May 9, 2022
Aaron Thompson, Assistant Division Director for the Utah State Office of Rehabilitation, joins Carol Pankow on this 14th episode of Manager Minute to talk about how Utah is making rapid engagement work. Carol has discussed this on two previous podcasts; however, each VR agency has tackled this differently. It is intriguing and exciting to hear about how different VR programs are confronting the dilemma facing VR on declining applications and consumer engagement.
Learn about Utah's “Back to Basics” approach, how they implemented this approach and how they involve their counselors and customers.
From Utah's unique Performance Dashboards and Blueprint Systems, there is so much to learn about how Utah is making rapid engagement work.
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VRTAC-QM Manager Minute: Putting Customers First-How Utah Makes Rapid Engagement Work!
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. I am so fortunate to have Aaron Thompson, assistant division director for the Utah State Office of Rehabilitation, joining me in the studio today. So, Aaron, how are things going in Utah?
Aaron: Well, first, thank you for having me. And things are going pretty well in Utah. I think we're spending a lot of focus. We're going to be talking about getting back to basics and really kicking off a lot of the initiatives that we have in the works.
Carol: Cool. Good to hear. I can't wait to get into it. So, Aaron, I know you've been with the agency for over 17 years. You've held a variety of positions from counselor to supervisor to district director, field services director to where you are today. And I know you've seen and done a lot in your career, which really leads us to this very important topic we're going to discuss today. The idea is really called rapid engagement, and I know I've discussed this on two previous podcasts. However, each VR agency has tackled this in a different way, which is super intriguing and exciting when tackling this dilemma that's facing VR on declining applications and declining eligibility. So VR is a program where we're over 100 years old now, and with all the longstanding programs, there can be a tendency to layer on additional policies and processes until we get buried under a bureaucracy of our own making. So when we visited back in March, I was really energized about the approaches you've taken in Utah and hoped our listeners would feel the same energy and enthusiasm as they hear the Utah story. Your director, Sarah Brenna, also briefly spoke about the efforts in Utah and the efforts around rapid engagement during the CSA VR conference. So I'm excited to explore this further and let's dig in. So Aaron, can you give the listeners a little background about the Utah program, like how many customers you serve, how many staff you have, and how the pandemic has influenced your numbers of applicants and individuals being served in the program?
Aaron: Certainly I appreciate the overview of the resumé and all the details. I've had a fun opportunity to move into a few different positions, but within us two are something that I think is interesting, is like we're one of the first five state VR programs as the program nationally was celebrating its 100th anniversary. That was also our anniversary that year. So we have a really unique position as being one of the flagship state agencies for people with disabilities. And we're a combined program, but we also have different specialized programs for people who are blind, visually impaired, deaf and hard of hearing. We also handle the Social Security disability determination and also we oversee the independent living contracts. But we're the VR program at our core. We have a staff of 250 counselors, support staff directors. We also have our in-house Pre-ETS program benefits planners and also a division that focuses on assistive technology services. So for that context, prior to the pandemic, we were serving about 17 to 18000 people with disabilities coming through VR. And certainly like a lot of other state agencies, we were hit pretty hard. We had a drop in applicant and individuals choosing to suspend services or delay. And of course, our priority at that time was ensuring that our staff were safe, that our clients were safe, and keeping the program going and doing that same shift as everyone else, adapting our procedures, getting people doing telework and remote work. So as we were entering the pandemic around that same time, we were in the process of clearing out our order of selection wait list. So we had this slump where we were getting in more applicants, and then it was a bit of a setback. But now we're in that process of rebuilding, getting out there, re-engaging with the community, identifying new partners, not just resting on this being the new normal, but seeing what else that we can do that's new and different to get our numbers back up. So thankfully, the drop has stabilized. So we're really working on rebuilding those new applicants coming into services from VR.
Carol: So about how many people are you serving today then?
Aaron: So currently we're at about 16,000 people who are coming through the VR program, so the drop has stopped, but we're working on that rebuilding and really focusing on some of the local level partnerships that our clients and staff are making out there and also trying to be different. We realize we can't just go back to the same referral sources and do things the same. So we're really challenging ourselves to get our name out there and move past the phrase that I hate hearing about VR being the best kept secret. We really want to be out there and let different types of disability groups know that we're here and how we can help them.
Carol: Yeah, I agree with that. I hate that too. About the best kept secret. I used to say that I'm like, Why don't we want to be a secret? We want people to come in the door. So tell me about the impetus to implement your back to basics approach. What caused you to want to dig in and do things differently?
