Promoting Employment of Urban Indian Center Customers with Disabilities Through Effective Referrals to State Vocational Rehabilitation Offices

Census 2000 found that more Native Americans (66%) live in urban areas than in outlying rural areas. It also found that, as a group, Native Americans have one of the highest disability rates at 24.3% (U.S. Census: Facts for Features, 2003). A good number of these seek services and supports from urban Indian centers. For many of these individuals getting, and maintaining, a good job is a high priority. Yet this does not mean they know about, or use, state vocational rehabilitation (VR) services as often as they could.

American Indians living in urban areas may also be under-represented in state-run VR service programs. One step to improving employment outcomes for Native Americans in urban areas is to develop effective referral procedures to local VR programs. This Practice Guideline first describes in general terms the vocational rehabilitation process. It then suggests steps urban Indian centers (UIC) can take to make effective referrals to local VR programs.

What is Vocational Rehabilitation?

Vocational rehabilitation can be thought of as a process to guide people with disabilities into getting a job. VR is not that simple, though. The VR process can be broken down into a set of stages, which usually do not overlap, especially in the initial stages. The seven stages are: Application, Eligibility, Assessment, Writing an Individual Plan for Employment, Services Provided, Job Placement, Follow-up and Case Closure.

The Stages of Vocational Rehabilitation

Application: It is necessary for a consumer to come to the VR appointment prepared. Applicants should bring any documentation pertaining to their disability, including documents from the Social Security Administration, doctors, hospitals, therapists, counselors, schools, teachers or any other professional familiar with their disability history. Applicants should be ready to sign release forms for confidential information so the vocational rehabilitation counselor may give full consideration to all of the applicant's challenges.

Eligibility: There are four basic questions for determining eligibility: 1) Does the
applicant have a physical or mental disability? 2) Is the disability keeping the applicant from working? 3) Does the applicant really need vocational rehabilitation to get a job? And 4) Will the applicant be able to benefit from the services available?

Assessment: The VR participant goes through a vocational assessment process to find the "right job." This may include a battery of physical and mental measurements, as well as general work related tasks and concepts. Besides numerous standardized tests, the assessor may document the participant's ability to show up on time, follow directions, stay on task, get along with others, and be groomed appropriately. It also offers an opportunity for the counselor to indicate any "red flags" to employment such as inappropriate acting out behavior or hygiene issues.

Writing an Individual Plan of Employment (IPE): The IPE is a contract between vocational rehabilitation program and the participant. It outlines the consumer's
goals and the steps necessary to reach the desired outcome. A typical IPE states the consumer's goal, followed by the reason for the need for VR, a list of the consumer's strengths to build upon, and finally the actual Plan to reach the goal. The action to be taken, who is responsible, what the VR participant will do, what the VR office will do, what other outside resources will do and a deadline for completion or re-evaluation are listed in each step of the Plan.

Services Provided: At this stage, the consumer is actively involved in acquiring the resources required to perform the job targeted in the IPE. Services can take many forms, such as education, training, acquiring tools or adaptive equipment, or technology.

Job placement: The consumer is taught job seeking skills and conducts a job search, and/or is directly placed into an opening which the VR agency has found available. This step is largely dependent upon the consumer's ability to process the tasks associated with the job application process.

Follow-up and Case Closure: Typically a VR participant's case is closed after 90
consecutive days of gainful employment. The successful closing of a case is usually an agreed upon measure between the counselor and participant.

Establishing a Referral Relationship Between an Urban Indian Center and VR

An effective referral relationship starts before the VR participant is identified. An initial meeting between the urban Indian center and VR staff and supervisors will allow for an understanding of each cooperating agency's programs, resources, and guidelines. As part of this meeting, the urban Indian center can clarify eligibility criteria for the State VR program; learn about the types of services participant may be eligible for; create a client flow of how VR consumers are going to be referred to the state VR; and understand the grievance procedures which the VR participants have available to them.

At this point, it is important to specify how confidentiality will be maintained for the VR participant. Include examples of releases of confidential information. To cover each program the participant will probably sign a release form for both the State VR office and the UIC. Without these in place the UIC and the VR office are not able to openly communicate about any mutual consumer's progress. The Release of Confidential information is useful as a tool for the annual report since it allows for both service providers to count case closures by acknowledging if consumers got a job and whether or not their case was closed. Also, it may help to alleviate the potential for the consumer to window shop for services.

Making Referrals to Vocational Rehabilitation

The first step to making a referral to the state VR is to identify the urban Indian center client who is interested in obtaining VR services. It is up to the urban Indian center employee to be aware of, and to offer, the State VR services to the potential candidate. They should also be able to explain what to expect as far as the process.

At this point, the UIC representative should call their VR contact and review the client's request to insure that the client is, indeed, eligible for VR services. This will help reduce the possibility of a client "getting the run around." It also prepares the VR program to expect a new referral and will ease that person's entry into the system, because it will allow for the state to make sure they have a time slot available in their calendar for a new participant.

With the participant's approval, a mutual meeting with the three (participant, UIC
employee and the VR counselor) may be set up after assuring that Release(s) of
Confidential Information have been signed. Finally, the State VR counselor meets with the urban Indian center staff member and the potential VR consumer for a warm handshake introduction.

In the best interest of customer service it would be helpful if the UIC staff follows up with phone calls to ensure that appointments are being kept and deadlines met. If appointments are missed, find out why and try some problem-solving solutions such as teaching the participant to use the local transit system, wear a watch or use a daily planner. Take some time to analyze any culturally sensitivity issues that may be overlooked. Each participant is an opportunity for growth and strengthening of the bond between the state VR program and your local UIC.

For information on cultural sensitivity training for state VR offices, contact AIDTAC for a list of trainers and or referral sources.

Conclusion

The local urban Indian center may be an effective conduit for the state VR system, if it follows-up with their consumers after referral. If the UIC is able to verify that the consumers they referred to the state VR are seeing results, it will ultimately reflective positively on that UIC. More importantly, American Indian people with disabilities will be better served.

Resources

Client Assistance Program (CAP), established as a mandatory, federal program, it assist people "in pursuing administrative, legal and other appropriate remedies to ensure their protection" when obtaining or looking for VR services. To access a list of CAP offices, go to http://www.nau.edu/ihd/natcap/Resource/resource2.html or ask your VR counselor.

State Vocational Rehabilitation offices may be found on the Web at:
http://janweb.icdi.wvu.edu/SBSES/VOCREHAB.HTM or check your local phone book.

Tribal Vocational Rehabilitation offices may be contacted at: http://www.canar.org/map.shtml

References

U.S. Census Bureau, Facts for Features (2003, November). American Indian/Alaska Native heritage month: November 2003. Retrieved September 4, 2003 from http://www.census.gov/Press-Release/www/releases/archives/facts_for_features/001492.html