Vocational Rehabilitation: Better Measures and Monitoring Could Improve the Performance of the VR Program (23-SEP-05, GAO-05-865). The Department of Education (Education) provides more than $2.5 billion annually to the states for a federal-state vocational rehabilitation (VR) program to help individuals with disabilities become employed. This program is among a large number of federal programs intended to assist people with disabilities. In 2003 GAO placed federal disability programs on its list of high-risk programs because many of these programs have not kept up with scientific advances and economic and social changes. GAO prepared this report under the Comptroller General's authority as part of an effort to assist policy makers in determining how federal disability programs could more effectively meet the needs of individuals with disabilities and addressed it to each committee of jurisdiction. In this report, GAO assesses the (1) extent to which state VR agencies assist individuals in achieving employment, and (2) performance measures and monitoring practices Education uses to manage this decentralized program and achieve legislative goals. -------------------------Indexing Terms------------------------- REPORTNUM: GAO-05-865 ACCNO: A37939 TITLE: Vocational Rehabilitation: Better Measures and Monitoring Could Improve the Performance of the VR Program DATE: 09/23/2005 SUBJECT: Aid for the disabled Employment assistance programs Employment of the disabled Federal aid to states Federal/state relations Monitoring Performance appraisal Performance measures Program evaluation Program management State-administered programs Strategic planning Vocational rehabilitation Vocational Rehabilitation Program ****************************************************************** ** This file contains an ASCII representation of the text of a ** ** GAO Product. ** ** ** ** No attempt has been made to display graphic images, although ** ** figure captions are reproduced. Tables are included, but ** ** may not resemble those in the printed version. ** ** ** ** Please see the PDF (Portable Document Format) file, when ** ** available, for a complete electronic file of the printed ** ** document's contents. ** ** ** ****************************************************************** GAO-05-865 United States Government Accountability Office GAO Report to Congressional Committees September 2005 VOCATIONAL REHABILITATION Better Measures and Monitoring Could Improve the Performance of the VR Program GAO-05-865 [IMG] September 2005 VOCATIONAL REHABILITATION Better Measures and Monitoring Could Improve the Performance of the VR Program What GAO Found Of the more than 650,000 individuals exiting the state VR programs in fiscal year 2003, one-third (217,557) obtained a new job or maintained their existing job for at least 90 days after receiving services. Education's data showed that the remaining two-thirds exited the VR program without employment most often because the individual refused services or failed to cooperate with the VR counselor (46 percent of the time) or could not be located or contacted (24 percent). The VR program purchased more than $1.3 billion in services for all individuals who exited the program in fiscal year 2003, two-thirds of which were used to provide services to individuals exiting with employment. Employment, earnings, and the amount of purchased services received while in the VR program varied significantly by individuals' disability type and other characteristics. In addition, state VR agencies varied substantially in the employment rates they achieved, the characteristics of individuals they served, their frequency of providing certain services, and their service expenditures. Individuals Exiting the VR Program, Fiscal Year 2003 . Without employment With employment 0 1020304050607080 Percent During the application phase After limited services After services under an employment plan Source: GAO analysis of Education data. Education's performance measures are not comprehensive, and its monitoring of state VR agencies has not resulted in timely feedback. Education does not comprehensively measure the performance of certain key populations, such as students transitioning from school to work, and tracks only the individuals who exit the program, not those still receiving services. In addition, Education's performance measures do not take into consideration all the variation among the state VR agencies or allow for comparisons with other workforce programs. Education's monitoring reports, which are its primary means of providing feedback to state VR agencies, are frequently late and based on data that are more than 2 years old. Consequently, state VR agencies do not receive the timely feedback needed to improve the efficiency and effectiveness of their programs. In managing the performance of the VR program, Education also does not censure poorly performing state VR agencies, reward strong performance, or take full advantage of opportunities to disseminate best practices. Education recently decided to eliminate its regional offices, which conducted most of the monitoring of state VR agencies, making the details of the future monitoring process unclear. United