Contents

Accommodating Students with Disabilities Training to be Health Providers

Health Sciences Faculty Education Project - Tools for faculty to help effectively teach their increasingly diverse student population, particularly students with disabilities. Faculty members playan important role in providing for our country's health care system: To produce highly trained and qualified professionals in each of the health science disciplines. The Health Science Faculty Education Project assists faculty to provide the most effective instruction for each student's unique needs and strengths.

Advocacy

Advocacy Links and Resources - Organizations as well as advocacy related books and other materials.

CPB/WGBH National Center for Accessible Media (NCAM) - A research and development facility that works to make media accessible to underserved populations such as people with disabilities, minority-language users, and people with low literacy skills.

Families USA: The Voice of Health Care Consumers - A national nonprofit organization which advocates high-quality, affordable health and long term care for all Americans. Families USA works at the national, state and grassroots levels with organizations and individuals to help them participate constructively in shaping health care policies in the public and private sectors. The organization issues reports and analyses, and works extensively through a variety of media to educate the public, opinion leaders and policy makers about problems consumers experience in the health care marketplace and what should be done to solve them.

The site includes information on many health-related advocacy resources:

Health Access - A statewide California consumer coalition of over 215 groups including religious organizations, seniors groups, organizations representing people of color, consumer advocacy groups, community organizations and unions, all united around a campaign to achieve affordable health care for all Californians.

Protection and Advocacy, Inc. (PAI) - Provides legal assistance to people with disabilities, including physical, developmental and psychiatric disabilities.

The Robert Wood Johnson Foundation - Based in Princeton, New Jersey, is the nation's largest philanthropy devoted exclusively to health and health care. It became a national institution in 1972 with receipt of a bequest from the industrialist whose name it bears, and has since made more than $2 billion in grants.

The Foundation concentrates its grantmaking in three goal areas:

Site Information includes:

Aging

Aging with Disability Resources

National Resource Center for Safe Aging - Promoting safe and healthy aging and applies state-of-the-art technology to increase awareness, and to collect, organize, and evaluate information about preventing unintentional injuries among older Americans.

Americans with Disabilities Act (ADA) Compliance

"Checklist for Existing Facilities version 2.1" -- The Americans with Disabilities Act for Readily Achievable Barrier Removal, August, 1995, 15 p. (Adaptive Environments Center, Inc., Barrier Free Environments, Inc., National Institute on Disability and Rehabilitation Research.)
The standard document for examining existing buildings and facilities for accessibility to people with disabilities, in compliance with Federal law, The Americans with Disabilities Act. Explains the purpose of the checklist, technical requirements, what this checklist can do and what it cannot do, and how to use it. Helpful format lists questions on the left hand side of each page and possible solutions on the right - easy to read, complete and follow, in priority order of:

Your Guide to the Americans with Disabilities Act Guides: Medical Offices Access, No. 24-280 BEUIOOI192, Council of Better Business Bureaus' Foundation - It contains suggestions for readily achievable--cheap and easy--methods for removing architectural barriers; methods for achieving effective communication; and guidance for determining whether your policies or procedures might exclude some people with disabilities.

Pacific Disability and Business Technical Assistance Center - Information and publications about the Americans with Disabilities Act.

ADA Information Line - provides information and free publications about the requirements of the ADA including the ADA Standards for Accessible Design. 800-514-0301 (voice) 800-514-0383 (TTY)

ADA Questions and Answers for Health Care Providers

ADA Regulations and Technical Assistance Materials - from the U.S. Department of Justice

ADA Settlement Agreement between US and Advocate Ravenswood Hospital and Medical Center - from the U.S. Department of Justice

ADA Settlement Agreement between US and Davis Hospital and Medical Center - from the U.S. Department of Justice

ADA Settlement Agreement between US and St. Luke's Hospital and Health Network - from the U.S. Department of Justice

Checklist for Readily Achievable Barrier Removal - Easy-to-use survey tool helps users to identify barriers in their facilities. The completed checklists and work sheets are the kind of documentation that organizations should keep on file to demonstrate that they are making a good faith effort to comply with the requirements of the ADA. Available for download in both a PDF version and a plain text version. 1995.

Consent Decree DeVinney and United States of America vs. Maine Medical Center - from the U.S. Department of Justice

Obligations of Hospitals and Nursing Homes to Provide Interpreters and Auxiliary Aids for Deaf and Hard of Hearing Patients - Note: this is a PDF file.

The U.S. Access Board - (Architectural and Transportation Barriers Compliance Board) is a federal agency which develops minimum guidelines and requirements for standards issued under the Americans with Disabilities Act (ADA) and the Architectural Barriers Act (ABA); develops accessibility guidelines for telecommunications equipment and customer premises equipment under the Telecommunications Act; develops accessibility standards for electronic and information technology under Section 508 of the Rehabilitation Act; provides technical assistance on those guidelines and standards; and enforces the Architectural Barriers Act. The Board was created under Section 502 of the Rehabilitation Act of 1973 to enforce the Architectural Barriers Act. The Board also has responsibilities under the Americans with Disabilities Act, the Telecommunications Act of 1996 and Section 508 of the Rehabilitation Act. The site includes:

U.S. Department of Justice's Americans with Disabilities Act - ADA Home Page

Communication Access

"A Guide to Planning Accessible Meetings," Kailes & Jones, ILRU, 1993. - Covers how to: plan accessible meetings which meet the standards and intent of Americans Disability Act; avoid embarrassing and illegal mistakes; create a meeting environment is friendly and accessible to all users; conduct site surveys; negotiate contracts with meeting facilities; offer communication, physical and visual/print material access; communicate about disability issues without offending people with disabilities; use accessibility symbols and signs; how to assess a meeting environment for potential "triggers" of Environmental Illness; and more.

Are Doctors Required to Provide Interpreters for Medical Visits and Other Medical-Related Situations? - from the National Association for the Deaf

Braille Works- Provides Braille, Large Print and Audio Cassette reading materials for the 17.6 million people with visual impairments in the United States today. 800.258.7544.

Brailling Materials - National Braille Press
88 St. Stephen Street
Boston, MA 02115
(617) 266-6160 (VOICE)
(617) 437-0456 (FAX)

Employers may obtain information on how to get publications, employment applications, etc. in alternate format for people with visual disabilities.

Caption Center Online, "Making Meetings Accessible".

