For the past 15 years developing a person centered service/support coordination role in the developmental disability system has been a priority for me. I have seen the changes from the mid 1990's of service coordination role to the present role. Luckily, we as a state system are moving back to the roles of advocacy, support, facilitation and resourcing that we were really getting good at in the mid 1990's.

When I started in 1995 with the Department of Mental Health as a service coordinator, my vision/passion and job were in alignment - helping people and their families live the lives they wanted. I spent time with people and their families in rural Missouri. There were few paid services, thus we relied on networking and coalition building to get people and their families supports they needed. We had time to get to know people and develop plans with them that focused on real outcomes. Service coordinators were identifying what changes needed to happen in the system to facilitate "real lives" for people. When paid services were authorized, congregate days services and vocational programs were switching to individualized supports in peoples' communities and supported employment was key. Service coordinators linked families together to provide support to one another, share resources and talk about school experiences - a general support network.

What happened?

Scarcity of resources and increased attention to quality of supports and services. The role of the service coordinator became inspector, monitor, justifyer of paid services and then if time, advocate, facilitator and resourcer. What I have seen is a gradual move away from the activites that save the system money (resourcing, advocacy, networking) to regulatory activities to keep people safe and preserve the limited dollars available within our state system. It seems strange that an increase in focus on quality would change the role of service coordinators so dramatically. Quality is good afterall.

When I ask this question around the country to service coordinators, "How many of us became service coordinators to monitor, complete paperwork,bill for our time, justify the need for services, and/or act as "police" in finding mistakes and concerns with agencies providing residential services?" No one has yet to raise their hand. These activities are not inherently "bad". Ensuring quality services/supports that do help people achieve their person outcomes is a really great thing! Service coordinators want to help people achieve success all around. Scarcity of resources brought about high numbers of people each service coordinator/support coordinator was supporting and fear on the "system's" part that we might run out of money. We built our system to respond to crises rather than prevent crises. This costs more in resources: money and time.

Recently in our state, we have started to hear the words supporting, connecting, planning with families and people and advocacy.  We are seeing traditional service models change - the advocacy service coordinators have been doing for years of saying people need more choices - to live how they want to live, work where they want to work and have CONTROL in their lives, is slowly changing.

Service coordinators have continued to be one of the voices from within the system for change. Using person centered thinking tools to identify what is working/not working from their perspective, as well as learning this for all the people they support, provides a foundation for action and change. We need this information in order to do the true sense of service/support coordination.