Journal of Vocational Rehabilitation - Volume 53, issue 3

Authors: Foley, Susan M. | Livermore, Gina

Article Type: Introduction

Abstract: BACKGROUND: Kentucky Office of Vocational Rehabilitation (OVR) and Minnesota Vocational Rehabilitation Services (VRS) successfully participated in a randomized control trial of an intervention designed in partnership with more than 100 VR personnel and twenty state VR agencies to identify effective practices for increasing earnings outcomes of Social Security Disability Insurance (SSDI) beneficiaries receiving VR services. OBJECTIVE: This paper introduces articles in the Special Issue to tell the story of the SGA Model Demonstration from design, testing, and impact evaluation. METHODS: The SGA Model Demonstration began reviewing administrative data, collecting expert opinion, and exploring current practice in …eight state VR agencies. After an eighteen-month period of capacity building, two state VR agencies randomized local offices and implemented a rapid coordinated team approach. RESULTS: State VR agencies are successfully participating in rigorous research activities including model demonstrations with experimental designs. CONCLUSIONS: Model demonstrations that include experimental designs are effective strategies to improve knowledge and build a better practitioner toolbox to advance employment outcomes of VR clients. Show more

Keywords: Vocational rehabilitation, disability, SSDI, SGA, employment

DOI: 10.3233/JVR-201102

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 257-260, 2020

Authors: Foley, Susan M. | Haines, Kelly | Mock, Linda

Article Type: Research Article

Abstract: BACKGROUND: The SGA Model Demonstration tested a coordinated team approach that integrated specific components of vocational rehabilitation services to determine if the model would increase earnings outcomes of Social Security Disability income beneficiaries who sought VR services in Kentucky and Minnesota. OBJECTIVE: This paper provides details on the first phase of development of the SGA intervention. METHODS: Researchers combined a Delphi process, key informant interviews, and administrative data review to identify practices that were high priority for inclusion in the model. RESULTS: Researchers reached a consensus on the high priority components to construct a …testable intervention under the control of the vocational rehabilitation system. CONCLUSIONS: The SGA Project team identified three practice domains to guide an intensive case study for Phase II development of the intervention. These included pacing of services, work incentives counseling, and strategies for employment service delivery. Show more

Keywords: Vocational rehabilitation, pacing, work incentives counseling, SSDI, SGA, employment services

DOI: 10.3233/JVR-201103

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 261-272, 2020

Authors: Foley, Susan M. | Haines, Kelly | Mock, Linda

Article Type: Research Article

Abstract: BACKGROUND: The SGA Model Demonstration tested a coordinated team approach to determine whether a combination of vocational rehabilitation practices improve earnings outcomes of clients who also receive Social Security Disability Insurance. OBJECTIVE: This paper describes Phase II of the development of the intervention. METHODS: Researchers and policy fellows conducted site visits, interviewed personnel from 8 State Vocational Rehabilitation agencies and related partners, drafted a proposed intervention and submitted it for review to a Delphi panel. RESULTS: Delphi ratings supported the proposed intervention as likely leading to improved earnings outcomes and recommended that the SGA …Project develop training, technical assistance, and capacity building activities to support implementation. CONCLUSION: The SGA Project invested 2 years developing an intervention by examining administrative data, consulting national experts, interviewing SVRAs directors and more than 100 practitioners across eight SVRAs. Pacing metrics were built into a team approach that included a vocational counselor, work incentives counselor, and a job development/job placement specialist with a business relations focus. Show more

Keywords: SSDI, vocational rehabilitation, disability, SGA, earnings, work incentive counseling, business relations, pacing

DOI: 10.3233/JVR-201104

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 273-285, 2020

Authors: Marrone, Joe | Thelin, Russ | Mock, Linda

Article Type: Research Article

Abstract: BACKGROUND: The SGA Project tested a rapid coordinated team approach in Kentucky and Minnesota. OBJECTIVE: The authors are members of a five-person Senior Technical Assistance (TA) Team that supported Kentucky and Minnesota as host sites in a l randomized controlled trial. METHODS: The TA team participated in a planning and implementation phase over the course of three years. At closeout, the TA team interviewed SVRA personnel on participation, recommendations, and challenges. RESULTS: TA was adapted to the needs of each state vocational rehabilitation agency to identify solutions to capacity challenges, staff training, concerns about …randomization, and team approaches. In both Kentucky and Minnesota, the dedicated TA team balanced the fidelity of the model with the need to align solutions with agency priorities, goals, and culture. CONCLUSIONS: Provision of intensive TA to support state vocational rehabilitation agencies to participate in a research intervention requires a focus on counselor skills and expectations, attention to competing priorities and interests of State VR Agencies, and an ability to build relationships at multiple levels of the agency. Show more

