Abstract
Background
Since their inception, State Vocational Rehabilitation (SVR) and American Indian Vocational Rehabilitation Services (AIVRS) have played pivotal roles in assisting millions of individuals with disabilities in securing and sustaining competitive integrated employment.
Objective
This article aims to inform readers about the historical context and key issues concerning AIVRS while proposing strategies for enhanced collaboration between AIVRS and SVR programs in joint service provision.
Methods
While published research on providing VR services to American Indians or Alaska Natives (AI/AN) is limited, much of the information in this article is based on the extensive knowledge of the authors, who collectively possess decades of experience in SVR and AIVRS.
Results
Key topics include (a) challenges encountered by the AI/AN population; (b) prevailing attitudes toward disability and employment within AI/AN communities; (c) a comparative overview of the histories and operations of SVR and AIVRS; (d) supporters of and advocates for AIVRS projects; (e) considerations when sharing cases; and (f) recommendations for fostering cooperative practices that benefit AI/AN communities.
Conclusion
By integrating culturally appropriate services, including holistic traditional healing, AIVRS projects and SVR agencies can offer complementary support while honoring the cultural heritage of AI/AN clients.
Introduction
The history of state vocational rehabilitation (SVR) dates to 1920, while American Indian Vocational Rehabilitation Services (AIVRS), also called Tribal vocational rehabilitation (TVR), was not established until the 1970s. Since their inception, both SVR and AIVRS have helped millions of individuals with disabilities obtain and maintain competitive integrated employment. Under current legislation, SVR and AIVRS operate independently. Though they provide similar services, TVR programs are uniquely authorized to provide culturally appropriate services for American Indian and Alaska Native (AI/AN) participants, as described below, while SVR agencies typically have larger budgets to cover high-cost VR services. For example, in the 2024 AIVRS discretionary grant competition, the average award was $550,000 (U.S. Department of Education, 2023). By contrast, in fiscal year 2024, the budgets for the formula grant for the continental U.S. SVR agencies (combining general and blind agencies where applicable) ranged from $12.2 million to $308.1 million (Rehabilitation Services Administration, n.d.b). AI/AN individuals with disabilities can exercise their informed choice to work with either or both programs, based on personal preference, convenience, and particular service needs (TVR Institute, 2020).
Methods
The purpose of this article is to familiarize readers with the history and issues surrounding AIVRS and to provide suggestions for improving cooperation between AIVRS and SVR programs in cases of joint service provision. Specifically, this article discusses (a) challenges faced by the AI/AN population; (b) AI/AN attitudes toward disability and work; (c) the history of and differences between SVR and AIVRS; (d) supporters of and advocates for AIVRS projects, (e) information to consider when sharing cases; and (f) suggestions for ways in which SVR and AIVRS can work together for the benefit of AI/AN communities. While published research on the AI/AN population and VR is limited (Lee et al., 2024), much of the information in this article is based on the extensive knowledge of the authors, who collectively possess decades of experience in SVR and AIVRS and hold leadership positions in organizations serving AIVRS projects.
Results
Challenges faced by the AI/AN population
In 2022, the AI/AN unemployment rate was 6.2 percent. This is significantly higher than that of the general population, which is 3.6 percent, and is also higher than all other racial and ethnic groups (U.S. Bureau of Labor Statistics, 2023). The situation on tribal reservations is even more dire, with unemployment rates historically ranging from 20 to 80 percent (Miller, 2012). For the combined years 2019–2021, the reported unemployment rates for AI/AN living on a reservation was 10.5 percent as compared to 8.1 percent for those not living on tribal land (Brundage, 2023).
The incidence of disabilities for AI/AN is also significantly higher than the general population. According to the American Community Survey (2023), there are an estimated 520,200 people with disabilities who identify solely as AI/AN, which is a disability incidence rate of 15.9 percent as compared to 13.6 percent for the general population. The unemployment rate during the combined years 2019–2021 for AI/AN with disabilities was 11.9 percent compared to 10.0 percent for AI/AN without disabilities (Brundage, 2023). These data indicate a significant need to support AI/AN individuals with disabilities in obtaining employment.
