TeamTech helps a state rethink resource allocation
Maximizing resources while improving services is the greatest challenge faced by state and local governments alike. Among the myriad of services provided by local government in Kansas, incarceration of juvenile and adult offenders is arguably one of the costliest. Healthcare costs for prisoners, particularly costs of prescription drugs, have had a crippling effect on county budgets. Because the federal government requires county government to provide healthcare to inmates – counties have little choice but to absorb the growing costs.
TeamTech partnered with the Kansas Association of Counties (KAC) and the Kansas Governor’s Health and Human Services (HHS) Cabinet Team to identify and bring together decision makers from county government and state agencies to determine the best way to save money on medical care costs for incarcerated populations. TeamTech set up and led the process which included gathering the initial data on who was spending what on healthcare costs. Prescription drugs and hospital costs were the two largest contributors to cost and many counties also discovered that they had been spending way too much on prescription drugs.
TeamTech helped participants identify ways in which governmental entities, including county and state detention facilities can save money and improve efficiency.
As a result of the project, county officials soon discovered that they can save administrative costs in two ways:
- By contracting with companies that specialize in providing correctional healthcare to inmates, counties not only save money on prescription drugs but also on legal expenses and administrative costs. These private companies assist correctional agencies by providing correctional healthcare and carefully screening and managing billing for off-site health care services. Through these contracts, local physicians still provide medical care to inmates, but the local providers now must adhere to policies and procedures that work elsewhere to contain costs.
- By gathering and examining data on their prescription purchases, counties were able to either renegotiate with their current pharmaceutical drug companies for better prices – or take advantage of large volume pricing by combining purchases with other counties. In some cases, counties obtained better prices by contracting through the Department of Corrections for prescription drugs. And in a few counties, local pharmacists adjusted their rates to match the lower rates that large pharmaceutical companies were offering.
- More efficient delivery of services: This program has resulted in significant savings to the tax payer. Greater cooperation between state and local government has tangible benefits: The Kansas Department of Corrections projects an annual savings of at least $1.4 million and Sedgwick County alone predicts an annual recurring savings of $1 million.
- Counties see value in working together: This successful effort has laid the groundwork for other local government collaborations and enables increased compliance with state and federal regulations. (Link here to The Kansas Collaborative)
“TeamTech brought the groups together, facilitated the conversation and steered the teams in a positive direction. They had the tools necessary to take the information state-wide.”
“The key to our success was that we had the right people at the table and the data we needed to analyze our current situation and make necessary changes. TeamTech didn’t just facilitate the meetings, they worked tirelessly to make sure that assignments were completed between meetings and prodded during meetings to get the best results.”
Director of the Shawnee County Department of Corrections
Teaching leaders how to talk with people, not at them
Ann Howie, formerly with American Century Investments
Communication issues are on everyone’s top ten list. Why? Because managers have expanded their “communication loop” as involvement has grown. The new audience is more diverse and demanding. Managers and project leaders can spend up to 75 percent of their day listening, talking, reading and writing. As a result, the first challenge is realizing the most effective way to communicate so individuals and businesses can move forward.
What follows is a personal account of one project leader. She attended the custom-designed curriculum developed by Team Tech, and the Organizational Development Department of the large global asset management firm where she is employed.
“After reading the “Talking with, not at, people” course description, I hoped the workshop would provide ideas on how to find information that I needed to make more informed decisions. As a project leader, I hoped to expand my skills so that our project teams improved their communication and our projects could then move forward more efficiently and effectively.”
I attended the two-day course. Here is my assessment:
- TeamTech provided common sense concepts using real life applications.
- Listening topics that I’d heard, or read, before were presented with innovation and creativity, in a plain language manner that makes these concepts different and relevant, yet simple.
- The diary we kept during class that included future planning and the one-on-one classmate discussions, allowed me to develop, critique, apply, and stick with what I had learned – not just for a week or two, but for several months now.
- The questioning and pre-planning techniques have now become habit for me.
- The most poignant “Ah Ha” moment for me during class was realizing that leaders/managers don’t have to know/have all the answers themselves. What leaders need is an understanding of how to use the resources and people that surround them. You can be a leader, facilitator and/or guide without being the official “manager” or “project leader.”
