1. Northst r Care for Children

7. Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

8. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

9. Northst r Care for Children Yes, it’s a great idea! But why is it called Northstar Care for Children? What alternatives did we consider?

10. 10,000 Lakes Care for Children?

11. Gopher Care for Children?

12. Walleye Care for Children?

13. Bunyan Care for Children?

14. Loon Care for Children?

15. Mosquito Care for Children?

16. Northst r Care for Children Clearly it was meant to be Northst r Care for Children

17. Northst r Care for Children

20. Why Northst r Care for Children? Counties and tribes have made great progress in child welfare over the past twenty years in terms of safely preventing placement and reunifying when it can’t be avoided. But for children who remain in foster care, the discrepancies in benefits between foster care, Relative Custody Assistance, and Adoption Assistance have made achieving permanency difficult.

21. Why Northst r Care for Children? Northstar Care is designed to tackle this…

22. Why Northst r Care for Children? Eliminates the discrepancy in benefits for children six and older. Unifies benefits for children five and younger, though still with the discrepancy. Creates uniform processes in assessment and benefits.

23. Northst r Care for Children DHS has put three different proposals before the legislature – in 2009, 2011, and 2013. Each was called Northstar Care for Children and had uniform assessments and benefits at its center. Each was an improvement on the previous version, based on feedback from counties, tribes, caregivers, and other stakeholders.

24. Northst r Care for Children The Northstar Care actually enacted by the Legislature was even better, adding the “extraordinary levels” and more state funding. This is based on what we know about it so far.

25. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

26. 2. Northstar Care to be Built into SSIS The legislature provided funds to have Northstar Care for Children programmed into SSIS. We plan for the assessment tool, the benefits calculations, eligibility for Guardianship or Adoption Assistance, fiscal reconciliation, and so on to be built into SSIS. More information will be available in the future as we get closer to implementation.

27. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

28. 1. Retains Current Programs for Current Children Northstar Care for Children is for children who enter one of its components in 2015 or after. The Pre-Northstar Care programs are retained for the children already in them and are slowly phased out as children exit. Pre-Northstar Care Programs Northstar Care for Children Before 2015 2015 & after

29. 4. Retains Current Programs for Current Children In general, a child in a legacy Pre-Northstar Care programs is “grandfathered” into that program. If the child doesn’t change placements or legal status, they stay in their current program.

30. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

31. 4. Transitions & Balancing Transitions: There is a kind of exception to the “grandfathering” leaving children in their legacy Pre-Northstar Care programs. Within budgetary and some other constraints, the commissioner may decide to transition children from the pre-Northstar Care Relative Custody Assistance or Adoption Assistance programs to Northstar Care for Children, provided this does not reduce the payment to the child’s caregiver.

32. Pre-Northstar Care Programs Northstar Care for Children Before 2015 2015 & after Transitions illustrated: This means that our two-door model is slightly altered... 4. Transitions & Balancing

33. Pre-Northstar Care Programs Northstar Care for Children Before 2015 2015 & after Transitions illustrated: This means that our two-door model is slightly altered... with a third door into Northstar Care. 4. Transitions & Balancing Special Transition Door for Some Children from Before 2015 Northstar Care for Children

34. 4. Transitions & Balancing Why Transitions: Provides additional tools for permanency. Earns additional federal revenue. Permits DHS to balance the spending among the three components (foster care, guardianship assistance, and adoption assistance). They each have different fiscal characteristics, and balancing them will keep Northstar Care fiscally sound along with key policy goals. Permits us to phase out the current programs somewhat more quickly than would otherwise be possible.

35. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

36. 5. Administration As now, counties and tribes administer Foster Care. As now, the state administers Adoption Assistance. As a change, the state will administer the new Guardianship Assistance, unlike RCA which counties administer. However, because the same assessment process is used throughout, the local agency has a greater role in determining the level of benefits for Adoption and Guardianship.

37. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

38. 6. Simpler 17 Benefit Levels There are 17 benefit levels in Northstar Care An “at-risk” level (Level A) Basic only (level B) 15 levels of supplemental difficulty of care This includes the five “extraordinary levels” added by the 2013 legislature

39. 5. Simpler Uniform Benefits for Age 6 and Older Children assessed as “Basic Only” (Level B) get a basic monthly payment based on their age We expect this to be about 15% of children (excluding the “at-risk” Level A children).

