Vocational Rehabilitation Program (Combined or General)

There are three key critical factors to consider in determining whether VR must continue to operate under an order of selection: staffing capacity, fiscal resources, and the amount of time necessary to serve eligible individuals assigned to a closed disability priority category who are in deferred services status. At the end of FFY19, 2,637 are assigned to a closed disability priority category and have been deferred for services. Indiana anticipates that approximately 1,000 newly eligible individuals will be assigned to a closed disability service priority category annually.

BRS has outlined five sequential steps to work toward serving all eligible individuals, ensuring federal requirements to serve individuals in order of disability priority and application data are met. VR is currently operating in step one – serving VR eligible individuals assigned to disability priority category 1, or those with the most significant disabilities. Priority category 1 is ‘open.’ Priority category 2 (individuals with significant disabilities), and priority category 3 (all other eligible/non-significant disability) are ‘closed,’ meaning that VR eligible individuals assigned to categories 2 and 3 are deferred for services. Once VR identifies that resources are adequate to progress to step two, individuals in priority category 2 will be released from deferred services status in phases. It is anticipated that it will take two to three years to complete step two, that is, to release everyone in priority category 2 who desire VR services, once VR begins this process. VR released approximately 200 individuals assigned to Priority category 2 from deferred status in February, 2020. Estimated staffing and fiscal resource needs outlined further below are focused on building capacity to continue to proceed with step two.

Once step two is complete, VR would then assess whether staffing and fiscal capacity are adequate to progress to step three, which is opening priority category 3. Once a category is open, there is no waiting time for services for newly eligible individuals assigned to that open category. The actions outlined for steps two and three would then be repeated for steps four and five, dependent on sufficiency of resources, for priority category 3. Again, it is anticipated that completion of step four could take multiple years. Resource needs for steps three through five will be assessed in the next state plan. More specifics on each step are outlined below.

Each of these three key factors – staffing capacity, fiscal resources, and length of time to complete each sequential step outlined above - will be addressed below, including specific challenges with each factor as well as strategies to mitigate challenges.

Staffing capacity: Since implementing an order of selection in August, 2017, VR has closely reviewed the percent of eligible individuals determined to meet criteria for priority category 1 (individuals with a most significant disability), an open service category. The percentage of eligible individuals assigned to priority category 1 is currently over 80%. Indiana recognizes that it is not uncommon to see an increase in the percentage of eligible individuals determined to meet criteria for open service categories once a VR state agency implements an order of selection, and did anticipate some increase, however the increase was larger than projected. Prior to order of selection, approximately 42% of eligible individuals met criteria for priority category one, and the increase to over 80% is significant.

Additionally, individuals are remaining in the VR system longer as evidenced by increased utilization of supported employment services as captured in VR employment service evaluation reports (https://www.in.gov/fssa/ddrs/4976.htm).

On average, 20-25% of VR Counselor positions were either vacant or filled with new staff in trainee status during FFY2019. VR modified the minimum education requirements for VR Counselors in recent years, and while initially experienced an increase in qualified candidates, this has tapered off over the last two years. Additionally, new hires often tend to have less experience and therefore require more training. New VR Counselors remain in training for 9 months on average, or longer in some cases before they are independently working a caseload. During the training period, caseload sizes of seasoned staff remained high, particularly in certain areas of the state, and supervisors also often carry a caseload. Offices experiencing vacancies also see increased caseload sizes for seasoned staff, with supervisors often carrying a caseload as well. It is not uncommon for many months to pass before a vacant position is filled, due to challenges in recruiting qualified candidates. Often times, vacant VR Counselor positions are posted multiple times before securing a qualified candidate. Once a candidate is hired, the lengthy training period begins.

Presenting further challenges to the recruitment of qualified VR Counselor candidates is the fact that Indiana continues to have only one university offering a Rehabilitation Counseling program of study, which graduates 5-10 students annually. Furthermore, the unemployment rate in Indiana is extremely low at 3.2% as of December, 2019, and it has become more challenging for BRS, like many employers, to attract qualified candidates. If resources became available to increase the number of staff, the availability of qualified candidates for those positions, and ability to attract those candidates to state government, is a significant concern.

While retention of VR Counselors has improved over the last few years due to significant efforts of BRS (efforts implemented to improve retention will be further outlined below), turnover of VR Counselor positions was approximately 30% in 2019, which continues to present challenges particularly in respect to recruitment of qualified candidates and the learning curve for new staff as outlined above.

