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Risky business: Multiple jurisdictional Victim Notification Systems

By: Doug Rowe
10.26.20

Read this if you have a responsibility for victim notification.

Is your state complying with state and federal victim notification system statutes? How do you know if you are (or aren’t)? The federal government passed the Victims’ Rights and Restitution Act in 1990. This act requires all federal law enforcement officers and employees to make their best efforts to accord victims of crime with the right to be notified of offender status changes (i.e., movement from incarceration to the community). All states have similar statutes; many are more prescriptive and specific to each state.

You may be thinking “we have implemented a victim notification system, we’re all set.” To be sure, it’s best practice to ask yourself these questions:

  • Does my state use multiple victim notification systems, possibly one for the Department of Corrections, and others in use for jails, courts, or by the prosecutor’s office?
  • Do victims understand how to register and use the system(s)?
  • If you have multiple systems in use across your state, do victims know they must register in each (assuming that the offender is nomadic)?
  • Are the systems interfacing with the victim notification system to provide real-time updates regarding offender status changes and movements, or is the data reliant on human entry alone?
  • Is there redundancy in your victim notification approach? Are you relying solely on the victim notification system for statutory compliance, or are there other measures in place?
  • Have you defined the term “victim” in your state? How do you distinguish “known victims” from “interested parties”? Are these two groups treated equally in your victim notification systems and processes?

As we have explored these questions with various corrections clients, we’ve found that states address them in unique ways. In many cases, initial information regarding victims is captured on a pad of paper; in some, that information is never transposed into electronic form. Smaller, rural jails are more inclined to manually reach out to victims in their tight-knit communities, while jails in larger jurisdictions may not have the capacity to do so, and rely much more heavily on automation to comply with victim notification requirements. 

Many states use multiple victim notification systems (jails may use one system, while prisons use another), without integrating them to share data about offender movements and victim registrations. This results in a gap of service to victims likely unaware of the ramifications of having multiple, disparate victim notification systems. Many mature victim notification systems have the ability to interface with systems such as offender management systems (typically managed by the state’s department of corrections), jail management systems (typically managed by each county sheriff’s office), prosecution systems, and others. 

These system integrations are critical to reducing redundancy and increasing the timeliness with which both offender and victim data is entered into the victim notification system and used to trigger the notifications themselves.

So how can you assess your processes? The first step is to determine if your state has a problem with, or compliance gap between current practices and victim notification statutes. Here are some steps you can take to assess your situation:

  1. Review the victim notification statutes in your state
  2. Inventory the victim notification systems in use across your state, including any interfaces that may exist with the systems described earlier
  3. Talk to victim advocates to learn more about how they use the systems to augment their efforts
  4. Connect with representatives within your state department of corrections, sheriff’s offices, prosecutors, courts, probation, and other groups that may be providing some level of victim advocacy and learn more about their concerns

If this is all overwhelming, try and take it one step at a time. You can also engage a professional consulting firm that can help you organize and systematically assess the problem, then collaborate with you to develop a plan to close the gaps. 

If you have questions about your specific situation, please contact our Justice & Public Safety team. We're here to help. To learn more about other choices in victim notification procedures and systems, stay tuned for our second article in this series, where we explore options for acquiring and implementing a statewide victim notification system.

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Read this if you have a responsibility for acquiring and implementing victim notifications for your jurisdiction.

In the first article of this three-part series we explored the challenges and risks associated with utilizing multiple victim notification systems across your state. In this article we will explore what the choices are to address these challenges. 

System elements to consider

Many jurisdictions are under the impression that there are only one or two choices for victim notification systems. Though there are certainly market leaders in this space, you should select a system model that best meets your jurisdiction’s profile. The profile may include some of these elements:

  • Risk aversion (i.e., How risk averse is your organization regarding system implementations?)
  • Budget (i.e., How will the initial project be funded? Does your jurisdiction prefer an annual subscription model, or a traditional perpetual license with annual maintenance and support fees?)
  • Staff (Who do you need to implement and maintain the operational system?)
  • Time (i.e., Are you already out of compliance with state statutes?)
  • Hosting environment (i.e., Do you want to host in the cloud or on premise?)
  • Victim notification reach (i.e., state-wide, single jurisdiction, multiple justice partners)
  • Victim notification policy and statute complexity
  • Data ownership (i.e., To what degree does your jurisdiction enable the selling of victim notification data outside of the jurisdiction?)

