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Jul 11, 2022

Joining Carol Pankow in the studio today is Toni Wolf, Commissioner of the Massachusetts Rehabilitation Commission (MRC) since 2017. Toni leads her agency with the belief, "If the system isn't enhancing the quality of life for the individual, we at MRC must change the system."


Toni explains how MRC has developed a culture of engagement with customers to build trust and make space for the conversation about what is possible.


Find out how the focus on engagement and partnerships with the Department of Mental Health and the Department of Transitional Assistance is moving the employment needle to quality. 


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Full Transcript


VRTAC-QM Manager Minute: Moving the Employment Needle to Quality - Learn How the Massachusetts Rehabilitation Commission has Used Engagement and Partnership to Pave the Path to Quality Employment




Speaker: Manager Minute brought to you by the VRTAC for Quality Management. Conversations powered by VR, one manager at a time, one minute at a time. Here is your host, Carol Pankow.


Carol: Well, welcome to the manager minute. Joining me in studio today is Toni Wolfe, commissioner of the Massachusetts Rehabilitation Commission since 2017. Toni has a rich history in the mental health arena and is leading her agency with the belief if the system isn't enhancing the quality of life for the individual, we at MRC must change the system. So, Toni, how are things going in Massachusetts?


Toni: Well, you know, first of all, I'm really proud of representing Massachusetts today. So thank you, Carol, for having us here. And Massachusetts is thriving. I mean, like everywhere across the country, there are enormous amount of job opportunities. And so I feel like it's our time. It's our time with people with disabilities. Inclusivity is the buzzword. People are really embracing it. They're really believing in it. And that includes people with disabilities.


Carol: Well, I'm glad to hear that. So, Toni, I don't know if you remember back, but I had the good fortune of meeting you back in 2017 when you were attending your very first CSVAR conference. And we chatted over lunch and you were getting your feet wet and now you've been at it for five years. I'd say you're probably one of the more seasoned VR leaders today. We've had such a turnover in the field these past eight years, so it's been pretty unbelievable. But it's awesome to see the things that you've been digging in and making so many enhancements to your agency, and people are definitely buzzing about the things happening in Massachusetts. So I wanted to focus our conversation today on the quality outcomes that you're seeing now. I know it didn't just happen by accident, and I'd like to unpack what went into the work you did with your agency. So can you give our listeners a little bit of perspective about MRC, like how many individuals you serve, kind of the number of staff you have, and any other facts that might help paint a picture of your agency?


Toni: Sure, I'd be happy to. Massachusetts is a small state compared to other states in the country. We have about 800 employees. We serve currently 15,000 people in VR. Now that used to be 22,000 before COVID. And that's true, I think for all the agencies right now we're seeing a decline, but we are also very eager to increase that number in addition to our VR services, which right now is about 57 million, we also have a very robust community living division, serving same number of people and actually increasing the dollars with federal dollars as well. So we're a little bit about 63 million in our community living division. And then we also manage and support Disability Determination Division that's funded obviously by SSA. So that gives you a little bit of a perspective of MRC, Mass Rehab Commission.


Carol: Yeah, I had no idea. You said you're small, but you're a lot bigger than I thought you were. That is awesome. So you had mentioned to me when we visited earlier that you're really focused on looking at quality jobs that can provide a career pathway for individuals. So what's that look like in the sectors that you're seeing in Massachusetts?


Toni: Well, I think, number one, we're really focusing a lot on cybersecurity. Those are positions that are starting salary is 65 and up. And we really want to help people really advance their career opportunities. So that also meant a longer training program because obviously it requires that kind of knowledge base working with the community colleges, working with our staff, working with the individual people are really seeing the value of cybersecurity and the job offerings are unbelievable. So again, there's a huge opportunity there. We're also seeing things like STEM positions, anything that's related to technology. And Massachusetts is really fortunate that we're at this hub right where we have amazing employer partners. So it really is an opportunity to really help people advance. And that's really what it's about. It's about mobility. You may not start in the job. That is exactly the job you want or the rate that you want, but does it give you the opportunity to have mobility? And that's what we're looking at.


Carol: So how is that impacted your data focusing on these different sectors? Have you started to see some changes in your data?


Toni: Well, we're definitely seeing in terms of higher wages now, I would love to say we want to see more of that, which is definitely true. We're also seeing that internships, apprenticeship programs are really the way to go on, not to say that people should not have a four year education opportunity, but we're really seeing short term training opportunities that gets people into the door with employers, then gives people the mobility access that they need.


