Loading...
HomeMy WebLinkAboutAgenda - 09-03-1996 - X-A 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: September 3, 1996 Action Agenda Item#--_ SUBJECT: Human Services Reform Task Force DEPARTMENT: Social Services PUBLIC HEARING: Yes_X—No BUDGET AMENDMENT REQUIRED: Yes_X—No ATTACHMENT(S): INFORMATION CONTACT: Report Marti Pryor-Cook, ext. 2802 TELEPHONE NUMBERS: Hillsborough 732-8181 Durham 688--7331 Mebane 227-2031 Chapel Hill 967-9251 PURPOSE: To present the final report from the Human Services Task Force. BACKGROUND: In February, the Board of Commissioners authorized a Human Services Task Force and charged it to present recommendations on: measurable county-wide outcomes in human services, human service priorities and the acceptable minimum service levels (safety net) for children and families, and current resources and the gaps in resources. On June 3, the Task Force Chair, Dr. Richard Edwards, Dean, UNC-School of Social Work, presented an interim report. This is the final report. RECOMMENDATION(S): 1. Schedule a special work session to discuss the Task Force recommendations, implications for human service priorities and funding, and an implementation plan. 2 TO I I AI [D . ■ . A NEW DESIGN FOR HUMAN SERVICES Report and Recommendations ORANGE COUNTY HUMAN SERVICES REFORM TASK FORCE September 3, 1996 Team Leadership Richard L. Edwards,Chair Marti Pryor-Cook, Director Dean,UNC School of Social Work Department of Social Services Michele Rivest,Children and Families Louise Baker, Adults Chris Moran,Outcomes Sharron Siler,Outreach Verla Insko, Facilitator Beachy Sanders, Staff Support 3 executive summary The Orange County Human Services Reform Task Force met from March through July 1996 to make recommendations relating to human services in anticipation of federal and state changes in funding and reporting requirements. We adapted the Human Services Advisory Commission vision statement into vision and mission statements, and we identified the following guidelines to assist in human services decision making. • Provide the essential elements of well-being, as presented in this report, not otherwise accessible through the private, nonprofit and public sectors. • Develop policies, regulations and guidelines that help realize the outcomes of well-being for individuals and their families. • Make investments in human services programs that contribute to outcomes of well-being and economic self-sufficiency and that demonstrate cost savings, cost benefits, or cost effectiveness. • Provide incentives to create jobs above the minimum wage to ensure economic self-sufficiency for all Orange County citizens. We developed a set of outcomes criteria to guide the community in developing consensus about outcomes expectations for human services. The Task Force recommends that all outcomes shall: • be mmsurable • support our vision • focus on people • provide a basis for setting priorities • address prevention as well as intervention • reflect reality; e.g., outcomes do not cost more than we have, but are not driven by resources; they have the support of all stakeholders, consider recipient responsibility, and are kept current 4 We identified certain basic factors that are essential for the well-being of every individual and for the community as a whole. These "essential elements of well-being" appear in the table below. Essential Elements of Well-Being Basic Survival Basic Growth Basic Economic and Develo ment Self-Sufficient • Food • Health Care Work (income) • Shelter • Safety (safe families • Training • Clothing and communities) • Transportation • Education • Dependent Care • Child Care To help Task Force members and others gain a visual perspective on the relationship between the essential elements of well being, available resources, and people, we designed a Rubik's Cube type of model. As this model depicts, we all require these essential elements of well-being and we all have multiple resources through which to access them, including personal, community, and government resources. We believe that most people, most of the time use their personal resources to provide their essential needs. When that isn't sufficient, people turn first to their community and then to government. While the role of government is relatively small, it is very important for the well-being of the total community. Finally, we developed goals related to each essential element of well-being and made recommendations on system improvements, gaps in services and service priorities. These recommendations are organized around four themes. • Outcomes and Evaluations • User-Friendly Services • Promoting Efficiencies • Promoting Collaboration 5 PREFACE On January 16, 1996, the Orange County Board of Commissioners appointed a Human Services Reform Task Force with a charge to: "Convene public and private sector stakeholders for 90 days and present recommendations to the Board on: measurable outcomes in human services, human service priorities, an acceptable safety-net for adults and families with children, current resources available to meet the needs, and gaps in the resources to support the needs." More than 40 citizens, including human service professionals, citizen activists, and human services users, worked on the Task Force; many others provided valuable information and advice. A listing of the Task Force membership appears in Appendix I. We accomplished our work through four subcommittees or work groups (Adults, Children and Families, Outcomes, and Outreach) and a series of whole-group meetings. This report reflects the consensus of the full Task Force. It is organized around the various elements in the charge with several exceptions that are described below. We added vision and mission statements to guide our work, developed guidelines to help achieve the vision and mission, identified criteria to help frame outcomes, and decided to use the term "essential elements of well-being' instead of "acceptable safety net." Lacking the data needed to establish measurable outcomes, we asked the Outreach Work Group to design an instrument that can be used to collect information, through surveys or focus groups, from system users, human service professionals, and the public-at-large. (See Outreach Work Group report in Appendix VI). 6 , CONTENTS Agreeing on Basics ......................................................................... 1 Assumptions Vision and mission Guidelines to realize the vision and mission Outcomes criteria The Human Services Rubik's Cube ................................................. 3 Toward The Essential Elements of Well-Being ............................... 4 Toward A Re-Designed System ...................................................... 7 Appendices I. Task Force membership ..................................................... 10 II. HSAC vision statement ..................................................... 16 III. Remarks by Scott Gardner................................................. 17 IV. Annotated bibliography of other relevant reports.............. 20 V. Chart Comparing Work Group Reports ............................ 22 VI. Work Group Reports ......................................................... 24 7 AGREEING ON BAS/CS ASSUMPTIONS The Task Force based its work on the following assumptions: • Human service agencies will, in the immediate future, experience a decrease in federal funding and an increase in discretion at the state and perhaps local levels about how dollars are spent_ • North Carolina is unlikely to appropriate funds to make up for all federal reductions, and corporate and foundation giving is unlikely to increase sufficiently to fund essential services affected in this round of government cuts. • Many people who are now eligible for assistance will be unable to provide for themselves and their families due to an inadequate transition period from eligibility to full economic self-sufficiency. • Addressing inefficiencies in the human services system may eventually free up some resources for other pressing problems within the system. VISION and MISSION STATEMENTS The following statements are adapted from the Orange County Human Services Advisory Commission vision statement (Appendix H) which was adopted by the Board of Commissioners in December, 1991. VISION: Based on our community values of caring, respect, diversity, economic opportunity, the enhancement of self-worth and optimal health and safety, citizens of Orange County should contribute to and participate in the well-being of the community to the extent we are able. MISSION: Orange County will use a coordinated, efficient, and effective network of resources that will provide a continuum of preventive and corrective services appropriate to promote economic, emotional, physical, and social well-being for all citizens. 8 GUIDELINES To assist in human service decision making that is based on the vision and mission of Orange County human services, the Orange County Commissioners should: • Provide the essential elements of well-being not otherwise accessible through the private, nonprofit and public sectors. • Develop policies, regulations and guidelines that help realize outcomes of well-being for individuals and families. • Make investments in human services programs that contribute to outcomes of well-being and economic self-sufficiency and that demonstrate cost savings, cost benefits, or cost effectiveness. • Provide incentives to create jobs above the minimum wage to ensure economic self-sufficiency for all Orange County citizens. OUTCOMES CRITERIA The purpose of human services outcomes criteria is to guide future work groups to establish outcome expectations and benchmarks that can be supported by the entire community. The Task Force recommends that all outcomes shall: • be measurable, • support our vision, • focus on people, • provide a basis for setting priorities, • address prevention as well as intervention, and • reflect reality; e.g., - do not cost more than we have, but are not driven by resources - have the support of all stakeholders - consider recipient responsibility - are kept current Measurability, perhaps the most difficult criterion to meet, requires that the we, as a community, agree on what changes indicate progress, know where we are now relative to where we want to be, and have the capacity to collect, analyze and interpret the data. To meet the test of measurability, human service professionals will need assistance from program evaluators and data collection and data analysis specialists. 