Policy and Practice | October 2022

Policy and Practice | October 2022

The Magazine of the American Public Human Services Association October 2022

Innovating Future Maximizing Modern Tools and Platforms for the


For this child and his family, the “Get Next Button” is pure magic.

At C!A, we are passionate about helping agencies increase their capacity so they can do more good. The Get Next Button is just one of our latest capacity-building solutions designed to help you serve as many customers as possible each day. The button ensures that the right work is delivered to the right worker at the right time – and the task has all of the insights behind it to help the worker make an immediate decision right then about whether a family can get the benefits they so desperately need. Who knew a button could be so life-changing…not only for those who are waiting for benefits… but for workers, too? Reach out – or come see the C!A Team at the ISM Conference exhibit hall – and see how Current™, C!A’s SaaS service delivery platform for human services featuring the Get Next Button, can transform and improve service delivery in your agency. What if you could go home tonight knowing you helped as many children and families as you possibly could today? And, it only took the click of a button.

Want to see the Get Next Button in action?

ask@changeagents.info 573.230.7470 Increase your capacity to do more good





Vol. 80, No. 5 October 2022




3 Editor’s Note

Collective Insights for the Future

5 From the Field

Wyoming’s Modernization Mantra: Grit, Compassion, Heart, and Humor

6 From Our Partners Helping Improve Safety for Children: Illinois Department of Children and Family Services Reimagines Collaboration with Microsoft Teams 8 From Our Partners The 988 Suicide & Crisis Lifeline: Components of Successful Implementation 10 Research Corner Strong Legal Frameworks for Data Integration: Four Questions for Moving Forward 26 Partnering for Impact Meet the Digital Benefits Hub: A First-Of-Its-Kind, One-Stop-Shop that Supports Practitioners Working Through Complexity to Improve Access to Public Benefits 28 Technology Speaks Saving Caseworkers Time While Serving Families Better: Using Natural Language Processing to Unlock Data in Allegheny County 29 Technology Speaks The Key to Kinship: Technology Helps Keep Kids Close to Home

Changing Our Relationship with Data Solving Our Capacity Crisis by Making Data Work for Us, Not the Other Way Around


From Great Resignation to Great Reimagination Tackling the Workforce Crisis in Health and Human Services

30 Association News

APHSA Recognizes Member Agencies and Partners at the 2022 EMWB Conference

40 Staff Spotlight

Jennifer Cortez, Grants and Contracts Manager


Innovating In a Digital World How an Enterprise Blueprint Connects Ecosystems with AI and Automation


October 2022 Policy&Practice

Strategic Industry Partners

APHSA Executive Governing Board

Chair Dannette R. Smith, CEO, Nebraska Department of Health and Human Services Vice Chair Rodney Adams, Former Director, Mecklenburg County (NC) Department of Community Resources Immediate Past Chair David A. Hansell, Former Commissioner, NewYork City Administration for Children’s Services Treasurer Reiko Osaki, President and Founder, Ikaso Consulting Elected Director Derrik Anderson, Executive Director, Race Matters for Juvenile Justice Elected Director Vannessa L. Dorantes, Commissioner, Connecticut Department of Children and Families

Elected Director Kathy Park, CEO, Evident Change Elected Director


Terry J. Stigdon , Agency Head/Executive Director, Indiana Department of Child Services Elected Director Jennifer Sullivan , Senior Vice President for Strategic Operations, Atrium Health Elected Director Eboni Washington , Assistant Director, Clark County (NV) Juvenile Justice Services Leadership Council Representative Justin Brown, Secretary, Oklahoma Department of Human Services Local Council Representative Dan Makelky , Director, Douglas County (CO) Department of Human Services




Policy&Practice October 2022

editor’s note By Jessica Garon

Collective Insights for the Future G reetings, readers! I am excited to share one of our

Zoommeetings, we are learning and benefiting from the specific expertise of teammembers in California, Kentucky, New York, Georgia, and the list goes on. To capture just a little bit of our team’s diverse insights, I asked them to share what’s top of mind for themwhen it comes to the topic at hand— Innovating for the Future: Maximizing Modern Tools and Platforms. And if you happen to be reading this while at the ISM Conference, please come say “hello” at the APHSA booth in the Expo Hall. We’d love to hear your thoughts and insights too! You can also reach out to me at jgaron@aphsa.org.

and artificial intelligence that is expanding resources and capabilities, we are a generation defined by the use of digital technology—and this was even before the pandemic changed our day-to-day routines almost overnight. It may not have even seemed possible before it happened, but COVID-19 prompted us to hit the fast forward button on innovations for the future. At APHSA, as we quickly adapted to being 100 percent remote, we also began growing—hiring new staff from all over the country, no longer limited to a pool of candidates in the Washington, D.C. metro area. As we sit on our daily

staple issues of Policy & Practice with you yet again—the “technology issue” as we often call it with our APHSA team. This issue always precedes our ISM Annual Conference & Expo, and if you haven’t done so yet, it’s not too late to register and join us October For quite some time, our country has been moving in a direction where tech nology changes almost everything we do. From the popularity of social media and online shopping to data sharing 23–26 at National Harbor, MD (visit www.ismconference.com) .

