ABSTRACT
National survey data reported by state MR/DD agencies for integrated and segregated employment and facility-based nonwork services provided during FYs 1988 and 1990 were examined. The percentage and total number of individuals in integrated employment grew significantly across the 2 years. However, there were no significant changes in the percentage or number served in facility-based settings. State MR/DD agencies continue to fund a dual service system, with the vast percentage of total resources allocated to segregated programs. Policy and funding incentives need to be developed to stimulate conversion of segregated services to integrated employment.
Subject(s)
Employment, Supported , Intellectual Disability/rehabilitation , Rehabilitation, Vocational , Sheltered Workshops , Adult , Cost-Benefit Analysis/trends , Disability Evaluation , Employment, Supported/economics , Female , Forecasting , Humans , Intellectual Disability/economics , Intellectual Disability/psychology , Male , Middle Aged , Rehabilitation, Vocational/economics , Sheltered Workshops/economics , United StatesABSTRACT
The current status of state mental retardation/developmental disability agency information systems related to day and employment programs for persons with disabilities was described, and data regarding the number and characteristics of persons served in different day-employment programs and the funding sources for these persons were summarized. Suggestions were made regarding data utilization and information systems design.
Subject(s)
Day Care, Medical , Information Systems , Intellectual Disability/rehabilitation , Rehabilitation, Vocational , Consumer Behavior , Humans , United StatesABSTRACT
This telephone survey of directors of 50 school-based clinics (SBCs) examined the influence of organizational factors on use of traditional funding sources, such as Medicaid and private insurance. These factors included: initial funding source (Robert Wood Johnson Foundation's School-Based Adolescent Health Care Program vs. comparison), administrative structure, age of clinic, and state Medicaid policy. Results indicated that over half (51%) of the clinics used Medicaid as a funding source to some extent, while fewer (32%) used private insurance. Use of Medicaid and private insurance, however, varied with the initial funding source, administrative structure, and age of the clinic. Initial funding source and age of the clinic were the strongest predictors of Medicaid usage. Barriers to traditional funding sources, as well as methods used to overcome constraints, are discussed. The importance of the link between a nontraditional health care delivery system, the school-based clinic, and the traditional funding sources of Medicaid and private insurance is examined in light of the organizational factors which facilitate this link.
Subject(s)
Ambulatory Care Facilities/economics , Ambulatory Care Facilities/organization & administration , Insurance, Health/statistics & numerical data , Medicaid/statistics & numerical data , School Health Services/economics , School Health Services/organization & administration , Fund Raising , Regression Analysis , United StatesABSTRACT
Data from two (1984-1985 and 1985-1986) national surveys of facilities providing vocational services to adults with developmental disabilities were used to analyze employment placement patterns and client-referenced outcomes. Most of these adults were working in sheltered environments; however, 17 to 19% of those served were placed into nonsheltered settings during the respective survey periods. Effects of individual and environmental characteristics on a variety of individual and facility-level employment outcomes were examined. Research and policy implications were discussed.
