COMPARISON OF COSTS INVOLVED IN MAKING WORKSITE ACCOMMODATIONS

Anthony J. Langton

Center for Rehabilitation Technology Services

South Carolina Vocational Rehabilitation Department

West Columbia, SC

ABSTRACT

The cost of worksite accommodations is a concern of employers, referral agencies and funding

sources. A cost analysis study of worksite accommodations completed by rehabilitation

technology specialists was compared to accommodation information available from the Job

Accommodation Network reported by employers. The comparison used mean cost data to

indicate cost for accommodations and to determine similarity of findings. Results showed

surprisingly similar cost estimates.

BACKGROUND

The use of worksite or job accommodations as a strategy to address the retention and hiring

needs of individuals with disabilities is becoming a common practice with a growing number of

employers. The Job Accommodation Network (1995) reports that the number of requests for

information and technical assistance on accommodation needs was 92,644 in 1993-94, an

increase of approximately 26% since 1991-92. Providing worksite accommodation services

represents an important, although still somewhat small portion of rehabilitation technology

service delivery activity (CRTS, 1994). Perceptions regarding the (high) costs of

accommodations and difficulty in securing adequate reimbursement for services are suspected as

reasons why greater use of worksite accommodations has not occurred.

Determining approximate costs for making accommodations for individuals with disabilities is an

important concern from employers and agencies working with individuals with disabilities.

Rehabilitation technology practitioners in particular are very interested in establishing a common

awareness of what worksite accommodations typically cost to assist them in securing necessary

funding and reimbursement for services rendered.

Extensive work done by the Job Accommodation Network has helped to gather useful data from

employers on their worksite accommodation activities. JAN (1995) reported that the typical

accommodation cost for most companies (78%) surveyed was less than $1000. Reports such as

these suggest that the cost for making accommodations for workers with disabilities can be

relatively inexpensive.

Information in Table 1 indicates the breakdown of accommodation costs reported by employers.

Table 1: Job Accommodation Network Cost of Accommodations (10/94-12/94)

Initial impressions of this data tend to suggest that the vast majority of accommodations are

actually very low in cost. Questions remained however as to whether these estimates took into

account costs such as evaluation, research and development and other services. Follow-up

survey questionnaires used to gather information from employers do not attempt to gather this

type of specific information. It also appeared uncertain if the time and effort of engineering and

technical staff was considered.

Actual costs of worksite accommodations can be difficult to determine. Many of the costs, such

as time involved with evaluation and research and development, are not always accurately

accounted for, even by rehabilitation technology specialists themselves. Many rehabilitation

technology specialists who provide work site accommodations fail to maintain a detailed record

of the staff time involved. This is likely to be more common in situations where technology

specialists are employed by programs and agencies where itemized fee-for-services accounting is

not required. It is also possible that there may be a tendency to underestimate the cost of

accommodations, possibly in an effort to present rehabilitation technology services in a (more)

favorable cost/benefit position or to avoid some charges Worksite Accommodation Costs

to be more likely to receive funding approval to implement the necessary changes.

The Worksite Accommodation Special Interest Group (SIG-14) initiated a survey in the Spring

of 1995 to gather additional information to address some of these concerns. The Cost Analysis

Survey involved an in-depth analysis of the time and effort used in completing worksite

accommodations to: determine accurate cost of worksite accommodation; breakdown costs of

accommodations to identify any hidden costs; estimate time/effort involved; identify sources of

funding; and to develop a profile of rehabilitation technology service providers.

The initial survey effort was completed in collaboration with the Center for Rehabilitation

Technology Services (CRTS), the Job Accommodation Network (JAN) and the RESNA

Special Interest Group on Worksite Accommodations (SIG-14). A survey form was developed

to collect cost information on three aspects of worksite accommodations: evaluation,

implementation and follow-up activities. This three part analysis was used primarily to

determine if there were (significant) staff and other resources involved in evaluation or follow-

up activities which were not being reported in the overall cost estimates for accommodations.

The survey form also attempted to collect accurate time/cost estimates by requesting detailed

reporting of units of service for specific technology services (e.g. staff time, mileage, etc.),

quantity of units (e.g. 2 hours, 25 miles, etc.) and cost per unit (e.g. amount charged per hour,

mile, etc.).

The survey was mailed to 114 members of the SIG-14 Worksite Accommodation Special

Interest Group.Twenty-seven complete surveys were returned, from eight different service

providers. Preliminary data from this survey was reported in a Special Session at the 1995

RESNA Conference. In this presentation, results were given, however there has been no formal

reporting of the findings. Due to the limited sample size, caution was advised in interpreting

these findings independently without further corroboration. Comparison of this data with

information available from the Job Accommodation Network was suggested as a method to

determine if the findings would be comparable to those gathered from employers.

OBJECTIVE

Through the comparison of the survey findings with data collected by the Job Accommodation

Network, this research sought to determine if any (significant) differences exist in estimates of the

cost of worksite accommodations between the two sets of

data.

METHOD/APPROACH

For the purpose of this comparison, only those cases which involved both evaluation and

implementation phase cost estimates have been selected. This, along with the removal of

accommodations provided in a setting operating on a flat rate funding basis, reduced the original

sample to only seventeen cases. Information on follow-up costs was also not included since the

amounts cited were minimal. For purposes of this comparison the mean costs of accommodations

from each source was used. The survey form also investigated who was providing the technology

services, source of funding , however this data was not used since comparable information is not

available in the JAN data. The cases and data elements selected were felt to provide the best

comparison to reported employer costs in the JAN cost information.

