Independent process and impact evaluations of the predictive analytics tool are underway. Yet while it is too soon to know the tool’s impact, it has reinforced a 20-year trend in which Cherna and his staff have pushed boundaries and sought to leverage technology to help people in need. To that end, they are exploring the possibility of creating an analytics tool to prevent child abuse and neglect. More broadly, they are adhering to a mantra that Cherna has embraced since the start of his tenure. “You’ve got to really get out there and not be afraid,” he said. “Do the right thing, and the rest kind of takes care of itself.”
Montgomery County Department of Health and Human Services: Confidentiality in a Multi-Service Agency
In 2007, when Uma Ahluwalia became the Director of the Montgomery County Department of Health and Human Services (DHHS), she, too, faced the challenge and opportunity of leading an organization in transition.
For DHHS, the journey of reinvention and modernization had begun in 1994 when four departments had been merged into a single agency (DHHS) with the objective of producing “integrated, coordinated, and comprehensive service delivery.” Prior to Ahluwalia’s arrival, the different departments had formally integrated, collocated their services, and created a single administrative structure. Nonetheless, DHHS had not made significant headway on coordinating treatments and services. This was a problem, Ahluwalia explained, because many of DHHS’s programs served the same clients but were not in dialogue about how best to support them.
Early in her tenure, Ahluwalia therefore strove to produce more effective coordination across DHHS’s programs. This included establishing a uniform intake form for all services, which created a “no wrong door approach” and made it easier to determine if a client requires multiple services. DHHS also launched a single client database and record. This has helped to create more detailed information about who the department is serving and “promoted information sharing for service integration.”
Still, the most important of these coordination efforts involved clarifying DHHS’s standing under the Health Insurance Portability and Accountability Act (HIPAA), a 1996 law that established “national standards to protect individuals’ medical records and other personal health information....” This was critical because, if cross-agency information sharing violated HIPAA, different programs would not be able to share data and coordinate their efforts. After an extensive legal analysis, DHHS determined that the entire agency was covered by HIPAA. This meant that even social service and income support programs could share information with one another. What’s more, DHHS has established an extensive infrastructure and trainings to ensure compliance with all privacy and confidentiality regulations. This includes a six-week annual workshop in which DHHS brings together officials from different disciplines, who are accustomed to not sharing data (often because of industry standards and norms), and emphasizes the benefits of collaboration.