What sort of challenges? How about the fact that individuals with developmental disabilities are living longer than ever, and as they age, their needs are becoming increasingly complex? In addition, with the “silver tsunami” of retiring and aging baby boomers approaching, the demand for services for seniors is increasing rapidly. Meanwhile, the workforce available to meet this increased demand continues to shrink.
And how is the landscape changing? Well, there is no doubt that technological advances have opened the door to opportunities for the individuals that we serve that simply didn’t exist a few short years ago. Additionally, the internet and social media have made families and the people we serve savvier and more informed about the choices available to them than ever before. With that increased knowledge comes an increase in expectations about the quality and availability of services.
Now, I don’t claim to be the only one to have recognized these trends, which seem to be creating a perfect storm that will irreversibly change the way services are delivered to some of our most vulnerable citizens. Many government agencies, providers, and advocacy groups are looking into the future and trying to make plans to ensure the individuals we serve don’t get lost in that storm.
I am encouraged by this, but I also want to make sure we all do our due diligence before moving forward too quickly with any one approach. I say that because I wonder if right now we are moving in one direction, and one direction only, without exploring a variety of options.
What direction is that? It is what we might call the “big bucket” direction. Government, both locally and nationally, seems to be pushing to consolidate administration of services for individuals with a wide variety of disabilities along with aging individuals – putting them all in one big administrative bucket. I am unsure of the argument. Maybe this will make it easier to administer, and navigate, programs and services by eliminating red tape. In this direction, the changes in funding and services will mainly come from centralized regulatory and policy-making perspective.
Now perhaps this “big bucket” direction is the best option. But let me at least consider an alternative – a direction we might call “divide and conquer.” In this direction, rather than lumping every disability (and aging) population into a “one size fits all” giant bucket, maybe it might make sense to separate the buckets so we can more precisely meet the incredibly diverse needs of these unique populations. With this direction, change is more likely to be driven by providers, families, and the individuals we serve, resulting in more self-determined outcomes.
Let me give you an analogy. Let’s talk about how our country has evolved in terms of how we dispose of our garbage (and let me be clear – I am not equating the population we serve with trash. Rather, I am looking at a historical example of a “big bucket” versus a “divide and conquer” approach to solving a problem). Back when I was young, nobody ever talked about recycling or composting. You threw all your trash in the trash can, and the garbage men came and picked it up and took it to the landfill. This was a “big bucket” approach.
Eventually, however, our society began to realize that we were running out of space, and there may be value in selected items being tossed. And slowly, a movement began to grow that encouraged people to recycle and compost. Not everything had to be trash. Some items had value and could be reused and repurposed. This movement was driven by the providers, such as Western Disposal. They educated the end-users. Making recycling and composting possible was the fact that some companies began to realize that they could make money in the recycling business. Ultimately, the movement toward a society that is much more focused on recycling was not fueled by government regulations, but rather by companies that could profit from recycling combined with a public that saw benefit in limiting the number (and size) of trash piles in their communities.
It is distinctly possible that our society could also benefit from an approach to services that doesn’t try to make every population in need fit into a single bucket.
So I encourage everyone involved in the decision making process about how we move forward with the design of our system to do their homework and ask the hard questions. Is one bucket really the way to go when it comes to serving the needs of such a diverse population? Will it really be more efficient or cost effective? Better for the end-user? Or perhaps we should consider having more than one big bucket. Maybe we should have several buckets, a bucket list of a different sort, if you will.
The important discussions surrounding the future of services are finally taking place. Let’s make sure the discussions are thorough and that we consider all alternatives before making any final decisions.
There is so much at stake. Then again, what do I know?
Great article, Mark!
ReplyDelete