Frequently Asked Questions (FAQs)
What is the Transformation Initiative?
Transformation is the Department of Human Services (DHS) and Oregon Health Authority (OHA) approach to fundamentally changing the way we do business to provide more effective and efficient client services, and improved accountability to Oregonians. The goal of transformation is to build a foundation for continuous improvement so we are always doing our best work by constantly measuring our performance, quickly resolving problems and efficiently using our financial and human resources.
Why are we transforming?
Transformation is essential to ensuring a stable future for both agencies, on whom hundreds of thousands of Oregonians of all ages depend for medical care, cash and nutritional assistance, housing, child protection, addiction recovery, mental health and public health services, vocational rehabilitation and other services.
As with many organizations, large numbers of employees will be eligible for retirement over the next few years. The agencies need to have a reputation as leading 21st century organizations to attract top-flight talent. Legislators and members of the public who provide the agency's resources demand an efficient, transparent organization that gets the most out its resources to produce high-level outcomes for vulnerable Oregonians.
Why are we transforming now?
Projections show a continuing growth in demand for services with a revenue stream that is not keeping pace, supporting our belief that transformation needs to happen now. Given today's economic climate, we can't wait. The more efficient our services are, the more Oregonians we can serve. Our aim is to become model health and human services organizations over the next few years to help Oregonians be healthy, independent and safe.
Is transformation an agency re-organization?
No. From time to time, state agencies have been re-organized to improve the organizational structure. Several years ago, for example, a DHS re-organization introduced integration cross-divisional work and greater understanding that most clients depend on cross-divisional services. Out of this work came the "no wrong door" approach to clients obtaining services. The purpose of Transformation is different from a re-organization. Transformation is putting DHS and OHA on a path to being as good as any health or human services agency in the world. This includes changing the culture of the organization with a promise of employee-driven continuous improvement. Transformation is about maximizing the value of the existing workforce, reducing costs and boosting efficiency through process improvements.
How is transformation happening?
We worked with one of the world's best organizational advisers to take an in-depth look at how we do our work. Out of this work came the Transformation Initiative Roadmap to guide the transformation.
The roadmap is organized around five themes:
Getting more with the public dollar;
Engaging with our partners;
Working together across divisions;
Developing world-class people and culture, and
Doing the right work the right way.
There are 10 teams at work one for each of the six divisions and for four of five themes. The division teams are composed of employees from all levels within the division. The themes teams involve employees from all divisions. Each team has a charter, a roadmap, a project manager and a sponsor to provide goals, objectives and the tools to get the work done. The Transformation Initiative theme for doing the right work the right way does not have a separate team. All teams work with DHS and OHA Lean Leaders to address the theme through existing initiatives and process improvement events.
What are Lean Leaders and how do they support transformation?
Lean Leaders are employees who have volunteered to be involved in the Transformation Initiative. They receive ongoing training and support from the Transformation Office in Lean, a system of thinking designed to relentlessly pursue process improvements and reduce waste. Lean empowers workers to make improvements in their environment. Lean creates a sustainable structure and process for change and continuous improvement. It is customer-focused and employee-driven.
Lean Leaders are critical to the success of the Transformation Initiative. Using proven Lean techniques and working with each division's transformation team, Lean Leaders plan and facilitate the individual process improvement efforts with the participation of staff, partners and providers. Lean Leaders work at the "front lines" of transformation. Their work rolls up through their divisions into the agency level Transformation Initiative Roadmap where progress and results are tracked and reported. Lean Leaders use Lean tools such as rapid process improvement (RPI) events and the Lean Daily Management System (LDMS), which includes daily huddles and performance data tracking. Every day more employees are learning about Lean and using Lean strategies to work more effectively as individuals and as members of a team.
Aren't DHS and OHA doing a good job now?
Yes. In fact, it surprises people to learn that DHS, OHA and their contracted providers serve more than 1 million unduplicated people annually. DHS is the state's largest agency with approximately 7,000 employees and 160-plus offices, and like any large organization, it sometimes has ways of doing business that are associated more with "how we've always done it" than with best practices. Employees in every division, who are experts in how the agency has done business, are identifying barriers that can be removed to permit them to do their best work.
Among the barriers are bottlenecks and overly complicated requirements that slow down work; errors that result from outdated technology or non-standard processes; decades-old fee structures that don't pay for essential services; and large numbers of different contracts for providers who deliver similar services.
How will this affect the people whom DHS serves?
These people are the reason DHS and OHA exist, and will be the ultimate beneficiaries of transformation. These are examples of the kinds of outcomes the initiative can be expected to deliver: Eligible self-sufficiency clients will wait less time for benefits; people with mental illness will spend less time in unnecessarily restrictive settings, and the time an abused or neglected child spends in foster care will be measured in months rather than in years.
Will partners, providers and other stakeholders be affected?
Yes, making DHS and OHA better business partners is part of the goal. How DHS and OHA do business affects stakeholders in a variety of ways, such as how quickly and accurately providers get paid for the services they deliver. DHS and OHA are including appropriate stakeholders in the transformation process, gathering data from them in surveys, interviews and conversations with leaders.
Will transformation involve employee layoffs?
No. Standards show that if the number of employees were to change, the agencies would need hundreds more not fewer. Realistically, state budget limitations may never staff DHS or OHA at the ideal levels. Transformation outcomes will produce an increase in agency staff capacity by introducing efficiencies that permit employees to be redeployed to other areas where they are urgently needed. There also will be savings that can be redirected to client services.
How will changing the culture through transformation affect employees?
Employees are committed to effectively serving clients; that is clear from the work they do and from what they say in surveys. But they are sometimes frustrated by the barriers they can encounter in trying to do their work, which the Transformation Initiative is changing.
When culture is likewise transformed, DHS and OHA will be fully accountable agencies where people trust and respect each other, and a place that offers fulfilling work, a work-life balance and a focus on mentoring and coaching. In the new culture employees will have the tools to identify challenges within the agency and recommend solutions. Permanent Lean staff will support employees and continuous improvement efforts for clients, partners and other stakeholders.
How will we know when transformation is complete?
Although the work of transformation never will be "done," we will have arrived when its principles are a core value of the agencies and their people. The formal Transformation Initiative will last 2-3 years. Following the initiative, DHS and OHA will have cultures in which empowered employees are motivated to identify barriers and figure out how to remove them, making DHS and OHA better places for clients to obtain services, for employees to work and for partners and businesses to work with.