In 2003, social service and mental health senior managers in Catawba County, N.C., faced a decision. Mental health reform was sweeping across the state; and beginning in July 2004, Catawba's public mental health agency would limit itself to determining eligibility. In the absence of another solution, the majority of the county's children and families would need to find support from among a hodgepodge of private agencies.
DSS' managers were concerned for the well-being of their clients. According to their Master Client Information System, up to 70 percent of families involved with child protection required some combination of substance abuse and mental health services. Research suggested that a privatized system would serve their clients poorly and frustrate efforts to coordinate services. Could DSS step into the breach?
Catawba County, population 151,000, is an hour away by car from Charlotte. Since 2000, Catawba County has experienced a severe economic downturn, including the loss of 14,000 jobs. As a result, DSS, an agency of 410 employees and a $186 million budget, has seen Medicaid cases rise 73 percent and food assistance cases rise 197 percent. The agency also supports some 240 foster care children.
These challenges notwithstanding, the agency has received 13 awards, among which is a joint award from the National Association of Counties and the U.S. Department of Health and Human Services for excellence in management and service provision. DSS senior managers trace their success to an agreement reached 11 years ago.
Inspired by Osborne and Gaebler's 1992 book, Reinventing Government, DSS Director Bobby Boyd and seven other Catawba County agency directors proposed that their boards and county commissioners judge the agencies on their client outcomes. If agencies consistently met or exceeded 90 percent of their outcome targets, the boards would guarantee stable funding and the right to reinvest cost savings realized by increased efficiency. The boards agreed, giving Boyd and his senior managers a mandate to maximize client outcomes and process efficiency.
Boyd and the management team set to work transforming the agency. First, they needed to improve their ability to gather, analyze, make decisions and "tell the agency story" based on data. The county provided basic IT support, but not the customized systems and analysis grounded in intimate knowledge of the agency they needed.
Boyd hired Rick Pilato, a former finance and management consultant, to put in place the data, analysis and business management infrastructure required. Pilato set out to build a team of business analysts and programmers who understood the agency's programs and delivered powerful, flexible and easy-to-use IT solutions; conducted internal audits to ensure programmatic adherence and efficient use of resources; mapped agency processes; and with staff and supervisors made processes more responsive and more efficient. …