977; Hawryluck,
sistently and for such a long time, even in the face
1972; Thomas, Henke and Pool, 1976). Vash,
of severe criticism? In large part this is due to the
quoted in Backer (1977), refers to an article which
extraordinary success of this measure/objective in
the political, legislative, and funding arenas. It is a
likened what happens when the State-Federal
very concrete criterion, easily transformed into
VR program counts numbers of 26 closures with
financial values, and hence more appealing than ab-
what happened in My Lai when "body count'
stract quality-of-life measures to those persons who
became the measure of whether we were win-
have to make tough financial decisions with limited
ning the war. The message was, "Get bodies,
resources. The fact that it has long been a part of
you have to get bodies!" In My Lai, that meant
the VR agency's MIS systems and of the R-300
civilians, including children. In VR, it may
report allows for year-by-year comparability virtual-
mean the dubiously or very mildly disabled.
ly all the way back to the beginning of the civilian
(p. 19)
rehabilitation systèm in this country. Any change,
no matter how good, would not only jeopardize this
Not only is the "Status 26" measure/objective con-
advantage but would also violate some 50 years of
ceptually weak but since it is used for performance
inertia. Lastly, while many of the shortcomings of
evaluation and hence, for the distribution of re-
the "Status 26" criterion have been recognized for a
wards, it can and does exert a potent influence on
long time, they are not overly visible and hence
behavior. To the extent that the mere accumulation
have been relatively easy to ignore (Backer, 1977).
of "Status 26" closures does not reflect the overall
purpose of the rehabilitation program in this coun-
What are some of the problems of using the
try, its establishment as the sole outcome objective is
"Status 26" closure as the principal outcome meas-
counterproductive. Counselors are openly challeng-
ure/objective? The basic difficulty is that it com-
ing it as a measure/objective, characterizing it as
bines and confounds a number of distinctly different
dishonest and incomplete. Thomas et al. (1976)
outcomes and treats them as if they were equivalent
suggest that the "Status 26" closure experience has
indices of success. Some of these outcomes include
caused many a rehabilitation counselor to learn to
categories such as: practice of a profession, other
work around it, leave, or learn to play the game. It
full-time competitive employment, less than full-time
deprofessionalizes counselor and supervisor alike.
competitive employment, self-employment, home-
making, farm or family work (including payment in
Outcome measures/objectives which, according to
kind), sheltered employment, home industries, and
the First Institute on Rehabilitation Issues (Backer,
other gainful homebound work (Backer, 1977; Rule
1977). should replace the simple "Status 26" closure
and Wright, 1974; Worrall, 1978). The lack of an
include vocational functioning and potential, econ-
accurate indicator strains both the internal and ex-
omic independence, physical functioning, and psy-
ternal evaluation of the system by making it diffi-
chosocial functioning. Other authors have called for
cult, if not impossible, to evaluate both the effective-
increased emphasis on the severely disabled and on
ness of counselor performance and the cost-benefit
the provisions of the 1973 Rehabilitation Act. for
ratio on tax dollars spent (Worrall, 1978). Any
consideration of the nature and quality of service,
379
removal of the problem of secondary gains, some
The "how" or process objectives. Beer and Ruh
consideration of occupational mobility, and, at a
(1976) have studied the Corning Glass experience
minimum, for multiple measurements (Backer, 1977:
with MBO and concluded that "how" or process ob-
CARF, 1977; Hawryluk, 1972; Thomas et al.,
jectives and assessments should be used in conjune-
1976).
tion with MBO so as to optimize employee develop-
ment and human resource utilization. It should be
Backer (1977) has provided a very extensive re-
made clear that this is in no way an attempt to re-
view of client variables that should/could be ad-
create the trait-factor approach to employee ap-
dressed by new outcome measures and of measures
praisal used in the 1950s in this country. The traits
potentially available as alternative outcome objec-
underlying that approach were vague and subjective
tives. In the following, three general classes of out-
at best; and a high rating on most jobs tended to
come objectives/measures will be discussed briefly,
require god-like qualities on the part of the
viz., actuarial/weighted closure or caseload profiles,
employee. Proven largely ineffective, such a system
scales, and benefit cost approaches.
is not advocated here. What is proposed instead is
the in-depth study of the modus operandi of success-
ful workers as a basis for extensive training. goal set-
Probably the most promising alternative approach
ting, appraisal, and feedback to employees in a
to the "Status 26" approach is a weighted case
system that would parallel MBO. In essence, such a
closure system that takes into account the fact that
system would provide employees with specific be-
some clients are more difficult to place than others,
havioral information on how to do the job better
recognizes client gain, and seems to provide a far
(Beer and Ruh, 1976).
better measure for service criteria, counselor per-
formance, and cost benefit. Most weighted systems,
while somewhat problematic, have proven prefer-
One approach that was fairly popular in the
able to the current "Status 26" closure measure
management literature during the early 1970s was
(Backer, 1977: Worrall, 1978). Having reviewed a
the Behaviorally Anchored Rating Scale (BARS)
substantial number of these weighting schemes,
which attempted to capture employee performance
Worrall (1978) concludes that they are only as good
in multi-dimensional behaviorally specific terms. It
as the data upon which they are based. He further
utilized a critical incident technique to create
points out that these systems can be constructed to
performance dimensions that were subsequently re-
include incentives for working with and for the
translated and scaled. Billed as vastly superior to the
severely handicapped, and that such measures can
vague trait approach, this technique purported to
be used to evaluate and compare the work of indi-
enhance its reliability and validity by casting the
vidual counselors. Walls and Moriarity (1977) sug-
supervisor in the role of observer rather than that of
gest a slight modification of the weighted case clo-
judge. Research on the use of this tool with a
sure approach, namely, the caseload profile which
number of different occupations has led to the fol-
not only avoids the problem of mixing nonadditive
lowing conclusions: Leniency effects are inconclu-
and nonlinear types of data but gives the counselor
sive. Dimension independence is largely undemon-
substantially better and more complete information
strated and reveals significant halo effects. Reliabil-
upon which to base needed improvements.
ity is moderate and is only slightly higher than
alternate techniques. There is currently little reason
The use of scales has been proposed to measure
to believe that BARS is superior to other employee
client gains other than narrowly vocational out-
evaluation instruments. However, we are cautioned
comes. Westerhide and Lenhart (cited in Worrall,
not to throw the baby out with the bath: An assess-
1977), after fully reviewing these approaches, con-
ment procedure for the "how" objective attainment
clude that they all fail to fully objectify what they
is clearly needed, and some form of behavioral
are measuring; moreover their abstractness greatly
approach seems to hold the most promise (Schwab,
restricts their utility for policy formulation. One
Hineman, and DeCoths, 1975).
scale that in the opinion of this author seems to have
particular merit in terms of its theoretical and
Beer and Ruh (1976) describe the development
statistical rigor is the Human Service Scale (Reagles
and Butler, 1976).
and use of the Performance Description Question-
naire for the "how" portion of the employee
Benefit cost, while conceptually sound, presents
appraisal at Corning Glass. While they report
massive measurement difficulties and requires com-
general satisfaction with this instrument and ap-
plex and somewhat problematic mathematical mod-
proach, no information is given on the performance
of the instrument with respect to the indicators cited
els and assumptions (Worrall, 1978).
by Schwab et al. (1975).
380
Some attempts have been made to apply similar
How Do You Evaluate Performance and What Do
approaches specifically 'to rehabilitation (Bolton,
You Do With The Results?
1978; Fraser and Wright, 1975; Greenwood and
Cooper, 1976). Bolton's (1978) assessment of the
As has been mentioned earlier, after using the
state of the art in this area has led him to conclude
MBO system for several years the Corning Glass
that our knowledge of counselor behaviors that pro-
Company found that it had several positive features
duce successful rehabilitation outcomes is virtually
as well as some distinct disadvantages. The Per-
nonexistent. While recognizing that assessment of
formance Management System (PMS) was developed
how the counselor achieves results is essential, he
in an effort to capitalize on the positive aspects.
strongly suggests that it should only be used for
Since the field of rehabilitation has only recently be-
diagnostic purposes at this time.
come concerned with MBO and the issue of
accountability, we may be able to avoid the pitfalls
of our counterparts in business and industry by
How Do You Set Performance Objectives?
learning from their experience. Rather than focusing
solely on the "what" of performance we should
include the "how." Figure 1 shows how this might
Counselors are frequently required to submit to
be accomplished by means of the PMS model.
changes in reporting requirements and in the
Essentially PMS has three parts, viz., MBO, Per-
manner in which their performance is appraised,
formance Development and Review (PDR), and
with little or no opportunity for input. If counselors
thought that such changes would enhance the mea-
surement of their performance and provide signifi-
Performance
cant feedback so as to help them do a better job,
Management
development and
by Objectives (MBO)
review (PDR)
they would probably respond more positively. For
the most part, they tend to view such changes as
Agree on objectives
Observe behavior
simply more paperwork and thus something to be
Set Criteria
Describe incidents
resisted (Backer, 1977).
typical of the person
Make plans
Analyze data
Staff should be totally involved in creating both
the "what" and "how" objectives against which they
Execute plans
Discuss problems
will be assessed. Such involvement provides for sig-
and goals
nificant input, subsequent ownership, and thus ac-
Measure results
Make plans
ceptance of and commitment to such a system
(CARF, 1977). Involvement is required both during
Review results
Review progress
the group planning phase for the system overall and
during the individual negotiation phase which
Begin new cvcle
Begin new cycle
should result in a job contract for a defined period.
Performance results
Such an approach requires that the employee have
evaluation (PRE)'
the skills to effectively engage in the negotiation.
Both the supervisor and the employee must agree
Make salarv decisions
not only on the outcome objectives but on the pre-
Make placement decisions
requisite specific behaviors/tasks (Burke & Wilcox,
1963; Turner and Lee, 1976a).
Figure 1. Performance Management System (PMS)
(Beer and Ruh, 1976)
A specific example of the use of such an approach
Performance Results Evaluation (PRE). What makes
in rehabilitation is the Objectives Priorities System
the PMS approach so unique is its conceptualization
(OPS) as described by Kay (1978). A modification of
in terms of these three distinct and temporally sepa-
the CARF (1977) system for individual counselors,
rate, yet interactive aspects (Beer and Ruh, 1976).
OPS is, in essence, a refined MBO system which
An absolutely essential ingredient of this system is
prioritizes objectives and provides a composite index
the performance improvement plan that is included
score. Negotiation is essential if motivation is to
under the PDR (Schlesinger, 1976).
occur. It requires that there be a clear logical rela-
tionship between clients and services, and between
It is suggested that Kay's (1978) OPS system take
purposes and measurable objectives. Otherwise the
the place of the MBO portion of the PMS in rehabil-
resulting contract will be purely arbitrary and will
itation settings. The PDR portion, however presents
not produce the desired effect.
a problem. Bolton's (1978) findings suggest that we
381
know far too little about this area to be able to con-
proach to connecting the MBO/OPS and PDR with
duct an effective performance development review.
the PRE. They propose a system of performance
This certainly underscores our urgent need for re-
contracting as the sole or at least primary basis for
search in this area. Such research should include at
pay increases and promotion. They further note
lease an attempt to use the Performance Description
that, to be successful, such a system must allocate
Questionnaire approach. In the interim we should
sufficient funds to pay maximum merit increases to
use what we know strictly for diagnostic purposes,
all employees who successfully complete their con-
i.e., for the purpose of assisting employees who are
tract. In addition, a true cost-of-living adjustment
having trouble, while minimizing the impact of the
must be built in if a real reward is to be given.
PDR portion of the model on the PRE.
Coven (1977) suggests that accountability data
While we are somewhat deficient in terms of the
should not be used for judging and blaming the
content of the PDR portion of PMS, we certainly
employee but rather for promoting growth and
have good information relative to how it should be
development. The PMS system put forward by Beer
approached with the employee. Burke and Wilcox
and Ruh (1978) allows the supervisor to both judge
(1963) have outlined four conditions necessary for
and develop employees. Backer (1977), CARF (1977),
successful performance appraisal: a) High levels of
and Turner and Lee (1976a) support the idea of
subordinate participation are essential in the devel-
attempting both with employees.
opmental interview, b) the supervisor must be per-
Thus it may not be absolutely necessary for all of
ceived by the employee to be helpful rather than
us to turn into phrogs (Harvey, 1977) in order that
critical, c) the supervisor must be willing to provide
the organizations for which we work be accountable,
solutions to job problems that are hampering the
It just requires that supervisors be properly trained
subordinate, d) both must jointly set specific goals
in goal setting and performance appraisal. Goal set-
for the subordinate for the immediate future. This
ting should include not only "what" objectives but
approach is, of course, not limited to the develop-
"how" objectives and be discussed by the supervisor
mental interview but reflects a general supervisory
in a supportive developmental fashion. There should
style. There is good research evidence to show that
these skills can be learned; it would seem most
be a clear link between the employee's performance
important that rehabilitation supervisors be given
(both "what" and "how") and discussion regarding
pay and promotion. Moreover, supervisors must es-
training in them.
tablish goals in a like fashion with their supervisors
With regard to the PRE portion of the model,
in order to encourage them in turn to engage in
Turner and Lee (1976,b) provide and excellent ap-
employee development behavior.
References
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human resources. Journal of Rehabilitation Administration,
Aiken, W.J., Smits, S.J., and Lollar, D.J. Leadership behavior
1977, 1 (2), 4-14.
and job satisfaction in state rehabilitation agencies. Person-
Greenwood, R. and Cooper, P. The case review technique for
nel Psychology, 1972, 25, 65-73.
assessing rehabilitation counselor performance. Journal of
Backer, T.C. New directions in rehabilitation outcome measure-
Applied Rehabilitation Counseling, 1976, 7, 124-127.
ment. Washington, D.C.: Institute for Research Utilization,
Harvey, J.B. Organizations as phrog farms. Organizational
1977.
Dynamics, 1977, Spring, 15-23.
Beer, M., and Ruh, R.A. Employee growth through performance
Hawryluk, A. Rehabilitation gain: A better indicator needed.
management. Harvard Business Review, 1976, July-August,
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59-66.
Kay, H.B. Reconciling program goal conflicts. Journal of Reha-
Bolton, B. Methodological issues in the assessment of rehabilita-
bilitation Administration, 1978, 2, 18-26.
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Levinson, H. Appraisal of what performance. Harvard Business
letin, 1978, 21, 190-193.
Review, 1976, July-August, 30-32, 34, 36, 40, 44, 46, 60.
Burke, R.J. and Wilcox, D.S. Characteristics of effective em-
Reagles, K.W., and Butler, A.S. The human service scale: A
ployee performance review and development interviews.