Consent Decree Regarding Health Care Services to People who are Deaf and Hard of Hearing (Connecticut Association of the Deaf and United States of America vs. Middlesex Memorial Hospital) - covers hospitals' responsibilities to the deaf under the ADA

Creating easy to read print materials your audience will want to read and use - Scientific and Technical Information Simply Put - Office of Communication, CDC, 8/99. Note: this is a 2.8MB PDF file.

"Effective Color Contrast: Designing for People with Partial Sight and Color Deficiencies," Arditi, Aries, Lighthouse International. 1999. - Covers principles of designing effective color contrast for people with partial sight or congenital color deficiencies.

Hospitals Responsibilities to the Deaf under the ADA

Interpreters - Obtaining Sign Language Interpreters
Registry of Interpreters for the Deaf
8719 Colesville Road, Suite 935
Silver Spring, MD 20910
(301) 608-0050 (VOICE/TDD/TTY)
(301) 608-0508 (FAX)

"Making Text Legible: Designing for People with Partial Sight," Arditi, Aries, Lighthouse International. 1999. - Covers maximizing legibility for people with partial sight.

Media & Disability Interest Group - Promotes academic research into disability issues and mass media. This includes issues related to portrayals, hiring practices, technology, civil rights, etc. Promotes architectural, communication, and attitudinal accessibility for people with disabilities at AEJMC annual meetings and all AEJMC activities. Promotes equal treatment and the necessary accommodation for students and professors with disabilities in university settings as outlined in the 1990 Americans with Disabilities Act. Appropriate accommodation can mean an enhanced learning environment for both students and faculty.

National Center on Disability and Journalism

Questions about Captioning, Caption Center Online, "FAQs - Frequently Asked Questions"

Speech to Speech (STS) News - A service offered in eight states by the state's Relay Service. Speech to Speech Relay enables people with speech disabilities who have great difficulty communicating by telephone, to use a telephone, and their own voice, voice synthesizer, voice enhancer, or electrolarynx.

Text Telephones, Using a TTY- Covers what are they, why and when are text telephones required.

Translating Materials for Non-English Speaking Audiences

Telecommunications device for the deaf - includes receiving and concluding a call, making a call, additional information, and common terminology.

How to Write Easy-to-Read Health Materials - Provides basics to help write easy-to-read materials. Writing in an easy-to-read manner is a skill. It takes years of experience to make it part of everyday writing habits. Brief gives some background information and "tricks of the trade".

Web Site Accessibility

Designing Accessible Web Sites -Booklet on creating sites that are accessible to people with disabilities. Topics include

W3C Web Accessibility Initiative (WAI)- from the consortium that maintains the World Wide Web's standards.

Assistive Technology

ABLEDATA - Provides information on assistive technology and rehabilitation equipment available from domestic and international sources. Its database contains:

AbilityNet - Assistive technology resources.

Augmentative and Alternative Communication Rehabilitation Engineering Research Center - Improves technologies that furthers the development of communication, language, natural speech, discourse skills, and literacy of people with significant communication disorders.

California Assistive Technology Systems (CATS) - A statewide project which promotes access to assistive technologies, related services, and information that enable people with disabilities to be successful, independent and productive.

Center for Applied Rehabilitation Technology (CART) - Addresses the technology needs of people with disabilities from a team approach.

Community Technology Centers' Network (CTCNet) - A network of more than 300 community technology centers where people get access to computers and computer-related technology, such as the Internet.

Equal Access to Software and Information (EASI) - A resource to the education community by providing information and guidance in the area of access-to-information technologies by individuals with disabilities.

High Tech Center Training Unit of the California Community Colleges - A state-of-the-art training and support facility for community college faculty wishing to acquire or improve teaching skills, methodologies, and pedagogy in Assistive and Instructional Computer Technology. The Center supports Assistive Computer Technology programs at 114 California community colleges. More than 7,000 students with disabilities are currently enrolled in High Tech Center programs statewide. This training unit carries out extensive research, testing and evaluation of new and emerging technologies of potential benefit to persons with disabilities.

RESNA - An interdisciplinary association for the advancement of rehabilitation and assistive technologies.

The Computer Access Center - Assist children and adults with disabilities in leading independent and productive lives by providing access to enabling technology.

This Los Angeles Center provides:

Trace Research & Development Center - A research, development and resource center on technology and disability.

WebABLE - Promotes the interests of adaptive, assistive and access technology researchers, users and manufacturers.

Disability .com, .net, .org Sites

Cripworld

Disability Mall

Disability Resources on the Internet

Enabled Online

iCan

The Boulevard

Disability-Related Consumer Organizations

AG Bell Association - "Empowers hearing impaired individuals to function independently by promoting universal rights and opportunities to learn to use, maintain and improve all aspects of their verbal communication, including their abilities to speak, speechread, use residual hearing and process both spoken and written language."

American Foundation for the Blind - A information and referral resource for people who are blind or visually impaired, the organizations and individuals that serve them, and the general public. Serves as a national advocate representing the interests of blind and visually impaired people before Congress and government agencies.

Independent Living Resources - Links to: state associations, statewide independent living councils, state-by-state and international listing of independent living centers with web sites. The site also includes resources on such topics as independent living and traditional paradigms; an orientation to independent living centers; and language issues such as You and I, Time to Get Rid of "Special"?

National Association of the Deaf - "Safeguards the accessibility and civil rights of 28 million deaf and hard of hearing Americans in a variety of areas including education, employment, health care and social services, and telecommunications." 51 state association affiliates, sponsoring and organizational affiliates, and direct members.

Programs and activities include:

National Federation of the Blind - (NFB) has affiliates in 50 fifty states plus Washington D.C. and Puerto Rico. Consumer and advocacy organization which "helps people who are blind achieve self-confidence and self-respect and to act as a vehicle for collective self-expression by the blind. By providing public education about blindness, information and referral services, scholarships, literature and publications about blindness, aids and appliances and other adaptive equipment for the blind, advocacy services and protection of civil rights, Job Opportunities for the Blind, development and evaluation of technology, and support for blind persons and their families, members of the NFB strive to educate the public that the blind are normal individuals who can compete on terms of equality."

Self Help for Hard of Hearing People - Self Help for Hard of Hearing People, Inc., a consumer, educational organization devoted to the welfare and interests of those who cannot hear well, their relatives and friends. SHHH has 12,000 National members and 9,000 chapter members in all 50 states. It acts as a "catalysts that make mainstream society more accessible to people who are hard of hearing. We strive to improve the quality of hard of hearing people's lives through education, advocacy and self help."

