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 organizations 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
organizations 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

1. Whether the services is actually accessible to
   people who need them.
2. Whether the organization actually sticks with
   its primary mission target population.
3. The degree to which the eligibility process
   incorporates popular perceptions of morality and
   social stigma into eligibility determinations.
4. 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.
Strategy Consumer Professional
Advocacy Self-help Advocacy Case Advocacy
Citizen Participation Consumers on Board No Consumers on Board
Coordination Limited coordination Coordinates services
Eligibility Requirements No income-testing Income-testing
Staffing Hires para-professionals Hires only professionals
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). Womens 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.