Appendix A: Communicating Progress
Last updated
Last updated
So your city has setup a performance management framework, what's next? Many cities joining the evidence-based government movement are beginning to recognize the importance of engaging their residents in exciting new conversations on how data and evidence can solve problems and improve their quality of life and sharing progress made during performance management processes. GovEx has compiled samples of dashboards, press releases, articles, infographics, blog entries, interviews, and social media communications that others have used to discuss Stat success stories. Our hope is that these examples will provide a knowledge base for cities as they seek to share their own progress and innovation.
Albuquerque, NM | Progress Report, 2014
Website and dashboards
Source: ABQ Progress Report
Chattanooga, TN | ChattaData, 2014
Sample Tweets
Kansas City, MO | KCStat, 2013 – 2014
Sample Social Media Use
King County, WA | Healthy Incentives, 2014
Article
###King County's Wellness Plan Beats the Odds
SEATTLE – When King County, Washington, launched its employee wellness program seven years ago, its motive was clear. “We were being eaten alive by runaway medical costs,” says the county’s top executive Dow Constantine.
By all accounts, the previous administration was desperate to bring down double-digit health care cost growth that threatened to destroy the entire budget.
That partially explains why King County, which spends nearly $200 million per year to insure 14,000 workers and their families, who mostly live and work here in the county seat, was willing to risk millions more on a wellness program that would prove to break the traditional mold.
It may also explain why labor unions took the unusual step of joining management in a plan that would ultimately shift more health care costs to workers.
But it doesn’t explain why this employee wellness program, which received an innovation award this year from Harvard University, has far surpassed all others in employee participation, health improvement and health care savings.
The program’s unusually high financial incentives for participation and an extensive outreach program to promote it are credited in large part for the program’s success.
In its first five years (2007 to 2011), the county’s “Healthy Incentives” program invested $15 million and saved $46 million in health care spending with sustained participation by more than 90 percent of its employees. Two years ago, $61 million in surplus health care funds were returned to county coffers because cost growth was lower than actuaries had projected. Seattle, the state’s largest city, is the county seat.
Employee health improved dramatically, raising King County employees’ health status above the national average and keeping it there. Smoking rates dropped from 12 percent of employees to less than 5 percent, and more than 2,000 employees classified as overweight or obese at the start of the program lost at least 5 percent of their weight, more than halving their risk of diabetes.
With an average age of 48.5 years and practically no turnover, the county’s worker population is getting healthier even as it’s growing older.
Outsized Performance
These results, documented in a 2012 internal report by former staff economist John Scoggins, are remarkable when compared to the generally lackluster performance of other wellness programs run by large U.S. organizations, including state and local governments. According to a 2013 report from the Rand Corporation, about half of all U.S. large employers offer some type of wellness program and the number is growing. But few end up saving any money and employee participation has been limited. Many fizzle out after a year or two.
On average, only 47 percent of employees participate nationwide, and only 2 percent of organizations that offer the plans report any reduction in health care costs, according to the study, which was funded by the U.S. Departments of Labor and Health and Human Services. Overall savings from wellness plans offered by the organizations Rand surveyed were too small to be statistically valid.
Still, evidence shows that workplace health programs have the potential to promote habit-forming healthy behavior, improve employees’ health knowledge and help workers get necessary screenings, immunizations and follow-up care. The Affordable Care Act encourages employers to expand wellness programs by loosening federal regulations that limit the financial rewards employers can offer workers for reaching certain health goals such as quitting tobacco use.
King County’s intensive education and outreach effort cost the county nearly $7 million in the first two years. Since then, the effort has tapered, but six full-time employees still work to maintain the county’s high participation rate. “We want to make sure that no one is left out because of lack of knowledge,” said Brooke Bascom, who runs the program.
The biggest draw, Bascom said, has been the financial incentives King County offers its employees for participating. Other wellness programs offer much less substantial rewards, according to the Rand report. Among the 10 percent of employees who don’t participate in Healthy Incentives, most say it’s because they don’t want to share private information about themselves. A small number are given exceptions because of health conditions or family issues that prevent them from participating.
More Than a Wellness Plan
Healthy Incentives offers a model that state and local governments should replicate, said Stephen Goldsmith, director of the innovations award program at Harvard’s Kennedy School of Government. Washington state is already emulating parts of King County’s wellness plan and Oregon is trying to start a similar program.
