An Evaluation of Choice Demonstration Projects

 

Executive Summary

 

 

 

 

 

 

 

 

Prepared by:
Susan Stoddard
Stuart Hanson
Tanya Temkin

 

 

 

InfoUse

2560 Ninth Street, Suite 320
Berkeley, CA 94710
(510) 549-6520 (V)
(510) 549-6523 (TDD)

 

 

 

Prepared for:
Rehabilitation Services Administration
U.S. Department of Education
330 C Street, SW, Room 3014
Washington, D.C.
Contract HR95034001

 

February 1999

Executive Summary

Title VIII of the Rehabilitation Act of 1992 (P.L. 102-569, Section 802 (g)) provided for seven Choice demonstration projects and an evaluation of project results. Funded through the U.S. Department of Education, Rehabilitation Services Administration (RSA), Choice grantees are Arkansas Rehabilitation Services (AR); Vermont Division of Vocational Rehabilitation (VT); Washington Division of Vocational Rehabilitation (WA); Berkeley Center for Independent Living (BCIL); Southwest Business, Industry and Rehabilitation Association (SWBIRA); The Development Team, Incorporated (TDTI); and United Cerebral Palsy Associations, Inc. (UCPA).

P.L. 102-569 provided grants to nonprofit organizations and state agencies to be used to increase client choice in the rehabilitation process, including the selection of providers of vocational rehabilitation services. Eligible clients were defined as individuals with a disability as defined in Section 7(8)(A) of the Rehabilitation Act who are not currently receiving vocational rehabilitation services under an Individualized Written Rehabilitation Program (IWRP) established through a designated state vocational rehabilitation (VR) agency. The legislation specified that a written plan would be established with full participation of the client; the plan would include a statement of the vocational goals, specific VR services to be provided, and an anticipated vocational services schedule (dates, duration of services). The legislation also asked for assurances that the demonstration grantee "ensure that any vocational rehabilitation service or related service is provided by a qualified provider who is accredited or meets other quality assurance and cost-control criteria as the state may establish." At least 80% of the funds awarded for any project "shall be used for direct services, as specifically chosen by eligible clients."

The application materials for the demonstration indicated that, in addition to increasing choice in the selection of providers, "the Secretary would encourage, but not require, grantees to demonstrate effective ways to increase client choice in other aspects of the rehabilitation process." This could include selection of goals, services, and providers. (C.F.D.A. Number 84.235D).

The legislation also authorized an evaluation of "the services provided, clients served, client outcomes obtained, implementation issues addressed, the cost effectiveness of the project, and the effects of increased choice on clients and service providers" in the demonstrations (PL 102-569, Section 802 (g)(7)). Coinciding with the October 1993 start date of the demonstration, Research Triangle Institute (RTI) was awarded a task order contract to assist the projects to prepare for the national evaluation. InfoUse was awarded the contract for the national evaluation in October 1995, two years after the demonstrations were underway. This Executive Summary presents evaluation findings based on data through early 1998. The demonstration projects are scheduled to end in September 1999.

Evaluation Approach

Measures of participant characteristics, services, costs, and outcomes varied across projects. To create a uniform data set across projects, InfoUse reviewed a randomly selected sample of approximately 30 participant files in each project during the two-year period from October 1994 to September 1996. Data were collected using a field instrument designed to identify service purchase detail, as well as selected demographics and outcomes.

To collect data on participant choice, satisfaction with project services, and employment outcomes, InfoUse conducted a telephone survey of a random sample of project participants. The survey focused on the extent of participants discretion in selecting a rehabilitation team, vocational goals, goods and services, providers, and job placements. The survey also measured the degree of satisfaction participants reported for these choices in the rehabilitation process and employment outcomes such as nature of employment, hours worked, earnings, and benefits.

Qualitative data collection and analysis included development of descriptions of each Choice project, short descriptions of individual participant experience, and promising practices. Qualitative data were collected through project site visit interviews and phone discussions with project staff, providers, consumers, parents, and advocates, VR directors, and other key informants.

The cost study was based on annual expenditure data from each project, augmented by estimates for in-kind costs and for one-time demonstration costs. Estimates for average per participant annual total cost and annual purchased service cost were developed.

