HHS Report: Integrated Services Can Make the Difference - Dept. of Health and Human Services' Office
Many agencies around the country are attempting to improve the piecemeal delivery of services through integration. Integration links multiple services to approach clients holistically.
"Services Integration for Children and Families in Crisis," a study by the HHS Office of Inspector General, discusses thirteen agencies that integrate services. The report looks at agencies ranging from adolescent-centered programs such as New Jersey's school-based youth program and San Francisco's homeless youth shelters to family-centered programs which emphasize parenting education and family support in Texas, New York, and Michigan. The organizations differ in size, funding sources, service locations, target populations, and staffing.
A program that integrates services to help families in crisis often provides parenting education, family counseling, adult education, job training, housing assistance, child care, and health services all at one location. To serve a young runaway, an agency initially provides medical treatment, food, clothing, and shelter. To continue its support following crisis intervention, the agency provides counseling, education, job training, and permanent housing to help the youngster learn to function independently.
Each agency uses a combination of integration approaches. Case management, interagency agreements, and collocation are the most common approaches. Coapplication procedures, noncategorical funding, and program consolidation also are used.
Programs that integrate services are innovative and effective. New Jersey's school-based program enlists corporations to serve as mentors for troubled teens. In San Antonio, Avance's parenting staff go into the home to videotape parent and child interaction for peer evaluation. East Harlem's Little Sisters of the Assumption runs a "grandmother" program which offers in-home assistance with daily chores and household management in addition to their social work and home health care services.
Families and children benefit from services integration. Integration can make services more accessible, comprehensive, and better coordinated. Multiservice centers located in a neighborhood or housing project offer the convenience of one-stop shopping. In several situations, interagency agreements have eliminated duplication of some services and filled gaps in other areas to provide comprehensive and coordinated treatment. At New York's Project Giant Step, not only does the preschool program prepare a 4-year-old for school, but parents and siblings also receive support services because of the importance the whole family plays in the 4-year-old's success. Some agency officials also noted that integrated service delivery will reduce more costly future social problems, such as delinquency or poor parenting.
Agencies are able to overcome barriers to integration. Bureaucracy, inadequate resources, and professional differences are some of the hurdles agencies encounter. Human factors such as dedication and good relationships can make the difference in overcoming these hurdles. Employees at Detroit's Families First do whatever in necessary to preserve families, including carrying beepers to be available day and night. Good working relationships in Iowa's county and State agencies cut through many professional differences and red tape.
