[House Hearing, 113 Congress]
[From the U.S. Government Publishing Office]
EVALUATING EFFORTS TO HELP FAMILIES
SUPPORT THEIR CHILDREN AND ESCAPE POVERTY
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HUMAN RESOURCES
of the
COMMITTEE ON WAYS AND MEANS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED THIRTEENTH CONGRESS
FIRST SESSION
__________
JULY 17, 2013
__________
Serial No. 113-HR06
__________
Printed for the use of the Committee on Ways and Means
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COMMITTEE ON WAYS AND MEANS
DAVE CAMP, Michigan, Chairman
SAM JOHNSON, Texas SANDER M. LEVIN, Michigan
KEVIN BRADY, Texas CHARLES B. RANGEL, New York
PAUL RYAN, Wisconsin JIM McDERMOTT, Washington
DEVIN NUNES, California JOHN LEWIS, Georgia
PATRICK J. TIBERI, Ohio RICHARD E. NEAL, Massachusetts
DAVID G. REICHERT, Washington XAVIER BECERRA, California
CHARLES W. BOUSTANY, Jr., Louisiana LLOYD DOGGETT, Texas
PETER J. ROSKAM, Illinois MIKE THOMPSON, California
JIM GERLACH, Pennsylvania JOHN B. LARSON, Connecticut
TOM PRICE, Georgia EARL BLUMENAUER, Oregon
VERN BUCHANAN, Florida RON KIND, Wisconsin
ADRIAN SMITH, Nebraska BILL PASCRELL, Jr., New Jersey
AARON SCHOCK, Illinois JOSEPH CROWLEY, New York
LYNN JENKINS, Kansas ALLYSON SCHWARTZ, Pennsylvania
ERIK PAULSEN, Minnesota DANNY DAVIS, Illinois
KENNY MARCHANT, Texas LINDA SANCHEZ, California
DIANE BLACK, Tennessee
TOM REED, New York
TODD YOUNG, Indiana
MIKE KELLY, Pennsylvania
TIM GRIFFIN, Arkansas
JIM RENACCI, Ohio
Jennifer M. Safavian, Staff Director and General Counsel
Janice Mays, Minority Chief Counsel
______
SUBCOMMITTEE ON HUMAN RESOURCES
DAVID G. REICHERT, Washington, Chairman
TODD YOUNG, Indiana LLOYD DOGGETT, Texas
MIKE KELLY, Pennsylvania JOHN LEWIS, Georgia
TIM GRIFFIN, Arkansas JOSEPH CROWLEY, New York
JIM RENACCI, Ohio DANNY DAVIS, Illinois
TOM REED, New York
CHARLES W. BOUSTANY, Jr., Louisiana
C O N T E N T S
__________
Page
Advisory of July 17, 2013 announcing the hearing................. 2
WITNESSES
Jon Baron, President, Coalition for Evidence-Based Policy,
Testimony...................................................... 6
Kristen Cox, Executive Director, Utah Governor's Office of
Management and Budget, Testimony............................... 17
Steve Aos, Director, Washington State Institute for Public
Policy, Testimony.............................................. 25
David B. Muhlhausen, Ph.D., Research Fellow, Empirical Policy
Analysis, The Heritage Foundation, Testimony................... 33
Tara Smith, Research Associate, Ray Marshall Center, Lyndon B.
Johnson School of Public Affairs, The University of Texas,
Testimony...................................................... 44
SUBMISSIONS FOR THE RECORD
Family Equality Council.......................................... 71
American Evaluation Association.................................. 77
Urban Institute.................................................. 87
Zero to Three.................................................... 94
Capital IDEA Board of Directors.................................. 101
PEW Charitable Trusts............................................ 103
Chautauqua Opportunities......................................... 106
EVALUATING EFFORTS TO HELP FAMILIES SUPPORT THEIR CHILDREN AND ESCAPE
POVERTY
----------
WEDNESDAY, JULY 17, 2013
U.S. House of Representatives,
Committee on Ways and Means,
Subcommittee on Human Resources,
Washington, DC.
The Subcommittee met, pursuant to call, at 4:06 p.m., in
room 1100, Longworth House Office Building, the Honorable Dave
Reichert [Chairman of the Subcommittee] presiding.
[The advisory of the hearing follows:]
HEARING ADVISORY
Chairman Reichert Announces Hearing on Evaluating Efforts to Help
Families Support their Children and Escape Poverty
1100 Longworth House Office Building at 4:00 PM
Washington, July 10, 2013
Congressman Dave Reichert (R-WA), Chairman of the Subcommittee on
Human Resources of the Committee on Ways and Means, today announced
that the Subcommittee will hold a hearing titled, ``What Really Works:
Evaluating Current Efforts to Help Families Support their Children and
Escape Poverty.'' The hearing will review evidence about the
effectiveness of programs designed to assist low-income families and
individuals, how Congress can ensure these programs are evaluated
effectively, and how funding can best be directed toward programs and
services that have the greatest impact on reducing poverty. The hearing
will take place at 4:00 pm on Wednesday, July 17, 2013, in Room 1100 of
the Longworth House Office Building. This hearing is the second in a
three-part series of hearings on welfare reform issues.
In view of the limited time available to hear from witnesses, oral
testimony at this hearing will be from invited witnesses only.
Witnesses will include experts on the evaluation of social programs, as
well as experts who use high-quality evaluations to inform public
policy decisions. However, any individual or organization not scheduled
for an oral appearance may submit a written statement for consideration
by the Committee and for inclusion in the printed record of the
hearing.
BACKGROUND:
The Federal Government spends hundreds of billions each year on
more than 80 programs for families and individuals with low income.
While each of these programs is intended to alleviate poverty and
improve the lives of those who receive these benefits, few programs
have been rigorously evaluated to determine if they actually achieve
their goals. According to social policy experts writing about the
evaluation of Federal social programs in 2010, ``[s]ince 1990, there
have been 10 instances in which an entire Federal social program has
been evaluated using the scientific `gold standard' method'' to
determine whether the program really works, and ``nine of these
evaluations found weak or no positive effects.''
Research has shown that dozens of specific interventions have
demonstrated positive results in addressing various social problems,
including by reducing child maltreatment, improving educational
achievement, and increasing employment and earnings. However, in some
cases, high-quality evaluations have revealed that some programs
previously believed to be effective actually had no impact. In other
cases, social programs expected to improve the lives of low-income
adults or children actually caused harm--meaning those who did not
receive the service or benefit avoided the detrimental effects caused
by the program because they did not participate. In addition, many
Federal social programs have never been rigorously evaluated to
determine whether they effectively address the problem they were
created to solve, and evidence of effectiveness is not routinely used
by Congress to address program deficiencies or redirect funding to more
effective programs and policies.
In announcing the hearing, Chairman Reichert stated, ``Americans
have always been willing to help those in need. But when the American
people are asked to fund programs to help those most in need, they
should be assured that their tax dollars are really making a positive
difference. Unfortunately, few of our Nation's social programs have
been rigorously evaluated, and even fewer have shown that they are
effective in addressing the problems they set out to solve. It is
critical that we learn more about what works to help low-income
families, that we ensure these programs are evaluated effectively, and
that we focus taxpayer resources on those efforts that truly help
families and children in need.''
FOCUS OF THE HEARING:
The hearing will review what we know about the effectiveness of
current programs designed to assist low-income families and
individuals, how Congress can ensure more social programs are
rigorously evaluated to determine their impact, and how high-quality
evidence can best be used to inform the design of social programs at
the federal level.
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Please Note: Any person(s) and/or organization(s) wishing to submit
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From the Committee homepage, http://waysandmeans.house.gov, select
``Hearings.'' Select the hearing for which you would like to submit,
and click on the link entitled, ``Please click here to submit a
statement or letter for the record.'' Once you have followed the online
instructions, submit all requested information. Attach your submission
as a Word document, in compliance with the formatting requirements
listed below, by Wednesday, July 31, 2013. Finally, please note that
due to the change in House mail policy, the U.S. Capitol Police will
refuse sealed-package deliveries to all House Office Buildings. For
questions, or if you encounter technical problems, please call (202)
225-1721 or (202) 225-3625.
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The Committee relies on electronic submissions for printing the
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The Committee seeks to make its facilities accessible to persons
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Note: All Committee advisories and news releases are available
online at http://www.waysandmeans.house.gov/.
Chairman REICHERT. Good afternoon, the Committee will come
to order. This is the second in our series of three hearings on
welfare reform. In our first hearing, we learned that programs
designed to help low-income families often don't do enough to
help recipients go to work and get ahead. Today we will explore
what we know about the effectiveness of such programs, how we
can hold more programs accountable for their performance, and
how we can ensure they provide real help so recipients can
support their families and move up the economic ladder. Over
one-third of American households receive low-income benefits
today, and Federal spending alone on these programs equals
$15,000 per individual below the poverty line each year. Yet
few programs can show that they improve outcomes for those in
need.
