Maine Division of Vocational Rehabilitation 
Comprehensive Statewide Needs Assessment
FFY 2012

October 1, 2012
Maine Division of Vocational Rehabilitation 
Comprehensive Statewide Needs Assessment
FFY 2012

Attachment 4.11(a) Statewide Assessment (full version comments)

Table of Contents

Executive Summary
I. Introduction:
A. Purpose of Comprehensive Needs Assessment
B. Description of Division of Vocational Rehabilitation and the Vocational Rehabilitation Process
II. BACKGROUND
A.  Maine’s Economy and Workforce
B.  Federal and State Landscape of Vocational Rehabilitation
C. Availability of Employment-Related Services to People with Disabilities in Maine
III. DVR SERVICES TO INDIVIDUALS IN MAINE
A. DVR Population Characteristics
B. DVR Process Flow
C. DVR Outcomes
D. DVR Services and Expenditures Costs
E.  DVR Consumer Satisfaction Survey:
F. Consumer and Stakeholder Input
IV. ESTIMATING POPULATION ELIGIBLE FOR DVR SERVICES AND UNMET NEEDS
A. American Community Survey
B. Social Security Recipients in Maine
C. Minority Populations in Maine
D. Students with Disabilities
E. Other Populations with Disabilities
V. COMPARISON TO OTHER STATES
VI. DISCUSSION
VII Recommendations
APPENDIX 1
APPENDIX 2

Executive Summary

The Maine Division of Vocational Rehabilitation (DVR) assists eligible individuals with disabilities to prepare for, achieve and retain employment in integrated community settings.  DVR administers the General Vocational Rehabilitation program in Maine for the Rehabilitation Services Administration.  A separate program is available to individuals who are blind or have visual impairments through the Maine Division for the Blind and Visually Impaired.  This Comprehensive Statewide Needs Assessment focuses on the General Vocational Rehabilitation program and on the needs of individuals eligible for those services.

The assessment, conducted jointly with the State Rehabilitation Council (SRC), is designed to answer important questions about the population eligible for DVR services that live in Maine and their vocational rehabilitation needs.  It serves to inform DVR’s strategic plan and goal development for the next three fiscal years, 2013 – 2015.  In its compilation, we rely on a variety of publicly available sources, including survey information from the United States Census Bureau and data from the Rehabilitation Services Administration and the Social Security Administration.  We gathered information from the Maine Departments of Labor, Education, and Health and Human Services, as well as numerous stakeholder groups, including people with disabilities, employers, and Vocational Rehabilitation counselors. 

Maine is a large geographical state, which spans 30,843 square miles.  The state is primarily rural in nature with a dispersed population of 1.3 million people and density of 43 people per square mile.  Census data available in 2010 indicates that the population is primarily homogeneous with 95% of the residents being white and a median age of 42.7 years.  At the time of this report, Maine was slowly rebounding from the 2007 to 2009 period of recession and seeing only modest improvements in the economy and labor market.  Historically, Maine’s economy has been based on goods producing industries, such as manufacturing and natural resources, but a trend to jobs requiring higher educational attainment in service producing, knowledge-based industries has been occurring over the last several years.

DVR provides vocational rehabilitation services to thousands of Mainers with disabilities each year, despite significant downturns in the economy and severe state budget shortfalls.  A major affect on the data and service provision during the past three years is that in October 2010 DVR successfully eliminated its waitlist in all three disability priority categories, which had been in place since 2001.  Between January 2009 and October 2010, DVR worked on streamlining many of its processes to increase efficiencies, contain costs, and contact many people who were on the waitlist (some of whom in categories 2 and 3 had been waiting for years), as well as those who had lost contact with the agency.  A large percentage of people were found to either not able or ready to re-engage with DVR at the time they were contacted, which clearly had a negative impact on our rehabilitation rate, but resulted in caseload numbers that were truly representative of active and progressing cases.

Individuals served by DVR remain generally very satisfied with the services that they receive and report feeling that they are treated with dignity and respect.  We have also received very positive feedback from providers, clients and our other agency partners that it is extremely helpful to all that DVR no longer has a waitlist.  In addition to the Market Decision, LLC, client satisfaction survey, we received valuable feedback by working with our SRC who conducted a facilitated public forum and developed an ongoing client satisfaction survey that is maintained on their website.  The public forum provided us with some targeted constructive feedback about the DVR program, including transition services, job development and consistency of services.  

In terms of case service expenditures, job development and placement continues to be the largest single service group, representing 20 to 26 percent of total DVR case costs each year.  A number of service groups saw large decreases, including maintenance services, transportation costs, and diagnosis and treatment services.  DVR has seen a drop in the cost of College or University Training, and Occupational/ Vocational Training as well.  Several specific new procedural directives were developed for counselors as guidance in determining that all financial assistance provided is directly related to a specific employment goal and absolutely necessary for an individual to obtain and maintain employment.  

In identifying the general population eligible for DVR services and estimating unmet needs of those with significant disabilities, this report used data available through the American Community Survey, the Social Security Administration, and the Maine Departments of Education and Health and Human Services:  

•	At the end of FFY 2010, DVR had 6,311 individuals in an active case status.  

•	For that same year, the ACS estimated that there were approximately 73,000 working-age adults with a disability who were not employed. 

•	Data from the Social Security Administration provided an estimate of 74,729 beneficiaries who would meet the DVR eligibility definition of “substantial impediment to employment.”  

•	Approximately one-third of DVR’s total caseload is students transitioning to adulthood. Of DVR’s sixty-six vocational rehabilitation counselors, twenty-five are assigned to school systems and working with youth in transition. 

The Maine Department of Education reported an anticipated need of employment services in 2010 for 10,504 special education students, ages 14 – 20, of which those with learning disabilities and physical impairments were the largest disability populations.  That noted, Maine, like the rest of the United States, is experiencing an increase in the numbers of individuals identified with Autism spectrum disorders and the most significant percentage of that increase has been in Lincoln, Hancock, and Waldo Counties – along Maine’s mid-coast.

•	The Department of Health and Human Services (DHHS) is a growing partner in the support and delivery of employment services for people with disabilities although recent staffing and funding cuts have negatively impacted access to services for people with mental illness, developmental disabilities and brain injury. 
o	DHHS supports approximately 4,700 people through a Center for Medicaid & Medicare Services 1915c Waiver, which allows individuals who have been found eligible for the Office of Adults with Cognitive and Physical Disabilities Developmental Services to become prepared for employment through Community Supports Services that can assist the person to volunteer, increase work-readiness skills and address issues of health and safety. Developmental Services provides on-the-job support through the waivers to about 900 people who are working throughout Maine and there are approximately 3,000 working-age MaineCare waiver recipients who are not working. Among those individuals, employment and referral to DVR are revisited during the person-centered planning process at least annually and DVR has seen an increase in referrals since the last assessment. Unfortunately, however, Developmental Services has a waitlist for individuals coming out of the school system to access waiver services, which impacts clients being able to obtain necessary long term supports after DVR services are provided.  

o	In addition to providing ongoing support to over 200 employed individuals with mental illness, the Office of Adult Mental Health Services at DHHS has a number of initiatives that promote employment among the individuals they serve. These include providing funding for community mental health agency employment specialists, as well as expanding the use of a clubhouse model to achieve community-based employment outcomes in three locations across the state.

Vocational rehabilitation services to minorities with disabilities in Maine have always been a challenge to DVR because of the state’s homogeneous population and low ethnic diversity.  In a state that has little statistical diversity of minority populations, Native Americans represent a historically recognizable group and DVR continues to work collaboratively with the Houlton Band of Maliseets, which was awarded a five year Section 121 grant in FY 2008.  The population of other minority groups is slowly increasing in Maine through resettlement programs and migrant employment, and DVR could do some more targeted outreach to help in the awareness of the program’s availability.  A vast majority of DVR’s population is white with only 3% being identified as a minority, which is in comparison to the 6% identified in the American Community Survey.

In addition to the unserved and underserved populations identified above, this assessment also gathered data and provided information on the anticipated vocational needs of incarcerated individuals with disabilities, older workers, veterans, those receiving Temporary Assistance for Needy Families (TANF), and individuals who are deaf or hard of hearing.  

Co-location in Maine’s network of Department of Labor (MDOL) One-Stop CareerCenters has provided DVR the opportunity to work in partnership with a number of other programs that are components of the statewide workforce investment system and can support the employment of people with disabilities. In October of 2010, DVR assisted MDOL’s Bureau of Employment Services in obtaining a Disability Employment Initiative Grant to continue work successfully started under Maine’s Disability Program Navigator Grant. Designed to promote employment through increased access to CareerCenter services and programs in targeted regions of the state, Maine’s DEI grant work includes increasing the number of CareerCenter locations that can accept Tickets and provide Employment Network services under Social Security’s Ticket to Work Program to beneficiaries.  The CareerCenters also have a number of other employment programs that could serve people with disabilities, such as the Maine Job Bank, a new online accessible CareerCenter tool that allows jobseekers from around the state to be matched with real-time available positions. Although the CareerCenter data is reliant on self-disclosure of disability, participation by job seekers with disabilities is low among the MDOL programs with 6.6 % of total Job Bank registrants and 3.2% of all individuals served under the Workforce Investment Act being identified as having a disability.  Among those that exit CareerCenter services, the entered employment rate for individuals with disabilities is 66.7% - compared to 73.8% for public assistance recipients or 84% for veterans. Only older workers enter employment at a lower rate – 64.3%. Average earnings reveal a similar picture with individuals with disabilities earning only $7, 325 compared to $9, 853 for public assistance recipients or $ 12, 401 for veterans.

DVR’s assessment also considered the need to establish, develop, or improve community rehabilitation programs (CRPs) within the state and generally found that the vocational needs of DVR clients are being met although a joint DVR CRP project was underway at the time of this report to improve the employment outcomes of clients receiving CRP services.  Surveys of VR counselors and CRPs did note the negative impact of high VR caseloads and hiring freezes on managing cases and supporting CRP referrals with informed client choice, as well as the inherent challenges of job placement in a large rural state during an economic recession.  Ongoing professional development for CRPs was identified as important, including disability-specific training on autism, mental health, brain injury and deafness, and there were concerns voiced about insufficient CRP’s that are fluent in American Sign Language.  The needs of employers were also considered, including their perceptions of how DVR and CRP services are beneficial in hiring and maintaining qualified workers with disabilities.  Since DVR’s last statewide needs assessment, BRS has dedicated a half-time position to develop its relationships with employers and serve as the agency’s single point of contact.  

In conclusion, the Division of Vocational Rehabilitation completed a major initiative in 2010 to eliminate its waitlist for all individuals eligible for VR services. The significant unmet vocational needs of Mainers with disabilities identified in this Comprehensive Statewide Needs Assessment  lends strong support to the importance of continued effort to sustain no waitlist and to further target several areas raised in this report, including:

•	Review and improve use of resources with community rehabilitation providers to increase employment outcomes.  
•	Continue to work closely with partners at DHHS to provide employment services while people with intellectual disabilities are facing a waitlist for long term supports in work services.  
•	Continue to work collaboratively with the Department of Education to provide seamless transitions to employment as more and more students seek VR services as they enter adulthood.
•	Continue to develop direct relationships with employers and business-to-business supports that result in successful models of employment for individuals with disabilities
•	Maintain no waitlist, while continuing to address the high numbers of individuals in Plan Development (Status 10), and focus on those who drop out of the program, including how we can better keep people engaged in the VR program once they have developed a plan.
•	Closely monitor financial and human resources in order to continue to maintain no waitlist for services.  

