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Crucial determination will arrive up to 3 months faster for Ohioans seeking vocational rehab services

IN BRIEF: When a person needs vocational rehabilitation services, their application is used to determine eligibility and priority. The process is getting a lot faster -- which means that people with disabilities will be able to speed up their return to work.

SMART STANDARDIZATION: Staff will be using one straightforward model to process an application for services -- compared to before when teams serving all 88 counties were mixing, matching, and modifying 5 different models to create their own approaches.

FASTER PROCESSING: The streamlined process will cut 92 days from the average start-to-finish process time. That’s a 71% reduction.

ALL ABOUT THE CUSTOMER: People who are applying for services will find out 92 days faster whether they’re eligible -- while also learning their priority status. For many, this will mean that they can get back to work or apply for a job some three months faster.

When a person needs vocational rehabilitation services, the competence and compassion of staff make a big difference. Both factors have long been hallmarks of the Ohio Rehabilitation Services Commission, and now a third crucial factor is gaining strength: quick response. Thanks to a week-long improvement blitz known as a Kaizen event, staff are turning the old way of doing things into a much faster, better, client-friendly process.

There are plenty of numbers that speak to major gains achieved by the team: from 5+ models to 1, from 129 days to 37, and 1 on 1. But first, there's some crucial background that makes these numbers meaningful. It has to do with the concept of "order of selection."

When a state vocational rehabilitation program, such as RSC, doesn't have adequate resources to serve all eligible individuals, the Code of Federal Regulations requires use of an "order of selection" (OOS). This sets out the parameters for selecting the order in which people are served, so that people with the most significant disabilities are served first. There are three priority categories for in Ohio OOS: 1. People with the most significant disabilities. 2. People with significant disabilities. 3. Individuals who meet the definition of eligible per the Administrative Code, but whose impairment does not rise to the level of a significant disability.

When a person is referred to RSC for vocational rehabilitation, or when they initiate contact themselves, they complete an application for services. RSC staff use that as a starting point, gathering additional information from other sources to determine eligibility and OOS category. People with the most significant disabilities are selected first to receive services.

These sticky notes are anything but random. They convey the outlines of three process maps, each assembled by a subgroup as part of the "clean sheet redesign" segment of the Kaizen event. This is when team members combine their understanding of the current situation with their ideas for improvement -- to come up with a potential redesign of the process.

The process sounds straightforward. But with so many people seeking services (Ohio has 800,000 working-age people with a disability) and so many staff people serving them across a big state (88 counties), the process had gotten complex.

Officially, there were five different eligibility and OOS models, with each office or team county choosing an approach based on its needs and staffing levels. Many teams used more than one model, or a combination of models, or their own modified versions. It was variation in the extreme, leading to numerous different models across the state. In terms of process time, it was taking 129 days on average for a client to go from referral to application to eligibility determination to the final step of order of selection. 

At the Kaizen event, team members reached consensus on one standard eligibility model to be used in all counties. They developed a streamlined process that, when fully developed, is expected to take just 37 days on average for those who go through the full process from referral to order of selection. That's 92 days faster than before. It means 92 fewer days that people with disabilities will be waiting to find out if they're eligible to receive services -- and if they are, to learn their priority status. For many, it means 92 fewer days to getting a job or getting back to work.

There have been previous efforts to increase efficiency, but this was the first time so many staff members (18) spent so much focused time (five days in a row) and had so much input (they reviewed suggestions gathered through an employee survey, integrating two-thirds of those ideas into the redesign).

The team had strong support from senior leadership (including Director Kevin Miller, Chief of Staff Brenda Cronin, BVR Deputy Director Susan Pugh, BSVI Deputy Director Dan Connors, and others). And facilitators from the LeanOhio Program Office helped the team uncover all the issues and opportunities. The week concluded with a full plan in place and some of the changes already under way.

There were character-building moments, to be sure. The first big challenge arrived late Monday, when the team began creating a detailed map of the current process. Processes, actually. It was painstaking at times as team members explained one step and then another and then another. Once completed, however, the map revealed too many eligibility models, too many steps, too many delay points, too many hand-offs. They all added up to too much wait time for people seeking vocational rehab services.

The team went on to develop high-impact improvements that make the process one seamless, continuous flow while keeping the focus on the customer. 

One big change, noted above, is that all staff serving in all 88 counties will be using the same model for processing an application for services. At the start of the process, applicants will be linked with one vocational rehabilitation staff person who handles the case all the way from application to determination of eligibility and order of selection. So clients will have the convenience of one contact, while counselors will have their own caseloads.

All clients will get the same standard information, which will be provided via scripts and straightforward information packets. And future plans include medical professionals being able to upload medical records directly to RSC's IT system.

Meanwhile, staff are strengthening their working relationship with the Division of Disability Determination, in order to get better at sharing medical resources for scheduling appointments and reviewing medical documentation. And they plan to use the SSA tape match as a fast way to identify clients who are already SSA-eligible -- this will speed up the process of getting medical records and thus process the case.

This report was published January 13, 2012. Projected and actual results may have changed since then. For the latest info, contact LeanOhio or RSC.
    RSC contacts:
    Mark Fay:
    Curt Morman:

Ohio Rehabilitation
Services Commission

Vocational Rehabilitation

Eligibility and Order of Selection
Determination Process: Team SUPERMODEL

December 2011

Team members
Team members: (left to right) Bill Lindsey, Eligibility Counselor, Lake County; Lois Mescher, Eligibility Counselor, Dayton; Devin Aumend, Caseload Assistant, Columbus; Tom Melfo, DDD Manager; Mark Fay, Area Manager; Christy Ash, Eligibility Counselor, Youngstown; Kerri Stickney, Caseload Assistant, Centennial; Sandy Burtscher, Supervisor, Sandusky; Karen Johnson, Eligibility Counselor, Columbus; Brian Eskridge, Caseload Assistant, Youngstown; Marianne Porter, VRP3 Liaison Counselor; Aneesa Locke, Rehabilitation Program Specialist, VRP3; Maria DiGennaro, Account Examiner, Columbus; Curt Morman, Area Manager; Pat Carroll, Account Examiner, Mansfield; Bocar Dieng, Consumer, RSC Staff.

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