Written by Mark Emery, CEO of Imagine!, with the creativity of Fred Hobbs. This blog is meant to discuss ideas of interest in the world of Intellectual Disabilities in Colorado and beyond. The blog is a “safe zone” where discussions are open and honest, and new ideas and new ways of looking at things are encouraged.
Today, I wanted to highlight some of the recent grants we’ve received to support Imagine! programs designed to increase the ability of the individuals we serve to become active members of their communities. Imagine! is a community-based organization, and we couldn’t succeed without the support of our community.
Many thanks to all the organizations listed below. If you’d like to see a list of everyone who contributed to Imagine! last fiscal year, take a look here.
The video above is a perfect representation of the issue facing the world of funding and delivering services in the field of developmental disabilities.
The round hole represents Medicaid. The square peg represents the needs of those we serve. And service providers are Gordon.
Here’s how it seems to work for those of us in the DD field: If the needs of the individuals we serve (square peg) don’t match Medicaid’s funding mechanism (round hole) then service providers (Gordon) are put in the unfortunate position of trying to make the fit anyway. Like Gordon discovers in the video, providers don’t have much leeway when it comes to changing individual needs, nor do they have much of a voice when it comes to changing the funding mechanism, so they end up stuck in the round hole themselves.
So what can we do? Well, I happen to think we can address the issue from all sides.
2) We can’t change the square peg of individual needs, but we can do a much better job of getting better data in order to understand needs in the aggregate, and then use demand management principles to address those needs.
Well, they have sure been busy over those past six months, so I thought I’d get you caught up. More than a dozen articles written by this talented crew have been printed locally. They have been heard on several radio stations.
In short, they have taken Imagine!’s mission and run with it. Taking advantage of the opportunities presented to them, these journalists have clearly demonstrated how much they have to offer to their community. The articles they write are smart, funny, and always provide a unique perspective.
Watching some of the first round of World Cup games this weekend started me thinking once again about language and how complex it can be – words can take on different meanings depending on context and tone. For instance, I notice that the television announcers often use the word “ambitious” when they want to imply that a player attempted to do something that was perhaps a little beyond what was required for that particular moment in the game. It has a slightly negative and condescending tone. And yet, in other contexts, we often use the word “ambitious” as a positive way to describe a person and their actions, as something to be admired, not frowned upon.
Now, I am aware that commenting on the complexity of language hardly represents original thinking on my part. It is no news to any one who speaks almost any language that the meaning and understanding of words can and usually does go beyond just a literal definition of the words.
But it is an issue that confounds those of us in the field of developmental disabilities (if that is the appropriate phrase). How do we describe the individuals who receive services from us? Two commonly used words are client and consumer. But both of those carry connotations that could be perceived as inaccurate at best and outright negative at worst. My colleague Colette Marie, who runs our Out & About department, and I recently had a discussion about this topic, and she sent me a follow up email on the subject. She had heard an interview on NPR with Bill Moyers, and she wrote:
Bill Moyers talked about his career, how he got started with NPR and the importance of NPR, the danger in becoming an exclusively “market-driven society.” He said that if you limit yourself to viewing or thinking of people only as “consumers” then the tendency is to only think about them in terms of what you might sell them and what they might buy, in other words, how you might make a profit out of them. Where as, if you view people as citizens, you can much better entertain the idea of “value,” what you might offer that would be of value and what they might be able to respond back with in a reciprocal, collaborative fashion. He talked about things that a market-driven society cannot provide, because while those things add value, they are not profitable.
We have had conversations in the past and I have voiced my objection to the term “consumer” instead of “client” or some other term. While we might not be able to change the prevailing term “consumer” right now, I think we are bound to voice our objection, or at least support thoughtful discussion, because “consumer” does imply that the relationship is strictly financial and one way: we sell, they buy.
Things Bill Moyers specifically mentioned that cannot happen in a strictly market-driven society, because they are not profitable, are art, public toilets, public libraries, public education, parks and activities and community relationships that nourish and feed the mind. He said that NPR was founded to provide people with information that would feed the mind, foster creativity and contribute something of value to their quality of life and that because they were not-for-profit, they could do so without regard to profit-driven agendas. This doesn’t mean that NPR doesn’t pay attention to finances and that it doesn’t have to figure out how to be fiscally sound.
I’m feeling like Bill Moyers is right on and very much in line with where we should be aiming. What do we have to offer that is of value? What do the people we are providing services to have to offer us and their communities? How might we feed and nourish our (“our” being participants, families, staff, community members) minds, hearts and spirits? And because this is the real world, how might we do this and do it in a way that is financially sound? (Please notice that the financial question comes last, just as it ought to.)
Placing a label (positive or negative) on the people who receive services from us is not a simple thing. How can we describe their relationship with us in way that is clear and concise and yet is neither negative, nor defines the individuals by their deficiencies?
Prompted by Colette’s thoughtful email, I am re-committing myself to being very careful about the language I use and words I choose. “People first” language goes without saying. Here are some other examples:
Why assume a person has multiple disabilities? Why not a single developmental disability?
I don’t like the implied ownership of people; “my consumer”, “our clients”. How about, “This is Bob – he lives with me.” In day service scenarios, “Here are some friends of mine.” “These are people I know.” “Here are people I’m with.”
Whatever I use, I intend to add to a person’s character in a good way, not diminish it.
I’d love to hear other ideas and suggestions. Language does matter, and the words we choose make a difference.
Two different classes are offered annually. One class was developed for teens and the other class was developed for adults. Having two classes allows the class curriculum to address the different needs of the students. The class curriculum for both classes covers decision making skills, street-smart safety, home security, fire prevention, and how to call on police for help.
