Evidence about the benefits and costs of supported and transitional employment for persons with severe disabilities is presented along with relevant caveats in the absence of controlled studies. Some of the major forms of supported and transitional employment services are compared with adult day care and traditional sheltered workshops, including work activity centers. Despite weaknesses in the data, sufficient information exists to argue that all forms of employment—supported, transitional, and sheltered—are more productive in terms of earnings and less costly to provide than adult day care. The lack of definitive data is seen as a major impediment to the expansion of supported and transitional employment options for people with severe disabilities; hence, stricter accountability is recommended. All service providers, regardless of the vintage of their programs, should be required to show benefits and costs within a uniform framework of measurement.
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