Developing a digital health strategy for people who use drugs: Lessons from COVID-19

COVID-19 has significantly exacerbated negative health and social outcomes for people who use drugs (PWUD) around the world. The closure of harm reduction services, ongoing barriers to employment and housing, and pre-existing physical and mental health conditions have increased harms for diverse communities of PWUD. Adapting current models of health and human service delivery to better meet the needs of PWUD is essential in minimizing not only COVID-19 but also drug-related morbidity and mortality. This article draws on research, practice, and advocacy experiences, and discusses the potential for digital health tools such as remote monitoring and telecare to improve the continuum of care for PWUD. We call for a digital health strategy for PWUD and provide recommendations for future program development and implementation.

Learning from the Managers of Human Service Organizations

Chapter 7 of Practice Research in the Human Services: A University-Agency Partnership Model focuses on the experiences and perspectives of human service agency managers. It describes a multiphase study examining the experiences of public and nonprofit managers involved in human services contracting. The study aimed to further our understanding of the accountability and service coordination challenges that these cross-sectoral relationships pose for managers, especially in the context of increasingly complex human service delivery systems. This study integrated case studies, a multi-county survey, and review of contract documents. The chapter also describes a second study that sought to inform managerial practice by examining managerial perspectives and experiences related to evidence-informed practice, using a multi-county survey incorporating closed and open-ended questions. Principles for practice research relate to the study design process, recruitment of study participants, engagement of agency staff, and translation of implications into concrete practice recommendations.

Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

Self-direction is an approach to human service delivery within long term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with IDD. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

Self-direction is an approach to human service delivery within long-term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with intellectual and developmental disabilities. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships, as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

The managerial and relational dimensions of public-nonprofit human service contracting

Public-nonprofit contracting for human services is complicated by the difficulty of fully specifying contracts in the face of complex human service delivery issues. To understand how public and nonprofit agencies resolve these complications while serving client populations effectively and meeting public accountability requirements, this article examines the following research question: given the complexity of human service delivery, how do public and nonprofit managers address the challenges of contract management? The study analyzes qualitative data from interviews and focus groups with managers from three San Francisco Bay Area county human service agencies and three nonprofit agencies contracting with these public agencies to deliver human services. Findings uncover the deeply relational and collaborative nature of human service contracting amidst technical challenges that reflect the underlying complexity of human service delivery. The results also show how public and nonprofit managers address these dynamics to inform the task of organizing and delivering human services.