Under contract with the U.S. Department of Education, Research Triangle Institute is conducting a longitudinal study of the federal-state vocational rehabilitation program, with a sample of over 8,000 clients. Its latest report describes and analyzes characteristics of VR consumers. Jamal Mazrui National Council on Disability Email: 74444.1076@compuserve.com ---------- A LONGITUDINAL STUDY OF THE VOCATIONAL REHABILITATION SERVICE PROGRAM SECOND INTERIM REPORT: CHARACTERISTICS AND PERSPECTIVES OF VR CONSUMERS December 1996 Submitted by Research Triangle Institute Submitted to Rehabilitation Services Administration U.S. Department of Education in partial fulfillment of requirements under ED Contract No. HR92-022-001 A LONGITUDINAL STUDY OF THE VOCATIONAL REHABILITATION SERVICE PROGRAM SECOND INTERIM REPORT: CHARACTERISTICS AND PERSPECTIVES OF VR CONSUMERS Becky J. Hayward, Project Director Michael D. Tashjian December 1996 Submitted by Research Triangle Institute Submitted to Rehabilitation Services Administration U.S. Department of Education in partial fulfillment of requirements under ED Contract No. HR92-022-001 Table of Contents Page EXECUTIVE SUMMARY...............................................v CHAPTER 1: INTRODUCTION........................................1 The Study's Information Goals and Reporting Schedule.......2 Data Collection Design.....................................3 Data Collection Problems and Strategies for Their Resolution......................................................4 Attrition and retraining..............................6 Sampling procedures...................................6 Locating selected consumers...........................7 Variability in office procedures......................8 CHAPTER 2: CHARACTERISTICS OF CONSUMERS........................9 Disability and Demographic Characteristics................10 Sources of Support........................................11 Labor Force Participation.................................15 History of labor force participation.................15 Consumers' status at application.....................17 Profile of most recent employment....................19 CHAPTER 3: CONSUMERS' PERSPECTIVES ON THEIR VR EXPERIENCE.....24 Consumers' Perspectives on Choice.........................25 Consumers' Interactions With Their Rehabilitation Counselors.....................................................30 Consumers' Perspectives on VR Services....................34 Perspectives on the VR Experience Overall.................35 List of Figures Page Figure 1. Topics of Interim and Final Reports...................4 Figure 2. Location of Offices Participating in the Longitudinal Study Spring 1996...........................................5 Figure 3. Data Collection Instruments, with Method of Frequency of Administration.....................................7 Figure 4. Schematic of Sampling and Data Collection Process.....8 List of Tables Page Table 1. Disability Characteristics of VR Applicants and Consumers......................................................10 Table 2. Demographic Characteristics of VR Applicants and Consumers......................................................12 Table 3. Educational, Marital, and Family Status of VR Applicants and Consumers........................................13 Table 4. Of Consumers Reported as Receiving Financial Assistance While VR Applicants or Consumers, Percentage Receiving Each Type of Assistance, Along with Average Amount of Assistance and Average Number of Months Received....................14 Table 5. Overall Work History of VR Agency Consumers..........16 Table 6. Total Number of Jobs Held in Lifetime................17 Table 7. Number of Years in Each Job for Consumers With an Employment History..............................................17 Table 8. Status of Consumers Not Working at Time of Application to VR..........................................................18 Table 9. Average Years in Job, Hourly Wage, and Number of Hours Worked Per Week for Consumers Working at Time of Application to VR..........................................................18 Table 10. Type of Job Held in Most Recent Employment Prior to Application to VR................................................19 Table 11. Type of Occupation in Most Recent Employment Prior to Application to VR................................................20 Table 12. Hourly Wage Earned in Most Recent Employment Prior to Application to VR................................................21 Table 13. Hours Worked Per Week in Most Recent Employment Prior to Application to VR................................................22 Table 14. Receipt of Job-Related Benefits in Most Recent Employment Prior to Application to VR.................................22 List of Tables (continued) Page Table 15. Consumer Satisfaction With Most Recent Employment Prior to VR Application.......................................23 Table 16. Consumer Choice: Perspectives on Choice of Vocational Goal, Among Current and Former VR Consumers................26 Table 17. Consumer Choice: Perspectives on Choice of Services, Among Current and Former VR Consumers................28 Table 18. Consumer Choice: Perspectives on Choice of Service Providers, Among Current and Former VR Consumers................29 Table 19. Nature and Frequency of Consumers' Interactions with the VR Counselor, Among Current and Former VR Consumers................31 Table 20. Consumers' Perceptions about the Quality of Their Relationship with the VR Counselor, Among Current and Former VR Consumers......................................................33 Table 21. Perceptions Regarding Timeliness of Events in the VR Process, Among Current and Former VR Consumers................34 Table 22. Perceptions of Current and Former VR Consumers about the Usefulness and Quality of Services Received through VR..........36 Table 23. Perceptions of Former VR Consumers about the VR Experience Overall.............................................38 EXECUTIVE SUMMARY This report contains selected preliminary findings from the Longitudinal Study of the Vocational Rehabilitation (VR) Service Program. The study, initiated in fall 1992, will produce a series of interim reports over the next three years that address key policy questions of interest to Congress, the Rehabilitation Services Administration (RSA), state VR agencies, and consumers. This second interim report presents data collected from VR consumers and their VR case files over the study's period of sample acquisition and baseline data collection. The remainder of this report presents preliminary findings in several broad areas. Chapter 1 presents an overview of the study's purposes and design. Chapter 2 is a profile of VR consumers that includes disability and demographic characteristics, sources and amounts of financial support, and consumers' pre-VR work history. Chapter 3 summarizes the perspectives of VR consumers regarding their choice in the selection of vocational goals, services, and providers; the nature and quality of interactions with their VR counselors; and their level of satisfaction with their overall VR experience. In the remainder of this summary we present key findings in each of these areas. Disability and Demographics þ Nearly three-fourths of VR consumers (71 percent) have acquired, as opposed to congenital, disabilities. þ At minimum, 75 percent of all VR consumers have disabilities classified as severe, including 26 percent who have most severe disabilities. þ About two-thirds of VR consumers (68 percent) are between the ages of 22 and 49 years old. þ Over half of VR consumers (57 percent) have a high school diploma or GED as their highest educational credential. Receipt of Financial Assistance During VR þ Nearly half (48 percent) of all consumers received some form of financial assistance during their VR experience, including 16 percent who received SSI-disabled and 12 percent who received SSDI. þ Average monthly assistance from SSI disabled is $408; on average, consumers have received this assistance for four and one-half years; SSDI recipients averaged $557 per month for an average of 56 months. þ Among consumers who received some form of financial assistance during their VR experience, 77 percent reported benefits as their primary source of support, while another 18 percent cited family or friends as their primary support. Work History Prior to VR Entry þ Nine out of ten (92 percent) VR consumers have