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2011-2015 Strategic Plan for the Dane County Department of Human Services

Introduction

Dane County Department of Human Services provides a range of human services to the citizens of Dane County. The Department operates a nursing home and administers over a dozen separate human service systems, which meet the needs of over 31,000 Dane County citizens annually. Most systems are governed by complex state and federal statutory and administrative requirements and are supported with a blend of state, federal and local revenues. The Department's annual budget is over $230 million, of which 73 percent is outside revenue that is primarily made up of state and federal funds.

The Department is committed to improving the lives of those it serves. It provides services to some of Dane County's highest need citizens, who rely on the Department's services because of disability, poverty, substance abuse, maltreatment, mental illness, and frailties due to aging. The Department employs 549 full-time staff, but approximately half of the Department's budget is used to support contracted services in the community typically provided by private, non-profit organizations. In 2010, the Department contracted with over 140 organizations in Dane County to provide services to consumers with physical and developmental disabilities, the elderly, children and adults with mental illness, homeless families, low-income adults seeking employment and children and youth with support needs stemming from child maltreatment or juvenile delinquency.

Every five years, the Department develops a strategic plan. The strategic plan guides the Department's work and priorities over the subsequent five years. The Department's leadership, or management team, made up of the director, deputy director, the three program division administrators and the administrator of Badger Prairie Health Care Center, develops the plan with input from a variety of different sources. The plan is presented to the Dane County Executive, the county executive's advisory committee on planning, the Human Services Board, and the county board's standing committee for human services, the Health and Human Needs Committee. The plan is also shared with the Dane County Board of Supervisors and will be publicly posted on the Department's website at www.danecountyhumanservices.org

The Department updates the plan annually by developing measurable objectives and timelines designed to help it reach its strategic goals. The annual plans are used to ensure the Department continues to make incremental and continuous progress toward achieving its strategic goals. The Department also provides an annual progress report to local policy makers and advisory boards.

This publication provides the strategic framework for the Dane County Department of Human Services for 2011-2015, including: its updated mission, vision and values; challenges and opportunities in the environment; and its strategic goals.

Mission, Vision and Values

Mission Statement

To provide cost-effective services that improve the lives of our consumers by emphasizing independence, respecting diversity, supporting individuals and families in the community, and promoting personal and community safety.

Vision

An innovative system in which partners work together to provide highly effective programs that improve the lives of those we serve and strengthen our community.

Values

  • All people have value.
  • Everyone we serve is treated with respect and dignity.
  • Diversity strengthens our community.
  • We promote individual and family independence.
  • We support collaboration and integration of services.
  • We support prevention and the least restrictive setting as part of our continuum of care.
  • We value innovative, evidence-based approaches.
  • We are leaders and catalysts for change.
  • We are accountable stewards of public funds.

Environment: Challenges and Opportunities

The Department is faced with many challenges and opportunities as it prepares to serve Dane County's citizens over the next five years. A weak economy, an increase in poverty, sharp increases in demand for services in some of the Department's systems, and a decrease in public revenues necessary to support the Department's services have all had an effect on the health of the Department and its ability to serve the county's highest need citizens.

In preparation for the development of its 2011-2015 strategic plan, the Department's leadership team reviewed consumer data trends, system outcome measures and demographic changes in order to assess where its most significant challenges and opportunities are. Additionally, the Department reviewed and considered the observations shared about the Department and its strengths and weaknesses through interviews and discussions with key stakeholder groups, including local elected officials, other local funders and contracted agencies.

The data review and stakeholder analysis formed a basis for the Department's management team to assess where its greatest challenges and opportunities are for the coming five years. Given the complexity and size of the Department's scope, there were not surprisingly many more issues identified than those that are addressed in this plan. It's helpful to be mindful of the fact that strategic planning is a process by which the leaders in an organization select and prioritize which challenges it will address and which opportunities it will pursue. The Department, as a strategic organization, has embraced this priority setting process to help determine how it will focus its resources in order to maintain the strength of its mission and pursue its vision.

The challenges and opportunities the Department has selected as those it will address through its strategic goal setting are listed briefly below.

