Empowerment, Partnership, and High Expectations: Just Words, or the Foundation of Effective Rehabilitation?

by Fredric K. Schroeder, Ph.D.

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Fred and Schroeder and Susan Benbow take part in the Millenium Symposium on Rehabilitation in the large conference room at the National Center for the Blind

���� From the Editor: Until January 20, 2001, Dr. Schroeder was Commissioner of the Rehabilitation Services Administration, U.S. Department of Education. He delivered the following remarks at the Millennium Symposium on Rehabilitation. This is what he said:

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���� I am very pleased to be here with all of you. This is an historic event. It is perhaps illustrative of the change in the nature of rehabilitation and in the assertion that rehabilitation is not something that is done to us and for us, but rather rehabilitation, as it should be, is a partnership.

���� My early experience in rehabilitation was in New Mexico. I was directing special education services for blind children with the Albuquerque public schools at a time when the programs for the blind in New Mexico were not what blind people in the state would have had them be. I had lived out of state for a period of years going to college and had worked for two years in Nebraska. When I went back to New Mexico in 1980, I went to a chapter meeting of the National Federation of the Blind. (Joe Cordova will remember those times.) The chapter meeting had probably twenty-five blind people, and of those Joe was one of the very few who had a job.

���� As I worked with the NFB in the state, we tried to encourage the agency to support people in pursuing training and good quality employment, but we were unsuccessful. For example, I remember a person who literally had a job offer, and the only thing needed was a Braillewriter in order to accept it. The agency for the blind in the state said that they didn't have any money for a Braillewriter, so they weren't able to provide that service. I don't say this to be critical of individuals who were there at the time--but it is fair to say, in fact we documented it, that mostly what the agency did was what we call physical restoration. If you came to the agency with a correctable eye condition, there was plenty of money to send you for eye surgery. But if you were a blind person and you needed a Braillewriter, there was no money.

���� I remember a young blind woman who had some vision. She wanted a job, and we got her signed up for services. One of the first things they did was to ask her what she wanted to do, and she said office work. So they sent her for a vocational evaluation. Weeks later nothing had happened, and nothing continued to happen, so I intervened in the case to see what the outcome of the evaluation had been. I found out that her case had been closed because she was ruled to be too severely handicapped to benefit from rehabilitation. There was no reasonable expectation that she could become employed. When I asked the basis for that decision, they said, "Well, she indicated that she wanted to do office work. We sent her for an evaluation, and the report came back saying she didn't see well enough to do office work."

���� The point of this is two-fold. One is to say we are not talking ancient history. This was twenty years ago. We are not talking about an isolated incident in one state that had poor services. I think we are talking about a condition in rehabilitation driven by a lack of expectations, a lack of belief in blind people. And, as I say, my point is not to criticize or belittle the people who were working in rehabilitation in New Mexico or anywhere else but to stress that there was no fundamental assumption that blind people could work and be productive.

���� One of the things I did in trying to make changes in the rehabilitation agency (this was while I was still on the outside--President of the NFB of New Mexico) was to help people file appeals to try to get the services they needed. The appeals were by and large unsuccessful--unsuccessful to the point that I wondered whether anybody who appealed a decision ever had that decision changed. At that time the standard was very simple: you appealed to the very agency that had denied you some sort of service. Not very just, but you went to the local supervisor, then you went to a district-level person, then you eventually went to the state VR director, who looked it over and decided that all the folks along the way had been correct and that you shouldn't get what you had asked for.

���� So I wrote a letter to the director of the agency (by the way, this was a combined agency), and I said, "I want to know for the past year how many blind people have asked for fair hearings and how many have been decided in favor of the client." I got a letter back saying that this was confidential information, that they couldn't divulge information about the clients. I wrote back and said, "Perhaps I wasn't clear. I don't want to know the names. I don't want to know any identifying information. I want to know how many blind people who were clients of your agency filed for fair hearings to challenge a decision, and how many determinations were made in the consumer's favor." I got back the same letter saying this is confidential information, and we can't provide it.

���� Again, my purpose is not to criticize the director of the agency, but rather to point out again the agency attitude that the consumer as represented by the consumer organization was on the outside and frankly had no business meddling in how the agency did its business.

���� Eventually we were able to create a separate agency for the blind in New Mexico. We did this in 1986 with the kind of concerted action the Federation has engaged in for its entire history. We went to the legislature and made the case. We fought a very hard battle. It was what in Washington is called grassroots effort, and it worked. So in 1986 we created a separate agency.