What we will hear today is that in many cases, these
programs are either untested or have not been proven to work.
According to program evaluation experts, ``Since 1990, there
have been 10 instances in which an entire Federal social
program has been evaluated using the scientific gold standard
method of randomly assigning individuals to a program or
control group. Nine of the evaluations found weak or no
positive effects.''
In another example, a review of 13 rigorous studies on
employment and training programs showed three-quarters of them
had weak or no positive effects on those that they were
supposed to be helping. All of this comes at a cost. The
programs in question continued to spend literally billions of
dollars every year without delivering the results promised to
those in need.
We know many social programs lack meaningful outcomes, but
some programs go further and can even be harmful. For example,
Scared Straight--which I am familiar with as a former sheriff--
organized visits to prisons by juvenile delinquents with the
goal of deterring them from future offending. However, instead
of reducing crime, these programs actually increased the odds
that participants will find themselves in trouble in the
future. In fact, a comprehensive review of research by
Washington State Institute for Public Policy estimated that
every dollar spent on the program actually creates $76 in
additional cost for taxpayers, crime victims, and the
participants themselves because the youth who go through these
programs are more likely to commit crimes in the future.
This all suggests that more programs, including those in
our jurisdiction, should be evaluated to ensure the families
are receiving real help. Ultimately, Congress and the
administration should fund what works so we can deliver better
results to those in need. This is an issue that can and should
be bipartisan as it is all about doing right by recipients and
taxpayers alike.
Last week the Obama administration hosted a full-day
conference on funding what works, highlighting how the private
sector is willing to work with government to ensure that
programs are really making a difference. Especially given our
current fiscal climate, it is important to ensure our resources
are focused on efforts that have the greatest impact on those
in need, and I am proud to say that my home State of Washington
is a leader in this regard, as Steve Aos of the Washington
State Institute for Public Policy will shortly tell us. We will
also hear from experts from Utah and Texas, as well as national
leaders, about what is being done and what more can be done to
ensure that these programs are held accountable for producing
real results. I look forward to all of your testimony today.
Mr. Doggett, would you care to make an opening statement?
Mr. DOGGETT. Thank you very much, Mr. Chairman, and thanks
to all of our witnesses. I welcome this opportunity to discuss
the programs and strategies that have proven to be most
successful in helping our families escape poverty. Federal
initiatives help raised 40 million Americans above the poverty
line in 2011 under a comprehensive measure that counts all
assistance known as the supplemental poverty measure.
Taken as a whole, public policy is having an immense impact
on the well-being of many of our least fortunate neighbors.
This, however, still leaves the question of which specific
approaches are most effective in achieving our objectives, and
as we contemplate that question, I believe that the focus of
this Subcommittee ought to be on the one program, the Temporary
Assistance for Needy Families, that is within our jurisdiction.
That ought to be our primary focus, especially since the TANF
program is set to expire on September the 30th. We have very
few legislative days prior to that time, with the Congress
being out most of August and the beginning of September, and I
would suggest we get about the work on that specific piece of
legislation.
I voted for the 1996 welfare reform law myself because I
believe that helping people find a job is the best strategy to
reducing poverty. But this premise hinges on two very important
principles. First, assistance has to be available when jobs are
scarce, as they have been until very recently; and, second, a
real effort has to be made to help people find, maintain, and
advance in employment. Any fair reading of the last decade of
the TANF program finds it lacking on both counts. The
percentage of poor single mothers who are working has been
dropping almost consistently for the past 12 years, after
having made significant progress in the mid and late nineties.
Even more troubling, the percentage of poor mothers who are
neither working nor receiving any assistance from TANF is more
than twice as high as it was when TANF was established in 1996.
Some of our colleagues often complain that our Federal
programs are allowed to drift on autopilot. That seems to me to
be accurate as it relates to TANF. This program is in real need
of a significant reevaluation rather than this stop-start for
brief periods approach that has been taken in recent years.
Instead of working toward that goal, we spent most of the last
year in this Subcommittee debating whether the administration
was giving the States too much flexibility in the TANF program.
For those who think that work requirements, stricter work
requirements constitute a panacea on this issue, it is
noteworthy that a number of States, including those that have
Republican Governors, have complained that the current TANF
work participation requirements really don't measure success.
Rather than continue the same tired old arguments, our
Committee can actively advance the debate on this issue by
reviewing evidence on specific strategies that might help TANF
recipients get and retain jobs. One promising approach is
boosting both employment and earnings through sectoral training
programs that target high-demand occupations and provide
training and job search assistance to low-income individuals.
Unlike some past training programs, these efforts are
squarely aimed at preparing folks for job opportunities that
exist in their communities. I look forward especially to having
a native from Austin, Tara Smith, with the Ray Marshall Center
at the University of Texas offer comments about the success
that is reflected in Capital IDEA in Austin and Project QUEST
in San Antonio that have shown real promise in helping people
find not only jobs, but lasting careers. The Alamo Academies in
San Antonio have taken this same successful sectoral employment
approach and have partnered with high schools, community
colleges, aerospace companies at Port San Antonio to provide
specialized advanced manufacturing training.
I have been out to meet with some of those students. They
are impressive. They are high school students who complete the
program and receive valuable credentials along with their high
school diploma when graduating, and some are averaging a
starting pay of over $30,000 out of school each year.
Mr. Chairman, I look forward to a productive discussion
about how these and other proven strategies might help us to
improve outcomes for TANF recipients and other struggling
Americans. Let's find a path forward toward our common goal of
increasing employment and reducing poverty. Thank you very
much.
Chairman REICHERT. Thank you, Mr. Doggett. Without
objection, each Member will have the opportunity to submit a
written statement and have it included in the record at this
point.
I want to remind our witnesses, please, to limit their oral
statements to 5 minutes. However, without objection, all of the
written testimony will be made a part of the permanent record.
On our panel this afternoon we will be hearing from Jon
Baron, president, Coalition for Evidence-Based Policy; Kristen
Cox, executive director, Utah's Governor's Office of Management
and Budget; Steve Aos, director of Washington State Institute
for Public Policy; David Muhlhausen, Ph.D. research fellow,
Empirical Policy Analysis, The Heritage Foundation; and Tara
Smith, research associate, Ray Marshall Center, Lyndon B.
Johnson School of Public Affairs at The University of Texas.
Welcome to all of you. Thank you for taking the time to be
with us today. I will just let you know that you see three
Members in front of you. Others are on the floor speaking on a
bill, which I just came back from. That is why we started a
little bit late. So we will have some other Members joining us
here shortly.
Mr. Baron, please proceed with your testimony.
STATEMENT OF JON BARON, PRESIDENT, COALITION FOR EVIDENCE-BASED
POLICY
Mr. BARON. Thank you, Mr. Chairman. Chairman Reichert,
Ranking Member Doggett, and Congressman Davis, I appreciate the
opportunity to testify before the Subcommittee on behalf of the
nonpartisan, nonprofit Coalition for Evidence-Based Policy. My
testimony will address how evidence-based program reforms can
greatly increase the effectiveness of government social
spending in improving people's lives.
It is often assumed that the only way to increase
government's impact on social problems such as poverty and
educational failure is to spend more money, an assumption that
conflicts with the current national interest in reducing the
deficit. Largely overlooked, however, are clear examples from
welfare and other areas where rigorous randomized trials, which
as you mentioned, are widely considered the strongest method of
evaluating program effectiveness, have identified program
reforms that produced important improvements in people's lives
while simultaneously reducing government spending.
As an illustrative example in the eighties and nineties,
government and foundations sponsored a large number of
randomized trials of State and local welfare reforms. Three
major reforms--two in California, one in Oregon--were found
especially effective. They focused on moving welfare recipients
quickly into the workforce through short-term job search,
assistance, and training, and were found to produce gains in
participants' employment and earnings of 20 to 50 percent
sustained over several years.
Importantly, they also produced net savings to the
government in reduced welfare and food stamps of between $1700
and $6,000 per person. These findings helped build the
political consensus for the strong work requirements in the
1996 Welfare Reform Act.
A second example is in foster care where in the late
nineties, HHS granted Illinois a waiver from Federal law to
implement subsidized guardianship, which is an alternative to
foster care in which the State pays a subsidy to the child's
relative or foster parent to serve as their subsidized
guardian, as their legal guardian.
Illinois evaluated subsidized guardianship in a large
randomized trial which, over a 9-year period, found that the
program increased children's placement in a permanent home by 8
percent, reduced their days in foster care by 16 percent, and
produced net savings to the foster care system of about $2300
per child. Based on those findings, CBO scored savings of $800
million for Federal legislation that was enacted in 2008 to
expand subsidized guardianship nationally. To identify enough
of these reforms to generate broad-based improvement in
government effectiveness will require strategic trial and
error. In other words, rigorously testing many promising
reforms to identify the few that are effective. The instances
of effectiveness that I just described are exceptions that have
emerged from testing a much larger pool.
