From: Kelly Pierce 
Subject: ncd rehabilitation report
Below is the controversial report on re-authorization of the
rehabilitation act.  it was distributed to leaders of blindness
organizations before last week's ncd meeting in New Mexico.  i find it
worthy of note that with all this technology that allows blind persons
rapid and easy access to written material such as this, our leaders find
it necessary to tell us about reports and documents rather than sharing
them with us and allowing us to read the information and decide for
ourselves.  I don't accept holding back informaiton just to issue
opinions about it.
kelly
             REAUTHORIZATION OF THE REHABILITATION ACT
              A REPORT OF THE PUBLIC POLICY COMMITTEE
                  NATIONAL COUNCIL ON DISABILITY
                          March 18, 1997
An earlier version of this report was approved in principle by
the National Council on Disability at its November 1996 quarterly
meeting in Phoenix, Arizona.  Subsequent revisions were made with
additional input from the Council and the Community.  This
version has been approved by the Public Policy Committee and
awaits final action by the Council at its March 1997 quarterly
meeting in Albuquerque, New Mexico.
The NCD Ad Hoc Committee on Reauthorization of the Rehabilitation
Act was appointed at the July 1996 board meeting to develop
recommendations related to the process of reauthorizing this law
in 1997, recommendations regarding amendments to it in general,
and recommendations concerning the NCD section of the Act in
particular.  Its members are Ela Yazzie-King, Lilliam Pollo, and
Hughey Walker.  Ela has chaired the committee and Jamal Mazrui
has been the staff assistant.
Besides these committee members, the following NCD members
attended the hearings sponsored by the Rehabilitation Services
Administration (RSA):  Yerker Andersson, Jack Gannon, John Kemp,
Bonnie O'Day, Debbie Robinson, Rae Unzicker, and Kate Wolters.
The committee appreciates the responses received to a survey it
developed to gather information about these hearings from NCD
members.  Some patterns were apparent based on these meeting
reports.
Participation was relatively high among professionals in the
disability field, consumers on Rehabilitation Advisory Councils,
blind persons, and individuals with disabilities who are
employed.  Participation was moderate among deaf persons,
African-Americans, and Native Americans.  Participation was low
among Asian-Americans, Hispanic-Americans, individuals with HIV,
consumers of the psychiatric service system, young adults,
unemployed persons, and people with cognitive disabilities.  NCD
has advocated with RSA to hold additional hearings or focus
groups for obtaining more input from disability populations that
have been traditionally underserved by VR agencies.
With regard to comments about the Act, people who spoke at
hearings overwhelmingly supported the continued need for a
federal-state partnership in designing and delivering
rehabilitation services to assist individuals with disabilities
in gaining skills of independence, attitudes of self worth, and
opportunities for competitive employment.  Blind persons
generally testified in support
of separate agencies for the blind.  Problems with the
independence of Rehabilitation Advisory Councils from the agency
management were cited, suggesting that the agency has undue
influence over the selection of RAC representatives.  Emphasis
was given to the continued need for the ombudsperson role of the
Client Assistance Program and the Protection and Advocacy
Program, including the recommendation that these programs be
required to be organizationally separate from the VR agency.
People from rural communities repeatedly mentioned problems of
accessing information and services that center in headquarter
offices in major cities.
In addition to the input obtained from hearings, NCD received
several written comments in response to an announcement in the
Bulletin newsletter.  These comments stressed the inadequacy of
access to the VR system for people with learning disabilities and
multi-chemical sensitivity.  They also expressed the desire for a
requirement that governor's advisory councils on disability at
the state level consist of a majority of people with
disabilities, similar to the structure of NCD at the federal
level.
Based on public input, staff analysis, and board discussion, the
NCD Rehab Reauthorization Committee makes the following
recommendations about changes needed in the Rehabilitation Act.