some amount of employment experience prior to applying for VR services. þ Roughly half (51 percent) have held at least two different jobs prior to applying to VR. þ About one-fourth (26 percent) of VR consumers were working at application, with an average tenure in that job of 5.2 years, seven months longer than the national norm. þ Overall, VR consumers had held their jobs for an average of approximately 3.5 years, one year less than the national average. þ With respect to their most recent employment: - A substantial majority (87 percent) held jobs in the competitive labor market. - Consumers earned a mean of $7.43 per hour (median $5.85), approximately three-fourths of the national mean hourly wage, and worked an average of 34.7 hours per week. - Approximately 35 percent received health insurance through their employer, substantially less than the national norm (52 percent). Consumer Choice in Selection of Vocational Goal, Services, and Providers þ A substantial majority of consumers reported either that they themselves selected their goal (31 percent) or that they and their counselor jointly selected a goal (42 percent). þ Three-fourths of consumers believed they had enough choice in the selection of their vocational goal, and 76 percent were satisfied with their vocational goal. þ Two-thirds of consumers reported that their counselor had told them about available services; of these consumers, 19 percent decided services themselves, 64 percent decided in consultation with their counselors, and 10 percent indicated their counselor decided the services; overall, 72 percent were satisfied with their choice of services. þ Of those consumers whose service providers had been selected at the time of our interview, 46 percent reported that they and their counselors jointly selected service providers, 23 percent selected their providers by themselves, and 17 percent reported that their counselor was the primary decisionmaker in selection of providers; overall, 81 percent of consumers were satisfied with their choice of providers. þ Overall, 46 percent of consumers reported having taken charge of decisionmaking during their VR experience to a great extent, 41 percent to some extent, and 10 percent not at all. Consumer Interactions With Their VR Counselor þ Approximately three-fourths of consumers were satisfied with the frequency of personal and telephone interactions with their VR counselor. þ Seventy percent of consumers believed that their counselor consistently demonstrated sufficient interest and concern for their needs, and 75 percent reported that their counselor was always willing to listen to their ideas and suggestions. þ Three-fourths of consumers reported that the eligibility determination process was timely. Consumers' Perspectives on Specific VR Services and on VR Overall þ Approximately 60 percent of consumers believed that their services had met all or most of their needs; 12 percent reported that the services did not meet any of their needs. þ Forty-two percent of consumers thought their services were excellent, and another 33 percent rated their services as good. þ Over half (53 percent) of consumers reported that VR matched or exceeded their expectations, while 35 percent reported that VR could have done more. þ Sixty-one percent of those consumers who had left VR at the time of the interview reported that their services had helped them get a job, and 63 percent of consumers employed following VR services obtained the type of job they wanted as a result of VR services. CHAPTER 1: INTRODUCTION Initiated in fall 1992, the Longitudinal Study of the Vocational Rehabilitation (VR) Service Program will address key questions of interest to Congress, the Rehabilitation Services Administration (RSA), state VR agencies, and consumers about the performance of the state-federal VR program. The study's design, reflecting the typical service patterns of VR program participants, calls for repeated contacts with individuals over a three-year period to obtain comprehensive information to support judgments about the benefits to consumers and society of the VR system as it currently operates. Because of the longitudinal nature of the study, RSA's design called for a number of interim reports that would, in an incremental fashion, begin making study findings available to policymakers and practitioners as the study proceeded over a six-year period. This report is the second of four interim reports that, along with the study's final report, will answer key questions about the program's impacts on participants. To orient readers to the study, this chapter of the report provides an overview of the study's information goals, reporting schedule, and data collection design and activities. This report contains selected preliminary findings based on data collected from study participants and their VR case files over the period of sample acquisition. These findings are generalizable to the population of individuals with disabilities who are applicants, consumers, or former consumers of VR services nationally. For purposes of this report, all findings are presented in the aggregate; that is, we have not analyzed the data for subgroups of individuals, such as those with severe disabilities, or persons with differing disabilities, or individuals of different ages. Future reports will contain detailed findings for subgroups of interest to RSA and others involved in administration and delivery of VR services to persons with disabilities throughout the nation. The remainder of this report contains the following chapters. Chapter 2 includes a profile of VR consumers that comprises (1) disability and demographic characteristics, (2) sources and amounts of financial support, and (3) history of labor force participation. Chapter 3 presents findings on the perspectives of VR consumers regarding their VR experience. It includes the following sections: (1) consumers' perceptions about their choice, or control, in decisionmaking about their VR experience, (2) nature and quality of interactions with their VR counselor, (3) consumers' perspectives on their VR services, and (4) former consumers' perspectives on the VR experience overall. The findings contained in these chapters come from three primary sources. First is information abstracted from VR case files. Second is a detailed work history interview administered to all study participants at the time of entry into the study. The third is a consumer satisfaction interview administered at baseline (entry into the study) and annually until closure for all study participants.[1] Remaining sections of this chapter review the longitudinal study's reporting schedule, data collection design, and current status, for the convenience of readers who may be somewhat unfamiliar with the study's activities. The Study's Information Goals and Reporting Schedule Commissioned by RSA and mandated by the Congress in the 1992 Rehabilitation Act Amendments, the VR longitudinal study has been designed to answer the following questions: þ What short- and long-term economic and noneconomic (e.g., independent living, community integration) outcomes do VR applicants and consumers achieve as a result of their participation in VR? þ What characteristics of individuals with disabilities affect their (1) access to and receipt of VR services and (2) short- and long-term outcomes? þ To what extent does receipt of specific VR services contribute to successful consumer outcomes? þ In what ways and to what extent do local environmental factors influence VR consumers' services and outcomes? þ In what ways and to what extent do the operations, resources, and organizational climate of VR agencies influence consumers' services and outcomes? þ What is the return on the VR program's investment? We note that the current report does not address these overarching research questions, because the study is relatively early in the four-year period of longitudinal data collection. The study's final report will address all of these questions in detail; in addition, future interim reports will address some aspects of these questions as data become available. Figure 1 is a schematic that summarizes the study's reporting schedule. As the figure shows, the interim reports, leading to the final report at the end of the study, will each build on the information contained in prior reports and will address additional topics as information becomes available over time. As noted, the primary focus of the