Mar 3, 2025
Join hostCarol Pankowas she divesinto the complexities ofOrder of Selection(OOS)in vocational rehabilitation with two expertguests:Theresa Kolezar, Director of IndianaCombined, andChris Pope, Director of theState Monitoring and Program Improvement Division at RSA.
In this episode, they break down:
· Why agencies implement OOS due to financial andstaffing constraints
· Key regulatory requirements and complianceconsiderations
· Strategies for managing and eventually liftingOOS
· Indiana VR’s data-driven approach to decision-makingand communication
· RSA’s insights on fiscal forecasting and policycompliance
If you're in the VR field, you won’t want to miss thisinsightful conversation onplanning, stakeholderengagement, and using data to overcome challenges.
Listen Here
Full Transcript:
{Music}
Chris: As you know, we have78 VR agencies and only eight of them have a closed prioritycategory, and only one of those eight have all priority categoriesclosed.
Carol: So by going back andsaying hey you gotta look at this other side of the house andreally analyze what's happening. It will give you the full picture,than what is playing into what's happening over here on the fiscalside of the house.
Theresa: For the majority offolks. They were maybe even having somewhat of a positive impactbecause we were able to get them processed, get them in sooner. Andyou know, there's obvious benefits that go along with lower caseload sizes.
Intro Voice:Manager Minute brought to you by the VRTAC for QualityManagement, Conversations powered by VR, one manager at a time, oneminute at a time. Here is your host Carol Pankow.
Carol: Well, welcome to themanager minute. Joining me in the studio today is Theresa Kolezar,director of Indiana Combined. And Chris Pope, director of the StateMonitoring and Program Improvement division at the RehabilitationServices Administration. So, Theresa, how are things going with youin Indiana?
Theresa: Oh, we're doingwell. Thanks. So happy to be here.
Carol: Thanks for being here.And, Chris, how are things going for you in D.C.?
Chris: Things are cold inD.C. at the moment, Carol, but we're hanging in there.
Carol: Yeah, not as cold asMinnesota.
Chris: I knew you were goingto say that.
Carol: Yeah. I'm like, wow,we're 14 below people. Well, there has been a lot happening withthe VR program over the past decade, and we certainly have had ourebbs and flows with funding and staffing. And as of late, thefiscal pendulum has been swinging, VR programs have beenexperiencing a tightening of the belt, so to speak, and discussionsabout the order of selection have been ramping up. And so for ourlisteners, order of selection is a process required under the VRregulations. When a VR agency does not have enough resources,whether it's funding staff or both, to serve all eligibleindividuals, and it's designed to prioritize services for thosewith the most significant needs. But over the years, order ofselection really has sparked a lot of tension. And for some it'sseen as just another layer of government red tape adding to thestigma around bureaucracy. Others argue that it undermines the veryspirit of the rehab act by limiting access to services instead ofpromoting inclusion. Critics point out that it can widen servicegaps. It leaves individuals with moderate disabilities withoutsupport, even though they still face serious barriers toemployment.
And for our counselors, order of selection canbring its own challenges, including the emotional burden ofexplaining to clients why they can't receive immediate services.And for clients, being placed on a waitlist can feel dishearteningand frustrating. And at the same time, agencies are grappling witha harsh reality. There's limited resources. Tough decisions have tobe made. So how do we balance fairness, inclusion and theconstraints of funding? And that is the question at the heart oftoday's conversation on order of Selection. So, Theresa, I've beena fan of yours for a long time. I think you bring a reallythoughtful approach to almost every difficult situation in VR, andyou been around a while, so I definitely want to pick your brainabout your thoughts and approach on the topic. And Chris, I'mreally count on you to bring the facts from an RSA perspective onwhat needs to happen with the Order of Selection. So let's dig in.So, Theresa, can you just tell us to start out with a little bitabout yourself and your journey into VR?
Theresa: Sure. I probablyhave the least interesting journey, but maybe the most classic. Iwent from straight from undergrad to graduate school to get mymasters in rehabilitation, got my CRC that same summer, and Ientered the rehab field initially with a nonprofit, CRP, beforecoming to Indiana VR in 2004. So I've been with the VR program fora little over 20 years. Made my journey starting from a VRcounselor and now director with, as you can imagine, a lot of otherroles along the way. And I think I'm a fairly tenured VR directorwith almost nine years under my belt in this role.
