State-Level Variation in Vocational Rehabilitation Services and Outcomes for Transition-Age Youth with Autism

Background:

Vocational Rehabilitation (VR) services might benefit many of the 50,000 youth with autism who turn 18 every year – only half of whom will hold a job for pay at any point between high school and their early 20s – most at part-time hours with low wages. The federal VR program provides grants to states to help individuals with disabilities find, maintain, or regain employment. Transition-age youth (TAY) with autism use VR services more than other age groups do, but they also have the worst employment outcomes. Individual-level factors are known to influence employment outcomes. Yet, we know less about the role of where you live in the U.S.

Objectives:  To characterize variation in individual-level VR services and employment outcomes across states.

Methods:  We analyzed VR service utilization and employment outcomes for 9,797 TAY with autism (ages 14-24) in the federal Rehabilitation Services Administration (RSA) database who received VR services and had a case that closed in FFY2014. Characteristics of these youth and their VR services use and outcomes were examined using bivariate analyses by state.

Results:

TAY with autism who used VR services were primarily male (84%), white (85%), and non-Hispanic (93%) with a mean age of 19 years at the time of VR entry. Approximately 55% were students when their VR case opened. Approximately one-third (29%) were receiving SSI benefits at VR application, and 68% were considered by VR to have a “most significant” disability. Over half (54%) received four or more VR services.

VR service use and related outcomes varied significantly by state. The percentage of TAY with autism who received VR services during secondary school varied by 70 percentage points across states (mean=68%, range 39-87%). TAY with autism who received VR services and exited with employment varied by 52 points across states (mean=58%, range 29-81%). The median hourly wage of those who exited with employment was $8 but ranged from $7.40 to $10/hour across states. The percentage of TAY with autism who received supported employment (SE) services varied by state. Nine states reported no SE services, while three reported rates of 100% (mean=23%). The amount of money states spent on services for VR service users with autism under age 25 averaged $6100 (range $1470-$9668).

Conclusions:  Nearly every state has some type of policy, legislation, or activities focused on improving employment opportunities for persons with disabilities. Although individual-level factors contribute to a diverse profile of employment outcomes for TAY with autism, VR service utilization and employment outcomes also vary widely according to the state of residence. Future research should examine the influence of state-level factors on individual outcomes using multilevel modeling methods with a focus on modifiable state-level factors. This study provided contextual baseline data about TAY with autism ahead of the implementation of new federally mandated pre-employment transition services for students– the design of which will also vary by state.