9 ORANGE COUNTY HUMAN SERVICES RUBIK'S CUBE The Rubik's cube type of model below shows the complex relationships between the essential elements of well-being, available resources and people. We believe that everyone needs all of these elements of well-being. To gain access to them, most people, most of the time,use their personal resources.When that isn't sufficient,people turn first to their community and then to government. While the role of government is relatively small, that role is quite important for the well-being of the total community. Basic Economic Self-Sufficiency work (income) training transportation dependent care O child care Government Basic Growth federal health care state safety (safe families JQ� county and communities) �Q towns Pv education Basic Survival Community food neighborhood associations shelter community volunteers clothing faith congregations nonprofits POPULATION Personal businesses wages, benefits foundations investments savings children 0 - 5 pension children 6 - 17 Social Security Medicare adults 18 - 65 independent Medicaid adults 18 - 65 dependent family friends adults over 65 independent neighbor adults over 65 dependent Source: Ed Siebert,Adults Work Group 10 TOWARD . . . THE ESSENTIAL ELEMENTS OF WELL-BEING The goals below, in combination with the outcomes criteria, should serve as the basis for creating specific and measurable outcomes statements that are supported by the whole community. BASIC SURVIVAL • FOOD Resources should be available to provide all Orange County residents with food adequate to meet their basic nutritional needs and adequate to preclude medical conditions related to malnutrition. • SHELTER Emergency and long-term housing alternatives should be available to all Orange County residents adequate to preclude medical conditions related inadequate shelter and/or ventilation. • CLOTHING Resources should be available to provide all Orange County residents with clothing adequate for daily life and work settings. BASIC GROWTH AND DEVELOPMENT * HEALTH CARE All Orange County residents should have access to and be encouraged to participate in preventive health care services. Basic, affordable, and age-appropriate medical, mental, and dental health care and emergency services should be available to all Orange County residents. Effective substance-abuse prevention and treatment programs should be available to all Orange County residents who need them. Strategy related to health care. • Develop a County sponsored HMO to provide medical coverage and services for families who are under-employed and no longer receive Medicaid. 11 • SAFETY (SAFE FAMILIES AND COMMUNITIES) Fear should not be a personal obstacle to participation and success at school, work, home or in the community. Workplaces should be safe for employees; and homes, schools and other community setting should be safe for all children, families and individuals living in Orange County. Emergency shelter should be available for any Orange County resident in danger from domestic violence, including spousal abuse, child abuse and elder abuse. Strategy related to safe families and communities. • Influence the creation of workplace policies that encourage public and private sector employees to be more involved with their children and with de endent adults Lor whom thg are responsible. • EDUCATION All Orange County residents should have access to educational opportunities to enhance: academic development, occupational readiness, personal growth, literacy and life skills. Strategy related to education. • Make parenting resources and appropriate child development instructions available and accessible to parents, guardians and others responsible for caring for children. BASIC ECONOMIC SELF-SUFFICIENCY • WORK (INCOME) All Orange County residents who are unemployed and able to work should find employment. Over tithe these people should experience work continuity and a gain in wages. All Orange County residents who are able should promptly achieve a living wage that supports themselves and those for whom they are responsible. Strategies related to work and income. • Create a temporary employment agency to provide benefits for trainees and new workers while they are gaining seniority and permanent job status. • Provide support services, such as child care subsidies, rent subsidies, transportation, and emergency assistance, for individuals and families who work in low income jobs that do not provide income adequate for economic sel -su icienc . 12 Strategies related to work and income, continued. • Facilitate monthly distribution of earned income tax credits. • Continue to strengthen child support enforcement and collection programs. • Use Employment Security Commission records to document changes in wa a and work continuity. • TRAINING All Orange County residents should have access to training options to enhance their employability and earning power. • TRANSPORTATION All Orange County residents should have affordable,.safe and reliable public or private transportation options necessary to access the essential elements of well-being. * DEPENDENT CARE Affordable, adequate dependent care options should be available to all Orange County residents who need and want them. • CHAD CARE Affordable, quality child care options should be available to all Orange County residents who need and want them. 13 TOWARD . . . A RE-DESIGNED SYSTEM The following recommendations are appropriate for all County funded human services agencies, including nonprofits, and for other human services funders, such as United Way and local municipalities. OUTCOMES AND EVALUATION • Approve the vision, mission, guidelines, outcomes criteria, goals and recommendations presented in this report. • Authorize a community consensus building process to develop outcome expectations for the essential elements of well-being. • Fund, create and put into place, at the beginning of the process, an outcomes-based evaluation system that includes: 1) training and resources for framing feasible outcome statements and accurate benchmarks, 2) equipment and training necessary to track and evaluate outcomes, 3) outside technical support to give comments on the evaluation process, and 4) an annual review and revisions of the human services vision, mission, guidelines, goals, expected outcomes and actual outcomes. USER-FRIENDLY SERVICES • Involve individuals and families directly in making decisions relating to the services they receive and in evaluating the delivery of services. • Involve staff, program participants and the community-at-large in planning and evaluating programs and services. • Create a unified management information system for services recipeints that uses a single intake form, assigns a single identification number and accommodates multiple entry points. • Institute a 1 year follow-up of all people who lose public assistance eligibility to determine their ability to provide for themselves and to identify any increased cost to the public due to loss of services. 14 • Integrate human services nonprofits into the County's information network by providing computer hardware, software, and training. Strategies for promoting user-friendly services. • Make services accessible to individuals and families outside traditional hours and standard locations. • Provide training for case managers to improve their ability to respond when needs occur with the most appropriate service. • Assign a lead agency for each recipient (preferably the agency with primary contact) that would, in turn, assign a case manager or outreach worker to coordinate appropriate agencies to develop and deliver an individualized services plan that uses all resources. PROMOTING EFFICIENCIES • Give agencies the authority and resources to identify and eliminate inefficiencies in the human services system. • Preserve current level of county funding within the human services system and apply carryover of any realized savings to re-engineering efforts; e.g., training staff and financing well-researched innovations. • Join with NC Association of County Commissioners, our own legislative delegation, and other bodies to lobby for county control of human services funds with the provision that counties will be held accountable for outcomes rather than for process or inputs. Strategies for promoting efficiencies. • Authorize agency directors to share client information to the extent possible within legal limits and to seek changes where undue focus on confidentiality works against positive outcomes for participants. • Create stakeholder work groups (front line workers, recipients, and citizens) to correct inefficiencies in local process, paperwork and reporting. • Use qualified volunteers or graduate students to flow-chart staff and recipient procedures for every program, verifying that each step contributes to the desired outcomes for the recipient • Examine and target for elimination any state regulations and reporting requirements that are disincentives to recipients or agencies. • Encourage human service agencies to train and use volunteers. • Provide meaningful incentives, such as bonuses or extra vacation days, for Count y em l ee su estions that are ado ted. 15 PROMOTING COLLABORATION • Use all available incentives and leverage, including policies, regulations