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Episode 103 VR Workforce Studio
The man with the magic glasses
Inspiring stories, experts, news and information about how assistive technology is helping people with disabilities to enter the workforce.
Rick Sizemore, rick.sizemore@dars.virginia.gov 540-688-7552 @vrworkforce
WWRC Foundation Lynn Harris, Foundation Director, lharris@wwrcf.org 540-332-7542 540-430-4490.
Betsy Civilette, DARS Communications Manager
Eric Choi YouTube
Business Development Unit – Contact for Windmills Training and other services
Alexis Duggan Blog YouTube Adult Daily Living Skills E-Book Purchase Coupon Code: Ms. Duggan
Erik K. Johnson Podcast Talent Coach
Council of State Administrators of Vocational Rehabilitation and the National Employment Team
ABLEnow, 844-NOW-ABLE (1-844-669-2253), able-now.com
National Clearinghouse for Rehabilitation Training Materials
Heather Servais hservais@neweditions.net @RSA_NCRTM
Virginia Department for Aging and Rehabilitative Services
Rehabilitation Services Administration
National Rehabilitation Association
Department of Labor Office of Disability Employment Policy
Wilson Workforce and Rehabilitation Center 540-332-7000 or 800-345-9972
George Dennehy with the Goo Goo Dolls George Dennehy
Lead On Lead On VR Music Video featuring George Dennehy and the Voices of Rehabilitation
Click Here for the Music Video
Lead On Lead On Karaoke – Free Download, now you can sing the VR National Anthem with a professional soundtrack from your phone. Click Here for the Free Karaoke Video
Special thanks to CVS Health, The Hershey Company and CSAVR and the WWRC Foundation for this support of the VR National Anthem
Voice Talent by Steve Sweeney
University of Wisconsin Stout’s Vocational Rehabilitation Institute Webinar on Podcasting and VR
Resources from the National Clearinghouse of Rehabilitation Training Materials (NCRTM)
Assistive Technology Resources
Assistive Technology for People with Mental Health Conditions: Part 1 (Institute for Community Inclusion) In Part 1 the presenters will provide an overview of the cognitive functions that affect job performance of individuals with mental health conditions. The objective of this webinar is to help participants understand the cognitive impact caused by mental health issues and the effects on employment outcomes.
Assistive Technology for People with Mental Health Conditions: Part 2 (Institute for Community Inclusion) In Part 2 the presenters will identify different types of assistive technologies to address executive function and emotional support for people with mental health conditions. The objective of this webinar is to help participants understand how assistive technology can address common cognitive barriers and improve employment outcomes.
Assistive Technology for Supporting Adults with Learning Disabilities: Part 1 (Institute for Community Inclusion) Part 1 describes the demographics of learning disabilities in the U.S. and will provide information about using assistive technology (AT) as an accommodation for adults with learning disabilities.
Assistive Technology for Supporting Adults with Learning Disabilities: Part 2 (Institute for Community Inclusion) In Part 2 this webinar will provide an overview of the types of assistive technologies available to support adults with learning disabilities in reading and writing.
Playlist 5: Technology Access for Individuals with Disabilities (WorkforceGPS) The purpose of this playlist is to present information on relevant considerations that support technology access for individuals with a range of disabilities. Accessible technology is designed to meet the needs of a broad range of users. The concept of accessible design is based on two types of access—direct and indirect. Direct access is facilitated when users can customize their technology interaction. Universal Design is one approach that embeds flexible presentation and response formats to allow broad-based access, minimizing the need for assistive technology. Indirect access design is based on products, devices, services, or environments that are compatible with a person’s assistive technology (AT) such as computer screen readers.
Braille Resources
January 4, 2022 is World Braille Day
Braille: What It Is, and Why It Is Important (Older Individuals who are Blind Technical Assistance Center) This on-demand course describes why braille is still important in today’s world for those who have vision loss. It also provides an overview of how the code works, equipment used for reading and writing braille, and barriers faced by those who want to learn and use braille. This course is available for 1-hour CRC, ACVREP, and NBPCB credit.
Understanding Accessible Technologies (DeafBlind Interpreting National Training and Resource Center) This module provides an introductory overview to different technologies that DeafBlind individuals may utilize. From iPhones and Apple products, to Braille displays, those working with DeafBlind individuals should possess a working familiarity with how these adaptive devices improve DeafBlind individuals’ lives and opportunity for employment. This course is available for 1-hour CRC credit.