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Personnel Psychology, 1963, 22, 291-305.
1976, 42 (3). 34-38.
Commission on Accreditation of Rehabilitation Facilities. Pro-
Rule, W., and Wright, K. A new slant to establish values: Ac-
gram evaluation in vocational rehabilitation facilities, Chi-
countability and counselor reward. Journal of Applied Re-
cago: Author, 1977.
habilitation Counseling. 1974, 5, 191-195.
Coven, A.B. Accountability in rehabilitation: The need for a
Schlessinger, L. Performance improvement: The missing com-
humanistic model. Journal of Applied Rehabilitation Coun-
ponent of appraisal systems. Personnel Journal, 1976, June,
seling, 1977, 7, 228-236.
274-275.
Downes, S.C., McFarland, F.S., and Alston, P.P. Survey of the
Schwab, D.P., Hineman H.G., and DeCaths, T.A. Behaviorally
NRCA membership regarding the basis for evaluating coun-
anchored rating scales: A review of the literature. Personnel
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Psychology. 1975, 28, 549-562.
seling, 1974, 5, 196-200.
Thomas R.E., Henke, R., and Pool, D.A. Accountability in vo-
Fraser, R.T., Wright, G.N. Improving rehabilitation personnel
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management. Journal of Rehabilitation, 1975, 43, (3),
22-24.
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Turner, A.J., and Lee, W.E. Motivation through behavior modi-
Walls, R.F., and Moriarity, J.B. The caseload profile: An al.
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1976, 9 (10), 1-4. (b)
COMMENTS ON THE LORENZ THEORY ARTICLE
By Anthony S. DeSimone, RSA Regional Program
ments. Counselors, through a representative
Director, Region X, Seattle, Washington.
committee, express their concerns directly to top
level management and join in the development
I have reviewed "Setting Performance Objec-
of policies and procedures affecting case flow
tives and Evaluating Individual Performance in
and process. The net result is better services to
Rehabilitation Settings," hoping for a reason-
handicapped people.
ably clear review of the issues and potential so-
lutions in this most critical area. After reading
Surely the VR system is a dynamic concept
the article, I became more impressed with the
and despite its critics it will survive as long as
author's inexhaustable use of acronyms and ref-
we can make healthy constructive recommenda-
erences than the subject with which he was ad-
tions for improving accountability.
dressing. Admittedly Dr. Jerome Lorenz has
chosen a most difficult subject to write about.
In my opinion it strikes at the very heart and
soul of the rehabilitation process. As an Admin-
By Mary E. Shortall, Training Officer, Vocational
istrator for the Federal program for the past 20
Rehabilitation Division, Minnesota Department of
years, I have heard discussions of this nature
Economic Security, St. Paul.
many times.
Evaluative, judgmental performance apprais-
To his credit Dr. Lorenz has attempted the
als do not provide for counselor/subordinate
almost impossible task of weaving together the
participation and mutual goal setting and will
findings of over 20 authors. While his intentions
not further employee development. The single
are of the highest order, it becomes somewhat
performance criterion, status 26 closure, cur-
difficult to follow the logic of the article. What
rently used in vocational rehabilitation en-
is clear and Dr. Lorenz deserves to be com-
courages judgmental performance reviews by
mended for it, is the need to bring these issues
supervisors because performance is evaluated
out in the open to be carefully assessed in the
only by outcome. Dr. Lorenz's review of the
hard reality of practice. What is clear is that
relevant literature indicates that the individual
public agencies have an awesome responsibility
performance appraisal process and subsequent
for developing a system of rewards or incentives
individual performance can be improved by
that goes beyond the status 26 closures. What is
using more sophisticated techniques combining
clear is that VR counselors in the public pro-
both outcome and process criteria.
gram are unique in the human services delivery
system and must be held accountable for the
Administrators and practitioners have long
authorization and expenditure of public funds.
recognized the problems inherent in the status
What is clear is that the services purchased
26 outcome criterion. It has led to distortion of
must be quality services and that handicapped
the program's intent, role conflicts for counse-
persons get the best possible service available.
lors and supervisors and has resulted in limiting
services to clients by encouraging counselors to
In my opinion, management by objectives is
screen out the more difficult clients and to
the key to the rehabilitation system both in
terminate services too early in order to obtain
terms of case management and in terms of per-
the yearly quota of "26's". The "26" outcome
formance management. In New Jersey, the
criterion fails to recognize extra effort expended
general agency sets its overall state goals after
in serving difficult populations, inadequately
management has agreed with counselors on
evaluates the quality of services provided to
their own individual expectations of achieve-
clients who are closed unsuccessfully after a
383
plan was initiated and it does not encourage the
negotiating outcome and prócess goals. A por-
tion of the Performance Management System
development of information which may be use-
ful in more effectively delivering services to tar-
could be useful to supervisors for evaluating
get disability populations. Human resources will
process and outcome performance and in devel-
be underutilized and the provision of quality
oping a performance improvement plan.
client services will be delayed until process per-
formance objectives are set. Counselors will be
The implications for staff development are
enabled to develop individual learning contracts
clear. Supervisory skills in conducting effective
more efficiently when they incorporate feed-
performance appraisals can be sharpened
back regarding both process and outcome ob-
through training in the conditions and elements
necessary for successful performance appraisals.
jectives.
Supervisors can be trained to use the Perform-
A weighted closure system, the Caseload Pro-
ance Management System which might serve as
file and the Human Services Scale, although
a desirable method to use to set objectives and
needing further refinement, offers alternatives
evaluate individual performance. A system of
for measuring outcome objectives. Process ob-
individual development planning has two signif-
jectives might be more adequately established
icant benefits. It is more likely to improve in-
and assessed through the Behaviorally Anchored
dividual performance because the-needs of each
Rating Scale of the Performance Questionnaire.
employee are identified and learning contracts
Dr. Lorenz established the importance of the
negotiated. The performance gaps of the
process used by supervisors in both setting and
agency's total program can be analyzed and
evaluating performance. He identified the Ob-
plans for improvement can be developed sys-
jective Priorities System as a tool to be used in
tematically.
Excerpts from "Up the Organization: How to Stop the Corporation
from Stifling People and Strangling Profits" by Robert Townsend
(Greenwich, Connecticut, Fawcett, 1970).
EXCUSES
TOO MUCH VS. TOO LITTLE
When you get right down to it, one of the most
Too little is almost always better than too much.
important tasks of a manager is to eliminate his
Space: Too much brings out the worst in empire
people's excuses for failure. But if you're a paper
builders. They'll fill up the excess so fast you'll wind
manager, hiding in your office, they may not tell
up with too little again. Too little makes you
you about the problems only you can solve. So get
creative in your use of people. Too much puts the
out and ask them if there's anything you can do tó
company emphasis on office grandeur, not on
help. Pretty soon they're standing right out there in
service and performance.
the open with nobody but themselves to blame.
People: One person with only half a job can wander
Then they get to work, then they turn on to success,
around and do real damage in his or her spare time.
and then they have the strength of ten.
The best organizations are sufficiently understaffed
so that if somebody does something that overlaps or
MISTAKES
invades your area of responsibility, your second re-
Admit your own mistakes openly, maybe even
action is: "Great! If you've got time to do that, you
joyfully.
do it from now on." This feeling comes right after
Encourage your associates to do likewise by com-
the first flash of territorial hostility. Organizations
miserating. with them. Never castigate. Babies learn
that have time to get into jurisdictional disputes are
to walk by falling down. If you beat a baby every
almost always overstaffed.
time he falls down, he'll never care much for
Money: A tight budget brings out the best creative
walking Beware the boss who walks on water and
instincts in man. Give him unlimited funds and he
never makes a mistake. Save yourself a lot of grief
won't come up with the best way to a result. Man is
and seek employment elsewhere.
a complicating animal. He only simplifies under
pressure. Put him under some financial pressure.
HIRING
He'll scream in anguish. Then he'll come up with a
To keep an organization young and-fit, don't hire
plan which, to his own private amazement, is not
anyone until everybody's so overworked they'll be
only less expensive, but also faster and better than
glad to see the newcomer no matter where he sits.
his original proposal, which you sent back.
384
UNITED STATES DEPARTMENT OF EDUCATION
OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES
REHABILITATION SERVICES ADMINISTRATION
WASHINGTON, D.C. 20202
July 5, 1983
Centers for Independent Living
Supported in whole or Part by Grants Under
Title VII, Part B, of the Rehabilitation Act of 1973
INDEPENDENT
LIVING
OCCASIONAL IDENTICAL LETTER
TO
TITLE VII, PART B GRANTEES
&
GRANT ASSISTED CENTERS
FY 1983
Number Twenty-four
385
UNITED STATES DEPARTMENT OF EDUCATION
OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES
REHABILITATION SERVICES ADMINISTRATION
WASHINGTON, D.C. 20202
July 5, 1983
Dear Colleague:
Enclosed is an updated directory of Centers for Independent Living supported
in whole or part by grants under Title VII, Part H, of the Rehabilitation Act
of 1973.
Shown in the left column is the grantee; the right column shows the Center(s)
supported by each grantee. There is at least one grant in each State including
the District of Columbia, Puerto Rico, the Virgin Islands, and American Samoa,
for a total of 74 grantees. Because a number of grantees have chose to contract
with more than one Center organization, a total of 156 Centers are receiving
assistance. The ratio of Federal support to total support for each grantee and
Center varies from only partial assistance to nearly full support.
Telephone numbers followed by TDD indicate that both voice and telecommunication
devices for deaf and hard of hearing persons are accessed by the same number.
Other Centers have separate lines for voice and TDD services. If only one
number is listed, it is assumed that TDD service is not available.
We would appreciate being apprised of any corrections that you may note at this
time or changes as they occur in the future. You may write to Independent Living
Projects Branch, Department of Education, Office of Special Education and
Rehabilitative Services, Rehabilitation Services Administration, 3214 MES Bldg.,
400 Maryland Avenue, S.W., Washington, D.C. 20202.
Sincerely,
arvin 78-
William J. Bean, Ph.D.
Chief, Independent Living
Projects Branch
Enclosure
386
CENTERS FOR INDEPENDENT LIVING
Supported in Whole or Part by Grants Under
Title VII, Part B, Rehabilitation Act of 1973, as amended
STATE
GRANTEE
CENTER LOCATION
ALABAMA
J.W. Cowen
Patricia M. Sheets
Division of Rehabilitation and
Independent Living Center
Crippled Children Service
3421 Fifth Avenue, South
2129 East South Blvd.
Birmingham, AL 35222
P.O. Box 11586
(205) 251-2223
Montgomery, AL 36111
(205) 281-8780
ALASKA
Theda Mason-Smith
Audrey Aanes
Division of Vocational Rehab.
Access Alaska
Department of Education
841 Dowling Road
Pouch F, M.S. 0581
Anchorage, AK 99502
Juneau, AK 99811
(907) 563-4060
(907) 465- 2814
AMERICAN SAMOA
Timothy Halnon
same
Office of Vocational Rehab.
Manpower Resources
American Samoa Government
Pago Pago, AS 96799
(684) 633-1805
ARIZONA
Roger Hodges
Kirk MacGugan
Rehabilitation Services
Arizona Congress for
Administration
Action-ILC
Department of Economic Security
1016 North 32nd Street
1400 West Washington
Phoenix, AZ 85008
Phoenix, AZ 85007
(602) 244-2766
(602) 255-3332
Sylvia Doss LaMont
Metropolitan IL Center
3333 E. Grant Road
Tucson, AZ 85716
(602) 244-2766
ARKANSAS
Theodoshia Cooper
Jerry Cooper
Division of Rehab. Services
Independent Living
Department of Human Services
Services Center
1401 Brookwood Drive
5800 Asher Avenue
P.O. Box 3781
Little Rock, AR 72204
Little Rock, AR 72203
(501) 568-7588
(501) 371-2316
TTY 568-7881
387
STATE
GRANTEE
CENTER LOCATION
CALIFORNIA
Joseph Klier, Jr.
Doug Broten
Department of Rehabilitation
C.A.P.H. IL Center
Program Development Division
605 W. Home Avenue
830 K. Street Mall
Fresno, CA 93728
Sacramento, CA 95814
(209) 237-2055
(916) 322-6604
Annette Rubino
IL Resource Center
423 W. Victoria
Santa Barbara, CA 93101
(805) 963-1359
TTD 963-0595
David Buckles
The Center for IL of
San Gabriel Valley
2231 E. Garvey Avenue
West Covina, CA 91790
(213) 339-1278
Frances Gracechild
Resources Blvd. for IL
1230 H. Street
Sacramento, CA 95814
(916) 446-3074
Brenda Premo
Dayle McIntosh Center for
the Disabled
8100 Garden Grove Blvd.
Suite 1
Garden Grove, CA 82644
(714) 898-9571
TTY 892-7070
Robert Bennett
Center for the Independence
of the Disabled
875 O'Neil Avenue
Belmont, CA 94002
(415) 595-0783
Norma Vescon
Darryl McDaniel ILC., Inc.
14354 Haynes
Van Nuys, CA 91401
(213) 988-9525
388
STATE
GRANTEE
CENTER LOCATION
Jim West
Northern CA IL Center
360 East First Street
Chico, CA 95926
(916) 893-8527
COLORADO
David L. Gies
Theresa Preda
Division of Rehabilitation
HAIL
Department of Social Services
1249 East Colfax Avenue
524 Social Services Bldg.
Suite 107
1575 Sherman Street
Denver, CO 80218
Denver, 8 80203
(303) 831-6381
(303) 866-5098
Jo Pat Dolsen
Pueblo Goodwill Industries,
Inc.
230 N. Union Avenue
Pueblo, 8 81003
(303) 544-9336
Judy Dixon
Center for People with
Disabilities
Medical Arts Building
1136 Alpine Building, BW3
Boulder, CO 80302
(303) 442-8662
Ron Halsey
Hilltop Rehabilitation Center
1100 Patterson Road
Grand Junction, CO 81501
(303) 242-8980
TTY 242-6171
Wade E. Blank
Atlantis Community, Inc.
2200 W. Alameda, Space #18
Denver, CO 80219
(303) 893-8040
Martha Lee Aaronson
The Center on Deafness
4128 S. Knox Court
Denver, CO 80236
(303) 758-1123
389
STATE
GRANTEE
CENTER LOCATION
CONNECTICUT Robert A. Voroscak
Peter Quinn
Division of Voc. Rehab.
New Horizons, Inc.
Department of Education
410 Asylum Street
600 Asylum Avenue
Hartford, CT 06103
Hartford, CT 06105
(203) 249-6275
(203) 566-5096
Arlene Brown
Center for Independent
Living
Goodwill Industries of CT
164 Ocean Terrance,
P.O. Box 3366
Bridgeport, CT 06605
(203) 336-0183
TTY 368-6511
DELAWARE
Robert W. Snider
Andrew Vincent
Division of Voc. Rehab.
