From Medical Rehabilitation to the Workforce:  An Introduction

Wilson Workforce and Rehabilitation Center (WWRC) provides a variety of medical rehabilitation services within its defined scope and mission through its Comprehensive Outpatient Rehabilitation Facility (CORF). Medical Rehabilitation through WWRC's CORF is clinically managed by a Physiatrist, a Board-Certified Specialist who specializes in Physical Medicine and Rehabilitation. A Medical Case Manager acts on behalf of clients, to serve as their advocate, and provides service coordination of the physician-ordered plan of care. Under the standards of a CORF, WWRC participates in blended funding, accepting and billing private, third party Insurance, and public Medicare/Medicaid funding sources for therapy services and DRS for non-medically necessary services.

 

Medical Rehabilitation ranges from short-term evaluation or assessment to treatment and transitional services leading to improved independence, workforce readiness, vocational training, and/or a return to work.  Medical Rehabilitation is vital to the Virginia Department for Aging and Rehabilitative Services/Division of Rehabilitative Services (DARS/DRS) in determining eligibility for Agency services and in developing/implementing a Plan for Employment for targeted Agency Vocational Rehabilitation (VR) clients.   

 

                    Evaluation/Treatment                             Specialized Assistive Technology                                    Outpatient Clinics                        
  • Physiatrist Consultation
  • Occupational Therapy
  • Physical Therapy
  • Speech-Language Pathology
  • Neuropsychological Evaluation
  • Psychological Testing/Therapy
  • Rehabilitation Nursing Consultation
  • Physical Work Performance Evaluation (PWPE)
  • Driving Evaluation
  • Behavior Support Services
  • Adaptive Driving
  • Assisted Listening Devices
  • Augmentative Communication
  • Assistive Computer Technology
  • Environmental Modification
  • Environmental Aids to Daily Living
  • Parastep® FES Assisted Gait
  • Rehabilitation Engineering
  • Vehicle Modification
  • Work Site & Ergonomic Evaluation
  • Home/School Accessibility Evaluation
  • Wheelchair Seating and Mobility
Outpatient clinics consist of a comprehensive medical rehabilitation evaluation led by a physician to assist with determining appropriate recommendations  and resources for clients to improve independence and/or prepare for/return to work

 

Treatment services may include up to five (5) hours of daily therapy, five (5) days per week, dependent on needs of the client. Comprehensive, state-certified driving services, provided by Certified Driving Instructors (CDI) and Driver Rehabilitation Specialists (CDRS), are managed through WWRC's Occupational Therapy Department.  

 

Behavioral Health Services Department Clinicians function as part of the WWRC Medical Rehabilitation Team to assist clients in achieving their optimal level of independence in community living. The Department is staffed by licensed clinical psychologists and licensed professional counselors as well as with a Behavior Services Team that provides group and individual sessions to assist clients in achieving the highest level of success as related to behavioral functioning in the campus environment.  This takes the form of a continuum of services that are proactive and geared to teaching and training as well as individual and group sessions to address chronic minor behavioral issues. 

 

Medical rehabilitation may be provided in a community outpatient or residential status.  VR clients who require nursing and/or attendant care to participate in vocational and medical rehabilitation programs are housed on Rothrock Hall.  WWRC's CORF also provides a small percentage of medical rehabilitation services for non-DRS clients, based on a defined capacity and the availability of resources. 

 

VR clients may be referred to WWRC for a medical rehabilitation only program or in combination with other vocational services in preparation for the workforce.  Medical Rehabilitation contributes significantly to the Agency rehabilitation rate (the ratio between successful and unsuccessful Agency closures in any given year) for VR clients served through WWRC.  

