MCHB ALL GRANTEES MEETING

MCHB Performance Measures

October 4-7,2004

JACK TENENBAUM: Thank you. It’s gratifying to see so many people so late in the day. There’s three hypothesis I think for this, one that all of you know that things close very early in Washington on Sunday, so there’s no other place to go. Two, some part of your body has gone to sleep because you’ve been sitting so long, and you can’t stand up and exit gracefully, or three, you’re actually interested and I’m going to go with three. Today I’m going to talk to you about performance measures. You’ve heard Dr. van Dyck speak about them and you’ve heard a number of people speak about them. We take them very seriously in the bureau because we have a legislative mandate. The Government Performance and Results Act of 1993 requires that we do that, that each federal program establish performance measure to be reported as part of the budgetary process, linking funding decisions and performance, and looking at improved outcomes for the target populations. This was developed by the way in a Democratic administration with a Democratic House and a Republication Senate, and the emphasis has not change in parties that control any of those institutions. This is a bipartisan effort and the Congress is serious about it.

In 1997 as you heard earlier today, MCHB developed performance measures for the Title V state block grantees, they were revised in 2000, and again in 2003, and approved by OMB. And, in those performance measures as Dr. van Dyck spoke earlier there has always been the option for specific performance measures developed by the states as part of the process. Using this model in 2001, MCHB developed 37 performance measures for its discretionary grants. Each grantee has the measures that were chosen for it by the program included in the process of application and reporting. There is also the capacity, just as with the state grants, for families of grants to develop their own performance measures. We now as of two days ago, have the capability to do this on a web-based system. While we will be asking you for slightly more data, we hope that it reduces your burden because the system is such that when you enter a number once and the state people can tell you about this because they use it, when you enter a number once anywhere in this application process, that number is captured and it’s populated everywhere that number has to go. You do not have to fill that number in ever again.

This system fully integrates with HRSA’s electronic handbook, previously known as GEMS, and it’s seamless, you will never know that you’ve gone from one to the other. We’ll talk more about this later. We have performance measure targets and financial forms, program planning kinds of issues, abstracts, target populations, the party of the pyramid for where you’re going to put those grant dollars, etcetera. Those must be completed as part of the application. In subsequent years, the application will include a performance measure report. These reports must be provided as a condition of the grant award. By the way, you’ve been told about the contractor being here to help you with this process. All of you in your packets should have gotten one of these yellow sheets. Our contractor for the performance application reporting system, SAIC, will be here from 8:30 tomorrow morning through 6:30 Wednesday evening to provide one-on-one assistance. So, please go and avail yourself of this assistance while they’re here.

Performance measures are not simply something we thought of to make life more difficult, it really does provide the information that we need as well as others that provide us information for management decisions and for policy development. It feeds into the budgeting process. Previously, performance measures, the *Gipper Report and the budgets were two separate documents and they sort of relate it. In 2006 for the first time they were integrated into one budget document. This is far more serious than it used to be. Performance budgeting is here and it’s quickly becoming more sophisticated. The data are required by the department, by the Office of Management and Budget, by the Congress, these are the people who decide how much is going to be allocated to what. And, OMB keeps telling us that they want outcome measures, not just process measures. We probably need some process measures in order to tell the full story, but we do need outcome measures.

If the programs are to survive, they must prove effectiveness. The latest figures that I’ve seen show that programs that are deemed to be ineffective or partially effective are recommended for reductions in the neighborhood of 40% on average. On the other hand, those programs that are deemed to be effective are recommended for increases in the neighborhood of four percent. I know it’s not a lot, but it beats the hell out of a 40% reduction. So, the question we have to ask of programs, the questions you have to ask of yourselves is did these programs do what they were supposed to do? How do we know? Well, through performance measures, through evaluations. And, those of us who actually believe this is a good thing. Everybody actually ought to believe this is a good thing. Everybody in this room for all program managers, knowing whether your program does what it’s supposed to do, or how to tweak that management to make it better ought to be a management goal. And, for everybody in this room as taxpayers, we want to know that the money we spend is actually doing what it’s supposed to do. Only the provision of data can make the case for program continuance, no data, no program, no shoes, no shirt, no service.

LAURA KAVANAGH: And, on that happy note.

DR. JACK TANENBAUM: On that happy note, and you’ll notice those slides had that nice blue calming background. Just trying to keep things nice and easy, because none of you were searched for weapons before you came in. When I do this to groups of grantees they get very hostile. So, I try to just calm things down. I will be here for the duration of this meeting, please come and see me about questions on performance measures, on the reporting system, and on evaluation for Tuesday and Wednesday mornings I will be holding roundtables on evaluation, which will include discussion of performance measures. We’ll start at O-dark-30, about right, and we’ll go through until the first meeting of the day. So, I will make myself available to talk to any and all of you here. Yes. It’s my pleasure before you all go out to turn the meeting back over to Dr. van Dyck for any questions or comments you may have.