AI/AN attitudes toward disability and work
The U.S. Bureau of Indian Affairs (2021) recognizes 574 culturally, linguistically, and ethnically distinct Indian tribes that are established as sovereign tribal governments, including 229 Tribal entities in Alaska. While there are many distinctions within AI/AN communities, there are also many similarities in tribal worldviews. The following section describes AI/AN attitudes toward disability and work and how these differ from predominant Western views.
AI/AN attitudes toward disability
AI/AN cultures often hold distinct views on disability. Many tribes do not have a particular word to describe or define “disability” and do not specifically recognize individuals as “disabled.” AI/AN typically believe that the body, mind, soul, and spirit are interconnected. “Unwellness,” or illness, is understood as disharmony in the interconnected workings of body, mind, soul, and spirit. If one of the four is out of accord, the whole being is out of harmony. Some tribal communities believe that illness is caused by violation of a taboo or sacred tribal custom. Other tribes believe that each individual is responsible for their own wellness and self-care; therefore, they must want to get well, as no one can do this for them. In contrast to the predominant Western view, disabilities are not generally perceived as limitations. Rather, all individuals are called upon to live to the fullest within the circumstances their Creator has allotted them. Family support is also very important. AI/AN with disabilities are often helped to find their place in their tribal communities without outside assistance, relying solely upon their families and traditional beliefs (Connors & Donnellan, 1993).
AI/AN attitudes toward work
Traditional AI/AN economic activity centered around subsistence and was attuned to seasonal changes, animal migrations, and growth cycles (Burnette et al., 2018). Time was not measured in eight-hour workdays but from sunrise to sunset. Each tribal member, including those with disabilities, engaged in or was responsible for daily tasks that promoted well-being for all members of the tribe (Connors & Donnellan, 1993). Traditionally, each gender had a specific role to play as part of the subsistence work environment. These traditional livelihoods, languages, beliefs, traditions, religions, and teachings of AI/AN communities were greatly affected, and in some instances destroyed, through deliberate government policies such as forced assimilation, removals from ancestral lands, the reservation system, tribal dissolution, and mandatory residential school attendance (Burnette et al.). These policies effectively destroyed the traditional economies and folkways of many tribal groups. Today, many AI/AN are employed in conventional “nine to five” jobs (Connors & Donnellan). A work culture previously founded on subsistence activities and historically effective work practices is now based on hierarchical organizational and corporate structures.
History and differences between SVR and AIVRS
SVR had its beginning in 1920, with the passing of the Civilian Vocational Rehabilitation Act (Public Law 236). The passage of the Rehabilitation Act of 1973 led to widespread changes in SVR, particularly the concept of “informed choice,” emphasizing that service recipients should be given the opportunity to make decisions in ways that reflect their strengths, resources, priorities, concerns, abilities, capabilities, and interests. This legislation has since expanded, with the most recent reauthorization occurring in 2014 (Saleh & Bruyère, 2023).
In contrast, the AIVRS projects were first established in the 1970s. Prior to this time, most AI/AN with disabilities were served by SVR offices. However, the needs of AI/AN were often not met through SVR and tribal members did not often seek out VR services, commonly for the following reasons: (a) the extensive diversity of AI/AN, which is not often adequately understood by nontribal members and service providers; (b) limited awareness among AI/AN of the services provided by SVR due to poor outreach; (c) the remoteness of tribal communities, which makes it difficult for tribal members with disabilities to travel to SVR offices in urban areas; (d) the lack of AI/AN VR counselors or staff employed by state VR agencies; and (e) widespread distrust of government agencies among tribal members, often stemming from historical and intergenerational trauma (TVR Institute, 2020).
