- Report Published -
|Coordination of the Delivery of Services to Facilitate the Self-Sufficiency and Support of Persons with Physical and Sensory Disabilities|
|HJR 45 (1990)|
The Commission on the Coordination of the Delivery of Services to Facilitate the Self-sufficiency and Support of Persons with Physical and Sensory Disabilities in the Commonwealth, established through HJR 45, has addressed service needs, availability of services, costs, and the quality of services for persons with physical and sensory disabilities. A plan of action for the next ten years has been developed which will form a system of programs and services within an infrastructure designed to be consumer-focused and community based.
General Definition of Problems
the Commission is committed to ensuring the design of a consumer-centered service system while recognizing the current system has some significant barriers to consumer empowerment. Among those identified are:
* unnecessary bureaucratic barriers and complex eligibility criteria;
* gaps in services and poor coordination of services;
* few incentives in the system to reward independence and self-sufficiency.
The Commission determined that the service system must use an individualized consumer approach, and give full participation and accountability to the consumer in his or her choices.
The Commission's activities have been driven by four major themes to include consumer focus, state investment, community-based services, and services coordination.
* The consumer is the central focus of the process; making the decisions, taking responsibility for those decisions, and being a full partner in the costs of these decision. State government assumes responsibility for the quality of the public services and programs, ensuring that services providers are good managers of resources. Providers should fulfill their mission to serve the consumer with imagination and creativity and assure that the unique needs of the consumer are met to catalyze self-sufficiency and independence.
* There will be a ling term shift of public dollars from consumption to investment through a shift in emphasis to funding programs which promote self-sufficiency and independence. The short term investments of general fund dollars will reap long term benefits.
* The design of a service delivery system must be community based. This affords the opportunity for decisions and planning to be done with the lowest common denominator for the most effective result.
* Finally, the existing agencies within the Commonwealth must work together to coordinate services to persons with physical and sensory disabilities.
Special Challenges and Actions
The Commission identified the core services necessary to fostering self-sufficiency and independence, the infrastructure for the most effective delivery of these services, and the funding needed to initiate this service system. The actions recommended are not intended to be an immediate panacea for the gaps and problems of the current system, but rather a beginning to an evolving system to meet the challenges. The recommended actions can be summarized in three major categories:
* The core services will include case management, personal assistance services, training, employment services, transportation, housing, education, independent living services, assistive technology, medical and therapeutic services, counseling, and family support services. Services will be available to individuals with physical and sensory disabilities of all ages, will be fully accessible, and will provide mechanisms for evaluation for quality assurance.
* The structure for service delivery will be community-based. The Commission adopted a proposal to establish local planning boards with government, business, and consumer representation. These boards will assess service needs and develop service plans which will be used by appropriate state agencies in their fiscal and programmatic planning for service delivery. The boards will also administer the local rehabilitative services incentive fund.
* Funding recommendations were made to support the development or enhancement of the core services, the local planning boards, and the rehabilitative services incentive fund. A "consumer service fund" was recommended which would fund unique or specialized service needs for which no other source of revenue is available. All services will be subject to a means test to insure the consumer's financial participation to the fullest extent possible.
* Interagency barriers which inhibit service coordination were identified and recommendations were made which will facilitate coordination for a more efficient and effective service system. A commitment to creating no new unnecessary bureaucracies has driven the recommendations for the service structure for persons with physical and sensory disabilities.
These actions will initiate a service system that will improve services while ensuring a long term economic and social return on the Commonwealth's investment.
The implementation of the Commission proposals will initiate the development of a consumer centered rehabilitation service system for persons with physical and sensory disabilities. The consumers and the providers have been challenged to work cooperatively to overcome obstacles to service access and interorganizational collaboration.
The Commission has established priorities for service funding to address the most critical gaps in a continuum of services. Service expansion will be directed to those services currently in pilot or special project status, such as supported employment, case management and personal assistance services. Eligibility requirements have been extended to include a wider age and disability population.
Community involvement has been a major theme of the Commission. Systematic planning for rehabilitation services has traditionally been developed at the state level and implemented locally. The proposed infrastructure for planning, Disability Services Planning Boards, will be composed of local government officials, consumers, and business leaders. Planning will be a bottoms-up approach. The Boards will assess and develop six-year plans for services to persons with physical and sensory disabilities in the community which will identify local needs, service gaps, priority populations and services. These Boards will also administer the local Rehabilitative Services Incentive Fund, where applicable. This money will be used to fund community based programs and services which will enhance the existing rehabilitation system.
The intent of the Commission is to encourage discrete entities to function as a coordinated system with paramount goals of consumer choice and local involvement. New funding is targeted to fill service gaps and stimulate client focused collaboration and enhanced consumer access to services. While the implementation of the Commission's work will not provide all the service options, it will produce a framework for an integrated, consumer based system upon which the Commonwealth and its many diverse communities can build and expand into the next century.