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5 Trends Driving the Future of Human Services

April 1, 2013 By Tracy Wareing, executive director of the American Public Human Services Association and Howard H. Hendrick, director of Human Services Business Strategy for Accenture and former director of Oklahoma’s Department of Human Services

Henry Ford unveiled the Model T in 1908 in a defining moment that changed travel and manufacturing—and influenced American life for years. Ford’s innovation and others like it—the airplane, the television, the Internet and the mobile phone—shattered the status quo, introducing the next frontier in how people live and work. While it’s not the stuff of history books, human services innovation is equally powerful. It’s happening now, fueled by trends that help agencies deliver outcomes today while preparing for tomorrow. 

Today’s do-more-with-less environment is more the rule than the exception. The political pressure to avoid displaying material reductions in service while costs increase and revenues fall is driving change in human services. Leaders know that processes, technologies and cultures must all be part of the change equation to deliver high-quality, cost-effective services. A recent survey of 2012 Human Services Summit attendees revealed a consensus around the value of progressing along the Human Services Value Curve (a framework developed by Antonio Oftelie at Harvard University), citing it as a high priority. Yet respondents acknowledged that moving their organizations to greater levels of maturity is a significant challenge. 

How can agencies move through the challenges of change? What today’s pragmatic human services leaders understand is that innovation does not have to be an all-or-nothing proposition—and that it is never a one-size-fits-all proposition. Innovation can be about bold moves or subtle shifts, and it can occur all at once at scale or incrementally in pockets and across functional areas.

Whatever the future of human services innovation looks like, the key for organizations lies in making the most of the forces of change in alignment with their unique circumstances. It’s about harnessing burgeoning ideas, trends and innovations that can bring about outcomes and impact in the short term—and hold strong potential for continued progress five or even ten years from now. So what are the most promising trends in human services? And how can organizations take advantage of them to move to greater levels of outcomes and impact for the people they serve? 

Human services organizations sometimes have entrenched ways of working. It is not uncommon for service delivery functions within a single agency to be isolated from one another, despite redundancies that mean higher costs and lower-quality services. Government agencies and nonprofit community-based organizations often work in parallel, but rarely with explicitly common goals and practices. 

Recognizing the need to maximize resource use and offer fresh ideas, some human services organizations are breaking through longstanding barriers and exploring nontraditional partnerships with each other—both nonprofits and the private sector. The result is a new human services ecosystem where organizations forge interactive and interdependent relationships that are mutually beneficial and directed toward a common goal. 

This mix of new people and resources creates important advantages. Working together broadens the discussion around the role of human services with other state and community services. It forces every contributing organization to consider core competencies and determine how the collective can best function for greater, system-wide impact at less cost. It adds a client and community-centered approach to program-centered accountabilities, and creates stronger social services through collaboration. 

The relationship between the Arizona Commerce Authority and the Arizona Department of Economic Security reflects the potential of nontraditional collaboration. Once operating in isolation, the state’s job generation mechanism and its human services system are finding ways to come together to meet their distinct missions while seizing the potential for collaboration where clear intersections exist. 

If this trend continues over the next five years, human services delivery could change dramatically. Broad coalitions of organizations with the right skills and resources led by human services agencies would jointly provide coordinated, cradle-to-grave human services with a shared emphasis on work, higher paying jobs with skill-ready workers and early intervention—minimizing the need for deeper-end government services.

An extension of this partnership climate, pay-for-success contracts are gaining traction as an alternative funding mechanism for human services programs that pays providers of goods or services when outcomes are met. These arrangements take on a variety of forms, and social financing is one of them. The basic principle is to encourage outside investment in preventive social interventions that ultimately benefit the common good—and reduce the need for costly future remediation for which taxpayers will have to pay. 

