Transcript Slide 1

The Condition of Children in Texas:
An Advocates’ View
January 17, 2007
Frances Deviney, Ph.D., Texas KIDS COUNT Director
Center for Public Policy Priorities
Center for Public Policy Priorities
www.cppp.org
Center for Public Policy Priorities
www.cppp.org
Overview
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Budget
Medicaid & CHIP
TANF
Nutrition
Child Protective Services
Early Childhood Education
Family Financial Security
Center for Public Policy Priorities
www.cppp.org
How Much Money Will There Be?
For 2008 and 2009, the Comptroller
estimated that legislators will have
$82.5 billion available for
general purpose spending
(of that, $7 billion is 2006-2007 revenue that
won’t be spent by August 2007 — the current
budget cycle’s “ending balance”)
plus
$8.1 billion in the Property Tax
Relief Fund
and
$4.3 billion in the “Rainy Day Fund”
(5% of revenue)
Center for Public Policy Priorities
www.cppp.org
How Much Are We Already Spending?
For 2006 and 2007, the Comptroller reports
$68.2 billion in general purpose
spending,
but:
In addition to that, almost $600 million out of
the “Rainy Day Fund” is being spent on child
protective services (CPS) reforms
And
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$82.5 B revenue, 08-09
68.2 B spent, 06-07
$14.3 billion “surplus”
Center for Public Policy Priorities
www.cppp.org
Why Isn’t That Really a “Surplus”?
$14.3 billion
$4.5 billion
$1.7 billion
Needed for K-12
(full cost of tax cut;
enrollment, other HB 1)
Center for Public Policy Priorities
Revenue in Excess of
2006-07 Spending
Higher Ed: formula
funding changes for
enrollment, costs
www.cppp.org
But Wait ! There’s More
$1.9 b left
$3.7 b
>$2.5 b
Health & Human Services:
“Truth in Spending”
entitlement caseloads & (GR dedications for parks,
costs; General Revenue System Benefit Fund, etc.)
for CPS
Center for Public Policy Priorities
OTHER: Prisons;
Business/ Eco. Devel.;
Judiciary; General Govt.;
Worker Pay/Benefits
www.cppp.org
2010-2011 Budget: $5.8 Billion Gap
Between Tax Cut Cost & Revenue
Cost of property tax cut
Billions
$10.0
Revenue from special session tax changes
$7.6
$7.5
$6.6
$5.0
$2.5
$4.1
$6.9
$4.2
$7.3
$4.4
$4.7
$2.1
$0.5
$0.0
2007
Center for Public Policy Priorities
2008
2009
2010
2011
www.cppp.org
Texas Net Expenditures – FY 2006
Transportation
11%
Other
5%
Government
Branches
4%
Education
34%
Public Safety &
Corrections
6%
HHS
36%
Employee
Benefits
4%
Source: Texas Comptroller of Public Accounts, All Funds Excluding Trust
Center for Public Policy Priorities
www.cppp.org
Entitlement Programs
Center for Public Policy Priorities
www.cppp.org
Loss of Staff
4,000,000
14,000
3,500,000
12,000
3,000,000
10,000
2,500,000
8,000
2,000,000
6,000
1,500,000
4,000
1,000,000
Eligibility Staff
Caseloads (recipients)
Staff* and Caseload Changes, 1997-2007
2,000
500,000
0
0
1997
Food Stamps
2004
Medicaid
2007
TANF
Total Staff
FY 2007 figure includes both state and contract staff
Center for Public Policy Priorities
www.cppp.org
Services to clients suffer
• Less than half of eligible households
get Food Stamps
• Half of uninsured kids (@700K)
eligible for Medicaid/CHIP, but not
enrolled
• Clients frustrated, deterred
• Lawsuits related to customer service
shortcomings
Center for Public Policy Priorities
www.cppp.org
A Vicious Cycle
Heavy workload
High turnover rates
Staffing
shortages
Center for Public Policy Priorities
OUTCOMES:
• System doesn’t work
• Client services suffer
• Public confidence in
system is undermined
• Alternative
approach/fix sought
www.cppp.org
What is “IE&E”?
