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The 2010-2011 National Survey of Community Rehabilitation Providers: 
Estimating the Number of Community Rehabilitation Providers in the United States

Research to Practice Brief Issue No. 54

By:

Originally published: 5/2013

Introduction

This is the second in a series of research to practice briefs based on the 2010–2011 National Survey of Community Rehabilitation Providers (CRPs) funded by the Administration on Developmental Disabilities and the National Institute on Disability and Rehabilitation Research. The aim of the survey was to identify and describe trends in employment and non-work services for individuals with intellectual and developmental disabilities (IDD) and other disabilities who receive services from CRPs. The purpose of this brief is to provide a national estimate of the number of CRPs in operation in the United States.

While making such an estimate was not the survey’s original intent, we have fielded multiple requests for the total number of CRPs derived from our research efforts. Despite several potential limitations, we are in a unique position to produce an estimate using data collected during the sampling and implementation phases of the survey research. This brief will describe the sampling frame, sampling methodology, verification process, and a step-by-step description of how the estimate was calculated.

Background

In 2003, the Research and Training Center (RTC) on Community Rehabilitation Providers to Improve Employment Outcomes estimated that there are approximately 8,100 CRPs that provide services to adults, youth, Social Security beneficiaries, and other people with disabilities (Menz, Napp, Koopmann, & Hagen-Foley). A national estimate of CRPs may be important to researchers, practitioners, federal agencies, and disability advocates for a variety of reasons. Enabling people with disabilities to enter the labor market is a priority concern for federal and state policy makers (Silverstein, Julnes, & Nolan, 2005; Kiernan, Hoff, Freeze, & Mank, 2011; NACDD, 2011). Policy shifts over the last two decades have established an increasing emphasis on integrated employment, and the federal government has set the tone for broad-based systems change (Rogan & Rinne, 2011).

CRPs are greatly impacted by these policy shifts, and are at the forefront of changes due to their role as the primary source of day and employment supports for people with disabilities. Furthermore, CRPs serve as a key community resource to re-engage individuals with disabilities into the community as a whole and provide equal economic participation (Menz, 2003). CRPs also play an integral role in carrying out disability-related employment policies, such as Ticket to Work and the Workforce Investment Act (Boeltzig, Butterworth, & Gilmore, 2006).

Our estimate calculation indicates that there are 5,408 CRPs nationally.

Furthermore, the sampling and data collection phases of the 2010–2011 CRP survey supported the theory that the landscape of CRPs varies significantly across states. The variation in states’ policies regarding licensing, accreditation, and definition of services highlighted the challenge in producing a national estimate of CRPs.

For example, some states have statutes in place that provide licenses to individual people--as opposed to community-based organizations--to provide day or employment services to one or more individuals with a disability. In other states, the majority of day and employment service providers are state-operated, and there are few private non-profit organizations in the market of CRPs. This variation across states and CRPs’ role in providing employment services to millions of individuals with disabilities nationwide further strengthens the case for developing an estimate.

Past findings indicate that the majority (70%) of those served by CRPs are individuals with intellectual and developmental disabilities (IDD) (Metzel, Boeltzig, Butterworth, Sulewski, & Gilmore, 2007; Inge et al., 2009). Over two thirds of CRPs provide work and non-work services in both integrated and facility-based settings (Metzel, 2007). Based on the most recent survey findings conducted by the Institute for Community Inclusion in FY 2010–2011, 1,016 CRPs reported serving a total of 201,672 individuals with all disabilities across employment and day services. Individuals with IDD represented 75% (n=150,330) of people supported by CRPs. The average number of individuals with all disabilities supported per CRP was 198 (Domin & Butterworth, 2012).

Sampling Frame

The team of researchers consulted various sources to assemble a comprehensive list of all potential CRPs in the nation. We collected lists from key disability organizations, including The Arc, United Cerebral Palsy, NISH, APSE, Easter Seals, United Way, International Clubhouse Coalition, NAMI, CARF, and various federal-state agencies and programs such as mental health, vocational rehabilitation, IDD, and Ticket to Work.

The lists were compiled into a master database. At this phase, the database housed over 20,000 records; each record contained an organization name and contact information (address, phone, email, contact person). Each record was considered to be a potential CRP. Multiple operating locations of CRPs were included in the database and treated as unique records.