Carol: Yeah, definitely youwould be. Because I remember being told when I left, I had sixyears, you know, and people were telling me usually the lifespan ofa VR director is about five years because the job is tough. Soyou're definitely one of our longer term folks. So, Chris, howabout you? How did you venture into the VR world?
Chris: Thanks, Carol. Well,similar to Theresa, my graduate degree in rehab counseling, Ibecame a CRC and began my career as a VR counselor with the Stateof New York in the general agency at the time, for about fouryears. And I've been with RSA now for a lucky 13. Just had my 13thanniversary. And in that time have served in a variety of roles.So, yeah, really happy to be here and now leading the divisionthat's responsible for all of our formula grant.
Carol: Yeah, it's super cool.It's been fun to watch your career, Chris, as you have grown.I remember one of the very first conferences you presented at, andI believe you were still, you know, more kind of on the stafflevel. And I thought, who's this guy? You were up there, you justhad such a great presence about you. And I'm like, he's goingsomewhere. And you have, it's come true.
Chris: Thanks, Carol.
Carol: So let's talk aboutthe realities of Order of Selection. It's not something that can beimplemented at the snap of a finger. And so I want to start withyou. What are those factors via our leaders need to take intoaccount.
Theresa: Yeah. You know it'shard I feel like I sort of came to terms with it because it's itdidn't feel so much like something we had to choose or decide upon,but more something we had to do. if your circumstances are suchthat you don't have the resources to serve everyone. So in Indiana,we enter the order in 2017, and I believe that was the first timein our history, as far as I know, it came after years of tryingother things, you know, implementing strategies to improve ourcapacity, stretch our resources. And just a few examples.Implementing efficiencies, changing to our staffing structure,changing our minimum VRC qualifications to a bachelor's degree, anda whole lot more. And those strategies were definitely focused forus at that time around staffing resources. But there were also somefiscal unknowns or concerns because right around that time, the 15earmark requirement was also, you know, kind of hitting us. And wewere trying to figure out how to shift those resources. So thestrategies we did pre they were definitely helpful. They wereeffective, but we still were left with a deficit. You know, westill had high caseload sizes. It was taking way too long for newreferrals to get an intake appointment. Our VRC turnover rate wasmuch higher than is optimal. Ultimately led us to identify that wewere not able to provide the full range of ER services to everyonewho was eligible, and therefore we needed to enter the Order ofSelection.
So we started planning for that probablyaround nine months prior to. The implementation and when I wasmaking my talking points, there's a lot that you have to do, right,to prepare for Order of selection. So discussion with our internalleadership, our VR council, our stakeholders, our staffconversation with RSA, drafting that state plan amendment, gettingthat out for public comment. We took a couple extra steps and metwith our other workforce partners because we thought, hey, they mayget more referrals here. We may want to tell them why and what'sgoing on over here and what this means. And then we of course, youhave to develop written procedures, adapt your case managementsystem. And then we also wanted to be really careful with ourmessaging to applicants. So we drafted some materials that wewanted our intake counselors to share and get that consistentmessage out there and, of course, training our counselors. So Ithink the nine month runway was probably a fast track Approach,thinking about all those steps. You want to do it right? You wantto be planful. But at the same time, once you identify that this isa need, you usually need it to happen pretty quickly.
Carol: Absolutely. I know forme, when I was a new director in Minnesota, I actually faced this.And Minnesota Blind had not been on an order for many, many, many,many, many, many years. And being a little naive, you know, cominginto VR going, we have this situation, you know, I'm thinking thisall can happen super fast. It does not. But I found for me, reallygetting grounded in understanding our data was so important becauseI see these things all going on. But you had to put all the piecestogether, get your fiscal side of the house and what's going on andhow you're making expenditures and investments in different thingsand what's happening with that. But what also is happeningprogrammatically, the people that are coming in and thecharacteristics of your caseload and all those different things,you had to put it all together to really get the complete picture.And for me, I know I had to do that rather quickly. So it becomessuper important to have people around you. If you are not thatperson you know, that can pull all that data and present it in away so you can really see the picture of what is happening and kindof unfolding in the state.
