My Vision for the IDD/MI System of Care

 I envision a full continuum of care for those with a wide range of developmental disabilities and mental health and behavioral challenges, which is highly specialized, person-centered, trauma-informed, and free of abuse and neglect, and where service recipients with complex needs can prosper and flourish. We need to offer services à la carte, free of charge, where service recipients are able to choose when, where, and which services are provided. We need to provide choice in all areas of service recipients’ lives. We need to bring back specialized congregate care residential facilities for those for whom a group home does not not suffice, both inside and outside of New Jersey. It would be ideal if service recipients had real friends and companions not just staff and other service recipients. We need separate specialized, highly secure residential facilities for those with criminal charges, and those with highly challenging behavior that requires more than 1:1 support so these individuals do not end up in inappropriate placements at correctional and psychiatric facilities. Service recipients should have access to appropriate transportation options, including small group rides when a bus or train is too overwhelming. Group Homes and day programs should be architecturally designed to be accessible and therapeutic for those with a wide range of disabilities, including being sensory-friendly for those with autism. We need to ensure that provider agencies do not abuse or violate service recipient rights by just writing it up as a behavioral support. Provider agencies should readily offer service recipients grievance forms and praise forms which you get forwarded directly to the state for review, an appropriate intervention, including monetary fines for bad inspections and frequent complaints. It would be ideal if service recipients could work in a job of interest that will lead to a professional career, with support, especially for those who are capable of more than just piecework. We do not want to underestimate or overestimate service recipients’ abilities, such that we are setting them up for success rather than failure. We need more surveillance cameras, including body cameras on staff to help detect abuse and allow the treatment team to determine what might lead to problem behavior by watching how staff and service recipients are interacting. Restraints and seclusions should be reserved for dangerous behavioral emergencies only and not used as a consequence for unruly behavior or because the staff is frustrated.  It would be great if social workers were trained in clinical criteria for each level of care so that service recipients are only referred to programs that will meet their needs. At the bare minimum, we should have access to written clinical criteria similar to Perform Care NJ’s Clinical Criteria https://www.performcarenj.org/provider/clinical-criteria that describe the level of care, admission, discharge, exclusionary, and continued stay criteria, using clinical diagnostic and observable behavioral terms to describe who is most appropriate for that level. Having a full continuum of care for the most challenging service recipients is the heart of my work.