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.