Human services collaboration key in small counties

By Kathy Flores
San Benito County, Calif.

and

Nadine Della Bitta
Siskiyou County, Calif.

Life in small rural counties offers opportunities and challenges not experienced in larger urban areas.  For those who live in these quiet locales, the privacy, independence and natural beauty inherent in these areas most certainly compensate for the lack of amenities found in more populated cities. There are, however, obstacles to life in small counties including the effective delivery of human services.

Human services clients in small counties face all the same problems of those in large counties, with fewer resources to help them work through these issues. Family violence, substance abuse and poverty create problems that staff in small counties must address with fewer community-based organizations, medical providers, educational institutions, living-wage jobs and affordable housing.

Expect the unexpected

What is a typical day like for a human services worker in a small county?

“Typical is not part of this job,” said Susan Cervelli, supervisor of emergency response for Siskiyou County (Calif.), Child Protective Services.  “Multiple responsibilities, limited service providers, staff shortages and long distances are just some of the realities we must juggle.” Cervelli said she keeps extra shoes under her desk and a change of clothes in her car to be ready at any time for calls to court or a home to investigate a report of child endangerment. 

In other California counties, the experience is similar.

Tamaran Cook, deputy public guardian in Nevada County, carries a full caseload, administratively supports the office and rotates into the intake function. In a small county she also wears other hats, such as the investigation of adult abuse and acceptance of applications for In-Home Supportive Services.

On any given day in Inyo County, caseworker Corrine Shuey works all programs related to welfare-to-work. “We back up other caseloads, talk with employers, help clients find other services and file disability and social security claims because there is no Social Security Administration office in our area,” she explained.

Limited resources in small counties mean staff must know all programs and support coworkers as well as clients. This takes versatility, cross-training, a strong sense of community and lots of heart.

How small can be large

Geographically and circumstantially, small counties can be anything but small. Inyo County stretches across 10,000 square miles from Mt. Whiney to Death Valley. Some Inyo workers travel more than 200 miles to see clients.  Siskyou County’s 6,300-square-mile area around Mt. Shasta requires workers to regularly travel more than two hours in one direction to serve some of the clientele and more than four hours in adverse weather conditions.

Limited public transportation challenges staff and clients in small agricultural counties such as Colusa, San Benito and Glenn. Remote communities in the coastal and Mother Lode regions mean long response times for ambulance and other emergency services. It can take clients hours to reach a county’s single provider of outpatient substance abuse treatment or other services.

Facing daily challenges

Staff uses creative strategies to overcome many of the limitations of small county life. Transportation issues are solved by using volunteer drivers, gas vouchers, mileage reimbursement, bus passes and even auto loan programs for welfare-to-work clients. 

Other problems are more persistent and not as easily solved. Unemployment remains high in counties with seasonal work in tourism or agriculture. Available jobs often do not pay a living wage, and affordable housing is scarce. In Inyo County, the average rent for apartments exceeds $800 monthly. An influx of retirees from urban areas places further pressure on housing costs.

As older people are moving in, younger individuals are moving away to find opportunities in larger communities. This exacerbates the challenge of finding and retaining qualified staff.  “We have been fully staffed for a total of about six weeks in the four-plus years I have worked in Siskiyou County,” said Cervelli.

There is closeness in small communities that benefits people in need of services.  Residents are aware of neighbors and businesses know their regular customers. This leads to more per-capita referrals to child and adult protective services in many small counties. Robert Mierzwak, adult services supervisor in Calaveras County, observes, “A neighbor may call or a bank may inform the agency of suspicions. We have a rapport with the community, so people are comfortable asking us to ‘talk to Mrs. Jones to see what’s going on.’”

Doing more with less

Collaboration is the key to providing needed services in small counties. Mierzwak tells his staff to build bridges to make connections. “We work well with other agencies because we are on a first-name basis,” he said. 

As a result of this collaboration, substations now exist in remote, rural areas of the county that provide a variety of public services including cash assistance, food stamps, Medi-Cal, behavioral health, employment assistance and public health.

   Siskiyou County brought together human services, the narcotics task force, public health, the district attorney and sheriff to form a Drug Endangered Children’s (DEC) program. This works well because there is a mutual understanding that collaboration is a necessity, resulting in very few “turf wars” said Cervelli.

Size really DOES matter.

(Kathy Flores is San Benito County’s Health and Human Services Agency director and Nadine Della Bitta is Siskiyou County’s Human Services director).