Mar 3, 2025
Join host Carol Pankow as she dives into the complexities of Order of Selection (OOS) in vocational rehabilitation with two expert guests: Theresa Kolezar, Director of Indiana Combined, and Chris Pope, Director of the State Monitoring and Program Improvement Division at RSA.
In this episode, they break down:
· Why agencies implement OOS due to financial and staffing constraints
· Key regulatory requirements and compliance considerations
· Strategies for managing and eventually lifting OOS
· Indiana VR’s data-driven approach to decision-making and communication
· RSA’s insights on fiscal forecasting and policy compliance
If you're in the VR field, you won’t want to miss this insightful conversation on planning, stakeholder engagement, and using data to overcome challenges.
{Music}
Chris: As you know, we have 78 VR agencies and only eight of them have a closed priority category, and only one of those eight have all priority categories closed.
Carol: So by going back and saying hey you gotta look at this other side of the house and really analyze what's happening. It will give you the full picture, than what is playing into what's happening over here on the fiscal side of the house.
Theresa: For the majority of folks. They were maybe even having somewhat of a positive impact because we were able to get them processed, get them in sooner. And you know, there's obvious benefits that go along with lower case load sizes.
Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.
Carol: Well, welcome to the manager minute. Joining me in the studio today is Theresa Kolezar, director of Indiana Combined. And Chris Pope, director of the State Monitoring and Program Improvement division at the Rehabilitation Services Administration. So, Theresa, how are things going with you in Indiana?
Theresa: Oh, we're doing well. 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 in D.C. at the moment, Carol, but we're hanging in there.
Carol: Yeah, not as cold as Minnesota.
Chris: I knew you were going to say that.
Carol: Yeah. I'm like, wow, we're 14 below people. Well, there has been a lot happening with the VR program over the past decade, and we certainly have had our ebbs and flows with funding and staffing. And as of late, the fiscal pendulum has been swinging, VR programs have been experiencing a tightening of the belt, so to speak, and discussions about the order of selection have been ramping up. And so for our listeners, order of selection is a process required under the VR regulations. When a VR agency does not have enough resources, whether it's funding staff or both, to serve all eligible individuals, and it's designed to prioritize services for those with the most significant needs. But over the years, order of selection really has sparked a lot of tension. And for some it's seen as just another layer of government red tape adding to the stigma around bureaucracy. Others argue that it undermines the very spirit of the rehab act by limiting access to services instead of promoting inclusion. Critics point out that it can widen service gaps. It leaves individuals with moderate disabilities without support, even though they still face serious barriers to employment.
And for our counselors, order of selection can bring its own challenges, including the emotional burden of explaining to clients why they can't receive immediate services. And for clients, being placed on a waitlist can feel disheartening and frustrating. And at the same time, agencies are grappling with a harsh reality. There's limited resources. Tough decisions have to be made. So how do we balance fairness, inclusion and the constraints of funding? And that is the question at the heart of today's conversation on order of Selection. So, Theresa, I've been a fan of yours for a long time. I think you bring a really thoughtful approach to almost every difficult situation in VR, and you been around a while, so I definitely want to pick your brain about your thoughts and approach on the topic. And Chris, I'm really count on you to bring the facts from an RSA perspective on what 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 bit about yourself and your journey into VR?
Theresa: Sure. I probably have the least interesting journey, but maybe the most classic. I went from straight from undergrad to graduate school to get my masters in rehabilitation, got my CRC that same summer, and I entered the rehab field initially with a nonprofit, CRP, before coming to Indiana VR in 2004. So I've been with the VR program for a little over 20 years. Made my journey starting from a VR counselor and now director with, as you can imagine, a lot of other roles along the way. And I think I'm a fairly tenured VR director with almost nine years under my belt in this role.
Carol: Yeah, definitely you would be. Because I remember being told when I left, I had six years, you know, and people were telling me usually the lifespan of a VR director is about five years because the job is tough. So you're definitely one of our longer term folks. So, Chris, how about you? How did you venture into the VR world?
