1.4: Ground Level Innovation

Those who produced early person-centered planning approaches did not set out to engineer individual planning processes for systems. In fact, naming person-centered planning as a distinct form of practice came very late in the 1970s and early 1980s. Identified practices, such as Personal Futures Planning (Mount, 1984), emerged from assemblage of ad hoc practices to identify desirable changes in the organization of services.

Our network participants felt personal responsibility to accompany known people in their quest for a good life in a particular place. Some were members of families of people with disabilities. At work, some network members were responsible for developing and managing local day or residential services. Others assisted institution inmates to resettle. Others organized families and young people seeking a path from (usually segregated) special education into adult life in their community. Others offered support in crisis. A few were responsible for developing regional systems of social care services. A few were disabled leaders of early efforts to encourage people with developmental disabilities to speak for themselves. All wanted publicly funded services to offer better assistance than they currently did.

While we were by no means the only people to develop a critique of existing services, our network provided a platform from which we could observe ourselves as actors in a system we increasingly felt called to change. A powerful instrument for self-observation came in the unexpected form of a service evaluation instrument, PASS (Wolfensberger and Glenn, 1973), which operationalized 34 dimensions of the principle of normalization. While very few authorities ever used PASS to score the quality of the services they commissioned, investments in teaching PASS and applying it in consultations offered us multiple, intense opportunities to observe and reflect on snapshots of the day-to-day experience of people in services. The process of team debate produced knowledge that stimulated innovation. We named many ways that current service practices –our practices– reproduced social exclusion and restrictions of human rights and analyzed their causes. We noted the costs and limits that established service structures imposed. Most important our practical imaginations were lit.

Growing commitment to change in our own practices and structures introduced ambiguity into the roles of those of us who worked in social care. We felt responsibility to change the system that we worked inside and depended on. Very few of us had job descriptions that authorized us to be change makers. A growing number of us discovered openings for innovation at the edges of our formal responsibilities. Some found enough space to create individualized alternatives to group living, develop integrated employment and other supports to community participation, prevent social isolation and promote belonging, and discover strategies for accommodating differences rather than focusing exclusively on fixing diagnosed deficiencies. Many times these were one

person innovations developed to interrupt a pattern of service failure that threatened a person with exclusion or to support a person and family with a strong vision and assets to invest in action. (For a variety of examples of such ground level innovations, see Meissner, 2013; O’Brien & Mount, 1991; O’Brien & Mount, 2015).

Our purpose, individualization of support for meaningful community roles, demanded a guiding and motivating narrative that expressed each person’s identity, capacities, requirements for assistance, and personal images of a desirable community future.

Otherwise we risked reproducing the institutional practice of classifying and managing people in groups. Identified approaches to person-centered planning emerged to invite people with different perspectives to come to a shared understanding of a desirable future that was strong enough to motivate and guide action. From its origin person-centered planning was inseparable from the work of discovering community opportunities and developing new ways to organize support.

The context of ground level innovation shaped these forms of person-centered planning differently than mainstream reforms would have done. Through years of development these enduring qualities of person-centered planning at the edge took shape. At their initiative or with their permission, innovators join a person in an effort to improve life chances for themselves and other people with developmental disabilities. The person is addressed as a citizen seeking more opportunity to live a community life that they value. Those involved recognize themselves as engaged in an action learning process. They explore new ways to push back limits on what is possible, rather than following established practices to produce more of the same. They will meet resistance, both in the world outside and within themselves. The purpose of meetings is to organize action and learning by all those involved, not to write orders, wishes, or demands for others to fill. Family, friends and other citizens are seen as allies and agents of change as are direct support workers. The number of people involved will change: a bigger circle of people will be involved in big changes; fewer when things are stable. Social care ser-vices are means to support citizenship. It is right that the person is in effective control of supports, though this can be complex in practice. The person’s desired future defines the context and limits for applying clinical expertise, technologies, and strategies that increase a person’s capacities to perform desired community roles. Because the social innovator’s effort is grounded in responsibility to a person they know, feedback on what is working and what is not is rapid, situated, and open to quick response and real time revision.

From its earliest days person-centered planning has contributed to ground level social innovation in two ways. It brings a person and their allies together to form a circle that collectively holds and updates an understanding of the person’s identity and images of a desirable future that are powerful enough to activate, focus, and sustain each circle member’s contribution to positive change in the person’s experience of community.

And, it builds habits of conversation that encourage deep listening, creative imagination, and courageous action when obstacles, failures, conflicts, and breakdowns of trust threaten the person.