From: Kelly Pierce 
Subject: ncd rehabilitation report (Forward)
     as homemakers/unpaid family workers than did separate
     agencies.  This finding is contrary to all other research I
     could identify.  The study agrees with above research that
     costs of rehabilitation in a specialized agency are higher.
Predominant arguments made by consumer groups in favor of
separate agencies:
     A separate state plan is required, and states must allocate
     a specific dollar amount to serve blind people.  This varies
     between seven and 21 percent, depending upon the state.
     Funds under other titles, such as Independent Living, Social
     Security reimbursements, and professional staff training are
     also specifically allocated to blind agencies by similar
     formulas.
     Consumer groups of blind people have more access to decision
     makers, such as agency directors, to have input and express
     concerns.  Agency directors have more access to the Governor
     or other policy officials to request additional funding,
     etc.
     Specialized knowledge of counselors and administrators is
     assured.  This includes orientation and mobility
     specialists, technology specialists, etc.  Staff can
     concentrate on the specific needs of blind people.
     Organizations for the blind say that the issues are more
     related to politics than quality.  There is a sufficient
     constituency in the country that wants blind services to be
     administered separately.
     Blind people are a relatively small share of the population
     of general rehabilitation clientele.  Specialized needs,
     such as needs for alternative formats, get overlooked in
     generic services.
     Public attitudes about blindness have been historically more
     negative toward blind people than toward other disabilities.
     Therefore, a specialized agency is needed.
Arguments in favor of combined administration:
     The blindness specific agencies were established during the
     1930s and 1940s, when blind people felt that they were not
     getting adequate rehabilitation services from the generic
     rehabilitation agencies.  These agencies were primarily
     serving people with what today would be considered less
     severe disabilities obtained through industrial accidents.
     This situation has changed, due to amendments to the
     Rehabilitation Act that require that the most severely
     disabled people be served first through an order of
     selection.
     Administrative costs of two distinct agencies are
     duplicative. Client costs in separate agencies are higher,
     with no evidence that the quality of service is greater.
     One administrative structure for all services would simplify
     disability programs and eliminate duplication, in accordance
     with recommendations in Achieving Independence.
     About 50 percent of blind rehabilitation clients have
     secondary disabilities.  The blindness agencies often lack
     the expertise in serving people with these additional
     disabilities.  This expertise can be found in the general
     rehabilitation agency.
     Blind people who receive intensive training in blindness
     skills, such as cane travel, braille, etc. generally go to a
     private non-profit organization to get these services.  The
     rehabilitation agency (whether separate or generic)
     generally purchases these services from another entity.
     Blind people would get this training, whether the agency
     administration was generic or specialized.
     The current system is unfair to other disability groups.
     Blindness is the only disability group with a specialized
     rehabilitation agency.  The evidence should be placed upon
     these agencies to show that they are more effective in
     providing services.  If there is little evidence to show
     that these services are more effective, why should one
     disability group be treated differently from others?
     Separate service structures weaken the coalition of people
     with disabilities as a whole.  Blind people are often pitted
     against other disability groups in advocating for resources.
     A separate service system for blind people contributes to
     social isolation from people with other disabilities.
     Contact with people who have other disabilities, through
     advocacy organization, advisory bodies, etc. allows blind
     people with secondary disabilities to have contact with
     people who share their disability. Cross fertilization also
     allows learning from each other and learning more about
     disability issues.
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