 

From Medical Rehabilitation to the Workforce:  Evolving Models of Success

WWRC's Medical Rehabilitation has played a significant role in evolving mission-centric partnerships with DARS/DRS, local and regional businesses, and other community partners.    Two of these partnerships are summarized below:

 

  • DARS/DRSMedical Outreach & Collaborative Return to Work Model

    Several decades of scientific research show that medical rehabilitation is critical for optimal recovery from most catastrophic injuries. The differences between acute and post-acute services are important to recognize. Acute services that are provided in hospitals or acute rehab facilities promote safety and self-sufficiency to return home. Post acute services like those offered at WWRC promote higher level skills involved with returning to life activities to include work. Without receiving the post-acute services that focus on issues such as compensatory strategies for impairments for executive functioning and learning to utilize assistive technology and adaptive equipment for physical impairments, many of these individuals may never develop skills necessary to return to employment.

     
    In response to this underserved population and a growing need, in early 2012, the local DARS/DRS Office piloted the use of a specialized VR Counselor position to serve a medical caseload and to coordinate continued therapy services for clients who are close to completing acute rehabilitation but who will need additional services and recovery before returning to the workforce.  The majority of this caseload participates in post-acute services offered on Rothrock Hall at WWRC.  The specialized VR Counselor position is housed on Rothrock Hall and works closely with WWRC therapy and nursing departments who serve the medical rehab unit.


    This VR counselor has developed relationships with area hospitals/rehab centers and other medical service providers that refer clients who are recuperating from new disabilities such as traumatic brain injuries, strokes, and spinal cord injuries; this keeps community partners and referral sources continuously aware of the Agency mission and services. After programming is completed at the center, clients are usually prepared to return to previous employment, to attend vocational training at the center, or to work with vocational counselors in their home field offices to engage in vocational services.  This specialty VR Counselor caseload position also serves as a statewide consultant to other DRS Counselors to provide information and facilitate appropriate referrals to WWRC.

     
    Continuous monitoring of referral numbers, utilization, outcome, rehabilitation rates, and workforce earnings for participants served allow for continuous program evaluation of this medical return to work model. 

     
  • Corporate Initiatives to Hire Qualified People with Disabilities 
     

    WWRC has recently begun to partner with Agency Business Development Managers to pursue corporate initiatives that target the hiring of qualified people with disabilities. Medical Rehabilitation has been a powerful factor in the success of this collaboration.   As an example, in Summer 2013, The Hershey Company manufacturing plant in Stuarts Draft announced an initiative, sponsored through a Hershey corporate initiative, to offer apprenticeships for approximately six individuals with disabilities. The announcement of this corporate initiative, titled "Hershey Extends Real Opportunities to Succeed" (H.E.R.O.S.), led to the beginning of a highly successful strategic partnership with DARS/DRS and WWRC that offered individuals with disabilities a six-month work experience on the production line.  During the apprenticeship, DARS/DRS clients could access any needed supports from WWRC to help them complete the program as long as they were able to perform the required duties at the end of the six months.

     
    WWRC's collaborative relationship with the local DRS Office positioned DARS and the Center as experts in understanding Virginia's workforce needs, as well as being acknowledged as the source of help and assistance for people with disabilities who wish to work.  Unique features of this partnership that highlight the impact of integrated WWRC Vocational and Medical Rehabilitation:

     
  • Understanding the Work Environment: The regional DRS Business Development Manager and targeted WWRC medical/vocational staff conducted a site visit at the Hershey manufacturing plant to assess a typical work station that DARS/DRS clients would use during their apprenticeship, if selected for the program.  This increased the likelihood of success for selected candidates, allowing a more targeted match of DARS/DRS client abilities with the needs of the business environment.

 

  • Candidate Screening Process: Following the Hershey site visit, the regional DRS Business Manager and WWRC staff determined it was critical for candidates to have the physical strength and stamina to perform labor at a typical work station in the Hershey plant. As DRS began screening potential candidates for the program, a WWRC Physical Therapist administered a physical work performance evaluation (PWPE), providing a reliable, valid, clinical assessment of an internship candidate's ability to complete physical labor. Candidates also participated in a simulated production line activity through the WWRC Materials Handling Training Program to assess how they would handle a work setting such as Hershey.  The results of the PWPE and the simulated production line were used by Vocational Rehabilitation (VR) Counselors in the local DRS Office, combined with other criteria, to select potential candidates for the apprenticeship program.