Policy & Practice December 2017

The Magazine of the American Public Human Services Association December 2017

PARTNERING FOR IMPACT

TODAY’S EXPERTISE FORTOMORROW’S SOLUTIONS

contents www.aphsa.org

Vol. 75, No. 6 December 2017

features

departments

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3 President’s Memo Co-Creating Generative Solutions for the Future

5 Editor’s Note

Storytelling in Our Field

6 Locally Speaking

A Common Agenda: A Strong Start in Life and in School

26 Technology Speaks

AI-Augmented Human Services

28 Legal Notes

Forging a Partnership Between Police, Youth, and Human Services Agencies

Structural Inequities in the Criminal Justice System A Personal Account

State and Federal Data Provide a Lifeline Data Sharing To Streamline the Lifeline Eligibility Process for Beneficiaries Nationwide

29 Reporting Child Maltreatment by Nonprofessionals: Obligatory or Discretionary?

30 From the Field

On Patrol: The Need for Better Collaboration Between Front-Line Police Officers and Child Protection Workers

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31 Association News

NSDTA and ISM Conferences and Awards

34 Staff Spotlight

Annette Coto, Compact Associate, Interstate Affairs and Compact Operations

40 Our Do’ers Profile

Adrienne Quinn, Director of the King County Department of Community and Human Services

Who Says Elephants Can’t Dance? Linking the Human Services and Third-Grade Reading for Transformative Change

Partners in IT Modernization Colorado Teams with CGI To Become First State To Modernize CCWIS

Cover Illustration by Chris Campbell

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December 2017 Policy&Practice

APHSA Executive Governing Board

Chair David Stillman, Assistant Secretary, Economic Services Administration, Washington Department of Social and Health Services, Olympia, WA Vice Chair and Local Council Chair Kelly Harder, Director, Dakota County Community Services, West Saint Paul, MN Treasurer Reiko Osaki, President and Founder, Ikaso Consulting, Burlingame, CA Leadership Council Chair Roderick Bremby, Commissioner, Connecticut Department of Social Services, Hartford, CT Affinity Group Chair Paul Fleissner, Director, Olmsted County Community Services, Rochester, MN Elected Director Anne Mosle, Vice President, The Aspen Institute and Executive Director, Ascend at the Aspen Institute, Washington, DC Elected Director Mimi Corcoran, Vice President, Talent Development, New Visions for Public Schools, Harrison, NY Elected Director Susan Dreyfus, President and CEO, Alliance for Strong Families and Communities, Milwaukee, WI

Vision: Better, Healthier Lives for Children, Adults, Families, and Communities Mission: APHSA pursues excellence in health and human services by supporting state and local agencies, informing policymakers, and working with our partners to drive innovative, integrated, and efficient solutions in policy and practice.

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Policy&Practice   December 2017

president‘s memo By Tracy Wareing Evans

Co-Creating Generative Solutions for the Future “Leading the development of thriving ecosystems takes tenacious leadership.” RODNEY ADAMS, MECKLENBURG COUNTY

O ne of the most inspiring moments for me in writing this column each year follows our annual APHSA Leadership Retreat, held in conjunction with the Harvard Health and Human Services Summit. Each year pioneering health and human services leaders from all levels of government, as well as other nations, join innovators from community-based organizations, philanthropy, other national associa- tions, academia, and industry to learn from each other and drive system-level thinking and change. At their core, these events—along with an additional day of shared learning convened by county members, embody the very theme of this issue— Partnering for Impact . This

year’s events focused on mobilizing ecosystems in order to drive the future of outcomes and impacts—something we clearly cannot do alone. To do so, we need willing partners from multiple vantage points, and with lived experiences from all aspects of the ecosystems we desire to connect more seamlessly to each other. At the heart of this shared journey sits the Human Services Value Curve, which, as a common lens for real- izing the potential of people and places, is serving as a useful model of interpretation for the field. The Value Curve is helping organizations build system capacity and create a learning environment. It is helping agency staff, community partners, and

philanthropic leaders see themselves in the broader value creation and impact we all desire for our communities. APHSA’s own Deputy Director Phil

See President’s Memo on page 35

The Human Services Value Curve

Ef ciency in Achieving Outcomes

Regulative Business Model: The focus is on serving constituents who are eligible for particular services while complying with categorical policy and program regulations. Collaborative Business Model: The focus is on supporting constituents in receiving all services for which they’re eligible by working across agency and programmatic borders. Integrative Business Model: The focus is on addressing the root causes of client needs and problems by coordinating and integrating services at an optimum level. Generative Business Model: The focus is on generating healthy communities by co-creating solutions for multi-dimensional family and socioeconomic challenges and opportunities.

Generative Business Model

Integrative Business Model

Collaborative Business Model

Outcome Frontiers

Regulative Business Model

Effectiveness in Achieving Outcomes

© The Human Services Value Curve by Antonio M. Oftelie & Leadership for a Networked World is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Based on a work at lnwprogram.org/hsvc. Permissions beyond the scope of this license may be available at lnwprogram.org.