Researchers and graduate assistants then conducted preliminary cleaning of the master list to eliminate ineligible types of organizations, such as One-Stop Career Centers (American Job Centers) or medical providers. In addition, we conducted a preliminary round of record cleaning to eliminate duplicate records in the master list.

A particular challenge was distinguishing duplicates for CRPs that have multiple operating locations. If a record matched another in the fields of organization name, street address, city, state, and zip code, it was considered a duplicate and eliminated from the database. In the case that the organization name was the same but the street address, city, state, or zip code differed, the record was considered a unique operating location of an organization and remained in the pool.

Following these initial cleaning efforts, we finalized a sampling frame consisting of 11,712 potential CRPs. Using this sampling frame, we then designed and executed a multi-step random sampling procedure.

Sampling Methodology

From the list of 11,712 organizations, we drew a random sample of 4,418 organizations. To draw the random sample, the records were migrated into SPSS and assigned a random identification number. Then, state by state, records were randomly selected to be included in the sample. This sampling design had two scenarios:

  1. In states for which there were less than 100 records, all organizations were included in the sample.
  2. In states for which there were more than 100 records, a random sample of 100 records was drawn.

This sampling strategy produced a final sample of 4,418 organizations.

Sample Verification

We designed a verification process to validate each record in the random sample for sampling inclusion criteria. Due to the variable nature of the lists used to compile the database of 11,712 organizations, this methodology was selected to ensure the organizations in the sample were the target audience for this research. The 4,418 organizations were examined by researchers and trained graduate students using two key eligibility requirements:

  1. the organization must provide day or employment services to people with disabilities, and
  2. the record must include a valid mailing address, telephone number, and email address.

The criteria for a valid email address was dropped midway through the sampling process in order to accelerate the sample verification. As a result, during the first half of sample verification, an organization that provided day or employment services, but did not have a working email address, was disqualified from the sample. This means that there are a number of CRPs that were not positively verified and included in the sample, which has implications for our estimate that will be explained later.

If an organization met these criteria, it was included in the sample and therefore deemed a CRP. If an organization did not meet these requirements, it was not included in the sample and marked “disqualified.” If the disqualified organization existed in a state with more than 100 organizations in the mailing list, the next randomly selected organization was checked for eligibility. This process continued until a) the target of 100 CRPs was reached in states with more than 100 organizations in the mailing list, and b) all organizations in states with less than 100 organizations in the mailing list were verified. In some cases, the mailing list pool was exhausted in states with more than 100 organizations in the original list, i.e., the pool was depleted before we reached 100 verified CRPs in the sample. In these cases, we included all verified CRPs in the sample.

The verification process continued on a rolling basis during survey implementation, as organizations were found to be ineligible during the fielding period. Throughout the implementation period, the survey sample was adjusted to reflect changes in organizations’ eligibility to participate in the study. An organization in the sample was found to be ineligible for the following reasons: address and phone number is invalid (n=61), the organization does not meet the definition of CRP for this research (n=221), employment and/or day services have been discontinued since the time of sampling (n=38), or the organization is a duplicate (n=78), i.e., the organization appears in the sample twice.

In order to maintain the ideal sample size, CRPs that were found ineligible were replaced using the next randomly selected organization from the state. This occurred for states with organizations in excess of the targeted sample. Therefore, states with fewer than 100 CRPs had no replacement pool and ineligible organizations were simply removed from the sample. Throughout the survey implementation, we conducted five waves of replacement. The replacement waves consisted of 26 to 76 cases, for a total of 282 replacement cases across five waves.

Verification Results

In sum, there were 11,712 organizations in the mailing list. As we attempted to reach and maintain the target sample of 4,418 CRPs, we examined 7,735 organizations during the verification process. Of these, 3,551 met the sampling criteria during the sampling phase and implementation phase (including replacement procedures) of the survey:

  1. provide day or employment services to people with disabilities, and
  2. have a valid mailing address, telephone number, and/or email.

From this, we can calculate an eligibility rate by dividing the total number of organizations found eligible (CRPs) by the total number of organizations examined for eligibility.

