Human Services Integration

The fashionable phrase, "human services integration," has many possible operational meanings. It is especially important to distinguish between integration as a set of administrative techniques or structural arrangements, on the one hand, and integration as a characteristic of services or their manner of delivery, on the other. This leaves open the possibility of empirically testing how certain structural changes might affect the delivery of services. Human services integration, as a set of structural changes, may be subdivided into (1) changes that appear to require at least some further centralization of authority; and (2) those that may allow continuation of the present typically pluralist or fragmented administrative pattern. The former are consistent with the principles of "scientific management" or "corporate rationalization;" the latter tend to increase the flow of service-relevant information laterally (among professionals) and downward (to clients). It is important to consider separately how each type of structural change may affect various services dimensions, including: accessibility, rates of use, efficiency, and effectiveness. Any causal connections between structural changes and dimensions of improved service delivery are mediated through changes in role and extra-role behavior. *A revised version of the paper, "Human Services Integration," presented at the 1976 meeting of the Ohio Academy of Science's Section on Administrative Sciences and Planning was published in PUBLIC ADMINISTRATION REVIEW, 1977. The latter may be especially important to integrating services, since it encompasses creative acts including initiation of cooperation, suggestions for improving organization, and self-training for new responsibilities. Different definitions of services integration may serve different political interests. Groups concerned with extending management control over a larger functional domain or a larger pool of resources will find it convenient to use "human services integration" to mean some degree of administrative integration. On the other hand, advocates of increased service effectiveness or improved quality and availability of services to client groups may be expected to define integration in terms of service delivery. There is some reason to believe that centralizing authority over services is either unrelated to or negatively associated with improved services delivery. This raises questions about the efficacy of federal proposals to improve services through administrative integration. Whatever its probable effect on the delivery of services, administrative integration must be regarded politically as an effort to legislate and enforce greater centralization of authority over a fragmented structure. It now appears that one set of interests has used the rhetoric of human services integration to mask and legitimize its challenge to the entrenched power of the autonomous human services professions. In the process, the question of whether one or more types of structural change can lead to improved delivery of services has nearly been lost.