Texas Foster Care TransformationCommunity-Based Care

Rep. James B. Frank – House District 69Maureen Metteauer - Legislative Director

Agenda

• Overview of Texas Department of Family and Protective Services

• Community-based Care and Senate Bill 11

• Q&A

James B. Frank

• A longtime resident of Wichita Falls, graduate of Rider High School, Texas A&M University;

• Career in Banking in Ft Worth and Wichita Falls; • In 2000, acquired local metal fabrication business known as BW Fabricators-

re-named Sharp Iron Group – 120 Employees;• In 2007 purchased California-based Transland -- manufacturer of dispersal

equipment for crop dusting and aerial firefighting;• Elected to the Texas House of Representatives in 2012;• Serving as the Vice-Chair of the Human Services Committee, which oversees

foster care system; – Authored HB 5 and Sponsored SB 11 in the 85th Session – Transformation of

Department of Family and Protective Services;

• Married to Alisha for 28 years; • Member of First Baptist Church of Wichita Falls, where he serves as a

deacon and Life Group leader. • Six sons aged 11 to 26.

Department of Family and Protective Services

• The mission of The Texas Department of Family and Protective Services is to protect children, the elderly, and people with disabilities from abuse, neglect, and exploitation by involving clients, families, and communities

Org Structure

DFPS Regions for CPS

1 Lubbock/Amarillo

2 Abilene/ Wichita Falls

3a Denton

3b Fort Worth

3c Dallas

4 Tyler

5 Lufkin / Nacogdoches

6A Houston

6B Galveston

7A Waco

7B Austin

8A San Antonio

8B Kerrville / Uvalde

9 Midland / Odessa

10 El Paso

11A Corpus Christi

11B Brownsville

Texas is broken into 17 regions for DFPS

DFPS Budget2018 2019

DFPS Total $ 2,037,341,220 $ 2,054,572,915

GR $ 1,143,690,346 $ 1,138,776,323

Fed $ 869,339,893 $ 887,681,249

Supplemental in Riders

$ 10,864,691 $ 14,669,054

FTEs TOTAL 12,739.9 12,829.7

Source: 85R SB 1 General Appropriations Act

CPS Funding

2006/2007 2008/2009 2010/2011 2012/2013 2014/2015 2016/2017 2018/2019

Appropriations 1,538,595,085.00 2,117,988,661.00 2,187,532,357.00 2,355,896,351.00 2,528,847,638.00 2,844,504,066.00 $3,469,042,352

Population 6,245,188 6,476,474 6,624,326 7,106,903 7,269,342 7,407,636

$1,538,595,085

$2,117,988,661

$2,187,532,357

$2,355,896,351$2,528,847,638

$2,844,504,066

$3,469,042,352

6,245,1886,476,474 6,624,326

7,106,9037,269,342 7,407,636

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

8,000,000

$0.00

$500,000,000.00

$1,000,000,000.00

$1,500,000,000.00

$2,000,000,000.00

$2,500,000,000.00

$3,000,000,000.00

$3,500,000,000.00

$4,000,000,000.00

po

pu

lati

on

Fun

din

g

Challenges in DFPS

• Lack of Placements for Children in Care

• Rising number of removals for kids in care – 5-11% percent increase

• Longer time in care

• More children aging out of care

CPS Intakes by Fiscal Year

234,620 239,102 240,688250,153 252,529

264,450255,514

241,428229,334

254,537

274,448289,334 295,500

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016* 2017*

Nu

mb

er

of

Ch

ildre

n

• FY2016-FY2017 Numbers updated• Source: DFPS IMPACT

Per Capita Rate for Removals and New PCSPs Combined

FY 14 FY 15 FY 16 FY 17

Removals 17,378 17,151 19,079 19,874

New PCSPs 18,634 17,762 11,483

TX Child population 7,216,132 7,311,923 7,407,636 7,500,272

Removals per 1,000 in

child population

2.40 2.34 2.57 2.65

Removals + new PCSP

per 1,000 in child

population

5.0 4.8 4.1

Removals and child population from DFPS databook

New PCSPs from DRIT 80904 - PCSPs during the fiscal year that ended in removal have been subtracted from the total number of new PCSPs so as not to double count