Chris: Thanks, Carol. Well, similar to Theresa, my graduate degree in rehab counseling, I became a CRC and began my career as a VR counselor with the State of New York in the general agency at the time, for about four years. And I've been with RSA now for a lucky 13. Just had my 13th anniversary. And in that time have served in a variety of roles. So, yeah, really happy to be here and now leading the division that'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, and I believe you were still, you know, more kind of on the staff level. And I thought, who's this guy? You were up there, you just had such a great presence about you. And I'm like, he's going somewhere. And you have, it's come true.
Chris: Thanks, Carol.
Carol: So let's talk about the realities of Order of Selection. It's not something that can be implemented at the snap of a finger. And so I want to start with you. What are those factors via our leaders need to take into account.
Theresa: Yeah. You know it's hard I feel like I sort of came to terms with it because it's it didn't feel so much like something we had to choose or decide upon, but more something we had to do. if your circumstances are such that 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 time in our history, as far as I know, it came after years of trying other things, you know, implementing strategies to improve our capacity, 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, and a whole lot more. And those strategies were definitely focused for us at that time around staffing resources. But there were also some fiscal unknowns or concerns because right around that time, the 15 earmark requirement was also, you know, kind of hitting us. And we were trying to figure out how to shift those resources. So the strategies we did pre they were definitely helpful. They were effective, but we still were left with a deficit. You know, we still had high caseload sizes. It was taking way too long for new referrals to get an intake appointment. Our VRC turnover rate was much higher than is optimal. Ultimately led us to identify that we were not able to provide the full range of ER services to everyone who was eligible, and therefore we needed to enter the Order of Selection.
So we started planning for that probably around nine months prior to. The implementation and when I was making my talking points, there's a lot that you have to do, right, to prepare for Order of selection. So discussion with our internal leadership, our VR council, our stakeholders, our staff conversation with RSA, drafting that state plan amendment, getting that out for public comment. We took a couple extra steps and met with our other workforce partners because we thought, hey, they may get more referrals here. We may want to tell them why and what's going on over here and what this means. And then we of course, you have to develop written procedures, adapt your case management system. And then we also wanted to be really careful with our messaging to applicants. So we drafted some materials that we wanted our intake counselors to share and get that consistent message out there and, of course, training our counselors. So I think the nine month runway was probably a fast track Approach, thinking about all those steps. You want to do it right? You want to be planful. But at the same time, once you identify that this is a need, you usually need it to happen pretty quickly.
Carol: Absolutely. I know for me, 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, coming into VR going, we have this situation, you know, I'm thinking this all can happen super fast. It does not. But I found for me, really getting grounded in understanding our data was so important because I see these things all going on. But you had to put all the pieces together, get your fiscal side of the house and what's going on and how you're making expenditures and investments in different things and what's happening with that. But what also is happening programmatically, the people that are coming in and the characteristics 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 becomes super important to have people around you. If you are not that person you know, that can pull all that data and present it in a way so you can really see the picture of what is happening and kind of unfolding in the state.
I think it just so foundationally because I know I have this little list at my desk of people that have called me looking at needing to go on order selection or thinking they're going to need to. And we have over a dozen states that have outreached in the last two months. And part of my advice to them has been back, you know, you have to get grounded to and what was your data telling you? Because you can't just base this all in sort of an assumption or something. You've got to be grounded. So I always think that that's a really important piece to start with. Now, Chris, I know from a regulatory perspective there are items that are absolutely critical for VR to have in place when you were considering Order Selection. Can you help us with that? Because I want to make sure people aren't making a mistake, you know, as they're kind of thinking through the process.
Chris: Definitely. There are several regulatory requirements, and before we address those, I thought I could provide just a little bit of context at the moment of where we're at with Order selection across the country. As you know, we have 78 VR agencies and only eight of them have a closed priority category, and only one of those eight have all priority categories closed. So this is significant progress over the past several years, I'd say since the passage of WIOA in 2014, in the past, as many as a fourth of our VR agencies had at least one closed priority category. And I can say that when RSA meets with congressional committees and other stakeholders, they often ask us for a status check on Order of Selection, and I can tell you that they respond really positively when we share that very few VR agencies are unable to serve all eligible individuals. Further, since RSA and our federal partners approved, the latest state plan would be the 2024 to 2027 state plans, RSA has approved one VR agency's new order of selection, and at the moment, we have 2 to 3 VR agencies that have submitted paperwork and are pending implementation.