I. Introduction:
A. Purpose of Comprehensive Needs Assessment
Maine Division of Vocational Rehabilitation (DVR) assists eligible individuals with disabilities to prepare for, achieve and retain employment in integrated community settings.  DVR administers the General Vocational Rehabilitation program in Maine for the Rehabilitation Services Administration.  A separate program is available to individuals who are blind or have visual impairments through the Maine Division for the Blind and Visually Impaired.  This comprehensive needs assessment focuses on the General Vocational Rehabilitation program and on the needs of individuals eligible for those services.

The assessment is designed to answer important questions about the population eligible for DVR services that live in Maine and their vocational rehabilitation needs. Information gathered for the assessment will guide DVR in its strategic plan and goal development for the next three fiscal years, 2013 – 2015.  Specifically, the report responds to federal regulations requiring Maine’s Division of Vocational Rehabilitation (DVR) to jointly conduct a “comprehensive statewide assessment” with the State Rehabilitation Council (SRC) every three years that describes the rehabilitation needs of individuals with disabilities residing within the State, particularly the vocational rehabilitation services needs of:

1.	individuals with the most significant disabilities
2.	individuals with disabilities who are minorities and individuals with disabilities who have been unserved or underserved by the vocational rehabilitation program
3.	individuals with disabilities served through other components of the statewide workforce investment system as identified by those individuals and personnel assisting those individuals through the components of the system.

Additionally, DVR is required to include an assessment of the need to establish, develop, or improve community rehabilitation programs within the State.  

To address these requirements, we rely on a variety of publicly available sources, including survey information from the United States Census Bureau and data from the Rehabilitation Services Administration and the Social Security Administration.  We gathered information from the Maine Departments of Labor, Education, and Health and Human Services, as well as numerous stakeholder groups, including people with disabilities, employers, and Vocational Rehabilitation counselors.   

B. Description of Division of Vocational Rehabilitation and the Vocational Rehabilitation Process
The Division of Vocational Rehabilitation (DVR) is an agency within the Bureau of Rehabilitation Services (BRS) located within the Maine Department of Labor (MDOL).  The mission of BRS is to provide full access to employment, independence and community integration for people with disabilities.  The Division of Vocational Rehabilitation provides services that are governed by the federal Rehabilitation Act of 1973 as amended, by working together with individuals with disabilities to achieve or maintain gainful employment.  

Federal statute mandates that each applicant entering the publicly funded program follows an individual process from application through eligibility, comprehensive assessment of rehabilitation needs, individual employment plan development, and provision of appropriate services to achieve employment.  Any individual with a disability and a commitment to find or maintain employment may apply.  Each applicant can expect an eligibility decision within 60 days of application.   An individual is eligible for DVR services if that person:
 
•	has a physical or mental impairment which, for the individual, constitutes or results in a substantial impediment to employment (Note: Substantial impediment to employment means that a physical or mental impairment hinders an individual from preparing for, engaging in, or retaining employment consistent with the individual’s abilities and capabilities); and
•	requires vocational rehabilitation services to prepare for, secure, retain, or regain employment consistent with the applicant’s unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. Required VR services must be necessary to overcome disability related barriers. Lack of resources by itself does not constitute a disability related barrier.

In addition, there is a presumption of benefit.  It shall be presumed the individual can benefit in terms of an employment outcome from vocational rehabilitation, unless the DVR counselor can demonstrate by clear and convincing evidence that such individual is incapable of benefiting from vocational rehabilitation services due to the severity of the disability of the individual.   Individuals who receive SSI and/or SSDI are presumed to be eligible for DVR services.

DVR uses a set of “status” codes to track an individual’s progress as they move through the VR process.  This allows both the state agency and federal agency, Rehabilitation Services Administration (RSA), to collect data to ensure timely service delivery and fiscal accountability. 

Each individual who applies for services has a determination of eligibility and works with a qualified VR counselor and others to determine an employment goal and the appropriate services necessary to achieve that goal. The Individual Plan of Employment (IPE) may include guidance and counseling, training, education, job search, and job placement among other things.  Every applicant coming to DVR has different abilities, goals, expectations and barriers to employment; therefore, each plan is individualized for each eligible consumer.  The successful conclusion of the VR process is an individual working in a job consistent with his or her capabilities for 90 days with the supposition of continued employment.  No consumer’s path is the same and the process is flexible enough to attend to new barriers as they arise.

By federal statute, any VR program that is unable to provide services to all eligible individuals must implement an Order of Selection, so that individuals with the most significant disabilities receive services first.  (See Appendix 1.) Under the Order of Selection, eligible individuals are assigned to a priority category, based on the severity of their disability and vocational barriers. The highest priority, Category 1, is given to individuals with the most significant disabilities and highest level of rehabilitation needs.  Categories 2 and 3 are assigned to individuals with disabilities, but who have fewer functional limitations or less complex rehabilitation needs than those in Category 1.  At the time of the last comprehensive needs assessment, DVR had been in Order of Selection since 2001 and was serving only individuals in Category 1 with a wait time of 26 weeks.  Individuals in Categories 2 and 3 were not being served at all.  Since then, DVR undertook and successfully accomplished a project that eliminated the waiting list for all eligible individuals on October 1, 2010.  

While helping individuals obtain employment is the ultimate success of the VR program, many VR cases are closed each year before the individual achieves and maintains employment for at least 90 days.  These closures happen for a variety of causes and can occur at any step in the VR process.  Some individuals who apply are found not eligible because they do not have a qualifying disability.  Others, after being found eligible, leave the VR program for several reasons, such as they find employment on their own, have an exacerbation of a chronic condition, do not want to remain on the waiting list, or cannot be located by their VR counselor for an extended period of time.  Everyone who applies for VR services has the right to appeal any decision made by the agency, including the decision to close a case.

Individuals can receive further support through post-employment services after becoming successfully employed if services are necessary to maintain, regain or advance in employment.  This assistance is limited in scope to two or less services and duration of six months or less.  If more comprehensive services are required, and/or there is a new disabling condition and/or it has been longer than three years since the case was closed successfully, a new application for DVR services must be completed.

II. BACKGROUND
 A.  Maine’s Economy and Workforce   
Maine is a large geographical state, which spans 30,843 square miles.  The state is primarily rural in nature with a dispersed population of 1.3 million people and density of 43 people per square mile.  The largest population center can be found in southern Maine in the greater Portland area where approximately 91,200 individuals reside. Residents are primarily white (95%) with small representation of Black (1.2%), Asian (1.0%) and Native American (0.6%) persons in particular geographical areas of the state.  Maine’s population growth is significantly lower than the rest of the country with a rate of 4.2% between 2000 and 2010 as compared to the national rate of 9.7%.    Additionally, the 2010 demographic profile released by the US Census Bureau indicates that Maine’s median age is 42.7 years, which is the oldest in the country.

Historically, Maine’s economy has been based on goods producing industries, such as manufacturing and natural resources, but a trend to jobs requiring higher educational attainment in service producing, knowledge-based industries has continued over the last several years. The decline of manual occupations and growth in education and health services, as well as professional and business services, has resulted in different demands for the skills and abilities of Maine workers.  

At the time of this report, Maine and the country were slowly rebounding from the 2007 to 2009 period of recession and seeing only modest improvements in the economy and labor market.  According to data available from the Current Population Survey, workers with disabilities were disproportionately impacted by job losses between 2008 and 2010, declining by 9% nationally   and the disparity was even greater in Maine.  Disability Status Reports provided by Cornell University from the US Census Bureau’s American Community Survey, indicate a 10.4 % job loss occurred in the employment rate of Maine workers with disabilities between 2008 (39.5%) and 2010 (29.1%), as compared to a 3.4% loss for their non-disabled peers for the same period of 2008 (81.4%) and 2010 (78%).

B.  Federal and State Landscape of Vocational Rehabilitation

Since DVR’s last comprehensive statewide needs assessment in 2009, the 25th anniversary of the Americans with Disability Act has occurred and rule changes were made to the Ticket to Work and Work Incentives Improvement Act.   Efforts continue to reduce employment barriers for recipients of Social Security benefits, including the Benefit Offset National Demonstration (BOND) project for SSDI beneficiaries. The Individuals with Disabilities Education Improvement Act continues to address transition services for children with disabilities, including the movement from school to integrated community-based employment. Effort has been made to reauthorize the Workforce Investment Act and Rehabilitation Act, but remains yet to be accomplished.  

Demand for community inclusion and access to employment by people with significant disabilities and their supporters continues to be strong across the country with consumer choice and opportunity for full participation being important for all.  The advocacy and advice of the State Rehabilitation Council, Independent Living Council and Disability Rights Center, as well as groups such as Maine APSE and the Alliance for Full Participation, help to ensure that rights are being respected, laws are being followed, and practices are being improved to increase the successful employment of people with disabilities.   

As noted above, the impact of the recent recession and current poor economic environment is of great concern as budget shortfalls threaten employment services and related supports.  DVR’s total annual budget is approximately $ 21 million, which is fixed by a formula based upon population growth and state average population, established by federal appropriation with approximately a four to one state match.  Through a strong partnership with Maine’s Office of Adult Mental Health Services, DVR was able to avert a combined state and federal funding cut in SFY 2010 of $1.3 million and $ 1.2 million in SFY 2011 through a re-appropriation of state general funds.  Further state budget cuts would result in DVR being unable to draw down its full federal allotment for rehabilitation services for Maine citizens with disabilities. 

Now, more than ever, it must be proven that the return on the vocational rehabilitation investment of people with disabilities goes beyond improved individual quality of life and makes good fiscal sense as well.    

C. Availability of Employment-Related Services to People with Disabilities in Maine  
While DVR services are an important resource for individuals with disabilities who are looking to enter or re-enter the Maine workforce, VR services are only one option in an expanding array of employment supports and services. Co-location in Maine’s network of Department of Labor (MDOL) One-Stop CareerCenters has provided DVR the opportunity to work in partnership with a number of other programs that support employment of people with disabilities.

In October of 2010, Maine’s Bureau of Employment Services (BES) was awarded a Disability Employment Initiative (DEI) Grant to build on the work successfully started under Maine’s Disability Program Navigator Grant. Designed to promote employment through increased access to CareerCenter services and programs in targeted regions of the state, Maine’s DEI grant work includes increasing the number of CareerCenter locations which can accept Tickets and provide Employment Network services under Social Security’s Ticket to Work Program to beneficiaries of SSI and/or SSDI. With 11 active Ticket holders, the program has recently begun receiving milestone payments and has generated $10, 232 in revenue for the CareerCenter system. The DEI grant is collecting limited data on individuals served by the grant. One objective of the grant is to conduct Integrated Resource Team (IRT) meetings on individuals with unmet needs that are impacting employment. During the life of the grant approximately 50 IRT meetings have been held.

The CareerCenters also provide a number of other employment programs that serve people with disabilities. Launched in the last 2 years, the Maine Job Bank is a new online accessible CareerCenter tool to allow jobseekers from around the state to be matched with real-time available open positions. The Job Bank currently has 23, 750 active job bank registrants of whom 1, 567 are self-disclosed job seekers with disabilities. This represents 6.6 % of total Job Bank registrants. Data reported on the ETA 9002 for Program Year 2011 show that under the Wagner-Peyser Act, Maine served 3, 328 individuals who disclosed a disability. This represents only 3.2% of all individuals served – and a significant decrease from the 4, 525 individuals served in 2008. Maine’s Workforce Investment Act (WIA) Annual Report for 7/1/2010-6/30/2011 documented that very few individuals with self-disclosed disabilities are receiving WIA services (741 across the state). Among those that exit services, the entered employment rate is 66.7% - compared to 73.8% for public assistance recipients or 84% for veterans. Only older workers enter employment at a lower rate – 64.3%. Average earnings reveal a similar picture with individuals with disabilities earning only $7, 325 compared to $9, 853 for public assistance recipients or $ 12, 401 for veterans.

