bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Study of Interagency Coordinating Councils
Authors: Lee Baker Dana , Stahl Eva Marie
Published: May 2008

Children with disabilities often require a variety of services to develop to their full potential. Currently, centralized services and residential institutions have become less accepted as a matter of course. Interagency Coordinating Councils (ICCs) were created to lead integration of services for children with disabilities in the context of decentralized service provision and a growing preference for person-centered, community-based services. In this article, the authors examine the federal ICC and several state ICCs in a case study of the challenges associated with orchestrating multilevel interagency collaboration. Emergent themes of interorganizational infrastructure, the shaping of participation, and service purposes and priorities are discussed as important elements of the ongoing creation of a new governance of services for children with disabilities.
A National Profile of SSDI Recipients and Applicants
Authors: Kennedy Jae , Olney Marjorie , Schiro-Geist Chrisann
Published: May 2008

Less than one half of 1% of Social Security Disability Insurance (SSDI) beneficiaries currently return to work. The 1999 Ticket-to-Work and Work Incentives Improvement Act (TWWIIA) charged the Social Security Administration with investigating early intervention strategies to divert some of the persons applying for benefits into work support programs before they enroll in SSDI. Any early intervention programming will require greater understanding of the claimant population. This analysis used data from the 1994 and 1995 National Health Interview Surveys to compare the estimated 3.3 million working-age SSDI claimants to the estimated 3.6 million beneficiaries. These comparisons showed substantial heterogeneity in both groups but found that claimants were less disabled, in better health, and more likely to be employed than beneficiaries. Both groups tended to have low incomes, and nearly 20% of claimants lacked health insurance. Approximately 70% of applicants (2.3 million) and beneficiaries (2.6 million) have not received vocational support services and do not believe that they need such services. These findings suggest that demand for vocational services vouchers may be low.
How States Implement Alternate Assessments for Students with Disabilities
Authors: Browder Diane , Ahlgrim-Delzell Lynn , Flowers Claudia , Karvonen Meagan , Spooner Fred , Algozzine Robert
Published: May 2008

The IDEA Amendments of 1997 mandate inclusion of students with disabilities in accountability systems. By 2001 professionals in many states had begun to develop alternate assessments to focus on students' performance relative to general education performance criteria. The purpose of this study was to examine how alternate assessments have been defined and aligned with state general education standards and to identify the methods that have been used to score the assessments. An analysis of states' documents revealed a variety of alignment and scoring methods. In most states, either assessments were linked to state general education standards or those standards were extended to include alternate assessments. Academic domains were measured in most states, but some states measured only functional skills. Most states used some form of rubric to score the alternate assessments, typically measuring mastery, progress, or level of independence. The article concludes with recommendations for enhancing national policy on alternate assessment.
Advocacy Issues and Strategies for the 21st Century
Authors: O'Day Bonnie , Goldstein Marcie
Published: May 2008

The authors conducted key informant interviews with 16 disability advocacy and research leaders; half of the interviews were with leaders in shaping national disability policy during and after passage of the Americans with Disabilities Act of 1990, and half were with state and local leaders representing constituencies who had not had a visible presence at the national level. During audiotaped telephone interviews, we asked the informants to identify the top 5 advocacy priorities for the next 10 years, as well as what strategies they thought could advance the disability advocacy agenda. Two overarching themes emerged: the impact of poverty among people with disabilities and the connections among various advocacy issues. The authors discuss the 5 issues most often cited by the participants, as well as issues particular to various constituencies, and draw conclusions about what strategies would advance the disability agenda.
Attitudes of Persons With Physical Disabilities Toward Physician-Assisted Death
Authors: Hwang Karen
Published: May 2008

Physician-assisted death (PAD) has been a passionately debated topic among people with disabilities. Opponents of legalized PAD have argued that social discrimination has rendered persons with disabilities a “vulnerable population” who could be pressured to “choose” death even when not mentally competent to do so. However, the data from Oregon do not appear to support the idea that persons choosing PAD were doing so out of psychological or social distress. An exploratory survey of persons with physical disabilities shows that respondents endorse a wide variety of views regarding PAD. Personal reflections and public policy considerations are discussed.
End-of-Life Care Policies for People With an Intellectual Disability
Authors: Botsford Anne L. , King Angela
Published: May 2008

