Outcomes Based Service Delivery (OBSD)

1. Outcomes Based Service Delivery (OBSD) East Central Alberta Child and Family Services Region 5 July 2009 OBSD East Central Alberta Child and Family Services July 2009

2. What are Outcomes Based Services • Simply put, they are services where all aspects of the services are focused on the ‘purpose’ of the work. • Less emphasis on ‘how’ and more on ‘what happens’. • And, more emphasis on collecting and regularly reviewing relevant data on outcomes achieved. OBSD East Central Alberta Child and Family Services July 2009

3. The Purpose of Shifting to Outcomes Based Services • The intention of moving to outcome based approach in Child Intervention is to improve the effectiveness of services that children receive as they move in and out of our system. OBSD East Central Alberta Child and Family Services July 2009

4. WHY? • Number of children receiving services has increases slightly, despite decreased intakes • Number of children in permanent care of the director is increasing, despite increased performance in the area of permanency • Number of children residing in group or residential care is increasing • Days of care per child is increasing OBSD East Central Alberta Child and Family Services July 2009

5. WHY? (cont) • Number of days to permanency for many children in care is lengthy despite increased performance in the area of permanency • Amount of time for children residing in group or residential care is too long for too many youth: • Group care tends to be treated as a valid placement option however it should only be considered as an intervention OBSD East Central Alberta Child and Family Services July 2009

6. WHY? (cont) • We have data available to begin to use our own evidence to guide decisions in the areas of policy, practice and resource allocation • We then have the opportunity to use our data/information to better engage our staff in the results of their work vs. the processes of their work. OBSD East Central Alberta Child and Family Services July 2009

7. OBSD East Central Alberta Child and Family Services July 2009

8. Outcomes Based Services Delivery • Will clarify the role of our contract agency sector, enabling them to participate as partners in ensuring that children, youth and families receive the right service at the right time. OBSD East Central Alberta Child and Family Services July 2009

9. What are ‘Outcomes’? • Generally speaking, Outcomes in CYS tend to centre on 4 domains (although there are variations): 1. Child Safety 2. Child Well Being 3. Permanence 4. Family and Community Support OBSD East Central Alberta Child and Family Services July 2009

10. What are ‘Outcomes’ (cont) • Each of those four ‘Outcomes’ domains have ‘indicators’ attached to them that are measurable through some generally agreed upon measures. OBSD East Central Alberta Child and Family Services July 2009

11. Outcomes Based Services Delivery There are two distinct yet connected components to this initiative • Outcomes data used to guide caseworkers and agency staff and to assess and understand the impact of their interventions • Performance or Outcomes Based Contracting OBSD East Central Alberta Child and Family Services July 2009

12. Outcomes Data for Practice • Using a “Communities of Practice” Model, Outcomes data will be regularly shared with both contract agency staff and Ministry caseworkers to anchor discussions about practice and generate ideas about continuous improvement. • A continue improvement cycle will be established to create a climate of ongoing learning. OBSD East Central Alberta Child and Family Services July 2009

13. What is Outcomes Based Contracting? Outcomes or Performance Based contracting can be defined as: • A model that focuses on outputs, quality, and outcomes of service provision and may tie at least a portion of a contractor's payment, as well as contract extension or renewal, to their achievement." OBSD East Central Alberta Child and Family Services July 2009

14. Management making decisions Measurement – need a clear distinction between measuring effort and achievement Performance: Inputs and Activities (EFFORT) Outputs and Outcomes (ACHIEVEMENT) Outcomes Based Contracting Using this information to support contracting and agency service delivery OBSD East Central Alberta Child and Family Services July 2009

15. Based on the purchase of units of distinct services in specific categories Focus on Inputs – whatis purchased Relatively inflexible funding. In year re-allocations are difficult and agencies are expected to return surplus dollars at year end Based on the purchase of mutually agreed upon and negotiated outcomes Focus on howpurchased services drive outcomes Allows the flexibility for agencies to reallocate funding in order to meet outcomes Traditional VS. Outcome Based Contracting OBSD East Central Alberta Child and Family Services July 2009