Through successful advocacy at the federal level led by the Navajo Nation, funds were authorized by Congress to the Rehabilitation Services Administration (RSA) to develop AIVRS project grants to serve tribal members with disabilities. In addition, the passage of Public Law 93–638, the “Indian Self-Determination and the Education Assistance Act” of 1975, was a key event that granted Indian Nations the authority to contract with the federal government to operate programs serving their tribal members. In 1975, the State of Arizona Division of Vocational Rehabilitation awarded the Navajo Nation government a three-year establishment grant to begin serving people with disabilities living on the Navajo Reservation. Similar to SVR, these services were consistent with each eligible individual's strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice, so that each individual may prepare for, and engage in, high-quality employment that will increase opportunities for economic self-sufficiency. The primary difference between SVR and AIVRS projects was, and remains, the provision of culturally appropriate and responsive services by the latter (TVR Institute, 2020).
The success of the Navajo Nation VR demonstration grant laid the foundation for the widespread establishment of AIVRS projects through the 1978 reauthorization of the Rehabilitation Act. In the 1978 Amendments to the Rehabilitation Act of 1973, Section 102 required SVR agencies to provide adequate VR services to American Indians with disabilities residing in the state. In addition, Section 130 allowed federally and state recognized American Indian tribes to apply for discretionary grants to provide VR services to tribal members on their reservation (TVR Institute, 2020). The Rehabilitation Act defines AI/AN as “an individual who is a member of an Indian tribe,” which includes AN and AN descendant as defined by the Alaska Native Claims Settlement Act (American Indian Vocational Rehabilitation Services, 2024). As a discretionary RSA grant program, AIVRS uses this federal definition of AI/AN when referring to Tribal members (TVR Institute).
From 1981 to 1985, the Navajo Nation was the only nation or AI/AN tribe to be awarded an AIVRS grant. In 1985, the Northern Cheyenne and Chippewa Cree tribes were also funded. In 1986, the Shoshone-Bannock and Confederated Salish Kootenai tribes were funded, bringing the total number of AIVRS projects to five. The 1992 Amendments to the Rehabilitation Act moved the AIVRS program to Section 121 and increased the funding available to the projects (AIVRTTAC, n.d.c). As of October 2024, there are 84 RSA-funded AIVRS projects and eight projects being served under a no-cost extension in 26 states (AIVRTTAC, n.d.b).
AIVRS projects are successful because they are designed to meet the cultural and VR needs of the AI/AN community members with disabilities. AIVRS projects are located in tribal communities. Staff members are often members of the tribal community, and all are trained to be culturally competent. The staff are connected to the community and familiar with local resources. In addition, some AIVRS staff speak the native language, which may be preferred by service recipients (TVR Institute, 2020).
Supporters of and advocates for AIVRS projects
Two of the organizations that work to advocate for AIVRS projects at the state and federal level and to improve service provision through training and technical assistance are the Consortia of Administrators for Native American Rehabilitation (CANAR) and the American Indian Vocational Rehabilitation Training and Technical Assistance Center (AIVRTTAC).
CANAR
CANAR was established in 1993 to advance and improve AIVRS services in response to conflicts between SVR services and tribal norms (Consortia of Administrators for Native American Rehabilitation, n.d.). CANAR is a membership-run organization and acts as an advocate and change agent for the AIVRS projects. In 1996, it advocated for 22 amendments to the Rehabilitation Act, 20 of which became law in the 1998 Amendments to the Rehabilitation Act. Some of its most significant recommendations were to increase the AIVRS funding cycle from three years to five years; to include participants who live near the reservation, extending AIVRS services to tribal members living beyond reservation boundaries; to add a priority preference for existing projects when evaluating grant proposals for continued funding; and to require that states with one or more AIVRS projects include at least one AIVRS project director as a member on their State Rehabilitation Council (TVR Institute, 2020).