Independent Living, Inc.
State Office Bldg., 7th Floor
Route 273
820 French Street
Liberty Knoll Apartments
Wilmington, DE 19891
Apt. B-1
(302) 571-3910
New Castle, DE 19720
(302) 328-1306
Carol Shaw
Easter Seal Soc. of Del-Mar
Adult Development Center
Landis Lodge
2915 Newport Gap Pike
Wilmington, DE 19808
(302) 995-6681
DISTRICT OF COLUMBIA
Vernon E. Hawkins
Don Gallaway
Rehabilitation Services
D.C. Services for IL
Administration
1400 Florida Avenue, N.E., #3
Commission of Social Services
Washington, D.C. 20002
Department of Human Services
(202) 397-8510 (TTY)
605 G. Street, N.W.,
Washington, D.C. 20001
(202) 727-3227
FLORIDA
Gerald Alonso
Donna Williams
Office of Vocational Rehab.
Disability Awareness Now,
Department of Health and
Inc. (DAWN)
Rehabilitative Services
102 NE 10th Avenue
1317 Winewood Blvd., Bldg. #6
Suite 2
Tallahassee, FL 32301
Gainesville, FL 32601
(904) 488-0058
(904) 377-5141
TDD 488-2867
TTY 377-5152
Joint project sponsored by both the State general VR
agency and the State VR agency for blind or visually
handicapped persons.
390
STATE
GRANTEE
CENTER LOCATION
(VACANT)
Self-Reliance, Inc. (CIL)
2002 G East Fletcher Avenue
Tampa, FL 33612
(813) 977-6368
TTY 977-6338
Barbara Bernhart-Logan
Space Coast Association of the
Physically Handicapped (SCAPH)
P.O. Box 2027
Satellite Beach, FL 32937
(305) 777-2964 (TDD)
Joseph Veisz
Leon Center for IL
1380 Ocala Road H-4
Tallahassee, FL 32304
(904) 575-9621 (TDD)
Jay Kaharl
Rehabilitation Institute of
West Florida
908 West Lakeview Avenue
Pensacola, FL 32501
(904) 438-3540
TTY 438-3542
Chip Gagnier, Acting Director
Center for Independent Living
130 West Central Blvd.
Orlando, FL 32801
(305) 843-2253
TTY 843-2297
Pat Erwin
Center for Survival and
Independent Living (C-SAIL)
1310 Northwest 16th Street
Room 101
Miami, FL 33125
(305) 547-5444
TTY 547-5446
Carl McCoy
Pinkney C. Seale, Jr.
Division of Blind Services
Rural Center for IL
2540 Executive Center Circle, W.
P.O. Box 818
Tallahassee, FL 32301
Quincy; FL 32351
(904) 488-1330
(904) 875-3235
391
STATE
GRANTEE
CENTER LOCATION
GEORGIA
Emmanuel Petkas
Jeffrey C. Roulston
Division of Rehab. Services
Atlanta Center for
Department of Human Resources
Independent Living
47 Trinity Avenue, S.W.
1201 Glenwood Avenue
Room 636-S
Atlanta, GA 30316
Atlanta, GA 30334
(404) 656-2952
(404) 656-6495
TTY 656-5011
TTY 656-2913
HAWAII
Lorraine Hirokawa
Kristin Mills
Vocational Rehab. and
Hawaii Center for IL
Services for the Blind Div.
677 Ala Moana Blvd., #402
Department of Social Services
Honolulu, HI 96813
P.O. Box 339
(808) 537-1941 (Island of Janu)
Honolulu, HI 96809
TTY 521-4400
(808) 548-4770
Mikey Tomita
Maui Center for IL
1446 D Lower Main Street
Room 105
Wailuku, HI 96793
(808) 242-4966 (Island of Maui)
TTY 242-4968
Chris Nagao
Big Island Center for IL
851 Leilani Street
Hilo, HI 96720
(808) 935-3777 (Island of Hawaii)
Gordon Kaluahine, Jr.
Independent Living Center
P.O. Box 3529
Lihue, HI 96799
(808) 245-4034 (Island of Kauai)
IDAHO
Kenneth Jones
Terry Hawley
Division of Vocational Rehab.
Dawn Enterprises, Inc.
State Board of Education
P.O. Box 388
650 W. State, Room 150
Blackfoot, ID 83221
Boise, ID 83720
(208) 785-5890
(208) 334-3390
A. Gene Christenson
Stepping Stone, Inc.
408 South Main
Moscow, ID 83843
(208) 833-0543
Jeananne Whitmer
same
Center of Resources for
Independent People (C.R.I.P.)
156 S. Third
Pocatello, ID 83201
(208) 232-2747
392
STATE
GRANTEE
CENTER LOCATION
ILLINOIS
Mike Steinhauer
Marca Bristo
Department of Rehab. Services
Access Living
P.O. Box 1587
505 N. La Salle Street
Springfield, IL 62705
Chicago, IL 60610
(217) 782-9432
(312) 649-7404
TDD 649-8593
Kendal Kerns
Rockford Access & Mobilization
Project, Inc. (RAMP)
1329 N. Main Street
Rockford, IL 61103
(815) 968-7467 (V/TTY)
INDIANA
Frances K. Shine
same
Allen County League for the Blind -
5800 Fairfield - Suite 210
Fort Wayne, In 46807
(219) 745-5491
IOWA
Louise Duvall
same
Iowa Commission for the Blind
4th & Keosauqua Way
Des Moines, IA 50309
(515) 283-2601
KANSAS
Robin O'Dell
Mitch Cooper
Division of Vocational Rehab.
Topeka Resource Center for
Department of Soc. & Rehab. Serv.
the Handicapped
2700 West 6th, Biddle Bldg.
421 SE Winfield
2nd Floor
Topeka, KS 66607
Topeka, KS 66606
(913) 233-6323
(913) 296-3911
TTY 233-6788
Robert Mikesic
Operation LINK
P.O. Box 1016
Hays, KS 67601
(913) 625-2521
Mona McCoy
same
Independence, Inc.
1910 Haskell
Lawrence, KS 66044
(913) 841-0333
393
STATE
GRANTEE
CENTER LOCATION
KENTUCKY
Jeanne Pherson
Betty Gissoni
Bureau for the Blind
Center for IL for the Blind
Kentucky Vocational Services
1900 Brownsboro Road
1900 Brownsboro Road
Louisville, KY 40206
Louisville, KY 40206
(502) 897-6439
(502) 893-0211
Eileen Ordover, Acting
same
Center for Accessible Living
835 W. Jefferson
Louisville, KY 40402
(502) 589-6620
TTY 752-6064
LOUISIANA
John Giese
Richard Royse
Department of Health & Human
New Orleans Center for IL
Resources
3308 Tulane Avenue, Suite 220
Office of Human Development
New Orleans, LA 70119
P.O. Box 44371
(504) 821-4981
Baton Rouge, LA 70804
TTY 821-4982
(504) 342-2277
Shirley Swanson
Independent Living Serv. Center
306 Ockley Drive
Shreveport, LA 71105
(318) 861-6682
MAINE
Denise Richards
same
Maine IL Center, Inc.
74 Winthrop Street
Augusta, ME 04330
(207) 622-5434
MARYLAND
James Fitzpatrick
Gloria Carpeneto
Maryland State Dept. of ED
Baltimore Citizens for Housing
Division of Vocational Rehab.
for the Disabled, Inc. (BCHD)
Office of Field Operations
2301 Argonne Drive, Box 242
200 West Baltimore Street
Baltimore, MD 21218
Baltimore, MD 21201
(301) 243-5445
(301) 659-2254
TTY 243-8085
MASSACHUSETTS
John J. Reilly
Robert Williams
Massachusetts Rehab. Commission
Boston Center for IL
Statler Office Bldg.
50 New Edgerly Road
20 Park Plaza
Boston, MA 02115
Boston, MA 02116
(617). 536-2187
(617) 727-2170
394
STATE
GRANTEE
CENTER LOCATION
Edwin (Ted) Abusamra
The Center for Living
and Working
600 Lincoln Street
worcester, MA 01605
(617) 853-1068
Charles Carr
Northeast IL Center
429 Broadway
Lawrence, MA 01840
(617) 687-4288
Eric Griffin
Independence Associates
Human Service Center
693 Bedford Street
Elmwood, MA 02337
(617) 378-3997
Patricia Spiller
Stavros, Inc.
691 S. East Street
Amhearst, MA 01002
(413) 256-0473
Michael Harvey
D.E.A.F., Inc.
(Development, Evaluation,
and Adjustment Facilities)
215 Brighton Avenue
Allston, MA 02154
(617) 254-4041
Ralph Calamari
Berkshire Project
496 Tyler Street
Pittsfield, MA 01201
(413) 447-7364
Irene Carpenter
The Renaissance Club
721 Branch Street
Lowell, MA 01851
(607) 452-3711
Maureen Ecker
same
Massachusetts Commission
for the Blind
110 Tremont Street
Boston, MA 02108
(617) 727-5554
395
STATE
GRANTEE
CENTER LOCATION
MICHIGAN
Robert McConnell
Ron O'Brian
Department of Education
Rehabilitation Institute
Michigan Rehabilitation Serv.
Center for IL
P.O. Box 30010
4 East Alexandrine
Lansing, MI 48909
Bicentennial Towers
(517) 373-3978
Suite 104
Detroit, MI 48201
(313) 494-9726
Alan Parnes
Center for Handicapper Affairs
1026 East Michigan
Lansing, MI 48912
(517) 485-5887 (TTY)
Jim Magyar
Center for IL, Inc.
2568 Packard Road
Ann Arbor, MI 48104
(313) 971-0277
Larry Lopez
Cristo Rey Hispanic
Handicapper Program
1314 Ballard Street
Lansing, MI 48906
(517) 372-4700
Nancy Jachim
Center for Independent Living
3375 Division, South
Grand Rapids, MI 59408
(616) 243-0846
Karen Duckworth
Kalamazoo County Center,
for Independent Living
P.O. Box 691
Kalamazoo, MI 49005-1091
(616) 345-1516
Rebecca Shuman
Midland IL Center-ARC
P.O. Box 1491
Midland, MI 48640
(517) 631-4439
Steve Kivari
Oakland Patient Environment
Nexus (OPEN)
35 West Huron, Suite 226
Pontiac, MI 48058
(313) 335-3377
396
STATE
GRANTEE
CENTER LOCATION
Steve Redmond
ARC/Ottawa County
246 S. River #65
Holland, MI 49423
(616) 396-1201
Glenn Leavitt
Glen Leavitt
Commission for the
Mid Michigan Urban Center
Blind/CIL
for Independent Living
309 N. Washington
Division of Vocational Rehab.
P.O. Box 30015
309 N. Washington
Lansing, MI 48909
P.O. Box 30015
(517) 373-9415
Lansing, MI 48909
(517) 373-9415
Glen Leavitt
Northern MI Rural Center
for Independent Living
209 W. First Street
Suite 102
Gaylord, MI 49735
(517) 732-2448
John Crews
John Crews
Senior Blind Program
Southeastern Michigan, CIL
411 G East Genesee
Commission for the Blind
Saginaw, MI 48607
Plaza Bldg., Suite 1130
(517) 771-1765
1200 6th Avenue
Detroit, MI 48226
(313) 256-1524
MINNESOTA
Marvin O'Spears
William Malleris
Division of Rehabilitation
Rochester Center for IL, Inc.
3rd Floor, Space Center
1306 Seventh St., N.W.
444 Lafayette
Rochester, MN 55901
St. Paul, MN 55101
(507) 285-1815
(612) 296-9150
TTY 285-1704
Roger Simon
Rural Enterprises for
Acceptable Living, Inc.,
(REAL)
244 W. Main Street
Marshall, MN 56258
(507) 532-2221
Walter Siebert
METRO Center for IL
1728 University Avenue
St. Paul, MN 55104
(612) 646-8342
TTY 646-6048
397
STATE
GRANTEE
CENTER LOCATION
Dick Strong
same
Minnesota State Services
for the Blind
Department of Public Welfare
1745 University Avenue
St. Paul, MN 55104
(612) 297-2467
MISSISSIPPI John H. Webb
John Lee
Division of Vocational Rehab.
Center for Independent Living
P.O. Box 1698
P.O. Box 1698
Jackson, MS 39205
Jackson, MS 39205
(601) 354-6825
(601) 961-4140
MISSOURI
Barbara Bradford
same
Disabled Citizens Alliance
for Independence
Box 675
Viburnum, MO 65566
(314) 244-3315
Margaret L. Shreve
same
The Whole Person, Inc.
7546 Troost Avenue, Suite 105
Kansas City, MO 64131
(816) 361-0304
David Tyrey
same
IL Center of Mid-MO, Inc.
111 S. Ninth, Suite 211
Columbia, MO 65201
(314) 874-1646
Don L. Gann
Max J. Starkloff
Missouri Div. of Vocational Rehab.
Paraquad, Inc.
2401 Est McCarty
4397 Laclede Avenue
Jefferson City, MO 65101
St. Louis, MO 63108
(314) 531-3050
MONTANA
Sister Janet Kennedy
same
Montana Independent Living, Inc.
1215 8th Avenue
Helena, MT 59601
(406) 449-4684
Wendy Holmes
same
Summit-IL Center
3115 Clark Street
Missoula, MT 59801
(406) 728-1630
22-065 O - 84 - 26
398
STATE
GRANTEE
CENTER LOCATION
NEBRASKA
Kristine Nolan Clare
same
Central Nebraska Goodwill Industry
Goodwill Center for IL
1804 S. Eddy
Grand Island, NE 68801
(308) 384-7896
Mike Schafer
Nancy Erickson
League of Human Dignity
League of Human Dignity
1423 0 Street
Independent Living Center
Lincoln, NE 68508
1423 o Street
(402) 474-0820
Lincoln, NE 68508
(402) 474-0158
Peg Henke
League of Human Dignity
700-1/2 W. Benjamin
Norfolk, NE 68701
(402) 371-4475
Kirk Garner
League of Human Dignity
Handicap Reach Out, Inc.
300 W. Second Street
Chadron, NE 69337
(308) 432-3393
NEVADA
Elaine Smith
Edward Buttera
Rehabilitation Division
CIL, Southern Chapter
Department of Human Resources
2401 W. Bonanza Road, Suite J
5th Floor, Kinkead Bldg.
Las Vegas, NV 89106
505 East King Street
(702) 646-0377
Carson City, NV 89710
(702) 885-4470
Karen O'Neill
Northern Nevada CIL, Inc.
