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Feb 23, 2022

Welcome to the Manager Minute. Joining Carol Pankow in the studio today is Susan Pugh, Deputy Director of the Bureau of Vocational Rehabilitation with the Opportunities for Ohioans with Disabilities. Susan has worked within the agency in a variety of capacities including, VR Counselor, Assistant Area Manager, and Assistant Deputy Director.


In this episode, Susan discusses Ohio’s rapid engagement process and the Lean approach that has reduced onboarding time and ushered in more customers. Susan and Carol cover a lot of the initiatives that Ohio has implemented to enable them to speed up the process so that customers are trained and employed as soon as possible.


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Full Transcript


VRTAC-QM Manager Minute: Get in and Get er’ Done! How Ohio Makes VR Work for Customers!



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: Welcome to the Manager, Minute. Joining me in the studio today is Susan Pugh, Deputy Director of the Bureau of Vocational Rehabilitation in the agency called Opportunities for Ohioans with Disabilities. Now that's a mouthful. Susan has worked within the agency in a variety of capacities, including VR counselor. She's been an assistant area manager and assistant deputy director. Susan, it's so great to have you here today. How are things going in Ohio?


Susan: Things are great. I appreciate the opportunity to talk with you today.


Carol: All right. Well, today's topic is covering this idea of rapid engagement and the idea behind that is getting customers in and moving as quickly as possible. So they are successful in your agency has been using that lean process to completely revamp many of your processes and procedures. And I know that private industry has successfully used Lean for many years to improve manufacturing processes. But I know sometimes it doesn't always translate over to VR because we don't make widgets, after all. But we do work with people, and I know VR often creates really complicated processes to help individuals move through the VR system. So when I was in Minnesota, our governor had brought forward the idea of using lean throughout state government with some pretty successful results. I remember our license bureau for when undergoing a huge overhaul and where it would take weeks and months to get license plates and get your license. They were able to get that down to a matter of days, and so that was excellent. I know we also had to have a lean coordinator in each of our agencies that would report up to the governor on a quarterly basis, and we really put a lot of effort into that and you were able to get exposed to this same concept through your agency director Kevin Miller. And I remember talking with you a little bit ago that you really done a lot to examine your agency's processes and practices so you can do more for individuals with disabilities. So let's chat about this. Can you talk to me a little bit about your introduction to Lean and how it works in your agency?


Susan: Yes. Our director, Kevin Miller, joined O.D. back in January of 2011, and one of the first things that he did was establish a division of performance and innovation for the agency, and now that that division is called our Division of Employer and Innovation Services, and that deputy director was tasked with bringing lean into the organization. And like you mentioned in Minnesota, we have a lean Ohio office that provides all kinds of resources and support for state agencies who want to do this. So the way we kind of started out was members of executive team went to something that was called at the time, a champion training and where we learned and we were briefly exposed to all the different aspects of lean and learned how to champion lean processes within the organization. And after that, we started sending staff because within lean, there are belts like within karate. And so we've had people that have become green belts and black belts in lean processes. Now all of our supervisors and managers and some of our program specialists also receive yellow belt training, which is comparable to the to the champion training that I was mentioning. So now it's really kind of ingrained into all of the aspects of what we're doing. We've done tons of different lean events, which I'm going to talk about here and a little bit, and it's just more ingrained into our culture 10 years later.


Carol: Well, I like the word that you used in grain because you really do have to make it become part of the agency's culture. Otherwise it ends up being this thing that sits over here on a shelf, you know, and employees are like, Well, whatever, you know, here's the latest and greatest. I wondered, though, did you have some skepticism about the process in the beginning? And was there any kind of pivotal moment when staff went, Oh, you know what? I kind of do get this. I see where we're going.


