Results and Reflections from the Cuyahoga Pay for Success Project

In 2015, Cuyahoga County launched the nation’s first county-level Pay for Success (PFS) project in the combined areas of homelessness and child welfare. The five-year, $4 million program aimed to reduce the length of stay in out-of-home foster care placement for children whose families are experiencing homelessness or who don’t have secure housing. The project used a randomized control trial to measure the impact of providing housing, case management, and trauma therapy to caregivers.

As in other Pay for Success projects, investors – including Nonprofit Finance Fund – provided up-front money needed to launch the program. (Read more about how Pay for Success and other results-based-approaches work.)

The project was implemented as planned but did not reduce the length of time children spent in foster care compared to a control group, and the County therefore did not make any outcome payments. One reason that the project didn’t reduce the time children spent in foster care is that, for families who were making progress toward reunification as a result of receiving housing and additional services, the County did not pursue other permanent options (e.g., adoption, legal custody with a relative) as quickly. As a result, their cases might be open longer than they might have otherwise. This led to higher rates of family reunification in the treatment group but not shorter stays in foster care.

While funders did not get a return of the money they invested, this project provides many examples of PFS working as intended even when the intervention does not achieve the social outcome being measured; for example:

There is now a rigorous evaluation that the County can use to make related policy and funding decisions. The Department of Children and Family Services (DCFS) is already considering an extension of this program to further explore how these services can continue to support the higher reunification rates experienced by African American families in particular, which was one of the unexpected outcomes revealed by the PFS data.
Additional interviews with case workers, service provider staff, and parents provided on-the-ground context for the quantitative results and can inform ongoing local efforts to better support families facing particularly difficult circumstances.
Now that we know this intervention does not reduce the length of foster care placements, the County and its partners can look for other ways to address this challenge based on the data and experience gained from PFS.
The County did not ultimately pay for the program costs because it did not reduce days in foster care. In this way, the project shifted risk associated with testing a promising, innovative intervention away from taxpayers and to other private and philanthropic funders.
This program brought together County leadership, social service and housing providers, project managers and advisors, an experienced research team, local foundations, and two national CDFIs in a collaboration that would not happen as part of a business-as-usual approach to addressing an intractable social challenge.
The program also resulted in some changes in how the County supports DCFS-involved families that will have a lasting positive impact beyond just those who participated in the PFS project.

Not every PFS project will achieve its desired outcomes, but the other benefits described above – data-informed policy, new partnerships, alignment towards better, more equitable community outcomes – are foundational to social sector innovation.

Innovation isn’t possible without a willingness to take thoughtful risks. At NFF, we continue to partner with people who share our belief that we can better support communities and their nonprofits, and to focus on the outcomes that help communities thrive.