Victim notification solutions range from hosted commercial off the shelf (COTS) solutions, which are typically least expensive; to custom solutions developed to address jurisdiction-specific needs. The latter tend to be more expensive, riskier than turnkey solutions, and take longer to operationalize. However, if your jurisdiction has unique requirements for victim notification, this may be a viable option. Unless you plan to engage the development vendor in a long-term contract for maintenance of this type of system, you must consider the impact on your existing IT staff. “Platform” solutions are a hybrid of COTS and custom development. With these solutions, there is typically a platform (i.e., Customer Relationship Management or CRM) on which the victim notification system is developed. Using a platform de-risks the development of the application’s architecture, may be a slightly less costly approach, and may simplify the maintenance of a system that is addressing unique requirements.

You may also already have licenses for victim notification capabilities, and not even realize it. Some offender management systems (OMS), jail management systems (JMS), and even prosecution systems (that support victim advocacy functions) may have built-in victim notification functionality included for the licensing price you are currently paying, or may include the option to purchase an add-on module. 

Advantages of using victim notification capabilities packaged with an existing system may include:

  • Lower acquisition and maintenance costs
  • Tighter integration with the OMS, JMS, or prosecution system may result in more seamless utilization of offender and victim data
  • You have a single contract, with a single vendor, reducing contract management overhead

A likely disadvantage, however, is the victim notification functionality may not be a robust as a point solution, or custom-built system. Additionally, if the “reach” of the JMS is a single county, then victim notification capabilities built into your JMS may not suffice for statewide use. However, if the built-in functionality meets your needs, then this is certainly a viable path to consider.

As mentioned in the first article, regardless of your approach the integration between your victim notification system and the JMS, OMS, prosecution system, and court system is critical to reducing redundancy and increasing the timeliness with which both offender and victim data is entered into the victim notification system―and used to trigger the notifications themselves.

Determining the best option for your victim notification system

So how do you determine which choice is best for your jurisdiction? The first step is to determine your jurisdiction’s risk profile versus the need to for jurisdiction-specific functionality. 

Mature market-based solutions are typically less risky to implement, since multiple jurisdictions are likely successfully using them to support their victim notification operations. However, these solutions may not be customizable or flexible enough to address your specific needs. 

“Build” models (using platform solutions or other application development models) tend to be a bit more risky (as many “from scratch” development projects can be); however these are more likely to address your specific needs. Here are a few questions that you should ask before making a determination between a COTS solution and a custom-build:

  1. Do we really have jurisdiction-specific victim notification needs?
  2. Can a COTS solution meet the statutes and policies in our jurisdiction?
  3. How risk-averse is our jurisdiction?
  4. Do we have time to develop a customized solution?
  5. Do we have the talent and capacity to maintain a custom solution?

Budget considerations

The next step is to determine your budget. We recommend you assess a budget over a 10-year total cost of ownership. The cost of a traditional, perpetual license-based COTS solution, including initial acquisition and implementation, will be higher in the first few years of use, but the ongoing annual fees will be lower. The cost of a custom-build solution will be even higher in the first few years, but annual maintenance should drop off dramatically. The cost of a subscription-based COTS solution will be relative even year over year. However, if you model these costs over 10 years, you will have a reasonable sense for how these costs trend (i.e., the cost of a subscription-based model will likely be higher over 10 years than the perpetual license model). 

The other consideration is how you plan to fund the system. If there are capital funds in the budget for initial acquisition and implementation, this may benefit the perpetual license model more than the subscription-based model. Regardless of the funding approach, you will likely be using the selected victim notification method for a significant period of time, so don’t settle.

