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I’:AO..‘ l :1..:On ‘ . .l l..Y-‘ V - :vviOo. ‘ ‘. ‘ Atlci‘lw‘t v rt?! lot .1...‘ I»... fir . titral‘ I ..olnlu|tl(ll n IES MICRIGAN STATE UNIVERS UBRAR ' l\\\\\\\\\\l\\ \\\\l\\\\\\\\\\l\\\\l\”\ll\l\\\\\\\\\\l 3 1293 00792 7340 This is to certify that the dissertation entitled SERVICE EFFECTIVENESS IN HUMAN SERVICE ORGANIZATIONS: A MULTI-SITE CASE STUDY presented by Caroline Malenfant Guzman has been accepted towards fulfillment of the requirements for Doctor of (kgufin Resource Philosophy Development fl Major professor Dme NOV. 17L 1992 MSU i: an Afflrmatt'vr Action/Equal Opportunity Institution 0-12771 F ii LIBRARY Michigan State University L I PLACE IN RETURN BOX to remove this checkout from your record. TO AVOID FINES return on or before date due. DATE DUE DATE DUE DATE DUE . _ R3" .334 lip 1733 ; ‘ 71L 1') fines 4W3 _JN0V192003 W11 0'4 MSU Is An Affirmetive ActiorVEquel Opportunity Institution email“: SERVICE EFFECTIVENESS IN HUMAN SERVICE ORGANIZATIONS: A MULTI-SITE CASE STUDY By Caroline Malenfant Guzman A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree DOCTOR OF PHILOSOPHY Department of Resource Development 1992 ABSTRACT SERVICE EFFECTIVENESS IN HUMAN SERVICE ORGANIZATION: A MULTI—SITE CASE STUDY By Caroline Malenfant Guzman Legislators, policy makers, administrators, service providers and recipients are all concerned with the effectiveness of human service organizations. The inability to consistently identify and manipulate indicators of effectiveness hinders the planning, implementation, and evaluation of human service organizations. Research is needed to expand the knowledge of indicators of effectiveness and their responses in a variety of situations. The concept of service effectiveness has been particularly elusive. This study attempts to increase knowledge in this area by using a crisis situation as an opportunity to examine service effectiveness. The social reconnaissance method of field research was used. Emphasis in this study was on identifying and exploring variables that impact on service effectiveness. The crisis in this instance was a natural disaster that impacted many rural counties in Michigan in the late 1980’s. This study focused on the organizational response of several human service organizations to farm families in three of the impacted counties. The purpose of this study was to identify variables that impact organizational effectiveness, specifically service effectiveness, in human service organizations. The specific indicators that were examined included; accessibility, timeliness, consistency, and service design. Accessibility and service design impacted the service effectiveness in all instances. Timeliness and consistency varied among organizations and counties. TABLE OF CONTENTS LIST OF FIGURES ........................................ x CHAPTER ONE - INTRODUCTION TO THE PROBLEM Introduction ........................................ 1 Statement of the Problem ................................ 9 Purpose of this Study .................................. 10 CHAPTER TWO - ORGANIZATIONAL EFFECTIVENESS ............. 11 Introduction .............................. . ......... 11 Effectiveness in Organizational Theories ...................... 12 Closed Rational System Models ....................... 14 Closed Natural System Models ....................... 14 Open Rational System Models ........................ 15 Open Natural System Models ........................ 16 Multiple Models ................................ 18 Competing-Values Approach to Effectiveness ............... 18 Effectiveness in Human Service Organizations .................. 19 Multiple Constituencies Milieu ........................ 20 Value Dilemmas ................................ 21 Service Effectiveness .............................. 21 Competing Objectives ............................. 24 Search for Criteria of Effectiveness ..................... 25 Human Service Organizations Response to Crisis ................ 26 Potential Indicators of Service Effectiveness Within Crises Situations 27 CHAPTER THREE - RESEARCH METHODS ..................... 29 Introduction ....................................... 29 Purpose of the Study .................................. 30 Research Objectives .............................. 30 Research Questions ............................... 30 The Broader Context of the Study .......................... 31 The 1986 Flood ................................. 31 The Response to the Flood .......................... 32 iv This Study ........................................ 34 Research Methods Used ................................ 37 Introduction ................................... 37 Social Reconnaissance ............................. 38 Data Collection ..................................... 40 Design of the Focused Interview Guide .................. 40 Preliminary Interviews ............................. 45 Selection of Key Informants ......................... 46 Data Collection Procedures .......................... 48 Recording of Data ............................... 50 County Statistical Data ............................ 51 Data Analysis ...................................... 51 Limitations of the Study ................................ 53 CHAPTER FOUR - OBJECTS OF THE STUDY .................... 56 Introduction ....................................... 56 Counties in the Study .................................. 56 Overview ..................................... 56 County A ..................................... 57 Population and income demographics ............... 57 Agricultural dependency ....................... 58 Employment ............................... 58 Impact of the 1986 flood ....................... 58 County B ..................................... 59 Population and income demographics ............... 59 Agricultural dependency . . . . 7 ................... 59 Employment ............................... 60 Impact of the 1986 flood ....................... 60 County C ..................................... 61 Population and income demographics ............... 61 Agricultural dependency ....................... 61 Employment ............................... 61 Impact of the 1986 flood ....................... 62 Organizations in the Study .............................. 62 Overview ..................................... 62 Department of Social Services ........................ 63 Mission and Programs ......................... 63 History .................................. 64 Funding ................................. 64 Organization ............................... 64 County A ................................ 65 County B ................................. 65 V County C ................................. 65 Michigan Employment Security Commission ............... 65 Mission and Programs ......................... 65 History .................................. 66 Funding ................................. 66 Organization ............................... 67 County A ................................ 67 County B ................................. 67 County C ................................. 68 Community Mental Health .......................... 68 Mission and Programs ......................... 68 History .................................. 68 Funding ................................. 70 Organization ............................... 70 County A ................................ 71 County B ................................. 71 County C ................................. 71 Cooperative Extension Service ........................ 72 Mission and Programs ......................... 72 History .................................. 72 Funding ................................. 75 Organization ............................... 76 County A ................................ 76 County B ................................. 77 County C ................................. 77 CHAPTER FIVE - RESULTS ................................ 78 Overview ......................................... 78 The Immediate Response ............................... 79 Selected Agency State Level Response ................... 79 D88 .................................... 79 MESC .................................. 79 CMH ................................... 79 CES .................................... 80 County Response ................................ 80 County A ................................ 81 County B ................................. 81 County C ................................. 82 Accessibility ....................................... 83 D88 ........................................ 83 County A ................................ 83 vi County B ................................. 84 County C ................................. 85 D88 Accessibility Summary ......................... 86 MESC ....................................... 86 County A ................................ 86 County B ................................. 87 County C ................................. 87 MESC Accessibility Summary ........................ 88 CMH ....................................... 89 County A ................................ 89 County B ................................. 89 County C ................................. 90 CMH Accessibility Summary ........................ 91 CES ........................................ 92 County A ................................ 92 County B ................................. 92 County C ................................. 93 CES Accessibility Summary ......................... 94 Accessibility Summary ............................ 94 Timeliness ........................................ 95 Introductiion ................................... 95 D88 ........................................ 95 County A ................................ 95 County B ................................. 95 County C ................................. 95 D88 Timeliness ................................. 96 MESC ....................................... 96 County A ................................ 96 County B ................................. 96 County C ................................. 96 MESC Timeliness Summary ......................... 97 CMH ....................................... 97 County A ................................ 97 County B ................................. 97 County C ................................. 97 CMH Timeliness Summary .......................... 97 CES ........................................ 98 County A ................................ 98 County B ................................. 98 County C ................................. 98 CES Timeliness Summary .......................... 98 vii Overall Timeliness Summary ......................... 98 Consistency ....................................... 99 Introduction ................................... 99 D88 ........................................ 99 County A ................................ 99 County B ................................. 99 County C ................................. 99 D88 Consistency Summary ......................... 100 MESC ...................................... 100 County A ............................... 100 County B ................................ 101 County C ................................ 102 MESC Consistency Summary ....................... 103 CMH ...................................... 103 County A ............................... 103 County B ................................ 103 County C ................................ 104 CMH Consistency Summary ........................ 104 CES ....................................... 104 County A ............................... 104 County B ................................ 105 County C ................................ 105 CES Consistency Summary ......................... 105 Consistency Summary ............................ 105 Service Design ..................................... 105 Introduction .................................. 105 DSS ....................................... 106 County A ............................... 106 County B ................................ 106 County C ................................ 107 DSS Service Design Summary ....................... 107 MESC ...................................... 108 County A ............................... 108 County B ................................ 108 County C ................................ 108 MESC Service Design Summary ..................... 109 CMH ...................................... 109 County A ............................... 109 County B ................................ 111 County C ................................ 112 CMH Service Design Summary ...................... 113 viii County A ............................... 114 County B ................................ 114 County C ................................ 115 CES Service Design Summary ....................... 115 Service Design Summary .......................... 116 Cumulative Summary ............................ 116 DSS ................................... 1 17 MESC ................................. 117 CMH .................................. 117 CES ................................... 117 CHAPTER SIX - SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS 119 Summary ........................................ 1 19 The Problem .................................. 119 This Study ................................... 119 Conclusions ...................................... 121 Overall Results ................................ 121 Differential Access .............................. 122 Timeliness ................................... 125 Consistency .................................. 125 Service Design Factors ........................... 125 Pre-existing Linkages ............................ 127 Staff Initiative and Leadership ....................... 127 Implications ...................................... 128 Limitations ....................................... 130 Recommendations ................................... 132 APPENDD( A - State Designated Flood Impacted Areas ............... 133 APPENDDI B - Focused Interview Guide ........................ 134 LIST OF REFERENCES .................................. 136 ix LIST OF FIGURES Figure 1: Path of Indicators of Service Effectiveness ........... 121 Figure 2: Extent of Local Control ....................... 123 CHAPTER ONE Introduction Throughout history people have struggled to meet their daily needs, to survive, and to prosper. Some individuals have been very successful in doing this and others have not fared as well. Society as a whole has found that it is in it’s own best interest if all peoples basic needs for food, shelter, and clothing are addressed. The means of addressing these basic needs have varied. Originally, the extended family was able to fulfill this role for all its members. The family provided shelter, food and other necessities. When they were not able to meet these needs the economic and political systems often responded in some way. For example, many landowners have extended shelter in exchange for access to labor. Still, there were always people that fell outside these informal systems for a number of reasons (e.g. unable to work due to age or physical condition). Until the early 1900’s communities dealt with these persons within their own community boundaries. They did this in a variety of ways. Some communities provided for these members in an informal manner through family or individual support. Other communities designated a town supervisor to find a solution such as indenturing a child or finding a spouse for a widow with children. Still 2 other communities addressed this issue through appointed or elected committees, church groups, or oversight boards that voted on which of these actions to be taken with individual recipients. (T rattner, 1974) Almost all of these independent solutions were focused on the ”worthy" poor - that is, persons that were not considered at fault for their circumstances. Persons that were considered "lazy” or responsible for their situation were often ordered out of town or placed in work programs.(Pumphrey and Pumphrey, 1961) With the increase in urbanization around the turn of the century, these traditional responses no longer were sufficient. The rapid growth of cities, the crowded living conditions, and the poor working conditions could no longer be dealt with on an individual and informal basis. Sheer numbers in need forced a more formalized approach. The rapid growth of institutional care in the form of almshouses, public hospitals, jails and insane asylums was seen as a humanitarian response to this need. Despite the high motives of their founders, these institutions tended to become overcrowded, neglected, and they often deteriorated rather quickly.(Mencher, 1967) The roots of modern human service organizations can be found in the private charity organizations that emerged in the late 1800’s. These organizations were formed in part as a result of the debate over the roots of economic misfortune. The charity organizations frequently were more concerned with the spiritual well-being of their recipients and the concept of 3 human weakness than with service provision. Yet they did fill a gap in society’s functioning. Efforts were made to feed and clothe large numbers of people at one time. Services were provided to people in their homes and neighborhoods. Alcoholism, child abuse, and mental illness were acknowledged. These ’friendly visitors’ defined a base—line for society to use in providing for the basic needs of its citizens.(Axinn and Levin, 1974) As society increased in complexity the definition of ”basic needs“ expanded. Advances in health care and public education resulted in increased expectations. Local counties and States began to respond to these needs with programming and financial support. For example, in 1911, Illinois enacted the first Mother’s Aid Law. This program provided financial support for mothers with small children at the State’s expense.(Coll,l969) It served as a model program for other individual states as they dealt with growing numbers of mothers and children with no means of support. The Great Depression changed the delivery patterns of services dramatically as the Federal Government became involved for the first time. Since the unemployment and resulting lack of ability of citizens to provide for their own basic needs was so severe, a national response was needed. The States could no longer meet the overwhelming needs. Federal programs were instituted that superceeded state programs and baselines for eligibility and service were set on a national level. Employment and income support were added to the list of ”basic rights" and remain to this day.(Mencher,1967) 4 Today Human Service Organizations exist as an institutional response of society to address the human needs of its citizens. Some organizations address income needs such as the Social Security Administration. Others address health needs such as substance abuse programs. Still other organizations address personal growth and development needs, such as the YWCA or Boy Scouts. Regardless of their specialized program goals, all organizations endeavor to "maximize individual potential and productivity as well as to ensure adequate provision of the basic necessities of life“ (Community Services Planning Council,1980,p.3). Human needs are addressed through a continuum of organizational models, flowing from natural helping networks of friends and families to complex and specialized organizations. These organizations can be private or public. This continuum of organizations, and the resulting network of agencies through which the services flow, is called the social service delivery system. Social services are provided to people within this system by a mix of public and private sector organizations. In general, the public sector provides the services that are mandated by law and frequently serve non-voluntary clients (e.g. the Department of Corrections). The public sector also reflects an emphasis on provision of income maintenance (Department of Social Services), education (Department of Education), health (Department of Public Health), and employment (Employment Security Commissions). 5 The private sector generally addresses improvement of social functioning (Child Guidance Clinics, counseling centers etc.) and works with voluntary clients. The private sector can be organized in a non-profit manner or can also be organized for profit. In some instances the public sector contracts with the private sector for the delivery of certain social services when it is believed that the private sector can deliver the services more effectively or efficiently (e. g. Foster Care services, Job Training Programs etc.). Human service organizations in the public sector operationalize and implement decisions regarding basic human services that have been made at the larger societal level. These include policy decisions (goals and objectives, population definitions etc.) as well as resource allocation decisions. Elected officials, program administrators, and service personnel med information that will allow them to offer services in response to people’s needs in a manner that reflects society’s concern, yet are also accountable to a known standard of performance. The concept of effectiveness, meaning the ability to cause or produce a positive result, is an overarching concern of all human service organizations. The more specific concept of organizational effectiveness seems simple at first glance. In its broadest sense, the question asked is whether the organization is doing what it said it would do. The organization’s behavior is measured against a set of pre-determined standards. Upon closer examination, the issue quickly becomes more complicated. Questions such as the following 6 come to mind: Is the effectiveness of the organization reflected in its annual unit cost for service; is the effectiveness related to the efficiency of the internal organization; is the effectiveness of the organization related to the satisfaction of the consumers of the service; who decides on the criteria and process to determine if the organization is effective; and are there any differences between human service organizations and other types organizations and how they operate? Social scientists have studied organizational effectiveness from many viewpoints (an overview of the theoretical development of organizational development will be presented in the second chapter). Consensus has been reached that overall effectiveness in organizations can be a product of several factors. These include external factors such as the design of policy or legislation, resource availability, complementary or competing services, and interorganizational linkages. Internal factors that may affect effectiveness include program design, staff management, turnover rates etc. These factors are present in all organizations, including human service organizations. Recent research has focused on service effectiveness as the touchstone for any study of organizational effectiveness in human service organizations (Patti,1985,l987; Rapp and Poertner,l987) since it reflects the main purpose of human service organizations - to provide service. Service effectiveness was selected as the primary concern of these authors and of this study. Service effectiveness is the component of organizational effectiveness that focuses on 7 the process of service provision as well as the benefits clients receive from a human service organization. The issue of the service effectiveness of human service organizations has been an ongoing major concern of policy makers, human service workers and human service recipients. This concept of service effectiveness is an elusive concept that is at the core of any service provision yet is subject to a shifting milieu of multiple constituencies, competing objectives, and resource and environmental constraints. The struggle to search for means to enhance service effectiveness is a primary concern. Yet little agreement exists on criteria of service effectiveness and specific organizational outcomes in human service organizations. As an example of this dilemma, a Family Services Agency might provide marital counseling. If after a number of counseling sessions a couple agrees to divorce the question could be