A White Paper of The American Council of the Blind
Why this White Paper?
The rehabilitation system is complex. Various funding streams deliver components of the system as a whole. Advocacy organizations have tried to change specific areas of the system without an overview of the effects to the larger program, and with varying results. The Workforce Innovation and Opportunity Act of 2014 (WIOA) is a perfect example of a well meaning, but flawed attempt to upgrade rehabilitation services and results. The flaws in the WIOA reauthorization are never more apparent than its consequences for people who are blind or have low vision. The American Council of the Blind wishes to educate and advocate for a more equitable rehabilitation system for our constituent community. For example:
- Just as physically disabled Americans move smoothly from medical interventions to adaptive equipment and therapy, so should newly blind and low vision patients be referred to resources where they can find and learn to use adaptive equipment and techniques to return to participatory, independent lives in their communities.
- Just as Americans can receive goods and services to improve their health and well being from Medicare, so should blind and low vision citizens be able to obtain equipment through Medicare that improves their ability to function independently, and with some measure of personal security.
- Just as disabled children are guaranteed a free, appropriate, quality public education, so should all Americans, regardless of age, be guaranteed free, appropriate quality rehabilitation.
- Just as in the mainstream workforce jobs are judged on the basis of wages, benefits, and upward mobility, so should Ability One jobs and workplaces be judged on these same criteria for determining successful placements by the rehabilitation agencies.
- Just as other training-to-work programs are monitored for quality of service and appropriate use of funding, so should the Randolph-Sheppard Priority be maintained and strengthened to serve blind and low vision students and job seekers.
- Just as veterans have received special attention to overcome society’s reticence in re-immersion and employment, so should attention be drawn to the capabilities and positive contributions of blind and low vision citizens to break down the prejudices that are, in many cases, the largest barriers to full inclusion and employment.
The American Council of the Blind offers this comprehensive overview to be used by its advocates, its affiliates, its stakeholders, and its partner organizations to help them educate and advocate for a system that will provide humane, meaningful, lawful, and successful rehabilitation to people who are blind, have low vision, or have multiple disabilities.
A Very Brief History
The United States has a longstanding commitment to equality of opportunity for its citizens, regardless of race, religion, gender, ethnic origin, and disability regarding employment, housing, health care, education, access to public programs and services, and access to commercial establishments, products, and services. After both World Wars, the country focused on returning disabled veterans to their families and communities as fully participating and contributing members of society. Although imperfect in implementation, this commitment is at the bedrock of American law and culture. As part of that commitment, our government has upheld and encouraged an informed electorate, and the literacy that provides access to information.
In 1973, the Rehabilitation Act set up the Rehabilitation Services Administration (RSA) within the Department of Education as the entity to oversee funding allocations to each state for the provision of rehabilitation services. From the beginning, Congress declared that rehabilitation was to be client centered. This concept was reinforced with the 1998 Amendments which introduced the focus on a client’s “informed choice.” The goals of this plan are developed "consistent with their strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.” Clients were to have input throughout their rehabilitation process, from the formulation of the Plan, through all phases of its implementation. The agency’s responsibility is to offer information and suggestions that the client can choose between. However, program implementation during the same time period has been steering funding increasingly toward vocational outcomes. And, ultimately, with the WIOA reauthorization of 2014, what used to be a Rehabilitation Plan based on a client’s abilities and interests became a demand for a choice between a vocational track before the client had any understanding of what their capabilities would be, or nothing.
Differences in Funding Streams and Service Delivery
Rehabilitation services have been provided differently for people with physical disabilities than people with sensory disabilities. For people with physical disabilities, most pre-employment skill rehabilitation services are provided and paid for in the medical/insurance model with which we are all familiar. This means that medical interventions, physical therapy, occupational therapy, assistive technology, and training are all covered by Medicare and other insurances. Therefore, when these clients entered the rehabilitation system, they were ready for specific vocational readiness skills and job placement services.
