The development of performance measures or metrics is an area that HSRI has been involved in almost since the inception of the Institute. Without the ability to quantify performance, public officials are hamstrung from understanding how to improve the quality, efficiency and effectiveness of what they do. Our work in this area takes many forms. We continue to support National Core Indicators – a large multi-state effort that generates data on performance across a range of domains. We are also assisting state officials to understand their performance relative to their goals of transformation in mental health. We have worked with public managers to develop state specific performance measures by which to assess the quality of services of child welfare services. Our work in substance abuse prevention has assisted federal policy makers to understand the performance of specific states and grant recipients. For many years, we have worked as part of the National Quality Contractor and the National Quality Enterprise, supported by the Centers for Medicare and Medicaid Services, to assist states to structure their Quality Improvement Systems to include valid and reliable measures of performance of their Home and Community Based waiver services.