More generally, most innovations, typically 80 to 90
percent, are found to produce weak or no positive effects when
rigorously evaluated, a pattern that occurs not just in social
spending, but in other fields where randomized trials are done,
including medicine and business.
In my testimony, I offer concrete suggestions for the
Subcommittee's consideration to greatly accelerate the rate of
program innovation and rigorous testing in social spending so
as to grow the number of proven cost saving reforms like those
I discussed. I suggest, for example, authorizing greater use of
Federal waivers to stimulate State and local innovation and
evidence building, which was a tool deployed with great success
in welfare reform under both Republican and Democratic
administrations. I also suggest steps this Subcommittee can
take to facilitate greater use of low cost randomized control
trials, such as the subsidized guardianship trial that I
described earlier, which cost just $100,000 to conduct, yet
identified an innovation that CBO scored as saving $800
million. These suggestions are designed to catalyze evidence-
driven improvements in a social spending system that, in many
cases, has fallen well short of its intended goals.
The American poverty rate, for example, now at 15 percent,
has shown little change, whether by official or the
supplemental measures, the National Academy measures since the
seventies. In K-12 education, reading and math achievement of
17-year-olds, who are the end product of our K-12 system, is
virtually unchanged over the past 40 years according to
official measures, even though there has been a 90 percent
increase in public spending per student, adjusted for
inflation, since that time. Evidence-based policy offers a
demonstrated path to more effective, less expensive government.
Thank you.
Chairman REICHERT. Thank you, Mr. Baron.
[The prepared statement of Mr. Baron follows:]
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Chairman REICHERT. Ms. Cox, please.
STATEMENT OF KRISTEN COX, EXECUTIVE DIRECTOR, UTAH GOVERNOR'S
OFFICE OF MANAGEMENT AND BUDGET
Ms. COX. Thanks for having me here, Chairman and Ranking
Member Doggett. It is an honor to be here. I am the executive
director of the Governor's Office of Management and Budget, and
prior to this position, I was the executive director of the
Department of Work force Services. We oversaw the
implementation and administration of over 90 different Federal
programs, which included everything from TANF and food stamps
to child care to housing, a plethora of services that impact
low-income individuals. I come to this discussion with a real
on-the-ground perspective in how you actually operationalize
evidence-based practices and penetrate into the day-to-day work
of our folks.
Let me go through some of what we do and some things for
you to think about. First of all, our goal in Utah is to
improve the operations of all of our systems in Utah State
government by 25 percent over the next 3-1/2 years, the
remainder of Governor Herbert's administration. It is a bold
initiative, but we think there is ample capacity in all of our
systems to do better, and in social services, it really resides
on integrating evidence-based practices into the day-to-day
work of our employees, so they are spending more and more of
their time doing what works, and less time doing the things
that don't or are wrapped up in compliance initiatives, which
is part of the Federal bureaucracy.
A few things, just observations we have before we get into
the evidence-based practices. One, there is significant goal
disalignment against--across services that serve low-income
individuals, so the ability to assess if a program has been
successful or not is so dependent on the point and policy
objective of the program that they are all over the place. For
example, the Food Stamp Act 1964's intended policy objectives
was twofold, to promote the agricultural economy, and to give
nutritional sustenance to low-income individuals. With
amendments, the ABAP program, employment and training services
were offered, but really more as an eligibility criteria than a
true strategy to move people to work. Add housing initiatives,
TANF, Medicaid, across the board, the policy objectives are
different, so when we really want to talk about the impact to
low-income individuals, we need to be clear on what our
intended purpose is, and we don't have that right now.
Second piece of concern is the ability of measurement. We
have too many contradictory and conflicting measures out there
in the public service arena. As an administrator of 90
different programs, trying to get clarity on how well I am
doing is a challenge. We have created a very simple ratio,
quality throughput divided by operating expense, which will
baseline and drive all of our performance in State government
in Utah. It is not so simple in the Federal navigation system
of measurements, even in common core. In Utah, we were very
aggressive about understanding how important evidence-based
practices was. When I was executive director of Work force
Services, we set up an evidence-based arm of our agency
specifically to do randomized sampling, propensity scoring,
everything we needed to know to analyze and assess TANF
participation, job training, does it work or not, but what we
found is what the national studies say on a very universal
level aren't necessarily true for the unique demographics in
Utah. Even within Utah, we saw variations from region to
region.
So while evidence-based practices at the national scale are
important to help direct Federal policy, the States need the
ability, flexibility, and resources to create that same ability
at the local level to really fine-tune and penetrate those
evidence-based practices into our system.
The next piece is penetrating evidence-based practices into
our operations. It is great to have theory, it is great to have
tons of data, you can Google and you can find hundreds of
social service evidence-based practice reports, but why aren't
they penetrating our system? Part of it is our folks are so
heavily focused on compliance activities that they don't have
the time to step back and think about what should we be doing.
It is not an excuse, but it is a reality for people.
Operationalizing takes the ability to translate global goals
into the day-to-day work of our employees, it requires that we
have clear policy objectives for them, it really requires that
we stop doing the stuff that doesn't work and start doing what
does. My hope is for every new policy initiative Congress puts
out, they eliminate another one. There is only 8 hours in a
day, it is the employee's biggest constraint. If you want them
to really spend 80 percent, 90 percent of the time that makes
the biggest difference, then we have got to strip away the 70
percent of the stuff that is junk.
A few suggestions or hopes or recommendations. A lot of
demonstration projects are going on at the national level.
Fantastic. Push some of those resources to the State level so
we can customize our own practices that we need to make it
relevant for us. Align the policy objectives, which is simple.
Not simple, but critical. Simplify the measures, as you said so
well, give States more flexibility in the ability to innovate,
hold us accountable, but give us the ability to be innovative.
Thank you very much.
Chairman REICHERT. Thank you, Ms. Cox.
[The prepared statement of Ms. Cox follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Chairman REICHERT. Mr. Aos.
STATEMENT OF STEVE AOS, DIRECTOR, WASHINGTON STATE INSTITUTE
FOR PUBLIC POLICY
Mr. AOS. Mr. Chairman, Members of the Committee, my name is
Steve Aos, and I am the director of the Washington State
Institute for Public Policy. You asked me to come today and
provide testimony on how the Washington State legislature,
another legislative body, is using the Institute to try to
reform public policies in the State of Washington, so I am
going to give a little bit of an overview of the Institute and
how the legislature uses it and then talk about some of the
specific applications of the approach in Washington.
The Institute was created 30 years ago in 1983. The
legislature passed a joint resolution in that session and said
we want to have an institute to help the legislative branch of
government figure some things out. The key aspect of the
Institute is that all of the assignments to us, including the
ones I will talk about today, come to us because the
legislature passes a study bill, goes through both Houses,
passes both Houses, and is signed by the Governor. We don't
respond to an individual Member's request, but a bill has to go
through and pass for it to have a study undertaken. And in
recent years what the legislature has been asking us to do, in
about the last 15 years, is to find out what works and what
doesn't work to achieve particular public policy outcomes. So
we will get a direction that will say how can Washington public
policy affect the crime rate in Washington State, or the rate
of child abuse and neglect, or how can we get greater high
school graduation levels in Washington State, and it will say
to the Institute, tell us what works and what doesn't to
achieve those outcomes.
It is a nonpartisan group, an equal number of Republicans
and Democrats are on our board of directors, and they are
cochaired by one Republican and one Democrat at all times, so
it was set up to be a nonpartisan group, and that is how we
operate.
What works and what doesn't work has been something that
the legislature has been finding particularly attractive in
learning how to do the numbers on the one hand and the
legislative process has been learning how to use the numbers to
actually craft budgets and policies in an increasing number of
important areas. When we do this work, when we get that
assignment to say what works, we are playing the role of the
investment adviser, if you will. We make buy and sell decisions
to our legislature, and we look all around the country and all
around the world at all of the most rigorous evaluations on a
given topic. We throw out evaluations that we think aren't
rigorous enough to warrant any further consideration, and then
we assess all that in a systematic way, and we do a cost-
benefit analysis, and we come back to our legislature saying
this thing looks like it is a winner, this thing is maybe iffy,
and this thing looks like a loser in terms of benefit cost.
You mentioned the Scared Straight program in your opening
remarks. We have got lots of losers. We love to find losers
because then if we are already funding those kinds of programs
in Washington, they have become things that we can then cut in
terms of programs that are ineffective. So that is the role
that the legislature has had us do consistently over time. The
hallmark of our work has been to take not only what works but
actually to do a benefit-cost analysis of each of those of that
effort.
Crime policy has been the area where we have moved it the
furthest, but we are moving ahead in K-12 education and child
welfare and some of the topics that are directly before this
Committee right now. We now actually can point to lower crime
rates in the State of Washington and the reduced level of
taxpayer spending in the State of Washington as a result of all
that work and all the previous budgetary decisions that have
been made from that work.
