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Transcript for May 2019 Brownbag

CaPROMISE: Lessons Learned

>> Mari Guillermo: Hi, everyone. I'm Mari Guillermo. And today we're here to do Brown Bag. CaPROMISE is a project that is funded by the Office of Special Education Programs in the Department of Education. We are in the sixth year of the project. So services will end on June 30th of this year. It's been five or six years.

And the goal of CaPROMISE was -- is -- so reduce the reliance of students with disabilities and their families supplemental security income. The outcomes for CaPROMISE included work experiences that are educational outcomes as well as more information and knowledge about Social Security benefits and work incentives associated with [INAUDIBLE].

>> There we go.

>> Okay.

>> Fred McFarlane: When we started and CaPROMISE and it was funded through the Department of Rehabilitation. They funded six projects nationally; we're the largest of six. This also has to be the largest research effort that the office of special education programs that undertaken. It's the total amount for all six projects is about $230 million over the five or six years of project, depending on how it came about.

And California chose a unique model compared to the other six. We were based within 20 different LEA's over the course of the six years. And it was driven from schools and staff within the schools, then to the community including rehabilitation that was part of it. Most of the other projects, the other five projects, really ended up looking at being within mental health or being within a state rehab agency or being in a university environment or in some instances, you know, one project is vital [INAUDIBLE] part of it.

We felt it made sense that you drive this from the students' perspective and their family, not from the professional perspective. So we established some values from the beginning. First, everything we would do would be person-centric. And that all the interventions would be around what made a difference for the students and their family. Which is kind of a switch. We've stayed away from regulation. We've stayed away from what were mandates as part of that.

A unique part of this -- this was a requirement of the proposal -- is you had to engage the entire family. So you could provider services not just [INAUDIBLE] but to the family unit who were housed. And that was for planning, it was for services, for outcome. And we'll be able to give you some examples of each.

Community engagement was critical. We ended up working with about 1200 different community agencies throughout the state of California. And then the long-term strategy as Mari indicated was focusing on outcomes -- making sure the kids graduated to high school and went onto post-secondary whether training or degree program. And they eventually would have a work experience that would result in employment and a long-term strategy make them self sufficient financially.

The intervention model we used was a person-centered family-driven model as part of that. And Mari's got some great examples that she'll be able to give you as we talk about it. I'll turn it back to you.

>> Mari Guillermo: And you notice on the title of this presentation that this is hard work. And the reason why it's hard work is it really, CaPROMISE is a value-driven program as opposed to income-driven program. And driving from a value in terms of that perspective [INAUDIBLE] has inspired a lot of consistency and focus. And we learn a lot of lessons from our families, students that we worked with and as a result of CaPROMISE. The career service coordinators provided direct intervention and services to the families as well as the managers that helped guide the efforts of the school district.

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As well as our dedicated CaPROMISE Department of Rehabilitation counselors. The partnership that they have been able to develop and sustain with the school districts has been very valuable and also helped with more of the lessons we've learned.

And so we grouped these lessons into six different categories, and they are not mutually exclusive. The first lesson -- the first lesson has to do with the culture of expectation and really rethinking the expectation it is essential to create self-sufficiency to our students and family.

The second lesson is maintain the person-driven family-centered focus, that value that Fred mentioned earlier. And we really must maintain the focus on how services will impact youth and their families.
The third lesson has to do with family engagement. And that is essential in the youth's attainment of self-sufficiency.

The further lesson gets at misconceptions and stigma associated with disability, that we have to change community perception and the stigma with disability if we want to maximize the potential for integration for students.

The first gets at collaboration, interagency as well as cross-organizational engagement. Again, the impact [INAUDIBLE]


And finally the sixth lesson gets at organizational structures and the silos and there are expectations, opportunities and challenges associated with them.
So what I'm going to do in the next few slides is to share with you some of the direct quotes from our CaPROMISE participants, the students, the families as well as our CaPROMISE staff to give you an idea of how really CaPROMISE came alive for everyone [INAUDIBLE] involved with the project.

The first lesson, again, gets at the culture and that it's really important that we elevate our expectations for individuals with disabilities. At intake with our CaPROMISE promise students on the average only about 50% of the students and the families expected to help with disabilities to become employed or pursue post-secondary education after high school.