Additional data outlining retention challenges is as follows:

• Out of 186 current VR Counselors positions:
  • 97 are filled with staff who have been employed with BRS more than 5 years, representing only 52% of staff. 
  • 35 are filled with staff who have been employed with VR more than 2 years, but less than 5 years, which is 19% of staff. 
  • 55 are either vacant or are filled with staff who have less than two years on the job, many of whom are still in the learning curve and in trainee status. This represents 29% of staff. 

Furthermore, an order of selection must be implemented on a statewide basis, in accordance with the [1]Rehabilitation Act. The requirement to implement the order of selection statewide presents some challenges as the vacancy rate and staff recruitment challenges vary across the state, with some offices experiencing a greater challenge than others and ongoing ebb and flow with vacancies and new staff. 

Demands on VR Counselors were significantly increased with requirements under WIOA, such as increased data collection and required post-exit follow up on VR participants. Indiana VR has also revised expectations of VR Counselors regarding engagement in the employment services process, to ensure a team approach to job placement and supported employment services. With these modified requirements and expectations, ideal average caseload sizes should not exceed 90 participants.

The current average caseload size is 118. Further efforts to improve retention of staff to reduce vacancies, improved recruitment efforts to fill vacancies more quickly, or additional VR Counselors positions are identified strategies needed to work toward this optimal ratio. All of these strategies present challenges, particularly expanding the number of VR Counselor positions due to lack of availability of qualified candidates as mentioned, as well as challenges with fiscal resources. VR believes that continuing to work toward improved staff retention and recruitment efforts is the best tool toward building and sustaining improved capacity, however some added staffing may also be necessary to reach adequate capacity.

Additional considerations include an assessment of the ability of VR to sustain compliance with meeting federal timeliness standards (e.g. determining eligibility within 60 days; IPE developed within 90 days) and avoiding delays in processing referrals. The capacity of employment service providers, including community mental health centers to provide timely and quality services must also be considered.

In light of staff retention and recruitment challenges, BRS has implemented numerous strategies to work toward increasing capacity and improving service provision over the past several years, including the following:

• Creating VR Case Coordinator positions in late 2014 to assist with billing, follow up on medical records, data entry into the VR Case Management system, and other administrative and case management related tasks that were often falling on the VR Counselors in prior years.
• Modifying VR Counselor qualifications in 2016 in light of the modified CSPD criteria under WIOA. BRS has historically struggled with obtaining and retaining staff with a Master’s degree in Rehabilitation or related area. By expanding VR Counselor qualifications to include individuals with a Bachelor’s degree in Rehabilitation or a related area, plus one year of relevant experience, BRS has increased its talent pool.  
• VR shifted 7 VR Counselor staff to a ‘Working Lead’ role in 2016 to help mentor newly hired VR Counselors in field offices that experience a high percent of new staff. These Working Leads have been very effective; however BRS has recognized that several additional Working Lead positions are necessary to truly meet the needs.
• After piloting a strategy that shifted VR Counselor roles into designated intake specialists and general counselors, BRS rolled this strategy out in all VR offices in July, 2017. Intake counselors are responsible for all new participant applications and eligibility and severity determinations. This strategy has assisted with consistency in severity determinations and has also enhanced skills for these designated staff. BRS will continue to evaluate this approach to determine the effectiveness of having designated intake counselors.
• BRS continuously reviews field office coverage areas on an ongoing basis, and shifts counties and staff as appropriate to level caseload sizes across offices to the extent possible.
• Systems modernization to gain efficiencies through implementation of a new case management system in 2019, as well as transitioning from a manual billing process to electronic claims payment system, also in 2019.
• Increasing VR Counselor salaries in 2019 by 10-13%.

While much improvement has been realized through efforts to improve staff capacity, overall challenges with staff capacity remain. BRS will assess the impact that the most recent strategies, implemented in 2019, which include significant systems modernization and staff salary adjustments, have a positive impact on retention and recruitment of qualified staff. The new case management system and claims payment system were implemented in late-May, 2019 and staff salary adjustments took place in October, 2019. BRS is hopeful that these significant strategies will have a positive impact toward building VR staff capacity.

Fiscal Resources: A primary fiscal challenge is the federal requirement to earmark 15% of federal funds for pre-employment transition services (Pre-ETS). This shift in funds reduced the amount of funding available for VR client services for eligible VR participants. While BRS has taken steps to mitigate this challenge, the requirement to shift funds nevertheless presents significant challenge. VR’s earmark requirement is estimated at approximately $9.5M for FFY20, which reduces the available budget for VR client services to an amount insufficient to provide the full range of VR services to all eligible individuals.