To promote integration and fairness within the disability
community and to promote coherent policy at the federal level
consistent with the Reinventing Government initiative, RSA should
no longer administer separate VR grants to state agencies that
only serve people with visual disabilities.  State governments
can make such a distinction at their discretion.  In recognition
of the need for specialized services for adjustment to particular
disabilities, RSA should now require that each state agency
develop a "specialized service plan" as part of its annual grant
application.  Specialized services to be addressed in this plan
should include--but not be limited to--those targeted to blind
persons, deaf persons, people with HIV, MCS, and mental illness.
In addition, for the next three years states that had a separate
agency for the blind should be required to show that funding for
direct services to blind persons is proportionally no less than
before.  For the same reasons as above, the current grant for
independent living services to older blind persons should now
become cross disability in nature.
Although the Rehabilitation Act amendments of 1992 included
language to strengthen services to ethnic minorities with
disabilities, progress in this area has been insufficient.
Therefore, RSA should mandate that state VR agencies establish an
identifiable program focused on multicultural and rural outreach.
It should report directly to the agency head and work to
integrate multicultural concerns throughout agency services.  It
should also assure that linguistic minorities can obtain
translation services and training in English as a Second
Language.
Rehabilitation Advisory Councils, established in each state under
the Act, should be transformed into "Rehabilitation Councils,"
which--like State Independent Living Councils--have co-sign off
authority on the annual plan the agency submits to RSA.  This
would give consumers more policy making and budgetary control
over state VR programs.
RSA should encourage VR agencies to redirect funds used for
college tuition to subsidizing wages of students in jobs during
the school year and summer.  Students with disabilities who have
their way paid completely by well-meaning VR agencies often lose
incentive to work during their college years.  They thus graduate
without the work experience and contacts of their peers and find
themselves much less attractive to potential employers.  Working
to earn tuition should remain a voluntary choice, since some
disabilities may make studying considerably more time consuming.
Instilling a responsibility to work as well as study during
college, however,  will tend to do students with disabilities a
favor in the long run.
RSA should change  policy so that consumers eligible for VR
services are no longer required to develop an Individualized
Written Rehabilitation Plan (IWRP) in order to receive services,
since this is often unnecessary paperwork for persons who already
know what particular services they need.
RSA and the Social Security Administration should jointly develop
measures to increase incentives for public and private VR
providers to promote career stability and advancement, not just
initial employment of people with disabilities.  Personnel
policies should reward VR counselors for client retention of a
job for at least 9 months, not just 60 days.  SSA should
reimburse VR providers for milestones along the way to economic
self sufficiency, not just for a placement of 9 months duration.
With regard to the section of the Rehabilitation Act that
authorizes NCD, its language should be changed to require that a
majority of the Council be people with disabilities themselves,
with remaining positions encouraged to be filled by parent
advocates and others with expertise in disability.
The present limit on the number of NCD staff should be
eliminated.  Among other things, this would allow NCD to add
staff in order to respond to the unanticipated high demand for
information and referral from the public.
Statutory language should be modified to clarify procedures for
hiring, supervising, and dismissing the NCD Executive Director.
Since NCD's required annual report will be eliminated after 1999,
the timing of NCD's other required report on "the status of
people with disabilities" should be changed to the most
symbolically appropriate day of the year:  July 26, the
anniversary of the ADA, which NCD originally drafted.
Since NCD is an independent federal agency, it should be allowed
to submit amicus briefs in disability cases at the federal level.
The official starting date of an appointment to NCD should be
changed to be the date of confirmation by the Senate rather than
nomination by the President.
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                               MEMO
TO:       NCD MEMBERS
FROM:     BONNIE O'DAY
RE:       DOCUMENTATION ON SEPARATE AGENCIES FOR THE BLIND
DATE:     MARCH 17, 1997
To facilitate Council discussion on the above matter, I have
attempted to summarize the arguments for and against separate
state agencies that provide rehabilitation services to blind
people, and to summarize research on this topic.  Given the
recent emphasis on performance based outcomes throughout the
government, I have stressed the effectiveness of separate versus
combined agencies for the blind.
