Ask the Scholar

Document scope · 1 page
doc
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory. For page-specific OCR and visual context, open one of the page chats.

Scholar Source Context

Document identity
localId
353713068
label
"Journal of Disability Policy Studies - 1994"
core
doc
dtoType
document
pageCount
1
Source metadata
Source extras
naId
353713068
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
99df39b1b42552cf
ocrText
Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: Donated Historical Materials Collection/Office of Origin: Frieden, Lex, Collection Series: Printed Materials Subseries: Periodicals OA/ID Number: 52131 Folder ID Number: 52131-002 Folder Title: " "Journal of Disability Policy Studies - 1994" Stack: Row: Section: Shelf: Position: JOURNAL OF DISABILITY POLICY STUDIES VOLUME 5 NUMBER 1 1994 The Journal of Disability Policy Studies is published by the Department of Rehabilitation Education and Research, University of Arkansas, Fayetteville. GENERAL EDITOR Michelle Fine, City University of Kay Fletcher Schriner, University of New York Arkansas, Fayetteville William Johnson, Arizona State ASSOCIATE EDITORS University Andrew Batavia, National Council on Richard Scotch, University of Texas at Disability Dallas Edward Berkowitz, George Washington Tom Seekins, University of Montana University EDITORIAL BOARD M. Anne Hill, Queens College Sheila H. Akabas, Columbia University Martha Hodgesmith, Kansas Association of Kathryn H. Anderson, Vanderbilt University Rehabilitation Facilities William A. Anthony, Boston University Marilyn Johnson, Northern Arizona University Adrienne Asch, The New Jersey Bioethics Reginald L. Jones, University of California, Commission Berkeley Monroe Berkowitz, Rutgers University William E. Kiernan, The Children's Hospital, Boston Douglas Biklen, Syracuse University Corinne Kirchner, American Foundation for the Frank Bowe, Hofstra University Blind David Braddock, University of Illinois at Chicago James Lambrinos, Union College Richard Burkhauser, The Maxwell School, Anita Leal, California State University Syracuse University Paul Leung, University of Illinois- Paul Castellani, New York State Office of Mental Urbana/Champaign Retardation and Developmental Disabilities Sar Levitan, George Washington University Frederick C. Collignon, University of California, David Mank, University of Oregon Berkeley Michael C. Morgan, Morgan and Associates, Salt Daniel Cook, University of Arkansas, Fayetteville Lake City, UT Gerben DeJong, National Rehabilitation Hospital Nancy R. Mudrick, Syracuse University William G. Emener, University of South Florida John Noble, Public Citizen Health Research Group, Stephen B. Fawcett, University of Kansas Washington, DC Daniel Ferritor, University of Arkansas, Fayetteville Margaret Nosek, Baylor College of Medicine Carol Fowler, University of Iowa Sylvia Walker, Howard University Gelya Frank, University of Southern California Douglas Watson, University of Arkansas, Lex Frieden, Baylor College of Medicine Fayetteville Marcus J. Fuhrer, Baylor College of Medicine Sara D. Watson, Berkeley Planning Associates Robert J. Funk, Washington, DC Paul Wehman, Virginia Commonwealth University Rochelle Habeck, Michigan State University Jane West, Jane West and Associates, Bethesda, MD Harlan Hahn, University of Southern California John D. Worrall, Rutgers University Cheryl Hanley-Maxwell, University of Wisconsin- Tennyson Wright, University of South Florida Madison Edward Yelin, University of California, San Susan Brody Hasazi, University of Vermont Francisco Tamar Heller, University of Illinois at Chicago Irving K. Zola, Brandeis University Subscription rates are $14.00 (individual), $22.00 (institutional). Foreign subscribers please add $5.00 for postage and handling. To enter a subscription, send check or purchase order to: Journal of Disability Policy Studies Department of Rehabilitation Education and Research University of Arkansas 346 N. West Avenue Fayetteville, AR 72701 (501)-575-3656 FAX (501) 575-3253 All other correspondence should be addressed to the Editor (address on inside back cover). The Journal of Disability Policy Studies is available on tape. Send change of address notice and recent mailing label to The University of Arkansas Press thirty (30) days prior to actual change of address. The Journal will not replace undelivered copies resulting from address changes; journals will be forwarded only if the subscriber notifies the local post office in writing and guarantees second-class forwarding postage. Back issues will be available at $13.00 per copy six (6) weeks after publication. (Foreign customers please add $2.00 postage per copy.) © Copyright 1994 by the University of Arkansas Board of Trustees JOURNAL OF DISABILITY POLICY STUDIES 1994 Volume 5 Number 1 Contents WINNER OF THE SECOND ANNUAL BATAVIA WRITING COMPETITION ON DISABILITY POLICY Applying Theory to Practice: A Prospective and Prescriptive Analysis of the Implementation of the Americans