Susan: Yes, One hundred percent at first it was really and I think you mentioned this earlier. It's kind of hard for our staff to think about our processes in these way. We've been trained that our processes all individualized and that's a good thing to meet the needs of the people that we serve. And it was really hard for them to think about standardizing that process as really a good thing. It was really counterintuitive to how we've always operated the program. Know, I think one of the other things that was kind of pivotal was looking at informed choice and how we could look at that differently. That informed choice isn't really free choice to where everybody has to have their path. We can kind of have some lanes. So to speak, that people are going into that will really help them meet their individualized objectives. So staff started participating in these lean events and despite that skepticism, once they really got involved, they were all in. For example, in these events are staff are empowered to make decisions. So it really uses frontline staff and also customers to help redesign these processes. And that really helped staff with buy in and then that team rolls it out to their peers. And so that in really helped, first of all. And then I would say the second thing was once we really started experiencing success and seeing these processes really result in the desired effects that we were looking for, then people were totally in, you know, they saw that it worked and then they wanted to do more of it because it makes things easier for our customers, but it also makes things easier for our staff. That's super


Carol: Cool. I like that about Lean. You know how it involves all these different layers of folks in the process. So it isn't just like some group over here is deciding a thing again, and then they're telling us what we're going to do. You know, I like that. I always remember all the little sticky notes up on the wall, churning out the whole process. And when you start moving sticky notes around and you go, Oh my gosh, great. We have like forty two steps to do this one thing, it is completely eye opening. Now I know when you and I had chatted, there were so many terrific projects that you had done and I'd like to break those down so our listeners can get a sense of what each is about. So can we start with the front door your process for getting rid of the waiting list? Can you tell me about that?


Susan: Yes. So this was back way in 2012, our first Kaizen event. So Kaizen means, I think, roughly break for the better or something like that. And it's really about process, like uncovering what is your process and fixing it. So at that time, as an agency, we averaged 127 days to eligibility from the start of the process to eligibility. And that was really the first piece of this was we didn't really know that that was our number before this happened because it is very data driven kind of activity. And I think we all would agree that 127 days is just unacceptable. And so staff really were like, Wow, no, this can't be we have to do better for the people that we serve. And so then our director said, I know that the federal standard is 60, but we're going to do 30 and our staff, myself included, I will freely admit we all looked at him like he had two heads. This was not possible. There were all the reasons, good reasons that we were at 127 days. We all knew we could do better, but to do 30 days was mind blowing. It just felt like an impossibility. So this team came together and they made all kinds of recommendations.

The first thing was they realized we didn't have a process for doing intake and eligibility. We had like 88. So we have 88 counties in Ohio. Every county had their own process, and so this group was tasked with creating something new. And so some of the main things that they did was, first of all, they eliminated a whole pre-application process. We used to have a referral form that was even before the application. They were like, Get rid of that. And that already took off like 20 something days just right off the bat. Like that easy. We also had designated counselors at the time to determine eligibility, which had helped us get more consistent with our eligibility decisions. But they said we have a 4 lane highway and we need an 8 lane highway. We can't do it this way anymore. And so we moved away from that designated eligibility counselor model. And then they developed a process and they put time frames for each step like you have to do this within certain days and this within certain days. And it just helped reframe the pace at which we were taking all of these steps. And there were a whole bunch of other things. But those are some of the examples of what this team had recommended, and our commitment to the team was whatever you recommend, we're going to do.

And so we did it. And over the years, we continued with a continuous improvement mindset. We started looking at different kinds of tools for tracking. We eliminated unnecessary assessments. I mean, we had people that were doing psych about us when we had a diagnosis just to figure out the functional limitations when the counselor can do an interview and figure out the functional limitations, right? So there's all kinds of things like this, and this really improved dramatically. And we have been at 23 1/2 days to eligibility for the last 4 fiscal years. And I'll tell you what I. Up for sure, during this pandemic, those numbers were going to go up. Our staff have just done a tremendous job with reducing these days to eligibility, and so all of these timeframes that reduce result in our being able to process cases quicker, get people to their employment goal quicker, which allows us then to have a space for the next person and serve more people. And this, like you mentioned, this was key in our eliminating our waiting lists. In 2014, we had been on order of selection for 25 years.


Carol: That's incredible. I mean, that is incredible.


Susan: Yeah, and in 2014, thanks to this and some other Lean processes, we were able to and we still are off of the order of selection.


