Narrative: j. 1. A.

To comply with provisions of Title I, Section 101, State Plans, of the Rehabilitation Act Amendments of 1998 and Section 721, State Plans, of the Rehabilitation Act as amended by the Workforce Innovation and Opportunity Act (WIOA), the West Virginia Division of Rehabilitation Services (DRS) and the West Virginia State Rehabilitation Council (WV SRC) conducted a three–year comprehensive statewide assessment of the vocational rehabilitation (VR) services needs of individuals with disabilities in West Virginia. The WV SRC established a sub-committee on the Comprehensive Statewide Needs Assessment (CSNA), which includes a representative from the Client Assistance Program (CAP), to work with the State Plan and Program Evaluation (SPPE) Unit of DRS in conducting the needs assessment study in 2018. The WV SRC–DRS Joint Committee on Needs Assessment was established in Fiscal Year (FY) 2018 to oversee the needs assessment activity. Joint committee members including those selected by WV SRC and DRS personnel were fully committed to the needs assessment study and want to ensure successful completion of its objectives.

Four major objectives of the comprehensive statewide needs assessment study included examination of the rehabilitation needs of: (1) individuals with significant and most significant disabilities, including their needs for supported employment services; (2) individuals with disabilities who are minorities and individuals with disabilities who have been unserved or underserved by the VR program; (3) individuals with disabilities served through other components of the statewide workforce development system; and (4) youth with disabilities, and students with disabilities, including their need for pre–employment transition services or other transition services. The role of community rehabilitation programs (CRPs) as service providers was reviewed to address the need to establish, develop, or improve CRPs in West Virginia.

To maintain effective and comprehensive service delivery programs for West Virginians with disabilities, the needs assessment identified various service needs of individuals with significant and most significant disabilities. Some needed services such as transportation, housing, and personal assistance are beyond the scope of the state VR program and thus, require coordination and cooperation among a diverse range of public and private agencies and other organizations serving West Virginians with disabilities. The needs assessment recognized the service providers’ perceptions of the needs of consumers with disabilities, including rehabilitation services associates, counselors, supervisors and managers of DRS, CRPs, and Workforce Development Board members throughout West Virginia.

As part of the WV SRC–DRS Joint Committee on Needs Assessment, the SPPE Unit conducted the needs assessment study for the agency in conjunction with WV SRC, which was fully involved from inception to the reporting of the results.

As part of the intake process for VR services, a question regarding service needs was posed to potential DRS consumers at the time of application. The reported service needs were then recorded in the DRS electronic case management system. In 2018, SPPE staff members conducted a qualitative analysis of the reported service needs of 1,004 persons with disabilities of various age and disability groups statewide. Included in these active cases with expressed VR service needs across the state were 90 persons with significant disabilities from minority backgrounds, 13 individuals aged 65 or older, and 655 transitioning youth. The findings of this analysis are presented below.

THE STATEWIDE NEEDS ASSESSMENT OF CONSUMERS WITH SIGNIFICANT DISABILITIES RESULTS OF THE ANALYSIS OF THE REPORTED SERVICE NEEDS OF PERSONS WITH SIGNIFICANT DISABILITIES

In 2018, SPPE staff members, under guidance of the WV SRC–DRS Joint Committee on Needs Assessment, conducted a qualitative analysis of the reported service needs of 1,004 persons with significant disabilities of various age and disability groups statewide. These individuals represent a good sample of consumers with significant disabilities that will continue to seek assistance from agencies in coming years, ceteris paribus. All 55 counties in West Virginia were represented in the sample. The demographic profile of these individuals with significant disabilities consists of the following characteristics:

Gender: 51.7% male, 47.0% female, 1.2% no response, and 0.1% did not self-identify;

Race: 90.8% White, 9.0% Other (African American/Hispanic/ American Indian/Asian), 0.2% Unspecified;

Age: 59.2% under 22 years old, 16.8% 22-34 years, 9.0% 35-44 years, 13.7% 45-64 years, 1.3% 65 years or older; and

Primary Impairment: 6.4% Sensory/Communicative Impairments, 18.2% Physical Impairments, 75.4% Mental Impairments.

Comments from the 1,004 DRS case management records were analyzed and grouped into one or more of five general service themes: education, training, health, employment/CRP, and support. More specific service themes, within each general theme, were then determined for each comment.

As part of the Comprehensive Statewide Needs Assessment, DRS identified the following as the most frequently reported service needs in each of the categories of Education, Training, Health, Employment/CRP, and Support, based on the qualitative analysis of the reported service needs of 1,004 consumers with significant disabilities. The approximate percentage of consumers with significant disabilities reporting each service need is also listed below.

EDUCATION (22.2%): Other (59.2%); 2-yr or 4-yr College (40.8%); Vocational Education (2.7%); High School Education (1.8%); Graduate Degree Education (1.8%); Tutoring (0.9%).

TRAINING (38.7%): Business/Vocational Training (73.3%); Drive Training/Licensing (12.6%); Other (10.5%); Job Search Training/Assistance (7.7%); Career Planning Training (4.9%); On-The-Job Training/Job Trial (0.5%); Work Adjustment Training (0.5%); Independent Living Skills (0.3%).

HEALTH (4.3%): Hearing/Audiological Services (44.2%); Psychological/Psychiatric (25.6%); Other (23.3%); Eye Care (2.3%); Speech/Communication Therapy (2.3%).

EMPLOYMENT/CRP (78.1%): Job Placement (90.1%); Vocational Counseling and Guidance (12.2%); Other (3.3%); Vocational Evaluation (2.0%); Supported Employment (SE, 0.8%); Psychological Evaluation (0.6%); Community-Based Assessment (0.5%); Job Coaching Other Than SE (0.5%); Life Skills Training (0.4%); Small Business Development (0.4%); Worksite Modification or Accommodation (0.4%); Direct Placement by CRPs (0.3%); Work-Related Tools or Equipment (0.3%); Labor Market Information (0.1%).

SUPPORT (8.6%): Financial Assistance (69.8%); Other (9.3%); Assistive Technology (8.1%); Housing Assistance (5.8%); Transportation (5.8%); Orientation/Mobility Services (1.2%); Assistive Devices (1.2%); Vehicle Modification (1.2%).