���� Now it seemed one of the things we ought to be doing was put blind people to work. So we began emphasizing honest to goodness employment for people, not those who had correctable blindness, but people who would be blind regardless of any kind of medical intervention. At the end of my first year I had the distinction of cutting the number of successful closures in half. It went from 110 to about fifty-five. I wondered to myself how this was possible. Here are the things I uncovered: at that time and previous to my coming, the agency had $730,000 devoted to case service. Of that $730,000, $700,000 had gone for medical procedures, which essentially left nothing for any other kind of service. We didn't reduce that wholly in the first year, but within about three years we were up over $1,100,000 in case service, and we were down under $150,000 in medical procedures.

���� One hundred ten people the year before had been placed in employment, and I thought to myself, "I know a lot of blind people in this state, and I can't think of a single one who went to work last year, much less a hundred-ten of them. Where are these blind people who have all gone to work?" Well, as you can imagine, most of them were people whose vision had been corrected. My first inkling of this was when I looked at the occupations of people who had gone to work the year before. One had gone to work as an airline pilot, which alerted me to the fact that perhaps this person wasn't blind when he or she walked out the door.

���� So we put an emphasis on really trying to help blind people get serious training and support and get into real jobs. Though there are many strategies for doing this, one of them is very simple. In performance evaluation I quit counting twenty-six closures, the code term for successful closures. I said that we would count only those people who were still blind when we closed them and who were making above minimum wage in full-time employment. Of course that is a standard that you could argue is not sufficiently conclusive, but it seemed to me a simple standard that everyone could understand. The expectation was that we wanted people to go to full-time employment at a living wage, and we wanted them to have been blind when they came in the door and blind when they walked out the door. I'm not against people getting their eyesight back, but I don't think that is why you have a rehabilitation agency.

���� When I left to go to RSA eight years later in 1994, I was sitting in a chapter meeting of the NFB. Instead of twenty-five people in the room, there were about seventy-five people. Instead of one or two of them being employed, as I went around the room, I couldn't think of a single person in that room who was unemployed. Let me give credit where it is due: my top rehab counselor was actually not a counselor at all but my deputy director Joe Cordova. We gave awards to our counselors for the greatest number of people placed in employment, and unfortunately, since Joe wasn't a counselor, I couldn't give him such an honor, but had I done so, he would have taken that award every year. People who were difficult to place would end up in Joe's case load, and Joe got them jobs. How? Well, he started with the assumption that they could work, that nobody should be relegated to isolation and poverty. Given the right encouragement, training, and support, they could go to work. And they did go to work.

���� We had been told for years that the sheltered workshop could not pay minimum wage. People who worked in a sheltered shop were called clients. They had no benefits whatsoever, no Social Security tax was withheld, and they were paid subminimum wages. As a result, when people left the shop, no matter how long they had been in it, they had no paid quarters into Social Security, so they didn't have access to SSDI, which pays better than SSI. They had no long-term security of any kind. We were told over and over that the shop could not pay minimum wage; the money was not there. I'll come back to that in a minute.

���� I remember at a state convention we had Rami Rabby as our national representative. Rami was engaged in a lively discussion with the person who was heading the workshop. He suggested that maybe minimum wage could be paid. This fellow began to pound the podium, and he started saying, "You show me where the money will come from. I defy you to look through my budget and show me where the money will come from."

���� Rami said, "Look, are you telling me that, if utility bills go up next summer, you will call up the electric company and say to them, `You come and show me in my budget how I can pay this new expense?'" He said, "I am sure it isn't provided for in the budget, but it is really nothing more than a matter of will."

���� The very first policy I issued on perhaps my first day, maybe my second day, effective immediately, was to begin paying minimum wage as a starting salary for all people who worked in a sheltered workshop. Eight years later we had not gone broke although we had to do some things differently. This is really the point. If you are going to pay minimum wage, the money has to come from somewhere, and the somewhere is the productivity of the people who are doing the work and the profitability of the items being made.