While the Bureau of Employment Services collects data on self-reported disability, it does not require that individuals disclose having a disability. BES officials have questioned if the recession and related increased competition in hiring is impacting the decrease they are seeing in the numbers of individuals choosing to disclose out of concern that it will make them less marketable to an employer. The DEI grant is addressing this through outreach and education to CareerCenter customers; however the grant is not present statewide.

In addition to BES and CareerCenter services, the Department of Health and Human Services (DHHS) is a growing partner in the support and delivery of employment services for people with disabilities. DHHS currently supports approximately 4,700 people through a Center for Medicaid & Medicare Services 1915c Waiver. The waivers allow individuals who have been found eligible for the Office of Adults with Cognitive and Physical Disabilities (OACPD)’s Developmental Services to become prepared for employment through Community Supports Services that can assist the person to volunteer, increase work-readiness skills and address issues of health and safety. Currently Developmental Services is providing on-the-job support through the waivers to about 900 people who are working throughout Maine. These services can provide support to both the individual and the employer to maintain employment. At this time, approximately 3,000 working-age MaineCare waiver recipients are not working. Among those individuals, employment is revisited during the person-centered planning process at least annually. 

In addition to providing ongoing support to over 200 employed individuals with mental illness, the Office of Adult Mental Health Services (OAMHS) in DHHS has a number of initiatives currently underway to promote employment among the individuals they serve. One builds upon Maine’s success in using the clubhouse model to achieve community-based employment outcomes and expands clubhouse services to a third location in Lewiston. Quarterly, joint management meetings between DVR, the Division for the Blind and Visually Impaired, OAMHS, and OACPD has ensured regular and ongoing communication. Development between the agencies of a comprehensive web site, www.employmentforme.com , allows for easy distribution of best practices and resources concerning employment for people with disabilities. The website is broken into three strands – jobseekers, service providers, and employers. Another recent collaboration is the launch of a shared workforce development system between DHHS and the MDOL Bureau of Rehabilitation Services. The new system provides ACRE employment specialist training, advanced topical training and mentoring for new employment specialists that support the shared provider standards between the departments.  Another shared promising initiative is increased employer outreach and diversity hiring. The Hiring Initiative Team (HIT) is a targeted employer outreach group made up of representatives of DVR, OACPD, OAMHS, and BES’ DEI grant and VETS program. HIT provides technical assistance and resources to businesses that have an interest in increasing their hiring diversity through the employment of people with disabilities. 

III. DVR SERVICES TO INDIVIDUALS IN MAINE

The Division of Vocational Rehabilitation (DVR) collects a variety of information about individuals when they enter the program, tracks the progress and services they receive, and records a successful closure of the case if the individual successfully completes at least 90 days of employment in an integrated setting.  In this section, we use DVR data to provide an overview of the characteristics of the current VR population, to describe the flow of individuals into and out of the DVR program, to examine outcomes of the VR program in terms of rehabilitation rates, and to outline the costs of DVR services from FFY 2007 through 2011.
Important to note during this reporting period is that DVR undertook and successfully completed an ambitious project to eliminate its waiting list for services.  Milestones that impacted service delivery and need to be taken into consideration when reviewing the data include concentrated additional temporary staffing (September 2009 through September 2011), implementation of business practice changes (January 2010) and the gradual elimination of the waiting list for all eligible individuals. Those with the most significant disabilities and in priority Order of Selection (OOS) Category 1 had no wait time as of April 1, 2010; those with significant disabilities Category 2 had no wait as of  June 1, 2010; and those with disabilities Category 3 had no wait as of October 1, 2010.

A. DVR Population Characteristics
Examining data collected about individuals who have moved through the DVR process to closure yields valuable information about the population served.  In Federal Fiscal Year (FFY) 2007, Maine DVR closed a total of 3,288 cases, and in FFY 2011, Maine DVR closed a total 3,900 cases, an increase of 19%.   Table 1 outlines the characteristics of the individuals represented among all closed cases in both years, the percentage change in the number of clients with a given characteristic (fifth column) and the change in the proportion of clients with a given characteristic (last column).

Findings
•	As part of the eligibility determination process, DVR staff record applicants’ primary disability type.  In FFY 2011, there were 1,374 (35%) cases closed where the individual had a mental illness, 1,331 (34%) with a cognitive disability, 687 (18%) with a physical disability, 243 (6%) deaf or hard of hearing, and 265 (7%) of closed cases were for individuals with no impairment (and who were deemed ineligible for services.)
•	The majority (56%) of cases closed in FFY 2011 were for people between the ages of 23 and 54, although a substantial portion (32%) were transition-age individuals under age 23 at the time they applied for VR services.
•	More than 4 out of 10 cases closed were for clients who did not have a high school diploma or GED at application, and almost 8 out of 10 did not have more than a high school education.
•	There continue to be more men than women (57% versus 43%) receiving VR services.
•	The vast majority (97%) of the VR population is White, and only 3% are identify themselves as being members of a racial or ethnic minority.
•	In FFY 2011, there were 740 (19%) cases closed of individuals who received Supplemental Security Income or SSI. In addition, 986 or 25% received Social Security Disability Insurance (SSDI).
•	Between FFY 2007 and 2011, there were several notable changes in both the following characteristics of the DVR population. 
o	Continuing a trend observed in the previous needs assessment, both the number and proportion of cases closed for individuals with cognitive disabilities have continued to increase; there were 990 individuals with cognitive disabilities in FFY 2007, and 1,331 in 2011, an increase of 26 percent. Cognitive disabilities actually overtook physical disabilities to become the second most common type of disability among DVR clients.
o	The number of transition-age individuals (under age 23) who received VR services continues to grow at a substantial rate.  There were 890 transition cases closed in FFY 2007, and that number grew by nearly thirty percent to 1260 in 2011.

Table 1
Maine Division of Vocational Rehabilitation	
Individual Characteristics for Closed Cases, FFY 2007 and 2011	
										
	FFY 2007		FFY 2011		% Change in # of Closures		Change in % of Closures	
	Number	Percent		 Number 	Percent		2007 - 2011		2007 - 2011	
	(A)	(B)		 (C) 	(D)		(C-A)/C		(D - B)	
							 		 	
All Closures	3,288	100		     3,900 	100		18.6		0.0	
							 		 	
Primary Disability Type							 		 	
No impairment	66	2.0		260	6.7		293.9		4.7	
Sensory*	212	6.4		248	6.4		17.0		-0.1	
Physical	816	24.8		687	17.6		-15.8		-7.2	
Mental Illness	1,204	36.6		1,374	35.2		14.1		-1.4	
Cognitive	990	30.1		1,331	34.1		34.4		4.0	
Age at Closure							 		 	
  Less than 23	890	27.1		1,260	32.3		41.6		5.2	
  23 - 54	2,013	61.2		2,193	56.2		8.9		-5.0	
  55 - 65	353	10.7		404	10.4		14.4		-0.4	
  Over 65	32	1.0		53	1.4		65.6		0.4	
Education							 		 	
  Less than HS	1,143	34.8		1,598	41.0		39.8		6.2	
  HS or equivalent	1,490	45.3		1,503	38.5		0.9		-6.8	
  Some College	458	13.9		573	14.7		25.1		0.8	
  College or more	197	6.0		224	5.7		13.7		-0.2	
Most recent work experience							 		 	
Working at time of application	509	15.5		511	13.1		0.4		-2.4	
Not working at application	2,779	84.5		3,376	86.6		21.5		2.0	
Gender							 		 	
Male	1,859	56.5		2,212	56.7		19.0		0.2	
Female	1,429	43.5		1,688	43.3		18.1		-0.2	
Race							 		 	
White	3,182	96.8		3,775	96.8		18.6		0.0	
Racial/ethnic minority	106	3.2		125	3.2		17.9		0.0	
SSI Income							 		 	
Received SSI income	702	21.4		740	19.0		5.4		-2.4	
Did not receive SSI income	2,586	78.6		3,160	81.0		22.2		2.4	
SSDI Income							 		 	
Received SSDI income	852	25.9		986	25.3		15.7		-0.6	
Did not receive SSDI income	2,436	74.1		2,914	74.7		19.6		0.6	
										
DVR client characteristic data is for all cases closed during the Federal Fiscal Year.  Characteristics are based on information recorded at time of application, unless otherwise noted. Some totals do not equal the number of clients served because the information was not available for all cases closed as applicants.  	
* Sensory includes deaf/hard of hearing and visual impairments	
Source: Maine DVR RSA-911 - Frequency Distribution Tables			

B. DVR Process Flow
The VR process begins when a person fills out and submits an application to the Division of Vocational Rehabilitation, and ends with the closure of the case.  Chart 1 below outlines across five federal fiscal years the number of individuals who passed through several key steps in the VR process: New Applications, New Plans Developed, and Case Closures.  The solid lines in the chart represent incoming individuals, and the dotted lines represent individuals leaving the DVR program (case closures).
Findings
•	Over the last 3 years the number of new applications has steadily increased, from a low of 3,014 in 2009 to 3,472 in 2011, an increase of 15%.  
•	Closures have increased by 19% over the five year period from 3,288 to 3,900.
•	There has also been a steady increase in the number of new Individualized Plans for Employment (IPE) developed from a low of 1070 in 2008 to a high of 1631 in 2011, a 52% increase.

CHART 1

Chart 2 looks more closely at the open DVR caseload (Status 02 – 24) at the end of the Federal Fiscal Year from FFY 2007 to 2011, and breaks out cases by the number of individuals who are: waiting for an eligibility determination (Status 02), on the waiting list (04), in Extended Evaluation/Trial Work Plan (06), off the waitlist and in IPE development (Status 10), and the remainder who have completed IPE’s and are in plan implementation (Status 12 – 24).  

Findings
•	The chart illustrates a 36% drop in the total number of active cases over the five year period, from 7,949 in 2007 to 5,862 in 2011, with the number of clients at each stage in the VR process shifting. 
•	The number on the waiting list has been reduced dramatically to 0 in 2011, from 1,421 in 2007. 
•	The waiting list reduction was accomplished while the number of clients in plan development also dropped from 2,917 in 2007 to 2,544 in 2011.  
•	Following a significant drop in the number of active cases involved in plan implementation in 2008, the numbers have remained steady at about 2,500 to 2,600.  
•	The number of open active cases represents about 40% of all active cases.

CHART 2

The goal of the VR process is for an individual to achieve and maintain employment consistent with his or her capabilities.  However, many individuals exit the program before reaching that employment goal.  Chart 3 details the number of individuals whose cases were closed in Federal Fiscal Years 2007 to 2011, according to the type of closure.  The different closure types noted indicate how far in the VR process the individual had progressed when his or her case was closed.

Findings
•	The number of successful employment outcomes (Status 26) has fluctuated over the 5 year period, from high of 730 in 2008 to a low of 573 in 2010.  
•	The number of closures in cases where the individual had developed and participated in an IPE, but did not achieve 90 days of employment (Status 28 closures), followed a similar pattern as successful closures. From a high of 810 in FFY 2011, to a low of 658 in FFY 2007.
•	The most significant trend in Chart 3 is the high number of closures to cases where the individual had been determined eligible but had not yet developed an IPE (Status 10-30 closures). In 2003 the number was 814, but in the last 5 years has not dipped below 1500.  
•	The number of cases closed as applicants doubled from 248 in 2007 to 511 in 2010.  

CHART 3

Another way to examine the flow of individuals through the VR program is to look at the length of time that individuals spend in the overall process, and in the various steps along the way.  Chart 4 below shows the length of time (in months) that it took successfully rehabilitated (Status 26) individuals to move through the VR process.

