based on the article by Adams and Krauth (1995)

The Patch approach, as the authors discuss, came out of a welfare experiment begun in the United Kingdom. It was an effort to deal with some of the perceived inadequacies of a more top-down, bureaucratic approach to welfare. It was popularized during the Clinton-Gore Administration, which had its own initiatives, one of them being 'reinventing government' (headed by Gore), much like the Bush White House has some of its own initiatives such as the faith-based initiative, or governing with accountability.

Let's do a brief review of the traditional, bureaucratic model, as presented by the authors in the book:

1. It's reactive (to crises, often)
2. It's fragmented (many departments, services, often connected either loosely or not at all, even though they may be serving some of the same people)
3. 'rule-driven' (go back to Weber and Perrow and bureaucracy and rules--are they 'red tape,' do they provide greater certainty and protection, or is the truth somewhere in between?)
4. They're bureaucratic, with hierachical structures, connections with state and federal government agencies;
5. They're professional-client-centered (that is, the relationship between the welfare professionals and clients is key to their success);
6. They're agency-based (parts of government, possibly with politicall agendas filtering through--think of the Fox Piven/Cloward thesis)
7. They're top-down--decisions are made somewhere in the higher reaches of the hierarchy, and filter down to the line workers, and then the recipients;
8. They offer a service-based approach--different agencies provide specific services;
9. They're driven by a case management model--individual cases are handled by line workers, who have case loads;
10. They're budget-driven, we would hope based on perceived need for services, but budgets are inherently political phenomena;
11. They often involve outsourcing of services, in which case the professionals may act more as managers, monitors, supervisors, gatekeepers, etc., for other non-profit and private organizations actually providing the services.

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Now for the patch approach:

1. It's 'decentered' (what does this mean?)
2. It's more outcomes-based (the means of reaching an outcome is less prescribed--in other words, they may have more leeway in meeting needs and less obligation to follow specific procedures)
3. They involve choice (in some cases, the idea is to provide people with choices about services available, and between providers of these services)
4. They're preventive--rather than trying not to 'screw up,' as the authors note, they are designed to provide services before problems turn into crises--in essence, they're more 'proactive' than 'reactive'
5. They're decentralized--patch actually refers to a geographic unit--usually a neighborhood or community of 5,000-10,000;
6. They're more market-based--back to the idea of 'consumer' or 'customer' choice;
7. They're multi-sector--they may include collaboration among public, private and non-profit organizations;
8. They're multi-disciplinary--social workers in protective services may work with housing inspectors, etc. Professionals often work together because they're working with the same people in many cases, which can facilitate coordination.
9. They attempt to draw/build on existing social capital (see this soc 315 lecture if you're unclear on the social capital concept)
10. Welfare is shared responsibility (it's development, really)
11. It's community, neighborhood-based (instead of service-driven)
12. The success depends on local knowledge, implication of the local community in activities and 'ownership' of the initiatives (they have to feel it's their)
13. They take a problem-solving approach (rather than offering services in pre-existing categories, they are more bottom-up--they're trying to identify problems and seek ways to address them that are consistent with the patch's mission and the community's goals)
14. They foster professional flexibility, a team-centered approach (think again about bureaucracy here, and the difference between routine and non-routine tasks)
15. Accountability is local (it doesn't move up and down the food chain, so to speak--in other words, professionals are less concerned about avoiding blame, and more concerned about addressing the issues and involving the communities and neighborhoods in decision making)

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The authors have a few reservations about the 'reinenting government' movement:

1. Markets tend to hurt the poor (think of labor markets and wage structure), so market-based approaches need to be pursued cautiously. Often when agencies contract through private/non-profits to provide services, there is a problem with the reward and effort relationship (as Perrow discusses--where subcontractors receive a lump sump for services, for instance, what incentive do they have to provide them? They make more profit by reducing services they provide)
2. It is not a cost-cutting measure (it ain't cheap, it's just different, but more cost-effective in long run-why?). The authors say that shifting the cost burden toward private or volunteer initiatives ultimately hurts women, who often play the important unpaid roles as volunteers, family caregivers.

They also contend that:

1. The patch approach requires radical restructuring (how or why?)
2. Services are less categorical, compartmentalized (is this a good thing?)
3. It is not service-based, it's customer/client-based (whether family, individual, neighborhood, community)
4. It builds social capital-schools, churches, 'informal helping networks,' neighborhood orgs, etc.
5. Its success requires intimate knowledge of the community. What kinds of knowledge? How would one go about learning about the community/neighborhood? Who would be the important contacts? Is it important to know about local power structures, and how would one find out?
6. Extensive time and training is needed to make the transition, as well as organizational latitude, space.

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The Patch pilot project in the book was funded by the Department of Health and Human Services. The Patch team included some of the following characteristics:

• 4 social workers (child protection casework)
• City housing inspector
• Juvenile Probation Officer
• County protective homemakers
• County health officer
• Project coordinator
• Volunteer from community
• Social work students

Might the make up of the team differ from one 'patch' to another? Why?

Members of the patch team have dual responsibilities-to their agencies, and to the team. The three goals envisioned in Iowa were to:

1. build knowledge of community served
2. bring wide range of skills to bear
3. develop common vision and strategy

Essential concepts to this approach include teamwork, use of social capital, integration, holism, local knowledge, partnership, collaboration (coordinating/facilitating role), shared ownership, implication (of the community, of the patch team) in outcomes, and flexibility.

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Possilbe difficulties with the patch approach

• Professional expertise, variability (are all professionals cut out for this less structured approach? Did their training prepare them for this?)
• Small group dynamics-this approach depends on a well-functioning team
• Resistance to change (from professionals, mostly)
• Transition from working 'outside,' 'alongside,' to 'within' a community--such a transition would take time, training, resources, and patience on the part of all participating parties
• Funding issues (especially because of the way welfare is funded-annual allocations-in the 'traditional' system, funding is not responsive to need, but to previous year and perceived demand)
• Role conflict, dual responsibility-working within the bureaucracy, but with the patch team (disagreeing with agency's recommendations, for instance, in the example of the mother trying to maintain custody of her child)-BUREAUCRACIES AND RULES-Would a bureaucratic structure, ironically, help protect the patch team individuals in such situations?
• The need to be flexible, adaptive, even though funding is fairly regular, systematic

Well, what do you think? Does a patch approach cure all of the perceived ills of rigid bureaucracy? Are there roles to play for different types of approaches? When might one work better than the other? Can the two operate together, actually complement each other? What are potential problems with such an approach (for instance, think of the criticism of public agencies as fragmented)?