Service DeliveryService Delivery

Incorporating concepts related to Incorporating concepts related to empowerment and service quality empowerment and service quality

into delivery systemsinto delivery systems

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

The organization’s mission statement The organization’s mission statement includes:includes:

Define the problem to be addressed by the organization.Define the problem to be addressed by the organization. Contain a statement of need.Contain a statement of need. Contain one or more goals that pertain to the problem to be Contain one or more goals that pertain to the problem to be

addressed by the organization. addressed by the organization. Identify core values that the organization will follow.Identify core values that the organization will follow. Identify a target population or intended beneficiaries.Identify a target population or intended beneficiaries.

For example:For example:Needs statement: Needs statement:

Elderly people, over 65, critically need a readily Elderly people, over 65, critically need a readily accessible, reliable, and accessible, reliable, and affordableaffordable service to refer them to providers who can help them obtain the services service to refer them to providers who can help them obtain the services they need to they need to continue living independentlycontinue living independently in their own homes or apartments. in their own homes or apartments.

Problem statement:Problem statement:Many elderly citizens in the community are forced to give up living independently Many elderly citizens in the community are forced to give up living independently because they lack transportation, are unable to perform heavy housekeeping and because they lack transportation, are unable to perform heavy housekeeping and maintenance tasks, and no longer have regular personal or family contacts.maintenance tasks, and no longer have regular personal or family contacts.

Client Population:Client Population:Residents in the downtown neighborhood over 65 who live independently but who Residents in the downtown neighborhood over 65 who live independently but who need assistance to continue living in their own homes or apartments. need assistance to continue living in their own homes or apartments.

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

Department of Social Work Education, CSUFDepartment of Social Work Education, CSUF

The Department of Social Work Education is specifically committed to the education of 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 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 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 programs intervene with individuals, families, groups and other small systems as well as with human service agencies, voluntary organizations, neighborhoods, and communities. 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 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 capacity of citizens to identify and address their own social welfare and social justice concerns and needs.concerns and needs.

  

To fulfill its mission in the region, the Department prepares social workers for agency and 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 community-based practice and for informed, active participation as social workers and citizens who are compassionate and proactive in response to human needs. who are compassionate and proactive in response to human needs.

  

  

Department Program GoalsDepartment Program Goals1 1 To educate beginning level generalists (BA) and advanced autonomous (MSW) To educate beginning level generalists (BA) and advanced autonomous (MSW)

social work practitioners to serve the surrounding region of the university social work practitioners to serve the surrounding region of the university focusing primarily on the Central San Joaquin Valley.focusing primarily on the Central San Joaquin Valley.

  22 To educate generalists and advanced autonomous social work practitioners to To educate generalists and advanced autonomous social work practitioners to

practice within a commitment to social justice.  practice within a commitment to social justice.  

3.3. To educate generalists and advanced autonomous social work practitioners to To educate generalists and advanced autonomous social work practitioners to practice within diversity/cultural awareness and exhibit diversity/cultural practice within diversity/cultural awareness and exhibit diversity/cultural awareness.  awareness.  

4. 4. To educate generalists and advanced autonomous social work practitioners to To educate generalists and advanced autonomous social work practitioners to practice within an empowerment perspective. practice within an empowerment perspective.

Goals and objectives are used to put the Goals and objectives are used to put the organization’s mission into actionorganization’s mission into action

Goals are broad, ambiguous, and pertain to an ideal we want to Goals are broad, ambiguous, and pertain to an ideal we want to reach such as “end homelessness” or “improve the quality of reach such as “end homelessness” or “improve the quality of life in the community.”life in the community.”

