Public services available to persons with disabilities in major U.S. cities.

Twenty-one U. S. city officials were surveyed to discover what services are available to persons with disabilities and what methods cities use to address disability issues. This study found various services available to persons with disabilities. The findings show cities use two methods for addressing disability issues: establishment of an office or designation of an individual. This study suggests cities are responding to the needs of persons with disabilities. However, closer analysis shows few cities strongly committed to insuring the rights of these individuals. The study concludes rehabilitation professionals and persons with disabilities must persuade cities to strengthen their protection of disability rights.

In the United States, the number of people with disabilities has increased significantly in the past 50 years (DeJong & Lifchez, 1983). This study uses the definition of disability provided by Section 504 of the 1973 Rehabilitation Act, which defines a person with a disability as someone who has a mental or physical impairment that limits one or more major life activities. La Plante (1988) reports that "14.1 percent, or 32.5 million persons, report some activity limitation due to chronic health conditions" (p. 9). As further medical advances are made and as our society ages, the number of people with disabilities will continue to grow (Manton, 1985). Consequently, the availability of public services to this population becomes increasingly important.

America does not have a specific policy on disability (Berkowitz, 1987). Instead, since the end of World War I the federal government has passed several individual pieces of legislation concerning disability issues. The most far-reaching legislation that has been enacted to date is Section 504 of the 1973 Rehabilitation Act. Often called a civil rights act, Section 504's goal has been to prohibit discrimination against persons with disabilities in federally funded programs, services, and benefits. It affects many basic city functions such as transportation, public facilities, education, and social services.

The literature provides little regarding what city services are available to persons with disabilities. Several articles describe cities with award-winning programs that integrate persons with disabilities into their communities ("Carolyn Keane," 1983, 1986; Cheatham, 1980; "Programs," 1988). Pomeroy (1983) discusses specific community-based recreational programs offered to people with disabilities. Poole (1985) examines the effects of federal budget cuts and decentralization on services for people with developmental disabilities in Greater Richmond, Virginia. And although no specific survey of public services for persons with disabilities was found, three studies did include disability services in their national surveys of cities' human services departments (U.S. Conference of Mayors, 1977; 1982; Agranoff & Pattakos, 1985).

The purpose of this study was to discover what public services are available to persons with disabilities in the major U.S. cities and what methods the cities use to address disability issues.

Method Population

This study's population was the 23 cities in the United States with populations over 500,000 (Statistical Abstract of the United States, 1987). Twenty-one of the cities participated in the survey, giving a response rate of 91 Survey instrument

The telephone survey developed for this study was pre-tested on the Deputy Commissioner of Disability and on the Assistant Commissioner of Operations at Chicago's Department on Aging and Disability. Based on the preliminary testing, modifications were made for the final survey instrument. Procedure

At the beginning of this study, the endorsement of Chicago's Department on Aging and Disability was received. This endorsement was acknowledged in all correspondence with survey participants.

Since Centers for Independent Living (CIL) are involved in public policy issues at the local level, they were used as resources to identify appropriate spokespersons in each of the cities surveyed. A list of CILs was obtained from the Administrative Director of the National Council on Independent Living (NCIL). From that list, 21 out of the 23 cities to be surveyed had active CILs. The directors of these 21 CILs were called and asked to identify a local official who they believed could best respond to a survey of their cities' services for persons with disabilities. All but four of the directors could identify a respondent for the survey.

In the four cities in which the CIL directors could not identify a spokesperson and in the two cities that did not have CILs, the individual Mayoral Offices were called. Three of the Mayoral Offices supplied the name of an official representative upon the first call. However, in the other three cities, repeated phone calls were necessary before a spokesperson could be identified. Once a list of city officials was compiled, a letter of introduction was sent to each of them. The letter explained the purpose and method of the study and assured confidentiality. Several days after receiving the letter, each city official was contacted by phone and either the survey was conducted or an appointment was made to do so later. Twenty-one surveys were completed between December 19, 1988 and January 11, 1989. Two cities could not be surveyed. In one case, despite exchanging numerous messages, successful contact did not occur. In the other case, the city official made two appointments but broke both.

The qualitative data collected in the survey were collapsed into similar categories and coded using nominal measurements. ABSTAT Statistical Program was run to compute frequency distributions on the variable responses. To maintain confidentiality, each completed survey was given an identifying case number and kept in a secure place.

Results The results of this study are divided into three sections. The findings presented are: * the year each of the cities began providing disability services and each city's reasons for establishing these services, * the two most common methods the cities have used to address disability issues, and * the public services that the cities have made available to persons with disabilities. Years and Reasons for Services

Most surveyed cities began addressing disability issues over a fifteen-year span. Forty-eight percent of the cities started providing services for persons with disabilities between the years 1973 and 1977, 19% between 1978 and 1981, and 14% between 1982 and 1988 (19% were unknown).

While 14% of the respondents were unsure of why their city established disability services, most of the survey respondents (86%) agreed services began because of one of three reasons: an administrative decision (38%), constituents' demand (24%), or Section 504 of the 1973 Rehabilitation Act (24%). However, of those 38% reporting administrative decisions as the reason for action, 76% of this group explained that these decisions resulted either from an administration's awareness of Section 504 or pressure from constituents. The remaining 24% reported the administrative decisions were made independently (12%) or the reasons were unknown (12%). Methods of Addressing issues

In order to address disability issues, 52% of the surveyed cities have established disability offices. The remaining cities (48%) have designated an individual to assume this responsibility. Additionally, whatever method those responding chose, 86% of the cities have appointed coordinators of Section 504 of the Rehabilitation Act. Nine percent of the respondents reported that their cities did not have Section 504 coordinators and 5% were unsure. Disability Off ices

An examination of the cities' disability offices revealed similarities and differences in organizational structure.