I think it just so foundationally because Iknow I have this little list at my desk of people that have calledme looking at needing to go on order selection or thinking they'regoing to need to. And we have over a dozen states that haveoutreached in the last two months. And part of my advice to themhas been back, you know, you have to get grounded to and what wasyour data telling you? Because you can't just base this all in sortof an assumption or something. You've got to be grounded. So Ialways think that that's a really important piece to start with.Now, Chris, I know from a regulatory perspective there are itemsthat are absolutely critical for VR to have in place when you wereconsidering Order Selection. Can you help us with that? Because Iwant to make sure people aren't making a mistake, you know, asthey're kind of thinking through the process.
Chris: Definitely. There areseveral regulatory requirements, and before we address those, Ithought I could provide just a little bit of context at the momentof where we're at with Order selection across the country. As youknow, we have 78 VR agencies and only eight of them have a closedpriority category, and only one of those eight have all prioritycategories closed. So this is significant progress over the pastseveral years, I'd say since the passage of WIOA in 2014, in thepast, as many as a fourth of our VR agencies had at least oneclosed priority category. And I can say that when RSA meets withcongressional committees and other stakeholders, they often ask usfor a status check on Order of Selection, and I can tell you thatthey respond really positively when we share that very few VRagencies are unable to serve all eligible individuals. Further,since RSA and our federal partners approved, the latest state planwould be the 2024 to 2027 state plans, RSA has approved one VRagency's new order of selection, and at the moment, we have 2 to 3VR agencies that have submitted paperwork and are pendingimplementation.
Carol: You might have a fewmore. Chris now coming because I have I have my list of peoplecalling. I mean really we do have 12 now on the list, so I expectmaybe some more outreach.
Chris: Yep. So in terms ofall of those regulatory requirements, like you said, VR agenciesneed to have a few things in place as they consider implementation.These include a comprehensive fiscal forecast, cost containmentpolicies if necessary, and assessment of staff resources. And asTheresa talked about, consultation with the State RehabilitationCouncil, so that fiscal forecast needs to address six data points.Average case costs, the projected number of new IPEs, the currentnumber of IPEs, the projected number of applicants and the cost ofany assessment services that might be needed to determine themeligible for the program. Projected increase or decrease in thecost of providing VR services to these groups of people, andprojected income, or in any other budget resources that may becomeavailable. The fiscal forecast produces that data, Carol, that youwere talking about, that demonstrates whether or not the VR agencycan do the following four things. Whether the agency can continueto provide services to all individuals currently receiving servicesunder their plans. Provide assessment services to all thoseindividuals expected to apply to the program over the next fiscalyear. Provide services to all individuals who are expected to bedetermined eligible in the next fiscal year. And finally, thatfiscal forecast needs to include data that demonstrates that the VRprogram will continue to meet all of the various programrequirements, like that 15% reserve requirement that Theresadiscussed. So in terms of creating an Order of Selection policy,there are about five things that the VR agency needs to include inthat actual policy.
First is it's priority categories, includingthe regulatory definition of what significant disability means, howthe VR agency will determine which individuals have the mostsignificant disabilities. And that definition must build on thatregulatory definition of significant disability. The policy needsto address whether the agency has elected to serve individualsoutside of the order of selection, who may require specificservices or equipment to maintain their job or to keep employment,was one of those new requirements. The policy must indicate how theVR program will provide information and referral services toindividuals who may be placed on a waiting list. And finally, thepolicy needs to describe how the agency will carry out the order,how it will be implemented so, in effect, how the waitlist will bemanaged and how the VR agency will decide when to open all of thoseother priority categories. I was happy that Theresa also mentionedthat VR agencies need to ensure that their case management systemcan fulfill the administration of the order. And we like to see inthe policy some discussion of what tracking mechanisms VR agencieswill use to account for such things as cost, staff time andcaseload sizes. So in other words, sort of that real time dataanalysis that That informs whether the order continues to benecessary or whether it can be lifted.
