CF Social Worker Nemours Children's Health Jacksonville, Florida, United States
Background: Cystic fibrosis and its employment corollaries have received little attention despite the fact that complications of CF represent numerous theorized barriers to optimal career outcomes. It is only recently that individuals with CF have been considered viable candidates for vocational rehabilitation (VR) services and only a small number are referred or receiving VR services nationwide. Mortality in CF is improving significantly with the advent of highly effective modulator therapies; nevertheless, it can significantly interfere with labor market participation and career development. Moreover, there is a higher rate of unemployment among individuals with CF compared to the general population.
Methods: State VR departments collect and report summary data in a federally mandated format called the Rehabilitation Services Administration (RSA) Case Service Report, known as the RSA-911. Data for 372 adults with CF was extracted from the Rehabilitation Services Administration’s Case Service Report (RSA-911) database for fiscal years 2018-2020 to predict employment outcomes of individuals with CF. Binary logistic regression analysis was utilized to investigate predictors of successful employment outcomes.
Results: Of the 372 previously unemployed people with CF who received VR services, 139 (37%) achieved successful employment outcomes. Gender, race, age, and significance of disability were not found to be significant predictors of employment outcomes. Only vocational rehabilitation service variables were found to be significantly related to achieving positive employment outcomes. Individuals receiving eight specific VR services (assessment, diagnosis and treatment of impairments, benefits counseling, short term job supports, job placement assistance, job search assistance, job readiness training, counseling and guidance) of the 28 available were more likely to obtain employment.
Conclusions: Individuals with CF may benefit from the assistance of state Vocational Rehabilitation (VR) agencies to achieve their employment goals. Since some individuals with CF might be at higher risk for unemployment over time, state VR agencies can assist people with CF in attaining employment. CF clinic staff should be familiar with the array of VR services. The CF Foundation’s Patient Registry 2020 Annual Data Report specified there were 17,967 adults with CF nevertheless during this same year only 145 were receiving VR services suggesting that many more individuals could be referred.
Acknowledgements: Thank you to the staff of the Rehabilitation Services Administration for their assistance in providing access to the dataset.