Finally, determine how to acquire the system (or systems integration vendor that will help you develop the system), which is the subject of the third article in our series.

If you have questions about your specific situation, please contact our Justice & Public Safety team. We’re here to help. To learn more about other choices in victim notification procedures and systems, stay tuned for our third article in this series where we explore the process (and pitfalls) of procuring a statewide victim notification system.

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Victim notification systems: What choice do you have?

Law enforcement, courts, prosecutors, and corrections personnel provide many complex, seemingly limitless services. Seemingly is the key word here, for in reality these personnel provide a set number of incredibly important services.

Therefore, it should surprise no one that justice and public safety (J&PS) IT departments should also provide a well-defined set of services. However, these departments are often viewed as parking lots for all technical problems. The disconnect between IT and other J&PS business units often stems from differences in organizational culture and structure, and differing department objectives and goals. As a result, J&PS organizations often experience misperception between business units and IT. The solution to this disconnect and misperception? Defining IT department services.

The benefits of defined IT services

  1. Increased business customer satisfaction. Once IT services align with customer needs, and expectations are established (e.g., service costs and service level agreements), customers can expect to receive the services they agreed to, and the IT department can align staff and skill levels to successfully meet those needs.
  2. Improved IT personnel morale. With clear definition of the services they provide to their customers, including clearly defined processes for customers to request those services, IT personnel will no longer be subject to “rogue” questions or requests, and customers won’t be inclined to circumvent the process. This decreases IT staff stress and enables them to focus on their roles in providing the defined services. 
  3. Better alignment of IT services to organizational needs. Through collaboration between the business and IT organizations, the business is able to clearly articulate the IT services that are, and aren’t, required. IT can help define realistic service levels and associated services costs, and can align IT staff and skills to the agreed-upon services. This results in increased IT effectiveness and reduced confusion regarding what services the business can expect from IT.
  4. More collaboration between IT and the organization. The collaboration between the IT and business units in defining services results in an enhanced relationship between these organizations, increasing trust and clarifying expectations. This collaborative model continues as the services required by the business evolve, and IT evolves to support them.
  5. Reduced costs. J&PS organizations that fail to strategically align IT and business strategy face increasing financial costs, as the organization is unable to invest IT dollars wisely. When a business doesn’t see IT as an enabler of business strategy, IT is no longer the provider of choice—and ultimately risks IT services being outsourced to a third-party vendor.

Next steps
Once a J&PS IT department defines its services to support business needs, it then can align the IT staffing model (i.e., numbers of staff, skill sets, roles and responsibilities), and continue to collaborate with the business to identify evolving services, as well as remove services that are no longer relevant. Contact us for help with this next step and other IT strategies and tactics for justice and public safety organizations.

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The definition of success: J&PS IT departments must define services

Your government agency just signed the contract to purchase and implement a shiny new commercial off-the-shelf (COTS) software to replace your aging legacy software. The project plan and schedule are set; the vendor is ready to begin configuration and customization tasks; and your team is eager to start the implementation process.

You are, in a word, optimistic. But here comes the next phase of the project—the gap analysis, in which your project team and the vendor’s project team test the new software to see how well it fulfills your requirements. Spending sufficient time and energy on the gap analysis increases the likelihood the resulting software is configured to support the desired workflows and processes of the agency, while taking advantage of the software’s features and benefits. Yet this phase can be stressful because it will identify some gaps between what you want and what the software can provide.

While some of the gaps may be resolved by simple adjustments to software configuration, others may not—and can result in major issues impacting project scope, schedule, and/or cost. How do you resolve these major gaps?

