How did New Hampshire use a Request for Information to generate innovations in prevention programming?
LESSONS FROM OTHER FIELDS
How did New Hampshire use a Request for Information to generate innovations in prevention programming?
By Sean Alexander, project leader, Scott Kleiman, managing director, and Jess Lanney, assistant director, Harvard Kennedy School Government Performance Lab*
Requests for Information (RFIs) are underutilized tools available to public child welfare agencies seeking to add new services or change the service mix already in place to support children and families. Before agencies go out for bids with a formal procurement, RFIs offer a structured way to solicit community input on new innovations, identify best practices and locally-driven solutions, bring to light any unrecognized challenges to service delivery, and signal changes in the agency’s strategic direction.
This strategy brief describes how New Hampshire used an RFI to rapidly gather community and provider input to shape the design of the state’s new child welfare prevention service array.
An opportunity to transform
The number of children with child protection cases who entered out of home care in New Hampshire increased by more than 75% between state fiscal years 2014 and 2018, one of the largest increases in the country over this time period. This trend elevated the need for the state to enhance the mix and availability of family strengthening services that could enable more children and their families to safely stay together.
In 2019, the state Legislature authorized $53 million in new funding to expand and improve the services available to New Hampshire families over the following two years. This investment offered New Hampshire the opportunity to accelerate the buildout of evidence-based programs focused on preventing children from entering foster care, which would be necessary for the state to later access federal match funding offered through the 2018 Family First Prevention Services Act (Family First).
The need for service innovation
New Hampshire’s focus on expanding child welfare prevention services reflected a growing national trend, in which states across the country are planning reforms that aim to shift child welfare spending toward earlier interventions. By 2022, Family First will be providing more than $180 million a year to support preventative investments by state and local governments. Many states plan to use Family First as a catalyst for transforming their child- and family-serving systems from a primarily reactive posture, in which the child protection agency intervenes only after harm has occurred, to one where upstream supports from community-based programs can prevent children from experiencing harm in the first place.
In New Hampshire, several challenges with the service array funded by the state’s Division for Children, Youth, and Families (DCYF) at the Department of Health and Human Services (DHHS) contributed to the concerning increase in the numbers of children entering foster care. First, the types of services available did not meet the evolving needs of the families. For example, 80% of allegations reported to DCYF were for neglect, which is linked to the effects of poverty — yet few services offered concrete supports that could help families address economic instability. Additionally, some services were unavailable in the state’s rural communities, and few services were focused on preventing entry into foster care. Second, many services were underfunded, making it difficult for providers to reliably operate their programs. Last, quality standards were inconsistent across programs and some services did not align with the national best practices that would be required for the state to access federal reimbursement. DCYF had little experience engaging community organizations in its planning process and many providers were worried that they might be left behind as the agency sought reforms.
DCYF recognized that the success of new investments in child welfare prevention programming required substantially more innovation in the program models offered in the state. Many existing programs lacked a robust evidence base, signaling that there were few off-the-shelf solutions that could be implemented without further development and evaluation. For example, the California Evidence-Based Clearinghouse for Child Welfare organizes child welfare programs by the quality of their evidence-backing. At the time New Hampshire was beginning to approach its redesign in 2019, the Clearinghouse had found only 32 of 479 rated child welfare programs well supported by existing research.
Request for Information
A Request for Information (RFI) is an informal solicitation of ideas, solutions, and/or recommendations to assist in the development of a scope of work for a contract. RFIs are underutilized by public child welfare agencies seeking public input as they add new services or change the mix of services already in place.
Unlike Requests for Proposals (RFPs), RFIs do not result in any contracts being awarded but instead are used as fact-finding activities to gather information about the marketplace of services and providers. An RFI can help public child welfare leaders learn more about the challenges facing families in a community, enabling the department to better scope the needs and goals to be addressed by the contracted service. Community organizations and national service providers can describe their capacity to deliver potential solutions to meet the identified need(s), including introducing new approaches that may not have been previously considered. RFIs also can be valuable in signaling to providers a new strategic direction or identifying an agency’s key priorities for upcoming contracts, preparing potential providers to respond with bids that best meet the agency’s goals.
