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A research based innovative placement program.

The Innovative Placement Program, which is being evaluated over a 3-year period through a grant from the National Institute on Disability and Rehabilitation Research, is managed by the Research & Training Institute of the National Center for Disability Services, a comprehensive vocational rehabilitation facility. The goal is to place people with disabilities into the work force as directly as possible by using technology and community resources to the fullest. A case manager provides or coordinates all services from the point of intake through placement, including follow along. The model includes:

* job-seeking skills training enhanced by group methods and peer support;

* the place-train approach using community and business sites for service delivery locations;

* functional assessment methods that link a person's abilities to specific training and job performance standards;

* applications of new technology, such as labor market information available in computerized databases and rehabilitation engineering innovations; and

* creative use of community resources to overcome problems such as lack of accessible and affordable transportation.

Hard to place people are referred from local state vocational rehabilitation offices. Over a 3-year period, some 100-120 people will be served.

The project's services were organized around Baldridge's (1972) systems view of human services organizations which contains five interdependent components, including services and technology, clientele, staff, administration, and external linkages. These components are used to outline research findings which substantiate the rationale for the Innovative Placement Program.

Services

Services refer to all the technizues and strategies available to help people obtain jobs. Services should provide an edge to them by minimizing the chance factor so prevalent in determining labor market outcomes (Rothstein, 1980). Effectiveness of these services can be measured by relating how each contributes to placement, which is the ultimate goal.

Evaluation services are frequently the first offered and include formal procedures such as medical, psychological and work evaluations to determine if a person is suitable for rehabilitation and, if so, to identify factors useful for vocational planning and service delivery. However, research which has explored the relationship of typical evaluation findings to placement suggests that the value of many accepted practices is questionable. For example, Stolarski (1985) found that standard psychological test findings were not useful in discriminating eventual placement outcomes. One study correlated vocational competency assessments made by work evaluators with the training and employment outcomes experienced by clients (Cook, 1983). Although there was a significant relationship between the assessments and whether clients completed a training program, there was no relationship to their eventual employment status. Therefore, the Innovative Placement Program has eliminated much of what is typically found in standard evaluation programs.

After evaluation, vocational training typically is given which can be offered in many different forms, including education, skills development and work adjustment. It is assumed that there is a logical progression that connects evaluation findings and training to the type of job a person gets. However, the empirical evidence that training achieves this is not encouraging. Chun & Growick (1983) conducted a study of congruence between training and eventual placements. The findings were that only half of the jobs were related to training, which was similar to that of earlier studies (Bowman & Micek, 1973; Dalton & Latz, 1978). However, when training is related to employment success rather than on a targeted job goal, positive results occur. Worrall and Vandergoot (1982) found that while training generally was related to successful outcome, on-the-job training was most strongly related to eventual employment.

A new approach to services has evolved recently, and is based on community-referenced instruction (Snell & Browder, 1986). This strategy minimizes transfer of learning and removes elements of the rehabilitation process that are not job related. Most resources and services are used at the placement site rather than prior to placement, as is done in traditional adjustment programs. An experimental evaluation of a community-based demonstration project serving 254 clients showed a 44 percent placement rate in competitive jobs. Twenty-two months after starting the program, 31 percent of the experimental group were competitively placed, compared to 19 percent of the controls. More of those from the control group were placed in sheltered settings. Benefit cost analyses were also favorable (Kerachsky, Thornton, Bloomenthal, Maynard & Stephens, 1985).

An evaluation of a supported work project operating at 17 sites, although not including an experimental design, had similar results. Two-thirds of all participants completed the program which led to placement of 81 percent working. It was estimated that program costs would be paid back in less than 2 years (Bailis, Jones, Schreiber & Burstein, 1984). Thus, community-based training and service delivery is emphasized in the Innovative Placement Program.

Another service technique receiving attention is the development of individualized placement plans which have been related to improved placement rates (Zadny & James, 1979). An experimental study to explore the extent of this relationship found that placement planning, if not actually producing more placements, had important results (Hansen, 1983), including:

* Time to placement was cut in half.

* Congruence between placement and training was improved significantly.

* Clients had more realistic expectations about the labor market.

* Counselors became more involved in placement.

