Tuesday, August 04, 2009

Baron-centered services

When we talk about person-centered services, and most of us speak about such services reverently, we assume that the most efficient and most morally appropriate support for people with disabilities would form from the will of the end user, be shaped by those closest to the end user and that each degree of separation from the end user would decrease influence significantly. I don't challenge that assumption which I find works both philosophically and mathematically.

I have written before here how frustrating it can be the degree to which advice, technical assistance, rule-making and program formation follow a feudal system in which the principality of DDS is invoked by the baronies of the regional centers to direct the viscounts and baronets of the various vendored agencies. This is the least efficient, most morally suspicious method of standardizing services, particularly when the message seems to be "Here is how to provide person-centered services."

A feudal system requires the consent of the governed as much as a Democracy does. It bears mentioning that one reason the community-based system revolves around such centralized control has been that the vendors are so cagey, political and reluctant to insist that knowledge flow both ways or even offer some when asked. Clients and their families could provide more guidance too, probably.

And yet, in the current funding environment, I find it noteworthy that in our collective panic, the trend seems to be toward a more feudal system, particularly where information sharing is concerned. The ELARC board retreat, rather than a conversation, was allocated nearly entirely to congratulating the regional center (something it deserves- in many ways ELARC has been a model of administrative competence) and the promotion of some person-centered tools they developed. The participants, vendors, clients and family members were asked their input only in the final 15 minutes and in response to the question "What can we do to promote use of these instruments."

So let it be said here that the purpose of this meeting was to promote person-centered process offers only irony and evidence that many who promote individualized support don't understand what they say they are promoting.

If current events require a new level of partnership and a higher degree of efficiency, there will be much more time spent in which vendors, families and clients instruct regional centers. It takes effort to make a smart system and it takes thought. The distributed wisdom of community-based system ought to be our best instrument for making opportunity ought of current challenges. To that end, the certainty of regional center personnel and the recalcitrance of direct care users and providers are the most obvious obstacles.

Sidenote: I don't suspect that regional center personnel or vendors are intentionally complicit in the centralized course of decision-making in this system. I just think that findings have followed the funding for so long that long-time participants in the system, a group in which I'll soon have to admit membership, don't even realize how arrogantly or submissively they are behaving.

57 comments:

paul said...

“A feudal system requires the consent of the governed as much as a Democracy does.”

And – the culture that has formed over the last 30 years has given that consent and has “[invoked] the the principality of DDS” time and time again.

Doug,

What do you think the first goal, action step (even a baby one), which is designed to halt further erosion, would look like?

My experience has taught me that our system is extremely inbreed. A HIGH percentage of our baronies are NOT strangers to people with disabilities, but are relatives of people with disabilities. IF this is true then more rules, regulation, and laws director toward this crowd will do little to improve things.

I have had a conversation with RC board member, which was also a parent of a person with a disability, that ask me a question for which they should already know the answer and perhaps even be the experts.

Once I was asked by a board member (also a relative...), “what can we do about this”. I answered yadda yadda, which prompted another response, “when can you get started”

Learned helplessness makes those empowered under the Lanterman act do nothing but point fingers, scream tui culpa, and feel entitled to “serving [insert name] for free”

Some have served on non-profit SLS providers yet know nothing about rate setting and service contracts. Yet - a properly function non-profit board would likely have to vote to approve a service contract.

Many junctions of communication and many advocacy organizations are funded in part by the Regional Centers making it all but impossible to have a truly independent voice.

And – as I have said before there exists NO organization in California that advocates for consumers as a matter of law, and I would probably add, because of our incestuous foundation, that there exists no independent advocacy organization that is able to begin to advocate objectively based on the simple value of “fairness” to all rather than the "me and mine" approach of today's alphabet soup.

Is our experiment in local control and privatization, the Lanterman Act, a failure? Can it be salvaged, or would it be better to resign ourselves to trying to create the best Baron-centered services that money can buy?

Doug said...

Paul, I can answer the question about action steps two ways: The big, difficult system-change way would be, as I say too often, to track results in terms of client preferences. I think it would help a ton if ideas and policies could be tested against a different standard from "what I think and wish were true."

A more immediate, more accessible step would be for clients, families, providers and regional centers to do some of their problem solving publicly. This is one of the things I'm trying to help Marty to do. The idea would be that, with consent of the client, the other stakeholders could be asked in public how to solve a problem the client was having.

I think a process would help parse the difference between the preferences, policies and regulations that either constrain or don't constrain responsive services. My hope would be that this can reduce access to glibness, out of which many barriers are constructed.

paul said...

Doug,

I think that the idea of “pars[ing] the difference[s] between […] preferences, policies and regulations that either constrain or don't constrain responsive services.” Is a great idea.

Critical to its success is that those involved have a generally accurate understanding of the public policies driving service delivery and the regulations promulgated. Can this be safely presumed?

How would you guard against such a venue becoming just another tool for advocates to misinform and misdirect people with disabilities, and other stakeholders with our collective opinions and misunderstandings?

Do traditional “Circles of support” and ID Teams fail to “parse the difference[s] between […] preferences, policies and regulations that either constrain or don't constrain responsive services.”, and if so how would a larger group drawn from the same well and placed upon a public stage fair better?

Doug said...

Paul, it can't be safely presumed, but in a virtual public square, there is plenty of opportunity for each person's illusions to be corrected. I think of this as a sort of analog wikipedia article where each person involved, from DDS, the regional center, public authority, hospital, vendor, family, etc. will have the opportunity to explain and defend their position to people presumably armed with the relevant documents. I don't know how well it would work, but it sounds worth a shot to me.

I think very well prepared ID teams probably do a good job and poorly prepared ones do not. But those ID teams don't have referees, which is how I see the public functioning.

stanley said...

[doug say] So let it be said here that the purpose of this meeting was to promote person-centered process offers only irony and evidence that many who promote individualized support don't understand what they say they are promoting.

[paul say] What do you think the first goal, action step (even a baby one), which is designed to halt further erosion, would look like?