and funding, to spur collaboration between and among agencies, recipients and citizen stakeholders. • Fund collaborative programmatic efforts (such as emergency assistance) rather than individual agencies, and invite interested agencies to work together to design a solution that features the best mix of services given the available resources. • Fund agencies that collaborate to deliver comprehensive services for addressing the total needs of individuals or families. Strategies for promoting collaboration • Create cross-agency stakeholder groups to develop and implement Orange County's approach to human services block grants, focusing on new, collaborative, and effective was to deliver services. - 0- 16 APPENDIX I MEMBERSHIP BY WORK GROUP ORANGE COUNTY HUMAN SERVICES REFORM TASK FORCE Report of the Orange County Human Services Reform Task Force, August 26, 1996 17 Adults Work Group Louise Baker,Chair 206 Lexington Road Chapel Hill, NC 27516 929-2297 Jan Brown,Manager Employment Security Commission 110 W. Main Street,Suite D Carrboro, NC 27510 W: 967-0177 Fax: 929-4217 Kathy Bryan,Executive Director Orange Enterprises,Inc. 500 Valley Forge Road Hillsborough, NC 27278 W: 732-8124 Fax: 732-4027 Sandy Davis, Social Worker Adult Protective Services Program Department of Social Services Whitted Human Services Center Hillsborough, NC 27278 967-9251 (2878) Thomas Maynard, Director Orange Person Chatham Mental Health 333 McMasters Street Chapel Hill, NC 27516 W: 918-1111 Fax: 918-1112 Jerry Passmore,Director Orange County Department on Aging PO Box 8181 Hillsborough, NC 27278 W: 732-8181 (2009) Fax: 6443044 Ed Siebert, Member Economic Development Commission 76 Cedar Hills Circle Chapel Hill,NC 27514 H: 968-6222 Hattie Van Hook 5608 Green Pines Road Cedar Grove, NC 27231 H: 732-3366 Gloria Williams,Executive Director JOCCA PO Box 27 Pittsboro, NC 27312 W: 542-4781 Fax: 542-0563 18 Children and Families Workgroup Michele Rivest,Chair Suite C-8,Carr Mill Mall Carrboro, NC 27510 Phone: 967-9091, Fax: 933-1008 John Birkholz, Board Member Ursula Murdaugh Chapel Hill Human Services Piedmont Health Services, Inc. c/o Orange High School, 500 OH Road 127 Kingston Drive Hillsborough, NC 27278 Chapel Hill, NC 27514 W: 732-6133 (3317) H: 942-5354 W: 933-8494 Fax: 933-9201 Paul Castelloe,PhD Student Amy Rabb,Program Director UNC School of Social Work Child Care Networks Pittsboro Road, CB#3500 C-7 Carr Mill Mall Chapel Hill, NC 27599 Carrboro, NC 27510 W: 962-6478 H: 942-9920 W: 942-0184(26) Fax: 929-2433 Joel Harper, President Daniel Reimer,Director Chapel Hill-Carrboro Chamber of Commerce Orange County Health Department 104 S. Estes Drive 300 W. Tryon Street Chapel Hill, NC 27514 Hillsborough, NC 27278 W: 967-7075 Fax: 968-6874 W: 732-8181 (2412) Fax: 644-3007 Judy Jacobs,Community Police Coordinator Karen Rose, Human Service Coordinator Hillsborough Police Department Town of Chapel Hill 127 N. Churton Street 828 Airport Road Hillsborough, NC 27278 Chapel Hill,NC 27514 W: 732-9381 (29) Fax: 732-2187 W: 968-2760 Fax: 968-2846 Barbara Levine,Board Member Janice Schopler, Associate Dean Child Care Networks UNC School of Social Work 8218 McKee Road CB#3500 _ Rougemont, NC 27572 Chapel Hill,NC 27599 H: 732-8080 Fax: 732-8733 W: 962-6445 Fax: 962-0890 Shirley Marshall, Friends of DSS Karen Wallace,Director former County Commissioner Orange County Communities in Schools 205 W. Poplar Avenue PO Box 1358, Suite B Carrboro, NC 27510 Hillsborough, NC 27278 H: 929-1150 W: 6446247 Fax: 644-6247 Brenda MkGee Donna Williams North State Legal Service,Inc. Orange County Schools PO Box 670 200 E. King Street Hillsborough, NC Hillsborough,NC 27278 W: 732-8137 Fax;644-0694 W: 732-6271 (259) Fax: Winnie Morgan Orange County Commission for Women 2720 Buckboard Drive Hillsborough, NC 27278 W: 732-1524 Fax: 19 Outcomes Workgroup Chris Moran, Chair 207 Wilson Street Chapel Hill, NC 27516 Phone: 929-6380 Fax: 933-1112 Philip Cooke, Professor Amy Rabb, Program Director UNC School of Social Work Child Care Networks Tate-Turner-Kuralt Building,CB#3550 C-7 Carr Mill Mall Chapel Hill, NC 27514 Carrboro, NC 27510 W: 962-6531 Fax: 962-0890 W: 942-0184 Fax: 942-3226 Tony Dalton,Assistant Director Karen Rose, Human Service Coordinator Developmental Disabilities Training Institute Town of Chapel Hill CB #3370,Carr Mill Annex, Room 2003 828 Airport Road 101 East Weaver Street Chapel Hill, NC Carrboro, NC 27278 W: 968-2760 Fax: 968-2846 W: 966-5463 Fax: 962-5837 Anita Daniels, Vice President Sue Russell, Executive Director Fund Distribution,Triangle United Way Day Care Services, Association Suite 1112, 1100 Perimeter Park West PO Box 901 Morrisville, NC 27560 Chapel Hill, NC 27514 W: 460-8687 Fax: 460-9091 W: 967-3272 Fax: 967-7683 Tara Fikes,Director Denise Shaffer, DSS OC Housing and Community Development PO Box 8181 PO Box 8181 Hillsborough, NC 27278 Hillsborough, NC 27278 W: 967-9251 (2845) Fax: 644-3005 W: 732-8181 (2492) Fax: 6443056 Rev. Sharon Freeland Karen Taylor,Member Director,Orange Congregations in Mission Human Services Advisory Commission PO Box 866 UNC, FPG Child Development Center 341 Ja Max Drive CB #8181, 105 Smith Level Road Hillsborough, NC 27278 Chapel Hill,NC 27514 W: 732-6194 Fax: 644-1126 W: 966-2559 Fax: Eleanor Lockland,Graduate Student UNC-CH,Public Health and Social Work Dept. of Maternal and Child Health CB#7400, Rosneau Hall S: 966-2017 Fax: 966-0458 Joyce K. Moore, RN, MPH Nurse Consultant,Pediatrics Suite 207,Bolin Creek Center CB#3415 Chapel Hill,NC 27514 W: 966-2135 Fax: 966-4987 20 Outreach Work Group Sharron Siler,Chair County Manager's Office PO Box 8181 Hillsborough, NC 27278 Phone: 732-8181 (2302) Fax: 644-3004 Officer Pete Lannon for: Benjamin Callahan,Chief Carrboro Police Department PO Box 337 Carrboro, NC 27510 W: 968-7709 Fax: 968-7737 Christopher Cooke,Continuing Ed. Specialist UNC School of Public Health Tate Turner Kuralt Building Pittsboro Road, CB #8165 Chapel Hill, NC 27599 W: 966-1104 Fax: 966-5692 Maxine Mitchell,Hearth Foundation 6113 A Hiway 86 Chapel Hill 27514 W: 933-9090 Fax 933-4501 Karen Rose,Human Service Coordinator Town of Chapel Hill for Ralph Pendergraph,CH Police Department 828 Airport Road Chapel Hill, NC W: 968-2760 Fax: 968-2846 Linda Wade,DSS PO Box 8181 Hillsborough, NC 27278 W: 967-9251 (2832) Fax 644-6005 21 Ex-Officio Members Ted Abernathy,Director Ralph Pendergraph,Chief Economic Development Commission Chapel Hill Police Dept. PO Box 1177 828 Airport Road Hillsborough, NC 27278 Chapel Hill, NC 27514 (see Karen Rose) Rev. George Allison,Chair Lindy Pendergrass, Sheriff DSS Board Orange County Sheriff s Department PO Box 261 144 E. Margaret Lane Hillsborough, NC 27278 Hillsborough, NC 27278 Rutha Brooks,Member Marti Pryor-Cook,Director DSS Board Department of Social Services 900 Faucette Mill Road PO Box 8181 Hillsborough, NC 27278 Hillsborough, NC 27278 Richard Edwards, Task Force Chair Eric Swanson, Manager Dean, UNC School of Social Work Town of Hillsborough 301 Pittsboro Street PO Box 429 Chapel Hill, NC 27599 Hillsborough, NC 27278 (see Judy Jacobs) William Harrison, Superintendent Orange County Schools 200 E. King Street Hillsborough, NC 27278 (see Donna Williams) Calvin Horton, Manager Town of Chapel Hill 306 N.Columbia Street Chapel Hill, NC 27516 (see Karen Rose) Lucy Lewis,Director Orange County Commission for Women 110 S. Churton Street Hillsborough, NC 27278 (see Winnie Morgan) Robert Mean,Manager Town of Crrboro PO Box 829 Carrboro, NC 27516 (see Pete Lannon) Neil Pedersen, Superintendent Chapel Hill Carrboro City Schools Lincoln Center,Merritt Mill Road Chapel Hill, NC 27516 967-8211 22 APPENDIX II THE HSAC VISION STATEMENT The collective vision of human services providers and funders of Orange County is to create a coordinated, efficient, and effective network of public and private resources that provides a continuum of ameliorative and preventive services. These services should be client- centered, accessible, offered at a minimum cost, and meet the needs for human development and daily living of individuals, families, and the community. This network of services should embody the community's values of caring, respect, diversity, economic opportunity, optimal health, safety, and the enhancement of self-worth. Services should be accessible and supported by a citizenry that is informed and educated about the issues of human services. Adopted by the Orange County Board of Commissioners in December, 1991. 