Coordinating Services Through Outcomes
Service coordination attempts to unify the pattern of services and supports that are provided to individuals with disabilities. This coordination can take place at a regional level by a regional service coordinator or case manager, and/or at the organizational level by the qualified disabilities professional or an individual program coordinator. In some instances the coordination of services takes place at both an external and internal level. An external service coordinator coordinates the supports and services between and among agencies, and an individual program coordinator designs a unified habilitation plan within a single agency. There is no consensus regarding the relative merits of either internal, external, or dual systems of service coordination. Local circumstances and expected outcomes suggest circumstances in which one method may be preferable to another method of coordination.
Program standards often do not enhance the coordination of services and supports because they focus on programs rather than people. As such, programs, and the staff of the individual programs, focus on those characteristics of the individual that are most directly linked to their program and the set of standards for that program. As a result, they downplay or ignore individual characteristics, needs, and situations that are more directly related to other programs and sets of standards.
For this reason, residential, vocational, leisure, health, and education programs focus on their own responsibilities and find it difficult to coordinate services across program settings. Each program is driven by a different set of expectations, standards, and rewards.
Program standards divide the individual and parcel out to the particular programs responsibilities for different aspects of the individual's life. Different agencies with different standards and expectations assume responsibility for distinct and limited aspects of the person's life. The work training program, for example, accepts responsibility for the individual, and the psychiatrist, medications, and behavior become separate issues that assume importance only if the individuals behaviors present obvious barriers in the work training program.
Personal Outcome Measures® are suited to service coordination because they are generic. They apply to a wide range of people with different challenges who may receive multiple services and supports from several different organizations. The Personal Outcome Measures® will assist the providers of supports and services to specify the manner in which their support or service contributes to the prioritized outcomes for each individual. The Personal Outcome Measures® will enable the service coordinator to recognize that residential, vocational, educational, health, and leisure services are different methodologies or means to the outcomes that people want in their lives. Any single support or service or combination of supports and services should be directed toward the prioritized outcomes for the individual. Personal Outcome Measures® provide the service coordinator with the practical guide to integrating and coordinating services around the individual rather than the organizational process of individual programs.
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