Of the statewide total of 1,004 persons with significant disabilities at the time of their DRS application, 655 persons were determined to be of transition status (age 24 and under). The demographic profile of this subset of transition status individuals with significant disabilities consists of the following characteristics:

Gender: 53.0% male, 47.0% female;

Race: 91.5% White, 8.4% Other (African American/Hispanic/American Indian/Native Hawaiian/Asian), 0.2% Unknown;

Age: 81.4% under 20 years old, 18.6% 20–34 years; and

Primary Impairment: 4.4% Sensory/Communicative Impairments, 11.5% Physical Impairments, 84.1% Mental Impairments.

As part of the Comprehensive Statewide Needs Assessment, DRS identified the following as the most frequently reported service needs in each of the categories of Education, Training, Health, Employment/CRP, and Support, based on the qualitative analysis of the reported service needs of 655 transitioning youth with significant disabilities. The approximate percentage of transitioning youth with significant disabilities reporting each service need is also listed below.

EDUCATION (28.1%): Other (58.7%); 2-yr or 4-yr College (42.4%); Vocational Education (0.9%); Graduate Education (0.5%); High School Education (0.3%); Tutoring (0.3%).

TRAINING (45.2%): Business/Vocational Training (72.6%); Drive Training/Licensing (13.5%); Other (11.8%); Job Search Training/Assistance (6.8%); Career Planning Training (5.4%); On-The-Job Training/Job Trial (0.7%); independent living skills (0.3%).

HEALTH (2.9%): Psychological/Psychiatric (42.1%); Hearing/Audiological Services (31.5%); Other (21.1%); Speech/Communication Therapy (5.3%).

EMPLOYMENT/CRP (75.4%): Job Placement (88.3%); Vocational Counseling and Guidance (16.4%); Other (2.4%); Vocational Evaluation (2.4%); Psychological Evaluation (0.8%); Community- Based Assessment (0.8%); Job Coaching Other Than SE (0.5%); Life Skills Training (0.4%), Small Business Development (0.2%); Direct Placement by CRPs (0.2%); supported employment (0.2%).

SUPPORT (9.5%): Financial Assistance (87.1%); Other (6.5%); Housing Assistance (3.2%); Assistive Technology Services (3.2%); Transportation (1.6%).

Of the statewide total of 1,004 persons with significant disabilities at the time of their DRS application, 90 persons were determined to be of minority status. The demographic profile of this subset of minority status individuals with significant disabilities consists of the following characteristics:

Gender: 55.1% male, 44.9% female;

Race: 3.3% American Indian, 2.2% Asian, 75.6% African American, and 18.9% Hispanic;

Age: 52.2% under 20 years old, 21.1% 20–34 years, 6.7% 35–44 years, 17.8% 45–64 years, 2.2% 65 years or older; and

Primary Impairment: 6.7% Sensory/Communicative Impairments, 16.7% Physical Impairments, 76.7% Mental Impairments.

As part of the Comprehensive Statewide Needs Assessment, DRS identified the following as the most frequently reported service needs in each of the categories of Education, Training, Health, Employment/CRP, and Support, based on the qualitative analysis of the reported service needs of 90 consumers with significant disabilities from minority backgrounds. The approximate percentage of consumers with significant disabilities from minority backgrounds reporting each service need is also listed below.

EDUCATION (21.1%): Other (63.2%); 2-yr or 4-yr College (42.1%); Graduate Degree Education (5.3%).

TRAINING (45.6%): Business/Vocational Training (75.6%); Drive Training/Licensing (14.6%); Job Search Training/Assistance (9.8%); Other Training (4.9%); Career Planning Training (4.9%).

HEALTH (7.7%): Other (57.1%); Psychological/Psychiatric (42.9%); Hearing/Audiological Services (14.3%).

EMPLOYMENT/CRP (77.8%): Job Placement (92.9%); Vocational Counseling and Guidance (7.1%); Other (5.7%); Supported Employment (1.4%); Job Coaching Other Than SE (1.1%).

SUPPORT (8.9%): Financial Assistance (75.0%); Assistive Technology Services (25.0%); Other (12.5%).

Of the statewide total of 1,004 persons with significant disabilities at the time of their DRS application, 13 persons were determined to be aged 65 years or older. The demographic profile of this subset of individuals with significant disabilities aged 65 years or older consists of the following characteristics:

Gender: 38.5% male, 61.5% female;

Race: 84.6% White, 15.4% Other (African American/Hispanic/American Indian/Native Hawaiian/Asian), 0.0% Unknown;

Age: 100% 65 years or older; and

Primary Impairment: 23.1% Sensory/Communicative Impairments, 53.8% Physical Impairments, 23.1% Mental Impairments.

As part of the Comprehensive Statewide Needs Assessment, DRS identified the following as the most frequently reported service needs in each of the categories of Education, Training, Health, Employment/CRP, and Support, based on the qualitative analysis of the reported service needs of 13 consumers with significant disabilities aged 65 years or older. The approximate percentage of consumers with significant disabilities aged 65 years or older reporting each service need is also listed below.

EDUCATION (0.0%).

TRAINING (15.4%): Drive Training/Licensing (100.0%).

HEALTH (7.7%): Hearing/Audiological Services (100.0%).

EMPLOYMENT/CRP (76.9%): Job Placement (90.0%); Other (10.0%).

SUPPORT (30.8%): Assistive Technology (25.0%); Orientation/Mobility Services (25.0%); Housing Assistance (25.0%); Vehicle Modification (25.0%).

RESULTS OF THE SURVEY OF DRS FIELD STAFF ON THE NEEDS OF PERSONS WITH SIGNIFICANT DISABILITIES

DRS is mandated under the federal Rehabilitation Act to periodically conduct a needs assessment of persons with significant disabilities. As part of this process and in conjunction with WV SRC, DRS issued a survey in 2018 to its field staff, including rehabilitation services associates, counselors, supervisors, and managers. The SPPE Unit developed a multiple-choice and open-ended response survey for DRS field staff to provide feedback on the service needs and service gaps of their consumers. The comprehensive survey asked them to offer their perceptions of the service needs and service gaps of persons with significant disabilities being served, including students with disabilities’ need for pre–employment transition services (Pre-ETS). The survey also obtained the specific areas where service needs and gaps were perceived to exist. The survey instrument and methodology were based on previous needs assessment studies, as they generated valid and reliable information on the service needs of persons with significant disabilities in West Virginia.