Disability-Related Publications

Advance for Occupational Therapy Practitioners - A weekly publication that provides up-to-date information on new occupational therapy products and techniques.

Disability Periodicals - News in a variety of disability and assisted technology issues. Links to disability-related magazines, e-zines and journals for people interested in disability issues.

Hearing Health - A bimonthly magazine designed for people who experience any degree of hearing loss, tinnitus or other hearing conditions.

Inside View - A quarterly newsletter dedicated to traumatic brain injury issues published by the Centre for Neuro Skills.

Journal of Visual Impairment and Blindness - An international, interdisciplinary journal of record on blindness and visual impairment from the American Foundation for the Blind. The Journal publishes scholarship and information and serves as a forum for the exchange of ideas, airing of controversies and discussion of issues. This monthly publication includes research articles, as well as shorter pieces of interest to practitioners and extensive news coverage about the field of visual impairment. The tables of contents are available on-line, but only a few articles can be viewed on the Web. Each issue includes a product evaluation section. Click here to see a listing of product evaluation articles.

Learning Disabilities - Covers understanding the issues, education options, medications, sources of information and support.

Topics in Spinal Cord Injury Rehabilitation - A quarterly journal that puts rehabilitation professionals in touch with the latest concepts and techniques used by many disciplines. From the linked page, you can view abstracts of the articles from past issues; full articles are not available on-line.

Disaster Preparedness for People with Disabilities

Disaster Preparedness for People with Disabilities - Includes "Tip Sheets" [English and Spanish] on earthquake safety, but have significant applicability for all types of disaster preparedness for people with disabilities [power outages, fires, floods, hurricanes, nuclear power plant accidents, tornados, tsunamis, volcanoes, winter storms and very cold or very hot weather]; tips cover: collecting emergency documents; creating an emergency health information card; specific issues for people who: use life support systems, service animals or are pet owners, are hearing impaired and people with mobility, visual, hearing, cognitive, psychiatric, communication and speech environmental illness or chemical sensitivities disabilities; and more.

Educating Health Professionals on Disability Issues

A Provider's Guide for the Care of Women with Physical Disabilities & Chronic Medical Conditions

Adjustment to Blindness And Visual Impairment - devoted to changing what it means to be blind through the promotion of the human potential to successfully adjust to and live with blindness and visual impairment.

Americans with Disabilities Act Information for Persons with Disabilities

Access to Public and Private Health Care Sources - publication # 011628

Answers to Questions Most Commonly Asked by Health Care Providers - publication # 011627

Both publications developed and available from:
The National Rehabilitation Hospital's
ADA Compliance Program
102 Irving Street, N.W.
Washington, DC 20010
(202) 877-1498 (Voice)
(202) 726-3996 (TDD)
(202) 723-0628 ( Fax)

Developmental Disabilities: Resources of Health Care Providers - Site strives to improve the health of persons with developmental disabilities in California by educating physicians and other healthcare providers about caring for this population. Designed to support persons with developmental disabilities and their families in making informed health care decisions.

Enhancing Medical Students' Knowledge about Those Who Live With Disabilities. "Both the research literature and our surveys among disabled individuals point to two key gaps in the medical care of severely disabled individuals. The first centers on physicians who withhold medical and rehabilitative services because of personal biases or misinformation. The second arises from health care providers who lack awareness of underlying causes that have a persistent influence on the health and wellbeing of severely disabled individuals. In both cases, the end result is that people with disabilities, particularly the severely disabled, often do not receive adequate care or important information to make informed decisions to guide their care and live independently."

Media & Disability Interest Group - Promotes academic research into disability issues and mass media. This includes issues related to portrayals, hiring practices, technology, civil rights, etc. Promotes architectural, communication, and attitudinal accessibility for people with disabilities at AEJMC annual meetings and all AEJMC activities. Promotes equal treatment and the necessary accommodation for students and professors with disabilities in university settings as outlined in the 1990 Americans with Disabilities Act. Appropriate accommodation can mean an enhanced learning environment for both students and faculty.

Partners in Health Care: Women with Disabilities & Their Health Care Providers

Removing Barriers to Health Care: A Guide for Health Professionals

Why Assisted Suicide Must Not Be Legalized by Marilyn Golden, Executive Committee, California Disability Alliance

Hearing

House Ear Institute/House Ear Clinic

National Institute on Deafness and Other Communication Disorders

Oregon Hearing Research Center and Tinnitus Clinic

Welcoming People with disabilities

Attitudinal Barriers - Note: this is a PDF file

Communicating With And About People with Disabilities

Dispelling Myths About the Americans with Disabilities Act

Diversity and Disabilities

Customers with Disabilities means Business

Myths and Facts About People with Disabilities

Employment Resources

California Department of Rehabilitation - Assists Californians with disabilities in obtaining and retaining employment and maximizing their ability to live independently in their communities.

Job Accommodation Network (JAN) - An information and referral service on job accommodations for people with disabilities; on the employment provisions of the Americans with Disabilities Act; and on resources for technical assistance, funding, education, and services related to the employment of people with disabilities.

JAN's work helps:

JobAccess - assists people with disabilities by providing a dedicated system for finding employment.

General Resources

Accessible Exam Table

Center for Universal Design - A national research, information, and technical assistance center that evaluates, develops and promotes accessible and universal design in buildings and related products. Information is provided in a variety of ways to ensure access.

DIMENET Independent Living Library - Resource materials developed by staff at independent living centers and other organizations involved in the independent living and disability rights movement. Most documents can be downloaded at no cost.

DRM Regional Resource Directory features thousands of disability-related local agencies and organizations, arranged by state and subdivided by topic.

Innovation Network, Inc. (InnoNet) is a 501(c) 3 organization that works toward enabling public and nonprofit organizations to better plan, execute, and evaluate their structure, operations, and services.

Merck Manual of Diagnosis and Therapy

Nursing Homes - Freedom Clearinghouse focuses on keeping people out of nursing home and living in the community with the resources they need -

Nutrition - Tufts University Nutrition Navigator is designed to help you sort through the large volume of nutrition information on the Internet and find accurate, useful nutrition information.

Office of Minority Health (OMH) - The OMH works to to improve and protect the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities.

Service Animal/Service Dog Bibliography

www.disAbility.gov - Gateway to the federal government's disability-related information and resources. This easy-to-use Web portal is a directory of government Web links relevant to people with disabilities, their families, employers, service providers and other community members. 

