July 26, 2011; Source: The Bridgespan Group | The needs of individuals and families are rarely if ever so isolable that they can be addressed and “solved” with narrow-gauge, single-service programs. According to the consultancy Bridgespan, the notion of providing help to clients with complex and interrelated challenges through “integrated extended support” is common in health-care delivery, but not so much in human-service delivery—but it should be.
In a brief paper, Bridgespan suggests that multi-service organizations (MSOs) are uniquely positioned to provide this kind of holistic help, “but their ability to deliver multiple services frequently doesn’t play out to MSOs’ ‘competitive advantage.’” The authors say that the problem is that “MSOs tend to be organized around the services they deliver, not the needs of the clients they service.” This service-centric approach delivers services that clients were referred to receive, not necessarily the services they really need.
Bridgespan says that MSOs should shift to being client-centric, which means “working with a client to set long-term goals, understanding what services the client will need to reach those outcomes, providing those services in a coordinated way, and following up to make sure the client achieves their goals.”
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There are a couple of challenges to this strategy, according to the Bridgespan authors. The obvious one is funding patterns—the likelihood that governmental agencies prefer to fund service-centric models. The authors also point to “all the attention that single-service agencies have been getting,” but this is less convincing.
The paper suggests techniques to deal with the funding challenge: “contract wizardry” to find public and private funding streams that work in a client-centric model, or trying to convince funders that client-centric is the way to go. But these ideas seem to fall a little short of today’s reality. Massive budget cuts at the federal and state levels are throttling local governments, with human-services funding taking a shockingly high share of the pain. Foundation funding is also increasingly hard to come by.
Assuming that client-centric service delivery is superior to service-centric, nonprofits are going to have to lobby governments and foundations to make that happen. Funding streams need to be protected, de-siloed, and increased in this recession. Programs that lend themselves to client-centric strategies, such as the Community Services Block Grant (CSBG) and the public-service component of the Community Development Block Grant (CDBG), have in some instances been first on the White House and congressional cut lists. That’s why they need to be crucial components of MSO advocacy strategies.—Rick Cohen