It is estimated that more than 650,000 individuals with intellectual disabilities live with caregivers who are 60 or more years old. As they age, they face end- of- life issues in relation to their caregivers, as well as their own health care needs. This article examines some of the major issues concerning end- of- life care for people with an intellectual disability, presents findings of a recent national survey on end- of- life care vis-á-vis the policy implications, and describes some of the emerging strategies and innovations designed to promote improved end- of- life care.
Concerns About Decisions Related to Withholding/ Withdrawing Life-Sustaining Treatment and Futility for Persons With Disabilities
Authors: Werth James L.
Published: May 2008

Disability rights advocates have expressed significant concern about the potential dangers assisted suicide poses for persons with disabilities. This article extends this examination of concerns to withholding and withdrawing treatment in general and, in the specific case of physicians, using the futility rationale to discontinue or not start treatment. The arguments set forth against assisted suicide are applied to withholding and withdrawing treatment and futility and are shown to be at least as applicable to these other forms of hastening death. The article concludes with some policy suggestions.
Policy, Prejudice, and Reality
Authors: Longmore Paul K.
Published: May 2008

The petitions of two quadriplegic ventilator users for doctoral-assisted suicide and the responses to them illustrate the issues that frequently appear in such cases and, therefore, the dangers of legalizing that practice. The courts, the media, and other observers failed to recognize or ignored the discriminatory elements of public policy, health-care delivery, and social services that make the lives of some people with disabilities unendurable; in particular, by denying adequate funding for independent living, by failing to offer appropriate psychological evaluation and intervention, and by disregarding the perspectives of disability rights movement leaders in these cases and on these issues.
Whose Choice Is It, Anyway?
Authors: Pavlides Merope
Published: May 2008

The purpose of this aricle is to examine four contemporary American films—Whose Life Is It Anyway?; `Night, Mother; One True Thing; and The Hours —that depict suicides of individuals with disability or illness, in an attempt to articulate how these images reflect, and influence, social perceptions of the worth of life in such circumstances. These films will be examined in light of dramatic structure, character depictions, and thematic intent. This review confirms the hypothesis that such films underscore our cultural tendency to view disability and illness as an experience that demands release rather than support.
Our Lives and Ideologies
Authors: Amundson Ron , Taira Gayle
Published: May 2008

The opposition to a public policy of physician-assisted suicide from within the disability-rights community seems to be surprising to academics who are supporters of other civil rights movements. Physician-assisted suicide is seen by them as a part of a progressive political agenda, akin to abortion rights and the civil rights of minorities. Many disability-rights advocates see physician-assisted suicide as quite the opposite—an example of discrimination against people with disabilities and a threat to their individual rights. The great conflict between these two interpretations is not much reduced by listening to one another's arguments. Perhaps it will be better understood by considering how the political beliefs of real individuals have been changed by their own experiences with disability. This article reports how two individuals were led to change their beliefs about physician-assisted suicide as a result of their life experiences with disability.
A Case Against Physician-Assisted Suicide
Authors: Radtke Richard
Published: May 2008

To discuss the issues surrounding physician-assisted suicide, I use myself as a case study to address the arguments surrounding dignity, unbearable pain, autonomy, length of life, quality of life, and duress as they apply to one's life. Problems are identified along with possible solutions. The lack of encouragement by society leads to an unsupportive environment, which causes us to underestimate any potential for a quality life we might obtain. A remedy to this problem would be the establishment of a community support network in which people could develop socially as well as mentally. Such a network would allow people with painful and life-threatening conditions to have access to information regarding both the technology that would enable them to explore life and the basic knowledge to enjoy life.
Caring for Aunt Alice
Authors: Saxton Marsha
Published: May 2008

This personal narrative explores the thoughts and emotions of a disability advocate as she becomes initiated into the charged arena of aging, care giving, and dying. She is assisting her increasingly disabled elder aunt through her end-of-life years. Both must grapple with many complex social and emotional issues: denial of disability, combativeness in reaction to dependence and loss of control, and the specters of assisted suicide and nursing home placement. They face the painful realization that even deep affection, family history, progressive politics, and extensive disability community resources do not necessarily ease the situation.
Why I Changed My Mind About Physician-Assisted Suicide
Authors: Olkin Rhoda
Published: May 2008

In 1996 a multidisciplinary conference was held at Stanford University to develop consensus guidelines for physician-assisted suicide (PAS). I attended as a representative of the disability community and entered the conference a proponent of PAS but exited as a devout member of Not Dead Yet. This article outlines the key issues leading to that conversion. The conference attendees were unable to reach consensus.
State-Level Interagency Agreements for Supported Employment of People With Disabilities
Authors: Metzel Deborah S. , Foley Susan M. , Butterworth John
Published: May 2008