On the other hand, those citizens with sensory disabilities, those who are blind, low vision, or deaf/blind, are served differently. Once medical interventions have been exhausted, eye care professionals release the patient, almost always without any guidance on where to find followup services. Insurances do not cover orientation and mobility, daily living skills, and assistive technology acquisition and training. Nowhere is this disparity more evident than the decision by the Centers for Medicare and Medicaid Services (CMS) in the early 2000s to exclude from reimbursement any equipment that uses a lens. For those who are deaf, hard of hearing, or deaf/blind, quite often Medicare does not cover hearing aids. A person who loses a limb has medical support, is automatically given physical therapy, is fitted with a prosthesis, and given occupational therapy to learn how to best use this new piece of equipment in their daily lives. And most or all of this is paid for by insurances. Because there is no insurance coverage for non medical adaptation services, at the point of release from medical services, most legally blind citizens cannot read standard print, cannot get around by themselves, cannot use computers or phones, nor can they cook and live independently. They are functionally illiterate, isolated, and do not know where or how to get help. Adults who have used their vision to navigate their lives and careers are no longer able to depend on their vision, and have to find alternative ways of living. This disorientation, almost always, causes loss of confidence and self esteem. If they find rehabilitation agencies through hard work and luck, they are not even ready to think about vocational readiness skills because they have not yet received even the most basic living skills to keep them out of costly institutions.
What is indisputable is that people who have recently experienced the loss of most or all of their vision need to learn adaptive skills different in kind from other disability groups. Certified professionals are necessary to deliver categorical services to blind or low vision clients, covered by insurances, regardless of age or vocational outcome for the purpose of returning them to independence and a participatory, contributing lifestyle in society.
The disparity in service delivery sometimes effects policy and program development and implementation at the state rehabilitation agency level. Although research suggests that blind and low vision clients are more successful in rehabilitation agencies focused on their specific skill acquisition needs for the obvious reasons outlined in the paragraph above, over one half of states have combined service provision for all disabled clients into one general agency. There are ten times as many clients with physical disabilities as there are with sensory disabilities, so the differences in service provision can get lost when formulating governmental policy. There are places where combined agencies are managed by people who may not be aware of, or interested in understanding the different models of the service delivery continuum. There have been professional counselors without specific certification or experience making unfortunate career path and training decisions for blind, low vision, and deaf/blind clients which diminishes outcomes. These mismatches may not occur frequently, but when they do, the results are devastating to those effected, and should be addressed.
One of the key elements of the Rehabilitation Act is the establishment of State Rehabilitation Councils (SRCs) for every rehabilitation agency regardless of their composition. These citizen councils have specific, mandated oversight responsibilities to ensure programs and services are meeting the needs of constituents. The designated stakeholder seats on SRCs are by gubernatorial appointment. An SRC’s ability to accomplish their responsibilities is partly dependent on the number of appointees available to do the work. Across the country, we hear time and time again that seats on SRCs go unfilled for far too long to be able to execute their vital oversight roles. Short of withholding federal funding, which would be highly counter productive, there seems to be no effective avenues of enforcement to ensure that governors fulfill this important appointment function.
The Myth of Integrated Employment
If a blind or low vision citizen is one of the 50% of clients who come out of rehabilitation with a job in the “regular” workforce, what jobs can they expect to be doing? No authoritative research has been done in this area. But anecdotal evidence suggests that a large percentage of people who are blind or low vision working in mainstream companies are doing jobs associated with their disability. Many are working at jobs where they are doing accessibility issues of mainstream products and services, social services where they help temporarily or permanently disabled clients attain the goods and services necessary for living as independently as possible, and civil rights to support clients in receiving the goods, services, programs, and products governments and businesses are reluctant to make available and accessible on their own. Although the current status of these jobs are within mainstream corporations rather than the historical approach of these mainstream companies not acknowledging their responsibility to make things accessible for all people, and leaving accessibility of their products and services up to third party, retrofit solutions, it could still be argued that these jobs are not as “competitive and integrated” as true integration would demand. They are good jobs, and much better than nothing, but they hint at an underlying presumption that still exists that blind and low vision job seekers are not as competent as their sighted contemporaries to do the same kinds of work that companies require of their sighted employees.