Issuing an RFI often is much quicker than releasing an RFP and typically must meet fewer compliance requirements. RFIs commonly include an introduction articulating the agency’s purpose and vision for redesigned services, a limited set of optional questions for respondents to address, and instructions for how to submit responses. Many highly effective RFIs are as short as a few pages.
A new approach for gathering community input
New Hampshire wanted to use its service redesign to spur innovation by providers, particularly around programs designed to strengthen vulnerable families and prevent children from experiencing maltreatment in the first place. The agency, like most others in the country, funded community provider organizations to deliver direct services to families referred by agency caseworkers. With the newly appropriated funds, the agency sought to enter into contracts with service providers that expanded the range of programming available so that more families that came to DCYF’s attention received services that could enable them to safely stay together.
- As it began considering procurements for the new contracts, however, the agency faced a series of questions about how to approach the redesign, including:
- What are the needs of families in New Hampshire that, when unaddressed, lead to involvement in the child welfare system?
- What services will best enable those families to stay together safely at home?
- What is the capacity of local service providers to deliver new services? Are there out-of-state service providers looking to come to New Hampshire?
- How should the agency approach matching individual families to the services that could best meet their needs?
Agency leaders recognized that the state’s answers to these questions would be sharpened by ideas from stakeholders across the child and family well-being system. To generate public input, New Hampshire issued a Request for Information (RFI) — a tool that had been rarely used by DCYF or by child welfare agencies in many other states.
With the RFI, the agency sought to learn from local service providers that often had deep ties to the families and communities served by the agency. DCYF also sought to learn from youth, parents, foster parents, advocacy organizations, and academic institutions. These stakeholders would be asked to share first-hand knowledge from their experience on the frontlines of care to describe the particular needs of local families and communities, suggest specific program models for the agency to consider, and describe what resources would need to be invested in providers to deliver these programs effectively.
In practice: Seven steps to complete a Request for Information
DCYF progressed through seven steps to develop and issue its RFI, and then synthesized the findings in a way that productively informed its procurement plans. These seven steps are common to any agency seeking to use an RFI:
1. Established the strategic vision and primary goals of the service redesign. New Hampshire’s leaders at DCYF and DHHS began the RFI process by affirming the state’s vision for the transformation they hoped to accomplish. Through the upcoming investments in its service array, the state aimed to enable more children to remain with their families by improving the quality of services available to strengthen families, offer more programming within communities across the state, and create greater capacity to keep kids safe. As part of this work, the agency designed a graphical representation of the potential future service array, which was included in the RFI to support a clear communication of the new vision (see chart below).
Components of future DCYF service array
2. Selected priority topics for community input. In the agency’s internal planning conversations, many potential topics emerged that warranted input from the community. These conversations highlighted a number of challenges with the existing service array for which provider ideas could be beneficial, such as waitlists, inconsistent quality across programs, and too few programs that focused on prevention. The agency recognized that including all of them would be time consuming for respondents, so the department prioritized two areas where questions in the RFI would be focused.
The first area of focus was community-based care coordination services. Called “community-based voluntary services,” this would be an entirely new component of the service array and DCYF had a range of questions about the best way to structure the services to meet the needs of children and families across the state. The second area of focus was home-based mental health, substance use, and parenting skill services, for which DCYF was interested in learning more about which specific evidence-based programs it could offer to best meet the needs of children and families and how DCYF could better support providers to deliver these programs.
DCYF also recognized that families and young people with lived experience in the child welfare system might be less ready to offer input through a formal RFI process. It set up separate mechanisms through which to solicit ideas from these important stakeholders, including targeted focus groups for parents and teens.
3. Crafted a short list of simple, specific, and open-ended questions for the RFI. Agency staff carefully crafted the RFI’s questions (provided in an appendix to this brief) to ensure needed input, while also leaving room for creative and unexpected ideas. Questions were short and free of jargon. All were optional, as it knew many respondents might not have the time, knowledge, or interest to answer them all. Responses to the 16 questions included in New Hampshire’s RFI were accepted in any format, including email and hard copy.