���� If you pay people on piece work, then it doesn't matter whether you have trained people well. It doesn't matter if the equipment works well. It doesn't matter whether it's an item that can be profitably sold because all of the inefficiency gets passed along through that piece rate. In other words, for some of you who are not familiar with this, you start with the industry standard. Perhaps the industry standard for making mops is ten mops an hour at a wage of five dollars an hour; therefore each mop is worth fifty cents in wages. You say to the blind worker, whether you make ten mops an hour or one doesn't matter. If you make ten, you get five dollars. If you make one mop, you get fifty cents, which some people argued and still to this day argue is fair. They say, after all, why shouldn't you pay people according to their productivity?

���� But if the guy in private industry making ten mops an hour is using modern equipment and new procedures, and the blind person is working on antiquated equipment that keeps breaking down, it isn't fair. In fact, in one workshop I knew at peak performance the equipment blind people were working on couldn't produce at even half the rate of the industry standard. So this isn't paying people according to their productivity, according to how much they produce; this is paying people an unfair wage based on poor management practices. Yes, we had to come up with the money, so one of the things we did was change the product line to be more successful. Another thing we did was quit having people do jobs that they weren't well suited to.

���� There was a woman--this is another of Joe Cordova's closures--she had a good personality, probably still does. I haven't seen her in a while. She had a college education. She's blind. She also had cerebral palsy, so she had only the use of one arm. In the sheltered workshop they had her assembling heavy rubber floor mats. Now to make minimum wage on these floor mats, you had to make twelve a day. She was able to make approximately one third of one mat a day because she was doing this very physical operation with one arm. In fact she testified when we created the Commission for the Blind. She brought out her paycheck. For two weeks of work her net pay was $5.14.

���� Joe thought to himself, a person with use of only one arm is not a good candidate for doing a very physical job. She also lived way up in the mountains and didn't have transportation. There was no good public transportation. We helped her to start a telephone answering service. She signed up a couple of doctors and some real estate agents, and she had all the calls forwarded to her house. She ran a private business out of her home and made a very decent wage.

���� What changed was the expectation. If you assume that blind people can be productive and competitive, then your energy is focused in a certain direction. That is to say, you are forced then to look differently at what is needed to make that enterprise work. We looked at modern practices and more successful product lines. We looked at matching people according to their skills.

���� It wasn't that the people who were in that workshop management prior to the commission's being created were bad people; they were not. In fact most of them were the same people who stayed on. What changed was the expectation--the fundamental belief in blind people.

���� We did some other things. The first was to raise the wages. The second was to go to the state personnel office and have all those positions classified as state jobs. So the people in our workshops were state employees, which meant they also got health benefits. They paid into a retirement plan. Social Security was withheld. These were real state jobs.

���� A fellow who had run the workshop years earlier and who was retired--he was a blind person, a decent enough fellow--came to me and said, "You are going to create a place that is so warm and safe and comfortable that nobody is ever going to leave." I call this a concept of rehabilitation through misery--if you make it miserable enough, people will leave. You wouldn't want to have good working conditions because people won't leave. The funny thing is we didn't have records going back very far, but from what we were able to tell, in the previous five years only one person had left the sheltered workshop. That made me wonder if the concept of rehab through misery was really an effective one. Of course the answer is it was not.

���� The truth of the matter is, if a person becomes blind in our society or grows up blind, the chances are that not only society around you assumes that you cannot be productive and competitive, but your family probably believes it, you probably believe it, and your friends probably believe it. If you go to the rehabilitation agency, and the people who are experts in employment of the blind also say to you, "Because of blindness you cannot be productive. You cannot compete as others do," why would you question that notion? If they say, "We have measured your productivity, your worth as an employee; and because of your blindness, your production is a quarter or a tenth of that of others," where would you go believing you could get a job?

���� About a year after we started the commission and raised the wages, one of our great moments occurred. A woman who had worked in our sewing department a long time and who was making about $6 an hour, which was quite a bit above minimum wage--I believe the minimum wage was about $4 an hour--came to me and said, "You know I'm making $6 an hour, and I'm doing the same operation that they do at the Levi Straus plant here in town. Those people are making $8 an hour." We had done many things to up the productivity in the shop, but we were still government, you know--we weren't going to do as well as Levi Straus.

���� I said, "I wish we could pay you $8 an hour. We probably can't, and you are right. You are doing the same job that they do at Levi Straus, and you are doing it as well as anybody they've got in their sewing department, so why don't we help you get a job at Levi?"--another Joe Cordova placement as I remember it. So this proved the lie of rehabilitation through misery. Instead we said to people, "Yes, you are capable." If you treat people as if they're capable, give them training, give them jobs that they are suited to and in which they can be successful, they might start to believe that they can do more than work in a sheltered workshop.

