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
365844834
label
ILRU [Independent Living Research Utilization] Profile of Independent Living Programs [1984]
core
doc
dtoType
document
pageCount
1
Source metadata
Source extras
naId
365844834
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
859d7a97a8c4ada4
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: Reference Materials OA/ID Number: 52147 Folder ID Number: 52147-004 Folder Title: ILRU [Independent Living Research Utilization] Profile of Independent Living Programs [1984] Stack: Row: Section: Shelf: Position: 7 Lex- here is an updated version of the report (hopefully, all the typos are gone now) How does it look ? EV A NATIONAL PROFILE OF INDEPENDENT LIVING PROGRAMS FOR PEOPLE WITH DISABILITIES COPYRIGHT 1984 ILRU PROJECT Work supported in part by C.S. Mott Foundation INTRODUCTION In 1983-1984 the Independent Living Research Utilization Project conducted an extensive survey of the independent living programs in the United States for the purpose of updating ILRU's informational data base, and documenting the continued vigorous growth of the independent living movement in this country. The information collected included demographic items, staffing pat- terns, utilization of funding resources, services provided and types of people using these services. DEFINITION OF INDEPENDENT LIVING PROGRAM The survey was sent to all programs listed in ILRU's DIRECTORY OF INDEPENDENT LIVING PROGRAMS. These programs can be catagorized into four groups: Independent Living Centers, which are characterized by consumer control, a wide range of services, and are primarily community-based, non- residential organizations; Independent Living Transitional Programs, charact- erized by short-term training in specific independent living skills with housing arrangements usually provided during the training; Independent Living Residential Programs, which have a primary focus on long-term housing needs and often transportation for the residents in the program; and Independent Living Service Providers, which offer specific services useful for living independently although they are not themselves independent living programs. SOURCE OF THE MAILING LIST The DIRECTORY has been compiled since 1977 from several sources: state vocational rehabilitation agencies, lists of ILPs funded under the federal independent living authority (Title VII of PL 93-112, as amended), and personal contacts with an extensive peer network in the movement. The final mailing list included 281 addresses. PROCEDURES Data collection was conducted by mailing a three-page survey to all listed programs in the DIRECTORY during November 1983. A follow-up letter was sent to non-responding organizations in January, 1984. The survey was completed in February 1984 with a total response of 162 programs. This is considered a good response rate since many of the original list of 281 programs either no longer exist or are not truly consumer-controlled, community-based independent living programs at all. Seven of the 162 programs which responded are not included in the statistical analysis because of their late response. Therefore, all statistics are based on 155 survey returns. It is estimated that this sample represents roughly 60% of the total number of ILPs operating today. Based on ILRU's experience in the field, this sample appears to be a very representative sample of the ILPs operating in the U.S. today. OVERALL RESULTS TABLE 1 NATIONAL SUMMARY DATA ON ILP TYPES AS OF FEBRUARY 1984 TYPE NUMBER PERCENT TOTAL ILC 109 70% 155* ILRP 13 8% ILTP 14 9% ILSP 21 13% # The following programs have aspects characteristic of more than one program type: Austin Resource Center for Independent Living, Austin TX Cedar Street Living Center, Blackfoot ID Center for Independent Living of Greater Bridgeport, Bridgeport CT Courage Residence, Minneapolis MN Independent Living Program, Seattle WA Metrolina Independent Living Program, Charlotte NC Prairie Freedom Center for Disabled Independence, Sioux