P&P August 2016

A cross the United States, there are 3,069 counties and more than 89,000 cities. Within these local governments is an array of essential services that often touch their residents’ lives on a daily basis, such as schools, road construction and maintenance, cor- rections, health, housing, and social support programs. In 2015, county gov- ernments invested $58 billion 1 in local human services. The reach and scale of local human services is enormous, and the potential to leverage this capacity to build well-being for Americans where it must be constructed—in local communities—represents a tremen- dous opportunity for achieving the change we seek. Local human service agency leaders have come together for multiple years through APHSA’s National Council of Local Human Service Administrators (Local Council). These local leaders share best practices and collaborate in their efforts to improve their service delivery systems. As an integral part of the APHSA family, the Local Council works to exert a positive influence on development of national policies and programs affecting local human services and to promote the profes- sional interests, competence, and leadership of county and city public human service administrators in the United States. Beginning in 2014, the Local Council committed to leveraging the collective strength of its collective partnership by focusing on a specific high-value proposition (see text box at right). In order to improve outcomes for families, Local Council member agencies are designing and implementing strate- gies to reduce the historical separation between housing, human services, and health systems. Agencies are also increasing the focus on upstream pre- vention-oriented programming, and developing data-driven, cross-sector solutions. Locals are proposing we leverage and deploy our entire service

delivery continuum in our counties to better serve and achieve enhanced impacts on the lives of those we serve. To accomplish this, we will need the cooperation from many federal and state agency partners that will allow us to blend and braid funding and policies to achieve individualized movement toward enhanced overall well-being. The “Local” Opportunity(ies) Over time, many of us undertake upgrades and renovations on our homes to maintain the quality of the structure and adapt the living space to our changing needs. Choosing which upgrades and renovations are most critical to achieve the outcomes we desire requires an honest assessment of our time, budget, and goals. Similarly, many of APHSA’s local member agencies have been carefully reviewing their health and human service systems and considering ways to upgrade or renovate their programs and operations to strengthen their organizational capacity and effective- ness. They have used this information to reflect on and make further adjust- ments to advance in their journey along the Human Services Value Curve, 2 a framework to help leaders envision and create a path for their organization to reach desired indi- vidual, family, and community-centric outcomes. Within 10 years, the Local Council will transform the health and well- being of communities across the country by shifting programming and funding upstream into prevention-oriented and consumer- driven cross-sector solutions that improve outcomes across the lifespan and significantly reduce high-cost institutional interventions within a “social determinants of health” framework.

In order to deliver targeted, high- impact interventions, Local Council members across the country are con- currently designing, developing, and implementing new initiatives. Critical innovations include a common assess- ment process and case management platform with sharable data metrics and outcomes. Collectively the Locals propose “creating a pathway for pros- perity and well-being” by designing, testing, evaluating, and spreading key elements of a fully integrated and effectively coordinated health and human service system that can be tailored to local organizations’ maturity, resources, and priorities. The vision and mission for how local organizations can best achieve the health and human services they desire focuses on four primary components: 1. A “Practice Model for Well-Being” that includes a fully integrated and comprehensive system of practice, inclusive of health, where any door is the right door 2. A coordinated, individualized universal assessment and holistic casework approach that promotes employment and self-sufficiency for those who can work and collabora- tive case planning for all clients 3. Evidence-based tools that can be leveraged by caseworkers and clients to flexibly manage and distribute benefits tailored to the true self-suffi- ciency needs of the family 4. An array of housing, educational, and employment options and accom- panying supports for transitional youth and their families that look holistically across the family needs for improved well-being Impacting Local Communities: A Practice Model for Well-Being When thinking about a commu- nity, and all the resources, services, supports, organizations, and programs

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August 2016 Policy&Practice