Findings
•	Overall, the number of months it took a VR applicant to complete the entire process decreased from 2007 to 2011, from 38 to 33 months – an average of less than 3 years. 

•	The length of time it takes to determine eligibility has remained at 2 months through the entire five year period. 

•	The length of time it took for eligible individuals to move from eligibility determination to the implementation of their Employment Plan (Elig to IPE) has remained steady at six to eight months for the entire five year period. This is a significant drop from the 12 months it took when there was a waitlist (prior to 2007).
 
•	There has been a 32% decrease in the average time spent in Plan Implementation from 2007 to 2011 (IPE to Closure) from 25 months to 19 months.  The growth in the overall time in the VR process may be directly attributed to the decrease in time spent on the waitlist.

CHART 4

Keep in mind that Chart 4 represents the best-case scenario, in that it only includes individuals who successfully completed the VR process.  It is also instructive to examine the length of time that people who did not have a successful outcome spent in the VR process.

Overall time in the VR process is trending downward not only for successful closures, but also across other closure types as well.  Chart 5 shows average time from application to closure for cases closed after the individual received IPE services, for successful closures, and for cases closed before the individual’s IPE was implemented. 
Findings
•	Regardless of the type of closure, time spent in the VR process decreased from 2007 to 2011. Individuals whose case closed before receiving IPE services went from an average of 22 months in FFY 2007 to 19 months in 2011. And time in the VR process for Status 28 closures decreased from 38 to 33 months over the same period.

•	Among the cases closed after receiving IPE services (Status 28) in FFY 2011, 37% were closed because the individual refused further services, and 34% were closed because the VR counselor was unable to locate or contact the individual (not shown). Similar proportions were observed among Status 30 closures (40% refused services, 39% could not be contacted).

CHART 5

C. DVR Outcomes
An important measure of the success of the Vocational Rehabilitation program is to look at employment outcomes for individuals.  A standard federal measure is the rehabilitation rate, which represents the total number of successful (Status 26) closures, divided by the total number of closures following the development of an IPE, including both successful (Status 26) and unsuccessful (Status 28) closures.  

The following Chart 6 breaks out the rehabilitation rate by disability type.

Findings
•	The proportion of DVR cases that were rehabilitated (i.e. worked for at least 90 days in an integrated setting) was an average of 48% from 2007 through 2011, and varied by only a few percentage points across this period. (See Appendix 2).
 
•	Rehabilitation rates are highest for clients with hearing loss, followed by those with cognitive, physical and mental illness-related disabilities. 

CHART 6
 
A second outcome measure for the Division of Vocational Rehabilitation is the change in earnings among individuals who successfully meet their employment goal.  Chart 7 below describes the change in average earnings among all successful closures.

Findings
•	There was a slight dip in the average wage at closure from $323 in FFY 2007 to $311 in FFY 2011.  The change between wages at application and closure narrowed from more than 300% in 2007 to 262% in 2011.  Average weekly earnings for 2011 closures went from $119 at time of application up to $311 at closure.  

CHART 7

Looking at the earnings and hours worked per week among successful closures by type of disability (Charts 8), we find that clients who are deaf or hard of hearing have the highest average weekly wages ($525) and hours worked (35), followed by those with physical disabilities ($310/week and 24 hours), mental illness ($254/week and 24 hours), and cognitive disabilities ($224/week and 22 hours).

CHART 8

Another important outcome of the VR program is the change in education level among individuals who are served.  The following (Chart 9) compares the education level of all closures from FFY 2011 at the time they applied for services to their education level at closure.
Findings
•	It should be noted 847 individuals who did not have a high school education at application achieved a high school diploma or equivalency or more while participating in the VR program.

•	More than 261 people increased their education level to postsecondary courses, degrees or certifications, and 56 achieved a college degree.

CHART 9

D. DVR Services and Expenditures Costs

Maine’s DVR program and the amendments to the Rehabilitation Act emphasize the importance of informed consumer choice – namely, providing DVR individuals with the information they need to choose vocational goals and determine the available services appropriate to meet those goals.  Thus, cost information can serve as an indicator for the mix of services that Maine’s DVR individuals have asked and received approval for over the past few fiscal years. 

As noted at the beginning of this section, DVR embarked on a significant service improvement project that eliminated its waiting list for services as of October 1, 2010.  To achieve and sustain this effort, the procurement of goods and services were evaluated and practices changed to reduce cost and improve service delivery, including a renewed focus on the core mission of VR services, offering Career Exploration Workshops and a new protocol for purchasing Hearing Aids and Services.

This section highlights trends in annual costs of DVR services and the service areas where these costs are concentrated.  DVR classifies services into nearly 100 categories.  For presentation purposes in this report, these categories are aggregated into a smaller set of eleven service groups, described below in Figure 1. 

FIGURE 1
Description of Vocational Rehabilitation Service Groups

VR Service Group	Example Services	
Job Development & Placement	Job Development, Analysis, Placement & Referral	
College or University Training	Tuition, boarding, fees, books, school supplies for college/university	
On-the-Job Supports	Job coaching both at the worksite and off site & on-the-job training	
Assessment	Community based situational assessments, and disability related evaluations	
Occupational / Vocational & Other Training	Business/vocational training, books, supplies, boarding, tutoring, fees, adult education, literacy, mobility training, truck driving school, etc. 	
Transportation	Cab/bus fares, car repair, gas	
Hearing Aid	Provision of hearing aids, molds and repair	
Rehabilitation Technology	Computer equipment, software, training, home/ building or vehicle modifications 	
Maintenance	Clothing, child care, food and shelter to enable IPE	
Diagnosis & Treatment	Medical exams, treatment, therapy & counseling	
All Other Services	Readers/interpreters, occupational tools & equipment, services to family members, purchased counseling & guidance	

Table 2 details DVR paid authorizations from FFY 2007 through 2011, broken out by service group.

TABLE 2
Maine Division of Vocational Rehabilitation	
Case Costs by Service Group and Federal Fiscal Year	
				Note: Sorted by FFY 2011 Case Costs	
							
 	DVR Case Costs		
VR Service Group	2007	2008	2009	2010	2011	% Change 2007-2011	
Job Development & Placement	 $ 1,742,394 	 $ 1,616,093 	 $ 1,953,671 	 $ 1,826,490 	 $ 1,915,808 	9%	
College or University Training	 $ 1,450,338 	 $ 1,537,167 	 $ 1,218,143 	 $ 1,112,013 	 $ 1,138,939 	-27%	
Assessment	 $    687,082 	 $    739,365 	 $    852,363 	 $    836,079 	 $    988,783 	31%	
On-the-Job Supports	 $ 1,035,184 	 $ 1,017,003 	 $ 1,056,003 	 $    929,494 	 $    862,090 	-20%	
All Other Services	 $    751,737 	 $    538,712 	 $    437,564 	 $    504,367 	 $    575,361 	-31%	
Hearing Aid	 $    570,277 	 $    555,226 	 $    537,881 	 $    438,099 	 $    483,588 	-18%	
Occupational / Vocational & Other Training	 $    691,783 	 $    603,741 	 $    574,475 	 $    457,570 	 $    479,414 	-44%	
Transportation	 $    744,733 	 $    525,536 	 $    374,558 	 $    354,612 	 $    418,314 	-78%	
Rehabilitation Technology	 $    605,608 	 $    287,366 	 $    373,376 	 $    252,910 	 $    399,422 	-52%	
Maintenance	 $    331,984 	 $    213,360 	 $    148,508 	 $    173,302 	 $    180,166 	-84%	
Diagnosis & Treatment	 $    118,620 	 $    107,649 	 $    119,594 	 $      85,742 	 $      72,885 	-63%	
TOTAL	 $ 8,729,740 	 $ 7,741,218 	 $ 7,646,137 	 $ 6,970,678 	 $ 7,514,770 	-16%	
Note: Total costs include direct service expenditures only.
Findings
•	Total expenditures fluctuate from year to year with a decrease from $8.7 million in FFY 2007 to $7.0 million in FFY 2010, and slightly up again to $7.5 million in FFY 2011. 

•	Job Development & Placement is the largest single service group, representing 20 to 26 percent of total DVR case costs each year, with a growth in spending by 9% from FFY 2007 to 2011, from $1.74 to $1.92 million.

•	Assessment spending was the only other service group that showed an increase, growing by 31%, from $687,000 to $989,000, and becoming the third highest expenditure after Job Development & Placement and College or University Training.
 
•	A number of service groups saw large decreases, including a dramatic 84% drop in maintenance services from $332,000 in 2007 to $180,000 in 2011, and a 78% drop in transportation costs from almost $745,000 in FFY 2007 to $418,000 in FFY 2011.  Diagnosis & Treatment services dropped by 63%, and spending for Rehabilitation Technology declined by more than 52% from FFY 2007 to 2011.

Chart 10 shows the percent of all DVR expenditures in FFY 2011 that were spent on each type of service. Job Development & Placement, College or University Training, and Assessment services were the top three service groups in terms of case costs in FFY 2011, with a total of $4 million – 54 percent of the $7.5 million in total DVR expenditures that year.     

CHART 10
Maine Division of Vocational Rehabilitation
Case Costs by Service Group, FFY 2011

Chart 11 outlines the trends in service costs over the past five federal fiscal years, FFY 2007 to 2011. The results underscore the growth in Job Development & Placement and Assessment costs, and the decline in College or University Training and On-the-Job Supports and Hearing Aids.

CHART 11

On a per-person basis as presented in Chart 12, the average the cost per successful closure has been dropping steadily over the last four years.  After reaching a high of $6,611 in FFY 2008, by FFY 2011 it had dropped to $5,392, an 18% decrease.  There was a 27% drop in the average cost for all types of closures, from $2,655 in FFY 2007 to $1,927 in FFY 2011. 

CHART 12

E.  DVR Consumer Satisfaction Survey:
Maine DVR has been surveying individuals regarding service satisfaction at the time of closure since 1997, but recognized in 2003 that the return rate was not providing statistically reliable data that could help improve agency services. Thus, a decision was made to join other New England States in a Rehabilitation Services Administration sponsored Customer Satisfaction Survey conducted by Market Decisions, LLC, a Maine-based research organization. DVR found the information provided by the survey extremely valuable and subsequently engaged Market Decision to conduct the survey again in 2006 and 2008. Following a RFP, Market Decisions was again awarded the contract to conduct the survey in 2011.

A random, stratified sample was utilized that included all active clients, all individuals closed successfully from a plan, and all individuals closed unsuccessfully after an IPE was implemented in the 12 months prior to the survey’s implementation. The survey followed a similar approach as in previous administrations with clients contacted by telephone with a follow up mail survey for those unable to participate by phone. Alternate formats were available by client request.  Table 3 below reports the overall service satisfaction of DVR respondents. The key findings section includes additional points of interest from the full survey report.