23 APPENDIX III REMARKS AT A TASK FORCE MEETING by SCOTT GARDNER, GENERAL MANAGER DUKE POWER COMPANY 24 A summary of comments made at the April 3, 1996 Task Force meeting by Scott Gardner, District Manger for Duke Power Mr. Gardner is active in various community agencies including Orange County Communities in Schools, the Triangle United Way,the Durham Education Network, and the Hillside High School Model School program in Durham. About 10 years ago, in an effort to become more competitive in the current market, Duke Power Company began an internal assessment and organizational re-engineering process. At that time, in addition to providing basic electrical power, the company was selling electrical appliances, electrical fixtures and electrical engineering advice to homeowners and businesses. We needed to get down to the most basic purpose of our company. What was our ultimate goal? We needed a vision that would last over time. We decided to ask our end-use customers what they wanted. We knew that internally generated surveys are often structured to get the answers the service providers want to hear, so we got outside consultants to design a survey that would be objective. We asked end-use customers, employees and stockholders what they expected. What we learned from the survey was that our customers wanted two things: reliability and low prices. They wanted the lights to come on every time they flipped the switch, and they wanted the cost to be reasonable. Now we had a concise vision that was supported by all the stakeholders. But we had to find a way to stay focused on the vision. Often when a company breaks its vision down into*short-term objectives and strategies it gets distracted from its ultimate goal. It's easy to make mistakes when your focusing on short- term issues and extraneous details. At Duke, for example, we had been doing more of the same, wrong things and expecting different results. That was insanity. Once you have identified your vision, build in a process that helps you stay focused on it. Our next step in re-structuring was to develop measurable outcomes that related specifically to the vision: reliability and low prices. Then we looked at each existing process and each step within the process and asked what value does it add. If none, the step was deleted. Organization also have to consider how a decision affects all three groups of stakeholders: the users, the employees, and the stockholders, or in the case of government, the service recipient, the employees, and the taxpayer. In Duke Power's process, employee numbers declined from 22,000 to 15,000; but, 25 reductions were made through attrition and only 2 layoffs. Duke also set up subsidiary companies to offer some of the discontinued services. Any management restructuring should be done by the management staff who will be affected by the changes. Restructuring is an on-going process. We revisit our vision and goals at least once a year to make sure the outcomes expected and the outcomes obtained are clear to the users, the employees, and the shareholders. At Duke Power, we are 10 years into the re-structuring process, but we aren't finished. So, what is government's role in human services? It is to help clients get back on the road to independence; and, when they can't, government's role is to provide a support system that empowers people to do as much as they can for themselves. Ask your human services stakeholders (the users, the employees and the taxpayer), "Where do we want to be five years from now? What outcomes do we as users, providers and funders want, and what information do we need to know we are getting the desired outcomes?" Don't count anything else. 26 APPENDIX IV ANNOTATED BIBLIOGRAPHY ON OTHER RELATED REPORTS A Blueprint for Self-Sufficiency (1995, The Skill Development Program Board, Orange County Economic Development Commission). Identifies target populations of people not achieving economic self-sufficiency, summarizes economic outlook and existing programs and services and makes recommendations to improve skill development services in Orange County. Automated Information and Referral Report (1995, Triangle United Way, Orange County Partnership for Young Children, and Orange County). Documents research findings on automated information and referral systems across the nation and makes recommendations on automating information and referral services in Orange County. Homeless Women and Children (1994, Orange County Commission for Women). Documents trends relating to homelessness among Orange County women and children and makes recommendations for increasing options for shelter and support during a transition to self-sufficiency. Innovation and Efficiency Report (1996, Commissioner's Office). Identifies examples of current innovations and efficiencies in Orange County Government and makes recommendations on ways to enhance the County's fiscal position without compromising current high quality levels of service. Labor Market Trends (1996, Economic Development Commission and Employment Security Commission). Information on current job vacancies and wages, labor market trends, and economic development and training opportunities in Orange County and the greater Triangle area. Levels of Collaboration Among Agencies in Orange County (1994, Orange County Manager's Office. Documents details of coordination among 32 human services agencies and local nonprofits that receive funding from Orange County. Master Client Index File Assessment (1991, Orange County Manager's Office) Identifies issues and makes recommendations on sharing client information across agencies while protecting privacy. Assesses computer hardware and software needs. 27 The Needs of Disadvantaged Families with Young Children in Orange County (1995, Orange County Partnership for Young Children). Survey results from low income families with children age five and under on the content and quality of the current service delivery system and on their current needs. Project Green Bananas. (1996, Public Private Partnership). Defines coordination and collaboration as practiced among Orange County human services agencies, presents findings on the current collaboration among local agencies, and makes recommendations about how to move beyond collaboration to defining and gaining consensus on community outcomes. Senior Centers Development Plan: 1996-2000 (1996, Orange County Department on Aging). Makes recommendations relating to a combination centralized- decentralized model for future Orange County senior centers, including locations, facility and program design, and funding strategies. Transportation Development Plan Update for Orange County: 1995 - 1999 (1995, Orange County Department on Aging). Reviews current availability of public transportation, examines various options for developing public transportation, and makes recommendation on implementing the best options. 28 APPENDIX V CHART COMPARING KEY COMPONENTS OF THE WORK GROUPS REPORTS 29 A. A s 6 y v> 40 Q d A wi C t ++ a, .r ... { y m to o CL Qa» O •;•; as . N '� ...�y 04 .A O. A„ "a IOU a °' y ea 1p •p O �, �1 '° w •• Fi 04 A y ae rp .., 0 +p. �, �► d v7 w Q r A d Ci V O Q d r O d ' A A ++ V ` 'C m 'E O ep •iw; #, 'C O i. 00 Cr da PA w PC � +� < > ar m 04 a a+ � > G � v V d w .. �: 'p •.., ee v � w O ate+ mR cna �3cn VCcnG`� v�i � � c w U aQ IV Go 3 ;. o lw a R A as [ A3 b b ful o a C V b d e � a a wa e a rs 30 APPENDIX VI THE WORK GROUP REPORTS • ADULTS • CHILDREN AND FAMILIES • OUTCOMES • OUTREACH 31 REPORT FROM THE ADULT WORKGROUP TASK FORCE ON HUMAN SERVICES/WELFARE REFORM JULY 1996 I. INTRODUCTION AND DESCRIPTION OF PROCESS Members of this group began their almost-four-month deliberations by considering elements of the so-called"Safety Net" of basic human services necessary to a positive quality of life. Not surprisingly, participants found it difficult to agree on what is actually basic and what is strongly desirable. One group member, Ed Siebert, undertook the task of preparing a matrix to illustrate the essential elements of well-being; that visual presentation(see attachments)was accepted and used by the entire Task Force. It also provided direction for this group's process as well as its outcome(goal) statements and recommendations. Early on, the workgroup took seriously "reform's" promise of more flexibility leading to use of funds according to local needs. Members focused on what agencies might do to increase efficiency immediately as well as on long term improvements that could be undertaken once federal and state reform measures are clearer. To do this, the group looked at one program(adult protective services) in depth as an example of excessive and duplicative paperwork, overly restrictive procedures, and lack of client accountability leading to poor use of staff time. (See attachments for more detailed descriptions of this example and the ones to follow.) Another analysis considered one developmentally delayed individual being served by at least eight (8) federal, state and local agencies and (10) different staff persons. Close scrutiny revealed there was no clear oversight responsibility and little or no collaboration, coordination, cooperation, or even contact among agencies and personnel. A third example illustrated the fact that a community action agency could succeed too well and be punished for it! A two-year training program student excelled to the point of being awarded a scholarship for a four-year degree. Because she did not fit the program's established goal of finding a job, the agency's future funding for that program is affected. These examples(and allusions to other similar ones) made a convincing case that there has to be a better way to serve human need than is presently being utilized. The question is,"How can funding sources, public and private agencies and their staffs break out of the boxes into which service delivery is now crammed?" Ultimately, drastic surgery will probably be reTA*. Also necessary will be tolerance for a temporary state of chaos and the willingness 19 face the fact that spending money upfront can lead to eventual savings and increaNA efficiency. .32 The outcome statements and recommendations which follow reflect the shared view on essential elements of well being as well as the development of strategies this group believes can improve this county's provision of human services. Members of the group express appreciation for the experience itself which has been eye-opening and stimulating. It also has offered a new understanding of other agencies and their work, and has resulted in admiration for those who are doing an excellent job under often-less-than- conducive conditions. Sincere appreciation is also due to Verla Insko who guided the work of this group with unusual skill, sensitivity, and good humor. Respectfully submitted, Louise Baker, Chair Jan Brown, Employment Security Commission Kathy Bryan, Orange Enterprises Sandy Davis, Social Services Tom Maynard, OPC Mental Health Jerry Passmore, Department on Aging Ed Siebert, OC Economic Development Commission Hattie Van Hook, Social Services Retiree Gloria Williams, JOCCA II. OUTCOME (GOAL) STATEMENTS III. RECOMMENDATIONS IV. ATTACHMENTS A. ESSENTIAL ELEMENTS OF WELL BEING(CHART OR CUBE) B. SERVICE EXAMPLES 33 H. OUTCOME (GOAL) STATEMENTS BASIC SURVIVAL Food. Shelter.Clothing Food No