Supported employment for people with disabilities has been a national policy since the late 1980s. Because its implementation usually requires the resources of at least 2 funding and service state agencies, written interagency agreements have been a formal strategy for policy implementation. This qualitative study analyzes interagency agreements for supported employment and the resulting collaborations of 6 states to identify the crucial characteristics that reinforce their utility and value. Commonalities and differences indicated three broad categories: outcomes, characteristics of the written agreements, and characteristics of the midlevel staff. Specific elements are discussed to improve creation and implementation of interagency agreements to expand supported employment for people with disabilities.
Self-Employment Policies
Authors: Arnold Nancy L. , Ipsen Catherine
Published: May 2008

In 1991—1992, the Research and Training Center on Rural Rehabilitation (RTC: Rural) evaluated 45 state vocational rehabilitation (VR) agencies' policies and procedures regarding self-employment for people with disabilities. Based on this analysis, researchers developed and broadly disseminated a model VR self-employment policy. In 2002, RTC: Rural investigated state policies again to see how they had changed. This article reports the results of that investigation. Overall, current policies are much more positive toward self-employment than previous ones. The number of model policy components addressed has increased from an average of 3.7 components to an average of 6.6 components. Many agencies have developed self-employment programs and published manuals specifically for counselors. The article concludes with policy recommendations and suggests areas for future research.
Connections Among the Core Concepts of Health Policy and the Core Concepts of Disability Policy
Authors: Stowe Matthew J. , Turnbull H. Rutherford , Umbarger Gardner T.
Published: May 2008

This article reports research that connects the core concepts of health care policy and the four related health care principles (benevolence, nonmaleficence, autonomy, and justice) to prior research on the core concepts of disability policy and a framework that reflects constitutional, ethical, and administrative principles.
Lessons Learned From the Provision and Funding of Employment Services for the MR/DD Population
Authors: Wehman Paul , Revell Grant
Published: May 2008

The goal of Ticket to Work is to support job acquisition and job retention among Social Security Administration (SSA) disability beneficiaries in job situations where earnings are sufficient to move these individuals off SSA disability cash benefits. This article considers the adequacy of provider payment incentives through the Ticket to Work for helping persons with mental retardation/developmental disabilities (MR/DD) achieve employment outcomes. It examines the work support strategies that have demonstrated their effectiveness in assisting persons with MR/DD acquire and retain employment, particularly with SSI and SSDI recipients. It analyzes the experience to date in using performance-based funding to purchase job acquisition and retention services, and the implications of this experience for the implementation of the Ticket to Work reforms. Specific areas related to the Ticket to Work addressed in the article include: the ceilings on current proposed milestone-outcome and outcome payments in the Ticket compared to what is known about providers' cost structures in other performance-based funding systems; and the factors likely to influence the decision-making of Employment Networks in accepting or rejecting Tickets. The article concludes with recommendations for restructuring the Ticket to Work to improve the adequacy of access to the Ticket program for SSI/SSDI recipients who are potentially viewed by Employment Networks as highly challenged in achieving an employment outcome.
The Division of Labor Among Systems of Therapeutic Care for Children with Disabilities
Authors: Leiter Valerie
Published: May 2008

This article demonstrates that there is a division of labor in therapeutic care for children with disabilities (i.e., physical, occupational, and speech/language therapy) between educational and medical systems, with educational systems providing the bulk of that care. Analyses of the 1994—1995 National Health Interview Survey Disability Follow-back show that the majority of children with disabilities who received therapeutic care (75%) received those therapies only through school, whereas the remaining children received therapies only through health insurance (14%) or through other or multiple systems (11%). The majority of children who received therapies through school received speech/ language therapy, whereas most who received therapies through health insurance received physical therapy. Children served through the schools were younger and were more likely to have communication and learning limitations, compared with those who received therapies through insurance. Policy implications regarding payment for pediatric therapies and coordination of care across multiple service systems are discussed.
Vouchers and Students with Disabilities
Authors: Etscheidt Susan
Published: May 2008

School choice initiatives such as open enrollment, magnet schools, charter schools, and voucher plans have been offered as methods of school reform. A publicly funded voucher plan in Florida targeting students with disabilities was considered as a possible model for the reauthorization of the Individuals with Disabilities Education Act. Although the model was not adopted in the reauthorized law, the potential impact of such voucher plans must be examined.. The empirical evidence regarding the impact of vouchers on parent choice, student achievement, and fiscal school management is inconclusive and incomplete. Further, the impact of voucher plans on educational programs for students with disabilities has not been thoroughly studied. Such an examination requires a multiparadigmatic analysis of legal, economic, academic, sociological, and political dimensions.
Reduction of Physical Restraints in Residential Treatment Facilities
Authors: Miller Jeffrey A. , Hunt Daniel P. , Georges Megan A.
Published: May 2008

