Wednesday, December 30, 2009

More On How The Current System Emphasizes The Disability

I came across this article in the paper on Sunday. It is a good example of how the Medicaid system is set up to emphasize the disability, rather than to focus on developing and supporting a person’s strengths and abilities (a flaw in the system I discuss here). While the disability in this case is not a developmental disability, the decision making process for funding services appears to be (sadly) the same.

Monday, December 28, 2009

Coming Attractions

Last week I posted my “wish list” for Santa. Some of you eagle-eyed readers may have noticed that it was really just a recap of some of my earlier 2009 blog postings.

In the same spirit, as I look forward to the New Year, I’d like to give a preview of some of the topics regarding the system of services for individuals with cognitive and developmental disabilities in Colorado and our nation I’d like to discuss in this forum.

Before I do that, though, I want to encourage all of you readers to make comments on my rants in the coming year. To push back. To tell me that I’m right when I’m right and that I’m wrong when I’m wrong. I’m not kidding when I say, “Then again, what do I know?” I don’t claim to have all the answers. Instead, I hope this blog can serve as a starting point for civil and productive discussion, not as the final word handed down from on high.

I hope you will join in the conversation as we explore complicated issues in 2010, including:

• Why I think we’ll see more examples of families and consumers facing dire circumstances as a result of system changes and funding cuts.

• Why we need to heed the advice I always give to my kids: “Don’t buy a car you can’t afford to maintain.”

• Why enrollment in employment services has dropped dramatically.

• What are we going to do with adults who have needs that can’t be met by the three models of residential care currently funded by Medicaid (
PCAs , Group Homes, and Host Homes)?

• What the community can do to help alleviate some of the problems facing the DD system.

• How the fractures in our community make it more difficult to find lasting solutions.

• What role Case Management should play in service delivery.

• Whose problem is this anyway?

In the meantime, I hope you all have a very happy new year.

Monday, December 21, 2009

My List for Santa

‘Tis the season to put together a wish list for Santa. Below is a list of a few things I’m asking for this year.

I’ve tried to be good this year, but you just never know. So maybe if Santa can’t deliver them to me, we can all work together to make the wishes on this list a reality, and not just for the holidays but for all seasons.

1) Those of us interested in solving some of the problems facing the system of service provision and delivery for people with developmental disabilities in Colorado work together to develop a synchronized, coordinated effort to address those problems.

2) We stop using a system of funding for people with developmental disabilities that emphasizes the disability.

3) We use Demand Management techniques as part of our service provision and delivery system so we can be more efficient in directing our limited resources to where they will be most useful.

4) We do a better job of serving parents of people with developmental disabilities (and click here for more).

5) We create a single, nation-wide definition of what constitutes a developmental disability.

6) Organizations serving individuals with developmental disabilities continue exploring how social media tools can help us better serve our consumers and stakeholders.

7) We continue to harness the power of community as we deliver our services (and click here for more).

8) All organizations and entities charged with serving some of Colorado’s most vulnerable citizens look internally to maximize efficiencies in service provision and delivery.

9) Most of all, I want an official Red Ryder, carbine action, two-hundred shot range model air rifle!

Just kidding about that last one.

Truthfully, the number one item on my wish list for Santa is that all of you out there have a safe and happy holiday season.

And that is one thing I do know!

Friday, December 18, 2009

Good News Friday!

I have been very fortunate in my years at Imagine! to have worked alongside so many talented, caring, and dedicated individuals. Those qualities have been especially important in this past year, when unprecedented system changes and a bad economy have combined to challenge our organization in many ways.

Even in a year when so many Imagine! employees have gone above and beyond to serve individuals with developmental disabilities, there are a few among us who excelled so greatly that they were worthy of the title “Employee of Distinction.” We received dozens of nominations from throughout our organization for this honor, and it was not easy to narrow the nominations down to six.

