Insights on turnover intent in state vocational rehabilitation agencies

Abstract

Background

The state vocational rehabilitation (VR) system has a long history as a leading public program serving individuals with disabilities. Hundreds of vocational rehabilitation counselors work in each of the 78 agencies representing every state and territory in the United States. However, chronic issues of employee turnover have served as a disruptor to vocational rehabilitation services while adding costs to the program for more than two decades. Turnover adds to the difficulty of maintaining a healthy work climate and serves to weaken agencies.

Objective

The aim of this brief report was to characterize the turnover phenomenon in state VR agencies and provides a synopsis of research findings indicating causes for the turnover.

Methods

A review and synthesis of the empirical literature presently available on turnover in state VR settings is provided.

Results

Although this brief report is a synopsis of research examining the turnover phenomena presently experienced by state VR agencies, many of the reasons qualified providers of VR services are leaving have remained consistent over the past two decades.

Conclusion

Recommendations are provided in an effort to support VR agency leadership in their recruitment and planning efforts to retain qualified providers.

Keywords

vocational rehabilitation rehabilitation counselors turnover

Introduction

The state vocational rehabilitation (VR) system was established in 1920 by the Smith-Fess Act (or Civilian VR Act). Subsequent legislation, like the Rehabilitation Act of 1973 as amended (P.L. 93–112) and the Workforce Innovation and Opportunity Act of 2014 (WIOA; P.L. 113–128), has continued to expand VR services to civilians with disabilities. Today, 78 state VR agencies receive federal funding from the Rehabilitation Services Administration (RSA), with total funding apportioned to states in 2020 of $3.4 billion (United States Department of Education [US DoEd], 2022). Over 800,000 individuals with disabilities (IWDs) are served by state VR agencies on an annual basis, with 116,524 of these individuals securing employment in 2020 (US DoEd, 2022). State VR agencies employ rehabilitation counselors (RCs) as their primary direct service provides and these RCs have been shown to facilitate higher quality employment outcomes for IWDs (Mackay et al., 2020). However, research evidence has demonstrated the persistent challenge of RCs turnover in state VR settings (Sabella et al., 2024).

Supply and demand

Schultz and Millington (2007) used a model of supply and demand to clarify the issue of turnover, with the convergence of “educational capacity and job attractiveness [creating] a unique problem for public rehabilitation agencies” (p. 134). Tansey et al. (2004) noted the critical shortage of RCs entering the field, with educational programs unable to meet the aggregate personnel needs of state VR agencies. The number of graduate programs in rehabilitation counseling has also decreased coinciding with legislative changes within WIOA that have effectively lowered the standards of the vocational rehabilitation professional (Sabella, 2017).

Staffing concerns have been noted by multiple researchers. Chan (2003) found the turnover rate of RCs in state VR agencies to be around 12%. A slightly larger estimate of turnover in state VR agencies of 16% was observed ten years later (Pitt et al., 2013). Armstrong et al. (2008) found the annual turnover rate to be higher, with 25.8% of surveyed RCs indicating they intended to leave their organization (n = 1,749). Perhaps even more alarming, the number of new professionals (less than five years of experience) intending to leave their position in the next two years was reported as 54.2% (Armstrong et al., 2008). The confluence of low supply, high demand, and high turnover creates a scarcity of qualified providers of rehabilitation counseling. A main solution among state VR agencies has been to hire individuals from comparable fields (e.g., social work and other counseling specialties). More recently, the solution has increasingly been to employ support personnel who are not master's-level counselors. Herbert et al. (2023) noted this in their research findings indicating that “there is an insufficient number of qualified job applicants” (p. 64). Counselor turnover and recruitment issues in filling these vacancies within the state VR systems results in a myriad of direct and indirect costs.

Direct cost

Direct costs of turnover are more easily observed and calculable as they reflect actual costs that are directly attributable to the event or cost object. Indirect costs are more ambiguous and challenging to calculate though may have far-reaching collateral cost. When considering the actual financial costs associated with turnover, Stacho et al. (2024) suggest the following formula: Total Cost of Turnover = (Cost of replacing an employee + Cost of lost productivity + Cost of lost knowledge and expertise)/ Total number of employees. This helps account for things like the cost of recruitment, background checks and pre-employment screening, initial orientation and training, and the time required for the new employee to be producing at a rate similar to or higher than the individual they replaced. A recent projection of direct cost is said to be five times the position's salary (Fortin, 2022).

