1. Vocational rehabilitation best practices evaluation: qualitative study Nothing to disclose! Aleksandra Tabaj, PhD and Črtomir Bitenc 21 st EUMASS Congress of Insurance Medicine and Social Security and the 4 th International Congress of Medical Assessors in Ljubljana, Slovenia, 9 - 11 June 2016

2. Basis for VR in Slovenia  Slovenian vocational rehabilitation network since 2004.  Ministry of Labour, Family, Social Affairs and Equal Opportunities, Employment service of Slovenia, providers of vocational rehabilitation  Present study was carried out by Development Centre of Vocational rehabilitation at University Rehabilitation Institute as public mandate.  Working group from all slovenian providers of VR and Employment service of Slovenia, cooperated in this study

3. Vocational rehabilitation is a public service and it covers in a network 14 providers, under the Act Vocational rehabilitation is the right of PwD CRPD was ratified in 2008 Assessment process is based on ICF from 2006 (Body Functions), in 2015 we prepared new core set with included Activities and Participation, Environmental Factors Standardisation of services was made in 2006. Employment rehabilitation is provided through fourteen services. Other conditions - accessibility, respect of needs, ethical codes) are also addressed. Every provider works with employers - has network of employers, there they can train PwD, do worktrials etc.

5. Methods  Retrospective qualitative cohort study 2010-2014: “Best practices evaluation in vocational rehabilitation”, population 5.321 persons, was carried out in 2014 in Slovenia  Specific questionnaire for VR providers/in-depth interviews for PwD, vocational rehabilitation providers, rehabilitation counsellors at Employment Service in Slovenia and employers  11 best practices defined  Criteria: outcomes, changes in characteristics of persons, advancements in employability, employment and quality of life  Statements of PwD, rehabilitation councellors and employers.

6. Why we selected those 11 cases?  PwD entire life wished to have employment in this area (strong proffessional orientation)  PWD had many barriers concerning mental health and high level of barriers in ability to work and occupational interest, but also in her private life due to TBI (several disabilities)  Highly motivated PwD: high benefits from insurance didn‘t prevent him to be in VR (high motivation)  At the begginning very low motivation, able to work 4 hours, receiving pension 4 hours, not able to get benefits from VR. Employer needed PwD for 4 hours (part time employment)  PwD unemployed 1 year, slowly making progress, received 3 offers for employment and chose the best for her where she felt safe (options).  Extremely high development of employability, at the start not able to be employed (employability)

7.  At the begginning socially isolated PwD, during rehabilitation increased social network as advancement of his social skills (social inclusion)  Traumatic event during rehabilitation could prevent VR, but due to inter institutions cooperation was VR successfully finished with employment (interinstitutions connection)  PwD had education, motivation, social competences, functional literacy, but couldn’t get employment. With VR this was possible (missing link)  Quick solution in searching employment: no work experience, low self esteem, low social skills. Besides employment and better self esteem and social skills also better quality of life was achieved (quality of life).  Pwd (blind) employed in public sector (severe disability, adaptation of workplace as still rare option in Slovenia)

8. Persons with disabilities  exposed relevant information at the beggining of the vocational rehabilitation process as one of the major concerns, which help them in cases that they were afraid of new engagement.  Training experience gave them better view on their abilities, enable gathering new knowledge and upgraded their skills, with constant support of professional workers  Motivation – financial as barrier – PwD with benefits from insurance are not eligible for benefits from VR

9. Employment counsellors  exposed regular contacts and monitoring the rehabilitees and professional workers as the key factor for successful outcomes. In practice this means regular month contacts.  In best practices it was observed that the key feature was also longer vocational processes, which enabled cooperation with stakeholders.  The quality of contacts between Employment service and providers enabled trust and innovative solutions with career orientation and active labour market policy measures

10. Employers  as the main reasons for success exposed rehabilitee‘s positive attitudes, potentials, ability to learn, talents, their professional attitudes and concerns.  It was very interesting that that spoke of good impact on the organizational culture, when rehabilitees were trained and employed.

11. Providers of vocational rehabilitation  exposed rehabilitees high level of motivation, social skills, ability to learn, adequate work habits, good personal attitudes, abilities for work in adapted work environment etc. as facilitators in the process of training and employment.

12. Conclusions  Almost all studied cases were connected with the employment outcome (10), which was successful regardless of barriers of disability. Not only employment counts!  Mainly (7) they were in supported employment. Positive changes in education, work experiences, social network, and support were found out.  Of highest importance was high motivation and successful social inclusion. In many times motivation was the main driving factor.

13. References Mreža izvajalcev zaposlitvene rehabilitacije od 2010 do 2013 (2010) Ministrstvo za delo, družino, socialne zadeve in enake možnosti Mreža izvajalcev zaposlitvene rehabilitacije od 2014 do 2020 (2014) Ministrstvo za delo, družino, socialne zadeve in enake možnosti Večletna evalvacija zaposlovanja invalidov (2014) Univerzitetni rehabilitacijski inštitut Republike Slovenije Zakon o zaposlitveni rehabilitaciji in zaposlovanju invalidov Uradni list RS, št. 16/07, 87/11 in 96/12 Zavod Republike Slovenije za zaposlovanje (2014) Podatki o vključitvah v zaposlitveno rehabilitacijo

14. Thank you for your attention! Contact: aleksandra.tabaj@ir-rs.si