Orange County resident will require treatment for malnutrition. Shelter Achievable housing alternatives shall be available to all citizens No Orange County resident will require medical treatment due to inadequate shelter or ventilation No more than x% of Orange County residents will experience homelessness in any calendar year and those who do will not remain homeless for more than x months. Clothing Resources are available to provide all Orange County residents with clothing adequate to support a sense of well-being. BASIC GROWTH AND DEVELOPMENT: Health Care. Safety.Education Health Care All citizens will have access to and be encouraged to participate in preventive health care services. Basic medical care shall be available to all citizens Safety Fear is not a personal obstacle to participation and success at school, work, home or in the community. The current rate of violence related injuries and deaths shall be monitored and reduced. The current rate of accident related injuries and deaths shall be monitored and reduced. Education All citizens will have access to educational opportunities to enhance: 1) academic development,2)career readiness, 3) personal growth, and 4) life skills. BASIC ECONOMIC SELF SUFFICIENCY: Work.Training.Transportation. Dependent Care Work All Orange County residents able to achieve economic self-sufficiency through employment shall do so. All participants who are unemployed will be able to find jobs. Over time they will experience work continuity and a gain in wages adequate to support themselves and those for whom they are responsible. Training All citizens have access to training options to enhance their employability and earning power. Transportation All citizens will have transportation options to access essential services. Dependent care Affordable,adequate dependent care options will be available to all citizens who need them. 34 III. SOME RECOMMENDATIONS FROM THE ADULT WORKGROUP First SWpss: These recommendations should be accomplished within a relatively short period of time 1. Facilitate the establishment of the long-discussed"single portal of entry"for any human service. 2. Use client's Social Security number as identification number, case number,etc. 3. Share basic information on the master client index(or whatever it is called)so all providers know where a person is receiving services. 4. Assign as case manager for each client a staff person from the agency with the most regular direct contact with the client. Give the case manager both authority and responsibility to: a. Oversee the development of a service plan agreed to by all agencies and the client,plan to include focus on client responsibility and accountability. b. Coordinate and monitor provision of services and client compliance. c. Keep all parties informed; seek further collaboration as necessary. 5. Promote and provide meaningful incentives for Orange County employee suggestions to improve the effectiveness and efficiency of human service. Meaningful incentives include bonuses, vacation days,etc. More substantive and time-consuming efforts: The following recommendations will take a longer time to evaluate and implement,as well as a considerable investment of money and effort on the part of many people. 1. Make a thorough"audittanalysis"of each human service agency using UNC graduate students from appropriate disciplines. Audit should include: a. Documentation of all services provided to judge appropriateness b. A flow chart of all steps taken by client and staff in each program, to eliminate duplication and waste. c. Identification of all regulations,routines, guidelines,limitations,etc. by funding source, so as to identify whether they are federal, state, or locally imposed. d. A careful analysis of all regulations routines, guidelines,limitations,etc.,to ensure that none proves a disincentive to clients or agencies. 2. Mount an intensive lobbying effort by the County Commissioners, HSAC, and others for increased local control over funding allocation,reporting requirements,service documentation,etc. 3. Give staff the freedom,resources,and responsibility for using common sense and judgment in making decisions toward achieving the ultimate goal for each client. Base evaluation on whether or not that client's situation an potential has improved over time. 4. Make optimal use of technology to avoid waste. Give all staff adequate training in use of computers, but avoid expecting everyone to be a secretary;. Provide more clerical support as becomes necessary. 35 SERVICE EXAMPLES STUDIED BY ADULT WORKGROUP I. EXCESSIVE PAPERWORK, INEFFICIENT PROCEDURES, OVERLY RESTRICTIVE GUIDELINES, LACK OF CLIENT ACCOUNTABILITY. An anlysis of work in the adult protective services program revealed staff fill in the same information by hand on many forms. Each client's Social Security number is written in addition to an ID number. Reporting requirements result in an inordinate amount of redundant paperwork which has become over- whelming, leaving less time for significant work with people. Because services must be provided regardless, many clients have no real stake in cooperating or following a plan of action to improve their situation. This results in staff persons repeating the same scenarios over and over. Staff'are . required to answer or return every phone call--even if the same emotionally unstable person calls several times a day! Confidentiality requirements(noble in theory) mean that staff often"go it alone" rather than work collaboratively with each other and across agencies, Many times this isolation leads to unnecessary duplication of efforts. II. A SINGLE CLIENT'S SERVICE CHART A developmentally delayed individual was shown to be receiving services from eight federal, state, or local agencies ranging from Social Security(SSI)to the county Parks and Recreation Department. At least ten different staff persons have some responsibility for him, but the agency seeing him daily has no case management authority. Thus, there is no overall care plan for him, no oversight responsibility, and in most cases no contact (let alone collaboration or coordination) among this plethora of agencies and personnel. III. SUCCESS BRINGS ITS OWN PUNISHMENT A young woman enrolled in a JOCCA-administered training program made all A's and B's during her two-year course. This resulted in her receiving a scholarship that would lead to a four-year degree. Despite her exemplary record and the praesise for her future usefulness and productivity, the fact that she did not go into a job(which is the goal of the training) resulted in a"negative termination" for the agency and ramifications for future program funding. 36 Adult Workgroup Members: Here are some thoughts as I've gone back through notes from these past weeks. I make no claim to their being in any way complete or accurate as to the disminsions of the group, but offer them as a jumping off place for our last meeting before the interim report. If you cannot make that meeting, will you please respond by sending any suggestions you may have. Many, many thanks! Louise Baker. SOME SUMMARY NOTES FOR THE ADULT WORKGROUP TASK FORCE ON WELFARE/HUMAN SERVICES REFORM GIVENS: 1. Any changes/improvements in the human services delivery system must provide positive incentives for both agency/provider and client. No aid recipient will be motivated to change behavior unless such change involves perceived rewards. No agency will work its hardest for long term client progress if its efforts are judged negatively because of different expectations. 2. Layers of bureacracy have not appeared overnight. Although some changes can be effected quickly, most will required thoughtfid evaluation, planning , and facili- tation--and up-front money. 3. The morass of paperwork and service guidelines evolved from good intentions to ensure accountability, equality and confidentiality. The result, however, has tended to obscure the major purpose of serving human beings in need. 4. "Self sufficiency" may never be possible for some persons. Indeed the fact that government entities exist at all is tacit admission that no individual/family/group can provide for all its needs alone. 5. Resistance to change from all parties is to be expected. Uncertainty is always threatening, and revamping any system means there will be a period of chaos until adjustment to changes has been made. 6. If"reform" means simply cutting resources and targeting services which can show the greatest savings(i.e. clients dropped from benefits)the quickest, agencies serving the most vulnerable will naturally seek to defend their and their clients' interests. 