16. Traditional VS. Outcome Based Contracting (cont) Monitor for usage and when critical issues arise Unintended financial disincentive for moving children through to less structured services Self monitoring Clearly identifiable difference between performing and non-performing contracts Built in financial incentive to move children through to less structured services OBSD East Central Alberta Child and Family Services July 2009

17. Predominant benefit to children and families • Increase in permanency placements • Decreased duration in care • Reduction in the use of residential care • Increase in placement stability • Decline in re-entry to services • Decreased length of stay in foster care/kinship care OBSD East Central Alberta Child and Family Services July 2009

18. Predominant benefit to agencies • Flexible funding mechanisms • Potential for longer term funding commitments • Ability to internally measure performance • Engagement with the broader system as a partner • Ability to reinvest committed dollars into programming • Increased communication between agency and public sector workers OBSD East Central Alberta Child and Family Services July 2009

19. Common Themes • Roles and relationships between caseworkers and contracted agencies needed to be well defined • Requires system wide commitment to improved outcomes (agency and public sector staff alignment) • Requires solid data collection processes across the systems and agreement on indicators OBSD East Central Alberta Child and Family Services July 2009

20. Common Themes (cont) • Requires good risk assumptions to build contracts and financing models that are feasible. • Requires structured opportunities to collaborate and reflect on achievement of outcomes OBSD East Central Alberta Child and Family Services July 2009

21. Cultural Shift/Change Management • Successful implementation of this initiative requires a cultural shift within the Ministry, within agencies and in the relationship between the two. • An inclusive Improvement and Innovation Framework will support the establishment of a model that will transform the business relationship and create true and sustained systemic improvements in service. OBSD East Central Alberta Child and Family Services July 2009

22. Outcomes Based Service Delivery Governance Structure • Ministry Executive Team • Project Sponsors • Executive Lead, Joni Brodziak • Steering Committee • Supporting Committees OBSD East Central Alberta Child and Family Services July 2009

23. Why a Phase In Approach? • To ensure that the final model will result in intended outcomes • To create buy-in and ownership across the system • To ensure solid communication • To ensure successful implementation OBSD East Central Alberta Child and Family Services July 2009

24. Current Status • Project Support Teams are being established that include representatives from contracted agencies and regional authorities • An ‘Outcomes Integration’ forum occurred May 27 and 28 • Work has begun on the development of funding, practice and reporting processes that be required for Phase-In implementation • An evaluation framework is being established • Regions are moving forward on implementation plans OBSD East Central Alberta Child and Family Services July 2009

25. Current Status • Region 3 (Calgary) was identified as a first up Phase in project. Tentative implementation for end of June 09. • Region 6 (Edmonton) has also begin Phase-In activity. Tentative implementation for July 09. • A target that has been established is that every Region will begin working with their staff and their agencies over the next fiscal year. • Regions have submitted high level plans for implementation which include engaging with the contract agency sector in their specific areas. OBSD East Central Alberta Child and Family Services July 2009

26. Next Steps • 2009-2010 Interim strategic direction for Child Intervention – short term • Group Care to lesser intrusive care • Foster Care to kinship Care or home • Decrease duration of days in placement • Increase Family Enhancement • 2009-2010 OBSD plan – long term • Region 5 Implementation Team • Request for Interest (RFI) • Community Planning • Request for Proposal (RFP) OBSD East Central Alberta Child and Family Services July 2009

27. Region 5 Unique Information • East Central Alberta Child and Family Services is responsible for providing services throughout the counties of Beaver, Camrose, Flagstaff, Lamont, Minburn, Two Hills, Vermilion River and the Municipal Districts of Provost and Wainwright • Approximate Population 109,981 • We have 6 Children Resource Centres within our region with over 68 FTE’s OBSD East Central Alberta Child and Family Services July 2009

28. OBSD East Central Alberta Child and Family Services July 2009

29. QUESTIONS Brian Holden Brian.Holden@gov.ab.ca Heather McKee Heather.L.McKee@gov.ab.ca OBSD East Central Alberta Child and Family Services July 2009