I’ve presented at conferences on the topic of the importance of social networking and social media for human services providers, and I have posted on this blog many times about our efforts at Keystone Human Services.  Now, many human services providers are on Twitter and Facebook, and it has me thinking about social networking and the people we support.  (For an example of the growing number of service providers on Twitter, see my list http://twitter.com/#/list/jbuford/intellectual-disability.)

People supported by human services providers are all vulnerable in one way or another—some only temporarily, others more systemically—and one of our important tasks is to shore up their areas of vulnerability.  Those efforts can sometimes lead to a blurring of the lines from a professional relationship to one that looks more like friendship.  The ethics of that are clearer in fields such as social work, psychology, and psychiatry (i.e. the principles of confidentiality and dual relationships)  than they are for the people who directly support people with intellectual disabilities, mental illness, autism, or other challenges in the community.  In this setting the guide posts are far murkier .

True to form, I have no answers to these myriad ethical dilemmas.  In fact, I don’t even have the questions.  I have a strong sense, though, that those of us who think we have an obligation to make sure our communities are welcoming to all people, need to think through the hazards, and the benefits, of “friending” people we support.    Already the digital divide disproportionately excludes many people from the community we all enjoy in the social media.

In my organization I’m putting together a diverse panel of people to begin to define questions and an ethical framework, but I’d like to have the conversation here in the social media as well.  Do you or your organization struggle to find the right answer to how to help someone with an intellectual disability navigate Facebook safely, without paternalism or odd blurring of lines?  Have you already answered questions about how to respond when someone you support “friends” you?  Please let me know how you are framing the questions, and maybe we can work together to craft answers.

Thanks!

Advertisements

Over a year ago I had the privilege of attending the expo portion of the Clinton Global Initiative annual meeting.  I was very impressed by all the people I had the privilege of speaking with, and  I wrote about it at the time.   (It’s  a little encouraging, actually, to reread that post and see how energized I was.) While there I visited with the good people from Pure Digital and loved that they were putting Flip video cameras in the hands of nonprofits to document their impact on people’s lives.    Wow, I thought, that would be great for Keystone Human Services, and for human services in general.  Self-documentation fits right in with our mission of supporting people in finding their voice in the community.

So, I am happy and humbled to report that Pure Digital has extended the grant to us, and I now have several Flips in my office, waiting for me to get my act together and create the self-documentation project.  This will be very cool, but I definitely didn’t do enough up-front work on the practical aspects of implementation.  Even people who have managed projects for years can sometimes lose sight of the importance of pre-planning.

It will be cool, though.  Thanks Pure Digital and Flip Spotlight;  you’re helping to Advance the Human Spirit.

imagesDaniel Henninger, the author of the Wonder Land column in the WSJ, wrote today (10-29-2009) about “Obama and the Old Hat People.”  Today’s column is about the current health care reform proposals making their way through the US Congress, and the current emphasis on dramatically expanding Medicaid alongside the much-debated “public option.”  Henninger places the thinking behind these proposals squarely in the “old hat” category, calling them “pre-iphone” proposals.

Leaving aside the politics or the persuasiveness of his argument, his use of “old hat” thinking and “pre-iphone” proposals got me thinking about old hat, pre-iphone proposals in human services.  In this field we are all too familiar with the Medicaid model and its myriad rules, regulations, complexities, compliance pitfalls, and frustrations.  15 minute billing increments, arcane rounding rules, encounter forms, eligibility change management, concurrent auditing, and much much more are part of the daily lives of human services delivery systems and the people we support.  They are also a part of the infrastructure –human and technological–that human services organizations must have to survive.  We all have software designed to manage the minutia of the rules.

images-1

It just doesn’t get much more old hat than that.  

Most human services organizations are moving to service models based fundamentally on the individual being served.  We call it person-centered-planning, self-determination, or any number of other names, but we are often stymied by old hat bureaucratic thinking.  In this time of technological innovation and social movements based on an increasing ability for individuals to belong to disparate de-centralized groups (social media being a very important example) AND an industry movement toward personal choice, we still haven’t been able to be very new hat, have we?

New hat would be a service delivery and funding model based on individually developed service plans.  New hat would be an iphone app that removes the bloat and just delivers the information relevant to that person in that moment.  I’m circling back, I think, to an earlier post about the need for innovation in human services.

 I want us to be post-iphone.  

We need to be new hat.

Moldova, the Country of the recent “Twitter Revolution” is often referred to as the poorest country in Europe.  I am spending the week back in Chisinau, the capital city, where I have been several times over the past few years.  There Keystone Human Services International  has a small office and a staff of about ten people who are supporting several projects.