Carol: Awesome. I'm surepeople are probably, as they're listening, taking copious notes. Sofolks need to know that there also is always a transcript that goesalong with the podcast. So if your wrist just broke, you will beable to just take a look at the notes and get all those things.That is super helpful. Chris, I wanted to ask as a follow up, sothat people that have outreached so far, those states that haveoutreached are you seeing? Is it a fiscally related issue? Is it astaffing? You know how sometimes the states are really strugglingwith having appropriate staffing? I know it's only been a few, butdo you know kind of what that looks like if it's based on more ofthe fiscal end of things, or is it they don't have capacity becausethey don't have any staff?
Chris: It's been acombination of all of those things, Carol. So we're seeing agencieswith limited fiscal resources, whether that be state appropriatedfunds, their inability to kind of fully leverage the federal award.It may be retention and recruitment of VR counselors. It could alsobe sort of capacity of providers, whether those are community rehabproviders or contractors who provide VR services. And oftentimesit's other things that kind of just contribute to those as well.And what we're hoping to see in those justifications that VRagencies submit is a real data informed discussion of thosefactors, like real time data in terms of both fiscal data andperformance data. So the money and the people.
Carol: Yeah, I can'tunderscore that enough, because I know the folks that have reachedout to us a lot of times they tend to talk about, you know, theirhair is on fire about this thing. And then I'm always bringingback. So if they're all focused just on the fiscal. But Isaid, what's happening in your program, what's going on? And thathas been very interesting as people are talking about. And thenthey call us back. They go, you know, the characteristics of theindividuals coming in the case characteristics, kind of pre-COVIDto now is different. And so we're finding clientele coming in hasmany more needs, and so the cost of the case are so much greater.And they hadn't realized it until they went back in. They just knewsomething was going on with the people, but they didn't understandwhat. So by going back and saying, hey, you got to look at thisother side of the house and really analyze what's happening. Itwill give you the full picture. And then what is playing intowhat's happening over here on the fiscal side of the house. So Ithink for, you know, we've all said it, the data is superimportant. I just want to underscore that. So Theresa, tell us alittle bit about your journey with Order Selection in Indiana andyour current picture what's happening?
Theresa: I echo the dataconversation, that's critical, and you really have to justify theneed for the order. So we did all of that really before we evenprobably got to that, that nine month runway that I spoke of. Butfrom there, our next step was to get our internal leadershipapproval. And there were hesitancies, which is understandable. Wereally had to work to articulate and help them understand thechallenges that we were facing. Again, justifying using that datathat we were not able to provide the full range of services toeveryone, while also meeting the range of other expectations, youknow, timeliness, getting people in the door in a reasonable periodof time. And we really had to work to articulate the negativeimpact of having these ongoing high caseload sizes and the cyclethat we were in with staff turnover. It just felt like we weregetting deeper and deeper into right into a hole and further andfurther away from optimal capacity. So ultimately, we presented theOrder of Selection as one something that is federally required forour agencies, you know, not able to provide that full range ofservices. And then two, a lever of sorts that would enable us tomaybe pause or slow some of that growth in participants, giving usthe space to get out of that cycle to rebuild our foundation, whichfor us primarily at that time, was fixing our long standingstaffing capacity challenges. But for those experiencing fiscaldeficits, of course, that focus would look very different. Once wegot leadership support, we moved as quickly as humanly possible.And now on the other side of it. I'm thrilled to share that we havenow opened all of our priority categories. We released the last 200or so from our waitlist just this past October, so we were in andout of the order in about a seven year period in Indiana.
