KPRC



Build New, High-Quality, Appropriate CapacityThe agency needs to shift the conversation from simply "building capacity" to "building high-quality, appropriate capacity". That is, the Department of Family and Protective Services (DFPS) needs to make sure that the agency is expanding capacity that will actually meet the needs of the children in our care, and DFPS needs to define what constitutes high quality so that providers can build the capacity that is needed for our children. Due to the high needs nature of many of these children, DFPS must provide care that will adequately meet these needs.Current Efforts:America's Kids BelongDFPS and the Office of the Governor are currently engaging in conversations with an organization called "America's Kids Belong" to develop and execute a recruitment campaign to address the current placement needs of children in foster care. America’s Kids Belong is a 501(c)3 organization that mobilizes government,?faith-based, business and creative leaders around the goal of permanency?and belonging for every child. Combining grassroots and “grasstops”?methods, America’s Kids Belong runs innovative campaigns in states to?ensure that every child is in a loving home by recruiting more foster and?adoptive families, as well as engaging wrap-around support for at-risk, foster?and adoptive families along the way.? America's Kids Belong uses the Stanford Collective Impact Model which requires the commitment of a group of important actors from different sectors to a common agenda for solving a specific social problem. They bring together leadership from the government, business, nonprofit, community provider, the faith community and the Arts to address the issue of foster care and adoption capacity. Expansion of Specialized Population Placements, including Domestic Minor Sex Trafficking VictimsUnfortunately, Texas has seen a growing population of children who have been sex-trafficked. This special population requires unique treatment and supervision to ensure their safety and healing. DFPS is proud to partner with organizations that want to focus on treatment within a specialized population. For example, The Refuge is breaking ground on a 50 acre ranch outside of Austin to provide girls who have been rescued from domestic minor sex trafficking with comprehensive treatment services. Strengthen Relationships with Stakeholders and PartnersDFPS could not accomplish its mission without the constant support of providers, stakeholders, legislators, faith leaders, and others around the state. The agency will work to strengthen the existing relationships we have with our partners and build new relationships. But more importantly, the agency will determine ways that these external partners can help immediately. DFPS will encourage collaboration, reciprocation, volunteering, anything that the agency believes will help the children in our care.Partnership with Casey Family ProgramsThe proposed federal legislation referred to as Family First is targeted towards reducing states' reliance on congregate care. Although the future of the legislation is uncertain, Texas is partnering with Casey Family Programs to develop an initiative to improve placement for children in care. The purpose of the initiative is to improve and build quality care for children in foster care. This project is in the planning phase, and it will likely be a multi-year effort.Hiring a Capacity Building SpecialistDFPS now has a Capacity Building Specialist, who works with our providers around the state to determine what barriers exist for capacity and expansion and to negotiate additional capacity. She is also following up on previous outreach to providers without current contracts with DFPS.Lower the Number of Children Sleeping in Offices by Securing Temporary Emergency Housing in their CommunityCPS has recently been successful in partnering with several faith-based organizations around the state to build this type of temporary placement for children in crisis. These organizations are allowing us to use their housing in order to keep our kids and staff safe, while looking for an appropriate placement. Targeted Recruitment of Out-of-State Providers to TexasCPS is communicating with out-of-state residential treatment providers in New Mexico, Oklahoma and Arkansas.? CPS staff has met with leadership for Peak Behavioral Health in Santa Teresa, NM just outside of El Paso and Desert Hills Residential Treatment Center (RTC), Albuquerque, NM.? Both of these organizations have expressed an interest in contracting with Texas.? DFPS worked with HHSC to modify the residential PEN language to allow out of state providers in bordering states to contract.? South Plains Behavioral Health in Norman, OK has responded to the PEN and DFPS is in the process of entering into a contract with this facility.? Sequel Youth and Family Services have also expressed an interest in opening an RTC in Dallas, Houston or the Austin area.? Their hope is to build a 96 bed facility.? Future Efforts:Expansion of Foster Care RedesignFoster Care Redesign provides the ability for the state, through a contract with a Single Source Continuum Contractor, or SSCC, to manage and build capacity in a geographic area that best meets the needs of children from that area.Foster Care Redesign is uniquely positioned to support DFPS’s efforts to build new, high-quality, appropriate capacity through its ability to develop innovative solutions to system challenges, engage local communities in supporting the needs of children in foster care, and clearly tracking outcomes achieved for children in care. With the structure of Redesign allowing for one SSCC to oversee the needs of an entire system within a defined geographic area, a comprehensive, well-organized approach to system improvement can be delivered. Many of the current efforts listed above, can be effectively supported and implemented under Foster Care Redesign through the ability of the SSCC to coordinate these efforts and services for both children and families. Early results of Redesign in Region 3b show that rural capacity has been improved, stakeholders and partners are engaged in