System Challenges and Opportunities:

  • Children of color served by the Department's child protective service and juvenile justice system are disproportionately placed in out-of-home settings, which challenges the Department to determine more effective interventions with families and children of color that will reduce this disparity.
  • Parents of color are sanctioned and lose benefits in the Wisconsin Works program at a higher rate than other parents, which challenges the Department to develop more effective strategies through W-2 to serve families of color that will reduce this disparity.
  • High need individuals and those with challenging behaviors bid the Department to develop and implement more effective service options for these high need populations.
  • Requirements associated with state and federal funding that is used to support adults with disabilities and the elderly will likely change substantially in the next five years, challenging the Department to plan for a significant transition in its long-term support system.
  • The population of elderly adults with dementia is growing and with it there is an increased risk of institutionalizing those adults, which challenges the Department to create new options for adults with dementia in order to avoid poor outcomes and the cost of institutionalization.
  • The Department has limited ability to collect and report on performance data for all its provided and contracted services, which challenges the Department to determine its most cost-effective services and make recommendations to policy-makers that are based on good performance data.
  • State and federal funding to support most mandated services the Department provides may either be reduced or frozen in the coming five years. This challenges the Department to determine how to fund services to mandated populations and ensure those services are highly effective.
  • Retirements, turnover and internal transfers have resulted in a loss of knowledge base and experience that challenges the Department to develop more effective staff orientation and training models that will ensure staff have the skills and ability needed to be effective.
  • Limited support for information technology (IT) challenges the Department to address the need for staffing and technical resources necessary to support IT requirements necessary for mandated reporting, service tracking and basic professional day-to-day operations.
  • Badger Prairie Health Care Center will be opening a new facility in 2011, which offers an opportunity to reconfigure its service system and improve its services to residents.
  • Delivery of economic support and work services is likely to become more regionalized in the next five years, offering the Department an opportunity to improve service delivery of economic assistance and work services.

2011-2015 Strategic Goals

The five-year goals for the Dane County Department of Human Services form the foundation for the Department to improve outcomes to those it serves and strengthen the core competencies of the organization. The Department's goals focus on four areas: improving the lives of the individuals it serves; improving the performance of its systems and its ability to publicly report on that performance; improving its financial health; and improving its organizational effectiveness and infrastructure.

Goals to Improve the Lives of Those We Serve
1. Create a successful transition for the shift in funding and policy governing the long-term support system for adults that ensures LTS populations have effective and continuous care.
# 1.a.
Initiative Area Further explore the option to plan for an Aging and Disability Resource Center (ADRC).
Current Status The State budget includes the opportunity for non-Family Care counties to start an ADRC. In the recent past, funding for ADRC operations was not available until a county was 2 months from implementation of Family Care.

In 2007 a work group drafted roughly 2/3rds of an application for ADRC funding as part of the Department's Family Care planning grant.
Chosen Target A decision about the start up of an ADRC in Dane County is made.
Tactics to Close the Gap Establish a committee or group to consider issues related to implementation; work with state staff concerning current expectations of ADRCs and contract language; determine fiscal feasibility of start up without county GPR.
Measures of Success A decision about the start up of an ADRC in Dane County is made.
Lead Staff Responsible ACS Division Administrator Fran Genter, Theresa Sanders and Barb Thoni.
2. Create a successful transition for the shift to regionalized services for EAWS that ensures low-income and other populations who rely on economic supports have access to those benefits in a timely and efficient manner.
# 2.a.
Initiative Area Income Maintenance (IM) Administration Model (Alternative to IM Centralization proposed in the Governor's 2011-2013 Budget Bill)
Current Status We have been operating a Change Report Center for Dane County for several years. In mid-2010 we began piloting regionalized Change Report Center Services for two other counties. The State has funded this effort, but funding is anticipated to end 6/30/11.

The Division Administrator has been involved in developing an alternative plan to the centralization of IM administration. The IM Centralization plan would leave the counties out of the picture altogether. The alternative plan will include county consortia, which will be responsible for IM administration.

The county representatives are optimistic that the alternative model will have the support of the Legislature and the Legislative Fiscal Bureau.
Chosen Target We want Dane County to be a lead agency within our IM multi-county consortia for EAWS services.
Tactics to Close the Gap
  • Work with State to complete the IM Service Delivery Model that will be approved in the 2011-2013 Budget Bill.
  • Define which services can be delivered through a centralized office and through a consortia service delivery model.
  • Negotiate scope of services with state and county partners.
  • Determine consortia to be served.
Measures of Success
  • The counties will continue to play a role in the administration of the IM programs.
  • Dane County will be a lead within its consortia.
  • Our consortia will meet or exceed performance measures.
Lead Staff Responsible EAWS Division Administrator and Tony Sis

By 12/31/2011
3. Improve outcomes for children and families of color in juvenile justice and child protective services.
# 3.a.
Initiative Area Provide effective services to children, youth, and families of color and/or other cultures.
Current Status Children/youth of color and/or other cultures are disproportionately represented on Division caseloads.

Children/youth/families of color are disproportionately represented in alternate care.

Staff diversity reflects that of the community but not that of consumers.
Chosen Target Decreased disproportionality of children/youth of color on Division caseloads.

Decreased disproportionality of children of color in alternate care.