TABLE 3
MAINE DIVISION OF VOCATIONAL REHABILITATION
OVERALL SERVICE SATISFACTION

	2003	2006	2008	2011	
Number of completed surveys	726	741	732	705	
					
Percentage of respondents: 					
Very or somewhat satisfied with Maine DVR Program	85%	83%	82%	81%	
Satisfied with the services received	82%	82%	82%	83%	
Services provided by Maine DVR compared favorably to services offered through their ideal program	
85%	
79%	
76%	
80%	
Would tell their friends with similar disabilities to go Maine DVR for help	
94%	
94%	
94%	
92%	
Services met expectations	79%	80%	78%	80%	
Maine DVR staff treated them with dignity and respect.	97%	94%	98%	91%	
Clients reporting problems with the agency	29%	26%	24%	18%	
Clients reporting having more than one counselor affected their ability to get services	
13%	
33%	
39%	
32%	

Findings:
•	DVR clients continue to report a very high (83%) level of satisfaction with the agency and the services they receive. 
•	DVR clients overwhelmingly (91%) feel that they are treated with dignity and respect.
•	The number of clients reporting problems with DVR continues to trend downward and is now under 20%.
•	The number of clients reporting that they had more than one VR Counselor that affected their ability to get services continues to decline.
•	For clients who participated in the recently launched “Career Exploration Workshop” 85% reported that it was somewhat or very helpful to them.
•	Individuals who had their case successfully closed and individuals with intellectual disabilities report statistically higher levels of satisfaction with VR services.
•	When problems did happen in VR, they tended to be related to difficulty communicating with staff, need for additional supports and services, inability to find employment, and paperwork difficulties. 17% reported needing additional guidance and support.
•	Almost half of respondents made suggestions for program improvement – primarily focused on increasing program effectiveness and staff issues.
•	Clients found DVR’s locations and services accessible.
•	Over 85% of clients reported that they were satisfied with their choice of service providers.
•	Clients who reported that they received adaptive equipment as a DVR service varied greatly across DVR regions – ranging from 4% to 25%.

F. Consumer and Stakeholder Input

In addition to receiving valuable feedback via Maine’s 2011 consumer satisfaction survey conducted by Market Decisions LLC, input has also been gathered using a number of methods. 

SRC Annual Meeting: The 2011 annual meeting of the State Rehabilitation Council included a facilitated public forum to solicit constructive feedback from current and former clients of Maine DVR. The room was filled to capacity and 16 individuals presented oral comments. An additional four individuals presented written comments. Many of the comments focused on the ways that VR had been helpful, including: 
•	Assisted the person to find employment
•	Purchased necessary items and services
•	Assisted with training and education
•	Provided useful guidance and counseling
•	Provided the client with new skills
•	Offered client choice
•	Assisted the person in self-employment 
•	Satisfaction with job development services
•	Participation in the Career Exploration Curriculum
•	New Hearing Aid Protocol and Program

Among the needs and concerns identified by the public forum participants were:
•	Client plan or desired service wasn’t supported
•	Better quality of purchased items
•	Need to expand capacity of VR Counselors
•	Inconsistency of services and message
•	Need for increased transportation assistance
•	Improved transition services
•	Disagreement with decision to close case
•	Increased targeted job development
•	Additional office location (in one county)

CRP and VRC Surveys: In January 2012, all Community Rehabilitation Providers (CRP’s) and Vocational Rehabilitation Counselors (VRC’s) were asked to participate in a joint survey. The survey incorporated questions of interest to Maine DVR’s Community Rehabilitation Provider Project, as well as questions designed for Maine’s needs assessment. Approximately 80% of CRP’s and 90% of VRC’s responded to the survey.  When asked to identify unserved or underserved populations, VRC’s identified: those needing long-term supports, individuals lacking transportation, individuals in rural locations, and individuals who are deaf/hard of hearing or late deafened. A significant percentage of VRC’s did not believe that there was a population of individuals who do not currently have access to services. CRP’s responses identified: Individuals with significant mental health needs, transition-age youth, individuals needing long-term supports, and individuals who are unaware of VR services as their top responses. When asked how well the diverse cultural needs of clients are being met, VRC’s responded that they felt that their clients’ cultural needs were being either very well or satisfactorily met. CRP’s similarly responded on balance that they felt client cultural needs were being met satisfactorily. Both VRC’s and CRP’s commented on the lack of diversity that is reflected in Maine generally and among the individuals they serve. A number were unsure if cultural needs existed. CRP’s remarked that clients with cultural needs often have needs for services beyond employment. VRC’s and CRP’s both noted that additional training would be useful. VRC’s commented on the good supply of interpreters and CART providers. 

In general, CRP’s believe that the vocational needs of clients are being met satisfactorily – although many noted the negative impact of high caseload numbers, difficulty filling positions during the hiring freeze and inconsistencies of services and message. CRP’s feel that the variety and volume of provider choices is satisfactory for clients, however some respondents noted that they felt that not all VRC’s present clients with true informed client choice concerning CRP’s. CRP’s reported that they feel they have satisfactory disability and diversity knowledge, but welcomed additional disability-specific training (autism, mental health, brain injury, deafness etc.). VRC’s also agreed that clients’ vocational rehabilitation needs were being met satisfactorily – although they noted the impact of large caseload size, varied skill levels of CRP’s and the challenges of Maine’s economy on service delivery and outcomes. VRC’s feel that the choice of CRP’s is in need of improvement.  The primary reason noted was limited availability of CRP choices in rural areas. VRC’s rated the disability and diversity specific knowledge of CRP’s as being satisfactory, but supported the importance of ACRE certification for employment specialists, as well as ongoing disability specific professional development. One suggestion was to include some of this training as part of regularly scheduled provider meetings. 

Employers:   Periodic surveys of employers yield a national and Maine-based sense of workforce needs and perceptions regarding the capacity of workers with disabilities to meet those needs.  In November 2008, the US DOL Office of Disability Employment Policy released a report, entitled Survey of Employer Perspectives on the Employment of People with Disabilities, which compared employer perspectives across various industries and within companies of varying sizes.  It found that larger companies are more likely to employ and actively recruit people with disabilities, but identified finding qualified people as a major challenge. The nature of the work was a concern for employers in industries with physically demanding tasks and the unknown costs of accommodations were noted as a hiring concern for many companies surveyed.  This study also identified the cost of health care and workers’ compensation, as well as fear of litigation, as being more challenging for small and medium sized companies.

More recently, the Kessler Foundation and The National Organization on Disability sponsored two studies in 2010 that studied the status of the employment of people with disabilities in the United States.  The first, released in July 2010, found that little progress had been made in closing the employment gap between people with disabilities and those without disabilities since the passing of the Americans with Disabilities Act of 1990.  The second, released in October 2010, examined employer perspectives in an attempt to provide some insights into this continuing trend of limited employment for people with disabilities.  It found that companies are broadly thinking about diversity hiring, but disability is not included to the extent that other diversity characteristics are.  A majority of the companies, all of which have over 50 employees, had hired people with disabilities, but they make up a very small percentage of their total workforce.  This survey also identified that employers do not perceive the services provided by   organizations who assist job seekers with disabilities as beneficial in helping them find qualified applicants.

Employer practices and attitudes regarding the employment of people with disabilities in Maine have also been examined by the Muskie School at the University of Southern Maine.  Multiple focus groups and two surveys of approximately 400 Maine business owners in 2005 and in 2006 suggested that public-private partnerships, easily accessible information, transitional employment arrangements, tax incentives and subsidies, reducing risks of lawsuits and health insurance costs, and most importantly, changing employer attitudes about the ability of people with disabilities to successfully perform at work are critical to increasing the employment rate of Mainers with disabilities.

Since DVR’s last statewide needs assessment, BRS has dedicated a half-time position to develop its relationships with employers and also serve as the agency’s employer single point of contact for the National Employment Team (NET), led by the Council of State Administrators for Vocational Rehabilitation.  Unlike many companies who are partners of the NET, a majority of businesses in Maine are small, and subsequently have different customer needs to be addressed. An employment model that does show promise here in Maine is one developed by Walgreens at its distribution centers in South Carolina and Connecticut.   A recent productivity analysis done by Walgreens in January 2012 showed clear evidence that distribution center employees with and without disabilities were equally productive.  More locally, Walgreens has been providing technical assistance and support to Tambrands, a Proctor & Gamble company in Lewiston, Maine.  The resulting public-private partnership of employer, state agencies and community rehabilitation providers has brought jobs to Maine, including employing over twenty people with disabilities in integrated positions in the company’s new Flexi Center.  Preliminary analysis of these placements found an average placement cost of $ 1,778 and a $ 9.00 per hour rate of pay.  Other Maine employers have expressed an interest in similarly partnering, so as mentioned earlier in this report, a Hiring Initiative Team has been established to respond to those workforce needs.

IV. ESTIMATING POPULATION ELIGIBLE FOR DVR SERVICES AND UNMET NEEDS
A. American Community Survey
To estimate the number of people eligible for DVR services in Maine, we use information from the American Community Survey (ACS), conducted each year by the United States Census Bureau.  The ACS is designed to provide both national and State level data on demographic, social, economic and housing characteristics of US households.  Table 4 details the sample selection process and the six questions that were used to identify the ACS disability population. 
Findings
•	In the 2008 - 2010 ACS, which was used to estimate the DVR-eligible population in the State, the first row indicates that there was an average of over 8,000 working-age adults in Maine between the ages of 16 and 64 were interviewed for the ACS.  Based on the sample from 2010, the Census estimated that there were a total of 775,441 working age adults living in the State.

•	The second row adds the work disability criterion, showing that in 2008 - 2010, a total of 3,023 respondents in the ACS reported a work disability, representing an estimated 108,302 Maine adults (12.4% of all Maine adults).

•	The final row adds the requirement that sample members be currently unemployed.  In 2008 - 2010, we identified a total of 2,031 individuals in the ACS sample with a work disability who were not already working.  Based on these 2,031 individuals, we estimate that in 2010 there were a total of 73,000 DVR-eligible adults in Maine (84.5% of all adults with a work disability). 
Table 4

Estimated Population Eligible for Services from
 the Division of Vocational Rehabilitation	
Maine Results from 2008 - 2010 American Community Survey	
			
 	Sample Size	Population Estimate	90% Confidence Interval	
Working-age adults (16-64) in Maine	24,339	875,441	( 866,247 - 884,635 )	
Working-age adults with a disability* (except those with a visual disability only**) 	3,023	108,302	( 104,107 - 112,497 )	
Working-age adults with a disability who are not currently working (or on temporary leave)	2,031	72,928	( 69,452 - 76,404 )	
				
Source: Muskie School of Public Service Calculations based on the American Community Survey Public Use Micro data Sample (PUMS)	
Notes:				
* Disability in the 2008 - 2010 ACS is defined based on responses to the following questions. Respondents who answer "yes" to one or more of the following questions are defined as having a disability:	
16a. Is this person deaf or does he/she have serious difficulty hearing?	
16b. Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?	
17a. Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions?	
17b. Does this person have serious difficulty walking or climbing stairs?	
17c. Does this person have difficulty dressing or bathing?	
18. Because of a physical, mental, or emotional condition, does this person have difficulty doing errands alone such as visiting a doctor’s office or shopping?	
** Because people with visual impairments are served by the Division of Blind and Visually Impaired (DBVI), people with a visual disability only are not counted in this analysis. (People who have a visual disability and another type of disability are included).	

Individuals living in institutionalized group quarters are also excluded from the analysis.	
Limitations 

There are several important limitations to note about using the ACS work disability population to estimate and describe the VR-eligible population in Maine.  First, while over 95% of individuals in Maine’s DVR program are between the ages of 16 and 64, there is technically no lower or upper age eligibility limit, so our estimates do not adequately describe potential young or elderly individuals who are eligible for DVR services.  This could lead to an underestimate of the number of people eligible for DVR services. 
 
However, there are also potential reasons why using the ACS could lead to an overestimate of the numbers of people in Maine who are eligible for DVR services.  The Census questions ask if individuals have serious difficulty performing specific daily functions, as opposed to the VR eligibility criterion that requires a “substantial impediment to employment.”  The ACS work disability definition may therefore be too general and include a number of individuals who would not be eligible for VR because they:
•	are unavailable to participate in VR or the workforce;
•	are not interested in getting a job or participating in VR; or
•	have difficulty working but not constitute a "substantial impediment to employment”.

Despite the limitations, the ACS is the best source available for state-level estimates of the population eligible for DVR services.  The large sample size for Maine alone and statewide coverage make it unique among federal surveys.  Also, the survey is repeated each year, allowing for examination of trends in the disability population in Maine over time.