Surveys were distributed by email from SPPE Unit staff to District Managers, who then distributed the surveys to field staff in their purview. Field staff were informed of the value and importance of their responses to the CSNA survey. Field staff were given approximately one month for survey completion and were told to contact SPPE Unit staff with any questions regarding the survey. Field staff were also instructed to submit completed surveys to the SPPE Unit via email. The survey was completed and submitted by 100 DRS field staff, including rehabilitation services associates, counselors, supervisors, and managers.

Respondent Information

The survey collected information about the respondent for use in data analyses and to assist DRS in making targeted and necessary changes based on the service needs and service gaps by office and district.

Respondents were asked to provide information about their primary caseload by selecting from: General Field, Blind/Visually Impaired, School/Transition, Deaf/Hearing Impairment. Respondents could select ‘Other’ and write-in a caseload not listed.

Respondents were asked to provide their DRS office location(s) and which county or counties in the state they covered.

Respondents were asked to provide the number of years they have worked in field services. Respondents were also asked to indicate job titles they have held at DRS by selecting from the following: Rehabilitation Counselor Trainee, Rehabilitation Counselor, Senior Rehabilitation Counselor, Certified Rehabilitation Counselor, Field Office Manager/Supervisor, District Manager, or Rehabilitation Services Associate. Respondents could also select ‘Other’ and write-in their job title if not listed.

Assessing Service Needs and Service Gaps

The main objective of the survey was to assess the service needs and service gaps for DRS consumers with significant or most significant disabilities. Seventy-one services were placed into six categories: Educational, Training, Health, Employment and CRP, Support, and Pre-ETS.  Each service was accompanied by checkboxes in two columns: Need and Gap. Respondents were asked to “please indicate whether most of the consumers you serve in your area can benefit from the service” by placing an ‘X’ in the Need column for that service. Additionally, respondents were asked to “indicate whether you feel there is a service gap (i.e., services are needed, but not available in sufficient quantities) for each service by placing an ‘X’ in the Gap column.” In each category (with the exception of Pre-ETS), respondents were also given the opportunity to include an “other” service by writing in and acknowledging whether a need or gap existed for that service.

Services from the survey are listed below by category:

Educational Services — High School Education, Special Education Service, Vocational Education, Adult Basic Education, 2-yr or 4-yr College, Graduate Education, Tutoring, and Literacy Instruction.

Training Services — Work Adjustment Training, Business/Vocational Training, Job Search Training/Assistance, On-The-Job Training/Job Trial, Career Planning Training, Training on Disability Rights, Training in Sign Language, Independent Living Skills, Life Skills Training, Drive Training/Licensing, Job Club Skills Training, Instruction in Reading Braille, and Instruction in Lip Reading.

Health Services — Physician's Services, Speech/Communication Therapy, Substance Abuse Treatment, Eye Care, Dental Care, Hospital Services, Occupational Therapy, Physical Therapy, Hearing/Audiological Services, and Psychological/Psychiatric Treatment.

Employment and CRP Services — Labor Market Information, Extended Assessment, Work Adjustment Training, Community Based Assessment, Trial Work Experience, Psychological Evaluation, Vocational Evaluation, Vocational Counseling and Guidance, Job Placement, Small Business Development, Worksite Modification or Accommodation, Work Skills Assessment, Life Skills Training, Direct Placement by CRPs, Job Development, Supported Employment (SE), Job Coaching Other than SE, Extended Supported Employment Service (ESES), and Work-related Tools or Equipment.

Support Services — Personal Assistant/Attendant Services, Reader Services, Orientation/Mobility Services, Housing Assistance, Assistive Devices (e.g., cane, wheelchair), Services to Family Members, Child Care, Peer Support, Post-Employment Services (follow-up), Transportation, Vehicle Maintenance/Repair, Financial Assistance, Assistive Technology Services, Interpreter Services, Home Modification, and Vehicle Modification.

Pre-Employment Transition Services — Job Exploration Counseling, Work-Based Learning Experiences, Counseling on Postsecondary Opportunities, Workplace Readiness Training, and Self-Advocacy Training.

Overall Service Needs for DRS Consumers

The survey included five questions where respondents were asked to list UP TO FIVE services that consumers need in their service area. The question was repeated for 1) consumers with disabilities in DRS general territories, 2) transitioning youth with disabilities (age 24 and younger), 3) individuals who are deaf/hearing impaired, 4) individuals who are blind/visually impaired, and 5) minority individuals with disabilities.  Respondents were also asked to indicate if they did not have experience working with consumers described in each question.

Barriers to Employment

Respondents were asked to “indicate (with an ‘X’) whether any of the following are substantial barriers, preventing the consumers you serve from gaining and/or maintaining employment.”

Respondents were provided a list of the following 17 potential barriers:

• Slow Job Market
• Employer Attitudinal Barriers
• Consumer Attitudinal Barriers
• Lack of Long-Term Support after Job Placement
• Lack of Qualified Service Providers
• Loss of Disability Benefits and/or Food Assistance
• Family Support
• Lack of Available Rehabilitation Services from CRPs
• Lack of Physical Access to Employer or Services (e.g., ramps, etc.)
• Adequate Housing
• Lack of Information Regarding Disability Resources
• Lack of Personal Care Attendant Services
• Child Care
• Transportation
• Inadequate Medical Care and/or Medical Insurance
• Lack of Time Spent with VR Counselor
• DRS Budget Restriction

Space was provided to write-in and rate an additional barrier not found on the list, if needed.

Integration with Core Partners

The survey included three open-ended response questions regarding respondents’ familiarity, experience, and recommendations on integrating services with Workforce Development System Core Partners of WorkForce WV and WV Adult Education:

1. In the space below, please describe your familiarity with the services that WorkForce WV and WV Adult Education provide and the level of need that our consumers with significant disabilities have for those services.
2. Please comment on your experiences with integrating service with WorkForce WV and WV Adult Education (e.g., using Labor Market Information, referrals to and from WorkForce WV, co-serving a client with Adult Education). In addition to your experiences, please discuss other activities that DRS could conduct with our core partners to further help our consumers with significant disabilities.
3. Please provide recommendations on how to better facilitate our partnerships with WorkForce WV and WV Adult Education (e.g., specific cross-trainings, co-location, etc.).

Other Comments

The survey concluded with two open-ended response questions: 1) “What can DRS provide you to better serve our consumers and help you perform your job more effectively and efficiently?” and 2) “Please provide any additional comments regarding unmet service needs of individuals with significant or most significant disabilities with whom you work.”