Aaron: I think it's interesting. During that time we had gone through about a 4 to 5 year period of a lot of significant change. Now change us something that's the normal we adapt to. But for context, we had a change in leadership. We had to rapidly implement an order of selection. And then we also moved from being under an education agency as our DSA and moving to Labor. We had a new case management system. We went paperless. Then of course all the fun with implementing WIO policies and procedures and audits. So we were in a constant cycle of change and as you said, layering. So we felt a need. We heard it from our clients, we heard it from our staff to take a step back because they wanted to know what are our priorities. And we also want it to be more intentional and less reactive. I think we were just in an environment and a culture of responding to change. So we did a lot of talking with our directors, with our frontline staff, and there was a consensus that they knew to do their jobs, but they didn't understand what their priorities were. What can we focus on now for the coming year, for the next two years? And we actually had an interesting conversation with one of our new deputy directors who was learning about VR and wanting to know what are your indicators, what are your outcomes? And he asked the question of what does good look like? And it was a good challenge not to raise it in a way about compliance or numbers, but his question was No, tell me, what does good VR look like? So we took that as an opportunity to really think about again, like, what are our core activities, things that we know at that management level.
But there was a disconnect with our staff. They didn't feel like they were being counselors. They felt like they were being case managers, having to check the box, having to do the compliance piece. So we really wanted to look at what are our needs, what's going to benefit our clients, and what are the barriers that can't be solved by putting out another policy, doing another technology change, we're really stripping things back to the core. So that's how the conversation got started about getting back to basics and what that meant for Utah VR.
Carol: I bet you were really happy about that new case management system and going paperless in light of the pandemic. I mean, like what timing?
Aaron: It positioned us very well to be agile and adapting to the pandemic and being able to get all of our counties out there doing Telework and serving their clients event well.
Carol: So let's chat some specifics of back to basics. How did you implement this approach and what went into it and how did you involve your counselors and customers?
Aaron: Well, one of the first things that we did is we did some research. We were really digging into the theory of constraints and identifying some of those limiting factors or the bottleneck in the VR process. So we've got some focus groups together with our directors, our program specialists, and we pulled in our counselors to do some VR process mapping of start to finish even when we're going out in the community and doing outreach and then identifying those points of constraint. And some of the biggest issues that we were encountering was how we have things set up with our eligibility developing plan. We felt comfortable once we got our clients engaged in services under an IPE. But then we also identified another constraint point at the end of the VR process. When someone's job ready, we saw significant delays with our clients being able to get employed in the areas that we were supporting and training them and we saw a pretty significant drop off. So by working together and doing a process mapping, we also got feedback from our client assistance program, the State Rehab Council, and we really dug into our consumer satisfaction surveys where people were coming in and just due to those delays with eligibility or working through their plan, I think that's where we saw a drop in motivation if it wasn't happening in a timely manner. And then we also looked at some of our numbers and of course, we saw the longer someone was sitting in an applicant status or eligible that's or we were losing people, we could see a clear correlation. The longer it was taking to achieve those milestones, the less likely someone was going to come in and participate and stay engaged. So I think by doing some of the foundational research and also pulling our staff into those focus groups to see about the VR process, from their perspective, it really informed on what we were going to do to address that problem that was identified.
Carol: So you talked a little bit about data changes. What do you see now in your data?
Aaron: I think when we primarily look at our data eligibility, when we started, of course, we were compliant, but it was about 49 days to make an eligibility decision. And then with plan development, I think our mindset was. Compliance. So we were doing it at 85 days and of course that was like, Oh, we're compliant, we're doing it right. But is that what best for the client? And even looking at the end, I'm a bit embarrassed to say, but it was taking our clients who were supported employment or even working with an employment specialist about 160 days to get employed when they were job ready. And of course that's where we saw that connection to the motivation. And when things were happening, that's when we saw that disconnect with the counselors and the clients not communicating. So now we're in a good place. I still think there is room for improvement following the pandemic and getting back to normal, but with eligibility, we're doing that in under 27 days. Our plan development has had the biggest drop in the time that it's taking. We're at about 50 days and then that time to placement when they're working with an employment specialist, our internal employment specialist is under 60 days. So I think the parts that we can really control, support our clients and inform it's working. I think people are moving through it and I think they're doing it in a way that feels right and comfortable and really supports that. Client Counselor Alliance.
Carol: Well, that's really encouraging. I mean, that's great progress. And I'm sure from the customer viewpoint, when you think about all of this and sort of wanting that rapid engagement when we're ordering from Amazon and we want it overnight delivery that...