As a field, we have made tremendous and

rapid gains in access to the data and technology needed to understand the complex issues that must be addressed to support family and community well-being. We’re approaching a critical juncture for reflecting on and lever aging lessons from crisis responses over recent years to establish a new path forward—one that meaningfully uses tech and data to offer families dignified access to supports.

I believe there is a growing appreciation across the field that technology and data modernization must be situated within the wholesale organizational shifts that are necessary to sustain innova tive practices. While systems integration and data sharing are key enablers of alignment, the end-goal generally is more holistic cross-program coordination to catalyze better service delivery and customer experiences.


I am so excited to join the Process Innovation team at APHSA where we are supporting states and local governments to leverage data and technology to transform their human services processes. In my first month, I have already seen the potential tech innovation has to overcome silos, streamline pro cesses, and improve the customer experience, and I’m energized by the amount of interest and movement emerging across the country.




October 2022 Policy&Practice

Vol. 80, No. 5


Policy & Practice™ (ISSN 1942-6828) is published six times a year by the American Public Human Services Association, 1300 N. 17th Street, Suite 340, Arlington, VA 22209. For subscription information, contact APHSA at (202) 682-0100 or visit the website at www.aphsa.org. Copyright © 2022. 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 1300 N. 17th Street, Suite 340, Arlington, VA 22209

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Policy&Practice October 2022

from the field Molly Tierney and Korin Schmidt

Wyoming’s Modernization Mantra: Grit, Compassion, Heart, and Humor

T here is no question that child welfare organizations need modern technology to support new, family-centered ways of working. What is acknowledged less often are the unique challenges of leading a child welfare workforce through change of this magnitude. At the Wyoming Department of Family Services (DFS), Director Korin Schmidt is approaching modernization with the recognition that these shifts will be hard—and they should be. Schmidt is helping her people antici pate and work through the discomfort of reshaping long-standing practices. She is also working to stay focused on the “whys”: Keeping kids safe at home. Providing opportunities for success for their families. Supporting the people who support these families. And she is inviting all stakeholders to join her in bringing grit, compassion, heart, and humor to the process of technology modernization. Accenture’s Molly Tierney spoke with Schmidt about the origin of her leadership philosophy, how she is bringing it to life with the Wyoming DFS workforce, and the outcomes she hopes to achieve. Molly Tierney: What is top of mind as DFS undertakes the design and development of a new Child Welfare Information System (CWIS)? Korin Schmidt: We are working to shift from “What do these kids need?” to “What do these families need so their kids can stay home safely?” That represents a big change, not only in how we work internally, but also in

with communities to get them support. That is the North Star that is guiding us.

how we support families and collabo rate with partners and stakeholders in the community. It requires a totally different approach to technology. It also requires a big change in mindset. For many years, the work of child welfare has been managing cases, managing families, managing children. That is what our Statewide Automated Child Welfare Information System (SACWIS) was built to do. But as we modernize to our CWIS, known as WyoSafe, “management” is no longer our primary focus. Instead, we need technology that helps us understand what families need and then engage

Tierney: I was riveted when I first heard you talk about “grit, compas sion, heart, and humor.” How are those four words helping you lead your team toward that North Star? Schmidt: Grit, compassion, heart, and humor are strengths required to succeed with a transformation of this nature and scale. Fortunately, they are also strengths we have always had in DFS. I am just recognizing and labeling them.

See Wyoming on page 32

Illustration by Chris Campbell/Shutterstock


October 2022 Policy&Practice

from our partners

By Anna Corley and Ty Abrams

Helping Improve Safety for Children: Illinois Department of Children and Family Services Reimagines Collaboration with Microsoft Teams

C ollaboration is a key factor for success in child welfare agencies. With the number of different people involved, the complex nature of casework, and other administrative burdens, it can be a challenge for caseworkers to communicate effec tively and consistently. This challenge only increased with the onset of the COVID-19 pandemic. Making it Easier to Keep Children Safe Under the leadership of Director Marc D. Smith, the Illinois Department of Children and Family Services (IL DCFS) has worked to improve connec tions between children and families, caseworkers, and other parties involved in families’ cases. Before and during the COVID-19 pandemic, the IL DCFS assembled a cross-functional team to discuss operational, financial, legal, and clinical aspects of an innovative development to casework practice. This team clearly identified that remote collaboration not only would enable connections that considered social dis tancing requirements, but also would create supportive care in a new way. Working together with Microsoft, the IL DCFS envisioned a collabora tion tool that would allow for use by numerous parties, video and phone capabilities, ease of documentation for case notes, and consistent support for children and families. The result of this collaboration is the Youth Teams App, a child welfare–specific solution residing









