Narrative: d. 2. M. i. II.

VR’s available and projected resources will not be adequate to ensure the provision of the full range of vocational rehabilitation services, as appropriate, to all eligible individuals in federal fiscal years 2017, and 2018. VR is experiencing a deficit of staffing in FFY17, and a deficit of both staffing and fiscal resources is projected for FFY18. Challenges in regards to insufficient staffing resources include high VR Counselor caseloads, a poor VR Counselor retention rate, diminished capacity to serve a recent growth in new referrals, and other factors further detailed below. Furthermore, VR anticipates a projected fiscal deficit of approximately $8 million for FFY18.

Total funding available in FFY17 for serving individuals in Title I ($43.5 million) and VI-B ($500,000), program income ($1 million), administrative costs including personnel ($26.5 million), and an increase in the pre-employment transition services set aside ($5 million) is $76.5 million. Additional staffing would be necessary to provide the full range of services to all eligible individuals in an equitable and expeditious manner. The total funding available for FFY18 is currently the same as in FFY17, however a fiscal deficit is projected due to costs associated with enhancing staffing capacity to serve all eligible individuals, and cost increases resulting from VR working toward full compliance with new federal requirements under WIOA, including spending 15% of Title I federal funds on pre-employment transition services and contributing to the operation costs of the Department of Workforce Development (DWD) Work One centers through infrastructure funding agreements. The anticipated projected deficit for FFY18 is $8 million. Therefore, a budget of approximately $84.5 million would be needed in FFY18 to serve all eligible individuals, which is at minimum 15,547, but will likely be an increased number of eligible individuals due to an increase in the number of referrals.

The current ratio of a seasoned VR Counselor (those staff who have completed their training, are out of new-hire probationary status, and are independently managing a caseload and taking applications from new referrals) to consumers is 1:148. BRS believes that a counselor-consumer ratio of no more than 1:100 is optimal to maintain efficient caseload management and high quality services. VR would need additional VR Counselors to work toward this optimal ratio. As the number of applications and eligible consumers continue to rise, the number of staff needed to meet consumer needs will increase as well.

Staff retention of VR Counselors has been a major concern for VR over the past few years. In recent years, the turnover rate for all VR field positions has been 41%, with turnover of 56% for VR Counselor positions. This turnover has been a major contributing factor to BRS’ diminished capacity to serve all individuals seeking VR services, and the inability to serve consumers already in the system in a timely manner. Additional data outlining retention challenges is as follows:

• Out of 170 current VR Counselor positions:

  • 59 are filled with staff who have been employed with BRS more than 5 years, representing only 35% of staff.

  • 87 are filled with staff have been employed with VR more than 2 years, which is 51% of staff.

  • 83 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 probationary status. This represents 49% of staff. At the time of this submission of this state plan amendment, 35 VR Counselor positions are vacant.

    VR has investigated likely causes of the increased turnover. The two most common reasons reported when a staff member resigns are the overwhelming work load, and the salary for the type of work VR Counselors perform and required qualifications. There are several factors that likely contribute to the overwhelming and dissatisfied experiences that VR Counselors report, including high caseload sizes and the breadth and depth of the case work. Additionally, during periods of time where vacant clerical and support staff positions go unfilled, VR Counselors must absorb those additional tasks, further reducing their ability to provide high quality counseling and guidance to consumers.

    VR Staffing capacity has been further diminished over the past two years by a 6% increase in referrals from 2014 to 2016. BRS expects a further increase in referrals over the next few years due to new federal requirements such as pre-employment transition services and limitations on sub-minimum wage employment, which will result in more individuals, especially youth with disabilities, applying for VR services. In fact, referrals for FFY17 as of March 1, 2017 (five months into the year), already exceed 8,000 individuals, and BRS anticipates at least a 10% increase in referrals over the next year or two.

• 2016 Referrals 13,531

• 2015 Referrals 13,671

• 2014 Referrals 12,813

Recruitment of qualified individuals to be a VR Counselor is also a significant challenge. Indiana continues to have only one university offering a graduate program in Rehabilitation Counseling, which graduates 5-10 students annually.

Obtaining additional VR Counselor and other field staff positions is needed to help address this challenge; however it is important to understand that this provides only a partial solution. BRS must also address issues related to low retention rates of VR Counselors and recruitment challenges. Furthermore, BRS must take into account the lengthy learning curve for new hires. Due to the broad scope of knowledge and skills required for the VR Counselor role, and dependent on the specific background and experience of the staff member, it takes newly hired VR Counselors anywhere from 6-18 months to learn all aspects of the job. New VR Counselor training in a mobile environment adds further challenge as staff are expected to work very independently and have reduced access to co-workers, compared to the office-based approach that existed prior to 2009. Newly hired staff typically work under very close Supervision and do not independently manage their caseloads or take a full schedule of new applications for 6-12 months after their hire date.