Objectives are steps to reaching the goal and must be Objectives are steps to reaching the goal and must be

a) Measurablea) Measurable

b) Time-limitedb) Time-limited

c) Related to a specific task or process c) Related to a specific task or process

d) Evaluabled) Evaluable

Sample Goals & Objectives for a Medi-Cal Sample Goals & Objectives for a Medi-Cal Outreach Program:Outreach Program:

Goal: Improve health care status among community residentsGoal: Improve health care status among community residentsObjective 1Objective 1: Recruit 10 community residents for paid employment as peer : Recruit 10 community residents for paid employment as peer

health educators by February 1, 2003. Evaluation criteria – number of health educators by February 1, 2003. Evaluation criteria – number of residents recruitedresidents recruited

Objective 2:Objective 2: Provide a series of six training workshops on Medi-Cal eligibility Provide a series of six training workshops on Medi-Cal eligibility by April 1, 2003. Evaluation criteria – number of workshops actually held, by April 1, 2003. Evaluation criteria – number of workshops actually held, number of people attending, findings from evaluation survey distributed to number of people attending, findings from evaluation survey distributed to those attending.those attending.

Objective 3Objective 3: Inform the public about Medi-Cal eligibility through local media : Inform the public about Medi-Cal eligibility through local media and community forums. Evaluation criteria: number of calls for more and community forums. Evaluation criteria: number of calls for more information to Medi-Cal hotline. Number of people attending forums. information to Medi-Cal hotline. Number of people attending forums.

Goals & Objectives can either focus on Goals & Objectives can either focus on task or process:task or process:

Task objectives focus on completing a specific activity or Task objectives focus on completing a specific activity or delivering a specific number of services.delivering a specific number of services.

Process objectives are a means used to complete a task-related Process objectives are a means used to complete a task-related activity. In community practice process objectives are most activity. In community practice process objectives are most often related to recruiting new members, leadership often related to recruiting new members, leadership development, increasing public awareness, or strengthening development, increasing public awareness, or strengthening the organization.the organization.

Once goals & objectives are in place, the Once goals & objectives are in place, the organization must:organization must:

Conduct a needs assessment to determine any service Conduct a needs assessment to determine any service gaps or community/population needs. Develop a gaps or community/population needs. Develop a structure and policies for delivering the service.structure and policies for delivering the service.

Examine how funding sources may determine how Examine how funding sources may determine how programs should be delivered and who should get programs should be delivered and who should get them.them.

Determine what potential beneficiaries want (ideally Determine what potential beneficiaries want (ideally through a formal process of consultation).through a formal process of consultation).

For government funded programs, regulations will often For government funded programs, regulations will often determine who is eligible for the service and how the determine who is eligible for the service and how the

service is delivered. This means that:service is delivered. This means that:

The organization must comply with what the funder wants them to do.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 The organization must be able to prove that they have delivered the service

and that it has been delivered in the intended manner.and that it has been delivered in the intended manner. Funding can be withdrawn or sanctions imposed if the organization does Funding can be withdrawn or sanctions imposed if the organization does

not do what the funder wants.not do what the funder wants. The wants and needs of the program beneficiaries may not be adequately The wants and needs of the program beneficiaries may not be adequately

addressedaddressed. . The organization may be required to balance conflicting demands from The organization may be required to balance conflicting demands from

constituents, funders, and clientele in order to remain in operation.constituents, funders, and clientele in order to remain in operation.

Examples of Regulations includeExamples of Regulations include::

Child Welfare Code Child Welfare Code Medi-Cal reimbursement requirements.Medi-Cal reimbursement requirements. Affirmative Action & Fair Employment LawsAffirmative Action & Fair Employment Laws School attendance policiesSchool attendance policies Social work licensing requirementsSocial work licensing requirements

Regulations often guide how organizations Regulations often guide how organizations determined who gets what in organizations.determined who gets what in organizations.

Eligibility criteriaEligibility criteria Application processes and other intake Application processes and other intake

proceduresprocedures Target populationTarget population Costs associated with receiving the serviceCosts associated with receiving the service

Consequently, regulations may affect:Consequently, regulations may affect:

1)1) Whether the services is actually accessible to people who Whether the services is actually accessible to people who need them.need them.

2)2) Whether the organization actually “sticks with” its Whether the organization actually “sticks with” its primary mission & target population.primary mission & target population.

3)3) The degree to which the eligibility process incorporates The degree to which the eligibility process incorporates popular perceptions of morality and social stigma into popular perceptions of morality and social stigma into eligibility determinations.eligibility determinations.

4)4) The degree of actual power the social worker has to make The degree of actual power the social worker has to make eligibility and service-related decisions.eligibility and service-related decisions.

