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Cornell University. ILR School. Employment and Disability Institute

Course 6: Organizational Change and Person-Centered Planning

Many, if not most, support services for people with disabilities have been traditionally organized to respond to entities that are far removed from the people for whom the services and supports were originally intended. Program structures, resource use and allocations, job descriptions, and outcome measurements are crafted based on external controls, such as funding sources, political agendas, compliance, etc., leading to a domino effect of establishing cost and control centers that serve the system itself rather than serving the unique interest and needs of the individuals who are relying upon the system to be responsive to them.

"System-centered" services are incompatible with providing person-centered services. Person-centered services assume that the "driver" of the services is the person who is making the request for services. It assumes that the person and those who know and care best about the person is the foremost expert and authority in the type of service and support that the person may want or need in order to get on with the business of life. This also implies that the services and supports that the person requests and receives are uniquely designed to be responsive to individual needs and desires. Most service systems are not set up to provide the level of intensity required to customized services. For organizations to move away from system-centered support toward supports and services that are more person-centered or person-driven, shifts in priorities need to happen. Culture, leadership, organizational structure and design must align with the values and principles of person-centered work.

There are eight steps that are necessary to transform an organization:

  1. Create a sense of urgency for the change. People need to feel and understand the need for change.
  2. Establish the right leadership group. Assemble a group/team with enough influence and power to lead the change effort.
  3. Create a vision. Vision is the source of new models, image and structure. Vision is the tool of conscious evolution, is present-centered and directs us toward the future.
  4. Communicate the vision. The language, symbols, and behaviors displayed in the organization must reflect the vision.
  5. Empower people to act in service to the vision. Remove obstacles to change. Analyze systems and structures that block moving in the direction of the vision. Encourage and support risk taking. Create an environment that fosters and promotes a culture for continuous learning. Build respect, trust and partnership within and among stakeholders.
  6. Create short-term wins. Recognize and reward improvements that lead toward the vision. Help people to learn to think "inside the box"~ meaning, help people expand and grow from comfortable skill sets and competencies rather than thrusting people into uncharted territory and expecting high performance.
  7. Consolidate improvements and continue to produce change. Look for, create and take advantage of opportunities to establish best practices.
  8. Institutionalize new approaches. Seek ways to change organizational expectations. Create positive pressure for change.

The organization is the foundation upon which the service delivery system within its walls are structured. If human service agencies are sincere in the desire to support people to live self-defined lives careful attention must be given to how closely the service structures truly align with the type, nature, duration and characteristics of the requests for services made by people with disabilities and their families.