Jake recently wrote a post on the huge challenges faced by primary care provider organizations in meeting EMR Meaningful Use regulations. This got me thinking about other data collection challenges facing nonprofits. Apart from computers and the Internet,* one of few aspects of grant writing that has changed since I started writing proposals when dinosaurs walked the earth is an ever-increasing RFP/funder emphasis on data tracking to demonstrate services delivered and improved “outcomes.”
The scare quotes around “outcomes” expresses how we feel about many of them. While we’re adept at creating plausible data collection strategies in proposals, regardless of what our clients are actually doing in the real world, we know that demonstrating service delivery levels and outcomes is a major issue for certain types of human services providers. These include many faith-based organizations (FBOs)** and ethnic-specific providers, some of which have been operating since the days of Hull House. We’ve worked for several nonprofits that have been providing services for well over 100 years.
It’s not unusual for smaller FBOs and organizations serving immigrant/refugee populations to provide services in what seems, from the outside, to be a chaotic manner. But the service delivery practices are actually well-suited to their mission. A range of services might be provided to a particular individual, like help with an immigration problem, but the agency will end up helping the person’s extended family members with all manner of issues. In many ethnic communities, the concept of “family” is malleable. A nominal “uncle” or “cousin” is actually not related but hails from the same village or clan in their country of origin.
Such services are usually provided on the fly and the harried case worker, who is typically a co-religionist or from the same ethnicity, hops from client problem to problem without time or interest in database entry. Like pulling a thread on sweater, helping one person in a 30-member extended family can result in dozens of “cases” that may not be separated and documented. The family often does not want the problem documented because of cultural/religious taboos and (often justified) fear of government officials. Thus, much service delivery is provided on the down-low.
Everyone knows that New York City has dramatically changed from the bad old Death Wish days of the 1970s to a glittering metropolis of 70-story apartment buildings for the one-percenters and a well-scrubbed, tourist-focussed Times Square. What isn’t generally known is that an amazing 37% of NYC’s population is foreign-born. This percentage is increasing. NYC has more foreign-born residents than the entire City of Chicago has residents! Rapidly growing NYY immigrant groups include Orthodox Jews from the former Soviet Union, Dominicans, Asians, Central Americans, and so on. We work for many nonprofits that serve these immigrant populations; this client type usually only serves their brethren. These nonprofits have great difficulty documenting the often extraordinary services they provide—one of the main reasons they hire us is because of our ability to weave their stories into the complicated responses required by RFPs, including service and outcome metrics. Like the proverbial centipede, these nonprofits walk perfectly, as long as no one asks them how they do it.
The data capture challenge is compounded because few prospective social workers enter grad school with the idea of becoming bean counters. Like the best doctors and teachers/professors, social workers start off with the idealistic notion that they will spend most of their time helping people, not doing data entry and accounting for every minute of their day. When not extruding proposals or writing novels, Jake is a college English professor. He can attest that much of his best teaching doesn’t show up in metrics.
Many of us have had a “hero teacher” at one point and a conversation or a book recommendation might have changed your life, but will not be reflected in grades or academic honors. Similarly, a case worker who gets a tacoria to hire the “nephew” of one of her clients as a busboy to keep him out of juvenile hall might set the young man on a positive life path, even though “job placement” is not part of her official duties and will not appear in the agency’s reports.
* Which have also made the world worse, at least in some respects.
** This this does not refer to industrial-sized FBOs like Catholic Charities or the Salvation Army, which operate with bureaucratic precision.