State-federal Vocational Rehabilitation System Research Articles

STEM Career Pathways for Transition-Age Youth With Disabilities

Background:Although there is an increasing demand for workers in STEM fields, people with disabilities are underrepresented in STEM educational programs and related occupations. Among those who achieved competitive integrated employment after serving under an Individualized Plan for Employment (IPE) by the state-federal vocational rehabilitation (VR) system, only 5.3% of individuals with disabilities were engaged in STEM jobs/careers during the years 2017–2019. Of those with an employment outcome in STEM fields, 8,348 (40.9%) were transition-age youth aged 14–24.Objective:Using Rehabilitation Service Administration (RSA-911) data for the fiscal years from 2017 to 2019, the current study investigated the characteristics of transition-age youth with disabilities aged 14–24 in the state-federal VR system that predicted employment outcomes in STEM fields.Methods:A logistic regression analysis was used to examine the associations between individual characteristics and STEM career attainment.Findings:Results illustrated that gender, race, living arrangement, and the receipt of general assistance/SSI/SSDI/TANF predicted employment outcomes in STEM fields.Conclusions:The research findings provide support for the understanding of demographic characteristics of transition-age youth with disabilities successfully closed in STEM jobs/careers after serving under an IPE. A discussion of the strategies and interventions associated with promoting career development and decisions toward the STEM field for transition-age youth with disabilities is provided.

Organizational and cultural factors that promote creative best practices in the public rehabilitation program: Findings from a four-state multiple case study

The state-federal vocational rehabilitation system is tasked to demonstrate accountability for employment outcomes of persons with disabilities. State VR agencies have sought to evaluate existing practices, and in areas that existing practices leave room for improvement, create the conditions for innovation to occur. The purpose of this article is to identify promising organizational and cultural factors that appear to promote best practices in the public vocational rehabilitation program. A multi-stage study utilizing the Consensual Qualitative Research (CQR) was conducted involving four high performing state VR agencies to discover emerging and promising organizational practices leading to improvements in employment outcomes of people with disabilities. The comprehensive examination revealed specific organizational practices, culture and structural elements that encourage and support the development of innovative, effective service delivery practices. Given the complexity of service provision and the increasing demand for successful outcomes, VR agencies must develop organizational cultures that facilitate transformational learning by employing evidence-based practices that lead to successful outcomes for agency consumers.

Acceptance rates in state–federal vocational rehabilitation of clients with brain injury: Is racial disparity an issue?

Primary objective: To utilize Aday and Andersen's Framework for the Study of Access to examine racial disparity within the State-Federal vocational rehabilitation system, among clients with brain injury. Research questions included: Do pre-disposing characteristics such as age, race, ethnicity, gender, marital status and education influence vocational rehabilitation acceptance rates in the US? Do enabling characteristics such as referral source, insurance coverage and primary source of support at application influence vocational rehabilitation acceptance rates in the US? Is there a difference, based on race, in the reason for case closure for vocational rehabilitation services?Methods and procedures: Exhaustive CHAID analysis was conducted with acceptance for rehabilitation as the criterion variable and pre-disposing characteristics as predictor variables. Chi-square analysis was calculated with regard to reason for closure.Main outcomes and results: Descriptive findings are presented. Of the pre-disposing factors, the most significant predictor of acceptance rate was education level. Pearson Chi-square analyses revealed significant differences between White and non-White clients with brain injury with regard to reason for closure.Conclusions: The data indicate that racial differences were only a small part of the overall equation and again that distinct disparity by race is not evidenced in the RSA-911 data for persons with a primary or secondary diagnosis of brain injury.

Vocational services associated with competitive employment in 18–25 year old cancer survivors