When possible, InfoUse made statistical comparisons with the basic public vocational rehabilitation system using data from RTI's Longitudinal Study of the Section 110 program. This current RSA-sponsored study is based on a representative sample of 8,500 participants in 37 VR offices in 30 states. Data collection was initiated in the fall of 1994.

The Choice Demonstration Projects

Below are brief descriptions of each Choice project. Table 1 displays the total number of enrollees, successfully rehabilitated and not successfully rehabilitated participants reported by each grantee.

Arkansas Rehabilitation Services

The Commitment to Client Choice (CCC) project, Arkansas Rehabilitation Services (ARS), serves southeastern Arkansas. This rural area was chosen for its high proportion of African-Americans with disabilities, high rates of poverty and unemployment, and a history of underserving people with disabilities. Project staff includes a full-time director and administrative assistant, 2 full-time counselors, a part-time consultant, and several contracted Consumer Connectors.

The CCC model starts with the basic VR model, adding "Consumer Connectors" who assist with transportation, completing forms, program planning, and job development/placement. Connectors, who are hired and fired by project participants, are required during intake and planning but are optional later in the process.

During pre-planning, the participant chooses other members of the rehabilitation team, receives a professional vocational assessment, and attends a day-long workshop on empowerment. The project uses a voucher system based on participant choice of services and vendors not restricted to ARS-approved providers.

During the period from April 1994 through April 30, 1998, 310 individuals ranging in age from 17 to 57 applied for services. Of these, 59% were African-American, and 60% were male. As of April 30, 1998, 243 individuals had enrolled in the project, 88 were successfully rehabilitated, and 65 individuals were closed as not successfully rehabilitated. Ninety others were still enrolled in the project.

Vermont Division of Vocational Rehabilitation

The Consumer Choice Demonstration (CCD), Vermont Division of Vocational Rehabilitation (DVR), provides services in the district offices of the State's Section 110 program. Project staff include a project coordinator and program specialist who provide overall direction and support throughout the state, one full-time counselor in each of four district offices, and four contracted Consumer Mentors.

When an opening is available in the Choice project, a random assignment process is used to determine whether the applicant is offered services through the Choice project or the Section 110 program. This process is based on the capacity to serve new participants in the Choice program and the number of new applicants in a given period of time. If, in the judgment of the counselor, the applicant has a disability and can benefit from the vocational services available through the Choice demonstration, the counselor may expedite eligibility and provide service funds as early as the first visit.

Emphasis throughout the process is on empowerment of counselors and their participants, and on streamlining the process leading to employment outcomes. DVR views the demonstration project as a vehicle for system change; CCD features, such as expanded self-employment, have been recommended for implementation statewide in the Section 110 Program.

Statistics prepared by the Choice project showed a population very similar to the Vermont Section 110 program participants in terms of age at referral, reported disability, education at referral, and gender. By the end of December 1996, DVR reported the following comparison between the Choice project and the Section 110 project:

The Division also reported that the average cost of purchased services for a successful closure was reduced from $3,257 to $1,753.

As of April 30, 1998, project records showed 662 individuals referred for service, and 618 persons enrolled. Of those enrolled, 467 participants completed vocational plans, 223 people were successfully rehabilitated, and 101 people were closed as not successfully rehabilitated.

Washington State Division of Vocational Rehabilitation

The Participant Empowerment Project (PEP) is an autonomous unit of the Washington State Division of Vocational Rehabilitation (DVR). It serves King County, the most densely populated county in the State. PEP employs a full-time director, two vocational specialists, an independent living specialist (contracted), and a clerical support person.

Eligible participants may attend informational classes taught by both community resources and project staff. Participants must choose a "Rehabilitation Team," including at least one other person such as a friend, family member, advocate, and, optionally, a PEP counselor. With help from the Team, participants formulate a written vocational rehabilitation plan, which may include self-employment or traditional employment goals. Consumers have the option of obtaining job development services from project staff and/or outside vendors. For goods and services purchased from outside vendors, each participant is given a purchase order.