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December 2017 Policy&Practice

Vol. 75, No. 6

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 website at www.aphsa.org. Copyright © 2017. 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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President & CEO Tracy Wareing Evans Editor Jessica Garon jgaron@aphsa.org Communications Consultant Amy Plotnick

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Policy&Practice December 2017

editor‘s note By Jessica Garon

Storytelling in Our Field

T hrough Policy & Practice we share your stories—successes, challenges, lessons learned—they all contribute to the pool of knowledge in our field. Unlike data and analytics—don’t get me wrong, they can change the face of human services—storytelling gets to the heart of the matter. Take, for example, our Deputy Executive Director’s feature article included in this issue, Structural Inequities in the Criminal Justice System: A Personal Account . This article provided Phil with an opportunity to recall, reflect, and report on his life-changing experience serving as a member of a grand jury. He describes this experience as being “woke” to the true injustice of racism and poverty. Does that mean he didn’t know these things already existed in our world? Of course not. But his experi- ence on the jury went deeper. Not all of us will be asked to serve on a grand jury, but through Phil’s first- hand account, we can gain insight on these issues. By sharing his personal story with a landscape view, we can shed a light on our country’s structural inequities and take this opportunity to work toward positive change. Here at APHSA, Phil’s experience helped initiate related strategies we’ll be advancing to address this issue. What else do we have in store? This year, we continued to apply the Human Services Value Curve to our work and desired future state. As this strategy is being adopted by human services agencies across the nation, we are examining services from the consumer’s point of view and real- izing the potential of our systems. We’re reaching beyond just individual families by focusing on communities, and in 2018, we’ll continue to widen our lens by focusing on ecosystems.

economic mobility for families and create thriving communities. This makes the theme of December’s issue—partnerships—extremely relevant and I look forward to part- nering with you in the coming year. I challenge you to be our next story- teller! Take a second to review our issue themes for 2018 (see page 4) and reflect on your past, present, and future. What story could you share with our readers that might provide new insight to our field, and ulti- mately, improve the lives of those we serve? As the popular saying goes, two heads are better than one.

As an editor and communications professional, I have an opportunity to read the latest and greatest from pas- sionate and dedicated leaders in the field, and from my perspective, eco- systems will be the future. As a Policy & Practice reader, you are probably familiar with ecosystems, espe- cially if you just read our President’s column in this issue. Just for good measure, here’s the definition from Antonio Oftelie, Executive Director of Harvard’s Leadership for a Networked World (LNW), “A set of intercon- nected organizations, machines, and services that can collaborate across boundaries, across silos, and design new solutions that address and solve root causes of individual, family, and community health and human services challenges.” In addition to our part- nership with LNW, APHSA is working closely with the Kresge Foundation to better understand how a focus on ecosystems can enable social and

Jessica Garon , Communications Manager at APHSA, can be reached at jgaron@aphsa.org.

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December 2017 Policy&Practice

locally speaking By Kate Garvey and the Members of the Alexandria Early Care and Education Work Group

A Common Agenda: A Strong Start in Life and in School

A lexandria, VA is a place where partnerships are the norm. If there is a problem, project, or event—Alexandrians approach it as a collaborative venture. Whether responding to the opioid crisis or carrying out the neighborhood Halloween party, Alexandrians work together. So it is not surprising that when it came to focusing on the best possible outcomes for young children and their families, a wide array of indi- viduals and organizations stepped up to face the challenge. In 2014, the Children and Youth Master Plan adopted by the City of Alexandria called for development of an “early care and education system that prepares children to succeed in life and in school.” The Early Care and Education Workgroup (ECEW)—a cross-sector workgroup comprising leaders from the school system, city agencies, funders, and the nonprofit community, and convened by the local community foundation—came together to accept this challenge and mission. A critical step in moving forward was to understand the challenges many families in Alexandria face. While the median household income for the city is high relative to the rest of the state, the number of children living in poverty is sizable and has been growing. The number of Alexandria City Public Schools (ACPS) students eligible for free or reduced meals is nearly 60 percent. Families in Alexandria are also linguistically and culturally diverse: 31 percent of residents speak a language other than English at home and students enrolled in ACPS represent 134 countries and 113 native languages. These data

suggested that the need in the city is significant and varied, yet, there are also valuable resources to build upon. Organized in late 2015, ECEW undertakes a “collective impact” approach to developing the system around a common agenda, framework, and set of strategies. Successful col- lective impact initiatives embrace a culture of continuous learning; develop an awareness of the context, conditions, and circumstances that surround the work; strive to under- stand what is working and what is not; and seek opportunities for improve- ment. This group did that and more. With a focus on trust and shared accountability, the group tackled long- standing barriers and confronted hard truths about how things had been done in the past and how things might be different in the future. The fol- lowing graphic reflects the key areas

of focus in creating the Early Care and Education System. Highlights of system alignment accomplishments include: „ „ GLASS DOORS: A unified recruit- ment tool was created for use by publicly funded preschool programs. In addition, a single, streamlined process that will help families deter- mine program eligibility and assure that families are matched with the right program is being developed. „ „ SEAMLESS SUPPORT: This effort to connect health and early education providers will help deliver coordi- nated and comprehensive care to children from prenatal to three years old. A survey of providers serving this population identified challenges in this area. Project champions across the health and early care and education sectors are currently working to build on the results of the

