Outline • Definition • Historical and rationale of integration • Model of integration - profession oriented integration - method oriented integration - agencies oriented integration - locality oriented integration - client oriented integration • Difficulties and solution of integration • Discussion • Others
What is integration? • It is to change the different parts into a new whole. • During the integrating process, each of the different parts will have to have some adjustments in order to cope with the change. • The quality of the new whole is totally different from the quality of the original parts. (譯自: 阮曾媛琪, 1992; 社會服務整合化的意義及展望.香港社會工作學報,第二十六卷第一期)
Why do we Integrate? • Respond to the changing needs of clients and society. • Repair the difficulty in Service Centre, e.g. overloaded and overstretched. • Solve the problem on service delivery. • Prevent duplication on service.
Allow centre to allocate the recourse flexibly. • Reduce the high expenses in social welfare agencies, e.g. the salary of senior worker. • Social Workers are suggested to be generalist in all fields.
The development of integration • Social welfare in the 1990s & beyond, the social welfare Department purposed on integrated approach. (See White paper Description 1991) • It aims at solving the difficulties brought by fragmented services provided by various department or agencies. • By adopting the integrated approach, service users can more easily get access to the service, and related departments. • Agencies can provide service with existing resources more vividly and economically.
The rationale of Integration approach: 1. Coordination and Integration of the Service Delivery: • Provide clients with more convenient access to a wide range of services (e.g. One-stop service) and enable more flexible and cost-effective use of available resources. Different service units join together to work for the betterment of the clients.
2. Holistic and Person-oriented approach • The coverage of the service should include all groups in society and no group is being left out. (Comprehensive coverage)The services provided by agencies should base on the needs of clients and society. Clients can get comprehensive care. It allows the worker uses multi-content and multi-level approach to meet the needs of clients.
Profession-oriented integration Definition: different professions joint together
Advantages 1. Multi-context intervention and assessment • Since social workers may not be competent enough to cope with different problems of the service users, profession-integration helps to gather professional knowledge from different fields to provide comprehensive service to service users and assess clients’ needs in broader and diverse context.
Example: school social workers can obtain information from teachers about the student’s behaviour problem in classroom in order to provide in-depth assessments. Teachers may also assist social workers to monitor the change of client in classroom.
2. Convenient to service users • Service users do not need to go to other agencies to obtain service, but can obtain different services in an integrated centre, so it is more convenient and less time-consuming to seek for services. • Example: parents can obtain family service in I.T. centre, the PHAB Association.
3. Able to access resources quickly • Profession-integration enhances the communication and co-operation among different professions, so social workers may help to identify these professions and related resources quickly.
4. Support different professions • With communication and discussion between professions, it helps to support different professions in providing service or designing intervention plan. • Example: School social workers support teachers in handling students’ emotional problem so that teachers can teach the class effectively.
Disadvantages 1. Time consuming Takes more time to communicate and cooperate with different departments and centres, so more time is consumed in administrative procedures.
2. Difference in vision, mission and work practice among different professions • With co-operation, the workers may have to meet the demands and expectation of other professions, which service users may sacrifice in obtaining some of the services. It is also difficult for different professions to come up with a consensus.
Example: The police of Yuen Long adopted the social work notion of “zero tolerance to family violence” and co-operated with Yuen Long IFSC, they arrest abusers without trying to remedy the situation and keep them over night, so as to protect the victims and other family members. Yet police may not understand the rationale behind, they may mislead or deprive clients during execution.
3. Higher the cost of service • Having more professions to deal with a case, it accelerates the cost of service. The agency may need to employ different professionals, so the service users may not be able to afford the cost.
Models of integration • Use all three social work practice methods to deal with the different levels of client’s problem. E.g. Case, Group, Community Work. The rationale of the integration is to provide preventive, supportive and remedial services to the clients.
For example: IFSC is integrated as family resources unit (preventive and educational), family support unit (supportive and empowerment) and family counseling unit (intensive counseling). Within these service units, it includes the practice of case, group and community work to intervene with client’s needs.
Advantages 1. Actively respond to clients’ needs • The model could provide initiative to client’s needs. For example: FSC used to specialize in doing the case. The case was received passively. The center could not put the first aid and assess potential risk of the family. The support network is rather weak for those families in need. After integration, more preventive and supportive work would be done as to response to the needs of the client. Worker would go outreaching to identify potential clients.
2. Easy to assessable • Before the integration, client needed to face geographic inconvenient. Different government departments would respond to their work individually. Case department and group department were different units that located in different areas. Client needed to refer to different departments when they undertook case or group intervention. Method integration which provides all three levels of practice would be undertaken in one single unit. Client no longer needed to refer to different departments to undertake different services.
3. Person-centered • Person centered approach is likely applied as client could get comprehensive case within three aspects of intervention. Clients can obtain different intervention methods according to their needs.
4. Simpler administration • One case file is used within the agency for each client when getting different services.
Disadvantages 1. The quality of work • Dealing with all different methods may introduce much more workload and pressure to workers. Different methods may require skills to handle the tasks; the worker may not familiar with all the methods and thus have pressure when they are requested to provide services that they are not good at.
