Southeast Minnesota: Regional Human Services Delivery Authority

Twelve counties are creating a regional service delivery authority that enhances quality and service outcomes, improves access and reduces costs.

A powerful combination of economic challenges, changing demographics that increased demand for human services and a lack of resources to meet performance outcomes had placed the region on an unsustainable path.

In response, 12 southeast Minnesota counties, with funding from the Bush Foundation, set out to address rising caseloads and reduced federal and state funding for public services, as well as increased demands for accountability in delivering program outcomes. They turned to Accenture to develop a human services delivery model that focused on moving from a county-based to a regional approach.

Accenture, along with county leadership, the Bush Foundation and state administrators, created a strategic plan including a redesigned operating model and business case for an innovative multi-county human services delivery organization. The newly designed multi-county framework for human services delivery would reduce overall costs by 15 percent, yield economies of scale and enable the 12 counties to deliver higher quality, more accessible services for citizens.

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Federal and state contributions to county-based human services programs have dropped significantly—from more than 70 percent of many county human service budgets in 2003, to less than 50 percent of many counties’ budgets today. The financial burden has shifted to the counties themselves, but at the same time, more citizens are turning to counties for help with human services. In addition, the Minnesota legislature passed legislation requiring counties meet certain performance outcomes for their human services programs.

Recognizing the rising workloads, declining staff, service delays and the need to provide consistent, high-quality outcomes to consumers, 12 counties in southeast Minnesota decided to take action, joining together to change the course of human services delivery in the region.

“We saw the potential to significantly increase our service capacity and develop more extensive expertise amongst our staff by working together and aligning some of our more administrative functions, and sharing those so that we could direct resources into service capacity rather than doing duplicative administrative activities in each of our individual 12 agencies. I saw a lot of opportunity for shifting where those resources were expended,” said Jane Wilcox Hardwick, director of Dodge County Human Services.

With funding from the Bush Foundation, the 12 southeast Minnesota counties selected Accenture to develop a new human services delivery model.

Accenture formed a cross-functional team of experts that specialize in areas including human services delivery, cross-jurisdictional collaboration, shared services and human services strategy. Collaborating with county human services directors and program supervisors, the team set out to build a human services organization from the ground up. They began by asking three key questions: how do we regionalize human services that are currently delivered independently by each county, how do we redesign delivery of human services in these counties and how much will it cost?

They embarked upon a discovery phase in which the team explored the types of programs the counties were managing, current capabilities and caseloads, the technologies they used, leading practices and the geographical factors that affect service delivery.

Using insight gained through this analysis, they developed a future services model that would help these counties achieve three critical goals: enhancing quality and service outcomes, improving access and reducing costs.

The Southeast Minnesota Redesign Project model shifts the cost curve for human services across the region down 15 percent, illustrating that the 12 counties could achieve significant savings if human services needs are managed and delivered on a regional basis. The counties collectively stand to save almost $35 million over the first five years, which amounts to a 7 to 9 percent reduction in total expenditures over projected spending in the region. Factoring in federal and state savings to human services funding, the redesign could yield more than $60 million in total tax dollar savings to the region over the first five years.

In addition to savings, the new model offers benefits to key stakeholders and consumers, including:

• Counties would access an expanded and consistent menu of regional human services that include volunteer coordination and drivers to help people use the services, expanded in-home counseling services for children and families, and homelessness and housing support programs.

• Citizens would access human services online and by phone, as well as in person and in locations that may be more convenient for them, giving the public more opportunities to reach services at the times and locations that work for their lives.

• The regional service delivery authority (SDA) would be led by a board of directors of area county commissioners, thereby offering continued regional control over human services delivery decisions.

The 12 counties participating in the development of the human services delivery model are Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha, Waseca and Winona.