Washington County
has entered the brave new world of funding most of its social service programs
through Pennsylvania’s pilot block grant program. Several factors will
determine whether this radical change in funding will improve the delivery of
social services, or go terribly wrong.
In the end, because of over sized funding cuts, it may not matter.
First,
some background is in order. When Washington County was admitted to the second
phase of Pennsylvania’s block grant program last October, as reported by this
newspaper, local officials were gushing with pride and enthusiasm. One would have thought our benevolent
Governor had permitted the County to win the lottery. After all, the block grant does combine seven
different funding streams into one pot, giving the County more discretion on
how the money is spent.
What went unsaid
was that “block grants” never appear in the public sector without “cuts in
services” being made within the same proposal.
In the case of Pennsylvania, the initial pilot program was announced at
the same time that Corbett proposed a 20 percent reduction in state human
service funding. While the cut was later
reduced to 10 per cent, when added to previous incremental cuts made by Corbett
(and previous administrations) the results were horrifying to anyone faced with
the already difficult task of administrating a county wide social services
program.
To add insult to
injury, these cuts went into effect at a time the Governor was insisting on low
business taxes, further reducing revenue.
Moreover, Corbett refused to join other states in adopting Medicaid
expansion, a federal program designed to help the same population that is the
recipient of the underfunded social service programs.
Before
these most recent cuts, local mental health, drug and alcohol, child welfare
and homeless assistance programs had already wrung out as much cost saving,
through administrative efficiencies, as was possible. Moreover, as their budgets were decreasing,
complex and expensive new federal regulations in areas such as HIPAA (health
information privacy rules) were being foisted upon them.
At the time the
block grant program was announced, the Governor’s Welfare Secretary said in his
press release: “The block grant will allow counties to prioritize their human
services spending to meet the unique needs of their communities”. What many social service professionals heard
was: “The block grant will allow counties to cannibalize programs that they do
not favor in order to provide additional funds to save underfunded programs
that are politically expedient.”
There was also a
concern among service providers that a block grant approach would result in an
ugly competition for the reduced dollars that are available. In 2012, the Executive Director of the
Pennsylvania Community Providers Association stated on the record: “The block
grants are almost entirely funded from the mental health system so the mental
health system becomes the bank for other services such as child welfare and
drug and alcohol rehabilitation” (Penn Live, June 5, 2012)
More
optimistic proponents of block grants claim that they provide flexibility to
better serve clients. I believe this is
possible to some degree, if the plan is to eliminate redundancies in similar
programs. For example many court systems
have adopted “one judge-one family” procedures in domestic relations to ensure
that one judge is assigned all proceedings involving the same family. Perhaps social service clients requiring
multiple systems could be handled in a similar manner. As a second example, some efficient courts
have begun to triage custody cases at the outset before deciding what
procedural course the parties should follow.
Such an approach could get social service clients into the appropriate
program more quickly. However, even with
such efficiencies, it is doubtful that combining funding sources in imaginative
ways will overcome the budget cuts to social services implemented over the last
several years. Bottom line, take away
funding and add some bells and whistles and our most vulnerable citizens will
still suffer the consequences of reduced services.
Enough
complaining, what can be done now that the budget cuts and block grant are a
reality and must be implemented? What actions should Washington County take to
launch its block grant funding with maximum success? First, someone must be accountable for the
implementation who is not a patron of any one program. This knowledgeable County watchdog must apply
rigorous evaluation to consumer outcomes and to the equity of conflicting
priorities within the various social services. For example, already depleted
mental health allotments should not be raided to provide funding for new
untested programs or faltering old ones, without good cause shown.
Second,
all of the social service programs affected by the block grant must be kept in
the loop and permitted to contribute to proposed changes. Third, any case management and/or computer
system changes to achieve efficiencies must be thoroughly tested before launch. Fourth, because Washington County is in the
second phase of the pilot program, it can determine what worked in other
jurisdictions.
The
best of all possible results would be to develop a nimble and effective block
grant program and then to have State and Federal officials reinstate the budget
cuts. Alas, if something in government
actually works, it is more likely to be rewarded with a commendation than a raise.
Given Corbett’s announcement on the new state
budget last week, a 1.2 billion dollar shortfall, the more likely scenario is
additional budget cuts. This will result in a further belt tightening of County
wide social services to the point of strangulation, no matter how effectively
the block grant is implemented. If this
is the case, the State has simply given the County more rope to perform the
hanging.
