Not every agency in California says its services are person centered, but most do. Some say client tailored, some say individualized, some say person driven. The idea is in the regulations, in most program designs, and on most websites, including ours. So it is worth asking what it actually means, and what changes when an agency takes it seriously.
Here is the simplest way I know to explain it. Imagine two agencies delivering the same Independent Living Services to the same young man. Both are vendored, both are compliant, both send a report every month.
At the first agency, the assessment takes forty five minutes and follows a checklist. The goals come from the checklist. The support professional is whoever has Tuesday afternoons open. The report says he "participated in community outings" and "worked on cooking skills."
At the second agency, the assessment takes as long as he needs it to take. The coordinator asks what he wants his life to look like and listens to the answer. The goals come from him: learning to take the bus to his cousin's house, cooking the three meals he actually likes, saving for a gaming console. The support professional is chosen because she communicates the way he does. The report tells his mother which bus route he has learned and which one is next.
Same service code. Same hours. Completely different lives.
What person centered actually means
Person centered support is not a tone of voice. It is a set of decisions made in a particular order. The person's own goals come first. The plan is built with them, in language they understand, around things they care about. Staff are matched to the person, not scheduled onto them. Progress is measured against the person's goals, not against a generic list. And when something is not working, the plan changes, because the plan was never the point. The person was.
When an agency works this way, people engage. They show up for sessions because the sessions are about their life. They make progress because the goals were theirs to begin with. They tell their families that someone is finally listening. When an agency does not work this way, people comply for a while and then quietly stop, and the agency writes "declined services" in the file.
A service built around a form produces paperwork. A service built around a person produces a life.
Support matters for more than the participant
One of the first stickers we ever printed said "Support matters." Over the past year I have come to understand how far that idea reaches. Four groups need support for disability services to work, and most agencies only plan for one of them.
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Participants
This is the obvious one, and it is still worth saying. Adults with developmental disabilities deserve support that treats them as the authority on their own lives. That means being asked, being heard, and being given time. It means goals that are theirs and a support professional who knows them.
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Families
Behind almost every participant is a parent, sibling, or spouse who has spent years coordinating services, filling out forms, and worrying about what happens next. Families are not bystanders to the plan. They are its memory and its safety net. They need an agency that answers the phone, explains things clearly in their language, tells them the truth, and shares the load instead of adding to it.
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Support professionals
The people doing the work are the service. When a support professional is undertrained, unsupported, and alone with hard situations, they burn out and leave, and every departure costs a participant a relationship they had just started to trust. Supporting staff is not a benefit. It is how you keep your promise to families.
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The community
Independent living does not happen inside a program. It happens on the bus, at the grocery store, at the gym, in the library, at a job. Every time a participant becomes a regular somewhere, the community learns something about disability that no campaign could teach it. A community that includes disabled adults in daily life is stronger, kinder, and more capable for everyone who lives in it.
When all four are supported, the system holds. When any one of them is left out, the others eventually feel it. A family without a partner gives up on services. A support professional without backing quits. A participant without a community has nowhere to practice what they are learning.
How bttr came to be
I spent years working inside disability services before I started bttr, most recently as an executive at a nonprofit in Oakland. I believed in the work. I also saw, up close, how often agencies lost sight of the people in it. I left that role in early 2025 after a long stretch of burnout, with no plan beyond rest.
A job interview at a technology company changed my direction. The interviewer noticed that I came alive when I talked about disability services and told me to keep doing that work. I did not get the job, and I am grateful. I went home and started applying to agencies in disability services, for any role that would let me do the work: director, supervisor, even direct support professional.
Those interviews taught me more than I expected. I asked a lot of questions, because I wanted to know what I would be joining. How do you run your programs? How is a service actually delivered once the plan is written? How do you match staff to a participant? What does a family hear from you between visits? Most of the time the answers were thin, and often they were the same from one agency to the next. The program designs had clearly been built from the same templates, and the day to day work had been built from the program designs. Agency after agency, the people were different and the model was identical, even when the brochure promised something person centered or tailored to each client. That was the moment I understood that many agencies are a template, and that a template cannot be person centered no matter what it says on the first page.
I kept learning on my own. I studied regional center vendorization and the Self Determination Program at night. A former coworker, Sophia, had started her own agency and showed me it could be done. A friend who worked with an agency that could not find staff told me to stop waiting: you either start, or someone else will.
In March 2025 I registered the business. I wanted to call it Better Living, because that is what I hoped the work would help people experience. The name was taken, so bttr it became. I wrote our program design around the ideas in this article: human compassion, person centered support, clear communication, and systems that make progress visible. The bttr Standard and our six skill tracks came out of those weeks. On June 28, 2025, we received our first vendor number from the Regional Center of the East Bay.
Our first participant's assessment ran long because I wanted him to feel heard. Afterward he told me no agency had ever made him feel that comfortable from the beginning. That sentence is the reason bttr exists. Since then we have added Coordinated Family Support, a second regional center, Supported Living Services, and statewide services through the Self Determination Program. We serve more than 150 families today. The sticker still says the same thing.
What we ask of ourselves
Our internal motto is 1% better every day. It keeps us honest. Person centered support is not something an agency achieves and then has. It is something you do again every morning: listening a little more carefully, explaining a little more clearly, calling the family back a little sooner, checking on a support professional before they have to ask.
Support matters for the participant whose life is being planned. It matters for the mother who has carried the coordination for twenty years. It matters for the support professional who shows up every Tuesday. It matters for the neighborhood that gets to know him. It matters for us.
That is why we say it the way we do. Support matters. For everyone.
Support matters. For everyone.