Aaron: Next day.
Carol: Yeah, I'm sure customers are very much appreciating, getting this, moving through the process, getting into their employment more.
Aaron: Quickly. It was really interesting getting that feedback from our CAP program. I mean, they were one of the first to tell us, you know, we're not getting the calls that we use to a significant portion of their time or people who didn't understand, am I eligible for services? What's next? Or I got this eligibility letter and I haven't heard from my counselor. I don't feel like I know what to do next. So that was a pretty hefty part of what we were working with them on. So to get that feedback of we're just checking in, we're not getting calls about this, what's going on, and I think we were able to happily share well, here's the reason why and here's what we're working on.
Carol: That's terrific. Kind of an unintended fun benefit from all of this, right?
Aaron: If you can get that seal of approval from CAP, you know you're in the right direction.
Carol: Yeah, that's great. So I want to talk about the performance dashboards. I know when you showed those to me, I was really blown away with everything that you can see and there was a great deal of transparency there. How did those come about and how are you using them today?
Aaron: I love our dashboard, so we use Tableau for data visualization to pull that information from our case management system and present it in a way that's usable that really connects with what we're looking at. And initially it was developed for management use at the admin level and for our regional managers. But we had a good conversation about, well, if we're seeing this and we're going to talk to our counselors about performance and numbers, they should be able to see the same information. So we really wanted to lay it out there in a way that wasn't like a compliance or it got you, but so they could use it to inform on their work and serving clients so they could see closures, MSG's, the days to eligibility to base the plan so they can have a better understanding of what our goals were. And I think when we have some of those initial conversations about rapid engagement, moving people through the process, I think we have people who were a bit concerned or have reservations. So being able to see other counselors who are making it work, I think it was like, oh, well, it can be done. And so we were really also encouraging them to reach out to your other offices and districts that they've developed a pathway or best practice. What can you learn from it and what can you implement in your own offices to show that something's doable, achievable and how to prioritize? So being able to see it, our counselors really like it. They feel it's a tool that helps them do their job and also how to prioritize.
Carol: Very cool. So how did you set your stretch goals in these different areas and get staff to buy in on that?
Aaron: First, it was really talking about setting an ambitious target and that was something that we were challenged to do, something that would really move the bar. And we had a conversation with our regional managers to say, Here's where we're at. Where do you think we can get to? We didn't want it to be a conversation where they felt that something was already decided that they didn't have input. So we wanted people to be comfortable, know that we were going to set some milestones and also letting them know that this isn't a process where you're going to be dinged. If we don't achieve it, we're really just looking at how we can push our program. I'd do it in the right way and talking with our counselors about why we're doing this. So I think I can confidently say it was a 360 process of what does good look like, what are you hearing? And we always try to use that framework of if you came in for services or a family member, when would you like to see things done? So we knew that they would still encounter barriers with records and appointments and follow through. But by setting those targets and people feel comfortable knowing, Hey, we can try, we can learn from it, we can share resources. That's how we came to setting those stretch goals by setting an ambitious target. We knew saying we're going to do it two days faster isn't going to move the mark. And so we exceeded those expectations.
Carol: I love that. I think that's a really great way and a nice approach. So staff could feel comfortable, like you're not all getting the axe right.
Aaron: And that's what we didn't want it to be something that this is in your performance plan and this is your standard. It's what can we do that's best for our clients? And I think everyone could get on board with that.
Carol: Yeah, I really get that sense. So your people really felt part of this whole process and that it makes everybody gets on board and makes it so much easier to move the train for sure. So I want to switch gears for a minute. You had something really interesting that came up that the governor's office had championed. Can you tell me tell our listeners a little more about this blueprint system?
Aaron: Would be happy to. So we have a great champion in our Governor's Office of Planning and Budget. The director was actually a former VR client in another state. She's someone who's blind. So she gets the VR program, she gets what we're setting out to do. And some of the biggest problems that we've had is coordinating with other agencies that are serving the same people. A lot of times people might be connected with the workforce development programs or TANF, and so they have competing goals, priorities and interests. So by doing this program, it pulls in other social service agencies to really develop a blueprint for supporting customer success. So we have the VR program. Hannah We have corrections, adult and family services and juvenile justice. So we all have an agreement in place where it pulls information from our case management systems, where it populates and identifies a match. So if there is a VR client who is also connected with corrections, when we register the cases are counselors will get an email and if they go into the system, they will see the name of who their counselor or case manager is, their contact information. It also pulls over information regarding any type of employment or family reunification plan that they have and also the milestones of what they're working on. And our expectation was, hey, if you get a notification, call that other case manager, have a conversation, involve the client.
