Recommendations for expanding employability services provided by independent living programs.

Services to persons with disabilities which target employment outcomes are in a process of change. The current rate of change is quickening relative to the historical stability of the concepts and operations of the state/federal vocational rehabilitation program which has been the major provider of employment services. Changes are occurring as a result of a number of obvious factors. Prime among these are the consumer movement and the changes in the Rehabilitation Act. There is, of course, much interaction between these two factors.

These changes are most apparent and meaningful in the quantity and quality of services available to persons with disabilities. Many new services (e.g., including rehabilitation engineering, rehabilitation technology) have been recently added to the constellation of available employment services. One of the most notable additions to the rehabilitation system is the implementation of independent living programs (ILPs). ILPs were originally funded under the Rehabilitation Act of 1973 for the purpose of meeting the unmet independent living needs of persons with disabilities. Specific core services were specified as necessary to meet the designation as an Independent Living Center (ILC) (as opposed to an ILP) but beyond those core services ILP and ILCs alike were guided largely by the concept of "unmet needs." Consequently, there is considerable variability in both the type and amount of services that ILPs/ILCs provide in the communities they serve.

According to the Report of the Comprehensive Needs Study (1975), which was mandated by the Rehabilitation Act of 1973, there is a need for ILPs to address employment of persons with disabilities. Consistent with the recommendations from that study, Section 702 of the 1978 Comprehensive Rehabilitation Services Act specified that independent living services should address the needs of individuals who were experiencing severe disability related limitation in their ability to engage or continue in employment or to function independently in family or community.

According to survey results reported by Berkeley Planning Associates (1986), ILPs have responded differentially to their charge. Findings in the Berkeley report pertinent to employment or vocational services are as follows:

* "...the Centers that make up the current Title VII, Part B program are extremely varied in their characteristics".

* "Over two-thirds (70%) of consumers are now, or have been in the past, vocational rehabilitation clients, and nearly one-third (30%) currently have an open case file with vocational rehabilitation".

* "Vocational services were provided by 43% of Centers and received by 13% of consumer respondents".

* "...employment and health care were areas where other agencies believed the effects of Center activities were least apparent".

Certainly ILPs have an emerging role in the delivery of employment services. In a recent survey conducted by the Research and Training Center on Independent Living at the University of Kansas, Jones, Petty, Bolles, and Mathews (1986) found that ILP directors rated "community accessibility and employment issues" as their "most prominent concern" from a list of 72 different services. Unfortunately, research concerning the type of employment-related services needed by ILP clientele has not been conducted.

The rehabilitation system as a whole continues to develop and recent history has seen major changes in priority groups for service as well as the goals of services. Preparedness for independent living and opportunity in the community are beginning to have equal goal status with the individual's "employability" in the eyes of service providers. ILPs are the service entity of the independent living (IL) movement and as such are prime movers in preparing persons with disabilities for independence and in advocating for community integration. They have and can be expected to continue to play a critical role in supporting the full community integration of persons with disabilities into mainstream America. Employment is a major component of independence in our society. The unique contributions that ILPs will make relative to employment within the rehabilitation system are yet to be seen. As a group they are active in the employment area but in a myriad of different ways. How, and if, they as a group will develop common roles as a part of a national system is yet to be conceptualized.

While the state vocational rehabilitation (VR) system has continued to move toward giving priority in service to persons with the more severe disabilities, certainly many people with disabilities of this classification have had difficulty in successfully engaging the state VR system as well as other vocationally oriented entities of the system, to meet their career development needs. Consequently, ILPs/ILCs have frequently been confronted with consumers expressing employment goals and a local/community system which has not met their service needs. Many of the ILP/ILCs have responded to this "unmet need" by providing employment services and support. It is estimated (Means & Bolton, 1992) that approximately one in four ILP/ILCs expends a significant amount of their resources on the provision of employment services. Some ILP/ILCs offer a range of complex services (e.g., assessment, training, placement) similar to those provided by VR. Others, and by far the largest group, offer only a few informal employment services. Not only do the types of employment services that ILPs provide vary, but also the degree of integration with other entities of the rehabilitation system vary according to a recent description of ILP/ILC provided employment services (Thayer & Rice, 1990). Some ILP/ILCs work in collaboration with other employment service providers in the community and some appear to provide employment services in isolation--perhaps even in a reactionary manner.

