Policy & Practice February 2015

The Office of Management and Budget (OMB) is using its bully pulpit to embed evidence-informed practices into government-led services and to jettison programs that have not proven to move the needle. On the ground, localities are leveraging these oppor- tunities with an eye on sustainable population-based health and well- being; their experiences and results are likely to impact whether these policy directions are here to stay. Modern Platforms States are taking an intentional look at their current business functions and the change needed to reach their 21st century enterprise-wide vision for interoperable and integrated systems. Technological advances are playing a key role in modernizing human service delivery, from the growing use of mobile apps to equip customer and workers with easy access to the tools and services they need, to the use of predictive analytics software to identify families at risk and uncover fraud. With these technological advances comes the need for skills, capabili- ties, and values never before required of those in social work. Agencies are hiring analytics experts, reevaluating hiring practices, and revamping devel- opment and training approaches in order to build the capacity of the work- force to use the data before it. On the flip side, the Millennial workforce grew up in environment where technology and its enabling abilities are second nature. If our sector is to attract them to the human service workforce, these tools and modern approaches must become standard fare. The biggest game changer for mod- ernization of human services may have come from an unlikely source—an exception to the OMB A-87 cost alloca- tion circular, designed to leverage the new Medicaid eligibility and enroll- ment systems for the human services side of the house. CMS’s recent decision to extend the Exception to December 2018 is a catalyst for states looking to modernize their systems. 3 APHSA, with and through our members, led the national push for this extension. It is a historic moment—allowing states additional time to complete the design, development, and implementation of

their integrated eligibility and enroll- ment systems.

Across the country, APHSA members are turning this vision into a reality for the communities they serve. As high- lighted in this article, six factors are helping human service agencies shape the path forward, manage for collec- tive impact, and ultimately, transform the system: l Š new integrated policy opportunities; l Š greater access to modern platforms ; l Š intentional space for innovation labs ; l Š an investment in real outcomes ; l Š application of science to human service delivery; and l Š co-creation through transformative partnerships. Each of these is briefly addressed below, followed by how APHSA is supporting its members’ efforts to understand and apply these factors. Integrated Policy In recent years, there has been an increasing number of demonstration projects designed to integrate service delivery across multiple programs and funding streams. At the national level, many of these efforts are being co-led by two or more federal agencies with the objective of achieving greater interoperability, spurring innova- tive solutions, and better leveraging community supports. 2 In Congress, reauthorization of long-standing programs is being done with renewed interest in exploring how best to link programs with desired outcomes—for example, the $200 million for SNAP Employment and Training pilots included in the reauthorization of the 2014 Farm Bill and various provisions of the recently enacted Workforce Innovation and Opportunities Act.

Innovation Labs I recently heard the word innova- tion described as an “old term that has new prominence,” and that is clearly playing out in human services. Agencies are increasingly focused on how they can embed continuous learning as part of the agency culture. The need to address long-seeded cultures and biases requires inten- tional focus on change management, organizational effectiveness, and read- iness. The ability to innovate and be creative plays a key role in this effort. Innovation laboratories—some as full departments and others with a few designated staff—are emerging at all levels of government, from the White House Office of Social Innovation and Civic Engagement to local human service agencies. San Francisco’s Human Service agency has a “design anthropologist” who is responsible for focusing on the design of the agency and looking for innovation opportuni- ties, identifying solutions quickly, and facilitating their implementation. In Philadelphia, there is an actual inno- vation lab in its City Hall—a physical place where city employees are asked to compare together and focus on inno- vation, ideation, and problem-solving. Investing in Outcomes Agencies are making investments to gain powerful insights into how they are actually performing, identify what works, and shed ineffective programs. By applying business intelligence plat- forms that present the data through specialized reports, caseworkers, supervisors, and top administrators are making better, informed deci- sions. 4 Predictive analytics, through new online tools, are being used to identify at-risk families, understand service gaps (e.g., geographic), and scan for fraud in eligibility and intake systems. High-quality, low-cost evalu- ations in the form of “rapid cycles” are being used to quickly determine whether an intervention is effec- tive and to continuously improve through rapid experimentation. 5 Rapid Cycle Evaluation tests components of a program rather than the whole

Tracy L.Wareing is APHSA’s executive director.

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Policy&Practice February 2015