BRS has experienced insufficient staffing resources for the last couple of years, and has been diligent in implementing numerous strategies to work toward increasing capacity and improving service provision. Some of those strategies are outlined below:

• BRS hired additional support staff 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 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 been able to broaden the talent pool. BRS will also be evaluating whether this modification in hiring criteria has any impact on staff retention.

• VR shifted 7 VR Counselor staff to a ‘Working Lead’ role 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.

• BRS has piloted a new strategy in one-third of field offices to evaluate whether efficiencies can be gained by having designated VR Counselor staff take all new consumer applications and make all eligibility and severity determinations. Early results from the pilot indicate that efficiency is gained through this model, and BRS anticipates that consistency in severity determinations will also be enhanced by having VR Counselors specialize in this area.

• BRS created a Program Initiatives Director who consults with staff regarding Small Business Enterprise, Home Modifications, Farm Modifications, and Vehicle Modifications. This individual serves as a subject matter expert for the VR Counselors when they have cases that involve these very difficult specialty services. These cases are often very time consuming for VR Counselors, and BRS has been able to offset some of that time with the addition of this new staff position.

• BRS is reviewing field office coverage areas on a regular and routine basis, and shifts counties and staff as appropriate to level caseload sizes across offices.

• BRS has continued to implement several, small improvements to the VR Case Management system to gain efficiencies where possible.

With the addition of new federal requirements under WIOA, BRS is forecasting an annual budget deficit starting with federal fiscal year 2018. While the VR Federal grant provides sufficient resources to Indiana, BRS is unable to draw all federal funds due to insufficient non-federal match dollars. BRS does not have sufficient funds to increase staffing and be compliant with new requirements under WIOA, including earmarking 15% of federal funds for pre-employment transition services, implementation of career counseling and information and referral services to over 4,000 individuals employed at sub-minimum wage, and participating in infrastructure funding agreements to support the operation of One Stop locations throughout the state. BRS is prepared to shift resources from other budgeted areas in order to work toward compliance with these new federal requirements, however even with the initiatives outlined below, a budget gap of approximately $8 million is still anticipated, starting in FFY18. Some examples of cost savings efforts are outlined below:

• BRS has been supporting an antiquated case management system that has been in need of replacement for the past several years. Though there is an initial added cost to implement a new system, there is a significant cost savings of about $800,000 per year that VR will begin to recognize in 2019, as the long term support of the new system is significantly less costly than the current system. BRS also expects to gain efficiency with staff time which will allow VR Counselors to better serve consumers, and allow BRS to recognize additional cost savings. Furthermore, more of the required federal reporting will be automated in the new system, freeing up additional resources.
• Although training is incredibly important, BRS has prioritized trainings and will reduce training costs beginning in FFY17. The majority of training will be conducted internally and will focus on services to individuals with the most significant disabilities, which is the primary population that will be served under the Order of Selection. Over the past several years, BRS has increased use of webinars and ‘train-the-trainer’ style events to reduce costs of training.
• BRS does not support uncompensated employment outcomes as required under WIOA. Elimination of uncompensated employment outcomes is projected to result in savings of around $1 million annually.
• BRS is reviewing other contractual agreements to determine if there are savings to recognize, however BRS has already eliminated non-essential contractual agreements over the past few years.
• BRS continues to review service rates to determine if there are additional savings to realize, however BRS has re-negotiated service rates for many different types of services over the past several years, and therefore further opportunities for savings are likely minimal. As a result of cost containment efforts, BRS continues to recognize a reduced spend on client services. These previous efforts included the purchase of hearing aids and devices at manufacturer rates, paying for medical services and devices at Indiana Medicaid rates, purchasing interpreter services through a single coordinating unit to reduce spend on travel, and implementation of a calculator to ensure consistency in maximizing other resources for post-secondary costs prior to utilizing VR dollars.
• BRS is investigating the potential impact of implementing financial participation policies for consumers, in line with federal requirements.
• BRS is exploring the use of Third Party Cooperative Arrangements and Interagency Transfer of funding with state and local public agencies, as applicable, for the provision of pre-employment transition services. BRS is seeking technical assistance in this area at the present time.

In summary, while many strategies have been implemented to improve staffing capacity, those strategies were insufficient to gain anything more than a temporary improvement. With the ongoing staffing capacity challenges and increase in referrals, as well as projected budget shortfall beginning in FFY18, BRS must begin to operate under an Order of Selection.