The key ingredient may be active counselor involvement required to monitor the plan; this may be supportive for the client during the difficult times while job searching. Evidence for the value of counselor involvement was found in a study done by Vandergoot, Maiman-Reich & Murphy (1983). Various approaches were tried to increase the motivation of clients during job searching. Motivators included counselor contact, which served as well as providing cash rewards contingent on job search behaviors. Formal placement planning and active counselor involvement in the placement process is central to the Innovative Placement Program.

An intervention that is becoming more prevalent is rehabilitation engineering. Mallik & Yuspeh (1979) reported that rehabilitation engineering applications were useful in creating job opportunities for 79 of 116 clients who were previously rejected for services because of the severity of their disabilities. Similarly, Tooman (1982) found that using a team to provide engineering services placed more people at about the same costs as a triditional placement approach. Technological applications appear to be a key factor in placement for people with physical disabilities, and these will be used as by the Innovative Placement Program.

The research literature indicates that once a person is working, post-placement services are needed to assure success. A survey of placement specialists ranked job coaching, awareness training for employers and co-workers and followup services as the most effective strategies to help people maintain jobs (Crimando, Belcher & Riggar, 1986). This study also explored why people lost their jobs. Recasting the findings into categories of productivity skills and social skills, it appears that productivity problems accounted for about 38 percent of failed placements, while social problems accounted for about 23 percent. Another study also found that productivity and social problems, alone or combined, could explain why people with severe disabilities lost their jobs (Hanley-Maxwell, Rusch, Chadsey-Rusch & Renzaglia, 1986). Both of these problems are behavioral ones that can be resolved with the appropriate behavior change strategy. Rehabilitation professionals can redeem the value of their prior services by monitoring post-placement performance and intervening as necessary to teach new ways of being productive or relating to others.

An important way counselors can help is by working with employers on behalf of clients. A study of 142 employers who had previous experience with rehabilitation programs (Young, Rosati, Vandergoot, 1986) confirmed that they valued the following services most:

* providing applicants with relevant occupational skills;

* providing clients with appropriate interpersonal skills;

* teaching clients how to conduct a thorough job search;

* providing pre-screened applicants; and,

* providing followup services, including work adjustment, personal/social adjustment and opportunities for phone consultation.

Although these services were in demand, the employers felt their needs were not fully met. For example, although 60 percent of employers said they used a variety of placement services, over 90 percent felt they could have used more. Even more striking was the disparity between employer needs and rehabilitation response in the area of followup services. Only about one-third of the sample was able to use these services while about 90 percent of employers needed them. This suggests that rehabilitation agencies are falling short. Or, a more positive view is that there are more opportunities to serve employers than we realize. Meeting their needs will most likely have direct impact on getting jobs.

One study found that employer ratings of client performance after 1 month on the job were the best predictors of eventual success (Liebert, 1984). Employers can quickly tell whether problems are likely to result in a failure. Staying involved with employers and clients during the initial employment period could be a useful strategy for ensuring successful placements and is central to the Innovative Placement Program.

In summary, the service delivery system begins with an intake interview of client's medical, educational and vocational history. Findings are used to identify strengths and weaknesses relevant to employment that need to be verified by appropriate evaluation procedures. A vocational assessment is then conducted. This process responds to questions raised during the intake. Specific procedures include:

* The Functional Assessment Rating System (FARS), which is a computer-based case management tool that allows a counselor to prepare an employment profile using all known information about the client. This is used to plan additional evaluation procedures, contribute to a service plan and serve as a baseline against which to compare a person's progress through the rehabilitation process.

* The General Aptitude Test Battery and the Apticom, which are used to measure aptitudes corresponding to those in the Dictionary of Occupational Titles.

* The Attitude Toward Disabled Persons Scale (ATDP), which is used to determine a person's attitude toward his/her own disability. Research at the Research and Training Center found that the ATDP predicted need for counseling during rehabilitation. Efforts are made to ensure that people have a positive attitude about themselves before they assume employment.

* Transfer-of-Skills Analysis, which is used with people who have a work history that includes skilled and semi-skilled jobs, to identify skills from past jobs that have not been lost due to an impairment. These are reviewed for their placement potential and are targeted during the job search should the person want to use them.

