1. Taking ACEs to Scale
A Move From ProgramThinking to System ChangeThinking
Infuse  Align  Accelerate
Susan Dreyfus
President and CEO
Alliance for Children and Families
March 2014

2. A 21st Century
Theory of Change2

3. If we want to enjoy
prosperity, we
must foster the
health and well-
being of all
people...
3

4. ...as leaders, we
must articulate a
clear and
compelling
vision, create a
culture for
innovation and
partnership, and
practice adaptive
leadership skills...
4

5. ...we must move from
program thinking to
systems change
thinking as the only
way to achieve the
ultimate outcomes we
strive for, which are to
ultimately:
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reduce the number of people
living in poverty,
increase the number of people
living safe and healthy lives
put more people on to pathways to
educational and employment success…

6. ...this will require us
to move from a
linear and
transactional
mindset to a
dynamic and
transformational
view across systems
and sectors...
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7. ...and share
accountability for the
alignment of mutual
policy, goals, and
values across systems
and sectors for
collective impact
that none of us can
achieve alone!
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8. One State
One Secretary's Story
“By necessity, government must be smaller. We must make a
dramatic shift in what can be expected of state government…
The recovery will be long and bumpy, but we will survive this crisis
and we will emerge stronger.”
− Former Washington State Governor Chris Gregoire, Aug.
12, 2010
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9. Service Integration is Critical for
Bending the Cost Curve over Time
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43%
of dollars
are used
for clients
who use 3
or more
services
$3.5 Billion
11% of DSHS
clients use three or
more programs,
but they cost 43%
of the dollars
11%
of clients use
3 or more
services
n = 243,536
Clients use multiple programs when
they have inter-related issues:
•Complex physical health conditions
•Family problems
•Behavioral health needs
•Criminal justice involvement
•Educational issues
•Employment barriers
Service and technology integration
can lead to:
•Improved support
•Improved accountability
•Improved planning
•Increased fraud detection and prevention
•Increased employee safety

10. It all kept converging…
One
Science
ACEs
(children and adults)
Toxic Stress
Executive Functions
(Frontiers of Innovation)
First 2000 Days
Two-Generation Poverty
Community Capacity*
Multi-System Involved
Children, Adults,
Families
Changing Demographics
Education
Desire for Better,
Broader and Deeper
Outcomes
Systems of Care
Principles
Budget Pressures
Health
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11. 5 11

12. Department of Social and Health Services
Moving from Linear to Dynamic
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Planning,
Performance
and
Accountability
Department of Social
and Health Services
SECRETARY
WASHINGTON STATE
Office of the
Governor
Health and
Recovery
Services
Admin.
Economic
Services
Admin.
Children’s
Admin.
Aging and
Disability
Services
Admin.
Juvenile
Rehabilitat
ion Admin.
Chief of Staff
Risk
Management
Financial
Services
Information
Services
Management
Services
Public Affairs
Eligibility
Effective Case Management
Health and Rehabilitation
Facility Based Treatment
Crisis Response
Poverty Reduction
Organizational Business Functions
Community Capacity Building
Educational Success

13. Leadership,
Organizational
Hardwiring,
Policy,
Practice, and
Budget
Infuse
Align
Accelerate
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How Do We Move the Science to Scale?

14. 14
Leadership and
Engagement

15. 15
Cross-Sector
Organizational
Hardwiring

16. Every Person
Every Time
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17. 17
Policy and Fiscal
Alignment

18. Welfare
to Work
Child
Welfare
Health
Care
Reform
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19. Thank You
Susan Dreyfus
President and CEO
Alliance for Children and Families
414-359-6546  sndreyfus@alliance1.org  @SusanDreyfus
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