Monday, February 14, 2005

Review

To the multitudes:

First of all, let me wish all my friends of easy virtue a happy Valentine's Day.

I kind of have the feeling this page is hard to follow for the few Californians who don't check every day. At some point in the near future, I'll try to learn how to categorize the entries by topic but for now, I'd like to post the overall reform agenda that I've written about.

The overall theme is that cost-effectiveness can be client-centeredness and visa-versa. Oh, and good.

I have written about possible system reform. The general idea is that the system would perform better at lower cost if the system were better disciplined by market forces and higher quality, more widely available information. These are the regulatory changes I'm interested in and advocating for:

1. Higher quality quality management, through a broad and active focus on outcomes determined from improvements in clients' lives and a learning model of evaluation.
2. Available self-direction/self-determination, with appropriately intrusive protections to broaden the role of clients and families in determing what supports will be most contructive.
3. Regional Centers should be increasingly accountable to communities and the state for both results and money. Boards of agencies that implement state mandates should be accountable to the greater community.
4. Provider rates should be based more on value, less on cost.
5. Information about the costs, outcomes and values of every agency and individual funded in this system should be reported in an accessible format to expand the ability of clients and their families to determine the most appropriate support and provider. The ideal being that service coordination becomes less prescriptive.

I have also written about the dialogue evolving in our system:
1. Everyone involved in the system should be linked to each other and to other people with disabilities for the purpose of providing a true dialogue and a combined voice. The California Disability Community Action Network (see link on left,) continues to be the best vehicle for this conversation.
2. Clients and their families as a group should not be spoken for by Regional Centers, Vendors, Employees of either, or associations of these. No professional group should seek to own or control "grassroots" advocacy.
3. We're basically all on the same page. Asked In public, more individualized, better funded, more efficient, and effective support for people with disabilities would be the goal of nearly all clients I've ever heard from, their families, staff, vendors, regional centers, and pretty well everyone I know in this system. I genuinely believe most of us mean it. I don't believe that people of ill-will are important enough in numbers or authority to be worth considering. All the reform to come can be a healthy negotiation among friends. Lighten up everyone, you're doing God's work and I'm sure the devil will forgive you for it.

2 comments:

Anonymous said...

Doug,

I agree that regional centers should be held accountable. They have shown that many of them are now so corrupt, the system is failing. May self-directed care is the only option. But what can we do now to protect ourselves from the corruption in the regional center system? In Southern California, several RC's are out of control. Any suggestions.

Doug said...

Thank you, mysterious creature.

Two main suggestions:
1. Argue for reform before funding in Sacramento and with families.
2. Be prepared for the possibility that not every good reform makes our lives easier or helps everyone equally.