Multiple Methods. Don’t let your optimism die on the vine. There are, in fact, multiple ways to address major gaps to keep you on schedule and on budget. They include:

Documenting a change request through a formal change control process. This will likely result in the vendor documenting the results of the new project scope. This, in turn, may impact the project’s schedule and cost. It promotes best practice by formally documenting approved changes to project scope, including any impact on schedule and cost. However, the change request process may take longer than you may originally anticipate, as it includes:

Documenting the proposed change
Scoping the change, including the impact on cost and schedule
Review of the proposed scope change with the project team and vendor
Final approval of the change before the vendor can begin work

Collaborating with the vendor on a solution that fits within the confines of the selected software. With no actual customization required, this may result in a functionality compromise, and may also involve compromise by the project team and the vendor. However, it does not require a formal process to document and approve a change in scope, schedule or cost, since there are no impacts on these triple constraints.

Collaborating with the vendor and internal project stakeholders to redefine business processes. This may or may not result in a change request. It also promotes best practice, as the business processes become more efficient, and are supported by the selected software product without customization. This will require a focus on organizational change management, since the resulting processes are not reflective of the “way things are done today.”

Accepting the gap—and doing nothing. If the gap has little or no impact on business process efficiency or effectiveness, this method is likely the least impactful on the project, as there are no changes to scope, schedule, or cost. However, the concept of “doing nothing” to address the gap may have the same organizational change ramifications as the previous point.

Of course, there are other methods for addressing major software gaps. The BerryDunn team brings experience in facilitating discussions with agencies and their vendors to discuss gaps, their root causes, and possible solutions. We leverage a combination of project management discipline, organizational change management qualifications, and deep expertise to help clients increase the success likelihood for COTS software implementations—while maintaining their vital relationships with vendors.

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Grappling with software gaps

People are naturally resistant to change. Employees facing organizational change that will impact day-to-day operations are no exception, and they can feel threatened or fearful of what that change will bring. Even more challenging are multiyear initiatives where the project’s completion is years away.

How can your agency or organization help employees prepare for change—and stay motivated for an outcome—many years in the making?


Start With the Individual

Organizational change requires individual change. For the change to be successful and lasting, an agency should apply organizational change management strategies that help lead people to your desired outcome.

With any new project or initiative, people need to understand why the project is happening before they support it. Communicate the reasons for the change—and the benefit to the employee (what’s in it for them)—so each individual is more inclined to actively support the project. Clearly communicating the why at the onset of the project can help employees feel vested in, and part of, the change. As Socrates said, “The secret of change is to focus all your energy, not on fighting the old, but building the new.” A clear vision can inspire each employee’s desire for the “new” to succeed.

Shift to Individual Goals

It’s a challenge to maintain your employees’ motivation for an organizational change occurring over the long haul. Below are some suggestions on how to sustain interest and enthusiasm for multi-year projects:

  1. Break the project down into smaller, specific milestones. Short-term goals highlight important deadlines and create tangible progress points to reach and celebrate. The master project schedule should be an integration of the organizational change management plan and the project management plan so any resource constraints you identify in the project management plan also become an input when identifying change management resources and activity levels. This integration also highlights the importance of key organizational change management milestones and activities in an effort to ensure they are on a parallel tack as traditional project tasks.
  2. Effectively communicate status updates and successes. In large, agency-wide projects, there are often a variety of stakeholders, each with different communication expectations and needs. The methods, content, and frequency of communication will vary accordingly. Develop a communications strategy as part of your organizational change management plan, to identify who will be responsible to send communications, when and how they will be sent, key messages of the communications, and what feedback mechanisms are in place to continue the conversation after initial delivery. For example, the project team needs a different level of detail than the legislature, or the public. Making the content relevant to each stakeholder group is important because it gives each group what they need to know so they don’t drown in a flood of unneeded information.
  3. Create buy-in by involving employees. A feeling of ownership naturally results from participation in a project, which helps increase enthusiasm. Often the time to do this is when discussing changes to business processes. Once you determine the mandatory features of the future state, (e.g., financial controls, legal requirements, legislative mandates) consider including stakeholder feedback on decisions more focused on preference. It is important for stakeholders to see their suggestions accepted and implemented, or if not implemented, that there was at least a structured process for thoughtfully considering their feedback, and a business case for why their suggestions didn’t make it into the project.
  4. Conduct lessons learned assessments after each major milestone. The purpose of conducting lessons learned activities is to capture what worked and what didn’t. Using surveys or other feedback systems, such as debrief meetings, allows stakeholders to voice their thoughts or concerns. By soliciting feedback after each milestone, leadership can quickly adapt to challenges, address any misunderstandings or concerns, and capitalize on successes.
  5. Reinforce how the project meets the goals of the agency or organization. Maintaining enthusiasm and support for a long-term goal takes a constant reminder of the overall organizational goals. It is important for senior leadership to communicate the impact of the project on the agency or organization and to stakeholders and keep the project at the forefront of people’s minds. Project goals may change during the duration of the project, but the project sponsor should continue to be active and visible in communicating the goals and leading the project.

