Creating New Governance Structures
(Fall 1994 Networkshop)
Enhancing Service Delivery Capacities
Bryan Sperry, former Deputy Commissioner of the Texas Health and Human Services Commission and now Executive Director of the Children's Hospital Association, profiled efforts to integrate and make more accessible the state's health and human services programs.
Problems of program coordination are substantial in Texas. The state has 11 agencies with 60,000 employees, 254 counties, 100 hospital districts, 1000 school districts, 160 juvenile probation boards, and various other agencies. State strategies for improving access to systems include the following:
- Co-housing of agencies (defined as having offices in proximity or
with direct electronic links) was targeted for March of 1994.
- A rationalized system to connect the state's existing 1-800
telephone numbers is being developed. There are nearly 100 such numbers
for health and human services alone.
- A strategic plan for information resources development has been
established, and funding for Management Information Systems (MIS) has
been sought. Agency efforts are being coordinated through the
Department of Information Resources. 4. Cross-agency study of
capabilities with respect to personnel, cost-accounting, and facilities
management is in process. Maintaining these internal systems requires a
great deal of managers' time, and making them compatible among agencies
is important to integration efforts.
- Coherence within systems is being promoted through reorganization
of state agencies. To avoid the possibility of agency reorganization
producing high anxiety but low impact on local conditions,
restructuring recommendations made to the state legislature give
careful attention to system goals and to design of local
service-delivery options.
- Reconceptualization of the nature of health and human services is
taking place. Focus has been on explaining Texas' roughly 300 programs
in a way useful to policymakers and the general public, who typically
have no personal experience as clients or service providers in the
system. A new plan and new budget are to be presented to the
legislature by the spring of 1995.
- An attempt to maximize use of available federal funds is being made. The Health and Human Services Commission budget has been cut by $300 million--funds that will have to replaced primarily through federal sources.