Here’s how the financial incentive part of the program works:
In the past, county employees didn’t pay a share of insurance premiums, but they did pay deductibles, co-insurance and co-pays. Healthy Incentives allowed workers to shave $200 off of their $500 deductible simply by filling out a health assessment form. They could get another $200 knocked off if they completed an “individual action plan,” such as attending six Weight Watchers meetings at work, completing five phone sessions with a tobacco cessation coach or learning how to better manage diabetes. Four years into the program, nonparticipants’ deductibles went up to $800.
In addition, employees who did not participate in the program had to pay a 10 percent higher co-insurance share of the cost of medical care after their deductibles were exhausted. When you put those two incentives together, the individual savings could come to more than $1,000 per year.
The program also encourages the use of less expensive generic drugs by increasing the co-pay for name-brand drugs from $15 to $30, while decreasing the co-pay for generic drugs from $10 to $7. These changes, put in place in 2010, resulted in $2.4 million savings to the county and a $1 million savings to employees by 2011.
Higher Value Providers
The wellness program began when former County Executive Ron Sims, credited with the big idea, donated $1.3 million in county dollars to help a fledgling health care organization, the Puget Sound Health Alliance, develop a medical claims database to help identify doctors and hospitals in the county that offered the highest quality services at the lowest prices. He also recruited large local employers including Alaska Airlines, Boeing and Starbucks to contribute money to the effort.
By analyzing claims data, the group found that one provider organization, Group Health Cooperative, was costing the county an average of $4,000 less per person per year while providing higher quality services than all other providers in the area. Group Health already served 20 percent of the county’s employees through its Seattle-based accountable care organization.
To encourage more employees to use Group Health, the county eliminated the deductible and added a graduated co-payment of $20 to $50 based on employees’ Healthy Incentives participation levels. Regence BlueShield patients remained subject to existing deductibles of up to $800. As a result, an additional 2,274 employees switched to Group Health, bringing its share of coverage to 30 percent. Between 2010 and 2011, the shift to Group Health reduced county expenditures by $6.5 million and saved employees $2.2 million.
“They needed a third party to do the research,” said Mary McWilliams who now runs the Alliance. “The unions would never have trusted the research if it had come from the county or the providers,” she said. The alliance since expanded to include the state of Washington.
Now called the Washington Health Alliance, the group plans to determine the highest-value services by physician groups and hospitals within the Regence network. Once those providers are identified, employees will once again be steered in their direction through reduced out-of-pocket expenses.
Too Much Rigmarole
Not everyone loved the program in the beginning. In its first two years, county employees objected to the time spent filling out forms and documenting their action plans. Some lodged formal complaints. Kathy Pompeo was one of them.
A supervisor in the Sheriff’s Office, Pompeo runs a 24-hour crew of data-entry workers who have little time to fill out online forms detailing their daily wellness activities. “My staff was very frustrated and very negative,” she said. They were spending more time reporting on their activities than working on their healthy behaviors. They participated, “kicking and screaming.”
Bascom said the county took complaints to heart and made the process easier. With such a diverse workforce — from bus drivers, road workers and custodians to law enforcement officers, doctors, attorneys and administrative workers — the county had to make accommodations so that everyone could participate. Bus drivers, for example, didn’t have access to computers, so the county developed a paper process.
Even the county executive complained that the process was cumbersome. “You’d get up in the morning and exercise and then have to sit down and log on to a computer. It didn’t make sense,” Constantine said. Now employees can text their activity to the program: “I’m walking my dog,” for example. And the county applies points toward their full participation status.
Has the county made it too easy to comply? Bascom doesn’t think so. Research shows that healthy habits can be formed in just four weeks. As for employees gaming the system by not really performing the activities they say they are, Bascom and others said they doubted much, if any, of that was going on.
“We’re a pretty ethical group,” Pompeo said, and there’s peer pressure to do the right thing. “It’s like having a running buddy or a diet buddy, only lots of them,” she said.
When Constantine took office in 2009, he was asked whether he wanted to continue the program. His response was immediate. “There was no question about continuing it,” he said. “Every employee was doing it, so it got internalized…. My question is why this hasn’t been done a thousand times before.”
Source: Stateline. King’s County Wellness Plan Beats the Odds. Pewtrusts.org. July 22, 2014. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2014/07/22/king-countys-wellness-plan-beats-the-odds. April 30, 2015.
Louisville, KY | Innovation Delivery Team, Mayor Fischer, 2012
Press Release
###Louisville Innovative Delivery Team to Tackle Urban Problems May 30, 2012
Louisville Mayor Greg Fischer has put together a special team that will take on five urban challenges.
The projects range from expanding recycling and reducing the number of low-severity 911 calls to implementing a more efficient rezoning process. Fischer announced a six-member “Innovation Delivery Team” will deal with the five goals, which will be funded by a $4.8 million grant from Bloomberg Philanthropies that the city received last year.