And we really wanted to make it about teaming together so much as a counselor, you feel like you're doing it by yourself, but pulling in everyone as a team to really talk about what are our priorities, how can we help our clients? And getting in that framework of giving our clients the right services, the right amount, the right time, and how we can support each other and work in tandem. So we've had this blueprint system for almost two years, and I think another gain that we learned from it is we had a lot of assumptions that the other programs knew what we do with VR. So it was really good to be able to educate them and give them more of an understanding. And so when they can see some of our plan information shared, I didn't know VR could do that or I didn't know these were the types of employment outcomes that you could help your clients with. And Oh well, what do you need for eligibility? I have that assessment. I can give the release and send it over to you. So we have people coming in our doors already having an application, having their records sent over, and that also helps speed up some of those rapid engagement milestones that we set up.
Carol: Yeah, I thought that was extremely awesome. I mean, like, it's just the coolest system I'd ever seen. When you demoed that, is there any information about this for our listeners? I just didn't know if there was something on the website, like the state's website or what would be the best way for people to find out more if they're interested in understanding more about the blueprint system?
Aaron: There is information on Blueprint Utah dot gov. It takes a link to a page that provides an overview and the philosophy of the program and any of the State VR agencies are welcome to reach out to me for more information. But truly having that champion with the governor's office made it work. I thought there would be the barriers with consent and data sharing, but we got the agreements in place. So having that push was a really great gain for us and also for our customers.
Carol: Yeah, I thought that was so cool. It'd be great if somebody could leverage the work that you all have done and take advantage. Having a similar system in their states. It was pretty amazing.
Aaron: Really happy to share.
Carol: That is awesome.
Aaron: And on that website there is information about the MOU that we developed.
Carol: Great. You know, as with any new initiative, it can be a lot for staff to pivot. And how are you engaging in recognizing staff participation and achievement with all of these initiatives that you've been putting into place?
Aaron: It's a lot. As we said before, I think people understand the reasons why we're doing something new and different. But I think overcoming that change fatigue really involved having their feedback and buy in and also looking for what we can take off of their plate. So something that we also did as we were running these new initiatives, we had counselor focus groups about time savers and it was really a true brainstorming session for them to give feedback about policies and procedures that were getting in their way that we could take back and then make adjustments and show them. It was your feedback that led to us making this change that also helps the quality of work in your job. In terms of recognition, we've made it a part of our culture with celebrating the new initiatives that we're putting in place. So at our annual in-service training, we give awards and recognition for like the district and offices that have the fastest time to eligibility, the fastest time to development of the plan. And we give incentives out that administrative leave and some of the other incentives that we can give. We want it to let them know you're doing something that benefits your clients, but we also recognize what you're doing and the adjustments that you're making. So it's kind of prompted some healthy competition and our staff pushing each other because they know that we appreciate it. They're helping, their clients are getting something and we have a district that will say, hey, we're coming for all of the awards this year. So it's nice to see that out there.
Carol: That's hilarious. There's nothing better than that healthy competition between districts. It's like, I'm coming for you people.
Aaron: It's out there back and forth. That's like a race to the finish those last few months towards the end of the performance year.
Carol: Yeah, good out of you guys. That's great. So what advice would you give to our listeners about taking steps to move in the direction of rapid engagement? I know we've gotten a lot of people out there. This is a buzz topic right now, but what are some good practical tips you'd have for the listeners out there?
Aaron: Think you really need to go into the mindset of customizing what works best for your stay and what works best for the unique challenges and barriers that you have. I think with every program that's going to look a bit different, and I think by having that conversation in terms of what are our needs, what does good look like for our agency, what are the other things that we have going on that might be barriers and how we can overcome that, have the conversation. Don't limit it to just being an administrative level, pulling your counselors. They're the ones who are doing the work, seeing the people, getting that direct feedback from your consumers and utilizing it really helped inform on what we needed to do and how we were going to go about doing it. I think that's the best advice I could offer is have that conversation and involve different people and different perspectives and make it work for your program.
Carol: Well said, Aaron. Well said. I really appreciate that and I thank you for joining me in the studio today. I appreciate this time with you and just learning about what Utah is doing to be successful. So I wish you great success.
Aaron: I appreciate it. Thank you for having me on and allowing me to share our story.
Speaker1: 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.