By Matt Epstein
When things work as designed, the state provides core services that nonprofits enhance by developing new approaches and filling in the cracks.
When the state fails, private agencies bear the weight, competing with each other to survive. Despite yeoman efforts, private groups cannot overcome public failure, and families will continue to suffer.
Families and professionals agree that our public systems have failed, not because of a lack of good, caring people but because of a poorly designed system based on outmoded assumptions and supported by illogical policies that undermine their morale and frustrate their efforts.
Hundreds of public entities at multiple levels leave no shortage of people to answer to, just a shortage of what is needed when it is needed.
Yet no public agency has the mission of helping families in need. Break the law, become seriously mentally ill or fail in school, and you might get something, not what you need but something. Otherwise, good luck.
Our prisons, mental hospitals and homeless shelters tell the story. Ineffective systems are never good but unconscionable with a large deficit that will reduce services even further.
Real improvement would require streamlining existing agencies and refocusing on outcomes rather than process. It would save hundreds of millions but may be beyond our political will.
But even minor policy changes would have dramatic impacts.
We rely heavily, for example, on group homes for children with mental health, family and juvenile-justice issues. They come home to the same environment even less able to cope.
Research shows that intensive family-focused services produce far better results at a fraction of the cost.
Instead, families deteriorate, children suffer, and we waste $30 million to $50 million every year.
But it is not all bleak.
The state Division of Social Services is instituting “multiple response systems” at the county level that are more family-friendly and service-oriented than the traditional investigative approach.
And the state Department of Public Instruction is instituting “positive behavioral supports” in local schools to help children with behavior problems.
Both initiatives are well-researched, effective and money-saving.
In Durham, local public and private agencies are picking up the “system-of-care” mantle, dropped by the state, that integrates all services across agencies through a family-centered approach that has had excellent results in other states.
But unless the state takes a hard look at its own policies, agency structures and services, and puts needed changes into effect, isolated positive initiatives will be overwhelmed by general system failures.
Matt Epstein is executive director of the Durham-based Center for Child and Family Health—North Carolina.