Feb 7, 2023
Joining Carol Pankow in the studio today is Damian Schlinger, State Director of the North Dakota Division of Vocational Rehabilitation. Learn how Damian and his team moved from a double-triple check culture to one that encourages and enhances staff autonomy using techniques and strategies that have had tangible results. Listen as Damian explains how his agency is eliminating low-value activities and is focusing on keeping customers engaged to achieve quality outcomes in North Dakota.
Speaker1: 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. Damian Schlanger, State Director of the North Dakota Division of Vocational Rehabilitation, is joining me in the studio today. So thanks for joining me, Damian. How are things going in North Dakota?
Damian: Things are going well. Good morning. Thanks for having me on, Carol.
Carol: Well, it was so funny. I was telling Jeff, the podcast producer, I'm like, you know, when you were talking at CSAVR this fall, I felt a little bit like Simon Cowell. You know, there's a panel up there. I'm looking down and you started talking and my head went up. I'm like, Who is that guy? And I went right up to you after that general session. I'm like, Can you be on a podcast? I just think you have the most awesome things that are going on, and I wanted to make sure that we could spread that out to the rest of the country. And I really love the quote on your slide deck during the conference, "Take care of your employees and they take care of your business", by Richard Branson. And I just think you only had maybe 8 minutes to talk there. And I thought we could have a little deeper conversation this morning. So let's dig in. So can you tell our listeners a little bit about yourself, like how long you've been at North Dakota VR and where do you come from? Because I know you did come out of VR. Can you tell everybody a little bit about your background?
Damian: For sure, yeah. So I'm a relative newbie to vocational rehab, so I was just two years as of this last December here. So but I've always been in a helping profession. So the last 20 years I spent in the medical industry in various different roles, I started out actually as an athletic trainer. And for people that don't know what that is, my wife would always say, if somebody gets hurt on a field or at a game, the guy that goes running out, that's what my husband does. So that kind of gives me an idea that's good. So it was really good and it was a great career for the longest time. But then I had little kids in that night and weekend thing really didn't always work out. So yeah. So then I found my way into clinic management. I had a great mentor and supervisor and first I managed some walk in clinics and then some surgical clinics, and then I found my way to occupational medicine and that's actually where the link with VR happened. So sometimes we would get injured workers that couldn't go back to their previous place of employment because the injury was so severe. So we had to figure out what could they do. So we would do functional capacity assessments and things of that nature. And then I would be on the call sometimes with a Voc Rehab counselor, and they would ask, Could they do this? Could they stand? Could they sit? So yeah. So then when I was looking to further my career in a Voc Rehab position came open for a director, I thought, Oh, that would be perfect. Yeah, that's kind of how I got my way here.
Carol: Very cool. That is kind of wild. I know we've all fallen into it in different ways, and that's really neat. I'm glad to know that about you. Give us a little picture about North Dakota VR. Like, how many customers do you guys serve? How many staff you have, and maybe a little bit about the challenges you're facing. You've got a very different complexity in your state.
Damian: Yeah. So we have definitely a high rural population. A lot of our state is rural and then there's obviously these big population centers throughout the state. So that's somewhat of a challenge. And then what has been great is across these last few years coming out of the pandemic, things have really increased to the point where we're starting to challenge our all time highs in certain areas. And I know certain states might listen to this and go, Oh, that's really small or whatever, but it's whatever your situation is, if you can challenge some of those all time highs, I think that's great. So certainly our clients served about 3800 of those each year. In our OIB, we actually helped 555 individuals last year. I think there was like 313 applications. But some of those things are going really well and coverage into rural areas is just a part of what we do. We have eight regions is kind of how we carve our state up and then we know there's a lot of windshield time in covering those more rural areas.
Carol: So about how many counselors would you have that cover all of that?
Damian: In the state, there are about 40. So in our bigger regions there might be as many as seven or eight, and then the smaller ones are usually 2 to 3.
