Recent attention to best practices has resulted in a complex array of terminology and a number of compendia of effective practices that may be daunting to public policy makers and administrators seeking solutions to important public problems. This study clarifies these distinctions and builds on them to create a decision tool that will help policy makers as they use best practice information in program adoption or development. Decision makers must know their goals in seeking out best practices. As they evaluate potential practices, they should consider not only the quality of available evidence of effectiveness but also the risk of harm to constituents and the cost per unit of benefit generated. The study applies the rubric to an emerging practice in support services for individuals with disabilities known as Cash and Counseling, demonstrating that the practice is low risk, cost neutral, and improves effectiveness and consumer satisfaction. The tool highlights the judgmental elements of concern in the decision process while providing a means to assess multiple decision dimensions in a coherent fashion.