���� These are the values that I believe in and that I tried to bring to the work in RSA. There has been a steady progression over the years of elevating expectations. It is never as fast or as dramatic as most of us would have it be, but I think it is there. One evidence is that people are saying that they will not accept isolation, segregation, unemployment, poverty, that people need the opportunity to work. We have tried to integrate that into the work that we have done.

���� One of the things I have felt very strongly about is that rehabilitation is not just about employment, but about high-quality employment. Well, that is kind of a vague term. What is a high-quality job? To my mind you cannot look at any job and say it is a good job or a bad job. The fact that a person works as a custodian doesn't tell you whether that's a good or a bad job. It depends on whether that person is suited for the job, values the job, is truly there by choice because he or she would likely have that job with or without blindness or because people have assumed that as a blind person he or she could not achieve more. This isn't to denigrate any job but to say truly, if we have a fundamental assumption of the equality of blind people, that drives the kinds of encouragement, the kinds of training, the kinds of job placements people get.

���� In 1992 the NFB got the language about consumer choice put into the Rehabilitation Act for the first time. I suppose one very important sign of the progress that we have made collectively in rehabilitation is that a lot of people only eight years later are taking credit for having put that language into the act. Just about everywhere I go, I meet people who take credit for having thought up the idea of choice.

���� Choice was really the first expressed federal policy acknowledging that rehabilitation is not about doing things to or for people, but that rehabilitation is a support to help and encourage and stimulate the individual so he or she can in fact make the kinds of life choices that others make. In 1997 I issued a policy directive called PD9704. We said very radical things there. We said for example that people ought to be able to decide for themselves what kind of job they might want. This was controversial; this was very controversial. Yet it has become less so even over the past three years. In fact in some places it is thoroughly embraced. In many other places people are trying to embrace it, trying to integrate it.

���� Yes, there are still a few who feel about it and about me the way they did when it was issued. But essentially the law says that we must make a determination of the employment outcome for each person according to the individual's "strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice." So what do all those words run together mean? They mean the collection of things that make up a human being. The job ought to be one that an individual wants to do, a job that the person values. It ought to be high-quality employment based on the individual's assessment and rooted truly in information and informed choice.

���� You could have argued fifteen years ago that blind people working for subminimum wages in a sheltered workshop in New Mexico were there by informed choice, but I would argue they were not. They weren't there based on factual information about blindness and the capacity of blind people to work. They were there based on widespread societal assumptions about our inability and the way those played out in society, in the individual, and in the rehabilitation system in our state.

���� Informed choice means fundamentally that a person who becomes blind or even grows up blind first needs to associate with other blind people. The individual first needs to know what is possible as a blind person. The family won't likely know, nor will his or her community. So first and foremost blind people need to have exposure to other blind people, not just for the encouragement from those who have done remarkable things, although that certainly is part of it, but also to gain perspective on how societal attitudes about blindness play out.

���� There are people in our society today, bright, capable, ambitious people who are blind whose lives have been devastated by discrimination, by rejection; and that is part of understanding blindness. Yet we must also understand that we as blind people can help encourage and sustain one another through the discrimination, through the rejection, through the diminished expectations that are all around us. Together we have the possibility of success, while on our own we have a very low probability of true success.

���� Being around other blind people is the first element, to my mind, of true informed choice. The second is to have the skills to back up elevated expectations. If you do not have the skills, then you cannot sustain the elevated expectations. If you have only a belief in equality, but you really don't have the capacity to go out and to travel and to be literate and to carry out those day-to-day activities, you won't sustain that elevated expectation. And by the way, while we are on that subject, if all you have is skills without the expectation, you will fall short of your potential--far short--because you will simply use those skills to do what you believe is possible for a blind person to do. You need the elevated expectations that come from other blind people, and you need to have that sustained by the skills and the support to back up those elevated expectations.

���� Then we need a rehabilitation system that does not view itself primarily as a gate keeper. We, of course, are gate keepers to some extent. There is only so much public money, and it has to be used wisely. But if we approach rehabilitation only as gate keepers, using our authority to hold the line and to prevent the extraordinary, we will lose the chance to help people become all that they can. I can tell you the way state and federal government work, at least in my experience. If you look at the rules and regulations in state government, you often find that one person one time manipulated the system in a bad way, resulting in a whole set of rules and procedures being put into place so that never again would a single person be able to cheat the state out of one thing. And now everybody is scrutinized and held to an oppressive standard.