Change is difficult—change that is years in the making is even more challenging. Applying a structured organizational change management process and using these tips can help keep employees energized and help ensure you reach the desired project goals.

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Change management: Keeping employees motivated during multiyear projects

As more state and local government workers enter retirement, state and local agencies are becoming more dependent on millennial workers — the largest and most educated generation of workers in American history. But there is a serious gap between supply and demand.

As noted in a 2016 report by the Bureau of Labor Statistics titled 
Household Data Annual Averages 15, only 25.6% of current
government workers are between the ages of 18 and 35.

This trend isn’t necessarily shocking; many millennials choose higher-paying jobs in the private sector over lower-paying jobs in the public sector, especially when the days of a lifelong government career, and generous pensions, are dwindling. But it is a serious labor problem for government agencies — one that requires creative solutions. To entice these new workers, state and local governments need to adopt new recruiting and retaining methods.

Recruiting Methods

While money matters to millennials, they also want to live a life of adventure, try new things, embrace trailblazing technology, pursue meaningful goals, and gain a sense of both personal and civic accomplishment. In short, these new workers have values that differ from previous generations. You can help entice them by:

  • Highlighting your state and local agency’s mission and greater purpose. Many millennials want to affect change and find careers consistent with their values. Include information in your job descriptions about the positive environmental and social impact your agency makes.

  • Updating your technology. Millennials have grown up with technology (literally at their fingertips), can adapt to change as no other generation before them, and often strive to remain on the “cutting edge.” By updating your agency’s technology, you will not only improve your organization and benefit the public you serve, but also have a better chance of recruiting the best and brightest millennials.

  • Providing them with a work-life balance. Life outside of work is just as important to millennials as their careers. They don’t plan to wait for retirement to finally pursue their interests, so providing them with a level of flexibility is key to recruitment. Consider offering flexible workdays, remote working capabilities, extended parental leave, sabbatical opportunities, and “mental health days.” The more flexibility state and local agencies provide, the more incentive there is for millennials.

Retaining Methods

Recruiting millennials for government jobs is challenging enough, and retaining them can prove even harder, as job hopping is standard practice for many members of this generation. Nevertheless, there are certain methods your agency can adopt to prevent millennial turnover. We suggest:

  • Investing in employee development and training. Training and creating opportunities for promotion and career advancement are motivating incentives to millennials. Professional development excites millennials and investing in them will pay off for the agency — and the employees will be more engaged and likely to stay.

  • Showing employees they are valued. Recognition is the biggest motivator besides money — millennials want acknowledgement for the good work that they do. Communicate achievements and provide awards to recipients in front of their peers. This not only gives them credit, but also motivates others. Continuing to communicate to your employees how their work supports their values reminds them they made the right decision in joining the public sector in the first place.

Make Your Move

Millennials are worthy of your attention! To compete with the private sector — to recruit and retain them — your government agency has to take an innovative approach to capitalize on this ever-growing demographic. If your state or local agency needs help refreshing your technology, reviewing current policies and procedures, or taking a fresh look at your processes, contact BerryDunn. We would love to talk about your commitment to your future!

You may also be interested in: CFOs for Hire; How to Attract and Retain Workers in a Seller's Market

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Getting millennial with it: How state and local governments can recruit and retain a new generation of workers

Electronic accessibility in every aspect of modern life has increased ten-fold, but government — and courts in particular — has been slow to follow.

