Service Delivery

1. Service Delivery Incorporating concepts related to empowerment and service quality into delivery systems

2. Organizations need to specify: • Their overall mission. • Organizational goals. • Programmatic goals and objectives. • Protocols/policies for establishing eligibility for service. • Protocols/policies for actually delivering services. • Policies for hiring/firing staff and staff behavior. • How services will be funded.

3. The organization’s mission statement includes: • Define the problem to be addressed by the organization. • Contain a statement of need. • Contain one or more goals that pertain to the problem to be addressed by the organization. • Identify core values that the organization will follow. • Identify a target population or intended beneficiaries.

4. For example: Needs statement: Elderly people, over 65, critically need a readily accessible, reliable, and affordable service to refer them to providers who can help them obtain the services they need to continue living independently in their own homes or apartments. Problem statement: Many elderly citizens in the community are forced to give up living independently because they lack transportation, are unable to perform heavy housekeeping and maintenance tasks, and no longer have regular personal or family contacts. Client Population: Residents in the downtown neighborhood over 65 who live independently but who need assistance to continue living in their own homes or apartments.

5. NASW The National Association of Social Workers (NASW) is the largest membership organization of professional social workers in the world, with nearly 150,000 members. NASW works to enhance the professional growth and development of its members, to create and maintain professional standards, and to advance sound social policies.

6. Department of Social Work Education, CSUF The Department of Social Work Education is specifically committed to the education of social workers at the bachelor's and master's level who will provide social welfare services and leadership within the central San Joaquin Valley. Graduates of both programs intervene with individuals, families, groups and other small systems as well as with human service agencies, voluntary organizations, neighborhoods, and communities. The department is committed to enhancing both the quality of life in the region and the capacity of citizens to identify and address their own social welfare and social justice concerns and needs. To fulfill its mission in the region, the Department prepares social workers for agency and community-based practice and for informed, active participation as social workers and citizens who are compassionate and proactive in response to human needs.

7. Department Program Goals 1 To educate beginning level generalists (BA) and advanced autonomous (MSW) social work practitioners to serve the surrounding region of the university focusing primarily on the Central San Joaquin Valley. • To educate generalists and advanced autonomous social work practitioners to practice within a commitment to social justice.   • To educate generalists and advanced autonomous social work practitioners to practice within diversity/cultural awareness and exhibit diversity/cultural awareness.   4. To educate generalists and advanced autonomous social work practitioners to practice within an empowerment perspective.

8. Goals and objectives are used to put the organization’s mission into action • Goals are broad, ambiguous, and pertain to an ideal we want to reach such as “end homelessness” or “improve the quality of life in the community.” • Objectives are steps to reaching the goal and must be a) Measurable b) Time-limited c) Related to a specific task or process d) Evaluable

9. Sample Goals & Objectives for a Medi-Cal Outreach Program: Goal: Improve health care status among community residents Objective 1: Recruit 10 community residents for paid employment as peer health educators by February 1, 2003. Evaluation criteria – number of residents recruited Objective 2: Provide a series of six training workshops on Medi-Cal eligibility by April 1, 2003. Evaluation criteria – number of workshops actually held, number of people attending, findings from evaluation survey distributed to those attending. Objective 3: Inform the public about Medi-Cal eligibility through local media and community forums. Evaluation criteria: number of calls for more information to Medi-Cal hotline. Number of people attending forums.

10. Goals & Objectives can either focus on task or process: • Task objectives focus on completing a specific activity or delivering a specific number of services. • Process objectives are a means used to complete a task-related activity. In community practice process objectives are most often related to recruiting new members, leadership development, increasing public awareness, or strengthening the organization.

11. Once goals & objectives are in place, the organization must: • Conduct a needs assessment to determine any service gaps or community/population needs. Develop a structure and policies for delivering the service. • Examine how funding sources may determine how programs should be delivered and who should get them. • Determine what potential beneficiaries want (ideally through a formal process of consultation).

12. For government funded programs, regulations will often determine who is eligible for the service and how the service is delivered. This means that: • The organization must comply with what the funder wants them to do. • The organization must be able to prove that they have delivered the service and that it has been delivered in the intended manner. • Funding can be withdrawn or sanctions imposed if the organization does not do what the funder wants. • The wants and needs of the program beneficiaries may not be adequately addressed. • The organization may be required to balance conflicting demands from constituents, funders, and clientele in order to remain in operation.