Carol: Gotcha. Well, I remember my grandma lived in Bismarck, and so even when I was learning to drive, my mom made us have so many hours behind the wheel. And I'm like, I'll drive to grandma's because it took us about 10 hours to get there. It was a long state to get through, to get to Bismarck. But I get my time in. So I completely understand that whole windshield time that folks have. So I know when you came in, you really hit the ground running. How did you come up with these activities You have focused on this past year around your staff?
Damian: One thing that I've been fortunate to do is because I've been in different spots, usually I'm in a spot for about four years is when I look backwards on my career. And so it's given me an opportunity to get into different situations where sometimes it's a realignment, sometimes you're starting up, sometimes they have great success and they just need to be polished. Some of the clinics or areas that I've been in. But what was interesting about ours is that they had really good, I call it Good Bones, almost like a house, You know, it's got good bones. You know, you don't have to replace a whole lot of things, but just to try to align everybody. So one thing that was interesting is that they had not, I don't know if team building efforts or coming across regions with different ideas was commonplace. I think they would sometimes share best practice, but it was almost like if it happened, it wasn't necessarily something they concentrated on. And when I visited the regions, all these folks, whether it was Frontline or regional administrators, had great ideas and then I had seen them. Maybe we're only enacted in that one region and I thought the other seven regions could really benefit from that. And plus, who doesn't love, you know, you have a great idea. And to see that come out of your mind and get legs and run across the state is a fantastic feeling. So that's a lot of what we concentrated on was just trying to get people to just share ideas and come together across the state.
Carol: Yeah, I think that's super cool. I know you have this dual approach. You really are focused on both the staff and your customers or clients or whatever you may call them in your state. And like in VR, we're always talking about clients in business and I think staff does get left out of this conversation. So I know you walked into this culture that was kind of double triple checks. You talked about that at the conference. How did you go about kind of beginning to revamp that culture?
Damian: I always think about assuming positive intent. I do a lot of reading on psychology and things of that nature and even the double and triple check cultures, if they exist, and those existed in the medical community that I started as well. It comes from a good places that you want to do the very best for your client, your patient, your whatever you call them, right? You want to have them have the best service ever. So I also know there's individuals that are really performance driven, but it's the same goal, right? They want to have great things happen for the customer. So it's about blending those two perspectives. So when I started to think about that even early in the career, I'm embarrassed to talk about it. But I ran headlong into a brick wall because I thought about the patient very much and thought about performance. Like how many could we serve, how quickly we could we get them in and out because nobody wants to be someplace for an hour and a half, especially if you're sitting in a clinic. But then what I realized is that my staff, I didn't share some of my thoughts necessarily openly outside my head a whole lot.
You know, we think about things a lot, and that continues to be a challenge for myself. But trying to understand, it's like I introduced a higher challenge to them. But then what I didn't understand is I wasn't necessarily investing in listening to them or growing their skills. So it's like those two pathways have to emerge together. So I actually pulled the staff together and I apologized to them. So then I was aware of it, you know what I mean? I couldn't just concentrate on the clients. It had to be growth of the team members as well as the service to the client as well. And so that's when I found out really Myers-Briggs, Keirsey Temperament Sorter, all those things. The big five, those were like the map. Otherwise it felt like I was stumbling around in the dark. But when I found those that felt like the key, really understanding individual motivation and the types of folks that are out there and then how to grow them, and then when they feel great and they're engaged and they're growing, the clients, it just it's natural. It's like peanut butter and jelly.
Carol: Oh, absolutely. You sing to my heart because I love that. I was always big on the Clifton Strength Finders. We did that because a lot of times you focus on people's deficits. So we're going to fix that. But why don't we build on the strengths people have and make them even like superpowers? And so really leaning into what are people doing well and helping them to do more of that.
Damian: Yeah, and there's all kinds of them out there too. I love, yeah, like you said, strength finders. We've done that as well. And actually what was interesting here just recently, we're starting to do a lot of like self directed project teams. And I also have done Disc assessments which really talks about personalities as they perform inside of a team because it's great if you have an individual, but who are we kidding? Like even in high school, my kids have been doing project based learning since they were in middle school, so I'm glad that that's happening in the schools because that's what real life is like. You rarely work as a lone wolf, so understanding that and who might be the best person to run the project? Who might be your document creator? Who might be your reporter or communicator, it really helps fit those skills in. A lot of those are based off of the same research. That's Carl Jung and all that. I remember doing actually a personality profile one time where they divided you into animals. You're either a golden retriever or a beaver or but it's all based on the same kind of four categories, you know.
