Katherine J. Inge

Supported employment and assistive technology for persons with spinal cord injury: Three illustrations of successful work supports.

The Virginia Commonwealth University/Medical College of Virginia (VCU/MCV) Model System of Care for individuals with spinal cord injury merges the best health care practices with an underlying foundation of consumer advocacy, patient education, and individual consumer empowerment. The VCU/MCV Model System project consists of six individual subprojects: Clinical Pathway Outcomes for SCI, Innovative Medical Issues, Dual Disability: Concomitant SCI and Traumatic Brain Injury (TBI), Community Reintegration, Consumer Advocacy, and Substance Abuse. The project:

Report: An analysis of self-employment outcomes within the Federal/State Vocational Rehabilitation System

An objective of the START-UP/USA project, funded by U.S. Department of Labor, The Office of Disability Employment Policy, is to study the extent to which the Federal/State Vocational Rehabilitation Program supports self-employment vocational alternatives for individuals with disabilities. The purpose of this report is to provide an analysis of self-employment participation and outcomes by individuals with disabilities within the Federal/State Vocational Rehabilitation (VR) System. This report focuses on outcomes in selfemployment through a longitudinal analysis of closure data contained in the Rehabilitation Services Administration (RSA) 911 Closure Reports for the period covering Fiscal Years 2003–2007. The data in this report provides a snapshot into the extent to which self-employment is occurring within the VR system as an employment outcome. First, it presents a longitudinal summary of the extent to which self-employment outcomes are occurring within the General and Combined VR agencies in the 50 states

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.

Moving employment research into practice: Knowledge and application of evidence-based practices by state vocational rehabilitation agency staff

The objective of this study was to identify barriers and facilitators to the use of evidence by professional staff of state Vocational Rehabilitation (VR) agencies. Data were collected via an online survey administered to 355 staff at three state VR departments. Over half of respondents could locate and comprehend research findings. Evidence-based practice (EBP) was not widely encouraged, but there was a positive relationship between the agency having sufficient funds and its support for EBP (r = 0.27, p = 0.001). The top two sources of information respondents used on the job were professional collaboration and the Internet, but not social media. State VR agencies tend not to expect that counselors will use EBP and provide limited incentives for them to do so. While VR staff value research and are open to trying new strategies based on research, translating evidence into usable and accessible products and developing efficient delivery strategies present challenges that the authors intend to investigate further in upcoming research. Knowledge translation strategies need to be developed for this audience.

Employment outcomes for individuals with spinal cord injuries: 2011–2013

BACKGROUND: Employment for individuals with spinal cord injury (SCI) varies by demographic, educational, and preinjury occupational characteristics. Individuals with SCI also face a number of physical and structural barriers to returning to work postinjury. Vocational Rehabilitation (VR) services through the use of the federal and state vocational rehabilitation programs is one option for obtaining the needed supports that lead to successful competitive employment outcomes. OBJECTIVE: This information is for those individuals with SCI whose cases were closed by VR in one of the four case closure codes: Status 08, Status 28, Status 30, or Status 26. The intent of this research is to profile participation, services received, and outcomes achieved by individuals with SCI who were participants in State Vocational Rehabilitation programs. METHODS:Using the Federal Rehabilitation Services Administration’s (RSA) 911-database, individuals with a primary physical disability of spinal cord injury who had their cases closed in Federal Fiscal Years 2011–2013 (n= 9,205) were selected to understand general demographic, education, SSI/SDI, and reasons for case closure information. More detailed analyses of data of services received, employment outcomes, and costs for individuals for whom an Individual Plan for Employment (IPE) also were completed. RESULTS: Nationally, state VR agencies reported closing 3,217 cases in FY 2011, 3,098 cases in FY 2012, and 2,890 cases in FY 2013 in the four case closure codes: Status 08, Status 28, Status 30, and Status 26. Status 26 closure represents those cases closed successfully. In this study, 991 individuals with SCI were closed in Status 26 during FY 2011, 972 in FY 2012, and 936 in FY 2013. The majority of cases closed successfully were for individuals who were white/Caucasian, and rates were slightly higher for individuals with an associate’s degree or more. CONCLUSIONS:The findings in this study are consistent with previous findings on the demographic characteristics of individuals with SCI and return to work. More research is needed on the relationship between certain demographic characteristics and successful employment postinjury, the impact of rehabilitation technology services on successful case closures, the types of jobs that individuals with SCI obtain, and what makes state VR programs in some areas more successful than others.

Improving the employment outcomes of individuals with traumatic brain injury: The effectiveness of knowledge translation strategies to impact the use of evidence-based practices by vocational rehabilitation counselors

OBJECTIVE: The objective of this study was to compare the effects of two knowledge translation (KT) strategies on the knowledge and future actions of vocational rehabilitation (VR) counselors when supporting individuals with traumatic brain injury (TBI). DESIGN: The study used a randomized pretest-posttest control group design. PARTICIPANTS: Participants were professional staff recruited from a single state VR agency who volunteered to participate in the study. The majority were female counselors with Master’s degrees. PROCEDURE: Participants were randomly assigned to one of two groups. Both groups received the same information on supported employment for individuals with traumatic brain injury (TBI) over a three month period. One group received the information via pre-recorded video presentations that were posted on an unlisted YouTube channel. The second group received the identical information via three briefs. At the beginning of each of the three months, each participant received either an email with the link to a pre-recorded presentation on YouTube or an email with the brief attached depending on the group assignment. The information could be accessed at their convenience across the one month period. Participants were assessed pre- and post-intervention with a Likert-scale instrument designed to measure knowledge of TBI, the effects of TBI on employment, and the efficacy of the supported employment approach for this group. In addition, participants were asked pre- and posttest how likely they were to fund services related to supported employment for individuals with TBI.

Ensuring support systems that work: getting beyond the natural supports versus job coach controversy

This article is intended to challenge the field of supported employment to enter into a new dialogue in which professionals agree that all people, regardless of life circumstances, need support systems in order to be successful. Furthermore, support systems can look vastly different from one another. The authors suggest that little benefit comes from arguing over which is better, or more cost-efficient: natural supports or job coaching. An alternative approach would be to view all support strategies in a customer service and accommodation framework. The concept of customer service is discussed and suggestions for identifying person-to-person support strategies are provided.

Barriers and facilitators to employment as reported by people with physical disabilities: An across disability type analysis

BACKGROUND: Extant research has reported on the factors associated with seeking and maintaining employment for individuals with different types of physical disabilities, such as cerebral palsy (CP), multiple sclerosis (MS), and spinal cord injuries (SCI). Some of these factors are barriers and others are facilitators. However, research has not determined whether the inhibiting and facilitating employment experiences of people with physical disabilities are similar across type of physical disability. OBJECTIVE: The goal of this study was to compare the employment experiences of people with physical disabilities with three different disabilities including CP, MS, and SCI to determine whether these employment experiences are similar. METHODS: Homogenous focus groups were conducted with individuals with CP, MS, and SCI concerning their employment experiences. These 18 focus groups were conducted telephonically, audio recorded, and lasted approximately 60 minutes each. Data from each disability type was analyzed separately and across disability type. RESULTS: Two themes were common among participants in the three disability types: 1) Health and 2) Barriers to Overcome. However, there were differences among the disability types within these themes. Some of these differences were unique to MS. CONCLUSIONS: This study provides a perspective on working with CP, MS, or SCI informed directly by individuals living with these disabilities, whether they were employed or unemployed, and gives a voice to the employment experiences of the individuals. The findings present information on the similarities and differences that individuals with various physical disabilities face when working.