I am here with two colleagues from the US to implement Social Solution’s  newly acquired software TOTAL: Record, and despite the language differences (Romanian is spoken in Moldova) and despite the differences in human service systems models, I am delighted to report that the implementation is going very well.  As I mentioned in earlier posts, leadership is very important, and in accordance with that reality, I have travelled here with the CEO of Keystone Human Services International.  As in all implementations, that makes all the difference.

Strictly as an aside. Social Solutions refers to TOTAL:Record as “financial performance management” software for human services organizations.  In another post I’ll write about how they are seriously under-estimating the software product they acquired, but I’ll save that for tomorrow, I promise.  Suffice it to say that we are implementing it in Moldova, where medicaid reimbursement rules are not a driving factor. to say the least!

We are deep in the detailed struggles of all implementations—-how to define fields, activities, costs, etc.  It is the task of turning diffuse programmatic activities of helping people achieve full active lives in the community (rather than in institutions) into the bits and bytes of reportable data—-ie.  information.  I love this stuff!

This is a particularly fun project to be on—I am not usually so deep in the details of our software implementations anymore.  This one, though, will serve as a model and an inreplaceable information source for what we hope will be many more projects, so I am bringing in the most experienced staff and the most talented software application experst we have—under my watchful eye.  It’s good to be reminded how important valid and reliable information regarding human services can be; and good to be reminded of how rare it is.  I feel privileged to be doing this work.

Like many other organizations, the company I work for, Keystone Human Services, is exploring the use of social networking to expand  support of our mission.  Our approach to human services is community-centric. and our mission is to create opportunities and support people in becoming active contributing members of the community.  Until a few short years ago, everyone at Keystone understood the word “community” to mean the physical community—a neighborhood community, a school community, a faith community, a business . . . you get the idea.

Our understanding of community has definitely changed.  This blog is beginning to be a community;  Keystone has active groups on Facebook and other social networking sites; and, we are beginning to blog about our newest organization Keystone Autisn Services.  The past few months have been very exciting and encouraging as I watch the organization begin to engage with the questions that this change in approach brings.

We’re dividing our efforts as follows:  Blogging and microblogging/Social Networking/Online fundraising/friendraising/ and Cause Related Marketing.

Our bloggers and microbloggers are tweeting and blogging about special events like Pawsabilities, which benefits our service dog agency, about new service offerings, like the Adult Community Autism Program, and about volunteer opportunities.  On Facebook we have groups for our agencies and specialty areas, and causes for our services that rely on philanthropy to keep going.  We use Just Means to connect our message with other socially conscious business and non-profits, and we are embracing new opportunities to speak directly with our stakeholders.

We know we are in the early stages of understanding what these new ways of communicating mean to our organization and to the delivery of human services, but I do wish we were encountering more evidence that  other human services organizations  are trying these tools. 

Let me know your thoughts.  Is your organization choosing integration of these tools or are you firewalling to keep your focus on your traditional services? 

Looking forward to hearing your responses.

I’m launching  a blog today to have a conversation about what it means to use technology in support of human services and human services organizations, how to do it well in the face of increasing US and EU (and others) regulation, how to do it effectively in support of an organization’s mission, and how to do it inclusively, so we create the communities we want to see.

The face of technology in human services has changed dramatically over the past few years.  We’ve begun to move away from the period of traditional niche technology providers with something of a captive market in their respective areas of dominance.  There were the usual players in behavioral/mental health, a different set of players in mental retardation/intellectual disabilities, another set in substance abuse, another in juvenile justice . . . you get the idea.  

As providers of wide ranging services, we struggled with the silo approach of the vendors, and with the legacy software being offered to us.  We saw the great strides being made in technology in other industries, and lamented that we were left working with 1970’s vintage tools.  Healthcare, which has often been viewed as a technology backwater, was a virtual juggernaut of innovation compared to human services.

As that situation changes and new vendors come into the marketplace, human services organizations are faced with new challenges and opportunities.  How do we take advantage of social networking to support our organizations and to help our organizations support the people we serve?  How do we pick a billing and clinical information systems vendor when the old usual suspects are fading away, but there doesn’t seem to be a new dominant player emerging yet?  How many technology vendors can this sector support with our excruciatingly thin margins and ever increasing workload?  what are the right tools to put in the hands of our business-office colleagues —  the tools that run our payroll systems, our accounting systems, and our asset management systems?

Every CIO has pressure to get the answers to these questions right, but in human services the pressure is more acute.  Organizational expectations are high, and resources are low.  Sure, that’s not new, and any CIO can relate to the mismatch between expectations and resources.   But in human services, in particular in nonprofit human services, organizations have to live with technology choices–good or bad—for a very long time.  

Please contribute to this conversation.  Let me know what you think about, what you worry about, and what challenges you’ve tackled or resolved.  I’m not just talking; I’m listening.