Children and adolescents with severe emotional and behavioral problems in residential settings can become so aggressive that physical restraints are utilized to keep them and others safe. Recently, the use of physical restraints in residential treatment facilities for school-aged children has come under increased scrutiny, and there have been legislative mandates that the use of physical restraints be reduced. This article describes a quasi-experimental field study conducted to examine the effectiveness of a 2-phase (organizational and milieu) physical restraint reduction intervention in a multisite residential treatment center. Results provide support for the effectiveness of organizational-level and milieu interventions for restraint reduction. Overall, restraint rates were reduced by 59% using these interventions.
Accessibility of Pennsylvania's Victim Assistance Programs
Authors: Frantz Beverly L. , Carey Allison C. , Bryen Diane Nelson
Published: May 2008

The prevalence of sexual abuse and domestic violence among women with disabilities is at least as high as the rates experienced by women without disabilities. However, according to anecdotal accounts and preliminary research, many victim service agencies are inaccessible and do not provide appropriate support and services for people with disabilities. This study examined the physical and programmatic accessibility of 55 rape crisis, sexual assault, and domestic violence agencies throughout Pennsylvania. Findings suggest that most programs had several accessibility structures in place, such as ramps and accessible restrooms. However, fewer programs had less well-known physical and programmatic accessibility features in place to ensure equal access to services. Recommendations focus on cross-system collaboration to provide access to victim services by all victims, including those with disabilities.
Challenges of Rights-Based Law
Authors: Palley Elizabeth
Published: May 2008

The least restrictive environment provision of the Individuals with Disabilities Education Act (IDEA, 1997) is an example of how American laws written to address structural barriers for people with disabilities may be constrained or circumvented by the American rights-based legal system. This article provides a background on rights-based and social relations approaches to policy implementation, reviews the relevant case law, reviews the economic implications of the IDEA, addresses institutional structural factors and concludes with policy recommendations.
The Capability Approach and Disability
Authors: Mitra Sophie
Published: May 2008

The definition of disability is of interest to disability policymakers and analysts because it has fundamental implications for eligibility for public programs, for the scope of legislation, and for the way disability prevalence is measured. The purpose of this article is to assess how an approach developed in economics to analyze issues related to the standard of living, the so-called capability approach, may help us understand disability at the conceptual level. The article first summarizes different theoretical models of disability (the medical model, the social model, the Nagi model, and the International Classification of Functioning, Disability and Health of the World Health Organization) and then presents the main components of the capability approach. The capability approach allows researchers to analyze (a) disability at the capability level; (b) potential disability; and, at the functioning level, (c) actual disability. This framework also helps explain how disability may result from three types of factors: the individual's personal characteristics (e.g., impairment, age, race, gender), the individual's resources, and the individual's environment (physical, social, economic, political). The article explores some implications of the capability approach for analyzing the employment and the standard of living of persons with disabilities.
Focus Groups and Methodological Reflections
Authors: Woodring Jonathan C. , Foley Susan M. , Santoro Rado Gabriella , Brown Keith R. , Hamner Doris M.
Published: May 2008

This article discusses the methodological issues and pragmatic dilemmas confronted by a group of researchers conducting focus groups composed of people with disabilities. As an initial component of a mixed-method, longitudinal research project, the intention was to gather perceptions of the ways in which recent policy initiatives shape the lives and employment experiences of people with disabilities. We present the methodological design issues we encountered in planning and conducting the focus groups with the hope that our reflections inform future qualitative research designs involving people with disabilities.
Perspectives of Foster-Care Providers, Service Providers, and Judges Regarding Privatized Foster-Care Services
Authors: Humphrey Kristen R. , Turnbull Ann P. , Turnbull H. Rutherford
Published: May 2008

This qualitative study examined perceptions of foster-care providers, service providers, and juvenile-court judges regarding privatized foster-care services in Kansas. Kansas was the first state to privatize all foster care, adoption, and family-preservation services. Most states report either beginning to implement managed-care principles in their child welfare services or exploring this option. Fifty-eight interviews with 33 participants (youth in out-of-home placements, their parents, foster-care providers, service providers, and judges) were conducted. The impact of privatization on access to services (i.e., mental health, appropriate out-of-home placement, aftercare, family support and family preservation, and reunification), communication, caseload levels, and spending is discussed. Recommendations regarding these issues are presented.
Students With Disabilities and Accountability Reform
Authors: Nagle Katherine , Yunker Carolyn , Malmgren Kimber W.
Published: May 2008