During the period from October 1993 to April 30, 1998, Washington PEP estimated that more than 450 individuals attended program orientation meetings. From this group, 379 individuals enrolled in the program, and 333 people completed IWRPs. Of those enrolled, 111 were successfully rehabilitated, and 76 people were closed as not successfully rehabilitated.

Berkeley Center for Independent Living

The Choice Enhancement and Empowerment Project (CEEP), Center for Independent Living in Berkeley, California (BCIL), targets persons with severe disabilities, particularly those from ethnic minority groups residing in Alameda and San Francisco Counties. CEEP employs a part-time director, a full-time project manager and accounting assistant, and a part-time secretary.

Participants learn about CEEP from friends, contacts in social service agencies, community organizations, or the California Department of Rehabilitation. After attending an orientation session with other applicants, an individual meets with a counselor to complete the application process and begin working on the design of a written rehabilitation program, and, if appropriate, a business plan. Staff encourage participants to shop around, find the best combination of product and service features available to them, and negotiate the price. There is no pre-established list of vendors. Participants use a project voucher, if that is acceptable to the vendor. They may also request that a check be made out to the vendor. In some situations the participant may pay for something out-of-pocket and bring in the receipt for reimbursement. CEEP offers workshops that anyone can attend while designing or completing a vocational plan. Topics include "Dressing for Success" and "Starting Your Own Business."

During the period October 1993 to March 1998, BCIL enrolled 416 individuals, of which 29% were African-American, and another 23% represented other ethnic minorities. Of those enrolled, 217 participants developed IWRPs, and 107 were successfully rehabilitated.

Southwest Business, Industry, and Rehabilitation Association (SWBIRA)

The Client Choice Project, Southwest Business, Industry, and Rehabilitation Association (SWBIRA), serves working-aged people with disabilities residing in Greater Phoenix or Maricopa County. The Client Choice Project is based on a case management model developed earlier by SWBIRA in Project NetWork, a demonstration project for the Social Security Administration. The project is staffed by a director and three (later two) full-time case managers.

After a mandatory orientation session, each participant attends a five-day "Job Search Skills Workshop" conducted by the National Institute for the Disenfranchised (NID), a spin-off of SWBIRA. The sessions are used to (1) provide information about the Choice project; (2) explore the meaning of participant empowerment through choice; and (3) complete a social-vocational history used to assess participant employability.

Case management begins with a social-vocational history, a preliminary assessment, an explanation of the voucher process, training, and education about choosing a placement specialist from a list of approved vendors. Each case manager arranges a meeting of the participant, family, or friend, and the placement specialist selected by the participant to develop a Written Vocational Plan (WVP). Almost all services, equipment, or goods are purchased from outside vendors. The case manager coordinates implementation of the participant's plan through these purchases and monitors progress on an ongoing basis. Each participant receives vouchers for blocks of ten hours of job placement specialist services. The case manager relies on participant feedback and vendor billings to monitor the placement specialist's performance.

For the period April 1994 to March 1, 1998, SWBIRA was contacted by 2,472 individuals. Of these, 868 individuals enrolled in the project and 453 completed a written vocational plan. The project reported that 249 enrollees were successfully rehabilitated, and 312 were closed as not successfully rehabilitated.

The Development Team, Inc. (TDTI)

Career Choice, The Development Team, Inc. (TDTI), has sites in Northern Virginia/Washington D.C., The San Francisco Bay Area, and Jacksonville, Florida. The project focuses on self-management and job recognition skills, drawing on proven job-seeking techniques to identify and pursue appropriate jobs. Participants were not required to be unemployed at time of enrollment. TDTI employs a full-time project director, a part-time materials and training coordinator, and a part-time clerical assistant. In addition, on-site group leaders are hired to conduct and manage each local group.

Career Choice is a peer group training program (one 3-hour session each week for 12 weeks, plus completion of at-home assignments). Groups consist of people with similar disabilities. Each group has a lead and co-facilitator, at least one of whom has a disability similar to the disability of the group members. In addition, invited guests may give presentations and lead discussions.

Each participant receives a customized training manual containing information, exercises, interactive tasks, homework assignments, and supplemental materials, which together constitute the substance of the training program. During the first five sessions, each participant deals with many personal and job readiness issues. The sixth session is spent translating the individual's job objectives and probable employment barriers into a written vocational plan.