The latest approach in Washington, passed unanimously in
the last two sessions, has been to take the Institute's list of
what works and what doesn't work and send a message to the
executive agencies saying align everything that you do and tell
us what approximates the Institute's list and what isn't on the
Institute's list, and those reports will then come back to the
legislature from the executive agencies in about five or six
different areas of public policy. So this is the legislature's
attempt to try to take the information we have been doing and
actually craft budgets around it by giving the executive branch
a time to respond, saying are you doing things that the
Institute has found to work or not work.
Mr. Chairman, I just wanted to give an overview today about
how the legislature back in your home State has been using this
information. By the way, it is 68 degrees back in your home
State today, I just checked. I am happy to get back there in a
few hours. It is real progress. Session by session, we get
better and better at doing the work, the legislature gets used
to asking the question and taking the information back, and it
is a nonpartisan effort, that is the thing that is perhaps most
encouraging. Thank you for allowing me to testify.
Chairman REICHERT. Thank you. I think 68 is the humidity
level here in DC. if I am not mistaken. At least.
Thank you for your testimony, Mr. Aos.
[The prepared statement of Mr. Aos follows:]
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Chairman REICHERT. Thank you, Mr. Muhlhausen, for being
here, and you are up for 5 minutes.
STATEMENT OF DAVID B. MUHLHAUSEN, PH.D., RESEARCH FELLOW,
EMPIRICAL POLICY ANALYSIS, THE HERITAGE FOUNDATION
Mr. MUHLHAUSEN. Thank you. My name is David Muhlhausen, I
am a research fellow in empirical policy analysis in the Center
for Data Analysis at The Heritage Foundation. I thank Chairman
Reichert, Ranking Member Doggett, and the rest of the Committee
for the opportunity to testify today on the need to evaluate
Federal social programs. The views I express in this testimony
are my own and should not be construed to represent any
official position of The Heritage Foundation. My testimony is
based on my recently published book, Do Federal Social Programs
Work?
My spoken testimony will focus on three points: First, the
best method for assessing the effectiveness of Federal social
programs is large-scale, multi-site experimental impact
evaluations that use random assignment. Unfortunately, these
scientific rigorous assessments are rarely done. From my count,
only 20 large-scale multi-site experimental impact evaluations
assessing the effectiveness of 21 Federal programs have been
published since 1990.
The consequence of so few Federal social programs being
rigorously assessed means that Congress has no credible
information on the performance of the majority of social
programs. To solve this problem, Congress should specifically
mandate the multi-site experimental evaluation of these
programs. When Congress creates social programs, the funding
activities are intended to be spread out across the Nation. For
this reason, Federal social programs should be assessed for
national effectiveness. While an individual program operating
at a single site may undergo an experimental evaluation, the
small scale single site evaluation would not inform Federal
policymakers of the general effectiveness of the broader
national program.
The success of a single program that serves a particular
jurisdiction or a population does not necessarily mean that the
same program will achieve similar success in other
jurisdictions or among different populations, thus small-scale
evaluations are poor substitutes for large-scale multi-site
evaluations. A multi-site experimental evaluation that uses the
performance of a program operating in numerous and diverse
settings will produce results that are more informative to
policymakers.
Second, the Federal Government does not have a good record
of replicating successful social programs on a national scale.
Policymakers and advocates often assume that a social program
that is effective in one setting will automatically produce the
same result in other settings. This is a faulty assumption. For
example, for the Center for Employment Training replication,
the Federal Government attempted to replicate the successful
outcomes of a youth job training program in San Jose,
California, in 12 locations throughout the United States. A
multi-site experimental evaluation found that the Federal
Government was unable to replicate the successful outcomes in
these other settings. Just because an innovative program
appears to have worked in one location does not mean that the
program can be effectively implemented on a larger scale.
Third, policymakers should be mindful that Federal social
programs do occasionally produce harmful impacts on recipients.
However, social program advocates too frequently ignore these
findings. Nevertheless, Congress should be aware of these
harmful impacts. Here are two examples. From the 3-year-old
cohort of the Head Start Impact Study, kindergarten teachers
report that the math abilities of children given access to Head
Start were worse than similar children not given access to Head
Start.
Students participating in educational, after-school
educational activities under the 21st century Learning Centers
Program, were more likely to have disciplinary and behavioral
problems such as getting suspended from school. Further, they
were less likely to achieve at high levels in class and were
less likely to put effort into English classes. With the
Federal debt reaching staggering heights, the best method for
assessing the effectiveness of social programs and making sure
that money is spent wisely are large-scale multi-site
experimental evaluations, yet to date, this method has been
used in only a handful of Federal programs. Congress needs to
reverse this trend of not rigorously evaluating Federal social
programs. Thank you.
Chairman REICHERT. Thank you, Mr. Muhlhausen.
[The prepared statement of Mr. Muhlhausen follows:]
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Chairman REICHERT. Ms. Smith, you are recognized for 5
minutes.
STATEMENT OF TARA SMITH, RESEARCH ASSOCIATE, RAY MARSHALL
CENTER, LYNDON B. JOHNSON SCHOOL OF PUBLIC AFFAIRS, THE
UNIVERSITY OF TEXAS
Ms. SMITH. Thank you. Good afternoon, Chairman Reichert,
Ranking Member Doggett, and Members of the committee. My name
is Tara Smith, I am with the Ray Marshall Center for the Study
of Human Resources at the University of Texas at Austin's LBJ
School of Public Affairs. Thank you for inviting me today.
This hearing's focus on families coincides with a growing
body of research on two-generation programs designed to link
services for children and parents so that families as a whole
can build the human capital they need to succeed in school and
the labor market. Today, I would like to share findings and
lessons learned from evaluations of two such programs.
Capital IDEA is a sectoral-based training program in
Austin, Texas, that was built on a model pioneered by Project
QUEST in San Antonio for employer-driven work force
development. Capital IDEA provides training primarily in health
care for low-income and disadvantaged adults. The evaluation
tracks participants from 2003 forward and includes outcome,
impact, and ROI analyses. CareerAdvance is a career pathways
program in Tulsa, Oklahoma, which provides parents of Head
Start and early Head Start students with training for health
care occupations. This program launched in 2009, and the
evaluation includes an implementation study as well as outcome
and impact studies focused on parents and children.
The impact evaluations for both programs use quasi-
experimental research methods based on a carefully matched
comparison group. There are five key points I would like to
emphasize about these evaluations. First, rigorous quasi-
experimental methods have been found to produce impact
estimates similar to those found in random control trials.
Quasi-experimental methods also address issues such as the
localized nature of programs which limits the pool of
prospective and eligible applicants needed to support a random
control trial.
Second, the use of administrative records and propensity
score matching techniques helps to keep evaluation costs
reasonable. In both evaluations State UI records provide
consistent, comprehensive, and inexpensive data on employment
and earnings. For Capital IDEA, the comparison group is drawn
from individuals who receive job search assistance at a local
one-stop career center and who closely resemble participants
along 18 characteristics, including demographics and prior
employment and earnings history. For CareerAdvance, the
comparison group is drawn from other Head Start parents matched
along multiple characteristics, including a documented interest
in pursuing further education and training. The rigor of the
comparison group matching design undergirds our confidence in
the evaluation findings.
Third, sectoral and career pathway models have demonstrated
effectiveness in a number of industries and labor markets by
connecting low-income and low-skilled adults with the training
they need to enter higher paying careers. If you have my
written testimony in front of you, the chart on page 3 shows
our most recent findings from Capital IDEA. We find that on
average the earnings of participants continue to grow over time
while comparison group Members who receive only job search
assistance or other basic work force services tend to have
relatively flat earnings.
My fourth point is that two-generation strategies which
look to build on sectoral or career pathway programs by linking
those adult education and work force training services with
high quality educational opportunities for children show
promise. Wrap-around and family support services including
child care, transportation assistance, counseling, and other
resources ensure that participants in both generations receive
the help they need to achieve at a high level.
In CareerAdvance this support can include a monthly
financial incentive for performance and attendance to help
offset the costs of participation and provide some financial
stability for the family.
Finally, because social programs rarely involve cookie
cutter approaches, it is important to consider a broad base of
evidence when evaluating program effectiveness. Implementation
and process evaluations provide important context for
understanding how programs operate and identifying which
services may lead to better outcomes and impacts over time.
This is particularly true for new and emerging programs and
program replication efforts.
In conclusion, strategies that focus on basic skills which
provide counseling and other support services, which increase
opportunities to earn and learn so that parents can support
their families while in training and target skill development
at high wage, high demand occupations in the local labor market
all appear to have significant rigorous evaluation support and
could be promoted in Federal programs.
