Research & Data > Research Reports > 11 > Gilmore > Voters

Qualitative Assessment of DSHS Accountability ScoreCard Measurements and Attitudes toward Image and Issues Among Washington Voters 

Executive Summary

Background
As part of its strategic planning process, the Department of Social and Health Services (DSHS) is committed to seeking input from its customers, the residents of Washington State. The Department commissioned this series of focus groups to explore the public's perceptions of the following issues.

• The measures used to assess goals on the agency's Accountability ScoreCard. 
• Recent DSHS policy changes
• Possible methods to contain rapidly rising DSHS medical costs.

In order to explore these issues, Gilmore Research Group (GRG) conducted a qualitative study, a series of six focus groups comprised of registered voters in the state, representing Eastern and Western Washington as well as both urban and rural areas. Sixty respondents from five cities or towns participated, providing their views of DSHS in several categories.

Impressions of DSHS
1. The main services respondents associated with DSHS were welfare, food stamps, and Child Protective Services

2. The services from the list that most surprised the respondents were licensing, the treatment of drug and alcohol abuse, and DSHS' involvement with incarcerated youth. Respondents were amazed that one in five Washington residents has received or currently receives benefits.

3. Respondents feel that the help provided by DSHS to low income residents and those who cannot take care of themselves is a necessi/ms/rdaty in most cases.

4. Impressions of the agency were that is large and bureaucratic. Some staff members were considered less than helpful, while others were considered very dedicated. Several groups brought up concerns about the process of child protection and removal of children from homes in the discussion of initial impressi/ms/rdaons.

Perceptions of Accountability ScoreCard
1. The DSHS Accountability ScoreCard goal categories appeared logical. The measures tended to define the goals when respondents looked at them together. However, in some cases, the goal was much broader and all of its implications could not be measured, because it would be difficult or impractical to collect such data. Respondents did not appear to consider that the agency might be tracking many other measures related to each goal.

2. The major category headings in the ScoreCard were seen as appropriate.

• The first category, "Health and Safety of Washington's Children," was perceived as an important focus for the agency due to the fact that children represent the future of our society.

• The second category, "Economic Development and Self-Sufficiency," seemed to cover adults in need due to low income, disabilities, or aging.

• Washington residents expected the goals of the third category, "Public Trust," to be fulfilled, although they might not have given that name to the category.

3. While the measures helped respondents to see the accountability of DSHS, some measures caused confusion because of ambiguous or cumbersome wording.

4. Other major themes which emerged from the discussion of specific measures included the following:

• Why couldn't the goal just be 100%, why settle for something less?

• Why give a number that is rising as a goal? This makes it look like DSHS  is trying to increase the number of clients it serves just to stay in business.

• Why not show a percentage instead of a number so that the resident will know whether the increase is due to growth in the population or a greater portion of those who need the specific service being served?

5. The discussion of the Accountability ScoreCard elicited some recommendations:

• Quite a few respondents believed that DSHS should focus more effort on rehabilitating the original families than facilitating adoptions so that the children could experience stability with their biological families.

• Lack of family cohesiveness also was believed to cost society, and residents would like DSHS to work toward reversing that trend.

• Several participants made final suggestions about the need for education about issues for the public and the need for life skills training for clients.

Controlling Medical Costs
The problem of rising medical costs was familiar to respondents, but none of these potential solutions offered by the agency was perceived as ideal. Preferences overall were in the following order:

1. Asking clients to pay part of the cost of services for prescription drugs or emergency room visits
2. Asking doctors to tell us why they ordered a more expensive drug rather than a cheaper choice
3. Having the client contribute an annual amount to his medical coverage
4. Refusing to pay providers' increased rates
5. Cutting back on the number of low-income people who get medical care from the state by only giving medical care to the poorest children
6. Cutting back on the number by putting people who need medical care on a waiting list

Policy Changes
Residents were asked about their awareness of recent changes regarding DSHS policy and/or focus with regard to welfare reform, child protection, and media.

1. Some respondents were aware of the recent DSHS policy that imposed a five-year lifetime limit on clients for receipt of welfare benefits.They felt that reform was a positive during the initial discussion of the agency.
2. The changes in focus and policy with regard to child welfare were not as well known to respondents, but generated positive reactions as well as concerns.
3. The media coverage was only briefly discussed, but respondents made little or no mention of positive stories about DSHS in the news.

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Modified: Monday September 17 2007

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