���� Years ago I was at an exit conference with the state auditor as part of our annual audit. In New Mexico in addition to all the written material and review of documents the state auditor had to ask the chief executive of every state agency personally the question, "At any time during the year did you use state money to buy coffee?" Because, who knows when, some agency had bought refreshments for some sort of meeting, and the state legislature thought it was a bad use of tax dollars. Not only did the legislature ban buying coffee, but they put it into law that the state auditor had to ask the chief executive of every state agency to verify that during the year no state dollars went to buy coffee.

���� These gate-keeping functions can end up creating absolute dysfunction. We all know of many, many examples. If you have ever tried to buy assistive technology for blind people--in the state where I was, sometimes it seemed likely that the person would retire before you could clear away the red tape to buy the technology. We cannot demoralize consumers. We must not make them feel as if they are being selfish or demanding when they express their needs. Instead, the spirit and attitude of the people who work in the agency must be encouraging--encouraging people to try and explore and develop their confidence and their skills, to stretch themselves to become the very best they can.

���� So the work we have put into place, not just PD9704, but the changes we proposed in the 1998 reauthorization, the regulations published yesterday that implement the 1998 amendments, the regulation you have heard about concerning sheltered work that went to the Federal Register on Tuesday of this week and should be published very shortly: all of these are to say to our system and to ourselves that what we are about is encouraging people to seek a place of real integration and get good jobs and that we should stand with them, encourage them in that pursuit.

���� Finally I will say to all of you what I said to the group of the CSAVR leadership a number of years ago. I had just met a young blind woman who was very capable; she had just graduated from high school, and she wanted to be a teacher. The rehabilitation counselor said to her, "You really haven't had any experience with teaching, so why don't we start by saying that you want to be a teacher's aide. That way you'll get some experience working with kids and see whether in fact you really want to be a teacher." Well, this eighteen-year-old young woman didn't know any better, so she put down on her plan that she wanted to be a teacher's aide.

���� This young woman's family had some money, and she had been accepted at a prestigious private college. The family intended to pay the tuition and living expenses. They knew she needed some technology in order to do well in college, so they went to the agency and said they'd like help in planning what kind of technology she needed (they were willing to pay for it). They requested help in deciding where to buy what she needed and in finding training to help her learn how to use it. The agency said they couldn't provide these services--this is not ancient history; it happened about three or four years ago. The reason the agency couldn't provide the service was that one doesn't need assistive technology to be a teacher's aide. That was her goal, and they couldn't provide a service that didn't support that goal.

���� I said to that small group from CSAVR: here is the problem. Let's use the analogy of grades, A, B, C, D, etc. If you think of the very best services that we can provide as A-level services, the problem that we who run public agencies have is that there are always more people who need help than there are resources to help them. It seems to me that there is pressure to say, okay, look, we need to be efficient; we need to economize. But if we do that at the level of the individual, over time we erode the system. It's insidious because, if you first start trimming back just a little bit, you can rationalize to yourself, look, we may not be giving A services, but we are giving B plus services, which are still really good services, and by doing this, we are able to serve more people than we otherwise could.

���� And of course the problem is that there are still more people at the door who need help, so over time you go from B plus to B minus services. And you say look, these are still good services--above-average services. By making these economies, we are able to serve more people. Yet there are still more who need help, so you slip to C services, and you are saying, but we don't promise people a Cadillac; these are good services, average, typical services. We can't do more because we have so many people who need the help. Maybe you stay at C services; maybe you slip to C minus or D plus services.

���� The problem is that there will still be more people who need the help; yet, when you go to the state legislature, when you go to the Congress and you ask for the resources, where is your constituency? Are people going to stand up and demand more money for the program when they've got C or C-minus or D-plus services? Do you want to have a constituency who stands up and says, "Well, it did take several months to get a plan written, and no, they didn't end up buying me the computer or supporting the training I wanted, but I did get a Braille watch, and the counselor was very nice to me and wished he could do more?" That's going to inspire your legislature or Congress to protect you? Of course not. This is not to be critical. This is politics.

