Case Management Workforce Supporting People With Intellectual and Developmental Disabilities: Indications of a New Frontier of the Workforce Crisis

Bogenschutz, Matthew; Dinora, Parthenia; Johnson, Khalilah R.

doi:10.1352/1934-9556-57.6.499

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Of the four original research papers, two described the United States “Cash and Counselling” model (Harry et al, 2017; Mahoney et al, 2019), one described Case Management services for people with intellectual and developmental disabilities (Bogenschutz et al, 2019), and one explored planning supports for people with complex support needs across disability, mental health, alcohol and other drugs, housing, and criminal justice (Collings et al, 2018). Components are summarized in Table 3 (Supplemental Material).…”

Section: Resultsmentioning

confidence: 99%

Intermediary Services to Assist People With Disabilities to Implement Individualized Funding Plans: A Rapid Systematic Review

O’Brien

Randjelovic

2022

Journal of Disability Policy Studies

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A systematic review was conducted to describe, and evaluate the effectiveness and cost-effectiveness of, intermediary services to support people with a disability to implement individualized funding plans. We included six records, including one subanalysis of randomized trial data, three qualitative studies, and two systematic reviews (reporting on 73 and 18 studies, respectively). No studies directly compared “consumer-directed plan plus intermediary services” to “consumer-directed plan with no/alternative intermediary,” so effectiveness of these interventions is uncertain. There is qualitative evidence from the perspective of disability planners and workers that intermediary interventions are important enablers of successful plan implementation. There is also qualitative evidence from consumer and family perspectives that external support is required to successfully navigate self-directed systems and that strong, trusting, and collaborative relationships with both paid and unpaid individuals in the person’s support network were facilitators of successful plan implementation. There was evidence of disabling practices and attitudes among some support agencies, resulting in coordinators being very risk averse in order to safeguard their clients. Suggestions for future research include carefully planned and ethically robust comparative trial designs, clear description and consistent delivery of interventions, and long-term evaluation of impact. The protocol was published on PROSPERO (CRD42020177607).

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Section: Resultsmentioning

confidence: 99%

Intermediary Services to Assist People With Disabilities to Implement Individualized Funding Plans: A Rapid Systematic Review

O’Brien

Randjelovic

2022

Journal of Disability Policy Studies

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“…This responsibility may be further complicated by the sheer number of people requiring support within the community (Szabo et al, 2012). The developmental service sector is experiencing what has been considered a workforce crisis (Bogenschutz et al, 2019; Tassé et al, 2020). Direct support agencies are struggling to maintain direct support professionals, as there are high turnover rates, poor compensation, and limited availability for training, supervision, and qualified personal (Bogenschutz et al, 2019; Johnson et al, 2021; Tassé et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…The developmental service sector is experiencing what has been considered a workforce crisis (Bogenschutz et al, 2019; Tassé et al, 2020). Direct support agencies are struggling to maintain direct support professionals, as there are high turnover rates, poor compensation, and limited availability for training, supervision, and qualified personal (Bogenschutz et al, 2019; Johnson et al, 2021; Tassé et al, 2020). As a result, agencies struggle to provide appropriate and effective training.…”

Section: Introductionmentioning

confidence: 99%

Training programme for community service providers who support adults with intellectual disabilities: A systematic quantitative literature review of single‐case research

Mullins,

Scott,

Cox

2023

Research Intellect Disabil

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BackgroundResearch on training direct support professionals to address challenging behaviour exhibited by adults with intellectual disabilities is essential in generating effective training approaches for this sector. This systematic review's objective was to evaluate the effects of training types and whether specific training delivery components influenced outcomes.MethodsFollowing PRISMA (2020) guidelines, 16 single‐case design studies were included that directly evaluated behaviour change of service providers training for adults with intellectual disabilities in community settings. Study quality was assessed using Horner et al. (Exceptional Children, 2005, 71(2), 165–180) criteria. The database searched included Academic Search Complete, CINAHL, Embase, ERIC, Psych Info, and Web of Science.ResultsDescriptive analysis of effect size outcomes suggested that all training types were associated with improved outcomes. Further, in situ training was associated with improved service provider performance. Interestingly, feedback was associated with poorer service provider performance.ConclusionsWe provide possible explanations for this surprising outcome and propose future research.

