Contracted Services

July 1, 2018 marked the beginning of the Department of Children, Youth, and Families (DCYF) and the commitment to improving outcomes for families with Performance-Based Contracting (PBC). DCYF has been strategically implementing performance standards in client service contracts across three key areas: Services (the “What”), Quality (the “How”), and Outcomes (the “Result”), as directed in House Bill 1661

Standards in each area are intended to link client service-level data to outcomes, allow for data analysis on services, and adapt to the needs of children and families as contracts adapt to change. The goal of PBC is to partner with providers and advocates to achieve DCYF’s long-term child and family outcome goals.

Key Performance Areas

PBC works in four areas:

  1. Link services (what we do) to quality metrics (how well we do it) to help influence outcomes (the results for children, youth, and families).  
  2. Build logic models based on existing measures (from state or federal requirements).
  3. Partner with stakeholders for equitable input (feedback or collaboration of efforts).
  4. Data analytics to align with DCYF outcome goals for children, youth, and families.

Key Performance Areas
Graphic developed with support from Third Sector Capital Partners, Inc.

By focusing on these key performance areas, PBC is able to evaluate the effectiveness of programs with a focus on disproportionality and disparity within program areas.

Each DCYF contract group uses the key performance areas to identify client-level services, a quality metric (including a target and a performance management tool) and an outcome metric (including a target and a performance management tool) to incorporate into existing contracts. PBC will incorporate more metrics in future contract iterations as client-level service data is available for analysis and with the support of stakeholder engagement.

Measuring Performance

DCYF contract groups identify which performance metrics to incorporate into client service contracts through the performance-based contracting phased process. Service metrics are standardized and include client demographics for program services. Program-specific quality and outcome metrics are developed in partnership with service providers, data analytics and stakeholder input. Data will be used in a continuous improvement process for determining future metrics.

Contracting Timeline

Equity

Programs within DCYF, currently and historically, have large disproportionalities and dipartites, contradicting DCYF’s commitment to better outcomes for children, youth, and families. PBC is a method used to ensure access to adequate data, stakeholder engagement, and ability to review current contracts to determine disproportionalities and disparities. Equity (eliminating disproportionalities and disparities) is the number one goal of PBC.

Contract groups have been going through the PBC process with deliberate attention to equity efforts in identifying metrics. Because of this, beginning in FY21, all PBC data will be disaggregated by race/ethnicity, income, and geographic location.

Data and Research

DCYF’s Office of Innovation, Alignment, and Accountability (OIAA), Research and Data Analysis (RDA), Stanford-Center of Poverty and Inequality (CPI), and Department of Health (DOH), have partnered with the contract groups to take on the large task of the data analytics portion of PBC. Each contract group has a dedicated entity assisting in:

  • Review of literature for best practices.
  • Review of current program data.
  • Developing the necessary client-level data needs for new or existing metrics.
  • Creating data displays to support the on-going PBC feedback loop to providers.

The data analytics partnership is vital to ensuring that contract groups are able to establish metrics that connect to outcomes and to review service, quality, and outcome metrics for continuous improvement. PBC could not be a successful measure of equity or program improvement without the commitment from the data analytics partnerships.

Stakeholder Engagement & Input

PBC continues to build on its equity commitment by focusing attention on stakeholder input, engagement, and feedback. Stakeholders are the key to understanding the service needs of the populations served, equitable quality metrics, and improving outcomes.

Stakeholder engagement can range from informing stakeholders of where the agency is heading to full shared leadership of an entire project. PBC utilizes a continuum of stakeholder engagement on many different levels for involvement in decision making and in collaboration. Each contract group identifies their stakeholders to guarantee all voices are heard in the development of metrics.

Phased Development Approach

There are more than 1,000 client service contracts in DCYF. PBC began with four contract groups and has added additional contract groups over the last two years. This process is deliberately spaced out into phases to allow provider and stakeholder input, evaluation and review of best practices and current services, and for data reporting and collecting.

Client service contracts have been placed into 25 contract groups to group similar services together for evaluation, but not necessarily to create the same quality and outcome metrics. Out of the 25 groups, 19 groups are currently engaged with the PBC phased process, with the remaining four to start PBC in July 2021. As new contracts are established for an array of client services, they are incorporated into an existing contract group or brought into the PBC phased approach in their own grouping.

