The Transformation of Public Sector Intellectual/Developmental Disabilities Programming

Abstract

Programming for persons with intellectual and developmental disabilities has shifted from state institutional care to community‐based services, facilitated by federal government support as well as services delivered by nongovernmental organizations (NGOs). For persons with mental retardation, epilepsy, cerebral palsy, and autism, these programs not only have moved into the health care orbit but also are in search of more holistic ways to maintain persons with their families and in communities. Three major forces have led to this shift: federal financing, particularly under Medicaid; integration of services around clients; and externalized service delivery by NGOs. These are increasingly connected forces, facilitated particularly by the Medicaid Home and Community‐Based Services Waiver. They have transformed state‐operated systems. Increasingly, states are working with NGO case management and service delivery providers to organize and integrate services to face this continuing challenge.

The experiences of family carers in the delivery of invasive clinical interventions for young people with complex intellectual disabilities: policy disconnect or policy opportunity?

“…At present it appears that ICI education for parents and social care workers is patchy and opportunistic with no clear programme or means of assessing and evidencing competence or providing ongoing support and supervision. The absence of a planned and coordinated strategic approach to education, preparation and supervision therefore offers the opportunity to offer accreditation for parents to delivery ICIs (Agranoff ).…”

“…As more people with intellectual disabilities require ICIs, there will be increasing demand for packages of care within and out with the family home setting. As a result there are wider strategic workforce and resource issues that must be identified and planned for by health services, social care and care providers to meet future demand (Agranoff ).…”

Understanding Interoperability in Collaborative Network Management: the Case of Metro High School

“…IOp involves both process and technical aspects of systems that need to be integrated by making components of systems work together [12][13][14]. Indeed, Glazer (2012, 119) concludes, "an operation must first be organized… and is fueled by effective decision-making and effective decision-making is driven by data" [15].…”

“…HCBS has financed an array of community services in all states-personal assistance, public accommodations, employment, technology access, post-school training-that are coupled with housing and income support in search of integrated client-based services [13]. The federal-state program allows for the necessary crosswalks between services and programs focused on maintaining disabled persons out of institutions and large facilities [10,13,32].…”

Entrepreneurship as a means to Employment First: How can it work?

“…As our national and local economies, as well as values-based developments in human services, demanded a look toward more equitable economic participation for all in the decades since, we found how difficult it can be, in our turbulent economic environment, for many marginalized people to get jobs of any kind -never mind ones that were satisfying to them and lead toward economic self-sufficiency (Agranoff, 2013;Block, Kasnitz, Nishida, & Pollard, 2015;Butterworth, Migliore, Sulewski, & Zalewska, 2014;Iceland, 2013).…”