The No Child Left Behind Act (NCLB) represents the most significant federal education policy initiative in a generation. The perceptions of key personnel from four states and eight school districts on the opportunities and challenges of meeting Annual Yearly Progress requirements for students with disabilities reveal a complex situation. The success of students with disabilities on NCLB mandates is dependent on myriad factors, including access to the general education curriculum and the capacity of educators to teach diverse learners. Findings from a qualitative analysis, part of a larger 5-year mixed-method study, reveal that although participants recognized the challenges ahead, most seemed willing to tackle these challenges to the best of their abilities. Moreover, participants from both general and special education systems recognized that students with disabilities are a vital part of the current education reform.
Are We Leaving Our Children Behind?
Authors: Towles-Reeves Elizabeth , Kampfer-Bohach Stephanie , Garrett Brent , Kearns Jacqueline F. , Grisham-Brown Jennifer
Published: May 2008

Researchers surveyed 52 deaf-blind coordinators to gain an understanding of their knowledge and involvement with their respective states' large-scale assessment systems in regard to students with deaf-blindness. Findings revealed (a) uncertainty by state deaf-blind coordinators regarding how well students with deaf-blindness fare in large-scale assessment systems and (b) that deaf-blind coordinators have had minimal opportunity to utilize their expertise in the development and implementation of state general and alternate large-scale assessments. If the NCLB Act (2002) is to achieve its policy goal of improving the academic performance of all students, greater attention must be paid to subgroups of students, such as those with deaf-blindness.
Cross-Disability Experiences of Barriers to Health-Care Access
Authors: Drainoni Mari-Lynn , Lee-Hood Elizabeth , Tobias Carol , Bachman Sara S. , Andrew Jennifer , Maisels Lisa
Published: May 2008

In this article, we present the results of a series of focus groups with people with disabilities, in which we took a cross-disability, lifespan perspective of disability. Consumers were asked about a broad set of barriers, such as problems with communication, transportation, and insurance, as well as about barriers related to physical accessibility. We used the Institute of Medicine's framework to categorize barriers as either structural, financial, or personal/cultural. Our results suggest that individuals with disabilities experience multiple barriers to obtaining health care and that these barriers are more pronounced for some types of health care than others. In addition, regardless of disability type, consumers consistently spoke about similar barriers. The results underscore the importance of taking a broad perspective when making policy decisions and the need for continued change and improvement in this area.
Market-Based Solutions for Improving Telecommunications Access and Choice For Consumers With Disabilities
Authors: Schaefer Kelly
Published: May 2008

Section 255 of the Telecommunications Act of 1996 requires telecommunications equipment and services to be accessible to and usable by consumers with disabilities if “readily achievable” (47 U.S.C. § 255(a)(b)(c)). This article suggests that the narrow application of the “readily achievable” standard using a product line approach limits access and choice with respect to telecommunications products for consumers with disabilities. As defined by Congress, the efforts that manufacturers must take to comply with section 255 are limited to those that can be accomplished “without much difficulty or expense.” Product manufacturers have discretion in choosing which of their products are accessible to and usable by consumers with disabilities. The author suggests that a broader application of the readily achievable standard using a universal design approach will maximize consumer and company goals and conserve public resources. Implications for telecommunications access policy reform are discussed.
A Cross-Disability Analysis of Person-Directed, Long-Term Services
Authors: Powers Laurie E. , Sowers Jo-Ann , Singer George H. S.
Published: May 2008

Person-directed service models have emerged as important initiatives in improving long-term care. Person-directed services typically have been targeted to particular groups, such as persons with mobility or developmental disabilities or elders with disability. Few attempts have been made to analyze the commonalties, differences, and relative efficacy of the various models. This article presents a cross-disability review of the common elements of person-directed services, describes three primary types of models (personal assistance services, brokered support, and cash and counseling), and summarizes the research evidence related to their efficacy. The major barriers that impede the expansion of person-directed services are discussed. Emerging research findings across disability groups suggest that person-directed services have a positive impact on factors such as quality of life, control, productivity, unmet need, use of preventative health care, and cost. The need to build the evidence base for person-directed services, to address barriers to the expansion of these service models, to support advocacy efforts, and to bolster the political will required for directing substantial resources to person-directed long-term services is emphasized.
Opportunities Lost, Possibilities Found
Authors: Rice Nancy
Published: May 2008