Fischer says the hope is to bring breakthrough ideas to Metro Government, such as new ways to reduce the number of vacant and abandoned properties.
“We’re soon going to take legal action to foreclose on 100 of the most market desirable properties. Once the city acquires these properties, they’re going to be converted to productive use by putting them into the hands of people who will improve and restore them,” he says. “So the goal with this project is to reduce the number of abandoned properties by 40 percent within three years and 67 percent in five years.”
About 100 U.S. cities applied for the philanthropic funding, and Louisville was among the five cities selected along with Chicago, Atlanta, New Orleans and Memphis. The Bloomberg grant is being doled out to the city over three years and Metro Government has to match the funding with $1.6 million.
Fischer had dedicated much of his 2012-13 budget plan to the Bloomberg programs, such as $90,000 to hire a nurse to reduce the number of non-emergency ambulance runs by 30 percent and $400,000 to increasing recycling by 25 percent over the next three years.
The five projects were identified and shaped over the last few weeks and started with city department directors, who proposed ideas for the team to focus on. The mayor was presented with more than 40 ideas, which were prioritized based on their effect on the community.
“There was a lot of competition for those,” says Fischer. “Imagine if you’re a chief or a director in the city and you have an opportunity for a group of experts to come and study what your challenge is, a challenge that you’ve identified and you’ve been trying to make progress on for the last several years and they’re going to help you take care of business.”
The Innovation Delivery Team projects are:
Make Louisville more “green” by increasing recycling and diverting solid waste from the city landfill – Through expanded city recycling services, new ordinances and increased public awareness this project will target a long-term increase in both residential and commercial recycling while also reducing the amount of bulk waste going into the landfill. One of the first action steps will be to distribute larger, 95-gallon recycling carts on two selected routes in the Urban Services District. Selling material to recyclers is better financially than paying to dump it at the landfill, with the added benefit of a more sustainable future. Goal: increase recycling 25 percent within three years and divert 90 percent of solid waste from the landfill in 30 years.
Reducing the number of low severity medical 911 calls and related EMS runs – Thousands of calls yearly to 911 and resulting EMS runs involve situations that are not medically severe. This has the potential to divert resources away from medical emergencies and is a costly burden to the city’s emergency response system. Louisville is already a leader in the nation by being the first U.S. city to adopt PSIAM – a system that triages low-severity 911 calls to more appropriate forms of care than emergency rooms. The project calls for expanding PSIAM triage capacity, providing an alternative phone number to 911 for low-severity patients, helping match recidivist low-severity 911 callers with more sustainable sources of patient care, and providing a means of alternate transport to decrease non-emergency ambulance usage. Goal: eliminate or redirect 30 percent of low-severity medical 911 calls within three years.
Reducing the number of vacant/abandoned properties – The more than 1,200 vacant and abandoned properties in Louisville negatively impact property values and create public safety and health issues. To quickly impact the problem, legal action will be taken to foreclose on 100 of the most market-desirable properties, followed by 200 additional properties within the next two years. Once the city acquires the properties, they will be converted to productive use by putting the properties into the hands of persons who will improve and restore them, creating urban gardens or urban forests, etc. Other action steps will include helping connect at-risk property owners with existing resources. Goal: reduce the number of abandoned properties by 40 percent within three years, 67 percent in five years.
Increasing Metro Animal Services live release rate of healthy, adoptable animals – The rising homeless pet population creates a huge challenge for Animal Services, which receives more than 12,000 animals yearly. Through greater use of technology and stronger partnerships with vets and advocacy and rescue groups, the number of pets coming into Animal Services will be reduced while pets being returned to owners and adopted by new owners will increase. Goal: increase the live placement rate to the national “best practices” standard of 90 percent within five years.
Implementing a friendlier, faster, more efficient rezoning process – The current process takes too long and is not customer friendly, hampering new businesses from starting up and making it difficult for residents to fully participate in neighborhood and community development. Action steps will include creating a “fast track” system to speed simple rezoning cases, improving public notice of rezoning cases and increased use of technology – such as allowing citizens to submit and pay for zoning applications online. Goal: reduce the average time to complete rezoning while also raising customer satisfaction.
The team will be led by Director Margaret Handmaker.
Source: "Louisville Innovative Delivery Team to Tackle Urban Problems." 893 WFPL News RSS. 30 May 2012. Web. 23 Apr. 2015. http://archives.wfpl.org/2012/05/30/louisville-innovative-delivery-team-to-tackle-urban-problems/.
