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“Creative Financing”: Funding Evidence-Based Interventions in Human Service Systems

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Abstract

Implementation and sustainment of evidence-based interventions (EBIs) is influenced by outer (e.g., broader environments in which organizations operate) and inner (e.g., organizations, their administrators, and staff) contexts. One important outer-context element that shapes the inner context is funding, which is complex and unpredictable. There is a dearth of knowledge on how funding arrangements affect sustainment of EBIs in human service systems and the organizations delivering them, including child welfare and behavioral health agencies. This study uses qualitative interview and focus group data with stakeholders at the system, organizational, and provider levels from 11 human service systems in two states to examine how stakeholders strategically negotiate diverse and shifting funding arrangements over time. Study findings indicate that, while diverse funding streams may contribute to flexibility of organizations and possible transformations in the human service delivery environment, a dedicated funding source for EBIs is crucial to their successful implementation and sustainment.

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Acknowledgements

This study is supported by U.S. National Institute of Mental Health grants R01MH072961 and R01MH092950, National Institute on Drug Abuse grant R01DA038466, and U.S. Centers for Disease Control grant R01CE001556 (Principal Investigator—Gregory A. Aarons). We thank participants from the service systems, organizations, and the participating providers and coaches for their collaboration and involvement in this study.

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Authors and Affiliations

  1. Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, 851 University Blvd SE, Suite 101, Albuquerque, NM, 87106, USA

    Elise Trott Jaramillo PhD, Cathleen E. Willging PhD & Lara M. Gunderson PhD

  2. Department of Anthropology, University of New Mexico, MSC01-1040, Anthropology 1, Albuquerque, NM, 87131, USA

    Elise Trott Jaramillo PhD, Cathleen E. Willging PhD & Lara M. Gunderson PhD

  3. Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive (8012), La Jolla, CA, 92093-0812, USA

    Amy E. Green PhD, Danielle L. Fettes PhD & Gregory A. Aarons PhD

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  1. Elise Trott Jaramillo PhD
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Correspondence to Elise Trott Jaramillo PhD.

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Jaramillo, E.T., Willging, C.E., Green, A.E. et al. “Creative Financing”: Funding Evidence-Based Interventions in Human Service Systems. J Behav Health Serv Res 46, 366–383 (2019). https://doi.org/10.1007/s11414-018-9644-5

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