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This human services contracting case describes an innovative system launched by the Oklahoma Department of Rehabilitative Services when faced with what it viewed as skyrocketing costs and ineffectual assistance for citizens with severe disabilities. Under fiscal pressure, the Department decided on a drastic change in its historic approach to contracting--which had reimbursed service providers for their billable hours. The new, "milestones" approach would reward vendors, instead, for specific results, on the road toward employment for the disabled. The case describes the virtues of the milestones system, as seen by the state; the fears of service providers and advocates that the new incentive system would cause a deterioration in the nature of assistance and therapy; and the early results of the program. Supported by a grant from Innovations in American Government Program; written for the Hauser Center for Nonprofit Institutions.

Learning Objective:
This case allows for analysis and discussion of the strengths and weaknesses of the new "Milestone" program in increasing the efficiency and effectiveness of the vendors under contract in achieving concrete results.

Other Details

Case Author:
Susan Rosegrant
Faculty Lead:
Peter Frumkin
Pages (incl. exhibits):
United States
Funding Source:
Innovations in American Government Program