workers being out on an island, trying to make decisions,” says Smith. With the use of the Youth Teams App, caseworkers have reported better engagement with families, foster parents, CASA workers, and court stakeholders. Instead of making 10 to 12 calls just to schedule a meeting, case workers can schedule meetings with a single process, which frees up critical

on the Microsoft Teams platform. The Youth Teams App is the first collabora tion solution that enables direct tie-in with child welfare case management systems, enabling creation of “teams” based on the people involved in the case, creation of documentation directly from scheduled meetings, and direct note updates based on content discussed in meetings. “If we let people communicate more often, they can make safety deci sions as a team, as opposed to individual

See Illinois on page 32

Image courtesy of Microsoft


Policy&Practice October 2022

Making a SHIFT... because outcomes won’t change if perspectives don't change

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 


October 2022 Policy&Practice

from our partners By Danielle Stumpf, Roshani Khatri, Laura Perez, Kat Crumpton, and Stephanie U'Ren

The 988 Suicide & Crisis Lifeline: Components of Successful Implementation

M any people experiencing mental health distress call 911 because it is a widely known emergency number and easy to use. Recent data have shown that people using 911 to get help with serious mental illness do not get the right care at the right time, and some even end up in law enforcement custody, rather than being seen by a mental health professional. The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) is the new three-digit, nationwide phone number that is locally operated and offers 24/7 access via call, text, and chat to trained crisis counselors who can help individuals experiencing mental health related distress. Mental health-related distress can include substance use crisis, suicidal thoughts, depression, or any emotional distress. The 988 Suicide & Crisis Lifeline is also available for indi viduals worried about a loved one who might need crisis support services. Its goal is to provide accessible and imme diate crisis intervention and support to every individual in need. 988 State Implementation andTop Challenges As of August 2022, 23 states 1 have passed legislation to facilitate the implementation of the 988 Suicide & Crisis Lifeline. Colorado, Nevada, and Washington enacted legislation with user fees to support 988 operations and provide financial sustainability for the system. Several states have established advisory groups or planning commit tees with representatives from state agencies, health providers, law enforce ment, emergency medical services, and

other partners to better coordinate the system and identify policy levers. Implementing a three-digit number for behavioral health emergencies in every state and providing 24/7 primary coverage through in-state call centers have presented certain challenges to states across the nation. As states prepare to launch the 988 hotlines, they have encountered key issues around infrastructure, workforce, 911 integration, the readiness of the crisis care continuum, cultural competence, and performance management. Solutions for State Agencies To address these key issues, states should consider the following to aid in the successful implementation of the 988 Suicide & Crisis Lifeline. Assess State Needs to Successfully Implement the 988 Suicide & Crisis Lifeline Despite meeting baseline require ments for the implementation of the

988 Suicide & Crisis Lifeline, state agencies are struggling to implement it. By performing a structured needs assessment, state agencies can evaluate their infrastructure, policies and pro cedures, funding, and workforce needs to better understand their readiness to implement and capability to sustain the 988 Suicide & Crisis Lifeline. This assessment provides insight for state agencies to understand their strengths, challenges, and areas of opportunity, and it should evaluate: n State infrastructure. It is impor tant to assess the infrastructure across the crisis care continuum to help ensure a smooth transi tion for individuals who need care quickly. Successful implementation should take certain considerations into account during the planning process, such as including all the interested parties representing diverse populations.

See 988 on page 33

Illustration by Chris Campbell


Policy&Practice October 2022

Driving digital transformation to create opportunities for safety, wellness, and prosperity Microsoft helps facilitate the digital transformation of Health and Human Services organizations with technologies that provide collaboration, innovation, security, and compliance with a deep commitment to supporting business needs. Discover how technologies like Azure, Dynamics 365, and Teams are empowering agencies to achieve more . Visit https://aka.ms/phandss or visit us at booth #531 in the ISM exhibit hall.


October 2022 Policy&Practice

research corner By Deja Kemp and Amy Hawn Nelson

Strong Legal Frameworks for Data Integration: Four Questions for Moving Forward

C ross-sector data sharing and inte gration has become more routine and commonplace, and for good reason. When governments and their partners bring together data safely and responsibly, policymakers and practi tioners are better equipped to: n Understand the complex needs of individuals and families n Allocate resources where they are needed most to improve services n Measure impacts of policies and programs holistically n Engage in transparent, shared decision making about how data should (and should not) be used n Institutionalize regulatory compliance

