Performance measures warn of service delivery disconnects
Key Takeaways
Arapahoe County, Colo. doesn’t contain any mountains, but for the last five years, it’s had a warning system for an avalanche of human service delivery problems. Before then, if things weren’t going smoothly, nobody knew it until it was a major problem. Now, the county has enough data to not only avoid disaster, but to also diagnose problems and point to solutions and improvements.
“You would get surprised,” said Cheryl Ternes, director of Araphahoe County Human Services, about the days before the new system was in place. “‘Oh my gosh we’ve got this huge backlog of applications.’ Well, why do we have it? It’s because we had a shortage of staff, or we’re just not getting the work done. Those things wouldn’t come to light until it was a dire situation. That’s not how it should be.”
ArapaSTAT, the county’s performance measure system, has been keeping track of how well services reach people in need and has been preventing systemic problems from developing. Before, even people who had been connected to the county sometimes weren’t getting the help they needed, or they faced delays in getting it. And for a long time, nobody knew exactly how to fix it.
“When you have a child in foster care, you need progress to get them a placement in a matter of days, not weeks,” Ternes said.
ArapaSTAT’s introduction followed the debut of the state’s statistical program, C-STAT.
“We knew it would be very important for our county Department of Human Services to have a similar performance measurement program,” Ternes said.
ArapaSTAT includes 25 different measures, mostly in childhood and adult protection and assistance payments programs, a few measures beyond what the state’s system monitors. Many measures are aligned with federal and state expectations for programs administered at the county level. The county’s primary investment has been in personnel — hiring a single program manager who had experience measuring performance data — to the tune of roughly $90,000 a year.
It took about six months to develop formulas and build databases and two years of analysis before the numbers started making a difference for county programs.
“It’s allowed us to dive into the data and if we’re not meeting a measure, we can look at the data, do some analysis and try to figure out how to improve,” Ternes said.
The analysis links data points to specific case files for further examination.
“You can see exactly what happened,” and where there’s room for improvement.
Results
Chief among ArapaSTAT’s positive results have been findings, trends and tendencies that provoke systemic change. For example, the county revised how it treated applications for food assistance after analyzing that process’ results.
The examination showed that county staff spent a lot of time following up with applicants to gather more information, often learning in the process that the applicants were eligible for expedited benefits, something applicants didn’t realize. But there’s a seven-day timeframe to complete applications for expedited benefits, and during the supplemental investigation process, the deadline for receiving expedited benefits would pass.
“We could examine each case and determine what transpired during the processing of the application that caused us to be overdue,” Ternes said.
Now the county requires all applicants to provide all information that would be asked of expedited beneficiaries.
“Now we treat all applicants like they are expedited,” she added. “We changed the whole business process.”
Not all measures lead to the overhaul of business processes, but they do give the county a barometer of how it’s doing.
For children in foster care, the county wants 99.68 percent of children in out-ofhome placement to complete their foster care without experiencing institutional abuse. Though the ultimate goal remains 100 percent, Ternes said the county measures how it has performed for particular measures, then raises the bar.
“We look at past performance and try to improve to a higher level,” she said. “Now we were able to home in on more issues and target them, since everything is measured and indexed to case files.”
Statistics and the staff
The shift to focus on data wasn’t met with universal acclaim by county staff, but the results it has yielded have given ArapaSTAT credibility that has led to buy in. The introduction of performance measures can provoke fear from front-line staff who may see data tracking as a way to penalize them.
“We had a pretty extensive communications plan around rolling it out to staff, but the key was trying to ease the fear about it being punitive,” Ternes said. “The key is being clear that our goal is to figure out how to move the needle in the right direction for families, children and other vulnerable people.”
The Human Services Department holds meetings on ArapaSTAT measures three times a month, and Ternes said her most visible indicator that staff members have embraced the program is the growing attendance at those meetings.
“More and more people started coming out once they realized this is the kind of thing that helps them do their jobs better,” she said, noting that staff members who deal with child abuse and neglect have taken a particular interest. “Because we’ve been successful, staff see the benefits. We stress that we don’t want to advertise when a department is falling short, we just want to get into the data and figure out how to fix it.”
Over the past five years, most of the county’s 25 measures have remained constant, and Ternes does not anticipate retiring them.
“Maybe if we are consistently exceeding our goals and could shift our focus elsewhere, but what we monitor is what is crucial to good human service delivery for our county,” she said.
The state of Colorado has awarded Arapahoe County the Distinguished Performance Award the last two years, after the county met 21 of its county-facing C-STAT measure goals 75 percent of the time. Arapahoe County is the only one of the state’s 10 largest counties to earn that honor twice in a row.
Mapping tool connects residents to services
With human service providers located all over Arapahoe County, the Human Services Department has organized nearly 300 of them in an interactive online mapping tool. ArapaSOURCE helps residents connect directly with 18 different types of service providers in a single place.
Centering on an address, the map offers up to 15 nearby providers for the 18 different categories at one time. They range from childcare assistance to aging services, with more of a dozen options in between, including job training, transportation clothing assistance and legal services.
By consolidating information on human service providers in one place ArapaSOURCE, offers some relief across the board. For residents who are eager to access services, they can now get that process into their own hands with more ease than ever before, and without the need for assistance by county staff. For county caseworkers, not only can they view provider offerings, but they have access to internal “maps” of human service clients. “
That helps us determine where we need to invest more resources, make more connections,” said Cheryl Ternes, director of human services. “It helps us keep an eye on where the most need is.”
Compiling a comprehensive and current list of service providers took county staff six months, but the county already had the GIS software on which the map was built. Arapahoe County is developing what will be a free smartphone app, but in the meantime, ArapaSOURCE can be viewed here.
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