Disability: 36 of every 100 had either an amputation or an orthopedic impairment or deformity as the major disability. 12 of every 100 had a mental illness as the major disabling condition. 10 of every 100 were blind or otherwise visually handicapped, as the major disabling condition. 7 of every 100 had a hearing or speech impairment as the major condition. 6 of every 100 had mental retardation as the major disabling condition. 5 of every 100 had a cardiac defect as the major disabling condition. Earnings at acceptance: 80 of every 100 had no earnings when accepted for services. Dependents: 13 of every 100 had 1 dependent. 9 of every 100 had 2 dependents. 8 of every 100 had 3 dependents. 16 of every 100 had 4 or more dependents. Referral source: 15 of every 100 were referred by physicians. 15 of every 100 were referred by hospitals and sanatoriums. 13 of every 100 were referred by educational institutions. 12 of every 100 were referred by public and private welfare agencies. 6 of every 100 were referred by the State employment services. Major occupation following rehabilitation: 24 of every 100 went into skilled and semiskilled occupations. 20 of every 100 went into service occupations. 16 of every 100 went into sales and clerical occupations. 15 of every 100 went into family enterprises. 8 of every 100 went into professional and managerial occupations. 7 of every 100 went into unskilled occupations. 7 of every 100 went into agricultural occupations. 3 of every 100 went into sheltered workshops. The proportion of women among the disabled who are rehabilitated has been rising to almost two-fifths of the total. The major portion of women who are rehabilitated go into paid employment in a variety of occupations, the remainder returning after rehabilitation to resume responsibilities for families and homes. This decade also showed the program's potential for financial growth under the new system of financing provided in the 1954 amendments for the basic Federal-State program of rehabilitation. The problems inherent in the previous financing system had contributed substantially to slowing program growth and had made for serious fiscal problems for both the Federal and State agencies. The new financing provisions assured the stability of State programs at the level each had attained in 1954 and then set in operation a new fiscal arrangement for alloting funds to States on a specific formula set in the law. The formula aimed at reflecting each State's need as expressed by its population and its ability to pay as expressed in its per capita income. The growth in Federal and State financial support of this program under this new financing system is shown in figure 3. 4. Extension and improvement project grants to States One of the new means of broadening the resources of the public program was the program of project grants to States for extension and improvement. More than 400 such projects have been sponsored by State agencies since 1955. About one-third were for improvements to rehabilitation facilities and workshops. Another third provided means for assignment of counselors and other specialized staff to serve the mentally ill and emotionally disturbed, in particular, as well as the mentally retarded, the cerebral palsied, the deaf and hard of hearing, and the blind. 5. Randolph-Sheppard vending stand program This program, functioning under the Randolph-Sheppard Act, gives preference to blind persons to operate vending stands on Federal and other property. Generally the State agency for the blind is the licensing agency. Now in effect for nearly 30 years, this program grosses an impressive $60 million yearly for over 2,800 operators, with an average of about $4,700 per operator. 6. Research and demonstration in rehabilitation From research and demonstration into the mainstream of vocational rehabilitation practice comes new knowledge of the nature of disability and techniques for controlling and reducing its impact, as well as the opportunity to show in application what is new and successful. The flow of results from research and demonstration into practice is a continuous process which has proved its worth over and over again in vocational rehabilitation, as it has in other programs. Since 1954 the Vocational Rehabilitation Administration has supported about 1,000 research and demonstration projects. These project grants support research investigations and demonstrations conducted by State agencies, by universities, and by other qualified public or private nonprofit agencies. They have ranged over the span of research basic in rehabilitation. Many have become signally important beginning points in efforts to reach numbers of previously neglected disabled persons. The demonstration project offers an important channel for testing the effectiveness of new or improved procedures. When a demonstration project including services turns out particularly well and appears suitable for widespread use, a prototype is tried out in a group of States. Commonly, after a starter period with VRA grant support, the demonstration is taken over with full sponsorship and support by a local community or State agency. The prototype demonstration series are under continuous review with an eye to dropping a prototype when it has served its major purpose, and adding a new one. Another channel for putting research results to work is the wide dissemination of published project reports. In these disability groups and other special categories, over 100 demonstration projects have been conducted: mental retardation; cerebral palsy; epilepsy; mental and personality disorders; blindness and visual handicaps; disabled public assistance recipients; older disabled workers; chronically ill; and the homebound. Figure 6 shows the rate at which Federal funds have been expended for this purpose and for the training of personnel to staff rehabilitation programs. The Vocational Rehabilitation Administration currently is trying to bring other advances in science and technology into rehabilitation. For example, in the field of sensory aids for the blind, the deaf, the hard of hearing and certain others, research grants with the Massachusetts Institute of Technology, Texas Christian University, the University of Cincinnati, and Wayne University (among others) are merging the professions of engineering, medicine, speech science, and psychology to develop new sensory aids. Plans are being made with the National Aeronautics and Space Administration to search the new inventions coming from the space research and development programs for devices or ideas which could be adapted to the needs of the blind, the deaf, the speech and hearing impaired, and others. New technological advances from engineering and space research are also opening new horizons in the rehabilitation of amputees and other orthopedically disabled persons. With VRA support, the Woodrow Wilson Rehabilitation Center Foundation in Fisherville, Va., and General Electric are collaborating to review GE's fund of technology from industrial, military and space research, to develop and improve orthotic and prosthetic appliances and equipment for medical rehabilitation. At Case Institute of Technology in Cleveland, the VRA is supporting a project aimed at enabling patients to use their paralyzed arms or legs by actuating muscles with electronic devices. The VRA program has three assets in building the Nation's resource of research manpower: (1) The research program attracts more and more research competence from an ever greater variety of professions into rehabilitation investigations. (2) In the research project review process-through the study groups and the National Advisory Council on Vocational Rehabilitation who review these projects-the contributions of highly qualified and competent professional and lay leaders are secured. (3) Rehabilitation research fellowships are awarded to enlarge and enrich our research resources by developing competent research workers in the professional fields which contribute to the Vocational rehabilitation of disabled persons. 7. Training workers for rehabilitation VRA's training grant program is a response to a serious shortage of qualified professional rehabilitation counselors, rehabilitation physicians, rehabilitation nurses, therapists, prosthetics experts, and a number of others. These shortages of trained personnel will become even sharper with the new personnel demands growing out of new programs such as Medicare, community health programs, and the planned heart disease, cancer, and stroke programs. Each year since the start in 1955 has seen an increase and in 1965, with a $19.8 million appropriation, 526 teaching programs received support and grants were made for 3,780 traineeships and research fellowships. In addition, support was provided for short-term continuing education courses which reached over 6,300 individuals. Training grants have enabled schools to employ faculty, field teachers, and clinic supervisors, and thus expand their admissions. They have enabled curriculum changes for incorporation of more rehabilitation content, more information about the nature and effects of disability, and the techniques and services that are utilized. From a quantitative standpoint, manpower has been augmented in fields where there were serious shortages. More trained clinicians are working in rehabilitation settings than ever before, and a number of graduates are now on the faculties of participating schools. Support is currently concentrated in the fields of medicine, with special emphasis upon residency training in physical medicine and rehabilitation; rehabilitation counseling; nursing; speech pathology and audiology; occupational therapy; physical therapy; psychology; recreation; sociology; dentistry; prosthetics, and orthotics; and social work. Encouragement is also given to the development of curriculums designed to provide specialized skills and knowledge required 54-564-65- -4 |