In addition to teaching how to be safe at home and in the community, the class fosters a positive relationship between our consumers and the police officers. This relationship building aspect of the class is extremely beneficial to our consumers. Prior to taking the class, many of our consumers had the misconception that police officers were to be feared and avoided, instead of recognizing that police officers are dedicated men and women who have chosen a career devoted to serving and keeping their fellow citizens safe. As the result of taking the class, it is much more likely for one of our consumers to seek out an officer if they become lost or require assistance while engaging in their community.
Here at Imagine!, we like to think that this class is beneficial to our entire community. When our consumers are able to successfully access the community and to live more independently, it increases the opportunities for them to be contributing members of the community through employment, volunteer work, and other activities. Safety First classes help to successfully incorporate our consumers into the fabric of our community, and the effort put forth by the Boulder Police Department has directly and positively impacted the lives of people who have taken the class, and their families.
The most recent Safety First for adults class was held in April, and a Safety First for Teens is scheduled for this fall. The teen class is designed for middle and high school aged students with developmental disabilities. The classes are a combination of lecture, small group and hands-on activities, and maintain a high instructor-student ratio. For more information, call Kris Gibson at 303-441-3332.
This past Wednesday I had the pleasure of attending a Boulder Economic Council event: The Boulder Economic Summit. The focus of the event, subtitled Boulder in 2035: Opportunities and Insights, was to look at the future from a variety of perspectives and to provide a insightful analysis of the trends, developments, competition, challenges, and opportunities that will impact Boulder and those who live and work there.
The event was tremendous, and the quality of the speakers was top-notch. I was especially impressed with the keynote speaker, Thomas Frey, Senior Futurist and Executive Director at the DaVinci Institute. In example after example, he demonstrated how the world in 2035 will be in many ways unrecognizable to those of us living in the here and now.
Ironically, despite all the future talk, what really struck me was the part of his presentation when he discussed Roman numerals.
In a nutshell, he talked about despite the many deficiencies of that numeral system (such as how the unwieldiness of the numerals made advanced math difficult, if not impossible), the system stuck around for a longer time than its usefulness would indicate because the Roman Empire was so big no other ideas or systems were able to emerge.
While Mr. Frey was speaking, it hit me. Medicaid is like the Roman numeral system. The system isn’t capable of meeting the current needs we are facing. At the same time, the system is so big we feel like we can’t change it. I recently read this guest blog post by Harold Pollack, Associate Professor of Public Health at the University of Chicago, in Ezra Klein’s blog. I think the post sums up the issue well:
Slapped together 45 years ago as a relatively small program that mainly financed healthcare to welfare recipients and their children, Medicaid has evolved into a huge and diverse program that finances almost half of American nursing home and long-term care, bears large responsibilities for the care of disabled adults and children, and is the major vehicle to cover millions of poor and near-poor Americans who would otherwise be uninsured.
Discussing the flawed nature of this federal/state partnership, Pollack continued:
Rising Medicaid expenditures undermine states’ ability to address other pressing needs. Saddled with balanced-budget requirements and constrained tax bases, dozens of states are cutting or constraining services at precisely the moment when these services are most needed to meet human needs and to stabilize local economies.
Medicaid has grown far beyond what it was originally designed to do, and its many flaws are jeopardizing the ability of states to meet some of the basic needs of their citizenry. And yet, the system is so big now that change or adaptation seems so daunting that few are willing to undertake the challenge. Furthermore, any attempt at change seems to come from the outside in, and there doesn’t appear to be a lot of inclination on the part of those who are “in” to look for solutions from the outside.
Eventually, the Roman numeral system was replaced by a superior decimal system. And I believe that eventually we as a society will be forced to examine the efficacy of using Medicaid as the funding mechanism for long-term services for people with cognitive, developmental, and intellectual disabilities. I just hope we don’t wait too long.
I think it is important to keep up with the opinions of colleagues we have in Colorado. Sometimes looking through the eyes of another ccan be revealing. I recently read the newsletter of a neighboring Community Centered Board and provider of services, and thought the message from their Executive Director was revealing. http://www.nmetro.org/Pagesfolder/el.php I think it is healthy to exchange ideas. Let me now what you think. Then again, what do I know.
This past week Imagine! received a donation from a very generous and enterprising group of youngsters: 5th graders taking part in Young Americans Center for Financial Education’s Young AmeriTowne program.
What is Young AmeriTowne? A program that teaches school kids about our country’s economic system in a fun and relevant way.
The program begins with several weeks of interactive lessons and activities taught by teachers in the classroom. Students learn important economic and business concepts such as supply and demand, budgeting, banking, government workings, and more. They elect a Mayor and Judge, vote on town laws, and apply and interview for jobs in town.
During the culminating event, students put into practice what they have learned when they attend Young AmeriTowne for the day and earn money running a life-like town of 17 businesses. Part of the program involves teaching the kids about philanthropy, and that’s where the Imagine! donation comes in. At the beginning of the school year, participants in the program selected six organizations, including Imagine!, to receive funds from the program. Through the generosity of the Community First Foundation, hard earned AmeriTowne dollars donated by the fifth graders are converted to real donations, matching the children’s gifts at ten cents per dollar.
In the picture to the right, you can see Imagine!’s Director of Public Relations Fred Hobbs receiving a check from the AmeriTowne Mayor at Wednesday’s inspiring check presentation ceremony.
Our thanks to the Young Americans Center for Financial Education, the Community First Foundation, and most importantly, to the many kind and giving children who donated!