Following this, an employability profile is developed by the case manager. Work Readiness Assessment Checklists, developed by the Research and Training Institute, document the person's employment strengths and weaknesses. The details and usefulness of the checklist are described later. Next, a local labor market analysis, using the employability profile, is done to identify a range of jobs that match the profile or that could be achieved with varying degrees of training.

Situational assessments are used if questions remain regarding which jobs would provide suitable opportunities. The case manager arranges for these at as many job sites as possible. These provide direct evidence about a person's ability to achieve at specific jobs and minimize the risk of making inappropriate placements.

The placement plan concludes the assessment process. All information is reviewed at a meeting attended by the client, his/her significant other(s), the referring counselor, the project cast manager, and the Employment Services Specialist (ESS) who assist in job development. The ESS professional works with Projects With Industry (PWI) employers to identify potential job openings. The plan includes the range of jobs targeted as appropriate, all services needed, where in the community the services are to be provided, the people responsible for service delivery, and target dates for completion of all services.

The second phase of the program is to provide community-based experiences designated t accomplish the targeted placement outcome. Clients participate in a job finding club to learn job seeking and job adjustment skills. They work together to find appropriate community opportunities for training and employment as specified in the placement plan. As community sites are found, an array of services are applied to accommodate the functional limitations of clients. The outcome of this second phase is a training and/or work site that is truly integrated. Job coaching is recommended when needed. Only when there are no suitable training sites in the community are services given in a rehabilitation setting.

The program provides rehabilitation engineering and technology services, when applicable, by a team consisting of a technology specialist, an occupational therapist and a rehabilitation engineer. All three participate in the evaluation. Depending on findings, the specialist locates aids and devices which overcome a person's limitations in the work. and/or training site. If none is found or if an aid or device needs additional modifications, the engineer designs and fabricates what is needed. The aid or device is thoroughly evaluated with adjustments made until it provides the functional capacity required.

Every client receives follow-along services to accommodate needs and concerns at the work or training site as well as in the home. For those in transitional and supported placements, job coach services are recommended until performance standards are met. For those in competitive jobs, follow along is provided as needed. As part of the placement plan, the case manager arranges for follow along prior to placement. Follow-along services are also offered to employers to ensure that their needs are met and that all possible reasonable accommodations are made for their workers. The original placement plan projects a 6-month period of follow-along services, which may or may not be revised and extended on the basis of the person's work performance. Six months is selected because successful work adjustment should be achieved, in most cases, within this time.

The Minnesota Satisfaction and Satisfactoriness Scales are used to assess work adjustment. After both the employee and employer indicate that this has satisfactorily occurred, the career plan, modeled after the original placement plan, is developed. This details short-and long-range goals and activities the client can pursue to upgrade his/her career as desired. When appropriate, the employer is asked to participate in this planning to assure the worker about the potential for future career development. This plan suggests what personal, employer and community resources can be used to further the individual's career.

Tailoring the Innovative Placement

Model

This general model must be adapted to the unique needs of people with disabilities. Fortunately, people seek vocational rehabilitation services primarily for employment purposes (Gregg, Miller & Roberts 1976; Murphy & Salamone, 1983).

People with disabilities are similar to other Americans in that the same demographic factors relate to labor market outcomes for both groups, such as education, age, work history, and family structures. Dunn (1981) reports the following findings from the work force in general that may be instructive for rehabilitation practices:

* The more occupations at which a person is willing to work, the better the chances of finding a job.

* An occupational goal often changes during the job search (Ullman & Gutteridge, 1973), illustrating the need for flexibility in the labor market and questioning the adherence to one goal or a limited set of job goals. If further illustrates how information obtained during a job search can be used to modify original goals.

* When the economy has been favorable, job seekers needed at least three interviews before a job was obtained (Ullman & Gutteridge, 1973). An unfavorable market would require more interviews. Clients need to have appropriate expectations and support during the job search.

* The more extensive the job search, the greater the eventual salary, job satisfaction and career progress (Ullman & Gutteridge, 1973).

* Applicants displaying greater interviewing abilities received higher salary offers (Ullman & Gutteridge, 1973). Skilled interviewing performance by clients may be our greatest tool in overcoming negative employer attitudes.

Kundu (1985) found that people with a work history prior to and after receiving a disability were more likely to become placed (94 percent) than those who worked only after their disability (71 percent) or only before their disability (60 percent). Those without a work history were the last likely to be placed. The importance of work history was also documented by Fraser, Clemmons, Trejo and Temkin (1983).