Carol: So yeah, it is super helpful. I know for folks maybe not using that. I liked that too. We did that with some of our self directed teams and we realized like we were kind of new into it and we were super excited and we're having these teams that there was a team and they were all awesome at talking, but there wasn't like that leader person to, okay, here's our agenda and keep that going. And we realized like that was bad on us because we hadn't sort of sorted that out correctly to have all the different styles within the team so you could get something all the way accomplished, right? You can't put all the same people together because then they're all just chatting. And so I learned a lot just applying those kind of principles. I think that's cool. Now, I know you guys did a survey and I understand that the state was using the Gallup Survey. Can you describe like how that process went?
Damian: Yes. So actually, the first survey that they did statewide came out actually a month or two before I even started. And what I like about this is it gives you an objective measure because I think you can get into any setting or into any region or whatever position you are, and you can kind of get a feel for it across time. But it is just that it's a feel and it's just a perspective from whatever seat you're at. So it was great about the Gallup survey is that you can break it down for region. I think you had to have at least five individuals because then they wouldn't parse the data out. They would really want to make sure things are confidential. But then you can take a look at certain groups. You could take a look at your leaders. So like your regional leaders, you could look at state office, you could look at all the leaders together, all of VR together. So that was really important to understand, like what the needs and concerns were for certain audiences. So then what they did is, so they did it in October of what would that have been? 20? And then they did another one in the spring and now they do it every October. Just to make sure that we understand where we're at. So we were at a, I think, 31% engagement at that time. And so we recognized that that was low for sure. And I know that they say through Gallup, at least their research is when you're at 50% roughly engagement, that's super. Anything north of that is fantastic. So even if you're around that, that's great. So then we really did a lot to make sure that we understood. It's like it was a new day and actually we were just coming off that it was 100 years of VR. So it's like, what are we going to do to reinvent it for the next 100 say? So we did a lot of looking at going out to our regions, understanding where the crux of the issues when we're trying to deliver service to clients. And that was new. There was one lady that had said, I don't know the last time I've seen a director, it's been years, you know, so you really want to make sure that we went out to them physically and saw them as well, because that means a lot they feel invested in. So it's just through that, including in projects. We created small teams in each region to then address their issues and talk about them and then took action. And a lot of it was just saying yes to a lot of the things they wanted to do, and that turned it. So we went to 61% and then now this last year I think I might have pressed the pedal a little too far on our performance. So there's always that balance to play. So back down to about 50%. So then I recognized, okay, you know, we're going to do a little bit more, make sure we're mixed and growing skills to match the challenges that are out there.
Carol: That's really cool because you can see, like the fruits of your labor. It's directly in those percentages. I get that. I know you had talked back at the conference when you were telling us your stories and you really threw your staff for a loop by that, going out and popping in on Zoom and all those different things, and they really didn't know what to make of you. I thought that was kind of cool. So what kind of tangible things have you seen change as a result of the efforts you put into place these last two years?
Damian: Oh, sure. There is so much, and I think there's probably tangible parts of it, and then there are also parts that you just feel like, I don't know if you still want to call them tangible, but maybe they aren't. Like when I think of the sort of soft indicators, I can tell that the team members know we have a place within HHS because HHS is where we're housed in the state. And then they're also, of course, aging divisions and DD divisions and so on and so forth. And there's hundreds of millions of dollars, lots of staff. So I think initially there was maybe that feeling like you're the redheaded stepchild, but now they know it. And of course, because now the workforce issue is such a great thing, not just in our state, but throughout the nation, they know we have a place at the table. So a lot of that was even just inviting in, like my supervisor, who was one of the executives at HHS, talking about our importance in a staff meeting of leaders and then also in our all staff meeting. So that made them feel connected to the rest of the group. So I know if you want to actually call that tangible, but it was a big thing.