Below you find the names of the six winners, along with a little information about what made their work so special in the past year, taken from their nomination. I think that when you hear some of what their coworkers had to say about them, you will agree that the six individuals selected as Employees of Distinction this year truly represent the best of Imagine!.

Wendy Breitenfeld

“I’ve repeatedly noticed that Wendy is always working with others, taking into consideration their unique schedules, needs, problems, and trying to come up with something that works. She devoted a fair amount of time to our department this spring to talk about our situation with all of our temporary employees, and she’s worked with us when we’ve been in unique situations that cause us to get into a scheduling knot. She seems to always be so level-headed, fair-minded, and willing to work things out.”

Ben Gallagher

“Ben maintains a laid back and positive attitude everyday. He is very respectful when working with the adult participants, acknowledging that while they may have an intellectual disability, they are still adults and should be treated as such. He is kind, caring, and knowledgeable while on shift and upholds Imagine's! mission in his devotion to the participants.”
Martha Heimbaugh

“Martha is continuing her friendly, caring ways as she learns her new job and assists consumers and staff in navigating the maze that is government healthcare. Everyone loves her and relies on her for the answers they need. She is a quiet, unassuming employee, but definitely the 'go to' gal in Innovations, without whom we would all be poorer and certainly less efficient!”

Mandy Holland

“Mandy is always looking for the “best fit” between families and therapists the very moment a service coordinator contacts her about a new referral. She asks service coordinators several questions in order to get as much information as possible and start making the best match. She does not just “plug in” a therapist who has space in their schedule. Making the best match possible up front contributes significantly to successful therapeutic outcomes for the child and family.”
Gail Scott

“Gail is incredibly dedicated to the families that we serve at Imagine!. She shows a great deal of compassion for families in the many dealings she has over phone and email and often tries to problem solve how we can help them. Many times just listening to a kind voice on the other end of the line is all a person needs – I have heard over and over how many of our families appreciate how she does that with such compassion and skill.”
Brian Shaw

“Brian teaches our consumers perspective in our photography class. He teaches our consumers how to view the world with an objective mind. He takes his students into the community to observe and appraise, through the lens of the camera, the world they view. A premise of his class is that none of us is limited in life, that the entirety of our community is available to us if we simply take the time to engage with it.”
Congratulations to all of our Employees of Distinction.

Monday, December 14, 2009

Looking For Internal Solutions

I know that many of the postings on this blog may seem like I am asking some other organization or entity to do the heavy lifting when it comes to solving some of the bigger issues surrounding the developmental disabilities community in Colorado.

But I want to make clear that I believe that Imagine! is not exempt from exploring solutions to some of our biggest challenges. That is why the administrative team here is looking very closely at everything we do in order to maximize efficiencies in our service provision and delivery.

The reason for this is simple. Every inefficiency we have cuts into our ability to serve consumers and families. That is not acceptable.

Despite my misgivings about recent system changes and concerns about recent budget cuts, I do think they have produced an unexpected and potentially valuable side effect. All of us who provide services for individuals with developmental disabilities are being asked to provide the same amount of services while having access to fewer resources to provide those services. Funding has been reduced, expectations haven’t.

Facing this situation, we have a couple of options: ignore the expectations and provide lower quality services, or find ways to meet those expectations despite the challenges.

I’m proud to say that we at Imagine! have chosen the latter option, even considering the daunting nature of the task. However, this means that we will have to examine everything we do from top to bottom.

Here are a couple of examples of what we have already been doing to achieve the lofty goal of continuing to provide quality services despite a decrease in available resources:

I have already discussed our efforts to use social media to improve our communication with all of our constituents and to better engage the community in the conversation about our services. The early results of these efforts have been extremely promising, and as we move forward into 2010 we will be exploring how we can implement social media platforms across our organization.

We have also engaged in ongoing efforts to improve our data collection, storage, and access. As I have mentioned in an earlier post, we don’t have good enough data to even know what the most effective way to deliver services might be. At Imagine! we have been steadily upgrading our data systems and either eliminating duplicative databases or improving our ability to share data across platforms, with an end goal of having all the knowledge we need when making programmatic decisions in the future.

