Missouri Developmental Disabilities Council's Position Creating a Culture of Coordinated Support

The Missouri Developmental Disabilities Council’s Reasons:

Far too often, agencies and organizations serving people with disabilities operate in “silos” – they focus only on what they provide and are often unaware of what others do. [1] Such a “fragmented system of services within high schools and adult services” [2] can result in people receiving poor, duplicative, or contradictory support, wasting time, effort, and state funds. [3] Worse, when people with disabilities receive poor services resulting in poor life outcomes, it contributes to society’s ongoing and incorrect view that they are unable to be full and productive members of their communities. [4]

Missouri should move away from the outdated and inefficient “silo system” and implement the Culture of Coordinated Support (CCS) model. [5] In a CCS, people and agencies work together to establish and implement shared plans, goals, and responsibilities that build upon each other’s strengths and resources. Thus, when multiple agencies are serving a person, they will develop joint goals with well-defined, coordinated responsibilities. As a result, the person’s plans and supports will be person-centered, consistent, and complimentary rather than “fragmented,” and possibly contradictory and counterproductive.

For example, Special Education programs, Vocational Rehabilitation agencies, and Medicaid Waiver providers are all required to provide services addressing education, employment, and independent living. [6] In a “silo system,” each agency would have its own plan with its own educational, employment, and independent living goals and supports. As a result, scarce state resources are spent on duplicative, possibly contradictory, efforts. In a CCS, the agencies work with the person, with the person in the lead, to develop a joint vision of success with shared goals based upon the person’s abilities, needs, and preferences. Then, the agencies would divide the responsibility to provide services to the person based upon each agency’s strengths and specialties. Consequently, services would be provided by the agency best suited to do so - schools would focus on education, Vocational Rehabilitation agencies on employment supports, and Waiver providers on independent living services - resulting in the person receiving more effective and efficient support. [7]

Successful CCS pilot projects have been implemented in other states and communities. For example, the Successful Transitions Project in Fair Haven, Vermont, involved a High School, Vocational Rehabilitation agency, and Medicaid Waiver provider collaborating and coordinating their efforts. After one year, students, parents, teachers, counselors, and other CCS participants completed a survey about the program. 100% of respondents said the Program improved the supports provided to students and provided better supports to meet student needs. [8]

The Missouri Developmental Disabilities Council’s Recommendations:

• When multiple Missouri agencies serve a person with disabilities, they should collaborate and coordinate their efforts to ensure that the person’s services are person centered and led, consistent, effective, and efficient. For example, agencies supporting high school students in transition should ensure that each student’s transition goals and objectives are consistent across programs and that their plans and supports build upon and complement each other, rather than duplicating efforts or contradicting each other.
• Agencies that are required by law to collaborate, like Special Education systems and Vocational Rehabilitation agencies, [9] should develop joint policies and procedures to ensure that their work is effective, efficient and based upon each person’s abilities, needs, and preferences.
• Missouri should convene a Culture of Coordinated Support Task Force of people with intellectual and developmental disabilities, state agencies, and other stakeholders. The Task Force should develop interagency agreements, policies, practices, forms, and pilot projects designed to increase communication, collaboration, and coordination of effort.
• Missouri should consult with and learn from states and agencies that have implemented successful Culture of Coordinated Support projects. [10]

 

References

[1] e.g., Gustin, J. & Martinis, J. (2016). Change the Culture, Change the World: Increasing Independence by Creating a Culture of Coordinated Support. Apostrophe Magazine. Available at: https://www.apostrophemagazine.com

[2] Katsiyannis, A., deFur, S., & Conderman, G. (1998). Transition services: Systems Change for Youth with Disabilities? Journal of Special Education, 32(1), 55-61.

[3] Gustin & Martinis, 2016; Martinis, J. & Blanck, P. (2019). Supported Decision-Making: From Justice for Jenny to Justice for All. A Theory to Practice Guide. Virginia: Something Else Solutions Press

[4] e.g., Blanck, P. & Martinis, J. (2015). The Right to Make Choices: The National Resource Center for Supported Decision-Making. Inclusion, 3(1), 24-33.

[5] Martinis, J. & Gustin, J. (2017). Supported Decision-Making as an Alternative to Overbroad and Undue Guardianship. The Advocate, 60(6), 41-46. Martinis & Blanck, 2019.

[6] See, 20 USC 1401(34) (required Special Education Transition services); 34 C.F.R. 361.48 (required Vocational Rehabilitation services); https://www.medicaid.gov/medicaid-chip-program-information/by-topics/long-term-services-and-supports/home-and-community-based-services/downloads/1915c-fact-sheet.pdf (required Person Centered Planning services)

[7] Martinis & Blanck, 2019.

[8] Martinis, J., Cassidy, K., Gustin, J., Nadeau, J., & Robinson, D. (2019). Creating a culture of coordinated support: The successful transitions program. Impact 32(1), 19-21

[9] 20 USC § 1401(34) (Special Education Transition services must be "coordinated" and include vocational education and services); 34 C.F.R. § 361.22 (Vocational Rehabilitation agencies must coordinate with schools).

[10] States and communities that have implemented Culture of Coordinated Support-based systems include Vermont (statewide Task Force); Tennessee (collaboration between state agencies, led by Developmental Disabilities Council); Fair Haven, Vermont (community based project); and Pickaway County, Ohio (community based project). See, also, Martinis, et al, 2019; Martinis & Blanck, 2019.

This document was developed in partnership and with support from the Missouri Developmental Disabilities Council (PL 106-402) and Jonathan Gerald Martinis, LLC (jgmartinisllc@gmail.com).