It may seem odd, but one of the joys of our work is going to programs and actually learning about what they do and what they accomplish. In our work for the Minnesota Department of Human Services, we will be visiting all 87 counties in Minnesota plus a number of health plans and tribal governments to learn about how they administer the Home and Community Based Waiver program and assess elements of the quality framework (.pdf) developed by MDH. This project is taking us around the state. A team of Improve Group staff (Sarah, Eric, Liz and Leah) spent time in International Falls and Grand Rapids this week. We had the chance to interview staff, conduct surveys and review participant records. We heard some funny stories -- and got to pick up some local culture like seeing the birthplace of Judy Garland (from the car). One of the things we like about these site visits is they make the abstract concepts of policy real -- they show us how things operate in a real-world context. For example, several Counties have said that just having policy information available on the Internet is helpful; they don't have to try to schedule multiple staff to attend a training and instead can easily direct their staff to needed resources. Other staff have talked about the difficulty of balancing costs with individual needs; if money were no object, individuals could really benefit from 1:1 therapies, specialized equipment, and other services; however, it simply is not possible to provide the most expensive services to everyone. Staff take their job of finding the best services possible to have the greatest impact on those individual lives while staying within cost limitations. These stories are very powerful and help us understand how important high-quality information and evaluation work is; it can help people in making those difficult decisions.