Redesigning the state rehabilitation program in New York State - services for the disabled - Streamlining Service Delivery

American Rehabilitation, Summer, 1997 by Lawrence C. Gloeckler

Over the past several years, state vocational rehabilitation (VR) programs throughout the country have been involved in fundamental redesign of the management and delivery of VR services. Recently, the Council of State Administrators of Vocational Rehabilitation (CSAVR) and the Rehabilitation Services Administration (RSA) received the prestigious Hammer Award, given by Vice-President Gore in recognition of their leading the way in the reinvention of government programs. The Vice-President stated that CSAVR "can be proud of your role in the largest reform initiative the United States has seen in this century."

While the following pages detail redesign efforts in New York State, the most important aspect of these efforts, wherever they are undertaken, is the people who benefit from these improvements. Administrative efficiencies, streamlined procedures and "user friendly" approaches mean nothing if they do not provide a better service that leads to a better result for people. People with disabilities, and employers, are the customers of state rehabilitation programs. Any redesign effort must improve our ability to meet their needs. It's that simple. It's that direct.

The Vision

There is an old saying: you won't get to where you want to go if you don't know where it is. That is a gem of wisdom for all of us to keep in mind as we reengineer our services, whatever they may be. It may sound trite, but it is essential to have a clear vision for your improvement efforts. In New York, we have embraced the vision so eloquently stated in the Rehabilitation Act of 1992

People with disabilities will. . .

"(A) live independently;

(B) enjoy self-determination;

(C) make choices;

(D) pursue meaningful careers; and

(E) enjoy full inclusion and integration in the economic, political, social, cultural and educational mainstream of American society. . ."

We have organized within the New York State Education Department so that all services for people with disabilities, from preschool, through school age, to vocational rehabilitation and independent living services, are administered under the same umbrella, to create a lifelong approach to reach this vision.

Redesigning vocational rehabilitation services will only reach its true potential to the extent that we are successful in the redesign of the rest of the lifelong continuum. However, it is a truly important component and has the potential to be an important catalyst in many more people's lives.

The Context for Redesign in New York

In the late 1980's, New York State's VR program, then called the Office of Vocational Rehabilitation, was mired in controversy and viewed widely as having become a cumbersome bureaucracy that had lost its sense of focus and responsiveness to the people it served. In 1990, the State Education Department began a stem to stern redesign of the system, including an overall reorganization of the management of all services to people with disabilities in the department and a renaming of the program to the Office of Vocational and Educational Services for Individuals with Disabilities (VESID). Though lengthy, the new name is more aligned to a new philosophy of service. That year, a serious and long-term redesign of the state VR system began.

The Use of Quality Management Strategies

If there is any government service that can benefit from the use of quality management tools and improved business practices, it is the vocational rehabilitation system. The tools to identify process improvements, redesign systems and procedures, and install continuous improvement measures should become an integral part of the everyday "business" of administering and delivering VR services. No systematic redesign should be undertaken, nor will it result in true systemic change, unless it is supported by a solid strategic management plan and redesign tools.

With the help of IBM and the Xerox Corporation, the VESID management team was able to receive substantial training on the use of quality tools and to set up a Quality Support Team structure to assist regional offices in institutionalizing continuous improvement practices. Without this initial attention to training and long-term support, our redesign efforts would not have been as successful.

Phases of Redesign

The redesign of the state agency's VR system was conducted in three phrases. The first phase focused on improving access to the program, one of the most problematic aspects of the system according to consumers and referring agencies. The intent was to refocus the consumer/counselor relationship and to build much stronger collaboration with other agencies. The goals were simple:

* Provide services to individuals as quickly as possible.

* Simplify the steps in the process of entering the vocational rehabilitation system.

* Provide the highest quality services possible.

Did it work? Chart A shows the dramatic increase in referrals, applicants, and people determined eligible for services.

[Chart A ILLUSTRATION OMITTED]

Applications were made simpler. The consumer became a primary source of information about his or her own needs and goals. Unnecessary evaluations, which had become a part of the "culture" of the system, were eliminated.