Trends in vocational rehabilitation: 1978, 1988, 1998.

This article examines consistencies and changes across a 20-year period in the public vocational rehabilitation program in the United States. The findings can be instructive, not only to the clients, counselors, and managers in the State-Federal program, but also to the consumers and rehabilitation professionals in a variety of other programs (e.g., mental health, independent living, home health, community rehabilitation, and one-stop centers in the Workforce Investment Act programs). A private rehabilitation program, for example, may find that the demographic composition of clientele has mirrored the State-Federal program, that their costs for services have exceeded those reported herein, or that their profile of occupational placement differs markedly. An organization may consider revision of its data-recording system to include relevant indices of intake, process, and outcome. Rehabilitation personnel in a variety of programs are interested in potential relationships between receipt of public benefits and success in vocational rehabilitation.

The Rehabilitation Services Administration (RSA) within the U.S. Department of Education provides the funding and oversight of the State-Federal Vocational Rehabilitation Program. The program is implemented at the state level through various state departments (Jones, 1995). Program evaluation includes collecting, analyzing, and interpreting client data as a basis for an assessment of service needs, patterns of use, program outcomes, and efficiency of services offered (benefit-cost ratios) (Bua-Iam, Majumder, Walls, Kunjara, 1997). A good rehabilitation database serves to (a) help maintain program accountability and integrity and (b) help identify facilitators as well as barriers to successful rehabilitation of persons with disabilities. Systematic reporting of all vocational rehabilitation cases (Case Service Report System, for SRS-RSA-300) was implemented in accordance with the Vocational Rehabilitation Act Amendments of 1954 and Regulations issued in 1966. The Rehabilitation Act of 1973 mandated development of program evaluation standards for the State-Federal Vocational Rehabilitation Program nationwide, and the state Vocational Rehabilitation programs were required to provide RSA with statistical data on a regular basis (Posavec & Carey, 1985).

The Rehabilitation Act and the Regulations implementing the Act strengthened the recording and reporting requirements. Form SRS-RSA-300 was revised July 1, 1974 for purposes of providing "... a comprehensive, standardized system of statistical reporting on the complete rehabilitation process for every individual coming in contact with that process, from first referral to final closure" (Rehabilitation Services Administration, 1974, p. 13). Form SRSRSA-300 had three parts. Part 1 was "to be recorded at the time of first referral." This part included name, address, referral date, referral source, age, and sex. Part 2 was "to be recorded at completion of the referral process." This part required data on SSDI status, SSI status, race, outcome of referral process, primary and secondary disabling conditions, previous case closures, marital status, dependents, number in the family, highest grade completed, work status, income from earnings and public assistance, and primary source of support. Part 3 was "to be recorded at time of closure." This part included date of closure, federal programs and Social Security statuses, severity of disability, cost of case services, work status, weekly earnings, occupation, time in case statuses, services provided (e.g., diagnostic, restoration, maintenance, college training, business or vocational training, on-the-job training),, and outcome of the rehabilitation process. The possible outcomes of a case could be (a) closed as not accepted for services, determined during the referral-application process or after extended evaluation (Closure Status 08), (b) closed after acceptance for services but before initiation of services under an individualized written rehabilitation plan or individualized plan for employment (Closure Status 30), (c) closed after acceptance for services and after initiation of services under an individualized written rehabilitation plan but not rehabilitated (Closure Status 28), and (d) closed rehabilitated (Closure Status 26).

Although some modifications to the case service report have been implemented since 1974, most of the original data elements have been maintained as the core of the statistical reporting system. Minor revisions to Form SRS-RSA-300 were proposed in the new Case Service Report System (Form RSA-911) in 1984 and subsequently were approved in 1986. For example, although the Office of Management and Budget (OBM) rejected three proposed data elements, "job referral" was approved as an additional type of service to be recorded as "yes" or "no" for each vocational rehabilitation case. Data elements for supported employment were added to Form RSA-911 in 1988, and reporting of monthly public assistance dollars, availability of medical insurance, and primary source of support at closure became part of the case service report system in 1991. In 1995, "year last employed," "rehabilitation technology services," "date of eligibility," "personal assistance services," and "previous employment status" were added to the case service report system. The system continues to evolve in the interests of data quality, measurement of program impact, and enhanced understanding of optimal service complements for the vocational rehabilitation of individuals with disabilities.

