Intermediary organizations who know how to broker and manage a fruitful relationship between public fundholders and prevention service providers look like being among the few winners in the new cost-benefit conscious climate.

Coverage of the progress of Project Redirection in Florida, and of the success of performance-based contracting illuminates the role of a new breed of middlemen and women, represented by the South Carolina-born, but largely “virtual” Evidence-Based Associates. [See: A contract to bring prevention science in from the edge and Building better performance with Dan and Clay.]

Evidence-Based Associates describe themselves as specialists in implementing and managing programs that address the unique needs of high-risk youth. They do without office headquarters and contracted staff and have no appliance or product they need to call their own. 

As partner Clay Yeager explains, EBA makes the connections between other people’s resources and takes a calculated financial risk by asking for payment on results, which are usually measured in human terms – fewer young people re-offending; fewer in prison.

The company was launched in 2004 by business corporation executive Curt Huston, who brought to the operation capital, business acumen and a knowledge about performance-based contracting.  Co-founder Keller Strother had already done much to make Multisystemic Therapy one of the most widely used evidence-based US programs, in his former role as president and founder of MST Services.

EBA is essentially a management company that has perfected routines for recruiting and training workers in existing provider organizations to deliver with fidelity programs such as Multisystemic Therapy and Functional Family Therapy. EBA staff do not deliver the evidence-based programs; they make sure their client their organizations do it to the desired standard.

If they do their job well, the Associates benefit financially, as do the provider agencies and the state.

Financial success is essential, but so is recognition by the prevention science community, particularly as Yeager and his colleagues begin to introduce their business model in other states, and to extend it to other aspects of children’s services.

Recent acknowledgment by Blueprints for Violence Prevention founder Del Elliott of the EBA redirection achievement in Florida is seen as a big step in that direction.

“The key to our success”, Yeager says, “is having the right programs, the right people and the right amount of attention to fidelity. We only choose programs with proven impact. We don’t employ people straight out of school. We rely on experts in juvenile justice, child welfare and residential services. We make sure the delivery of the intervention is as pure as can be found”.

In the process, they are changing the traditional model of performance accountability. EBA has to achieve results to get paid. The provider agencies have to deliver fidelity or they lose their contract. The state wants to see fewer young people in custody, not as a matter of ideology, but because it is a tangible consequence of better outcomes.

A bigger test in so harsh an economic climate will be whether new types of intermediary organizations can profitably be brought to bear on public policy around the world.