Monday, August 30, 2004

The Problem with Providers

OK. I am a service provider, director of a regional center vendor agency. I confess. The concern regarding any reforms proposed by service providers, whether regional center vendors or regional centers themselves, is that our bright visions of the future tend to be better funded, less restricted versions of the present. The idea is almost always that if we were given the funds and the freedom to do what we now do for the people we now serve the lot of people with disabilities would improve.

This denies the central question about this system- are the people it serves getting the best possible most appropriate support. There's something anti-evolutionary about the premise that agencies need to thrive for people with developmental disabilities to do so. What about people who are poorly served, not only because of staff turnover or poor qualifications but also because the agencies serving them are philosophically unable to keep pace? I know that better wages for direct care staff would expedite the progress of clients. I suspect that the disappearance of some agencies would as well.

One question with no clear answer- could the elimination of underperforming agencies and their overhead free up enough resources to provide for better funding of well-performing agencies and a general improvement of the support people with disabillities receive? It is possible when you consider how many millions of dollars go to agency infrastructure and real estate that the closure of a few large site-based agencies could release significant funding back into the community. Whether or not that helps depends on whether the agencies do, and how much.

The purpose of reform needs to always be to sustain the progress being made by people with developmental disabilities. On the survival of service providers, even the service providers should be agnostic.

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