second interim report is on VR consumers, including consumer characteristics and perspectives on VR. At RSA's request, topics covered in this interim report differ somewhat from the study's original specifications. Rather than addressing organizational culture of VR offices, the report focuses entirely on consumers. Subsequent reports will present findings on organizational culture and other contextual factors as they relate to consumer services and outcomes. Data Collection Design Collection of information required to address the evaluation's questions is currently underway, following a multistage design that involved selection of a random sample of 40 local VR offices (in 32 state agencies located in a total of 30 states) and a sample of 10,000 current and former consumers of VR services. (During the past year, data collection at three of the 40 offices has terminated, owing primarily to difficulties in employing and retaining qualified individuals to serve as field data collectors. At present, data collection continues in 37 of the original 40 offices selected for study. Reduction in the number of sites has resulted in reduction in the total number of individuals selected for study as well.) The data collection design will yield nationally generalizable findings. Figure 2 indicates the states in which the participating offices operate. In order to assess the longer term outcomes of VR participation, the study is implementing a cohort design that involves random selection of individuals at one of three stages of involvement with VR. First, 25 percent of the total sample is selected as applicants to VR and followed for three years during and in some instances following VR services. The larger cohort, 50 percent of the sample, is selected in a service status; these individuals will be followed Figure 1 Figure 2 for three years as they complete VR and enter jobs or other post-VR circumstances. The third cohort includes 25 percent of the sample, selected at closure from VR services; the experiences of these individuals in employment, receipt of other services or benefits, and community integration will be followed for three years. This design accommodates the average length of stay in VR and at the same time permits us to track the post-VR earnings, employment, and community integration of individuals following exit from VR either as "successful" or "unsuccessful" closures. Figure 3 summarizes the data collection instruments and administration schedules for the study. As noted, the study's field data collectors are gathering detailed information through interviews with study participants as well as through abstraction of case file information. Additionally, we are obtaining information from local office managers, rehabilitation counselors, and other office staff, along with information from state VR agencies on policies and procedures that affect the delivery and outcomes of services. Figure 4 is a schematic that describes the sampling and data collection process that we initiated in fall 1994 and expect to continue through the end of 1998. Field data collectors in each of the participating sites are responsible for actual conduct of data collection activities; they are supervised by centrally located staff. As noted in the figure, all data collection is electronically conducted. Each month, field data collectors transmit a listing of all case-level status changes occurring in the office during the prior month. Consumers are then randomly selected into one of the three cohorts, and the data collectors contact them to request their participation in the study. Once they have agreed, the data collectors conduct a series of baseline interviews (which differ somewhat according to cohort) and abstract service information from their case files. For active consumers, file data collection occurs quarterly until closure. Following closure, data collection occurs once a year and consists of updates on consumers' employment and earnings status, receipt of benefits or services from VR or other sources, and community integration. Sample acquisition and baseline data collection for the study's participants were completed in October 1996. Figure 3. Data Collection Instruments, with Method and Frequency of Administration INSTRUMENT METHOD OF ADMINISTRATION FREQUE NCY OF ADMINI STRATI ON Consumer Interviews Work History Interview Interview Baseli ne Function Interview Interview Baseli ne and case closur e Satisfaction Interview Interview/Self-administrationBaseli ne and annual ly to closur e Follow-up Interview Telephone Interview Annual ly from closur e of case file Consumer Records Consumer Characteristics Data FormAbstraction of Applicant/Consumer Records Baseli ne with update s as necess ary Service Sheets Abstraction of Applicant/Consumer Records Baseli ne and quarte rly Agency Instruments State Policies and Procedures FormSelf-administration Baseli ne with annual update as necess ary Local Office Manager QuestionnaireSelf-administration Baseli ne with annual update as necess ary Other Local Office Staff QuestionnaireSelf-administration Baseli ne with termin ation of study VR Counselor Questionnaire Self-administration Baseli ne and termin ation of study Figure 4 CHAPTER 2: CHARACTERISTICS OF CONSUMERS Findings reported in this and subsequent chapters comprise population estimates for individuals with disabilities at all stages of involvement with the state-federal VR program: that is, beginning with application for VR services; through the VR process of eligibility determination, service planning, and services; and following closure from the system as "successful" (achieved an employment outcome, or a 26 closure) or "unsuccessful" (determined not eligible for services, determined eligible but left before receiving services, or received services but left the system without an employment outcome). For purposes of this interim report, we have presented all findings in the aggregate; that is, across all consumers, rather than for specific subgroups, such as persons currently receiving services or those having achieved an employment outcome. Later interim and final reports will examine the characteristics, services, and outcomes of specific subsets of the VR consumer population in order to answer the study's research questions fully. Subsequent sections of this chapter provide a profile of VR consumers during the period of approximately January 1995 through November 1996. Some of the findings reported here (e.g., type and severity of disability, educational status) are also available through RSA's national reporting system (the RSA-911 and RSA-113); we have also collected these data as part of the longitudinal study in order to permit analyses of the population along these dimensions and to explore associations among consumer characteristics, services, and outcomes once the study's data collection is completed. We report some of these data in this chapter in order to provide the reader with a grounding for understanding consumers' perspectives on VR that appear in Chapter 3. That is, understanding the characteristics of VR consumers as a group facilitates analysis of their perspectives on their VR experiences. Other data reported in this chapter are not available through RSA's data system; these findings are available for the first time on the population of persons who come into contact with the VR system nationwide. Included in this category are descriptions of onset of disability, details on receipt of financial assistance, and the nature of VR consumers' labor force participation prior to their entry into the VR system. Disability and Demographic Characteristics As shown in Table 1, analysis of case record data indicates that nearly three-fourths (71 percent) of VR consumers have acquired, as opposed to congenital (25 percent), disabilities. Table 1 Disability Characteristics of VR Applicants and Consumers Characteristic Percentage Type of disability Orthopedic, including amputation 29.0% Mental illness 20.0% Nonorthopedic physical 11.8% Mental retardation 8.4% Learning disability 7.6% Hearing impairment 7.6% Vision impairment 5.5 % Substance abuse 5.5% Traumatic brain injury 2.1% All other conditions 1.1% Missing 1.4% Severity of disability Most severe 26.2% Severe 49.2% Nonsevere 16.7% Missing 7.8% Onset of disability Congenital 25.4% Acquired 70.7 % Missing 3.7%Source: Consumer case records Disabilities reported most frequently include orthopedic impairments (29 percent) and