Why Develop an Integrated Approach to the Delivery of Social Services?
Over the past several years, social service providers have increasingly recognized that families seeking assistance often face multiple, complex needs and that they require the services of more than one program. For example, Temporary Assistance to Needy Families (TANF) workers who have focused on helping move clients into jobs, often find that in addition to needing basic job skills, their clients may face substance abuse, domestic violence, or mental health issues that interfere with successfully obtaining and keeping a job. Child welfare workers are increasingly recognizing that in addition to mental health, substance abuse, and domestic violence challenges, their clients frequently need economic supports and assistance to more effectively manage their lives and provide adequate care for their children. In order to access the range of services they need, these families must often go to multiple locations and interact with a range of rules and regulations and a variety of caseworkers and case plans. Some caseworkers may have inconsistent expectations and obligations in different case plans or programs may conflict. In addition, agencies often face limitations (actual or perceived) on the type of services they can fund. The fragmentation and complexity of such service delivery makes it extremely difficult, if not impossible, for many families to obtain the services they need. Ironically, the most vulnerable families, those who need the most help, are the least likely to be able to navigate such a complex, fragmented “system.” Thus, a number of states and localities have begun experimenting with ways to provide a more family-centered, seamless service delivery system, a system that offers a broad continuum of services and tailors these services to the strengths and needs of individual families. The goal is generally to provide services and supports to families to help them move towards greater independence while promoting the health and well-being of all family members. The service array is intended to focus not only on immediate, crisis needs of families, but also to provide prevention and early intervention services that help families avoid reaching a crisis.
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What Does an Integrated Social Services System Look Like?
There are a variety of ways to integrate social services across programs, but five components are generally present when integration is sought. These components may vary in emphasis and may be approached in different ways, but they seem to be core components to integrated systems of social service delivery.
Single Point of Entry
The first element of most models of integrated service delivery is a single point of entry for families. The notion here is that “there is no wrong door,” that wherever a family first interacts with the social services system, family members can be connected to a broad range of services.
Comprehensive Family Assessment
A second element involves a comprehensive assessment of the family’s needs in order to develop an appropriate service plan. This may mean a preliminary screening of all family members, followed by a more intensive assessment of particular concerns identified in the screening. Alternatively, comprehensive assessments may be initiated for all family members from the outset. The goal is to identify the strengths and needs of a family early on and connect them with relevant services and supports as quickly as possible.
Joint Case Planning
A third component of many cross-program integration models involves a single case plan or service plan for the family and a primary caseworker who coordinates with a multidisciplinary team made up of staff from all relevant programs. Alternatively, a family may have more than one plan, but the plans are jointly developed across programs, with input from the family, so that the resulting plans are complementary, not conflicting. Under such circumstances, the family generally has a primary caseworker or team member who ensures that the plans are coordinated.
Co-location of services is often a fourth element of integrated service delivery. This enables a family to obtain all needed services at a single location. When co-location is not feasible, it becomes important that the case manager or some other member of the family’s team ensure that referrals are made and received and that the family can access services at other locations. Facilitating coordinated services in such situations often requires the provision of ongoing contact with and support for the family.
A Sense of Partnership
A fifth element of cross-program integration is often a new way of doing business for staff. As the previous components indicate, staff’s day-to-day interactions with families under integrated models of service delivery differ from the more typical fragmented, “silo,” or “stove-pipe” program-specific model. Rather than trying to determine if a family meets the requirements to participate in a program, staff work with the family to determine what the family needs and then look to what programs and funding streams are available to address those needs. Staff interactions across programs also differ in an integrated model. Staff need cross-training and knowledge about the variety of services and supports available to families, not just those available in their program. Staff need to share information, but do so in a way that is respectful of families’ privacy. Staff from different programs and agencies also share accountability and joint responsibility for the success of the families they serve and for compliance with relevant statutes, regulations, and policies. The traditional boundaries and “turf” lines no longer apply.