DFPS Dashboard - SnapshotNov ‘11

Nov ‘12 Nov ‘13 Nov ‘14 Nov ‘15 Nov ‘16 Nov ‘17 %Change since 2016

Total Number

of Removals

1,32

8

1,321 1,243 1,181 1,125 1,421 1,678 18.1% increase

12-month

Recidivism

(INV)6.5% 6.8% 7.5% 7.7% 7.3% 8.5% 8% 5.9% decrease

12-month

Recidivism

(FBSS)7% 6.6% 7.9% 5.4% 6.4% 9.9% 11.4% 15.1% increase

12-month

Recidivism

(CVS)6.6% 8.8% 9.8% 11.5% 10.9% 10% 10.3% 3% increase

Total Monthly

Calls Received

at SWI

62,4

72

59,020 58,025 57,806 62,477 65,403 68,225 4.3% increase

Lacking Foster Care Capacity

31

13

24

27

23

29

3836

2523

19

7

10 10

6

3 2 3 3 4

1

7

2 1

64 5

02

911

9 9

1

7

10 11

2 2

6

0

5

10

15

20

25

30

35

40

April May June July August September October November December January

Children Without Placement (CWOP)

DFPS Data Warehouse 2017

86%

76% 75%70% 66% 64% 63% 62% 61% 60%

55%

14%

30%

54%57% 59% 61% 61%

11B 1 10 5 2 6A 8A 3C 11A 7A 4 7B 6B 9 8B 3A

In Catchment

Out of Catchment

Placement In and Out of Catchment Regions

Source: DFPS Occupancy Analysis 2016

Note: DFPS will update this analysis in 2018.

46%43%

41%

39% 39%

25%24%

34% 36% 37% 38% 39% 40%45%

Senate Bill 11• Expansion of the community-based care model for foster care:

– Single Source Continuum Contract (SSCC) provider manages foster care services at a community level. (Foster Care Redesign

– Requires robust readiness review and stringent quality assurance testing and contract oversight

– Blended rates and innovative financing plus community involvement

– Single Plan of Service for Children

• Enhanced tracking of child abuse cases and child fatalities, including fatalities that had previous department interventions;

• Foster care capacity plan to identify areas around the state lacking in foster homes and address shortages;

• Expedited mandatory medical review for foster kids;

• Pilot program for Family-Based Safety Services.

• Administrative changes to allow DFPS to: – Better manage its workforce;

– Administer a grant program to allow faith communities to recruit foster parents;

– Study allowing young adults to become foster parents;

– Requires DFPS to provide foster youth with their vital records.

CPS Budget Notes

• FTEs allocated for CPS functions totals • 10,355.3 in fiscal year (FY) 2018 and 10,409.2 in FY 2019.

• The funding for Senate Bill 11 is broken down:• Rider 33: Contingency for Senate Bill 11, and totals $18.4 million in General

Revenue, $20.4 million in All Funds and is included in the amounts in the table above. Region 3B

• Rider 21: Community Based Care, Region 3B, is broken down in Foster Care Redesign, and totals $86.7 million in All Funds. • Additional funding of $6.8 million in General Revenue and • $8.3 million in All Funds is available above the existing appropriations for three

legacy system regions to begin implementing Community Based Care in the 2018-19 biennium. The funding is broken down in Rider 35, Contingency for Community-based Foster Care Appropriations, and is included in the table.

Existing and Proposed CBC Catchment Areas

1 Lubbock/Amarillo

2 Abilene/ Wichita Falls

3a Denton

3b Fort Worth

3c Dallas

4 Tyler

5 Lufkin / Nacogdoches

6A Houston

6B Galveston

7A Waco

7B Austin

8A San Antonio

8B Kerrville / Uvalde

9 Midland / Odessa

10 El Paso

11A Corpus Christi

11B Brownsville

RFP for Region 2 has closed and the Dept. is in negotiation with bidder. RFP for Bexar County (San Antonio) is currently pending.

SB 11 / CBC Goals

(1) the safety of children in placements;

(2) the placement of children in each child's home community;

(3) the provision of services to children in the least restrictive environment possible and, if possible, in a family home environment;

(4) minimal placement changes for children;

(5) the maintenance of contact between children and their families and other important persons;

(6) the placement of children with siblings;

(7) the provision of services that respect each child's culture;

(8) the preparation of children and youth in foster care for adulthood;

(9) the provision of opportunities, experiences, and activities for children and youth in foster care that are available to children and youth who are not in foster care;

(10) the participation by children and youth in making decisions relating to their own lives;

(11) the reunification of children with the biological parents of the children when possible; and

(12) the promotion of the placement of children with relative or kinship caregivers if reunification is not possible.

