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Improving Access to Competitive Employment For Persons With Developmental Disabilities as a Means of Reducing Social Security Expenditures
by Paul Wehman, Michael West, John Kregel, & Kelly Kane-Johnson
Abstract
The Social Security Administration (SSA) disability programs have experienced tremendous growth in both beneficiaries and expenditures, threatening the viability of this safety net for individuals with disabilities. This article suggests that one means of assisting SSA beneficiaries to reduce dependence, thereby slowing program growth, is for SSA to directly or indirectly fund competitive employment initiatives focusing on individuals who are currently served in nonremunerative day support programs. These initiatives require coordination of SSA trust funds with vocational rehabilitation and mental retardation/developmental disability funding streams.
We live in an unprecedented era of fiscal demands on health and human service programs in the United States. For decades, education, health and rehabilitation programs have steadily grown in size. Concurrent with this growth has been a dramatic acceleration in funds expended on behalf of Social Security Administration (SSA) beneficiaries, both from the Supplemental Security Income (SSI) program and Disability Insurance (DI) (Stapleton & Dietrich, 1995). This increase in expenditures has given politicians and policy makers serious concern. Given extraordinary budget deficits over the past 15 years, taxpayers no longer have the luxury of funding disability programs which do not yield meaningful outcomes. In the case of Vocational Rehabilitation (VR) and return to work programs, meaningful outcomes are those which help people with significant disabilities gain and hold competitive employment. From 1990 to 1995, SSA disability benefit program expenditures grew from $31.1 billion to $52.3 billion, a 68% increase (Daly, 1995). The primary causes for this growth are (1) increasing numbers of persons applying and determined eligible, and (2) lack of return to the work force for beneficiaries (Rupp & Scott, 1995). Both of these variables could be substantially and positively altered if competitive employment was emphasized as a national policy initiative. This paper proposes just such an initiative for one segment of SSI/DI beneficiaries, those receiving extended employment services funded through the Federal/state Vocational Rehabilitation program and state mental retardation/developmental disability systems.
Competitive employment has historically been viewed as beyond the reach of millions of Americans with disabilities. Congress and SSA have supported this belief by providing long term payments to persons with disabilities for not working (Stapleton, July 17, 1996). However, these policies ignore recent advances made in employment services, such as job coaches, natural supports, assistive technologies, and legislative mandates such as Americans with Disabilities Act (PL 101-336). Sadly, what has resulted is long term placement of many persons with significant disabilities in nursing homes (Braddock, Hemp, Bachelder, & Fujiura, 1995), segregated employ-ment or day programs such as adult activity centers and sheltered workshops (Murphy & Rogan, 1995), or on waiting lists (Hayden & Abery, 1994).
It is individuals in segregated work options who are the primary focus of this article. Segre-gated options go by such names as sheltered workshops, work activity centers, day treatment centers, or day support centers. In these types of facilities, contracted work is brought into the center for participants to perform. Most are certified by the U.S. Department of Labor to pay salaries below the national minimum wage if the productivity of participants is determined to be substantially less than non-handicapped workers performing similar work. Many such centers lack steady contract work, and many focus primarily on teaching pre-vocational or social skills rather than providing remunerative employment (Schuster, 1990).
An alternative vocational approach which has been developed specifically for individuals with severe disabilities is supported employment. This employment option combines time-limited training and adjustment services provided at the place of employment, with ongoing follow-along services to the consumer and/or employer to promote job maintenance (Wehman & Kregel, 1985). According to current VR regulations (Federal Register, June 24, 1992), the target popu-lation consists of those with "the most severe disabilities" who traditionally have not had access to competitive employment, that is, have been served in segregated options or have been unable to access vocational services altogether. This pro-gram has grown from fewer than 10,000 participants in 1986 to over 105,000 in 1993 (Wehman & Revell, in press).
After over a decade of research, empirical evidence confirms that the majority of individuals with severe disabilities who need relatively permanent employment services fare better in sup-ported employment than in sheltered work or other types of day services. One of the first studies was the National Employment Survey for Adults with Developmental Disabilities (Kiernan, McGaughey, & Schalock, 1986), which examined segregated and integrated services and outcomes for more than 85,000 individuals served by 1,119 agencies. Quarterly earnings of sheltered workshop clients were $402.75, compared to $786.01 for individuals in supported employment, with hourly wages averaging $1.31 and $2.59, respectively.