Eligibility rate = 3,551 / 7,735 = 0.459

Then, we can take this rate of eligibility and apply it to the total number of records in the mailing list to estimate the number of CRPs we would have identified if we examined all 11,712. We multiply the eligibility rate by the total number of records in the mailing list to produce an estimate of the number of CRPs in the national mailing list: Estimate = 0.459 * 11,712 = 5,376

This estimate can be further refined by separating the states for which we have an exact figure and states for which we can use the state-specific eligibility rate to make an estimate. We examined all organizations in the mailing list for 32 states (either because the original list contained fewer than 100 records, or because the list was exhausted during the verification and replacement phase). From these 32 states (including the District of Columbia), we positively identified 1,682 CRPs.

For the other 19 states, we can estimate the number of CRPs using the eligibility rate for each state multiplied by the number of organizations in the mailing list for that state. We estimate an additional 3,726 CRPs exist in the nation, for a total of 5,408.

Findings

Our estimate calculation indicates that there are 5,408 CRPs nationally. Considering possible error and CRPs that were not identified in the original list, we suggest that there are between 5,000 and 6,000 CRPs that provide employment and/or non-work services to people with disabilities in the United States as of 2009. This estimate is based on the sampling criteria for the 2010–2011 National Survey of Community Rehabilitation Providers, and is not a statistical calculation, which limits our ability to provide a confidence interval for this estimate.

Table 1 on the following page provides the data points used to calculate this estimate for each state, and includes the total figures in the final row.

Table 1. State-by-State Data Points for Sampling, Verification, and Estimate Calculation

Table 1. State-by-State Data Points for Sampling, Verification, and Estimate Calculation

Data Points

(1)

(2)

(3)

(4)

(5)

State

Number of potential CRPs in original mailing list

Number of CRPs examined for eligibility

Number of CRPs found eligible & included in the final sample 1

CRP eligibility rate 2

Estimated number of total eligible CRPs in sample 3

AK

33

33

19

0.576

19

AL

132

132

67

0.508

67

AR

105

105

64

0.610

64

AZ

183

183

86

0.470

86

CA

648

209

100

0.478

310

CO

109

109

63

0.578

63

CT

163

163

93

0.571

93

DC

32

32

10

0.313

10

DE

77

77

28

0.364

28

FL

501

313

98

0.313

157

GA

236

236

99

0.419

99

HI

44

44

24

0.545

24

IA

177

162

99

0.611

108

ID

50

50

22

0.440

22

IL

419

168

97

0.577

242

IN

301

228

98

0.430

129

KS

302

200

101

0.505

153

KY

159

159

68

0.428

68

LA

284

182

93

0.511

145

MA

450

239

100

0.418

188

MD

267

195

102

0.523

140

ME

82

82

42

0.512

42

MI

264

185

95

0.514

136

MN

420

156

99

0.635

267

MO

252

252

94

0.373

94

MS

88

88

41

0.466

41

MT

71

71

42

0.592

42

NC

311

199

99

0.497

155

ND

61

61

24

0.393

24

NE

46

46

35

0.761

35

NH

179

179

51

0.285

51

NJ

228

228

97

0.425

97

NM

352

352

65

0.185

65

NV

78

78

32

0.410

32

NY

435

138

100

0.725

315

OH

590

245

97

0.396

234

OK

174

174

94

0.540

94

OR

139

139

79

0.568

79

PA

456

154

100

0.649

296

RI

73

73

46

0.630

46

SC

103

103

54

0.524

54

SD

48

48

28

0.583

28

TN

258

249

95

0.382

98

TX

1164

349

98

0.281

327

UT

53

53

29

0.547

29

VA

164

164

93

0.567

93

VT

40

40

23

0.575

23

WA

399

249

98

0.394

157

WI

367

216

100

0.463

170

WV

69

69

33

0.478

33

WY

76

76

37

0.487

37

TOTAL

11712

7735

3551

0.459

5408

1This number is out of Data Point 2

2 Eligibility rate was calculated by dividing Data Point 3 by Data Point 2

3Estimate was calculated by multiplying Data Point 4 with Data Point 1

Limitations

The study was not designed to produce a national estimate of the number of CRPs in operation across the country; therefore, the limitations should be carefully considered. This figure should be used only when providing users with the contextual information:

There are also two assumptions made by the researchers to support the production of a national estimate of CRPs:

Additional limitations apply to the sampling procedures we employed for this study:

Conclusion

In providing this estimate of the number of CRPs in operation in the United States, we have attempted to address a national policy question using the resources available. A great deal of effort was dedicated to refining the sample for the 2010–2011 CRP survey, and the documentation of each step of the process has allowed us to extrapolate our findings beyond the original goals of the study. Despite the limitations of this estimate, it serves as an important measure to researchers, practitioners, federal agencies, and advocates who aim to positively impact the lives of individuals with disabilities.

