The Colorado Department of Human Services has the job of determining how state government can efficiently aid desperate poverty, how mental institutions can provide safety and care without adding harm or trauma, and assuring working parents that their childcare provider has quality.
That’s just three of 100 questions executive director Reggie Bicha and his department heads review each month under the C-Stat performance management meetings and measurements that keep a 5,000-employee bureaucracy, with a nearly $2 billion annual budget, rolling in the right direction.
More war room than red tape, C-Stat is how Colorado solves its most difficult problems for the state’s poorest and neediest residents. DHS services that range from government money and nutrition to youth detention and programs to prevent domestic violence and drug addiction.
“We deal with people often on the worst day of their life,” Bicha told Colorado Politics last week.
Bicha talked about how C-Stat, the engine behind the DHS machine, as Colorado’s performance management measure marks its fifth anniversary.
He and his department heads meet every Wednesday from 3 to 5 p.m. in a conference room the size of a 7-Eleven in DHS’s office tower a block north of the state Capitol. Tables are arranged in a cornered U to focus attention on a podium that stands in front of a projector screen.
Each department leader takes a turn up front and center to field ideas and talk about progress.
As a group, they take stock of every problem, try to break down the silos between departments to find solutions and discuss ways to measure that solution once it’s in progress. If it succeeds, they celebrate. If it fails, they talk about why and find another solution.
“The office director is responsible for the performance of these measures, so there’s a level of accountability, and their job is to come prepared to tell us where things are going well, why they’re going well and how do we get more of it,” Bicha explained. “And where things aren’t going well, why aren’t they going well and what are we going to do about it.
“And don’t tell me what we’re going to do about it in the next six months. Tell me what we’re going to do about it in the next six weeks.”
It started in Wisconsin
When Bicha came to Colorado in 2011, the state was under a court order to reduce the amount of time it takes to get food and financial assistance to the very poor. The counties administered the complicated, time-consuming enrollment. Less than half the time people couldn’t get their benefits within 30 days, as the law required. The more than half the time, the amount would be either too much or too little, Bicha said.
“C-Stat helped to give us a framework so we could look at why people were getting bad decisions in a bad period of time, what we needed to do about it, hold us accountable for fixing it and seeing if it got better,” Bicha said.
In January, DHS was released from the court order because it had raised its success rate above 98.7 percent.
Before joining DHS, Bicha was the first secretary of the Wisconsin Department of Children and Families, where he created a program similar to C-Stat called KidStat.
Started under Democratic Gov. Jim Doyle, Kidstat has continued under Republican Gov. Scott Walker.
When Gov. John Hickenlooper hired Bicha to fix Colorado’s long-beleaguered human services agency, the former Denver mayor was promising the administration would exercise the three Es of good government — efficient, effective and elegant.
“He said we were going to measure everything we did to know whether or not it was effective,” Bicha said of Hickenlooper. “And C-Stat gives us a way to operationalize one of the governor’s three E’s, which was effectiveness. Is government actually making a difference?
“In this case, in human services, people come to us because something is a problem in their life. And this is a way for us to know, ‘Is the result we’re doing resulting in them being better off. And how do we know that? What does it look like? And if it’s not, what are we doing about it to make it better?’”
C-Stat meetings bring attention to such problems as re-traumatizing mentally and emotionally fragile people at state institutions while trying to provide for their care and safety. He cited a hypothetical example of male staff members restraining a woman who has been traumatized by rape. Seclusion also can be detrimental to some patients who are in crisis, he suggested.
C-Stat led to a review of individual patient’s cases to see why they were restrained or secluded, including whether DHS employees might be resorting to the practice more than they should. The result was to try “verbal Judo,” how to talk someone down rather than hold someone down. The institutions set up “mini spas,” as Bicha called them, where patients could go voluntarily to relax in a recliner under weighted blankets and soft lighting while listening to soft music.
“They could de-escalate themselves, rather than us putting them in a seclusion room and locking the door,” Bicha said.
Transparency and results
The meetings and problem-solving also offer transparency and yield valuable data. The public can review the C-Stat issues and follow the progress on the department’s website.
“When we go ask for legislative or budgetary changes they’re almost always linked to something we’re looking at in CSTAT,” Bicha said.
“When it comes to child welfare workers at the county level, I can very clearly show what’s not getting done for kids and what performance issues are risk because the counties don’t have enough employees, enough social workers to do the work,” Bicha said.
With C-Stat, lawmakers and local government leaders work off common data and timelines.
“That sort of alignment is critical to make sure we’re all rowing in the same direction for the people we’re serving and we’re using the taxpayer’s resources as efficiently as we can, and most importantly, when people come to us, sometimes on the worst day of their lives they can have greater assurance we’re doing everything we can to make sure they’re getting the right service in the right way at the right time.
“And, lastly, if we’ve got stuff that’s not working, let’s stop doing that, alright?”
Bicha has no illusions about what happens when Hickenlooper is no longer the governor in a year and a half. Whether the governor is a Republican or a Democrat, he or she would probably bring in a new human services director, Bicha said.
“I hope people look back over these last eight years and say it wasn’t always the easiest road, but we always had a north star about being the most effective system,” he said. “Sometimes that meant confronting things that made people uncomfortable or uneasy, sometimes it meant getting myself in a little bit of trouble with other branches of government, but it always what was most important was the people we serve and the taxpayers who are resourcing us, and how do we make certain we’re focusing on them, as well.”