Illustration by Chris Campbell

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Policy&Practice December 2017

range of professional development activities that includes teachers from all of the city’s publicly funded preschools working collaboratively across programs. Alignment of cur- riculum is also a goal. While much progress has been made, we continue to strive for a system that is fully aligned, comprehensive, accessible, equitable, and of high quality that results in the best possible outcomes for Alexandria’s youngest residents. Kate Garvey is the Director of the Department of Community and Human Services for the City of Alexandria, VA.

understanding of the gaps and opportunities in existing funding streams and discover ways to better combine and optimize funding for a more equitable system. Early care and education providers shared significant information about their funding, demonstrating trust in the process and a belief that a shared funding strategy would be effective. „ „ THE QUALITY COLLABORATIVE: The Quality Collaborative is a shared professional development pilot involving all publicly funded early childhood programs in the city that is focused on improving teacher– child interactions. Now in its third year, the project has included a

survey—including broader commu- nity input—to identify priorities for creating stronger connections. „ „ DATA STEWARDSHIP: The ECEW is working to identify and share data that will help illustrate progress, trends, and gaps in the system. Data collection and analysis will help guide project priorities and work plans. Multiple program partners distributed a family survey devel- oped by the ECEW at the end of the school year to gather baseline data on awareness of and access to early care and education services in the city. „ „ COMMUNITY AND FUNDER MOBILIZATION: A fiscal mapping study was carried out to increase

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December 2017   Policy&Practice

A Personal Account Justice System Structural Inequities in the Criminal

By Phil Basso

a colleague, I was “woke.” For me, serving as the deputy of a national human services association, being woke feels like being foolish—for not knowing before what I now know in my bones. But it also feels like being cleaner, wiser, and more equipped. My summons to serve on a District of Columbia (DC) grand jury came in a small official-looking envelope. Mandatory service it said, with no exceptions. I had been called to petit jury service before—the 12 people comprising a trial jury—and had been picked for one. But this was a grand jury, and I had no idea what it was or did. To quote

circumstances. They don’t get the help they need early enough, and then sometimes become abusers themselves, learning about violence from those around them, unlike the role models I had growing up. Then they find themselves in front of a grand jury, where there is no chance for that support or empathy. Where they are demonized, despite who they really are and who they might have become. Today’s felon is yesterday’s vulnerable child. Grand juries don’t hear one case at a time, with all the live witnesses and evidence lined up in sequence by the prosecutor, as they would do for a regular trial. We heard evidence on 73 criminal felony cases. Any given case was presented to us piecemeal, over any number of days or weeks. By the time we were asked to deliberate and vote on a case, our sole yellow legal pads served as our best recall. The average time we had to deliberate and vote was around 20 minutes per case, including cases with more than 10 “counts” or elements of criminal behavior. When asked to vote on an indictment, it was often near the end of a day or near our lunch break. Throughout this cycle of evidence and indictment votes, we were reminded that our role was to deter- mine probable cause, and not guilt beyond a reasonable doubt. That was the job of the trial jury—12 people who would have to vote unanimously to find someone guilty. We were told that probable cause was the “lowest legal bar” for the court to estab- lish. This continual reinforcement served to focus us on DC’s written probable cause standards for the dif- ferent felony counts before us. And in the earliest days of our jury duty, my primary focus for each case was simple: “Did the crime probably occur? Did the accused probably do it? Is the evidence credible?” II. Starting to Really Understand “Don’t think about what happens after your vote.” I knew what our court liaison meant when she reinforced this principle with us—the prosecutors had been reminding us daily that probable cause is different than guilt beyond

Criminal grand juries in DC serve for five straight weeks, hearing witness testimony or other evidence for pro- spective criminal felony cases from DC government prosecutors. The role of a grand jury is to determine whether the prosecutor and government have “probable cause” to bring such a case to trial, in the form of criminal “indict- ments.” Did the crime probably occur, and did the accused probably do it? The evidence provided is limited to a prosecutor’s objective of meeting probable cause tests or require- ments that fit the criminal charges in question. There are no defense attor- neys involved. A DC grand jury has 23 people on it, and votes to indict or not when the prosecutor asks them to do so. A simple majority of 12 “yes” votes results in an indictment. On our first morning of service, we were told that we were upholding the U.S. Constitution’s Sixth Amendment, which guarantees the rights of criminal defendants—including the right to a public trial without unnecessary delay, the right to a lawyer, the right to an impartial jury, the right to know who your accusers are, and the nature of the charges and evidence against you. Were we a shield as envisioned by the Founding Fathers and envied the world over? Going into my grand jury service, I sure thought so, and I was dedicated