Indirect costs

Employee turnover has been shown to significantly impact organizational performance and productivity (De Winne et al., 2019). In counseling settings, this can mean a decrease in the quality of services provided to clientele (Garner et al., 2013), lower fidelity to service plans (Woltmann et al., 2008), poor client outcomes (Williams & Plotts, 2010), and lower rates of client satisfaction (Plomondon et al., 2007). It has been suggested that the state VR system is in a state of decline that needs to be countered with creative leadership and professional evolution (Tansey & Garske, 2007). For RCs in state VR settings, particularly those new to the job, experiencing “incongruence relative to values, expectations, and needs, this increases the chance for turnover intent and actual turnover” (Pitt et al., 2013, p. 12). In other words, if new RCs feel that the job does not allow them to function as a trained provider of rehabilitation counseling, dissatisfaction with the job will occur, and the likelihood of turnover will increase.

Discussion

Reasons for leaving

Landon et al. (2024) examined the impact of organizational factors and professional identity on the turnover intent of RCs working in state VR agencies. Indicators of turnover intent were identified that corroborated with many of those from earlier studies (Armstrong et al., 2008; Pitt et al., 2013). Factors shown to have a statistically significant impact on an RCs intent to quit included: (a) people, (b) pay, (c) caseload correspondence, (d), promotion, (e) supervision and (f) professional identity.

People

Co-workers and colleagues were found to be a significant contributor to turnover intent (Landon et al., 2024). Good colleagues and a positive work environment often leading to individuals staying, whereas colleagues and work environments seen perceived as negative or restrictive were reasons for RCs to leave. For new professionals, this may be due to feelings of isolation or lack of support or seeing other coworkers unhappy in their present position and just “putting time in” until they can retire. When workers do not thrive in their work setting, turnover intent is likely to increase. Shannon (2009) compared the mentoring practices of VR agencies in two states (i.e., Kentucky and Illinois). Findings indicated that RCs paired with mentors and employed for a minimum of five years were less likely to leave their place of employment. Solid mentors seem to be an attribute within this profession that play a role in retaining VRCs.

Pay

Higher pay from other work sectors lures RCs away from the state VR practice setting (Herbert et al., 2023; Landon et al., 2024). When RCs with a master's degree and years of experience can double or triple their salary by working for the Veterans Administration in a similar capacity or by going into other public or private industries, it is not surprising that RCs are leaving. This represents a loss of training costs, investment in the professional, and also a loss of institutional knowledge as seasoned RCs take their experience elsewhere for better compensation (Herbert et al., 2023).

Caseload correspondence

In the Landon et al. study (2024), caseload correspondence was defined as the difference between the RCs ideal and actual caseload size. With caseload sizes being reported as larger than ideal, RCs may have less time to provide individualized counseling and may experiences increased stressors related to caseload management. Pitt et al. (2013) found the perceived impact of managing a large caseload size to influence an individual's intent to quit. With worker satisfaction increasing as caseload size goes down (Armstrong et al., 2008), it is likely that “large VR caseload sizes prevent the development of effective counseling-client working alliance” (Kierpiec et al., 2010, p. 7). With high caseload size, it is reasonable to expect an increase in worker stress, and stress has been shown to be a reason RCs leave the state VR work setting (Layne et al., 2004). From an RCs perspective, if one cannot develop a strong working alliance with their consumers due to high caseload demands, satisfaction with the work setting decreases and intent to quit increases (Armstrong et al., 2008; Landon et al., 2024).

Promotion

Opportunities for promotion have been found as one potential reason that state VR employees look for employment elsewhere (Armstrong et al., 2008; Herbert et al., 2023; Landon et al., 2024). The perceived lack of promotional opportunities led one state agency to rethink the number of years of experience required prior to promotion to alleviate some of the turnover strain associated with the lack of promotional opportunities (Herbert et al., 2023). Other promotional strategies included allowing RCs to work on projects meaningful to them and consistent with agency goals and promotions based on performance measures (Herbert et al., 2023).