You wonder why it's so low, why not 80% of the families having that expectation for themselves or their students with disabilities? And we wonder what is it that professionals communicate with students and families that their expectations are so low?

And the first quote is one from one of our staff in the schools. And the kids who are getting jobs before CaPROMISE had IEP's had stated "Work was not a viable goal." So if you had an IEP for the last 15 years and the child stated work was not a viable goal, how is that [INAUDIBLE] your expectation for the child?

And this is the next quote is from a student, "When I applied for college, I qualified for honors classes and stats classes -- and I didn't think I even qualified." So she's gone through education all these years not thinking she had the skills or knowledge to pursue post-secondary education.

And finally, the message from the staff is that we can never give up on students -- we have to keep working with them. That comes up when consumers or families do not respond after three contacts, phone, missed meeting or text messages. That we can't just close the case and give up on that family. Because we're not sure is it because they're not interested or is it because they're overwhelmed or maybe they are in crisis and this might be the one time that the contact will make a difference in that person's life?

>> Fred McFarlane: If I can add just one additional observation, when we talked to a lot of the school personnel, on the student's IEP a lot of times starting in middle school there's a box already checked on that IEP that says are a [INAUDIBLE] or are you a certificate student? And the majority are checked with a certificate student. So the message that goes out to the families are my son or daughter is never going to be able to get employment. So they're not going to graduate.

And then teachers, therefore, see that and say this person's already determined to be a certificate student. They don't have the academic competency. So that expectation gets started well before in many instances before they come into school.

And as Mari made one of the first bullets, we heard this a lot that on the IEP, based on the student, the student is not capable of work. And so when that comes from the education system and gets ingrained in the parents, it also carries forth with the students as well.

And so if our expectations are you're going to fail and you're told that from a young age, you probably will fail.

And so that was part of what Mari was talking about expectations.

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>> Mari Guillermo: When we get to lesson two, family-centric, this is not just a service option. It's not just a item you list under an array of services. It's not something you put in a checklist and once you check it off, it's done and you don't have to do it again. It's really a value that has to be used in the way you interact with them, in the way you provide the services, and the way you support the family.

And it has to be something that is truly valid. And, again, it's used throughout every [INAUDIBLE] that you do [INAUDIBLE].

The first quote gets at this idea of programs being incompliance. Person-driven plans has been very powerful. Our district was good at compliance which was our culture. Check the boxes, get ready for review. But we missed the spirit of what the students needed.

And so there's that compliance in terms of what's convenient for the program versus what is truly needed by the student. And that's a much harder -- that's where the hard work begins, but that's where the impact can be achieved.

And that's captured in the second quote from a student. And the student didn't specifically refer to my CSC provided [INAUDIBLE] with planning, what this quote captures is how person-driven planning is a value that impacted the student and how he saw the relationship with the career service coordinator: My CSC helped me with my strengths and weaknesses -- more than what the schools did, CaPROMISE helped us learn how to speak up and how to act. And how often do you hear kids with disabilities say my case provide helped me with my [INAUDIBLE]? Because that program still operates from the staff perception.
A person-driven, family-centric really gets at that [INAUDIBLE].

This quote is from a manager and really captures the distinction between person-driven planning and the procedure versus person-driven family-centric as a value. And these are the instructions he gave to the staff: I want you to have a conversation with the student and figure out what they want and provide services based on those conversations. I don't want to give you a check list. The checklist, you're not ever done but the checklist makes it seem like there's a point of done.

And families' lives, students lives, professional knowledge and information should be continuous. And as that evolved and information becomes available, it's a continuous [INAUDIBLE].
>> Fred McFarlane: One other part that was interesting when we first started working with school people and with the rehabilitation [INAUDIBLE] is one of the first questions they had is well, what's the [INAUDIBLE]? We said aren't. They said what kind of data do you want? We want you to understand what the student wants and what the family needs and how you go and proceed with that. But yeah, isn't there a structure? We said no.

And they struggled with that. They said, well, can't we print out forms and use those? We said no, you need to be able to do it based on the individual. Five years later, now they don't want to use any forms as a part of it.

