Academic journal article The Journal of Rehabilitation

Development of Community Follow-Up in a Comprehensive Rehabilitation Center

Academic journal article The Journal of Rehabilitation

Development of Community Follow-Up in a Comprehensive Rehabilitation Center

Article excerpt

The purpose of rehabilitation is to increase the independence of the person receiving services when he or she returns to the community, either through increased employment or improved daily living skills. To measure the degree of improvement in employment or daily living, follow-up is necessary. The Commission on the Accreditation of Rehabilitation Facilities requires follow-up as a part of the outcomes measurement of efficiency, effectiveness, and satisfaction. Accreditation bodies for vocational training such as the Southern Association of Colleges and Schools have recommended follow-up of employers of former students at least one year after employment. Recent drafts of proposed reporting requirements of the 1992 Amendments to the Rehabilitation Act necessitate more detailed information on the earnings, employment and satisfaction of former rehabilitation clients for periods up to three years.

Despite this increased emphasis on post-service assessment, there is little in the recent rehabilitation literature which describes the actual efforts of comprehensive rehabilitation centers to implement follow-up, to share information with rehabilitation counselors in the field, and the impact of follow-up on subsequent placement. Bolton (1981) provided the most comprehensive review of follow-up of vocational rehabilitation programs. In the studies he reviewed, about two-thirds of the former vocational rehabilitation clients were working and fifty percent of the former clients of workshops and comprehensive centers were employed. Sankovsky and Newman (1972), with a 70% response to a mail survey, found that two-thirds of those who completed vocational training in a comprehensive rehabilitation center were employed. Cook (1983) determined from a mail survey, that 70% of former clients at the Arkansas Rehabilitation Center had been employed after leaving the Center although not all retained employment. Chope and Reagles (1976) provided a check list for characteristics of successful follow-up studies, and Carle and Adler (1980) presented the model used in a rehabilitation hospital for patients with spinal cord injury. More recently, Bolton (1991) described the use of the Work Satisfactoriness Survey to assess the response of employers to client work habits, Closson et al. (1994) assessed follow-up by telephone for clients of a rehabilitation hospital, and Vogel (1995) summarized the use of employment commission data to track longer term employment of comprehensive center clients.

With the renewed emphasis on outcomes and accountability for a range of social and health programs, follow-up results have again become important, both to assess individual success and to increase client input into program and placement planning. Staff are interested in whether the rates of success for recent programs with a greater number of clients with severe disabilities and other social and psychological problems are similar to those found in the earlier studies of the 1960's and 1970's. In addition to profiling individual client success, follow-up information from the client and employer provides important input for program content to match workplace needs and for joint planning for successful community placement. This paper describes the steps in developing the follow-up process, the types of measures used, and the initial results.

Method

Description of Rehabilitation Center

Woodrow Wilson Rehabilitation Center (WWRC) is a comprehensive rehabilitation center which provides a spectrum of services including medical rehabilitation, vocational evaluation, training and independent living services for people with a range of disabilities. A division of the Virginia Department of Rehabilitative Services, WWRC serves approximately 3,000 clients a year from throughout the Commonwealth of Virginia and surrounding states and territories. Upon completing a program at WWRC, the client receives job placement and other services from the rehabilitation field counselors in the home community. …

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