Results

Results are based on 100 surveys that were completed and submitted by DRS field staff.

Respondent Information Primary Caseload

General Field caseloads were reported as the primary caseload by 39 (39% of the 100 respondents) respondents, while 34 (34%) reported a primary caseload of School/Transition. Six (6%) reported Blind/Visually Impaired primary caseloads and Deaf/Hearing Impaired primary caseloads were reported by three (3%) respondents. Twenty-one (21%) respondents indicated a primary caseload of “Other.” These were generally managers with a specialty caseload, but also included some Rehabilitation Service Associates (RSAs). One of the “Other” respondents indicated a “School/Transition” and “Family” caseload. Two of the “Other” respondents indicated a mixed caseload of General Field and School/Transition. Further examination led to these respondents being categorized as having a primary caseload of School/Transition.

Office Location

The total number of respondents by district and office location are as follows:

District 1 (28 Respondents) — Charleston-14, Point Pleasant-3, Ripley-0, Spencer-1, Teays Valley-7, Multiple-3.

District 2 (20) — Clarksburg-6, Elkins-2, Morgantown-5, Fairmont-2, Weston-2, Multiple-3.

District 3 (6) — Parkersburg-0, New Martinsville-0, Weirton-5, Wheeling-1.

District 4 (10) — Beckley-2, Lewisburg-0, Oak Hill-0, Princeton-3, Summersville-3, Multiple-2.

District 5 (21) — Huntington-14, Logan-2, Marshall University-1, Mullens-1, Welch-2, Multiple-1.

District 6 (15) — Keyser-2, Martinsburg-3, Moorefield-4, Romney-0, Multiple-6.

Years of Experience in DRS Field Services

Of the 100 respondents, 98 reported the number of years worked in DRS Field Services. Respondents had varying amounts of experience working in Field Services, from less than one year to 35 years (mean = 9.4 years). Many respondents (34%) reported four or fewer years of Field Services experience.

Titles Held

All 100 respondents reported having held at least 1 title in Field Services. Of the 100 respondents, 19 reported having been Rehabilitation Counselor Trainees, 73 had been Rehabilitation Counselors, 37 had been Senior Rehabilitation Counselors, and 19 had been Certified Rehabilitation Counselors. There were 20 current/former RSAs, 20 current/former Branch Office Managers/Supervisors, and 7 current/former District Managers.

Service Need/Use

Service need/use for each service was assessed to allow respondents to indicate which services their consumers need/use most often. This was done independently of the service gap assessment as some services may be highly needed/used but are readily available and therefore do not require an increase in availability.

Services that were identified as needed by 50% or more of the total respondents are listed for each service category below with the percentage of respondents in parentheses:

Educational Services

Vocational Education (89%), 2-year or 4-year College (78%), Tutoring (73%) High School (66%), Special Education (60%), and Adult Basic Education (59%).

Training Services

Job Search Training/Assistance (85%), Career Planning (75%), Life Skills Training (75%), On-the- job Training/Job Trial (73%), Business Vocational (72%), Independent Living Skills (67%), Drive Training/Licensing (65%), Work Adjustment Training (62%), and Training on Disability Rights (59%).

Health Services

Psychological/Psychiatric Treatment (76%), Substance Abuse Treatment (58%), Physician’s Services (57%), and Eye Care (50%).

Employment and CRP Services

Labor Market Information (79%), Vocational Counseling and Guidance (79%), Job Placement (79%), Community Based Assessment (73%), Psychological Evaluation (72%), Work Skills Assessment (71%), Vocational Evaluation (70%), Job Development (68%), Work Adjustment Training (66%), Direct Placement (66%), Life Skills (65%), Job Coaching (other than Supported Employment; 58%), Work-related tools or equipment (53%), and Trial Work Experience (51%).

Support Services

Transportation (81%), Financial Assistance (57%), and Assistive Technology (55%).

Pre-Employment Transition Services

Job Exploration Counseling (72%), Counseling on Postsecondary Opportunities (72%), Workplace Readiness Training (69%), Work-Based Learning Experiences (66%), and Self-Advocacy Training (64%).

Service Gaps

Respondents that indicated a perceived service gap were totaled for each service.  The number and percentage of respondents who reported a gap for the service are in parentheses followed by the number of responses by DRS office location. Some respondents identified more than one office.

Educational Services

The five most commonly reported gaps for educational services were:

Tutoring (48, 48%) -- Beckley-2, Charleston-7, Clarksburg-2, Elkins-2, Fairmont-2, Huntington-8, Keyser-3, Lewisburg-1, Logan-1, Marshall-2, Martinsburg-2, Moorefield-4, Morgantown-2, Mullens-2, New Martinsville-1, Oak Hill-1, Point Pleasant-1, Princeton-2, Ripley-2, Romney-3, Spencer-2, Summersville-4, Teays Valley-2, Weirton-3, Welch-1, Weston-2, and Wheeling-1.

Literacy Instruction (21, 21%) -- Beckley-2, Charleston-1, Clarksburg-2, Fairmont-1, Huntington-2, Keyser-1, Lewisburg-1, Marshall-1, Martinsburg-1, Moorefield-1, Morgantown-3, Oak Hill-1, Point Pleasant-1, Princeton-1, Romney-1, Summersville-3, Teays Valley-1, and Weirton-2.

Adult Basic Education (19, 19%) -- Beckley-1, Charleston-3, Clarksburg-2, Elkins-1, Huntington-4, Keyser-1, Lewisburg-1, Logan-1, Marshall-1, Morgantown-1, Oak Hill-1, Point Pleasant-1, Princeton- 1, Romney-1, Summersville-2, Weirton-2, and Wheeling-1.

Vocational Education (18, 18%) -- Beckley-1, Charleston-3, Clarksburg-1, Elkins-3, Huntington-3, Keyser-2, Lewisburg-1, Marshall-1, Martinsburg-1, Oak Hill-1, Summersville-3, Teays Valley-1, Weston-2, and Wheeling-1.

Special Education (13, 13%) -- Beckley-1, Charleston-3, Fairmont-2, Huntington-1, Keyser-3, Logan- 1, Point Pleasant-1, Romney-1, and Summersville-1.