• Modernization of eligibility determination and
enrollment:
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Better technology/greater automation
Centralized and paperless computer system
Remote application options
More partnerships with nonprofits
• Outsourcing development, administration, and
partial staffing of system
• Significant staffing reductions & office closures
Center for Public Policy Priorities
www.cppp.org
Pros and Cons of Privatization
Center for Public Policy Priorities
www.cppp.org
Problems with IE&E
• Technical problems
• Poor training of contractor staff
• Staffing shortages
Lead to:
• >100K kids lose health coverage between Dec
05 and Sep 06.
• Large backlog of applications in pilot area
• Rollout on hold indefinitely, though TIERS (new
computer system) is being expanded
• Serious delays in application processing in most
metro areas; error rates also on the rise
Center for Public Policy Priorities
www.cppp.org
Children’s Health Care
Center for Public Policy Priorities
www.cppp.org
Uninsured Texas Children:
We CAN Cut the Number in Half by Enrolling Kids
Who are Eligible Right Now
•Texas is home to nearly 1.4 million uninsured children.
• 2/3 of these uninsured Texas children are below 200% of the federal
poverty line, despite Medicaid and CHIP.
•More than HALF our uninsured Texas Kids Could be enrolled in
Medicaid or CHIP today! (Adjusting for ~230,000 undocumented kids; another
160,000 legal immigrant (LPR) children can participate in CHIP (Pew Hispanic Center)).
Texas Children who are Uninsured, 2004-05 – U.S. Census
All incomes, ages 0-18
20.4%
1.367 million
28%
919,000
(2-year average 2004-05 Census CPS)
< 200% FPL, ages 0-18
(2-year average 2004-05 Census CPS)
Center for Public Policy Priorities
www.cppp.org
Texas CHIP Coalition & the Insure
Texas Kids Campaign
• Cut the number of uninsured Texas kids in half
by enrolling every eligible child in CHIP and
Medicaid
• 12 months continuous eligibility for CHIP and
Children’s Medicaid
• Provide adequate reimbursement for Medicaid
and CHIP providers
• Invest in outreach and education to ensure that
all eligible children get the care that they need
Center for Public Policy Priorities
www.cppp.org
Texas CHIP Coalition & the Insure
Texas Kids Campaign
• Eliminate bureaucratic roadblocks to
encourage personal responsibility and help
low income families achieve self-sufficiency:
– Fix problems with the Integrated Eligibility
System to prevent eligible kids from losing
CHIP and Medicaid coverage
– Eliminate the CHIP asset test
– Eliminate the CHIP 90 day waiting period
for uninsured children
– Deduct childcare and child support
expenses when calculating income for
CHIP
Center for Public Policy Priorities
www.cppp.org
Bills of interest
• SB 266 (Zaffirini)
– Changes Child Medicaid eligibility review
from 6 months to 12 months
• HB 669 (Coleman)
– Changes income eligibility from gross family
income to net family income < 200% FPL
– Also changes 6 to 12 mo. Eligibility
• HB 510 (Farabee)
– Mental health parity for children
Center for Public Policy Priorities
www.cppp.org
Nutrition
Food Stamps &
School Breakfast/Lunch
Center for Public Policy Priorities
www.cppp.org
Food Stamps
• Approximately 1 in 5 TX Children Receives
Food Stamps
• Unfortunately, nearly half of eligible
children are not enrolled.
• Privatized eligibility & enrollment system
– Poor customer service
– Increased error rates from FY05-FY06
Center for Public Policy Priorities
www.cppp.org
Error Rates Increase
Center for Public Policy Priorities
www.cppp.org
Food Stamps
• CPPP will propose a strategy to protect and
improve access in the new privatized system
• Could include:
– Increased funding for staff
– Statutory standards related to access
– Data collection requirements
• Bill by Rep. Rodriguez & Sen. Zaffirini to
increase food stamp recipients' monthly benefit
for the purpose of buying more fruits and
vegetables.
