R-5, Center for Independent Living Services and Their Effect on Community Participation

Comparing the U.S., Japan and South Korea

This research project measures the effectiveness of Center for Independent Living (CIL) services for people with disabilities.

The title of the presentation was "A Comparative Study of the United States, Japan and Korea on CIL Services that Improve Community Participation for People with Disabilities," co-authored by Glen W. White, Craig Ravesloot, Chiaki Gonda Kotani, KyungMee Kim, Shoji Nakanishi, Ahn Ji Hwan, Jeff Gordon and the Consumer Empowered Team.

In the U.S., CIL staff members were surveyed to identify the top 10 most important services for enhancing community participation among consumers.

The procedures used in the U.S. study were replicated in similar studies conducted in Japan and South Korea. The data from these three countries were then used to conduct a comparative study of CIL services in terms of strengths and weaknesses.

Purpose

The U.S. government funds centers for independent living (CILs) to provide four core services for people with disabilities: peer counseling, information and referral, independent living (IL) skills training and advocacy. More recently, de-institutionalization has become a fifth core service.

But there has been little or no empirical evidence that shows how center services affect the community participation of their consumers. This project developed a tool that CILs can use to measure the independent living dimensions of their services.

The tool is a survey that asks CIL staff members to rank the importance of services offered by their organization. (In a second phase of the study, consumers are also surveyed.) With the information provided by this new tool, CILs may choose to enhance their services, modify staff training and tailor programs to help their consumers participate more fully in the community.

Replicating the Research in Asia

In collaboration with disability leaders and researchers in Korea and Japan, we extended the research to both countries. The survey was translated into Korean and Japanese and placed online.

While CIL services and philosophies in the two Asian countries differ in some ways from the U.S. and from each other, the basic elements of the survey applied to all three countries. In the U.S., 420 staff members at 65 CILs took the survey. In Japan, 288 staff at 65 CILs took part, and in Korea, 175 staff from 54 CILs completed the survey.

Lessons Learned

All three countries have similar response patterns in general. The following content categories were viewed as less important by all: employment, mental health, assistive technology, health care and recreation.
While Korea and Japan have emphasized personal assistive services and peer counseling, they also note value in the process dimensions – how the services are delivered – which reflects their core IL philosophy.
In the top 20 items of importance, Japan and Korea CIL staff agreed on the importance of at least one item in each of the U.S. core service areas.

These findings should be interpreted through a cultural, economic and political lens. The intent of this study is not to determine whether one country offers better CIL services than another, but to examine our commonalities.

For more information, contact Glen White, glen@ku.edu; Craig Ravesloot,cravesloot@comcast.net; or the Research and Training Center on Measurement and Interdependence in Community Living at the RTC/IL, 4089 Dole, 1000 Sunnyside Avenue, Lawrence, KS 66045, 785.864.4095 (voice), 785.864.0706 TTY, RTCIL@ku.edu

National Institute on Disability and Rehabilitation Research grant H133B060018

CIL Staff Ratings of Top 5 Services by Importance

USA	South Korea	Japan
1. Provides services in a way that empowers consumers to make their own choices.	1. Provides personal assistant services management training.	1. Provides services in a way that empowers consumers to make their own choices.
2. Advises consumers about benefits they are eligible for (e.g., Medicaid, SS, housing).	2. Helps people with disabilities find the types and amounts of personal assistive services they need.	2. Gives services to help integrate consumers into the community once emancipated from nursing home.
3. Provides services in a way that encourages consumers to advocate for their own rights.	3. Provides competent, confidential and respectful peer counseling services.	3. Provides nursing home emancipation services.
4. Works for the rights of people with all types of disabilities/chronic health concerns (e.g., sensory, mental health).	4. Gives services to help integrate consumers into the community once emancipated from a a nursing home.	4. Works for the rights of people with all types of disabilities/chronic health concerns (e.g., sensory, mental health).
5. Uses partnerships with other agencies in the community to help consumers meet IL needs (e.g., transportation providers, housing authority).	5. Provides services in a way that encourages consumers to advocate for their own rights.	5. Helps with decision and policy-making regarding other community services for consumers.