With Disabilities Act 1 Sara D. Watson ARTICLES The Economic Consequences of Disability: A Comparison of German and American People With Disabilities 25 Richard V. Burkhauser and Mary C. Daly Privatizing Vocational Rehabilitation: Options for Increasing Individual Choice and Enhancing Competition 53 Carolyn L. Weaver Multiattribute Evaluation of Program Alternatives Within Special Education 77 Darrell R. Lewis, David R. Johnson, Ronald N. Erickson, and Robert H. Bruininks BOOK REVIEWS Paul C. Higgins's Making Disability: Exploring the Social Transformation of Human Variation 113 Lawrence O. Gostin's Implementing the Americans With Disabilities Act 123 Applying Theory to Practice A Prospective and Prescriptive Analysis of the Implementation of the Americans With Disabilities Act Sara D. Watson Center for the Study of Social Policy JOURNAL OF DISABILITY POLICY STUDIES Volume 5 Number 1 1994 1 2 JOURNAL OF DISABILITY POLICY STUDIES EDITOR'S NOTE Sara D. Watson is the winner of the second annual Batavia Writing Competition on Disability Policy. The Journal of Disability Policy Studies is pleased to publish her prize-winning article, "Applying theory to prac- tice: A prospective and prescriptive analysis of the implementation of the Americans With Disabilities Act." ABSTRACT Current implementation research, including that on disability policy, is largely retrospective and descriptive, examining experiences after implementation is largely complete in order to identify relevant vari- ables that help explain implementation outcomes. This article seeks to use theoretical implementation research in a different way, one that is prospec- tive and prescriptive, that will improve its usefulness for public adminis- trators. It seeks to use this method of analysis to examine the prospects for implementation of the Americans With Disabilities Act (ADA). Based on theoretical implementation research and on comparisons with the implementation of other pieces of legislation, this article makes predic- tions about the future implementation of the ADA and develops recom- mendations to prevent potential problems. It then discusses the need to refocus implementation research to improve its relevance to practitioners. Over the past 20 years, a wealth of theoretical models has evolved to analyze and explain the difficulty or ease of implementing public poli- cies. Early articles in this genre used single case studies to argue that implementation was indeed a worthy area of study, distinct from policy formulation (Derthick, 1972; Pressman & Wildavsky, 1973). Subsequent models proceeded from this basis to identify specific variables that would affect or predict successful implementation (Van Meter & Van Horn, 1975; Montjoy & O'Toole, 1979; Mazmanian & Sabatier, 1983). The latest gen- eration of implementation research seeks not to add more variables, but to begin to synthesize them and determine which ones are important in dif- ferent circumstances (Matland, 1991). The vast majority of the hundreds of implementation studies that have been conducted and published, including those on disability policy, share ANALYSIS OF THE IMPLEMENTATION OF THE ADA 3 a common perspective and purpose. The studies are largely retrospective, rather than prospective, examining well-established implementation pro- grams from a distance of several years or even decades. They are also descriptive, rather than prescriptive, explaining why outcomes occurred but rarely making recommendations for specific programs. One of the most recent and creative books on implementation research introduces a "third generation" of research that tests, rather than only gen- erates, hypotheses (Goggin, Bowman, Lester, & O'Toole, 1990). How- ever, while the research is prescriptive rather than descriptive, it is still retrospective rather than prospective-the works the authors cite were published as much as 13 years after the project being examined began (pp. 171-191). Kelman (1984) uses implementation research both pros- pectively and prescriptively, but he designs a plan for a hypothetical pro- gram which has never been enacted. Partly because of this descriptive and retrospective nature of traditional implementation research, there is little evidence that policymakers use any of the published research to influence their decisions and improve actual implementation (O'Toole, 1986, pp. 190-205). Kelman (1984, p. 77) notes, Much of the dissatisfaction with the contribution of imple- mentation research, in my view, arises from the fact that the results of that research have been insufficiently used to address specific implementation problems. Most existing research involves retrospective case studies that seek to explain why something has not worked. Research of that sort does not meet the original promise to help policy analysts or public managers with particular situations. The literature is virtually devoid of cases in which existing generalizations have been used, pros- pectively and prescriptively, to