Carol: I love that. I likethat you said you want to project, you know, the ways to get kindof out of the order to open the categories and do that. I know forstates that have contacted us, that's one of the pieces of adviceI've been giving. I'm like, okay, you're thinking about the rightnow, but you also have to think about the future because that iseveryone's biggest worry. You're going to do this thing and it'snever going to go away. People are going to be in a waitlistforever. You're never putting strategies in place to come out onthe other side of that. And I know for me in Minnesota, that wasvery much part of what I had to do. And given the circumstances wehad at that time, I had this plan and I said, if you all can hangwith me, I believe by about 2018 or so, end of 17-18, we're goingto be on the other side of this, which actually ended up playingout and coming true. And so you've got to not only like react toyour current situation, but you want to be thinking thoughtfullyabout what are those things that you can put in play so that youaren't just going to stay there? This is the lever we're pullingand we're going to be here forever. So I really like that you saidthat. I know, Theresa, when you and I talked earlier, Orderselection can often be treated like a bad word in the VR world, andit is loaded with a lot of stigma and frustration. But at its core,you know, when you and I were chatting and, you know, you just boilit down, it really is a mechanism. It's a tool required by law toprioritize services when resources are limited. And so if we can'tdo everything for everyone, it's a system that outlines how to makethose tough decisions. What are your thoughts about Order ofSelection and how we can maybe shift the conversation to reduce thestigma and see it for what it is? It can be this necessary lever tobalance fairness amongst those limited resources.
Theresa: Yeah, that'sprobably one of the trickiest parts in communication.Communication, right. Communication. Communicating withstakeholders about Order Selection will probably always bechallenging. It's a challenging thing, but I think there's a coupleof things that were really helpful. And one is sharing a game planto address the underlying resource challenges. Is a helpfulapproach, right. Making sure that there's game plan. This isn't theend result, right? This is going to enable us to make this shiftand again kind of get out of the cycle. We also found it helpful toshare the federal requirements. So just very factually, if youcan't serve all you have to prioritize certain populations first.And the Order of Selection is the prescribed process for complyingwith that. And I think it's a good process for doing that. It'seffective at making sure the prioritization happens. Additionally,we also share data throughout our process on the percent ofeligible individuals who were impacted. And what that showed isthat the majority of individuals were actually not impacted. Youknow, relatively speaking, a pretty small percent of folksultimately went on a wait list. And, you know, you could evenargue, and I think we did a couple of times that for the majorityof folks, they were maybe even having somewhat of a positive impactbecause we were able to get them processed, get them in sooner.
And, you know, there's obvious benefits thatgo along with lower case load sizes. So we often relay that onlyabout 10% of eligible individuals were going on a wait list, and90% were meeting that criteria for those with a most significantdisability, which was our open category for a good bit of our sevenyears. I will say people were a little wary of that stat. They kindof had a hard time believing that, and I think that it's becausethat term MSD or most significant disabilities, it definitely hasmeaning. But also we found it could be a little bit misleading. Youknow, people thought, oh, to be MSD, someone must look like this,right? And we actually found that those meeting that MSD criteriawere really a more inclusive group than maybe that term peoplewould perceive that term to imply. And that was just anothereducational opportunity for our stakeholders and our referralsources.
Carol: I like that you talkedabout the communication piece around all this, because that reallyis important. It's almost as important as all of the plans you'reputting in place. All the things that Chris told us about that needto go in developing that communication plan, that goes along withhow you discuss this out amongst all the stakeholders and such, issuper important. I know, Chris, do you have any insights on thispart, on the stigma or anything you wanted to share?
Chris: I guess I just had acouple thoughts on like the element of fairness that you talkedabout in dealing with fairness and at the same time limitedresources. So I guess I would just say that order of selection isonly one of the cost containment measures afforded to VR agenciesthrough the law and through regulations. And there are otherthings, too, that VR agencies may want to consider, and that'scomparable services and benefits. How we inform people and referthem to other workforce development programs. Those may be ourpartners or others. How we balance what VR Agencies by in terms ofservices and what we provide in-house in the cost kind ofassociated with both strategies. One of the other things that RSAoften considers VR agencies to look at when we're talking aboutimplementing an order is kind of carefully evaluating the need torequire additional assessments when the law allows and promotes theuse of existing information. So sort of not overdoing thateligibility determination process because that often comes withcost. Right. And then finally VR agencies should also bereassessing sort of their routine practices and policies thatresult in increased cost. That may not always be necessary. Sowe're really looking at kind of the entire fiscal picture of theprogram, not just those VR service costs that are provided toeligible individuals.
