HUMAN SERVICES RESTRUCTURING TASK FORCE

MINUTES

November 25, 1997 - Fourth Meeting of 1997

MEMBERS PRESENT

MEETING IN BRIEF

Minutes prepared by Patty Funaro, Sr. Legal Counsel

  1. Summary and Procedural Business.
  2. Task Force Member Updates.
  3. State Policy Objectives.
  4. Innovation Zone Panel.
  5. School Representatives Panel.
  6. Task Force Discussion of Recommendations.

TASK FORCE BUSINESS

1. Summary and Procedural Business.
The fourth meeting of the Human Services Restructuring Task Force was held on Tuesday, November 25, 1997, in the Supreme Court Chamber, State Capitol. The meeting convened at 10:17 a.m. and adjourned at 5:00 p.m. The Task Force approved the minutes of the meetings of the Task Force held on October 27 and 28, 1997, as corrected to reflect Senator Maddox's attendance at both days of the meeting. A corrected copy of the minutes is on file with the Legislative Service Bureau.
2. Task Force Member Updates.
a. Senator Maggie Tinsman. Co-chairperson Tinsman provided the Task Force with a progress report from the Program Duplication and Resource Utilization Subcommittee.
b. Mr. Tom Wilson. Mr. Tom Wilson provided a summary of the local forum that he and Co-chairperson Tinsman held in eastern Iowa. He reported that approximately 40 people participated. He noted the great interest of those present in addressing the issues concerning the population of children 0-5 years old and their families, that many people are doing good things already, and that those present expressed concern that if duplication is eliminated it is not at the expense of choice by the consumer. Co-chairperson Tinsman added that in one instance a school superintendent stated that the 0-5 age group issues did not really concern him in his position, but that following the discussion he realized that providing necessary services and supports to that age group results in fewer children requiring additional services and supports when they enter the school system. Those participating had been notified through a direct mailing.
c. Senator Jerry Behn. Senator Behn stated that he had not held a public forum to date, but had spoken with the local human services office administrator. The administrator noted that the biggest problem is the complexity of the programs themselves and the inflexibility in moving funding, stated that the central office had added staff while his local office was downsizing, suggested that staff be compensated on a case-weight basis, and recommended that the computer system be integrated more fully.
d. Dr. James Austin and Representative Brad Hansen. Dr. Austin reported that he and Representative Brad Hansen used public service announcements (PSAs) to inform people of the forum held in their area of western Iowa. Over 70 people attended, with some traveling from as far away as 100 miles. He said that the forum discussion focused on child care, working together across agencies, issues of confidentiality and being able to share information between service providers and others, and the duplication among home visit programs. Forum participants also expressed interest in expanded health services including the idea of a single location for children ages 0-5 to receive services or at the very minimum a preliminary health check.
e. Representative Robert Osterhaus. Representative Osterhaus reported that he has met with providers and agencies who expressed their concerns including the time expended and often wasted in finding funding through grant writing and in meetings of decision makers. He suggested that long-term funding might be a solution. Another concern is the integration of the computer system, but he finds this frustrating since implementing the X-PERT program has been a long process and is still not available. (X-PERT is a computerized system being developed by DHS for determining eligibility for major assistance programs such as Medicaid.) He also stated that there is a lot of data, but very little usable information and cautioned that even though decategorization and other local programs are seemingly working well, there are instances even within those communities in which some groups dominate and others are excluded.
f. Senator Elaine Szymoniak. Senator Szymoniak shared that Polk County is working to collaborate through United Way, and that she will update the Task Force as this work continues.
3. State Policy Objectives.
a. Overview. Ms. Mary Revealy and Mr. Marv Weidner, Department of Management and staff to the Council on Human Investment (CHI), discussed the development of a results-based performance management system in Iowa. CHI was created through legislation in 1993 and was charged with, in part, the development and implementation of such a system. Ms. Revealy noted that CHI determined that the focus should be on accountability and that the results or state policy objectives should be grounded in public input. Public input was provided through the use of statistically valid opinion polls carried out by a research group and through surveys and focus groups. The data collected from these efforts was used to develop the state policy objectives which are long-term goals and which are also the basis for Budgeting for Results (BFR), a process to align desired results with programs and appropriations of funding. Budgeting for Results is to be fully implemented by all state agencies by the year 2000, and at that time it will be possible to determine the amount of funding directed at a particular result. Additionally, the data collected in determining the desired results can be used to focus on specific interests such as the population of children 0-5 years of age. Ms. Reavely also noted that developing statewide objectives is fundamental to a results-based system so that local initiatives such as innovation zones can align their results with the overall goals of the state in order to measure progress and to provide for accountability.