History Lesson
The idea that criminal court proceedings are accessible by the public is a pillar of our justice system, rooted in the First Amendment. This public right to unrestricted access in criminal and civil court proceedings has been interpreted by many states to extend to court documents and court records (as long as not otherwise protected).

Traditionally, public access to court proceedings and records has been limited to those taking place in the courthouse, between the hours of 8:00 am and 4:00 pm. In most every other aspect of our lives, we have 24/7 access to everything from live streaming of our home security systems, to ordering our groceries or dinner from our mobile devices — while traveling at 30,000 feet! Government — and courts in particular — has been slow to follow in the rush to 24/7 electronic accessibility.

Part of the rationale behind the hesitation to jump on the electronic bandwagon, are the ethical issues surrounding unlimited electronic public access. So while the First Amendment provides for public access to information, conversely the Fourteenth Amendment interprets the definition of “liberty” to include a right to privacy. Deciding between these two semmingly contradictory rights becomes a challenge for courts when determining what form of electronic access is appropriate for court documents.

The pros
Unlimited electronic access to publicly available documents:

  • Serve a variety of public interests while eliminating the need to travel to the courthouse to research and copy documents.
  • Acts both as a deterrent to violating laws and as protection to those whose rights have been violated.
  • Tends to instill fairness, transparency, and equality of court proceedings.
  • Protects the community and allows the media to report on matters of public interest in a more convenient, timely, and streamlined manner.

The cons
While there are compelling reasons to provide electronic public access, they don’t take into account the potential for it to be used inappropriately. Risks include:

  • Increased chance of identity theft, leading to loss of property, finances, and credit
  • Exposure to sensitive information that may be harmful to all those involved
  • Negative impact on privacy
  • Deter public interest lawsuits for fear of overexposure
  • Mistakes or abuse of legal process can have far-reaching implications on individuals

What can states do?
Allowing unlimited remote electronic access to court documents could compromise the privacy rights and concerns of individuals and increase the risk of harm to those participating in court proceedings. This issue demands the full attention of the courts nationwide, but not with an “all-or-nothing” approach.

Many states struggle with striking this balance. To mitigate some of the potentially damning effects, states have taken different approaches. The National Center for State Courts (NCSC) has brought attention to the issues on several occasions. In 2002, the NCSC and the State Justice Institute funded the project, “Developing a Model Written Policy Governing Access to Court Records” and more recently the NCSC has published the “Privacy/Public Access to Court Records Resource Guide”.

Some states have redacted confidential information from electronic documents and some have limited what information or categories are available on the internet, only posting some combination of the following:

  • Appellate decisions
  • Final judgments, orders, and decrees
  • Basic information of the litigant or party to the case
  • Calendars and case docket lists

Our recommendation
States must agree upon the amount of access they will provide electronically. To tackle this, each state should:

  • Consider forming an access committee(s) to determine what guidelines are needed to balance the free access rights of the public with the privacy rights of individuals
  • Policy decisions should be publicly posted to the judiciary, legislators, and the public at large; and
  • Should be regularly revisited to ensure an appropriate balance is continually achieved

Interested in learning how your state can address this or similar issues? Reach out to BerryDunn's justice and public safety experts and we can discuss the particular issue facing your state and the best practices for approaching it.

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Striking a balance: Public right of access to court records vs. the privacy rights of individuals

Read this if you are a director or manager at a Health and Human Services agency in charge of modernizing your state's Health and Human Services systems. 

When states start to look at outdated Health and Human Services systems like Eligibility Systems or Medicaid Enterprise Systems, they spend a lot of time on strategic planning efforts and addressing technology deficiencies that set the direction for their agencies. While they pay a lot of attention to the technology aspects of the work, they often overlook others. Here are three to pay attention to: 

  1. Business process improvement
  2. Organization development
  3. Organizational change management

Including these important steps in strategic planning often improves the likelihood of an implementation of Health and Human Service systems that provide the fully intended value or benefit to the citizen they help serve. When planning major system improvements, agencies need to have the courage to ask other critical questions that, when answered, will help guarantee greater success upon implementation of modernized system.

