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Human Solutions for Human Services

By: Larry Goolsby and Bertha Levin

Posted February 26, 2015 on Funding for Results.

Every day public state and local human service agencies deliver essential social programs to communities across the country. From early childhood care and foster systems to eldercare and welfare administration, human services form the backbone of some our most valuable government services. These agencies touch the lives of millions by strengthening capacity, independence, and sustainable outcomes for individuals, families, and communities. Continuing to drive innovative, results-based approaches to human services could not be a more important task.

The American Public Human Services Association (APHSA) is the national membership association that works with and through these public agencies to continuously improve effectiveness, increase societal returns, and advance service sustainability nationwide. Our leaders work with engaged partners and stakeholders to generate creative solutions for the many challenges in our field today. Through dynamic leadership and path-breaking partnerships, they are finding new answers to old problems.

Our field now has unprecedented opportunities for innovation, alternative funding models, and breakthrough technologies. These new approaches, tools, and relationships are converging to transform our work into a system that creates community-wide change with meaningful and sustainable results. This exciting new field is already bringing in badly needed outside resources and accelerating the pace of innovation and creative solutions with nontraditional funding sources such as Pay for Success and social impact financing.

A number of our leading agencies are already pioneering outcomes-based initiatives with impressive results:

South Carolina

In the late 2000s, the South Carolina Department of Health and Human Services (SCDHHS) implemented the evidence-based Nurse Family Partnership (NFP) program to improve early childhood care in the state. In 2013 the State of South Carolina ranked fourth highest nationally in the rate of premature births, and more than 11 percent of Medicaid births were premature. NFP addresses these challenges by sending visiting nurses and trained health care workers into the homes of low-income, pregnant women both before birth and for 18 to 40 months afterward to provide support and education. In areas receiving NFP service, the number of healthy births and healthy children in the first three years of life increased, reversing statewide trends.

Helping mothers become better parents in early childhood prevents troubles down the road, which is not only socially responsible, but also cost-effective. The program costs roughly $4,800 per family per year, but a 2005 Rand analysis showed the NFP interventions with high-risk families has the potential to save as much as $34,000 for every child served.

The success of NFP encouraged South Carolina to expand the program from a few hundred people to 4,000 recipients and, in June 2013, NFP was named an awardee of the Harvard Social Impact Bond (SIB) Lab. The expanded program is projected to be operational by April 2015. The program is projected to reduce state costs in areas such as neonatal intensive care and spending on child abuse and special education services, all of which are linked to premature births.

Cuyahoga County, Ohio

In 2013, the Cuyahoga County Department of Job and Family Services in Cleveland, OH announced that it would apply a PFS approach to its Partnering for Family Success Program. This program reduces out-of-home foster care placements for children of homeless mothers through a mix of housing assistance and behavioral health services. As part of this project, Cuyahoga County will become the first county-level government in the nation to establish a special legislative item and sinking fund for PFS. Its local Social Impact Financing Fund was approved in July 2014. In October 2014, Cuyahoga also became the first county in the nation to enter into a multi-year PFS contract, in collaboration with several local partners and funders. The county plans to fully implement its PFS program in 2015.

Colorado Department of Human Services

In January 2012, the Colorado Department of Human Services (CDHS) implemented a centralized data and analysis system to maximize fiscal resources and improve the lives of those in need of public services. The C-Stat initiative collects and shares success indicators and program measures from across five state departments to pinpoint areas in need and adjust performance. Since implementation, two-thirds of the roughly 100 performance measures have shown improvement.

The comparative statistics management tool measures indicators across CDHS’ program offices. The formerly siloed offices now work together through a commitment to better address constituent concerns, as well as hold agencies accountable for achieving results. Successes include cutting application processing times for community access and independence services by a third in two years, achieving a 90-percent level of at least one family contact per month for youth in state-operated facilities, and dramatically reducing wait times for behavioral health competency examinations.

Analyzing the data indicators collected in C-Stat has allowed the state to make informed, collaborative decisions about resources and establish clear outcomes measures to affect positive change. The program has now been extended to the county level, and public, quarterly progress reports have increased transparency and service.

These are only a few examples illustrating the ways in which public human service agencies are meeting today’s challenges through better evidence and effective innovations.

Learn more about APHSA’s work by visiting our website and reading about our Pathways initiative.

Larry Goolsby ( is Director of Strategic Initiatives at the American Public Human Services Association (APHSA). Bertha Levin ( is a Senior Program Associate at APHSA. You can follow APHSA on Twitter @APHSA1.

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