I’ve been concerned for some time that the global economic downturn might lead to a resurgence of institutions as models of “care” for people needing extra support to live in the community.  Sadly, I’m seeing that my fears are well-founded.

Today I opened the Wall Street Journal to an article titled “The Best Thing About Orphanages” by Richard B. McKenzie.  The author seems to know whereof he speaks, in that he references with some fondness his own childhood in an institution.  He doesn’t point out, but certainly could, that the child welfare and foster care system in the US can be the stuff of nightmares.

A few moments later, I cam across the Sacramento Bee news item that  financially devastated California is dramatically reducing funding to help support seniors and people with disabilities to stay in their own homes.  The budget crisis is all too real, and unquestionably some painful budget cuts must be made.  This decision, though, strikes me as rather severe.  Nursing home beds are expensive and scarce, the same Sacramento Bee article mentions that many other supports (the nutrition program, among others) are being eliminated.  The vulnerable are becoming increasingly marginalized.

I don’t doubt for a minute that all the people involved are trying to do the right thing–trying to balance competing priorities.  It is up to us, though, to lead the way and remind decision-makers of the practical consequences of policy decisions.  Despite the challenges, we must not return to the days of institutionalization.

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imagesDaniel Henninger, the author of the Wonder Land column in the WSJ, wrote today (10-29-2009) about “Obama and the Old Hat People.”  Today’s column is about the current health care reform proposals making their way through the US Congress, and the current emphasis on dramatically expanding Medicaid alongside the much-debated “public option.”  Henninger places the thinking behind these proposals squarely in the “old hat” category, calling them “pre-iphone” proposals.

Leaving aside the politics or the persuasiveness of his argument, his use of “old hat” thinking and “pre-iphone” proposals got me thinking about old hat, pre-iphone proposals in human services.  In this field we are all too familiar with the Medicaid model and its myriad rules, regulations, complexities, compliance pitfalls, and frustrations.  15 minute billing increments, arcane rounding rules, encounter forms, eligibility change management, concurrent auditing, and much much more are part of the daily lives of human services delivery systems and the people we support.  They are also a part of the infrastructure –human and technological–that human services organizations must have to survive.  We all have software designed to manage the minutia of the rules.

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It just doesn’t get much more old hat than that.  

Most human services organizations are moving to service models based fundamentally on the individual being served.  We call it person-centered-planning, self-determination, or any number of other names, but we are often stymied by old hat bureaucratic thinking.  In this time of technological innovation and social movements based on an increasing ability for individuals to belong to disparate de-centralized groups (social media being a very important example) AND an industry movement toward personal choice, we still haven’t been able to be very new hat, have we?

New hat would be a service delivery and funding model based on individually developed service plans.  New hat would be an iphone app that removes the bloat and just delivers the information relevant to that person in that moment.  I’m circling back, I think, to an earlier post about the need for innovation in human services.

 I want us to be post-iphone.  

We need to be new hat.

Moldova, the Country of the recent “Twitter Revolution” is often referred to as the poorest country in Europe.  I am spending the week back in Chisinau, the capital city, where I have been several times over the past few years.  There Keystone Human Services International  has a small office and a staff of about ten people who are supporting several projects.

I am here with two colleagues from the US to implement Social Solution’s  newly acquired software TOTAL: Record, and despite the language differences (Romanian is spoken in Moldova) and despite the differences in human service systems models, I am delighted to report that the implementation is going very well.  As I mentioned in earlier posts, leadership is very important, and in accordance with that reality, I have travelled here with the CEO of Keystone Human Services International.  As in all implementations, that makes all the difference.

Strictly as an aside. Social Solutions refers to TOTAL:Record as “financial performance management” software for human services organizations.  In another post I’ll write about how they are seriously under-estimating the software product they acquired, but I’ll save that for tomorrow, I promise.  Suffice it to say that we are implementing it in Moldova, where medicaid reimbursement rules are not a driving factor. to say the least!