Carol: Oh, yeah, I call it tangible. That's pretty cool.
Damian: Good. And then just relationships with a lot of our providers are certainly other warmer. They're more frequent, they're more collaborative. One of the regional administrators said back in the golden era, he would call it that, you know, we did X, Y and Z. So we really restored a lot of that because we realized that as our providers go, so goes VR. So that was a critical relationship to mend and then also elevate. And we're trying to do that with a lot of other areas advocacy groups, employers, our sister divisions or sections within HHS. It's all working in that direction.
Carol: Good for you. Good stuff. What are your next steps like? What do you want to do next? Or are you just continuing on this trajectory? Do you have some big ideas? Where are you going?
Damian: Oh, sure. And actually this is a great time. So we just took a look at our strategy now have our strategic plan set for 2023. So we really have four major areas of concern. So one is certainly staff development. We continue to have new challenges. The needs of our clients change every year and we want to make sure that we really keep up on that. Another one is what we call just efficiency and design. So a lot of it matches our main areas or strategic priorities. We are still a lot of paper and pen and we don't use a lot of electronic systems, so we do want to transition to that type of situation and also see if we can centralize some teams. So we worked with different states, Texas, Indiana and in Nebraska just to see what they have going on, because we want to use the best of what anybody's done throughout the nation. And then we're also looking at other things like outreach, continuing to expand outreach awareness, whether it's meeting with partners like I just talked about or social media. We just want to be where the eyeballs are as much as possible to attract as many clients as we can. It was actually a really great compliment and I feel so great for all the people that work in VR. I just did our budget detail testimony this last week and one of the senators asked, he said at the end of the presentation, he said, everything seems to be going up and going well in VR, where some of ours aren't as busy. He goes, What's the secret? I did not want to leave the podium and I'm not a great public speaker. I usually want to get off of there as soon as I can, but that was a really great feeling. It just speaks to the work that's been done across the last couple of years because I think we concentrated on the right things and the right stakeholders. So we're excited about that and looking forward to this next year. So self directed teams is a big part of that. So if my leaders hear this podcast before Monday morning, maybe they'll have a little bit of heads up, but we're going to continue to grow in that direction.
Carol: That's very cool. I know there's nothing better than being able to tell the story of the agency and people really noticing, because I know folks are still struggling across the country. A lot of your colleagues are kind of at this holding pattern or really buried down with not having enough staff trying to get the clients to come back and all of that. But it seems like you're on this upward trajectory and getting some. How about the staff? I just was curious like, what is your vacancy rate look like right now? Are things picking up for you? Are you fill in those jobs? How's that going?
Damian: That's a great question. And actually it's good timing, too, because when we did that testimony last week, we got some recent turnover numbers. So it was interesting. So when I got here a couple of years ago, we saw that across the data that I had was the last seven years of our counselors was about 28% turnover and it had been in 2019 as recent as high as 35% turnover. So I mean, it just undermines your ability to complete that mission. I mean, you can do a pretty good job, there's no doubt about it. But it's hard. So we looked at some of the crux of what was going on there, and certainly it was involvement being heard, feeling like they had the ability and autonomy to do a lot of things. So there was some situations like that or even simple. We were able to increase the counselors limit of decision making or spending up to $10,000, and it had been capped artificially at five. And I said, You took the procurement training at $10,000. Why are we capping it at five? So there was a lot of little things like that that really helped the autonomy of situations. And you know what? I've been talking in a line here and I forgot the original question. Let's go back to that. What was your question, Carol? My apologies.
Carol: Well, no, I was just asking about how it was going with your staffing, Attrition and turnover.
Damian: Yeah, my apologies. Sometimes we get talking in one direction and I'm like...
Carol: We're good. I'm all good. I'm flowing with you.
