Pay For Success

“And How Are The Children?” Reflections on ICS’ 4th PFS Convening of Early Childhood Advisors


By Mary Garvey, Director of Innovation and Inclusion

There is a tribe of people that inhabits parts of Kenya and northern Tanzania.  For generations they have greeted one another with the saying: “And how are the children.”  The expected response is: “The children are well.  Yes, all the children are well.”  Two things stand out to me about this greeting.  First, there is the inherent understanding that the well-being of children is reflective of how society is doing on a whole.
Secondly, all (not some) children must be well in order for all to be well. 

At ICS, we believe that children’s well-being must be at the forefront, as our mission is to ensure the success of all children.  Our recent Pay for Success Convening of Early Childhood Advisors in Charlotte, NC provided an opportunity for us to gather influential partners in the field, and gauge the impact of Pay for Success (PFS) thus far, while we discussed and planned for the future of early childhood initiatives both within and separate from PFS.

Our more than one-hundred Convening participants included government agencies, service provider organizations, legislatures, universities, and foundations.  They traveled from 13 states and the District of Columbia, and three attendees even crossed an ocean to join us – coming from the United Kingdom & Australia. We were pleased to have in attendance colleagues from current and past technical assistance recipient jurisdictions representing the Oklahoma Department of Mental Health and Substance Abuse Services, the City of Tallahassee Office of the Mayor and Representative Loranne Ausley’s Office, the Tennessee Commission on Children and Youth, the City of Spartanburg, and the City of Tempe..  Most attendees arrived at our Convening having some familiarity with Pay for Success; all were staunchly committed to bettering our communities by improving outcomes for children and families through Pay for Success.

Our opening plenary focused on the challenges and opportunities in building data infrastructure that maximizes evaluation impact and outcomes.  The ensuing discussion around data access and use as a critical component of PFS was invigorating, educational, and thoughtful.  Throughout the Convening, plenary sessions offered a detailed overview of the state-wide expansion of Nurse-Family Partnership (NFP) in South Carolina; lessons learned from PFS feasibility studies supported by the Social Innovation Fund (SIF) and the U.S. Department of Education; an informed outlook on post-SIF policy implications for early childhood; and legislative updates.  Highlights included discussion of SIPPRA and opportunity zones as potential PFS project funding opportunities, while also hearing confirmation that, though the level of engagement has shifted, the philanthropic community on a whole is still very much interested in this work.

Day one’s Convening breakout sessions highlighted three common early childhood focus areas within PFS.  The home visiting session homed in on the critical role of programs like Family Connects and NFP in the lives of young children.  Colleagues affiliated with preschool projects in the City of Tempe in Arizona, Pomona Unified School District in California, and Westminster Public Schools in Colorado led the early learning session. The third breakout session explored child-welfare through the lens of social determinants of health.

Post-feasibility topics and broader themes framed breakout sessions on day two.  Attendees learned about the nuts and bolts of transaction-structuring and how to bolster service provider readiness for outcome-based financing such as PFS.  Experts came together to share their thoughts on those special characteristics that have led to ongoing success with PFS in certain areas of the country.  This day also brought on spirited discussion of potential differences in implementation between homegrown and national program models.  Finally, we focused on special education as an important innovation in PFS, and gleaned international lessons from trends in PFS initiatives abroad. Session presentations are available here.

By the end of the PFS Convening, two questions persisted: How are the children? Are all the children well?  After a few seemingly unrelated references to the aforementioned tribe of people – the first at Mayor Andrew Gillum’s Fourth Annual Summit on Children in Tallahassee this past May,  – those have been some of my most pressing guiding questions each day.

Are the children safe?

Are the children healthy?

Are the children provided for?

Are the children loved?

In addition to the ongoing commitment to young children and their families reflected by the energetic participation at our Convening, I am heartened by the PFS initiatives that have launched or are in development – ones that focus on housing, asthma, child welfare, child and maternal health, and early learning.  The impact of PFS on early childhood thus far tells me that the children are better off.

However, until we can respond, “The children are well, yes, all the children are well,” our work is yet to be done.  ICS was privileged to host yet another opportunity – our Pay for Success Convening of Early Childhood Advisors – as we joined together to that end.