• By Dartington SRU
  • Posted on Friday 23rd July, 2010

The man who makes the prevention motor run

There are scientists, there are policy makers and then there are the oilers—the people who bring the cogs together and make them run smoothly. Clay Yeager is a Pennsylvania-based oilman. He has arguably done more than any other American to help good prevention ideas make it into day-to-day practice.So many developments owe much to Yeager’s entrepeneurial effort—the proliferation of Communities that Care as well as the widespread application of evidence-based programs in Pennsylvania, the international prominence of Nurse Family Partnership, and the integration of proven models into child welfare and youth justice systems in Florida and other states. Yeager’s working life started a long way from high quality evidence. “I was a fresh-out-of-college probation officer in 1973,” Yeager told Prevention Action earlier this month. “In hindsight, we didn’t know anything. We worked on gut instinct. Our primary function was maintenance and supervision. The only thing we measured was the number of days until a youngster turned 18.”“Shortly before committing suicide, Robert Martinson reviewed over 200 studies on offender rehabilitation and concluded ‘nothing works’. There was not a lot of optimism around”.Things began to turn around in the early nineties. Yeager attended the National Juvenile Justice Conference in Boston Massachusetts where he heard David Hawkins talk about Communities that Care. Yeager was in Boston with senior officials from Pennsylvania. They all quickly reached the same conclusion. Hawkins’ work could help turn around the state’s losing battle with youth crime.They got to work. At its high point, Communities that Care was being used in over 120 Pennsylvanian communities, leading to the implementation of many of the evidence-based programs recommended by Blueprints for Violence Prevention. Funds were found to support the work.“There was an exponential increase in resources” observed Yeager. “We started with $2 million per year in 1998. We doubled it in 1999, Doubled it again the year after and by 2001 there was a $16 million annual investment”.Hawkins’ admiration for Yeager’s work in Pennsylvania and nationwide is well recorded. “He is a remarkable man,” says Hawkins. ”The most effective communicator I have known. He is a vigorous entrepreneur, and a charismatic, effective and tireless leader. He moves people to take confident action through his inspirational words, personal and professional example, and excellent management skills.” Yeager learned much from this work. Political leadership is, for him, a vital component to make good ideas routine. He worked closely with Pennsylvania Governor Tom Ridge, a man he admires greatly.“Tom Ridge knew instinctively that it was not sufficient to get tough on offenders, that putting more and more kids into the juvenile justice system was not the answer. He knew there had to be a focus on prevention also. For him this was a political matter. He used to say ‘good policy IS good politics.’”Governor Ridge backed the Communities that Care effort. First Lady Michele Ridge also took a prominent role in a range of activities designed to promote prevention is the state. She served as Chair of the statewide prevention initiative, called The Children’s Partnership while Yeager as Executive Director.Yeager also learned that early gains are too easily eroded. Funds had steadily increased until the politics changed and they started to go down. Priorities changed and, in no time, Pennsylvania’s 11 million citizens were spending $2 billion per year to lock up 52,000 offenders and disinvesting in evidence-based prevention.“I learned the value of embedding ideas in local culture and practice. Politicians can get a good idea off the ground quickly. They can also destroy a good idea. What can stop them? People. Local people who care about good outcomes for our kids and wise spending of their taxpayer dollars. It simple makes too much sense to ignore.”By 2004, Yeager was on the national stage. He took on the tough role of translating proven university based model Nurse Family Partnership to a successful business venture.“Universities are not set up for business,” observed Yeager. “That’s not a criticism. We want universities to do what they are good at. But when somebody who has funds to help kids wants to get hold of a Nurse Family Partnership or a Multi-systemic Treatment and they phone the office of the person who invented the product, they don’t always get a quick response. My job was to create an organization that could build demand for the product and respond to that demand.”The success of Yeager’s efforts are there for all to see. By many estimates, Nurse Family Partnership is the largest and most embedded of all evidence-based programs. Its originator, David Olds, is full of praise: “As Chief Executive Officer of Nurse Family Partnership National Service Office, Clay inspired other Board members, NFP leadership and staff by connecting with the best in them and giving them direction by example and with outstanding administrative skills. In communicating with the public, Clay displays these same talents, by inspiring them to take intelligent action based on our highest human aspirations.” Yeager’s recent work for Evidence Based Associates, previously reported in Prevention Action [link], has been about finding ways to install a suite of proven models in mainstream systems in Florida and elsewhere. What is impressive about this effort is EBA’s readiness to share the financial risk with the state, and the ability to get third party providers to successfully deliver complex programs like Functional Family Therapy.There is much talk in the prevention world about what is called ‘Type 2 Translation’ and getting ideas to scale. For Yeager, this is his day job.And what of the world of probation he left behind? “Probation as a system is staffed by highly educated people who are research focused. They are discerning. They work at a local level so they know what it means to make a decision that must protect public safety and promote the rehabilitation of the offender. They are surrounded by people who promote all kinds of fads and fashions but they have to work out what will be effective, now, and in the long term.”Finding out more about what works in clinical practice and getting this evidence into routine use will become increasingly important according to Yeager. So too will be the effort to better connect practitioners with the economic consequences of their decisions. “A juvenile offender can cost $175,00 or more per year. A probation officer with a dozen difficult kids can be sanctioned millions of dollars of expenditure. It is important to know that something like Functional Family Therapy will cost maybe just $5,000 per case while producing better outcomes. It will not always be the answer. But the economics demands that the clinician asks the question.”Prevention Action talked to Yeager against the backdrop of the disastrous BP oil spill in the Gulf of Mexico. Yeager is a very different kind of oilman. Over three decades now he was gracefully lubricated the connections between the worlds of science, policy and business on behalf of troubled children and their families.ReferencesDouglas Lipton, Robert Martinson and Judith Wilks, The Effectiveness of Correctional Treatment: A Survey of Treatment Evaluation Studies, Praeger Press, New York, 1975Martinson, R. (Spring 1974). ‘What Works? - Questions and Answers About Prison Reform, The Public Interest, 22-25, Spring 1974

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