Mund (1978) reported that, in 1975, the State-Federal Vocational Rehabilitation Program, evaluated 1,326,000 referrals for rehabilitation services and rehabilitated 392,000 individuals. Mosher (1978) congratulated the vocational rehabilitation system for making inroads combating discrimination and monumental unemployment of persons with disabilities. He called, however, for improved assistance in identifying skill potentials, providing relevant vocational training, and assisting in the job placement process. Buchanan et al. (1998) indicated that "one of the greatest challenges faced in today's rehabilitation organizational climate is the absolute necessity of evidencing value of services" (p. 97). He called for the establishment of an integrated system of outcomes management. Vogel (1995) has suggested that "the existing vocational rehabilitation database can be enriched with other automated information that is potentially useful in assessing and planning for services on an institutional as well as statewide programming basis" (p. 29). Many researchers have examined the Vocational Rehabilitaiton system and rehabilitation processes and have provided both concrete guidance and extrapolations on where and how to improve the vocational rehabilitation program. For example, an in-depth analysis of the RSA Case Service Report System data for 1992 (Majumder, Walls, Fullmer, & Misra, t997) helped identify specific factors which appeared most likely to limit success in achieving competitive employment outcomes from vocational rehabilitation by various target populations of the vocational rehabilitation program.

Emphasis on the "rehabilitated" case closure criterion (Closure Status 26) plays a significant role in program evaluation. There has been a growing concern, however, over the use of this single criterion to measure adequate quality of vocational rehabilitation outcomes. Walls and Tseng (1987) emphasized the need to develop multiple outcome criteria to reflect accomplishment of clients. Walls (2001) reiterated the complexity of developing a comprehensive system of outcome measures for the rehabilitation program. Client outcomes in rehabilitation interact with input and process variables which differ across disciplines of medical, vocational, and independent living rehabilitation.

What are the differences from input to output since 1978? The present investigation examines trends in selected intake, process, and outcome variables from 1978 to 1988 to 1998. Certainly, macro trends across decades may obscure important changes that occur from year to year or even month to month. Value may be derived, however, from a broad-scale view of minute measures (e.g., client characteristics at acceptance, intervention services, and employment outcomes). The following research questions were the focus of the study. Over these 20 years, have there been changes in (a) proportion of persons served across various disabling conditions, (b) demographics of the individuals served, (c) frequency of a given service, (d) the number and proportion rehabilitated, (e) occupational distribution among those who were rehabilitated, and (f) proportions of competitive employment of those rehabilitated?

Method

Data

The national data for all agencies in the U.S. State-Federal Vocational Rehabilitation Program were analyzed for fiscal years 1978, 1988, and 1998. The national data included a record (observation) for each person applying for vocational rehabilitation services in those years. In the national data tapes, there were records for (a) 856,400 individuals in 1978, (b) 606,193 individuals in 1988, and (c) 596,266 individuals in 1998. These numbers included the four categories of records described previously. Thus, some individuals were ineligible or for other reasons were not accepted for services in the State-Federal Vocational Rehabilitation Program (Closure Status 08). Those who were found to have a disabling condition and were accepted for service became "clients." Those clients could exit as unsuccessful prior to receiving rehabilitation services (Closure Status 30), exit as unsuccessful after receiving rehabilitation services (Closure Status 28), or exit as successful after receiving rehabilitation services (Closure Status 26).

Design and Procedure

In the present research, all agencies in the national program were included (General Agencies, Agencies for Individuals with Visual Impairments, and Combined Agencies). All individuals referred for services constituted the population. Year of Case Closure (1978 versus 1988 versus 1998) was the non-manipulated independent variable. The dependent variables were (a) Intake Variables (e.g., age, education, disabling condition), (b) Process Variables (services received, cost of case services, time in the rehabilitation process), and (c) Outcome Variables (work status, gain in earnings, occupation, rehabilitation status). Overall numbers of individuals are reported in the major categories for each year, and percentages are used to allow direct interpretations of trends across the years.