At the eleventh session, each individual presents his or her plan and purchase recommendations; the group rates each plan and apportions a specific sum of money to fund each member's plan. At the twelfth session, a Job Club is organized to support people who will be job-hunting in the next few months.

For the period March 1994 through April 30, 1998, 209 individuals enrolled in the TDTI project. Of these, 175 individuals completed the peer group training. Slightly more than half of these people (52%) were female; 23% were African-American. As of April 20, 1998, 113 individuals were employed at follow up, and 62 individuals were closed as not successfully rehabilitated.

United Cerebral Palsy Associations

The Choice Access Project, United Cerebral Palsy Associations (UCPA), has service sites in Southfield, Michigan, Harahan (Greater New Orleans), Louisiana, and Pittsburgh, Pennsylvania. The part-time Project Director and clerical assistant is located in Gauthier, Mississippi; financial management is performed by the central UCPA office in Washington, D.C. Full-time Choice Coordinators are employed in the three service sites.

The project targets persons with concurrent limitations in communication, manipulation and mobility. Given this definition of eligibility and the referral networks in the host organizations, the project tends to serve individuals with cerebral palsy, although eligibility is not limited to those with cerebral palsy.

The participant's application is screened initially for eligibility by the project coordinator. Final selection for participation is conducted by a local "Referral Committee" consisting of a group of local volunteers including a person with a disability, family member, UCPA representative, local VR counselor and local school representative.

Each project participant is allocated a fixed budget, "Your Money." Services begin with a detailed planning process called Personal Futures Planning that involves family members, friends, teachers, service providers, and the Choice site coordinator. The coordinator then helps the participant hire an "employment advisor" to work with the participant to support "informed choice." The participant follows the UCPA supported employment service model.

A payment schedule for milestone accomplishments is suggested to the participant, who negotiates and enters into contracts with service providers for services. These may include employment facilitation, a vocational profile, a meeting on the vocational profile, job development, job analysis, and job site supports such as job coaching, equipment, and/or personal assistance services. Vendors receive payment directly from the central UCPA office in Washington, D.C. Each participant hires and fires his/her employment advisors and providers. Project success depends heavily on the skills and participant responsiveness of service providers.

The project plans called for serving 15 participants per site per year or 225 individuals in the 5-year grant period. As of May 1998, the project had enrolled 223 individuals who also completed a written vocational plan. Of the 223 participants, 86 were reported as having achieved the jobs of their choice. This group includes both open and closed cases.

Highlights

Project approaches and objectives influenced the characteristics of the target populations served. Some projects targeted a range of people with disabilities, while others concentrated on specific conditions or underserved groups. One project (UCPA) was designed for a group that was more severely disabled than any of the other project target populations. Three projects served populations that were more educated and more prepared for work (BCIL, TDTI, and SWBIRA) than the other project populations. The three state VR agency grantees (Arkansas, Vermont and Washington) served populations who were more similar to those individuals served in the Section 110 program.

Projects varied according to the types of choice offered to participants, once they decided to enroll. All projects permitted choice of vocational goals, choice of service providers and vendors of goods and equipment. In some projects, once participants opted to enroll in the programs, the projects required participants to take part in standardized service processes such as peer group training or an "Employability Workshop."

Sources of services provided to participants varied from project to project. There were also variations in the types of internally-provided services charged directly to participants. For example, empowerment training was provided by project staff, outside vendors, volunteers, or a combination of these sources. Counseling, guidance, and placement services were sometimes provided by project staff or a combination of internal and external sources. However, education, transportation, housing, and maintenance services were provided solely by outside vendors.

Some projects experienced substantial implementation problems. These problems included hiring delays caused by civil service systems, staff attrition, resistance from the service provider community, bureaucratic resistance to innovative payment systems, and heavy demand from the consumer community. Each project made adjustments in their service process to address these problems.

Overall, since opening their doors to consumers, the projects reported enrolling 2,956 people. As of April, 1998, 977 participants were successfully rehabilitated.

