2.12 How do we identify what works to improve conditions of well-being?

The Short Answer

1. Look at the research, but don’t be limited by research. Find out what has worked in other places to turn the curves you are working on. But research will never give us all, or even most, of the answers. Use your common sense and knowledge of your community to decide what will work here.

2. Consider no-cost and low-cost ideas. Money is important, but it is not everything. The community has more energy than money can buy. When people are given permission to think about no-cost and low-cost actions, often half to two-thirds of their ideas can be accomplished without new money.

3. There are two pointers to what works in the preceding steps of the process. Each element of the story behind the baseline is a pointer to action. And each partner or potential partner is a pointer to action.

4. Rate your ideas against criteria. Consider SPECIFICITY (Is this idea actionable?); LEVERAGE (How much impact will it have on the curve?); VALUES (Is it consistent with our personal and community values?); and REACH (Is it feasible and affordable this year, next year, 2 to 10 years).

5. Fit the pieces together. Having selected priorities for action is not the same as having a coherent plan. We need to consider how these pieces fit together in a system of services and supports, not just a loose confederation of good ideas.

What works, what could work, to turn these conditions around? What would it take to have all children zero to age five healthy and ready for school? What would it take to have all children succeeding in school? The answers are a combination of science and common sense. The following sections do not give the answer (no one can), but they do offer an approach for you and your partners to figure out for yourselves what will work to turn the curves in your community, city, county or state.

• Look at the research. The science part is about the research that has been done over the last 20 plus years on programs that actually make a difference in the well-being of young children and their families. While some of this is still controversial, we know that quality child care, regular health care, family support, and parent education all play a key role in the healthy development of children.
• Don’t be limited by research. The common sense part is that not all things that work have been proven by the research community. What works ideas should build on your experience and what you and your partners know about the community in which you live. What do you think would work here? Involve as many partners as you can in this thinking process, including the parents of young children. Be disciplined about this part of the work as well. Not all ideas are good ideas. Test each idea against the question: AWould this make a difference in the well-being of young children and their families? Would it help turn the curves we are trying to turn?
• Consider what has worked outside the county. There is a growing body of experience from other counties, states and countries about what works to improve the well-being of children and families. These are sometimes referred to as best or promising practices. And a number of books, journals, and websites provide access to this experience. Localities with successful efforts are usually willing to host visitors, and this can be a powerful way to get beneath the surface of advertised claims to what really worked or didn’t work. Some technical assistance centers can help arrange site visits or peer-to-peer consulting within California and across the country. It goes without saying that what works in one community may not work in another. So, look for experience in counties and communities with economic and demographic characteristics similar to your own.
• Consider no-cost and low-cost ideas. No-cost and low-cost ideas can be among the most powerful parts of your plan. We have a tendency to think about everything as a money problem. And while money is certainly important, it is not the only way to turn a curve. There are many ways for partners to make contributions to this work (e.g. use of volunteers, advertising by the media, family-friendly policies by the business community, support groups by the faith community, streamlined policy or procedure by public agencies, etc.) that make a crucial contribution at low cost and without using public funding sources. When groups are given the challenge to turn a curve (say for reading scores or immunization rates) and are asked to include at least one no-cost or low-cost idea, it often happens that half to two-thirds of the good ideas are no-cost or low-cost. The simple act of asking for no-cost and low-cost ideas has the effect of changing people’s mindsets.

**Remember: The purpose of the work is not how to spend the money we have. It’s how to get the results we want.

• Use pointers to action. There are two pointers to what works in the preceding steps of the process. Each element of the story behind the baseline is a pointer to action. And each partner or potential partner is a pointer to action. The group should seek advice from a wide range of partners on what it would take to get all children healthy and ready for school. Then, ask each partner the following questions:
  • What is your best assessment of whether our children are now healthy and ready for school and why?
  • What could work in this county to improve this situation (including no-cost and low-cost ideas)?
  • What can you contribute (time, money, and expertise)?
  • How do we create a strategy to turn a curve or set of curves (i.e. actually measurably improve the well-being of children, adults, families or the community as a whole)?

The kind of process described above usually ends up with a long laundry list of everything anybody ever thought was a good idea to do for children and families, completely undisciplined, and completely unaffordable. The trick in this work is not to create such a laundry list, but a coherent strategy, that we can actually afford to implement that will actually produce the results we want.