Falls SD Rehabilitation Institute Center for Independent Living, Detroit MI Roosevelt Rehabilitation Independent Living Skills Training, Warm Springs GA Summit Independent Living Center, Missoula MT Woodrow Wilson Center for Independent Living, Fishersville VA These progrmas have been classified according to the program type they most resemble. Table 1 figures indicate: o Well over half (70%) of the ILPs are consumer controlled, community based independent living centers. This is a significant increase from the 1977 survey which showed only 12 of 52 programs polled to be ILCs. o Only 8% of the programs are primarily residential, as opposed to 15 of the 52 programs in the 1977 survey. This possibly indicates that disabled consumers are finding more diverse methods of meeting their housing needs and are no longer directly requiring residential services from the ILPs. GROWTH IN NUMBER OF ILPs TABLE 2 NUMBER OF ILPS OPEN PER YEAR (96% reporting) YEAR TOTAL ILC ILRP ILTP ILSP (Cumulative Number/Number new programs added that year) 1970 or before 5/5 0/0 1/1 2/2 2/2 1971 6/1 0/0 1/0 3/1 2/0 1972 9/3 3/3 1/0 3/0 2/0 1973 10/1 3/0 2/1 3/0 2/0 1974 13/3 5/2 2/0 3/0 3/1 1975 17/4 7/2 2/0 3/0 5/2 1976 27/10 15/8 3/1 4/1 5/0 1977 33/6 19/4 3/0 4/0 7/2 1978 41/8 25/6 4/1 4/0 8/1 1979 48/7 29/4 6/2 4/0 9/1 1980 88/40 59/30 9/3 5/1 15/6 1981 120/32 83/24 11/2 7/2 19/4 1982 134/14 96/13 11/0 8/1 19/0 1983 144/10 105/9 11/0 9/1 19/0 1984 146/2 106/1 12/1 9/0 19/0 FIGURE 1 NUMBER OF NEW PROGRAMS PER YEAR 40 35 30 25 20 15 10 5 0 <-170 75 80 '84 o Data indicate that the years of highest growth for the ILCs were 1980-1981, when federal funding through Title VII, Part B became widely available. TYPE OF STAFF TABLE 3 STAFF BREAKDOWN (in average percentages) % % % Paid Volunteer Disabled Non-disabled Board of Directors 1% 99% 49% 51% Exec. Director 99% 1% 50% 50% Peer Counselors 40% 60% 84% 16% IL Skills Trainers 81% 19% 35% 65% Administrative Staff 86% 14% 39% 61% Other 67% 33% 44% 56% Both the board of directors and the executive director show a 50/50 split disabled/non-disabled catagories. The boards are voluntary, while directors are paid. Over half (60%) of the peer counselors are volunteer and most (84%) are disabled. Most IL skills trainers are paid (81%) and non-disabled (65%). Most administrative staff are also paid (86%) and non-disabled (61% GEOGRAPHICAL DISTRIBUTION TABLE 4 AVERAGE PERCENTAGE OF PERSONS SERVED ACCORDING TO LOCATION Immediate community 70% Rural areas 15% Other cities in state 13% Outside state 2% TABLE 5 DISTRIBUTION OF CENTERS BY STATE STATE TOTAL ILC ILTP ILRP ILSP (dir) (reg) (pop) # CTRS/# PEOPLE SERVED PER MONTH) REGION 1 CT 3 2/168 2/168 ME 6 3/565 2/550 1/15 MA 14 9/1901 7/1143 1/20 1/208 1/30 NH 1 0 RI 3 2/440 1/300 1/140 VT 2 1/230 1/230 REGION 2 NJ 3 2/280 2/280 NY 25 10/2036 8/1114 1/754 1/168 REGION 3 DE 2 2/125 1/50 1/75 MD 1 0 PA 6 4/775 2/515 2/260 VA 9 5/398 2/298 3/100 WV 3 3/150 3/150 DC 1 1/138 1/138 REGION 4 AL 1 0 FL 14 4/865 3/615 1/250 GA 5 3/608 2/600 1/8 KY 5 0 MS 2 0 NC 1 1/20 1/20 SC 1 0 TN 1 1/45 1/45 REGION 5 IL 6 5/2222 2/130 2/92 1/2000 IN 3 1/54 1/54 MI 16 12/837 8/721 2/84 2/32 MN 8 6/1345 4/345 1/1000 OH 5 5/275 2/150 2/170 1/45 WI 6 6/425 5/325 1/100 REGION 6 AR 2 2/395 1/189 1/206 LA 4 1/105 1/105 NM 1 1/140 1/140 OK 2 2/121 2/121 TX 14 5/714 4/689 1/25 REGION 7 IA 3 1/100 1/100 KS 6 6/454 4/389 2/65 MO 7 3/117 3/117 NE 4 4/710 4/710 REGION 8 CO 6 4/2400 3/2265 1/135 MT 3 3/356 2/331 1/25 ND 2 0 SD 3 1/73 1/73 UT 1 0 WY 2 2/57 1/2 1/55 REGION 9 AZ 3 2/100 1/100 1 CA 28 14/2179 12/2166 2/13 HI 5 1/94 1/94 NV 2 2/142 2/142 REGION 10 AK 2 1/101 1/101 ID 5 4/117 1/30 1/35 2/52 OR 6 4/241 3/165 1/76 WA 14 10/1096 5/959 3/72 2/65 o California has the largest number of ILPs (14 survey returns, 28 listed in the directory of ILPS), followed by New York (10 from survey, 25 in directory), Michigan (12 from survey, 15 from directory) and Washington (10 from survey, 14 from directory). o Colorado serves the largest number of people (2400), however 