#ThinkAboutIt

 We all know the saying:

A chain is only as strong as its weakest link.

Think about the HCBS (Home and Community Based Services) chain:

Assessment → Service Plan → Authorization → Provider Availability → Appropriate Match → Training → Competency → Reliable Service → Safe Community Living.

There are a lot of links.

And here’s the part we don’t talk about enough:

The system doesn’t necessarily carry the consequence when one breaks.

The person does.

Assessment gets it wrong?

The person lives with the consequence.

Authorized hours aren’t staffed?

Someone at home fills them.

Provider doesn’t understand the person?

Someone teaches and supervises.

Provider doesn’t show?

Someone stays or the person scrambles to try to find help. 

The system misses a risk?

Someone watches for it anyway.

And when the person and their natural supports become very good at compensating for all those weak links, something remarkable can happen:

The system calls the outcome success.

No crisis.

No hospitalization.

No institutional placement.

“Everything seems fine.”

But perhaps everything isn’t fine.

Perhaps someone has simply been preventing the consequences of system failure from becoming visible.

And then comes the cruelest part:

The person’s stability can be used as evidence that they don’t need as much support.

Think about that.

The better people become at compensating for inadequate systems, the less visible their actual need can become.

So when someone has successfully remained in the community for years, don’t just ask:

“Is the current level of service working?”

Ask:

“What—and WHO—is making it work?”

Because absence of crisis is not evidence of absence of need.

Sometimes it is evidence of extraordinary prevention.

And when the person and their natural supports are repeatedly holding together the weak links, the system should not take credit for the chain holding.

It should recognize who has actually been carrying it.
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