Wyoming assessment of rehabilitation needs

WYOMING ASSESSMENT OF

REHABILITATION NEEDS

2006




Prepared for
The Wyoming Division of Vocational Rehabilitation,

Jim McIntosh, Administrator

and

The State Rehabilitation Council
by
Western Management Services, LLC

Cheyenne, Wyoming 82003

February 2007

Table of Contents

(An executive summary is available as a separate document.)

Page 3 5 6 8 8 8 10 18 21 22 23 23 25 31 32 32 36 49 50 51 55 62 64 66

Introduction and Goals History of the Rehabilitation Act Continuum of Services Demographics Wyoming’s Population in General Minority Populations Populations with Disabilities in Wyoming Demographics of DVR Caseload Population Projections for Wyoming Projected Employment Outlook and Labor Market Public Input and Concerns Focus Groups Mail Surveys Interviews Resource Inventory Vocational Rehabilitation Other Services that Promote Independence Internet Resources Efficacy of Vocational Rehabilitation Services Wyoming Students in Transition Innovative Transition Ideas from Research and Other States The School to Work Opportunities Act Analysis and Findings Recommendations

Basic Principles of Rehabilitation Philosophy “Comprehensive treatment involves the “whole person”, because life-areas are interdependent. Rehabilitation programs must be conducted with interdisciplinary and interagency integration.” Excerpt taken from a list of 20 principles developed by Jenkins, W.M., Peterson, J.B. & Szymanski, E.M. (1992). Philosophical, historical and legislative aspects of the rehabilitation counseling profession. In R.M. Parker & E.M Szymanski (Eds.), Rehabilitation Counseling, (2^nd ed.), (pp. 1-41), Austin, Texas: PRO-ED, Inc.

INTRODUCTION AND GOALS

The Rehabilitation Act, as amended, Public Law 99-506, Section 101(a) requires that in order to be eligible to participate in programs under Title I, each state shall submit to the Commissioner of the Rehabilitation Services Administration (RSA) a State Plan for vocational rehabilitation services that meets the requirements of this section.
The State Plan must include the results of a comprehensive, statewide needs assessment, jointly conducted by the Wyoming Division of Vocational Rehabilitation and the State Rehabilitation Council every three years. The statewide needs assessment must examine the need to establish, develop, or improve community rehabilitation programs within the State. It must also describe the rehabilitation needs of individuals with disabilities residing within the State including:

1. 
   Individuals with the most significant disabilities, including their needs for supported employment services;
   

2. 
   Individuals with disabilities who are minorities and individuals with disabilities who have not been served or are underserved by the vocational rehabilitation program carried out under this Title;
   

3. 
   Individuals with disabilities served through other components of the statewide workforce investment system (other than the vocational rehabilitation program), as identified by such individuals and personnel assisting such individuals through the components;
   

The State goals and priorities are based on an analysis of:

1. 
   The performance of the State on the standards and indicators established under Section 106;
   

2. 
   Other available information on the operation and the effectiveness of the vocational rehabilitation program carried out in the State;
   

3. 
   Any reports received from the State Rehabilitation Council (SRC), under Section 105(c) and the findings and recommendations from monitoring activities conducted under Section 107.
   

The goal of the statewide assessment is to provide the foundation for an action plan that identifies opportunities for improving program performance in the following three critical areas with special emphasis on students in transition:

1. 
   Traumatic and Acquired Brain Injury programs development;
   

2. 
   Severe and persistent mental illness (SPMI) programs development;
   

3. 
   Students in Transition. Especially important are the following;
   

a.) Determine the potential pool of referrals to the Agency from all schools statewide;