Implementation Timeline

PBC is a massive undertaking -creating change to services by ensuring more than 1,000 client service contracts set up successful services for children, youth, and families across Washington State. To have lasting impact, PBC’s timeline reaches that goal by systematically developing an iterative process. Because of this, the timeline spans from 2018-2023. Although this appears to be a slow-moving process, each contract group is joining PBC at different stages in a staggered approach to allow for data analysis, stakeholder input, and continuous improvement efforts. Because contract cycles differ depending on program, each program may only be able to implement contractual changes at the beginning of a contract cycle – calling for a timeline that allows for contractual changes at the beginning of a contract cycle instead of through amendments.

implementation Timeline

Fiscal Year Reporting

Contract periods may fall under the state fiscal year or the federal fiscal year. For the purposes of PBC, we follow the state fiscal year and collect data according to the contract period. PBC identifies each contract period as the year below.

Year Contract Cycle
FY20 July 1, 2019 – June 30, 2020 October 1, 2019 – September 30, 2020
FY21 July 1, 2020 – June 30, 2021 October 1, 2020 – September 30, 2021
FY22 July 1, 2021 – June 30, 2022 October 1, 2020 – September 30, 2022
FY203 July 1, 2022 – June 30, 2023 October 1, 2021 – September 30, 2023

Contract Groups

There are 19 contract groups who are currently involved with the PBC implementation process. The remaining six contract groups will start the process in July 2021. Because the approach is staggered for contracts groups to begin the PBC implementation process, groups vary within the project by phases. As of FY21, the 19 contract groups account for 1,013 contracts within the implementation process of PBC.

Contract Groups by Phase

On Hold (27%)
Approved temporary delay for FY21
Phase 1: Launching (27%)
Working to meet some of the PBC requirements
Phase 2: In Progress (42%)
Meets some of the PBC requirements
Phase 3: Completed (4%)
Meets all of the PBC requirements
Juvenile Rehabilitation (JR): Gang Reduction and Intervention Program Adolescent Housing Independent Living Services ECEAP
JR: Physical Health & Safety Placement Services Combined In-Home Services  
JR: Behavioral Health Placement Support Services BRS  
JR: Legal Child Welfare (CW): Physical Health & Safety Family Time  
JR: Chaplain/Cultural Services CW: Behavioral Health Adoption Services  
JR: Rehabilitation/Detention Services Tribal Services Home Visiting  
  ECLIPSE ESIT  
    Community-Based Child Abuse Prevention  
    Juvenile Courts  
    Reentry  
    Office of Juvenile Justice  

Contract groups are in different phases and focus on different aspects of PBC.

Phase 1: Service and Quality metrics that already exist within their contracts to align with PBC process.

Phase 2: Quality and Outcome metrics to enhance the current contract with the assistance of data analytics.

Phase 3: Continuous Improvement and Performance Feedback Loop.

Current Contract Cycle Number of Contracts in PBC FY20 Expenditures (partial)
July 1, 2020 – June 30, 2021 (FY21) 1013 (FY21) $328.6 million

*Does not include all contract group expenditures

Program Areas

Listed below are the current Service, Quality and Outcome metrics and summaries for the program areas. These metrics represent the PBC aspects of contracts, not the overall success of programs. All contracts have additional metrics to support success of the programs outside of PBC and are listed elsewhere on the DCYF website.

Independent Living Skills (ILS)
(Phase 2)

The goal of the Independent Living (IL) program is to prepare foster and former foster youth (15 – 21 years old) to live independently by increasing their skills, knowledge and competency in key areas. The IL program is voluntary and is open to all youth that meet eligibility.

The IL program implemented the PBC Quality Standard by included quality measures, targets, and performance management tools (PMTs) into their FY21 contracts. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 12 (FY21) $2.9 million
Responsible Living Skills Program (RLSP)
(Phase 1)

The Responsible Living Skills Program (RLSP), offered under a regional contract in each of DCYF’s six regions, provides supervised residential services (in either institutional or home-based living situations) that encourage positive youth development and teach young people independent living skills.

The goal of the Responsible Living Skills Program is to prepare foster youth (15-21 years old) to live independently by increasing their skills, knowledge, and competency in key areas.

RLSP is working to implement Phase 1 of PBC, focusing on meeting the Services and Quality Standards. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 6 $740,000
Early Childhood Education and Assistance Program (ECEAP)
(Phase 3)

The goal of Early Childhood Education and Assistance Program (ECEAP) is for families, ECEAP providers, and local communities to work together to ensure the growth of healthy, resilient children. The program does this by providing child-centered, individualized preschool education and health coordination services built on a foundation of strengths-based family support for the specialized populations we serve. 