asked how this could be evaluated. This could be an example of service "effectiveness, " since the woman was able to remove herself from an abusive situation. Or, this was not an effective service because the marital relationship was dissolved. Many problems are associated with specifying service effectiveness in the organizational context. A commitment to providing effective service is meaningless unless these problems are addressed and several decisions made. These include: determining the costs associated with service effectiveness and 8 the method selected to determine these costs; inclusion of worker satisfaction and efficiency; and the process for the selection of the decision criteria. Research is thus needed that will help persons concerned with service effectiveness in human service organizations identify variables that need to be considered in their decision making. As can be seen in the review of the literature at this time it is not possible to present one comprehensive approach or “right” way to consider organizational effectiveness. However, the exploration of variables that impact service effectiveness will add to the knowledge base and strengthen informed decision making. Previous studies have examined overall organizational effectiveness from both an external and internal perspective. General indicators of service effectiveness have been suggested but much more information about their performance is needed (Patti,1985,l987; Pruger,l991). One way to examine indicators of service effectiveness is to study an organization under stress. A crisis provides an opportunity to identify variables that affect effectiveness since the disruption of normal functioning highlights organizational dimensions both,internal and external (Keys and Ginsberg, 1988). Research on organizational response to a crisis provides us with an insight into organizational effectiveness as variables are sorted out and examined. Differences can be addressed within a limited time frame and knowledge gained that can strengthen the knowledge base of organizational effectiveness and service effectiveness in particular. This study examined the response of 9 selected human service organizations in this crisis to new clientele from the agricultural sector. Statement of the Problem Effectiveness is a major concept in the study of organizations including human service organizations. Researchers have attempted to understand organizational effectiveness for many years. In the market economy, effectiveness can generally be evaluated in terms of profit. In human service organizations however, it is a more elusive concept since it has multiple domains and always contains a normative component. The inability to consistently identify and manipulate indicators of effectiveness hinders the planning, implementation, and evaluation of human service organizations. Legislators, policy makers, administrators, service providers, and recipients are all concerned with the effectiveness of human service organizations. Research is thus needed to expand and refine our knowledge of indicators of human service organizational effectiveness. This study attempts to increase knowledge in this area by using a crisis situation as an opportunity to examine service effectiveness. Emphasis in this study was on identifying and exploring variables that impact on service effectiveness. The crisis in this instance was a natural disaster that impacted many rural counties in Michigan in the late 1980’s. This 10 study focused on the organizational response of several human service organizations to farm families in three of the impacted counties. Purpose ofthis Study The purpose of this study was to identify variables that impact organizational effectiveness, specifically service effectiveness, in human service organizations. The specific indicators that were examined included; accessibility, timeliness, consistency, and service design. The study attempted to ascertain differences in the structural and programmatic responses of the human service organizations to the 1986 flood crisis in three rural Michigan counties. It was assumed that this would provide potential indicators of service effectiveness that would be of use to policy makers, practitioners in humans services, and to social scientists. CHAPTER TWO ORGANIZATIONAL EFFECTIVENESS Introduction The effectiveness of all organizations, including human service organizations, has been shown to be of critical interest to a wide group of people, including social scientists, policy makers, administrators, service workers, and service recipients. The research on organizational effectiveness will be explored in this chapter. The focus of this study was on the identification of indicators of effectiveness from the perspective of performance outcomes and service quality and most of the literature reviewed will thus focus on this. Other aspects of organizational effectiveness such as design of policy or personnel administration were not studied, and will thus not be reviewed in depth. Organizational effectiveness is a construct that is common to all organizational theories, though it is often dealt with implicitly. In a market economy effectiveness can generally be evaluated in terms of the bottom line which is profit (e. g.quarter1y returns to stockholders). In human service organizations, it is more difficult to identify and select performance criteria that establish the meaning of effectiveness. 11 12 A summary of the literature on effectiveness in organizations in general will be presented first, followed by a review of effectiveness in human service organizations. Previous attempts in the literature to define effectiveness and establish criteria will be included, as well as the difficulties in doing so. Then an examination of how a crisis situation provides an opportunity to identify variables affecting organizational effectiveness will be presented, since this study examines organizational effectiveness in a crisis context (by examining the response to a natural disaster of four human service organizations in three rural counties in Michigan). Effectiveness in Organizational Theories The position exists that organizational theory cannot address both market-based and non-market organizational concerns (Heydebrand, 1977). Recent social scientists have argued, however, that in general organizational theory cuts across all types of organizations but that special attention needs to be paid to peculiarities of each type of organization (Scott,l987; Rainey,l991). Effectiveness is one of these areas. In a market based economy that is functioning properly, the market serves to balance the interests of the internal organizational participants and the external consumers. The organization prospers when both interests are 12 A summary of the literature on effectiveness in organizations in general will be presented first, followed by a review of effectiveness in human service organizations. Previous attempts in the literature to define effectiveness and establish criteria will be included, as well as the difficulties in doing so. Then an examination of how a crisis situation provides an opportunity to identify variables affecting organizational effectiveness will be presented, since this study examines organizational effectiveness in a crisis context (by examining the response to a natural disaster of four human service organizations in three rural counties in Michigan). Effectiveness in Organizational Theories The position exists that organizational theory cannot address both market-based and non-market organizational concerns (Heydebrand, 1977). Recent social scientists have argued, however, that in general organizational theory cuts across all types of organizations but that special attention needs to be paid to peculiarities of each type of organization (Scott,l987; Rainey,l991). Effectiveness is one of these areas. In a market based economy that is functioning properly, the market serves to balance the interests of the internal organizational participants and the external consumers. The organization prospers when both interests are 13 satisfied. There is a consistent relationship between inputs and outputs that provides feedback to the organization and is available for decision making. In a non-market environment there is no direct relationship between the services an organization provides and the income it receives for providing them (Downs, 1967). Output measures are frequently missing or unclear. Goals may be vague or even conflict. The two primary dilemmas facing organizations that function outside the market are selection of indicators of effectiveness and the selection of criteria or standards to measure effectiveness (Scott, 1987). An analysis of the literature on effectiveness, as perceived by different organizational scientists, presents a mixture of insights and contradictions. A great variety of perspectives on effectiveness exist. Though each perspective illuminates an aspect of the concept of effectiveness, experts cannot agree on one conclusive model or framework (Goodman,Pennings, and Associates, 1977 ; Cameron and Whetten,1983; Scott,l987; Rainey,l991). However, each perspective focuses on a significant feature of organizations and has implications for organizational effectiveness. The following section of this chapter contains a presentation of the main theoretical perspectives with the focus on the concept of effectiveness within each area. In general, the literature contains a number of models that have developed over time. These models developed more or less chronologically. They will be briefly described below. 14 W The Closed Rational System Models portray organizations as tools designed to achieve preset ends. All of the theories included in this model ignore or minimize the difficulties posed by connections to a wider environment. For example, they ignore or minimize the impact of outside economic forces. Theories included are: Bureaucratic Theory by Weber (1904— 5); Scientific Management by Taylor (1911); Administrative Theory by Fayol (1919); and Decision Making by Simon (1945). With a focus on goals, effectiveness translates into measures of outputs and the economies realized in transforming inputs into outputs (Scott,l982,1987). This is operationalized by using the specific goals of the organization as the basis for generating criteria of effectiveness. Criteria of effectiveness are determined by the same person who determines the organizational goals and measured against the standard they determine. W In response to the constraints of the closed rational system model, social scientists began a transition to Closed Natural System Models in the late 1930’s. Much of the work done by the human relations social scientists in the 1940’s and 1950’s falls under these models. Social scientists in this category are: Roethlisberger and Dickson (1939); Mayo (1945); Roy (1952); Whyte (1959) and Dalton (1959). Barnard (1945) also contributed to this model with 15 his work on Cooperative Systems. This work expanded the view of the organizational structure to allow for more complexity and flexibility. Yet most of the work done within this tradition focused on the internal workings of the organization. As a result, effectiveness within this tradition acknowledges the importance of organizational goals but adds the dimension of ”support" goals or internal goals. In addition, these internal goals take precedence if there is a conflict. For example, worker satisfaction with working conditions could take precedence over increased productivity. The emphasis on organizational survival also drives goal selection. Criteria generated by this model emphasize measures of participant satisfaction, morale, and interpersonal skills (Cameron and Whetten,1983; Scott,l987 ). WM Beginning in the late 1950’s another transition occurred. The organization as a rational system again came into focus but this time with a slight difference. The view of the organization shifted from a closed system to an open system so that most of the theories now could be classified as Open Rational System Models. These included work on Bounded Rationality (March and Simon,l958; Udy,l959; and Pugh,et al,1969) and work on Comparative Structural Analysis (Blau,1970). Lawrence and Lorsch( 1967) and 16 Thompson(l967) contributed work on Contingency Theory. Williamson(1975) and Ouchi(l980) pursued work on Transaction Costs Theory. The work of each of these social scientists emphasizes the interdependence of the organization with its environment. In most instances the emphasis is on the types of changes that can be done in a rational way to assist the organization to respond to its environment. Many empirical studies were done to understand and explain characteristics of the environment in which the organization is located. For instance, the study of external power structures became important. Problem solving and decision-making became more important. This reflected the sense that organizations must take environmental complexities and variety into account. Information processing and changes in organizational form in response to environmental demands and constraints shape definitions of effectiveness under these models. For example, organizations began to participate in community or regional planning processes. ' Specific criteria to measure effectiveness flow from the assumption that organizations are rational and the choices made by organizations are rational. This was evident in the approach taken to the planning process. W In the early 1970’s another shift took place in the overall style of organizational models. The concept of open rational models has been 17 challenged by an Open Natural System Models. These included; Organizing (Weick,1969), Negotiated Order (Strauss et al.,1963), Ambiguity and Choice (Olsen,1976), Strategic Contingency Model (Hickeson et al.,1971; and Pfeffer, 197 8), Population Ecology (Hannan and Freeman, 1977), Resource Dependence (Pfeffer and Salanacik, 1978), and Institutionalist Theory (DiMaggio and Powell,l983). These models are clearly open systems models and emphasize the importance of the environment in shaping the structure and behavior of organizations. The primary difference from the open rational system model is the challenge to the assumption that organizations function rationally (Scott, 1987). Each of these models emphasize adaptation to some degree. Exchanges between the organization and environment are seen as conditions of survival. They also look at the balance of resources and the extent of organizational dependency. Yet, they recognize an element of unanticipated consequences. As would be expected, as the models increase in complexity the indicators of effectiveness also become more complex to reflect social and cultural processes. Criteria to measure effectiveness become dependent on the sub—areas selected for emphasis. They can include measures with an internal or external focus, such as a study of personnel satisfaction or a study of censumer satisfaction. 18 We]: Other writers such as Etzioni (1968,1975), Thompson (1967), or Lawrence and Lorsch (1967) have tried to combine the previous grouping or paradigms into more complex models of organizations. However, since the assumptions underlying these theories differ, it is difficult to combine them into one mega-model that satisfies all the involved social scientists. C I' -]I I 5 I I BE I' Quinn and Rohrbaugh (1983) have developed a “competing-values" approach to organizations that focuses on effectiveness. Their model attempts to incorporate the competing values of the previous theories. These include; an internal and external focus, flexibility and control with human resource development, productivity, stability and growth. The research done on this approach has indicated that if these values are mapped out in quadrant fashion, it is possible to begin to anticipate organizational effectiveness. For example, if an organization is effective in terms of control it is likely that the same organization will be less effective in terms of flexibility. Though this model also raises many questions of how to identify indicators of effectiveness and measurable criteria, it does make the point that effectiveness cannot be approached in a unitary manner. This model also identifies the problems of multiple and conflicting goals, environments, and 19 constituencies. Any organizational analysis must acknowledge these contradictiom and address the efforts made to do so. Effectiveness in Human Service Organizations It is apparent from a review of organizational theory that the indicators of organizational effectiveness and the criteria used to evaluate effectiveness are not produced by an objective, apolitical process. These criteria are normative and often conflicting. Measures based on outcomes are likely to be different from measures based on processes or organizational structure. Various constituencies will favor different criteria at different points in time. This is most obvious in an examination of effectiveness in human service organizations. As mentioned previously, human service organizations operate outside the market economy. There is no direct link between the service provided by the organization and the income it receives for these services. It is possible for an organization to excel in its management criteria yet have little observable impact on the clients it serves. This is not to say that other organizations are not concerned with a broad array of issues. However, Alfred P. Sloan’s dictum that the goal of General Motors is not to make cars, but to make money is still the creed of most American enterprises (Gummer, 1984). 20 MW] C |°| . MT Human service organizations exemplify the problems with effectiveness that exist with multiple constituencies. The multiple constituencies nature of human service organizations means that performance must be defined broadly enough to include all the competing interests, activities, and goals of individuals and groups, both inside and outside the organization’s boundary (Martin, 1980; Meyer and Rowan, 1977). These individuals and groups have expectations of the organization, may have a stake in its fate, and/or control over valued resources (Scott, 1987; Connolly, Conlon, & Deutsch, 1980). A balance needs to be found between these external and internal constituents if the organization is going to continue to function. Since human service organizations depend on multiple constituencies for internal and external resources, the competing demands must be taken into account. At times it is difficult to decide which constituent’s reeds takes precedence. For example, an organization may provide income maintenance. Decision makers need to prioritize the needs of the recipient and the needs of the tax payer. ”Costs" of selecting one constituent group over another need to be considered. Human service organizations are constantly dealing with these decisions while the milieu is shifting around them. 21 Yalnemlemmas Value dilemmas are widespread in human service organizations and are contextual, not absolute (Brewer, 1984). The stated goals of the agencies often include changing complex societal conditions. The goals of the agency can also be conflicting. For example, a delinquency prevention program might have a goal to divert youth from the criminal justice system. At the same time the program might also have a goal to work with the police when they come in contact with a juvenile. In other instances, the manner in which the agency functions seems more important than the actual results it achieves. In practice, there may be conflict in working with individuals who desire no police contact. This is a common complaint against many of the larger bureaucracies such as a State Department of Social Services. Human service organizations face these value issues constantly. Even the term effectiveness is value-laden and normative. In its simplest sense, effectiveness is used to refer to the extent to which an activity attains its ends. In human service organizations this meaning is complicated by disagreements over what the ’it’ is that’s to be accomplished. These value dilemmas form the underpinnings of all definitions of effectiveness in human service organizations. S . Em |° Service effectiveness is one element of organizational effectiveness that has assumed primary importance for human service organizations. The main 22 reason for this is that the primary business of the human service organization is changing people and/or the social conditions in which they live. The acquisition of resources, the efficient utilization of resources and the satisfaction and development of staff are all important to provide effective services, but they are, or should be, subservient to the objective of providing service (Patti, 1985). With this emphasis on service effectiveness becoming accepted by most human service organizations, Hudson (1986), has stated that the research work ahead will consist of developing and testing the knowledge needed to transform this ”mission" into practice reality. Elements of service effectiveness must be identified and ways learned to measure these. Rapp and Poertner (1987) have identified two major elements of service effectiveness. The first element focuses on the process of service provision. This process includes the degree to which the practice and behavior of personnel, the organizational structures, and operating processes reflect concern with the clients and their well being. This can be observed in the attitude of the receptionist, design of intake procedures and numerous other activities that demonstrate individuality and respect. The second element that Rapp and Poertner (1987) discuss focuses on client outcomes. This refers to the benefits that clients receive as a result of the service they received from the human service organization. These can be observed in such changes as behaviors, skill levels, and attitudes. 23 Both Patti (1985, 1987) and Brewer (1984) have taken this concept of service effectiveness one step further. They state that effectiveness may be assessed in terms of process, impact, or response. They also add the awareness that although these outcomes may be related they are not necessarily related. Process, in this framework, concentrates on the internal workings of the organization. Administrative decisions, personnel management issues, and ongoing operational procedures would all fall in this category. An example of process effectiveness would be reflected in the ability of the client to participate in determining their service goals. Another example would be staff satisfaction with in-service training. Impact, in this framework, addresses changes in the client system or changes in the environment as a result of the organizations actions. Improved skill levels, changes in attitudes or behaviors, and changes in environmental conditions would all be in this category. An example of impact effectiveness would be an increase in a clients’ ability to communicate. Another example would be an increase in the housing stock in an area. Response, in this framework, addresses the organization’s attempts to respond to its surrounding environment. Changes in program design and implementation resulting from environmental changes such as budget availability, new clientele, or a heightened awareness of a social problem would fall into this category. An example of service response effectiveness would be 2A the organization’s ability to develop a new service. Another example would be the development and distribution of resource guides listing services. These concepts must be operationalized in order to examine service response effectiveness. Patti (1987), and Rapp and Poertner (1987) suggest general areas but do not address specific indicators nor did any other literature. Since this study focuses on the response of human service organizations, the elements of service response effectiveness that were selected for examination are: accessibility, timeliness, consistency and service design. [2 I' Q] . I' Even though human service organizations embrace service effectiveness, the institutional forces of a complex socio-political environment cannot be ignored. The manager or administrator of a human service organization must also be concerted with efficiency, productivity, resource acquisition, and staff morale (Rapp & Poertner, 1985). There is some agreement among organizational researchers that it is not possible to simultaneously Optimize performance in all areas (Quinn & Rohrbaugh,l981; Steers,1975) This suggest that service effectiveness should be seen in the total context of performance goals for the organization, yet implementing this is not easy. The perceptual questions of “effective for whom? at what cost? over what domain?” are always present. Kahn (1977) and Brewer (1984) suggest a more limited and pragmatic approach. They encourage striving for an 25 understanding of organizational effectiveness only in terms of selected goals, criteria or circumstances. S If C'I' [Eml' The search for service effectiveness in human service organizations is complicated by the fact that the field consists of a very heterogeneous cluster of organizations which vary dramatically by purpose, auspice, technology, and clientele. Service effectiveness looks very different in different types of organizations(Whetten, 1978) . This can increase our understanding of the different approaches to organizational effectiveness resulting in so many and such varied criteria. A lack of consensus exists on what constitutes a useful and valid set of criteria in what circumstances. One of the most critical decisions in assessing organizational effectiveness is the choice of measures or indicators. This decision is somewhat arbitrary and has received relatively little attention in the literature. Goodman, and Pennings(l977) advocate moving fi'om general theories to models that relate specific dependent variables to specific settings. Criteria must be selected and observed to gain understanding of their nature before progressing further. 