Lean in Human Services: Developing an Agency-Wide Culture of Continuous Improvement

Alicia Kone, Owner and President, Koné Consulting

Brian Kerr, Senior Lean Consultant, Koné Consulting

Clarisa Simon, Staff Development Director, San Mateo County Human Services Agency

1

Developing an agency-wide culture of continuous improvement 2College Board benefits for low-income high school students 2

LEAN IN HUMAN SERVICESDeveloping an agency-wide culture

of continuous improvement

Overview of today’s session

1. Meet the San Mateo County Human Services Agency (HSA)

2. HSA’s engagement with Lean—method and results

3. HSA’s Lean Design Team

4. Challenges and opportunities of Lean in human services

5. Q&A

Developing an agency-wide culture of continuous improvement 3

San Mateo County

“All of California in one county.”

• ~750,000 population

• 2018 figures:• Medi-Cal: ~169,000 individuals

• CalFresh: ~37,000 individuals

4

San Mateo County Human Services Agency

Vision

“All San Mateo County residents enjoy a healthy, safe, prosperous, and collaborative community.”

Strategic Goals (2015-2020)

1. Customers: Achieve and Sustain a Healthy, Safe, and Productive Life

2. Workforce: Enhance Employee Skills to Support Excellence

3. Operations: Enhance Internal Infrastructure to Optimize Outcomes

4. Innovation: Harness Creativity and Interconnectedness as a Leading Human Services Agency

5. Collaboration: Cultivate Community Partnerships to Achieve Shared Goals

Developing an agency-wide culture of continuous improvement 5

What is Lean?

Lean is maximizing

customer value through

eliminating waste, with respect for

people

Developing an agency-wide culture of continuous improvement 6

HSA’s Lean journey—methods and results

• Initial state: several isolated, sporadic “Lean projects”

• October 2015: Lean transformation kicks off

• Economic Self-Sufficiency is the “model cell” for Lean, though all branches have been involved in continuous improvement

•

April 2017: Lean Design Team established

Developing an agency-wide culture of continuous improvement 7

Reduction in Renewal Backlog

Developing an agency-wide culture of continuous improvement 8

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

D E C - 1 3 S E P - 1 5 D E C - 1 5 M A R - 1 6 J U N - 1 6 S E P - 1 6 D E C - 1 6 M A R - 1 7 J U N - 1 7 S E P - 1 7

Timely Application Processing

Developing an agency-wide culture of continuous improvement 9

Jun-2015 Jun-2016 Jun-2017 Jun-2018

Healthcare Coverage 71% 80% 91% 82%

CalFresh (SNAP) 92% 86% 93% 92%

CalWORKs (TANF) 98% 92% 97% 98%

General Assistance 96% 92% 97% 98%

Reduction in Requeue Rate

Developing an agency-wide culture of continuous improvement 10

14%

4%

2%

1%0%

2%

4%

6%

8%

10%

12%

14%

16%

0

5,000

10,000

15,000

20,000

25,000

30,000

FY14-15 FY15-16 FY16-17 FY17-18

Volume Requeue Rate

CalFresh Payment Accuracy Rate

Developing an agency-wide culture of continuous improvement 11

73%

81%78%

95%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Jun-15 Jun-16 Jun-17 Jun-18

”Not just FCR!”Lean continuous improvements in…

• Employment Services• Learning needs assessment

• Job search assistance

• Economic Self-Sufficiency• Call center

• Lobby management

• Disability services

• Other programs

• Children and Family Services• Foster care

• Transportation

• Hotline

• Staff Development

• Administration

Developing an agency-wide culture of continuous improvement 12

Lean Design Team

• Volunteers from across HSA—from different branches, at different levels of the org chart

• 6 month training series in 2017, now meeting quarterly

• Started as “Lean Champions”—championing lean in their units, buildings, and with their peers

• Now the “Lean Design Team”—helping HSA design business processes in a Lean way (customer value, continuous improvement, respect for people)

Developing an agency-wide culture of continuous improvement 13

Developing an agency-wide culture of continuous improvement 14

Lean champions checklist

Checklist for all members of the group.

Expectation: if you’re on the team, you’re working towards checking all of these items off—NOT that you’d already done so.

Challenge: finding opportunities for each person to check the next item off their list.

Challenges of Lean in human services

• Getting everyone onto the same page (leadership, management, staff…)

• Lean isn’t just about making cars

• Developing shared agreement about “what good means”

• Measuring performance / setting goals and targets

• Fear and other responses to change

• Working across silos in a department or agency

Developing an agency-wide culture of continuous improvement 15

Possibilities for Lean in human services

• Getting all levels of an organization involved in solving problems

• Strengthening the organization’s “muscles” for adapting to change

• Developing an appetite for improving performance

• Everyone sees how they are contributing to the mission and purpose of the organization

• Happier staff

• Continuous improvement everywhere

Developing an agency-wide culture of continuous improvement 16

Questions?Thank you!

Developing an agency-wide culture of continuous improvement 17