“Thinking about what

happens after I vote” started to seemawfully

important in reality,

assaults, sexual felonies, child abuse, and domestic violence. I’ve had the opportunity to recite this list a few times to live audiences, and almost a year later, I can’t do it without starting to cry: „ „ A child is sent to stay with “friends” for the summer and returns in shock and with various injuries we see in evidence photos; „ „ A young girl tells us about her being prostituted many times daily on drugs in a basement, with a chip on her shoulder and a teddy bear in her arms; „ „ A man comes to visit DC from a small town in the South to visit his old flame, is stabbed repeatedly, and then dragged along a bloody floor by a jealous ex-boyfriend; „ „ Two sisters testify about a history of sexual abuse from their stepfather, never having told each other until now, in the hope that he would focus on one of them and ignore the other. I was also deeply troubled each day by how people—just like me when they started out—experience long histories of abuse and neglect in their relationships and material comparedwith what wewere being told in theory.

to being an excellent jurist. I. “Lost Potential” and “Suffering”

As Grand Jury One , we were given the prospective felony cases that were the hardest to listen to: murders,

Phil Basso is the Deputy Executive Director of the American Public Human Services Association.

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Policy&Practice December 2017

a reasonable doubt. But I couldn’t help thinking that we were assuming a lot about what happens to the accused later in the criminal justice process. Once they were indicted, we were assuming that people were then going to have a trial with a petit jury and a defense lawyer in their corner. We were assuming that the entire jury would have to find them guilty beyond a rea- sonable doubt for them to go to jail or otherwise pay for these crimes. We were assuming much more preparation and evidence would be needed by our prosecutors for a jury trial and conviction to happen.

compensated for the number of cases they handle and close, not for winning cases at trial. A large majority of the accused in the cases we were hearing were poor people and minorities, African American, or Hispanic. Once we voted to indict them, it was very unlikely that they were ever going to trial. In other words, we were, in essence, giving them a felony record right then and there, and much more than that depending on their ultimate plea bargain. And it gets worse, illustrated by this additional finding: � Grand juries support indictment requests from prosecutors at such Poor, minority peoplewere sometimes pleading guilty to felonies, even if they were innocent.

a high rate that, according to legal scholars, “a competent prosecutor can indict a ham sandwich.” Of the 20-plus indictment requests our grand jury voted on, we rejected one. And that time, the prosecutor returned and asked us a range of ques- tions on where they went wrong. Why? Because prosecutors can go to another grand jury and ask for an indictment again. I began to realize that the way things were set up, a grand jury was not so much a Constitutional shield as it was a rubber stamp for indictments and plea bargains, with no “reasonable doubt” test ever being met by anyone! And sometimes—maybe 1 percent or maybe 10 percent of the time— innocent people were pleading guilty to felonies. That is, poor, minority people were sometimes pleading guilty to felonies, even if they were innocent. III.The Same People from the Same Neighborhoods All places have great strengths and potential—even ones facing serious problems and public safety challenges or struggling economically. These places are often more feared than sup- ported outside their own boundaries, and the approaches taken by police, educators, and landlords are some- times more punitive, the opposite of privilege, than is warranted or

“Thinking about what happens after I vote” started to seem awfully impor- tant in reality, compared with what we were being told in theory. Back home in front of the Internet, it was easy for me to quickly find out the following things: � Most criminal indictments never see the light of day. They never get in front of a petit jury, because they are plea bargained. � In 1977, 25 percent of criminal indictments resulted in jury trials. That has since shifted to 3 percent to 8 percent today, depending upon the jurisdiction in question. Why so few, and why this big shift? � Due to evolving case law from our country’s higher courts, the com- plexity, and therefore the cost, of criminal trials has risen dramati- cally since the Sixth Amendment was written. � Minimum sentencing laws, espe- cially for some drug-related crimes, have created much greater differ- ences between a plea bargain and what will happen if a person is con- victed at trial. � Almost all poor people who are indicted for a crime plea bargain. For the most part they don’t have enough money for bail and for a good defense attorney. � Public defenders may be good at the law and at trial, but they are

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December 2017   Policy&Practice

on a shooting and cold-blooded murder. The man who was licensed and trained to use a firearm at work to protect others’ property will no longer be able to protect or occupy his own home. We voted to indict this man with great reluctance. � Responsible Family. On TV, certain families from hard places can be depicted as loony, irresponsible, and full of drama. Upon hearing of their 16-year-old son’s involvement in a high-profile shooting being broadcast on local news, this family gathers up their son and turns him in. They stay with him and support him as he faces multiple felony indictments, but never waver in their conviction that their son needs to learn responsibility. This from one of DC’s “bad neighborhoods.” � Phone and Metal Pipe Pals. Two 20-something friends get into a cellphone beef, with one taking the other’s phone and running away with it. The other friend chases him into an alleyway, where the phone thief picks up a metal pipe to back away his temporary foe. A 911 call sets the process in motion for a mul- ticount felony indictment request, including the parents, for obstruc- tion of justice. Our jury voted this one down, not due to the probable cause test, but because “if this happened in an affluent place in DC, it would be never have gotten to us.” Both the accused and the victims we came to know often brought us pain and sorrow—the “knowing” so elo- quently understood by my friend. But they also brought us hope and inspi- ration—especially victims of abuse. Especially the children we met, who at times were shrugging off what we could hardly hear. IV. “Thank God for Grand Juries” One other important thing I took away from grand jury duty was a fuller awareness of the strong motivation