2. Use of the resources • The resources may be reduced after method integration. One service center is used to capture the work of case, group and community work. However, the resources may not be enough to provide all three aspects. Center has to balance the resources and provide a fixed amount of group work and community work project. The resources may not be flexible enough in response to client’s needs. • For example: some of the family service centers such as single parent center would be incorporated in the IFSC. The original resources to run those family centers would not be given to IFSC. There are insufficient resources to provide service to those clients and the quality of service would be lower.
3. The quality of worker • The worker used to specialize in doing one field unit, however, after integration; worker would require being skillful in both group work, case work and community work. Workers may not be able to master the demands of all the methods .They would not handle the work properly as lack of skill training.
4. Complicated administrative procedures • Different methods may associate with different administration procedures, providing all these methods by a single agency may make the overall administration complicated. Even though having the same case file, different services may still be provided by different workers
Example: • DECC (district elderly community center) • Integration of Social Welfare Department, DECC, NEC, Non-Governmental Organization elderly centres, home services, care & attention home, nursing home, the leisure and cultural service department and Hospital Authority.
Advantages 1. Re-deploying existing resources:Different agencies join in the service can manipulate the resource more efficiency. The flexibility of the service can be increase due to the more resources in used. Service become more faultless which is benefit to our service users.
2. Injection of new resources:Different kind of service provided wide range of resource. It solved the problem which is lack of resources, knowledge and professional. It expand the function to provide a wide range services to the services users.
3. Increase agencies communication and cooperation: Agencies oriented integration highlight the issue about cooperating between different agencies. The information, knowledge were interchange within agencies. Due to the cooperation increase, service become diversely and gives more choice to service users. Resources saving with integration that reduce the repetition expenditure on the same resources.
4. Save some NGO’s life and retain them in the community Resources, manpower supported by different agencies save some NGO’s life. They can had more chance to provided service and maintain there competitiveness in the community. 5. Joining professional workers together:such as social worker, psychologist, elderly assessment workers, doctors…etc. therefore, they could provide one stop-service to service users.
Disadvantages 1. More complicated cooperation that may take a long time to work with other departments. 2. Takes more time to communicate and cooperate with all the departments and centres. 3. More difficult to allocate resources because there may lack of manpower to proceed the service render provided by the different departments.
Definition • Within one locality, different agencies or workers join together. e.g. agencies join together to respond to hot issues like indecent assault. (Lo, 2006)
Example 1: • The anti-family-violence road-show of Thye Hua Kwan Moral Society, Family Service Centre (Bedok North) in Singapore.
Background: • Family Service Centre (Bedok North) located in old, poor district where a lot of women suffer from family violence. • Family violence doesn’t only happen to those low-educated women, but also to the high-education one. • Victims often did not like to disclose themselves. • “Reporting family violence is the only way to stop violence.” Fidzah (The Social worker) told us. • The goal of the road show is to arouse the awareness of local people about the issue and encourage them to report it to The FSC. • Therefore, different centre cooperated to achieve these goals.
Details of the road-show: • Road show titled “Break the Silence, Seek Help to End Family Violence” held on Sunday (July, 2006). • The road combined a myriad of elements of music, drama, games, pictures to convert anti-violent message.
Example 2: • 朗日計劃 of Yuen Long (West) Integrated Family Service Centre Programme Details: • This is a programme jointly held by an Integrated Family Service Centre of Social Welfare Department, an Integrated Family Service Centre of a NGO and a Youth Centre of a NGO.
Objective: • The programme aimed at building community and social network between CSSA recipients and single-parent families in two targeted public housing estates. The programme made use of the client data from the Social Security Field Unit to screen out targeting clients.
Example 3: • 元朗區福利辦事處—元朗西「服務區域為本」協作網絡會議 • Programme Details: • This cooperate-network meeting is organized by the Social Welfare Department. Members of the meeting included staff from Social Welfare Department, Social Security Field Unit, Family and Child Protective Service Unit, Integrated Family Service Centres of Social Welfare Department, Integrated Family Service Centres of Non-governmental Organizations, children and youth centres, secondary schools, primary schools, kindergartens. The rationale of the meeting is to create a communication platform to enhance the cooperation between various agencies and departments within the district. The meeting also served provided a platform for promotion of services. The meeting is held every half year.
The meeting focused on monitoring and improving the welfare services of the Yuen Long District. Some foci of the meeting were prevention of family violence, enhance residents’ sense of belonging, improve communication platform between agencies and between agencies and residents.
Advantages To clients: • As different types of welfare organizations will join and hold function together to target the hot issue, citizens could know more about hot issue and types of services they needed at the same time. • Locality-oriented integration responds to the hot issues which usually reflect the needs of people. • Easier to access as there are more than one agency involved. • It enhances local people’s sense of belonging to the community.
To Social Worker: • Multi-level intervention • Bring in more views and alternatives in tackling the issues • Enhance workers’ sense of belonging to the locality • Enhance the cooperation of workers in different agencies. • Self improvement by learning from other social worker on handling the case, group, or community work.
To centre: • It facilitates the mutual cooperation process among agencies within the locality • Different agencies may have different network and user groups, they can greatly increase the work effectiveness and efficiency by working together. • Agencies can assess clients’ needs in broader and diverse context.
It may simplify administration and communication procedures after discussion and compromises over communication platform like meetings • It allows multi-context intervention. • It prevents service duplication. • Better use of resources through centralized management • For the more public advertisement of welfare organizations to the citizens. • Provide different service creatively and flexibly .