P&P August 2015
P&P August 2015
The Magazine of the American Public Human Services Association August 2015
Marketplace of the Future
Discovering the latest and best human service delivery systems
TODAY’S EXPERTISE FORTOMORROW’S SOLUTIONS
contents www.aphsa.org
Vol. 73, No. 4 August 2015
features
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It’s in the Cloud Innovative approaches to improving child welfare outcomes
7 Avoidable Legal Mistakes Child Protective Services Investigators Make
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Using Data to Move Social Services into the 21st Century
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Framing the Transformation
How emerging trends led to a change management toolkit for agency and association leaders
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2,400 iPads. 1 Agency. 5 real-world lessons to strengthen your mobile-enabled workforce
departments
3 Director’s Memo
24 MyTurn
30 Partnering for Impact The Nightingale Medical Respite Program
Pathways to create opportunities and advance equity
“The time has come,” the Walrus said …
5 From the Field
26 Technology Speaks
31 Association News Update from NSDTA
Credibility that grows with honesty and time
“Drag-free drift” in delivering human services
40 Our Do’ers Profile
6 From Our Partners
27 The curious case of user adoption
Rachael Wong, director of the Hawaii Department of Human Services
How technology can impact health and human services There’s no such thing as an IT project … only business projects with IT components
28 The FieldWorks
Wisconsin’s modernization efforts in child care regulation
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August 2015 Policy&Practice
INDUSTRY PARTNERS Platinum Level INDUSTRY PARTNERS Platinum Level
APHSA Board of Directors Officers President Raquel Hatter , Commissioner, Tennessee Department of Human Services, David Stillman, Assistant Secretary, Economic Services Administration, Washington Department of Social and Health Services, Olympia, Wash. Treasurer, Local Council Representative Kelly Harder, Director, Dakota County Community Services, West Saint Paul, Minn. Secretary Tracy Wareing Evans, Executive Director, APHSA Past President Reggie Bicha, Executive Director, Colorado Department of Human Services, Denver, Colo. Director Eric M. Bost, Assistant Director of External Relations, Borlaug Institute, Texas A&M University, College Station, Texas Director Mimi Corcoran, Independent Consultant, Harrison, N.Y. Director Susan Dreyfus, President and Chief Executive Officer, Alliance for Strong Families and Communities, Milwaukee, Wis. Director Reiko Osaki, President and Founder, Ikaso Consulting, Burlingame, Calif. Affiliate Representative, American Association of PublicWelfare Attorneys Ed Watkins, Assistant Deputy Counsel, Bureau of Child Care Law, New York State Office of Children and Family Services, Rensselaer, N.Y. Nashville, Tenn. Vice President
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Policy&Practice August 2015
director‘s memo By Tracy Wareing Evans
Direct from Our Members Pathways to Create Opportunities and Advance Equity
A s we approach the 20th anni- versary of welfare reform, there is a heightened national discussion of the growing income gap in this country and what it will take to create opportunity and advance equity for all Americans, no matter what their zip code. The House Ways and Means Human Resources Subcommittee has recently undertaken a series of hearings to understand how we can better address poverty, strengthen work engagement, and build the capacity of individuals and communi- ties. In late April, I had the opportunity to communicate to the Subcommittee our members’ insights on how we can more effectively connect Americans to the workforce and to a sustainable career path. I joined five other pan- elists in a strikingly consistent call for Congress to modernize TANF by moving from “participation that counts to engagement that matters.” Given the importance of this national policy debate, I thought it was important to provide Policy & Practice readers with the text of my oral comments to the Subcommittee: OralTestimony to House Ways and Means Subcommittee on April 30, 2015 Our Framework —Mr. Chairman, your description for today’s hearing expresses this Subcommittee’s inten- tion to “examine ways to make the federal welfare program work more efficiently and more effectively as a hand up from poverty, not a hand out.” We, too, are interested in what evidence tells us actually works and how public investments can return
progress. We must support changes in the broad human service system that more effectively deliver “engagement that matters,” ultimately getting parents into sustainable jobs with wage progression and advancement opportunities. Engagement —At its core, TANF was designed to help low-income parents build a pathway out of poverty and toward economic security for their family while assuring the safety and well-being of their children. Our members believe that TANF partici- pants who can move directly into a job should have the opportunity to do so. Our members also know that most TANF participants are families in crisis and face various obstacles that require targeted and appropriate supports to become work-ready, get a job, and stay in the workforce over time. Indeed, their very presence in the TANF
real and lasting value. We urge the Subcommittee to look beyond TANF. As laid out in our members’ Pathways agenda, success in the workplace is a function of not just TANF and other human service programs, but a wide segment of the broader community, including the education and training system, the private sector, nonprofit groups, and other government agencies. In today’s rapidly evolving world, neither TANF recipients, nor anyone else needing employment, are likely to succeed without the collective and aligned effort of all these sectors. What TANF Needs —My remarks about TANF today are provided within this broader context. While our members do recommend some changes in TANF’s details (as noted in my written statement), their overarching concern is with the full workforce engagement system and how its com- ponents must be better aligned and coordinated if we are to make real
