| KCCI's, the Iowa Channel, breaking news segments was entitled, Out with paperwork. In with family time. The story continued, "The Iowa Department of Human Services has new plans for child welfare."
This story coincided with the release of a redesign that PSG shepherded for the Iowa Department of Human Services - a redesign process that crossed both child protection and juvenile justice systems to look anew at the system of support for kids who come into public care.
The redesign that resulted, called Better Results for Kids, is designed to give case workers more time with families. Let's understand each of the phrases KCCI chose to use.
In with family time.
The current system is child-centered. While well-intentioned, case worker after case worker said that the system made them work with behavior and treatment of specific kids. They felt this led to 'the kid is deficient' thinking and made it difficult to address underlying family issues. The new design is designed to be family focused - and includes the whole family in assessment, goal setting, and services aimed at family success.
Out with paperwork. This verbatim from early interviews speaks for itself: "My staff spends half of each day filling out paperwork to prove that we're working." Designers of the new system quickly focused on driving time out of the system - time, that is, that social workers were spending on documentation1. Leaders of the system have embraced this challenge and have set a goal of reducing documentation requirements by 50% this next year.
Underneath the headline are these key features of the redesign:
- Thousands of kids and their families who are considered at low risk of serious abuse will receive their services from local, non-profit agencies. DHS Director Kevin Concannon believes that this transfer to community agencies will help utilize and draw from more natural family supports -- such as neighbors, ministers and volunteers.
- With the transfer of less serious cases, workers will have their caseloads significantly reduced - with the intent that the time freed up is to be spent in 'face to face time' with those families most in need or most at risk of serious abuse.
- Across all, a focus on outcomes. Currently, the DHS and JCS systems are structured around a "fee for service" model, paying public employees for adhering to standards of practice and providers for supplying services. Neither public nor private participants are rewarded (or sanctioned) based on whether or not their work leads to positive changes in the lives of kids - reduced levels of abuse, more kids reunited successfully with families and placed in permanent and safe settings, and more effective rehabilitation for juvenile delinquents. The new design intends to do just that. It winnowed down a much longer list of desired outcomes to place unflagging attention on the following six:
- Outcomes for children: safety, permanency, well-being, and academic/ skill preparation
- Outcomes for communities: safety and offender rehabilitation.
Director Concannon was quoted as saying that the new design jump-starts a desired culture change, one that "elevates the importance of families, puts more emphasis on the open involvement of communities, and places a stronger emphasis on outcomes."
What does the redesigned system look like? Reduced to its most basic components, the redesigned system has six sequential steps that children and families will experience:
- Prevention - encouraging local collaborations - such as parent training, family support networks, student mentoring, after school programming, or other family or youth development resources - that are needed in a child welfare or juvenile justice case to help the child or parents succeed.
- Assessment - engaging families and determining what is needed to accomplish desired outcomes for the child and community;
- Addressing needs - developing a single, family-centered plan and bringing together the resources to support this plan;
- Delivering services - providing services that achieve expected results;
- Monitoring progress - gauging the progress toward achieving the outcomes specified for the child/family. Although the State may have ultimate responsibility for collecting these data, the system will develop the competence of the family in making judgments about their own progress;
- Transitioning out of the system - the child and family "exit" the system prepared to continue their lives in a healthy and successful manner.
The design is organized with more detail and implementation recommendations for each of these six steps. You'll also see the pieces of Iowa's system that are being retained and are acting as foundation pieces upon which this design is built. If you are interested in learning more about this project, please contact my partner Rick Heydinger (rick@psg.us) who directs this project for PSG.
To recap, I have often written about the redesigns that PSG does or helps our clients to do. As you know, what I love most about redesign is asking, "If we were to start anew, how would we want our public systems to operate?" In this case, the answer is clear:
| Out with the Old |
In with the New |
| Focus on the child |
Focus on whole family |
| Focus on child's behavior and treatment |
Focus on child's safety and permanency |
| "Cookie cutter" approach |
Individualized, community-based services. Specialized, more intensive supports for those most at risk of serious abuse |
| Many 'hand-offs' |
One single plan per family, with transitioning seen as a process, not an event |
As we start this new year, what would be the elements of your public system you would most want to place in the "Out with the Old" and "In with the New" categories?
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