Center for Public Policy Priorities
www.cppp.org
School Breakfast/Lunch
Over 2.5 million students (or 60% of the
school population) receives free or
reduced-price lunches in TX public
schools Texas Department of Agriculture, 2006 data
Center for Public Policy Priorities
www.cppp.org
School Breakfast/Lunch
• HB 454 (Representative Rodriguez)
– Allows individual school districts to
participate in “Provision 2”
– This program allows very poor districts in
Texas to serve breakfast & lunch to all
students
– HB 454 would allow individual schools (e.g.,
poor schools in wealthy districts) the
opportunity to extend this service to their
students
Center for Public Policy Priorities
www.cppp.org
Temporary Assistance for
Needy Families (TANF)
Center for Public Policy Priorities
www.cppp.org
TANF Work Requirements
• Recent changes at the federal level
–At least 50% of adults on TANF must
engage in a narrowly defined set of work
activities or the state will face penalties.
–Texas may push lawmakers to eliminate
current exemptions from the work
requirement.
Center for Public Policy Priorities
www.cppp.org
TANF Work Participation
Exemptions
• In Texas, the majority of these exemptions
currently go to persons:
– With disabilities, or
– Adults caring for children with disabilities
• Very hard for these families to comply
with the work requirement.
Center for Public Policy Priorities
www.cppp.org
TANF Full-Family Sanction
• If these exemptions are eliminated, many
families will be “cut off” from TANF and
will no longer receive assistance.
• Under Texas’ “full-family” sanction policy
adopted in 2003, everyone in the family
(including children) loses their assistance
when an adult breaks a program rule.
Center for Public Policy Priorities
www.cppp.org
Children Receiving TANF
• Since the full-family sanction was
instituted in 2003, tens of thousands of
children have lost assistance.
• As of 2004, only 213,000 Texas children
received cash assistance
– 63,000 children dropped from 2003 to 2004
– Down from over 550,000 in the mid-1990s
Center for Public Policy Priorities
www.cppp.org
TANF During the 2007
Session?
CPPP’s proposed strategy:
1. Create separate assistance program for families
with serious barriers to employment
2. Create a Post Employment Work Supports
3. Help families comply with TANF requirements
4. Require reports on “good cause” exceptions
5. Expand the “One-Time TANF” (OTT) program
Center for Public Policy Priorities
www.cppp.org
Child Protective Services
Center for Public Policy Priorities
www.cppp.org
Texas Child Protection System, 2005
6.3 million children in Texas in 2005
1.5 million living in poverty
About 806,000 calls to DFPS Intake
338,021 children in CPS investigations
61,433 confirmed victims of abuse or neglect
12,412 removed from home
Approximately 29,000 kids in legal custody of Texas
child welfare system in 2005
Center for Public Policy Priorities
www.cppp.org
Senate Bill 6 Reform of CPS*
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Investigations
Privatization
Managed Medical Care
Use of medications by foster youth
Cultural Awareness
Kinship care
Services for youth transitioning out of foster care
Improving legal representation of children and
parents
*79th Texas Legislature, 2005
Center for Public Policy Priorities
www.cppp.org
Theories Supporting
Privatization
• CPS in need of reform
• Private entities = innovation
• With less bureaucracy, better
outcomes for kids
• Competitive procurement process
stokes better outcomes
Center for Public Policy Priorities
www.cppp.org
Short List of Concerns about
Privatization of CPS
• CPS lacks capacity to monitor contractors
• Contractors unversed in all aspects of case work and lack
experience dealing with families
• Lack of uniform training for contractors – different
outcomes for children
• Mixed results with privatization efforts in other states
• Question about ultimate responsibility for children –
court related duties
• Lack of adequate funding – likely more expensive than
current system
• Most importantly, impact on children while problems
worked out – 29,000 + kids currently in substitute care
Center for Public Policy Priorities
www.cppp.org
Where is the Privatization Effort?