Additional requirements under WIOA that have a budget impact include the provision of career counseling and information and referral (CCIR) services to over 4,000 individuals employed at sub-minimum wage, and participation in infrastructure funding agreements to support the operations of One Stop locations throughout the state.

The average cost per participant is also increasing as outlined in Indiana’s 2019 Comprehensive Statewide Needs Assessment (CSNA), which revealed that average cost per participant is increasing 6-10% annually. This must be considered in projecting the cost of providing services to VR eligible individuals in FY20 and FY21, and in determining whether Indiana VR can begin to progress toward step two in the sequential process outlined above. 

As mentioned above, additional staff positions may be necessary to continue to build staff capacity, however this also has a fiscal impact. Any additional staff positions will result in added expense. The need for expanded or altered office space to accommodate any added staffing also has a budget impact. All of these factors must be considered in determining whether fiscal resources are adequate to provide the full range of VR services to all eligible individuals. Indiana VR continues to lack sufficient fiscal resources to serve all eligible individuals. Of the 2,637 total number of eligible individuals deferred for services as of the end of FFY19, nearly 2,000 were assigned to priority category 2. VR may have sufficient fiscal resources to serve a portion of these individuals over the next two federal fiscal years, however does not have sufficient fiscal resources nor staff capacity to serve all individuals waiting for services in FFY20 or FFY21. Staff and fiscal capacity is also insufficient to open any additional disability priority services categories at this time.

Length of time to serve eligible individuals assigned to a closed disability priority category: While fiscal and staffing resources are two critical factors to evaluate in order to determine capacity to provide the full range of VR services to all eligible individuals, a third equally critical factor must be considered. The third factor is the amount of time necessary to serve the eligible individuals in deferred services status. As of the end of FFY19, 2,637 VR eligible individuals were in deferred services status (i.e. assigned to closed disability priority categories). While two priority categories remain closed, Indiana VR anticipates that approximately 1,000 newly eligible individuals will be assigned to a closed disability service priority category annually. Therefore, the total number of eligible individuals deferred for VR services will continue to grow until VR determines there are sufficient resources, including statewide staff capacity, to begin serving individuals in deferred services status.

There are five sequential steps that must be followed in serving individuals in deferred status, in order of priority and application date as federally required. The graphic above outlines those five steps and they will be outlined in more detail below to better articulate how the ‘length of time’ factor must be considered in determining the ability to move out of an order selection.

Step One: Step one as indicated in the graphic above is the current status, with all eligible individuals assigned to priority category 1 receiving VR services with no waiting period. Approximately 80% of eligible individuals are assigned to priority category 1.

Step Two: When VR determines that sufficient resources are available, step two is to begin serving eligible individuals deferred for services who are assigned to priority category 2. These individuals must be served in order of application date and would be released from deferred status in phases. It is important to understand that disability priority category 2 remains ‘closed’ until all eligible individuals deferred for services in service priority category 2 are served. This means that during step two, newly eligible individuals assigned to priority category 2 would continue to experience a waiting period before services could begin.

Step Three: After all eligible individuals in priority category 2 who have been deferred for services have the opportunity to develop an IPE to initiative services, VR will determine whether fiscal and staffing resources are adequate to progress to step three, which is opening priority category 2. Once a priority category is open, there is no waiting period for services for individuals assigned to that category.

Step Four: The process outlined in Step two is repeated for individuals in deferred status in priority category 3.

Step Five: The process outlined in Step three is repeated for individuals in deferred status in priority category 3. Once all disability service priority categories are open, VR moves out of order of selection.

Given the sequential steps required to move out of an order of selection. VR has focused its assessment of capacity and resource needs on movement to step two as outlined in the process above. VR projects releasing individuals in priority category 2 from deferred status in numerous phases. In determining capacity to progress to step two, VR has reviewed the service area location of individuals deferred in priority category 2 to assess staff capacity at each individual field office. While the assessment of capacity and fiscal resources is ongoing, VR released approximately 200 individuals assigned to priority category 2 from deferred status in February 2020, and will work toward further releases from priority category 2 throughout FY20 and FY21.

VR’s available and projected resources is not adequate to ensure the provision of the full range of vocational rehabilitation services, as appropriate, to all eligible individuals in FFY20 and FFY21. In consideration of the three factors as outlined above, staff capacity, fiscal resources, and time needed to serve those in deferred services status, BRS must continue to operate under an order of selection. BRS will begin releasing eligible individuals deferred for services in priority category 2 during FY20, however does not anticipate opening this category during FY20 or FY21.

[1] 34 CFR 361.36(e)1