Data sharing and integration is also not without risks, and clear legal frameworks are essential to mitigate those risks, protect privacy, and guide responsible data use. Designing the appropriate legal framework for your context can be a complex task and a test of endurance. In response, Actionable Intelligence for Social Policy (AISP) created Finding a Way Forward: How to Create a Strong Legal Framework for Data Integration 1 to support the essential and chal lenging work of exchanging, linking, and using data across government agencies. This resource was devel oped in partnership with our national network of integrated data systems to

provide clear guidance on how to get started, including guiding questions to explore with partners, checklists to assist with drafting legal documents, memorandum of understanding tem plates, and site examples. We suggest starting with “the four questions” to identify relevant next steps for your jurisdiction. The Four Questions When working to establish data flow across public-sector organiza tions—specifically government agencies—the initial question partners ask is, “Is this legal?” While this is an essential question

Figure 1


Policy&Practice October 2022

transparent and comprehensible.

to answer, it is also the lowest bar. To ensure data use is both legal and ethical, we strongly encourage you to grapple with broader considerations to help you decide, together with your partners, whether and how to move forward with data sharing and integration. Figure 1 outlines the four questions we recommend asking throughout all stages of this work. Determining Legal Authority and Drafting Agreements After thinking through the four questions, you will need to consider your legal authority for sharing and integrating data. In many contexts, data can be shared, if shared for a purpose allowed under the law. Most often, legal authority relies upon contracts, or as they are commonly known—legal agreements. We recom mend agreements that are: (a) tiered; (b) standardized but flexible; and (c)


We suggest a three-tiered approach for legal agreements to govern data access and use for an inte grated data system: a Memorandum of Understanding (MOU), a Data Sharing Agreement (DSA), and a

Data Use License (DUL). Depending on the specifics of your context and purpose, other agreements may also be needed, such as confidenti ality or nondisclosure agreements for individual staff. Agencies may use different terms to refer to legal agreements. Examples include: data security agreement, information

sharing plan, memorandum of agree ment, data sharing agreement, data exchange agreement, and data use agreement. We recommend learning the terms used by the agencies you hope to partner with and using them consistently.

See Legal Frameworks on page 34










October 2022 Policy&Practice

Changing Our Relationship with Data Solving Our Capacity Crisis by Making Data Work for Us, Not the Other Way Around

By Ken Miller


ig data and analytics have been transforming industries from health care to finance. Even

moribund and unchangeable baseball is being revolutionized by data. With rapid learning, big data promises to produce fresh insights that can trans form strategy. Given this promise, why then has government—and specifically human services—been so slow to join the revolution by continuing to resist the allure and charms of big data? Simply, our historic relationship with data in government has been less than positive. Some would even say it has been borderline abusive. Rather than a helpful tool that can increase our workers’ capacity to do more good, data has been a margin ally helpful money pit that has robbed our workers of precious time and resources. How much time and money has your agency spent on building data systems? How much time and money has been dedicated to “reporting”? And rather than producing fresh insights that drive new innovations, how often has the data instead been used to complete accountability reports that are then weaponized against the very people who spent all their precious time producing them? More pointedly, what percentage of your staff time is dedicated to finding “that data” in “that system” and “that system” that goes into “that report” for “those people” so they will stay off your backs? Does this sound familiar?

1. We encounter data that are used primarily for accountability … against us. When you think of all the data your agency collects, is it used for learning… or accountability? That is, are you and your colleagues the consumers of the data in an effort to uncover insights that improve opera tions, or are you and your colleagues the producers of data merely intended to keep funding sources satisfied? Accountability is not bad, and keeping funding sources informed of our progress and proficiency will always be a necessary mandate. But, the account ability movement has had two massive effects detrimental to our ability to improve. First, again, our most precious resources are being used to generate reports. This time, effort and money are crowding out any initiative to use data for learning. My colleagues and I see this often when we work with an agency and begin asking learning questions that require data to give a correct answer. The usual response is “you want us to generate another report?” Even though this report would help solve a major puzzle, the fatigue of data collection trumps the desire for insight and, in turn, any positive action that could be taken. Second, accountability measures, no matter how well intentioned, breed fear. By their very nature, account ability metrics create a top-down, fear-based system where one body (a funding source or legislative com mittee or upper management) is in a position to take resources from another. The fear may be severe in some cases and quite mild in others, but it has the same effect: we expend most of our analytic energy justifying, reporting and, in some cases, outright gaming the system to ensure we look good. Vertical accountability systems have contributed mightily to our toxic relationship with data. I recall a workshop I conducted with a large county where we were supposed to be developing performance measures for each agency. The agency leader of the juvenile justice agency was exceptionally bright, but as soon as we came to an exercise to develop measures, immediately pretended not to understand. After some prodding about why there were no metrics for the