Keywords: Vocational rehabilitation, disability, SSDI, SGA, technical assistance, quality enhancement approach, systems approach

DOI: 10.3233/JVR-201105

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 287-296, 2020

Authors: Martin, Frank | Sevak, Purvi

Article Type: Research Article

Abstract: BACKGROUND: The Substantial Gainful Activity (SGA) Project demonstration tested innovations to improve the employment of nonblind vocational rehabilitation (VR) clients receiving Social Security Disability Insurance (SSDI) benefits. OBJECTIVE: We describe the SGA Project model components, the implementation experience in Kentucky, and the impact of the innovations on VR service and employment outcomes. METHODS: The evaluation used information from site visits and VR administrative data. We estimated impacts by comparing the outcomes of SSDI-only clients who applied for services at randomly assigned offices that implemented the SGA Project innovations to those who applied at other offices. …RESULTS: Participants did not consistently receive all components of the innovations. Nevertheless, the innovations led to a 17 percentage-point increase in clients with a signed individualized plan for employment within 30 days of application, an 8 percentage-point increase in closures with competitive employment, and nearly 6 percentage-point increase in the number of clients with earnings at or above the SGA level. CONCLUSIONS: The early, positive impacts on key outcomes suggest the SGA Project innovations could hold promise for other VR agencies and for a broader set of VR clients. The evaluation illustrates the potential for random assignment demonstrations to test innovations in VR service delivery. Show more

Keywords: Vocational rehabilitation, disability, SSDI, SGA, employment

DOI: 10.3233/JVR-201106

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 297-305, 2020

Authors: Kehn, Matthew | Honeycutt, Todd

Article Type: Research Article

Abstract: BACKGROUND: In 2015, the state vocational rehabilitation (VR) agency in Minnesota was one of two agencies that implemented the Substantial Gainful Activity (SGA) Project demonstration, whose innovations were designed to improve employment outcomes of nonblind VR clients receiving Social Security Disability Insurance benefits. OBJECTIVE: To present findings on the implementation experiences and the impacts the innovations had on service and employment outcomes. METHODS: The evaluation involved qualitative and quantitative methods from an office-level randomization design. Using interview and administrative data, we assessed implementation and impacts on service pacing, client engagement, and employment. RESULTS: Clients …at treatment sites experienced shorter times for developing an individualized plan for employment and were less likely to drop out of services early, but the intervention had no impacts on employment or earnings. As a result of the intervention, agency leadership and staff changed their perceptions of the initial plan for employment, the value of site-based job placement staff, and Social Security Administration benefits knowledge. CONCLUSIONS: The SGA Project innovations generated positive impacts on key service delivery and client outcomes. Evaluation findings and staff experiences in implementing the innovations suggest a number of implications for other VR agencies interested in adopting features of the SGA Project innovations. Show more

Keywords: Vocational rehabilitation, disability, SSDI, SGA, employment

DOI: 10.3233/JVR-201107

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 307-317, 2020

Authors: Taylor, Allison B. | Blackburn, Nerlie

Article Type: Research Article

Abstract: BACKGROUND: The SGA Model Demonstration included a qualitative follow-along study of participants’ return-to-work decision-making. OBJECTIVE: The authors describe the findings, including motivations of SSDI beneficiaries to seek employment and vocational rehabilitation (VR) services, and the social, familial and personal considerations in returning to work. METHODS: This study used a longitudinal qualitative approach, involving a series of in-depth interviews with SSDI beneficiaries who sought services from state VR agencies in Minnesota and Kentucky. RESULTS: Motivations of SSDI beneficiaries to seek employment extend beyond economic need. Fear and confusion associated with balancing financial risks and rewards …of returning to work influenced whether participants felt ready to do so. Yet while financial considerations are important, they are often embedded in or superseded by motivations related to family engagement, roles, and responsibilities; activity and social engagement; and the personal meanings of work. Financial and benefits counseling provided through the SGA Model was widely praised by participants, and the informed decision-making process facilitated by the coordinated team approach allowed many to envision pathways that had not previously seemed viable. CONCLUSIONS: Decisions to return to work are governed by multifaceted processes. VR services that are responsive to these complexities can empower individuals to make informed decisions. Show more

