Vocational Rehabilitation Program (Combined or General)

Regarding “underserved” individuals, federal guidelines do not prescribe specific groups for analysis. Rather, it has been suggested that each state should examine matters from multiple perspectives to identify potentially underserved populations. This CSNA considered input received from the State Rehabilitation Council via the 2017 Unmet Needs Survey and also by way of its Report of Public Forums. It also conducted an analysis of internal program data, and in doing so, this CSNA defined the term “underserved” as any group for whom it may be shown that any of the following conditions are true; a higher than average percentage of those closed from eligibility for reasons that the individual’s disability was too severe, or, a rehabilitation rate that is far below that of the agency average, or average weekly earnings far below the agency average. All things considered, the 2017 CSNA identified the following groups as potentially underserved: A.) Individuals with Autism, B.) Individuals who are Blind, C.) Individuals who are Deaf, D.) Individuals with Intellectual Disabilities, E.) Individuals with Major Physical Impairments, F.) Individuals with Serious Mental Health Impairments, and G.) Individuals with Disabilities who receive Social Security.

Group A —Individuals with Autism: The top vocational rehabilitation needs identified among those with autism spectrum disorders were: Supported Employment, Extended Supports, Living Wage & Benefits, Applied Social Skills Training, and Employment Preparation & Job Placement that capitalizes on the individual’s strengths and interests. VR program data examined over a six year span indicate that the majority of VR consumers with an autism diagnosis were in need of supported employment services. While the agency’s rehabilitation rate for individuals with autism outperforms the agency average from FY 2014 through 2016, weekly wage outcomes were significantly lower than the agency norm. Training compatible with the individualized interests of persons with Autism Spectrum Disorders has been shown to positively impact rehabilitation outcomes and earnings. Post-secondary education support for those meeting college admission requirements should include efforts to insure adequate post-secondary accommodations and college preparation. Persons with Autism who do not require supported employment have been found in need of individualized job development more so than most other disability types. The nature of functional limitations associated with Autism Spectrum Disorders can often complicate interpersonal relationships. Situational coaching and applied social skills training have been found useful in this regard.

Group B — Individuals who are Blind: The top vocational rehabilitation needs identified among individuals who are blind were: Orientation & Mobility Training, Assistive Technology, Transportation, and Career Guidance. While the agency’s average weekly wage for individuals who are blind outperforms the agency’s total average from FY 2014 through 2016, the rehabilitation rate for blind individuals (57.4%) was significantly lower than the agency norm (67.5%) for the time period. Many rehabilitation outcomes were hindered due to limitations in personal independence and transportation. Research has shown orientation & mobility training, education, and competence with assistive technology has been shown to positively impact rehabilitation outcomes and earnings (Bell, 2015). SRC members representing the blind community have emphasized the need for career guidance that supports preparation for in-demand careers, such as those within science, technology, engineering, and mathematics (STEM).

Group C — Individuals who are Deaf: The top vocational rehabilitation needs identified among individuals who are deaf were: Interpreting Services, Assistive Technology, Career Guidance, and Training for In-Demand Occupations. Although agency outcomes (in terms of rehabilitation rate and average weekly wage) for individuals who are deaf are both above the agency average, many individuals who are deaf and working were found to be in un-skilled, semiskilled or other manual occupations. Historically, there has been an under representation of the deaf population in professional and administrative occupations. Concerns have been raised that jobs held by individuals in this population are frequently characterized by low job security and little opportunity for advancement beyond entry-level. Research has shown that, though reliable and stable employees, the average individual who is deaf and working earns 72 % as much as the average individual with normal hearing in the labor force. Pre-vocational individuals who are deaf have greater difficulty in obtaining employment. The average levels of educational completion fall below that of the general population, further handicapping their ability to compete. Obstacles surrounding communication are important factors related to the earnings and occupational attainment of these workers.

Group D — Individuals with Intellectual Disabilities: The top vocational rehabilitation needs identified among individuals with intellectual disabilities were: Community Inclusion, Fair Wages, Employment Supports and Benefits. Agency outcomes in FY 2014 through 2016 for persons with intellectual disabilities for both rehabilitation rate and weekly wage were significantly lower than the agency norm. VR program data examined over a six year span indicate that the majority of VR consumers with an intellectual disability were in need of supported employment services. Many publications acknowledge the importance of school to work transition outcomes, that early exposure to a wide range of work-based learning experiences plays a large part in later outcomes for individuals with intellectual disabilities. Regarding those who have already made the transition from secondary education, it will be important for VR to monitor and address the need to offer VR services to those individuals who are currently being served within day programs.

Group E —Individuals with Major Physical Impairments: The top vocational rehabilitation needs identified among individuals with major physical impairments were: Accessibility, Transportation, Assistive Technology, Housing, and Medical Care & Supplies. Many persons with physical limitations made their voices heard in the 2017 SRC Unmet Needs Survey and also at SRC Public Forums held around the state. Transportation and accessibility remain formidable barriers for wheelchair users, often presenting a more daunting challenge than work itself. Many told us of ongoing health care needs that are expensive and impossible to manage without proper medical benefits. Others emphasized the challenges they face finding accessible, affordable housing.

Group F —Individuals with Serious Mental Health Impairments. The top vocational rehabilitation needs identified among individuals with mental health impairments were: Access to Mental Health Care & Treatment, Individualized Placement Supports. Persons with mental health impairments are well represented in the ADRS service population, and are found in adequate proportion in all areas of the state. In terms of rehabilitation outcomes, however, agency data reveals that both weekly wage outcomes and rehabilitation rate were below the agency norm for the period. It has been established that some persons with Mental Health Disabilities, particularly those with the most significant disabilities, require specialized services that are sensitive to the unique limitations and treatment needs that are common among this population. Along this line of reasoning, several participants in this year’s SRC Unmet Needs Survey expressed interest in VR’s backing of the Individualized Placement and Supports model, as well as funding for Certified Peer Support Specialists.

Group G —Individuals with Disabilities who receive Social Security: To be eligible for Social Security Disability Insurance (DI) or Supplemental Security Income (SSI), a person must be deemed unable to engage in substantial gainful activity (SGA) due to a significant and long-lasting health condition. Because of this requirement, once receiving benefits, those who may be willing and able to work are often afraid of losing their benefits if they earn too much. Others are confused by the complex program rules governing benefit receipt for beneficiaries who work. Still others are unaware of the various incentives that SSA provides to encourage beneficiaries to return to work. VR Customers on the roles of SSI/SSDI need guidance tailored to their unique circumstances. This guidance should come with persons who possess a deep knowledge of the relationship between SSA work incentives and the VR process.