Sage Journals: Discover world-class research

Abstract

BACKGROUND:

Results-based funding models can improve Vocational Rehabilitation (VR) client employment outcomes, but evidence suggests that gaps in services occur when provider risk is not compensated.

OBJECTIVE:

The purpose of this qualitative study is to learn how VR agencies deliver and pay for job development and placement services, the factors that shape decision-making, and the outcomes of such decisions.

METHODS:

Administrators from 40 VR agencies identified informants to take part in qualitative interviews about how their agency delivers, contracts, and pays for job development services. Interview notes were analyzed to identify themes and dimensions in the data.

RESULTS:

Gaps in provider services exist in rural communities, where provider risk is increased due to economic, transportation, and delivery barriers. Strategies to overcome barriers focused on expanding available providers by lowering requirement for provider entry, increasing recruitment activities by the VR agency, reducing financial risk in the form of incentives, tiered payments, and shared funding models, and increasing agency capacity and support.

CONCLUSIONS:

Strategies for effective VR service delivery are shaped by multiple factors and choice points at the agency level. A deeper understanding of the intended and unintended consequences of service delivery models is an important contribution to informed decision-making.

Keywords

Vocational Rehabilitation service delivery rural disability results-based-funding

Get full access to this article

View all access options for this article.

References

Bradley, C., Ebener, D., & Geyer, P. (2013). Contributions to successful VR outcomes among non-Latino (Caucasian) and Latino consumers with hearing loss. Journal of Rehabilitation, 79(2), 24–33.

Doney,

(n.d.). Regulations implementing the rehabilitation act of 1973, as amended by the Workforce Innovation and Opportunity Act. Regional training series. Presented at the RSA Regional Training Series.

Dutta, A., Gervey, R., Chan, F., Chou, C.-C., & Ditchman, N. (2008). Vocational Rehabilitation services and employment outcomes for people with disabilities: A United States study. Journal of Occupational Rehabilitation, 18(4), 326–334. https://doi.org/10.1007/s10926-008-9154-z

Ford, L., Mitchell, D., & Marrone, J. (2017). Vocational Rehabilitation partnering with community rehabilitation programs In business engagement and employer support (pp. 1–20). Boston, MA: Institute for Community Inclusion, UM-Boston.

Gates, L. B., Klein, S. W., Akabas, S. H., Myers, R., Schawager, M., & Kaelin-Kee, J. (2005). Outcomes-based funding for vocational services and employment of people with mental health conditions. Psychiatric Services, 56(11), 1429–1435. https://doi.org/10.1176/appi.ps.56.11.1429

Hayward, B., & Schmidt-Davis, H. (2005). Longitudinal study of Vocational Rehabilitation (VR) services program, Third final report: The context of VR services (pp. 1–78). Research Triangle Institute. Retrieved from http://www.ed.gov.policy/speced/leg/rehab/eval-studies.html

Heinrich, C. J., & Choi, Y. (2007). Performance-Based contracting in social welfare programs. The American Review of Public Administration, 37(4), 409–435. https://doi.org/10.1177/0275074006297553

Ipsen, C. (2012). Vocational Rehabilitation approaches to job development (Research Report) (pp. 1–6). RTC:Rural: University of Montana Rural Institute. Retrieved from https://scholarworks.umt.edu/ruralinst_employment/17/

Ipsen, C. (2017, June). Effective rural VR job development. Presented at the RTC: Rural State of the Science Webinar, University of Montana Rural Institute, Missoula, MT. Retrieved from http://rtc.ruralinstitute.umt.edu/knowledge-translation/state-of-the-science/rural-vr-sos/

10.

Lu, J. (2016). The performance of performance-based contracting in human services: A quasi-experiment. Journal of Public Administration Research and Theory, 26(2), 277–293. https://doi.org/10.1093/jopart/muv002

11.

Lugas, J., Timmons, J., & Smith, F. (2010). Vocational Rehabilitation services received by youth with Autism: Are they associated with an employment outcome?(Research Brief No. 48) (p. 4). Boston, MA: Institute for Community Inclusion, UM-Boston.

12.

McGrew, J. H., Johannesen, J. K., Griss, M. E., Born, D. L., & Katuin, C. (2005). Performance-based funding of supported employment: A multi-site controlled trial. Journal of Vocational Rehabilitation, 23, 81–99.

13.

Novak, J., Mank, D., Revell, G., & O’Brien, D. (1999). Paying for success: Results-based approaches to funding supported employment. In

Revell ,

K. J.

Inge ,

Mank , &

Wehman , The Impact of Supported Employment for People with Significant Disabilities: Preliminary Findings of the National Supported Employment Consortium (pp. 25–42). Richmond, VA: Virginia Commonwealth University.

14.

O’Brien, D., & Cook, B. (n.d.). Oklahoma milestone payment system (No. 2; pp. 1–19). Oklahoma: Department of Rehabilitation Services.

15.

O’Brien, D., & Revell, G. (2005). The milestone payment system: Results based funding in Vocational Rehabilitation. Journal of Vocational Rehabilitation, 23, 101–114.

16.

Rehabilitation Services Administration. (2017, August 22). WIOA performance accountability for Vocational Rehabilitation programs. Retrieved October 8, 2018 fromhttps://ncrtm.ed.gov/Download.aspx?type=doc&id=4363

17.

Rigles, B., Ipsen, C., Arnold, N., & Seekins, T. (2011). Experiences of rural vocational rehabilitation clients who leave the system prematurely: A qualitative exploration. Rehabilitation Counseling Bulletin, 54(3), 164–174.

18.

Schultz, J. C. (2008). An examination of factors contributing to public rehabilitation counselors’ involvement in job placement and development activities. Journal of Rehabilitation, 74(4), 9–17.

19.

Seekins, T., & Greiman, L. (2014). Map Facts: Disability in Rural America (Policy Brief). Missoula, MT: University of Montana Rural Institute. Retrieved from https://scholarworks.umt.edu/ruralinst_independent_living_community_participation/8

20.

Strauss, A., & Corbin, J. (1998). Basics of qualitative research techniques and procedures for developing grounded theory (2nd ed.). London: Sage Publications.

21.

Thiede, B., Greiman, L., Weiler, S., Beda, S. C., & Conroy, T. (2017, March 16). Six charts that illustrate the divide between rural and urban America. The Conversation. Retrieved from http://theconversation.com/six-charts-that-illustrate-the-divide-between-rural-and-urban-america-72934

22.

Ysasi, N., Tiro, L., Sprong, M., & Kim, B. J. (2018). Marketing vocational rehabilitation services in rural communities. In

D. A.

Harley ,

N. A.

Ysasi ,

M. L.

Bishop , &

A. R.

Fleming , Disability in Vocational Rehabilitation in Rural Settings (pp. 545–552). Cham, Switzerland: Springer International Publishing.

Vocational Rehabilitation (VR) funding of job development and placement services: Implications for rural reach