pullin
Post on 21-Dec-2014
267 Views
Preview:
DESCRIPTION
TRANSCRIPT
Commonwealth of MassachusettsExecutive Office of Health and Human Services
Overview Presentation by
Melissa Pullin, Director of EHSResults
November 2009
Managing Performance. Focused on Results.
2
EHSResults!Context: Overview of EOHHS
EHSResults Overview 10/09
Massachusetts Executive Office of Health and Human Services (EOHHS) is comprised of 16 state agencies, including …
Medicaid (MassHealth) Mental Health
Public Health Elders
Transitional Assistance Veterans
Developmentally Disabled Blind; Deaf & Hard of Hearing
It has an annual budget of approximately $13.5B, or about half of the Commonwealth of Massachusetts budget
It employs about 23,000 employees and contracts with approximately 1,000 human service providers
3
EHSResults!EOHHS Call to Action
“We need to transform to a culture that is outcomes-focused, not just budget- or process- focused. We need to talk more often and openly about what our policy and program goals are, and use performance information that communicates how well we are achieving those goals as the starting point for our management discussions, rather than an after-the-fact reporting requirement. This change in culture is not easy, and will take several years.”
Dr. JudyAnn BigbySecretary, Executive Office of Health & Human ServicesNovember 2007
EHSResults Overview 10/09
4
EHSResults!Why (and How) Performance Management?
The National Performance Management Advisory Commission recently identified three fundamental government challenges that are addressed through the use of performance management:
Need to focus the organization on results that are important to stakeholders
Need to improve results within resource constraints
Need to gain and keep the public’s trust and confidence
They also summarized the three main approaches that governments may choose from in defining their performance management process:
“Stats” approach (think CompStat program in NYC; CitiStat program in Baltimore)
Balance Scorecard (think Kaplan and Norton approach)
Strategic planning cascading system of objectives, strategies & measures (think EHSResults)
Source: National Performance Management Advisory Commission“A Performance Management Framework for State and Local Government: From Measurement & Reporting to Management & Improving”Public Review Draft, July 2009
EHSResults Overview 10/09
5
EHSResults!Our Approach & Main Work Streams
At the beginning of the Patrick Administration, EOHHS began an exciting initiative called EHSResults
EHSResults takes an innovative approach to performance management, aiming to foster transparency, accountability, creativity and cross-agency collaboration
Four Main Work Streams Support Our Approach:
Strategic Goal Area Maps & Associated Outcomes
Intranet-Based Dashboard Reporting Tool
Associated Performance Management Activities
Public Awareness of Our Strategic Goals and Performance
EHSResults Overview 10/09
6
EHSResults!Strategic Goal Area Maps
Four Main Work Streams Support Our Approach:
Strategic Goal Area Maps & Associated Outcomes
Intranet-Based Dashboard Reporting Tool
Associated Performance Management Activities
Public Awareness of Our Strategic Goals and Performance
EHSResults Overview 10/09
7
EHSResults!Approach to Strategic Goal Area Maps
The strategic goal area maps identify cross-agency, Secretariat wide goals and sub-goals that address the question, “What should EOHHS deliver to Massachusetts residents?”
Supporting outcome measures identified from agency programs provide indicators of how well EOHHS is meeting its goals, and answer the question, “How does EOHHS know if it is accomplishing its goals?”
