Improving Outcome Accountability of Block Grants: Lessons Learned From the Preventive Health and Health Services Block Grant Evaluation

Author:

Lamia Tamara L.1ORCID,Lowry Garry F.2,McLees Anita W.3,Frazier Cassandra M.4,Young Andrea C.1

Affiliation:

1. Office of the Director, Center for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA

2. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA

3. Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA

4. Division of Performance Improvement and Field Services, Center for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA

Abstract

The flexibility federal block grants provide recipients poses challenges for evaluation. These challenges include aggregating data on wide-ranging activities grant recipients implement and the outcomes they achieve. In 2014, we began designing an evaluation to address the challenges of assessing outcomes and to improve outcome accountability for the Preventive Health and Health Services Block Grant. Through the use of evaluability assessment methodology, review of existing data and the literature, and key informant interviews, we developed a measurement framework to assess outcomes resulting from recipients’ ability to use grant funds to meet their locally prioritized needs. We argue our evaluation approach demonstrates that block grants, and other similarly flexible programs, can be evaluated through appropriately designed measures. Our efforts challenge the idea that flexibility presents an insurmountable barrier to evaluation and outcome accountability for federal block grants.

Publisher

SAGE Publications

Subject

Strategy and Management,Sociology and Political Science,Education,Health (social science),Social Psychology,Business and International Management

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