By CHRISTIAN SOURA
S.C. Department of Health and Human Services
Last week, Gov. Nikki Haley announced the launch of a new Pay for Success (PFS) project in South Carolina. This initiative is focused on measurably improving the quality of life for first-time mothers and their newborns by providing the Nurse-Family Partnership (NFP) program to about 3,200 additional families.
The NFP model has been shown through decades of research to improve prenatal health and school readiness, increase maternal employment, and reduce child injuries and the incidence of abuse and neglect.
This is the first PFS project in the nation to focus solely on maternal and child health, the first that has been exclusively designed to serve Medicaid beneficiaries, and the first to be launched by a Southern state.
What makes the PFS approach unique is that the initial costs of providing public services are largely borne by investors or the philanthropic community, while the government only pays its full share if the program meets a set of predetermined goals. At the center of a PFS project is a thorough, independent evaluation that carefully measures the effectiveness of that program.
The people of South Carolina and their elected representatives entrust me with billions of dollars each year with which I am to provide for the health and well-being of the most disadvantaged among us. The best way that I know how to do this is to target our investments on programs that have a proven track record.
Through PFS contracting, we can select an intervention that has a strong evidence base, scale it to reach those in the greatest need, then rigorously measure and evaluate the results. If we are to be successful in lifting our neighbors out of poverty and helping them to lead healthier and happier lives, then we have to be relentless in building upon programs that work, while at the same time being prepared to set aside those that do not.
During the next five years, NFP has committed to producing meaningful, double-digit reductions in the rates of preterm births and child injuries in South Carolina. Furthermore, at least two-thirds of the families who receive this support must come from the rural and underserved communities that need this help the most.
At the end, the project’s impact will be assessed by a randomized, controlled trial, often cited as the “gold standard” in evaluation. This study will serve as the basis of additional research that will lead to further refinements of the NFP model.
I’m proud of what we’ve accomplished now that we are enrolling the first few families in our PFS initiative. I’ll be even happier when the public demands that we run the rest of the government this way.
Christian L. Soura is director of the S.C. Department of Health and Human Services.