Staff of increased diversity.
Tactics to Close the Gap
  • Require culturally competent services from providers.
  • Emphasize need for culturally competent services in RFP processes.
  • Continue active recruitment of minority alternate care providers.
  • Provide two or more appropriate training programs for foster parents; require participation.
  • Increase staff diversity by means of special recruitments and other recruitment tactics.
  • Identify, arrange, and support culture competence training for staff; require participation.
Measures of Success
  • CPS and DEL case openings for families of color will decrease as a percentage of the whole.
  • Children/youth of color in placement will decrease as a percentage of the whole.
  • Youth of color placed in corrections each year will decrease as a percentage of the whole.
  • Staff will increase in diversity by at least one staff person each year.
  • Foster homes of color/culture will increase by at least one each year.
  • Sixty per cent of staff and foster parents will participate in diversity-related training each year.
  • Field students will include at least one of color/culture.
Lead Staff Responsible CYF Division Administrator Lee; all managers
4. Improve outcomes for families of color in Wisconsin Works.
# 4.a.
Initiative Area W-2
Current Status Previous reports have shown that a disproportionate number of families of color are sanctioned in the W-2 Program.
Chosen Target Reduce disproportionate sanction rates for families of color.
Tactics to Close the Gap
  • Review data and gathering tool to ensure that data is accurate and correctly interpreted.
  • Study reports for any patterns that can be addressed.
  • Provide worker training as appropriate to combat disparate treatment.
  • Conduct regular review of case actions to correct and coach workers in more appropriate actions with customers.
  • Obtain technical assistance from the State.
Measures of Success Sanction rates for families of color will be reduced as measured by Department of Children and Families.
Lead Staff Responsible EAWS Division Administrator and Barb Berlin by 12/31/2011
5. Improve the availability of evidence-based programming to address high need individuals and those with challenging behaviors in need of long-term care. This includes children and youth whose needs are met in both the long-term support system and in the child protective service or the juvenile justice systems.
# 5.a.
Initiative Area Maintain individuals with significant medical and dementia care needs in their own homes or CBRF's.
Current Status A growing number of individuals living in the community are experiencing dementia coupled with significant medical needs. Many do not receive specialized supports. Some CBRF's are not well trained in serving this population.
Chosen Target Improve results for individuals with dementia by identifying individuals at high risk for MMHI or other out of home placement and offering supportive services to those individuals and their care providers.
Tactics to Close the Gap
  • Work with nurses in LTC case management agencies (CLA, DCHDS, SMCE) to better coordinate care with medical professionals.
  • Offer dementia training and technical assistance to selected CBRF's.
Measures of Success
  • 80% of individuals supported at home remain at home for at least six months.
  • Data is collected to determine best interventions and appropriate goals for 2012.
  • Certificate for completing eight hours of dementia care training is awarded to four CBRF's in 2011.
Lead Staff Responsible Theresa Sanders
# 5.b.
Initiative Area In-home supports for children with autism.
Current Status Parents of children with significant disabilities, including autism, need greater and more sophisticated help in the home in order to keep their children in the home or help them return home from institutional placement. A pilot program began in fall 2010 at UCP.
Chosen Target Improve results for children with autism by providing intensive support in their parental home.
Tactics to Close the Gap Develop a program that will provide increased support to parents and children with disabilities who are at imminent risk of institutionalization. This will include clinical supervision, in home parent education and highly-trained intensive respite staff.
Measures of Success
  • A children's crisis prevention response supports 4-6 children at imminent risk of placement out-of-home or families with children residing in institutional settings who would like to return home.
  • 70% of the children are successfully returned to the community or remain at home.
Lead Staff Responsible Donna Winnick
December 2011
# 5.c.
Initiative Area Foster care capacity.
Current Status As of December 2010, seven DD children reside in non-waiver billable, institutional settings. Two local, waiver-billable, shift staff, treatment foster homes for children needing non-traditional foster care currently exist.
Chosen Target Develop capacity to address current needs. Improve services and coordination between children's long-term support and other Children, Youth and Family services.

Work jointly with CYF to ensure efficient use of provider capacity.
Tactics to Close the Gap Increase local, community-based treatment foster care home options for children with autism and other significant disabilities who the courts determine are unable to live in their family homes. Assist with training CYF staff on CLTS program and billing process.
Measures of Success
  • Assuming demand warrants continued resource growth, four non-institutional treatment foster care alternatives will exist by December 2011.
  • Programs serve children from both ACS & CYF Divisions. Children smoothly transition to adult services.
Lead Staff Responsible Donna Winnick
December 2011
# 5.d.
Initiative Area Implement new children's long-term support programming for seriously emotionally-disturbed children in foster care; facilitate shift of consumers between the children and adult systems.
Current Status This is a new initiative in 2011. Presently, these children and youth are served by non-specialist social workers and no supportive Medical Assistance monies are brought to bear to support programming. Youth in traditional CYF programs frequently do not receive continuing services when they reach age 18.
Chosen Target Improved services and coordination between children's DD long-term support staff/services and children, youth and family staff/services.