Health Care

Health, Wellness and Aging with Disability - Information on, and links to, health, wellness and aging with disability, including cerebral palsy, conferences, developmental disabilities, exercise, health information online, managed care, polio, spinal cord injury, and women's issues.

Access to Health Services

"Disability and Access to Health and Support Services Among California's Immigrant Populations" - UCLA Center for Health Policy Research, January, 2000, 66 p. A.E. "Ted" Benjamin, Ph.D., Steven P. Wallace, Ph.D., Valentine Villa, Ph.D., and Kathy McCarthy, R.N., M.S.P.H.

An academic paper, helpful to policy makers, explores both published and anecdotal information about immigrant populations with disabilities and their access to health care or support services. California's immigrant population is 26% of the state; mostly Latino and Asian. Review of existing search includes:

Report measures the level of disability among U.S. immigrants and to assess the disabled population's use of medical and supportive services. Researchers use data from National Health Interview Survey supplements (1994), comparing immigrant population statistics to native-born populations generally, native-born Californians, and California immigrants to U.S. immigrants. This analysis can be helpful to advocates and policy-makers working to increase health and access to services for immigrant populations with disabilities and to refute claims that immigrants place an extra burden on U.S. health care systems.

"Accommodating Adult Patients with Disabilities" - LookSmart On-line article, Illinois Nurses Association, Mar/Apr, 2004, 5 p. Arleen D. Fearing, R.N., Ed.D.

A brief article about the health care needs of people with disabilities with a noted attention to individuals with sensory impairments, this article is directed primarily at nurses. It covers:

Good as a handout to generate discussion among health care professionals in training or still in a school setting.

Removing Barriers to Health Care: A Guide for Health Professionals, RBHC.12.98, 1998, 17 pp. - This booklet provides guidelines and recommendations to help health care professionals ensure equal use of the facility and services by all their patients. This guide gives health care providers a better understanding of how to improve both the physical environment and personal interactions with patients with disabilities.

Benefits

"Managed Care for People with Disabilities: Designing the Benefit Package" - Carol Tobias, Medicaid Working Group, March, 1998, 22 p.
A Publication of The Robert Wood Johnson Foundation's Medicaid Managed Care Program for the Center for Health Care Strategies, Inc., Princeton, New Jersey

A good explanation of why the design of a managed care Medicaid-funded benefits package must take into account flexibility and complexities when offered to people with disabilities. Report examines the options for designing a benefit package and lessons learned about the impact of different decisions by different states. It also discusses opportunities available through managed care that are more creative than what can be offered in fee-for-service systems. Notable additions required by people with disabilities or chronic conditions are: less or no limits on duration and scopes of services, particularly outpatient and community-based services; differences in where care is provided; access to durable medical equipment or assistive technologies. Covered by sections:

Care Coordination

"Case Management in Long Term Care Integration: An Overview of Current Programs and Evaluations" - California Center for Long-Term Care Integration, November, 2001, 94 p.
Andrew E. Scharlach, Ph.D., Nancy Giunta, M.A., and Kelly Mills -Dick, M.S.W., University of California, Berkeley, Center for the Advanced Study of Aging Services, 120 Haviland Hall #7400, Berkeley, CA 94720-7400, (510) 642-3285

The purpose of this paper is to provide a framework for California state and counties engaged in long-term care integration work (Assembly Bill 1040, 1995). Emphasizing a spectrum from "care coordination" for persons who are least vulnerable yet need supportive services to "case management" for those who are most vulnerable and need significant types of intensive services, the authors review:

The narrative is accompanied by tables, conclusions, and references.

"Case Management in Long Term Care Integration Programs" - Power point presentation consisting of 47 slides [undated]
Terri Taylor, R.R.T./R.N., M.B.A., M.H.A., Nurse Consultant II, Department of Health Services, Office of Long Term Care

This presentation bullets definitions and features of six case management in long-term care integration programs - Texas, Arizona, Minnesota, Wisconsin, PACE and California. Flow charts are used to demonstrate different models. Also covered: roles and responsibilities of the case manager in all six systems, eligibility, types of services offered, assessment levels, steps which need to be taken, and problems that often surface.

"Coordination of Care for Persons with Disabilities Enrolled in Medicaid Managed Care: A Conceptual Framework to Guide the Development of Measures" - US Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long Term Care Policy, December, 2000, 33 p.
Shoshanna Sofaer, Dr.P.H., Barbara Kreling, Martha Carmel M.S.P.H., of Baruch School of Public Affairs

The purpose of this grant-funded report is to develop measures of care coordination which are both feasible and meaningful in assessing the performance of Medicaid-funded managed care organizations serving people with disabilities. The conceptual framework developed here clarifies the meaning of "care coordination" using an extensive review of literature and interviews with experts in health care systems' measurements, clinicians, and people who have studied related fields. Questions answered are:

Six pages of resources are cited after the paper's conclusion.

"Financing Health Care for Women with Disabilities" - RAND White Paper, 2003, 9 p.
Prepared by Janice Blanchard & Susan Hosek for the FISA Foundation

FISA Foundation (Pittsburgh, PA) commissioned RAND to assess what is known about the key financial issues affecting access to appropriate primary health care for women with disabilities and to recommend strategies for effectively addressing these issues. Using literature review and interviews with women who have disabilities, policymakers, physicians, insurers, and representatives from coordinated care plans, the authors make recommendations for national, state, and local policymakers seeking to eliminate health disparities and improve the quality of care for women with disabilities. Includes:

"Fully integrated care for frail elderly: Two American models" - International Journal of Integrated Care, November, 2000, 29 p.
Dennis L. Kodner, Ph.D., Senior Vice President, Knowledge and Innovation, Metropolitan Jewish Health System & Executive Director, Institute for Applied Gerontology, Tel 718.630.2550; Fax 718.630.2559; Email: dkodner@mjhs.org, and Corinne Kay Kyriacou, Ph.D., Director of Research, Institute for Applied Gerontology

Article examines "so-called 'fully integrated' models of care in detail," using two American programs - "the social health maintenance organization" and "the program of all-inclusive care for the elderly." Theory is that fully integrated care and other organizational models lack a meaningful analytical paradigm against which they can be measured. Data about the two programs was gathered, analyzed and literature was reviewed. After defining key terms, the authors detail desired features of an integrated care program, the two American programs studied, and compare them, using narrative and tables. Two brief case studies are described with lessons learned from each. The paper concludes with recommendations and lengthy list of resources, autobiographical notes, useful links and extensive footnotes.

