by Charles H. Crawford
Almost 30 years ago, organizations such as the American Coalition of Citizens with Disabilities called upon disabled people everywhere to demand that Congress pass the Rehabilitation Act. Many believed, and many hoped that the Rehab Act would be the cornerstone upon which we would build a new era of opportunity for people with disabilities, allowing us to become partners with the service system to get the kind of training we needed and help in finding work. Since then, we have seen a series of changes in the world we live in, and as succeeding administrations put their own imprints on the act and the way rehab services could be delivered: the coming of the technology revolution; the opportunity society; the independent living movement; the supported employment phenomenon; the reconcentration of rehabilitation on jobs; the imposition of questionable personnel standards which require rehab counselors to earn master's degrees, the curriculum for which may have little or no relevance to informing them about the needs or potentialities of people who are blind; a limited absorption of the rehab system into the larger workforce development system with its one-stop job centers; and the objectionable redefinition of employment to exclude so-called non-integrated settings. All of these trends, events, and reactions to a dynamic world represent a whirlwind of change and yet is the average blind person better off today than 30 years ago? The answer to this and related questions will in major part become a significant consideration as we begin to address the coming reauthorization of the law.
First, it is important to understand that the rehabilitation system is a partnership between the federal government that dispenses most of the money and the states to administer a national program of rehabilitation for folks with disabilities. How the partnership is defined and what requirements exist for all the participants are the results of how the law is written and re- authorized from time to time by the Congress. Here are some of the questions we must answer in developing our position on reauthorization. Does the system really work?
Studies have shown that blind folks who receive rehabilitation training from agencies that have been set up to meet our specific needs do better than people who are served by the generic agencies who try to serve everyone with a disability with a one-size-fits- all approach. However, we still encounter states where simplistic administrative thinking leads to the consolidation of agencies without regard for output. Even in those states where we have been able to get our own agencies, we are confronted in many cases with what they call "order of selection" which prioritizes who gets services and who waits. Moreover, we are seeing an increasing trend in some state agencies for the blind to narrow their approach to providing training to consumers so that it conforms with a monolithic philosophical premise that may work for some but not for all blind and visually impaired consumers. Should jobs be the only focus?
There is no doubt that the principle function of a rehabilitation agency has come to be defined as getting jobs for consumers. This is a good thing. Yet, are we seeing too many agencies ignoring the person in favor of the product? What about folks who choose to work at or above minimum wage in non-integrated settings? How about other employment outcomes that used to exist like "Homemaker," for people who take on the responsibility of running a home while others go off to work? What about the great numbers of elders and other consumers who either cannot or choose not to work? Has the system become too burdensome to itself and us?
Do we really need all the rules, regulations, policies, procedures, reports, monitoring, policy sub-guidance, and all the rest of the paperwork that demands a heavy administrative burden on the system? Do we need counselors with advanced degrees while important discrete job functions such as providing technology- related services remain largely catch as catch can? Do we need forms, master forms, and sub-forms to process almost every decision? Even in the best of circumstances have we created magnificent machines that cost more than the value of what they provide? In short, have we abandoned both consumers and agency staff in favor of paper realities that see people as mere data elements in a report? How well does the system do in conforming to our principles of consumer cooperation?
ACB has carefully constructed principles of consumer cooperation that provide for balance, consumer input, equality of opportunity and joint effort with agencies. Some are doing well with this and others remain unclear. No matter what other considerations may be included in the mix, these principles of best practice will have great impact on our activities with respect to reauthorization. Are resource, personnel, and other systemic issues being addressed?
There is no question that the resources available to the rehab system are hardly adequate. Neither is there any question that personnel are too often asked to do a great deal of work with insufficient supports, low pay, and little recognition. Reforming rehab must address not only consumer issues, but in addition, any efforts at reform must honor all the good people who work so hard on our behalf. Even as this is true, we must seek management practices that empower line staff and decrease cost-intensive administrative practices that lead to inefficiency and delays. Highly prescriptive and process-oriented procurement practices are an example of where improvements can be made.
There are many more questions than have been presented here. We know, for example, that it is not useful either for RSA or for consumers of rehab services to have to rely on data that is consistently out of date. Why in an age dominated by I.T. professionals and an onslaught of information and data are we still relying on statistics which are years behind current realities? The law must ultimately facilitate a system that serves the needs of consumers in a way that attends to all the pieces of the puzzle, but if that is to happen then consumers, professionals, administrators and all other concerned parties must gather at the table and revamp the system itself.
ACB does not have all the answers, but in partnership with all who care about building a first-rate rehabilitation system, we can get there.