2,005 are strictly general information and referral calls. Illinois has 2,222 which includes a school service program for 2,000 people. of the states that have programs serving the more typical IL needs, California is again first with 2179, followed by New York (2036) and Massachusetts (1901). MAP SHOWING LOCATIONS OF INDEPENDENT LIVING PROGRAMS (ILPs) IN THE UNITED STATES DISTRIBUTION OF FUNDING RESOURCES TABLE 6 FUNDING SOURCES AND BUDGET PERCENTAGE AVERAGED FOR ALL PROGRAMS Federal/State funds 79% Local funds (city, county) 4% Foundations/Private agencies 8% Funds generated (fees, memberships) / Other 9% o Federal and state taxes, most generally Title VII funding and state voca- tional rehabilitation agency funding, comprise the major funding resource for Independent Living Programs. TABLE 7 COMPARISON OF FUNDING RESOURCES AND AGE OF PROGRAM PROG. 1% STATE/ 1% LOCAL 1% PRIVATE 1% SELF- AGE (in yrs) |FED. FUNDS FUNDS FUNDS |GEN. FUNDS 15 or more 148 111 120 122 10-15 151 13 [29 117 5-10 166 18 114 112 <5 185 13 |8 15 o As programs mature, funding sources apparently grow more diverse with a trend toward greater reliance on self-generated funds and less reliance upon tax dollars. TABLE 8 COMPARISON OF BUDGET SIZE AND AGE OF PROGRAM AGE |<100,000 100,000- I 400,000- 700,000- |>1,000,000 (in yrs.) I per yr. 400,000 700,000 11,000,000 >15 0% 33% 0% 33% 33% 10-15 0% 43% 14% 43% 0% 5-10 9% 45% 18% 12% 15% <5 24% 69% 6% 1% 0% o Younger programs tend to have smaller budgets, which would be expected since they are also more dependent on a single (government) source for their support. TABLE 9 COMPARISON OF NUMBER OF SERVICES OFFERED BY AGE OF PROGRAM AGE 0-2 3-5 6-8 9-12 (in yrs.) SVCS SVCS SVCS SVCS >15 0% 33% 67% 0% 10-15 40% 40% 10% 10% 5-10 20% 17% 33% 27% <5 10% 26% 45% 23% o Older programs have more liklihood of offering a few specialized services while younger programs tend to offer a greater variety of services. TABLE 10 COMPARISON OF NUMBER OF DISABILITY TYPES SERVED BY PROGRAM AGE AGE 0-2 3-5 6-8 9-11 (in yrs.) TYPES TYPES TYPES TYPES >15 50% 25% 25% 0% 10-15 50% 0% 17% 33% 5-10 24% 16% 28% 32% <5 12% 16% 26% 46% o Older programs tend to serve a more specialized disability population, while younger programs tend to serve a greater spread of persons with various disabilities. CHARACTERISTICS OF PERSONS SERVED TABLE 11 AGE DISTRIBUTION AGE PERCENTAGE 0-18 years 8% 19-30 years 37% 31-64 years 40% 65 and over 15% o This distribution reflects the fact that there are numerous social service programs for school-age and retired citizens, so the most numerous population in the independent living programs are the working age people. TABLE 12 DISTRIBUTION BY DISABILITY (120 programs reported these statistics) DISABILITY UNITS OF I % OF TOTAL # OF PRGMS % OF TOTAL TYPE SERVICE SERVICES OFFERING # OF PRGMS PROVIDED PROVIDED SERVICES Spinal Cord Injury 3443 18% 95 79% Cerebral Palsy 1836 10% 86 72% Brain Injury 981 5% 83 69% Amputee 394 2% 65 54% Stroke 995 5% 76 63% Blind 2996 16% 94 78% Deaf 1294 7% 76 63% Deaf-Blind 182 1% 28 23% Mental Illness 1414 7% 70 58% Mental Retardation 2267 12% 70 58% Other# 3422 18% 81 68% Total 19,224 # Included under other are the following: Multiple disabilities, Arthritis, Aged, Alcoholics (or other drug addictions), Chronic medical conditions (including cancer, heart disease, respiratory, diabetes, kidney dysfunction), DD, Dwarfism, Dyslexia, Epilepsy, Incontinence, LD, MD, Neuromuscular (including ALS, Frederich's ataxia, spina bifida, MS, polio), Orthopedic, Speech impairment. o Spinal cord injured persons have the highest representation by any single disability group (18%), followed by blind (16%), mental retardation (12%), and cerebral palsy (10%). o A high percentage (18%) of consumers have various other disabilities, showing a fairly unviersal usage of the services offered by independent living programs. PERCENTAGE OF PROGRAMS WHICH ARE RESTRICTED BY DISABILITY TYPE: 36% o The most common restrictions seen in programs are: physical disabilites