Transcript
Singers: VR Workforce Studio
Barclay Shepard: But I once heard someone say that for individuals, technology makes things easier. For an individual with a disability, assistive technology makes things possible.
Announcer: Four…three..two….one…. VR Workforce Studio, podcasting the sparks that ignite vocational rehabilitation through the inspiring stories of people with disabilities who have gone to work.
Jered Lem: Tech Support this is Jered speaking how may I help you?
Rose Hilderbrand: I have a position at Masco Cabinetry.
Alfred McMillan: I’m a supervisor at Sedexo.
Announcer: As well as the professionals who have helped them.
James Hall: A job, and a career, you got to look at how life changing this is.
Announcer: And the businesses who have filled their talent pipelines with workers that happen to have disabilities.
Debby Hopkins: To help expand registered apprenticeship.
Announcer: These are their stories.
Megan Healy: Because there is such a great story to tell about people with disabilities.
Announcer: Now here is the host of the VR workforce studio. Rick Sizemore.
Rick Sizemore: Welcome to episode 103 of VR Workforce Studio. Rick Sizemore, along with Betsy Civilette. Hello Betsy.
Betsy Civilette: Hey Rick, and happy new year.
Rick Sizemore: Happy new year to you as well.
Betsy Civilette: Oh, we have got an exciting show today focusing on assistive technology or A-T for short.
Rick Sizemore: Yeah. Betsy AT has become such an important part of vocational rehabilitation. The conversation today is all about the equipment and the specialized devices that help many people with disabilities to open up a whole new world of possibilities in the workforce.
Betsy Civilette: And also you’ll hear from some of our AT experts about these services they provide and how that can help you to go to work.
Rick Sizemore: Yeah. Well, it’s time for our big inspiration showcase with Eric Choi, sometimes known as the man with the magic glasses. He’s here to talk about his story of vocational rehabilitation. Welcome to the podcast.
Eric Choi: Thank you for having me.
Rick Sizemore: Eric, like so many people, you were on a career track working as a graphic designer and then life changed, what happened?
Eric Choi: So, I was considered somewhat active person, I enjoyed playing golf on the weekends and do a lot of things around the house, pretty handyman. And six years ago in December, I went to mountain bike with my buddies and then I went over the handlebar and broke my neck.
Rick Sizemore: You were in the hospital after this terrible accident, a quadriplegic, wondering if you’d be able to get back to work when you had an aha moment right there in the hospital, tell us what happened.
Eric Choi: When I was inpatient, I had interpreter come in to help with my wife understand my injuries and everything. I speak Korean, which is my native language, and speak English, so I looked into that and I found out maybe there’s a job out there for me as interpreter. It’s perfect job for someone like myself.
Rick Sizemore: And while the perfect job, you still faced several challenges in terms of the computer, your workstation, the technology that it takes to get along in the world today. How did you get help with that?
Eric Choi: I contacted DARS helped me out with the assistive device, dragon, voice control, dictation software and quadjoy mouse. I know I can use that technology for something a lot more other than graphic-related work, and dragon dictation software comes in pretty handy as far typing versus speaking.
Rick Sizemore: Tell is how that works for someone who may be at home and they may be in a similar situation that you were in. How does that software actually enable you to get your job done?
Eric Choi: I guess a dragon speech program allows you to write letters, emails, browse the web, pretty much anything that’s computer related. Now, on top of that, I needed the mouse function, the dragon dictation software doesn’t have full, what you call, accessible mouse function on the PC. And then I learned from DARS counselor that there is a special mouse for quadriplegic like myself, it’s called quadjoy, and that was extra, extra bonus to work around computers.
Rick Sizemore: Well, so you’re at home, you’re trying to figure out your life and you’re working with DARS, how did it feel? Take us back to the moment when you realized working with DARS that there’s this technology that would help you as a person, really, with very limited use of your hands to be able to be highly functional using a computer.
Eric Choi: At the beginning I wasn’t quite sure how things going to work out, because everything was new to me, and everything starts out slowly, one thing at a time. And yes, I had to be very patient and work with a counselor and, yeah, that’s pretty much it, you have to have patience.
Rick Sizemore: Right. But spring forward today, you are able to do your work as a result of this technology.
