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SUMMARY
The Office of the Auditor General has conducted a performance
audit of the Arizona Department of Economic Security’s (Department) service
integration initiative pursuant to a November 20, 2002, resolution of the Joint
Legislative Audit Committee. The service integration initiative is a major
attempt to restructure the Department’s service delivery approach. Its intent is
to improve outcomes for families served and maximize services provided with the
resources available.
This audit was conducted as part of the sunset review process
prescribed in Arizona Revised Statutes §41-2951 et seq and is the fourth in a
series of six reports on the Department of Economic Security. The three reports
already issued have examined the Department’s welfare programs (Auditor General
Report No. 04-02), the unemployment insurance program (Auditor General Report
No. 05-01), and information security (Auditor General Report No. 05-04).
Subsequent reports will review the Division of Developmental Disabilities and
analyze the Department based on the 12 statutory sunset factors.
In 2004, department management issued a new statement of the
Department’s vision, mission, and guiding principles in its strategic plan.
Among the new principles were three that focused on improving the Department’s
level of integration: 1) effective integration of systems of care, 2) service
coordination across systems, and 3) partnership with communities. The Department
has six divisions that provide many different services to individuals and
families with needs related to a wide range of factors such as aging, income,
unemployment, and disability, and an additional three divisions providing
administrative support. Historically, government agencies such as the Department
that administer federal and state human services programs have administered
services in a “siloed” manner. Although the Department has attempted some
service integration pilots in the past, there has been little or no coordination
between programs administered by different divisions. The current service
integration initiative is designed to change this condition.
Service integration is not a new idea, but the federal
government’s 1996 Personal Responsibility and Work Opportunity Reconciliation
Act, which is more commonly called welfare reform, re-energized the idea because
the federal legislation led many states to examine the links between their cash
assistance and job training and placement programs. The Department’s current
efforts are comparable with current trends in other states. Some efforts are
system-oriented, emphasizing organizational reform; others are service-oriented,
emphasizing the development of systems and processes that will improve the
client experience and lessen service fragmentation; and a third approach
emphasizes bringing together different sectors such as education, mental health,
and juvenile justice.
Department should take steps to ensure
service integration efforts are sustainable
(see pages 7 through 18)
The Department’s first steps to implement its current service
integration initiative appear to be in keeping with recommended practices drawn
from studies of such efforts. Department management have expressed their
commitment to service integration and taken steps to coordinate planning so they
can communicate a consistent message to staff. Management has also participated
in planning activities related to service integration that focused on nationally
recognized programs, and started to look at system-oriented issues, such as
funding mechanisms and information systems, that will support its service
integration efforts. At the same time, the Department has also implemented
several local service-oriented efforts that emphasize developing systems and
processes that will improve the client experience and reduce service
fragmentation. The Department’s effort will eventually have to address a number
of staffing-related issues such as hiring staff with the necessary
qualifications and providing training. Finally, the Department is working to
improve communication and collaboration with other governmental and
nongovernmental organizations.
To help ensure it meets its service integration goals and can
sustain integration into the future, the Department should learn from its own
previous efforts, establish comprehensive outcome measures, and evaluate
outcomes of its current initiative. Although some past efforts were evaluated,
the Department has not systematically assessed lessons learned from previous
integration efforts that did not continue past their pilot stage, such as a
federally supported Community Services Integration Project (CSIP) that operated
in Flagstaff the 1980s, and an Integrated Service Office (ISO) pilot project
that operated in west Phoenix in the 1990s. The ISO pilot project was not
evaluated after it ended, so no lessons learned or explanations for termination
were documented.
In contrast to previous initiatives, the Department regards
its current initiative as a change in the way it does business, not a pilot
program, and it has developed guiding principles that include evaluating
services for outcomes. However, to help ensure its service integration efforts
succeed and are sustainable in the future, the Department should identify and
make plans to overcome the barriers to success encountered by past efforts. In
addition, it should continue to share experiences and ideas from local office
initiatives with other local offices, to facilitate their development of
successful service integration initiatives, and identify measurable outcomes,
assess the implications of relying on its current measures, and evaluate the
success of its service integration efforts.
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