Perspectives: NDEAM and the Role of Vocational Rehabilitation Counselors (Part 1 of 2)

Author’s Note: On Sept. 26, 2023, the U.S. celebrated the 50th anniversary of the Rehabilitation Act of 1973, also known as the “Rehab Act.” The Rehab Act was the first bill in Congress focused on addressing the need for equal access for people with disabilities. The Rehab Act requires elimination of accessibility barriers in the areas of employment, transportation, and physical access. In addition, this law also created rights for the disability community. Section 503 of the Rehab Act requires employers under federal contract to take “affirmative action to hire, promote, and retain employees with disabilities.” (Source: Department of Labor)

The National Disability Employment Awareness Month (NDEAM) theme for 2023 is “Advancing Access and Equity: Then, Now, Next.” The Office of Disability Employment policy will use this year’s theme to celebrate the 50th anniversary of the Rehab Act and promote events marking its anniversary. The Rehab Act is what paved the way for the Americans with Disabilities Act of 1990. One of the major parts of the Rehab Act is that it set up grants to states for independent living services, supported employment and vocational rehabilitation services, client assistance programs, and more.

However, when it comes to equity and employment for people with disabilities, there are a number of improvements needed. Some of these improvements should happen at employment support provider level, others at the employer level, and still others at the systems level.

In Part 1 of this 2-part blog post, we will focus on recommendations for improvements at the level of employment support providers, sometimes called vocational rehabilitation (VR) counselors.

Vocational rehabilitation (VR) is a major funder of employment services for people with disabilities. While VR has been around since the 1920s, some people with disabilities still have unsuccessful outcomes despite receiving VR services. This is especially true for people with intellectual / developmental disabilities and autism, who still face major hurdles in our society to achieve real jobs for real pay. Data suggests that people with autism had the highest rate of unsuccessful cases.

In order to better support people with disabilities, VR needs to become more person-centered. Some potential solutions focus on the level of the vocational rehabilitation providers, while other solutions are focused more on VR agencies and state services systems.

First, solutions that VR counselors can adopt to promote more person-centered employment supports include:

• Do not insist that people with disabilities choose career goals based on what’s written in occupational outlook books or briefs on what jobs are fastest growing over the next 10 years.
• Focus on meaningful careers, not just jobs. A career is what someone does for a living. It is focused on something a person with a disability has a passion for. One example is disability policy advocacy, in my case. A career comes with opportunities to grow and benefits like paid time off. It is in an area and with a business that values people with disabilities. A job provides a paycheck and a place to go every day to make money. It may not always be in an area a person has a passion for. A job for a person with disability is often in food services, sanitation services or “filth,” flower shops, or filing related activities (also known as the 4 F’s of disability employment: food, filth, flowers, filing).
• Train VR staff on how to get creative and encourage the people they serve to take advantage of and use work incentives to support people with disabilities in attending college, starting their own businesses, and having careers, not just jobs. Work incentives include SSDI subsidy, IRWE-Impairment Related Work Expense deductions, PASS plan, etc. Additional training requirements for all VR counselors should include customer-focused job development and person-centered practices.[ii] 
• All VR staff should be trained on presuming competence, having high expectations, and teaching us and our families how to dream big about employment goals. Schools and providers must embrace high expectations and use strength-based methods rather than the deficit or medical model of disability. Professionals must project hope from the time children with disability are born until the time they graduate high school and move into adulthood. Disability is a fact of life; as the COVID-19 pandemic has shown us, anyone can become disabled at any time. More often than not, when we set low expectations, it limits our quality of life. There is more to life than staying home, collecting benefits, and living with family isolated from the rest of world. Overprotection is harmful to our mental health in the long term.
• Invest in peer mentoring where disability providers hire people with disabilities to support others with disabilities. This will allow VR to support peer mentoring programs, and peer run employment support groups for those who are unemployed or under-employed. It also is a great a way to presume competence because it promotes hiring people with disabilities by state employment networks.

While these recommendations have the potential to generate more person-centered VR supports, they may not get much traction without parallel system-level supports, such as:

• Increasing wages for VR counselors to address staffing shortages.
• Increasing access to VR and employment support services for people who are on waiting lists for HCBS.
• Developing programs for employment supports for individuals who are interested in self-employment or gig economy careers.
• Moving away from the “Place and Train” model of service that sticks people with disabilities in any job. This model is centered on employers rather than on the personal needs, choices, or goals of people with disabilities.
• Giving money to self-advocacy organizations to facilitate peer-led job clubs and Hire Up programs that support people with disabilities who are unemployed or underemployed in overcoming challenges.
• Changing the name of the Division of Vocational Rehabilitation to HireAbility to better reflect what they do, which is supporting people with disabilities to get jobs and increase economic independence.

Some states are adding benefits to the Medicaid state plan, like the Community First Choice Option waiver, but in states like Maryland, someone like me is still unable to get supports. Adding HCBS services to the state plan is a perfect solution, but it must have looser criteria and not be based solely on medical needs or nursing level of care. 

While we have come a long way in advancing equity in disability employment for some, we still have a way to go in improving employment outcomes for adults with autism and other developmental disabilities. Given how the pandemic has opened the door to remote work, now is a perfect time to invest in initiatives that prepare people with autism and other disabilities for professional roles. Lastly, our system needs to support career advancement. The time is now to invest and expand job coaching so that all people with disabilities can experience meaningful work.

i https://www.crisoregon.org/cms/lib/OR01928264/Centricity/Domain/45/Documents/32IRI_autism.pdf

ii https://rrtc.vcu.edu/news/customernl.htm