Young adult cancer survivors report difficulties related to employment. This study investigated the association of vocational services on work in young cancer survivors unemployed prior to receipt of services. Administrative data obtained for years 2004 and 2005 from the Rehabilitation Services Administration (RSA) database was used in the analyses. A total of 368 cases aged 18-25 who were closed during the 2 years with a diagnosis of cancer were identified. All cancer survivors were unemployed at the time of application. Data on demographic characteristics, employment and vocational services were extracted and analyzed in relation to employment. Multivariate logistic regression was used to examine the relationship among services provided and work outcomes accounting for demographic characteristics. Cancer survivors represented 0.4% of the total population that received vocational services in the state-federal vocational rehabilitation system. Of the unemployed cancer survivors who received services, 190 (51.6%) achieved successful employment while 178 (48.4%) were not employed following receipt of vocational rehabilitation services. Gender (woman) (OR = 1.79; 95% CI: 1.16 to 2.76), vocational training (OR = 2.03; 95% CI: 1.03 to 4.00), miscellaneous training (OR = 4.01; 95% CI: 1.80 to 8.97), job search assistance (OR = 4.01; 95% CI: 1.80 to 8.97), job placement services (OR = 2.24; 95% CI: 1.11 to 4.52), on-the-job support (OR = 4.20; 95% CI: 1.66 to 10.63), and maintenance services (OR = 2.85; 95% CI: 1.38 to 5.90) were all related to an increased odds for employment. Provision of cash or medical benefits (e.g., Social Security Disability Insurance benefits) (OR = 0.43; 95% CI: 0.28 to 0.67) was associated with lower employment following vocational services. Very few young adult cancer survivors were involved in the state-federal rehabilitation program. Despite this, the provision of certain vocational rehabilitation services was related to increased employment in this group. Those who received job search assistance and on the job support were four times more likely to be employed following such services. While those in receipt of benefits were less likely to be employed, it is very likely that those receiving such benefits are the more severe cases. It is worth noting that the exact direction of these relationships can not be determined with the current design. Young adult cancer survivors who are seeking employment and can qualify for such services may benefit from certain services offered by state vocational rehabilitation agencies. This represents another service to consider when employment is a goal.

Predictors of Successful Closure in the State-Federal Vocational Rehabilitation System: Findings from a Sample of Persons with Disability and Substance Use Disorders

Numerous studies have focused on the predictors of successful closure of state-federal vocational rehabilitation (VR) applicants. However, there appears to be only one study focused solely on the predictors of employment with persons who were deemed eligible for services based on their alcohol or drug abuse diagnosis. This retrospective study examined the predictors of employment among this population. A sample of 940 persons with a primary or secondary diagnosis of alcohol or drug abuse and a closure status of 26 or 28 was randomly selected from the 2005 Rehabilitation Service Administration (RSA) 911 data. A combination of consumer characteristics, VR service variables, and work disincentives predicted employment. Knowledge of these predictors suggests ways for counselors to better serve consumers via accurate assessment, appropriate planning, and efficient case coordination.

An Exploratory Investigation of Rehabilitation Counselors' Perceived Readiness to Undertake Substance Use Disorder Screening in Vocational Rehabilitation

Screening for problems related to substance use occurs routinely in many systems of care and human services. However, at present, there is no universally accepted process for performing such a screening in the state-federal vocational rehabilitation system. This exploratory study analyzes data obtained from rehabilitation counselors participating in a substance use disorder screening implementation initiative. The responses provide preliminary information regarding rehabilitation counselors' perceived readiness to undertake such an initiative and potential barriers to its successful implementation.

Inequities in the VR System

This investigation determined whether differences still exist for racial minorities and women in terms of acceptance rates, employment outcomes, and quality of successful closures in the state-federal vocational rehabilitation system. Three control variables— age, education level, and severity of disability—were used in a logistic regression model. Differences in odds (based on odds ratio estimates) were found for the following: (a) acceptance rates—favored European Americans over African Americans, (b) employment outcomes—favored European Americans over both African Americans and Native Americans, and (c) quality of closures—favored men over women, with age acting as an effect modifier.

Unique issues in assessing work function among individuals with psychiatric disabilities.

With the admission of people who experience psychiatric disabilities in the state-federal vocational rehabilitation system and the Social Security disability rolls in the 1960s, assessment of their capacity to work has been a major concern. Given the rising rates of claims for psychiatric disability in both the public and the private sectors, and the disappointing employment outcomes of people with psychiatric disabilities compared to those with other disabilities, there have been numerous initiatives to accurately assess their employment potential. Historically, such assessment within the Social Security Administration has relied upon evaluation of a person's medical impairment, but numerous studies suggest a weak relationship between measures of psychiatric diagnosis or symptoms and work outcome. Efforts have been undertaken to identify valid and reliable methods of assessing the ability of people with psychiatric disabilities to work. The authors review (a) methods of assessing work function for this population, and (b) the literature on predictors of work functioning and the nature of psychiatric disability, and suggest implications for disability determination policies and for future research.

Management of work disability. Resources for vocational rehabilitation.

To review the state-federal vocational rehabilitation (SF-VR) system and its utilization by persons with rheumatic conditions. SF-VR system instruction manuals, and literature on rheumatology rehabilitation, work disability, and rehabilitation counseling were reviewed. National and Massachusetts state SF-VR system data on persons with "arthritis and rheumatism" were analyzed. The SF-VR system is used by a small proportion of persons with rheumatic diseases. Fifty-two percent of clients with arthritis are employed after receiving services. Although evidence indicates that VR services for persons with rheumatic conditions improves their chances for reemployment, the SF-VR system is underutilized.

State-Federal Vocational Rehabilitation System Exceeds 100,000 Rehabilitations

State-Federal Vocational Rehabilitation System Exceeds 100,000 Rehabilitations