APHSA Annual Report 2017

to understand the root-causes of this fatigue factor, and found five primary elements with high consensus: Ø Ø Making the Value Curve “real world” to all CS staff. The model was being conveyed in ways that did not enable the workforce to apply it to their roles, teams and functions within the greater system. This finding resulted in related exercises between supervisors and their staff and within cross-program groups, which addressed the issue and generated significant insight and support. Ø Ø Communicating “two-way” versus “top-down.” The agency leadership has engaged in an array of activities to strengthen dialogue between senior management and the organization, reinforced by the awareness that solutions to complex problems are best discovered through empowered teams comprised of staff at all levels. Ø Ø Using continuous improvement tools to make changes, versus adding new initiatives “on top of” current work with no baseline assessments. The agency has adopted improved methods for facilitating problem-solving methods and planning groups focused on improving the overall efficiency of the agency. Ø Ø Using effective meeting management, facilitation and project management resources. These skill sets are being fostered and used more intentionally as a result of this finding. Ø Ø Thoughtfully managing limited staff capacity. The agency is learning how to phase and stage new activities and priorities in ways that build capacity. CS is also using lessons learned from this information to take another look at the revamped performance management system that was instituted in 2015. The agency is now able to track the impact of performance changes on the root-causes that drive specific outcome goals for the populations it serves. These new strategies include modern client assessments that go beyond holistic needs to the underlying factors that move families from surviving to thriving. They also include a potential national model for understanding and proactively addressing the “financial cliff effect” that families often face when they begin to experience financial success.

costs down while reinvesting annual savings into further care delivery reforms www.ncbi.nlm.nih.gov/ pubmed/25367993 . Hennepin Health is actively extending its model to serve complex families and children in addition to the Medicaid expansion population. Through a return on investment model, Hennepin Health is leveraging health care dollars, to address social determinants of health and value purchasing social services as a means to reduce overall costs and improve wellness in their patient population. Investing in housing, employment supports, intensive harm reduction efforts for chronic inebriates, child well-being, and other social supports to improve health, Hennepin Health has realized significant cost reductions and has annually been able to reinvest in new system innovations for continuous population improvements. MEMBER SUCCESS The Dakota County (MN) Community Services Agency (CS) has been widely recognized within the state, as well as nationally, as a resource on how to drive collaboration, innovation and partnership within the agency, and within the broader communities it serves. CS has authority for the traditional human services program array and the county's corrections and healthcare services. Agency leadership has established a highly collaborative and energized workforce and was an early adopter of the Value Curve as an organizing framework and lens undergirding their overall strategic plan. Building off a stable platform for program integrity and collaboration across these programs, CS has recently sought to apply more efficient root- cause assessments, not only with their clients but also within their organization. The agency was challenged by significant “innovation fatigue” in their efforts towards integrating services and progressing through the Value Curve stages and sought collaboration with APHSA. This demonstrated a willingness of senior leadership to let go of “knowing the solutions,” make themselves available to new ways of thinking and systematically collect data to learn and adapt their efforts. APHSA conducted a survey and focus groups for all CS management and supervisory staff


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