Lawmakers continue review of foster care redesign

As implementation of foster care redesign continues in Texas, lawmakers are reviewing the issue and could take it up during the 84th legislative session in 2015. Both the House Committee on Human Services and the Senate Committee on Health and Human Services are studying the child welfare system as part of their interim charges. In addition, the Sunset Advisory Commission met in June to hear testimony on staff recommendations to reform the foster care system at the Department of Family and Protective Services (DFPS) and will meet again in August to approve or revise the recommendations.

Redesign of the state’s foster care system has involved changing the way the state obtains and contracts for services provided to children under state supervision. The process began in January 2010 when DFPS joined with child welfare stakeholders, such as former foster youth, providers, advocates, and agency staff, to solicit recommendations on how to improve the system.

In 2011, the 82nd Legislature enacted SB 218 by Nelson, which formally implemented foster care redesign at DFPS by directing the agency to adopt stakeholder recommendations included in a report published by the department. The report produced eight quality indicators for foster care redesign, including ensuring that children are safe and that they receive appropriate services, have a chance to participate in decisions affecting their lives, and have foster placements near their home communities.

SB 218 also directed DFPS to change how the state contracts and pays for child welfare services. Before enactment of the bill, the state contracted directly with smaller agencies to place children in foster homes and provide residential and treatment services. The bill permits DFPS to competitively procure for one or more DFPS regions a single contractor to coordinate all of these services in the contracted area. Contractors – known as single source continuum contractors (SSCCs) – may be for-profit or nonprofit and may subcontract with other agencies to provide services. Child Protective Services (CPS) under DFPS will continue to perform case management, but contractors may provide supplemental case management. Procurement of SSCCs is being phased in to give children and providers time to adjust to the new design.

Under the bill, DFPS may pay providers based on their performance rather than the child’s level of need. Before SB 218, providers were paid lower rates for children with lower service levels and higher rates for children needing more services. Foster care redesign aimed to remove the incentive for providers to improperly keep a child at a higher service level than necessary and to reward providers when children in their care made progress.

Under the redesigned system, the state pays SSCCs a single blended case rate that includes a base rate per child that varies with the child’s age, regardless of the required service level, and is specific to the SSCC’s region, also known as a catchment area. The rate is multiplied by the number of days the child remains in paid foster care. SSCCs may earn an incentive payment if the number of days a child spends in care is less than the average for the child’s service level. If a child spends more days in care than the average, the SSCC must pay DFPS for the extra days, though SSCCs will not be required to pay more for the extra days during the first year the single blended case rate is used.

The House Committee on Human Services met in April to monitor implementation of foster care redesign and evaluate its impact on the child welfare system. The Senate Committee on Health and Human Services met in February to review DFPS’s efforts to reduce child fatalities and make recommendations for how the agency can more effectively use data to improve outcomes for children. New reports of fatalities of children in foster care have raised questions about state oversight of SSCCs and resulted in DFPS placing a temporary hold on new foster care placements by one contractor. A House select committee on child protection is charged with studying the incidence of abuse and neglect fatalities in Texas and making recommendations to protect children.

For more information, see the DFPS report, Improving Child and Youth Placement Outcomes: A System Redesign.

by Lauren Ames

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