Gateway or Gatekeeper? Social Services Agencies & the Referral System
The human service world is full of gatekeepers – individuals or organizations that control access to resources. Gatekeepers manifest in countless ways: they can look like staff who determine eligibility criteria, place people on wait lists, or restrict days and hours that someone can access services.
We recognize that some of this is unavoidable and at times important. We are all working with limited resources that make structure and guidelines necessary. However, for individuals using services, the gates can feel restrictive, endless, and oppressive. We have been thinking about the role that social service providers inadvertently play in perpetuating these systems of oppression. We think that folks accessing services deserve better. We think that as providers, we have a responsibility to do better.
The social services department at Bread for the City has begun to explore and wrestle with which of these gates can be opened and turned into gateways – entry points to access resources. How can we move toward a more humane, compassionate, and just service delivery model that will value program participants’ time and energy? We believe the starting place is to assume that individuals and families know what they need. Our resources will be better used to support increased independence, well-being and cooperation within the community if we create a system that places client interests at the center.
Currently in the social services world many agencies rely upon a ‘referral system’ in order to screen for eligibility and control demand for services. In this context, a ‘referral’ means a written letter or form that a staff person from an agency/organization completes for a client to be able to access goods like food, clothing, furniture, or computers from another agency/organization. These requirements are not uniform across DC non-profits. Every agency has different requirements for what kinds of referrals they will accept, the information they must contain, how long they are valid for and who can complete and sign them. The graphic below summarizes the current referral system.The current referral system places a burden on clients both financially and emotionally. Clients incur the costs of transportation to two agencies along with the cost of time away from work and/or childcare. Additionally, the service delivery system is so often dehumanizing and it’s hard to have to ask for help. Folks are struggling to feed their family and then have to go two places to get one piece of the help they need. Not to mention the stress and hassle factor of negotiating multiple complex and inefficient systems. Last week, we heard from clients in the community impacted by this system during an open meeting. We estimated that with the cost of transportation ($2-$5 on bus, much more on metro!) and at least 2 hours off work for travel and wait time ($8.25 DC minimum wage) – getting a referral could cost someone nearly $20! Also, remember that this isn’t a one-time thing – that agencies that require referrals are asking clients to do these steps over and over again each time they need the specific good (clothing, food, computer, financial assistance with IDs).
We envision a better system that puts the client at the center and believes the client is, in fact, the best expert of their own need and capacity. This system would eliminate the need for a 3rd party written referral by encouraging providers to create internal intake processes that reflect their eligibility requirements. We know this model can work – at Bread for the City we do not require these third-party written referrals for our general services (food, clothing, legal, medical, social services). Instead we have an internally designed and run intake system to screen for our eligibility requirements like DC residency, income and family size. Intake also helps us to track the information we need to monitor and improve our services. We believe that this works better for both the client community that we serve and for our staff.
We have begun to hold open meetings with clients interested in being involved in this advocacy effort. If you are interested in joining us to work for a better way please feel free to contact Kathleen Stephan at firstname.lastname@example.org.