Transcript Child Welfare Services Funding and Structure

Funding Child Welfare Services
in California
Frank J. Mecca
Executive Director
County Welfare Directors Association of California
As Presented to the Child Welfare Council
April 14, 2008
Presentation Goals
 Basic understanding of child welfare services
 Structure and funding
 County role as broker of services
 Challenges facing child welfare services system
 Options for overcoming these challenges
What is Child Welfare Services?
 Child Welfare Services program vs. system
 Child Welfare- and Probation-supervised children
 Child Welfare Services program includes:
 Five Components: Hotline, Emergency Response, Family
Maintenance, Family Reunification, Permanent Placement
 Foster Care (a.k.a Out-of-Home Care)
 Adoptions
 Kin-GAP
 Independent Living Program
 Transitional Housing
Child Welfare Services Funding
 Total funding: $4.7 billion annually
County Funds
26%
$1.2 billion
$1.6 billion
State Funds
34%
$1.9 billion
Federal Funds
40%
Breakdown of Federal Funding
 Total federal funding: $1.9 billion annually
Title IV-B
4%
Other
7%
TANF
9%
Title IV-E
80%
Rules for Federal Funds
What does it fund?
Fund
Source
Open or
Capped?
Title IV-E
Out-of-Home
Care
Casework
Prevention, Early
Intervention, and
PostPermanency
Services
Open
YES
YES
NO
TANF
Capped
SOME
SOME
NO
Title IV-B
Capped
NO
NO
YES
Who Federal Funds Can Be Used For
 Title IV-E
 Children must be in care or at imminent risk (candidates)
 Recent restrictions in federal candidacy rules
 Must meet income eligibility rules dating back to 1996
 Title IV-B
 Small subset of funding may be used for:
 Children not yet in foster care system
 Children who have exited foster care system
 Remainder used for children in or at risk of foster care
Role of Philanthropy
 Provides at least $20 million each year
 Prevention, early intervention, post-permanency
 Differential Response
 Family-to-Family Initiative
 California Connected by 25
 Guardian Scholars
Annual State Budget Process
 Three primary components
 Out-of-Home Care Costs and Adoption Subsidies
 Case Management Services
 Ancillary Services
 State and county share non-federal costs of program
 Child Welfare Services: 70% state/30% county
 Foster Care: 40% state/60% county
 Adoption Assistance: 75% state/25% county
 Kin-GAP: 50% state/50% county (no federal $)
 THP+: 100% state
 Many counties “overmatch” required minimum spending
 31 counties “overmatched” $171 million in 2006-07
Where the Money Goes
Ancillary
Services
7%
Case Management
Services
36%
Out-of-Home
Care
57%
Out-of-Home Care Costs
 Caseload-driven and uncapped
 Rates set in statute by type of placement
 Foster Family Homes and Relatives
 Foster Family Agencies
 Group Homes
 Adoption Subsidies
 Based on age of child and/or level of care
 No statutory COLA for payments to caregivers
 5% increase effective Jan 1, 2008 (first increase in 6 years)
Case Management Services
 Caseload-driven but capped
 Caseload-per-worker “yardstick” for each component
 “Hold Harmless” and augmentation
 Funds can be spent across components
 Based on cost per social worker
Case Management Services (Cont.)
 Cost per social worker
 Based on 2001-02 costs per worker
 Caseworker Ratios
 Based on outdated caseload standard
 SB 2030 Workload Study recommended lower caseloads
SB 2030 Workload Study
Activity
Existing
Standard
Hotline Staff
Recommended Standard
Minimum
Optimal
322.5
116.1
68.7
Emergency
Response
15.8
13.03
9.88
Family Maintenance
34.97
14.18
10.15
Family
Reunification
27.0
15.58
11.94
Permanent
Placement
54.0
23.69
16.42
Ancillary Services
 Mostly small, categorical funds
 Typically pass-through of federal funds or state General Fund
appropriations targeted toward specific purposes
 Examples include:
 Kinship Supportive Services Program (KSSP)
 Child Abuse Prevention, Intervention and Treatment (CAPIT)
 CWS Outcome Improvement Project
 Promoting Safe and Stable Families (PSSF)
 Services for emancipating youth (ILP, THP)
Child Welfare Services System
 System relies on many partner agencies
 Counties are both service providers and brokers
 Counties also purchase services directly
(to much lesser extent and with limited funding)
April’s Story
April’s Story
 April is 12, and has a brother, 6, and sister, 2, all in foster care
 Her mom and dad get into lots of fights, and her dad sometimes
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hurts her mom. Her mom is depressed and angry a lot.
Both of April’s parents use drugs. Her mom is trying to get help
with her drug problem. April’s dad was arrested and is in jail.
Mom couldn’t pay the rent on her own and lost their apartment.
The children are placed with their aunt. Their aunt loves them, but
gets stressed out trying to care for them.
The children all had health exams, and her brother has a medical
problem that might be a developmental disability.
April has a learning disability, and needs help with school work.
