Introduction to Outcomes Based Service Delivery in Southern Alberta David O’Brien MSW, RSW Southern Alberta Child and Family Services Authority

What is Outcomes Based Service Delivery? Outcomes Based Service Delivery (OBSD) is an approach to managing the expenditure of public funds to achieve social policy goals. It involves program management through measurement of outcomes achieved by clients. Isn’t this the way things have always been done? 2

Traditional Social Policy and Program Development To address social problems governments pass laws, creating a legal authority for a service delivery program. Government employees design and deliver services to mitigate the problem. Government is often both purchaser and provider of the service (schools, hospitals). In Children’s Services most intervention services have been purchased from community agencies. 3

Performance Measurement: Inputs Versus Outcomes Outcomes for ‘soft’ services such as child safety are believed to be difficult to measure. Performance measures are often based on inputs (cost per unit of service), rather than outcomes (observable benefit to a child). This puts the focus on efficient management of resources, rather than outcomes. Example: a parenting group class is offered because it is less costly than providing in home supports for the same families, but how do we know which makes children safer? 4

OBSD is About Ends Rather than Means Outcomes measurement is based upon a concrete, behavioral description of client capabilities post intervention. Not on the number of sessions attended, hours of service delivered, satisfaction surveys, or client self reports. Outcomes need to be observable to be measureable. OBSD is about achieving clearly defined ends (child safety), rather than facilitating the means to an end (providing services). 5

Mandate for Change Alberta Response Model (2001) Child, Youth and Family Enhancement Act (2004) Casework Practice Model (2007) All called for: Increased client engagement Shift towards prevention and early intervention from core protection Closer integration of Children’s Services into the community of family support agencies. 6

OBSD Calls for Change in Authority-Agency Relationships In traditional child protection work the authority completed its assessment of needs and intervention plan before contracting for services from community agencies. There was a hierarchy of workers and processes; the ‘deciding’ work was separated from the ‘doing’ work. This medical model based approach sees diagnosis as the highest skill. The ‘expert’ making the diagnosis is seen as best equipped to prescribe the treatment. OBSD calls for authority/agency partnership. 7

OBSD Calls for Principle-Based, Collaborative Practice OBSD was built from the principle: “Authority, agency and family will work collaboratively to identify needs, develop a single plan, and achieve agreed upon outcomes.” OBSD practice calls for joint authorship in the intervention process. 8

Collaboration is More than Co-operation But haven’t we always collaborated? CS has always co-operated with agency partners in the sense of coordinating our parallel processes; for example, an agency plan to complement the authority intervention plan. This is not the same thing as the authority and agency worker producing a joint plan through a shared process with the family. 9

OBSD: Interdependence versus Integration In OBSD the authority and agency workers do not become one. The authority worker alone retains delegated child protection authority and accountability. What we are working to accomplish: safety, security and healthy development for children is rooted in legislation and is not negotiable. Choices about how we accomplish safety (or who does what) are shared by the authority, agency and family working together. 10

Developing a Joint OBSD Process OBSD was founded on the belief that expertise for practice is embedded in the hard won knowledge, skills and abilities of front line staff of both the authority and agency in facilitating communication and intervention processes with families that build safety and wellbeing for children. This is the expertise used to develop the joint OBSD practice process. Developing the OBSD model was worker led. 11

Building OBSD Process in Partnership with Families OBSD process is a relationship based approach, rather than an expert model. Or working with, rather than working on people. Workers approach the family with an ‘attitude of not knowing’ and engages in a joint process of discovering what is and what might be, rather than what is not and what should be. The OBSD process was developed by workers through reflection on what could be seen to work with families. 12

OBSD and Signs of Safety OBSD can be done without use of the Signs of Safety and the Signs of Safety can be done without OBSD, however... In the Southwest Region the OBSD Pilot involved transitioning to Signs of Safety based practice as both are based upon the same principles of inclusive, collaborative, strengths- based, solution-focused, relationship- based practice. 13

Outcomes Based Learning Focusing on outcomes teaches us what works best with the families that we serve. Developing collaborative relationships with individual families teaches us what success looks like to them as well as to us. Strengths based solutions are specific to the family, requiring the service provider to custom build a family centered intervention through the development of an extended family and community based support network for the child. 14

Norming OBSD Thinking The experience of working in an OBSD model is demonstrating the real possibilities of partnerships in child protection; we produce better outcomes by working together. In OBSD practice agency and authority workers share joint accountability for their process with the family and the outcome; it’s not a case of mine plus yours, but ours. OBSD sees (extended) families and communities as full of resources, by including everyone with an interest in the child we build safety. 15

Interdependent Partnerships is Becoming the New Norm in Child Protection We look to the community to help us to complete this shift in practice. 16