Don’t forget, it’s not only about new technology—it’s about gaining efficiencies in your business processes, structuring your organization in a manner that supports business process improvements, and helping the people in your organization and external stakeholders accept change.  

Business process improvement 

When thinking about improving business processes, a major consideration is to identify what processes can be improved to save time and money, and deliver services to those in need faster. When organizations experience inefficiencies in their business processes, more often than not the underlying processes and systems are at fault, not the people. Determining which processes require improvement can be challenging. However, analyzing your business processes is a key factor in strategic planning, understanding the challenges in existing processes and their underlying causes, and developing solutions to eliminate or mitigate those causes are essential to business process improvement.

Once you pinpoint areas of process improvement, you can move forward with reviewing your organization, classifying needs for potential organization development, and begin developing requirements for the change your organization needs.

Organization development

An ideal organizational structure fully aligns with the mission, vision, values, goals, and strategy of an organization. One question to ask when considering the need for organization development is, “What does your organization need to look like to support your state’s to-be vision?” Answering this question can provide a roadmap that helps you achieve:

  1. Improved outcomes for vulnerable populations, such as those receiving Medicaid, TANF, SNAP, or other Health and Human Services benefits 
  2. Positive impacts on social determinants of health in the state
  3. Significant cost savings through a more leveraged workforce and consolidated offices with related fixed expenses—and turning focus to organizational change management

Organization development does not stop at reviewing an organization’s structure. It should include reviewing job design, cultural changes, training systems, team design, and human resource systems. Organizational change is inherent in organization development, which involves integration of a change management strategy. When working through organization development, consideration of the need for organizational change should be included in both resource development and as part of the cultural shift.

Organizational change management

Diverging from the norm can be an intimidating prospect for many people. Within your organization, you likely have diverse team members who have different perspectives about change. Some team members will be willing to accept change easily, some will see the positive outcomes from change, but have reservations about learning a new way of approaching their jobs, and there will be others who are completely resistant to change. 

Successful organizational change management happens by allowing team members to understand why the organization needs to change. Leaders can help staff gain this understanding by explaining the urgency for change that might include:

  • Aging technology: Outdated systems sometimes have difficulty transmitting data or completing simple automated tasks.
  • Outdated processes: “Because we’ve always done it this way” is a red flag, and a good reason to examine processes and possibly help alleviate stressors created by day-to-day tasks. It might also allow your organization to take care of some vital projects that had been neglected because before there wasn’t time to address them as a result of outdated processes taking longer than necessary.
  • Barriers to efficiency: Duplicative processes caused by lack of communication between departments within the organization, refusal to change, or lack of training can all lead to less efficiency.

To help remove stakeholder resistance to change and increase excitement (and adoption) around new initiatives, you must make constant communication and training an integral component of your strategic plan. 

Investing in business process improvement, organization development, and organizational change management will help your state obtain the intended value and benefits from technology investments and most importantly, better serve citizens in need. 

Does your organization have interest in learning more about how to help obtain the fully intended value and benefits from your technology investments? Contact our Health and Human Services consulting team to talk about how you can incorporate business process improvement, organization development, and organizational change management activities into your strategic planning efforts.

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People and processes: Planning health and human services IT systems modernization to improve outcomes

Read this if you are in a management role at a state Medicaid agency.

States are facing unique pressure on resources and budgets due to the COVID-19 pandemic, coupled with potential uncertainty following an election year. Healthcare innovation and transformation is one route state Medicaid agencies (SMAs) may take to minimize operational costs and improve access to services. Here are some tactics, flexibilities, and practical steps to help realize innovation during this time.

US Supreme Court Justice Louis Brandeis is credited in 1932 with popularizing the phrase that states are the “laboratories of democracy”. In this case, Medicaid may be the ‘laboratory of health policy and innovation", in part as state Medicaid and Children’s Insurance Programs (CHIP) are collectively the largest US healthcare payer, covering 74 million individuals.

