VR-IL Directory: Introduction

Introduction

In recent years, several publicly-funded vocational rehabilitation (VR) agencies and consumer-controlled, community-based, independent living centers (ILCs) have undertaken collaborations focused on improving employment outcomes for people with disabilities. Increased employment is a key issue for the disability community. Less than one-third of working-age persons with disabilities are in the labor force (McNeil, 1997), and three-quarters of those who are not working would like to do so (National Organization on Disability, 1994).

Successful collaborations between ILCs and VR agencies draw on the respective strengths of both types of organizations in helping people with disabilities achieve independent living skills and vocational skills. Such partnerships are promising strategies for helping consumers join and remain in the work force. Previous research has identified at least 70 partnerships operating between ILCs and state-federal vocational VR agencies (Hanson, 2000). However, program and practice characteristics that enable such collaborations to succeed are not well understood.

The purpose of this publication is to provide the VR and IL communities as well as other consumer and professional groups with a directory of programs and practices that exemplify the best approaches to employment-focused collaboration. The VR-IL Employment Outcomes Partnership Project is funded through National Institute on Disability Rehabilitation and Research grant #H133B50005 to the Rehabilitation Research and Training Center on Independent Living and Public Policy at the World Institute on Disability. InfoUse used a "best practice" methodology to systematically determine what programs and informal practices qualify as exemplary models of collaboration. An independent seven-member Expert Panel from the VR and IL communities designed the nomination process, developed appropriate selection criteria and rated the nominated programs and practices using a blind review process.

The expert panel strongly felt that the field could benefit from information about all existing employment-focused partnerships. Twenty-eight of the known collaborations participated in this project's nomination process, with 11 collaborations completing the entire cycle of nomination, investigation, and review. (Earlier findings are reported at http://www.wid.org/ildp/briefs/intro-brief1.html). This directory provides detailed information about these 11 collaborations and summary information about those that withdrew or otherwise did not complete the nomination process. Readers are invited to contact any ILC or VR agency listed in this directory. Finally, you are encouraged to help expand our understanding of collaborations between VR agencies and ILC s by providing additional information about other collaborations through our Web site.

Significance of the Project

The significance of this project lies not only in the need to increase employment among people with disabilities, but also in the similarities and differences between community-based, consumer-controlled independent living centers and publicly funded state-federal vocational rehabilitation agencies. Despite distinctly different origins, both programs are inextricably linked as key elements of the local and state system of services for people with disabilities in the United States. In this section we briefly trace the development of the state-federal VR system and local independent living centers, and discuss some of the factors that encourage collaboration.

Background

Since its inception in 1920 when Congress passed the Smith-Fess Act (P.L. 66-236) and later under the Rehabilitation Act of 1973 (P.L. 93-113) and subsequent amendments, state-federal VR agencies have provided services that help individuals with disabilities "prepare for and engage in gainful employment to the extent of their capabilities" (Section 100 [a]). Current law (Rehabilitation Act of 1992, P. L. 102-569; see also Workforce Investment Act of 1998), defines employment as "entering or retaining full-time or, if appropriate, part-time competitive employment in the integrated labor market; satisfying the vocational outcome of supported employment; or satisfying any other vocational outcome the Secretary may determine to be appropriate (including...self-employment, telecommuting, or business ownership)..."

The federal government funds up to 80% of the 83 state-federal VR agencies with a minimum of 20% supplied by each state. In addition, 38 tribal agencies also receive funding from the federal government to conduct vocational rehabilitation programs. Both provide an array of independent living and employment-related services to individuals with disabilities using a well-defined rehabilitation process whose steps include evaluation, determination of eligibility, goal-setting and service planning, service provision, and case closure. At the center of the VR process is the professional rehabilitation counselor who combines clinical skills to assess the consumer's needs, goals, and abilities, and brokering and case management skills to purchase services for consumers and monitor progress towards positive outcomes.

As an outgrowth of the disability rights movement in the 1960's and 70's, ILCs have developed as a significant force for both services and advocacy for people with disabilities (Lachatt, 1988). Originally authorized in the Rehabilitation Act of 1978, 260 consumer-controlled, community-based agencies currently receive over $42 million in support from the federal government under Title VII, Chapter 1, Part C of the Rehabilitation Act of 1992 (Rehabilitation Services Administration, 1998). Centers offer an array of "independent living" services to individuals with significant disabilities, including the core services of information and referral services, independent living skills training, peer counseling, and individual and systems advocacy. Centers may provide additional services to enhance the independence, productivity, and quality of life of persons with significant disabilities and the understanding and integration into society of all individuals with disabilities. To these ends, ILCs funded under the Rehabilitation Act have the legal authority to offer employment-related services. In fact, nearly 60% of ILCs provide employment-related services (Means and Bolton, 1992). These include job or career development, job placement, or supported employment services; training or support related to job modification, retention, or mobility; and/or community and employer awareness efforts focusing on the benefits of hiring people with severe disabilities.