Placement stability for children/youth in community settings.

Improved transition to adulthood for youth.
Tactics to Close the Gap
  • Identify and train staff for this function.
  • Identify eligible children and youth.
  • Assess consumer functional needs and create and implement individualized plans to meet the needs.
  • Secure state approval for plans.
  • Create billing mechanisms; secure CLTS monies.
  • Issue RFPs for frequently-utilized services (as necessary).
Measures of Success Staff will serve 30-35 identified consumers.

Consumer's functional needs will be met as demonstrated by placement stability and avoidance of hospital placements.

Increased service capacity for this specialized population.
Lead Staff Responsible Division Administrator Lee;
Mental Health Services / Alternate Care Manager Wills
6. Improve the service model for caring for residents of BPHCC.
# 6.a.
Initiative Area Service Delivery model
Current Status Attendance patterns by some employees are poor, intermittently affecting continuity of care for some residents.

We have staff turnover because of the large number of .2 FTE staff positions
Chosen Target
  • Improve ability of staff to provide continuity of care for residents at BPHCC.
  • Improve unit (neighborhood) performance and consistency.
  • Improve attendance (so residents more consistently receive care from core staff.)
Tactics to Close the Gap
  • Establish more core-like assignments for part-time employees/decrease float assignments. Contract changes would be necessary to obtain results.
  • Enhance unit leadership and extend/decentralize span of control:
    • New clinical care coordinator approved in the budget.
    • New RN position description.
    • Modify Attendance Policy and/or add incentives for sick leave. Contract changes would be necessary for sick leave modifications.
Measures of Success
  • State regulatory survey results.
  • Resident-family satisfaction.
  • Lower CNA turnover.
Lead Staff Responsible Steve Handrich/Dee Heller
7. Improve alternatives to in-patient care for adults, including those who pose a risk to themselves or others and those with dementia.
ACS
# 7.a.
Initiative Area Reducing adult, non-geriatric inpatient hospitalizations at MMHI & WMHI.
Current Status Inpatient costs have steadily risen due to growth in utilization and cost of care per day. Adult non-geriatric care has averaged 3,739 days/year during 2008 – 2010. Expenses have been over budget for four of the last five years. A hospital diversion initiative was funded in the 2010 budget to develop a Care Center model. Based on the results of an RFP, one Care Center opened at the end of 2010 and another will open in early 2011.
Chosen Target
  • Maximize use of the Care Centers.
  • Reduce the number of days of adult non-geriatric care compared to historical averages.
  • Capture MA crisis stabilization revenue, which is essential to covering costs of the Care Centers and other alternatives to hospitalization.
Tactics to Close the Gap Monitor Care Center usage with providers. DCDHS and JMHC ESU staff will discuss all MMHI/WMHI admissions twice weekly to explore community alternatives. Encourage and monitor use of other inpatient alternatives such as Recovery House, Badger Prairie Health Care Center and crisis homes.
Measures of Success
  • In 2011, reduce adult, non-geriatric inpatient days by at least 20% compared to historical averages.
  • 2011 inpatient costs are within budget.
  • 80%+ utilization rate for the Care Centers for September 2011 forward.
  • Earn $900,000 in MA Crisis revenue in the Care Centers.
Lead Staff Responsible Mary Grabot, Carrie Simon
# 7.b.
Initiative Area Reducing geriatric inpatient hospitalizations at MMHI.
Current Status Geriatric MMHI care averaged 1,249 days/year during 2007 – 2010 (4 years). Average length of stay was 74 days for 2007 – 2009. To address the needs of individuals hospitalized for dementia related behavior, a specialized team was developed to strategize and develop community services rather than maintain people on the Geriatric Treatment Unit at Mendota.
Chosen Target
  • Reduce the number of days of geriatric care compared to historical averages.
  • Reduce the length of stay in MMHI for elders who are 60 and older.
Tactics to Close the Gap
  • Geriatric care team assesses individuals at MMHI for possible community care and pursues alternatives when appropriate.
  • Geriatric care team provides training to community-based service providers.
  • ACS Division and BPHCC staff work to enable discharges to the new BPHCC facility.
  • ACS Division and Care Center staff determine in what circumstances the Care Centers would be an option for an older adult.
Measures of Success
  • Geriatric care team facilitates discharges to community alternatives for four older adults.
  • In 2011, geriatric inpatient days are reduced by at least 20% compared to historical averages.
  • Care Centers serve some older adults and prepare written guidelines regarding admissions of older adults by July 1, 2011.
  • Data on patient exchanges between MMHI and BPHCC is tracked and analyzed for 2010 & 2011.
Lead Staff Responsible Mary Grabot, Carrie Simon and Theresa Sanders.