By investing in proven approaches and promising strategies,
such as two-generation initiatives, and supporting a broad
range of research and evaluation efforts on those investments,
the Federal Government can play an integral role in building
the knowledge base needed to expand and improve efforts to move
families out of poverty. Thank you.
Chairman REICHERT. Thank you, Ms. Smith.
[The prepared statement of Ms. Smith follows:]
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Chairman REICHERT. And for your information, panelists, now
is the question-and-answer phase, so I am sure the Members on
the Committee would like to ask a few questions. I will start
with Mr. Baron. In your testimony, you note the important
groundwork laid for welfare reform when high quality
experiments were conducted in the eighties and nineties to find
the best way to help people move from welfare to work. In fact,
this research helped shape the successful 1996 reforms which
created TANF.
Beyond TANF, however, the Subcommittee oversees other
programs that haven't benefited from the type of
experimentation and high quality evaluation that led to welfare
reform. Given where we are now, in your opinion, what should we
be focused on first? What would be our number one priority, and
is this just the first thing we need to focus on and are there
any other priorities that kind of fall off of that? I would be
interested in hearing that.
Mr. BARON. Thank you. One of the reasons why there is such
a large body of strong, in many cases, replicated evidence from
randomized trials in Welfare-to-Work is because the Federal
Government had in place for many years, starting at the end of
the Reagan administration through the first Bush
administration, and then into the Clinton administration, a
waiver evaluation policy, meaning the Federal Government said
to the States, we will allow you to do your own welfare reform
demonstrations. We, the Feds, will waive provisions of law and
regulation to allow you to do those reforms if, and here was
the quid pro quo, you do a rigorous evaluation, usually a
randomized evaluation, to determine whether it works or not.
That policy, that waiver evaluation policy resulted in more
than 20 large-scale randomized control trials that contributed
to the important body of knowledge, the evidence that helped
inform the work-focused 1999 Welfare Reform Act.
That kind of waiver-evaluation approach could be used in
many other programs. The same general concept, it would have to
be adapted, it could be used in unemployment insurance, in
foster care, in SSI, and disability insurance, and other areas
to allow State and local innovation, open the door fairly wide,
coupled with a requirement for rigorous evaluation to determine
which of those innovations really work and which do not.
That is something that--and also importantly, as in
welfare, with a requirement for cost neutrality, so that you
are testing innovations that are designed to improve people's
lives while not adding to the deficit or that are cost saving
while also improving people's lives or not causing any harm.
Chairman REICHERT. Appreciate that. Thank you.
Ms. Cox, you describe how Utah has a specific division in
the Department of Work force Services focused on building
evidence about the effectiveness of programs. What did you find
most difficult about measuring effectiveness? I am going to
guess one of the things was the disalignment piece that you
spoke about.
Ms. COX. Uh-huh.
Chairman REICHERT. How did you use this information to make
decisions about which programs were managed and funded?
Ms. COX. Well, you know, I have the same question I think
you raised earlier, do job training programs work or not? I had
heard a lot of the literature, just like you had, but we wanted
to test it in Utah. So we did a really rigorous assessment
longitudinal, we did the whole randomization, and looked at--
this is just one of the studies, for example, in job training,
did it make a difference or not. The bigger question was
sometimes, and what the type of job services that were
delivered and when.
So we found, for example, unpaid internships really didn't
work, paid internships didn't work in all parts of the State
except for one place, so it was replicating why that worked. We
found that occupational training tied to an employer did work.
So there are things we found that did and didn't work, but
the interesting thing we found, for example, is that when they
completed the training was a big variable. We had too many
people, 50 percent of our folks coming into the job training
program, starting it, stopping halfway through or a third of
the way through. The taxpayers lost the up front cost, and the
person doesn't get the benefit, so it really forced us to look
at new strategies on completion. Same thing with TANF
participation. What things do people tend to participate in
without us having to chase paperwork. They tended to be
employment related and things that related to their lives and
then which of those ended up helping them become self-
sufficient and moving to jobs. We were able to more narrowly
tailor what kind of participation activities we focus on. The
challenges are, there is not a budget, there is not an
appropriation in these Federal programs. Like I said, 80
percent of our budget at Work force Services was Federal. It
wasn't a set-aside amount of money saying, here, do evidence-
based practices, it is something we had to kind of internally
create and cobble together some funds for that to happen, and
there is not an appropriation directly for that. That funding
piece is a challenge because while we talk at this level, and
you guys have to make those decisions because you have such a
huge impact on the Nation, once you get into the operational
level, people kind of may not take it as seriously, and there
is not a requirement or mandate with some cases like this for
that to really happen. As we go now, a look at all the other
services in State government will be doing the same thing.
Chairman REICHERT. Thank you for that answer. My time has
expired, but I am going to ask Mr. Aos a quick question because
I know he has to leave and catch an airplane here in a few
minutes. Could what you do in Washington State be replicated at
the Federal level, and what are some of the key challenges we
might have to overcome here in the Capital to do so?
Mr. AOS. Mr. Chairman, I have worked in the State capital
of Washington for 36 years, so I know that place pretty well. I
don't know this place very well, so I am not going to be the
one to give you advice on can what be done in Washington State
be transferred to Washington, DC. I think the principle is that
it works so well in Washington State is that the request for
this information is bipartisan. We rarely get a demand for a
study that only comes from one party or the other. It is almost
unanimous votes, that they want to find out what reduces crime
or what gets more high school graduates.
The other thing that we have done then is that the rigor
with which we as the people that draw the information go
through to assess the evidence fairly and to use return on
investment analysis to rank options because you can find things
that work that cost an awful lot more money than the benefits
they derive, so it is that aspect.
And, then, finally, I would just add that we use that
evidence to cut programs in addition to add programs that work,
and I think that that message that the legislature is using
evidence to change budgeting up and down has resonated around
and causes actions and responsiveness to the notion so that
evidence-based doesn't mean just a code word for spend more
money.
Chairman REICHERT. Thank you for your answer. Mr. Doggett,
you are recognized.
Mr. DOGGETT. Thank you, Mr. Chairman. Mr. Aos, I notice in
your evaluation it looks like as far as child welfare is
concerned that the Nurse Family Partnership, the visiting nurse
program for low-income families, is way out on top as being the
most cost-effective program.
Mr. AOS. Yes, it is right near the top of our list. I think
it is also a buy recommendation from Jon Baron's group as well.
Mr. DOGGETT. Exactly. Thank you. I wanted to ask him also,
what is it about this program that seems to have the most
benefit?
Mr. BARON. The program is very well designed in the
following sense: It is for women who are poor, pregnant with
their first child, and most of them are single. They are
visited by a nurse, many of them--you know, they are pregnant
with their first child, they are concerned about their health,
so they are particularly receptive to advice from a nurse. The
nurse teaches them basic parenting, nutrition, not to smoke or
drink during pregnancy. If they are interested in practicing
birth control, how to do it effectively. One of the reasons
this program is on the top of Steve's list and the top of our
top tier panel's list is that it has been evaluated in three
different randomized control trials, in different cities,
different ethnic groups, actually different decades.
In all three cases, it was found to produce large
improvements in life outcomes including, for example, a 40 to
50 percent reduction in incidents of child abuse and neglect
and hospitalization.
Mr. DOGGETT. You are aware that the Federal funding for
that program expires in little more than a year, the Federal
Home Visiting Program. Do you favor its extension?
Mr. BARON. Definitely. In many Federal social programs,
evidence plays little role in how funds get allocated, whether
they are formula programs or even most competitive grant
programs. The evidence-based home visiting program is an
important exception to that. Evidence, especially for the
largest grants plays a central role in determining what gets
funded.
Mr. DOGGETT. Thank you very much.
Ms. Smith, let me talk to you about another innovative
program that you focused on with Capital IDEA and Project
QUEST. This is not only about just securing any job that is
there, but as you mentioned a career pathway so that a person
has hopes of not only getting a job but getting a job that will
help them support their family at a livable wage. As I
understand the program, again, it is not just about how you
have become a radiology technician or someone who works in
semiconductors, but it is about getting some counseling to go
along with that training to be sure that you are able to
fulfill all the responsibilities. Can you elaborate a little on
how those programs work?
Ms. SMITH. Yes. The Capital IDEA model provides the
occupational training as a connection with the associate degree
program or community college program that builds that
occupational skill, but they also work on building the soft
skills that are important in the workplace and make someone a
successful employee, and so through weekly sessions with a
career coach, participants go through and talk about issues
like time management, communication and interpersonal
relationship skills, and work on building kind of some self-
confidence that they can take into the workplace and make sure
they are going to be a valuable employee.
Mr. DOGGETT. And how might those programs interface with
TANF? Is there the potential to assist more TANF recipients,
but to help them achieve some of the same success that Capital
IDEA and Project QUEST are already achieving?
