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Vocational services for individuals with intellectual and developmental disabilities (ID/DD) have been available for several decades. Legislative and policy initiatives stemming from the enactment of the Fair Labor Standards Act of 1937 which exempted sheltered workshops from minimum wage requirement helped to build the foundation for public support for the development and delivery of facility-based vocational services. Funding for vocational and employment services for individuals with ID/DD currently is furnished primarily through states’ Section 1915 (c) Medicaid waiver programs. Job placement and other time limited supports are also offered through the state-federal vocational rehabilitation (VR) program. Waiver-funded employment services were at first only available to persons who had previously resided in an institution (ICF/MR). The Balanced Budget Act of 1997 permitted states to offer supported employment as an “extended habilitation service” to all persons funded under the state’s 1915 (c) Medicaid waiver program including those without a prior history of institutionalization. The state-federal vocational rehabilitation program has funded vocational and employment services for persons with ID/DD since at least the early 1970s.

The purpose of this review of the literature was to examine the “state-of-the-science,” or “state-of-the-art,” in the delivery of vocational and employment services to individuals with intellectual and developmental disabilities with the goal of providing a comprehensive review of scientific and empirical literature regarding employment services.