Support Coordination – Complexity [PDF]

Working In Complexity
Lessons For System Change From Support Coordination

John O’Brien & Patti Scott

Nov. 2019


We advocate a strong view of inclusion and self direction that disrupts most current ways that publicly funded assistance to people with ID/DD are organized and delivered. Progress in realizing these values calls for deep change.

We find the Cynefin framework a helpful way to guide the design and practice of Support Coordina- tion.* Cynefin distinguishes ordered situations –in which best practice and good practice define good solutions– from complex situations, where adaptive solutions are discovered through purposeful action in particular situations.

Progress toward inclusion and self direction requires the capacity to work in complexity.

  • Different understandings of inclusion and self-direction lead to significant disagreements about howto implement policies including the recent CMS Setting Requirements and Employment First policy.
  • These disagreements can only be effectively resolved by generating social inventions that test avariety of ways to offer people with ID/DD individualized support to experience self-direction and valued roles in community life and broaden and build from what works.
  • These social inventions must be co-created with people with ID/DD and the diverse people with whom they participate in community life. They can’t be imposed.