Connecticut’s system of providing more than $12 billion in health and human services is confusing, splintered and inefficient. With a realignment and reorganization of the services now provided by seven separate and distinct state agencies, the state could more effectively utilize limited tax dollars, while providing better services with better outcomes.
Since taking office in 2011, Gov. Dannel P. Malloy has made strides in improving the system by adding a cabinet-level position focused on non-profits, and by creating the Governor’s Cabinet on Nonprofit Health and Human Services.
But to actually fix the big and complex problems, that now advisory-only Cabinet should be empowered to develop an overall strategic plan and to implement it.
Under the current system, the state provides day programs and group homes for people with mental illness and intellectual disabilities; substance abuse treatment; homeless shelters and shelters for victims of domestic abuse; juvenile justice and alternative incarceration programs. While some services are provided directly by the state, others are delivered through contracts with private nonprofit agencies.
A recent study of those services by CT21, a nonprofit think tank created by business and municipal leaders, found that individuals and families have a difficult time finding the services they need. Even when people are able to find and get services, there is no mechanism to determine how successful or effective those services are.
Further, the study found that each of the seven state agencies contracting with private providers has a different process for developing and requesting proposals, contracting, rate setting and payment, measuring performance, and collecting data.
While critics may argue that a new cabinet-level position or agency is simply more government bureaucracy, it could actually streamline systems, if it has a vision for change, and the authority to make it happen.
Among the charges for the new office: develop a strategic plan with a single service delivery model for all of the state’s programs and create a single system for all components of contracting, paying and accountability.
The new office could also create financial incentives for private agencies and nonprofits to consolidate and make changes of their own, such as reduction of administrative costs by sharing back-office operations or space with other providers. With creative coordination, private providers could put more of their limited dollars towards direct services.
Today, every agency has a vested interest in protecting its work, and no incentive to make the kind of transformation that is needed.
Change is hard, especially here in the land of steady habits. But as we emerge from one of the most difficult economic recessions, change is the only way we will survive.
James P. Torgerson is CEO and president of UIL Holdings Corporation and chair of the CT21 Steering Committee