System Change in Iowa: Vocational Rehabilitation Partnership

1. System Change in Iowa: Vocational Rehabilitation Partnership Dr. Robert Stensrud, Drake University robert.stensrud@drake.edu Micheleen Maher, Division of Vocational Rehabilitation Services micheleen.maher@iowa.gov Sheila Stoeckel, Navigator – Mason City sheila.stoeckel@iwd.state.ia.us

2. What We Learned From Previous Grants • Systems Don’t Trust Other Systems • It’s All About Risk • Trust Reduces Risk But Takes Work • Trust Takes Explicit Agreements • Systems Change Takes Networking

3. Systems Don’t Trust Other Systems • Local Agencies Don’t Trust Each Other • Local Agencies Don’t Trust State Agencies • State Agencies Don’t Trust Local Agencies • Nobody Trusts Federal Agencies • Federal Agencies Don’t Trust Anybody

4. It’s All About Risk • Clients Want to Reduce Their Risk When Seeking Services • Employers Want to Reduce Their Risk When Hiring People • Providers Want to Reduce Their Risk When Referring People • Communities Want to Reduce Their Risk When Supporting Agencies and Individuals

5. Trust Reduces Risk But Takes Work • A Shared Purpose is Critical • Open Give-and-Take Communication Builds Trust • There Always Will Be Crises • Crises Can Increase or Decrease One’s Sense of Risk • States Are in the Business of Reducing Risk and Building Trust • Somebody Has to Take a Risk and Lead the Trust Building

6. Trust Takes Explicit Agreements • Local Partners Have to Be Clear on Who is Responsible for What • Problem-Centered Agreements Prevent Turf Battles • Memoranda of Agreement Are Worth the Effort • It’s the Journey, Not the Destination • Agreements Are Like Onions, Today’s Solutions Uncover Tomorrow’s Problems

7. Systems Change Takes Networking • A State Assistance Team Networked with Local Agencies • Navigators Were Key to Building Local Collaboration • Navigators Couldn’t Get Stuck Providing Direct Service • We All Have to Show the Community That We and Our Clients Are Members • We All Have to Show That We and Our Clients Are Solutions

8. Navigators Were Key to Networking • Navigators Were Key to Bridging Collaboration Among Agencies • Navigators Were Key to Helping Clients Move Between Agencies • Navigators Were Key to Mapping Community Resources • Navigators Were Key Guides for All the People Trying to Make Sense of the System

9. Barriers/Challenges Statewide • Uncertainty resulting from placement of Rehab Act into Workforce Investment Act • Uncertainty re: infrastructure costs to support One-Stops and impact on VR clients

10. Barriers/Challenges Local • Overcoming past histories and agendas • Obtaining staff buy-in to collaborative efforts developed by Managers • Gaining clarity in goals and roles for partners • Setting measurable outcomes and monitoring Navigators’ work with VR clients • Constant partner turnover and need to continually update and educate all staff • Setting a referral method between agencies

11. Strategies/Actions Statewide • Encouragement from State Administrators for collaboration around grant-writing to bring resources to the state for individuals with disabilities • Input from VR and other partners in hiring Navigators

12. Strategies/Actions Local • All partners work to minimize duplication • Educate Navigator about VR and identify gaps that require Navigator assistance • Develop referral, follow-up and monitoring mechanisms • Maintain close contact and communication • Establish everyone’s roles at the outset • Cross Training of partners • Group meetings held to build relationships

13. Overcome Concerns Statewide • Funding from WIG and Systems Change grants allowed experimentation and produced results • Cooperating in projects allowed people to work together at the state and local levels and form relationships • When there are touchy issues, relationships lead to problem solving

14. Overcome Concerns Local • Identify the benefits of working together that outweigh the costs • Plan ahead to schedule meetings • Meet regularly and follow through with commitments • Build and maintain trust

15. Maintain Relationships Statewide • Collaboration between Governance Group and Support Team • Forming a collective response to issues from state-level administrators and sharing information statewide

16. Maintain Relationships Local • Developing an Employment Network with all partners who are trying to assist individuals with disabilities in their job search efforts • On-going communication and willingness to listen to the other point of view

17. Changes Statewide • Identification and solution to barriers that prevent collaboration around client-service issues • More familiarity with of partner agency staff, leading to increased trust

18. Changes Local • Strengthened partnership between agencies and better coordination of services • More awareness by staff of other partners’ activities • Increased cynicism in a couple areas due to negative experiences in either defining the role of the Navigator or identifying results

19. Sustain Changes Statewide • Continued meetings of Governance Group and Support Team • Permanent funding for Navigators

20. Sustain Changes Local • Continue the activities that have begun • Continually evaluate and try to improve • Obtain buy-in and repetition, as with any project

21. Advice Statewide • Get people with good communication skills who are willing to listen to varied input • Respond in a collaborative way that is focused on client outcomes

22. Advice Local • Take time to develop the Navigator as a resource from the beginning • Make sure outcomes are reported and convey that information to VR staff so they can help improve the process • When things don’t work out, find another way to approach a situation • Keep focused on how to improve the customer experience for the individual with a disability • Make sure you have buy-in and not just head nodding