Front-line workers have power because:Front-line workers have power because:

They determine who gets what.They determine who gets what. The client is often dependent on them for free The client is often dependent on them for free

services and consequently, the client is obligated to services and consequently, the client is obligated to act in an appropriate manner in order to continue to act in an appropriate manner in order to continue to receive service.receive service.

The worker has discretion to interpret the rules and The worker has discretion to interpret the rules and may incorporate stigma into the decision-making may incorporate stigma into the decision-making process.process.

Handler (1992) describes why workers have Handler (1992) describes why workers have powerpower

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

Common barriers that prevent client access to programs Common barriers that prevent client access to programs include:include:

Wait time for serviceWait time for service Lengthy or complex applications.Lengthy or complex applications. Income-testing.Income-testing. Documentation requirements.Documentation requirements. Costs or fees for serviceCosts or fees for service Hours of operation.Hours of operation. Geographic Location/TransportationGeographic Location/Transportation Language/culture (printed documents; translation services; bilingual staff,etc.).Language/culture (printed documents; translation services; bilingual staff,etc.). Availability of day care servicesAvailability of day care services Social stigmaSocial stigma Physical access/availability of services for people with disabilities.Physical access/availability of services for people with disabilities. Immigration statusImmigration status Service coordination, case management, and other gatekeeping processes.Service coordination, case management, and other gatekeeping processes.

Organizations may not intend to exclude Organizations may not intend to exclude clientsclients

But must preserve/maintain own resources.But must preserve/maintain own resources. Have organizational values that limit service Have organizational values that limit service

provision to socially acceptable groups.provision to socially acceptable groups. Can not meet demand for service and must Can not meet demand for service and must

turn people away or refer them elsewhere.turn people away or refer them elsewhere.

Although regulations and funder demands may restrict how Although regulations and funder demands may restrict how organizations deliver service, organizations can set many parameters organizations deliver service, organizations can set many parameters

for how services will be delivered.for how services will be delivered.

By establishing their mission, goals, and objectives.By establishing their mission, goals, and objectives. By reaching a consensus among participants on a future vision By reaching a consensus among participants on a future vision

and values to guide the organization.and values to guide the organization. By establishing a strong board of directors that can advocate to By establishing a strong board of directors that can advocate to

maintain the autonomy of the program and help make sure maintain the autonomy of the program and help make sure services fit the needs of clients.services fit the needs of clients.

By hiring administrators who incorporate social work and By hiring administrators who incorporate social work and other social justice-oriented principles into their personal other social justice-oriented principles into their personal leadership strategies.leadership strategies.

Three principles identified in the social work Three principles identified in the social work literature as important for the delivery of services literature as important for the delivery of services

includeinclude:: Empowerment of staff members and clients.Empowerment of staff members and clients. A commitment to service quality.A commitment to service quality. Making services consumer drivenMaking services consumer driven

Concepts of qualityConcepts of quality Total quality management (staff members help Total quality management (staff members help

establish quality criteria, monitor whether standards establish quality criteria, monitor whether standards are met, and devise new ways to measure quality.are met, and devise new ways to measure quality.

Can be established by licensing and regulatory bodiesCan be established by licensing and regulatory bodies Can be incorporated into program objectives and Can be incorporated into program objectives and

outcome measures for the program.outcome measures for the program.

Attributes of empowerment-oriented Attributes of empowerment-oriented organizationsorganizations

  The provision of training in leadership and decision-making for clientele.The provision of training in leadership and decision-making for clientele. The provision of organizational resources such as advocates who can serve The provision of organizational resources such as advocates who can serve

as liaisons between clients and staffas liaisons between clients and staff The provision of logistical support to clients involved in organizational The provision of logistical support to clients involved in organizational

decision-making such as meals, transportation and child caredecision-making such as meals, transportation and child care The provision of incentives for both staff members and clients to work The provision of incentives for both staff members and clients to work

together cooperatively to make decisions.together cooperatively to make decisions. The provision of information to clients that allow them to choose among The provision of information to clients that allow them to choose among

available service options. available service options.

Purpose of using empowerment-Purpose of using empowerment-strategiesstrategies

Makes services more responsive to the needs of Makes services more responsive to the needs of clients.clients.