Carol: You might have a few more. Chris now coming because I have I have my list of people calling. I mean really we do have 12 now on the list, so I expect maybe some more outreach.
Chris: Yep. So in terms of all of those regulatory requirements, like you said, VR agencies need to have a few things in place as they consider implementation. These include a comprehensive fiscal forecast, cost containment policies if necessary, and assessment of staff resources. And as Theresa talked about, consultation with the State Rehabilitation Council, so that fiscal forecast needs to address six data points. Average case costs, the projected number of new IPEs, the current number of IPEs, the projected number of applicants and the cost of any assessment services that might be needed to determine them eligible for the program. Projected increase or decrease in the cost of providing VR services to these groups of people, and projected income, or in any other budget resources that may become available. The fiscal forecast produces that data, Carol, that you were talking about, that demonstrates whether or not the VR agency can do the following four things. Whether the agency can continue to provide services to all individuals currently receiving services under their plans. Provide assessment services to all those individuals expected to apply to the program over the next fiscal year. Provide services to all individuals who are expected to be determined eligible in the next fiscal year. And finally, that fiscal forecast needs to include data that demonstrates that the VR program will continue to meet all of the various program requirements, like that 15% reserve requirement that Theresa discussed. So in terms of creating an Order of Selection policy, there are about five things that the VR agency needs to include in that actual policy.
First is it's priority categories, including the regulatory definition of what significant disability means, how the VR agency will determine which individuals have the most significant disabilities. And that definition must build on that regulatory definition of significant disability. The policy needs to address whether the agency has elected to serve individuals outside of the order of selection, who may require specific services or equipment to maintain their job or to keep employment, was one of those new requirements. The policy must indicate how the VR program will provide information and referral services to individuals who may be placed on a waiting list. And finally, the policy needs to describe how the agency will carry out the order, how it will be implemented so, in effect, how the waitlist will be managed and how the VR agency will decide when to open all of those other priority categories. I was happy that Theresa also mentioned that VR agencies need to ensure that their case management system can fulfill the administration of the order. And we like to see in the policy some discussion of what tracking mechanisms VR agencies will use to account for such things as cost, staff time and caseload sizes. So in other words, sort of that real time data analysis that That informs whether the order continues to be necessary or whether it can be lifted.
Carol: Awesome. I'm sure people are probably, as they're listening, taking copious notes. So folks need to know that there also is always a transcript that goes along with the podcast. So if your wrist just broke, you will be able 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, so that people that have outreached so far, those states that have outreached are you seeing? Is it a fiscally related issue? Is it a staffing? You know how sometimes the states are really struggling with having appropriate staffing? I know it's only been a few, but do you know kind of what that looks like if it's based on more of the fiscal end of things, or is it they don't have capacity because they don't have any staff?
Chris: It's been a combination of all of those things, Carol. So we're seeing agencies with limited fiscal resources, whether that be state appropriated funds, their inability to kind of fully leverage the federal award. It may be retention and recruitment of VR counselors. It could also be sort of capacity of providers, whether those are community rehab providers or contractors who provide VR services. And oftentimes it's other things that kind of just contribute to those as well. And what we're hoping to see in those justifications that VR agencies submit is a real data informed discussion of those factors, like real time data in terms of both fiscal data and performance data. So the money and the people.
Carol: Yeah, I can't underscore that enough, because I know the folks that have reached out to us a lot of times they tend to talk about, you know, their hair is on fire about this thing. And then I'm always bringing back. So if they're all focused just on the fiscal. But I said, what's happening in your program, what's going on? And that has been very interesting as people are talking about. And then they call us back. They go, you know, the characteristics of the individuals coming in the case characteristics, kind of pre-COVID to now is different. And so we're finding clientele coming in has many 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 knew something was going on with the people, but they didn't understand what. So by going back and saying, hey, you got to look at this other side of the house and really analyze what's happening. It will give you the full picture. And then what is playing into what's happening over here on the fiscal side of the house. So I think for, you know, we've all said it, the data is super important. I just want to underscore that. So Theresa, tell us a little bit about your journey with Order Selection in Indiana and your current picture what's happening?
