Quality of institutional and community human service programs in Canada and the United States

This methodological and substantive study was based on Wolfensberger and Thomas' (1983) Program Analysis of Service Systems' Implementation of Normalization Goals (PASSING), a program evaluation method used by teams of trained raters to assess the quality of human service programs. PASSING is based on Social Role Valorization, an internationally influential theoretical and philosophical approach to structuring human services, particularly services for persons with handicaps or other potentially devaluing conditions. The data for this study were derived from a sample of 213 programs evaluated with PASSING during 1983-88 in Canada (45%), the United States (51%), and the United Kingdom (4%). The programs served mainly mentally retarded persons (40%), subgroups of clients with "mixed" (different) impairments and conditions (38%), or psychiatrically impaired persons (6%). The results showed that PASSING has adequate internal consistency and interrater reliability and yields data suitable for statistical treatment with interval-level, parametric procedures. The average level of quality of services in the sample on the total PASSING scale and its five subscales (Program Relevance, Intensity, Integrativeness, Image Projection, and Felicity) was only modest, however. Community group residences (n = 77) were of significantly better quality than community vocational programs (n = 56), and both were superior to institutional residences (n = 20). Also, Canadian programs (n = 76) were of significantly better quality than U.S. programs (n = 77). An outstanding vocational program that was not part of the study sample was used to illustrate concrete ways in which the quality of many human service programs could be greatly improved, typically at little cost.