Damian: Okay, So anyway, so yeah, so there was definitely a lot of turnover and that was a situation. So we wanted to make sure we did as much as possible because usually people want to throw money at an issue and it's usually one of the last solutions, not one of the first. So we were able to get good engagement out of that. There was no doubt, and it slowed the turnover train a little bit. So it was 23%. This was overall not just counselors in 2021. So it's like, okay, that slowed down, but it's still a quarter of my staff every year. So what was really great is the we really have progressive leaders in HHS and then also in our HR department. I know a lot of people think of state government as stodgy and slow and so on and so forth, but actually they've been more inventive and collaborative than anywhere I had worked at before. So they really took a look at, we were able to increase wages for some of the individuals that were coming in, knew that was a big deal. So we've had extremely low turnover in the last couple of years and I know some of that's just because it's been a couple of years. But also that helped and it was kind of an unconventional approach because they had tried to approach increasing wages in different methods. One was a booklet and it's hard for individuals to make decisions of a whole booklet. So we just went with a very simple one pager, talked about we had the funding to do so, federal authority to do so. We have the flexibility to move some money between lines. And so then we were able to and I know that caused some disruption for our staff that had been existing there, like, well, these new people are getting paid more. I almost had to crack a few eggs to make an omelet. And so what happened is eventually HR and our exec spot into, yes, we need to increase wages for our staff. So then we were able to do that this last October. So that's been huge and that slowed it down. Now I think the stat was 18% this last year and we can see month to month it's diving. So yeah, it's inclusion. Being with your teammates, feeling like you're heard, they have to be compensated. Right. It's always kind of the four main things, I think, but it's working well.
Carol: Good for you. You've hit that on all the fronts. I was just reading an article about autonomy. They're saying folks first they wanted that flexibility in their work schedule, work life balance. But now the big buzzword is people wanting that autonomy. They want to be able to make decisions. A lot of times we have that just overarching smack down. You know, 14 people are reviewing every single thing and approving and you're like, oh, my goodness, these people have been trained. They've gone through school, like, let them go.
Carol: Yeah, good for you. You've hit it on every front. That is pretty amazing to be able to get through the increases. Have you seen any kind of trend like former staff coming back because they've heard, well, there's more money now and there's, you know, like we have autonomy and all these things are going on. I wondered if you're seeing anything like that.
Damian: You know, I haven't seen anything in that regard yet, even though there are I mean, across these last couple of years, I saw a couple stars leave for some higher compensated areas. And I thought, boy, I'd love to be able to get them back. So we haven't gone there yet. But if I can just continue to keep and grow, the individuals that we have, they're bright. We have some new faces that are wonderful, but I think that's a good thing. And then also, once they stay here and they're here for a while, it gives that opportunity for promotion and that just all feeds in together positively, I think.
Carol: Yeah, very cool. Very cool. So how about all this work now you're thinking about your positively impacting your staff, you're having less attrition. You've done a lot of neat things culturally. How is it translating into your outcomes for your customers? Are people getting into employment? Is there more people getting into work? What are you seeing on that front?
Damian: Oh yeah, and this is all fresh in my head. So this is a good time to have this podcast. But we took a look at and we always do that because I think what's interesting is that when you have discussions amongst your leadership, of course we're going to all have different perspectives on things. But what matters is the objective data, like objective truth matters. So we always make sure that we have that at the fore. We keep a dashboard. So we take a look at that month over month, year over year, because it helps indicate like where are the weaknesses in our system that we can shore up because they're not just weaknesses in building a car or an iPhone. This is service. To clients you know, that they care about. So we've taken a lot of look at that. When I take a look at like our closed our number of successful closed, we think within this next biennium we can actually get to the high point that we've ever had. Back in 2000, we had a really high watermark and we're on our way to do that in the next couple of years. But even if you look month to month and across this last year, the number of individuals of client served, the number of "in plan". We could see month to month that it's building, not that we're adding the months together, but each month it's increasing. So in going with that, we're also trying to decrease what it takes to do the work. So that's where that double triple check culture had to go away. It's like, let's concentrate on doing it once and doing it right and then we can move on to the next person, you know, instead of having to revise it. But it's been great.