See Director’s Memo on page 32
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August 2015 Policy&Practice
Vol. 73, No. 4
www.aphsa.org
Policy & Practice™ (ISSN 1942-6828) is published six times a year by the American Public Human Services Association, 1133 Nineteenth Street, NW, Suite 400, Washington, DC 20036. For subscription information, contact APHSA at (202) 682-0100 or visit the web site at www.aphsa.org. Copyright © 2015. All rights reserved.This magazine may not be reproduced in whole or in part without written permission from the publisher.The viewpoints expressed in contributors’ materials are the authors’ own and do not necessarily reflect the policies or views of APHSA. Postmaster: Send address changes to Policy & Practice 1133 Nineteenth Street, NW, Suite 400, Washington, DC 20036
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Policy&Practice August 2015
from the field
By Doug Racine
Credibility That Grows With Honesty and Time
A s CEOs move forward with the transformational challenges of integrating health and human services and modernizing IT systems, rela- tionships with their partners in the legislative branch take on an even greater importance. The inherent tensions between the two branches of government, regularly played out in budget and policy discussions, can become even more daunting. Personal relationships with key legis- lators—leaders, committee chairs, and members of the budget and policy com- mittees—are of paramount importance. And those relationships need regular attention and constant nurturing. In interviews and discussions with many CEOs from around the country, a consensus emerged that partisan differences between an administra- tion of one party and legislators of the other can be overcome with effective communication, the building of trust, and a clear understanding of the roles and responsibilities of members of the legislative branch. Yes, political
general public. Otherwise, the only news is bad news. Respect for the protocols, courtesies, and etiquette of the legislature. Knowing that legislators need to be “in the know.” They don’t like sur- prises any more than the CEO’s boss does. Strong internal systems for coordination of communications, responses to legislative inquiries, and timely resolution of constituent complaints. Procedures that allow for quick policy and bill reviews enable rapid responses to the daily twists and turns of the legislative process. A crisis management plan is crucial to guide communications and legal considerations when a crisis does occur. CEOs are judged by how they manage those difficult situations.
and philosophical disagreements are inevitable. Some CEOs suggested that the polarization of politics in Congress, especially with respect to the Affordable Care Act, has widened the partisan divides in their states. But all agreed that the politics can be put aside if the relationships are strong. What makes for effective working relationships that produce results? It starts in the executive branch. The CEO must have the confidence and support of the governor. When CEOs are speaking to legislators, they must know they will not hear something different from the governor and his or her staff. Constant communication so that both the CEO and the legislator understand each other’s perspectives and concerns. An “open door” policy that allows for quick and easy access is one CEO’s philosophy. Accurate, reliable, and neutral health and human service information. Stories of success should be com- municated to legislators and to the
And sometimes, despite the best efforts, things just go wrong and
See Legislature on page 34
Illustration by Chris Campbell/Shutterstock
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August 2015 Policy&Practice
from our partners
By Mark Allen
How Technology Can Impact Health and Human Services
T he passage of the Affordable Care Act (ACA) shifted more respon- sibility for the delivery of benefits in health and human service programs to the states. The momentum of the ACA and programs like the A-87 exception prompted many states to modernize the administration of public assistance programs to enhance customer service for applicants and recipients and to remain compliant with the updated legislation. These initiatives have resulted in improvements to program integrity, integration with other health and human service programs, and ultimately provide better services to citizens. The ACA put the wheels of change in motion, and now, with unprecedented innovations taking place in technology, health and human service managers and administrators are in a unique position to advance their organizations’ mission while con- tinuing to improve operations. nology is that proper application can address both mission advancement and business efficiency. Those managing health and human service agencies must consider both when making infra- structure decisions. The decision does not have to be an all or nothing proposi- tion, but it should be one that results in positive impacts and gains in the short term, and has increasing poten- tial to improve business processes and customer services over the long term. The short-term goal for many health and human service agencies remains in the need to streamline enrollment and eligibility processing. This requires reengineering and automating legacy Advancing the Mission While Improving Business Efficiency The beauty of innovative tech-
and/or paper-based systems, with the goal of readily guiding citizens and providers to what they need, when they need it. With intense decision-making driving these processes, automating business decisions is a critical means to achieving both short-term and long- term goals. This is where a business rules management system (BRMS) can help. The Benefits of Adopting a BRMS The effective management and auto- mation of business rules provides a number of valuable benefits to health and human service organizations. A BRMS can decrease costs, improve compliance, and provide a better citizen experience. These systems can help your organization make better and faster decisions, and be agile enough to rapidly adapt to changing rules and regulations. These systems help you:
