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Chairman McKeon, Representative Kildee, and members of the Committee, thank you very much for inviting me to discuss the Rehabilitation Act, which has played an essential role in empowering people with disabilities to contribute to American society. The current reauthorization process provides an opportunity for all of us to work together to promote the goals the President has identified for all disability programs and policies --- inclusion, not exclusion; independence, not dependence; and empowerment, not paternalism. Today we are closer to achieving these goals than ever before, in part because of the bipartisan cooperation the reauthorization of this Act has enjoyed over the years.
Helping disabled people to live independently and become meaningfully employed is not just the right thing to do. It is a necessary thing to do. As President Clinton has said, our nation cannot afford to waste the talents, skills and wisdom of a single individual.
Those of us involved in the efforts to bring top-quality services to people with disabilities have to look beyond politics to our common goal. That goal is to create policies, programs, and institutions that facilitate the ability of all Americans to lead independent, productive lives and to contribute to American society. Serving disabled people according to their individual needs and interests
The Rehabilitation Services Administration (RSA) in the Office of Special Education and Rehabilitative Services assists States and other providers to supply disabled people with the services they need to achieve their employment and independent living goals. The Vocational Rehabilitation State Grants program, the largest vocational rehabilitation program, provides $2.2 billion in formula grant assistance to States to help individuals with disabilities prepare for and engage in gainful employment. Vocational rehabilitation services may include job training and placement, job development, counseling and guidance, assistive technology, personal assistance services, interpreter services, reader services, orientation and mobility services, supported employment services, and school-to-work transition services.
The heart and soul of the program is to provide services that meet the aspirations, needs, abilities, and priorities of each individual, consistent with the individual's informed choice. A VR counselor and an individual with a disability work together as partners to develop a rehabilitation program that matches the person's strengths and interests to employment opportunities.
Since established by the Smith-Fess Act 75 years ago, State Vocational Rehabilitation programs (now authorized by the Rehabilitation Act of 1973, as amended) have served some nine million individuals. At present, there are more than one million eligible individuals, 76 percent of whom have significant disabilities, in the system of State VR agencies. In fiscal year 1996, 213,000 of the approximately 450,000 individuals who exited the VR program achieved an employment outcome.
One of our major objectives for this reauthorization will be to better meet the needs of the clients served by the VR programs and to improve the outcomes that are achieved. To aid in this effort, in 1992 we launched a national longitudinal study of the State VR programs. We are currently analyzing preliminary data from that study and are using that information as we develop a legislative proposal. Promoting economic independence
As a group, persons who achieve an employment outcome as a result of vocational rehabilitation services each year show notable gains in their economic status. In fiscal year 1995, 88 percent of the almost 210,000 individuals who achieved an employment outcome entered the competitive labor market or became self-employed.
As a result, there has been a dramatic decrease in the number of persons who are determined ineligible for services. In 1992, one applicant in 16 was determined ineligible because the individual's disability was too severe, but by 1995, only one in 34 individuals was determined ineligible for this reason.
There has also been a large increase in the total number of eligible individuals in the VR system. In 1992, there were 949,000 eligible individuals in the VR system, while preliminary 1996 data show about 1,225,156 individuals in the system -- a 29 percent increase over a four-year period.
Consequently, many State VR agencies are unable to meet the current demand for services, and the number of agencies that cannot serve all eligible individuals has increased since FY 1992. If a State agency cannot serve all eligible individuals, the Rehabilitation Act -- under the "order of selection" provision -- requires the agency to first serve individuals with the most severe disabilities. In FY 1992, 26 of 81 State VR agencies, or 32 percent were operating under an order of selection. By the beginning of FY 1997, 37 of the 82 State VR agencies, or 45 percent, were operating under an order of selection.
Despite these challenges, State VR agencies have been successful in increasing the numbers of individuals achieving an employment outcome. In 1996, 213,334 individuals achieved an employment outcome, an increase of 11 percent from 1992. Goals for Reauthorization
Today, despite great gains made under the Rehabilitation Act, and despite our economy's clear need to make use of the skills and talents of all individuals, nearly half of working-age persons with disabilities are unemployed.