So it's changing that mindset as well.

>> Mari Guillermo: Yeah. And, you know, one of the things that you have to think about is how you value your staff. If they are evaluated based on a check list versus, you know, what truly person-centric planning is [INAUDIBLE].

The third lesson has to do with family engagement. Remember, the goal of CaPROMISE -- so the goal of CaPROMISE, again, is to reduce families' reliance on Social Security income.
So that check is [INAUDIBLE] by the student with the disability. However, many of our families who have CaPROMISE live at, near or below the poverty line. [INAUDIBLE]

And if we are to reduce reliance, we really have to take a look at how do we engage the whole family unit? And not just engage them in serving the student with a disability, but really looking at how do we serve the whole family?

And how do you do that? A lot of that starts first with establishing trust with the family. Family engagement -- it's [INAUDIBLE]. But it's really very difficult. And then the third quote from a parent really captures the idea of how difficult it is to establish trust. "I've been promised so many things by different programs what will be different by CaPROMISE? CaPROMISE stands out. People meeting me in the community for help." And so it's continually reinforcing to establish where they're at and where they want to reach out, not just what's convenient for us as a program.

It also requires consistency and responsiveness to the families' needs and not [INAUDIBLE] which is captured in the second quote. The CSC which is our career services coordinator, wow, she always stayed in touch and provided as much services as she could.

So if we are going to engage families, we have to provide services that add value to their lives. And so add value to their lives, it has to respond to the needs they have.

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>> Fred McFarlane: We talked about this a little bit at the [INAUDIBLE] conference, when you were doing the recruitment process how did you get buy-in from the families? They probably thought, it's another program, they're all the same. What did you do?

>> Mari Guillermo: You know, at first we thought it would be very difficult. We thought families would automatically seek help because [INAUDIBLE] reliance on it [INAUDIBLE].
I think for many of the families, they had at least the ones who enrolled felt like there could be a better future for their student and the fact that services would be available to the family as well -- that might be a factor of willingness.

>> Fred McFarlane: We actually had some families because it was an experimental design -- by the way, that wasn't our choice, that was a requirement -- but there were some families that we had parents that actually said some prayers that their child could get included in this program with regard to services. We had a number of them that came back on appeal and said, you know, can't you guys reverse this? We were given five slots that we could identify exceptions for that to include them in the experimental. And we could have dealt with that ten times based on --
So like Mari said, that surprised us. That wasn't -- you know, we had some of the others that were -- we're concerned about another program, what are you going to take away from us? I think that's part of both fear and experience.

>> Imagine at the start of this is pretty daunting knowing the recruitment numbers you had to get through.

>> Mari Guillermo: Yeah, it was. But the schools were amazing. I think the fact that it didn't require the family to come to the school or the office to get services.

The schools, the staff went out to the families' homes and in many cases the parents didn't respond to the initial outreach because they were working. And, you know, the traditional Monday through Friday, 9:00 to 3:00, they're working. So some of our staff actually set up times to go and meet with families at work at a certain time during the break.
And I think that whole individualized approach caught the attention. Otherwise we would not have gotten [INAUDIBLE].

>> [INAUDIBLE] The amount of effort they put in to connect with individuals was really pretty phenomenal. That they did that. I suspect some of the school districts didn't know they were working in the community or working outside of the traditional hours.

But yeah, it became a badge of honor as they were getting students signed up, which is really pretty -- we didn't expect that. We expected it would be really difficult.
And then we did some things where every week we would have a phone call and every week show where everybody was for recruitment. So there developed some school district competition. Gosh, you're at 73% and we're only at 55%. And we're going to catch up to you. So there was some healthy competition among the LEA.

>> Mari Guillermo: Keeping everyone informed was one of the [INAUDIBLE] statewide that [INAUDIBLE].

>> I mean, the project is really fascinating from, like, an OD perspective for those who have a couple students I'm flashing back to the [INAUDIBLE]. And, you know, you're talking about major structural changes about how services is done. It's pretty incredible.