mental illness (20.0 percent), while only about two percent have traumatic brain injury. Reflecting the requirements of the 1992 Rehabilitation Amendments, agencies are reporting severity of disability at three levels, with 49.2 percent of persons classified as having a severe disability and an additional 26.2 percent having a most severe disability. Fewer than 20 percent have disabilities characterized as nonsevere. The majority of VR consumers are male (52 percent) and white (83 percent), with 14 percent African-American (Table 2). Most are in the lower range of the working-age population: over two-thirds are between 22 and 49 and only 13 percent between 50 and 59, although the program does serve a fair number of youth (13 percent are 21 or under) and some persons beyond the traditional working age (four percent of consumers are over 64). Over half (56 percent) of VR consumers have a high school diploma or GED as their highest educational credential (Table 3), and one-fifth received special education services during elementary or secondary school. Average years of education completed is 11.9, and only about 10 percent have attained either a two-year associate or bachelor's degree. Forty-six percent of VR consumers were never married; average number of dependents is slightly less than one. Sources of Support Nearly half of all consumers receive some form of public or other financial (e.g., family and friends) assistance during their VR experience. Sixteen percent receive SSI-disabled, and 12 percent, SSDI. As noted in Table 4,[2] monthly assistance from SSI-disabled is over $400 (mean of $408, median of $446); average length of time consumers have received this assistance is nearly 55 months (median 41 months). For SSDI recipients, mean monthly amount is nearly $560 (median $520), and length of time is 56 months (median 33 months). Other forms of public assistance reported for VR consumers include general assistance ("welfare"), with six percent of recipients reported receiving about $260 per month over a two-year period; AFDC (four percent, Table 2 Demographic Characteristics of VR Applicants and Consumers Characteristic Percentage Gender Female 48.5% Male 51.5% Age <=21 12.9% 22 - 29 17.4% 30 - 39 26.2% 40 - 49 24.8% 50 - 59 12.8% 60 - 64 2.4% >64 3.5% Race/ethnicity White 83.3% African-American 14.2% American Indian or Alaskan Native 0.5% Asian or Pacific Islander 0.9% Of Hispanic origin 9.9% Source: Consumer case records Table 3 Educational, Marital, and Family Status of VR Applicants and Consumers Characteristic Percentage Highest degree obtained High school diploma or GED 55.6% Two-year associate's degree 4.5% Four-year bachelor's degree 5.3% Master's degree 1.3% Doctoral degree 0.2% Missing or not indicated 33.1% Evidence that received special education services in school19.6% Years of education completed Average 11.9 years Minimum 0.0 years Maximum 23.0 years Marital status Married 28.4% Widowed 3.6% Divorced 16.4% Separated 5.7% Never married 45.6% Number of dependents Average 0.89 Minimum 0.0 Maximum 12.0 Source: Consumer case records Table 4 Percentage of Consumers Reported as Receiving Financial Assistance While VR Applicants or Consumers, by Type of Assistance, Average Amount of Assistance, and Average Number of Months Received* Type of financial assistance% of all consumersAverage monthly assistanceAverage months receiving assistance Mean Median Mean Median SSI - aged 0.6% $ 657.23 $633.00 50.4 36 SSI - blind 0.9% $381.02 $435.00 53.5 48 SSI - disabled 16.0% $408.30 $446.00 55.3 41 SSDI 11.9% $ 556.68 $521.50 56.1 33 General assistance 6.0% $ 258.45 $212.00 26.0 12 AFDC 4.4% $ 351.20 $305.00 26.6 12 Veteran's disability 1.2% $ 541.53 $400.00 75.1 23 Other disability 2.1% $ 750.57 $566.50 22.3 12 Other public support 4.2% $ 473.42 $343.00 51.2 84 Family and friends 8.8% $ 844.83 $800.00 44.5 12 Workers' compensation 3.5 %$ 814.08$749.0020.0 13 Private relief agency 0.3% $ 319.65 $298.00 8.3 9 Private insurance 0.8% $1,029.37$841.00 43.3 14 Public institution (tax supported) 0.6% $ 564.28 $470.00 33.0 24 All other (excluding wages) 2.7% $ 580.31 $489.00 24.7 12 *Analysis of case files indicated that 47.9% of consumers were receiving some type of financial assistance at the time of entry into the study. Source: Consumer case records for a period of 27 months and about $350 per month), and other public support (51 months at $475 per month. About nine percent have family and friends as a source of support (45 months and $844 per month). Among persons receiving some form of assistance (half of all consumers), 77 percent report benefits as their primary source of support; while 18 percent report family or friends as their primary source of support. As these data indicate, persons receiving federal disability benefits, including SSDI and the various forms of SSI, tend to have been receiving such benefits for between four (for SSI-aged and SSI-blind) and five years (SSI-disabled). Persons receiving Veterans disability have, on average, received such benefits for over five years (median two years). On the other hand, consumers on workers' compensation have been receiving those benefits for less than two years (a mean of 20 months; median of 13). Labor Force Participation Our source of information on labor force participation among VR agency consumers is a work history interview that we administered to all VR participants at entry into the study. The interview asks consumers to report the type of occupation, wages earned, hours worked, receipt of employment-related benefits (e.g., medical insurance) and overall job satisfaction, for each job held in the two years prior to applying for VR services, and for their longest uninterrupted period of employment, regardless of when they held that job. We have organized our findings on consumers' labor force participation into two broad areas. The first area, consumers' overall history of labor force participation, discusses the extent to which VR consumers have employment experience and describes the employment status of consumers at application to the VR system. We then provide a summary description of consumers' most recent employment experiences, including the types of jobs held, wages earned, and other salient employment-related topics. Where possible we use data on the U.S. working-age population in these same areas to provide a context for considering the employment history of VR consumers. History of labor force participation. Data from the work history interview indicate that approximately nine of every 10 VR consumers have some amount of employment experience before applying for VR services. Table 5 summarizes the work history of VR consumers prior to entry into the VR system, and, as indicated, just 8.2 percent of VR agency consumers have never Table 5 Overall Work History of VR Agency Consumers Work history Percentage Never worked for two consecutive weeks8.2% Have worked, but not in two years prior to application to VR 27.4% Have worked in two years prior to VR entry, but not working at application to VR 38.4% Working at application to VR 26.0% Source: Work History Interview worked at a job lasting two weeks or more. At the other end of the spectrum, 26 percent of all consumers were working at the time of application, while another 38 percent, though not working at VR entry, had worked at some point in the two years prior to applying for VR services. Overall, then, nearly two-thirds of all consumers (64.4 percent) have a recent history of employment at the point of VR entry. Approximately 27 percent of consumers have worked at some time in their life, but not during the two years prior to applying for VR agency services. Although most VR consumers enter the system with some amount of employment experience, data from the work history interview indicate that such experience varies greatly. For example, approximately 40 percent of consumers have held only one job in their lifetime, while roughly 21 percent have held at least three jobs prior to applying for VR services (Table 6). On average, VR consumers worked at each job held in their lifetime for approximately 3.5 years (Table 7). However, this average may not provide an accurate picture of consumers' job stability overall, since some individuals (about one percent) reported having held a job for 30 years or more. The median number of years in each job-1.6 years-may be a more realistic reflection of the work experience of most VR consumers. Table 6 Total