“There is nothing more important than a good, safe, secure home.”
This quote from Rosalynn Carter, who has dedicated the last four decades to improving the quality of life for people around the world, was the first thought that came to mind when I read Rethinking human services delivery: Using data-driven insights for transformational outcomes.
The report begins with a simple story about a man who had repeated visits to the emergency department until some medical staff paid him a visit at his home. At the heart of the story lies a lesson that can be shared with anyone working in human services delivery today: As a result of the way we structure our programs, health and human services agencies today can sometimes miss important information about the actual lives of individuals and families—information that can lead them to miss the mark on getting the right services and supports to individuals so they can improve lives. Today, by design, many agencies take a program-centric view of the world and are often more transactional in nature than they are transformational.
How can human services agencies be transformational? How can we help human services agencies focus their resources on doing the right work, for the right people at the right time, and thus achieve meaningful results? It’s about looking above and beyond the output measures that are engrained into programs. It’s about making sure that quantitative transactions are making qualitative changes in people’s lives. Take the following as an example: a transactional interaction is when a human services agency focuses only on identifying the services an individual is eligible for and signing them up. A transformational agency will go further to help ensure those services and programs align with that person’s goals and how he or she wants to achieve them.
A transformational system can impact the health care programs that human services agencies provide to their citizens. It can target services to those who not only are neediest, but also the costliest individuals—doing good while reducing costs. It can also help agencies capture the right individuals (e.g., super utilizers) early, prevent their cases from escalating, identify redundant services, and streamline those that add the most value to individuals’ lives. Goals in a transformational system can be living, breathing ones that change if new populations become a priority.
This will likely require human service agencies to change their business processes. But, changes in business processes may bring positive changes across the board. Standardizing, rationalizing, and automating services can not only reduce costs, but also relieve caseworkers – the front line workers – from much of the paperwork and administrative tasks that bog them down today. In turn, their time will be freed up to focus on enhancing the lives of their clients.
Advances in technology and analytical techniques have made it easier than ever for human services agencies to move beyond transactional service delivery. It can start with three priorities:
A transactional system only captures and tracks what is wrong. A transformational system considers the why and uses information to determine what to do and to track the outcome of that intervention in real time so that it can change course as needed.
For example, when the District of Columbia’s Department of Human Services’ Economic Security Administration looked at overhauling the Temporary Assistance for Needy Families (TANF) program, it faced a group of recipients who had languished on the rolls for years. In 2011, the agency decided to turn that around. It turned to a solution-focused assessment, which asked questions like “With the problems you face, how do you manage to get through every day?” and “What have you tried to address your problems? What worked and what didn‘t?” Instead of focusing only on “doing things right,” the District began focusing on “doing the right thing” for its clients. While the redesigned program is still in its early phases, the initial evaluation showed a tenfold increase in work activity among TANF recipients.
In the past, when human services executives wanted to drive change, they typically changed the people doing the work or the policies driving their work. Today, they can focus on the business processes to affect change. Perhaps it is not just a safe, secure home that everyone needs. Some may need transportation to get to medical appointments and others may need in-home assistance when they have to leave a care recipient to get their own needs met. In the end, if human services agencies can focus on the transformational services, rather than the purely transactional services, they could see life-changing outcomes—ones that not only meet individuals’ needs, but also are efficient and cost effective.