40. 6. Simpler 17 Benefit Levels Most children get basic plus a supplemental difficulty of care payment. Based on the uniform assessment, one of 10 standard levels plus up to five “extraordinary levels”. Northstar Care Monthly Supplemental DOC Levels Extraordinary Levels

41. 5. Simpler Uniform Benefits for Age 6 and Older Adding them together yields the total monthly payment. Here are some examples for 6-12 year olds. $670 Basic Level D $200 Level J $800 Supplemental Difficulty of Care Level Q $1500 Extraordinary Supplemental Difficulty of Care $670 Basic $670$870$1470$2170

42. 5. Simpler Uniform Benefits for Age 6 and Older Here are the same examples, but for children 13 and older, who have a higher Basic payment but the same additional Supplemental Difficulty of Care. $790 Basic Level D $200 Level J $800 Supplemental Difficulty of Care Level Q $1500 Extraordinary Supplemental Difficulty of Care $790$990$1590$2390 $790 Basic

43. 6. Simpler 17 Benefit Levels The “extraordinary levels" were added by the 2013 Legislature. These require state approval. They are for children with extraordinary needs who require intense supervision where a gap cannot be met by another program, such as an MA waiver. We’re working on the details right now.

44. 5. Simpler Uniform Benefits for Age 6 and Older Northstar Care for Children provides for uniform benefits when a child moves among the components when the child is six or older. Minnesota has not had as much difficulty moving children five and younger to permanent families. One of the compromises in Northstar Care was to not have uniform rates for children moving to permanency who are five or younger.

45. 5. Simpler Uniform Benefits for Age 6 and Older Northstar Care monthly benefits for children five and younger who move to permanency are half the foster care rates. $565 Basic Level Q $1500 Extraordinary Supplemental Difficulty of Care $283 Basic $565$2065$283$1033 $565 Basic Level Q $750 Extraordinary Supplemental Difficulty of Care $283 Basic

46. 5. Simpler Uniform Benefits for Age 6 and Older $565 Basic Level Q $1500 Extraordinary Supplemental Difficulty of Care $283 Basic $565$2065$283$1033 $565 Basic Level Q $750 Extraordinary Supplemental Difficulty of Care $283 Basic Northstar Care monthly benefits for children five and younger who move to permanency are half the foster care rates. That’s not ideal, but still higher than current rates for RCA and AA.

47. 6. Simpler 17 Benefit Levels Benefits for children in Northstar Care are adjusted annually based on USDA figures, the same way that foster care rates currently are.

48. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

49. 7. Minnesota’s Uniform Assessment We call the tool the MAPCY – the M innesota A ssessment of P arenting for C hildren and Y outh. Having a single uniform assessment process is central to the success of Northstar Care for Children. DHS has been working for nearly five years on the assessment tool with counties, tribes, caregivers, youth, and other experts.

50. 7. Minnesota’s Uniform Assessment DHS has conducted two tests of the MAPCY. We plan a full field test this fall, and are actively looking for counties and tribes to volunteer. Upon validation, the MAPCY will be programmed into SSIS.

51. 7. Minnesota’s Uniform Assessment The MAPCY is comprehensive and supports good practice. All three current processes are primarily focused on how “ sick ” the young person is. We want to shift the focus to how the caregiver can meet their needs. Some of those needs are handled by the caregiver, but some by others.

52. A.Placement Experience B.Dynamics in the Caregiver’s Home C.Supervision, Guidance, and Structure D.Mental Health, Physical Health, & Development E.Preserving Connections F.Developing Identity G.Education H.Child Care (ages 0-12) 7. Minnesota’s Uniform Assessment

53. What are the child’s needs? What parenting is the caregiver(s) doing to meet those needs? Those are the questions addressed by the MAPCY, and the rater selects from multiple choice answers. Two things to rate: 7. Minnesota’s Uniform Assessment

54. The rater doesn’t pick the benefit level. It’s multiple choice or yes/no. Rates the child on a four-level scale and selects parenting indicators. The computer does the rest. Less subjective: 7. Minnesota’s Uniform Assessment

55. The computer adds up all the domains, including any special points, to get the final score. The final score is then translated into a benefit (monthly payment) level. 7. Minnesota’s Uniform Assessment

56. Northst r Care for Children Topics Covered 1.Background 2.Northstar Care to be Built into SSIS 3.Retains Current Programs for Current Children 4.Transitions & Balancing 5.Administration 6.Simpler 17 Benefit Levels 7.Minnesota’s Uniform Assessment 8.Fiscal Partnership of State, Counties & Tribes

57. Over-all, Northstar Care for Children costs more than the current set of programs. The federal and state governments pick up the extra costs. There are lots of provisions to make that happen.

