Notes from the CEO – July 12, 2019

I have shared this story before, but its relevance is recurring.

In another working life, I was employed as a Manufacturing Manager for a supplier to the automotive industry.  This was in the early days of “outsourcing,” when entire product lines were sometimes being transferred from an automaker’s internal operations to an outside supplier – and with each product line for which we would take responsibility, a Project Manager was assigned.  In many instances, I was the liaison for these product launches between our company and the automaker; in one particular case, the Project Manager was an amicable gentleman who had risen through the ranks to his current status, which he enjoyed immensely – but he could also be quite stern on occasion.  He was big on deadlines.  And for every one that I was assigned, I completed it ahead of schedule – except one.  I perceived it as a small issue; a July deadline for an August launch, and in the grand scheme of things not a significant job.  When I was late, I remember pleading my case that it wasn’t that big a deal, and it would be done in plenty of time.  First, he glared across the table and made it very clear to me – and all in the room – that he was unhappy, and this was a mistake that should not be repeated. Then he smiled at me – and I’ll always remember what he said:

“You’re still late, Todd.  In this business, you do what you say you’re gonna do, when you say you’re gonna do it, or it all falls apart.  Might be a week late when it doesn’t matter, then it turns into a month late when it does matter.  You’re a smart kid, you oughta know that.  Of course it’s only July.  But it’ll be Christmas before you know it.”

I have replayed this scene in my mind countless times – whenever assurance is given or a deadline looms. It has become woven into the fabric of our workplace culture among the team here at MARO.  The lessons taken away have to do with integrity of commitment, and urgency of delivery. And I believe there should be a continuous sense of urgency in our minds, in what remains a dynamically shifting landscape of regulations and service provision. For those organizations providing supports funded by Medicaid, a transformation from facility-based to community-based employment is a clear mandate through the Home and Community Based Services (HCBS) regulations, sharpening the focus on supports that allow individuals with disabilities to experience enhanced quality and fullness of life.  As you know, the HCBS compliance deadline has been postponed by CMS from 2019 to 2022 – but irrespective of how this is acknowledged in Michigan, or at the local level, it is imperative to move forward with the process of provider transformation.

Unless we, as a network, continue to embrace these changes – while still advocating for individual choice within a person-centered, self-determined service delivery system – we will not be in a position to meet the needs and raised expectations of the people we serve and their families.  Regulations such as HCBS, and WIOA for VR-funded services, establish a framework of raised expectations – these regulations build the car; advisory committees and court decisions might offer a roadmap for what must be different, defining what change looks like as a destination; but it takes practitioners to drive the car and operationalize the transformation process.  Practitioners like MARO members organizations.

There are three legs to the stool of Employment First – policy, practice, and funding alignment.  It is my firm belief that the energy source driving change will be effective practice dissemination by the service provider community – both public and private sector – which means change will only truly occur and be made real by the people doing the work.  Job creators – the businesses actively recruiting a more inclusive workforce; job connectors, the employment specialists connecting businesses with talent; and job holders, individuals with disabilities optimizing employment potential and connecting with community in meaningful ways.

We need to build capacity – the system as it is designed today is not built to deliver the outcomes that are now expected.  This change will be executed in policy; in practice; and alignment with funding.  Outcome oriented service delivery and reimbursement models will become increasingly prevalent. The policies are in place – but just because the regulations say it, that doesn’t make it so.  This is why MARO wholeheartedly embraced the concept of Employment First over 5 years ago – identifying competitive employment in an integrated setting as the optimal outcome for individuals with disabilities; why we actively aligned with the Office of Disability Employment Policy’s Technical Assistance grant; and why we worked hard to secure an investment from the State of Michigan supporting the Executive Order on Employment First – providing access to training and technical assistance for members of this association that would otherwise not have been available.  It remains true today that we must feel the urgency that arises whenever firm resolve is required to achieve a challenging objective, or whenever a deadline is established – no matter how far off on the horizon.  Whether it’s 2019 or 2022, we must continue to push for the highest level of independence and inclusion for individuals with disabilities – because this delivers on the promise of our mission. This association and its members will continue to be drivers of change, to guide this journey, proactively impacting the process and defining the terms of change – rather than reactively responding to it.  And we must remain diligent in that pursuit – because it will be Christmas again before you know it.