7, No human enterprise can be immune from cheating and corruption: the best mane@ corporations have to contend with dishonest employees and customers. Human services agencies should never focus more on weeding out the cheaters than on helping persons in need. 37 WELFARE REFORM AND HUMAN SERVICES TASK FORCE CHILD AND FAMILY WORK GROUP The Child and Family Work Group has developed its vision of an adequate safety net of services for children and families,and the community. Our vision includes the following areas: • EFFECTIVE SERVICE DELIVERY SYSTEM • EDUCATION, CHILD CARE, AND CHILD DEVELOPMENT • EMPLOYMENT • NURTURING FAMILIES & COMMUNITIES •BASIC PHYSICAL AND MENTAL HEALTH CARE • SAFETY • TRANSPORTATION We see these areas as interconnected, with one area interdependent on another to provide a comprehensive service system. In each area, we have identified key principles and components. We also provide a set of core services for each area. These are not in priority or rank order. Rather, all of these services are critically important for the community and its children and families. Committee members included; Michele Rivest, Orange County Partnership for Young Children John Birkholz,Chapel Hill Human Services Paul Castelloe, UNC School of Social Work Judy Jacobs,Community Police,Hillsborough Police Department, Barbara Levine, Board of Directors, Child Care Networks Shirley Marshall,Friends of DSS Winnie Morgan,Consultant Ursala Murdaugh, Piedmont Health Services Amy Rabb, Child Care Networks Dan Reimer,Orange County Health Department Janice Schopler, UNC School of Social Work Karen Wallace, Orange County Communities in Schools Donna Williams, Orange County Schools 38 EDUCATION, CHILD CARE, AA CHILD DEVELOPMENT An adequate safety net for children and families exists when.. • every child has a reasonable chance to develop physically,emotionally, intellectually. • children aren't robbed from their childhood by taking on parental roles. • families are able to find safe, affordable quality child care. • each adult is literate. • every child can go to school in a setting that teaches to their strengths, values, and diversity in learning. Key Components 1. Practical job training No Lifelong education ► Child care and early education ► Parenting resources ► Health education ► Vocational and job training ► Considers public, private, and alternative education including home schooling Essential Core Services ✓ Affordable,quality,child care services,and resource and referral services.Currently, child care resources are particularly inadequate for afterschool, evenings, and summer care; and child care subsidies are not adequate for all families who quality for services. ✓ Parenting resources and information about child development. The Committee supports the use of family resource centers to promote parenting and believes these centers should be located at the schools and in high-risk neighborhoods. ./ Respite care. Respite care services are needed for families who are caring for handicapped children and elderly parents. ✓ Health Education. Health education needs to be offered in the schools and elsewhere in the community. ✓ Literacy Training. Literacy training needs to be available for those adults who are literate to ensure that they and their children learn to read which is an essential skill needed for today's society. The Committee supports the use and expansion of community-based libraries and bookmobile& 39 EFFECTIVE SERVICE DELIVERY SYSTEM An adequate safety net for children and families exist when... • there is an effective,comprehensive service delivery system. Key Components ► planning and evaluation ► individual case management ► services are accessible and available outside traditional hours and locations ► coordinated services across and between agencies ► customer-service oriented Essential Core Services ✓ Access Services must be accessible to children and families outside traditional hours and standard locations. ✓ Dignity and Respect. Families must be treated with dignity and respect, and with understanding of cultural diversity in our community. ✓ Advocacy and Case Management. Children and families need active case management to ensure that services are coordinated and relevant to their needs. Advocacy on behalf of the child and family may also be needed to ensure access to needed services. ✓ Interagency Collaboration. Interagency collaboration is essential to ensure that services are comprehensive and linked to meet the needs of children and families,and to prevent duplication or inefficiency in service delivery. ✓ Public Awareness. Publicity and other forms of public awareness needs to be increased so that families know what resources exist in the community and have information about how to access these resources. ✓ More Case Workers. More case workers need to be hired to ensure that families can be treated with dignity and receive the necessary services. Currently,caseloads are too high in many areas and consequently children and families may be neglected to wait too long for help. ✓ Family Involvement. Families must be involved in the decisions regarding the services they receive to ensure that families are empowered and that services are relevant. 40 EMPLOYMENT An adequate safety net for children and families exists when... • all have work and/or meaningful activity. • parents have jobs that provide an adequate living wage for themselves and those for whom they are responsible. Key Components ► Living wage for families with children ► Supplemental support when wages are inadequate. ► Work place policies that promote families caring for their children. Essential Services ✓ Skills training and retraining. Job skills training is essential, and must be coordinated and available, at both an entry and advanced levels. Welfare recipients, high school students and displaced homemakers should receive special assistance. Support groups should be available for those who are unemployed. Vocational education services should be available at schools and in the community. ✓ Job Creation. Jobs must be created that support families with adequate incomes to care and provide for their children and other family members. ✓ Child Care. Quality child care services must be an essential component of any employment effort in the county. ✓ Transportation. Transportation services must be an essential component of any employment effort in the county. ✓ Work Place Policies. Work place policies should be encouraged that support flex-time for parents, school mentoring, and opportunities for community education, such as health care and parenting, at the work-site. ✓ Wage Supports. When families earn minimum wages, there are not able to escape poverty and adequately care for their children and other family members. Wage Supports or enhancements should be available to support families. ✓ Work-site Protection and Lowrance. Work-site injury prevention must be maintained at the county level,and disability insurance must be available for all workers in all employment fields. 41 NURTURING FAMILIES & COMMUNITIES An adequate safety net for children and families exists when... • basic needs are met for food,clothing,shelter, health,education, and emotional well-being. • every child has at least one nurturing, dependable parent or adult they can rely on. • children are born wanted,and raised in a safe, nurturing environment. • families have an adequate nutritious diet, and no one goes to bed hungry. • children and families have homes. • support systems exist for emergencies. Key Components • All families,however, they define themselves • Home and community-based settings for child and family services ► Parents have the capacity,skills, and resources to "parent" effectively ► Strong,self-sufficient families ► Warm and sanitary homes, with running water ► Meals served at school ► Food Stamps and Women, Infants, and Children (WIC) Feeding Program Essential Core Components • Parenting Education and Resources. Parents need access to parenting training that includes conflict resolution,child abuse prevention,domestic violence awareness, and substance abuse prevention. Services should be widely available and respectful of cultural diversity. • Support Networks for Grandparents. Grandparents are taking a more active, and often primary role in raising children. Support to grandparents in this role needs to be extended and networked. • Child Support. Children deserve the financial support of their parents, and child support enforcement and collection services need to be strong. ✓ Education and Recreation. Age-appropriate and developmentally appropriate education and recreation services should be available for children and families at various sites throughout the county. ✓ Mentoring Programs. Families go through many different transitions during their life-cycles, and children and families need mentors to help them complete these transitions successfully. Families who are in transition from welfare to work particularly need mentoring assistance. ✓ Emergency Resources. Emergencies resources need to exists 24 hours per day,seven days a week when a family experiences a short-term crisis. V. Supplemental Assistance. When families incomes are inadequate to support their health and well-being,the community should make supplemental assistance available to the family. 42 BASIC PHYSICAL AND MENTAL HEALTH CARE An adequate safety net for children and families exists when... • families can afford basic physical and mental health care for all members,especially children. • all children and families have basic physical and mental health care that includes preventive, general,and specialty care. • physical and mental health care is readily available and accessible closeby. • physical and mental health care is of good quality. Key Components ► Dental care ► Preventive care ► Ongoing, routine, and emergency health care ► Life-long care ► Speciality and long-term care ► Mental Health ► Case management Essential Services ✓ Basic Health Care. Age-appropriate, affordable, and accessible health care needs to be available for all children and families in the county. Health insurance or other forms of guaranteeing access to health care must be available for all children and families. ✓ Prenatal Care and Maternity Care. Prenatal care and maternity care coordination are essential services to ensure that children get off to a healthy start, and to prevent infant morbidity and mortality. Well-baby care should be part of this continuum of services. ✓ Mental Health professionals. Mental health professionals need to be available to children and families in the schools and other community settings. Extended hours are essential for working families. ✓ Emergency Health Care Services. Emergency health care services must be maintained for children and families. ✓ Dental Care. Affordable dental care is essential for children. ✓ Wellness Health Checks. Prevention services, such as wellness health checks (includes developmental,hearing,and vision screenings)for children ages 0-21 are important to prevent unnecessary illness and disease. ✓ Nutrition and Feeding programs. Adequate nutrition is essential