Number of Jobs Held in Lifetime Number of jobs held Percentage None 8.2% One 40.2% Two 28.8% Three 13.2% Four 4.8% Five or more 2.6% Do not know 2.2% Source: Work History Interview Table 7 Number of Years in Each Job for Consumers With an Employment History Mean Median Minimum Maximum 3.5 years 1.6 <1.0 36.4 Source: Work History Interview Consumers' status at application. We asked the 74 percent of consumers not working at the time of application to indicate their status at that time; Table 8 summarizes their responses. As shown, 33 percent of them were actively seeking employment, another 28 percent were not looking for work, and 20 percent were students. "Homemaker" best described the status of 14 percent of consumers not working at the time of application, while very few consumers were volunteers, unpaid family workers, or trainees in a noncompetitive environment. Table 8 Status of Consumers Not Working at Time of Application To VR Status Percentage Not working, but looking for work 32.9% Not working and not looking for work 28.1% Student 20.0% Homemaker 13.5% Trainee or worker in noncompetitive environment 2.5% Unpaid family worker 1.9% Volunteer worker 1.1% Source: Work History Interview As noted earlier, 26 percent of VR consumers were working at the time of entry into the VR system, and on average, these individuals had held their jobs for slightly over five years (Table 9). Again, since the mean may be skewed somewhat by a few consumers who have held jobs for 30 years or more, the median of 2.8 years may be a more useful figure. Regardless of whether the mean or median is used for comparisons, data from the work history interview Table 9 Average Years in Job, Hourly Wage, and Number of Hours Worked Per Week for Consumers Working at Time of Application to VR Job held at applicationMean Median Minimum Maximum Years in job 5.2 2.8 <1.0 36.4 Hourly wage $7.60 $6.00 $1.00 $40.00 Hours worked per week31.9 36.0 1 100 Source: Work History Interview indicate that VR consumers working at the time of application to VR had been employed in these jobs for more than one year longer than the mean or median job tenure for VR consumers overall. As Table 9 also indicates, consumers working at the time of application to VR worked an average of approximately 32 hours per week and earned $7.60 per hour, with medians of 36.0 hours per week and $6.00 per hour, respectively. Profile of most recent employment. We asked consumers with a work history to provide information about their most recent job, regardless of when they had held the job in relation to the time of entry into VR. As shown in Table 10, a large majority (87 percent) of them have most recently worked in the competitive labor market, with no other type of employment accounting for even five percent of the total. Table 10 Type of Job Held in Most Recent Employment Prior to Application to VR Type of job Percentage Competitive labor market (regular)86.5% Sheltered work 3.3% Self-employment 3.8% Supported employment 1.9% Homemaker 0.2% Unpaid family worker 0.3% Other 4.0% Source: Work History Interview Table 11 summarizes findings from the work history interview with respect to the types of occupations consumers held in their most recent employment. Service occupations account for the largest percentage (27 percent), followed by professional, managerial or technical occupations (21 percent), and clerical or sales positions (18 percent). No other single category of occupation accounts for more than six percent of consumers' most recent employment experience. Table 11 Type of Occupation in Most Recent Employment Prior to Application to VR Type of occupation Percentage Service 27.0% Professional, managerial, or technical21.1% Clerical/Sales 17.8% Machine Trades 5.1% Benchwork 4.7% Structural Work 4.2% Processing 2.1% Agriculture 1.6% Miscellaneous 16.3% Source: Work History Interview On average, VR consumers held their most recent job for 3.6 years, with a median of 1.5 years. Nationally, average employee tenure with the same employer is 4.5 years;[3] thus VR consumers overall have held their most recent job for an average of one year less than the national norm. However, the average job tenure for VR consumers who were employed at the time of application for services (representing approximately 26 percent of consumers) is slightly longer than the national norm. The mean hourly wage in the most recent jobs held by VR consumers is $7.43 per hour (median of $5.85), as indicated in Table 12. Twenty-one percent of VR consumers earned minimum wage or less during their most recent period of employment, while 62 percent earned between $4.26 and $10.00 per hour. Average hourly earnings for all private industry employees in the U.S., according to the Bureau of Labor Statistics, are $11.12 for 1994 and $10.83 for Table 12 Hourly Wage Earned in Most Recent Employment Prior to Application to VR Hourly wage Percentage Less than $4.25 12.4% $4.25 8.6% $4.26 - $10.00 62.0% More than $10.00 17.0% Mean hourly wage (median) $7.43 ($5.85) Source: Work History Interview 1993.[4] Thus, in their most recent jobs VR consumers earned, on average, approximately two-thirds of the national average hourly wage.[5] VR consumers worked an average of 34.7 hours per week in their most recent job (Table 13). As shown, approximately one-fifth worked 20 hours a week or less in their most recently held job, with another fifth reporting having worked between 21 and 35 hours. Only 14.9 percent reported working more than full-time (i.e., 41 hours or more each week). One measure of the quality of employment is the availability of various job-related benefits. In 1993, approximately 52 percent of all wage and salary workers in the U.S. aged 15 years or older were covered by a group health plan provided by their employer.[6] As shown in Table 14, over one-third of VR consumers (35.3 percent) reported having health insurance through their most recent job, while slightly more (39.3 percent) received one or more other job-related benefits, such as vacation or life insurance. Thus, in comparison with the national average, VR consumers were much less likely to have employer-provided health insurance in their most recent job. Table 13 Hours Worked Per Week in Most Recent Employment Prior to Application to VR Number of hours per week Percentage 20 hours or less 20.9% 21 - 35 hours 20.0% 36 - 40 hours 44.1% 41 hours or more 14.9% Mean hours per week (median) 34.7 hours (40.0) Source: Work History Interview Table 14 Receipt of Job-Related Benefits in Most Recent Employment Prior to Application to VR Fringe benefit Percentage Health/medical insurance 35.3% Other fringe benefit 39.3% Source: Work History Interview The lack of employment-related benefits does not appear to have had a negative influence on consumers' overall satisfaction with their most recent job, as indicated in Table 15. A large majority (85 percent) of VR consumers reported being satisfied with their most recent job, including 48 percent who liked their job "very much," and another 37 percent who liked their job "fairly well." Less than seven percent did not like their job at all. Table 15 Consumer Satisfaction With Most Recent Employment Prior to VR Application Level of satisfaction Percentage Liked the job very much 48.3% Liked the job fairly well 37.4% Did not like the job much 7.7% Did not like the job at all 6.5% Source: Work History Interview CHAPTER 3: CONSUMERS' PERSPECTIVES ON THEIR VR EXPERIENCE Of particular concern to federal policymakers, state and local practitioners, and consumers and other stakeholders is whether the VR system is sufficiently responsive to the preferences and interests of its consumers. The 1992 Rehabilitation Act Amendments articulate this concern in terms of what has become widely known as "choice." Among specific requirements regarding choice, or consumer control, are the following: [The state plan shall]. . .describe the manner in which individuals with disabilities will be given choice and increased control in determining their vocational rehabilitation goals and objectives. . . .(Section 101(a)(29)). . .