The most-used structure for disability offices is a unit (55%) within a city department or a Mayor's Office. The remaining offices are designated as separate city commissions (27%) or city departments (18%).

Two-thirds of the disability offices (64%) answer directly to the city manager, the mayor, or an assistant to the mayor, while a third (36%) are administered by city department heads.

The number of employees in the cities' disability offices ranges from 1 to 150. Most of the offices (64%) have one to five employees, while 27% have 40 to 150 employees and 9% have 20 employees. Also, the number of people with disabilities that the offices have employed varies from zero to 40. Of those offices having employees with disabilities, half of them (50%) have one to two employees with disabilities, 30% have 5 to 10 employees with disabilities, and 20% have more than 10 employees with disabilities.

Variations in the size and the source of disability offices' funding can also be seen. The disability offices' budgets range from $25,000 to $8 million. While one respondent could not estimate the amount of the office's budget, 60% of the budgets are between $25,000 and $200,000, 20% are approximately $2 million, and another 20% are greater than $5 million. Many of the respondents reported that their disability offices receive funds from several sources, including federal, state, county, and city governments. However, all the disability offices are allocated some city revenue and over a third of the offices (36%) receive solely city funds. individual Positions

Forty-eight percent of the surveyed cities have designated an individual to address disability issues. Like the disability offices, these individual positions vary in their location within the city structure and in their j ob titles.

Sixty percent of the individual positions designated to address disability issues are located in Mayoral Offices, 30% are located in city departments, and 10% are in city councils.

Twenty percent of the cities call these individuals "Handicap Coordinator" or "Disabled Persons Program Coordinator." The remaining cities (80%) have assigned the responsibilities of disability issues to positions with titles unrelated to disability (e.g., Special Assistant to Neighborhood Services, Equal Employment Specialist, Urban Planning Specialist). Available Public Services

The survey questioned the local officials on the availability of public services to persons with disabilities in six areas: housing, employment, transportation, recreation, advocacy, and supportive services. As Table I displays, the respondents reported that their cities have numerous public services available to persons with disabilities.

Both indirect and direct services were reported available by the cities. The indirect services focus on eliminating architectural and attitudinal barriers in the environment. Examples of these indirect services include: developing accessible housing and public transportation, educating the public on disability issues, and establishing disability advisory boards. The direct services concentrated on employment, transportation, recreation, and supportive assistance. Job placement, paratransit systems, special recreational events, and referral systems are all examples of these direct public services.

Although the cities have numerous services available to persons with disabilities, several of the respondents reported that the extent of some of these services has often been limited. These respondents described services such as public housing, public transportation, and nutrition programs as being provided "on a limited basis" or "minimally."

Discussion

The present survey suggests that the 21 major U.S. cities responding have numerous public services available to persons with disabilities. However, upon closer analysis of the methods used to address disability issues, it seems that only a few of the cities are strongly committed to insuring the rights of these individuals. Many of the cities apparently lack such a commitment. This lack of commitment is demonstrated by the absence of an easily identifiable disability position or office, or by the establishment of a disability office with a low budget, small number of employees, and few employees with disabling conditions. Additionally, many of the disability offices and positions are very vulnerable to political changes, being created and directly controlled by elected officials. At best, the majority of cities surveyed are barely protecting the basic rights of persons with disabilities mandated 17 years ago by Section 504.

The cities' weak commitment to insuring disability rights has profound effects on the daily lives of people with disabilities. Inaccessible housing, inaccessible transportation, and inadequate employment opportunities all reinforce dependency and undermine the goals of rehabilitation.

If individuals with disabilities are to achieve maximal independence, rehabilitation educators and direct service practitioners need to move beyond the standard medical model of disability. Traditionally, the medical model has emphasized adapting the individual to society. However, the present study shows that despite rehabilitation efforts, persons with disabilities continue to face numerous barriers in their communities. As Hahn (1982) has identified, disability is currently defined not as an individual's failure to meet the expectations of society, but as society's failure to adjust to the needs of persons with disabilities. Rehabilitation professionals must expand their role and become advocates for the implementation of disability rights.

Further research must explore the limitations, resulting from inaccessibility and discrimination, that the society at large imposes on persons with disabilities. Specifically, researchers must ask persons with disabilities themselves to identify the barriers which, despite the skills they acquired through rehabilitation, continue to limit their independence. Questions of this kind could easily be included in the long term follow-up of rehabilitation clients. The findings and implications of such studies should be presented to policy makers so that they understand that rehabilitating the individual is not enough. Public policy decisions which begin adjusting society to the needs of persons with disabilities are necessary.

While the cities in this study reported providing various services for persons with disabilities, much more must be done to insure equal rights for this population. Rehabilitation professionals, along with persons with disabilities, must not be content with partial protection of disability rights. Together, they must persuade cities to reexamine their commitment and strengthen their methods of guaranteeing these rights. Only then will persons with disabilities be able to achieve true independence.

Acknowledgments

I gratefully acknowledge the support Chicago's Department on Aging and Disability gave me in this study. In particular, I thank the staff of the Planning Department and Audrey McCrimon, Director of Illinois's Department of Rehabilitation Services, formerly Chicago's Deputy Commissioner of Disability. Additionally, I thank the members of the National Council of Independent Living for their assistance in identifying survey respondents and the city officials who graciously gave their time to complete the surveys.

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