supporting the mission, the quality of data has improved, and most contract outcomes are showing improvement over the legacy system. Redesign also gives DFPS a better method for spending state funds in a way that produces results. Redesign contracts state very specific outcomes for which the contractor is accountable, and this focus on results allows DFPS to contract with providers who can demonstrate what outcomes are being achieved, and who can clearly explain how funding is used. This is a vast improvement over the legacy state system where DFPS’s ability to influence specific outcomes is more limited.DFPS is entering into the third year of the contract with ACH in Region 3b.? The RFP for Region 2 closed on November 2, 2016 and the Department and HHSC are evaluating the proposals received. DFPS anticipates awarding a contract in Region 2 in Spring 2017.? The LAR includes a request to expand into eight additional catchment areas and DFPS will soon release an updated Implementation Plan which includes the planned schedule for roll-out of the additional areas during the 2018-2019 biennium, subject to Legislative approval and funding. Expansion of Redesign will support many of the existing efforts to improve capacity through a regional approach that allows local decision-making and community engagement. The agency anticipates that children will experience better outcomes and move more quickly toward safe permanency through the expansion of Foster Care Redesign. Through performance-based incentives, providers are encouraged to help a child improve and insure that they get appropriate services. This allows for leverage for the state, through accountability, and allows DFPS to identify and reward the best providers.Faith Leader Summit OutcomesDFPS hosted a Faith Leader Summit on November 2, 2016, and has seen some great momentum come out of this event. In fact, DFPS is partnering with the community on an additional Faith Leader Summit on June 7 in Waxahachie in conjunction with the Southern Assemblies of God University. This Faith Summit provides an excellent opportunity to educate our faith leaders from around the state on some of the ways that they and their congregations can get involved. As a result of the Faith Leader Summit in November, DFPS has been in communication with a number of existing and proposed providers who want to expand their ability to serve the children in the care of the state. DFPS is excited about a number of opportunities, including a new 1,000 acre ranch resort in Waco that would be repurposed to provide summer camps for foster youth, temporary respite or shelter, as well as serve specialized populations, such as those affected by domestic minor sex trafficking.Private Foundation InvolvementDFPS has also been approached by a number of private foundations who are not interested in running or building campuses or facilities of their own, but would like to invest capitol into organizations that would be qualified to build capacity. DFPS is working with these private organizations to connect them with providers that would be interested in expansion.Streamline Training and Regulations to Encourage More Foster FamiliesDFPS hears all too often from parents and concerned parties that the regulations and hoops that a potential foster parents must jump through in order to receive the proper training are a critical factor in why many choose not to foster or adopt or continue in this mission. It is our goal to ensure that qualified families of all backgrounds are not hindered in their wish to care for the children of our state because of unnecessary barriers.Current Efforts: More Transparency of Child Placing Agency Training Reporting RequirementsH.B. 781, 84th Legislature, Regular Session, 2015, requires DFPS to determine what training models each Child Placing Agency around the state utilizes and report this required training on the DFPS website. This information allows a potential foster family to decide what CPA may be best for them to work with. It is undeniable that the more informed a foster family is prior to taking a child into their home, the more likely they are to be a successful family. It is also our hope that by reporting these training requirements, our providers around the state will continue to move toward a more collaborative approach to training, which will ultimately provide cost savings. While safety and liability will always remain as concerns, eliminating unnecessary or duplicative barriers to training is tantamount to building quality capacity. If individuals are interested in caring for children and are qualified to do so, but are ultimately discouraged by overly burdensome regulations, then the agency must act.Technical Assistance Peer ProgramThe agency will establish a technical assistance peer program for contracted providers. This program will pair experienced and highly competent providers with peers that are either new to the system, and/or experiencing challenges in an effort to strengthen and improve the quality of care. Residential ContractsThe agency will analyze the current Residential Child Care Procurement and Contracting procedure to identify opportunities for coordination, efficiencies and streamlining processes and implement changes as identified. DFPS will establish a requirement in the residential contract for each child placing agency to develop at least one foster home that helps to fill a specific capacity gap in the community. Future Efforts:Updating PRIDE TrainingTexas is one of five states that worked to develop the PRIDE training for perspective foster parents that is used by DFPS and some CPAs. DFPS will update this training to include Trauma Informed Care in the foster parent training. Improving Support Services to Existing FamiliesIt is a priority of DFPS and our communities around the state to provide proper support services to families who have answered the call to care for children who have been abused or neglected. This is a major responsibility for a family, and the agency must do everything in its power to make sure that these families are properly trained, receive appropriate placements and continue