ACS Disability Population Characteristics

To describe the population of individuals eligible for DVR services, we again use the American Community Survey and the sample of individuals with a disability described above.  The ACS includes a number of demographic and socioeconomic characteristics that are useful for this purpose.  To improve the reliability of our estimates, we combined respondents from the 2008 through 2010 ACS who met the disability definition, for a total sample of 2,031 individuals.  The results are shown in the second column of Table 5. 
Findings
•	The most common type of disability among the disability population is ambulatory, at 57%.
•	55% report a cognitive difficulty.
•	Over a third report difficulty in independent living.
•	One in five has difficulty performing self-care activities.
•	Hearing difficulties are the least prevalent disability type, at 17 of the ACS disability population.
•	Over one third of the population is ages 55 to 64.
•	One quarter of individuals with a disability did not complete high school or pass an equivalency test.  About 3 in 10 have some post-secondary training or have a college diploma.
•	Only 13% of the population has recent work experience.  
•	6.2% belong to a racial or ethnic minority.
•	Twenty nine percent received Supplemental Security Income in the past year, the federal program that provides cash assistance to low-income individuals with severe disabilities.
•	Just over one third received Social Security Disability Insurance.
•	
 TABLE 5

Maine Division of Vocational Rehabilitation Client Characteristics	
and Selected Comparisons to ACS Comparison Population	
					
	DVR Clients, FFY 2011*		Comparison Population**		
	N=3900		(Pooled 2008-2010 ACS)		
			N=2,031		
	Percent		Percent	Difference	
Primary Disability Type (DVR)					
No impairment	6.7		 	n/a	
Sensory	6.4		Disability type		
Physical	17.6		information is 		
Mental Illness	35.2		not comparable		
Cognitive	34.1		 		
Disability Type (ACS)					
Hearing	 		16.9	n/a	
Cognitive	Disability type		55.1		
Ambulatory	information is 		56.8		
Self-care	not comparable		20.0		
Independent Living	 		39.0		
Age at Closure					
  Less than 23	32.3		10.0	22.3	
  23 - 54	56.2		54.5	1.7	
  55 - 65	10.4		35.5	-25.1	
  Over 65	1.4				
Education					
  Less than HS	41.0		26.6	14.4	
  HS or equivalent	38.5		39.8	-1.2	
  Some College (incl AA degree)	14.7		27.3	-12.6	
  College or more (BA or higher)	5.7		6.3	-0.6	
Most recent work experience					
Working at time of DVR application (ACS: Worked in past 12 months)	13.1		12.9	0.2	
Not working at application	86.6		87.1		
Gender					
Male	56.7		53.0	3.7	
Female	43.3		47.0		
Race					
White	96.8		93.8	3.0	
Racial/ethnic minority	3.2		6.2		
SSI Income					
Received SSI income at application (ACS: in past year)	19.0		29.3	-10.3	
Did not receive SSI	81.0		70.7		
SSDI Income					
Received SSDI income at application (ACS: in past year)	25.3		36.8	-11.5	
Did not receive SSDI income	74.7		63.2		
					
* DVR client characteristic data is for all cases closed in FFY 2011, including both successful and unsuccessful closures.  Characteristics are based on information recorded at application unless otherwise noted.	
** Comparison population defined as individuals age 16 - 64 with a non-visual disability who do not report working in the past week (or being on temporary leave). 	
Source: Maine DVR Data and Muskie School of Public Service Calculations based on the American Community Survey Public Use Micro data Sample (PUMS)	

Are DVR Services Reaching the Eligible Population?

To determine if there are certain segments of the eligible population that are not being reached by the DVR program, we compare the characteristics of ACS disability sample against information collected by the agency on current DVR individuals (Table 1).  The result is shown in Table 5. Disability type information is not presented as a side-by-side comparison because the ACS disability measures are not comparable to the way that DVR collects primary disability type from each applicant.

•	Table 5 indicates that individuals in the DVR program are much more likely to be under age 23 at closure than individuals in the ACS disability sample.

•	DVR participants are generally less educated than the eligible population, with 41% lacking a HS degree versus only 27% in the ACS with a disability sample.

•	DVR individuals are also more likely to be male (57% versus 53%).

•	Historically, only a very small proportion of Social Security beneficiaries who qualify under a disability category have participated in the labor market, due largely to disincentives associated with the potential loss of cash and health benefits.  Federal laws like the Ticket to Work and Work Incentive Improvement Act and associated changes to Social Security program rules have reduced these disincentives, but many beneficiaries remain fearful about pursuing work.  Not surprisingly, recipients of Social Security cash benefits are therefore less likely to participate in the DVR program than the numbers in the ACS work disability would suggest:  DVR participants are less likely to be SSI recipients (19% versus 29%) and less likely to receive SSDI (25% versus 37%).  Maine’s SSI and SSDI participation rates are higher than Vocational Rehabilitation programs in states with similar VR expenditures. 

•	Table 5 indicates that DVR serves proportionately fewer individuals of racial or ethnic minorities than those identified in the ACS work disability population.

B. Social Security Recipients in Maine    
An alternative source of information that can be used to estimate the number of people in Maine who are eligible for DVR services comes from the Social Security Administration (SSA).  Maine residents who receive SSI or SSDI are presumed to be eligible for vocational rehabilitation services, as long as the individual is interested in getting a job.  Therefore, all SSI and SSDI recipients who qualify for payments from the Social Security Administration under a disability eligibility category are potentially eligible for DVR services and/or services from the Division for the Blind and Visually Impaired.

Table 6 lists the number of Maine recipients of both SSA programs by VR Region from December 2010.

Findings
•	It shows that there were more than 33,000 SSI recipients, and almost 56,000 SSDI recipients living in Maine.

•	Because many of these individuals are eligible for both SSI and SSDI, we cannot compute a precise total of individuals eligible for Social Security benefits. We estimate that there are approximately 75,000 Social Security beneficiaries with disabilities living in Maine, all of whom would meet the DVR eligibility definition of “substantial impediment to employment.”

TABLE 6

Open Maine DVR Cases, SSI and SSDI Recipients	
December 2010	
								
		Open DVR Cases	SSI Recipients	SSDI Recipients	
VR Region	Counties Included	Number	Percent	Number	Percent	Number	Percent	
Region I	Cumberland, York	2,018	34.2	7,977	23.9	15,480	27.9	
Region II	Androscoggin, Franklin, Oxford, Sagadahoc	1,493	25.3	6,687	20.0	10,655	19.2	
Region III	Kennebec, Knox, Lincoln, Somerset, Waldo	1,522	25.8	8,443	25.2	13,320	24.0	
Region IV	Hancock, Penobscot, Piscataquis, Washington	668	11.3	7,763	23.2	11,915	21.5	
Region V	Aroostook	196	3.3	2,568	7.7	4,155	7.5	
TOTAL	 	5,897	100.0	33,438	100.0	55,525	100.0	
								
Sources:								
- DVR Accumulative Caseload Report as of 10/31/2011.  Run on 11/2/2011.  Open cases from the Skowhegan Office (District 46) have been deducted from the Region IV total and added to the Region III total in order that the DVR Regional data is comparable to the SSI/SSDI data by county.	
-U.S. Social Security Administration, Office of Policy. SSI Recipients by State and County, 2010 - Maine
http://www.socialsecurity.gov/policy/docs/statcomps/ssi_sc/2010/	

-Social Security Administration, Office of Retirement and Disability Policy. OASDI Beneficiaries by State and County, 2010 - Maine. http://www.socialsecurity.gov/policy/docs/statcomps/oasdi_sc/2010/	
	
Because the Social Security data includes breakdowns by county, we can also use it as a proxy to examine whether DVR is reaching the geographically dispersed population of people with disabilities in Maine.  Chart 13 below compares the distribution of open Maine DVR cases, SSI recipients, and SSDI beneficiaries from December 2010.  First of all, it shows that the geographic distribution of both SSI and SSDI recipients is fairly similar; Region I (Cumberland and York counties) has a slightly higher concentration of SSDI recipients than SSI recipients (28% versus 24%), but the other Regions are essentially the same.  This concurrence supports the idea that the Social Security information is a reasonable indicator of where in the State of Maine people with severe disabilities are living.  

Comparing the distribution of Open DVR Cases against the Social Security program information, we see that there is a much lower proportion of open DVR cases who lived in Regions IV and V (14%) relative to SSI and SSDI recipients (31% and 28%).  

CHART 13

C. Minority Populations in Maine 

As indicated in Table 5, the vast majority of the DVR population is White, 3% compared to 6% identified in the ACS work disability potentially identifying a population of un-served individuals.  Table 7 below shows the distribution by Minority group for all cases closed in FFY 2011. 

Table 7

Minorities Served	FFY 2011	
 	#	%	
All 	3901	 	
White	3775	97%	
Black/African American	80	2%	
American Indian/Alaska Native	70	2%	
Asian	18	0%	
Native Hawaiian/Pacific Islander	4	0%	
Hispanic/Latino	51	1%	
Total # Minorities	223 	6%	
			
Note: The total exceeds the number of clients because individuals may list multiple race/ethnicity groups.  	

Another way to determine unmet needs for the Minority population is to identify where this population is located.  Table 8 shows the distribution of the minority population served by DVR Regions.  

Findings
♦	Although Region I only closed 32% of the cases in FFY 2011, 48% of the minorities served were in this region.  
♦	Regions II and III show a reverse trend, 22% closed of which 16% were in minority groups in Region II, and 21% closed with 13% minority for Region III.  

Table 8

FFY 2011	Minorities Closed	All Cases Closed	
Region	#	%	#	%	
I	99	48%	1222	32%	
II	33	16%	850	22%	
III	26	13%	814	21%	
IV	47	23%	828	21%	
V	9	4%	165	4%	

D. Students with Disabilities 
Prevalence: Students with disabilities are both represented in DVR’s current caseload and are an indicator of the possible disability distribution and needs of the future. Since the time of DVR’s last needs assessment, the Maine Department of Education has ceased collection of anticipated need for employment services data on students in special education. Using a current breakout of students ages 14-20 by disability category (see Chart 14), DVR can project however, that students with learning disabilities and those with physical impairments continue to be the largest disability populations. Of the over 10, 500 students in this age group in Maine schools, only 78 are identified as hearing impaired and 33 are identified as having a traumatic brain injury. Autism numbers continue to grow. While individuals with autism number 621, further analysis (see section below, E. Other Populations with Disabilities) reveals that this number will be increasing significantly in the coming years.

Chart 14

Distribution of DVR Transition Counselors:    Each Maine high school – and private special purpose school - has an assigned VR Counselor who has primary responsibility for serving its students. Recent changes in Maine law have required administrative consolidation of school districts, and as a result many high schools are in new districts that may not align with DVR service districts. Additionally a small number of high schools have closed or have been combined with other high schools. 

Chart 15 examines the numbers of VR Counselors who serve transition students with the current population of students in special education who are ages 14-20.  While not all of these students will become VR clients, it would appear based on this analysis, that there may be greater capacity in certain areas of the state than others. In particular, Region 1 (Cumberland and York Counties) and Region 4 (Hancock, Piscataquis, Penobscot, and Washington Counties) have the potential to be asked to serve a greater number of transition age clients per counselor in comparison to Region 3 (Kennebec, Knox, Lincoln, Somerset, and Waldo Counties) and Region V (Aroostook). In Region 2 (Androscoggin, Franklin, Oxford, Sagadahoc Counties) there appears to be a more equitable ratio of students to counselors.

