Evidence-based Policy in a Bipartisan Congress (Yes, It’s a Real Thing)
Our work in evidence-based policy at the Center began with a federal grant initiated by the White House Office of Social Innovation and Civic Participation under something called the Social Innovation Fund (“SIF”). Designed to be a “catalyst for impact,” the SIF provided funding and support for direct services in evidence-based programs as well as enabled entities such as ours to explore whether a new approach to public-private partnerships, called Pay for Success (“PFS”), could help move the needle on difficult-to-solve social problems like persistent homelessness, school readiness, and breaking the cycle for justice-involved youth and adults. Catalyzing systems-level change came without a federal mandate that this is how it (whatever it was) ought to be done. Instead, the SIF empowered local governments and nonprofits to implement evidence-based approaches to problems defined and informed by local knowledge.
The Bipartisan Budget Act of 2018, signed early this morning, provides continued funding for many important programs, and it also brought to fruition two significant initiatives for the PFS field: the Social Impact Partnerships to Pay for Results Act and the Pay-for-Outcomes provision in the Maternal, Infant, and Early Childhood Home Visitation Program. Both create new opportunities to expand the use of PFS, which is an important tool in the toolbox of the evidence-based policy movement. To be successful, a few important principles must be followed: first, by driving resources to high-quality, rigorously-measured programs through public-private partnerships, we ensure that the initial promise of success is never lost in the reality of implementation. Second, to collectively identify seemingly intractable problems defined at the local level, we have to make sure that we invite the right people to the table for the right reasons.
This is why the Social Impact Partnerships to Pay for Results Act (“SIPPRA”)—originally proposed under S.963 and H.R.576—is so important. We often talk about solving the wrong pockets problem, which Urban Institute Senior Fellow John Roman (now Senior Fellow with NORC at the University of Chicago) described as when “the entity that bears the cost of implementing a practice—including an evidence-based best practice—does not receive a commensurate benefit.” Consider your own city seeking to address homelessness: the majority of the cost savings would accrue not to your city’s budget, but instead to faraway state- and federally-funded programs—that’s a wrong pockets problem. At the same time, there’s a clear incentive to bring state leadership to the table. The clever way that SIPPRA puts federal, state, and local leaders on the same team is by establishing a $100 million fund to support the solutions when PFS projects deliver savings accrued at the federal level. Before, these savings were effectively money left on the table.
Restoring Funding for Early Childhood Programs with a Focus on Outcomes
Efforts to continue funding the Maternal, Infant, and Early Childhood Home Visitation Program (“MIECHV”) after September 30, 2017 were unsuccessful. Fortunately, this program has not only been restored through a 5-year reauthorization but also a key part that includes an option to use a PFS approach called Pay-for-Outcomes. Included in the original version in the House (H.R.2824,which passed the House on September 26, 2017, and S.1829), the Pay-for-Outcomes provision would allow for states to contract with providers on based on measurable outcomes with a requirement for rigorous, independent evaluation.
These important programs result in better outcomes for at-risk children and families. With measurable outcomes, such as improved maternal and newborn health, improved school readiness, and family economic self-sufficiency, there’s a strong case for MIECHV and programs like it.
And, echoing the sentiments of locally-identified solutions, we see similar efforts in Utah. State Senator Luz Escamilla introduced the Nurse Home Visiting Pay-for-Success Program (S.B.161), which would create the enabling legislation necessary to support a PFS approach for evidence-based home visiting. Having visited Senator Escamilla and her staff to discuss this bill, I can see first-hand how effective policy-making can be as much about the passion for serving at-risk children as it can be about providing guardrails for fiscal responsibility. During our meeting, we talked about why her efforts were necessary to fill the gap left by the expiration of MIECHV funds last fall. I hope that the passage of S.B.161 will lead to a redoubling of our efforts in Utah with newly-available federal funds.
Why This Matters
To put it simply, we’re seeing action in a bipartisan Congress that recognizes and corrects a market failure—a disconnect between our best intentions and hard work have resulted in some unforeseen and unanticipated less-effective outcomes. Correcting for such market failures requires recognizing there’s a problem in the first place, and it’s reassuring to know that such solutions can be achieved through bipartisan efforts.
Before PFS and other forms of outcomes-based policymaking, there was little to incentivize evidence-based programs, let alone measure and evaluate them in a way that would achieve accountability, transparency, and fiscal responsibility. At the end of the day, whether you’re from a Blue State or a Red State, we can find common ground under a “Purple Flag.” Why? Because some of our greatest problems are not bound by state lines, legislative districts, or political ideology. And the people experiencing these problems deserve more action and more programs backed by evidence.
Time to get to work.