A New Way of Assessment - Medical Model vs Person Centered

Dohn Hoyle, Partners in Policymaking Faculty Member, Activist and Organizer
24. A New Way of Assessment - Medical Model vs Person Centered
So, typical 1915 person might have assessments by as many as seven different professionals every year, and those assessments wouldn't look a lot different than the one that came the year before, and not only that, but then they built the plan for the person based on the deficits that they found. Whereas we were talking about person-centered planning and looking at things a different way, so the person who was good at math could end up being a rocket scientist, or teach math, or do whatever there was, right?
Instead of saying, "Well, if you're good at math, you don't get to do math anymore. You have to work on what you can't do." Because when you find people's deficits, we say, "Okay, you don't brush your teeth quite correctly, or you don't do this, or you don't do that." Whatever it is, depending on what your profession is, what you're taught in school is assessments, and assessments are designed to look for deficits, and once you find a deficit, you have to be able to goal around it. Well, that's not what we wanted for people.
You know, that that might work for a new student in special ed a little bit, but it's not gonna work for people who've been through it and now are adults and looking to get a life. So person-centered planning, in many ways, was trying to get around the tyranny of ... the professional tyranny of, of assessments and, and deficits, and the change was enough that our department had naysayers for all kinds of reasons, but it was enough for them to say, "I mean, we won't need to have everybody see all these professionals every year, and they won't have to be sitting, and we have paid them to sit in class."
And we said, "Well, you know what? If they're, if they're good and the person likes them and the person wants them there, okay." They can be part of the plannings, but they ... people also have to have the opportunity to say, 'No, I don't want the dietician in my plan. I don't want the psychologist in my plan.'"
You know, the idea that people with disabilities have told me over and over again: "Never tell anybody what you like because they'll take it away from you and make you earn it." You know, to people with disabilities learn some things much quicker than the rest of us learn, and to know that "Don't tell anybody you like something because boy, they'll take it away from you and make you have to do what they want in order to get it again and then they'll dose it out to you in, in minor ways." The upshot of all that was that we ended up with a 1915(b) waiver, which is a ... it's called a managed care waiver, but it dictated that people had to have a person-centered plan.