Barriers of Poverty and Bureaucracy Pose Challenges to Service Agencies, Families
San Diego--Until Hamilton Elementary School became the site of an ambitious experiment by city and county officials here to ease access to services for troubled families, Tina Graves did not know where to turn for help.
Caught in an abusive marriage and unable to meet her family's basic health, housing, and food needs, Ms. Graves, who has three children at Hamilton, says she "came to the school to talk to a counselor about how to ease the stress" that dominated her life. She also worried that stress was exacerbating her 8-year-old son's increasingly frequent respiratory problems.
As it turned out, Ms. Graves was not aware of the help available from state, county, and city programs.
"I never really tried before," she recalls.
Her only experience with public assistance had been with the San Diego Housing Commission. She re4calls how she had to show up once a week for several weeks "just to get on the waiting list" and then how she had to wait three years for subsidized housing.
Before that, "we had to move every six months," she recalls.
With monthly rents averaging at least $550 in her City Heights neighborhood, she says, "you see people just fall under."
The city, county, and school officials who launched the interagency collaborative known as "New Beginnings" recognized that, to many parents, the school may be the most familiar and accessible place to seek help.
In addition to setting up a center at Hamilton to assess families' needs, offer services, and refer them for help elsewhere, San Diego agency officials hope to "reinvent" what they concede is a fragmented and unwieldy system of services.
Learning To Cope
Since New Beginnings started, Ms. Graves has been learning to traverse the various avenues of assistance.
In the pilot phase of the collaborative, a school-based social worker helped her summon the courage to "get my husband out of the house" and file for a restraining order, she says.
He also helped her set up free weekly counseling sessions and arranged for a local church to donate food until she could get on welfare.
Once Ms. Graves gets on her feet, she expects to begin job training under the state's welfare-reform program, Greater Avenues for Independence. She has also learned that MediCal, the state's Medicaid program, will cover her son's medical costs.
The social worker "helped get me out of a situation I couldn't get out of myself," she recalls. "Now I'm the boss: I say what goes."
Ms. Graves, who once shunned local p.t.a. meetings because she "didn't think they were doing anything for the community," has atel10ltended several New Beginnings sessions at the school and has offered to volunteer in the effort.
Ms. Graves still struggles daily to piece together the aid her family needs. Lacking transportation, she has to rely on bus tokens from the social worker to take her son to the doctor, and she worries about having to negotiate the legal system if her husband seeks custody of their children.
Like Ms. Graves, "thousands of San Diego families face circumstances which threaten their well-being and promise only a bleak future," according to a study agency officials launched in 1989 to assess existing services.
The aim of New Beginnings is to create a more unified system and streamline the eligibility process. But results of the 10-month feasibility study show what a daunting task they face.
In addition to analyzing the numbers of families served by various agencies to identify gaps and areas of overlap, the study explored barriers that prevent families from getting aid and preclude workers from giving it.
Surveys and discussions conducted for the study involved workers from city and county social-services, health, probation, and housing agencies; the San Diego city schools; and the San Diego community-college district.
The families shared "a common thread of poverty," and many "also exhibited a common history of physical and/or substance abuse," the study found.
Agency workers said food, shelter, health care, and safety topped their clients' concerns, but they also identified as pressing needs education, child care, job skills, counseling, intervention in cases of physical or substance abuse, and transportation.
But the workers perceived many parents as "unaware of their failure to meet socially acceptable standards in the areas of discipline, child safety, cleanliness, and supervision" or "in a state of denial" about personal problems, the study showed. They viewed families as exercising "little control over their circumstances."
In cases where families sought help, the study showed, they often encountered "long waiting lists, inflexible requirements, and inconvenient locations."
To keep a 7:30 A.M. appointment at the welfare office, for example, Ms. Graves would have to find child care or bring her children and leave the house at 5, walk to a bus stop, and ride the bus for more than an hour. Appointments were timed so closely that she would have to reschedule if she arrived late.
Like Ms. Graves, many families in the study felt inhibited by a system that required them "to make trips to many agencies, meet multiple eligibility criteria, [and] talk to an endless stream of workers." While they found some workers helpful, they often felt "devalued, hassled, and ignored" by agencies.
At the same time, the workers said barriers between institutions discouraged them from coordinating their services and approaching families holistically. Disincentives included overspecialized services, distant offices, restrictions on data sharing, overlapping or "incongruent'' rules, and insufficient equipment.
The workers also voiced frustration about time constraints and approaches that focus most resources on families "chronically in crisis"--rather than on prevention--and allow them "to do little more than put bandages on family problems."
Obstacles in communicating with families included language barriers, the lack of telephones at home, and a high rate of family mobility.
A migration study of the 1987-88 school year by school officials showed Hamilton pupils had the highest mobility in the district, with slightly more than half attending the school 120 to 180 days, and almost a third attending 60 days or less.
The agency workers also reported feeling "dehumanized" by the "narrowness and inflexibility" of their roles and the lack of feedback on their accomplishments.
Job D. Moraido, the social worker based at Hamilton for three months as part of the New Beginnings study, notes that, in his regular role as a child-protective-services worker for the county Department of Social Services, "if there was no protective issue, we had to close the case."
As a family-services advocate at Hamilton, however, "I could work with any family that needed help," he notes.
Mr. Moraido, who acted as a caseworker for 20 "multiple problem" families picked by the school, also found them "less distrustful" and more open in a school setting because it "doesn't do investigations like welfare or child-protective services."
While Hamilton runs numerous outreach, counseling, and recreational programs, and staff members stock extra food or "quietly slip used jackets and socks" to children in need, the study showed officials have been hampered by a sense of isolation and lack understanding of how to refer families to other services.
Agency officials say basing some services at the school and "cross training" workers there will help bridge such barriers, and they add that setting common goals has al4ready improved the way some services are provided.
But they concede collaboration has not been easy.
"The more agencies you involve, and the more elected policymaking bodies, the more difficult it is," says Thomas W. Payzant, superintendent of the San Diego schools.
Key challenges, adds Richard W. Jacobsen Jr., director of the Department of Social Services, have been been "getting everyone to be patient" and "making sure what is going on is not 'personality based"' to ensure continuity when current agency leaders move on.
Officials also say it has been difficult pulling already overworked staff members off other projects to devote time to the collaborative.
But perhaps most difficult, says Cecil H. Steppe, the county's chief probation officer, is "overcoming the mindset that 'we have always done it this way."'
Copies of "New Beginnings: A Feasibility Study of Integrated Services for Children and Families" are available for $6 each, with appendices for $2 each, from the Office of the Deputy Superintendent, San Diego City Schools, Room 2248, 4100 Normal St., San Diego, Calif. 92103-2682.