Cost and Finances

"Adults with Disabilities in Medi-Cal Managed Care: Utilization and Expenditure Trends 1995-2001" - Medi-Cal Policy Institute, Prepared by Todd Gilmer, Ph.D., University of California San Diego
June, 2003, 17 p.

The report details Medi-Cal beneficiaries with disabilities who were served between 1995 and 2001, comparing two groups using their demographics, disease conditions, service use, and expenditures. The two groups used were individuals eligible for Medi-Cal because of their eligibility for TANF (Temporary Assistance for Needy Families, or CalWORK in California) and beneficiaries age 65 and over. Attractive publication with full color charts and graphs.

"Final Budget Summary 2005-06, Health and Human Services Agency" - California Department of Finance, 719 p.

This is the state budget for California from the Budget Act of 2005. Appropriations reduced or eliminated by the Governor are shown in strike-out type. Appropriations shown in italics incorporate the Governor's veto actions. Technical corrections are shown in strike-out type followed by underscored type. Errors in the Budget Act are corrected in this publication. Considerable page-flipping is needed to find the Health and Human Services Agency budget pages. Must be financial-savvy to understand this document.

"Improving Health-based payment for Medicaid Recipients: CDPS" - Health Care Financing Review Volume 21, No 3: 29-64, Spring, 2000, 35 p.
Richard Kronick, Ph.D., Todd Gilver, Ph.D., Tony Dreyfus, M.C.P., and Lora Lee, M.S.

"This article describes the Chronic Illness and Disability Payment System (CDPS), a diagnostic classification system that Medicaid programs can use to make health-based capitated payments for TANF (Temporary Assistance for Needy Families) and disabled Medicaid beneficiaries. The authors describe the diversity of diagnoses and different burdens of illness among disabled and AFDC (Aid to Families with Dependent Children) Medicaid beneficiaries. Claims from seven states are analyzed.... The authors also compare the taxonomy and statistical performance of CDPS to other leading diagnostic classification systems, finding the new model performs better in a number of respects." Article includes charts, graphs, tables, a brief list of references. Concludes with a set of payment weights states can use and diagnostic profiles of SSI and AFDC beneficiaries; believes they have proven that the CDPS model is better than others examined. This article is highly technical, written for health care finance analysts and similar professionals.

"Medi-Cal Expenditures: Historical Growth and Long Term Forecasts" - Public Policy Institute of California, June, 2005, 90 p.
Thomas MaCurdy, Raymond Chan, Rodney Chun, Hans Johnson, and Margaret O'Brien-Strain

California's Medicaid program (Medi-Cal) has increased by a third in real terms over the last five years. Assuming rapid growth in the program may continue, this paper answers the following questions by forecasting expected costs of Medi-Cal through 2015:

The approach used here counts costs in the year services were provided, NOT the year claims are paid (which the state Department of Health Services uses), so figures and forecasts are not comparable in those terms. This report also does not forecast for the near term (2004 through 2008). Includes enrollment figures, costs per enrollee, graphs, charts, tables, description of data sources, references and forecasting methodology.

"The Impact of California's Fiscal Crisis on Medi-Cal Health Plans" - California HealthCare Foundation, Medi-Cal Policy Institute, September, 2003, 64 p.
Branch McNeal, C.P.A., Sundee Easter, M.B.A., Kate Goergen, Rick Potter, C.P.A., and Steven Schramm, Mercer Government Human Services Consulting

The goal of the study was to examine the current fiscal status of Medi-Cal participating health plans, determine their on-going financial viability, provide insights to policymakers faced with tough budget decisions, and make recommendations using a 2000 study by Laguna Research Associates as a benchmark. Both national and state financial data were used for analysis and projection. Mercer concluded that:

Data and Statistics

"A Researcher's Guide to Medi-Cal Data" - Medical Care Statistics Section, California Department of Health Services, rev. November, 2005, 44 p.
Jim Klein

This is a guide for those performing research using Medi-Cal fee-for-service paid claims and managed care encounter data. Includes narrative, charts, samples and graphs. Manuals for claims and data mentioned in this guide are available through the state agency's website (http://www.dhs.ca.gov/mcss).

Covered are:

Appendices include Medi-Cal description and expenditures/eligibles sources; detail of lag factors for eligibility retroactivity, and the fee-for-service claims file.

Durable Medical Equipment and Assistive Devices

"Assistive Technology Fact Sheet" - US Department of Health and Human Services, Administration on Aging, August, 2003, 4 p.

A brief consumer-directed fact sheet defining assistive technology and giving descriptions of examples. A helpful handout for newcomers to disability and/or aging. Questions answered include:

[May have difficulty gaining access to this web address, but keep trying!]

Education Resources

"A Training Program for Medical Professionals about Improving the Quality of Care for People with Disability and Chronic Illness" (Resource Paper) - Developed by the World Institute on Disability & Center for Health Care Strategies, Kaiser Permanente Foundation, & California Healthcare Foundation, March, 2005, 20 p.

Manual accompanying a training program for medical professionals, including training goals, suggestions for trainers about disability issues, a workshop facilitator's guide with training format options, and a 22 minute video "Access to Medical Care: Adults with Physical Disabilities." The training program uses the video to prompt discussion, engage in case studies, facilitate small group exercises, explain on-line resources, and an evaluation of the training by those who take it. Formats are designed for one, two or three hour workshops. Excellent outline for a brief exposure to disability issues in health care.

Guides for People with Disabilities

Resources on Managed Care for People with Disabilities - Information on and links to such topics as: understanding managed care, how to pick a plan, how to evaluate your current plan, strategies for managing your managed care, what to look for in health care providers, Medicare and Medicaid, advocacy issues and resources, medical information, research projects, complimentary approaches.

Long Term Care

"Health Care Organization and Incentives Under Emerging Models of Elderly Health Care" - Dept. of Health Administration and Policy [no date], 10 p.
David R. Graber, Ph.D., M.P.H. and Anne Osborne Kilpatrick, D.P.A.
Medical University of South Carolina, 171 Ashley Ave., Charleston, SC 29425

Brief article describing existing models of elderly health care that receive capitated payments, including:

The potential significance of these programs for providing financial incentives, comprehensiveness of health care, volume of institutional services, and primary care orientation is analyzed. The three programs are compared with each other in terms of organizational issues, health care issues, and financial systems. A two-page reference list is included at the article's end.

