Conclusion

Washington Division of Vocational Rehabilitation found implementing informed choice was complex and nonlinear. It also found that participants achieved employment outcomes at the same or better rate than the traditional program. Generally, participants did not ask for or spend more money than they needed to achieve their goals. When participants controlled the process and had ownership of their rehabilitation decisions, they were committed to their plan. Eighty percent of PEP’s participants developed a plan.

Helping participants control their rehabilitation process so they achieve their desired employment outcomes is difficult. It goes against how many professionals have been trained and requires new paradigms to be created. PEP found that (at a minimum) the following elements must be in place for participants to control their rehabilitation process:

Acknowledge and build upon participants perspective, their willingness to take risks and make decisions about controlling their rehabilitation

Planning must occur at the participant’s pace not the organization’s pace

Participants must be able to obtain information and expertise from a wide variety of sources.

Counselors and participants must be able to establish a relationship prior to planning so the counselor can be a resource to participants rather than a gatekeeper.

Planning must be holistic.

Participants must control their individual budgets to achieve their employment outcomes.

Participants must drive the process, including interviewing and contracting directly with providers for their own services.

The traditional rehabilitation system values a linear, medical approach, where the professional is expected to provide the solution. In implementing lessons learned from PEP, the Division must make both attitudinal and structural changes. As a first step, the Division has streamlined and rewritten all its policies and procedures to be more user friendly. The policies and procedures are meant to provide participants and staff with a wide range of possibilities and allow the system to be more flexible.

The Division is well aware of the connection between informed choice and the participant controlling their resources. It has been and will continue to work on different procurement methods that the participant can control. Attitude is perhaps the largest barrier to informed choice and participant control, attitude cannot be legislated. Attitudinal change will happen over time with constant reinforcement from the agency leadership.