58. 8. Fiscal Partnership of State, Counties & Tribes Northstar Care includes additional state appropriations plus additional federal Title IV-E funds. But it is designed to be basically fiscally neutral for counties and tribes in the American Indian Child Welfare Initiative. The Feds pay more The State pays more The County pays about the same The Tribe pays about the same

59. 8. Fiscal Partnership of State, Counties & Tribes The non-federal share for children in all three components is shared by the state and counties and child welfare initiative tribes. This is in contrast to the existing arrangement where counties and tribes pay for foster care and the state pays for Relative Custody Assistance and Adoption Assistance. Current arrangements with tribes include other provisions which are expected to continue under Northstar Care.

60. 8. Fiscal Partnership of State, Counties & Tribes The state share and local share will be calculated based on historical data (some still in the future) of what the various parties have paid in calendar years 2011, 2012, 2013, and 2014. These shares will include the legacy Pre-Northstar Care programs, to avoid all problems with programs phasing in or phasing out. 2011201220132014

61. 8. Fiscal Partnership of State, Counties & Tribes A series of calculations are employed to avoid cost shifting from the state to counties and tribes. Additional calculations are employed to avoid cost shifting among counties and tribes.

62. 8. Fiscal Partnership of State, Counties & Tribes To avoid cost shifting from the state to counties and tribes, these shares are further adjusted based on trends during those years (we expect the state share to continue to grow and the local share to continue to decline). To avoid cost shifting among counties and tribes, the local share is adjusted based on historic relative shares. To avoid these relative shares becoming stagnant relics of past behavior, DHS will adjust these shares over time based on relative changes in utilization – use of Foster Care, Guardianship Assistance, and Adoption Assistance (counties and tribes that use more than they did in the past should go up, those that use less should go down).

63. 8. Fiscal Partnership of State, Counties & Tribes The commissioner is to ensure that these adjustments are not unduly influenced by: – One-time events – Anomalies – Small changes that appear large compared to a narrow historic base (such as one family moving into or out of a smaller county) – the results of the transfer of responsibilities to tribal social service agencies under the American Indian Child Welfare Initiative.

64. 8. Fiscal Partnership of State, Counties & Tribes DHS Financial Operations Division will likely perform an over-all reconciliation process. How much each agency spent, how much DHS spent, net off any federal revenue, and how much each one’s share was. This will yield an amount that DHS owes the agency or vice versa.

65. 8. Fiscal Partnership of State, Counties & Tribes A common question is how this can work. People note that counties and tribes currently pay for foster care, which usually lasts months or a year or two. The state currently pays for RCA and AA, which last for many years. How can this work out to counties and tribes paying about the same amount?

66. 8. Fiscal Partnership of State, Counties & Tribes Think of counties and tribes paying for groceries while the state pays the mortgage. Groceries last for just a week or two, while the mortgage lasts for 30 years. But you have to buy more groceries every week.

67. 8. Fiscal Partnership of State, Counties & Tribes On average, how much do you pay for groceries each month (or foster care each quarter)? On average, how much does the state pay for the mortgage each month (or RCA/AA each quarter?) The key is that you can amortize both of them. Even though they start out with different time horizons, you can break all the costs down into an average cost for the same length of time.

68. 8. Fiscal Partnership of State, Counties & Tribes You can do ratios and work it all out. Local Share Local Share New Fed & State

69. 6. Fiscal Partnership of State, Counties & Tribes All of this boils down to a county or tribe paying approximately the same for Northstar Care as they would have paid for children in foster care under the existing programs. And that’s not counting any other savings they may accrue by not having them in foster care.

70. Northst r Care for Children If you aren’t able to get your questions answered now, please send them in. Northstar Care for Children FAQ will be posted on the DHS web site. Send questions to: northstar.care@state.mn.us

71. Northst r Care for Children