Organic farming and row crops.

In some ways, the DDS system is the future of effective government, depending on entitled rights and an engaged private sector to serve the needs of a challenged population. The mission of the whole edifice is to sprawl, broad and variable enough that each person served can find their own access point to the help they need for their challenges and aspirations. An organic approach like this parallels innovations in the business world where individualization has proven more efficient in many scenarios than the standardization that the industrial revolution brought and maintained.

The culture of government, however, has trouble with risk and risk is synonymous with variation. So, having envisioned an ecology of support, the organs of government soon fall back to establish control and order. Instead of encouraging relatively unfettered innovation, the regulations develop over time to specify the types of service available and to constrain the freedom of the service providers, rather than specifying outcomes and allowing competing and co-existing models for delivering such. For example, if you compare the older regulations governing Independent Living Services with those governing Supported Living Services, their are significantly more barriers established in the latter. Consequently, individuals who would be classic supported living clients may receive Independent Living Services instead as a result of, perhaps, economic or health risks which result in sometimes leaving apartments to stay long-term with family.

Over time, the instinct at regional centers has often been to harden and sharpen the distinctions. For example, to deny any individualized living support or training to individuals who live with their families or in group homes, which often has the effect of limiting people to their current setting. The consequence has tended to be to regiment the people served rather than to liberate them.

Risk and Marginal Benefit-a new service plan

Today is my jet-lag recovery day. On the Doug is Goofy scale from 9 to 10, I think I'm at 9.91 this morning. Here are some thoughts about system reform from my vacation (Yes, I am that sorry.)

One concern I keep coming back to is the way the system is constructed to encourage innovation, individualism and creativity except the system of "accountability," which strongly discourages, um, innovation, individualism, creativity.

My sense is that the system as a whole is inefficient and ineffective because the mission is so expansive but the process for reward and correction is so constricting.

So I would offer these suggestions"

1. Service planning and evaluation should be specifically related in the regulations.
2, Service planning should distinguish between goals which allow for a great deal of variation in results (risk-seeking or risk neutral,) goals which should be pursued with some specificity while allowing for some defined variation in acceptable results (risk vs. reward) and goals which should be strictly defined in terms of outcome (risk averse.)
3. Service planning should include a hierarchy of benefit so that success can be usefully evaluated not in terms of box-checking but in terms of how the client experiences life and how the community experiences the client. On my vacation I was thinking about adapting Earned Value Analysis, a tool used in project management for service evaluation. I'm sure I'll write something fascinating about that next time the Doug is Goofy Scale falls back to 9.5 or so.