Theresa: I echo the data conversation, that's critical, and you really have to justify the need for the order. So we did all of that really before we even probably got to that, that nine month runway that I spoke of. But from there, our next step was to get our internal leadership approval. And there were hesitancies, which is understandable. We really had to work to articulate and help them understand the challenges that we were facing. Again, justifying using that data that we were not able to provide the full range of services to everyone, while also meeting the range of other expectations, you know, timeliness, getting people in the door in a reasonable period of time. And we really had to work to articulate the negative impact of having these ongoing high caseload sizes and the cycle that we were in with staff turnover. It just felt like we were getting deeper and deeper into right into a hole and further and further away from optimal capacity. So ultimately, we presented the Order of Selection as one something that is federally required for our agencies, you know, not able to provide that full range of services. And then two, a lever of sorts that would enable us to maybe pause or slow some of that growth in participants, giving us the space to get out of that cycle to rebuild our foundation, which for us primarily at that time, was fixing our long standing staffing capacity challenges. But for those experiencing fiscal deficits, of course, that focus would look very different. Once we got leadership support, we moved as quickly as humanly possible. And now on the other side of it. I'm thrilled to share that we have now opened all of our priority categories. We released the last 200 or so from our waitlist just this past October, so we were in and out of the order in about a seven year period in Indiana.
Carol: I love that. I like that you said you want to project, you know, the ways to get kind of out of the order to open the categories and do that. I know for states that have contacted us, that's one of the pieces of advice I've been giving. I'm like, okay, you're thinking about the right now, but you also have to think about the future because that is everyone's biggest worry. You're going to do this thing and it's never going to go away. People are going to be in a waitlist forever. You're never putting strategies in place to come out on the other side of that. And I know for me in Minnesota, that was very much part of what I had to do. And given the circumstances we had at that time, I had this plan and I said, if you all can hang with me, I believe by about 2018 or so, end of 17-18, we're going to be on the other side of this, which actually ended up playing out and coming true. And so you've got to not only like react to your current situation, but you want to be thinking thoughtfully about what are those things that you can put in play so that you aren't just going to stay there? This is the lever we're pulling and we're going to be here forever. So I really like that you said that. I know, Theresa, when you and I talked earlier, Order selection can often be treated like a bad word in the VR world, and it 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 boil it down, it really is a mechanism. It's a tool required by law to prioritize services when resources are limited. And so if we can't do everything for everyone, it's a system that outlines how to make those tough decisions. What are your thoughts about Order of Selection and how we can maybe shift the conversation to reduce the stigma and see it for what it is? It can be this necessary lever to balance fairness amongst those limited resources.
Theresa: Yeah, that's probably one of the trickiest parts in communication. Communication, right. Communication. Communicating with stakeholders about Order Selection will probably always be challenging. It's a challenging thing, but I think there's a couple of things that were really helpful. And one is sharing a game plan to address the underlying resource challenges. Is a helpful approach, right. Making sure that there's game plan. This isn't the end result, right? This is going to enable us to make this shift and again kind of get out of the cycle. We also found it helpful to share the federal requirements. So just very factually, if you can't serve all you have to prioritize certain populations first. And the Order of Selection is the prescribed process for complying with that. And I think it's a good process for doing that. It's effective at making sure the prioritization happens. Additionally, we also share data throughout our process on the percent of eligible individuals who were impacted. And what that showed is that the majority of individuals were actually not impacted. You know, relatively speaking, a pretty small percent of folks ultimately went on a wait list. And, you know, you could even argue, and I think we did a couple of times that for the majority of folks, they were maybe even having somewhat of a positive impact because we were able to get them processed, get them in sooner.
