NAPC Annual Conference May 9-10, 2003 A silomar. Goals for the Alliance’s Roundtable To introduce the Alliance for Human Services’ model of comprehensive.

NAPC Annual Conference

May 9-10, 2003Asilomar

Goals for the Alliance’s Roundtable

• To introduce the Alliance for Human Services’ model of comprehensive community planning for health and human services to NACP members

• To highlight challenges we face as planners who are committed to achievement of outcomes and systems reforms identified in the comprehensive master plan

• To present strategies the Alliance is employing at the neighborhood level to improve outcomes for residents

• To foster dialogue among NAPC members at the national, regional and state levels about how to address challenges for community planning in the 21st century

Our Mission

To develop the comprehensive health and human services master plan for Miami-Dade County

To align public and private investments in health and human services in accordance with the needs, best practices and outcomes established in the comprehensive plan.

Our Guiding Principles

A shared vision of the needs of Miami-Dade residents

Targeting funding to the identified needs in the Master Plan

Improved coordination, collaboration and communication across systems

Increased accountability for investments--outcomes vs. workload measures

Promoting synergy, through mutual support and networking

Leveraging resources across systems

Promoting partnerships between the public and private sectors

Ensuring flexibility to respond to new or emerging community needs

Improving outcomes for consumers and caregivers, and

Improving the quality of life for all Miami-Dade county residents 

Composition of Our Board

Agency for Health Care

Admin.

Florida

Dept. of Health

Florida Dept. of Juvenile

Justice

FL Dept. of Children and

FamiliesAlliance for

Aging

Miami Dade County

Miami Dade

Public Health Trust

Miami Dade

Homeless Trust

Dade County Public

Schools

Miami Dade Empower- ment Trust

John S. and James L.

Knight Foundation

Health Foundation

of South Florida

Dade Community Foundation

South Florida

Workforce

Miami Dade School

Readiness Coalition

United Way of Miami-

Dade

2 Business Seats:

CITIBANK FLORIDA

& APPLICA

2 Ad Hoc Seats:

Advocacy and Faith Based Organization

New Entity:

The Children’s

Trust

5

ADVISORY COMMITTEE

REPS.

Comprehensive Health and Social Services Master Plan

(SSMP) Priorities for 2001-2004

Developed SSMP goals, outcomes and best practices to improve the quality of life in Miami Dade County in nine cluster areas:

Basic Needs: Hunger and Poverty/County-Wide Services

Children, Youth and Families Elders Children and Adults with Disabilities Immigrants and New Entrants Special Needs Populations, including

Mentally Ill, Homeless, Substance Abusers and Survivors of Domestic Violence, Rape and Sexual Assault

Health Workforce Development for Special

Needs Populations Criminal Justice: Ex-Offenders returning

to the Community and Juvenile Justice

Cross- System Reform Goals

Revenue Maximization--to increase the level of federal financial support for health and social services programs that are eligible for federal matching funds

Common Administrative Assessments--to increase efficiencies by streamlining and coordinating contract monitoring to funded agencies with multiple contracts

Outcome Based Funding--to improve accountability by ensuring documentation of the results achieved by funded health and social services programs.

State of the ArtBenchmarking and GIS Mapping

The Community Service Planning Center at the Department of Children and Families provides “state of the art” Geographic Information System technology that allows the SSMP to graphically depict areas of highest need in Miami-Dade County—at the zip code/census block group level.

The Center also produces the Alliance’s annual “Benchmarks” report which tracks progress over time on quality of life indicators selected by the Board in FY 2000-2001 (education, employment, health and social status, public safety)

73.83%72.05%

53.23%52.20%53.90%

73.22%73.18%

60.23%62.30%63.80%

0.00%

20.00%

40.00%

60.00%

80.00%

Miami-Dade Florida

1996-1997 1997-1998 1998-1999 1999-2000 2000-2001

Economic and Community DevelopmentEducation Measures

*Beginning with 1998-99 school year, the method of calculating the graduation rate for Florida's public high schools has been revised to track individuals by student ID numbers beginning with their first time enrollment in 9th grade. The new rate calculation accounts for incoming transfer students and outgoing transfer students are removed from the tracked population.

Source: Florida Department of Education Bureau of Education Information & Accountability ServicesGraduation and Dropout Rates by District

Graduation Rate

Public Private Participation in Development of SSMP Priorities

Over 3,000 individuals and 600 organizations participated in community engagement activities to provide input on the SSMP through:

Cluster meetings Community forums Neighborhood-based focus groups Consumer and provider surveys First Annual Institute (cross-clusters)

Intended Uses of the SSMP

• Blueprint for allocation of public and private funds based on a data-driven, research-based comprehensive plan

• A tool for systems change across public and private sectors

• Identification of public policy issues for advocacy

• Identification of opportunities to coordinate or leverage funds with special focus on revenue maximization opportunities

• Identification of barriers to care as well as ways to eliminate or reduce fragmentation and duplication of services

• Promotion of civic engagement in development of transparent, open-competitive processes for allocating funds based on need, program standards and best practices with assurances of accountability for public funds

Above all the SSMP is intended to be a resource for documenting improved outcomes for the citizens of Miami Dade County

Major Challenges in Miami-Dade

• Historically, the allocation of funds for CBOS was not based on research-driven planning or needs assessments

• Impact of shifts in federal and state policies regarding funding of health and human services (devolution)

• Silo-mentality in government bureaucracies leads to a

multiplicity of barriers to collaboration and coordinated funding

• Cultural, linguistic and geographic diversity of population in need of services in Miami-Dade County

• Difficulty of measuring impact of funded programs and changes in outcomes and benchmarks in short time frame (three year planning cycle)

STRATEGY AND RATIONALE FOR Neighborhood Based Planning

• Difficult, if not impossible, to create an integrated, coordinated health and human services system county-wide in a county as complex and diverse as Miami-Dade

• Certain neighborhoods in Miami-Dade County are driving county-wide indicators

• The Alliance’s efforts to promote Neighborhood Based Planning will result in improved outcomes over time, at the neighborhood level, and those changes will drive county-wide indicators in the right direction.