- The class also provided tools to draw out missing information and fill in the gaps. I was very excited to learn that I could also use these concepts to guide meetings and conversations from the side without seeming bossy or rude and taking over.
In my personal and professional life (work, home, church, etc.) this course and the concepts taught provided many positive effects.
- As an analyst, project lead, co-worker, peer, daughter, sister, wife, and mom; nearly every day, I find myself asking my personalized version of the questions Kathleen and Joel provided during class. And yes, I still keep my reference list in my planner (it goes everywhere I do.)
- I’ve found that this approach brings about more open and honest participation and a stronger commitment to projects because ideas and resolutions come from everyone involved. It is a way to guide and influence others [and myself], but I am not telling (talking AT), I am sharing (talking WITH). People realize the topics via their own experiences and learn for themselves. All of this fosters ownership, teamwork, better communication overall, and win-win results.
- Practicing this for several months, I’ve found that people around me are adopting these same techniques. We accomplish more in shorter amounts of time, we trust each other more than we did previously, and we are more open and close than we were before. We collaborate and celebrate in coming up with solutions that are much better than if we’d worked on things on our own.
- I think another real benefit of the course is that Joel and Kathleen, by example, use these techniques to facilitate the entire class. You walk away having experienced the difference of being ‘spoken WITH’ versus being ‘spoken TO.'”
Process and protocol help turn an organization around
A not-for-profit agency, with more than $50 million in annual revenue, had grown exponentially overnight with the receipt of a state contract to provide adoption services for the children in state custody. Managing the many systems that needed to efficiently coordinate at this rate of growth reached a state of crisis. By June 2001, the organization was struggling to meet key operational and financial goals. The Board asked management to seek outside help to assist with process improvement. By early 2002, the organization’s ability to continue to operate beyond June 30, 2002 was questionable.
TeamTech was hired in April 2002 as a key partner to the Chief Operating Officer, the Executive Vice President of Human Resources and their respective teams. Our approach encompassed six key strategies:
- Assess and Understand. This initial assessment took two days to complete. A financial analysis was the first step. We quickly determined that our process improvement efforts needed to be expanded to a turnaround effort. Next, we focused on resources within the organization – which key processes were adding to net assets and which processes were draining net assets. We identified key values that would guide decision-making and potential process improvements, including adhering to best practices. Finally, we assessed internal leadership to tap strengths as well as supplement and address weaknesses.
- Identify, Link and Translate. Together with leadership, we identified the key organizational processes that linked to the critical performance indicators identified by the Board so we could closely monitor the impact of changes. Then, we translated these indicators into front-line language. For example, social workers became involved in calculating the number of children they needed to place each month to reach certain adoption placement percentage goals while maintaining best practices. As a result, associates beyond finance and top leadership became aware of the impact they had on the organization’s performance.
- Involve Those Impacted. We formed Process Improvement Teams, which included front-line staff members and supervisors, to focus on improving the operational processes that drain net assets. Leadership set goals for each team. Teams received process improvement tools “as needed” rather than through formal classroom training, and the core operating values became: data-driven, customer-focused, process- (not people) focused, and time- and budget-conscious. These teams were essential for four reasons:
- staff members needed some sense of control in the midst of the turnaround,
- the associates doing the work were the ones that knew how to improve it,
- individuals were encouraged to develop their analytical and decision-making skills so the improvement process could remain intact beyond our engagement, and
- we were able to increase our ability to assess morale and concerns. TeamTech initially facilitated all of the Process Improvement Teams.
- Focus, Focus, Focus. Due to the short time frame and crisis situation, actions were prioritized into three categories: immediate, mid-range and long-range. Actions that would positively impact the key performance indicators on or before June 2002 received immediate attention.
- Partner with, Mentor and Coach Key Leadership. We had to make tough decisions quickly. We met or talked daily with the Chief Operating Officer in our role as a sounding board, mentor and coach. We sat down regularly with the operations leadership team to help facilitate decisions pertaining to the redesign of the service delivery model. We suggested and validated strategies as well as raised questions to ensure thinking was as comprehensive as possible.