Chart 15

E. Other Populations with Disabilities
Corrections:   In 2011, Maine DVR launched a workgroup with representatives of the corrections system across Maine. This workgroup has met regularly to examine how the two systems can work more effectively together. A DVR/DBVI procedural directive was issued in January 2012 that assigns a VR Counselor to each state facility and outlines how and when DVR will work with incarcerated applicants and identifies follow-up guidelines. Historically, many individuals who may be eligible for DVR services upon reentry into the community have been either unaware of services or due to transiency and lack of coordination between DVR and Corrections have failed to appropriately access services. The new protocol also includes resources to collect eligibility data from the corrections system. Maine has not collected definitive information concerning disability and the prisoner population. According to a recent report from Maine’s Chapter of NAMI, “Mental Health Services in Maine: A Blueprint for Action”, at least 16% of inmates in Maine’s prison systems have been identified as having significant and persistent Mental Illness. A 2010 report by Maine’s Juvenile Justice Task Force also identified that approximately 75% of Maine’s incarcerated youth have diagnoses related to mental health, substance abuse and trauma. With the launch of DVR’s new MaineAware case management system, clients with current or previous corrections involvement will be flagged – allowing for better data collection, management and targeted interventions.

Older Workers:  Maine has historically ranked in the top three oldest states according to general population. According to the 2010 ACS survey, over a third of individuals with disabilities in Maine are ages 55-64. As seen in Table 1, DVR cases involving individuals ages 55-64 experienced a 14.4 % growth in the numbers of closures since 2007.  In recognition of the needs of Maine’s older workforce and the needs of employers for trained workers, the Coastal Counties Workforce Investment Board applied for and was awarded funding to develop the Aging Worker Initiative. Under this effort, approximately 15 % of participants have self-disclosed a disability. An examination of services provided through the Bureau of Employment Services in Program Year 2010 reveals that individuals aged 55-64 with disabilities are represented across programs (Re-Employment, WIA formula, Trade Assistance, National Emergency Grants), however numbers are low at 137. 

Native Americans:    In a state that has little statistical diversity of minority populations, Native Americans represent a historically recognizable group.  While according to the US Census, Native Americans are just 0.6% of Maine’s population, they represent 2% of DVR cases closed in FFY 2011 (Table 7). This higher percentage may be due in part to Maine’s close working relationship with its Native American VR Section 121 program. Maine was awarded this funding for the first time in 2008. Maine DVR and the Section 121 program, Wabanaki Vocational Rehabilitation, have established a Memorandum of Understanding, revisited annually, that promotes collaboration through shared training and professional development, regular meetings, and co-enrollment as appropriate. According to Wabanaki VR, Maine has approximately 13, 500 tribal members who are located both on reservations and defined land, as well as scattered across the state. Tribal members are primarily located in Washington and Aroostook Counties. In Washington County, 4.4% of the population identify as Native American. Unemployment figures among the Micmac and Maliseet tribes range from 55 to 76%. In Federal Fiscal Year 2011, Wabanaki VR served 75 clients and closed 17 successfully in employment.

Learning Disabilities:   Maine’s State Rehabilitation Council has expressed concern that there is not enough known about service provision to people with learning disabilities in Maine. With the exception of data on transition age students in Maine that shows that students with learning disabilities represent the largest disability category (Chart 14), there is little other current data collected in Maine on the total population of individuals with learning disabilities. People with learning disabilities may be represented across disability categories. Further analysis is needed to learn if Maine DVR is serving a representative ratio of individuals with learning disabilities. Now that Maine DVR is able to serve individuals in Order of Selection Categories 2 and 3, it is much more likely that individuals with learning disabilities - which may present less of a barrier to employment than some other disabilities – will be served by DVR. Maine DVR continues to do outreach with schools to educate them on the elimination of the waitlist and the resulting broader population of students who may be served.

Autism:  Maine, like the rest of the United States, is experiencing an increase in the numbers of individuals identified with Autism spectrum disorders. Approximately 6% of students in special education – who are transition age – are considered to have Autism (Chart 14). Data from the Maine Department of Education shows, however, that among all students in special education, 8% are categorized as having an Autism disability. The growing identification of Autism is most apparent when looking at younger students who are being identified with special education needs. Thirteen percent of students age 6 who receive special education services do so under the category of Autism. Analysis from the Maine Developmental Disabilities Council highlights a 111% increase from 2004 to 2010 in the numbers of students being identified under the autism exceptionality.  The Maine Department of Health and Human Services 2011 Autism Spectrum Disorders Report confirms that numbers of individuals served with Autism are increasing in all counties of Maine; however the most significant percentage of increase has been in Lincoln, Hancock, and Waldo Counties – along Maine’s mid-coast. Maine DVR is working closely with our partners in Education and Human Services to prepare for meeting the workforce needs of this population. In 2012, Maine DVR is partnering with the University of Maine’s Center for Community Inclusion’s Family Centered Transition Project to increase education, outreach and services to transition age youth and their families with the goal of improving post-secondary outcomes, including employment. 

Veterans:  Maine has historically had a high percentage of residents who are veterans. According to the National Center for Veterans Analysis and Statistics, at this time Maine has over 138, 000 veterans. Over 40% of Maine’s veterans are over age 65 - a figure that is in line with national averages. With the passing of WWII veterans, overall numbers of veterans continue to decline nationally, as well as in Maine. This contrasts with the Center’s data that shows that the numbers of veterans with service-connected disabilities is growing at a steep rate (over 3.2 million individuals nationally). This spike is no doubt related to the increasing numbers of servicemen and women who are returning from conflict in Iraq and Afghanistan. Medical improvements are saving the lives of soldiers, but often leaving them with significant disabilities. In recognition of the increasing needs of veterans, Maine DVR executed a Memorandum of Understanding with Veterans Affairs - Vocational Rehabilitation and Employment (VA-VR & E) in 2011. The MOU outlines how the two agencies will work together to maximize resources and services for individuals with disabilities who need vocational rehabilitation services. The MOU also supports cross-training of VA - VR& E counselors and identifies a veteran’s liaison in each of the larger DVR field offices. With the adoption of the new MaineAware case management system, better data is going to be able to be collected and managed concerning veterans who access DVR. Maine’s Wagner-Peyser jobseeker data shows that during the last program year, 18 % or 614 of the 3, 328 individuals who self-reported disability, were veterans.

TANF:   Individuals who receive TANF (Temporary Assistance for Needy Families) often have significant barriers to employment. Recently enacted legislative changes in Maine will now enforce a 5 year limit for individuals to receive TANF benefits. In anticipation of these changes, Maine DVR has been working closely with the Department of Health and Human Services to share data on the numbers and needs of individuals who will be exiting TANF rolls. DVR field offices will be collaborating with DHHS to share information on services and resources available. Over 2,100 individuals who receive TANF- ASPIRE services self-report as having a disability (emotional/mental health, medical, learning and alcohol/substance abuse). These individuals are spread across the state according to general population distribution with the exception of the South Paris (Oxford County) and Calais (Washington County) offices, which appear to report a higher ratio of individuals with employment barriers. Additional analysis by DHHS has further identified that among those who self-report disability, approximately 50% are not receiving MaineCare services and treatment for their stated disabling condition. This may represent an area where DVR and DHHS can work together to expand access to treatment - ultimately reducing employment barriers.

Traumatic Brain Injury:   In 2011, Maine DVR joined the Department of Health and Human Services and other partners to offer a conference on brain injury and employment. The overwhelming response to the conference confirmed that there is a growing need for increased understanding of the impact of brain injury on employment and standards of best practices for employment professionals. In January 2010, the Muskie School of Public Service prepared a needs assessment report on brain injury in Maine for DHHS – Brain Injury Services and the Maine Acquired Brain Injury Advisory Council. Among the key findings of the report were that people with brain injury do not have sufficient financial and geographic access to services and that many providers do not have adequate training concerning brain injury. A very recently released report by the Acquired Brain Injury Advisory Council of Maine identified improving employment opportunities for persons with brain injuries as one of their top three priorities. Building on the results of the 2011 conference, the group recommended that the Departments of Health and Human Services and Labor should better coordinate vocational rehabilitation and long-term job supports, as well as provide additional training on brain injury rehabilitation to all staff. The report also noted that data concerning brain injury is often difficult to separate from other disabilities due to disability definition and collection.

Immigrant Resettlement & “New Mainers”:  While Maine’s minority population is small (see section II, A.), two areas of Maine have seen significant increases in the numbers of non-English speakers due to refugee resettlement programs. According to the 2010 American Community Survey, approximately 84,000 Maine residents speak a language other than English at home. Among persons naturalized in Maine during fiscal year 2010, the countries of origin most represented were: Somalia, Canada, Sudan, China, and the Philippines. Additionally, over 1,300 people obtained legal permanent resident status in Maine during that same year. Those individuals most often came from Somalia, China, Canada, Iraq, Kenya and the Philippines. Refugee resettlement in the cities of Portland and Lewiston are reflected in significantly different demographics than in Maine as a whole. According to the US Census Bureau, the population of Portland is 85% White, 7 % Black, and 3.5 % Asian, and of Lewiston is 87% White and 9% Black. This compares with Maine’s general population which is over 95% white. The percentage of foreign-born residents in Portland is 11% and in Lewiston is 5% while in Maine overall it is only 3 %. As seen in Table 5, the ACS Comparison Population estimates that 6.2% of individuals with a work disability in Maine belong to a racial or ethnic minority. VR Counselors who are serving clients in Portland and Lewiston may need additional training and resources to meet the needs of a very diverse population. Targeted culturally appropriate outreach may also be needed to ensure that information concerning VR resources is available to individuals who belong to potentially underserved minority populations. 

Deaf, Hard Of Hearing & Late Deafened: Individuals who are Deaf and Hard of Hearing are estimated to be 16.2% of adults, nationwide (National Center for Health Statistics/CDC, 2010). Rates of individuals identified with hearing loss increases with age. The 2010 ACS estimated that in Maine there are 22, 564 individuals of working age who have a hearing disability. After age 65, the percentage of individuals with hearing loss increases substantially. As seen in Chart 6, individuals with hearing loss served by DVR have a consistently higher rehabilitation rate (81%) in comparison to individuals with other disabilities. Individuals with Hearing Loss also have higher average weekly wages and hours worked at DVR successful closure (Chart 8).

Maine DVR has recently hired a new Director for the Division of the Deaf, Hard of Hearing and Late Deafened. In conjunction with this new hire, Maine’s three Rehabilitation Counselors for the Deaf will now be supervised by the Division Director – strengthening the resources and skills of the Deaf Services team. The Maine Bureau of Rehabilitation Services (BRS) has a contractual agreement to procure hearing aids for eligible Maine clients of the Vocational Rehabilitation Program. This contract is in the form of a cooperative agreement through the state of Minnesota, which in turn contracts directly with hearing aid manufacturers around the United States.  BRS has been making use of these contracts since October 2010 and has realized significant savings (over $300,000 in FFY 2011) for the state, which has allowed DVR to serve additional individuals who otherwise may not have been able to access services.

During the collection of stakeholder feedback, DVR received many positive comments about the impact of the new hearing aid protocols. Areas of concern that were identified included: the lack of community rehabilitation providers (CRP’s) who are fluent in ASL; the quality of transition services to youth who are deaf or hard of hearing; and the need to increase DVR and CRP understanding of Deaf culture. As the population of Maine continues to age and as DVR is now able to serve individuals in all three Order of Selection priority categories, it is increasingly likely that the number of individuals who experience hearing loss and who need DVR services to obtain or maintain employment will continue to grow.
 V. COMPARISON TO OTHER STATES
Comparing Maine’s Division of Vocational Rehabilitation to its peer state VR agencies can provide further insight into areas for focus in the coming years. Maine’s peer states include Idaho, Montana, New Hampshire and Vermont. These states were selected as “peers” because each state’s VR program served between 2,600 and 5,600 individuals in FFY 2010, have grants of similar size ($16 to $19 million) from the Rehabilitation Services Administration, and are largely rural states with less than 1.6 million total populations. It should be noted that the VR agencies in both Montana and New Hampshire serve individuals with blindness and visual impairments under a single combined agency, unlike Maine, Idaho and Vermont where these individuals are served by a separate unit. Also, Maine was the only state among this set of peers with a waiting list in effect through FFY 2010.

