A predictable, inevitable, and unfortunate truth about health and human services in the U.S. has been revealed by the Great Recession, according to Dave McCurley, Accenture’s global managing director for human services.
In a keynote given at the American Public Human Services Association ISM Conference last year, Mr. McCurley said that by complicating the assistance benefits delivery service model and by operating in the traditional stove-pipe manner, “we are jeopardizing the very steps [the needy] are taking towards their own self sufficiency.”
It seems that by placing application centers, low-income housing, job training and medical facilities at dispirit parts of the city or county, those using the services tend not to use them as effectively as they could. In that same speech, McCurley cited a Florida official who said 67 percent of his food stamp cases were employed and over half of the Medicaid are working. At the same time, record low revenue levels have forced state and local governments to layoff case managers, enact furloughs, and cut funding to programs like Medicaid, food stamps and welfare-to-work programs.
The Great Recession has ushered, what McCurley and others call, the New Normal – unprecedented level of demand for services when budgets are the worst they’ve been in fifty years. Add to that new transparency requirements and the burden on health and human service employees only grows. “It’s time to do a control-alt-delete to deal with the New Normal,” McCurley told CivSource in an interview.
Accenture’s vision for the New Normal is a framework of integrated health and human services they are calling Family-First. The Famliy-First framework is just that – a family-centric model of assistance benefits service delivery. The basic premise of the framework groups programs by the time of life they’re usually used and by the type of service the program provides. An example is immunization: it’s administered at birth and throughout childhood and it’s a prevention service. Another example is long-term care, which is given to seniors and elderly citizens as a support service.
“We have yet to find a situation where a program doesn’t fit in one of those boxes,” McCurley said.
If only the problem with many health and human service agencies was organizational, but unfortunately most assistance programs are administered by federal entities, making the problem even more complex.
“USDA, HHS, Labor and HUD, all provide some degree of services benefits and are themselves in desperate economic circumstances. The problem is their data is not coordinated, and in many cases working against one another by not knowing who’s getting what.”
In combination with the Family-First framework, Accenture has worked with clients in Norway and New York City to develop technologies that compliment an integrated health and human services organization.
Last month, Accenture released a service-oriented architecture (SOA) solution called the Accenture Public Service Platform, or APSP, is designed to help government agencies improve performance and business processes through automation, managed workflow and by facilitating interaction between caseworkers and citizens. APSP utilizes open-source and commercial components, allowing governments to integrate the new platform with legacy and external systems already in place.
Other technologies such as business intelligence and a common client index can help case managers look at identifiers across all the programs and report on the evolution of individuals within the system, McCurley said.
In New York, a Web-based tool called Access NYC allows people to apply through a single access point for thirty-five benefits programs. Those programs are managed by fifteen different agencies and eight federal funding streams, which McCurley says represents an on-ramp for health agencies to become integrated. A related program, called HHS Connect in New York City, is also an on-ramp, McCurley said, for case managers.
“Its part of a journey map – all people inside the same box being aware that they’re not just a housing assistant worker, they’re part of a larger integrated team.”
But perhaps more important to the success of Access NYC and other integrated programs is the legal and policy foundation that has to be in place in order to share information between agencies and different levels of government. What laws allow for what kinds of information to be shared? Are those laws local, federal or state and how can an agency see through those laws to better serve those in need?
“The good news is if you can get policy and legal taken care of, the technology is there. The team in NYC has done the legal, policy and finance footwork. It’s as critical as anyone designing any IT system.”
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