Carol: That's good. I'm gladyou brought all of that up, because we often do talk about theseother factors. And I asked people, are you also looking at what areyou getting bang for your buck? And not that we're trying to bangon vendor communities, but do you have vendors where people neverlike they're never done with service, they never graduate, theynever get to the end? I mean, maybe it's looking back at that andgoing are the ways in which their training really working for yourclientele? Maybe not. Maybe you need to circle back and work withthem or have a parting of the ways and think about that. I alsolike the thinking about really leveraging our partners. I mean, thewhole rehab act, when it was redone, you know, and we had the 2014WIOA comes out of that. We always had partners, but I don't thinkwe were very good at leveraging what things are they doing. And Ifeel like some of this stuff is duplicative. You know, why are weoffering these same sort of trainings that are now at the one stopthat people can access and go to those courses or whatever, youknow, types of things that they're offering. So it does force youto take a look at that and really actually live in to WIOA andleveraging the partnerships and the funds across all these systems.I like that. Thank you Chris, for saying that. Order Selection alsohas to be a super thoughtful process. And so, Chris, I know youtalked about the data points that folks should look at. Theresa,what are the data points you look at regularly? And I like itbecause some directors talk about kind of they're reading the tealeaves to complete your fiscal forecasting, or there's some otherthings that you like to do.
Theresa: Oh gosh, yeah, Wecould talk all day on fiscal forecasting. But to just kind of bebrief, you have to look beyond just what did we spend last year andapply that and assume that. And I think if you don't have programstalking to fiscal sometimes that is the fiscal assumption. Right.By fiscal staff being made. So with the pendulum swings that wetend to see in VR, which of course are highly driven by trends andapplicant and participant counts, you really need to have a verylayered approach to forecasting. This is where, again, that programknowledge and fiscal knowledge, it's essential that they're pairedup. Just a few things to consider would be beyond the basics right.What is your data show? What are your trends? Show. But what's inyour state plan? What are the goals? What are the initiatives thatyou have in place? There may be a fiscal impact to those, right?There may be a staff resource impact to those. So for instance, avery obvious example in our state plan, we have some goals aroundincreasing enrollment in post-secondary training. There's somefiscal impact there. We need to know what that is, how to applythat, and then really have an understanding of our ability tosustain that goal into the subsequent years.
Again, the applicant and participant growthtrends are super important. So keep your eye on and then any impactof any other outreach or collaborative partnerships that might becontributing to some of that program growth. You know, more peopleserved generally is going to mean more expenses. And then justquickly, from kind of a fiscal standpoint, something that might bea little bit unique beyond, again, all the basic essentials offiscal forecasting is we really have to account for carrying over acertain portion of our dollars. And that really comes down tomaking sure we don't have, you know, disruptions and services andcan comply with this period of performance requirements. So we findin Indiana that, you know, carrying over like 20 to 25% works wellfor us, ensures that we can continue authorizations past 9/30 andnot have that challenge of waiting until ten/1, you know, toencumber new funds. And that just keeps the flow of services going.So I'll just add that as maybe a nuance that others aren't alwaysthinking about.
Carol: Yeah, I appreciatethat because I think that having that strategy I did too, as adirector, wanting you have your sweet spot of what you like to havein that carry over, because it really does promote that consistencywhen you have that hard start and stop, and especially in an era ofcontinuing resolutions, you know your whole strategy with howyou're flowing into the next year and how all that's going to work.You need to think about that piece for sure. Now, I know a bigproblem has existed around priority categories and the mostsignificant disability designation. And many programs have threecategories, but almost 90% of the customers are in category one,which makes it difficult, you know, when you're implementing anOrder of Selection. How did you address that in Indiana?