Both ILCs and state VR agencies receive significant funds through the same federal legislation (Rehabilitation Act of 1992 [P. L. 102-569]; see also Workforce Investment Act of 1998), and both are administered by the same federal agency (Rehabilitation Services Administration). However, traditionalists in the VR system believe that VR is the preeminent provider of employment-related services, since rehabilitation counseling is a professional field with a well-defined rehabilitation process, counselor performance standards, and requisite postgraduate training. In their view, ILCs merely provide supplemental services that can help an individual with disabilities achieve an employment outcome (Haworth and Rice, 1990).

VR agencies and ILCs have developed very different approaches to addressing consumers' employment concerns. Traditional VR agencies are likely to attribute employment problems to the individual's physical or mental impairment, functional limits, skill deficits, and lack of motivation and cooperation. In contrast, independent living centers are likely to focus on limitations in the environment, the medical model, and narrow professional attitudes. Traditional VR solutions often focus on the assessment and training of the individual, while ILCs are likely to use advocacy, self-help, and consumer control (Haworth and Rice, 1990; DeJong, 1979. ILCs often advocate for the rights of consumers in state VR agencies, and not infrequently take an adversarial role.

Factors encouraging collaboration

In recent years, at least three factors may have encouraged the two systems to work more closely together. First is the emphasis on consumer choice, itself an outgrowth of the movements for disability rights and consumer empowerment. Federal legislation (Rehabilitation Act of 1992 [P. L. 102-569]; see also Workforce Investment Act of 1998) requires that VR agencies modify the traditional, professional-driven rehabilitation process to allow consumer choice in the selection of vocational goals, service providers, and employment outcomes. Not only have these changes narrowed the ideological gap between ILCs and VR agencies by empowering consumers, but they may also have encouraged VR agencies to develop fee-for-service arrangements with a wide range of nontraditional vendors including ILCs (Stoddard, Hanson, and Temkin, 1999).

Second, the disability rights and consumer movements spurred the establishment of Statewide Independent Living Councils (SILCs) in the Rehabilitation Act of 1992. These independent entities are mandated to jointly develop, with the state VR agency, the State rehabilitation plan, as well as monitor, review, and evaluate the implementation of the State plan. Each SILC includes at least one ILC director, other ILC representatives, parents and guardians of individuals with disabilities, representatives from private business and service providers. With such strong consumer representation, SILCs have helped encourage state VR agencies to find strategic roles for ILCs in the service system for people with disabilities.

Finally, independent living centers have tended to expand their services as they search for additional revenues (Benjamin, et al, 1997). To find revenues to supplement their Title VII grants from RSA and to respond to the service needs of their constituents, many ILC have explored fee-for-service and other contractual relationships with local VR offices

Overview of the VR-IL Employment Outcomes Partnership Project

This study applied a participatory action research (PAR) approach to an established methodology for identifying exemplary practices in a human services field. PAR entails the active involvement of research stakeholders, including consumers and providers, in defining research questions, developing methodologies, and implementing the research. The best-practices methodology used in this study involves identifying potentially exemplary programs through a wide-reaching nomination process, gathering detailed program information, and review by an Expert Panel. This evaluation methodology has been used extensively in research on education and services for people with disabilities, including studies of exemplary practices in supported employment, independent living services, transitional services, job services (Regional Rehabilitation Exchange, 1989, 1991, 1993) and assistive technology resources for children with disabilities and their families. (Temkin et al, 1999).

In the VR-IL Project, members of the VR and IL communities were proactively involved in the planning and conduct of the research. An Expert Panel, most of whose seven members have a disability and have worked extensively in VR agencies and ILCs, was instrumental in developing the criteria for exemplary programs and practices, reviewing data submitted by collaborating ILCs and VR agencies, and selecting the exemplary partnerships, among other activities.

The project was interested in collaborations between state VR agencies and ILCs as well as partnerships between VR programs run by American Indian tribes and ILCs. Project staff and the Expert Panel also thought it important to identify collaborations that are conducted informally–that is, without project-specific funding or staff, written agreements, or project-specific reporting practices–as well as formally constituted programs. Our goal was to "cast a broad net" that would capture collaborations that are informal yet highly effective and replicable.

The project was conducted in five steps:

Planning. First, the project developed the research methodology. This entailed a review of the literature on collaborations between VR agencies and ILCs and approaches to identifying exemplary practices. The Expert Panel was key in developing basic eligibility prerequisites^{Footnote 1} a wide-ranging nominations process, and criteria for exemplary status, reporting requirements, and incentives to participate.

