Academic journal article The Journal of Rehabilitation

Reducing the Cost of Providing Supported Employment Services: A Preliminary Study

Academic journal article The Journal of Rehabilitation

Reducing the Cost of Providing Supported Employment Services: A Preliminary Study

Article excerpt

Since the 1980s, individuals with severe disabilities throughout the world have achieved competitive employment within their communities via supported employment programs. The supported employment process is traditionally broken into two phases. The first involves initial placement and training, where the supported employee is placed in a community-based position and taught how to perform the essential functions of the job. The second phase involves continued follow along services that help ensure the supported employee is able to satisfactorily maintain their position. In this stage, employment specialists may visit the supported employee periodically to provide additional training that the supported employee may need.

Before supported employment was officially defined in the federal legislation, research explored the financial implications of empowering individuals with disabilities to work within their communities (cf. Brickey & Campbell, 1981; Cho & Schuermann, 1980). Over three decades later, the consensus in the rehabilitation literature is that, in most situations, supported employment seems to be more cost-effective than facility-based vocational programs, such as sheltered workshops (Cimera, 2012; Kregel, Wehman, Revell, Hill, & Cimera, 2000). With this in mind, recent economic literature on supported employment has shifted away from exploring how much supported employment costs to how costs can be reduced while improving the outcomes achieved by workers with disabilities (e.g., increasing the length of time supported employees keep their jobs).

Many studies have explored how to improve the initial placement and training phase of supported employment. For example, several studies have examined the merits of utilizing "natural supports" when training supported employees (Cimera, 2001, 2007; Zivolich, Shueman, & Weiner, 1997). However, to date, no study has explored ways to provide more efficient and cost-effective follow along services. Given that follow along services may last for years, compared to only a few months of initial training, identifying a method of providing effective and efficient follow along service is paramount in improving supported employment programs as a whole. Moreover, as the amount of funding available to supported employment decreases, finding more effective and efficient methods for delivering vocational services is essential.

It is for this reason that this preliminary study explored a method of reducing the costs of follow along services while improving the vocational outcomes achieved by supported employees (e.g., wages earned, hours worked, length of employment). Specifically, in Wisconsin, follow along services can be provided by adult service agency staff (e.g., job coaches) or individuals who do not work for any agency (e.g., co workers, friends, family members of the supported employee).

Critics of Wisconsin's follow along programs may argue that individuals (i.e., non-job coaches) who provide follow along services are untrained and, therefore, could not provide quality services. They may even suggest that there is a risk of exploitation; that is, friends and family members may attempt to become service providers solely for their own financial gain. Either way, supported employees may suffer.

Proponents of individually-provided follow along services argue that individuals agreeing to provide follow along services are more likely to know the supported employee on a personal basis than professional job coaches. Therefore, they would be more inclined to support and motivate the supported employee--which could result in better vocational outcomes at a reduced cost. Further, advocates argue that individuals providing follow along service would be more likely to have the supported employee's best interests in mind than agency-based job coaches who see the supported employee as a "client" rather than a person.

Clearly, many questions remain about the efficacy of "individually-provided" follow along services. …

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