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ROGAN #1

Hello and welcome.  My name is Pat Rogan and it’s a pleasure to have this opportunity to talk 
with you today about organizational change, which is the process of shifting from facility based 
to community based services and supports for adults with disabilities, sometimes known as 
conversion.  In this session, I would like to provide an overview of some of the national trends 
that have influenced our current practices.  As well as discuss a recent national conversion or 
organizational change study, highlighting some of the information that we’ve learned from 
multiple organizations around the country, who have undertaken this challenging but rewarding 
process.  Third, I’d like to talk about the underlying values and quality indicators that would help 
to steer or guide our practice as we undertake this shift.  And finally talk about some of the 
primary components of the organizational change process.  I hope that you find this information 
helpful, whether or not you’re just beginning the dialogue within your organization or with other 
stakeholders about the mission, vision, and values of day services. Or whether you’re further 
along, and you need to reinvigorate the dialogue or refocus your efforts to achieve customized 
integrated supported employment for adults with disabilities and work towards full citizenship 
for each individual.

Let’s begin with the national trends that have led us to this point in time.  Why are we even 
focusing on this topic of organizational change?  What’s the rationale? Why would organizations 
undertake this process?  I think it’s apparent that through the Individuals with Disabilities 
Education Act and other school reform efforts, that there are many families who have come 
through an increase of education who are asking for similar services in the adult world.  They 
want to transition into meaningful, typical, integrated adult lifestyles.  We also know that there’s 
been an amazing array of legislative decisions made through the Rehabilitation Act and our 
Workforce Investment Act, the Ticket to Work, Americans with Disabilities Act, and other 
legislation that highlights access to services and supports choice, inclusive of services.  Also very 
significantly a recent Rehabilitation Services Administrative ruling that facility based services 
would not be deemed a satisfactory employment outcome [which is a] very significant shift at 
the policy level.  We also know that many states, some more than others, have taken the 
legislation to heart and are working both in spirit and in practice to translate that at the regional 
and local level within states.  

What else is driving our current day services?  You know that many states have been and 
continue to undertake deinstitutionalization, moving people out of state institutions into 
community and certainly this has a huge impact on day services.  Some states are even 
institution-free at this point in time.  You may be familiar with the Supreme Court’s fairly recent 
Olmstead Decision, that mandates that services be provided in the most integrated setting, again 
very big implications for day services.  And concurrently with these other movements and trends, 
is the growing voice of self-advocates in people with disabilities. Whether it be through a forum 
of People First and self advocates becoming empowered organizations, and other advocates who 
have been finding their voice and working towards self-determination with the assistance of 
national initiatives, such as the self-determination initiatives through the Robert Wood Johnson 
Foundation.  

What else is driving services?  Certainly money talks, and we’ve been seeing a variety of 
approaches to tweak and reconstruct the way that dollars flow for services to people.  Such as 
results based funding or focus on outcomes, personal budgets, putting the resources in the hands 
of people with disabilities to purchase the desired services and supports, and of course, Medicaid 
waivers that are offering more flexibility and individualization for purchasing services.

I’ve been very interested in tracking our efforts nationally around organizational change 
conversion to understand who’s doing what and where. I have learned that there are hundreds of 
organizations that have either fully shifted to services without walls, without having a place to 
which people go as well as many who are somewhere in that process in that journey toward 
building their community based services.  

Last, but not least, we have national advocacy organizations, such as APSE, such as TASH, and 
others, that are not only elevating the discourse around organizational change and community 
services, but are also providing resources and a point of connection for the various constituents 
around the country. A lot is happening to get us to where we are today and to just magnify the 
importance of this one component, shifting the way day services are provided.