Results

In 1978, of the 856,400 people who were referred to the State-Federal Vocational Rehabilitation Program, 392,954 were served, and 229,909 were rehabilitated. In 1988, 606,193 were referred, 321,521 were served, and 218,413 were rehabilitated. In 1998, 596,266 were referred, 359,892 were served, and 223,691 were rehabilitated. Because of the large numbers of individuals, an alpha level of p<.01 was adopted for all statistical tests of significance. Four tables and one figure are presented to describe similarities and changes from 1978 to 1988 to 1998. Table 1 presents proportions for categories of disabling conditions, as well as secondary disability and severe disability. Tables 2, 3, and 4 show percentages for various intake variables, process variables, and outcome variables, respectively. Figure 1 illustrates the trend from 1978 to 1988 to 1998 in competitive employment, extended employment, and homemaker or unpaid family worker rehabilitation.

[FIGURE 1 OMITTED]

Table 1 presents the distribution of disabling conditions (primary disability categories) for (a) those Rehabilitated (R) through the vocational rehabilitation program (Status 26 case closure) and (b) those served but Not Rehabilitated (NR) after the individualized plan for employment was initiated (Status 28 case closure). The percentage of rehabilitated clients with total blindness increased from 1% in 1978 to 5% in 1988 and 5% in 1998. Emotional conditions (28%, 32%, and 28%, respectively), orthopedic conditions (21%, 21%, and 20%, respectively), and mental retardation (14%, 13%, and 13%, respectively) were consistent and dominant in the number of rehabilitants. Proportions of those Rehabilitated (R) and Not Rehabilitated (NR) were similar, with the exception of Emotional Conditions. The percentages for NR were higher than for R when clients had Emotional Conditions (9% higher, 9% higher, and 10% higher in 1978, 1988, and 1998, respectively). Rehabilitants having a secondary disability increased from 25% in 1978 to 37% in 1988 to 40% in 1998, and rehabilitants classified as having a severe disability increased from 44% to 64% to 83%. Clients who were not rehabilitated showed similar increases across the decades for secondary disability and severe disability.

Related to Table 1, chi-square analyses were computed for numbers of rehabilitants for (a) year by major disability categories and (b) year by severe disability categories. Distribution of rehabilitants in major disability categories of sensory (visual, heating), orthopedic (including amputation), emotional (psychotic, neurotic, substance abuse), mental retardation, and other (e.g., epilepsy, cardiac disorder, respiratory disorder) was not significantly different across the years, chi-square (8, N = 657,000) = 9.9, not significant. The distribution of rehabilitants who were classed as severe versus not severe, however, yielded a significant difference across the years, chi-square (2, N = 756,000) = 57.9, p < .01. As may be noted in Table 1, severe disability classification increased sharply in that 20-year period.

Table 2 shows basic "intake" variables from the intake-process-outcome systems view of rehabilitation. The age distribution reflects appropriate ages being served as well as (a) decrease in the age less than 21 category and (b) an increase in the age 41 to 65 category. The gender distribution of rehabilitants is consistent in 1978, 1988, and 1998. Similarly, the race distribution is stable across the years. The marital status distribution shows an increase in the clients who were not married (which included widowed, divorced, separated, and never married). Those who had less than a high school education decreased in both rehabilitants and non-rehabilitants, and the high school and more than high school frequencies increased. The work status at intake distribution indicates that the majority of clients were not working at the time they sought vocational rehabilitation services. The public benefits at intake distribution reveals that, although the majority of clients were not receiving public benefits, the percentage of rehabilitants who were receiving public benefits at intake increased from 22% in 1978 to 39% in 1998. The primary source of support distribution demonstrates a rise in self-support at the time of intake (to 26% for rehabilitants in 1998), but dependence on others for support for the majority of clients at the time of intake continues to be high.