only (no MI or MR), blind, mentally retarded (usually multiply handicapped), or mentally ill. TABLE 13 SERVICES OFFERED SERVICES PERCENTAGE OF PROGRAMS AVERAGE PERCENTAGE OFFERING THE SERVICE OF PERSONS USING SERVICE Housing assistance 82% 18% Peer counseling 79% 14% IL skills training 77% 16% Attendant assistance 67% 9% Financial counseling 58% 7% Family counseling 46% 3% Other I & R 44% 11% Reader/Interpreter referral 43% 3% Vocational counseling 42% 5% Other counseling 39% 9% Vocational training 23% 3% Vocational placement 23% 3% Client advocacy 92% Systems advocacy 85% Newsletter 74% Media coverage 74% Annual report 74% Speaker's bureau 70% Social/ Recreational activities 68% Transportation 63% Residential service 33% Wheelchair repair 24% Medical treatment or Sheltered workshop or Protective supervision 15% o The services most widely offered are: Client advocacy (individual help for specific problems) with 92% of the programs offering that service, followed by systems advocacy ( (i.e. working in the community for accessible housing, transportation, etc.) 85%, with housing assistance (82%) and peer counseling (79%) in third and fourth place respectively. o The most used services (Table 13) are: Housing assistance (18%), independent living skills training (16%), and peer counseling (14%). In addition to the data already reported, the national independent living survey also listed two open-ended essay questions. The first dealt with the usefulness of services, while the second asked about methods of program eval- uation. The following is a compilation of those responses. The number in front of each catagory designates the number of programs listing that as a useful service. DESCRIPTION OF MOST USEFUL SERVICES IN INDEPENDENT LIVING PROGRAMS ADAPTATIONS 14 Technical assistance and architectural/environmental consultation 13 Adaptive equipment, homemaker aids, mobility aids, W/C repair ADVOCACY 31 Individual advocacy 20 Community advocacy 1 Legal assistance ATTENDANTS 26 Attendant/aid referral 26 Attendant care services 3 Attendant management training COMMUNICATIONS 28 General information and referral 4. Relay calls 3 Interpreter referral 2 American sign language training 1 Language translation and interpretation 1 Communication aids 1 Newsletter 1 Community outreach--consumer identification COUNSELING 53 Peer counseling, role modeling, informal peer support and advice 29 Benefits and community resources advisement 23 Adjustment counseling--mental health, individual adjustment, behavioral intervention, problem-solving, psycho-social groups 9 General counseling 4 Family counseling EDUCATION 79 Independent living skills training--ADL skills, basic communication, orientation and mobility, homemaking skills, medication training, medical self-reliance, budgeting, assertiveness training, time management, monitoring 4 Continuing education including topical workshops 3 Participant volunteer training activities 3 Case management coordination 1 Educational assistance 1 Independent living evaluation 1 Training for spouses, parents, and institutional staff HEALTH CARE 3 Home health care 1 Medical restoration 1 High quality community based health care 1 Support services--speech, physcial therapy, etc. HOUSING 54 Housing assistance 9 Transitional living arrangements 7 Residential care/housing SOCIALIZATION/RECREATION 16 Socialization/recreation including sports programs 1 Adult day program TRANSPORTATION 27 Transportation service 2 Transportation referral 2 Driver's education 1 Vehicle modification VOCATIONAL 9 Vocational counsel 8 Vocational and prevocational training 8 Vocational placement and job development 1 Vocational support services o The services most often described as being the most useful are: 1. Independent living skills training (79 responses) 2. Housing (54 responses) 3. Peer counseling (53 responses) 4. Advocacy (52 responses, the combined total of individual advocacy (31), community advocacy (20) and legal assistance (1) METHODS USED TO EVALUATE PROGRAM EFFECTIVENESS