>> Fred McFarlane: Did you go back to that, using some of the [INAUDIBLE]. The ones that probably were most frequently used were were the human resource because it was an organic process. And the other part with a the symbolic one. There was a lot of getting people to engage in the schools that they all did things differently, which was great. But they would bring people together. They always had food, whenever they brought people together they had food.

>> Arkansas?

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>> Fred McFarlane: Arkansas had pie. Sweet potato pie, yeah. I don't know how well that would have gone out here. [LAUGHS]

But food was a big deal. And that was talked about, about being able to do that. So there was a symbolism, and the food was kind of like the family coming together.
And so I think [INAUDIBLE].

I'm glad you asked those questions because we forgot about them. And Mari touched on them a little bit, there were multiple ways of engaging the staff which was one of our concerns. So there was weekly phone calls, manager phone calls every month. There were phone calls from managers, those were every two weeks. There were list serves that brought people together. We eventually brought in vendors to do one-on-one's with staff. So there were multiple learning strategies that were used to facilitate communication [INAUDIBLE].

>> Mari Guillermo: And that was important because as you recall [INAUDIBLE]. And so in order to build the capacity of the staff, to elevate their expectations [INAUDIBLE], we really needed to invest the time in staff development, to individualized technical assistance because the staff were starting at different point. And trying to meet their training needs as staff development wherever they were at.
When you hear person-driven it was also how we approach the training of the staff that really permeated throughout.

And in terms of family engagement during enrollment also carries through, throughout the program. And it really reinforced that when you're working with families that are [INAUDIBLE]. And this quotes at that, that we need to dig deeper when parents say they don't want student to work because they want to concentrate on school. And the truth is the parent is afraid of the student loosing SSI. So you have take time to ask is it because of benefits? Other programs wouldn't dig deeper to find out why parents aren't returning calls, in the proactive. There's a lot of more than what [INAUDIBLE]. And to really have that trusted rapport.

The other training that our staff also received was they became certified benefits planner to coordinate for university. And that allowed them to -- gave them the expertise and the knowledge to then be able to [INAUDIBLE] with families [INAUDIBLE] the benefits. Because that was a very large [INAUDIBLE] going into CaPROMISE.

And finally, CaPROMISE was good because we keep pushing forward. Just because the students obtain a work outcome, they thought we stopped provided services for them. That provided the foundation for going forward and continually looking all the other ways to [INAUDIBLE].

>> Fred McFarlane: The issue of work experience, that comes up a lot. And as Mari mentioned, the fear of lost benefits and also fear for their child, too. Because they have gone through a whole variety of challenges with their kids. The idea of letting them go off to school or being alone at school etc. So that was one part of the work experience.

And we said that there would be 100% would get paid work experience. We made the decision to set that number at 100%, knowing that we probably wouldn't make it. But we also knew that if we set it at 80%, we'd probably make 60%. And where we're at is about 93% or 94% of the students that had either paid or unpaid. And there's multiple paid and unpaid experience.
But it goes back to kind of setting those expectations for everybody to follow.

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>> Mari Guillermo: And relating to that I mean, that takes us at that lesson four of changing perceptions. When you have the student in the community, that's one of the most visible ways to change perception. In terms of what individuals with disabilities are capable of doing. 

And so not only do you change our expectations as professionals, expectations families and students have for themselves and for [INAUDIBLE] with disabilities but then [INAUDIBLE] the community.
And this is especially true for students with significant disabilities. Fred mentioned our target was 100%. The main concern for most of our staff was but what about the individuals who have the most [INAUDIBLE]? How do we get them employed?

And because of the expectation, we have many students who would be considered significant disabilities having that work experience.

And so -- and that's captured in the first quote, student with an extremely significant disability it was challenging to think about ways to get him employed but they got him employed.

One parent alluded to never picturing her son ever being employed. She couldn't imagine -- double pay, referring to the job coach, paying for the worker -- the child with the disability as well as for the one-on-one. She couldn't wrap her head around that. And so being able to provide that experience for the student and in turn for the family is very significant.

And some parents feel that regular businesses do not hire people with disabilities because they themselves haven't seen people with disabilities working in the community, at least with the level of disability of [INAUDIBLE] child. So that is how the work experience is a good example of changing perception.

>> [INAUDIBLE] a lot of kids with autism?