Supervision

Landon et al. (2024) and Sabella et al. (2024) have found supervision to be a statistically significant predictor of turnover intent among state VR personnel. Supervision has two delineated types: (a) administrative supervision and (b) clinical supervision. Administrative supervision focuses on the needs of the agency. Foci include adherence to agency policy, proper completion of eligibility and other paperwork, and monitoring case expenditures (Herbert & Trusty, 2006). Administrative supervision ensures overall agency accountability and adherence to federal regulations. Research indicates that employees of state VR agencies are more satisfied with the administrative supervision they receive as opposed to clinical supervision (Herbert & Trusty, 2006).

Clinical supervision, by comparison, focuses on developing specific skills like the practitioner's counseling skills, ethical decision making, and facilitating successful client outcomes (Herbert & Trusty, 2006). A model comparing clinical supervision and administrative supervision specifically found that the provision of clinical supervision and a strong supervisory working alliance minimized the turnover intentions of employees (Sabella et al., 2024). By comparison, administrative supervision did not impact turnover intent, suggesting that although “administrative supervision is essential to agency health …, neglecting clinical supervision may lead to counselor skill stagnation and erosion of work motivation” (Sabella et al., 2024, p. 8).

Professional identity

In counseling, the tension felt when an individual's values do not align with their actions is known as dissonance. Vocational dissonance, then, is the discrepancy between what the worker feels they have been trained to perform and the job tasks they actually get to perform. Vocational dissonance can have complicating effects on professional identity. Professional identity is a confluence of many factors which includes level of education, membership in professional organizations and associations, and credentialing (i.e., licensing and certification; Oswald et al., 2020). Other factors effecting professional identity are attributed to the diverse specializations within rehabilitation counseling (Mellin et al., 2011). Although professional identity was not a significant contributor to the final model in the Landon et al. (2024) study, it was shown to have an impact.

Recommendations

Hiring considerations

Sabella et al. (2020) examined how supervisors assess and develop professional dispositions (PDs) in state VR agencies. One of their recommendations was to consider using formalized procedures for evaluating PDs during the hiring process. This approach can help identify RCs at the time of hire who possess the characteristics, qualities, and attitudes desired by the agency, and are also knowledgeable about rehabilitation philosophy, disability rights, and serving IWDs. Research indicates most state VR agencies have an internship program (Herbert et al., 2023), but paid internships with medical benefits may need to supplant the more commonplace practice of unpaid internships to be desirable to the rising workforce. Hiring a well-qualified workforce with the PDs state agencies are looking for will likely decrease the onboarding time necessary for new professionals and ensure a high-quality service is provided to the clients/consumers served by state VR agencies. Additionally, it would be reasonable to expect more agency commitment from counselors when their PDs are a good match for the work in the state VR agencies.

Meaningful work/valuing the work

Those RCs who feel their work within state VR agencies has meaning and purpose, and feel they are contributing to the unique mission of their agency, are more likely to remain with their employer (Herbert et al., 2023). In many ways, the philosophical purpose of serving IWDs and facilitating employment outcomes, along with the people they interact with, co-workers and consumers alike, are the reasons why some RCs stay employed in the state VR setting. They find the job inherently rewarding and take pride in the work they are doing. However, the rewarding nature of the job should not be taken for granted, as other factors can outweigh this sentiment and lead to increased turnover intent of RCs.

Internal marketing

One way to capitalize on the inherently rewarding nature of the job is internal marketing or reinvesting in their employees. Research has shown that when RCs are highly satisfied with their work, consumer satisfaction also increases (Capella & Andrew, 2004). This indicates that when administrators and leadership personnel of state VR agencies invest in the well-being and satisfaction of their workforce (the internal market), they are also investing in the satisfaction rates of their consumers (the external market). Successful internal marketing strategies reflect many of the recommendations noted in this brief report: (a) recruitment and selection of appropriate people, (b) competitive wages and benefits package, (c) ongoing professional development and training, and (d) supervision and evaluation (Capella & Andrew, 2004; Lewis, 1991). Agency directors and leadership teams can demonstrate recognition of the valued contributions of their workforce by developing internal marketing strategies designed to increase the overall satisfaction of their employees.