[doug say] A more immediate, more accessible step would be for clients, families, providers and regional centers to do some of their problem solving publicly. This is one of the things I'm trying to help Marty to do. The idea would be that, with consent of the client, the other stakeholders could be asked in public how to solve a problem the client was having

[doug say I think very well prepared ID teams [IDT] probably do a good job and poorly prepared ones do not. But those ID teams don't have referees, which is how I see the public functioning.

A lot of potential in these baby steps...maybe i hear the thundering hoof beats of that great horse silver...who is the mask man...

perhaps a return to those thrilling days of yesteryear...a return to the original intent of Lanterman.

A well prepared IDT certainly a major factor, key...perhaps a PIP type training for IDTs.

my feeling is this was the intent of Lanterman: IDT determine needs...

at the determining needs stage RC, whoever, should not consider cost...

development of well prepared IDT should be prime focus in this step...why not an IDT referee...not sure who the public would be at...say an IPP meeting for my daughter.

Circle of support(COS) maybe the public...COS should have a place at the IPP meeting...

Re: This is one of the things I'm trying to help Marty to do

How can all stakeholders help...

stanley seigler

ps hope others read this.

Doug said...

Stan, thanks for asking. CDCAN is always in need of financial support for starters. Anything stakeholders can spare would be welcome. Just as importantly, it's important to have help organizing local public problem-solving meetings. Whenever we can start piloting the public fora will be great but it will need various stakeholders to agree to talk about what they do, what they need and what constraints they feel they face. I suspect that will take a lot of good natured volunteerism and more than a little pressure.

paul said...

“I think of this as a sort of analog wikipedia article where each person involved, from DDS, the regional center, public authority, hospital, vendor, family, etc. will have the opportunity to explain and defend their position to people presumably armed with the relevant documents.”

Interesting - everything is "worth a shot"

Doug,

Does your Wiki take sheer numbers alone to be successful, or is something else required (culture, particular values…etc)?

Is not the “opportunity to explain and defend ... position[s]” what we have now on all the vaious list-servers?

Do not our various internet venues, and Townhall Telemeetings, provide “a virtual public square, there is plenty of opportunity for each person's illusions to be corrected?”

Are they successful? Why - Why not?

I have seen Regional Center Directors provide some pretty innacurate information that went uncorrected on list-servers, and other public forums, that were well populated by vendors, families, and DDS.

Is something MORE than mere “opportunity?” needed for success?

As we speak, some Regional Center web pages contain incorrect eligibility information.

Undertanding who can and who cannot become a consumer is arguably the first step to having a ANY position about delivery of services…NO?

I have even seen an RC Director lie, not white. I have only seen a correction to a lie ONCE.

Wikipedia is all but completely anonymous. Is this important?

Do people decided whether to make corrections or apply accountability based upon an interlocutors social status or the influence and power and influence the interlocutor has over the life of a consumer, vendor, or family member?

How would your idea be different from the current CDCAN Townhall telemeetings, which invite ALL to participate?

stanley said...

[doug say] to do some of their problem solving publicly. This is one of the things I'm trying to help Marty to do... ID teams don't have referees, which is how I see the public functioning... it's important to have help organizing local public problem-solving meetings. (See dougs originals for context)

are we on the same page re a public referee... what would a public referee look like...would it perhaps be circle of support members for a person...

I am thinking specific action/process...not general discussion...ie/eg:

specific plans to organize local public problem-solving meetings...plans to have a public referee at an IDT meeting.

assume the public as a referee is different than local public problem-solving meetings...are there plans for such a meeting...dates, etc...

repeat comments/opine:

A well prepared IDT certainly a major factor, key...perhaps a PIP type training for IDTs...my feeling is this was the intent of Lanterman: IDT determine needs.

development of well prepared IDT should be prime focus...why not an IDT referee...not sure who the public would be at...say at an IPP meeting for my daughter

stanley seigler

paul said...

“ID teams don't have referees, which is how I see the public functioning.”

Doug et al,

I have noticed a tremendous difference between the “way things work” and the way things are, “intended to work” (pardon the conceit). Hence, the reason, I believe, we are so SHOCKED when the judiciary opines.

So – I ask you and others:

Exactly how do you (and any others) see the IPP process (IDT – planning team), as defined by Lanterman (the way it is “supposed to work”) vis-à-vis the way it actually works? (If you see a difference)

????????????????????

paul said...

Perhaps a better first question:

Doug & Stanley,

Who/what do you see as being part of the planning (ID) team/

Doug said...

Paul, just to make clear: By "analog" I mean this is not an internet thing but a public forum with faces or, at least, voices. I think it's the publicness that makes a difference. ID team meetings are, by default (and by law without the consent of the client) private affairs. That allows a lot to go unchallenged, unquestioned and unlearned from. It isn't as much that there need to be 20 or 200 or 20,000 people involved as that everyone involved has to know that 2 million could hear what is said. A lie or incorrect assertion will be public as long as this blog will be.

Stanley, I don't see this as a revision to existing regulations and practices. I think the normal IDteam meeting will remain private and confidential. But, if a few times a year, someone had a similar meeting publicly to track down the errors in the process, other private events can be better informed.

Paul, from my perspective the ID team is one (1) client. one (1) regional center staff person, plus whoever else the client wants at the meeting as well as anyone the regional center employee wants to bring and to whose presence the client consents. Sort of like dating, in that regard. Two parties + wingmen.

If you are asking for an optimum, I would say every ID team meeting is best if in addition to the two initial parties, there are also any service providers and any close family or intimate friends. A good ID team meeting can be very constructive.

paul said...

"ID team meetings are, by default (and by law without the consent of the client) private affairs. That allows a lot to go unchallenged, unquestioned and unlearned from."

Doug,

What is it in the IDT/IPP process that you believe, by personal knowledge or gut instinct, needs to be "challenged" or "questioned"?

I think I understand your solution, but I think that I missed the problem. Sorry.

Second - Since the IDT process is, as you say, a private affair, what to you proffer to "explain and defend [your] position?" that there is a problem?

Thanks

paul said...

?Is there a Problem?

PREFACE
In kindergarten adults tried to teach us that the rules are based on fairness and not outcomes. I have watched 4th graders make up some pretty creative games during recess. The game often results in a disgruntled participant. When I ask why so disgruntled I get, “what does disgruntled mean”, and then I get, “I was eliminated first, I got stuck with the joker, hit with the ball, or simply I lost – the rules aren't fair” Sometimes, in today's competitive world it is not the child that is complaining, but the coach, or soccer mom/dad.

