The Coordinating Council of Broward (CCB)

Workshop on a Human Services Delivery Model: Final Report (December 1996)

Introduction

The Workshop

Summary and Conclusions

Introduction

The South Florida Regional Planning Council (SFRPC) was retained by the Coordinating Council of Broward (CCB) in October to facilitate a workshop on a human services delivery model for Broward County. In preparation for that workshop, SFRPC staff conducted structured interviews with the members of the CCB, and with the Chairman of the Steering Committee, in order to identify key issues and concerns. In addition, SFRPC staff prepared Human Services Delivery Models: An Issues and Options Paper, which was distributed to participants prior to the workshop. This report was developed to provide a basis for the exploration of alternatives for the human services delivery system in Broward County, with a focus on options and choices available. The issues and options report includes a summary of the results of the interviews.

The principal objective of this Final Report is to help The Coordinating Council of Broward bring focus to its effort to define a model for human services delivery in the county. Drawing from the interviews and the discussion in the workshop, this report highlights issues on which there is general agreement, identifies those which require further clarification, and suggests some additional steps which must be taken in order to move forward.

The Workshop

The four-hour workshop was held on December 9, 1996, with the participation of representatives of all but one of the entities which compose the CCB. In addition to the Council membership itself, the Chairman of the Steering Committee and co-chairs of the Steering Committee work groups attended, along with six additional staff and resource people. Appendix A includes a list of workshop participants.

After introductions, SFRPC staff reviewed the agenda (Appendix B) and the rules of engagement with the participants. This was followed by an overview of the findings contained in Human Services Delivery Models: An Issues and Options Paper, beginning with a brief outline of four modes of human services delivery: collaborative, neighborhood-based, centralized and competitive. In a relevant paragraph in that document, CCB members were reminded that:

It is important to note at the beginning that, from the practical application point of view, these four potential modes of delivery are not necessarily mutually exclusive. Hence, understanding the strengths and limitations of and options within each potential mode can provide a good basis for generating alternatives for a human services delivery system for Broward County. Selecting from and combining different aspects of the four modes to create a human service delivery system model for Broward County is the ultimate challenge.

SFRPC staff then summarized findings from the individual interviews, emphasizing the major concerns and issues raised by CCB members.

Characteristics of the Desired Human Services Delivery Model

In the discussions which followed, workshop participants first were asked to identify the characteristics that a model of the human services delivery system should have. These were recorded and participants were then asked to mark those characteristics which were most (blue) and least (red) desired. In most cases, red votes highlight differences of opinion among participants as to the most important features of the model, since an attribute identified by one person as being desirable was considered inappropriate by another.

Appendix C lists the characteristics identified, together with the respective number of blue and red “votes” received. It should be noted that, due to a lack of time, many of the attributes listed in this exercise were not defined in detail, leading to a lack of clarity as to the meaning of some of the votes cast. Participants felt that attributes with a small number of votes should be the subject of further discussion prior to being confirmed as desired characteristics of the model.

Strengths and Weaknesses of Alternative Service Delivery Modes

The next step in the workshop was the discussion of the four modes of service delivery. These isolated modes were intended to set a framework for the discussion, in order to help focus on the desired characteristics of the model and to offer a vision of possible combined approaches through the use of one or more of these modes. The strengths and weaknesses of each individual mode were discussed and recorded. At the end, participants were asked to identify the strengths of the modes which they considered to be most important. The strengths and weaknesses, together with the “votes” on the strengths, are transcribed in Appendices D1, D2, D3 and D4.

Next Steps to Be Taken

The final activity at the workshop was a discussion of next steps to be taken by the CCB as a follow-up to the interviews and the workshop. Success in the Council's ambitious work program for the coming year will require progress in building a consensus on the features of the model for human services delivery. Appendix E contains the suggestions recorded from that discussion.

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Summary and Conclusions

The concerns expressed by CCB members in the interviews conducted prior to the workshop were summarized in Human Services Delivery Models: An Issues and Options Paper, and are transcribed below.

