1. Colorado Children’s Caucus Out of Home Care: A Status Update
Brian Brant (Vice President Child and Family
Service Lutheran Family Services) representing Fostering Colorado
Dr. Skip Barber from the Colorado Association of Family and Children’s Agencies (CAFCA)

2. Reimbursement for Out-of-Home Care
Critically low reimbursement rates jeopardizing the wellbeing of Colorado foster care and juvenile justice youth
Programs unable to compete for staff and unable to retain employees
No rates setting methodology
Rates of reimbursement arbitrarily set
CDHS eliminated all rate setting methodologies in rule over a dozen years ago

3. Colorado Department of Human Service Placement History
Total OOH FC Group/CPA Kinship Kinship FC RTC/RCCF
5433* ** ***
* a decline of 23.23% **a decline of 44.65% ***a decline of 64.54%

4. Client Acuity and Cost are higher in Out-of- Home Care today
As increasing numbers of clients are served in lower levels of care (A GREAT THING!!!) the client population requiring the most intensive services (and hence the most costly to serve) are the clients today being served in out-of-home care.
These youth require:
greater supervision,
more treatment services,
greater psychiatric consultation/oversight and
more medical services.

5. Client Acuity and Cost are higher in Out- of-Home Care today
While youth are not sicker today, the youth in out-of-home care have a higher AGGREGATE acuity rate.
At the same time the system has requested shorter lengths of stays, more school stability, an emphasis on keeping siblings together and greater agency accountability which have driven agency’s indirect costs. The result is that, even without considering inflation, the cost of doing out-of-home care today is much greater than it was 12 years ago.

6. History of Rate Adjustment for Child Welfare Services
Year Adjustment CPI Lost to inflation
SFY No adjustment 1.40% 1.40%
SFY No adjustment 2.10% 2.10%
SFY % added 2.70% 0.70%
SFY % added 4.10% 0.85%
SFY % added 3.30% 1.80%
SFY % added 2.30% 0.80%
SFY No adjustment 5.80% 5.80%
SFY % reduction % 2.00%
SFY No adjustment % %
SFY No adjustment 3.60% 3.60%
SFY % added 1.70% %
SFY % added 1.50% %
SFY % added 3.00% %
13 Year History
11.45% added % %

7. Foster Care Adjustments
No community provider rate increases were regularly passed along to CPAs (Child Placement Agencies) until the last three years
Whereas the legislature has passed community provider increases of 18.95% since 2004, CPAs only received 6.2%

8. The System is Dramatically Underfunding Service Providers
SB Mandated the State, Counties and Providers come up with a rate setting methodology
The State of Colorado is out of compliance with federal law which requires a methodology
SB workgroup failed to develop a methodology
The JBC is now considering a new bill to address this deficiency

9. Current Levels of Reimbursement
County negotiation of rates has resulted in CPAs base anchor rates being under funded by 6.52 million dollars (SFY ).
An investment in foster care is an investment in permanency for children where parental rights have been terminated (nationally 52% of children adopted from foster care are adopted by their foster parent).
Current funding for residential treatment providers is less than 78% of audited costs
This figure gets progressively worse each year
In spite of salaries in the private sector being half what public employees receive

10. CPA Closures
A decade ago there were 63 CPA and today there are only 38
Since Jan. 1st of this year 3 CPAs have closed
Frontier Family Services
Innovations for Children
A Brighter Day

11. Residential Treatment Facilities Closed in last ten years
Adolescent and Family Institute (20 beds)
Cedar Springs Hospital Residential Unit (25 beds)
Children’s Ark (Brookhurst) (60 beds)
Colorado Boy’s Ranch (55 beds)
Court House/Beacon Center (40 beds)
Denver Family Crisis Center (50 beds)
Excelsior (190 beds)
Gemini/Family Tree (20 beds)
Griffith Centers in Rifle, Grand Junction and Larkspur (100 beds)
Flatirons Behavioral/Centennial (20 beds)
Hands Up Homes (18 beds)
Jefferson Hills Lakewood (closed but later reopened as another type of service) (60 beds)
KidzArk (50 beds)
Lost and Found (30 beds)
Mountain Crest (20 beds)
Mountain Star (20 beds)
Namaqua (25 beds)
North Range Behavioral Health- Kathleen Painter Littler Center (40 beds)
Reflections for Youth (40 beds)
Turning Point closed several of its locations (30 beds)
Youth Emancipation Services (15 beds)
Youthtrack (40 beds)

12. Those who care for Colorado’s children in care need your help
Watch for the bill coming from the JBC regarding provider rates
When allocating funds for state salary increases and expansions of program in child welfare and/or youth corrections make sure that additional funding is recommended for private providers