This page was updated July 20, 2018, to reflect progress in the state.
Minnesota joined the Pew-MacArthur Results First Initiative in June 2015. This partnership resulted from bipartisan legislation signed in April 2015 that called for an assessment of state corrections and human services programs. Soon after, Minnesota’s executive and legislative branches issued letters of support for implementing the Results First approach. These policymakers saw an important opportunity to further incorporate rigorous research, local expertise, and data in the decision-making process.
Minnesota Management and Budget (MMB) spearheads implementation of the Results First approach and coordinates with executive and legislative leaders, agency staff, counties, courts, and other key stakeholders to conduct comprehensive program inventories and cost-benefit analyses on investments across the state. An advisory committee consisting of legislators, leaders from the executive and judicial branches, county officials, and representatives from tribal nations guides the work. The panel advises on the state’s use of the Results First approach and identifies practical applications for the analyses.
Since Minnesota joined the Results First Initiative, MMB staff have completed and released program inventories and cost-benefit analyses in a number of social policy areas, including adult criminal justice, adult mental health, substance use disorder, juvenile justice, and child welfare. Lawmakers, counties, and state agencies have continually found constructive ways to incorporate the findings into budgets and policy decisions.
Adult criminal justice
In its first report, MMB worked collaboratively with the Minnesota Department of Corrections and county correction agencies to assess 19 programs designed to rehabilitate offenders and reduce the likelihood of future criminal activity. MMB concluded that the majority of these programs produce benefits that exceed costs and demonstrated the potential for evidence-based practices to help reduce recidivism and public spending in the criminal justice system. MMB’s report also identified disparities among counties in the availability of evidence-based programs and found that demand for these services regularly exceeded a county’s ability to offer them.
Adult mental health
MMB inventoried and assessed adult mental health programs that aim to reduce the incidence or symptoms of serious disorders, including anxiety, major depression, and post-traumatic stress. Through this work, MMB identified the high cost of inpatient and residential treatment beds, quantified the lifetime costs associated with serious mental illness in Minnesota, and determined potential service continuum opportunities. The report also encouraged investment in evidence-based prevention and early intervention programs that could reduce the demand for more expensive or less effective inpatient treatments. Using cost-benefit analysis, MMB found that the majority of programs assessed had estimated benefits that exceeded their costs. Benefits ranged from 80 cents to nearly $4 per $1 invested.
Substance use prevention, treatment, and recovery
In 2017, MMB inventoried and assessed the research evidence available for prevention, treatment, and recovery services for adults and youth with substance use disorder. Of the 118 programs identified, more than half earned an evidence rating of proven effective or promising. Using cost-benefit analysis, MMB found nearly all programs analyzed to have projected benefits exceeding their costs. Additionally, the program inventory revealed gaps in service delivery, especially access to treatment and recovery options in rural areas. MMB’s analysis concluded that the most cost-effective strategy to address substance use disorders was to identify at-risk individuals and intervene early. It found that prevention could generate benefits ranging from $15,000 per incidence of alcohol use disorder to $309,000 per incidence of opioid addiction.
MMB’s team also worked with state and local partners to assess the evidence of effectiveness for juvenile justice offerings. It found 67 services in place in Minnesota—25 proven effective or promising and 39 theory-based. Three services showed no evidence of affecting future juvenile arrests or delinquency. Another important finding: While the total number of juveniles interacting in the system is declining, youth of color and American Indian youth continue to be overrepresented. This problem is not unique to Minnesota, and MMB contended that it was not an immutable feature of the state’s juvenile justice system.
MMB worked with state and local partners to identify existing, publicly funded child welfare services and to estimate the benefits and costs of those services. The resulting inventory contains 74 services, of which 22 had high-quality evidence of effectiveness for reducing child maltreatment and out-of-home care or improving child and family well-being. The analysis provides information on the costs associated with core aspects of the systems; for example, an average episode of out-of-home care costs approximately $28,000. Additionally, system spending on child welfare activities by federal, state, and county partners totaled more than $500 million annually in Minnesota.
MMB continues to expand its program inventory and cost-benefit analysis in additional policy areas. The team continues to find avenues for using evidence to improve decision-making. For example, MMB will use Results First findings to inform the development and enactment of the next biennial budget.