RESULTS

Despite differences in the sample sizes and manner that data was collected, the cost of

accommodations were more similar than expected. Findings from the Cost Analysis Survey

suggest that the average cost for worksite accommodations, including evaluation and

implementation costs, was $1,503. Recent quarterly report findings (10/94-12/94), which are

shown in Table 2, show slightly higher costs with the mean cost increasing to $1,631.

Table 2. Comparison of Cost Accommodation Findings

Further comparison with other JAN data shows that the mean cost for all job accommodations

since October 1992 was $1,057.

DISCUSSION

The purpose of this comparison was not to determine which set of figures was more accurate.

The data Worksite Accommodation Costs available to make such an in-depth comparison is not

readily available. It is also important to acknowledge that "average costs", while being a

convenient way to view cost data, can tend to be misleading. The severity of the disability and the

extent of functional impairment have not been factored into either of these sets of figures. It seems

apparent that the costs for making a job accommodation for an individual with a severe disability,

whether to retain someone who has been injured or to hire a new employee, will likely be more

costly than someone with only minimal functional impairment.

Initially, in looking at the data in the JAN report, there was some concern as to whether

employers would provide a comprehensive enough report to capture all the costs of making

accommodations. An advantage of the Cost Analysis Survey was the level of detail that was

collected in multiple areas. Expectations were that the mean costs of $1,503 would have been

higher than those reported to JAN by employers. The similarity of the cost estimates would tend

to suggest that adequate attention is being given by employers to reflect the full array of costs.

It is still uncertain however, whether sufficient consideration is given to the involvement of

rehabilitation technology specialists in accommodations reported in the JAN data. A difference

in the two survey efforts that may be worth further investigation is in the way that rehabilitation

engineers and other technology specialists are accounted for in the evaluation phase of

accommodations. According to JAN, the time spent by technology specialists doing evaluation

is considered to be part of general consultation services to the employer and would not be

typically counted as part of the accommodation costs for a specific individual.

There was no attempt within the scope of this paper to investigate the distribution of functional

limitations and disability profiles within the various categories reported.

It is important that additional research consider various outcomes measures and factor in

severity of disability. Cost data alone can inadvertently be used set limits which can impede the

quality of services and impact outcomes and customer satisfaction.

Determining the actual cost/benefit of worksite accommodations, as well as other rehabilitation

technology service interventions, will increase in importance as the field moves toward greater

cost controls under managed-care programs. Information being collected by the Job

Accommodation Network and work of the SIG-14 Worksite Accommodation group provides

an excellent reference point to continue the investigation. A complete report of the total Worksite

Accommodation Cost Analysis Survey, including analysis of additional cost and funding factors

along with a profile of service providers, is available through the Center for Rehabilitation

Technology Services .

REFERENCES

Flynn, C.C.(Ed.)(1994). Rehabilitation Technology Services in Vocational Rehabilitation

Agencies Survey. West Columbia, SC: Center for Rehabilitation Technology Services.

JAN (1995). Job Accommodation Network U.S. Quarterly Report (10/1/94-12/31/94).

Morgantown, W.V.: Job Accommodation Network.

Langton, A.J. et al.(1995). Worksite Accommodation Cost Analysis Survey Report. Unpublished document. West Columbia, S.C.: Center for Rehabilitation Technology Services.

ACKNOWLEDGEMENTS

Specialist recognition goes to Mr. Glenn Hedman, Rehabilitation Engineer, University of

Illinois-Chicago for his assistance in the original survey development and Special Session

presentation and Neil Lown, Center for Rehabilitation Technology Services, for his assistance in

data collection and analysis.

The Center for Rehabilitation Technology Services is part of the South Carolina Vocational

Rehabilitation Department. Support for this research was provided by the National Institute on

Disability and Rehabilitation Research (NIDRR), U.S. Department of Education, Washington,

D.C. for the Rehabilitation Engineering Research Center on Rehabilitation Technology

Applications in Vocational Rehabilitation Grant # H133E200002-95.

Anthony J. Langton

Center for Rehabilitation Technology Services

South Carolina Vocational Rehabilitation Department

1410-C Boston Avenue

West Columbia, SC 29170

Indications from JAN are that employers report that accommodations have allowed them to

retain or hire qualified workers

The feasibility of asking employers to routinely report more detailed information is admittedly

questionable.

If significant discrepancies in cost estimates were found however it would be an indication that

further investigation should be completed.

Comparison with cost analysis data from the Job Accommodation Network yielded very similar

cost figures.

It would be useful to know if rehabilitation engineers or other rehabilitation technology

specialists were involved in the accommodations reported in the JAN data. A result of the

American's with Disability Act (ADA) is that many employers have realized that they are

responsible to make reasonable accommodations in their employment practices. In many cases

this involves using existing human resource or existing technical support staff to recommend and

implement many of the accommodations. This situation, while being a very positive

development, makes in difficult to determine the role of the rehabilitation technology

professional is playing.

Determining actual benefit that will be realized from a work site accommodation is a complex

and involved undertaking. (need sources/support)

File:Resnapap.96