1. Foster Care Redesign: Improving Child/Youth Placement Outcomes
Stakeholder Forum June 14, 2010

2. Challenges Facing the Texas Child Welfare System
Imbalance in geographic distribution of services and providers
Insufficient number of residential providers that offer a full continuum of services

3. Current Equation (Child’s Needs) + (Lack of Community Resources) =
Placement outside of home community
Increased number of changes in placement
Separation from sibling(s) and family
Lack of educational continuity
Fractured social support system

4. Goal of Redesign
"The goal of the (foster care) redesign is to improve outcomes for children and families by creating sustainable placement resources in communities that will meet the service needs of children and youth in foster care, using the least restrictive placement settings."

5. Redesigning the Equation
(Child’s Needs) + (Adequate Community Resources) =
Placement in home community
Decreased number of changes in placement
Placement with sibling(s) in close proximity to family
Educational continuity
Strong social support system

6. Project Objectives
Determine where and what kind of services are needed
Determine how to contract for quality services, including recommended outcomes, performance measures and procurement processes
Determine how to pay for those services (fiscal system/payment methodologies that align incentives with process and quality objectives)

7. Project Parameters
Case management will remain the role of DFPS, however, model can include expanding role of the private sector’s work with families
System design will neither preclude nor require additional funding

8. Decision-Making Approach
Analyze/consider data
Identify and define problems
Generate options and assess feasibility of options
Develop models that ‘test’ hypotheses and their corresponding policy, programmatic, practice and fiscal manifestations
Engage stakeholders in reviewing/refining the analysis
Final recommendations and a plan for implementing new foster care system due by December 31, 2010

9. Technical and Planning Expertise
DFPS has contracted with two entities who are working
collaboratively to develop the redesign proposal:
PDF Group, LLC:
- Engaging stakeholders
- Managing, planning and developing the proposal, including recommendations for a systemic, effective approach to remodeling the current foster care system
Chapin Hall, University of Chicago:
- Working with American Humane
- Facilitating and coordinating fact-finding research
- Obtaining stakeholder input and support
- Analyzing data and conducting simulation modeling

10. It’s A Winning Scenario!
Goal – Children spend less time in care.
How – Provider establishes network of foster homes in counties where demand exceeds supply
Result – Proximity equals support and minimal escalation of behavioral issues
Impact – Reduced placement disruptions; children achieve permanency more quickly
Fiscal – Lower levels of need; less time in care resulting in a reduction in revenue for provider (improved outcomes create disincentive for provider)
Leverage – (Through redesign) Provider is able to reinvest a % of the revenue the state would have otherwise paid for child to remain in care at higher level of need.

11. Stakeholders Children and families Judiciary Providers
Foster care network/association
Child advocates
DFPS field staff
Others which include, but are not limited to:
- HHSC, Medicaid, and other enterprise agencies
- Texas child welfare boards
- State and federal child welfare partners

12. Public Private Partnership (PPP)
Representative of key stakeholder groups
including:
Foster youth alumni
Providers
Child advocates
Judiciary
DFPS Advisory Council
DFPS executive leadership
Role in the redesign effort:
Provide guidance to the initiative
Serve as conduit of communication between constituents and peers
Propose recommendations to DFPS Commissioner

13. Communications Principles Fully engage stakeholders
- Provide opportunities for meaningful input
- Keep stakeholders fully informed of project status
Ensure understanding of Foster Care Redesign project objectives
Provide all information in an inclusive, transparent manner to ensure project integrity
Provide opportunities for the Department to understand and stay current on stakeholder interests and opinions

14. Communications - Project updates and notices - Project survey
Methods
Website
- Project updates and notices
- Project survey
- Mailbox
Alerts
In-person meetings
Briefings
Stakeholder forum

15. Communications Progress
Stakeholders around the state have been engaged in project
activities since January 11, 2010
Project website, mailbox and survey were launched in April 2010
- 622 public and private stakeholders responded
- 95 Texas counties represented in survey responses
Over 600 public and private stakeholders have been involved in
face-to-face meetings
- Regional provider meetings
- Focus groups
- Stakeholder initiated presentations and meetings
More planned stakeholder forums coming

16. External Stakeholder Input
Systemic (Primarily Provider Issues)
Eliminate Billing Service Level
More Predictability Regarding Number and Type of Placements
Want Better “Up-Front” Assessments
Want to Work With Families of Children They are Caring For

17. Internal Stakeholder Input
Concerns
Will Something Really Happen?
How Will Implementation Impact My Workload?
Fiscal and Political Implications
Ideas
Eliminate Billing Service Level
Eliminate “Leveling” Based on Behavior

18. Stakeholder Consensus
Quality Indicators
Continuum of Services
Services to Child; Not Child to Services
De-Link Authorized and Billing Service Levels

19. Child Outcomes
Improved child functioning as indicated by a decrease in intensity of service need while in care
More timely achievement of permanency
- Reunification
- Adoption
- Permanent and legal placement with relatives

20. 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

21. Stakeholder Question
Given the agency’s current budget constraints, what cost-neutral suggestions do you have to improve outcomes that support children being:
- Placed in their home communities?
- Appropriately served in the least restrictive environment that supports minimal moves?
- Connected to family and other individuals important to them?
- Placed with siblings?
- Offered services that respect their culture?

22. Questions or Additional Comments?
Information will also be posted to our website at