Narrative: p. 1. A.

Goal 1: Stabilize the downward trend in new applicants in FFY 2017 to 390.

Baseline data: The number of new applicants in FFY 2009 was 553; the number of new applicants in FFY 2010 was 540; the number of new applicants in FFY 2011 was 460; the number of new applicants in FFY 2012 was 455; and the number of new applicants in FY 2013 was 436. New applicants have been on a downward trend since 2008.

Strategies:

1. Reduce the average number served per year per caseload from the current 104 cases per counselor through efforts to address cases stalled in status 24 without action and cases where contact has been lost and all reasonable efforts to reestablish contact has been done.

2. Establish and implement minimum standards for frequency of client contact and measure that through regular and annual case reviews.

3. Each district office will be responsible for a district specific project to analyze where referrals are coming from and target outreach efforts to major stakeholders and other environments where blind or visually impaired would likely come into contact with and absent from the database.

One of the critical data points Rehabilitation Services for the Blind measures and tracks monthly is new applicants to the vocational rehabilitation program. An aspect of the dashboard includes graphing trends going back to 2008, and the number of new applicants had been trending downward every year until 2017. The number of new applicants in 2013 was 436 and by 2016 the number had reduced to 331. RSB has concluded that in PY 2017 the number of new applicants was 334 and in PY 2018 the number had increased to 367; therefore RSB has stabilized and began to increase the number of new applicants.  

The replenish rate focuses on quarterly statistics which are presented at Quarterly management meetings. Field staff have received training designed to improve verification of where referrals heard about RSB services to provide feedback for targeted outreach activities. Case finding project objectives are developed for each district office. One of the potential barriers to increasing new applicants is the average caseload size. Historical data shows that caseload size reached a high of 127 cases per caseload in the VR program. An increase in caseload size may act as a disincentive to increasing new referrals. Historical analysis indicated the length of time on service increased as a consequence of a poor economy and an increase in the number of individuals selecting a vocational goal requiring college level training. In an effort to overcome this barrier, RSB began redistricting to redistribute and clear caseloads, resulting in an equalization and reduction of the average caseload size. These efforts reduced caseload averages resulting in 120 cases per counselor in FFY 2013, 104 in FFY 2015 and 86 in FFY 2016.  In PY 2017 the case load average was 91 and has remained at 91 for PY 2018. Therefore, RSB has been able to maintain a reasonable case load below the intended goal of 104.

A dashboard system was implemented in System 7 in the beginning of 2017 that displayed the number and/or percentage of cases for all field staff and managers where there had been no case note filed for 6 months. When the dashboard was initially implemented the percentage of cases without case notes for a period of 6 months was 20%; and on 6/30/2019 the percentage had reduced to 5%.

Each District office has targeted outreach efforts to stakeholders to heighten awareness of RSB programs. Each District Office participates in local outreach events such as health fairs, job fairs, and reverse job fairs. All RSB District Supervisors attend their local Workforce Development Boards meetings; and are involved in “Inclusion Committees” and local “Nexus” groups interacting with job seekers and businesses, and other ventures where individuals with disabilities may participate. In addition, District Supervisors participate in Cross Divisional Meetings where they share information regarding RSB with other divisions within the department. 

In FFY 2014 RSB began a coordinated effort with the State Rehabilitation Council in the development of a targeted marketing plan based on historical referral data. RSB identified historical data for a period of three years from FFY 2015 through FFY 2017. The data captured referral information including how applicants heard about RSB and who referred them to the agency. RSB has provided additional training to staff on referral data collection to enhance our understanding of where applicants were hearing about the agency and our vocational services. A three year analysis shows the number of referrals in FFY 2015 was 513 with 77.4% applying for services, FFY 2016 was 536 with 61.75% applying for services, and FFY 2017 was 493 with 76.06% applying for services. A recent analysis of PY 2018 data shows the number of referrals was 554 with 55.96% applying for services. Thus, the total number of referrals is on the rise indicating that enhanced initiatives to heighten awareness of RSB services has improved client referrals. The requirement to serve potentially eligible students with a disability who have not yet applied for VR services could impact these numbers.

Goal 2: Improve employment outcomes to enhance economic stability and self-sufficiency for clients who exit the VR program.