JWOD/Ability One
In 1936, Congress passed the Javitz, Wagner, O’Day Act, now known as Ability One, that guaranteed that workplaces that employed 75% blind workers would have priority in being awarded government contracts. As society has evolved in their recognition of the capabilities of people who are blind or low vision, and as assistive technologies have progressed to allow equal access to do the same kinds of jobs as sighted workers, the Ability One program has allowed blind and low vision citizens opportunities for meaningful careers in a country where these workers are still not viewed as valued members of the mainstream workforce. Despite the evolution of Ability One workplaces, they are still viewed by many as inferior “sheltered workshops” evoking images of nineteenth century sweatshops where wages are sub-minimum. Although inaccurate, these perceptions persist and the RSA has persisted in excluding placements in these workplaces from constituting a successful placement, regardless of salary or other comparative factors. In fact, 1997 amendments and 2014 Workforce Innovation and Opportunity Act (WIOA) reauthorizations have continually emphasized the concepts of “competitive, integrated” workplace settings. No one would quarrel with these concepts as aspirational long term goals. But in an era of persistent seventy percent unemployment of disabled citizens looking for work, a fifty percent rate of successful job placements by rehabilitation agencies, and rising productivity through automation replacing jobs at every level of organizations, “competitive, integrated” mandates seem counter productive.
Randolph-Sheppard Priority
Also in the 1930s, Congress passed the Randolph-Sheppard Priority. This program prioritized vending, snack bar, and mess hall concessions on government and military properties for blind and low vision entrepreneurs. The Business Enterprisers Program (BEP) was established to train these blind vendors. Since its inception, the program has been subverted. Concessions have been contracted with commercial entities rather than continuing the commitment to blind and low vision vendors. The BEP, which in many cases is implemented through the state rehabilitation agency, no longer actively promotes young blind and low vision entrepreneurs into the program. Other recent issues within the program include:
- Both the Department of Defense and the Veterans Administration spend more time working to undermine the Randolph-Sheppard Priority for federal facilities than they do honoring it, thus depriving blind vendors of many lucrative sites,
- Each state’s autonomy causes fragmentation in program delivery,
- No federal funding is available so states use 110 funding and no accounting is required allowing states to be creative about using the funds for other programs,
- Some states rent Randolph-Sheppard facilities to non-disability corporations to secure funds for the 110 money,
- General Vocational Rehabilitation (VR) programs lack the initiative to provide basic life skills for newly blinded individuals, thereby seriously minimizing their ability to determine their path to employment let alone self-employment,
- Some states attempt to define "active participation" as "advisory.” Sovereign immunity allows less recourse for BEP Managers.
The Workforce Innovation and Opportunity Act of 2014 (WIOA)
This reauthorization was written to address and update perceived shortcomings in the Rehabilitation Act. Some of the assumptions that seemed to underly revisions were:
- The government has extremely limited responsibility in providing rehabilitation services to people who lose substantial vision as adults unless those citizens are interested in going back to work,
- The decades longstanding figure for unemployment of disabled Americans is still 70%,
- The decades longstanding success rate of job placement by rehabilitation agencies has been 50%,
- Disabled students graduate from schools and go onto Social Security for the rest of their lives,
- Quite often, there is not enough money to serve vocationally oriented clients, and money is still spent on non vocationally oriented clients
- Money is being spent on older individuals who experience blindness or low vision, and who have supposedly finished their contributions to society through work,
- Vision rehabilitation professionals are perceived as less valued than occupational therapists, are paid less, and are too few to meet demand.
At the time WIOA was written, the differences between services provided to physical and sensory disabled clients were ignored, so that well-meaning legislators and administrators have actually done harm to citizens in their attempts to do better. There are some perceptions that are false, and large assumptions of causality that are faulty. Certainly, the current outlook for disabled citizens in general, and blind and low vision people in particular, is dismal and needs work. But the wrong work will only lead to failure and frustration, whereas the right work, while hard, will fulfill the American Dream in ways not conceived of in the past.