Carol: I love that you talked about the data because, you know, it is a data driven world today, but you guys were looking at the data back when maybe not everybody was really looking at the data. So you're ahead of the curve. So WIOA wouldn't have thrown you as big of a curve ball when WIOA, as it did for maybe some other states, I think that's terrific. Now I know fast tracks another project that your agency is well known for. And in fact, it was the project that had me contacting you for more information. And then I found this really great treasure trove of all the cool things you were doing, and we have to talk about all of them, of course. So can you tell us about fast track?


Susan: Yeah, Fast Track was another result of a Kaizen that we did back in 2017. So this was implemented in April of 2017. And really the impetus was, you know, we'd have people come in and they didn't need as much. Maybe they'd worked before. Maybe they only needed something to help them save a job, you know, some equipment or something like that, and we had to take them through the whole thing every time. And our director said we need a fast like an express checkout at the grocery store sort of a thing so that people that are coming in that we can just quickly serve them and get them to their outcomes. And so we brought a team together to take a look at this. And they determined like if somebody needed three or fewer services or services that were likely to take no more than three months, they didn't need lots of assessments or things like that, then they would be a good candidate for this fast track. So we implemented it and they did a fantastic job. We were able to just really get people into a plan super quickly. But let me tell you what happened is that it really begs the question if we can do it quickly for people who are on this fast track, why can't we do that for everybody? And so it really kind of took us down a path with looking more now at time from plan to eligibility and the overall customer service, because we know when people come to see us, they are coming for us to get them a job in six months. They want to get them a job now or they want to get involved with training now. They don't want this long, convoluted process and complicated process. And so this was just a really great project that our field staff kind of designed and came up with. So last year, we had about 153 people use that fast track model. And I'll say that's kind of officially because our timeframes are so quick anymore that really a lot of people are getting rapidly into these jobs. So of those 153 last people, 105 of them are closed successfully. So we really have a strong success rate when we look at that model, which is really again about engaging rapidly people, they stay engaged. They get to that employment outcome at a greater percentage than individuals who were not so intensively moving forward as quickly.


Carol: I love that you're always like challenging your thinking and your processes and taking a look and like, All right, how does this apply to, you know, a different situation? I mean, if you think about how VR typically operates, if those folks that needed to come in and they really only needed like three months or less the services and they were waiting for eligibility, you know, 60 days and then you're going to do a plan in 90 days and maybe in six months, you get around to the first service gets provided or something. It's done like if they were going g to lose their job right, their job is gone. It's done. So this just plain makes smart business sense to do this.


Susan: Yeah.


Carol: So let's see, where do we go next? How about your IPS model and how those principles have leaked out to serving other populations?


Susan: Yeah. So this is another area of focus for us. We've enjoyed a wonderful partnership with our Ohio Department of Mental Health and Addiction Services for years and the IPS model individualized placement and support. It's a true evidence based practice model, and there are several different philosophies or aspects of the model things like rapid engagement, which we're talking about today. Open to everyone who wants to work, it's integrated with treatment, all of those things, and so the practice really measures fidelity to that model. We have really been working with mental health and addiction services. I'd say, I think over the last 15 years, but in particular, I'd say over the last 5 or 6, really good traction with implementing this model to improve our outcomes for individuals that we serve with severe and persistent mental illness. We've done some things like we've given accreditation waivers for mental health providers who deliver individualized placement and support models. We've established a supported employment services on our fee schedule that has a 25 percent enhancement in the rate over traditional job development rate that we did back in 2017, all to really help build capacity for this model.

And IPS has been around for a long time. And I can remember 15 years ago this conversation, it just was really different. I think we had concerns in the VR system about some of these aspects of fidelity to the model at the time, when we talked about rapid engagement and we had all these processes, we're like, Yeah, that's not the way our system works, right? It's really open to everyone who wants to work. We would say, Yeah, but what about this situation? Are we really going to, you know, whatever? And I think we're just in a totally different place as a system now, and the language barrier between the two systems has been erased. So when they talk about zero exclusion, we're talking about a presumption to benefit. It's really the same concept. And I think as our system has evolved, we've been providing much better customer service to individuals with mental illness, and that has helped our partnership with mental health, which then in turn helped improve the outcomes for the people that we serve.