And, you know, there's obvious benefits that go along with lower case load sizes. So we often relay that only about 10% of eligible individuals were going on a wait list, and 90% were meeting that criteria for those with a most significant disability, which was our open category for a good bit of our seven years. I will say people were a little wary of that stat. They kind of had a hard time believing that, and I think that it's because that term MSD or most significant disabilities, it definitely has meaning. But also we found it could be a little bit misleading. You know, people thought, oh, to be MSD, someone must look like this, right? And we actually found that those meeting that MSD criteria were really a more inclusive group than maybe that term people would perceive that term to imply. And that was just another educational opportunity for our stakeholders and our referral sources.
Carol: I like that you talked about the communication piece around all this, because that really is important. It's almost as important as all of the plans you're putting in place. All the things that Chris told us about that need to go in developing that communication plan, that goes along with how you discuss this out amongst all the stakeholders and such, is super important. I know, Chris, do you have any insights on this part, on the stigma or anything you wanted to share?
Chris: I guess I just had a couple thoughts on like the element of fairness that you talked about in dealing with fairness and at the same time limited resources. So I guess I would just say that order of selection is only one of the cost containment measures afforded to VR agencies through the law and through regulations. And there are other things, too, that VR agencies may want to consider, and that's comparable services and benefits. How we inform people and refer them to other workforce development programs. Those may be our partners or others. How we balance what VR Agencies by in terms of services and what we provide in-house in the cost kind of associated with both strategies. One of the other things that RSA often considers VR agencies to look at when we're talking about implementing an order is kind of carefully evaluating the need to require additional assessments when the law allows and promotes the use of existing information. So sort of not overdoing that eligibility determination process because that often comes with cost. Right. And then finally VR agencies should also be reassessing sort of their routine practices and policies that result in increased cost. That may not always be necessary. So we're really looking at kind of the entire fiscal picture of the program, not just those VR service costs that are provided to eligible individuals.
Carol: That's good. I'm glad you brought all of that up, because we often do talk about these other factors. And I asked people, are you also looking at what are you getting bang for your buck? And not that we're trying to bang on vendor communities, but do you have vendors where people never like they're never done with service, they never graduate, they never get to the end? I mean, maybe it's looking back at that and going are the ways in which their training really working for your clientele? Maybe not. Maybe you need to circle back and work with them or have a parting of the ways and think about that. I also like the thinking about really leveraging our partners. I mean, the whole rehab act, when it was redone, you know, and we had the 2014 WIOA comes out of that. We always had partners, but I don't think we were very good at leveraging what things are they doing. And I feel like some of this stuff is duplicative. You know, why are we offering these same sort of trainings that are now at the one stop that people can access and go to those courses or whatever, you know, types of things that they're offering. So it does force you to take a look at that and really actually live in to WIOA and leveraging the partnerships and the funds across all these systems. I like that. Thank you Chris, for saying that. Order Selection also has to be a super thoughtful process. And so, Chris, I know you talked about the data points that folks should look at. Theresa, what are the data points you look at regularly? And I like it because some directors talk about kind of they're reading the tea leaves to complete your fiscal forecasting, or there's some other things that you like to do.
Theresa: Oh gosh, yeah, We could talk all day on fiscal forecasting. But to just kind of be brief, you have to look beyond just what did we spend last year and apply that and assume that. And I think if you don't have programs talking to fiscal sometimes that is the fiscal assumption. Right. By fiscal staff being made. So with the pendulum swings that we tend to see in VR, which of course are highly driven by trends and applicant and participant counts, you really need to have a very layered approach to forecasting. This is where, again, that program knowledge and fiscal knowledge, it's essential that they're paired up. 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 in your state plan? What are the goals? What are the initiatives that you have in place? There may be a fiscal impact to those, right? There may be a staff resource impact to those. So for instance, a very obvious example in our state plan, we have some goals around increasing enrollment in post-secondary training. There's some fiscal impact there. We need to know what that is, how to apply that, and then really have an understanding of our ability to sustain that goal into the subsequent years.
