Looking back (the private agency perspective)

There is perhaps the misconception that partnership means we’re buddies. That’s not what it’s about - this partnership is a redefined, clearly understood shared accountability. A conversation about results is not just whether or not something is working. It is what do we do differently? And why?

Again, note the “we.” Talking about what “we” can do frees us up to acknowledge our own challenges, because we know the focus will be on how we can solve problems, rather than pointing out each other’s faults.

One of the values of being part of this team is now I understand my public agency partners and the context in which they work better. I have a clearer sense of their challenges unique to that world, and how they differ from mine. This understanding helps inform my future interactions.

Looking back (from the public agency perspective)

The work is done; the recommendation has been implemented.

Reflecting on the team’s work together, this experience has already impacted agency interactions outside of this task force.

Statewide public and private agencies will continue to have issues of challenging each other, but this opens up the door for clinical conversations which enhance and make the partnership more effective. There’s less finger pointing and talk of “You’re not doing this right…” We talk about how we can come together to figure out how we can do “that’ better.

Nationwide we’ve found there is not much insight on how to move performance contracting forward. The one thing we’ve heard over and over is that the communication and the relationship makes or breaks it.

When all parties commit to open communication, it creates an understanding that leads us to a better working relationship. Taking that relationship to a higher level exposes the reality that we really can see better results.

In the end…

While we wrestled with those questions, a natural progression in the conversation was to staff. More than ever, we needed to support front line staff and supervisors to help them realize the results we will achieve together.

How did we do this? Again – we focused on practice. Keeping front line staff and supervisors from both public and private agencies in mind, we discussed what they would need to be successful together. Success was defined as the outcome of the case, and this success can not be achieved without both agencies problem solving together.

In the end this team, whose charge was to recommend changes for a payment structure, created a recommendation that contained more language about practice improvement than payment.

Not a perfect fit

To define our route, we first asked the question, “How are we doing today?” (Notice “we”). We pulled some data and looked at some individual cases. Focusing on practice alone, we said, “Our goal is to do better. Let’s do it.”

Reality was that we were doing well. But the goal is to do better, so we identified cases that just don’t “fit” typical case progression. Then we asked the question, “How do we deal with the cases that don’t “fit?”

“When a case doesn’t “fit,” what is the practice that supports the safety of the child and the family – that can keep the agency involved?” We looked at practice and practicality – if disincentives are used to manage outcomes, at what level can agencies sustain providing services?

The first concern is the safety of the child and family, so how do we define a manageable approach to these cases? Most important – what is a manageable approach that both private and public agencies can successfully work together on?

A different kind of conversation

It’s easy to point the finger and tell others what they’re doing wrong, but not as easy to talk in front of everyone about what you’re doing wrong. One of our team members was instrumental in setting the tone for the team’s success. She talked about reviewing hundreds of cases and finding where her own staff struggled to meet expected outcomes. In front of all of us, she said the framework just wasn’t working. She said, “I need to figure out with you how to make this work.”

A few simple words that changed the conversation.

We decided to define the end at the beginning; start with the end in mind. How do we define “safe case closure?” And the result was rich conversation that focused on the work we share.

Once the trust and relationship is there, things just start happening. Instead of protecting who is “right” or “wrong” everyone’s energy is spent on innovation, problem solving and the future.

Let’s not talk about money…let’s talk about what we want to achieve.

Historically public and private agencies walked into meetings in our perceived roles: the state has a regulatory/compliance role and the private agency has the responsibility to fulfill a contract. Deciding that our first meeting would center around what we want to achieve and our shared responsibility to achieve a common objective kept us focused on what was important. By concentrating on the best way to keep kids safe, we were able to see how our roles compliment each other

When we prepared for the first meeting of the task force, we agreed: Let’s not talk about money – let’s talk about what we want to achieve.

Fortunately we both agreed this was the best approach for our first meeting. When we all came together for the first time - focused on the objective – something remarkable happened. We started out talking about the practice of keeping kids safe. That’s what we’re all about. That’s what we know.

In the room were two Chief Executive Officers of human service agencies, a program manager and two levels of DHS administrative personnel. The total years of experience in human services in that room tipped the scales, and we started our task of defining a pay structure by talking about best practice in keeping kids safe.

Another leg of the journey

The next collection of posts is a workgroup formed to address a specific issue. Evan represents the Iowa Dept. of Human Services and Doug represents a private agency.



First Things First

Another example of partnership in practice is the FSRP Safe & Timely Case Closure Workgroup.

Charged with a fast-track task, the team needed to perform an in-depth analysis of the current Family Safety Risk & Permanency (FSRP) contract configuration and recommend changes for the payment structure. The FSRP program is relatively new – it’s how we work with families that have documented abuse or neglect.

Key to our results was the decision to first take time to think through the best practices of keeping children safe. We realized we couldn’t talk about payments at all until we talked about how we work together so that we can jointly do the best job for Iowa’s kids and families.

Naturally, successful practice is first and foremost when we work in child welfare, but the public and private agencies had unique insight from their own perspectives. And that insight included what was going well…and what wasn’t.