Baseline data: In the FFY 2011 reporting period (aggregate data from year 2010 and 2011) the performance level on Standard/Indicator 1.6 was reported as 22.5. In the FFY 2012 reporting period (aggregate data from year 2011 and 2012) the performance level on Standard/Indicator 1.6 was reported as 29.58. In the FFY 2013 reporting period (aggregate data from year 2012 and 2013) the performance level on Standard/Indicator 1.6 was reported as 30.89

Strategies:

1. Continue the job specific training and maintenance of skills for all vocational counselors and district supervisors through the Counselor Academy initiated in FFY 2012 and develop competency component.

2. Continue to monitor and emphasize the data points of percent of new applicants who are unemployed at application and use of low incident placement strategies such as on-the-job training, supported employment, work experience and targeted job placement.

3. Continue to emphasize learning appropriate alternative techniques of blindness critical to successful employment; such as orientation and mobility skills; alternative skills of blindness to access, store and retrieve print information; and personal care skills.

4. Develop and improve coordination and collaboration with core partners and local Workforce Development Boards to braid services and assist clients in obtaining employment consistent with their strengths, resources, priorities, concerns, abilities, and capabilities.

5. Enhance employer engagement activities to increase employer services and recruiting, hiring, retaining, and promoting individuals with disabilities.

In FFY 2017, the difference between the percentage of clients who report their own income as the largest single source of support at the time they exit the VR program and the percentage who report their own income as the largest single source of support at the time they apply for VR services was 32.2%, exceeding the minimum required performance level.

RSB has created and engaged in numerous training and skill building activities that are crucial in working towards improved employment outcomes. RSB provides Motivational Interviewing (MI) training to all vocational rehabilitation counseling staff and an MI training module has been placed on the Employee Learning Center as a mandatory training requirement. The Counselor Academy training in October 2012 provided specific training and maintenance focused on the comprehensive assessment and IPE development. RSB reinstated the Counselor Academy training in the fall of 2019 and plans to hold these trainings twice a year to ensure that RSB staff receive continuous, up-to-date, job specific training and skills enhancement. RSB initiated Rehabilitation Teacher job specific and competency based training in FFY 13 via the RT Focus Group and a cooperative agreement with the Nebraska Center for the Blind. This provides additional enhancement of the fundamental skills of blindness necessary to achieve and maintain successful employment via hands on training. RSB developed a counselor focus group to allow counselors to communicate and share information, solve problems, improve performance, build teamwork, and move projects forward. The focus groups will be led by the Vocational Rehabilitation Counselors and will have the RSB Director present to offer expertise and guidance as needed.

RSB has also focused efforts on improved employment outcomes to clients who are deaf-blind. RSB continues to monitor the percent of new applicants who are unemployed at application and use low incident placement strategies, such as supported employment to enhance services and employment outcomes to deaf-blind clients. RSB also has a cooperative agreement with Missouri Division of Vocational Rehabilitation to jointly serve deaf-blind clients. 

Rehabilitation Services for the Blind (RSB) joined in a pilot project with MVR, Department of Mental Health (DMH), and Community Rehabilitation Programs (CRP’s) to expand customized employment opportunities for Missourians with disabilities. This flexible process is an individualized approach to employment planning and job development for one person at a time, one employer at a time. Its design personalizes the employment relationship between a candidate and employer to meet the needs of both.

In 2019, the group began piloting initial trainings by bringing together agency representatives from MVR, RSB, DMH, and contracted CRP’s. Together the agencies trained vocational rehabilitation counselors and targeted case managers on key strategies, such as identifying and providing the right supports for a specific job. The agencies also trained CRP employment specialists on the goals and objectives for meeting client and employer needs including tactics, such as customizing job descriptions based on unmet needs. This collaboration is momentous in advancing service coordination designed to meet current and future workforce needs.

RSB has pursued opportunities to expand the coordination, collaboration, and the braiding of services with partners. RSB now has a local staff person attend all of the local board meetings. RSB executive staff meet with MVR quarterly to identify opportunities to partner and/or enhance service provisions. RSB executive staff are involved with multiple WIOA committees, and has a representative on the MAWD (Missouri Association for Workforce Development). RSB is involved with efforts to enhance provision of customized employment in the state and is working together with the core partners on a system to identify co-enrolled clients.

RSB collaborates with the Training and Employment Administration of Missouri (TEAM). TEAM is an association of local Workforce Development Board (WBD) leaders serving as advocates for the workforce development system. TEAM holds monthly meetings allowing the opportunity for all WIOA partners and all local WBD’s to come together at one time to discuss program updates and developments. This collaboration opens the door for wide-spread communication among partners throughout the state, cultivates local partnerships and serves as a conduit for agency alignment

Goal 3: Modernize the VR service delivery system to be consistent with WIOA requirements and improve the quality, timeliness and effectiveness in the provision of those services.

