By John Estrem, CEO
For more than 25 years, I have worked in social services as a volunteer, advocate and leader. I have served the homeless, the young, the old and people with disabilities. During this time I have seen a subtle but disturbing shift in the relationship between government and the organizations that serve people in need.
Since the founding of our country, the U.S. government has directly provided few social services to its citizens. Instead, the model has been to partner with (and fund) organizations to provide those services. This differs from the common European model where services are provided directly by government to its people. The genius of our approach is that organizations funded, often faith-based or other nonprofits, bring much expertise to the table. Nonprofits produce passionate volunteers and additional funding (donations), as state support is rarely adequate. More importantly, these organizations are often locally based. Why is this important? Because relationships formed by living and working in the community make people accountable and more responsive to needs of their neighbors.
In the last 15 years, something has changed. The relationship between government and service providers has deteriorated. Rather than being seen as partners helping those in need, we are treated as vendors. While that may not sound significant, it makes all the difference in the world. When we are treated as partners, our contributions are respected and honored. We are acknowledged as making a difference in the neighborhoods in which we make our own homes. Our decades – sometimes centuries – of service are a testament to our commitment to the community. When treated like vendors, it is often interpreted that we are only in this for the money and pushed to provide more for less. The services we provide – our product – are subsequently treated as a commodity. Recently, we have read news stories of providers cheating the state-federal Medicaid program through fraudulent billing practices. Reactions to this unfortunate problem might be to say we need more policing, more paperwork, more policies. I contend that cultivating a true partnership is a better way to hold us all accountable. In building relationships, we also build trust and openness. In my experience, people tend to rise to the level expected of them.
For more than a year, Hammer Residences has been one of six providers serving the disability community who has joined with a physician’s group to create the Altair Accountable Care Organization to search for more innovative solutions that provide better and more cost-effective support. In this collaborative, we are working together to design ways to share information, agree on important benchmarks and even integrate a person’s housing, employment, health and social well-being. I believe this example of “upstream” thinking is just what is needed. We need to redesign social services in a collaborative way, leveraging the knowledge of those of us in the field, rather than trying to do what we have always done for less money. This simply won’t work anymore.
We have many social issues to address in Minnesota right now. Increased homelessness and hunger, an education system that is falling behind, systemic racism, an aging population with increased needs and people with disabilities not able to get services they need. This may seem overwhelming, and in some ways it is. But nothing meaningful gets done if we continue being suspicious of agencies whose mission it is to serve. For 92 years, Hammer has been a nonprofit resource for the disability community. I am a tax-payer too. I am concerned about serving in the most efficient and effective ways possible. As such, I want to find solutions that work. But to do so requires us to come together, respecting one another’s expertise in order to find the right answers. I challenge us all – private and public sectors – to find that path to partnership.