Of course, the life of a consumer is not a game, but in many aspects the values behind the process are the same. The planning team’s objective should be designing an IPP that is most supportive of the needs of the consumer with public policy as the backdrop. The consumers wants and desire play a LARGE part in this process. BUT – the wants, needs, and desires of others, in regards to particular outcomes, should not define the process.

10 years ago an “advocate” said the following:

“Given real choices and information on how to make them, I believe there would be less consumers spending their lives in the family home, group homes, facilities, and institutions.” January 1999

Which means that IF “consumers spend their lives in the family home, group homes, facilities, and institutions,” then they were not “given real choices [or] information on how to make them”. POSSIBLY*, but more often it is “I was illuminated first, I got stuck with the joker, or simply I lost – the rules aren't fair” It is possibly Father knows best. It is possibly self-serving.

“Advocates” rarely advocate for SLS when they have a son or daughter in a Group Home, and rarely advocate for a Group Home when their son or daughter is in SLS. Why not?

If someone is not able to articulate or show an objective reason why the process is not fair then we need to at least suspect that is not the process that someone thinks is the problem, but the failure of a particular outcome to align with needs of someone other than the consumer.

*POSSIBLY
Sometimes the outcome itself is evidence of a flawed process. This is the “advocates” beloved position (the above is probably an example) – the “matter speaks for itself”. But – even this takes some work that most avoid.

QUESTION

Doug,

What would you say to someone that asks how your solution [public forum], absent a showing of a, problem, is not just another way of having an SLS provider, Group Home provider, ICF provider, VOR, CAPT, CAIC, ARC, CDCAN, PDQ, BGS, ABC, or XYZ get a chance influence the outcome rather than ensure the fidelity of the process?

Doug said...

Paul, I think I misleaned. I think it is right and good and proper and optimum that IDTs/IPPs are by default private. They should be.

But even the best format has problems. A problem that I see with the IDTs is one we can call the "Problem of the Comment," like blog comments (not yours, but generally across the known blogosphere) you have people introducing bias as fact, preference as necessity, etc.

Imagine I attend many IDT meetings. I can go to one with a client who is an expensive nuisance and wants to be taken once a week to a distant doctor where parking is expensive, and I can say "Really, we can't afford to take this client so far and the regulations prevent our letting the clients pay for gas and parking." Then I can go to the IDT meeting for a client who needs to be driven to a distant school three days per week and say "You know, we can do this if the client pays for parking and gasoline." In all likelihood, neither the SC nor the client will know what the actual rules are, what policy is or that I just said the opposite to a different client.

So I guess the point is that, while the meetings should be private, if we can correct some of the costs of that privacy by opening up a few conversations to scrutiny and criticism , we can strengthen the private meetings that normally and rightly occur.

Am I making sense yet? I think I know what I mean.

paul said...

Yes you are making complete sense.

However –

You identified a conclusion, what you call the "Problem of the Comment”. “people introducing bias as fact, preference as necessity, etc.” without providing for us anything to justify your conclusion.

You conclude that, “neither the SC nor the client will know what the actual rules are..” without providing for us anything to justify the conclusion.

I am not concerned, at this point, about the public vis-à-vis private.

My observations* is that in the past we have often drawn conclusions with little, and often no, basis. Then advocacy is focused on those conclusions [comment of “advocate” from previous post is just one example*]. The end result is often Gordian’s knot.

I am asking you, as you suggest above, to, “explain and defend [your] position” that IDTs generally (sometimes? most of the time?) "do not know what the actual rules are..” You have told use WHAT you think, but without an explanation and defense of WHY you think it you are asking the readers to take your conclusions and facts on faith.

While I have no trouble believing your every conclusion, supposition, or assumed premise my “lack of trouble” or affinity for your point of view [Truly – not blowing sunshine] does not change my underlying potential problem, a perhaps valid but unsound argument used to formulate a solution.

Second [getting ahead of myself]: As I have asked before, if “neither the SC nor the client will know what the actual rules are..” how does your solution, which draws more people FROM THE SAME WELL magically provide constructive “scrutiny and criticism”. IF 2/3rds of the IDT you describe above DOES NOT, “know what the actual rules are” how will your larger forum, drawn from the same well [or are you drawing water from elsewhere?] NOT provide participants for which 2/3rds are ignorant of, “what the actual rules are?”

I know that this is a BLOG, and likely not the forum, but I only hope that some forum, someplace, public or private, exists that demands an explanationof the WHY and not just the WHAT

*Doug,
Years ago I would "explain and defend" every assertion of fact and conclusion that I presented with citations, footnotes, and links. It was obnoxious to many and I took a lot of heckling from Andy. I quickly discovered that such things have little value with "advocates". Rather I have seen a great preference to build the facts around a conclusion.

Hence my skepticism.

Doug said...

Paul, your skepticism has a lot of merit. This is why I wish we would count and measure a little so that anecdata wasn't the only data.

I would point you to "In all likelihood" which was intended to soften the strength of the part you quoted. It is not always so, but in my experience has always been so, when the matter came up. A friend of mine who is an SC, when I bring up regulations likes to retort "Doug, I work at a regional center. What would I know about regulations?"

What I can tell you is that I have heard many things contrary to regulations stated as regulations and many things not written in formal policy, stated as formal policy. I'm not trying to pick on anyone either. A lot of clients and families have a lot of illusions about the rules. A good start for surveying this system might be a quiz for participants on what the statutes, regulations and policies actually say.

So, I offer my observations (TM) lacking any data and knowing that contrary data is unavailable. When I argue that the system starves for accountability and metrics, that's what I mean.

I can't tell you how much I appreciate being kept honest about this stuff. It comes much too easy to confuse what we think we see with what is. I do try to state my opinions as opinions, but you are absolutely right. What I state here is my impression and I can only defend myself by saying that I wish there was some information available to challenge my conclusions with.

I think I answered your second question, but I'll try again (not meant to sound cranky.) A cow that has been herded it's whole life is a herd animal. A wild cow tends to live more like deer. I think people who in small, private meetings might behave glibly will behave more rigorously in public gatherings.