With reference to Table 2, two-way chi-square analyses were calculated for numbers of rehabilitants in the dimensions of (a) year by gender, (b) year by race, (c) year by education, and (d) year by public benefits at time of application. Distribution of males and females did not vary significantly over the years, chi-square (2, N = 672,000) = 0.2, not significant. The race distribution also did not differ significantly across the time periods, chi-square (4, N = 663,000) = 0.9, not significant. The education distribution, however, showed progression toward higher levels of education from 1978 to 1988 to 1998, chi-square (4, N = 672,000) = 21.1, p < .01. A greater proportion of rehabilitants tended to be receiving public benefits in 1998 than in 1978, chi-square (2, N = 672,000) = 16.3, p < .01.

Table 3 reports percentages for "process" variables in the State-Federal system of vocational rehabilitation. The services distribution indicates that, as a basis for determining the rehabilitation plan and other services, diagnostic and evaluation services were received by more than 80% of clients. Such services, however, as well as restoration service and maintenance service, tended to decrease from 1978 to 1988 to 1998. The cost of case services appears to have increased from 1978 to 1988 to 1998, as would be expected in the percentages reported (where dollars were not adjusted for inflation). Adjusted dollar means for case service costs are presented subsequently. The months spent in the rehabilitation process distribution reveals more months for rehabilitation and non-rehabilitation in the later time periods than in 1978, with concomitant reduction in cases taking less than 12 months.

Further analyses related to Table 3 included (a) mean cost of case services (unadjusted and adjusted), (b) chi-square of year by cost categories, and (c) chi-square of year by months spent in rehabilitation. Mean costs per rehabilitant (unadjusted for inflation) were $1,072 in 1978, $1,918 in 1988, and $3,632 in 1998. In adjusted dollars, mean costs were $1,640 in 1978, $1,630 in 1988, and $2,216 in 1998 (adjusted for inflation using the 1982-1984 consumer price index). The adjusted mean case service cost for rehabilitants was almost the same in 1978 and 1988, but it increased by 36% in 1998. For unadjusted dollars, the case service costs increased significantly in year by cost category (less than $1,000, between $1,000 and $5,000, and more than $5,000), chi-square (4, N = 672,000) = 68.3, p < .01. Another chi-square analysis for year by months spent in the rehabilitation process (less than 12 months, between 12 and 23 months, and more than 23 months) did not show a significant difference in the number of months to achieve the rehabilitation outcome from 1978 to 1988 to 1998, chi-square (4, N = 672,000) = 11.3, not significant.

Table 4 indicates percentages for "outcome" variables for rehabilitants. The work status at closure distribution shows predominant placement in competitive employment (71% in 1978 to 82% in 1988 to 88% in 1998). The gain in weekly earnings (from referral to closure) distribution gives evidence of more than $100 gain for 41%, 60%, and 69% of rehabilitants, respectively. The occupation at closure distribution reveals increased numbers of clients gaining employment in (a) professional-technical-managerial and (b) service occupations. Clerical and sales occupations maintained substantial proportions.

Related to occupation at closure in Table 4, chi-square analysis of year by occupational categories (professional-technical-managerial, clerical and sales, service, and other trades, including agriculture, processing, machine trades, bench work, structural work, miscellaneous) yielded a significant difference, chi-square (6, N = 594,000) = 21.1, p < .01. The increases for professional-technical-managerial and service over the years at the completion of the rehabilitation program contributed strongly to this trend.

Figure 1 illustrates a substantial increase in the proportion of rehabilitants achieving competitive employment (including self-employment) from 73% in 1978 to 84% in 1988 to 91% in 1998. Rehabilitation to noncompetitive employment (extended employment in a community rehabilitation program) tended to decrease from 14% in 1978 to 6% in 1988 to 4% in 1998. Similarly, there was reduction in the non-wage categories of rehabilitation (homemaker or unpaid family worker) from 13% in 1978 to 10% in 1988 to 5% in 1998.

Discussion

The Rehabilitation Act of 1973 mandated prioritization of rehabilitation services to people with severe disabilities. Indeed, there was conscientious endorsement of this mandate, as indicated by a major increase in the proportion of rehabilitants with severe disabilities, from 44% to 83% over the 20-year period. Given this mandate to serve individuals with severe disability, one might expect the proportion of individuals rehabilitated to competitive employment to decline. Instead of a decline in competitive employment due to a larger proportion of more difficult cases, however, the program registered great success in achieving competitive employment, from 73% to 91% in the 20 years.