Training Services

The five most commonly reported gaps for training services were:

Drive Training/Licensing (41, 41%) -- Beckley-2, Charleston-2, Clarksburg-2, Elkins-3, Fairmont-2, Huntington-8, Keyser-4, Lewisburg-1, Logan-1, Marshall-1, Martinsburg-2, Moorefield-1, Morgantown-1, Mullens-1, Oak Hill-1, Point Pleasant-2, Princeton-2, Ripley-1, Romney-2, Spencer- 1, Summersville-4, Teays Valley-2, Weirton-4, and Weston-2.

Life Skills (31, 31%) -- Beckley-1, Charleston-8, Clarksburg-2, Elkins-3, Huntington-3, Keyser-2, Logan-1, Marshall-1, Martinsburg-3, Moorefield-2, Morgantown-1, Mullens-1, Point Pleasant-2, Ripley-1, Romney-2, Spencer-1, Summersville-1, Weirton-2, and Weston-3.

Job Club Skills (30, 30%) -- Beckley-2, Charleston-2, Clarksburg-2, Elkins-2, Fairmont-1, Huntington-6, Keyser-2, Logan-1, Marshall-1, Martinsburg-3, Moorefield-1, Point Pleasant-3, Ripley- 1, Romney-2, Spencer-1, Summersville-1, Teays Valley-3, Weirton-1, Weston-3, and Wheeling-1.

On-the-job Training/Job Trial (29, 29%) -- Beckley-3, Charleston-5, Elkins-3, Huntington-3, Keyser-4, Lewisburg-1, Logan-2, Marshall-1, Martinsburg-1, Moorefield-1, Mullens-1, Oak Hill-1, Point Pleasant-2, Princeton-1, Romney-2, Summersville-3, Weirton-3, and Weston-2.

Sign Language Training (29, 29%) -- Beckley-1, Charleston-2, Clarksburg-2, Elkins-2, Fairmont-2, Huntington-2, Keyser-1, Lewisburg-1, Logan-1, Martinsburg-1, Moorefield-1, Morgantown-2, Oak Hill-1, Point Pleasant-2, Princeton-2, Ripley-1, Romney-1, Spencer-1, Summersville-2, Teays Valley- 5, and Weirton-3.

Health Services

The five most commonly reported gaps for health services were:

Psychological/Psychiatric Treatment (41, 41%) -- Beckley-1, Charleston-8, Elkins-3, Huntington-5, Keyser-5, Logan-1, Marshall-1, Martinsburg-1, Moorefield-3, Morgantown-2, Point Pleasant-1, Princeton-2, Ripley-1, Romney-3, Spencer-1, Summersville-2, Teays Valley-2, Weirton-4, Welch-1, and Weston-1.

Substance Abuse Treatment (40, 40%) -- Beckley-3, Charleston-3, Clarksburg-2, Elkins-3, Fairmont- 1, Huntington-7, Keyser-5, Lewisburg-2, Logan-1, Marshall-1, Martinsburg-4, Moorefield-2, Morgantown-1, Oak Hill-2, Point Pleasant-1, Princeton-4, Romney-3, Summersville-4, Teays Valley- 3, Welch-2, Weston-1, and Wheeling-1.

Dental Care (40, 40%) -- Beckley-2, Charleston-6, Clarksburg-4, Elkins-3, Fairmont-2, Huntington-6, Keyser-2, Lewisburg-1, Logan-1, Marshall-2, Martinsburg-1, Morgantown-1, Mullens-1, Oak Hill-1, Point Pleasant-1, Princeton-3, Summersville-3, Teays Valley-2, Weirton-3, Weston-1, and Wheeling- 1.

Speech/Communication Therapy (21, 21%) -- Beckley-2, Charleston-4, Elkins-1, Fairmont-1, Huntington-2, Keyser-3, Lewisburg-1, Marshall-1, Martinsburg-2, Moorefield-2, Oak Hill-1, Point Pleasant-1, Princeton-2, Romney-1, Summersville-2, Teays Valley-1, Weirton-1, and Welch-1.

Eye Care (18, 18%) -- Beckley-1, Charleston-2, Clarksburg-2, Elkins-3, Fairmont-2, Huntington-1, Keyser-1, Logan-1, Martinsburg-2, Morgantown-1, Point Pleasant-1, Romney-1, Teays Valley-1, Weirton-1, and Weston-1.

Hearing/Audiological Services (18, 18%) -- Beckley-1, Charleston-2, Clarksburg-1, Elkins-2, Farimont-2, Huntington-1, Keyser-2, Martinsburg-2, Moorefield-1, Morgantown-2, Point Pleasant-1, Romney-2, Summersville-2, Teays Valley-3, Weirton-1, and Weston-1.

Employment/CRP Services

The five most commonly reported gaps for employment/CRP services were:

Vocational Evaluation (37, 37%) -- Beckley-2, Charleston-7, Clarksburg-3, Elkins-2, Fairmont-1, Huntington-7, Keyser-5, Lewisburg-1, Logan-1, Marshall-1, Martinsburg-2, Moorefield-2, Oak Hill-1, Point Pleasant-2, Princeton-1, Romney-3, Summersville-2, Teays Valley-1, Weirton-4, and Weston- 1.

Job Placement (31, 31%) -- Beckley-2, Charleston-4, Clarksburg-2, Elkins-2, Huntington-3, Keyser- 4, Lewisburg-1, Logan-2, Marshall-1, Martinsburg-2, Moorefield-1, Oak Hill-1, Point Pleasant-2, Princeton-1, Romney-2, Summersville-2, Teays Valley-2, Weirton-3, Welch-2, and Weston-1.

Job Development (28, 28%) -- Beckley-2, Charleston-5, Elkins-4, Huntington-3, Keyser-4, Lewisburg-1, Marshall-1, Martinsburg-2, Moorefield-1, Oak Hill-1, Point Pleasant-1, Princeton-3, Romney-2, Summersville-2, Teays Valley-1, Weirton-3, and Weston-2.

Trial Work Experience (25, 25%) -- Beckley-1, Charleston-4, Elkins-3, Fairmont-2, Huntington-3, Keyser-2, Lewisburg-1, Logan-1, Martinsburg-1, Oak Hill-1, Point Pleasant-2, Princeton-2, Romney- 2, Summersville-2, Weirton-4, Welch-1, and Weston-2.

Extended Supported Employment Services (24, 24%) -- Charleston-2, Elkins-2, Huntington-5, Keyser-4, Logan-1, Marshall-1, Martinsburg-1, Point Pleasant-2, Princeton-1, Ripley-1, Romney-2, Spencer-1, Summersville-2, Weirton-3, and Weston-1.

