Organizational Change

In June ‘03, Maine Gov. Baldacci signed into law the Dirigo Health Reform Act. A major premise behind the law is that successful health care reform must address cost, quality, & access simultaneously & with equal vigor. Named for Maine's motto: To Lead-the program is designed to guarantee health coverage by ‘09 to those who cannot afford insurance. The ME Governor’s Office of Health Policy & Finance (GOHPF) has partnered with NASHP to develop issue briefs keeping states abreast of the reform.

This paper report son the author's forays into Systems Chnage.The system change efforts include the closure of a state operated institution for people with mental retardation in Maine (Pineland Center), the closure of a state operated institution in Arizona (theArizona Training Center in Tucson) and the introduction of consumer selfdirected model also in Arizona.

This introduction to root cause analysis, and its adaptation to developmental disabilities systems, has been commissioned by the Human Services Research Institute (HSRI) in an effort to assist state DD program administrators enhance their risk management and quality improvement activities. It is designed to provide guidance on the use of root cause analysis to individuals charged with managing programs and larger systems that serve and support persons with developmental disabilities.