-
MN Association of County Administrators Fall Conference October
2012
-
Review the basic provisions of the “State-County Results,
Accountability and Service Delivery Redesign Act” (“the Act”)
passed in 2009
Review work done to date to implement the Act
Raise awareness of how the Act will impact
counties Discuss key questions for counties to consider
-
State Issues 2007 Legislative
Auditor report ◦ DHS lax in oversight role ◦ Variation in
programs
between counties ◦ Variation on quality and
service level DHS resources
stretched responding to 87 counties
County Issues Reduction in state
funding for programs Resistance to
increased property taxes
Process requirements vs. administrative simplification
“Unfunded Mandates”
-
Transparent system accountable for results Consider economies of
scale to reduce
administrative cost and redirect resources to improve service
capacity
Simplify administration and reduce process
requirements Solicit and respond to citizen input
-
Steering Committee on Performance and Outcome Reforms
Commissioner power to remedy failure to meet
performance outcomes State-County Results, Accountability, and
Service
Delivery Redesign Council Process for establishing a Service
Delivery Authority Transition to new bargaining unit structure
-
Component 1:
Establishment of a performance measurement
and management system
Component 2:
Authority to create a new type of service delivery
model
-
Committee Composition…*
3 DHS Reps
4 County reps chosen by MACSSA/AMC
3 client/advocates appointed by Commissioner
*DHS commissioner representative and county commissioner
co-chair
-
11/01/09: Establish list of “essential” human services
(state and federal mandated statewide)
12/15/09: Develop 3-year work plan and form workgroups to
include clients/advocates
02/15/10: Develop a uniform review and graduated accountability
process for responding to county/SDAs failure to make progress on
achieving performance measures (prior to commissioner remedies)
01/15/11: Report annually any recommendations for legislative
consideration
12/15/12: Develop and recommend minimum outcome
standards for the essential services, based on level of
available resources
-
Voluntary incorporation of administration and operation with
another county
Mandatory incorporation with another county ◦ Incorporating
county not financially liable for cost of remedying
performance
Transfer of authority for program administration and operation
to commissioner
County subject to remedies shall provide funding needed
to remedy performance
-
Goal: The purpose of the remedy process is to hold the human
services system accountable for improving outcomes for the people
we serve by driving continuous improvement in performance.
Continuous improvement is not the sole responsibility of one party,
but is jointly owned by the state, the counties and non-profit
partners.
-
Remedies of MS 402A.18 (loss of county service control) are the
“end” for counties failing to meet outcomes
Fiscal penalties should be part of the remedy process ◦ Preceded
by a warning and time for corrective action ◦ Result in a real loss
of funding; not so large as to significantly impact
ability to deliver service ◦ Scaled to degree of non
performance
Allowance for extenuating or exceptional circumstances
required
State technical assistance offered as part of remedies
process
-
Performance Steering Committee goals…
Implement a quality and transparent process
Create opportunities for stakeholder input and participation
Emphasize continuous improvement
-
Four workgroups were formed: Children’s Services, Convened
September 2010 Income Supports, Convened January 2011 Adult
Services, Convened August 2011 Technical Advisory Panel, Convened
July 2011 Workgroup composition ◦ State ◦ County ◦ Community
Partners
-
Income Supports Results
People are economically
secure
People have access to health care and receive
coordinated/ effective services
Children have the opportunity
to develop to their fullest
potential
Children’s Services Results
Adults and children are safe
and secure
Children have stability in their living situation
Adult Services Results
Adults experience a
quality life
Adult Services
Low income people have health coverage
The way people
access, enroll, and maintain health care coverage is timely,
respectful, and non-discriminatory
People with
specialized health care needs are connected
to resources and services
Adults have access to
individualized care
Adults have access to health care
Adults receive
coordinated services
People have the opportunity to attain
and maintain employment
Both parents contribute to
children’s financial security
The way people access
and enroll in income support services is
timely, respectful, and non-discriminatory
People unable to meet
their basic needs receive safety net
services