Keep up with the pace of change. With IT backlogs of change requests that may take months to deliver, a BRMS helps change business logic in hours not months. Improve efficiency and produc- tivity. A BRMS helps to automate recurring decisions that are governed by policy and guidelines, significantly reducing the need for manual interven- tion and processing. Ensure compliance. A BRMS helps capture policy and regulation in the form of business rules that are enforced automatically with each transaction. And every decision in the BRMS provides an audit trail. Improve citizen service. A BRMS helps provide more responsive expe- rience to citizens, serving as the backbone to deliver a modern and powerful self-service experience.
See BRMS on page 34
Illustration by Chris Campbell
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Policy&Practice August 2015
from our partners By Carole Hussey
There’s No Such Thing as an IT Project … Only Business Projects with IT Components
W hy do you invest so much money in technology? To solve business problems. There are many compo- nents to a project: policy, program, legal, funding, and yes, technology. Information Technology (IT) invest- ments must be aligned with your organization’s strategy and goals. Proper due diligence must be con- ducted to ensure that you are investing in the right things and that there is value derived from those investments. There are many options and consid- erations that require comprehensive analysis and planning in advance of all decisions and execution. With so much at stake, how can you afford not to plan your projects with a broad and holistic perspective? IT to support business needs and processes is no longer just nice to have. It is an expectation and a necessity. It is how you conduct your business and serve your clients. This is just as true in the public sector as it is in private industry. A younger work force, tech- nologically equipped clients, decreased budgets, and staffing reductions all support the demand for technology in your business. Responding to client needs, complying with regulations, managing workloads, and measuring outcomes are all business problems that require technological and data- driven solutions. Unfortunately, without considering all potential areas of impact and opportunity, technology can sometimes exacerbate issues or create new problems, rather than achieve the intended outcomes. Technology is not a silver bullet to solve all of your business problems. For instance, equipping your staff with a smartphone or iPad® without
costly to address issues effectively. In this reactive mode, all of the options that were once available may be limited. In the IT world, it’s common to hear that projects fail due to poor require- ments, lack of project management, and inadequate testing. These, however, are symptoms of bigger and broader issues. System requirements will not be correct if the business problem to be solved is not thoroughly contemplated, a comprehensive business process has not been developed, and business impacts have not been fully considered. Without these elements, projects tend to be managed through the software development lifecycle, which is focused solely on the technology and not on the business. All of the impacts to the broader environment and stakeholders may not be evident until the project is fully implemented. Another issue that often occurs is what you could call “one vendor, one approach.” If you have a vendor that you are under contract with, and you want to leverage that contract to
a plan for how to use them and what you hope to achieve may become a wasted investment. Worse yet, there may be unintended consequences from a “failed” technology project. If you haven’t given careful consideration to possible regulatory violations, data- sharing limitations, labor implications, or funding options for your project, you may be exposing your organization (not just the project) to significant risk. For projects with sizable IT compo- nents, responsibilities such as project management and project sponsorship are often delegated to a technology department or senior technology pro- fessional. While seemingly logical, this delegation introduces the risk of critical business needs falling victim to technological perspective. As a result, project management becomes reactive, preventing goal-oriented and effective solutions. Without an intentional and well-designed planning process on the front-end and holistic project manage- ment focused on solving the business problem throughout the project life- cycle, true project implications may not be revealed until it’s too late or too
See IT Project on page 35
Photograph via Shutterstock
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August 2015 Policy&Practice
Innovative Approaches to Improving Child Welfare Outcomes
hild welfare (CW) agencies are increasingly driven to improve operational efficiency, increase information-sharing, and better By ruthie seale and william saunders C integrate processes across operational and jurisdictional boundaries—all with the goal of providing seamless, superior services to families that need help protecting and caring for their children. Recently, the concept of cloud computing has captured significant attention as both a business and computing model that enables government agencies like child welfare to achieve these daunting objectives. The current buzz within the information technology industry involves customers “moving to the cloud.” But defining the cloud and showing how child welfare agencies can take advantage of its efficiencies as the private sector is doing remains a challenge and opportunity for many public-sector organizations.
