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Service Delivery

Service Integration

What is service integration and how can it be established?

Service integration and collaboration are related but distinct methods of service delivery. Urban Institute researchers provide a description of the difference between service integration and coordination/collaboration: "Integration is characterized by features such as common intake and 'seamless' service delivery, where the client may receive a range of services from different programs without repeated registration procedures, waiting periods, or other administrative barriers. In contrast, coordinated systems generally involve multiple agencies providing services, but clients may have to visit different locations and re-register for each program to obtain services [1].

The U.S. General Accounting Office (GAO) defines two types of service integration: (1) system-oriented, in which agencies attempt to create new services and develop new service delivery structures and (2) service-oriented, in which agencies try only to link clients to services while maintaining their own structures [2].

Service integration is expected to achieve several goals. Primarily, service integration is intended to make it easier for clients to access services by providing them with a single point of entry [2]. For example, agencies practicing service integration might assign staff from several agencies to serve shared clients in one place, as in the case of the job-search centers established under the Workforce Investment Act. These one-stop centers are staffed by employees of a number of agencies that provide services such as welfare assistance, economic development, and adult education. This makes it possible for clients to receive from one place a broad range of assistance normally provided in different locations. In addition, access to services is expected to increase because by working closely and communicating with different agencies staff members become more knowledgeable about resources available for shared clients. Combining resources, such as staff and facilities, is also expected to minimize duplication and may allow participating agencies to stretch their funding further. Finally, by referring clients to other agencies for additional services, integration allows each agency to specialize in particular strengths [3].

The foundation of service integration is collaboration with other agencies. Thus, establishing a successful service integration effort requires also striving to establish successful collaboration between participating agencies. The GAO has identified several characteristics necessary for successful service integration [2]. Many of these characteristics also apply to collaborations.

• Gain support from key political officials and other key stakeholders, and provide incentives to encourage participation and cooperation.
• Participating agencies should develop a "common vision" to increase agreement on goals and strategies.

Begin by identifying common needs among shared clients. This will focus attention on issues around which participating agencies can work to reduce duplication of efforts and reduce the workload for some agency staff.

• Establish new administrative and management structures that are independent of the participating agencies. This allows the service integration effort to proceed without being encumbered by any reputations associated with the individual participating agencies.

Despite its benefits, there are also challenges to establishing service integration. While these challenges are interrelated, there are several major categories of barriers to service integration [3].

• Bureaucratic barriers and turf-protection
  • Management and staff may be concerned about losing control over their own organization or the clients they have traditionally served.

• Different philosophies and missions
  • Organizations often have different philosophies and goals that lead them to different ways of doing business - both in terms of the goals and methods of service delivery.

• Differences in performance measures and obtaining credit for services and results
  • Organizations may be held accountable for different types of activities and integrating services may make it difficulty for individual agencies to demonstrate the success of their individual activities.

• Incompatible management information systems
  • Particularly in regard to computer systems, organizations are often oriented toward collecting different types of information about their activities and clients (such as attendance and community referrals)

• Different eligibility requirements
  • Organizations may differ in the type of clients they are required to serve.

Such differences between organizations require careful consideration of possible strategies for overcoming these obstacles. For example, it may be necessary to redesign computer systems so that agencies working together can utilize a compatible data system for the purpose of sharing information. In addition, there may a need to seek innovative solutions that shape activities in a way that can serve the goals of more than one agency as well as provide feedback on the performance measures individual agencies are required to track.

More Information

The following resources are available to those interested in establishing or improving service integration.

• The Urban Institute has a number of reports on human services, including service delivery and service integration. Two relevant reports include:
  
  
  • Literature Review on Service Coordination and Integration in the Welfare and Workforce Development Systems
    
  • Coordination and Integration of Welfare and Workforce Development Systems

• The U.S. Department of Education provides a searchable database of summaries of research articles pertaining to education. There is also a summary of research on the topic of service integration. www.eric.ed.gov (PDF file)

• Researchers from the Cornerstone Consulting Group produced a report that discusses services integration and community partnerships. The report focuses specifically on the issue of teen pregnancy, but the concepts are applicable to many topics. www.aspe.hhs.gov.

• The General Accounting Office prepares reports for Congress on a range of issues. A report is available on service integration and its effectiveness in the service provision for low-income populations. See www.gao.gov, search for 1992 report, number HRD-92-108, entitled "Integrating Human Services."

• New!  With school success being strongly linked to non-academic factors such as poverty, family relationships, and mental and physical health status, meeting youths' needs requires collaboration between schools and community services. The WestEd policy brief Using School-Community Partnerships to Bolster Student Learning addresses this issue by offering information about the importance of schools creating partnerships with youth-serving organizations and giving examples of what some school districts have done to develop such partnerships. The policy brief describes several characteristics of effective partnerships between schools and community agencies. A key characteristic is the ability of a school to identify organizations that can coordinate services, enhance communication between partners, and provide the partnership with the stability that is necessary to sustain funding. Policy recommendations that can be carried out at the state and local level are also provided in the policy brief. Read the brief at www.wested.org/online_pubs/po-02-04.pdf (PDF file).