Vocational Rehabilitation:

Evidence for Federal Program's Effectiveness Is Mixed

PEMD-93-19: Published: Aug 27, 1993. Publicly Released: Aug 27, 1993.

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Pursuant to a congressional request, GAO reviewed the Rehabilitation Services Administration's (RSA) federal-state vocational rehabilitation (VR) program, focusing on the: (1) eligible population; (2) characteristics of individuals who are accepted into the program and those who are not; (3) services clients receive; and (4) program's outcomes.

GAO found that: (1) 14 million to 18 million Americans are potentially eligible for VR due to work limitations; (2) 5 to 7 percent of the eligible disabled population are served by the VR program per year; (3) individuals with work disabilities tend to be older, less educated, and poorer than the general work-age population; (4) the predominant disabling conditions causing work limitations are musculoskeletal and cardiovascular impairments; (5) 65 percent of those served in 1988 had severe disabilities as compared to 69 percent of the eligible population; (6) successful VR applicants are generally similar to unsuccessful applicants, except that they tend to be more disabled; (7) VR applicants generally reflect the eligible population and tended to be young, male, and less likely to have orthopedic or chronic health problems; (8) most VR clients receive diagnostic, evaluation, counseling, and guidance services, some clients receive skill-enhancing training and education services, and few receive services targeted to their specific disability; (9) VR services vary according to individual disabilities; (10) rehabilitated clients are more successful than unrehabilitated clients and dropouts in the long-term; and (11) unrehabilitated clients and dropouts tend to be employed below preprogram levels within the first 2 years after the program and have similar long-term economic outcomes.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Department has continued its support for the 6-year longitudinal study begun in 1992. The contract for this study has been modified to include data from the Survey of Income and Program Participation to obtain comparison data on the experiences of VR participants and nonparticipants.

    Recommendation: The Secretary of Education should continue the longitudinal evaluation of the VR program authorized in the Rehabilitation Act Amendments of 1992. In addition, effort should then be made to detail the experiences of participants and non-participants so that outcomes can be linked to the services received from VR or from other providers.

    Agency Affected: Department of Education

  2. Status: Closed - Implemented

    Comments: A memorandum of understanding between the Social Security Administration and RSA, signed on February 16, 1994, allows for the continuing exchange of data. RSA is assessing the analytic staffing and resource needs to take advantage of the new data that will be available.

    Recommendation: The Secretary of Education should negotiate an agreement with the Secretary of Health and Human Services to implement the provision of the Rehabilitation Act Amendments of 1992 calling for further data links. Examining more recent cohorts would show whether the program's effects have been maintained as program funds are spread ever thinner, and as larger and larger proportions of clients with severe disabilities participate in the program. All the RSA case service report data on client services should be included in the files used for computer matching; this will permit the Secretary of Education to explore in as much detail as possible (given the limitations of the data states are now required to send RSA) how differences in VR services affect clients. More complex statistical analyses of further data links could help control even better for pre-program differences.

    Agency Affected: Department of Education

  3. Status: Closed - Implemented

    Comments: In February 1994, RSA added funds to a NIDRR Research and Training Center to research the disparity in services for minority individuals. RSA has provided a second year of funding to 11 Regional Rehabilitation Continuing Education Programs to implement a Cultural Diversity initiative that addresses personnel and service issues, including service disparities across racial groups.

    Recommendation: RSA should further examine the specific issue of racial disparities in spending.

    Agency Affected: Department of Education

  4. Status: Closed - Implemented

    Comments: RSA is examining the feasibility of collecting information on cost and the type of services received by individual clients instead of collecting only aggregate data. RSA has reached a preliminary decision (subject to OMB approval) to expand the number of services provided to be reported on its revised data collection instrument. The revised instrumentation was approved by OMB on January 13, 1995.

    Recommendation: RSA should develop plans for improving data on services received by VR clients as part of the recommended data review.

    Agency Affected: Department of Education: Rehabilitation Services Administration

  5. Status: Closed - Not Implemented

    Comments: The National Commission on Rehabilitation Services has not been instituted. The agency did not support GAO's recommendation that the institution of the commission would be advantageous.

    Recommendation: The National Commission on Rehabilitation Services should make the broad issue of the adequacy of an average purchased-service amount of $1,573 per client (and of less than $500 for half the clients) an early agenda item. The issue is especially important in view of the expansion of eligibility, enacted in the same law, that has the potential to stretch the VR budget over an even larger group of clients.

    Agency Affected: National Commission on Rehabilitative Services

  6. Status: Closed - Not Implemented

    Comments: The agency did not concur in this recommendation because of the costs that would be associated with expanded data collection activities.

    Recommendation: RSA should collect additional data on the referral process itself in order to determine why certain groups are less likely than others to apply for VR services.

    Agency Affected: Department of Education: Rehabilitation Services Administration

  7. Status: Closed - Implemented

    Comments: The agency concurred with this recommendation. Data review has begun. A notice inviting public comment was published in the Federal Register on December 23, 1993. Meetings with constituent groups and expert panels to discuss technical and policy aspects of possible changes were held in Spring 1994. The draft final report was issued in January 1994. The report recommends modification in 22 variables, improved documentation, and establishment of the RSA/SSA data links on a routine basis.

    Recommendation: RSA should begin the data review authorized by the 1992 amendments to the Rehabilitation Act and work as well with the National Commission on Rehabilitation Services, if it is established, to develop plans that could improve information in the area of disability and rehabilitation.

    Agency Affected: Department of Education: Rehabilitation Services Administration

  8. Status: Closed - Not Implemented

    Comments: The Department does not concur in this recommendation. The Department does not believe that it would be advantageous to establish a National Commission on Rehabilitative Services because it would draw resources from vitally needed program functions.

    Recommendation: The Secretary of Education should take steps to initiate the National Commission on Rehabilitation Services authorized by the Rehabilitation Act Amendments of 1992.

    Agency Affected: Department of Education

 

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