Carol: I love that, you know, a lot of times people forget to talk about customer service in government. You know, you think, Oh, like you can't have good customer service and government, but we can't afford to not have good customer service. I mean, as a system, when you look at all of the graphs like RSA will come to CSC and put up their graphs, what's happening nationally, you know, you see all these numbers tanking and people not getting into employment. We have to rethink like everyone has to rethink. And so it's exciting to listen to you because I think it will spark ideas and other folks as they're thinking about what they're doing in their own states. Now your state is an employment first state and we are as well in Minnesota. Can you tell me about your counselors working with the most significantly disabled population and being embedded in colleges? I know the stats say you are 4th from the bottom regarding median wages and what are you doing to move the needle on that?


Susan: Yes, we are in employment first state and we have a very robust employment first partnership agreement with our Department of Developmental Disabilities and yes, Minnesota Senate delegation years ago when we were early within that partnership to take a look at what we were doing. And you sent some of your VR staff and some of your partners also came to visit Ohio. That employment first partnership agreement with DOD started back in 2013 and really has been about helping people move from segregated settings into community employment. But in addition, we really recognize that we hadn't been serving individuals with disabilities who are going to college like we had many years ago, and there were part of that was being on order selection impacted that we have financial needs testing for training and a lot of the schools just kind of had written us off, to be honest with you. And we were serving some students, but not a lot. And so we have a program called Ohio College to Careers. This initiative was a part of our governor, Mike DeWine's vision for making Ohio a disability inclusion state and model employers for individuals with disabilities. When he came into office within literally minutes of taking his oath of office, he signed this executive order about this vision for services to individuals with disabilities in our state, which was wonderful. So as a part of the furtherance of that vision, we have Ohio college to careers and it embeds a counselor in the Disability Services Office or the career service officer. Kind of both. At 15, what started out is 15 Ohio State colleges and universities. So in 2019 we started at 15 colleges. 4 of those are 2 year schools and 11 of them are 4-year schools. And in 2021. Just this past year, we expanded to the two historical black colleges and universities in Ohio, Wilberforce and Central State. So now we have a total of 17 schools participating in this program, so it's a real, career focused model, we do obviously pay for students tuition and those investments are important for people with disabilities that we serve. But the most important thing that I think our counselors offer is that career focused model, how to help them get into internships, how to get the job placements once you're done with school, how to give you the technology that you need to be successful in your studies, the additional support and wraparound services, whether that be interview clothes or a computer or whatever those things are, that you need to be successful in your school. And when we talk to the colleges, that was something that they saw as missing, that they saw that sometimes their students with disabilities are the people that they had the most difficulty finding an internship placement for, and they welcomed our business relations staff. So this has in addition to our dedicated counselors, there are two career development specialists that focus on kind of the business relations end of the program. They do employer spotlights career education. They have an internship dashboard. They do specialized hiring events. All those things that really kind of just help those students achieve their career success. It's not going to do anybody any good to get a degree and then not actually achieve the employment that they were looking to obtain


Carol: Exclamation point on the end of that. So I know your kind of earlier on in this project, are you starting to see some like what's the data telling you about it?


Susan: Yeah, definitely. We see a broader array of employment goals that were helping people to achieve definitely higher wages, obviously with people that are getting those credentials, those degrees. And I think that's really kind of you'd mentioned median earnings. We did a great job of getting people into jobs, but we do really need to focus on increasing the wages and the hours and thusly the median earnings of the people that we serve. And so that's really about helping them attain credentials and degrees that are going to move them into those higher wage occupations.


Carol: When you're really living into the spirit of the whole WIOA process, really, I mean, that speaks exactly to what Congress is trying to do back in 2014. I think that's great. So switching gears again a little bit when you and I visited, you know, a month or so ago, there are so many intriguing things that you talked about, but one of them that has really piqued my interest was your team's work with a drug courts, and I really hadn't heard of anything like that. So why don't you tell us and the listeners a little more about that?


