New Solutions for Government Human Services

Transcription

1 Strategic Planning, J. Kost Research Note 12 September 2003 New Solutions for Government Human Services Historically, government human services agencies have had to custom-build their mission-critical applications. Technologies available today offer a potentially faster and lower-risk approach to new, more-effective solutions. Core Topic Government: Domain-Based Government Technology Key Issue What technology issues will be important in health and human services? Strategic Planning Assumption Through 2007, the most-significant administrative problem that human services agencies will face will be the marrying of the unique needs of each case with the mostappropriate solution available from the various programs available (0.9 probability). Human services programs have evolved dramatically during the past several generations, often experiencing tectonic shifts as political perceptions evolve regarding their need and value. Prior to the Great Depression, most human services needs were addressed by the families or religious institutions of those in need. However, because the Great Depression generally overwhelmed the ability of families and charities to care for all of those in need, government programs were created. In the mid- 1960s, the number and complexity of government programs grew dramatically as part of the "war on poverty." As political leadership challenged the effectiveness of these programs in the 1980s, their growth was slowed and more flexibility was shifted back to lower units of government. Since the mid-1990s, even more flexibility has been granted to noncentral governments and private agencies to offer new or more-flexible services (see Figure 1). Gartner Reproduction of this publication in any form without prior written permission is forbidden. The information contained herein has been obtained from sources believed to be reliable. Gartner disclaims all warranties as to the accuracy, completeness or adequacy of such information. Gartner shall have no liability for errors, omissions or inadequacies in the information contained herein or for interpretations thereof. The reader assumes sole responsibility for the selection of these materials to achieve its intended results. The opinions expressed herein are subject to change without notice.

2 Figure 1 The Evolution of Human Services Delivery Family and Church New Deal Great Society Devolution Welfare Reform Government Role Time Technology Capability + Technology Technical Need Source: Gartner Research (August 2003) The upper portion of Figure 1 graphically depicts the relative role of government in the delivery of human services during these eras. The lower portion of Figure 1 depicts how the role of technology has evolved. Early on, IT was nonexistent. With the development of mainframes and large-scale payroll systems, technology began to play a more-prominent role in human services during the 1960s as agencies moved management of cash assistance programs onto computers. However, until the late 1990s, little of this technology development was specifically designed for or targeted at human services agencies. Other than financial management, technology played little or no role in farmore-qualitative activities, such as case management, until very recently. When human services were primarily the responsibility of the family and charities, the beneficiaries of those services were given only those things that were perceived to be necessary in the short term (such as money, clothing, food, spiritual guidance and job tools). Through the 1970s, as the government's role grew, services became more homogeneous (for better or worse). With welfare reforms beginning in the early 1980s and continuing into the mid-1990s, more programs have become available to meet the unique and highly varying needs of each case. Yet, because of the complexity of administering all of these programs, 12 September

3 few government jurisdictions or policies have adapted to better apply these programs to the needs of their constituents. Note 1 Human Services Defined Human services programs are government programs that provide income to people or families in need, provide assistance to enable self-sufficiency from these programs, or which help support or protect children, the disabled, and the elderly in situations where they are dependent on others. These programs include cash assistance, workers' compensation, unemployment insurance, child support, Medicaid, Medicare, Social Security and pensions (U.S. and non-u.s. definitions), child welfare and protective services. Human services agencies exist to meet complex financial and social needs of qualifying individuals and families (see Note 1). By their very nature, these needs may vary from one individual or case to another. Because societal needs are so diverse, a wide variety of programs has been, and continues to be, created to address them. Each of these programs may have different eligibility criteria. The most significant administrative challenge human services agencies will continue to face will be marrying the specific needs of each case with the most appropriate solution or program. This is, first and foremost, a problem of case management for employees of human services agencies and the technology infrastructure intended to support them. One of the great lessons learned from successful "e-government" strategies around the world is that technology can enhance government's ability to create citizen-centric services. In the case of human services, assessment tools have been created to determine the right solution to the right problem. As in the financial services sector, a greater range of products and services are available. And, as in the financial services sector, tools exist to enable effective case management of the needs of the individual. Creating a strong business case for human services projects has often been challenging because most solutions are built at very great expense with little direct financial benefit. More-effective case management can result in clients needing support from government for a shorter period of time and less fraud. Additionally, the availability of these products, along with the more-effective e-government strategies of phased implementation, customer-centric service models and userfriendly maintenance of the application drive less-expensive implementations at lower risk. By optimizing the capabilities of these products, financial return on investment can be achieved through more-efficient deployment of staff across programs and geographies, more-effective management of outside service providers, and more-effective performance measurement tools and techniques. The Technology This technological evolution is ready for human services agencies to take advantage of. By applying commercial technologies such as customer relationship management (CRM) to case management, government can truly create "one-stop shopping" for citizen services. By empowering single-point-of- 12 September

