New York City’s eight health and human services (HHS) agencies provide billions of dollars worth of services each year to more than two million people,1 many of whom are served by more than one agency. The services offered by these agencies are largely provided through thousands of contracts between city agencies and for-profit and nonprofit organizations. In most respects, each agency acts as an autonomous organization with its own business processes for managing all aspects of its mission: identifying its clients’ needs, providing services, verifying eligibility, managing procurement and contracts with service providers, case management, and tracking progress and outcomes. This uncoordinated approach to service provision has resulted in an inefficient set of practices that hinder efforts to meet the needs of city residents. For decades, senior city executives and policy experts have been frustrated by missed opportunities and inefficiencies created by these fragmented services.
During the last eight years, the city launched three innovative policy initiatives that use information technology and administrative data to integrate HHS processes in an effort to strengthen cross-agency policy development, increase the quality and efficiency of service delivery, and improve the outcomes of HHS clients. The city established an interagency research team in the Office of the Deputy Mayor for Health and Human Services, developed an online procurement and management system for health and human service agencies, and systems to coordinate the delivery of services. Significant progress has been made in moving the city closer to a modernized service system that integrates information across agencies, uses data to drive policy more effectively, makes informed decisions, and measures the outcomes of these services consistently and frequently.
Solidifying and expanding these gains will require cooperation and coordination at the highest levels of city government. It will also require dedicating staff and funds to support future development. With sufficient stewardship, these initiatives can continue to revolutionize public administration, saving the city money while improving client outcomes and worker effectiveness.
This brief first outlines some of the problems with fragmentation that the policy initiatives aimed at addressing. Next, it discusses the challenges these efforts have faced and the strategies used to tackle them. And finally, it looks ahead at lessons learned and forthcoming issues that will need attention. To produce this brief, the authors reviewed documents provided by the Mayor’s Office, interviewed key government and provider staff, and drew on their own professional experiences designing and evaluating health and human services and programs. View Full Whitepaper