Ms. SMITH. Certainly. Actually both of those programs, as
well as the Career Advance program in Tulsa, serve TANF
recipients already. They are part of that low income and
disadvantaged group that these programs are explicitly trying
to move forward in the workplace.
Mr. DOGGETT. Are there other recommendations that you have
that we should consider as we are renewing and reauthorizing
the TANF program to assure that more economically disadvantaged
people actually move into living wage jobs?
Ms. SMITH. Yes, I think reconsidering the work requirements
to allow individuals to engage in that longer term intensive
skill development that has been shown to lead to higher paying
careers that actually move people out of poverty would be an
important change to consider. The emphasis on work first with a
very short term emphasis on job achieving skills hasn't been
shown to be effective in the same way that building an
occupational credential that employers value has.
Mr. DOGGETT. And, Ms. Cox, isn't that also the finding of
an analysis in Utah that was made last year, that work first is
not necessarily as important as the training activities?
Ms. COX. Actually, I don't think it is either/or. I think
it is short-term occupational training that is connected to an
employer, so I think it is bridging both of those worlds. We
know that connection to the labor force over time is an
important indicator based on what we saw, and I can't speak for
other States, but for long-term--after 4 years there were
retained earnings and increased earnings.
So there is a balance. For men, for example, their
struggles seem to be a little bit different. There is not a lot
of men in TANF, but our population has gone from 6 percent to
13 percent. Men in TANF often have criminal background issues.
Sometimes they need to get attached to the labor market quickly
so they can reengage. Most of our TANF recipients get off--70
percent are off between 2 and 9 months--so this long-term thing
isn't as critical as maybe for the folks in the 30 percent who
don't have a high school diploma.
So I am always really cautious of this one-size-fits-all
and the need to really let States give us the policy
objectives, the goal of the outcome. Do the evidence-based
practices at the national level, but States need to customize
it for their unique demographics.
Mr. DOGGETT. Thank you all.
Chairman REICHERT. Thank you, Mr. Doggett. Mr. Renacci, you
are recognized.
Mr. RENACCI. Thank you, Mr. Chairman. I want to thank the
witnesses for testifying today. In my home State of Ohio, an
estimated 1.8 million Ohioans are living below the poverty
line. Poverty in my home State of Ohio has increased by
approximately 58 percent over the last decade despite a
stagnant population and a whole host of Federal programs
created to end the cycle of poverty. So I am glad that we are
here today to discuss policies that work because, frankly, the
people of Ohio and the Nation cannot continue on this path. We
must find ways to address our struggling economy, improve our
education system and work force training programs, and connect
individuals to temporary resources they need to succeed.
With that in mind, and I would like to start with you
first, Ms. Cox, what should the Federal Government's role be in
social welfare? And to add on to that, should the Federal
Government incentivize States to focus on outcome-based
programs and should funding to States be tied to performance? I
know you talked a lot about your State and maybe funding toward
the State.
Ms. COX. Well, again, you know, our goal is, even within
the State of Utah, 25 percent improvement over the next 3\1/2\
years, and some State agencies are saying that is impossible,
but when we get into the guts of the systems we are seeing
there is a lot of capacity there. Having said that, I am all
for outcomes and results. It is taxpayer dollars, and we need
to be accountable. My preference is that we are held
accountable and then given the flexibility to design the
solutions that work. We spend a significant amount of time and
energy on demonstration projects at the national level and
pilot projects, and we at the State just need the flexibility.
We have people at our doorstep today. I don't have 5 years to
do a demonstration project. You guys can and give me what I
need. I need the outcomes and the flexibility to get the
results today for the people standing on my doorstep.
So we need that, and then we also really need to emphasize
with States that they, too, need to be held accountable for
results, and in many cases, they need to pay more attention to
evidence-based practices and not just do what feels good.
Mr. RENACCI. So, in general, you believe that States should
be given the dollars but there should potentially be incentives
tied to those outcomes, and it should be outcome based?
Ms. COX. I would be open--the devil is in the details, or
God, depending on which way you say it, so it would depend on
the program and how it was specifically designed, but it is
something I wouldn't be scared of.
Mr. RENACCI. Anyone else want to take a stab at that, what
the Federal Government's role should be? Mr. Baron?
Mr. BARON. Yes, I think one of the challenges here with
holding States accountable and so on is that at this point we,
meaning the country really, and researchers and policy
officials really don't have a whole lot of strong evidence,
replicated evidence, as David referred to, about what works. A
lot of times. So there is not----
Mr. RENACCI. But if, in Ohio, we have approximately 58
percent over the last decade has increased, you know, something
is not working.
Mr. BARON. Yes. The system is not working, meaning over
time, and it is true nationally, even since the early
seventies, the poverty rate across the United States by various
measures has not changed a whole lot, despite a whole lot of
innovation, a whole lot of things going on. What is lacking, I
would suggest, are interventions like the Nurse Family
Partnership we discussed before, where the strong evidence that
has been replicated across different sites that they work. So
as a first step doing the kind of innovation and coupled with
evaluation designed to grow the number of proven programs might
be paramount. In the few cases where there are proven
approaches like the Nurse Family Partnership, just try to scale
those up more widely.
Mr. RENACCI. Let me change the pace to outcome because I
know as a small businessowner before I got here, I set programs
up and then I looked at the outcomes and decided if they
weren't working we would change those programs. So we have
programs that aren't working. What are some of the consequences
of leaving in place government programs that do not work? I
mean, why are we leaving these in here? Are you saying that we
don't have the outcomes yet? I mean, there are certain things
that aren't working. What are some of the consequences of
leaving those programs still intact? Mr. Muhlhausen.
Mr. MUHLHAUSEN. Well, one of the consequences is that we
waste billions of dollars and we leave people with no hope, and
so I think we need to--when we look at programs, especially
programs that are trying to lift people out of poverty, are the
comprehensive effect of various programs, are they trapping
people in poverty? So if someone who is receiving TANF
benefits, food stamps, and also a housing subsidy, if they get
a job and increase their earnings so they get a chance to work
more hours, will their income increase cause them to lose their
housing subsidy? In that case, that is an incentive not to gain
the additional experience, not to gain the additional income
through your own labors. So in some sense, the combined effect
of our entire welfare system can create a trap for individuals.
Mr. RENACCI. Thank you, Mr. Chairman, I yield back.
Chairman REICHERT. Mr. Davis.
Mr. DAVIS. Thank you very much, Mr. Chairman. I want to
thank all of the witnesses for coming.
I know that the Ranking Member has raised a question
relative to the home visiting program, the nurse visiting in
program. And I couldn't help but smile because I recall that
when we were working on the Affordable Care Act that one of the
provisions that I supported very strongly, and actually secured
a woman to come and testify from the Near North Health Corp.
which is a community health center in Chicago. And I run into
her quite frequently. And I always tell her whenever I do that
she was very instrumental in helping us to include that program
in the Affordable Care Act. And so I was very pleased to hear
your analysis and the impact of it.
Let me ask, when programs like that, for whatever the
reason, are not reauthorized, are not refunded, does that take
away or detract from progress that is being made relative to
not only moving people out of poverty, but also in helping them
improve the health status of people and communities that they
benefit?
Mr. BARON. Congressman, funding of the Nurse Family
Partnership, which incidentally was launched as a pilot program
under the Bush administration--proposed by the Bush
administration, and then scaled up by the Obama
administration--that funding, there is strong replicated
evidence that it improves people's lives. So defunding it
presumably would do the opposite. But I would also note that
the detail is in the specific type of home visiting program.
The Nurse Family Partnership has been shown effective, but
there are many other types of home visiting programs that have
been shown not to work. There was a Federally sponsored
evaluation, the Comprehensive Child Development Program at HHS
in the nineties, which was a paraprofessional home visiting
program. There was a large randomized demonstration that found
no impacts.
So one of the unique things about the program that was
enacted is that it had a high evidence standard so that
specific home visiting models, like the Nurse Family
Partnership, received priority for funding. That is unique in
Federal social spending.
Mr. DAVIS. Thank you very much. I really appreciate that
kind of work, having been engaged not only in health care but
also in aspects of dealing with poverty and poverty-stricken
people and communities for a long period of time. I just find
that to be incredible work.
Dr. Muhlhausen, let me ask you, if I could--I go through
the list of different kinds of programs. And I just looked at
Supporting Healthy Marriages. Do you have any revelations on
the impact of a program like that, or that specific program?
Mr. MUHLHAUSEN. Well, there are two programs, Building
Strong Families and Supporting Healthy Marriages. And I think
the goal is noble. But both of these evaluations show that both
programs failed to affect the rate of marriage. So that,
considered that in that sense, the program is a failure. In the
case of the Building Strong Families case, the program actually
had some negative impacts. But you have to balance that
between, if you look at the site-by-site analysis, on the local
level in some cities, the program had consistent negative
effects; but in Oklahoma, while it didn't boost marriage, it
actually found some positive impacts on the marital
relationships of individuals participating.