- Close the Accountability Loop. With the COO as the leader, we were fierce about deadlines and accountability. We created an action plan of who was to do what by when at the end of every meeting and used it as the agenda for the next meeting. We hammered away at the need to “close the feedback loop” so we would know if the changes made to improve processes had the intended results. We facilitated regular meetings with operations and finance staff members to study weekly cash flow statements, monthly financials and key performance charts to ensure understanding. We shared and celebrated the accomplishments of each Process Improvement Team.
The ability to move quickly and effectively was accomplished through the collaborative efforts of many departments and teams. Individual efforts were critical and surpassed expectations. Buy-in was built among the staff members by the leadership and participation of Operations and Human Resources.
- Within 60 days of the beginning of the engagement, the negative drain on net assets stopped, with surpluses in the following months;
- More than 450 people kept their jobs;
- Process Improvement Teams remain intact, and are now a regular part of the way the organization “gets things done;” and
- Children in state custody have continued quality and continuity of care.
Mentoring leaders helps strengthen large organization
A large state social service agency, with more than 6,000 employees and an operating budget of $1.8 billion, was challenged to streamline its operations. The FY03 state budget crisis intensified the challenge presented to the agency and its leadership. These challenges created the need for deeper integration of programs and a greater need for staff members to partner with the larger community.
The Agency’s Secretary and her executive team believed that the capacity to be both strategic and facilitative were critical competencies for the agency as it continued to meet growing service needs with fewer dollars and people. Further, she and the team wanted to model this new leadership style.
The Secretary and her seven person executive team committed a year of their time to increase their strategic facilitation skills by working with TeamTech.
TeamTech, in partnership with the executive team, designed a one-year mentoring program aimed at enhancing the team’s and each individual’s strategic facilitation capacity. This mentoring program included:
- A kick-off retreat to introduce the benefits of strategic facilitation and think through how to integrate the team’s strategic plan with this new skill set.
- Eight content sessions that focused the team on:
- Strategic processes which enable people to hold the relationship between the task at hand and the big picture. A critical skill when working with multiple stakeholders.
- Facilitative/Reflective processes which perpetuate the act of thinking and taking action together. A critical skill when managing a tightening fiscal situation, staff reductions and vocal stakeholders.
- Monthly practicums for the executive team and individuals to apply newly acquired strategic, reflective and facilitative skills to upcoming meetings, decisions and problem-solving sessions. These practicums provided opportunity for:
- Detailed planning and preparation;
- Facilitation practice and coaching;
- On-site observations and direct feedback; and
- Feedback and professional development.
- A closing retreat to evaluate the year and project the future.
- The Agency Secretary as well as the seven member executive team finished the one-year training program.
- The leadership team has a working knowledge of the following four skills, which helped them learn to strategically manage the everyday crisis rather than the everyday crisis managing them.
- Big picture thinking so that all the dynamics at play in a problem can be identified and a strategic response developed.
- Being intentional about what people need to know and experience to make good decisions and achieve an outcome.
- Building shared vision so employees and stakeholders can see the practical next steps that need to be taken.
- Facilitating meetings that demonstrate effective communication and collaborations.
- As individuals and as a team they developed competencies in strategic, facilitative and reflective processes – “All critical to the continuous reshaping of our business in ways that increase the value to the public.”
“TeamTech was the best fit for this need because of Kathleen and Joel’s experience and credibility within the agency. Everybody on the team believed they could help us reposition the organization in a rapidly changing environment with growing demand for services and fewer resources.”
Top-to-bottom audit – and creativity – help state save millions
The primary responsibility of the governor is to manage the public’s resources wisely. This is a challenge even in the best of times, but in the face of a serious budget shortfall, only the most innovative thinking will lead to a state government that is not only more efficient but more accessible to the citizens.
