# Achieving Competitive Customized Employment through Specialized Services - Veterans: ACCESS-VETS

> **NIH VA I01** · JAMES A. HALEY VA MEDICAL CENTER · 2022 · —

## Abstract

Restoring employment is an important rehabilitation goal for Veterans with spinal cord injury (SCI)
because employment impacts both quality of life (QOL) and longevity. Due to the medical complexity
of SCI, however, these Veterans face unique employment barriers that are not adequately addressed
by current Department of Veterans Affairs (VA) vocational services. Vocational services for Veterans
with SCI need to address these employment barriers, which relate to physical health, finances, time
for job search, and caregiver issues. Customized employment (CE), an innovative strategy for
tailoring vocational services to meet individual needs of people with complex disabilities, could be
adapted for use in SCI rehabilitation. This research will evaluate a CE intervention to help Veterans
with SCI discover their strengths, customize employment plans, and find competitive integrated
employment in their communities. The proposed intervention, Achieving Competitive Customized
Employment through Specialized Services (ACCESS), is a user-driven, standardized CE program
delivered by a trained employment specialist and is effective for a non-clinical, community-based
population of adults with disabilities. This research is needed to test ACCESS as a complement to
clinical services for a clinically defined population and to assess the potential of CE for subsequent
implementation in the VA.
 This proposal is responsive to Veterans’ reported desire for individualized vocational rehabilitation
services and to the Modernization Plan and the MISSION Act, which emphasize Veteran-centered,
community-based approaches to care. The proposal goals align with the Transformation Plan of the
Office of Mental Health and Suicide Prevention, which prioritizes evidence-informed, community-
based employment services. Recognizing the rapid adoption of CE in state and federal agencies, VA
is partnering with the Office of Disability and Employment Policy (Department of Labor) to introduce
and train VA vocational staff on CE as a promising practice; however, integration of CE into standard
VA clinical services has not yet been implemented. In support of VA efforts to assist Veterans to
achieve competitive employment and reintegration into civilian life, this proposal will evaluate CE
within the context of existing VA vocational services.
 The purpose of the proposal is to evaluate the impact of a CE intervention for Veterans with SCI
(ACCESS-Vets) on employment outcomes. The short-term goal is to determine effectiveness of
ACCESS-Vets for Veterans with SCI. The long-term goal is to guide research on and adoption of CE
as part of evidence-informed vocational services in the Veterans Health Administration (VHA) to
improve employment outcomes for Veterans with SCI. The proposed 4-year, mixed-methods, multi-
site, randomized clinical trial will test the ACCESS-Vets intervention in a sample of Veterans with SCI
who have received or are currently receiving Individual Placement and Support...

## Key facts

- **NIH application ID:** 10554089
- **Project number:** 5I01RX003349-02
- **Recipient organization:** JAMES A. HALEY VA MEDICAL CENTER
- **Principal Investigator:** Lisa Ottomanelli
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2021-06-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10554089

## Citation

> US National Institutes of Health, RePORTER application 10554089, Achieving Competitive Customized Employment through Specialized Services - Veterans: ACCESS-VETS (5I01RX003349-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10554089. Licensed CC0.

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