We know that there are still many barriers that must be removed before all disabled individuals can enter or stay in the workforce. These barriers include disincentives in health care and economic assistance programs, lack of transportation, and employer and individual attitudes regarding the employability of individuals with disabilities.
We recognize that vocational rehabilitation is only part of the solution to the unemployment of individuals with disabilities, and are taking steps to remove barriers in other areas.
The FY 1998 budget contains a number of initiatives designed to assist people with disabilities who are eligible for SSDI and SSI. For example, the Administration's 1998 budget proposal for the Department of Health and Human Services provides funding for a Medicare demonstration project to encourage Social Security Disability Insurance (SSDI) beneficiaries to return to work. Under the four-year demonstration project, certain SSDI beneficiaries who return to work could receive up to four additional years of Medicare coverage without paying the Part A premium. Also, the 1998 budget gives States the option of creating a new Medicaid eligibility category for SSI recipients to encourage them to earn above certain income levels. SSI beneficiaries who become eligible for this new category would contribute to the cost of the program by paying a premium determined on a sliding scale based on income.
We must continue to explore ways to address the broad range of factors contributing to the high unemployment of individuals with disabilities. I am convinced that by working together, the Administration, Congress, individuals with disabilities and their advocates, service providers, and employers can turn the wasted talents of disabled people into an important resource for securing our nation's future.
In preparing the Administration's proposal for reauthorizing the Rehabilitation Act, the Office of Special Education and Rehabilitative Services has held forums at which groups and individuals with an interest in the Rehabilitation Act had opportunities to share their ideas about ways to improve the Act. These groups included State VR agencies, community-based service providers, consumer and advocacy organizations, parents, employers, and individuals with disabilities. The public input we received was valuable in focusing our reauthorization efforts.
I believe that any discussion on the future of the Rehabilitation Act and America's disability employment policies must focus on the achievement of seven goals. We intend to submit legislation that reflects these goals.
First, we should strengthen the Act's emphasis on serving individuals with the most significant disabilities. Rehabilitation services may be useful to all individuals with disabilities, but they are absolutely vital to individuals with the most significant disabilities. We should do nothing to weaken the Act's current direction, which places priority on serving populations that have historically been unserved or under served. Without VR services, people with the most significant disabilities are the least likely to gain employment.
We must recognize that, given limited resources, the VR system will not be able to accommodate all individuals who require services in order to attain their employment goals. We should work to improve cooperation and coordination between State VR programs and other employment and training programs to increase the capacity of the State's overall employment system to serve all individuals with disabilities.
Second, we must continue to enhance consumer choice. The 1992 Amendments required State agencies to provide consumers of VR services with choices regarding employment goals, services, service providers, and methods of providing those services. The Amendments included a clear policy explicitly providing that clients be equal partners throughout the rehabilitation process. Congress believed that individuals with disabilities must have the right to make informed choices about their vocational goals, the services that will enable them to reach those goals, and the providers of those services.
In order to develop new methods of promoting consumer choice in the rehabilitation process, RSA funded seven demonstration projects. These projects have developed a variety of innovative methods for expanding consumer choice in the rehabilitation process. For example, one project encourages consumers to form a team, comprised of members of his or her personal support network -- their counselor, family members, friends, and helping professionals. Directed by the consumer, the team provides help in self-assessment, problem-solving, advocacy, and resource expansion leading to an employment goal.
Some of the demonstration projects seek to promote choice by changing the role of the rehabilitation counselor. In one project, counselors are retrained to focus on the continual provision of the supports consumers need to assume responsibility. This project now measures its counselors' performance, in part, on the extent to which consumers report increased ability to access resources and make informed decisions. We are currently evaluating these demonstrations to assess their impacts on client outcomes. Successful projects can serve as models for widespread application.
Aside from funding the demonstration projects, RSA is working across the country to help State VR agencies increase opportunities for their clients to make effective choices. For example:
I believe that these efforts must be continued and expanded. In our deliberations about reauthorization, we must continue to reach toward the ideal of guaranteeing that people with disabilities are active participants in the rehabilitation process.