���� If on the other hand you give each client A services--now does A-level service mean wasting money, lavishing money?--of course not. These are my tax dollars too--after Saturday, there won't be as many of my tax dollars [laughter]. We're not talking about wasting money or squandering money or being lavish with money. We are talking about taking risks with money, sometimes doing things that we are not entirely certain will work, but, if we give people A services and there is not enough money to go around, then you've got people demanding access to these services, saying, "These are vital services. These services change people's lives, and I need them too." Then you have a constituency.

���� So all of this is to say, in my view, that the future of rehabilitation is certainly dotted with many challenges, but they are different only because of the context, the times in which we live, the new environment. There have always been challenges to the system. I can say to you: should I ever find myself running a state rehab agency again, I will seek to build an agency that has a constituency. I want the ordinary consumer, the ordinary blind person to say, "By my coming to this agency, my life was changed." I don't think this is just feel-good philosophy. I think this is good rehabilitation practice.

���� I will boast on a bit of data about the New Mexico agency which I came upon after I got to Washington. I didn't know what I am about to tell you when I was there. When we did our first trial run of the standards and indicators, I was very proud of one fact. The New Mexico blind ranked number one in the nation in job placements. (I can tell you exactly how that was calculated.) But it was number one in placements, and it was next to the last in the amount of money spent per case. That is to say, the agency spent more money per case than all but one other agency. Now I consider that a plus. If you don't, then just remember that Art Schreiber was director at that point. If you think that it was a plus, then just remember that he was using the infrastructure I put in place.

���� You could say, "Okay, you did get a lot of people jobs. You did it very expensively; yet wouldn't it be a reasonable goal to say let's get that same number of people jobs, or even more, but let's do it less expensively? Isn't that still an important value?" Let me give you one more piece of data--I didn't ask for this; one of my staff came to me and had done a very interesting run. He looked at the proportion of blind people who went off Social Security benefits as a proportion of successful closures in each state. New Mexico did not just rank number one in the number of blind people whose incomes, because of the services provided, were sufficient to get them off benefits. Proportionally, New Mexico was getting blind people off benefits at a rate three times the national average of agencies for the blind because it invested in people. It took risks. Not all the money spent ended up paying off, but in the aggregate the idea of using our resources in partnership with blind people to support and encourage them to live full and normal lives works. It works!

���� This is why I started by saying I see today's meeting as such an historic event, such a landmark. As Dr. Maurer pointed out in his opening comments, this is no longer the day when you had the consumers on the outside and the rehab agency on the inside and the two battling one another. Our future in very practical terms depends on partnership, genuine honest-to-goodness partnership. But also our experience shows us that the best rehabilitation practice is partnership, working with blind people in support of elevated expectations, expectations drawn from the collective experience of blind people. The more you do it, the easier it gets because you get the base, the infrastructure of people who can then be the foundation for the next generation.

���� A number of years ago I was on the scholarship committee of the NFB, and I met a young man from the state of Wisconsin. He was eighteen years old. He had just graduated from high school. He was going to college that fall to major in composite materials engineering. I said to him, "Chad, when I was eighteen, I didn't even know there was such a thing as composite materials engineering."

���� Chad said, "When you were eighteen, there wasn't." Which was not my point. But compare the situations that I described in New Mexico: a person comes into an NFB chapter meeting, that is to say, a gathering of twenty-five blind people, only one or two of whom have a job. Compare that to a person coming to a gathering of seventy-five blind people, of whom virtually all have jobs or are in college preparing for employment. These are very different environments. Success builds on itself, helps sustain it, helps stimulate more of it.

���� In conclusion I would say that the perspective I have learned to have on blindness has come through my association with the National Federation of the Blind, from many hours of reading Dr. Jernigan's and others' speeches that shaped my beliefs and attitudes about blindness. It came from being part of the community of blind people, of sharing in our collective successes and bearing our collective failures, from understanding that the real barrier to full equality and opportunity in employment is truly what Dr. Jernigan said many years ago, not the lack of eyesight, but attitudes about blindness--attitudes of society, attitudes of our families, of ourselves, of the rehabilitation profession.

���� Our collective challenge is to reshape our attitudes by collectively building on an assumption that blind people can live full, normal, productive lives and then acting as if we believe it through our policies, our programs, our training, and the risks that we take. This to me is what rehabilitation is about. This to me is the underpinning of the success that we have created, and this notion of working collectively has been proven so many times in so many different ways that in my view it is the clear path for our future.