ECEAP implemented the agency’s PBC Service and Quality Standards in FY20 by introducing aligned metrics, targets, and Performance Management Tools across all of their contracts. They also implemented the Outcome Standard in FY21 by introducing a Vision and Health Screening metric, target, and Performance Management Tool in their contracts. (Data will be available in FY22.)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 55 (FY21) $132 million
FY20 Service and Quality Metrics

ECEAP prefers not to use numbers of children to avoid confusion between the number of children served and the number of slots due to turnover.

Number of funded slots (class spaces): 14,117

Priority Populations

  • 91% (14,210 of 15,597) of enrolled children with 50 or more priority points as determined during eligibility screening
    • Of the children with fewer than 50 priority points, 4% were on an Individualized Education Program (IEP). 

Interrater Reliability

  • 98.8% (738 of 747) of ECEAP Lead Teachers who have been employed six or more months shall maintain active Teaching Strategies GOLD® IRR Certification
    • DCYF ECEAP is aware from ongoing communication with contractors across the state that COVID-19 impacted completion rates for teachers. This is something we will explore in the coming months of analysis.
Community-Based Child Abuse Prevention (CBCAP)
(Phase 2)

The goal of these community-based family support contracts funded by the Community-Based Child Abuse Prevention (CBCAP) program is to work collaboratively with Washington State organizations to fund and support capacity-building of the organizations. The goal is to implement high quality family support programming to increase the Strengthening Families Protective Factors for families and reduce the likelihood of child abuse and neglect. CBCAP, a federally funded grant program, is explicitly capacity-building for primary and secondary child abuse and neglect prevention. These contracts are one aspect of CBCAP-funded work in Washington.

In addition to funding programming for families, these contracts also focus on building the capacity of community providers to evaluate their services and use the results to make improvements. Because of this unique focus, CBCAP is identifying tools and measurement approaches for their FY22 contracts that measure the impact of the capacity-building efforts. They are doing this to assess the agency's capacity to evaluate and assess program impact. This will require new data collection in FY22 with initial assessment of this approach in FY23. (Data will be available in FY23.)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 6 (FY21) $239,780
Early Childhood Intervention and Prevention Services (ECLIPSE)
(Phase 1)

Early Childhood Intervention and Prevention Services (ECLIPSE) serves children 0-5 years old who are at risk of child abuse and neglect and may be experiencing behavioral health issues due to exposure to complex trauma.

ECLIPSE has implemented the Services Standard and currently collects client level data. ECLIPSE will move forward with implementing the PBC Quality Standard beginning in FY21 by developing quality measures, targets, and performance management tools (PMTs) as part of a program redesign brought on by the COVID-19 pandemic. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 2 (FY21) $4.65 million
Early Support for Infants and Toddlers (ESIT)
(Phase 2)

The goal of Early Support for Infants and Toddlers (ESIT) is to enable children ages birth to 3 with developmental delays or disabilities to be successful during early childhood years and beyond in a variety of settings. 

ESIT started implementing the agency’s PBC Service, Quality and Outcome Standard in FY20 by introducing aligned quality metrics across all of their contracts. They are currently implementing a new data collection system to collect service data and will resume PBC implementation in September 2021 after the legislative exception for PBC expires. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
September 1, 2020 – June 30, 2021 (FY21) 22 (FY21) $8.15 million
FY20 Service and Quality Metrics

Clients served: 19,729 Children

Provider Capacity

  • 79% of providers are currently using the COS Decision Tree Tool
Home Visiting
(Phase 2)

The goal of Home Visiting (HV) is to provide regular home visits from a trained professional to pregnant mothers or families to improve parent-child relationships, school readiness, and child health.

HV implemented the agency’s PBC Service and Quality Standard in FY20 by introducing aligned metrics, targets, and PMTs. They also implemented the Outcome Standard in FY20 by introducing a Healthy Birthweight metric, target, and PMT in their FY20 Nurse Family Partnership (NFP) contracts. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 42 (FY21) $15.82 million
FY20 Service, Quality, and Outcome Metrics

Clients Served: 2,786 families were served during SFY20, and on average 75% of funded slots were actively filled throughout the entire year.

Participants are defined as actively enrolled if they received at least one home visit during the 90 days prior to the last day of the measurement period. During Q4 of SFY20, this definition was expanded to having received at least one home visit or one encounter during the 90 days.

Family Retention

  • 639 of participants remained engaged in the program for 12 months after enrollment.
  • 469 of participants remained engaged in the program for 18 months after enrollment.

All 2,786 participating families were not necessarily eligible to meet the 12 and 18 month retention milestones, depending upon when they enrolled in the program (e.g. they were newly enrolled during SFY20 or they had been enrolled longer than 18 months at the start of SFY20). 

In reviewing this data point over time:

  • More than 40% of families exit before one year; this has steadily declined.
  • Percent of families enrolled for two or more years has steadily increased, up to 39%. 

Depression Screening

  • 69.1% (715 of 1034) of enrolled primary caregivers had a completed depression screening using an approved, validated tool within three months postpartum.
  • SY20 Depression Screening rate measure.
  • 119 enrolled primary caregivers who screened positive for depression received a follow-up referral to or connection with appropriate services.

Programs may conduct depression screening with participants outside of the time frame for the definition of this milestone, which go unreported here. 

Healthy Birthweight (NFP contracts)

  • 362 (89%) of participants gave birth to an infant of healthy birthweight (greater than or equal to 2,500 grams and less than 4,500 grams).

A healthy birthweight is defined as greater than or equal to 2,500 grams and less than 4,500 grams.

Tribal Services
(Phase 1)

In addition to direct services provided by DCYF, additional services are funded through contracts with federally recognized Indian Tribes and other Indian organizations in the state enabling providers to serve their own Tribal members and off-reservation Indians. These contracts include Indian Child Welfare (ICW) and Community Juvenile Accountability Act (CJAA).

This contract group will begin implementing PBC Service and Quality Standards in FY21 for FY22 contracts. (Data will be available in FY23.)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 40 (FY21) $3.14 million
Adoption Services
(Phase 2)

The Adoption Services Contract Group provides services to reduce adoption barriers for children in Washington. Adoption Services provides three main services: Out-of-State Adoption Services, Adoption Recruitment Services, and Adoption Home Study Services.

The Adoption Services program implemented the PBC Quality Standard by including quality measures, targets, and performance management tools (PMTs) into their FY20 contracts. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 2 + private out of state agencies (FY21) $800,000
Behavior Rehabilitation Services (BRS)
(Phase 2)

The goal of Behavior Rehabilitation Services (BRS) is to provide temporary intensive wraparound support and treatment program for children and youth with high-level, complex service needs. 

BRS started implementing the agency’s PBC Service and Quality Standards in FY19 by introducing aligned quality metrics and targets across all of their FY20-21 contracts. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
October 1, 2020 – June 30, 2021 (FY21) 40 (FY21) $100 million
FY20 Service and Quality Metrics

Clients Served: 749 youth

Permanency

  • Reduction in the length of stay by 10% from the agency’s baseline average.*
  • Increased the number of transitions to family, relative, adoptive home, and foster home guardianship by 10% from the agency’s baseline average.*
  • Increase the number of transitions to less intensive services, such as a regular foster home or transitional housing, by 5% from the agency’s baseline average.*

*Data will be available in FY22.

Family Engagement Metrics

  • Number of youth providers complete a Child and Family Team meeting for each youth on a monthly basis at least 90% of the time.*

*Data will be available in FY22.

Placement Stability

  • 56.8% of referrals to services were accepted into the program.
    (Acceptance Rate is determined by denial code reasons).
  • Number of youth providers transitioned from their program with a 30-day notice less than 10% of the time.*
  • Number of youth providers provide each youth with a WISe screen every six months and prior to discharge at least 90% of the time.*

*Data will be available in FY22.

Combined In-Home Services (CIHS)
(Phase 2)

The goal of Combined In-Home Services (CIHS) is to improve family functioning in order to promote the young person's health, safety, and welfare; thereby allowing the family to remain intact, and children to remain or return home. 

CIHS implemented the agency’s PBC Service Standard in FY19 and Quality Standard in FY20 by aligning quality metric, target, and PMT in FY21 contracts. Data for the quality metric will be available in FY22. They will implement the Outcome Standard and include an outcome metric, target, and PMT in FY22 contracts. (Full data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
October 1, 2020 – June 30, 2021 (FY21) 83 (FY21) $30 million
FY20 Service Metrics

Clients Served: 7,143 families (23,700 individuals)

  • Data collection was interrupted due to COVID-19 in March 2020. Client and family counts are incomplete for FY21.

Engagement Metrics

  • Number of service episodes with three or more treatment sessions that have a completed CANS-F Family Plan for Change assessment.*

*Data will be available in FY22.

