Human service delivery in a multitiersystem
Human service delivery in a multitiersystem
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This article examines the nature of interorganizational relationships that
are formed within a multi-tier human service delivery system. Taking
into account the hierarchical structure of a statewide initiative to
support early childhood education, the study investigates the
differences in the relationships between organizations at the service and
administrative levels of the system. Forty-nine administrative level and
146 service delivery level relationships are evaluated. Findings indicate
that organizations involved in direct service delivery form more
collaborative relationships. Thus, when government provides funding
for human services, policymakers must seek to balance public
accountability with the advantages believed to be inherent in devolved
service delivery. Furthermore, practitioners who appreciate the
importance and nuances of interorganizational relationships will be in a
position to better manage their organizations in an environment of
increased collaborative activity and joint delivery of services. Going
forward, human service systems will continue to involve organizations
from the public, nonprofit, and private sector. A better understanding of
how these organizations work together is crucial to the effective
delivery of these essential services.
In the United States, the delivery of human services
is a constant puzzle for policy makers, practitioners, and
academics. The difficulty stems from the interrelatedness of
issues being addressed and the role and scope of
government involvement in the process. Since the
complexity of the social problems in question is not going
away, the primary area of interest for this study revolves
around administration and the role of government.
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Currently, much of government’s work is being carried out
through complex and indirect administrative approaches
(Kettl, 2000), leading to third-party entities playing an
increasingly significant role in the design, management,
and execution of policy responsibilities (Heinrich et. al.,
2010). This devolution strategy is envisioned as a way to
deliver services in an innovative manner that is consistent
with local needs. This approach is embraced in the field of
human services since policy makers and practitioners
realize that no single organization is in the position to
successfully address the multifaceted problems that face
society. The focus on collaboration is evident in the fact
that governmental funding streams often require
documentation of ongoing human service collaboration in
order for communities to secure funding (Sandfort, 1999).
Underlying the push towards collaboration is the belief that
by working together human service organizations can
integrate their services, producing more effective and
efficient delivery and addressing the needs of multiproblem
clients in a more comprehensive manner (Konrad, 1996).
This article examines how collaboration manifests
itself in a hierarchical service delivery system. By
examining a statewide multi-tier system that seeks to
deliver a “high quality, comprehensive, accountable system
of care and education for every child beginning with a
healthy birth” (North Carolina Partnership for Children),
the study addresses two principal questions. First, what is
the nature of the interorganizational relationships between
members of the service delivery system? Second, does the
degree of collaboration differ between organizations at the
service delivery level of the system and those at the
administrative level? Collaboration is a central component
of most strategies to address social issues and the literature
relating to the concept accepts that a variety of
organizational relationships may arise. Yet, public policy
often views collaboration as a one-size-fits-all concept,
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promoting collaborative activity without taking into
account the complexity involved in such efforts. Increasing
our understanding of how collaborative activity may, or
may not, differ within a service delivery system begins to
build a foundation upon which we can better appreciate the
nuances of collaboration in the field of human services, and
should assist in developing strategies that can address the
issues of effectiveness and accountability in a devolved
system of governance.
HIERARCHY IN THE HOLLOW STATE
Since the great society programs of the 1960’s most
social programs have been managed through a similar
approach. First, ambitious goals are set by the federal
government which provides state and local governments
with funding to manage programs, and in turn the state and
local governments contract out the delivery of the programs
to local organizations. This leads to the joint production of
services and, if to be done effectively and efficiently,
requires collaboration between a number of dissimilar
organizations. It is the nature of the relationships between
these organizations that provides the “hollow” in hollow
state. Milward and Provan (2000) speak of the hollow state
as the degree of separation between a government and the
services it funds, and identify the central task of the hollow
state as arranging networks rather than managing
hierarchies (p. 362). However, when looking at a multi-tier
service delivery structure that receives substantial funding
from government, as is common in the human services, it is
difficult to view it as having completely abandoned
hierarchy. Instead one sees a web of interorganizational
relationships that form within a more or less hierarchical
structure. Kettl (2002) notes that horizontal relationships
have not displaced vertical relationships; rather they have
been added to the system. In their review of over 800
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research studies on governance, Hill and Lynn (2005) do
not find evidence of the decline of hierarchical governance.