Susan: Yeah, this is another great program in partnership that we have achieved. Again, this is part of Governor DeWine's vision and was part of his budget in the last biennium. That kind of established this partnership with Recovery Ohio, our Department of Mental Health and Addiction Services. The Supreme Court of Ohio is a big player with this because they manage all these specialty dockets and our Office of Workforce Transformation. And so we had a successful model that had been developed in our Butler County, where we had a dedicated counselor that worked as a member of that drug court team to assist that person in their recovery. And when that person was ready to get started with employment, they would engage our counselor and they would work to help them figure out what kind of job and help them get that job. And then eventually we added an internal job developer that really helped again with that rapid engagement. You know, we're right there as part of the team. We're engaging them rapidly when it's time and we're quickly getting them into employment and that helps support the individual's recovery. This was a real successful model, and one of our governors important initiatives is to really focus on recovery and substance use disorders. And so this was just a great fit for us to expand.

So in 2018, we expanded. So this is called jobs for recovery, And so we expanded into 7 counties. And right now we're expanding further into an additional 8 counties. This has been just a great partnership. I think when we talk to the courts, they have lots of people on these teams to support people in their recovery and avoiding the criminal justice system, and this really helps them have a dedicated resource. This was like a gap that they had identified, and people need to get work. Work supports recovery, but they didn't have an expert on the team around employment, and that's what OOD really brings to the table. And so we use that rapid engagement model, we place them into employment. We also can do some of those extra services. Get them transportation that they need to job interviews or again, interview clothes or other things that they didn't have resources for in the past. So it really filled a gap. So this has been just a great program in Ohio and it's still in the kind of ramping up phase, and it's just been a really positive and highly successful model.


Carol: What a difference it makes when you have elected officials that are like putting investments into this area with employment and people with disabilities, it's pretty amazing. I mean, I kind of wonder then where do you guys think you would be if that hadn't happened, if you didn't have Governor DeWine that had some of these initiatives?


Susan: Yeah, you know, I think we really tried hard. We think of our participants as our customers, business partners, our employer partners, but also our state agency partners, our customers. And so we want to be a part of the solutions to help them reach their goals. So whether it's a drug court that needs to help people get into employment to support their recovery, whether it's a developmental disabilities agency that is trying to move people from segregated settings into community employment, we can be a part of that solution.


Carol: I love it. It's exciting. I like to follow you guys. I know I get regular updates through one of my colleagues, Kristine Johnson, who lives in Ohio and subscribes to newsletters and said she's always sending me things she's like. Read this This is like amazing the work that they're doing, so I'm going to switch again a little bit to the pandemic, of course. So the pandemic, I know it's been brutal on VR. And when you look at the numbers over the last two years, it's been really, really tough. However, your agency, again, you're engaged in jobs now. So what is that all about?


Susan: So this was another cousin back in September 2018, we did a cousin to improve our job and candidate sourcing model. We have now more than six hundred and 50 employer partners that we are actively working with. And what this is, is really kind of identifying high demand positions within our employer partners and we make a searchable list available. Then we establish a process for quickly getting a person into placement with that employer partner. So when I rewind years ago and I was a counselor, people would come and say, I just want a job now, and I would say, Well, that's not how it works. I don't have a bank of jobs. We have to do our process and we're going to do a good job so that we know it's a good fit and so on and so forth. And that's just malarkey. You know, if somebody comes in and says, I need a job now, we need to say we're going to get you a job now, and we have six hundred and fifty business partners that we work with. There's not a reason that we can't do that. And so that's really what this was about is how do we as quickly as possible do that match? Still, because that's what our business partners, our employer partners appreciate about working with us is we're going to do that screening, but renew it quickly so that the needs of the business partner are met and the needs of our participant. So initially, that was called job. Now we pivoted a little bit with this when the pandemic hit and we moved to an urgent hiring list because soon after we went home back in March of 2020…


Carol: eons ago!


