Social service integration
Social service integration efforts coordinate access to services across multiple delivery systems and disciplinary boundaries such as housing, disability, physical health, mental health, child welfare, and workforce services. Approaches to integrating and coordinating social services vary depending on community needs and service availability, and can be system- or sector-based, agency-based, or client- or family-based (King G, Meyer K. Service integration and co-ordination: A framework of approaches for the delivery of co-ordinated care to children with disabilities and their families. Child: Care, Health, and Development. 2006;32(4):477-492.
Link to original source (journal subscription may be required for access)King 2006). Efforts can focus on improving collaboration across sectors, client pathways to service, or coordination and resource sharing across different levels of government (Governing Institute (GI), KPMG Government Institute. The integration imperative as the driver of reform: US state and local government innovations in human and social services delivery. 2014.
Link to original source (journal subscription may be required for access)GI-Integration 2014).
Expected Beneficial Outcomes (Rated)
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Improved access to social services
Other Potential Beneficial Outcomes
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Increased enrollment in social services
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Increased social service efficiency
Evidence of Effectiveness
Integrating social services is a suggested strategy to improve access to social services (Mathematica-Cody 2010, RAND-Europe 2012, MDRC-Support center), and reduce service gaps, fragmentation, and duplication (King G, Meyer K. Service integration and co-ordination: A framework of approaches for the delivery of co-ordinated care to children with disabilities and their families. Child: Care, Health, and Development. 2006;32(4):477-492.
Link to original source (journal subscription may be required for access)King 2006, Packard 2013). Such efforts appear to increase access and enrollment, especially for veterans (Fisher MP, Elnitsky C. Health and social services integration: A review of concepts and models. Social Work in Public Health. 2012;27(5):441–68.
Link to original source (journal subscription may be required for access)Fisher 2012) and vulnerable populations such as homeless people with mental illness and low income women who are pregnant or post-partum (Guerrero EG, Henwood B, Wenzel SL. Service integration to reduce homelessness in Los Angeles County: Multiple stakeholder perspectives. Human Service Organizations: Management, Leadership & Governance. 2014;38(1):44-54.
Link to original source (journal subscription may be required for access)Guerrero 2014, Rosenheck 2001, YG-Program search). Social service integration is also recommended to better serve individuals with disabilities (Smith TJ. One Stop Service Center Initiative: Strategies for serving persons with disabilities. Journal of Rehabilitation. 2013;79(1):30-36.
Link to original source (journal subscription may be required for access)Smith 2013). A case study of the Care Coordination model suggests that health and social service integration can increase positive experiences among patients, reduce per capital cost, and improve health outcomes (Craig C, Eby D, Whittington J. Care Coordination model: Better care at lower cost for people with multiple health and social needs. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; 2011.
Link to original source (journal subscription may be required for access)IHI-Craig 2011). However, additional evidence is needed to confirm effects.
Case studies and interviews suggest that successful efforts to integrate social services include a coordinating mechanism to manage collaboration, quality measurement and data-sharing tools to track outcomes and share information, and financing and payment methods that support and reward coordination (CWF-McGinnis 2014). Stakeholder involvement, strong commitment from an executive team, and aggressive marketing of mutual goals across agencies and departments can also improve service integration efforts (Packard 2013).
Community centers can offer a “one-stop shopping” model of service that coordinates access to social services (CDC-Community center).
Impact on Disparities
Likely to decrease disparities
Implementation Examples
States are working to coordinate and integrate social services. Many states have restructured service delivery to: improve public, non-profit, and private sector collaborations, develop place-based service integration, enhance client pathways to service, and coordinate programs and resource sharing across different levels of government (Governing Institute (GI), KPMG Government Institute. The integration imperative as the driver of reform: US state and local government innovations in human and social services delivery. 2014.
Link to original source (journal subscription may be required for access)GI-Integration 2014).
Several counties and states have adopted one-stop office models of service. Examples include San Mateo County, CA; Mesa and El Paso County, CO; Bibb County, GA; Jefferson County, KY; the state of Nebraska; Montgomery County, OH; Coos and Jackson Counties, OR; Fairfax County, VA; and Racine and Kenosha Counties, WI (Rockefeller Institute-Service integration). Other states have established integrated social service delivery systems through Medicaid Accountable Care Organizations (ACOs), as in Colorado, Maine, Minnesota, Oregon, and Vermont (CHCS-Mahadevan 2015).
Implementation Resources
CWF-McGinnis 2014 - McGinnis T, Crawford M, Somers SA. A state policy framework for integrating health and social services. Commonwealth Fund (CWF). 2014.
Citations - Evidence
* Journal subscription may be required for access.
YG-Program search - Youth.gov (YG), Interagency Working Group on Youth Programs (IWGYP). Evidence-based program directories: Program directory search.
CDC-Community center - Alcaraz R. New community center to prevent youth violence. Atlanta: Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services (US DHHS).
Mathematica-Cody 2010 - Cody S, Reed D, Basson D, et al. Simplification of health and social services enrollment and eligibility: Lessons for California from interviews in four states. Princeton: Mathematica Policy Research (MPR); 2010.
RAND-Europe 2012 - RAND Europe, Ernst & Young LLP. National evaluation of the DH integrated care pilots. RAND Health Quarterly. 2012;2(1):8.
Fisher 2012* - Fisher MP, Elnitsky C. Health and social services integration: A review of concepts and models. Social Work in Public Health. 2012;27(5):441–68.
MDRC-Support center - Manpower Demonstration Research Corporation (MDRC). Work advancement and support center demonstration.
Rosenheck 2001 - Rosenheck R, Morrissey J, Lam J, et al. Service delivery and community: Social capital, service systems integration, and outcomes among homeless persons with severe mental illness. Health Services Research. 2001;36(4):691–710.
CWF-McGinnis 2014 - McGinnis T, Crawford M, Somers SA. A state policy framework for integrating health and social services. Commonwealth Fund (CWF). 2014.
Guerrero 2014* - Guerrero EG, Henwood B, Wenzel SL. Service integration to reduce homelessness in Los Angeles County: Multiple stakeholder perspectives. Human Service Organizations: Management, Leadership & Governance. 2014;38(1):44-54.
King 2006* - King G, Meyer K. Service integration and co-ordination: A framework of approaches for the delivery of co-ordinated care to children with disabilities and their families. Child: Care, Health, and Development. 2006;32(4):477-492.
Packard 2013 - Packard T, Patti R, Daly D, Tucker-Tatlow J. Implementing services integration and interagency collaboration: Experiences in seven counties. 2013;37(4):356-371.
Smith 2013* - Smith TJ. One Stop Service Center Initiative: Strategies for serving persons with disabilities. Journal of Rehabilitation. 2013;79(1):30-36.
IHI-Craig 2011* - Craig C, Eby D, Whittington J. Care Coordination model: Better care at lower cost for people with multiple health and social needs. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; 2011.
Citations - Implementation Examples
* Journal subscription may be required for access.
Rockefeller Institute-Service integration - Nelson A. Rockefeller Institute of Government. Case studies in service integration: Metros.
GI-Integration 2014* - Governing Institute (GI), KPMG Government Institute. The integration imperative as the driver of reform: US state and local government innovations in human and social services delivery. 2014.
CHCS-Mahadevan 2015 - Mahadevan R, Houston R. Supporting social service delivery through Medicaid Accountable Care Organizations: Early state efforts. Center for Health Care Strategies (CHCS). 2015.
Date Last Updated
- Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
- Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
- Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
- Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
- Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
- Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results.