13. Examples of Regulations include: • Child Welfare Code • Medi-Cal reimbursement requirements. • Affirmative Action & Fair Employment Laws • School attendance policies • Social work licensing requirements

14. Regulations often guide how organizations determined who gets what in organizations. • Eligibility criteria • Application processes and other intake procedures • Target population • Costs associated with receiving the service

15. Consequently, regulations may affect: • Whether the services is actually accessible to people who need them. • Whether the organization actually “sticks with” its primary mission & target population. • The degree to which the eligibility process incorporates popular perceptions of morality and social stigma into eligibility determinations. • The degree of actual power the social worker has to make eligibility and service-related decisions.

16. Front-line workers have power because: • They determine who gets what. • The client is often dependent on them for free services and consequently, the client is obligated to act in an appropriate manner in order to continue to receive service. • The worker has discretion to interpret the rules and may incorporate stigma into the decision-making process.

17. Handler (1992) describes why workers have power Workers are members of organizations, and it is the organizations that determine how their resources are to be allocated. If the clients want these resources, then they must yield at least some control over their fate. In addition, workers have other sources of power: expertise, persuasion, legitimacy, specialized knowledge, and interpersonal skills (p. 281).

18. Common barriers that prevent client access to programs include: • Wait time for service • Lengthy or complex applications. • Income-testing. • Documentation requirements. • Costs or fees for service • Hours of operation. • Geographic Location/Transportation • Language/culture (printed documents; translation services; bilingual staff,etc.). • Availability of day care services • Social stigma • Physical access/availability of services for people with disabilities. • Immigration status • Service coordination, case management, and other gatekeeping processes.

19. Organizations may not intend to exclude clients • But must preserve/maintain own resources. • Have organizational values that limit service provision to socially acceptable groups. • Can not meet demand for service and must turn people away or refer them elsewhere.

20. Although regulations and funder demands may restrict how organizations deliver service, organizations can set many parameters for how services will be delivered. • By establishing their mission, goals, and objectives. • By reaching a consensus among participants on a future vision and values to guide the organization. • By establishing a strong board of directors that can advocate to maintain the autonomy of the program and help make sure services fit the needs of clients. • By hiring administrators who incorporate social work and other social justice-oriented principles into their personal leadership strategies.

21. Three principles identified in the social work literature as important for the delivery of services include: • Empowerment of staff members and clients. • A commitment to service quality. • Making services consumer driven

22. Concepts of quality • Total quality management (staff members help establish quality criteria, monitor whether standards are met, and devise new ways to measure quality. • Can be established by licensing and regulatory bodies • Can be incorporated into program objectives and outcome measures for the program.

23. Attributes of empowerment-oriented organizations • The provision of training in leadership and decision-making for clientele. • The provision of organizational resources such as advocates who can serve as liaisons between clients and staff • The provision of logistical support to clients involved in organizational decision-making such as meals, transportation and child care • The provision of incentives for both staff members and clients to work together cooperatively to make decisions. • The provision of information to clients that allow them to choose among available service options.

24. Purpose of using empowerment-strategies • Makes services more responsive to the needs of clients. • Makes services more effective • Increases worker job satisfaction and reduces turnover. • Helps develop new resources for the organization (worker skills, clients become volunteers and lobbyists) • Helps conserve agency resources

25. Service delivery strategies are choices managers make for the delivery of services. Gilbert & Specht (1986) differentiate between consumer-oriented and professional-oriented strategies.

26. Additional Reading on Access, Power, & Regulations • Fabricant, M., & Burghardt, S. (1992). The welfare crisis and the transformation of social service work. New York: Sharpe. • Fix, M., & Passel, J. (1999). Trends in noncitizens’ and citizens’ use of public benefits following welfare reform, 1994-97. Retrieved from http://www.urban.org/immig/trends.html. • Kalil, A., Seefeldt, K., & Wang, H. (2002). Sanctions and material hardship under TANF. Social Service Review, 76, 642-662. • Smith, S. R., & Lipsky, M. (1993). Nonprofits for hire. MA: Harvard University Press. • Stromwall, L. (2002). Mental health barriers to employment for TANF recipients. Journal of Poverty, 6 (3), 109-120.

27. Additional Readings on Feminist Organizations Chernesky, R., & Bombyk, M. (1995). Women’s ways and effective management. In J. Tropman, J. Erlich, & J. Rothman (Eds.), Tactics and techniques of community intervention (pp. 232-239). Itasca, IL: Peacock Publishers. Gutierrez, L., & Lewis, E. (1999). Empowering women of color. New York: Columbia University Press. Hyde, C. (1994). Commitment to social change: Voices from the feminist movement. Journal of Community Practice, 1(2), 45-63. Morgen, S. (1994). Personalizing personnel decisions in feminist organizational theory and practice. Human Relations, 47, 665-684. Van Den Bergh, N., & Cooper, L. (1986). Feminist visions for social work. Silver Springs, MD: National Association of Social Workers.