Also, it's not like the rules are hidden in a vault. If I am correct, that many privately developed plans suffer because of misunderstanding of the rights and responsibilities of the parties, that is not because nobody knows the rules. More likely, nobody who knows the rules is in the room, or, worse, exactly one person who knows the rules is present. I think if you open the conversation, those who know the rules can inform those who don't. The goal is toward a better informed community.

paul said...

Doug,

Just when I think that the smell of the cow herd is to much to tolerate I get a breath of fresh air. - THANKS!

I believe that your premise, assumed or proven, that, “the system starves for accountability and metrics” is probably sound. As a side note I think that WHY we are starved is probably a more useful piece of information than the FACT that we are starved…

In other words - I am not so sure about other more critical assumption.

CAN WE ASSUME:

* That those that participate, those closest to people with disabilities, want to know the rules?

*That those closest to people with disabilities who don’t know the rules WANT or DESIRE to expend the necessary energy to be informed by those that do know the rules?

*That those closest to people with disabilities share your goal of, “a better informed community?”

IN SUM
Can we assume that those closest to people with disabilities want “accountability and metrics”?

The critical ingredient to the success of the Wiki project is Wiki’s culture (the Five Pillars and more…). Can we assume that our CULTURE contains the basics attributes necessary for a chance of success of any attempt to create a “better informed community?”

I believe that there is ample evidence that many have begun to behave as if they believed that they could accomplish more through disinformation than they can through a “better informed community”. The birth of the Advodiva. It has worked for the cable news talking heads eh…why not developmental services?

Of course – a yucky playing field should not hinder attempts to create, “a better informed community”!! Butbut – recognizing, appreciating, and RESPECTING the playing field for what it is (mud, manure, snow, AstroTurf, or grass) certainly helps…

EVERYONE,
Is the CULTURE of our community critical/relevant towards any attempt at creating a better informed commuity, and

Do we have the CULTURE that it takes to begin a movement towards “a better informed community”, and

If not – what do you think that we can do about changing this fact???

paul said...

One more obnoxious (well maybe not) post then my vacation ends…

This was recently passed on to me (just July), and I found it applicable to this discussion:

On a list-serve that is dedicated to Autism, which has been in existence since 1998 and has over 800 members, a participant posted the following:

“My son was diagnosed with PDD.....which I guess is a mild form of autism.”

To which the moderator, who apparently has, “worked with the most disabled in direct care for most of [his] life, but mostly with autistics.” Replies:

“The jury is out as to the relationship between autism and PDD but I suspect many PDD's are on the spectrum...”

The National Institute of Neurological Disorders says that:

“The diagnostic category of pervasive developmental disorders (PDD) refers to a group of disorders characterized by delays in the development of socialization and communication skills.

The Nation Institute of Mental Health says, and the DSM-IV agrees that:

“...two disorders were described and are today listed in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (fourth edition, text revision) as two of the five pervasive developmental disorders (PDD), more often referred to today as autism spectrum disorders (ASD).”

In Sum (and on Wikipedia):

“The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), refers to a group of five disorders.."

The three main forms of ASD are:
- Pervasive developmental disorder not otherwise specified (PDD-NOS), which includes atypical autism, and is the most common;

- Autism, the best-known;
- Asperger syndrome;
- Rett syndrome; and
- Childhood disintegrative disorder (CDD).

While the NIMH uses PDD and ASD interchangeably ASD is sometimes considered a sub-category of PDD and includes only:
1. autism
2. Asperger syndrome
3. Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), sometimes called atypical autism.

Also: Sometimes PDD is short for what really is PDD-NOS

FACTUAL MORAL OF THE STORY:

Autism IS a specific Pervasive Developmental Disorder
Most PDD’s ARE on the spectrum (except Rett syndrome; and
Childhood disintegrative disorder (CDD).

So what does it mean when the moderator of a 10 year old public forum re: autims informs a participant that, ““The jury is out as to the relationship between autism and PDD but I suspect many PDD's are on the spectrum...”?

What does it mean when/if a friendly correction is met with hostility?

What does this say about the greater “community’s” desire, or lack thereof, to be better informed.

If ANY of my definitions are wrong, if I am being mean, an arse, a jerk NOS, please tear me a new one.

While I understand that a diagnosis and labels are all but meaningless when it comes to service delivery and the development of an IPP by the planning team I suggest that the The National Institute of Neurological Disorders,The Nation Institute of Mental Health, and the DSM-IV are anlogous to the “rules”, Lanterman and regs...

What does it say when many can participate for years and still get the most fundamental peaces of information incorrect. An “autism expert” does not know what a PDD is (in the age of Google), and a Regional Center Director does not know some of the basics re: “fair hearing”, ..Et Cetera..Etc. etc…etc…

Doug said...

OK, my answer to your question: It says that people get away with being glib. That isn't unique to any particular community, but it is probably easier to be glib in a system like ours than in one where people can be easily held accountable.

Was a friendly correction met with hostility? The jury is out on hostile self-assurance being associated with working among populations with autism.

stanley said...

Many good thoughts, information here...to pick out a few:

[paul say] Is the CULTURE of our community critical/relevant towards any attempt at creating a better informed community, and...Do we have the CULTURE that it takes to begin a movement towards “a better informed community”, and...If not – what do you think that we can do about changing this fact???

I dunno...maybe a baby step is more discussion as on dougs blog...

not sure about the culture...eg, the culture kicked me off a list (caldd) and all on the list agreed with list owners (exec director, VMRC) decision (except maybe andy)...and my comments were very similar to those expressed here and on the autismca yahoo list

[doug say] Paul, I think I misleaned. I think it is right and good and proper and optimum that IDTs/IPPs are by default private. They should be...[doug say] So I guess the point is that, while the meetings should be private, if we can correct some of the costs of that privacy by opening up a few conversations to scrutiny and criticism , we can strengthen the private meetings that normally and rightly occur...from my perspective the ID team is one (1) client. one (1) regional center staff person, plus whoever else the client wants at the meeting as well as anyone the regional center employee wants to bring and to whose presence the client consents

IDTs/IPPs are by default private. They should be...well not sure...believe more open IDT mtgs would be another positive change...

in addition to IDT members mentioned by doug...perhaps DDS, AB reps...ABs need to be more involved w/ individuals...and DDS needs to be more aware of RC management details.