agency, the response was, “Why would I build the hammer they are going to use to hit me over the head?” Data have so much to teach us, but that will never happen in such a climate. Insights gleaned from data are extremely delicate creatures. They need safe and open places to grow. Insights do not appear where fear persists. For some information on account ability systems that do inspire our workforce, please see my article, “Band of Brothers” (see www.changeagents. info/band-of-brothers) . 2. We aren’t asking the right ques tions. There are so many insights that will transform your operations. Unfortunately, they are hiding from us in a place we rarely look: our work systems. We don’t think about work this way. In government in general, and particularly in human services, we don’t see work systems. We usually see programs, policies, practice, and people. But weaving through all of these are work systems—that is, the processes that we use to produce “widgets” for “customers” so that we—and they—can achieve desired outcomes. (This is the entire point of my book, We Don’t Make Widgets [see www.changeagents.info/widgets ]). It is through these systems that all of our hard-working staff makes things happen for their clients. Unfortunately, it is also these very systems that cause so much frustration and burden for staff and customers alike. When the systems work, magic can happen. When the systems are instead complex Rube Goldberg contraptions deluged by an endless flood of work without nearly enough capacity to work it, well you get what we have…it is a mess. The best way out of this dilemma is first to make it visible—to see how these systems meander through our workplaces. Where do they start? Where do they end? What is produced? Who uses it? What do they want? Draw a picture. Make the systems visible. Second, understand the systems using—you guessed it—data. Every system has vital signs, a few key metrics that tell you the health of the system and alert you when there is

Public servants are resistant to the siren song of data and analytics because, for too long, the data haven’t been serving us, we have been working for data, and it has been a toxic boss. Human services faces a phenom enal capacity crisis—there is way more work than resources available. Data hold the key to solving this crisis but our relationship with data has to change. We need to flip the script and take charge—no longer working in service of data used by others against us. Rather, we need to put data to work for us so we, in turn, can better serve those in their time of need. Imagine if all of the energ y consumed by accountability was redirected toward learning? Relationship Number One Data’s primary role should be that of a teacher or someone who shows the way. All of the time and money we have invested in data systems should be producing mountains of insights. Insights that fundamentally change how we work and what we achieve. So where are these mountains? Why aren’t we learning? Why are data not teaching us? There are three key reasons.

Ken Miller is the founder of the Change & Innovation Agency (C!A ® ).


Policy&Practice October 2022

fascination and curiosity of our people to solve this non-trivial puzzle. Relationship Number Two In addition to being our teacher, data should also be our co-worker. The central dilemma facing human services is our lack of capacity. There is simply more work coming in then any agency has resources to deliver. Data should not just point out this obvious fact, it should also roll up its sleeves, get its hands dirty, and actually help us do the work. How can that happen? Consider the vast majority of tasks that your dedicated workers perform: locating people, validating and verifying income and assets, monitoring changes in status whether it be employment, incarceration, family composition, and so on. The bulk of our staff time is dedi cated to finding, validating, verifying, and monitoring data. The bulk of that time can now be done by data itself. Let me give you an example. Our vital human services programs are all undergoing a capacity crisis.

Curiosity. Asking questions. And, from those questions come insights. The more questions we ask and the deeper we dig, the more insights will appear. Sadly, it seems like we have stopped asking. Why are we not looking at our current situation, scratching our head and asking “Why does it have to be this way?” “Why don’t our systems work for our clients and our staff?” “How will we ever dig out of this pile?” Most of us start our work life extremely fascinated and filled with questions, but eventually the bureaucracy extin guishes our light. The complexity and powerlessness we encounter drains our spirit and creates a sense of apathy that nothing can really change. We cannot let this happen, especially when the stakes are so high and people rely on us in their moments of need. In human services we have been handed the most amazing puzzle—the most difficult Rubik’s Cube. How can we serve the most customers with the biggest impact with not nearly enough resources? People love to work on puzzles (did you finish Wordle today?). We have to find a way to ignite the

danger. These are not accountability measures. They are not for other people. They exist to help us learn and act. At a minimum we should know: n How many people need help? n How long does it take to help them? n How many people can we serve on the first try? n Where is work piling up? n Where are we losing capacity? 3. We aren’t curious. In human services our focus is on helping families and communities. None of us signed up to be plant managers overseeing the production of “widgets” in complex processes. But, to be most effective and understand what is happening in an agency, we need to embrace the plant manager role. We must look at and break down the systems and ask the questions that need to be asked. Unfortunately, a lack of curiosity often stands in our way of doing so and is the greatest impediment to using data and developing insights. For transformation to occur, govern ment needs to be constantly learning. What precedes learning? Fascination.

See Data Relationship on page 35

Reinventing Child Welfare with Technology

30% More foster homes approved per year


Fewer days to approve families


Time saved by social workers using Binti


ROI from cost savings and federal funding



October 2022 Policy&Practice



Policy&Practice October 2022



Tackling the Workforce Crisis in Health and Human Services By Tiffany Dovey Fishman, Will Arnold, Jamia McDonald, and Amrita Datar


sk health and human services executives what they worry about these days, and the workforce crisis nearly always tops the list.


