Assessment and Referral : VR Reach-Up Program

Program/Practice Name: VR Reach-Up Program

Agency Name: Vermont Division of Vocational Rehabilitation

Contact Information:

Karen Blake-Orne
VR Reach-Up
Vocational Rehabilitation
63 Professional Drive
Morrisville, VT 05661-9724
(802) 888-1312
Karen.Blake-Orne@ahs.state.vt.us

Type of Program/Practice: VR Reach-Up is a special program that provides vocational counseling, case management, support services, and job search/placement assistance to all TANF participants in Vermont who possess a significant disability-related barrier to employment.

Program/Practice Description: Since 2001, Vocational Rehabilitation (VR) Vermont has worked with the Department for Children and Families (DCF) to help Temporary Assistance for Needy Families (TANF)1 recipients who have been identified as having a disability that is a barrier to employment. These recipients are referred by DCF to VR for services. They are provided with a specialized VR counselor who also serves as the TANF Reach-Up case manager. This means a single counselor provides all services, thus blending the resources of both VR and DCF to provide vocational services and case management.

VR Reach-Up clients are parents who are experiencing a disability that affects their ability to obtain or keep a job. Disabilities, often trauma based, include depression, posttraumatic stress disorder, anxiety disorders, substance abuse, bipolar disorder, and other personality disorders. The current program is the result of multiple years of learning about ways to assist TANF recipients stabilize their lives and obtain meaningful employment.

Innovations and Results: There have been two initiatives in the last two years that have significantly altered the way the VR Reach-Up program is administered. The Teaming initiative was introduced by the DCF Reach-Up Director as a way to provide services to families in a way that appeared seamless for customers and made the best use of an integrate team comprised of five partners including VR. The Creative Workforce Solutions (CWS) initiative was introduced by the VR Director as a vehicle to provide coordinated and collaborative employer outreach across the agency which builds on the Dual Customer approach. The Dual Customers are those seeking employment and the potential employer. In order to assist people who are faced with significant challenges in obtaining employment, both employers and job seekers need to be provided support. The VR Reach-Up program is now more integrated into the overall DCF Reach-Up team at local and statewide levels. The services to DCF customers through the VR Reach-Up grant have increased as a result of Teaming in combination with CWS. The model for progressive employment supported through the CWS initiative is also a good match for the VR Reach-Up program as it allows participants to engage in short, time-limited activities that relate to employment and gradually build and increase over a short period of time to result in competitive employment. Trial work experiences that are time-limited and well organized have resulted in employers who previously stated they had no openings offering employment to a person who has been made visible to them through a work experience.

Individual-level innovations. VR Reach-Up focuses on three concepts that underlie the supported employment model: treatment addressing the identified disability, individualized support, and tailored employment experiences. VR has a wealth of resources that can be provided, including a job developer, job coach, home visits, and various assistive technologies. This results in stability and increased likelihood that VR Reach-Up customers maintain stable employment.

Systems-level innovation. VR Reach-Up uses cross-agency integration to reduce boundaries and facilitate partnering and relationship building with DCF Reach-Up staff. This includes cross-agency training and full participation in the Reach-Up Teaming Initiative as well as the Creative Workforce Solutions initiative which contribute to improved communication and collaboration around staff and customers.

New model. VR Reach-Up is in a developmental phase as the program adjusts to the many changes brought by the Teaming and CWS initiatives. Staff no longer have capped caseloads and exist in their own silo connected only by the referrals they receive. VR Reach-Up Counselors are now expected to participate in multiple levels of the DCF Reach-Up process based on local teaming plans facilitated by the DCF local leadership and a statewide partnership. Depending on the expertise of the counselors, they may offer additional assessments and consultation to other team members who are also serving customers with disabilities. This assists the teams in serving customers with disabilities more adequately as the number who potentially qualify for VR services exceed the VR capacity that exists for the program. Designated employment staff still work directly with VR Reach-Up Counselors customers to facilitate work experiences and training, but are now part of a CWS Employment Team which provides them with additional support in the employment realm by increasing business contacts and relationships that benefit all staff and programs.

Operations: Reach-Up Teams follow a structure of Orientation, Assessment, Assignment, and services through sub-teams, one of which is the VR Team. This VR Team includes the VR Reach-Up Counselor and often 1-2 additional DCF Reach-Up Case Managers. This structure allows customers with disabilities to be flagged early on in the initial assessment process and potentially assigned directly to the VR Team for more assessment and service. Other customers who are initially assigned to the Resource or Employment Teams for service may also be referred to the VR Team when a disability issue comes to the surface. This is done by bringing the case back to the Assignment meeting/Team with medical evidence or anecdotal evidence of the need for assessment or service by the VR Team. When possible, meetings are held to transition the customer from the referring team to the staff on the VR Team. The VR Reach-Up Counselor may take the case based on the extent of the disabling condition, their caseload size, or may not take the case but will be available to the DCF Reach-Up Case Managers for consultation and support. Additionally when a customer transitions from one of the case managers on the VR Team to the VR Reach-Up Counselor, a "hand-off meeting" is held whenever possible with the VR Counselor, the customer, and the Case Manager.

