ATU647 – Vocational Rehabilitation Updates with Theresa Koleszar and Kristina Blankenship

Hi, this is Theresa Koleszar, Director of the Indiana Bureau of Rehabilitation Services.

Hi, and this is Kristina Blankenship, Director of Business and Community Engagement for the Vocational Rehabilitation Program here in Indiana. And this is your assistance technology update.

Hello and welcome to your Assistive Technology Update, a weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist individuals with disabilities and special needs. I’m your host, Josh Anderson with the INDATA Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. Welcome to episode 647 of Assistive Technology Update. It is scheduled to be released on October 20th, 2023.

On today’s show, we are super excited to have part one of our interview with Theresa Koleszar and Kristina Blankenship. They are on to tell us all about vocational rehabilitation here in Indiana. We also have a quick story about a partnership between AT&T and Gallaudet University to make accessible football helmets. And we are joined by Amy Berry from Bridging Apps with an app worth mentioning. As always folks, we want to thank you so much for listening. Now let’s go ahead and get on with the show.

Listeners, you can probably tell by this show, I do love assistive technology and talking about it. But something I really love to do on my weekends is watch football. I’m a huge Colts fan here from Indiana, huge fan of Notre Dame, but really just a huge fan of the sport and getting to watch it. As I was watching college football this last Saturday, I saw a commercial on there that I hadn’t seen before. Now apparently, this commercial’s been out for a minute, so I’m a little bit behind the times, but I must admit, trying to watch football and wrangle with kids at the same time, sometimes I do miss things, especially the commercials. But on the commercial it showed Gallaudet University, which I am very familiar with just because I have known folks that went there, done accommodations for folks heading there, and just have known about the university for quite a while just because of the kind of work I’m in.

So Gallaudet University, for those who do not know, pretty much uses ASL to teach most of their classes and is attended mostly by folks who are deaf or hard of hearing. So the commercial itself was talking about their football teams. In the commercial it shows the plays are sent in via ASL or other kind of hand signals. But as the defense changes the play, the coach is trying to get the attention of the quarterback but is unable to get his attention. The quarterback, of course, is focused on snapping the ball, on studying the defense and all the other things that you do at that position. So the commercial essentially is showing this kind of problem. How do I get that quarterback’s attention? And the solution, I guess, as you would call it, is a 5G connected football helmet made by AT&T.

So very, very cool that this is something thought of and that they’re rolling it out at Gallaudet. So October 5th was the first time this was actually used in a game. Essentially, the way that it works is the helmet has a heads-up display. The head coach then has a tablet computer with the whole team’s playbook installed on it, and he sends those plays to the quarterback over 5G, and it pops up in this little heads-up display next to their right eye. Quarterback can then relay the play to his team just as anyone else would. This results in some clear communication, also speeds up the process. If you really think, if the coach has to relay everything to the quarterback via ASL hand signals, then the quarterback has to relay it to the whole team. It can really slow down the process, and you only got so many seconds to get the play in, get up to the line of scrimmage, get in the right position, everyone’s set and snap the ball.

So this really can make that a whole lot easier. But then also, if you need audible, if something happens, if that defense changes a little bit or a new play is needed, boom, that can be sent straight to that heads-up display as well. So very seamless. Very cool. I love that they’re rolling this out at Gallaudet. But then also, if you really think this could help deaf or hard of hearing individuals who want to be a quarterback or maybe a captain of the defensive players, or maybe just play on the team period. Something where not everyone on the team would have to communicate via ASL, there would still be a way for them to get those plays. There would still be a way for them to be able to participate in the same way that their hearing counterparts do all the time.

I could also see how this could take away some home field advantage if you start using it for just everyone because suddenly you don’t have to worry about communicating those plays, and that crowd noise really would not affect folks in the same way. But I think it’s very cool that AT&T was able to make this 5G helmet in order to get the information straight from the coach to the quarterback so that they can call the plays and work with the rest of the team. And again, while rolling this out at Gallaudet is very cool because that’s going to help that school especially, but if we really think, this also opens the doors for other individuals who perhaps use ASL or are otherwise hard of hearing, that they can participate on perhaps their own school, a team, be that high school, college, or anywhere else because this technology is out there and is available.

I’m sure we’ll probably see more stories about this, but I was just very excited. It excites me more than sitting there watching football, which of course, as I said, is just the way I unwind and really get to enjoy doing on the weekend. And then suddenly a commercial comes up with adaptive technology and football mixed together. Really made my weekend. For those folks who haven’t got to see that commercial or who perhaps have not seen this new technology, I definitely wanted to share it with you. So I will put a link over to Gallaudet’s website where they talk about this helmet. There’s a bunch of other links on there where you can easily go and dig a little bit deeper on it. But very cool stuff, and a very cool mix of two of my favorite things, assistive technology and American football. Next up on the show, please join me in welcoming back Amy Berry from Bridging Apps with an app worth mentioning.