Goals to Improve Our Ability to Measure and Report to Our Stakeholders and the Public on the Performance of Our Systems
8. Create a system to measure and communicate system performance for each of the Department's service systems.
Admin
# 8.a.
Initiative Area Department-wide Performance Measures.
Current Status There is a diverse range of data collection across divisions. Reporting requirements set forth by funders, primarily the State of Wisconsin, drives many performance measures in existence throughout the Department. Staff throughout the Department gather data on the programs they oversee to monitor outcomes and program effectiveness. Utilization data is available for many of the programs in the ACS and CYF Divisions.

The Department had been reporting annually on program performance (Program Status Reports) and key measures (Strategic Scorecard). These reports were temporarily discontinued during the transition of CDBG programs to the Human Services Department. Now that those programs are well established we will have staff capacity to resume reporting.
Chosen Target
  • Improve the identification of all existing performance measures across all department systems.
  • Develop performance measures for systems that have none.
  • Determine what discreet measures contribute to each system's overall performance.
  • Align and assign discreet measures that contribute to purchased contracts.
  • Collect and report outcomes regularly to our stakeholders
Tactics to Close the Gap
  • Complete a gap analysis-identify data collection and performance measures currently in place throughout the Department, identify unmet needs and identify priorities.
  • Meet with M-Team for input on evaluation reports/tools of interest to each division.
  • Meet with Health & Human Needs for input on evaluation reports/tools of interest to the committee.
  • Revise Strategic Scorecard or develop a similar report that synthesizes key data that is being reported across the Department.
  • Establish a regular review process for key measures to improve utilization and understanding of data.
  • Strategize on ways to obtain meaningful consumer input and feedback on programs.
Measures of Success
  • Develop reports or tools to meet reporting needs of divisions across the Department.
  • Develop reports or tools to meet the needs of the Health and Human Needs Committee.
  • Update the Strategic Scorecard/synthesize key data currently being reported.
  • Develop performance measures in those program areas that do not have well-defined measures.
Lead Staff Responsible Jean Kuehn, Lori Bastean and Ariel Barak
ACS
# 8.b.
Initiative Area Alternative Sanctions Measurable Objectives.
Current Status 2009 Report on successful completions and recidivism drafted but not posted on DCDHS website nor widely distributed.
Chosen Target Report the successful completion rate of each AODA-focused Alternative Sanction program;Report the two year re-arrest rate for each Alternative Sanction program.
Tactics to Close the Gap Draft a 2010 annual report; Have the report reviewed by a county standing committee and/or by the Criminal Justice Group; Post the report on the DCDHS website.
Measures of Success 2010 Alternative Sanction annual report is posted on the DCDHS website by July 1, 2011.
Lead Staff Responsible Todd Campbell and Debra Natzke
# 8.c.
Initiative Area Use the Supported Employment Report to gather aggregate data regarding community employment outcomes in the DD system.
Current Status Currently the Supported Employment Report is collected bi-annually (April and October) from all Supported Employment providers. ACS does not currently report aggregate outcomes.
Chosen Target Analyze data and report 2010 aggregate outcomes for supported employment. Create new outcome report format that will include outcomes by agency.
Tactics to Close the Gap Refine system of data collection and analysis to enable timely and accurate reporting twice per year.
Measures of Success
  • By 3/31/11, pilot data analysis and reporting of aggregate outcomes for the 2010 calendar year.
  • By 12/31/11, pilot new outcome report that includes outcomes by agency.
Lead Staff Responsible Doug Hunt
# 8.d.
Initiative Area Create a system to measure performance for DD adult support brokers and case managers
Current Status At the end of 2008 the seven POS Broker Agency directors (including Dane County's adult case management DD unit) agreed on a uniform "Consumer Satisfaction Survey" for broker services. Consumers, guardians, as well as other DD POS agencies completed the survey. Results were tabulated and used internally by broker agencies.

Currently, there is no agreed upon approach to publicize and distribute results of the consumer satisfaction survey for broker services.
Chosen Target Consumer satisfaction with DD broker services will be collected in a consistent manner across broker agencies and results will be available for review by consumers and their families, guardians and providers.
Tactics to Close the Gap By December 2011 the DD system will have a summary report that displays results from the consumer satisfaction survey for broker services. Ideally the format will resemble something akin to Consumer Reports and can be shared with people with disabilities, their guardians and allies.