States Government Accountability Office Contents Letter Results in BriefBackgroundOne-Third of Individuals Exited the VR Program Nationwide with Employment, although Employment Rates Varied Significantly among State VR Agencies Education's VR Performance Measures Are Not Comprehensive, and Its Monitoring of State VR Agencies' Performance Has Not Resulted in Timely Feedback ConclusionsRecommendations for Executive ActionAgency Comments and Our Evaluation 1 3 4 11 30 37 39 40 Appendix I Scope and Methodology Appendix II State VR Agency Exit and Employment Rates, Fiscal Year 2003 Appendix III State VR Agency Population Proportions by Primary Impairment, Fiscal Year 2003 Appendix IV Social Security Beneficiaries' Employment Rates by State VR Agency, Fiscal Year 2003 Appendix V State VR Agency Percentages of Total Agency Service Budget Spent on Each Service Category, Fiscal Year 2003 54 Appendix VI State VR Agency Total Administrative Costs as a Percentage of Total Expenditures, Fiscal Year 2003 60 Appendix VII State VR Agency Average Total Expenditures in Fiscal Year 2003 Per Person Exiting with Employment in Fiscal Year 2003 Appendix VIII Comments from the Department of Education Appendix IX GAO Contacts and Staff Acknowledgments Tables Table 1: Performance Indicators and Performance Targets for State VR Agencies Table 2: Time in Program, Number of Services, and Cost of Services by Type of Exit from the VR Program, Fiscal Year 2003 Table 3: Percentage of Individuals in the VR Program Receiving Services by Each of the 22 Service Categories Tracked by Education, Fiscal Year 2003 Table 4: Transitioning Students Exiting the VR Program with Employment after Services under an Employment Plan, Fiscal Year 2003 Table 5: Per Capita Service Costs by Each Type of State VR Agency, Fiscal Year 2003 Table 6: Blind or Visually Impaired Individuals Exiting with Employment from Blind State VR Agencies versus Combined State VR Agencies, Fiscal Year 2003 9 15 16 23 29 30 Figures Figure 1: Individuals Exiting the VR Program, Fiscal Years 1997 2003 6 Figure 2: Individuals Exiting the VR Program, Fiscal Year 2003 12 Figure 3: Reasons for Individuals Exiting the VR Program without Employment, Fiscal Year 2003 13 Figure 4: Primary Impairments of Individuals Exiting the VR Program, Fiscal Year 2003 18 Figure 5: Rates of Exit from the VR Program by Primary Impairment Group, Fiscal Year 2003 19 Figure 6: Median Hourly Wage by Impairment Group among Individuals Exiting the VR Program with Employment who did Not Require Ongoing Support Services, Fiscal Year 2003 20 Figure 7: Employment Status of Individuals Exiting the VR Program in Fiscal Year 2003 Who Previously Participated in the VR Program 21 Abbreviations GPRA Government Performance and Results ActIEP individualized education programOMB Office of Management and BudgetPART Program Assessment Rating ToolRSA Rehabilitation Services Administration VR vocational rehabilitationWIA Workforce Investment Act This is a work of the U.S. government and is not subject to copyright protection in the United States. It may be reproduced and distributed in its entirety without further permission from GAO. However, because this work may contain copyrighted images or other material, permission from the copyright holder may be necessary if you wish to reproduce this material separately. United States Government Accountability Office Washington, DC 20548 September 23, 2005 The Honorable Michael B. Enzi Chairman The Honorable Edward M. Kennedy Ranking Minority Member Committee on Health, Education, Labor, and Pensions United States Senate The Honorable John A. Boehner Chairman The Honorable George Miller Ranking Minority MemberCommittee on Education and the Workforce House of Representatives The Department of Education (Education) provides more than $2.5 billion annually to the states for a federal-state vocational rehabilitation (VR)program to help individuals with disabilities become employed, consistentwith the Rehabilitation Act of 1973. In fiscal year 2003, these state programs provided services to more than 1 million individuals withdisabilities. Although Education provides more than three-quarters of the program's funding, states have significant latitude in how they administertheir VR programs. In the past several years, key legislative changes have been enacted relating to the VR program. For example, the Rehabilitation Act was reauthorized as part of the Workforce Investment Act (WIA) in 1998, whenVR became 1 of 17 mandated partners in state workforce investmentsystems. In addition, the Ticket to Work and Work Incentives Improvement Act of 1999 expanded the types of rehabilitation servicesavailable to Social Security disability beneficiaries by providing for privatized services in a market previously dominated by the public VR program. More recently, in 2003, we placed the modernization of federal disability programs on our list of high-risk programs because many of these programs have yet to incorporate scientific advances and economic and social changes that have redefined the relationship between impairments and the ability to work.1 In addition, these programs have faced long standing challenges in ensuring the timeliness and consistency