So staff engagement numbers we talked about, OIB applications are up. Actually eligibility. I think that's something that I spoke about at conference that was wonderful. And actually this came from the outside one of our providers. And then there was a few clients that talked about how long it takes to get the process rolling, and that engagement upfront was so key. And actually even our data individual, Warren, talked about this a lot and it was a concern of his because the data showed it. So then when we looked at it, it's like, yeah, we are taking too long. So just in a lot of adjustments that our assistant director Alicia made with comparing with other states, we found that we were going above and beyond the regulation, but it didn't necessarily add any value to the process. It didn't add any value to the client nor the business client. So she said, Why are we doing this? So we got to rid a lot of those things. And it was I mean, from April to I think it was November, we saw the change. It was like 32% faster. So that was wonderful. And that also helped the provider community feel like they were heard too. So it's just a win win all the way around. I think it was great. And that's all. While our client satisfaction either stayed the same or improved, that's when you know that counterbalance to it. I mean, you can go faster and then not please people. But also it stayed the same or got better. So we know we're in the right place.
Carol: Well, and we've done a whole series on rapid engagement. I think I've done three podcasts with different states about rapid engagement and just thinking about what people's expectations are today. You know, VR is kind of based on this very methodical system, and it's built in a lot of these time frames. But if you took all of those like 60 days for eligibility and then you're going to have 90 more days to do a plan and it's six months before they get a service.
Damian: Oh, yeah.
Carol: You come in from your medical background, you know, if somebody came in, you're an athletic trainer and you're like, well, I'm going to do an assessment and then I'm going to get back to you in about 30 days on that, and then we'll make your plan. People would think you're nuts. Like, there is no way people want it. They want it right now.
Damian: It's totally overlooked. And I agree. And maybe that's my perspective from that previous industry I was in is different. Like there's walk in clinics. You can access any information you might want from your bank, your investment account immediately. So it was about, I'd say a month ago or so, there was a great Harvard Business Review article I came across and said, Your competitors aren't who you think your competitors are. And I thought that was really key for a government agency or maybe even VR by itself is that you can't just compare yourself to VR. You have to compare yourself to any industry. It could be the hospitality industry because your clients have experiences in all those areas. So we shouldn't fool ourselves that good enough for government is the way that we are going to do things. You know, it has to be good enough for that person they set What quality really means for us and engagement and results are key to that.
Carol: Oh my gosh, you're hitting so many chords with me right now that I just, I used to do this training years ago about customer service in the government and people would be like, Well, you know, I always called people hostages because they can't go shopping around to get another service provider. You're the person. And so they're hostages and we kind of serve them when we want to. And just to flip the script on that. So I would really challenge our staff to think about that. Just because you can take 60 days. Do you want to do that? Like that's not what we're about. And so really challenging, that kind of thinking. Yeah, and I'm sure your background plays a lot into this, so I'm really happy to hear about what you've done with this rapid engagement.
Damian: And actually Carol I was going to say, so it's not just my background. I have to give credit. There are a lot of individuals in VR that also saw that, and so some of the phrases that they use, I kind of steal them or borrow them and use them as well. One of our leaders was talking about the front line. Sometimes there can be some perspective that that's my quote unquote time frame. It's like, no, it's not. That's the client's time frame. We don't own it. And also, I would never want to say to a client, like, we're going to have our level of service be the government regulation for this. Nobody wants to hear that ever. You know what I mean? And it's a big part because you think about physical health in the medical world or economic health. One of the frontline staff emailed me the other day and said, we're actually saving lives because economic health matters and it matters in stress, it matters in depression, anxiety. Where are you going to get your next meal? Can you pay rent? That's a big deal. And if you say like, Oh, you're going to have to wait on that 60 or 90 days, forget it. It's existential. You know their done.
Carol: You know, it's too late. Yeah. Just like you say. You've got to pay your heat bill. You got to pay your mortgage, get your food on the table. People come to us and they're often in this very critical stage. So when we put all that time in between us and any next steps, they're just like, what is happening? And so then we wonder why in the statistics it's how do we lose people? They're no longer interested in services. They moved on because we haven't done anything. And so we need to, we're in this. spot where we can. Like where else can you go that you get these tangible resources that you can give to the individual sitting across from you? There's not very many places. If you go to your regular counselor and you're talking to them about all of your issues, it's not like your counselor goes, Oh, hey, we'll pay your house payment this month because I know you're stressed out. They can't do that. Yeah, we have things we can help in supporting that individual to getting the life that they want. We're incredibly blessed to be able to have this opportunity.