I would love to have had a DDS rep present at IPP mtg where RC PhD psychologist, after a 45 min meeting with my daughter, said she was not autistic...

this in conflict w/ Emory, UCLA, and pro bono Bevely Hills psychiatrist opines...not to mention 30 some years (at time of evalution) of living with kanner autism...not any spin offs.

finally DDS’ paul carleton had a discussion w/ NLACRC and fair hearing was canceled. Kath got 1:1 support...

she probably would lost a fair hearing...admin law judges have little to no understanding of needs...to them its all about cost...

wish paul carleton could have been appointed DDS director...he can be at Kath's IPP anytime.

Confidentiality laws, private meetings tend to protect the abusers and status quo-ers...any discussions that really should be private could be handled in an IDT executive type session.

oh/btw...there is much just disdain re lack of DD community knowledge...not an excuse but it s also disdaining is the lack of knowledge in most of society's disciplines...ie/eg;

many think the free market is the path to nirvana...in fact the economy has done better under tax and spend donkeys than GOP elephants.

stanley seigler

Ps. hope others read the ideas/thoughts expressed here...including st nick, e. bunny, t. fairy and wonderland/oz citizens...the time has come to speak of cabbages and kings, etc, etc...

paul said...

Glib, glibly and glibness..

It does seem to distill down to this and the more systemic and problematic…The fact that people, “get away with being glib.” Far too easily…

So – people may care, but not enough to expend the energy not to be glib.

Or – they care more about appearing to care. Being a glibber would be the shortest means to this desired ends (delusional or not),

Or?
...no?

stanley said...

Something to consider when looking for solutions

[paul say] So – people may care, but not enough to expend the energy not to be glib.

not an excuse but oft wonder where people who survive from paycheck to paycheck and live with a child that sleeps 4 hrs in 24 and screams most of the time whiles awake finds time/energy to care enough not to be glib...

some, maybe many do.

stanley seigler

paul said...

“… wonder where people who survive from paycheck to paycheck and live with a child that sleeps 4 hrs in 24 and screams most of the time whiles awake finds time/energy to care enough not to be glib...”
stanley

I doubt that such an archetype/stereotype has the time to be glib, let alone not….and if they do, what you describe is certainly a good “excuse”.

However, excuses, no matter how understandable, do not dismiss the potentail fact that glibeness is likely a large barrier to a “better informed community”.

stanley said...

[paul say] However, excuses, no matter how understandable, do not dismiss the potential fact that glibness is likely a large barrier to a “better informed community”.

Perhaps...but glibness (whatever that implies) pales by comparison to the bs documented in your timeline documentary (the bs by those paid to implement Lanterman)...and the paid advocacy mislead of the stakeholders re workforce legislation...ie;

glibness not a likely large barrier...certainly not a fact...perhaps:

an example that leads you to believe glibness a large barrier would be helpful to insure barriers are addressed in order of their importance...

of course guess the elephant could be eaten in one bite...being great progress has been made addressing real issues to date...OR

if you refer to your and andy's glibness...perhaps it is a large barrier to a “better informed community”...enjoy it tho...even the teasing of an old man.

stanley seigler

stanley said...

[stanley said] glibness not a likely large barrier...certainly not a fact...

on second thought maybe it is...I was playing humpty dumpty and defined glibness as cuteness...as in too cute by a half.

if an actual definition Characterized by fluency of speech or writing that often suggests insincerity, superficiality, or a lack of concern...was intended, then;

glibness is a likely a large barrier...further, bs in pauls timeline documentary (ARCA’s defense of change in DD eligibility) and CRA’s mislead of the stakeholders re SEIU workforce legislation are examples of glibness...tho;

these examples demonstrat little fluency in speech...see them more closely related to bs.

stanley seigler

paul said...

“see them more closely related to bs."
Stanley

“Know Your Audience”

I am told that this a major, if not #1, rule to public speaking.

In any case, I think that the BSers follow the rule very well. Such BS is much harder to peddle when the audience is thoughtful, careful, or thorough.

An RC director cannot BS about the regulations if he/she believed that ANYONE would actually take 10 minutes and use the easily searchable Title 17 on DDS website to “check it out”,

BSers shovel it someplace, and that place is on the heads of people that are thoughtless in their response or accountability – the glib. It is shoveled here because people ALLOW IT.

BSers cannot survive without an audience, and they have that audience in people that respond to potential IHSS abuse with, ”Nah ah”, or the failure of a district court to grant a preliminary injunction with “Dumb judge”

stanley said...

[paul say] BSers cannot survive without an audience, and they have that audience in people that respond to potential IHSS abuse with, ”Nah ah”, or the failure of a district court to grant a preliminary injunction with “Dumb judge”

unsure what ‘nah ah’ means...but if meant to imply anyone believes IHSS fraud does not exist or should not be addressed...then the bsers have an audience...it consist of those who use glibness to mislead...for surely the misleaders don't believe anyone believes IHSS fraud should not be addressed

the response to the IHSS fraud issue was/is: sure it exist. address/eliminate it. but NOT with cuts to human services...they did not believe the govs bs/glibness that IHSS cuts were THE answer to a balanced budget (see Gov's Bum Rap on IHSS http://groups.yahoo.com/group/DDRIGHTS/message/5126)...and;

have only heard one person respond with dumb judge...so

the gibbers/bsers have an audience of one cynical old man who was kicked off a bsers list with full approval of their glib a-hole buddies...btw;

I stand by my opine of the judge...weel will retract, apologize and restate: the decision was dumb...perhaps judge has made many brilliant decisions...and maybe one can explain how this was a brilliant decision also.

btwbtw so far all cuts to IHSS/human services have done to eliminate IHSS fraud is to revise IHSS Provider Timesheet...anyone believe this will eliminate fraud...there are bridges they can buy.
http://groups.yahoo.com/group/DDRIGHTS/message/5211

repeat:[paul say] BSers cannot survive without an audience, and they have that audience in people that respond to potential IHSS abuse with, ”Nah ah”, or the failure of a district court to grant a preliminary injunction with “Dumb judge”

based on dumb judge response example...they have that audience in one cynical old man with whom no one agrees...guess i should be flattered...tho confused by the logic...or lack there of.