>> Mari Guillermo: Yes. The highest number in terms of the disabilities demographics of our students, most of them fell under intellectual disabilities -- autism [INAUDIBLE]?

>> Fred McFarlane: Yes.

>> Mari Guillermo: And multiple disabilities. So a large percentage of our students would be considered [INAUDIBLE].

>> Individuals where there is a lot of unemployment. Your participation numbers are really, really impressive.

>> Fred McFarlane: Yeah. If you look at [INAUDIBLE] identified including autism, etc., they're about 40%. So pretty high percentage. And when it came to a recruitment -- back to your question -- one of the comments that we get was literally within about the first month or two was, you know, should we recruit students that have a better chance?

And are our response was you recruit students who are on SSI between the aging of 14 and 16 -- that's the end of the criteria. [LAUGHS]

So -- and so that kind of changed the discussion as part of it.

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>> Gives more validity to the study, too.

>> Fred McFarlane: And one of the things that occurred just in the last six months one of the staffing cases on the phone, we're kind of down to the really difficult ones, students that have [INAUDIBLE]. And so we've been asking their service coordinator to present on a Monday phone call. And there would be up to 100 people that saying have you thought about this or looked at these options, have you tried these things? So you use the collective wisdom to support that one individual.

And that's been successful.

>> Mari Guillermo: And collective -- in terms of interagency collaboration and engagement. So interagency collaboration and engagement.

So we're going to start the whole family unit, it can't just be one [INAUDIBLE] to the family unit. It really requires a lot of collaboration and engaging of other community agencies and programs that -- who haven't physically given services [INAUDIBLE] Department of Education. And one of the best investments for program start up time for CaPROMISE is when we asked all the career service coordinators at the very beginning to go out and learn their community, learn what programs are there, what resources are there. Anything that you think our families may be able to access or benefit from.

And that really proved to be so critical, essential in being able to serve the family unit. And this quote really captures the complexity of the families we were working with. And the case management that our career service coordinators were involved with. "The families were in crisis. We saw a lot of distress and heart break. We had to peel away each layer before we could get to the program -- layers of homelessness, drug addiction, criminal records, food, transportation, lifestyle. We didn't see all that until you go into the home."

That really captures the dynamic the students operate in and really addresses the needs of the family after you go where they are. And you can respond to the needs we see [INAUDIBLE] program and not just know them but work in collaboration with them.

I'm going to jump to lesson six in terms of organizational structures. One of the things we learned but we already knew was that the way our organizations are structured, the siloed that they operate in, they really get in the way of that interagency collaboration, that partnership.

But if we are to [INAUDIBLE] we have to find a way to restructure the organization. And this quote really gets into that: Not every family want services at a certain time. Be patient, we can't give up on them. Families expect that you'll give up on them. If you don't give up, then I'll open up to you and give you a chance but you have to establish trust.

And if you think of the way our programs are structured, the eligibility requirements, the different things on the checklist that need to be checked off before services can start, the time restrictions of getting documents and returning phone calls and how often they call before they close your case. Those all get in the way of not [INAUDIBLE] and really CaPROMISE comments was being with the family for the long haul. And that gets into that culture of change [INAUDIBLE].

>> Fred McFarlane: Just the issue around [INAUDIBLE].

We identified six actions. And by the way, what Mari was alluding to six lessons learned and the actions are -- we have both [INAUDIBLE].

And we think -- sustainability.

And these are, if you'll it's the first two are really focused on the provider. And they follow the principle of a person-driven program. We didn't start with the system, we started with what has to change with regard to the family. So the first part is understanding all transition services. [OVERLAPPING SPEAKERS]

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>> Fred McFarlane: So one of the outcomes is that we get 24 kids -- [OVERLAPPING SPEAKERS]

>> Fred McFarlane: And that's an outcome that we've looked at because of [INAUDIBLE].

So one of the first [INAUDIBLE] is make sure that you're really clear of what your outcome is about sitting in a classroom. It's really about where everything else [INAUDIBLE].
The second one is identifying community partners and -- [OVERLAPPING SPEAKERS]

We talked to one of the projects and they made sure they called people between the fifth and [INAUDIBLE] day of the month before their phones were turned off. You want to really reach them, you have to be able to do it on their timeline, not ours.