Theresa: Yeah, that's exactlywhat we saw. And we balanced this by a couple of key strategies.One is that we did not release anyone from the waitlist until alittle over two years into our process. That's kind of howwe, how bad of a cycle we were in. And again, it's a lever.It's that dial. We had some targets like caseload sizes,retention rate that we were tracking as a gauge to when we couldstart moving people off that waitlist. So just for example, averagecaseload size is getting to under 100, turnover being less than20%. So those were some indicators to watch to start releasingfolks. Another strategy that was really helpful is that we opted todo larger releases each quarter instead of kind of smaller, morefrequent releases. And this gave us the opportunity to really haveour staff know that it was coming the same time each quarter. Theycould carve out time because it is a lift on top of the day to day,right? You've got to reach out to folks multiple times. You've gotto schedule them for meetings. You've got to get IPEs in place. Andthen with those reviews of the, you know, again, we might look atlike 2 to 300 people to see, can we take 300? Can we take 200? Isit somewhere in the middle? How does that break down across your 26offices? And inevitably each quarter, one office got hit with ahigh number. And then there were a few that had very little. So wealso had to weigh that and see where we could balance our resourcesto make those work. You know, at the end of the day, you ultimatelyhave to release more people from the waitlist than new people whocame in as eligible that quarter in order to get ahead of it. Sothat was another data point that we looked at.
Carol: Did you find thatactually learning kind of through Covid, a lesson, you know, withworking remotely and all of that, did that help as you're lookingat distributing across the 26 areas? Because you can I mean, andI've talked to other directors about this now you can work withpeople. Maybe you're in this part of the state, but you can workwith other folks as well to keep them moving. So maybe there isn'tthis huge one off, it's just got 200 people and the other officesget one, you know, they don't have any. Did you find some abilityto flex that around the state?
Theresa: Absolutely. That'sexactly what we did. So those offices that were hit hard, ofcourse, they were also the offices with the highest number ofvacancies. It just seemed to be how it fell every quarter. Soabsolutely, our region managers really did it. We have five ofthose five regions. They really did an excellent jobtroubleshooting that, you know, we helped where needed. But theyfor sure did that looking across offices in their region and evenacross the state. We also have about 7 or 8 working leadcounselors, kind of floater counselors. So we were able to deploythem to the areas with the highest need. And then as we progressedthrough the order, we had a pretty robust outreach process. As wewere getting ready to release folks, we ended up centralizing thata little bit to take some of that load off of our field staff aswell. So, you know, you kind of have to adjust as you go. Move yourresources where you can. But absolutely, we found that to be agreat strategy.
Carol: Chris, you have anythoughts on that about the priority categories and the mostsignificant disability? I just wondered because I know folksstruggle with that. You were looking contemplative, so I thoughtmaybe you might have something to add.
Chris: My philosophy with alot of things, Carol, has always been less is more. And youmentioned that most of our agencies have three priority categories.And if I were able to say this is a requirement, that wouldprobably be what I would say. But, you know, VR agencies haveflexibility to develop more than three. I would just caution thatas you get more complicated, things get more complicated forapplicants to understand and for VR counselors to implement. Soagain, I would just say that the law requires that the significantdisability category be identical to what's in the rehab act and theregs, and that that most significant category needs to build uponthat. So we often see agencies talking about more functionallimitations, more services being needed, more time needed to helpthe person reach their employment goal. So the more specificitythere, the better is. I think that helps VR counselors kind ofunderstand where to place people when they're determinedeligible.
Carol: Yeah, that's reallygood advice. Now I know, Theresa, also, you have talked aboutwanting to bust the myth that nobody gets off the waitlist. And howcan we better do that?
Theresa: I can't tell you howmany times I've heard that in Indiana, and that was part of the alot of the grief is that there was this thought that we'll neverget out. So we know that's not true. The facts are there. You know,there are many states. And Chris shared, you know, 25% down to lessthan ten. So less than ten states. So we know it happens. There arestates who've done it. I don't know if we do enough to highlightthat to kind of our stakeholders, you know, at large and celebratethat. So maybe that's part of the answer. You know, we have thoseactual examples. That's an important part of the communication tointernal and external stakeholders. The other piece here isoutlining the conditions that need to be in place to progress, toopening more categories, to ending the order, and then people cansee you hitting those target milestones. They may start believingthat, oh wow, there's some actual notable objective progress here.We are getting closer to the end. This does seem doable.