New Orleans, LA | BlightStat, Mayor Landrieu, 2012
Press Release
###City surpasses blight reduction milestone of 10,000 units by 2014 January 09, 2014
NEW ORLEANS, LA— Today, Mayor Mitch Landrieu announced that the City has exceeded its goal of reducing the blight count in New Orleans by 10,000 units by 2014. The milestone was confirmed through an independent study by University of New Orleans Professor Peter Yaukey, PhD.
Dr. Yaukey presented his findings at today’s BlightSTAT meeting, the City’s performance management tool for tracking the City’s progress towards reducing the blight count in New Orleans. Dr. Yaukey’s survey, the most recent authoritative estimate, found that the City has reduced blight in New Orleans by 30 percent between September 2010 and April 2013. The third party validation results are a culmination of Mayor Landrieu’s successful, aggressive, and comprehensive blight strategy launched in 2010.
“When I took office in 2010, New Orleans had the worst blight problem in America and no strategy to deal with it,” said Mayor Landrieu. “We got to work on this community-wide effort and we’re now fighting blight faster here than anywhere else in the country. Today’s announcement is the result of true collaboration between City government and residents with a common goal of improving the quality of life of our neighborhoods.” After extensive public input, research on best practices, and advice from national experts, Mayor Landrieu announced an aggressive blight reduction strategy in October 2010 with an ambitious goal of reducing the blight count in New Orleans by 10,000 units by 2014. The strategy prioritizes data-driven decision-making, innovative new enforcement policies, and opportunities for reinvestment to grow and strengthen neighborhoods.
Read 2014 report on the City’s Blight Reduction Strategy
Since the Blight Reduction Strategy launched:
Over 54,000 Code Enforcement inspections have been performed;
Over 500 first time homebuyers have been assisted in buying a home through the City’s successful Soft Second Mortgage Program.
Over 4,000 properties have been demolished;
$3.4 million has been collected through the City’s lien foreclosure process;
Over 2,000 former Road Home properties were sold by the New Orleans Redevelopment Authority (NORA) and 75 percent of those new property owners met their compliance agreements by the one year deadline; and
The City has secured over $30 million in federal funding to reinvest in blighted neighborhoods.
“Our strategy increased enforcement and helped us turn the corner on blight in New Orleans,” said Deputy Mayor and Chief Administrative Officer Andy Kopplin. “Once the City started taking enforcement more seriously, blighted property owners started taking their responsibility more seriously, and as a result many of those blighted property owners have come into compliance on their own. That has helped us to achieve our goal.”
In 2014, the City is doubling down on efforts to reduce blight across New Orleans and will ensure the tools are in place to keep up the momentum. The 2014 budget invests nearly $500,000 dollars for new inspectors and title research staff to help speed up the process.
New process using data-driven decision-making
In 2010, the City launched the BlightSTAT management program in order to coordinate data and information to measure blight and track the City’s progress toward meeting goals related to Mayor Landrieu’s Blight Reduction Strategy. BlightSTAT meetings are working meetings, open to the public, and are intended to provoke constructive dialogue on what’s working, what’s not, and what the various City departments and agencies need to do to improve. Citizens are invited to these public meetings to ask questions and to provide input on how the City’s blight reduction programs can be improved. The analysis for BlightSTAT meetings are held every second Thursday of the month at 8:00 a.m. in the 8th floor conference room at City Hall.
“At BlightSTAT, we’ve proved that if you can measure it, you can manage it. I want to thank Mayor Landrieu, the blight reduction team at City Hall, and the hundreds of citizen activists who have recognized the value of data to drive results and have helped make BlightSTAT a success,” said Oliver Wise, Director of the Office of Performance and Accountability. In order to improve efficiency, the City implemented a new information technology system called LAMA that is used to track all code enforcement and permitting activities in City government. The new technology replaced an outdated and unreliable system and now provides real-time updates across City departments that utilize the data.
In 2012, the City partnered with Code for America to create a website called BlightStatus , an interactive online tool for residents to track the progress of blighted units within the Code Enforcement system in New Orleans. For the first time in the City of New Orleans’ history, residents can now review up-to-date property information directly from City records without stepping foot inside City Hall. BlightStatus has improved the City’s work with neighborhood groups and individual residents in the fight on blight.
Restructuring and reorganizing
In order to streamline accountability and improve coordination, the City reorganized its blight fighting-departments in 2010. In the past, Housing Code Enforcement was responsible for inspecting blighted properties and Environmental Health was responsible for inspecting overgrown lots. To improve coordination and efficiency, the City merged those two departments, and since then, Code Enforcement has performed over 54,000 inspections.
