Second in a Multipart Series on the Past Decade's Health and Human Services Journey.
In October of this year, we celebrated 10 years of the Harvard-related events, including the APHSA Leadership Retreat held the Friday before the annual Health and Human Services Summit. The themes from the Retreat themselves tell a story--from the first gathering of mostly state-level commissioners in year one to the early design work of what would become a multiyear focus on driving transformation through our Pathways framework--shared learning as the Human Services Value Curve gained traction to development of a strategic playbook for the field to major paradigm shifts in policy and practice as leaders at all levels apply the generative lens to their daily work.
APHSA Leadership Retreat Theme by Year
2010: Retreat of state leaders held in conjunction with the first Harvard Health and Human Services Summit
2011: Design work on what came to be known as Pathways
2012: Pathways: The Opportunities Ahead for Human Services
2013: Driving Systems Transformation
2014: Promoting Innovations and Demonstrations
2015: The Human Services Value Curve: Turning Ideas into Outcomes
2016: Leading in Uncertain Times: The Power of Generative Thinking
2017: Leading with Purpose--Charting a Collective Course Toward a Human-Serving Ecosystem
2018: Leadership Through a Generative Lens: Building Well-Being from the Ground Up
2019: Building Thriving Communities: Achieving Our Vision Together
One of my most memorable moments from the early years was when then-Connecticut Commissioner Rod Bremby, during a peer review of the Pathways initiative--which was shaped at the time around program-specific themes--opened his reflections with a simple statement: "We need to be BOLDER." In those few words, he was inspiring us to disrupt our long-standing mindsets and often highly entrenched ways of doing business, push ourselves out of our comfort zone, and collectively take steps as leaders to shift from program-to systems-thinking.
In further reflection today, I realize that Rod was also challenging us to "stand up" to our friends. Harry Potter fans will recall Professor Dumbledore's now infamous line: "It takes a great deal of bravery to stand up to our enemies, but just as much to stand up our friends," uttered when he awarded 10 points to Gryffindor to Neville Longbottom, sealing their win of the annual house cup. For our field, former Commissioner Bremby was challenging the oft-repeated mantra of "too few resources" and "too little flexibility." Together we leaders in the sector had to craft our own future state--by taking a deep look at what roadblocks we, ourselves, were perpetuating within the existing system and simultaneously creating space for innovation and making room for what is possible.
At APHSA, we began to apply "zoom in, zoom out" tactics--understanding that as a national organization we needed to be both close to the ground to better understand the possibilities and pain points and then widen the lens to see the full national landscape in order to identify the ripe levers of system change. We also took to heart the teachings of Harvard Professor Ron Heifetz who, in his presentation at the Summit, introduced adaptive leadership principles to the growing Value Curve Community:
Leadership is a special sort of educating in which the teacher raises problems, questions, options, interpretations, and perspectives, often without answers, gauging all the while when to push through and when to hold steady.
Being comfortable with ambiguity is central to leading within an adaptive lens. Professor Heifetz helped us understand that as leaders in a transforming field we need to keep the level of distress within a tolerable range for adaptive work to happen. Heifetz calls this the zone of productive disequilibrium. To be adaptive leaders in a highly complex and ever-changing world, we had to understand that leading through an adaptive challenge meant helping a team find its learning zone, through which new ideas and solutions emerge.
To help capture the shared learning across the Value Curve Community, we began to craft a strategic playbook, designed to guide our work as an Association. During one strategic planning session, I recall Phil Basso, Director of Organizational Effectiveness, suggesting that we look to other fields for successful transformation models; we focused in on work that had been done in the education sector and found a relevant model, which noted that successful transformations have four phases important to creating the buy-in, proof, scaling, and continuous learning required to drive systems level change:
* First, we must open up the current system to the possibilities of innovation/evolution.
* Second, we must demonstrate related innovations to practice and foundational supports that have the desired impact toward our desired future state.
* Third, we must scale and embed these innovations through policy/fiscal levers; supporting infrastructure (including IT and workforce) and new terminology, theories, and standards.
* Fourth, we must continue these phases as an upward spiral of monitoring, learning, and renewal.
In coming together annually at Harvard to push our thinking on the art of the possible, the Value Curve Community has exemplified this transformation model--first introducing ideas, including those from other fields and sectors; then sharing lessons from demonstrations in the field; and then taking those lessons beyond the classroom at Harvard and considering what is needed in policy and practice to drive systems level change, all the while fostering continuous learning cycles. We have learned, together, what it means to be a generative leader and have coalesced around the imperative of work--the well-being of all people in all places.