Technique to assess your what works ideas against criteria:

One way to do this is to assess the what works ideas according to established criteria. Four criteria are offered for your consideration:

• Specificity: Is the proposal specific about what will be done, when, and by whom, or is it a rhetorical statement of need like curing poverty or disease? Proposals need to take the form of specific and actionable items that can be funded and implemented.
• Leverage: How great an impact will this proposal have on the curves we are trying to turn? We are looking for actions that are high leverage, not token efforts.
• Values: Is the proposal consistent with our personal and our community values? There are many proposals that are potentially effective but violate important principles of equity and fairness. The best approaches must be true to community values and must take into account differences in cultures and community norms.
• Reach: Is it feasible and affordable? Can it be done this year, next year, or in 3 to 10 years? These criteria can help space out our efforts over time.

What works ideas can be rated on a worksheet against these criteria. We are looking for actions that are high on all four criteria: actions that are specific, high-leverage, consistent with our values, and that can be implemented sooner rather than later. Each proposal can be rated high, medium, or low on these four criteria. Those that rise to the top can become the first year’s plan. Others that are high on the first three criteria, but lower on the fourth can be targeted for later years.

If you run this process as an exercise, here are some methods to consider:

• The work should start with a list of proposed actions.
• Break people up into groups of 6.
• Ask one person in each group to be the representative for each criterion. So, one person would be the representative for specificity, one for leverage, and so forth.
• Ask the people who are the specificity representatives to raise their hands. Your job is to make sure that the group is talking about something that could actually be done, not something vague and rhetorical. “Everyone has housing” is vague. In contrast, “Build 3 new units of low-income housing” is specific.
• Ask the people who are representatives for leverage to raise their hands. Your job is to make sure we’re not kidding ourselves about this work. Will this really make a difference, or is it a token effort?
• For the representatives for values: your job is to make sure that we are true to our personal and community values. There are many actions that are specific and high leverage that are not consistent with our values. For example,  if you wanted to reduce the child abuse rate, you could just stop doing abuse investigations – this is very specific but not consistent with our values.
• For the representatives for reach: your job is to make sure this can actually be done, and to help think about when and what it would take to do it.
• Point out that this is an opportunity to fix the proposals. If something is not specific enough, then make it more specific.
• Finally, when using the Low | Medium | High rating system, it’s OK if the ratings are L-M or M-H. .. or even L-H where the group simply can not agree. Encourage groups to listen to dissenting opinions, as there is always the danger of “group think” and it is not uncommon to see one person’s view turn around a group.

• Fit the pieces together. Selecting priorities for action is not the same as having a coherent plan. We need to consider how these pieces fit together in a system of services and supports, not just a loose confederation of good ideas. This means consideration of the charge in Prop 10 to create a comprehensive, collaborative, integrated, consumer-oriented and easily accessible system of services and supports for young children and their families.

Create a special part of the process (a subcommittee or task force) to look at:

• How the system of services is configured,
• the parts of the system that are difficult for families with young children to access or negotiate,
• how services can be made more accessible to families of different cultures, and
• the walls we have to break down between service systems to lessen duplication and bureaucracy.

This group may identify additional action items which require funding, such as the creation of a resource and referral network for child care, the placement of new screening and diagnostic services in family centers, or the addition of evening and weekend hours for health care or child care services. These can be added to the what works agenda and ranked against other proposals.

Many of the changes necessary to improve the service system will involve no-cost and low-cost actions such as the collocation of existing services, the creation of common forms across systems, shared intake and assessment services, or wrap-around funding for children in out of home care.

One community focused on making the system accessible. Every point of contact with the parents and children were knowledgeable workers who could help clients access any service. Another image which might be helpful is that of a service system with a “front room” and a “back room”. In the front room, families and children get what they need in a seamless, culturally competent and consumer-friendly way. In the back room, we run the financial and technical systems necessary to make the front room work.

The product of this work should be a visual map of how the service system now looks, and how it should look, from the consumer’s point of view. This can be used as a tool to move the system to become more friendly to families with young children.

**Remember: The purpose of this work is not planning. The purpose of this work is doing. There is a tendency for planners to become so enamored with their planning process that they forget there are other things to do in addition to planning. It is necessary to do the best planning possible without letting the planning process itself become the point of the work.