'Producing results' instead of 'providing services' Going nowhere fast

June 09, 1996|By Sara Engram

IMAGINE THAT a governor, frustrated by the rising costs of social problems, took a very bold step by banishing buzzwords and the kind of thinking they inspire.

There could be no more fuzzy calls to ''strengthen families,'' no more endless discussion of ''systems reform'' or ''service integration.'' Instead, the governor would require specific objectives for dealing with social problems.

Sure, state agencies could work to strengthen families, but only as a means toward an end. They could reform systems or integrate services or even empower communities, but only in pursuit of specific objectives.

The governor would have a wide choice of objectives, but they would have to be concrete and measurable.

He could focus on juvenile crime, setting a goal of a 25 percent reduction in these offenses over a specific period. Five years might be enough for a good effort, but he could also tailor a goal to fit the length of his term.

Rather than juvenile crime, he might choose to concentrate on drug abuse, aiming for a reduction in the number of addicts by 25 percent during a specified period. Or he could choose to reduce school drop-outs, adolescent pregnancy, reports of child maltreatment, the number of babies born with low birth weight or unemployment in poor neighborhoods.

Any of these goals would provide something now lacking in the social-services bureaucracies -- a goal of actually producing results that can be measured. It would also illustrate how the fragmentation of the current system can hamper efforts aimed at actually improving people's lives.

If the state got serious about any one of these goals and designed a comprehensive program to deal with it, any success would have a beneficial effect on other problems as well. Common sense tells us that no social problem is an island, existing alone. But conventional government focuses every day on the trees while missing the fact that the forest is burning.

There is a catch to this approach. In order to measure progress toward an objective, there must be an accurate baseline. And for all our love of statistics, this society has failed to expect much precision when it comes to social-service programs.

Do the dollars we invest in dealing with adolescent pregnancy or juvenile crime or drug treatment actually make things better? We don't know, because we rarely have a good handle on the size of the problem. For instance, we often hear that there are 50,000 drug addicts in Baltimore. But try to trace the origin of that number and you find yourself, as I did, chasing in circles.

Moreover, that statistic doesn't provide any clue as to the fluidity of the addict population. Surely some addicts are kicking the habit, moving away or dying. Do we have an exactly equal number of people developing drug addictions each month?

A good baseline

It wouldn't be easy pinning down and monitoring that information, but it's not impossible. Businesses survey populations for marketing purposes every day. Surely there is a way to obtain a reasonably good baseline on social problems.

But a baseline does little good unless it's backed up with the ability to track the clients of treatment programs. That would require a solid management information system, a notorious weak spot for social-service programs. No wonder it is so difficult to hold programs accountable.

For the field of social services, measurable results -- real accountability -- has taken a back seat to day-to-day operations. The field has become so preoccupied with ''providing services,'' that it has trouble focusing on ''producing results.'' But as pressures on tax dollars grow and taxpayers begin to resist spending for no visible positive benefits, that attitude has to change.

Patricia O'Campo of the Johns Hopkins School of Public Health and Hygiene, who specializes in evaluating maternal and child health services, notes that the old attitudes in which measurable results are not a priority have helped to create a vicious cycle. ''We keep reinventing the wheel,'' she says. By not insisting on rigorous evaluations, we never learn what works best, and where we can most profitably spend our time and money.

It's easy to denounce that attitude and blame bureaucracies and bureaucrats. But the fact is, our elected leaders let them get away with it. And no wonder -- if you set a goal, you might have to explain to voters why that goal hasn't been reached.

Accepting accountability is risky business. But until we have leaders willing to take that risk, we'll continue to muddle along, spending more and more dollars to go nowhere fast.

Sara Engram is deputy editorial-page editor of The Sun.

Pub Date: 6/09/96

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