790 Sutro Street
Reno, NV 89512
(702) 322-6046
NEW HAMPSHIRE
Bruce A. Archambault
Kenneth Sweet
Division of Vocational Rehab.
Granite State IL Foundation
105 Loudon Road
P.O. Box 410
Concord, NH 03301
Goffstown, NH 03045
(603) 271-3121
(603) 669-7242
399
NEW JERSEY
George R. Chizmadia
Gordon Anthony
Division of Vocational
Disabled Information Awareness
Rehabilitation Services
and Living (DIAL)
Department of Labor & Industry
234 Parker Avenue
John Fitch Plaza
Clifton, NJ 07011
P.O. Box 2098
(201) 472-5540
Trenton, NJ 08625
TTY 472-6329
(609) 292-5987
Eileen Goff
Handicapped Independence
Program (HIP)
Social Service Federation
44 Armory Avenue
Englewood, NJ 07631
(201) 568-0817
NEW MEXICO
Terry P. Brigance
Andrew Winnegar
Division of Vocational Rehab.
New Vistas IL Center
Department of Education
College of Santa Fe
604 San Mateo
St. Michaels Drive
Santa Fe, NM 87501
Sante Fe, NM 87501
(505) 982-4555
(505) 473-0550
TTY 473-1414
NEW YORK
Greq O'Connor
Burt Danovitz, Ph.D.
Office of Vocational Rehab.
Allied Resources Center for
State Education Department
the Handicapped
99 Washington Avenue
1506 Whitesboro Street
Albany, NY 12234
Utica, NY 13502
(518) 473-7620
(315) 797-4642
Pat Figueroa
Center for Independence of
the Disabled in New York
853 Broadway, Room 611
New York, NY 10003
(212) 674-2300
Michael Crinnin
Arise, Inc.
501 East Fayette Street
Syracuse, NY 13202
(315) 472-3171
Richard Manley
Westchester County IL Center
Office of the Disabled
148 Martine Avenue
White. Plains, NY 10601
(914) 682-7799
TTY 682-3408
Joint project sponsored by both the State general VR
agency and the State VR agency for blind or visually
handicapped persons (in part).
400
STATE
GRANTEE
CENTER LOCATION
Douglas Usiak
Western NY IL Project
3108 Main Street
Buffalo, NY 14214
(716) 836-0822
Darrell L. Jones
RCIL
464 South Clinton Avenue
Rochester, NY 14620
(716) 546-6990 (TTY)
Debra L. Hamilton
Capital District Center for
Independence, Inc. (CDCI)
10 Colvin Avenue
Albany, NY 12206
(518) 459-6422
TTY 459-7847
NORTH CAROLINA
Bob H. Philbeck
John Ross
Division of Vocational
Metrolina IL Center
Rehabilitation Services
909 S. College Street
Department of Human Resources
Charlotte, NC 28202
State Office
(704) 375-3977 (TTY)
620 N. West Street, Box 26053
Raleigh, NC 27611
(919) 733-5766
TTY 733-5920
NORTH DAKOTA
James O. Fine
Linda Fansler
Division of Vocational Rehab.
Center for Independent Living
ND Department of Human Services
1007 18th Street, N.W.
State Capitol
Mandan, ND 58554
Bismarck, ND 58505
(701) 663-0376
(701) 224-2907
OHIO
G.E. Minteer
Doris Brennan
Ohio Rehab. Services Commission
Services for IL, Inc.
4656 Heaton Road
25100 Euclid Ave., #105
Columbus, OH 43229
Euclid, OH 44117
(614) 438-1296;1286
(216) 731-1529
Lynn Benjamin
Total Living Concepts, Inc.
3333 Vine Street, Suite 101
Cincinnati, OH 45220
(513) 751-1795
401
STATE
GRANTEE
CENTER LOCATION
OKLAHOMA
Helen Kutz
same
United Cerebral Palsy of
Cleveland County
601 North Porter
Normand, OK 73071
(405) 321-3203 (TTY)
Roland W. Sykes
same
Physically Limited, Inc.
1724 East 8th Street
Tulsa, OK 74104
(918) 592-1235 (TTY)
OREGON
Tom Huffsmith
Vikki Rennick
Vocational Rehab. Division
Tri-County IL Program, Inc.
Department of Human Resources
8213 S.E. 17th Ave.
2045 Silverton Road, N.E.
Portland, OR 97212
Salem, OR 97310
(503) 249-1225
(503) 378-3830
Mary Alice Brown
Community Services of Lane
County
2621 Agusta Street
Eugene, OR 97403
(503) 485-6340
John Blarjeske
Nuerological Services Center
Good Samaritan Hospital
1015 S.W. 22nd Avenue
Portland, OR 97210
(503) 229-7348
Charles Young
Claude Garvin
Oregon Commission for the
Volunteer Braille Service, Inc.
Blind
1931 N.W. Flanders
535 S.E. 12th Avenue
Portland, OR 97209
Portland, OR 96214
(503) 222-1472
(503) 238-8380
PENNSYLVANIA
Chris Forbrich
Barbara Donnelly
PA Office of Vocational
Resources for Living Independent
Rehabilitation
(RLI)
Labor and Industry Bldg
4721 Pine Street
Room 1320
Philadelphia, PA 19143
Seventh and Forster Streets
(215) 476-2217
Harrisburg, PA 17120
TTY 476-2291
(717) 787-5548
Joint project sponsored by both the State general VR
agency and the State VR agency for blind or visually
handicapped persons.
402
STATE
GRANTEE
CENTER LOCATION
Judith Barricella
Harmarville Rehab. Center. Inc.
Center for Independent Living
P.O. Box 11460
Guys Run Road
Pittsburgh, PA 15238
(412) 781-5700
Greg Meehl
Erie Independence House, Inc.
Center for Independent Living
956 W. Second Street
Erie, PA 16507
(814) 459-6161
Irene Osborne
Nevil Institute for Rehab. Serv.
919 Walnut Street, Room 400
Philadelphia, PA 19107
(215) 627-3501
PUERTO RICO
Luis A. Bonilla
Maria Rosa Iturregui
Vocational Rehab. Program
Rio Piedras Rehabilitation
P.O. Box 1118
Center
Hato Rey, PR 00919
P.O. Box 1118
(809) 725-1792
Hato Rey, PR 00919
(809) 725-1792
RHODE ISLAND
William A. Messore
Herbert Lumbert
Social & Rehabilitative
Parapledic Association of
Service
RL IL Program
Vocational Rehabilitation
120 Dudley Street
40 Fountain Street
Providence, RI 02905
Providence, RI 02903
(401) 331-4447
(401) 421-7005
Peter Holden
Blackstone Valley Center
for Retarded Citizens
115 Manton Street
Pawtucket, RI 02861
(401) 727-0510
Ann Silveria
Providence MH Center
100 Fountain Street
Providence, RI 02903
(401) 274-7111
Joint project sponsored by both the State general VR
agency and the State VR agency for blind or visually
handicapped persons (in part).
403
STATE
GRANTEE
CENTER LOCATION
SOUTH CAROLINA
Paul G. Knight
Betty Easler
Vocational Rehabilitation
Life Exploration and
Department
Alternatives Program
Independent Living Program
1400 Boston Avenue
P.O. Box 4945
West Columbia, SC 29169
Columbia, SC 29240
(803) 758-8731
(803) 758-7143
SOUTH DAKOTA
John E. Madigan
David Miller
South Dakota Department of
Prairie Freedom Center
Vocational Rehabilitation
for Disabled Independence
Richard F. Kneip Building
800 West Avenue, N.
700 Illinois Street, N.
Sioux Falls, SD 57104
Pierre, SD 57501
(605) 339-6581
(605) 773-3125
TENNESSEE
O.E. Reese
Fred Dinwiddie
Division of Vocational Rehab.
Easter Seal Center for IL
1808 West End, Room 1400
1177 Poplar Avenue
Nashville, TN 37203
Memphis, TN 38105
(615) 741-2521
(901) 726-6404
TEXAS
Ted M. Thayer
Don Grazier
Texas Rehabilitation Commission
Houston Center for IL
Division of Vocational Rehab.
6910 Fannin Street,
118 E. Riverside Drive
Suite #120
Austin, TX 78704
Houston, TX 77030
(512) 445-8285
(713) 795-4252
TTY 795-5261
Robert Simpson
Austin Resource Center for
IL
2818 San Gabriel
Austin, TX 78705
(512) 473-2684
TTY 473-2688
Marshall Levett
E1 Paso Opportunity Center
for the Handicapped (EPOCH)
8929 Viscount, Suite 101
El Paso, TX 79925
(915) 591-0880 (TTY)
Bernice Cantu
San Antonio IL Services (SAILS)
2803 E. Commerce
The Barbara Jordan Center
San Antonio, TX 78203
(512) 226-0054 (TTY)
404
STATE
GRANTEES
CENTER LOCATION
Robert Packard
John Humbart
Texas Commission for the Blind
Independent Living Program
Field Services Division
2201 Sherwood Way
P.O. BOX 12866
Suite 118
Austin, TX 78711
San Angelo, TX 76901
(512) 475-1784
(915) 949-4601
Juanita Hollaway
IL Rehabilitation Program
State Commission for the Blind
8100 Washington, Suite 119
Houston, TX 77007
Adele Baker
IL Rehabilitation Program
State Commission for the Blind
4410 Dillion Land #20
Corpus Cristi, TX 78415
(512) 854-2361
UTAH
Gary LaComb
Willard Smith
Division of Rehabilitation Serv.
Utah Independent Living
Utah State Office of Education
Center, Inc.
250 East Fifth South
764 South 200 West
Salt Lake City, UT 84111
Salt Lake City, UT 84101
(801) 533-5991
(801) 359-2457
VERMONT
Stanley Greenburg
same
Vermont Association for the Blind
37 Elmwood Avenue
Burlington, VT 05401
(802) 863-1358
Sid Davis
Jean Mankowski
Agency of Human Services
Vermont Center for Independent
Division of Vocational Rehab.
Living
103 South Main Street
174 River Street
Waterbury, VT 05676
Montpelier, VT 05602
(802) 241-2194
(802) 229-0501
VIRGIN ISLANDS
Felecia A. Brownlow
same
Virgin Islands Association for
Independent Living, Inc.
P.O. Box 3305
Charlotte Amalie
St. Thomas, VI 00801
(809) 774-2740
405
STATE
GRANTEE
CENTER LOCATION
VIRGINIA
John Wade
Amy Cornsweet
Virginia Department of
Richmond Center for IL
Rehabilitative Services
6118 Jahnke Road
4901 Fitzhugh Avenue
Richmond, VA 23225
P.O. Box 11045
(804) 233-2033
Richmond, VA 23230
(804) 257-0281
Carol Summers
Woodrow Wilson Center for
Independent Living
Fishersville, VA 22939
(703) 885-9851
John Chappell, Jr.
Endependence Center of Tidewater
855 W. Brambleton Ave.
Norfolk, VA 23510
(804) 623-8069
(804) 623-8092
Tony Young
Endependence Center of N. Va.
4214 9th Street, North
Arlington, VA 22203
(703) 535-ECNV
Audrey Davis
Martha Lassiter
Virginia Department for the
VA Dept. of Visually Handicapped
Visually Handicapped
Independent Living Center
397 Azalea Avenue
1809 Staples Mill Road, Suite 101
Richmond, VA 23227
Richmond, VA 23230
(804) 264-3112
(804) 257-0030
Betsy Smithka
ILC for Multi. Handicapped Blind
2300 9th Street, S. #203
Arlington, VA 22204
(703) 979-3415
Debra Persinger
Department for the Visually
Handicapped
Independent Living Center
1030 S. Jefferson Street
Suite 200
Roanoke, VA 24016
(703) 982-7122
WASHINGTON
Robert Thurston
Della Shafer
Division of Vocational Rehab.
Community Home Health Center
Dept. of Social & Health Serv.
200 W. Thomas
OB 21C
Seattle, WA 98109
Olympia, WA 98504
(206) 282-5048
(206) 753-2756
406
STATE
GRANTEE
CENTER LOCATION
Tracy Harris
Community Service Center
for Deaf & Hard of Hearing
914 E. Jefferson
Room 329
Seattle, WA 98122
(206) 322-4996 (V/TTY)
Jack Gerringer
Good Samaritan Hospital &
Rehabilitation Center
408 14th Avenue, S.E.
Puyallup, WA 98371
(206) 845-1759
Ellen Rapcoch
Spokane Cnty of Comm. Serv. Dept.
Broadway Center Building
N. 721 Jefferson, Suite 403
Spokane, WA 99260
(509) 456-5722
Robert Bourke
Kittitas Community Action
Council, Inc.
115 W. 3rd Street
Ellensburg, WA 98926
(509) 925-1448
Lonnie Davis
University of Puget Sound
Law School
Morton Clapp Center
949 Market St., Suite 366
Tacoma, WA 98402
(206) 756-3480
Karen Veon
Greater Lake Community
Health Center
9108 Lakewood Drive, SW
Tacoma, WA 98499
(206) 594-8933
Jeanne Dockham
Coalition of Handicapped
Organizations
3127 E. Everyreen Blvd.
Vancouver, WA 98661
(206) 696-6068
TTY 696-6070
407
STATE
GRANTEE
CENTER LOCATION
(VACANT)
Legal Advocacy Center
914 E. Jefferson, Room 326
Seattle, WA 98122
(206) 324-5782
WEST VIRGINIA
Linel Parker
Ira Herman
State Board of Voc. Rehab.
Huntington Center for
Division of Vocational Rehab.
IL, Inc.
State Capitol
914 1/2 Fifth Avenue
Charleston, WV 25305
Huntington, wV 25701
(304) 348-9130
(304) 525-3324
Karen Newton
same
Coordinating Council for IL, Inc.
Box 677
Morgantown, W 26507
(304) 599-3636
TTY 598-2424
Thelma N. Hall
John R. Adkins
Multi-County Community Action
Appalachian CIL, Inc.
Against Poverty, Inc.
1427 Lee Street
718 Morris Street, P.O. Box 3228
Charleston, WV 25301
Charleston, WV 25332
(304) 342-6328 (TTY)
(304) 344-3453
WISCONSIN
Duane Zimdars
Eileen Berkley
Division of Vocational Rehab.
Access to Independence, Inc.
P.O. Box 7852
1954 E. washington Ave.
Madison, WI 53703
Madison, WI 53704
(608) 266-1134
(608) 251-7575
William Hatcher
Southeastern Wisconsin Center
for IL, Inc. (SEWCIL)
1545 S. Layton Blvd., Room 524
Milwaukee, WI 53215
(414) 643-0910
Gretchen Russert
Stout Program for IL-Voc.