26 Human Service Organizations Response to Crisis In the broadest sense, a crisis for an organization occurs at a point in time when action must be taken. This turning point or decision point can be the result of internal or external pressures. An example of an internal pressure could be changes in personnel or leadership. Examples of external pressure couldbeadecreaseinresourcesoranaturaldisaster. Any crisis disrupts the normal functioning of the organization. Some change is inevitable at this point. The decision to respond or not to respond always results in change as the organization moves in a new direction or struggles to maintain the status quo. Some researchers believe that change can only occur within an organization if the organization is experiencing enough discomfort or strain to provide the incentive to pay the costs that change entails (Brager, 197 8). Since a crisis is a propelling force for change, it provides an opportunity to study patterns of response when the system is severely shaken (Charles and Choon, 1988). A natural disaster is a special type of crisis since it is the consequence of a sudden force outside the control and influence of the political, economic, and social system (Thompson and Hawkes, 1962). In some respects a natural disaster “tears open the organization" and provides an opportunity to observe its responses to the crisis. 27 Regardless of the type of crisis or disaster, there are common elements that appear as the organization begins to respond. These are well documented in the literature and include: an emphasis on primary values; a shortened time perspective; family-directed behavior; a predominance of direct action; and a neglect of institutional patterns (Thompson and Hawkes, 1962; Wallace, 1957; Carleton, 1987). The ability of the organization to respond under these conditions can help researchers understand the organization’s overall effectiveness. The organization can adapt and alter its behavior in a variety of ways. These adaptations can be reflected in structural dimensions such as a change in hours of service or location of service provision. They may also be observed in a change in the internal functioning such as a change in the decision making pattern. These adaptations also can be observed in external linkages as the agency loosens or tightens its boundaries. 0: 9,, 99-2: 9r 9f rut; .lau9"9.. r 9--.: °' 9. z 999 As stated earlier, human service organizations are focusing on service effectiveness as the primary area for indicators of organizational effectiveness. When a human service organization is involved in a crisis situation, the response component of service effectiveness assumes precedence. This provides the opportunity to identify and explore potential indicators of service effectiveness. 28 Service effectiveness as response focuses on the organizations attempts to respond to its surrounding environment. The human service organizations ability to respond to the crisis falls in this category. Potential indicators of service effectiveness response in crises that will be examined in this study are: accessibility of the service for potential recipients; timeliness of the service; consistency within the organization and among counties providing the same service; and the overall design of the response. When these indicators are examined and compared with the anticipated response patterns mentioned earlier in this section a better understanding of organizational effectiveness should emerge. Chapter Three will present the methodology used in this study. CHAPTER THREE RESEARCH METHODS Introduction Effectiveness is a core concept in organizational theory that is especially relevant for human service organizations. As shown in the previous chapter, effectiveness is difficult to define and identify. A crisis situation can provide us with an opportunity to begin to identify variables that address organizational effectiveness in human service organizations. Since criteria and indicators of organizational effectiveness in human service organizations are still in the developmental stage this study must necessarily be exploratory in nature. The use of multiple sites that suffered from the same natural disaster will allow comparison of response among sites. The use of multiple organizations will allow comparison within and among sites. Qualitative methods rooted in the social reconnaissance tradition provided the structure of the research methodology. This chapter provides information on the purpose of this study as well as the broader conth of the 1986 flood. The research methodology is presented. The process of data collection as well as the process of data analysis is also 29 30 discussed. Limitations of this study are addressed in the concluding section of the chapter. Purpose of the Study B I Q] . |° The purpose of this study was to explore the response of the human service delivery systems in three rural Michigan counties to the 1986 flood crisis. The study attempted to identify variables in the structural and programmatic responses of the human service organizations that impacted service effectiveness to farm families. Indicators selected for review included; accessibility, timeliness, consistency, and service design. W Several specific questions guided the research: 8 1. What was the initial response of the community to the flood crisis? 2. How were several selected social service agencies organized in three different rural communities, and what services did they provide? 3 . How did selected social service agencies in three different rural communities respond to a common crisis (a flood) in terms of: a. organizing and delivering services? b. serving different clientele? 31 4. What was the response of the selected agencies to the crisis in terms of: a. accessibility? b. timeliness? c. consistency? d. service design? 5. What implications do the results of the study have on how human service agencies can enhance organizational effectiveness? The Broader Context of the Study W The central portion of the Lower Peninsula of Michigan experienced one of its largest and most widespread stems ever in September, 1986, resulting in severe flooding throughout the region. Some locations received up to 11 inches of rain in a 24-hour period during September 10-11, which exceeded 100-year old records. The Soil Conservation Service also reported that many of the major rivers in the mid-Michigan area surpassed their estimated 500-year flow rates resulting in massive flooding and damage. It was estimated that a storm of this magnitude can be expected only once every 250-plus years (MAES,1988). This flooding caused major problems for agriculture in the State. Crops were damaged. Soil was eroded. Drains, buildings, roads, and dams were lost 32 or damaged. President Reagan designated 30 mid-Michigan counties as a federal disaster area in September,1986. 19 more counties were added to this list in October and November by the U.S. Secretary of Agriculture (See Map, Appendix A). This study focused on the initial 30 designated counties. W In early 1987 the Michigan legislature provided special funds to the Agriculture Experiment Station(MAES) at Michigan State University to do a study of the impact of the September 1986 flood and the ongoing farm financial crisis on Michigan agriculture. A team of researchers from the College of Agriculture and Natural Resources, the College of Human Ecology and the Rural Sociology program in the College of Social Science developed seven individual research projects and gathered information on various components of this problem. The individual reports on the different research studies were compiled into a final report that was given to the Michigan Legislature in January, 1988. These research projects studied the following: flooding damage to farmland and drainage systems; impact of flooding on farm income and financial status; the adjustments of agribusiness; impact of declining farmland values on local revenues; farm family stress; the role of community development institutions; and socioeconomic impacts on rural communities. They explored the impact of the flood and agricultural crisis on local 33 institutions and the community. The responsibility for the research project focusing on the socioeconomic impacts on rural communities was assumed by the rural sociology faculty in the department of Sociology at Michigan State University. The study on the community response of human service organizations and social service delivery systems was a sub-unit of the rural sociology project and was conducted by this author. This was the study that provided the basis for this dissertation. A committee, composed of members of the Rural Sociology faculty, College of Human Ecology faculty, and several graduate students, began meeting in the winter of 1987 to shape the focus of the overall study. Meetings continued through the spring of 1987, with several decisions being made. Counties to be studied were identified and communities within these counties selected for more intense study. The decision was made to focus this study on communities and farm families that were hit especially hard by the farm crisis. Data for the projects were collected from throughout Michigan and the 30 initially designated disaster counties. However, three counties were also selected for more intensive study. For the purposes of this study, they will be referred to as Counties A, B, and C. This is being done to preserve the anonymity of the respondents. These three counties were selected because they experienced significant agricultural losses in the floods, had varying degrees of dependency on agriculture, and were geographically dispersed throughout the 34 state. Intensive interviewing and data collection efforts were undertaken within these three counties. The faculty from the College of Human Ecology focused on farm families identified from the list of farmers that were maintained by Michigan State Universities’ Cooperative Extension Service. A combination of a mail questionnaire complemented with intensive farm family interviews was conducted within each of the three counties. The faculty from Sociology chose to divide their study into two components. One group focused on an analysis of all Michigan counties’ dependency on agriculture. The other group designed a socioeconomic analysis of three specific communities within the selected counties. This latter group continued to meet to refine the methodology, develop interview questions, and divide up tasks among individual group members. This study was designed as a sub—unit of the community study. The faculty members involved handled the internal University research processes and clearance for use of human subjects. This Study The examination of the human service organizations and the social service delivery system was undertaken as a sub-unit of the sociology project that focused on community response to the flood in the three selected counties. 35 There is one notable difference between this study and the sociology project. The rural sociology project focused primarily on three individual local communities within the selected counties, whereas this study used county boundaries. Human service organizations generally use county boundaries to geographically limit the target populations. For this reason, the county was defined as the community rather than the smaller village/city units. This study explored the overall response to the flooding in each of these counties. First, information was obtained about the immediate response of each county to the flood. This included the structure and location of the disaster center, if applicable, as well as all participant agencies. Data also were gathered about the organization and processing of clients at the disaster site, within each county from as many human service organizations as could be identified. Additional information was obtained from each of the human service organizations in the three counties regarding the individual response of their agencies to the crisis. This included information on the services they provided to farm families on an ongoing basis, as well as a description of the services and programs that were designed in response to the flood crisis. In each county, as many major social. services agencies that could be identified were included in the interviews. These included the county level offices of the Red Cross, the Cooperative Extension Service, the Social Service Office, the Health Department, the Michigan Employment Security 36 Commission, the Community Mental Health Office, the Community Action Agency, private church social service organizations, the hospital social worker, and the coordinator of public service transportation. The Department of Social Services(DSS), Community Mental Health(CMH), Michigan Employment Security Commission(MESC), and the Cooperative Extension Service(CES) were selected for more detailed investigation within each of the three designated counties. This decision was made since these four agencies all had policy decisions at the state level that mandated some response to the farm flood crisis and they operated on a county wide basis. That is, they had comparable service areas. Such an approach provided a more solid base for comparison than some of the more localized social services(e.g. Catholic Social Services). The choice was made not to focus on health issues, or on education services by the schools, or social services by the churches, due to questions of manageability and geographical boundaries (e.g. church boundaries overlapping county lines or serving less than the county area). The sociology faculty examined communities in each county by interviewing key informants within the schools, businesses, churches etc. in order to gather information on the effects of the crisis on their organization and community. This researcher chose to focus on how human service organizations responded to the farm crisis and the resulting non-traditional clientele. This choice was made since the crisis provided an opportunity to 37 examine human service organizational effectiveness, an ongoing interest of this researcher. The crisis placed new demands on the social service agencies. They needed to put services in place quickly for non-traditional clientele. The larger study encouraged the inclusion of this data to gain a fuller picture of the community response and a better understanding of what determines organizational effectiveness in human service organizations. Research Methods Used Intmdnfiinn Field research was selected as the most appropriate methodology for this particular study. It was selected due to the nature of the problem, the research questions, the state of the literature, the amount of information reeded, the time span available to conduct this study, and the resource constraints the author was working within. As discussed in the previous chapter, service effectiveness is difficult to observe. However, the flood crisis provided the opportunity to address this issue. Using field research, it was possible for a trained observer to ask broad questions and gain a comprehensive perspective. of the community’s response to the flood in a relatively short time span. 38 It was shown in the literature that accessibility, timeliness, consistency, and service design were important variables in assessing effectiveness in human service organizations. Field research is a very effective methodology for studying nuances of change in attitude and behavior in a concentrated time frame. This methodology allowed observation of the responses of the human service organizations to the crisis. Field research is a social research method that involves the direct observation of social phenomena in their natural settings (Babbie, l983,p.244). It is especially useful to the study of social processes over time. It is also appropriate when behaviors and attitudes are best understood within their natural settings. The response of the human service organizations to the flood crisis in the three counties reflects both of these criteria. Field research also allows a depth of understanding that may not be possible with some other methods. It is a useful method in an exploratory study when determining variables is one of the research objectives. This is compatible with the efforts in this study to examine organizational effectiveness and to obtain a more precise understanding of service effectiveness. 5 . I B . The social reconnaissance method of field research as developed by Irwin T. Sanders provided the overarching methodological framework for this study. This method has its roots in the work of Douglas Ensminger in the late 39 1930’s (Sanders,1985,p.237). It is an approach to community study that focuses on the interrelationships within the community to prepare a "community profile“ . This profile highlights the distinctive social features of a particular community at a point in time and has also been compared to holding a mirror up to the community. The social reconnaissance method uses a team approach to gather a large amount of qualitative data about a community in a short period of time. The team members develop a common set of questions that form the basis for the study. Then various sectors of the community are interviewed to gain their perspective on the issues being studied. The final results are then compiled, analyzed, and edited. This method has been extensively used in research, consultation, and training. It was selected for this particular study because the social reconnaissance method allowed the collection of useful data with reasonable inputs of time and money. Of particular importance was the shortage of time, since the study results had to be provided to the state legislature. The limitations of the social reconnaissance method are the issues of reliability and generalizability that are shared with all field methods. The use of multiple researchers (even with training) complicates reliability since different researchers might elicit different responses or interpret them differently. Generalizability is difficult since the researcher has an very comprehensive knowledge of a small piece of reality. This understanding is 40 less generalizable than results based on rigorous sampling and standardized measurements . Data Collection An interview team stayed in each of the three selected counties for a three—four day period during July, 1987. The team members interviewed key informants using a focused interview guide. Data were recorded on-site. A day long follow up visit to each site in August, 1987 completed the data collection process. 12 . E II E I I I . G 'I A focused interview guide was developed for all members of the interview team. This guide consisted of the following sections: an introduction; establishment of the respondent’s areas of competency; some direct target questions about the farm problems; sector foci questions; the collection of hard data if available; suggestions for other contacts; and a thank you for participation in the study. The focused interview guide for the human service organizations personnel also followed this basic outline. However, the specific sector foci questions on human service organizations were designed based on literature review, input from faculty in the Departments of Resource Development, 41 Sociology and the School of Social Work, and previous experience on the part of the interviewer. The questions in this section sought to identify: a description of services, including any new services for farm families in response to the crisis; the agencies’ role within the community; internal organizational structure of the organization; interagency linkages with other human service organizations; an understanding of the patterns of service delivery in the community; and the history and development of these patterns. A copy of the overall focused interview guide is available in Appendix B. The questions included in the interview guide for the social service sector are discussed below. Overall, eight general questionsgwere asked. "Eachisw presented below, with a description of the specific- information that, was being , , solicited through follow up or probing questions. 1. Please tell me about your agency and the services you provide: Internal organizational structure - chain of command; Relation to ”parent" agency; Funding sources - Federal, State, Local, Other; Board of Directors? Structure, amount of power, actors. This question was designed to produce an internal. r9341 map. of tbs seam! . and theflbeginning of an understanding of its vertical linkages with the parent agency 42 and funding sources. It also was designed to elicit information about the relationship of the agency to the power structure within the local community. 2. What is your role in the agency? What tasks do you perform, where do you fit in? How long have you been with the agency? Are you from the area? Where did you go to school? This question was designed to help assess the perspective and credibility of the key informants. The information also clarified their perception of their role as it would influence the rest of their answers. 3 . Have you seen an increase in farm families seeking services - whether they qualify or not? What kind of services? Who else in the agency works with farmers? How did you handle the debt/asset ratio problem? What about in the rest of the community? This question was designed to obtain information about a change in demand for services by the farm families in this and other agencies. 43 4. What Services are available for farm families? In your agency? Any hard data available about this? In other agencies in the community? Are you working together with any other agencies? Any contacts that would be useful to me in or out of agency? This question was designed to obtain information about the extent of actual service provision to farm families as well as the structure of the delivery of that service. It attempted to identify participants in community agencies that were providing service and interagency cooperation. 5. What was the initial response of the community to the flood crisis? How was it organized? Who initiated it? Were the Feds. helpful? Who were the key agencies in the community? Do you feel it went smoothly? This question was designed to understand the initial community response to the flood and the agencies’ reactions. Information also was gathered highlighting the web of horizontal linkages in place. 