Summary
Highlights
The speaker introduces the concept of 'Technology First' and clarifies its relation to 'Person First' approaches. A technology-first approach considers technology solutions initially, without abandoning traditional in-person support. It aims to improve quality of life, maintain independence, and achieve personal goals. It also highlights that technology first does not mean eliminating staff but rather reallocating staff support, enabling individuals to take ownership through technology.
Four key tenets are discussed: technology helps improve quality of life and independence, every person is a candidate for enabling technology regardless of disability or skill level, it involves reallocation of staff and not elimination of human support, and the balance of in-person support and technology is unique to each individual's needs and circumstances.
The presentation distinguishes 'enabling technology' from other terms like assistive technology, adaptive equipment, and durable medical equipment, defining it as products, services, and devices promoting independence and self-determination. Examples include medication dispensers, video doorbells, smart speakers (like Google Home or Amazon Alexa), and wearables (e.g., Apple Watch with fall detection). Remote support is also explained as a service model that uses technology to allow staff to support individuals from a distance, always paired with in-person backup.
The speaker addresses audience questions regarding the extent of the support system for remote technologies, emphasizing the need for a local backup plan in case of serious injury. Different models of remote support systems are discussed, including homegrown systems, third-party providers, and in-house organizational support. The importance of contingency plans for in-person response is highlighted.
Challenges include organizational resistance to shifting from a 'caretaker' to a 'supporter' mindset, the myth that technology is only for mild disabilities, and the integral concept of 'Dignity of Risk.' Limited training opportunities for staff are identified as a major barrier, leading to the development of specialized certifications like those offered by "Shift" to standardize best practices.
Strategies to combat reluctance and foster buy-in include incorporating experiential components into training (e.g., demonstration spaces), educating staff on what enabling technology is and is not, encouraging staff to consider how they use technology in their own lives, and starting with small implementations to build success. It's crucial for staff to understand that technology is a 'both/and' scenario, complementing rather than replacing human support.
Funding for enabling technology can be tricky due to state-specific waivers, funding caps, and limitations on types of products. Solutions include identifying existing funding sources and waivers, exploring grants from self-advocacy agencies and foundations, and considering contributions from the person supported or their family. The increasing affordability of mainstream technologies and the trend of providers purchasing equipment without reimbursement to reduce long-term expenses are also discussed.
Successfully adopting a technology-first approach requires significant work in developing policies, procedures, and systems, as well as expertise. Organizations must decide whether to use existing staff or hire dedicated personnel. Using existing staff can be cost-effective but may lead to overwhelm, while new hires bring fresh skills but need to learn organizational specifics. Partnerships with organizations like Shift can provide resources, guidance, and training to facilitate this transition.