EHSResults Overview 10/09
EOHHS’ strategic goal area map development was lead by cross-agency leadership identified by Secretary Bigby
Strategy “maps” were developed for each of the EHSResults strategic goal areas
8
EHSResults!Strategic Goal Areas Compliment the Administration’s Work
EffectiveGovernment
Jobs & Self Sufficiency
Safe Communities
Educating Kids in
Our Care
CommunityFirst
Civic Engagement
AffordableHousing
Clean EnergyAnd Housing
EfficientTransportation &
Mobility
SafeCommunities
Economic Growth andJob Creation
Effective Government
Quality, Affordable Health
Care for All
World Class Education
MassGOALS Reporting Areas
Wellness andQuality
Of Health Care
EOHHS’ strategic goal framework is rooted in the Patrick Administration’s original priority areas
EOHHS’ Strategic Goal Areas
EHSResults Overview 10/09
9
EHSResults!Strategic Goal Areas Highlight our Agencies’ Important Work
• Ensure access to education related programming, services & opportunities for children & youth in EOHHS care• Maximize school attendance and engagement for children & youth in EOHHS care• Maximize stability in education programs for children & youth in EOHHS care• Maximize educational success for children & youth in EOHHS care
• Provide client-centered customer service• Develop & maintain a high performance workforce• Improve internal efficiencies• Increase efficiencies and quality of the POS system
• Surveillance – Monitor key indicators of safe communities• Preparedness – Develop infrastructure to support safe communities• Prevention – Deliver proactive & targeted services to individuals, families & communities• Intervention – Intervene where needed to ensure safety of individuals, families & communities
• Ensure access to care• Advance health care quality• Contain health care costs• Promote individual wellness• Promote healthy communities
• Increase accessibility & diversity of available jobs for targeted residents through policy & employer outreach• Provide employment support services for targeted adults• Maximize number of targeted adults who move toward self-sufficiency and independence through employment• Successfully transition EOHHS youth entering the workforce
Effective Government
Jobs & Self Sufficiency
Safe Communities
Wellness & Quality of Health Care
EducatingKids inOur Care
• Help individuals transition from institutional care• Expand access to community-based long-term support• Improve the capacity and quality of community-based long-term supports• Promote awareness of long-term supports
Community First
EHSResults Overview 10/09
10
Cross-agency development of the Strategic Goal Area Maps resulted in Secretariat-wide goal statements that are supported by agency-specific outcome metrics
EHSResults! Approach to Identifying Goals and Outcomes
Provided supporting agency level outcomes to track success at meeting goals
Identified multiple sub-
goals necessary to deliver highest
level goals
Defined EOHHS’ highest level goals, ensuring alignment within and between agencies & EOHHS
Example within Jobs and Self Sufficiency Goal Area:
Goal
Sub-Goal
Outcome MeasureOutcome Measure
Outcome Measure
Maximize number of targeted adults who move toward self-sufficiency and independence through employment
Maximize number of targeted adults who obtain health benefits from employers
Percent of individuals with disabilities with employer sponsored health benefits at time of employment
Sub-GoalSub-Goal
EHSResults Overview 10/09
11
EHSResults!Strategic Goal Area Map Example
EHSResults Overview 10/09(Strategic goal area map showing illustrative example)
12
EHSResults!Major Strategic Goal Area & Outcome Accomplishments to Date
EOHHS Strategic Goal Areas and Outcome Measures
EffectiveGovernment
Jobs & Self Sufficiency
Safe Communities
Educating Kids in
Our Care
CommunityFirst
Wellness andQuality
Of Health Care
EHSResults Overview 10/09
Strategic goal area maps have been developed for each of the six goal areas, resulting in
25 major goal statements
About 75 subgoal statements
Approximately 50 - 100 associated outcome measures per map
13
EHSResults!Executive-Level, Intranet-Based Dashboards
Four Main Work Streams Support Our Approach:
Strategic Goal Area Maps & Associated Outcomes
Intranet-Based Dashboard Reporting Tool
Associated Performance Management Activities
Public Awareness of Our Strategic Goals and Performance
EHSResults Overview 10/09
14
EHSResults!
We’ve started developing “dashboard” reporting for EOHHS executives
EHSResults Overview 10/09
EffectiveGovernment
Jobs & Self Sufficiency
Safe Communities
Educating Kids in
Our Care
CommunityFirst
Wellness andQuality
Of Health Care
15
EHSResults!Internal Reporting Promotes our Goals & Helps Us Evaluate Performance
EOHHS is focused on our strategic goals and measuring our success; We’re developing internal reporting on our goals & measures, available to EOHHS leadership
Jobs &Self Sufficiency
Safe Communities
Wellness and Quality
Of Health Care
Educating Kids in
Our Care
Effective Government
EOHHS Strategic Goal Areas and Outcome Measures
Goal Area Summaries Outcome Measure Details
Community First
EHSResults Overview 10/09(Summary & detail are illustrative examples)
16
EHSResults!
