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ROGAN #2

Let's go ahead and look at some of the information that we gathered from this national study.  
We looked across states and found many, many organizations that had undertaken this process. 
We wanted to learn and to get a snapshot from them. How they were doing? What lessons 
they've learned? How they might share their information and expertise with others?  For this 
particular study, we focused on 41 organizations and 25 states. Of those, 12 had actually taken 
the full process to where they no longer had facility-based services.  All of the others were 
somewhere along the process.  

The survey not only gathered information about the demographics:  Who they served? What their 
staffing patterns were? Also most importantly, about that process that they undertook.  We're 
very interested also, in finding out why they undertook the process? What was the catalyst for 
this change? It was very interesting to learn that primarily it was individuals in the leadership 
positions within each organization, whether it be the CEO or executive director or top level 
management personnel, who are driving this, the change process.  I guess that's not a surprise, 
but very significant.  

What were some of the barriers?  Certainly, you know, there's no point in time when everything's 
going to exactly right and in place, and all the pieces lined up perfectly.  We wanted to learn 
what seemed to be getting in peoples way, either before they ever undertook the process or as 
they've proceeded through change. These are rank ordered. About 70% of the respondents 
indicated that negative attitudes, for example, were their biggest impediment.  Just the belief 
systems and the attitudes and stereotypes that all of the stakeholders held from staff to family 
members to board members, business personnel and so on [were negative].  Funding rated 
second.  I think that's interesting, but right up there, regulations get in the way.  We still have a 
lot of old stuff on the books that relates to our traditional system services.  There’s lack of 
expertise. There's no road map. There's no one way.  You have to make it on your own as you 
learn from others, but ultimately gear it to your own unique circumstances.  And [there’s] lack of 
leadership, while a CEO or an executive certainly can try to drive the direction, there has to be 
many others who are in leadership roles to carry it through.  

Some of the other barriers that people mentioned are: we always butt up against transportation;  
people mentioned personal services; personal care attendant issues; and safety net issues.  What 
happens when people might fall out of jobs?  Most importantly, though, barriers exist and these 
organizations found a way to get around, and walk right through them.  We learned that one of 
the key elements is to begin to rally folks around. What are we about?  What is our direction?  
Where are we going?  What sort of outcomes do we want to achieve?  What's the process of the 
path to get there. That articulation of the mission, vision, and values of an organization is really a 
critical early starting point.  The strong leadership piece is promoting the leadership from within 
so that each and every player feels that they have a voice. They have a role to carry and push for 
positive change.  

We've learned that stakeholder involvement is really critical.  Who are your constituents? How 
will any of the changes you undertake impact them personally, individually?  We'll talk a little 
bit later about a process of trying to learn about and pull in your stakeholders. You have their 
buy-in and their support in the process.  We also learned from these organizations, that an 
investment in ongoing staff development, education, training, and developing a climate culture 
of learning was really critical to their innovation, and [the staff’s] willingness to be flexible and 
continue to roll with the punches.  Other strategies that we learned about included examining the 
organizational structure.  How are you currently aligning the staffing patterns in the 
organization?  Are they resulting in the kind of outcomes that you would like to achieve?  How 
might you, perhaps, redefine some of the position descriptions to more effectively deliver the 
services.  

Person-centered planning is just a core anchor key element of all individualized services. While 
there are many versions of the planning processes that have come out in the literature in our 
field, whatever one you use, the objective essentially is to learn, who is this person?  What are 
there interests, dreams, needs? We develop an individualized plan for their daily activities and 
the types of supports they might need.  

And finally, team work is an element that is important to examine.  It is critical as you help 
people redeploy or shift from traditional roles and practices to roles that take them out into the 
community, often working alone or having a lot of freedom on their own.  How might you 
structure so that staff can learn from each other? Support each other? Capitalize on the expertise 
of the various team members.  What were the outcomes?  What did these organizations report as 
the efforts that they achieved?  

While it's fairly simplistic to say people with disabilities were happier, and 90.5% reported this. 
If we dug deeper, essentially what they're saying was that people expressed a growth in their 
self-esteem, and their feelings of self-worth.  People repeatedly talked about the money they 
earned and the increase in their wages and earning that check.  People talked about their greater 
independence and the relationships that they had built in the community.  In all of its various 
shapes and forms, people were saying, "I like it better here in the community."  Very few 
expressed an interest in returning to the facility.  

Staff and organizations reported better quality services.  They felt more focused. They felt that 
they were more streamlined, more directive in what they wanted to accomplish and aligned in 
their practices.  About 70% said that they had better community/employer relations.  I guess this 
is no surprise.  In that they have to be out and about and of the community.  They join the 
Chamber. They develop those business relationships and partnerships.  While not wholeheartedly 
saying this was a good thing, the majority of staff did come away feeling a sense of satisfaction 
and accomplishment, feeling a strong purpose and direction in their work, and being very excited 
about many of the very positive changes in people's lives that they were a part of, and 
instrumental in achieving.  

Lastly, in terms of the outcomes rated about a third of individuals responded that they felt they 
were being more cost efficient in their services through streamlining, through being very 
thoughtful about the way that they allocated their dollars, perhaps unloading some of the costs in 
their building and equipment, and so on. Perhaps getting additional sources of revenue, all 
helping to add up to a segment  that this was working for them financially. It's important that we 
not sell organizational change on the basis of cost savings.  

I put this last piece in to highlight the way that staff reacted to the organizational change process. 
As you know, an organization is only as strong as its weakest link. Because staff are the frontline 
workers, they're the ones that are going to make it happen or not. It's important to know that the 
majority of the staff in these organizations supported the change, that it was the right direction 
and that it was a worthwhile undertaking.  About 64% reported that staff left.  This doesn't mean 
that 64% of the staff left, but of the organizations, more than half reported that they lost staff, 
whether they left or were asked to go. I think that's important, because there are individuals who 
will not buy in, and in many cases it's just as well.  It's best that they move on and out, so you 
can get folks who really want to drive the change.  A small segment reported that there were 
some people who actually mobilized against the change, working hard to maintain what they 
always had. We understand that.  A change can be very scary. People were fearful. There was a 
great deal of investment in the services and facilities that people had worked long and hard for, 
for many years.