Tuesday, February 21, 2006

Oh, I said I'd write weekly didn't I?

My new friend, PARCA writes a blog advocating Regional Center Reform. He and I agree on a lot, and I was reading his site today, where he reminded me that I haven't ground my accountability axe recently. Shame on me.

Accountability is a massive deficit in this system. How much money is spent on needlessly restricting clients, providing useless services through feckless providers, choosing costlier options to superior ones, adding layers of bureaucratic duty or regulation unaccompanied by better outcomes? I don't know and neither does anyone else. So a lot, no doubt. Lest someone accuse me of regional-center bashing, I do hereby confess the lack of accountability is systemwide and applies to vendors, regional centers, pretty much anyone taking a penny under the DDS line item. My own belief is that the lack of accountability probably does more harm than the lack of funding to consumers.

The big picture need for accountability requires a systemic, thoughtful approach and drastic reform. But here's something we can do today:

A low-cost, drip-dry way to improve the oversight in our system would be to improve transparency. This can be accomplished with a little care for confidentiality by the magic of carbon-copying. As a matter of policy, any communication sent to a provider agency can be cc-ed to their vendoring regional center. Any communication sent to a regional center, if clients' names are redacted, can be cc-ed to the Department of Developmental Services (DDS) or the Centers for Medicare and Medicaid Services (CMS.) Any communication sent to the department can be sent to CMS as well.

It's a poor substitute for a system of outcome measurements that defers to choice, but I'll wager it would help in the interim.

"Be careful for nothing; but in every thing by prayer and supplication with thanksgiving let your requests be made known unto God." -Phillipians 4:6 (KJV)


MobiusMan said...

Knowing the RCs from the clients' parents standpoint.....Herculian accountability is required and demanded of consumers and families to be "considered" for allocations of budget originally intended for their use.
The hackneyed "transparency" allusion/illusion to me suggests one is to look through or past an organization or individual; and being hard pressed to find anything of substance.
Kind of like the Casper (the friendly ghost) Syndrome cute, some entertainment value, little of substance, and not actually real or reality based.
Give us a living breathing system to serve living breathing people.
We need accountability.
Accountability not transparency.
Can be done within current system or can be "reformed".....but the RCs are not going to ask themselves to do better, or even if or how they could pass a simple agency performance review.
RCs get money because DDS gives out money. Self determination IF it were generally accepted or regarded would be ramped up and implemeted, not slowly marginalized.
It threatens RC jobs. Which it should not and does not. Really.
Vendors/families/clients/advocates should convene to discuss these issues and don't need RC "approval" to exercise freedom of speech and expectation.
We risk everything by doing nothing and risk nothing by trying everything. Now. Today.
Name the time. Name the place. Let the games begin. I have a baton to pass and others events ahead in which to compete.
Lets tackle the "Royal Seven" regional centers of Los Angeles County.
I will not lay down the baton any more than the torch of civil rights of special needs populations in California.

A son's dad

Doug said...

Honestly, Mobius Man, I think there is no such thing as accountability without transparency. If you don't know what decisions have been made, you can't tell if they were honest, and the outcomes can be labelled as unplanned.

Like you, I have high hopes for SD, although I disagree about one thing: It has to cost RC jobs and it has to cost Agency jobs or it isn't working. Transferring control means transferring responsibility. I'm not talking about major shifts, a lot of transferring can happen with RC staff doing things they've never had time for before. That said, I won't believe that what we're doing is SD until a few agencies close and a few RC positions are cut.

There's a good chance that SD will become a Community Integration program which is related but not the same. I'm watching for that.

SquareGirl said...

Doug, I think you have provided us with some very specific doable suggestions that make a lot of sense. I too agree that transperancy is necessary for accountability...anywhere and everywhere.

I am curious to see what happens with SD, but am also quite certain that if it is done effectively, accountability and responsibility will be spread more evenly throughout the community and many positions and agencies will be cut out, due to better and more direct quality assurance. With an increase in accountability, the quality of services will need to improve and become more integrated and inclusive to service the needs of the population of developmental disabilities which is ideally what we are all striving for.

Doug said...

Agreed, Square Girl, nothing is more important than having the system really be responsible to the clients themselves. *In my best Opie voice* Gosh I hope it works out that way. You bet I do!

MidLifeCrisis said...

I always knew you liked squaregirl better than me.