As reported in Chart 16, the employment rate among individuals whose cases were closed after receiving services in FFY 2010 in Maine and its peer states varied from 42% to 63%. Maine has the second lowest overall rehabilitation rate among its peer states.

CHART 16

Breaking out the FFY 2010 rehabilitation rate by disability type in Chart 17, we see that the same general pattern observed in Maine exists in all the peer states; individuals with communicative impairments tend to have the highest rehabilitation rates, and those with mental and emotional disabilities tend to have the lowest. (Note that individuals with visual impairments are not included in these figures.) Compared with the peer state average (far right bar), Maine’s rehabilitation rates (far left bar) are significantly lower for three of the four disability types. Only among individuals with communicative impairments does the Maine rehabilitation rate match its peers. 

CHART 17

Among successful closures shown in Chart 18, Maine has the lowest average hours worked per week, but average earnings are actually higher than most of its peer states.

CHART 18

Again breaking out the employment outcomes among successful closures by disability type in Charts 19 and 20, we find that in terms of average hours worked per week, Maine lags its peers except for clients with communicative disorders, where Maine actually exceeds the peer averages.  Notable is that we find that average hourly earnings at case closure in Maine exceed the peer state average by more than $1 among those with physical disabilities, and more than $3 among those with communicative impairments.

CHART 19

CHART 20

Compared to its peer state VR agencies, DVR clients with successful employment outcomes spent an average of 17 months longer in the VR process. As noted earlier in this report, Maine DVR had a waiting list until the end of FFY 2010, which impacted the average case length of individuals reported in Chart 21 below.  FFY 2011 data (reported previously in Chart 5) does show an improved 33 month average for individuals successfully placed in employment, but the time remains well above Maine’s peer states.

CHART 21

VI. DISCUSSION

DVR has continued to provide vocational rehabilitation services to thousands of Mainers with disabilities each year, despite a significant downturn in the economy and severe state budget shortfalls.  This Needs Assessment is detailed and comprehensive as DVR and its State Rehabilitation Council worked together to gather and analyze a wide range of information, including the agency’s own performance data, existing disability population statistics, disability population projections and input from stakeholders.  

As noted earlier in this report and in comparison to the 2009 Needs Assessment, a major affect on the data and service provision during these past three years is that in October 2010, DVR successfully eliminated its waitlist in all three disability priority categories.  This waitlist had been in place since 2001, so between January 2009 and October 2010, Maine DVR worked on streamlining many of its processes to increase efficiencies and contain costs.  In addition, staff contacted many people who were on the waitlist, some of whom were in categories 2 and 3 for years, as well as many individuals who had lost contact with the agency.  A large percentage of people were found to have already started employment plans with us, but were either not able or ready to re-engage with us at the time they were contacted.  This had a negative impact on our rehabilitation rate, which is clear from the data shown in this report.  

As with the 2009 Needs Assessment, individuals served by DVR remain generally very satisfied with the services that they receive and report feeling that they are treated with dignity and respect.  We have also received very positive feedback from providers, clients and our other agency partners that it is extremely helpful to all that DVR no longer has a waitlist.  In addition to the Market Decision, LLC, client satisfaction survey, we received valuable feedback by working with our SRC who conducted a facilitated public forum and also has developed a client satisfaction survey that is maintained on their website.  The public forum provided us with some targeted constructive feedback about the DVR program, including transition services, job development and consistency of services.  

In terms of case service expenditures, job development and placement continues to be the largest single service group, representing 20 to 26 percent of total DVR case costs each year.  A number of service groups saw large decreases, including maintenance services, transportation costs, and diagnosis and treatment services.  Maine DVR has seen a drop in the cost of College or University Training, and Occupational/ Vocational Training as well.  Maine DVR developed several specific new procedural directives for counselors to use to help determine that the assistance they were giving in these areas were directly related to a person’s employment goal and absolutely necessary for an individual to obtain and maintain employment.  

In the areas of unserved and underserved groups, existing disability population statistics suggest that Maine has a large population of individuals with disabilities, including those receiving SSI and/or SSDI, who are working age adults and might benefit from services through DVR.  Transition students (clients under the age of 21) with disabilities make up 32% of the population that we serve and we have 25 of our 66 VR counselors working within the school systems to serve these students.  This past year, Maine DVR updated our Memorandum of Understanding with the Department of Education with the goal of making a smoother connection of these students to the VR programs.  

In addition, DVR has seen an increase in the numbers of referrals from our partners at DHHS.  The fact that Developmental Services has a waitlist for individuals coming out of the school system to access waiver services impacts clients being able to obtain long term supports.  There have been a number of staff changes and cuts in DHHS, which also negatively impact access to services for people with mental illness and developmental disabilities.  Additionally, improving employment opportunities for individuals with brain injury has been identified as a need in Maine.  

Services to minorities with disabilities in Maine have always been a challenge to DVR because of the state’s homogeneous population and low ethnic diversity.  DVR continues to work collaboratively with the Houlton Band of Maliseets, which was awarded a five year Section 121 grant in FY 2008.  We re-visit our Memorandum of Understanding every year with the goal of providing better services to Maine’s Native Americans.  The population of other minority groups is slowly increasing in Maine through resettlement programs and migrant employment, and Maine DVR could do some more targeted outreach to help in the awareness of our program’s availability.  

VII Recommendations

Maine’s Division of Vocational Rehabilitation completed a major initiative to eliminate the waitlist and provide “the right service at the right time” to its consumers.  Maine DVR successfully eliminated its waitlist in all three categories effective on October 1st, 2010.  In addition to eliminating the waitlist, a number of recommendations and procedures were put into place with the goal of streamlining and using our staff and financial resources more efficiently.  

This Comprehensive Statewide Needs Assessment lends strong support to the importance of continuing with no waitlist and further targeting several areas that were raised in this report, including:

•	Review and improve how we are using our resources with community rehabilitation providers to increase employment outcomes.  
•	Continue to work closely with our partners at DHHS to provide employment services while people with intellectual disabilities are facing a waitlist for long term supports in work services.  
•	Continue to work collaboratively with the Department of Education to provide seamless transitions to employment as more and more students seek VR services as they enter adulthood.
•	Continue to develop direct relationships with employers and business-to-business supports that result in successful models of employment for individuals with disabilities
•	Maintain no waitlist, while continuing to address the high numbers of individuals in Plan Development (Status 10), and focus on those who drop out of the program, including how we can better keep people engaged in the VR program once they have developed a plan.
•	Closely monitor financial and human resources in order to continue to maintain no waitlist for services.  

APPENDIX 1
Order of Selection

ORDER OF SELECTION

A.	Priority Category # 1, "Most significantly disabled" means an eligible individual who meets the following criteria:

(1)	who has a serious limitation in terms of an employment outcome in four or more functional capacity areas. Functional capacity areas are; mobility, work tolerance, communication, self-care, interpersonal skills, cognition and learning (self- direction), or work skills.  "Serious limitation in terms of an employment outcome" means a reduction of one's capacity to perform, due to severe physical or mental impairment, to the degree that the individual requires services or accommodations in order for the individual to work or be a fully functioning member of the community; and

(2)	whose vocational rehabilitation can be expected to require multiple vocational rehabilitation services, meaning two or more core vocational rehabilitation services as outlined in Section 9 of this rule, services 9.1 through 9.14; and

(3)	whose vocational rehabilitation can be expected to require an extended period of time.

B.	Priority Category # 2, "Significantly disabled" means an eligible individual who meets the following criteria: 

(1)	who has a serious limitation in terms of an employment outcome in at least two or three functional capacity areas.  Functional capacity areas are; mobility, work tolerance, communication, self-care, interpersonal skills, cognition and learning (self- direction), or work skills. "Serious limitation in terms of an employment outcome" means a reduction of one's capacity to perform, due to severe physical or mental impairment, to the degree that the individual requires services or accommodations in order for the individual to work or be a fully functioning member of the community; and

(2)	whose vocational rehabilitation can be expected to require multiple vocational rehabilitation services, meaning two or more core vocational rehabilitation services as outlined in Section 9 of this rule, services 9.1 through 9.14; and

(3)	whose vocational rehabilitation can be expected to require an extended period of time; and

(4)	who has one or more physical or mental disabilities resulting from amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, acquired traumatic brain injury, heart disease, hemiplegia, hemophilia, HIV infection, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculo-skeletal disorders, neurological disorders (including stroke and epilepsy), spinal cord conditions (including paraplegia and quadriplegia), sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment for determining eligibility and vocational rehabilitation needs to cause comparable substantial functional limitation.

C.	Priority Category # 3, "Disabled" means an eligible individual who has;

(1)	a serious limitation in terms of an employment outcome in 1 or more functional capacity areas.  Functional capacity areas are; mobility, work tolerance, communication, self-care, interpersonal skills, cognition and learning (self- direction), or work skills.  "Serious limitation in terms of an employment outcome" means a reduction of one's capacity to perform, due to severe physical or mental impairment, to the degree that the individual requires services or accommodations in order for the individual to work or be a fully functioning member of the community; and:

(2)	whose vocational rehabilitation may or may not require multiple core vocational rehabilitation services as outlined in Section 9 of this rule, services 9.1 through 9.14; or

(3)	whose vocational rehabilitation may or may not require an extended period of time.

Individuals Not Meeting the Order of Selection Criteria

		Eligible individuals who do not meet the Order of Selection category currently being served will have access to services through information and referral. Individuals will be provided vocational rehabilitation counseling and guidance to assist such individuals in preparing for, securing, retaining, or regaining employment, and will be appropriately referred to other programs, including other components of the statewide workforce investment system.

APPENDIX 2  

Maine Division of Vocational Rehabilitation	
Case Closure Status by Disability Type, FFY 2007 - 2011	
						
	Federal Fiscal Year	
	2007	2008	2009	2010	2011	
All Closures						
Total Closures	3288	3604	3513	3848	3900	
Status 26	696	730	649	573	705	
Status 28	658	759	670	714	810	
Rehabilitation Rate*	51%	49%	49%	45%	47%	
Visual or no impairment						
Total Closures	72	104	121	252	265	
Status 26	2	0	1	1	0	
Status 28	0	1	1	0	2	
Rehabilitation Rate*	100%	0%	50%	100%	0%	
Deaf/Hard of Hearing						
Total Closures	206	236	269	225	243	
Status 26	116	134	143	124	154	
Status 28	26	32	44	30	36	
Rehabilitation Rate*	82%	81%	76%	81%	81%	
Physical						
Total Closures	816	873	805	832	687	
Status 26	150	170	116	104	116	
Status 28	175	204	185	172	147	
Rehabilitation Rate*	46%	45%	39%	38%	44%	
Mental Illness						
Total Closures	1204	1289	1226	1276	1374	
Status 26	203	174	157	118	163	
Status 28	255	276	251	253	318	
Rehabilitation Rate*	44%	39%	38%	32%	34%	
Cognitive						
Total Closures	990	1102	1092	1263	1331	
Status 26	225	252	232	226	272	
Status 28	202	246	189	259	307	
Rehabilitation Rate*	53%	51%	55%	47%	47%	
						
*Rehabilitation Rate = Status 26 Closures / Status 26 + Status 28 Closures