Improving Child/Youth Placement Outcomes: A System Redesign

1. Improving Child/Youth Placement Outcomes:A System Redesign

2. All Eyes on the Prize • In 127 Days DFPS will have recommendations and a plan to implement a new foster care model in the state of Texas. • The new system design will be a result of the joint efforts of both public and private stakeholders working in collaboration to improve outcomes for children, youth and their families.

3. Challenges Facing the Texas Child Welfare System • Imbalance in geographic distribution of services and providers • Insufficient number of residential providers that offer a full continuum of services

4. Current Equation (Child’s Needs) + (Lack of Community Resources) = • Placement outside of home community • Increased number of changes in placement • Separation from sibling(s) and family • Lack of educational continuity • Fractured social support system

5. Goal of Redesign "The goal of the (foster care) redesign is to improve outcomes for children and families by creating sustainable placement resources in communities that will meet the service needs of children and youth in foster care, using the least restrictive placement settings."

6. Project Objectives • Determine where and what kind of services are needed • Determine how to contract for quality services, including recommended outcomes, performance measures and procurement processes • Determine how to pay for those services (fiscal system/payment methodologies that align incentives with process and quality objectives)

7. Quality Indicators • Children are placed in their home communities • Children are appropriately served in the least restrictive environment that supports minimal moves for the child • Connections to family and others important to the child are maintained • Children are placed with siblings • Services respect the child’s culture • To be fully prepared for successful adulthood, children and youth are provided opportunities, experiences and activities similar to those experienced by their non-foster care peers. • Children and youth are provided opportunities to participate in decisions that impact their lives.

8. Project Parameters • Case management will remain the role of DFPS, however, model can include expanding role of the private sector’s work with families • System design will neither preclude nor require additional funding

9. Decision-Making Approach • Extensive Stakeholder Involvement • Process Guided by Stakeholders • Decisions are Informed by Data • Develop models that ‘test’ hypotheses and their corresponding policy, programmatic, practice and fiscal manifestations • Recommendations Due to the Commissioner by December 31, 2010 • Commissioner will make the Decision on Recommendations and present to the Texas Legislature in January 2011.

10. Technical and Planning Expertise DFPS has contracted with two entities who are working collaboratively to develop the redesign proposal: • PDF Group, LLC: - Engaging stakeholders - Managing, planning and developing the proposal, including recommendations for a systemic, effective approach to remodeling the current foster care system • Chapin Hall, University of Chicago: - Working with American Humane - Facilitating and coordinating fact-finding research - Obtaining stakeholder input and support - Analyzing data and conducting simulation modeling

11. Goal – Children spend less time in care. How – Provider establishes network of foster homes in counties where demand exceeds supply Result – Proximity equals support and minimal escalation of behavioral issues Impact – Reduced placement disruptions; children achieve permanency more quickly Fiscal – Lower levels of need; less time in care resulting in a reduction in revenue for provider (improved outcomes create disincentive for provider) Leverage – (Through redesign) Provider is able to reinvest a % of the revenue the state would have otherwise paid for child to remain in care at higher level of need. How Does It Work?

12. Stakeholders • Children and families • Judiciary • Providers • Foster care network/association • Child and family advocates • DFPS field staff • Others which include, but are not limited to: - HHSC, Medicaid, and other enterprise agencies - Texas child welfare boards - State and federal child welfare partners

13. Public Private Partnership (PPP) Representative of key stakeholder groups including: • Foster youth alumni • Providers • Child advocates • Judiciary • DFPS Advisory Council • DFPS executive leadership Role in the redesign effort: • Provide guidance to the initiative • Serve as conduit of communication between constituents and peers • Propose recommendations to DFPS Commissioner

14. Communications Principles • Fully engage stakeholders - Provide opportunities for meaningful input - Keep stakeholders fully informed of project status • Ensure understanding of Foster Care Redesign project objectives • Provide all information in an inclusive, transparent manner to ensure project integrity • Provide opportunities for the Department to understand and stay current on stakeholder interests and opinions

15. Communications Methods • Website - Project updates and notices - Project survey - Mailbox • Alerts • In-person meetings • E-mail • Briefings • Stakeholder forum

16. Communications Progress • Stakeholders around the state have been engaged in project activities since January 11, 2010 • Project website, mailbox and survey were launched in April 2010 - 622 public and private stakeholders responded - 95 Texas counties represented in survey responses • Request for Information (RFI) • Notice sent to all licensed and/or contracted residential child care providers • 18 responses received • Over 1000 public and private stakeholders have been involved in face-to-face meetings - Regional provider meetings - Focus groups - Stakeholder initiated presentations and meetings

17. Youth Issues • Maintain connections with Families and Siblings • Psychotropic Medication • Normalizing Activities: • “Enough Room to Learn” • Jobs, drivers licenses • Extracurricular Activities • Participation in decision-making including input regarding placement decisions, case planning and opportunity to participate in court hearings.

18. Stakeholder Input • De-Link Billing Service Level from Authorized Service Level • Provide a Continuum of Care for Children in Care • Provide More Services to Families of Children in Foster Care • Maintain Progress and Move Forward on Addressing Disproportionality • Improve the Assessment Process • Increase Family, Child and Youth Involvement in Decisions Impacting Their Lives • Better Collaboration/Coordination Between DFPS and Providers

19. Preliminary Design To Date • Performance Based Contract (PBC) • RFP for a continuum of care in catchment areas • First year should be a hold harmless year for PBC • Open to for-profit as well as not-for-profit sector • RFP open to non-Texas agencies but preference given to providers with experience in Texas • Blended Case Rate- Elimination of Billing Service Level linked to Authorized Service Level • Single Continuum Contract

20. Questions or Additional Comments? Email: FCRedesign@dfps.state.tx.us Information will also be posted to our website at www.dfps.state.tx.us/Child_Protection/Foster_Care/redesign.asp