Damian: And there's some things that we do, too, that I think helps shorten that gap because, I mean, we live in a different world sometimes from our clients and I think about that a lot. Like when I go home, I go to a nice house that has lots of food and it's warm and all that stuff too. And then clients might not be that way. It's almost like we have two sets of clients. There's those ones, like you said, that are living in almost crisis, and then there's ones that are looking to advance their career and they're both very important. But those ones that are on that edge, we try to share a lot of stories of kudos or great impact in all of our staff meetings. And there's been a lot that came from one region across this last three months that it's like when you read them, it warms your heart because they talk about, I can support myself now, I can support my family. It's like, Oh, that's what got us all here. And I think we need to continue to keep that at the fore because otherwise it just feels like a client becomes a case and they're not, you know, there's still a client.
Damian: Those are big things we try to do.
Carol: Yeah, I love that. That's awesome. So I want to switch gears for just a minute. Now, I know everybody's talking about spending money because there's been a lot of money going back to the Treasury, a lot of money being returned through re allotment each summer. And so do you have strategies or how are you guys doing that with spending the money and actually get that out the door so we aren't returning all these funds to the Treasury or to the US government. We want to spend them on our VR purposes.
Damian: And actually it was interesting, I can't remember the name of the fellow that presented to us from Pennsylvania, so he thinks a lot the same way I do. I identified, I call them seven different levers. But in his conversation or his presentation, I think he had like ten or 12. It was really great. But one thing that I think about is provider rates. One thing that was interesting is we had always matched our hourly rate to what DD was doing in our state. But I said, that's like basing your checkbook off how much your neighbor makes. Like it didn't make any sense to me, you know what I mean? We're in a position where we're flush with funds and we can put them to use, so let's do it. So we increase them recently here, 15%, and they hadn't been increased for a long time. The other thing that we did was minimum tuition allowance had been at $600 for a number of years and that was necessity. Back in 2012, we had a situation where our fiscal folks and our program folks weren't necessarily connected. So we went into an order of selection. We ran ourselves out of money, and the key culprit was tuition. So I can understand that trepidation to increasing that. But it was a need and we heard it a lot from the outside community. So we did that way and went from, I think it was 600 to 1000. And then also when we talked about the counselor and some of the impact they can have, it was interesting. So another part that was totally necessary at the time is they went to counselor budgets in 2012 and we have a lot of people that are in our colors training goals like guardians, people that want to protect and make sure they do things well. So they started to treat that money as an individual checkbook almost. And that might have constrained what we would spend on clients because you know that if you had 100,000, let's say, at the beginning of the year, and then all of a sudden it's April and you're down to 10,000, well, now you might start to restrict what you spend on a client versus the one that would have came the first day of the new year. So we abolished counselor budgets. We just went to a regional plot and I think that helped people be a little bit more freer with what was going on. And then certainly the wages increased, put some dollars to use.
Damian: So it's a lot of that. As far as some of the levers we pulled. Oh one that I would be remiss to mention as well. Our client financial participation. It had been if you made $25,778 for those nonexempt services, you were zeroed out your would not contribute in some of those areas. So we changed that. We actually doubled our financial participation limits. It actually helped a lot of those families that weren't necessarily in a crisis yet. But if something happened, you know, they're just hanging on and then it's really hard to get hearing aids or whatever when you're making 25,000. I mean, that's a decision between rent and a hearing aid. So opening that up helped a lot. And then actually, we always participate at least 20%. You could make a million. Not that there's millionaires coming in for your services, but you could do that as well. And so our participation level is it's open ended, kind of goes 80, 60, 40, 20, and then it just stays. We always participate at least 20%. So that's had great effect, I think, in attracting clients and so on. So yeah, those have been a lot of the levers we've pulled this last year or two.