The lack of uniformity in the activities of ILPs is to be expected as they are in the early stages of development and no "model" (which is commonly accepted) of their participation in this area of service exists. Furthermore, there is no explicit conception of how ILP/ILCs might best become an orchestrated part of an employment service preparation system, or, agreement that they should not.

If it is accepted that ILP/ILCs currently offer some resources not to be commonly found in other rehabilitation system providers (e.g., peer support, mentoring, community advocacy, greater expectations of persons with severe disabilities) consideration of their participation as a collaborator in the employment service system seems warranted.

A problem represented by this state of affairs is how scientific inquiry might contribute to the effective and efficient evolution of service entities (both old and new) as a part of a larger system with newly created goals and resources. It would probably not be appropriate to quantitatively evaluate and compare different models of employment service delivery by ILPs as there is not general agreement as to whether or not they should provide employment services. It is probably also too early, at least for the authors, to prepare a position paper addressing and promoting a model of how things should be. Consequently, the current research focus is that of fact finding. This report documents the process and outcomes of a project designed to identify the major considerations involved in ILPs' provision of employment services. The context of this exploratory effort was that of facilitating the initiation or expansion of employment services in four experimental sites. The project was viewed as an early exploratory effort to identify the major considerations (e.g., attitudes, constraints, resources, etc.) which will be relavant to planning the employment activities of ILPs as a part of the rehabilitation system.

Research Process and Procedures

Selection of Demonstration Sites

The demonstration sites were not randomly selected but, rather, were chosen on the basis of geographic proximity to the research team. Single service programs and/or programs targeting special populations were eliminated as possible demonstration sites. Only programs providing multiple services, including the "core" services required by law for independent ILCs and serving a cross-disability population, were considered. Source of funding was not considered in the selection process. All four ILPs invited to participate agreed to participate.

Description of Demonstration Sites

The four ILPs selected to participate in the experimental intervention were located in four different states in HEW Region VI. The four sites were selected to span the range from small to large in terms of scope of services provided and to represent small cities and large metropolitan areas. In terms of employment services provided at the initiation of the project, one center offered no programs or services specifically addressing employment. One center offered a range of employment services including employability development programs, supported employment services, and placement support. In this center, employment was an active consideration within all the IL services provided. One center offered no established programmatic employability services but did help those consumers looking for work to locate jobs. The other center's employment activities were limited to a supported work program contracted with the state rehabilitation program. To document the differences among the ILPs in demographic characteristics and employability services offered, the four sites were compared on the questionnaire that was used in our earlier national survey of ILPs (Means & Bolton, 1992). These data demonstrated that the four experimental sites do, in fact, span the range of demography and services offered by ILPs nationally.

Intervention

The intervention in this study was the provision of consultation and technical assistance addressing the development of employment services. The provision of technical assistance and consultation toward a specified outcome is a typical intervention within the rehabilitation system, and the process for the provision of technical assistance and consultation is well documented and replicable. The consultant's role as described by Goodstein, Nolan, and Pfeiffer (1992) may take six directions. They are 1) the advocate or champion, 2) the stakeholder, 3) the trainer, 4) the facilitator, 5) the coach or content expert, and 6) the strategist. During the course of the one-year intervention period the principal investigator was involved in all of these roles as well as the provision of technical assistance in the support of specific activities of the ILPs. Although the consultative relationship is a complex relationship and difficult to accurately describe, the major activities of the project team designed to support the ILPs' initiation and/or expansion of employment services are provided by activity area.

Involving Demonstration Sites in Project

The four sites selected for possible inclusion in the project were initially contacted by telephone for the purpose of briefly explaining the project and requesting an on-site meeting with the executive director and other staff the executive director might wish to involve. In each case the executive director accepted the invitation to have the primary researcher visit the ILP and present the project. At all four sites the majority of the ILP staff attended this introductory meeting. A detailed explanation of the projected activities that were to be involved in the demonstration phase of the project was given. Specific aspects of the proposed demonstration phase that were emphasized were:

1. The ILP would need to be interested in initiating, expanding, and/or improving employment services.

2. The principal investigator's (PI) role would be that of providing consultation and technical assistance in support of the ILP's employment service goals. The PI would exercise no direct control within the decision makings process of the ILP.