Nominations. Next, the project conducted a far-reaching nomination process through outreach at conferences, mailings to all ILCs and VR agencies known to the Rehabilitation Services Administration, e-mail lists, and the World Wide Web. The project received a total of 30 nominations, of which 28 met project prerequisites.

Collecting data. After screening nominations to make sure applicants were eligible to participate, the project collected detailed program information through a written questionnaire and in-depth interviews. Eleven programs and practices completed this stage of data collection.

Most nominations were submitted by only one agency in the collaboration, so we interviewed the partner agency for each collaboration for verification. These interviews not only provided additional perspectives on the particular collaborations under study, but also illuminated the more general nature of VR/IL relationships in the states where these collaborations operate.

Preparing data. After completing data collection from nominee programs, we prepared brief descriptive profiles of each collaboration, with identifying information removed. These were distributed to the Expert Panel along with the questionnaire responses from the nominees.

Reviewing data and selecting programs. The Expert Panel rated each of the 11 programs and practices according to the criteria it had developed, and deemed the six highest scoring programs and practices to be exemplary. The Panel also derived a set of characteristics that typify exemplary programs, as well as a set of basic features that are essential in any successful relationships between VR agencies and ILCs.^{Footnote 2}

Footnotes

¹ Pre-requisites for participation in the study specified that the collaboration must involve a state VR agency and an ILC; must have definable employment-focused goals; must be consistent with principles of consumer empowerment; must be able to document how many individuals are served, what service was provided, and what results were obtained; and must be willing to share public documents about the program or practice. Also, both the VR agency and ILC must believe that the collaboration is effective and be able to describe the program or practice. Back to main text.

² The methodology and project background is described in more detail in VR-IL Employment Outcomes Partnership Project Nomination and Selection Manual. The Manual also includes all instrumentation and documents used in data collection and analysis. Back to main text.

Criteria for exemplary programs

The project's Expert Panel developed the standards for determining to what extent each nominee program reflected exemplary qualities. The Panel identified criteria that were grouped into five general domains:

Program practice goals and objectives that include criteria for the extent of clarity of program/practice goals, the clarity of authority under which the program or practice was created, and specificity and inclusiveness of the target population;

Program/practice processes including criteria for consistency, responsiveness to consumers, and adequacy of documentation;

Quality of collaboration that includes criteria for the stability and sustainability of the collaboration, mutual sense of trust and understanding of roles and responsibilities, frequency of communication, and extent to which the collaborators serve each other's consumers;

Outcomes including criteria for how well nominees succeeded in helping consumers achieve or retain employment or self-employment;

Overall assessment including assessment of replicability of the program/practice.

Although Panel members had very diverse concepts about the best ways to meet the vocational and independent living needs of persons with disabilities, they agreed that these five general domains and the specific criteria for each domain were appropriate measures of excellence.

Findings

The Expert Panel's findings were twofold. First, after scoring each program and practice based on the above criteria, the Panel recognized the three top-ranking formal programs and the three highest-ranking informal practices as exemplary. These are described in detail in the following chapter in this Directory.

Second, the Panel noted that certain distinctive features characterize these exemplary programs and practices. These characteristics include:

A focus on the total needs of consumers–that is, services and resources necessary for independent living and achievement of personal goals–as well as concern with the consumers' vocational goals;

A focus on making fundamental alterations to the system of services for people with disabilities, locally or on a broader scale;

A willingness to "think outside the VR-IL box" by involving other services such as agencies serving people with psychiatric disabilities, developmental disabilities, or other specific types of disabilities; public agencies assisting TANF recipients; and schools and universities;

An emphasis on addressing issues of cultural and ethnic diversity;

The use of consumer satisfaction methods and assessment tools that include measures of satisfaction specific to the collaborative project between VR and the ILC;

A focus on serving hard-to-serve populations not traditionally well served by either VR agencies or ILCs, such as Deaf/Blind youth, young people with mild to moderate developmental disabilities and learning disabilities, and people with psychiatric disabilities who have been channeled into sheltered employment;

Cross-training of staff between VR agencies and ILCs, and posting of one agency's staff at the other's offices; and

An awareness of employers as the "customer" of the collaborative program, using strategies to encourage employers to hire and retain consumers with disabilities.

Finally, the Panel observed that certain elements of working relationships between VR agencies and ILCs seem to be essential to a basic level of cooperation. All nominee programs and practices evidenced these essential features; the ones recognized as exemplary have other notable characteristics in addition to these "baseline" features.

The elements needed for basic cooperation include:

A focus on consumers' vocational goals;

Documentation in case files of services provided and individual outcomes, with external reporting of aggregate data on service provision and outcomes;

An explicit willingness by collaborators to "cut through the red tape" in their agencies through flexibility and streamlined procedures;

Periodic meetings to discuss inter-agency relationships and progress of mutual consumers;

Efforts to avoid duplication of services; and

The commitment and capability of staff at each agency to work together despite acknowledged differences in organizational goals and service approaches.

