Why Do Rehabilitation in a College Setting?

There are a variety of benefits to providing certain forms of health care services outside of the traditional healthcare setting. And, there are some definite benefits to providing educational rehabilitation services in a college setting for those desiring long-term support.

The benefits to the individual and to society are reviewed in detail in the Context & Concepts pages of this website.

For the affected individual:

  • Social Support is vital to healing. An ever-increasing body of medical literature is documenting the important role that social support plays in recovery and rehabilitation.
  • Stroke survivors and those with long term disabling conditions need long-term support. Long-term rehabilitation is just that—long term. Stroke symptoms are seldom eliminated or adequately adapted to in the acute care or short term medical rehabilitation setting. Currently, Medicare and insurance plans limit the amount of therapy provided, and thereby place an artificial cap on rehabilitation support and achievement.
  • Enhancement of quality of life and improvement of functional abilities benefit both survivors and families. The attainment of functional abilities especially related to standard activities of daily living go a long way in reducing survivors’ feelings of dependency. The presence of a disability is not the most important factor to consider. Rather it is the impact that the condition has on the person’s state of independence that makes the critical difference. By the same token, caregiver burden is reduced each time a new level of function is achieved.

At the public policy level:

  • Enhancement of quality of life and improvement of functional abilities also benefits the broader community and the taxpayer. Rehabilitation interventions that enhance functional abilities have been shown to be cost-effective, and are associated with fewer hospitalizations later, greater levels of independence, and lower mortality. Higher levels of function prevent reliance on expensive residential care.
  • The demographic shift requires new and more services. The U.S. population, age 65 and over, is expected to double in size within the next 25 years. By 2030, almost 1-out-of-5 Americans — some 72 million people — will be 65 years or older. The health of older Americans is improving, yet 14 million people age 65 and older reported some level of disability in Census 2000. Since the Baby Boomers, who have shaped societal norms throughout their lives, are now reaching their sixties, they will be looking for new and innovative solutions to the health care challenges they will increasingly face.
  • The health care crisis is escalating and innovative solutions are needed. In the past forty years, the cost of medical care in the United States has risen from 3% to 15.3% of the GNP, while at the same time (using standard measures such as infant mortality rate, life span, and services to the poor, etc.) the quality of care has degraded. The number of medical settings that refuse to participate in Medicare and MediCal is increasing along with the number of uninsured citizens. In Santa Cruz County, the Center is seen by local medical professionals as an enormous benefit. The largest source of referrals comes from the local hospital’s rehabilitation facility. The medical director of Dominican Hospital Rehabilitation Center serves on the Center’s Advisory Board and is a frequent speaker at Honor’s Day, the Center's graduation ceremony.
  • There are advantages to providing service outside of the traditional system. Traditional systems hold a certain worldview that can restrict visualizing solutions that may lie outside the institutional field of vision. And, entrenched systems can hinder innovation. For example, in any entrenched system the following points often hold true:
    • For every innovative idea there are at least five rules against it!
    • Innovations provoke disciplinary protectionism.
    • Systems tend to be shaped by reimbursement policies.
  • Moving a problem in search of a solution from one established system (e.g. medicine) to another (e.g. education) can be very liberating, since the rules, disciplines and reimbursement policies are different enough to allow for innovation. Just looking at a problem from a fresh perspective will often lead to surprising solutions. By the same token, new successful systems are often developed when the innovators don’t have enough “experience” to know that their method “just isn’t done!”
We are grateful to Congressman Sam Farr and the US Department of Education,
Office of Special Education and Rehabilitation for the funding support that made this website possible.