Photograph via Shutterstock
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easily, and on demand—and in most instances, without significant capital expenditures. The model makes sense from a practical standpoint, because govern- ment agencies want to achieve lower computing costs, improve quality of service, and more quickly deploy new capabilities. The movement of applications and information to the cloud has also accelerated due to new economies of scale and evolving con- sumption models. For example, the U.S. federal government’s Cloud First policy mandates that agencies take full advantage of cloud computing benefits to maximize capacity utilization, improve IT flexibility and responsive- ness, and minimize costs. Child Welfare Agency Investments Like many government organiza- tions, CW agencies increasingly are innovating to help lower costs, increase efficiency, and improve operational agility. Cloud computing is integral to that innovation, and now is rec- ognized as both a business and a deployment model that can transfer how CW agencies work with children and families to achieve family reunifi- cation, adoption, or to provide services to children as they age out of the system. There are three primary business drivers for CW agencies looking to reap the benefits of cloud computing: l First, similar to the private sector, CW agencies seek to improve services and experiences for children and families. These include better, more integrated, and targeted services, while reducing the long- term cost of delivery. l Second, CW agencies aim to overcome budget cuts and associ- ated constraints while combating rising service delivery costs. CW agencies must maximize funding in order to effectively meet the needs of children and families, and for new families formed through adoption or guardianship. In the current economic climate, governments are faced with declining tax revenues and other sources of revenue, while operational costs generally continue to rise.
Cloud computing is a technology model that changes the way govern- ment agencies consume information technology (IT) services and how they deploy these services to their stakeholders. In its simplest term, cloud computing is the practice of using a network of remote servers on the Internet to store, access, and manage data. Although some see cloud computing as an IT initiative, many government agencies are con- sidering changing the way they do business to optimize services toward constituents. From a technology standpoint, cloud computing offers a model for enabling convenient, on-demand access to a pool of shared computing resources. These resources range from various applications that specific industries and organizations provide to service customers and to manage their businesses, to the tools devel- opers use to create those applications. It also can include the computing infrastructure—databases, servers, and storage, for example—used to power the applications. Simply put, cloud services provide the ability for end users to use parts of bulk IT resources over the Internet quickly,
l Third, CW agencies seek to deliver more innovation in response to demands from service providers that expect government service to be of the same quality they can find in the private sector. These include personalized solutions for the unique demands of the families and children they serve. And, in response to customer demands, they need to do so much more rapidly than ever before. Cloud Transforming Child Welfare Cloud technologies can improve service delivery for CW agencies. In Joe Mullich’s article in The Wall Street Journal, “16 Ways the Cloud Will Change Our Lives,” he describes a world in which end users will be able to make smarter decisions based on the nearly ubiquitous access to relevant information. He notes approx- imately 10,000 laptops are reported lost every week at 36 of the largest U.S. airports. These laptops carry sensi- tive information, such as personal, customer, financial, and payroll infor- mation, subjecting organizations to embarrassment and financial risk if important information is exposed. We know that secure cloud environments can eliminate those concerns, and actually increase security by storing encrypted data remotely in cloud servers. The laptop or mobile device no longer needs to store data; rather, it becomes the instrument by which to access it. Cloud services enable agencies to: Simplify Access: The cloud can help caseworkers access any type of data regardless of location; this results in caseworkers spending more time in the field working with families and children. As the millennial genera- tion continues to enter the workforce, they expect technology to enable their work—anywhere and from any device. Cloud services allow CW agencies to keep this next generation of case- workers engaged and motivated. No longer will caseworkers have to spend time in the office researching the history of a case and keying in redundant data. They can capture assessment data, notes, and informa- tion in real time and can access, edit,
Ruthie Seale is the director of HHS Strategic
Programs—East at Oracle Corporation.