WIOA’s Largest False Assumption
The so called remedies in WIOA are based on the assumption that rehabilitation was faulty. The assumption seems to say that if more and better rehabilitation services were provided, disabled clients would get more and better jobs. Therefore, if the Rehabilitation Services Administration (RSA) in the Department of Education (DOE) cannot provide adequate services, then expertise from the Department of Labor (DOL) should prepare clients more successfully. It also assumes that If the system focused on more rigorous standards, and rid itself or minimized allocations of funds for supposed extraneous programs such as nonvocational outcomes and keeping older blind individuals out of institutions, then fewer people would be served and better results would be realized.
Although there is always room for improvement, the barriers to employment of people who are blind or have low vision are not rehabilitation services. The barriers to employment of people who are blind or have low vision are in the minds of those who hire employees. The reason that there is 70% unemployment among people with disabilities is that people who hire do not think that people with disabilities can do the work as well as their sighted contemporaries. Until this persistent falsehood is eradicated from the public consciousness, there will be no meaningful progress in the statistics of unemployment, rehabilitation success rates, or young people on the Social Security rolls.
Victims of WIOA
As a result of falsely identifying remedies in WIOA, changes in rehabilitation service provisions have produced frustration, heartache, and loss of motivation for those seeking employment. Many have resigned themselves to SSI or SSDI after bumping up against the wall of prejudice too many times.
And for those who have not yet had the confidence to even try for an employment outcome, WIOA has thrown them out of the system. Not only do they experience the frustration and heartache of vision loss, but lack of services leave them in physical and social isolation, and functional illiteracy. This is not only a matter of misguided use of resources, it is a neglect of people’s civil rights.
Consequences of Current Rehabilitation Legislation, Regulations, Policies, and Practices
Pre-Employment Transition Services (Pre-ETS)
WIOA mandates 15% of rehabilitation funding is to be spent on secondary students through the age of 26 years old. This money is to be spent on these required five core areas: 1) job exploration counseling; 2) work-based learning experiences, including internships, that is provided in an integrated environment to the maximum extent possible; 3) counseling on opportunities for enrollment in comprehensive transition or postsecondary educational programs at institutions of higher education; 4) workplace readiness training to develop social skills and independent living; and 5) instruction in self-advocacy, which may include peer mentoring. The mandated skill acquisition covered under a blind or low vision student’s Individualized Education Plan (IEP) under the Individuals with Disabilities Education Act (IDEA) are an Expanded Core Curriculum which includes the following subject areas: assistive technology, career education, compensatory skills, independent living, orientation and mobility, recreation and leisure, self determination, sensory efficiency, and social interaction. Education and rehabilitation agencies are supposed to blend these services together for the improved success of disabled young adults in the job market.
However, for several years, the American Council of the Blind has proposed to Congress the Cogswell-Macy Act in an attempt to address weaknesses and gaps in service in the implementation of IDEA. Not only would the provisions of this Act fill service gaps, but it would also properly strengthen accountability of education systems around the country through IDEA and lessen the need for funding from RSA for skills which ought to be provided in students’ IEPs. The major consequence of the misguided use of funding is that rehabilitation agencies are not able to meet their service provision obligations to adult clients. Thirty-one (31) state agencies are unable to serve all of their currently eligible clients, and eight (8) agencies are currently unable to serve any new clients at all. This means hundreds, if not thousands, of people who have lost some or all of their vision are left on waiting lists for months and years with no skills, technology, or training to regain physical and social independence.
Post-secondary education to prepare citizens who are blind or have low vision for the workforce has shortcomings as well. Even though rehabilitation agencies fund trade schools and colleges/universities for eligible clients, these institutions are, at best, uneven in their commitment to accessible equipment, instructional materials, internet hubs such as Blackboard, classes, and testing. And because, quite often, post-secondary education happens in a different state than where the student attended secondary school, there is a lack of continuity Pre-ETS delivery.