So you have to learn what happened in Oklahoma but
systematically, when you look at the entire program, there is
not much success.
Mr. DAVIS. And I think that is so unfortunate because I
think that marriage does play a significant role in the
ultimate organization and development of our society. And many
of my friends and many people that I interact with don't have
much faith in it, I believe. Thank you very much.
Chairman REICHERT. Thank you, Mr. Davis. Mr. Reed.
Mr. REED. Thank you, Mr. Chairman. Thank you to our
witnesses.
Ms. Cox, I wanted to start with you and move to a couple of
other people on the panel. I am very interested in us starting
our conversation as we go down this path of TANF reform and
other reforms as to coming to a common understanding as to what
the definition of ``it works'' is. And I want to have a clear
understanding from the panel as to--especially you, Ms. Cox--
out in the field, on the frontline, in the States. How is it
presently defined to be ``a success'' under these programs? I
have heard things such as getting people out of poverty. It is
as easy as defining people who get the benefits, who actually
receive a check. So I just want to get clarification from you
on that. And then if you have any guidance or recommendations
as to what is a good working definition of defining success.
Ms. COX. It is a really great question, because we talk
about it in such broad terms, self-sufficiency and moving
people out of poverty. But what do we mean by that? TANF--in
Utah, is 50 percent of poverty level. Food stamps has a
different eligibility criteria. Medicaid now we know with the
ACA reform is going to take you to up 130 percent plus. So at
what point does the Federal Government mean ``out of poverty''
because there are so many different contradictory definitions
of what that means. In Utah, again, with over 90-plus programs
for TANF, our definition for quality is throughput divided by
operating expense so we can get a quality cost per case. It is
the number of positive closures we have, the percentage of
those that are placement and employment, right? Because
sometimes it is so easy for a State to say, oh, they got
married, they got Social Security. We want to focus on
employment because we know in the long term, that 4 or 5, 6
years down the road, that gives them a better chance at self-
sufficiency divided by those costs. We can hit that. That is
step one. But if our entire caseload of people who are on low-
income services--our TANF caseload is a drop in the bucket. We
spent a lot of time on TANF. But in our State, it is 6,000 to
10,000 of cases--that is not individuals--and our entire
caseload is more like 200,000.
So the broader question is what is the policy objective for
Medicaid, for food stamps, for child care? Because if we don't
drive those policy objectives, TANF isn't going to move the
whole system. TANF has been a success. We know in the last 16
years, caseloads have declined almost by 50 percent. We can
continue to improve it. We know that. I can get people off of
TANF. But moving them off food stamps and Medicaid into true
self-sufficiency, that is a much broader public policy agenda
that has yet to be defined. So for us, it is benefit. Their
case is closed. They are off benefits. And they have a job.
That is the ideal scenario for us.
Mr. REED. That is the ideal. Okay. Mr. Muhlhausen.
Mr. MUHLHAUSEN. I think one thing we need to think about is
policy significance versus statistical significance. We like to
come here, and especially me, we like to talk about statistical
significance, a particular program, boost the wages up let's
say a head of the household by $1,000 every year. This finding
was statistically significant. Well, what is the policy
significance of that? That additional $1,000, does it
necessarily raise that family above, say, the poverty level?
So sometimes these programs we are talking about are
actually--while they do have a positive impact, and I can say
statistically significant, meaning we believe the results
actually occurred and were reliable. But sometimes the size of
the effect is actually not that meaningful as far as changing
the individual's life. So I think we need to think about not
only statistical significance, but also policy significance. Is
a program, let's say, moving somebody above the poverty
threshold? And are they on a trajectory where they are not
going to be dependent on receiving future government services?
Mr. REED. Go ahead, Ms. Smith. Please.
Ms. SMITH. I think a standard way of looking at whether you
are making a difference for families is, are they in stable
employment with rising earnings? That is what lifts families
out of poverty. And it has been shown to have a really positive
impact on the children of those families as well. They do
better when they have that sort of financial security.
Mr. REED. I am getting--because I am running out of time
and I don't mean to cut you off.
I am getting consensus from the panel that having a simple
definition of, we are going to have x number of dollars or x
number of benefits in the hands of a recipient, is probably not
the best definitional program or definition of success. Am I
misinterpreting anything anyone is saying there? With all the
nods of the head, it sounds like there is agreement there. So I
appreciate that because a lot of times, I have conversations
with Members up here and they are just as simple as, Well, if
we get x number of dollars in the hands of a recipient, that is
a win. That is a success. And clearly it is much broader than
that. My intention in doing the work here is to improve lives,
not just give benefits to people. So I appreciate that. With
that, I yield back.
Chairman REICHERT. Thank you. Mr. Kelly.
Mr. KELLY. Thank you, Mr. Chairman. Again, thank you all
for being here.
One of the things I am trying to understand--and it is not
for a lack of investment, is it, on the part of the government?
I am looking at the investment that we make each year. And if
the numbers I am hearing are right, it is about $600 billion a
year that goes into trying to lift people out of poverty or
support the most vulnerable in our society. That is a lot of
money. But I think our concern is, what is the return on that
investment? What are investing these dollars in? And the idea
was to lift people out of whatever conditions they were in.
So, Ms. Cox, I heard you say that part of the problem is,
sometimes there is a negative incentive because once you get
out of one level, then you go into another. And all of a
sudden, it is like, well, this doesn't work in my best
interest.
So best practices, are you able to share those with each
other? I know there are a lot of programs. Your State is doing
some things that maybe other States should do.
Do you have the ability to communicate back and forth?
Ms. COX. Yes. There are associations and forums. But you
know, when you are in the trenches--and especially during the
recession, our caseloads increased by 63 percent. So we were
just treading water to get through that and get people back to
work and contain costs. We were able actually to reduce our
costs by 33 percent while our caseloads increased by 63 percent
and improve our timeliness. But it is really difficult. It is
nice to have the luxury, with all due respect, to analyze this
stuff for 4 or 5 years. But that isn't a reality when you are
on the ground.
So we need people--these brilliant people here to inform
us, to educate us. We are committed to evidence-based practices
in Utah. It is the only way we will hit our 25 percent
improvement in some of our agencies. But sometimes we need
States just to be able to innovate to get to the clear results.
Because if we don't have time to do the evidence-based
practice, and we are not allowed to innovate, we are stagnant,
and we can never make progress. So that is the bind States are
in. We need evidence-based practices. But when it is not there,
we need the flexibility to innovate to get the results for you
guys and for the taxpayers.
Mr. KELLY. And you mentioned innovation. My friend David
Bradley has talked to me many times. He is with the National
Community Action Foundation. And he talks about the ability to
look at innovation, to look at the performance data, and then
also local control of these dollars. And again, I have a friend
in Sharon, Pennsylvania, by the name of Ron Errett who runs a
program up there. It is the Community Action Partnership of
Mercer County. So I have seen locally in the district that I
represent a lot of programs that work really well. And I think
we have got to be careful that we don't paint everybody with
the same brush and say, we are wasting this money. Nothing is
going the right way. I don't think that is true. And we
referenced the Nurse Family Partnership, how much that has
worked.
But it does come down to, how do we get that? How do we get
the innovation message out? How do we share those practices?
Mr. Baron, you made some comments about that when you talked
about the ability. And the results speak for themselves. When
you see something good, how do you get that out? Because I have
got to tell you, in my district, I was able to look up and down
northwestern Pennsylvania. The poverty level is probably
somewhere between 25 and 30 percent. Not really mattering what
town you go into, big cities, little towns, it is about the
same. This poverty thing is something that is really troubling
that we spend all this money, but we haven't gotten any results
and we don't see that happen. I know part of it is the economy
not bouncing back. And maybe we are spending a lot of time
criticizing programs and not coming up with leadership programs
or strategies that lifts everybody.
Ms. COX. Can I make one more point on that just to be kind
of bossy?
Mr. KELLY. Sure.
Ms. COX. There are associations, administrators, that are
always connecting and going to conferences and talking about
best practices. But part of the challenge is, we have the
evidence-based practice. But if you were to look and do our
mapping and look at an employee's time. They have 8 hours a
day. And let's say we even know what the evidence-based
practice is. We know that they should be doing X, Y, Z every
day with their customers to get the impact. If you were to map
out how much time they actually spend doing that, in some
cases, you will find 10, 20, 30, 40 percent of their time is
actually spent on the evidence-based practice. The rest of the
time it is spent on compliance, recording, paperwork, a lot of
other stuff. So can you imagine the capacity to impact low-
income individuals? If we could just double the time on the
ground in your operations and in your systems design of what
people do----
Mr. KELLY. I am going to agree with you because I have got
to tell you. I run a private business. We do the same thing
with our business trying to be in compliance. If I could just
do what we are designed to do every day and not worry about
being in compliance with the Feds, the local, and the State, we
would probably get a lot more done. Mr. Baron you were going to
say something?