Coker, Osgood, and Clouse (1995) studied individuals in sheltered and supported employment who were matched by age, sex, measures of intelligence, primary disability, and secondary disabilities. Average hourly wages of those in sheltered employment was $1.72, compared to $3.95 for those in supported employment; average annual salary for individuals in supported employ-ment was double that of their matched cohorts in sheltered employment. It should also be that these two studies only examined sheltered employment earnings. Many supported employment partici-pants have previously been involved in day support services with little or no remuneration, or were out of the service system altogether, and so their earnings would be even lower.
Longitudinal analyses of persons moving from sheltered to supported employment have also been conducted. Early studies (Hill & Wehman, 1983; Lagomarcino, 1986; Vogelsberg, Ashe, & Williams, 1985) established that both service con-sumers and taxpayers benefitted from service movement. More recent evidence continues to affirm these benefits (Helms, Moore, & McSewyn, 1991; Thompson, Powers, & Houchard, 1992). For example, Kregel, Wehman, and Banks (1989) studied 1,550 individuals who transitioned from alternative services to supported employment and found that weekly work hours, hourly salaries, and monthly earnings increased from 280% to 576% across disability groups. Finally, RSA data for FY 1991 show that individuals entering supported employment averaged $0.84 an hour in their previous places of employment (again, primarily sheltered employment and work activities), but were closed earning an average of $4.13 per hour.
These data are extremely encouraging in that we have found an employment philosophy and technology that works. Thousands of individuals who were previously deemed unproductive by industrial standards and paid accordingly have been assisted to perform work at or above minimum wage in the competitive work force. However, this option must be utilized more fully and invested in nationally to affect the historical trends of segregation of persons with severe disabilities.
Despite the growth of the supported employment program, all available evidence indicates that segregated employment services remain the primary service options for the overwhelming majority of individuals receiving long-term employment services (Mank, 1994; McGaughey, Kiernan, McNally, Gilmore, & Keith, 1994). A survey of state mental retardation and developmental disabilities funding systems found that the majority of consumers receiving extended employment services were in sheltered employ-ment (44%) and day activity programs (37%), with only 16% served in supported employment (McGaughey, Kiernan, McNally, & Gilmore, 1993). Additionally, a survey of day programs conducted by McGaughey, et al. (1994) found that while the number of persons served in integrated employment increased dramatically from 1986 to 1991, the average number of persons in segregated options also increased by over 28%.
These are critical data to evaluate, especially when one considers the efficacy of supported employment as an alternative strategy for enhancing competitive employment as an outcome. This article proposes a Federally-funded competitive employment initiative for those individuals currently and potentially receiving segregated vocational services, as a means of increasing their earnings and reducing dependence on SSA disability programs.
Supported employment programs have primarily been initiated within existing VR-funded rehabilitation facilities that long histories of providing sheltered employment, day activity services, and other segregated services for their caseloads. Those facilities remain the primary points of access to community-based employment services, including supported employment. A major impediment to increasing the numbers of individuals with severe disabilities entering sup-ported competitive employment is the conflicting and counter-productive ways in which Federal funds are used by the states and consequently by provider agencies. Recent empirical evidence supports this assertion:
The Rehabilitation Research and Training Center on Supported Employment at Virginia Commonwealth University (VCU-RRTC) conducts annual surveys of state supported employment programs, including the VR and extended service (mental health, mental retardation, etc.) service agencies. This survey has consistently found that only a small per-centage of provider agencies have shifted resources from segregated services to sup-ported employment. In FY 1993, the most recent year for which data have been collected, respondents indicated only 15.7% of agencies in their state had downsized segregated ser-vices (Wehman & Revell, in press).
The VCU-RRTC also recently completed (August, 1995) a national survey of 385 randomly-selected supported employment provider agencies in 40 states. Survey respon-dents were asked if their agency had downsized staff, consumers, or funds allocated for segregated employment options and increased that of community-based employment services. Only 87 (22.6%) of survey respondents indicated that their agency had shifted resources to community-based employment. Moreover, after an average of five years of conversion effort, these agencies as a group continued to allocate most service slots and financial resources to segregated services (VCU-RRTC, unpublished raw data).