Susan: yes, yes, we learned quickly from our employer partners that they had just some urgent needs to fill spot. And so we like to say don't ever waste a crisis. So we really moved in a different direction with that. And so we started publishing and doing active candidates sourcing for these urgent hiring needs of our employer partners. And so we moved into doing virtual hiring events to directly source these candidates. So at these hiring events, we're actually doing interviews with the employers for open positions that they are actively recruiting for. And this has been a great model. We've had some that have been for us. We've done them for specific employers statewide. We've done some around certain industries, we've done some targeted for specific groups. We tried doing one for transition students last year, for example. We're about to do our second work from home virtual hiring events that are just employers who have work from home opportunities that are people really can benefit from. So that has been kind of an evolution over the last 5 years or so of this candidate sourcing model that we've had, and we've been tremendously successful with that. In fact, while our numbers are down a little bit with applications, eligibility, new plans, our placements and closures are comparable to or better than pre-pandemic or last year's numbers, with placement really pleased with the work that our staff have been doing to do these virtual hiring events. And continue to place people in light of the pandemic.


Carol: I was going to ask that I'm glad you said that about your numbers because I was curious. I know a number of you, probably in just a cohort with a few that are experiencing good placement numbers. I know a lot of folks it's kind of taint the last two years, so that sounds pretty creative with the virtual hiring and the remote work from home. A lot of people are interested in that, and it really can take away some of those barriers that some of our customers face with transportation and all that. Hoo ha. Right. When you can work from home, which is incredible, I love it. So when you look back and you analyze the impact of all this work you've done. How have the numbers looked for your customers as you reflect back kind of on the value overall of all of these projects that you've worked on?


Susan: Well, number one, getting off of order of selection has been a game changer for us. That's never a good situation to have to sit across the desk for somebody and say, we can't help you. We know we could, but we can't. And so that has been just a huge deal for us. But as I mentioned earlier, we've been averaging 23 1/2 days to eligibility for the previous 4 fiscal years. And we've really seen with all of these things our time from eligibility to plan trending down over the last fou4 years or so ago, we've been from about 60 days to about 49 days. And so that also has been just a tremendous benefit, customer service wise to the people that we serve. I just mentioned our placement and closure numbers. Those have been really great. And so kind of our next steps within the organization is really just to focus on the quality of the employment outcomes that we're achieving the credentials, getting more people into credential programs so that we can help them kind of move out of poverty and increase those median earnings for the program.


Carol: So for our listeners out there, what would you recommend, Susan, as some, you know, tips from yourself as far as if somebody is looking and thinking, we need to do our processes differently, like where do you even start? You guys have been doing this now for over a dozen years, and you have a lot of good learning experiences under your belt. What advice would you give to others?


Susan: I think I mentioned a few minutes ago, but don't waste a crisis. A crisis can really spur innovation. I know, for example, we have been trying to get remote counseling going for years, and it just never took off. But now remote counseling has been going great. Our participants love it. That wouldn't have happened without this pandemic. And so that's just one example. But Lean really is a great tool. It can't make the decisions for you, but it can give you the tools for looking at data and doing the process improvement to help make the right decisions for our customers. Another thing I would mention is just really listening to the voice of the customer, and that's an important component or concept within lean processes. And really looking at things through the lens of that customer experience really helps build a system around the needs and the preferences of the people that we serve, which is critical to our success. And then I think really thinking of ourselves as a workforce agency, we're not necessarily as much of a social service agency and really kind of looking at these processes and how they can raise those bar of expectations for the people that we serve. It's a great tool.


Carol: So I'm sure that there's going to be folks that want to reach out to you for a little advice or some assistance. How would folks best contact you?


Susan: Yeah. So I would welcome a conversation with anyone who wants to talk more about this so you can reach me by email. Probably the best way, Susan, S U S A N dot Pugh at OOD.Ohio.Gov is my email. Yes, please reach out. You can also see my contact information on our website as well, if you would like to reach out.


Carol: I sure appreciate your time. This has been really exciting and I'm sure you're going to get some contacts. I really thank you for your time today and I really wish you much success and everything you're doing, and I definitely will circle back with you down the road as you keep creating new and groovy things that you're doing in Ohio.


Susan: Thanks much. Thank you. I appreciate the time to share the good news about what our staff is doing out there. It's been a great ride.


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