Support Services

The five most commonly reported gaps for support services were:

Transportation (64, 64%) -- Beckley-3, Charleston-6, Clarksburg-6, Elkins-4, Fairmont-3, Huntington- 7, Keyser-7, Lewisburg-2, Logan-2, Marshall-1, Martinsburg-4, Moorefield-4, Morgantown-2, Mullens-1, Oak Hill-2, Point Pleasant-3, Princeton-3, Ripley-1, Romney-5, Spencer-1, Summersville- 5, Teays Valley-7, Weirton-4, Welch-1, and Weston-4.

Housing Assistance (37, 37%) -- Beckley-3, Charleston-4, Clarksburg-4, Elkins-2, Fairmont-2, Huntington-4, Keyser-1, Lewisburg-1, Martinsburg-1, Moorefield-2, Morgantown-2, Oak Hill-1, Point Pleasant-2, Princeton-3, Romney-1, Summersville-4, Teays Valley-2, Weirton-2, Welch-1, Weston-1, and Wheeling-1.

Financial Assistance (33, 33%) -- Beckley-1, Charleston-5, Clarksburg-4, Elkins-3, Fairmont-3, Huntington-5, Keyser-2, Marshall-1, Martinsburg-1, Moorefield-1, Morgantown-1, Point Pleasant-2, Romney-2, Summersville-3, Weirton-2, Welch-2, Weston-1, and Wheeling-1.

Peer Support (32, 32%) -- Beckley-3, Charleston-3, Clarksburg-2, Elkins-3, Fairmont-3, Huntington- 2, Keyser-3, Lewisburg-1, Marshall-1, Martinsburg-1, Moorefield-2, Morgantown-2, Oak Hill-1, Point Pleasant-1, Princeton-1, Romney-1, Summersville-2, Teays Valley-3, Weirton-1, Welch-1, Weston-2, and Wheeling-1.

Child Care (30, 30%) -- Beckley-1, Charleston-3, Clarksburg-3, Elkins-1, Fairmont-3, Huntington-2, Keyser-2, Martinsburg-1, Moorefield-2, Morgantown-2, Point Pleasant-1, Princeton-1, Ripley-1, Romney-2, Spencer-1, Summersville-3, Teays Valley-3, Weirton-1, Welch-2, Weston-1, and Wheeling-1.

Pre-Employment Transition Services

The five most commonly reported gaps for Pre-ETS were:

Work-Based Learning Experiences (25, 25%) -- Charleston-4, Clarksburg-1, Elkins-2, Huntington-3, Keyser-2, Logan-1, Martinsburg-3, Moorefield-3, Mullens-1, Point Pleasant-1, Romney-2, Spencer-1, Summersville-2, Weirton-3, Welch-1, and Weston-1.

Work Place Readiness Training (25, 25%) -- Charleston-3, Clarksburg-1, Elkins-4, Huntington-2, Keyser-2, Logan-1, Martinsburg-2, Moorefield-2, Mullens-1, Point Pleasant-1, Princeton-1, Romney- 2, Spencer-1, Summersville-1, Weirton-1, Welch-1, and Weston-3.

Self-Advocacy Training (19, 19%) -- Charleston-4, Clarksburg-1, Elkins-2, Huntington-2, Keyser-2, Logan-1, Martinsburg-1, Moorefield-1, Point Pleasant-1, Princeton-1, Romney-2, Spencer-1, Summersville-2, Teays Valley-1, and Weston-1.

Job Exploration Counseling (13, 13%) -- Charleston-3, Clarksburg-1, Elkins-2, Huntington-2, Logan- 1, Martinsburg-1, Point Pleasant-1, Spencer-1, Summersville-1, and Weston-1.

Counseling on Postsecondary Opportunities (12, 12%) -- Charleston-3, Elkins-2, Huntington-2, Logan-1, Martinsburg-1, Moorefield-1, Ripley-1, Spencer-1, Summersville-1, and Weston-1.

Overall Service Needs for West Virginians with Disabilities

Respondents were asked to identify the top five overall service needs for different consumer groups with which they have experience with providing VR services. Respondents were asked to indicate if they did not have experience working with the consumer group. The number and percentage of respondents who indicated a gap for the service are in parentheses followed by the number of responses by DRS office location. Some respondents identified more than one office.

Note:  New categories created to incorporate answers that were not specific to a pre-existing service category from the survey. For example, the “Overall Training” category was created to include a number of open-ended responses where the respondent indicated a need for training, but not a specific type; for example, “Training options” and “Training services.” The Miscellaneous category contains individual responses that were not clear in meaning or otherwise could not be grouped into a particular theme.

General Territories

The survey asked participants to “Please list the TOP FIVE services that our consumers with disabilities in DRS general territories need within your service area.” There were 82 respondents to this question. The most commonly reported service needs were:

Transportation (45, 54.88%) -- Beckley-4, Charleston-2, Clarksburg-4, Elkins-2, Fairmont-1, Huntington-3, Keyser-3, Lewisburg-2, Marshall-1, Martinsburg-2, Moorefield-1, Morgantown-4, Oak Hill-2, Point Pleasant-3, Princeton-5, Ripley-2, Romney-2, Spencer-3, Summersville-4, Teays Valley- 5, Weirton-4, Welch-1, and Weston-2.

Overall Training (28, 34.15%) -- Beckley-1, Charleston-3, Clarksburg-1, Elkins-1, Fairmont-3, Huntington-3, Keyser-2, Martinsburg-3, Moorefield-3, Morgantown-1, Mullens-1, Point Pleasant-2, Ripley-2, Romney-2, Spencer-3, Summersville-1, Teays Valley-2, Weirton-1, and Welch-1.

Job Placement (23, 28.05%) -- Beckley-1, Charleston-4, Clarksburg-3, Fairmont-3, Huntington-2, Keyser-1, Logan-1, Martinsburg-1, Moorefield-1, Morgantown-2, Point Pleasant-2, Ripley-1, Romney-1, Spencer-2, and Teays Valley-2.

Psychological/Psychiatric Services (17, 20.73%) -- Beckley-1, Charleston-5, Fairmont-1, Huntington- 5, Lewisburg-1, Martinsburg-1, Oak Hill-1, Princeton-1, Ripley-1, Spencer-1, Summersville-1, Teays Valley-1, Weirton-1, and Wheeling-1.