Development Center
University of Wisc-Stout
Menomonie, WI 54751
(715) 232-2293 (V/TTY)
STATE
GRANTEE
CENTER LOCATION
WYOMING
Dave Andrews
Robert Carbon
Division of Vocational Rehab.
Independent Living Rehab.
Dept. of Health & Soc. Services
550 Rancho Road
326 Hathaway Building
Casper, WY 82601
Cheyenne, WY 82002
(307) 577-11016
(307) 777-7385
408
U. S. DEPARTMENT OF EDUCATION
OFFICE OF SPECIAL EDUCATION
AND REHABILITATIVE SERVICES
REHABILITATION SERVICES ADMINISTRATION
WASHINGTON, D.C. 20202
INFORMATION MEMORANDUM
RSA-IM-83-35
June 21, 1983
TO:
STATE REHABILITATION AGENCIES (GENERAL)
STATE REHABILITATION AGENCIES (BLIND)
RSA REGIONAL COMMISSIONERS
RSA SENIOR STAFF
SUBJECT: Transmittal of Report: "Caseload Statistics, State Vocational
Rehabilitation Agencies, Fiscal Year 1982"
The attached report presents a statistical summary of caseload activity
in State vocational rehabilitation agencies during Fiscal Year 1982
based on Form RSA-113, The Quarterly Caseload/Expenditure Report.
As in recent years, overall caseload activity for Fiscal Year 1982 was
characterized by declines in most measures. Active cases served declined
for the seventh year in a row and the 226,924 cases closed rehabilitated
during this fiscal year represented the fewest number of successful
case closures recorded since Fiscal Year 1968.
Activity among severely disabled cases was down for the third consecutive
year during Fiscal Year 1982. However, these cases continued to account
for a larger proportion of the total active cases available.
There are four agency tables included in this year's report. They show
the numbers of total and "severe" cases rehabilitated and served. The
remaining tables indicate national trends only. For the first time in
many years you will find a table which presents, on a national basis,
the number of cases rehabilitated and served per 100,000 population
residing in the United States for Fiscal Year 1971 through Fiscal Year 1982.
This measure, too expresses the decline in caseload activity. We
returned to this method of computing the rates to allow for continuity
in comparison from one decade to the next. Finally, you will also find
a series of seven charts interspersed throughout the report.
We hope this report, like the ones in the past, will serve as an
important informational source of the State-Federal program for
vocational rehabilitation.
Commissione
Attachments
cc:
CSAVR
409
Rehabilitation Services Administration
Office of Program Operations
Basic State Grants Branch
June, 1983
Caseload Trends Through Fiscal Year 1982
INTRODUCTION
Fiscal Year 1982 was a year in which the number of persons in State agency
caseloads, as measured in a variety of ways, continued to decrease and, in
most instances, decrease sharply. Compared to Fiscal Year 1981, fewer persons
applied for services, fewer were accepted for services, fewer were rehabilitated
and served, and fewer were still in receipt of services as Fiscal Year 1982
ended. Even cases of severely disabled persons were not spared from the over-
all decline, although their losses were not as steep as those for the non-
severely disabled population. The severely disabled continued to account for
increasing proportions of clients in State agency caseloads. In terms of
total caseload volumes, the State-Federal program is no larger than it was
about 12 to 14 years ago. For caseloads of severely disabled persons,
volumes in Fiscal Year 1982 resembled those five years earlier.
REHABILITATIONS
In Fiscal Year 1982, 226,924 disabled persons were vocationally rehabilitated
in the State-Federal program. This result represented (a) a decline of
11.3 percent from the 255,881 rehabilitations attained in Fiscal Year 1981,
(b) the fewest successful closures in 14 years, and (c) the seventh decline
in the last eight years following the peak performance of 361,138 rehabilitations
in Fiscal Year 1974.
Rehabilitations of severely disabled persons in Fiscal Year 1982 numbered
129,866. This accomplishment represented (a) a loss of 6.2 percent from the
138,380 rehabilitations effected in Fiscal Year 1981, (b) the fewest such
successes in five years, and (c) the third year in a row of a decline in this
key target group of disabled persons after a high of 143,375 rehabilitations
was reached in Fiscal Year 1979. The percentage of all persons rehabilitated
in Fiscal Year 1982 who were severely disabled rose to 57.2 percent, the highest
ever recorded.
PERSONS SERVED
In Fiscal Year 1982, there were 958,537 persons who received vocational
rehabilitation services. This finding represented (a) a decline of 7.7 percent
from the 1,038,232 persons served in Fiscal Year 1981, (b) the smallest such
number recorded in the last 12 years, (c) the first time in 12 years that the
number served fell below one million persons, and (d) the seventh decline in
as many years since the high point of 1,244,338 persons served was reached
in Fiscal Year 1975.
The number of severely disabled persons served totalled 571,542 in Fiscal
Year 1982. This was (a) 4.9 percent below the total of 600,727 for the prior
fiscal year, (b) the fewest served in five years and (c) the third consecutive
decline in as many years after a high of 611,994 was established in Fiscal
Year 1979. Of all persons served in Fiscal Year 1982, 59.6 percent were severely
disabled, the highest such proportion recorded.
410
NEW APPLICATIONS FOR SERVICES
The number of persons newly applying for rehabilitation services was 564,443
in Fiscal Year 1982. This was (a) a loss of 11.6 percent from the 638,542
new applicants the year before, (b) the fewest number of new applicants in
14 years and (c) the sixth decline in the last seven years after the all-time
high of 885,737 was experienced in Fiscal Year 1975.
ACCEPTANCES FOR SERVICES
The number of persons accepted for vocational rehabilitation services in
Fiscal Year 1982 was 333,439. This was (a) a loss of 10.7 percent from the
373,310 newly accepted clients in the prior year, (b) the fewest number accepted
into the program since Fiscal Year 1968, and (c) the sixth time in the last
seven years of a decreasing trend after a high of 534,491 acceptances occurred
in Fiscal Year 1975.
Severely disabled persons among those newly accepted for services totalled
200,601 in Fiscal Year 1982. This was (a) a loss of 10.6 percent from the
224,309 acceptances in the previous year, (b) the fewest number of new active
cases recorded in the seven years for which data are available and (c) the
third consecutive decrease after a high of 226,287 acceptances occurred in
Fiscal Year 1979. The proportion of new active cases that were of severely
disabled persons remained at 60 percent for the second year in a row.
APPLICANTS STILL IN PROCESS
The number of applicants whose eligibility for services was still being evaluated
as of September 30, 1982 was 232,245. This represented (a) a decrease of
9.8 percent from the 257,610 persons in evaluation on the same date one year
earlier, (b) the fewest number of end-of-year applicants in 13 years. and
(c) the fifth decline in the last seven years after the highest backlog of
applicants of 357,653 was attained at the end of Fiscal Year 1975.
CLIENTS STILL RECEIVING REHABILITATION SERVICES
The number of persons still in receipt of rehabilitation services on September 30,
1982 was 589,038. This represented (a) a loss of 5.7 percent from the 624,669
persons receiving services on September 30, 1981, (b) the fewest number of
end-of-year cases in 12 years and (c) the seventh consecutive decline since the
highest backlog of 778,448 persons still receiving services was reached at the
end of Fiscal Year 1975.
The number of severely disabled persons still receiving services on September 30,
1982 was 351,109. This was (a) a decrease of 4.3 percent from the 366,885
severely disabled persons in receipt of services on the same date one year
earlier, (b) the fewest number of end-of-year cases in six years and (c) the third
reduction in a row since the highest backlog of 381,078 cases of severely disabled
persons occurred at the end of Fiscal Year 1979.
411
NEW EXTENDED EVALUATION CASES
There were 28,778 new extended evaluation cases received by State agencies
during Fiscal Year 1982. This figure was (a) 18.3 percent below the
35,224 cases received during the previous fiscal year, and (b) the fewest
number of new extended evaluation cases recorded since Fiscal Year 1972.
This decline in new extended evaluation cases, more than likely, stemmed
from the loss in Trust Funds monies which were often used to serve such cases.
ACCEPTANCE AND REHABILITATION RATES
More than half, 56.1 percent, of the applicant and extended evaluation
cases processed during Fiscal Year 1982 were determined eligible for VR
services. This rate represented (a) a slight increase from the prior
year when 54.8 percent of the cases processed were accepted, and (b) the
second lowest acceptance rate recorded since. Fiscal Year 1972.
Overall, roughly, three out of every five (61.4 percent) active cases
closed during Fiscal Year 1982 were closed rehabilitated. This was the
lowest overall rehabilitation rate reported since Fiscal Year 1946.
The rehabilitation rate for severely disabled cases closed in Fiscal
Year 1982 was 58.9 percent. This was the lowest rehabilitation rate
recorded for such cases in the seven years for which data are available.
RATES PER 100,000 POPULATION
Another way of measuring the decline in the impact of the VR program is
to look at the rates per 100,000 population. Nationally, the number of
persons rehabilitated by State VR agencies for every 100,000 persons
residing in the United States has declined from as much as 170 in
Fiscal Year 1973 to only 97 in Fiscal Year 1982. The national rate of
active cases served per 100,000 population in Fiscal Year 1982 was 409.
This was the seventh consecutive decline recorded for this caseload
item since the high of 570 occurred in Fiscal Year 1975.
CAUSES OF CASELOAD DECLINES
The declines in caseload volumes in recent years are attributed to
(a) decreases in the purchasing power of the rehabilitation dollar
including the near total loss of funding from Social Security monies
in Fiscal Year 1982 and (b) continued emphasis in providing services
to the severely disabled for whom rehabilitation efforts are more
costly. It is estimated that the purchasing power of funds available to
State rehabilitation agencies declined by 29.2 percent in the relatively
short period from 1979 to 1982. In dollar terms, the loss was
approximately $361 million. (In actual as opposed to constant dollars,
the loss was only $72 million, or 5.8 percent.) Of the $361 million
decrease in purchasing power between 1979 and 1982, $186 million is
attributed to the impact of inflation on Federal and State monies
expended under Basic Support, and $175 million to the cutoff of funding
from Social Security and a small Innovation and Expansion grant program.
It was subsequent to Fiscal Year 1979 that numbers of severely disabled
persons accepted into, rehabilitated by, and served by the rehabilitation
program began to decline.
412
SECTION I
TOTAL CASELOAD ACTIVITY
FIGURE A
NUMBER OF PERSONS REHABILITATED, FY 1921 - 1982
400
FY 1982 - 226,924
FY 1981 - 255,881
350
$ ALL-TIME HIGH
FY 1974 . 361,138*
300
250
NUMBER (000)
200
150
100
50
0
1920
1930
1940
1950
1960
1970
1980
FISCAL YEAR
Tuble E - Number of active CEBBE serval and persons rebibilitated by Strate
vocational rehabilitation agencfem, Placel Terms ESGE - 1909
Firm1
Charges
Persona
Ufacul
Cures
Personal
22-069 o 04 27 I II Il
Year
Served
Wear
Served
1882
951,517
226.924
1981
1,031,232
255,881
1950
230,544
66,193
1900
1,095,139
27F.1136
1960
255,724
50,597
1979
1,127,551
288,325
1949
216,997
50,020
ESTAL
1,167,991
294,336
T94B
191,063
53,131
19777
1,204,487
291,252
1947
170,14F
43,880
6976
1,238,446
308,328
1945
168,796
36,106
1975
1,244,338
324,039
1945
161,050
41,925
1974
1,201,661
361,138
1944
145,059
43,997
1973
1,176,445
360,726
1943
129.207
42,61B
1972
1,111,045
326,138
1942
91,572
21,757
1,000,650
293,272
1941
78,320
14.579
ISTO
875,901
266,975
1940
65,624
11,890
THE
788,614
241,390
1939
63,575
ID_747
1968
680,405
207.518
T938
63,666
9,844
1967
569,907
173,594
1987
11,091
418
1966
499.454
154,279
10,338
1915
441,332
134,859
1935,
9,402
ED64
399,852
HIS_700
1934
8,062
1963
36F,691
110,136
L933
5,613
1962
375,635
102.300
1932
5,592
1961
320,963
92,501
1931
5,184
ISMO
257,950
88,275
1930
4,605
1959
280,384
80,739
1925
4,645
1958
258,444
14,317
1921
5,002
1967
233,582
1907
5,092
1956
221,118
65,640
1926
5,604
1955
203,009
57,981
TIR25
5,825
1954
201,219
55,825
1924
5,654
1953
221,849
66,303
1923
4,530
1952
228,490
63,632
1922
1,898
11920
523
If DETA price the 1931 mot available
414
Table 2. - Number of cases in caseloads of State vocational
rehabilitation agencies during Fiscal Years 1972 - 1982
Applicants and Active Cases
Active Caseload Only
Number of Cases
Percent Change
Number of Cases
Percent Change
Fiscal
(Statuses 02-30)
From Previous
(Statuses 10-30)
From Previous
Year
Year
Year
1982
1,473,313
- 9.7
958,537
- 7.7
1981
1,631,167
- 5.7
1,038,232
- 5.2
1980
1,728,987
- 1.3
1,095,139
- 2.9
1979
1,751,862
- 3.5
1,127,551
- 3.5
1978
1,815,564
- 2.7
1,167,991
- 3.0
1977
1,866,707
- 3.0
1,204,487
- 2.7
1976
1,925,049
- 0.7
1,238,446
- 0.5
1975
1,937,872
+ 5.2
1,244,338
+ 3.6
1974
1,824,545
+ 6.2
1,201,661
+ 2.1
1973
1,798,132
+ 5.4
1,176,445
+ 5.9
1972
1,706,110
+ 9.9
1,111,045
+10.9
415
FIGURE B
NUMBER OF PERSONS REHABILITATED AND NOT REHABILITATED,
AND REHABILITATION RATES, FY 1972 - 1982
400
350
REHABILITATIONS FY 1982 8 226,924
FY 1981 R 255,881
300
250
200
NON-REHABILITATIONS FY 1982 - 142,575
FY 1981 - 157,682
150
100
0
1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982
REHABILITATION RATES
75.0 74.1 73.4
69.6
62.9
64.0
64.8
64.9
64.5
61.9 61.4
PERCENTAGE
1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982
FISCAL YEAR
Table 3 -- Number of persons rehabilitated and not rehabilitated by State vocational
rehabilitation agencies, Fiscal Years 1972 - 1982
Persons Rehabilitated
Persons Not Rehabilitated
Fiscal
Percent Change
Percent Change
Rehabilitation
Year
Number
From Previous
Number
From Previous
Rate 1/
Year
Year
1982
226,924
-11.3
142,575
- 9.6
61.4
1981
255,881
- 7.7
157,682
+ 3.3
61.9
1980
277,136
- 3.8
152,672
- 2.3
64.5
1979
288,325
- 2.1
156,258
- 2.2
64.9
1978
294,396
+ 1.1
159,846
- 2.4
64.8
416
1977
291,202
- 4.0
163,706
- 8.6
64.0
1976
303,328
- 6.4
179,139
+26.3
62.9
1975
324,039
-10.3
141,851
+ 8.4
69.6
1974
361,138
+ 0.1
130,871
+ 3.9
73.4
1973
360,726
+10.6
125,991
+15.8
74.1
1972
326,138
+12.0
108,784
+12.5
75.0
1/ Rehabilitation rates show the number of persons rehabilitated as a percent of all
active case closures, whether rehabilitated or not.
