This brief provides a closer look at using evidence in the contracting process, one strategy identified in “A Guide to Evidence-Based Budget Development,” a 2016 brief.
State and local governments frequently rely on community-based organizations to serve individuals and families. In 2012, according to the Urban Institute, governments spent approximately $80 billion through contracts or grants on human services programs that were delivered by nonprofit organizations. Given the critical role these organizations play in assisting vulnerable populations, policymakers should take steps to ensure that whenever possible, funds are invested in programs and services that are proved to work. One promising strategy government leaders can use is to incorporate evidence requirements into their contracting and grant processes.
Increasingly, policymakers recognize that they can improve outcomes, strengthen accountability, and reduce costs by using rigorous evidence to inform choices about which services should be supported with public funds. This issue brief profiles four jurisdictions that are using evidence-based contracting to significantly increase the number of people reached by proven, effective programs: Georgia (child welfare), Florida (juvenile justice), New York (substance abuse), and Santa Cruz County, California (criminal justice).
In developing a system that supports evidence-based contracting, policymakers will want to:
- Use data and research to identify needs and incorporate them into the requirements. In developing the grant and contract language, staff should use data from community needs assessments or similar processes to identify the evidence-based programs that address those needs and have been shown to be effective in achieving the desired outcomes in a given population.
- Work closely with provider organizations throughout the process. Agencies should work closely with community-based providers, county governments, or local health clinics to build support for and understanding of evidence-based principles before issuing grant announcements or embedding requirements in contracts.
- Define criteria for “evidence-based” and be specific in grant announcements. Within state and local governments, there is often significant uncertainty as to what constitutes an evidence-based program. Creating formal definitions of evidence and embedding these definitions in contracts will help clarify expectations of provider organizations and government officials. When feasible, contracts should specify sources, such as nationally recognized research clearinghouses, where providers can find information on a wide range of programs that meet a given standard.
- Build mechanisms into the grants to monitor implementation fidelity and outcomes. A large body of research shows that well-designed programs that are implemented without fidelity to their treatment model are unlikely to achieve the outcomes policymakers and taxpayers expect. As part of their contract requirements, providers should be compelled to report on interim outcomes that are correlated with effective program delivery, in addition to long-term outcomes. Government agencies should direct resources to carefully monitor these efforts.
- Agency: Office of Prevention and Family Support (OPFS), Division of Family and Children Services.
- Policy area: child welfare.
- Number of providers: 100.
- Total funding for grants/contracts: approximately $9.1 million in calendar year 2014.
- Funding for evidence-based programs: 100 percent of direct service prevention program providers within OPFS are required to offer evidence-based programming.
The Georgia OPFS requires that all contracted prevention services—including family preservation, child abuse prevention, and family support and coaching (home visiting)—utilize evidence-based approaches that meet specified criteria. OPFS works with community-based organizations to promote the safety and well-being of families at risk of entering the child welfare system. Before the office was created in the late 1990s, the state Children’s Trust Fund promoted evidence-based programs through home visiting grants and other prevention programs. In 2014, Governor Nathan Deal (R) created OPFS to administer grants initially operated through the trust fund, as well as other prevention funding sources, and provide training and technical assistance to support community-based organizations delivering child maltreatment prevention activities.
The strategy—to use grant-making as a mechanism for increasing the use of effective evidence-based programs and thereby improving outcomes for Georgia’s children and families—has changed over time. Now the office identifies clear criteria for the level of evidence that programs must meet to be considered for funding, but it also gives providers more flexibility to choose among programs that meet those criteria.
Initially, the office issued requests for proposals that required grantees to implement specified evidence-based program models (selected from several evidence-based registries). Although this method was successful in encouraging community-based organizations to begin implementing such programs, the approach offered few program alternatives and therefore limited providers’ ability to deliver services that would meet the needs of diverse populations.
To address this limitation, the office now distributes funding, including state and federal grants, to provide a wider menu of evidence-based options. Communities can choose the best program to address specific needs as long as the intervention meets the evidence standards. For example, the Division of Family and Children Services recently released, under OPFS, a statement of need for the Promoting Safe and Stable Families program that included eight core evidence-based models from which providers could choose, as well as 33 other evidence-based practices that could be selected based upon specific community needs.3 (Box 1) Another grant opportunity for family support and coaching services identified five models that meet the minimum evidence requirement, based on criteria developed by the California Child Welfare Clearinghouse or other evidence-based registries. “Slowly but surely [through our contracting process] we are implementing evidence-based programs in all categories of primary and secondary prevention in the state,” said Carole Steele, OPFS director.4
State leaders are also taking steps to ensure that these programs achieve expected outcomes by building requirements into contracts for outcome reporting, training, and monitoring program implementation. OPFS requires service provider organizations to work with program developers (the organizations or individuals who generate and license a particular model program) to access training and other supports as part of their contract. “Requiring this close communication has helped build capacity and ensure success for these provider agencies,” Steele said. The state also has some capacity to support the training and implementation needs of providers if program developers are not available. For example, for two evidence-based models—Parents as Teachers and Healthy Families America—the state provides its own training and technical assistance through a contract with the Center for Family Research at the University of Georgia. This ensures that providers are equipped with the training necessary to implement the program as originally intended and achieve expected outcomes.