The data cited herein suggested that the rehabilitation program indeed is working with more difficult cases and serving individuals with more severe disabilities such as blindness and emotional conditions. Since enactment of the 1943 Vocational Rehabilitation Amendments which extended services to persons with mental illness and mental impairments, services to those individuals have increased. In contrast to predominant service to clients with orthopedic impairments prior to 1943 (75%), in the present study about 20% of rehabilitants had orthopedic impairments, but more than 40% had emotional conditions or mental retardation (conditions usually requiring extensive service). Additionally, rehabilitants with total blindness increased from 1% to 5% in the present investigation. Also contributing to case difficulty (a) secondary disability increased from 25% to 40% for rehabilitants, and as noted (b) severe disability increased from 44% to 83% for rehabilitants.

Potential further contribution to case difficulty stems from disincentives operating for clients who are receiving public benefits (e.g., Walls, 1982; Walls, Dowler, & Fullmer, 1989; Walls, Zawlocki, & Dowler, 1986). Persons receiving public benefits often are those with severe disabilities and most in need (Majumder et al., 1997). In 1978, only 22% of rehabilitants were receiving public benefits at intake, but receipt increased to 29% in 1988 and 39% in 1998. More than 50% of non-rehabilitated clients had public benefits in 1998. The public vocational rehabilitation program is a participant in the "welfare to work" movement.

Coupled with service to clients with more severe disabilities who are more likely to have a secondary disability and to have public benefits at application, (a) the cost of case services has tripled, and (b) time in the rehabilitation process has increased. Even in terms of constant dollars adjusted for inflation, the average cost of case services increased 36% in the 1988 to 1998 time period. Fewer cases are being closed in less than a year, and more cases are taking more than two years. The modest cost-of-living adjustments in agency funding are not keeping pace with the large increases in real costs for case services and personnel. Counselors and managers conscientiously seek funding for case services from "other sources" (e.g., client's resources, Workers Compensation, Pell Grant). The "do more with less" syndrome, however, slows services to people with disabilities. Programs will be pressured to find ways to augment case-service funding or to develop alternative strategies to serve clients and meet performance standards.

In spite of the challenges discussed, the public vocational rehabilitation program has adapted to the changing needs, adjusted the program accordingly, and performed admirably. Over time, variations due to endogenous (e.g., policy and program) and exogenous (e.g., economy and labor market) factors contribute to changes in organizational operations and outputs. In 1996, the Rehabilitation Services Administration and the Council of State Administrators of Vocational Rehabilitation formulated a joint vision and strategy to shift focus more toward consumer-responsive, high-quality, efficient vocational rehabilitation outcomes in integrated settings. This partnership placed renewed emphasis on streamlining public vocational rehabilitation through best practices in eligibility determination, vocational planning, service implementation, and employment outcomes. The percentage of rehabilitants who achieved competitive employment increased by 17% from 1978 to 1998. More clients are achieving professional-technical-managerial positions than in former times, and gains in weekly earnings (consonant with Vogel's 1995 emphasis) across all classes of occupations are contributing to independence. Although a micro view would be useful to understand the magnitude and direction of the impact of input and process variables, individually and collectively, on outcomes, the macro view that this study provides can be beneficial at policy and program-management levels. Rehabilitation workers in the variety of human-service programs work with people. These people are not dry statistics in a graph or table. But seeing the trends across the years in the largest rehabilitation program (a) alerts us to past and potential issues, (b) causes us to examine our present caseload management and service-delivery approaches, and (c) may trigger considerations and strategies for future effective actions that will benefit people with disabilities. The findings presented in this investigation reflect the strong commitment of the public vocational rehabilitation program to enhance the employability and employment of individuals with severe disabilities. The national rehabilitation program moved the vast majority of their clients toward economic independence.