Promising Practices

Each choice demonstration pioneered specific "practices" from which there was much to learn about implementing choice. InfoUse selected sixteen promising practices as candidates for replication. These practices are grouped according to major components of the rehabilitation process as presented below. Detailed descriptions of each promising practice are provided in Promising Practices in the Choice Demonstration Projects: An Operations Manual.

Entry

Entry practices include outreach, eligibility decision-making, and information exchange between applicants and the Choice program. Specific project practices include:

Empowerment Training

Empowerment training assists participants to identify and choose their own vocational goals; advocate for themselves; develop vocational plans; choose appropriate services and vendors; and seek, obtain and maintain the employment of their choice. Specific project practices include:

Helpers

Helpers in formal and informal roles are assigned to designated individuals by the participant and the Choice projects for the express purpose of empowering and supporting the participant in the choice process. These practices may include assisting participants with choosing goals and services, and in assuming a more empowered consumer role. Specific project practices include:

Plan Process and Development

Plan Process and Development refers to the rehabilitation process which centers around the participant, and which is guided by a written rehabilitation plan. These plans identify goals, strategies for attainment, timelines for intermediate objectives, and specific goods and services to be purchased. Choice projects have introduced innovations in how written rehabilitation plans are developed, especially in terms of participant involvement and control. Specific project practices include:

Payment Systems

Payment Systems encompass the various methods used by Choice projects to pay for goods and services included in participants' plans. Systems of accountability are included in this category, along with methods of payment, such as vouchers, purchase orders, and cash. Specific project payment systems include:

Other

Other promising practices include those that have been implemented and which appear to increase choice, but do not fit well in the other categories described. Specific project practices include:

Highlights

Promising practices include techniques to enhance choice at both the personal and institutional levels. Some Choice strategies, including empowerment training, are intended to enhance participants' personal decision-making abilities, self-confidence, positive work attitudes, and job-seeking skills. Other approaches introduce structural changes in intake procedures, payment processes, and staffing patterns traditionally used in state vocational rehabilitation systems.

Some promising practices have already been implemented in state VR 110 programs as an option for services. These include Vermont's expedited eligibility, imprest cash, and self-employment plans and practices which have been adopted across the state; and UCPA's employment advisors model which is used in Michigan Rehabilitation Services' "Rehabilitation Renaissance Project." The Vermont Division of Vocational Rehabilitation invited TDTI to conduct a limited demonstration of its group model in two local offices.

While most projects experimented with variations in the payment process, most payment approaches revealed the source of funds to the provider, or required the provider to bill the Choice grantee rather than the participant.

Some types of "promising practices" appear to be valuable options to offer (but not require) in the rehabilitation process. Most projects experimented with some "helper" model. In general, helpers were very valuable to a subset of participants. Empowerment training was another frequently implemented model, with great variation from project to project in terms of content, flexibility, and responsiveness to participant feedback.

Purchased Services and Service Providers

InfoUse examined patterns of service purchase, provider use, and impact of choice on providers of purchased services. The data are based on case file extraction, provider interviews and focus groups, and interviews with staff and participants.

Highlights

Many providers who dealt with Choice participants were not aware of the projects at all. This was particularly true for retailers, educational institutions, and training programs.

Project designs had a significant impact on the available choice of service sources. Some services were provided by in-house staff; other services were available from vendors. Other projects made the same service available both from in-house staff and outside vendors, including "open market" retail stores.

Some price differences worked in the participant's favor, especially when external providers established fees on a sliding scale for individuals but used a pre-established (and usually higher) rate in dealing with an agency buyer. In several instances, the price to individuals was lower than the price for the same service purchased by the state or by the service organization.

Participants Served

Table 2 summarizes key participant demographic and disability characteristics obtained from a random sample of project case files. The table also summarizes these data across projects and compares the results with the VR Longitudinal Study.

Highlights

The project populations differed considerably in terms of prior work experience, non-disability related barriers to employment, educational level, age, and other variables that could influence selection of vocational goal, services and goods purchased to attain the goal, and employment outcomes.