William Saunders is the director of Government Cloud at Oracle Corporation.
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Policy&Practice August 2015
In addition to important business drivers, childwelfare technology professionals and operationsmanagers face their own set of challenges and opportunities to modernize childwelfare services. Cloud computing can help—by containing costs, improving processes, and increasing service quality.
Final Points to Consider In addition to important business drivers, CW technology professionals and operations managers face their own set of challenges and opportunities to modernize child welfare services. Cloud computing can help—by con- taining costs, improving processes, and increasing service quality. Ask yourself: Does your agency have periods of peak workload activity? If yes, cloud computing provides on- demand service delivery. This means agencies can accommodate uneven computing loads on an as-needed basis, spinning up resources and envi- ronments when needed, using them during the peak, and eliminating them when the workload dissipates. This can dramatically reduce expenditures for resources that are largely idle during off-peak periods. Is this your agency? Does your orga- nization have a broad combination of applications, written in a wide variety of programming languages, running on a confusing mix of platforms that don’t talk to each other? Can they share timely, accurate, and valuable information? Standardization and consolidation in a cloud environ- ment can reduce costs and improve agility at every level in your agency. Protecting and serving children and families is your mission. Cloud solutions can be an enabler to help you more effectively deliver modern services to your important clients. That’s when modern technology para- digms fall to the background and you can focus on what matters most.
Deployment is minimal, the infra- structure is ready, and the security requirements are already in place. Incremental Modernization: While demands for modern services are high, the risks associated with modernization need not be. Gone are the days when “rip and replace” applies to all aspects of IT moderniza- tion. Cloud computing changes this. For example, on-demand provisioning allows for agile development, testing, and deployment of agency applica- tions by delivering resources only when needed. Put differently, cloud computing allows an organization to stand up test and development environments that are identical, only when needed, use them temporarily, and eliminate them when the need no longer exists. Why is this important? This functionality better enables faster development of services. The modern- ization approach can be incremental, replacing pieces of functionality rather than the entire application. This can reduce project risk, enable better training, and, subsequently, increase adoption. Subscription Based: Cloud com- puting virtually eliminates vendor lock-in. The services are based on sub- scriptions, allowing the flexibility for customers to move from one provider to another as circumstances dictate. Depending on the service model, the customer may choose neither to own the application nor the hardware on which it runs, allowing for a very low cost for entry to explore different services, service models, and service delivery organizations.
and enter observation notes and data throughout the day using their mobile device. The extra time in the field allows caseworkers to visit with more children and families and modern cloud tools allow caseworkers access to current information on demand. Mobility: Some of the biggest oppor- tunities for CW agencies will arise through mobile scenarios. Caseworker- client communications will improve. For example, cloud computing gives mobile-device users a level of speech recognition accuracy that is virtu- ally on par with call center-based transcription services. Imagine a caseworker at a client site needing to communicate with someone who only speaks Spanish. The caseworker could contact the client through the mobile device and have their words instantly translated into the other’s language using voice recognition and translation software. Analytics: The cloud can enable CW agencies to better understand the population being served by tracking overall service usage and create the ability to identify and prioritize service needs. Traditionally, child welfare agencies use trend analysis to assist in decision-making. They accomplish this by comparing data over time and identifying the results—predicting outcomes. Predictive analytics are changing the way cases are managed and are impacting and improving all aspects of child welfare, from placements to outcomes. The cloud offers the ability to take advantage of predictive analytics through the use of data feeds to tuned data models.