In social financing, foundations or other non-government entities infuse capital for a specific intervention and, if a predefined social outcome is achieved, funders recoup their investment plus a reasonable rate of return. Prison recidivism programs in the United Kingdom and New York City number among those that have been funded via social financing. Similarly, Dakota County (Minnesota) Community Services, supported by the Bush Foundation, has explored the business case for its Re-entry Assistance Program, developed an outcomes measurement framework, and a re-investment design to support social investment funding. 

Not only do such pay-for-success models align incentives across sectors and promote the wise use of precious taxpayer dollars, they are rooted in a strong outcomes focus. To monetize social outcomes, value must be inherently data-driven and outcomes-based. This drives discussion on measurable impact and emphasizes return on social investment in an entirely new way. Non-government funding opportunities also tend to increase tolerance for the risks that accompany innovation. Continued momentum here could mean that, as soon as five years from now, agencies could regularly pay providers only when social outcomes are met or exceeded. 

The proliferation of data and the sophistication of technology to draw insights from it is a double-edged sword for many human services organizations. While today’s data-rich environment has brought an ability to measure outputs and some outcomes, it can also create a swirl of complex questions without easy answers. What data do we have? What data should we be collecting? How do we protect our data’s integrity? 

Descriptive and predictive analytics are at the heart of the information boon as organizations work to make data insight actionable. Human services agencies using analytics today are most often using descriptive analytics for simple reporting or to detect and correct non-compliance after transactions are completed. The more exciting promise of analytics lies in a more proactive application. Predictive analytics can increase understanding of the relative effectiveness of different programs so that interventions—and resources—can be smartly targeted for better outcomes. As one 2012 Human Services Summit attendee explained: “Analytics is the way we are going to be able to figure out where to target our resources.” 

There is also tremendous potential for organizations to deepen analytics insight to develop preventive interventions that stave off later traumas and future reliance on the social safety net among specific populations. Consider the story of the Hillside Work-Scholarship Connection, a public-private partnership focused on reducing dropout rates among at-risk youth, so they are ready for a productive life after high school. 

Working in the Rochester, New York school district, Hillside used predictive analytics to understand the relationship of specific risk factors—attendance, suspensions and standardized test scores among them—to graduation rates. Hillside understood that some students would graduate without their intervention, and other students would not graduate even with it. The organization developed a data-driven recruitment strategy based on which students would be the most likely to benefit from the program. It’s an approach that improves return on investment for participants and funders alike. 

As the use of analytics matures in the coming years, this success points to a future where key decisions, including resource allocation and service provisioning, are based on known impact and proven results in all aspects of human services delivery.

While public human services delivery is unlike anything in the private sector, this does not mean that agencies have nothing to learn from commercial practices. Even before Henry Ford’s day, the private sector had an R&D model where innovation was valued. 

The opportunity here is for human services leaders to fearlessly challenge “insider” mindsets that see only differences and inconsistencies between private sector and public sector services—and consider the potential of “outsider” innovations. The advantage lies in lower-risk innovation that aligns with consumers’ service delivery expectations. Agencies should consider the example of customer-centered organizations that use multichannel touch points, customer and product segmentation, targeted promotions and self-service options. Translated to the human services environment, such approaches could mean quicker access to jobs, job skill development, eligibility determination and other services, so that people can experience economic recovery faster.

Looking to service delivery innovators in retail, financial services, telecommunications and insurance, the Australia Department of Human Services is reaching people in new ways through service center experiences, self-managed channels and online and mobile options. Targeting students receiving stipends, the Department launched its first mobile app, which allows them to conduct a number of tasks from their smartphones. The Department reports that users are conducting an average of 40,000 transactions per week, which eases pressures on service centers.

As other human services agencies begin to explore such “outsider” practices, what’s business-as-usual in other industries may increasingly define the new face of human services delivery. 

Serving the whole individual, a tenet of human services transformation, is impossible without health and human services integration—from strategic vision through tactical implementation. A 2012 Human Services Summit attendee explained the vision, “The challenge is sustaining a long term strategy to be able to view our customers from eligibility determination through delivery of services and assess health outcomes of the overall populations.”