A national survey of 643 vocational service providers conducted by the Institute for Com-munity Inclusion (McGaughey et al., 1994) requested respondents to identify their agencies' segregated and integrated service trends for the previous five years. Only 18% of agencies reported that they had reduced or discontinued their facility-based programs, with the majority either expanding or keeping constant their consumers in segregated options.
The McGaughey et al. study (1994) also requested the number of individuals who had entered facility-based services and community-based employment during the previous year. Respondents reported that more individuals entered segregated programs than entered sup-ported and non-supported competitive employ-ment combined.
Finally, RSA data for FY 1993 indicate that 9,930 individuals were closed rehabilitated in sheltered employment that year, despite the mandates of the 1992 Amendments to the Rehabilitation Act for integrated, competitive employment as the option of choice.
For individuals with disabilities in the United States, the primary source of support is Medicaid, and most states use SSI eligibility for determining Medicaid eligibility (Braddock & Hemp, 1996). Of 33.4 million Medicaid bene-ficiaries in 1993, 3.5% were adults with mental retardation or developmental disabilities, and 11.5% were adults with other types of disabilities. An unknown number of persons with disabilities are also likely to be included under other bene-ficiary subgroups, such as children, elderly persons, and recipients of Aid to Families with Dependent Children (AFDC). While SSI is a means tested program, DI requires that an individual meet insured status based on recent work activity. Approximately one-third of SSI beneficiaries are also SSDI recipients.
The economic disincentives of employment for SSA beneficiaries have been well documented. As Bowe (1993) notes, SSI and DI are "depen-dence oriented." That is, in order to receive assistance claimants must prove themselves to be incapable of engaging in substantial gainful activity (SGA), currently defined by SSA as earned income of at least $500 per month. Fear of losing benefits, particularly health care coverage, per-suades most beneficiaries to limit their earnings or not enter the job market at all. Data reported by the SSA (1996) underscore the economic dependence experienced by beneficiaries (see Table 1 on the following page). Moreover, analysis conducted by SSA indicates that in the overwhelming majority of cases, individuals tend to remain on SSI and SSDI rolls until they either reach retirement age, at which point they are eligible for Social Security, or until death (Rupp & Scott, 1995).
Table 1
Employment Status of SSI
Beneficiaries as of March, 1996
5,179,015 disabled SSI recipients
68.4% are working age (18-64)
8% of disabled SSI recipients of working age had earnings
Average earnings were $317 a month
Source: Social Security Administration, 1996
Effect of VR Services on SSI/DI Benefit Status As previously documented, the majority of indi-viduals with severe disabilities who are enrolled in vocational services are served in segregated options and wages in those options tend to be low, typically below minimum wage. A logical assumption would be that the majority of these individuals would fail to achieve SGA. While information is not directly available regarding receipt of benefits for individuals in segregated options, available evidence indicates that this is indeed true. Data reported by the RSA for VR case closures in FY 1993, the most recent year available, indicate that of 10,544 individuals closed in sheltered employ-ment, 27.5% received DI benefits and 56.6% received SSI at the point of case closure, compared to only 13.7% and 11%, respectively, of indi-viduals closed in competitive employment.
It should be noted that this population only includes individuals whose cases were successfully closed by the VR system in one year. An estimated 711,000 individuals, primarily with mental retar-dation and other developmental disabilities, are currently served in segregated work or non-remunerative activity programs (McGaughey et al., 1994). Because individuals in such programs have limited or no earnings, the percentages cited above for participation in SSI/DI should be considered very conservative estimates. Still, assuming equal participation in the SSI/DI programs, at least one-half million individuals in segregated employment services receive SSI, DI, or both. Because few individuals placed into segregated work options leave to enter the competitive work world (Murphy & Rogan, 1995; Schuster, 1990), the likelihood of leaving the SSA rolls as a result of segregated employment is negligible.