• Off-track
• RFPs for the IA and
IE – on indefinite
hold
• Creating climate of
uncertainty within an
already fragile and
under funded agency
Center for Public Policy Priorities
www.cppp.org
Crisis in the Making for
Conservatorship Caseworkers
• Investigators have job security and are
paid $5,000 more
• New non-caseload positions have job
security and often come with salary
increases
• Training increased from 6 to 12 weeks
• Conservatorship caseloads hit the tipping
point and then implode
Center for Public Policy Priorities
www.cppp.org
DFPS Funding Issues:
$
Investigations
$
Case Management
Much needed improvements made to front-end
of CPS system due to 2005 legislation, but no
additional funds allocated to remainder of
system, which is also in dire need of attention
Center for Public Policy Priorities
www.cppp.org
How can CPS Improvements
Started by the 79th Legislature
be Continued?
• Look at the failures of the Integrated
Eligibility & Enrollment privatization
effort……Stop Privatization
• Focus on conservatorship
Center for Public Policy Priorities
www.cppp.org
How Can Conservatorship be
Saved?
• Increase funding to lower caseloads
• DFPS – generic contracting authority
• Task CPS with creating a System Improvement
Plan:
– Reduce caseloads
– Improve kinship care
– Increase family group conferencing
– Bring projects started by SB6 to scale
• Medical & Education Passports, Medical Home, Review of
Medications, Improve Issues around Disproportionality
Center for Public Policy Priorities
www.cppp.org
Selected Child Protection
Bills
• House Bill 363 (Naishtat)
– Removes all reference to privatizing case management
services in the Family Code that was altered by SB 6
in 2005
• HB 662 (Dukes)
– Requires DFPS to develop a state-wide, long-range
strategic plan for child abuse and neglect prevention
– Charges the Interagency Coordinating Council for
Building Healthy Families with facilitating
coordination of service delivery among agencies
Center for Public Policy Priorities
www.cppp.org
Early Childhood Education
Center for Public Policy Priorities
www.cppp.org
Early Childhood Education
• In 2004 in Texas
– Nearly 123,000 children receiving subsidized
child care (5.2% of 0-12 population)
• But 36,000 on waiting lists
– Over 166,000 children attending Pre-K
(24.2% of 3 & 4 year olds)
– Nearly 64,000 children participating in Head
Start (9.3% of 3 & 4 year olds)
Center for Public Policy Priorities
www.cppp.org
Selected Early Childhood
Education Bills
• SB 50 (Zaffirini)
– Omnibus bill that expands Pre-K services, increases
reimbursement rates for providers, improves
recruitment, retention, and quality of EC
professionals
• SB 264 (Ellis)
– Expands free pre-K programs to all four-year olds
• HB 575 (Straus) & HB 482 (Villarreal) & SB 113
(Van de Putte)
– All Foster Care children ages 3 to 4 to be eligible for
pre-K even if conservatorship status changes
Center for Public Policy Priorities
www.cppp.org
Immigration
• HB 28 (Rep. Berman)
– Citizen children born in Texas to
undocumented immigrants would not be
eligible for:
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TANF
Food Stamps
Health Care or Coverage
Public Housing
Public Education in primary, secondary, or higher
education
• Unemployment or Retirement Benefits
Center for Public Policy Priorities
www.cppp.org
Other Bills of Interest
• SB 98 (Senator Zaffirini)
– Require LBB to prepare a child impact
statement any bills or joint resolutions
considered by the legislature
– Must address whether & how bill impacts:
• Emotional, physical, intellectual, and financial
needs & access to resources
• Different groups of children
• Ability of parents to provide for child well-being
Center for Public Policy Priorities
www.cppp.org
Sustained & Balanced
Investment in Children
and Families is the Key
Center for Public Policy Priorities
www.cppp.org
Healthy Children Come from
Healthy Families
Center for Public Policy Priorities
www.cppp.org
Presenter Contact Information
• Frances Deviney, Ph.D.
– Texas KIDS COUNT Director & Senior
Research Associate
– 512/320-0222, ext. 106
– [email protected]
Center for Public Policy Priorities
www.cppp.org
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Center for Public Policy Priorities
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