Several years ago, the Caldwell County Commissioners identified the resolution of a problem that every board of commissioners in the state can relate to. They wanted to reduce the mountains of redundant paperwork that human service clients must fill out prior to receiving assistance, and they wanted to make it easier on caseworkers to keep track of what benefits their clients were receiving.

They wanted to accomplish this goal by using an integrated computer database that would be accessible via the Internet and would allow staff members in various agencies access to client records. But there was a slight problem—nobody else in the county has a similar program.

"About five years ago during the budget process, the county commissioners kept seeing all these requests for funding from a lot of agencies that seemed to be delivering the same kinds of services to the same people," said David Hill, the Caldwell County Human Resources Director. He is also overseeing the integrated human service project. "The commissioners asked us if we could find a more efficient way of spending money for all of these agencies.

"We traveled to Indiana, Kentucky, Florida and Arkansas and tried to find out who was already doing this. When we went to these places, we got in touch with a couple of software companies who had the software that could do what we wanted it to do. But after we visited a couple of sites, we found out it wasn’t doing exactly what we wanted it to do. They were good for one agency that might have several locations, but they weren’t sharing all the information (with other agencies)."

Undaunted, the county continued its quest, which eventually led to Bob White and Dennis Betz. They are a couple of software developers in Arkansas who, through a grant from the State of Arkansas and the federal government, had designed a program that allowed ninety-six agencies in four counties access to a shared database of client information. Hill led a group that included Commissioner Alden Starnes and the directors of several county human service agencies to Arkansas on a fact-finding mission.

After seeing the system at work and meeting with White and Betz, Caldwell County entered into a business agreement with the duo and their newly formed company, @ware. White and Betz developed a system for Caldwell County. In return, the county agreed to serve as a beta site for other counties who might be interested in a similar program.

Caldwell County’s integrated human services project is to be launched in January, Hill said. Once it is up and running, it will provide many benefits, including better client services, streamlined case management and a reduction of fraud.

The program features five core partners—the county health and social services departments, the Foothills Area Mental Health Program, Communities in Schools, which includes SmartStart, and Blue Ridge Community Action, Inc. The county is funding 50 percent of the cost to run the program while each partner kicks in 10 percent.

Several other agencies, including the local community college and the Employment Security Commission, were involved at the beginning but for a variety of reasons decided not to participate, said Hill. The program is designed with expansion in mind.

"We are treating this like a business, not a government, and that took a different mentality to a large degree," said Caldwell County Manager Bobby White. "We made a decision early on that we would not try to convince every agency in the county to join. We wanted to build a system that was expandable so if they decided they wanted to join, they can. The capabilities of this project are enormous."

While the agencies stand to benefit from the program, the primary goal is to improve services for clients, said White. Many of the clients of these agencies receive assistance from other agencies. Each time a client goes to a new agency, they must fill out a long application to be eligible for services. Most of the information on the application is the same, so what Caldwell County did was develop one common application form for every agency.

"That was one of the biggest complaints we heard, was that people had to fill out the same paperwork over and over again," said Staff Development Specialist Gail Colbert, who is leading the training on the new system for county employees. "Once they go to one place and fill that paperwork out, when they go to the next place that information is already in the system.

"It’ll help the caseworkers, too, because you had to ask the same questions and pull out the same information. It’ll save them a lot of time. Caseworkers have a lot to do when they first set an account up. I’m excited about it just from being a former caseworker. If I had this, I could have helped a lot more people. You’re going to cut out so much of the paperwork and time, it’s going to be unreal."

Before the information can be shared with other agencies, however, the client has to agree and sign a release. If a client doesn’t want their information shared with other agencies, they can refuse to sign the release. It is to a client’s advantage, however, to have the information readily available to caseworkers at every agency. Not only will it cut down on the voluminous paperwork, but it will also improve the services they receive.

