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Whole Person Service: A Journey Map Toward Self-Sufficiency – Part 3

This blog is part 3 in a series focused on whole person care. Continue reading the series with part 1 and part 2.

We have described the importance of whole person care and a holistic view in our previous blogs (Part 1 and Part 2). In this blog and the next few, we will talk about how we envision actually delivering holistic whole person services (WPS).

As a leading provider of health and human services and solutions, Gainwell Technologies feels strongly about the need to help our clients support their recipients and help them attain something that can truly make a difference in their lives: self-sufficiency.

We believe self-sufficiency is a great influencer between one’s self-respect and perpetual reliance. Furthermore, we believe the best way to achieve it is a tireless effort to enable what we call “Determinants of Self-Sufficiency.” It may sound simple, but at the same time, it has proved rather difficult to achieve.

Our WPS framework addresses the inclusion of multiple services to address one’s fundamental needs and barriers and effect long-term improvement toward self-sufficiency. It also addresses the different states a recipient may be in at the time of service, along with the type and objective of the services associated with the different states. Let us walk you through this journey to self-sufficiency.

Steps toward self-sufficiency

A powerful prerequisite is an agency’s ability to integrate and coordinate multiple services, sometimes with other agencies, which can be in the form of data integration or system interfaces, for example. This, of course, needs to be done with a proper data sharing and usage agreement in place, with proper and utmost data security and regulatory compliance. 

With integration in place, an agency can start coordinating. Early-stage coordination can be as simple as convenient, streamlined interagency communication or a well-controlled view of “shared cases”. These may be in the form of referrals or a case management solution providing a limited view to an external or partner agency employee.

The journey to self-sufficiency is a trying, lengthy one, but it can also be a life-changing and powerful one. Gainwell considers three recipient states in this journey. The most serious state is In Distress. Someone needs active assistance, potentially immediately. For instance, a person may need urgent ER care, shelter for the night or expedited food assistance for the family. In this state, the objective of the services that an agency provides should be to help the recipient recover.

A key point is that we provide immediate assistance and relief as necessary and also start to pay attention to long-term improvement. We don’t want just to provide a “band-aid” benefit. At the same time, we should recognize that someone in this state may not be prepared, emotionally or physically, to think about long-term prospects.

After an initial recovery and some improvements, a recipient enters the At-Risk state. In this state, the objective is to stabilize the situation by providing supplemental assistance. Perhaps a recipient can now benefit more from behavior counseling or skills training in addition to ongoing housing assistance or supplemental nutrition assistance. Recipients usually will spend the most amount of time in this state — with many ups and downs and sometimes even with serious relapses.

Given the above, we aim to provide agency workers with productivity solutions that put all relevant and necessary information at their fingertips and further equip them with data-driven intelligent assistance. With information on all the services that a recipient is receiving the caseworker will be able to manage the agency’s services as well as referrals to partner agencies under proper access control and information-sharing agreements. They can also assist with auxiliary information such as pre-arranged transportation service for a referral appointment.

As for the recipient, disparate information sources and multiple manual applications should be a thing of the past. An upfront assessment can welcome and engage the individual and help a caseworker understand the person’s needs and barriers. This understanding helps construct an improvement plan, again assisted by data-driven analytics. As a recipient travels on a journey to self-sufficiency, clear and convenient communication and the availability of relevant information — such as services and their locations — can greatly improve outcomes.

Through a trying and lengthy journey and with additional improvements, a recipient can triumph and finally reach a Self-Sufficient state. Here the objective should be to sustain self-sufficiency by providing advisory assistance. Advisory assistance can be low cost and low touch, with the caseworker acting more as a lifestyle coach.

Again, predictive analytics will be paramount here. The idea is that when someone’s employment, family life or living situation changes, it could be a predictor or potential indicator of future risk. The quality of life for everyone involved will be better if that risk can be mitigated through a proactive measure.

The right combination

In each of the three states, an important consideration is what an optimal combination of assistances provided is, and proper sequencing when there are necessary interdependences. Once again you can see the increasing importance of data analytics.

The aim should be to address the immediate needs, eliminate any barriers and solve the problem for the longer term — and get that person on their way to self-sufficiency, perhaps gradually but measurably. The key is identifying their needs and barriers and matching effective services to those. Again, intelligence driven by data analytics can play a critical role here, with performance feedback from real-world data.

Someone can engage in or with whole person service starting in any state. The objective is to help the recipient improve toward self-sufficiency irrespective of the state in which the recipient started their whole person journey.

Paving the way

Helping our clients enable positive Determinants of Self-Sufficiency is a Gainwell vision. We are working tirelessly to make the whole experience as seamless, sensible and streamlined as possible for recipients, and as efficient and productive as possible for the employees. We will be there with our clients every step of the way along the maturity journey toward true Whole Person Service. In our next blog, we will share more about our Whole Person Service solutions.

About the Authors

Chris Van Vlack is a regional general manager at Gainwell Technologies. He has more than 25 years of commercial and public sector health and human services experience. Chris is currently leveraging his experience to help Gainwell develop new innovative strategies that will help transform the way in which recipients of the HHS programs are engaged and served through State and Local agencies. The goal of this work is to improve the overall recipient experience and contribute to improving their circumstances.     

Dawn Wilder is an account general manager at Gainwell Technologies. She has more than 30 years of public sector health and human services experience. Having observed service delivery at the ground level through years of human services consulting, Dawn is passionate about the need to move to a whole person, whole family, whole community service model.