Shortly after her election in 2002, Kansas Governor Kathleen Sebelius made good on her campaign promise to conduct a top to bottom performance review of state government. She assembled more than 60 volunteers – from business leaders to citizens – to come up with suggestions for streamlining state government and making it more accountable to its people. The Governor and her transition team turned to TeamTech for help in managing the process and in assuring a successful outcome for participants and the citizens of Kansas
These first Budget Efficiency Savings Teams (BEST) identified potential dollar savings by conducting a top to bottom performance review of state government. More than just an audit, the BEST teams were also charged with coming up with innovative solutions and identifying new ways of doing state business. TeamTech was called on to design a process and establish a plan and framework for identifying solutions. TeamTech worked with private industry, citizens and policymakers to identify key values for improved decision making. Participants agreed that in order to bring about effective change, decisions on the future direction of state government must meet the following criteria:
- Customer focused
- Continuous improvement
- Cross-agency perspective
- Enterprise-wide thinking
- Decentralized decision-making with accountability
- Centralized accessible information
In addition to working directly with the Best Teams, TeamTech also designed a process to gather input from the public. In a matter of eight weeks (mid-November of 2002 to mid-January 2003) these five initial public BEST Teams received over 2000 e-mails, faxes and phone communication from Kansans about ways the state could improve efficiency.
This initial BEST process as led and facilitated by TeamTech produced cost and operating efficiencies by:
- Identifying dollar savings through streamlining and removing redundancies: These initial five BEST Teams identified $60 million in potential savings. Governor Sebelius used these savings ideas in her state fiscal year (FY) 2004 Budget presented to the Kansas Legislature. One year later those dollars had been saved.
- Institutionalizing dollar savings by creating a management culture that encourages collaboration and resources sharing: The work of these initial BEST Teams spurred a more comprehensive internal process. We know that change from the inside out is the only effective way to sustain systemic change. TeamTech continues to facilitate dozens of internal cross-government BEST Teams charged with streamlining and finding savings. Thanks to cross-government purchasing efforts, nearly $27 million in purchased goods and services were realized in FY2005. The County/State Offender Population Prescription Drug Team has realized over $2.4 million in recurring annual savings for both county and state government (both FY05 and FY06).
Governor Sebelius and other state agency leaders consider the first phase efforts of BEST a success.
“Oftentimes, people in organizations have good ideas, but institutional barriers prevent them from being heard. At TeamTech our role is to establish venues in which people at all levels can share ideas and be heard.”
How to corral conflicting visions – with care
Kansas City was lucky.
A coalition of more than 100 area social service agencies, behavioral health centers, institutions and more joined forces to address the societal ramifications of trauma and toxic stress. But, as is typically the case when large groups join forces, the collective felt messy. Lots of people meant there were lots of opinions – about how to grow and govern. Lots of stakeholders meant there was a lot at stake, including organizations needing to meet their individual goals. And, lots of commitment meant high emotions ran high.
It’s a good problem for a community to have – lots of passionate people committed to helping people heal. But passion doesn’t always solve the problem.
That’s where TeamTech came in.
The Kansas City group, operating at the time under the name Trauma Matters KC, requested TeamTech’s help to design and navigate a process for consensus. They needed someone who could act quickly as well, since the group’s grant was ending. There was significant tension around the question of which umbrella group could best build upon previous successes – and lead future work.
“There were lots of voices that needed to be heard,” said Jennifer Brinkman, who was involved in the process and serves as president of Alive and Well Communities in St. Louis. “And a lot of confusion among the various stakeholders about who was doing what.”
Time was critical in this initiative. Not only did the groups need to find a solution, they needed to do so quickly in order to maintain the excitement of the volunteer workforce and leverage its commitment.
“TeamTech was so efficient. They were quickly able to see clarity and move us through the problem to a solution,” said Brinkman.
Patricia Davis, a program manager for trauma-informed care at Kansas City’s Children’s Mercy Hospital, said TeamTech got up-to-speed quickly. “Team Tech was highly recommended as an expert at capacity building, but they were able to do that in a way that mirrored how we work. Awareness of trauma informed care, toxic stress and resilience was not only relevant to the ultimate goals of the coalition, but was also imperative to the process of reaching those goal,” said Davis. “They were able to incorporate the concepts and principles into the work and with all negotiations.”