of decisions related to benefits and services for people with disabilities. We have prepared this report under the Comptroller General's authority as part of a continued effort to help policy makers better understand the extent of support provided by federal programs to people with disabilities and to assist them in determining how these programs could more effectively meet the needs of individuals with disabilities in the 21st century. As it may prove helpful in the deliberation of committees with jurisdiction over VR issues, we have addressed this report to each of these committees. In this report, we assess (1) the extent to which state VR agencies assist individuals in achieving employment and (2) the performance measures and monitoring practices Education uses to manage this decentralized program and achieve legislative goals. To perform our review, we analyzed data from two datasets maintained by Education, one a record of the cases for all individuals who exited the VR program after their cases were closed during fiscal year 2003 (the most recent year for which data were available for us to use in time for production of this report) and the other a record of the expenditures for each state VR agency in fiscal year 2003. We determined that the data we used were sufficiently reliable for our purposes by performing electronic testing for obvious errors in accuracy and completeness, reviewing available documentation, and interviewing Education and state VR agency officials knowledgeable about the data. We also reviewed relevant laws, regulations, Education's policy documents relating to the VR program, and the required state plans for each state VR agency's program. Further, we interviewed key program officials at the national and regional levels, selected state VR agency officials, and advocates for people with disabilities. Finally, we conducted site visits to state VR agencies in California, Maryland, Minnesota, New Mexico, Tennessee, and Virginia. We selected these sites to achieve a mix of state VR agency structures, operations, and performance as well as to achieve geographic diversity. We conducted our review from August 2004 through September 2005 in accordance with generally accepted government auditing standards. For a more complete explanation of our methodology, see appendix I. 1GAO, High-Risk Series: An Update, GAO-03-119 (Washington, DC: January 2003). Results in Brief Of the more than 650,000 individuals exiting the state VR programs in fiscal year 2003, one-third (217,557) obtained a new job or maintained their existing job for at least 90 days after receiving customized services. Education's data showed that the remaining two-thirds exited the VR program without employment most often because the individual refused services or failed to cooperate with the VR counselor (46 percent of the time) or could not be located or contacted (24 percent). The VR program purchased more than $1.3 billion in services for all individuals who exited the program in fiscal year 2003, two-thirds of which was used to provide services to individuals exiting with employment. Employment, earnings, and the amount of purchased services received while in the VR program varied significantly by individuals' type of disability and other characteristics. In addition, state VR agencies varied substantially in the employment rates they achieved, the characteristics of individuals they served, their frequency of providing certain services, and their service expenditures. For example, state VR agency employment rates ranged from 20 to 74 percent in fiscal year 2003. Education's performance measures are not comprehensive, and its monitoring of state VR agencies has not resulted in timely feedback. Education does not comprehensively measure the performance of certain key populations, such as students transitioning from school to work, and tracks only the individuals who exit the program, not those still receiving services. In addition, the performance targets Education sets for state VR agencies do not take into consideration all the demographic or economic variations among states. Further, Education's performance measures do not allow for comparison of the VR program with other workforce programs. Education's monitoring reports, which are its primary means of providing feedback to state VR agencies, are issued over 2 years after performance data have been collected. Consequently, state VR agencies do not receive the timely feedback needed to improve the efficiency and effectiveness of their programs. In managing the performance of the VR program, Education also does not censure poor performers, reward strong performers, or take full advantage of opportunities to disseminate best practices to the state VR agencies. As part of its larger reorganization, Education recently decided to eliminate its regional offices, which conducted most of the monitoring of state VR agencies, making the details of the future monitoring process unclear. We are making several recommendations to Education so that it can improve its oversight of state VR agencies and help them most effectively target their resources to achieve better employment rates. In this regard, we recommend that Education