44 6. Was there anything else going on for farmers before the flood happened (social services)? Who was in charge? Did your agency participate? Do you think it was helpful? This question was designed to assess the effort that had been made in the community to respond prior to the flood. It was aimed at eliciting information about previous linkages, coalitions etc. 7. Have there been any program changes in the community since the flooding? Is this being sustained? Who is in charge? Do you think it’s going to work? What about the future? This question was designed to ascertain on-going or permanent changes or responses to the flood experience. It was an attempt to document shifts in services that might have occurred. 8. Anything else that may have been overlooked? Any perceptions, comments etc.relating to the response? 45 Any ideas on what the response to the farm situation should be? Who else should be contacted? Any other suggestions? This question was designed to draw on their knowledge of the agency and the community to include anything else that they perceived as important. Bl" Il' Prior to the preliminary interviews, the research team members role played the interview format to familiarize themselves with the questions and the flow of the interview. They then conducted preliminary interviews to test the format. These interviews were conducted with persons identified by the Cooperative Extension Service within one of the affected three counties. They included four farm families in County B, the township supervisor in a selected community in County B, and the superintendent of a school system in a selected community in County B. The team members conducted the interviews in pairs to provide more opportunity for observation and extensive feedback to each other. These interviews were also taped with the consent of the interviewee for learning purposes. Each team member processed and recorded their interviews prior to discussing them for modifications. 46 The initial interview guide did not need adjustment but the student interviewers found they did need to work on flexibility in allowing persons to tell their “stories“ yet include all the requested information. They held another role playing session to work out some alternative styles of interviewing, before proceeding with the interviews of key informants. W13 Key informants are used when it is necessary to gather a large amount of information in the most efficient manner. One variant is to begin with a few key informants, who in turn provided the names of additional key informants. This method of snowball sampling involves asking one of the participants in the event to recommend others for interviewing, and then each of the next set of respondents is asked to give further recommendations. This method is useful in targeting critical actors in a community which was important in this study. In the human service organization sector the agencies to be approached were initially located through the use of the telephone directory. All three counties had a section in the phone book that listed governmental and helping social service agencies. The staff of each county office of the Cooperative Extension Service were the first personnel interviewed in each county. They were asked for additional contacts. In most instances, they were able to provide names of persons in the organizations that would be helpful. All of the 47 three counties also had some kind of resource guide that listed key human service agencies within that county. Efforts were made to identify and contact all human service organizations within the three counties. In County A ten on-site interviews were conducted, as well as three extensive phone interviews. Those interviewed included: the County Extension Director and Extension Home Economist; the Community Mental Health(CMH) Flood Project Director; two CMH therapists specifically assigned to the flood project; the Department of Social Services Director; the Public Health Nurse; the hospital social worker; the Christian Neighbors Director; the Women, Infants and Children’s program administrator (a food program located in the Public Health Department in every county in Michigan, except County A); the Michigan Employment Security Commission representative; the Red Cross coordinator; the special needs transportation coordinator; the coordinator of the Community Action Program; and the local substance abuse counselor (which was the program where people sentenced for substance abuse would have to attend). In County B there were ten on-site interviews with two in-depth phone interviews. Those interviewed included: the County Extension Director and 4- H Youth Agent; the Community Mental Health Special Projects team (two Masters level staff and two Bachelors level staff hired specifically for the flood project); the Director of the Department of Social Services; the Public Health Nurse; the MESC case manager; the administrator of the 8-Cap (the local 43 Community Action Agency); the special needs transportation coordinator; the Director of the Office of Human Services (a religious group); the Women’s Aid Director (head of the new shelter and counseling program); and the Crisis Line counselor (the 24 hour multi-purpose crisis line). In County C there were fifteen on—site interviews. Those interviewed included: the County Extension Director, the Extension Home Economist, and Extension Project Assistant (a part time para-professional specifically hired for the flood project); the Community Mental Health Coordinator; the MESC administrator; the Supervisor of the Department of Social Services’ Emergency Needs who worked on the flood project; the Disaster Relief Coordinator for the county; the Economic Developer for the region; the special needs transportation director; the Director of the Community Action Program; the hospital social worker (the only hospital in the area); the Public Health coordinator (for all services); the coordinator of Project Help (a religious coalition); the administrator of the substance abuse program for the county; the coordinator of the women’s programs (crisis line and shelter); and the social worker for Catholic Social Services (the only private counseling center in the area). W The interviewer had an introduction letter signed by the Director of the Michigan State University Agriculture Experiment Station(MAES); the project leader (a professor in the sociology department at Michigan State University), 49 and the associate chair of the sociology department at Michigan State University (see Appendix C). These provided a point of entry and legitimacy to the request for the interviews. The interviewer spent several days in each of the three counties collecting information. In each county the County Cooperative Extension Office served as an operating base. However, in each of the individual towns within each county, the local schools also offered the use of their telephones and office space for arranging interviews. This researcher made phone calls to set appointments from each of these sites as necessary throughout the entire project. Following this initial time period, the interviewer returned a few weeks later for two more days per county to do some “clean-up” and gathering of missing information. The data collection was accomplished between late June,1987 and the end of August, 1987. This interviewer found that being in the area for a concentrated period of time facilitated access to persons to be interviewed in a number of ways. Agency staff understood the time constraints and scheduled interviews more quickly than may have happened with an open-ended calendar. Additionally, the agency staff made frequent "referrals” to their peers in other agencies and in some instances made direct phone calls to facilitate the next interview. Since these were small communities it didn’t take long for word to get around that an interviewer was in town. Contacts were initiated by agency personnel during meals as well. 50 Appointments were made with key informants in each of the human service organizations. In each instance, the interviewer followed the focused interview guide as closely as possible. In instances when the specific information that was requested was unknown to the respondent (i.e. number of contacts with farmers) the agency personnel often contacted someone else within their agency in an attempt to secure this information. Most interviews were one and one-half to two hours in length and took place in the office of the interviewee. In a few instances follow-up information was gathered off-site at the convenience of the interviewee. (For example, the Community Mental Health worker met at a local restaurant and then later went to the County Cooperative Extension Office with the researcher). We Notes were taken during each interview, following the format of the interview guide. Any documenting materials that were available also were collected. The interviewer had access to a portable personal computer and all field notes were entered on computer operated document files on the day of the interview. The schedule was constructed so that time was built in to enter the field notes. This schedule was adhered to as much as possible. There were a few instances when the opportunity arose for an unplanned interview that was important, which meant a slight delay in writing up the notes. However, all 51 notes were entered as soon as possible, and prior to the next interview whenever possible. [I | SI l' l' I D I Additionally secondary data on the three counties were used for county demographics. Data were used from the 1980 census report and from the 1988 update of the census. In many instances, the 1988 data more accurately reflected the demographics of the county at the time of the 1986 flood. When data from the 1980 census report were used they were identified as such in the text. Data Analysis Field notes were recorded immediately. A rough coding procedure was also begun in the field. Each interview was assigned a file number. As the interviews progressed, themes began recurring and additional files were developed. Separate files were set up on interagency cooperation, overall disaster response, public agency involvement, private non-profit agency involvement, demographic information, and so on. As interviews were completed, they were coded and cross-referenced within these files. The use of key informants and snowball sampling assisted in the focusing and refinement of the data. This was the beginning of the data analysis. Later 52 the initial files were reviewed and recategorized according to the selected indicators of service effectiveness that were identified through the literature search. These four indicators were; accessibility, timeliness, consistency, and service design. The immediate response of the state of Michigan and of Counties A, B, and c to the 1986 flood were examined. This included the process of the designation of the disaster sites by the Governor and the President. The overall response to the crisis by each county were also examined. This information presents the backdrop to the examination of the indicators of service effectiveness in the selected agencies. The use of multi-county sites in this study provided the opportunity for comparison among agencies and among counties. The state level response of DSS, MESC, CMH, and CBS were examined and compared. This was done because the mandate to each county from the state agency established the norm of behavior for the county level agencies. The data collected in this study was analyzed according to the four selected indicators of service effectiveness; accessibility, timeliness, consistency, and service design. Accessibility was measured by physical location, hours of service, outreach efforts, and public relations efforts. Timeliness was measured by participation in the disaster center, time frame of program initiation, and length of time for program processing. Consistency was measured by standardization within the county, common definitions, 53 common forms, and common results. Service design was measured by the degree of centralization of authority, the integration of the program into the internal organization, inter-organizational linkages, and consumer participation in the program design. The data on each indicator were analyzed for each of the four organizations studied, and according to the three counties. The data on each organization were subdivided by county. The data were analyzed for similarities and differences. The state mandate was used as the norm for each agency. The agency was compared to the norm for each variable. Comparisons were also made for each agency across counties. Limitations of the Study This study was an exploratory comparative study designed to identify variables that impact organizational effectiveness, particularly service effectiveness, in human service organizations. Data were gathered that could inform future researchers and ultimately contribute to an improvement in service delivery. This study was deliberately qualitative because of the development of the knowledge base at the time the study was conducted and because , the key factors in service effectiveness were still being identified and clarified. 54 There are limitations inherent in this type of research design. Since it is qualitative it cannot give precise descriptive statements about a large population. As a result it is often suggestive in nature rather than definitive. Another potential limitation of field research is in the area of reliability. The measurement of qualitative data is quite subjective and includes the bias of the researcher. The question always arises whether another researcher would measuredresamedataandgetthesameresults. Thiscanbepartially addressed through comparative analysis which was utilized in this study. The use of key informants can also bias the study. Though it is a very good means of gathering large amounts of data in a short period of time, it does run the risk of reflecting the bias of the key informers especially that of the initial key informants. . It is also possible that persons with knowledge that would affect the research were omitted from the sample. One of the biggest limitations faced by field researchers is the problem of generalizability. Though the researcher may have comprehensive information on the subject it is less generalizable than results based on rigorous sampling and standardized measurements. Again, a study design using comparative data is stronger than one using only one situation but generalizability is still a problem for field research. Finally, there is a lack of supplementary quantitative data. In many instances agencies had surprisingly little documentation on services they had provided. It appeared that there was a weak link between the delivery of 55 services and actual documentation of serviws that was sent to funding agencies. In some cases the organizations were not able to give actual numbers of clients served but gave estimations. In the majority of the organizations they were not able to separate the county residents they had served into farm, non-farm or town residents. As a result, much of their opinion was anecdotal and based on personal experience. Quantitative data that delineated the numbers of farmers and other rural residents served by each program, would have been informative. This data would have strengthened the understanding of the indicators of service effectiveness through measuring utilization of service. This data would also have been useful for administrators and policy makers in their evaluations of the services provided. CHAPTER FOUR OBJECTS OF THE STUDY Introduction In order to better understand this study, background information and demographics of Counties A, B, and C will be discussed in this chapter. The history of Community Mental Health, the Michigan Employment Security Commission, the Department of Social Services, and the Cooperative Extension Service will also be presented. Further, information about the typical organization of these selected human service organizations will be included. Counties in the Study Mules! Three counties from among the 30 counties originally designated as disaster counties were selected as the focus of this study. These counties experienced severe losses in the 1986 floods as reflected in their requests for help on the statewide farm hotline and applications for financial relief. The three counties will be called A, B, and C in order to maintain the confidentiality of the responses obtained during the interviews with key informants within the four organizations. This section will present relevant demographics on each of the three counties. This demographic data will 56 57 include; population statistics, income and employment statistics, dependency of the county on agriculture, and the impact of the flood in the county. The MAES index of agricultural dependency will also be included in this section. This index was prepared by researchers at Michigan State University to determine which counties within Michigan were more dependent on agriculture, and, as a result, more vulnerable to crisis within the agricultural sector. The index was determined by factor analysis and translated into a composite index that standardized scores for the state on a county by county basis. The score for each county reflects the degree to which the county deviates from the state mean of dependency on agricultureCMAES,1988). WA WWW County A is located in southwest Michigan, bordering Lake Michigan. Approximately 50 % of the land in County A is first class farmland(MAES,l988). In the 1988 census, 79.6% of the population in County A was considered rural and 6.9% of this population was considered rural-farm residents, with the remainder(l3.5%) being urban. Senior Citizens and children are the most vulnerable demographic groups and consume a higher proportion of resources than the general public. The population of County A was estimated at 88,994 with 39.6 % of that population being children under 18 years and senior citizens 65 years and older (U .S.Bureau of Census,l988). County A’s estimated median household income 58 in 1988 dollars, was $26,159. This was below the state median of $28,956 (Michigan Department of Management and Budget, 1988). W The MAES index of agricultural dependency places County A in the slightly dependent category. The County Extension Director stated that agriculture in County A is a combination of dairy, fnrits, root crops, and produce. The soils in County A range from sandy soils along the lake, that support blueberries and grapes, to muck soil that is good for root crops such as onions and potatoes. Employment As shown by the MAES index, agriculture is an important business in this county. The County Extension Director stated that tourism is also a substantial industry especially along the Lake. He added that small manufacturing also contributed to the county’s economic base. Both the County Extension Director and the DSS Director commented that the nearby cities of Grand Rapids, Holland, and Kalamazoo both draw high numbers of county residents outside the county lines for employment. In 1988 the average unemployment rate in County A was 5 .0 (Michigan Employment Security Commission) which approximated the state average. MW Based on the applications for financial relief, the root crops, produce, and blueberries were the crops that suffered the most damage in the county from the 1986 flood. Additional damage occurred along the lakeshore with severe erosion and debris accumulation (MAES, 1988). 59 Short term losses were extensive. The average total payment made in the state to each impacted county was $2.3 million. The flood payments in County A totaled $4 million. This does not include the multiplier effects that resulted from lack of farm income and products. County A also suffered long term losses from erosion and drain damage. Carroll! Eomflafiouniincomedemomnhics County B is located in mid-central Michigan. Over 70% of the land in County B is first class farmland (MAES,1988). In the 1988 census update, 58.7% of the population in County B was considered rural, l3 .2 % of this population was considered rural-farm residents, with the remainder (28.1%) being urban. The population of County B was estimated at 39,587 with 41.2% of that population being children under 18 and senior citizens over 65 (U .S.Bureau of Census, 1988) who utilize a disproportionate amount of resources. County B’s estimated median household income in 1988 dollars, was $22,862. This was significantly lower than the State median income of $28,956 (Michigan Department of Management and Budget, 1988). W The MAES index of dependency on agriculture listed County B as moderately dependent upon agriculture. The MDA statistics reflect that agriculture in County B consists of primarily cash crops of beans (navy, soy, and red), corn, and potatoes. 60 Employment As evidenced by the MAES index, agriculture is an important business in this county. The MESC representative described the other stable sources of income for the county. He stated that some residents earn their income working in small industries located in two small industrialized cities within the county. Many other residents commute to jobs in the nearby larger cities of Lansing or Grand Rapids. Still other residents work for the Michigan Department of Corrections within the prisons in two nearby counties. In 1988 the average unemployment rate was 8.2% which was significantly higher than the 5 % unemployment rate for the state (Michigan Employment Security Commission). Wood Losses in the 1986 flood were extensive. Many of the crops had not been harvested before the flood and the flood made it impossible to do so. In addition to crop losses, the drainage system in the county was severely damaged, along with many bridges and dams. County B received $17.5 million for relief. The average payment made in the state was $2.3 million. This figure did not include the multiplier effects that were felt throughout the community in loss of farm income and products. Long term effects of the flood included soil erosion, debris removal, and damage to bridges and erosion control structures. 