4 contact caseworkers, a single worker can better manage the needs of each case and ensure that the right programs and services are brought to bear to meet the needs of the case and achieve the desired outcomes. With CRM-type solutions, sophisticated service requests that are supported by powerful workflow engines can enable moreeffective and efficient management of a case across multiple service providers, multiple programs, and even multiple government jurisdictions. In "MarketScope: CRM for Government Human Services," we evaluate several product offerings that potentially meet the needs of human services agencies. Until now, most of the technology needs of human services agencies could only be met via extensive customization, commercial technology or build-from-scratch projects. Projects such as these are expensive, time consuming and carry a high degree of risk. For several years, hoping to minimize these problems, the U.S. government provided funding for state and local government for new systems, only if they transferred operational systems from other jurisdictions. However, because the business rules vary so much from state to state, even these so-called "transfer systems" required massive investment and time for customization, with little reduction in risk. Further, government procurement processes demanding "turn-key" projects compounded the risk and have discouraged many jurisdictions from attempting new systems to take advantage of the flexibility granted by the 1996 welfare reforms. However, with the products now available, Gartner believes it is time for human services agencies to examine the potential of products available and eliminate the barriers that prevent investment in these tools. Some of the characteristics built into these products that human service agencies should evaluate include: The ability of the product to address complex/multiple relationships Multichannel management and call center capability Workflow management Intelligent scripting Modularity of applications for multiple programs Ease of maintenance and upgrade System administration by business users, not technologists Program interfaces Built-in skills management capabilities 12 September

5 Multilevel access control Automated reporting features and program analytics In addition to the impact on clients and end users, using available products rather than custom-built solutions has an effect on an organization's approach and willingness to replace technology. Custom-built solutions are technology-intensive efforts in which the business users are largely limited to a policy role. Conversely, because they are more intuitive to use, available products often enable a much higher degree of involvement by users in the development and maintenance of the tool. This enables program administrators to remain in greater control of projects and to minimize the risk associated with large custombuilt projects. Pricing and Investment A big part of the challenge of the approach of custom-built solutions or transfer systems is the difficulty of predicting the amount of effort required to complete the job. Cost overruns are common for these projects (with all of their attendant political risks), even though projects of this nature are impossible to accurately predict. An advantage of buying a solution rather than building it is that the total cost is more-easily predicted and planned for. Because there are more suppliers in the human services market, the pricing for products is more competitive. A major challenge for product vendors and governments is achieving a price solution that is appropriate for large human services agencies. Because most of the work that custom development would do has already been done in these products, the price per seat can appear daunting. A true total cost of ownership analysis will reveal that product costs over time will usually be dramatically lower than custom development. However, the value of these products to each role performed by employees in human services agencies will vary. For example, the intake worker or case manager managing a large caseload will get greater value from these products than a foster parent with only an occasional need to interface with the system. Government agencies and vendors need to understand the relative value associated with product use and find a pricing scheme of mutual benefit. The Future In most cases, government human services agencies can't stand still. The technology they rely on is outdated and requires huge expense for maintenance, while offering little flexibility. At the same time, public policy makers are recognizing that government programs can be more effective if they are individualized to the 12 September

6 unique needs of each family situation, rather than following a "one size fits all approach" based on national, monolithic programs. The impetus for welfare reform that occurred in the United States in 1996 was the leadership of a handful of state governors who concluded that the status quo was unacceptable and sought the necessary changes and flexibility to enable new approaches. Although the 1996 law changes were important, they only began to lay the groundwork for what can and should be achieved in the next generation. Having more-robust technology, coupled with the potential to tear down the organizational silos that make programs and service delivery so ineffective and inefficient to administer, and confusing for those in need to take advantage of, the right leadership can and must emerge to enable the next generation of human services programs. Bottom Line: New technologies offer great promise in matching the needs of citizens with human services programs and services available. Government human services agencies, including those that fund them, need to evaluate the pros and cons of new product offerings as an alternative to the current approach of custom-built solutions. When appropriate, regulatory and process barriers to using such products must be removed. 12 September