We are deep in the detailed struggles of all implementations—-how to define fields, activities, costs, etc.  It is the task of turning diffuse programmatic activities of helping people achieve full active lives in the community (rather than in institutions) into the bits and bytes of reportable data—-ie.  information.  I love this stuff!

This is a particularly fun project to be on—I am not usually so deep in the details of our software implementations anymore.  This one, though, will serve as a model and an inreplaceable information source for what we hope will be many more projects, so I am bringing in the most experienced staff and the most talented software application experst we have—under my watchful eye.  It’s good to be reminded how important valid and reliable information regarding human services can be; and good to be reminded of how rare it is.  I feel privileged to be doing this work.

So far our efforts with social networking have produced mixed  results, which is not unaligned with our expectations.   All in all, though,  I’d say it’s been a success.

I’ll start not with the strategy, but with the functional areas of the organization we’re trying to impact.  Our first serious efforts were on behalf of Susquehanna Service Dogs (SSD), which is a program within Keystone Children & Family Services.  SSD holds PawsAbilities, its major fundraiser ,in March in Harrisburg PA.  It is a 2-day event and its success relies heavily on a large turnout.

This year we heavily promoted the event through Facebook groups and local event websites.  We recruited influential bloggers with service-dog credibility, to urge people to attend and/or to donate.  We tweeted before, during, and after the event.  We did live video streaming from some of the most fun events–like the dock dogs.  It was a lot of work!

The end result was more press coverage, happier vendors (they got much more exposure), a more connected support community, and about the same turnout as the prior year.  Given that the prior year was a year of very high attendance, and given that the US economy is very different this year (especially in mid-March) we’re calling this an enormous success.  The blogs are continuing and are generating real followers and creating distinct communities, which is wonderful.  The Facebook group has grown from about 25 members to over 700  (a squad!) and even our flagship website, www.keystonehumanservices.org is receiving new traffic.

Lessons learned  so far:

  • This is a lot of work, and it doesn’t seem to fall naturally into any one area of corporate responsibility.  In our case, IT is the champion, but that seems to be relatively rare.  Whoever takes the lead needs to be prepared to add a fair amount of workload.
  • The online toolset is still in a state of flux, so be prepared to try several before you land on the one(s) that are best suited to your organization.
  • Be prepared for internal skepticism.  There are still people in my organization who firmly believe that computers are time wasters, and that most people don’t need access to the Internet.  As much as I would sometimes like to dismiss that thinking as irrelevant in this decade, I need to take seriously the underlying concerns.  We have serious work to do, and we mustn’t let ourselves get distracted by fads. I need to be able to justify this effort with clear strategy statements and with clear results.

that’s all for today . . . .

 

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I found myself discussing software implementation strategies with colleagues  today, and a question was posed to me about a stalled project at an organization we’re familiar with.  The project has been stalled for quite a while, and even the predictable flared tempers are starting to die down.  The project appears to be on a long slow death march, according to some insightful observers.

I don’t necessarily agree.  I’ve seen more moribund projects than this one be revived and become successful generators of organizational ROI.  For me, the key is the perspective of the person at the top.  If that person still believes in the strategic and operational value of the project, and if the technology tool is viable, then the project can be saved.  If the person at the top has lost interest, or never had it in the first place, then everyone should pack up and go home. 

It really comes down to leadership and whether the CEO is willing or capable of exercising it.  It’s that simple.  A strategic software implementation in a human services nonprofit is an exercise in and a committment to an overhaul of tired business processes, to a reorganization of duties, and to a new way of measuring success.  CEOs need to be prepared for the inevitable grumbling they will hear along the way.

This isn’t unique to human services organizations—every enterprise implementation faces those challenges.  What’s a little different for those of us in the human services’ world is that our organizations in general haven’t developed much sophistication around technology.  I often see the extremes of a culture that shuns technology and whose employees don’t know how to use a computer and a culture of thinking that  clicking the “install” button on shiny new software will solve all organizational ills, living side by side in the same agency.  The CEO has got to step up.