In addition, they raise the possibility that new
administrative tools and techniques are being created to
facilitate governance within a hierarchical system. This
suggests that the emphasis within governance theory on
primarily horizontal structures may be missing a key
vertical element that holds the system together 1 .
When considering human service delivery, it is
important to keep in mind that most systems incorporate
public and private organizations. In addition, the services
being provided are typically viewed as public goods and
substantial funding for their provision comes from
government. In the context of devolution this creates a
scenario where government can choose to contract out
services and then set about managing those contracts, or
government can choose to partner with other organizations
to realize the delivery of services. For services that lack
complexity and offer straightforward solutions the former
is a viable strategy. However, when issues are complex and
goals are broad, government may not be able to clearly
specify what a contractor needs to do to meet public needs
(Whitaker et. al., 2004). When this occurs, the option of
partnership and collaboration is more appealing. Evident in
this choice is that the success of whatever strategy is
selected will depend on the nature of the interorganizational
relationships that are formed.
1 For an in depth discussion on the impact on governance of the use of
third parties to deliver services see the 2010 special issue of the
Journal of Public Administration Research and Theory, “A State of
Agents”.
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COLLABORATION AND
INTERORGANIZATIONAL RELATIONSHIPS
WITHIN A HIERARCHY
Collaboration is essential to the joint production of
human services, yet what is meant by collaboration is
seldom specified. While collaboration has many definitions
and can result in numerous organizational forms, this
article identifies collaboration as taking place within the
context of an interorganizational relationship, that is, when
two or more organizations work together. Within a multi-
tier hierarchical system of service delivery, there are
varying levels at which these relationships will manifest
themselves. In a devolved service delivery system the
management issues will differ from level to level,
suggesting that the appropriate form of relationship may
also differ. Moreover, the challenges and barriers to
collaborative efforts will vary at different levels within the
delivery system (Sandfort, 1999; Miller & Ahmad, 2000),
indicating that the nature of the relationships will be
important to overcoming the difficulties and that various
forms of collaboration may be more effective at different
levels.
A range of concepts seek to capture the
collaborative nature of interorganizational relationships,
including partnerships, alliances, and joint production.
While the terminology may differ, what is consistent is that
the nature of these relationships organizes along a
continuum, and that positioning on the continuum is based
on the level of organizational integration that is evident in
the relationship (Bailey & Koney, 2000; Frey et al., 2006;
Gajda, 2004). Bailey and Koney (2000) propose a four
level continuum of interorganizational processes that
moves from cooperation to coordination, collaboration, and
finally coadunation. In a human service delivery system,
coadunation would entail the joining of two organizations
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into a single entity, a merger. The scope of this study does
not encompass coadunation; it does however add a point to
the continuum. When a funder contracts with a private or
nonprofit organization in a purely market based transaction,
where organizational integration is minimal, the
principal/agent relationship is evident. In such conditions,
the principal (funder) is more concerned with ensuring the
agent (contractor) is fulfilling its obligations and does not
intimately involve itself with the delivery of the good or
service.
In a multi-tier human service delivery system that is
initiated by government and includes a multitude of
organizations from the public and private sectors, the
interorganizational relationships formed will fall along a
continuum ranging from principal/agent to collaborative.
The appropriate nature of the relationship will depend on
the goals of the organizations entering into the relationship.
Goals for state or federal level governmental organizations
will differ from those of local governments or service
providers. Therefore, in an effective service delivery
system the nature of the relationships should differ
depending on the level of the hierarchy involved. In other
words, state level organizations have different objectives
than do local level service providers. State level agencies
are concerned with aspects of control, coordination, and
equity. Their desire is to see that all services meet certain
expectations, are not redundant, and are available to all
members of their constituency.