61 CQIIIIDLC WW2: County C is located in the "thumb' area of Michigan bordering Lake Huron. More than 70% of the land in County C is first class farmland (MAES,1988). In the 1988 census, 100% of the population in County C was considered rural and 17.9% of this population was considered rural-farm residents. The population of County C was estimated at 40,777 with 43.5% of that population being children under 18 and senior citizens over 65 (U .S.Bureau of Census,l988). County C’s estimated median household income in 1988 dollars, was $21,242, very much lower than the median income of the state which was $28,956 (Michigan Department of Management and Budget,l988). Agficnlmmljmdency According to the MAES index of agricultural dependency, County C ranked very dependent on agriculture. The County Extension Director stated that agriculture in County C is a combination of dairy, pork and crops. Sugar beets and beans are the main cash crops. Efforts to diversify agricultural products have included a sunflower operation and on- site processing efforts for sunflower seeds and products. Employment As evidenced by the MAES index, agriculture and related industries assume primary importance in this county. The Economic Development Coordinator stated that small manufacturing businesses that supply the auto industry in the Flint area are also a major employer. He added that tourism is increasing and is a major thrust of the Economic Development 62 Council in one of the larger small cities within the county. In 1988 the average unemployment rate was 9.3 % , almost twice the state average of 5 % (Michigan Employment Security Commission). W The 1986 flood was especially destructive in the western section of County C. The county received 11 inches of rain in less than a 24 hour period. The drainage system, bridges, and dams were not able to handle this plus the additional rainfall that occurred during this time period. Since crops had not been harvested at the time of the rains and flood, they rotted in the fields. Short term losses were extensive. The average total payment made in the state was $2.3 million. County C received $11.5 million. This does not include the multiplier effect that the loss of farm income and products had on agribusiness and the local communities. Long term losses included soil erosion, fence destruction, and feed shortages. Organizations in the Study 912mg)! The Department of Social Services(DSS), the Michigan Employment Security Commission(MESC), Community Mental Health(CMH), and the Cooperative Extension Service(CES) of Michigan State University were selected for more intensive analysis. These organizations were selected since they are 63 state wide organizations with services available in each county of Michigan. Each of these state central offices issued a mandate for the county level offices to respond to the flood impacts in their counties. This provided a basis for comparison among counties and organizations. Information on the mission and programs, history, funding, and structural organization are included below. The typical organizational structure in each of the three counties is also included so that similarities and differences that occurred in response to the flood can be highlighted. D | | [S . I S . W The public aid programs are designed to help persons meet their basic needs of food, shelter, and clothing. Specific programs included under this category are: Aid to Families with Dependent Children, Food Stamps, Medicaid, Supplementary Security Income ($81), and General Assistance. Eligibility for one of the public aid programs does not necessarily preclude eligibility for another. Benefits are provided in a variety of forms. In some instances, such as 881, direct monetary aid is given. In other instances, non-monetary forms of assistance such as food stamps are provided. The form of the assistance fluctuates with the political and economic decisions made at the federal level (Handel, 1982) . 54 Binary As mentioned earlier, the federal govemment’s initial efforts at income maintenance came about as the result of the Great Depression. The Social Security Act of 1935 provided the basis for federal intervention in income maintenance. Programs resulting from this legislation can be classified as social insurance programs or as public aid programs. Unemployment compensation is an example of a social insurance program. The Department of Social Services is an example of a public aid program. The primary distinction of a public aid program versus a social insurance program is that it is governed by a means-test. The applicant must demonstrate evidence of need and be without an alternate source of income to meet that need. Also, these programs usually do not expect the recipient to have contributed in any way prior to receiving the benefits (W yers, 1987). Funding Financing for the public aid programs comes from the general fund of the United States. The public aid programs are financed by tax dollars. Quanizntign The federal government’s control over each of these programs- is different but they do provide baselines for all states to follow. These programs allow the states much latitude in how they operate and administer the programs. This explains the wide variation in benefits from state to state. It also explains the variability in requirements for participation in employment and training programs. All staff are State of Michigan employees. Each county has a Social Services Board composed of three county commissioners that is responsible for reviewing the local budget. 65 W The Department of Social Services is located in the county complex within the county seat. The Department shares a building with the county Health Department. The Community Mental Health Center is also located in the complex. All DSS services are available at this location but the client must come in and apply for them in person. The organization does not have a toll free line available for clients and all phone calls outside of the immediate city are long distance. MB The Department of Social Services is located just outside the city limits of the county seat. All DSS services are available at this location but the client must come in and apply for the services in person. The organization has a toll free line for clients to contact the Department. mm The Department of Social Services is located within the county seat. The Department shares a building with the Public Health Department. All DSS services are available at this location but the client must come in and apply for the services in person. The organization has a toll free line for clients to use to contact the Department. “.1. E I IS 'l C . . W The intent of unemployment compensation is to provide temporary, partial wage replacement to workers who are involuntarily unemployed (Jones, 1987). It is a joint federal and state program with broad federal guidelines that all states follow. 66 m The severe depression of the late 1920’s and early 1930’s thrust millions of families and individuals into poverty or serious economic jeopardy. The patchwork of existing state programs and private charity was overwhelmed with the need. The federal government stepped in and created income maintenance programs for certain categories of people. This ultimately resulted in the passage of the Social Security Act of 1935 (Coll,l969). Unemployment Compensation is an income maintenance program. Income maintenance programs are of two types; social insurance programs and public aid programs. The primary difference is that the social insurance programs are for anyone who meets certain criteria (such as disability or covered employment) while the public aid programs utilize needs tests to determine eligibility (analysis of income reeds and assets). Unemployment Compensation is a social insurance program. Funding The financing for this organization and its programs comes from a payroll tax on employers. The actual implementation of the financing for this program is quite complex and varies among states. Each state chooses its own method of service delivery but follows a formula based on past experience with the program. The state’s share of the tax is used for cash benefits to eligible unemployed workers. The federal share of the tax is used for program administration, the federal share of extended and special programs, and for loans to states whose own tax funds have been exhausted (Wyer,1987). 67 The Disaster Unemployment Assistance programs originally are federally funded. Complex formulas then determine what amount the state reimburses the federal government. When an area is declared to be a Federal Disaster Area, all persons in that area that meet the criteria are eligible. Eligibility for Disaster Unemployment Assistance is primarily determined through unemployment due to the disaster and demonstration of previous employment in that field. Additional criteria are determined on a program by program basis relevant to the disaster (Congressional Budget Office, 1983). W The Michigan Employment Security Commission has branches throughout the state. Michigan residents can apply for benefits from any county within the state regardless of their county of residence. All policy and program decisions are made at the state and federal level. The local office implements the state programs. There is no local advisory board. W The MESC programs in County A county are available by a toll-free phone line and on-site in the two neighboring counties. All MESC services are available, including unemployment compensation and job placement, through those means. W The MESC office in. County B is located within the county seat. The office is in a self-contained building in the central area of the city. All services, including unemployment compensation and job placement, are available through this office. 68 mm The MESC office in County C is located within the county seat. MESC shares a building with the county Department of Social Services. All services, including unemployment compensation and job placement, are available through this office. W W Mental health services are provided under both public and private auspices. In general, only persons with adequate insurance or personal financial resources are able to participate in the private sector. The public sector’s primary mission is to provide care to persons who are medically indigent or unable to receive care from other sources (Callicutt,1987). Him The first general hospital in America, Pennsylvania Hospital, accepted mentally ill patients from its completion in 1756. The first state hospital for the mentally ill was opened in Williarnsburg, Virginia in 1773. Other states soon followed this example. The primary treatment at this time was confinement, typically with chains and other restraints (Deutsch, 1949). The reforms of Dorothea L. Dix, Benjamin Rush, William Tuke and Phillippe Pinel in the late 1800’s called attention to the plight of the mentally ill and the callous and inhumane treatment they were receiving. Political efforts in this area resulted in the establishment of asylums for the care of mentally ill. In most instances, chains were prohibited and emphasis was on kinder treatments including exercise and activities (Trattner, 1974). 69 This remained the status quo until the early 1900’s. At that time a citizens movement, spearheaded by Clifford Beers, identified the problem of mental illness as one requiring government intervention. World War I highlighted the need for treatment of military and civilian personnel. The U.S. Surgeon requested the American Red Cross to establish social services for federal hospitals in 1919 (French, 1940). Formal training programs for workers in psychiatric mental health began in this era. From January 1,1941 through December 31,1945 approximately one million patients with neuropsychiatric disorders were admitted to U.S. Army hospitals. This set the stage for the federal government to have a major impact on the field of mental health. The National Mental Health Act of 1946 provided for the funding of research, training of professional personnel and monies to the states for pilot projects. The National Institute of Mental Health (NIMH) was formed in 1949 to oversee the development of the mental health system in the United States (Deutsch,1949). The Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 was originally designed to provide for the construction of facilities. However, amendments allowed provisions for staffing of these centers under federal guidelines. This legislation resulted in a fundamental change in the public mental health service delivery system. The establishment of centers in the community focused on treating the patient in his home environment near family, job, and friends. 70 Initially Community Mental Health Centers were responsible for providing mental health services for a specific geographic area. They were required to provide inpatient, outpatient, partial hospitalization, 24-hour emergency services, consultation, and education. With deinstitutionalization in the 1970’s (the movement of patients from long-term hospitals to the community for treatment) the community mental health centers have become even more important. The federal government also implemented access criteria and guidelines for fee scales (Lieberman, 1975). The 1980’s saw no change in the mandate for Community Mental Health but a major change in the funding. This has had programmatic implications as states have been unable to meet the program needs due to insufficient funding. Funding The passage of the Omnibus Budget Reconciliation Act of 1981 under the Reagan Administration discontinued the direct funding of the community mental health centers. The shift from categorical to block grants to the states provided that the states have the responsibility for distribution of the funds. The federal impact is still being felt but individual states are starting to assert their distinctive imprint on these centers. The funding formula has been altered with the states now expected to provide an increased share of funding and many states are unable to meet the need. ngnmzntign Michigan has Community Mental Health Centers located throughout the state. These centers receive their funds directly from the Michigan Department of Mental Health. Each center has a local board that is 71 responsible for the policy, funding, personnel, and administration of the programs. All program decisions are made by this local board with oversight by the State. The state Department of Mental Health develops policies, guidelines, and institutes special programs including prevention. Each center hires its own Executive Director who is responsible for staffing the center. COHEN—A The Community Mental Health Center in County A is located in the county human services complex within the county seat city. It shares a building with the services for the developmentally disabled but has a separate parking area and entrance. All of the legislated services are coordinated through this center. These include; inpatient counseling, outpatient counseling, services to the developmentally disabled, community support services, emergency services, education, and prevention. W The Community Mental Health Center in County B is located in one of the larger communities in the county but not in the county seat. It has its own separate building and no other agencies are located with it. This center provides outpatient counseling, emergency services, education, and prevention, but contracts for inpatient counseling with the local hospital. Services to the developmentally disabled are also contracted out to a private agency. W The Community Mental Health Center in County C is located in a separate building adjacent to the hospital in the county seat. This center provides inpatient counseling in conjunction with the hospital. 72 Outpatient services, emergency services, education, and prevention are provided both in the building and in outreach locations throughout the county. Services to the developmentally disabled are also provided through the center. W3 Cooperative Extension’s primary mission is education. This includes a heavy emphasis on education for rural residents. However, within the last two decades Extension has expanded its scope beyond agriculture and the rural arena. Regardless of the specific programming, Extension emphasizes education as a means to help people help themselves. Programs include the Expanded Food and Nutrition Education Program (EFNEP); expanded 4-H and youth programs; consumer education; family relations; agricultural production and marketing; natural resources development and conservation; and community improvement. Histmy The roots of the Cooperative Extension Service can be traced back to the earliest days of this country. George Washington, Thomas Jefferson, and Benjamin Franklin all experimented with different crops and farming methods. ”Scientific agriculture“ was generally carried out by the wealthy farmers since they were the only ones that could afford the risk inherent in the experimentation (Prawl, Medlin, & Gross,1984). The American Philosophical Society, founded in 1743, also devoted some attention to agricultural topics. In 1785, Benjamin Franklin organized the 73 Philadelphia Society for Promoting Agriculture. The South Carolina Society for Promoting and Improving Agriculture was also founded the same year. These societies developed newsletters and other publications to spread information on improvements in agriculture (Scott, 1970). These early societies were generally founded along community and county lines but soon merged into state organizations. The first agricultural fair took place in Pittsfield, Massachusetts in 1810. These fairs offered opportunities for education, socialization, and entertainment. They were eventually organized in every state. The first state board of agriculture was established in New York in 1819. The Ohio legislature formed a state board of agriculture in 1846 and by 1854 the officers of the board were conducting three—month courses at Oberlin College on the sciences and their application in agriculture (Prawl, Medlin, & Gross, 1984). Massachusetts Agricultural College began hosting summer institutes in agriculture in 1869 and several other institutions followed this model. The Kansas State Agricultural College developed a different model. lectures were provided at the College but also in several populous areas of the State (Kelsey, 1955). One of the difficulties confronted by the early efforts to disseminate improved agricultural practices was the shortage of reliable, factual, and research tested data that could be used by farmers. The Morrill Land-Grant 74 Act of 1862 began addressing this issue. The Act provided federal land to each state on the basis of 30,000 acres for each member of Congress from that state. Proceeds from the sale of this land were to be used as an endowment for the establishment of a college to teach "such branches of learning as are related to agriculture and the mechanic arts“ (Prawl, Medlin, & Gross,1984). The scarcity of textbooks and instructional materials led the instructors into the field to initiate research projects and studies. This model led to the development of ”experiment stations” with the first one in. the United States established in 1875 at Wesleyan University, Connecticut. It was funded by state and private funds. Inadequate funding continued to be a problem for the land-grant colleges. Morrill continued to introduce legislation to address this md from 1872 until 1890 when the Second Morrill Act was passed. This new act made operating funds available to the land-grant colleges. It also required that those states operating colleges only for whites had to provide separate but equal facilities for blacks (Kelsey,1955). The Organic Act of 1862 that formed the USDA, included the idea that useful information on agriculture should be diffused among the people. The Hatch Act of 1887 contained similar language and established the Agriculture Experiment Stations. In 1891 Rutgers University, New Jersey, organized a formal extension department to sponsor short agricultural courses off campus. Cornell University established its extension division in 1894 (Scott, 1970). 75 At the same time, institutes were being developed for rural women and rural youth. These later developed into extensions homemaker clubs and 4-H youth programs- In 1908 President Theodore Roosevelt appointed a Commission on Country Life to recommend legislation to enhance the well-being of farmers and others living in rural areas. In 1909, that commission recommended that a nationwide system of extension be established. Between 1909 and 1913 at least 32 bills were introduced into the House or Senate to provide support for such a program (Eddy, 1957). In 1911 Frank Lever, a representative from South Carolina, introduced a bill calling for a nationwide extension service. Sen. Hoke Smith introduced a similar bill in the Senate on July 16,1912. After much discussion and debate, a compromise bill passed. On May 8,1914 the Smith-Lever Act was signed into law. The Smith-Lever Act was patterned after both the Hatch Act (1887) and the Morrill Act (1862). It created the third link between the federal government, represented by the USDA and the land-grant institutions. Together these Acts provided for research, teaching, and an extension service. They have been modified several times during the last 70 years but the basic intent remains the same (Prawl, Medlin, & Gross,1984). Funding Cooperative Extension is funded by a combination of Federal, State and County funds. Funding from the Federal level is determined by a 76 formula that is based on the rural/urban distribution and is passed on to the State Land Grant University. Each State provides a portion of the budget which goes to the Land Grant University though the apprOpriation process. Formulas are developed between the Land Grant University and the County Government to determine what each county will fund. Qrgnniznfign The Cooperative Extension Service in Michigan is organized through Michigan State University, the statewide land-grant institution. Each county or group of counties generally has a County Extension Director, an Agricultural Agent, a Home Economist, a Youth Agent and staff support. One of these agents may serve in more than one capacity depending on the staffing patterns and job responsibilities. Specialists in various areas such as Beef, Poultry, or Community Development support local initiatives that result from program planning done at the local level. They are usually located at the University though in some instances the pragmatics of distance requires location in one of the county offices. The county staff reports to Regional Directors from the state support staff. With few exceptions (again due to the distance factor) this staff and the administrators of Cooperative Extension are located at Michigan State University. mm The Cooperative Extension Oflice is located in an annex to City Hall in the county seat. All Extension services are available at 77 this site. The organization does extensive multi-media outreach and meets with clients in their homes as well as at other sites. mm The Cooperative Extension Office is located in the county seat. All Extension services are available at this site. The organization does extensive multi-media outreach and meets with clients in their homes as well as at other sites. Cguntyfl The Cooperative Extension Office is located in the county seat. All Extension services are available at this site. The organization does extensive multi-media outreach and meets with clients in their homes as well as at other sites. CHAPTER FIVE RESULTS Overview The immediate response to the 1986 flood by the State of Michigan and the three selected counties (Counties A, B, and C), is included in this chapter. This provides the contextual backdrop to an examination of service effectiveness in the selected agencies. The state level response of each of the selected agencies is also included in this presentation. The official position of the Department of Social Services (DSS), the Michigan Employment Security Commission (MESC), the Department of Mental Health-Community Mental Health (CMH), and the Cooperative Extension Service (CES) provide a basis for the comparison of county agency behavior. The research findings are organized according to the four indicators of service effectiveness; accessibility, timeliness, consistency, and service design. The data on each indicator is presented by agency and county. Relevant comments from the interviews are included as appropriate. Persons are identified by role. These comments include examples, points of clarification, and opinions. 