Research:  There is little conclusive evidence that having a
separate administrative agency that serves blind and visually
impaired people produces better results.  The primary experts on
this subject are within two agencies; the Mississippi Research
and Training Center on Blindness and Low-Vision, and the American
Foundation for the Blind.  Studies used in this document were
either conducted or summarized by these agencies.  The studies
are summarized below:
     MSA (1975).  This study is commonly known as the "Mallas
     Report".  At one point the report states that specialized
     agencies have distinct advantages, at another point, it
     concludes that the leadership ability of agency directors
     overrides the administrative agency structure.  Because the
     validity of the study cannot be evaluated, it received
     little serious attention (Kirchner, 1982).
     JWK (1981).  This study was commissioned by the RSA, with
     closely specified methodology and design.  Agencies were
     classified as "general" (18), "mixed" (21) and "separate"
     (14) based upon a number of defining characteristics.  Many
     of the comparisons revealed slight to no differences among
     agency types.  The study found that client costs under
     separate agencies were slightly higher than under generic
     agencies.  This could mean higher degree of services (a
     positive) or administrative inefficiency (a negative).  The
     difference in rehabilitation rate was negligible (77 percent
     for special agencies versus 74 percent for general
     agencies).  However, general agencies closed a
     higher percentage in competitive employment than specialized
     agencies.  A significant finding of the study was that
     specialized caseloads were a significant factor in improved
     services to visually impaired clients, and that general and
     specialized agencies did not differ in the number of
     counselors with specialized caseloads.
     AFB (1980).  AFB used R-300 data from RSA from 1971.  The
     separate agencies served a much higher percentage of legally
     blind clients than general agencies did.  But it must be
     kept in mind that the data is very old, before regulations
     were adopted requiring order of selection--that the most
     severely disabled people be served.  The study also found
     that blind agencies served a higher percentage of people
     over age 55.  This might account for the higher number of
     closures as "homemaker" or "unpaid family worker" (Kirchner,
     1982).
     JVIB, 1996):  In a more recent study that was published in
     the Journal of Visual Impairment and Blindness (JVIB) by the
     American Foundation for the Blind (1996) the impact of
     separate vocational rehabilitation agencies on access to
     services for developmentally disabled blind clients was
     reported.  (Roughly, this refers to people who are blind
     that have other disabilities acquired before age 22.)  The
     results indicated that visually impaired DD people in states
     with specialized agencies are less likely than those in
     other states to receive services, except when an agency
     budget is large. (Summary provided by Moore, 1996)
     Moore also conducted a brief analysis of RSA data for FY
     1994.  The average cost per case closure for totally blind
     clients was $6,100 for general agencies, versus $7,300 for
     separate agencies for the blind.  For legally blind clients,
     the costs were $3,600 and $3,800 respectively.  The rate of
     rehabilitation (successful closure) varies from year to
     year; during 1990-92, the general rehabilitation agencies
     did better, for 1993-94, the blind agencies did better.  The
     rate of rehabilitation was 60 percent for general agencies
     and 67 percent for blind agencies.  (Remember that blindness
     agencies have a higher rate of closures in homemaker/unpaid
     family worker status).  The separate agencies rehabilitated
     more blind people than general agencies (6,200 versus
     4,800).  There is little that can be concluded from these
     data, according to Moore, without an analysis of case
     closures, population of states with separate versus combined
     agencies, etc.
     NAC study (1997).  The National Accreditation Council uses
     the above data (RSA-1994) and draws some different
     conclusions.  They agree that the agencies for the blind
     closed about 1,500 more cases, but they conclude that the
     rate of rehabilitation was higher among generic agencies
     (67.6 percent) than blind agencies (65.6 percent). They
     state that 53 percent of clients served by specialized
     agencies had additional disabilities, as compared to 47
     percent of the general agency clientele.  NAC conducts an
     analysis of people whose only disability is blindness, thus
     excluding people with secondary disabilities from the
     analysis--half the clients.  Excluding these clients, NAC
     found that the generic agencies placed a higher percentage
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