WASHINGTON COUNTY’S BLOCK GRANT PROGRAM

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.