Interview with Governor Deal
Daily Update - December 19, 2013
- Community Conversation on Foster Care Reform
Community Conversation on
Foster Care Reform Notes – 12/17/13
This Forum was sponsored by the Partnership to
Protect Children (the group that is primarily responsible for the
Lieutenant Governor’s Work Group that Sen. Millar chairs)
Rick Jackson, President of Jackson Healthcare
and Philanthropist opened the meeting.
- He has given to many private providers in
Georgia in the past and present.
- He is on the Board at FaithBridge and
supports incorporating church congregations in assisting with
recruiting and supporting foster care. He believes this model
could be more scaleable than other service models and provide a
better return on investment.
- He has a relationship with Jeb Bush who
supports the One Church One Child Program. He stated that Jeb
Bush called Gov. Deal and asked him to talk to Rick about the
work that was accomplished in Florida on reforming their child
welfare system.
- He reported that the Florida system reform
was born out of many failures/concerns of their state child
welfare department (what we call DFCS) and was began by a bill
introduced by two legislators (and has been modified several
times since its inception). The reform applies business
disciplines to the non-profit sector. He listed the
pros/successes of the Florida ‘privatization’ efforts as:
non-profits not struggling as much as in Georgia, has created a
lot of “volunteerism” (in-kind giving), uses flexible spending
which is a key to Florida’s success, has produced better results
and has had widespread support by politicians and other
stakeholders.
- Recently the McLaughlin Group conducted a
survey in Georgia that asked citizens questions about if they
would support foster care reform. Mr. Jackson reported that the
results indicated the “highest” supported bi-partisan issue ever
rated, which is important for an election year. He said the
polling results will be posted on the Partnership to Protect
Children’s website.
- Mr. Jackson stated that he wants to work
with others to create a “specific plan” that will make a
difference. Though the plan is not yet decided he wants it to
include an execution plan. He concluded his remarks by stating
that “Government was never meant to be a parent” and that the
audience should ask is our current system the best for children
or not.
Next on the program Michael Cusick, former
President of the National Organization of State Associations (NOSAC)
and Tarren Bragdon, CEO of the Foundation for Government
Accountability gave an overview of the Florida Public-Private
Partnership.
- The reform began in Sarasota. Now there
are 18 regions. The state agency saw the reform as a “hostile
take over”.
- The state continues to provide the
investigative services, except in five regions where the
sheriff’s department oversees investigations.
- Casework, Foster Care, Diversion Services
and Adoptions were privatized statewide.
- Each region has a non-profit lead
organization; several of these were created as collabortives/partnerships
of various smaller organizations. Each region receives a lump
sum of money and it is the responsibility of the lead agency to
see to it that all the children in need of services in their
region receive the appropriate services. The lead agency
contracts with providers in their regions for a full array of
services needed to meet the set twelve outcome goals
(well-being, safety and permanency related).
- Some of the results for the state have
included shortening by half the amount of time children spend in
out of home care (went from 36 months to 24 months) and greatly
increasing adoption rates.
- Keys to success – Flexibility,
Transparency, Accountability and some Investment.
Next on the agenda via conference call we
interacted with George Sheldon, the former Acting Assistant
Secretary for the Administration for Children and Families.
Secretary Sheldon made several points regarding the IV-E waiver
process.
- He believes strongly that for the states
that have received the waiver that much innovation has been
accomplished. He indicated that last year eight more states
were accepted and that currently there are 14 states interested
but only 10 more waivers are set to be granted.
- He said the IV-E waiver was “key” to
Florida’s reform success, emphasizing it involved the
communities and non-profits at a much higher level than
previously accomplished. The flexibility it brings is to tear
down many of the funding silos and allows for MH, BH, SA
services to be paid for by these traditionally child welfare
(previously exclusive) funds. He states that flexibility allows
for the child and the families to get the services they need and
not just the services that a traditional IV-E funding stream
will pay for.
- He urged Georgia to consider entering into
negotiations for this waiver stating “clearly it seems to be in
Georgia’s best interest to begin the negotiation process”. He
said Georgia can always decide it is not in our best interest
and back out. He reported that the negotiation process with
state leaders and the Children’s Bureau is critical as various
“triggers” can be put in place to ensure funding increases or
does not decrease if certain sought after trends/outcomes
occur. In this negotiation process Georgia would need to
determine the “base year” to set the funding levels at.
- Other points he made included the
importance of connecting the educational department with child
welfare. He also urged that children be brought to the tables
and listened to as they all want ‘normalcy’ and have great
suggestions/feedback on how we can help them to achieve it.
Next there were directors of Florida providers
(including Chris Card of Lutheran Family Services and Irene Rickus
of The Children’s Home) that spoke about what the Florida
Public-Private Partnership meant for providers, children and
families.
·
The state trade association played some key roles in
determining contracting protocols and other policy determinations on
the behalf of the provider community.
·
All of the lead agencies are non-profits.
·
Many Mental Health, Substance Abuse and Behavior
Health provider took advantage of the funding shift and formed
creative partnerships within the regions – “created systems of care
that made sense.”
·
Contracts with providers are ‘fixed rate’ determined
by cost reimbursement however there is access to a risk pool (safety
valve) in situations of some unexpected phenomenon (natural disaster
or sudden influx of a population in need of services). The Lead
agency sets the rates. Lead Agencies have to be able to manage
multiple contracts.
·
The 18 lead agencies have both flexibility and some
uniformity as to how they can spend the funds and contract with
providers. All contracts are competitively bid every five years
(most lead agencies that were awarded contracts were ‘in-state’
providers).
·
Capital funds are not included in the rate setting but
consideration is given to them in setting up the contracts and
payment agreements.
·
Equipment (IT, phone…) is owned by the state or lead
agencies.
·
Sunshine Health is the statewide CMO that contracts
with the lead agencies.
·
Lead Agencies can only claim 4% for administrative
costs (resulted in some ‘creative’ bookkeeping). However up to 8%
of funds can go unspent in a year, these unspent funds go to the
lead agency for reinvestment purposes.
·
The state (DFCS) case workers were given priority
hiring status by the providers.
·
They reported that foster parents seem to be much more
satisfied as recruitment and retention rates have soared.
·
They reported that currently the average case load
size for a case manager is around 25 with some spikes at times to
35.
The conversation seemed well received by
members of the audience. I shared that it would have been
preferable to have had this forum prior to the initiation of the
Lieutenant Governor’s work group. It will be critical that we
continue to actively participate in this foster care reform
conversation in the coming months. - submitted by Ron Scroggy