Keywords: People with disabilities, employment of people with disabilities, social security beneficiaries, qualitative research, vocational rehabilitation

DOI: 10.3233/JVR-201108

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 319-333, 2020

Authors: Connelly, John | Wooderson, Stephen

Article Type: Research Article

Abstract: BACKGROUND: The Council of State Administrators of Vocational Rehabilitation (CSAVR) represents the chief administrators of the 78 vocational rehabilitation (VR) agencies in every state, territory, and the District of Columbia. In anticipation of the 100th anniversary of the public VR program, CSAVR launched its Vision 2020 goals with an express interest in innovation. CSAVR recognizes that research is important to provide the data that VR agencies need to continually improve their outcomes and services. OBJECTIVE: The authors make a case for why researcher-VR partnerships are an important strategy for innovation and provide suggestions for strengthening those partnerships. …METHODS: The authors describe CSAVR’s investment in research and provide data from a survey of state VR agencies on research participation. RESULTS: Researchers can increase state VR agency participation in their projects by involving the agency in study design, minimizing the time and resource burden on the agency, and demonstrating that the proposed research will yield products that benefit customers and improve staff competency. CONCLUSION: VR agencies are motivated to engage in research that will clearly add value and improve operations with minimal burden. It is hoped that greater agency participation in research will yield better data to guide agencies in the future. Show more

Keywords: Practitioners, implementation, public agency participation in research, vocational rehabilitation

DOI: 10.3233/JVR-201109

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 335-340, 2020

Authors: Contreary, Kara | Honeycutt, Todd

Article Type: Research Article

Abstract: BACKGROUND: The U.S. government has implemented several programs to reduce federal expenditures on Social Security Disability Insurance (DI) and help beneficiaries return to work, but the limited success of these efforts has raised interest in approaches that help workers with disabilities remain in the workforce. OBJECTIVE: This paper provides information on individuals at risk of applying for DI benefits to help build the evidence base for policies that provide workers with disabilities support to eliminate the need to apply for and receive DI benefits. METHODS: Using three panels of the Survey of Income and Program Participation …matched to SSA administrative data, we describe the employment characteristics of seven groups at risk of applying for DI benefits before and after application, as well as the outcomes of their DI applications. RESULTS: New private disability insurance recipients were more likely to apply for and receive DI than members of other at-risk groups. However, individuals with high healthcare expenditures made up the largest proportion of successful applicants across the at-risk groups considered here. CONCLUSION: While it seems plausible that individuals within an at-risk group who are likely to apply for DI benefits can be identified and provided supports to help them maintain employment, focusing on a specific group to promote employment over DI benefits may have a limited effect on the DI program because applicants come from multiple groups. Show more

Keywords: Social Security Disability Insurance, individuals with disabilities, program application

DOI: 10.3233/JVR-201110

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 341-352, 2020

Authors: Stapleton, David C. | Martin, Frank H.

Article Type: Research Article

Abstract: BACKGROUND: Vocational rehabilitation (VR) can potentially help disability-insured workers stay at work or return to work when they experience a disability. Such assistance could prevent or delay entry into the Social Security Disability (SSD) program. OBJECTIVE: We present descriptive statistics on the extent to which new VR applicants for 1998 through 2005 receive SSD benefits before or after VR application. METHODS: We matched Rehabilitation Services Administration (RSA-911) records for the years 1998 through 2009 with the Social Security Administration’s program and earnings files. RESULTS: The analyses show that a substantial number of VR applicants …entered SSD in the 60 months following VR application—more than 60,000 (12.3 percent) of the first-time VR applicants in 2002. The analyses also disclose variation in SSD entry across states, with some states accounting for entry percentages twice as high as that of others. We also found a positive relationship between our measure of wait time and entry into SSD. CONCLUSIONS: Although the large number of VR applicants entering SSD after VR application is modest compared to the number receiving an SSD award each year, the potential influence of VR services on later SSD and Medicare expenditures could be in the billions of dollars annually, in either direction. Show more

Keywords: Vocational rehabilitation, disability, Social Security Disability, employment

DOI: 10.3233/JVR-201111

Citation: Journal of Vocational Rehabilitation, vol. 53, no. 3, pp. 353-365, 2020