Agency Outcome Measures
Agency specific outcome measures provide another way to view strategic goal measures and include agency identified indicators that monitor how well each agency is meeting its own goals
CHE DMH
MCBHCF MRC VET
DYSDPHDDS
ELD MCDHLY ORI
EHSDTADCF
Agency Outcome Measures
Agency Outcome Measures
EHSResults Overview 10/09(Summary & detail are illustrative examples)
17
In addition to its executive-level dashboard reporting, EHSResults produces “paper” reports and emails them to executives for regularly scheduled meetings and ad hoc uses
EHSResults!Pushing Reports to Executives
EHSResults Overview 10/09(Report data are illustrative examples)
18
EHSResults!Dashboard Reporting Accomplishments to Date
CHE DMH
MCBHCF MRC VET
DYSDPHDMR
ELD MCDHLY ORI
EHSDTADCF
EOHHS Strategic Goal Areas and Outcome Measures
Agency Outcome Measures
EffectiveGovernment
Jobs & Self Sufficiency
Safe Communities
Educating Kids in
Our Care
CommunityFirst
Wellness andQuality
Of Health Care
EHSResults Overview 10/09
Dashboard reporting has been developed for four of our six strategic goal area maps representing
Approximately 500 EOHHS strategic goal area outcome measures
Around 80 agency-specific outcome measures
19
EHSResults!Other Performance Management Activities
Four Main Work Streams Support Our Approach:
Strategic Goal Area Maps & Associated Outcomes
Intranet-Based Dashboard Reporting Tool
Associated Performance Management Activities
Public Awareness of Our Strategic Goals and Performance
EHSResults Overview 10/09
20
EHSResults!Associated Performance Management Activities
EHSResults Overview 10/09
Examples of other performance management activities at EOHHS include:
Fiscal year priority development for 2009Last year, EOHHS identified three FY priority initiatives; For each of those
areas we developed business plans (including things like ROI’s, competitive environment analyses, etc.), milestones and outcome measures for reporting
Recurring EHSResults “spotlight” in weekly HR newsletter to all employees
Individual manager performance objectives tied to EOHHS strategic goals Completed for FY09 cycle with higher level managers ; Each
manager identified 3 – 5 performance objectives using EHSResults goal area structure
FY09 and FY10 “Results Plans” (f/k/a budget spending plans) tied to ResultsAgencies were asked to identify their top 3 – 5 priorities including associated performance measures, caseload and spending
estimates
21
EHSResults!Public Awareness of Our Work
Four Main Work Streams Support Our Approach:
Strategic Goal Area Maps & Associated Outcomes
Intranet-Based Dashboard Reporting Tool
Associated Performance Management Activities
Public Awareness of Our Strategic Goals and Performance
EHSResults Overview 10/09
22
EHSResults!We’re Going Public
EHSResults Overview 10/09
We will soon be promoting our work publicly through our mass.gov/eohhs internet site and other channels
Goal is to launch first version of web presence in January 2010
Content will be relatively static but help promote EOHHS’ use of performance management & our high-level strategic goals & performance measures
Content & design work currently underway
23
EHSResults!