And what of the efficacy of programs funded for these Pre-ETS services? Is skill acquisition leading to work experiences? Are work experiences leading to full-time employment? Millions of dollars are being spent on experimental programs. These programs have not yet been evaluated and formulated into best practices. But recent research by the National Research and Training Center for Blind and Low Vision at Mississippi State University suggests that constant, long-term awareness campaigns will be necessary to change the attitudes of hiring managers in the mainstream workforce. No amount of compensatory education will make blind or low vision job seekers equally or more attractive than sighted applicants until the underlying prejudices are addressed.
Loss of the “homemaker/unpaid family worker” closure
When first written, the Rehabilitation Act offered rehabilitation services to those who were not employed outside the home, but provided essential services to those in their family and home. This category could be considered a successful outcome, and full services could be expended for these clients. It will be no surprise that this closure was utilized disproportionately by clients who were blind or had low vision. As mentioned above, it often requires time, renewed competence, and renewed confidence for those adults who lose vision before they can assess their vocational interest, direction, and commitment. The homemaker closure provided an avenue for the client to adjust to their new life, and, quite often, after this adjustment period, they committed themselves to a vocational outcome.
In WIOA, the exclusive zeal for “competitive, integrated employment” excised the homemaker closure as a successful rehabilitation outcome. Potential clients who were unwilling to commit to a vocational outcome were excluded from receiving services. The consequences of this WIOA change are that clients who were vocationally ready receive services. Some clients declare a vocational outcome who are not really interested in employment so they can receive services. And those who do not declare a vocational outcome are denied services and are left with extremely limited resources to pull themselves out of functional illiteracy.
Independent Living Centers (ILCs) and Nonvocational Rehabilitation
ILCs were created to provide peer mentoring services for physically disabled citizens after their medical and insurance resources were exhausted. Many disabled citizens have received satisfactory support for both vocational and nonvocational outcomes through peer mentoring. They were not designed for, nor were they equipped to provide the kinds of in-depth services to clients who were blind or low vision who came to them other than some peer counseling on adjustment to being disabled. Even these sessions were not geared specifically to the special needs and concerns that accompany profound vision loss.
With the new provisions of WIOA, ILCs have been assigned the daily living skills component of vocational and nonvocational rehabilitation. Many ILCs, despite receiving additional funding, continue to be unwelcoming, unwilling, and unable to provide the specialized services to blind and low vision citizens necessary to fulfill these responsibilities. As a consequence, the state rehabilitation agencies must still provide daily living skill training to their vocational clients. For nonvocational clients, it is even worse. It has fallen to the ILCs to provide communication, orientation and mobility, and daily living skills (categorical services) to nonvocational clients. Most ILCs have been unable and/or unwilling to hire professionals to render these important services. So, if citizens who experience profound vision loss have chosen not to pursue a vocational outcome, the only place they have to turn to, the ILCs, are not providing the kinds of professional services so necessary to prevent blind and low vision citizens from becoming functionally illiterate, totally dependent on their family and friends, and isolated in their homes or institutions.
The Department of Labor and the “Ticket to Work” Program
Historically, people who had been rehabilitated with functional job skills were funneled into the Ticket to Work Program for job placement services. Until very recently, the computers in Ticket to Work centers available for client use had no software to make them accessible to blind and low vision clients. Even when the change occurred, only one computer in a center was equipped with the software. Not only did a blind or low vision client have to overcome the prejudice of hiring personnel in businesses, they had to overcome the same prejudices in the governmental centers supposedly helping them to get jobs. Obviously, the success rate for these partnerships was less than optimal.
WIOA assigned state Department of Labor agencies, State Rehabilitation Agencies,, and State Independent Living Councils to cooperatively create and implement the State Plan for the use of federal and state funding for rehabilitation. The first 2-year cycle of Combined State Plans have been submitted and implemented, and the second biannual Plans are being completed. Other than a few meetings of representatives of the three responsible agencies during Plan preparation, no one seems to know how much cooperation is taking place.
