Managing third-party accountability in human services contracting: Contract accountability in human services

Abstract

This article analyzes the use and limitations of nonmonetary contract incentives in managing third-party accountability in human services. In-depth case studies of residential care homes for the elderly and integrated family service centers, two contrasting contracting contexts, were conducted in Hong Kong. These two programs vary in service programmability and service interdependency. In-depth interviews with 17 managers of 48 Residential Care Homes for the Elderly (RCHEs) and 20 managers of 10 Integrated Family Service Centers (IFSCs) were conducted. Interviews with the managers show that when service programmability was high and service interdependency was low, nonmonetary contract incentives such as opportunities for self-actualization professionally or reputation were effective in improving service quality from nonprofit and for-profit contractors. When service programmability was low and service interdependency was high, despite that only nonprofit organizations were contracted, many frontline service managers reported that professional accountability was undermined by ambiguous service scope, performance emphasis on case turnover, risk shift from public service units and a lack of formal accountability relationships between service units in the service network. The findings shed light on the limitations of nonmonetary contract incentives.