Recommended questions to address or to consider:
Whether or not you believe that Milestones is on balance an improvement over the previous system for paying vendors of employment services for the severely disabled, assess its greatest strengths relative to the status quo ante.
Whether or not you believe that Milestones is on balance an improvement over the previous system, assess its greatest weaknesses and risks.
The vendors providing employment-related services for the severely disabled in Oklahoma, both prior to and after the 1996 reforms, were private, but not-for-profit. Was this an essential constraint under the earlier input-based contracting system? What would have been the advantages and disadvantages of for-profit private suppliers under the pre-1996 fee-for-service system? Is the case for restricting contracts to non-profits (instead of contracting with both non-profit and for-profit vendors) stronger, or weaker, with the new Milestones system? Why?
What are the characteristics of a social service function that make it most suitable to outcomes-based contracting? What characteristics make outcomes-based contracting inappropriate? Under what general circumstances is inputs-based private contracting (rather than outcomes-based contracting, on the one hand, or direct governmental service delivery, on the other) likely to be the most suitable way to deliver public services?
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