4. Drafted a welcoming, jargon-free cover letter for the RFI to invite broad feedback from the community. Division leadership wrote a letter (provided in an appendix to this brief) inviting input and communicating the value of gathering ideas from across the community. The letter was free of any contracting or legal terminology, and was intended to increase accessibility for community members less familiar with navigating procurement documents.
5. Utilized a strategic communications effort to release the RFI. New Hampshire released its RFI in late September 2019. The state undertook a strategic communications effort to maximize community awareness of the RFI and generate a large number of responses. It identified and contacted dozens of service providers across the state and the New England region to request responses — including many providers that had not worked previously in the state. The agency also reached out to stakeholders in academia, advocacy groups, and community coalitions. DHHS put out a press release to further publicize its request for input and New Hampshire Public Radio published a story highlighting the RFI.
6. Engaged respondents during the open response period. Two weeks after the RFI was released, and four weeks before responses were due, the agency hosted an optional respondent meeting with interested vendors and community members to discuss the vision of the service array redesign and clarify the kind of information requested. About 50 vendors and community members attended the session. After an agency presentation, half of the time was reserved for the agency to respond to questions from participants. Official answers to these questions, as well as the materials from the meeting, were subsequently posted online for anyone to review.
7. Synthesized responses to incorporate learning from the RFI into concrete plans for the service redesign. The state received 38 responses representing over 50 provider and advocacy organizations, experts and academics, peer state agencies, and parents. A working group of agency staff carefully reviewed each response to synthesize findings and incorporate the input into the agency’s vision for the future service array and its upcoming procurement plans.
Incorporating community input into agency planning
In April 2020, six months after the RFI was issued, New Hampshire released a Request for Proposals procurement for community-based voluntary services (CB-VS), which would be the first set of new services added to the state’s service array as part of the state’s movement toward prevention. The goal of CB-VS is to offer supports to families involved in an investigation — but who DCYF is unable to serve through traditional court-ordered services — that could prevent subsequent contact with the child welfare agency through case management and connections to other family strengthening resources.
The CB-VS RFP featured many elements that were informed by community responses to the RFI. Some of the priorities that emerged as a result of this input included:
- Honoring family voice. Authentic engagement of caregivers, youth, and children throughout service provision would be critical to shaping and delivering an effective service. The CB-VS RFP requested proposers describe their approach for doing so.
- Offering flexibility in program design. Programs would need to remain flexible (not “one-size-fits-all”) to support the unique needs of each family. In the RFP, the state suggested potential evidence-based programs but also invited agencies to offer creative solutions and models to achieve program goals. In addition, it offered providers flexibility to customize service planning and deploy a pool of flexible funding to address emergent family needs (such as concrete supports to address economic insecurity and transportation).
- Seeking creative solutions for statewide access to services. The RFP suggested a range of ideas for enabling statewide access to newly contracted services, such as telehealth-based program models, non-traditional staffing models (such as telecommuting, remote staffing), and subcontracting with other organizations to deliver services across regions. The RFP encouraged providers to propose other creative solutions to support statewide access to CB-VS, with a focus on delivering services in rural areas.
- Advancing collaboration between the agency and the provider to improve service delivery. Data-driven, high-frequency interactions between the state and providers would be expected to ensure the delivery of consistent and high-quality services.
- Ensuring adequate funding for service delivery. The RFP emphasized the state’s recognition of the importance to pay providers at a level that enabled them to develop and deliver new programs. The state developed plans to provide some initial funding to cover start-up costs until service provision could begin and asked applicants to specify the variety of costs they expected to incur in order to launch CB-VS.
- Seamlessly coordinating services. DCYF described the role it expected its own staff to play in making access to services quick and easy for families, especially during the initial handoff of cases to providers. DCYF expressed its commitment to working with vendors to develop clear processes to coordinate services, as well as train and support its internal staff.
New Hampshire’s 2019 Request for Information for DCYF Service Array Redesign is available on the state webpage. Slides from the respondents meeting and answers to respondent questions have also been published there.
The Harvard Kennedy School Government Performance Lab (GPL) has published many resources about RFIs on its website. To review other RFI examples, visit the GPL’s library of government documents and search for “RFI”. To learn about other strategies for gathering constructive input to improve procurement processes, see Twelve strategies for gathering constructive input to improve your RFP. For more information about results-driven contracting strategies, including additional guidance and procurement examples, visit the GPL’s Results-Driven Contracting page.
