The Coordinating Council of Broward (CCB)

Model Characteristics for Health, Education and Human Services Delivery (July 1997)

EXECUTIVE SUMMARY

The current system for the provision of health and human services has been accused of being “ad hoc”. We are not even sure how many organizations compose the human services delivery system with counts ranging from 600 to over 1200. Broward County has a strong desire to continue to move toward a rational, coordinated and responsive approach to the planning, delivery, and evaluation of health, education and human services. In the past, those who saw a need and were able to attract funding, established a service and delivered that service. As long as they were successful in attracting sufficient funding, they continued to operate. There is not a systematic way to establish priority. Because of the nature of the system, there may be waste of effort and money due to duplication. Changing and emerging needs often are not identified until there is a crisis. There is no formal structure for relating the allocation of resources to community priorities or for relating desirable outcomes to continued funding.

Across Broward County, a consensus appears to exist that a more economical, responsive and accountable system for delivering human services must be implemented. The old way is no longer acceptable or affordable. Concerns expressed by CCB members with the present system include:

• Gaps in the services provided; duplication of services; fragmentation of services; and the need for a single point-of-entry for service access by clients.
• Insufficiency of funding; the category/institution rather than clients/based focus of funding; the funding parity issue for Broward County; and the impact of welfare-to-work changes.
• Relations among human service funders and providers are characterized by (1) poorly defined roles, (2) inadequate communication/information sharing, and (3) a need for more cooperation/collaboration (getting beyond the “silo landscape”).
• Need to use outcome and performance criteria throughout the system in order to gain a greater level of accountability.
• Specific trends in the community (increasing frustration among immigrants; impact of crime resulting from drug utilization; growth in numbers of frail elders).

The future health, education and human services system must provide a sufficient infrastructure to address and significantly overcome these concerns. As a framework for this infrastructure, The Council identified the following core values:

• Continue to build on The Council's current approach, moving beyond coordination to collaboration.
• Design services for the customer.
• Show sensitivity to all kinds of diversity.
• Provide a single point of entry for the client establish a Shared Information Network including client information on a need-to-know basis.
• Improve communication and information sharing among agencies, make the computers talk to each other.
• Eliminate gaps in services and unnecessary duplication of services.
• Enhance overall system integration, but do not create a “super agency”.
• Share staff, buildings, funding information co-locate services.
• Make the model dynamic, easily modified to respond to constant change.
• Systematic use of outcome/performance criteria, enhanced accountability.
• Ensure a high level of policy-maker commitment.

A new model system should respond to documented needs, provide accountability and ensure that emerging needs are identified in advance of a community crisis. After needs are determined through a community assessment process, priorities should be established. There are opportunities for action that do not require funding. These opportunities must also be defined by the priorities of the community. In the final analysis every day each individual and organization within Broward County's health, education and human services network should be guided by the true needs and priorities of the community.

In responding to the challenge of defining a future “model” for the health, education and human services delivery system(s), it did not appear feasible or practical to define a single “model” for the entire system(s). What did seem to be most needed and practical was the development of model characteristics and supportive components that can be used as a framework for decision making by all stakeholder groups. It is envisioned that The CCB can facilitate the use of these model characteristics and supportive components to promote actions among policy-makers, funders, providers and the public to achieve the expected changes in the future delivery system(s).

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The following four broad characteristics have been identified:

• Progression from Coordination to Collaboration – It is essential that all major fund allocators learn how to work together in a collaborative style. It is critical to support each other's initiatives. One of the most important skills to develop will be how to involve others when decisions are being made:
  • Sharing of resources (e.g. staff and funding) – There is a variety of funder/allocation organizations in Broward County. This fact will not change. All the resources available must be brought to the table. Money is only one resource. Expertise, knowledge, connections and good will are also valuable resources. All of these resources must be shared to reach common goals.
  • Willingness to give up sole authority – While the decision making should ultimately remain vested in each independent organization; it would be strengthened when it is carried out according to a common set of principles on a collaborative basis.
• Designed for the Customer – There must be appropriate levels of input by the users (customers/clients) of the system in identifying their needs as a basis for establishing service and funding priorities. Funders need to address funding allocations based on community priorities, not the perpetuation of existing providers.
• Accountable/Results Oriented – The system should be focused on achieving satisfactory outcomes for services funded including a means of ongoing evaluation of the system's effectiveness in achieving the desired characteristics.
• Effective Communication Process – With change occurring rapidly around us, it is important for the community as a whole to be educated about the system and its parts. This is particularly necessary for those who use the system. It is also important that the public be able to communicate to the policy makers, funders and providers relative to their level of satisfaction, needs and expectations of the delivery system.

Having defined these four broad characteristics of the future system(s), pages seven through nine of this report defines specific criteria for each characteristic. The intent is to provide these characteristics and criteria as a checklist as a framework for decision making by the public, funders, providers and policy makers to assist the delivery system(s) towards the positive changes expected.

To further assist the system(s) in moving from where it is today to where it needs to be in the future, The CCB is facilitating the development of the following supportive components, which are described in more detail in Section IV of this report:

• Shared Information Network Including Specific Data
• Community Assessment Process
• Collaborative Legislative Agenda
• Collaborative Budgeting and Planning
• Collaborative Grant Development

The attempt in this “model development” initiative is to define what the delivery system model of the future should look like. In other words, what are the basic characteristics that such a future delivery system should possess in order to meet future needs and expectations and overcome the existing deficiencies? If there is consensus that the core values, basic characteristics and supportive components adequately define what we should be building toward, the following actions are recommended for consideration by The Council as a means of moving from the conceptual to the reality of implementation.

Recommendation #1: Assign the Steering Committee the responsibility to develop specific work objectives to evaluate the three collaborative community initiatives referenced in Section V. of this report, against the approved basic characteristics and core values. Based upon this analysis, specific actions would be recommended to The Council for using these initiatives, and others where appropriate, to provide program and/or neighborhood level testing of the model characteristics and new community assessment process in addition to any community-wide assessment implementation.

Recommendation #2: Identify emerging systemic changes such as Welfare Reform (WAGES), to encourage the changing delivery system's use of the model characteristics in defining expected results as such changes are implemented.

Recommendation #3: Based upon the new community assessment results, identify any other service delivery “models” that might be used as positive initiatives for further development.

Recommendation #4: Develop the model characteristics and core values into a set of checklist guidelines and develop a plan and timetable for promoting their use as criteria for funding allocations, contracts, grants, strategic planning and budgeting by all components of the system. The characteristics should be linked to the outcome measures process.

Recommendation #5: Assign the Steering Committee the responsibility for developing specific work objectives as part of its proposed 1997-98 Action Plan, to assist The Council in tracking the actions outlined as a result of this report.

For information about other activities of the SFRPC in cooperation with the CCB, see Human Service Issues and The Coordinating Council of Broward. For additional information, please contact Richard F. Ogburn of Council staff.

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Updated on September 4, 1997