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From the Field

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Originally published: 5/2003

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Introduction

By combining financial resources, the Minnesota Rehabilitation Services and Department of Mental Health collaborated to create the Coordinated Employability Projects. Since the early 1990s, this partnership has funded 29 local demonstration projects for the expansion of employment services for people with mental illnesses. The core mechanism is the use of Department of Mental Health funds to match federal vocational rehabilitation funds. The strong working relationship between a middle manager from each agency has made this a productive and respected collaboration. Sandie Brown and Claire Courtney discuss the value of this collaboration and present some challenges, strategies, and outcomes that have strengthened the collaboration between their two agencies.


So, Given All the Challenges to Interagency Collaboration, Why Bother?

Sandie Z. Brown and Claire T. Courtney

Interagency agreements are one strategy to formalize collaboration. To reach the goal of increased supported employment for people with disabilities, interagency agreements may outline a specific plan to:

Interagency agreements need to be action-oriented. This means tasks, roles & responsibilities, resources, and expected outcomes are clearly defined.

Since the 1970's the Federal government has encouraged state and local rehabilitation services and mental health agencies to develop ways of working together to serve the vocational needs of people with serious mental illness. Minnesota has had a collaborative agreement between the two State agencies in place since 1985, but significant differences between the two systems -- with different missions that developed to meet different needs and different goals -- have often made it difficult for local practitioners to develop collaborative strategies that can be implemented in their own communities. Local collaboration is strong in some areas and communities, and in others the mental health and rehabilitation services systems continue to operate independently of each other, often to the frustration of people with mental illness and their family members.

Given the Challenges to Interagency Collaboration, "Why Bother?"

The Minnesota Experience

Minnesota's mental health and rehabilitation services agencies' interagency collaboration presents a model which highlights the value that, as we face the challenges of economic development and preparation of this country's workforce, no one should be left behind. So why do we continue to bother to collaborate? Because we believe, and have demonstrated, that when agencies have caretakers of the vision to improve services, the goals remain fluid and alive and result in services that are continually being improved.

The Role of Advocates

Because of longstanding interagency collaboration and a joint mission between state agencies in Minnesota, mental health advocacy groups have coalesced around the topic of employment of people with serious mental illness and have played a significant role in developing legislative proposals to expand services. The support of mental health advocacy groups has increased and heightened awareness of the need for employment services and job retention supports in the mental health community and ultimately resulted in increased legislative appropriations.

Dealing with Challenges

Resource Commitment

Challenge 1: An inability to obtain a new legislative appropriation for ongoing funding for a set of 5 time-limited rehabilitation services funded Supported Employment projects for people with serious mental illness.

Interagency Strategy 1: The mental health agency and the rehabilitation services agency worked with our State Mental Health Advisory Council to approve one-time bridge funding of these projects with Federal Block Grant funds so the projects would not terminate prior to the next opportunity to seek a new legislative appropriation. Through the MN Human Services Department's budgeting process, the mental health department requested $1 million in new funding to transfer to rehabilitation services to continue existing projects and fund new ones. This proposal was not included as a priority in the Human Services Department's legislative request and the rehabilitation services agency was not allowed to request any funding for service increases.

Interagency Strategy 2: Mental health advocates were able to use the information and program outcome data noted in a legislative report published by the two agencies 'The Status and Evaluation of the Coordinated Employability Projects' to demonstrate to the legislature the success of the projects in improving the employment of people with serious mental illness. This report, which is a pdf file, can be found at www.mnworkforcecenter.org/rehab/ee/reports/spmi2000.pdf.

Outcome

Advocates were successful in obtaining a new ongoing state appropriation for the projects in the amount of $500,000 per year during this past legislative session. Advocates and the providers they organized to lobby used this information in a grassroots campaign that successfully obtained increased funding ($500,000 per year ongoing) for the projects from the Minnesota legislature.

Challenge 2: Local mental health initiatives want to use new flexible mental health funding to assist consumers to become self-employed. There is, however, an inherent conflict in having social service agencies assume a "banker" role with public funds and in acquiring the skills to evaluate the viability of business plans. Although the rehabilitation services agency has a mandate to assist consumers with self-employment plans, rehabilitation counselors consistently report that they have neither the time nor expertise to assist consumers directly with business plan development and financing strategies nor a place to refer consumers for the assistance they need.

Interagency Strategy: Given the considerable failure rate for business start-ups in our country, mental health and rehabilitation services agencies contracted with Partnership Development Corp. to provide technical assistance on Consumer-self-employment to our agencies. Partnership Development Corporation recently conducted a resource inventory of the banking and business development agencies in our large 7 county metro area and have developed recommendations (now under consideration) for how the public systems could partner with other community resources to better meet consumers self-employment needs.

Expanding Capacity

Challenge: The need for more employment resources for the urban metro area, minority populations and several large rural geographic pockets still exists, as well as the need to expand capacity building in ongoing supported employment projects. Also, our mental health system is in the process of implementing the Medical Assistance Rehabilitation Option and targeting "best-practices" which will result in considerable changes in mental health service delivery-including a reduction in traditional day treatment services.

Interagency Strategy: Rehabilitation services in conjunction with mental health in a recent new "best practices" RFP process targeted the areas most in need for new services by giving priority to the urban metropolitan area, services to immigrants, rural unserved areas, supported education and conversion of day treatment programs to supported employment. Funded were: two rural projects including one that will incorporate a supported education component in conjunction with 2 universities, one urban model that will convert a day treatment program to supported employment for people who are southeast Asian and another urban project that will incorporate vocational services with intensive community case management teams in 2 counties.

Tracking Outcomes

Challenge: The Coordinated Employability Projects appeared to be an effective strategy for improving employment for people with serious mental illness, but comparative statewide data was lacking. This lack of outcome measurements to document the effectiveness of employment programs for people with serious mental illness is an impediment to securing funding for expansion.

Interagency Strategy: In conjunction with providers of these services, the two state agencies developed and implemented a state-of-the-art statewide longitudinal electronic provider reporting system for the Coordinated Employability Projects. From 1999-2000, 13 providers reported demographic, specific employment and job retention support information on 542 program participants receiving supported employment. The report also documented a lack of statewide coverage of the services. Data from this reporting system was compiled by program staff and submitted to the Minnesota Legislature in December of 2000. Highlights from this report (This is an adobe pdf file. It can be found at http://www.mnworkforcecenter.org/rehab/ee/reports/spmi2000.pdf) include:

Sandie Z. Brown is a Mental Health Program Consultant in the Minnesota Department of Mental Health.

Claire T. Courtney is a Rehabilitation Specialist for Mental Health with the Rehabilitation Services of the Minnesota Department of Economic Security.

Photo of the authors, Sandie Z. Brown and Claire T. Courtney

Resources

Butterworth, J., Foley, S., & Metzel, D. December 2001. Developing interagency agreements: Four questions to consider. Boston: Institute for Community Inclusion, University of Massachusetts.

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