Children’s needs are met (individual, emotional, and
developmental)
Children’s important
relationships are strengthened and
maintained
Children are in quality, stable child care
Children are stable in their living situation
Children have
permanent families
Children are safe from abuse and neglect
Children are safe from
self-harm
Adults are safe from abuse and neglect
Adults experience safety based on individual needs
Adults achieve maximum
independence
Adults have the opportunity to attain
and maintain employment
Adults are supported
and connected
Adults are empowered to make choices
Alignment of Outcomes Across Service Areas Po
pula
tion
Out
com
es
Cou
nty
Prog
ram
Out
com
es
-
Clear expectations Integration & Alignment Collaborative
partnership Accountability Tools to continuously improve
-
An Effective Performance Management System Requires a Strong
Foundation: A clear understanding of the results we are trying
to
achieve The ability to know if we have achieved those results An
understanding of the stakeholder values and priorities
that guide how we will go about achieving those results
Alignment with best practices in performance
management
-
Essential system requirements: Fully engaged leaders
Understanding of client needs Relevant measures and analysis
Collaborative action and governance Aligned resources
-
Why is a new model needed? ◦ Form must follow function ◦
Counties need the right tools to achieve results
-
Council composition…* 4 Legislators (house/senate) 4 DHS reps 2
county commissioners (AMC) 2 county directors (MACSSA) 2 labor reps
(ex-officio) *DHS commissioner representative and county
commissioner co-chair
-
Provide review of redesign process and establishment of service
delivery authorities
Ensure consistency to the extent appropriate between service
delivery
authorities Review and recommend waivers requested by service
delivery authorities Establish a process for public input on the
scope of essential services Serve as a forum for conflict
resolution between all parties Engage in a program improvement
process Identify and recommend incentives for participation in
service delivery
authorities
-
Can be established for all or some essential services
A single county or a group of counties with population of 55K or
more, OR
At least 4 counties without regard to population – all in close
geographic proximity
Duties of the service delivery authority include broad language
similar to pre-existing statute
-
Identification Exploration Notification Negotiation
Certification Implementation Evaluation
-
Added to chapter in 2011 Established employees of a service
delivery authority as
public employees Established service delivery authorities as
public employers Sets process for recognition of exclusive
representative for
employees of service delivery authority
-
New performance standards Continuous improvement expected Clear
remedy process for failure to meet
performance expectations Requires innovative strategies to
manage for
results ◦ Business process changes (e.g. case-banking; NE EDMS)
◦ Organizational/Structural changes (e.g. SWHHS)
-
In what human services program areas are we struggling to
achieve desired results?
What are the barriers that are getting in the way of our
performance success? ◦ Lack of specialized staff expertise? ◦
Funding? ◦ Inefficient internal business processes? ◦ Program rules
and regulations? ◦ Complex & unnecessary administrative
requirements?
What tools do we need to address those barriers? ◦
County-specific performance data? ◦ Flexibility from certain rules
and requirements? ◦ Staff training? ◦ Better economies of
scale?
-
Questions?
Judith Brumfield Interim Director
Scott County Health & Human Services
[email protected]
Kate Lerner Director of County Relations
Minnesota Department of Human Services
[email protected]
mailto:[email protected]:[email protected]
2009 State-County Results, Accountability, �and Service Delivery
Redesign Act�(SDA Act)��MN Statute 402A���Primary Objectives For
TodayStory Behind the ActProposed SolutionThe ActTwo Major
ComponentsSteering Committee on Performance and Outcome
ReformsSteering Committee on Performance and Outcome
ReformsCommissioner Power to Remedy Failure to Meet Performance
OutcomesRemedies ProcessRemedies ProcessSteering Committee on
Performance and Outcome ReformsSteering Committee on Performance
and Outcome ReformsSlide Number 14What We WantFinal ReportFinal
ReportTwo Major Components Service Delivery Authority: �A new
service delivery modelState-County Results, Accountability, and
Service Delivery Redesign Council�Redesign Council Duties��Service
Delivery Authority Requirements�Process for Establishing a Service
Delivery Authority�Transition to New Bargaining Unit Structure�How
Will “The Act” Impact Counties?Key Questions to ConsiderSlide
Number 27
