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Person-Centered Services and Organizational Context:
Taking Stock of Working Conditions and Their Impact
Hulgin, K.M. (2004) Person-centered services and
organizational context: Taking stock of working conditions and their impact.
Mental Retardation, 42(3), 169-180.
Article Summary
The author compared eight agencies that had adopted person-centered services, to
a greater or lesser extent, for individuals with disabilities. Her goal was to
determine the types of contextual factors within an organization that would
either enhance or limit the provision of person-centered services. Data was
collected over a 2.5-year period and focused on the question, “What is
associated with the proportion of person-centered services that an organization
provides?”
The agencies were distinguished by the following factors: characteristics,
images of people with disabilities, images of organizing, and approaches to
policy. On a continuum that followed their allocation of resources and
commitment to person-centered services, they were identified as learning
organizations, a smorgasbord organization, or an innovative bureaucracy.
The six learning organizations were those most committed to person-centered
service delivery. This category subdivided into ground-up and conversion
organizations. The four ground-up organizations had started based on providing
person-centered services and did not have a history or tradition of providing
segregated, center-based services for individuals with disabilities. They also
had the most control over their size, allowing a very personalized approach. The
two conversion organizations had some history in providing congregate services
but were still young and small enough to change to person-centered programs.
Interestingly, one of the two agencies lost two-thirds of its staff and the
other saw a complete turnover during the conversion process.
The smorgasbord organization was a private, parent-driven organization that had
a long-standing tradition of providing services to individuals with disabilities
who had been excluded from most public programs. It was innovative in getting
funds but retained largely segregated programs as part of a long-standing
commitment to protect those people who parents felt that the public had
rejected. This did not prevent them from endorsing and utilizing some
person-centered services as a formal part of their organizational programming.
The lone innovative bureaucracy was a large state agency that operated one of
North America’s oldest institutions. It had a long-standing history of providing
segregated services for individuals with disabilities; and its limited
person-centered services, although well-executed, were clearly the exception to
its more traditional center-based facilities. As person-centered services are
increasingly put into place, the study shows that both policymakers and
organizational leaders would be wise to look at the change process in regard to
organizational contexts to determine how to best move in this direction.
AAMR Journals Online
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Special Topic:
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