The Support Broker Coalition and DD Program Specialist will continue to work closely to develop the best approach for sharing/publicizing the results of consumer satisfaction surveys for public use.
Measures of Success
  • By December 2011 the DD system will have a summary report that displays results from the consumer satisfaction survey for broker services.
  • Consumers, family members and guardians report that the information is helpful.
  • Concerns over possible misuse of consumer satisfaction surveys are allayed.
Lead Staff Responsible Eric Linn-Miller
December 2011
BPHCC
# 8.e.
Initiative Area System performance.
Current Status Our state regulatory survey results have not been consistently strong (the number of survey citations, and in 2008, the severity).
Chosen Target
  • To be seen as superior care provider.
  • To feel confident that we are providing outstanding care 24/7/365.
Tactics to Close the Gap
  • Utilize QI process to focus, refocus clinical efforts.
  • Improve care planning communication (for consistency/efficiency). This has clinical and IT implications.
Measures of Success
  • State regulatory survey results compared to state averages (and assess severity).
  • Avoid repeat deficiencies.
  • Reduce staff turnover for .2 or other part-time staff.
  • Evaluate resident family satisfaction.
Lead Staff Responsible Steve Handrich/Dee Heller
Cynthia Albrecht - 12/1/11
CYF
# 8.f.
Initiative Area Create a system to measure, communicate, and enhance AODA system performance.
Current Status Information is collected. However, there is no system to subsequently collate, analyze, communicate, and utilize this information to enhance AODA system performance.
Chosen Target
  • An improved AODA information system will exist at the close of 2011.
  • Agencies will utilize information to enhance operations.
  • Improved outcomes for consumers leaving treatment will ultimately result.
Tactics to Close the Gap Each AODA provider will compile and report data to DCDHS at the time of consumer admission and discharge. Data will relate to (1) sobriety, (2) employment, (3) housing, (4) support group attendance, and (5) arrests at times of admission and discharge.

DCDHS, in consultation with partners, will use these data to assess system performance.
Measures of Success
  • Consumers will report a reduction in frequency of use at discharge compared to admission.
  • The number of consumers employed or in school at discharge will exceed that at the time of admission.
  • The number of consumers arrested in the 30 days prior to discharge will be less than that in the 30 days prior to admission.
  • The number of consumers with stable housing situations will be higher at discharge than at admission.
  • The number of support groups attended by consumers will be higher at discharge than at admission.
Lead Staff Responsible AODA Manager Todd Campbell
EAWS
# 8.g.
Initiative Area Communication.
Current Status The Division has no routine communication devices or PR materials.
Chosen Target Materials are developed for public relations with one or more methods for dissemination.
Tactics to Close the Gap
  • Define service system.
  • Review data available.
  • Develop system for obtaining needed data.
  • Develop routine communication vehicle.
Measures of Success We will have a model for public relations materials and a method for disseminating them.
Lead Staff Responsible EAWS Division Administrator, Tony Sis, and Barb Berlin by 12/31/2011
9. Improve practices for bidding and contracting for purchased services.
Admin
# 9.a.
Initiative Area Improve contracting process.
Current Status
  • The language in POS contracts does not always clearly identify performance expectations.
  • Contract language is not always consistent across all POS contracts.
Chosen Target
  • Improve contract language on performance expectations.
  • Consolidate funding streams for targeted services to focus scarce resources on high performance contractors and where appropriate reduce the number of contractors.
  • Create consistency in contract language.
Tactics to Close the Gap
  • Provide incentive/disincentive to comply with contract.
  • Make contract meaningful to both contract managers and contracted agency.
Measures of Success
  • 100% of the POS contractors sampled are in compliance with their contracts.
  • All contracts clearly delineate what is being purchased and the expected deliverables.
Lead Staff Responsible Edjuana Ogden, Dyann Hafner, G.P. Foster
# 9.b.
Initiative Area Contract costing.
Current Status The costs & numbers of units identified in contracts may not be current if historical data is used.
Chosen Target
  • Each contract reflects the contract costs including number of units and cost per unit.
Tactics to Close the Gap
  • Assess whether the cost of the contract is accurate based on expected number of units to be delivered and the cost of each unit.
  • Develop a methodology whereby the actual number of units to be contracted can be accurately determined.
  • Develop a methodology whereby the actual cost of the contract by units can be accurately determined.
  • Make adjustments to contracts (for 2012) to accurately reflect the cost of the contracts including number of units and costs.
Measures of Success
  • All contracts have been assessed to determine whether the number of units and the cost of each unit are accurate.
  • Methodology for determining the actual number units to be contracted per contract is developed.
  • Methodology for determining the actual cost per unit to be purchased per contract is developed.
  • 2012 contracts are adjusted to accurately reflect the cost, number of units, and cost per unit.
Lead Staff Responsible Edjuana Ogden, G.P. Foster, Accountants
# 9.c.
Initiative Area Review contract development.
Current Status Contract development across the Department is sometimes confusing.
Chosen Target
  • Process for contract development thoroughly reviewed and understood.
Tactics to Close the Gap
  • Interview contract managers on the process used to develop each POS contract.
  • Identify key participants in the POS contract developmental process.
  • Look for consistencies/ inconsistencies in contract development.
  • Document/flowchart contract development.
Measures of Success
  • All POS contract managers in each division have been interviewed on contract development for the contracts they manage.
  • Identify consistencies and inconsistencies in current contract development.
  • Develop a technical assistance document for contract development of all contract types.
Lead Staff Responsible Edjuana Ogden, G.P. Foster, Contract Managers