What we do know are the results. Before WIOA, successful outcomes of rehabilitation hovered around 50%. The recent figure is 52%. Time will tell if improvement continues and becomes significant. But advocates agree that the system is not yet significantly improved. Further, the diffusion of responsibility among the different state agencies has obscured accountability and oversight by citizen councils (SRCs) mandated by the Rehabilitation Act.
Independent Living Services for Older Individuals who Are Blind (OIB)
The federal government has long recognized its responsibility to people over 55 years old who have lost significant vision and who are not pursuing a vocational goal. However, over time, funding for this program has not changed despite dramatic increases in the numbers of eligible citizens. Nor is funding sufficient for equipment and training so that older citizens can stay independent in the 21st century. Skills at twisting a dial on a television receiver, or finding the right holes on a rotary telephone are no longer sufficient to keep seniors from being institutionalized. Nor are seniors with vision loss content to stay at home and wait for friends and good samaritans to come by for a visit. Many still want to engage and contribute to their communities, including the very American institution of volunteerism.
But governmental entities do not yet seem to value volunteer contributions to society. Even though this country would quite literally fall apart without its system of volunteers sustaining recreational and social services, to name just two areas, there is very little formal recognition of work done without monetary compensation. Currently, the OIB program provides approximately $525 for approximately 3% of seniors who qualify. In short, some of the consequences of current funding levels are:
- Insufficient funding to identify and encourage eligible citizens to take advantage of what the program has to offer,
- Insufficient professional practitioners to give the kinds of prompt, frequent training that would be necessary for successful skill acquisition,
- Insufficient funding to allow eligible clients to acquire appropriate modern communication devices and training, and
- Insufficient funding to help seniors equip their homes for independent living and prevention of institutionalization.
Again, it is necessary to reiterate that peer mentoring, while possibly successful for a very few, is not adequate for the majority of cases over the long term. To the contrary, since older learners have different characteristics than younger ones, the most effective approach would be to identify those characteristics and set specific certification standards for professionals working with older clients.
Eye Care Professionals and Rehabilitation Services
As mentioned above, the disparity of continuity between physical and sensory disability groups is unconscionable. Regarding vision, there is no smooth transition from when medical interventions are complete and a client’s adaptation to their new situation starts. Eye care professionals must see themselves as connected to rehabilitation and be able to steer blind or low vision patients in the correct direction. Whether funding for these services comes from the rehabilitation system or the insurance system is a matter for further discussion by stakeholders. But disregard for the futures of blind and low vision patients by eye care professionals cannot continue.
Suggestions for Equitable, Effective Rehabilitation for the Future
Continuity of services
Virtually every day, the American Council of the Blind receives calls from people who have recently lost profound vision or their concerned relatives or friends asking where they can get some help in dealing with their new life status. People with physical disabilities are smoothly and systematically moved from medical intervention to acquisition of equipment and training. People with sensory disabilities are rarely afforded the same care. This discontinuity in services must end. The abyss between eye care professionals and rehabilitation services must be bridged.
Adaptive Equipment Parity
People with physical disabilities receive adaptive equipment that matches their lifestyle and goals funded by Medicare and/or insurances. People with sensory disabilities are confronted with the CMS “lens exclusion” or denials of hearing aid reimbursements. This disparity in treatment must end. The ACB backed Medicare Demonstration of Coverage for Low Vision Devices Act is a possible first step to normalize adaptive technology coverage.
Baseline Rehabilitation
People with physical disabilities are not asked whether they are going to work before being fitted with a prosthesis. People who lose their vision are asked if they are going back to work before they are given orientation and mobility, daily living skills, adaptive technology or any kind of service. This disparity must end. A baseline level of rehabilitation for living independently in the 21st century should be established and provided for clients of all ages, “consistent with their strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.” After those basic skills are in place, then the client can make choices about whether to enter vocational rehabilitation or not.
Rehabilitation Practitioners
Successful rehabilitation starts with skilled professionals able to provide training on a regular basis. In many cases, because of low salaries and high case loads, new practitioners are not coming to the field. Also, some institutions where clients reside do not accept current credentials of rehabilitation providers into their institutions to provide services. In order to serve current and future needs, incentives are needed to attract and retain new professionals to the field. Parity with occupational therapists in credentials and salary would have the desired results.