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August 2015 Policy&Practice
Human services is experiencing many of the same challenges
capacity within and throughout public, nonprofit, and private human services to move up the Value Curve—using a business model that highlights the capacity and competencies that are needed to generate practical, yet innovative, solutions. The model is designed to provide a roadmap for improving human service outcomes, value, and legitimacy through the lens of four progressive stages of value to individuals, families, and com- munities: regulative, collaborative, integrative, and generative. As public agencies and nonprofit multi-service organizations (MSOs) focus their organizations on this stage progression, they invariably recognize the need to partner together, while they also see the tremendous benefit of doing so: l When public agencies advance to a stage where they are advocating for culture change within their commu- nities, to reduce overall community risk factors and increase opportu- nities (generative), they must join forces with MSOs. l When public agencies improve their organizations’ functioning in order to better manage and sustain innovations, they are more capable and motivated to align clear vision, strategy, management practices, cultural patterns, and quality staff— all of which increase readiness and ability to partner strategically. l And when strategic partnerships and financial dynamics between the public and MSO sectors in a given community improve, this results in more transformative approaches to practice and service, and mutual acceleration through the Value Curve stages. Our Partnership with the Kresge Foundation APHSA was awarded a two-year grant, beginning July 1, 2013, to support a range of work that would advance the transformation of human services in the 21st century, including the testing, development, and initial
implementation of a change manage- ment toolkit for agencies determined to make this journey. We had two critical assets ready to bring to this challenge: n The Health and Human Services Value Curve and APHSA Maturity Model, used to assess one’s desired and current stage of progress along a broad range of related factors. APHSA’s National Collaborative for Integration of Health and Human Services continues to develop guidance for systems planning their related strategies. n The APHSA Organizational Effectiveness (OE) practice and Handbook, developed since 2004 and evaluated in 2012, with very promising findings that connected the using OE practice, making desired changes, improving services, and improving impact. To date, OE has been employed through 80 projects in 30 states. Two primary types of input were used to inform the design and content of this toolkit, one that combines the core methods and tools from the Value Curve and for OE: n Field testing and implementing tools and methods with three agencies actively and explicitly advancing through Value Curve stages. These agencies are located in Hampton, Va., Olmsted, Minn., and Sonoma, Calif. n Patterns and themes generated from documenting a broad range of agency and community innovations gathered as another part of our work under the Kresge grant The Toolkit’s Specific Purpose and Design The change management toolkit is designed for agency or association directors and their leadership teams, helping them to understand the “moving parts” involved in such a transformative change effort: n Gauging their readiness for complex change, n Assessing themselves compared to a desired future state, and
that all modern systems face, including rapidly changing economic forces, social structure, demographics, com- munications, and technology. Leaders from all sectors of our field must be able to adapt to this changing environ- ment, and lead a culture change within their organization that supports a more collaborative, creative, and innovative way to deliver services in communities across the nation. Indeed, it is impossible to deliver a truly holistic platform of solutions and supports to people, families, and communities in need of them, without a highly collaborative partnership approach. This approach results in more efficient and effective intake and eligibility platforms; more effective casework and engagement practices that respond well to any and all root causes for the challenges faced by the people we serve; and more powerful, far-reaching advocacy and capacity- building efforts that are much larger than the needs of any individual or family case. An Emerging Framework for Field Transformation Developing stronger cultures and strategic partnerships is also how APHSA is approaching its internal operations and partnerships. One such strategy is APHSA’s partnership with Harvard and Accenture since 2010, to jointly sponsor Harvard’s Human Services Summit. This annual series has provided an opportunity for par- ticipants to learn from and network with the world’s foremost human service practitioners—public and private, domestic and global, along with Harvard faculty and researchers and industry experts on ways to col- lectively address our most challenging issues. A key framework developed for the summit by the Technology and Entrepreneurship Center’s Leadership for a Networked World, and used to advance critical issues during this event, is the Human Services Value Curve. APHSA’s objective is to build
Photograph via Shutterstock
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August 2015 Policy&Practice
Figure 1. Human Services Value Curve Components, adapted from Antonio Oftelie, Harvard’s Leadership for a NetworkedWorld.
