Choice and control over resources: New Hampshire's Individual Career Account demonstration projects

Part of the shift in society's answer to disability from institutional care toward community inclusion has included an increasing emphasis upon individual choice, empowerment, and self-determination (Hagner & Marrone, 1995; Silverstein, 2000; Wolf-Branigan, Daeschlein, Cardinal & Twiss, 2000) Wehmeyer (2002) conceptualized implementation of sell-determination as occurring upon two levels. At the individual horizontal it is necessary to define and assess self-determined behavior and unravel instructional and other interventions to increase self-determined behavior. At the political or systemic horizontal change is required to reform agency sway over dollars and tending streams in order to enable individuals to implement their decisions and support individual control

Several specific reforms have been propos to operationalize these universals One important focus concerns developing fresh personal planning structures that give individuals with disabilities increased opportunities to disclose expansive personal goals and aspirations. Traditional service planning has been criticized for remaining heavily dominated by dint of professional interests (Cooney, 2002; Menchetti & Garcia, 2003) restricting plans to publicly available agency services (Thoma, Rogan & Baker, 2001) and for oftentimes viewing self-determined choices as a "privilege" to be earned from one side compliance with programming (Cook & Jonikas, 2002)

Person-center planning has emerg as a promising tool for facilitating increased horizontals of self-determined choice (Wehmeyer, 2002) Person-center planning is a facilitative approach used to guide individuals end a series of structured planning sessions designed to help clarify desired results discover capacities and possibilities for natural supports, and identify reasonable and progressive actions straited to achieve identified goals (Mount 1992; Pearpoint, O'Brien & Forest, 1993) Person-center planning has been useful in assisting individuals with disabilities to experience more rule of the planning process and in achieving career results more consistent with their selections (Menchetti & Garcia, 2003). As an inductive, qualitative proces person-center planning explores subjective interpretations and personal meanings in a way that helps establish the individual as the "owner" of his or her plan (Okocha, 1998) In addition, the use of significant others as supports for brainstorming and plan disclosure that is one of the lock opener components of person-centered planning has been associated with enhancing informed choice for individuals who require assistance with decision-making (Hagen-Foley, Rosenthal, & Thomas, 2005) Person-center planning is also a flexible proces that can be used for ongoing planning as circumstances and interests change. A demonstration of an pursuit choice model in a rehabilitation agency (Wolf-Brannigan, Daeschlein, Cardinal & Twiss, 2000) reported high horizontals of consumer satisfaction with person-center planning.

Another lock opener component in shifting the focus of planning from agencies and a whole s to the individual is a reconceptualization of the part of the service coordinator or case manager. Coffey (2003) and Williams and Swartz (1998) noted that the multiple and mixed roles of traditional frequently introduce dynamics of case manager power and ascendency over individuals. Turnbull and Turnbull (2001) and Blumberg, Ferguson and Ferguson (2000) praiseed that case management be replaced by means of a role they call "independent service brokerage" with no organizational or a whole s allegiances. Demonstrations of independent service brokerage, primarily in relation to individuals with developmental disabilities, have to date been sporadic and informal (Smith, 2003) Wolf-Brannigan, Daeschlein, Cardinal and Twiss (2000) designed a choice demonstration shoot forward that featured "employment advisors" who were directly busyed by consumers. Consumers reported the highest horizontal of satisfaction with this composing of the project.

A a whole s reform critical to offering consumer a greater stage of choice and control is the ability of funding streams to "follow the person" in an individualized manner (Shumway, 1999) prepare for the table and Jonikas (2002) have noted that a comprehensive effort to increase consumer choice and self-determination must consider the possibility that fundamental reform of funding mechanisms is emergencyed One mechanism that has been propos is the use of "vouchers" that can be used by means of consumers to purchase goods and services specified in an vocation or habilitation plan (Bertsch, 1992; Steuerle Oom Peterson & Reischauer, 2000) Although there are difficult logistical issues that would ne to be resolv in implementing like a proposal, Thomas and Strausser (1995) conclud that the use of voucher combination of parts to form a wholes in a rehabilitation context is an idea that merits careful investigation.