A Rationale for a Conversion Strategy
A primary rationale underlying a changeover strategy from predominately segregated work programs to integrated employment is that those individuals who are in segregated work programs are more likely to be dependent on SSA benefits than are those in competitive employment. Obviously, this affirms what we all know instinctively. This is a critical rationale because this allocation of trust fund moneys, as well as enormous amounts of local, state, and other Federal funds from VR, mental health, and mental retardation agencies have gone into facility-based services, assuming that these were important training grounds for individuals with disabilities to ultimately enter the competitive work force. A primary rationale underlying a changeover strategy from predominately segregated work programs to integrated employment is that those individuals who are in segregated work programs are more likely to be dependent on SSA benefits than are those in competitive employment. Obviously, this affirms what we all know instinctively. This is a critical rationale because this allocation of trust fund moneys, as well as enormous amounts of local, state, and other Federal funds from VR, mental health, and mental retardation agencies have gone into facility-based services, assuming that these were important training grounds for individuals with disabilities to ultimately enter the competitive work force.
Obviously the long term data compiled by McGaughey et al. (1994) and other sources show that this has not been the case. Our own research at the VCU/RRTC strongly suggests that once people enter supported employment they are more inclined to have their competitive employment work income be their primary source of support, with Social Security being a secondary source (Kregel et al., 1989). National data from the RSA confirm this as well; at intake 43% of supported employment participants' primary source of support is SSI or DI. Although many supported employees continue to receive a reduced level of benefits at closure, the primary source of support for the majority of participants is their own earnings.
An illustration of reduced SSI dependence from our own supported employment consumers would be instructive. Brandon is a young man of 21 years who has moderate mental retardation and cerebral palsy. He attends a local high school and will be graduating this June. Before he acquired his first job, he was receiving $300 a month in SSI benefits. His only activities outside of school were watching sports on TV and listening to the radio, with bowling on Fridays with his family.
Brandon started working with a job coach in September 1994. After spending time with him and discussing his job preferences, the job coach assisted Brandon to obtain a job at a local grocery store as a courtesy clerk and bagger. He works from 15 to 20 hours per week at $4.50 per hour. Since he began working, Brandon's life outside of school has changed dramatically. He is socializing more with his nondisabled peers at school, and participates in activities at work, such as contests, incentive programs, company picnics and parties. After graduation, he will have the chance to expand his work hours. Brandon's SSI benefit has decreased to $169 per month, for an annual savings to the Social Security trust fund of $1,572 per year.
Brandon's case helps to put a human face on this challenging public policy arena. Without the assistance of a job coach, what chance of competitive employment would Brandon have had? If Brandon's life after school was typical of most individuals with multiple disabilities, i.e., gradu-ation to segregated services or to waiting lists for services, what would his SSI benefit have been?
If only half of the persons currently served in sheltered workshops and activity centers could enter supported employment like Brandon, the savings to the Social Security trust fund would approach $400 million per year. Yet people like Brandon, who are given the chance to work in supported employment rather than in sheltered programs, are the exception. In order to increase the likelihood that more are afforded this choice, it is critical to tie the funds that day programs receive to the nature of the service and into ultimately the outcomes they deliver. If a day program receives a certain number of program slots and a per diem rate of reimbursement regardless of the nature of the service or outcomes for the consumer (a very common practice in state mental retardation/ developmental disability systems) then we should not be surprised if they deliver essentially segre-gated day program services, which may likely include nonremunerative activities.
Leveraging the Power of the
Rehabilitation Act
The Rehabilitation Act, which comes up for reauthorization next year, is one way to implement local systems change efforts. Suggested amend-ments (Mank, 1994; Wehman & Kregel, 1995) might include: The Rehabilitation Act, which comes up for reauthorization next year, is one way to implement local systems change efforts. Suggested amend-ments (Mank, 1994; Wehman & Kregel, 1995) might include:
Requirements for VR Counselors that the only successful closures (Status 26) are those which occur in competitive employment. Currently in many states, placement into unpaid occupations or low-paying segregated settings can be counted as successful placements.
Termination of the use of Rehabilitation Act funds for construction of facilities and purchase of equipment for in-house work. Title I of the Rehabilitation Act allows states to allocate establishment grants for these purposes.