When compared to the Section 110 program, the Choice projects served a population that was 1) more ethnically diverse; 2) more concentrated in age to those between 22 to 39; 3) more likely to have higher educational levels (college or beyond); 4) more likely to report orthopedic or physical disabilities and learning disabilities, and less likely to report mental illness, mental retardation, hearing or visual disabilities; and 5) less likely to be working at application. These differences reflect demonstration outreach, eligibility, and service practices, and vary by project.

Participant Choice, Satisfaction, and Employment Outcomes

Each of the seven Choice demonstration projects approached "choice" in a different way. To understand participant perceptions of choice, satisfaction, and employment outcomes, InfoUse conducted a telephone survey of a random sample of program participants.

Highlights

The Choice projects earned high scores for participant involvement in decision making during the rehabilitation process. About half of Choice participants reported that they, alone, chose their job. Similarly, about half of all participants reported that they were solely responsible for choosing their vocational goal. In contrast, less than one third of Section 110 consumers in RTI's Longitudinal Study of the Vocational Rehabilitation Services Program reported that they, alone, chose the vocational goal.

In choosing what goods and services to purchase, four out of five of Choice participants reported that they alone, or together with project staff, made the decision. This is almost the same percentage as their counterparts in the VR program. This suggests that decision making in goods and services may call for more joint effort, collaboration, and staff expertise than goal setting and job choices.

Choice participants were satisfied or highly satisfied with their involvement in choosing goods and services, the available choice of services, and the actual services purchased. No statistical differences were found between satisfaction of Choice participants and Section 110 consumers regarding these decisions.

Overall Project Costs and Cost-Effectiveness

InfoUse analyzed the overall costs of the seven Choice demonstration projects in order to determine (1) what project factors shaped average annual costs per participant, (2) what are the total annual costs per participant taking into account in-kind and replication relevant costs, (3) what are the average annual costs per participant for goods and services purchased from outside vendors, (4) what are the annual costs per participant for services provided internally, and (5) how do average annual costs per participant compare with the VR program?

Highlights

Average annual purchased services costs ranged from $654 to $3,306 per participant across the projects. For all projects, average annual purchase services costs per participant was $1,700. In contrast, VR's average annual cost per consumer was $997.

Total average annual cost per participant in the seven projects was $3,670, and ranged from $2,030 to $6,967 across the seven Choice projects. The VR program spent an average of $1,910 per consumer per year.

Across projects, average per participant costs varied according to type of participant served by the projects, program practices, limitations on participant budgets, and the amount of services provided directly by project staff. Added costs frequently were incurred in providing the additional services and supports useful in expanding choice (e.g., helpers, empowerment training, extensive consumer plan-making processes).

Costs of individual practices cannot be estimated from the data; therefore costs of transferring the practice to the basic VR program is unknown.

Recommendations and Areas for Further Investigation

The Choice demonstration projects have provided substantial information about the implementation of informed choice in the rehabilitation process. While much has been learned, several areas of additional research are needed to support the implementation of successful informed choice in VR services. The following are recommendations for policy, practice, and further research.

Adopt Expedited Eligibility

Informed choice is compatible with, and supported by, "streamlining" initiatives such as expedited eligibility. Continued clarification of state agency eligibility documentation requirements is needed to eliminate unnecessary time between application and eligibility in the VR process.

Implement Imprest Cash

The success of the imprest cash system in Vermont in reducing stigma and supporting informed choice, especially at the initial stages in the VR process, suggests that state agencies explore similar alternatives in their procurement policies. Vermont has learned a great deal about implementing imprest cash, including how to determine appropriate uses of cash, how to estimate monthly demand for cash in local offices, and how to document that the cash made available to consumers is spent as intended.

Provide Training for New Services

Helpers and empowerment training, provided on a fee-for-service basis, could give useful technical assistance during the vocational planning and service purchase stages of the vocational rehabilitation process to counselors, supervisors, and consumers. To refine these practices, further research is needed about how differences in participant characteristics and disabilities affect the need for helpers, empowerment training, and counselor involvement.

To implement these practices, guidelines are needed for conducting systematic staff training. State personnel development systems could be designed to include a program on consumer choice.

Explore Impact of Alternative Methods of Purchasing Services

Because of their size, the projects did not have an impact on providers. But the methods developed by the projects promise quite an impact if used on a major scale, and no one knows what that impact will be. Additional large-scale research could address how any changes in the way consumers/agencies purchase services would impact VR's $1.5 billion a year in service purchases and suppliers of rehabilitation services.

