Academic journal article Policy & Practice of Public Human Services

Making Service Integration a Reality

Academic journal article Policy & Practice of Public Human Services

Making Service Integration a Reality

Article excerpt

The need for public human service agencies to integrate services is well established. Most human service agencies recognize that in order to achieve positive outcomes for vulnerable families and children, they must focus holistically on the customer. We know that many customers arrive at the door of human services with a complex set of needs that no one program service area can fulfill on its own.

At the same time, we also know that each program area has its own philosophy, goals, service structure, and terminology that are challenging issues to overcome when integrating services. Funding streams and federal mandates contribute to the challenge of integrating services by pulling a human service agency in different directions. As a result, "Ms. Jones" walks into a human service agency office a whole person and the system virtually breaks her and her family into pieces in order to serve her, consistent with the structure of most human service programs.

Despite and perhaps because of these challenges, we know human service agencies can no longer afford not to integrate services. The lives of children and families literally rely on the extent to which human service agencies integrate services for better performance.

Challenges of Service Integration

Although service integration is well established in theory, making it an operational reality has remained elusive over the last 20 years, but not for lack of effort or creativity Some agencies have made phenomenal progress toward service integration, despite complex and ever-changing political, economic, demographic, and technological conditions. One-stop shops have emerged, joint planning has been initiated, colocation of two or more service agency's staff has been implemented, standard initial screening tools and eligibility processes have been established, and the merging of data systems is ongoing in many jurisdictions. While there have been successful pilot programs over the years, there have been few broadly implemented system changes that have brought service integration pilot programs "to scale." Historically, pilot programs and studies of best practices have not been widely replicated, not because they were "bad" strategies, but rather a critical component was missing: high-performance leadership.

Although we traditionally associate "leadership" with the work of the chief executive, the missing component in successfully integrating services is leadership work performed throughout the agency. An agency with sufficient leadership capacity to integrate services is made up of employees who all perform components of leadership work, management work, task/technical work, and team skills.

Why Has Service Integration Been So Elusive?

We know why we need to integrate services, we know what we've learned from our successes and failures, and we know that we must build leadership capacity throughout the organization. Why, then, have we been unable to make service integration a reality? In a nutshell, we are trying to get integrated performance from a hierarchical system that was designed for standardized production. There is no "standard" customer; each needs different things in different combinations at different times for different reasons. Nor are we doing production work.

The hierarchical organizations we work in were designed 100 years ago for standardized production under drastically different economic, technological, social, and political conditions. The rate of change during that time was relatively slow. Service integration has been elusive because it requires that we create flexible, performance-based, integrated organizations despite our hierarchical history and structure. In a survey of APHSA members, today however, 86 percent of the respondents said they envision their agencies integrating or consolidating its services in the future.

Creating an Integrated, High-Performing Organization

Creating an integrated, high-performing organization requires specific leadership work at all levels of the organization. …

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