Replacement of per capita funding to the states with allocations based on the previous fiscal year's successful competitive employment closures. Chapter 110 funding formulas should provide incentives for competitive employment (including supported employment) as the ultimate goal for all consumers.
While some may find these to be radical suggestions, the fact remains that the ADA, The Developmental Disabilities Act, and the Rehabili-tation Act Amendments of 1992 all philosophically and legally promote competitive employment as a preferred outcome, yet funding methods and imple-mentation have failed to follow suit. It can be argued that many of the funds that are supporting local day programs are not Federal in nature, and instead flow from general state revenue and local community service programs. Yet, if the Federal government would even subtly shift its emphasis to placing a premium on funding competitive employ-ment, this would be a powerful message to local and state policy makers that the Federal govern-ment, including SSA, is extremely interested in helping people with disabilities realize their full work potential and to fulfill its national policy of integrated employment for all citizens with disabilities.
It seems unlikely, however, to assume that large numbers of the 5,000 to 6,000 day programs and rehabilitation facilities can rapidly convert over 40 years of entrenched day program services into community based and business industry oriented competitive employment. Therefore, it would be advantageous if a small percentage of the SSA trust funds could be utilized in the capacity of both financial incentives for change, with a financial reserve to help community rehabilitation providers make this difficult one time only changeover, along with training and technical assistance funds to help accomplish this task. The amount of funds need not be overwhelming if part of the Medicaid Waiver portions of Rehabilitation Act case service dollars and a very small portion of the Social Security trust funds were allocated for the "Operation Competitive Employment" initiative. This type of strategy would seem to hold an enormous amount of potential for stimulating the activities that are necessary for community rehabilitation providers to expand supported em-ployment services.
The ultimate issue for SSA policy in the context of a policy related to defunding segregated day programs is: Will a significantly large enough group of people who are on SSI or DI who participate in these programs be able to greatly reduce their reliance on these funds if a conversion or changeover strategy is aggressively pursued by the Social Security Administration? In order to answer this question, we must be able to confirm first that there are a large number of people in these programs. This is possible through MR/DD, MH, and VR data. In addition to knowing the number of people who are in these programs, we need to understand their likelihood for staying on SSI or DI for long periods of time. Once again the data certainly seem to support this notion. Finally we must validate the fact that SSI or DI beneficiaries who are in segregated day programs are likely to stay there for a long time. There seems to be a significant amount of data from a number of sources that confirm this as well. Persons who are assigned to sheltered workshops and adult activity centers do not rapidly exit these programs into competitive employment for long periods of time; in fact, the opposite appears to be the norm.
Because the employment rate and earnings of SSI beneficiaries are both so low (e.g., SSA, 1996) that even a modest amount of success in reversing the long-term trend toward entrenchment of day programs would in a relative short period of time begin to pay off. One can reasonably ask, however, if supported employment in the last 8 to 9 years has been successful with over 100,000 participants now involved in supported employ-ment or a 10 fold increase since 1986, why has there not been more of a significant reduction in the SSA liability? A reasonable answer to this is that as a nation we have made only a relatively small public investment in supported employment, several hundred million dollars over a 5 to 8 year period from all sources, Federal, state, and local (Revell, Wehman, Kregel, West, & Rayfield, 1994). Consider the possibility of 1 to 2 billion dollars going into financial incentives for changeover and technical assistance and training, as well as a clearly defined mission statement to help people with disabilities leave SSI/DI rolls and become either partially or fully employed. Supported employment has to date represented a large national demonstration that has not had the depth of financial resources behind it.
In this section, we will describe a seven-point strategic plan for a national shift in policy and practice in the employment of SSA bene-ficiaries. Several of these points have been alluded to previously but warrant reiteration. We believe that each of these strategies is consistent with national policy as iterated in the Rehabilitation Act and the Americans with Disabilities Act, with best practices, and with the demands and interests of in-dividuals with disabilities and their families. Most require coordination of effort from Federal pro-grams that fund services for individuals with disa-bilities, including SSA, VR, the Administration on Developmental Disabilities, and other agencies. However, this coordination is essential to achieving a coherent nation policy on disability that focuses on meaningful employment, at levels consistent with individuals' full potential, reduced economic dependency, and consumer-driven services.