Set Limits on Service Budgets

Limits on individual service budgets worked well in the Choice projects for participants, staff, and administration, supporting the establishment of such limits in the VR program.

Conduct Research on Employment Outcomes

Findings on employment outcomes were inconclusive. Additional research is needed to determine the impact of informed choice on employment outcomes, using follow-up surveys to track the long-term employment impact of Choice practices. In future demonstrations, the relationship between vocational rehabilitation process objectives and short and long-term employment outcomes should be clarified.

Evaluate Success of Transfers to VR System

Some state VR systems have adopted major components of some Choice models. The Vermont Division of Vocational Rehabilitation has implemented expedited eligibility, imprest cash, and other promising practices throughout the state. The Michigan Rehabilitation Service has adopted UCPA's supported employment-based approach to informed choice in several local and district offices throughout the state. Evaluation of the cost and employment outcomes of these transfers in the VR program will provide further information on choice.

Use State I&E Funds to Create Other Choice Options

Other state VR agencies might use Innovation & Expansion (I&E) dollars to develop their own Choice initiatives within the state (in coordination with the state Rehabilitation Advisory Council and with RSA review).

Conduct Large Scale Evaluation Research

The demonstration projects have developed many promising practices. Yet, the small scale of the projects has limited the understanding of the potential impact of these new models on costs. This could be addressed through a large-scale systematic testing of these promising practices and other informed choice approaches at the field office level in state rehabilitation agencies using control groups and uniform data.

 

Table 1: Project-Reported Outcomes

 

Project Enrolled Closed - Successfully Rehabilitated Closed - Not Successfully Rehabilitated

N N N

Arkansas

243 88 65

Vermont

618 223 101

Washington

379 111 76

BCIL

416 107 1

SWBIRA

868 249 312

TDTI

209 1132 62

UCPA

223 863 1

TOTAL

2,956 977

1 Information Not Available

2 Employed at follow up of 6 months, 12 months, 18 months, and 24 months.

3 Includes closed and open cases

 

Table 2: Participant Demographic and Disability Characteristics

 

Project

Participant Demographic Characteristics

Primary Disability:

Three most frequent groups (RSA-911 Codes)

 

Age

% <=21

% 22-39

%40+

%

Minority

%

Female

%

Completed High School or Beyond

Disability Group

%

AR

38.2%

49.9%

8.8%

58.8%

44.1%

85.2%

Physical1

Learning

Mental Illness2

64.7%

17.7%

8.8%

VT

10.0%

63.3%

26.7%

3.3%

33.3%

73.3%

Physical

Mental Illness

Substance Abuse

56.7%

23.3%

10.0%

WA

10.0%

53.3%

20.0%

23.3%

43.3%

73.4%

Learning

MR3

Physical

20.0%

16.7%

16.7%

BCIL

0%

54.5%

45.4%

60.6%

51.5%

87.9%

Physical

Mental Illness

Sensory4

63.6%

15.2%

12.2%

SWBIRA

6.4%

41.9%

48.3%

35.6%

45.2%

83.8%

Physical

Mental Illness

Learning

58.1%

16.1%

16.1%

TDTI

0%

50.6%

48.3%

35.6%

58.1%

96.8%

Physical

Sensory

Learning

36.5%

29.3%

9.7%

UCPA

9.3%

65.6%

25.4%

37.7%

46.9%

N/A

Physical

Sensory

MR

59.4%

25.1%

9.4%

All Projects

9.3%

53.7%

33.9%

32.8%

45.3%

77.0%

Physical

Mental Illness

Learning

52.0%

14.9%

10.8%

VR Long

13.3%

42.9%

43.9%

16.3%

47.6%

67.6%

Physical

Mental Illness

Sensory

39.6%

18.5%

15.0%

1 Physical: Orthopedic impairments including amputation, or nonorthopedic physical disabilities

2 Mental Illness: psychotic disorders, neurotic disorders

3 MR: Mental retardation

4 Sensory: Visual and hearing impairments

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