In recent years, there has been increasing momentum around the connection between these areas, some of it spurred by the requirements of the Affordable Care Act (ACA). Opportunities for coordinated service delivery and holistic planning and economies of scale for infrastructure investments should create positive value where planned vision exists at the start. 

As the mechanisms for paying for and delivering healthcare change post-ACA, it is an optimal time to come together and refocus on measuring the right kind of outcomes. This provides a richer understanding of how overall population health is often an indicator of the effectiveness of specific social programs, revealing “hot spots” for integration. 

Consider the Home and Healthy for Good program in Massachusetts. It provides housing to homeless individuals as a first priority and then focuses on health issues. Data have shown a significant drop in participants’ Medicaid costs, revealing a link between housing and healthcare costs, and highlighting a place where continued and even broader interoperability would likely bring additional value.

As states integrate health and human services, the future vision is one where the distinction between health and human services fades, both in theory and in operation, and wellness is defined holistically as a function of a person’s social, economic, physical and mental state.

Henry Ford’s use of assembly line manufacturing and interchangeable parts helped make the Model T affordable to the common man. While human services organizations share common ground around the need for change, the paths to change are varied. Different organizations will be ripe for different trends. Some jurisdictions are already rich in an entrepreneurial atmosphere, while others may need legislative action as a first step to incubating change. 

Yet for all, success will require adaptive leadership and a pragmatic approach that never lets the perfect be the enemy of the good. The search for improvement is continual, and reaching the next frontier requires the courage to lead. 

This article was published previously in Policy & Practice, the journal of the American Public Human Service Association.

Image courtesy of Shutterstock

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Adaptive Leadership Rises in Human Services

An autistic child must go to a residential treatment facility because his school cannot manage him — his mother, who is the only one who has the soothing touch her child responds to, is forced to give up custody. Thinking creatively, human services practitioners work with the school district to hire his mother, so she can be the one to give him the in-classroom support he needs. The boy stays in residential care for less than a month and the family moves forward together. This is the art of the possible in human services — and adaptive leaders are making it happen.

With budget cuts driving fewer resources and the economic downturn creating increased demand, human services leaders must continue to develop creative approaches to deliver programs with the resources they have. This pressure — and the media attention that covets headlines about tragedies over stories of triumph — can be overwhelming.

Yet there is optimism among human services leaders despite these challenges. Today’s environment is cultivating a new breed of adaptive leaders who favor possibility over pessimism, fearlessly go against the grain, and feel energized where others are paralyzed. As adaptive leaders break through traditional barriers to build capacity through outcome-oriented business models and family centered approaches, they are driving profound changes.

Adaptive leadership stands in stark contrast to the leadership style prevalent in human services of a decade ago that managed inputs and outputs in an institutional and bureaucratic environment where preserving the status quo was paramount. This transactional leadership model has become ineffective today. Clearly, as organizations traverse the human services value curve, there exists a need for transformational change — and transformational leadership.

Ron Heifetz, co-founder of the Center for Public Leadership at Harvard Kennedy School, has pioneered the concept of adaptive leadership with his book, Leadership on the Line — Staying Alive Through the Dangers of Leading, which he co-wrote with Marty Linsky.

According to Heifetz, moving an organization or system through transformational change requires identifying and resolving a mix of “technical” challenges (problems we can fix with current knowledge and abilities) and “adaptive” challenges (problems that require learning and the application of new competencies). People and stakeholders must internalize the changes, shedding old practices and loyalties, accepting new ones and developing new structures, systems and cultures. Adaptive leaders “exercise leadership” by guiding and pacing people through both the discomfort and opportunities of this adaptation.

This concept can be applied to the human services where “adaptive challenges” arise from driving change across two dimensions. The first is “technical innovation,” which involves typical changes that organizations and people experience when making incremental changes within existing structures. The second is “organizational innovation,” which is atypical change that requires new roles, capabilities and competencies within a new paradigm.

