Dakota contracts for social services aid

Dakota County has long been known for its robust social services.

But even here, economic woes and changing demographics -- bringing increased demand for help while making it harder to add staff to handle new clients -- are stressing resources.

Kelly Harder, the county's director of community services, offered a plumbing analogy: "We can't control the flow of water in the pipe. The pipe is getting smaller and the pressure is getting higher. I need relief valves along the way."

For 2011, the county is seeking that relief through the private sector, entering into contracts with private companies and nonprofit agencies that will help with case management when people seek social services.

"This is a giant leap of change," Commissioner Nancy Schouweiler said at a recent meeting where board members discussed contracts for case management help for people with disabilities.

Other metro-area counties have had such contracts for years, across a variety of programs. Dakota County has maintained more of a one-stop shop.

People came to the county, learned what assistance they were eligible for, and then had their cases managed by county staff.

The county will still be the first point of contact for people seeking services, and county staff will still do the eligibility assessments for different assistance programs.

After that, clients in some cases will have a choice about who will manage their care -- the county or a private organization.

If problems arise between clients and contractors, the county will help clear them up.

"We will continue to provide case management, but we do need to find other alternatives because our caseloads are getting to the point of [being] beyond management as well," Harder said. "Contracting out does not mean we're compromising quality."

A recommended load for one staff member is 55 to 60 cases. In the programs that cater to senior citizens, staff members are already at that point. In a program that helps people under age 65 with disabilities, staff carry an average load of 62 to 72 cases.

Kay Dickison, the county's deputy director of social services, said the growth is too much to handle without more staff.

"We know that as caseloads have grown, it's not just the stress of our staff," Dickison said; clients don't get as much time with case workers. "We're purchasing more contact."

The county also has pushed some of its chemical dependency treatment workload -- specifically, the state-mandated assessment to determine how much help people need -- to the private sector.

And the county is working with Blue Cross and Blue Shield to re-evaluate an arrangement under which the county does case management for the private company that holds the state contract. It costs the county more to do that than it is being reimbursed.

"We were subsidizing that contract," Harder said.

"It's been a culture of Dakota County to keep the standard and the bar really high" for social services, Harder said. "Can we afford the bar to be as high as it always has been in the context of quality?"