Substance Abuse Treatment (14, 17.07%) -- Charleston-3, Elkins-1, Huntington-7, Logan-1, Point Pleasant-1, Princeton-1, and Weston-1.

Transitioning Youth

The survey asked, “From your experience with transitioning youth with disabilities, please list the TOP FIVE services that you feel these consumers need in your service area.” There were 74 respondents to this question.  The most commonly reported service needs were:

Transportation (38, 51.35%) -- Beckley-3, Charleston-2, Clarksburg-3, Elkins-1, Fairmont-1, Huntington-2, Keyser-3, Lewisburg-2, Marshall-1, Martinsburg-3, Moorefield-1, Morgantown-4, Mullens-1, Oak Hill-2, Point Pleasant-2, Princeton-5, Ripley-1, Romney-3, Spencer-2, Summersville- 5, Teays Valley-2, Weirton-4, and Wheeling-1.

Job Exploration Counseling (26, 35.14%) -- Charleston-4, Clarksburg-4, Elkins-3, Fairmont-2, Huntington-3, Keyser-1, Martinsburg-1, Moorefield-1, Point Pleasant-2, Romney-1, Summersville-1, Teays Valley-3, Weirton-1, and Weston-2.

Work-Based Learning Experiences (23, 31.08%) -- Beckley-1, Charleston-1, Clarksburg-6, Fairmont- 3, Huntington-1, Keyser-2, Lewisburg-1, Logan-1, Martinsburg-2, Moorefield-4, Oak Hill-1, Point Pleasant-1, Princeton-3, Romney-2, Summersville-2, Teays Valley-1, Weirton-1, and Welch-1.

Workplace Readiness Training (16, 21.62%) -- Charleston-1, Clarksburg-2, Elkins-1, Fairmont-1, Keyser-2, Martinsburg-3, Moorefield-4, Morgantown-1, Point Pleasant-1, Princeton-1, Romney-2, Teays Valley-2, Welch-1, and Weston-2.

Overall Training (15, 20.27%) -- Charleston-3, Elkins-2, Fairmont-2, Keyser-1, Mullens-1, Point Pleasant-1, Princeton-1, Ripley-1, Spencer-2, Summersville-1, Teays Valley-2, and Weston-1.

Deaf/Hard of Hearing

Respondents were asked, “From your experience with individuals who are deaf/hard of hearing with disabilities, please list the TOP FIVE services that you feel these consumers need in your service area.”  There were 32 respondents to this question.  The most commonly reported service needs were:

Hearing/Audiological Services (19, 59.38%) -- Beckley-1, Charleston-1, Clarksburg-1, Elkins-3, Martinsburg-1, Morgantown-1, Point Pleasant-2, Princeton-1, Teays Valley-2, Weirton-4, Weston-2, and Wheeling-1.

Interpreter Services (12, 37.50%) -- Beckley-1, Clarksburg-1, Keyser-2, Martinsburg-3, Moorefield-2, Morgantown-1, Point Pleasant-1, Romney-2, Teays Valley-4, Weirton-1, and Wheeling-1.

Assistive Technology (7, 21.88%) -- Charleston-1, Huntington-1, Moorefield-1, Morgantown-1, Ripley-1, Spencer-1, Teays Valley-1, and Wheeling-1.

Job Placement (6, 18.75%) -- Charleston-1, Clarksburg-1, Fairmont-1, Martinsburg-1, Morgantown- 2, Point Pleasant-1, and Teays Valley-1.

Sign Language Training (5, 15.63%) -- Beckley-1, Clarksburg-2, Teays Valley-1, and Wheeling-1.

Blind/Visually Impaired

Respondents were asked, “From your experience with individuals who are blind/visually impaired with disabilities, please list the TOP FIVE services that you feel these consumers need in your service area.” There were 26 respondents to this question.  The most commonly reported service needs were:

Assistive Technology (12, 46.15%) -- Charleston-2, Clarksburg-2, Huntington-1, Keyser-2, Martinsburg-4, Moorefield-2, Morgantown-1, Romney-2, Teays Valley-1, and Wheeling-1.

Transportation (10, 38.46%) -- Beckley-1, Charleston-2, Clarksburg-2, Huntington-1, Keyser-1, Lewisburg-1, Martinsburg-1, Moorefield-1, Oak Hill-1, Princeton-1, Romney-1, Summersville-1, Weirton-2, and Wheeling-1.

Orientation/Mobility Services (7, 26.92%) -- Charleston-1, Clarksburg-2, Keyser-2, Martinsburg-3, Morgantown-3, and Romney-2.

Assessment (5, 19.23%) -- Beckley-1, Charleston-2, Clarksburg-1, Fairmont-1, Huntington-1, Lewisburg-1, Martinsburg-1, Princeton-1, and Summersville-1.

Job Placement (4, 15.38%) -- Charleston-2, Clarksburg-1, Fairmont-1, Keyser-1, Martinsburg-1, Moorefield-1, and Romney-1.

Minority Individuals

The survey asked, “From your experience with minority individuals with disabilities, please list the TOP FIVE services that you feel these consumers need in your service area.” There were 64 respondents to this question.  The most commonly reported service needs were:

Transportation (30, 46.88%) -- Beckley-4, Charleston-3, Elkins-1, Huntington-4, Keyser-2, Lewisburg-2, Marshall-2, Martinsburg-2, Moorefield-1, Morgantown-2, Oak Hill-2, Point Pleasant-2, Princeton-3, Ripley-1, Romney-1, Spencer-1, Summersville-2, Teays Valley-5, Weirton-2, and Welch-1.

Job Placement (17, 26.56%) -- Beckley-1, Charleston-2, Clarksburg-1, Fairmont-1, Huntington-4, Keyser-2, Marshall-1, Martinsburg-2, Moorefield-1, Morgantown-1, Point Pleasant-2, Romney-2, Teays Valley-3, and Welch-1.

Overall Training (16, 25%) -- Beckley-1, Charleston-2, Clarksburg-1, Elkins-1, Fairmont-1, Huntington-1, Keyser-3, Martinsburg-2, Moorefield-2, Morgantown-1, Mullens-1, Point Pleasant-1, Ripley-1, Romney-3, Spencer-1, Teays Valley-1, Weirton-1, Welch-1, and Weston-1.

Counseling and Guidance (11, 17.19%) -- Charleston-4, Clarksburg-2, Farimont-1, Huntington-2, Keyser-1, Marshall-1, Martinsburg-1, Moorefield-1, Romney-1, Teays Valley-1, and Wheeling-1.

