Contracting for Service as a Mechanism for the Delivery of Human Services: A Study of Contracting Practices in Three Human Service Agencies in Massachusetts

摘要

This study was undertaken to obtain empirical material against which to evaluate the theoretical arguments in favor of the use of contracting with nongovernmental providers by public agencies for the delivery of social services. Three State agencies in Massachusetts were chosen for the study: the Massachusetts Rehabilitation Commission, the Department of Elder Affairs, and the Protective Services Program for Children. Interviews took place with administrators and direct services staff as well, and service, financial, and programmatic data were collected. Detailed reports are presented that describe the practices of each agency in regard to purchase of service or contracting for service. These case studies are analyzed to trace the impact of forms of service delivery (direct provision, purchase of units of service, and block contracting) on efficiency and effectiveness. The optimum situation is seen as one in which a program is managed by an efficient public agency with a strong capacity for service planning. That agency maintains full control of its allocation of resources in order to give priority to clients who are defined by its mandate as most in need of its services. It purchases services as part of its overall plan when conditions point to the desirability of such purchases; these purchases are an integral part of individual case planning. Decisions in regard to selection of the provider and monitoring of the quality of the purchased service take place at a point where they can be influenced by client expressions of satisfaction and dissatisfaction. The agency uses its rate setting procedures to evaluate providers' costs in the most cost - efficient manner possible. Additional research is needed particularly on practices in which formal contracts are used. Tables, a bibliography of 14 citations, and an executive summary are provided.