Rules: the new institutions.

C S Holburn

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PubMed · 2189057

Rules: the new institutions.

C S Holburn

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Abstract

Despite the pervasive philosophy of normalization and the more recent emphasis on "quality assurance," service provision in today's Medicaid-funded residential environment has become more regulation-oriented and less person-oriented. In this article, this argument was presented in the context of rule-governed versus contingency-shaped behavior of caregivers. The culpable process was identified as the coercive enforcement of inaccurate rules, which precludes responsive staff action and generates adverse consequences. The impenetrable system of rules was compared to the "old institutions," and solutions were advanced to bring staff members more in contact with the natural contingencies of teaching and caring.

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Education of Persons with Intellectual Disabilities Health Policy Humans Institutionalization Intellectual Disability Medicaid Quality Assurance, Health Care United States Journal Article

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C S Holburn. 1990. Rules: the new institutions.. https://pubmed.ncbi.nlm.nih.gov/2189057/

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