Third, we must promote high-quality employment outcomes. In an effort to assist States in improving employment outcomes, RSA has shifted the focus of its monitoring system from a compliance-based approach to an outcome-based approach that emphasizes how well State VR agencies are fulfilling the purposes of the Act -- assisting individuals with disabilities to move into meaningful employment. RSA is also developing performance measures for States to ensure accountability for client outcomes and to encourage continuous program improvement.
RSA is also expanding its efforts in providing technical assistance to State VR agencies focused on quality employment outcomes. In 1996, RSA sponsored a national conference on effective employment strategies for individuals with disabilities and follow-up activities are underway in all regions of the country.
State VR agency staff must have the necessary skills and training to meet the complex employment needs of individuals with significant disabilities. The system must encourage high- quality placement for its customers and discourage rehabilitation counselors from seeking low-quality quick placements. We do not want to place such a premium on numbers that counselors are driven to avoid seeking challenging employment outcomes for their customers that may require a greater investment of time and resources. We want people to find jobs, but beyond this, we want people to find jobs that they find satisfying and allow them to become self-supporting. The 1992 Amendments describe this concept in terms of employment outcomes consistent with an individual's "strengths, resources, priorities, concerns, abilities, and capabilities." In other words, jobs that people want and value.
Fourth, we must increase employer involvement. In the four years I've served as Assistant Secretary, RSA Commissioner Frederic Schroeder and I have spoken with employers across the nation. OSERS has conducted a series of focus groups with employers to solicit their perspectives on the employment of people with disabilities, including attitudes toward hiring and promotion, employer needs, and business incentives. Employers participating in these focus groups were very appreciative of our efforts to bring them into the national discussion and listen to their views and concerns. They identified a number of key issues such as access to qualified applicants, support systems and placement follow up, training and placement issues, and the cost of accommodations. However, the common theme running through all of the discussions was the need for service providers to take the time to know the employers -- to understand their businesses, and to learn what jobs are out there and what skills they require.
Our discussions with employers have taught us that employers must be active partners in efforts to increase the employment of people with disabilities. VR officials in every State must strengthen their partnerships with local business communities and potential employers to remove barriers to the employment of people with disabilities and to ensure that job training programs meet the needs of today's job market. Furthermore, we must work together to develop employer incentives to keep disabled employees in the workforce.
Fifth, we must continue our efforts to streamline the rehabilitation process. I firmly believe that a major component of efforts to ensure high quality services must be the elimination of unnecessary policies and paperwork for federal programs, and the simplification of procedures so that VR agencies can focus on their main mission -- serving individuals with disabilities.
In a collaborative effort to reduce unnecessary non-statutory requirements that can impede the rehabilitation process, the Rehabilitation Services Administration entered into an agreement with the Council of State Administrators of Vocational Rehabilitation (CSAVR) to streamline our nation's vocational rehabilitation service delivery system.
RSA and State VR agencies are working together to identify unnecessary paperwork, rules and reports and to identify for possible elimination State-imposed requirements that are not mandated by Federal law and regulations. Most of the 82 State VR agencies have undergone the first wave of streamlining activities, and many are now observing improvements in service delivery and an increase in employment outcomes.
Furthermore, RSA-supported Regional Continuing Education Programs have trained personnel in many State VR agencies in how to "streamline" their operations. At the Federal level, we have reduced the number of required state plan attachments.
We believe that by streamlining the rehabilitation process we can address much of the frustration that clients have experienced and ensure that the system continues to respond to the demands for increased efficiency and partnership with consumers entering the VR system.
Sixth, we must attempt to create a system that fully meets the independent living needs of individuals with disabilities. In addition to its efforts to promote the employment of individuals with disabilities, RSA supports several programs that address the independent living needs of individuals with significant disabilities. The largest of these, the Centers for Independent Living program, supports approximately 240 centers that are designed and operated within local communities by individuals with disabilities and that provide a broad range of independent living services to individuals with significant disabilities. In 1995, Federally supported centers for independent living provided services to approximately 136,000 individuals across the country.