to a child's and families health. A variety of nutrition and feeding programs should be in*place in child care,schools, and other community settings. ✓ Child Spacing and Family Planning. Children are wanted and healthier when there is adequate child spacing and family planning services available. ✓ Immunizations. Childhood immunizations are critical to preventing unnecessary childhood diseases. Affordable vaccines and outreach efforts need to be part of this effort. ✓ Substance Abuse Prevention and Treatment. Substance abuses, including tobacco and alcohol,directly cause or contribute to many of the problems children and families experience. Substance abuse prevention and treatment services need to be expanded 43 SAFETY An adequate safety net for children and families exists when... • houses, schools, and other community settings are physically safe. • personal safety is assured in homes, neighborhoods, schools, and other community settings. Key Components Prevention and eradication of the following: ► accidents ► environmental hazards ► domestic violence ► violent crimes ► street violence child abuse ► substance abuse Essential Core Services ✓ Affordable,Basic Housing. Families need access to affordable, basic housing that is sanitary, and included running water, electricity and heat. ✓ Emergency Shelter. Children and families need access to emergency shelter, particularly those who are homeless or experiencing domestic violence. ✓ Safety Inspections. To ensure that homes,schools, and community and work sites are safe, adequate safety inspections need to be maintained at the county level. ✓ Community Safety Education.Children and families need public information on home and environment safety precautions, and injury and accident prevention. ✓ Community Police and High Crime Coverage. Community police need to be available in high crime areas, and more safety officers need to be available during high crime times of the day or season. Public schools need to be safe environments for children. ✓ Child Protective Services. Child Protection Services are essential for children at risk of neglect or abuse. ✓ Crisis Counseling. When children or families are experiencing crisis,counseling services needs to be available in the community. ✓ Community Health Education. Health education awareness and outreach services must be available to promote good health and nutrition and disease prevention. 44 TRANSPORTATION An adequate safety net for children and families exists when... • children and families have either personal or public transportation. • transportation is available and affordable. Key Components ► personal or public transportation ► availability and affordability Essential Core Services ✓ Transportation Vouchers. Transportation vouchers to support the cost of transportation is essential for low-income families who need services but lack private transportation. ✓ Public Transportation Routes Expansion. Public transportation needs to be expanded around the county to ensure that families can travel easily between work and school and work and child care regardless of where they live in the county. The current system does not meet the needs of families with young children. ✓ Information Services. Transportation resources need to be publicized so that families know how to access available resources. 45 TRANSPORTATION An adequate safety net for children and families exists when... • children and families have either personal or public transportation. • transportation is available and affordable. Key Components ► personal or public transportation ► availability and affordability Essential Core Services ✓ Transportation Vouchers. Transportation vouchers to support the cost of transportation is essential for low-income families who need services but lack private transportation. ✓ Public Transportation Routes Expansion. Public transportation needs to be expanded around the county to ensure that families can travel easily between work and school and work and child care regardless of where they live in the county. The current system does not meet the needs of families with young children. ✓ Information Services. Transportation resources need to be publicized so that families know how to access available resources. J 46 Outcomes Work Group Report August 1, 1996 Introductory Remarks When the Task Force convened, the charge to the outcomes committee was to develop measurable outcomes statements for the human service delivery system. In retrospect, our experience must have been much like that of Lewis and Clark who, as they set off to explore the Northwest Territory, believed they could reach the Pacific Ocean by following the course of the Missouri River. We found that we couldn't write measurable outcomes without first agreeing on what would indicate a change or improvement, how much these factors needed to change to show acceptable progress, the how we would establish the starting points or benchmarks. Our task became much easier when we decided to begin where we were and make recommendations about needed improvements, including training and assistance in writing outcomes. Several relevant points grew out of our discussions. Outcomes have to be realistic. We can't do everything and, for those things we can do, the outcomes will be "less- than-perfect." The most sobering realization was that some current recipients will be left in the lurch and our community is not preparing for that probability. As an additional assignment, the Task Force asked our work group to develop guidelines to help operationalize the vision and mission statements. We submit these below along with a list of essential services and some of the recommendations suggested during the course of our discussions. Submitted by: Chris Moran, Chair Phil Cooke Tony Dalton Anita Daniels Tara Fikes Rev. Sharron Freeland Eleanor Lockland Joyce K. Moore Amy Rabb Sue Russell Denise Shaffer Karen Taylor 47 Guidelines to oDeradonalize the vision and mission statements Vision Statement and Guidelines Based on our community values of caring, respect, diversity, economic opportunity, the enhancement of self-worth and optimal health and safety, all citizens of Orange County should contribute to and participate in the well-being of the community to the extent we are able. 1. Agencies involve staff, program participants, and community at large in planning and evaluating services. 2. Orange County provides a continuum of work opportunities to meet the economic self-sufficiency needs as well as the abilities, skills and interest of all citizens. 3. Agencies effectively integrate volunteers into the human service system.- Mission Statement and Guidelines Orange County will use a coordinated, efficient, and effective network of resources that will provide a continuum of preventive and corrective services appropriate to promote economic, emotional, physical, and social well-being for all citizens. 1. Orange County provides essential elements of well-being not otherwise accessible to citizens through the private, nonprofit or public sectors. 2. Clients have one major case manager who coordinates an appropriate and flexible delivery of services across agencies. 3. Funding priority is given to agencies that collaborate to deliver services. 4. Funding priority is given to agencies that use comprehensive strategies for addressing the total needs of an individual or family. 5. Investments in human services should demonstrate activities that contribute to self- sufficiency. Essential Services Outcomes and/or recommendations should fall into the following three areas of essential services: self-sufficiency, safety and personal development. Self Sufficiency Safety Persona Development Adequate income/job Education/training Food Meaningful work Housing Participation in decision making Clothing Medical care Child care if needed Trans ortation 48 Recommendations SYSTEM ISSUES Outcomes and Technology • Train staff, recipient, and citizen committees in how to develop outcome statements and provide the resources to define reasonable benchmarks. • Provide up-to-date technology, training on how to use it, and assistance with evaluation design. Case Managers/Outreach Workers • Increase the response capability of case managers and outreach workers so they have the flexibility to provide the most appropriate service and the freedom to respond to needs when they occur. • Give internal departments the authority to identify and eliminate ineffectiveness. • Reduce the amount of paperwork required of human service professionals Collaboration • Provide funding for collaborative strategies, incentives for collaboration across agencies, and tangible rewards for agencies and collaborations that realize efficiencies and save money. • Pull together 2 - 3 agencies that deal with the same recipients and have them come up with a collaborative plan Changed Culture • Expect human service agencies to demonstrate positive changes in the quality of life for recipients who have the potential to change. • Do abetter job of telling the human service story; focus on successes. • Demonstrate that human service workers are valued. Volunteers • Give qualified volunteers adequate training and clear job descriptions, so they can contribute more effectively in community planning and direct delivery of services. ESSENTIAL SERVICES • Adequate income/job Encourage an increase in the number and kinds of jobs in Orange County which pay a minimum of$8.00/hr or more for families leaving public assistance. • Shelter Increase the amount of rent subsidies for those who will be under employed and no longer receiving public assistance. • Medical Care Develop a County sponsored plan to provide major medical coverage for families who will be under employed and no longer receive Medicaid insurance. • Child Care Provide child care subsidies for families who work in low income jobs that do not provide earnings necessary to support a quality child care arrangement. 