b. Agency Directors. Mr. Weidner discussed one way in which the data is being used to focus on specific interests. The enterprise strategic planning process is a means of bringing state agency directors together in planning teams to develop strategic plans to achieve the Governor's leadership agenda, which includes goals, strategies, and the Governor's state policy objectives.
c. Long-term Focus. In response to an inquiry by Co-chairperson Hubert Houser relating to the choice to implement the system at a time when there will be changes in the executive branch, Mr. Weidner explained that the process to develop the state policy objectives was based upon a four-year time frame and that the state policy objectives were developed in such a way as to transcend any election cycle. He emphasized that any governor or state department director can use the data to determine priorities, as can the General Assembly. Ms. Revealy added that CHI assists with the process of collecting data for the purpose of determining goals, but the decision as to what the priorities are and how to achieve the goals is in the hands of the decision makers, including the members of the General Assembly.
d. Executive Branch Focus. In response to an observation by Co-chairperson Tinsman that, unlike other states in which the legislature has formally addressed the desired results for the state, the process in Iowa has been largely an executive branch endeavor. Mr. Weidner responded that members of the General Assembly do serve on CHI, but that members of the General Assembly do not seem to understand the program. Mr. Weidner asked the Task Force to make recommendations regarding enhancing the involvement of the General Assembly. Senator Szymoniak provided an historical overview of the development of CHI, noting that it began as part of a larger effort to provide the necessary means for people to move out, and stay out, of poverty. Even though the idea developed at the time of welfare reform, it grew beyond this. There were attempts to involve legislators, including meetings and presentations by staff to appropriations subcommittees, with little response.
e. Validity of Process. Mr. Roger Gutmann inquired as to the validity of the process if CHI is charged with developing a consensus model, but elected officials are not included. Mr. Weidner responded that the intent is that all elected officials have a role in impacting the results. Mr. Weidner noted that this is the first year that the Governor is using the objectives in planning and budgeting and that CHI only provides the information but that it is within the purview of the General Assembly to make decisions. He suggested that BFR is a means of making executive branch agencies more accountable to the General Assembly.
f. Alternatives. Ms. Arlene Dayhoff stated that CHI has moved in a cumbersome manner and inquired as to whether the process could be placed outside of the Department of Management (DOM) so that it is not interpreted as an executive branch entity. Senator Szymoniak suggested that it was difficult to find a place for CHI and that DOM was selected because it touches all departments.
4. Innovation Zone Panel.
Mr. Marc Baty, DHS Administrator, Linn County; Ms. Angela Hill, ADAA (an alcohol and drug abuse program), Red Oak; and Ms. Marjean Sargent, City Council Member, Malvern, comprised a panel of innovation zone representatives, with additional input provided by Ms. Julie Schmidt, a member of the Task Force.
a. Truancy Focus. Ms. Angela Hill noted that the innovation zone board in her three-county area is a diverse group of people intent on improving the community. The board decided to select a specific issue to provide a focus for the work of the board and one that would have the greatest ripple effect. The issue selected is truancy because it has linkages with juvenile crime, vandalism, teen pregnancy, drug abuse, and other issues affecting teens. She noted that those involved in the board work cooperatively and that it has been a great learning experience. Ms. Hill stated that the board developed from the decategorization group that was already in existence and that the board was broadened to include other interested parties as the issues facing the board required. The board includes supervisors from each involved county and school superintendents from each school district. Ms. Julie Schmidt added that the board is not really considered a formal governing structure. She noted that the expansion beyond the initial decategorization group even necessitated the hiring of the existing part-time staffer for the decategorization project to provide staffing to the combined initiatives on a full-time basis.
