A comparison of the cost-ineffectiveness of supported employment versus sheltered work services by state and demographics of program participants

BACKGROUND: Supported employment has long been regarded as a good investment for individuals with disability and taxpayers. However, not all supported employees are cost-effective to serve in the community. By examining supported employees who are not cost-effective, we can better understand how to make supported employment more effective and efficient. METHODS: The costs-per-month served and per-hour worked of 40,118 supported employees funded by state-federal VR agencies were compared to estimates of costs of sheltered workshops found in the literature. Rates of cost-ineffectiveness were examined by demographic variables (e.g., gender, ethnicity, impairment) and across all state-federal VR agencies throughout the United States and its territories. RESULTS: Supported employees cost state-federal VR agencies an average of $342.07 (SD = $418.45) per month they received services. This was well below the lowest estimated monthly cost of sheltered workshops of (i.e., $593.72). However, supported employees cost VR agencies $7.23 (SD = $15.46) per hour they worked in the community. This was well above the lowest estimated hourly cost of sheltered workshops (i.e., $6.73). Costs-per-month served and costs-per-hour worked varied considerably from agency to agency, with substantial proportions of supported employees served by most agencies not being cost-effective to serve in the community. CONCLUSION: Rates of cost-ineffectiveness did not appear to be significantly influenced by supported employee demographics. Disparities among state-federal VR agencies were most likely the result of differences in policies or training of adult service providers. Future research will need to explore these issues.