49 Orange County Welfare Reform Task Force Outreach Committee Charge: Develop recommendations on an acceptable safety-net level of services for the Children and Families, Older Adults and Outcomes subcommittees by getting input from focus groups of clients. (Due to time constraints and procedural limitations, the committee was not able to obtain input from clients. However, the committee did review findings from similar projects,developed a survey and focus group questions;and identified potential focus groups to convene.) Develop recommendations for a public education program that will inform clients, funders, and the general public about the work of this Task Force. (The plan for informing the community about the work of this Task Force includes sponsoring a press conference, a presentation to the BOCC; and conducting local radio interviews.) Members: Sharron Siler, Chair, Orange County Manager's Office Christopher Cooke, UNC School of Public Health Peter Lannon, Carrboro Police Maxecine Mitchell,HEARTH Family Resource Center Gwendolyn Price, Orange County Department of Social Services Marti Pryor-Cook, Orange County Department of Social Services Karen Rose, Chapel Hill Police Department Linda Wade, Orange County Department of Social Services RECOMMENDATIONS: ♦ To solicit input from a geographically, economically, and ethnically broad and diverse population of Orange County residents. It is suggested that input be obtained from both client and non-client individuals as any system changes may potentially impact all citizens ♦ To obtain information through the use of surveys and focus groups Surveys can be used as a supplement to focus group discussions or alone,and made available in various agencies throughout the county. The surveys will provide demographic information about the groups and verify diversity. Focus groups will promote further dialogue and an exchange of ideas. The committee has developed a sample survey and focus group questions,and identified potential focus groups to convene. (See Attachments I,H&III). 50 ♦ To ensure that the information is reliable and valid, the appropriate,survey research and data analysis should be conducted ♦ To develop a public education program following the data analysis component. This program will inform clients,fenders,and the general public about the input received from the community. ♦ To identify a lead agency or project director to coordinate the information gathering, data analysis, and public education efforts. 51 ATTACHMNT I Orange County Welfare Reform Task Force I. Let's talk about you... 1) ❑ Male ❑ Female 2) Age: 3) Race/Ethnicity: ❑ 16 or younger ❑ African American ❑ 17-21 ❑ Asian ❑ 21-30 ❑ Caucasian ❑ 30-40 ❑ Latino ❑ 40-50 ❑ Native American ❑ over 50 ❑ Other 4) Are you a single parent? ❑ Yes ❑ No 5) Are there children or adults in your household that depend on you for care? ❑ Yes ❑ No II. Let's talk now about your household: 6) How many children live in your home? How many adults live in your home ? 7) What are the ages of the children who live in your home? 8) What is your family's main source of income? ❑ Employment ❑ Child Support ❑ Public Assistance ❑ Other 9) What is your family's average(net)monthly income? ❑ $0-$499 ❑ $500-$999 ❑ $1,00041,499 ❑ $1,50041,999 ❑ $2,000-$2,999 ❑>$3,000 10) Have the adults who are parents(including you) in your house completed any of the following? Mother Father ❑ high school ❑ ❑ ❑ college ❑ ❑ ❑ GED ❑ ❑ 11) Do you have a telephone? ❑ Yes ❑ No 12) What do you call your community? 52 III. Let's talk about services... 13) Who do you go to if you have a problem or need help?(check all that apply) ❑ Neighbor ❑ Church ❑ Family member ❑ Friend 0 Public Agency 0 Other 14) Have you ever sought services from an agency? ❑ Yes ❑ No If yes, what agency/agencies? (check all that apply) ❑ Social Services ❑ Health Department ❑ Women's Shelter ❑ Inter-Faith Council (IFC) ❑ Mental Health ❑ Day Care Agency 0 Public Housing ❑ OCIM 0 JOCCA ❑ Public School ❑ Community House/IFC Shelter ❑ Other 15) Does anyone in your household receive or need help with any of the following services? Receives Currently Needs Help With ❑ Aid to Families with Dependent ❑ 0 Children(AFDC) ❑ Food Stamps ❑ 0 ❑ Veteran's Assistance (VA) ❑ ❑ ❑ Educational Assistance ❑ 0 ❑ Child Support ❑ ❑ ❑ Supplemental Security Income ❑ ❑ (SSI/Disability) ❑ Medicaid ❑ 0 ❑ Social Security 0 0 ❑ WIC (Nutrition Program: Women, 0 0 Infants and Children) ❑ Housing (Rental Subsidy) 0 0 16) Does anyone in your household need help now with any of the following? ❑ Paying for Child Care ❑ Paying for Adult Day Care ❑ Finding Child Care 0 Finding Adult Day Care ❑ Transportation 0 Medical/Health Care ❑ Prenatal Care ❑ Mental Health Care 0 Child Immunizations/shots 0 How to Discipline Your Children ❑ Dental Dare ❑ Violence ❑ Vision 0 Money Management ❑ Getting a high school diploma 0 Nutrition Education 0 Learning to read ❑ Drug or Alcohol Problems ❑ Food ❑ Disabilities 0 Parenting Education ❑ Other 53 IV. Let's talk about transportation... 17) Do you Imve your own transportation? ❑ Yes ❑ No 18) Is transportation a problem for you? ❑ Yes ❑ No If yes,what is the problem? ❑ Too expensive ❑ Hard to get to public transportation ❑ Reliability of Own Vehicle ❑ Other 19) How do you get around? ❑ Taxi ❑ Friends ❑ Walk 0 Bicycle ❑ Own car ❑ Family ❑ Bus system/Public Transportation 0 Other V. Let's talk about health services... 20) Where do you go when you or your children are sick or need health care? 0 Private Physician ❑ Health Department Clinic ❑ Hospital ❑ Emergency Room ❑ Prospect Hill Clinic ❑ Piedmont Health Clinic ❑ Other 21) Does your family have: ❑ Health insurance ❑ SSI (Supplemental Security Income) ❑ Self-paid ❑ Medicaid ❑ Other 22) What would make health care services easier for you to use? 0 More convenient location 0 More hours of availability ❑ Less cost 0 Other VI. Let's talk about recreation... 23) How ft do you have to travel to get to a recreation facility? ❑ Less than a mile ❑ 2-5 miles ❑ more than 5 miles 24) What type of recreation facility do you use? ❑ community centers ❑ gyms ❑ athletic fields 0 senior centers 0 parks other 25) Are these facilities age appropriate and safe? ❑ Yes ❑ No ATTACHMENT U 54 Orange County Welfare Reform Task Force Outreach Committee Focus Group -Questions for Discussion 1. What do you think are basic human needs? 2. On the average, in Orange County, how much money does a family of(4)need in order to meet their own basic needs? per month $ (or) per year $ 3. How do you define economic self-sufficient? 4. Do you have a goal to be economically self-sufficient? 5. Do you consider yourself to be economically self-sufficient at this time? YES NO 6. In order to meet this goal, what do you need? 7. What do you see as the goal(s)of human services agencies? (a) promotion of economic self-sufficiency (b) prevention ' (c) intervention (d) personal growth&development (e) other 8. What do you see as the goal of Orange County Dept.of Social Services(DSS)? 55 9. Label the following services as follows: S=Essential for Basic Survival Dr-Essential for Basic Human Development E— Essential for Economic SelfSufficiency N=Not Essential food clothing shelter education health care medical dental mental health education and prevention emergency safety domestic violence intervention substance abuse prevention and intervention child abuse prevention and intervention other work(income) training transportation dependent care child care legal assistance for emergencies financial assistance for emergencies financial counseling recreation parenting skills and training 56 10. Number the following system changes as follows: I=Very Important 2=Helpful 3=No Opinion 4=Not Important Eliminating "red tape" Providing information on how and where to can get the services needed Eliminating waits at appointment time Having all services available at one location/place Requiring only one intake interview Having accurate and up to date information/referral Employing friendly agency workers Having agencies stay open in the evening and on weekends Implementing "family friendly" workplace policies 57 Welfare Reform Task Force ATTACHMENT III Outreach Committee Focus Groups(proposed) ♦ Public Housing (a) Residence Council -(meets the 2nd Tuesday/month; 6:30pm; Dept. of Housing) (b) Housing Community Center- Carr Court (c) Coachwood Apts./Gateway Village/Whitted Forest ♦ Chambers of Commerce (a) Chapel Hill- Contact: Jim Carter, Chair, Business Affairs Committee (932-2737) (meets 1 st Wednesday/month; 8:00am; Duke Power) (b) Hillsborough- Contact: Mark O'Neil (493-0395) (meets on an Ad Hoc basis) ♦ Ministerial Alliances (a) Contact: Chris Moran(929-6380) (b) Contact: Rev. Sharon Freeland(732-6194) ♦ Women's Groups (a) Jr. League of Orange/Durham- Contact: Charlotte Clark, President (office: 613-8103/home: 489-6466)(meets 1 st Wednesday/month; am or pm) (b) Extension Homemakers - Contact: Deborah Taylor,Cooperative Extension Service(732-8181, ext. 2055) (Individual Clubs meet monthly; Council meets quarterly) ♦ Youth (a) Teens in Power/Kellogg Project-Contact: Iris Fuller(563-0875) (b) Street Scene Teen Center-(929-9675) ♦ Teachers/Educators (a) Carolyn Long,President, Orange County Association of Educators,and Teacher at Central Elementary(732-3622) (b) Karen Wallace, Ex. Director, Orange County Communities In Schools(644-6247) ♦ Law Enforcement (a) Hillsborough Police Dept. -Contact: Judy Jacobs(732-9381) (b) Carrboro Police Dept. - Contact: Pete Lannon(968-7709) ♦ Senior meters (a) Galleria-Contact: Janice Tyler(968-2071) (b) Efland Community Center-Contact: Ron Gallerani(563-6358) ♦ Businesses (a) Brookshire Nursing Center-Contact:Jeff Mukamal(6446714) (b) Resolute Building Company- Contact: Dave Anna(933-1000) (c) UNC Employment-Contact: Jack Stone/Kathy Dutton/Linda Lane(962-2991)