A Quick Look
Vocational rehabilitation agencies can find it difficult to serve rural clients due to smaller caseload volume, the physical distance between cases and fewer employment opportunities for clients. However, vocational rehabilitation for rural clients can be improved by establishing practices with front-end milestone compensation, the hiring of local contractors to serve more isolated rural communities and granting rural providers the option to choose between hourly fee-for-service and results-based funding models.
Barriers to rural vocational rehabilitation include:
- Large service areas with limited cases
- Travel costs for clients and providers
- Low number of caseloads in rural areas as compared to higher density communities
- Fewer job openings for clients in rural areas
- Difficulty in connecting a provider with multiple, geographically dispersed communities
- Difficulties with results-based compensation in areas with low caseloads
Strategies to mitigate rural vocational rehabilitation barriers:
- Hire limited use providers from within local communities, including teachers and retirees
- Cover travel costs for providers
- Make connections with local chambers of commerce and business leaders to maintain listings of local employment opportunities
- Provide temporary travel cost support for clients who have recently received employment
- Allow options for rural providers to receive compensation by hourly rates or through front-end milestones
- Waive provider accreditations for heavily underserved areas
- Agency finances required training for rural providers
Putting It Into Practice
Vocational rehabilitation practitioners can expand services into rural communities by:
- Hiring a contractor from within the underserved community
- Adapting compensation schedules for rural clients, including hourly fees that do not include travel time
- Developing front-end milestones for effective, low volume, results-based compensation in combination with fee-for-service
- Making connections with local community organizations
- The recommendations in this study are based on responses from 40 vocational rehabilitation administrators from 35 states. Investigators Catherine Ipsen and Stacey Bliss are at the University of Montana, Missoula, Montana. Rebecca Goe is from Partnership Health Center, Missoula, Montana.
- Landon, T., Connor, A., McKnight-Lizotte, M., & Peña, J. (2019). Rehabilitation Counseling in Rural Settings: A Phenomenological Study on Barriers and Supports. Journal of Rehabilitation, 85(2), 47–57.
- Research and Training Center on Disability in Rural Communities, Rural Institute for Inclusive Communities, University of Montana. (2019).
Ipsen, C.; Goe, R.; & Bliss, S. (2019). Vocational Rehabilitation (VR) funding of job development and placement services: Implications for rural reach. Journal of Vocational Rehabilitation, 51 (3), 313-324. DOI: 10.3233/JVR-191048