Education, Rehabilitation, and Vocational Rehabilitation
Ideally, educators and rehabilitation professionals should be working together to prepare children who are blind or have low vision for life and work. Even before the WIOA revision of the Rehabilitation Act, ACB brought to Congress the Cogswell-Macy Act to help identify and address gaps in educational services, especially to those children who have multiple disabilities. Cogswell-Macy has not been passed. Instead, WIOA mandated that fifteen percent of rehabilitation funding must be expended on Pre-Employment Transition Services (Pre-ETS), in part to cover areas not adequately mastered under a student’s IDEA Individualized Education Plan (IEP). As a result, thousands of adults in 39 agencies are having to wait months and years to receive services to keep them independent and functioning. Everyone wants our children who are disabled to succeed. But more attention should be brought to the efficient interaction between the education system and the rehabilitation system. And beyond that, attention must be given to breaking down the barriers of prejudice in the hiring environment to avoid lifelong enrollees in the social security system.
Employment
It is not within the scope of this document to discuss the outlook for jobs in the future of “increased productivity” or, replaced workers at all levels of employment by increasing use of robots and AI. But, given the historical precedent that people with disabilities are “last hired, and first fired,” the question of how we as a country care for the increasing numbers of nonworking adults will need to be addressed in general, and specifically for vulnerable populations.
Since 2001, this country has extended a large commitment to the rehabilitation and employment of disabled veterans. If the same commitment of public relations assets and funds were devoted to uplifting the image of people who are blind or have low vision, there might be a real shift in their employability. Equitable education, quality employment preparation, and excellent rehabilitation skills are obviously very important, needed, and currently, not universally provided. But even those who have been lucky enough to receive and take advantage of quality preparation will not overcome prejudice in hiring.
Accept Ability One Placements as Successful Closures
It is past time to develop realistic criteria for differentiating dead-end, sub-minimum wage JWOD facilities from those JWOD facilities that provide decent work, decent wages, and training for upward mobility. The former should be encouraged to upgrade their programs. The later should be rewarded by being designated as acceptable placements for rehabilitation clients. At the same time, comparable businesses in the same areas as JWOD facilities should be targeted for the anti-prejudice program above to provide future employment opportunities.
Randolph-Sheppard Priority
Revive commitment to the Randolph-Sheppard/Business Enterprise Program in training and placements by:
- States should have reciprocity for prospective vendors moving from another state like other jobs, requiring testing and training on state laws,
- Requiring states to use 110 funds for specified purposes and vendor set aside fees only for BEP purposes and federal funding for expanding the RS Program based on the number of current facilities,
- Tightened rules on the time a sighted person can manage a new or interim facility,
- Rehabilitation agencies should utilize training programs in other states if they cannot provide the life skills training or use community colleges to supplement training in areas such as technology,
- RSA should enforce a more robust definition of “active participation” for all State Licensing Agencies (SLAs),
- Mediation and arbitrations between SLAs and vendors should be resolved more quickly.
- In the current- and post-pandemic world, many governmental workers and potential concession customers will continue working from home so the Randolph-Sheppard Program managers and government building managers will need to contemplate re-structuring office building vending locations to assist government leaders in minimizing the large congregation of staff in one location.
Maintain livelihoods of vendors and preserve vending services to building employees and visitors by evaluating alternatives such as:
- Converting cafeterias to Micro Markets with limited Hot Food for lunch,
- Adding mini micro markets around the facilities,
- Expanding selections in vending machines or breaking large vending machine banks, and spreading the machines on various levels,
- And most importantly, maintaining communications between SLAs, vendors, and building management teams.
Health Related Issue
One of the largest causes of vision loss is diabetes. Thousands of children and adults are trying to manage this disease to prevent further loss of vision, and more health care and institutional expenses. After years of approaching the vendors of diabetes related monitoring and insulin delivery systems to ask them to make this equipment accessible, ACB has offered the Accessible Durable Medical Equipment Act in Congress. The accessibility technology is readily available now. This Act must be passed to mandate what should be seen as basic consumer rights and responsiveness by the manufacturers, but, to this point, is not.