3. The PI would participate as requested in brainstorming and planning meetings specifically concerning employment services or other more general planning meeting that might influence employment services.

4. The PI would be responsible for responding, as feasible, to the ILP's requests for locating, securing, and making available materials and methods having to do with employment of persons with disabilities and employment services.

5. Any ILP staff time or service costs associated with increasing and/or expanding employability services would be the responsibility of the ILP. No project funds were available to support the direct provision of services.

Planning

The first phase of the intervention consisted of meeting with the executive director and/or other staff of each ILP for the purpose of examining those specific directions the ILPs might wish to pursue to better meet the employment needs of their consumers. It should be noted that while the intervention is divided into activity areas for discussion purposes, some general planning took place during the initial meetings to secure the ILPs' agreement to participate, as well as throughout the intervention period. In each of the four ILPs tentative goals were set to initiate new employment programs and/or to increase the quality or quantity of existing employment services.

Provision of Employment Intervention Information

Each ILP was provided with a basic library of employability development materials which support the conduct of employment preparation classes and activities to contribute to consumers' preparedness for work. ILP staff were encouraged to review the materials and request any support they might need to implement or further examine the different interventions as possible additions to their service programs. In addition to the provision of the basic employment services library, the principal investigator was available to respond to any specific information requests related to employment services the ILPs might have. Such requests were periodically made and responded to throughout the intervention phase.

Provision of Consultation

The principal investigator was available to ILP staff to participate in planning meetings as well as to respond to a variety of requests from individual staff relevant to employment services planning. During the course of the intervention period, 30 on-site consultations were made with the four experimental sites, in addition to over 100 telephone contacts. Again, the motive of the principal investigator was not to "push" the provision of employment services, but rather, to provide information relative to the provision of employment services and to support and facilitate any initiatives of the ILPs. It is assumed that merely being in communication with the ILPs itself tended to keep employment services under consideration.

Results and Discussion

The research strategy used in this project is that of qualitative methodology. The orientation of this research effort is consistent with the goals of qualitative research as described by Taylor and Bogdan (1984) in that the issues affecting services and policy may fruitfully be explored by first-hand involvement in the naturalistic setting. Data were collected by the project team in the form of field notes, based on interviews and observations that developed during the site visits and follow-up telephone calls. These raw data were translated into a series of general conclusions about the process, followed by a set of recommendations for enhancing the initiation or expansion of employment services offered by ILPs.

The following observations are viewed as having major importance in determining the role ILPs may play in the provision of employment services within the community.

1. The ILPs are not "stable" organizational entities in terms of staffing. In comparison to the state rehabilitation program, relatively high staff turnover was observed. In some cases employment intervention planning and implementation was influenced by staff turnover.

2. Although some staff in the demonstration sites held professional credentials in some area, most persons providing the various services were not professional vocational rehabilitationists. The major consequence was that staff were not prepared by training or experience to conduct employment service interventions and it was not an "expected" work role.

3. Only one of the four ILPs had what could be described as ongoing communication with the state rehabilitation program concerning the provision of employment services within the community. In three cases there was a notable isolation of the ILP from the state agency employment program, although a few specific cooperative arrangements existed.

4. Some negative feelings existed concerning collaboration between ILPs and state rehabilitation agencies. There is little doubt that some agency counselors perceive involvement of the ILP with VR clients as a threat. This is probably attributable to the advocacy and empowerment role of ILPs. While there were some negative feelings voiced regarding collaboration between the ILPs and the state rehabilitation agency, the facilitation of meetings between the two entities resulted in better communication and established the foundation for working together.

5. The "unmet needs" in the experimental communities were many. As might be expected there were obvious significant needs for transportation, personal assistance, housing, and advocacy among a myriad of other needs presented to the local ILPs. The ILPs were funded at only "token" levels relative to the unmet IL needs of persons with disabilities within their communities. In such a situation almost any conceivable service response is justified and concurrently inadequate. Priority setting at the community level is at best confusing. Relative to their mission statements, ILPs are doomed to failure despite their many significant contributions. This situation may profoundly influence the organizational climate. There are simply too many unmet needs.