This is Amy Berry with Bridging Apps, and this is an app worth mentioning. This week’s featured app is Bookshare Reader. Bookshare Reader is a simple app for accessing books from the www.bookshare.org website and service. Bookshare is a library for people with qualifying print disabilities that make it difficult and/or impossible to read a printed book. In order to join, you must either pay for an annual subscription or you might qualify for one of the free membership plans. For more information and to check eligibility, visit the bookshare.org website.

At this time, the app only supports text only books, meaning the new human narrated audiobook are not supported. While the Bookshare app is very simple, it gets the job done and may be perfect for those who want a very simple interface to consume their books. Best of all, as mentioned, it’s completely free. So the only thing you need to pay for is the subscription to the service. The Bookshare app is available for iOS and Android devices. For more information on this app and others like it, visit bridgingapps.org.

Listeners, I’m sure over the years that you’ve heard me mention Vocational Rehabilitations many times on this show. Our clinical team here has enjoyed a great relationship with this amazing service, and I really wanted to just have some of the folks from VR on the show this week to talk about all the great programs that they do. New things that are going on, and just other things they have available to help individuals with disabilities find and maintain gainful employment. Since this is National Disability Employment Awareness Month, I cannot think of a better time to have them on the show to again just learn about some of the new things they’re doing and just what Vocational Rehabilitation does. So please join me in welcoming Theresa Koleszar and Kristina Blankenship to Assistive Technology Update. Kristina Theresa, welcome.

Thank you.

Thank you.

I am really excited to really dig in and really learn a little bit myself about the new things that are going on and let our listeners learn a little bit about VR and all the great things that you all do. But before we do that, could you tell our listeners a little bit about yourselves?

Sure, and thanks Josh for having us. It’s been a minute since I’ve done a podcast, so this is fun.

Awesome.

Well, as I said, my name is Theresa, and I have been with the Bureau of Rehab Services here for a little over 19 years now. I’ve been the director for, gosh, almost eight years, and I love it. I always say I know VR so well that I just can’t imagine doing anything else.

I know exactly how that feels. Maybe not with VR, but I do know how that definitely feels with your job. Kristina, what about you?

Hi, thanks again. Also, reiterating what Theresa said, thanks for inviting us on this podcast. I’ve been with the State for 12 years, and eight of them have been with the Bureau of Rehabilitation Services in the role of Business and Community Engagement. I consistently am learning something new every single day. I love my job. I feel like the job found me.

And in fact, listeners, we were talking just before about loving our jobs and how it just doesn’t feel like you’re working sometimes because it’s always something new, always something fun, and always just another thing coming up that we get to do. Well, I guess, let’s start with the big picture. What is vocational rehabilitation or VR?

Well, I’m glad you asked Josh because some people may not be familiar with VR. So just for a really quick background, vocational rehabilitation or usually called VR or voc rehab, is a federally and state funded program. We provide a very wide array of services that are designed to support people with all types of disabilities in achieving employment. And when we talk about employment, we’re really talking about competitive integrated employment. So the same kind of employment opportunities that are available to anyone. We serve people with all types of disabilities. Sometimes there’s a perception that maybe we only serve these types of folks, but not those types of folks, and that’s not the case.

We get to work with folks who may have mental health conditions, intellectual or developmental disabilities, sensory impairments that might involve hearing or vision loss or both, wide array of physical impairments around mobility or neurological conditions. The list goes on. And then the wide range of services really is about as big as you can imagine, and then some. It can include helping people with career exploration. So people who are not sure what they want to do or what might be available in their communities. Training, and that could be formal post-secondary training or training on how to use some kind of equipment or adaptive aid. Certainly help with employment, whether that is finding a job or learning the job, retaining the job. Also support with transportation, very, very important in terms of getting to work. Understanding the impact of work and earnings on public assistance that folks might have, Social Security, Medicaid, those kinds of things, assistive technology, something you’re very familiar with, and also, we can help folks with self-employment opportunities.

You all do some very amazing things. And I’ve got to admit, I think there was even one or two in there that I didn’t know about, and I’ve been doing this on the AT side for about 10 years, and the job coach before that, but I think there were some things in there I didn’t even know. But I know one of the other reasons we really had you on is because there’s some new things going on. So what’s new with VR?

Yeah, there’s always something new in VR. I think what I want to focus on today, we’re really excited about this and it really sets the stage for where we’re going. So I’d like to just talk broadly about some of our targeted goals and the priorities that we’ve outlined for the next couple of years. We’ve been working on our state plan every two years. We do that. That includes, again, those goals, those priorities, based on what we see our needs that are right in front of us. So I’d love to share those, and then some specific strategies that we hope are going to help us to work toward those goals. The goals really come down to two pretty big areas, engagement and outcomes. So more specifically, improving our customer engagement and their participation in VR, and the second goal, around increasing our outcomes. So both the number of people getting jobs and then also the quality of those employment outcomes that people are getting.

