Big changes in the administration of government-operated human services in Minnesota are in the works, and Cook County intends to stay ahead of those changes to maximize its ability to have a voice in them.
On Tuesday, September 15, 2009, the county board met with Cook County Public Health & Human Services Director Sue Futterer to talk about how Cook County would respond to new requirements set by the state earlier this year.
In January, Governor Tim Pawlenty proposed consolidating into 15 regional centers the human service departments that most of the state’s 87 counties currently administer independently. What came of that proposal was not the system he suggested, but rather new legislation designed to make human services more efficient and more effective.
According to the Association of Minnesota Counties Human Services Redesign Liaison Group, “This legislation allows counties to utilize already existing models of community partnerships, build on innovations, and streamline the system to best serve communities, clients, and taxpayers.”
The legislation allows counties to design their own Service Delivery Authorities – alone if their population is over 55,000 or in collaboration with other counties.
Service Delivery Authorities (SDAs) will be accountable for meeting measurable performance outcomes, but they will also be allowed some flexibility in designing their programs. If they come up with innovative and more effective ways to deliver services, they will have the option of waiving state mandates that would otherwise apply.
Other benefits of creating or joining an SDA could be cost savings by consolidating administrative functions, the ability to specialize in certain services such as adoption and take advantage of the specialties of other counties, and more flexibility in tailoring programs to community needs.
Counties collaborating through Service Delivery Authorities must have a combined population of 55,000 and be within reasonable geographic proximity of one another or include at least four counties within reasonable proximity of one another if they do not have a combined population of 55,000. The combined population of Cook County and Lake County (our only neighbor) is only about 17,000, according to Futterer.
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Some counties not collaborating with other counties will be allowed to create their own Service Delivery Authorities as long as they otherwise meet all requirements of the new legislation.
If Cook County becomes part of a regional SDA, would local residents be required to travel to obtain needed services? Futterer imagines workers doing more traveling than clients. “To provide services locally is important,” she said.
Commissioner Bob Fenwick hopes the new system will offer clients “what’s really needed” and lead to high client satisfaction. He said that the Mayo Clinic has moved toward more focus on client satisfaction as a desirable outcome measure.
“One of the concerns that I have,” Futterer said, “is that services could get really fragmented.”
A state steering committee has been formed to develop and review performance outcome standards. Counties will not automatically be required to join Service Delivery Authorities, but if they fail to meet the standards they could be required to join an SDA or come under the administration of the state commissioner of human services.
A state council is also being formed that would identify incentives for counties to collaborate, approve the formation of SDAs, and oversee their operation.
Commissioner Fenwick recommended that the county be proactive and get started collaborating with other counties now. Since Cook County already helped create the Arrowhead Health Alliance with Lake, Carlton, and Koochiching counties to administer health care programs for qualifying residents, the county board suggested that Futterer begin looking to this group for collaborative partners.
Personnel Director Janet Simonen maintained that working out union issues across counties would be a major challenge.
Futterer said those working on the changes are trying to work on how they can succeed rather than focusing on what isn’t going to work. She referred to a March 1 article by Katherine Barrett and Richard Greene in an online edition of Governing magazine (www.governing.com). “By bringing agencies together,” the article states, “a government can cut back on the number of expensive officials necessary to lead, eliminate duplicative administrative tasks, ease communications and make services more readily available to citizens.” The result can improve effectiveness, speed, and flexibility.
When consolidation is not done well, “it can create giant governmental units that are perceived as insensitive, confusing, rule-bound and unwieldy,” the authors assert. When saving money is the sole goal, the effort of consolidating can backfire.
Theauthors cite examples of both successful and failed consolidations. They quoted governmental administrator Bob O’Neill, who said, “…The fewer the rules, the better the group can do.” He believes organizational structures based on a set of values and principles work better than rules, regulations, and procedures.
With Sue Futterer currently holding the position of president of the Minnesota Association of County Social Service Administrators, Cook County probably has a pretty good chance of staying on top of this wave of change.
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