In lieu of an abstract, here is a brief excerpt of the content:

To understand street-level bureaucracy one must study the routines and subjective responses street-level bureaucrats develop in order to cope with the difficulties and ambiguities of their jobs. —Michael Lipsky, Street Level Bureaucracy: Dilemmas of the Individual in Public Services Bureaucracies have problems with marginalized people, and vice versa. Even when assisted by adequately funded, well-intentioned programs with eager social workers, marginalized individuals typically have a hard time escaping from poverty and societal disenfranchisement. Quite often their situations deteriorate precisely because of the misdirected “help” offered by social or human services. The design, delivery, management, and accountability of these services are not compatible with the multiple, complex, and interrelated structural problems facing the marginalized. Families with behavioral problems, the homeless, the mentally ill, 167 8 Providing Services to the Marginalized: Anatomy of an Access Paradox albert jan kruiter and jorrit de jong This chapter is based on research that was conducted in the Netherlands by Albert Jan Kruiter, J. de Jong, J. van Niel, and C. Hijzen, and published in 2008 as De Rotonde van Hamed; Maatwerk voor mensen met meerdere problemen (Hamed’s roundabout: Customized solutions for people with multiple problems). This research was funded by G27, an association of twenty-seven medium-large cities in the Netherlands. An earlier version of the chapter was presented to the Network of Innovators in the Mediterranean Region (InnovMed) convened by the United Nations Department of Economic and Social Affairs, Division of Public Administration, in Dubrovnik, April 25, 2008. 08-7501-1 CH 8 10/28/08 5:25 PM Page 167 drug addicts, and unemployed and underage school dropouts all share at least one problem in common: they don’t fit into the service-provision molds of standardized bureaucracies. Professionals working with these clients often feel that they are victims of an access paradox: there are plenty of resources to help the marginalized, but rules and regulations often inhibit the provision of adequate care. Many professionals fear that they have become part of the problem instead of part of the solution . In this chapter we examine the nature of this access paradox. We will also draw lessons from successful attempts to create tailor-made solutions for marginalized people based on research we did in thirteen Dutch cities.1 Many Problems, Many Agencies Maurice is not fit enough to work, and he and his wife, Alice, have five children to support. Maurice and Alice are in serious debt. Because they owe the tax authority a great deal of money, they have enrolled in a debt rehabilitation scheme that allows them to spend only one euro a day per person. A financial coach monitors their expenses and decides how much their allowance for the month should be. Alice works one day a week as a cleaning lady and Maurice is on welfare. The law stipulates that welfare recipients must apply for work while accepting benefits , forcing Maurice to seek employment even though his physician has recommended that he stay home and rest. In an effort to resolve these conflicts, a social worker suggests that Maurice start volunteer employment in order to practice working regular hours. Whatever Maurice does, he cannot satisfy the demands of all the people trying to help him. In fact, he is always violating at least some of the rules to which he is subject simply because the programs and policies that apply to his situation are not in sync with one another. In his own words, Maurice has “his back against the wall.”2 Maurice’s story is typical of people with multiple problems in the Netherlands. It is hard to find the exact number of individuals living under circumstances like these, because there are no reliable statistics for this category. “Marginalized people with multiple problems” inherently show up in multiple-policy categories and derivative statistics. Agencies rarely combine and filter their statistics for this “category ,” but experts estimate that between 35,000 and 70,000 Dutch families (or between 160,000 and 170,000 people) deal with multiple structural problems in their daily lives.3 Furthermore, these difficulties are almost always interrelated. To 168 albert jan kruiter and jorrit de jong 1. The cities are Leeuwarden, Groningen, Zwolle, Deventer, Enschede, Hengelo, Arnhem, Heerlen, Eindhoven, Nijmegen, Dordrecht, Zaanstad, and Leiden. 2. We interviewed over twenty-five people in situations similar to Maurice’s. Maurice’s story has been simplified for the sake of brevity, and the names have been changed in order to protect the privacy of...

Share