b. Broad Involvement. Ms. Marjean Sargent noted that additional member involvement was initiated by those who were already involved making contacts with a broader spectrum of people, including parents and children. She said that the various disciplines work well together, but that patience is required to work through systems other than your own. Both Ms. Sargent and Ms. Schmidt emphasized the need for citizen input. Ms. Sargent stated that it takes time to get parents, businesses, and government entities focused on the same goal and that the business community is slowly coming on board. She also added that public health representatives as well as the ministerial community are involved. The board will also enlist the assistance of the schools in selecting student representatives for the board.
Ms. Sargent said that the focus of truancy was selected to pull the community together, but that there are additional issues to be addressed. She noted that the broader focus could be the development of "life skills" for all students.
Ms. Schmidt emphasized the importance of the "state team" representatives who provide a conduit for the local entity in working with the state. The state team includes representatives from the Departments of Human Services, Public Health, and Education.
Ms. Hill reported that funding is provided by DHS and that there is also school at-risk funding, decategorization funding, in-kind contributions from schools, public health, and juvenile justice grant funding.
c. Local Governance. Ms. Schmidt noted that there is a variety of local governance entities in the community including innovation zones, decategorization, public health planning, and others, and that it is the hope to work toward forming one collaborative entity.
The panel members suggested that if the state is going to define the local governance entity through legislation, there are "natural leaders" in each community but others, who have concerns and ideas but who might not be natural leaders, should also be involved. Ms. Hill suggested that those who are not "natural leaders" will come forward if they are contacted by others in the community and if the channels remain open for this. She emphasized that people have to want to be involved.
d. Desired Results. The panel members noted that they have not formally identified desired results. Ms. Schmidt said that the Department of Education suggested asking school principals to identify high-risk students to utilize in measuring results. However, the board wanted established criteria and so will use at-risk guidelines to identify students, and school truancy officers will work with these families. The board will then identify measurable results from these activities, such as grade improvement and a decrease in truancy. Even though each school defines truancy in a different manner, once the individual systems of recordkeeping are understood, results can be retroactively measured.
In a response to an inquiry about institutionalizing the board in case the time would come that the board could not agree, the panel suggested that the state team is helpful in working through problems, but that at some point it would probably be a good idea to formalize the governance structure.
e. Linn County. Mr. Marc Baty provided input later in the day, due to earlier time constraints. Mr. Baty noted that each governance structure in his community has a high degree of overlap. He described the collaborative efforts and the community partnerships which have developed including those between the public and private sectors. He described "Foresight 20/20" which is an attempt to coordinate the various collaboratives across disciplines.
Mr. Baty suggested using a systems approach to community collaboration. He said that the systems approach would require everyone in the community to cluster around a common set of goals and outcomes. He noted that managing change is very difficult and that implementing initiatives on a pilot project level is a good idea. He suggested establishing near-, mid-, and long-term goals. He also noted that local governance does not necessarily connote simplicity and is not the panacea for all human services problems.
He noted that people want input into their communities and involvement in local affairs. The role of a parent is complex and labor-intensive and parents need support and the skills to manage their families. There is an opportunity for new partnerships between the branches and levels of government, including municipal governments.
f. Confidentiality. The issue of confidentiality is problematic because people interpret restrictions differently and the legal community always cautions agencies and others to "play it safe." Members of the Task Force suggested that obtaining releases and involving parents could overcome much of the problem. Mr. Baty advised obtaining information from the national Youth Law Center on this issue. Mr. Baty suggested two models for further consideration: the LINC model, which puts neighborhoods in the picture, and the PATCH model used in Cedar Rapids, which is a place-based strategy and has helped the public to identify and personalize the bureaucracy of human services.
