Florida is the only study state to transfer full responsibility for the operation of its mental health services program to an agency that has no direct ties to the welfare or the employment services system. The program is housed within the Department of Children and Families (DCF)(10) and operates under both the Mental Health and the Substance Abuse Program offices but collaborates on policy issues with the Office of Economic Self-Sufficiency.(11) A program director and three staff members in the state office administer the program. In each DCF district or region, at least one specialist oversees program activities in the local office. All program employees are hired as "other personnel services" (OPS) employees, which are temporary positions renewed every six months, without employment benefits (such as health insurance, sick leave, and retirement).
The DCF district or region administrator selects and contracts with mental health and substance abuse treatment providers in each local community. The terms of these contracts are negotiated with the TANF specialists and local district administrators. In some communities, there is one primary contractor, and in others there are many contractors. Contracted service providers include a range of organizations such as substance abuse and community mental health centers, residential treatment providers, faith-based organizations, and hospitals. The contracted service providers hire outreach workers, conduct clinical assessments, and provide mental health and substance abuse treatment.
The advantage of transferring administrative responsibility to a mental health agency is that the state can bring into play the agency's in-depth understanding of the local mental health system that the TANF agency does not have. The drawback is that it can be much harder to integrate mental health services into existing welfare employment services, and, indeed, Florida's system is the least integrated of the four study states. The integration of services is further complicated by the fact that the employment services system that serves TANF recipients is locally administered, making the employment expectations and service delivery structure different in every local office.
Communication and Collaboration between Agencies and Workers
A recurring theme in each study site is the importance of communication and collaboration among agency administrators and mental health and employment staff. Three strategies or factors appear to foster or improve communication and collaboration.