So, to all my CEO readers, take a deep breath and own the technology plan for your agency.  It’s a great way to get to know your company all over again.

tomorrow’s post will be on preventing project near-death experiences.

I’ve gotten some off-line feedback from CEOs on my last post, “it starts at the top.”  I’ve heard that many CEO’s want to use technology strategically, but they don’t know how to translate that into action.  

This post will be about the role of the CEO relative to technology.  The CEO needs to have the vision of what information and communication can do for their agency, and how it promotes the agency’s strategic vision.  If you’re a CEO and don’t already have that view of your agency, here’s how to get it.

Start first with your strategic vision for your organization, and with your mission statement.  For example, my organization, Keystone Human Services, has a mission statement that includes the following: Create opportunities for growth and meaningful life choices so that all people can be valued, contributing members of their community.  That mission statement is broad enough to encompass many areas of service, but is grounded in the idea of the individual and the community.

That means, then, that everything the organization does, including technology, either contributes toward achieving that mission, or it should be re-evaluated.  

Practically speaking, that means that whenever your company is looking for ways to use technology, link it back to the mission.  My organization made a commitment a long time ago that every employee needed an email address and needed access to the Internet.  Well before this was accepted practice, we moved forward with this vision, because our mission is community-based.  The “community” is not just the physical community we can touch, it is also the “virtual” community created on the web.  The mission guided us toward the practical technology action we needed to take.

Then the CEO, knowing that this direction would encounter some internal resistance, asked for monthly reports of how we were doing, started sending regular email updates to employees, and started using the tool he wanted others to use.  This led to the culture change we were looking for, and set the stage for the use of other tools.  We still have a long way to go, but our employees know where we are heading.

If you’re a CEO and your organization isn’t using technology as strategically as you would like, get together with your IT leader(s) and talk about what’s holding you back.  If you start at the top, keep it grounded in the mission, and use the tools you want others to use, then you’re on your way.

  All successful technology implementation projects start with the CEO or Executive Director.  In many Human Services organizations (HSO’s), that will come as news to the CEO, and in some cases, it’s news to the IT Director (if there is one.)  But it’s an important guideline that often is the difference between success and failure.

I’ve been talking with a nonprofit HSO CEO for several months as we worked together on a local effort.  His organization is stuck in technology project, and his agency is not alone.  I could be writing about at least ten different organizations I work with, and many of you will recognize the problem.  Too many nonprofits have been there. 

The agency has been trying to implement new software for over a year, and are still in the early stages of the project.  The CEO honestly believes it’s the vendor’s fault, because that’s what his IT staff is telling him.  He’s very frustrated and even angry at times, because he did so many things right.  He set the right tone–one of efficiency gains, and cash flow improvement, he helped select a forward-thinking vendor, and he empowered his people to go make it happen.  He was very supportive every step of the way, and then he stepped back to watch the progress.

So, what went wrong?

What he did do, was great.  What he didn’t do, though, helped sink the project.  He didn’t stay involved.  He didn’t ask for routine updates on the status.  He didn’t establish a mechanism for resolving internal disputes about process improvement.  He CEO let change-averse technicians undermine the project, and he’s relying on them to explain why it’s a year behind schedule.  Not surprisingly, they blame the software company. 

CEO’s must stay engaged in technology implementations.  They don’t need to attend every meeting, or stay on top of the thousands of details, but they need to stay interested.   The CEO sends a thousand signals every day about what’s important to the company, and what’s important is what s/he is talking about and asking about.  The standard project management tool of keeping the “executive sponsor” fully informed and engaged, is critical to keeping a project on track.  That’s why the software company is not blameless here either—they clearly didn’t do a good job with expectation setting, with communication, with project management or with change management.   They didn’t even get the fit/gap analysis right.

 With leadership from the two CEO’s, both from the HSO and the software company, the situation can still be turned around.   Two wiser, more successful organizations will be the result.

Success starts at the top.