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Liz BuschKeymaster
Yes, this project had many moving parts, and I agree, Melissa, that including a Fairness Monitor was a wise move. Solicitations for technology are always tricky, and the buyer is going to want to ensure there’s room for upgrades as the technology improves – which in this case, could have happened during the solicitation process, considering how long it took.
Liz BuschKeymasterI see your point about the advantages of avoiding Contract A with a project like this, Joseph. Of course, it is possible to build negotiations into a Contract A project, if you clearly articulate what can and cannot be negotiated and explain exactly how the process will work. If this were my project, I would likely not ask for any pricing until the very end (i.e. the final RFP), after all specifications and clarifications were complete so as to avoid any perception that vendors were allowed to change pricing.
Liz BuschKeymasterI couldn’t agree more with your thoughts on planning, Nicole. It can sometimes be an uphill battle with senior executives to get approval for such long solicitation timelines – May 2012 for the RFI to July 2014 for the RFP closing date plus time for evaluation and contract negotiations. But when you’re talking about a mission-critical service that is going to be costly, taking the appropriate time to plan has many pay-offs.
Liz BuschKeymasterI hear your frustrations with funding programs that have inadequate outputs, Bob. I typically see this when services don’t include measurable outcomes. We came up with an idea for one RFP I managed many years ago to address this. It was for a program designed to connect people with sustainable employment where in the past, the contractors were paid for each individual that went through the program regardless of whether they became employed. When we did the RFP, we kept that model, but added incentive payments when an individual had sustained employment at 6-month and 12-month intervals after the program ended. I’m not sure what the final outcome to that approach was, though, as I wasn’t involved once the contracts were signed.
Liz BuschKeymasterI agree with your thinking here, Bob, but I sometimes wonder the message governments give when social objectives, such as Fair Trade, are worth a small percentage of the overall points. For example, if an RFP assigns 5 points to social objectives and 25 points to price, a vendor would think long and hard if they want to maximize their score for social objectives by proposing Fair Trade products if this will result in a higher proposed price (i.e. they may lose more than 5 points in the pricing evaluation).
Liz BuschKeymasterI like your thinking on this, Colin, but I do have a question about using outcomes-based commissioning for social services. Although I see the benefits as you do, one of the concerns is that contractors will “cherry-pick” participants in these programs to help ensure that they can meet their success metrics. In other words, those individuals who have a high chance of success are picked first, and those who arguably need the supports more often aren’t accommodated due to lack of space in the program. How could this be addressed?
Liz BuschKeymasterYour research and observations are very interesting, Don. It begs the question as to whether Fair Trade something only those wealthy enough for travel / post secondary educations can afford.
Liz BuschKeymasterI like how you compare this to good vs evil, Nicole :). In simplistic terms, it sure feels that way, but as you point out it isn’t so clear in daily living. I wonder if the shift will happen at all if governments don’t use their influence and buying power to encourage it.
Liz BuschKeymasterThat’s a good distinction, Amelie. It all depends on how the outcomes are defined – i.e. supporting someone to stay independent longer, or providing care that improves quality of living so an individual does not need as much support. Both of these outcomes have a broader outcome in common though – less stress on the health care system and dollars.
Liz BuschKeymasterI agree that this is another great area to consider outcomes-based commissioning, Kimberly, particularly since the overall percentage of the population over 65 is expected to grow. One of the challenges, though, would be the metrics that define the intended outcome. For example, as the overall percentage of this age group grows, the demand for supported living units will also grow. In developing metrics these outcomes, would the idea be to slow that growth? Keep it at status quo (meaning that no new supported living units are needed despite the increase in this population)? Or perhaps to change the ratio of individuals over 65 living in their own homes vs those in supported living situations?
Liz BuschKeymasterWhat a great example, Anise. It’s wonderful to see governments taking a long-term view to a problem, instead of the usual 4-years-to-the-next-election timeframe. Given all the challenges faced by the health care system across the country, creating a program to better support one segment of the population that heavily relies on that system is a great way to meet longer term objectives. I’d love to see statistics over the next few years to see if the intended outcomes were achieved.
Liz BuschKeymasterThese are great examples, Anick, where outcomes-based commissioning could make a significant difference to the “pain points” of current service delivery models. I agree that strong leadership and champions are key to its success for the reasons you’ve stated plus one other that I’ve encountered. When you have contractors who have been delivering the same services for years under direct award, they can get a sense of entitlement to their contract. If you change direction that results in these vendors losing “their” contract, they can get very vocal with the media and elected officials about their disagreement with this decision.
Liz BuschKeymasterThat’s an excellent thought, Don. I agree that governments’ main objectives are not operating retail stores, but they might do so for other reasons (e.g. regulating public safety, revenue generation, etc.). Taking an outcomes based approach might result in very different approaches….
Liz BuschKeymasterI like this idea of a co-op program, Kim. How do you think it might work?
Liz BuschKeymasterDo you know what the government did to determine the need for this program, Melissa? Was there a lot of consultation with patients, health care providers, patients’ families, pharmacies, etc.?
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