Supervision

Just as the lack of supervision can lead to turnover intent, the provision of clinical supervision has been shown to decrease the turnover intent of RCs working in the state VR system (Sabella et al., 2024). Clinical supervision focuses on aspects of the job that are motivating to counselors, namely their own skill development and their work with their consumers. Even when experiencing challenging work conditions, clinical supervision may offset the vocational dissonance felt by RCs and provide assurances that the work RCs do is meaningful and valued. Through skill specific development, fostering ethical decision-making, and building an appropriate supervisory working alliance, clinical supervision is an important way for the state VR system to help retain highly qualified professionals. Moreover, for new RCs, clinical supervision has been shown to help increase employment outcomes for new RCs (those with less than five years of experience; McCarthy, 2013). Given the propensity of new RCs to seek employment opportunities relatively quickly after their initial hire (Armstrong et al., 2008; Landon et al., 2024), the provision of clinical supervision has the potential to target the group most likely to have an increased turnover intent.

Opportunities for advancement

Two recent studies identified opportunities for promotion as reasons they might stay or leave employment with a VR agency (Hebert et al., 2024; Landon et al., 2024). With relatively fewer supervisory positions, options for promotion other than purely supervisory or administrative roles might appeal to those RCs who desire new opportunities. Examples include multiple counselor seniority levels, agency trainer roles, serving as mentors to new counselors, or community liaisons with other agencies. These positions may help RCs feel they are contributing in meaningful ways to the agency and provide an opportunity to recognize and value the contributions of RCs within and without the agency.

Wages and caseload size

The promise of “Low Pay and High Caseload Size” is not a realistic marketing slogan or strategy for any work sector. Yet, this seems to be the reality of many state VR agencies (Pitt et al., 2013). With a demonstrated discrepancy between the preferred caseload size and the actual caseload size RCs are assigned to in the state VR setting (Landon et al., 2024), RCs are left with little time to focus on the aspects of the job they prefer, such as counseling and guidance. The turnover rates continue to exacerbate the issue of high caseloads due to counselor vacancies and retirements, and the remaining RCs must absorb these vacant caseloads. Despite the difficulty and time required to successfully lobby state legislators, agency administrators committed to improving the compensation rates of their RCs have been successful in at least two state agencies (i.e., Kentucky and North Carolina; Herbert et al., 2023).

Although there is a demonstrated need to increase wages and decrease caseload size to improve the vocational dissonance of RCs in state VR agencies (Landon et al., 2024), this is easier said than done given limits to state budgets and legislative restraints. However, some states are finding unique ways to ensure RCs can focus more on the aspects of the job they find meaningful (Herbert et al., 2023). These practices (e.g., outsourcing eligibilities to a local university, using bachelor level workers to focus on administrative tasks) show promise and the potential need for state VR agencies to consider a multi-tiered approach to the provision of VR services where RCs provide direct counseling and adjustment services to clients, and supervise the bachelor's level workers providing the case management tasks. This helps bring a measure of prestige and recognition to the RCs for their skill, education, and abilities.

Conclusion

The turnover phenomenon in state VR agencies has persisted for many years. The statement “Working with a marginalized population means you work in a marginalized field” seems to aptly describe the state VR work setting. Low pay, surging caseload sizes, and a workforce that often feels undervalued and as though they are not doing the job for which they were trained are all elements of the turnover intent of RCs in state VR agencies. Although agency directors and administrators may not be able to directly influence some elements of the turnover puzzle (e.g., pay or caseload size), they can ensure supervisors have the time and the “mandate” to provide clinical supervision. Agency leadership at all levels may take the opportunity to consistently demonstrate appreciation and acknowledgement of the work provided by RCs in their agencies. Developing and implementing opportunities for advancement and positions of responsibility are also plausible for agency leaders to develop and implement. At some point, administrators and leaders must commit to advocating with state legislatures to increase pay and work towards smaller caseload sizes. This will take time and may not always result in success but outwardly demonstrates a commitment to their workforce. To truly confront the chronic turnover epidemic they are presently experiencing, a multi-faceted approach by agency administrators and leaders is necessary to alleviate some of the vocational dissonance experienced by RCs in state VR agencies.

Footnotes

Acknowledgements

None to report.

Ethics statement

Not applicable.

Informed consent

Not applicable.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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