2010 10-22 foster-redesign
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2010 10-22 foster-redesign






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    2010 10-22 foster-redesign 2010 10-22 foster-redesign Presentation Transcript

    • Improving Outcomes for Children and Youth: Foster Care Redesign Texas Alliance Child Care Administrators’ Conference October 15th, 2010
    • Agenda
      • Project Overview
      • Quality Indicators
      • Stakeholder Involvement
      • Status
        • Preliminary Model
        • Issues
        • Next Steps
    • Overview
      • Goals
        • Improve outcomes for children and youth
          • Permanency
          • Well being
      • Parameters
        • Neither requires nor precludes additional funding
        • Does not include transfer of case management responsibilities
    • 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.
    • Project Objectives
      • Determine Where And What Kind Of Services Are Needed.
      • Determine How To Contract For Those Services:
        • Outcomes
        • Performance Measures
        • Procurement Processes
      • Determine How To Pay For Those Services:
        • Rate Structure
        • Fiscal Implications
    • Process
      • Review of Previous Work, Recommendations and Plans
      • Coordination with Other Groups Working On Foster Care Related Issues
      • Review and Analysis of Other States’ Experiences in Performance-Based Contracting
        • Calls with Missouri and Tennessee
        • Review of Kansas, Illinois, Florida and other Models
        • National Reports
      • Extensive Stakeholder Involvement
      • Internal and External Implications Workgroups
    • Stakeholder Involvement
      • Guiding Body: Public-Private Partnership
      • Other Involvement To Date
        • 2,210 stakeholders participated in 132 meetings, focus groups or presentations
        • 2,659 webpage views
        • 2,057 visitors to webpage
      • CPS/Provider Meetings in Every Region
      • Texas Council of Child Welfare Boards
      • Judicial Commission for Children, Youth and Families
    • Stakeholder Involvement
      • Texas Network of Youth Services (TNOYS)
      • Statewide Youth Leadership Council
      • Advocates
        • Texas Court Appointed Special Advocates
        • CPS Statewide Parent Collaboration Group
        • Public Forum
        • Texans Care for Children
        • Advisory Committee for Promotion of Minority Adoption
        • Texas Association for the Protection of Children
      • Other Workgroups/Legislatively Mandate Committees
      • Internal DFPS and HHSC Staff
    • Work Groups
      • Public-Private Partnership and Other Stakeholders
        • Fiscal Matters Workgroup
        • Services Workgroup
        • Assessment Focus Group
        • Collaboration Focus Group
        • Accountability
        • Performance Measurement
      • Internal Workgroups
        • Contract
        • Procurement
        • Placement
        • Disproportionality
        • Utilization Review
    • Report: Request for Proposal Responses
    • RFI Responses
      • Respondents
        • Twenty Responses
          • 19 Texas Providers
          • 15 Currently Licensed By DFPS, Some Multiple Licenses
          • 5 Were COA Accredited
          • 1 Self-identified As Medicaid Provider
      • Overarching Themes
        • Ensure Accountability
        • Improve Assessment Process
        • Provide Flexibility
        • Improve Collaboration
        • Improve Use of Technology
    • Improving Contracting
      • Improving Availability/Developing New Capacity
        • Contract For Continuum
        • Use Case Rates
        • Provide Incentives For Exceeding Performance Measures
        • Develop Partnerships/Networks
        • Contract For Specific (Minimum) Number Of Beds, Specific Services
        • Provide More Flexibility To Meet Unique Needs
        • Continue to Use Medicaid Services
    • Improving Services
      • Engage Communities
        • Use Team Approach
        • Use “Wrap-around” Services
        • Develop Community Partnerships To Establish Network
        • Contract With A Community Development Organization
      • Improve Assessment Processes
      • Use Trauma-informed Care
      • Have Foster Care Providers Work With Families
      • Encourage, But Don’t Require Accreditation (Until It Can Be Funded)
    • Improving Accountability
      • Use RFP to Select Providers
      • Contract for Specific Outcomes, Measure Achievement of Outcomes
      • Implement Objective, Measurable Performance Measures (Based On Quality Indicators) and Align ASFA and CFSR Requirements
      • Implement UR Process with Benchmarks
      • Require Continuum Contract Agency to Demonstrate Capacity to Develop, Manage and Maintain Subcontracting Relationships
    • Status Preliminary Design
    • Preliminary Design Elements
      • Building the Infrastructure
        • How to Contract
        • Where to Contract
        • How to Pay
      • Improving Efficiency
        • Increased Coordination of Services to Families
        • Enhanced Collaboration
        • Engagement of Community
      • Improving Outcomes
        • Enhanced Role in Working with Families
    • Preliminary Design
      • Basic Elements
        • Contract for Continuum of Care
        • RFP for Continuum
        • Increased Family Involvement
        • Better Collaboration
    • Project Objectives: December 2010
      • Determine How To Contract
        • How to Procure
        • What to Procure
        • What Performance Measures
      • Determine Where To Contract
        • Gap Analysis (Where Services Are Needed)
      • Determine How To Pay
    • How To Contract: Decisions
      • How to Procure
        • Performance-Based Contract
          • Established Outcomes
          • Maximum Flexibility
          • Incentives with First Year “Hold Harmless”
        • Request for Proposals (Competitively Procured)
          • Open to For and Not For Profits
          • Open to In-State and Out-of-State Providers (with preference for Texas Experience)
          • Open to a Variety of Networking/Contracting Models
    • How to Contract, Continued
      • What To Procure
        • Continuum Of Foster Care (All Levels Of Foster Care)
        • Separate Allocation For Services To Families Of Children In Provider’s Care (Currently Contracted Services)
      • What Performance Measures
        • Outcomes
          • Days In Care - Time To Permanency
          • Improvement In Child Functioning/Service Level
        • Quality Indicators
    • Where to Contract
      • Decided
        • Continuum Contract in Geographic Catchment Areas
        • Multiple Contracts for “Fall Back”/Contingency Plan
        • Catchment Area Large Enough to Minimize Financial Risk
      • In Process
        • Other Criteria for Catchment Areas
    • How to Pay
      • Decided
        • Eliminate Link Between Billing And Authorized Levels Of Care
        • Rate Includes Consideration Of Blend Across Levels Of Service
        • Resources Will Be Transferred Equivalent To Transferred Responsibilities
      • Still In Process
        • Consideration Of Expected Utilization
        • Incentives Based On Reductions Of Days In Care
    • Other Decisions
      • No Child Will Be Moved From Stable Placement To Accommodate “Close Proximity” Requirement
      • Decisions Will Be Made On “Best Interest Of The Child”
      • Implementation Will Be Gradual; No Statewide “Flip The Switch”
      • Various Models May Be Used For Delivering Continuum
      • Continuum Will Include All Levels Of Foster Care
      • Funds For Services To Families Will Not Be Part Of Blended Rate; Will Be Separate Allocation
      • DFPS Will Commit Resources For Administrative Costs “Trade-offs”
    • Next Steps
      • Implementation Issues
        • Implications Workgroups
        • Report
          • PPP Recommendations
          • Stakeholder Participation/ Input
          • High Level Implementation Plan
        • Innovation Zones
          • Governance
          • Criteria for Decision-Making
    • Questions?