5. School Representatives Panel.
a. Overview. A panel comprised of Mr. Phil Phillips, School Board Vice President, Carroll; Mr. Alan Jensen, Superintendent, English Valley and Tri-County Schools; Ms. Veronica Stalker, Superintendent, Waukee Community Schools; and Ms. Margaret Borgen, School Board Member, Des Moines Independent School District, provided input regarding recommendations to improve school collaboration with other efforts and reaction to the follow-up strategies of the Task Force.
b. Recommendations. Recommendations and responses included:
6. Task Force Discussion of Recommendations.
The remainder of the afternoon was utilized in discussing potential recommendations of the Task Force.
a. Other States. Co-chairperson Houser provided information which he gained through participation in a meeting in Oregon with others discussing devolution. He noted that many states are similar to Iowa in that they are trying a variety of options, while other states are confused as to how to proceed. He cautioned that any action taken must not enlarge the existing bureaucracy and that the state-level agencies should not dictate the process.
b. Duplication Subcommittee. The Task Force began its review of the follow-up strategies compiled following the two-day retreat, by addressing the issue of desired results. Co-chairperson Tinsman shared the results of the Program Duplication and Resource Utilization Subcommittee for the population of children ages 0-5 and their families, as a possible starting point in establishing results. The Task Force discussed the issue of developing desired results beyond the 0-5-year-old population. Some members suggested that using the 0-5-year-old population as an initial basis for devolving additional funds might facilitate ease of measurement of results.
c. Desired Results. The Task Force members discussed including in the final report a request that the General Assembly adopt results for all human services. Some options would be to adopt the state policy objectives developed by CHI or adding to those, or choosing to focus in the short term on specific goals such as those developed for the population of children ages 0-5. Task Force members discussed the inconsistency of establishing goals for only the ages 0-5 population and devolving only those funding streams when some local initiatives currently address populations beyond the ages 0-5 population. The Task Force was reminded that the focus of the Program Duplication Subcommittee is the population of children ages 0-5, but that the full Task Force focus is not limited in this way. Additionally, the Institutions and Facilities Subcommittee will also have recommendations which are not limited to an age-specific population.
Following discussion, the Task Force was asked to view their task as one of making recommendations at a variety of levels including developing and utilizing a results-based framework for human services which involves public and private entities at all levels, reviewing funding streams and resources, addressing the issue of local governance and enhancing its role, and eliminating barriers.
d. Local Governance. Members focused on the aspect of local governance and requested that models for service delivery at the local level be proposed, the issue of pooled funding be addressed, and methods for measuring accountability between the state and local levels be addressed. Mr. Baty suggested that there are existing models in Iowa such as decategorization that can be expanded through changes in Code language to provide a model for local governance. He suggested that instead of beginning an entirely new program, the Task Force consider building on existing programs with proven track records as a means of expansion. It was suggested that the state agencies be requested to provide a description of their plans for working with innovation zones.
e. Written Proposals. The Co-chairpersons suggested that Task Force members send their recommendations, in a written format, to the Legislative Service Bureau staff so that the materials can be distributed to members well in advance of the next meeting. The Co-chairpersons also determined that the remaining issues facing the Program Duplication and Resource Utilization Subcommittee are issues that the full Task Force should also address. Members of the Task Force who are members of the Subcommittee suggested that the final meeting of that Subcommittee scheduled for December 2, 1997, be cancelled and that the members of that Subcommittee instead be invited to attend the final meeting of the full Task Force on December 18, 1997, to provide input and to participate in the discussion of these issues.
f. Use of Facilitator. The Co-chairpersons suggested utilizing the services of a facilitator for the final meeting in developing final recommendations.

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