2.12 How do we identify what works to improve conditions of well-being?

The Short Answer

1. Look at the research, but don’t be limited by research. Find out what has worked in other places to turn the curves you are working on. But research will never give us all or even most of the answers. Use your common sense and knowledge of your community to decide what will work here.

2. Consider no-cost and low-cost ideas. Money is important but it is not everything. The community has more energy than money can buy. When people are given permission to think about no-cost and low-cost actions, often half to two thirds of their ideas can be accomplished without new money.

3. There are two pointers to what works in the preceding steps of the process. Each element of the story behind the baseline is a pointer to action. And each partner or potential partner is a pointer to action.

4. Rate your ideas against criteria. Consider SPECIFICITY (Is this idea actionable?); LEVERAGE (How much impact will it have on the curve?); VALUES (Is it consistent with our personal and community values?); and REACH (Is it feasible and affordable this year, next year, 2 to 10 years).

5. Fit the pieces together. Having selected priorities for action is not the same as having a coherent plan.   We need to consider how these pieces fit together in a system of services and supports, not just a loose confederation of good ideas.

Full Answer

  • Given the results we want (children healthy and ready for school) ;
  • Given the indicators of those results and the story behind the indicator baselines;
  • Given the partners around the table

What works, what could work, to turn these conditions around? What would it take to have all children zero to age five healthy and ready for school? What would it take to have all children succeeding in school? The answers are a combination of science and common sense.  The following sections do not give the answer (no one can) but rather offer an approach for you and your partners to figure out for yourself what will work to turn the curves in your community, city, county or state.

!   Look at the research. The science part is about the research that has been done over the last 20 plus years on programs that actually make a difference in the well-being of young children and their families. While some of this is still controversial, we know that quality child care, regular health care, family support and parent education all play a key role in the healthy development of children. The chart displays the references in the Prop 10 legislation to what works. Prop 10 commissions should use these categories as a starting point for considering what works. There are some references in the appendices to other what works resources.[9]

!   Don’t be limited by research. The common sense part is that not all things that work have been proven by the research community. What works ideas should build on your experience and what you and your partners know about the community in which you live. What do you think would work here? Involve as many partners as you can in this thinking process, including the parents of young children. Be disciplined about this part of the work as well. Not all ideas are good ideas. Test each idea against the question: AWould this make a difference in the well-being of young children and their families? Would it help turn the curves we are trying to [email protected]

!   Consider what has worked outside the county. There is a growing body of experience from other counties, states and countries about what works to improve the well-being of children and families. This is sometimes referred to as Abest @ or Apromising @ practice. And a number of books, journals and websites provide access to this experience. Some of these are listed in Appendix A. Localities with successful efforts are usually willing to host visitors, and this can be a powerful way to get beneath the surface of advertised claims to what really worked or didn =t work. Some technical assistance centers (also listed in Appendix A) can help arrange site visits or Apeer to peer @ consulting within California and across the country. It goes without saying that what works in one community may not work in another. So, look for experience in counties and communities with economic and demographic characteristics similar to your own.

!   Consider no-cost and low-cost ideas. No-cost and low-cost ideas can be among the most powerful parts of your plan. We have a tendency to think about everything as a money problem. And while money is certainly important, it is not the only way to turn a curve. There are many ways for partners to make contributions to this work (e.g. use of volunteers,   advertising by the media, family friendly policies by the business community, support groups by the faith community, streamlined policy or procedure by public agencies etc.) that make a crucial contribution at low cost and without using public funding sources.[10] When groups are given the challenge to turn a curve (like reading scores or immunization rates), and are asked to include at least one no-cost or low-cost idea, it often happens that half to two thirds of the good ideas are no-cost or low-cost. The simple act of asking for no-cost and low-cost ideas has the effect of changing peoples= mindsets.

Remember : The purpose of the work is not how to spend the money we have. It=s how to get the results we want.

!   Use pointers to action. There are two pointers to what works in the preceding steps of the process. Each element of the story behind the baseline is a pointer to action. And each partner or potential partner is a pointer to action. The group should seek advice from a wide range of partners on what it would take to get all children healthy and ready for school. Then ask each partner the following questions:

  • What is your best assessment of whether our children are now healthy and ready for school and why?
  • What could work in this county to improve this situation (including no-cost and low-cost ideas)?
  • What can you contribute (time, money and expertise). How do I create a strategy to turn a curve or set of curves? (i.e. actually improve the measurable well-being of children, adults, families or the community as a whole)

Criteria for selecting what works and crafting them into a strategy

The notion of tables

The kind of process described above usually ends up with a long laundry list of everything anybody ever thought was a good idea to do for children and families, completely undisciplined and completely unaffordable. The trick in this work is not to create such a laundry list, but a coherent strategy, that we can actually afford to implement that will actually produce the results we want.

See the

What Works
Criteria Worksheet

Technique toAssess your what works ideas against criteria. One way to do this is to assess the A what works @ ideas according to established criteria. Four criteria are offered for your consideration:

Specificity: Is the proposal specific about what will be done, when and by whom; or is it a rhetorical statement of need like Aend poverty and cure [email protected] Proposals need to take the form of an actionable item which can be funded and implemented.

  Leverage: How great an impact will this proposal have on the curves we are trying to turn? We are looking for actions which are high leverage, not token efforts.

Values: Is the proposal consistent with our personal and our community=s values. There are many proposals which are potentially effective which violate important principles of equity and fairness. The best approaches must be true to community values and must take into account differences in cultures and community norms.

