Creating Person-Centered Systems
By Valerie J. Bradley
People with disabilities have made great strides over the past several decades. We have moved from an assumption that people with disabilities should be segregated in institutions to believing that they should live everyday lives in our communities. More recently, there is a real concern that our systems are more likely to offer services and supports based on what is important for the person rather than also addressing what is important to the person. We need to change this. Services and supports are not just to protect people’s health and safety but to help them lead more fulfilling lives—lives in which they can define what is important to them. Embracing this idea is one thing; making it happen in practice is harder.
We call this emphasis on helping people to have more fulfilling lives of their own choosing a person-centered approach. This approach recognizes each individual’s unique gifts, identifies people’s strengths, identifies supports to overcome challenges, and tailors supports to the individual’s preferences and goals. A fully person-centered system approach includes individual actions, provider approaches, and system/policy structures that prioritize a focus on an individual’s needs and preferences. To ensure that our systems are operating in a person-centered way, we need to develop universal guidelines that promote person-centered thinking, planning, and practice.
The services and supports available to each individual are spelled out in their support plan. Therefore, the questions described below should determine how the planning process is carried out. Central to a person-centered planning process is balancing what is important to the person and what is important for the person.
Questions to consider when exploring what is important to a person:
- What are your hopes and dreams?
- What brings you joy?
- What things make you comfortable? Or feel safe?
- How do you describe “a good life” for yourself?
- How do you want to spend your days? Free time?
- What types of activities or experiences allow you to have choice and control in your life?
- Who do you want in your life?
The planning process should also explore other aspects of a person’s life. Questions to consider when exploring what is important for a person:
- Do you have a choice of providers?
- Can you include family members and friends in the process?
- Does your plan include community as well as paid supports?
- Are supports tailored to your aspirations and goals?
- Are you offered the ability to self-direct your services?
All individuals receiving supports should have access to person-centered planning. To be confident that this approach is, in fact, happening, it is important to develop consistent indicators that help us to determine whether people are actually experiencing person-centered outcomes. Provider and system indicators include, but are not limited to, the following:
- Are people’s preferences honored in the planning process?
- Do people have control of their daily schedules?
- Are people able to have jobs or volunteer in their communities?
- Can people choose the staff who support them?
- Are conversations conducted in the person’s language?
- Are people’s rights and preferences respected?
To carry out person-centered practices, case managers, support staff, and family members need to understand how to support people in ways that maximize their ability to control and direct their own lives. Therefore, systems need to provide training opportunities at all levels to build competency. By making services and supports more person-centered, we reinforce the importance of treating each person as a unique human whose individual needs and goals are to be respected and addressed. In doing so, people with disabilities can take active direction of their own lives.
Valerie J. Bradley is President Emerita of the Human Services Research Institute.
DRC-NH, in collaboration with the UNH Institute on Disability and the New Hampshire Council on Developmental Disabilities, distribute a quarterly RAP sheet to educate community members and policy makers about the latest research, policy, practice, and advocacy issues affecting individuals with disabilities and their families.