Carol: I love that you said that because I think internships and apprenticeships we have not been very good at in VR. I mean, I don't think it's so good for a long time and I'm really glad WIOA has put a focus on that as well. And I think society as a whole has put sort of this, you know, the prestige around this four year degree or you've got your masters in, they're forgetting all these awesome occupations where you can have an internship or apprenticeship, you know, and get into a certain position and we're missing the boat, like making that somehow seamless because those are crazy careers. Like, I have a plumber at my house right now and you go, Those people are making a lot of money. It's not like five bucks an hour or so.


Toni: Well, and it's also relying on the resources of the employer. Employers really are eager to have people come in to the door and really support them and also really advance them so that they can keep a good employee. So it's really about maximizing not only the VR resources, but the employer resources with internships and apprenticeships and also helping people explore what's out there. Know there are positions that we've never heard of before that didn't even exist three years, five years ago. They exist today. So let's really help people think about what's out there.


Carol: Yeah, I think the pandemic opened up a whole new world to what we learned, what was possible from all of that. Right now, I know this idea of engagement has been really important to you. Can you tell us about the strategies that you have developed around engagement?


Toni: So this is very hot and mass rehab. So what we saw was that we missed people in the beginning steps, right? That we looked at our data and looked at the statuses and what was happening and how we lost people. And engagement means before you even talk about employment, you engage the individual to say, I'm here, let's think about what's possible. All right. And we spent a lot of time and we're using a lot of state resources to make sure that we are giving employees the opportunity to engage in individual. What that means is building a relationship, connecting with them, going where they are not always making sure that the individual comes to us. So that could be at a residential program, that could be at a community setting, that could be someone's library or natural community. It's really, again, going where they are or where they feel comfortable and engaging. And what we're seeing is, is that that opportunity allows people to begin to build a trusting relationship, to then be able to talk about work, talk about what's next, give you the opportunity to think about, am I really interested in employment? Maybe I could be right, because we're seeing people so hesitant right now, so even more so than ever, it really requires engagement.


Carol: So how did that happen with the staff? I know some other states have been talking with staff, have been a little hesitant about going out and meeting people, especially meeting people in their homes or things like that. But even meeting people in the community, folks have been worried about data privacy and all different things. How did you work with staff to make all this happen?


Toni: Well, we started first with one of our programs, which is a partnership with the Department of Mental Health. And we hired people that what we're calling mental health specialists, mental health rehab staff who really enjoy that population and understand the challenges and the strengths of people with mental health conditions. And we set up front, you're going where they are, you're going in the community residence, you're going. So that really set the tone automatically. Let me just say that. And also, we talked about engagement. What we did was we kind of looked at some of the principles we really want to instill throughout MRC and let's do it on a small scale basis. So we have a $4 million project with a Department of Mental Health. We have about 25 counselors, and they are going in the community settings, they're going in the residential programs, they're going in clinics. All right. They're going where consumers are, right, where it's not such an effort to engage people. And we also are making sure that our counselors are working within a team, that it's wonderful that VR has traditionally been one on one. But what we know also is that people really thrive when there are more resources at the table. So not just think about the person in the VR lens, but think of the whole person.


Toni: So is their home safe? All right. Do they have food on the table? All right. Can they think about work? Can they think about going on an internship? What about their transportation? How can we help people? So again, it's not only just working with the individual, but working with other resources so that people can really thrive on their goals. So that's when we started that. And then we expand it to a different partnership, which is our Department of Transitional Assistance Partnership. So again, we made sure that people learned and heard the value of going where the consumer is. And I have to say now what we're calling via are throughout the agency, people are realizing that that office is not the Pandora's. We can open that up. Right? We don't have to be glued to the door. And there was a myth that in VR for some of our counselors that felt like if an individual went to the office, that meant that that was kind of a test. They were really committed. Right. We know that's not true. There's lots of reasons why people don't make appointments. Right. It doesn't mean that they're any less interested in achieving their goal. So I do think in this, a remote arena that we've all experienced, it also is opening up enormous opportunities.


Carol: Yeah, you are spot on on that. I remember the whole test concept. If they get there and think about Minnesota like Winter and there maybe someone is also in a wheelchair and they're trying to navigate buses and then trying to get through our parking lot. That's not plowed very well. And then they're late. And then the counselor is thinking, wow, they weren't very committed to getting here. It just probably took him 2 hours to get here. So we don't have to put people through kind of through the paces. I know you're talking about this partnership with mental health. And of course, you've had that long, rich history in the mental health arena. So I wasn't surprised that you were engaging in partnering with your Department of Mental Health. How is that relationship blossomed over these last five years? Have there been any things you've been doing specifically to sort of cultivate that?


