And a note on trust and reform

Here is something in the way of reform: Who do we trust?

If a reform requires regional center discretion, such as the frequent proposal to require maximum cost efficiency from a vendor or allowing negotiated payments, most of the community won't trust the reform because we don't as a rule trust regional centers.  We don't trust regional centers because as a rule, they aren't trustworthy.  They aren't trustworthy because, as a rule, when someone at a regional center does something unwise, whimsical or badly, nothing unpleasant will happen to them.  This tends to be true for individual service coordinators, executives, boards and middle managers.  The community but for ARCA won't support reforms that empower the regional center to do anything because we all know well that regional centers are too empowered already.

If a reform empowers vendored agencies, we won't support it either.  Take for instance, the example of proposals to have vendors rather than regional centers perform the service coordination function.  The community won't support that reform to empower private vendors because the community doesn't trust us and the community doesn't trust us because we have not been reliably trustworthy.  We are not reliably trustworthy because, in general, nothing bad ever happens to agencies for poor performance.  Nothing bad happens to agencies for poor performance because nothing bad happens to regional centers for poor performance.

There are a lot of reasons that self-determined services (SDS) make sense, but I suspect one reason SDS offers the only recent example of reform (stalled as it is) must be that it doesn't empower anyone who has any experience with power to be proven untrustworthy.  Not long hence, support brokers and financial management services must take their places as proxies for the politically untouchable clients as stereotypical reprobates.  Soon, we will not trust them because they will not have been trustworthy because nothing will happen to the bad ones because nothing bad will happen to the people meant to oversee them.

Reliable accountability remains the reform needed before any other can be expected to go forward. 

A note on DDS work groups.

Today during the CDCAN town hall teleconference, DDS Director Terri Delgadillo mentioned the working groups she has convened to look at structural reform. Such working groups are typically composed primarily of association representatives and an aberration or two.  Recognizing that these work groups are a step toward transparency and community input, a few questions ought to be asked.

How representative are the work groups?

How transparent are the meetings?

Do the work groups advance a reform agenda?

The first question is easy.  The work groups are not representative in any important way.  They do tend to be diverse ideologically in the sense that whatever CRA is calling itself now always defends congregate facilities and whatever Protection and Advocacy is calling itself now, had its staff been trained in the practical arts rather than law, would likely chloroform and kidnap every client that entered such a place.  But there's a problem of selection bias in calling the work groups ideologically diverse.  As long as CRA' and PAI' are at the table, congregation v integration seems like a more important issue than it does almost anywhere else.  So, what passes for diversity tends be a divergence of limited viewpoints rather a collective voice.  The work groups seem not to be meaningfully integrated into or representative of the greater community of people interested in the development or reform of our system.  

I suspect if you could inebriate the architects of the work groups (and you generally can,) they would tell you that the real selection is based on getting buy-in rather than input.  The first composition probably begins with the list of groups with the means to scuttle or inconvenience legislation, continues with the natural opponents of the first group, and ends with Connie L. This is politically smart, and as long as the goal is pacific politics, the process makes sense.  But if the time for reform has come at last, workgroups made up of well known "stakeholders" with rigid "positions" will get in the way.