develop an implementation plan. Finally, O'Toole's most sweeping comment is: "There is no reason to assume that policy actors do, can or should make decisions about public policy primarily on the basis of research findings" (1986, p. 203). Rather than use this comment to call for change, he goes on to explain why this situation is acceptable (e.g., policymakers have other resources at their disposal and SO do not need to use research). Consistent with Goggin and Kelman, this paper supports efforts to con- tribute to raising the level of respect for published research whose purpose is not only to create this body of knowledge but also to apply it to emerg- ing programs and thereby test and refine it. This means research that is prospective, rather than retrospective, as well as prescriptive, rather than 4 JOURNAL OF DISABILITY POLICY STUDIES descriptive. This is not to say that such research should dominate the lit- erature; only that it should have a place of respect in the published liter- ature alongside theoretical work. Publishing such research provides much wider dissemination of information to policymakers, is more accessible to future researchers, and gives policymakers access to assistance when they may not have the time or resources to hire consultants. 1 Within this context, this article seeks not to create a new model of implementation theory, or to add more items to the 300 variables that O'Toole (1986) listed as already having been identified by researchers as affecting implementation. Rather, it seeks to use existing research to analyze the expected implementation problems of a new law and to recom- mend actions to preempt them. While there have been few studies explicitly examining the imple- mentation of federal disability policy (e.g., Berkowitz, 1984; Percy, 1989), mainstream research on public policy implementation has largely ignored lessons from disability legislation. Even a 1984 book on implementation of civil rights policy did not mention disability rights legislation such as the Education for All Handicapped Children Act of 1975 or the Rehabili- tation Act of 1973 (Bullock & Lamb, 1984). However, the enactment of the Americans With Disabilities Act (ADA) of 1990 (P.L. 101-336; 104 § 327) provides an opportunity to use implementation research to exam- ine a complex and wide-ranging implementation challenge in the disability field and to use early experiences in a major area of disability policy to contribute to this aspired change in the literature on implementation. The ADAprohibits discrimination on the basis of disability in the areas of employment, public services, public accommodations, transportation, and public communications. To narrow the scope of my argument, this article will focus on the successful implementation of Title I (employ- ment), with occasional references to the other sections. However, the same method could, of course, be used on any section. To vastly oversimplify the bill's requirements, Title I of the bill now prohibits discrimination on the basis of disability in all facets of employment for firms of 15 or more employees. Employers are required to make "reasonable accommoda- tions" for employees or prospective employees unless to do SO. would be an "undue hardship" (Burgdorf, 1991b). The ADA has been hailed as the most significant civil rights bill ever conceived for people with disabilities and as the broadest civil rights bill in the United States for the past 25 years (Burgdorf, 1991a). However, it is such a broad bill that its implementation issues are similar to those in a ANALYSIS OF THE IMPLEMENTATION OF THE ADA 5 variety of laws, including civil rights and also consumer and environ- mental legislation. For example, the level of change in behavior required of employers is similar to that required by the Civil Rights Act of 1964. Both require employers to disregard what in some cases was (and is) deeply ingrained behavior and to behave differently toward a group against whom they had discriminated with impunity. The ADA shares with both civil rights and consumer legislation the need to inform millions of people of their newly established rights and to secure those rights against generally better-funded opponents. Because the bill requires reasonable accommodation for people with disabilities in employment settings, devel- opments in technology and their impacts on the bill's implementation are reminiscent of environmental legislation rather than traditional civil rights legislation. The implementation of nondisability civil rights legislation does not depend upon, and will not change significantly even with, mas- sive advances in technology. However, standards for complying with both the ADA and environmental legislation will change based on the level of technology available. In both cases, new technology can make require- ments that had seemed infeasible now eminently reasonable. For example, cheaper pollution screening devices can make a lower emissions level easier to