Strategies:

1. Update policy manuals and administrative rule based on federal guidance and WIOA requirements.

2. Continue to update and provide high quality staff training and support on implementation of WIOA, effective case service processes, and skills necessary to ensure that the personnel have a 21st century understanding of the evolving labor force and the needs of individuals with disabilities.

3. Conduct annual case record reviews of case practices to determine consistency and adherence to federal and state requirements and determine where additional guidance is needed.

4. Enter into an agreement with the Missouri Department of Labor to access the UI wage database.

The VR policy manual was updated in PY 17 based on federal guidance and WIOA requirements. The update was completed by a group of administrative and field staff. All changes were made in cooperation and with the SRC approval. No public comments were received during the open comment period. Changes to the VR state administrative rule is currently under legal review.

A new staff training and quality control position was created in FY 16 to meet the new training requirements. This position has been creating new staff orientation training, blind immersion training, and coordinating training sessions to ensure personnel have a 21st century understanding of the evolving labor force. This includes trainings offered by MERIC that focus on labor markets and trends in Missouri. This position is also responsible for case reviews for adherence to federal and state requirements. Monthly checks are made in the electronic case management system for compliance with new federal time frames and service requirements. RSB is the second year of this four year strategy and will continue to make progress. RSB has entered into an MOU with the Missouri Department of Labor to access the UI wage database.

The RSB review team has updated the process for annual review of case files by establishing a three tier review process in which district supervisors conduct monthly reviews of their staff case files, followed by the Assistant Deputy Director’s monthly review of case files from selected district offices and finally an annual review by the review team of administrative staff.  An updated Service Record Review Guide form has been developed to address each state and/or eligibility status of client case records.  The annual review team also reviews case records previously reviewed by the district supervisors and Assistance Deputy Director to ensure RSB has a comprehensive understanding of the process. Benefits of this process include immediate feedback to staff lending insight into staff training needs, alignment of RSB processes, and continuous adherence to WIOA requirements.

Goal 4: Develop a Transition Services best practice resource guide consistent with federal regulations in the delivery of services to Youth with Disabilities and Students with Disabilities.

Strategies:

1. Create a diverse work group consisting of state level and front line staff, client, parent or other professional advisory representatives when possible and relevant to the group tasks. The goal of the work group is to evaluate the current efforts against best practices and evidence based practices and available resources to assess the strengths and the improvements needed regarding transition services for blind and visually impaired to promote the involvement of stakeholder when planning and implementing services to provide successful transitions to employment, learning and independent living. The work group must assess the strengths and the improvements needed regarding transition services for blind and severely visually impaired and new federal regulations.

2. Train District Supervisors and Counselors in the best practices resource guide and provision of transition services. All of the strategies in Attachment (o) will be used to improve services to individuals in FFY 2017. Specific strategies used to "expand" services for individuals with disabilities and support innovation and expansion activities are listed as follows:

• Expanding the use of Supported Employment by increasing the number of vendors as needed, training staff to more appropriately use Supported Employment and improving the vendors’ capacity to serve blind and visually impaired clients through RSB-provided materials.

• Improving the services provided to clients who are unemployed when they enter the VR system through improved assessment, employment goal development and use of innovative strategies for job development and placement.

In 2013 a workgroup was created consisting of front line, supervisory and administrative staff to begin reviewing current policy, process and procedures and to begin identifying outside professionals and client representatives to serve on the committee. The work group made significant progress in evaluating processes and updating training information. A training presentation was created that outlined VR transition services, emphasizing coordination with local educational authorities and how VR transition services should coordinate with and compliment, but not replace, services provided under IDEA. In 2013 and 2014 the training was widely presented to district office staff, to the SRC and a public forum, at the Children’s Vision Summit, and the Association for Education and Rehabilitation of the Blind and Visually Impaired.

The passage of WIOA and changes to transition services contained therein immediately made a significant amount of the work, training and success of this group obsolete. A Transition Services Coordinator was hired to oversee transition services including Pre-Employment Transition Services for Students with a Disability. This position analyzed guidance and regulations and assisted in updating policy and developing services consistent with the new regulations. A Transition Resource guide was developed, which contains best practices for ensuring access to and utilization of Pre-Employment Transition Services by students with disabilities. The resource guide is available both to internal staff (vocational rehabilitation counselors, children’s specialists, and district supervisors) as well as clients and those potentially eligible for services. The guide outlines best practices while providing distinct resources and specific examples for taking part in or providing pre-employment transition services.