Reach: Is it feasible and affordable? Can it be done this year, next year, or 3 to 10 years. This criteria can help space out our efforts over time.

What works ideas can be rated on a worksheet against these criteria. We are looking for actions which are high on all four criteria: actions which are specific, high leverage, consistent with our values and which can be implemented sooner rather than later. Each proposal can be rated high, medium or low on these four criteria. Those that rise to the top can become the first year’s plan. Others that are high on the first three criteria, but lower on the fourth can be targeted for later years.

If you run this process as an exercise, here are some methods to consider:

  • The work should start with a list of proposed actions.
  • Break people up into groups of 6.
  • Ask one person in each group to be the ombudsman for each criteria. So, one person would be the ombudsman for specificity, one for leverage and so forth.
  • Ask the people who are the specificity ombudsmen to raise their hands. Your job is to make sure that the group is talking about something that could actually be done, not something vague and rhetorical. “Everyone has housing” is rhetorical. “Build 3 new units of low income housing” is specific.
  • Ask the people who are ombudsmen for leverage to raise their hands. Your job is to make sure we’re not kidding ourselves about this work. Will this really make a difference or is it a token effort?
  • For the ombudsmen for values: Your job is to make sure that we are true to our personal and community values. There are many actions that are specific and high leverage that are not consistent with our values. If you want to reduce the child abuse rate, just stop doing abuse investigations – very specific but not consistent with our values.
  • For the ombudsman for reach: Your job is to make sure this can actually be done, and to help think about when and what it would take to do it.
  • Point out that this is an opportunity to fix the proposals. If something is not specific enough then make it more specific. etc.
  • Finally, when using the Low Medium High rating system, it’s OK if the ratings are L-M or M-H. .. or even L-H where the group simply can not agree. Encourage groups to listen to dissenting opinions as there is always the danger of “group think” and it is not uncommon to see one person’s view turn around a group.

!   Fit the pieces together. Having selected priorities for action is not the same as having a coherent plan.   We need to consider how these pieces fit together in a system of services and supports, not just a loose confederation of good ideas. This means consideration of the charge in Prop 10 to create a comprehensive, collaborative, integrated, consumer oriented and easily accessible system of services and supports for young children and their families.

Create a special part of the process (a subcommittee or task force) to look at

  • how the system of services is configured,
  • the parts of the system that are difficult for families with young children to access or negotiate, and
  • how services can be made more accessible to families of different cultures
  • the opportunities we have to break down walls between service systems and lessen duplication and bureaucracy.

This group may identify additional action items which require funding, such as the creation of   a resource and referral network for child care, the placement of new screening and diagnostic services in family centers, or the addition of evening and weekend hours for health care or child care services. These can be added to the what works agenda and ranked against other proposals.

Many of the changes necessary to improve the service system will involve no-cost and low-cost actions such as the collocation of existing services, creation of common forms across systems, shared intake and assessment services, or wrap around funding for children in out of home care.

One community labeled their work to make the system accessible ANo wrong [email protected] meaning that every point of contact with the parents and children should involve knowledgeable workers who could help access any service. Another image which might be helpful is that of a service system with a Afront [email protected] and a Aback room. @ In the front room, families and children get what they need in a seamless, culturally competent and consumer friendly way. In the back room we run the financial and technical systems necessary to make the front room work.

The product of this work should be a visual map of how the service system now looks, and how it should look, from the consumer s point of view. This can be used as a tool to move the system to become more friendly to families with young children.

Remember: The purpose of this work is not planning. The purpose of this work is doing. There is a tendency for planners to become so enamored with their planning process they forget there are other things to do in addition to planning. It is necessary to do the best planning possible without letting the planning process itself become the point of the work.

A special note about service system reform. Systems reform has become a code word for making sense out of the highly categorical system of services which have grown up over the past 50 years. We now operate a system where it is entirely possible for the child welfare, juvenile justice, mental health and education systems to all be working with the same familyand not even know it. It is very important that we do the work necessary to make these systems work as one. But it is equally important that we keep these reform efforts in perspective. Systems reform of whatever sort is a means to improving results for children and families, it is not an end in itself. Take child welfare for example. We could have the best functioning child welfare system in the world, and rates of child abuse could continue to rise. The child welfare system is like the MASH unit in the Korean war, taking in casualties. Expecting to end child abuse by fixing the child welfare system is like asking the MASH units to end the Korean war.

Front Room – Back Room: One useful and powerful image which can be used to describe the intent of systems reform efforts (as part of larger strategies to improve results) is the idea of front room and back room. (NOTE: Cite first reference to this idea in one of the CSSP or FP papers.) One day we would like to have a service system which has a front room and a back room. In the front room, children and families will get what they need, based on what they need, not this crazy collection of categorical programs we have created. In the back room we’ll categorize the hell out of them so we can claim every conceivable dollar to pay for what’s in the front room. Right now we have just a back room. And as a consequence the funding system very often drives the service system, when it should be the other way around.

An important implication or corollary of the front-room back room image is that it is not necessary to fix the financing system for services before fixing the service system itself. The accumulation of funding requirments from federal state and local laws is enormously complex, and it is unlikely that there will be any coordinated action any time soon to make sense of it. But the funding system is often used as an excuse for not trying to make sense of the service system. This is just an excuse. If you can figure out what you want the front room to look like, then creative fiscal people and other partners can make it happen.

Marc2.12 How do we identify what works to improve conditions of well-being?