These changes aren’t easy, and often such difficult changes meet resistance, both internally and externally. However, I think they will be very beneficial to us in the long run. That’s why we’re working hard to inspire and motivate members of our staff every chance we get.

Our mission at Imagine! is to provide innovative supports and services for individuals with developmental disabilities. In order to meet that mission, I believe it is imperative that we never rest on our laurels or assume we have arrived, especially considering the challenging environment we find ourselves in right now.

Then again, what do I know?

Friday, December 11, 2009

Good News Friday!

The story I’m about to share took place a couple of months ago, but since I have been talking recently about the importance of community involvement in DD services, I thought now would be a good time to in include the story as a Good News Friday post.

Hunter Davis, a twelve year old student at Broomfield Heights Middle School, was with his dad when they came across the wheelchair next to a dumpster. They took the wheelchair home, having no idea what it was worth.

Hunter was crossing the street with the wheelchair attached to his bike when he encountered a Broomfield police officer, who inquired about the chair. Hunter explained he had found it next to the dumpster, and the officer said he wanted to check the serial number to make sure the chair hadn’t been stolen.

In checking the serial number with the manufacturer, Officer John O’Hayre and Sergeant David Walts discovered that the wheelchair was not stolen. Instead, it had belonged to a woman in her 90s who had passed away, and cost $3,000 when new.

Hunter could have sold the chair, but instead chose to donate it to Imagine! to help people with developmental disabilities.

“I just want the wheelchair to go where it will do the most good,” said Hunter.

The chair is in excellent shape, and has been given to F.R.I.E.N.D.S. of Broomfield so it can be utilized by people with physical limitations to assist them during community activities.

All of us associated with Imagine! express our gratitude to Hunter’s parents Greg and Debbie, the Broomfield Police Department, and especially Hunter. Hunter’s actions make him a role model and serve as an excellent example of community involvement.

Tuesday, December 8, 2009

By The Community, For The Community

While preparing my recent good news Friday post about Labor Source’s 25th anniversary, I started thinking about what made that program successful for so long, and also about how the current system of service delivery threatens that success.

In 1995, I wrote an annual update on Labor Source, outlining the fundamental philosophy of the organization. Labor Source was to be an organization for the community by focusing on the needs of the community as well as the needs of people who have a disability. Here’s more of what I wrote:

By accepting the definition of community membership as having similar interests and requiring contribution to common goals, we have established direction for a service that contributes to the common good of the community. Contributions by those we support verifies community membership. This direction for service and support contributes to further acceptance of people of all abilities.

The power of financial earnings is realized through greater opportunities for choice and enhanced quality of life. By utilizing our available resources to support this venture, consumers of our services, through their purchasing power, ultimately contribute dollars back to the community. Everyone benefits. People who have a disability exercise a greater degree of choice, and the community benefits from their role as true consumers.

Those words mean as much to me now as they did 15 years ago.

In those early days of Labor Source, we had a fundamental purpose that drove everything we did: engaging with the community so all could benefit. That purpose determined hiring decisions, directed program development, and ensured that all of our efforts included all interested parties including staff members, consumers, and the community at large. Our system of funding back then gave us the freedom to use that purpose as our guide.

But a significant change has taken place in funding for service delivery since then, and that change has made the fundamental goal of true community membership and partnership much more difficult to achieve.

Now, I believe service delivery in the DD world has much more to do with meeting Medicaid regulations than it has to do with providing community opportunities and involvement. So the purpose of what we do is completely backwards from what it used to be.

If our fundamental purpose now is to meet Medicaid requirements, success will soon be measured by how well we are able to bill for our services, instead of how many opportunities we are providing to our consumers. The community will be taken out of the equation, and we will begin to isolate and segregate individuals with disabilities. Bureaucratic-based decisions will outweigh people-based decisions.