The ModelResidents Service Providers

Stakeholders

Everyone who is going to contribute to the solution must be involved in developing it

Planning• Focus on identification, mobilization and coordination of

resources in the community that are available to provide primary prevention and early intervention services

• Neighborhood Resource Teams (NRT) will develop and implement a community planning process aimed at

improving outcomes for children, youth, and families

Planning: Activities• Complete an inventory of the strengths and

assets

• Develop and implement a technical assistance agreement

• Develop an outreach campaign to engage and mobilize neighborhood residents, service providers, faith-based organizations, businesses, and other community leaders

• Convene at least three quarterly meetings

• Move towards full implementation

Full Implementation• Neighborhood resource centers will coordinate with

other children, youth, and family service providers in the community to:

• provide resource and referral servicescrisis interventionassessmentsshort-term case planningfollow-up services

• sustain a neighborhood based alliance of residents and agencies

Full Implementation:Deliverables

Ongoing implementation of a neighborhood based resource and referral system with established linkages to a network of agencies that provide core services to children, youth, and families in the community

• Promote information sharing and coordination among service providers and residents

• Identify gaps/barriers to care in the service continuum at the neighborhood level

• Develop plans for improving cross system coordination to benefit clients at the neighborhood level

• Develop quarterly updates of the resource inventory• Documentation of issues raised and resolved regarding

gaps and barriers• Linkage and referral agreements signed• Documentation of locally identified strategies for improved

service delivery coordination and collaboration

Technical Assistance

NRT receive technical assistance from consultants who would assist them in every stage of the project

– building coalitions and networks of service providers and stakeholders

– Engaging the community in neighborhood based asset mapping– developing resource and referral systems (or expanding existing

networks of service providers) to provide coordinated care

Lessons Learned• There were no blueprints to follow – national models

were in various stages of implementation

• Neighborhood models elude standardization – the model of promoting neighborhood based services must be flexible to help communities define goals, create structures for decision making, and operationalize their strategic plans. The result is very different approaches to implementation of the model in each neighborhood

• During implementation phase, it has been difficult for neighborhoods to evolve from the abstraction of the community planning model into a focused project with clear outcomes and benchmarks to work toward

Lessons Learned: Collaboration Takes Time

• Local CBO funding has traditionally been based on competitive bidding which is in direct conflict with a collaborative model. Long standing competition for scarce resources affects the ability of neighborhood based organizations to plan and work collaboratively

• Only one grantee was named to serve as “lead agency” for the NRT. The success of this model depended to a large degree on the leadership skills of the project coordinator. In some sites the “lead agency” model resulted in a climate in which some participants did not feel they had an equal voice at the table in shaping the service delivery system

Lessons Learned:Resident Involvement

• Some Neighborhood Resource Teams did not fully understand the role of residents in the planning process – Often view them as misinformed or troublemakers

• Residents often feel uncomfortable in the meeting culture, resent that everyone at the table is paid to be there except them, and often focus on individual needs not on neighborhood-wide issues

Lessons Learned:Organizational Readiness

• Five NRT grantees represented various stages of organizational capacity, readiness and development, yet they were expected to report to a unified standard

• Level of technical assistance varied greatly from neighborhood to neighborhood

Lessons Learned:Technical Assistance

• Neighborhood Resource Teams were not always clear about the role of technical assistance –and did not always take advantage of resources offered

• Technical Assistance provider did not consider themselves accountable for outcomes produced by the NRT

• Coordination of community technical assistance

NRT Achievements (Short Term)

• Forum now available at the neighborhood level to address system-wide issues that providers never had time to work on, or never worked on collaboratively

• Resident and consumer involvement in planning and implementation of service provision is now recognized as valuable to the process

• NRTs are utilizing data gathered at the neighborhood level to identify emerging needs, gaps, and barriers to care and are beginning to develop collaborative service plans and funding requests to address local needs

• Common intake and referral forms have been developed for utilization by providers in NRT sites

Benefits:

• Due to the new structures developed at the neighborhood level, all of the NRT have been able to attract new funds to the neighborhood

All NRTs were able to bring additional programs to the neighborhood including: after-school, child-care,

community health access projects. Several are now engaged in our assessment of the needs of at risk elders.

• Collaboration and communication among service providers has improved resulting in more effective and efficient service delivery

Neighborhood Level Outcomes• One Family Safety focused NRT developed their model

to include 6 hubs that serve as one point of entry for services in the neighborhood (no wrong door)

• One School-Readiness focused NRT reported that in the last 9 months, 51 parents read to their children at least 3 times/week

• One Family Safety focused NRT reported that in the last 9 months, only 1 out of 197 children whose families completed intensive (3 month or longer) child abuse prevention programs reported a finding of “some indication” of maltreatment within 6 months of program completion

Neighborhood Level: Continued

• One NRT developed Neighborhood Advocacy Coalition to represent the residents in the community. A professional translator is now being utilized to ensure active participation of residents without a language barrier

• Alliance partners are beginning to target their investments to support collaborative efforts in high need neighborhoods

Feedback/Discussion