The Holy Grail
EHSResults Overview 10/09
24
EHSResults!Tying Outcomes to Budget
EHSResults Overview 10/09
Our research has shown that a few (but not many) larger government entities in North America are making a strong tie between performance management & their budget process
Notable examples include the Commonwealth of Virginia (Virginia Performs program), the Ontario Ministry of Health and Long Term Care, and Washington State (GMAP)
Most successful outcome-to-budget ties seem to be centered around providing useful information, not creating a punitive environment; Most took several years to set up
25
EHSResults!Tying Outcomes to Budget
EHSResults Overview 10/09
For EOHHS, tying performance outcomes to budget would have many benefits, including
Providing a fact basis for what programs are delivering desired results
Understanding the relationship between $$ and outcomes and using this data to drive investment decisions
Providing data points for setting priorities in budget cutting environments
Better informing the public about how and why we spend our $$
26
EHSResults!Tying Outcomes to Budget
We have taken several passes at making “the tie” but have encountered stumbling blocks
Our EHSResults approach using strategic goals was meant to encourage creative thinking and participation, not shoe-horn our activities into spending buckets
Programs are often not designed around single outcomes and, by design, they often combine multiple outcomes to best meet client needs
A budget “unit” is not consistently defined within and across EOHHS
Monitoring a budget / performance tie requires lots of resources
Cultural resistance (to target setting and linking outcomes to $$s) is real and needs to be factored into systematic changes
Our goals and measures do not represent everything we do
Because of those challenges, EOHHS is taking an incremental approach to starting the outcome-to-budget tie by using the spending plan process
EHSResults Overview 10/09
27
Departments identify 3 – 5 strategic priorities for the FY. For each strategic priority they provide:
A brief overview for each, including things like changes from last FY, milestones, challenges / risks, populations served & caseload estimates
Estimated spending / funding and clients or units of service in order to derive a spending per client or unit of service estimate
Three to five associated outcome measures, including targets and prior year actuals
EHSResults!Using the Spending Plan Process as Step 1
EHSResults Overview 10/09
EOHHS uses its spending plan process to request priorities, outcomes and strategic ties from Agencies …
… This type of strategic priority information is the basis for much of the agency spending plan conversation with the Secretary
28
EHSResults!
Lessons Learned
EHSResults Overview 10/09
29
EHSResults!Lessons Learned: Our Overall Approach
What started out as a technology project isn’t that at all
In the concept stage, we were an 80:20 technology to business resource split. In reality, we are a 75:25 business to technology split.
Outcomes, metrics, measures… We can use the same words & mean different things
Different organizations & approaches use the same words in different ways. We check with users to ensure our vocabulary is understood & matches our intent.
Both program managers & leaders often default to identifying process measures
Caseload & dollars are traditional measures. We are constantly reminding staff and ourselves that we need to focus on client results / outcomes.
We maintain credibility by remaining facilitators; we’re not subject matter experts
The agencies and EOHHS leadership know their programs, data and environment. Our goal is to facilitate change & empower others to use it.
Top dog EOHHS support and agency champions are necessary for our success
Our Secretary promotes & requires participation; our agency “business representatives” keep projects moving.
EHSResults Overview 10/09
30
EHSResults!Lessons Learned: Dashboard Reporting
Most (all?) of our executives don’t know their passwords and don’t want to log on
In our culture, we need to email and promote “canned” (.pdf) reports. Our initial expectation that executives would log on to see data was unrealistic.
Targets make some people uncomfortable and some people downright cranky
Our reporting compares actuals to targets. Some agencies did not have or resisted setting targets, some did not feel directly responsible for the result.
Sometimes we take the Big Brother approach to changes and enhancements
Optimally, business users would request new functionality. When they don’t, we make educated guesses about what might be helpful.
Users prefer to see only measures they “own”, not by EOHHS strategic goal area
Although we report by agency view, we also report by goal area so enterprise-wide policy implications & cross-agency comparisons are visible.
What to measure? Check. How to get to data? Check. Now what do we DO with it?!
Identifying, capturing, providing context & reporting the data is big. But figuring out how to use the data and analysis is the real bugaboo…
EHSResults Overview 10/09
31
EHSResults!Lessons Learned: Non-Reporting Activities
We exploit all reasonable opportunities to embed ourselves into on-going activities
Whether it’s budget exercises or leadership meeting agendas or HR employee communications, we try and embed our work into people’s daily work in order to promote performance management at EOHHS & increase name recognition.
A lot of our unit’s time is required to communicate our messages
EOHHS employees, dashboard users, data owners, the public, clients, advocacy groups… yipes! We try to segment stakeholders & communication strategies
Leadership’s use of our reporting in on-going meetings is vital
Our Secretary made our reports a mandatory agenda item at her regular meetings with Commissioners. Guess what? People now pay more attention.
We strive to be an operational unit & not perceived as administration-based
We previously used consultants but are switching to an FTE-only staffing model. We hope this promotes stability, saves money & limits our exposure to funding cuts. We constantly reinforce the message that we are here to stay…
EHSResults Overview 10/09
32
EHSResults!
Questions? Comments? Ideas? Advice?
EHSResults Overview 10/09
Melissa Pullin
Director, EHSResults
melissa.pullin@state.ma.us
top related