[including] alternative goals, objectives, services, entities providing such services, and methods used to provide or procure such services (Section 102(b)(1)(B)(x)). One of the factors that may affect the services and outcomes of VR consumers is the extent to which they perceive themselves to be integrally involved in decisionmaking regarding their VR services. Another is their level of satisfaction with specific aspects of their VR experience (e.g., timeliness of eligibility decisions and responsiveness of VR staff) and with the efficacy of their VR services overall. In order to assess the extent to which choice and satisfaction are associated with various VR outcomes, we administer a satisfaction interview at baseline (the point at which an individual enters the longitudinal study) and periodically thereafter. In addition to its utility for future analyses, the data collected in this instrument provide information regarding consumers' perspectives on VR that is useful in itself to policymakers and practitioners. As with other information contained in this interim report, the findings reported on consumers' perspectives reflect individuals in various stages of the VR process, including persons currently receiving services and individuals who recently left VR as 26, 28, or 30 closures. We do not administer the interview to applicants until they have begun to receive services. Further, we will collect satisfaction data over time and we will be able to track the extent to which consumers' views change as they proceed through the VR process. Nevertheless, at present these findings do shed considerable light on the views of VR consumers across the nation regarding their VR experiences. Included in this chapter are the following sections: (1) consumers' perceptions of choice in selection of vocational goal, services, and service providers; (2) nature, frequency, and quality of consumers' interactions with their VR counselors; (3) consumers' perspectives on specific VR services; and (4) their perspectives on the VR experience overall. One of the issues that the study's data on consumer control and satisfaction raises is the appropriate interpretation of the findings. For example, is a finding that over three-fourths of VR consumers are very or somewhat satisfied with their vocational goal a positive reflection on the VR system, or a negative one, or neutral? What level of satisfaction is required to determine that VR is doing a good job in planning and delivering services to consumers? In an attempt to place the findings in this chapter in context (that is, to provide some benchmarks for use in judging the meaning of the findings), we have investigated the research on consumer satisfaction in VR and in other fields (e.g., medical rehabilitation services). While relatively little comparable information is available in the recent published literature,[7] to the extent that we were able to identify results of studies whose populations and data were relatively similar to the instruments we are administering, we include these findings in this chapter. Consumers' Perspectives on Choice The satisfaction interview collects parallel information on three topics that address consumers' perceptions about their involvement in decisionmaking about their VR services. These topics are selection of vocational goal, selection of services, and selection of service providers. For each topic, consumers responded to parallel questions that asked who was involved in making decisions and whether the consumer was satisfied with the results. Additional questions were specific to each of the three topics. In terms of selection of vocational goal, a substantial majority of VR consumers reported either that they themselves selected the goal (31.1 percent) or that they and the counselor selected the goal together (41.6 percent) (Table 16). Seven percent reported that the counselor decided the goal; five percent indicated that they already had a job and did not want a different one. In response to a question regarding whether the consumer believed that he or she had adequate choice in selecting the vocational goal, three-fourths believed that they had enough choice. Table 16 Consumer Choice: Perspectives on Choice of Vocational Goal, Among Current and Former VR Consumers Consumer perceptions of decisions regarding the vocational goalPercenta ge Consumers' perceptions of the decisionmaking process associated with selection of a vocational goal Consumer decided the vocational goal 31.1% Counselor decided the vocational goal 7.1% Consumer and counselor decided the goal together41.6% Another VR staff member decided the goal 0.4% A family member or advocate decided the goal 0.9% Consumer already had a job and did not want a different one 5.1% Consumer doesn't remember the decision process 4.4% Other 7.8% Perceptions of adequacy of choice in selecting the vocational goal Yes, the consumer believed he/she had enough choice74.9% No, the consumer did not believe he/she had enough choice19.7% Consumer does not remember 1.9% Missing 3.5% Consumers' level of satisfaction with the vocational goal Very satisfied 51.4% Somewhat satisfied 24.4% Indifferent 7.5% Somewhat dissatisfied 6.0% Very dissatisfied 6.0% Don't know 1.5% Source: Consumer Satisfaction Interview (baseline administration) Similarly, 76 percent commented that they were either very or somewhat satisfied with their goal (51.4 percent were very satisfied, and 24.4 percent were somewhat satisfied). Twelve percent were somewhat or very dissatisfied with the vocational goal they were pursuing. Two-thirds of consumers indicated that their counselor had told them about the services they could choose through the VR agency (Table 17). Of these consumers, 64 percent indicated they and their counselor decided on services together; 19 percent decided on their services by themselves, and 10 percent indicated their counselor decided the services. Overall, forty-three percent of consumers who were receiving or had received services in VR were very satisfied with their choice of those services; an additional 29 percent were somewhat satisfied. Six percent were very dissatisfied and eight percent were somewhat dissatisfied. As Table 18 indicates, among consumers whose providers had been selected at the time of interview (65 percent), 46 percent indicated that they and their counselor jointly decided on providers; 23 percent made the decision on their own; 17 percent reported that their counselor was the primary decisionmaker in selection of providers. We asked these consumers whether their counselor gave them information that was helpful to them in making the best possible choices of providers. As shown in Table 18, 76 percent of respondents indicated that their counselors provided enough information. Fifty-four percent were very satisfied with the available choice of providers, and an additional 26 percent were somewhat satisfied. Only five percent were very dissatisfied with the available choice of providers. Overall, then, consumers reported a high level of satisfaction with the choices available to them as they selected their goal, planned their services, and made decisions about providers of services. In most instances, decisions about these issues occurred as a joint process between consumer and counselor or with the consumer autonomously making the decision. Rarely were others, such as a friend or family member, involved in selection of services and service providers, although in a relatively small percentage of cases (10 percent for services and 17 percent for providers), consumers indicated that the counselor made the decisions autonomously. Asked to what extent they took charge of decisions during their VR experience, 45.8 percent reported having taken charge "to a great extent" and 41.1 percent "to some extent." Ten percent responded "not at all." These findings, indicating that 86.9 percent of consumers were to some or a great extent in control of the decisionmaking process, can be compared with findings from a Table 17 Consumer Choice: Perspectives on Choice of Services, Among Current and Former VR Consumers Consumer perceptions of decisions regarding selection of services Percentage Of consumers reporting that their counselor told them about the services they could choose through the VR agency,* percentage reporting how decisions about selection of services occurred Consumer decided the services he/she would get19.0% Counselor decided the services consumer would get10.1% Consumer and counselor decided the services together63.8% A family member or friend decided the services 1.3% Consumer doesn't remember the decision process 2.6% Other 3.2% Consumers' level of satisfaction with the choice of services made available to them Very satisfied 43.0% Somewhat satisfied 28.5% Indifferent 9.3% Somewhat dissatisfied 8.1% Very