to engage in wraparound services. By ensuring that a family has support from their community, DFPS can retain more quality foster families, thereby providing more stable placements for children and grow capacity through more tenured foster families.Current Efforts: Temporary Respite ServicesThe agency is proud to partner with First Lady Cecilia Abbott in rolling out a plan that will engage our faith communities by requesting their assistance in providing temporary respite services. These individuals would be trained by a child placing agency and would then be available to provide what would equate to "babysitting" services for families with foster youth. These volunteers must be background checked, checked in the central registry and must receive some basic training. Allowing a family to have a date night or a Saturday to run errands will only provide much needed relief and more stability for foster families. Through providing these services, we believe that we will not only be able to better maintain our current foster family population but also provide more support for new foster families.Travis County CollaborativeThe Travis County Collaborative for Children is an initiative that brings together child welfare professionals, volunteers, and community leaders to help children in foster care achieve permanency more quickly. The Collaborative has been truly innovative in their approach to respite and support of their CPAs and foster families. They have brought a group of CPAs to the table and asked them to be flexible and reciprocal in their training requirements. This allows for any individual who is trained by any CPA in the collaborative to provide respite can provide these services for any of the CPAs in the collaborative. First Lady Cecilia Abbott and DFPS sent a letter in January to providers statewide, imploring them to collaborate with other CPAs on innovative ways that they can better serve the families in their area.Case Management/Integrated Care Coordination (ICC)The Governor's Office and DFPS are developing a plan to establish case coordination and case management to provide proper services to families and children. DFPS will contract with an eligible organization to provide Integrated Care Coordination (ICC). Coordination will occur among all medical and behavioral health service providers, school personnel, foster parent(s), biological family and any other significant individuals or systems in the child’s life that will result in a better experience for that child. The program will serve high-needs foster children in specific areas of the state.As part of the contract, the coordinator will also recruit foster homes with Medicaid-supported wrap-around services or proven in-home interventions to achieve the child's goals for a permanent home.Use Available Medical Information for the Child to Ensure Proper Placements and Treatment ServicesBeginning on September 1, 2016, caseworkers began using the Child and Adolescent Needs and Strengths Assessment (CANS) to help develop the Child Plan of Service. Within 90 days of a child coming into care, a child must have a Texas Health Steps Assessment as well. With the help of the CANS and the Texas Health Steps assessment, we have a better picture of our children in care and what services they need. A family that is offered true wraparound services from a provider is able to care for a higher needs child, because of the additional support. Identifying a child's true needs and ensuring that they are receiving appropriate treatment while in a placement can lead to success. By utilizing all of our available screening tools and information on the history of a child, we can best place a child and allow for them to receive proper care.Future Efforts:Faith Based Provider Involvement through Open Table and Other InitiativesThe faith community is a critical partner in our efforts to serve this fragile foster youth population. Open Table allows congregants to care for and mentor youth who have aged out of the foster care system. Temporary respite would allow congregants to support foster families in their church and community. Encouraging your small groups or neighborhood groups to "adopt" a foster family, provide meals, lawn care, even house cleaning services can make a huge impact on these families. A letter from Texas First Lady Cecilia Abbott and myself was sent to faith leaders around the state on January 12th, encouraging pastors to identify families within their congregations and communities that could use additional support. DFPS will continue to work with many organizations to help establish licenses and contracts to help address capacity. Most importantly, DFPS will make sure that we can directly connect our Faith-Based Organizations with licensed providers in their area, so that congregants can immediately begin getting involved.CarePortal ExpansionThe CarePortal has been a pivotal first step for many individuals and families to become involved with child welfare. The CarePortal provides the opportunity for churches, faith houses and congregants from around the state to donate necessary items (like car seats, pack and plays, strollers, diapers, etc.) for families and children in our care. This program allows a community to wrap around a family and support their community through donations. The CarePortal is currently active in 23 counties. Expansion of CarePortal is in the works and our Faith Specialists around the state are continuing to recruit more organizations to take part in this program. Adjust Licensing TypesDue to the diverse population that DFPS serves, providers must be afforded flexibility in the way facilities are licensed. As we work for find appropriate placements for all the children in our care, the most effective way to do that is to ensure that qualified providers can build capacity and that DFPS can license those providers properly. For example, with pending federal legislation, as well as ongoing litigation, DFPS is working to move away from congregate care and move toward placing children in more home-like settings. Not only do we believe this will best serve our children, but we believe that there