Community Based Care Logic ModelGoals Business Changes Inputs/Resources Activities Outputs

Short-Term Outcomes

Long-Term Outcomes

• To create sustainable placement resources in communities that meet the service needs of childrenand youth infoster care, usingthe leastrestrictive placement settings

• To contract with community-based nonprofit and local government entities to provide case management services to children and families

• To promote community ownership, flexibility, and innovation in providing services to children and families

• Competitively procureSingle Source Continuum Contractors (SSCC) to provide placement and foster care services in designated geographic areas

• Compensate SSCCs for some start-up and network development costs

• Use a single blended foster care rate and exceptional care rate

• Resource allocation for purchased services

• Contract with the SSCC to provide case management services to children in the temporary or permanent managing conservatorship of the department, their families, relatives, and kinship caregivers; and to young adults in extended foster care

• Utilize performance- based contracts that include incentives and remedies

• Public Private Partnership

• Established Quality Indicators

• DFPS governance and decision-making structure

• DFPS implementation team

• Designated CBC Catchment Areas

• Local CBC administrators, contract managers, and quality assurance staff

• Historical performance data

• Fiscal model for Incentives and remedies

• IT functionality

• Performance, quality assurance, and continuous quality improvement data and processes

• Independent process and outcomes evaluator

• Competitive procurement

• Staged rollout

• Communication and change management plan

• Regionally established operations manuals with protocols for DFPS and the SSCCs

• DFPS-SSCC transition plans for resources, services, and case management

• Readiness assessments

• Transitional support andtraining

• SSCC IT systems

• SSCC development and management of foster care network and service contracts

• SSCC case management model

• CANS Initial and ongoing assessment of child and family service needs

• Single plans of service for children and families

• SSCC payment structure and utilization Reviews

• Community ownership and partnerships

• Adequate local foster care placement capacity

• Placement settings that meets children’s therapeutic needs in leastrestrictive settings

• Support for kinship placements

• Services that meet the medical, developmental, emotional, and behavioral needs of children in care

• Reunification services / services that meet the needs of the families with children in care

• Maintenance of contact between children and their families and important persons

• Services that respect each child’s culture

• Preparation of children and youth in substitute care for adulthood

• Opportunities, experiences, and activities that are available to children and youth not in substitute care

• Participation by children and youth in decisions that impact their own lives

• Safety of children in placements

• Placement of children in their home community

• Sibling groups placed together

• Minimal placement changes

• More time spent in the least restrictive environment, preferably a kinship or, foster family home

• Child well-being maintained or improved in foster care

• Youth are prepared for independent living

• Improved permanency outcomes with no increase in the return- to-carerate

• Reunification of children with their biological parents when possible

• Promotion of the placement of children with relative or kinship caregivers

• Decreased paid foster care days for children under age 18

• Decreased time to legal permanency

CBC Rollout

Stage I

Foster Care Network Development

Placement Services

Child & Adolescent Needs and Strengths (CANS) Assessment

Single Child Plan of Service

Purchased Services for Children and Youth

Preparation for Adult Living (PAL) for youth in paid foster care

Adoption Services

Performance Monitoring begins at 85% placements transitioned

Stage II

Case Management Services (ACF Requirements) for all children in substitute care / conservatorship and their families. Includes court services.

Single Plan of Service for Children and Families

Purchased Services for Families

Family Reunification Services

Kinship Services

Transitional Living Services - Preparation for Adult Living (PAL) for youth in substitute care (foster and kinship care)

Interstate Compact on the Placement of Children (ICPC)

Performance Monitoring begins at 85% cases transitioned

Stage III

AFTER 18 Months:

Performance assessment for incentives & remedies begin

Continual assessment for all contract performance measures and incentives and remedies annually ongoing

Source: DFPS CBC Overview July 2017

Summary of Key Contract Outcome Measures

Safety Children/youth are safe in placement.

Placement and

Substitute Care

Services

Children/youth are placed in close proximity to family and

community.

Children/youth are placed with their siblings.

Children/youth are placed in the least restrictive setting.

Children/youth have stability in their placement.

Child Well-being The wellbeing of children is maintained or improved in substitute

care.

Permanency Children / youth achieve timely permanency

Children/youth exit substitute care to a permanent home

Children who achieve permanency do not return to substitute care

Preparation for Adulthood

Youth are fully prepared for adulthood.