In human services organizations, those exercising adaptive leadership help staff, stakeholders and partners learn new practice models and new competencies — and pace the innovation at a rate that an organization and its people can sustain.

Adaptive leaders are making inroads in all sectors, but this leadership style especially aligns well with the social sector.

Human services leaders often cannot be as autonomous and authoritarian in their leadership styles as executives in the private sector and other state agencies are. Many must also manage through more complex stakeholder and partner dynamics and organizational structures.

Adaptive leadership is ideally suited to drive creative approaches in such a complex environment. Adaptive leaders are well positioned to create cultural norms, tangible plans and expectations in which continuous improvement and transformative change will occur.

Adaptive leaders set up and use systematic mechanisms for monitoring progress, impacts and lessons learned, creating a “learning organization” to drive outcomes. Adaptive leaders adhere to several fundamentals:

Know the organization. Traditional human services leaders view the organization as a singular entity, a monolith rich in sameness, common thinking and common doing. Adaptive leaders know their organizations as ecosystems bound together by a common purpose, but steeped in difference. They understand that their agencies include stakeholder groups that overlap, but that each group has its own unique characteristics. As such, moving people toward a common center means understanding existing competencies and attitudes.Forecast the future. Adaptive leaders get ahead of change before it happens because they take the long view of all impacts. This approach includes a willingness to consider longer-term strategies for change, despite the short political cycle, and an evolutionary versus a short-term results orientation. In this, short-term but unsustainable and potentially traumatic strategies of recent times are replaced by adaptive leaders’ measured understanding of “what it will take.”Break down barriers. Adaptive leaders are not turf oriented. They focus less on championing an organization’s place in the larger enterprise than on championing across the enterprise. This is important because human services is broadening to a community of interest that looks beyond contractual relationships, and is more about developing a collective of nontraditional public- and private-sector partners focused on sustaining whole community well-being.Be disruptive. Adaptive leaders privilege outcome-focused goals and principles above all else, even if they require major changes to organizational norms and sacred cows. This mindset is evident in approaches that were rare even five years ago, such as shared services, cross-jurisdiction collaboration and social media outreach. Disruption is also as much about building new competencies as it is about effectively letting go of old ones. Be agile to get to the end game. Adaptive leaders adjust mid-course if new information is revealed or if economic, technological or social changes occur that require a different approach. This spirit is couched in a realization that leaders must carefully calibrate an organization’s readiness for change and set the right pace accordingly.Empower the organization. Adaptive leaders focus on empowering and flattening the organization to deemphasize hierarchy and silos. They engage staff at all organizational levels in collaborative, cross-functional diagnoses of problems and solution identification. These leaders also foster other voices of leadership from all levels of the organization because they can seed change and motivate others. Sense and respond. Adaptive leaders hold true to their understanding of other people, and of themselves. They consider deeper impacts of gains and losses, and perform self-checks, realizing they may have their own barriers to work through to get to desired outcomes.

There are variations within the adaptive leadership style in human services. While leaders may lean more toward one, there is overlap and fluidity among them as leaders adapt to changing circumstances.

Silo smashers take the big picture view of the entire human services community of interest rather than having a myopic view of their own agency. They are open to new ideas because they are not mired in narrow context or subject-matter expertise. This relational mindset is vulnerable — in a good way — to the influence and interests of others.

Moreover, silo smashers are adept at driving outcomes that require cross-program and cross-system practices and services. These leaders can demonstrate a lack of pragmatism or systematic planning and execution if they are not well rounded or if they fail to surround themselves with necessary and complementary capabilities.

Lynn Johnson, executive director of the Jefferson County, Colo., Department of Human Services, is a model silo smasher. With a commitment to “do something different” to improve the agency’s program effectiveness and reputation, she has embarked on a transformation initiative to bring together historically siloed programs. To drive this change, Johnson is working across stakeholders — including 600 staff and 65 nonprofit and 350 faith-based groups — to drive a cultural shift.