reevaluate its performance measures to Background ensure better alignment with program goals and develop a better monitoring process that includes timelier and more effective feedback to state VR agencies. In commenting on the report, Education indicated that it is in full agreement that better measures and monitoring could improve the performance of the VR program. In addition, Education highlighted initiatives either planned or under way to improve the management of the VR program. Title I of the Rehabilitation Act of 1973 authorizes a federal-state VR program to provide services to persons with disabilities so that they may prepare for and engage in gainful employment.2 Education provided an estimated $2.6 billion in fiscal year 2005 in grants to the states and territories based on a formula that considers the state's population and per capita income. Grants to individual states ranged from about $9 million to nearly $250 million. Four of the five territories received less than $3 million each. The act generally requires states to match federal funds at a ratio of 78.7 percent federal to 21.3 percent state dollars. Each state and territory designates a single VR agency to administer the VR program, except where state law authorizes a separate agency to administer VR services for individuals who are blind. Education provides a single Title I grant to each state. States authorizing a separate blind VR agency decide how the grant will be apportioned between the general VR agency and the blind VR agency. Education tracks the performance of 80 state VR agencies-24 states have separate blind and general agencies; and 26 states, the District of Columbia, and five territories each have a single combined agency. The 80 state VR agencies are housed in various departments of state government, such as state departments of labor or education, or they may be free-standing agencies or commissions.3 State VR agencies also vary in their operations and locations. For example, some agencies provide services through several offices located throughout the state, while others provide services through one central location. Education collects information about all individuals who exit each state VR agency's program during a particular fiscal year, as reported by the 2This legislation was most recently reauthorized as part of the Workforce Investment Act of 1998. 3In this report, the term state VR agencies refers to agencies in the 50 states, the District of Columbia, and the territories of American Samoa, Guam, Northern Marianas Islands, Puerto Rico, and the Virgin Islands. 80 state VR agencies. The record for each individual exiting the program includes information such as whether or not each individual became employed, the weekly earnings and hours worked for individuals if they exited the VR program with employment, the types and costs of services they received, and demographic factors, such as impairment type, gender, age, race and ethnicity, public benefits, and income from work at the time of application. Education also collects summary information on agency expenditures in a number of categories from each state VR agency. Education tracks individuals in terms of seven types of case closures, which can be collapsed into four categories, for individuals who o exited without employment, during the application phase (including individuals who were found ineligible; individuals who could not be determined to be eligible or ineligible for various reasons such as they could not be located or contacted, they failed to cooperate or they refused services; and individuals who were found eligible, but were placed on a waiting list); o exited without employment, with limited services (including individuals who were found eligible, but who left the program before an employment plan could be developed, or agreed to an employment plan, but left before receiving services under that plan);4 o exited without employment, after receiving services under an employment plan; and o exited with at least 90 days of employment, after receiving services under an employment plan. Education considers several types of work activities to meet its definition of employment. First, Education counts as employment the paid work activity of an individual, who may or may not require ongoing support services, in an integrated work setting, that is, a setting typically found in the community where individuals both with and without disabilities 4State VR agencies are required to develop a written individualized plan for employment for each eligible individual that includes the specific employment goal, the rehabilitation services needed to achieve that goal, the entities that will provide the services, and the methods available for procuring the services. The plan must be agreed to and signed by the eligible individual or by the individual's representative and approved by the VR counselor. interact.5 Second, Education counts self-employment as employment, whether the business is managed by the eligible individual or the state VR agency. Finally, Education considers certain types of unpaid work activity to be employment, such as homemakers whose work activity is keeping house for themselves or others in their