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“…There have been significant difficulties in recruiting and retention of case managers, due to a limited applicant pool and salary being viewed as low compared to qualifications and demands of the job. (Bogenschutz et. al.…”

Section: Clients In Isls and Group Homesmentioning

confidence: 99%

Narrative power: social control in ISLs and group homes

Bledsoe¹

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Narrative power is used in residential settings providing care for adults with intellectual and developmental disabilities as a tool of social control. Framing narratives, stories and accounts influencing the accepted version of events, are used by clients, staff people, supervisors and professionals to influence and control the behavior of people in this social world. Identity narratives, stories and accounts influencing the accepted identity of different social actors, are also used to influence and control the behavior of people in these settings. Individualized Supported Living arrangements (ISLs) and group homes are settings where the social role of a client, a person with intellectual and developmental disabilities receiving support in this setting, is a clearly marked social role with almost no ability to exert narrative power independently, making the framing narratives and identity narratives of other actors the dominant narratives in their lives. Staff people, supervisors, case managers, behavior analysts and other professionals in this social world are able to effectively use narratives as tools of social control over clients, staff and other social actors within this milieu. These decentralized settings typically have one to three clients living in homes and apartments in the community with direct care staff support to assist them with their individualized needs, including activities of daily living, medication administration, behavioral support and community integration. Staff people routinely work for extended periods of time with no effective supervision, setting up a significant power disparity between staff and clients. Framing narratives and identity narratives are routinely deployed by staff in these settings to control the behavior of clients. Attempts by others to use these same tactics to control the behavior of staff people and other non-clients in this social world are routinely met with alternative narratives, or counter-narratives, that blunt the effectiveness of these tactics. Clients were unable to effectively deploy counter-narratives, with the exception of making allegations of abuse or neglect against staff people or others. This tactic sometimes led to outside agencies conducting inquiries. Lengthy ethnographic interviews of eighteen people with insider experience in the social world of ISLs and Group Homes were conducted in an active interviewing style designed to elicit narratives detailing the ways in which power is used as a tool of social control. These narratives were transcribed and analyzed to assess how the respondents used narratives to depict the use of power in this social setting. This analysis produced a number of significant findings. The most significant behavioral changes reported by respondents occurred when the framing narrative or identity narrative was internalized, effectively making the person their own agent of social control. Respondents all depicted themselves in positive terms, while framing others in negative terms and were supportive of increased accountability for other social actors in this setting, but not for themselves. Client advocates are necessary for meaningful client choices to be implemented in this social world, due to the lack of client narrative power in these settings. Institutional methodologies of social control can and do occur in decentralized community placements, making oversight to prevent the abuse and neglect of vulnerable clients a critical need in these settings. The reluctance of caregivers and others to report abuse and neglect of clients, despite being mandatory reporters, appears to be due to fear of reprisals and lack of faith that reporting abuse and neglect will make a difference. Agencies providing ISL and Group Home services receive significantly different levels of oversight based on political and social connections, with large and well-connected agencies getting differential treatment not afforded to smaller agencies with less political pull.

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Case Management Workforce Supporting People With Intellectual and Developmental Disabilities: Indications of a New Frontier of the Workforce Crisis

Cited by 4 publications

References 9 publications

Intermediary Services to Assist People With Disabilities to Implement Individualized Funding Plans: A Rapid Systematic Review

Intermediary Services to Assist People With Disabilities to Implement Individualized Funding Plans: A Rapid Systematic Review

Training programme for community service providers who support adults with intellectual disabilities: A systematic quantitative literature review of single‐case research

Narrative power: social control in ISLs and group homes

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