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?