Eric Choi: I’m a contractor freelancer, I set my own schedule. I can do the interpreting job online or in person and it’s just working out super, super nice so far.
Rick Sizemore: One of the DARS staff that helped you learn how to use all this technology was a woman named Carrie Clawson, she’s an occupational therapist. What was it like working with her?
Eric Choi: She was wonderful, very patient with me and we spent quite a few hours on Zoom call to… She helped me learn the dragon dictation software.
Rick Sizemore: The dragon and the other software you talk about seems to have made all the difference. We talked with Carrie and it’s interesting to get her take on how significant your accomplishment really is in terms of going to work and what your story might mean to others in a similar situation, let’s take a listen to what she said.
Carrie Clawson: Eric really had a lot of significant needs, we don’t often see someone who has as many assistive technology needs that Eric has, so I think for people sitting at home wondering, “Is this something that I can do? Would I be able to work? Would I be able to be successful?” , and just like Eric’s glasses you just don’t know what might be out there that would help you be able to be successful in work, and certainly at DARS we have a lot of experienced people who can help figure that out.
Rick Sizemore: So, Eric, what about these glasses that Carrie mentioned?
Eric Choi: The glasses I’m wearing right now, it’s smart glasses. It’s another great tool. I told Carrie this is another great tool for a quadriplegic like myself as part of assistive technology.
Rick Sizemore: Okay. So, tell us, what does smart glasses do for you?
Eric Choi: So this glass I’m wearing, you see two little circle on each side of the glasses, that’s the camera actually, so it has two video cameras, and it has three built-in microphone. Just above my ear, there’s a speaker on one on each side, and it’s a Bluetooth capable, and I can answer the phone without hands. I can take photos, voice control. I can record videos, voice control, and I can listen to the music. And it’s wonderful thing, it’s all hands free. And I’m using this glasses as we are doing the Zoom meeting. Yeah, it’s working out wonderful.
Rick Sizemore: Pretty cool glasses.
Eric Choi: I know I look smarter with it.
Rick Sizemore: Eric, I’d be careful, I think Carrie is in love with those new glasses.
Carrie Clawson: Oh, okay, my first comment is I’m super jealous, that I want those for me.
Rick Sizemore: Ray-Bans, baby. He looks good.
Carrie Clawson: I know. Yeah, they do. And just I love that technology is in a place where we have things like that that are available for anyone to use, and certainly he’s benefiting from that kind of technology. Very cool.
Rick Sizemore: So we’ve talked about some of the high tech items that DARS has helped you evolve in your work, what about other AT that you’re using?
Eric Choi: I still use mouth stick to do certain things when I’m not in front of my PC. Yes it does help a lot with my limitation.
Rick Sizemore: What a journey you’ve been on, you have a YouTube channel and we’re going to put the link to that in the show notes of the podcast. It was amazing to see you feeding yourself for the first time, tell us about these devices that you used that have enabled you to become so much more independent.
Eric Choi: Well, as far the feeding device, that’s just, I guess it’s known as Quad-Fork. Yes, it took me almost five years to get to that far, but my thing is, if you don’t move, if you don’t try, it’s not going to improve, so every day’s challenging, I got to work at it little at a time, one day at a time.
Rick Sizemore: And you have a YouTube channel.
Eric Choi: So I started out my YouTube channel just because I was curious about what other quadriplegic like myself are doing to improve their health and recovery.
Rick Sizemore: So you’ve learned from others. What is your main message?
Eric Choi: Take it one day at a time. You got to keep push, you got to keep pushing yourself. Never give up, if you give up, there’s no hope.
Rick Sizemore: Final thoughts about your new career track.
Eric Choi: So, yeah, this interpreting job is very exciting, I’ve done a few assignments already, I have many more to do and I have a lot more to learn as I continue. And it gives me pride, self-confidence and that my disability is not limiting myself and my family as far financially. And also there’s a lot more potentials down the road.
Rick Sizemore: Well, listen Eric, you are leading the way for many and your message will inspire a lot of people. We thank you again for being with us today. Eric Choi comes to us from his home in Northern Virginia. Thank you, Eric.
Eric Choi: Thank you for having me.
