P&P February 2016

2015 HHS Integration Self-Assessment During the summer of 2013, and again in 2015, the National Collaborative provided APHSA state and local members with an elec- tronic self-assessment instrument to understand where they were on the road to human service integration and data interoperability, important benchmarks relative to achieving the Pathways vision. Based on earlier discussions with state and local CEOs, we framed our survey questions around the dozen parameters shown in the accompa- nying chart. A brief description of these parameters (aka Key Features) was developed by the advisory group for each of the four levels of integration maturity— Regulative, Collaborative, Integrative, and Generative. The result was a 4 x 12 matrix we have described as our H/HS Horizontal Integration Maturity Model. 1 In developing the self-assessment, we provided four possible responses to each question based on the characteristics in the Maturity Model. A respondent’s answers could then be easily cross- walked to one of the four previously mentioned maturity levels. Over the course of the two surveys in 2013 and 2015, APHSA was provided with a snapshot of its members’ current status and progress toward systems integration. While this was by no means a scientifically based analysis of the highly complex mix of current activities in every state and county, the full report, “On the Road to Horizontal Integration: Results from APHSA’s 2015 National Survey of Health & Human Service Agencies” can be found

12 KEY FEATURES REVIEWED BY APHSA’S SELF-ASSESSMENT IN 2013 AND 2015 • Organization’s Vision/Strategic Focus • Defining Success • Governance/Decision-Making • Adaptive Leadership/Organizational Change • Access to Services by Consumers • Eligibility and Enrollment: Common Processes/Shared Services • Role of Front-Line Worker Relative to Coordinated Service Delivery • Measures • Integrated Infrastructure/Cross-Boundary Communications • Workflows • Use of Data and Front-Line Workers’ Access • Use of Technology

on our web site. 2 Although the report focuses on the results from the 2015 survey, a comparative analysis of the results from both the 2013 and 2015 surveys is also included. 2015 Top Five Key Features Farthest Along the Integration Pathway 1. Adaptive Leadership/ Responsiveness to Change Sixty-three percent (63%) of all responses to our questions on this topic were either Integrative or Generative. Respondents saw the leadership of their organizations as being highly mindful of changing circumstances and prepared to move quickly when necessary. 2. Governance/Decision-Making While some respondents tended to say their key decision-makers were exclusively internal to their organiza- tion, nearly half (46%) indicated they include people from other parts of the enterprise, or even external to it. 3. Vision/Strategic Focus Four out of 10 respondents (42%) believed that their organizations were focused on addressing the root causes of their program participants’ needs, with many of them working with partners outside the H/HS enterprise.

4. Outcomes/Defining Success More than a third (37%) of the responses on these topics was either Integrative or Generative. 5. Consumer Access One out of three respondents, (33%) overall, thought their organization’s infrastructure for enabling program participants to access the services provided was either Integrative or Generative. 2015 Five Key Features Least Far Along on the Road to Integration 1. Use of Technology 3 Of all 12 Key Features, the Use of Technology was viewed by the respon- dents to be the least far along in terms of being fully integrated. Nearly 9 out of 10 respondents provided responses that were either Regulative or Collaborative. We asked such questions as: (a) “How is technology used in your orga- nization?”; (b) “Which technology features most closely characterize your eligibility and enrollment system today?”; (c) “What would you say is the primary purpose for which your systems were designed?”; and (d) “Is data shared with others, and for what purpose?” In response, the answers that came back included: “Technology is

Megan Lape is the director of the National Collaborative for

Integration of Health and Human Services at APHSA.

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Policy&Practice   February 2016