This qualitative study examines the communication between and among participants during the planning process for inclusion in an urban high school. Participant groups (administrators and teachers) were found to be “talking past one another.” Engaging in dialogue was difficult due to the parties' perceptions of each other, their perception of each other's work and priorities, and role expectations. Shared leadership is offered as a framework for moving inclusion forward in urban high schools.
Provider Perceptions of Their Capacity to Offer Accessible Health Care for People With Disabilities
Authors: Bachman Sara S. , Vedrani Mark , Drainoni Mari-Lynn , Tobias Carol , Maisels Lisa
Published: May 2008

The purpose of this article is to provide preliminary data about the results of a comprehensive survey of providers regarding their perceptions of access to health care for people with a broad range of disabilities. We conducted a mail and telephone follow-up survey of providers that contract with two managed care organizations, the Massachusetts Division of Medical Assistance, and the Assisted Living Association (36% response rate). Data were analyzed using standard methods. Results suggest that providers are more likely to provide services to patients with chronic illness, mobility, cognitive, or psychiatric impairments than they are to serve individuals with communication limitations or visual impairments. Providers also reported that people with communication impairments are the most difficult to serve. However, respondent perceptions also suggest that individuals with disabilities do not have easy access to health-care providers, despite changes brought on by the Americans with Disabilities Act.
The Economic Impact of Disability in the United States, 1997
Authors: Yelin Edward , Cisternas Miriam , Trupin Laura
Published: May 2008

The purpose of this study was to estimate the increment in medical care expenditures and wage losses associated with disability in the adult population after taking into account other characteristics of adults with disabilities. The authors used the 1997 Medical Expenditures Panel Survey Household Component (MEPS), a national probability sample of the noninstitutionalized population, to tabulate all medical care expenditures of the adult MEPS respondents, stratified by disability status. They then used regression techniques to estimate the increment of health care expenditures attributable to disability. They used the same methods to estimate the magnitude of the earnings losses sustained by persons with disabilities. Adults with disabilities incurred mean total medical care expenditures of $8,035, for a total of $182.6 billion. The mean increment in medical care expenditures specifically attributable to disability among those 18 and older was $2,953, for a total of about $65.9 billion. Persons with disabilities ages 18 through 64 earned $10,191 less, on average, than other persons these ages, for a total of $115.3 billion. The average increment in earnings losses attributable to disability was $13,160, for a total of $148.9 billion. A large proportion of the total medical care expenditures of adults with disabilities would occur in the absence of the disability, but persons with disability actually earned more than would be expected on the basis of their other characteristics.
Medicaid and Employment of People With Disabilities
Authors: Sulewski Jennifer Sullivan , Gilmore Dana Scott , Foley Susan M.
Published: May 2008

Recent public policy has sought to broaden the role of Medicaid, which typically serves people with limited income, to include increasing employment among people with disabilities and supporting people with disabilities who are working. In late 2001, we surveyed Medicaid agencies regarding their provision of services to working people with disabilities and collaboration with disability- and employment-related agencies and services. One third to one half of respondents were involved in Workforce Investment Act implementation at the state level and/or were implementing a Medicaid Buy-In option for working adults with disabilities. Collaboration with disability- or employment-focused agencies occurred at similarly moderate rates, with activities such as trainings and working groups being the most common types of collaboration reported. These findings suggest that while policy efforts to expand Medicaid's role in supporting employment of people with disabilities have been somewhat successful, there is potential for considerably more engagement of Medicaid agencies in this important issue.
Work Status and Work Performance of People With Disabilities
Authors: Ozawa Martha N. , Yeong Hun Yeo
Published: May 2008

As the U.S. economy is thrust into the global economy and meets global economic competition, the country needs to mobilize people with disabilities to participate in the labor force and enable them to work and earn money optimally. Therefore, it is important to investigate the extent to which disability affects the employment rate and the levels of hourly wages and monthly earnings. This article presents the results of a study that investigated the net effect of disability on the work performance of adults. The specific areas of investigation were employment rate, monthly earnings, hourly wages, and hours of work per week. The major findings were that both statistically and substantively, the rate of employment and the level of monthly earnings of people with disabilities are significantly lower, controlling for other variables. Policy implications are discussed.
Disaster Preparedness and Response for Persons With Mobility Impairments
Authors: Fox Michael H. , White Glen W. , Rooney Catherine , Rowland Jennifer L.
Published: May 2008