• Gaps in the services provided; duplication of services; the fragmentation in services; and the need for a single point-of-entry for service access by clients.
• Insufficiency of funding; the category/institution rather than client-based focus of funding; the funding parity issue for Broward County; and the impact of welfare-to-work changes.
• The 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”).
• The need to use outcome and performance criteria throughout the system.
• Specific trends in the community (increasing frustration among immigrants; impact of crime resulting from drug utilization; growth in the number of frail elders).

There was general agreement during the workshop on the need to address most of these issues and concerns. The listing of desired characteristics of the model for human services delivery in Broward County, together with the identification of strengths and weaknesses of the four modes discussed at the workshop, permitted the points of possible consensus below to be highlighted. Agreement on these desired characteristics should be reconfirmed by the Council at the earliest opportunity.

The Goal (Desired Characteristics of the Human Services Delivery Model)

• 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 clients establish a common client database
• Improve communication and information sharing among agencies make the computers talk to each other
• Eliminate gaps in services and 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

Further discussion is appropriate on certain aspects of the desired model. As mentioned above, characteristics which received red “votes” may represent areas of disagreement. In addition, some apparent contradictions in the voting, such as the votes cast against the utilization of existing capital resources, may have been due to the failure to provide clear definition of the terms being used. The Coordinating Council may wish to further debate the items below, or request Work Group 1 to provide additional clarification on their importance to the model.

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Model Characteristics to be Clarified

• Eliminate duplication of services
• Utilization of existing capital resources
• Integrates all of the service providers
• Demonstrate cost-effectiveness
• Legislatively compliant
• Marketing strategy
• Non-categorical funding
• The need for constant research and evaluation
• Characteristics of the target area for implementation of a pilot project (broad representation, portion of County population to be included)

An additional issue emerged at the workshop with regard to the neighborhood-based mode of service provision. Several participants indicated that the neighborhood-based approach is an important strategy for implementation of the other three service delivery modes, but should not be considered a mode of delivery by itself. Nonetheless, a large number of votes was given to the strengths identified for this mode: the empowerment of clients and the use of the neighborhood as a resource. Clarification of the Council's direction to Work Group 1 on the role for neighborhood-based service delivery in the desired model is critical to further refinement of the proposal to be developed.

This additional direction may include a consensus definition of the desired characteristics of the model, as well as the appropriate strategies to be applied in different human service delivery circumstances throughout Broward County. It was felt that more clarity in the definition of terms used also may help the CCB to establish the required guidelines for work group actions.

Finally, CCB members showed an interest in moving forward quickly with the definition of a model which can be implemented through a pilot project. The work currently underway in ZIP Code 33311 and the efforts of the Memorial Healthcare System in several neighborhoods of Broward County were identified as existing projects to be considered, as appropriate.

Next Steps

The Steering Committee of The Coordinating Council of Broward has established four work groups, each of which has developed an Action Plan for the next year. These Action Plans have been reviewed and approved by the CCB itself. Work Group 1 has been designated to develop proposals for the model for human services delivery based on input obtained from the workshop. Therefore, as a follow-up to the workshop, it is recommended that the CCB:

• review this Final Report and define the characteristics of the desired model for human services delivery based on
• (1) confirmation of consensus items from the list above and
• (2) clarification of items on which there was not a clear consensus;
• forward the resulting list of agreed-upon characteristics to Work Group 1, together with instructions on how to address any characteristics upon which consensus could not be reached;
• establish a timetable for that group to propose a composite model or models to embody the desired characteristics, and strategies for a pilot project; and
• review the proposal from Work Group 1 and decide on a pilot project to be implemented.

It is further recommended that additional guidance be given by the CCB to the other three work groups in order for them to move forward on their respective work programs and accomplish critical advances necessary to the implementation of the proposed model. In particular, agreement on the items below should be confirmed and passed on to the respective work groups:

• make computers and information systems talk to each other in order to move towards an integrated client information system for human service delivery;
• develop and implement outcome and performance criteria for human service delivery; and
• monitor and evaluate pending changes due to welfare reform, including the preparation of recommendations for state legislative action where necessary.

For a copy of the full report, including the appendices, please contact Richard F. Ogburn at the SFRPC or The Coordinating Council of Broward.

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Updated on Feb. 11, 1997