Southeast Minnesota. Human Services. Redesign. Executive Summary. February Human Services. Empowering Services, Improving Lives

Transcription

1 Sutheast Minnesta Human Services Redesign Executive Summary February 2013 Human Services Empwering Services, Imprving Lives

2 Wh Is Cnsidering This Opprtunity? Cunties Ddge Mwer Steele Waseca 2

3 Opprtunity fr Redesign Building n an histry f cllabratin, the twelve cunties f sutheastern Minnesta are seizing the pprtunity fr redesign by addressing current trends with innvative ideas, new partnership mdels, and a visin fr human services delivery and administratin. Histry f cllabratin Service delivery and administrative crdinatin acrss numerus areas Crss-cunty cmmitment t cnsumer utcmes A perfect strm f challenging trends: Recessin-driven increase in service demand Reduced state revenues/increased cst-shifting t Cunties Reduced Cunty resurces/staff due t recessin-impacted tax and ther revenues Current human services apprach is unsustainable: Increasing wrklads, declining staff, service delays t cnsumers N relief envisined fr freseeable future Grwing human service utcme expectatins and interest in shared services and reginallybased services: MN Legislature enactment f Service Delivery Redesign Authrity and Essential Human Service Delivery standards (Chapter 402A) Bush Fundatin interest in prmting/supprting public endeavrs that result in increased psitive utcme, effectiveness, and efficiency 3

4 Key Summary Benefits By redesigning the current mdel fr service delivery, the reginal perating mdel prvides imprved efficiency and better utcmes fr clients. Imprved Services Financial Flexibility Enhanced Access Increased specializatin and imprved delivery f prgram services via centralizatin f administrative functins Imprved prgram effectiveness thrugh use f evidenced-based practices, metrics tracking, and quality assurance prcesses Greater ability t keep pace with grwing demands fr services despite reduced state and federal funding Onging surces f revenue generated by bth new, specialized psitins fr grant writing, revenue maximizatin, and fraud prtectin, as well as ptential t cntract functins t ther cunties Shared service centers allw the public t access the service center f their chice based n cnvenience, rather than where they happen t live Online and phne access channels (as well as in-persn) which prvide the public with a greater ability t reach services at the times and places that wrk fr them Lcal and Reginal Cntrl Strnger ability t define and cntrl the scpe f services needed t meet federal and state utcmes rather than relying slely n service prvisins champined in St. Paul and Washingtn D.C. Greater ability t chart the regin s wn curse fr the future, particularly in an envirnment f increasing expectatins fr lcal accuntability and limited resurces Future expansin in t additinal cunties and/r services prvides pprtunity fr increased scale 4

5 DRAFT Fr Discussin Purpses Caselad Size Implicatins The SDA prvides an increased level f service fr prgrams that require mre intense levels f interventin while increasing efficiency fr prgrams that are mre transactinal in nature Prgram Current Cases / Wrker Average Expected Cases / Wrker Average Scial Services Supprt Services Adult Behaviral Health: - Mental Health - Chemical Dependency Adult Prtectin Adult DD / Waivers Child Behaviral Health Child Welfare / Prtectin Child DD / Waivers Incme / Fd / Medical Assistance Child Supprt Licensing Increased Level f Service Increased Efficiency 5

6 Key Design Principles Tw key design principles infrmed the tw principle questins f the perating mdel design phase. Key Design Questin Hw d we reginalize the administratin and delivery f human services? Hw shuld we redesign ur service delivery? Design Principle MN Service Delivery Authrity (SDA) statute Systems f Care practices Descriptin Outlines hw a Human Services Delivery Authrity can be rganized under Minnesta law, and the bligatins f such an rganizatin. We recmmend this SDA be rganized under this legislatin An emerging leading practice in Human Services delivery that emphasizes a cnsumer-fcused means f service delivery, rather than a prgram-fcused apprach 6

7 Enabling Legal Framewrk Minnesta Statutes Chapter 402A, Essential Human Services; Cunty Delivery prvides enabling legislatin fr the frmatin f a Service Delivery Authrity (SDA) this mechanism prvides the regin with a strng ptin fr a legal framewrk fr redesign. Overview Vluntary cunty gvernance/management structure certified by Redesign Cuncil (apprved by DHS Cmmissiner) Passed in 2009 HHS mnibus budget bill (Chapter 402A) SDAs utilize already existing mdels f cmmunity partnerships, build n innvatins, and streamline the human services system t best meet the needs f cmmunities, clients, and taxpayers Hw It Wrks Must meet minimum ppulatin threshlds (55,000 minimum) via single r multicunty structure (with certain exceptins) Can serve as single cunty SDA if minimum ppulatin threshld is met Can cmbine with ther cunties in reasnable gegraphic prximity as an SDA t deliver a service, sme services, r all services Must designate a single administrative agent t cmmunicate with DHS May be granted waivers frm state regulatins t achieve better results N structure specified in law 7