Goals to Improve the Department's Financial Health and Effectively Manage Scarce Resources
10. Improve the Department's ability to protect and strengthen the services it is mandated to provide.
ACS
# 10.a.
Initiative Area Begin to bill the 19.15(I) Consumer Recovery Services (CRS) MA benefit.
Current Status This is a new, locally matched MA benefit. $57,700 in revenue is budgeted in 2011. LTE Social Worker to be hired in January to assess consumers for eligibility and implement program.
Chosen Target Pursue CRS funding for work services and as a replacement funding source for individuals transitioning off MA Crisis Stabilization funding.
Tactics to Close the Gap Hire an LTE to start CRS funding process; DCDHS staff are fully trained on CRS; train case managers and POS agencies on CRS requirements and processes; identify eligible consumers; gather service data and bill MA CRS.
Measures of Success
  • Earn at least $57,700 in CRS funding for work services.
  • Transfer at least 5 consumers from MA Crisis to CRS funding.
  • By 09-01-11, develop plan for expansion of CRS billing for 2012.
Lead Staff Responsible Carrie Simon
# 10.b.
Initiative Area ACS Division maximizes revenue earned.
Chosen Target From 2004 Adopted to 2011 Adopted, ACS Division non-GPR revenues increased by $27 million, or $3.8 million annually. Revenue as a percentage of total budget increased from 79.7% to 84.0%. Revenues of $120.1 M are budgeted for 2011.
Current Status Services for consumers are maintained and expanded through appropriately pursuing new and existing revenue streams.
Tactics to Close the Gap Pursue sustainable revenues; assist consumers in gaining and maintaining MA eligibility; train POS partners on revenue source rules and appropriate billing practices; assure revenue covered services are fully and accurately billed.
Measures of Success
  • ACS Division earns at least $120.1 million non-GPR revenue in 2011.
  • The 2012 DCDHS Budget Request reflects revenues being at least 84.0% of total budget.
Lead Staff Responsible Fran Genter, assisted by ACS Division management staff and DCDHS accounting staff
CYF
# 10.c.
Initiative Area Educate public and policymakers as to importance of child protective services and juvenile justice services and need to support those services; secure all possible alternative/ supplemental funding for such services; prioritize programming to support during times of declining public revenues.
Current Status CPS and DEL demands increase as the population increases. Staffing numbers are static. CPS and DEL purchased-services levels are static as well. The CYF Division is significantly reliant on County GPR monies.
Chosen Target
  • Informed HHN Committee membership.
  • Improved media coverage.
  • Diversified and expanded revenue streams.
Tactics to Close the Gap
  • Present information to HHN Committee on regular basis.
  • Prepare and provide information to media on regular basis.
  • Pursue any/all appropriate non-traditional funding streams.
  • Identify essential services and be sure they are adequately funded.
Measures of Success
  • Make formal presentations to Committee 4 or more times during year.
  • Prepare two significant media releases each year.
  • Non-GPR monies increase as percentage of budget each year (2010 benchmark: 51.5%).
Lead Staff Responsible Division Administrator Lee; all managers
11. Diversify revenue streams at BPHCC.
BPHCC
# 11.a.
Initiative Area Reducing GPR.
Current Status Over 55% of our budget is County GPR.
Chosen Target
  • Refine and expand marketing efforts to increase the number of residents that are supported by Medicare or private-pay.
Tactics to Close the Gap
  • New building.
  • Modify therapy services/engage an agency that specializes in LTC therapy (operationalize 2011 budget change, effective with new building)
  • New work rules that project staff professionalism.
Measures of Success
  • Census increase to 117.
  • Patient mix change to 4.5 private pay, 1.9 Medicare A, and 110.6 Medicaid.
Lead Staff Responsible Steve Handrich/Dee Heller/Cynthia Albrecht – 12/31/11