Again, the applicant and participant growth trends are super important. So keep your eye on and then any impact of any other outreach or collaborative partnerships that might be contributing to some of that program growth. You know, more people served generally is going to mean more expenses. And then just quickly, from kind of a fiscal standpoint, something that might be a little bit unique beyond, again, all the basic essentials of fiscal forecasting is we really have to account for carrying over a certain portion of our dollars. And that really comes down to making sure we don't have, you know, disruptions and services and can comply with this period of performance requirements. So we find in Indiana that, you know, carrying over like 20 to 25% works well for us, ensures that we can continue authorizations past 9/30 and not have that challenge of waiting until ten/1, you know, to encumber 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 always thinking about.
Carol: Yeah, I appreciate that because I think that having that strategy I did too, as a director, wanting you have your sweet spot of what you like to have in that carry over, because it really does promote that consistency when you have that hard start and stop, and especially in an era of continuing resolutions, you know your whole strategy with how you'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 big problem has existed around priority categories and the most significant disability designation. And many programs have three categories, but almost 90% of the customers are in category one, which makes it difficult, you know, when you're implementing an Order of Selection. How did you address that in Indiana?
Theresa: Yeah, that's exactly what we saw. And we balanced this by a couple of key strategies. One is that we did not release anyone from the waitlist until a little over two years into our process. That's kind of how we, 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 could start moving people off that waitlist. So just for example, average caseload size is getting to under 100, turnover being less than 20%. So those were some indicators to watch to start releasing folks. Another strategy that was really helpful is that we opted to do larger releases each quarter instead of kind of smaller, more frequent releases. And this gave us the opportunity to really have our staff know that it was coming the same time each quarter. They could 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 got to schedule them for meetings. You've got to get IPEs in place. And then with those reviews of the, you know, again, we might look at like 2 to 300 people to see, can we take 300? Can we take 200? Is it somewhere in the middle? How does that break down across your 26 offices? And inevitably each quarter, one office got hit with a high number. And then there were a few that had very little. So we also had to weigh that and see where we could balance our resources to make those work. You know, at the end of the day, you ultimately have to release more people from the waitlist than new people who came in as eligible that quarter in order to get ahead of it. So that was another data point that we looked at.
Carol: Did you find that actually learning kind of through Covid, a lesson, you know, with working remotely and all of that, did that help as you're looking at distributing across the 26 areas? Because you can I mean, and I've talked to other directors about this now you can work with people. Maybe you're in this part of the state, but you can work with other folks as well to keep them moving. So maybe there isn't this huge one off, it's just got 200 people and the other offices get one, you know, they don't have any. Did you find some ability to flex that around the state?
Theresa: Absolutely. That's exactly what we did. So those offices that were hit hard, of course, they were also the offices with the highest number of vacancies. It just seemed to be how it fell every quarter. So absolutely, our region managers really did it. We have five of those five regions. They really did an excellent job troubleshooting that, you know, we helped where needed. But they for sure did that looking across offices in their region and even across the state. We also have about 7 or 8 working lead counselors, kind of floater counselors. So we were able to deploy them to the areas with the highest need. And then as we progressed through the order, we had a pretty robust outreach process. As we were getting ready to release folks, we ended up centralizing that a little bit to take some of that load off of our field staff as well. So, you know, you kind of have to adjust as you go. Move your resources where you can. But absolutely, we found that to be a great strategy.
Carol: Chris, you have any thoughts on that about the priority categories and the most significant disability? I just wondered because I know folks struggle with that. You were looking contemplative, so I thought maybe you might have something to add.
Chris: My philosophy with a lot of things, Carol, has always been less is more. And you mentioned that most of our agencies have three priority categories. And if I were able to say this is a requirement, that would probably be what I would say. But, you know, VR agencies have flexibility to develop more than three. I would just caution that as you get more complicated, things get more complicated for applicants to understand and for VR counselors to implement. So again, I would just say that the law requires that the significant disability category be identical to what's in the rehab act and the regs, and that that most significant category needs to build upon that. So we often see agencies talking about more functional limitations, more services being needed, more time needed to help the person reach their employment goal. So the more specificity there, the better is. I think that helps VR counselors kind of understand where to place people when they're determined eligible.
Carol: Yeah, that's really good advice. Now I know, Theresa, also, you have talked about wanting to bust the myth that nobody gets off the waitlist. And how can we better do that?
