Results Based Accountability The Fiscal Policy Studies Institute Santa Fe, New Mexico 1

What is RBA? RBA is a disciplined way of thinking and taking action that can be used to improve the quality of life in communities. It can also be used to improve the performance of programs, agencies and service systems. 2

Results Accountability is made up of two parts: Performance Accountability is about the well-being of CLIENT POPULATIONS For Programs – Agencies – and Service Systems Population Accountability is about the well-being of WHOLE POPULATIONS For Communities – Cities – Counties – States - Nations 3

DEFINITIONS RESULT or OUTCOME INDICATOR PERFORMANCE MEASURE A condition of well-being for children, adults, families or communities. A measure which helps quantify the achievement of a result. A measure of how well a program, agency or service system is working. Population Performance Children born healthy Rate of low-birthweight babies 4 Percent of eligible pre-natal clients enrolled in xyz home visiting program.

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The Matter of Baselines Baselines have two parts: history and forecast H M L History Forecast Turning the Curve OK?

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How much did we do? Program Performance Measures How well did we do it? Is anyone better off? Quantity Quality Effect Effort # % 9

How much did we do? How well did we do it? Is anyone better off? # Clients/customers served # Activities % Common measures e.g. client staff ratio, workload ratio, staff turnover rate, staff morale, % staff fully trained, % clients seen in their own language, worker safety, unit cost % Skills / Knowledge (e.g. parenting skills) # % Attitude / Opinion (e.g. toward drugs) # % Behavior (e.g. school attendance) # % Circumstance (e.g. working, in stable housing) # % Activity-specific measures e.g. % timely, % clients completing activity, % correct and complete, % meeting standard 10

How much did we do? How well did we do it? Is anyone better off? Least Important Quantity Quality Effect Effort Most Important Least Most Also Very Important

How much did we do? MDH Leadership Training How well did we do it? Is anyone better off? Number of employees receiving leadership training Percent of employees in the ELP who are satisfied with the leadership training program Quantity Quality Effect Effort # of employees who graduated from the ELP who were promoted to a leadership position % of employees who graduated from the ELP who were promoted to a leadership position

Program: _______________ Performance Measure (Lay definition) Performance Measure Baseline Story behind the baseline Partners Three Best Ideas – What Works No-cost / low-cost ONE PAGE Turn the Curve Report: Performance Action Plan

Select 3 to 5 Performance Measures at each level of the organization 3 - 5

How Population & Performance Accountability FIT TOGETHER

Contribution relationship THE LINK Between POPULATION and PERFORMANCE POPULATION ACCOUNTABILITY Result: Minnesotans are healthy Your role: Ensure a highly skilled and stable state public health workforce. CUSTOMER RESULTS PERFORMANCE ACCOUNTABILITY MDH Leadership Training Program 16 Number of employees receiving leadership training Percent of employees in the ELP who are satisfied with the leadership training program # of employees who graduated from the ELP who were promoted to a leadership position % of employees who graduated from the ELP who were promoted to a leadership position

Every time you make a presentation, use a two-part approach Result: to which you contribute to most directly. Population Accountability Program: Performance measures: Story: Partners: Action plan to get better: Performance Accountability Your Role

RBA at MDH  RBA 101 training sponsored by the Governor’s Office July 2012  RBA 101 for all managers and supervisors November 2012 OPI internal training, consultation, facilitation to:  Executive Leadership Team Consultation  Health Steering Team Consultation  Interested divisions/sections  RBA 101 for Local Public Health and MDH May 2013  EO requirement for Performance Measures by May

Population Accountability Track  MDH activities:  Health Steering Team developed results and indicators for the department  Use of RBA criteria  Communication power  Proxy power  Data power 19

Population Accountability Track  Next steps:  Monitor and communicate the data. Create a dashboard.  What curves need to be turned?  Divisions/Offices encouraged to develop additional indicators, as needed, and engage with community partners to “turn the curve” when appropriate. 20

Performance Accountability Track  Mark’s advice:  Identify performance measures  Simplify reporting  Turn the curve on performance  Post charts on the wall 21

Infrastructure and Support  Mark’s advice:  RBA expert in each unit  RBA Practice Community  Self Assessment Questionnaire  Highlight/communicate RBA success 22

Infrastructure and Support  MDH Activities:  Office of Performance Improvement expertise and support  Intranet resources and library  Train the Trainer - RBA Performance Measure Development 23

Where Does RBA Fit? 24

Where Does RBA Fit? 25

Where Does RBA Fit? 26

Where Does RBA Fit? 27

Resources: Trying Hard is Not Good Enough, Mark Friedman RBA Website: RBA Monthly Newsletter: archive2.com/?u=fb3578ba8f13ca fc9e&id=20214c10e7&e=1dbc0bff8f 28 Vermont Department of Health: