Policy & Practice December 2018

Early Childhood Councils to inten- sify their education and recruitment efforts to expand the number of pro- viders who are rated high-quality and willing to care for children receiving the subsidy. Performance has improved by 184 percent, going from 21 percent in December 2014 to 60 percent in June 2018. 3. The department oversees the oper- ation of 10 state-secure youth services facilities and ensures the safety and education of approximately 645 youth in commitment and 257 youth in deten- tion. For several years, the Division of Youth Services has been moving away from a punitive correctional culture toward a trauma-responsive envi- ronment. Included in these efforts is reducing the use of isolation or seclu- sion. Research does not show that the common practice of holding youth in isolation reduces problem behavior in juveniles. In fact, this is known to result in anxiety, depression, paranoia and psychosis, re-traumatization, exacerba- tion of mental illness, and increased risk of suicide and self-harm. Since implementing these changes, youth-on-staff assaults in facilities are down 22 percent from three years ago. The use of seclusion decreased 68 percent from October 2016 through July 2018. The average time spent in seclusion has averaged under an hour for nearly two years, far better than the national average. In July 2018, the average time spent in seclusion was 39 minutes. The national field average is 4.43 hours for detained youth and 10.95 hours for committed youth. There were no incidents of seclusion of more than four hours in 2017, and only three in 2018 through July. The results show the value of implementing new approaches to caring for youth and provide a model for other jurisdictions to follow. The thought of using measures, setting targets, and rigorously managing something as seemingly subjective as the delivery of human services, might initially spark appre- hension, but it shouldn't. With the right structure, unrelenting focus, and leadership willing to critically look at practice and results, a PerformanceStat leadership strategy has the potential to drive positive change, as opposed to “tumbling down the fear hole.”

the code that generates the report, and its illustration on a C-Stat slide.

Note from Ken Miller:

4. Recognize and celebrate good performance. When a program achieves its C-Stat target on any given measure for six con- secutive months, we publicly recognize themwith a C-Stat Award. We gave our first C-Stat Award in March 2013 and have given a total of 20 awards to state, county, and even contractor staff, in C-Stat meetings and in counties. When senior executives travel to counties and CDHS facilities to celebrate success in person, this recognition exhibits our commitment to performance improvement and C-Stat as a strategy. These awards tap into both intrinsic motivation (a personal sense of accom- plishment) and extrinsic motivation (framed certificate, cupcakes, modest gift certificate) for staff. Awards are both for individual employees as well as for those who worked as a group or unit, which makes more employees winners and can boost employee morale. C-Stat has allowed us to drive systemic change in many human services programs at once. While not all program improvements are a result of C-Stat, there are several examples of performance gains that we are confident would not have been possible without it. I describe three examples below. 1. The department’s Public Assistance and Food Assistance Programs serve Coloradans who are facing financial hardship. In partner- ship with counties, program staff process five public assistance applica- tion types as quickly and as accurately as possible. In 2004, the department was sued for its slow application pro- cessing. The case was settled in 2008, requiring the state to process applica- tions within the legal limits 95 percent of the time for at least 12 straight months. To achieve this, improvement strategies included business process re-engineering that engaged counties in developing streamlined applica- tion processes and creating simplified reporting tools. Performance has improved more than 40 percent during the last six years. Processing times for Food Assistance applications in partic- ular improved from 70 percent timely

in October 2007 to more than 95 percent timely each month throughout 2017, and to date in 2018. In fact, most applications can now be sub- mitted online and applicants receive a response within 48 hours. 2. The department’s Office of Early Childhood oversees the Colorado Child Care Assistance Program while advancing high-quality, licensed child care throughout the state. Research indicates that children who receive child care in high-quality child care facilities are more likely to be ready for kindergarten. In 2014–15 and 2015–16, we prioritized increasing the number the number of low-income Colorado children enrolled in high- quality child care facilities. Targets were set each year. Improvement strategies included working with the have provided a clear example of how measurement can be used for good and the real results that come from a learning culture.Thank you, Colorado, for your example and your thoughtful challenge. In my article published in the August issue of Policy and Practice , ‘‘Gaming the System,’’ I emphasized that the true purpose of measurement is for insight and innovation and that great leaders create the conditions for those to flourish.This article from my friends and partners in Colorado demonstrates both. In their earnest rebuttal of my cautionary points, they

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December 2018 Policy&Practice