Service Level Type of Care FY2016-17 FY2018-19 Annual

Basic Child Placing Agency $43.71 $48.47 $17,691.55

Foster Family $23.10 $27.07 $9,880.55

Residential Treatment Facility /GRO $45.19 $45.19 $16,494.35

Moderate Child Placing Agency $76.72 $85.46 $31,192.90

Foster Family $40.44 $47.37 $17,290.05

Residential Treatment Facility/ GRO $103.03 $103.03 $37,605.95

Specialized Child Placing Agency $101.86 $109.08 $39,814.20

Foster Family $51.99 $57.86 $21,118.90

Residential Treatment Facility/ GRO $162.30 $197.69 $72,156.85

Intense Child Placing Agency $186.42 $186.42 $68,043.30

Intense Foster Family $92.43 $92.43 $33,736.95

Intense Residential Treatment Facility $260.95 $277.37 $101,240.05

Emergency Shelter $129.53 $129.53 $47,278.45

Intensive Psychiatric Transition Program $374.33 $374.33 $136,630.45

Intense Plus General Residential Operations Residential Treatment Center (GRO/RTC)

$400.72 $146,262.80

New Service Treatment Foster Family $277.37 $101,240.05

3-Day Medical Review

3-Day Initial Medical Exam Within 3 business days of removal

Texas Health Steps Medical Check-Up Within 30 days of removal and then based on

periodicity schedule

Child and Adolescent Strengths and Needs

Assessment

Within 30 days of removal and then annually

thereafter.

Task Estimated Completion

Monitor and strengthen CANS implementation Ongoing

Monitor and strengthen THSteps compliance Ongoing

Initiate 3-Day Medical Exam Implementation April 2018

Complete 3-Day Medical Exam Implementation December 2018

Monitor 3-Day Medical Exam Implementation January 2019-December 2019

Report on 3-Day Medical Exam

Implementation to the Legislature

December 2019

Implementation ScheduleImplementation planning for the initial three-day medical exam and strengthening of the completion of the TH Steps checkup and CANS assessment will be completed according to the schedule below:

CBC and Community health care

• CBC presents a unique opportunity to partner in services to at risk families and foster youth.

• Children experiencing abuse and neglect often have trauma; require availability of services in each community;

• Community health providers are positioned to lend expertise and partnership to the SSCC in each region.

Total Number* of Unique Children in Conservatorship/ FBSS/ and Safety Placements 2015-2017 by Region**

Region

2015 2016 2017

Children in CSV Children in

FBSS)

Children

(PCSP)

Children in

CSV

Children in

FBSS)

Children

(PCSP)

Children in

CSV

Children in

FBSS)

Children

(PCSP)

1 2,506 3,850 1,761 2,712 3,874 1,355 3,073 3,910 827

2 1,457 3,406 1,056 1,717 4,052 653 2,052 4,033 379

3E 4,112 9,311 3,707 4,219 10,763 3,061 4,290 11,824 2,293

3W 6,226 8,511 3,589 6,354 9,238 2,765 6,093 12,143 1,959

4 3,293 3,177 1,969 3,651 3,210 1,456 3,656 3,125 842

5 1,666 1,403 878 1,845 1,700 658 1,961 1,709 633

6A 5,910 12,009 4,012 5,938 12,358 4,003 5,896 13,189 3,938

6B 2,128 5,875 1,892 2,203 6,470 1,707 2,321 7,037 1,668

7 6,324 6,171 3,013 6,661 6,827 2,340 6,836 6,726 1,590

8 7,400 11,090 3,696 7,277 12,028 2,495 7,729 13,378 1,895

9 1,647 2,154 692 1,665 2,066 390 1,640 2,042 159

10 736 2,973 526 635 3,179 370 662 3,210 314

11 3,943 15,280 2,151 3,918 14,813 1,066 4,106 16,371 503

999 0 5 152 0 21 103 2 5 37

State

Total 47,348 85,215 29,094 48,795 90,599 22,422 50,317 98,702 17,037*Counts reflect a distinct count of children (0-17 years old) in Conservatorship, FBSS (FPR only) and PCSPs.

Economic Costs of “Opportunity Youth”

Taxpayer burden Societal burden

Annual (per youth) $13,900 $170,740

Adult lifetime (per youth) $37,450 $529,030

Aggregate lifetime burden (in present value terms) from the current cohort of opportunity youth

$1.59 trillion $4.75 trillion

THANK YOU!