The Human Services Value Curve: From Concept to Execution

By Tracy Wareing Evans    July 2016

Throughout my travels this summer, I have had the opportunity to spend time with many of our members, partners, and other transformative leaders steering our collective work. One theme that continues to emerge in our conversations is the Human Services Value Curve. I have even heard things like, "APHSA... aren't you the Value Curve people?" How cool is that?! The Value Curve (VC) is helping to lead a broad spectrum of changes across the health and human services landscape and we are thrilled to be one of the many key players pioneering this work.

Since its introduction in 2010 by Antonio Oftelie and Harvard's Leadership for a Networked World, we are seeing more and more examples of agencies and their community partners applying the VC through a range of actionable strategies, and winning stakeholder support for advancing through its four stages. For those of you not yet accustomed to the VC, it describes how health and human services are provided to those we serve a four progressive levels of value, each building from and expanding the consumer value delivered at the more formative levels:

  • At the Regulative level, consumers receive a specific product or service that is timely, accurate, cost-effective and easy to understand. Many agencies and systems around the country are focused on achieving efficient and effective service within a specific program area, and to a large extent this is good for consumers. But we know that there are value limitations of sending those we serve through many program doors, engaging them within a limited program scope, or focusing primarily on program compliance and related output goals as measures of our own performance and value, whether or not these outputs have the desired consumer impact.
  • At the Collaborative level, consumers “walk through a single door” and have access to a more complete array of products and services that are available “on the shelf.” At this level, agencies with their partners focus on cross-programmatic efficiency and effectiveness, often requiring operational innovations like unified intake and eligibility systems, cross-program service plans that address multiple consumer needs, and shared data platforms or protocols to support these integrated services. Certainly a big step up in value for consumers, but not the best we can do.
  • At the Integrative level, products and services are designed and customized with input from consumers themselves, with the objective of best meeting their true needs and enabling positive outcomes in their lives. The focus at this stage is on more consultative consumer engagement methods, product and service flexibility, and enhanced service delivery. This is all geared toward supporting people to prevent problems upstream, versus fixing or recovering from them downstream. This all requires redefining casework practice and skills, providing real-time technology tools for caseworkers, establishing new forms of data and analysis geared toward problem prevention, and instituting highly adaptive program design and funding mechanisms.
  • At the Generative level, different organizations providing various products and services are joining forces to make the consumer’s overall environment better for them, resulting in value that is broader and more systemic than an individual or family might receive directly. At this stage of value, agencies with their partners focus on general consumer advocacy and co-creating capacity at a community-wide level as a means to meet consumer needs. This requires collective efforts targeted at community-level infrastructure building, and enhancing societal beliefs and norms about government in general, and those we serve in particular. This ultimately results in greater commitment to leveling the playing field, plugging everyone into the community as a whole, and employing practical solutions that work.

The VC stages must be seen as mutually reinforcing building blocks that, each in turn, enable future stage progression. This is particularly true at the regulative level. While initially viewed as an "inferior" stage, a number of leaders reported that improving and strengthening a foundation of sound regulative work is frequently the necessary first step to moving beyond that stage and up the VC.

For many agencies, the VC framework has provided a more comprehensive structure to their work and strengthened initiatives already in place. Many leaders have found the VC frame to be highly persuasive and attractive to policymakers and other stakeholders because of its focus on customers, service and impact.

One local agency emphasized its use of the VC for working with customers at the personal level; consumers in that county designed their own "Family Value Curve" tool that engages individuals and families in planning and executing their personal movement up the VC. Agency leadership is using the insights and knowledge that customers bring to the table to strengthen the progress and impact of self-sufficiency planning, often with dramatic results – a clear advantage of problem solving with families, not for them.

Another common VC theme is the importance of greater alignment with and connection to the health sector. Several state commissioners are developing stronger relationships with their health sector peers around these concerns and believe VC principles will be key in illuminating the opportunities and advantages for both sectors. Many state and local leaders also point to the growing adoption of a "culture of health" model that has substantial value for both sectors, even though it is currently used far more frequently in the health sector. Taking full advantage of this perspective will require a broader understanding of what overall "health" truly means – a state of well-being that goes well beyond the traditional medical and physical sense of the term.

At APHSA, we capture the learnings from our members and partners and are committed to supporting our members in Value Curve progression — a system that drives transformation and enables all people to realize their full potential. If you are interested in learning more about how our consulting team supports members and partners, please visit the APHSA Organizational Effectiveness page or contact Phil Basso, Director, Organizational Effectiveness (OE), at [email protected].

About the Author

Tracy Wareing Evans (full bio)

President and CEO
American Public Human Services Association

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