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Toward a Single Coherent Vision: Sustaining Interdepartmental Collaboration to Support Community Integration for Persons with Disabilities
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Modeling automobile manufacture after uncoordinated human services illustrates the shortcomings of a delivery system without cohesion. Rather than selling a car fully assembled, it would be up to the customer to figure out which parts are needed, where to buy them, and how to put them together to the best effect. There would be no overall design for the car and no quality management to make sure the parts fit or to determine how well the cars were working. There would be no way to measure how much each car cost or to determine the most effective allocation of resources.

While the delivery of human services is considerably more complex than car manufacture, comparing the assembly of an automobile to coordinating the interdepartmental delivery and management of human services helps to illustrate the need for investing in collaboration. An automobile manufacturer sees bringing the parts of a car together and assembling them into an automobile as part of the series of steps required to produce a car. No one expects it to happen for free. Someone at Ford Motor Company is paid to know how the different parts are related and to have a plan for how they should come together. There are people paid to assemble the car; assembly is not something they try to find time for, in between their other responsibilities.

In contrast, we often seem to see the “assembly” of the disparate services provided by the State into a comprehensive human service system as either an unnecessary step or something that should happen automatically, without additional resources. Interdepartmental coordination and collaboration might be a stated goal, but often departments are not given or do not make available the necessary resources to make it happen. As a result, the “specialization” within individual departments and bureaus results in “fragmentation.” For a state, the cost of not collaborating means an inefficient use of resources and ineffective services. From the consumer perspective, lack of coordination means frustration, wasted time, and can sometimes lead to more dire consequences such as institutionalization or incarceration, poor health or death.

This document is written in the wake of a two-year process of developing Maine’s response to the Olmstead decision. The purpose of this document is to marry the resulting vision for coordination and consistency across departments with a sustainable, collaborative governance structure that will incorporate that vision into the workings of Maine’s state agencies. (Author)
Boston, MA
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A program of the U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration, Center for Mental Health Services