Strategy #1: Phase out segregated options for persons entering the adult service system. It is improbable and unrealistic to expect that all SSA beneficiaries involved in segregated work and non-work programs can be moved to supported employment programs immediately or even within a few years. However, the conversion of state, local, and Federal resources from segregated to integrated options can be accomplished through attrition and by phasing out segregated options for persons who are entering the adult service system. As Mank (1994) writes, this policy change is the "clearest statement that can be made about the future of employment for people with significant disabilities" (p. 17).: Phase out segregated options for persons entering the adult service system. It is improbable and unrealistic to expect that all SSA beneficiaries involved in segregated work and non-work programs can be moved to supported employment programs immediately or even within a few years. However, the conversion of state, local, and Federal resources from segregated to integrated options can be accomplished through attrition and by phasing out segregated options for persons who are entering the adult service system. As Mank (1994) writes, this policy change is the "clearest statement that can be made about the future of employment for people with significant disabilities" (p. 17).
Strategy #2: Cap current funding for existing segregated work and non-work options. A finite amount of public resources are available for employment services for individuals with disa-bilities. It is imperative and consistent with national policy that those resources be used in ways that promote consumer choice and self-determination, financial independence, and quality of life. Clearly, these goals and career choices can best be reached by putting resources into competitive employment options, including sup-ported employment for those with the most severe disabilities. Several states have already moved to halt the growth of segregated services by capping funds or program slots (e.g., Washington, Oregon).: Cap current funding for existing segregated work and non-work options. A finite amount of public resources are available for employment services for individuals with disa-bilities. It is imperative and consistent with national policy that those resources be used in ways that promote consumer choice and self-determination, financial independence, and quality of life. Clearly, these goals and career choices can best be reached by putting resources into competitive employment options, including sup-ported employment for those with the most severe disabilities. Several states have already moved to halt the growth of segregated services by capping funds or program slots (e.g., Washington, Oregon).
Strategy #3: Provide financial incentives for competitive employment. Many provider agencies face financial disincentives to expanding their supported employment programs to accom-modate all eligible consumers (West, 1995). To offset these disincentives, rehabilitation facilities can be given a premium, financed by the SSA trust fund, for supported employment placements of SSI/DI beneficiaries with severe disabilities. These premiums can be directly based on the amount of reduction of the beneficiary's SSI or DI cash benefits. This proposal is similar to that offered by other groups (i.e., the Return to Work Group) for nonworking SSA beneficiaries; however, SSA should also target individuals who are currently receiving segregated services who would benefit from supported or unsupported competitive employment, and are therefore working and earning below their capabilities.: Provide financial incentives for competitive employment. Many provider agencies face financial disincentives to expanding their supported employment programs to accom-modate all eligible consumers (West, 1995). To offset these disincentives, rehabilitation facilities can be given a premium, financed by the SSA trust fund, for supported employment placements of SSI/DI beneficiaries with severe disabilities. These premiums can be directly based on the amount of reduction of the beneficiary's SSI or DI cash benefits. This proposal is similar to that offered by other groups (i.e., the Return to Work Group) for nonworking SSA beneficiaries; however, SSA should also target individuals who are currently receiving segregated services who would benefit from supported or unsupported competitive employment, and are therefore working and earning below their capabilities.
Strategy #4: Coordinate Federal/state funds and SSA trust funds. A national changeover strategy from segregated to integrated employment for all who would choose that option requires that RSA, SSA, and state agencies be consistent in both policy and funding with one another and consistent with national policy as iterated in the Reha-bilitation Act and the Americans with Disabilities Act. Eliminating the cycles of dependency and underemployment of SSI/DI beneficiaries requires that all governmental entities reinforce competitive work placements for persons with disabilities and eliminate disincentives within the system to con-vert resources to supported employment for those with the most severe disabilities.: Coordinate Federal/state funds and SSA trust funds. A national changeover strategy from segregated to integrated employment for all who would choose that option requires that RSA, SSA, and state agencies be consistent in both policy and funding with one another and consistent with national policy as iterated in the Reha-bilitation Act and the Americans with Disabilities Act. Eliminating the cycles of dependency and underemployment of SSI/DI beneficiaries requires that all governmental entities reinforce competitive work placements for persons with disabilities and eliminate disincentives within the system to con-vert resources to supported employment for those with the most severe disabilities.
