16. Repurpose for Results

A 2014 Minnesota law (subdivision 7) requires the Minnesota Department of Human Services to use the Self-Support Index to monitor each county’s performance in assisting clients to become self-sufficient. Counties that meet performance targets receive a 2.5% bonus payment from the state, and counties that perform below the expected target must submit a performance improvement plan. In counties where “no improvement is shown by the end of the multi-year plan, the county or tribe’s allocation must be decreased by 2.5%” (Section 256J.626(7)(a)(2)).

A 2016 Minnesota law (section 14, line 15.21) allows the state to use the savings achieved from reducing the sentences of minor drug offenders for evidence-based drug and mental health treatments for offenders still in prison or under supervised release. The evidence to support this law comes from the Department of Corrections’ research, which found that providing offenders drug treatment reduces recidivism rates.

Juvenile Crime Prevention Councils (JCPC) exist in all 100 North Carolina counties in order to direct funding to programs that address the localized risks and needs identified for youth in that community. Reviews of program outcomes and performance (including successful completion of programming) include program monitoring, standardized program evaluation protocol, quality of service scoring through comprehensive review of data and program practices, and quarterly reporting. Egregious issues are addressed with corrective requests (including Program Enhancement Plans) or funding cessation. Trends and non-performance are addressed by informing the JCPC so that they may better be able to make use of state funding by allocating funds to other programming sources. The section is moving toward performance-based contracts for state-contracted services.

In New Mexico in 2014, a Pew Charitable Trusts report cited an example where a cost-benefit analysis revealed a program was not generating cost-savings. The report stated that the New Mexico Corrections Department program inventory, conducted in 2012, “found that fewer than 10 of the more than 40 programs studied were evidence-based.” Further, “the department’s drug abuse prevention programs, Therapeutic Communities, was not operating according to its evidence-based design and, as a result, was not achieving desired outcomes. The department subsequently replaced the program with an alternative, Residential Drug Abuse Treatment, that the Results First analysis showed would generate a return of $4 in benefits for every $1 invested.”

Senate Bill 390 passed in late May, creating the Advisory Committee for a Resilient Nevada (ACRN) housed within the Department of Health and Human Services. ACRN subsequently released its first biennial report assessing the current state of Nevada’s opioid epidemic, including misuse, drug-related deaths, and injury. Comprehensive analysis found that “Fentanyl deaths increased 227% since 2019”, and major gaps in services included: lack of standardized reporting, data on unauthorized immigrants or others not connected to the current treatment or surveillance systems, and a lack of capacity for community-based prevention programs across all counties. More education and monitoring was an overarching issue found as well. ACRN recommended revisions to current public health efforts, including “increasing the reporting and analytical capacities within the DHHS Office of Analytics to support sharing standardized data between public safety agencies and those monitoring local overdose spike response plans”; “establish a statewide all -payer claims database (APCD) that includes claims for all medical, dental, and pharmacy benefits with enough detail to identify physical and behavioral health comorbidities and de-identified demographic factors important for the meaningful analysis of health disparities, including but not limited to race/ethnicity, geography, sexual/gender orientation, pregnancy, etc.”; and “developing a statewide provider gap/needs assessment, using a diversity, equity, and inclusion (DEI) framing, to determine the current provider network array and what is missing, especially in the fee-for-service system.”

To support performance improvement, since 2021, Texas Workforce Commission grant managers for the Building Construction Trades grant conduct quarterly meetings where the grantees can share barriers and issues and discuss possible solutions that may have been implemented by other grantees.  An example of one such meeting can be viewed here.

The Texas Workforce Commission reviews its grantee performance monthly or quarterly. Per deobligation policy in state statute, the Commission has authority to terminate contracts for poor performing grantees. Funds deobligated from grantees are typically first available to transfer to other grantees within the program, before they are pulled back to agency wide reserves. It states:

“[Texas Workforce Commission] may deobligate funds if performance and/or expenditures are not meeting a detailed program plan and implementation schedule; and/or expenditure projections at the following intervals: twenty-five percent (25%) of the grant period; fifty percent (50%) of the grant period; and, seventy-five percent (75%) of the grant period.”