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The Condition of Children in The Condition of Children in Texas: An Advocates’ ViewTexas: An Advocates’ View

January 17, 2007

Frances Deviney, Ph.D., Texas KIDS COUNT DirectorCenter for Public Policy Priorities


Overview

• Budget• Medicaid & CHIP• TANF• Nutrition • Child Protective Services• Early Childhood Education• Family Financial Security


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)


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 $82.5 B revenue, 08-09 - 68.2 B spent, 06-07

$14.3 billion “surplus”


Why Isn’t That Really a “Surplus”?

$14.3 billion

Revenue in Excess of 2006-07 Spending

Needed for K-12 (full cost of tax cut;

enrollment, other HB 1)

Higher Ed: formula funding changes for

enrollment, costs

$4.5 billion$1.7 billion


But Wait ! There’s More

Health & Human Services: entitlement caseloads & costs; General Revenue

for CPS

“Truth in Spending” (GR dedications for parks, System Benefit Fund, etc.)

OTHER: Prisons; Business/ Eco. Devel.;

Judiciary; General Govt.; Worker Pay/Benefits

$3.7 b>$2.5 b

$1.9 b left


2010-2011 Budget: $5.8 Billion Gap Between Tax Cut Cost & Revenue

$0.5

$4.1 $4.2 $4.4 $4.7

$7.6$7.3$6.9$6.6

$2.1

$0.0

$2.5

$5.0

$7.5

$10.0

2007 2008 2009 2010 2011

Cost of property tax cut

Revenue from special session tax changes

Billions


Texas Net Expenditures – FY 2006

HHS36%

Employee Benefits

4%

Education34%

Other5%

Government Branches

4%Transportation

11%

Public Safety & Corrections

6%

Source: Texas Comptroller of Public Accounts, All Funds Excluding Trust


Entitlement Programs


Loss of Staff

FY 2007 figure includes both state and contract staff

Staff* and Caseload Changes, 1997-2007

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

1997 2004 2007

Cas

eloa

ds (

reci

pien

ts)

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Elig

ibilit

y S

taff

Food Stamps Medicaid TANF Total Staff


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


A Vicious Cycle

High turnover rates

Staffing

shortages

Heavy workload

OUTCOMES:• System doesn’t work• Client services suffer• Public confidence in

system is undermined• Alternative

approach/fix sought


What is “IE&E”?

• Modernization of eligibility determination and enrollment:– 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


Pros and Cons of Privatization


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


Children’s Health Care


Uninsured Texas Children:We CAN Cut the Number in Half by

Enrolling Kids Who are Eligible Right Now

Texas Children who are Uninsured, 2004-05 – U.S. Census

All incomes, ages 0-18 (2-year average 2004-05 Census CPS)

20.4% 1.367 million

< 200% FPL, ages 0-18 (2-year average 2004-05 Census CPS)

28% 919,000

•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 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


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


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


Nutrition

Food Stamps & School Breakfast/Lunch


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


Error Rates Increase


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.


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


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


Temporary Assistance for Needy Families (TANF)


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.


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.


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.


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


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


Child Protective Services


6.3 million children in Texas in 2005

1.5 million living in poverty

12,412 removed from home

About 806,000 calls to DFPS Intake

338,021 children in CPS investigations

61,433 confirmed victims of abuse or neglect

Texas Child Protection System, 2005

Approximately 29,000 kids in legal custody of Texas child welfare system in 2005


Senate Bill 6 Reform of CPS*

• 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


Theories Supporting Privatization

• CPS in need of reform• Private entities = innovation• With less bureaucracy, better

outcomes for kids• Competitive procurement

process stokes better outcomes


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


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


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


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


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


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


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


Early Childhood Education


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)


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


Immigration

• HB 28 (Rep. Berman)– Citizen children born in Texas to

undocumented immigrants would not be eligible for:• TANF• Food Stamps• Health Care or Coverage• Public Housing• Public Education in primary, secondary, or

higher education• Unemployment or Retirement Benefits


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


Sustained & Balanced Investment in

Children and Families is the Key


Healthy Children Come from Healthy Families


Presenter Contact Information

• Frances Deviney, Ph.D.– Texas KIDS COUNT Director & Senior

Research Associate– 512/320-0222, ext. 106– [email protected]


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Center for Public Policy Priorities900 Lydia StreetAustin, TX 78702

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