Journal of Vocational Rehabilitation

{\it Objective:} Determine whether the number of job coaches provided by local nonprofit disability service providers (``boards'') significantly affected the employment outcome for individuals with mental retardation (MR) in South Carolina in 1997.

{\it Study Design:} Health, demographic and IQ information for individuals with MR (IQ 20--74) were matched with employment information derived from written surveys supplied by the boards. The study group comprised 431 employed and 6659 unemployed individuals. Logistic regression was used to assess the relationship between employment outcome and the number of job coaches per individual served.

{\it Results:} Job coach numbers per board varied from 0.00 to 2.48 job coaches per 100 individuals, with mean and median values of 0.97 and 0.87 coaches per 100 individuals. The effect of coaches on employment likelihood was approximately two times greater for individuals with low (IQ 20--39) than for high IQ (IQ 40--74), approximately three times greater for individuals in counties with low (3--6%) or intermediate (6--9%) unemployment and approximately ten times greater for individuals located in highly (>75%) urbanized counties. The likelihood of employment given the addition of one job coach per 100 individuals increased by factors of 0.37 to 2.49 in rural or moderately urban areas and by 3.79 to 25.70 in highly urban areas.

{\it Conclusions:} These results suggest that expenditures on job coaches are effective, and that such expenditures may be most effective if applied in urban counties with low or intermediate unemployment rates.

This research study examined the effect of a job readiness training program on job readiness self-efficacy and work personality factors among 77 job readiness training participants in a major urban city. Participants were compared for gender and ethnic differences. T-test results indicated significant differences in the self-perceptions of participants and the job-readiness evaluations their instructors completed in relation to job readiness self-efficacy and some aspects of work personality. Increased focus on interpersonal and social skills training that incorporates both process and performance training programs as part of a comprehensive job readiness training program is suggested.

This manuscript presents findings from a qualitative study of six community rehabilitation providers that successfully closed a facility-based program. Potential organizations were selected using a national nominations process and results from a 1991 national survey of community rehabilitation providers. Following a screening process, participating organizations were selected to provide diversity in location and size. Primary data collection took place during a two-day site visit with each program. The six organizations that participated in this study established an explicit goal to redirect resources from facility-based services to community employment, and each succeeded in closing a sheltered workshop or other facility-based program. Catalysts for the change were almost exclusively internal to the organization. The change in each organization was based on a change in organizational values and goals, but was often supported by other factors including financial concerns or other pressures. While leadership and the approach used to implement the change process varied, there was striking consistency across seven themes or characteristics of the organization that suggest organizational and systems strategies for approaching change. These themes included an openness to risk taking, shared values that drive service delivery, an ongoing process of self evaluation, linkages to external resources, a holistic focus on consumer needs, direct staff roles in organizational goals and decision-making, and an emphasis on continuous improvement. Strategies for state systems, community rehabilitation providers, and advocates are reviewed.

As a result of a combination of legislative, academic and social changes, increased numbers of students with disabilities are considering post-secondary education as a viable option [2]. Students with disabilities view access to post secondary education as (1) an opportunity to enhance their chances of obtaining and maintaining employment [1], (2) a means of earning a higher annual income [4], and (3) a pathway to life-long independence and a greater quality of life. With a greater number of students with disabilities enrolling in colleges and universities nationwide, it is become more apparent however, that many campuses are not equipped to meet the unique and varied needs of these students. Just because access to post-secondary education is increasing for students with disabilities, it does not always follow that students selecting this option will discover welcoming, supportive campus climates, programming and services that will facilitate choice, independence, and social participation, or adequate supports to promote academic success. Even at universities that have a solid record of developing and implementing model service delivery activities in support of students with disabilities, it is questionable as to whether these activities have, to any significant degree, impacted the underlying campus climate.

Twenty-one studies on the cost-efficiency of supported employment were reviewed to answer three questions: (a) ``Is supported employment cost-efficient?'' (b) ``Are supported employees with severe or multiple disabilities cost-efficient?'' and (c) ``Are certain models of supported employment more cost-efficient than others?'' This review concluded that supported employment is eventually cost-efficient from the worker's and taxpayer's perspectives. Further, all supported employees are cost-efficient, however, individuals with mild mental retardation are more cost-efficient than individuals with severe mental retardation. Finally, although literature is sparse, individual placements appear to be the most cost-efficient methods of supported employment.

Supported employment consists of an array of services and is one of many service venues available to individuals with disabilities. Analyses of costs and benefits provide valuable evidence with regard to the economic feasibility of alternative programs and assist with the decisions of which of these programs to expand, reduce, or discontinue. Human service providers must also be accountable to the recipients of their services, and have an obligation to ensure that individuals with disabilities and their families benefit from service participation. These seemingly incongruent perspectives, the participant's perspective, the provider's perspective, the taxpayer's perspective and the perspective of society in general, may be addressed individually, or addressed concurrently in an effort to fulfill all obligations of service provision. Likewise, cost analyses may be used to compare supported employment services to other service venues, or they may be used within the supported employment venue to compare cost efficiency of various supported employment services. This article is a review of the procedures used in benefit-cost analyses of supported employment provision, with emphasis upon the purposes of various analyses.