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Cziltang wanders the trackless wastes in search of truth, beauty and personal enlightenment. He had tried to be self-sufficient, growing his own ideas, but they withered and died in the great intellectual drought that gripped the land in his youth. One day, as he gazed at the parched landscape around him, he realized that somewhere there must be ideas growing. Somewhere, rational discourse must still survive. Since that day, he has searched for a mythical land of fields and forests of living ideas. Now and again he finds a thought or two in the rubble of an occasional deserted outpost of civilization. Its a hard way to live and its not much of a life, but that's just how it is, out here in the Ratlands |
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I couldn't possibly make this up...
link I was doing some internet searching at work today looking for information on performance measures. Performance measures are all the rage now in the public sector. I'm not making light of this, but it's just that I've seen fads in management come and go over the last 25 years and with each new batch of concepts (or old concepts dressed up so that the consultants can sell books, materials and services) comes a new jargon that has to be learned to be able to wade through the material. Still, the idea of performance measures in the public sector tends to send shudders down the spines of human services types. In more concrete settings, performance measures have been around as a planning tool for a long time. Fire Departments, for example keep track of the number of fires they respond to, but they also keep track of response times. An industry standard recommendation is that fire departments respond to 90% of calls within 4 minutes. If, due to city expansion, response times in a particular area increase significantly, the fire department can make a case that a new fire station should be built in that area. As I understand it (and I am by no means an expert in the area) in the above example, the number of fires responded to is an 'output measure,' roughly speaking, 'what you do'. Response times, on the other hand, would be an 'outcomes measure,' or roughly speaking, 'what your results are.' Human services types are generally pretty good at output measures; things like how many clients do you have, how many forms did you fill out, how many times did you do 'X' for clients and the like. In my business, output measures are things like what is the the average daily population of the facility, how many clients did we have last year, how many referrals did we make, etc. What gives human services types the heebie-jeebies are outcomes measures because they essentially ask questions like "are you any good at doing 'X'? Historically, human services organizations haven't had to answer these types of questions because you don't get funding for a program if someone doesn't think its a good idea. But now, people are asking questions about how tax money gets spent and funding decisions get based on the answers to the questions raised by outcomes measures. For example, let's talk about suicide. Generally most of us think that suicide is a bad thing. We think we should try to prevent people from killing themselves. Someone gets the idea that if there was someone around to talk to, who could hook suicidal people up with appropriate help, maybe we could prevent some suicides from happening. So, we authorize funding a suicide hot-line. Now simple output measures would be to say we got 3650 calls on the suicide hot-line last year and we got 365 people placed in the psych ward for intervention services. In times gone by that would probably have been sufficient to demonstrate the 'need for continued funding.' But now people are asking questions like, "How effective are your services? How many of the 365 people you got committed killed themselves anyway? Or, how many of the 365 were repeat customers (indicating that whatever the 'intervention' was, it wasn't effective at moving the consumer out of the 'at-risk' category)? Human services types have had a tendency to hide behind the idea that there are so many variables involved in human behavior that it isn't fair to hold them accountable for outcomes. But with public funding (i.e. available tax money) stretched so thin, human services agencies are being asked to be accountable for their results anyway. And, I support this idea. If a program can't demonstrate that it is doing what it was set up to do, it shouldn't expect to continue to be funded. OK, enough background. The Federal Department of Health and Human Services is trying to help state departments of aging improve their outcomes measures. I'm going to quote the grant description, because frankly, I couldn't possibly make this stuff up:
Only the Federal Government could come up with a program to award money for Standard POMP and Advanced POMP. by CziltangPosted: Monday, August 23 2004 10:47:48 PM
It isn't all bad
link Some time back I wrote about my frustration with the lack of resources available for dealing with mentally ill clients. In particular I wrote about one individual who I called Bob. Since that time, due in large part to a fair amount of pressure and scrutiny from the local judiciary (OK, the Judge had some of the Mental Health people who were allegedly working on Bob's case subpoenaed into Court to explain, on the record, why Bob couldn't get the services he needed) Bob got a second chance. I have to admit (albeit grudgingly) that when properly motivated, the local Mental Health people can do some pretty good work. Bob was returned to our facility. The Mental Health folks put together a viable plan for assistance. When the pieces were in place, Bob got to go out into the community. Bob is currently stable, living in a group home, working part-time and doing repair and maintenance work at the group home. The Mental Health folks staged a celibration lunch for him the past Friday. I was mildly surprised that they invited me (although less so when I found out they weren't picking up the tab). I am not surprised that Bob is doing well. I was a bit surprised to find that the Mental Health folks seem to have decided that Bob isn't really that hard to work with. Perhaps they will be a bit less resistive the next time someone like Bob comes along. by CziltangPosted: Sunday, August 22 2004 09:48:02 PM |
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