In 2020, states have faced the dual challenge of a public health emergency and corresponding state budget uncertainty, squeezing resources just as projected state revenues have dramatically shrunk. SMAs must be creative to meet competing priorities: administering their programs while responding to the public health emergency. Here are some tactics, flexibilities, and practical steps to help realize innovation during this time. 

Reimagining funding for state Medicaid agencies

Identifying a source of funding is often challenging. Three options to consider include:

  1. Advance Planning Documents (APDs)
    While strictly for information systems, APDs can unlock 90/10 match for Development, Design, and Implementation (DDI) or a 75/25 match for operations. This funding is above most state Federal Medical Assistance Percentages (FMAPs). Realistically, program changes generally require system changes too. Consider reviewing whether you could tie the initiative to Medicaid Information Technology Architecture (MITA) business process maturity and/or outcomes-based system certification criteria. Linking personnel, training, project management, and any equipment for system needs into an APD can be an effective way to help fund the process and system changes.
  2. Partnerships
    An SMA can look further afield if sister agencies have funds available. This is especially true if braiding federal payment streams is an option. For example, many developments that benefit Medicaid can also help CHIP. The federal matching rate for state CHIP programs is typically about 15 percentage points higher than the Medicaid matching rate.  
  3. Certified Public Expenditures (CPE)
    Under 42 CFR § 433.51 and the Social Security Act, another governmental entity besides the SMA can contribute state matches allowing the state to draw Federal Financial Participation (FFP). One option can be another governmental entity using state dollars at the state, county, or even local level, to deliver health services (if covered under the Medicaid state plan) to Medicaid members.  

Interagency cooperation to generate savings in the health and human service (HHS) space will be the topic of a forthcoming article.

Getting help: Communications planning and the role of project management

As SMAs pursue more complex initiatives such as addressing Social Determinants of Health (SDoH)—collaborating not just with providers but with other public agencies, community organizations, vendors, federal partners, advocacy groups, and health systems—the need to coordinate such a diverse circle of stakeholders increases. Demonstration projects, system implementation efforts, and major healthcare initiatives in particular, require coordination of stakeholders throughout each project phase.

Health and human services (HHS) organizations sometimes underestimate the role of project management. For example, project management is often seen as simply “making sure things are complete” by the deadline, but there are other advantages such as establishing efficiency, improving the quality of service delivery, controlling costs, and better coordinating staff for the SMA. With stretched public workforces and more tasks in the current business environment, you want to get as much done—preferably faster, cheaper, and with less risk—and deliver the expected benefits. 

Guidance on priorities from senior leadership can help organizations establish clear and visible sponsorship to help establish success. Strategic change needs a strong champion within the SMA who has the ability to convene key stakeholders and keep projects on task.

Procuring the tools

After determining funding and before executing a project, you prepare by getting the tools you need—whether tools that involve systems, subject matter experts, or general project assistance.  If the Request for Proposal (RFP) process is not an option, consider whether a pre-qualified vendor list or cooperative contract vehicle would work for you. Cooperative contracts are increasingly popular at the federal, state, and local levels. A few cooperative options include:

The solution is strategy

Keeping Medicaid innovation moving forward requires strategic focus that combines funding, communications, project management, and procurement. The strategy you develop can help the outcome of the initiative to be greater than the sum of its parts. By using all available tools, including those discussed here, your SMA can prioritize innovation.

Next steps

  • Evaluate your program and identify initiatives to prioritize in the coming year. Ask your CMS contact about the latest applicable guidance. 
  • Develop APDs to help fund technology needs for initiatives, along with training your SMA team and providers. 
  • Implement a communications management approach to engage stakeholders.
  • Marshal project management resources and develop a realistic and achievable roadmap to success.   
  • Explore agency contracting vehicles, cooperative contracts, and other procurements tools. 

We’re here to help. If you have more questions or want to have an in-depth conversation about your specific situation, please contact the Medicaid consulting team
 

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The solution to help Medicaid innovation moving forward