The success of these centers in facilitating the independence and empowerment of individuals can be illustrated with anecdotal data. For example, the Center for Independent Living of Central Pennsylvania reports that it provided peer counseling to a young man in a nursing home. Everett, an African-American quadriplegic in his mid-20's, had been injured in a motorcycle accident and was feeling depressed after a year in a nursing home. Everett was not receiving adequate physical therapy, was struggling to push a manual wheelchair, and was faced with the prospect of living in a nursing home for the rest of his life. Four months after meeting Everett, Center personnel had helped him find local community housing, secure a personal attendant, and acquire an electric wheelchair. Everett is one of seven people whom the center moved from nursing homes to the community last year. In addition, the center helped 31 individuals move to a less restrictive living arrangement and provided services that prevented 108 consumers from moving into nursing homes.
We must strengthen our commitment to these local and State efforts to promote the independence and empowerment of individuals with significant disabilities, and ensure that our efforts to promote employment proceed in tandem with these activities.
Finally, in building a truly inclusive society, we must utilize rehabilitation research to identify effective strategies and practices that can enhance the economic and social self-sufficiency of individuals with disabilities. The National Institute on Disability and Rehabilitation Research (NIDRR), funded under the Rehabilitation Act, brings a comprehensive view and an intensity of focus on applied research that enables persons with disabilities to function better at work, in the family, and in society. NIDRR funds are used to support rehabilitation research, demonstration projects, and related activities, including the training of persons who provide rehabilitation services or who conduct rehabilitation research. In addition, NIDRR supports projects to disseminate and promote the use of information concerning developments in innovative rehabilitation interventions, strategies, and assistive technology devices; and data analyses on demographics of disability.
The Adaptive Parenting Equipment: Idea Book 1 was developed with support from NIDRR at Through the Looking Glass, a Rehabilitation and Training Center in Berkeley, California. The publication describes equipment such as lifting harnesses and baby bathingcarts that can help disabled mothers and fathers of small children practice successful parenting.
Most of the built-in features that allow disabled individuals to use the Microsoft corporation's Windows 95 computer program were the result of research and development conducted by one of the Rehabilitation Engineering Research Centers supported by NIDRR.
Research supported by NIDRR and carried out at Smith-Kettlewell Eye Research Institute led to Talking Signs, transmitters in public places that can broadcast to receivers carried by blind persons information written on office doors, building entrances, bus stops, etc.
Furthermore, NIDRR coordinates technical assistance, training and materials development projects which help businesses, local governments and others comply with the Americans with Disabilities Act.
For the past two years, NIDRR has been involved in a comprehensive effort to ensuring the relevance of its research to improved employment outcomes for individuals with disabilities. For example, NIDRR convened a special conference of its employment research centers and conducted a workshop to discuss future directions for vocational rehabilitation/employment research. In addition, NIDRR in conjunction with the Social Security Administration, sponsored several conferences on factors in return to work. As a result of these and other efforts, NIDRR plans to restructure its employment-related research to include, for example, studies of the employment of individuals with disabilities in the context of the broader economy and incentives in the income support and health insurance programs. Common Goals
Mr. Chairman and members of the Committee, thank you again for allowing me to share some of the Administration's ideas on the Rehabilitation Act.
As I said earlier, the goals of the Rehabilitation Act transcend politics. I think we can agree that our goal in the reauthorization of the Act must be nothing less than the creation of a guarantee of excellence -- excellence in the quality and scope of services, and excellence in outcomes. We envision a system that focuses resources on the greatest needs and promotes accountability for consumer outcomes while supporting continuous program improvements. We also envision a system driven by the informed choices of its consumers, includes partnerships with employers and other employment and training programs, strengthens the rehabilitation process, utilizes research and technology to improve services, and, most importantly, results in the movement of individuals into high-quality jobs and independent living in the community. Although we have made considerable progress towards this ideal, we have not yet fully achieved it.
We are eager to work with you to make this ideal a reality. Our challenge is clear: we must work to protect, strengthen, and update the Rehabilitation Act to guarantee that people with disabilities lead productive lives and contribute to our society to the best of their ability.
I look forward to working with you to meet this challenge.
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