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Transcript
If you’re not confused,
you’re not paying attention
– Tom Peters
Creating Blue Space :
Fostering Innovative
Support Practices
Hanns Meissner
Seeking Good Form
The Four Primary Forms that DD Services Have Taken Over the Past 60 Years
Institutional
Care
Managed
Care
Integrative
Supports
Community
Supports
Brian’s Story Tracks the Evolving Developmental
Disabilities System
Emerging Support Models Reflect Our Striving
for the Wholeness of Our Communities
We need
institutions to
care for special
populations
We need
mechanisms to
coordinate all
the services for
needy
consumers
We need circles
to connect a
person’s unique
qualities to a
community
We need
communities
with capacities
to socially
include all its
members
Evolutionary Voices
I’m a
consumer –
satisfy me
I’m a
patient –
cure me!
I’m a person
– listen to
me
I’m a citizen
– include me
Our Beliefs About People with Disabilities Influences How a
Person We Support Experiences the Community
Through a Window
Part of a
Programmed
Activity
Community
As an Active Citizen
Supported by a
Circle
Roles Shift
Power-Over
Doctor/Expert
Patients to Be Cured
Consumers to Be Habilitated
Teacher/Instructor
Person to Be Developed
Coach/Facilitator
Power-Shared
Citizen to Be Engaged
Community Resource
Our Assumptions About People with Disabilities
People with
Disabilities are
Tragic &
Vulnerable
People with
Disabilities
are
Consumers
with Clinical
Needs
People with
Disabilities
are
Individuals
with
Capacities
People with
Disabilities
are Citizens
Our Design Responses
Create Special
Institutions
Coordinate
Care
PersonCentered
Supports
Community
Resources
The Outcomes that Emerge From Our Care and Support Designs
Personal
Care,
Activity,
Housing
Plan of Coordinated
Care, with
Appropriate Levels of
Service, Customer
Satisfaction
Individualized
Supports
leading to job,
home &
relationship
Valued
Roles – A
Life of
Distinction
Each Care/Support Model is distinguished by the way it solves
nine problems
• How does the culture of an agency create core beliefs that guide
support practices towards inclusion?
• How do our underlying beliefs and assumptions about disability
serve as the foundation for how supports are organized and
delivered?
• What kinds of outcomes are sought within each type of support
model?
• How can we address the increased complexity and competing
commitments that come with individualizing supports?
• What kind of leadership is required?
• How the roles and relationships between those who provide
assistance and those who receive it change?
• How assistance is delivered and experienced?
• What organizational conditions facilitate the emergence and
sustainability of individualized arrangements ?
• How is social innovation generated?
Levels of Individualized Supports –
Leveraging Change Through Design
Low – Working
Within the Box of
Legacy Services –
Offering Menu
Options
Medium – Taking
the Box Apart –
Redesigning and
Reinvesting Legacy
Services
High – Working
Outside the Legacy
Box – Co-creating
with Individuals and
Families
Elements of Individualized Support
•
•
•
•
Choice (have options from which to choose)
Decision making (have a role in making
decisions)
Control (have control over aspects of their
life space and resources)
Involvement (in the settings where they
spend their lives and their community)
How Individualized is the
Support?
Types of Individualized
Supports
Degree of Choice (range,
variety and life options)
Degree of Decision Making
(participation and selfdirection)
Degree of Personal
Space & Ownership
(control of resources)
Degree of Social
Integration (valued
roles)
Low (Focus on
Customizing or
Modifying Current
Practices and Service
Environments)
.Person-Centered
Planning Leading to
Individual Supports in
Daily Routines in
Program
.Expanded Menu of
Options
.Community Outings
.Provides a Menu of Services
.Choices Regarding Daily
Routines
.Choices about activities in
which to participate
Assists Individual in Making
Decisions Around Daily
Schedule, Meals, Decorating
of Common and Personal
Space
.Input Regarding Program
Activities
.Downsizes a Home
So Individual has
Their Own Bedroom
.Provides Opportunity
to Select Housemates
.Assists Individual in
Experiencing & Being
Present in the
Community on a
Weekly Basis
.Participates in a Small
Group that Community
Sites to Visit or
Volunteer
Medium (Focus on
Designing Individualized
Services and Support
Environments)
.Person-Centered
Designs
.Shared Living
.Alternative Staffing
Arrangements (Live-In,
Paid Neighbors)
.Supported Employment
.Life Coach
.Agency with Choice
(1)
.Provides Choices to the
Individual/Family Regarding
Living Arrangements
(Where/Whom), Type of
Job, Kind of Life Style
.Assists the
Individual/Family to Assume
Primary Decision Making
Roles Regarding Hiring
Staff, How Quality is
Defined, Spending of
Personal Allowance Funds,
Decorating of Living Space
.Supports Individual
in Designing a Home
Situation
.Finding a Suitable
Location, and Setting
Up the Home to the
Specifications of the
Individual
.Supports the Individual
in Participating in the
Community at a Job,
Place of Worship, and
with as Association on
a Frequent or as
Desired Basis
High (Focus on
Supporting SelfDetermination)
.Support uniquely
tailored (wrap-around)
.Support-Scenarios
(options to select from)
.Mix of natural and paid
providers.
Support Broker
.Fiscal Intermediary
.Agency of Choice (2)
.Choices Provided to
Individual in Key Life Areas
(Relationship, Home, Health,
Work)
.Individual and Family are
Supported in Primary
Decision Making Roles
(Finance and Budget,
Vocation, Life Style)
.Assist Individual in
Owning or Leasing
Own Their Home.
.Individual Budget
.Cash and Counseling
.Home of your own
.Supports Individual to
Play Active and
Primary Roles in
Friendship, Marriage,
Associational Life, and
Employment (outside of
paid staff
arrangements)
We Are Experiencing A Mismatch Between the World’s
Complexity and the Level of Our Response
Evolving Change Management
Approaches
Rational
Plan
Strategic
Marketing
Appreciative
Inquiry
Social Labs
Citizenship Outcomes Require the
Capacity to Socially Innovate
Revealing Our Immunities to Change