achieve. Cheaper computer devices can make some accommo- dations "reasonable" that would previously have been too expensive. This early point in ADA's implementation history is the ideal time to apply existing scholarship to make predictions regarding areas of relative difficulty and to prescribe the actions that policymakers can take. to improve implementation and to decrease the chances that the bill would be ignored (e.g., acts of discrimination are not prosecuted or otherwise stopped) or that the perceived costs of prohibiting discrimination become SO high that the public demand that the bill be weakened. This cost could take many forms; for example, accommodations that are claimed to be SO expensive that they threaten a firm's viability, or restrictions on medical exams that are perceived to interfere with public safety. I first explore features of the bill and its environment that existing research predicts will affect implementation. Within this discussion, I describe innovative initiatives already being taken at the federal level to promote successful implementation and point out areas of potential imple- mentation problems. I make recommendations to preempt some of these problems and finally discuss how a new format for implementation research, building on the themes here, could encourage policymakers to use the literature in their work. 6 JOURNAL OF DISABILITY POLICY STUDIES Variables Affecting Implementation One of the models for assessing implementation that fits ADA well is that of Mazmanian and Sabatier (1983). To organize this section, I will use their three major categories: "Tractability of the Problem," "Ability of Statute to Structure Implementation," and "Nonstatutory Variables Affecting Implementation." However, the discussion within each section will vary somewhat; in particular, it will incorporate some of the refinements Mazmanian and Sabatier have made on their pioneering model (Sabatier, 1986). The ADA is strongly affected by both top-down and bottom-up factors, both of which will be discussed in this context. Tractability of the Problem Sabatier and Mazmanian start their assessment of implementation by examining the nature and scope of the problem the legislation was designed to address. To organize this discussion, I first establish the prob- lem the ADA was designed to address. Second, I examine the actions nec- essary to accomplish this goal. Determining the problem ADA implementation is designed to address. If the ADA's only goal were to prohibit discrimination, implementation would be easier to achieve and to evaluate. However, even though advo- cates now emphasize that the ADA is not a panacea, and must be accom- panied by other supports, such as health care reform, more is expected of it than this single goal. At the 1992 meeting of the Association for Public Policy Analysis and Management, a plenary session on the status of lower- income people in the 1990s featured two eminent scholars, Christopher Jencks and Ronald Mincy, discussing the relative importance of equal economic opportunity and social respect as policy outcomes. While these scholars focused on the status of minorities and women, the same is true of people with disabilities. Their problems encompass not only the well- defined economic issues of equal employment opportunities and equal access to transportation, housing, and public facilities, but also the more amorphous issues of societal integration and respect. Ultimately, proponents of ADA hope it will not only end discrimina- tion but also promote parity with nondisabled persons in terms of employ- ment wages and rates, and access and integration into mainstream society (Worklife, 1990). As the experience with laws prohibiting discrimination against minorities and women shows, these ends are far more difficult to ANALYSIS OF THE IMPLEMENTATION OF THE ADA 7 measure and to accomplish. Several economists have noted that if the only goal were improved employment rates, for example, perhaps a bet- ter alternative would be to provide tax incentives to encourage employ- ers to hire people with disabilities, or to help people with disabilities overcome the hurdle of leaving public benefit programs (Burkhauser, 1990). However, disability advocates chose to design a civil rights bill, rather than an entitlement or public benefits bill, for specific reasons. Inevitably, the ADA will be evaluated not only on the more limited goal of prohibiting discrimination but also on how it contributed to the broader goal of achieving economic parity with nondisabled persons and com- plete integration into the community. Alleviating the problem. Eliminating discrimination on the basis of dis- ability involves two steps: People must change their behavior SO that they no longer take discriminatory actions, and they must make reasonable accommodations. The level of behavior change required has both depth and breadth. On the face of it, one would expect this aspect of the law to be ADA's greatest challenge. However, closer