References

Boeltzig, H., Butterworth, J., & Gilmore, D. S. (2006). The National Survey of Community Rehabilitation Providers, FY2002-2003. Report 3: Involvement of CRPs in the Ticket to Work and the Workforce Investment Act. Research to Practice Brief. Boston, MA: University of Massachusetts Boston, Institute for Community Inclusion.

Domin, D., & Butterworth, J. (2012). The 2010–2011 National Survey of Community Rehabilitation Providers. Report 1: Overview of services, trends and provider characteristics. Research to Practice Brief. Boston, MA: University of Massachusetts Boston, Institute for Community Inclusion.

Inge, K. J., Wehman, P., Revell, G., Erickson, D., Butterworth, J., & Gilmore, D. S. (2009). Survey results from a national survey of community rehabilitation providers holding special wage certificates. Journal of Vocational Rehabilitation, 30(2), 67–85.

Kiernan, W. E., Hoff, D., Freeze, S., & Mank, D. M. (2011). Employment First: A beginning not an end. Intellectual and Developmental Disabilities, 49(4), 300.

Menz, F. E., Napp, A., Koopmann, R., & Hagen-Foley, D. (2003). Phase I. Community- based rehabilitation programs: Development of a national database and findings from a study to identify barriers and incentives to serving Social Security recipients. Unpublished technical report. Menomonie, WI: University of Wisconsin-Stout, Stout Vocational Rehabilitation Institute, Research and Training Centers.

Metzel, D. S., Boeltzig, H., Butterworth, J., Sulewski, S., & Gilmore, D. S. (2007). Achieving community membership through community rehabilitation providers services: Are we there yet? Intellectual and Developmental Disabilities, 45(3), 149–160.

National Association of Councils of Developmental Disabilities (NACDD) (2011). The time is now: Embracing Employment First. Retrieved from: www.nacdd.org/documents/EmploymentFirstFINALNov132011_PRINT.pdf

Rogan, P., & Rinne, S. (2011). National call for organizational change from sheltered to integrated employment. Intellectual and Developmental Disabilities, 49(4), 248–260.

Silverstein, R., Julnes, G., & Nolan, R. (2005). What policymakers need and must demand from research regarding the employment rate of persons with disabilities. Behavioral Sciences and the Law, 23, 399–448.


RESEARCH TO PRACTICE

Issue No. 54 2013

The 2010-2011 National Survey of Community Rehabilitation Providers was developed and implemented with support from the Administration on Developmental Disabilities, U.S. Department of Health and Human Services (#90DN0216) and National Institute on Disability and Rehabilitation Research (NIDRR) and the Rehabilitation Services Administration (RSA), U.S. Department of Education (#H133B070001). The opinions contained in this manuscript are those of the grantee and do not necessarily reflect those of the funders.

The authors acknowledge the work of the survey team including Heike Boeltzig, Frank Smith, and Susan Foley. Ben Kramer helped develop the national list of CRPs. Tony Roman from the UMass Boston Center for Survey Research supported sample design and the analysis plan. This survey represents the support and work of a broad array of ICI staff including the graduate assistants, administrative staff, and the Marketing and Communications team. And in particular we thank the pilot sites that tested the survey design and the survey respondents for their willing participation.

Suggested Citation

Haines, K., Domin, D., Butterworth, J. (2013). The 2010-2011 National Survey of Community Rehabilitation Providers: Estimating the Number of Community Rehabilitation Providers in the United States. Research to Practice Brief, Issue No. 54. Boston, MA: University of Massachusetts Boston, Institute for Community Inclusion.

For more information, contact: Kelly Haines
Institute for Community Inclusion
University of Massachusetts Boston
kelly.haines@umb.edu
This publication will be made available in alternate formats upon request.

ICI: promoting inclusion for people with disabilities