CONSUMER/CLIENT BASED 53 Client satisfaction survey 25 Individual follow up 2 Peer evaluation 2 Improved coping skills (determined from client's response) 2 Client input to staff evaluations 1 Progress as monitored by clients PROGRAM/GOAL BASED 16 Evaluate goal completion 13 Skill improvements (including dwelling, transportation, education, self- care, driving, leisure, medical self-reliance, job placements, involvement in community activities) 10 Needs assessment (pre and post) 6 Management by objectives system 5 IPPs 3 Program evaluation system 3 Client service data/Service evaluation form 2 Quality assurance program 1 Client progress eval based on W.H.O. Classification of Impairment, Disability and Handicap 1 Personal fitness profiles 1 Workshop evaluation form 1 Results 1 Psychological testing 1 Client testing and assessment GENERAL REPORT FORMS/STANDARDIZED EVALUATIONS 8 Lawrence R & T Center evaluation form 7 Case management review 2 Internal evaluation (monthly or quarterly) 2 Performance eval developed by Walker and associates 1 West Virginia R&T Center evaluation form 1 University of Washington (Deborah Wilkerson) IL evaluation project 1 University of Arkansas (Rick Rossler) client outcome system 1 Local university social work department evaluation form 1 Weekly progress notes CHANGES MADE 4 Change in living situation 2 Number of barriers removed in community, number of accessible housing units identified 2 Work adjustment (productivity) STAFF EVALUATIONS 15 Evaluation of program by board and administration 13 Staff report forms forms (monthly, quarterly, yearly, at termination of service) 5 Input from consumer advisory council 5 Staff development meetings 4 Staff monitoring, performance review 4 Staff satisfaction 4 Staff recommendations 1 Annual review by executive director 1 Training STATISTICS 13 Numbers served 9 Statistical analysis of services provided 2 Unit cost 2 Length of time in ILS program 1 Effectiveness and efficiency measures 1 In-out referral ratio 1 Length of time out of hospital FEEDBACK FROM OUTSIDE AGENCIES, OTHERS 23 Outside agency evals/reports to agencies/monitoring by funders 16 State DVR collection system 7 Community feedback (incl. PR, media, support funds) 4 Independent/CPA audits 2 Health care professional feedback 2 Family feedback 2 Referral sources 2 CARF audit 1 HUD forms and regulations 4 In process of developing system o The most popular evaluation systems are: 1. Client satisfaction survey (53) 2. Individual follow-up (25) 3. Outside agency/funder's evaluations (23) O Comparing the results of Table 13 with the essay question which asked which programs were most beneficial, similar results were obtained. Seventy-nine programs answered that independent living skills training was the most beneficial service they offered, and 16% of the clients used it. Housing assistance and peer counseling were also popular services with 54 and 53 programs responding that these were beneficial, while 18% and 14% of the clients used them. The top three services were the same, in both catagories: number of people served and usefulness of service. SUMMARY The national independent living program survey results indicate that the programs are working with people who have a wide range of disabilities and that the programs offer a number of services which appear to be consistent with the reported needs of the disabled consumers. As programs mature, the services vary, and many programs have services which were not adequately cap- tured by this survey but were added as supplemental material. This again indicates the importance of consumer involvement in making their programs flexible enough to continue to meet the changing needs of those who benefit from the services. As the independent living movement continues to grow, the programs are growing too. It would appear that a very healthy trend is occurring. # Examples include: Rural branch operations set up by urban programs, innova- tive personal care attendant programs, and strong community advocacy programs.