The City also dramatically improved the capacity of its administrative hearings section so that more blight cases could be heard. In 2011, the average time between the initial property inspection and a hearing was 160 days. In 2013, that time was cut in half to 80 days.
In addition, the City now has dedicated staff for researching real estate ownership of blighted properties, preparing cases for legal actions as well as a legal team that files foreclosures on properties eligible for Sheriff’s sale. The 2014 budget invests nearly $500,000 dollars for new inspectors and title research staff to help speed up the process.
Better enforcement policies in place
In the past, the City’s code enforcement process was ineffective because owners of blighted properties faced no consequences for failing to pay their code liens and/or bringing their properties into compliance. As part of the new Blight Reduction Strategy, the City has strengthened the code enforcement process by utilizing the enforcement tools available in order to obtain compliance, including Sheriff’s sale or demolition. Since 2010, the City has filed writs of foreclosure on 1505 delinquent properties and demolished over 4,000 blighted units.
In 2013, the City Council passed new ordinances proposed by the Landrieu Administration that significantly strengthen the City’s enforcement capabilities on residential and commercial blight. Under the revisions, all properties must comply with minimum property standards, such as sanitary and maintained yards and structurally sound, secure buildings. Previously, this was only enforced on unoccupied properties. If a property is occupied, additional standards will be required, such as, ensuring that properties supply sufficient ventilation, plumbing, and electricity. These new requirements protect basic quality of life needs for all residents.
Creating opportunities for redevelopment
In addition to stronger enforcement against blighted property owners, the City’s Blight Reduction Strategy works to provide opportunities for residents to do their part to clean up their neighborhoods and/or to return blighted properties back into commerce.
In 2012, the City re-launched the Soft Second First Time Homebuyer Assistance Program . Since then, it has provided purchase assistance and closings cost assistance to over 500 households throughout the city. The Affordable Homeownership Development Program component of the program has resulted in the transfer of 70 formerly blighted properties to be rehabilitated and to construct new homes for persons of low and moderate income. In total, the program will have stimulated the rehabilitation or new construction of homes on nearly 200 formerly blighted and vacant properties primarily located in place-based development areas.
NORA is in the final stages of the NSP2 program having provided financing to over 470 units of affordable housing across the city. In an effort to promote commercial redevelopment, NORA has invested more than $8.6 million and leveraged $74.6 million in the revitalization of about 300,000 square feet of commercial real estate on Oretha Castle Haley Boulevard, Broad Street and at the former Gentilly Woods mall. In addition, NORA has seen remarkable success with the Lot Next Door program. More than 811 Road Home properties were sold through the Lot Next Door Program (under both the 2008 ordinance and the 2013 revised City ordinance) since October 2010.
“Our partnership with the City is stronger than ever, and we will continue to work to provide opportunities for our citizens to redevelop and return vacant properties to commerce,” said Jeff Hebert, Executive Director of NORA.
As part of the City’s on-going effort to get the community involved in rebuilding their neighborhoods, the City organized five Fight the Blight Days and subsequently six NOLA FOR LIFE Days since 2010. The events leverage and foster community involvement while remediating blight issues and providing City resources to residents. The next NOLA FOR LIFE Day is scheduled for Saturday, January 11, 2013 .
Strategy earns national recognition
In 2012, the Harvard University Kennedy School of Government Ash Center for Democratic Governance and Innovation recognized the City’s Blight Reduction Strategy as a “Bright Idea in Government.” The Bright Ideas initiative is designed to promote creative government initiatives and partnerships and create an online community where innovative ideas can be proposed, shared, and disseminated.
Additionally, the City’s Blight Reduction Strategy was awarded the U.S. Department of Housing and Urban Development Secretary’s Award at the 2012 Council on Philanthropy Conference for its public-philanthropic partnership with the Greater New Orleans Foundation (GNOF), NORA and the Center for Community Progress (CCP). Through this partnership, New Orleans is developing a national model for addressing blight. Cities from across Louisiana and the country are working to replicate the success of New Orleans.
Hebert and Wise are 2012 recipients of the Innovation Award from the Bureau of Governmental Research. The Innovation Award recognizes employees who have used innovative solutions to solve pressing problems.
Source: "City Surpasses Blight Reduction Milestone of 10,000 Units by 2014." Www.nola.gov. N.p., 9 Jan. 2014. Web. 23 Apr. 2015. http://www.nola.gov/mayor/press-releases/2014/20140109-blight/.
Santa Monica, CA | Wellbeing Project, 2014
Infographic
“Let’s go beyond economic indicators and use the science of wellbeing. Let’s understand what we’re doing well – and where we as a community can take steps to improve.”