Family Time
(Phase 2)

The goal of Family Time is to strengthen and preserve the family bond to build strong, safe families and communities. 

Family Time implemented the agency’s PBC Service and Quality Standard in FY20 by introducing aligned metrics and targets across all of their FY20-21 contracts. They are currently implementing the Outcome Standard and will include an outcome metric, target, and PMT in FY22-23 contracts. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 68 (FY21) $24 million
FY20 Service and Quality Metrics

Clients served: 1,975 families.

Acceptance Rate Metrics

  • Number of referrals accepted by providers.*

*Data will be available in FY22.

Timeliness of Service Metrics

  • Number of visits occurring within five days of accepted referral.*

*Data will be available in FY22.

Placement Services
(Phase 1)

Placement services contracts provide for short term and long-term placements of children in DCYF care. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 207 (FY21) *

*Not all phase 1 contract groups have reported the amount of expenditures for FY20.

Physical Health & Safety
(Phase 1)

The Physical Health & Safety contracts provide for Pediatric Interim Care, Diagnosis of Physical Neglect, Physical and Sexual Abuse, and Drug and Alcohol Testing and Collection Management. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 6 (FY21) *

*DCYF will be updating the FY20 expenditures soon.

Behavioral Health
(Phase 1)

Behavioral Health contracts provide for Professional and Psychological/Psychiatric Services, Sexually Aggressive Youth Services, Foster Care Assessment, and Services to High-Risk Pregnant Teens. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 334 (FY21) *

*DCYF will be updating the FY20 expenditures soon.

Placement Support Services
(Phase 1)

Placement Support Services contracts provide for Child Support Aide / Respite Care and Foster Care Child Support Aide Services, Short-term Case Aide Support and Case Management/Borrowed Home Services. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 9 (FY21) *

*DCYF will be updating the FY20 expenditures soon.

Juvenile Courts
(Phase 2)

The goal of Juvenile Courts is to serve the highest-risk youth with the intention to prevent recidivism by connecting youth to services using research-based treatment approaches that span a continuum of care.

Juvenile Courts started implementing the agency’s PBC Service and Quality Standard in FY19 by aligning quality metrics and targets in the FY20 contracts. Data for the quality metric will be available in FY22. They will implement the Outcome Standard and include an outcome metric, target, and Performance Management Tool in FY22 contracts.

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 56 (FY21) $4.074 million
FY20 Service and Quality Metrics

Clients Served: 1,543 youth.

Program Starts

  • 69% (1,492 of 2,163) of youth estimated in contractors’ applications to start an Evidence-Based Practice (EBP) who started an EBP.
Office of Juvenile Justice (OJJ)

The goal of the Office of Juvenile Justice (OJJ) is to be an active partner and support funding for community-based, state approved, evidence-based interventions for youth who come into contact with the justice system. The system provides a continuum of prevention, early intervention, intervention and rehabilitative services operated by both the county and state governments.

Thirty-three juvenile courts serve as the administrative authority for youth (under the age of 18) who come in contact with the justice system. Because of this unique focus, OJJ is identifying PBC metrics for their FY22 contracts measuring the impact on contractors and the system as a whole. (Data will be available in FY23.)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 20 (FY21) $1.2 million
Reentry
(Phase 2)

The goal of Reentry is to support the successful transition of youth reentering their community through workforce skills and job training opportunities. 

Reentry started implementing the agency’s PBC Service and Quality Standards in FY19 by introducing metrics, targets, and a PMT into the FY20 contract for job readiness services. They completed the process in FY20 by also introducing metrics, targets, and PMTs in FY21 contracts for pre-apprenticeship training. Data for the additional quality metric will be available in FY22. They will implement the Outcome Standard and include an outcome metric(s), target(s), and PMT(s) in all FY22 contracts. (Data will be available in FY22)

Current Contract Cycle Number of Contracts FY20 Expenditures
July 1, 2020 – June 30, 2021 (FY21) 3 (FY21) $950,000
FY20 Service and Quality Metrics

Clients Served: 266 youth.

Program Completion Metrics

  • Number of youth who receive a RISE plan before program exit (job readiness services).*
  • Number of youth who complete all possible certificates and complete a work-based learning opportunity on campus at a JR facility (pre-apprenticeship training only).*

*Data will be available in FY22.

Questions?

Jage Curl, Policy Analyst, Performance-Based Contracting, DCYF Office of Innovation, Alignment, and Accountability:

jage.curl@dcyf.wa.gov