78 79 The Immediate Response WW 1285 As a result of the 1986 flood and the presidential disaster designation, persons in the affected counties were eligible to receive emergency assistance. The funding for this assistance was channeled from the Federal level through the Michigan Department of Social Services. Each county in the disaster area was eligible to apply for this funding. Designated uses for the funds included; food, shelter expenditures, clothing, and heating assistance. MESC Following the 1986 flood, the MESC implemented the Disaster Unemployment Assistance Program (DUA). DUA is a special form of unemployment insurance that is available once a county has been designated a disaster site. All persons whose employment was impacted by the disaster were eligible to apply. Applications for DUA were completed at the county level MESC office and routed to the central office in Detroit. The only computers that could run the program to determine eligibility and the amount of the assistance were located in the Detroit office. The results of the determination were then returned to the county offices and checks were disbursed at that level. CMH At the time of the 1986 flood, the State Department of Mental Health initiated services to victims of the flood in conjunction with the federal disaster team (a team of federal employees who travel to disaster sites to provide 80 assistance). When it became obvious that the impact of the flood was severe and would be long lasting, the State Department applied for funding to the federal government to be used for special projects in the affected areas. The amount of the funding was based on the assessment of total damage within the state. When the funding became available to the State Office, they requested proposals from the individual counties that were designed to meet their unique needs. The State Department of Mental Health disbursed the monies based on the requests from the individual counties. CBS The CBS offices in each county were already involved in providing assistance to farmers experiencing financial difficulties prior to the 1986 flood. At the time of the flood, the state office requested that all involved counties increase their efforts to facilitate utilization of all the available programs from the state level offices. Each county was responsible for designing their own response based on their previous experience and current assessment of need. This response could incorporate existing programs or develop new programs at the discretion of the county staff. Comm Each county in Michigan has a disaster contingency plan on file with the Governor’s administrative office in Lansing. When the Governor declares an area to be an official disaster site the plan is available for implementation. The designated disaster coordinator for each affected county is responsible for the 81 implementation of the plan. Each county establishes and implements its own plan with oversight from the Governor’s staff. If the disaster is so severe that the Governor requests Federal intervention, a federal disaster team composed of federal employees and volunteers is available to come into the area. The Federal team provides assistance as necessary with the emphasis on local involvement and preferences. The 1986 flood in Michigan resulted in thirty counties immediately being declared a Federal disaster area. The response of these selected counties provided a backdrop to the responses of their human service organizations. The initial response is detailed below. Conn“ The federal disaster team met with the local agencies that chose to participate. They did not select a central physical site or a central referral agency. Each agency decided its own level and manner of participation. Television, radio and newspaper informational bulletins were made available to the public that included a list of telephone numbers for county residents to contact. W At the request of the county disaster coordinator, the federal disaster team assisted with the set up of a central disaster site. This center was opened within a week of the flooding and remained open fourteen to sixteen hours per day for three consecutive days. Public service messages in all the media provided information on the existence of this central center. Area agencies were invited to participate. DSS, MESC, CMH, and CBS 82 all participated. Other agencies in County B that participated in the centralized disaster site were: the Red Cross; Agricultural Soil and Conservation Service (ASCS -responsible for crop loss reports and reimbursement); 8-Cap (the community action agency) and the Ofiice of Human Services (a church affiliated emergency needs program). Clients went to the central site and selected agencies and programs they thought would meet their needs. Forms were filled out ont- site. The disaster center stayed open as long as it took to process persons desiring service. After three days the decision was made that the bulk of the applications were received and the site was closed. Individual applications were still taken at the respective agencies. Cgunty_C At the request of the county disaster coordinator, the federal disaster team assisted with the set-up of a central disaster site. This center was open fourteen to sixteen hours per day for six consecutive days. Public service messages in all the media provided information on the establishment of this center. Area agencies were invited to participate. DSS, MECS, CMH and CBS all participated. Other agencies in County C that participated in the centralized disaster site were: the Red Cross; ASCS; the Small Business Association; and the Human Development Corporation (HDC-the local community action program). This site was set up on an intake model. All clients spoke with an initial interviewer who recommended the agencies that were most appropriate for each client. All clients automatically were referred 83 to DSS and HDC. The disaster coordinator stated that this was done so ”no one would feel bad about getting help“ . The site also had a processing out station so that someone could double check that people saw everyone they “were supposed to see.” It also eliminated people coming back more than one time. The disaster coordinator stated that they had originally anticipated being open one or two days. They were surprised at the extent of the damage and the demand for services. After the central site closed, individual applications were still taken at the respective agencies. Accessibility The indicators of accessibility used in this study were; physical location, hours of service, outreach efforts, and public relation efforts. The results are presented by agency and county in the following section. Relevant comments from the interviews are also included. DSS CgunQLA The Department of Social Services in County A is located in the county complex on the outskirts of the county seat city. The office is in a one story building with handicapper access. The Public Health Department is located in the same building. The Community Mental Health programs are in .84 an adjacent building. The office is open from 8 a.m. until 5 p.m.. No outreach services were available as a result of the flood. No public relations efforts were made to inform the citizens of eligibility for the monies designated from the Emergency Needs Program. TheExecutiveDirectorstatedthattheydidnotseeanincreaseinfarm families attempting to use services. She said that they implemented the State criteria in the following manner: assets used in employment are excluded in the Medicaid eligibility assuming they are showing a "reasonable rate of return' which is defined as 6% of their equity value. For Food Stamps the assets which are essential to employment or self '1 employment are excluded entirely, unless the type of employment has terminated (e. g. the person no longer intends to farm). W The County B Department of Social Services is located in the county seat. The building is handicapper accessible. Hours are 8 a.m.- 5 p.m. . No outreach services were available as a result of the flood. No public relations efforts were made. The Executive Director acknowledged that several farmers called for their services but there was nothing the agency could do to respond since all help is based on eligibility. He stated that farmers always have assets and the only farmer they can help is one who has already declared bankruptcy. The director also stated that he was responsible for the emergency food 85 stamp program and the emergency preparedness program in the county. He said that there was no funding available and to the best of his knowledge these programs had never been accessed. He stated that outreach is especially difficult for DSS since all their programs are tied into the central computer. They do not have the capacity to take the programs off-site. He also added that in his personal opinion, the state office had a lot of“ hype” about helping farmers but did not offer the counties the support to follow through. CQJIBIJLC The Department of Social Services in County C is located in the county seat. The building is handicapper accessible. Hours are 8 a.m.- 5 p.m. . DSS participated in outreach efforts with CBS, CMH and the existing countywide farm crisis network. The emergency needs supervisor stated that she spent a considerable amount of time on outreach. Materials on the emergency needs programs were available throughout the community at other human service agencies and various sites such as grocery stores and laundromats. This county was the only county that was able to document assistance to farm families. They helped between 75-100 farm families. The major action they took to increase access, was to obtain special permission from the state office to develop a form to be used in determining eligibility. This form balanced assets and debts on a dollar for dollar basis. 86 Farmers received food stamps, medical assistance, emergency assistance, furnace replacements, general assistance, and other emergency needs. The exemption for the debt/asset ratio form was extended from September, 1986 through April,l987. DSS 5 'l TI S Each of the DSS offices were similar in location and hours of service provision, yet the DSS office in County C was the only agency to utilize the state emergency assistance program. Additionally, County C was heavily involved in outreach efforts through its participation in the disaster site and through interagency linkages and they were the only county DSS agency to participate in public relations efforts. The decision to participate seems more important to access than the selected indicators. This leaves the question of why the DSS agency in County C was the only one to participate. This idea will be pursued in Chapter 6. MESC mm MESC did not have a disaster registration location within the county. All applications had to be filed in one of the neighboring counties. Those offices were open from 8 a.m.- 5 p.m.. There was no outreach available. Public service announcements were available through television and radio spots. The county press as well as newspapers from nearby cities also 87 W MESC is located in the county seat. The building is handicapper accessible. The hours are 8 a.m.- 5 p.m.. MESC participated in the initial disaster site and was available during all the hours of operation. They also made extensive outreach efforts. Fliers were distributed to the Cooperative Extension office and at various other places throughout the community. The staff in County B assisted applicants in completing the forms in the MESC office. They also shared their changing knowledge of the client’s eligibility as they received it from the Detroit office. In addition to the printed materials previously mentioned, they also utilized television, radio, and the newspaper to inform persons of their programs. CQumLC MESC has a satellite office physically located within the DSS building. Only one worker is available there (the regional office is in a neighboring county). The building is handicapper accessible. Operating hours are 8 a.m.- 5 p.m.. MESC participated in the initial disaster site and was available during extended hours of operation. The staff assisted clients with completing the necessary paperwork. They worked closely on outreach efforts with CBS and the farm crisis network. They utilized all of the media including television, radio, and newspapers to convey information to the public. 88 MESC ! '1 TI S The MESC Disaster Assistance Program was available throughout the state regardless of the county of residence. Registration sites were available in Counties B and C. No physical site was available in County A. It did not seem to make a difference to accessibility whether a site was located within the county. Many residents from County C chose to register in a neighboring county yet the interviewee in County C stated that the staff were overwhelmed with registrants from outside the county. Counties B and C participated in the initial disaster site and emphasized outreach. The MESC in County B printed flyers and distributed them throughout the community, including stores and the CES office. The MESC in County C worked closely with the CES office and also with the agencies participating in the farm crisis network. Overall, the outreach efforts did not seem to make a difference in clients access to the program. On initial review it would appear that access to MESC services was difficult based on the selected indicators. However, whether there was a physical site located in the county did not seem to make a difference in the client’s utilization of the MESC service. It is possible that whether or not the agency did something, this was the type of benefit that people wanted so they took action on their own behalf. There was no data available about the impact of the increased services on the clientele. It is possible that the extra attention affected their attitude but it did not affect their access to service. 89 CMH mm CMH in County A is located in the county office building complex in the county seat. The building is handicapper accessible. Hours of operation are from 8 a.m.- 5 p.m. with evening hours scheduled on a flexible basis two evenings a week. At the time of the flood, CMH instituted a mental health hot-line that was available 24 hours per day. They also located one of the program therapists in the CES office two mornings per week to increase their outreach attempts to farm families. Other outreach efforts included presentations to children in schools, at 4-H clubs, and at 4—H day camp. These presentations were designed to assist the children in the areas to develop coping skills and stress management. All program services were free. CMH depended primarily on press releases and printed pamphlets to increase awareness of their programs. The pamphlets were available in grocery stores, pharmacies and other community businesses and agencies. Cgunt CMH in County B is located in a city other than the county seat. The building is handicapper accessible. Hours of operation are from 8 a.m.- 5 p.m. with evening hours as necessary. This office provided extensive outreach to the farm community. They distributed brochures describing the programs throughout the county. In addition, they utilized the list of all persons who filed for any type of disaster reimbursement through ASCS to identify potential clients. They did ”cold calls" to each farm listed. That is, at least two of the workers dropped in 90 unannouncedtoshareinformafionontheprogramwithdlefarmfanfiliesand workers. They also conducted programs in the schools to help the children and adolescents deal with the crisis. CMH in County B used press releases, and radio spots to inform persons of their services. They also presented information on their program at several community informational meetings. mm The CMH worker in County C was physically located in the CES office in the county seat. The building was handicapper accessible. The operating hours for the office are 8 a.m.- 5 p.m. though many community activities and meetings were held in the evenings. This office used a para-professional program aide, an ex—farm wife, to assist in identifying farm families that might need assistance. This staff person followed up on the list of persons who filed for assistance by phone to see if they desired any further contact. If they did, in most instances the CMH worker met with the families at their farms. These services were provided at no cost to the participants. County C used the disaster center to initially inform large numbers of people about their services. They also used television, radio, and newspapers. Their ongoing participation in the farm crisis network increased their exposure to other human service agencies for referrals. Finally, many pastors of area churches participated in the farm crisis network and shared the information on the programs with their congregations. 91 mm 3 .1.“ 8 Access to each of the CMH programs was controlled at the county level. Each agency made its own determination of the need for outreach and public relations. Programs varied in their emphasis on the client population but all programs were initiated at the county level in response to the state initiative. The physical site and hours of operation varied among counties and were linked to the outreach and public relations efforts. Each county provided outreach, though the form of that outreach varied among counties. Counties A and B provided outreach services to children and adolescents. County C did not. County A was the only county to establish a 24 hour crisis line. County A and County c worked closely with CBS and used (2133 as a physical location for a portion of their program to increase their outreach efforts to farmers and utilized flexible hours. County B and County C used the disaster lists and did outreach at the farms. County B and County C also utilized other community agencies for assistance with their outreach efforts. Respondents stated that they felt that outreach services did seem to increase the numbers of participants in the programs over what they anticipated. All of the counties participated in public relations efforts to increase knowledge of the programs. They used pamphlets, newspaper articles, and public service announcements on radio and television. County B also distributed flyers at the CES office. County C used the farm crisis network and church announcements to increase public information. The public relations 92 efforts did seem to increase the numbers of participants in the programs. The program in County A closed in August prior to the conclusion of the grant period while the programs in County B and County C received continuation grants and special funding. The questions come to mind why did County A operate this way and why did the others continue? Why does it appearonthesurfacethattheprograminCountonfferedthesameaccessbut the people did not come? These questions will be pursued in Chapter 6. LIES mm The CBS office is located in the county seat in an older county building. The building is not handicapper accessible. The hours are from 8 a.m.- 5 p.m. with flexible hours as needed for meetings. CES does outreach as part of its ongoing program and included outreach on the flood projects on a regular basis. They primarily served a facilitating role between the farm families and the community agencies that were providing programs. All of the printed materials from any participating agency were available in their office. The staff participated in interviews regarding the flood that were included in all media forms. They also assisted CMH in formatting the information that was distributed to the farm families. 99.111113 The CBS in County B is located in the county seat. The building is an older county building and is only partially handicapper accessible. 93 The hours are from 8 a.m.- 5 p.m.. Evening and weekend hours are scheduled as necessary for meetings and activities. CES does outreach as part of its ongoing program. They increased their outreach efforts in response to the flood crisis. They did this through special publications, increased contact with farm support groups, and presentations in the school. The emphasis in this outreach was to increase community awareness and utilization of the programs that were available. The staff issued press releases, gave presentations to service clubs, and distributed flood program information from other agencies throughout the community at any site they visited. W The CBS in County C is located in the county seat. They share a conference room and other space with the County Commission. The building is handicapper accessible. The hours are from 8 a.m.- 5 p.m.. Evening and weekend hours are scheduled as necessary for meetings and activities. CES does outreach as part of its ongoing program. They increased their outreach efforts in response to the flood crisis. They issued special publications, made presentations to service clubs, and informed each client they worked with about the programs that were available. They offered physical space in the office to the CMH flood project worker. They also assisted in identifying an ex-farm wife to work on the CMH project. The staff utilized the farm crisis network to expand the knowledge in the 94 community about the various programs. They also distributed pamphlet and other printed materials from other agencies at the CES office and places they CES ! 'I 'l Ii 5 CES access varied minimally among counties. CES served a facilitating role in each county. Any differences among counties were in the form of the agency’s response but not in the act of responding. 5 '1 TI S Access to services in DSS seemed to be determined more by the local interpretation of policy than by physical location, hours, outreach efforts or public relations efforts. In MESC none of the selected indicators made a difference in the clients access to service. The clients wanted these services and took the initiative to secure them. In CMH the structure of the program as designed by the local agency did seem to impact access. Also, existing interagency linkages enhanced access. Outreach and public relations seemed to play a very important role in CMH access. The removal of stigma for non-traditional clients may also have played a role in access to the CMH agencies. Access to CES services seemed to be equally consistent among counties. CES served a facilitating role to assist the other agencies expand their services to non-traditional clientele. 95 In DSS and MESC, the state control over access to the program was emphasized. Local control played a larger role in CMH and CBS access issues. Overall, outreach and public relations seemed to increase access with the exception of MESC in general and CMH in County A. Timeliness Intmdnfiinn The indicators of timeliness used in this study are: participation in the disaster site; how quickly programs were initiated following the disaster designation; and the length of time clients had to wait to receive the service. The information is discussed by agency and county below. DSS CountLA County A did not organize a central disaster site. The DSS director stated that the emergency needs programs were not utilized within the county. Cguntyj County B did participate in the central disaster site. They did not implement any emergency needs programs in the county. CgungLC County C did participate in the central disaster site. All persons who received services at that site had contact with DSS. They did implement the emergency needs program that was available 96 through the State office. This program was in operation within one week of the opening of the disaster site. The director stated that the usual waiting period for benefits was three to four weeks. W None of the indicators of timeliness seemed to make a difference in the agency’s response. Participation in the disaster site, the time frame for program initiation and the length of time for results to be implemented did not seem to impact performance. MESC QQunQLA County A did not organize a central disaster site. The Disaster Unemployment Assistance program(DUA) was implemented within one week of the disaster designation. Processing of claims took from twor'three months. County} County B participated in the central disaster site. The DUA program was implemented within one week of the disaster designation. Processing of claims took from two-three months. Cgunu County C participated in the central disaster site. The DUA program was implemented within one week of the disaster designation. Processing of claims took from two-three months. Want The indicators of disaster site participation, time frame of program initiation and time until visibility of results did not seem to impact the response of the agency. m CountyA County A did not organize a central disaster site. CMH did elect to participate in the state program. Startr'up time was approximately one month from the time of the disaster designation. Processing time for clients was from one to two weeks. CountyB County B participated in the central disaster site. They wrote a proposal to participate in the state program. This program began approximately one month from the time of the disaster designation. Processing time for clients was from one to two weeks. County_C County C participated in the central disaster site. They participated in the state program. Their project began approximately one month from the time of the disaster designation. Processing time for clients was from one to two weeks. C! m I' I' S The indicators of disaster site participation, time frame of program initiation, and length of time until results did not impact the response of the agency to the crisis. 