REHABILITATION DEFINED by Nell C. Carney, Commissioner Rehabilitation Services Administration From the Editor: This article appeared in the March, 1991, Newsletter of the National Rehabilitation Association. Nell Carney, to the best of our belief and knowledge, has the highest appointive office in the federal government which has ever been held by a blind person and also the highest appointive office in the federal government which has ever been held by a woman with a disability. With reauthorization of the Rehabilitation Act on the horizon, a few individuals and groups representative of single- focused interests have suggested rehabilitation needs to be reorganized, revamped, restructured, or redefined to provide lifelong services and care for individuals with disabilities. This is so, they say, because present rehabilitation programs are not meeting the total needs of disabled people, most of whom need lifelong care. Of the approximately 43 million Americans with physical and mental disabilities, the majority do not need lifelong care. Indeed, those of us who have received appropriate rehabilitation services participate fully in society and need only the opportunities and conveniences afforded to all citizens. People with disabilities now participate in every vocation known to our civilization. We run for public office, hold public office, participate in political activities, and influence election outcomes. Vocational Rehabilitation, Independent Living, and Supported Employment have all played a major role in gains made in independence and integration into the work place and community by disabled people. By no means, however, are these the only services that may be needed by people with disabilities in order to live full, productive, meaningful lives. The word rehabilitation suggests a process that is finite. Rehabilitation services authorized in the Rehabilitation Act are designed to be of relatively short duration because rehabilitation service is an intervention process that moves in, provides the necessary service, and moves out of the way to allow the disabled person to integrate physically, socially, psychologically, and economically into the environment. There are provisions for extended services in cases where needed, but no service is infinite nor should it be. The basic underlying philosophy of rehabilitation is to increase independence, not create dependence. Traditionally, rehabilitation has been defined as individualized, structured, and a short-term human service process that utilizes the case management method to provide diagnostic, training, and referral and placement services to people with disabilities. Rehabilitation services is a process that allows a human interaction to take place between a person with a physical or mental disability and a service provider. In the process, need for adjustment to the disability, training needs, and other needs including technological, social, and economic are identified. The person with the disability and the service provider then jointly agree on a plan to meet the identified needs, and the plan is implemented, leading to competitive employment and/or independence and increased quality of life for the person with the disability. Throughout the process, the person with a disability has input and choices and the service provider provides guidance, resources, advocacy, and coordination of services with other service providers. All rehabilitation services are goal-oriented and are designed to create independence. Irrespective of definitions, the programs authorized in the Rehabilitation Act and administered by RSA have proven to be of value to disabled people. The largest of these, the state/federal Vocational Rehabilitation Program, has placed 15 million disabled people in employment since it began as a small program 70 years ago. Last year alone (1989), just under 1 million disabled people were placed in employment. Two hundred twenty-six thousand of these were placed in competitive employment. The program has always had the support of the Congress and the various administrations and has repeatedly proven to be cost-effective. Similarly, the Supported Employment program and the Independent Living programs, although much newer authorities, have established value to disabled people and to the community. In 1989 the Supported Employment Program placed 51,000 severely disabled individuals in employment. Many of these will go on to natural support systems and to integration into the community. The preparation for and attainment of independence and integration by disabled people is dependent on more than one service delivery system. While rehabilitation is a key service system because it offers the potential for economic and social independence, other services, including health care, insurance, affordable housing, recreation, accessible transportation, civil rights, and advocacy are crucial to the goals of independence and integration and ultimately choices and empowerment. To suggest replacing rehabilitation services with other crucial programs does not seem like a reasonable solution to the dilemma created by services deficits. Rehabilitation services are critical to the empowerment of disabled individuals, and to suggest that all of the needs of the disabled population can be met by continuing to expand the Rehabilitation Act is to suggest legislation so diverse that major focus could not be directed to any single program and effective and efficient administration would be difficult if not impossible. Coordination among the various agencies providing services for people with disabilities has become a routine function of federal government for the current administration. We are already seeing the positive effects. Rehabilitation and the President's Committee on Employment of People with Disabilities are working together to create additional opportunities for competitive placement. RSA and EEOC are working together to provide technical assistance to employers for compliance with the Americans with Disabilities Act. Rehabilitation and Special Education are joining efforts to create transition programs from school to work for disabled people, and RSA and the Social Security Administration are sitting down together to plan for future endeavors that will bring the two agencies together to increase opportunities for disabled people. The services provided through the present authorities in the Rehabilitation Act are essential to the empowerment of people with disabilities. Vocational Rehabilitation, Independent Living, and Supported Employment create opportunities for economic and social independence for millions of people with disabilities each year. Maintaining and promoting these programs are responsibilities in which we all share if we are sincere in our commitment to choices and empowerment for people with disabilities.