Full Compliance with Recommendations

Performance Evaluation & Research Division
Building 1, Room W314
State Capitol Complex
(304) 347-4890

Issue 1: The Division's Rehabilitation Services Have a Positive Impact on the Earnings and Work Continuity of Individuals with Disabilities.

Recommendation 1

We recommend that the Division of Rehabilitation Services conduct periodic long-range outcome evaluations. These evaluations should measure the success of the program over a long wage history that can better judge work continuity than the 60-day criteria allows. Comparison groups should be used in the evaluation as was used in this analysis. The Division should test additional demographic variables not used in this study. Also, a cost-benefit analysis of rehabilitation services should be conducted as part of the periodic evaluation.

Level of Compliance: In Compliance

On January 2, 1996, the Division of Rehabilitation Services entered into a contract for $65,000 with the West Virginia Rehabilitation Research and Training Center to conduct a program evaluation study for the Division. This study is a more extensive study than the Legislative Auditor's study which evaluated the impact of the Division's programs on the earnings and work continuity of individuals with disabilities in West Virginia. The Legislative Auditor's analysis of the Division's impact on earnings and work continuity included client characteristics such as age, sex, and severity of disability. As requested by the Legislative Auditor, the Research and Training Center included type(s) of services received, education, marital status, dollars to provide rehabilitation services, and time spent in the rehabilitation program.

A preliminary report was delivered to DRS by the Research and Training Center in March of 1997 (Conclusions of the study are contained in Appendix A). This study concluded, as did the Legislative Auditor's study, that DRS rehabilitants do have a positive impact on their wage earnings as a result of the Division's rehabilitation services. The report concluded that the "agency's on-going program evaluation efforts and a periodic detailed examination of specific program evaluation issues....will assist the WVDRS program to continue on the path of achieving successful rehabilitation." Thus, the Legislative Auditor recommends that DRS continue their program evaluations to determine the effectiveness of their rehabilitation services.

Recommendation 2

The Legislature should consider statutory changes that requires the Division to submit long- range outcome evaluations to the Legislature.

Level of Compliance: Requires Legislation

In a response provided to the Legislative Auditor, DRS stated that they would have no objection should the Legislature choose to codify this practice as a statutory requirement.

Recommendation 3

We recommend that the Division examine why a large number of individuals receive substantial services yet are not rehabilitated. The Division should determine the number of these individuals, why these individuals dropped out of the program, the costs of providing services, and other characteristics that could remedy this condition.

Level of Compliance: In Compliance

The Division has been upgraded on this recommendation from Partial Compliance to In Compliance. In June of 1997, the Legislative Auditor's Office received a report by the West Virginia Rehabilitation Research and Training Center entitled "Analysis of the Partial Participants (Status 28 Case Closures) of WVDRS" (Conclusions and Recommendations of this report are contained in Appendix B). This report provided a detailed study of DRS partial participants, their costs, and reasons for dropping out of the program. The report also included a comparison of WVDRS partial participants with those of other state programs. Recommendations include as a short term response having DRS counselors closely examine cases that involved either extremely high case services cost, and attempting to reduce these costs. As a long term response the report recommended that the agency examine reasons for partial participants closures through focus groups and/or survey techniques. Also, the report recommended that an identifier or a warning system for partial participants be developed.

Recommendation 4

PERD recommends that DRS: a) determine what services should be provided at the WVRC which are not available at the community level; b) identify alternate funding sources for the Center; c) phase out direct funding for the Center, shifting those funds to the field program and requiring the Center to compete for field services funds; d) develop and submit a plan to the Joint Committee on Government Operations relating to this recommendation by December 1, 1996.

Level of Compliance: Part (a): In Compliance;
Part (b): In Compliance;
Part (c): In Compliance;
Part (d): In Compliance.

Part a) In Compliance in the February 1997 update.

Part b) In Compliance: In the February 1997 update, DRS received a planned compliance for identifying alternative funding sources for the Center. These alternative funding sources as identified by the Division included: improving the billing system; exploring outpatient therapy services on a fee for service basis; discuss with PEIA the development of a PEIA Disease Management Program; and developing a work hardening program with the Workers' Compensation Division. The Division has made significant progress in exploring these funding sources. In addition, for the first time, the West Virginia Rehabilitation Hospital located within the Center received $1,939,000 in federal Disproportionate Share funds for FY95. They also expect another DSH payment of approximately $1,9000,000 for FY96. According to agency management, the eligibility for these funds became available as a result of the utilization of new accounts receivable software developed by Arnett and Foster. The Legislative Auditor recommends that DRS continue to explore alternative funding sources for the WV Rehabilitation Center and its hospital.

Part c) In Compliance: The Division as stated in the February 1997 update decline adopting the approach of phasing out direct funding for the Center. Division management feels that this approach would leave the center with an uncertain financial foundation and eventually threaten its continued operation. The Division has attempted to downsize funding for the center by reducing the FY 1997 budget by $853,929. This downsizing included reducing dental services; discontinuing two underutilized training programs; and termination of some temporary employees. According to division management, the downsizing activities and the increase to the field services budget for FY97 resulted in the Agency closing the fiscal year with counselors able to provide services through the end of the year, whereas before field services routinely ran out of money before the end of the fiscal year. The Legislative Auditor commends the Division for downsizing the Center's budget.

Part d) In Compliance: The Division did not submit a plan to the Joint Committee on Government Operation by the December 1, 1996 deadline. This part of the recommendation requests the division to submit a plan for parts 4a - 4c. Since the Division is now in full compliance with parts 4a - 4c, which constititute the complete implementation of the recommended plan, the Legislative Auditor feels that Part 4 d) has been negated by the Division's full compliance with parts 4a -4c.

Recommendation 5

PERD recommends that the Division renegotiate the current cooperative agreement with the Workers' Compensation Division to include payment for case management services including at a minimum the initial evaluation and the Individual Written Rehabilitation Plan development process. A copy of the revised agreement is to be submitted to the Joint Committee on Government Operations by June 15, 1996.

Level of Compliance: In Compliance in the February 1997 update.