Goals to Improve Our Infrastructure and Organizational Effectiveness
12. Improve staff competency and knowledge base.
ACS
# 12 a.
Initiative Area There is an effective transition process when staff with unique areas of expertise resign or retire.
Current Status The DD system anticipates the retirement of a DD Program Specialist in the next year. This position has unique responsibilities and the incumbent has knowledge not held by other staff.
Chosen Target Improve the methods for transmitting historic and institutional knowledge from resigning or retiring staff to new staff.
Tactics to Close the Gap Begin recruiting process immediately upon receipt of program specialist retirement announcement. Seek permission to hire 30 days prior to the incumbent's retirement. Incumbent prepares written materials on key issues and processes.
Measures of Success We will have a hired and trained a DD program specialist prior to the retirement of the current program specialist. Written materials on key issues and processes are available for the new staff person.
Lead Staff Responsible Monica Bear
August 2011
CYF
# 12.b.
Initiative Area Improve staff training; improve performance evaluations completions; improve staff retention rates.
Current Status
  • New worker training resources are limited.
  • Performance evaluation completion is inconsistent.
  • CPS staff turnover is problematic.
  • Presently 35% of CPS intake staff have less than 1 year of experience.
Chosen Target
  • Opportunities for staff training are expanded/improved.
  • Training and orientation programs are provided to all new staff.
  • All staff are evaluated on an annual basis.
  • CPS staff retention improves.
Tactics to Close the Gap
  • Pursue free / non-traditional training opportunities; develop same; coordinate with other agencies.
  • Continue new staff training program; expand availability.
  • Track performance evaluation completion.
  • Improve caseload sizes.
Measures of Success
  • 2011 training offerings are equivalent or better than base year 2010.
  • New staff training continues throughout 2011; training expands beyond CPS topics.
  • All staff are evaluated on an annual basis (more frequently for probationary employees.)
  • Less turnover in CPS staff.
Lead Staff Responsible Division Administrator Lee; Staff Development Manager Sue Milch; all other CYF managers.
EAWS
# 12.c.
Initiative Area Personnel.
Current Status We have limited ability to transmit historical knowledge and match internal transfers to jobs. Position descriptions are regularly updated. Most evaluations are done timely.
Chosen Target
  • Improve the methods used for transmitting historic and institutional knowledge from retiring staff to new staff.
  • Expand opportunities for staff to obtain training in their field.
  • Expand training and orientation programs for all new staff to include a focus on excellent customer service.
  • Improve methods for matching staff with jobs open for internal transfers.
  • Commit to timely evaluations for all staff.
Tactics to Close the Gap
  • Require staff to maintain a detailed task list that can be used to transmit specialized duties to a successor.
  • Target training funding so that staff can obtain training that will qualify them for transfers and promotions.
  • Develop additional training modules on customer service for all EAWS staff.
  • Set a goal of 100% of evaluations on a timely basis.
Measures of Success
  • Each Specialized or management position will have a detailed task list.
  • Staff will be able to obtain funding for needed training.
  • Additional training modules on Customer Service will be available and in use.
  • All evaluations will be completed timely.
Lead Staff Responsible EAWS Division Administrator, Tony Sis, and Barb Berlin by 12/31/2011.
13. Improve the IT support necessary for the Department to effectively manage its programs.
  1. Increase Department's ability to successfully launch regionalized EAWS services including advanced call center software and other supportive technology.
  2. Increase the Department's ability to successfully generate data reports on the performance of all of its service systems.
  3. Increase the Department's ability to do more electronic record storage.
14. Improve the current use of the Department's leased and owned facilities.
Admin
# 14.a.
Initiative Area Enhance use of DCDHS leased and owned facilities.
Current Status DCDHS owns or leases facilities at NPO, JCO, SMO, STO, SPO & BPHCC, JFF Offices, ECI sites, Detox.
Chosen Target
  • Increased occupancy rate of Department's facilities.
  • Improved alignment between space and use.
  • Increased efficiencies in occupied buildings.
Tactics to Close the Gap
  • Identify all DCDHS space, both leased and owned.
  • Identify occupants of space in all DCDHS buildings (State, County, & others).
  • Determine the amount of vacant space and what to do with that space (lease or use for other County needs.)
  • Assess whether realignment of vacant space is practical and possible.
  • Review the Master Plan for other possible uses and efficiencies of space or sale/termination of leases.
Measures of Success
  • All DCDHS space is identified as leased or County owned.
  • Occupants of each building are identified as either County, State, or other.
  • Vacant space for all buildings is determined.
  • All vacant space has been reviewed and space is identified where realignment is both practical and possible.
  • Other practical uses of the space have been identified based on the Master Plan.
Lead Staff Responsible Laura Huttner, Gaylord Plummer, G.P. Foster

April, 2010

10/14/2011

Department of Human Services | Dane County