as we can become more tender and compassionate beings.” I think she’s right. So I’m no longer trying to move past these and other profiles from my community: � Mom. She was one of our first cases, a young mom who was street smart and street tough. She was a witness to her own assault by a recent boy- friend. Near the end of her testimony she looked to our jury, tears rolling down, and begged us to help her find another place to live so she could focus on her kids’ education and get a good job. � Bird of Prey. Some witnesses came before us in orange jumpsuits and shackles. This man in his 50s had seen it all. He looked at us with the curiosity and quiet intensity of a bird of prey. At first he scared me. But by the end of his testimony, I just realized he was a quiet, introspec- tive man, aware of and accepting his fate in life, with stoicism and a well-schooled alertness to the next situation where he’d have to glide away or attack. � Zac. My son’s name. He’s in the Marine Corps, which was a reason- able decision on his part given his limited “executive functioning” capacity. This witness, also in shackles, spoke in the same cadence and determined but easygoing tone of my own son. He was able to repeat from memory five different accounts of a carjacking gone to murder, told to him at different times. His accounts were so consis- tent, yet at the same time so varied and nuanced, that they broke my heart, thinking of his lost, brilliant potential. � Off-Duty Guard. A man supports his wife and two daughters, one with severe learning disabilities. The other daughter befriends a loafer who refuses to leave this man’s house for months. He finally calls the police, who briefly visit and tell him there’s nothing they can do. Thirty minutes later, 911 is called

effective. The forces within these communities close ranks among them- selves much of the time as a result. Our jury learned right away that the court process was itself not trusted by most of the people brought before us. Ratting and snitching were viewed by many as akin to the crimes we were reviewing. One witness sprang away from the stand, claimed to be “on every drug” and begged to be let go out of fear for his family. Others calmly lied to us, and others laughed and joked as they were lying. These place-based conditions may result in a cycle of crime and community-based fear, but not because the people living there are genetically predisposed, or are not possessed of American values. There’s just no trusted substitute for those with influence who live in the community itself. One day when we didn’t have anything on our regular docket, we were told we would be handling the “RIP” cases that day. RIP cases are for potential drug indictments. These were brought to us to complete, soup to nuts, in less than an hour. A detective or police officer was interviewed by the prosecutor, we were given instruc- tions, and we voted. While most of these cases struck us as credible, two related concerns arose. First, drug use in middle-class or affluent places is also high—witness opioid abuse—but since the methods of dealing are more visible and dangerous in poor places, we were only seeing those. Second, since the drug trade in poor places requires arming one’s self, almost all the indict- ments carried counts of violent crime that result in a much harsher outcome for those involved. I recently shared with a friend my sense of not being able to move past the experience. She reminded me that what I cannot “move past” is healthy, in the sense that I can no longer dispense with empathy and disregard painful things taking place in my com- munity. According to this friend, “it makes the ‘knowing’ worth the pain,

Today’s felon is yesterday’s vulnerable child.

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Policy&Practice   December 2017

� “Oh, is that still on the screen?” Again, some, but not all, prosecutors would leave upsetting pictures on a video or overhead screen for a few extra seconds while they searched their papers, making sure we were too upset to let anyone get away with the crime at hand. � “This is technically assault and kidnapping with a deadly weapon.” The written laws and standards for things like assault and kidnapping can be “jacked up” by prosecutors, I think to add counts to indictments without them really being appropriate. We had a case where the accused allegedly grabbed and held a victim who was falling, and were told that this justified a kidnapping count. � “Danny.” This quote looks different than the others, right? For a con- trasting example, one prosecutor actually explained both sides of the argument for indicting the accused before we voted on the case. He even shared with us what he thought the chances of conviction were in a petit jury trial. He went back over the facts of the case and answered our questions until we had none left. We found the police officers we met to be reasonable, respectful, and diverse in their backgrounds (age, race, gender). The detectives we encountered were also generally credible. What was troubling about law enforcement officers involved in our cases was how different their practices seemed to be in high-crime neighborhoods. Their approach appeared to be far less relational and much more task oriented than I’ve experienced when calling an officer or other emergency response profes- sionals myself. I now understand that the “structural” elements of what happens in reality—how work, policies, and procedures operate and result in outcomes and impacts that may be expedient, and may seem normal, but are unfair and inequitable. V. What We Can Do This list of suggestions is by no means conclusive, and my hope is that

