Magazine article Policy & Practice

Racing to Achieve Pathways' Vision

Magazine article Policy & Practice

Racing to Achieve Pathways' Vision

Article excerpt

Over the past five years, the American Public Human Services Association (APHSA) has worked to translate its Pathways vision of a proactive, client-centric, 21st century health and human service business model into reality by undertaking a number of activities under the banner of the National Collaborative for Integration of Health and Human Services (National Collaborative), previously known as the National Workgroup on Integration (NWI).

These included developing a horizontal integration maturity model for health and human service (H/HS) agencies, technical guidance documents on financing and technology, two documents on the use of Big Data-an Analytic Capability Road Map and the Roadmap for Analytic Capacity Building-as well as state and local workforce development and analytics committees, all of which can be found on APHSA's National Collaborative web page. In addition, the National Collaborative broadened its strategic partnerships to include all of APHSA's affiliates, other nonprofit membership organizations, university faculty members, and private foundations. Federal involvement with our long-time federal partners- the U.S. Department of Agriculture's Food and Nutrition Service (FNS), the Administration for Children and Families (ACF), and the Centers for Medicare and Medicaid Services (CMS)-was recently expanded to include the Social Security Administration (SSA) and the U.S. Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation (ASPE).

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 electronic 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 accompanying 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.1 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 crosswalked 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 on our web site.2 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 organization, 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. …

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