417
FIGURE c
NUMBER OF APPLICANTS ACCEPTED AND NOT ACCEPTED FOR
VOCATIONAL REHABILITATION SERVICES, AND ACCEPTANCE RATES,
FY 1972 - 1982
600
500
ACCEPTED FY 1982 - 333,439
FY 1981 - 373,310
400
NUMBER (000)
300
NOT ACCEPTED
FY 1982 . 260,518
FY 1981 - 308,173
200
O
1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982
ACCEPTANCE RATES
65.1 63.1 64.5 63.8
PERCENTAGE
57.5 58.2 57.5 57.8 57.5 54.8 56.1
1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982
FISCAL YEAR
Table 4 - Number of applicant and extended evaluation cases accepted and
not accepted for VR services by State vocational rehabilitation
agencies, Fiscal Years 1972 - 1982
Applicants Accepted
Applicants Not Accepted
Fiscal
Percent Change
Percent Change
Acceptance
Year
Number
From Previous
Number
From Previous
Rate 1/
Year
Year
1982
333,439
-10.7
260,518
-15.5
56.1
1981
373,310
- 9.5
308,173
+ 1.2
54.8
1980
412,356
+ 0.2
304,525
+ 1.1
57.5
1979
411,560
- 1.9
301,077
- 2.8
57.8
418
1978
419,590
- 3.6
309,624
- 0.9
57.5
1977
435,144
- 5.3
312,515
- 7.9
58.2
1976
459,620
-14.0
339,494
+12.1
57.5
1975
534,491
+ 4.6
302,942
+ 7.7
63.8
1974
511,226
+ 1.6
281,376
- 4.4
64.5
1973
503,318
+ 1.3
294,271
+10.5
63.1
1972
496,680
+ 6.1
266,312
+ 8.0
65.1
Acceptance rates show the number of cases accepted for VR services as a percent
of all applicant and extended evaluation cases accepted and not accepted.
419
FIGURE D
NEW APPLICANTS AND NEW ACTIVE CASES DURING
FY 1972-1982
900
NEW APPLICANTS FY 1982 . 564,443
800
FY 1981 - 638,542
700
600
NUMBER (000)
500
400
NEW ACTIVE CASES
FY 1982 - 333,439
300
FY 1981 - 373,310
0
1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982
Table 5 -- Number of new applicants, new extended evaluation cases and new active cases in the
caseloads of State vocational rehabilitation agencies during Fiscal Years 1972 - 1982
New Applicants
New Extended Evaluation Cases
New Active Cases
(Status 02)
(Status 06)
(Status 10)
Fiscal
Percent Change
Percent Change
Percent Change
Year
Number
From Previous
Number
From Previous
Number
From Previous
Year
Year
Year
1982
564,443
-11.6
28,778
-18.3
333,439
-10.7
1981
638,542
-11.7
35,224
-15.0
373,310
- 9.5
1980
722,847
+ 3.6
41,426
+ 1.5
412,356
+ 0.2
1979
697,873
- 2.4
40,843
- 1.0
411,560
- 1.9
420
1978
715,367
- 4.2
41,240
- 1.7
419,590
- 3.6
1977
746,377
- 2.3
41,948
+ 8.1
435,144
- 5.3
1976
763,714
-13.8
38,792
- 7.3
459,620
-14.0
1975
885,737
+ 9.9
41,848
+28.5
534,491
+ 4.6
1974
806,000
+ 1.2
32,556
+ 6.8
511,226
+ 1.6
1973
796,116
+ 1.3
30,486
+ 6.6
503,318
+ 1.3
1972
786,117
+ 7.8
28,587
+12.0
496,680
+ 6.1
Table 6 - Number of applicant, extended evaluation and active cases remaining at the end
of the ffacal year in caseloads of State vocational rehabilitation agenctes,
Fiscal Years 1972 - 1982
Total Cases Remaining
In Applicant Status
In Extended Evaluation
In Active Stratures
(Statuses 02 - 24)
(Status 02)
(Status 66)
(Statures IC - 24)
Fiscal
Number
Percent Change
Number
Percent Change
Number
Percent Change
Number
Percent Change
Year
From Previous
from previous
From Previous
F FOUR Previous
Year
year
Year
Year
1982
843,301
- 7.3
232,245
- 9.8
22,013
-18.9
589,038
- 5.7
1981
909,431
- 8.6
257,610
-13.3
27,152
-15.6
624,669
- 6.1
1980
994,654
- 1.1
297,148
+ 1.9
32,175
+ 2.2
665,331
- 2.6
421
1979
1,006,202
- 4.3
291,730
- 4.5
31,504
- 2.9
682,968
- 4.3
1978
1,051,698
- 4.3
305,514
- 3.5
32,435
- LD
713,749
- 4.8
1977
1,099,284
- 0.3
316,662
+ 0.4
33,043
+4.7
749,579
- 0.8
1976
1,103,088
- 5.6
315,549
-11.8
31,560
- 4.2
755,979
- 2.9
1975
1,169,040
+ 1.1
357,653
+12.4
32,939
+41.9
778,448
+ 9.7
1974
1,051,160
+ 3.3
318,297
+4.1
23,211
+ 7.9
709,652
+ 2.9
1973
1,017,144
+ 1.2
305,902
- 0.8
21,514
+5.3
689,728
+ 2.0
1972
1,004,876
+ 9.6
308,331
# 8.0
If
20,422
+12.8
676,123
+10.2
Table 7. - Selected Caseload Volumes: Fiscal Year 1982
vs. Fiscal Year 1981 and All-Time High
All Time High
Caseload
Fiscal Year
Percent
Percent
Measure
change:
Fiscal
change: 82
1982
1981
82 vs. 81
Year
Number
VS. high
Total applicants
821,332
934,209
-12.1%
1975
1,204,262
-31.8%
New applicants
564,443
638,542
-11.6
1975
885,737
-36.3
Applicants on hand,
end of year
232,245
257,610
- 9.8
1975
357,653
-35.1
Total active cases served
958,537
1,038,232
- 7.7
1975
1,244,338
-23.0
New active cases
333,439
373,310
-10.7
1975
534,491
-37.5
Rehabilitations
226,924
255,881
-11.3
1974
361,138
-37.2
422
Non-rehabilitations
142,575
157,682
- 9.6
1976
179,139
-20,4
Active cases on hand,
end of year
589,038
624,669
- 5.7
1975
778,448
-24.3
Severe active cases served
571,542
600,727
- 4.9
1979
611,994
- 6.6
New severe active cases
200,601
224,309
-10.6
1979
226,287
-11.4
Severe rehabilitations
129,866
138,380
- 6.2
1979
143,375
- 9.4
Severe non-rehabilitations
90,567
95,462
- 5.1
1981
95,462
- 5.1
Severe active cases on hand,
end of year
351,109
366,885
- 4.3
1979
381,078
- 7.9
428
Table @ E Number of persons rehabilitated and served by State
vocational rehabilitation agencies per 100,000 population, 1/
Fiscal Years 1971-1982
Rehabilitations
Active Cases Served
Fiscal Resident
Rate per
Rate per
Year
Population 2/(mil)
Number 1/
100,000 population
Number 3/
100,000 population
1982
229.3
222,940
97
936,543
409
1981
227.2
201,483
110
1,014,610
447
1980
224.6
272,204
121
1,069,863
476
1979
222.1
283,106
127
1,101,016
496
1970
219.0
200,531
132
1,141,024
019
1977
217.6
286,906
132
1,177,993
641
1976
216.6
297,147
138
1,209,791
561
1976
213.3
318,201
149
1,214,585
570
1974
211.4
365,520
168
1,172,906
555
1973
209.3
355,614
170
1,160,772
550
1972
206.8
321,612
166
1,089,825
527
1971
204.0
200,100
141
904,902
483
1
Rates are based on the estimated total resident population en July 1
of each fiscal year except for Fiscal Years 1971 and 1981 which are
based OR the Decennial Cansus as of April 1, 1970 and 1980, respectively.
Source: U.S. Bureau of the Census, Current Population Reports,
series P=25, Nos. 802 and 903,
Resident population does not include information from Puerto Rice or any
of the outlying territories,
Excludes data From Pyerto Rico, Virgin Islands, Guam, American Samoa,
Trust Territories of the Pacific Islands and Northern Mariana Islands,
424
Table 9 -- Number of applicant, extended evaluation and active
cases in State vocational rehabilitation agencies,
percent change and percent distribution,
Fiscal Years 1981 - 1982
Fiscal Year
Percent
distribution
Percent
Fiscal Year
Caseload item
1982
1981
Change
1982
1981
Applicants (02)
Number available
821,332
934,209
-12.1
100.0
100.0
On hand, Oct. 1
256,889
295,667
-13.1
31.3
31.6
New since Oct. 1
564,443
638,542
-11.6
68.7
68.4
Number processed
589,087
676,599
-12.9
71.7
72.4
Accepted for VR (10)
317,461
354,041
-10.3
38.7
37.9
Accepted for EE (06)
28,778
35,224
-18.3
3.5
3.8
Not accepted for VR
or EE (08)
242,848
287,334
-15.5
29.6
30.7
Total on hand, Sept. 30
232,245
257,610
- 9:8
28.3
27.6
Extended evaluation
cases (06)
Number available
55,661
67,260
-17.2
100.0
100.0
On hand, Oct. 1
26,883
32,036
-16.1
48.3
47.6
New since Oct. 1.
28,778
35,224
-18.3
51.7
52:4
Number processed
33,648
40,108
-16.1
60.5
59.6
Accepted for VR (10)
15,978
19,269
-17.1
28.7
28.6
Not accepted for VR (08)
17,670
20,839
-15.2
31.7
31.0
Total on hand, Sept. 30.
22,013
27,152
-18.9
39.5
40.4
Active cases (10-30)
Number available
958,537
1,038,232
- 7.7
100.0
100.0
On hand, Oct. 1
625,098
664,922
- 6.0
65.2
64.0
New since Oct. 1
333,439
373,310
-10.7
34.8
36.0
Number closed
369,499
413,563
-10.7
38.5
39.8
Rehabilitated (26)
226,924
255,881
-11.3
23.7
24.6
Not rehabilitated (28)
104,615
116,156
- 9.9
10.9
11.2
Not rehabilitated (30)
37,960
41,526
- 8.6
4.0
4.0
Total on hand, Sept. 30
589,038
624,669
- 5.7
61.5
60.2
1
Active cases served.
SECTION TII
SERVICE DISABLED CASELADD
ACTIVITY
Table 10 - Severely disabled clients in the active caseloads of
State vocational rehabildtation agencies, Fiscal Years 1981 - 1982
Fiscal Year 1982
Fiscal Year 1981
Caseload
ATE
Severely disabled
ATT
Severelydisabled
Item
clients
Number
Percent
Percent
clients
Number
Percent
Percent
of total
Change US.
of total
Change WB.
FY 1981
FY 1980
Cases on hand, Oct. 1
(Statuses 10 the 24)
625,098
370,941
59.3
- 1.5
664,922
376,418
56.6
- 1.3
New since Oct. 1
333,439
200,601
60.2
-10.6
373,310
224,309
60.1
- 0.2
425
Total available
958,537
571,542
59.6
- 4.9
1,038,232
600,727
57.9
- 0.9
Total processed
369,499
220,433
59.7
- 5.7
413,563
233,842
56.5
1/
Rehabilitated
226,924
129,866
57.2
- 6.2
255,881
138,380
54.1
- 2.9
Not rebabilitated (28)
104,615
67,795
64.8
NA
116,156
NA
INA
NA
Not rehabilitated (30)
37,960
22,772
60.0
NA
41,526
NA
INA
INA
Cases on thand, Sept. 30
(Statuses 10 the 24)
589,038
351,109
59.6
- 4.3
624,669
366,885
58.7
- 1.4
1/
Less than 0.05 percent
NA - Not available
426
FIGURE E.
SEVERELY AND NON-SEVERELY DISABLED PERSONS REHABILITATED,
FY 1974 - 1982
250
FY 1982 - 97,058
200
NON-SEVERE
FY 1981 - 117,501
NUMBER (000)
150
100
SEVERE
FY 1982 . 129,866
FY 1981 . 138,380
50
O
1974 1975 1976 1977 1978 1979 1980 1981 1982
SEVERE AS PERCENT OF ALL REHABILITATIONS
PERCENTAGE
49.7
51.4
54.1
57.2
43.8
47.0
40.5
31.6
35.7
1974 1975 1976 1977 1978 1979 1980 1981 1982
FISCAL YEAR
427
Table 11.
=== Persons rehabilitated by State vocational
rehabilitation agencies and percent change
from previous year, by severity of disability:
Fiscal Years 1974 = 1982
A, Severely Disabled
Fiscal Year
Rehabilitations
Percent Change
1982
129,866
= 6,2
1981
138,380
- 2,9
1980
142,545
- 0.5
1979
143,375
+ 3.6
1978
138,402
+ 8.5
1977
127,522
+ 3.7
1976
122,938
+ 6.3
1975
115,746
+ 1,5
1974
113,997
2/
B. Non-Severely Disabled
/
Fiscal Year
Rehabilitations
Percent Change
1982
97,058
-17.4
1981
117,501
-12.7
1980
134,591
- 7.1
1979
144,950
= 7.1
1978
155,994
= 4.7
1977
163,680
- 9,3
1976
180,390
-13,4
1975
208,293
-15.7
1974
247,141
2/
Comparison to same period of previous year.
Data not available,
428
Table 12. -- Total, Severely and Non-Severely Disabled Cases
Rehabilitated by State Vocational Rehabilitation
Agencies and Percent Severe, Fiscal Years 1974-1982
Fiscal
Severely
Non-Severely
Percent
Year
Total
Disabled
Disabled
Severe
1982
226,924
129,866
97,058
57.2
1981
255,881
138,380
117,501
54.1
1980
277,136
142,545
134,591
51.4
1979
288,325
143,375
144,950
49.9
1978
294,396
138,402
155,994
47.0
1977
291,202
127,522
163,680
43.8
1976
303,328
122,938
180,390
40.5
1975
324,039
115,746
208,293
35.7
1974
361,138
113,997
247,141
31.6
Table 13. - Rehabilitation Rate for Severely and Non-Severely
Disabled Clients of State Vocational Rehabilitation
Agencies, Fiscal Years 1976 - 1982
Rehabilitation Rate
Fiscal
Year
Total
Severe
Non-Severe
1982
61.4
58.9
65.1
1981
61.9
59.2
65.2
.