Rick Sizemore: Today’s show is all about assistive technology, for a complete listing of information and resources discussed on today’s show, visit us at vrworkforcestudio.com and check episode 103’s show notes. Betsy recently talked with Barclay Shepard, we join them now as we continue our discussion on assistive technology,
Betsy Civilette: I’d like to welcome our next guest, Barclay Shepard, who manages our rehabilitation technology services as well as Virginia’s Assistive Technology System or VATS. Well, welcome Barclay.
Barclay Shepard: Thank you. Glad to be here. Appreciate you inviting me.
Betsy Civilette: First off, I want to thank you Barclay for connecting us with Eric Choi. His story is fascinating, not only because he has overcome so many barriers transitioning to a life with quadriplegia, but he also uses English as a second language, Korean being his native language. But his language skills have led him to a satisfying career as an interpreter, all with the help of assistive technology.
Barclay Shepard: Yeah, Eric is really a great example of how an individual can overcome significant barriers due to functional limitations and environmental access issues, to find a career that matches up with his unique interest and skills.
Betsy Civilette: Well, assistive technology sounds like it’s so cutting edge but it’s actually something that can help someone with a disability. So, in layman’s terms, what is assistive technology?
Barclay Shepard: We’d like to refer to assistive technology or AT, we abbreviate it that way, as cool tools, gadgets and specialized devices that helps an individual overcome environmental or programmatic barriers due to the nature of their disability. Really, assistive technology can be broken down into two main categories, equipment or devices and services. AT equipment or devices vary greatly from very low tech options to very high tech options. Low tech options can be anything as simple as adding Velcro to attach two items together. A mid tech can be something that’s such as handheld technology or something that involves a little bit more technology involved in it. Or more high tech could be adaptive driving equipment. And, really, assistive technology is everything in between and beyond that.
Betsy Civilette: Well, let’s think about the person listening to this podcast, maybe in a situation like Eric faced after his injury, how does someone access AT services and what are some of the most common services that your AT team offers VR clients.
Barclay Shepard: We refer to our AT program or AT team in the Vocational Rehabilitation Program, Rehabilitation Technology Services Team. Our AT services are just one of the critical services that DARS clients may be eligible for. Based on individual needs, the vocation rehabilitation counselor can refer a client to our AT program. Once referred, members of our AT team will review the individual’s case or medical information and meet with the individual to learn more about their goals, ability and interests. Our AT staff have considerable knowledge and experience in working with individuals with disabilities in a variety of environments from an individual’s home, to their work site, school or possibly their training program. Our AT staff include licensed occupational therapists, rehabilitation engineers, rehabilitation engineering technicians, computer systems engineers, and AT specialists.
Barclay Shepard: Our occupational therapists or OTs examine activities of daily living as they relate to employment and tasks that support employment. Their goal is to work with the individual to identify equipment and accommodations, to help individual obtain and maintain employment. Services include assistive technology assessment, AT trials, where an individual try a variety of equipment available in our AT lab inventory. Basically, it’s a try before you buy situation, see if it works for you or if it doesn’t work for you. And they have a variety of equipment in the statewide AT labs, computer accommodations, ergonomic work solutions, handheld technology. The occupational therapist will write a report, make recommendations to the counselor based on the client’s input, their observations and their experience.
Barclay Shepard: Rehab engineering staff work with individuals to determine appropriate off-the-shelf and custom assistive technology solutions. Services might include work site modifications, home modifications, vehicle modifications, and custom fabrication. Examples of custom fabrications, we have examples where the rehab engineering staff have worked with an individual client to design and build custom key guards for cell phones and keyboards, ergonomic tools for specific job tasks, ramps and safety rails for home access, custom wheelchair mounting solutions for tablets, laptops, and other handheld technology equipment for work and school, as well as equipment recommendations for vehicles. And we’ve even helped individuals adapt farm equipment. The entire AT team across the state regularly meets to collaborate and discuss client needs in order to draw from their vast experience, with the ultimate goal to find the best solution for the unique needs of the individual. We want individuals to be successful in achieving their career goals.
Betsy Civilette: You have so many great success stories from your AT team. Eric talks about the joy joystick, I believe your team helped him acquire, it’s just one example. But thinking about the AT services that Eric received during the middle of the pandemic, that had to be a difficult time for him as well as your AT staff, to help him. How are you able to provide these services to help Eric get to work in his dream job as an interpreter during the pandemic?
