Friday, December 30, 2005

About Comments

In order to prevent disruption of the comments on this site by spammers and taggers, I am disallowing anonymous commentary. N.B. This does not require someone to expose their actual identity. If you wish to comment on this site without disclosing who you are, you can establish a free account by registering with blogger. These accounts do not require anymore information than an email account which can be blocked from view in the "Edit my profile" section of your new blogger account. I apologize for any inconvience.

OK, I got a bunch of spam on this very comment so now there is a verifier requirement. I think it may be difficult for people with certain disabilities to use, so if you wish to comment and have trouble, there is an email address connected to my profile and I will be happy to post comments even if I disagree with them. No profanity, though, please.

Monday, December 05, 2005

Value Stream Management, Summary and Conclusion

The Lean model proposed through Value Stream Management offers moral excellence to the agencies serving people with disabilities. The Lanterman Act promises choice, integration, health and safety as outcomes of three billion dollars in funding to Californians with developmental disabilities. The statutes passed within the Lanterman Act, the regulations produced under the Lanterman Act and the policies and procedures of our agencies, however promise next to nothing.

The assurances that do exist fall into two categories. Caseload ratios, provider qualifications, records responsibilities and board membership standards are all process requirements which partly define costs but have no measured bearing on client outcomes. The outcomes promised and measured, mainly on Individual Program Plans (IPPs) and Individual Service Plans (ISPs) rarely get followed up on. In other words, quality is neither designed into nor inspected into this system.

Every professional working in the system and every client and family benefitting from it does so toward the purpose that people with disabilities live better, more meaningful lives of greater consequence to their communities. The accomplishment of that goal is a moral good. Any waste absorbing resources which would otherwise serve the goal of the system is an ethical taint on those who tolerate it.

Advocates frequently point to poor funding by the state and lack of responsiveness of regional centers and their vendors as the great evils suffered by people with disabilities, but I submit that the most plentiful errors depriving our clients has been the systemwide failure to account for and eliminate waste. Furthermore, as long as this is the case advocating for resources is hampered by our inability to assure lawmakers of what the benefit will be from greater investment, if any.

W. Edwards Deming, the statistician Total Quality Management guru famously argued that quality cannot be inspected into a system, it has to be designed in. At the end of the day, the most compelling moral challenge to the constituents of this system is to build in process which eliminates waste and improves quality. Until that happens, the contrast of client-centered values and labyrinthine process will remain an unfunny irony.