October 2022 Policy&Practice

The staffing challenge in health and human services is not new, of course. But it has reached a new level. Vacancies for eligibility caseworkers at the Texas Health and Human Services Commission, for instance, have qua drupled the last two years. 1 When health and human services agencies do hire, new employees often take months to become fully productive. The resulting capacity deficit impedes an agency’s ability to carry out its mission. The past 20 years have seen a massive shift in the labor force— gradual at first, then drastic, as the pandemic amplified existing trends. Four and a half million workers quit or changed their jobs in 2021—the highest number in history—and that trend in voluntary turnover is projected to continue through 2022. 2,3 And as retiring baby boomers are replaced by Generation Z, we are seeing a massive shift in what workers want from their employers. 4 Consider the following: n The pandemic has accelerated expectations around where work is done: 70 percent of workers want a hybrid remote-office model. 5 n Employers are struggling to engage their workforce: 52 percent of workers are “not engaged,” meaning they are psychologically unattached to their work and organization. 6 n Individuals expect to have multiple employers over their lifetime: the tenure of a worker in the U.S. economy is just four years. 7 To effectively navigate this massive disruption, health and human services agencies should consider redesigning the workforce experience (see Figure 1). That will require action on three critical fronts: n Improving individual employee and organizational well-being n Addressing the persistent capacity gap by investing in learning and development n Crafting a new workforce value proposition that reflects critical shifts in worker values Improving Individual and Organizational Well-Being A robust body of evidence demon strates that hope is a psychological

strength and a buffer against stress, adversity, and burnout, and that a hopeful mindset improves organiza tional and individual outcomes. In 2019, the Oklahoma Department of Human Services (OKDHS) launched an initiative to bake the science of hope into its full range of programs and activities. The goal is to improve staff retention and provide better outcomes for Oklahomans who are trying to overcome trauma and adversity. Theorists define hope as the belief that the future will be better than the present, and that individuals can take practical steps to achieve that improve ment. The concept includes three elements: goals that motivate a person to pursue an outcome; pathways or strategies that can lead to the goals; and willpower, the mental energy that drives an individual along those pathways. 8 Working in partnership with the Hope Research Center at the University of Oklahoma, OKDHS designed a program to transform itself into a hope-centered and trauma-informed organization. That means creating policies, programs, and practices based on hope science, and continually evalu ating whether those activities nurture a sense of hope or create and communi cate hopelessness. 9 After developing a road map for its transformation, OKDHS started training its staff in hope science. As of 2021, more than 77 percent of OKDHS staff had completed hope aware ness training. Beyond that, 116 staff members had taken training to become hope navigators, expert leaders who help to create a culture of hope in the agency and the communities it serves. Surveys of the staff showed that 91 percent of the workforce had devel oped a high sense of collective hope, with “a strong sense of connection to our agency, shared goals, collective construction of pathways, and collec tive willpower to pursue those goals.” 10 Addressing the Persistent Capacity Deficit The loss of capable employees often has a devastating ripple effect. Workloads increase, leading to burnout and lower job satisfaction. This, in turn, begets more turnover. Coupled with a steep learning curve for new

Tiffany Dovey Fishman is a senior manager with Deloitte’s Center for Government Insights.

Will Arnold is a managing direc tor with Deloitte Consulting LLP.

Jamia McDonald , JD, is a principal with Deloitte Consulting LLP’s Government & Public Services prac tice.

Amrita Datar is a research man ager with the Deloitte Center for Government Insights.


Policy&Practice October 2022

Figure 1: Workforce experience is shaped by eight key relationships that impact overall worker satisfaction

Source: Deloitte analysis.

Crafting a NewWorkforce Value Proposition A closer look at attrition shows that the “great resignation” is not a great resignation at all, but rather a reflec tion of the shifting values of millions of individual workers. For many, the pandemic prompted reflection about what is most impor tant in their lives. Work, it turns out, was not as important as many had thought, and people became less willing to center their lives around it. While some left the workforce alto gether, many more reflected on what they wanted to get out of their jobs. Younger workers have long told poll sters that money is only one of several key factors that drive their employ ment decisions. The tight job market offers the chance for them to follow through on their convictions. Deloitte’s Global Millennial Survey suggests that dissatisfaction with workplace culture and an employer’s social commit ment are equally important reasons to consider leaving a job. Data show that there has been a sig nificant shift in worker values. Today’s workers want: n Flexibility across all dimensions n Work that works for them n An opportunity to exercise their entrepreneurial spirit

employees, turnover creates a severe capacity deficit. In working to break this vicious cycle, health and human services agencies should invest more in learning and development (L&D) and in greater support for new hires. For many workers—particularly Gen Z and millennials—continuous learning and skill development can vastly improve job satisfaction. 11 In a study by Udemy, 80 percent of employees said that more L&D oppor tunities would help them feel more engaged at work. 12 While benefitting individual employees, upskilling and training initiatives can also address specific skill gaps within the organi zation, while making the workplace more attractive to job seekers. Almost 50 percent of workers say they would consider switching jobs for better training and upskilling opportunities, and more than 60 percent say such opportunities provide an important reason to stay at their current jobs. 13

