Dutchess County NY, which frequently turns to CGR to assist with assessments involving its human services delivery system, engaged CGR to review the Department of Mental Hygiene. Over the years, selected in-house services have been contracted out to nonprofits due to county financial constraints and a need to reduce staffing and payroll. Over the same period, the scope of services has expanded to meet new needs for a larger client base. The department is serving a younger and more difficult-to-serve population along with a population of older, previously institutionalized individuals it has historically served. CGR found no evidence of unneeded or redundant programs, but concluded service delivery could be improved by providing expanded supervision, training and staff development support to the contract agencies that now represent the core of the department's service system. CGR also recommended instituting enhanced internal efficiencies and controls and improving use of data for management purposes.