Barclay Shepard: I can tell you it wasn’t easy at first, however, COVID did present challenges as well as opportunities that we hadn’t planned, in the past we provided nearly all of our services in person with some follow up phone calls and email, and due to the concerns of COVID, it was nearly impossible to provide services in the same way that we were used to. Early on our team problem-solved ways to provide virtual services and providing these services involved a lot of technology challenges from internet connectivity, contact free equipment drop offs, how do we get equipment to an individual, to remote equipment set up and demonstration as well as training.
Barclay Shepard: In Eric’s case, he’s such a determined, likable and capable individual. Our occupational therapist was able to meet virtually with Eric and our AT team to determine appropriate assistive technology solutions that met Eric’s unique needs. Our team was able to use equipment from the statewide AT lab inventory and drop it off at Eric’s home. Eric was able to use the AT equipment for an extended period of time to be able to produce and edit his videos. This allowed Eric time to determine if the equipment met his unique needs. The occupational therapist provided multiple virtual training sessions for dragon and naturally-speaking software, which is a speech to tech software program, so that Eric could meet his productivity needs. The computer systems engineer was able to spec out an appropriate laptop and the team was eventually able to work with the counselor to purchase the recommended equipment for him to be successful in his job as an interpreter. The team eventually was able to set up an ergonomic workstation in his home with recommended laptop and a quad joy mouse. All of this took a team of dedicated and innovative AT professionals, as well as Eric, a guy who is willing to research and try different pieces of assistive technology that meet his unique needs.
Betsy Civilette: That’s wonderful. I think one of the unique things with your services are that you can do a kind of, try-before-you-buy with some of the AT devices.
Barclay Shepard: Yeah, that is true. We do have our AT labs, we have them scattered throughout the state, distinct areas, and the occupational therapist can work with an individual client to access a variety of equipment that they have in those AT labs, and really try before they buy or try before the Vocational Rehabilitation Program buys it.
Betsy Civilette: Great. Not only though do you work with VR clients, but you also assist older adults, in fact, VATS has teamed up with No Wrong Door Virginia to offer AT kits to meet the unique needs of older adults as well as those with disabilities. Could you tell us just a little bit more about these efforts?
Barclay Shepard: Another program that’s administered by DARS is the Virginia Assistive Technology System which is the name of our state’s Assistive Technology Act program. The goal of VATS is really to increase access to an acquisition of assistive technology devices and services for all the Virginians, all ages, all disabilities, all abilities in all areas of the state. VATS partnered with Virginia No Wrong Door to address the independence, health and safety of older adults as well as individuals with disabilities. One of the programs that VATS is providing within this collaboration with No Wrong Door are assistive technology kits. And what we’ve done is we partnered with No Wrong Door to develop these kits as well as place them strategically across the state with No Wrong Door partners. And those partners include area agencies on aging and centers for independent living.
Barclay Shepard: There are three kits that we have developed. One of them is called an emergency preparedness kit, the other one is a social health kit, and the last is a training kit. The emergency kit, it’s a kit that we use to demonstrate a few affordable and user friendly technologies and assistive technology devices that can help our older adults and Virginians with disabilities plan for and develop their own emergency kit. And we’re hoping that by providing these kits and a corresponding guidebook will help create a conversation among people and encourage families as well as organizations to develop their own personal kit.
Barclay Shepard: The social health kit is an interesting kit, people have really been hurting and isolated, and this was a kit that we developed with No Wrong Door partners to kind of address these issues. We were looking at trying to find items that would help connect people and promote communication as well as social inclusion and to really help mental health issues such as reducing stress and anxiety and in general, improve safety and general awareness. Examples of items in this kit are items such as the Facebook portal, the Echo Show, security cameras and doorbells, webcams, wifi picture frames, fidget blankets, magnifiers, temporal orientation clock, artificial fish tanks, which is kind of interesting, and as well as robotic companion pets. And we’ve seen several of the area agencies on aging use these robotic companion pets, they’re cats and dogs, and the little robots, and they move and they make sounds and things like that, but they’re very calming for individuals. And with some individuals, it’s a good way to initiate conversation with them and talk about the past or talk about pets that they might have had.
Barclay Shepard: So we also have the last of the kits, it’s really a training kit. And it doesn’t really contain devices, but it’s really a series of videos that VATS has developed and is continuing to develop in order to help older adults and Virginians with disabilities connect with valuable community resources. If anybody wants to access any of the information, you can always contact VATS at www.vats.org or you can go to the No Wrong Door site at easyaccess.virginia.gov.