Over time, I have come to appreciate how much focus is needed in the opening up and demonstration phases to spark shifts in mental models, and why constantly zooming in and out is crucial to understanding what is ripe for broader action. Only then can we truly SHOW what's within our reach. You can see how these phases came to life in the pages of Policy & Practice from 2012-2014 in the charts that accompany this column. And, we've also added the timeline starting in 2010 to our website history page, and will continue with the next years of our shared journey in the next issue.
P&P Issue Director's Memo February Introduction to Pathways: The Opportunities 2012 Ahead for Human Services April APHSA's Innovation Center--a Pathway to 2012 Breakthrough Practices June Today's Expertise for Tomorrow's 2012 Solutions--Leading Us Down New Paths August Technology--What's in Store for Us in 2012 2022? October Recap on Pathways Progress and Next 2012 Steps December Focus on Getting to Impact Through 2012 Collective Efforts February A Model for Transformation 2013 April In Pursuit of Adaptive Leaders at All Levels 2013 June Organizational Effectiveness 2013 August Policy Forum Energizes Members with New 2013 Insights and Innovative Solutions October APHSA to Unveil New Website and Social 2013 Media Platforms December Our Path: A Catalyst for Transformation 2013 April A Top Priority--Human Services Innovations 2014 June Organizational Effectiveness--Paves the 2014 Way for Agency Innovation and Improvement August Policy Forum Highlights Innovation in the 2014 Field and Research-Based Insights October APHSA's Partnership Demonstrates Power 2014 of Public-Private Collaborations P&P Issue Excerpt February Most people know us through the administration of specific 2012 programs that have been traditionally structured to answer particular needs--including child protection, job preparation, child support, food assistance, and care for the elderly, among others. These discrete benefits and services are critically important, yet they are tools we employ toward a much broader and more holistic mission: investments that enable children, families, and adults to achieve meaningful and lasting positive outcomes in their lives. April The role of the [APHSA Innovation] Center is to provide a 2012 place to introduce cutting-edge ideas and support members and other leaders in thoughtful, focused experimentation and discussion that helps create a new national narrative and position our membership on the leading edge of system transformation." June The economic times have placed a greater demand on services 2012 while budgets at all levels of government continue to be slashed ... community resources and services have been severely impacted too, affecting the ability of us all to meet the needs... While the strain is real, leaders in the field see opportunity in this difficult time, and agree on the need for change. August I cannot help but be curious about what we'll be saying 2012 about IT in 2022: Will IT be supporting an efficient, seamless delivery of services through a customer-focused marketplace at the right time for maximum impact? Will the policy debates of the day still echo the debates of today or will they transcend to issues we cannot fathom? How will social media (or whatever we may call its descendant) fit into the picture? What kind of news tools will be available to the workforce? To our customers? October One of our explicit goals in Pathways is to change the 2012 language used to talk about health and human services from a tendency to describe our work in ways that are crisis-response-, dependency-, program- and output-oriented to descriptors that are person-centered and focused on prevention, capacity-building, integration, and outcomes. We are working to more accurately describe the current system, and through a well-articulated "future state," help steer national policy so that federal law, regulations, and guidance accurately reflect that vision. December While the concepts of collective impact and co-creation are 2012 new ones for our field... they offer significant promise for bringing about the next generation of human services in the country. At APHSA, we are committed to working with sister organizations to explore these ideas further, focusing on how we can leverage the incredible passion and expertise that leaders from both sectors bring to the table. February Transformational efforts should be informed by an 2013 environmental scan that helps us understand our context, including when to move opportunistically for quick wins and when to be patient. Transformation takes years (sometimes decades) to achieve, requiring many tactical steps along the way. April Introduced APHSA's reflective thinking questions to help 2013 members focus on adaptive leadership development. June Creating space in our world for innovation to happen is 2013 challenging, Our organizational structures, compliance-driven business models, and deep-seated agency cultures don't necessarily promote environment where innovation is embraced, let alone more "transformative" ways of doing business.... A focused approach on organization development and effectiveness is one way ... APHSA can assist members in their transformation efforts. August [At the Forum} we explored alternative ways of financing 2013 human services, what a social return on investment strategy can do for our industry, the changing dynamics of the federal-state-local relationships, and practical approaches to leadership through an adaptive lens. October Our goal is to build an even stronger network