An Integrated Approach to Human Services

From Policy & Practice magazine

Technology allows human service agencies to have a comprehensive view of client needs, giving caseworkers the best information to look at services across programs and to allocate available resources to assist customers. Having an integrated, big- picture view allows agencies to deploy necessary services quickly in a well-coordinated fashion, getting people back on their feet fast.

Integrated services delivery is not new. In fact, when human service agencies began to emerge from the newly created welfare system during the Great Depression, they formed an integrated safety net primarily for women and children who had no means of support. But years of new and expanding services and programs had the residual effect of creating separate, self-contained agencies with different rules, regulations, requirements and funding.

With the advent of welfare reform in the 1990s, one response to the challenge of helping families become self-sufficient was to revive the concept of integrated services. Today the technology exists to support re-integration of human services, and many agencies are taking advantage of these resources. But integration calls for people within agencies to be involved and invested in the process of sustainable change.

In the most basic terms, an integrated service delivery approach serves people better, more efficiently and effectively. If improved services coordination overall could reduce each family’s average stay by just one week within the four largest human service programs—Medicaid, Temporary Assistance for Needy Families, the Supplemental Nutrition Assistance Program and unemployment insurance—the United States would save $45.4 billion per year. The outcome would be a faster track to self-sufficiency for the family.

The scale and results vary, but essentially, all human service agencies are, to some degree, interconnected by virtue of the people they serve. The challenges arise from extremely complicated policies, conflicting regulations and various discipline perspectives (doctors working with social workers, or fraud investigators working with eligibility staff, for example). What’s more, different cultures within each agency and group frequently conflict even though they serve the same clients. Each organization has its own drivers and operational goals.

However, to achieve truly integrated services, organizations must overcome their own interests and look at clients’ needs.

To begin the integration process, agencies can ask a few practical questions about governance, technology and operating models:

• Can agency staff be united with a clear vision and strategy to integrate services? Can it reach agreement on client needs and goals?
  
  
• Are there enough creative and influential people in leadership roles willing to take on big challenges and make changes?
  
  
• Is leadership willing to identify a long-term strategy and stick with it? Is the political climate right to inspire confidence and long-term sustainability?
  
  
• Are there proper evaluation models in place? Will those evaluating and auditing the system be able to conduct reviews with a holistic, conceptual view of integration, or will a more direct approach be needed?
  
  
• Does the agency have the proper investment strategy for long-term success?
  
  
• Can program advocates see the big picture, or will they try to protect their turf?
  
  
• Is the IT team flexible and open to integrating computer systems, or will it be resistant or even unwilling to let go of old, categorical models?
  
  
• Has leadership accounted for new training needs—specifically, cross- discipline training?
  
  
• Does the compensation and classification system account for the skills and knowledge required for an integrated system? Is recruitment set up to draft people willing to work in an integrated environment?
  
  
• Is there a strategy in place to respond to problems unique to an integrated system?
  
  
• Will the staff embrace a sense of stewardship and be willing to avoid a model that rewards specialization? Is there a plan to address various forms of resistance?
  
  
• Is there a rewards and recognition system in place for those who effect positive change?
  
  
• Are there professional project management standards in place with visible leadership support, user involvement, measurable goals and quality measures?