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Measuring social change and Primary Client Management by Julie Cousler, Former Vice President of Health Promotion & Wellness Congreso developed its Primary Client Management or PCM model in 2007 to bring our vision of a one-stop-shop model to fruition. Through an intensive organizational planning process Congreso reached out to other large multi-service organizations across the country to see how they managed, how they ensured that their clients truly had all of their needs met under one roof or more.
No one had such assurances. Like Congreso, they counted on staff training and initiative to probe further with clients, to see how else the organization could help them.
Through Congreso’s PCM model, an individual entering any one of Congreso’s more than 20 case-management programs across four divisions receives a standard comprehensive assessment. Through this assessment an action plan can be developed that ensures appropriate and accountable referrals/connections are made (parenting supports, family planning, behavioral health, domestic violence, their ability to meet their family’s basic needs, GED, ESL, and employment assistance). The Primary Client Manager monitors their attendance and outcomes, and closely monitors their progress toward self-sufficiency. What’s unique about this model is simply that Congreso has built in the training to conduct a comprehensive assessment and develop an action plan that can monitor the success of referrals and attendance electronically. In addition, the PCM challenges all individuals to have an education or vocational goal while they are removing their social and/or health barriers.
Congreso’s PCM model is based on the premise that people need to be able to earn a living wage, to support their family with dignity, and move up and out of poverty; to do that they must address their health and social needs. For an individual living in poverty, people will likely continue to struggle with community and family violence, poor health outcomes, school delinquencies and a high dropout rate that cripples the most impoverished areas of our community. Helping someone to move up and out of poverty requires a holistic approach based on a compassionate relationship with a skilled worker who understands the challenges faced in the community, and it requires resources to meet their needs. The PCM offers guidance and encouragement, connection to resources, support in managing use of these resources, where in the long-term, individuals can obtain a GED, learn or improve their English, develop skills through a training program, and enter into a job where they can climb the ladder of success. These important life milestones for many of Congreso’s clients occur with the right timing and stability to succeed, where health and supportive service needs are met, so individuals can concentrate on progress, versus crisis and maintenance.
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Consider – Ana, a community member who walks in for energy assistance with a bill threatening shutoff. She is trailed by two little ones, and she is clearly pregnant. Five years ago, the crisis counselor would have helped her to complete the LIHEAP (Low-Income Home Energy Assistance Program) application. She would have probably been asked if there was anything Congreso could help her with. She might have gotten more support services. Today, Congreso’s integrated service delivery model assures each person in need that walks through our door that they will be connected with all of the help that they need. Today, that same woman might be referred into a case management program, and through comprehensive assessment per client manager would learn her needs around health and safety, the status of her children’s health, school progress and development, parenting and basic needs, and employment, education, and income, the end goal being movement up the economic ladder. What do we measure when there is so much to measure – how do you measure educational and workforce gains within a social support context? How do you measure if a client is safe and healthy? Congreso’s assessment measures 17 agency-wide indicators, including whether a client (or their children) is making progress in gaining literacy and math skills, if a client is able to gain financial literacy skills, and ultimately, if the client can attain at least two years of postsecondary education and/or maintain employment for at least six months. For as long as the client stays with their PCM, the PCM will track client progress in meeting their education and employment goals and refer them to programs and services that may be needed to remove barriers to clients attaining their education and employment goals.
For nearly two years Congreso has operated its case management services through this integrated model across multiple programs. Through the model’s workgroup, Congreso monitors its process and outcomes to continue to improve upon the model. Quantitative data that utilizes the agency’s 17 indicators to measure a client’s progression provides a lens for assessment, along with qualitative data on individual clients documented by PCMs, as well as the data of PCM supervisors who are monitoring compliance, and client progress on the ultimate goals of employment and education. Feedback from the PCMs themselves provides a critical voice for assessment, through focus groups and regular feedback through multiple channels in the quality assurance team, providing real-time feedback about the progress, success and challenges, together seeking the perfection of the model
In short, we have found a way to bring science into the art of measuring social change. |