AIVRTTAC
AIVRTTAC provides training and technical assistance to governing bodies of Indian tribes that administer an AIVRS project and is the only national technical assistance center for AIVRS projects (Rehabilitation Services Administration, n.d.a). AIVRTTAC, which is housed at Northern Arizona University's Institute for Human Development, and the TVR Institute, which is housed at Northwest Indian College, were funded by RSA in 2015. In 2021, the two merged into a single partnership entity to better serve the training, technical assistance, and continuing education needs of AIVRS staff (AIVRTTAC, n.d.a). The goal of AIVRTTAC is to ensure VR staff have the knowledge and expertise to provide culturally appropriate and responsive services. This is accomplished through the provision of intensive training and technical assistance (ITTA); targeted training and technical assistance (TTTA); universal training and technical assistance (UTTA); and credit- and non-credit-bearing academic/capacity building programming that is respectful of and responsive to the beliefs, practices, and cultural attributes of AI/AN with disabilities. The result is an increase in the knowledge and skills of AIVRS project personnel, which results in improved employment outcomes for AIVRS participants. AIVRTTAC staff recognize and respect each tribe's unique history, sovereignty, oral traditional knowledge, spirituality, languages, beliefs, values, livelihoods, ceremonies, and perspectives about tribal members with disabilities (AIVRTTAC, n.d.a).
Discussion
Information to consider when sharing cases
The historical and traditional contexts of the AI/AN communities and AIVRS, as described above, are essential to consider when providing VR services to AI/AN with disabilities. If the participant chooses to exercise their informed choice and decide to work with both a SVR agency and an AIVRS project, additional considerations must be taken into account.
Cultural sensitivity
When sharing VR cases, both SVR agencies and AIVRS projects should recognize the distinction between their programs, especially in terms of cultural responsiveness. AIVRS emphasizes services that honor and reflect the cultural backgrounds of participants. Relevant regulations that guide this work include 34 Code of Federal Regulations (CFR) Part 371.6(xvii), which stipulates that AIVRS projects must incorporate culturally relevant practices, including treatment by native healing practitioners when necessary; and 34 CFR Part 371.41(a)(2), which states that expenditures for services reflecting the cultural background of AI/AN participants are justified when those services assist individuals with disabilities in achieving their vocational goals (American Indian Vocational Rehabilitation Services, 2024). Culturally appropriate interventions are essential for addressing historical trauma, which is handed down through generations and is connected to the effects of residential schools, racism, discrimination, chronic trauma, and the everyday impacts of trauma on the family system (Methot, 2019). Its symptoms include stress, domestic violence, substance abuse, mood and stress disorders, diabetes, and low life expectancy, which cumulatively lead to severe psychological, economic, social, environmental, and physical distress in the AI/AN population (Brown-Rice, 2013; Duran et al., 1998; Tiedt & Brown, 2014).
Employment outcomes
When developing an employment outcome, VR counselors should consider working with the client to define an outcome that is aligned with the client's cultural values and community standards. Employment may involve work that contributes to the community or reflects traditional skills and knowledge. Also, in relation to cultural sensitivity, consider how tribal values and perspectives on work, success, and community engagement influence the client's vocational goals.
VR services
When describing required VR services on a joint Individual Plan for Employment (IPE), SVR counselors should ensure that they include culturally relevant options, such as holistic traditional healing services to address physical, emotional, mental, and spiritual barriers to employment, that can only be provided by the AIVRS project. When designing services, VR counselors should respect how the participant and their family understand and approach holistic traditional healing.
Vendors
When searching for vendors for the required services on a joint IPE, VR counselors should always seek out vendors who can provide culturally responsive services. This may include native healing practitioners or organizations that understand the cultural context of the participant's needs. Likewise, VR counselors and clients should consider exploring comparable services that reflect traditional practices, ensuring that providers understand and respect the cultural heritage of the participants.
Evaluating progress
When evaluating progress, VR counselors should consider the cultural values and beliefs of the client, particularly with regard to disability and employment. If the participant received culturally responsive services, VR counselors should assess whether they have been beneficial to the participant. One way to do this is to track how culturally responsive services addressed the participant's barriers to employment and document the integration of these services in case notes, particularly at the time of case closure. Both SVR agencies and AIVRS projects, either individually or jointly, should celebrate the participant's success by acknowledging how their cultural identity played a role in their vocational journey.