98 SEES County_A County A did not organize a central disaster site. CES implemented the state request for assistance within one week of the disaster designation by coordinating office space with CMH. CES responded to requests for information and from county residents within one week. CountyB County B participated in the central disaster site. CES implemented the state request for assistance within one week of the disaster designation through increased multi-media contacts. County residents received information within one week of requesting it. County; County C participated in the central disaster site. CES implemented the state request for assistance within one week of the disaster designation through a joint proposal with Community Mental Health and expansion of information services. County residents received information within one week of requesting it. [ES 1. l' S The indicators of disaster site participation, time frame of program initiation, and length of time for program results did not seem to impact the response of the agency to the crisis. 0 II I. l' S The selected indicators of disaster site participation, time frame of program initiation, and length of time for program results did not seem to impact the response of any of the agencies studied. Consistency Introduction The indicators of consistency used in this study were: overall standardization of the program within the county; common definitions of eligibility; common forms for processing; and common results (i.e.services received by clients). The information is discussed by agency and county below. DSS CounnLA County A did not participate in the state emergency needs program. They were consistent in all categories since no one received service. County_B County B did not participate in the state emergency needs program. They were consistent in all categories since no one received service. County_C County C did participate in the state emergency needs program. A DSS representative met with each person filing for assistance to inform them of the DSS programs and to assist them in the completion of the forms. The emergency needs supervisor said that the Executive Director for the county assisted in developing the debt/asset ratio form that they used with all farm families. In addition, she stated that she sent all the farm families to the same set of workers. She said these workers were more receptive to working 100 with the farmers and that way people would be treated more equitably. (She also said that some of the DSS workers felt farmers had no rights to any benefits, regardless of the state program, so she made sure no farmers were sent to them). 75-100 farm families received assistance from DSS in County C. Wm DSS was highly consistent within each county on the indicators of standardization, common definitions, common forms, and common results. However, DSS was inconsistent among counties on these same indicators. This again raises the question of why these differences among counties occurred when each county organization was operating on the same directives from the state office. MESC Coumy_A MESC was very inconsistent on all indicators. With no physical site in the county, residents filed their DUA’s in neighboring counties. Assistance was not available for completing the forms. The definition of farm unemployment changed mid-way through the program. For example, if a person owned a dairy herd and was still milking, this farmer was considered still working even if the milking operation only produced 20% of the total previous farm income. This definition was later 101 adjusted to include this type of situation after discussions with the central office in Detroit. As a result, no one at the county level was able to facilitate the filing process for the clients. Financial results were very inconsistent. CES, CMH, Christian Neighbors, and Public Health staff all noted that they knew of circumstances where two persons with similar situations received quite different amounts of money. No one was able to understand why this occurred. CountyB The casework supervisor stated that farmers were a difficult group for MESC to handle since they didn’t fit into any of the prev-existing categories. He said that the staff attempted to be as consistent as possible but there were many difficulties built in from the start that made standardization difficult. For example, since MESC pays unemployment based on weekly income (in contrast to annual income) farmers that paid themselves a salary on a weekly basis received a lot more unemployment per week than farmers who used money when they needed it. There were other situations that didn’t ’fit’ MESC’s usual operating procedures. If a farmer had both cash crops and a dairy operation he was not considered eligible for unemployment: if he was still milking he was still ’working,’ and therefore not unemployed. Also, a farmer was allowed to do salvage work in the fields but if he said he was working or cleaning the fields and did not specifically state it was salvage work he was denied benefits. The state central office in Detroit changed these definitions of farm 102 unemployment in mid-program to accommodate these problems. The state office also changed the application forms. The county supervisor stated that this made it very difficult as they tried to assist people with the applications. He said the staff wanted to help people receive benefits but found the changes very frustrating since they had incomplete information themselves. Since all final processing was completed in the Detroit office, the county staff had minimal control over the final results. The supervisor stated that it was very difficult to explain to a client why they were denied when they often did not understand it themselves. CountyJ: MESC had one staff person that helped clients complete the paperwork in County C. He stated that many persons went to a neighboring county to file for DUA since it is a larger office. The staff person stated that the regulations made it difficult for farmers to receive MESC benefits. For example, if a wife ran the tractor and kept the books, yet listed herself as a housewife and not a farmer on the annual income tax, she was not eligible for benefits. Efforts at standardization within the county were also hindered by the amount of paperwork needed. Different information was required for individual farmers, partnerships, incorporations etc. . He stated that it was extremely difficult to be helpful. Definitions and forms were changed mid-stream. He said that he felt this was an attempt to be helpful to farmers but that it was so complicated that many of them left and did not return. 103 He also stated that in many instances he did not understand why one person received benefits and another did not. He stated that the entire process was a "mass of confusion". mm For the only program whose services flowed through a single point, MESC was consistently inconsistent. The indicators of standardization within the county, common definitions, common forms and common results all yielded mixed results. These indicators differed widely within each county. They also differed among counties. Since all the determinations were made out of the Detroit office this lack of consistency was unexpected. M W The CMH organization in County A utilized common definitions and common forms. However, of the nine other agencies interviewed, only CES knew about the CMH farm crisis program. Both the CMH and CBS workers stated that the CMH farm crisis program was never fully integrated into CMH or the community. The CMH farm crisis program was terminated by the State office three months before the scheduled termination date due to lack of use. CountyB The CMH organization in County B did use common definitions, common forms and seemed to achieve common results. All eleven of the other agencies in the county that were contacted were familiar with the 104 program- The project provided direct service and information and referral services to several farm families. Exact numbers are not available since FEMA does not allow their release. This is based on the concept that distress resulting from a disaster is a normal reaction. Records are destroyed upon the project’s completion to avoid labeling and stigma of all the participants. W The CMH organization in County C did use common forms, common definitions and seemed to achieve common results. Each of the fourteen other agencies in the county that were contacted were familiar with the program. The project provided direct service to many farm families. As noted above under County B exact numbers are not available due to FEMA regulations. Wu County B and County C were standardized and consistent within the county on the indicators of common definitions, common forms, and common results. County A used common definitions and common forms but they did not experience common results. TIES CountyA CES services were standardized within the county. They used common definitions, materials, and programs from the state office. They 105 facilitated farm families use of services from other agencies. Qounty_B CES services in County B were standardized within the county. They used common definitions, materials, and programs from the state oflice. They facilitated farm families use of services from other agencies. Countyfl CES services in County C were standardized within the county. They used common definitions, materials, and programs from the state office. They facilitated farm families use of services from other agencies. CES_ Wu The indicators of standardization, common definitions, common information, and common results did not vary within or among the counties studied. War! The indicators of consistency varied across agencies and counties. Consistency could vary both within and among counties. MESC and DSS varied the most. CMH experienced some variability in County A. CES did not vary on the selected indicators. Service Design Introduction The indicators of service design used in this study were: the degree of centralization of authority; structure of the internal organization; 106 interorganizational links; and consumer participation in the program design. The information is discussed by agency and county below. DSS policy is set at the state level. However, the county director is responsible for seeing that the policy is implemented within the county and his/her philosophy can affect policy resulting in a form of modified centralization. The organization can be classified as a typical bureaucracy with a formal organizational chart resembling a pyramid. There are clear paths of authority. All local DSS offices have a three person advisory board composed of county commissioners. N 0 other mechanism exists for consumer participation at the county level. (mum In County A, DSS did not participate in any inter- organizational groups or committees. The child abuse and prevention council (an inter-organizational council that is mandated by law) had not met in over one year. County A’s DSS does have an advisory committee composed of three county commissioners. They are potential recipients but not consumers of DSS services. None of the commissioners on the social service board were farmers. CountyB DSS in County B participated with other agencies in a variety of ways. They participated in the child abuse coordinating council, the job training consortium, the substance abuse council and the central disaster site. 107 All of the other agencies interviewed were aware of DSS ongoing programs. They were also aware that DSS did not provide emergency services following the flood. The DSS office in County B does have an advisory committee composed of three county commissioners. They are potential recipients but not consumers of DSS services. None of the commissioners on the social service board were farmers and no other mechanism for consumer participation exists. Countyfi DSS in County C was heavily linked with other agencies in the community. In addition to the child abuse prevention council, the employment consortium, and the substance abuse council, DSS also played a leadership role in the farm crisis network. All of the other agencies interviewed in the county were aware of DSS ongoing programs and their special programs for disaster assistance. DSS in County C does have an advisory committee composed of three county commissioners. They are potential recipients but not consumers of DSS services. Two of the commissioners on the social service board were farmers but no other means of consumer participation exists. mm The DSS in each county experienced a high degree of centralization and formalization. All of the DSS agencies were rigid in their internal organizational linkages. However, variance occurred in the external 108 organizational linkages. County A had minimal linkages, County B had moderate linkages with external organizations. County C had a high degree of interorganizational linkages in place prior to the crisis. Counties A and B did not have farmers as consumers included in their service design in any manner. In County C two of the three social service board members were farmers but this was the only point of input for consumers. MESC MESC had no control or input into the disaster relief program at the county level. The organization can be classified as a typical bureaucracy with a formal organizational chart resembling a pyramid. There are clear paths of authority. There is no defined role for consumer participation in service design at the county level. CountLA MESC did not participate in any inter-agency organizations in County A. They had no consumer participation in their program design. CountyB The MESC supervisor stated that all of his staff was extremely frustrated at their lack of input into the disaster program. MESC participated in a variety of interorganizational committees. These included: the disaster site; the job training consortium; and the substance council. They had no consumer participation in their program design. Countyf, The MESC worker stated that he was very frustrated at his inability to affect the program or assist clients. MESC participated in 109 numerous interorganizational committees. These included: the disaster site; the job training consortium; the substance abuse council; and the farm crisis network. There was no role for consumer participation. W MESC had a high degree of centralization and formalization in each of the counties studied. The internal organizational linkages were also rigid in each county. Consumer participation in design was not implemented in any of the counties. The only variance in the indicators was in the area of interorganizational linkages. County A had minimal external linkages. Counties B and C had moderate external linkages. cm The Department of Mental Health at the state level requested proposals from any county that was designated eligible for disaster assistance and felt that extra CMH services were needed in their area. Each local Community Mental Health board and organization decided the extent and type of their participation. Consumers were represented on the local Community Mental Health board through advisory committees. CountyA County A submitted a proposal that was approved and funded by the state. The state approved the concept of the project. The county had control over the project design and implementation. 110 County A hired one B.A.level program coordinator on a full time basis. They also ’purchased’ 50% of two masters level workers for therapy. One of these workers went to the CES office once per week to meet with clients. The B.A. worker coordinated the project, instituted a night time hot-line, did community education, referrals, and stress management programs. She also did a natural disaster workshop in one school district and at a 4—H youth camp. The flood response project was never fully integrated into the CMH structure. The CMH project coordinator for the disaster assistance program said that she thought CMH never really wanted the program in the first place. She did not have secretarial support and was unable to receive the permission to pursue programs she felt were necessary to the success of the program. She stated that she thought the county CMH administrators wanted to use the money to support their own programs. For example, they funded a summer child-parent program with project funds yet no farm families or disaster victims participated. This was a program that had been in existence during the summer for ten years. Also, the programs were supposed to be free to all disaster victims. Yet, insurance companies were billed for the project clients that had insurance, even though the clients were counted in the project statistics. The Extension Home Economist felt that the CMH worker did not follow up on any of her suggestions to increase the number of farm family members receiving service. She stated that the CMH worker coordinating the flood disaster program needed to be more involved in the community. None of the 1 11 other agencies interviewed in the county were familiar with the program. The CMH flood project did not participate in interorganizational exchange with the exception of working with CBS. The ongoing CMH program did not participate in any inter-agency councils or groups either. CMH includes consumers on its citizen advisory board, however, none of the board members were farmers. County_B County B CMH organization submitted a proposal that was approved and funded by the state. The state approved the concept of the project. The county had control over the project design and implementation. County B hired three B.A. level outreach workers and one masters level counselor to work on the flood project. The staff prepared a resource directory targeted at farm families. They approached every family that applied for disaster assistance. The B.A.workers provided information and referral services, community programming, and workshops in the schools. The masters level worker did more intensive individual and family counseling. The program was well integrated into the local county CMH structure. The workers participated in all staff meetings and activities. They utilized the general secretarial pool and had offices in the CMH building. The program was also well integrated into the community. They worked closely with CBS, as well as other community agencies and churches. Each of the other agencies within the county were familiar with the program. Their information and referral resource guide was available throughout the community 112 at agencies and businesses. The local county CMH does have a citizens advisory board. The president of this board is a farmer. Counlyfl County C submitted a proposal to the State Department of Mental Health that was approved and funded. The state approved the concept of the project. The county had control over the project design and implementation. County C hired one masters level therapist and a part time para- professional. The masters level therapist was a CMH employee who requested released time to work on this project. He worked out of the CES office on a full time basis for the duration of the project. The para-professional was an ex—farm wife who was already working with CES an a job retraining program for persons exiting farming. The program was structured outside the normal CMH organization. However, the worker stated that he made a special point to be visible in the CMH office each day. He also said that he stopped by on at least a weekly basis to inform the CMH executive director of the projects progress. This was in addition to the monthly written reports. This program was extremely well linked with other community organizations. The worker participated in the farm crisis network, the minister’s network, the substance abuse council, the job training consortium and the chamber of commerce. He stated that he was a member of the chamber 113 sincehesoldwaterpurifiersonaparttimebasis. Hesaidthatthechamber provided an excellent means of broadening the base of support for the CMH program. The worker stated that the CES involvement strengthened the community linkages through offering physical space and sharing networks and contacts. The CMH worker was able to draw on previous CES contact with the target client group. County C’s CMH had a citizens advisory board. Two of the members were farmers and one member was a farm implement dealer. Winery The CMH’s in each county experienced a low degree of centralization and formalization. Each county also experienced flexible internal organizational linkages. Variance in interorganizational linkages was present. County A had minimal interorganizational linkages. Counties B and C had high degree of interorganizational linkages. Consumer participation in service design varied among counties, with County A having minimal participation. County B and County C had a higher degree of participation, though all participation was limited to membership on the local advisory boards. CES CES had a low degree of centralization in each of the counties studied. They were able to conceive and implement programs that they thought were 114 needed in their county. The state office requested increased programming as a result of the flood but the form of that programming was completely up to the county office. CES had a high degree of consumer participation reflected in various advisory committees and participation by staff in interorganizational groups. CountLA The program in County A focused on facilitating farmers’ knowledge and utilization of other programs. The CBS office gave space to the CMH program and also shared lists off farm families with CMH. They also did an in-service for their clerical staff so that they could be helpful to clients on the phone. The County Extension Director stated that CES wanted to be helpful and responsive in any way possible. CES was linked with CMH for the flood project. The Extension Home Economist stated that CES had tried to do some other programming with CMH in the past and she had not found them to be very responsive. CES did not participate in any other human service organization network. They did have extensive linkages with farm associations and commodity groups. CES encourages consumer participation in a number of program related advisory councils. Many farmers are among these participants. County} The program in County B focused on facilitating farmers access to services of other programs. The Extension Home Economist also focused on increasing support groups for farm families that were experiencing l 15 County B CES participated in a number of inter-agency programs. These included: the employment training council, the substance abuse council, and an adolescent project. These were in addition to the more traditional farm associations and groups. CES encourages consumer participation in a number of program related advisory councils. Many farmers are among these participants. W The program in County C focused on facilitating farmers access to services provided by other programs. The CMH project was located within the CES office. CES participated in several interorganizational activities. They were members of the farm crisis network, the child abuse council, the substance abuse council, and the job training program. These were in addition to the numerous traditional farm associations and groups. CES encouraged consumer participation in a number of program related advisory councils. Many farmers are among these participants. CES S . D . S CES experienced a low degree of centralization and formalization in each county. The internal linkages were also flexible in each county. County A had a moderate amount of interorganizational linkages while Counties B and C had a higher degree of interorganizational linkages. Consumer participation in 1 16 service design was moderate in County A but higher in Counties B and C. W DSS and MESC both had a high degree of centralization and formalization with rigid internal organizational structures in each of the counties studied. CMH and CES had a low degree of centralization and formalization with flexible internal organizational structures. County A had minimal interorganizational linkages in DSS, MESC, and CMH. CES in County A had moderate interorganizational linkages. This is in contrast to County B with minimal linkages in DSS, moderate linkages in MESC, and a high degree of interorganizational linkages in CMH and CES. In County C, MESC had moderate linkages but DSS, CMH, and CES had high linkages. Consumer participation was non-existent in MESC and DSS in each of the counties. Consumer participation in CMH varied from minimal participation in County A, to high participation in Counties B and C. CES had moderate consumer participation in County A. Participation in Counties B and C was high. W A cumulative summary of the selected indicators of service effectiveness response to farm families is presented below by organization. 