The whole issue of immigration in California is a silent issue a lot of times. Folks don't want to talk about it. But that's a key element. So really engaging the community as partners, not just as service providers.

>> Mari Guillermo: The other part related to that is that your staff, if they can speak the language of the families, they are more open to [INAUDIBLE].

>> Fred McFarlane: That was really understanding cultural context. And not just the culture of their language but the culture of how they live and what their expectations. Some of the families live in a culture of dependency on other sources. And so helping them break from [INAUDIBLE] is important.

So that's one. So those first two areas really address the interaction between the student and the family and schools and rehab agencies.

The next two really address issues around how do we get our systems together? These are probably the two hardest ones to get operational. You know? How do you get the department of employment and rehabilitation and education to agree on one common thing?

And that's -- they all talk about wanting to provide transition, but they all have a different definition of it. And they all have different outcomes for it.

And so getting them to sit at the table and not talk about their [INAUDIBLE] but talk about how they're serving individuals is really the intention.

I'd love to say that we've accomplished that -- we haven't.

But we sure have had a lot of discussions that raised the topic.

>> Mari Guillermo: And as you mentioned earlier, that is where some of the disconnect because [INAUDIBLE]. Versus CaPROMISE [INAUDIBLE]. We're looking at it from different perspectives.

>> Fred McFarlane: Yeah, things like legislation and how that [INAUDIBLE] coming up and our [INAUDIBLE] performance measures. How do those apply [INAUDIBLE]. And so I think you're looking at that and being able to do it objectively and not from the self-serving perspective from those organizations is really, really critical.

We started those discussions. And we hope they'll continue at this point. And then the last two really address at the federal level. So we look at the first two, those are things you can do now. Those are in your local community.

The next two are really at the state level, and those are kind of intermediate outcomes that you would look at.

And then the final two are at the federal level. One is aligning legislation, when IDEA comes up for reauthorization, aligning it with the requirements [INAUDIBLE]. Because right now they -- they're tangential in agreement but there's different outcomes. So really looking at that federal legislation that there is so agreement.

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And then one that became a challenge for us was identifying what a disability is, Social Security, IDEA, rehab, employment will all look at the same person and they'll come up with different definitions of disabilities. And that disability -- that designation drives services and expectations and expenditure.

And I think it's something everybody's aware of. We don't get a sense that we'll have the strength to try and look at how to do that [INAUDIBLE]. And it drives your expenses, how you spend dollars, drives how you put your resources.

One example within the schools, we said what kind of documentation do you use to measure disability? And Mari and I were started by it because they said "Well, we get what the parents say and we speak to the individual and we identify the disability." There wasn't any common documentation.

And some parents, as an example, don't want the term autism. So schools have, okay, we'll call it learning disability. Because it's more socially acceptable.

So that alignment, and then we want the label, then people draw conclusions. So those are the six actions that we would hope that are looked at.

>> Yeah, it's not necessarily saying we've got to have extra funding, it's just the way the funding is allocated is maybe different [INAUDIBLE].

>> Fred McFarlane: There is in our mind in having worked on this, I think there's enough money. And that doesn't mean we can't use more resources. But being able to wrap around those dollars and those services and not be so siloed with regard to expenditures will free up the opportunities for schools as an example to be able to provide those services.

I'll use California. You take a look at the work [INAUDIBLE] and a variety of others, they're all doing the same thing. But schools are well, we have a [INAUDIBLE] contract and we have to fill a slot. And then we have [INAUDIBLE] we have to fill a slot. It's not a slot that you fill with a student [INAUDIBLE], it's a how can you wrap up services?

>> Mari Guillermo: And by filling the slot, you're limiting the number of students that can go. So you're only serving a small number of students. We talk about the silos, it's everything from the definition of a disability to the budgets that are allocated. And it compartmentalizes what families are able to access and the way their lives -- [INAUDIBLE] doesn't silo the programs.

>> Fred McFarlane: That's where we are.

>> I'm going to unmute everyone, everyone listening online. So if you have a question, say it if you're in the room. Any questions from those online?

