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  • Title: The Program Without Walls: innovative approach to state agency vocational rehabilitation of persons with traumatic brain injury.
    Author: O'Neill JH, Zuger RR, Fields A, Fraser R, Pruce T.
    Journal: Arch Phys Med Rehabil; 2004 Apr; 85(4 Suppl 2):S68-72. PubMed ID: 15083424.
    Abstract:
    OBJECTIVE: To describe the Program Without Walls (PWW), a person-centered, community-based approach for state rehabilitation counselors to provide vocational rehabilitation (VR) services to people with traumatic brain injury (TBI). DESIGN: Nonrandomized posttest only matched control group design using existing state VR data. SETTING: Community-based within 2 district offices of the state-federal VR program in New York State. PARTICIPANTS: VR consumers with TBI (N=42); 21 received PWW services, and 21 matched controls received traditional VR services. INTERVENTION: All participants experienced the initial VR process: eligibility determination and the development of an individualized employment plan. Participants receiving the traditional approach were referred to various organizations for services and monitored by their state VR counselor. Those receiving PWW services were never "handed off" to outside agencies. Instead, they received person-centered, community-based services from a team of freelance consultants who were recruited, trained, and supervised by the state VR counselor overseeing the PWW team. MAIN OUTCOME MEASURES: Data were gathered from VR central files for all consumers with a primary or secondary disability of TBI. Outcome variables were case status at closure, weekly earnings at closure, hours working at closure, and cost of case services. RESULTS: The PWW successfully placed more consumers who worked a greater number of hours per week and earned more per week than those who received traditional VR services without increasing the cost of case services. CONCLUSIONS: The PWW showed promise as a systems change effort to improve VR services for people with TBI.
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