Each case manager was
assigned a part of |
We
created TCHSA in 1985, by bringing under one umbrella four human service
programs: Children and Youth; Mental Health; Mental Retardation; and
Drug and Alcohol. Before that, these county programs were delivered
through separate agencies, following the state and federal government's
categorical formula of providing human services. |
| The Cracks in the System | MH | MR | C & Y | D & A |
|
The categorical system
wasn't designed with families in mind, or clients with more than one
human service need. Programs were geared to a targeted audience or a
specific problem. Each had its own director and support staff as well as
caseworkers trained in the program area.
It was expensive for the county and clients were slipping between the cracks. We labeled people by category. Individuals with more than one categorical problem trekked from one office to another, duplicating paperwork at each stop. Clients and families with multi-service needs often had several case managers. Services were fragmented. Interaction among programs was rare. Casemanagers were reluctant to share information because of client confidentiality issues, turf conflicts and competition for funding.
|
| A Catalyst for Change |
|
All that began to change
in 1983, when a perceptive Tioga County judge noted that his courtroom
was increasingly overcrowded. In one case, 30 people from various
agencies were all working with the same family. ‘Fix the problem,’ he
urged county commissioners and program directors.
|
 |
| Changing the System |
|
We set out to create an
agency that could monitor and manage county needs within state and
federal categorical guidelines as well as provide holistic services for
clients and their families. It didn’t happen overnight. It took two
years of planning, public hearings and support from the State’s Policy
and Planning Department to mold a single, unified system.
|
| The First Steps |
 |
The separate categories
of Children and Youth (C & Y), Drug and Alcohol (D & A), Mental Health (MH) and Mental Retardation (MR) were fused into one agency. All administrative and program authority was vested in a single administrator, reporting to the county commissioners. To accomplish this, Tioga County broke from the joinder it had helped establish with neighboring counties for MH, MR and D & A services. Aging services, offered through the four-county Area Agency on Aging, elected to remain in the joinder. |
|
In 1985, the department
of Family Services was
created to oversee all case management functions of the three previously
autonomous categories of C & Y, MH and MR. Categorical titles were
eliminated and one Family Services director was named to manage the
department. D & A case management was formally established in Family
Services in 1992, when funding became available.
All supervisors and case managers were cross-trained to provide holistic, family-based services. This process was achieved incrementally. For the first two years of the transition, caseloads were still assigned categorically. Each supervisor, however, managed caseworkers from at least two categorical areas. Caseworkers with expertise in one category helped train supervisors. These supervisors, in turn, trained other caseworkers. This hands-on experience with different categorical programs as well as state-mandated training paved the way for the Agency to begin utilizing cross-trained case managers in 1987. |