8 Systems f Care Practice The system f care mdel is designed t prvide an enhanced quality f service t clients, thus imprving the utcmes that can be achieved and reducing lng term cst f care. Key principles include: 1. Cmprehensive array f services and supprts 2. Individualized services and supprts / individualized plan 3. Cmmunity-based - Least restrictive, mst apprpriate envirnment, utilize natural supprts 4. Persn-centered Clients participate in all aspects f the planning and delivery f services and supprts 5. Integrated services and supprts acrss systems and prviders 6. Cllabratin/crdinatin acrss multiple systems 7. Strengths-based nt deficit driven 8. Culturally and linguistically respnsive 8

9 Visin and Missin Statements Visin Quality human services with great results! Missin The Sutheast Minnesta Reginal Human Services Delivery Authrity is a visinary cllectin f cunties united in delivering human services t all its residents by: 1. Offering a full cntinuum f care with cnsistent high quality 2. Emphasizing preventin and early interventin 3. Emphasizing innvative, regin-wide use f a netwrk f peple and resurces 4. Partnering with clients and cmmunity prviders 5. Being accuntable t citizens fr effectiveness in care delivery and efficiency in the csts t serve 9

10 Guiding Principles 1. Strive fr the best pssible shrt-term and lng-term utcmes fr each available taxpayer dllar 2. Develp an engaged-client-centered system that is fcused n meeting individual client needs, including accessibility, by ffering chices that meet persnal and cmmunity utcmes rather than prviding a ne size fits all apprach 3. Ensure pprtunities fr clients t grw accuntability and bear persnal respnsibility in achieving persnal gals and utcmes 4. Implement a system-wide cmmitment t measurement, learning, and cntinuus imprvement 5. Prvide transparency, equity in utcmes and access, and cnsistency f pprtunity 6. Meet State and Federal perfrmance standards, as established 7. Create a win-win-win fr clients, the cunties, and Minnesta 8. Allw fr the pssibility f including additinal cunties, services, and/r cntracting ut SDA-develped services 10

11 Organizatinal Structure The rganizatin chart is designed t frmalize ppulatin-based practice and prvide the administrative infrastructure t supprt the reginal delivery system. Cnsideratins 1: Behaviral Health Supervisrs versee cntracted case managers 2: One Adult DD Supervisr will supervise Child DD Casewrkers and will have a dual reprting relatinship t bth the Adult and Children s Manager 3: Adult Prtectin Supervisr manages guardianship prgram 4: Adult Services Manager versees Specialized Services Crdinatr (1 FTE nt pictured) 5: Licensing has 0.5 FTE Supervisr split between Adult and Child Services 6: One Clerical Staff member will serve as an Executive Assistant t the Executive Directr. The remainder will reprt t lcal ffice managers 11

12 Technlgy Overview Mdern technlgy tls will be needed at the state-, the SDA-, and the fieldlevel t equip a reginal wrkfrce. Rle f Technlgy in a SDA Envirnment Imprve verall human services client access, experience, and utcmes Prvide a mre effective and efficient service delivery prcess acrss the regin Equip casewrkers, supprt staff, and managers with mdern technlgy features and capabilities Key Technlgy Tls State Systems - MAXIS - PRISM - MMIS - SSIS - MEC2 - MN-ITS - Odyssey - WMS - HIX SDA Management Systems - Finance - Analytics/Reprting - Access Center Management - SharePint - Infrmatin and Referral - Human Resurces - Electrnic Dcument Management SDA Infrastructure - Netwrk - Phnes/Cell Phnes, Tablets - Laptp/PC, Printers - Servers - Security/Data-Security - Integrated Cmmunicatins - Electrnic Data Strage - Remte Supprt - Vide Cnferencing 12

13 Facilities Apprach The SDA will cnsist f a regin-wide netwrk f peple, resurces, and services, delivered thrugh a mix f service delivery centers and remte wrkfrce, t ptimize capacity and bring service delivery clser t the client. Service Centers will cntinue t exist in each cunty, with ptential t add additinal facilities if there is demand Service Centers Remte Wrkfrce 13

14 Peple The SDA will be empwered thrugh its peple - develping the right peple fr the SDA means develping yur human capital and equipping them t serve yur cnsumers. Peple Internal External Key Principles Reginal career path fr SDA emplyees Dedicated persnnel develpment Emphasis n specializatin Circles f supprt prvide infrmal netwrk fr cnsumers Navigatrs cnnect cnsumers with the cmbinatin f cmmunity and gvernment resurces that will best meet their needs 14