Grand juries technically may call additional witnesses or request additional evidence, yet we never once did so. Why? Because pros- ecutors were highly skilled in redirecting our requests into expla- nations and reinforcement that we were not a petit jury, and only needed enough evidence to deter- mine probable cause. � “You have 15 minutes, and today is my deadline.” On occasion prosecutors explained to us that a 100-day allowable period to secure an indictment on a case was expiring that very day or the next. Given our dockets and scheduled breaks and end times each day, we were regularly in a situation where we had to rush through deliberations and votes to support that process. � “So now that you’ve agreed to put your video interview on the record…” Some prosecutors would ask victims to go back over their recorded testimony, to the point where they became upset in front of us. They would do this gently and supportively in tone, but we often asked each other afterward, “Why was that necessary when we could just read or watch what’s on the record?”

among the professionals we encoun- tered to meet their own immediate and case-driven objectives, which were to secure a “yes” vote for the requested charges and an official indictment as efficiently as possible. At one point a prosecutor who was getting to know us well said, “Thank God for Grand Juries.” Prosecutors know that a thoughtful grand jury will ask questions that help them think through their cases and address flaws in their arguments and evidence. But more important, grand jury votes— almost always affirmative—enable the targeted multicount indictments to go on record and put the plea bargaining process in motion. Here are some of the specific examples of the things prosecutors say that reinforce my perspective: � “I’ve clearly established probable cause—any questions before you vote?” This was a commonly used device that prosecutors used on a lay jury to basically intimidate them to give a “yes” vote. Prosecutors would almost invariably ask us this question, staring at us with keen readiness to argue down any thoughts of a “no” vote, before we were left to the deliberation and voting tasks. � “You’ve seen enough evidence to determine probable cause.”

See Grand Jury on page 36

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December 2017   Policy&Practice

A DATA LIFELINE State & Federal Data Sharing To Streamline the Lifeline Eligibility Process for Beneficiaries Nationwide Lifeline shares APHSA members’ goals of achieving better outcomes for benefi- ciaries, while streamlining the administrative costs for states and protecting the integrity of the program. To that end, Lifeline is establishing data connections with state health and human services agencies to streamline the eligibility verification process, both for beneficiaries and state program administrators. T By Michelle Garber he federal Lifeline Program is actively partnering with state human services agencies across the country to improve the process for Medicaid and Supplemental Nutrition Assistance Program (SNAP) participants to get qualified for the Lifeline benefit for phone and broadband service. Beneficiaries served by state health and human services agencies are also potential Lifeline customers, because customers can be approved as eligible for Lifeline by showing that they participate in SNAP or Medicaid. 1

to identify official documentation that can serve as proof of participa- tion, so USAC will have a full catalog of acceptable documentation, and eligible beneficiaries can get approved seamlessly and quickly. USAC is also consulting with its partners about what resources, tools, and training USAC can provide to social workers and community advocates to help eligible consumers sign up and retain this essential benefit. USAC sincerely appreciates our partners’ efforts to make the National Verifier’s launch a success. Looking ahead, USAC is actively pursuing new partnerships to identify the next set of National Verifier states. Our goal is to implement the National Verifier in the most effective and efficient manner possible. To partner with USAC to launch the Lifeline National Eligibility Verifier in your state, or to learn more, please contact Jessica Zufolo, USAC’s Director of State and Federal Partnerships, at Jessica.Zufolo@usac. org , or visit our website, usac.org/li . Lifeline strongly values our partner- ships with APHSA members to improve outcomes for our shared beneficiaries in low-income, at-risk communities. When the National Verifier launches in December 2017, we look forward to continuing those relationships and establishing new ones to deliver Lifeline in the most effective and effi- cient matter possible. Together, we can deliver affordable telephone and Internet services to our country’s SNAP and Medicaid recipients. eligible for Lifeline if they participate in the following programs: Supplemental Security Income, Federal Public Housing Assistance, Veterans Pension or Survivors Benefit, Bureau of Indian Affairs General Assistance, Tribal Head Start (if household meets the income qualifying standard), Tribal Temporary Assistance for Needy Families, and Food Distribution Program on Indian Reservations. 2. If an automated data connection is not available to a qualifying program, the National Verifier will prompt the consumer to submit proof-of-eligibility documentation, and live agents at the Lifeline Support Center will review the items and return an eligibility decision. Reference Notes 1. Customers can also be approved as

