The State of America’s Direct Support Workforce Crisis 2022

The longstanding direct support workforce crisis, exacerbated by the COVID-19 pandemic, has led to closures of critically needed services and a denial of access to community-based supports.
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Connections - 10.31.22

GoodLife U 2022: Tech-Enabled Service Models, Part 4

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This month in our video blog, Dr. Mike Strouse sits down with Ivo Ivanov for a discussion about how to grasp a simple and attainable vision of The Final Rule, where individuals—regardless of their abilities—can access the support they need in the ways they most want.

At its core, the Final Rule promotes living a normal life, which is actually a pretty simple vision. Humans are social beings and if there’s a silver lining from the tragedy of the pandemic in the last few years it’s that technology has advanced drastically and given us an opportunity to connect with each other despite the distance between us.

The workspace is changing, too. In a recent study researchers found that 65% of those looking for a new job consider first whether or not the job can be done virtually. Why has virtual work struck such a cord? Hundreds of C-Level decision-makers across the country that we work with connect with us more often than not from their homes. We believe the work-from-home trend is a sign that the goal is to live a life that can unfold organically, and it is made possible by technology.

“It is time to consider the value of technology as a place killer.”

We see this in other industries, too, and while human services are often the last ones to adopt innovative solutions, we cannot afford to ignore these messages. It is time to consider the value of technology as a place killer. Blockbuster went away because of what technology made possible. When Netflix combined technology with a redesigned service model, the delivery of movies changed. Grubhub did this with takeout; Amazon did this with books and goods; Instacart did this with groceries.

We’ve been killing places for a long time (for example, GoodLife’s history includes advocating for and facilitating the closure of out-of-favor mental health institutions across the country), but especially after the pandemic, business plans that depend on a brick-and-mortar store hold less appeal. Places have long existed to provide goods and services to consumers in a cost-effective way for the business owners. But this exchange is based largely on the terms set by the business owners. Now there are new demands for delivering goods and services on the terms set by the customer. As consumers we are less inclined to rearrange our lives by having to “go to” a place to get what’s needed when we can acquire what’s needed through delivery, on demand.

“We no longer want to live our lives based on someone else’s terms—we want life to be lived on our own terms which are made possible by technology.”

Instacart, Amazon, StationMD—almost all industries have been impacted by technology in a way that has ended our reliance on the storefront. We no longer want to live our lives based on someone else’s terms—we want life to be lived on our own terms which are made possible by technology.

If we are being honest, a group home is a place we send people for care. It’s not their home. It’s a place they are required to live in order to get the care they need. And while it may be homey, group-homes are the familiar, cost-effective way to deliver care on the provider’s terms—not the consumer’s. This is where our journey begins and it’s time to look toward that new vision.

“A group home is a place we send people for care. It’s the familiar, cost-effective way to deliver care on the provider’s terms, not the consumers.”

We’ve polled providers across the country and asked this question: if we were required to accomplish the Final Rule tomorrow and serve every one of the people you support in one- or two-person living arrangements, how many of you could do this? No one raises a single hand. When you put this requirement on the back of 50 years of staff instability, along with the trends of the coming senior care needs, we cannot continue to pretend that we have the capacity (labor, resources, human capital, etc.) to accomplish the Final Rule. It is fool-hardy to think that we can deliver care in smaller and smaller settings without leaning on technology. But as caregivers, we will be caught in the middle. People deeply desire and need the human connection and the human touch, so we have a challenge ahead of us to merge what’s been made possible by technology with the human touch.

“We have a challenge ahead of us to merge what’s been made possible by technology with the human touch.”

We are inevitably marching toward the vision of the Final Rule, which is no different than the one set by thought-leaders in the 1970s. However, we are absolutely going to need to do things differently moving forward.

Remember, Netflix is not just Blockbuster + technology. Netflix innovated an entirely new business plan that was made possible by technology and allowed the products, services, and goods to be delivered at the moment and place that the consumer desired. We don’t bolt technology onto some traditional approaches and call it good. It is time to look at what is now possible thanks to technology, to rethink our business plans and to reimagine what’s possible.

So that’s the vision. There’s the journey. It’s time to start talking about it.

Embracing future models of care can be really overwhelming, but innovation is often easier to access and integrate than you might think! If you’re interested in working with our specialized GoodLife U team to affordably and sustainably explore next-generation service models including those that utilize iLink, please reach out to us. We’d love to connect with you.

Mike Strouse is the President/CEO of GoodLife Innovations.