15 Metrics Measuring utcmes and the return n taxpayer investment is an imprtant part f the SE Minnesta Cunties Human Services Redesign prject. Type f Metric Examples Surce Human services utcmes Stakehlder Return n taxpayer investment Operatinal Children s Services Incme Supprts Adults Services Cnsumer satisfactin levels Wrkfrce satisfactin levels Cmmunity engagement Impact t HS and t cunty budget f prgrams and services Service levels fr internal HR, IT, Finance, and ther functins Service levels fr external-facing functins, including access centers, custmer services SDA Steering Cmmittee n Perfrmance and Outcmes Refrms SDA-specific SDA-specific (pulling analysis frm cunties and ther surces) SDA-specific 15

16 Funding Mdel Principles Simple - Use understandable frmulas fr cllecting cunty cntributins Stable - Minimize swings and fluctuatins in year-t-year cntributins required frm each cunty Represent t sme degree ppulatin, histrical demand fr service, and ability t pay Recgnize an equal benefit t each cunty f participating in the SDA 16

17 Gvernance Structure Gverning Bard 8 Bard Members 2 cmmissiners frm each cunty Appintment and Term Appinted by the Cunty Bard fr tw year terms Alternates Each Cunty must appint ne alternate Vting Each bard member has ne vte Officers Chair and Vice Chair - 2 Year Terms Supermajrity - 75 % f vtes required fr specified majr decisins Adptin f initial SDA agreement and all amendments Admissin f new cunty members Electin f Bard Chair & Vice Chair Adptin f the annual budget 17

18 Gvernance (cnt.) Finance Cmmittee Finance Cmmittee Vice Chair f Bard Chairs the Cmmittee Staff Liaisns SDA Administratr & SDA Finance Directr One Representative frm Each Cunty - Administratr r Finance Directr/CFO 18

19 Business Case Overview The business case cnsists f three key sets f data, which answer the questins utlined belw: 1 2 Current State Status Qu What des each cunty, as well as the regin as a whle, spend n human services tday? If the cunties cntinue dwn their current path, hw much will be spent n human services in the future? 3 Future State Hw much will the cunties spend in the future, if they redesign their system and mve t the Service Delivery Authrity utlined in the Operating Mdel? *Indirect csts which represent human services csts which the cunties receive, but are nt included n the DHS cst reprts were nt included in this analysis. It is assumed that all indirect csts tday will cntinue t take place in the future. Indirect csts represent $1.6MM acrss the regin. 19

20 Cst Avidance - Ttal Under the SDA, the five-year ttal cst f delivering services is prjected t decease by 0.1% relative t the Status Qu 29 Ttal Cst ($M) Ttal Cst Decrease: $171K (0.1%) Status Qu (Ttal) Future State (Ttal) Tday Year 1 Year 2 Year 3 Year 4 Ttal FTE Estimate: 180 Year 5 20

21 Cst Avidance - Cunties Based n the prjectin f cunty csts, cunties are expected t see a 0.2% increase ver the five year perid fllwing implementatin Ttal Cst t Cunties ($M) 12 Ttal Cunty Cst Increase: $132K (0.2%) Future State (Cunties) Status Qu (Cunties) Tday Year 1 Year 2 Year 3 Ttal FTE Estimate: 180 Year 4 Year 5 21

22 Organizatin Chart Cmparisn The cunties have FTEs tday, which will increase t 180 FTEs in the SDA under current assumptins. In ttal cst terms, by year five* f the mdel the cunties wuld be lking at a $7,705 ttal annual cst avidance. # # Directrs / Managers / Supervisrs Wrkers Legend Current Org. Size Cst: $27,874,300* Ttal FTEs: Admin Supprt Services 7 77 Adult Services Child Services 4 31 Future Org. Size Cst: $27,867,225* Ttal FTEs: Admin Supprt Services 6 73 Adult Services Child Services *Csts represent ttal cunty-csts (nt just persnnel csts) in Year 5 f the future based n business case prjectins 22

23 Implementatin Cnsideratins Implementatin planning shuld incrprate a big bang mdel, where all cunty HS staff and services transitin t the SDA at the same time* Plan transitin f existing staff int new psitins as apprpriate Crdinate with DHS and legislature n necessary regulatry and technlgy changes Member cunties shuld be cmpletely in r ut - this mdel and business case des nt cntemplate giving cunties the capability t pick and chse sme services and nt thers Engage all key internal and external stakehlders in detailed planning and implementatin Emphasize cmmunicatins and change management thrughut the transfrmatin *The SDA Executive Team will transitin in t the SDA fur mnths befre the big bang date in rder t ensure a smth transitin fr all ther staff and services 23

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25 Next Steps Presentatins t the member Cunty Bards and Human Services Staff Finalize a funding allcatin methd Cnvene a meeting f the fur Cunty Bards Present the financial Pr Frma t the Cunty Bards Hst an infrmatinal meeting fr Cmmunity Partners Present a recmmendatin t the fur Cunty Bards Cunty Bards vte n mving frward t the next implementatin phase Crss Functinal Detailed Design 25