Lifeline is a $1.5 billion federal program designed to make phone and broadband service affordable for low-income households. It provides a discount of $9.25 per month, and households on federally recognized tribal lands can receive up to $34.25 per month. This important benefit was established by the Federal Communications Commission, and is administered by the Universal Service Administrative Co. (USAC), an independent, nonprofit company that handles the program’s day-to-day administration. The data connections from state health and human services agencies will be used by a new, nationwide tool called the Lifeline National Eligibility Verifier (National Verifier). With it, prospective beneficiaries can apply for Lifeline and the National Verifier will automatically check the con- nected federal and state data sources to determine whether the applicant is enrolled in Medicaid, SNAP, and other qualifying programs. 2 If they are, the applicant is automatically approved for Lifeline. In August 2017, USAC announced the first six states for the Lifeline National Eligibility Verifier: Colorado, Mississippi, Montana, New Mexico, Utah, and Wyoming, as well as a key partnership with the U.S. Department of Housing and Urban Development, which provided a connection to Federal Public Housing Assistance

data. The National Verifier will “soft launch” in December 2017, and “hard launch” in March 2018. Under the National Verifier model, all Lifeline eligibility verification will be handled by a single, neutral entity whose primary goal is to protect the integrity of the program, and protect these public funds from waste, fraud, and abuse. This model will deliver efficiencies to existing state eligibility verification processes, which are often managed by health and human services agencies and require exten- sive IT coordination with multiple phone and broadband companies. The National Verifier also provides a more streamlined experience for beneficiaries, giving them a single source of eligibility verification, rather than different processes depending on the telephone or Internet company they choose or the state they live in. Prospective beneficiaries will be able to use the National Verifier to check their eligibility with their computer, mobile device, or through a participating tele- phone or Internet company. Establishing data-sharing agree- ments with state and federal agencies is no small feat! USAC, the program’s administrator, collaborated closely with state health and human services agencies to establish the data connec- tions that power the National Verifier. USAC relied heavily on state agencies, including SNAP and Medicaid direc- tors, to understand and uphold state laws and codes, find the technology resources to prepare the data sources for connection, and align state-level Lifeline processes with the federal processes to avoid undue burden on beneficiaries. The project also bene- fitted from vibrant discussions with our state-level partners about protecting customers’ sensitive, private, personal data, and protecting the integrity of the program. There are other ways that USAC is actively engaging with state and especially the eligibility verification process. One example is preparing for those cases where the National Verifier cannot find an active SNAP or Medicaid participation record. We are working with APHSA members federal agencies to improve the delivery of the Lifeline Program,

Michelle Garber is the Vice President of the Lifeline Program at Universal Service Administrative Co.

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Policy&Practice December 2017

DANCE? WHO SAYS ELEPHANTS CAN’T

By Dr. janice m. gruendel LINKING THE HUMAN SERVICES AND THIRD-GRADE READING FOR TRANSFORMATIVE CHANGE ublished in 2002, Who Says Elephants Can’t Dance? Leading a Great Enterprise through Dramatic Change hit the bookstores as a “must read” for the business sector. Written by former IBM CEO Lou Gerstner, the book traced nearly a decade of leadership that transformed IBM from a massive,

p

hierarchical mainframe company into a nimble information services global business. In Gerstner’s view, this transformation was about more than stabi- lizing and growing its assets. It was all about culture change, “steely-eyed” strategy development, relentless passion, deep integrity, and world-class performance. Today, 15 years later, our health and human services agencies are engaged in the same journey—from functioning as large, lumbering organizational pachyderms to nimble, light on their feet, much more effective entities for their customers. A recent body of work, compiled by the BEST NC Pathways to Third Grade Reading initiative, provides a new lens on this process through its examination of “what works” to improve children’s essential skill development in reading. So, what do the health and human services have to do with third-grade reading? It turns out—quite a lot. And, as in the IBM journey, when our health and human services structures similarly transform themselves, they gain incredible power to more positively affect the learning and life success of America’s most important assets—its families and their children.

Why Third-Grade Reading? This particular skill, at this par- ticular point in time, is an important one because early reading compe- tence correlates with ongoing school success and the capacity of individ- uals to function as productive adult employees, parents, and citizens. The end of third grade is a key pivot point because that is when instruction shifts from a focus on “learning to read” to one that expects students to be able to “read to learn.” Thus, knowledge and skill gaps at this critical educational juncture can derail students’ success throughout their educational careers. Reading performance in the early years also provides a keen lens on troubling edu- cational, health, racial, and economic inequities as well as the essential role of the health and human services to impact child and family outcomes. The Pathways Journey In the fall of 2016, the North Carolina Early Childhood Foundation partnered with the Institute for Child Success to examine the research litera- ture on “what works” to advance the proficiency of third-grade students in the essential skill of reading. The focus was on evidence-informed policy, practice, and programs related to 12 contributors to reading proficiency at the end of the third grade. Through a collective input process, these indicators were selected from more than 40 data elements with some relationship to early reading, and they were clustered for analysis into three domains—health, family support, and birth-to-eight early care and elementary school education. The

