Developing a performance-based contracting strategy for delivery of critical services to ensure children are placed in the most appropriate setting and are provided the most effective services
Every child deserves the opportunity to grow up safe, healthy, and with a family.
The Harvard Kennedy School Government Performance Lab’s work in child welfare and early childhood helps state and local governments discover, demonstrate, and scale solutions that enable children and families to succeed. We measure the success of our projects in terms of the health of new moms and their babies, the number of vulnerable children protected from harm, the share of young people successfully transitioning to adulthood, and the volume of families living and thriving together at home.
Our technical assistance focuses on strengthening prevention, improving child welfare interventions, and taking a more coordinated approach to service delivery, such as:
Through engagements with governments around the country, we have identified a set of 17 model management strategies to remedy common causes of underperformance by public child welfare agencies and produce continuously rising outcomes for these children, young people, and families. These strategies include:
Identify maltreated children not reported to the child welfare agency by comparing trends across human service systems (strategy 2)
Drive real-time improvements to service delivery through active contract management (strategy 8)
Accelerate permanency by using data to uncover stalled cases and address systematic case management barriers (strategy 9)
Analyze workforce data to improve recruitment, retention, and supervision of frontline staff (strategy 12)
Provide whole-family supports to the most vulnerable children and families (strategy 14)
Our current focus is on establishing high-visibility “model agency” demonstrations of child wellbeing systems for the 21st century, refining these model management practices by continuing intensive technical assistance with individual jurisdictions, and developing dissemination resources, tools, trainings, and partnerships to affect standards and practices nationwide.
Children & Families Projects
Creating performance metrics, developing short- and long-term strategies for service allocation, and aligning the service array around the core needs of children and families served by the state
In 2013, over 50 percent of the 36,000 cases investigated by Connecticut’s Department of Children and Families (DCF) had an indication of parental substance use. DCF hoped to support these recovering parents by matching them to recovery and support services while limiting removals of their children, so the agency worked with the GPL to launch the Family Stability Pay for Success project. This project identified a crucial gap in services for families with children aged 3-6 and expanded these services to support 500 additional families in need. The GPL also worked with DCF to tailor its identification, referral, and enrollment processes to better address the specific needs of families with substance use issues. Although the project is still underway, initial results have shown promise, and the final results will be evaluated by a randomized control trial.
In Illinois, approximately 700 youth per year become simultaneously involved in the child welfare and juvenile justice systems. These dually-involved youth experience very poor outcomes; on average 1,300 arrests per year and 230,000 days spent in congregate care. With pro-bono technical assistance from the GPL, the state tested a new model for supporting families involved with multiple agencies and has re-engineered data systems to improve performance management and referral processes. It now takes the state child welfare agency less than three days to identify a dually-involved youth, down from over 90 days on average. Once flagged as dually-involved, youth are matched to a wraparound facilitator who serves as their primary contact for support and refers them to appropriate services in a coordinated manner. As part of the project, Illinois is also expanding the clinical and social services available to dually-involved youth (including family therapy and community-based placement), with the goals of reducing days spent incarcerated and in congregate care and improving child well-being.
Michigan sought to expand prenatal and postpartum support in order to reduce the likelihood of negative health outcomes for new mothers and their children. With pro bono technical assistance from the GPL, Kent County is expanding comprehensive nurse home visiting services to every Medicaid-eligible, first-time mother to provide prenatal care, breastfeeding support, parenting and life skills-building, and additional services as needed. Assessed by a rigorous evaluation, the program is helping to reduce preterm births and rapid repeat pregnancies for new moms.
The GPL worked with DCYF on strategic planning to assess service needs and design an approach for improving services for children and families, executing a results-driven procurement for a new set of service contracts, strengthening their contract and provider performance management practices, and designing a strategic procurement management system to improve the results of contracted spending throughout the agency.
Striving to lower rates of preterm births and child injuries, the South Carolina Nurse-Family Partnership aims to give new moms the care they need to have healthy pregnancies and babies. The GPL worked with South Carolina’s Department of Health and Human Services (SCDHHS) to provide nurse home visiting services to 4,000 low-income, first-time mothers from the second trimester of their pregnancy until their child’s second birthday. The model incentivizes NFP to focus on enrolling mothers from low-income zip codes, reducing child injuries and pre-term births, and increasing healthy birth spacing. After the project concludes in 2022, the state will make success payments that will be reinvested into NFP in South Carolina based on outcomes evaluated by a randomized control trial.
Within most human services agencies, there is a subset of highly vulnerable families who have particularly multi-faceted or complex needs that are not being adequately addressed. In the traditional approach to serving these families, government treats each facet of the family’s challenges through a separate, siloed agency, usually focusing only on the family members who present to the system. As a result, these vulnerable families are likely to either engage with many services in a disjointed, ineffective way, or to receive one siloed service even though they have much more complex needs.
To reimagine a system of supports for these vulnerable families, the GPL is working with Chicago to develop a system to better coordinate services that address vulnerable families’ overall needs, thereby providing the holistic supports these families need to attain social and economic mobility. To do so, the GPL is helping the Department of Family and Support Services (DFSS) assess the current challenges for highly-vulnerable families interacting with DFSS and designing a pilot intervention to provide more holistic supports for a priority subset of these families by better coordinating resources across DFSS' workforce, youth services, homelessness and domestic violence, and children's services divisions.
Improving referrals and treatment adherence among child welfare parents in need of behavioral health services and using data for more informed strategies to reduce child fatalities
Developed Pay for Success strategies to improve outcomes of youth dually-involved in child welfare and juvenile justice systems
Conducting feasibility analysis on a cross-jurisdictional partnership for implementing early childhood education programming
Strengthening interagency collaboration to improve early childhood outcomes
Refining population targeting, family engagement, and service delivery of family home visiting programs through reprocurement and data-driven contract management practices
Assessing feasibility of Pay for Success project focused on reducing unintended pregnancies
Increasing the use of outcomes and performance measures in contracts for child welfare programs and services
Improving outcomes for criminal justice-involved youth through the City's Community Safety request for proposals
Assessing Pay for Success feasibility for a range of human service areas including maternal and child health, housing, and re-entry services
Connecting at-risk families with high quality early learning programs and family home visiting services