The View From Washington

1
The View From Washington

• Federal Changes and Assessing State Performance

2
Outline of Presentation

• Budget Reconciliation
• ICPC Reform
• CFSR Results
• State Demonstrations and Findings
• State Agency Actions

3
Budget Reconciliation

• The bill reduce funding for foster care, targeted
  case management and case management, child
  support and extends TANF.
• Many provisions will require changes in 2006.
• The Administration releases the FY 2007 budget on
  February 6, 2006.

4
Budget Reconciliation

• Eligibility for IV-E foster care maintenance and
  adoption assistance (Rosales)
• Title IV-E administrative cost claims
• Promoting Safe and Stable Families program
• Targeted Case Management
• Court Improvement section of Title IV-B

5
Rosales

• Eligibility for IV-E foster care maintenance and
  adoption assistance
• The language reverses the Rosales v. Thompson
  decision which permitted broader eligibility
  criteria for children living with specified
  relatives within 6-months of entering foster care
  
• Although the Rosales decision didnt pertain
  directly to adoption assistance, this language
  also clarifies adoption assistance eligibility to
  ensure the same limitation as was made with
  foster care maintenance
• Effective October 1, 2005

6
IV-E Administrative Costs

• Title IV-E administrative cost claims are
  eliminated
• Unlicensed foster homes with the exception that
  claims can be made for up to 12 months or as long
  as it takes a state to normally license a foster
  family home, whichever is shorter, for a child in
  a relative home that is in the process of
  becoming licensed or approved.
• A new requirement is added to conduct foster care
  candidacy redeterminations every six months.

7
IV-E Administrative Costs

• Eliminates administrative cost claims for
  children in ineligible facilities (such as
  detention centers, psychiatric and medical
  hospitals, and institutions with more than 25
  beds), with the exception that claims can be
  retroactively made for one calendar month but
  only if the child is returned to an eligible
  foster care setting.
• Effective October 1, 2005

8
Targeted Case Management

• The language would prohibit certain foster care
  services from being covered by Medicaids
  Targeted Case Management benefit (1) Research
  gathering and completion of documentation
  required by the foster care program (2)
  Assessing adoption placements (3) Recruiting or
  interviewing potential foster care parents (4)
  Serving legal papers (5) Home investigations
  (6) Providing transportation (7) Administering
  foster care subsidies (8) Making placement
  arrangements (9) also includes the language but
  not limited to which allows for further
  restrictions via regulation.

9
Targeted Case Management

• Would limit federal financial participation for
  case management and targeted case management
  services when a third party would also be liable
  to pay for these services, including as
  reimbursement under a medical, social, education,
  or other program. 
• Effective January 1, 2006

10
Court Improvement

• Funds for improved data collection and training
  are appropriated at 100 million (20M per year)
  over 5 years.
• Adds requirements to state plans for Title IV-E,
  Title IV-B, and the PIPs to demonstrate
  meaningful collaboration between courts and child
  welfare agencies.
• Flexibility is provided for states to determine
  state policies relating to public access to child
  abuse and neglect proceedings.

11
ICPC Reform

• 60-day home study requirement (15 day extension
  allowed under certain circumstances)
• 30-day timely home study bonus of 1500
• Tracking requirements
• House no bill introduced during first session of
  the 109th Congress

12
APHSAs ICPC Reform

• Clarifies applicability
• Clarifies jurisdictional issues
• Defines Assessments
• Addresses Placement Authority
• Allows for Rulemaking (i.e. timeframes) and
  Enforcement
• Addresses Financing

13
Measuring State Performance

• Strongest Indicators Across States
• Proximity of placement (49 states including CA)
• Placement with siblings (36 states including CA)
• Foster care re-entry (26 states)
• Weakest Indicators Across States
• Needs Services (1 state)
• Mental health of child (4 states)
• Child and family involvement (5 states)
• Placement stability (5 states)
• Permanency goal for child (5 states)

14
CFSR Findings
15
CFSR Findings
 
16
Program Improvement Plans

• CFSRs and PIPs have been administratively costly
  for states.
• Analysis of the time lapse between the date
  states must submit a PIP and ACFs PIP approval
  date showed a range from 45 to 349 business days.
• 18 states have completed their PIPs.
• HHS has finished the PIP implementation
  evaluation in 8 of those states, all of which
  were determined to have met the goals of the PIP.