"Improving County Long Term Care Systems to Build Toward Integration" - The California Center for Long Term Care Integration: Final Report, June, 2003, 9 p.
Submitted to the California HealthCare Foundation, CHCF Grant #01-1364

Summary of a two year project designed to support 19 participating counties' efforts towards improving their long-term care systems. The project's work led to drafting California legislation (AB 3054) which would continue an advisory group initiated by the project. This "Options Group" was created out of representatives of these 19 counties, consumers, physicians, community-based organizations, health plans, and agencies along with consultants and experts. A "Technical Advisory Group" was convened to explore systems and integration issues. Conclusions were drawn in an "Options paper," which listed three primary approaches:

"The Olmstead Decision and Long-Term Care in California: Lessons on Services, Access, and Costs from Colorado, Washington, and Wisconsin" - California Health Care Foundation, December, 2003, 46 p.
Eliot Z. Fishman, Ph.D., Bruce C. Vladeck, Ph.D., Ann-Gel S. Palermo, M.P.H., and Margaret H. Davis, M.H.S.

In response to the 1999 Supreme Court decision in Olmstead v. L.C., this comprehensive report details positive programs in California which support the court's findings and goes into more depth about the glaring problems in the state. These problems are:

Ultimately the authors recommend that the state could address these problems by redirecting resources currently spent on institutional care or by drawing federal Medicaid funds more effectively. The narrative includes information about Olmstead, the policy context in California, descriptions of programs for various disability groups; comparison of California's program to similar ones in Colorado, Washington, and Wisconsin. Includes helpful graphs, charts, appendices, and endnotes. Recommendations for policy-makers and advocates are written in detail.

"Understanding Medi-Cal: Long-Term Care" - Medi-Cal Policy Institute, Lucy Streett, M.P.H., September, 2001, 35 p.

This guide presents information about Medi-Cal's long-term care programs. Statistical data - annual unduplicated counts (or average monthly estimates) of participants in California's complex system - are included. Well laid-out with graphs, charts and pictures, the guide answers the following questions:

Especially helpful are the on-line resources and glossary of words used at the end of the guide.

Medi-Cal Managed Care for Seniors and People with Disabilities

"Adults with Disabilities in Medi-Cal Managed Care: Conference Summary" - Medi-Cal Policy Institute, June, 2003, 20 p.
Prepared by Health Systems Research, Inc.

This is a summary of conference proceedings based on discussions in February, 2003. The purpose of the conference was to discuss the possibility of moving more people with disabilities into the California managed care system. Findings from the Medi-Cal Policy Institute were shared and discussed. Participants included policymakers, program administrators, health plan representatives, provider organization representatives, consumer advocates, and researchers. Topics covered in the conference summary:

Appendices included the publications shared and mentioned above, agenda for the conference, and list of participants.

"Adults with Disabilities in Medi-Cal: The Beneficiary Perspective" - Medi-Cal Policy Institute, Center for Disability Issues and the Health Professions, September, 2003, 52 p.
Brenda Premo, June Isaacson Kailes, Erin Schwier, and Curtis Richards

This paper details the results and findings from twelve focus groups conducted throughout California to solicit input from people with disabilities and their families about possible changes to the Medi-Cal program. These focus groups indicated significant problems with both fee-for-service and managed care delivery systems of Medi-Cal. Participants in the focus groups were almost unanimous in stating their lack of understanding of Medi-Cal services, benefits, and grievance procedures; difficult finding physicians and accessing health services, particularly locating specialists. There were three primary categories of barriers:

    1. information barriers
    2. access barriers
    3. coverage barriers

The study recommends:

Details of the project, including statistical and demographic data, methodology, recruitment and participation information, and findings of inconsistent quality in different counties and different health plans.

"Faces of Medicaid" - Kaiser Commission on Medicaid and the Uninsured, April, 2004, 12 p.

Pictorial descriptions of various recipients of federal Medicaid-funded programs and health services, this brochure puts a human face on what it means to be a Medicaid beneficiary. Three primary groups, with examples from different states across the U.S., are:

Helpful handout to introduce Medicaid program to general public.

"It Takes More than Ramps to Solve the Crisis of Health Care for People with Disabilities" - Rehabilitation Institute of Chicago, September, 2004, 76 p.
Judy Panko Reis, M.A., M.S., Mary Lou Breslin, M.A., Lisa I. Iezzoni, M.D., M.Sc., and Kristi L. Kirschner, M.D.

Attempting to challenge the general health care system of the U.S., this study provides information, resources and recommendations for integrating people with disabilities into our health care systems. Topics include:

Resource information is included in the appendices, along with examples of accessible examination tables, mammography projects, clinical services for women with disabilities, research and training centers, clinics, legal and advocacy services, and references. Tables include population by age, gender, and disability, race and disability, and instances of discrimination. Excellent publication for all involved in health care policy-making and decision-making.

"Making Tough Choices: Adults with Disabilities Prioritize their Medi-Cal Options" - California Healthcare Foundation, December, 2004, 38 p. Marjorie Ginsburg and Kathy Glasmire, Sacramento Healthcare Decisions, Inc.

Using a computerized tool and interactive group process called CHAT (Choosing Healthplans All Together), 12 separate groups in urban, suburban and rural settings designed their Medi-Cal benefits by making choices from 14 categories of service. Participants (131 total) were given a limited budget and had to prioritize services most vital. This paper is a full report of the process, the types of participants and their disabilities, and its findings:

"Mandatory Medicaid Managed Care - Plan and Enrollee Perspectives on the Enrollment Process" - Kaiser Commission on Medicaid and the Uninsured, October, 2000, 16 p.

Dicusses the enrollment process in mandatory Medicaid managed care programs in nine states (CA, CT, FL, MD, MI, MO, NM, OK, and OR) from the perspectives of beneficiaries and participating health plans. Two of California's counties were studied in depth, making the study site total ten. Questions addressed:

Several strategies are suggested following a summary of the issues emerging from the study. Comparative tables and charts help the reader navigate the details from each study site.

[May have difficulty gaining access to this web address, but keep trying!]

"Medicaid Managed Care for Persons with Disabilities: State Profiles" - The Economic and Social Research Institute, December, 1998, 134 p.
Marsha Regenstein, M.C.P., and Christy Schroer

Most managed care programs were developed for the majority of Medicaid beneficiaries, people who do not have chronic conditions or disabilities. With more states seeking ways to cut Medicaid costs, this paper looks at the options states have as they decide whether or not to move more people with chronic conditions and disabilities into managed care programs. Data about Medicaid managed care programs was gathered from all 50 states and the District of Columbia through interviews and follow-up telephone calls. Key findings:

These are the first six of 15 findings. The full report gives details about all states and findings.