households and unpaid workers in a family business or family farm. While the total number of individuals exiting the VR program has increased slightly over the past several years, the number of individuals exiting with employment has remained relatively stable. (See fig. 1.) Figure 1: Individuals Exiting the VR Program, Fiscal Years 1997-2003 700,000 600,000 500,000 400,000 300,000 200,000 100,000 0 1997 1998 1999 2000 2001 2002 2003 Fiscal year Total exits Exits with employment Source: GAO analysis of Education data. State VR agencies that determine they will not be able to serve all eligible individuals who apply for services are required to state the order in which they will select individuals for services. Agencies using an order of selection process must develop criteria for ensuring that individuals with 5In contrast, Education does not count as employment the work activity of individuals who perform their work for a public or nonprofit organization in a segregated or sheltered setting, that is, a setting in which the eligible individuals primarily interact with other individuals with disabilities. Education's term for this is "extended employment." the most significant disabilities will be selected first for services. Thirty nine of the 80 state VR agencies were using an order of selection process in fiscal year 2003. Beginning fiscal year 2004, 42 of the agencies are using an order process. The Rehabilitation Act requires state VR agencies to enter into cooperative agreements with other entities that are part of the state's workforce investment system. This workforce investment system includes a One-Stop system, which is required to provide a number of employment-related services to job seekers and employers at a single location. The act also requires state VR agencies to coordinate with public education officials to facilitate the transition of students with disabilities from school to work. Students with disabilities receive special education and related services from their school under an individualized education program (IEP). Beyond these required interactions, state VR agencies may also enter into third-party cooperative agreements with other state or local agencies to coordinate the services provided to their common program participants. Education must abide by several statutes and executive branch directives to measure and monitor the performance of the VR program. The 1998 amendments to the Rehabilitation Act required that Education establish and publish evaluation standards and performance indicators for the VR program. The standards and indicators were supposed to include outcome and related measures of program performance that facilitate the accomplishment of the purpose and policy of the act. The act also gave Education the authority to reduce or suspend payments to state VR agencies that have performance falling below a certain level and fail to enter into a program improvement plan or substantially comply with the terms and conditions of such a plan. The act also directed Education to conduct annual review and periodic on-site monitoring of state VR agencies to determine, in part, whether they were complying with the standards and indicators. Education performs this monitoring function through the 10 regional offices of its Rehabilitation Services Administration (RSA). In response to the 1998 amendments, Education established new performance measures in June 2000 that consisted of two standards for evaluating the performance of the state VR agencies, one relating to the agencies' performance in assisting individuals in obtaining, maintaining, or regaining high-quality employment and the other relating to the agencies' performance in ensuring that individuals from minority backgrounds have equal access to services. In addition, Education published performance indicators that establish what constitutes minimum compliance with these evaluation standards and required performance targets for each indicator. Six performance indicators were published for the employment standard, and one was published for the minority service standard. State VR agencies must meet or exceed performance targets in four of the six categories for the first standard and meet or exceed the performance target for the second standard in order to have passing performance. Table 1 provides details on these standards and indicators. Table 1: Performance Indicators and Performance Targets for State VR Agencies Performance target General or combined state VR agencies Blind state VR agenciesa Performance Indicator 1. Employment standard Change in employment-the number of individuals exiting the Equal or exceed previous Equal or exceed VR program with employment in the current performance year performance year previous compared with the number exiting with employment in the prior performance year performance year Employment rate-percentage of individuals receiving services 55.8% 68.9% under an employment plan who exit the VR program with employment Competitive employment rate-percentage of individuals exiting 72.6% 35.4% the VR program with employment who were competitively employedb Significant disability rate-percentage of individuals exiting the 62.4% 89.0% VR program