If youre not confused youre not paying attention

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 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 Person. Centered 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 Self. Determination) . 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