that 2013 functions both deliberatively and organically to drive smart policy decisions, connect members, and spread knowledge. December Announced the APHSA Human Services Roundtable, supported by 2013 the Kresge Foundation, and designed to bring national partners together to support development of a modern frame for human services and arm us all with a new narrative. April To make systematic and broad-scale demonstrations and 2014 adoption of innovation the norm in our work, not the exception, we are calling for a continuous series of demonstrations covering multiple approaches to funding, policy and customer engagement, and partnerships that will both support new ideas and scale up existing innovations. June Shared the promising results of the third-party evaluation 2014 of APHSA's organizational effectiveness process. August True to the conference theme, Transformation in Action, 2014 shared innovative ideas and numerous examples of what is working and why, including use of rapid-cycle evaluation, application of brain science to understand the extreme stress experienced by families, and introducing framing science. October Announced the partnership of APHSA, the Alliance for Strong 2014 Families and Communities, and the National Organization of State Associations for Children (NOSAC) to collectively influence the policy changes necessary to align an outdated federal financing system with proven practices. P&P Issue Theme, Key Content February Driving Transformation-An Integrated Policy 2012 Agenda * Introduced foundational elements of Pathways: The Opportunities Ahead for Human Services * Role of Children's Cabinets * OMB Partnership Fund on Program Integrity April Breakthrough Practices 2012 * Title IV-E waivers * Public-private partnerships * Education training programs * Access/benefit coordination for nutrition programs June Managing Change 2012 * APHSAs National Workgroup on Integration (NWI)--release of Governance guidance * Adaptive leadership * Change management * Path ways TAN F and SNAP papers August Technology Issue 2012 * APHSAs NWI guidance on integrated human services and utilizing the A-87 cost allocation * Supreme Court ruling on ACA * New data on child care subsidy programs * IT improvement for the workforce October The Health and Human Service Marketplace 2012 * APHSAs Pathways--Alternative financing framework * Global lessons in systems integration * Money follows the person: promoting independence for people with disabilities December Decision 2012 Is Over: Now What? 2012 * Congressional outlook in 2013 * APHSAs NWI 21st Century Business Model Guidance * Data standardization * Lessons from abroad February Driving Transformation 2013 * Trends in human services * Values-driven leaders * Local innovation in practice (from APHSA's Raise the Local Voice) * Transforming workforce capacity * Live Well San Diego profile April America's Changing Demographics 2013 * Healthy aging * Supporting employment opportunities for older workers * Immigration reform * Senior poverty June Shared Governance--Creating Effective 2013 Collaborations * Tracking Supreme Court trends * Role of government in the 21st century * Financial empowerment * Pathways paper on Gainful Employment * Employment for people with disabilities August Prevention--Getting Ahead of the Spiral 2013 * Understanding root causes * Career pathways * Teen pregnancy prevention * Pathways papers on Social Return on Investment (SROI) and Behavioral Health October Technology--Integrating Systems to 2013 Improve Human Service Delivery * Impact of social media on Congress * Health care reform * Systems integration December Impacts and Outcomes--Tracking and 2013 Evaluating Strategies for Better Human Services Delivery * Evidence-based practices * First mobile apps in social services * Simplifying access to improve outcomes * Improving employment for people with disabilities * Social impact bonds April Authentic Voices 2014 * "Treating" poverty * Constituent feedback to inform programmatic decision-making * Restorative staffing * Empowering youth June Transformation in Action--Making 2014 Connections to Make a Difference * Leading transformation * Federal IV-E waivers * NWI Analytics Capacity Roadmap * Blended/braided funds * Service integration in Dakota County * CalWorks program in San Diego August The Modern Marketplace--How Tech is Forever 2014 Changing Human Services Delivery * Pathways visioning paper * Introducing framing science * Mobile IT apps in the field * Roots of burnout * Integrated service delivery * IT and health care reform October Healthy Families, Strong Communities 2014 * Hawaii's business process reengineering * Financial capability services * Health and human services convergence * Predictive analytics in child welfare * Child obesity P&P Issue Commentary from Field Leaders and Experts February From our members' Pathways Open Letter to Policymakers 2012 and Stakeholders: "Our solutions will require changing health and human services programs and funding streams so that they become integrated, outcomes-focused, and centered on the needs of people rather than compliance with bureaucratic outputs." April On building stronger communities through public and nonprofit 2012 human services partnerships: "We must continue to move beyond program outcomes to partner and leverage resources across sectors and within communities for impact." June Harvard's Antonio Oftelie and Accenture's Julie Booth, along 2012 with APHSA's Executive Director Tracy Wareing, headlined how adaptive leadership principles were shaping field transformation, noting that: "Today's environment is cultivating a new breed of adaptive leaders who favor possibility over pessimism, fearlessly go against the grain, and feel energized where others are paralyzed." August On leveraging the opportunity for cross-system 2012 interoperability: "The health and human services field is at a critical, squarely on the threshold of what promises to be a very different future than the world today. Although modern technology can deliver whatever system design is envisioned, it is up to the nation's health and human services leaders to see the vision, think strategically, and pan for the future today." October On thinking globally and acting locally, a long- time 2012 leader in the field shared that "the many demographic and economic forces that shape our human services challenges are common to our peers in other nations" and "the better we understand the broader world in which we live, the better equipped we are to act within our own sphere of influence." December From NWI's guidance on the need to integrate health and 2012 human services: "The new business model for health and human services calls for an integrated sector seamlessly exchanging information and sharing core infrastructure, integrating and coordinating public benefits and services around the consumer's need ... all the while driving toward the realization of outcomes that will sustain the consumer long into the future, thereby benefiting the individual, the community, and the state over time." February On the future of human services: "Recognizing the need to 2013 maximize resources and offer fresh ideas some human services organizations are breaking through long-standing barriers and exploring nontraditional partnerships with each other--both nonprofits and the private sector. The result in a new human services ecosystem where organizations forge interactive and interdependent relationships that are mutually beneficial and directed toward a common goal." April From a national partner on bridging the divide regarding 2013 immigration reform: "lost in the political debate ... are facts about the immigrants who are already here, their role in the workforce, and their impact on states." June From then-Delaware Governor Jack Markell, "employers must be 2013 comfortable employing people with disabilities in order to harness the talents of the next generation. Savvy business leaders already get it." August Under our Pathways' policy initiative, we noted: "that our 2013 current policy and funding environment is creating greater need for an investment in human services ... land] within this context, Social Return on Investment offers human services agencies an opportunity to ensure the community impact and social value of their services and programs." October From APHSA's NWI about the pathway for integration of 2013 health and human services: "Fortunately, there has never been a better time to leverage federal financial support, analytical support systems, technology, and advances in business process re-engineering to connect the widely held, positive vision for where organizations need to be, and the challenges and opportunities state and localities currently face." December On solving social problems through evidence-based practices: 2013 "to rectify the lack of proven policy solutions, we must formulate working solutions and scale levidence-based] solutions nationwide ... government social spending should incorporate far more experimentation, perform more rigorous evaluations of ideas, and reallocate fund from less effective programs to more effective ones." April On supporting the well-being of the workforce: "Bottom 2014 line--business and motivational research and lessons from working with health and human services programs yield this pointed advice. Listen to staff, involve them in change, equip and free then to do good work, hold them accountable, and recognize and assure them." June On transformation work Harvard's Antonio Oftelie shared: 2014 "It is equally important to know what transformation isn't. You can't buy it from a vendor, or proclaim it from a podium. It's also not a fancy word for innovation. While innovation is an important tool to help organizations become more effective and efficient... it's incremental and short term in nature. Transformation builds on innovation by not only shifting the mission of an enterprise, but also the capabilities deployed in order to achieve heightened impact and an entirely new value proposition over time." August On technology's role under health care reform: "By investing 2014 in IT upgrades that enhance data sharing across programs and make reporting more efficient, both health care and benefit providers will have an unprecedented holistic view of their clients, improving individual and overall population outcomes." October On addressing the social determinants of health: "Health and 2014 human services convergence is wholly coordinated and data-driven service delivery that empowers individuals and occurs across health, social services, and community-based providers in both public and private sectors. This coordinated, agile, and common sense approach contributes to healthier residents, healthier communities--and at scale--a healthier nation. The impacts are profound: system changing, policy changing, and life changing."
(1.) See www.aphsa.org/APHSABlog
By Tracy Wareing Evans
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|Title Annotation:||president's memo|
|Author:||Evans, Tracy Wareing|
|Publication:||Policy & Practice|
|Date:||Dec 1, 2019|
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