Volume 4 Issue 23, November 7, 2017
During the past 50 years, we have experienced profound change in the services and support for people with intellectual/developmental disabilities. Many large, costly, and dehumanizing institutions have closed, while community supports promoting inclusion and self-direction have blossomed across the country. As a result, people with disabilities are living longer than ever, with a higher quality of life. There has been great progress, yet there is still ample room to improve.
Today, services are also affected by significant changes that are creating a disruptive environment in the I/DD marketplace. Support dollars are stagnating for economic reasons, managed care has an increasing role in administering I/DD funding, and our philosophy of support is evolving within this culture of change.
While change often induces more complexities in service delivery, one thing is certain: we are witnessing a revolution. Here is where the revolution is heading:
The foundation of this revolution includes key concepts. The first is the notion of “presumed competence.” At its core, we assume everyone is competent, resulting in support based on need and preference, not paternalistic charity. Presumed competence provides a counter yet complementary approach to “dignity of risk” by shifting the notion of providing the dignity to assuming the capabilities to take risk are inherent.
The second is the belief that in any system the key to great service and support is the alignment of financial incentives and desired support. Providers offer service to consumers who happen to have a disability, but the expectation should be no different than they are for other business entities.
Revolutions always create anxiety because of our natural reaction to change. This revolution is doing the same, and there are also many reasons to be excited about what the future holds.
Note: This special issue of SalientValue is co-authored with Drew Smith and Kelly Friedlander of Community Bridges Consulting Group (www.cg-bg.com). We greatly appreciate their inspiration and dialogue that led to this article.
Tom was the Founder and Managing Partner of VERTESS. He was a Certified Merger & Acquisition Advisor (CM&AA), consultant, and Licensed Psychologist with over 35 years of very successful national experience in the healthcare marketplace, including co-founding and building a $25 million behavioral health/disabilities services company. Tom represented sellers and investors across the healthcare spectrum and was recognized for his executive leadership in the 2005 Entrepreneur of the Year issue of Inc. Tom passed away in December 2018.