Dana Scott Gilmore

Pushing the Employment Agenda: Case Study Research of High Performing States in Integrated Employment

Organizational variables, including policies, practices, collaborations, and funding mechanisms resulting in high performance in integrated employment, were described through case study research in 3 states. Findings address how contextual factors, system-level strategies, and goals of the system are related as well as how they sustain systems change. Strategies such as flexibility in funding and practices; communication of values through data, rewards, and funding incentives; and innovation diffusion through relationships and training were most successful when they were embedded within the context of a solid values base, a network of dedicated stakeholders, and clarity about systemic goals. Implications are presented with respect to state systems, community rehabilitation providers as partners in planning, and future leadership in the field.

Achieving Community Membership through Community Rehabilitation Provider Services: Are We There Yet?.

Findings from an analysis of the characteristics and services of community rehabilitation providers (CRPs) in the early years of the 21st century are presented. Services provided by CRPs can be categorized along two dimensions: purpose (work, nonwork) and setting (facility-based, community). The number of individuals with disabilities present provides a third perspective for analysis. The majority of CRPs provided both work and nonwork services, and the majority of those that provide employment services offered both integrated and facility-based employment. Individuals with developmental disabilities were most likely to be supported in facility-based work (41%), followed by nonwork services (33%), and integrated employment (26%). Despite some changes in CRP characteristics, the goal of community membership has not yet been widely achieved.

An Analysis of Trends for People with MR, Cerebral Palsy, and Epilepsy Receiving Services from State VR Agencies: Ten Years of Progress.

This article presents the results of a secondary analysis of the RSA-911 database from the Rehabilitation Services Administration. All successful vocational rehabilitation (VR) closures for individuals with mental retardation, cerebral palsy, and epilepsy for five data points between 1985 and 1995 were investigated. Trends in the use of competitive employment versus sheltered workshops and employment outcomes (hours and earnings) are examined. The use of supported employment in the VR system and its outcomes are also discussed. An additional analysis of the impact of the 1992 Rehabilitation Act amendments is included. Findings include increased incidence of competitive employment and supported employment services but a decrease in real earnings.

Survey results from a national survey of community rehabilitation providers holding special wage certificates

The purpose of this paper is to present the findings from a national survey of a random sample of community rehabilitation programs (CRPs) that hold Special Wage Certificates established under Section 14(c) of the Fair Labor Standards Act (FLSA), 29 U.S.C. 214(c). The intent of the survey was to identify the types of services provided, the trends in the employment services, and the factors that were perceived as inhibiting and facilitating integrated employment outcomes. The survey results are categorized for this report in the following three areas: 1) characteristics of community rehabilitation programs, 2) organizational change trends, and 3) factors that influence the type of employment program utilized by consumers with disabilities. Representative results from the survey are that overall, facility-based programs continue to be the predominant service provided by community rehabilitation programs holding 14(c) certificates. Of the 20,075 staff members identified as serving consumers, only 1,741 (8.7%) are reported as working with individuals earning at least minimum wage. Although competitive employment and individual supported employment services among these CRPs are growing at a faster rate than other services, use of facility-based services continues to expand. Overall, the findings indicate that the organizations that provide daily services to those Americans with disabilities utilizing 14(c) certificates are continuing to predominately support facility-based work and non-work activities versus services leading to integrated employment outcomes.

Community-Based Nonwork Supports: Findings From the National Survey of Day and Employment Programs for People With Developmental Disabilities

This article presents findings on community-based nonwork (CBNW; activities that do not involve paid employment but take place in the community) from a 2001 survey of state intellectual disabilities/developmental disabilities agency directors. Survey responses indicated that CBNW is a considerable and growing part of the day services mix but that it is loosely defined with respect to requirements, activities, populations served, and goals. Although CBNW has the potential to enhance the lives of people with disabilities, these findings raise some concerns, including how quality can be assured when supports are loosely defined, how CBNW can be provided without taking resources away from supported employment, and whether community connections can be made when people are supported in groups.

Factors That Impact Resuscitation Preferences for Young People With Severe Developmental Disabilities

A cross-sectional descriptive study was performed to evaluate resuscitation decisions and factors that impact these choices for young people with severe developmental disabilities residing in a skilled nursing facility. Decision-makers were provided with information to clarify resuscitation preferences. Parents/guardians of 30 of the 67 residents also completed a survey. A significant number of decision-makers changed their resuscitation preference to DNR after detailed explanations were provided. Survey results suggest that interpersonal relationships, such as those with family members, religious leader, and physician, were more influential for families who chose full resuscitation compared to those with DNR preferences. Factors such as perception of quality of life and medical condition of the individuals with developmental disabilities were not significantly different between these two groups.