P&P February 2016

Policy&Practice

February 2016

Megan Lape

is the director

of the National

Collaborative for

Integration of Health

and Human Services

at APHSA.

2015 HHS Integration

Self-Assessment

During the summer of 2013,

and again in 2015, the National

Collaborative provided APHSA state

and local members with an elec-

tronic self-assessment instrument to

understand where they were on the

road to human service integration

and data interoperability, important

benchmarks relative to achieving the

Pathways

vision.

Based on earlier discussions with

state and local CEOs, we framed our

survey questions around the dozen

parameters shown in the accompa-

nying chart. A brief description of

these parameters (aka Key Features)

was developed by the advisory group

for each of the four levels of integration

maturity— Regulative, Collaborative,

Integrative, and Generative. The result

was a 4 x 12 matrix we have described

as our H/HS Horizontal Integration

Maturity Model.

In developing the

self-assessment, we provided four

possible responses to each question

based on the characteristics in the

Maturity Model. A respondent’s

answers could then be easily cross-

walked to one of the four previously

mentioned maturity levels.

Over the course of the two surveys in

2013 and 2015, APHSA was provided

with a snapshot of its members’ current

status and progress toward systems

integration. While this was by no

means a scientifically based analysis

of the highly complex mix of current

activities in every state and county, the

full report, “On the Road to Horizontal

Integration: Results from APHSA’s

2015 National Survey of Health &

Human Service Agencies” can be found

4. Outcomes/Defining Success

More than a third (37%) of the

responses on these topics was either

Integrative or Generative.

5. Consumer Access

One out of three respondents, (33%)

overall, thought their organization’s

infrastructure for enabling program

participants to access the services

provided was either Integrative or

Generative.

2015 Five Key Features

Least Far Along on the

Road to Integration

1. Use of Technology

Of all 12 Key Features, the Use of

Technology was viewed by the respon-

dents to be the least far along in terms

of being fully integrated. Nearly 9 out

of 10 respondents provided responses

that were either Regulative or

Collaborative.

We asked such questions as: (a)

“How is technology used in your orga-

nization?”;

(b)

“Which technology

features most closely characterize

your eligibility and enrollment system

today?”;

(c)

“What would you say is the

primary purpose for which your systems

were designed?”;

and (d)

“Is data shared

with others, and for what purpose?”

In response, the answers that

came back included:

“Technology is

12 KEY FEATURES REVIEWED BY APHSA’S

SELF-ASSESSMENT IN 2013 AND 2015

• Organization’s Vision/Strategic Focus

• Defining Success

• Governance/Decision-Making

• Adaptive Leadership/Organizational Change

• Access to Services by Consumers

• Eligibility and Enrollment: Common Processes/Shared Services

• Role of Front-Line Worker Relative to Coordinated Service Delivery

• Measures

• Integrated Infrastructure/Cross-Boundary Communications

• Workflows

• Use of Data and Front-Line Workers’ Access

• Use of Technology

on our web site.

Although the report

focuses on the results from the 2015

survey, a comparative analysis of the

results from both the 2013 and 2015

surveys is also included.

2015 Top Five Key Features

Farthest Along the

Integration Pathway

1. Adaptive Leadership/

Responsiveness to Change

Sixty-three percent (63%) of all

responses to our questions on this topic

were either Integrative or Generative.

Respondents saw the leadership of

their organizations as being highly

mindful of changing circumstances

and prepared to move quickly when

necessary.

2. Governance/Decision-Making

While some respondents tended to

say their key decision-makers were

exclusively internal to their organiza-

tion, nearly half (46%) indicated they

include people from other parts of the

enterprise, or even external to it.

3. Vision/Strategic Focus

Four out of 10 respondents (42%)

believed that their organizations were

focused on addressing the root causes

of their program participants’ needs,

with many of them working with

partners outside the H/HS enterprise.