Carol: Yeah, I think goingback to that communication strategy for sure can help. I know withour SRC, and I had laid out the plan like I had all these pointsthat we needed to do to kind of get through our struggle. And asthings were met or we were able to achieve other savings in certainareas without impacting, you know, a quality of a service. Man ,itwas great. Like no stone was unturned as we did that. But I wantedto be super transparent. Here's all the things. And I kept a littlechart, like, here was this savings, or here we met this thing sopeople could see we were actively working a process all the waythrough, versus okay, we are pulling the lever and the lever isjust staying closed down. That's it. They don't see the other end.All that work that's being done behind. So what is your best advicefor state directors contemplating pulling the lever?
Theresa: Well, we definitelylooked at it as that lever or that dial, and we felt that that gaveus an opportunity. We really would not otherwise have had to takeaction on addressing a really significant foundation or core issuewhile slowing down that incoming train a little bit and refocusingour resources, staffing and fiscal building adequate resources andcapacity. It's an ongoing effort. It never ends. It's one of themore difficult things, probably, that we do, but it's so criticalto carrying out services in general, let alone good qualityservices. And it requires a very thoughtful plan and a lot ofsimultaneous strategies. You know, all the strategies weimplemented from salary adjustments to, you know, creating thoseworking lead counselors I mentioned, we developed a layer of casecoordinators to take on some of the case management aspects. Ithink some states call them rehab techs. Lots of gaining oftechnology, you know, modernization and efficiencies and then some.Right. It ultimately helped us with two really big systemic needs.And one was getting cancer caseload sizes to manageable levels andreducing our VRC turnover. I mean, those things are gold when itcomes to staff capacity.
Carol: Now, Chris, I don'twant to steal your thunder, but what I'm going to say to folks toois call RSA. Like, reach out to your liaison and talk to them aboutyour situation. You want to start those conversations because theworst thing I would think is you're a state liaison at RSA and youjust get this boom, we want to do it. We need to go on March 1stand today is January, you know, 24th. You want to have thatpartnership all the way along. And I know, Chris, you can speak alittle more to that for sure.
Chris: Carol, you know, weoften talk about with clients early and sustained engagement. And Iwould encourage VR agencies to take the same approach with us atRSA. Reach out early and keep that conversation going. The order ofselection approval process is going to be iterative. In 99% oftimes, RSA will have feedback and will have questions, and we'llwant to see justifications be made as strong as possible. So toyour point, Carol, our ability to approve orders of selectionovernight is not possible. Theresa talked about sort of a ninemonth on ramp. I wouldn't say it's going to take that long on ourend, but it will take at least a couple of weeks. And the strongerthe justification we receive, the better. Again, I would just saythat consider all of the flexibilities that the Rehab Act offers toVR agencies when it comes to managing the program, in addition toimplementing an order. And we talked about some of those before,but they could mean cost containment from financial participationto preferences to instate services, to looking at theadministrative costs that you might pay for providing services,your staffing capacity, and really leveraging the ability of yourSRC. To advocate for the program, we often talk about the return oninvestment of the VR program, and it really is unlimited. Ourprogram offers a lot of flexibility to be creative, to help peoplemeet their career goals, and that's kind of the best thing we havegoing for us to argue for the sustainability of the program movingforward.
Carol: Yeah. Excellentpoints. The SRC can do so much more than we can do, really, and alot of venues and have a different voice and a seat with thegovernor. You know, they're appointed by the governor. They have adifferent mode of communication that they can use that we cannot.So we definitely don't want to forget about them. All right guys,so we're coming to a conclusion. Any last parting thoughts fromeither of you for our listeners?
Theresa: Well, I'll just add,I think we've touched on a lot of great lessons learned incommunication. Number one, really important. And we've hit on someideas and strategies around that. And then the second, having thatgame plan, it's critical so that we're all viewing Order ofselection, not as that end result right, or that indefinite status,but as that lever or that dial that can be adjusted to address thesituation at hand and then get back on track, get out of the order,be able to serve everyone who needs those services.
Carol: Awesome. I reallyappreciate you both and appreciate having this conversation. Andfor our listeners who were taking notes, because I know you guysread the transcript because that will help you with all of that.You can go back through and highlight the things you need to do.Thanks so much for being here today. Appreciate you.
Theresa: Thank you.
Chris: Thanks, Carol.
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