April’s Family Case Plan
 April’s aunt is the out-of-home care provider while CWS
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tries to reunify the family
Help April with her learning disability
Address parents’ substance abuse issues
Secure mental health services for April and her parents
Help April’s brother with his developmental disability
Help April’s mother find safe, stable housing and a job
Facilitate regular visitation between the children and parents
Provide domestic violence and other counseling
Common Services CWS Brokers:
 Substance abuse treatment for April’s mother
 Domestic violence services for her parents
 Mental health services for April, her siblings, mom and aunt
 Education for April’s learning disability
 Health care for the children
 Regional Center services for April’s brother
 Housing for the entire family
 Employment assistance for April’s mother
 Parenting and Anger Management classes for April’s parents
Substance Abuse Services
 CWS refers to county Alcohol and Drug department
 Limited entitlement through Medi-Cal
 Limited funding for services
 No statewide priority for CWS clients
 Limited range of services
 CWS also contracts directly with service providers
Domestic Violence Services
 No entitlement funding
 Services through local community-based organizations
 Funded with fees on marriage licenses, other minor sources
 CWS pays any fees charged to perpetrator
Mental Health Services
For Foster Children
 Entitlement to full-scope Medi-Cal
 Includes medically necessary EPSDT services
 Assessments and therapy for diagnosed conditions
 Prevention/early intervention also provided via:
 Proposition 10 (for kids aged 0-5 and families)
 Proposition 63
 Available Title IV-B/county overmatch, for services not covered
by Medi-Cal or not medically necessary
Mental Health Services
For Parents
 No entitlement unless parent is otherwise Medi-Cal eligible
 Can receive indirect services via child’s treatment plan
 Independent assessments (not via county mental health)
 Other options:
 Prop 63 programs and SAMHSA grants
 CalWORKs quasi-entitlement if in Welfare to Work
 CWS purchases with available Title IV-B/county overmatch
Education Services
 All children:
 Entitlement to education
 Entitlement to special education services
 Foster children:
 Right to remain in school of origin
 Right to immediate enrollment in new school
 Transfer of records within two business days
Ensuring Educational Access
 Many foster children need:
 IEPs for special education
 Frequent transfer of records
 Tutoring
 Transportation to and from school
 Access to education services has been a major challenge
 Foster Youth Services is very effective model
 Recent augmentation has helped
 Not funded to fully serve every child who could benefit
Health Care Services
 For foster children
 Entitled to full-scope Medi-Cal and EPSDT
 Services through CHDP for regular exams, preventive care
 Public Health Nurses in child welfare and probation agencies
 For parents
 Not entitled to Medi-Cal when children removed
 Must continue to meet eligibility requirements on their own
 Finding providers, particularly specialists, is often a challenge
Regional Center Services
 Entitlement for children with developmental disability (or
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at risk if aged 0-3)
Conduct intake and assessment for services
Services driven by individualized plan
Regional Center purchases or secures services not paid for by
foster care
Children in both systems are called “dual agency”
 Lack of homes to serve these children
 Out-of-home care (not services) paid with foster care funds
 State law makes Regional Center payer of last resort
Housing Services
 Case plans often require parents to secure “safe and stable”
housing, but only limited assistance is available
 HUD programs (i.e., Section 8)
 Eligibility based on income
 Long waiting lists
 No priority for CWS families
 Involvement with CWS can undermine housing assistance
 CWS may pay first/last month’s rent and security deposit for
FR cases – if Title IV-B/county overmatch available
Employment Services
 Services (not grants) to families in both CWS/CalWORKs:
 Employment services and training
 Substance Abuse treatment
 Mental Health treatment
 Domestic Violence services
 Housing assistance (generally limited to once in a lifetime)
 Workforce Investment Act may be available
 Federal grant, limited funding
 Target populations (CWS families are not targeted)
Challenges
 Obsolete and inflexible federal funding scheme
 Federal funds focus on out-of-home care, not services
 High caseloads
 Reliance on other systems with their own priorities,
funding limitations, and accountability structures
 Woeful lack of funding for prevention, early
intervention, and post-permanency services
Possible Solutions
 Title IV-E Waiver
 Federal legislation
 State options
Title IV-E Waiver
 Five-year waiver in two counties (38 percent of CA caseload)
 Allows flexible use of otherwise inflexible funds
 Prevention, early intervention, post-permanency services ok
 No eligibility requirements
 Expected caseload reductions due to:
 Fewer children entering system
 Shorter stays
 Less recidivism
 Stable funding
 Two percent annual increase in federal funds
 Capped state funds for out-of-home care;
 Two percent increase in state funds for case management
 Federal funding does not go down when caseload drops
Title IV-E Waiver
Rewards and Risks
 Rewards
 Stable funding with guaranteed modest growth
 Funds can be used for all children and for all services
 Savings due to lower caseload costs are reinvested in system
 Risks
 No new federal dollars if caseloads unexpectedly go up
 No new federal dollars for policy changes that increase costs
 No accommodation for pre-waiver caseload declines
 More of a “risk transfer” than “risk sharing”
Pending Federal Legislation
 Invest in Kids Act (H.R. 5466, McDermott)
 Removes the eligibility test for Title IV-E funds
 Expands Title IV-E to include prevention, early intervention, and post
permanency services, and Kin-GAP
 Extends federal support for foster care to age 21
 Provides $200 million to reduce social worker caseloads
 Some new costs would be offset by lower federal sharing ratio
 Kinship Caregiver Support Act (H.R. 2188/S. 661)
 Reps Davis and Johnson; Senators Clinton and Snowe
 Expands Title IV-E to include Kin-GAP
 Foster Care Continuing Opportunities Act (S. 1512, Boxer)
 Extends federal support for foster care to age 21
State Options
 Increase funding for child welfare services
 Leverage private funds to bring successful initiatives to scale
 Prioritize foster children and families within partner agencies
 Align partner agencies’ accountability systems with CWS
Questions/Discussion
Frank J. Mecca, Executive Director
County Welfare Directors Association of California
(916) 443-1749
[email protected]