will be cost avoidance through the new licensing types, as DFPS will not have to enter into as many expensive, child-specific contracts with this new proposal.Current Efforts: Proposed License TypesIn response to feedback from legislators, stakeholders, and providers, DFPS is proposing the creation of new license types for residential child-care providers that will allow for children to be served in the least restrictive environment while receiving the services they need while in care. Currently, DFPS has three existing license types, which are: Child-Placing Agency - a person, including an organization, other than the natural parents or guardians of a child who plans for the placement or places a child in a child-care facility, agency foster home, agency foster group home, or adoptive home.General Residential Operation - a child-care facility that provides care for more than 12 children for 24 hours day, including facilities known as children's homes, halfway houses, residential treatment centers, emergency shelters, and therapeutic camps.Independent Foster Home - a child-care facility that provides care for either no more than six children for 24 hours day (family home) or no more than seven to 12 children for 24 hours a day (group home)The proposed new license types, which encompass currently license, types are: Residential Child-Care Facility - This license type would allow one license to cover multiple services such as a CPA and GRO or GRO with multiple types. The license would not be associated with one location. It would allow children to move between a continuum of placements within the same license without a disruption in the support services they receive. For instance, under this license type, a child may be able to move from a Residential Treatment Center to a foster home and be able to have the same case manager.Child-Placing Agency - This would follow our current CPA license type, however it would eliminate foster group homes. It would also limit foster family homes to a capacity of six children, but would allow a capacity of eight children with a waiver.Specialized Child-Care Operation - This would replace the independent foster home license types. The homes would be limited to a capacity of six children, but would allow a capacity of eight with a waiver. It would not have to be a primary residence of the caregiver. It would require a houseparent(s) with a Director to oversee the operation. The idea is for this license type to allow for operations that are not compatible with other license types but that want to serve a specialized population of children, such as victims of human trafficking.Foster Family Operation - This is a current GRO license type. The new license would allow multiple foster family homes with a houseparent(s) in each foster family home. An administrator would oversee all of the homes. These homes would be in or near the same location. Each home would be limited to a capacity of six children, but would allow a capacity of up to eight with a waiver.General Residential Operation - This would follow the current GRO license type. Capacity would be changed to serve nine or more children, instead of 13 children under current standards. This would include the RTCs, group care, and emergency shelters.To facilitate licensure changes, statutory changes and minimum standards changes will be needed. Updating changing licensing types also creates an opportunity to streamline the rules that apply to different license types, making the rules easier for providers to understand without sacrificing safety.Future Efforts:Long-term Monitoring of LicensureAs the needs of the Texas children's population evolve, DFPS must do the same. It is important for CPS and Child Care Licensing to communicate about the needs of children so both divisions can be responsive and evolve with changes in practice and industry. We will continue to be critical of our own licensing practices to ensure that we can properly serve the children of Texas. Increasing Foster Care RatesDFPS pays a daily rate for the care of children who have been removed from their homes and placed in foster homes or residential treatment facilities as a result of abuse or neglect allegations. The current rate structure is based on level of care (basic, moderate, specialized, and intense) and the rates do not fully fund the cost of care. Providers who do not accept our children often cite the rate as an obstacle. DFPS included a rate increase in the fiscal year 2018-19 Legislative Appropriations Request.In order to stabilize and improve the system, DFPS and HHSC are working together on a comprehensive approach to identify appropriate rates that will maintain our current capacity and encourage providers the opportunity to expand capacity. The proposed foster care rate structure will include: Full funding for the actual cost of care;The Foster Care Redesign Risk Corridor for Blended Rate (ceiling/floor for flexibility in varying case mix);Treatment Foster Family program to prevent children from escalating and entering psychiatric hospitalization;Integrated Case Management for the highest needs children in foster care; andKinship Care Payments and Expansion;Currently, these caretakers receive a $1,000 one-time integration payment for the oldest child in a sibling group and $495 for each additional sibling and a yearly stipend of $500 per child. As many of these caretakers are older adults or operate on a fixed-income, a yearly stipend of $500 is simply not enough to provide for the children in their care. If a child's relative is unable to afford to care for the child with the current payments available, that child is then diverted into foster care. DFPS supports both the implementation of a payment structure similar to monthly payments made to foster parents for ALL kinship caregivers, in addition to flexible funds to be used to become a verified foster home. Monthly kinship payments would increase the number of relative placements and reduce the number of foster care placements, which would reduce the amount of foster care payments. ................
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