HIGH-QUALITY EARLY CARE & EDUCATION B-8 EARLY CARE AND ELEMENTARY SCHOOL EDUCATION

HEALTH

FAMILY SUPPORT

HEALTHY BIRTHWEIGHT

SAFE AT HOME

EARLY INTERVENTION SOCIAL-EMOTIONAL HEALTH PHYSICAL HEALTH

FAMILY SUPPORTS

GRADE PROMOTION

POSITIVE PARENT-CHILD INTERACTIONS

SUMMER LEARNING LOSS

READING WITH CHILDREN

CHRONIC ABSENCES

of these indicator areas, the body of research related to each leaves much to be desired. We began thinking we would simply source studies that met the gold standard of research and that had been recognized by evidence- based clearinghouses. We quickly learned that there was less agreement on “the evidence” across rating sources than we expected. We also learned that while some studies did find signifi- cant impacts based on a solid research methodology, others studying the same intervention did not. We learned that each of the indica- tors has a synergistic relationship with several (or many) of the others. Most important, physical health, social- emotional health, family supports (formal and informal) and positive parent-child interactions are linked with each other and are huge drivers of early reading success. These relation- ships, and the data that reveal them, became an important element in the format for reporting our findings for each indicator. We learned, not surprisingly, that there are two “mediators” in this vital process early on—the nature of the adult–child relationship, and the nature of the adult–child–family relationship to our health and human services delivery systems (and, of course, to education). While these two mediating relationships are certainly true for all of us, they are especially relevant for children growing up in families with trauma, toxic stress, and multigenerational adversity, including economic challenge and inequity related to race and ethnicity.

chart above provides a useful short- hand version of the domains and the indicators within each. At the beginning of our work, in October 2016, the review process pre- sented itself as a reasonably short-term project of culling the literature on evidence-informed policies, practices, and programs related to each of the 12 indicators. The research journey actually took about nine months to complete, and at the end we had written (and rewritten) hundreds of pages and employed more than 2,000 citations to fairly represent a complex set of impacts and relation- ships—all at play in the process of young children’s acquisition of grade- level reading skills. What We Learned We learned that there is no silver bullet in assuring that America’s children become capable readers by the age of eight. The journey to reading proficiency does not begin with the academic process of phonics, vocabulary, or comprehension instruc- tion during elementary school, or kindergarten, or even preschool. It begins with the preconceptual health of mothers to be, with their histories of adversity and present lives of trauma and toxic stress, and with the capacity of our health and human services systems to early on identify challenges, address them, and support vulnerable women and families from the moment of conception and throughout the first eight years of their children’s lives. We learned that while there is evidence of “what works” within each

Janice M. Gruendel is a Senior Fellow at the Institute for Child Success.

Policy&Practice December 2017 20

Implications for the Expansion of Dancing Elephants

of healthy, safe, smart, and strong children. To better serve their clients, many health and human services are already engaged in transforming themselves from lumbering pachyderms into data-enabled, trauma-informed, resilience-building organizations and systems. As this process of intentional transformative change occurs—and it must—our organizations become better able to support family well- being and the positive relationships between children and their primary caregivers that are essential to healthy development, strong minds, and learning success in the first eight or nine years of life. For vulnerable families, the effec- tiveness of our health and human services organizations and systems— supports—is intrinsically linked to the effectiveness of our families, their children’s learning, and the future of our nation. The Pathways third-grade reading portfolio provides another lens into this process and confirms the essential connection between learning to read and the effective operation of our health and human services systems. Gerstner describes six elements in IBM’s transformative journey. They are all relevant to our health and human services systems as revealed as reflected in policy, practice, and program interventions and

These are, in fact, the families whose children demonstrate the greatest levels of developmental challenges early in life, social and behavioral challenges early in schooling, and reading challenges at the end of the third grade. They are also the families who often populate our human services caseloads. We did identify a broad group of policies, practices, and interven- tions shown to impact third-grade

It is now clearly understood by vir- tually everyone that our brains grow most rapidly and dramatically during the early years of life. This growth is influenced by woman’s preconceptual, prenatal, and postpartum health, her experiences with present (and prior) adversity, and the economic and social environment in which she and her family lived before, during, and after the period of pregnancy and birth of her children. Fathers and extended family members, neighborhoods, and whole communities are all essential elements in the drama, opportunities, and challenges of children’s entry into the world. Poverty, racism, and chronic adversity hurt development; safe, supportive, nurturing rela- tionships and experiences buffer adver- sity and promote the devel- opment

reading in a positive way and at demonstrable levels for each of the 12 indicators. Published in August 2017, the Pathways

“What Works for Third Grade Reading” (http:// buildthefoundation.org/ pathways-working-papers/) portfolio defines terms, presents data on why the indicator matters, and identifies “evidence- and research- based policy, practice, program, and capacity-building options that can move the needle on the major factors that impact children’s reading profi- ciency at third grade.” These are freely available for download. A webinar on how various communities are already using the rich base of information included within and across the papers was presented in late October and is available from the North Carolina Early Childhood Foundation.

through the third-grade reading lens. Know your customers and their needs. Gather lots of data and then apply it. Execute, execute, execute. Ask: Is it working? If not, change it. Be an impassioned leader. Match resources to strategies. Yes, Virginia, there are dancing ele- phants and we must become them.

December 2017 Policy&Practice 21