Terms and conditions
In the “terms and conditions” section of the IPE, VR counselors should consider respecting the participant's cultural values and responsibilities, such as community obligations or tribal ceremonies. It is particularly important to be flexible and aware of how traditional practices may affect timelines or commitments within the IPE.
Supported employment
When developing supported employment plans, VR counselors and clients could discuss employment that aligns with traditional tribal roles or contributes to the community. For example, they could explore employment opportunities that incorporate or respect tribal traditions, such as positions in tribal governance, cultural preservation, subsistence activities, or traditional crafts.
Post-employment services
When considering post-employment services, VR counselors should consider offering services that continue to reflect cultural values, such as maintaining relationships with native healers or community leaders who can provide ongoing support. Also, in relation to cultural sensitivity, VR counselors should consider emphasizing the role of cultural practices in maintaining long-term employment stability and personal well-being.
Ethics related to recognizing culture in service provision
Certified Rehabilitation Counselors (CRCs) and Canadian Certified Rehabilitation Counselors (CCRCs) are required to follow the Code of Professional Ethics for Certified Rehabilitation Counselors. In addition, many state VR agencies and AIVRS projects have adopted the Code, regardless of the certification status of the staff. Section A.2.a. of the Code states that CRCs must “demonstrate cultural humility and respect for the cultural identity of clients when developing and implementing culturally responsive rehabilitation strategies and treatment plans by providing and adapting interventions” (Commission on Rehabilitation Counselor Certification, 2023, p. 4).
A few other sections of the Code are particularly relevant to the provision of culturally responsive VR services. For example, Section A.3.e. addresses the importance of including a person's support network and enlisting their support when appropriate. Section A.4.j. addresses accepting gifts by acknowledging that “in some cultures, small gifts are a token of respect and gratitude” (Commission on Rehabilitation Counselor Certification, 2023, p. 7). In addition, Section D covers several standards related to the need to “reduce bias, minimize discrimination, and prevent harm” and “describes the ethical responsibility of CRCs/CCRCs to exhibit cultural knowledge and skills aligned with the core values of the profession” (Commission on Rehabilitation Counselor Certification, p. 14).
Conclusion
There are several ways in which SVR agencies and AIVRS projects can successfully work together for the benefit of AI/AN clients. For one, it is essential for SVR counselors to recognize each tribe's unique sovereignty status and relationship with the federal government as well as its traditional forms of leadership and alignment with the tribal government. SVR counselors should learn about and respect each individual tribe's history, government, and leadership in their service area. In particular, SVR counselors could develop an understanding of the cultures of the various tribes being served, including their perception of disability and work. Cultural understanding could be promoted in many different ways, such as through staff development and training, during the hiring process, and inclusion in performance evaluations and career advancement decisions.
Another way to empower AI/AN staff and participants is for non-native staff to understand the importance of embracing heritage by encouraging AI/AN staff and participants to take pride in their tribal identity and incorporate tribal ways of knowing into their practices. This enhances their ability to advocate for culturally based services. Also, encourage them to listen to and include the voices and teachings of their ancestors in the program's practices and connect the community's wisdom with VR practices to strengthen employment opportunities.
An additional way is to conduct outreach to strengthen relationships in the community. One powerful method is through storytelling and advocacy by sharing success stories within the community to inspire engagement and support for VR services, both SVR and AIVRS. VR staff can use these stories to build relationships with key stakeholders such as tribal leaders and employers.
By incorporating culturally appropriate services, including holistic traditional healing, SVR and AIVRS can provide complementary services while celebrating the participant's cultural heritage. The journey toward employment is not only about achieving vocational objectives but also about honoring the participant's identity, community, and traditions. This framework ensures that the IPE is grounded in cultural responsiveness, aligning with the unique needs of AI/AN participants.
Footnotes
Acknowledgements
The authors have no acknowledgments.
Ethics statement
Not applicable since no data was collected.
Informed consent
Not applicable since no data was collected.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Information in this article is based upon the work of the authors under a grant from the U.S. Department of Education (PR/Award #H250Z210001). However, the contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government (Authority: 20 U.S.C. 1221e-3 and 3474).
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.