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Ensuring Quality Services for the Blind: Do We Have the NAC?

by Charles Crawford and Christopher Gray

 

Have you ever wondered how all the various interests and elements come together to define a service and to put benchmarks in place to guarantee it is a quality service? Often, we can identify a service that missed the mark, but understanding why this has happened and what can be done to improve things is sometimes easier said than done.

Yet as a consumer organization, we must constantly work toward better services. The alternative is either to advise blind and visually impaired people to move to an area where services are better, or just to accept what we get.

ACB has always endorsed standards and accreditation as one important approach that gives consumers reasonable expectation of receiving credible services from schools and agencies. Indeed, the general population relies in much the same way on accreditation to assure them that educational, medical, transportation, and other services are worthwhile. Teachers must be certified as well as ophthalmologists, social workers, mobility specialists and a host of others who provide services to the blind community and to all our communities in general. Since 1966, ACB has stood alongside those who say that the blind community is better served with a stable process of accreditation than without one. Also since that time, a self-serving and transparent attack has been mounted against the principles and mechanisms for accreditation by those who sought only to control that process for their own ends. Partly for this reason and partly due to many other factors, accreditation has been a complicated and divisive issue in our community. First, let’s look at a little background.

One effort in accreditation that has been ongoing for many years has been to establish standards and subsequently accredit blindness agencies based on reviews of their process, performance, and qualifications. This work has been a part of the business of what many have known as NAC, which stands for the National Accreditation Council. Despite the existence of NAC since the late 1960s, that entity has never gone any further than accrediting 25 percent of all the agencies and schools serving blind people. Today, the membership of NAC is down to 10 percent or less of all the providers upon whom we rely for services. Should this be of concern to ACB? If so, then what problems need addressing and what outcomes should we be seeking?

ACB’s major concern with respect to NAC over the years has been insufficient consumer involvement in the development of standards and process of accrediting agencies and schools. Between roughly 1980 and 1990, we had good reason to believe things were changing and that the inclusion of more and more blind consumers had moved away from tokenism toward real involvement. For many reasons, this fell apart during the 1990s. Part of the problem was funding; another part was organizational changes within NAC. We have responded to our exclusion from the standards setting and accreditation processes by maintaining a stance of “Nothing about us without us.” Our reactionary approach, along with the Federation’s more active opposition to NAC, has certainly kept away all those people who want to do things for us rather than with us. Unfortunately, it has also led to a stagnation in the updating, growth and quality of accreditation services, and this situation cries out for change if blind people are going to receive the caliber and quality of services that all of us know we need.

ACB has proposed to the NAC board that they substantively “change their ways” by including the “active participation” of consumers in their development of standards and through the process of accreditation. ACB has stated further that only by adopting our principles of consumer cooperation can NAC truly involve all consumer organizations to ensure balanced and enriched results.

If NAC, or a successor organization, takes on this challenge seriously, then the power of consumerism will have been added to the academic reasons for standards and accreditation. Under this formula, agencies and schools for the blind would be motivated, not only by the reasonable proposition that they should adhere to specific and high standards, but also by the certainty that customers expect quality and a minimum predictability of good service from agencies that have been accredited. This should be true across the country.

There is much more to this story of how we can achieve quality services throughout the land, but let’s leave other parts of the discussion to future issues of the Forum and get to work on reshaping, and if necessary reforming, the world of accreditation before too many more blind people are left to the luck of the draw or forced to live with little or no choice in what they get. As we provide you with more details on this topic in future articles, rest assured that ACB stands as it has stood since 1966: squarely in support of accreditation based on sound standards and separated from any single organization’s political agendas and endeavors. We believe in rehabilitation that serves all comers who qualify for the service based on their needs, not based on a model similar to a boot camp, or so rigid that there is no opportunity for personal choice. Accreditation based on professionalism rather than politics has always been ACB’s first consideration and will continue to be so.