Table 1

Percentages of Vocational Rehabilitation Clients with Types of
Disabling Conditions

                                 1978                  1988
Disabling
Condition                    R          NR         R          NR

                             N=         N=         N=         N=
                           229,909    163,045    218,413    103,108
                              %          %          %          %

Major Disability
  Total Blindness              1          1          5          2
  Partial Blindness            4          3          4          3
  Total Deafness               2          1          3          2
  Partial Deafness             4          2          6          2
  Orthopedic                  21         22         21         24
  Absence of Limbs             3          2          2          1
  Emotional Cond.             28         37         32         41
  Mental Retardation          14         13         13         12
  Other Conditions            23         19         14         13
                             100        100        100        100

Secondary Disability
  Yes                         25         18         37         41
  No                          75         82         63         59
                             100        100        100        100

Severe Disability
  Yes                         44         46         64         66
  No                          56         54         36         34
                             100        100        100        100

                                  1998
Disabling
Condition                     R         NR

                             N=         N=
                           223,691    136,201
                              %          %

Major Disability
  Total Blindness              5          3
  Partial Blindness            3          2
  Total Deafness               3          2
  Partial Deafness             5          1
  Orthopedic                  20         21
  Absence of Limbs             1          1
  Emotional Cond.             28         38
  Mental Retardation          13         11
  Other Conditions            22         21
                             100        100

Secondary Disability
  Yes                         40         47
  No                          60         53
                             100        100

Severe Disability
  Yes                         83         86
  No                          17         14
                             100        100

Note 1. R=Rehabilitated (Status 26 case closure). NR=Served but Not
        Rehabilitated (Status 28 case closure).
Note 2. Percentages are rounded to whole numbers (e.g., 34.8% would
        be 35 in the table).
Note 3. Other Conditions include, for example, conditions related to
        circulatory system, respiratory system, nervous system,
        endocrine system, digestive system, and genitourinary system.
Note 4. Major Disability code was missing for 50,047 cases in 1978,
        missing for 1,707 cases in 1988, and missing for 100 cases in
        1998. Percentages for Major Disability categories were
        calculated excluding missing codes.
Table 2

Percentages of Client Intake Variables for Rehabilitants and
Non Rehabilitants

                                    1978                  1988
Intake
Variables                      R          NR         R          NR

                               N=         N=         N=         N=
                             229,909    163,045    218,413    103,108
                                %          %          %          %

Age
  Less than 21                  28         27          8         10
  21-40                         47         46         61         64
  41-65                         24         26         27         25
  More than 65                   1          1          4          1
                               100        100        100        100

Gender
  Male                          56         61         56         59
  Female                        44         39         44         41
                               100        100        100        100

Race
  White                         78         75         80         75
  Black                         20         23         18         23
  Other                          2          2          2          2
                               100        100        100        100

Marital Status
  Married                       31         26         28         23
  Not Married                   69         74         72         77
                               100        100        100        100

Education
  Less than H S                 58         68         46         48
  High School                   31         24         37         37
  More than H S                 11          8         17         15
                               100        100        100        100

Work Status at Intake
  Working for Wages             22         29         20          9
  Homemaker or UFW               5          3          4          2
  Not Working                   73         68         76         89
                               100        100        100        100

Public Benefits at Intake
  Receiving                     22         36         29         35
  Not Receiving                 78         64         71         65
                               100        100        100        100

Primary Source of Support
  Self                          16          7         18         10
  Other                         84         93         82         90
                               100        100        100        100

                                    1998
Intake
Variables                      R          NR

                               N=         N=
                             223,691    136,201
                                %          %

Age
  Less than 21                   8         10
  21-40                         53         54
  41-65                         36         35
  More than 65                   3          1
                               100        100
Gender
  Male                          54         55
  Female                        46         45
                               100        100

Race
  White                         79         74
  Black                         19         23
  Other                          2          3
                               100        100

Marital Status
  Married                       25         19
  Not Married                   75         81
                               100        100

Education
  Less than H S                 37         42
  High School                   42         40
  More than H S                 21         18
                               100        100

Work Status at Intake
  Working for Wages             24         12
  Homemaker or UFW               3          1
  Not Working                   73         87
                               100        100

Public Benefits at Intake
  Receiving                     39         51
  Not Receiving                 61         49
                               100        100

Primary Source of Support
  Self                          26         17
  Other                         74         83
                               100        100

Note 1. R=Rehabilitated (Status 26 case closure). NR=Served but Not
        Rehabilitated (Status 28 case closure).
Note 2. Percentages are rounded to whole numbers (e.g., 34.8% would be
        35 in the table).
Note 3. UFW = Unpaid Family Worker
Table 3