Implications

Both the data collection process and the findings of the VR-IL Project underscore the evolving and often transitory nature of VR-IL collaborations. In recent years, various investigations have reported about 70 formal and informal collaborations between independent living centers and state VR agencies. VR-IL Project staff tried to contact all of these partnerships. For various reasons, a number of these are no longer current. Others are re-evaluating the feasibility of their collaborations and did not wish to participate in the VR-IL project. Many of the eleven programs and practices that completed the data collection process acknowledged the frequently slow and arduous process of building trust and cooperation between VR agencies and ILCs.

A self-selection dynamic inherent in the data collection process ensured that collaborations confident of their viability would participate. Data collection required nominees to complete a lengthy questionnaire either in writing or by interview and submit available supporting documentation, including contractual agreements, memoranda of understanding, aggregate consumer outcome data, consumer satisfaction assessment instruments, and other data. All nominees who chose to spend substantial time providing the project with necessary data believed they had something of value to impart to other VR agencies or ILCs. We believe these eleven collaborations are highly instructive for other VR agencies and ILCs exploring the potential for new partnerships and evaluating existing ones.

These collaborations have provided a set of data on which to base some initial conclusions about what is required to establish and maintain basic working relationships between VR and IL. Identifying these "baseline" features may offer guidance to those agencies trying to achieve some initial level of working together. These practices may be the preconditions for developing programs that are exemplary. Thus, we describe these basic-level programs and practices as well as those that are recognized as exemplary.

Directions for future research

This investigation of exemplary program and practices must be considered exploratory. The Office of Educational Research and Improvement (OERI) in the U.S. Department of Education recently promulgated regulations for evaluation of "exemplary" educational programs that state that such programs are effective based on empirical data (34 CFR 701). Few of the programs considered exemplary in the VR-IL study, however, were able to provide empirical data of effectiveness in achieving positive employment outcomes. In many cases, the participating ILCs sought to help their consumers achieve independent living goals that were related to eventual employment but did not directly result in employment–for example, some collaborations worked to help consumers develop IL skills needed to become VR-eligible. Findings of programs' excellence tended to rest on the high quality of their collaborative relationships and other qualities identified by the Expert Panel. The present study lays the groundwork for more thorough study of how well VR-IL partnerships help consumers achieve eventual successful completion of their written vocational plans or retention of their jobs.

The OERI regulations specify replicability as one criterion for evaluating exemplary educational programs, a criterion that was adopted by the Expert Panel in the VR-IL project. Some of the exemplary collaborations had in fact been replicated within their states; most had not. In either case, collaborations could only postulate reasons why their projects had been replicated or hold the promise of replication.

Staff members in several collaborations attributed the success of demonstrated or potential replication to systemic factors such as flexible policies to expedite entry into the VR system and vendorization policies favorable to ILCs. Nearly all collaborations cited "trust" as a precondition for future replication efforts. Yet creating trust is a highly idiosyncratic process, and may be preconditioned by the personalities of the staff involved in the collaboration or the historic relationships between an ILC and its local VR office. Further research that more thoroughly explores the contexts of VR-IL collaborations is needed to identify what has enhanced or inhibited the process of replication, and what has allowed exemplary partnerships to develop in the first place.

References:

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Hanson, S, (2000). Policy background and literature review. In S. Hanson and T. Temkin, VR-IL Employment Outcomes Partnership Project: Nomination and Selection Manual, Final Report. Berkeley, CA: InfoUse.

Lachatt, M., (1988). The Independent Living Service Model: Historical Roots, Core Elements and Current Practice. Hampton, N.H: Center for Resource Management.

McNeil, J.M. (1997). Americans with disabilities: 1994-95. U.S. Bureau of the Census, Current Population Reports, P70-61. Washington, D.C.: U.S. Department of Commerce.

Means, B. L., and Bolton, B. (1992). A national survey of employment services provided by independent living programs. Journal of Rehabilitation, 58 (4, Oct/Nov), 22-26.

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Rehabilitation Research Exchange (1993). RRX Catalog of Exemplary Programs. Austin, TX: Southwest Educational Development Laboratory.

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Temkin, T., Kraus, L., Galvin, J., Carlson, B., Hanson, S., Jans, L., Ripple, J., and Samels, K. (1999). Needs assessment and resource analysis for the Family Center on Technology and Disability: Final report. Berkeley, CA: InfoUse.

Thayer, T., and Rice, B. D., (Eds.) (1990). Vocational rehabilitation services in independent living centers. Report from the Seventeenth Institute on Rehabilitation Issues, Fayetteville, AR: University of Arkansas Research and Training Center in Vocational Rehabilitation.

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