Theresa: I can't tell you how many times I've heard that in Indiana, and that was part of the a lot of the grief is that there was this thought that we'll never get 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 less than ten. So less than ten states. So we know it happens. There are states who've done it. I don't know if we do enough to highlight that to kind of our stakeholders, you know, at large and celebrate that. So maybe that's part of the answer. You know, we have those actual examples. That's an important part of the communication to internal and external stakeholders. The other piece here is outlining the conditions that need to be in place to progress, to opening more categories, to ending the order, and then people can see you hitting those target milestones. They may start believing that, 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 going back to that communication strategy for sure can help. I know with our SRC, and I had laid out the plan like I had all these points that we needed to do to kind of get through our struggle. And as things were met or we were able to achieve other savings in certain areas without impacting, you know, a quality of a service. Man ,it was great. Like no stone was unturned as we did that. But I wanted to be super transparent. Here's all the things. And I kept a little chart, like, here was this savings, or here we met this thing so people could see we were actively working a process all the way through, versus okay, we are pulling the lever and the lever is just 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 advice for state directors contemplating pulling the lever?
Theresa: Well, we definitely looked at it as that lever or that dial, and we felt that that gave us an opportunity. We really would not otherwise have had to take action on addressing a really significant foundation or core issue while slowing down that incoming train a little bit and refocusing our resources, staffing and fiscal building adequate resources and capacity. It's an ongoing effort. It never ends. It's one of the more difficult things, probably, that we do, but it's so critical to carrying out services in general, let alone good quality services. And it requires a very thoughtful plan and a lot of simultaneous strategies. You know, all the strategies we implemented from salary adjustments to, you know, creating those working lead counselors I mentioned, we developed a layer of case coordinators to take on some of the case management aspects. I think some states call them rehab techs. Lots of gaining of technology, 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 and reducing our VRC turnover. I mean, those things are gold when it comes to staff capacity.
Carol: Now, Chris, I don't want to steal your thunder, but what I'm going to say to folks too is call RSA. Like, reach out to your liaison and talk to them about your situation. You want to start those conversations because the worst thing I would think is you're a state liaison at RSA and you just get this boom, we want to do it. We need to go on March 1st and today is January, you know, 24th. You want to have that partnership all the way along. And I know, Chris, you can speak a little more to that for sure.
Chris: Carol, you know, we often talk about with clients early and sustained engagement. And I would encourage VR agencies to take the same approach with us at RSA. Reach out early and keep that conversation going. The order of selection approval process is going to be iterative. In 99% of times, RSA will have feedback and will have questions, and we'll want to see justifications be made as strong as possible. So to your point, Carol, our ability to approve orders of selection overnight is not possible. Theresa talked about sort of a nine month on ramp. I wouldn't say it's going to take that long on our end, but it will take at least a couple of weeks. And the stronger the justification we receive, the better. Again, I would just say that consider all of the flexibilities that the Rehab Act offers to VR agencies when it comes to managing the program, in addition to implementing an order. And we talked about some of those before, but they could mean cost containment from financial participation to preferences to instate services, to looking at the administrative costs that you might pay for providing services, your staffing capacity, and really leveraging the ability of your SRC. To advocate for the program, we often talk about the return on investment of the VR program, and it really is unlimited. Our program offers a lot of flexibility to be creative, to help people meet their career goals, and that's kind of the best thing we have going for us to argue for the sustainability of the program moving forward.
Carol: Yeah. Excellent points. The SRC can do so much more than we can do, really, and a lot of venues and have a different voice and a seat with the governor. You know, they're appointed by the governor. They have a different 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 from either of you for our listeners?
Theresa: Well, I'll just add, I think we've touched on a lot of great lessons learned in communication. Number one, really important. And we've hit on some ideas and strategies around that. And then the second, having that game plan, it's critical so that we're all viewing Order of selection, not as that end result right, or that indefinite status, but as that lever or that dial that can be adjusted to address the situation 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 really appreciate you both and appreciate having this conversation. And for our listeners who were taking notes, because I know you guys read 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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