Toni: Yeah. So we first created a vision statement as a group so that we wanted to make sure this was a long term historical perspective. We wanted a vision statement. We wanted to make sure both agencies were committed short term and long term to really work with people with mental health conditions. We also on a monthly basis, even today, this project has been going on for four years. We look at the key performance indicators. All right, how are we doing? What is the say? What does this actually mean? Maybe we need to go back and dig into the data to see if there are other things that we can tweak. So it is really a partnership that we're doing with EMH and with MRC and it also involves other clinicians. And so how do we help other clinicians who may not always think about employment? All right, but how do we help them as well? See, broaden their lens to make sure that employment is part of their discussion with the individual.


Carol: When you talk to you about that partnership with the Department of that transitional assistance, I don't have a good feel exactly for what all that department does. But can you talk a little bit about that and how you have cultivated that? Like what is we didn't have a department that was named that. So I'm not understanding exactly what they what they do.


Toni: Yeah. So I'm not sure what's related to other states. So I apologize. But they are. The Department of Transitional Assistance provides residents with cash benefits, food assistance and workforce training opportunities. We're really excited to partner with the Department of Transitional Assistance on our Empowered to Employ program. Gotcha. It's a group that traditionally has not always seen individuals with disabilities, and yet we know that individuals with disabilities are everywhere. All right. So we sat down and said, look, the individuals that we work with are using your services. We are the experts in the disability arena. Let's partner together. You are the experts in benefits. You are the experts in food security issues. You are the experts in supporting individuals with food assistance and other economic features. Let's combine our efforts, and that has really been an eye opener for both DTA and for MRC. And I say that for MRC side. Traditionally we don't always see individuals as part of a family, all right. That they too are caregivers. And so a lot of individuals that we are servicing through our DTA project are single parents. So it has enriched our consumers, it has reached our staff, let me say, to really appreciate the challenges people have that are also caregivers themselves with a disability. Right. And it has helped to because they're seeing something incredibly positive when people get employed. All right. So it helps them also believe that more is possible for their individuals. So I think it's been a really enriching partnership and we are in the process of expanding that partnership. It's been so successful.


Carol: That is brilliant because if you think about it, you want to look for a job, but you're also you have these basic needs like.


Toni: Childcare.


Carol: Food. You know, I need food and I need childcare and I need all this other stuff. And so it's kind of this really revolving circle. And if you can't, you've got to get it all met together so that that all is in sync. That's right. So if somebody was wanting to reach out to that because we it was our Department of Health and Human Services and Minnesota would be that agency that did that and that kind of the SNAP and TANF and all these different programs. How would somebody reach out to get that relationship going? If you were giving some advice to your colleagues out there, how could they go about trying to engage that partnership?


Toni: So, you know, I would be lying to tell you that it was not something that happened easily. But at the same token, it was about relationship building. That's what everything is about. So it was really at that time the commissioner myself talking about where our shared individuals that we service were right how to think about that differently and not being so siloed in our roles and in our departments, but really looking at what I'm calling collaboration. Right. And we had more in common than we had. That was different. And so that really, really allowed us to really think about let's start a pilot project where we're working together, where we're looking at actually having a VRC in a DTA office. And this was pre-COVID. All right. So our VR counselor actually sat and was headquartered in a DTA office to start building relationships, and that then grew over time. And that's really, I think how you build partnerships is that you start building relationships, you start thinking about the shared individual that we all care about and serve and what's best for them. And I have to say, DTA has been a great, great partner.


Carol: That's smart. I mean, that was really smart, starting with that VR counselor in their office. Good for you. So I know partnership is definitely a theme and you took some lessons you've learned to help you secure. You get a Disability Innovation Fund grant from RSA in 2021. So what's the premise of that grant you wrote, I think you had called it Next Gen. It was something kind of snazzy like that.