117 1285 Accessibility did not vary within counties but did vary among counties. Timeliness did not seem to impact service effectiveness. Consistency did not vary within counties but did vary among counties. Service design indicators did not vary within the counties but did vary among counties specifically in the extent of linkages with external agencies. MESC Accessibility did not vary within or among counties. Timeliness did not seem to impact service effectiveness. Consistency varied on all indicators both within and among counties. Service delivery did not vary within the counties but did vary among the counties. CMH Accessibility did not vary within the county but did vary among counties. Timeliness did not seem to impact service effectiveness. Consistency varied within County A but not Counties B and C. Service delivery varied within and among counties. CES Accessibility did not vary within or among counties. Timeliness did not seem to impact service effectiveness. Consistency did not vary within or l 18 among counties. Service design did not vary within the county but did vary in the extent of external linkages. Chapter six will provide a discussion of these findings as well as a more detailed discussion of key variables. CHAPTERSIX SUMNIARY, CONCLUSIONS, AND RECOMMENDATIONS Summary We!!! Legislators, policy makers, administrators, service providers and recipients are all concerned with the effectiveness of human service organizations. The inability to consistently identify and manipulate indicators of effectiveness hinders the planning, implementation, and evaluation of human service organizations. Research is needed to expand the knowledge of indicators of effectiveness and their responses in a variety of situations. The concept of service effectiveness has been particularly elusive. Ihisstudr This study was conducted as a sub-section of a larger study funded by a special grant from the Michigan legislature to the Agriculture Experiment Station at Michigan State University. The purpose of the larger study was to summarize the impact of the 1986 flood and the ongoing farm financial crisis on Michigan agriculture. Data was collected during 1987 and the final report was delivered to the Legislature in January,l988. 119 120 This particular study explored the response of the human service delivery systems in three rural Michigan counties to the 1986 flood. The focus of the study was on an attempt to identify variables in the structural and programmatic responses of the human service organizations that impacted service effectiveness, particularly on the non-traditional agricultural clientele. The data was collected in three rural counties selected by the research team for intensive study during the summer of 1987. Field research was selected as the most appropriate methodology due to the nature of the problem, the research questions, the state of the literature, the amount of information needed, the time span, and resource constraints. The social reconnaissance method of field research, as developed by Irwin T. Sanders, provided the methodological framework for the study. Intensive interviews with key informants provided the data. The emergency situation provided a window into organizational effectiveness and particularly service effectiveness, as the flood crisis disrupted the normal functioning of the human service organizations. The human service organizations faced immediate and heavy demands from the larger community. Their ability to respond and the nature of that response provide insight into the variables that contribute to their service effectiveness. The research questions were as follows: 1. What was the initial response of the community to the flood crisis? 2. How were several selected social service agencies organized in three 121 different rural communities, and what services did they provide? 3 . How did the selected social service agencies in three different rural communities respond to a common crisis (a flood) in terms of: organizing and delivering services to a different clientele than usual? 4. What variables affected the organizational effectiveness of the response of the agencies: accessibility; timeliness; consistency; and service design? 5 . What implications do the results of the study have on how human service agencies can enhance organizational effectiveness? Conclusions QnmlLResults An overall summary of the results would suggest the following path of the indicators of service effectiveness: Access— > Y Timeliness— > Service Design— > Effectiveness l N Consistency Em Path of Indicators of Service Effectiveness Access is either present or absent. If access is present, timeliness becomes the next important variable. In a crisis situation the timeliness of the response can make the difference between utilization or lack of service. 122 Following this, service design would assume precedence with consistency being included as a factor of service design. 11 Th l' I 5 Access is a critical variable because it is the entry point into the delivery system for the human service organization. This would suggest that accessibility to service needs to be emphasized as a focal point for service effectiveness. In this particular study the access of farmers to selected human service organizations following a crisis was reviewed by agency and by county. Each of the organizations studied was a statewide organization with a mandate to provide services in response to the crisis. Yet from the data it seems that the mandate to provide services was necessary but not sufficient for access into the delivery system of the human service organization. Why was this so? One possible explanation might be that the human service organizations were not able to respond to this crisis since they do not usually serve this population (farm families). For example, access to MESC was extremely complicated in all the counties. Midway through the implementation phase the organization redefined its definitions of farmers in response to political pressure. MESC does not typically serve the farm population and was unable to respond quickly to the special problems presented by farm unemployment resulting in frustration on the part of county staff and of the farmers. DSS provided services to farmers in one of the three counties studied. 123 Again, from comments made by staff in each of the counties, it is evident that they do not usually provide service to farmers. CMH staff also commented that they lack experience in providing services to farm families. CES was the only organization studied that had extensive experience in providing services to farm families. Another possible explanation for the differential access may be found in the degree of local control experienced by the administrators of the program. No local High local control control MESC DSS CMH CES W Extent of Local Control MESC had no local control or discretion in the administration of the program. Everything was funneled from the Detroit office. As a result, the organization was not able to respond quickly even when the problems inherent in servicing the farm population became evident. On the surface it seems that DSS had no local control. However, access to the program was largely determined by the position of the County Social Services Board and the County Director. Two of the counties made no effort to implement the state program. The third county not only implemented the program but received permission to use a different debt/asset ratio form than 124 the general form designed at the state level. The fact that two of the three commissioners on the Social Services Board in that county are farmers combined with that county’s heavy dependence on agriculture suggests that the political clout of farmers is an important factor in their ability to have access to human service organizations. CMH had more local control than DS or MESC yet in one of the counties studied the CMH disaster program was terminated before the end of the grant period. Since each county was able to design and implement their own program why did this happen? In looking at this particular program in more detail it is possible that though the county administrators had control over the access to the program as well as its service design, behaviorally they did not support the program. For example, the disaster worker had no support staff. Also, the implementation of the service design gives us additional clues. Though the service was designed to be free, farm families that had insurance were charged for the services. In effect, the staff time was paid for by the flood disaster project and by the insurance of some farmers that did participate. Monies targeted for prevention services to children as a result of the trauma they experienced were utilized to fund a summer program that had been in existence for the last ten summers. No farm children participated during the course of the study. These factors, combined with limited outreach, would suggest that the administration of the program utilized the monies to fund ongoing programs and did not have a deep 125 commitment to meeting the needs of the farm families. 1' I. In this particular study, timeliness did not vary among counties. In addition, in those counties that did implement the programs, they were implemented quickly. It is possible that timeliness would be a factor if it varied among counties or if an organization did not respond in a timely manner. Consistencr Consistency was constant within each organization on a county wide basis with only one exception. CMH in County A did not standardize their response and did not experience common results. This could be due in part to the suspected lack of administrative commitment to the program. It could also be due in part to the youth and inexperience of the crisis program director as it was her first position upon receipt of her B.A. degree. It could also be due to the lack of pre-existing linkages within the broader community. Wotan Other factors in service design also made a difference in service effectiveness. For example, as stated earlier three of the four agencies studied had minimal experience with farm families. Yet, CMH was able in two of the three counties studied to respond to the need. It is possible that this is due in 126 part to the ability of the staff in those two counties to minimize the stigma associated with receiving services. These two counties initially had a central site where everyone went to receive service. This design of the initial response in itself reduced the stigma since all recipients of any service were processed through the same site. In one of the counties all recipients went to DSS regardless of their self-identification of need. The worker had stated that because DSS was checked on each referral form she felt that the stigma usually attached to the agency was reduced. In the two counties where CMH had high caseloads in the disaster project the workers also made a conscious effort to reduce stigma. For example, they made cold calls on anyone that had received financial assistance of any form from the federal disaster funds. In both of these counties, the CMH workers did extensive outreach and met with farm families on the farm rather than asking them to come into the office. Additionally, it is possible that the fact these two counties made an effort to include male workers as part of the team also increased their success with the male farmers. Besides the outreach efforts at the farm, they also utilized other agencies to distribute materials and increase awareness of the services. The brochures and pamphlets emphasized the fact that the flood affected everyone and that it is normal to have responses of depression or anxiety because of the crisis. They also encouraged concern for neighbors as well as immediate family members. 127 2 .I. 1.] Though preexisting organizational linkages was not selected as a variable, many respondents commented on its importance. In referring to the earlier data, it appeared that those counties that had pre-existing linkages were more likely to implement a strong county wide disaster response plan. In addition, the interagency cooperation seemed to enhance the responsiveness of the organizations. Also,the counties that had strong inter-organizational linkages provided more total service than the county with fewer inter-organizational linkages. In-depth information on the nature of the relationships would need to be included formally in a future study. For instance, what was the effect of sharing office space ? In this study CES and CMH shared office space in County A and in County C. This was a very successful model in County C but totally ineffective in County A. Further research is needed to determine why this difference occurred. Slfll'l'l' II I 1' Though staff initiative and leadership were not selected as variables for this study it is likely that they also played an important role. In the two counties where staff were more involved, it seems that the organizations were more responsive to the farm families. CES in County A did not have as many external linkages as in County B 128 and County C . It could be that CES’ efforts fell on non-responsive organizations. Also, the CES organization in County A had just experienced a change in staff. The County Extension Director that left was very popular and it is possible that the new agent had not had the time to solidify contacts. Implications This study contributes to the knowledge base of organizational effectiveness, specifically service effectiveness response in human service organizations. The use of a crisis situation to highlight potential indicators of service effectiveness response allowed a concentrated view of the organizational functioning that may not be as evident during its day to day functioning. The demands of the crisis situation tore the organization open for public viewing. The ability of the organization to respond and the form of this response was examined through the selected indicators. Since this crisis was so widespread, the use of a multi-site design allowed a larger degree of generalizability than is possible with single site case studies. A review of the service effectiveness indicators both within each organization and county and among organizations and counties strengthened the results. As stated in the literature review, service effectiveness response addresses the organizations’ attempts to respond to the surrounding 129 environment. The results of this study emphasize the importance of access and service design as indicators of response in overall service effectiveness in a crisis situation. This study suggests the importance of outreach efforts to access in a crisis situation. It also suggests the importance of pre-existing inter- organizational linkages to the service design in times of crises. Though some work had been done in this area previously, there has been little empirical verification of indicators of service effectiveness in times of crises. Administrators, policy makers, and human service workers can use the results of this study to assist in the planning, implementation, and evaluation of human services. For example, since access and service design seem to be key variables, resources of time and funding could be allocated to these areas. Outreach was critical to access for the non-traditional clientele in this study but is often ignored in practice. This study suggests that outreach is essential in a crisis situation. Previously existing inter-organizational linkages seemed to assist in the development of strong service designs. It is possible that prior knowledge of the organizational mission and staff allowed for increased service effectiveness. The discrepancies in service effectiveness in DSS and MESC suggest the importance of training for all county staff. It also suggests the necessity of clear and close communication between the central state staff and the county staff. The difficulties DSS and MESC experienwd with the farm families also 130 suggests the importance of understanding the particular mds of groups of non- traditional clients. In this situation the organizations had no consistent way to deal with the implications of the debt/asset ratio. Policies need to be sensitive to need, yet consistent throughout the organization. Finally, the importance of the political clout of policy makers cannot be overlooked. Service effectiveness response was stronger in County B and County C where farmers were more visible on the elected county boards. Limitations There are a number of limitations inherent in an exploratory comparative study that are limitations in this specific study. By nature this type of study is often suggestive rather than definitive. In addition, it is not possible to give precise descriptive statements about a large population. Reliability is always a problem in this type of study. The use of comparative analysis helped address this issue, however, bias on the part of the researcher or the key informants could skew the results. Replicability in the scientific sense is not possible. Generalizability is also a problem with this study. As mentioned earlier, the use of comparative data is helpful in addressing this problem but does not eliminate it. This study can suggest areas for further exploration. This research study was the result of an emergency situation. Though 131 this crisis provided the opportunity to view service effectiveness, the crisis situation also contributed to some of the limitations of the study. For example, FEMA requires that CMH data be destroyed at the end of the disaster projects to avoid stigmatizing the population served. This is based on the assumption that all persons would experience difficulties during a crisis situation and would return to their normal state of functioning by the end of the crisis. This meant that exact numbers of clients served were not kept which severely limited this study. Additionally, the results are only good in a crisis situation but are not reflective of the routine day to day operations of the organizations. It is quite possible that in a non-crisis situation with traditiional clients service effectiveness would be different. Also, the selected organizations have different missions so service effectiveness is relative though the inclusion of data from three counties strengthens the comparison. Another unanticipated difficulty was in the overall record keeping of the selected organizations. There was a surprising lack of total documentation of all service provision. In addition, with the exception of CES, the organizations did not keep separate statistics on farm families, rural residents or town residents. This data would have strengthened the study considerably. Each of the organizations stated that it would be useful to have this information. A future study may be possible that will be more successful at obtaining this type of data. 132 Recommendations This study suggests future research in a number of areas. Access and service design were strong indicators of service effectiveness in a crisis. It would be interesting to examine these two variables in a non-crisis situation using data from the same organizations. The impact of pre-existing organizational linkages as an indicator of service effectiveness could also be explored. A number of studies have been done on inter-organizational cooperation but these have not looked at this variable as a predictor of service effectiveness on a more generalizable scale. If pre-existing organizational linkages were found to be a predictor of service effectiveness response, the implications for service design are numerous. This study was qualitative by design since indicators of service effectiveness were being identified and examined. If more quantitative data were available on services provided to farm families it might be possible to do a broader study of these indicators that would have greater generalizability. This information would also assist the organizations with their policy decision making and planning. APPENDICES APPENDIX A STATE DESIGNATED FLOOD IMPACTED AREAS “A to?” NW ALGEI m M Luci m “We WW ‘ “I," w” 50"“ "so, i i fig 4' 49"» MW mm manna M's! mm assumes m one-um Ino- uuls oectou curls Mm mac oceans mam 'Mlooau mum um lav ' I vuecou W W mm! W xtuv -" _ V, ' unfit . arr-mu an": IOIOIA W W: noun _ mum We M urea mm W ; CA“ I‘. M IMHO! W WWI! 133 APPENDIX B TYPICAL INTERVIEW Introduction Who you are. What we are doing. What kind of information we are looking for. How long we need to talk. What value this project will have. (Use letter of introduction and handout, if necessary.) Establish Respondent’s Areas of Competency His/her job and position. Nature of the business, organization, agency Relate personally to these in some way. Some Direct Target Questions 'As you see it, what have been some of the more significant changes that have occurred in this community (this community, this county, this area) --this past year (since last summer) ---during the past five to ten years." ”During recent years agriculture in America has been experiencing some difficult times. As you see it, have these farm problems been very serious around here? Why is that? Explain. ”Have any farm problems had a noticeable effect upon your community in any way?” How so? 'Do any of the effects or changes you have noticed seem temporary? Or do you think they are of a more lasting permanent kind? I guess what I am asking is if the quality of life around here is changing and in what ways?” ”Who is most affected by these changes? And in what ways?” ”What about five years down the road from now? What do you see as the future of this community, given the extent to which it is dependent upon farming?" Sector Foci Questions ”What about the sector you represent (business, agency, government, health, real estate, schools, churches, sales, etc.) “Have things been changing? In what ways?” 134 'Have any of the problems in agriculture had a noticeable effect upon your sector? What kind of problems have been manifested?” 'Have these problems been mainly financial? Or have there been some social or even psychological effects and changes that you sense?" “What about community morale? What was it like last summer? What about now?” “What is your sector doing to help improve conditions? (your fellow business people, the governing boards in the township, farmers in this area, etc.?)" ”What is your sector doing to help improve the community-n- and maybe to strengthen the situation of farm families around here?“ Collect Hard Data, If Possible Statistics on trends in schools, business, township, etc. Suggestions About Whom Else To Consult Thank You. 135 LIST OF REFERENCES REFERENCES Abels, P. and Murphy,M. 1981 MW Siam: Appronon, New Jersey: Prentice-Hall, Inc.. Allen,.J W. 1989 WWW Examples—9f W Washington, D. C: Urban Institute. Axinn,J. and Levin,H. 1974 W New York: Free Press. Babbie,E. 1983 :1th Fmotioo of Sooinl Rosoaroh.Belmont,California: Wadsworth,Inc. . Bachrach,L. L. 1981 Rockville: Department of Health and Human Services. Baldwin,J .N. 1987 ”Public Versus Private: Not That Different, Not That C0nsequential.’ MW 16. 181-193. Bell,W. 1983 Contompomryfiooialflelfam. New York: Macmillan Publishing Co. . Bendor, J., & Moe, T. 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