Wednesday, September 22, 2010

Not Paying Attention

Before you read anything else in this post, please take a look at the video below and take the test.

In a study where people were asked to watch the video above and take the test, half the people who watched the video didn’t notice the gorilla. It is an interesting trick of the brain. Because test takers are told to focus on the ball, their brains tend to make assumptions about everything else in the scene. The brain fills in details by itself, even if those details don’t actually match what is happening on the screen.

I was thinking about this test recently because of a Conflict of Interest Task Force report just issued by The Colorado Department of Human Services (CDHS) and the Department of Health Care Policy and Financing (HCPF).

According to the report, CDHS and HCPF:
“have been aware of potential conflicts of interest in the developmental disability services delivery system related to the multiple roles that Community Centered Boards (CCBs) hold for some time. Several Community Centered Boards and the Division for Developmental Disabilities developed and implemented various safeguards intended to mitigate the potential for conflicts of interest. However, results of the State Auditor’s Office 2009 Audit of the Home and Community Based Services Waiver for People with Developmental Disabilities indicated that the potential for conflicts of interest, examined in a December 2007 study by the University of Southern Maine (USM), Muskie School of Government titled “Addressing Potential Conflicts of Interest Arising from the Multiple Roles of Colorado’s Community Centered Boards” had not been resolved. To this end, in February 2010, the Departments solicited applications for and convened a stakeholder group to develop recommendations for resolving the conflict of interest issues inherent in the developmental disabilities system, the Conflict of Interest Task Force (COITF).”
Now, is there a potential for conflict of interest in how our system is set up? Of course. Are there some families who feel that they have not gotten the proper information on the full range of services available to them because of this conflict of interest? Again, yes.

But by all accounts, the number of families and individuals who feel that way is very small. Most families feel as if the system of selecting services works for them. That’s not just me saying that. Here’s a direct quote from the report: “A large majority of the public, both family members and self-advocates, did not want change in their current services or personnel.”

I can’t help feeling that this Conflict of Interest Task Force is simply counting the number of passes, just like in the video. So much time, energy, and focus is being spent on this one issue while the many gorillas in the room are completely ignored.

What gorillas? Well, here are some issues in the DD world that no task force has been convened to study:

• Currently 30% of adults with a developmental disability who are eligible for services in our service area are not receiving any service. This figure is projected to exceed 40% by 2020.

• Hundreds of children who have a developmental disability and are served through the Division of Child Welfare lack knowledgeable advocacy on their behalf.

• There is no single entity accountable for knowing how many children in the Child Welfare system have a developmental disability.

• Dozens of children who have a developmental disability and are served through the Division of Child Welfare are in placements in the state of Tennessee due to the lack of qualified providers and adequate rates to Colorado providers. This is a tremendous financial burden on the counties of Colorado.

• The developmental disabilities services system has endured program elimination, jobs lost, cuts in levels of service, and service rate cuts, all as a result of uncontrolled Medicaid Waiver expenses unrelated to the current recession.

A fraction of a percentage of adults with developmental disabilities enrolled in services through the Department of Human Services have encountered an acknowledged, unmitigated conflict of interest associated with case management and service provision.

In better times, it might make sense to address that issue. But not now. Not when we have so many other issues to address. Issues that have a far greater impact on the ability of our State’s service providers to deliver quality and meaningful services to some of our most vulnerable citizens.

Then again, what do I know?

1 comment:

  1. Mark, this is a great post. It cetainly points to some fundamental problems in Colorado's service delivery system.