Strategy #5: Stimulate provider agency conversion. All providers of Federally-funded vocational services should be required to develop a five-year strategic plan that targets competitive employment for at least 50% of their constituents, and provide them the technical assistance and financial support needed to accomplish this goal. This will help to "level the playing field" of em-ployment services and give consumers and their families more opportunities to enter the com-petitive work force and increased choice in the types of services and jobs they wish to pursue.: Stimulate provider agency conversion. All providers of Federally-funded vocational services should be required to develop a five-year strategic plan that targets competitive employment for at least 50% of their constituents, and provide them the technical assistance and financial support needed to accomplish this goal. This will help to "level the playing field" of em-ployment services and give consumers and their families more opportunities to enter the com-petitive work force and increased choice in the types of services and jobs they wish to pursue.
Strategy #6: Establish a Pool of Federal reserves. Many provider agencies do not initiate or expand competitive employment options for their consumers with severe disabilities because of limited staff expertise and organizational experi-ence. Funds should be made available by Federal sources (i.e., RSA, SSA) for training and technical assistance needs and for short-term assistance in staffing. These funds could be appropriated to the states for targeting TA needs, such as new pro-viders of supported employment, unserved or underserved geographic areas, etc. : Establish a Pool of Federal reserves. Many provider agencies do not initiate or expand competitive employment options for their consumers with severe disabilities because of limited staff expertise and organizational experi-ence. Funds should be made available by Federal sources (i.e., RSA, SSA) for training and technical assistance needs and for short-term assistance in staffing. These funds could be appropriated to the states for targeting TA needs, such as new pro-viders of supported employment, unserved or underserved geographic areas, etc.
Strategy #7: Make key amendments to the Rehabilitation Act. We have noted that VR Counselors in many states have the option of closing individuals successfully in sheltered employment and even unpaid occupations. Elimi-nating these options will provide an incentive to Counselors to authorize supported employment for individuals with the most severe disabilities. In addition, Title I of the Rehabilitation Act allows states to allocate establishment grants for the con-struction of rehabilitation facilities and purchase of equipment for in-house contracts. Rather than spending precious funds to construct buildings to continue segregated services, these funds could be better spent on building business alliances, com-munity support systems, assistive technology resources, and community placement capacities.: Make key amendments to the Rehabilitation Act. We have noted that VR Counselors in many states have the option of closing individuals successfully in sheltered employment and even unpaid occupations. Elimi-nating these options will provide an incentive to Counselors to authorize supported employment for individuals with the most severe disabilities. In addition, Title I of the Rehabilitation Act allows states to allocate establishment grants for the con-struction of rehabilitation facilities and purchase of equipment for in-house contracts. Rather than spending precious funds to construct buildings to continue segregated services, these funds could be better spent on building business alliances, com-munity support systems, assistive technology resources, and community placement capacities.
Despite a national policy of integration and competitive employment for individuals with disabilities mandated by the ADA and the Rehabilitation Act, and despite systems change initiatives across the nation funded by the Reha-bilitation Services Administration (RSA), inte-grated and segregated vocational service options continue to compete for funds and participants. Mank (1994) argues that this situation is caused by conflicting national disability services policies in that the same legislation and programs that fund integrated employment training and placement also fund segregated services. Provider agencies which are not committed to expansion of integrated employment opportunities have little economic incentive to do so.
In this article, we have presented a rationale and strategies for a national initiative to expand competitive employment options for individuals with disabilities, coordinating SSA, RSA, and mental retardation/developmental disability funding streams and policies. We can no longer continue to deny the overwhelming majority of persons receiving long-term employment supports the chance to escape unemployment, underemploy-ment, and segregation, while waiting for provider agencies to, in the words of Weiner-Zivolich and Zivolich (1995), "convert their values and services at their own pace" (p. 311). Beyond the need to preserve Social Security benefits, radical new policy directions and initiatives are needed in order for individuals with significant disabilities to realize the goals of full citizenship and self-determination as iterated in the ADA and the Rehabilitation Act.
References
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