Policy Resource

Washington Home Visiting Stakeholders Focus on Sustainability

Feb 9, 2016

Washington has engaged in public-private collaboration to strengthen state systems and infrastructure that support home visiting.

Historically, in Washington State, home visiting has been rooted in local community leadership. This approach resulted in the expansion of vital services for families, but also fragmented, uncoordinated, and duplicative programs. To create a more sustainable approach to home visiting, state and local communities have focused on two key priorities: systems building and leveraging private sector resources. These efforts ultimately led to the creation of the Home Visiting Services Account (HVSA) in 2010 in legislation. It is a public-private partnership between the Washington State Department of Children Youth and Families and Thrive Washington (Thrive), a statewide nonprofit organization that matches public dollars with private funding to invest in a portfolio of evidence-based and promising practices for home visiting programs. In four years, HVSA increased funding for home visiting services and grew the number of home visiting slots from 100 to over 2,000, while also expanding counties served from four to 22.

State and private leaders capitalized on HVSA’s well-developed infrastructure to pursue a new funding opportunity, Pay for Success (PFS), that leverages private capital to expand high-quality prevention programs, such as home visiting. In March 2015, the state began to assess the feasibility of expanding home visiting services through a PFS model. To accomplish this work, a governance structure was launched in May 2015 with a Project Management Team, a Steering Committee, and an Advisory Committee providing leadership. Four working groups—Data Access/Population, Intervention/Outcomes, End Payer/Legal/ Regulatory, and Funder Development—met regularly and conducted the tasks to inform a feasibility report.

In April 2016, Washington State completed the feasibility study to determine if a Pay for Success funding or contracting model could significantly expand, strengthen and scale proven home visiting programs statewide. Through the feasibility report, the state learned that there are many possible ways to use a Pay for Success approach to deliver social services. Pay for Success is more than just financing; it is a framework that helps government and nonprofit partners think differently about how the right mix of investments and incentives lead to the best outcomes.

Washington uncovered key lessons that may be helpful to other MIECHV leaders: the critical partnership with philanthropic partners, other state agencies and state legislators; the value of a funded position to work on sustainability; and the importance of communication to building sustainability.

Reviewed July 2018.

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