6. Above and beyond core services it is difficult to determine the specific rationale for providing the services that most of the centers provide. There probably is a significant need within the community for almost any service imaginable and consequently any service offered is warranted. The provision of any particular type of service appears to be more dependent on the orientation of ILP staff and support available for that service, or the cost of providing the service, rather than the strength of the need in the community.

7. With respect to staff and organizational development, ILPs are poorly supported in comparison to most government funded organizations. Staff training, research, and technical assistance/consultation opportunities are rare.

Recommendations

Improvement of the rehabilitation service delivery system is a process which is not best served by isolated attention to any particular element of that system. While the current research effort was primarily concerned with determining the consequences of providing limited support (i.e., technical assistance and consultation) to community based ILPs, these specific findings are but one piece of the puzzle, and have limited value when viewed independently. Consequently, in the interest of facilitating the development of the rehabilitation system as a whole to better serve the employment needs of persons with severe disabilities, the current recommendations will be discussed in conjunction with other project activities and other system considerations in an effort to yield the greatest utility in providing guidance for planning. The recommendations are broadly-based and extend to many aspects of the overall rehabilitation system of which ILPs are a part.

General Recommendations

There appears to be little justification in most communities for preparing ILPs to provide comprehensive employment services to people with disabilities. There are typically well established service programs available to meet many of the needs presented by people with disabilities. In looking toward the future of people with disabilities in the employment area, it appears prudent to plan for collaborative efforts among service entities found in the community. One of the major barriers to quality employment services identified by this study was "turfism." To further exacerbate this problem by encouraging ILPs to provide comprehensive employment services ignores one of the major impediments to enabling people with disabilities to benefit maximally from current services.

While it is not recommended that ILPs develop encapsulated employment programs, it is recommended that ILPs provide employment services as community needs dictate, and as they are uniquely or at least best prepared to provide these absent services. Experience with the current project suggests the following fertile areas for ILPs' involvement in employment services: working with people with very severe disabilities, providing independent living skills training support for state rehabilitation clients, using the state rehabilitation program to provide employment services for the ILP clients, serving an advocacy role for work opportunities in the community, and providing long-term employability evaluation and preparation services for the types of people the state rehabilitation program would view as very high risk for employment success.

Recommendations for Consumers of Employability Services

Consumers continue to increase their influence on the types of services delivered and how services are delivered. Most of this influence has been yielded via consumer groups and other organized efforts to advise and persuade. Despite the efforts of disability advocacy groups and others attempting to improve the rehabilitation system, many persons with disabilities continue to "fall through the cracks" of the local rehabilitation service system. One apparent reason for service failures, especially with employment services, is poor coordination of services. While the current rehabilitation system in many communities may not offer system-initiated collaborative services, there is no reason why persons with disabilities, on their own initiative, cannot become concurrent consumers of services provided by ILPs, state rehabilitation agencies, and other service providers as appropriate. It is recommended that they do so.

Recommendations for ILPs' Action

Initiate communication with state agency and other rehabilitation service providers. ILPs are charged with addressing the unmet needs of persons with disabilities in the community. Given the universal paucity of ILPs' budgets, there is little justification for duplicating state agency services which are readily available. ILPs which have taken an isolationist stance could benefit from establishing good communications with state agency service providers, resulting in the development of utilization strategies and warranted utilization for ILP consumers. Good communication is also the basis for influencing employment service providers to utilize the services of the ILP in support of consumers' overall independence goals.

Provide leadership in facilitating the achievement of employment goals of persons with the most severe disabilities. The state rehabilitation system is currently encountering many obstacles in successfully meeting the employment goals of many persons with more severe and multiple disabilities. At the same time federal regulations and the consumer movement are having increased expectations of the state agencies for this population. ILPs have frequently made significant contributions to the employment goals of people that the state agency has deemed "without vocational potential." ILPs, with their unique resources, could play a needed role in developing and transporting methods and techniques for meeting the career goals of persons with the greatest barriers to participation in the workforce.

