Father holding his young son, both are smiling

Boosting Childhood Health in Connecticut

Public Sector Solutions, Children & Families

Highlights

3,000Caregivers in Connecticut receiving improved home visiting services

$20M

Annual spending on home visiting contracts that are now tied to outcomes

Since 2017, Social Finance has collaborated with the Connecticut Office of Early Childhood (OEC), a state agency that supports children from birth to grade school in Connecticut, to create and maintain an outcomes rate card (ORC). An ORC is a performance-based partnership between a government and an external service provider, or a network of providers, that enables governments to pay service providers varied amounts based on whether they achieve one or more predefined performance metrics.

Goals

  • Shift OEC toward a performance-based approach to home visiting services.
  • Improve data integration among OEC and its service providers.
  • Support multigenerational outcome improvements for families who qualify as low-income.

The Work

Social Finance developed and implemented strategies to achieve these goals through:

  • Service identification: Worked with OEC to identify which of its services would benefit from an ORC, in which service providers would receive bonus payments, on top of their fee-for-service contract amounts, for achieving predefined metrics. Selected the home visiting portfolio as the most promising fit because of its flexible funding sources, including state and federal dollars; evidence-based models; procurement opportunities; and policy goals.
  • Provider engagement: Helped plan and lead 10 community listening sessions to inform the home visiting system’s overall priorities, one of which was collecting feedback on rate cards.
  • Metric selection: Reviewed OEC home visiting benchmarks, policy priorities, and historical data to identify payment-linked outcomes. Metrics included in OEC’s first home visiting rate card included full-term birth and reduction in child maltreatment. In the most recent rate card, metrics include key population enrollment; prenatal enrollment; caregiver education, training, or employment; and prenatal and postpartum care.
  • Payment system analysis: Used historical OEC data to understand the agency’s baseline performance and establish payment terms. Providers receive payments twice per year based on outcomes achieved.
  • Performance management: Receive ongoing rate card performance data to track program and system performance and inform recommendations to providers for increasing metric achievement.

Participant Stories

Mother little child holding hands walking in a grass field at sunset

For Jazmin, a Home Visitor Helped Jumpstart Her Career

Jazmin knew her home visitor—matched through a home visiting program funded by OEC—would help her navigate pregnancy, birth, and early parenting. What she didn’t foresee was that her home visitor would also help her achieve her career goals.

How It Works

The Results

5Following the successful launch of the initial ORC in 2018, Social Finance and OEC launched five additional ORCs over subsequent funding cycles

$20MOEC's annual spending on outcomes-based home visiting contracts

3,000OEC incorporated ORCs into all home visiting service provider contracts, which provide services for nearly 3,000 caregivers each year

80%+Percent of OEC home visiting providers reporting that rate card payments are significant and that find the ORC to be a motivating tool


The partnership with Social Finance has provided OEC the opportunity to implement multiple iterations of the outcomes rate card and realign and renew the agency's vision for the evidence-based home visiting program. Ashley McAuliffe, Family Support Division Director, Connecticut OEC

Partners

Header photo courtesy of Connecticut OEC.

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