Ok-well-so...there is a larger audience, tho not represented by pauls examples. Bsers/glibbers audience is more likely represented by:

those who believe the govs bs re his budget fixes; those who believed CRA's bs re workforce legislation; those who allowed ARCA to change DD eligibility criteria; and those who believe the judges decision re a preliminary injunction was brilliant.

stanley seigler

paul said...

“I stand by my opine of the judge...weel will retract, apologize and restate: the decision was dumb...perhaps judge has made many brilliant decisions...and maybe one can explain how this was a brilliant decision also.”
Stanley Seigler

Stanley,

I am not yet familiar with a anyone that has stated that the judges decision was, “brilliant”. However, should you find such a person you should ask them to explain. Until that time you are crediting “someone” with something only you said and you are asking “someone” to explain something that was said only by you[????????]

Personally, I do not think that we have a dichotomy between dumb and brilliant. Most decision are in the boring zone that is in between this false dichotomy.

Preliminary injunction, permanent injunction, motion for judgment on the pleadings, summary judgement, judgment as a matter of law, Judgement N.O.V., etc…are technical, boring, and only something that someone like Andy can adore and love.

A plaintiff seeking a preliminary injunction must show that the plaintiff is:

1. likely to succeed on the merits,
2. likely to suffer irreparable harm in the absence of the injunction,
3. that the balance of equities tips in plaintiffs favor, and
4. that an injunction is in the public interest.

Any person making a decision in this matter (judge), or any person having an opinion about the ruling (“restate: the decision was dumb...”) that is not thoughtless, superficial, or insincere – aka GLIB, must look at the evidence, expert testimony…etc., and apply the “rules” above. At the very least a person that believes , “the decision was dumb” must be familiar with the judges rational.

Are you familiar with the evidence or expert testimony offered by the plaintiff?

Are you familiar with the judges rational?

If so - will you please explain why you think that the judges “decision was dumb?”

Doug said...

OK, a little light hosting from the blogger:

Stanley, there are good reasons that clients who want private meetings ought to get them. And there are always problems with client choice. If a client feels abused, misused or underserved by their provider, they might want to tell the SC that without said provider standing there with ball and gag. If the client feels abused, mistreated, etc. by his/her father, likewise. But, if a few brave pioneers would open their IPP/IDT meetings to the public, I think a lot could be learned of value in private meetings. It's also worth remembering that an unknown percentage (I'm guessing between 10 and 90, although there's no data to support my guess) of IPP/IDT meetings go satisfactorily for everyone. Before we add a costly referee to the process, I'd be interested to find out how many aren't happy with the process now.

By the way, what were you thinking taking your daughter to Emory? Only a fool would go there. (Class of '95, employee '92-'97)

Paul, yes. Definitely. Just as one example, how often do people say in public that we're the first ones cut and the last to have our funding restored. I think the rule is that accountability for accuracy is inversely proportional to the popularity of the sentiment. Though I'd like to see the raw data.

Stan, nobody ought to feel obliged to know any particular set of facts that they don't wish to speak of. What annoys me, and I think Paul as well, is the form of advocacy which encourages or antagonizes change based on unchallenged and unsupported assumptions. Problems identified that way are unlikely to be solved that way.

I agree, Paul.

Stanley, I agree with your examples and I might add some in which the SEIU was glib, but there seems to me to be a culture in our advocacy that welcomes, for example, CRA/CDSA to raise high alarm when SEIU does anything at all. I think that invitation also helps explain why SDS can't get off the ground, why the only reforms that seem to pass are rate-cuts, eligibility challenges and the narrowing of the entitlement. I have to think we could make wiser changes to our system if we were a little less democratic in defining current reality.

Just so, Paul.

Right, Stanley, BS is a cultural environment. I happen to agree that IHSS fraud may well be a big problem and may not be aligned at all with severity of a disability, which means the solution might not address the problem. I'd add that if the judge is right on the law, you haven't drained the BS swamp by thinking his or her decision was wrong.

OK, Paul, true and we are nice to my friend, Stanley.

stanley said...

[paul say] Personally, I do not think that we have a dichotomy between dumb and brilliant. Most decision are in the boring zone that is in between this false dichotomy...Preliminary injunction, permanent injunction, motion for judgment on the pleadings, summary judgement, judgment as a matter of law, Judgement N.O.V., etc...are technical, boring, and only something that someone like Andy can adore and love.

Believe paul (not andy) adores and loves boring, legal, semantic, technical minutia...and have no doubt paul is technically correct...but;

hope sotomayer lied to the senate and she will indeed apply empathy to the law and it will filter down to the lower courts in Gods lifetime.

In the opine of a cynical old man who no one pays attention: any legal opine that supports dumb political moves...(eg, cutting IHSS funding to fix budget) is dumb, immoral and criminal in the HiHigh Court...if there is one and the HiJudge (She, maybe) truly has empathy.

In any event legal technicalities should not be our idols...truth/compassion should be the goal of law...oh/btw;

The judges decision was a not boring technicalities to those w/ special needs...compassionate decisions are crucial to their survival...but who cares as long as there are CYA technicalities...and we can endlessly discuss semantics.

Moving on to off topic: [doug say] By the way, what were you thinking taking your daughter to Emory? Only a fool would go there. (Class of '95, employee '92-'97)

As well known emory is one of the nations top schools and medical centers...kath born in atlanta...chief of pediatrics st josephs there said it was just colic and we were young parents...so took kath to emory...neurologist was a cold but brilliant fish...immediately said it was autism...then visit with emory psychiatrist headed us to ucla for treatment/cure (HA)...planned on being there 3 years...that was 1968...

oh, they also have a good trade school (gatech 1959) in atlanta and another top college (morehouse) mainly black students in my time...and agnes scott for the debutantes.

stanley seigler

paul said...

Stanley,

I think that the first step to making things they way they ‘ought’ to be is understanding how things ARE. This is also a first step to a “better informed community”

I think that the first step in understanding the way things ARE is understanding that any comments by a poster, opinion or fact, about the way things ARE is not necessarily a reflection upon a poster’s feelings re:

The sky is blue. This does not mean that blue is my favorite colour, or that I adore the sky or the sky is my idol.