Makes services more effectiveMakes services more effective Increases worker job satisfaction and reduces Increases worker job satisfaction and reduces

turnover.turnover. Helps develop new resources for the organization Helps develop new resources for the organization

(worker skills, clients become volunteers and (worker skills, clients become volunteers and lobbyists)lobbyists)

Helps conserve agency resourcesHelps conserve agency resources

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

professional-oriented strategiesprofessional-oriented strategies..

StrategyStrategy ConsumerConsumer ProfessionalProfessional

AdvocacyAdvocacy Self-help Self-help AdvocacyAdvocacy

Case AdvocacyCase Advocacy

Citizen ParticipationCitizen Participation Consumers on Consumers on BoardBoard

No Consumers on No Consumers on BoardBoard

CoordinationCoordination Limited Limited coordinationcoordination

Coordinates Coordinates servicesservices

Eligibility Eligibility RequirementsRequirements

No income-testingNo income-testing Income-testingIncome-testing

StaffingStaffing Hires para-Hires para-professionalsprofessionals

Hires only Hires only professionalsprofessionals

Additional Reading on Access, Power, & Additional Reading on Access, Power, & RegulationsRegulations

Fabricant, M., & Burghardt, S. (1992). Fabricant, M., & Burghardt, S. (1992). The welfare crisis and the transformation of The welfare crisis and the transformation of social service worksocial service work. New York: Sharpe.. New York: Sharpe.

Fix, M., & Passel, J. (1999). Trends in noncitizens’ and citizens’ use of public Fix, M., & Passel, J. (1999). Trends in noncitizens’ and citizens’ use of public benefits following welfare reform, 1994-97. Retrieved from benefits following welfare reform, 1994-97. Retrieved from http://www.urban.org/immig/trends.htmlhttp://www.urban.org/immig/trends.html..

Kalil, A., Seefeldt, K., & Wang, H. (2002). Sanctions and material hardship under Kalil, A., Seefeldt, K., & Wang, H. (2002). Sanctions and material hardship under TANF. TANF. Social Service Review, 76Social Service Review, 76, 642-662., 642-662.

Smith, S. R., & Lipsky, M. (1993). Smith, S. R., & Lipsky, M. (1993). Nonprofits for hireNonprofits for hire. MA: Harvard University . MA: Harvard University Press.Press.

Stromwall, L. (2002). Mental health barriers to employment for TANF recipients. Stromwall, L. (2002). Mental health barriers to employment for TANF recipients. Journal of Poverty, 6Journal of Poverty, 6 (3), 109-120. (3), 109-120.

Additional Readings on Feminist Additional Readings on Feminist OrganizationsOrganizations

Chernesky, R., & Bombyk, M. (1995). Women’s ways and effective management. In J. Chernesky, R., & Bombyk, M. (1995). Women’s ways and effective management. In J. Tropman, J. Erlich, & J. Rothman (Eds.), Tropman, J. Erlich, & J. Rothman (Eds.), Tactics and techniques of community Tactics and techniques of community interventionintervention (pp. 232-239). Itasca, IL: Peacock Publishers. (pp. 232-239). Itasca, IL: Peacock Publishers.

Gutierrez, L., & Lewis, E. (1999). Gutierrez, L., & Lewis, E. (1999). Empowering women of colorEmpowering women of color. New York: Columbia . New York: Columbia University Press. University Press.

Hyde, C. (1994). Commitment to social change: Voices from the feminist movement. Hyde, C. (1994). Commitment to social change: Voices from the feminist movement. Journal of Community Practice, 1(2)Journal of Community Practice, 1(2), 45-63., 45-63.

Morgen, S. (1994). Personalizing personnel decisions in feminist organizational theory Morgen, S. (1994). Personalizing personnel decisions in feminist organizational theory and practice. and practice. Human Relations, 47Human Relations, 47, 665-684. , 665-684.

Van Den Bergh, N., & Cooper, L. (1986). Van Den Bergh, N., & Cooper, L. (1986). Feminist visions for social workFeminist visions for social work. Silver . Silver Springs, MD: National Association of Social Workers.Springs, MD: National Association of Social Workers.