"Medi-Cal Beneficiaries with Disabilities: Comparing Managed Care with Fee-for-Service Systems" - California HealthCare Foundation Issue Brief, August, 2005, 12 p.
Lisa Chimento, Moira Forbes, and Any Sander, The Lewin Group; June Isaacson Kailes, Brenda Premo, and Curtis Richards, The Center for Disability Issues and Health Professions, Western University for the Health Sciences; and Chris Perrone, California HealthCare Foundation

Brief paper synthesizes recent research about the experiences of non-elderly beneficiaries with disabilities in managed care and fee-for-service systems in California and other states. The purpose of this review is to help policymakers understand and evaluate options for changing service and payment systems under Medi-Cal. Key findings:

Makes recommendations to strengthen the Medi-Cal program's performance, measurements, public reporting, reimbursement systems, and coordination across programs.

Tables and graphs enhance the narrative.

"Meeting The Challenge of Serving People with Disabilities: A Resource Guide for Assessing the Performance of Managed Care Organizations" - US Department of Health and Human Services, July, 1998, 34 p.
Center for Health Outcomes Improvement Research, Center for Health Policy Research Shoshanna Sofaer, Dr.P.H., Sabra F. Woolley, Ph.D., Kyle Anne Kenney, B.A., Barbara Kreling, B.A., and D. Richard Mauery, M.P.H.

Resource guide to help those who want to begin to work towards a comprehensive system for measuring the performance of Medicaid funded health care systems in caring for people with disabilities, particularly managed care programs. The authors use measures already available (in 1998) that have a clear relationship to domains of performance that are important to people with disabilities. Organized in outline fashion with five chapters, it covers:

Five specific measuring systems are presented (HEDIS(R), PERMS, CAHPS, Oregon's Health Plan Adult Satisfaction Survey of 1997, and Picker Institute Patient Surveys). References, resources, notes, and an appendix with an example of collecting date for a particular performance measure are included.

"Serving Persons with Disabilities in Medicare Managed Care: Assuring Continuity Quality and Cost Effectiveness" - Technical Assistance Conference of the Health Resources and Services Administration and Centers for Medicare and Medicaid Services, April 17, 2002, 22 p.

Highlights of proceedings of a national conference on Medicaid funded managed care programs for people with disabilities held in Los Angeles. Most speakers listed are representatives of health care plans and medical institutions. Topics covered:

The goal of this conference was to learn how to provide quality, comprehensive services to people with disabilities in a Medicaid managed care environment. Appendices of handouts and slides are included.

"Understanding the Health Care Needs of People with Disabilities: Findings from a 2003 Survey" - Kaiser Family Foundation, December, 2003, 27 p.
Kristina Hanson, Tricia Neuman, and Molly Voris

This report details the results of a national telephone survey of 1,505 non-elderly adults (18-64) with permanent physical and/or mental disabilities, including a detailed description of survey methods and results. The goal was to describe health care experiences across a broad array of disability types and sources of health insurance, specifically those receiving SSI or SSDI income and those not receiving payment from either of those two programs. Key findings were that people with disabilities are at "significant socio-economic and health-related disadvantages when compared to the non-elderly U.S. population as a whole." Numerous tables and graphs detail the numeric findings of this large survey. Conclusions and policy implications included recommendations for both improved health care systems and strengthened funding coverage for those without insurance or who are under-insured.

"Nondiscrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities: ADA Standards for Accessible Design" - Department of Justice, 28 CFR Part 36, Revised as of July 1, 1994, 92 p.

Standard federal format from the "code of federal regulations" (CFR), listing and explaining accessibility guidelines for compliance with The Americans with Disabilities Act (ADA). Each section is clearly marked with detailed measurement standards and pictures or graphics showing how accessibility works in multiple situations. Definitions of terms begins the description, technical requirements are explained and then shown. This is a "must-have" document for any public entity seeking to ensure or increase its accessibility to people with disabilities.

"Adults with Disabilities in Medi-Cal Managed Care: Health Plan Practices and Perspectives" - Medi-Cal Policy Institute, prepared by Jackie Rudich Nolan, September, 2003, 34 p.

Written for California policymakers and other stakeholders to provide insights and information relevant to expansion of managed care programs for non-elderly Medi-Cal beneficiaries with disabilities in response to budget deficits in the state. It is based on a survey of health plans currently providing managed care services to members with disabilities in Medi-Cal. Findings include:

Discussed are barriers and challenges; promising practices; and favorable conclusions about using managed care for people with disabilities.

"Adults with Disabilities in Medi-Cal Managed Care: Lessons from Other States" - Medi-Cal Policy Institute, prepared by Center for Health Care Strategies, September, 2003, 48 p.
Nikki Highsmith, M.P.A., and Stephen Somers, Ph.D.

Examines how well managed care programs for people with chronic illnesses and disabilities served people in other states: Massachusetts, New Jersey, Oregon and Pennsylvania. Interviews were conducted with senior state Medicaid officials, health plan executives, and leaders from consumer organizations. Also mentioned in the report are the experiences of other states the authors knew had developed programs in this area. Key findings are:

"The California Working Disabled Program: Lessons Learned, Looking Ahead" - Medi-Cal Policy Institute, California HealthCare Foundation, April, 2003, 83 p.
Joanne Jee and Joel Menges, The Lewin Group

Based upon the relatively new "Californians Working Disabled Medi-Cal Buy-In Program (CWD)," this study examines the factors affecting enrollment in the program and to estimate enrollment and cost impacts of potential program changes. Enrollment as of June 2002 was 652 people, far lower than state officials had anticipated. Two analyses were conducted: a quality review of stakeholders' experience with the program; and a gathering (by survey, telephone, teleconference, interview) of the experiences of the CWD enrollees, those eligible but not enrolled, and county eligibility workers to gain insight and suggestions for improvement. Chapters cover:

Themes emerging from this feedback include: increase program outreach to potential users; improve eligibility worker knowledge; improve program attractiveness; and eliminate barriers to employment for people with disabilities. Authors also recommend that:

    1. raise the income limit to 450% of FPL
    2. eliminate asset level restrictions
    3. combination of the two options above.

