Despite its overall prosperity and booming economy, King County in Washington state faced persistent inequities in poverty, homelessness, and unemployment based on race and place. This case covers the period 2014 to 2019, during which the county developed and implemented new equity- and outcome-driven approaches to address these problems. Starting in 2014, the county began shifting its orientation and operations to focus more on preventive social service programs. The county shifted from a traditional procurement model for social services, in which it assessed contract service providers' performance at the end of a contract, to "active contract management," in which the county worked closely with service providers throughout the contract period to achieve specific outcomes that both parties agreed upon in advance. Renewal of a provider's contract depended on whether the service provider met those outcomes. The case highlights how public organizations, such as county governments, develop and implement innovations. This process includes leadership and operational risks; creating theories of change; evaluating outcomes; effective use of data; relationships with outside organizations like service contractors; and resource requirements and constraints. The county's first and flagship innovative initiative was Best Starts for Kids (BSK), a comprehensive suite of programs that focused on early childhood and youth development. In 2016, the county funded BSK via a $65 million annual voter-approved tax levy. The first BSK initiative, launched in 2017, was the Youth and Family Homelessness Prevention Initiative (YFHPI). It was novel because the county was contracting with 25 smaller community organizations to reach communities with persistent rates of poverty and higher likelihoods of entering homelessness. The case, set in 2019, details the opportunities, successes, and challenges of both YFHPI and the county's cultural and operational shifts so far.

In 2016, Santa Clara County was launching a six-year project aimed at reducing the enormous costs of treating its most acute mental health care patients − $45 million a year − while improving their treatment and quality of life. For the project, the county chose a new model called "Pay for Success" (PFS), in which governments only pay service providers if their efforts are successful. By contrast, in the traditional payment model, providers bill the government on a regular basis for activities and outputs, such as the number of hours spent counseling clients. To provide service providers with working capital during multi-year projects, Pay for Success programs may be paired with Social Innovation Financing, under which commercial investors, foundations and high net worth philanthropists fund the organization's ongoing operations. They are then repaid to the extent that service providers meet their promised outcomes. The PFS model was growing, with $200 million in play in 45 projects around the world. But its detractors raised questions about issues such as 1) using private funds for services for vulnerable people being served, 2) the high government transaction costs of the projects, and 3) potential incentives for service providers to game the system by cherry picking clients or providing inferior services to reduce government costs. Santa Clara County was doing the first PFS project in the mental healthcare space, and had chosen the for-profit service provider Telecare. Butmany decisions still had to be made: How could the county attract Social Innovation Financing partners and negotiate a repayment structure that worked for all parties − while making sure that incentives and motivations were aligned? How should the county measure the success of this project? Which were the right metrics to assess - and which should be linked to payment?

In 2014 The Alta Gracia clothing factory in the Dominican Republic was doing something quite unusual in the industry; it was paying its employees a living wage, which was 350 percent higher than the country's minimum wage. Knights Apparel, which owned the four-year old factory, also provided benefits, health care, and allowed the workers to unionize. Most apparel factories paid employees a minimum wage, which in some places was not enough to pay for workers' basic needs and the needs of their families. Knights Apparel founder and CEO Joe Bozich, the driving force behind Alta Gracia, came to this decision from both business and personal motivations. Knights Apparel was the number one provider of licensed collegiate logo apparel, and Bozich saw the opportunity presented by the growing number of college students unhappy with the working conditions of the people making their schools' branded apparel. Personally, Bozich said he wanted to provide "hope and a pathway out of poverty for generations to come." However, Alta Gracia's production costs were 20-30 percent higher than at Knights' other factories, and Alta Gracia was losing over half a million dollars a year. Knights was able to keep Alta Gracia open only by subsidizing it with funds from its profitable business units. Knights was a private company, but Bozich was still accountable to his board and the company's large multi-billion-dollar institutional investors. Over time, Bozich had convinced many of them to back Alta Gracia, but he needed to pull the factory into profitability soon in order to prove it was a viable business model. If Alta Gracia was successful, Knights would have to decide if it should be expanded. There was also the question of whether Knights would be able to replicate Alta Gracia, and if it could, should it? Other companies had tried and failed to offer a living wage and become profitable. Would Knights be different?

This 2014 case discusses the U.S. nonprofit organization B Lab and its mission to support and help drive investment capital toward private enterprises that 1) aim to provide social and environmental benefits, and 2) are accountable to stakeholders (such as employees and their community) in addition to their equity investors. B Lab created robust tools for assessing the impact of these enterprises so that the social and environmental Return on Investment could be measured and evaluated in a consistent, comparable and transparent fashion. The tools were based on a 200-point assessment scheme called the B Impact Assessment. In addition, B Lab created a certification called "B Corp," which identified companies that considered diverse stakeholder interest in its definition of corporate and fiduciary responsibility. B Lab also created and championed a new legal form, the Benefit organization, which supported those organizations. Through these activities, B Lab played an important role in the relatively new practice of impact investing, which seeks to generate positive social or environmental value alongside financial returns. In 2014 the eight-year-old company was at a strategic crossroads. Many organizations found the B Lab assessment process to be burdensome, and the investment markets were showing a lack of interest, if not resistance to, using B Lab's measurement systems. Many market participants wanted to focus only on specific parts of B Lab's assessment, or wanted more customized tools to suit data collection for their own existing metrics. However, enabling investors to do that would make it harder for B Lab to create common standards - a key part of the organization's mission. B Lab's leaders were grappling with the issue of how far to go to meet the market with highly customized products and services that investors were demanding, versus how much B Lab should lead the market to a higher bar for measuring impact.

This 2014 case describes how the Los Angeles-based Magnolia Community Initiative (MCI) - a network of 70 government, nonprofit and for-profit organizations from multiple sectors - is trying to create population-level change for 110,000 people in a neighborhood plagued by poverty and low education levels. The case discusses the challenges for such a network and raises questions about 1) how to measure progress and outcomes and 2) what factors contribute to success or failure. The six-year-old initiative had built the large network, linked participating organizations together to better serve clients, and designed a new data-driven system for measuring progress and outcomes. However, MCI had not yet seen any improvements in population-level outcomes or intermediate-level outcomes for the neighborhood. MCI is an example of "Collective Impact," an approach to solving social problems that involves commitment from many groups around a common agenda - with the specific features of a centralized infrastructure, a dedicated staff, a structured process, shared measurements, continuous communication and mutually reinforcing activities among all participants.