Toni: Well, that's what we want to be snazzy. I think VR has a rap of not being innovative and that's not true. We are incredibly passionate here at MRC. Every staff person is incredibly passionate about the work they do, and yet we also have to translate it so people think differently about us, that we are innovative, that we do really look at servicing the individual and the family in a really robust way. So next gen is to serve what we're calling 18 to 30 year olds. All right. It is really about translating what we do to their needs. It's again, focusing on the team approach so that if somebody does not feel comfortable working as part of a team, they would not use next gen. But this is a very much of a team effort. The thinking behind this is that there would be a benefit specialist up front, there would be a counselor, there would be a peer mentor, someone with lived experience themselves. That's part of the team that could help an individual. They would be somebody that also understands outreach and the importance of outreach and the resources in the community. And the thinking is that the youth or the young adult is we're calling that person 18 to 30 really is part of the circle of that team and they will decide who they want to work with at that point in time. It doesn't always have to be the VR counselor that's the case manager or the care person that's coordinating efforts. So it's really putting the young adult in charge. And what we're hearing with youth and young adults, they want to feel like they're dictating what happens and they should. It's their life, right? So it's really putting the young adult in the center and really making sure that they're driving the ship. So we're very excited. And next gen, it does mean thinking very differently around VR services. It does mean, again, internships, apprenticeships, working in the community very differently. But we're very excited about this opportunity.


Carol: That's really cool. So I see you're probably like a year into this.


Toni: Now we're actually in a year of model design. And just to give you an idea of what we've done, we have vetted it with a number of young adults. We have vetted with sister agencies. We have vetted it with families because very much families have felt left out and not as included as they should in thinking about services. And I think that, again, there's always this sometimes myth, sometimes reality, that if you involve the family, the individual is not as independent. And we believe that both parties have a voice in that. And sometimes it's different. A different voice. All right. But if you don't, again, bring people to the player together, you won't have the results that you want. And that's really what this is all about, is really making sure that that young adult is successful and has results.


Carol: Well, I'm definitely going to follow up with you later on a later podcast about how things are going with that project. I'm really excited to hear about that. That is very cool. Now, I know we talked about the pandemic for just a second. At the beginning, you talked about the number of customers you're serving, went down from 22000 to 15000. Obviously, we saw this major contraction during the, you know, the pandemic and the people served in VR. So did you have any surprises as you kind of look back on the pandemic, any kind of surprises that may have come up that you learned about? And are your numbers starting to come back up?


Toni: Yeah, we are. Recently, we see about a 25% increase in the last 60 days. So we are seeing the numbers increase. I think, again, it's depending upon each state and where they are with their COVID rates. But Massachusetts has been very aggressive. Every state employee here in Massachusetts is required to have a vaccination. So we've been very aggressive in that. I think when I think about surprises as horrible and as challenging COVID has been, both in terms of people's personal lives, people's losses, it also has really, I think, demonstrated the resiliency of us as people. And it has meant that people had to change. There was no choice. We all had to react and we all had to react quickly. And so it has relied it has required us to rely on technology faster. And for some of us like myself, it always is a little bit of a challenge to learn a new technology. But it made me I haven't had no choice. And in some times when you have no choice, you embrace change and you don't even realize you're embracing change until you're in it. So I think for MRC, it really helped us really be able to appreciate the resiliency of our workforce, the resiliency of the individuals we serve. You know, we made sure that we did not close any cases for a long period of time. We just wanted to engage. All right. Let's not worry anymore about numbers for a while. This is a pandemic, but continue to reengage and have a relationship with that individual and. The individual will come back. And that's what we're seeing in the last 60 days. Our numbers have been increasing.


Carol: That's exciting to hear. Good for you. I think that's that's a good approach, that engagement. And I know for so many of the customers, people were losing employment. You know, they got laid off during that. So there was a lot of things and a lot of just everybody was struggling with personal issues, whether, you know, being ill or family and all of that. So I think keeping connected. So are your staff, are they back at the office or are you guys still working hybrid or.


Toni: Yeah, so we're embracing the hybrid model. We think there's enormous strengths and we actually are just now engaging with working with a vendor to really be able to have feedback every month from our consumers so that we understand what their experience is. Because what we're seeing is it's changing, right? People are beginning to feel more comfortable, but we want to really evaluate that. What are the things that an individual is experiencing well and what are the things that they're not experiencing? Well, at MRC, we are hearing that a lot of individuals we serve really appreciate remote access. It eliminates transportation challenges. It gives a quick opportunity. All right. And we've also had, I think, really fortunate opportunity to also offer technology to our individuals. So we've spent about $15 Million to make sure that people have the technology they need. So there was not a divide, a digital divide, which is what I was fearful of, to be honest. Yeah, we have now staff using technology, but we don't have individuals with disabilities using technology. So it does require training, it does require some education. We're also doing some things like what I would call soft tricks, soft skill training on how do you actually look when you're working remote, right? What are some of the things that you need to be mindful of when you're interviewing remotely? Right. So really being able to help people have a little bit more self awareness in this remote arena. But I think that it's been really a great opportunity for everyone. And what I'm seeing in our small state, even though we're small, right, it has allowed us to talk to the East and the West State in 5 minutes. Right. We've pulled more meetings together in a more collaborative way because we don't have to drive two and a half, 3 hours to get to that meeting. And so I think it has allowed us more access, more communication access for sure.


