Wednesday, February 08, 2006

Administration

I think our system has a funny relationship with administration. On the one hand, it's almost a tenet of faith that administrative costs deprive the clients. On the other, the State and Regional Centers sure seem to come up with a lot of ideas for vendors to do more of it. There are a few things that stand out to me about the role of administration in our system.

The first is this: Our system derives its efficiency and effectiveness from the individualism in the service planning. In theory always and in reality sometimes, services provided are so well matched with the client and his or her situation that there is no waste and yet every disability-related need is met. OK, right, but the point is, the matching of service to need and the flexibility to treat each client individually clearly requires more management that one-size-fits-all solutions. Add to that our emphasis on integration and services being located in the home and in the community and it becomes clear that the quality-assurance and communications functions of administration are more demanding and more productive than in standardized, facility-based models of care.

The second thing that stands out is this: Administration and management interfere with the process by which individuals and their staff find their own way. Quality Assurance, service planning and coordination are all interventions in the organic process of person-centered support. Administration may be necessary or beneficial but it can easily be stultifying, invasive and counter-productive. Like this entire system, cost-benefit analysis should be applied to both administration and the regulations and policies that promote administration to make sure we do the optimum amount of administration the best way possible. I should clarify that by analysis I mean analysis and nothing that begins with "I think" like this post did.

2 comments:

Doug The Una said...

Parca, we all do what we're able for change. I blog. No need for thanks.

I don't know any facts about RCOC, and don't work with them but the reputation among providers is pretty dismal. I know a lot of providers in the trap of not wanting to turn their backs on OC clients but not wanting to continue working there. I had a similar problem with a different Regional Center and I'll never take another referral from that one until the top three levels of management there are gone. It would be a massive "reform" if Regional Centers that serve clients badly were held as quickly accountable as the ones that budget poorly.

Doug The Una said...

Parca, that's the reputation among providers for that Regional Center. I agree that SGPRC seems very ethical and I've experienced nothing at ELARC that I'd call unethical. We used to work with (and be vendored by) other RCs that I did find too morally or philosophically compromised to work honestly with.

I agree, the pass-through was tricky. Not to perseverate endlessly, but we really need a lot more accountability, transparency and clarity in this system or else I agree with you that increased funding is unlikely to help.