Table IV.2: Logistic Regression Analysis Predicting Whether Physically Disabled Clients Were Employed in 1985 Table IV.3: Logistic Regression Analysis Predicting Whether Emotionally Disabled Clients Were Employed in 1985 Table IV.4: Logistic Regression Analysis Predicting Whether Mentally Retarded Clients Were Employed in 1985 Table IV.5: Summary Statistics for Logistic Regression Analyses Table IV.6: Predicting Earnings Levels for Clients With Any Earnings From Employment in 1985 Table IV.7: Ordinary Least Squares Regression Analysis Predicting 1985 Real Annual Earnings of Physically Disabled Table IV.8: Ordinary Least Squares Regression Analysis Predicting 1985 Real Annual Earnings of Emotionally Disabled Table IV.9: Ordinary Least Squares Regression Analysis Predicting 1985 Real Annual Earnings of Mentally Retarded Table IV.10: Summary Statistics for Ordinary Least Squares Table IV.11: Program Effects in 1985, by Severity of Disability Figure 5.4: Average Real Annual Earnings From Wages 58 60 Figure 5.1: Short-Term Outcomes of the VR Program Chapter 1 Introduction Individuals with disabilities are more likely to be unemployed or living in poverty than are Americans without disabilities. One goal of the landmark Americans With Disabilities Act of 1990 was to increase the employment opportunities for individuals with disabilities by reducing such barriers to employment as the inaccessibility of workplaces and the discriminatory practices of employers. But many individuals, especially those with severe disabilities, are also in need of education, skill training, and other assistive services to effectively prepare them to take advantage of work opportunities. The Rehabilitation Act of 1973, as amended, authorizes the Department of To be eligible for the program, a person must possess (1) medical Traditionally, the VR program has been justified as a good investment, with supporters pointing to cost-benefit studies showing high positive ratios of earnings gains of former clients to money spent on program services and administration. But questions have been raised about whether the program 'The Rehabilitation Services Administration (RSA) in the Department of Education is responsible for the overall administration of the program. There are 83 state agencies in the 50 states, the District of Columbia, and U.S. territories and protectorates. In some states, one agency serves all persons with disabilities, while in 26 states there are two agencies, with one serving only blind clients. "This third criterion was modified in the 1992 reauthorization of the VR program (Rehabilitation Act Amendments of 1992, P.L. 102-569). Under the revised act, it is presumed that any applicant's employability can be enhanced, unless the state agency can demonstrate otherwise with clear and convincing evidence. All the data used in this report are from years before this change. Introduction is able to serve all those who are eligible and desire services, whether the services provided are sufficient in scope and suitably targeted to meet the needs of a diverse clientele, and whether the program's effects persist over the long term. Effective vocational rehabilitation programs are important for a number of reasons. First, a productive and humane society is enhanced by the useful employment of as many of its adult members as possible. Second, statistics suggest that the population of Americans with work disabilities may be increasing. Some scholars have argued that recent reductions in the risk of death from accidents and illnesses are associated with an increasing risk of disability. And third, technological developments such as the availability of assistive devices and new behavioral training techniques have made it possible for individuals who were previously regarded as unemployable to enter the workplace. Effective vocational rehabilitation programs are thus both more necessary and more feasible than in the past. Those responsible for decisions about the state-federal VR program now more than ever need information about how those with disabilities are being served and what works. One uncertainty in designing the program concerns how those with the most severe disabilities are treated. On one hand, the law requires the VR program to give them priority. Yet critics have argued that the state agencies operating the VR program may do the opposite by employing a strategy called "creaming"--that is, most frequently accepting for services those applicants with greater amounts of work experience or education, or with less severe disabilities. Such decisions could be made as a result of pressure to achieve the largest numbers of rapid rehabilitations at the lowest cost. Another persistent issue is the extent of the services provided and the accuracy with which services are matched to needs. Once a client is accepted, a VR agency provides individualized rehabilitation services that follow a written plan drawn up by a rehabilitation counselor in consultation with the client. Clients may seek assistance for a number of reasons, and the service regimens that are offered vary in both length and type. For most clients, a primary reason for seeking rehabilitation services is getting or keeping a job in the competitive labor market, doing work suited to their abilities. For some, all that may be required is a little counseling and guidance, as well as help in finding job opportunities to pursue. But for others, employment may depend on the agency's spending Introduction money to purchase an assistive device, such as a hearing aid, a wheelchair, or a specially equipped van. And for still others, success in a job may require an extensive period of higher education, training in social skills, or therapy for a problem relating to mental illness or substance abuse. Critics have argued that the VR agencies may prefer to give a larger number of clients the less expensive in-house services, such as diagnosis, counseling, and guidance, rather than (potentially) serving fewer but concentrating resources on the more expensive and prolonged services that could give clients the skills and technology necessary for long-term success in the labor market. In addition to uncertainties about who is eligible, who accepted, and how they are served, there has been a more fundamental uncertainty concerning the long-term vocational outcomes for clients after they leave the program, and how former clients compare with persons who are not served. A central objective of this study was to analyze the work and earnings history of both program participants and nonparticipants for 8 years after leaving the program, using a previously unexamined data source. Objectives, Scope, and Methodology The Chairman of the House Subcommittee on Select Education asked us to provide information on several aspects of both the population with disabilities and the state-federal VR program, to help in the reauthorization of the VR program in the last congressional session.3 Specifically, we were asked to answer the following questions: 1. How many people with disabilities are potentially eligible for 2. What are the characteristics of those people who receive services? 3. What types of services are received? 4. What results are achieved through the delivery of vocational In further defining issues for study, we reviewed literature on VR, This subcommittee was renamed the Subcommittee on Select Education and Civil Rights in the 103rd |