Her approach is rooted in the philosophy that magic happens when there is no single leader and teams are allowed to focus on what they do best, making cross-program connections and taking risks along the way. It’s an outcomes-based focus made possible by cross-community engagement and whole-person, whole family solutions.

As Johnson explains:

“We started looking at the passion circles. We started saying, what are you passionate about? You know I have a huge agency, 13 different departments — 50 different programs. We all did our passion circles, and then we linked them because we didn’t want to be doing different things. We wanted to be driving in the same direction.”

First movers know that sustainability requires pioneering spirit that spurs renewal and embraces risks. They understand that trust requires being one’s own worst critic, which is counterintuitive for many leaders. These leaders are data and logically driven, and confident that moving the needle is strengths-based, instead of deficits-based.

These leaders make their own blueprints and know how to adjust midstream if outcomes are not forthcoming. They are likely to analyze root causes and underlying drivers of an effective practice as part of planning and execution.

The Washington Department of Social and Health Services moved from transactional management to transformational leadership because of former Secretary Susan Dreyfus’s passionate first mover approach.

Dreyfus recognized that driving outcomes in difficult times demanded “a different and dynamic organization.” She asked everyone to join her in leadership, and flattened the organization. She also set a unique precedent, finding unexpected value in ambiguity as only adaptive leaders can:

“… in bureaucracy as soon as something becomes ambiguous we want to shut it down, we want a technical solution, we want to get it under control because it’s in that space of ambiguity that bad stuff can happen from the political standpoint, and yet it’s that one space if we allow it to happen is where creativity occurs.”

Future drivers look to the horizon. They want to understand why things are the way they are and address problems at the root. These leaders are effective in driving outcomes requiring community capacity building and working from a low baseline current state. Weaknesses can arise if future drivers over-analyze and do not move quickly into execution mode.

With an eye to the future, the Hampton, Va., Department of Human Services — initiated by Walt Credle and now led by Director Wanda Rogers and Deputy Director Denise Gallop — used a legislative driver as a springboard to dramatic and lasting change. The department spearheaded the coordination and alignment of more than 30 programs over a 15-year period.

Creative and integrated service strategies ultimately led to positive outcomes. Hampton has not had one child placed in a residential treatment facility since 2007. The community has not placed a child in a group home since 2008. There has also been a greater than 85 percent reduction in foster care numbers. Part of this success comes from the future driving leadership vision to involve family perspectives in developing solutions. Rogers explains this “common sense” approach:

“We always, always, always start with a good assessment of what this family brings to the table and what this family wants, partnerships, public and private providers, recognizing that families are the experts about their families. When we begin to do that, we were able to really lock into moving from knowing to doing …”

While the results that these adaptive leaders have achieved are impressive, adaptive changes are only starting to take shape in human services, and most exist in pockets.

To make a lasting impact in human services, adaptive leadership must move beyond the top of the organization chart. Sustaining its value means “giving back the work” to everyone — embedding this spirit across the organization and addressing resistance by confronting its non-constructive forms with conviction. The adaptive model involves co-creating solutions and making it possible for stakeholders and partners to process change, add competencies and give up old ones in a protected environment.

Just as human services practitioners used a one-child-at-a-time approach to help an autistic boy stay in school, so must adaptive leadership be a one-leader-at-a-time approach where the art of the possible ultimately becomes a part of an organization’s DNA.

Republished from Policy & Practice, American Public Human Services Association. Antonio Oftelie is executive director of Leadership for a Networked World and fellow at the Technology and Entrepreneurship Center at Harvard University; Julie Booth is Accenture managing director for North American Human Services; Tracy Wareing is executive director of the American Public Human Services Association. The article reflects insights shared by human services leaders at the 2011 Human Services Summit, held at Harvard University in October 2011.

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