Policy & Practice February 2015

Key Questions Likely to Impact the Actual Path Forward l What is the tolerance level for government to innovate and be

the science of behavioral economics can be applied to the delivery of human services to rapidly test what “lands” with a customer and achieves the desired behavior. For example, what kind of notice is likely to lead a non-cus- todian to play his or her child support or how can information provided to a parent receiving a child care subsidy ensure that they enroll their child in a high-quality child care setting. Collective Impact There is a growing emphasis on understanding the art and the science of true partnerships and how those partnerships can be force multipliers toward a common agenda. Collective impact requires shared goals and measurements, and a governance and accountability system that reflects a collective—not an individualized— approach. 9 Illinois has produced a Framework for Healthcare and Human Services to assist states in good gover- nance and interoperability, including across public-private partnerships. 10 Local jurisdictions are particularly adept at tapping the natural resources within a community (e.g., San Diego fire departments conducting blood pressure screens to promote preventive care). How APHSA is Supporting its Members along the Transformation Journey Pathways provides a consistent frame for both proactively advocating for modern, integrated policy and responding to what national policy- makers are doing. Whether we seek results-based funding for safe children and strong families by modernizing the financing of child welfare or respond to an NPRM on regulations governing child care, child support or SNAP, Pathways provides the integrated lens by which our members believe policy must be designed if we are to maximize resources and achieve the kind of outcomes that we desire. At APHSA, we are working through our technical assistance platforms—the National Workgroup on Integration as well our Organizational Effectiveness

program or service and helps foster a continuous improvement environment within an agency. Four years ago, the idea of social impact financing (paying for actual outcomes once the outcomes are secured) was largely unknown to human services. Now these financing models are emerging all over the country, with growing interest from service providers eager for funding to help them demonstrate the effec- tiveness of their program and from government agencies interested in finding ways to finance and scale such programs. This is a new place for philanthropic capital to support exploration and help accelerate new models for financing services. National policymakers are interested as well. The Corporation for National and Community Service established the Social Innovation Fund and recently announced $12 million in awards to eight organizations to advance and evaluate emerging models that align payment for human services with verified social outcomes. 6 And leg- islation has been introduced in both chambers of Congress with hearings held on Capitol Hill. Other alternative financing struc- tures are also emerging. Performance Partnership Pilots were recently announced allowing for the blending and braiding of funding aimed at disconnected youth across multiple funding streams—in this case, educa- tion, labor, and health and human services. 7 There are also “pay for performance” measures appearing in legislation such as the recent reautho- rization of the Workforce Innovation and Opportunity Act, which includes provisions for incentivizing better employment outcomes, not just paying for training. Science Science is being applied to human services in ways never imagined. What we know about the development of the brain, especially the long-term impacts of trauma and adversity on children and their parents, is leading to new understanding of how difficult it is to “hear through the noise.” This information suggest that our historical approach to services may have little

impact on someone with impaired adult executive functioning skills (i.e., the cognitive processes located in the prefrontal cortex of the brain that help us self-regulate and plan). For a brilliant explanation of the damage of maternal depression and toxic stress on children’s development and what is needed to support those mothers, I encourage you to listen to a Ted Talk by Dr. Elisabeth Babcock, president and CEO of Crittenton Women’s Union. 8 The science of Behavioral Economics is also impacting human service delivery. Agencies are asking how to adapt tools from behavioral science to improve the well-being of children and families. Behavioral interventions in human service delivery are being tested by a small teamwithin the White House Office of Science and Technology and through the Behavioral Interventions to Advance Self-Sufficiency (BIAS) project at the Department of Health and Human Services. These teams look to identify what small changes in the environment may change behaviors and decisions. Much like marketers work to understand the behavior of consumers, l How do we create the conditions for achieving collective impact, particularly when our procurement and funding structures are outdated? creative? If government fails during a test of innovation will it be allowed to “learn” and “pivot” to shift or change its focus? l Where will technology be the most disruptive? Will government be able to respond? Can government leverage partners in both the private for-profit and nonprofit worlds to position itself to more nimbly adapt to changing technology and maximize new tools, rather than falling behind? l Are we hiring for the values and skills needed to operate in an ever- changing environment requiring high levels of adaptability and analytic skill? Do we understand the generational differences and what they mean for our field?

(OE) practice—to help member agencies fully leverage the Cost

See Pathways on page 38

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February 2015   Policy&Practice