Carol: That is excellent. I'm glad to hear that. What advice would you give to colleagues across the country? You know, they may want to pivot and focus more on engagement and partnership. And obviously, you've been doing this for five years now. And as you said with something earlier, it doesn't just happen overnight. It takes some time. But in your wise wisdom hat, what advice would you give folks out there?


Toni: Well, I don't think I have any right to give anybody advice because we're all learning. But what I will say is that it does take time, but you really have to believe that people are committed to the work. And I do want to say that there is not a staff person here at mass rehab that's not committed to the work. You can't teach commitment. All right. You can teach change. You can help people adapt to change. You can't teach commitment. And so I think for me, it's really helping people understand the change, have the vision of the change. And one of the things that we did here was that we had a roadmap. We literally, when I came on board, brought in a consultant to help us develop a roadmap of where we're going. And in that roadmap, we still have a roadmap steering committee that really looks at are we keeping true to the priorities we've set and we communicate out quarterly to the results of that roadmap? Are we still staying true to what we said we want to work on in spite of COVID or maybe because of COVID? Right. Doesn't take away the direction and the vision of the agency. And so I think more flexibility is necessary in VR. I think innovation is absolutely essential and I think being able to translate the work differently is really also important. What we're getting feedback from young adults just with our own name called Mass Rehabilitation Commission, is that people are not broken. There's nothing about rehab that should be in our name. So we are also looking at our own branding exercise and we have a great communications director that's helping us do that. But it really is about how do we translate differently to the population we're serving. Young adults today are different, all right? They want different things. They want quicker reactions. They want responses. We need to be that reactive in a positive way.


Carol: That's like the Amazon overnight delivery. They want a quick we all do. If you can't touch your screen and scroll and all of that, you're like, what's going on?


Toni: That's right.


Carol: Yes, absolutely. So you've talked about so many cool things. I've been interested in this contractor that's doing the surveys monthly, and you've talked about the different projects you've had. Does any of this live on your website, any information about some of your projects? Because folks I know people always like to go, hey, can you get us a link to a website so we can go look?


Toni: So this is when I think our director of communications probably like scrounging right now because we're aware that a website does not reflect as much as we would like. We're in the process of developing a new website and enhancing our website. So please get on board and connect with us. And we'll be. Happy to give you any information we have. I really think this is a community that we have to support each other in change. And I want to put a shout out to California, who's really helped us as we developed our eligibility process and expedited eligibility. Thanks to California. All right. And we have now a centralized eligibility system called MRC Connect so that people can actually apply for services one time, whether it's in VR or HCL, that's really about really again streamlining processes. So for the individual we serve, it's not such a bureaucratic process. So I do think that innovation is really critical. Our website may not reflect that yet, so just reach out to us.


Carol: Okay, that sounds really good. And Joe Xavier would love that you gave him a shout out. We did a podcast with Joe's team about, I think about four podcasts to go talking about the rapid engagement, and it is our highest downloaded podcast that we've had to date. It's been really fun, but you are so right, Toni. I mean, it takes a village and VR and people have all these incredible ideas. I know Joe helped me back in the day and a team model approach and so many different things I took from colleagues across the country. And then you take it and make it yours, you know? So I love that you're willing to have people reach out and just contact you.


Toni: Yeah, please do.


Carol: Thanks much for sharing. You packed a lot into this half hour. I love it. And so there's been a lot of very cool things that you've talked about. And I definitely am going to want to circle back with you at a later date just to find out the progress, especially on your Next Gen, very snazzy, cool Grant. So it sounds good and thanks much. I wish you the very best, Toni. Great job.


Toni: Thank you. Thank you for allowing us to shine a little bit and MRC will be proud. But more importantly, I think everyone really cares about the work across the country. So thank you for helping us do that.


Carol: Have a great day.


Toni: All right. You too. Bye bye.



Speaker: Conversations powered by VR, one manager at a time, one minute at a time. Brought to you by the VRTAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcast, or wherever you listen to podcasts. Thanks for listening.