Specialized Credentials for Rehabilitation Professionals Working With Older Clients
Just as there is a difference in service delivery between children and adults, so there should be between adults and older adults. Learning and technological capabilities will differ between younger and older rehabilitation clients. To ensure successful rehabilitation for all, not only should rehab professional credentials be upgraded, we should add specialization certification of rehabilitation professionals for service delivery to older citizens who lose vision.
Make Agencies Coordinating Services at the State Level Accountable to Citizen Oversight Bodies
As mentioned earlier in this document, WIOA divided responsibility for delivering rehabilitation services between state agencies associated with the Department of Labor, the Rehabilitation Services Administration, and the Independent Living Centers. The State Rehabilitation Councils (SRCs) mandated by the Rehabilitation Act were designed to be more than Advisory Councils. They were to provide guidance and oversight of agencies licensed by RSA to deliver rehabilitation services. Currently, SRCs have no access or comparable oversight of the Labor and ILC rehabilitation functions. The ACB believes that this diffusion of citizen oversight is inconsistent with the spirit and intention of the original Rehabilitation Act. If the responsibilities for service delivery is going to continue to be shared, ACB calls on Congress to mandate appropriate opportunities for SRCs to interact with representatives of all responsible agencies on a regular basis to ensure proper coordination across agencies.
The composition of these citizen oversight councils is mandated in the Rehabilitation Act. Approximately fifteen (15) seats are allocated to different stakeholder groups to try to ensure a broad perspective to agency oversight, and to accomplish the Council’s mandated functions. However, governors and their designees who are tasked with appointing citizens to these Councils are notorious for being slow or negligent in keeping the seats filled. It seems that the only recourse RSA has to enforce compliance is to withhold funding, which does no one good, and which is almost never formally used. ACB would like to see compliance enforcement measures put in place that does not jeopardize client outcomes, but puts more pressure on the state and the agency to live up to their responsibilities to their clients and disabled citizens.
Conclusion
Even before the passage of WIOA, too many people who are blind or have low vision were not adequately served, “consistent with their strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.” Thousands of people eligible for rehabilitation services were not being directed to the rehabilitation system and getting the services they needed. Even for those citizens who found and entered the system, half of the clients who wanted to work, including young people transitioning from school, were not getting jobs. Clients who were not ready to look for work, including people over the age of 55, were not receiving equipment and training to live participatory lives independent of institutionalization. Ability One jobs were not considered jobs. Commitment to the Randolph-Sheppard Priority was eroding. And rehabilitation professionals with too large case loads and inadequate salaries, were under increasing pressure to close cases.
And then came WIOA. The “improvements” may have helped some groups of disabled citizens, but it was disastrous for people who are blind or low vision. Practitioners came under even more pressure to close cases, but only if the jobs were competitive and integrated with the job seeker’s non-disabled peers. Nonvocational rehabilitation went away, except for a pittance provided citizens over 55. 15% of rehabilitation funding was mandated to shore up inadequate special education services. Thousands of eligible citizens sit, illiterate and isolated, because of the 15% mandate. Oversight power of the SRCs has been eroded by the diffusion of responsibility between state agencies.
Erroneous assumptions and misdirected remedies are doomed to failure, and in the meantime, citizens who are blind or have low vision are, in many cases, being negatively impacted. It is time to reconfigure the rehabilitation system to capture, encourage, and include all citizens who approach or qualify for rehabilitation services. It is time to re-envision the rehabilitation system to provide adequate equipment and training to uphold an independent, participatory lifestyle for every eligible citizen. It is time to change the workplace culture and overcome the underlying prejudice that prevents people who are blind or have low vision from full inclusion in the workforce. In short, it is time to recommit authentically to the original intent of the Rehabilitation Act for each blind or low vision client: The goals of this plan are developed "consistent with their strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.”