State governments are dramatically improving results for residents by using data and evidence to inform their budgets, policies, programs, and management decisions. As representatives from Results for America and the University of Pennsylvania’s Actionable Intelligence for Social Policy, we’re encouraged and inspired by the states that are leading this work and hope that sharing their stories will help other states to do the same.
One state with a long track record of data use and evidence-based policymaking is Washington.
The Washington Department of Social and Health Services’ Research and Data Analysis Division (RDA) houses an Integrated Client Database that brings together 30 data sets from 10 state agencies to “support cost-benefit and cost offset analysis, program evaluations, operational program decisions, geographical analyses and in-depth research” (p. 1). The Department’s database includes statewide, individual-level data on vital records, health care, child welfare services, juvenile and adult justice, public assistance, homelessness, and employment.
Under the leadership of Dr. David Mancuso, Health Economist at Washington State Department of Social and Health Services, the state has not only invested in the necessary technology to facilitate data linkage and storage, but also in the human capacity to put it to good use. In the last five years alone, they’ve used integrated data to study high-priority state government social policies and programs. They’ve explored the impact of assisted housing on education outcomes; the housing status of youth exiting foster care and criminal justice systems; the prevalence of Adverse Childhood Experiences(ACEs) and the association between ACEs and use of emergency rooms; and the outcomes of providing home visiting services to TANF families. These studies have informed policy changes and resource allocation and are now serving as the baseline for evaluation of new state and philanthropic investments in these areas.
Washington State’s investment in data sharing and integration has also allowed them to deploy new data analytic tools, including the Predictive Risk Intelligence SysteM (PRISM), which helps case managers access information about individual clients and their service histories, inform decisions about targeting resources, and better coordinate care. According to RDA’s estimates, PRISM has allowed the state to reap $10 million Medicaid savings by identifying high-need clients and reducing duplicative and fragmented interventions. This example demonstrates the value of both the intervention, and the data capacity that enabled it, and has allowed the state to advocate for sustained investment in both.
Washington’s ongoing success story, which was included in Results for America’s 2018 Invest in What Works State Standard of Excellence, demonstrates the various ways that state governments are using data to improve results. With 15 different criteria in areas ranging from data use and evaluation policies to use of evidence in grant programs, the 2018 State Standard of Excellence offers state governments a road map for how they can increase their use of data and evaluation and move towards more evidence-based policies in order to achieve improved results for their residents.
The State Standard of Excellence highlights three important data-related areas where states can make progress to improve results. First, Data Leadership examines whether state government have senior staff members charged with using high-quality administrative data to improve programs. Second, Data Policies/Agreements identifies if state governments have data-sharing policies designed to improve outcomes for publicly funded programs. Third, Data Use looks at whether state governments have the capacity to link administrative data sets in order to better understand outcomes and improve programs.
AISP’s work with state and local governments validates the importance of these three criteria. As conveners of a national network of jurisdictions that are building and using integrated data systems, we’ve seen the impacts up close.
As an example of data use, a 2014 Indiana executive order created the Management Performance Hub (MPH), a collaboration between the state’s Office of Management and Budget (OMB) and the Office of Technology (IOT) designed to facilitate the linkage, storage, and analysis of administrative data. The MPH quickly proved to be a valuable tool for driving evidence-based policy. The new agency’s first major undertaking was to address the state’s high level of infant mortality. By linking data across 17 data sets, MPH staff were able to better understand and map mortality rates, discovering that a single high-risk subpopulation accounted for only 1.6% of births statewide but 50% of infant deaths, and that inadequate access to pre-natal care accounted for 65% of infant deaths. This information drove increased investment in a targeted strategy to identify those at-risk and connect them with vital resources to reduce infant mortality.
Indiana’s quick success with cross-agency data use led the state to invest in even more senior data leadership capacity. In 2017, Indiana created the position of Chief Data Officer (CDO), tasked with coordinating data analytics and data transparency for state agencies. Since then, under the leadership of CDO Darshan Shah, the MPH has created new public-facing data mapping and visualization tools on transportation safety, Medicaid optimization, and Naloxone treatment, a linked Education and Workforce Development (EWD) longitudinal dataset designed to answer key questions about the education and workforce pipeline, and an online process for external researchers to request linked data.
Another strong example of Results for America’s state standards in action comes from Massachusetts, where a Secretariat-level cross-agency working group was empowered by Governor Charlie Baker to investigate best practices to improve the state’s data policies and data sharing agreements. After extensively mapping existing agreements, the team worked with agency counsel to draft one overarching MOU, or “Constitution” for state data sharing, as well as a streamlined process for executing future agreements.
Massachusetts’ commitment to building the capacity to link administrative data sets was both demonstrated and validated by one particularly powerful example of data use. In 2015, the state passed a law known as Chapter 55 with the aim of developing a coordinated and evidence-based response to the quickly escalating opioid epidemic. As no single data set included all individuals who had experienced a fatal or non-fatal overdose, linkage between data sets was critical to enable Massachusetts to explore the trajectories of those who were prescribed opioids. Since then, the interagency data effort has informed major state-level policy and program changes to better combat the crisis, and Massachusetts recently reported declining rates of opioid related-deaths for the first time in seven years.
Figure 3 Source: Opioid-related Overdose Deaths among MA Residents, Massachusetts Department of Public Health Brief, May 2018
Washington, Indiana, and Massachusetts clearly demonstrate that, by prioritizing data sharing and the use of evidence and evaluation in policy and budget decisions, states can achieve significant impacts and better results for residents. To achieve more progress, every state government must commit to the hard work of better using data and evidence, one step at a time.
WANT TO LEARN MORE?
● Read Results for America’s State Standard of Excellence and dig in to the Leading State Examples. Then use the 15 Criteria as a roadmap for advancing the work in your state government.
● Check out AISP’s website for free resources on data sharing and integration, including this short brief, and consider applying for the AISP Learning Community for help getting started and access to a network of state peers.
WANT TO SHARE MORE?
We want examples of how your state is making progress on using data to achieve better results. Please share by tweeting at us @Results4America and @AISP_Penn or contacting us directly: Nichole Dunn and Della Jenkins