for procuring and allocating resources
assistance or facilitation. However, a toolkit coupled with limited technical assistance can work well, as evidenced by our testing with Hampton, Olmsted, and Sonoma counties. The toolkit is available electroni- cally through APHSA’s web site, and will also be delivered through our “learning by doing” institutes and direct OE consulting activities. It is designed with the following sections: 1. An introduction that defines the stages of the Value Curve in opera- tional terms. 2. A brief summary of transformation themes stemming from our docu- menting of innovations taking place around the country and also from our three test sites: Sponsorship, Staff Engagement, Partnerships, and Resources. 3. A brief discussion of readiness for change and links to the APHSA readiness assessment tool. 4. A discussion of “big leadership” as a driving force for sustaining a trans- formation effort, as the most critical readiness and sustainability factor, and links to APHSA’s adaptive lead- ership tool. 5. Specific sections with links to related tools and templates for: a. Defining the desired future state b. Opening up stakeholders and staff to the possibilities of transformation c. Establishing a strategy platform and sponsorship structure for the work d. Establishing improvement teams and work teams to connect the strategy to effective and empowering planning and imple- mentation activities e. Effective facilitation as a critical support function to teaming f. Building capacity in critical change and sustainability areas, including data and analysis, support functions, general work- force, through partnerships, and
n Planning strategies that will address the reasons for the gaps between their current and desired state. Having such tools raises aware- ness for how agency leaders and their partners can concretely move through stages of the Value Curve together, and helps to build efficacy and, therefore, commitment to actually doing so. Indeed, our recent self-assessment scan of state and local agency CEOs indicated that these leaders, by and large, clearly want to advance to the Integrative and Generative stages, yet, at the same time, make very limited progress in across most of the related fronts required. Some very high-readiness agencies will be able to use the toolkit without additional support and actually advance through the Value Curve stages in a self-directed manner, but most need some form of technical support. We do not think a toolkit alone can be designed for systems to apply in transformative efforts without any form of additional technical
g. Communicating for impact throughout the transformation effort h. Monitoring progress, impact, lessons, and adjustments to form a continual learning cycle i. Topic-specific tools for common barriers and enablers to change and innovation While appearing robust and complex, this toolkit is comprised of a small fraction of the APHSA Organizational Effectiveness Handbook, and only includes those tools identified by the test sites as relevant and clearly useful to them. The full range of tools avail- able can, therefore, be reserved for an experienced internal or external OE facilitator to employ once a system is committed to moving forward. In Closing Agencies, MSOs, and communities around the country using the tools and language of this toolkit will further strengthen the impact resulting from similar efforts to the annual Harvard Summits. Indeed, it is already evident in many ways that our field is speaking and working in a more unified manner using the precepts of these materials. As we continue distributing and sharing the toolkit, through future efforts—a peer-to-peer “learning by doing” institute or other means of tech- nical support—this value will continue to grow. And through our efforts to facilitate understanding and application of these tools, as well as through embedding management strategies to ensure con- tinued improvement and innovation, we have, by extension, more communi- ties aligning around common ideas, goals, frameworks, and strategies. This “collective impact” will grow as we advance the use of these models, tools, and facilitative techniques.
Phil Basso is APHSA’s deputy executive director.
Anita Light is the director of
APHSA’s National Collaborative for Integration of Health and Human Services.
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Policy&Practice August 2015
2015 EVENTS & CONFERENCES
INFLUENCE BUILD CONNECT 2015
Hyatt Regency Savannah
National Association for Program Information and Performance Measurement Annual Education Conference Enhancing the Integrity and Outcomes of Human Service Programs
IT Solutions Management for Human Services Annual Conference Sharing Innovative Solutions, Connecting IT Professionals, Collaborating with Private Sector Partners
Renaissance Seattle Hotel
Renaissance Seattle Hotel
National Staff Development and Training Association Annual Conference Sharing Ideas and Resources on Organizational Development, Staff Development and Training
American Association of Public Welfare Attorneys Annual Training and Education Conference Attorneys Sharing Knowledge and Promoting Innovation
American Association of SNAP Directors Annual Education Conference Strengthening Long Term Family Health and Well-Being
Join Us AT THESE INNOVATIVE EVENTS
www.APHSA.org @APHSA1
2,400 iPads.
1 Agency.
5 Real-World Lessons to Strengthen Your Mobile-Enabled Workforce
By Amy Kershaw and Matthew Burnham
Cool. Helpful. Efficient. Productive.