I also doubt that “lying”, or hoping for it, will improve much.

Doug said...

Sure, Stan. I was kidding about Emory and I know the reputation the hospital enjoys. Just poking fun because my degree is from there, too.

Paul, why do you hate blue?

stanley said...

[paul say] The sky is blue

agree...

[paul also] I also doubt that “lying”, or hoping for it, will improve much.

I also say: NO doubt, my lying/hoping or not lying, will NOT improve anything...sotomayer’s lying (to senate how she would interpret law) might result in a kinder justice for all. she might apply empathy and common sense vice javert’s justice...

vice dumb decisions as one that condemned IHSS workers to poverty wages and special needs folks to very questionable support/care.

there are many ways to eliminate fraud vice cutting IHSS wages...one, eg, enforce current laws...cutting wages punishes the innocent and does nothing to correct to problem.

it was a dumb fix and a dumb decision

stanley seigler

it's not me it's you said...

“Paul, why do you hate blue?”

Doug,

Please pay attention!!!

It is clear that I hate the entire rainbow, as well as People with disabilities, my mother, mother nature, God, and Humanity generally. AND – Stanley is my only friend to boot!!!

Butbut - the issue is not me.

Why do you love blue!!

paul said...

Where does "too cute by a half" come from?"

and what does it mean? 150%?

Anyone?

Doug said...

Stanley, I think we can all agree on the dumb fix part. I'll do so even before I remember which fix we're talking about.

Paul, what proof do you have that I love blue? I do like your mother, though.

OK, guys, I'll try to get a new post up so. I think the law of diminishing marginal returns affects this thread.

Andrew said...

Nice to know that two people are thinking of me when I'm not around ...apparently, you're not one of 'em, Doug.

Stan, regarding your banishment from lesser listserv ... I recall Paulie leaping to your defense and storming the walls alone, at first.

I straggled into camp a while later, looked around and saw that the place was, "like nowhere's-ville, man ...where are the camp girls?" I lobbed a couple of plague-riddled corpses over the wall (the lowest part, by the way), and then ambled off to Doug-ville, where I soon found that I "dug Doug ... ya dig?"

And you'll get no pity points from me, Pops ... getting booted from such a list is like being the first flea to flee ... to find a fine new host, on the silken porceline (not porcine!) skin of the youngest legal, camp laundress.

Paul, I only derided your footnotes because I knew there were guys out there with considerably bigger footnotes ... footnotes that could go on and on for pages ... and a tad more impressive than those little "ibids" of yours.

Doug, whose lawn does a fella have to mow to get an envite to your public IPP's? .... I'm asking for a friend!

... by the way, that cologne is dynomite. Well-suited to your rough-hewn, ranch hand philosopher persona. And as soon as you tire of my mangling of mixed metaphors (or all too altruistic aliterations) you need only say the word, and they're gone! ... banished! forever expelled from the light, like some obnoxious crank from a lame listserv.

By the way, I think mixed metaphors are still illegal in a few Southern states. (... yet another, for chrissakes! I just can't help it sometimes ...it's turning into a nervous tic ... seeking a perfectly porcine patroness)

Thinking of you other two as well,

Andy

stanley said...

[andy say]...

danged if I know...but

know what he should not have said: [andy say] I recall Paulie leaping to your defense and storming the walls alone, at first.

should have let sleeping dogs lie...one reason it leaves your recall in question.

From kick off time paulie opined: [paul say] I will understand and support any decision that Dick Jacobs makes...most agree that the Union [the list] might very well have fallen if Lincoln [dick] did not take this step http://groups.yahoo.com/group/DDRIGHTS/message/4367

reflection on some other storming wall comments in the ref (DDRights message 4367) above might provide insight to group thinkers...the audience of the bsers/glibers...paul is really not one of them, but sometimes its difficult to tell the difference.

comparing dick to lincoln is beyond the pale...and the list did fall.

stanley seigler

paul said...

“comparing dick to lincoln is beyond the pale”

Stanley,

You are losing your edge.

You forgot the part where I basically, by inference, in not so many words, said/implied that Dick is twice as honest as old Abe, and basically, by inference, in not so many words, said/implied that Dick can make a rock that God cannot move.

Interpolation said...

Interpolation
Is there a vaccine against it?

"I personally would choose NOT to ban an individual from the list. However,
personally I have been offended only once by our alleged transgressor
(officially ;>). I will understand and support any decision that Dick
Jacobs makes, for it is he, as creator of the list, has the burdens and
obligations associated…. Furthermore, such subjects are truly “frontier”
subjects and I am certainly not qualified to judge"

Boot Boo!! said...

"30 days ago I would not have recognized ANY reason to ban someone from a
list server, and I would have provided several arguments against such an
act. However, Stanley’s behavior over the last 4 weeks in the very
least “challenge” my arguments.

I too am uncomfortable with this act, and I too fear the slippery slope.
Could we compromise with a 90-day suspension? I don’t know… Was Stanley
given any formal warning?"


Ah - the flea circus - such fond memories. I cannot believe that I was so naive..."warning"!!! "90 days"!!! What was I thinking??

What did Justice Potter say about flamers

"I shall not today attempt further to define the kinds of material I understand to be embraced within that shorthand description; and perhaps I could never succeed in intelligibly doing so.
But I know it when I see it, and Boo is definitely spot on"


paid for by the committe to Boot Boo

stanley said...

[paul say] paul said...Interpolation said...Interpolation; Boot Boo!! Said

say what...

[stanley say] know what he [andy] should not have said: I recall Paulie leaping to your defense and storming the walls alone, at first.

does boot boo rant improve your recall, andy...in any event will put sleeping dog back to sleep on this blog...but

a review of the context re paulie’s storming the walls defense...provide insights to group think and the group think audience, bsers/glibers have...if interested goto DDRights@yahoogroups.com

I could care less about any defense...it is not about me...

it's sadly humorous, cal-dd/paul made/make me the issue.

stanley seigler

stanley said...