b.) Develop strategies for improving working relationships with school district personnel and programs statewide;
c.) Propose new alternative methods to identify school children with disabilities rather than wait for referrals;
d.) Explore the willingness of school districts statewide to provide office space in the school for VR counselors;
e.) Identify and inventory all existing organizations and resources currently offering transition services and recommend ways the Agency can link with these services to improve the Agency’s transition services statewide;
The purpose of the needs assessment according to the Rehabilitation Act is to identify and understand the needs of individuals with disabilities in the State and to use that information to make appropriate operational and programmatic adjustments to ensure the effective and efficient delivery of services to those individuals.
Commensurate with the goals and purposes described above, this assessment collected the following information: demographic data; public input from six focus groups; the results of two mail surveys and numerous interviews; details regarding the policies of relevant state and federal programs; and innovative ideas from elsewhere in the nation. The needs assessment also emphasized the collection of information relating to students in transition. All information was analyzed to identify gaps in services. Recommendations were developed accordingly.

HISTORY OF THE REHABILITATION ACT

The end of World War I is often identified as the beginning of federally funded rehabilitation services in the United States (http://www.rcep7.org/~orient/history/hist09.htm). Disabled veterans, returning from the war, needed job skills training because they could no longer do the jobs they had done prior to the war. As a result, Congress passed the Soldiers Rehabilitation Act of 1918.
In 1920, congress expanded eligibility to include anyone with a physical disability. Because the law now authorized services beyond the veteran population, the Soldiers Rehabilitation Act was no longer an appropriate title. The name was changed, and the Rehabilitation Act was born.
In 1943, again motivated by the demands of war, congress amended the Act. Services were expanded to include surgeries and equipment necessary to enhance employability. Eligibility was expanded beyond physical disability to include the blind and the mentally ill.
In 1954, an amendment was passed to allow funding for research.
In 1964, Lyndon Johnson successfully promoted several amendments to the Act as a part of his Great Society initiative. As a result, the eligible population was greatly expanded to include people with drug and alcohol addiction, those with repeat jail sentences, those with behavioral disorders, and some welfare recipients. The program was soon overwhelmed with clients, causing many severely disabled clients to complain that they were not getting adequate attention.
In 1973, congress responded to the complaints of the severely disabled and passed a new Rehabilitation Act. It gave priority to those with the most severe disabilities. Also during the late 1960s there had been a national push to de-institutionalize persons with disabilities. The 1973 Act responded to this movement by promoting services that enhanced opportunities for de-institutionalization.
In 1986, congress passed amendments that shifted the focus of vocational rehabilitation from “protected jobs” to “typical” community jobs. Previously many jobs obtained by disabled people were in environments created specifically for disabled people. The 1986 amendment required training for jobs in a typical working environment that included people without disabilities. The emphasis was on community inclusion.
Additional amendments were passed in 1992 giving people with disabilities expanded civil rights. The 1992 amendments created State Rehabilitation Councils to enhance input from people with disabilities. The amendments also set minimum standards for the training of vocational rehabilitation counselors, established performance standards and required states to conduct a needs assessment every three years. In addition, the 1992 amendments required state vocational rehabilitation agencies to presume that everyone could benefit from vocational rehabilitation thus ending the practice of denying services to the most severely disabled under the assumption that they cannot be helped.
In 1998, the Act was amended again. The 1998 amendments required the Rehabilitation Act to become part of the Workforce Services Investment Act and required state Vocational Rehabilitation agencies to establish partnerships with other agencies providing employment related services.
In summary, the progression of the Rehabilitation Act over the past 80 to 90 years can be described as follows: Eligible client populations have been considerably expanded. Services have been expanded to include those that go beyond direct job skill training to include support services important to employment. There has been increased recognition of the need for all service delivery organizations to work closely together to promote the independence of the client. In addition, State Rehabilitation Councils have been created to provide a more direct voice for those with disabilities. Even though there have been many changes, the Act retains its focus on the goal of promoting independence.

CONTINUUM OF SERVICES
While vocational rehabilitation services are essential to promote the independence of people with a disability, other services are also important. In the past few decades, there has been a national trend toward expanding programs that offer in-home and community-based services such as independent living skills, transportation, medication management, mental health counseling, etc. (see history of the Rehabilitation Act, previous page). This trend has been motivated by the high costs of institutionalization and the preference of most people to remain independent.