Self-Advocacy (10, 15.63%) -- Clarksburg-3, Huntington-1, Martinsburg-1, Moorefield-1, Morgantown-1, Princeton-1, and Teays Valley-2.

Barriers to Employment

The top five most frequently indicated barriers were Transportation (92 responses), Slow Job Market (63), Lack of Family Support (63), DRS Budget Restrictions (57), and Employer Attitudinal Barriers (56).

Integration with Core Partners

DRS Field Staff members were asked three open-ended response questions regarding their familiarity, experience, and recommendations on integrating services with Workforce Development System Core Partners of WorkForce WV and WV Adult Education.

1. In the space below, please describe your familiarity with the services that WorkForce WV and WV Adult Education provide and the level of need that our consumers with significant disabilities have for those services.

There were 93 responses to this prompt. Responses were categorized on two dimensions: 1) Familiarity with services provided by WorkForce WV and WV Adult Education and 2) level of need for those services. For the familiarity dimension, responses were judged to express either high familiarity, some familiarity, or no familiarity. Twenty-three responses (24.7%) indicated high familiarity, 50 responses (53.8%) indicated some familiarity, and 20 responses (21.5%) indicated no familiarity. For the need dimension, responses were judged to express either high need, some need, or no indication. Seventeen responses (18.3%) indicated high need, 24 responses (25.8%) indicated some need, and 52 responses (55.9%) indicated no need.

* A large proportion of respondents expressed no indication of need, typically by not addressing the dimension of need in their response. This suggests that many respondents may have failed to recognize the two-part nature of the question or may have become so involved in discussing familiarity that they forgot to discuss need. Separating the item into two separate parts may remedy this in the future.

2. Please comment on your experiences with integrating service with WorkForce WV and WV Adult Education (e.g., using Labor Market Information, referrals to and from WorkForce WV, co-serving a client with Adult Education). In addition to your experiences, please discuss other activities that DRS could conduct with our core partners to further help our consumers with significant disabilities.

There were 89 responses to this prompt. Responses were categorized on two dimensions: 1) whether the field staff had experience with integrating services with WorkForce WV and WV Adult Education and 2) whether other activities that DRS could conduct with core partners were discussed. In categorizing experience with integrating services, mention of referral of individuals to a core partner was not regarded as service integration.

The responses of 17 field staff (19.1%) indicated experience with integrating services with core partners. Among the remaining responses, 19 field staff (21.35%) mentioned that they had referred consumers to partners or had received referrals from partners. Other field staff explicitly stated that they had limited or no experience with integrating services.

The responses of 19 field staff (21.35%) discussed activities that DRS could conduct with core partners. Among the remaining responses, five field staff (5.62%) discussed activities that core partners could conduct (e.g., forward labor market research information with a client’s referral) to make things easier. Several others gave no recommendations.

3. Please provide recommendations on how to better facilitate our partnerships with WorkForce WV and WV Adult Education (e.g., specific cross-trainings, co-location, etc.).

There were 82 responses to this prompt. Suggestions with similar themes were grouped and some respondents provided comments that spanned multiple themes. The most common recommendation theme involved training or cross-training (generally focusing on learning what other partners provide), with 45 (54.88%) responses. Having meetings between the partners was the next most common theme (15, 18.29%), followed by information access (11, 13.41%) and communication (7, 8.54%). An additional 11 responses (13.41%) indicated no recommendation (e.g., “N/A” or “No comment”).

Comments and Suggestions

There were 83 respondents that provided comments when asked for ways in which DRS could help them perform their job more effectively and efficiently.  Suggestions with similar themes were grouped and some respondents provided comments that spanned several themes. The most common response themes were Training (23 respondents, 27.71%), Budget/Staffing (15, 18.07%), Policy Changes (11, 13.25%), Service Provision (11, 13.25%), and Communication (10, 12.05%).

Additional Comments on the Unmet Service Needs of Individuals with Disabilities

There were 38 respondents that provided additional comments which were grouped into major themes. Fourteen responses (36.84%) were related to service provision. The next most common responses were for Transportation (9 respondents, 23.68%), Policy changes (5, 13.16%), and Budget/staffing issues (3, 7.89%). An additional eight responses (21.05%) indicated no topic (e.g., “N/A” or “None”).

Discussion

As part of the FY 2018 CSNA, DRS field staff members were surveyed on the VR service needs and gaps for West Virginians with significant disabilities. The responses will be used in conjunction with other CSNA activities to develop the PY 2020-2023 Unified State Plan, including agency goals and priorities, and related strategies. A total of 100 DRS field staff members provided detailed insight into the perceived service needs and gaps throughout the state. The current survey responses echo previous CSNA results, with many of the same service needs and gaps being reported. Overall, the most commonly reported service needs for the FY 2018 CSNA were for Transportation, Overall Training, Job Placement, Psychological/psychiatric services, and Substance Abuse Treatment. Transportation has consistently been the most often reported barrier for West Virginians with significant disabilities. DRS continues to implement and monitor various strategies to improve transportation availability.

Minority Populations

In compliance with the Rehabilitation Act, the survey asked respondents to identify the service needs of individuals from minority backgrounds.  The most commonly reported service needs were Transportation, Job Placement, Overall Training, Counseling and Guidance, and Self-Advocacy; the first four services being identical to the top four service needs for minorities from the FY 2015 CSNA.

CRP Services

As required by the WIOA, the survey asked respondents to identify any need for CRP services, including SE. The top reported CRP service needs were Community Based Assessment, Work Skills Assessment, Direct Placement, Work Adjustment Training, and Life Skills Training. In recent years, DRS has adopted goals and priorities to improve access to CRP services. Through successful strategies, DRS now utilizes a statewide network of 80 CRP locations. These CRPs provide valuable services throughout the state, benefiting West Virginians with significant disabilities. Transitioning youth also benefit from CRP services through the provision of pre-employment transition services, including career exploration.

Transitioning Youth (TY)

Respondents were asked to provide the top service needs for TY with significant disabilities. The top five reported service needs for TY were Transportation, Job Exploration Counseling, Work- Based Learning Experiences, Workplace Readiness Training, and Overall Training. DRS will continue to partner with state and local school systems to ensure access to VR and other pre-employment transition services for students with disabilities. Through these partnerships and shared resources, TY will have increased opportunities to achieve competitive, integrated employment.