What is individual service coordination?
Individual Service Coordination (ISC) is a service families may choose to use when they need help obtaining needed supports for their sons or daughters to live as independently as possible in the community. ISC is a distinct social service that enables people with mental retardation and their families to find, utilize and coordinate available resources and opportunities in their communities on the basis of individual need (The Arc, 1990). Other terms used to describe ISC activities include service coordination, service integration, client-level service coordination and case management.
What are the major components of an individual service coordination system?
Although ISC systems vary, they typically include the following components:
Who provides individual service coordination ?
ISC may be provided by human service, mental health or developmental disabilities agencies, health care providers, education agencies and frequently by families themselves. Parents or guardians who arrange for services, therapies, appointments and payments, and manage the home and social dimensions of their child's life are, in fact, providing service coordination.
Agencies providing individual service coordination typically employ service coordinators to support individuals in obtaining the programmatic and support services which they need and seek. The service coordination system should be independent of providers of services to ensure that service coordinators are free to advocate based on the preferences and needs of the individual rather than the needs or constraints of the service providing agency (The Arc, 1990).
What is the role of the service coordinator?
Service coordinators help people with mental retardation and their families identify and obtain needed services. Service coordinators also advocate for, monitor and evaluate services along with families or guardians. A key role of the service coordinator is to assist people with the process and paper work necessary to obtain services. The system of multiple agencies providing services for people with mental retardation can be complex and confusing. Families often must collect information, fill out forms, make appointments and visit different places before the right services for their family member can be obtained. All of this can be time consuming and frustrating. Good service coordinators provide a "single point of entry" into services for the person with mental retardation.
Individual service coordinators should be well-trained and know the community, individuals and families whom they serve. They should be competent, sensitive and committed to representing the interests and preferences of the individual and/or family. They must provide reliable information, help explore options, coach individuals and families and guide in making informed decisions and gaining access to services and supports. They also should assist in the coordination of service providers to work with the individual toward consistent goals which reflect the personal needs and wishes of the individual (The Arc, 1990).
What is the individual's or family's role in individual service coordination?
Services should be developed around the individual and family rather than trying to fit them into existing services merely because of availability. Service coordinators should utilize and strengthen formal and informal resources. Informal resources include family, friends, co-workers and neighbors (The Arc, 1990).
The person or family or guardian who requests service coordination assistance holds the ultimate decision-making power throughout the service coordination process, including:
What are the elements of "best practice" for an individual service coordination system?
Individual service coordination services vary, but there are some key elements that indicate quality services. These include:
(Minn. Governor's Planning Council on Developmental Disabilities, 1988.)
What are some conditions that inhibit a service coordinator's effectiveness?
Too many people to serve. The chief problem faced by many service coordinators is the number of people they have to serve. Service coordinators may serve more than 100 people, some close to 300. The Arc believes the number of individuals served by each service coordinator must be kept to a minimum in order to assure the service coordinator the opportunity to establish strong working relationships with individuals and families. Variables which must be considered when establishing that number include level and intensity of need, geographic location, crisis situations and age of individuals (The Arc, 1990).
In general, good practice is for each service coordinator to serve no more than 25-30 individuals (Minn. Governor's Planning Council on Developmental Disabilities, 1988). However, there are circumstances when a service coordinator can serve only 10-15 people effectively because of the various factors mentioned above.
Inadequate Training. Untrained service coordinators are often hired. As a result, they might spend more time on paperwork and other tasks with less effective outcomes. They might not address problems in a timely fashion, if at all. Preservice training should not focus solely on clinical social work, but should include community organizing, advocacy and state-of-the-art approaches.
Gaps in community services. In order to be effective, a service coordinator needs to have access to a wide range of community resources. A 1987 survey by The Arc revealed extensive waiting lists for community services throughout the United States. More than 63,000 people were waiting for residential services, while nearly 76,000 were waiting for daytime programs (The Arc, 1988).
Services must also be appropriate and satisfying for the individual and his/her family and based on value-based principles such as individualization, respect, dignity, freedom from harm, integration (participation), independence (interdependence) and productivity contribution) (The Arc, 1989). Gaps may exist if available services do not meet these elements of quality.
What is needed for high quality service coordination to be widely available?
The Arc believes that it is in the public interest that people with mental retardation be integrated into their communities. Therefore, public funds should be made available at appropriate levels to support the essential function of individual service coordination that is of high quality as measured by effectiveness, responsiveness, continuity, reliability and acceptability to the user (The Arc, 1990).
The Arc. (1988). "A Status Report on Waiting Lists for Community Services."
The Arc. (1989). "Position Statement on Quality."
The Arc. (1990). "Position Statement on Individual Service Coordination."
Minnesota Governor's Planning Council on Developmental Disabilities. (Jan. 11, 1988). Summary of Case Management Practices.
This fact sheet was prepared with the assistance of The Arc's Program Services for Children and Adults Committee, 1990.
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Revised July 1992