Awesome. So let’s start, because I know there’s a lot of times, especially if I talk to younger folks with disabilities, they don’t really know what VR is. They may not have heard of it, may not be aware of it or things like that. So can you tell us more about your strategies around engagement?

Absolutely, yeah. Well, we know that people leave the VR program for a lot of different reasons. The type of exit of course, we want to see more of, are people exiting because they achieved their goaL. They’re working and they’re independent and they no longer need our support. But of course, we also have people who leave for other reasons after they receive services, but maybe don’t quite get to that employment goal. For those folks, the biggest reasons we see them exiting are that they either just don’t want services anymore, which could mean that they are not maybe finding them as valuable as we would hope, or we just can’t reach them after we make multiple attempts to try re-engage them. So there’s probably a lot of different reasons that occurs. Life happens to folks, but also sometimes it can be hard for all of us to stay motivated, or as I said, people might just not be finding the value in the services. And that is something we can try to impact.

Something we do see a lot on our… I shouldn’t say a lot, but when we do tend to get more of a negative response on our customer satisfaction surveys, a lot of times that centers around, “Gosh, it just took too long. It just took too long to get the services that we needed.” So how are we going to address this? Well, over the last several months we’ve been working with our team to facilitate more of a rapid eligibility determination process. So it shouldn’t take people a long time to find out if they’re even eligible for VR, right? By federal law, we have 60 days to make that determination, but really, that’s far too long to let people know if they’re eligible.

We’ve had some early success with this. We’ve done some training to give our staff some tips, some strategies, some permissions on ways that they could get to that eligibility decision a lot faster. We’ve already seen about a seven or eight percent decrease in the amounts or length of time between application and eligibility from ’22 to 2023. We’re currently averaging about 33 days to get from that first intake appointment to a determination of eligibility. So 33 days pretty good, but we think we can do better. We’d like to see at least another 10% or so drop and definitely get within a 30-day turnaround from application to eligibility as we go forward.

Nice.

We’re always evaluating opportunities to streamline and to modernize processes. Just because we’re a government service doesn’t mean we have to always look like one, right? So we’re always looking at ways to modernize.

We have an employment advisory group that brings providers to the table to share their feedback, their strategies. We honed in on a few different topics with them just last month actually, and really let them drive, “Where do you want this group to go? What do you want this group to really focus on this coming year?” They selected looking at opportunities to streamline and reduce administrative burden within that employment services arena. So we’re excited to see what we can learn there and hopefully get to the point where we’re implementing those recommendations and those ideas. We know employment specialists are super busy, and so if we can get to the point where they’re spending less time on administrative tasks and more time on people-centered tasks, that is the direction we want to go. And then just lastly on this, I’ll mention that we’ve tried to be very intentional about embedding conversations with our VR team at the field level into their regular regional meetings around the importance of the quality of the interactions they have with VR participants.

This really should start with that person’s very first interaction with VR and with a VR counselor. But of course it’s important throughout someone’s participation in the VR program. We’re aiming to improve engagement of those who come into VR, and then in addition, we’re also conducting some targeted outreach to students. We’ve seen some interesting shifting in that population in VR with the onset of pre-implement transition services a few years ago, and we just felt we needed to reconnect, reengage with schools and the student population and get more of those folks back into VR and pursuing employment. So we’re really trying to target an increase in students entering the VR program.

Nice. I think those are great strategies and they’re really attacking them on a lot of different levels I think, as well as far as getting people involved. Keeping them involved I know, can be the hard thing. Looking for a job for anybody is just a tough grueling process. So anything you can do to just keep them engaged and help them along that whole process is really a great thing. You also mentioned improving the employment outcomes. Can you share more details about what areas you’re working in in that?

Absolutely. We’re focusing on improving capacity. There are some challenges around capacity. We aren’t the only industry facing that, of course, we’re really seeing that threaded throughout a lot of different industries. I know we talked about that a little bit earlier, but it’s really important to have that capacity so we can be timely and services are of a high quality. It probably comes as a surprise to no one that finding and keeping staff has really risen to be, if not the top, then one of the top challenges over the last few years, and again, that includes our employment services providers.

We actually conducted a capacity survey with those providers over about a one-year period, so from late 2021 and then all throughout 2022. The results were really interesting. They indicated that over 75% of our providers, and we’ve got about 80 providers, we had a pretty good response rate to the survey. We didn’t get everyone to respond, but I think we had 50 to 60 who responded. So of those, about 75% indicated that they have one or two vacancies each quarter on their employment services team. That might not sound like a lot, but then when we looked at how large those teams were, more than two thirds of those providers had seven staff or less, and then half of those had three staff or less. So you’re seeing where I’m going with that?

