Wednesday, October 7, 2009

I Demand We Think About Demand Management!

It is time to start using Demand Management as part of a plan to provide services for individuals with cognitive and developmental disabilities here in Colorado and across the nation.

Let’s have a hypothetical conversation so I can explain more.

Hypothetical You: What exactly are you talking about?

Hypothetical Me: Let’s start with the basics: Demand Management uses strategies to control the demand for a fixed resource, rather than supply more of the resource.

You: Ummm . . . OK. What does that mean?

Me: You actually see Demand Management everyday. Here’s one example: have you ever tried to merge on to a major highway from an arterial road during rush hour? Chances are there were some traffic lights there to control how quickly you could actually get on the highway. Now, have you noticed that those traffic lights aren’t operating during slower times?

This is how traffic planners manage your demand for using the road. When the demand is the highest, they slow up access. Urban planners realized awhile back they can’t continue to add more lanes of traffic (supplying more resource) forever, so instead they focused on limiting availability of the resource (thereby controlling demand).

And those traffic lights on exits are only one example of how Demand Management works in traffic management. Transportation Demand Management techniques can also include increasing transportation choices, adopting land use patterns that encourage non-automobile forms of transportation, and trip reduction or carpooling programs.

Without Demand Management, we would potentially be facing traffic like this:

You: That makes sense. But why should Demand Management be applied to our world, the world of services for people with cognitive and developmental disabilities?

Me: Quite simply, we have a much higher demand for resources than we have resources available. That is the case in Colorado and across the country, and it isn’t going to be changing any time soon. And sadly, we don’t even know what the actual demand is. And because of that, we can’t really measure how to get the best rate of return on the limited amount of resources we do have, let alone explore other options of funding and service delivery.

You: Sounds great to talk about, but how would we ever actually make it work?

Me: There is already a successful model of how Demand Management can be used in the provision of services for individuals with cognitive delays and disabilities right here in Colorado: our Early Intervention (EI) Services. Every eligible child in EI is assessed for need, as well as on a hierarchy of specific needs. So the area of need that most requires addressing in each individual child is targeted first.

I’m not saying that every child gets everything they need, but every child’s needs are addressed. These can be tough choices, but in an environment of limited resources, those choices need to be made.

And because there is good data in terms of who needs what, opportunities have arisen to explore other funding options. In fact, federal guidelines recommend that IFSP planning teams explore possible funding sources for EI services that have been agreed upon by the team in the following order of priority: the general rule is that family resources, private and public insurance programs are first. Second are specialized programs for specific purposes and populations. Last are the most flexible state and federal funds that are used to fill the gaps.

Because they are practicing Demand Management techniques, the EI system has a good grasp on demand, and therefore can make reasonable projections regarding the costs to each of the above funding sources, and then determine what kind of services can be provided to whom.

You: OK, how can we make this work elsewhere?

Me: Well, here’s where I don’t have an answer. We do not have the knowledge we need in adult services to practice Demand Management. For example, how many people are eligible?; what are their assessed needs?; is the number of eligible people increasing?; are the resources increasing?; diversifying?; how does the need change as the eligible person ages?. To make informed decision about this system of services, the lack of this kind of knowledge is unacceptable. Then we can get to the tough question.

It is a tough question. Do we direct the limited resources to those who have the most need,?; those that have been waiting the longest?; the oldest or youngest?; Or do we direct resources to those with less need, but who may be better positioned to work or contribute with a little assistance?

Truthfully, this is a conversation that can’t even take place in real life because we don’t know the true demand well enough.

Hence, the hypothetical conversation.

But I would strongly argue that we should build Demand Management techniques into our services. We know the demand is way beyond than the available resources to meet that demand as the system is currently structured. We need to explore new options and approaches, and Demand Management has worked in other systems and might get us where we need to be next..

You: Then again, what do you know?

Me: Exactly.

No comments:

Post a Comment