inspection suggests that this part will become easier over time. Ending discrimination against people with disabilities means pro- scribing deeply rooted and long-held fears about people with disabilities. Even without these fears, unthinking discrimination is ubiquitous, from too-tall deli counters to public address systems with no visual alternative. However, as the population continues to age and as medical science advances, more people will know someone with a disability or become a member of that group themselves. Furthermore, as professional schools (of architecture, public policy, etc.) and organizations educate their stu- dents and members, more people will be aware of their obligation to con- sider the needs of people with disabilities. We can therefore expect that this familiarity will help in inducing people to be aware of the need for, and make, these accommodations. For this reason, this part of the imple- mentation process will become easier. Regarding the size of the target group, according to Sabatier and Mazmanian's earlier research, "In general, the smaller and more definable (capable of being isolated) the target group whose behavior needs to be changed, the more likely the mobilization of political support in favor of the program and thus the more probable the achievement of statutory objec- tives." However, Sabatier (1986) later revised this statement to acknowl- edge that this effect often has a curvilinear shape: Efforts that are too small often go unnoticed. The ADA may well fit this second model. The ADA is 8 JOURNAL OF DISABILITY POLICY STUDIES one of the few laws that requires an active behavior change of a significant percentage of the American population. The sheer size of this effort, coupled with other implementation activities, may actually promote imple- mentation. It is SO big it cannot be ignored. ADA's wide sweep has spawned thousands of seminars, training manuals, speeches, articles, and sources of technical assistance. Furthermore, the author's interviews with numer- ous businesses suggest that it creates significant peer pressure as employ- ers discuss compliance among themselves. Therefore, we can expect that the size of behavior change required will actually promote not only wide- spread implementation but also more successful implementation. However, there is another side to this large effect. The definition of dis- ability in the ADA includes a potentially vast number of people. Many of those people do not fit the traditional image of disabled persons-people who are wheelchair users, visually impaired, or hearing impaired. In fact, under both the Rehabilitation Act of 1973 and the ADA, the largest cate- gory of impairment by far was back impairment (usually not spinal cord injury) (Mastroianni, 1993). This wide scope inevitably means that people will use the ADA to make claims that the public and the media may judge as frivolous or "undeserving." For example, the Equal Employment Opportunity Commission (EEOC) recently found in favor of a hospital worker who claimed discrimination after the hospital in which he worked forced him to cover up a tattoo that said "HIV positive" (LRP Publications, 1993). While the hospital's act clearly was discriminatory; one could imag- ine conservative critics deriding this application of the law. Thus, one danger for the ADA is that the public will perceive the law as protecting people with tenuous claims, rather than as protecting those who seem to be true victims of damaging discrimination. Implementation of the ADA's reasonable accommodations require- ments will be affected by technological advances in ways that parallel those in environmental legislation. For example, while most people with disabilities require only inexpensive accommodations (Collignon, 1986), some people do require, and some companies will be required to provide, expensive accommodations. But, because the technology of accommo- dations is not static, what was unreasonable this year may be much cheaper (e.g., voice synthesizers) and or prevalent (e.g., working from home), and therefore reasonable, in the future. Companies requesting more specific answers as to what accommodations can be expected of them must rely on cases that are either negotiated or tried in court. A company may be able to examine previous cases and determine what level of expen- diture was considered reasonable for a firm with comparable characteris- tics and then to apply that level to its own situation. However, review of ANALYSIS OF THE IMPLEMENTATION OF THE ADA 9 settled cases cannot indicate what specific intervention will be considered reasonable. This situation is not meant as a criticism of the bill but simply to point out that it is an aspect that will require ongoing attention. In sum, the tractability of the problem is a significant but not insurmountable chal- lenge for ADA implementation. Ability of Statute to Structure Implementation The Rehabilitation Act of 1973, which prohibited discrimination