Takeaway: Specifying desired outcomes in contracts can help clarify providers’ responsibilities and allow for meaningful comparisons of performance. Agencies can then use this information to identify areas in which providers need additional training or support.
Principle 4: Prioritize evidence-based interventions.
Directing funding toward interventions that have been shown through research to be effective can increase the likelihood that programs will achieve desired impacts.
Example: The New York State Division of Criminal Justice Services conducted cost-benefit analyses and used other research tools to identify effective, evidence-based programs aimed at reducing crime.5 This process revealed that investments in some of those programs could reduce offender recidivism by up to 12 percent and generate returns on investment upwards of $4 in taxpayer benefits for each $1 spent on programming. Based on these findings, the division restructured more than 100 contracts, representing approximately $21 million annually, to prioritize and support evidence-based, cost-beneficial alternatives to incarceration.
Takeaway: Jurisdictions can use the contracting process to prioritize funding for programs that have been proved effective.
Principle 5: Build in measures to track program implementation.
Programs are most effective when they’re implemented according to their original design. Deviations—such as a change in location, population served, or setting—can jeopardize the anticipated benefits.
Example: The Pennsylvania Commission on Crime and Delinquency contracted with EPISCenter, an implementation support organization, to develop common indicators for measuring implementation fidelity and outcomes for 16 evidence-based community prevention programs operated by grantees throughout the commonwealth.6 The metrics help providers monitor their programs and allow the commission to remotely track implementation across grantees to identify problems and make needed adjustments in real time, rather than waiting until the contract is up for renewal. Through these efforts, Pennsylvania generated an estimated $55.8 million return on these investments in fiscal year 2013-14.7
Takeaway: Leaders can specify in contracts key milestones of program implementation, such as the time from intake to treatment, to ensure that public programs yield intended outcomes.
Principle 6: Allow for experimentation or adaptation when evidence is limited.
While prioritizing evidence can help produce desired outcomes, evidence-based options are not always available. In these circumstances, jurisdictions can allow providers to pilot new programs, adapt existing ones to incorporate evidence-based principles, or evaluate new and untested programs to build the evidence base.
Example: Following passage of a 2007 law that required state funds to support the use of evidence-based programs, the Tennessee Department of Children’s Services built evidence requirements into its contract guidelines with local juvenile justice program providers.8 The department can still contract for programs that are not evidence-based as long as they incorporate key elements of evidence-based practices. The department uses a standardized assessment tool developed by researchers at Vanderbilt University9 to determine the extent to which juvenile justice programs align with elements of practice that research has shown to be effective at reducing recidivism.
Takeaway: Allowing for experimentation or adaptation enables jurisdictions to meet the unique needs of their communities and fill gaps where there is limited evidence of what works.
Principle 7: Support providers in meeting rigorous standards.
State and county leaders can support providers’ capacity to deliver services by creating forums for collaboration between contracting agencies and service organizations, as well as offering technical assistance and training on implementing evidence-based programs.
Example: The South Carolina Center of Excellence in Evidence-Based Intervention at the University of South Carolina helps behavioral health providers in the state identify and implement evidence-based interventions for children, youth, and families. In 2016, the center issued a report that named key evidence-based interventions that could support this population, along with information on each program’s implementation requirements, related costs, which outcomes could be affected, and target population.10 The center then worked with provider organizations across the state to help them select programs that target the specific needs in their communities and that were feasible to implement based on each organization’s capacity.
Takeaway: Enhancing provider capacity and expertise can help jurisdictions better serve diverse populations and deliver high-quality services.
The contracting process provides a strategic opportunity for state and county leaders to prioritize evidence in their budget and policy choices. These key principles can help jurisdictions strengthen the quality of their contracted services and foster a culture that uses evidence to make decisions along with providers and other stakeholders, while increasing the likelihood that the services purchased are effective in meeting community needs and producing positive outcomes.