South Carolina

The South Carolina Revenue and Fiscal Affairs Office (RFA) is authorized by recurring budget provision (103) and various statutes (§44-6-170) to collect and integrate data at the state level. The budget provision gives RFA the authority to maintain MOUs with the majority of state agencies and the authority to execute additional ones. Since 1975, the office has helped improve government efficiency, enhance outcomes for residents, and reduce disparities through the integration of data across policy domains and data sources, as well as agencies and departments. The agency has a staff of approximately 75, composed of analysts, statisticians, epidemiologists, database administrators, web developers, GIS analysts, economists, surveyors, and project and program managers.

The South Carolina Revenue and Fiscal Affairs Office maintains an integrated data system, a data warehouse that links data from individuals being served by more than 20 state agencies and other organizations. This system has facilitated program improvement efforts and numerous research studies, including a randomized controlled trial (RCT) as a part of the state’s Pay for Success initiative to improve outcomes for low-income mothers and their babies. South Carolina has continued to expand its evaluations, including an RCT on the impact of Managed Care Organizations. In 2020, the state shared its updated report on how it would utilize the integrated data system to support COVID-19 Response.

A 2021 state law established a trust fund in the State Treasury for the purpose of making Pay for Success contracts. Each agency entering into a Pay for Success contract must provide funding into the trust to cover 100% of the potential success payment. Upon written authorization by the state agency head whose state agency has entered a Pay for Success contract, the state treasurer will make payments from the trust fund.

From 2016-2020, South Carolina carried out a Pay for Success project to expand home visiting services to 4,000 additional low-income mothers and their children. South Carolina’s Department of Health and Human Services (SCDHHS) used the contract to deliver preventive services to first-time mothers in the state’s Medicaid program with the goal of improving the health outcomes of mothers and their babies. As part of the project agreement, South Carolina will make up to $7.5 million in success payments to sustain Nurse-Family Partnership’s services only if independent evaluators find positive results. In order to incentivize implementing agencies to enroll low-income mothers who may have more risk factors, project partners made enrollment from low-income zip codes a payable outcome. Additional payable outcomes for the project include reductions in child injury rates, preterm births, and rapid repeat pregnancies.