>> Fred McFarlane: No questions? [LAUGHS]

>> This is a very fascinating, you know, study on so many levels. You know, we had a number of discussions here, I mean, do you anticipate writing a book on maybe [INAUDIBLE] on disability policy, this redesigned system?

It's just really fascinating to see especially like a state like California with these huge systems that you've been able to really reshape and have people rethink what they do in very fundamental ways. It's very interesting, you know, to get the thoughts of the field.

>> Mari Guillermo: Well, and that's what the culture could be. In the beginning we're looking at it from [inaudible] what would be the impact of CaPROMISE or what would be our presentation for change? And the more we dug deeper into it, when you see the lessons and call to action, what we tackled with is nothing new and in fact go back 30 years [INAUDIBLE] transition interagency collaboration [INAUDIBLE] we're still asking how do we do this and that? It is a question of changing the system but more deeply than that, the culture requires really getting in touch with what we truly value. And so that's [INAUDIBLE].

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>> Fred McFarlane: I'm pretty certain that Mari and I will write [INAUDIBLE]. And I think one of the areas that we noticed is I'm trying to think of the easiest way to describe this, that the culture within the organizational change won't happen because in most instances, if you have one thing that doesn't work, that drives your future as opposed to 99 things that did work.

And so there's a organizational and leadership aversion to taking action. And that seems to impact the culture.

And one of the things -- and we heard that in multiple ways from parents. And from school staff. You know, some parents didn't get back to the staff for three or four months. In some instances they would be dropped. You didn't respond to my last three emails, I'll close you.

But then you dig in, as [INAUDIBLE] talked so eloquently about what's going on and the amount of stress and chaos in their life is really powerful.

So there's a reason. Now, that's not the case in every instance. But a lot more than [INAUDIBLE]. And I think that's where that aversion to action comes from leadership standpoints.

>> I want to quickly share -- I was nodding all the way -- I'm in the field of intellectual disabilities for over 20 years and worked at a community rehab program [INAUDIBLE]. So I know that the expectation when I first would speak -- also [INAUDIBLE] works really intensely with the school district.

So I'm more -- I graduated from [INAUDIBLE]. But it's just a very [INAUDIBLE] to get a balance between the value-driven because it does take time to get to know, gain trust, how to get the quality [INAUDIBLE] and not necessarily [INAUDIBLE]. Because the key to growing larger and larger especially [INAUDIBLE] increase numbers are especially [INAUDIBLE]. Can't catch up with.

So it's very difficult. And finally, you gets the trust -- earn trust from the family. But then [INAUDIBLE]. So, again, I felt deeply all [INAUDIBLE] and heart break all accumulated and really hit to the point to really discuss what the need of the client is. Taking the time that [INAUDIBLE]. It's very hard to provide the quality of service that [INAUDIBLE]. I see the challenges and what's required but I also understand it's hard to change organizational thinking. I think only if we can [INAUDIBLE] the way you think for professional educators and work with [INAUDIBLE] what we need to look at and do is really what the person needs [INAUDIBLE].

So a lot of families don't trust.

>> Fred McFarlane: They don't even know who you are.

>> Thank you. [INAUDIBLE] I also found a need, become to the cultural thing, they wanted to get a worker [INAUDIBLE] but they're afraid of asking. Because there are so many things -- and I'm trying to do the monthly meetings, it helps to [INAUDIBLE] so that some of the things that CaPROMISE has done hopefully as community members and professional can help them not only weighing [INAUDIBLE] but the teacher will tell them [INAUDIBLE]. Maybe partnership like you say is not become a partner, really work almost like a support system so that, you know, [INAUDIBLE].

>> Mari Guillermo: And you touch on many of the really difficult parts in terms of the systems change, in terms of case load, how you're evaluated as a professional. And also that concept of last resort because everybody wants to be the [INAUDIBLE] of last resort. So all those pieces are really telephone areas that it's part of that need to be looked at. But there's a culture [INAUDIBLE].

>> Last chance for any online people?

[Laughs]

>> All right, well, awesome presentation. Thank you folks.

>> Fred McFarlane: Thank you.

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DISCLAIMER: This text is being provided in a rough draft format. It is not a verbatim transcript. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings.