Vocational/Developmental
REHABILITATION REVIEW 
July 17, 1989, Volume 6, No. 28 
Senator Dole Addresses Annual Conference

Senator Robert Dole (R-KS), commenting that he may be the only elected official left in Washington during the July 4 break, gave a memorable presentation to conference attendees covering such areas as the national debt, employment opportunities for persons with disabilities, the Americans with Disabilities Act (ADA), and work incentives legislation.

In praising the accomplishments of NARF's members during the 20th Anniversary celebration, Senator Dole said: "For two decades, you have pioneered creative programming and political advocacy for disabled Americans. In the process you have opened doors of opportunity for countless thousands of Americans -- giving new hope to their lives and in the process enriching our nation with their talents and creativity."

Senator Dole emphasized the need for President Bush to continue to be active in both word and deed on programs that serve persons with disabilities. Assuring the attendees of his own commitment to these issues Senator Dole stated, "You can be sure this is one area where I will never let down."

Senator Dole outlined his views on the major priorities facing Congress regarding disability issues: access, opportunity, independence and integration. Commenting on the access issue he said: "The disabled want to work...they deserve a chance to work. It's part of what we all call being an American. If we can get them to work -- it's not only the disabled, but this whole country which will benefit. Congress should focus on creating incentives for employment of the disabled, and -- equally important -- eliminating the disincentives that currently exist." The Senator cited legislation which he will introduce shortly with Senator Riegle (D-MI), called the Social Security Work Incentives Act, which will allow persons receiving Social Security Disability Insurance (SSDI) to continue to work and receive their benefits and access to health care.

The Senator also touched on the problem of serving persons with disabilities through the Medicaid program. Commenting that people with severe disabilities deserve full access to quality services, he referenced Senator John Chafee's (R-RI) bill, S.384, the Medicaid Reform Act, to develop quality community services in support of states participating in the institutional aspects of the Medicaid program. "It is part of an effort a number of us in Congress are spearheading to provide a real choice - choice among various available services, and choice among a variety of living situations."

Commenting on the ADA bill, he said: "There is also one overriding problem which must always remain at the top of our agenda, until it is finally resolved - discrimination against the disabled. Nearly sixteen years ago the Congress took an important initial step in addressing this problem by enacting Title V of the Rehabilitation Act of 1973. That legislation prohibits recipients of Federal funds and contracts from discriminating against people with disabilities. Recent Supreme Court cases and the enactment of several important pieces of civil rights legislation such as the Civil Rights Restoration Act and the Fair Housing Amendments of 1988 have strengthened the legal base of our struggle against discrimination. Today, on Capitol Hill, the issue is manifest in the debate over the Americans with Disabilities Act."

Although in strong support of the concept of the bill, Senator Dole stopped just short of supporting the legislation as written. He and his staff are in the process of collaborating with other members in Congress and the Administration to clarify specific provisions of the legislation.

"I want to ensure that as we remove the barriers now facing persons with disabilities - as we must - we do not place an unfair and unreasonable burden on the private sector, which must acommodate to the mandates of this worthwhile legislation. I want the private sector to join in enthusiastically - because they see the benefits they will derive from being able to utilize the resource represented by the disabled; not to be dragged in kicking and screaming, because we have totally ignored their legitimate concerns, or failed to understand the real dollar costs that they will bear."

Calling for a balanced phase-in of the... (continued on page 2)

This Week's Watch
Futures.....2
Honors......2
Presidents's Award......2
JTPA........3
Employment Exchange.....5

NARF Voc Committee Approves Plan for Futures Conference
At NARF's Annual Conference, the Vocational/Developmental Facilities Committee met and approved a motion to recommend to the Board a plan for an overall futures forum for facilities. The motion was later approved by the full Board.

The Committee had a spirited discussion regarding the future of facilities, how they will operate and what types of services they will provide as we head into the 21st century. It is expected that further plans for a futures conference will be outlined before and during the fall meeting, which will be held in San Francisco, CA.

The Committee also approved a number of other motions that originated from the Residential Task Force. The motions below were all adopted by the Board. 
o The adoption of the Medicaid reform positions contained in the Residential Task Force report;
o A residential recruitment plan;
o A Residential Planning Subcommittee made up of a chair, co-chair, and two or three residential members.

John Niederman, Chairman of the new Residential Committee, also presented a long list of issues that the Committee will begin to evaluate.

In addition, members attending the Vocational Committee meeting were presented with brief overviews from staff on Capitol Hill regarding the National Affordable Housing Act, Title XX, and the Job Training Partnership Act.

Seven Rehab Agencies & Individuals Win Honors
Seven individuals received national honors recently at NARF's Conference for exemplary contributions to community rehabilitation for persons with disabilities.

Marnette Hatchett, Chair of the Awards Committee, said of the presentations, "This is NARF's way of honoring those who have distinguished themselves, demonstrated leadership and made important changes in the field." The 1989 award winners were: 
Mac Hightower-Vandamm, Executive Director of the Delaware Curative Workshop, Inc., Wilmington, Delaware, received the Milton Cohen Distinguished Career Award for over 30 years of outstanding service and leadership to the field for physical rehab. She has served on numerous state and national committees, including presidency of the American Occupational Therapy Association and has lectured throughout the world.

Sheltering Arms Day Rehabilitation program located in Richmond, Virginia was given the Outstanding Medical Rehabilitation Program for 1989 for providing dynamic rehabilitation for community reentry through the integration of patients' lives in the community and the restorative rehabilitation process.

The Outstanding Achievement in Vocational Rehabilitation Award was given to the Production Sewing Program of Vocational Guidance Services in Cleveland, Ohio. For 12 years the production sewing program has been mass producing the WINGS line of adaptive clothing, which has been sold through both J.C. Penny and Sears Roebuck catalogs as well as in hospital and nursing home gift shops.

Indianapolis Colts received NARF's Community Service Award for substantial annual contributions to Noble Centers of Indiana. Their personal involvement has made a significant change in how the community views persons with developmental disabilities. 

Michigan Association of Rehabilitation Facilities located in Okemos, Michigan, received the Outstanding State Chapter Award for improvements in public policy by helping to establish a responsive and responsible comunity-based network. NARF has provided leadership in joint planning and major coalition initiatives throughout the State of Michigan.

William A. Spencer, President of the Texas Institute of Rehabilitation Research (TIRR) Foundation and Chair of the Department of Rehabilitation at Baylor College of Medicine since 1957, received the Individual Oustanding Achievement Award. He established the National Foundation for Infantile Paralysis and expanded that program to the present TIRR, now internationally-known as a model for comprehensive rehab.

Weicker Receives NARF President's Award
Former Connecticut Senator Lowell Weicker, Jr. received NARF's President's Award at the Annual Conference for his exemplary contributions to advance rehabilitation nationally for persons with disabilities. The honor was presented in the form of an engraved plaque recognizing his human service achievements and professional accomplishments.

Senator Weicker received the President's Award for authoring milestone legislation that improved the quality of life for all citizens and increased employment opportunities for persons with disabilities through Projects with Industries. He was the second Senator to chair the Senate Subcommittee on the Handicapped and has been the primary author of other Rehabilitation Amendments of 1983, the Education of the Handicapped Amendments of 1983 and the Fair Housing Act of 1988.

Senator Dole (continued from page 1)
... requirements of the legislation, Senator Dole also mentioned his interest in seeing that technical assistance be provided for the private sector in order to help them administer the changes that this bill would require.

Asking facilities to get involved in the drafting of the ADA bill, Senator Dole concluded by saying "It is going to be up to you. I don't have to tell you to stay involved, but I can assure you that your involvement can pay off. It can pay off not only as you directly deal with the issues... but it can pay off, too, in the political arena. I'm not talking about partisan politics. Disabled issues know no partisanship. But I am talking about letting your Senators and Congressman know what you think, what you want."

HHS Secretary Pushes for More Physical Therapists
The Secretary of U.S. Department of Health and Human Services, Lewis W. Sullivan, announced [at the 65th Annual Conference of the American Physical Therapy Association (APTA) in Nashville] his desire to see more Americans pursue a career in physcial therapy.

In response to the latest Bureau of Labor Statistics report which indicated a significant shortfall of physical therapists, Secretary Sullivan said, "Part of the problem is that physical therapy education is having a problem in recruiting qualified faculty. Current estimates are that there are 100 faculty positions going unfilled in education programs for physical therapists."

NARF, in testifying before both the Senate and House Appropriations Subcommittees on Labor, Health and Human Services, and Education in early May, agreed stating that, "Rehabilitation facilities, both medical and vocational, continue to face severe shortages in personnel and training programs that provide in-service and re-training for existing staff - particularly occupational therapists, physical therapists, speech-language pathologists and audiologists." NARF also commented that the need for these professionals far exceeds the supply in all but a few places in the country. "Assisting educational programs for rehabilitation professionals cannot meet the current demands or increase the numbers of graduates to meet these needs. This is due to the lack of funding for program development and expansion, inadequate supply of faculty, and little or no funds for scholarships or loans to attract students into the program, including minority students."

Secretary Sullivan, in speaking before the 4,000 physical therapists, expressed his support for special pay scales for allied health professionals such as those approved by Congress for the National Institutes of Health and his confidence that with continued work "we will achieve better and more accessible health care for all Americans."

Labor Secretary Dole Proposes Changes to JTPA
Secretary of Labor Elizabeth H. Dole announced on June 29 the Administration's proposed changes to the Job Training Partnership Act to target assistance and training to those least skilled and most disadvantaged. Secretary Dole's changes would center around the establishment of a Youth Opportunity Unlimited (YOU) program to provide intensive, comprehensive employment and training services to youth most at risk of failure in the job market.

In outlining her proposal for the House Education and Labor Committee, Secretary Dole said "We must break the cycle of cynicism that has hold of many of our youth. There is an urgent need for more than job training. Many desperately need basic skills training, literacy, and remedial education. We must arm our youth not just with a job but with the independence and skills for a lifetime of productive work."

The proposed changes are based on five principles:
o Targeting assistance to those most "at risk" of failure in the job market. This proposal offers challenge grants to stimulate community-wide action targeted to youth in the nation's most problem-ridden inner city neighborhoods and rural areas. The YOU program will direct funds to communities with large numbers of economically disadvantaged youths and adults;
o Achieving a comprehensive, coordinated human resource program. This plan requires governors to develop a coordinated human resource plan which includes a variety of state and Federal resources to target services for the disadvantaged. Other programs that would be coordinated along with JTPA might include vocational education, the JOBS program and the new Family Support Act, an adult basic education resource;
o Enhancing program quality. This encourages the individualization and intensification of JTPA services for participants depending upon their needs; 
o Accountability. Local programs will establish achievement objectives for participants so that they know what they can expect from JTPA as well as what is expected of them; 
o Maintaining the successful cornerstone of the current JTPA program. The new proposed changes will continue to draw on the talents at the state level, particularly the Private Industries Councils.

The new proposal expects to expand upon the cooperative relationships among various community-based resources. This language appears to provide extended opportunities for rehabilitation facilities who are able to access and provide services through the JTPA program.

House Subcommittee Passes Medicaid Home and Community Care Options Act
The House Energy and Commerce Subcommittee on Health and the Environment, chaired by Representative Henry Waxman (D-CA), passed H.R. 1453, the Medicaid Home and Community Care Options Act, which seeks to remove the discrimination against persons with mental illness. Added to the bill was an amendment that included coverage for persons who "due solely to mental illness are unable to perform without substantial assistance two or more activities of daily living." This crucial amendment will allow states the option to add a new service to their Medicaid plans for elderly persons who are either physically or mentally disabled, providing a wide range of home and community based services.

The bill was included as part of the House Budget Reconciliation Act which provides for a "reconciliation" procedure for bringing existing spending by the Federal Government into conformity with the Congressional budget resolution. Prospects for passage of the bill in the House appear promising.

A similar bill, S.785, has been introduced in the Senate by Jay Rockefeller (D-WV). However, prospects of immediate passage appear to be less likely than those in the House.