It is difficult to know how knowledge of work history can be used for placement purposes. Skills learned on previous jobs might still be within a person's capacity. Past employers may be good job lead sources. One study used a transferability of skills analysis of work histories of over 200 people to develop worker-trait profiles (Underwood, 1981). These profiles were used to develop a statistical model to predict those likely to become employed. A nearly 80 percent correct rate of prediction was obtained. The same study tested an alternate method for developing the worker-trait profile based on work evaluator recommendations. Although almost equally correct predictions were made, the researcher showed that considerably fewer resources were needed to generate the worker-trait profiles using the transferability of skills analysis. As described earlier, the Innovative Placement Program will employ this approach to identify residual skills to be considered during occupational planning.

Work readiness assessment is done formally or informally with almost all clients. However, rehabilitation counselors have a difficult time identifying it (Kneipp, Vandergoot & Lawrence, 1980). It is a difficult construct that has much appeal but for which suitable objective measures do not yet exist. Recently, attention has been paid to disincentives to work inherent in rehabilitation and disability related programs (Berkowitz, 1980; Walls, Maisson & Werner, 1977; Walls, 1982). The evidence suggests that people who participate in benefit programs rarely obtain jobs and are rarely work ready.

To aid both the client and the case manager in determining work readiness, the Innovative Placement Program uses Readiness Planning Checklists at different stages of the rehabilitation process. The first checklist assesses the client's medical, psychological and vocational situation. The checklist is then used as a planning tool to determine needed services and issues to be addressed along with a tentative time schedule. Finally, after readiness for working is apparent, a second checklist, measuring readiness to job search, is used to serve as a mutually written agreement between the case manager and client, thus enabling the client to share in the placement process with the case manager's guidance. It is used to plan and monitor all services that are required to move the client toward successful placement.

People with disabilities are an excellent placement resource, and over half find their own jobs (Zadny & James, 1976; Fraser, 1978). This strength can be enhanced by careful planning, flexibility and support. Ugland (1977) found that by providing clients with an information support system, their job finding activities and outcomes were greatly enhanced beyond that of another group of clients which did not receive support.

In view of these findings, the Innovative Placement Program equips people with effective job seeking skills through a job finding club. The case manager and clients work together to find appropriate community opportunities for training and employment as specified in the placement plan. The families and others in the clients' support networks are asked to assist in the search. The purpose of these strategies is to teach people to be as responsible for their own placement as possible. However, this does not release the case manager from active placement involvement. The case manager provides ongoing counseling and support from the point of intake to post-placement.

Staff Factors

Not much research is available that relates staff characteristics, functions and interactions to placement outcomes. Although placement is the goal of many rehabilitation programs, one study revealed there are many staffing approaches, suggesting there is little consensus as to how to best get the job done (Vandergoot & Swirsky, 1980). This Innovative Placement Program requires the case manager to be responsible for the entire service process, but also uses special placement resources. Clients are referred to a Placement Assistance Program supported by PWI funds from the Rehabilitation Services Administration. This program is staffed by Employer Service Specialists who do job development and use a subcommittee of employers to recommend job leads. These supports help develop community-based placements. The case manager and ESS share employer development activities and work site visits.

After community sites are identified as potential training and employment opportunities, the ESS and case manager conduct a Critical Items Analysis. This is an abbreviated job analysis procedure to determine if any potential tasks at the work or training site will be difficult for a person to do, given his/her functional limitations. If such problems are found, a technology services evaluation is conducted.

A Site Assessment, which is a thorough review of the work/training site, is also conducted by the case manager and/or ESS. The grounds and buildings are inspected to see if barriers exist which impede access. If there are barriers, the technology team develops an approach that reasonably accommodates the person and is manageable to the employer.

Counselors may tend to view placement as part of service delivery rather than as the goal of services. It has been found that counselors may refer clients for placement to turn them around from failure to success (Crystal, 1981). This approach is hardly the concept of a pre-screened job applicant pool employers expect and which is an essential part of vocational rehabilitation marketing strategies.