with competitive employment who have significant c disabilities Wage Ratio-ratio of the average hourly earnings of individuals 0.52 0.59 exiting the VR program with competitive employment to the average hourly earnings for all employed individuals in the state Increase in self-support-the difference between the percentage 53.0 30.4 of individuals exiting the VR program with competitive employment who report their own income as the largest single source of economic support at the time they exit the VR program and the percentage who report their own income as the largest single source of economic support at the time they apply for VR services 2. Equal access to services standard The service rate for all individuals with disabilities from minority 0.80 0.80 backgrounds as a ratio to the service rate for all non-minority d individuals with disabilities Source: GAO analysis of Education data. aBlind state VR agencies must report each year the aggregated data for the 2 previous years for performance indicators 1.1 through 1.6. bEducation defines competitive employment as work that is performed on a full-time or part-time basis in an integrated setting for which the individual is compensated at or above the minimum wage but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities. Education also counts in this category individuals whose earnings from self-employment are equivalent to at least the minimum wage. cThe Rehabilitation Act defines a significant disability as one that seriously limits one or more functional capacities and can be expected to require multiple VR services over an extended period of time. dEducation defines service rate as the result obtained by dividing the number of individuals who exit the VR program after receiving one or more services under an employment plan by the total number of individuals who exit the VR program. The Government Performance and Results Act of 1993 (GPRA) also requires federal executive branch agencies such as the Department of Education to set goals, measure their performance, and report on their accomplishments. Agencies are required to develop annual performance plans that use performance measurement to reinforce the connection between the long-term strategic goals outlined in their strategic plans and the day-to-day activities of their managers and staff. Among its performance goals for fiscal year 2005, Education is assessing its performance in assisting state VR agencies to achieve required performance targets on one performance target-1.2. In 2002, the Office of Management and Budget (OMB) directed that the performance of a range of federal job training and employment programs be measured consistently to allow for the comparison of results across these programs. These common measures would be consistent with the common goals of these programs, that is, to improve participants' employment and earnings and focus on measures of outcomes and efficiency. OMB identified the VR program as one of the federal programs that would be targeted for using the common measures. Using its Program Assessment Rating Tool (PART), OMB assessed the effectiveness of the VR program in 2003 as part of its effort to hold federal agencies accountable for accomplishing results. The PART evaluation looks at four areas of assessment-program purpose and design, strategic planning, management, and results and accountability. Programs are rated in one of five categories: effective, moderately effective, adequate, ineffective or results not demonstrated. OMB will use the rating and relating findings to make decisions about budget and policy. OMB rated the effectiveness of the VR program as adequate and made recommendations to Education for improving program management and performance measures. As part of its assessment, OMB reviewed Education's performance indicators 1.2, 1.3, and 1.5. One-Third of Individuals Exited the VR Program Nationwide with Employment, although Employment Rates Varied Significantly among State VR Agencies More than 217,000 individuals with disabilities exited the state VR programs with employment in fiscal year 2003 after receiving customized services. This group represents one-third of the 650,543 individuals who left the program nationwide in fiscal year 2003 after submitting an application for services. The most common reasons that the remaining two-thirds of the individuals left the program without a job were that the individual refused services, failed to cooperate, or could not be located or contacted. State VR agencies collectively purchased more than $1.3 billion in services for all individuals who exited the program in fiscal year 2003, two-thirds of which was used to provide services to individuals exiting with employment. Employment, earnings, and the amount of purchased services received while in the VR program varied significantly by individuals' type of disability and other characteristics. In addition, the state VR agencies varied substantially in the employment rates they achieved, the characteristics of individuals they served, their frequency of providing certain services, and their service expenditures. One-Third of Individuals Exited the VR Program Nationwide with Employment in Fiscal Year 2003