Oh, yeah.

Potentially, right? Potentially mean a pretty high vacancy rate. To experience that quarter over quarter over quarter, that’s a whole other layer of challenge. So we absolutely recognize that we need to find ways to improve the capacity of our current providers while also seeing if we can tap into or create other pathways for participants to get the services that they need. We’ve already done a couple of things here, and certainly need to do more and have more on the horizon. Something we just recently implemented was introducing performance incentive payments for our employment service providers. We just did this in July, so very, very new. And really, these are extra payments that providers can obtain when their efforts ultimately result in that via participant achieving employment that meets certain benchmarks around the hourly wage, the number of weekly work hours, and then whether the employer offers healthcare benefits to them.

So yeah, we’re anxious to evaluate this. I was looking at some data yesterday, and we’ve got quite a few of these already authorized, I think around 40 or so just since we rolled this out in July. So it’s starting to pick up a little bit, and we’ll be keeping our eye on this to see if this indeed is helping to lead to more of those quality outcomes while also presenting another kind of funding mechanism to our providers that maybe they could use to somehow turn that into some help with recruitment and retention. We’re also working with a vendor recruiter. We work with a lot of different vendors. We tend to talk a lot about our employment service providers, and they’re a hugely important vendor for us. We do a lot of services through them, but we also work with a lot of other partners and a lot of other organizations for other services that we need, from training to medical services to assistive technology to tutoring. The list goes on.

We’ve worked with this vendor recruiter to hopefully help us target getting some new vendors into the system. She’s making some great headway, but again, there’s always more work in front of that. We’ve been particularly helpful in recruiting some medical providers to perform some evaluations. We really are seeing an increased need right now for audiologists and ENTs as we’re starting to serve more people. With ending our waiting lists, we are seeing more folks come back who are coming to VR for maybe some help with some kind of hearing aid or hearing device. And so we need to build back up our audiology vendors. That’s one area that we’re really focusing some energy around right now. Something else we recognize is that people probably coming into VR are not always utilizing their local Work 1 to the extent that they can.

We implemented some, we’re calling them navigators. We’re going to have them in 10 of the 12 Work 1 regions here. We’ve got seven or eight in place right now and a few that we’re working to fill. The hope is that they can turn that around. They can help VR participants who really could benefit from some of those workforce services to get past some of those access barriers and really be able to be mutually served across both programs.

And then finally, one other area I want to mention that we’re highlighting in our upcoming state plan, is to expand opportunities for VR participants to get work-based learning experiences as well as more enrollment in post-secondary training, especially training that’s going to lead to credentials. We see a lot of room for improvement in the number of VR clients who are enrolled in post-secondary credential bearing programs.

And again, we’re looking at lots of strategies around this, including taking a fresh look at how the VR financial support process for determining funding for training. Fairly recently, we made a little bit of a switch to our counselor assignments, and we now have about 20 VR counselors who we refer to as our post-secondary specialists. So they’re really honing in on working with populations enrolled in post-secondary training. And then, we’re doing a lot of training with our staff on thinking about VR more from that mindset of a career pathway and not just a job coming at the end of someone’s process.

Nice. And yeah, all those are great points. And even with turnover and not having enough staff, I know some ways that’s been a double-edged sword for some providers just because when people are [inaudible 00:25:21] for jobs, sometimes it’s a little easier to get folks with disabilities into those jobs. But if you don’t have enough folks to help those folks get into the jobs, then it’s just kind of a never ending cycle.

I’ve run into some providers at a conference about a week back and definitely heard some of those stories from quite a few of them, but all of them really liked where VR was going in trying to assist them and help them attract and get new folks.

Listeners, unfortunately, that is all the time that we have for today’s show. So make sure to join us next Friday as we continue our conversation with Kristina Blankenship and Theresa Koleszar, as they tell us about the new initiatives and the great things that they’re doing at Vocational Rehabilitation here in the beautiful state of Indiana.

And as we close out, our tribute to National Disability Employment Awareness Month, thank you again for listening, and we’ll see you next week. Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on Assistive Technology Update? If so, call our listener line at 317-721-7124. Send us an email at tech@eastersealscrossroads.org or shoot us a note on Twitter @INDATAproject.

Our captions and transcripts for the show are sponsored by the Indiana Telephone Relay Access Corporation or INTRAC. You can find out more about INTRAC @relayindiana.com. A special thanks to Nikol Prieto for scheduling our amazing guests and making a mess of my schedule. Today’s show was produced, edited, hosted, and fraught over by yours truly.

The opinions expressed by our guests are their own and may or may not reflect those of the INDATA Project, Easterseals Crossroads or supporting partners or this host. This was your Assistive Technology Update, and I’m Josh Anderson with the INDATA Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. We look forward to seeing you next time. Bye-bye.