Agencies struggling with limited in-house L&D resources are turning to learning as a service (LaaS) as a supplement to support the growth of their direct care, social services, and public health professionals. LaaS offerings provide bundled learning that continually evolves to reflect best practices across all domains of health and human services, reflects changing federal regulations and state interpretations, and meets the needs of all types of learners. State of the art learning experiences are those that: n Enable cohort-based, dialogue driven learning through interactive modules n Drive learner engagement through short-form content and applied skills practice n Provide blended learning that builds up gradually, is easily digestible, and integrates a variety of modalities n Facilitate learner search, guided discovery, and content recommendations

A closer look at attrition shows that the “great resignation” is not a great resignationat all, but rather a reflection of the shifting values ofmillions of individual workers.

See Great Reimagination on page 36


October 2022 Policy&Practice

How an Enterprise Blueprint Connects Ecosystems with AI and Automation Innovating In a Digital World

By Chris Shriver, Donald George, and Sunaina Menawat

he demand for state govern ment health and human services (H/HS), such as child care, cash, food, and medical benefits continues to grow due to the COVID-19 pandemic, rising inflation, and associated societal impacts. The need for virtual access to customers and employees over the past year has also accelerated a reset of the human-technology interface. The digital channel has become a primary source of engagement, unleashing opportunity, as well as creating new challenges for recre ating empathy, sense of belonging, and human connection. State government H/HS programs are increasingly managing com peting priorities such as expanding coverage while containing costs, T

delivering coordinated services across a complex fragmented ecosystem of applications and infrastructure cost effectively, and dealing with uncertainty about future federal funding to maintain a sustainable statewide integrated H/HS ecosystem. Agencies are driving toward a statewide inte grated services ecosystem that facilitates a whole-person-care approach in an effort to increase health and well-being throughout residents’ entire lives. Recent events have furthered the need for a virtual enterprise that operates in an envi ronment where purpose, intent, and wider societal impact have come to the forefront and is designed to advance the next gen eration of modern tools for the workforce and customers.

The Virtual Enterprise Blueprint is comprised of six building blocks, outlined below, for openness, inno vation, and sustained growth. The Blueprint guides H/HS moderniza tion and extends the ecosystem across agencies and community organiza tions. Below we highlight examples of modernizing H/HS business processes and facilitating emerging data-driven virtual enterprises. 1. Openness Using Market-Making Platforms and Ecosystems Openness is the defining character istic of the Virtual Enterprise, which animates the stretching of business platforms that are being envisioned to encompass wider ecosystems. By optimizing platform economics, open connectivity, and frictionless engage ment, the Virtual Enterprise enables

all participants across market-making platforms and ecosystems.

IBM Virtual Enterprise Blueprint The COVID-19 pandemic has

Case Example: San Diego Integrated Care Using Connected User Experience Platform ConnectWellSD is a county program that was launched in 2015 and con tinues today whereby IBM brought together an integrated system of care within San Diego County. We deliver and maintain market-leading user experience and case management tools implemented using human centered design principles. Leveraging open platforms, to support approxi mately 5,700 employees serving approximately 3.4 million residents, allows for greater utilization and platform economics to be delivered for future extensibility, scalability, and flexibility as programs expand and enhance care delivery.

accelerated the focus on virtualized enterprises that support openness as a key transformation approach and connect multiple ecosystem services across health care, human services, energy, transportation, and other markets. IBM’s Virtual Enterprise Blueprint provides the building blocks that bind ecosystems and networked organizations, connect intelligent workflow across the ecosystem, leverage digital technologies, apply agile development methods and tools, and integrate collaboration tools to holistically transform business models. The outcome of applying the Blueprint is to enable automation of system processes and enhance data sharing and integration inside and externally to the ecosystem.

Donald George is Lead Healthcare Architect at IBM Consulting.

Chris Shriver is Partner, Health & Human Services, at IBM Consulting.

Sunaina Menawat is Associate Partner, Health & Human Services and Public Health, at IBM Consulting.