1980
64.5
60.9
68.7
1979
64.9
62.1
67.8
1978
64.8
62.5
67.0
1977
64.1
61.4
66.3
1976
62.9
60.0
65.0
Severe as a percent of severe and non-severe cases.
21 Rehabilitations ÷ (All active cases closed).
429
FIGURE F
SEVERELY AND NON-SEVERELY DISABLED PERSONS:
NEW ACTIVE CASES, FY 1976 - FY 1982
250
200
SEVERE
less!
FY 1982 - 200,601
NON-SEVERE
FY 1981 - 224,309
150
FY 1982 - 132,838
FY 1981 - 149,001
100
0
1976
1977
1978
1979
1980
1981
1982
SEVERE AS PERCENT OF ALL NEW ACTIVE CASES
60.1
60.2
PERCENTAGE
53.8
55.0
54.5
48.9
49.4
1976
1977
1978
1979
1980
1981
1982
FISCAL YEAR
22-065 0 - - 84 - 28
430
FIGURE G
SEVERELY AND NON-SEVERELY DISABLED PERSONS:
ACTIVE CASES SERVED, FY 1976 - 1982
700,
SEVERE FY 1982 R 571,542
FY 1981 M 600,727
600
NUMBER (000)
500
NON-SEVERE
400
FY 1982 a 386,995
FY 1981 , 437,505
300
0
1976
1977
1978
1979
1980
1981
1982
SEVERE AS PERCENT OF ALL CASES SERVED
55,3
57.9
59,6
PERCENTAGE
54,3
44.8
47.2
51,4
1976
1977
1978
1979
1980
1981
1982
FISCAL YEAR
431
Table 14. - Number of persons severely and non-severely disabled
in active caseloads of State vocational rehabilitation
agencies and percent severe: Fiscal Years 1976 - 1982
A. New Cases and Cases Not Rehabilitated
New Active Cases
Not Rehabilitated (28, 30)
Fiscal
Non-
Percent
Non-
Percent
Year
Severe
Severe
Severe
Severe
Severe
Severe
1982
200,601
133,353
60.1
90,567
52,008
63.5
1981
224,309
149,001
60.1
95,462
62,220
60.5
1980
224,729
187,627
54.5
91,346
61,326
59.8
1979
226,287
185,273
55.0
87,541
68,717
56.0
1978
225,630
193,960
53.8
83,051
70,795
54.0
1977
214,803
220,341
49.4
79,954
83,752
48.8
1976
224,720
234,900
48.9
82,037
97,102
45.8
B. Cases Served and Cases on Hand at End of Period
Active Cases Served
On Hand At End of Period
Fiscal
Non-
Percent
Non
Percent
Year
Severe
Severe
Severe
Severe
Severe
Severe
1982
571,542
386,995
59.6
351,109
237,924
59.6
1981
600,727
437,505
57.9
366,885
257,784
58.7
1980
606,049
489,090
55.3
372,158
293,173
55.9
1979
611,994
515,557
54.3
381,078
301,890
55.8
1978
600,063
567,928
51.4
378,610
335,139
53.1
1977
568,826
635,661
47.2
361,350
388,229
48.2
1976
555,533
683,078
44.8
350,558
405,586
46.4
1
Severe as a percent of severe and non-severe cases.
432
SECTION III
AGENCY TABLES
Table 15 a Number: of rehabilitations in State Vocational
Rehabilitation agencias: Fiscal Years 1981 and 1982
Total rehabilicarions
Region and
Fiscal Year
Perment
assency
1982
1981
change
U. S. Total
226,924
255,881
-11.3
Region T
a 10,640
11,441
- 7.0
Compertique
1,872
2,260
-17.2
Maine
966
952
1,5
Massachusetts
4,633
4,594
0.8
New Hampshire,
952
961
9.9
Rhode Island
1,000
1,117
-10.5
Vermine,
846
540
1.1
122
127
- 3.9
Mageschusetts
411
719
-42.8
#Shode Island
17
116
-33.6
61
55
10.9
Region IT
21,050
21,056
## =
New Jerney,
5,722
6,413
-10.8
New York,
10,233
9,095
12.5
Puerce Rice
3,652
4,209
-13.2
Virgin Islanda
39
30
2.6
AND Jerrey
348
318
9.4
#See York
1,054
983
7.2
Region TTT
29,948
38,747
-22.7
Delaware
770
859
-10.4
District of Columbia.
1,390
1,497
-7.1
Maryland.
3,637
5,395
-32.6
Pennsylvania
14,431
20,939
-31.1
Virginia
5,067
5,209
- 2.3
Rear Virgini
3,636
4,075
-10,8
@galamare
24
31,
-22.0
Pennsylvand
569
267
113.1
*Virginia
A04
675
-14.9
Region IV
52,879
58,185
-9.1
Alabama
5,49%
6,606
-16.9
Vierida
7,931
8,376
-11,6
Georgia
6,036
7,021
-14.0-
Kenencky
3,605
3,555
1.4
Mismissippi
4,437
4,589
- 3.3
Forth Carolina
9,895
9,899
AM
South Carolina
8,037
9,269
-13.3
Tennessee
4,795
5,447
-12.0
AFlorida,
59A
681
=12.8
*Rentucky
238
262
- 9.2
Mississippi
547
554
a 1.3
"Norgh Carolina
836,
927
221,
271
a 9,8
*Sauch Carolina
AM:
*Temessee
216
178
27.9
Begion V
38,232
42,225
- 9.5.
Filingis
7,051
7,875
-10.5
Indiana,
3,232
3,594
-10.1
Michigan
6,705
7,712
=13.1
Minnesot
4,458
4,934
. 9,6
Chig
9,856
11,246
-12.4
Visgousin,
6,036
6,003
0.5
*Michigan
325
305
6,6
Minnesota
569
557
2.2.
(continued)
433
Table 15 - Number of rehabilitations= in State Vocational
Rehabilitation agencies: Fiscal Years 1981 and 1982
Total renabilitations
Region and
Fiscal Year
Percent
agency
1982
1981
change
Region VI
32,929
36,354
- 9.4
Arkansas
3,507
3,624
- 3.2
Louisiana.
6,045
6,289
- 3.9
New Mexico
1,000
944
5.9
Oklahoma
6,544
7,486
-12.6
Texas
13,908
15,860
-12.3
"Texas
1,925
2,151
-10.5
Region VII
11,258
13,196
-14.7
Iowa
2,187
2,495
-12.3
Kansas
1,246
1,822
-31.6
Missouri
6,173
6,766
-8.8
Nebraska
1,315
1,686
-22.0
*Iows
90
109
-17.4
*Missouri
172
232
-25.9
"Nebraska
75
86
-12.8
Region VETT
8.395
9.217
-8.9
Colorado
2,554
3,034
-15.8
Montana
918
931
- 1.4
North Dakota
756
842
-10.2
South Dakota
772
869
-11.2
Utah.
2,581
2,720
- 5.1
Wyoming
747
747
-
*Utah.
67
74
- 9.5
Region IX
15,005
17,070
-12.1
American Sames
&
13
NA
-
Artzona
1,577
2,049
-23.0
California
11,064
12,742
-13.2
Guar
102
76
34.2
Hawaii
1,041
942
10.5
Sevada
1,030
1,186
-13.2
Northern Marianas
27
17
58.8
Trust Tarritory
15I
58
160.3
Region L
&
6,588
8,389
-21.5
Alasics
505
558
- 9.5
Idaho
1,040
1,043
- 0.3
Oregon
1,756
2,380
-26.2
Washington
2,944
4,002
-26.4
*Idaho
56
53
5.7
*Oregon
78
142
-45.1
*Washington
209
277
-0.9
# Agency for the blind
Estimated
b
Combined data for general and blind agencies
NA Not Available
** - Lass than 0.05 parcent
484
Table 10
XS
times of severely disabled to State
Vountional agencies
Fiscal TOMES 1981 and 1902
favore.ly
Region and
disabled rehahilisations
Fereaus
Persons
agency
Viscal Year
change
govern
1982
1981
Us Ha Total
129,800
130,380
as 6.2
57.2
Region I
7,912
0,158
of 3.0
74.4
Connections.
1,108
1,397
-17.1
59.2
749
058
13.8
77.5
Medica,
3,684
3,518
4.7
79.5
637
669
12 4.8
60.0
New
Rhode Island,
649
628
3.3
64.9
414
331
25.1
75.0
Vermone
122
127
= 3.9
100.0
ALL
719
-43.0
100.0
Caland
77
116
-39.6
100:0
Marking
61,
55
10.1
100.0
IT
13,294
13,479
= 113
63.2
3,468
4,241
and
00.0
New Jersey
Item YORK.
6,829
0,204
10.1
60.7
Puerte Lice.
1,599
1,844
-13.3
43.8
35
20
75.0
89.7
Virgin Islanda
311
181
71.8
89.4
"New Jersey
7.2
- York
1,054
909
100.0
Amaina DT
19,639
22,367
*16.0
65.6
MI
403
B 1.5
57.4
Disariet of Columbia
SOJ
414
U.S
36.1
3,076
2,702
-13.1
37.1
MaryLand,
as
11,226
14,189
⑉10.1
77.8
Virginia
2,870
1,202
*10.4
56.4
2 14
46.2
Rest Virginia,
1,681
1,740
24
11
all.1
100.0
460
209
100.1
80.0
Wishing
307
397
-10.1
80,4
hundon IV
28,043
29,019
B 3.4
13.0
-3,407
4,009
al4.5
62.4
Alabama
4,263
4,093
111.
09.8
Flogida
3,009
3,006
B LJ
49.9
Caurgia,
1,951
1,686
17:0
54.1
Emergely
3,005
2,061
5.0
67.7
4,107
4,011
1.4
41.5
March Caroline
4,200
4,033
5.8
53.1
South Carolina
2,147
2,494
-13.9
44,8
Tennessee
427
484
-11.8
1.9
Florida
LSS
179
-13.4
65.1
*Kentusky
Mississippi.
:317
343
23 776
58.0
555
-032
-10.2
66.4
"Horth Carolina,
*doweb Carolina.
318
217
0.5
98.8
#Tennadora,
194
101
2015
80.8
PayLAn V
22,515
25,071
as 4.9
58.0
5,630
5,307
'5.9
70.7
Hithwis
1,745
2,036
-14.3
54.0
Indians,
Mehigan
3,321
3,700
=11.7
49.5
3,448
2,690
10 9.5
54.9
Minnesuea
Onlo.
9,110
5,892
-13.1
51.9
3,440
3,196
7.6
57.0
Visamin
325
305
6.6
100.0
501
477
0.0
80:0
(countured)
435
Table 16 -Number of severaly disabled rehabilitations in State Vocational
Rehabilitation agencies: Fiscal Years 1981 and 1982
Severely
Region and
disabled rehabilitations
Percent
Percent
agency
Fiscal Year
change
severe
1982
1981
Region VI
15,098
14,896
1.4
45.9
Arkansas
2,280
2,149
6.1
65.0
Louisiana
2,471
2,702.
- 8.5
40.9
New Mexico
471
563
-16.3
47.1
Oklahoma
1,519
1,704
-10.9
23.2
Texas
6,806
6,116
11.3
48.9
*Texas
1,551
1,662
- 6.7
80.6
Region VII
5,933
6,456
- 8.1
52.7
930
1,136
-18.1
42.5
Lows
807
910
-11.3
64.8
Kansas
Missouri
3,016
3,221
- 6.4
48.9
Nebraska
864
797
8.4
65.7
*Toss
--90
109
-17.4
100.0
*Missouri
151
202
-25.2
87.8
*Webraska
75
81
- 7:4
100.0
Region VIII
4,549
9,061
-10.1
54.2
Colorado
1,638
2,092
-21.7
64.1
Montana
473
465
1.7
51.5
North Dakota
446
451
- 1.1
59.0
South Dakota
334
354-
- 5.6
43.3
Utah
1,198
1,209-
- 0.9
46.4
Wyozing
393
416
- 5.5
52.6
*Utah
67
74
- 9.5
100.0
Region IX
8,579
8,866
- 3.2
57.2
American Same
T
NA
-
53.8
Arizona
1,116
1,080
3.3
70.8
California
6,274
6,678
- 6.0
56.7
GUER
57
33
72.7
55.9
Hawaii
517
429
20.5
49.7
Nevada
493
587
-16.0
47.9
Northern Marianas.
19
12
58.3
70.4
Trust Territory
96
47
104.3
63.6
Region X
4,304
5,413
-20.5
65.3
Alaska
267
284
- 6.0
52.9
Idaho
784
752
4.3
75.4
Oregon
1,004
1,514
-33.7
57.2
Washington
1,906
2,466
-22.7
64.8
*Idaho
56
53
5.7
100.0
*Oregon
78
142
-45.1
100.0
*Washington
209
202
3.5
100.0
* Agency for the blind.
Estimated
b
Combined data for general and blind agencies
NA Not available
486
Table 17 - Number of persons. estyed by Stiate Vocational
Rehibilitation agencies* Fiscal Years 1981 and 1982
Total served
Region and
Fiscal Year
Percess
sureey
1982
1901
change
U. S. Total
958,337
1,038,232
a 7.7
Beginn I
47,920
91,117
- 0.3
8,408
9,115
1 7.8
Malue
3,901
3,962
- 1.5
Messachusetts.
27,859
22,718
& 3.8
New Hampshire
3,994
3,974
0.5
Rhode Islands
4,549-
3,156
-11.7
Vermont.
2,651
3,026
-12.4
*Connectious
452
473
& 4.4
Massachusetts
1,522
2,057
-20.0
"Rhode Island.
364
411
-11.4
*Vermont
220
227
- 3.1
Region II
100,361
107,173
& 6.4
22,996
25,460
- 9.8
New Jersey
Behr York
90,451
32,449
- 3.8
20,992
22,782
- 7.9
Puerto Bleb.
212
218
- 2.8
Virgin Islande
1,652
1,609
2.7
"New Jersey
4,098
4,655
-12.0
"New York
Region III
121,112
140,378
-13.8
Delaware
2,639
2,393
1.8
District of Columbia
6,009
5,630
6.7
Maxy Landa
17,233
23,503
-20.9
Pennsylvania
56,669
69,503
-18.5
Virginia
20,572
21,234
- 3.1
West Virginia
12,993
13,447
- 3.4
*Delaware
105
112
- 6.2
*Pennsylvania.