dissatisfied 6.4 % Don't know 1.7% Missing 3.0% *At the time of interview, 66.5 percent of consumers had discussed services with their counselor; an additional 1 percent had dropped out (as status 30 closures). Source: Consumer Satisfaction Interview (baseline administration) Table 18 Consumer Choice: Perspectives on Choice of Service Providers, Among Current and Former VR Consumers* Consumer perceptions of decisions regarding selection of providers Percentage Of consumers reporting that their service providers had been selected,* percentage reporting how decisions about service providers occurred Consumer decided the providers of services he/she would get23.4% Counselor decided the providers of services 16.9% Consumer and counselor decided the providers together45.9% A family member or friend decided the providers 1.6% Consumer doesn't remember the decision process 5.1% Other 7.1% Consumers' views about whether their counselor gave them information that helped them make the best choices of providers Yes, counselor gave information to make the best choices75.8% No, counselor didn't provide enough information22.1% Don't remember 2.1% Consumers' level of satisfaction with the available choice of providers Very satisfied 54.3% Somewhat satisfied 26.4% Indifferent 6.9% Somewhat dissatisfied 6.0% Very dissatisfied 5.1% Don't know 1.3% *At the time of interview, 65 percent of respondents reported that their providers had been selected. Source: Consumer Satisfaction Interview (baseline administration) recent study of consumer satisfaction conducted by the Texas Rehabilitation Commission (TRC) (Schwab et al., 1993), which reported that 79.5 percent of respondents felt involved in decisions about services all or most of the time. Consumers' Interactions With Their Rehabilitation Counselors Table 19 presents information on the nature and frequency of consumers' interactions with their counselor during the year prior to the satisfaction interview (which occurred between December 1995 and October 1996). We asked about three types of contacts: face-to-face meetings, phone calls, and letters from the counselor. At the time of interview, consumers were at various stages of the VR process: about half were in active services, while the other half had closed from VR in one of three statuses (26, 28, 30) and based their responses on their recollection of their time in VR. As shown in the table, 34 percent of consumers met with their counselor once a month or more frequently, while 20 percent met with the counselor once every three months and 35 percent had met with the counselor only once or twice during the past year. Ten percent reported not having met with a counselor at all during the period in question. Seventy-six percent of consumers were satisfied with the frequency of their face-to-face meetings with their counselor. Twenty-one percent of consumers talked on the phone with their counselor at least twice a month (15 percent, two to three times a month, and six percent at least once a week). Twenty percent had a phone conversation with the counselor about once a month, and 17 percent once every three months. Over a quarter (26 percent) had talked with the counselor only once or twice, and 15 percent indicated they had not talked with the counselor at all during the prior year. Overall, 76 percent of consumers were satisfied with the frequency of their phone conversations with their counselors. Finally, consumers reported having received an average of 3.6 letters (median 3.0) from their counselor during the past year; the minimum number of letters received was 1 and the maximum was 50 over the course of the year. Table 19 Nature and Frequency of Consumers' Interactions with the VR Counselor, Among Current and Former VR Consumers Consumer - counselor contacts during past year Percentage Frequency of face-to-face meetings in past year Once a week or more 4.6 % 2 - 3 times a month 9.0% About once a month 20.1% Once every 3 months 20.3% Only once or twice 34.6% Not at all 10.2% Consumers reporting satisfaction with frequency of meetings75.5% Frequency of phone calls in past year Once a week or more 6.3% 2 - 3 times a month 14.5% About once a month 20.0% Once every 3 months 16.8% Only once or twice 25.8% Not at all 15.3% Consumers reporting satisfaction with frequency of calls76.3% Number of letters from counselor in past year Mean (median) 3.6 (3.0) Minimum 1.0 Maximum 50.0 Source: Consumer Satisfaction Interview (baseline administration) To examine their perspectives about the quality of these interactions, we asked a series of questions regarding consumers' views about their relationship with the counselor (Table 20). As shown in the table, 70 percent of consumers believed that their counselor consistently demonstrated sufficient interest and concern for their needs. Seventy-five percent found their counselor always willing to listen to their ideas and suggestions, and two-thirds could not think of anything they would have wanted their counselor to do differently. Overall, 45 percent were very satisfied with their counselor's assistance in working toward employment; an additional 25 percent were somewhat satisfied. Eight percent were very dissatisfied and eight percent somewhat dissatisfied. The recent consumer satisfaction study conducted by the TRC asked consumers who had recently closed from TRC as either 26 or 28 closures whether their counselors took time to listen to their needs. The researchers reported that 84.8 percent of respondents reported that counselors listened to their needs all or most of the time. This finding compares with 89.8 percent of consumers in the VR longitudinal study who reported that their counselors were always or sometimes willing to listen to ideas and suggestions (Table 20). However, the longitudinal study reflects the perceptions of consumers who are still receiving VR services as well as those who have been closed from the system and consequently is not precisely comparable to the study group in the Texas study. Finally, Table 21 reports information on issues relevant to the consumer-counselor interaction, though the activities reported, including timeliness of eligibility determination and of arrangement for services, are not entirely within the counselor's control as the VR system operates. In terms of eligibility determination, 76 percent of consumers believed that the determination did not take too long; that is, they believed that the eligibility determination process was timely. In terms of arrangement for services, nearly half of consumers (47 percent) were very satisfied with the speed with which their counselor arranged for services, and 28 percent were mostly satisfied. Seven percent were very dissatisfied. Table 20 Consumers' Perceptions about the Quality of Their Relationship with the VR Counselor, Among Current and Former VR Consumers Consumers' perceptions regarding counselor's performancePerc ntage Extent to which counselor showed enough interest, attention, and concern for consumer's needs Always 70.4% Sometimes 16.7% Rarely 6.2% Never 4.6% Extent to which counselor was willing to listen to consumer's ideas and suggestions Always willing 75.0% Sometimes willing 14.8% Rarely willing 4.6% Never willing 3.1% Whether consumer would have liked the counselor to do some things differently Yes 32.0% No 66.4% Overall satisfaction with counselor's efforts to help consumer work toward obtaining employment Very satisfied 44.3% Somewhat satisfied 24.9% Indifferent 8.7% Somewhat dissatisfied 7.9% Very dissatisfied 8.0% Don't know 1.5% Source: Consumer Satisfaction Interview (baseline administration) Table 21 Perceptions Regarding Timeliness of Events in the VR Process, Among Current and Former VR Consumers Consumers' perceptions about timeliness Percentage Consumers' views regarding whether the VR agency took too long to make an eligibility determination Yes, the agency took too long 22.1 % No, the agency didn't take too long 75.8% Don't know 1.4% Consumers' satisfaction with the speed with which the counselor arranged for the consumer to receive services Very satisfied 46.8% Mostly satisfied 28.2% Indifferent 6.5% Somewhat dissatisfied 7.8% Very dissatisfied 7.1% Don't know 0.9% Source: Consumer Satisfaction Interview (baseline administration) Consumers' Perspectives on VR Services As noted in an earlier section, a substantial majority of consumers, at the baseline interview, were satisfied with the amount of choice they were able to