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Slide #2

Let's start here by looking at the way many organizations in our communities are 
currently structured.  [They are] kind of like a pyramid, with the CEO or 
executive at the top.  We've got some fiscal people, who have some marketing 
position, the human resource person, and even some vice presidents in upper 
managerial staff.  Then we've got the programs:  residential, sheltered work, 
day activity, supported employment, and then some.  Ring a bell?  Look familiar?  
As we begin to move away from facility based services, this might be helpful to 
kind of see where we're moving from, and what we're moving to.  Traditionally 
because of the boxes into which we place people, the programs into which people 
are slotted, we end up slicing individuals in different parts and pieces of 
their day and their lives.  

Instead, with our design around the people, services designed around each 
person, we're looking more realistically at the individual that has implications 
for the way the staffing patterns evolve.  Instead of organizing people tied to 
a program or a department, we're looking around the people, instead of having 
people whose job description is so isolated.  In some organizations, we have 20 
odd job descriptions, all working with the same set of people.  It's really 
quite amazing, in a very tight specialist kind of approach, we see more 
organizations that have broadened the job descriptions, and have helped people 
to become broad band a bit in the way that they learn and do some role sharing 
as a member of the team and learn each others’ roles.  I'll talk more about that 
as well.

Here are a couple other examples of the shift that we might think about and 
undertake in organizational structure.  Some places assign case load by 
disability level.  You work with this population. You've got that program with 
people who have these characteristics. Whether it be people with the highest 
support needs, people with behavioral issues, people who are older, and so on.  
It might make more sense for us to think rationally. Who do you know?  Who do 
you already have a relationship with?  Maybe geographically, where do you live?  
I live there, too.  I know that community.  You're in that community.  What 
might be a different way for us to organize in a common sense approach around 
the people we serve?  [Look at] management issues in a hierarchical or a stacked 
kind of organizational chart.  

There's a lot of management decisions that are flowing from the top to the 
frontline people.  What we're hoping is that we're going to see a lot more 
empowerment or investment in frontline staff who might be able to take on more 
of those decision-making roles. They know the people best.  They're closest to 
the individuals receiving services.  [When] backing up to the ratios, sometimes 
we say our ratios are 6 individuals to 1 staff.  If we move to a teaming 
structure, it might make sense to say, “We have this many people, 20 
individuals, who are being supported by a team of staff who share roles in the 
day to day services.”  

As people move up in an organizational hierarchy, it's typical that they move 
away from the individuals who receive services.  Sometimes to the point of being 
so distant and yet still making the decisions that affect the services, that 
there's a disconnect.  We are hoping, and [we] have seen it work that by 
flattening and removing some of those middle manager roles, we empower the team 
leaders and the people on the frontline. [We] also set an expectation throughout 
the organization that people do have contact with the people receiving services.