Programs That Tie Funds to Effectiveness Are at Risk

By ANNIE LOWREY

 WASHINGTON — Policy experts and academics consider home-visiting programs — where nurses counsel teenage mothers and other at-risk parents — to be among the most effective social interventions. The programs slash the incidence of neglect, bolster infant health and in some cases save taxpayers money by cutting costs.

But not all programs follow best practices, or even track their results. To tackle that problem — to make the initiatives more effective and accountable — the Bush administration created a pilot program tying federal financing to policy outcomes. States could get federal financing if they put in place research-supported best practices.
There are now six such “evidence-based” pilot programs that make taxpayer dollars contingent on results and that would seem to have natural appeal to Congressional Republicans. But they are under threat from a House proposal that eliminates all federal financing for four of the six programs, including the home-visiting program, and significantly cuts money for a fifth.
Republicans say that no decisions are final, and that the appropriations process is in its early stages. Democrats promise to fight for the initiatives, and argue for their inclusion in next year’s budget. Policy experts worry not just about the evidence-based programs, but also about the future of such mechanisms to make government money go further and work better.
“The hard-working taxpayer deserves more careful consideration of how we spend their money,” said Representative Denny Rehberg, Republican of Montana, who is chairman of the appropriations subcommittee that cut the evidence-based financing. “We requested updates on findings from evaluations and other activities conducted using these funds. The committee will review the results carefully so we can make an informed decision about whether or not to fund this in the future.”
The evidence-based pilot programs make up a tiny portion of federal spending, accounting for about $1.2 billion out of a $670 billion budget for nonmilitary discretionary programs in the 2011 fiscal year. Nevertheless, policy experts hold that they represent an important change in how Washington thinks about accountability for such spending.
“All of these programs sprang out of asking the question: How can we get better results with less money in a constrained fiscal environment?” said Robert Gordon, executive associate director of the White House budget office. “If your goal is to change how government works and to send a signal that results matter, programs like these are powerful.”
The idea of tying money to outcomes seems commonsensical. But policy experts say most federally financed social programs — like the preschool program Head Start or job retraining initiatives for displaced workers — do not consider results when determining how to allocate money.
“For most large social programs,” said Jon Baron, president of the Coalition for Evidence-Based Policy in Washington, “the federal government plays the role of a faucet. It directs the agencies to allocate large streams of funding, often determined by formula. Evidence about which programs are effective or not does not come into the picture.”
That began changing during the Bush administration, after years of research showed taxpayers spending billions of dollars for sometimes negligible results on things like substance abuse prevention and early childhood education.
The Bush administration created the home-visiting initiative, a $10 million competitive grant pilot program to help state and local governments invest in “quality assurance systems,” train workers and establish programs with “strong fidelity to a proven effective model,” in 2008. Congress expanded the spending to $13.5 million the next year.
When the Obama administration came into office, it decided to “turn the dial up,” said Peter R. Orszag, a former budget director who is now a vice chairman at Citigroup. “The ethos is not just to spend money blindly, but to make investments — to spend money on things that demonstrate that they work. If you try three approaches to job training, you actually try to over time dedicate more money to the programs that work better.”
The administration drastically expanded the home-visiting program, increasing spending to $1.5 billion over five years. And it decided to apply the evidence-based ethos to other programs. Congress approved $75 million to study and replicate the most effective teenage-pregnancy prevention programs, for instance. It also added competitive, evidence-based financing for two work force training programs, an initiative to improve student achievement and an initiative to help low-income communities.
The administrators of the programs say it may take several more years to see hard results. For instance, Paul Carttar, the director of the Social Innovation Fund, says it remains focused on building the infrastructure for its competitive grants to community organizations. But he estimates the program has already reached 70,000 people through local initiatives with a “very significant evidence requirement.”
“There are other benefits of these programs that oftentimes are not really appreciated,” Mr. Carttar said. “Other federal agencies can adopt the best practices identified by evidence-based programs. By that same logic, they also have tremendous value, not just to federal grant-makers, but to philanthropic grant-makers, individual donors — anyone who thinks about money creating an impact.”
The proposed budget cuts have bewildered social scientists and good-government experts. “Why, in a constrained budget environment, do you cut the programs that have to show they’re working?” asked Ron Haskins, a former Republican Congressional staff member and White House adviser who is co-director of the Brookings Center on Children and Families. “It makes no sense.”
The White House has also strongly objected to the subcommittee’s zeroing out financing. Jacob L. Lew, the White House budget director, sent a letter acknowledging the necessity of budget cuts, but asking that Congress retain spending for programs that can help states save money and improve outcomes. “In a period of limited resources, these initiatives encourage and reflect the systemic changes and evidence-based interventions that can achieve the greatest impacts at the lowest cost,” he wrote.
Mr. Rehberg, the appropriations subcommittee chairman, stresses that nothing is final. “The days of blindly throwing money at any and all programs without any consideration of how well they work are over, as well they should be,” he said in an e-mail.
But Democrats on the subcommittee have said they will fight for their inclusion.
“These initiatives are targeted, focused investments that would improve our schools and help American families during these difficult economic times,” said Representative Rosa L. DeLauro of Connecticut, the senior Democrat on the subcommittee. “Cutting these initiatives, and many other worthwhile programs and services, is the wrong direction.”