Funding: The DCF Economic Services Division provides $1.7 million per year to VR to provide vocational rehabilitation services to individuals on TANF who have a disability. VR contributes additional funding to support disability-related services. Additional funds from Economic Services Division  to VR for employment services and social security disability application assistance bring this grant to a total of $4 million per year.

Staffing: VR Reach-Up has 10.5 full-time employees working in VR and additional employment training specialists. VR Reach-Up staff can provide mental health/substance abuse referrals plus vocational services. Because the VR Reach-Up counselor is the TANF case manager for their customers with disabilities, counselors have a complete understanding of both the Reach-Up program and VR in its entirety.

Additional Information: Progressive employment, as an approach to obtaining competitive employment through progressive steps, has been very successful for those contemplating employment. The participants who do not believe they can obtain employment may do well with exploring interests, going on informational interviews, attending a company tour, engaging in a one-day job shadow, and then taking part in a part-time placement with an employer. VR Reach-Up offers intensive support to employers and Reach-Up participants during trial work experience. As part of the CWS collaborative, VR Reach-Up employment staff assures employers that they are under no obligation as a result of a work placement, and the employment staff engages in regular monitoring with the employer to ensure a positive work experience for both the VR Reach-Up customer and the employer. The employment staff offer support to employers in cases when participants do not follow through in order to maintain the relationship with the employer for a future placement. Participants are encouraged to follow through with their placements by receiving a small monetary training off-set that defrays the cost of being at work. This incentive has prompted individuals to follow through with their placements and the employer has then offered them competitive employment.

1 Reach-Up is the TANF program in Vermont.

Tips to Implementation: VR Reach-Up follows a supported employment model which has its origins in working with developmentally disabled populations. The VR agency is a customer-focused organization using data-driven decision-making. VR Reach-Up employment staff operate with the freedom and flexibility to provide a wide range of resources to their Reach-Up clients. Modification of the work requirement (for TANF clients) is a central concept to the VR approach. Instead of the perception that TANF participants are being deferred (stopping the clock and thus relieving individual responsibility for complying with the TANF timeline for employment), VR Reach-Up describes its process as a modification and/or gradual increase in work participation. The concept of modification has implications for participants (they are still responsible) and for VR Reach-Up staff (they are always looking for a person's highest level of ability versus their disability).

From a more macro standpoint, partnering in a collaborative way with DCF Economic Services Division and other partners both at the State and local levels is valuable and requires effort. The complexity of the Teaming initiative and the CWS initiative have required all of the partners to work toward creation of a shared mission where the greater good of the partnership takes precedence over individual’s holding tightly to their individual program stance. The resulting leadership structure is that of a matrix wherein there exist direct supervisors, local supervisors, and programmatic supervisors. Negotiating these roles and boundaries takes time and development of trust. Shared projects have helped this trust grow to support the matrix model of leadership. While one of the most complex types of management, matrix leadership has the potential to offer the richest and most productive collaboration between multiple partners. Leadership training is essential to ensure all partners can increase their ability to give and receive feedback as well as create agreements that support healthy boundaries for partners and their staff. 

Keys to Success: In addition, the success of VR Reach-Up can be attributed to several other factors. VR Reach-Up staff members have master's level training and some have prior experience with TANF, having worked for the Economic Services Division. They are trained to be flexible and customer service oriented by providing individualized services to clients. The wealth of employment resources and access to mental health/substance abuse treatment also contribute to the effectiveness of their work with TANF clients. VR Reach-Up's Management staffs' close relationship with DCF-ESD Management staff has also been a key to an ongoing, healthy partnership that honors the important work we are doing with an underserved population.

Successes: Successes include integrating VR Reach-Up into the Teaming initiative and increasing collaboration of the employment staff dedicated to Reach-Up through the CWS initiative; consistently engaging a hard to serve population in mental health and substance abuse treatment with successful results; continuing to assist between 40 to 65 individuals in obtaining competitive employment per year even during the economic recession; and assisting 100-115 individuals per year to obtain SSI/SSDI benefits so they are served by the appropriate poverty program.

Challenges: Challenges include creating movement with passive clients who can have just enough engagement but no positive accomplishments; supporting individuals who often have deep trauma resulting in fear and depression; operating despite limited resources in a rural State where adequate housing and transportation is difficult to find; and maintaining hopefulness in staff even while they serve a high-needs population that is slow to move toward employment.

Other Lessons Learned: VR Reach-Up Counselors have developed expertise in documenting functional capacity that supports participants' applications for Supplemental Security Income and Social Security Disability Income benefits for eligible Reach-Up clients and their families. Increased assessment up front for more appropriate plan development has also been helpful in reducing long-term reliance on Reach Up.

The following tools are associated with VR Reach-Up Program.  Please send us an email at upitoolkit@icfi.com for more information about these tools.

Disability Screening Form for Referral to Division of Vocational Rehabilitation

This form is used in some districts to help case managers identify appropriate cross team referrals, i.e., referrals from the Resource Team to the VR Team.

Explaining Services Checklist

A document that offers explanation of the process and obtains a participant’s signature so that the VR Reach-Up Counselor can refer to that document when the participant is not complying with the program.

Reach-Up Spending Limits and Support Services Matrix