Betsy Civilette: I mean, AT has clearly changed the lives of so many people that you’ve worked with so it’s wonderful to hear about Eric’s success and everything else that you guys are doing to help our older Virginians and Virginians with disabilities. So thank you so much, Barclay for joining us today. And again, check out all the VATS learning videos on their website, which is listed in the show notes or contact one of the AT team if you have any questions.
Barclay Shepard: Thank you.
Rick Sizemore: Betsy Civilette is the communications director for the Virginia Department for Aging Rehabilitative Services and Barclay Shepard is the manager of Rehabilitation Technology Services and the Virginia Assistive Technology System. Well, it’s time for our National Clearinghouse report with the always entertaining and informative Heather Servais. Happy new year, Heather.
Heather Servais: Happy new year Rick. I’m so excited to kick off 2022 and be back on the podcast.
Rick Sizemore: Lots of cool stuff going on. What did you think of Eric’s story? The man with the magic glasses.
Heather Servais: I’m so impressed with just how quickly technology advances and what a difference it can make in our lives, especially with something like smart glasses that Eric was talking about, that was new to me.
Rick Sizemore: Yeah, that was amazing. So, I’ll bet you have a lot of resources for us in the Clearinghouse related to assistive technology, what’s up?
Heather Servais: We have a lot of resources to share on assistive technology. We actually have two training series that were created by the Institute for Community Inclusion. The first is Assistive Technology For People With Mental Health Conditions, and this is a two part series. And it really goes through the different types of technology that would be available to assist those with mental health conditions and how technology can really help address some common cognitive barriers and help with improving employment outcomes. We also have another training from Institute for Community Inclusion on supporting adults with learning disabilities through assistive technology. And it’s a very similar setup, but both of these are very helpful and it’s a different way to look at assistive technology with different disability types.
Rick Sizemore: That’s awesome. You always have such good resources and it was World Braille Day.
Heather Servais: We celebrated World Braille Day on January 4th, and I really want to take a moment to share two resources that are featured from some of our partners. Our friends at the Older Individuals Who Are Blind Technical Assistance Center released a training called Braille, What It Is And Why It’s Important. And this really goes through why braille is still important in today’s world for those who have vision loss. And the good news is that it’s also available for one hour of CRC or ACVREP credit, so that’s a bonus. We also have a little bit of a blend of World Braille Day with assistive technology, are friends at the Deaf Blind Interpreting National Training and Resource Center, creating and understanding accessible technologies training, that’s an on-demand training. And it goes through things like how iPhones and Apple products’ braille displays and how all of these adaptive devices can help working with deaf, blind individuals. And this course is also available for one hour of CRC credit.
Rick Sizemore: Heather Servais, always a pleasure to have you on our podcast. Heather is the director of the National Clearinghouse of Rehabilitation Training Materials.
Heather Servais: Rick, hope you have a wonderful new year.
Rick Sizemore: Here’s Lynn Harris, director of the Wilson Workforce And Rehabilitation Center Foundation.
Lynn Harris: The foundation is pleased to bring you these exciting stories of how vocational rehabilitation is changing people’s lives. We thank all of our partners in podcasting who made this episode possible, Aladdin Foods Management, fueling students, community and culture, the Council of State Administrators of Vocational Rehabilitation, bringing talent to America’s workforce for 100 years, CVS Health, revolutionizing the consumer health experience and the Hershey Company, named to CNBC’s list of America’s Most Just Companies. You can find out more about becoming a sponsor at wwrcf.org, or find our contact information in the show notes at vrworkforcestudio.com.
Rick Sizemore: You can always find another exciting episode as we podcast the sparks that ignite vocation rehabilitation here at the VR Workforce Studio. Until next time, I’m Rick Sizemore.
Steve Sweeney: The VR Workforce Studio podcast is owned and operated by the Wilson Workforce and Rehabilitation Center Foundation. The foundation publishes and distributes the VR Workforce Studio and manages all sponsor arrangements. Audio content for the podcast is provided to the Wilson Workforce and Rehabilitation Center Foundation by the Virginia Department for Aging and Rehabilitative Services in exchange for promotional considerations.