Past NCAPPS Webinars

Person-Centered Approaches to Supporting Dignity of Risk for People with Disabilities

March 23, 2023, from 3:00-4:30 pm ET

In the words of Richard Branson, “You don't learn to walk by following rules. You learn by doing, and by falling over.” Dignity of risk is the idea that taking reasonable risks is essential to learning new things and supporting autonomy for people with disabilities. Risk should be balanced with ensuring the person’s health and welfare. People with disabilities often have less personal control over risk-taking as a result of other people making decisions about risks that should or shouldn’t be taken for them. When people with disabilities are supported to make their own choices and accept the reasonable risk involved, it can lead to personal learning, growth, and feelings of self-worth, autonomy, and independence. In this webinar, national experts, providers, people with lived experience, and state representatives will examine best practices for assessing and addressing risk through person centered practices while balancing choice, decision-making, and satisfaction. Critical to the success of these concepts is the role of Direct Support Professionals, and how they are supported to not intervene when someone makes a mistake, how their response can spur learning, and how to recognize when risk is too great and the person’s informed decision may lead to significant consequences. Webinar participants will hear stories from several agencies demonstrating real person-centered practice of dignity of risk.

Meet the presenters

Mary Lou Bourne

Mary Lou Bourne is a long-term service and supports system consultant and has dedicated her career to transforming service systems by designing and implementing high-quality, person-centered services for people with intellectual and developmental disabilities. During her tenure as Chief Quality and Innovation Officer for NASDDDS, she was the Director of National Core Indicators and directed the evolution of the Workforce Stability survey which was utilized across 28 states. She has served as a Malcolm Baldrige National Quality Examiner, a member of several CMS Technical Expert Panels and has delivered training and technical assistance in 38 states.

Elise Messner

Elise Messner has worked in the ID/D/A field for the past 30 years as a Direct Support Professional, manager, and for the last 12 years, the Executive Director of the Learning Community of PA. She’s a trained Person-Centered Thinking Coach and a 2012 graduate of the National Leadership Institute on Developmental Disabilities. Elise has a passion for creating supportive cultures where people who use services and DSPs are supported and empowered through the practice of person-centered approaches.

Susan Arwood

Susan Arwood is the Executive Director of Core Services of Northeast Tennessee, a provider agency that provides residential and community supports for adults with IDD.  Prior to coming to Core Services, Susan spent a 30+ year career with the Tennessee Division of Rehabilitation Services.  Susan and her team lead Core Services through CQL Person Centered Excellence with Distinction Accreditation and designation as a TN DIDD Person-Centered Organization, Enabling Technology Transformation Agency and Employment First Agency.

Carl Lipford

Carl Lipford is an advocate at Core Services and was living in a home with 24/7 supports and housemates when TNDIDD introduced an enabling technology project in 2018. Carl was not happy with his life; his dream was to live alone in a trailer park. Through the ET project, Carl realized his dream. Five years later, Carl is living his best life and has shown the nation how important it is to assume competence.

Shannon Nehus

Shannon Nehus has over 30 years of experience working with people with Intellectual and Developmental Disabilities (IDD). She joined TennCare in 2017 as the Long-Term Services and Supports Intellectual and Developmental Disabilities Program Director. Prior to that, she spent 26 years in leadership in the provider community providing supports to children and adults with IDD. She has a Master of Science degree in Educational Psychology from Tennessee Tech University.


NCAPPS is an initiative from the Administration for Community Living and the Centers for Medicare & Medicaid Services to help States, Tribes, and Territories to implement person-centered practices. NCAPPS webinars are open to the public, and are geared toward human services administrators, providers, and people who use long-term services and supports. All NCAPPS webinars will be recorded and archived at