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·	From Theory To Practice

• Introduction
• What was evaluated
• Highlights and Conclusions
• Background
• Methodology

Introduction

The National Vocational Rehabilitation Project (NVRP) is a pilot project to test the potential for assisting beneficiaries of the Canada Pension Plan Disability (CPPD) program to return to work. The NVRP was evaluated to see if it could be expanded and made a permanent part of the CPPD.

What was evaluated

The NVRP evaluation looked at how the program is delivered, how much it costs, its impact on CPPD beneficiaries, and how it might be improved.

Highlights and Conclusions

• The evaluation supports the role of a permanent rehabilitation function within the CPPD. Many CPPD beneficiaries can be rehabilitated and returned to work, and significant cost savings are possible, even when the proportion of participating CPPD clients is small.

The project returned a significant number of CPPD beneficiaries to regular employment. About 42% of NVRP clients - a total of 160 people - successfully completed their rehabilitation plans, and of these, about 60% returned to work. The successful rehabilitation of 160 clients translates into savings of $4.5 million after three years, $15 million after 10 years, and about $30 million by the age of 65, if clients do not return to the disability rolls.

• There is significant potential to expand the CPPD rehabilitation function, although to what extent remains to be investigated.

Indicators that the rehabilitation function could be expanded include stakeholder interviews and NVRP data; a Statistics Canada survey showing that 31% of CPPD beneficiaries felt they could do some kind of work now or in the future, and that 24% were interested in vocational rehabilitation; a finding in the CPPD evaluation that 10% of beneficiaries may benefit from vocational rehabilitation; and past CPPD estimates that 15-25% of beneficiaries aged 20-55 could be rehabilitated.

• More CPPD beneficiaries could benefit from vocational rehabilitation if changes were made to the client selection process to help identify suitable candidates.

Better information gathering and improved screening could help identify potential clients for rehabilitation when they first apply for CPPD. A follow-up system could identify rehabilitation opportunities for clients whose medical condition has stabilized. As well, use of a standardized screening tool could help identify which CPPD clients might benefit from rehabilitation.

• Some CPPD beneficiaries can be rehabilitated even after collecting benefits for several years, once their condition has stabilized. This fact should be considered when selecting candidates for rehabilitation.

Research, expert opinion and stakeholder interviews generally support current client selection criteria, and point to factors such as early identification, age, education, and motivation, as well as benefit levels and receipt of other benefits as “good” predictors of vocational rehabilitation.

Over time, fewer and fewer CPPD beneficiaries report having the potential to return to work. However, the proportion of individuals who say they have some residual capacity to work after several years on CPPD is fairly substantial. These beneficiaries could be identified as suitable candidates for rehabilitation if there were follow-up reviews to assess their potential.

• Stronger incentives could be used to foster client commitment to the program, and to encourage potential participants to undertake rehabilitation.

Integrating rehabilitation within the CPPD will help to change the perception that CPPD is an entitlement for life. CPPD’s information gathering and communications have not focused on rehabilitation principles, or supported a rehabilitation function within the program.

To assist in building client confidence in the rehabilitation process and to encourage participation, rehabilitation measures should be considered which emphasize gradual disengagement from CPPD, where appropriate, and gradual engagement with work. Such measures would build on relationships with other service providers to address broader career goals and to develop stronger links to employment opportunities.

• There are strengths and weaknesses in the third-party delivery system.

This system is flexible in the face of varying demand for service and the need for specialized professional resources. However, the performance of outside contractors has been uneven. Concerns were identified regarding the communication, through a third party, of project goals and policies, and the rationale for NVRP decisions. An appropriate balance should be struck between contracting out and internal service delivery, and the performance of private contractors should be better monitored.

• There is a potential for NVRP to work more closely with other service providers.

More than half the NVRP clients surveyed said they were receiving Workers’ Compensation, private long-term disability insurance, or other similar benefits in addition to CPPD. However, there were few cost-sharing agreements. This is partly because public and private disability insurance programs have different definitions of eligibility and disability.

• If the rehabilitation function is expanded and made a permanent part of the CPPD, it is likely to result in noteworthy cost savings.

Any permanent rehabilitation function within CPPD should be accompanied by some changes:

• include rehabilitation as an underlying goal in the CPPD;


• provide the kind of communication needed to support the rehabilitation process, and to inform beneficiaries of CPPD rehabilitation goals;


• use cost-effective screening and improved information gathering to support on-going reviews of CPPD clients’ rehabilitation potential;


• use stronger incentives to encourage committed participation in rehabilitation; and,


• make more effort to co-ordinate CPPD rehabilitation activities with those of other service providers, and to negotiate partnership agreements.

Background

Canada Pension Plan (CPP) provides disability benefits to contributors whose severe and prolonged mental or physical disabilities prevent them from pursuing any substantially gainful employment. The CPP has the legislative authority to operate rehabilitation programs to assist these clients to regain the capacity to work. The NVRP reflects a growing interest in vocational rehabilitation among CPP administrators, private disability insurers, and advocates for disabled persons. It also addresses concerns about a growing number of disability claims.

Following a screening process, CPPD beneficiaries who are identified as having potential for rehabilitation may consent to participate. Rehabilitation services are contracted through private consultants across Canada. The quality of their services is monitored by the CPP.

Clients continue to receive their CPPD benefits and after completing rehabilitation, may have a three-month job search or trial work period. Once the regained capacity is confirmed, CPPD benefits cease. As of March 31, 1996, 623 CPPD beneficiaries had participated, or were still participating in the NVRP. Of these, 160 had successfully completed their rehabilitation plans and were no longer receiving CPPD benefits.

Methodology

The NVRP evaluation is based on a survey of NVRP clients, interviews with key stakeholders, a review of administrative data and literature, and two focus groups with HRDC staff and other representatives from the rehabilitation field.