We’ve been down that road before, and I don’t think anyone of us wants to go there again.

Then again, what do I know?

Friday, December 4, 2009

Good News Friday!

Earlier this week, I was honored to be invited to speak to the staff of Imagine!’s C.O.R.E./Labor Source department as part of Labor Source’s 25th anniversary celebration, a milestone officially reached in October.

For those who don’t know, Labor Source is the vocational component of C.O.R.E./Labor Source.

What has allowed this pioneering project to succeed for 25 years has been a group of Imagine! employees who thrive on creativity, possess an unquenchable work ethic, and are driven by a passion to improve the lives of people who have a developmental disability. The other key element in this equation is the effort put forth by consumer after consumer. There are two hard working consumers in the picture to the right, Letosha Patton and Melinda Stewart. Both Letosha and Melinda work at The Hungry Toad in Boulder, a business that has been using Labor Source crews for an incredible 18 years!

My years working with the Labor Source team were some of the most important years of my life. Congratulations to everyone ever involved with this very vital service.

Tuesday, December 1, 2009

Making The Case For a Community Based System

During my Thanksgiving travels last week, my family and I found ourselves in a Midwestern state (which shall remain nameless) at a point where we had been driving too long, and needed to stop for the night. We spotted a hotel in a suburban area of a major city, and after checking in, decided to eat dinner at a chain restaurant located about 100 yards across the street from the hotel. We’d been driving all day, so we decided to just walk.

And there’s where we encountered a problem. The street we had to cross we pretty busy, and there was no good way to cross. Even at the closest intersection, there was no crosswalk, no cross signal, no real sidewalk, no nothing. It was as if the concept of a pedestrian just didn’t exist. We all felt like George Costanza trying to cross the street with his Frogger machine.

It made me appreciate the fact that I live in a community that actively embraces alternative methods of transportation.

So what does this have to do with the world of developmental disabilities? Well, it took me visiting a place that was so pedestrian unfriendly for me to realize how good I had it at home. And that started me thinking about community values and their importance. So many of us choose to live in communities because of what the community stands for. And that started me thinking about an aspect of the DD system in Colorado that perhaps we don’t give ourselves enough credit for: our unique, public/private community based system of services.

Many of Colorado’s organizations dedicated to providing services for individuals with developmental disabilities, including Imagine!, were started locally by family members who wanted their children to have the same opportunities to engage in the community as their friends’ and neighbors’ children had. Not surprisingly, the services that emerged reflected that local nature. These organizations may have grown and changed, but I think the fundamental philosophies of community based services remain. I also happen to think that is a good thing.

Anyone who lives in Colorado knows that the Boulder community and the Colorado Springs community are vastly different: different values, different attitudes, different outlooks. Because of the community based system of services we have in this state, those differences are reflected in the way services are provided to local citizens with developmental disabilities in Boulder and Colorado Springs. That seems to me to be to be a healthy approach that is good for the community and good for the individuals served.

I bring this up because we are at point where it is inevitable that the current system of service provision and delivery in Colorado will be questioned. If you read this blog you know that I am fully behind change, and I think everything we do needs to be examined to determine how to best meet the needs of those we serve in the context of severe restrictions on resources. During that process, however, I would urge us not to throw the proverbial baby out with the bath water. Let’s keep the philosophy that local communities are best able to determine how to protect their most vulnerable citizens.

While considering this modest proposal, ask yourself a few questions. Do you want a State regional system with a one-size-fits-all approach? Do you think the State is in a position to handle service provision? Should the State be involved in providing services at all? If not a State run system, then is there a model out there that will work better? Should providers be for profit or not for profit? Should advocacy groups be providing services? Where is the line that separates advocacy groups, services providers, and Community Centered Boards (CCBs)?

I don’t claim to have the answers to all these questions. But I do believe that our community based system is a good model that needs work. We should take the good parts and build on them as we re-imagine how we do business.

Then again, what do I know?