Carol: That's very cool. I'm really glad you mentioned counselor budgets. I know on the QM on our fiscal team as we go out and we're talking with states, it's one of the things we advocate against having counselor budgets because of the very reasons you said you can almost end up being like you're on an order without being on one because it becomes then this is my pod and I'm protecting it. And if something is going to go outside of it, even though folks have a mechanism where you can ask for more money or whatever, people don't, and so they're restricting what they're doing. And so moving that up. I'm really happy to hear you say that because we advocate for that all the time.
Damian: Yeah, and all that comes from a good place. And I'm also I'm not silly enough to think like that. I created all this or the people that are here that created all this positivity to it's really because when they went into order selection, they made the right decisions that we have this money to spend now. So I appreciate the efforts of the leaders of the past and it really put us in a good position to capitalize on, I think.
Carol: Well, and it absolutely speaks to that. You need to continuously evaluate your position. So because you were there in 2010, it's now 2023 and you're in a different spot. You don't want to keep operating in the same way. You want to keep evaluating, looking at what you're doing, pivoting, making changes, and that's part of it. I think VR sometimes struggles a little bit with keeping sort of the same keep an eye on. We're doing the same thing, same way. We keep going. But the world has changed in the circumstances of a change and so much has changed that it really forces you to look in and go, Hey, we've got to react to this so we can move ahead of it to for the future. So we're setting up our program continuously for the future to be the best we can be.
Damian: Agreed. Yeah. The one big thing that came from that too, is we started to do forecasting within VR. You know, we didn't necessarily rely on our physical folks and the ones that we have now are fantastic. So don't get me wrong there, but it was helpful. Patti, who in our office takes a look at that. They were always planning for the worst case scenario, which if I had been here ten years ago, I would get that too. But the situation had changed and we made some little tweaks because also we started to notice they had always assumed that the grant would stay flat. But if you look at it, I think it's like 1.018%. It increases each year was our average roughly. And it might be different state to state. But it's interesting how much money that feeds into your bottom line and then you need to plan for because it's like you can't be at either extreme where you spend yourself into order, but you can't be on the other end where you're sitting with a giant pot of money where we are collectively. Now you want to know that those dollars are being put to good use. So we try to hit that happy medium.
Carol: Absolutely. We work with folks all the time on doing some forecasting and having a spending strategy, and we lay it out like, all right, what's your situation look like? How much carryforward do you have? What are you projecting this year? What's the increase? Some of the folks, the increase in the formula grants more like 7%. So when you look at that year over year, that's a big jump. You've got a lot of things you're maneuvering around to figure that out. So I know a lot is going on in VR and it can be really overwhelming. We have a lot of new directors in, we have a lot of new leadership. There's a lot of people like yourself who are coming in from the outside. What advice would you give to your colleagues across the country? They're trying to figure out what to do. What kind of advice would you.
Damian: Give them outside of the engagement that we talked about before? I think the other areas is I call it cutting through, and that's when we talked about popping into meetings, so on and so forth. Visit your regions. And it's not that I know and there's a lot more layers in other states that are maybe here too, but whoever the direct supervisor is, that can't be the person that's visiting the region. It has to be somebody above that so that they know that their voices are heard and are important and find those good ideas and cut through. I think also a lot of what we do is that certainly there is in our state plan, there's goals that are introduced and so on and so forth, but I would say have a strategic plan that doesn't sit on the shelf, make sure you're assessing your regions, hearing their input, pulling all that together, and then ruthlessly prioritize. So what I find is like, you can have I've heard this call, the disease of distraction is you can work yourself to death on a very large number of medium or low priority items, but you really don't get anywhere. But if you tackle those probably 10 to 15 big items, it's like it has a cascading effect. The medium priority become low priority. The low priority just kind of disappear. Ruthlessly prioritize, say yes to good ideas, concentrate on your objective metrics, and things really turn out. So that's the way we've done it here, Anyway.
Carol: I love that ruthlessly prioritize. Oh my gosh, you need to write a book or something. You are full of a lot of amazing ideas. I really appreciate you being on the show today and I'm wishing you the very best as you continue your ventures in North Dakota. Thanks a bunch!
Damian: Thanks for having us on. You have a good day.
Speaker1: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!