Percentages of Process Variables for Rehabilitants and Non Rehabilitants

                              1978                   1988
Process
Variables                 R          NR         R          NR

                          N=         N=         N=         N=
                        229,909    163,045    218,413    103,108
                           %          %          %          %
Services
  D and E Service          95         95         92         83
  Restoration Service      42         42         39         28
  Maintenance Service      24         25         22         19
  Adjustment Training      22         25         21         18
  College Training         17         21         10         11
  Bus. or Voc.Train.       17         22         13         12
  On-the-Job Training       7          8         10          5
  Misc. Training           11         13         13          9

Cost of Case Services
  Less than $1,000         70         83         56         68
  $1,000 to $5,000         27         15         36         27
  More than $5,000          3          2          8          5
                          100        100        100        100

Months Spent in the Rehabilitation Process
  Less then 12             49         58         36         20
  12 to 23                 24         19         32         31
  24 or more               27         23         32         49
                          100        100        100        100

                                 1998
Process
Variables                    R          NR

                              N=         N=
                           223,691    136,201
                              %          %

Services
  D and E Service             83         81
  Restoration Service         33         24
  Maintenance Service         17         15
  Adjustment Training         22         21
  College Training            15         17
  Bus. or Voc.Train.          14         13
  On-the-Job Training          8          5
  Misc. Training              18         15

Cost of Case Services
  Less than $1,000            36         54
  $1,000 to $5,000            43         34
  More than $5,000            21         12
                             100        100

Months Spent in the Rehabilitation Process
  Less then 12                35         25
  12 to 23                    31         32
  24 or more                  34         43
                             100        100

Note 1. R=Rehabilitated (Status 26 case closure). NR=Served but Not
        Rehabilitated (Status 28 case closure).
Note 2. Percentages are rounded to whole numbers (e.g., 34.8% would be
        35 in the table).
Note 3. For the Service categories, the percentages do not add to 100%
        because an individual can receive more than one service.
Note 4. D and E Service is Diagnostic and Evaluation Service.
Table 4

Percentages of Outcome Variables for Rehabilitants

Outcome
Variables                         1978        1988        1998
                                   R           R           R
                                   N=          N=          N=
                                229,909     218,413     223,691
                                   %           %           %

Work Status at Closure
  Competitive Employment           71          82          88
  Self-Employment                   2           2           3
  Extended Employment              14           6           4
  Unpaid Family Worker              1           1           0
  Homemaker                        12           9           5
                                  100         100         100

Gain in Weekly Earnings from Application to Closure
  More than $100                   41          60          69
  $51 to $100                      17          12           9
  $1 to $50                        12          10           8
  $0 or Loss                       30          18          14
                                  100         100         100

Occupation at Closure
  Prof., Tech., Manage.            12          10          18
  Clerical and Sales               24          21          24
  Service                          18          19          28
  Agricultural                      3          14           2
  Processing                       14           3           2
  Machine Trades                    9           2           4
  Bench Work                        6          16           5
  Structural Work                   8          10           7
  Miscellaneous                     6           5          10
                                  100         100         100

Note 1. R=Rehabilitated (Status 26 case closure).
Note 2. Percentages are rounded to whole numbers (e.g., 34.8% would be
        35 in the table).
Note 3. No percentages are presented for individuals who were Not
        Rehabilitated because these Outcome Variables did not apply to
        them.
Note 4. The Work Status percentages for State Business Enterprise (BEP)
        were less than 1%.

References

Bua-Iam, P., Majumder, R.K., Walls, R.T., & Kunjara, A. (1997). Key output indicators (Technical Report). Morgantown, WV: West Virginia Rehabilitation Research and Training Center.

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Author Notes

Appreciation is expressed to George Demanelis, Thomas Freeman, and Richard Kuznicki for assistance in transferring data sets from tapes. Thanks are given to Dianna Griffin for manuscript preparation.

Richard T. Walls, Ph.D., International Center for Disability Information, College of Human Resources & Education, West Virginia University, Morgantown, WV 26506-6122. Email: [e-mail]