Another study revealed differences in expectations reported by counselors and clients regarding goals of services, types of services and accountability for accomplishing services (Murphy & Salomone, 1983). People came to a rehabilitation agency for vocational purposes and expected help to get a job. Counselors on the other hand, did not expect to get involved with job placement. Clients have indicated that they feel neglected by their counselors during the job search (Murray, 1981). Studies repeatedly show that counselors spend relatively little time on placement (Zadny & James, 1977).

The Innovative Placement Program requires that, along with the assistance of the ESS, the client and case manager be responsibile for placement activities. Continued case manager contact ensures case continuity and enables the case manager to provide encouragement, maintain client motivation and reduce anxiety during job searching.

Administrative Factors

Program policy can be designed to facilitate placement. Zadny & James (1979) discovered these relationships:

* Requiring specific individualized placement plans was related to higher rates.

* Placement rates achieved by counselors tended to follow agency-set goals; also, encouraging local labor market contacts was related to higher placement rates.

Smits & Emener (1980) surveyed counselors and administrators of several state rehabilitation agencies to assess views the two groups had concerning constraints that limit the time counselors spend on placement even though it is a high priority (Zadny & James, 1977). Ability to develop placements was not considered in performance appraisals. Therefore, placement was perceived as a low priority. Paperwork was too time consuming and administrators had mixed feelings about the value of placement specialists. Several recommendations emerged from these findings. Obviously, placement needs to become a real priority, which should be reinforced by setting performance expectations and actual consequences for meeting or not meeting placement goals.

Another study by Pretz (1980) concluded that emphasizing placement issues does show a relationship to placement outcomes. Over 140 counselors and supervisors of 22 field offices of state agencies were surveyed. The offices were divided into high and low functioning units on the basis of placement productivity. Important perceptions included the following:

* Establishing goals for caseload sizes and placements was associated with high productivity.

* Agency standards for time spent on placement were associated with fewer unsuccesful closures.

* Performance evaluation based on placement expectations was linked to increased productivity.

* High producing offices had counselors who felt they were knowledgeable about placement and the local labor market, while counselors from less productive offices felt more knowledgeable about preparing clients for work readiness.

* Participative administrative approaches and clear policy communication were found more frequently at the productive offices.

In response to these findings, the Innovative Placement Program is using a computer-based information system that tracks events of the entire rehabilitation process. This system permits the case manager to record a great deal of information with a minimum of effort. It is clear to the case manager that placement is the priority and all activities are justified in terms of how they contribute to placement outcomes. All staff meet weekly to make decisions about how to manage the resources of the project.

External Linkages

Probably the most important connections rehabilitation programs must make is with employers. Referral sources and other community agencies are important also. Although scant, research done on PWI programs which initiate employer advisory councils (Vandergoot & Swirsky, 1982; Pretz, Daggett & Koren, 1982) found that although the number of placements does not seem to increase during the first year or two, the quality of placements in terms of wages and retention rates shows improvement. Other outcomes showed that councils provided additional resources such as funds, new training equipment, community-based training, and information pertinent to local labor markets. Another study found that facilities which did not adopt the advisory council model received few of these resources, while those that applied the model received substantial contributions of resources (Vandergoot & Swirsky, 1982).

The Innovative Placement Program links applicants to existing openings in the local labor market. The PWI program has an extensive network of over 300 employers. The families and others in the support networks of applicants are asked to assist in the search process. In addition, local placement networks of rehabilitation professionals are used to increase the labor market contacts. The objective of all is to access as many resources and contacts as possible.

Summary

The Innovative Placement Program is a deliberate attempt to integrate research and practice, not only in the design of the service model, but in other ways as well. The management information system is designed to organize client, service and research data in a way that does not burden the case manager. The system is computerized and, eventually, all reports will be generated from information in the database. All research analyses will be done from the database as well. The service staff meet regularly with research staff to share impressions and plan for refinements of the program. Finally, the advisory board has representatives from referral sources, employers, service personnel, and research staff. Thus, the program is not only an attempt to use research but a demonstration of how research and service professionals can maintain ongoing collaborative relationships.

Bibliography

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Dr. Vandergoot is Vice President of Research and Ms. Wenzel is Case Manager at the National Center for Disability Services, Albertson, New York.
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Title Annotation:research findings used to develop system of job placement for the disabled
Author:Wenzel, Victoria
Publication:American Rehabilitation
Date:Sep 22, 1990
Words:5393
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