Redesigning the Work of Human Services

By John O'Looney | Go to book overview

SUMMARY

Attempts to build a more collaborative and integrated service delivery system have been made from within major program blocks and, also, across a number of program areas. Despite the marginal advance toward a more collaborative and integrated system of services for children and families, the aggregate effect of efforts to reform the service system from within program blocks has been disappointing. As Sharon Kagan ( 1993) has noted, the "lack of a master plan for uniting these categorical efforts can result in multiple overlapping initiatives, further fostering fragmentation they were meant to eliminate." While the within-field efforts to bridge service system islands have often produced counterindications, the legislative efforts, demonstration grants, and block grant procedures designed specifically to foster more comprehensive, cross-program service integration have provided only gentle, noncompelling reminders that alternative ways of delivering services might exist. The collective failure of these multiple efforts and varied approaches to resolving the twin problems of service fragmentation and duplication provide numerous cautionary tales. The Northampton demonstration, for example, highlights the failure of top-down change and the need to have numerous technical, administrative, personnel, and policy supports in place prior to attempting to implement a redesign plan. Other efforts to redesign the work of human services have run aground on different shoals: They failed because they did not have executive level support, because they did not develop their plans in coordination with state and federal authorities, or because the proposed changes were not those that mattered to the community of persons the programs were designed to serve.

Failure, however, provides a stimulus to learning and an impetus to refine one's concepts and plans. The definitions and assumptions provided in the first part of this chapter represent a beginning to this process of refining our understanding, and the brief history of service integration efforts presented in the second part of this chapter suggests that the case for service integration is not always obvious to those who are responsible for implementing the service delivery system. Service integration efforts tend to be associated with the larger personal, political, technological, and ideological forces at work in the community and in the various levels of government.

The purpose of this chapter is to outline some of the key concepts and events in the history of efforts to redesign the work of human services. In the next few chapters, I delve more specifically into the theoretical basis for adopting service integration and collaborative governance as strategies for the redesign of human services work.


NOTES
1.
There is extensive literature on the question of whether public resources at different levels and in different categories are disproportionately allocated to poorer or

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