AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006
JACK TENENBAUM: Good afternoon. Thank you all for coming on a Saturday afternoon. I’m the Bureau’s Evaluation Officer and over the course of the last few years we’ve seen a change in not just the bureau and not just in HRSA but government wide, a recognition of the need for evaluation. Given the reduction in available resources and the increased competition among programs, this should come as no surprise. We now have reached the point, I mean, years ago Congress used to ask us, “What did you do with your money?” And we’d say, “We gave it all away.” And they’d said, “Good. We’ll give you more next year.” And then Congress got a little bit more sophisticated and said, “What did you do with the money?” And we said, “Well, we gave it away and we saw 1,000 pregnant women in the first trimester pregnancy.” And Congress said, “Great. We’ll give you more next year.” Now Congress asks the question, “What did you do with the money?” And we have to tell them and so we spent it all and we saw 1,000 pregnant women and the follow-up question is, “So what? What difference did it make? What did it do?” And that’s what we have to answer and that’s what we need evidence for.
In doing that, we run a number of evaluations out of the bureau. Two of them you’ll hear about today. One deals with the common thread that runs throughout all of the block grants and that is the development of infrastructure and its effect. The other is looking at the bureau’s performance measures both for the block grant and for the discretionary grant and seeing how those mesh, and seeing whether those are indeed the questions and the data we ought to be collecting.
We need to do this periodically. The need for evaluation has increased, not because I’ve been greatly effective at changing viewpoints, but because of GPRA, which was passed in ’93 and more recently the part process used by OMB all of which require performance measure evaluations evidence and so that’s what’s really driving this. And the data that I have seen show that for programs that get rated high by OMB there’s somewhere on an average of four percent increase in funding. Those that get rated moderately effective get somewhere about 20 percent decrease in funding. And those that have been rated not effective either get no funding or the average is actually 40 percent decrease in funding. And while four percent increase may not be anything to write home about, it sure beats a 40 percent decrease.
Given all of that, laying the foundation for why we need to do evaluations and why we ask you for these data, I’m going to introduce Vivian Gabor who is a Senior Associate with Health Systems Research to talk about the infrastructure building assessment project and following her will be Margo Rosenbach who is a Vice President at Mathematic of Policy Research out of Boston to talk about the performance measure assessment.
Vivian?