"One of the benefits of this integration of all the agencies was an integrated, managed-care approach to the clients or families," said Hill. "You might have different case managers in different agencies, and they’re never speaking to each other and developing different approaches to addressing this family’s needs. This allows for the coordination of the case management."

Another benefit of the program will be to help agencies cut down on fraud. By giving caseworkers at every agency access to the records, they can see exactly where clients have been and what benefits they have received.

Before, a caseworker in the health department would have to call the caseworker in social services to find out what benefits a client has been given. Now the information will be available with the click of a mouse. Not only will the clients be able to receive their benefits quicker, but also the caseworkers will be able to make sure that they indeed are eligible to receive the assistance they are asking for. And if a client’s caseworker is not available for some reason, another caseworker from the agency can look up the client’s information.

"We wanted to make sure that everybody was treated equally as they went around to get these services," said Commissioner Alden Starnes. "Before, we didn’t have track of who was getting what. They could go to social services and get a big pile of money, then go to the health department and get a big pile of money and then go somewhere else and get a big pile of money. Finally you’d run out of money and have a lot of people who were not being serviced. So we wanted to be sure that everybody was equalized in this."

Because of the ability to track what assistance clients are receiving, most of the faith-based or non-profit human service agencies in Caldwell County are interested in becoming connected to the program as well. Colbert, who had worked for Caldwell County DSS for six years, said that as many as fifty local agencies have expressed an interest in becoming a partner.

"That is one of our goals," said Colbert. "We had a meeting with the churches and the community agencies, and they are just ready to go. We had two churches at the meeting who had helped the same person that day, whereas this would have stopped that. They just don’t know (what each other is doing).

"In the summertime, a lot of the agencies give out free air conditioners. This one girl got four free air conditioners before they caught up with her. We found them at a pawnshop. By helping stop fraud, you are able to help more people."

Hill said that the partners would meet in January and begin discussions on what to do about the community-based agencies that wanted to sign up.

"The faith-based organizations are knocking on our doors and wanting to use it now, but we are still tweaking the system," said Hill. "What we’ll talk about at our next meeting is when we will allow the rest of the agencies to join. When that decision is made, then we’ll have to decide do we charge, and if so, how much do we charge to use this service?"

The major concern on any Internet-base system is security. Much of the information collected by the agencies is of a sensitive and personal nature that clients don’t want made public. Not all of the information gathered is relevant to all the agencies either, Hill said. For instance, someone checking on a child’s eligibility for SmartStart doesn’t need to know that the child’s parents might be receiving unrelated benefits from another agency.

The program will have five levels of security. Department heads will determine which levels of information are needed in their respective areas and assign those levels to the various caseworkers. Information that is only needed in one department will not be shared with the other agencies.

"The concerns over security in the system, who’s going to be able to get into these files and how deeply? That was the pervading concern," said Caldwell County Health Director, Doug Urland. "We’ll do this, but you’ve got to assure us that this was just as good as putting a paper file under lock and key.

"But what’s more secure—two hundred medical files in a room somewhere that somebody could break into and trash, or having it all on a computer system? This is probably more secure. There are firewalls in place."

Another major hurdle involved transcending the different regulations governing the various departments. Each of the partners credited County Manager, Bobby White and the Board of Commissioners for establishing a working atmosphere of trust and cooperation.

"We’ve all got regulations, but we weren’t going to let that defeat us," said John Alexander, the Director of the Foothills Area Program. "We were going to move forward and do it anyway if it made sense. Everything was right. Unlike anywhere else in the country, you had the elected officials who were for it and you had a group of agencies that were for it, so when you have those elements coming together, it was going to work."

According to Dr. John Thuss, a member of the Caldwell County Board of Commissioners, the idea wasn’t a hard sell. "There wasn’t a great big turf issue because there was an early buy-in to the project," he said. "We have some really knowledgeable and really dedicated people. It’s a humongous undertaking, but when you’ve got good people around you, it’s a whole lot easier."