Appendix: List of Questions Included in New Hampshire’s 2019 RFI
Questions on Community-Based Services
1. We envision case management and care coordination as the core components of Community-based voluntary services.
a. What are the most effective case management and care coordination models we should consider for structuring this program?
b. What case management and care coordination models are most effective at addressing the basic and economic needs associated with a higher risk of entering the child protection system?
c. What are the EBPs (included in the Title IV-E Prevention Services Clearinghouse, the California Clearinghouse, or identified elsewhere) that could be utilized within the case management and care coordination aspects of a community-based voluntary services program?
2. How could the system be designed to ensure that children, youth, and families served through Community-based voluntary services have access to other available services, such as those anticipated in Subsection 4.2, as needed?
a. In that circumstance, should the Community-based voluntary service provider offer those services directly? For example, through an agreement with another provider or through a referral to DCYF to authorize an additional service line?
3. Is your organization currently capable of establishing a Community-based voluntary services program as described in this RFI?
a. What would be the anticipated time to start-up?
4. In your estimation, how much money will it cost to provide a Community-based voluntary services program and how many families would your organization be able to serve?
a. You may provide estimated cost information in whatever format makes sense for you. If helpful, use the table below to consider the kinds of costs to include. Alternatively, you can share your anticipated cost in a “per family total” or “per family per day” rate.
5. Should Community-based voluntary services be procured as one statewide contract or regionally? If regionally, how should the regions be structured?
6. What could DCYF provide to ensure availability of Community-based voluntary services statewide, including the rural parts of New Hampshire?
7. It is anticipated that establishing Community-based voluntary services program will reduce the recurrence of child maltreatment, reduce the recurrence of referral for child protective assessments, and reduce the need for out-of-home placements. Given those outcome goals, what interim metrics should we consider to assess process in delivering this service and success of the service?
8. What other opportunities, challenges, issues, or factors should DCYF be considering as we prepare to procure these new services?
Questions on Home-Based Services
1. What are the most important evidence-based practices (EBPs) that the Division for Children, Youth, and Family’s needs to add to its service array to stabilize the family, strengthen protective factors, address basic and economic needs, and prevent further maltreatment or entry to out-of-home placement?
a. Of those identified, which do you recommend DCYF prioritizes as it establishes new EBPs?
2. Of the EBPs approved in the Title IV-E Prevention Services Clearinghouse, do any of these EBPs currently operate today in New Hampshire? At what scale and where? By whom are these programs funded?
3. Of EBPs not currently approved in the Title IV-E Prevention Services Clearinghouse, do any of these programs currently operate today in New Hampshire? At what scale and where?
4. What EBP(s) is your organization currently capable of or capable of quickly implementing that would benefit children and families in NH?
a. Are there additional anticipated start-up costs, and if so, what would they be?
b. What rate would be necessary to support the sustainable provision of the EBP?
c. What would be the anticipated time of implementation?
5. What could DCYF do to support service providers in New Hampshire incorporating EBPs into their existing programs to make them more effective and eligible for new resources?
6. What needs assessment tools, used for either service planning or outcomes assessments, would be most helpful to assess children and family’s strengths and needs?
7. What other opportunities, challenges, issues, or factors should DCYF consider as we prepare to procure these new services?
8. What could DCYF provide to ensure service availability statewide, including the rural parts of New Hampshire?
*The Government Performance Lab (GPL) at the Harvard Kennedy School of Government conducts research on how governments can improve the results they achieve for their citizens. An important part of this research model involves providing hands-on technical assistance to state and local governments. Through this involvement, the GPL gains insights into the barriers that governments face and the solutions that can overcome these barriers. By engaging current students and recent graduates in this effort, the GPL is able to provide experiential learning as well. The GPL wishes to acknowledge that these materials are made possible by grants and support from Casey Family Programs, the Endowment for Health, and the New Hampshire Charitable Foundation. For more information about the Government Performance Lab, please visit our website at http://govlab.hks.harvard.edu.