by the federal government and federal contractors and grantees on the basis of disability, was the closest predecessor to the ADA. Partly because law- makers did not recognize the significance of the language, the relevant sections of the bill violated virtually every implementation recommenda- tion in the literature. The sections included very terse language, had no explanations of what constituted discrimination, were buried among other provisions, and included no technical assistance provisions. As a result, development of regulations and implementation of the law were protracted and only partly successful. Learning from that experience, disability advo- cates were well aware of the need to incorporate implementation mea- sures into the ADA. The ADA specifically creates an implementation plan that responds to the factors raised in the section above. To clarify the problems ADA was designed to address, the bill spells out objectives in detail. To effect behav- ioral change, it directs comprehensive technical assistance. These factors are explored below. Objectives. In contrast to the Rehabilitation Act, the ADA, through leg- islative language, regulation, and technical assistance manuals, spells out its objectives in great detail. There are long lists to define discrimination (Sec. 102), disability (Sec. 3), reasonable accommodations (Sec. 109), etc. There are specific timetables for publication of regulations and com- pliance (e.g., Sec. 106, 108). The terms which are not strictly defined- there is no single criterion to define "reasonable"-were deliberately left flexible to allow employers and employees to work out solutions together. One part of the ADA language may indeed impede implementation, however. The ADA prohibits pre-offer medical exams and disability- related inquiries. In cases where the public would perceive that these med- ical exams protect the public safety, there may be a clash between public perception of reasonable precautions and the requirements of the ADA. For example, the EEOC is now wrestling with the law's implications for the ability to ask police officers, physicians receiving recertification, and 10 JOURNAL OF DISABILITY POLICY STUDIES other professionals if they have a history of drug abuse or mental illness (Mastroianni, 1993). If the public perceives that EEOC's ultimate guid- ance on this issue ignores public safety concerns, it may undermine sup- port for the vigorous enforcement of at least this portion of the ADA. The carrot: Technical assistance. The ADA specifically directs rele- vant agencies to undertake technical assistance efforts (Sec. 504, 506). As mentioned earlier, many implementation efforts are already underway; for example, the relevant agencies have already published and distributed regulations and their own technical assistance materials. Early in 1992, the EEOC, which is responsible for Title I, sent out mailings to several mil- lion small business owners using lists from the IRS; in one month (April 1992) EEOC distributed 144,000 technical assistance materials (National Council on Disability, 1992). These and other agencies distributed grants to various organizations to undertake technical assistance. The National Institute on Disability and Rehabilitation Research (NIDRR) has funded 10 regional disability and business accommodation centers whose job is to help businesses and indi- viduals understand and comply with the law. Many of these grants went to coalitions that included business organizations opposed to the ADA. While some disability groups bitterly opposed awarding grants to busi- nesses that had actively opposed the ADA, including them in outreach efforts to their peers did (and does) help ensure the relevance of the mate- rials and effective distribution.2 EEOC and the Department of Justice have also funded an innovative program to train disability activists around the country to serve as media- tors and community education specialists in their areas. The trainees are obligated to conduct ADA training for 50 persons with disabilities or par- ents of children with disabilities and for 30 businesspeople. They must also approach businesses that are not in compliance with Title III and help those businesses become accessible. The innovation and significance of this program (as yet unchronicled by implementation researchers) can be illustrated by comparing it to the Environmental Protection Agency hiring Greenpeace activists to serve as mediators for citizen groups petitioning companies to comply with the Clean Air Act. These mediators do not have an official role in the dispute resolution process, but it is significant that disability activists-not local officials, professional consultants, or busi- ness people-are the only ones who can claim any even semisanctioned training in ADA dispute resolution. This indicates a government commit- ment to street-level implementation guided by program beneficiaries. These programs are funded for a limited time, and a key measure in