The objective of this study was to assess the impact of a major disaster on county-level preparedness for persons with mobility disabilities. The authors surveyed 30 randomly selected Federal Emergency Management Agency (FEMA) disaster sites between 1998 and 2003 to determine disability surveillance capacity, the extent to which the disaster experience influenced changes in policies and practices, whether persons with disabilities were involved in the planning process, what factors appeared to drive the planning process, and whether current policies and procedures could be “best practices.” They found that people with disabilities were poorly represented in emergency planning; federal training on the needs of people with disabilities appeared useful, although only 27% of emergency managers reported completing the training; 20% of emergency managers reported having disability guidelines in place; and county-level surveillance systems were ineffective. Sixty-six percent of counties had no intention of modifying their guidelines to accommodate the needs of persons with mobility impairments, citing limitations from (a) costs, (b) limited staffing, (c) lack of awareness, (d) other security demands, and (e) broader responsiveness to all “special needs individuals.” The authors suggest that improved training, awareness, and surveillance are needed so communities can better respond to the needs of persons with disabilities before, during, and after local disasters. Possible techniques include developing improved technology assistance, providing environmental modifications to improve access for persons with disabilities during disasters, and ensuring far greater participation of persons with disabilities in all phases of the disaster planning and response process.
Consumer Perspective
Authors: Rooney Catherine , White Glen W.
Published: May 2008

The purpose of this qualitative study is to gain a better understanding of disaster preparedness for and the difficulties faced by persons with mobility impairments to guide future research and policy development. From an online Internet survey, 56 persons with mobility impairments who have experienced a catastrophic event described what was helpful for survival, what difficulties were experienced during and after the event, lessons learned, and future directions for emergency management. From a consumer perspective, it was found that both general and disability-related disaster preparedness efforts were useful for the survival, independence, health, and safety of persons with mobility impairments. It was also found that coworkers, family, friends, neighbors, and strangers often formed spontaneous networks during and after disasters that provided needed assistance. Difficulties surfaced when there was a lack of community and workplace evacuation plans, someone was left behind during an evacuation, there was no accessible sheltering or temporary housing, and infrastructure broke down (power, public transportation, and elevators). Persons with mobility impairments encouraged their peers to develop individual preparedness plans and to be active in community-based disaster planning. Emergency management was asked to address the needs of persons with disabilities and to include them in emergency management.
Moving Beyond “Special Needs”
Authors: Kailes June Isaacson , Enders Alexandra
Published: May 2008

Disaster preparation and emergency response processes, procedures, and systems can be made more effective for people with disabilities, as well as for the population as a whole. An essential element of building appropriate levels of capacity, specific planning, and response success is to move beyond use of the “special needs” category, to better identify and address the diverse needs of those included under this label. This article provides disability demographics and describes special needs populations to lay the foundation for this change. It suggests the development of a more accurate and flexible planning and response framework based on essential, sometimes overlapping, functional needs: communication, medical needs, maintaining functional independence, supervision, and transportation (C-MIST). It also proposes new approaches to functional support, leadership, service delivery, and training.
Disaster Care for Persons With Psychiatric Disabilities
Authors: Person Cheryl , Fuller Elizabeth J.
Published: May 2008

There is growing concern that the management of persons with psychiatric disabilities after disaster has been inadequate. Unfortunately, the literature is extremely limited, and empirical evidence on the best practices for addressing the needs of persons with psychiatric disabilities after disasters is sparse. A literature search of articles published in 3 widely used databases revealed only 12 articles on the topic. The 12 reviewed articles included persons with psychiatric disabilities after both natural disasters and acts of terrorism, both in close proximity to the disaster site and far away and in 3 different treatment modalities. All of the studies used clinically based samples. The available literature indicated that many persons with psychiatric disabilities demonstrate an ability to handle the stress of a disaster without decompensation from their primary illness. However, the literature also revealed that persons with severe mental illness (SMI) can experience posttraumatic stress disorder (PTSD), depression, anxiety, and illness exacerbation after disaster. There is evidence that persons with SMI can be resilient in the short term when they are enrolled in an assertive community treatment program prior to the disaster; however, the outcomes for people with severe mental illness in other treatment modalities are unclear. Well-designed studies with clinical and population-based samples on disaster reactions of persons with psychiatric disabilities are needed for disaster psychiatrists and emergency planners to develop empirically based treatment guidelines for this population.
The Built Environment, Evacuations, and Individuals With Disabilities
Authors: Christensen Keith M. , Blair Martin E. , Holt Judith M.
Published: May 2008

