Issues in Government Purchase of Family-Based Services
Sandra O'Donnell and Ronald D. Davidson
Family-based services, like other social services, can be either provided directly by government agencies or purchased from the private sector. In longer-standing fields of service, we have witnessed a clear trend in the past two decades toward increased use of purchase of service ( Hansmann, 1980; Kettner & Martin, 1987; Kramer, 1982; Kramer, 1985; R. S. Smith, 1989). This trend is the product of funding programs such as Title XX and other policies that encourage purchase of service and that are based on a philosophy of "privatization." Because most family-based services have originated since the enactment of Title XX, we do not know if there is a trend in the field toward public purchase and away from public provision of service. Nor do we know of any evidence to support ideological statements that family-based services delivered in one sector are superior to those delivered in another, or if services delivered by private for-profit agencies are more or less effective than those delivered by nonprofit agencies.
We do know that many family-based services are provided by the private nonprofit sector through purchase of services with government agencies ( National Resource Center on Family Based Services, 1987; K. Nelson, Landsman, & Deutelbaum, 1990; Pecora, Kinney, Mitchell, & Tolley, 1980; Stehno, 1987), particularly in state-administered systems ( Tyler, 1990). Accordingly, how we purchase family-based services and how well these methods promote effective, efficient services to families are important issues in government implementation of family-based service systems. Little attention has been given to them, in part because the family-based field has focused on more basic issues, such as securing political support and designing