Meanwhile, across the state of Missouri, the same issues faced a similar group. Alive and Well St. Louis, also dedicated to understanding the role and impact trauma plays in a community, was losing its sponsoring organization.
So first, TeamTech, led by CEO Kathleen Harnish McKune, helped the Kansas City groups unite under a common mission, and then TeamTech helped that group unite with the St. Louis group. By forming one overarching non-profit, the new group, called Alive and Well Communities, is able to leverage economies of scale, best practices – and a whole host of resources.
“I cannot tell you how impressed we were that she could move us through the process that quickly – without losing people along the way. She never compromised input for speed,” said Brinkman.
Today, the organization is up and running, sharing a common vision, and working hard to make Missouri a healthier state.
Moving a mental health team from sinking to soaring
When Tim DeWeese took over as director of a large county mental health department, he inherited an organization in shambles.
“Broken,” he said. “That’s the one word I’d use to describe us.”
The department was operating without a common mission, which, no surprise, lead to a disengaged workforce. What’s more, the department’s balance sheet was bleeding so badly the county had to bail them out.
To turn the department around, DeWeese knew he would have to align teams around a common vision – a clear and purposeful direction. He’d have to do it quickly. He’d need everyone to have buy-in. And he’d have to be practical about changes.
“I didn’t want some big strategic plan weighted down with theory,” he said. “I wanted a plan that was actionable. And I wanted someone to help me see it through through to the end. It was such a mess, I knew I needed someone to hold us accountable.”
A colleague recommended TeamTech because of the group’s bias for action, its practical approach to strategy – and its relentless emphasis on accountability.
Now, after two years of working with TeamTech, the department is hardly recognizable. For the first time in a decade, its revenue stream is in the black – and there’s a growing reserve. They’re recording the highest levels of productivity they’ve ever had. And, according to the recent county-wide employee engagement survey, their employees are among the most passionate and happy with their work.
“I couldn’t have done it without TeamTech,” he says. “None of us could have.”
The key? Empower everyone
Kathleen Harnish McKune, CEO of TeamTech, knew that to move the mental health department forward, buy-in would need to be widespread. The solution: TeamTech’s “Everyone A Leader” workshops. The workshops pivot on the idea that leadership is a decision not a title. The hands-on sessions are driven by the idea that if an organization isn’t empowering everyone to lead from where they sit, they’re not using their resources wisely.
For DeWeese, the real turnaround came after adopting the Everyone A Leader mindset. From the front lines to the board room, employees felt empowered to lead from their positions.
“We had engaged staff and so we then had engaged clients,” he said. “In fact, our client ‘no show’ rate dropped from 35 percent to 12 percent. That’s unheard of.”
The department now works with a unified clinical philosophy and approach. The entire organization knows the strategic direction they’re headed. And everyone comes to work ready to lead.
“I figured it would take us five or six years to turn the place around,” DeWeese said. “But we’re in an incredible place in half that time.
“The most important part of this though is that we’re better serving our clients. And that’s the reason we’re all in this field in the first place.”
A different approach to winning
DeWeese had worked with consultants in the past. Government agencies are no stranger to seeking guidance from outside sources. But, honestly, he’d never had much luck.
“We’d build a plan—a good plan—and it would sit on a shelf. It was never built to be acted on,” he says.
Out of the gate, DeWeese saw differences between TeamTech and previous consultants he’d hired. For one, TeamTech outlined expectations up front. They wouldn’t just build a strategic plan. They’d build it and launch it. Second, they helped the group identify – and remove – the barriers preventing them from succeeding.
“It was a huge difference,” he says. “It forced us to think strategically about how we remove, mitigate or work around barriers.”
The most impactful by-product of that approach, says DeWeese, is that it forced them to identify their strengths. Most outside consultants start with “What’s wrong?” and assume goals haven’t been met because of a deficiency – or two or three. Instead, TeamTech helped them focus on their strong points – and then harness that energy to break down barriers.
“It was very ‘meta’ for us,” says DeWeese. “We’re in the business of helping people with mental illnesses remove barriers. That’s what we do.”
