Why aren’t more Ontario community organizations seeking integration of services?

In the face of balancing shrinking budgets and increased service needs, some community and broader public sector organizations have embraced integration and shared services. Hospitals and the soon-to-be-defunct Community Care Access Centers have traditionally gone the furthest by establishing shared services, while some smaller community organizations have sought looser collaboration or some limited integration.

But there are literally hundreds of agencies, boards, committees, and community organizations that have not considered integration, or have not gone far enough (you can only achieve so many gains from collaboration).  

But should they? And why should they?

There are absolutely fabulous reasons for attempting integration of systems, services or processes, but there are also some important things to contemplate first.

Based on our own research and experience, here are three myths about shared services for community and public sector organizations.

Myth #1: You Will Definitely Save Money

Although it is possible to reduce budgets and cost of service delivery by integrating services across multiple community organizations, this is not a “done deal”.  What often happens is two organizations will combine their services (for instance providing respite care or primary care) as they are without reducing roles, resources or systems.  

Often organizations are so concerned about losing staff or negatively impacting services they won't make the necessary -but hard- decisions that lead to budget savings.  Budget reductions can only come from reducing processes, people or technology, and these are not a foregone conclusion with shared services.

In addition, the goal of integration services may be more around increasing and improving services, which may require additional costs through investment in new resources.

Myth #2: You Will Lose Staff

Most organizations I work with list this as one of their top concerns. Certainly in some situations if you merge or integrate two of the same processes there can be some redundant roles. If two organizations with the same size finance function merge them together, there may not be a need after for two CFOs.

But in my experience this doesn't always have to happen. Often managers in community organizations wear multiple hats - one manger could be part-time FTE on financed, part on IT and part on operations.

In which case taking away the finance activities allows that manager to focus more effectively on operations and IT. I have also been involved in mergers or integrations where the resulting organizational model is larger and requires more staff than before.

Myth #3: You Can Avoid Integration By Ignoring It

I have been involved in several community service integration projects involving feasibility assessments with several or a lot (over 40) small and medium sized organizations. Inevitably I encounter a leader who feels their organization can avoid change and remain in their current if they just keep their noses clean, their budgets balanced and their heads low. The problem with this approach is it is akin to sticking your head in the sand and avoiding acknowledging the hard truths about the changing contexts within which your community organization works. 

In Ontario, the reality is that there will be flat-line or decreasing funding for many community services for several years. I have heard from several Local Health Integration Network executives who have pointed out they just can't afford to keep funding the large number of community organizations in their catchment. They clearly support community services, and the type of activities these organizations provide, but the sheer numbers of organizations is unsustainable.

In other sectors - community support services, disability services, child and youth mental health services- the funding ministries are implementing system transformations that are revamping funding and service delivery models that in many cases lean towards service consolidation.

It is About How You Approach It

I would argue that shared services or service integration can be positive to your organization, your clients and your community as long as organization leaders are clear on what they wish to achieve out of the integration effort, and how they will achieve it.