Other

National Patient Air Transportation Hotline

Higher Education

Association on Higher Education and Disability (AHEAD) - An international, multicultural organization of professionals committed to full participation in higher education for persons with disabilities. Address the need and concern for upgrading the quality of services and support available to persons with disabilities in higher education.

Statement on the Use of Scented Products - Dalhousie University, Canada. Encourages faculty, staff, students and visitors to avoid the use of scented personal care products.

TLT Group - "Higher education has begun an irreversible transformation, and information technology is part of it. New technology options arrive at an accelerating and confusing pace. It's easy, but not necessary, to waste time and money. The TLT Group helps you understand realistic options, develop effective strategies, and regain confidence and control. Though the collective experience on hundreds of campuses, in leading dozens f workshops, and in running a listserv with more than 6,500 subscribers, we believe the best first step is establishing a TLT Roundtable. More than 400 colleges and universities have launched local TLT Roundtables to re-focus key resources and relevant services on the common goal of improving education through more effective use of technologies."

History of Disability and the Health Professions

A Brief History of Blind Physicians

Managed Care and People with Disabilities

Links to Medicaid and Medi-Cal information.

Profiles of People with Disabilities in the Health Professions

"Barriers Fall for Disabled Medical Students" - November, 2003 NY Times article about Jeffrey Lawler, 4th year Western University of Health Sciences medical student and other health care providers with disabilities. - Note: this is a PDF file.

Blind Physicians In Current Practice - "There is a common misperception that we have to be all things to all people, and that anyone who falls short of perfection is somehow incomplete." - Dr. Yarnell

Career Development For Doctors With a Disability, British Medical Journal, BMJ 7154 Volume 317: Saturday 1 August 1998 - Doctors with disability can face discrimination and hostility from their colleagues, though they are more likely to be better employees. Stuart Mercer, general practitioner and amputee, discusses these issues in this article.

Center on Self-Determination Stories of exemplary health science professionals with diverse abilities who are practicing as nurses, doctors, dentists and dental hygienists.

Deaf Professor Creates Web Site to Help Deaf Children Communicate By Bianca P. Floyd

Disability Leads Student To Medical School - Like all medical students, he faces numerous challenges which will put all his abilities to the test in coming years. For Jeff, however, there are additional obstacles to overcome.

Disabled Students Encouraged to Pursue Science Careers

For doctors with disabilities, overcoming obstacles is part of the job. By Julie G. Madorsky, MD, and Barry Corbet

Margaret Stineman, M.D. by June Isaacson Kailes, Disability Policy Consultant and Susan Madison, consultant.

Michael Ain - "Aiming High," by Melissa Hendricks - John Hopkins Magazine, April 1999 - In the rough and rugged world of orthopedic surgery, Dr. Michael Ain stands out. Ain has a form of dwarfism called achondroplasia.

Persistence and Perseverance - For doctors with disabilities, overcoming obstacles is part of the job. By Julie G. Madorsky, MD, and Barry Corbet

Thomas E. Strax, M.D., Doctor, Physiatrist, Administrator, Executive Dr. Tom Strax comes from a long line of physicians, including his father and beloved cousin who served as a key mentor throughout his education. With athetoid cerebral palsy, becoming a doctor was not a "piece of cake," but it seems that Tom had many cards stacked in his favor, not the least of which was his singular desire.

Reference Tools

Drug Questions

Prescription Drug Patient Assistance Programs Finder

familyvillage.wisc.edu

Medication Assistance Programs - provides detailed information about each company's assistance program, including the company's name, the program's address, the telephone and fax numbers, guidelines and notes, the health care provider's role, the patient's role, information needed to initiate enrollment, information regarding the amount of medication and how it is dispensed, refill information, the estimated response time, and limitations of the program.

Medwatch - Medical product safety information from the U.S. Government Food and Drug Administration.

The Medical Letter for Drugs and Therapeutics

The MEDLINEplus Drug Link

The University of Miami's School of Medicine, Louis Calder Memorial Library - Internet Listings for Pharmacology and Toxicology

The Medicine Program - For a $5 processing fee for each medication requested, The Medicine Program site will assist the patient in the enrollment process. Patients without access to the Internet can contact a health care provider or a pharmaceutical company to receive information about medication assistance programs.

U.S. Food and Drug Administration - Center for Drug Evaluation and Research.

U.S. Food and Drug Administration Consumer information - From the FDA's Center for Drug Evaluation and Research.

Research

Guidelines and Categories for Classifying Participatory Research Projects in Health Promotion

National Center for Medical Rehabilitation Research (NCMRR) - Fosters "development of the scientific knowledge needed to promote the health, productivity, independence and quality of life of people with disabilities. This is accomplished by supporting research on enhancing the functioning of persons with disabilities that is useful in their daily lives. A primary goal of the Center is to bring the health-related problems of people with disabilities to the attention of America's best scientists in order to capitalize upon the myriad advances occurring in the biological, behavioral, and engineering sciences. The congressionally mandated report, 'Research Plan for Medical Rehabilitation Research,' describes seven cross cutting areas of research that guide the funding priorities of NCMRR. Those areas are: improving mobility, enhancing behavioral adaptation to disability, understanding the body's responses to disabling conditions from an integrated standpoint, developing new assistive technology to improve useful functioning, improving measurement tools to assess the consequences of irreversible physical impairments, investigating the effectiveness of rehabilitative interventions, and training medical rehabilitation scientists."

National Center for the Dissemination of Disability Research - Provides a central information resource on NIDRR-funded research projects and increases the accessibility of research outcomes. Links to a variety of research findings:

National Clearinghouse of Rehabilitation Training Materials - provides a wide variety of disability related training resources locates, collects and distributes a wide variety of training materials such as participant and trainer manuals, videos, syllabi and curricula from publicly funded rehabilitation training programs for rehabilitation practitioners in state, federal and private agencies nationwide. These materials are not generally found in a traditional library. Provides reference and research services locates and delivers training materials to your doorstep. In most cases materials not available on-line are shipped within two working days. Ppaper based documents such as training manuals, monographs and articles audio and video tapes electronic documents, CD-ROMS and computer programs from the NCRTM collection.

National Rehabilitation Information Center (NARIC) - collects and disseminates results of federally funded research projects. Literature collection, which also includes commercially published books, journal articles, and audiovisuals, averages 200 new documents per month. Serves professional and lay person, who is interested in disability and rehabilitation, including consumers, family members, health professionals, educators, rehabilitation counselors, students, librarians, administrators, and researchers.