Policy&Practice October 2022 22

and engineers built an AWS-based COVID-19 data lake and developed a series of analytics insights, including predicting disruptions due to COVID 19, using mobility, citizen behavior, etc., leveraging machine learning, and natural language processing. 3. Agility Through Extended Intelligent Workflows The Intelligent Workflow is the golden thread that animates the Virtual Enterprise. It creates the backbone of the value chains that bind the ecosystem participants. As the reach of the workflows is extended, the power of applied technologies such as extreme automation, artificial intel ligence (AI), Internet of things (IoT), and others is multiplied to unlock effi ciency and differentiation and render the platforms ever more attractive. Case Example: Integration Eligibility SystemModernization An integrated eligibility system (IES) is the enabling technology behind state-level Medicaid and

human services programs in the United States. The core of an IES is automated rules and a case management and workflow system that encodes logic to enable timely and accurate eligibility determinations for Medicaid and other human services programs. With the pending end of the Public Health Emergency, states are applying the use of intelligent workflows to automate, where possible, the eligibility redeter minations business process to drive improved customer engagement and reduced workload for caseworkers. 4. Purpose Furthered by Sustainability and Impact The Virtual Enterprise reinforces the extent of connectedness around the world and the impact of humans on each other and on the planet. Ecosystem-focused business models are helping provide solutions to the biggest challenges of our time including climate, health, security, and equality.

2. Acceleration from Science and Data-Led Innovation The openness of the Virtual

Enterprise accelerates access to new sources of product and service inno vation. It takes a scientific discovery approach, constantly experimenting, and relying on predictive and prospec tive analysis fueled by the massive amounts of data it can access from itself and its ecosystem partners. Case Example: Rhode Island Department of Health Data and Analytics During the pandemic, the State of Rhode Island required immediate assistance to track and manage the vast amounts of population-health data that were coming in from various sources across the state (hospitals, clinics, and counties). IBM partnered with the state COVID-19 unit to develop a data strategy, governance, analytics infrastructure, and provide action able insights to inform policy decision making. A team of data scientists

See Blueprint on page 37

Connecting People WITH PURPOSE

Master of Science in Human Services Administration

While Carrie Jones enjoyed her career as a wellness clinic practice manager, she couldn’t ignore an inner calling to do more. Now thanks to a university community that introduced her to all aspects of the human services profession, Carrie is more connected to helping people in ways she never imagined.

Courage to be more.

(800) 334-5532 | saintleo.edu

October 2022 Policy&Practice 23

Making human services more human: Improving outcomes for families through digital service delivery Every day, government agencies throughout the country work to protect our neighborhoods, educate our students, build and maintain our communities, and provide services and support to children and families in need. That’s not an easy job. And no one person, agency, or organization can do it alone. That’s why leaders turn to Deloitte. Our mission is to help you achieve your mission—making human services more human to improve outcomes for families and communities.

Policy&Practice October 2022 24


Strategic ‘advise’ services We can be your collaborator as you work to tackle your agency’s most complex, transformational challenges through helping activate your strategic priorities, supporting informed decision-making, and developing road maps to achieve your desired future state. • Strategic planning • Analytics for decision-making • Innovation and leading industry trends • New operating model design • Impact analysis on legislative/ policy changes • Operations analysis and process review transformation, and service is at the heart of everything we do. That’s because, like you, we understand that the best way to improve the well-being of our communities is to elevate the human experience of human services. Connect with us today to learn how we can work together to bring innovative solutions to your most complex challenges so you can better protect and improve the health, safety, and well-being of the families and communities you serve. Learn how to make human services more human Our passion for innovation,

We help leaders elevate the quality of life of those they serve by improving digital service delivery, making it more convenient for people to access benefits, strengthening program integrity, and protecting the social safety net for those who are most vulnerable. Our solutions combine innovative technology with strategic support to help your agency meet current and future needs including: Digital service delivery Our solutions are designed to help you transform the lobby experience, provide new curbside service, and connect with clients virtually. • Reimagining in-person, curbside, and lobby experiences • Virtual appointments and collaboration • Human experience management Talent experience and the future of work No matter where your agency’s workforce model is headed—in person, virtual, or hybrid—we can help you reimagine your talent experience and consider investments in infrastructure, secure collaboration platforms, and remote diagnostic and management capabilities to optimize your workforce and deliver services and support to families more efficiently. • Telework enablement and productivity • Workforce experience support • Intelligent process automation

Attending the 2022 ISM Annual Conference & Expo? Stop by Deloitte’s booth (#507) in the exhibit hall. Or scan the QR code to interact with us during the conference. www.deloitte.com/ us/ism

Contact us:

Kenny Smith Human Services

Transformation Leader Deloitte Consulting LLP kensmith@deloitte.com

Learn more at www.deloitte.com/us/hhs

This is an advertisement and does not represent an endorsement by the publisher. This publication contains general information only and Deloitte is not, by means of this publication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services. This publication is not a substitute for such professional advice or services, nor should it be used as a basis for any decision or action that may affect your business. Before making any decision or taking any action that may affect your business, you should consult a qualified professional advisor. Deloitte shall not be responsible for any loss sustained by any person who relies on this publication. As used in this document, “Deloitte” means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/ us/about for a detailed description of our legal structure. Certain services may not be available to attest clients under the rules and regulations of public accounting. Copyright ©2022 Deloitte Development LLC. All rights reserved.

See Charting Our Next Course on page 31

October 2022 Policy&Practice 25

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