The process of filtering the client's IPP through vendor codes has two major costs. The most important is to the well-being of the client. This post will explore the less important cost, to the efficiency of the system.
To recap, the process of planning and purchasing support in California's developmental system begins with the client, those the client cares to have input and the service coordinator from the Regional Center, as well as any professional support providers in place to review the clients preferences, their disabilities and to plan for whatever support will mitigate the effects of the disabilities on the individual's aspiration. Good start if done correctly.
The next step is generally to attribute the supports to certain vendor codes based on matching needs with codes, but primarily based on Regional Center POS policies. At this point, the plan becomes centered on the vendors not the clients. The efficiency cost is this: If the POS policies are taken as gospel and they too often are, there can be a gap in resources which can only be bridged by purchasing the wrong support for too much money.
Here's an example off the top of my head but not theoretical. If a Regional Center tries to contain costs by limiting units of service available based on vendor codes, one can imagine (or name) a client whose needs exceed the provisions of the POS policy. If, as often happens, the regional center seeks to maintain those policies rather than make an exception, a client can fail to live in their own home, leading to a group home which leads to a day program which typically requires transportation. The result is, and this happens frequently in this system that when $5000 per year in support doesn't suffice to maintain a client in their own home, plan B costs closer to $40,000 per year while providing the wrong services for the client.
The response often made by people defending POS policies by vendor code is that they make exceptions when following the policy will lead to the client's living in a more restrictive setting. Heck, we're required by law. Anyone who works directly with clients knows how rarely this is the case. We go through this process. There is typically a long road into crisis and a longer one back from the brink. Clients in our program have died, ruined their credit or lost their health before the evidence that the POS policies were deficient became clear enough for the exception. The client who died now costs the State nothing. The others now cost the state roughly 6-8 times what the adequate level of support would have cost.
The result is that the system does not behave like a continuous array of supports to be tailored to the client's needs and preferences. It flows like lumpy oatmeal and people get involved in day programs they neither need nor want because the group home they didn't want to live in requires it. This is a costly problem that merits fixing for the sake of the budget if not for the sake of the clients.
4 comments:
Knowledge is of two kinds.
We know a subject ourselves,
or we know where we can find information upon it.
(Samuel Johnson)
This dad
this son
must be doing something right as the last few weeks have had the System Lords and the Gatekeepers applying an inordinate amount of pressure upon us as we "just" try to live in our community, our town with an expectation that an 11 year old boy with low incidence disabilities belongs with his family........not THE group/congregate facilities offered and proferred.
There's something happening here
What it is ain't exactly clear
Government waste, of dollars appear
To try to make us NOT care
United we stand
To always care
And expect
Compassion
Humanity and
Assistance
Any standards less than that are no standards at all
The Cartographers of old were correct in drawing California as an Island for they must have known that special needs families would inhabit a place/location not connected to the mainland....difficult to locate, hard to navigate to/from, and seen by very few if any general/mainlanders.... easy to imagine not existing at all.
But we do exist.
We Are.
DP and SQ....MM and his son find this system soooo screwed up that we pass the baton tonight for it has tired us out for the moment, but after a good night's sleep(or not in case of a sometimes sleep disordered son and sleep deprived dad).....we will expect you to pass the baton back in a day or week or two.......We refuse to opt out or be co-opted in this system...this is the hardest thing a dad or mom will endure and it can/will/does get even harder....BUT...as a home bound professional....I continue to help other parent and professionals navigate the systems and ofttimes come back with success stories
Let's inspire one another in the challenge of this all for substantive and real ways to design and build better supports.........
My son's needs call out
into the darkness of the night and slowly into the early morning hours
Later
nice post
Mobius Man, I appreciate the Samuel Johnson quote, I hadn't heard it before. And the poem, although I regret what you're going through. I know XXXX appreciates your care and I hope that working together we can make things better for him.
Daredevil, Spam is always appreciated. Salaam.
PARCA, welcome. What makes you say that a deputy family resource center person in unnecessary. I understand what you're saying. My preferred approach would be to address the errors in the design of our system that allow foolishness to prosper at the expense of helping clients.
Parca, when you made your reference to an RC director giving a relative an unnecessary job I thought you might be referring to one whose daughter became a deputy director at the Family Resource Center attached to that RC.
And I agree with you, that DDS seems to be much harder on RCs that have trouble budgeting than those that just don't serve clients well, although I'll give them the benefit of the doubt that this is because of difficulty quantifying anything that doesn't have columns.
For that reason, I really believe that more accountability and more measuring of outcomes is a big part of the cure. Let the RCs that are uncommitted to the entitlement they exist to implement and unpleasant to their partners answer for results.
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