[andy say] And as soon as you tire of my mangling of mixed metaphors (or all too altruistic aliterations) you need only say the word, and they're gone! ... banished! forever expelled from the light, like some obnoxious crank from a lame listserv.

Before THE WORD, let there be light:

Back to the topic/issue or at least a corollary: the Interdisciplinary Team (IDT)...a review of some IDT thoughts here with a action plan,to the barricade, in mind is worthwhile...

stanley seigler

paul said...

Stanley,

Some of my comments, in this thread, were meant to be “too cute by a half”, whatever that means. I will be serious (disclaimer: only for the moment)

Time and time and time again you place yourself in “the subject” bright light. When people respond to your input you complain, “I am not the issue”

This thread was traveling well. It did not involve your kick from cal-dd nor did it call anyone an ass hole (spelling it a-hole doesn’t make it something less) until you posted the following:

“the gibbers/bsers have an audience of one cynical old man who was kicked off a bsers list with full approval of their glib a-hole buddies...btw;”

Stanley,

If you breach a subject (BTW) be a grown up and expect responses. We can put you on extinction, but that is treating you like a child, and I hope that you will not ask that of me or others.

If you are going to hide behind “old man” then I suggest you begin to act like one

Doug said...

Andy, if they happen, the public IPPs are expected to be broadcast by internet feed. Of course, my friend, you will be invited in person if I hold one and I hope to be invited in person if you hold one.

As for whatever happened on whatever listserv or blog, I don't know what you guys are talking about so I'm skipping this part after welcoming Boo!! Boo!! and Interpolation.

stanley said...

[paul say] boot boo, whatever...

sigh oh my...bless your heart, too cute by half child.

stanley seigler

Andrew said...

Most Gracious Host wrote: As for whatever happened on whatever listserv or blog, I don't know what you guys are talking about ...

You're kidding, right? How could you not know? ... Ever hear of Armageddon?

The Trail of Tears runs through your living room, and you somehow miss it?

The multitudes fill your front yard and bear witness to the Passion, climb your roof for the crucifixion, and stand beneath your rolled up garage door in stunned amazement of the resurrection ... and you're too preoccupied with blogging or Biercing to notice anything odd or amiss around the hacienda?

My dear friend, don’t you think the time has finally come to wake up and smell the genocide?

... or, at least, a dilligent revisiting of "The Rape of the Lock."

-- Surprised in Santa Cruz

stanley said...

[ap say] You're kidding, right? How could you not know? ... Ever hear of Armageddon?

[ap say] But when to Mischief andy bends his Will,
How soon he finds fit Instruments of Ill!


Why you mock trials and tribulations of a childish old man hiding behind an old man...

guess, impossible to bend your will to DD issues...

not surprised in neverland...

stanley seigler

Doug said...

Stanley, you're safe here, old feller.

Andy, I find your summaries most helpful when I already know what the hell you're talking about.

Stanley, nice line. I couldn't be prouder than to have Pope cited and a heroic couplet in my comments section.

For while we strike, bite and shuffle,
Our purpose lost amid scuffle,
O'er all must stand the humane cause
For which we wet our busy claws.

Andrew said...

Most (of the time) Gracious Host says ... Andy, I find your summaries most helpful when I already know what the hell you're talking about.

Yeah, sure ... you're telling me you understand all that "boy stood on the burning deck" blather, yet you find ME? confusing!

Hey, if I'm such a bewilderbeast how could I have become a manager... and a boss of all I survey? ... Let alone ascend to the rarified heights of Service Provider o f the Year 2003 !

You don't take your seat in the middle of the head table in the Pantheon of Provision and Billing, by leaving a trail of scratched heads in your wake ... on your march to managerial mastery, magnificience

Any time I even dream I may have been anything less than absolutely, incontrovertibly, transpicuous, I double my Meth habit and explain everything in at least six different, distinct and defining ways. ...

You can be assured, no one walks or runs away without a very clear conception of exactly what it is I have in my head ... and it's not peanuts by the peck!

Stanley, you must take some small comfort--whether cold or caliente--from the precipitious and permanent coma the old Eden fell into upon your Fall.

Yeah, yeah, I know, ... it's not about you ... it's about those "differently deified" folks on the short end of the stick. Anyway, you left with an honorable discharge, in my book ... they can't brand an eagle ...

..."... What do you do when you're Bandded, when you know you're a man ..."

... confusing!

(...) Confuse, this, why don't you1 ?... what's so crazy and confounding about Chuck Conners! (???)

(... played ever so briefly for the Dodgers, didn't he Stanton?)

---stone, cold clear in Santa Cruz

too cut by 3/4 *-*o*e budy said...

WOW! 50 replies

(marching band music sounds)

stanley said...

[andy say] honorable discharge, in my book ... they can't brand an eagle ...

apologies for more off topic comments...but feel I must acknowledge my eulogy by andy...thanks; however I am just old not dead...in my mind I still make the long throw (to maybe chuck conners at first) from deep in the hole at short for the out.

Will let you know when I make the final “installment” and say “no uncle”.

stanley seigler

too cute by a whole/hole said...

“apologies for more off topic comments...but feel I must acknowledge my eulogy by andy...thanks;”

I FINALLY GET IT!!

Change of topic is OK, and it is OK to have stanley be the “issue” IF comments about the issue/topic involve sugar and spice and everything nice.

Sorry so obtuse…still a chance for a “fat ugly man” to learn from a GREAT-BUNS OF STEAL “old man”

stanley said...

[paul aka whatever say] I FINALLY GET IT!!

bless yo heart child...oh if you only did...what a wonderful blog this would be...

my last off topic on this blog...goto DDRights@yahoogroups if interested...again apologies to blog for prolonging this bs...

stanley seigler

Doug said...

Andy, I should add I appreciate the heck out of you even when I have no doggone idea what you're saying. That was a good laugh.

Paul, does this make me a real blogger?

Stanley, in my mind I still disappoint Mudville.

Indeed, Paul.

OK, guys. Feel free to continue the group hug. No more moderation is needed on this post, I assume.

paul said...

"No more moderation is needed on this post, I assume."

You know what they say about assume.

Andy is trying to steal my best friend with group think!

paul said...

sorry - technically it is only group think when Andy agrees with "others" but you know what I mean...