Achieving Efficiency in Human Services Delivery Proves Elusive for State

Perhaps this is why they call it bureaucracy.  Even when the goal is more family-friendly, responsive and efficient operations, it requires the following:  a presentation to the Governor’s Cabinet on Nonprofit Health and Human Services from the state legislature’s Bi-Partisan Municipal Opportunities & Regional Efficiencies (M.O.R.E.) Regional Entities Sub-Committee Human Services Working Group.  It occurred, without fanfare, at the State Capitol on May 6, 2013.

The subject:  a proposal now being considered by the state legislature to do what many in the room described as implementing a provision of law that generally dates back to the last century, circa 1992, that has been sitting on a shelf, as State Rep. Tim Bowles described it, waiting for just the right convergence of administration and legislature to take another crack at insisting on implementation.  Bowles viewed its original creation from the vantage point of the Office of Policy and Management, where he worked during the Weicker administration.

The plan, updated for 2013:  re-align the “service boundaries” of a series of state agencies in order to make them more easily navigable for families with troubled or challenged youth who can, at times, find themselves dealing with as many as 16 agencies and filesnonprofit organizations for necessary services, requiring a nightmare of navigation through agency after agency.

The state agencies involved: the Department of Social Services, Department of Developmental Services, Department of Children and Families, Department of Mental Health and Addition Services would adjust their geographic boundaries to create six service delivery areas that align with the six Regional Education Service Centers boundaries – thus bringing human services and education into geographic alignment, no easy task according to those gathered to discuss the proposal.

The initiative is embodied in House Bill 5267, approved by the Human Services Committee and now awaiting House action.  It’s stated goal:  “to establish an integrated human service delivery system to ease access for consumers and reduce inefficiencies.”

As was noted during the meeting, the bill omits the Department of Public Health from the list of participating agencies.  It also lays out a relatively aggressive time line for implementation – especially weighed against two decades of delay – including a plan to be submitted by 2014 that would include consolidation of office space, relocation of staff, implementation of one-stop services for referrals to services.  The one-stop centers would be required at half of agency office locations by December 2015, and the remainder by the following year.  All of which makes the stated expectation, in response to questioning by dubious Cabinet members,  that the plan implementation would move slowly – taking as long as a decade – even more curious, and seemingly inconsistent with the language of the bill.

The Office of Fiscal Analysis could not provide a fiscal impact for the planned service coordination, which also includes common information technology development.  The Office of Legislative Research report underscores the imperative for better coordination and collaboration by describing the status quo:  DCF has six regions covering the state.  DDA and DSS each have three regions covering the northern, southern and western parts of the state, but DSS maintains either a large regional office or a sub-office within the larger regions.  DMHAS has five service regions.

The Regional Educational Services Centersmap (RESC), whose boundaries would be mirrored by the other agencies, were created more than 30 years ago to “furnish programs and services” to Connecticut’s public school districts.  RESC works with DCF, DMHAS, DMR, DPH, DSS, the Department of Corrections, Department of Education and Board of Education & Services for the Blind on statewide issues.

The M.O.R.E. Human Services Working Group proposals also calls for “the establishment of pilot Regional Human Service Coordination Councils consisting of elected officials, representatives from DSS, DDS, DCF, DMHAS, DOC, ED, PH, Workforce Development Boards, Non-Profits, and Family Advocacy groups to coordinate regional efforts and continue studying and implementing more efficient service delivery.”

The Governor's Cabinet on Nonprofit Health and Human Services was established in September of 2011 to analyze existing public-private partnerships with respect to the state's health and human services delivery systems and to make recommendations to enhance the effectiveness of those systems in regard to client outcomes, cost-effectiveness, accountability and sustainability.   Members include:

  • Co-Chair Terry Edelstein, Nonprofit Liaison to the Governor
  • Co-Chair Peter S. DeBiasi - President/CEO, Access Community Action Agency
  •   Michelle Cook, State Representative
  •  Robert Dakers, Executive Finance Officer, Office of Policy and Management
  • Joette Katz, Commissioner, Department of Children and Families
  •  Terrence W. Macy Ph.D., Commissioner, Department of Developmental Services
  •  Patricia Rehmer, Commissioner, Department of Mental Health and Addiction Services
  • Dr. Jewel Mullen, Commissioner, Department of Public Health
  • Roderick L. Bremby, Commissioner, Department of Social Services
  •  Stefan Pryor, Commissioner, Department of Education
  • William Carbone, Executive Director, Judicial Branch
  • Yvette H. Bello, Executive Director, Latino Community Services
  •   Deborah Chernoff, Communications Director, SEIU 1199NE
  • Roberta Cook, President/CEO, BHcare, Inc.
  • Marcie Dimenstein, LCSW, Senior Director, Behavioral Health Connection, Inc.
  • Patrick J. Johnson, President, Oak Hill
  • Daniel J. O'Connell, Ed.D., President/CEO, Connecticut Council of Family Service Agencies
  • Maureen Price-Boreland, Executive Director, Community Partners in Action
  • Anne L. Ruwet, CEO, CCARC, Inc.
  • Amy L. Porter, Commissioner, Department of Rehabilitation Services