3,326
2,844
16.9
Wirrinia.
1,566
1,652
- 5.2
Region IV
210,507
220,365
- 4.5
Alabama
25,291
26,786
- 5.6
Florida
31,582
33,417
- 5.5
Georgia
24,673
25,23L
- 2.2
Kentucky
15,091
14,331
5.3
Mississippi
17,045
16,951
0.6
North Carolina
36,273
37,597
- 3.5
South Carolina
32,230
35,034
- 8.0
Tennessee
17,886
20,024
-10.7
*Florida
2,479
2,721
- 8.9
*Esutucky
857
976
-12.2
"Hississippi.
1,711
1,675
2.1
"North Carolina
3,631
3,788
- 4.1
"Souch Carolina
872
950
- 8.2
*Tennesses
886
884
0.2
Region V
169,031
179,775
- 6.0
29,747
-
Illinois
30,553
- 2.6
Indiana
14,229
15,166
- 6.2
Michigan
32,941
38,738
-15.0
Minnesota
22,004
23,086
- 4.7
Chio
39,381
42,893
- 8.2
Wiscousin
27,075
25,716
5.3
*Michigan
1,673
I,699
- 1.5
"Minnesota
1,981
1,924
3.0
(continued)
See footnotes at end of table.
437
Table 17 - Number of persons served by Stare- Vocational
Rehaoflitation agencies: Fiscal Years 1981 and 1982
Total served
Region and
Fiscal Year
Percent
agency
1982
1981
change
Region VI
130,260
140,865
- 7.5
Arkansas
13,891
13,588
2.2
Louisiana
31,206
31,769
- 1.8
New Mexico
3,677
4,029
- 8.7
Oklahoma
29,789
32,602
- 8.6
Texas
46,438
52,767
-12.0
*Texas
5,259
6,110
-13.9
Region VII
45,129
48,659
- 7.3
Iowa
12,252
12,596
- 2.7
Kansas
4,892
6,027
-18.8
Miseouri
20,597
21,193
- 2.8
Nebraska
5,452
6,606
-17.5
*Town
547
568
- 3.7
*Missouri
1,031
1,245
-17.2
*Nebraska
358
424
-15.6
Region VIII
34,430
36,582
- 5.9
Colorado
10,354
11,593
-10.7
Montana
3,911
4,246
- 7.9
North Dakota
3,707
4,115
- 9.9
South Dakota
3,407
3,492
- 2.4
Utah.
10,320
10,413
- 0.9
Wyoming
2,443
2,413
1.2
*Utah
288
310
- 7.1
Region IX.
68,877
77,170
-10.7
American Samoa
35
NA
-
Arizona
7,113
7,328
- 2.9
California
52,882
61,104
-13.5
Guam.
286
331
-13.6
Hawaii
5,494
5,391
1.9
Nevada
2,598
2,633
- 1.3
Northern Marianas
84
62
35.5
Trust Territory.
385
321
19.9
Region I.
30,910
35,948
-14.0
Alaska
1,898
2,035.
- 6.7
Idaho
4,654
4,596
1.3
Oregon.
7,988
8,577
-6.9
Washington
14,862
18,932
-21.5
*Idaho
208
223
- 6.7
*Oragon
316
419
-24.6
*Washington
984
1,166
-15.6
* Agency for the blind
a/ Estimated
b/ Combined data for general and blind agencies
NA Not available
438
Table 18 = Number: of severely disabled persons served by State
Vocational Rehabilitation agencies:
Fiscal Years 1981 and 1982
Severely disabled served
Region and
Percent
Parcent
agree?
Fiscal Year
change
severe
1982
1981
U. S. Total
571,542
600,727
- 4.9
59.6
Region I
35,225
36,565
- 3.7
73.5
4,978
5,609
-11.2
59.2
Connecticut
Maine
3,170
2,818
12.5
81.3
- 0.9
79.6
Massachusetts
17,398
17.549.
New Hampshire
2,677
2,743
- 2.4
67.0
Rhode Island
2,502
2,771
- 9.7
55.0
Vermont
1,942
1,907
1.8
73.3
452
473
*Counecricut
- 4.4
100.0
*Magenchusetts
1,522
2,057
-26.0
100.0
*Thode Island
364
411
-11.4
100.0
*Vernout
220
227
- 3.1
100.0
Region II
62,774
68,571
- 8.5
62.5
New Jersey
15,091
17,366
-13.1
65.7
New York
32,912
35,218
- 6.5
65.2
Puarto Rice
9,036
9,869
- 8.4
43.0
Virgin Islands
135
187
-27.8
63.7
"New Jersey
1,50Z
1,276
17.7
90.9
*New York
4,098
4,655
-12.0
100.0
Region III
82,195
89,900
- 8.6
67.9
Delaware
1,522
1,504
1.2
57.7
District of Columbia
2,446
1,979
23.6
40.7
9,564
11,861
-19.4
MaryLand
55.5
Penusylvania
44,856
50,028
-10.3
79.2
Viryinia
12,816
13,770
- 6.9
62.3
West Virgini
6,803
6,974
- 2.5
52.4
*Ualaware
105
112
- 6.2
100.0
*Pennaylvania
2,633
2,219
18.7
79.2
Virginia
1,450
1,453
= 0.2
92,6
Region IV
125,643
127,140
- 1.2
59.7
Alabama
17,218
18,207
- 5.4
68.1
Florida
18,465
19,710
- 6.3
58.5
Georgia
14,488
13,526
7.1
58.7
Kentucky
9,083
8,087
12.3
60.2
Mississippi
12,455
11,916
4.5
73.1
North Carolina
18,104
18,520
= 2.2
49.9
South Carolina
18,791
18,362
2.3
58.3
Termeses
9,329
10,586
-11.9
52.2
*Vloride
1,885
2,143
-12.0
76.0
*Rentucky
594
624
- 4.8
69.3
Mississippi
1,002
1,045
- 4.1
58.6
*North Carolina
2,594
2,695
- 3.7
71.4
*Souch Carolina
863
934
- 7.6
99.0
*Tennessee
772
785
- 1.7
87.1
Region V
99,349
102,322
- 2.9
58.8
Illinois
24,683
22,367
10.4
83.0
Indiana
7,374
8,204
-10.1
51.8
Michigan
18,411
21,553
-14.6
55.9
Minnesota
11,658
12,154
- 4.1
53.0
Ohio
19,252
20,740
= 7.2
48.9
Wiscousin
14,542
13,908
4.6
53.7
*Michigea
1,673
1,699
- 1.5
100.0
Minnesota
1,756
1,697
3.5
88.6
See footnotes at end of table.
(continued)
439
Table 18 - Number of severaly disabled persons served by State
Vocational Rehabilitation agencies:
Fiscal Years 1981 and 1982
Severely disabled served
Region and
Percent
Percent
agency
Fiscal Year
change
severa
1982
1981
Region VI
59,955
63,485
- 5.6
46.0
Arkansas
9,695
8,934
8.5
69.8
Louisiana
10,570
13,879
-23.8
33.9
New Mexico
2,187
2,445
-10.6
59.5
Oklahoma
6,988
7,500
- 6.8
23.5
Texas
26,032
25,650
1.5
56.1
*Texas
4,483
5,077
-11.7
85,2
Region VCI
24,398
23,281
4.8
54.1
Lowa
5,206
5,465
- 4.7
42.5
Kansus
3,875
3,149
23.1
79.2
Missouri
9,568
9.676
- 1.1
46.5
Sebraska
4,004
2,974
34.6
73.4
*Town.
545
568
- 4.0
99.6
"Missouri
842
1,030
-18.3
81.7
Webrasks
358
419
-14.6
100.0
Region VIII
18,881
20,623
- 8.4
54.8
Colorado
6,899
8,086
-14.7
66.6
Montans
1,835
2,087
-12.1
46.9
North Dakota
2,176
2,398
- 9.3.
58.7
South Dakota
1,427
1,451
- 1.7
41.9
Utah
4,908
4,943
- 0.7
47.6
Wyoming
1,348
1,348
**
55.2
"Utah
288-
310
= 7.1
100.0
Region IX
42,267
45,196
- 6.5
61.4
16
NA
45.7
American Sames
Arizona
4,987
4,154
20.1
70.1
California
32,863
36,828
-10.8
62.1
Goza
152
185
-17.8
53.1
Hamaii
2,541
2,416
5.2
46.3
Nevada
1,355
1,393
-2.7
52.2
Northern Marianas.
.63
42
50.0
75:0
Trust Territory
290
178
62.9
75.3
Region X.
20,855
23,644
-11.8
67.5
Alaska
975
1,022
- 4.6
51.4
Idaho
3,539
3,535
0.1
76.0
Oregon
4,936
5,387
- 8.4
61.8
Washington
9,897
11,933
-17.1
66.6
*Idaho
208
223
- 6.7
100.0
Oregon
316
419
-24.6
100.0
"Washington
984
1,125
-12:3
100.0
*
Agency for the blind.
a
Estimated
b / Combined data for general and blind agencies.
NA - Not available
** Lass than 0.05 percent.
440
GLOSSARY OF TERMS
1. Caseload Statuses: There are 14 status classifications under the caseload
status coding structure coded in even numbers beginning with 02 and ending
with 32 (code 04 is excluded). Following is a brief description of each
status:
a. Status 02 - Applicant: As soon as an individual signs a document
requesting VR services, he or she is placed into Status 02 and is
designated as an applicant. While in Status 02, sufficient information
is developed to make a determination of eligibility (Status 10) or
ineligibility (Status 08) for VR services, or a decision is made to
place the individual in extended evaluation (Status 06) prior to
making this determination.
b. Status 06 = Extended evaluation: An applicant is placed into this
status when a counselor has certified him or her for extended evaluation.
Individuals placed into this status may be moved from this status to
either Status 10 (accepted for VR) or Status 08 (not accepted for VR)
at any time within the 18-month period allowed to complete the
eligibility determination.
C. Status 08 = Closed from applicant or extended evaluation statuses:
This status is used to identify all persons not accepted for VR services,
whether closed from applicant status (02) or extended evaluation (06).
d. Active caseload statuses: An individual who has been certified as
meeting the basic eligibility requirements is accepted for VR, designated
as an active case and placed into Status 10. The active statuses are:
Status 10 - Individualized Written Rehabilitation Program (IWRP)
development: While in this status, the case study and diagnosis are
completed to provide a basis for the formulation of the IWRP. The
individual remains in this status until the rehabilitation program is
441
written and approved.
Status 12 - Individualized Written Rehabilitation Program (IWRP) completed:
After the IWRP has been written and approved, the client is placed into
Status 12 until services have been actually initiated.
Status 14 - Counseling and guidance only: This status is used for those
individuals having an approved program which outlines counseling, guidance
and placement as the only services required to prepare the client for
employment.
Status 16 - Physical or mental restoration: Clients receiving any physical
or mental restoration services (e.g. surgery, psychiatric treatment or
being fitted with an artificial appliance) are placed into this status
until services are completed or terminated.
Status 18 - Training: This status is used to identify persons who are
actually receiving academic, business, vocational or personal and voca-
tional adjustment training from any source.
Status 20 - Ready for employment: A client is placed into this status
when he or she has completed preparation for employment and is ready to
accept a job but has not yet been placed, or has been placed into but has
not yet begun employment.
Status 22 - In employment: When an individual has been prepared for, been
placed in, and begun employment, he or she is placed into Status 22. The
client must be observed in this status for a minimum of 60 days before the
case is closed rehabilitated (Status 26).
Status 24 - Service interrupted: A person is recorded in this status if
services are interrupted while he or she is in one of the Statuses 14, 16
18, 20 or 22.
442
e, Active caseload closure statuses: A alient remains in the active caseload
until completion of the TWRP or case termination. Closures from the
active caseload are classified in one of the following three categories:
Status 26 a Rehabilitated: Active cases closed rehabilitated must as a
minimum (1) have been declared eligible for services, (2) have received
appropriate diagnostic and related services, (3) have had a program for
VR services formulated, (4) have completed the program, (5) have been
provided counseling, and (6) have been determined to be suitably employed
for a minimum of 60 days.
Status 28 - Closed other reasons after IWRP initiated: Cases closed into
this category from Statuses 14 through 24 must have met criteria (1), (2)
and (3) above, and at least one of the services provided for by the IWRP
must have been initiated, but for some reason one or more of criteria
(4), (5) and (6) above were not met.
Status 30 = Closed other reasons before IWRP initiated: Closures from the
active caseload placed into Status 30 are those cases which although
accepted for VR services, did not progress to the point that rehabilitation
services were actually initiated under a rehabilitation plan (closures
from Statuses 10 and 12.).
f. Status 32 = Post-employment: Persons previously rehabilitated are placed
into this status while in receipt of post-employment, follow-up or follow-
along services devoted to helping the client maintain employment.
2. Active caseload: The number of cases in the active statuses (10 to 30).
443
3. Active cases served: The total number of active cases available during the
period--the sum of new active cases and active cases on hand at the beginning
of the period. It is also the sum of the number of cases closed from the
active statuses and the number on hand at the end of the period.
4. Severely disabled: Cases of individuals who fall into any of the four
categories listed below: 1. Clients with major disabling conditions such
as blindness and deafness, which are automatically included, and other
disabilities as qualified, such as a respiratory disorder with sufficient
loss of breath capacity, 2. Clients who, at any time in the VR process, had
been Social Security Disability Insurance (SSDI) beneficiaries, 3. Clients
who, at any time in the VR process, had been recipients of Supplemental
Security Income (SSI) payments by reason of blindness or disability, and,
4. Other individual cases with documented evidence of substantial loss
in conducting certain specified activities.
5. Severely disabled caseload: The number of cases in the active caseload class-
ified as severely disabled.
6. Rehabilitation rate: The number of cases closed rehabilitated as a percent of
all cases closed from the active caseload. (Rehabilitations as a percent of
the sum of rehabilitations and non-rehabilitations.)
7. Acceptance rate: The number of cases accepted for VR as a percent of all
cases processed for eligibility. (Acceptances as a percent of the sum of
acceptances and non-acceptances.)
8. Rehabilitations per 100,000 population: The number of persons whose cases
are closed rehabilitated for every 100,000 persons residing in the United States
derived from Decennial Census data for 1970 and 1980 and updated for population
changes during the interim years and since 1980.
9. Active cases served per 100,000 population: The number of active cases
served for every 100,00 persons residing the United States as derived from
Decennial Census data for 1970 and 1980 and updated for population changes
during the interim years and since. 1980.