17
CFSRs Round II

• HHS has now determined that state performance may
  not be reasonably re-reviewed until at least one
  year following completion of the PIP so as to
  ensure data for round II cover a period after the
  state completes the PIP.
• The onsite review must find that outcomes were
  substantially achieved in 95 of cases reviewed
  as opposed to 90 in the initial round.
• For 50 cases, this means that only 2 or fewer
  cases could be out of compliance in order to
  achieve substantial conformity.
• Comments on Data Composite Measures have been
  solicited by HHS.

18
State Demonstrations

• Assisted Guardianship/Kinship Permanence 9
  states
• STATES DE (2002) MD (2004) NM (2005) MT
  (2006) IL (2008) OR (2009) NC (2009) MN WI
• FINDINGS Children in kinship care in the
  experimental group exited foster care more
  rapidly than those in the control group The
  availability of subsidized guardianship resulted
  in a higher permanency rate in the experimental
  group and did not result in higher rates of
  subsequent reports of abuse and neglect.
• Capped IV-E Allocations and Flexibility to Local
  4 states
• STATES IN (2005) OH (2009) OR (2009) NC
  (2009)
• FINDINGS The number of children placed in
  out-of-home care was lower in the experimental
  group than in the control group. Analysis showed
  a consistently lower rate of re-entry in the
  experimental counties in comparison to the
  baseline year.

19
State Demonstrations

• Services to Caretakers with Substance Use
  Disorders 4 states
• STATES MD (2002) DE (2002) IL (2005) NH
  (2005)
• FINDINGS A higher percentage of children in the
  experimental group were reunified. The average
  length of time in foster care was reduced by
  one-third, and the proportion of cases with
  children entering foster care was lower in the
  experimental group.
• Managed Care Payment Systems 5 states
• STATES CT (2002) MD (2002) CO (2003) MI
  (2003) WA (2003)
• FINDINGS During the first year of
  implementation, the experimental group experience
  fewer days in residential treatment. The
  experimental group demonstrated a significantly
  higher rate of exit into adoption.

20
State Demonstrations

• Intensive Service Options 2
• STATES MS (2004) CA (2005)
• FINDINGS Preliminary findings indicate that the
  placement disruption rate in the experimental
  group was lower.
• Adoptions and Post-Permanency Services 2 states
• STATES ME (2004) MN
• FINDINGS Preliminary findings suggest some
  statistical differences have emerged in favor of
  post-adoption services on four family level
  variables.
• Tribal Administration of IV-E Funds 1 state
• STATE NM (2005)
• Enhanced Training for Child Welfare Staff 1
  state
• STATE IL (2007)

21
State Agency Actions

• RECENT INCREASES IN STAFFING LEVELS
• WV Appropriated 2.9 million for 219 new child
  welfare staff.
• NE Appropriated 5.1 million in state funds and
  1.02 million in federal funds for a variety of
  purposes including the creation of 120 new
  positions.
• NC Appropriated 4 million in state funds and 1
  million in TANF funds for 89 new county child
  welfare staff.
• AK Appropriated funds for 26 new positions

22
State Agency Actions

• MD state legislation created fiscal penalties if
  the child welfare agency fails to fill a certain
  number of caseworker and supervisor positions by
  specific dates.
• AZ Created 137 spots for new Child Protective
  Services caseworkers
• CT and NJ also appropriated funds for hiring
  additional caseworkers as part of their
  comprehensive system reform efforts.