Tl;dr - Originally conceived as a project focusing on giving DOR staff a convenient way to submit applications on behalf of DOR clients for other CHHS services, this project pivoted to a new challenge when the original problem was not pervasive. The project focused on better servicing foster youth eligible for DOR services by scaling up a successful partner model used by one of the counties.

Department of Rehabilitation - Shared Services Engagement Narrative

Team Members: Crystal Favareille, Marni Sager, Jeremy Rabideau
Office of Innovation Director: Chaeny Emanavin
Department Engagement Champion: Kerry Gantt

The Initial Problem

The Department of Rehabilitation (DOR) asked the Office of Innovation to engage with them on the problem statement: find ways to connect the consumers who are applying for Vocational Rehabilitation, to additional state services, so consumers are less likely to have to visit so many offices to access state services.

It has been a long time interest of the Secretary of Health & Human Services, Michael Wilkening, and many other staff at all levels of state service, to be able to connect consumers with as many possible services at one time. It seems like a no-brainer to want to streamline the potentially bureaucratic application process for Californians in need, who don’t often have time to wait for things like food, housing, vocational services, etc. but, pairing with a department like Rehabilitation, to work on this goal, where they are just completing the roll-out of their “expedited enrollment” process which is a revolutionary approach to get consumers approved for services, in record time, was a match made in heaven.

Discovery

The Innovation team began with a comprehensive discovery process during which we interviewed over 30 individuals, including staff at the DOR Central Office, Field Offices, staff from multiple departments within California Department of Social Services, staff from collaborating local/community agencies, policy experts, and more. The themes that arose during these interviews led the team to pursue two main focus areas. The first was around collaboration and coordination of care, and the second was around communication.

The connection of consumers to additional services, as part of the original ask by DOR, was emerging as a true need, but instead of the connection at a state level, it became clear that it was an initial collaboration at the county/local level, and coordination of the care being provided, that had the highest potential to impact the end user, and improve their experience, most immediately. This came to light after interviewing multiple field office counselors who reported that the majority of consumers coming to DOR for vocational rehabilitation had already received assistance, if needed, with food and/or housing. The goal of enabling consumers to connect with multiple state services at one time could be a great future project, but it might be a better match for one of the departments intervening in service provision for these more basic needs for survival.

The team found a DOR field office where there was already an existing model of collaboration and coordination of care, in this case for Foster Youth, that seemed like a fantastic model to consider scaling and adapting for different populations. The unique model involved Foster Youth being served more effectively by the DOR field office, Department of Education, and Workforce Development partners working collectively to coordinate the care for their consumers. It took the different entities learning about the work of their counterparts, obtaining consents for release of information, developing a shared application, and then meeting regularly in person to ensure the needs of each of these individuals were being met. The connectivity between services allowed for better efficiency and quality of care, and less duplication, than if each of the entities was working in their own silo.

The communication focus arose out of some workshops, discussions with stakeholders, both internal and external, who identified possible opportunities in this area. Internally, we heard themes around possible changes to the current modes of communication within DOR as a department, and the desire for additional communication from the field offices up to the Central Office. It is never surprising to hear about challenges related to internal communication within a large organization or bureaucracy, as the structure of these large organizations, and of government in general, make communication inherently difficult. But, it seemed that good internal communication would be key to ensuring the success of implementing any new type of service provision model, and getting buy in from those impacted by the change.

Externally, knowledge gaps amongst External stakeholders, i.e. other Health & Human Services departments, State departments, County offices, and community organizations, became a recurrent theme. Many of the external stakeholders the team interviewed were unaware of DOR as a possible service provider, either due to the fact that they didn’t know DOR existed, they didn’t know the population served by DOR or were unaware of the specific services provided. This was going to be an important focus area for the team as well, because a model based around collaboration with county/local partners could only work if the partners were connected to DOR and knowledgeable about the services provided and population served.

New Challenge Statement

After meeting with our Champions and Executive staff at DOR, to share with them all of the feedback we had received during our discovery interviews, and how we came to identify these specific focus areas, they were on board with us proceeding in a slightly new direction. We decided together on a new challenge statement: How might we best meet the needs of Foster Youth through coordinating care and collaborating with partners?

The new challenge statement led the team to conduct a number of workshops with users from inside DOR central office, field offices, outside community resources, and other state agencies. Workshops ranged from bringing together participants from a wide variety of agencies servicing foster youth to create a journey map of a foster youth accessing services to brainstorming ways we might work on internal DOR communication and external communication with stakeholders.

Prototyping & Deliverables

Out of these workshops, using the feedback about existing processes, prototype models, and potential areas of opportunity, the team was able to create:

• A stakeholder map of all entities involved in foster youth services
• Internal Communication Decision Tree for Sharing
• Information from Central Office out to the Field Offices
• Communication Flow Model for Information coming from Field Offices to Central Office
• Created a visual representation of an existing foster care collaboration process which was adapted into a scalable model that could be used at any of the Department of Rehabilitation Field Offices for their most relevant target population

What you can use in your Department

Through the work of the Office of Innovation team, DOR was able to see the value in identifying existing models and best practices that they can share and scale within the organization. Using their own experts and already proven models, DOR can build off of the passion and skills of existing employee to build upon their great work and further enhance the lives of the consumers they serve. Utilizing and scaling models that leverage collaboration and coordination of care, DOR will be able to more effectively make those connections between consumers and the local services that will benefit them. This coordination also focuses their efforts on the services they provide best, which allows them to make the most efficient use of their resources.

Quotable Quotes

Since leaving DOR less than a month ago, the OI team has heard that there are new local connections to community resources that have been established and are flourishing in at least one of the local field offices.

“A thirty minute meeting with all stakeholders in the room saves days of time and an unquantifiable reduction in frustration.”