exercise in decisions regarding their vocational goal and services that would help them to meet that goal. Also important to the issue of consumers' perspectives on their VR experience is the extent to which they viewed the services they received as meeting their needs, their rating of the quality of those services, and their level of satisfaction with the services. In reviewing the information in Table 22 on these topics, the reader should keep in mind that while the VR system is responsible for the design and provision of services intended to meet the needs of consumers, to a great extent VR arranges for those services but does not actually provide them directly. Hence, while the agency has responsibility for exercising as much quality control over service provision as possible, consumers' perspectives on quality of services likely apply at least in part to perceptions about the actual provider of services as well as to the agency's role in arranging services. As shown in Table 22, about 60 percent of consumers believed that their services had met all or most of their needs. Twenty-six percent reported that their services had met some of their needs; 12 percent believed that their services met none of their needs. Two-fifths (42 percent) wanted additional services that they had not received from VR. While many consumers would have liked to have had additional services, most rated those they did receive relatively highly. Forty-two percent thought their services were excellent, and 33 percent rated them as good. Only eight percent rated their services as poor. Similarly, nearly half (47 percent) were very satisfied with the services they received; an additional 28 percent were mostly satisfied; seven percent were very dissatisfied with their services Perspectives on the VR Experience Overall In addition to their views on specific services, we asked former consumers to comment on their perceptions of the VR experience overall (Table 23). Not surprisingly, persons who left VR with an employment outcome (persons closed in status 26) reported a more positive perception of their VR experience than did those who closed without an official employment outcome (in status 28 or 30), although interestingly 22 percent of those closing as unsuccessful reported that they were working at the time the VR agency closed their case. Among former consumers closed as 26, two-thirds held the view that VR had exceeded or matched their expectations (as opposed to 35 percent of former consumers closing as status 28 or 30). Sixty-three percent of consumers with an employment outcome reported that their services had been helpful in obtaining a job, and 64 percent obtained the type of job they wanted as a result of their VR experience. Comparable figures for individuals not closed with an employment outcome but reporting that they were working at closure were as follows: 40 percent viewed their VR services as helpful, and 51 percent indicated that they obtained the type Table 22 Perceptions of Current and Former VR Consumers about the Usefulness and Quality of Services Received through VR Consumers' perceptions regarding services Percentage Consumers' reports of the extent to which their services met their needs Services met all needs 29.3% Services met most needs 30.9% Services met some needs 24.8% Services met no needs 12.4% Question not answered 2.6% Consumer wanted additional services that he/she did not receive 41.5% Consumers' rating of the quality of services received from the VR agency Excellent 41.6% Good 32.7% Fair 12.9% Poor 8.9% Question not answered 3.9% Consumers' reports of satisfaction with services received from the VR agency Very satisfied 47.7% Mostly satisfied 28.8% Indifferent 5.7% Somewhat dissatisfied 7.3% Very dissatisfied 7.4% Question not answered 3.2% Source: Consumer Satisfaction Interview (baseline administration) of job they wanted. Nearly nine-tenths of successful consumers indicated they would refer a friend to VR if that person needed similar services, and over two-fifths had done so. Among 28 closures, 75 percent would refer a friend, and 29 percent had done so.[8] Finally, asked a series of questions whose intent was to illuminate whether consumers believed VR was worth the investment, 60 percent of 26 closures commented that if they had to pay for their own services, they would purchase "exactly the same rehabilitation services [they] received from the VR program." Twenty-four percent of this group would buy "better or different" services, while 8.5 percent thought they would not purchase rehabilitation services at all but would spend the money on other needs. Among 28 closures (i.e., consumers who received VR services but were not terminated as having achieved an employment outcome), one-third indicated they would buy the same services; 39 percent would buy better or different services, and 16 percent would not buy rehabilitation services but would use the money for something else. Table 23 Perceptions of Former VR Consumers about the VR Experience Overall Consumers' perceptions about the VR experience Percentag e, by closure status 26 2 8 / 3 0 Consumers' reports of whether the VR experience met expectations VR exceeded expectations 24.9% 6 . 9 % VR lived up to expectations 40.8% 2 8 . 2 % VR could have done more 24.2% 5 0 . 7 % No opinion/not answered 10.2% 1 4 . 2 % Consumers' reports of whether services were helpful in obtaining a job* Services helpful 63.1% 4 0 . 1 % Services not needed or not helpful 20.2% 4 2 . 2 % Not sure/no opinion 9.2% 1 4 . 3 % Question not answered 7.5% 3 . 4 % Consumers reporting that the job they got was the type of job they wanted 64.3% 5 0 . 9 % Consumers' reports of whether they would refer a friend to VR Consumer would refer a friend 87.5% 7 4 . 7 % Consumer has referred a friend 42.0% 2 9 . 4 % Consumers' perceptions on the usefulness of services and experiences individuals receive through VR If I had to pay for it, I'd buy exactly the same rehabilitation services that I received from the VR program. 59.4% 3 3 . 4 % If I had the money to buy my own rehabilitation services, I'd try to buy better or different services from the ones I received through the VR program. 23.8% 3 9 . 1 % If I had the money, I wouldn't have spent it on rehabilitation services at all; I would have used it for other things I needed. 8.3% 1 5 . 7 % Question not answered 8.5% 1 1 . 7 % *Analyses limited to persons working at the time of closure (includes both 26 and 28 closures; does not include 30 closures) Source: Consumer Satisfaction Interview (baseline administration) 1. Persons selected into the study as applicants to VR (in status 02) do not complete the satisfaction interview at baseline since they will have had relatively little experience with VR at that point; these individuals complete the interview at one-year intervals or at closure if they leave VR prior to the end of a year. Those selected at closure (26, 28, 30) complete the interview only once, as they enter the study. Persons currently in services when they enter the study complete the interview at that time and then annually until closure for up to three years. 2. Because average amounts and lengths of assistance are skewed, Table 4 reports both mean and median for these variables. In general, these data indicate that some consumers have received assistance for extended periods of time, thus increasing the group means. 3. U.S. Bureau of Labor Statistics, News, USDOL 92-386. 4. U.S. Bureau of Labor Statistics, Bulletin 2445. 5. Since the dates of most recent employment for some consumers precedes 1993 and average earnings increase over time, this figure underestimates slightly the percentage of the national average represented by VR consumers' earnings. 6. U.S. Bureau of the Census, unpublished data. 7. During the 1970's, a number of researchers conducted studies of consumer satisfaction in VR, among individuals in sheltered workshops, and in other contexts. Given the extensive changes in both the rehabilitation delivery system and the empowerment of persons with disabilities over the past 25 years, use of data from these early studies to provide context for our findings seems ill advised. 8. In a study of 26 and 28 closures, Hayward et al. (1992) reported the following: 88.5 percent of 26 closures and 77.8 percent of 28 closures would refer a friend to VR. Only 31.6 percent of 26 closures had actually referred a friend to VR; 35.9 percent of 28 closures reported having done so