The Development of Consumer-Driven Human Services Information Technology Initiatives: The Lake County Indiana Experience

Article excerpt

Introduction

Both consumers and advocates in Lake County are working cooperatively to address the problems of pervasive poverty and quality of life in the region. Recently, the Child, Adolescent, and Family Branch of CMHS, SAMHSA awarded a five-year grant to fund the Child Mental Health Initiative (CMHI) in the county. In the CMHI project, case coordination is realized using an orchestrated 'wraparound team' approach to envelope the family and child with needed supports. Simultaneously, the Lake County Integrated Service Delivery Board (ISDB) is implementing a one-stop-shop approach for human service delivery across the county. In both initiatives, improved case coordination can be realized with technology that facilitates virtual service integration. It is this approach that is articulated in the recently completed Lake County Human Services/Information Technology Mapping Project (MSITMP), a project commissioned by both consumer and provider stakeholders. The problems, solutions, and outcomes articulated at the person and system level are as follows.

Person Level Context

Person level problem

Consumers in the community voice anxiety about their ability to penetrate a human service system that does not hear their voice. As such, many consumers are not knowledgeable about the range of services available to them, have limited ability to advocate on their own behalf, must navigate long and laborious referral and case-coordination processes, and lack direct communications links to those who coordinate services. They also face language and literacy barriers that exacerbate the problems associated with accessing services.

Person level solution

The proposed project provides consumers peer education, chat rooms for a way to build consensus, and instant messaging through a secure messaging/document exchange network in order to realize real time mutual support and communication to care-coordinators. The secure network will allow consumers to communicate with providers using secure e-mail, instant messaging, and digital document access. The network will also be integrated with an existing information and referral database already deployed in the county. Consumers will be assisted in the use of the technology by an extensive program of education and peer mentoring along with a computer recycling program designed to allow consumers to purchase low-cost PC workstations for use at home. Deployment of this solution will take place in the second year.

System Level Context

System level problem

As in most regions of the country, human service systems in northwest Indiana providing services to families and children are fragmented and isolated and do not have effective and efficient modalities of communication to facilitate coordinated and efficient case-management activities. This is a result of categorical streams of funding, the multiple systems servicing the same population (i.e. juvenile justice, education, child welfare, and mental health, Medicaid, TANF), and the discordance of these systems. As reported in the HSITMP, communication between providers exists between sectors on an informal, as-needed basis rather than through formalized and well-integrated processes. The absence of standards for information sharing and the technological infrastructure needed to facilitate such exchanges has rendered the services system incapable of managing its collective and ever increasing caseloads; allowed the services system to be less than responsive to the complexity of consumers' needs; and left consumers out of the process of monitoring their needs and accomplishments.

System level solution

The proposed project involves the development of the organizational structure needed to support the human services information infrastructure in the county. As an organizational change process, the development of this organizational structure will include the development of rules of data exchange, data standards, and the architectural standards needed to use internet technologies to support the secure transaction of data between local human service agencies, consumers, and key state agencies. …