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Redesigning delivery of health and human services

STAPLES — If county governments had a clean slate to redesign health and human services — for child protection and public welfare — what would it look like?

A collaboration between Crow Wing and Todd counties is looking at just that.

Funds for a redesign concept organizers hope will be a pilot project with statewide implications came from a grant through the Minnesota Chamber of Commerce with dollars from the Bush Foundation. The Brainerd Lakes Chamber and Staples-Motley Area Chamber and the state chamber co-sponsored the project. The Long Prairie Chamber was a partner in the endeavor. The project was one of six funded across the state with a stated goal of being more effective and efficient.

The study, compiled during the past five months for a new design, was unveiled Tuesday at a joint meeting of Crow Wing and Todd county boards at Staples City Hall. 

The Reardon Group, based in Golden Valley, involved county staff members who work in health and human services and the people, their clients or customers, who use those services in focus groups.

The team, the group named Design Lab, looked at corrections, law enforcement, public health and social services. The study, which was more about concepts than action plans, encompassed 38 pages. 

One of the first questions posed by The Reardon Group asked if there was the courage and leadership to make the changes, noting participants feared a “this-is-how-we’ve-always-done-business” philosphy and resistance to change.

Both Crow Wing and Todd counties submitted separate proposals for grants to the state chamber in August and then agreed to work together. 

With fewer resources to pay for services, Tim Houle, Crow Wing County administrator, said it’s the shackles people place on themselves that bind them to the current system. Counties have stark choices to make, Houle said, adding he can’t sell a vision of cut, cut, cut as a vision of a brighter tomorrow. But Houle said he could sell a vision of doing things better and cheaper with better outcomes for the client.

“This is about real people, people we know,” said Lynda Erickson, Social Services supervisor with Crow Wing County.

Allison Boisvert, a consultant with The Reardon Group, works with social justice and is a national trainer on the subject of generational poverty. Boisvert said she brings the added view of someone who was a long-term welfare recipient before finding a 30-career in the field, ending up managing emergency services in the Twin Cities for Catholic Charities.

“I’m a great fan and a greater critic perhaps of social delivery systems,” Boisvert said. “We are going to pay for this one way or the other. How do we want to do it and how can we do it with the knowledge of the people who actually do the work.”

Criticisms were heard of a beaurocratic process overloaded with red tape and light on common sense. Examples included people who are unable to get help until a situation worsens; or assistance, such as a need for a car battery to keep a job, that doesn’t qualify in program constraints. 

Recommendations including tailoring services based on need with front-line staff given the flexibility to make decisions, making better use of technology, improving communications, eliminating duplicated efforts and identifying barriers to change — such as state legislation and federal regulations. 

“It’s a concept,” said Tim Reardon, of The Reardon Group. “One that needs to be thought through and examined.”

Reardon said people reported the assistance that made the greatest difference to them in terms of getting the services came at the tail end, when the one-on-one effort could have been better served at the beginning. 

The group reported front-line workers frustration at knowing what an individual needed to be successful but being unable to provide it because of program constraints designed to give the same service at the same time at the same intensity. 

Reardon said a transformation to a new model won’t be easy, but he thought the counties had a unique opportunity to “hit a home run.”

For the counties, next steps will be looking at changes they can make and looking at legislative changes to pursue with the partnership of the chambers. Houle said they aren’t sure where this will take them but they like where they are going. 

After the meeting, Boisvert said it will only work if the changes are implemented and front-line staff empowered. Boisvert said an important aspect is involving the clients in their own recovery. Instead of throwing services at them, she said the clients need to be engaged with clear ideas for what is required of them for services given and consequences following whenever possible. She said people who use the food shelf should give what they can even if it’s a dollar or an hour of volunteer service. 

She said some people will have to be cared for through social services because they don’t have the ability, others need situational help perhaps after a job loss, and others are set up by the system to be paralyzed by their own dependency. 

“The hand out kills,” she said. “It destroys them.”

If food stamps are given the recipient should have a job attached, such as going to a class for basic work skills like showing up on time and everyday, both things Boisvert said she had to be taught. Middle class people mistakenly think those skills are inherent, Boisvert said, adding people need to do whatevery they can to contribute to their own recovery. “All services should be attached to expectation.”

RENEE RICHARDSON may be reached at or 855-5852.