TeamTech knows the key to melding missions: Listening
When several non-profits realized their missions had grown incredibly similar – while funding had grown sparser – they initiated talks of merging. The non-profits all, in one way or another, provided medical care for patients who fell through the cracks. The safety net of the safety net is how they described themselves.
Andrea Routh, CEO of one of the medical societies at the time, knew merging them would be tough. They were all strapped with small staffs, busy Boards and an ever-increasing demand for services.
After securing a grant to pay for facilitators, the group of non-profits tapped TeamTech to help them assess the feasibility of a merger. Could they do it? What would the resulting organization look like? And, most importantly, how would it impact their clients?
“It was a huge challenge,” said Routh. “TeamTech’s job was tough. They had to facilitate agreements and consensus among a lot of different entities with a lot of different viewpoints. “
50 balls in the air
After months of meetings focused on unraveling the complex organizational structures of each entity, the groups agreed on a resolution for the Kansas City Medical Society Foundation to run the different programs, taking leadership over the initiative.
“I cannot believe that TeamTech was able to bring us to consensus,” said Routh. “There were 50 balls in the air at all times – and a lot of egos tossing them.”
On track and on task
Of all the many skill sets Kathleen Harnish McKune, CEO of TeamTech, brought to the table, her relentless focus on the future was, perhaps, the most impressive. Kathleen was organized, efficient and always thinking about the next decision that needed to be made.
As much as TeamTech moved the group forward, they never sacrificed listening for efficiency. In fact, said Routh, their ability to listen so well is what helped propel the group forward.
“They could quickly assess where there was consensus and where there wasn’t,” she said. “They could condense everyone’s comments very efficiently — and it’s because they were so good at listening.”
Interested in learning more about how TeamTech can get your organization moving?
How to get a group unstuck – and moving forward together
An unhealthy board. A budget in the red. And absolutely no plan past putting out the fire-of-the-day.
That’s how Melissa Reed describes the state of Prairie Paws Animal Shelter (PPAS) when she took over as Executive Director in 2014. The rural animal shelter, based in Ottawa, Kansas, had outgrown its mom-and-pop style of leadership and needed to regroup on multiple levels. New board. New strategy. New programming.
“We needed to build a common vision out of diverse perspectives. I knew it wasn’t going to be easy but I knew exactly who to call,” said Reed, who had worked with TeamTech throughout her non-profit career.
For PPAS, the tipping point came after construction of its new facility. A generous donor had agreed to fund the building, but the final cost far exceeded the original pledge. Reed inherited the problem and turned to Kathleen Harnish McKune and her cadre of TeamTech coaches to put the shelter back on track.
Kathleen helped the new Prairie Paws Board of Directors look beyond the daily, tactical issues and build a three-year strategic plan. It was no easy feat, said Reed, since the organization was operating at a loss.
‘Kathleen helped the board see that financial sustainability required strategic planning,” said Reed. “Out of the gate, she built consensus around that as our common goal.”
For Reed, handing her board over to a consultant could have felt uncomfortable, but she’d already experienced TeamTech’s collaborative, inclusive approach to working with leadership.
“Kathleen really listens,” she said. “She recognizes that a board has to be healthy, passionate, excited and driven – not just focused on the day-to-day. TeamTech helped us balance the daily challenges while thinking about the future.”
Getting the group unstuck
In short, TeamTech helped Prairie Paws Animal Shelter break out of the rut of focusing only on the day ahead. Once they began moving forward, PPAS administrators realized they needed to broaden their vision even more by understanding the community’s needs.
TeamTech stepped in again; this time to facilitate community assessment focus groups aimed at starting new programs for PPAS.
“The community assessments gave us key insights that helped us really build out our strategic plan,” said Reed. “Once again, Kathleen was able to make everyone around the table feel heard – and get unstuck. They’re methods are amazing at getting people to see the vision ahead – and focus on what’s important.”
Today, Prairie Paws is no longer operating in the red. The Board is strong and thriving. And, most importantly, everyone’s aligned and moving forward together.
“Honestly,” said Reed, “we couldn’t have done it alone. I needed TeamTech’s help getting there.”