These are some of the words that social workers used to describe the 2,400 iPads that the Massachusetts Department of Children and Families (DCF) distributed to improve social worker efficiency and effectiveness in 2014. This was near the start of DCF’s journey to become a mobile agency—a journey that continues today. MOBILE MATTERS From smartphones to tablets, mobile technology is part of the fabric of life. As such, developing mobile device strategies for citizen service and workforce productivity is a public- sector priority. In fact, a recent survey reveals that a majority of state CIOs sees “mobile devices and apps” as a key area for the strategic agenda and operational plans. Social workers across human services—including child welfare—have an affinity for mobile technology. Every day, social workers connect with people during visits, in the car, at court, and from home. When your office is everywhere and face-to-face connections mean everything, mobile devices are more than cool gadgets; they are lifelines for delivering outcomes. FAST START, FAR REACH DCF’s mobile journey began after an internal inquiry to improve the agency’s engagement with children and families. The Child Welfare League of America recommended mobile devices to improve compliance and communication,
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August 2015 Policy&Practice
suggesting that social workers use them to enter real-time data into iFamilyNet, the state’s web-enabled SACWIS system. After rapidly deploying iPads to field staff, DCF teamed with Accenture to analyze the initial rollout and create a blueprint for future implementation. FIVE LESSONS LEARNED This analysis—and insights from DCF’s transformation experience— reveals five lessons for any human service agency developing or strength- ening its mobile workforce. 1. Look beyond the device—focus on the mission. Creating a mobile workforce is not just about distributing devices and watching results happen. Agencies must develop mobile workforce programs with a perspective on howmobile can drive the mission forward, tying mobile metrics to case practice metrics. DCF is making an important shift over time. Mobile devices are viewed as essential tools for essential work—from fieldwork to new employee training. By connecting mobility to the mission and wrapping cultural change around it, DCF is creating an environment where device development is a vital part of the future operating model.
agencies, such as juvenile justice and transitional assistance, as they con- template a move to a more mobile workforce. 5. Get input from the field—early and often. The workforce knows best when it comes to mobile devices. As such, agencies should start with the field: What do social workers need? Consider formal bidirectional feedback channels to ensure that leading practices are shared widely and consistently, that field feedback is gathered, and that innovation is not limited to silos. DCF staff uses the DCF app store to request apps to translate languages, look up medications, get weather alerts, enable dictation, and set up car seats correctly. DCF also conducts field surveys of their workforce to under- stand needs and practices. All of these suggestions support social workers’ needs in the field and help agency lead- ership better understand the potential of the devices. CONTINUING LEARNING The first agency-wide survey showed that 74 percent of the DCF work- force is comfortable with the mobile devices—66 percent feel more efficient using them. In addition, 87 percent of supervisors—who recently received iPads as part of the second round of deployments—think that social workers are more effective with them. DCF continues to enhance its mobility initiative as part of a port- folio of reforms aimed at program and organizational effectiveness. Plans are underway to make IT investments with a view toward an enterprise mobile approach and to align department policy, communication, and training strategies to reflect the new mobile environment. Like mobile technology itself, DCF is on the move. The agency has learned that the destination is not the device itself. Because empowering a human service mobile workforce, like empow- ering families, entails being flexible, responsive, and open to change.
2. Bring the office to the field—break down the walls. Mobile devices have provided social workers with flexibility and real-time access to information that is neces- sary for their work with children and families. Social workers already spend more time in the field than they do in the office. Now that they have mobile devices to interact, communicate, report, and serve, traditional in-office mandates can be too limiting. In providing social workers with mobile devices, agencies must address an issue with human resources (HR) policy and practice implications. DCF discovered the need to develop consis- tent HR policy to maximize the benefit of the mobile devices. 3. Think infrastructure—not just tools. No technology tool—including mobile devices—works in isolation. As human service agencies make mobile the main technology platform for the workforce, hardware and software investments must reflect this fact. A mindset shift among IT staff is key. At DCF, user interface design is increasingly about mobile user inter- face design. Developers need to think about how social workers access and use information on-the-go and the fact that they want to use mobile devices to facilitate service provision and interac- tions with families. 4. Look beyond your agency—don’t go it alone. Departments across all levels of gov- ernment are focused on mobility. This creates an opportunity to look outside individual agency boundaries for support. State-level information tech- nology systems and human resource agencies, in particular, can assist with procurement, security, application development, human resources policy development, and other operational needs. DCF has regular conversations with the Massachusetts Executive Office of Health and Human Services, the Massachusetts Office of Information Technology, and the Massachusetts Human Resources Division to solicit and share information. DCF is also sharing lessons learned with its sister
Amy Kershaw is the assistant com- missioner for Policy and Practice at the
Massachusetts Department of Children and Families.
Matthew Burnham is a Public Service Strategy executive at Accenture.
Reference Note 1. 2014 State CIO Survey, NASCIO/ TechAmerica/Grant Thornton
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Policy&Practice August 2015
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