Mr. BARON. Yes. One of the challenges in sort of
identifying and sharing best practices, things that really work
is that a lot of programs, almost every program claims to be
evidence-based and backed by strong evidence and effective. And
the truth is, while some of them are, when most programs--even
those that are backed by pretty good evidence--are subjected to
a definitive evaluation, many of the promising findings are not
reproduced. Sometimes they are. So you do have some examples of
effectiveness, but many times they are not.
Steve Aos' organization, the Washington State Institute,
does a valuable service by trying to distill what is really
backed by strong evidence from others that are not. But there
are some instances. There was a program that the reemployment
and eligibility assessment program at the Department of Labor
which has been shown very effective in a four-State randomized
control trial with large effects on employment outcomes and
reductions in spending.
Mr. KELLY. Thank you.
Chairman REICHERT. Thank you. Mr. Crowley.
Mr. CROWLEY. Thank you, Mr. Chairman. Thank you for
yielding me the time.
I think we are all good stewards. I think we all want to be
good stewards of our taxpayer dollars and certainly we want to
put money where we think it best works for the American people.
Mr. Baron, I just want to follow up my comments of Mr.
Doggett as well as Mr. Davis as it pertains to the Nurse Family
Partnership is the kind of program that has been proven to get
results. As you know, I know--I am not so sure my colleagues
know--that the program started in my home State of New York--in
fact, in Elmira, in my good friend, Mr. Reed's district. And I
have long followed the very impressive work that they have been
involved in replicating this model and achieving very
significant positive outcomes. Reductions in child abuse and
neglect, better educational outcomes for children, and greater
likelihood of economic stability for the mother, these are just
some of the results that actually save the government money in
the long term.
Mr. Baron, do you think that is correct, that it has an
effect in terms of saving taxpayer dollars in the long run?
Mr. BARON. In this case, I think the answer is yes,
especially with the Nurse Family Partnership. One of the trials
that was done in Memphis, Tennessee, measured not only the
impacts you are describing, like child hospitalizations and
educational outcomes for the children, it also measured
participants' use of government assistance--Medicaid, food
stamps, welfare over a 12-year period. And this was not a
projection. They measured use of government assistance in the
treatment versus control group. So this was a credible finding.
And it found that the program produced savings that more than
offset the cost of the program.
Mr. CROWLEY. Mr. Baron, would you also agree that programs
like this particular one are an example of the importance of
looking at successes not just in the short term, but in the
greater awards to our society down the road? And not just
immediate.
Mr. BARON. Yes. Because some of the effects are longer
term. Some of the effects were short term. There were immediate
effects on reductions in child maltreatment and
hospitalizations. But there were also longer term.
Mr. CROWLEY. So leading to a much longer and productive
life for the child in the long term.
Mr. BARON. That is correct. But a slight nuance on that is
that some programs--especially in work force development--they
produce short-term effects, which dissipate over time. And so
for those kinds of programs, it is important not only to
measure the short-term effects which are sometimes large, but
whether it produces sustained effects on the amount of----
Mr. CROWLEY. I appreciate your comments.
Better access to health care coverage, nutrition programs
in early childhood, we believe leads to greater health and
reduced medical costs later in life. And that is what we are
talking about at this point in time as it pertains to the Nurse
Family Partnership.
Strong education, mentoring, and family supportive programs
reduce incidents of criminal activity and school dropout rates
as well. I think too often, we have a tendency and I think is a
willingness to cut a program for ideological purposes not
because it is what is in the best interest of our country. We
see it in the Affordable Care Act. We have seen it in the farm
bill nutrition programs. We have seen it as well in the social
services block grants and others. It seems like the lesson here
today is that we need to carefully invest in the programs that
work and really put a lot of thought and study into our
budgeting process.
So I would think the budget approach we have recently seen
with policies, like sequestration, is the exact opposite of
what we ought to be doing. Blunt across-the-board cuts and not
replacing them with a thoughtful plan that grows the economy
certainly doesn't fit with the evidence-based approach that
seems to be the recommendation of the witnesses here today. I
would hope that my colleagues not just on this Committee but on
the Budget and Appropriations Committees as well and every
other Committee draw lessons from this hearing. And I look
forward to more a constructive conversation and hearings like
this in the future.
With that, I yield back the balance of my time.
Chairman REICHERT. I can assure my good friend that I am
very interested in evidence-based results as an old time cop.
So with 33 years in that field, I am looking for evidence. Mr.
Young.
Mr. YOUNG. I want to thank the chairman for holding this
hearing on what really works. I think it is incredibly
important. It may be mundane to some people. It may be boring
to others. Metrics and data and all these other things. But let
me begin by defining the challenge and perhaps identifying the
opportunity or opportunities as I see them here. My interest in
this topic actually emerged the second I found out I was going
to get on this committee. I suspected it wasn't unlikely I was
going to be on the Human Resources Subcommittee, and that is a
good thing. We deal on this committee with what some regard as
unsolvable social pathologies. And I sort of refused to believe
that.
So I know a number of pilot programs over the years have
taken place across our 50 States. So I directed Members,
associates on our team to try and identify the results of those
different pilot programs and find some central repository where
we could find out what really works and under what
circumstances. It was incredibly tedious work; and frankly,
there was no such repository. There was not a navigable Web
site. There wasn't a particular organization that seemed to
have answers about what really works and what data you could
look at and what works under different circumstances.
I found this frustrating as a policymaker. And I think at
the State level, local level, not for profits, academics, think
tankers, and so on, could all benefit from more clarity here
and a more robust collection of data.
What are we left with without this sort of repository of
accessible data? Well, we make policy based on ideology, on
politics, on analogy, sometimes anecdotes, the news of the day;
but we don't really make decisions based on the hard data. So I
started doing a bit of reading. I discovered that in 1988,
under the AFDC Reform Act of that year--not often talked
about--there was a requirement that data be collected on the
recipient population of AFDC. That data years later--oftentimes
it does take years for this information to be teased out--that
data established the intellectual groundwork for a bipartisan
reform of the AFDC program, now the TANF program.
We need to make similar efforts in other areas. We need to
do more evidence-based policymaking.
Mr. Baron, thank you. It is so great to see you here today.
You are really a gift to this conversation. I thank everyone
else as well. And we have convened a group of people to discuss
this topic. It is my hope that we can come up with a more
systematic way of collecting data in a number of different
areas and promulgate and disseminate that data to others for
the purpose of research and also for the purpose of evaluation
so that when innovation occurs at the State level, we will know
if, in fact, it is working and then share. It is an iterative
process. Share what is learned with others. And that will
enable us to do very creative things, like social impact funds,
pay for performance, pay for success in some of these social
areas, the same sort of thing we do in, say, the transportation
sector, performance-based contracting.
Mr. Baron, you said Congress could take steps in your
statement toward what I have envisioned, I believe, by
authorizing and encouraging agencies to allow greater research
access to administrative data with appropriate privacy
protections so as to facilitate low-cost rigorous evaluation.
I have two questions for you. First, what data is the
Federal Government failing to collect that we ought to be
collecting about beneficiaries of government programs? And
second--and I see my time is running down, so you can submit
this in writing. But second, I did want to get it on the
record, what data is already being collected by the Federal
Government, such as receipt of government assistance,
employment status, earning status that we should release to the
public for research purposes so it is not just our bureaucrats
who are armed with all the information.
Mr. BARON. I would like to submit a response in writing.
But also a very quick answer to the second part of your
question. This Subcommittee took a major step forward, we
believe. We were very supportive of the subcommittee's action
to increase researcher access with appropriate privacy
protections to the National Directory of New Hires, the NDNH
data, which has, at the Federal level, the employment and
earnings records. You can use it to measure employment and
earning records--earning outcomes for participants in any
study. It should be more widely available. It would reduce the
cost of some of these rigorous studies by a factor of 10 or
more.
Mr. YOUNG. Thank you.
Mr. REICHERT. Thank you, Mr. Young. Thank you to all of the
witnesses for being here today and taking the time to be with
us. And we have finished this almost in record time, just in
time for votes. I thank the Members for being here too. We look
forward to working with you and reaching out to you and asking
you questions, more questions that will come, I am sure, as we
struggle with trying to find solutions here that are evidence-
based, where we hold programs accountable, make sure that we
are really helping those people who need the help and ensure
that they are moving up that economic ladder as we all hope
that they do.
So if Members have additional questions for the witnesses,
they will submit them to you in writing. And we would
appreciate receiving your responses for the record within 2
weeks. The Committee stands adjourned. Thank you.
[Whereupon, at 5:30 p.m., the subcommittee was adjourned.]
[Submissions for the Record follow:]
Family Equality Council
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American Evaluation Association
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Urban Institute
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Zero to Three
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Capital IDEA Board of Directors
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PEW Charitable Trusts
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Chautauqua Opportunities
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