Policy and planning for the evacuation of individuals with disabilities would benefit from a more informed and accepted understanding of the complexity of evacuation issues. This article proposes a framework perspective on 4 forms of emergency evacuation according to the timing and duration of the evacuation (protective, preventive, rescue, and reconstructive), as well as 3 overlying factors that affect all emergency evacuations: the behavior of the individual, the planned systems active in the event, and the environment in which the event occurs. The Americans with Disabilities Act Design Requirements for Accessible Egress is discussed to demonstrate the value of evaluating policy and planning according to the proposed framework. Recent catastrophic events have demonstrated a disproportionate effect of emergency evacuations on individuals with disabilities. These events have raised questions concerning the appropriateness and effectiveness of evacuation policies and practices, prompting many organizations to develop and disseminate evacuation planning solutions for the needs of individuals with disabilities. Policy and planning discussions for the evacuation of individuals with disabilities would benefit from a more informed and accepted understanding of the complexity of evacuation issues. This article attempts to explain the complexity by proposing a framework that emphasizes the conditions associated with various forms of emergency evacuations and factors that affect an individual's response to these conditions. The intent of the framework is to clarify the assumptions associated with emergency evacuations and to provide a framework that one may use to evaluate the appropriateness of the resulting policies and planning initiatives.
Promoting Basic Accessibility in the Home
Authors: Nishita Christy M. , Liebig Phoebe S. , Pynoos Jon , Perelman Lena , Spegal Katie
Published: May 2008

Visitability legislation, which requires minimum accessibility in single-family homes, is an unprecedented advancement in disability policy that began with the passage of an Atlanta ordinance in 1992 and has spread to other jurisdictions. Based on the diffusion of innovation model (Gray, 1973), our study used interviews, news articles, and analyses of legislation to examine the spread of the visitability concept, the patterns of diffusion, the opposition's main concerns, and the mechanisms by which advocates overcame opposition and facilitated passage. Results indicated that a policy entrepreneur (Kingdon, 1995) was largely responsible for the consequent spread of visitability across cities and states in a horizontal pattern of diffusion. Opponents from the building industry were largely concerned about added cost, which forced advocates to employ education and negotiation tactics. Despite considerable controversy, proponents' success provides other advocates with lessons on how to ensure a more widespread impact on U.S. housing stock.
Accommodations for Licensure and Certification Examinations
Authors: Blair Martin E. , Salzberg Charles L.
Published: May 2008

The public develops confidence in the skills and abilities of many professionals by recognizing that a professional has demonstrated his or her competence through successful completion of certification or licensure examinations. The Americans With Disabilities Act requires that accommodations on licensure and certification exams be provided to qualified individuals who request them. Policy discussions on this topic typically focus on the eligibility of individuals to receive such accommodations. The research literature is virtually silent on the practical issues related to appropriate accommodations and the effect that these may have on exam accommodation policy. This review describes the legal and policy background related to exam accommodations. It reviews the scant research related to appropriate exam accommodations in higher education and public education and puts forth a series of policy and implementation questions that should be considered as reasonable accommodation policies are developed and implemented for licensure and certification exams.
Examining an Alternate Assessment
Authors: Johnson Evelyn S. , Arnold Nancy
Published: May 2008

This study reviewed the alternate assessment results (N = 1,404) from 1 state that uses a portfolio system. It addressed 3 main questions: (a) the extent to which assessment content was linked to the state's general curricular standards, (b) the types of tasks that operationalized the general curricular standards, and (c) the correlation of the completeness of the portfolio with student performance. Although we found connections to the general curriculum on paper, the actual tasks used to represent the standards raised concerns about the strength of those connections. Additionally, we noted serious concerns with construct underrepresentation. Finally, practical issues with portfolio assembly may be contributing to poor student performance. We present implications for practice in the context of federal regulations such as No Child Left Behind and the Individuals With Disabilities Education Act, as well as existing research on alternate assessment practices.
Students With Severe Speech and Physical Impairments
Authors: Zascavage Victoria T. , Keefe Charlotte H.
Published: May 2008

This qualitative study examined barriers to literacy for individuals with severe speech and physical impairments. The study gave voice to parents, teachers, university faculty, and administrators involved in the literacy education of these students. Following a constant comparison to model parameters set by disability rights authors, 4 dominant models emerged from the dialogue: (a) medical, (b) materialist, (c) administrative, and (d) social barriers. The medical and materialist models reflected the dominance of a functional/life-skill curriculum and the lowering of academic expectations for traditional literacy achievement. The administrative model intertwined with financial allocations in areas of teacher training, assistive technology, and classroom materials. The social barriers model influenced marginalization in scheduling for literacy instruction and inclusion in scope and sequence curricula.