Even though it is recognized that most individuals with a disability prefer to avoid an institutional setting, this may not be possible without a comprehensive infrastructure of services at the local level. This comprehensive infrastructure is sometimes called a “Continuum of Care” or “Continuum of Services” (Figure 1). Because vocational and support services are both important, a good Continuum of Services infrastructure must include a wide range of physical, cognitive, and vocational rehabilitation services as well as in-home and community-based services necessary to promote independent living.

As indicated earlier, the purpose of this assessment is “to identify and understand the needs of individuals with disabilities in the State and to use that information to make appropriate operational and programmatic changes to ensure the effective and efficient delivery of services to those individuals.” Because individuals with disabilities often require the services of diverse programs, many of which are not vocationally oriented, it is imperative that the various program administrators coordinate their programs. To assist with this coordination, information about many programs, relevant to promoting the independence of people with disabilities, is outlined in this report.

“Community-based services and supports such as housing, transportation, personal care assistance, tutoring, job coaching, caregiver respite and other assistance and accommodations may be needed to avoid unnecessary placement in long-term care settings and to ease stress on peer and family relationships, and to enhance performance in school and work. These services and supports may come from multiple, private, local, state and federal programs and assistance.” Guide to State Government Brain Injury Policies, Funding and Services. National Association of State Head Injury Administrators

Figure 1: Continuum of Services for People with Disabilities

(Services Needed to Maximize Independence)

DEMOGRAPHICS

Wyoming’s Population in General:
In 2000, the United States Census Bureau estimated that were 493,782 people in Wyoming (Table 1). Approximately 62 percent (307,216) were between ages 18 and 65 which is the core “working age” group. Laramie County and Natrona County had the largest populations in the working age group. Niobrara County and Hot Springs County had the smallest. Population density ranged from a low of 0.9 persons per square mile in Niobrara County to 30.4 in Laramie County. The low density of Wyoming’s rural counties presents a challenge for providers of services to persons with disabilities. Low density also contributes to the difficulties rural communities face in providing adequate public transportation and in providing employment opportunities.

Table 1: Wyoming’s Population in 2000 Source: U.S. Census Bureau
	Total Population	Number Under 18	Number 18 to 64	Number Over 64	Percent Over 64
Albany County	32,014	5,894	23,474	2,646	10.1%
Big Horn County	11,461	3,287	6,249	1,925	23.6%
Campbell County	33,698	10,456	21,471	1,771	7.6%
Carbon County	15,639	3,772	9,947	1,920	16.2%
Converse County	12,052	3,430	7,293	1,329	15.4%
Crook County	5,887	1,581	3,438	868	20.2%
Fremont County	35,804	9,827	21,227	4,750	18.3%
Goshen County	12,538	3,034	7,332	2,172	22.9%
Hot Springs County	4,882	1,076	2,828	978	25.7%
Johnson County	7,075	1,712	4,088	1,275	23.8%
Laramie County	81,607	21,023	51,233	9,351	15.4%
Lincoln County	14,573	4,502	8,271	1,800	17.9%
Natrona County	66,533	17,300	40,809	8,424	17.1%
Niobrara County	2,407	544	1,412	451	24.2%
Park County	25,786	6,302	15,744	3,740	19.2%
Platte County	8,807	2,233	5,116	1,458	22.2%
Sheridan County	26,560	6,412	16,027	4,121	20.5%
Sublette County	5,920	1,526	3,683	711	16.2%
Sweetwater County	37,613	10,869	23,735	3,009	11.3%
Teton County	18,251	3,632	13,355	1,264	8.6%
Uinta County	19,742	6,605	11,759	1,378	10.5%
Washakie County	8,289	2,258	4,715	1,316	21.8%
Weston County	6,644	1,598	4,010	1,036	20.5%
Wyoming	493,782	128,873	307,216	57,693	15.8%