Recommendations for State Rehabilitation Agencies

Training should be provided to VR service providers concerning the IL movement and the role of ILPs. Many front-line state agency service providers are probably threatened by the IL movement and ILPs as the service entity of that movement. Some of the primary issues involved are: career preparation versus one-time placement, empowerment as it relates to the Individual Written Rehabilitation Plan (IWRP), the right to fail, and cost-effectiveness of services. It was observed that front-line agency personnel do not understand the IL movement and the consequences that the movement is having on the entire rehabilitation system.

Recommendations to Policy Makers

Jointly fund ILPs and state rehabilitation agencies to initiate, demonstrate, and evaluate collaborative services. If it is assumed that the best employment services can be delivered through cooperative efforts of ILPs and the state rehabilitation programs, then efforts should address cooperation. While in some community-based relationships between the state agency and the local ILP are excellent, and collaborative programming to serve the employment needs of clients in the community is in place, this is generally not the rule. In many communities one gets the impression that an overt adversarial relationship exists and that even the attitudinal basis for working together in the interest of clients is missing. Although time may eventually lead to a resolution of issues, it is believed that policy structuring and monies supporting collaborative ventures, at least on a demonstration basis, would lead to more suitable and satisfactory arrangements.

Facilitate the stability of ILP staff and programming. The frequent changes in administration and service delivery staff, along with the resultant changes in available skills and programming, continues to be a barrier to the organizational development efforts of ILPs. Why ILPs experience high staff turnover has not been investigated and it is recommended that such research be funded. Factors which are probably related are: inadequate budgets to meet needs, the personal response of being overwhelmed and frustrated, low pay, the lack of staff support services, and the lack of relevant education and/or experience in those filling administrative roles. Once the primary factors related to program stability are identified, responses to address them could be formulated and implemented.

Provide support for ILPs to develop employment services. Many ILPs are currently making concentrated efforts to meet the VR needs of persons with the most severe disabilities. The rehabilitation system has historically underserved this population, and is currently experiencing difficulties in meeting their needs; however, ILPs are filling the gaps in many communities and are doing so without adequate support. It is recommended that ILPs be funded, at least on a demonstration basis, to develop methods and techniques for serving the employment needs of this population in partnership with other service entities of the rehabilitation system.

Summary

ILPs are involved in the provision of employment services to persons with disabilities. How they could best contribute to the employment goals of people with severe disabilities as a part of the larger rehabilitation system has not been addressed. Currently, their mission is that of serving in those instances where the system has failed. Recommendations are made for including ILPs as an integral part of a collaborative system for serving the employment needs of persons with severe disabilities.

Post-script. Since the conclusion of the one-year experimental phase of the project, two of the experimental sites have initiated major employment services in collaboration with the local rehabilitation system. Both of these projects are supported by grant funds.

Acknowledgements

This project was supported by Research and Training Center grant NIDRR H133B80065 from the National Institute on Disability and Rehabilitation Research to the Arkansas Research and Training Center in Vocational Rehabilitation, University of Arkansas, Fayetteville.

References

Berkeley Planning Associates (1986). Comprehensive Evaluation of the Title VII, Part B of the Rehabilitation Act of 1973, As Amended, Centers for Independent Living Program. U.S. Department of Education. Rehabilitation Services Administration.

Jones, M., Petty, C., Bolles, C., & Mathews, R. (1986). Independent living: A survey of program and service needs. Rehabilitation Counseling Bulletin, June, 278-283.

Goodstein, L. D., Nolan, T. M., Pfeiffer, J. W. (1992). Applied strategic planning: An introduction. San Diego, CA: Pfeiffer & Company.

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

Means, B. L., Parkerson, S., Estelle, K. (in press). Employability/employment approaches currently practiced in independent living programs: A resource document. Fayetteville: University of Arkansas Research and Training Center in Vocational Rehabilitation.

Urban Institute, The. (1975, June). Report of the comprehensive services needs study. (Contract #HEW 100-74-0309, p. 854). Washington, DC: Rehabilitation Services Administration.

Taylor, S. J., & Bogdan, R. C. (1984). Introduction to qualitative research methods: The search for meanings (2nd ed.). New York, NY: Wiley.

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